Frontiers in global women's health最新文献

{"title":"Determinants of complete antenatal care in Sub-Saharan Africa: a multilevel analysis of Demographic and Health Surveys from 28 countries.","authors":"Hamse Adam Abdi, Osman Mohmed Osman, Abdulkadir Mohamed Nuh, Hamse Arab Ali, Abdisalam Hassan Muse","doi":"10.3389/fgwh.2026.1845317","DOIUrl":"10.3389/fgwh.2026.1845317","url":null,"abstract":"<p><strong>Background: </strong>Antenatal care (ANC) quality is assessed by the number of recommended ANC services a woman receives during pregnancy, including blood pressure checks, urine and blood sampling, and administration of iron supplements. The World Health Organization recommends that, to make ANC services an effective preventive measure, the content and quality of care should be routinely monitored.</p><p><strong>Methods: </strong>A total of 394,067 women who gave birth 5 years before the survey were included. We used Stata version 17 for data management and analysis. A multilevel logistic regression model was fitted. Finally, the adjusted odds ratios (aOR) with 95% confidence intervals (CIs) are reported. Statistical significance was defined as <i>P</i>-value < 0.05.</p><p><strong>Results: </strong>Complete ANC was significantly higher among women with primary (aOR 1.63, 95% CI 1.59-1.66), secondary (aOR 2.31, 95% CI 2.26-2.37), or higher education (aOR 2.99, 95% CI 2.84-3.15); among those living in poorer (aOR 1.05, 95% CI 1.03-1.08), richer (aOR 1.04, 95% CI 1.01-1.07), or the richest households (aOR 1.14, 95% CI 1.10-1.18), and among women who wanted later pregnancies (aOR 1.25, 95% CI 1.23-1.28). It was lower among women with unwanted pregnancies (aOR 0.54, 95% CI 0.53-0.56), those who were working (aOR 0.90, 95% CI 0.89-0.92), those exposed to media (aOR 0.97, 95% CI 0.95-0.99), those living in female-headed households (aOR 0.96, 95% CI 0.94-0.98), and among all ever-married women (married aOR 0.67, 95% CI 0.63-0.71; cohabiting aOR 0.68, 95% CI 0.64-0.72; widowed aOR 0.38, 95% CI 0.33-0.43; divorced aOR 0.66, 95% CI 0.60-0.74; separated aOR 0.63, 95% CI 0.57-0.68).</p><p><strong>Conclusion: </strong>This study demonstrates that fewer than 2 in 10 women in Sub-Saharan Africa receive all recommended antenatal care services, indicating low coverage. The key determinants of complete antenatal care were identified, including household wealth, maternal education, pregnancy intention, marital status, media exposure, sex of the household head, and maternal employment status.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1845317"},"PeriodicalIF":2.4,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129435","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":"Preconception care knowledge, attitudes, and practices among women attending a private women's hospital in Riyadh, Saudi Arabia: a cross-sectional study.","authors":"Rola E Alhabbash, Aiman Y Alwadi, Sadeq B Abu-Dawas, Abdullah Binsaeedu, Beenish Maqsud, Sally Yahya, Fouad F Jabri, Mohammad H Rajab, Noara K Alhusseini","doi":"10.3389/fgwh.2026.1947977","DOIUrl":"10.3389/fgwh.2026.1947977","url":null,"abstract":"<p><strong>Introduction: </strong>Preconception care (PCC) is an important preventive strategy for improving maternal and fetal outcomes by addressing modifiable health risks before conception, yet its uptake remains limited in Saudi Arabia and evidence from private healthcare settings is scarce. This study assessed PCC knowledge, attitudes, and practices among women attending a private women's hospital in Riyadh, identified perceived barriers to PCC utilization, and examined factors associated with these outcomes.</p><p><strong>Methods: </strong>A cross-sectional questionnaire study incorporating one open-ended question on barriers was conducted among 203 women aged 18-45 years attending outpatient clinics at a private women's hospital in Riyadh during March 2025. Participants were recruited by convenience sampling and completed a structured Arabic questionnaire adapted from a previously published instrument, expert-reviewed and pilot-tested, with acceptable internal consistency for the attitude and practice scales (Cronbach's alpha 0.727 and 0.862). Scores were dichotomized using a modified Bloom's cut-off, with sensitivity analyses at alternative thresholds. Associations were assessed using chi-square or Fisher's exact tests and Firth penalized logistic regression.</p><p><strong>Results: </strong>Knowledge was high, with participants answering 92.3% of items correctly, and attitudes were predominantly favorable, with 89.2% scoring at or above the neutral midpoint. Practice was low, and 56.2% reported no preconception preparation. Knowledge and practice were not associated (<i>r</i> = -0.001), and no sociodemographic characteristic was associated with either preconception preparation or attitude. The most frequently reported barriers were lack of awareness of available services (46%), financial constraints (25%), difficulty of access (25%), and unplanned pregnancy (14%).</p><p><strong>Discussion: </strong>Favorable knowledge and attitudes were not accompanied by preventive action, and the barriers women described were predominantly structural rather than cognitive. These findings identify potentially important targets in this setting, particularly the visibility, affordability, and routine offering of preconception services. As the study was conducted in a single private facility using convenience sampling, multicenter and population-based studies are needed to establish wider applicability.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1947977"},"PeriodicalIF":2.4,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139584","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":"Bridging gaps in perinatal mental health services for socioeconomically disadvantaged women.","authors":"Lem Ngongalah Udeozor, Catherine El-Zerbi, Josephine Wildman, Malcolm Moffat, Judith Rankin","doi":"10.3389/fgwh.2026.1850520","DOIUrl":"10.3389/fgwh.2026.1850520","url":null,"abstract":"<p><strong>Introduction: </strong>Perinatal mental health (PMH) is a critical aspect of maternal and child wellbeing, yet many women, particularly those from socioeconomically disadvantaged backgrounds, face significant barriers in accessing timely and appropriate support. While national policies have aimed to improve PMH services, disparities in awareness, accessibility, and engagement persist. This study explored the challenges and facilitators to PMH service access in the North East and North Cumbria (NENC) region in England, with a focus on identifying actions to improve accessibility.</p><p><strong>Methods: </strong>A two-phase qualitative study was conducted with 43 participants. Phase 1 involved semi-structured interviews with service providers from healthcare, voluntary, and community sectors who support women experiencing socioeconomic disadvantage (<i>n</i> = 23). Phase 2 comprised interviews with women from diverse, socioeconomically disadvantaged backgrounds who had experienced PMH challenges (<i>n</i> = 20). Data were analysed thematically and subsequently mapped to Levesque's conceptual framework of healthcare access, to examine individual and system-level factors influencing access to and engagement with PMH services.</p><p><strong>Results: </strong>Findings highlight multiple barriers to accessing PMH care, including the lack of routine mental health discussions in antenatal care, limited visibility of services, cultural stigma, and structural challenges such as service fragmentation and system distrust. Women from disadvantaged backgrounds often faced additional barriers due to digital exclusion, language difficulties, and lack of childcare. Participants identified six key actions to improve access: embedding PMH discussions into routine maternity care, enhancing service visibility through targeted outreach, expanding flexible service models, strengthening cultural competence, building trust through community-based models, and improving coordination and referral pathways between PMH support and existing healthcare and social services.</p><p><strong>Discussion: </strong>Addressing barriers to PMH access requires a multi-level approach that prioritises proactive service integration, workforce capacity building, and community-led engagement strategies. Strengthening service coordination and ensuring culturally responsive and flexible care models are critical steps toward improving equity in PMH support.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1850520"},"PeriodicalIF":2.4,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139603","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":"Climate change and vertically transmissible infections in maternal and neonatal populations: a systematic review.","authors":"Kimberly Sarah Mc Alpine, Tim Groteclaes, Danielle Travill, Margaret Brennan, Natasha Lalloo, Ruvimbo Forget, Carla Devantier-Du Plessis, Lebohang Radebe, Nicholas Brian Brink, Ashraf Coovadia, Matthew Francis Chersich, Darshnika Pemi Lakhoo","doi":"10.3389/fgwh.2026.1931882","DOIUrl":"10.3389/fgwh.2026.1931882","url":null,"abstract":"<p><strong>Background: </strong>Climate change influences infectious disease dynamics and disrupts maternal and neonatal health services, both of which are pathways through which the risk of vertically transmissible infections may increase.</p><p><strong>Methods: </strong>We systematically reviewed evidence on the association between climate-related environmental exposures and infection-related outcomes relevant to vertical transmission in pregnant or intrapartum women, neonates, and infants. Screening, extraction, and risk-of-bias assessment were performed independently in duplicate. Owing to substantial heterogeneity, findings were synthesised narratively. GRADE scoring was used to assess certainty of evidence.</p><p><strong>Results: </strong>Of 4,579 records identified, 42 full texts were reviewed and 6 studies included. Studies examined drought/famine, temperature, humidity, and climate zone in relation to HIV, group B streptococcus (GBS), varicella-zoster virus (VZV), and bacterial meningitis. No study reported vertical transmission as an outcome. Higher temperature and humidity were associated with increased maternal GBS colonisation. Three studies suggested cooler and/or drier conditions were associated with increased VZV transmission or earlier serological acquisition. One study found drought-associated famine was linked to increased HIV prevalence in pregnant women in rural Malawi. Certainty of evidence was very low across outcome groupings.</p><p><strong>Conclusions: </strong>This review found evidence suggesting climate-related exposures may be associated with infections relevant to vertical transmission through pathogen-specific biological pathways, broader social disruption, and deprivation. There is currently insufficient evidence to determine the impact of climate change on vertical transmission or related outcomes. Closing this gap should be a priority for research and climate adaptation in maternal and neonatal health.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251124435, PROSPERO CRD420251124435.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1931882"},"PeriodicalIF":2.4,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139644","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 associated with prior pregnancy loss among multigravid women: a retrospective machine learning analysis from an African population cohort.","authors":"Patricia Nabisubi, Timothy Mwanje Kintu, Mugume Twinamatsiko Atwine, James Bumba, Lawrence Muwonge, Herbert Agasi, Davis Kiberu, Julius Okwir, Fredrick Elishama Kakembo, Daudi Jjingo, Annettee Nakimuli, Ronald Galiwango","doi":"10.3389/fgwh.2026.1803064","DOIUrl":"https://doi.org/10.3389/fgwh.2026.1803064","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy loss remains a significant challenge in obstetric care, with traditional risk assessment methods, such as clinical history and radiological investigations, often lacking precision in predicting outcomes. This study applied machine learning (ML) to develop a robust model for identifying factors associated with pregnancy loss, with the goal of highlighting candidate predictors for further investigation and validation in future studies in African populations.</p><p><strong>Methods: </strong>The study utilized sociodemographic, clinical and laboratory variables collected at baseline from an ongoing cohort study titled \"Future maternal cardiovascular health after pre-eclampsia in an indigenous African population\". A total of 1,017 pregnant women attending Mulago National Referral Hospital in Kampala, Uganda were enrolled between 2019 and 2021. However, the outcome question was not administered to women on their first pregnancy, limiting the modeling population to multigravid women (<i>n</i> = 655). Advanced ML tools in R and Python were employed to process the de-identified data, including rigorous data cleaning, feature selection, and handling of missing values. Several ML classifiers were trained and evaluated using cross-validation techniques and the training-test split approach, with performance assessed using Matthew's Correlation Coefficient (MCC), precision, recall and F1 score.</p><p><strong>Results: </strong>Random Forest achieved the highest discrimination (MCC 0.36, 95% CI 0.25-0.47; ROC-AUC 0.74, 95% CI 0.63-0.83), followed closely by CatBoost (MCC 0.35, 95% CI 0.18-0.46; ROC-AUC 0.71, 95% CI 0.61-0.77); confidence intervals for the two ensemble models overlapped substantially. Both outperformed logistic regression (MCC 0.22, 95% CI 0.08-0.35). Across both tree-based models and both SHAP and permutation-based importance methods, the number of pregnancies carried past seven months, maternal age, and maternal education ranked as the leading correlates. Subgroup analysis showed broadly consistent discrimination across reliable age, education, and maternal tribe.</p><p><strong>Conclusion: </strong>A few sociodemographic and obstetric history factors are statistically associated with a documented history of pregnancy loss among multigravid women in this Ugandan cohort. Because the outcome reflects reproductive history rather than the result of an observed pregnancy, these findings should be read as hypothesis-generating groundwork for future prospective, externally validated risk-prediction research rather than as a clinical tool for identifying women at risk of a future miscarriage.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1803064"},"PeriodicalIF":2.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119405","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":"Systematic review protocol on COVID-19 vaccine hesitancy among lactating people.","authors":"Ephraim Senkyire, Gloria Senkyire, Ernestina Asiedua, Victor Tawose-Adebayo, Jude Kyeremeh Ameyaw, Rullmann Twi Owusu, Emmanuel Lamptey, Alex Asamoah, Magdalena Ohaja","doi":"10.3389/fgwh.2026.1828078","DOIUrl":"https://doi.org/10.3389/fgwh.2026.1828078","url":null,"abstract":"<p><strong>Background: </strong>Lactating people experiencing SARS-CoV-2 infection encounter physical, emotional, and psychosocial challenges during the postpartum period compared to the general population. Despite the importance of COVID-19 vaccination globally, campaigns aimed at vaccinating at-risk populations, including pregnant and lactating people (PLP), have faced challenges, leading to a low uptake among PLP. The objectives of this study are to discover lactating people's perceptions toward COVID-19 vaccination uptake and to explore facilitators and barriers that inform their COVID-19 vaccination decision process.</p><p><strong>Methods: </strong>The search will be carried out using the MEDLINE (PubMed), CINAHL, Embase and Scopus databases. The search will utilise Medical Subject Headings (MeSH) terms and keywords to optimise results. The MeSH terms used will include 'breastfeeding OR lactation', 'COVID-19 vaccine', and 'vaccination hesitancy', along with various iterations of these keywords. Boolean operators 'AND' and 'OR' will be applied to expand the search scope. The search criteria will be limited to recent articles published between 2020 and 2026, in English, and with available abstracts. Two reviewers will independently screen titles/abstracts and full texts, while two reviewers will extract data. Study selection will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol guidelines, and study quality will be evaluated using the Appraisal Tool for Cross-sectional Studies (AXIS), JBI qualitative checklist and MMAT.</p><p><strong>Result: </strong>Data will be analysed thematically following the approach outlined by Braun & Clarke (2006), presenting findings as a narrative summary.</p><p><strong>Conclusion: </strong>This review will help to design clear communication and targeted campaigns, building trust in vaccine safety and effectiveness.</p><p><strong>Ethics and dissemination: </strong>No formal ethical approval is necessary since this study does not involve the collection of primary data. The findings will be shared via a peer-reviewed journal article and presented at conferences.<b>Clinical Trial registration number:</b> International Prospective Register for Systematic Reviews (PROSPERO) number CRD42024568930 (Version 1.5).</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1828078"},"PeriodicalIF":2.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119475","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":"Emergency cesarean delivery followed by extended left hepatectomy and right hepatic hemangioma enucleation for giant hepatic hemangioma with intratumoral hemorrhage in late pregnancy: a case report.","authors":"Yuting Xiao, Honghui Zhang, Weiming Yi, Chao Guo, Ting Dai, Chuang Peng, Xinli Zhang, Dan Liu","doi":"10.3389/fgwh.2026.1899670","DOIUrl":"https://doi.org/10.3389/fgwh.2026.1899670","url":null,"abstract":"<p><p>Management of giant hepatic hemangioma (HH) complicated by intratumoral hemorrhage in late pregnancy is rarely reported and remains particularly challenging because maternal hemorrhagic compromise and fetal safety must be addressed simultaneously. We report the case of a 36-year-old gravida 2 para 1 woman at 33 weeks and 5 days of gestation who was admitted after a heterogeneous abdominal mass was detected on routine prenatal ultrasonography. Contrast-enhanced computed tomography (CT) demonstrated a giant lesion in the left hepatic lobe that was considered most consistent with HH complicated by intratumoral hemorrhage and an additional hemangioma in the right hepatic lobe, and laboratory testing revealed severe anemia and hypoalbuminemia. After blood transfusion, albumin supplementation, and multidisciplinary evaluation, the patient underwent emergency cesarean delivery followed by extended left hepatectomy and enucleation of the right hepatic hemangioma. Both the mother and the neonate recovered uneventfully, and no significant abnormalities were noted during 1 month of follow-up. This case highlights that in late pregnancy complicated by hemorrhagic giant HH, early recognition, rapid multidisciplinary decision-making, and timely combined obstetric and hepatic intervention may be lifesaving and can achieve favorable maternal and neonatal outcomes.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1899670"},"PeriodicalIF":2.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119339","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":"Determinants of maternal health service utilisation among refugee women in Krisan and Ampain camps, Ghana: <i>a cross-sectional analysis</i>.","authors":"Linus Baatiema, John Kuumuori Ganle, Francis Appiah, Daprim Samual Ogaji","doi":"10.3389/fgwh.2026.1807016","DOIUrl":"10.3389/fgwh.2026.1807016","url":null,"abstract":"<p><strong>Background: </strong>Maternal healthcare utilization among refugee populations remains a major public health concern due to intersecting social, structural, and health system barriers. Guided by Andersen's Healthcare Utilization Theory (1995), this study examined the determinants of antenatal care, skilled delivery, and postnatal care among refugee women in Ghana.</p><p><strong>Methods: </strong>A cross-sectional analytical study was conducted among 410 refugee women aged 15-49 years residing in the Krisan and Ampain refugee camps in the Western Region of Ghana. Eligible women who had experienced a pregnancy within the preceding two years were recruited using a census approach. Data were collected using a structured interviewer-administered questionnaire. Because the prevalence of ANC attendance (≥4 visits) was low, Firth's penalized likelihood logistic regression was used to examine factors associated with ANC utilization. For skilled delivery and PNC utilization, conventional multivariable logistic regression was used. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported, and statistical significance was assessed at <i>p</i> < 0.05. Camp location was included as a fixed effect in all models. Multilevel modeling was not employed as only two camps were included, which is insufficient for reliable random effects estimation.</p><p><strong>Results: </strong>The majority of refugee women attended fewer than four ANC visits (93.9%), while 72.4% delivered with skilled birth attendants and only 31.0% received postnatal care. ANC utilization was significantly higher among women residing in Krisan Camp (AOR = 9.54; 95% CI: 1.68-54.30) and those receiving transport support (AOR = 4.31; 95% CI: 1.12-16.58). Income was not significantly associated with ANC attendance, with women earning GHS 100-499 (AOR = 0.06; 95% CI: 0.00-1.00) and ≥ GHS 500 (AOR = 0.03; 95% CI: 0.00-1.05) having lower odds of ANC attendance. Trustful social networks were paradoxically associated with lower ANC utilization (AOR = 0.32; 95% CI: 0.11-0.96). Skilled delivery was associated with education, with secondary or higher education linked to lower odds (AOR = 0.56; 95% CI: 0.31-0.99), while media exposure showed a marginal positive effect. Postnatl utilization was higher among Muslim women (AOR = 2.02; 95% CI: 1.15-3.55) and lower among married women (AOR = 0.62; 95% CI: 0.39-0.98).</p><p><strong>Conclusions: </strong>Maternal healthcare utilization among refugee women in Ghana is influenced by complex interactions between social support, access-related factors, and individual characteristics. Interventions that strengthen social networks, improve transport and service accessibility, and address contextual barriers within refugee camps are critical to improving maternal health outcomes.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1807016"},"PeriodicalIF":2.4,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076987","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":"Contraceptive ever-use among women of reproductive age in Northern Ghana: a comparative analysis of logistic regression, LASSO penalised regression, and random forest machine learning approaches.","authors":"Joseph Lasong, Mavis Kala, Torjim Salifu, Yula Salifu","doi":"10.3389/fgwh.2026.1857008","DOIUrl":"10.3389/fgwh.2026.1857008","url":null,"abstract":"<p><strong>Background: </strong>Contraceptive uptake in Northern Ghana remains low despite high awareness, suggesting barriers not fully captured by additive models. This study compared logistic regression, LASSO, and Random Forest to predict contraceptive ever-use and identify determinants among women in Tamale Metropolis.</p><p><strong>Methods: </strong>A facility-based cross-sectional survey (January-April 2023) included 414 women aged 15-49 from three public health facilities. Outcome: contraceptive ever-use. Twelve predictors included knowledge/attitude scores, wealth tertile, education, parity, marital status, occupation, age, cultural barriers, health worker attitudes, and information source. Model discrimination was assessed via AUC with 95% CIs; LASSO used 10-fold cross-validation (<i>λ</i>.min=0.012); Random Forest used 500 trees.</p><p><strong>Results: </strong>Random Forest achieved highest discrimination (AUC=0.865, 95% CI:0.83-0.90), outperforming logistic regression (AUC=0.727) and LASSO (AUC=0.723) (both <i>p</i> < 0.001); logistic and LASSO did not differ (<i>p</i> = 0.91). Logistic regression identified five independent predictors: positive attitudes (AOR=1.53), education above primary (AOR=2.72), parity (AOR=2.95), health worker as information source (AOR=2.07), and richest wealth tertile inversely associated (AOR=0.49). Knowledge was non-significant in regression but ranked second in Random Forest importance, suggesting non-linear/interaction effects. LASSO retained nine predictors, dropping cultural barriers, health worker attitudes, and age.</p><p><strong>Conclusions: </strong>Random Forest provided better discrimination and may complement regression for prediction, though regression remains essential for interpretable effect estimates. Attitude change, education, and counselling quality are priority targets. The inverse wealth association warrants qualitative investigation, as polygyny, religiosity, and partner dynamics were unmeasured.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1857008"},"PeriodicalIF":2.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042095","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 study on the association between different delivery modes and pelvic floor muscle strength in women during early postpartum period.","authors":"Huanyu Lin, Xuhong Lu, Shu Yu, Min Yu","doi":"10.3389/fgwh.2026.1835125","DOIUrl":"10.3389/fgwh.2026.1835125","url":null,"abstract":"<p><strong>Background/objectives: </strong>Pelvic floor dysfunction (PFD) arises from factors such as degeneration and trauma, leading to weakened pelvic floor fascia, ligaments, perineum, adjacent muscles, and other supporting structures in women. Clinically, PFD manifests as stress urinary incontinence (SUI), pelvic organ prolapse (POP), and abnormal pelvic floor muscle strength, substantially impairing women's health. This study investigated the association between pelvic floor electromyography results in postpartum women at 6-8 weeks after delivery and various pregnancy- and childbirth-related factors, with the aim of identifying determinants of impaired pelvic floor function during the early postpartum period.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 1,154 postpartum women who delivered at the Obstetrics Department of Zhongshan Hospital, Dalian University, and underwent pelvic floor electromyography 6-8 weeks postpartum. Participants were classified into the vaginal delivery group (<i>n</i> = 802) and the cesarean section group (<i>n</i> = 352) based on delivery mode. The analysis examined differences in early postpartum pelvic floor muscle strength between the two delivery modes and identified factors influencing pelvic floor muscle strength in each group.</p><p><strong>Results: </strong>Electrical activity of pelvic floor muscles in both the fast- and slow-twitch phases was lower in the vaginal delivery group compared with the cesarean section group, whereas resting-phase values before and after contraction were higher in the cesarean section group. In the vaginal delivery group, independent risk factors for early postpartum pelvic floor muscle strength impairment included pregnancy weight gain > 16 kg, second-stage labor duration ≥ 2 h, advanced maternal age at first birth, episiotomy, perineal laceration, and gestational hypertension. In the cesarean section group, pregnancy weight gain ≥ 11.5 kg, pre-pregnancy BMI > 24 kg/m², gestational hypertension, premature rupture of membranes, preeclampsia, history of uterine fibroids, and full-term delivery were identified as independent risk factors.</p><p><strong>Conclusions: </strong>Both delivery modes are associated with changes in early-postpartum pelvic-floor muscle electromyographic activity. Altered EMG suggestive of impaired muscle activation is observed more prominently among women after vaginal delivery, while greater changes in resting pelvic-floor muscle tone are noted in the cesarean-delivery group. Cesarean delivery, therefore, does not eliminate the risk of impaired pelvic-floor muscle function or the development of PFD.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"7 ","pages":"1835125"},"PeriodicalIF":2.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032139","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}