Frontiers in reproductive health最新文献

{"title":"Challenges associated with sexually transmitted infection partner notification approaches in Africa: a scoping review protocol.","authors":"Noluthando Mpobole, Raikane James Seretlo, Keatlegile Moses Eskia Mabena, Hanlie Smuts, Mathildah Mpata Mokgatle","doi":"10.3389/frph.2026.1951049","DOIUrl":"10.3389/frph.2026.1951049","url":null,"abstract":"<p><strong>Background: </strong>Despite extensive prevention efforts, sexually transmitted infections (STIs) remain a major public health concern across Africa. Partner notification (PN) is an important component of STI case management that aims to identify and manage sexual partners of people diagnosed with STIs and thereby reduce onward transmission and reinfection. Previous reviews have examined PN strategies in developing countries and sub-Saharan Africa, including acceptability, efficacy, barriers and facilitators, but these reviews have focused on specific populations, outcomes or periods and have not comprehensively mapped challenges experienced by both patients and healthcare providers across African settings. This review will therefore map the nature, range and distribution of reported challenges associated with current STI PN approaches across Africa.</p><p><strong>Objective: </strong>The objective of this scoping review is to map out the challenges experienced by healthcare providers and patients with current STI PN approaches across Africa.</p><p><strong>Methods and analysis: </strong>Guided by the Joanna Briggs Institute (JBI) methodology for scoping reviews and the Population-Concept-Context(PCC) framework, a systematic search will be conducted across PubMed, Scopus, Web of Science CINAHL and African Journals Online (AJOL), supplemented by Google Scholar, and specified grey literature sources. Peer-reviewed qualitative, quantitative and mixed-methods studies published in English between 2011 and 2026 focusing on STI PN challenges in African settings will be included. Two reviewers will independently screen titles, abstracts and full texts. Two reviewers will independently screen titles, abstracts and full texts and chart data using a standardised JBI-informed charting form. Disagreements will be resolved through consensus or adjudication by a third reviewer. The results will be synthesized narratively and presented using tables and thematic maps.</p><p><strong>Discussion: </strong>By systematically mapping structural, systemic and interpersonal barriers such as stigma, fear of violence, resource constraints and linguistic limitations this review will highlight critical knowledge gaps in STI management in Africa.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1951049"},"PeriodicalIF":3.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082910","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":"Immediate initiation of oral contraceptive pills after an early pregnancy loss does not increase the risk of retained products of conception.","authors":"Leah Cooper, Radhika Sharma, Mindy B Frishman, Hanikka Muna, Danielle Jean, Yang Liu, Molly B Moravek, Samantha B Schon","doi":"10.3389/frph.2026.1918673","DOIUrl":"10.3389/frph.2026.1918673","url":null,"abstract":"<p><strong>Introduction: </strong>Retained products of conception (rPOC) are a common complication following early pregnancy loss (EPL) and may contribute to infertility and delays in subsequent fertility treatment. Oral contraceptive pills (OCPs) are frequently initiated after EPL in infertility patients to synchronize the menstrual cycle prior to fertility treatment; however, it is unknown whether immediate initiation of OCPs affects the incidence of rPOC.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study at a single academic reproductive endocrinology and infertility practice including patients who experienced EPL following embryo transfer between 2015 and 2023 and subsequently underwent office hysteroscopy (OHS). Patient demographics, infertility diagnoses, EPL management modality, and OCP initiation following resolution of EPL were collected through chart review. rPOC was diagnosed by direct visualization during OHS.</p><p><strong>Results: </strong>A total of 188 women with EPL following embryo transfer were included, of whom 42 (22.3%) were diagnosed with rPOC at the time of OHS. There were no significant differences in demographic or infertility characteristics between patients with and without rPOC. Following EPL, 52.1% of patients underwent surgical management, 31.9% expectant management, and 16.0% medical management, with no significant association between management modality and rPOC (<i>p</i> = 0.3). Fifty-five patients (29.3%) initiated OCPs following resolution of EPL. A history of uterine surgery before EPL was independently associated with rPOC. Patients who had prior uterine surgery were 2.38 times more likely to have rPOC than those who had no history of uterine surgery (aOR 2.38, 95% CI 1.08-5.73). OCP use was not associated with rPOC after adjusting for prior uterine surgery and time to OHS (aOR 1.17, 95% CI 0.54-2.47).</p><p><strong>Discussion: </strong>Immediate initiation of OCPs following EPL after embryo transfer was not associated with an increased risk of rPOC in this infertility population. These findings support the use of OCPs after EPL to facilitate fertility treatment planning, though larger prospective studies are needed to further evaluate factors associated with rPOC.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1918673"},"PeriodicalIF":3.1,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13612538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066509","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":"Magnesium sulfate for severe preeclampsia and eclampsia management at the primary healthcare level in sub-Saharan Africa: a systematic review.","authors":"Assitan Baya Sidibe, Alexandre Delamou, Fatoumata Bintou Traore, Youssouf Keita, Ben Moulaye Idriss, Aminata Cissé","doi":"10.3389/frph.2026.1911083","DOIUrl":"10.3389/frph.2026.1911083","url":null,"abstract":"<p><strong>Background: </strong>Preeclampsia and eclampsia are major causes of maternal and perinatal morbidity and mortality in low- and middle-income countries. Magnesium sulfate (MgSO₄) is the most effective intervention for eclampsia prevention and treatment. However, evidence for its use at the primary healthcare level remains limited as most studies have focused on hospital settings.</p><p><strong>Methods: </strong>This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic databases were comprehensively searched for relevant studies published between January 2003 and December 2024. MEDLINE via PubMed, Cochrane Library, African Index Medicus, and Google Scholar were comprehensively searched for relevant studies. Studies reporting the use of MgSO₄ in primary healthcare settings were included. Data were extracted using a standardized data collection form.</p><p><strong>Results: </strong>Seven studies, most of which were conducted in Nigeria, met the inclusion criteria. MgSO₄ was available in most primary healthcare facilities but remained underutilized. Task sharing with community health workers was identified as a promising strategy for improving its use. Also, shortcomings were observed in the referral and evacuation system as well as in patient monitoring mechanisms. All studies highlighted the need to strengthen the continuous and regular training and supervision of CHWs to improve early detection and appropriate management of preeclampsia cases.</p><p><strong>Conclusion: </strong>MgSO₄ administration at the primary healthcare level is a critical intervention for reducing maternal and perinatal mortality associated with preeclampsia and eclampsia. Strengthening task-sharing approaches and community-level integration may enhance health system resilience in sub-Saharan Africa.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1911083"},"PeriodicalIF":3.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042254","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":"Impact of ethanol sclerotherapy on pelvic pain and quality of life in patients with endometriomas (ESCOMA study): protocol for a randomised clinical trial.","authors":"Rodrigo Guevara-Peralta, Jose Manuel Martinez-Garcia, Carlos Ortega-Expósito, Maria Jesús Pla-Farnós, Carlos Yeste, Judit Peñafiel, Júlia Guevara-Figueras, Jordi Ponce, Amparo García-Tejedor","doi":"10.3389/frph.2026.1911200","DOIUrl":"10.3389/frph.2026.1911200","url":null,"abstract":"<p><strong>Introduction: </strong>Endometriosis is a chronic gynecological disease associated with pelvic pain, infertility, and reduced quality of life. Ovarian endometrioma is its most common manifestation. Although laparoscopic cystectomy is widely used, concerns regarding ovarian reserve have led to increasing interest in conservative approaches. Ultrasound-guided ethanol sclerotherapy (EST) has emerged as a minimally invasive alternative with potential benefits for symptom control and reproductive outcomes. The ESCOMA trial aims to evaluate the impact of EST compared with expectant management on quality of life in women with ovarian endometriomas.</p><p><strong>Methods and analysis: </strong>ESCOMA is a prospective, multicentre, randomised controlled trial comparing ultrasound-guided ethanol sclerotherapy with expectant management. A total of 288 women with ovarian endometriomas will be randomised in a 1:1 ratio. The primary outcome is change in quality of life at 6 months, assessed using the Endometriosis Health Profile-5 (EHP-5). Secondary outcomes include pain reduction, changes in pain-related biomarkers, ovarian reserve markers, cyst size reduction, reproductive outcomes, adverse events and complications, diagnostic accuracy, and healthcare costs. Analyses will be performed according to both intention-to-treat and per-protocol principles.</p><p><strong>Ethics and dissemination: </strong>The study was approved by the Clinical Research Ethics Committee of Hospital Universitari de Bellvitge (PR070/25). Written informed consent will be obtained from all participants.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov, identifier NCT06955221.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1911200"},"PeriodicalIF":3.1,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042272","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":"Ethical perspectives of fertility preservation through experts' opinions.","authors":"Silviya Aleksandrova-Yankulovska, Marcin Orzechowski, Katharina Hancke, Karin Bundschu, Florian Steger","doi":"10.3389/frph.2026.1952541","DOIUrl":"10.3389/frph.2026.1952541","url":null,"abstract":"<p><strong>Background: </strong>Fertility preservation is the process of saving or protecting a person's reproductive substance of human origin intended to be used later in that person's life. Fertility preservation technologies have benefits and risks. Among the most discussed issues is the access to these technologies and their funding. Our study aims at the identification and analysis of specific ethical challenges associated with fertility preservation through the perspective of experts in this field.</p><p><strong>Methods: </strong>Between March and July 2026, 16 qualitative interviews with experts were conducted. The interview guide consisted of 12 open-ended main questions and 5 follow-up questions. The content of the interviews was analysed using thematic analysis by Braun and Clarke.</p><p><strong>Results: </strong>Themes identified through the method of thematic analysis were: 1) autonomous decision-making; 2) benefits and risks of fertility preservation; 3) access to fertility preservation; and 4) funding. Within the themes, sub-themes could be identified. The experts supported the involvement of children in decision-making in an age-appropriate manner. Most experts did not support the allowance of postmortem reproduction, but supported information provision in this regard. Medical benefits and risks prevailed over social benefits and risks. All patients' groups, including those for non-medical indications, should have access to fertility preservation, but funding through health insurance was unanimously supported only for medical indications.</p><p><strong>Conclusion: </strong>The decisions about fertility preservation are decisions influencing the rest of the life of the patients and the fulfilment of the right to reproduction. All patient groups that can benefit from fertility preservation technologies should have access to them, including minors, healthy women, and transgender individuals. Medical indications for fertility preservation should be covered by health insurance, while the funding of non-medical indications is still debatable. The importance of informed consent for fertility preservation was underlined, particularly in paediatric cancer cases, where the involvement of children in decision-making is supported in accordance with their maturity. As successful as fertility preservation technologies might be, full, proper, and individualised information should be provided to patients to avoid the risk of false hope.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1952541"},"PeriodicalIF":3.1,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026710","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":"Isolated right fallopian tube torsion associated with hydrosalpinx and multiple uterine leiomyomas in a 50-year-old woman: a case report.","authors":"Khaled F Al-Ali, Zaid Al Ali, Dima M Alem, Ruba Abdalhadi, Yazan Dibas, Samaa' Milhem, Saadeh Jaber","doi":"10.3389/frph.2026.1904637","DOIUrl":"10.3389/frph.2026.1904637","url":null,"abstract":"<p><strong>Background: </strong>Isolated fallopian tube torsion (IFTT) is a rare gynecologic emergency that frequently presents with nonspecific symptoms and may mimic other causes of acute abdominal pain, resulting in diagnostic delay.</p><p><strong>Case presentation: </strong>A 50-year-old woman presented with a 2-day history of right lower quadrant pain without gastrointestinal, urinary, or gynecologic symptoms and was initially admitted with suspected appendicitis. Pelvic ultrasonography demonstrated right hydrosalpinx with absent Doppler flow, while contrast-enhanced computed tomography revealed a 6 cm × 2.5 cm hydrosalpinx with a possible whirlpool sign, multiple calcified uterine fibroids, and a cervical lesion; the appendix was normal. Based on the clinical and radiologic findings, right fallopian tube torsion was suspected. Owing to the presence of multiple large fibroids and concern for possible sarcomatous change, the patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Intraoperatively, a gangrenous, torsed right fallopian tube and a bulky, fibroid uterus were identified. Histopathological examination confirmed ischemic necrosis of the right fallopian tube consistent with torsion and demonstrated benign leiomyomata with hyalinization and calcification, without evidence of malignancy.</p><p><strong>Conclusion: </strong>IFTT should be considered in women presenting with acute unilateral lower abdominal pain. Early recognition and prompt surgical intervention are essential for definitive diagnosis and prevention of adverse outcomes.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1904637"},"PeriodicalIF":3.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019025","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 \"puberty deadline\": cultural constructions of maturity, anticipated shame, and child marriage as a perceived risk-mitigation strategy in rural Niger.","authors":"Jean Christophe Fotso, Aichatou Hamadou, Ferdinard Ngong, Paul Bukuluki","doi":"10.3389/frph.2026.1922270","DOIUrl":"10.3389/frph.2026.1922270","url":null,"abstract":"<p><strong>Introduction: </strong>In rural Niger, child marriage remains highly prevalent, often functioning as a mechanism of risk mitigation. This qualitative study explores the cultural and bio-social drivers of child marriage, focusing on the intersection of physical maturation, anticipatory shame, and economic vulnerability.</p><p><strong>Methods: </strong>The study drew on 53 in-depth interviews, six body mapping focus group discussions (FGDs), and 9 social norms mapping FGDs with adolescents, parents, and community leaders (n = 165) in the Maradi region.</p><p><strong>Results: </strong>We find that participants perceive the biological onset of menarche as a 'puberty deadline.' This biological trigger socially reclassifies girls from children to women perceived to be vulnerable, sparking acute parental anxiety over premarital sexuality and the stigma of out-of-wedlock pregnancy. Conversely, the reported covert use of contraceptives by some adolescent girls, sometimes with maternal complicity, serves to protect reputations while delaying marriage, highlighting complex implications for adolescent autonomy and consent.</p><p><strong>Discussion: </strong>Our findings highlight a stark gender asymmetry in the transition to adulthood and demonstrate that child marriage in this context is perceived to be driven by the dual pressures of moral safeguarding and poverty. Implications for future interventions include addressing both the gendered cultural narratives of maturity and the underlying economic desperation sustaining the practice, which may be essential for achieving lasting change.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1922270"},"PeriodicalIF":3.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992719","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":"Preoperative imaging for endometriosis awareness: an online survey study.","authors":"Bassem Gerges, Allie Eathorne, George Condous","doi":"10.3389/frph.2026.1917458","DOIUrl":"10.3389/frph.2026.1917458","url":null,"abstract":"<p><strong>Introduction: </strong>In 2024, an international consensus statement on non-invasive imaging techniques for the diagnosis of pelvic deep endometriosis was published, recommending transvaginal sonography as the first-line imaging modality because of cost, availability, and low impact on the environment. Despite the increasing body of evidence supporting the use of imaging in the preoperative diagnosis of endometriosis, there is a paucity of data to confirm patient awareness. The aim of this study was to use an online survey or questionnaire from patients to collect quantitative data regarding their awareness, exposure, and experience with preoperative imaging for the diagnosis of endometriosis.</p><p><strong>Methods: </strong>This was a cross-sectional study, based on an online, international survey completed by patients with self-reported endometriosis from multiple online endometriosis groups. The survey went live from November 2025 to March 2026 and consisted of women and gender-diverse individuals with self-reported endometriosis, with a minimum required number of 100 participants.</p><p><strong>Results: </strong>A total of 180 participants started the survey, of which 142 (78.9%) completed the exercise. The mean age of the participants was 31.6 [standard deviation (SD) 8.7] years, with a median time of endometriosis diagnosis of 2 years (interquartile range 1-5), of whom 99 (69.7%) had at least one surgery, with a mean number of surgeries of 1.8 (SD 1.2). The majority of participants were from Australia (66.2%), followed by Canada (16.9%), New Zealand (11.3%), and the United Kingdom (2.1%), and an equal number were from Brazil, India, the Philippines, and Spain (0.7% each). Overall, 53.5% of participants agreed that endometriosis can be diagnosed without surgery, while only 32.4% agreed that bowel endometriosis can be diagnosed before surgery. Of these, the percentages of participants who agreed that bowel endometriosis can be preoperatively diagnosed with ultrasound, magnetic resonance imaging, computed tomography, and colonoscopy were 32%, 35%, 15%, and 15%, respectively. The participants obtained knowledge about endometriosis investigations and treatments from various sources, including their gynecologists (71.8%), general practitioners (57%), fertility specialists (11.3%), family members (12%), friends (21.8%), social media (68.3%), and other sources (29.6%).</p><p><strong>Conclusion: </strong>There is a disparity between participant awareness in our study and the evidence in the literature regarding the availability and accuracy of preoperative imaging for the diagnosis of deep endometriosis, possibly due to the misinformation disseminated via social media<b>.</b></p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1917458"},"PeriodicalIF":3.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992739","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":"BRIDGES: a patient-centered, community-informed HIV doula program that supports infant feeding choice among Hispanic and Caribbean families: a study protocol.","authors":"Rachel Mpanu-Mpanu, Melanie Francis, Kassandra N Garcia, Lunthita M Duthely","doi":"10.3389/frph.2026.1896729","DOIUrl":"10.3389/frph.2026.1896729","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In 2023, U.S. Perinatal HIV Guidelines shifted from recommending exclusive formula feeding to endorsing shared decision-making for infant feeding among pregnant and postpartum persons with HIV (PPWH) on antiretroviral therapy (ART) with sustained viral suppression. While the risk of HIV transmission through breastfeeding is small (&lt; 1%) with sustained viral suppression, adherence protocols are complex and clinical support infrastructure remains underdeveloped. Doula care has demonstrated benefits for breastfeeding initiation, maternal anxiety reduction, and postpartum follow-up, yet no studies have examined HIV-specialized doula programs supporting infant feeding choice among non-English speaking PPWH in North America.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Using a patient-centered, community-informed framework, BRIDGES (BReast and Infant feeding Doulas to address Gaps in Education and Support) is an HIV Doula education and support program designed to improve maternal/child health outcomes and reduce perinatal transmission. The program aims to support heterogeneous infant feeding options through doula-mediated prenatal education, ART adherence support, lactation counseling, and postnatal care coordination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In collaboration with the Pediatric Community Advisory Board, South Florida Health Departments' Perinatal HIV Programs, and University of Miami (UM) Ob/Gyn, a doula-based intervention was developed for pregnant and postpartum women with HIV. The study employs a sequential mixed-methods design: Aim 1 builds the BRIDGES intervention through community engagement, embedding an Infant Feeding Choice Community Advisory Group; Aim 2 evaluates BRIDGES in a single-arm interventional study of 15 mother-baby dyads. Data collection includes sociodemographic, clinical, obstetrical, and psychosocial measures (HIV stigma, medical mistrust, resilience), along with individual and group interviews. The Consolidated Framework for Implementation Research (CFIR) guides evaluation of implementation determinants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The BRIDGES intervention pairs each mother-infant dyad with an HIV-trained doula from enrollment during pregnancy through 12 weeks postpartum. The doula supplements clinic education with prenatal education on infant feeding options (breastfeeding, formula, banked donor milk), ART adherence support, lactation counseling, and guidance on clinical monitoring protocols specific to feeding choice. Clinical monitoring protocols differentiate between breastfeeding dyads (monthly maternal viral load, infant ARV prophylaxis until weaning, enhanced infant HIV testing) and formula-feeding dyads (standard of care).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Significance: &lt;/strong&gt;BRIDGES addresses a critical gap at the intersection of evolving HIV infant feeding guidelines and doula-supported perinatal care. This intervention was shaped by a collaborative effort that ensures its cultural relevance, linguistic","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1896729"},"PeriodicalIF":3.1,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957396","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":"Trends in obesity prevalence during early pregnancy in Gran Canaria, Spain, 1993 to 2022.","authors":"Inmaculada Bautista-Castaño, Helmut Schröder, Laura Molero Sala, Alicia Inmaculada Martín Martinez, Verónica Dávila-Batista, Luis Peña Quintana, Lluis Serra-Majem","doi":"10.3389/frph.2026.1922881","DOIUrl":"10.3389/frph.2026.1922881","url":null,"abstract":"<p><strong>Introduction: </strong>The global prevalence of obesity has increasingly affected women of reproductive age, leading to several adverse outcomes during pregnancy, childbirth, and for their newborns. The objective of this study was to estimate time trends in early pregnancy among women who delivered live births in Gran Canaria (Spain) from 1993 to 2022 with stratified analysis by age, educational level, and parity.</p><p><strong>Methods: </strong>Data were obtained from 178,305 pregnant women who delivered at the Maternal & Child University Hospital of Gran Canaria (HUMIGC) between 1993 and 2022. The study period was divided into three intervals: 1993-2001, 2002-2010, and 2011-2022. Trends of early pregnancy obesity prevalence were examined globally and by educational level, age groups, and parity categories. Analysis was performed by multivariable logistic regression, adjusted for potential confounder variables.</p><p><strong>Results: </strong>The prevalence of obesity in early pregnancy increased significantly from 8.3% (95% CI 8.0-9.0) in 1993 to 22.5% (95% CI 21.0-24.0) in 2022. Multivariable logistic regression analysis adjusted for age, educational level, and parity revealed that obesity increased significantly in 2002-2010 (OR 1.73. 95% CI: 1.67-1.95) and further in 2011-2022 (OR 2.59, 95% CI 2.50-2.69) compared to 1993-2001. This upward trend was observed across all age groups, educational levels, and parity categories. Formal interaction analyses showed that the increase over time differed significantly according to age, educational level, and parity (all <i>p</i> for interaction < 0.001), with the greatest increases among women with university education and primiparous women.</p><p><strong>Conclusions: </strong>The prevalence of obesity during early pregnancy significantly increased in Gran Canaria (Spain) between 1993 and 2022. This increase was consistent across age groups, educational levels, and parity categories. Prenatal counselling should be implemented to help overweight women lose weight before pregnancy, ensuring they are fully informed about the potential risk of excess weight on pregnancy, childbirth, and neonatal outcomes.</p>","PeriodicalId":73103,"journal":{"name":"Frontiers in reproductive health","volume":"8 ","pages":"1922881"},"PeriodicalIF":3.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922000","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}