Frontiers in reproductive health最新文献

{"title":"End-user research into understanding perceptions of and reactions to a microarray patch (MAP) for contraception among women in Ghana, Kenya and Uganda.","authors":"Moushira El-Sahn, Rose Elliott, Mona El-Sahn, Jeff Lucas, Trisha Wood Santos","doi":"10.3389/frph.2024.1351692","DOIUrl":"10.3389/frph.2024.1351692","url":null,"abstract":"<p><strong>Introduction: </strong>Many organizations are developing new contraceptive products and approaches that promote self-care including a microarray patch (MAP) that has the potential for self-administration with appropriate training. We studied women's perceptions of the MAP technology with the primary goal of providing feedback on product attributes to inform early technical design decisions regarding various MAP contraceptive products in development by MAP developers.</p><p><strong>Methods: </strong>Our study consisted of a qualitative phase with in-person In-Depth Interviews (IDIs) with a total of 60 women of reproductive age (WRA) and quantitative surveys, via face-to-face computer-assisted interviews of a total of 927 women in Ghana, Kenya and Uganda. Women's perceptions on 12 attributes of the MAP were assessed through written descriptions, a profile, and visual stimuli such as graphics and images.</p><p><strong>Results: </strong>Overall, the most widely preferred attribute set included: a hand-applied MAP, utilizing one circular patch, with a sticky backing, no larger than 2 cm diameter in size, applied by self, to the arm, offering sensory feedback (clicking sound and/or color change signals) to confirm enough pressure, successful application and removal, lasting 6 months with up to 12 months return to natural state of fertility. There is space to allow for variation in MAP designs (including the use of an applicator or provider administered MAP) if the design promotes and reflects the needs and expectations of users and providers.</p><p><strong>Discussion: </strong>The contraceptive MAP had a high and broad level of appeal amongst all groups of women who participated in the study and has a strong value proposition around important contraceptive needs such as ease of use, convenience, and discretion.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1351692"},"PeriodicalIF":0.0,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10954799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186466","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":"Fear, misinformation, and pharmaceutical messianism in the promotion of compounded bioidentical hormone therapy.","authors":"Robert P Kauffman, Eric J MacLaughlin, Lindsay A Courtney, David D Vineyard","doi":"10.3389/frph.2024.1378644","DOIUrl":"10.3389/frph.2024.1378644","url":null,"abstract":"<p><p>Compounded bioidentical hormone therapy (cBHT) for menopausal symptoms maintains popularity in western countries despite the availability of hormone products in different formulations and dosages produced by pharmaceutical companies with federal oversight. Akin to many populist therapeutic trends in the history of medicine, cBHT advocates tend to capitalize on consumer fears about existing FDA-approved hormone treatments. Unsubstantiated, exaggerated, or outright false claims are commonplace in promoting cBHT. Given these elements, the basic elements of pharmaceutical messianism continue to drive the cBHT movement.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1378644"},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10937438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133410","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":"Preterm birth and stillbirth during COVID-19 pandemic in Bihor County/Romania.","authors":"Radu Galis, Paula Trif, Diana Mudura, Romina Murvai, Lucia Georgeta Daina, Florin Szasz, Rodica Negrini, Adrian Hatos, Beáta Fatime Gyarmati, Mandy C Daly, Jan Mazela, Boris W Kramer","doi":"10.3389/frph.2024.1286496","DOIUrl":"10.3389/frph.2024.1286496","url":null,"abstract":"<p><strong>Background: </strong>International studies have reported conflicting data about the effects of COVID-19 pandemic policy measures on maternal and neonatal health. A major impact was reported on stillbirth and prematurity. The published literature suggests that the economic setting influenced the effects of imposed mitigation measures with a more severe effect in low-income countries.</p><p><strong>Objectives: </strong>Our objective is to compare pregnancy outcomes at the only tertiary Maternity Hospital in Bihor County-Romania before and during the COVID-19 pandemic. This study aims to observe and document differences in perinatal outcomes across these periods, without inferring direct causation related to the pandemic or its associated restrictions.</p><p><strong>Materials and methods: </strong>We used data from the registries of Public Health Services Bihor to conduct a retrospective cohort analysis of preterm births and stillbirths during the COVID-19 pandemic in Bihor County, Romania. Pregnancy outcomes were compared between the pandemic period (March 2020-February 2022) to the corresponding historical pre-COVID-19 period (March 2018-February 2020). Maternal socio-demographic variables and neonatal characteristics of these periods were also examined.</p><p><strong>Results: </strong>The COVID-19 pandemic period was associated with an increase in the stillbirth rate (RR: 1.53, 95% CI, 1.05-2.23). Preterm birth was significantly impacted during this period and showed changes when analyzing gestational age (RR: 0.88, 95% CI, 0.79-0.96) or birth weight (RR: 0.91, 95% CI, 0.82-1.00). The main cause of stillbirth was intrauterine asphyxia due to placental causes (67.6%) or cord pathology (12.6%), the most frequently encountered maternal pathology was cardiovascular (28.3%) or infectious (21.7%). Our study revealed no significant changes in terms of maternal and neonatal characteristics during the two-year pandemic period.</p><p><strong>Conclusions: </strong>Lockdown restrictions in Bihor County, Romania were associated with an increase in stillbirths, whilst preterm birth rate decreased. This raises concerns about whether pandemic policy measures may have led to a failure in identifying and offering proper care for pregnant women who were more likely to experience an antepartum loss. Further studies across the globe are needed in order to integrate comparable data that will help develop adequate protocols and policies for protecting maternal and child health during the next pandemic that will follow.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1286496"},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10937441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133411","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":"Editorial: Multipurpose prevention technologies for HIV, STIs and pregnancies.","authors":"Barbara A Friedland, Andrea Ries Thurman, Harriet Nuwagaba-Biribonwoha, R Karl Malcolm","doi":"10.3389/frph.2024.1384153","DOIUrl":"10.3389/frph.2024.1384153","url":null,"abstract":"","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1384153"},"PeriodicalIF":2.3,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10927752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140112343","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":"Estimating the costs and perceived benefits of oral pre-exposure prophylaxis (PrEP) delivery in ten counties of Kenya: a costing and a contingent valuation study.","authors":"Steven Forsythe, Urbanus Kioko, Guy Mahiane, Robert Glaubius, Abednego Musau, Anthony Gichangi, Jason Reed, Daniel Were","doi":"10.3389/frph.2024.1278764","DOIUrl":"10.3389/frph.2024.1278764","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Kenya included oral PrEP in the national guidelines as part of combination HIV prevention, and subsequently began providing PrEP to individuals who are at elevated risk of HIV infection in 2017. However, as scale-up continued, there was a recognized gap in knowledge on the cost of delivering oral PrEP. This gap limited the ability of the Government of Kenya to budget for its PrEP scale-up and to evaluate PrEP relative to other HIV prevention strategies. The following study calculated the actual costs of oral PrEP scale-up as it was being delivered in ten counties in Kenya. This costing also allowed for a comparison of various models of service delivery in different geographic regions from the perspective of service providers in Kenya. In addition, the analysis was also conducted to understand factors that indicate why some individuals place a greater value on PrEP than others, using a contingent valuation technique.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data collection was completed between November 2017 and September 2018. Costing data was collected from 44 Kenyan health facilities, consisting of 23 public facilities, 5 private facilities and 16 drop-in centers (DICEs) through a cross-sectional survey in ten counties. Financial and programmatic data were collected from financial and asset records and through interviewer administered questionnaires. The costs associated with PrEP provision were calculated using an ingredients-based costing approach which involved identification and costing of all the economic inputs (both direct and indirect) used in PrEP service delivery. In addition, a contingent valuation study was conducted at the same 44 facilities to understand factors that reveal why some individuals place a greater value on PrEP than others. Interviews were conducted with 2,258 individuals (1,940 current PrEP clients and 318 non-PrEP clients). A contingent valuation method using a \"payment card approach\" was used to determine the maximum willingness to pay (WTP) of respondents regarding obtaining access to oral PrEP services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The weighted cost of providing PrEP was $253 per person year, ranging from $217 at health centers to $283 at dispensaries. Drop-in centers (DICEs), which served about two-thirds of the client volume at surveyed facilities, had a unit cost of $276. The unit cost was highest for facilities targeting MSM ($355), while it was lowest for those targeting FSW ($248). The unit cost for facilities targeting AGYW was $323 per person year. The largest percentage of costs were attributable to personnel (58.5%), followed by the cost of drugs, which represented 25% of all costs. The median WTP for PrEP was $2 per month (mean was $4.07 per month). This covers only one-third of the monthly cost of the medication (approximately $6 per month) and less than 10% of the full cost of delivering PrEP ($21 per month). A sizable proportion of current clients (27%) were unwilling to pa","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1278764"},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10920246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095291","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":"Bacterial vaginosis testing gaps for transmasculine patients may exacerbate health disparities.","authors":"Hale M Thompson, Laura K Rusie, John A Schneider, Supriya D Mehta","doi":"10.3389/frph.2024.1344111","DOIUrl":"10.3389/frph.2024.1344111","url":null,"abstract":"<p><strong>Introduction: </strong>Bacterial vaginosis (BV) is associated with non-optimal changes in the vaginal microbiome and increased susceptibility to STIs and HIV in cisgender women. Much less is known about the sexual health of transmasculine people and susceptibility to BV, STIs, and HIV. This study's objective was to assess BV testing and outcomes of transmasculine and cisgender women patient populations at a large, LGBTQ + federally qualified health center.</p><p><strong>Methods: </strong>Retrospective electronic health record data were extracted for eligible patients having at least one primary care visit between January 1, 2021, and December 31, 2021. Transmasculine patients were limited to those with a testosterone prescription in 2021. We conducted log binomial regression analysis to determine the probability of receiving a BV test based on gender identity, adjusting for sociodemographic characteristics.</p><p><strong>Results: </strong>During 2021, 4,903 cisgender women patients and 1,867 transmasculine patients had at least one primary care visit. Compared to cisgender women, transmasculine patients were disproportionately young, White, queer, privately insured, living outside Chicago, and had a lower rate of BV testing (1.9% v. 17.3%, <i>p</i> < 0.001). Controlling for sociodemographics, transmasculine patients were less likely to receive a BV test [Prevalence Ratio = 0.19 (95% CI 0.13-0.27)].</p><p><strong>Discussion: </strong>The low rate of BV testing among transmasculine patients may contribute to disparities in reproductive health outcomes. Prospective community- and provider-engaged research is needed to better understand the multifactorial determinants for sexual healthcare and gender-affirming care for transmasculine patients. In particular, the impact of exogenous testosterone on the vaginal microbiome should also be determined.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1344111"},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051183","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":"Key programmatic and policy considerations for introducing multipurpose prevention (MPT) methods: reflections from healthcare providers and key stakeholders in South Africa.","authors":"Alison Kutywayo, Paballo Mataboge, Nqaba Mthimkhulu, Catherine E Martin, Lorrein S Muhwava, Mbali Mazibuko, Nthabiseng Makalela, Khanyiswa Kwatsha, Vusile Butler, Saiqa Mullick","doi":"10.3389/frph.2024.1249750","DOIUrl":"10.3389/frph.2024.1249750","url":null,"abstract":"<p><strong>Introduction: </strong>Multipurpose prevention technologies (MPTs) simultaneously prevent HIV, other sexually transmitted infections, and/or unintended pregnancy. Key gatekeepers, [healthcare providers (HCPs) and key stakeholders] require proactive engagement before product implementation. This manuscript identifies HCP demand creation strategies, key stakeholder considerations for the adoption of MPTs in South Africa.</p><p><strong>Methods: </strong>Formative research was conducted in three districts in three South African provinces (July to November 2022). Nurses initiating oral PrEP at facility and mobile study sites participated in 4-hour participatory workshops, exploring HIV prevention, including MPTs, demand creation strategies, and preferred MPTs training packages. Activities were observed, transcribed, and thematically analysed. Five online in-depth interviews (IDIs) with Key informants (KIs) (National/district programme implementers and technical leads) and one in person, exploring key programmatic and policy considerations for MPT adoption. IDIs were approximately 40 min long, audio recorded, transcribed, and thematically analysed.</p><p><strong>Results: </strong>Twenty-one Professional Nurses completed workshops: 19 female. Six IDIs were conducted with 4 Facility Managers, 1 NDoH representative and 1 DoH Provincial Deputy Director. All participants were females, aged 30-60+ years with >10 years' in SRH/HIV policy/advocacy/research. Community conversations and information at the clinic were the best MPT demand creation methods among HCPs. KIs identified five considerations for future MPT implementation: HCP training; demand creation and messaging; existing PrEP policy amendments; preparing users for additional choice; and sustaining MPT provision.</p><p><strong>Conclusion: </strong>Contraceptive implant and oral PrEP implementation lessons learned should be proactively considered when preparing for MPT introduction. HCP training and demand creation are of particular importance before MPT introduction.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"6 ","pages":"1249750"},"PeriodicalIF":2.3,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10912167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041020","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":"Innovations in monoclonal antibody-based multipurpose prevention technology (MPT) for the prevention of sexually transmitted infections and unintended pregnancy","authors":"S. Dohadwala, Matthew T. Geib, J. Politch, Deborah J. Anderson","doi":"10.3389/frph.2023.1337479","DOIUrl":"https://doi.org/10.3389/frph.2023.1337479","url":null,"abstract":"Monoclonal antibodies (mAbs) are currently being produced for a number of clinical applications including contraception and the prevention of sexually transmitted infections (STIs). Combinations of contraceptive and anti-STI mAbs, including antibodies against HIV-1 and HSV-2, provide a powerful and flexible approach for highly potent and specific multipurpose prevention technology (MPT) products with desirable efficacy, safety and pharmacokinetic profiles. MAbs can be administered systemically by injection, or mucosally via topical products (e.g., films, gels, rings) which can be tailored for vaginal, penile or rectal administration to address the needs of different populations. The MPT field has faced challenges with safety, efficacy, production and cost. Here, we review the state-of-the-art of mAb MPTs that tackle these challenges with innovative strategies in mAb engineering, manufacturing, and delivery that could usher in a new generation of safe, efficacious, cost-effective, and scalable mAb MPTs.","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"58 27","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139441813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of daily oral PrEP use during pregnancy on bone mineral density among adolescent girls and young women in Uganda","authors":"Kidist Zewdie, F. Kiweewa, Timothy Ssebuliba, Susan A. Morrison, Timothy R Muwonge, Jade Boyer, Felix Bambia, Josephine Badaru, Gabrielle Stein, K. Mugwanya, Christina Wyatt, Michael T. Yin, A. Mujugira, Renee Heffron","doi":"10.3389/frph.2023.1240990","DOIUrl":"https://doi.org/10.3389/frph.2023.1240990","url":null,"abstract":"Oral pre-exposure prophylaxis (PrEP) is recommended during pregnancy for at-risk cisgender women. Pregnancy is known to impede bone growth and tenofovir-based PrEP may also yield detrimental changes to bone health. Thus, we evaluated the effect of PrEP use during pregnancy on bone mineral density (BMD).We used data from a cohort of women who were sexually active, HIV-negative, ages 16–25 years, initiating DMPA or choosing condoms for contraception and enrolled in the Kampala Women's Bone Study. Women were followed quarterly with rapid testing for HIV and pregnancy, PrEP dispensation, and adherence counseling. Those who became pregnant were counseled on PrEP use during pregnancy per national guidelines. BMD of the neck of the hip, total hip, and lumbar spine was measured using dual-energy x-ray absorptiometry at baseline and annually. We compared the mean percent change in BMD from baseline to month 24.Among 499 women enrolled in the study, 105 pregnancies occurred in 90 women. At enrollment, the median age was 20 years (IQR: 19–21) and 89% initiated PrEP. During pregnancy, 67% of women continued using PrEP and PrEP was dispensed in 64% of visits. BMD declined significantly in women using PrEP during pregnancy compared to women who were not pregnant nor used PrEP: relative BMD change was −2.26% (95% CI: −4.63 to 0.11, p = 0.06) in the femoral neck, −2.57% (95% CI: −4.48 to −0.66, p = 0.01) in total hip, −3.06% (95% CI: −5.49 to −0.63, p = 0.001) lumbar spine. There was no significant difference in BMD loss when comparing PrEP-exposed pregnant women to pregnant women who never used PrEP. Women who became pregnant were less likely to continue PrEP at subsequent study visits than women who did not become pregnant (adjOR: 0.25, 95% CI: 0.16–0.37, p < 0.001). Based on pill counts, there was a 62% reduction in the odds of high PrEP adherence during pregnancy (adjOR = 0.38, 95% CI: 0.27–0.58, p < 0.001).Women who used PrEP during pregnancy experienced a similar reduction in BMD as pregnant women with no PrEP exposure, indicating that BMD loss in PrEP-using pregnant women is largely driven by pregnancy and not PrEP.","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"27 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139446907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and ethnic disparities in preterm birth: a mediation analysis incorporating mixtures of polybrominated diphenyl ethers","authors":"Zifan Wang, Cuilin Zhang, Paige L. Williams, A. Bellavia, Blair J. Wylie, Kurunthachalam Kannan, Michael S. Bloom, Kelly J. Hunt, T. James-Todd","doi":"10.3389/frph.2023.1285444","DOIUrl":"https://doi.org/10.3389/frph.2023.1285444","url":null,"abstract":"Racial and ethnic disparities persist in preterm birth (PTB) and gestational age (GA) at delivery in the United States. It remains unclear whether exposure to environmental chemicals contributes to these disparities.We applied recent methodologies incorporating environmental mixtures as mediators in causal mediation analysis to examine whether racial and ethnic disparities in GA at delivery and PTB may be partially explained by exposures to polybrominated diphenyl ethers (PBDEs), a class of chemicals used as flame retardants in the United States.Data from a multiracial/ethnic US cohort of 2008 individuals with low-risk singleton pregnancies were utilized, with plasma PBDE concentrations measured during early pregnancy. We performed mediation analyses incorporating three forms of mediators: (1) reducing all PBDEs to a weighted index, (2) selecting a PBDE congener, or (3) including all congeners simultaneously as multiple mediators, to evaluate whether PBDEs may contribute to the racial and ethnic disparities in PTB and GA at delivery, adjusted for potential confounders.Among the 2008 participants, 552 self-identified as non-Hispanic White, 504 self-identified as non-Hispanic Black, 568 self-identified as Hispanic, and 384 self-identified as Asian/Pacific Islander. The non-Hispanic Black individuals had the highest mean ∑PBDEs, the shortest mean GA at delivery, and the highest rate of PTB. Overall, the difference in GA at delivery comparing non-Hispanic Black to non-Hispanic White women was −0.30 (95% CI: −0.54, −0.05) weeks. This disparity reduced to −0.23 (95% CI: −0.49, 0.02) and −0.18 (95% CI: −0.46, 0.10) weeks if fixing everyone's weighted index of PBDEs to the median and the 25th percentile levels, respectively. The proportion of disparity mediated by the weighted index of PBDEs was 11.8%. No statistically significant mediation was found for PTB, other forms of mediator(s), or other racial and ethnic groups.PBDE mixtures may partially mediate the Black vs. White disparity in GA at delivery. While further validations are needed, lowering the PBDEs at the population level might help reduce this disparity.","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"28 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139445128","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}