BMJ Sexual & Reproductive Health最新文献_第2页

Acceptability of digital health intervention during pregnancy to inform women about postpartum contraception (DIGICAP): a pilot randomised controlled study. 怀孕期间数字健康干预的可接受性，以告知妇女产后避孕（DIGICAP）：一项试点随机对照研究

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-16 DOI: 10.1136/bmjsrh-2024-202479

Michelle Cooper, Caroline J Free, Kevin Ka-Wing Kuan, Karen McCabe, Emmanuela Osei-Asemani, Charles Opondo, Sharon Cameron

{"title":"Acceptability of digital health intervention during pregnancy to inform women about postpartum contraception (DIGICAP): a pilot randomised controlled study.","authors":"Michelle Cooper, Caroline J Free, Kevin Ka-Wing Kuan, Karen McCabe, Emmanuela Osei-Asemani, Charles Opondo, Sharon Cameron","doi":"10.1136/bmjsrh-2024-202479","DOIUrl":"https://doi.org/10.1136/bmjsrh-2024-202479","url":null,"abstract":"Background: Pregnancy within a year of childbirth has negative impacts on women and their children's health. We developed a digital health intervention (DHI) to empower women in contraceptive choices postpartum. Our pilot randomised controlled trial (RCT) aimed to establish the feasibility of a main RCT of the effects of the DHI compared with standard care on long-acting contraception use.Methods: Our pilot RCT recruited 52, 20-24 weeks pregnant women in NHS Lothian, UK between October 2022 and April 2023. Participants were randomised 7:3 to receive either the DHI (n=37) in addition to standard care, or standard care alone (n=15). Telephone survey follow-up was at 24 weeks' gestation and 6 weeks postpartum. Semi-structured qualitative interviews (n=10) were conducted with participants receiving the DHI.Results: All eligible women joined the study and completed follow-up. All intervention participants found the animation highly acceptable; one participant requested text message discontinuation. We completed followed up on 37/37 (100%) of participants. DHI participants reported they valued access to credible contraceptive information that supported decision making in a non-pressurised way.Conclusions: Our DHI is highly acceptable and a trial is feasible. A larger trial is needed to establish if the DHI increases uptake of long-acting reversible contraception postpartum and reduces unintended pregnancies within 12 months of childbirth.Trial registration number: (Trial registration ISRCTN48521918).","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Self-reported contraceptive method use at conception among patients presenting for abortion in England: a cross-sectional analysis comparing 2018 and 2023. 英国堕胎患者在怀孕时自我报告的避孕方法使用情况：2018年和2023年比较的横断面分析

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-13 DOI: 10.1136/bmjsrh-2024-202573

Rosie McNee, Hannah McCulloch, Patricia A Lohr, Anna Glasier

{"title":"Self-reported contraceptive method use at conception among patients presenting for abortion in England: a cross-sectional analysis comparing 2018 and 2023.","authors":"Rosie McNee, Hannah McCulloch, Patricia A Lohr, Anna Glasier","doi":"10.1136/bmjsrh-2024-202573","DOIUrl":"https://doi.org/10.1136/bmjsrh-2024-202573","url":null,"abstract":"Background: Recent media attention has been given to an apparent shift away from hormonal methods of contraception. While an increase in fertility awareness-based or 'natural' family planning methods is reported in the grey literature, there are no robust data to determine any such trend in the UK.Methods: We compared self-reported contraceptive use at conception among patients presenting for abortion at British Pregnancy Advisory Service from January to June 2018 (N=33 495) and January to June 2023 (N=55 055) using chi-square (χ2) tests of association.Results: Reported use of fertility awareness-based methods of contraception around the time of conception increased from 0.4% in 2018 to 2.5% in 2023 (p<0.001). In contrast, use of hormonal methods of contraception decreased from 18.8% in 2018 to 11.3% in 2023 (p<0.001) and use of long-acting reversible contraception fell from 3% to 0.6% (p<0.001). Those reporting using no contraception at the time of conception significantly increased by 14% (p<0.001) when comparing data from 2018 (55.8%) with data from 2023 (69.6%).Conclusions: Significantly fewer abortion patients report using effective methods of contraception around conception while also reporting an increased use of fertility awareness-based methods. Further research is needed to understand the reasons for this change.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Remember vasectomy: challenges and successes-one small snip for mankind. 记住输精管结扎术：挑战和成功——对人类来说是一小步。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-08 DOI: 10.1136/bmjsrh-2024-202431

Gareth James, Melanie Atkinson

引用次数: 0

Evaluating the effectiveness of a tailored online educational video on the contraceptive knowledge and decision making of young women from culturally and linguistically diverse backgrounds: findings from the EXTEND-PREFER study. 评估定制在线教育视频对来自不同文化和语言背景的年轻女性避孕知识和决策的影响：EXTEND-PREFER 研究的结果。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2024-202236

Danielle Mazza, Jessica R Botfield, Jessie Zeng, Claudia Morando-Stokoe, Noushin Arefadib

{"title":"Evaluating the effectiveness of a tailored online educational video on the contraceptive knowledge and decision making of young women from culturally and linguistically diverse backgrounds: findings from the EXTEND-PREFER study.","authors":"Danielle Mazza, Jessica R Botfield, Jessie Zeng, Claudia Morando-Stokoe, Noushin Arefadib","doi":"10.1136/bmjsrh-2024-202236","DOIUrl":"10.1136/bmjsrh-2024-202236","url":null,"abstract":"Background: Young Australian women from culturally and linguistically diverse (CALD) backgrounds are vulnerable to unwanted pregnancy. We aimed to assess whether an online educational video, co-designed with young CALD women, can increase their contraceptive knowledge, preference for and uptake of long-acting reversible contraception (LARC).Methods: Online advertising was used to recruit young CALD women aged 16-25 years. Participants completed the pre-video survey (S1), watched the 13-min co-designed video, then completed a survey immediately afterwards (S2) and 6 months later (S3). Outcomes were analysed using McNemar tests and multivariate logistic regression.Results: A total of 160 participants watched the video, completed S1 and S2, and 57% of those completed S3. At S1 only 14% rated their knowledge about every contraceptive method as high. Knowledge improved at S2 for all methods (aOR 3.2, 95% CI 2.0 to 5.0) and LARC (aOR 4.7, 95% CI 2.9 to 7.5). Overall method preference for LARC increased from 2.5% (n=4) at S1 to 51% (n=82) at S2. Likelihood of using a LARC increased at S2 (aOR 3.8, 95% CI 2.6 to 5.6). The overall proportion of participants using a LARC increased from 8% at S1 to 11% at S3; however, this increase was not significant (p=0.7).Conclusions: The significant increase in knowledge, likelihood of use, and preference for LARC underscores the potential of online video-based contraceptive education to address contraceptive knowledge gaps and challenge misconceptions about LARC held by young women. Combining contraceptive education with supports to LARC access is crucial for empowering young CALD women to make informed contraceptive decisions.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"18-26"},"PeriodicalIF":3.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141316730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sexual and reproductive health clinical consultations: problematic bleeding with the implant. 性健康和生殖健康临床咨询：植入物出血问题。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2024-202423

Eloise Mary Aikin Smellie, Jayne Kavanagh

引用次数: 0

Changes in male permanent contraception as partner access to long-acting reversible contraception (LARC) increases: an analysis of the National Survey for Family Growth, 2006-2010 versus 2017-2019. 随着伴侣获得长效可逆避孕药具（LARC）机会的增加，男性永久避孕的变化：2006-2010 年与 2017-2019 年全国家庭增长调查的分析。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2024-202372

Isabel Beshar, Jodi Y So, Kate A Shaw, Erica P Cahill, Jonathan Glazer Shaw

{"title":"Changes in male permanent contraception as partner access to long-acting reversible contraception (LARC) increases: an analysis of the National Survey for Family Growth, 2006-2010 versus 2017-2019.","authors":"Isabel Beshar, Jodi Y So, Kate A Shaw, Erica P Cahill, Jonathan Glazer Shaw","doi":"10.1136/bmjsrh-2024-202372","DOIUrl":"10.1136/bmjsrh-2024-202372","url":null,"abstract":"Objective: Male permanent contraception (PC), that is, vasectomy, is an effective way of preventing pregnancy. In the United States, male PC use has historically been concentrated among higher-educated/higher-income males of White race. In the last decade, use of long-acting reversible contraception (LARC) has increased dramatically. We sought to understand how sociodemographic patterns of male PC have changed in the context of rising LARC use.Study design: We examined the nationally representative male public use files of the National Survey for Family Growth (NSFG) across five survey waves. Our outcome was primary contraceptive use at last sexual encounter within 12 months. Using four-way multinomial logistic regressions (male PC, female PC, LARC, lower-efficacy methods), we compared sociodemographic factors predictive of male PC use versus reported partner LARC use between 2006-2010 (early) and 2017-2019 (recent) waves.Results: We included 15 964 participants. From 2006 to 2019, there were absolute declines in male PC from 8.0% to 6.8%, while male-reported partner LARC use increased three-fold, from 3.4% to 11.0%. Among the highest economic strata, use of LARC converged with male PC. In adjusted analyses, high income significantly associated with male PC use in the early wave (OR 4.6 (1.4, 14.8)), but no longer in the recent wave (OR 0.9 (0.2, 4.2)). Marital status remained a significant but declining predictor of male PC across survey waves, and instead, by 2019, number of children newly emerged as the strongest predictor of male PC use.Conclusion: Sociodemographic variables associated with vasectomy use are evolving, especially among high-income earners.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"43-50"},"PeriodicalIF":3.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Influence of the COVID-19 pandemic on births and induced abortions in Southern Sweden: a register-based study. COVID-19 大流行对瑞典南部出生和人工流产的影响：一项基于登记的研究。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2023-202162

Jesse D Thacher, Andreas Vilhelmsson, Annelise J Blomberg, Lars Rylander, Anna Jöud, Lone Schmidt, Charlotte Ørsted Hougaard, Eva Elmerstig, Ditte Vassard, Kristina Mattsson

{"title":"Influence of the COVID-19 pandemic on births and induced abortions in Southern Sweden: a register-based study.","authors":"Jesse D Thacher, Andreas Vilhelmsson, Annelise J Blomberg, Lars Rylander, Anna Jöud, Lone Schmidt, Charlotte Ørsted Hougaard, Eva Elmerstig, Ditte Vassard, Kristina Mattsson","doi":"10.1136/bmjsrh-2023-202162","DOIUrl":"10.1136/bmjsrh-2023-202162","url":null,"abstract":"Background: Pandemics are linked with declining birth rates, but little is known about how the COVID-19 pandemic has influenced childbearing decisions. We aimed to investigate the associations between the COVID-19 pandemic and reproductive decisions, specifically to identify potential changes in the frequency of deliveries and induced abortions in Skåne, Sweden.Methods: Using the Skåne Healthcare Register, we identified women aged 15-45 years who had at least one pregnancy-related care visit registered between 1 January 2013 and 11 November 11 2021. Deliveries and induced abortions were identified, and changes in weekly delivery and abortion counts were assessed using an interrupted time series design. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated from a Poisson regression model.Results: During the study period we identified 129 131 deliveries and 38 591 abortions. Compared with the counterfactual (exposed interval assuming COVID-19 had not occurred), pandemic exposure was associated with fewer deliveries (RR 0.93; 95% CI 0.89 to 0.98). For abortions, pandemic exposure appeared to be associated with fewer abortions (RR 0.95; 95% CI 0.90 to 1.00); however, age-related differences were found. Among women aged 25 years and over, pandemic exposure was more strongly associated with fewer abortions. Contrastingly, among women aged under 25 years, abortions appeared to increase.Conclusions: The COVID-19 pandemic seemed to have contributed to a decline in births in Southern Sweden. During the same period, abortions declined in women in the older age range, but contrastingly increased among younger women.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"9-17"},"PeriodicalIF":3.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Influences on ethnic minority women's experiences and access to contraception in the UK: a systematic qualitative evidence synthesis. 影响英国少数民族妇女避孕经历和机会的因素：系统性定性证据综述。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2024-202488

Ryan James Cory, Rebecca Mawson, Emma Linton, Dalal Y Al-Bazz, Kate Fryer, Richard Ma, Caroline Anne Mitchell

{"title":"Influences on ethnic minority women's experiences and access to contraception in the UK: a systematic qualitative evidence synthesis.","authors":"Ryan James Cory, Rebecca Mawson, Emma Linton, Dalal Y Al-Bazz, Kate Fryer, Richard Ma, Caroline Anne Mitchell","doi":"10.1136/bmjsrh-2024-202488","DOIUrl":"10.1136/bmjsrh-2024-202488","url":null,"abstract":"Background: Accessible contraception is critical for promoting the health and well-being of women and their families. In the UK, contraception is free at the point of access, but only 55% of pregnancies are planned, with negative implications for maternal and infant outcomes. In general, women from ethnic minorities use contraceptives less than white women. Barriers to the uptake of contraceptives have been identified, including perceived poor information from healthcare professionals and concerns about side effects. However, most studies do not include representative proportions of women from ethnic minorities. Evidence suggests that ethnic minority (EM) women feel targeted and coerced by healthcare professionals regarding contraception.Methods: A systematic search of Medline, Embase, and PsycINFO via Ovid, CINAHL, and Web of Science was conducted to identify primary qualitative and mixed-methods studies exploring ethnic minority women's experience of contraception in the UK. The data were charted using thematic analysis, using both summary and synthesis.Results and conclusions: 16 studies met the inclusion criteria, including the perspectives of 717 participants from an ethnic minority. Four overarching themes were developed: contraceptive knowledge, beliefs, family, and services. Similar to women in general, ethnic minority women have concerns about side effects, especially infertility, value the perspectives of their peers and male partners, and express a preference for female healthcare professionals. Novel perspectives included conflicting ideas about the influence of religion and stereotyping of ethnic minority women. Culturally competent consultations and a better understanding of hormonal hesitancy are essential.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"64-73"},"PeriodicalIF":3.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Local anaesthesia for pain control in surgical abortion before 14 weeks of pregnancy: a systematic review. 妊娠 14 周前手术流产中局部麻醉止痛：系统综述。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2024-202437

Regina Renner, Madeleine Ennis, Adrienne McKercher, Jillian T Henderson, Alison Edelman

{"title":"Local anaesthesia for pain control in surgical abortion before 14 weeks of pregnancy: a systematic review.","authors":"Regina Renner, Madeleine Ennis, Adrienne McKercher, Jillian T Henderson, Alison Edelman","doi":"10.1136/bmjsrh-2024-202437","DOIUrl":"10.1136/bmjsrh-2024-202437","url":null,"abstract":"Background: Abortions are common and associated with procedural pain. We aimed to evaluate benefits and harms of local anaesthesia given for pain control during surgical abortion at less than 14 weeks' gestation.Methods: We searched a systematic review on local anaesthesia for pain control for surgical abortion at less than 14 weeks' gestation using uterine aspiration. We searched multiple databases through December 2022. We evaluated study quality using the Cochrane Risk of Bias 2 (RoB2) instrument and assessed the certainty of evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation). Outcomes included intraoperative pain (with dilation, aspiration or procedure), patient satisfaction and adverse events.Results: Thirteen studies with 1992 participants met the inclusion criteria and the majority were judged as low risk of bias. Intervention protocols were heterogeneous, limiting meta-analysis. A 20 mL 1% lidocaine paracervical block (PCB) reduced pain with dilation compared with sham PCB (mean difference (MD) -37.00, 95% CI -45.64 to -28.36) and aspiration (MD -26.00, 95% CI -33.48 to -18.52; 1 randomised controlled trial (RCT), n=120; high-certainty evidence). A PCB with 14 mL 1% chloroprocaine was associated with a slight reduction in pain during aspiration compared with normal saline PCB injected at two or four sites (MD -1.50, 95% CI -2.45 to -0.55; 1 RCT, n=79; high-certainty evidence). Other RCTs compared a range of local anaesthetic types, PCB techniques and topical anaesthetics. Participants reported moderately high satisfaction with any type of pain control and studies reported few adverse events that were rarely medication-related.Conclusion: RCT evidence supports PCB efficacy but was inconsistent and of low certainty for topical anaesthesia.","PeriodicalId":9219,"journal":{"name":"BMJ Sexual & Reproductive Health","volume":" ","pages":"54-63"},"PeriodicalIF":3.4,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Centring women's voices in contraceptive innovation: building the case for an on-demand, pericoital pill. 将妇女的声音集中到避孕创新中：为按需服用的围产期避孕药提供依据。

IF 3.4 3区医学

BMJ Sexual & Reproductive Health Pub Date : 2025-01-06 DOI: 10.1136/bmjsrh-2024-202510

GIlda Sedgh, Laura J Frye, Kristina Gemzell-Danielsson, Nathalie Kapp, Kayode Afolabi, Angela A Boateng, Mary Mulombe-Phiri, Sharon Cameron, Kanya Manoj, Kirti Iyengar, Abigail Grace Winskell, Kristen M Little, Susannah Gibbs, Eden Demise, Stephen Bell

引用次数: 0