Sexual & Reproductive Healthcare最新文献

{"title":"Associations of physical activity and weight gain during pregnancy with pregnancy-related pelvic girdle pain intensity – A retrospective cohort study","authors":"Ragnhild Byberg ,&nbsp;Inger Marie Mjølsnes ,&nbsp;Ingvild Dalen ,&nbsp;Inger Økland ,&nbsp;Anne Marie Gausel","doi":"10.1016/j.srhc.2024.101008","DOIUrl":"10.1016/j.srhc.2024.101008","url":null,"abstract":"<div><h3>Objective</h3><p>The aims of this study were first, to explore pain trajectories of pelvic girdle pain, and second, to explore if weight gain during pregnancy and/or physical activity before and during pregnancy were associated with the severity of pelvic girdle pain.</p></div><div><h3>Methods</h3><p>The study included data from a retrospective cohort study in 2009, with data collection performed via questionnaires. Group-based trajectory modelling was performed on the reported intensity of pelvic girdle pain in each pregnancy month, and associations between the latent classes and physical activity and/or weight gain were assessed.</p></div><div><h3>Results</h3><p>A total of 569 women were included in the analyses. Five distinct trajectory classes for the course of pelvic girdle pain were identified. A higher body mass index (BMI) increase during pregnancy was negatively associated with the probability of being pain free, with –3.2 percentage points per unit increase in BMI (95 % CI −5.3 to −1.1; <em>p</em> = 0.003), and positively associated with the probability of experiencing early onset moderate to severe pain, +1.1 percentage points per unit increase in BMI (95 % CI 0.2 to 2.1; <em>p</em> = 0.022). Weight gain below recommendations was negatively associated with early onset moderate to severe pain; –10.6 percentage points per unit increase in BMI (95 % CI −18.8<!--> <!-->to<!--> <!-->-2.4;<!--> <em>p</em> = 0.011). Physical activity in pregnancy was not significantly associated with pain trajectory classes when adjusting for pre-pregnancy variables.</p></div><div><h3>Conclusions</h3><p>Our findings suggest that pelvic girdle pain intensity during pregnancy can take multiple courses and is associated with weight gain during pregnancy.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877575624000636/pdfft?md5=51763c9a3646bfcd6468642cec8bc57a&pid=1-s2.0-S1877575624000636-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parent-infant closeness and care practices during therapeutic hypothermia in Swedish neonatal intensive care units","authors":"Pyrola Bäcke ,&nbsp;Anna Axelin ,&nbsp;Johan Ågren ,&nbsp;Ylva Thernström Blomqvist","doi":"10.1016/j.srhc.2024.101010","DOIUrl":"10.1016/j.srhc.2024.101010","url":null,"abstract":"<div><h3>Objectives</h3><p>The aim of this study was to investigate care practices among Neonatal Intensive Care Units (NICU) providing Therapeutic hypothermia (TH), and more specific to investigate staff’s experiences of parental participation, presence, and possibilities of being close with their infant during TH.</p></div><div><h3>Methods</h3><p>A descriptive, qualitative, and quantitative study. All Swedish NICUs providing TH (n = 10) participated. Data were collected during January–April 2021 via a questionnaire followed by a semi-structured interview with the registered nurse and the neonatologist responsible for TH at each unit. Descriptive statistics were calculated, and a qualitative content analysis was performed.</p></div><div><h3>Results</h3><p>All NICUs allowed parents unlimited stay with their infants and were keen to support parental presence, which was a prerequisite for promoting parent-infant closeness. Standardized routines regarding the infants’ care space and course of action were described as time-efficient and staff-saving, which freed up time to focus on the families.</p></div><div><h3>Conclusion</h3><p>Standardized routines regarding the care space setup and the medical and caring approach, as well as the NICU environment and practices around the families, can promote or curb the possibilities of parent-infant closeness. Well-established care practices and good environmental conditions with flexibility regarding the family’s needs are therefore required.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S187757562400065X/pdfft?md5=2ba2589d7e2e1ceb0325cc939d4d1b9a&pid=1-s2.0-S187757562400065X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141842692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The pathways to reproductive health education for women with physical disabilities in vietnam","authors":"An Nguyen,&nbsp;Narelle Warren,&nbsp;Andrea Whittaker,&nbsp;John Gardner","doi":"10.1016/j.srhc.2024.101009","DOIUrl":"10.1016/j.srhc.2024.101009","url":null,"abstract":"<div><h3>Objective</h3><p>To examines the access to reproductive health information by women with physical disabilities in Ho Chi Minh City, Vietnam.</p></div><div><h3>Methods</h3><p>An ethnography was used in this research. Data collection was conducted by using observations, photovoice, and in-depth interview with 30 participants, which including 20 women with physical disabilities, 5 healthcare providers, and 5 key informants.</p></div><div><h3>Results</h3><p>Research findings revealed that women with physical disabilities had variable reproductive health knowledge with some women being more informed than others. They obtained reproductive health knowledge via four pathways: family, school, community, and self-learning via peers and the Internet. They learned different types of information from these sources, but their reproductive health resources remained limited, leading to very little reproductive health knowledge for women.</p></div><div><h3>Conclusion</h3><p>Most women in this research are not educated by family members about reproductive health issues due to the Vietnamese cultural and social norms about sexual and reproductive health and ideas about disability. Some women have the opportunity to complete grade 9 and higher education levels, hence they are able to access authorized information via biology classes and other sexual and reproductive health training courses. Some recommendations are given including [1] Comprehensive sexual and reproductive health education should be taught in schools; [2] The Ministry of Education and Training works with NGOs to provide more authoritative sexual and reproductive health documents or workplace training for all people with disabilities; [3] Social policy makers in Vietnam should review their policies regarding improving the quality of life of people with disabilities.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877575624000648/pdfft?md5=2127fb70b3e471064a649049dbc05341&pid=1-s2.0-S1877575624000648-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141729811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘Better taking the risk than a lifetime punishment of early forced marriage’: Young people’s perceptions and experiences towards voluntary termination of pregnancy in northern Mozambique","authors":"Gilda Gondola Sitefane ,&nbsp;Esmeralda Mariano ,&nbsp;Birgitta Essén ,&nbsp;Pia Axemo ,&nbsp;Khátia Munguambe","doi":"10.1016/j.srhc.2024.101007","DOIUrl":"10.1016/j.srhc.2024.101007","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to explore young people’s perceptions and experiences on access to voluntary termination of pregnancy (VTP) in northern Mozambique.</p></div><div><h3>Methods</h3><p>A qualitative study of twelve focus group discussions was conducted from June to September 2021 in Nampula province, northern Mozambique. A total of 94 purposively selected 15–24-year-old males and females participated in the study. Data was inductively coded and reflexive thematic analysis inspired by Braun and Clarke was applied. Socio-Ecological theory was used to frame the discussion.</p></div><div><h3>Results</h3><p>Despite VTP being decriminalized and by law to be provided free of charge, unsafe abortion remains a common choice among young people towards unintended pregnancy. Barriers to help-seeking access to safe VTP include: 1) <em>fear</em>, 2) sociocultural gendered <em>norms and power dynamics</em>, 3) <em>lack of VTP service provision</em> at nearest health facilities, and 4) <em>unaffordable</em> services where available. Fear associated with early forced marriage, a parental corrective action towards premarital pregnancy coupled with lack of male financial autonomy to afford illicit charges, remain the most important factors preventing young people seeking for help at family and safe VTP services at facility level.</p></div><div><h3>Conclusions</h3><p>Amidst multiple barriers in accessing health services, unsafe abortion is viewed by young people as a better option than facing a lifetime punishment of early forced marriage, a common parental corrective action towards premarital pregnancy.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877575624000624/pdfft?md5=a6290a4fd4725e45ac3b2fa7e7baece7&pid=1-s2.0-S1877575624000624-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141637156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrapartum fetal monitoring practices in Norway: A population-based study","authors":"Kristin Jerve Aanstad ,&nbsp;Are Hugo Pripp ,&nbsp;Rebecka Dalbye ,&nbsp;Aase Devold Pay ,&nbsp;Anne Cathrine Staff ,&nbsp;Anne Kaasen ,&nbsp;Ellen Blix","doi":"10.1016/j.srhc.2024.101006","DOIUrl":"10.1016/j.srhc.2024.101006","url":null,"abstract":"<div><h3>Objective</h3><p>To describe intrapartum fetal monitoring methods used in all births in Norway in 2019–2020, assess adherence to national guidelines, investigate variation by women’s risk status, and explore associations influencing monitoring practices.</p></div><div><h3>Methods</h3><p>A nationwide population-based study. We collected data about all pregnancies with a gestational age ≥ 22 weeks during 2019–2020 from the Medical Birth Registry of Norway. We used descriptive analyses, stratified for risk status, to examine fetal monitoring methods used in all deliveries. Univariable and multivariable logistic regression models were used to determine factors associated with monitoring with cardiotocography (CTG) in low-risk, straightforward births.</p></div><div><h3>Results</h3><p>In total, 14 285 (14%) deliveries were monitored with only intermittent auscultation (IA), 46<!--> <!-->214 (46%) with only CTG, and 33<!--> <!-->417 (34%) with IA and CTG combined. Four percent (2 067/50 533) of women with risk factors were monitored with IA only. Half (10<!--> <!-->589/21 282) of the low-risk women with straightforward births were monitored with CTG. Maternal and fetal characteristics, size of the birth unit and regional practices influenced use of CTG monitoring in this group.</p></div><div><h3>Conclusions</h3><p>Most births are monitored with CTG only, or combined with IA. Half the women with low-risk pregnancies and straightforward births were monitored with CTG although national guidelines recommending IA.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877575624000612/pdfft?md5=1d6e4bab27e5a32168952a5dc7978939&pid=1-s2.0-S1877575624000612-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Core recommendations of effective preconception counselling services in low-and-middle-income countries – A scoping review","authors":"Fitriana Murriya Ekawati ,&nbsp;Anis Widyasari ,&nbsp;Harti Rahmi Aunurul Lisa ,&nbsp;Cika Golda Putri Ame ,&nbsp;Amita Tuteja","doi":"10.1016/j.srhc.2024.101005","DOIUrl":"10.1016/j.srhc.2024.101005","url":null,"abstract":"<div><h3>Background</h3><p>Extensive guidelines and recommendations are available for preconception counselling service in high-income-countries. However limited comprehensive recommendations are available for preconception care and counselling in low-and-middle-income countries (LMICs), where most of maternal mortality occurs in the settings.</p></div><div><h3>Aim/Objectives</h3><p>This review aims to identify any design, model or set of recommendations for their potential adoption to develop preconception care and counselling service for LMICs context.</p></div><div><h3>Methods</h3><p>A systematic literature search was conducted in five major databases to identify articles covering any designs, models or recommendations on preconception care, for or from LMICs settings published between 2013–2023. Articles on any single screening for preconception counselling, those evaluating the service without specific model or sets of recommendations were excluded. Articles satisfied the inclusion criteria were then appraised and were extracted and analysed using inductive approach of thematic analysis.</p></div><div><h3>Findings</h3><p>A total of nine articles were eligible for complete review, mostly were review papers, editorials and commission articles with moderate manuscript quality. Three themes of recommendations emerged from the analysis: Platforms, Core Principles, and Women Empowerment. The Platform contains recommendations on the settings, while Core principles provide essential recommendation of screening and management, while the theme Women Empowerment highlights the importance of empowering women to prepare and decide on their pregnancy.</p></div><div><h3>Implications</h3><p>Actual model of preconception care in LMICs is deficient, results of this review will inform research on the development of appropriate preconception care in LMICs . We also propose for access equity and strategies to promote women empowerment as the key to succeed the preconception care in LMICs.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592285","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":"Inter-generational impact: Exploring the influence of older sister-in-law’s contraceptive choices on her peer contraception adoption in India","authors":"Anjali Bansal ,&nbsp;Laxmi Kant Dwivedi ,&nbsp;Mrigesh Bhatia ,&nbsp;S.V. Subramanian","doi":"10.1016/j.srhc.2024.101004","DOIUrl":"10.1016/j.srhc.2024.101004","url":null,"abstract":"<div><h3>Objective</h3><p>Social network-based reproductive decisions are critical. This study compares the effect of an older peer contraception<!--> <!-->use on her younger peer's use, as they share the closest social network within the household, and tend to influence one another for reproductive decisions. In this study we considered peers as two sister-in-law living in the same household.</p></div><div><h3>Methods</h3><p>We used data from the fifth round of National Family Health Survey which was conducted between the year 2019 and 2021. We deployed multinomial multivariable logistic regression to find the association between older women contraception use on her younger peer. Also, an attempt has been made to determine contraceptive clustering within households in India and select states.</p></div><div><h3>Results</h3><p>The multinomial analysis found that all the women in the household used the similar method, but still relied only on the female sterilization as the sole method for their family planning. The multinomial multivariable method found that younger peers were 3.42 time odds more likely to use permanent method if her older peer had used it previously. Also, it was found 11% increase in any modern contraception use of younger peer if all her older peer will use any modern contraceptives in India. For all the states, the contraception clustering within household ranged from 5% to 14%, with highest in Himachal (14%).</p></div><div><h3>Conclusion</h3><p>Empowering older women as peer educators in contraception workshops can foster informed discussions, dispel myths, and promote the use of modern contraceptive methods among younger peers. Integrating such initiatives into government existing policies like Mission Parivar Vikas is crucial for improving contraceptive uptake, with ASHA workers and community health volunteers playing a pivotal role in delivering targeted education within households.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877575624000594/pdfft?md5=7f88a0e540e05d7cec3df99fc3a17dd6&pid=1-s2.0-S1877575624000594-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A group intervention for pregnant multiparas with fear of childbirth: A protocol of a feasibility study of the MOTIVE trial","authors":"Laura Sandström ,&nbsp;Marja Kaunonen ,&nbsp;Anna Liisa Aho","doi":"10.1016/j.srhc.2024.101003","DOIUrl":"10.1016/j.srhc.2024.101003","url":null,"abstract":"<div><h3>Background</h3><p>Although research interest in fear of childbirth has increased, interventions targeting especially multiparas with fear of childbirth have been overlooked, although untreated fear can cause serious adverse effects on the mother and the whole family. Thus MOTIVE (Multiparas overcoming Childbirth Fear Through Intervention and Empowerment), an intervention for pregnant multiparas with fear of childbirth, was designed.</p></div><div><h3>Methods</h3><p>This is a protocol of a single-arm non-randomized feasibility study of the MOTIVE trial with a mixed-methods design. The primary aim of the intervention is to assist pregnant multiparas with fear of childbirth, with the desired outcome to alleviate fear. MOTIVE consists of four group sessions (2 h each); three during pregnancy and one after giving birth and in addition of a phone call after birth. The intervention is provided by a midwife and a psychiatric nurse at the maternity hospital. Quantitative data will be gathered via self-report questionnaires at three time points, at baseline, at 4 weeks post-baseline and post-intervention. Qualitative data will be gathered by diaries, open-ended questions from post-intervention questionnaires, and individual interviews. The target is to assemble four groups of four multiparas over a 12-month period.</p></div><div><h3>Discussion</h3><p>The findings will provide insights into the feasibility and acceptability of the intervention and will inform revisions to it. The results will guide the development of a definitive, larger-scale trial evaluation to further examine the efficacy of the refined intervention.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877575624000582/pdfft?md5=d5fb46dbebf7baa9c86931e57500811e&pid=1-s2.0-S1877575624000582-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma-informed support after a complicated childbirth – An early intervention to reduce symptoms of post-traumatic stress, fear of childbirth and mental illness","authors":"Hanna Andersson ,&nbsp;Katri Nieminen ,&nbsp;Anna Malmquist ,&nbsp;Hanna Grundström","doi":"10.1016/j.srhc.2024.101002","DOIUrl":"10.1016/j.srhc.2024.101002","url":null,"abstract":"<div><h3>Objective</h3><p>Women who experience obstetric interventions and complications during childbirth have an increased risk of developing postnatal post-traumatic stress and mental illness. This study aimed to test the effect of a trauma-informed support programme based on psychological first aid (PFA) to reduce the mothers' symptoms of stress, fear of childbirth (FOC), anxiety and depression after a complicated childbirth.</p></div><div><h3>Methods</h3><p>The study population consisted of women ≥ 18 years old who had undergone a complicated childbirth (i.e. acute or emergency caesarean section, vacuum extraction, child in need of neonatal care, manual placenta removal, obstetric anal sphincter injury, shoulder dystocia or major haemorrhage (&gt;1000 ml)). A total of 101 women participated in the study, of whom 43 received the intervention. Demographic questions and three self-assessment instruments measuring stress symptoms, FOC, anxiety and depression were answered one to three months after birth.</p></div><div><h3>Results</h3><p>The women in the intervention group scored significantly lower on the stress symptom scale, with a halved median score compared to the control group. There was no significant difference between the groups regarding FOC, depression and anxiety.</p></div><div><h3>Conclusion</h3><p>Our results indicate that this PFA-based support programme might reduce post-traumatic stress symptoms in women who have gone through a complicated childbirth. With further studies in a larger population, this support programme has the potential to contribute to improved maternal care optimizing postnatal mental health.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877575624000570/pdfft?md5=f6a457d04c9935648b5e06b7a25f7ac7&pid=1-s2.0-S1877575624000570-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with persistent sexual dysfunction and pain 12 months postpartum","authors":"Sonia Bhandari Randhawa,&nbsp;Andrea Rizkallah,&nbsp;David B. Nelson,&nbsp;Elaine L. Duryea,&nbsp;Catherine Y. Spong,&nbsp;Jessica E. Pruszynski,&nbsp;David D. Rahn","doi":"10.1016/j.srhc.2024.101001","DOIUrl":"10.1016/j.srhc.2024.101001","url":null,"abstract":"<div><h3>Objective</h3><p>Identify factors associated with persistent sexual dysfunction and pain 12-months postpartum in an underserved population.</p></div><div><h3>Methods</h3><p>Extending Maternal Care After Pregnancy (eMCAP) is a program addressing health needs/disparities of patients at risk for worse perinatal outcomes. Participants completed the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and Urinary Distress Index (UDI-6) 12-months postpartum. The PISQ-12 was dichotomized with scores &lt; 32.5 indicating sexual dysfunction. Urinary incontinence (UI) was defined as at-least-somewhat bothersome (vs. none or not-at-all bothersome) urgency urinary incontinence (UUI) or stress urinary incontinence (SUI). Screening for anxiety and depression was completed using Generalized Anxiety Disorder-7 (GAD-7) and Edinburgh Postnatal Depression Scale (EPDS). Bivariate and multivariable logistic regression analyses were performed for sexual dysfunction vs. normal-function, and pain vs. no-pain, using demographic, peri/postpartum, and social-determinant-of-health variables as correlating factors.</p></div><div><h3>Results</h3><p>328 sexually active patients provided data. On bivariate analysis, sexual dysfunction (n = 31, 9.5%) vs. normal function (n = 297, 90.5%) groups showed no differences in age, BMI, parity, mode of delivery, episiotomy/laceration types, or breastfeeding. Sexual dysfunction was significantly associated<!--> <!-->with both UUI and SUI: 12 (39%) vs. 46 (15%) had UUI, p = 0.001, and 20 (65%) vs. 97 (33%) had SUI, <em>P</em> &lt; 0.001; the dysfunction group also had higher GAD-7 and EPDS scores and greater overall stress levels. On multivariable analysis, SUI and stress remained significantly associated: OR (95% CI) 2.45 (1.02–6.03) and 1.81 (1.32–2.49), respectively. Comparing pain (n = 45, 13.7%) vs. no-pain (n = 283, 86.2%), dyspareunia patients endorsed greater stress levels.</p></div><div><h3>Conclusion</h3><p>The interplay between sexual health, incontinence, and mental health deserves further study, and all three should be routinely addressed in postpartum care.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592286","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}