-
Reproductive Health Jun 2024Access to an on-demand pericoital oral contraceptive pill - used to prevent pregnancy within a defined window around sexual intercourse - could offer women more... (Review)
Review
BACKGROUND
Access to an on-demand pericoital oral contraceptive pill - used to prevent pregnancy within a defined window around sexual intercourse - could offer women more reproductive agency. A contraceptive with this indication is not currently available in any market. This review aims to understand international user appeal for an on-demand pericoital oral contraceptive pill.
METHODS
Systematic scoping review, comprising 30 peer-reviewed papers published between 2014-2023.
RESULTS
Data from 30 papers reporting on research from 16 countries across five World Health Organisation regions suggests widespread user appeal for on-demand oral contraceptive pills that can be used peri- or post-coitally, especially among women who are younger, more educated or who have less frequent sex. Women of varying age, wealth, employment or relationship status, and with different prior experience of using modern contraceptives, were also interested. Women identified clear rationale for use and preference of these types of product: close alignment with women's sexual lives that comprised unplanned, spontaneous or occasional sex; perceived convenience and effectiveness; discreet use of pills to negotiate contextual circumstances that constrained their reproductive agency. Factors inhibiting use included knowledge barriers and attitudes of service providers, a lack of knowledge and misinformation among end-users, women's dislike of menstrual side effects and myths related to the effects of hormone content on future fertility.
CONCLUSIONS
Introduction of an on-demand pericoital oral contraceptive pill could expand contraceptive choice for diverse women experiencing unmet need for modern contraception and constrained sexual and reproductive agency. Priorities for future research include: broadening the geographical scope of evidence to include SE Asia and the Pacific, and international rural and peri-urban settings; documenting the perspectives of adolescents and unmarried young people; identifying opportunities for innovation in the supply channels to enhance appropriate, affordable access to on-demand oral contraceptives; and unpacking how to bring new pericoital contraceptives to the market in a variety of international settings.
Topics: Humans; Female; Contraceptives, Oral; Contraception Behavior; Coitus; Health Knowledge, Attitudes, Practice; Pregnancy; Sexual Behavior; Patient Acceptance of Health Care; Contraception
PubMed: 38943120
DOI: 10.1186/s12978-024-01829-7 -
BMC Pregnancy and Childbirth Jun 2024Pregnancy is an important period of life for women and their husbands as the couple's health is essential. The present study evaluated the impact of some factors...
INTRODUCTION
Pregnancy is an important period of life for women and their husbands as the couple's health is essential. The present study evaluated the impact of some factors (marital adjustment with depressive symptoms) on health-promoting behaviors in pregnant women and their husbands based on the actor-partner interdependence model (APIM).
MATERIALS AND METHODS
This descriptive study examined 211 couples (pregnant women and their husbands) in pregnancy clinics of Babol University of Medical Sciences using a convenience sampling method. The participants completed Spanier's Dyadic Adjustment Scale (DAS) (1979), Edinburgh Postnatal Depression Scale (EPDS) (1987), and Walker's Health Promoting Lifestyle Profile II (HPLPII) questionnaire (1997). The relationships between women and their husbands were also evaluated using structural equation modeling with R software according to the Lavaan (latent variable analysis) package based on APIM-SEM.
RESULTS
The pregnant women's marital adjustment positively affected their health-promoting behaviors (β = 0.456, 95% Cl: 0.491-0.998, p < 0.001) and their husbands' (β = 0.210, 95% Cl: 0.030-0.726, p = 0.048). Pregnant woman's depressive symptoms also negatively affected their health-promoting behaviors (β=-0.088, 95% Cl: -0.974-0.074, P = 0.236) and their husbands' health-promoting behaviors (β=-0.177, 95% Cl: -0.281 - -0.975, P = 0.011). Furthermore, the husband's marital adjustment only positively affected his studied behaviors (β = 0.323, 95% Cl: 0.0303-0.895, P < 0.001) but did not affect the pregnant woman's health behaviors. The husband's depressive symptoms had a negative impact on his studied behaviors (β = 0.219, 95% Cl: -0.122 - -0.917, P = 0.001) and did not affect the pregnant woman's depressive symptoms. Our findings confirmed the mediating role of depressive symptoms in pregnant women and their husbands on the association of marital adjustment and health-promoting behaviors. According to the actor-partner study, a pregnant woman's marital adjustment scores positively affected her studied behaviors and her husband (β = 0.071, 95% Cl: 0.042-0.278, P = 0.015) by decreasing her depression score. Therefore, the husband's marital adjustment score positively affected his studied behaviors by decreasing his depression score (β = 0.084, 95% Cl: -0.053 -0.292, P = 0.005), and it did not affect his wife's health-promoting behaviors.
DISCUSSION AND CONCLUSION
These findings suggest healthcare providers, obstetricians, and psychologists evaluate the husbands' symptoms of depression and health-promoting behaviors in the routine pregnancy care of pregnant women. They also pay great attention to marital adjustment as a determinant of reducing depressive symptoms in pregnant women and their husbands.
Topics: Humans; Female; Pregnancy; Spouses; Iran; Adult; Male; Depression; Health Behavior; Pregnant Women; Surveys and Questionnaires; Marriage; Young Adult; Health Promotion; Adaptation, Psychological
PubMed: 38943077
DOI: 10.1186/s12884-024-06652-3 -
BMC Pregnancy and Childbirth Jun 2024In the United States, maternal health inequities disproportionately affect Global Majority (e.g., Asian, Black, and Hispanic) populations. Despite a substantial body of...
In the United States, maternal health inequities disproportionately affect Global Majority (e.g., Asian, Black, and Hispanic) populations. Despite a substantial body of research underscoring the influence of racism on these inequities, little research has examined how experiences of gendered racial microaggressions during pregnancy and birth impact racially and ethnically diverse Global Majority pregnant and birthing people in obstetric hospital settings. We evaluated the psychometric properties of an adapted version of Lewis & Neville's Gendered Racial Microaggressions Scale, using data collected from 417 Global Majority birthing people. Findings from our study indicate that our adapted GRMS is a valid tool for assessing the experiences of gendered racial microaggressions in hospital-based obstetric care settings among Global Majority pregnant and birthing people whose preferred languages are English or Spanish. Item Response Theory (IRT) analysis demonstrated high construct validity of the adapted GRMS scale (Root Mean Square Error of Approximation = 0.1089 (95% CI 0.0921, 0.1263), Comparative Fit Index = 0.977, Standardized Root Mean Square Residual = 0.075, log-likelihood c2 = -85.6, df = 8). IRT analyses demonstrated that the unidimensional model was preferred to the bi-dimensional model as it was more interpretable, had lower AIC and BIC, and all items had large discrimination parameters onto a single factor (all discrimination parameters > 3.0). Given that we found similar response profiles among Black and Hispanic respondents, our Differential Item Functioning analyses support validity among Black, Hispanic, and Spanish-speaking birthing people. Inter-item correlations demonstrated adequate scale reliability, α = 0.97, and empirical reliability = 0.67. Pearsons correlations was used to assess the criterion validity of our adapted scale. Our scale's total score was significantly and positively related to postpartum depression and anxiety. Researchers and practitioners should seek to address instances of gendered racial microaggressions in obstetric settings, as they are manifestations of systemic and interpersonal racism, and impact postpartum health.
Topics: Humans; Female; Psychometrics; Racism; Pregnancy; Adult; United States; Reproducibility of Results; Surveys and Questionnaires; Hispanic or Latino; Male; Young Adult; Healthcare Disparities; Aggression; Black or African American; Delivery, Obstetric
PubMed: 38943057
DOI: 10.1186/s12884-024-06642-5 -
BMC Pregnancy and Childbirth Jun 2024Educational programs incorporating physical activity (PA) sessions and nutritional workshops have demonstrated potential benefits for overweight and obese pregnant...
BACKGROUND
Educational programs incorporating physical activity (PA) sessions and nutritional workshops have demonstrated potential benefits for overweight and obese pregnant women. However, participation in such programs remains challenging. This prospective study aimed to investigate the factors influencing participation and regular attendance, while examining changes in health behaviors, along with obstetric and neonatal outcomes.
METHODS
Pregnant women with at 12-22 weeks' gestation a BMI ≥ 25 kg/m2 were invited to join an educational program combining three nutritional workshops conducted in groups and 12 weekly PA sessions. They self-selected their participation into the program. Regardless of program uptake and regularity of attendance, the women's PA levels, eating behaviors, and affectivity were assessed using validated questionnaires at 20-24 weeks, 32-34 weeks, and postpartum. A multivariable logistic regression model was used to determine the factors influencing participation.
RESULTS
Of the 187 women enrolled in the study, 61.5% agreed to participate in the program. Of these, only 45% attended six or more sessions (regardless of the nature of sessions, i.e. nutritional workshops and/or PA sessions), while only 8.7% attended six or more PA sessions. Participation was associated with higher rates of problematic eating behaviors and lower PA levels at baseline, while regular attendance was mainly associated with higher household incomes. No significant difference was observed between participants and non-participants in terms of changes in eating behaviors, PA levels, or affectivity. However, at the 32-34 week visit, regular participants displayed a higher change in positive affectivity, but unexpectedly also in cognitive restraint, than non-regular participants, a difference that did not persist at postpartum.
CONCLUSION
The educational program combining nutrition and PA was shown to be safe. Women facing challenges related to health behavior displayed a willingness to sign up for the program, but tailored interventions addressing their individual challenges are needed to improve attendance. Accordingly, four recommendations are proposed for the design of future interventions.
TRIAL REGISTRATION
ClinicalTrials.gov; Identifier: NCT02701426; date of first registration: 08/03/2016.
Topics: Humans; Female; Pregnancy; Adult; Exercise; Prospective Studies; Obesity; Overweight; Pregnancy Complications; Feeding Behavior; Prenatal Care; Health Behavior
PubMed: 38943053
DOI: 10.1186/s12884-024-06648-z -
International Journal of Emergency... Jun 2024Mesenteric arterial thrombosis is an extremely rare thrombotic event, especially during pregnancy, that can cause rapid fatal consequences unless the patient receives...
BACKGROUND
Mesenteric arterial thrombosis is an extremely rare thrombotic event, especially during pregnancy, that can cause rapid fatal consequences unless the patient receives early definitive treatment.
CASE PRESENTATION
We report the case of a 34-year-old female presenting in her seventh week of gestation with severe abdominal pain who was promptly diagnosed with mesenteric artery occlusion amidst incipient miscarriage. The patient underwent a successful mesentery artery embolectomy, recovered and was later diagnosed with elevated factor VIII activity.
CONCLUSION
The diagnosis of mesenteric ischemia should be considered in pregnant women presenting with severe abdominal pain and any prior predisposing factors. Our case highlights the pivotal role of the emergency physician in maintaining a high index of suspicion coupled with timely and determined action. The prognosis of this high mortality condition depends on prompt diagnosis, early definite management and successful multidisciplinary cooperation.
PubMed: 38943051
DOI: 10.1186/s12245-024-00661-x -
BMC Pregnancy and Childbirth Jun 2024Phytochemicals are non-nutritive bioactive compounds with beneficial effects on the metabolism of glucose. This study aimed to clarify the possible causal effect of the...
BACKGROUND
Phytochemicals are non-nutritive bioactive compounds with beneficial effects on the metabolism of glucose. This study aimed to clarify the possible causal effect of the pre-pregnancy dietary phytochemical index (DPI) on gestational diabetes mellitus (GDM).
METHODS
In this prospective cohort study 1,856 pregnant women aged 18-45 years who were in their first trimester, were recruited and followed up until delivery. The dietary intakes of participants were examined using an interviewer-administered validated 168-item semi-quantitative food frequency questionnaire (FFQ). Inverse probability weighting (IPW) of propensity scores (PS), estimated from the generalized boosted model (GBM) were used to obtain a adjusted risk ratio (aRR) for potential confounders.
RESULTS
During the follow-up period, 369 (19.88%) women were diagnosed with GDM. DPI scores ranged from 6.09 to 89.45. There was no association between DPI scores and GDM (aRR: 1.01, 95% confidence interval [CI]: 0.92, 1.08; p trend = 0.922). When comparing DPI quartile 4 (most pro-phytochemical content) to quartile 1 (few phytochemical contents), there was no significant difference between them (aRR: 0.97; 95% CI: 0.75, 1.25; p = 0.852). Also, there was no significant difference between DPI quartile 3 and quartile 1 (aRR: 1.04; 95% CI: 0.81, 1.34; p = 0.741) as well as DPI quartile 2 and quartile 1 (aRR: 0.92; 95% CI: 0.71, 1.21; p = 0.593).
CONCLUSIONS
Although this data did not support the association between pre-pregnancy DPI scores and GDM, further cohort studies to ascertain the causal association between them are warranted.
Topics: Humans; Female; Pregnancy; Diabetes, Gestational; Adult; Prospective Studies; Young Adult; Phytochemicals; Diet; Adolescent; Middle Aged; Risk Factors; China; Pregnancy Trimester, First; Cohort Studies
PubMed: 38943050
DOI: 10.1186/s12884-024-06643-4 -
Scientific Reports Jun 2024The aim of this study was to assess the correlation between gut microbial taxonomy and various ovarian responses to controlled ovarian stimulation. A total of 22 IVF...
The aim of this study was to assess the correlation between gut microbial taxonomy and various ovarian responses to controlled ovarian stimulation. A total of 22 IVF cycles with a follicle-to-oocyte index (FOI) < 0.5 and 25 IVF cycles with FOI ≥ 0.5 were included in this study. Baseline demographic characteristics were compared between the two groups. Metagenomic sequencing was performed to analyze fecal microbial community profiles. Mice were used to evaluate the effect of Bifidobacterium_longum on ovarian response to stimulation. Compared with FOI < 0.5 group, women in group with FOI ≥ 0.5 had significant more oocytes retrieved (p < 0.01). Prevotella_copri, Bateroides_vulgatus, Escherichia_coli and Bateroides_stercoris were more abundant in FOI < 0.5 group while Bifidobacterium_longum, Faecalibacterium_prausnitzii, Ruminococcus_gnavus and Bifidobacterium_pseudocatenula were more abundant in FOI ≥ 0.5 group. After adjusting for women's age and BMI, Pearson correlation analysis indicated alteration of gut microbiome was related with serum E2, FSH, number of oocytes retrieved and clinical pregnancy rate. Animal study showed ovarian response will be improved after Bifidobacterium_longum applied. An increased abundance of Bacteroidetes and Prevotella copri, as well as a decreased abundance of Bifidobacterium longum, have been found to be associated with poor ovarian responsiveness. Changes in gut microbiomes have been observed to be correlated with certain clinical characteristics. The potential enhancement of ovarian response may be facilitated by the integration of Bifidobacterium longum.
Topics: Female; Gastrointestinal Microbiome; Animals; Humans; Metagenomics; Adult; Mice; Ovulation Induction; Ovary; Pregnancy; Feces; Fertilization in Vitro
PubMed: 38942886
DOI: 10.1038/s41598-024-65869-6 -
Scientific Reports Jun 2024Methicillin-resistant Staphylococcus (MRS) has been associated with neonatal infections, with colonization of the anovaginal tract being the main source of vertical...
Methicillin-resistant Staphylococcus (MRS) has been associated with neonatal infections, with colonization of the anovaginal tract being the main source of vertical transmission. The COVID-19 pandemic has altered the frequency of antibiotic usage, potentially contributing to changes in the dynamics of bacterial agents colonizing humans. Here we determined MRS colonization rates among pregnant individuals attending a single maternity in Rio de Janeiro, Brazil before (January 2019-March 2020) and during (May 2020-March 2021) the COVID-19 pandemic. Anovaginal samples (n = 806 [521 samples before and 285 during the pandemic]) were streaked onto chromogenic media. Colonies were identified by MALDI-TOF MS. Detection of mecA gene and SCCmec typing were assessed by PCR and antimicrobial susceptibility testing was done according to CLSI guidelines. After the onset of the pandemic, MRS colonization rates increased significantly (p < 0.05) from 8.6% (45) to 54.7% (156). Overall, 215 (26.6%) MRS isolates were detected, of which S. haemolyticus was the most prevalent species (MRSH, 84.2%; 181 isolates). SCCmec type V was the most frequent among MRS (63.3%; 136), and 31.6% (68) of MRS strains had a non-typeable SCCmec, due to new combinations of ccr and mecA complexes. Among MRS strains, 41.9% (90) were resistant to at least 3 different classes of antimicrobial agents, and 60% (54) of them were S. haemolyticus harboring SCCmec V. MRS colonization rates and the emergence of multidrug-resistant variants detected in this study indicate the need for continuing surveillance of this important pathogen within maternal and child populations.
Topics: Humans; Female; Pregnancy; COVID-19; Staphylococcal Infections; Methicillin-Resistant Staphylococcus aureus; Adult; Brazil; Pregnancy Complications, Infectious; Anti-Bacterial Agents; SARS-CoV-2; Microbial Sensitivity Tests; Pandemics; Vagina
PubMed: 38942787
DOI: 10.1038/s41598-024-64422-9 -
Asian Journal of Surgery Jun 2024
PubMed: 38942628
DOI: 10.1016/j.asjsur.2024.06.095 -
The Lancet. Public Health Jul 2024Alcohol container labels might reduce population-level alcohol-related harms, but investigations of their effectiveness have varied in approach and quality. A systematic... (Review)
Review
Alcohol container labels might reduce population-level alcohol-related harms, but investigations of their effectiveness have varied in approach and quality. A systematic synthesis is needed to adjust for these differences and to yield evidence to inform policy. Our objectives were to establish the effects of alcohol container labels bearing one or more health warnings, standard drink information, or low-risk drinking guidance on alcohol consumption behaviour, knowledge of label message, and support for labels. We completed a systematic review according to Cochrane and synthesis without meta-analysis standards. We included all peer-reviewed studies and grey literature published from Jan 1, 1989, to March 6, 2024, in English, French, German, or Spanish that investigated the effects of alcohol container labels compared with no-label or existing label control groups in any population on alcohol consumption behaviour, knowledge of label message, or support for labels. Data were synthesised narratively as impact statements and assessed for risk of bias and certainty in the evidence. A protocol was preregistered (PROSPERO CRD42020168240). We identified 40 publications that studied 31 labels and generated 17 impact statements. 24 (60%) of 40 publications focused on consumption behaviour and we had low or very low certainty in 13 (59%) of 22 outcomes. Alcohol container labels bearing health warnings might slow the rate of alcohol consumption (low certainty), reduce alcoholic beverage selection (moderate certainty), reduce consumption during pregnancy (low certainty), and reduce consumption before driving (moderate certainty). Interventions with multiple types of rotating alcohol container labels likely substantially decrease alcohol use (moderate certainty) and reduce alcohol sales (high certainty). To the best of our knowledge, this is the first systematic review on multiple types of alcohol container labels assessing their effects for certainty in the evidence. Limitations included heterogeneity in label designs and outcome measurements. Alcohol container labels probably influence some alcohol consumption behaviour, with multiple rotating messages being particularly effective, although effects might vary depending on individual health literacy or drinking behaviour. Alcohol container labels might therefore be effective components of policies designed to address population-level alcohol-related harms.
Topics: Humans; Alcohol Drinking; Alcoholic Beverages; Product Labeling; Health Knowledge, Attitudes, Practice
PubMed: 38942559
DOI: 10.1016/S2468-2667(24)00097-5