AJOG global reports最新文献

{"title":"Contraceptive utilization and associated factors among reproductive age women attending psychiatric outpatient services, at northwest Amhara regional referral hospitals, Ethiopia","authors":"Getanew Kegnie Nigate MPH ,&nbsp;Yohannes Ayanaw Habitu PhD ,&nbsp;Worku Chekol Tassew MSc ,&nbsp;Yeshiwas Ayale Ferede MPH ,&nbsp;Elsa Awoke Fentie MPH","doi":"10.1016/j.xagr.2025.100530","DOIUrl":"10.1016/j.xagr.2025.100530","url":null,"abstract":"<div><h3>Introduction</h3><div>Family planning is essential for all reproductive age women, and it is particularly Important for women with mental illness. Women with mental illness have a special need for Family planning as they carry a high risk of unplanned or unwanted pregnancy, sexual violence And poor obstetric outcomes. However, regarding contraceptive utilization and associated Factors among women with mental illness in low–income countries including Ethiopia is not Adequately explored.</div></div><div><h3>Objective</h3><div>To assess the magnitude of contraceptive utilization and associated factors among reproductive age women attending psychiatric outpatient services, at the northwest Amhara regional referral hospitals, Ethiopia</div></div><div><h3>Methods</h3><div>An institutional–based cross-sectional study was conducted among 810 study participants. A systematic random sampling technique was employed to recruit study participants. A structured and pretested questionnaire was used to collect the data. Data was entered in Epi data 3.1 and then exported to Stata version 14 for analysis. Model fitness was checked by using Hosmer and Lemeshow goodness. Both bivariable and multivariable logistic regressions were used to identify factors associated with contraceptive utilization among psychiatric outpatients. In multivariable logistic regression variables having a <em>P</em>-value less than 0.05 with 95% CI were considered as independently associated factors for the outcome Variable.</div></div><div><h3>Result</h3><div>About 42.59% (CI: 39.18–46.0) of the respondents were using family planning Contraceptive methods at the time of the study. Higher educational level (AOR=3.84 [95% CI: 1.81–8.16]), women who had no intention to have children in the future (AOR=1.53 [95% CI:1.02–2.30]), women counseled about family planning contraceptive method by a clinician (AOR=4.06 [95% CI:2.53–6.49]), good knowledge of family planning (AOR=2.77 [95% CI:1.90–4.03]), fear of side effect of psychiatric medication (AOR=1.57 [95% CI:1.09–2.25]) were factors associated with contraceptive utilization.</div></div><div><h3>Conclusion and recommendation</h3><div>Approximately 42.59% of women with psychiatric illnesses were using modern family planning methods. Significant predictors included having a higher education, good knowledge of family planning, not planning to have children in the future, believing that psychiatric medications are compatible with family planning, and receiving counseling on modern methods from healthcare providers. It is essential for healthcare providers to enhance family planning counseling in mental health clinics to improve knowledge and utilization of these methods.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100530"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094730","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":"Expulsion rates 12 months after early versus interval postpartum intrauterine device placement: a randomized trial","authors":"Sarah Averbach MD, MAS ,&nbsp;Florin Vaida PhD ,&nbsp;Erica Hinz MD, MPH ,&nbsp;Gennifer Kully MSc ,&nbsp;Arnab K. Dey PhD, MBA ,&nbsp;Monica A. Lutgendorf MD ,&nbsp;Sadia Haider MD, MPH ,&nbsp;Lisa G. Hofler MD, MPH, MBA","doi":"10.1016/j.xagr.2025.100547","DOIUrl":"10.1016/j.xagr.2025.100547","url":null,"abstract":"<div><h3>Objective</h3><div>The early postpartum period, 2 to 4 weeks postpartum, is an optimal time for intrauterine device (IUD) initiation; placement can be co-located with early postpartum or infant visits. We aimed to compare expulsion rates at 12 months postpartum for IUDs placed early compared to the standard interval 6-week visit.</div></div><div><h3>Study Design</h3><div>This is a randomized controlled trial conducted at four U.S. medical centers. Participants were randomly assigned to early (14–28 days) or interval (42–56 days) postpartum IUD placement after vaginal or cesarean birth. We used transvaginal ultrasound to confirm IUD presence and position at 6 months. Chart review and telephone surveys were used to verify IUD presence and position at 12 months.</div></div><div><h3>Results</h3><div>Between March 2018 and June 2021, 203 participants were assigned to early and 201 to interval IUD placement; 238 (58.9%) contributed outcome data by phone survey (and electronic medical record review) at 12-months postpartum. Among participants who received an IUD and provided 12-month outcome data, complete expulsion rates were 4 in 124 (3.2%; 95% confidence interval [CI], 0.90 to 8.2) and 0 in 114 (0%; 95% CI, 0 to 3.2) in the early and interval groups; a between-group difference of 3.2 percentage points (95% CI, −0.01 to 8.0, <em>P</em>=.054). Partial expulsion counts and rates were 16 (12.9%; 95% CI, 7.6 to 20.1) and 13 (11.4%; 95% CI, 6.2 to 18.7) in the early and interval groups; a difference of 1.5 percentage points (95% CI, −7.2 to 10.2, <em>P</em>=.75). Among all 404 participants, IUD utilization rates at 12-month follow-up were 113 (55.7%; 95% CI, 48.5 to 62.6 among participants in the early group) compared to 95 (47.3%; 95% CI, 40.2 to 54.1, <em>P</em>=.10 among participants in the interval group). Participants were more satisfied with early compared to interval placement, 107 (86.3%; 95% CI 79.0 to 91.8) vs 87 (76.3%, 95% CI 67.4 to 83.8 95%) <em>P</em>=.048<strong>.</strong></div></div><div><h3>Conclusion</h3><div>Complete expulsion rates at 12 months are low (&lt;5%) when IUDs are placed in the early and interval postpartum period. Satisfaction is higher with early postpartum IUD placement.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100547"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144841432","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":"Management of uterine artery pseudoaneurysm: a case report of noninterventional treatment with systematic review","authors":"Vincent Landré MD ,&nbsp;Hans-Christoph Pape MD ,&nbsp;Ksenija Slankamenac MD, PhD ,&nbsp;Nicole Ochsenbein-Kölble MD ,&nbsp;Nina Kimmich MD","doi":"10.1016/j.xagr.2025.100555","DOIUrl":"10.1016/j.xagr.2025.100555","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Uterine artery pseudoaneurysm (UAP) is a rare but potentially life-threatening condition that can result in severe hemorrhage. Due to its nonspecific clinical presentation, it is often misdiagnosed, leading to delays in appropriate intervention. UAP commonly arises following uterine trauma, including cesarean section, vaginal delivery, and other gynecological procedures or pathologies, such as endometriosis. While selective arterial embolization is the preferred treatment, noninterventional management may be a viable alternative in selected cases.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Case Report&lt;/h3&gt;&lt;div&gt;We present a case of a 33-year-old woman in her first pregnancy diagnosed with UAP at 27 gestational weeks (GW). She complained about intermittent left lower abdominal pain without vaginal bleeding. Initial imaging with Doppler ultrasonography and noncontrast magnetic resonance imaging (MRI) identified a left paracervical mass consistent with a UAP. Further imaging with contrast-enhanced MRI confirmed the diagnosis and revealed thrombosis of the lesion. Given the absence of perfusion and clinical stability, a noninterventional approach was pursued. The patient remained hemodynamically stable and was discharged after 6 days of hospitalization. At 38+4 GW, she underwent a scheduled cesarean section, and both maternal and neonatal outcomes were favorable. Follow-up at 12 months postdiagnosis showed no recurrence or complications.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A systematic review was conducted, analyzing peer-reviewed studies from 1955 to 2024 in PubMed and EMBASE databases. Inclusion criteria focused on human studies reporting UAP, with data extracted on risk factors, diagnostic modalities, treatment strategies, and clinical outcomes. Statistical analyses included the Student’s &lt;em&gt;t&lt;/em&gt; test for continuous variables and the Pearson chi-square test for categorical variables.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Out of 790 initially identified articles, 131 met inclusion criteria, comprising 144 patients with uterine artery UAP. Among these, 20 patients were pregnant, and 124 were nonpregnant. Comorbidities were more common in pregnant patients (55% vs 34.7%). Prior uterine manipulation occurred in 50% of pregnant and 90.3% of nonpregnant cases, with laparotomy and cesarean sections being most frequent. Vaginal bleeding was the most common symptom in nonpregnant patients (81.5%), while pain dominated in pregnant cases (85%). Imaging primarily involved ultrasound and angiography, combined with computed tomography (CT) in nonpregnant women (70% vs 35%) and MRI in pregnancy (70% vs 11.3%). Embolization was the main treatment (90% in pregnancy, 99% in nonpregnant), with few complications and no reported deaths. Statistical analysis showed a significant association in nonpregnant patients between vaginal bleeding and the need for transfusion (&lt;em&gt;P&lt;/em&gt;&lt;.05), as well as between bleeding and smaller UAP size (24.5 vs 32.3 mm, &lt;em&gt;P&lt;/","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100555"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925596","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":"Ruptured rudimentary horn pregnancy in third trimester: a case report","authors":"Ayalkibet Alemayehu Debele MD ,&nbsp;Wondu Belayineh MD ,&nbsp;Eyerusalem Fissehatsion Dejene MD ,&nbsp;Fekade Yerakly Lucas MD ,&nbsp;Zekarias Dejene Adugna MD ,&nbsp;Teketel Tadese Geremew MD","doi":"10.1016/j.xagr.2025.100549","DOIUrl":"10.1016/j.xagr.2025.100549","url":null,"abstract":"<div><div>The rudimentary uterine horn is a Müllerian anomaly, which is characterized by a partial failure in development and fusion. Pregnancy rarely occurs in this horn, and if it does, it usually ruptures in the first or second trimester of pregnancy. It can be missed during antenatal ultrasound scanning and carries a high risk of maternal and fetal mortality. A 26-year-old gravida 2 para 1 Ethiopian woman presented with a gestational age of 29 3/7 weeks and sudden onset abdominal pain of 9 hours of duration. At presentation, the patient was in hemorrhagic shock with abdominal tenderness and signs of fluid collection, and the fetal heart rate was 124 bpm. The patient’s hemoglobin level was 9.4 g/dL. The patient underwent an emergency laparotomy for a ruptured rudimentary horn with active bleeding. Excision of the rudimentary horn was performed, and the mother was discharged with improvement. Although pregnancies in a rudimentary horn rarely progress to the third trimester of pregnancy, this condition should be suspected in patients with hemodynamic instability and abdominal pain. Excision of the rudimentary horn can prevent maternal mortality.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100549"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931776","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":"Comparing physician and artificial intelligence chatbot responses to posthysterectomy questions posted to a public social media forum","authors":"Shadae K. Beale MD ,&nbsp;Natalie Cohen MD ,&nbsp;Beatrice Secheli MD ,&nbsp;Donald McIntire PhD ,&nbsp;Kimberly A. Kho MD, MPH","doi":"10.1016/j.xagr.2025.100553","DOIUrl":"10.1016/j.xagr.2025.100553","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND&lt;/h3&gt;&lt;div&gt;Within public online forums, patients often seek reassurance and guidance from the community regarding postoperative symptoms and expectations, and when to seek medical assistance. Others are using artificial intelligence in the form of online search engines or chatbots such as ChatGPT or Perplexity. Artificial intelligence chatbot assistants have been growing in popularity; however, clinicians may be hesitant to use them because of concerns about accuracy. The online networking service for medical professionals, Doximity, has expanded its resources to include a Health Insurance Portability and Accountability Act–compliant artificial intelligence writing assistant, Doximity GPT, designed to reduce the administrative burden on clinicians. Health professionals learn using a “medical model,” which greatly differs from the “health belief model” that laypeople learn through. This mismatch in learning perspectives likely contributes to a communication mismatch even during digital clinician–patient encounters, especially in patients with limited health literacy during the perioperative period when complications may arise.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;div&gt;This study aimed to evaluate the ability of artificial intelligence chatbot assistants (Doximity GPT, Perplexity, and ChatGPT) to generate quality, accurate, and empathetic responses to postoperative patient queries that are also understandable and actionable.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN&lt;/h3&gt;&lt;div&gt;Responses to 10 postoperative queries sourced from HysterSisters, a public forum for “woman-to-woman hysterectomy support,” were generated using 3 artificial intelligence chatbot assistants (Doximity GPT, Perplexity, and ChatGPT) and a minimally invasive gynecologic surgery fellowship–trained surgeon. Ten physician evaluators compared the blinded responses for quality, accuracy, and empathy. A separate pair of physician evaluators scored the responses for understandability and actionability using the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P). The final scores were the average of both reviewers’ scores. Analysis of variance was used for pairwise comparison of the evaluator scores between sources. Lastly, the Kruskal–Wallis test was used to analyze Flesch–Kincaid scoring for readability. The Pearson chi-square test was used to demonstrate the difference in reading level among the responses for each source.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;Compared with a physician, Doximity GPT and ChatGPT were rated as more empathetic than a minimally invasive gynecologic surgeon, but quality and accuracy were similar across these sources. There was a significant difference between Perplexity and the other response sources, favoring the latter, for quality and accuracy (&lt;em&gt;P&lt;/em&gt;&lt;.001). Perplexity and the minimally invasive gynecologic surgeon ranked similarly for empathy. Reading ease was greater for the minimally invasive gynecologic surgeon re","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100553"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907101","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":"Stress and quality of life postpreterm birth during polycrises: prospective cohort study","authors":"Rima Kaddoura PhD ,&nbsp;Reine Zankar MD ,&nbsp;Hani Tamim PhD ,&nbsp;Martine El Bejjani PhD ,&nbsp;Ziyad R. Mahfoud PhD ,&nbsp;Pascale Salameh PhD ,&nbsp;Lama Charafeddine MD, FAAP","doi":"10.1016/j.xagr.2025.100557","DOIUrl":"10.1016/j.xagr.2025.100557","url":null,"abstract":"<div><h3>Background</h3><div>Preterm birth remains a leading cause of neonatal mortality globally and is worsened in crisis-affected countries like Lebanon. This study explored how social determinants of health relate to preterm birth and maternal postpartum outcomes, including quality of life (QoL), perceived stress, and social support.</div></div><div><h3>Objective</h3><div>to explore the impact of the social environment in polycrises context on preterm birth, the association between preterm birth and maternal postpartum QoL, perceived stress, and social support.</div></div><div><h3>Study Design</h3><div>A prospective cohort study was conducted in three Lebanese hospitals from September 2021 to December 2023. A total of 116 mother-infant pairs (78 full-term, 38 preterm) were recruited. Data on social determinants, perceived stress (PSS-10), social support (MSPSS), and QoL (WHOQOL-BREF) were collected at delivery and 4 to 6 months postpartum. Analyses included <em>t</em> tests, chi-square tests, and linear mixed models.</div></div><div><h3>Results</h3><div>Mothers of preterm infants had significantly higher stress (PSS-10: 19.53 vs 15.29, <em>P</em>=.011) and lower QoL scores across physical (39.16 vs 57.4, <em>P</em>&lt;.001), psychological (54.08 vs 66.91, <em>P</em>&lt;.001), and social (58.53 vs 69.56, <em>P</em>=.007) domains at delivery. At 4 to 6 months postpartum, all mothers reported declines in social support (71.8 vs 67.3, <em>P</em>=.003), social QoL (69.4 vs 61.4, <em>P</em>=.005), and environmental QoL (70 vs 64.5, <em>P</em>=.012).</div></div><div><h3>Conclusion</h3><div>This study highlights the impact of social support, stress, and QoL on preterm birth outcomes in a crisis-affected region. Mothers of preterm infants experienced higher stress and lower QoL at birth, suggesting the need for targeted interventions to support maternal mental health. Addressing these social determinants is needed for improving pregnancy outcomes, particularly in vulnerable populations facing multiple social and economic challenges.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100557"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144904032","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":"First-time presentation of acute uterine prolapse in third trimester of pregnancy: a case report","authors":"Abraham Fessehaye Sium MD,&nbsp;Amani Nureddin Abdu MD,&nbsp;Hika Hailu Kitila MD,&nbsp;Tadesse Urgie MD","doi":"10.1016/j.xagr.2025.100543","DOIUrl":"10.1016/j.xagr.2025.100543","url":null,"abstract":"<div><div>Uterine prolapse that develops before onset of pregnancy will usually resolve spontaneously by the end of the second trimester of pregnancy without further complications, whereas prolapse that develops during pregnancy is usually first noted in the third trimester of pregnancy. A 28-year-old woman, gravida 3 para 2 (both vaginal delivery), presented with a history of mass protrusion per vagina of 6 hours duration at a gestational age of 34 6/7 weeks of gestation. On physical examination, a complete prolapse of the cervix through the vagina was noted, with part of the lower uterine segment in the vaginal canal. Pelvic ultrasound confirmed the prolapse, with report of part of the lower uterine segment in the vaginal canal. With an assessment of acute uterine prolapse, the patient was placed in a moderately Trendelenburg position, and the prolapse was reduced manually. The cervix was repositioned into the vagina and packed with sterile gauze soaked in saline. Acute presentation of uterine prolapse in the third trimester of pregnancy for the first time is a very rare occurrence. If encountered, a conservative approach that aims at replacing the prolapse back to its position, allowing the cervical edema to subside, should be performed.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100543"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738963","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":"Exploratory analysis of placenta accreta spectrum content on TikTok using #placentaaccreta, #accreta, and #placentaprevia","authors":"Minhazur Sarker MD,&nbsp;Rachel Wiley MD, MPH,&nbsp;Scott Harvey MD,&nbsp;Chia-Ling Nhan-Chang MD,&nbsp;Jerasimos Ballas MD, MPH","doi":"10.1016/j.xagr.2025.100552","DOIUrl":"10.1016/j.xagr.2025.100552","url":null,"abstract":"","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100552"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144919743","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":"Socio-psychological distress, violence, and food insecurity in women undergoing gynecological examinations: insights from a cross-sectional study of an Italian Tertiary Clinic","authors":"Tina Pasciuto PhD ,&nbsp;Francesca Moro PhD ,&nbsp;Drieda Zace PhD ,&nbsp;Lidia Borzì MSc ,&nbsp;Katiuscia Patrizi MSc ,&nbsp;Roberta Di Battista MSc ,&nbsp;Francesca Ciccarone MD ,&nbsp;Floriana Mascilini PhD ,&nbsp;Elena Teodorico MD ,&nbsp;Giulia Zinicola MD ,&nbsp;Maria Luisa Di Pietro PhD ,&nbsp;Giovanni Scambia PhD ,&nbsp;Antonia Carla Testa PhD","doi":"10.1016/j.xagr.2025.100546","DOIUrl":"10.1016/j.xagr.2025.100546","url":null,"abstract":"<div><h3>Background</h3><div>The reality of gynecological patients represents a distinct subgroup of the population in which social and psychological distress can coexist alongside the burden of the disease. “Unmet social needs,” including social distress, which encompasses gender and family violence, abuse, unemployment, and food insecurity, are now widely recognized as critical determinants of health. Some studies have examined the social needs experienced by patients with gynecological disorders, but primarily in gynecologic oncology patients.</div></div><div><h3>Objective</h3><div>This study aims to assess the prevalence of socio-psychological distress, experiences of violence, and food insecurity in patients attending a tertiary outpatient gynecological clinic. Data were collected using a tailored open-ended questionnaire administered by trained volunteers.</div></div><div><h3>Study design</h3><div>This is a prospective cross-sectional study. An ad-hoc questionnaire, validated through the Delphi methodology, was administered to all women attending the Gynaecological Outpatient Clinic at Fondazione Policlinico A. Gemelli IRCCS in Rome, Italy, from March to November 2023. Their responses were analyzed focusing on self-reported socio-psychological distress, violence experienced and food insecurity. Inferential analysis was provided to evaluate the possible association with socioeconomic distress and clinical characteristics of patients. Multivariable logistic regression models for predicting outcomes were performed including those parameters that were statistically significant at univariable analysis (<em>p</em> value &lt;.05).</div></div><div><h3>Results</h3><div>A total of 408 women were included in the study. One hundred and fifty-two (37.2%) reported socio-psychological distress, 136 (33.3%) violence, and 60 (14.7%) food insecurity. Independent risk factors for socio-psychological distress included oncological conditions (OR: 3.76, 95% CI: 1.55–9.11), chronic conditions (OR: 2.22, 95% CI: 1.38–3.57), economic difficulties (OR: 3.91, 95% CI: 2.20–6.93), and experiencing violence (OR: 4.65, 95% CI: 2.83–7.65). Independent risk factors for violence were benign gynecological conditions (OR: 1.95, 95% CI: 1.02–3.74), alcohol use (OR: 1.88, 95% CI: 1.16–3.04), economic difficulties (OR: 1.72, 95% CI: 1.02–2.90), and experiencing food insecurity (OR: 1.92, 95% CI: 1.03–3.59). The only independent risk factor for food insecurity was having economic difficulties (OR: 6.01, 95% CI: 3.06–11.81).</div></div><div><h3>Conclusion</h3><div>Socio-psychological distress and experiences of violence were found to be prevalent in over one-third of the population studied. Identified risk factors include the type of gynecological condition, economic hardship, and food insecurity. These findings underscore the urgent need for the development of comprehensive social support systems to assist women with gynecological conditions. While integrated clinical and social ","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100546"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893560","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 supportive needs in pregnant women with substance use, a qualitative study","authors":"S. Heidarifard PhD ,&nbsp;M. Khoshnamrad PhD","doi":"10.1016/j.xagr.2025.100548","DOIUrl":"10.1016/j.xagr.2025.100548","url":null,"abstract":"<div><div>Pregnant women with substance use (SUD), are a vulnerable group with special reproductive health needs. The study aimed to assess the supportive needs of pregnant women with substance use. This study adopted a 3-phase qualitative methodology: (1) qualitative content analysis to identify supportive needs, (2) a 3-round Delphi process involving 20 purposively sampled experts (conducted via email over 6 months), and (3) a nominal group technique session with 10 of the original experts to prioritize critical needs. The focus was on pregnant women with substance use disorder. Five categories of needs emerged: socio-cultural support, health/financial support, consultation services, psychological needs, and access to training. Among these, education on sexual health, sexually transmitted diseases, and harm reduction principles during pregnancy scored highest (mean: 3.95). Expert consensus via the nominal group emphasized developing an educational protocol based on the Theory of Planned Behavior to address behavioral changes aligned with maternal needs. The paramount need for pregnant women with SUD is structured education on sexual health and harm reduction in pregnancy. Findings advocate for tailored, theory-based interventions to provide holistic support, potentially improving maternal and fetal outcomes.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100548"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879704","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}