Journal of women's health最新文献

{"title":"Pregnancy Anxiety and Risk of Gestational Diabetes Mellitus Among a Diverse U.S. Cohort.","authors":"Cheng-Tzu Hsieh, Lu Zhang, Jessica Britt, Skye Shodahl, Amy Crockett, Liwei Chen","doi":"10.1089/jwh.2024.0453","DOIUrl":"10.1089/jwh.2024.0453","url":null,"abstract":"<p><p><b><i>Background:</i></b> Pregnancy anxiety increases the risk of preterm birth but less is known about the impacts on glucose intolerance during pregnancy, such as gestational diabetes mellitus (GDM). The present study examined the relationship between pregnancy anxiety and the risk of GDM in a prospective cohort Centering and Racial Disparities (CRADLE) study of racially diverse pregnant women in the United States. <b><i>Methods:</i></b> This is a prospective analysis among racially diverse pregnant women in the United States who enrolled in the CRADLE study. Pregnancy anxiety was assessed twice using the Pregnancy-Specific Anxiety Scale (PSAS): the baseline survey at <20 gestational weeks (GW) and the second survey at >30 GW. GDM was screened at 24-30 GW and diagnosed based on the Carpenter and Coustan criteria. The associations of baseline PSAS score (>9 [median] versus ≤9) and PSAS score change with GDM risk were estimated using multivariable logistic regressions with adjustment for potential confounders. <b><i>Results:</i></b> Among a total of 2,310 women (40.74% Black, 20.91% Hispanic), 154 (6.67%) developed GDM. No association was found between baseline PSAS and GDM (adjusted odds ratio [OR]: 0.99; 95% confidence interval [CI]: 0.70-1.42) after adjusting for confounders. Individuals with an increased PSAS during pregnancy had 52% higher GDM risk (adjusted OR: 1.52, 95% CI: 1.04-2.23) compared with those with no change or decreased scores. <b><i>Conclusions:</i></b> Pregnant individuals who increased their pregnancy-specific anxiety level during pregnancy had a higher risk of developing GDM. <b>Clinical Trials Registration Identifier:</b> NCT02640638. Registered with ClinicalTrials.gov December 29, 2015. Study recruitment began February 24, 2016. URL of ClincialTrials.gov registration site: https://clinicaltrials.gov/ct2/show/NCT02640638?term=NCT02640638&draw=2&rank=1.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"206-213"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468913","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":"An Analysis of Opioid Consumption and Patient Recovery after Hysterectomy by Surgical Approach.","authors":"Jennie J DeBlanc, Chad M Brummett, Vidhya Gunaseelan, Sawsan As-Sanie, Daniel M Morgan","doi":"10.1089/jwh.2023.0863","DOIUrl":"10.1089/jwh.2023.0863","url":null,"abstract":"<p><p><b><i>Background:</i></b> Minimally invasive hysterectomy is preferred to open hysterectomy due to lower morbidity, but recent data regarding the association of surgical approach with patient recovery and opioid consumption are lacking. <b><i>Objective:</i></b> To analyze how postoperative opioid use and return to baseline activity vary by surgical approach for hysterectomy. <b><i>Study design:</i></b> This was a retrospective cohort study including hysterectomy patients from the Michigan Surgical Quality Collaborative registry that was linked to the State of Michigan's prescription drug monitoring program. We analyzed two primary outcomes with respect to surgical approach: opioid consumption in the 30 days following surgery, measured in morphine milligram equivalents (MMEs), and return to baseline activity >4 weeks after surgery. Adjusting for demographics, comorbidities, preoperative opioid use, surgical indication, clinical events at 30 days postoperatively, and surgical approach, we used multivariable linear regression and logistic regression models to identify factors associated with our primary outcomes. <b><i>Results:</i></b> Lower opioid consumption was reported with minimally invasive hysterectomy, with mean postoperative opioid consumption (95% CI) of 32.70 (27.15-38.26) MMEs for vaginal, 39.91 (37.17-42.65) MMEs for laparoscopic, and 54.97 (48.81-61.13) MMEs for open hysterectomy. Other covariates associated with lower opioid consumption included older age and year of surgery in 2019 versus 2018. Predicted probability of return to baseline activities >4 weeks after surgery was 51% (44-57%), 43% (40-45%), and 64% (60-69%) for vaginal, laparoscopic, and open hysterectomy, respectively. <b><i>Conclusion:</i></b> Minimally invasive approaches to hysterectomy are associated with lower postoperative opioid consumption and a more rapid recovery relative to open hysterectomy.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"242-250"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739942","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":"From Healing to Hurting: Addressing Sex- and Gender-Based Differences in Chronic Postsurgical Pain.","authors":"Lopa Misra, Suneela Vegunta, Tarrah A Folley","doi":"10.1089/jwh.2024.0701","DOIUrl":"10.1089/jwh.2024.0701","url":null,"abstract":"","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"156-158"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290205","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":"Hand Osteoarthritis and Subclinical Cardiovascular Disease in Middle-Aged Women.","authors":"Rodrigo Rafael Flores-Marinelarena, Tatiana Sofia Rodríguez-Reyna, Carlos Cantú-Brito, Martín Lajous, Mario H Flores-Torres, Valeria Valaguez-Moreno, Carlos Eduardo Herrera-Venegas, Andres Catzin-Kuhlmann","doi":"10.1089/jwh.2023.1088","DOIUrl":"10.1089/jwh.2023.1088","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To determine subclinical cardiovascular disease (sCVD) in middle-aged women with clinically manifested hand osteoarthritis (HOA) and to improve the characterization of cardiovascular risk in this population. <b><i>Design:</i></b> We cross-sectionally evaluated the relationship between HOA and sCVD in 1,803 volunteers from the Mexican Teachers' Cohort. From 2012 to 2016, a subsample from Mexico City, the Northern state Nuevo León, and the Southern states Chiapas and Yucatán was invited for clinical evaluations, during which neurologists examined carotid arteries using ultrasound, and a standardized HOA questionnaire was also administered. HOA was defined as age ≥45 years, hand joint pain, and morning stiffness that lasted no longer than 30 minutes. sCVD was assessed using the intima-media thickness (IMT) and atherosclerotic plaques. <b><i>Results:</i></b> Among participants with a mean age of 51 years (±4), 18.4% met the criteria for HOA, and the prevalence of carotid atherosclerosis was 23.1%. After multivariable adjustment, women diagnosed with HOA had a 1.8% (95% confidence interval [CI] 0.3, 3.3) greater mean IMT than those without this joint disease. Similarly, women with HOA had 36% (95% CI 1.01, 1.84) higher odds of carotid atherosclerosis. <b><i>Conclusions:</i></b> HOA is associated with sCVD in middle-aged women. This relationship might be due to low-grade chronic inflammation; however, further research is required to clarify the underlying mechanisms.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"78-84"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349210","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":"Maternal Risk Conditions and Outcomes by Levels of Maternal Care.","authors":"Carla L DeSisto, Alexander C Ewing, Hafsatou Diop, Sarah Rae Easter, Elizabeth Harvey, Debra J Kane, Miriam Naiman-Sessions, Godwin Osei-Poku, Melanie Riley, Birgit Shanholtzer, Audrey M Stach, Ramya Dronamraju, Andrea Catalano, Elizabeth A Clark, Sabrina A Madni, Lindsay S Womack, Elena V Kuklina, David A Goodman, Sarah J Kilpatrick, M Kathryn Menard","doi":"10.1089/jwh.2024.0547","DOIUrl":"10.1089/jwh.2024.0547","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> To (1) determine associations between maternal risk conditions and severe adverse outcomes that may benefit from risk-appropriate care and (2) assess whether associations between risk conditions and outcomes vary by level of maternal care (LoMC). <b><i>Methods:</i></b> We used the 2017-2019 National Inpatient Sample (NIS) to calculate associations between maternal risk conditions and severe adverse outcomes. Risk conditions included severe preeclampsia, placenta accreta spectrum (PAS) conditions, and cardiac conditions. Outcomes included disseminated intravascular coagulation (DIC) with blood products transfusion or shock, pulmonary edema or acute respiratory distress syndrome (ARDS), stroke, acute renal failure, and a composite cardiac outcome. Then we used 2019 delivery hospitalization data from five states linked to hospital LoMC. We calculated associations between risk conditions and outcomes overall and stratified by LoMC and assessed for effect modification by LoMC. <b><i>Results:</i></b> We found positive measures of association between risk conditions and outcomes. Among patients with severe preeclampsia or PAS, the magnitudes of the associations with DIC with blood products transfusion or shock, pulmonary edema or ARDS, and acute renal failure were lower in Level III/IV compared with <Level III facilities. Among patients with cardiac conditions, the magnitudes of the associations with these outcomes, along with stroke, were also lower in Level III/IV compared with <Level III facilities. The proportion of patients with risk conditions that delivered in <Level III facilities was 19.8-46.8%. <b><i>Conclusions:</i></b> Odds of severe adverse outcomes among women with selected risk conditions were lower for births occurring at higher-level facilities, supporting the benefit of risk-appropriate care.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"51-59"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503020","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":"History of Pregnancy Loss and Risk for Higher Midlife Blood Pressure in Parous Females.","authors":"Amy R Nichols, Izzuddin Aris, Sheryl L Rifas-Shiman, Marie-France Hivert, Jorge E Chavarro, Emily Oken","doi":"10.1089/jwh.2024.0285","DOIUrl":"10.1089/jwh.2024.0285","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Pregnancy loss has been associated with later cardiometabolic conditions, potentially due to shared underlying etiology, but associations with midlife blood pressure (BP) remain unclear. <b><i>Methods:</i></b> We examined participants enrolled 1999-2002 in prospective Project Viva. At midlife ∼18 years after enrollment, we collected lifetime pregnancy history and measured BP. Exposures included any pregnancy loss or number of pregnancy losses. Outcomes were systolic and diastolic BP (SBP, DBP), and American Heart Association (AHA) BP categories. We performed multivariable regression adjusted for race and ethnicity, education, income, perceived body size at age 10 years, and age at outcome. <b><i>Results:</i></b> Of 623 participants, 33.7% reported pregnancy loss, 9.6% had elevated BP, and 34.8% had hypertension. Mean(±standard deviation) age was 50.7 ± 5.0 years, SBP 118.1 ± 15.6 mmHg, and DBP 74.8 ± 11.5 mmHg. In adjusted models, any pregnancy loss was associated with higher SBP (β = 2.25 mmHg, 95% confidence interval [CI]: -0.23, 4.78). Strongest associations with SBP were among those with first pregnancy loss ≥35 years (β = 5.58 mmHg, 95% CI: 1.76, 9.40 versus 0 pregnancy losses and first pregnancy <35 years). All associations with DBP were nonsignificant but similar in direction. For AHA outcomes, pregnancy loss was associated with higher risk for elevated BP (relative-risk ratio [RRR] = 2.93, 95% CI: 1.58, 5.43) but not with hypertension (RRR = 1.45, 95% CI: 0.95, 2.22) versus normotension. In models examining race and ethnicity, SBP was higher among non-Hispanic White and Hispanic individuals with pregnancy loss; non-Hispanic Black individuals had higher BP regardless of pregnancy loss status. <b><i>Conclusions:</i></b> History of pregnancy loss was associated with higher SBP and elevated BP category at midlife. These findings highlight reproductive history as an important consideration for cardiopreventive strategies and interventions.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"187-197"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468908","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":"Should I Stay, or Should I Go? Emotional Exhaustion's Association with Intent to Leave in a National Sample of Female Physician Trainees.","authors":"Tyra Fainstad, Adrienne Mann, Lila Steinberg, Maria A Woodward, Ami Shah","doi":"10.1089/jwh.2024.0470","DOIUrl":"10.1089/jwh.2024.0470","url":null,"abstract":"<p><p><b><i>Background:</i></b> Physician burnout disproportionately affects women and contributes to attrition from the workforce, a costly problem that likely begins in training. Female physicians leave the workforce significantly earlier than male counterparts. The association between burnout and attrition intent in women physician trainees is unknown. <b><i>Methods:</i></b> This is a cross-sectional analysis of baseline data from a national sample of female physician trainees in a randomized controlled trial testing a well-being program in 2022. Participants completed surveys on burnout and intent to leave. Associations were analyzed using chi-square testing and univariable linear regression. <b><i>Results:</i></b> A total of 1,017 trainees responded. The average standard deviation (SD) age was 30.8 (4.0) years, 959 (94.3%) self-identified as a woman, and 540 (53.1%) as White. One-fifth (207, 20.7%) were in postgraduate year (PGY)-1, 198 (19.8%) PGY-2, and 595 (59.5%) ≥ PGY-3. Most scored positively for burnout; 77.5% experienced high emotional exhaustion (EE). One-fifth (20.6%) reported some intent to leave their program before graduation, and 32.7% reported intent to leave their specialty within 2 years. There was a strong association between EE scores and intent to leave: trainees reporting a high likelihood to leave before graduation had a 22.27 higher EE point average than those reporting no likelihood (95% confidence interval [CI]: 7.80, 36.74, <i>p</i> = 0.003). <b><i>Conclusions:</i></b> Attrition intent was associated with burnout. Addressing burnout during training will not only benefit trainees but could impact the retention of women physicians.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"214-220"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349213","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":"Analysis of Alcohol Use and Alcohol Use Disorder Trends in U.S. Active-Duty Service Women.","authors":"Stephanie Tower, Amanda Banaag, Rachel Sayko Adams, Miranda Lynn Janvrin, Tracey Pérez Koehlmoos","doi":"10.1089/jwh.2023.0497","DOIUrl":"10.1089/jwh.2023.0497","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Alcohol use (AU) and disorders (AUDs) have been increasing among women over the past decade, with the largest increases among women of child-bearing age. Unprecedented stressors during the COVID-19 pandemic may have impacted AU for women with and without children. Little is known about how these trends are impacting women in the military. <b><i>Methods:</i></b> Cross-sectional study of active-duty service women (ADSW) in the U.S. Army, Air Force, Navy, and Marine Corps during fiscal years (FY) 2016-2021. We report the prevalence of AU and AUD diagnoses by FY, before/during the COVID-19 pandemic (2016-2019; 2020-2021, respectively), and by parental status. Log-binomial and logistic regressions examined associations of demographics, military, and family structure characteristics, with AU and AUD, during pre-COVID-19 and COVID-19 timeframes. <b><i>Results:</i></b> We identified 281,567 ADSW in the pre-COVID-19 period and 237,327 ADSW in the during COVID-19 period. The prevalence of AU was lower during the COVID-19 period (47.9%) than during the pre-COVID-19 period (63.0%); similarly, the prevalence of AUD was lower during the COVID-19 period (2.7%) than during the pre-COVID period (4.0%). ADSW with children had larger percentage decreases during the COVID-19 period. ADSW with children had a consistently lower prevalence and odds of AUD compared with ADSW without children in the pre- and during COVID-19 periods. <b><i>Conclusion:</i></b> Decreasing trends in AU and AUD among ADSW were unexpected. However, the prevalence of AU and AUD may not have been accurately captured during the COVID-19 period due to reductions in access to care. Continued postpandemic comparison of AU/AUD among women by parental status and demographic factors may guide targeted health efforts.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"60-69"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866617","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":"Exploring Reasons for Loss to Follow-up in Pregnancy of Unknown Location: A Mixed-Methods Study.","authors":"Anne N Flynn, Arden McAllister, Alicia Jen, Sarah Gutman, Antoinette Allen, Corinne Kete, Natasha Seth, Nathanael Koelper, Sarita Sonalkar","doi":"10.1089/jwh.2023.1146","DOIUrl":"10.1089/jwh.2023.1146","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To quantify proportions of loss to follow-up in patients presenting with a pregnancy of unknown location and explore patients' perspectives on follow-up for pregnancy of unknown location. A pregnancy of unknown location is a scenario in which a patient has a positive pregnancy test but the pregnancy is not visualized on transvaginal ultrasound. <b><i>Study Design:</i></b> We conducted a retrospective cohort study of patients with pregnancy of unknown location who presented to an urban academic emergency department or complex family planning outpatient office. We sought to calculate the proportion of patients lost to follow-up, defined as inability to contact the patient within 2 weeks. We then conducted focus groups of patients diagnosed with a pregnancy of unknown location. We used thematic analysis to identify themes related to follow-up. <b><i>Results:</i></b> We reviewed 464 charts of patients diagnosed with pregnancy of unknown location. The median age in this cohort was 27 with most patients identifying as Black (80%, <i>n</i> = 370) and using public insurance (67%, <i>n</i> = 315). When looking at loss to follow-up rates, Black patients experienced loss to follow-up (20%, <i>n</i> = 72) more often than White patients (4%, <i>n</i> = 2; <i>p</i> = 0.003). Focus group participants had a mean age of 31.8+/-4.8, and the majority were of Black race (<i>n</i> = 16, 72.7%). Participants identified barriers to follow-up including the long duration of management, general inconvenience, and poor communication with their health care team. Participants felt a burden of responsibility to learn about their condition and to self-advocate for their follow-up and communication of results. <b><i>Conclusions:</i></b> These data indicate that Black patients are more likely to experience loss to follow-up compared with White patients during monitoring for pregnancy of unknown location. Patients identified many barriers to follow-up and felt that successful follow-up required substantial self-efficacy.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"118-124"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498389","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":"Barriers to Preferred Contraception Use in Mississippi.","authors":"Amanda Nagle, Klaira Lerma, Gracia Sierra, Kari White","doi":"10.1089/jwh.2024.0127","DOIUrl":"10.1089/jwh.2024.0127","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Many Americans are not using the contraceptive method they prefer, but there has been limited study of how this may be related to health system barriers. We evaluated how such barriers to contraceptive care are related to unmet contraceptive preference in Mississippi and which contraceptive methods are preferred by those who report an unmet preference. <b><i>Materials and Methods:</i></b> Between September 2020 and February 2021, we used social media advertisements to recruit Mississippi residents 18-45 years of age, who were assigned female at birth, for an online survey. We asked respondents if they wanted to use a different contraceptive method or start using one, and if so, which method they preferred. We assessed barriers in the reproductive healthcare services environment (e.g., long wait for appointments, unaffordability or lack of insurance acceptance). We used multivariable-adjusted Poisson regression models to test the relationship between experiencing one or more barriers to reproductive healthcare and having an unmet contraceptive preference. <b><i>Results:</i></b> Among 462 eligible respondents, 37% had an unmet contraceptive preference. Most respondents (83%) reported one or more barriers to accessing office-based reproductive healthcare. Respondents who experienced a barrier had almost twice the prevalence of unmet preference as people who experienced no barrier (prevalence ratio 1.81, 95% confidence interval: 1.14-2.86). Among respondents with unmet preference, short-acting hormonal, long-acting reversible, and permanent methods were most desired. <b><i>Conclusion:</i></b> We find that nearly two-fifths of reproductive-aged Mississippians with capacity for pregnancy are not using their preferred contraceptive method. Structural barriers to care are very common and are significantly associated with experiencing unmet contraceptive preference, undermining reproductive autonomy.</p>","PeriodicalId":17636,"journal":{"name":"Journal of women's health","volume":" ","pages":"198-205"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126094","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}