AJOG global reports最新文献

{"title":"Does women empowerment alone influence contraception utilization in Bangladesh perspective? Findings from the 2017–2018 Demographic Health Survey using a structural equation model analysis","authors":"Md. Nawal Sarwer MPH ,&nbsp;Effat Ara Jahan MSc ,&nbsp;Akibul Islam Chowdhury MSc","doi":"10.1016/j.xagr.2024.100434","DOIUrl":"10.1016/j.xagr.2024.100434","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Women empowerment is a crucial issue that is less studied as a factor of contraceptive use among married women that helps to achieve sustainable development goals.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to assess the relationship between women empowerment and contraceptive use.</div></div><div><h3>STUDY DESIGN</h3><div>This cross-sectional study used 2017–2018 Bangladesh Demographic and Health Survey data, which included 12,006 women (weighted) aged 15 to 49 years. Hierarchical logistic regression and structural equation models were used to show the relationship between women empowerment and contraceptive use.</div></div><div><h3>RESULTS</h3><div>Overall, increased use of contraception was associated with increased age, urban residence, increased wealth index, and education level of both the husband and wife. After controlling individual and locality factors, the findings from the regression model showed that women empowerment in terms of women decision-making, attitude toward violence, and social independence significantly influences contraceptive use (<em>P</em>&lt;.05). However, the structural equation model analysis revealed a negative but nonsignificant relationship between overall women empowerment and contraceptive use (β=−0.138; <em>P</em>&gt;.05).</div></div><div><h3>CONCLUSION</h3><div>This study implies that greater women empowerment may not always act as a stronger determinant of contraceptive use, and therefore, other contributing factors, such as age, education, religion, husband's participation, joined decision-making, economic status, and couple relationship, should be considered.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100434"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017184","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":"The primiparous IgA and IL-5 colostrum concentration based on maternal factor: corroborate the inflammation pathways to IgA colostrum synthesis","authors":"Kadek A. Kurniawan MD ,&nbsp;Sri Winarsih Apt., MKes ,&nbsp;Nurdiana Nurdiana MD, MKes ,&nbsp;Sri Andarini MD, MKes ,&nbsp;Wiwit Nurwidyaningtyas MBiomed","doi":"10.1016/j.xagr.2024.100436","DOIUrl":"10.1016/j.xagr.2024.100436","url":null,"abstract":"<div><h3>Background</h3><div>Immunoglobulin A (IgA) plays a crucial role in the maturation the neonatal mucosal barrier. The accumulation of IgA antibody-secreting cells (ASCs) in the lactating mammary gland facilitates the secretion of IgA antibodies into milk, which are then passively to the suckling newborn, providing transient immune protection against gastrointestinal pathogens. Physiologically, full-term infants are unable to produce IgA, required for mucosal barrier maturation for at least 10 days after birth. Prior studies declare that interleukin 5 (IL-5) responsible to encourage of IgA-producing B cells maturation during lactating periods.</div></div><div><h3>Objective</h3><div>This purpose of this study was determine IgA and IL-5 colostrum concentration based on maternal factors.</div></div><div><h3>Study design</h3><div>Ninety primiparous with full-term pregnancy and vaginal delivery were enrolled in a cross-sectional study. Colostrum samples were collected on the first day after delivery, followed by the measurement of IgA and IL-5 concentrations using ELISA. Sociodemographic and maternal factors were recorded based on participants’ self-reports using a questionnaire.</div></div><div><h3>Result</h3><div>The results showed that mean of colostrum IgA concentration in primiparous 24.9 ± 0.3 years old (95%CI: 24.3–25.6) was 1.51 ± 0.15µg/mL, while colostrum IL-5 concentration was 82.37 ± 20.2pg/mL. The results showed that IgA levels were not significantly correlated with age, education, occupation, weight, height, body mass index (BMI), fish consumption, or smoking habits but were significantly related to baby sex disappointment and weight gain during pregnancy (<em>P</em>&lt;.05). Meanwhile, the IL-5 concentration was significantly correlated with smoking habits, baby's birth weight, and maternal age.</div></div><div><h3>Conclusion</h3><div>The composition of IgA and IL-5 in breast milk is strongly associated with several maternal factors including baby sex disappointment, weight gain during pregnancy, smoking habits, baby's birth weight, and maternal age. This maternal factor corroborate the recently evidence refer to inflammatory pathways involvement in colostrum IgA synthesis.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100436"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061601","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":"A low-middle income country experience: conventional hysterectomy vs conservative placenta accreta spectrum management","authors":"M. Adya F. Dilmy MD ,&nbsp;Jenica X. Budiman BMedSci ,&nbsp;Yudianto B. Saroyo PhD ,&nbsp;Amanda Rumondang MD ,&nbsp;Yuditiya Purwosunu PhD","doi":"10.1016/j.xagr.2025.100453","DOIUrl":"10.1016/j.xagr.2025.100453","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Placenta accreta spectrum is one of the most dangerous complications of pregnancy, and its incidence has been rising in recent years. The standard management approach is an elective cesarean-hysterectomy, but it presents with its own set of risks and complications. Although conservative management options exist, there is a lack of definitive guidelines and must be considered on a case-by-case basis.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to describe and compare the outcomes (surgical duration, intraoperative blood loss volume, and maternal mortality) of patients with placenta accreta spectrum who were treated with a hysterectomy and those treated with conservative surgery in the Dr. Cipto Mangunkusumo General Hospital, a tertiary referral hospital in Indonesia.</div></div><div><h3>STUDY DESIGN</h3><div>Data from 271 patients with placenta accreta spectrum at the Dr. Cipto Mangunkusumo General Hospital that were collected over 3.5 years were taken and analyzed in this retrospective cohort study. Data collected included the patients’ age, reproductive history, placenta accreta index score, gestational age, emergency status, management method, type of hysterectomy, surgery duration, intraoperative blood loss volume, histopathologic data, and maternal mortality. The data were analyzed using the Statistical Package for Social Sciences, version 29, with statistical significance set at <em>P</em>&lt;.05. Mann-Whitney U tests, independent <em>t</em> tests, chi-square tests, and correlation tests were used where appropriate.</div></div><div><h3>RESULTS</h3><div>There were no significant differences in the demographics and reproductive history between the hysterectomy and conservative surgery groups. There was considerable difference in terms of surgical duration, intraoperative blood loss, and placenta accreta index score. The hysterectomy group had longer surgeries (median 180 minutes vs 135 minutes; <em>P</em>&lt;.01), greater blood volume lost (median 1000 mL vs 700 mL; <em>P</em>&lt;.01), and higher placenta accreta index scores (median 6.5 vs 5.5; <em>P</em>&lt;.01). The maternal mortality rate of this study was 1.1%, all of whom were patients from the hysterectomy group, but this finding was not statistically significant.</div></div><div><h3>CONCLUSION</h3><div>In this study, patients who underwent conservative surgical management for placenta accreta spectrum experienced shorter surgeries with less bleeding and no maternal death. These patients typically had lower placenta accreta index scores, which may have influenced the choice of management methods and affected surgical outcomes. Although conservative surgery is a viable option, patients and surgeons must carefully weigh the risks and benefits before deciding on a treatment approach.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100453"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551448","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":"Phlegmasia cerulea dolens as a complication of radiation therapy in endometrial cancer: a case report","authors":"Milan Ho BS ,&nbsp;Arash Fereydooni MD, MS, MHS ,&nbsp;Graeme McFarland MD ,&nbsp;Babak Litkouhi MD ,&nbsp;Amer Karam MD ,&nbsp;Edmund J. Harris Jr MD ,&nbsp;Elizabeth L. George MD, MS","doi":"10.1016/j.xagr.2025.100443","DOIUrl":"10.1016/j.xagr.2025.100443","url":null,"abstract":"<div><div>This study reports the case of a 61-year-old female patient with recurrent endometrial cancer who developed phlegmasia cerulea dolens and compartment syndrome of the right lower extremity 1 day after receiving high-dose radiation therapy. In addition, the patient had a right main pulmonary artery embolus. The patient underwent inferior vena cava filter placement, open common femoral vein thrombectomy, 4-compartment fasciotomy, and vacuum-assisted superficial groin wound closure. The patient was discharged on postoperative day 6 on rivaroxaban. Imaging at 6 months and 1 year postoperatively demonstrated a wide patency of the deep venous system in the right lower extremity, and anticoagulation was discontinued. The patient was followed up for surveillance in a gynecologic oncology clinic with no evidence of disease for 2 years, after which the patient was transferred to an outside facility. In conclusion, phlegmasia cerulea dolens can occur in the setting of immobility because of high-dose radiation therapy and in the absence of deep venous thrombosis prophylaxis. Rapid identification of phlegmasia cerulea dolens on physical examination and early vascular surgical intervention can result in favorable outcomes.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100443"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487745","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":"Assessment of maternity protection among healthcare workers in Ghana","authors":"Joycelyn Darkwah MD, MPH ,&nbsp;Augustina Koduah BPharm, MSc, PhD","doi":"10.1016/j.xagr.2025.100447","DOIUrl":"10.1016/j.xagr.2025.100447","url":null,"abstract":"<div><h3>Background</h3><div>Female workers who are pregnant or breastfeeding require adequate support to balance their roles as mothers and employees. This support comes in the form of Maternity Protection (MP). Low maternity protection among female workers is a major public health concern. Less research has been done on all the components of MP, especially among healthcare workers in Ghana.</div></div><div><h3>Objective</h3><div>The study aims to assess maternity protection as a whole (all the components of maternity protection) among female healthcare workers (HCWs) in health facilities in the Agona West District of Ghana.</div></div><div><h3>Study design</h3><div>A descriptive cross-sectional study involving 102 female workers in all the health facilities in the Agona West District of Ghana was conducted. A multistage sampling technique was employed. The International Labour Organization (ILO) standard questionnaire (adapted) was administered to assess all components of MP such as maternity leave, cash benefits, health protection at work, employment and discrimination, and childcare arrangements.</div></div><div><h3>Results</h3><div>All (100%) participants stated that they had paid maternity leave but 7.8% received less than the 12-week statutory maternity leave. 23.5% felt that their health and that of their child were at risk due to work. Regarding employment and discrimination, none of them were dismissed due to pregnancy or childbirth. However, 2 % did not get their due promotion and 12.7% stated that they received unpleasant comments related to pregnancy or birth. Concerning breastfeeding, 82.4% of all the HCWs were able to breastfeed for at least 6 months whilst among all the HCWs, 17.6% were able to breastfeed whilst at work. 25% of the HCWs were somewhat satisfied with their childcare arrangements.</div></div><div><h3>Conclusion</h3><div>Maternity Protection among female healthcare workers in health facilities in Agona West District is moderate. The roles of pregnant or nursing mothers in the workplace should be adapted to their health needs, promoting a healthy work environment. This study recommends that the heads of the health facilities and all stakeholders ensure maternity protection through education, awareness, and review of workplace policies as well as establish control measures for those who flout this policy.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100447"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419874","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":"Episiotomy and severe perineal laceration among Asian American, Native Hawaiian, and Pacific Islander nulliparous individuals in California","authors":"Tracy Chidyausiku MS ,&nbsp;Shalmali Bane PhD ,&nbsp;Meryl M. Sperling MD ,&nbsp;Elliott K. Main MD ,&nbsp;Suzan L. Carmichael PhD","doi":"10.1016/j.xagr.2025.100450","DOIUrl":"10.1016/j.xagr.2025.100450","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Asian American, Native Hawaiian, and Pacific Islander individuals have increased risks for episiotomy and severe perineal laceration during vaginal delivery. The Asian American, Native Hawaiian, and Pacific Islander population in the US is diverse yet few studies disaggregate results within specific ethnicity populations.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study investigated the variability in risks for episiotomy and severe perineal laceration among 16 disaggregated Asian American, Native Hawaiian, and Pacific Islander groups, compared to Non-Hispanic White nulliparous individuals, and assessed what factors may explain the variability in risk.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study design&lt;/h3&gt;&lt;div&gt;Birth and fetal death certificate files linked to hospital discharge records were used to identify nulliparous, term, singleton, vertex vaginal deliveries among California births, 2007 to 2020. Poisson regression models were used to examine risks of episiotomy and severe perineal laceration among 16 Asian American, Native Hawaiian, and Pacific Islander ethnicity subgroups compared with Non-Hispanic White individuals. Sequential adjustment was utilized to assess if maternal social, health-related, and delivery-related factors may explain the variability in risk for episiotomy and severe perineal laceration.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among the 224,964 Asian American, Native Hawaiian, and Pacific Islander individuals in this study cohort, the overall prevalence of episiotomy was 18.5% (N = 41,559) and prevalence of severe perineal laceration was 8.9% (N = 20,013); the prevalence of both outcomes declined during the study period. Within subgroups, prevalence of episiotomy ranged from 9.8% among Other-Pacific Islander individuals to 24.5% among Korean individuals. Prevalence of severe perineal laceration ranged from 3.4% in Guamanian individuals to 15.2% in Indian individuals. In fully adjusted models, risk ratios were greater than 1.0 (with confidence intervals excluding 1.0) for 6 subgroups for episiotomy and 9 subgroups for severe perineal laceration, compared to Non-Hispanic White individuals. After adjustment, Korean individuals were at highest risk of episiotomy (adjusted risk ratio 1.80 [95% CI 1.75, 1.85]), and Indian individuals were at highest risk of severe perineal laceration (adjusted risk ratio 2.14 [95% CI 2.07, 2.21]). Adjustment for social factors (nativity; education; payer) tended to attenuate risk ratios; subsequent adjustment for maternal health and delivery-related factors including maternal age, height, pre-pregnancy body mass index, hypertension, diabetes, gestational weight gain, fetal stress/incomplete fetal head rotation (occiput transverse or posterior), large infant size or shoulder dystocia, and forceps/vacuum did not impact risk ratios substantially.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Prevalence and risks of episiotomy and severe perineal laceration varied widely among Asian American, N","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100450"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487740","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":"Gestational weight gain and increased risk of cesarean delivery across body mass index categories","authors":"Pearl A. McElfish PhD ,&nbsp;Britni L. Ayers PhD ,&nbsp;Nicola L. Hawley PhD ,&nbsp;Aaron Caldwell PhD ,&nbsp;Austin Porter DrPh ,&nbsp;Michael D. Macechko MD ,&nbsp;Donya Watson MD ,&nbsp;Jennifer A. Callaghan-Koru PhD ,&nbsp;James P. Selig PhD ,&nbsp;Jennifer A. Andersen PhD ,&nbsp;Nirvana Manning MD ,&nbsp;Lanita White PharmD ,&nbsp;Enrique Gomez-Pomar MD ,&nbsp;Clare C. Brown PhD","doi":"10.1016/j.xagr.2025.100445","DOIUrl":"10.1016/j.xagr.2025.100445","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Unnecessary cesarean delivery can have negative implications for both mothers and infants. In the United States, the proportion of women undergoing cesarean delivery exceeds the acceptable World Health Organization proportion. Reducing cesarean deliveries is a national goal of Centers for Disease Control and Prevention Healthy People 2030, the American College of Obstetricians and Gynecologists, and the Alliance for Innovation on Maternal Health.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to examine if excessive gestational weight gain is associated with increased risk of cesarean delivery across multiple body mass index categories.</div></div><div><h3>STUDY DESIGN</h3><div>Analysis was conducted using vital records data from the National Center for Health Statistics birth records. Only low-risk births were included (singleton, term-gestation [≥37 weeks], cephalic presentation, and first birth to exclude women who had a prior cesarean delivery). We used the rate of gestational weight gain (lb/wk) measured as both a categorical and continuous variable. These results were confirmed by a sensitivity analysis using total gestational weight gain (lb).</div></div><div><h3>RESULTS</h3><div>Regardless of prepregnancy body mass index category, women with excessive gestational weight gain had a higher risk of cesarean delivery. Among women with a healthy prepregnancy body mass index, the risk of cesarean delivery decreased with appropriate weight gain, suggesting a potential protective effect of moderate weight gain for individuals with a healthy prepregnancy body mass index. However, weight gain beyond the appropriate level increased the risk of cesarean delivery. For women with overweight or obese prepregnancy body mass index, any increase in gestational weight gain was associated with a higher cesarean delivery risk.</div></div><div><h3>CONCLUSION</h3><div>This study found a strong association between an excessive rate of gestational weight gain and the risk of cesarean delivery, regardless of prepregnancy body mass index, suggesting the need for continued efforts to reduce excessive gestational weight gain across populations.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100445"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377935","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":"Nongravid incarcerated uterus with leiomyomas treated with uterine artery embolization and hysterectomy: a case report","authors":"Katherine Kuo MD ,&nbsp;Signy Holmes MD, FRCPC ,&nbsp;Jen Tomlinson RN ,&nbsp;Peter Klippenstein MD, FRCSC ,&nbsp;Elly Trepman MD ,&nbsp;John M. Embil MD, FRCPC","doi":"10.1016/j.xagr.2025.100449","DOIUrl":"10.1016/j.xagr.2025.100449","url":null,"abstract":"<div><h3>Background</h3><div>The incarcerated uterus in the nongravid patient is rare, and usually is associated with uterine leiomyomas. Leiomyomas may be treated with uterine artery embolization, but the use of embolization has been reportedly rarely in treating nongravid uterine incarceration.</div></div><div><h3>Case</h3><div>A 50-year-old gravida 2 para 2 woman presented with acute abdominal and flank pain and urinary retention. Her medical history included uterine leiomyomas and nephrolithiasis. Physical examination showed an enlarged uterus (size, 22 weeks). Magnetic resonance imaging showed an incarcerated uterus, complete bladder outlet obstruction, uterine retroflexion and enlargement, and leiomyomas. She was treated with an indwelling Foley catheter, preoperative uterine artery embolization, and total abdominal hysterectomy.</div></div><div><h3>Conclusion</h3><div>Preoperative uterine artery embolization may be a useful adjunct to hysterectomy in the treatment of the nongravid incarcerated uterus associated with leiomyomas in women who have completed family planning.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100449"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601226","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":"Effects of the sampling time on the vaginal microbiota in healthy pregnant women: a prospective observational study","authors":"Hiroshi Mori MD ,&nbsp;Eiji Shibata PhD ,&nbsp;Emi Kondo MD ,&nbsp;Mitsumasa Saito PhD ,&nbsp;Kiyoshi Yoshino PhD ,&nbsp;Kazumasa Fukuda PhD","doi":"10.1016/j.xagr.2025.100460","DOIUrl":"10.1016/j.xagr.2025.100460","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Studies using 16S rRNA gene sequencing have extensively examined the vaginal microbiota changes of pregnant women. However, no study has examined these changes considering the time of day at which vaginal fluid samples were collected from near-term pregnant women.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To describe the vaginal microbiota of Japanese near-term pregnant women with normal pregnancy outcomes and potential vaginal microbiota changes from wake-up to bedtime.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study design&lt;/h3&gt;&lt;div&gt;In this prospective observational study, vaginal swab specimens were obtained from healthy near-term pregnant women twice on the same day, after waking up and before bedtime. All specimens were examined for total bacterial cell count per gram of vaginal fluid, Nugent score, pH, and vaginal microbiota analysis using 16S rRNA gene sequencing. Initially, the wake-up and bedtime samples of all participants were analyzed at the genus level using next-generation sequencing. Subsequently, all samples were analyzed at the genus and species levels using Sanger sequencing.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Sixteen pregnant women were enrolled in this study. The median age of the participants was 32.5 years, and the median gestational age was 38 weeks. Median bacterial counts in vaginal fluids at wake-up and bedtime were 3.9 × 10&lt;sup&gt;9&lt;/sup&gt;/g and 3.6 × 10&lt;sup&gt;9&lt;/sup&gt;/g, respectively, with no significant difference. Vaginal microbiota analyses based on 16S rRNA genes showed that the vaginal microbiota in pregnant women with no abnormalities during pregnancy was limited to a single flora dominated by &lt;em&gt;Lactobacillus&lt;/em&gt; spp. and included pregnant women with highly diverse vaginal microbiota. Genus-level analysis using next-generation sequencing showed that the vaginal microbiota differed between wake-up and bedtime in more diverse samples but not in less diverse samples. However, these differences were small compared to individual differences. The dominant genera in each sample had similar relative abundances in both wake-up and bedtime samples. However, the non-dominant genus &lt;em&gt;Streptococcus&lt;/em&gt; spp. was significantly more frequently detected in bedtime samples. In species-level analyses, the proportions of dominant and non-dominant species showed little change between wake-up and bedtime.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The vaginal microbiota of pregnant women with normal pregnancy outcomes was not necessarily dominated by &lt;em&gt;Lactobacillus&lt;/em&gt; spp. Further studies are required to define the vaginal microbiota in healthy pregnant women. When vaginal fluid samples were collected from the same pregnant women at wake-up and bedtime under the same conditions, the differences between wake-up and bedtime samples were greater for women with high diversity of the vaginal microbiota than for those with low diversity. However, these differences were not sufficiently large to exceed individual differences, and almo","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100460"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551447","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":"Barriers and facilitators to telemedicine contraception among patients that speak Spanish: a qualitative study","authors":"Marielle E. Meurice MD, MAS ,&nbsp;Gennifer Kully Msc ,&nbsp;Sarah Averbach MD, MAS ,&nbsp;Antoinette Marengo MD ,&nbsp;Jesse Nodora DrPH ,&nbsp;Maricela Cervantes MPH ,&nbsp;Sheila K. Mody MD, MPH","doi":"10.1016/j.xagr.2024.100428","DOIUrl":"10.1016/j.xagr.2024.100428","url":null,"abstract":"<div><h3>Background</h3><div>Telemedicine contraception services have increased since the COVID-19 pandemic. There may be unique equity implications and language barriers for patients who speak Spanish.</div></div><div><h3>Objective</h3><div>To identify the barriers and facilitators of telemedicine for contraception care among patients who speak Spanish using a community-based participatory research approach.</div></div><div><h3>Study Design</h3><div>The study was designed and conducted in consultation with a community advisory board. We interviewed 20 patients after telemedicine and in-person contraception visits conducted in Spanish at Planned Parenthood of the Pacific Southwest in Southern California between April 2022 and May 2023. Telemedicine visits were conducted by audio only. Two coders analyzed the data using thematic analysis.</div></div><div><h3>Results</h3><div>The average age of the participants was 32.5 years old (range 19–45). Most participants had some college education (13/20, 65.0%) and public insurance (18/20, 90.0%). Most chose a short-acting contraceptive method (11/20, 55.0%). Five key themes were identified. (1) Participants reported less comfort with video technology and a preference to not be seen during the appointment, therefore preferring audio-only for telemedicine visits. (2) Participants did not report difficulty with Spanish interpreters using telemedicine. (3) Telemedicine has conveniences related to time, work, childcare, and transportation but may have inconveniences related to method receipt. (4) Preference for physical exam and preventative care and familiarity with the in-clinic model motivated people who sought in-person care rather than technology barriers with telemedicine. (5) There is trust in the privacy and confidentiality of the visits, but privacy at home for the individual may impact choice for in-person care.</div></div><div><h3>Conclusion</h3><div>Among patients who speak Spanish, telemedicine contraception care was acceptable and had many conveniences. Many patients who speak Spanish preferred audio-only for telemedicine contraception visits. Use of interpreters and technology were not perceived barriers to care.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100428"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048800","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}