Reproductive Health最新文献

{"title":"PCOS and breast cancer risk: hormonal modulation and epidemiological trends.","authors":"Jyolsna Ponnaratta Kunhiraman, Reyon Dcunha, Ganesh Venkatraman, Anujith Kumar, Satish Kumar Adiga, Nagarajan Kannan, Guruprasad Kalthur","doi":"10.1186/s12978-026-02355-4","DOIUrl":"10.1186/s12978-026-02355-4","url":null,"abstract":"<p><strong>Background: </strong>Hormonal signals intricately regulate breast growth and development. Any perturbations due to altered endocrine and metabolic conditions, such as in polycystic ovary syndrome (PCOS), may influence breast cancer risk. This review highlights the susceptibility of women with PCOS to breast cancer, with a focus on the potential contribution of its comorbidities, such as hyperandrogenism, obesity, insulin resistance, diabetes, menopausal status, inflammation, and use of ovulation induction agents to this association.</p><p><strong>Methods: </strong>This is a narrative review including articles and information collected from PubMed, Scopus, Google Scholar, and the World Health Organization (WHO) websites. Studies were selected based on the availability of an abstract and research publication in English. Reports related to PCOS, its characteristics (hyperandrogenism, hyperinsulinemia, insulin resistance, type 2 diabetes, obesity), fertility treatment, and their association with breast cancer were included.</p><p><strong>Results: </strong>The interrelation between PCOS and breast carcinoma remains ambiguous due to inconsistent and inconclusive epidemiological evidence. The comorbidities associated with the condition are reported to collectively or individually influence this association. Women with PCOS present anovulatory cycles and have a high necessity of undergoing ovulation induction, further altering hormonal dynamics. Evidence in the literature suggests that the number of treatment cycles, age at the onset of treatment, and cumulative doses of agents used for ovulation induction are a few other factors that could affect breast cancer risk, though the results are inconclusive.</p><p><strong>Conclusion: </strong>Existing literature suggests that PCOS and its characteristics may impact the process of breast development and possibly contribute to breast cancer, although the evidence is still conflicting. Moreover, temporary alterations of endocrine profile following fertility medications may have a significant influence on the breast cancer risk, although research has shown inconclusive evidence. Hence, robust experimental studies are required to understand the underlying mechanisms and the long-term health implications for women with PCOS due to the intricate association between these factors.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006563","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":"Correction to: Perceived need of information and education about conception preparedness (CP) among engaged and soon to be married couples: a qualitative survey.","authors":"Richard Nsengiyumva, Olive Bazirete, Thiery Claudien Uhawenimana, Darius Gishoma, Ing-Marie Carlsson, Pamela Meharry, Haeun Lee, Lori Jody R","doi":"10.1186/s12978-026-02352-7","DOIUrl":"10.1186/s12978-026-02352-7","url":null,"abstract":"","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"23 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13188778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982480","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":"Age at menopause and risk of sarcopenia in postmenopausal women: evidence from the China health and retirement longitudinal study.","authors":"Yachai Li, Liang Qin, Yan Wang, Shentai Li, Li Ling, Nan Jia","doi":"10.1186/s12978-026-02358-1","DOIUrl":"10.1186/s12978-026-02358-1","url":null,"abstract":"<p><strong>Background: </strong>Menopausal age is closely associated with women's health, but research on its association with sarcopenia risk remains insufficient. Our study aimed to explore how menopausal age affects the risk of sarcopenia in postmenopausal women.</p><p><strong>Methods: </strong>Based on the China Health and Retirement Longitudinal Study (CHARLS) database, we included 3,410 postmenopausal women from 2011-2015. Participants were divided into five groups according to menopausal age: premature menopause (< 40 years), early menopause (40-44 years), intermediate menopause (45-49 years), normal menopause (50-55 years), and late menopause (> 55 years). Sarcopenia was identified using the 2019 Asian Working Group for Sarcopenia (AWGS 2019) criteria. Mixed-effects logistic regression models were used to analyze the association between menopausal age and sarcopenia.</p><p><strong>Results: </strong>The study included 3,410 postmenopausal women with a mean age of 64.39 ± 8.68 years and overall sarcopenia prevalence of 35.40%. Compared to the average age at menopause group (50-55 years; 1,593/3,410; 46.70%), premature menopause (127/3,410; 3.70%), early menopause (385/3,410; 11.30%), intermediate menopause (1,098/3,410; 32.20%), and late menopause (207/3,410; 6.10%) were all associated with increased sarcopenia risk. Compared to normal menopause (50-55 years), early menopause (40-44 years), intermediate menopause (45-49 years), and late menopause (> 55 years) were associated with statistically significant increased sarcopenia risk, while premature menopause (< 40 years) showed a non-significant elevated risk (OR = 1.40, 95% CI: 0.89-2.21, p = 0.1438). This association was stronger among women with late menarche, rural residence, married status, non-retirement, or low education levels.</p><p><strong>Conclusions: </strong>Both earlier and later than average menopausal age may be associated with increased sarcopenia risk in Chinese postmenopausal women, although the association for premature menopause did not reach statistical significance in fully adjusted models.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974866","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":"High folic acid supplementation is associated with vaginal bleeding in early pregnancy in a fetal sex-specific manner: findings from two prospective cohort studies.","authors":"Hongyan Wang, Shalem Leemaqz, Melanie D Smith, Dylan McCullough, Anya L Arthurs, Tanja Jankovic-Karasoulos, Gustaaf A Dekker, Claire T Roberts","doi":"10.1186/s12978-026-02344-7","DOIUrl":"10.1186/s12978-026-02344-7","url":null,"abstract":"<p><strong>Background: </strong>Vaginal bleeding in early pregnancy is associated with adverse pregnancy outcomes. Excess folic acid ingestion has shown potential adverse effects on pregnancy outcomes. However, little is known about the fetal sex-specific influence of excess folic acid supplementation on vaginal bleeding. We aimed to determine whether increasing folic acid supplementation is associated with vaginal bleeding in early pregnancy with respect to fetal sex.</p><p><strong>Methods: </strong>Two prospective cohorts of nulliparous pregnant women were accessed: prior to (SCOPE, n = 1164) and post (STOP, n = 1300) folic acid food fortification in Australia. Logistic regression was used to examine the relationship between folic acid supplementation and vaginal bleeding severity with fetal sex, as well as the relationship between vaginal bleeding and pregnancy outcomes, after adjusting for confounders.</p><p><strong>Results: </strong>Reported spotting and mild vaginal bleeding was more common in STOP, compared with SCOPE. Women from the two cohorts who experienced spotting and mild vaginal bleeding in pregnancy were more likely to have supplemented with ≥ 800 μg folic acid daily and had higher serum folate concentration, compared with no folic acid supplementation. Women who supplemented with ≥ 800 μg folic acid per day, and with a male bearing pregnancy, had > twofold greater odds [adjOR 2.14, (95% CI) 1.15-3.99, SCOPE and STOP] of vaginal bleeding in early pregnancy which was more likely to be more severe compared to those who did not supplement. This association was stronger (adjOR 2.85, 95%CI 1.23-6.57) in the STOP cohort. Furthermore, vaginal bleeding was associated with spontaneous preterm birth (sPTB) without premature rupture of membranes, placental abruption and small for gestational age (SGA) and lower gestational age at birth, the latter of which showed a male-fetus dependence, based on total cases in the two cohorts combined.</p><p><strong>Conclusions: </strong>This study reveals a novel association between fetal sex and vaginal bleeding during early pregnancy, which is influenced by high folic acid intake. Our data suggest < 800 μg/day folic acid supplementation post food fortification may be safer, especially in male-bearing pregnancy, consistent with guidelines that recommend 400 μg/day folic acid to prevent neural tube defects. Vaginal bleeding in early pregnancy needs more clinical attention as it may be an indicator for later pregnancy adverse outcomes.</p><p><strong>Trial registration: </strong>SCOPE and STOP studies were registered with Australian New Zealand Clinical Trial Registry (ACTRN12607000551493; Registration date 26th October 2007 and ACTRN12614000985684; Registration date 12th September 2014, respectively).</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147932113","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":"Bypassing primary healthcare facilities for maternal and child health services in low- and middle-income countries: a scoping review.","authors":"Myunggu Jung, Jaeun Son, Seungmi Lee, Sangchul Yoon","doi":"10.1186/s12978-026-02351-8","DOIUrl":"10.1186/s12978-026-02351-8","url":null,"abstract":"<p><strong>Backgrounds: </strong>Bypassing primary healthcare (PHC) facilities for maternal and child health (MCH) services is an increasingly common phenomenon in low- and middle-income countries (LMICs). This behaviour can undermine health system efficiency by overburdening referral hospitals and leaving PHC centres underutilised in LMICs. However, no comprehensive review has examined this behaviour. This scoping review synthesises evidence on how bypassing is defined, its prevalence, determinants, and how the concept has been framed in LMIC settings.</p><p><strong>Methods: </strong>Following PRISMA-ScR guidelines, we systematically searched PubMed, Embase, and Web of Science for peer-reviewed studies published between January 2010 and September 2024. Eligible studies reported empirical qualitative, quantitative, or mixed-methods findings on bypassing behaviour in PHC settings for MCH services in LMICs. We used a thematic synthesis approach to map definitions, estimate prevalence, and identify determinants and conceptualisations of bypassing behaviour.</p><p><strong>Results: </strong>20 studies from 11 LMICs met the inclusion criteria. Definitions of bypassing varied considerably, particularly regarding service type, treatment of referral or complication cases, and facility level. Because of this heterogeneity, reported prevalence of bypassing ranged widely from 1.8% to 88%, and these values were not directly comparable across studies. Determinants of bypassing behaviour fell into three broad categories: (1) individual factors such as higher socioeconomic status and previous obstetric complications; (2) perceptions of service quality, including inadequate equipment and negative prior experiences; and (3) sociocultural influences shaped by community perceptions. Conceptually, bypassing was interpreted both as a reactive response to perceived weaknesses in PHC and as a proactive strategy to seek safer and higher-quality care. Several studies also framed bypassing as a systemic issue, highlighting the limited obstetric capacity and readiness of PHC facilities and the need to reconsider the role of PHC in maternal care delivery.</p><p><strong>Conclusion: </strong>Evidence from this review shows that bypassing PHC facilities for MCH services is common in LMICs, especially for childbirth care. The behaviour reflects concerns about PHC quality rather than physical proximity to facilities. The substantial variability in how bypassing is defined highlights the need for conceptual clarity, including a clear distinction between voluntary bypassing and clinically indicated referrals. Strengthening both the technical and experiential quality of PHC, and clarifying its role within maternal care pathways, is essential. Clearer integration with higher-level facilities would also support more coordinated referral systems and help reposition PHC within maternal health service delivery.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875676","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":"Population-based self-sampling under primary care conditions - a possible approach for cervical cancer screening in Indonesia (IndoCerCa study).","authors":"Supriyatiningsih Wenang, Dianita Sugiyo, Sutantri Sutantri, Lidia Febrianti, Wiwik Kusumawati, Ova Emilia, Muhammad Ary Zucha, Ardhanu Kusumanto, Detty Siti Nurdiati, Mohamad Saifudin Hakim, Faizah Dwi Tirtasari, Boedi Andriani Ontowiryo, Pia Wilkening, Peter Hillemanns, Jörg Haier","doi":"10.1186/s12978-026-02350-9","DOIUrl":"10.1186/s12978-026-02350-9","url":null,"abstract":"<p><strong>Introduction: </strong>In low- and middle-income countries (LMICs), cervical cancer is a major burden. Screening is mainly based on visual inspection lacking sufficient sensitivity and specificity. For roll-out of colposcopy-based early detection sufficient qualified staff is not available. Several self-sampling device products have been proposed as alternative, but their usability in primary care needs to be proven. Implementation of an HPV-based self-sampling approach in a population-based setting in Indonesia was evaluated.</p><p><strong>Methods: </strong>Four self-sampling devices (2 urine, 2 swab) were applied in a primary care setting covering an entire district in Indonesia with Kulon Progo as pilot region. Cluster randomization was used for comparison of rural and urban areas. HPV-testing was done using standardized and validated PCR-techniques. HPV-positive women and a randomly selected HPV-negative control group underwent colposcopy, PAP smears and biopsies for cervical intraepithelial neoplasia (CIN) validation.</p><p><strong>Results: </strong>In 21 primary care units 2056 women (30-55 y) were recruited. Three devices achieved sufficient technical validation (92.1 - 99.7% DNA detection rate). Participant's test acceptance was 99.1%. HPV-prevalence was 2.6% (urine 2.4%, swab 2.8%). In 29.4% of HPV-positive women high-risk HPV-16/18 were detected. Colposcopy and morphological examination were refused by 3.0% of HPV-positive women and were technically invalid in 5.0%. Pathology revealed Negative for Intraepithelial Lesion or Malignancy (NILM) in 55.8%, CIN I in 25.0% and CIN II + in 3.8%. In the control group CIN I was found in 2.0%. This resulted in a sensitivity of 27.4% for all CIN and 100.0% for CIN II + , with specificities of 98.5% and 97.7%, respectively. The negative predictive values (NPV) were 97.9% and 100.0%, and positive predictive values (PPV) were 34.1% and 4.5%. Regression analysis confirmed high negative predictive impact of HPV-negativity in women > 40 years.</p><p><strong>Conclusions: </strong>Under primary care setting self-sampling-based HPV-testing is accepted. Urine- and swab-based techniques can be applied if the test systems provide technically valid DNA-detection rates. The prevalence was very low and requires further comparison within Indonesia. High NPV of this approach supports its applicability as screening in LMICs. For high-risk lesions PPV is still low suggesting a combination with additional test that are mainly independent from the availability of qualified staff.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13321520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842027","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":"Trends, regional disparities, and projected burden of anemia among women of reproductive age in Ghana, 2000-2030.","authors":"Abdul-Wahab Inusah, Temple Jagha, Michael G Head, Abdul-Aziz Seidu, Shamsu-Deen Ziblim","doi":"10.1186/s12978-026-02345-6","DOIUrl":"10.1186/s12978-026-02345-6","url":null,"abstract":"<p><strong>Background: </strong>Anemia remains a significant public health concern among women of reproductive age (WRA) in Ghana, contributing to adverse health and socioeconomic outcomes. Despite national nutrition and malaria control interventions, progress has been modest with persistent regional disparities. This study assessed national and regional trends in anemia prevalence among WRA from 2000 to 2019, quantified regional inequalities, and forecasted national prevalence to 2030 to measure progress toward global reduction targets.</p><p><strong>Methods: </strong>Population-representative estimates of anemia among WRA were obtained from the WHO Health Equity Assessment Toolkit (HEAT) database. National and regional prevalence were analyzed using four inequality measures: difference (D), ratio (R), population attributable risk (PAR), and population attributable fraction (PAF). Time-series forecasting was conducted using an ARIMA (1, 1, 0) model to project prevalence from 2020 to 2030.</p><p><strong>Results: </strong>Anemia prevalence among WRA declined modestly from 47.8% in 2000 to 44.3% in 2019, a 3.5%-point reduction. The Ashanti region recorded the greatest decline (43.3% to 37.3%), while the Upper West region observed the highest increase (41.0% to 45.2%). Regional inequalities widened from 2000 to 2019 across several measures: D (18.1 to 22.2), R (1.5 to 1.6), and PAF (- 16.2 to - 18.4). ARIMA forecasting suggests a plateauing effect, with national prevalence projected to reach 43.6% (95% CI: 40.4-46.9) by 2030.</p><p><strong>Conclusion: </strong>The modest decline in prevalence, coupled with widening regional inequalities and a projected plateau through 2030, indicates that current progress is insufficient to achieve WHO global targets. Addressing these gaps requires geographically targeted, multi-sectoral interventions, such as improving food storage infrastructure and integrating malaria control with nutritional counseling, to accelerate progress and ensure equitable health outcomes for WRA across all regions of Ghana.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842058","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":"Tailored-prom: tailored therapeutic regime in patients with preterm premature rupture of membranes to prolong pregnancy, improve maternal and neonatal outcomes, and reduce antibiotic burden: a randomized controlled trial protocol.","authors":"Karolina Mikova, Anna Jouzova, Zdenek Lastuvka, Klara Jonas, Truong An Nguyen, Jana Termerova, Vaclava Adamkova, Hana Benakova, Jiri Hrdy, Lenka Planickova, Petra Hanulikova, Tereza Lamberska, Richard Plavka, Lukas Hruban, Andrea Stanikova, Jiri Vojtech, Michal Koucky, Martina Borcinova, David Cibula, Katerina Mackova","doi":"10.1186/s12978-026-02353-6","DOIUrl":"10.1186/s12978-026-02353-6","url":null,"abstract":"<p><strong>Background: </strong>Preterm premature rupture of membranes is a major cause of preterm birth and is associated with substantial maternal and neonatal morbidity. Current management is largely uniform and includes routine administration of antibiotics and antenatal corticosteroids, although a considerable proportion of women do not have infection or inflammation at the time of membrane rupture. This approach may lead to unnecessary exposure to medication and suboptimal timing of treatment. Measurement of interleukin-6 in amniotic fluid is a promising marker of intra-amniotic inflammation and may allow a more individualized management strategy. The aim of this study is to evaluate whether tailored antibiotic and corticosteroid therapy based on interleukin-6 levels in amniotic fluid can prolong pregnancy compared with standard care.</p><p><strong>Methods: </strong>This is a prospective, randomised controlled trial conducted at two tertiary perinatal centres. Pregnant women aged 18 years or older with singleton pregnancies complicated by confirmed preterm premature rupture of membranes between 22 + 0 and 33 + 6 weeks of gestation will be eligible. After providing signed informed consent, participants will be randomised in a 1:1 ratio to tailored management or standard care. In the tailored arm, transabdominal amniocentesis will be performed within 24 h of admission, and subsequent antibiotic and corticosteroid therapy will be guided by the interleukin-6 concentration in amniotic fluid. In the standard care arm, antibiotics and antenatal corticosteroids will be administered at admission according to current guidelines. The primary outcome is pregnancy latency longer than 7 days from membrane rupture to delivery. Secondary outcomes include overall latency to birth, maternal infectious and non-infectious morbidity, and short-term neonatal outcomes. A total of 138 women will be randomised to account for the expected drop-out and non-feasible amniocentesis.</p><p><strong>Discussion: </strong>This trial addresses an important clinical question by testing a personalised approach to the management of preterm premature rupture of membranes. If effective, tailored treatment based on interleukin-6 measurement may prolong pregnancy, reduce unnecessary exposure to antibiotics and corticosteroids, and improve maternal and neonatal outcomes. The results may support a change toward more individualised care in this high-risk obstetric population.</p><p><strong>Trial registration: </strong>EU Clinical Trials Register: 2024-520237-77-00. Registered on 30th March 2025.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841963","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 child marriage in Eastern and Western provinces in Zambia and effective preventive interventions: Findings from a rapid document review and three stakeholder meetings.","authors":"Hannah Kabelka, Joseph M Zulu, Pam Baatsen, Maryse Kok","doi":"10.1186/s12978-026-02327-8","DOIUrl":"10.1186/s12978-026-02327-8","url":null,"abstract":"<p><strong>Background: </strong>Zambia has one of the highest child marriage rates in the world. Drivers of child marriage are multifaceted, complex and interrelated, firmly embedded in the social and cultural context. This study explored why, despite lower poverty and equal teenage pregnancy levels, child marriage is more prevalent in Eastern than in Western province in Zambia; and mapped effective preventive interventions. This knowledge is vital for informing the development of effective preventive interventions in Eastern Zambia and beyond.</p><p><strong>Methods: </strong>Guided by a conceptual framework on drivers of child marriage by Psaki et al. (2021), this study combined a rapid review of the literature on drivers and preventive interventions concerning child marriage relevant to Zambia with three participatory stakeholder meetings in Zambia to discuss, validate and complement findings.</p><p><strong>Results: </strong>Poverty and lack of opportunity, including low education levels, are among the main drivers of child marriage in Zambia. Influenced by socio-cultural and gender norms and practices, people in the Western and Eastern provinces seem to react differently to teenage pregnancy. In Eastern province, pregnancy is often followed by marriage, while in Western province, a historical high value of education makes more pregnant girls to continue school. Conditional cash transfers to keep girls in school and, to a lesser extent, empowerment interventions emerged as the most effective evidence-informed preventive interventions. Limited acceptability of young people's sexuality and needs for information and services and too little involvement of traditional and religious leaders need further attention to address child marriage in both provinces.</p><p><strong>Conclusion: </strong>Interventions to prevent child marriage in Zambia need to focus on the main drivers of the practice. Norm change around the value of education, conditional cash transfer, working towards increased acceptability of sexual and reproductive health information and services for young people, empowerment interventions and strategic alliances with traditional and religious leaders, can contribute to combat child marriage.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13156867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841960","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 type of contraception use among US college students: A needed update.","authors":"Sara B Oswalt, Alyssa M Lederer","doi":"10.1186/s12978-026-02314-z","DOIUrl":"10.1186/s12978-026-02314-z","url":null,"abstract":"<p><strong>Background: </strong>While rates of unintended pregnancy are declining among adolescents and young adults in the United States (US), rates remain higher than other industrialized nations and are associated with both educational and economic challenges. Studies examining young adult contraceptive practices are dated and limited in scope. Understanding current contraceptive use of young adults is critical to ensure intentional pregnancies.</p><p><strong>Methods: </strong>We used the American College Health Association-National College Health Assessment III 2022-2023 national dataset to examine contraceptive use patterns among 30,568 sexually active 18- to 24-year-old college students at 4-year institutions. Differences based on students' biological sex, race/ethnicity, year in school and number of sexual partners in the last 12 months were examined. Prevalence estimates with confidence intervals were calculated; chi-square tests were used to assess initial bivariate differences and t-tests were used to determine significant pairwise comparisons. Bonferroni correction set the significance level to p<.001219.</p><p><strong>Results: </strong>Most sexually active college students were using contraception (87.6%); however, there were significant differences among students based on demographic characteristics. Black, Latinx, and multiracial students and students with more than one sexual partner in the last 12 months were less likely to use contraception (ps < 0.001). There were also differences in the types of single and dual contraceptive methods used among students based on demographics. Significant differences based on race/ethnicity occurred across all methods and combinations of methods. Results indicated less consistent patterns of differences for sex, year in school, and number of sexual partners for single and dual use.</p><p><strong>Conclusions: </strong>This study provides a critical update on contraceptive use among US college students. The findings indicate which subgroups may be more at risk for an unintended pregnancy due to lower overall contraceptive use and use of methods that are less effective. Differences in race/ethnicity regarding contraceptive use continue to exist, and students with fewer years of education emerged as another essential group deserving attention. Improved awareness of methods and access to birth control are potential strategies to increase uptake. College health professionals and other clinical providers who work with US college students can use these findings to inform discussions with students who may need additional information about all available options.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13321439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842042","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}