Reproductive Health最新文献

{"title":"The state of postpartum contraceptive use in India: descriptive lessons from nationally representative survey data.","authors":"Nicole E Johns, Abhishek Singh, Shruti Ambast, Nandita Bhan, Katherine Hay, Vedavati Patwardhan, Lotus McDougal","doi":"10.1186/s12978-025-01978-3","DOIUrl":"10.1186/s12978-025-01978-3","url":null,"abstract":"<p><strong>Background: </strong>Postpartum contraception is a key tool to delay or prevent subsequent pregnancy after birth. Though prior research has demonstrated substantial dynamism in contraceptive use throughout the postpartum period, most measurement of postpartum contraception has focused on aggregate use of any method at a single time point. We sought to more thoroughly examine the continuum of postpartum contraceptive use amongst women in India.</p><p><strong>Methods: </strong>We use 2019-21 National Family and Health Survey reproductive calendar data from n = 149,518 women with a birth in the one to five years prior to survey. We present estimates of postpartum contraceptive use by month postpartum, use of specific methods, initiation, duration, stopping, method switching, and subsequent pregnancy. We examine sociodemographic and birth factors associated with postpartum contraceptive use using multivariate logistic regression models. We also examine patterns of postpartum utilization for subpopulations of interest (adolescent mothers age 15-19 and first time mothers) and test whether conclusions are sensitive to a two-year rather than one-year postpartum time period definition.</p><p><strong>Results: </strong>We find that 59% of Indian women used a method of contraception within the first year postpartum, that condoms and female sterilization were the most commonly used methods, and that patterns of postpartum contraceptive use differed substantially by month, method, and subpopulation. Among postpartum contraceptive users, 9% switched methods, 19% stopped using contraception entirely, and 5% had another pregnancy within the first year postpartum. A number of sociodemographic and birth factors are associated with postpartum contraceptive utilization, and patterns of use differ meaningfully for adolescent and first-time mothers. Most findings were consistent when using a two-year rather than one-year time frame.</p><p><strong>Conclusions: </strong>The dynamic nature of postpartum contraceptive use suggests limited value of static contraceptive uptake targets, whether for program planning or as measures of success, and bolsters the need to center and to improve reproductive agency, empowerment, and access throughout the postpartum period.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"39"},"PeriodicalIF":3.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drivers of hygienic menstrual practices among reproductive-age women: evidence from Nepal demographic health survey-2022.","authors":"Nihal Hasan, Pradeep Kumar, Rahul Rajak","doi":"10.1186/s12978-025-01976-5","DOIUrl":"10.1186/s12978-025-01976-5","url":null,"abstract":"<p><strong>Background: </strong>Exclusive use of hygienic methods during menstruation has not received adequate attention in Nepal, with limited research utilizing nationally representative data. Therefore, this study explored the prevalence and factors influencing exclusive hygienic menstrual practices among women of reproductive age in Nepal.</p><p><strong>Methods: </strong>This study included 13,065 reproductive-age women from the Nepal Demographic and Health Survey (NDHS-2022). To quantify the proportion of the total variance attributable to differences between communities, the study used multilevel logistic regression and identify significant factors of exclusive use of hygienic methods among women in Nepal. The concentration Index (CI) and Concentration curve (CC) were also calculated to measure the socio-economic inequality of exclusive use of hygienic methods among reproductive age women.</p><p><strong>Results: </strong>Only 48% of Nepalese women aged 15- 49 years used exclusively hygienic methods to prevent bloodstains during menstruation. The results from multilevel model revealed that young women aged 15-24 (AOR = 2.52, p < 0.001), women with 10 years and above education (AOR = 1.98, p < 0.001) from the richest wealth quintile (AOR = 2.26, p < 0.001), never married women (AOR = 1.44, p < 0.001), owned a smartphone (AOR = 1.41, p < 0.001) and women with exposure to mass media at least once a week (AOR = 1.35, p < 0.001) are more likely to use hygienic methods as compared to their counterparts. The concentration curve results indicated that the exclusive use of hygiene methods is concentrated in women from higher economic backgrounds (CI: 0.21). Among the geographical regions of Nepal, the highest inequality was witnessed in Madhesh province (CI: 0.25), followed by Bagmati province (CI: 0.22).</p><p><strong>Conclusions: </strong>The findings suggest the need for multidimensional interventions and educational programs targeting socioeconomically vulnerable women to address unhygienic menstrual practices. Also, there is a need to educate adult women on biological facts and good hygienic practices, as they can impose cultural taboos and restrictions on the next generation.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"38"},"PeriodicalIF":3.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LUSSY score predictive of failure of surgical closure of obstetric rectovaginal fistula in the Democratic Republic of the Congo.","authors":"Justin Lussy Paluku, Franck Katembo Sikakulya, Cathy Mufungizi Furaha, Eugénie Mukekulu Kamabu, Olivier Mukuku, Zacharie Kibendelwa Tsongo, Stanis Okitotsho Wembonyama, Charles Wembonyama Mpoy, Jeannot Sihalikyolo Juakali","doi":"10.1186/s12978-025-01971-w","DOIUrl":"10.1186/s12978-025-01971-w","url":null,"abstract":"<p><strong>Introduction: </strong>Rectovaginal fistula (RVF) is a complex debilitating condition that results from several etiologies, obstetric trauma being the most common. Occasionally RVF closure is non-successful. The objective of this study is to develop a predictive score to identify predictors of failure of surgical closure of obstetric RVF (FSCORVF) in the Democratic Republic of the Congo.</p><p><strong>Methods: </strong>This was an analytical cross-sectional study conducted on 268 patients with obstetric RVF who have received surgical management. We proceeded with a bivariate and then multivariate analysis. Score discrimination was assessed using the ROC curve and C-index and score calibration was done according to the Hosmer-Lemeshow test.</p><p><strong>Results: </strong>Surgical closure of RVF failed in 12.31% of cases (33/268). After logistic modelling, five criteria emerged as predictive factors of FSCORVF (LUSSY Score): the presence of moderate/severe fibrosis (aOR: 36.25; 95% CI: 1.88-699.37), combined RVF with other type of fistula (aOR: 61.41; 95% CI: 8.78-429.72), fistula size > 3 cm (aOR: 82.45; 95% CI: 10.48-648.58), per-operative hemorrhage (aOR: 27.84;; 95% CI: 5.08-152.47) and postoperative infection (aOR: 1161.35; 95% CI: 46.89-28765.47). A score of 0 to 22 was obtained with a value ≤ 9 points indicating a low risk of FSCORVF, a value between 10 and 12 defining a moderate risk and the value ≥ 13 points corresponding to a high risk of FSCORVF. The area under the ROC curve of the score is 0.9744 with a sensitivity of 90.91%, a specificity of 97.87%, a positive predictive value of 85.71% and a negative predictive value of 98.71%.</p><p><strong>Conclusion: </strong>This study identified predictive factors for FSCORVF in the DRC, grouped in the LUSSY score. Complex fistulas (fistula size > 3 cm, severe fibrosis, combined fistulas) require advanced surgical routes different from the transvaginal and the transperineal ones used in the present study. Prevention of intraoperative hemorrhage and postoperative infections requires rigorous preparation, appropriate antibiotic prophylaxis, and strict postoperative follow-up.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"37"},"PeriodicalIF":3.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction Note: The comparison of two different protocols ultra-long versus medroxyprogesterone acetate in women with ovarian endometriosis: a prospective randomized controlled trial.","authors":"Haiyan Guo, Tong Du, Hongyuan Gao, Qianwen Xi, Ling Wu, Qifeng Lyu, Qianqian Zhu","doi":"10.1186/s12978-025-01977-4","DOIUrl":"10.1186/s12978-025-01977-4","url":null,"abstract":"","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"36"},"PeriodicalIF":3.6,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of economic growth and recessions on maternal and child health outcomes in sub-Saharan African countries: a systematic literature review.","authors":"Helena Yeboah, Olumuyiwa Omonaiye, Sanni Yaya","doi":"10.1186/s12978-025-01973-8","DOIUrl":"10.1186/s12978-025-01973-8","url":null,"abstract":"<p><strong>Background: </strong>The discourse surrounding the relationship between economic growth and maternal and child health has extended over several years. While some studies highlight the potential positive impact of economic growth on maternal and child health, others challenge the conventional belief that economic growth invariably translates to improved maternal and child health. Recent findings suggest that its role as a sole determinant of mortality outcomes has declined over time. This systematic review aims to consolidate existing literature and offer a comprehensive overview of this relationship in sub-Saharan African countries.</p><p><strong>Methods: </strong>A structured search of Medline, Embase, Web of Science, EconLit, and Global Health was conducted. Inclusion criteria encompassed studies published between 2000 to 2022 that examined national level economic growth and recession in conjunction with health outcomes of mothers and children in sub-Saharan African countries.</p><p><strong>Results: </strong>A total of 1167 studies were initially identified from the database searches, of which 18 met the inclusion criteria for data extraction. The review presents a range of findings. Eleven studies underscore the significant impact of economic growth in reducing child mortality and undernutrition, and maternal mortality rate. Conversely, other studies indicated insignificant or inconsistent associations, emphasizing the importance of various socio-economic factors such as female education, equitable resource distribution, effective governance, and comprehensive maternal and child health coverage and interventions. These factors are considered crucial in maximizing the benefits derived from national economic growth.</p><p><strong>Conclusions: </strong>Future research should explore alternative economic growth indicators such as, inequality-adjusted Human Development Index and Genuine Progress Indicator, to better capture several socio-economic factors. Additionally, expanding the timeframe could provide a more comprehensive understanding of the impact of economic growth and recession on maternal and child health in sub-Saharan Africa.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"35"},"PeriodicalIF":3.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shifting participatory approach when ideology meets reality: a grounded theory study based on project leaders' experiences with peer-led sex education programs for and by persons with intellectual disabilities and/or autism.","authors":"B Nelson, M Emmelin, A Agardh, L Löfgren, M Stafström","doi":"10.1186/s12978-025-01975-6","DOIUrl":"10.1186/s12978-025-01975-6","url":null,"abstract":"<p><strong>Background: </strong>This study explored peer-led sex education for individuals with intellectual disabilities and/or autism (ID/ASD) from the perspective of project leaders within Swedish non-governmental organizations (NGOs). The purpose of this Grounded Theory study was to develop a conceptual model that characterizes the ways in which peer-led sex education is implemented by Swedish NGOs. This was done by exploring what the concept of peer-led sex education means to NGO project leaders, and how they experience, explain and reason about the application of peer education in their daily operations.</p><p><strong>Methods: </strong>This study conducted 12 qualitative in-depth interviews with project leaders working with peer-led sex education initiatives. Grounded Theory enabled the construction of a conceptual model.</p><p><strong>Results: </strong>The study identified the core category, \"Shifting participatory approach when ideology meets reality,\" encapsulating project leaders' experiences in managing peer-led sex education programs. Three distinct approaches were discerned: (1) The Radical approach, where project leaders prioritize empowerment and norm criticism, striving to create an inclusive and equitable environment for individuals with ID/ASD. This approach resonates with Paulo Freire's pedagogy of the oppressed, emphasizing liberation through education. (2) The Pragmatic approach, which navigates the tension between ideology and pragmatism, recognizing the co-dependency between project leaders and persons with ID/ASD. External pressures from funders and the requirements to achieve tangible project outcomes inform this approach. (3) The Skeptical approach, which exhibits caution, doubting the capabilities and willingness of individuals with ID/ASD to challenge societal norms and work equally with people without ID/ASD.</p><p><strong>Conclusions: </strong>The findings underscore the complexity of peer-led sex education programs and highlight the need for a balanced approach that addresses both ideological aspirations and practical constraints. Empowerment and norm criticism are central to fostering agency and challenging oppressive systems. However, the pragmatic realities of project management and external pressures necessitate a delicate balance. Understanding these diverse approaches can inform the design of more effective initiatives, ultimately contributing to sexual and reproductive health and rights of individuals with ID/ASD.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"34"},"PeriodicalIF":3.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial distribution and factors associated with unmet need for contraception among women in Ghana.","authors":"Yaw Marfo Okyere, Richard Gyan Aboagye, Ebenezer N K Boateng, Joshua Okyere, Augustus Osborne, Bright Opoku Ahinkorah","doi":"10.1186/s12978-024-01935-6","DOIUrl":"10.1186/s12978-024-01935-6","url":null,"abstract":"<p><strong>Background: </strong>Unmet need for contraception is a significant public health concern in sub-Saharan Africa, affecting over 20% of women. We assessed the spatial distribution and factors associated with unmet need for contraception among women in Ghana.</p><p><strong>Methods: </strong>The study was conducted in Ghana, and data was extracted from the 2022 Demographic and Health Survey. A weighted sample of 7762 women who were either married or cohabiting and aged 16-49 years was included in the study. Multilevel regression analysis was performed to identify the factors associated with unmet need for contraception. The results were presented using adjusted odds ratio (AOR) with their respective 95% confidence interval (CI). Spatial analysis using GetisOrd G hotspot and cluster and outlier analyses were employed to examine the patterns of unmet need for contraception at the district level.</p><p><strong>Results: </strong>The proportion of unmet need for contraception among the women was 26.7% [25.3-28.2]. The hotspot districts for a high unmet need for contraception in Ghana were West Mamprusi Municipal, Mamprugu Moagduri, East Mamprusi Municipal, Yunyoo-Nasuan, and East Gonja Municipal. Women's age was associated with a lower likelihood of unmet need for contraception with the lowest odds among those aged 35-39 years [AOR = 0.31, 95%CI = 0.18, 0.53] compared with those aged 16-19. Working women [AOR = 0.74, 95%CI = 0.60, 0.91] and those who heard family planning messages at community meetings [AOR = 0.84, 95%CI = 0.70, 0.99] had lower odds of unmet need for contraception compared to those who were not working and those who did not hear family planning messages at community meetings.  Cohabiting women [AOR = 1.25, 95%CI = 1.01, 1.53] and those from female-headed households [AOR = 1.36, 95%CI = 1.13, 1.63] were more likely to have unmet need for contraception relative to their married counterparts and those from male-headed households, respectively. Parity was associated with unmet need for contraception, with the highest likelihood reported among women with four or more births [AOR = 6.47, 95%CI = 3.99, 10.48] compared to nulliparous women. Women residing in Greater Accra, Volta, Eastern and Bono East regions had higher odds of unmet need for contraception than those in the Western region, with the highest odds among those in Greater Accra [AOR = 2.38, 95%CI = 1.52, 3.72].</p><p><strong>Conclusion: </strong>Our study has shown that there are regional and district variations in the unmet need for contraception among women in Ghana. Improving access to and availability of contraceptive methods, particularly in hotspot districts in the northern parts of Ghana, is crucial. Targeted interventions for specific age groups, empowerment of women through employment, and the promotion of shared decision-making are recommended strategies to reduce the unmet need for contraception and enhance reproductive health outcomes.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"31"},"PeriodicalIF":3.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The thought that i could continue with school got lost: a qualitative exploration of the impact of COVID-19 on the education and sexual and reproductive health of Malawi youth.","authors":"Elikem Togo, Tawonga W Mwase-Vuma, Chrissie Thakwalakwa, Elizabeth Millar, Milissa Markiewicz, Esme Kadzamira, Janine J Kayange, Dadirai Mkombe, Jessica Fehringer","doi":"10.1186/s12978-025-01972-9","DOIUrl":"10.1186/s12978-025-01972-9","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic and associated lockdowns altered social interactions and the health and education context of Malawian youth. It is important to understand the repercussions of the pandemic on the wellbeing of youth so that policymakers can better mitigate negative outcomes and address future pandemic needs.</p><p><strong>Methods: </strong>This study used qualitative data from an evaluation of the \"Secondary Education Expansion for Development\" project to assess how COVID-19 impacted the education and sexual and reproductive health outcomes of youth in Malawi. Focus group discussions and key informant interviews were conducted in rural and urban areas with primary and secondary school students, their caregivers and teachers, and community leaders, providing insights on how the pandemic impacted them.</p><p><strong>Results: </strong>Both male and female students lost motivation to continue their learning during the COVID-19 related school closures and teacher strikes. Participants reported that some female students became pregnant, married early, and sometimes engaged in sex work to make ends meet. There were also reports of increased financial barriers to sending children to school when they reopened, and there were reports of lower grades and poorer quality of teaching post-school closures.</p><p><strong>Conclusions: </strong>The findings highlight the need for community- and policy-level strategies to mitigate interruptions to students' schooling and protect them from outcomes like pregnancy and early marriage that could further hinder their education.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"33"},"PeriodicalIF":3.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and awareness of female sexual and reproductive health and rights and intimate partner violence in the Fako Division, Cameroon.","authors":"Nkongho Nchong Achere, Sylvester Ndeso Atanga, Thomas Obinchemti Egbe, Tendongfor Nicholas","doi":"10.1186/s12978-025-01974-7","DOIUrl":"10.1186/s12978-025-01974-7","url":null,"abstract":"<p><strong>Background: </strong>Interventions towards ending intimate partner violence (IPV) and female sexual and reproductive health and rights (SRHR) violation are more successful when the prevalence amongst females, and awareness level of these rights amongst males and females are known. This fosters a compounding holistic impact on women's health and wellbeing throughout the rest of their lives.</p><p><strong>Objective: </strong>This study assessed the prevalence of IPV and SRHR violation amongst females and the awareness of IPV and female SRHR amongst males and females in the Fako Division, Cameroon.</p><p><strong>Methods: </strong>A cross-sectional community-based quantitative study design was used to collect data from participants in Limbe and Buea health districts of the Fako Division. Participants were selected through a multistage sampling technique. A structured questionnaire was used to collect data on IPV from 860 female participants and on the awareness of SRHR from 1487 male and female participants. The data was analyzed in SPSS version 26. Factors associated with the number of IPV experienced by females and awareness of IPV and SRHR were identified using poison and logistic regression models respectively. Awareness of IPV and SRHR among males and females was compared using a Chi squared test. p < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Of the 860 females surveyed, 818 (95.1%) and 556 (64.7%) have experienced at least one form of IPV and SRHR violation respectively. Factors independently associated with the number of times IPV was experienced included being an internally displaced person (p = 0.004, IRR = 1.38), unskilled (p = 0.001, IRR = 1.48), divorced (p < 0.001, IRR = 3.09), widowed (p < 0.001, IRR = 0.08) and earning a lower income (p = 0.003, IRR = 0.72). In addition to having a lower level of education, the associated factors were similar to the prevalence of SRHR violation experienced. Both males (85.5%, 83%) and females (85%, 87%) had a high awareness level of IPV and female SRHR. Amongst the factors associated with IPV awareness, level of education was significant in both females and males (p = 0.015, 0.038 respectively) and having a skilled job was significant (p = 0.003) with female SRHR awareness.</p><p><strong>Conclusion: </strong>This study showed that though both males and females have a high awareness level of IPV and SRHR, the prevalence of IPV and SRHR violation amongst females is still very high. Male-directed education aimed at promoting behaviour change that fosters respect of women's rights, changes harmful social norms and engages men as champions of female SRHR and ending IPV will likely decrease the prevalence of IPV and female SRHR violation.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"32"},"PeriodicalIF":3.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double-blind, non-inferiority, randomized controlled trial of dexamethasone 4, 5 and 6 mg for preventing adverse neonatal and maternal outcomes in very preterm to late preterm pregnancies between 29 ⁰ and 36 ⁶ weeks of gestation: study protocol.","authors":"Saifon Chawanpaiboon, Punnanee Wutthigate, Sanitra Anuwutnavin, Sureelak Sutchritpongsa","doi":"10.1186/s12978-025-01965-8","DOIUrl":"10.1186/s12978-025-01965-8","url":null,"abstract":"<p><strong>Background: </strong>Premature birth poses significant health challenges, including respiratory distress syndrome (RDS). Corticosteroids reduce the incidence of RDS, but higher dexamethasone doses may lead to adverse neonatal outcomes, such as growth restriction and neurodevelopmental issues. Determining the appropriate dose is crucial to balance efficacy and safety. Dexamethasone is inexpensive and widely available in most low- and middle-income countries. This study aims to compare the efficacy and safety of 4-mg, 5-mg and 6-mg dexamethasone in preventing RDS among preterm infants. This trial aims to determine whether lower dexamethasone doses are as effective as the standard dose in preventing RDS in preterm infants. By assessing efficacy and potential adverse outcomes, this study will provide critical insights for optimizing treatment protocols and improving neonatal care.</p><p><strong>Methods: </strong>This randomized controlled trial will include pregnant women with gestational ages between 29⁰ and 36⁶ weeks admitted to Siriraj Hospital and three secondary centres in Thailand. The participants will be randomly assigned to receive intramuscular dexamethasone at 4 mg, 5 mg or 6 mg, which will be administered every 12 h for a total of four doses over 48 h. The same dose will be used for rescue or repeat courses. The primary outcome will be the incidence of RDS, defined by clinical criteria and confirmed by a neonatologist. The secondary outcomes will include other adverse neonatal and maternal outcomes.</p><p><strong>Results: </strong>The study requires 1,560 participants, accounting for a 15% loss to follow-up. The data will be analysed via descriptive statistics, chi-squared tests for categorical data, and one-way ANOVA or Kruskal-Wallis tests for continuous data. An independent Data Safety Monitoring Board will conduct interim analyses every 3 months to ensure participant safety and study integrity.</p><p><strong>Discussion: </strong>This trial addresses the gap in research regarding optimal dexamethasone dosing for preventing RDS in preterm infants. The study will provide evidence on whether lower doses of dexamethasone (4 and 5 mg) are as effective as the standard 6-mg dose and will examine their potential adverse outcomes. The results will guide adjustments to medical practice guidelines, aiming to align them with clinical practices while ensuring safety and efficacy. Trial registration page https://www.thaiclinicaltrials.org/export/pdf/TCTR20220511003 10/05/2022.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"30"},"PeriodicalIF":3.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}