Journal of women's health最新文献

{"title":"Trends in Adverse Pregnancy Events Among Veterans: Racial Disparities and Care Coordination.","authors":"Lynette Hamlin","doi":"10.1089/jwh.2024.0690","DOIUrl":"10.1089/jwh.2024.0690","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"163"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Earlier Menarche and Fibroid Severity in Individuals Seeking Hysterectomy.","authors":"Eva Laura Siegel, Brianna VanNoy, Lauren C Houghton, Nadia Khati, Ayman Al-Hendy, Cherie Q Marfori, Ami R Zota","doi":"10.1089/jwh.2024.0403","DOIUrl":"10.1089/jwh.2024.0403","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Early menarche is associated with uterine fibroid risk, but the association between menarcheal timing and fibroid severity remains to be explored. Given the hormonal dependence of fibroids, earlier menarche may increase physical burden (e.g., number of fibroids) and/or symptoms (e.g., heavy menstrual bleeding), though the two are not always correlated. We hypothesized that individuals with earlier menarche are more likely to have severe fibroids. <b><i>Design:</i></b> We analyzed observational data using linear regression models to examine the association between earlier age at menarche and fibroid severity. <b><i>Subjects</i></b>: Individuals seeking hysterectomy (n = 110) for fibroid management at a hospital in Washington, D.C. from 2014 to 2021 as part of the Fibroids, Observational Research on Genes and the Environment study. <b><i>Exposure:</i></b> Participants recalled age at menarche during adulthood. We modeled age at menarche continuously, and we defined early menarche as menarche before 12 years in descriptive analyses. <b><i>Main Outcome Measures:</i></b> We evaluated three types of fibroid severity outcomes: self-reported symptoms using validated scales, clinical parameters (e.g., fibroid number and size), and age at hysterectomy. <b><i>Results:</i></b> In our predominantly Black sample, early menarche (i.e., <12 years) was reported by 25.5% (28/110) of participants. In adjusted linear models, earlier menarche was associated with increased symptom severity [<i>b</i> = -3.3 (95% CI: -6.05, -0.56)], younger age at hysterectomy [<i>b</i> = 0.8 (95% CI: 0.2, 1.41)], and uterine weight over 250 g (compared with ≤250 g) [<i>b</i> = -0.05 (95% CI: -0.11, -0.00)], but not with other measures of physical fibroid burden. <b><i>Conclusion:</i></b> Earlier menarche was associated with measures of fibroid severity. Prolonged exposure to estrogen <i>via</i> early menarche may accelerate the tumorigenesis process. Patient-reported symptoms as well as measures of physical burden should be considered when investigating the etiology of fibroid-related morbidity.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"235-241"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical Considerations for Using Continuous Glucose Monitoring in Patients with Gestational Diabetes Mellitus.","authors":"Kristin Castorino, Celeste Durnwald, Stacey Ehrenberg, Nicole Ehrhardt, Dianna Isaacs, Carol J Levy, Amy M Valent","doi":"10.1089/jwh.2023.0864","DOIUrl":"10.1089/jwh.2023.0864","url":null,"abstract":"<p><p>Gestational diabetes mellitus (GDM) is the most prevalent metabolic complication during pregnancy. GDM is associated with adverse perinatal, neonatal, and long-term health consequences. Studies have demonstrated that the use of continuous glucose monitoring (CGM) reduces the incidence of maternal and neonatal complications in pregnant women with type 1 diabetes. Although the use of CGM in GDM has not been well studied, a growing body of evidence is showing potential benefits in the GDM population. This article discusses the advantages and challenges of CGM and provides practical guidelines for using this technology in the GDM population.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"10-20"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attitudes and Experiences Regarding Communication About Maternal Vaccination: Qualitative Findings from Non-Hispanic Black Pregnant People.","authors":"Isabel Mendez, Veronica G Gilliard, Laura A Randall, Angela Robertson","doi":"10.1089/jwh.2024.0950","DOIUrl":"10.1089/jwh.2024.0950","url":null,"abstract":"<p><p>Comprehensive prenatal care incorporates recommended vaccines to help protect the mother, the pregnancy, and the infant from adverse health outcomes and severe illness from vaccine preventable diseases (VPDs). However, vaccinations during pregnancy remain underutilized, often influenced by concerns about vaccine safety and low perception of disease risk. Self-reported vaccine hesitancy among pregnant people in the United States has significantly increased in the last few years, and influenza and Tdap (tetanus, diphtheria, and pertussis) vaccination rates have declined. Furthermore, the number of vaccines routinely recommended during pregnancy has expanded. Communication strategies tailored to pregnant people may help build vaccine confidence among pregnant people and their health care providers. While characteristics and perceptions associated with hesitancy to vaccinate during pregnancy are documented in existing literature, more information is needed on promising communication practices preferred by subgroups of pregnant persons, particularly Black pregnant people who have higher rates of illness from VPDs and greater risk of pregnancy-related complications. This article summarizes literature on the current landscape of prenatal vaccination, discusses qualitative findings from focus groups with non-Hispanic Black pregnant people, and describes promising practices for communicating with this group about vaccination. Promising practices include specifying the benefits of vaccination for both the pregnant person and the infant, outlining potential risks, and emphasizing the overall importance of vaccination during pregnancy, while also acknowledging that many non-Hispanic Black pregnant people may have health concerns they perceive as superseding vaccination.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mothers with Breastfeeding Difficulty Report Increased Depressive Symptoms and Impaired Maternal-Infant Bonding on Social Media.","authors":"Elizabeth A Wright, Aashna Mehta, Anita L Nelson","doi":"10.1089/jwh.2024.0151","DOIUrl":"10.1089/jwh.2024.0151","url":null,"abstract":"<p><p><b><i>Background:</i></b> Protection against postpartum depression is a commonly cited maternal benefit of breastfeeding. However, recent studies have found that negative breastfeeding experiences may actually increase the risk of depressive symptoms. <b><i>Objective:</i></b> To investigate women's self-reported associations between breastfeeding experiences and depressive symptoms on a social media platform. <b><i>Study Design:</i></b> An electronic search was conducted on Reddit of all original user posts using keywords \"breastfeeding\" and \"depression\" from February 2013 to July 2021. Relevant posts and corresponding comments were manually extracted, evaluated for inclusion and exclusion criteria, and analyzed for thematic content. <b><i>Results:</i></b> In total, 584 entries was analyzed. Mothers most frequently described difficulty breastfeeding as the cause of new onset mental health symptoms (53%); however, mothers breastfeeding without difficulty were also susceptible (20%). Mothers also reported exacerbated preexisting mental health symptoms-predominantly related to difficulty breastfeeding (17%), but again, others experienced no difficulty (6%). Common words included among all entries were \"guilt\" (17%), \"fail\" (14%), \"pressure\" (7%), \"shame\" (6%), and \"alone\" (6%). Among mothers mentioning bonding (<i>n</i> = 99), 58% reported that breastfeeding inhibited infant bonding, versus 1% enhanced bonding; furthermore, 63% reported increased bonding after switching to formula versus 8% unchanged and 6% decreased bonding. Nearly one-quarter (23%) of all posts described inadequate breastfeeding counseling. Finally, 9% of all posts reported a negative experience with health care providers versus 6% a positive experience. <b><i>Conclusions:</i></b> Mothers struggling to breastfeed may not experience the classically described benefits of breastfeeding, instead experiencing increased depressive and other mental health symptoms and impaired maternal-infant bonding. Furthermore, limited provider disclosure about potential breastfeeding challenges and alternatives to breastfeeding may exacerbate mental health symptoms associated with breastfeeding difficulties. Balanced information should be presented to mothers contemplating breastfeeding in order to minimize maternal perceptions of \"failure.\"</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"251-260"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"No One Really Prepares You\": Lived Experiences of Women Division Chiefs in Academic Medicine.","authors":"Jaspreet Loyal, Rebecca Beagan, Magna Dias, Andrea Asnes","doi":"10.1089/jwh.2024.0416","DOIUrl":"https://doi.org/10.1089/jwh.2024.0416","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Although women have comprised at least 50% of medical school classes for decades, women remain underrepresented in leadership positions. Although the proportion of women division chiefs in the U.S. academic medical centers is small, it is growing. Division chief positions can be a precursor to more senior level leadership positions. Our objective was to explore the lived experience of women division chiefs across specialties. <b><i>Materials and Methods:</i></b> We conducted a qualitative study using semi-structured interviews of women division chiefs from medical and surgical subspecialties in 2023 at a major academic medical center in the northeastern United States. We used the grounded theory approach and the constant comparative method until thematic sufficiency was reached. <b><i>Results:</i></b> We interviewed 18 of a total of 29 women division chiefs (62%). The following major themes emerged: (1) Most women are externally motivated to seek out the division chief role, (2) formal preparation or leadership development prior to taking on the section chief role is lacking, (3) leaders (both men and women) who sponsor and mentor women facilitate their success, and (4) women leaders face specific challenges including promotion delays and lack of recognition of their authentic leadership styles. We found the following minor themes: (1) Lack of formal onboarding to the division chief role; (b) positive influence of women in senior leadership roles within the institution; and (c) barriers to leadership roles include feeling undervalued in preceding leadership roles, navigating parenthood, and need for broader sponsorship. <b><i>Conclusion:</i></b> Opportunities to support the continued growth of women division heads include more deliberate recruitment and succession planning; a structured, formal onboarding process; acceptance of authentic leadership styles; and more practical ways to support parenting.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change in Postpartum Visit and Contraception Rates Pre-COVID-19 to Post-Lockdown in Six U.S. Federally Qualified Health Centers.","authors":"Rebecca K Campbell, Emma Gray, Rachel Caskey, Cristina Barkowski, Jena Wallander Gemkow, Nivedita Mohanty, Kristin Rankin, Sadia Haider","doi":"10.1089/jwh.2024.0691","DOIUrl":"10.1089/jwh.2024.0691","url":null,"abstract":"<p><p><b><i>Background:</i></b> Postpartum care, including contraception, benefits maternal health and decreases mortality, which increased in the United States with COVID-19. Pandemic disruptions to postpartum health care access in vulnerable populations are not well understood. We utilize electronic health record (EHR) data for prenatal patients (<i>n</i> = 2,265) at six urban Federally Qualified Health Centers (FQHCs) from one year prepandemic (January 1, 2019) through one year after the first stay-at-home orders (\"lockdown\") (March 31, 2021). <b><i>Objective:</i></b> We investigated (1) changes in rates of postpartum visit (PPV) and postpartum contraception receipt in the post-lockdown versus prepandemic periods and (2) characteristics predictive of differential changes in PPV and contraception rates. <b><i>Materials and Methods:</i></b> Visit and prescription records from EHR were used to classify if patients received PPV and most/moderately effective contraception within 60 days postpartum, analyzed separately and as a composite variable: PPV and contraception, PPV only, or no PPV. Risk differences comparing post-lockdown with pre-COVID-19 pandemic were estimated using binomial regression and generalized logistic regression models adjusted for age, race/ethnicity, language, and clinical site. Effect modification by sociodemographic and clinical covariates was examined. <b><i>Results:</i></b> Total patient volume fell 21% in the post-lockdown versus pre-COVID-19 period. Rates of PPV decreased in absolute terms by 9.6 (95% confidence interval: -13.6, -5.6) and contraception by 8.1 (-13.3, -2.8) percentage points. After adjustment, PPV and contraception decreased by 9.3 percentage points (-13.1, -5.4), while PPV only was stable (-0.4 [-4.3, 3.6]). <b><i>Conclusions:</i></b> These findings suggest a substantial impact of the COVID-19 pandemic on postpartum care in FQHCs and community health centers. Supply and demand drivers require further examination to inform strategies to improve postpartum care access and subsequent maternal health outcomes.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Maternal Morbidity and Other Perinatal Complications Among Black, Hispanic, and White Birthing Persons With and Without Physical Disabilities.","authors":"Willi Horner-Johnson, Bharti Garg, Jonathan M Snowden, Aaron B Caughey, Jaime Slaughter-Acey, Ilhom Akobirshoev, Monika Mitra","doi":"10.1089/jwh.2024.0694","DOIUrl":"https://doi.org/10.1089/jwh.2024.0694","url":null,"abstract":"<p><p><b><i>Background:</i></b> People with physical disabilities are at increased risk of adverse perinatal outcomes, including severe maternal morbidity (SMM). Risks may be even greater for disabled people in minoritized racial or ethnic groups, but little is known about this intersection. <b><i>Methods:</i></b> We analyzed linked hospital discharge and vital records data from California, 2008-2020. We identified physical disabilities using diagnosis codes for maternal congenital anomalies, major injuries, musculoskeletal disorders, or nervous system disorders. We compared birthing persons in five groups (Black and Hispanic with and without physical disabilities, White with physical disabilities) to a reference group of non-Hispanic Whites without disabilities. We used Poisson regression to assess associations with SMM and other outcomes, with and without adjusting for sociodemographic and clinical covariates. <b><i>Results:</i></b> Disabled Black and Hispanic birthing persons had particularly high relative risks (RRs) of SMM (Black disabled RR = 6.13, 95% confidence interval [CI]: 4.94, 7.61; Hispanic disabled RR = 3.67, 95% CI: 3.29, 4.10) as compared with nondisabled White persons. These risks were greater than those for nondisabled Black (RR = 2.05, 95% CI: 1.99, 2.11), nondisabled Hispanic (RR = 1.36, 95% CI: 1.34, 1.39), and disabled White birthing persons (RR = 2.44, 95% CI: 2.16, 2.77). For most other outcomes, risks were also largest for disabled Black birthing persons, followed by disabled Hispanic birthing persons. <b><i>Conclusions:</i></b> Black and Hispanic people with physical disabilities are highly likely to experience SMM and are at increased risk for other complications and adverse outcomes. Efforts are needed to understand underlying causes of these disparities and develop policies and practices to eliminate them.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Effect of Depression, Anxiety, and Post-Traumatic Stress Disorder on Anti-Müllerian Hormone Levels Among Women Firefighters.","authors":"Michelle A Valenti, Leslie V Farland, Kaiwen Huang, Yiwen Liu, Shawn C Beitel, Sara A Jahnke, Brittany Hollerbach, Caitlin C St Clair, John J Gulotta, Jamie J Kolar, Derek J Urwin, Paola Louzado-Feliciano, Jordan B Baker, Kepra L Jack, Alberto J Caban-Martinez, Jaclyn M Goodrich, Jefferey L Burgess","doi":"10.1089/jwh.2024.0534","DOIUrl":"https://doi.org/10.1089/jwh.2024.0534","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To assess whether depression, anxiety, and post-traumatic stress disorder (PTSD) are associated with serum anti-Müllerian hormone (AMH) levels. <b><i>Study Design:</i></b> We used data from a sample of women firefighters from the Fire Fighter Cancer Cohort Study. Participant demographics, reproductive history, and self-reported clinical diagnosis of anxiety, depression, and PTSD were collected with serum for AMH analysis at enrollment. <b><i>Main Outcome Measure:</i></b> Linear regression models were used to estimate the association between anxiety, depression, and PTSD and log transformed AMH levels adjusted for age years (continuous and squared) and body mass index. Percent difference in AMH was calculated by [exp(β) - 1] × 100. <b><i>Results:</i></b> Among 372 participants, with mean ± standard deviation age 32.54 ± 6.32, clinical diagnoses were reported as follows: depression (15%), anxiety (18.2%), or PTSD (8.7%). No statistically significant association was observed between depression and AMH levels (-22%Δ, 95% confidence interval [CI]: -47.3, 14.5). Women firefighters with a history of anxiety (-33%Δ, 95% CI: -53.5, -4.2) and PTSD (-66%Δ, 95% CI: -79.1, -44.6) had lower serum AMH compared with participants without those conditions. When individuals with concurrent PTSD were excluded, the association between anxiety ceased to be statistically significant (26.7%Δ, 95% CI: -17.9, 92.6). <b><i>Conclusion:</i></b> A history of clinically diagnosed anxiety or PTSD was associated with statistically significantly lower AMH levels. This association offers insight into the potential biological mechanisms through which mental health conditions may influence reproductive health.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproductive Loss and the Law: The Nascent Evolution of Bereavement Remedies.","authors":"Eli Y Adashi, Daniel P O'Mahony, I Glenn Cohen","doi":"10.1089/jwh.2024.1026","DOIUrl":"https://doi.org/10.1089/jwh.2024.1026","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}