Journal of women's health (2002)最新文献

{"title":"Variations in Perinatal Interventions and Outcomes Among Active-Duty Service Women in the U.S. Military Health System.","authors":"Lynette Hamlin, Amanda Banaag, Cathaleen Madsen, David Miller, Tracey Pérez Koehlmoos","doi":"10.1177/15409996251406785","DOIUrl":"10.1177/15409996251406785","url":null,"abstract":"<p><strong>Introduction: </strong>Adverse perinatal outcomes disproportionately affect minoritized and lower-income women in the United States and are often linked to employment, insurance, and education. This study investigated whether these disparities persist in the Military Health System (MHS) among active-duty service women (ADSW), an employed, universally insured population with at least a secondary education.</p><p><strong>Methods: </strong>This cross-sectional study used data claims of ADSW ages 17-49 with births during 2016-2023. International Classification of Diseases, 10th revision (ICD-10) diagnostic, Medicare Severity Diagnosis Related Group, and Current Procedural Terminology codes were used to identify births, perinatal outcomes, and maternal comorbidities. Analyses included descriptive statistics of patient demographics including race, rank as a proxy for socioeconomic status, and incidence of perinatal interventions and outcomes; and modified Poisson regressions assessing variation between groups.</p><p><strong>Results: </strong>There were 218,386 births by 158,012 ADSW in fiscal year 2016-2023, with the greatest representation among White (42.91%), Black (27.16%), and enlisted (82.63%) members. Black, Asian and Pacific Islander, and American Indian/Alaska Native women showed higher risk of preterm labor, induction of labor, and cesarean section, whereas Asian and Pacific Islander and American Indian/Alaska Native women also had higher risk of postpartum hemorrhage. Officers had a higher risk for cesarean births, perineal lacerations, postpartum hemorrhage, and high-risk pregnancy at ages 35 and older.</p><p><strong>Conclusions: </strong>In this study, ADSW of minoritized races and lower rank experienced disparities in perinatal outcomes in the MHS. Lower hemorrhage risk for Black women contrasts with national data but aligns with previous MHS studies. Further research is needed to determine the factors influencing both positive and negative outcomes for ADSW.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"542-550"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Racially Divergent Evolution of Multiple Births in the United States.","authors":"Eli Y Adashi, I Glenn Cohen","doi":"10.1177/15409996251406489","DOIUrl":"10.1177/15409996251406489","url":null,"abstract":"","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"523-524"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Considerations for Hormone Therapy in Idiopathic Primary Ovarian Insufficiency.","authors":"Dewonna Ferguson, Sara Shihab, Paru David, Suneela Vegunta","doi":"10.1177/15409996261422118","DOIUrl":"10.1177/15409996261422118","url":null,"abstract":"","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"608-610"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Primary Cesarean Births Among People with Epilepsy: A Population-Based Cohort Study.","authors":"Kelly F Darmawan, Stephanie A Leonard, Kimford J Meador, Thomas McElrath, Suzan L Carmichael, Deirdre Lyell, Yasser Y El-Sayed, Tiffany Herrero, Maurice L Druzin, Danielle M Panelli","doi":"10.1177/15409996251405047","DOIUrl":"10.1177/15409996251405047","url":null,"abstract":"<p><strong>Objective: </strong>Pregnant people with epilepsy are at increased risk of severe maternal morbidity (SMM). Cesarean birth is a known contributor to SMM; however, the factors driving cesarean rates in this population remain poorly understood. We evaluated whether primary cesarean births were increased among nulliparous, term, singleton, vertex (NTSV) live births in people with epilepsy and whether differences were explained by sociodemographic, clinical, or hospital factors.</p><p><strong>Materials and methods: </strong>This cohort study used linked data from NTSV live births in California from 2007 to 2018. <i>International Classification of Diseases, Ninth Revision, Clinical Modification</i> (ICD-9-CM) and <i>International Classification of Diseases, Tenth Revision, Clinical Modification</i> (ICD-10-CM) diagnosis codes were used to identify those with epilepsy, including subcategories of epilepsy (generalized, focal, and unspecified). Risk ratios (RRs) estimated the association between epilepsy subtypes and primary cesarean birth, adjusting for potential confounders.</p><p><strong>Results: </strong>Of 1,550,586 NTSV births, 5,027 (0.3%) were among people with epilepsy. People with epilepsy had a higher risk of cesarean birth than people without epilepsy (32.1% versus 26.6%, RR: 1.21; 95% confidence interval [CI]: 1.16-1.25). After sequentially adjusting for sociodemographic, clinical, and hospital factors, the significant increase in cesarean birth among people with epilepsy persisted (aRR: 1.18; 95% CI: 1.13-1.23). When stratified by epilepsy type, the risk of cesarean birth was increased for people with unspecified epilepsies (aRR: 1.18; 95% CI: 1.13-1.23), which was the largest subgroup.</p><p><strong>Conclusions: </strong>The risk of NTSV cesarean birth was increased in people with epilepsy and was not explained by the measured sociodemographic, clinical, and hospital characteristics, suggesting that other unmeasured factors may be contributing. Understanding these factors is crucial for developing targeted strategies to safely reduce cesarean births and potentially improve maternal outcomes in people with epilepsy.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"525-531"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147319346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disability and Opioid Pain Reliever Use in Reproductive-Aged Women: An Analysis of a Canadian Cross-Sectional Survey.","authors":"Chloe G McKee, Hilary K Brown, Andi Camden","doi":"10.1177/15409996261428018","DOIUrl":"10.1177/15409996261428018","url":null,"abstract":"<p><strong>Background: </strong>Prescription opioid analgesic use among reproductive-aged women is prevalent in North America. Women with disabilities experience high rates of pain and structural barriers to accessing resources, potentially increasing their likelihood of opioid use and harm. Yet, few studies have examined opioid analgesic use in this population. This study compared the use of opioid pain relievers and nonmedical opioid use in reproductive-aged women with and without disabilities across Canada.</p><p><strong>Methods: </strong>We analyzed data from the 2018 Canadian Community Health Survey for 11,062 women aged 15-49 years. Disability status (30.6%) was determined using the Washington Group Short Set on Functioning. Modified Poisson regression was used to calculate prevalence ratios (PRs) for use of opioid pain relievers within the past 12 months, comparing women with and without disabilities, and by disability severity (mild, moderate/severe) and number of impacted functional domains (1, ≥2). Multivariable models adjusted for sociodemographic factors and health behaviors.</p><p><strong>Results: </strong>Women with disabilities were more likely than those without disabilities to use opioid pain relievers (19.6% versus 10.3%, adjusted prevalence ratio (aPR): 1.71, 95% confidence intervals [CI]: 1.47-1.99) and nonmedical opioids (6.2% versus 3.0%, aPR: 1.77, 95% CI: 1.28-2.43). A dose-response relationship was observed, with greater differences among women with moderate/severe disabilities and disabilities in ≥2 functional domains, compared with women without disabilities.</p><p><strong>Interpretation: </strong>These findings suggest a need for comprehensive education for health care providers on disability and pain management. In their early reproductive years, women with disabilities may benefit from accessible education and counseling on the risks and benefits of opioid pain relievers, with a focus on addressing social determinants of health.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"551-559"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147392207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Disparities in Severe Maternal Morbidity Among Patients with Polycystic Ovarian Syndrome.","authors":"Carolyn Robb, Rebecca Strafella, Jay Ayar, Rahi Desai, Annieka Reno, Noa Grunfeld, Elizabeth Drugge, Vani Dandolu","doi":"10.1177/15409996261423855","DOIUrl":"10.1177/15409996261423855","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between race and severe maternal morbidity (SMM) in delivery hospitalizations with polycystic ovarian syndrome (PCOS).</p><p><strong>Design: </strong>Retrospective cross-sectional study using the Nationwide Inpatient Sample (Q4 2015-2019). SMM was defined by the CDC algorithm of 21 ICD-10 indicators. Multivariable logistic regression assessed associations between race and SMM, adjusting for demographics, insurance, hospital type, obesity, hypertension, and diabetes.</p><p><strong>Subjects: </strong>Delivery hospitalizations with PCOS (ICD-10 E28.2).</p><p><strong>Results: </strong>Of 3.1 million deliveries, 19,962 (0.64%) had PCOS; 444 (2.22%) experienced SMM. Patients were predominantly White (66.7%) and <35 years (76.9%). Common comorbidities included obesity (30.2%), hypertension (9.5%), and diabetes (5.1%). Unadjusted analyses showed the highest SMM among Black (3.4%), Native American/Other (3.0%), and Asian/Pacific Islander (2.7%) patients. SMM was also more common among those ≥35 years, with public insurance, and at urban teaching hospitals. In adjusted models, Native American/Other (adjusted odds ratio [AOR] 1.44, 95% confidence interval [CI] 1.07-1.92), Black (AOR 1.42, 95% CI 1.11-1.81), and Asian/Pacific Islander (AOR 1.40, 95% CI 1.07-1.83) patients had significantly higher odds of SMM compared with White patients. Additional predictors included age ≥35 years (AOR 1.54, 95% CI 1.31-1.80), obesity (AOR 1.19, 95% CI 1.01-1.39), hypertension (AOR 1.65, 95% CI 1.32-2.04), and public insurance (AOR 1.35, 95% CI 1.14-1.60). Urban nonteaching hospitals (AOR 0.63, 95% CI 0.50-0.79) and Midwest hospital region (AOR 0.76, 95% CI 0.62-0.93) were associated with reduced odds of SMM.</p><p><strong>Conclusion: </strong>Racial disparities in SMM persisted among patients with PCOS despite adjustment for comorbidities and hospital factors. Race-conscious prenatal care and structural interventions are needed to reduce inequities.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"560-566"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Association Between Perceived Discrimination in Health Care and Postpartum Contraception.","authors":"Jonas J Swartz, Tracy Truong, Catherine Gervais, Evan R Myers, Geeta K Swamy, Maria I Rodriguez, Norma Davis, Keisha Bentley-Edwards","doi":"10.1177/15409996251404406","DOIUrl":"10.1177/15409996251404406","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the association between perceived discrimination in health care and postpartum contraceptive plans among a diverse group of postpartum individuals.</p><p><strong>Materials and methods: </strong>This was a cross-sectional study of individuals postpartum prior to hospital discharge recruited from a single tertiary care hospital between 2021 and 2023. Participants completed a 10-minute electronic survey during their postpartum stay, which included the Perceived Discrimination in Healthcare Scale and questions about their contraceptive plans. The primary exposure was perceived discrimination characterized as no or one experience of discrimination versus multiple experiences of discrimination. The primary outcome was planned tier of postpartum contraceptive efficacy. Multinomial logistic regression was used to examine associations between perceived racial discrimination in health care and planned postpartum contraception.</p><p><strong>Results: </strong>Among 482 participants, 21.4% reported multiple discrimination experiences with disproportionately frequent reports among those with Black versus non-Black race (52.4%, <i>p</i> < 0.001). Planned contraceptive method tiers included most effective (43.0%), moderately effective (29.7%), less effective (13.1%), and no contraception (14.2%). Perceived discrimination was not significantly associated with planned contraceptive use (<i>p</i> = 0.371). Multivariable analysis showed nonstatistically significant increased odds for less effective contraception (adjusted odds ratio [OR], 1.46; 95% confidence interval [CI]: 0.71-3.01) and similar odds of no contraception (adjusted OR, 1.09; 95% CI: 0.55-2.17) among those with multiple discrimination experiences.</p><p><strong>Discussion: </strong>Higher levels of perceived discrimination were not significantly associated with postpartum contraceptive efficacy tier though wide confidence intervals reflect we were likely underpowered. The prevalence of discrimination warrants intervention. Improving patient-provider communication may reduce perceived discrimination and its potential impact on contraceptive choices.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"585-593"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Related to Early Initiation and Adequate Prenatal Care in Virginia: A 5-Year Study.","authors":"Priyadarshini Pattath, Kenesha F Smith Barber","doi":"10.1177/15409996251407943","DOIUrl":"https://doi.org/10.1177/15409996251407943","url":null,"abstract":"<p><strong>Objectives: </strong>Late and inadequate prenatal care (PNC) increases risk of poor birth outcomes, such as low birth weight and risk of prematurity. There remain persistent maternal and infant racial and socioeconomic disparities and inequities in PNC initiation and adequacy of PNC in Virginia. The objective of this study is to describe sociodemographic factors associated with initiation of PNC and adequacy of PNC and birth outcomes.</p><p><strong>Methods: </strong>Cross-sectional study using secondary analysis of 2016-2020 Virginia Pregnancy Risk Assessment Monitoring System was performed (<i>N</i> = 4,516). The outcomes of interest included initiation of PNC in the first trimester, adequacy of PNC, and birth outcomes. Sociodemographic variables included age, race/ethnicity, education, insurance, and maternal education. Bivariate analysis and multivariate logistic regressions were performed.</p><p><strong>Results: </strong>Race/ethnicity, income, education, and insurance had significant association with initiation of PNC in the first trimester. Non-Hispanic Black women (adjusted odds ratio [aOR] = 0.634; 95% CI: 0.45-0.90) and Hispanic women (aOR = 0.602; 95% confidence interval [CI]: 0.42-0.87) were less likely to have adequate PNC compared with non-Hispanic White women. Those who were over age 35 had higher odds of preterm birth compared with those aged 25-34 (odds ratio [OR] = 1.57; 95% CI: 1.07-2.32). Non-Hispanic Black mothers had higher odds of low birth weight compared with non-Hispanic White mothers (OR = 2.09; 95% CI: 1.27-3.45).</p><p><strong>Conclusion: </strong>The findings highlight the opportunity to provide PNC for Hispanic and non-Hispanic Black women, women with low income and low education. Results will lead to the identification of strategic partnerships across disciplines and agencies to address gaps in services for these subpopulations.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":"35 6","pages":"594-601"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Suicidal Behavior: Comparisons Between Pregnancy and Postpartum Periods and Nonpregnancy, 2006-2019.","authors":"Erica S LeCounte, Jason L Salemi, Cheryl A Vamos, Heather A Flynn, Russell S Kirby","doi":"10.1177/15409996261423419","DOIUrl":"10.1177/15409996261423419","url":null,"abstract":"<p><strong>Background: </strong>The perinatal period is considered protective against suicide among women of reproductive age. However, it is unclear if this applies to nonfatal suicidal behavior. This study compared rates and determinants of suicidal behavior during pregnancy/delivery, postpartum, and nonpregnancy/nonpostpartum.</p><p><strong>Materials and methods: </strong>A repeated cross-sectional study was performed using 2006-2019 Florida hospital discharge records. Trends in hospitalization rates were assessed for suicidal ideation and intentional self-harm by pregnancy period, and adjusted rate ratios (aRRs) were estimated using negative binomial regression models to compare pregnancy/delivery and postpartum to nonpregnancy/nonpostpartum. Determinants were also compared across pregnancy periods.</p><p><strong>Results: </strong>Hospitalization rates for suicidal ideation in 2018-2019 versus 2006-2007 were 3.5, 5.9, and 5.1 times higher during pregnancy/delivery, postpartum, and nonpregnancy/nonpostpartum, respectively. In contrast, rates for intentional self-harm declined during nonpregnancy/nonpostpartum (RR = 0.85), with no significant change during pregnancy/delivery or postpartum. Compared with nonpregnancy/nonpostpartum, aRRs for suicidal ideation were significantly lower during pregnancy/delivery (aRR = 0.08) and postpartum (aRR = 0.13). Similar findings were observed for intentional self-harm (aRRs = 0.08 and 0.14, respectively). Determinants varied slightly by behavior and period. During pregnancy/delivery and postpartum, younger age, non-Hispanic Black race (pregnancy/delivery only), and Medicaid/Medicare or \"Other\" payer were positively associated with both behaviors, whereas Hispanic ethnicity and Medicaid/Medicare or \"Other\" payer were positively associated with both behaviors during nonpregnancy/nonpostpartum.</p><p><strong>Conclusions: </strong>Suicidal behavior is a significant concern during the reproductive period. Increasing access to mental healthcare and tailoring interventions to high-risk populations are important to reducing hospitalization rates.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"574-584"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146169235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Risk of Gynecologic and Obstetric Diagnoses in Patients with Ehlers-Danlos Syndromes.","authors":"Marisa R Imbroane, Hanna Kim, Cydni Akesson, Elliott G Richards","doi":"10.1177/15409996261418483","DOIUrl":"10.1177/15409996261418483","url":null,"abstract":"<p><strong>Background: </strong>To evaluate if patients with Ehlers-Danlos syndromes (EDS) are at an increased risk for gynecologic and obstetric diagnoses compared with age-matched patients without EDS.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the TriNetX research network. The study included female patients aged 18-44: there were 50,809 patients per cohort after matching for age. The risk of 18 gynecologic diagnoses and 6 obstetric diagnoses were assessed between the cohorts based on ICD-10 coding.</p><p><strong>Results: </strong>Patients with EDS were at an elevated risk for almost all the diagnoses assessed. The greatest increase in risk was seen for urogynecologic conditions. These patients were also at an increased risk for benign gynecologic diagnoses, adverse obstetric outcomes, and they received more fertility care.</p><p><strong>Conclusion: </strong>Using a large database, we were able to validate prior studies that assessed a limited number of conditions, our work expands on the conditions EDS patients may encounter.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":"567-573"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}