Women's health (London, England)最新文献

{"title":"Number of significant life events and perinatal depression in a diverse rural population: A brief report of a cross-sectional study.","authors":"Marcia Williams, Eli Iacob, Ryoko Kausler, Sara E Simonsen, Tumilara Aderibigbe, Gwen Latendresse","doi":"10.1177/17455057251338368","DOIUrl":"10.1177/17455057251338368","url":null,"abstract":"<p><strong>Background: </strong>Significant life events (SLEs) correlate with perinatal depression (PD) risk; however, little is known about this association in rural populations.</p><p><strong>Objectives: </strong>Using the Neuman systems model, we hypothesized that individuals with higher SLEs would have higher PD risk, and we evaluated this association with data collected from six of Utah's diverse rural health districts.</p><p><strong>Design/methods: </strong>This cross-sectional study included pregnant and postpartum individuals visiting six rural public health clinics who completed screening with the Edinburgh Postnatal Depression Scale (EPDS) and an 8-item SLE assessment in Spanish or English. Multinomial logistic regression assessed the association between SLEs (0, 1, and ⩾2) and PD risk status (EPDS ⩾9).</p><p><strong>Results: </strong>Data from 4245 screening surveys identified 2 primary racial groups: white (79.8%) and American Indian/Alaska Native (7.6%), with 20.2% of individuals identifying as Hispanic. Overall, 49.4% of individuals reported one SLE and 10.5% reported two or more SLEs. Significant predictors for PD risk included 1 SLE (OR = 1.84, 95% CI [1.56, 2.15]) or ⩾2 SLEs (5.18, 95% CI [4.31, 6.23]), regardless of racial/ethnic background.</p><p><strong>Conclusion: </strong>Screening for PD risk in a rural population should include an assessment of SLEs, given the relationship between the two. Improving culturally appropriate local resources to support individuals and their families during the childbearing year should be considered, particularly for those experiencing SLEs.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251338368"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082448","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":"Predictors of postpartum depression among new mothers in Kumasi, Ghana: A multicenter study using Bayesian analysis.","authors":"Joyce Emakayor Bening, Felix Darko, Richard Anterkyi, Vera Korkor Narh, Nana Yaa Agyeman Prempeh, Nityanand Jain, Albert Lawrence Kwansa, Ernest Kissi Kontor, Michael Ntim","doi":"10.1177/17455057251343953","DOIUrl":"10.1177/17455057251343953","url":null,"abstract":"<p><strong>Background: </strong>Postpartum depression is a significant public health challenge. Understanding the predictors of postpartum depression can inform targeted interventions and support systems for new mothers.</p><p><strong>Objectives: </strong>To identify and quantify sociodemographic and obstetric predictors of postpartum depression among mothers in Kumasi, Ghana.</p><p><strong>Design: </strong>A cross-sectional multicenter prospective study.</p><p><strong>Methods: </strong>A total of 502 postpartum mothers from five hospitals were included. Bayesian logistic regression analysis was used to assess model uncertainty and complex interactions between sociodemographic, economic, and obstetric factors on postpartum depression.</p><p><strong>Results: </strong>The pooled prevalence of postpartum depression was 25% (range 13% to 31%). Education attainment [coefficient = -0.43, 95% credible interval: -0.57 to -0.29, (adjusted odds ratio (aOR) = 0.65] and economic support from multiple earning members (coefficient = -0.28, 95% credible interval: -0.33 to -0.22, aOR = 0.75) substantially reduced the likelihood of postpartum depression. Being a single mother (coefficient = 0.34, 95% credible interval: 0.24 to 0.44, aOR = 1.40) increased the risk of postpartum depression. Planned pregnancies (coefficient = -0.25, 95% credible interval: -0.28 to -0.21, aOR = 0.78), doing physical exercise (coefficient = -0.26, 95% credible interval: -0.30 to -0.23, aOR = 0.77), and exclusive breastfeeding (coefficient = -0.23, 95% credible interval: -0.28 to -0.19, aOR = 0.79) were protective factors for postpartum depression. On the other hand, cesarean sections (coefficient = 0.34, 95% credible interval: 0.24 to 0.43, aOR = 1.40) and spontaneous vaginal deliveries (coefficient = 0.56, 95% credible interval: 0.47 to 0.65, aOR = 1.75) increased the risk of postpartum depression.</p><p><strong>Conclusion: </strong>Our findings emphasize the importance of identifying modifiable predictors of postpartum depression, including sociodemographic, economic, and obstetrical factors, in Kumasi, Ghana. Interventions addressing these factors, such as financial support programs, maternal education, and physician training, may significantly reduce the regional burden. Policies tailored to low-resource contexts and exhibiting local cultural sensitivity are needed for enhancing maternal-child health outcomes in Ghana and comparable regions.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251343953"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236201","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":"Reproductive health crisis amidst a natural disaster in Pakistan: A call to action.","authors":"Summaiyya Waseem, Syed Hassan Ahmed, Khabab Abbasher Hussien Mohamed Ahmed, Taha Gul Shaikh, Irfan Ullah","doi":"10.1177/17455057251344725","DOIUrl":"10.1177/17455057251344725","url":null,"abstract":"<p><p>In 2022, Pakistan and the South Asian region experienced unprecedented natural disasters. The country was devastated by severe floods caused by unusually high monsoon rains and river overflows. The Pakistani government reported that at least 80 districts nationwide were impacted, leading to the loss of one million homes, over 1000 fatalities, and 1600 injuries. The floods left no one unaffected, but vulnerable groups, such as pregnant women and adolescent girls, suffered the most. The United Nations Population Fund estimates that at least 650,000 pregnant women were trapped following the flood crisis, while 73,000 women required urgent obstetric treatment due to impending deliveries. The United Nations Population Fund responded by distributing 7411 newborn baby kits, 8311 menstruation kits, and 6412 clean delivery kits on an emergency basis. In response to the crisis, global leaders convened at the 76th World Health Assembly in Geneva, committing to enhancing healthcare resilience. These commitments present a critical opportunity for Pakistan to strengthen its reproductive healthcare system, improve disaster preparedness, and integrate climate adaptation policies into its health sector. Furthermore, in October 2022, Pakistan announced its National Adaptation Plan to address climate change and mitigate the impact of future disasters. Given the devastating effects of the floods on maternal and reproductive health, immediate and sustained action is required to fortify Pakistan's healthcare infrastructure, enhance emergency response measures, and ensure reproductive health services are accessible to all affected communities.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251344725"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236202","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":"Exploring engagement patterns within a mobile health intervention for women at risk of gestational diabetes.","authors":"Signe B Bendsen, Timothy C Skinner, Sharleen L O'Reilly, Elena Rey Velasco, Mathias S Heltberg, Ditte H Laursen","doi":"10.1177/17455057251327510","DOIUrl":"10.1177/17455057251327510","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus poses a significant global health concern during pregnancy, with behaviour change interventions offering effective risk reduction.</p><p><strong>Objectives: </strong>Understanding diverse engagement patterns of pregnant women within mobile health (mHealth) interventions is vital for personalised healthcare. Tailoring interventions based on participant engagement types can enhance program effectiveness. This study aimed to explore engagement patterns among pregnant women at risk of gestational diabetes using the Liva app.</p><p><strong>Design: </strong>This retrospective study serves as a secondary analysis of a randomised controlled trial, focusing on engagement patterns among participants in the intervention arm who received digital health coaching. The intervention group comprised participants enrolled in the Liva app, receiving mHealth lifestyle coaching. Our analysis concentrated on app usage data from 328 participants within the intervention group during the first phase of the study.</p><p><strong>Methods: </strong>Principal component analysis reduced data to two dimensions, revealing principal components (PCs). A Gaussian mixture model clustered participants into distinct engagement patterns.</p><p><strong>Results: </strong>Analysis of data from 328 pregnant women using the Liva app identified 3 distinct engagement clusters: Cluster 1, \"Averagers\"; Cluster 2, \"Goalers\"; and Cluster 3, \"Immersers.\" These clusters correlated with two PCs. \"Averagers\" engaged moderately with both \"Coach Features\" and \"Goal Features.\" \"Goalers\" predominantly used \"Goal Features,\" while \"Immersers\" engaged with both \"Coach Features\" and \"Goal Features.\" Notably, 82% of participants fell into the \"Averagers\" category.</p><p><strong>Conclusion: </strong>This study reveals that individuals, despite similar program participation under uniform conditions, engage with the program differently. Understanding these differences is essential to provide personalised support during pregnancy and has implications for tailored medicine, digital health, and intervention development. Further research is needed to validate these findings across diverse healthcare settings, exploring engagement patterns throughout different pregnancy phases and their impact on health outcomes.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"21 ","pages":"17455057251327510"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227915","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":"Using mHealth to reduce disparities in Black maternal health: Perspectives from Black rural postpartum mothers.","authors":"Natalie Hernandez-Green, Morgan V Davis, Oluyemi Farinu, Kaitlyn Hernandez-Spalding, Kennedy Lewis, Merna S Beshara, Sherilyn Francis, LeThenia Joy Baker, Sherrell Byrd, Andrea Parker, Rasheeta Chandler","doi":"10.1177/17455057241239769","DOIUrl":"10.1177/17455057241239769","url":null,"abstract":"<p><strong>Background: </strong>Racial disparities are evident in maternal morbidity and mortality rates globally. Black women are more likely to die from pregnancy and childbirth than any other race or ethnicity. This leaves one of the largest gaps in women's health to date.</p><p><strong>Objectives: </strong>mHealth interventions that connect with women soon after discharge may assist in individualizing and formalizing support for mothers in the early postpartum period. To aid in developing an mHealth application, Black postpartum mothers' perspectives were examined.</p><p><strong>Design: </strong>Utilizing the Sojourner Syndrome Framework and Maternal Mortality & Morbidity Measurement Framework, group interview discussion guides were developed to examine the facilitators and barriers of postpartum transitional care for rural Black women living in the United States to inform the development of a mobile health application.</p><p><strong>Methods: </strong>In this study, seven group interviews were held with Black mothers, their support persons, and healthcare providers in rural Georgia to aid in the development of the Prevent Maternal Mortality Using Mobile Technology (PM³) mobile health (mHealth) application. Group interviews included questions about (1) post-birth experiences; (2) specific needs (e.g. clinical, social support, social services, etc.) in the postpartum period; (3) perspectives on current hospital discharge processes and information; (4) lived experiences with racism, classism, and/or gender discrimination; and (5) desired features and characteristics for the mobile app development.</p><p><strong>Results: </strong>Fourteen out of the 78 screened participants were eligible and completed the group interview. Major discussion themes included: accessibility to healthcare and resources due to rurality, issues surrounding race and perceived racism, mental and emotional well-being in the postpartum period, and perspectives on the PM³ mobile application.</p><p><strong>Conclusion: </strong>Participants emphasized the challenges that postpartum Black women face in relation to accessibility, racism and discrimination, and mental health. The women favored a culturally relevant mHealth tool and highlighted the need to tailor the application to address disparities.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"20 ","pages":"17455057241239769"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11113071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077405","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 chronic pelvic pain in women with endometriosis: A national study on clinical and sociodemographic characteristics, lifestyles, quality of life, and perceptions of quality of care, during the COVID-19 pandemic.","authors":"Vincenza Cofini, Mario Muselli, Emiliano Petrucci, Chiara Lolli, Erika Pelaccia, Maurizio Guido, Franco Marinangeli, Leila Fabiani, Stefano Necozione","doi":"10.1177/17455057241227361","DOIUrl":"10.1177/17455057241227361","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is a persistent inflammatory condition that affects women of reproductive age and causes pelvic pain. Chronic pelvic pain is a chronic regional pain syndrome involving the pelvic area.</p><p><strong>Objectives: </strong>This survey aimed to characterize the clinical and sociodemographic characteristics, lifestyles, quality of life, and perceptions of quality of care in women with endometriosis who reported chronic pelvic pain during the Covid pandemic.</p><p><strong>Design: </strong>We conducted a cross-sectional survey among the Italian population from July to September 2021.</p><p><strong>Methods: </strong>Snowball sampling was used to interview a large sample of adult women who reported a diagnosis of endometriosis, through a self-reported questionnaire. Univariate and multivariable logistic regression analyses were performed to identify the factors associated with chronic pelvic pain. The primary outcome was describing women who reported chronic pelvic pain.</p><p><strong>Results: </strong>A total of 661 out of 1045 (63%) women who responded to the survey reported chronic pelvic pain. The multivariable analysis evidenced that chronic pelvic pain was related to physical and mental quality perception, pelvic floor disorders (adjusted odds ratio = 1.58; 95% CI = 1.10-2.27; <i>p</i> = 0.012), dyspareunia (adjusted odds ratio = 1.87; 95% CI = 1.31-2.65; <i>p</i> < 0.001), adhesions syndrome (adjusted odds ratio = 1.49; 95% CI = 1.05-2.11; <i>p</i> = 0.026), and the delay in diagnosing endometriosis (adjusted odds ratio = 1.04; 95% CI = 1.00-1.09; <i>p</i> = 0.034). The only social factor associated with chronic pelvic pain was marital status (adjusted odds ratio = 0.66; 95% CI = 0.46-0.93; <i>p</i> = 0.019).</p><p><strong>Conclusion: </strong>In the pandemic period, there was a very high prevalence of chronic pelvic pain in women with endometriosis in Italy. The pandemic highlighted the need for careful attention to diagnose endometriosis and the need for psychological and partner support, which would allow better pain management and prevent chronicity.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"20 ","pages":"17455057241227361"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10919124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051264","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":"Periconceptional folic acid usage and its associated factors in eastern Sudan: A cross-sectional study.","authors":"Ahmed Ali Hassan, Albagir M Hassan, Amal O Bashir, Gamal K Adam, Nadiah AlHabardi, Ishag Adam","doi":"10.1177/17455057231224176","DOIUrl":"10.1177/17455057231224176","url":null,"abstract":"<p><strong>Background: </strong>Several countries poorly adhere to the World Health Organization's recommendation of folic acid supplementation in the periconceptional period, especially in limited-resource settings.</p><p><strong>Objective: </strong>The objective of this study was to investigate the prevalence of and the factors associated with folic acid usage in the periconceptional period among pregnant women at Gadarif Maternity Hospital in eastern Sudan.</p><p><strong>Study design: </strong>This is a cross-sectional study.</p><p><strong>Methods: </strong>This study was conducted in eastern Sudan from April to September 2022. A total of 720 pregnant women in their first trimester were enrolled. The sociodemographic characteristics and clinical and obstetrical data of pregnant women in their first trimester were assessed using a face-to-face questionnaire. In addition, multivariate regression analysis was performed.</p><p><strong>Results: </strong>In this study, the median (interquartile range) of the age and gravidity of the enrolled women was 26.3 (24.14-29.52) years and 2 (1-4), respectively. Of these 720 women, 423 (58.8%) used folic acid during the periconceptional period, while 27 (3.7%) women used folic acid in the preconceptional period. None of the investigated factors (age, residence, education, employment, body mass index, or gravidity) were associated with periconceptional use of folic acid.</p><p><strong>Conclusion: </strong>The study revealed a low prevalence of folic acid usage in preconceptional period among pregnant women in eastern Sudan. Additional efforts are needed to promote folic acid usage in the preconceptional period as well as in the first trimester.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"20 ","pages":"17455057231224176"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10822062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139572313","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":"Prevalence and factors influencing anemia in women of reproductive age visiting a tertiary care hospital (Jinnah Postgraduate Medical Center) in Karachi: A cross-sectional study.","authors":"Farheen Ashraf, Muhammad Musab Nafees Uddin, Muhammad Saqlain Mustafa, Zaib Un Nisa Mughal, Sajid Atif Aleem","doi":"10.1177/17455057241227364","DOIUrl":"10.1177/17455057241227364","url":null,"abstract":"<p><strong>Introduction: </strong>Anemia is a significant public health concern, primarily affecting young children, pregnant and postpartum women, and menstruating adolescent girls and women. This study aimed to evaluate the prevalence of anemia and associated factors in women of reproductive age visiting a tertiary care hospital in Karachi, Pakistan.</p><p><strong>Objective: </strong>The primary objective was to determine the prevalence of anemia in women of reproductive age, while the secondary objective was to investigate potential causes of anemia within this demographic group.</p><p><strong>Design: </strong>A prospective cross-sectional approach was employed, adhering to Strengthening the Reporting of Observational Studies in Epidemiology guidelines. A questionnaire-based method was used to assess anemia, and data were collected from women aged 14 to 40 years.</p><p><strong>Method: </strong>The study was conducted at the Jinnah Postgraduate Medical Center from January to May 2023. The study was approved by the Institutional Review Board of Jinnah Sindh Medical University (Institutional Review Board reference number JSMU/IRB/2023/699). A sample of 397 women was included, and various demographic and lifestyle factors were assessed.</p><p><strong>Results: </strong>In this study of 397 participants, 71.5% were found to have anemia, primarily microcytic anemia (48.2%). Anemia prevalence was highest among the 14-18 years age group (80.7%) and those from lower socioeconomic backgrounds (73.6%). Factors such as frequent tea consumption, irregular mealtimes, and pica consumption were associated with higher anemia rates. Pregnant women and those with more children were at a heightened risk of anemia.</p><p><strong>Conclusion: </strong>The study reveals a notable prevalence of anemia among women of reproductive age with a surprising emphasis on younger individuals and lower socioeconomic groups. Dietary habits, lifestyle choices, and pregnancy status play significant roles in anemia development. Targeted interventions are essential, particularly for younger women, those from disadvantaged backgrounds, and pregnant individuals, to combat anemia effectively in this region.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"20 ","pages":"17455057241227364"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10826371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139572315","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":"Prophylactic tranexamic acid for reducing intraoperative blood loss during cesarean section in women at high risk of postpartum hemorrhage: A double-blind placebo randomized controlled trial.","authors":"Kelvin E Ortuanya, George U Eleje, Frank O Ezugwu, Boniface U Odugu, Joseph I Ikechebelu, Emmanuel O Ugwu, Ahizechukwu C Eke, Fredrick I Awkadigwe, Malachy N Ezenwaeze, Ifeanyichukwu J Ofor, Chidinma C Okafor, Chigozie G Okafor","doi":"10.1177/17455057231225311","DOIUrl":"10.1177/17455057231225311","url":null,"abstract":"<p><strong>Background: </strong>Postpartum hemorrhage remains a leading cause of maternal mortality especially in developing countries. The majority of previous trials on the effectiveness of tranexamic acid in reducing blood loss were performed in low-risk women for postpartum hemorrhage. A recent Cochrane Systematic Review recommended that further research was needed to determine the effects of prophylactic tranexamic acid for preventing intraoperative blood loss in women at high risk of postpartum hemorrhage.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness and safety of tranexamic acid in reducing intraoperative blood loss when given prior to cesarean delivery in women at high risk of postpartum hemorrhage.</p><p><strong>Study design: </strong>The study is a double-blind randomized controlled trial.</p><p><strong>Methods: </strong>The study consisted of 200 term pregnant women and high-risk preterm pregnancies scheduled for lower-segment cesarean delivery at Enugu State University of Science and Technology, Teaching Hospital, Parklane, Enugu, Nigeria. The participants were randomized into two arms (intravenous 1 g of tranexamic acid or placebo) in a ratio of 1:1. The participants received either 1 g of tranexamic acid or placebo (20 mL of normal saline) intravenously at least 10 min prior to commencement of the surgery. The primary outcome measures were the mean intraoperative blood loss and hematocrit change 48 h postoperatively.</p><p><strong>Results: </strong>The baseline sociodemographic characteristics were similar in both groups. The tranexamic acid group when compared to the placebo group showed significantly lower mean blood loss (442.94 ± 200.97 versus 801.28 ± 258.68 mL; p = 0.001), higher mean postoperative hemoglobin (10.39 + 0.96 versus 9.67 ± 0.86 g/dL; p = 0.001), lower incidence of postpartum hemorrhage (1.0% versus 19.0%; p = 0.001), and lower need for use of additional uterotonic agents after routine management of the third stage of labor (39.0% versus 68.0%; p = 0.001), respectively. However, there was no significant difference in the mean preoperative hemoglobin (11.24 ± 0.88 versus 11.15 ± 0.90 g/dL; p = 0.457), need for other surgical intervention for postpartum hemorrhage (p > 0.05), and reported side effect, respectively, between the two groups.</p><p><strong>Conclusion: </strong>Prophylactic administration of tranexamic acid significantly decreases postpartum blood loss, improves postpartum hemoglobin, decreases the need for additional uterotonics, and prevents postpartum hemorrhage following cesarean section in pregnant women at high risk of postpartum hemorrhage. Its routine use during cesarean section in high-risk women may be encouraged.The trial was registered in the Pan-African Clinical Trial Registry with approval number <b>PACTR202107872851363</b>.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"20 ","pages":"17455057231225311"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10822094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139572319","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":"Transgender and gender diverse people with endometriosis: A perspective on affirming gynaecological care.","authors":"Sam Jeffrey, Louis Ashton, Tania Ferfolja, Mike Armour","doi":"10.1177/17455057241251974","DOIUrl":"10.1177/17455057241251974","url":null,"abstract":"<p><p>Transgender and gender diverse people presumed female at birth experience gynaecological conditions, such as chronic pelvic pain at elevated rates, estimated to impact between 51% and 72% of this population, compared to rates of up to 26.6% in cisgender women. The negative impact of these conditions is likely amplified due to limited access to safe and affirming healthcare. Despite this high prevalence rate, there is limited research investigating the prevalence, presentation or management options for trans and gender diverse people with endometriosis. Cisgender women with endometriosis report barriers to accessing care, with lengthy times to diagnosis and limited treatment options available. However, barriers for trans and gender diverse individuals are enhanced by physician bias and lack of education in gender-affirming care. This is reflected in stories of discrimination and denial of basic healthcare. A healthcare environment built on the presumption that gynaecological patients are women, others trans and gender diverse patients, which can result in avoidance of needed medical care. A lack of knowledge of gender-affirming care alongside healthcare provider bias highlights a need for gender-affirming care and bias reduction training in undergraduate healthcare provider curricula. Research to date assessing current curriculum in Australia and Aotearoa (New Zealand) shows limited inclusion of lesbian, gay, bisexual, trans, queer, intersex, asexual and other related identities content as a whole with gender-affirming care being among the least-frequently addressed topics. This review will detail barriers to accessing gender-affirming healthcare specific to gynaecology, interweaving the experiences of a non-binary individual seeking access to gender-affirming endometriosis care.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"20 ","pages":"17455057241251974"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140924230","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}