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Background Not having an established relationship is associated with an elevated risk of Chlamydia trachomatis (CT) infection, but this might reflect selection into and out of unions. Although union formation and union separation are common events in reproductive age, little is known about changes in CT risk before and after these transitions. Methods We linked Finnish Population Register data to the National Register of Infectious Diseases and used fixed-effects linear probability models that account for all time-invariant confounders to examine changes in women's 6-month CT risk 3 years before and 3 years after entry into first cohabitation (n  = 293 554), non-marital separation (n  = 201 647) or marital separation (n  = 92 232) during 2005–14. Results From 3 years to 1 year before first union formation, the 6-month risk of CT increased slightly, peaking at 1.27% immediately prior to union formation (95% confidence interval 1.22–1.31). It declined sharply following union formation, being only 0.40% (0.34–0.46) 6–12 months after union formation with little changes thereafter. Among women separating from non-marital unions, the risk increased from 0.50% (0.42–0.57) to 1.45% (1.40–1.49) around the time of separation and decreased following separation. The pattern of findings was relatively similar for marital separation, although the observed risks and changes were smaller in magnitude. Conclusions Our results based on longitudinal data and individual fixed-effects models indicate that the period immediately after separation may be causally associated with an elevated risk of CT. This suggests that recently separated women should be identified as a high-risk group for CT. [ABSTRACT FROM AUTHOR]

Background: Exposure to domestic violence by triggering repetitive distress and fear can affect neurodevelopmental and mental health in the short and long term. This, in turn, has been linked to an increased risk of substance abuse, such as alcohol abuse in adulthood. Objective: The present study aimed to evaluate the association between exposure to violence from the father toward the mother and alcohol abuse in Peruvian women. Design: Cross-sectional study Methods: We conducted a secondary analysis of data from the Peruvian Demographic and Family Health Survey (ENDES) of 2019. A total of 19,980 reproductive-aged women (15–49 years old) were surveyed using the Health Questionnaire during 2019. The dependent variable of the study was alcohol abuse, collected through self-report, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Intimate partner violence (IPV; violence perpetrated by the father against the mother) was considered as the exposure variable. To assess the association of interest, we only considered observations with complete data and used binary logistic regression models, calculating crude odds ratios and adjusted odds ratios (aOR). For the multivariable model, we adjusted for confounding variables (age, marital status, education level, wealth index, ethnicity, residence, current smoker, depression, and IPV). Results: We analyzed a final sample of 9953 women. The prevalence of interparental violence and alcohol abuse was 41.3% and 1.5%, respectively. We found that interparental violence was associated with higher odds of alcohol abuse (aOR: 2.10; 95% CI: 1.03–4.28) after adjusting for age, marital status, education level, wealth level, ethnicity, area of residence, current smoking, depression, and IPV. Conclusion: We identified that women of reproductive age who have been exposed to interparental violence were at higher odds of experiencing alcohol abuse issues. Plain language summary: Understanding the link between witnessing parental violence and alcohol abuse in Peruvian women Witnessing violence between parents during childhood can leave deep emotional scars. This study explores whether such experiences are related to alcohol abuse among Peruvian women in their adult years. Using data from a national health survey in Peru, the experiences of nearly 20,000 women were analyzed to determine if witnessing violence between their parents during childhood was linked to alcohol problems later in life. Responses from the 2019 Peruvian Demographic and Family Health Survey were examined, focusing on women's reports of childhood exposure to violence between parents and current alcohol abuse, controlling for factors like age, education, and mental health. The study found that women who witnessed their parents engaging in violence were more likely to abuse alcohol as adults. About 41% of the women reported seeing such violence, and of these, a higher proportion struggled with alcohol compared to those who did not witness violence. Understanding the link between childhood experiences and adult behaviors can help develop targeted interventions to prevent alcohol abuse. This research highlights the need for support systems that help women cope with the emotional impacts of childhood trauma, potentially reducing alcohol-related problems in the future. [ABSTRACT FROM AUTHOR]

This systematic review and meta-analysis aim to synthesize the information on menstrual cup adoption among reproductive-age women in India. A comprehensive search was conducted in four databases following PRISMA 2020 guidelines. A total of 18 articles were included in this review. The findings of the studies were described narratively, and meta-analysis and sensitivity analysis were also performed. The pooled prevalence of knowledge regarding menstrual cups among women in the included studies was 35 percent (CI: 0.23–.49). Just 5 percent (CI: 0.02–0.12) of women use menstrual cups. Only 24 percent (CI: 0.17–0.33) of the women who used menstrual cups reported leakage as one of the key barriers or issues to menstrual cup use. Nevertheless, 62 percent (CI: 0.42–0.78) of non-users have a pooled prevalence expressing willingness to use in the future. The price was found to be both a motivating and discouraging factor for using menstruation cups. Currently, menstrual cup use among Indian women and girls is very low. However, user reviews suggest that menstrual cups are an appealing and safer replacement for conventional period supplies. To fully realize the potential of menstruation cups, significant education, and awareness efforts are required to ensure proper usage. Furthermore, initiatives to lower the initial cost of menstruation cups are critical. [ABSTRACT FROM AUTHOR]

Background Nigeria has the largest global burden of HIV new infections in children despite global and national concerted efforts at the reduction of mother-to-child transmission of HIV. The goal of this study was to determine the associations between maternal characteristics, practices and mother-to-child transmission of HIV infection among mothers living with HIV. Methods This is a hospital-based descriptive cross-sectional study. Information was obtained using interviewer-administered questionnaire from the 240 participants. Data were analyzed with SPSS version 26, and P  < 0.05 was considered statistically significant. Results Out of the 240 mothers recruited, 129 (53.8%) were within 25–35 years of age, with a mean age of 31.08 ± 5.65. A total of 35 (14.6%) of the participants had at least a child with HIV infection. Maternal ART status before childbirth (AOR = 0.02, 95%CI = 0.01–0.05, P  = < 0.001) was the singular determinant of having a child with HIV infection. Mothers who delivered outside the health facility were about four-fold at risk of having an infected child (AOR = 3.89, 95%CI = 1.82–8.50, P  = 0.070). Conclusion The prevalence rate of mother-to-child transmission of HIV is high. Routine HIV testing services and the provision of accessible and affordable reproductive health services are recommended for all women of childbearing age. [ABSTRACT FROM AUTHOR]

Background. Despite global efforts to promote contraceptive use and ensure reproductive health, Somalia continues to face significant challenges in this regard. This study aims to explore the prevalence of contraceptive use in Somalia and identify the determinants influencing its use. Methods. A total of 8,162 reproductive‐aged women's data were analyzed extracted from 2020 Somali Health and Demographic Survey. The outcome variable was contraception use, classified as any contraception use (yes vs. no), any modern contraception use (yes vs. no), and any traditional contraception use (yes vs. no). The explanatory variables were factors at the individual, household, and community level. The multivariate binary logistic regression model was used to explore associations of outcome variables with explanatory variables. Results. The findings revealed low prevalence of contraceptive use among Somalia women, with only 7% reporting its use. Among them, less than 1% utilized modern contraceptive methods. Several determinants of contraception use were identified, including younger age, higher educational attainment (primary and secondary education), higher parity, exposure to family planning messages through mass media, urban place of residence, and residing in the northwest and northeast regions of Somalia. Conclusion. The results underscore the urgent need for substantial efforts to improve contraceptive use in Somalia. Strengthening healthcare facilities to provide comprehensive sexual and reproductive health services, with a particular focus on promoting contraception uptake, is crucial. Public awareness campaigns and educational programs should also be prioritized to enhance knowledge and understanding of contraception among Somali women. [ABSTRACT FROM AUTHOR]

Background: The development, approval and adoption of the malaria vaccine has provided effective supplemental protection against malaria for children in Ghana. However, heightened awareness of the new vaccine will play a critical role in its mass deployment and acceptance among potential recipients. This study therefore determined the sociodemographic characteristics associated with malaria vaccine awareness and ascertained the influence of traditional media exposure on awareness in Ghana. Methods: The study used the Demographic and Health Survey 2019 Malaria Indicator Survey Data. After necessary recoding, chi-square and complex survey bivariate/multivariate logistic regression analyses were performed using STATA 18.0. Results: Among the participants, 35.65% (95% CI: 33.83%–37.51%) had heard about the malaria vaccine. Positive predictors of awareness included higher education attainment (AOR = 1.92, 95% CI: 1.28–2.88), rural residency (AOR = 1.28, 95% CI: 1.05–1.56) and being in the northern part of the country (AOR 1.54, 95% CI: 1.14–2.07). Other positive predictors of awareness were Guan ethnicity (AOR = 1.75, 95% CI: 1.09–2.81), malaria health education (AOR = 1.73, 95% CI: 1.45–2.07) and radio set ownership (AOR = 1.39, 95% CI: 1.19–1.62). Television ownership (AOR = 0.84, 95% CI: 0.69–1.01) showed no significant relationship with awareness. Conclusion: The general nationwide awareness has not yet reached a desirable level. This study suggests that, the awareness drive, preferably through radio campaigns, must target individuals with less than tertiary education and urban communities. Awareness campaigns on televisions should be evaluated and possibly redesigned for effectiveness. [ABSTRACT FROM AUTHOR]

Background: Short birth interval (SBI) has profound implications for the health of both mothers and children, yet there remains a notable dearth of studies addressing wealth-based inequality in SBI and its associated factors in India. This study aims to address this gap by investigating wealth-based disparities in SBI and identifying the underlying factors associated with SBI in India. Methods: We used information on 109,439 women of reproductive age (15–49 years) from the fifth round of the National Family Health Survey (2019-21). We assessed wealth-based inequality in SBI for India and its states using the Erreygers Normalised Concentration Index (ECI). Additionally, we used a multilevel binary logistic regression to assess the factors associated with SBI in India. Results: In India, the prevalence of SBI was 47.8% [95% CI: 47.4, 48.3] during 2019-21, with significant variation across states. Bihar reported the highest prevalence of SBI at 61.2%, while Sikkim the lowest at 18.1%. SBI prevalence was higher among poorer mothers compared to richer ones (Richest: 33.8% vs. Poorest: 52.9%). This wealth-based inequality was visible in the ECI as well (ECI= -0.13, p < 0.001). However, ECI varied considerably across the states. Gujarat, Punjab, and Manipur exhibited the highest levels of wealth-based inequality (ECI= -0.28, p < 0.001), whereas Kerala showed minimal wealth-based inequality (ECI= -0.01, p = 0.643). Multilevel logistic regression analysis identified several factors associated with SBI. Mothers aged 15–24 (OR: 12.01, p < 0.001) and 25–34 (2.92, < 0.001) were more likely to experience SBI. Women who married after age 25 (3.17, < 0.001) and those belonging to Scheduled Caste (1.18, < 0.001), Scheduled Tribes (1.14, < 0.001), and Other Backward Classes (1.12, < 0.001) also had higher odds of SBI. Additionally, the odds of SBI were higher among mothers in the poorest (1.97, < 0.001), poorer (1.73, < 0.001), middle (1.62, < 0.001), and richer (1.39, < 0.001) quintiles compared to the richest quintile. Women whose last child had passed away were also significantly more likely to have SBI (2.35, < 0.001). Furthermore, mothers from communities with lower average schooling levels (1.18, < 0.001) were more likely to have SBI. Geographically, mothers from eastern (0.67, < 0.001) and northeastern (0.44, < 0.001) regions of India were less likely to have SBI. Conclusion: The significant wealth-based inequality in SBI in India highlights the need for targeted interventions focusing on economically disadvantaged women, particularly in states with high SBI prevalence. Special attention should be given to younger mothers and those from socially disadvantaged groups to enhance maternal and child health outcomes across the country. [ABSTRACT FROM AUTHOR]

Anaemia in women of reproductive age (WRA) can be effectively addressed if supported by a better understanding of the spatial variations, magnitude, severity and distribution of anaemia. This study aimed to map the subnational spatial distribution of anaemia (any, moderate and severe forms) among WRA in Ethiopia. We identified and mapped (any, moderate and severe) anaemia hotspots in WRA (n = 14,923) at the subnational level and identified risk factors using multilevel logistic regression. Kulldorff scan statistics were used to identify hotspot regions. Ordinary kringing was used to predict the anaemia prevalence in unmeasured areas. The overall anaemia prevalence increased from 16.6% in 2011 to 23.6% in 2016, a rise that was mostly related to the widening of existing hotspot areas. The primary clusters of (any) anaemia were in Somali and Afar regions. The horn of the Somali region represented a cluster of 330 km where 10% of WRA were severely anaemic. The Oromia–Somali border represented a significant cluster covering 247 km, with 9% severe anaemia. Population‐dense areas with low anaemia prevalence had high absolute number of cases. Women education, taking iron‐folic‐acid tablets during pregnancy and birth‐delivery in health facilities reduced the risk of any anaemia (P < 0.05). The local‐level mapping of anaemia helped identify clusters that require attention but also highlighted the urgent need to study the aetiology of anaemia to improve the effectiveness and safety of interventions. Both relative and absolute anaemia estimates are critical to determine where additional attention is needed. [ABSTRACT FROM AUTHOR]

Background: Following COVID-19 vaccination, some women suffered from menstrual cycle disturbances. This study aimed to investigate menstrual cycle disturbances after COVID-19 vaccination in women of reproductive age. Materials and Methods: This cross-sectional study was performed on 407 vaccinated women in the vaccination center of Imam Hossein Hospital (Tehran, Iran) between October 2021 and October 2022. They were interviewed based on a research-made checklist which consisted of two areas of questions about the baseline characteristics of participants and menstrual cycle characteristics to explore menstrual characteristics following COVID-19 vaccination. Results: The prevalence of menstrual disturbances was higher after the third dose (38.3%) compared with the second (27.9%) and first (17.7%) doses (P<0.001). After the first dose, a history of polycystic ovarian syndrome [PCOS, odds ratio (OR)=7.35, 95% confidential interval (CI)= (3.64-14.82), P<0.001] and menstrual disturbances with unknown etiology [OR=15.23, 95% CI=(6.30-36.80), P<0.001] could predict menstrual disturbances. After the second dose, a history of menstrual disturbances with unknown etiology [OR=3.83, 95% CI=(1.47-9.94), P=0.006] and menstrual disturbances after the first dose [OR=201.96, 95% CI= (40.99-994.90), P<0.001] were predictors of menstrual disturbances. After the third dose, a history of menstrual disturbances with unknown etiology [OR=3.09, 95% CI= (1.00-9.52), P=0.048], menstrual disturbances after the first [OR=9.82, 95% CI=(1.38-69.69), P=0.022] and second [OR=7.83, 95% CI=(1.46-41.92), P=0.016] doses could predict menstrual disturbances. Conclusion: We detected that many women experienced various menstrual disturbances after vaccination against SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). Furthermore, a history of menstrual abnormalities (before COVID-19 vaccination and following the previous doses of these vaccines) was associated with developing menstrual disturbances. [ABSTRACT FROM AUTHOR]

Introduction: Contraceptive switching from a more effective to a less effective method is a concern, especially in developing countries with high unmet needs for family planning. Indeed, the lack of understanding regarding the reasons behind contraceptive switching behavior in the study area poses a significant challenge in effectively addressing this issue. Objective: This study aimed to assess the magnitude and factors associated with long-acting contraceptive switching in Mizan-Aman town, southwest Ethiopia. Methods: A community-based cross-sectional study was conducted, involving 345 women randomly selected from the population of married women in their reproductive age group. Data collection was conducted through interviewer-administered questionnaires. Bivariate and multivariable logistic regression analyses were employed to ascertain factors linked with contraceptive method switching status. Statistical significance was determined at a P -value of less than.05. Results: Out of the 345 participants interviewed, the prevalence of switching from long-acting to short-acting contraceptives was 28.4%, 95% CI (13.6%, 33.2%). Upon adjusting for confounding variables, factors significantly associated with contraceptive switching included women aged 31–35 [adjusted odds ratio (AOR) = 0.58; 95% CI (0.36, 0.74)] and aged 41–49 [AOR = 0.54; 95% CI (0.48, 0.82)], those with formal education [AOR = 0.79; 95% CI (0.52, 0.87)], those desiring future pregnancy [AOR = 2.12; 95% CI (1.98, 3.38)], experiencing complications from previous method use [AOR = 3.67; 95% CI (2.57, 7.40)], and encountering stockouts of their preferred contraceptive choice [AOR = 2.01; 95% CI (1.39, 3.24)]. Conclusion and recommendation: The study area exhibited a notable prevalence of switching from long-acting contraceptives. Complications arising from prior method use and the unavailability of preferred contraceptive options emerged as significant factors influencing this switching behavior. Thus, it underscores the importance of providing counseling and ongoing support to women, ensuring access to safer and more effective modern contraceptive methods. [ABSTRACT FROM AUTHOR]

Background: Racial and ethnic disparities in cesarean rates in the United States are well documented. This study investigated whether cesarean inequities persist in midwife‐led birth center care, including for individuals with the lowest medical risk. Methods: National registry records of 174,230 childbearing people enrolled in care in 115 midwifery‐led birth center practices between 2007 and 2022 were analyzed for primary cesarean rates and indications by race and ethnicity. The lowest medical risk subsample (n = 70,521) was analyzed for independent drivers of cesarean birth. Results: Primary cesarean rates among nulliparas (15.5%) and multiparas (5.7%) were low for all enrollees. Among nulliparas in the lowest‐risk subsample, non‐Latinx Black (aOR = 1.37; 95% CI, 1.15–1.63), Latinx (aOR = 1.51; 95% CI, 1.32–1.73), and Asian participants (aOR = 1.48; 95% CI, 1.19–1.85) remained at higher risk for primary cesarean than White participants. Among multiparas, only Black participants experienced a higher primary cesarean risk (aOR = 1.49; 95% CI, 1.02–2.18). Intrapartum transfers from birth centers were equivalent or lower for Black (14.0%, p = 0.345) and Latinx (12.7%, p < 0.001) enrollees. Black participants experienced a higher proportion of primary cesareans attributed to non‐reassuring fetal status, regardless of risk factors. Place of admission was a stronger predictor of primary cesarean than race or ethnicity. Conclusions: Place of first admission in labor was the strongest predictor of cesarean. Racism as a chronic stressor and a determinant of clinical decision‐making reduces choice in birth settings and may increase cesarean rates. Research on components of birth settings that drive inequitable outcomes is warranted. [ABSTRACT FROM AUTHOR]

Background: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has become a major worldwide public health issue, with a focus on developing nations. Despite having a very low HIV prevalence, South Asia faces serious issues with stigma and false information because of a lack of awareness. This stigma highlights significant gaps in popular awareness while also sustaining unfavorable attitudes towards those living with HIV/AIDS. Pakistan is ranked second in South Asia for the rapidly increasing AIDS epidemic. Thorough information and optimistic outlooks are essential for successful HIV/AIDS prevention, control, and treatment. But false beliefs about how HIV/AIDS spreads lead to negative perceptions, which highlights the need to look into how women's knowledge and attitudes about HIV/AIDS in Pakistan are influenced by sociodemographic traits and autonomy. Methods: The purpose of this study is to evaluate Pakistani women's discriminatory attitudes and level of awareness on HIV/AIDS. This study used data (the women in reproductive age 15-49 years' dataset) from the Pakistan Multiple Indicator Cluster Survey to conduct an analytical cross-sectional analysis. To represent the respondents' attitudes and knowledge towards people living with HIV (PLHIV), two composite variables were developed and composite scored. Binary logistics regression was used to identify predictor variables and chi-square was used for bivariate analysis. Results: The findings reveal that almost 90% of Pakistani women have poor knowledge and attitude with HIV/AIDS. In Punjab, 72.8% of rural residents have low knowledge, whereas only 20.6% of young individuals (15-< 25 years old) show the least amount of ignorance. Education is shown to be crucial, and "Higher "education is associated with superior knowledge. Urban dwellers in Khyber Pakhtunkhwa typically have more expertise. Knowledge of HIV is positively correlated with education; those with higher education levels know a lot more (odds ratio [ OR ] = 5.419). Similarly, quintiles with greater incomes show a higher likelihood of knowing about HIV (OR = 6.745). The study identifies age, wealth index, place of residence, educational attainment, and exposure to contemporary media as significant predictors influencing HIV knowledge and attitudes among women in these provinces. Conclusion: The majority of respondents had negative opinions regarding the virus, and the majority of women in the study knew very little about HIV. Individuals who live in metropolitan areas, have higher incomes, are better educated, are exposed to contemporary media, and are generally more aware of HIV and have more positive attitudes towards HIV/AIDS, or PLHIV. The study found that, in comparison to those living in urban environments, those from rural areas with low socioeconomic level have a negative attitude and inadequate understanding. [ABSTRACT FROM AUTHOR]

Background: HIV remains a global public health concern, and women continue to be disproportionately affected. Understanding the factors associated with pre-exposure prophylaxis awareness among women is crucial as an effective HIV prevention strategy. Objectives: We investigated the prevalence and associated factors of pre-exposure prophylaxis awareness among women in Burkina Faso. Design: This was a cross-section study that used population-based data. Methods: A total of 17,659 women of reproductive age (15–49 years) from the 2021 Burkina Faso Demographic and Health Survey were analyzed. Percentage and multivariable logistic regression model were used to examine the prevalence and factors associated with pre-exposure prophylaxis awareness. Results: The prevalence of pre-exposure prophylaxis awareness was 8.2% (95% confidence interval = 7.8%–8.6%). Women's age was positively associated pre-exposure prophylaxis awareness. Women with primary and secondary education had 39% and 48% higher odds of pre-exposure prophylaxis awareness, when compared with women with no formal education. The odds of pre-exposure prophylaxis awareness were 1.40 (95% confidence interval = 1.19–1.66) times higher among Christians when compared with the Muslims. Women who were exposed to mass media including newspaper or magazine, radio, TV, and Internet had higher odds of pre-exposure prophylaxis awareness, when compared with those without exposure to mass media channels. Women who have previously tested for HIV had 37% higher odds of pre-exposure prophylaxis awareness, when compared with those who have not been tested (adjusted odds ratio = 1.37; 95% confidence interval = 1.09–1.72). Conclusion: This study found women's age, geographical region, education, religion, exposure to mass media channels, employment, and HIV testing to be associated with pre-exposure prophylaxis awareness. These findings can inform the development of targeted interventions and public health campaigns to increase awareness and practice to pre-exposure prophylaxis, particularly among key population. [ABSTRACT FROM AUTHOR]

Background and Objectives: The prevalence of cocaine use has increased in the United States, with an estimated 5.5 million people have used it at least once in 2019. We report trends in cocaine use for reproductive age females who participated in the National Survey on Drug Use and Health (NSDUH, 2005–2019). Methods: Interviewers for NSDUH recruited and assessed a representative sample of the US noninstitutionalized population. The prevalence of cocaine use was estimated annually for females (15–44 years; n = 295,751). Joinpoint regression was then used to test for significant changes in trends. Results: Approximately 2.4% of females (n = 8136) reported past 12‐month cocaine use. Joinpoint regression revealed an initial decline in cocaine use prevalence between 2005 and 2011, followed by a robust increase (2011–2019 annual percent change = 5.2; 95% confidence interval = 2.6, 7.8%). This nonlinear trend was observed for all subgroups, except for adolescent and pregnant females for whom a decrease in cocaine use prevalence was observed. Discussion and Conclusions: Although the prevalence of cocaine use remains scarce among US females, the uptake in use after a period of initial decline is concerning, highlighting the need for continued public health awareness and action. Scientific Significance: Cocaine use among females of reproductive age is particularly concerning given the increased likelihood of transitioning to disordered use and the risk of use during pregnancy. Previous studies have not reported cocaine use estimates specific to reproductive age females or only reported co‐drug use patterns, without detail of specific cocaine use trends. [ABSTRACT FROM AUTHOR]

Objective No studies have examined whether alcohol taxes may be relevant for reducing harms related to pregnant people's drinking. Method We examined how beverage-specific ad valorem , volume-based, and sales taxes are associated with outcomes across three data sets. Drinking outcomes came from women of reproductive age in the 1990–2020 US National Alcohol Surveys (N  = 11 659 women |$\le$| 44 years); treatment admissions data came from the 1992–2019 Treatment Episode Data Set: Admissions (N  = 1331 state-years; 582 436 pregnant women admitted to treatment); and infant and maternal outcomes came from the 2005–19 Merative Marketscan® database (1 432 979 birthing person–infant dyads). Adjusted analyses for all data sets included year fixed effects, state-year unemployment and poverty, and accounted for clustering by state. Results Models yield no robust significant associations between taxes and drinking. Increased spirits ad valorem taxes were robustly associated with lower rates of treatment admissions [adjusted IRR = 0.95, 95% CI: 0.91, 0.99]. Increased wine and spirits volume-based taxes were both robustly associated with lower odds of infant morbidities [wine aOR = 0.98, 95% CI: 0.96, 0.99; spirits aOR = 0.99, 95% CI: 0.98, 1.00] and lower odds of severe maternal morbidities [wine aOR = 0.91, 95% CI: 0.86, 0.97; spirits aOR = 0.95, 95% CI: 0.92, 0.97]. Having an off-premise spirits sales tax was also robustly related to lower odds of severe maternal morbidities [aOR = 0.78, 95% CI: 0.64, 0.96]. Conclusions Results show protective associations between increased wine and spirits volume-based and sales taxes with infant and maternal morbidities. Policies that index tax rates to inflation might yield more public health benefits, including for pregnant people and infants. [ABSTRACT FROM AUTHOR]

This study explores the association between health system changes over the last decade and women's preventive care utilization in Illinois. A cross-sectional analysis using Illinois Behavioral Risk Factor Surveillance System (BRFSS) data from 2012–2020 among women aged 21–75 (n=21,258) examined well-woman visit (WWV) receipt and breast and cervical cancer screening overall and over several time periods. There was an increase in the prevalence of receiving a WWV for Illinois women overall from 2012–2020. However, the overall adjusted prevalence difference was only significant for the 2020 versus 2015–2019 comparison and not for 2015–2019 versus 2012–2014. The COVID-19 pandemic was not associated with a decrease in the prevalence of mammogram use but was manifest for cervical cancer screening, particularly for Black women. Finally, those reporting having a WWV in the past year had a significantly higher prevalence of being up to date with screening compared with those not reporting a WWV. [ABSTRACT FROM AUTHOR]

Aim: This Study Aimed to Assess the Intention to Have a Third Child among Millennial Parents (25–40 years old) with Two Children in a City in Eastern China and to Explore the Influencing Factors Related to Fertility Intention. Design: A cross‐sectional design study. Methods: A convenience sampling method was used to enrol participants of childbearing age who visited two tertiary hospitals in Hang zhou, a city in eastern China, from June 2021 to March 2022. We conducted a face‐to‐face questionnaire survey with 520 participants and calculated the prevalence of intention‐related factors. Multivariate logistic regression was used to analyse the independent influencing factors of fertility intention. Results: In total, 105 (20.2%) participants had the intention to have a third child. The results showed that 'employment status', 'age', 'reasons for wanting a third child', the considered 'biggest barrier to having a third child', 'views on the three‐child policy', 'desired free services', 'supporting work policies' and 'assistance policies' were significant independent influencing factors of intention to have a third child (p‐value < 0.05). The intention of the participants 'over 30 years old' was 2.466 times that of those '30 years old and under', and 'older age/personal health status' was considered the 'biggest barrier to having a third child'. Regarding policy and social reasons, the participants who need 'medical assistance' policy negatively affect the intention to have a third child (OR = 0.453, 95% CI = 0.247–0.830). Implications for Healthcare/Nursing: Nursing plays an important role in health promotion. Nurses can help couples make wise decisions about fertility by providing professional consultation, education, evaluation and support. They can also provide corresponding nursing and guidance to improve couples' health quality and overall reproductive success. Conclusions: The general level of intention to have a third child of Millennial parents with two children is still low. The participants who are 'housewives/househusbands', 'over 30 years old', and satisfied with the state of 'medical assistance' have higher fertility intentions. Patient or Public Contribution: It is particularly meaningful for the policymakers to improve the social support system and raise universal awareness to encourage childbirth. [ABSTRACT FROM AUTHOR]

Marijuana is the most commonly used federally illicit substance among reproductive-age women in the United States. Updated information on marijuana use in this population can inform clinical and public health interventions. Data from the 2013–2019 National Survey on Drug Use and Health was used to report weighted prevalence estimates of marijuana use in the past month, past 2–12 months, and past year among women aged 18–44 years with self-reported pregnancy status. Bivariate analyses and general linear regression models with Poisson distribution using appropriate survey procedures identified factors associated with past-year marijuana use by pregnancy status. Among pregnant women, 4.9% (95% confidence interval [CI]: 4.1–5.6) reported marijuana use in the past month, 10.4% (95% CI: 9.3–11.5) in the past 2–12 months, and 15.2% (95% CI: 13.9–16.6) in the past year. Among nonpregnant women, 11.8% (95% CI: 11.5–12.0) reported marijuana use in the past month, 7.8% (95% CI: 7.6–8.0) in the past 2–12 months, and 19.5% (95% CI: 19.2–19.9) in the past year. After adjusting for sociodemographic characteristics, past-year marijuana use was 2.3–5.1 times more likely among pregnant, and 2.1 to 4.6 times more likely among nonpregnant women who reported past-year tobacco smoking, alcohol use, or other illicit drug use compared to those reporting no substance use. Pregnant and nonpregnant women reporting marijuana use, alone or with other substances, can benefit from substance use screening and treatment facilitation. [ABSTRACT FROM AUTHOR]

Background: Unintended pregnancy is a global health problem. The number of unintended pregnancies globally is still high, accounting for 1 in 4 pregnancies. In Indonesia, it occupies 15% of total pregnancies. However, studies discussing the determinants of unintended pregnancies in Indonesia were conducted on a small scale. Methods: This cross-sectional research utilized the data of 15,316 respondents of the 2017 Indonesia Demographic and Health Survey. Results: The prevalence of unintended pregnancies in women with live births in the last 3–5 years was approximately 16%. The highest risk of unintended pregnancies was recorded for those with the youngest age, living in urban, and were grand multipara and for the couples who did not know each other’s preferences. Conclusions: Strengthening communication, information, and education in family planning programs, particularly for young women and grand multipara and promoting men’s involvement can help prevent unintended pregnancies. [ABSTRACT FROM AUTHOR]

Background: Female genital mutilation (FGM) has negative health implications and has long been recognised as violating sexual rights. Despite the huge efforts expended on eradicating FGM, generational continuation of the practice, i.e. the act of mutilated women also mutilating their daughters, persists in Nigeria. This study investigated the individual, household, and community factors associated with generational continuation of FGM among women in Nigeria. Methods: The study analysed data from the 2018 Nigeria Demographic and Health Survey (NDHS). A weighted sample of 3835 women with FGM history and who had given birth to female children was analysed. Models were estimated using mixed-effects multilevel logistic regression with Stata 16.0. Results: The results showed that 40.0% of women continued FGM for their daughters. Regional prevalence of FGM continuation ranged from 14.9% in the South-South (the lowest) to 64.3% in the North-West (the highest). Women aged 15–24 years (uaOR = 0.40; 95% CI:0.28–0.57) and rich (uaOR = 0.44; 95% CI:0.35–0.56) had the least likelihood of generational continuation of FGM. In communities with low proportions of women unexposed to the media, the likelihood of FGM continuation was significantly higher (uaOR = 1.85; 95% CI:1.35–2.53). Generational continuation of FGM was significantly lower in communities with moderate proportions of uneducated mothers (aOR = 0.6; 95% CI:0.42–0.86). Conclusion: FGM continuation was high in Nigeria, and it was most common among older and poor mothers and in communities with large proportions of uneducated women and those unexposed to the media. Existing National Policy and Plan on FGM elimination should be strengthened to target these characteristics. [ABSTRACT FROM AUTHOR]

Introduction: Tea consumption with meals affects iron absorption, increasing the risk of iron deficiency. Our study investigated the association between tea consumption patterns and serum ferritin levels among women of childbearing age (WCA) in Nandi County, Kenya. Methods: We conducted a cross-sectional analytical study among 160 WCA selected using a systematic random sampling technique from Kapsabet Ward. Information on tea consumption practices was gathered using a researcher-administered questionnaire, and serum ferritin and C-reactive protein were measured. We assessed associations between tea consumption and iron status of respondents by multivariable regression analysis, adjusting for potential confounders, including parasitic infections and recent severe blood losses. Results: The prevalence of anaemia and iron deficiency among the study participants were 86.2% and 45%, respectively. Majority (90.6%) of the respondents consumed tea or coffee, with an infusion time of more than 5 min (60.0%) and a moderate tea strength (64.1%), within 1 h before or after meals. Iron deficiency was associated the number of teacups consumed (adjusted odds ratio = 7.282, 95% CI = 3.580–14.812). Conclusion: High tea consumption is positively associated with iron deficiency among WCA. Lower tea infusion strength, shorter tea infusion duration, and a lower number of teacups overall consumed, as well as consuming tea 1 h before or after meals instead of with meals, may be recommended for better outcomes in iron status among WCA. [ABSTRACT FROM AUTHOR]

Objective: We investigated the efficacy of iliofemoral venous stenting in women of childbearing age treated for post-thrombotic syndrome (PTS) and assessed the influence of pregnancy on stent occlusion. Methods: A retrospective analysis was conducted on women of childbearing age who underwent endovascular stenting for PTS due to chronic iliocava occlusion across 15 centers from 2009 to 2020. The study assessed pregnancy rates, primary patency rates, secondary patency rates, and clinical efficacy using the Villalta score for PTS severity and the Chronic Venous Disease Quality of Life Questionnaire – version 20 (CIVIQ-20), 6–12 months after the procedure. The impact of pregnancy on stent occlusion was analyzed using classical and multi-state survival analyses. Prophylactic low-molecular-weight heparin or fondaparinux was administered to patients during pregnancy until 6 weeks post-partum. Results: In total, 211 women with PTS underwent endovascular stenting, with a median age of 31 years (range: 16–42). Following recanalization, significant improvements were observed in the Villalta score (p < 0.0001) and the CIVIQ-20 score (p < 0.0001). Thirty-seven (17.6%) women became pregnant and 49 (23.2%) experienced stent occlusions. The 1-year and 5-year occlusion-free survival probabilities were 80.6% (95% confidence interval [CI]: 75.1–86.4%) and 66.6% (95% CI: 57.4–77.4%), respectively. There was no significant association between pregnancy and stent occlusion-free survival (hazard ratio = 1.00 [95% CI: 0.11–8.92], p = 0.9930). Conclusion: Iliofemoral venous stenting in women of childbearing age was an effective treatment for post-thrombotic syndrome, and it did not increase the risk for stent occlusion during pregnancy when accompanied by appropriate anticoagulation. Clinical relevance statement: This study demonstrates that pregnancy following iliofemoral venous stenting for post-thrombotic syndrome does not elevate the risk for stent occlusion. Key Points: • The severity of post-thrombotic syndrome and the quality of life, as measured using the Villalta score and Chronic Venous Disease Quality of Life Questionnaire – version 20, respectively, showed significant improvements 6–12 months after iliofemoral venous stenting. • The occurrence of pregnancy after recanalization in women of childbearing age did not lead to a significant increase in the risk for stent occlusion. [ABSTRACT FROM AUTHOR]

Background Violence, a notable human rights concern, has a public health impact across the globe. The study aimed to determine the prevalence and determinants of domestic violence among ever-married women aged 18–49 years in India. Methods Secondary data analysis with National Family Health Survey 5, 2019–21 data (NFHS-5) was conducted. The complex sampling design of the survey was accounted-for during analysis. The primary outcome was domestic violence. Prevalence was reported with 95% confidence interval (CI). Prevalence ratio was reported to provide the factors associated with domestic violence using Poisson regression. Results About 63 796 ever-married women aged 18–49 years covered under domestic violence module of NFHS-5 survey were included. Prevalence of domestic violence (12 months preceding the survey) was 31.9% (95% CI: 30.9–32.9%). Physical violence (28.3%) was the most common form followed by emotional (14.1%) and sexual violence (6.1%). Women with low education, being employed, husband being uneducated or with coercive behavior had significantly higher prevalence of domestic violence. Conclusions One-third of the reproductive age-group women were facing some form of domestic violence. Target group interventions like violence awareness campaigns, women supportive services and stringent law enforcement should be implemented to eliminate domestic violence by year 2030. [ABSTRACT FROM AUTHOR]

The objective: to study the impact of adenomyosis on the psychosomatic status of women of reproductive age. Materials and methods. A complex clinical-laboratory and instrumental prospective examination for women with adenomyosis was conducted in 224 patients aged 30 to 50 years (average age – 42.0±1.8 years). These patients were included in the main group of the study. The patients of the main group were divided into two subgroups depending on the form of adenomyosis: Group I – diffuse form – 106 women, Group II – nodular form – 118 women. The control group included 84 healthy women of reproductive age with a regular ovulatory menstrual cycle and no history of gynecological diseases. To assess the psychosomatic status of patients with adenomyosis we used the Aleksandrowicz method: a questionnaire of neurotic disorders – symptomatic (QND- S). Results. The conducted studies established that the largest number of patients were 36–40 years old – 92 (41.1±3.3%) women in the main group, and 37 (44.0±5.4%) women in the control group. A total of 152 (67.9±3.1%) patients of the main group were of reproductive age, 72 (32.1±3.1%) patients were of perimenopausal age. In patients with adenomyosis disorder of the menstrual cycle in the form of hyperpolymenorrhea was found in almost every third patient, and algomenorrhea – in almost every second person. The diagnosis was established for the first time in 8.49±2.7% of patients in Group I (9 women) and 3.38±1.8% in Group II (4 women). Less than 5 years of the disease was observed in 34.91±4.6% of patients of the Group I (37 women) and in 51.69±4.6% of the Group II (61 women). From 5 to 10 years, the disease was observed in 56.60±4.8% of patients of the Group I (60 women) and in 44.93±4.6% of the Group II (53 women). Affective stress (up to 15.50%), sleep disorders (up to 20.22%), anxiety-phobic disorders (up to 11.18%) were determined most often. Conclusions. In the vast majority of patients of reproductive age who have adenomyosis with pain syndrome, the personal characteristics are dominated by symptoms such as anxiety-phobic and depressive disorders, affective tension, sexual, obsessive and anankastic disorders. [ABSTRACT FROM AUTHOR]

Background: Maternal transmission of human immunodeficiency virus (HIV) commonly occurs from mother to child during pregnancy, delivery, and breastfeeding which accounts for almost all the new HIV infections among children aged 0–14 years. Despite major efforts and progress in controlling and preventing HIV, it continues to pose a great public health threat, especially in Indonesia. This study assessed the factors associated with the knowledge of mother-to-child transmission (MTCT) of HIV among reproductive-age women in Indonesia. Methods: This study used data from the 2017 Indonesian Demographic and Health Survey (IDHS). We sampled 39,735 reproductive-age women (15–49 years) for analysis. Using Stata version 16.0, multilevel logistic regression models were fitted, and the results were presented as adjusted odds ratios (aORs) with their confidence intervals (CIs). Results: The study found that 72% of women had knowledge of MTCT of HIV. Women who were aged between 45 and 49 years (aOR = 1.65, 95%CI = 1.46–1.88) had higher odds of knowledge of MTCT of HIV than those aged 15–19 years. Women who attained higher education (aOR = 2.92, 95%CI = 2.06–4.15) had increased odds of knowledge of MTCT of HIV than those with no formal education. Women who had four children (aOR = 1.19, 95% CI = 1.05–1.35) had higher odds of knowledge of MTCT of HIV than nulliparous women. Women who frequently read newspapers/magazines (aOR = 1.14, 95%CI = 1.06–1.25) and frequently used the internet almost every day (aOR = 1.28, 95%CI = 1.19–1.38) had higher odds of knowledge of MTCT of HIV than those who did not read newspapers/magazines and non-users of internet, respectively. Women within the richer (aOR = 1.11, 95%CI = 1.02–1.20) and the richest (aOR = 1.14, 95%CI = 1.04–1.25) wealth quintile higher odds of knowledge of MTCT of HIV than those in the poorest wealth quantile. Women who resided in rural areas were less likely to have knowledge of MTCT of HIV (aOR = 0.79, 95% CI = 0.74–0.86) than those in urban settlements. Conclusions: Knowledge of MTCT of HIV was slightly above average. The study findings on the factors associated with knowledge of MTCT of HIV provide evidence for policymakers and clinicians to utilize in the quest to eliminate MTCT of HIV among children. We recommend that awareness programs should consider the key findings from this study when delivering public education or when developing interventions to improve women's knowledge on MTCT of HIV. [ABSTRACT FROM AUTHOR]

Childhood abuse has been associated with adverse medical, psychological, behavioral, and socioeconomic outcomes in adulthood. Despite this, limited research explores the connection between childhood abuse and unintended pregnancy during adulthood. Notably, existing studies have predominantly focused on high-income countries, leaving a significant gap regarding low- and middle-income nations. This study aims to investigate the impact of childhood physical, sexual, and psychological abuse on the prevalence of unintended pregnancies and explore the interaction effects of childhood abuse on unintended pregnancy occurrences. The cross-sectional survey study was conducted between October 2015 and January 2016 in the Chandpur District of Bangladesh. Data were collected from 426 married women aged 15–49 years who had at least one child of six months or younger. The assessment of child abuse pertains to the mother's own experiences of childhood abuse and not abuse inflicted on her child. The prevalence of childhood physical, psychological, and sexual abuse was 37%, 26%, and 15%, respectively. About 25.1% of their most recent pregnancies were unintended. Notably, women with a history of childhood sexual abuse were twice as likely to experience unintended pregnancy compared to those without such a history. Furthermore, a dose-response connection was observed between the combined exposure of all categories of childhood abuse and a higher risk of unintended pregnancy. These findings highlight the need for targeted interventions, such as comprehensive sex education, accessible mental health support, and improved child protection frameworks, to address the potential repercussions of maternal childhood abuse and reduce the incidence of unintended pregnancies. [ABSTRACT FROM AUTHOR]

Zika virus (ZIKV) is spread by mosquitos, sexual intercourse and vertically during pregnancy. The 2015–2016 ZIKV epidemic infected millions in the Americas and resulted in thousands of infants born with malformations. Though the clusters of severe birth defects have subsided since 2017, ZIKV transmission remains a concern throughout Latin America and the Caribbean. Travel-associated and sexually-transmitted Zika, therefore, remain potential routes of transmission for women of reproductive age and their partners. This is particularly true for communities with high immigrant and foreign-born populations in Central Brooklyn, New York. Limited information has been collected on the perception by this population of ZIKV and how high-risk women engage in preventive practices. Using a survey adapted from the WHO, we assessed engagement in mosquito-related preventive practices while traveling. Data from 483 respondents on knowledge and perceived ZIKV concern, along with demographics as correlates of engagement in preventive practices were collected using a convenience sample between September 2020 and January 2021. Data were collected via a multipronged approach using social media in REDCap. Our findings show that being white/not Hispanic, pregnant, knowledgeable and concerned about ZIKV, and having enough information about ZIKV were all significantly associated with an increased likelihood of engaging in preventive practices while traveling. Multivariable logistic modeling revealed that knowledge was significantly associated with an increased likelihood of engaging in preventive practices while traveling (AOR = 1.90, 95% CI [1.28–2.83]). These findings underscore the importance of directing tailored health education efforts to vulnerable populations. [ABSTRACT FROM AUTHOR]

In studies that contain repeated measures of variables, longitudinal analysis accounting for time-varying covariates is one of the options. We aimed to explore longitudinal association between diet quality (DQ) and non-communicable diseases (NCDs). Participants from the 1973–1978 cohort of the Australian Longitudinal Study on Women's Health (ALSWH) were included, if they; responded to survey 3 (S3, 2003, aged 25–30 years) and at least one survey between survey 4 (S4, 2006) and survey 8 (S8, 2018), were free of NCDs at or before S3, and provided dietary data at S3 or S5. Outcomes were coronary heart disease (CHD), hypertension (HT), asthma, cancer (except skin cancer), diabetes mellitus (DM), depression and/or anxiety, and multimorbidity (MM). Longitudinal modelling using generalised estimation equation (GEE) approach with time-invariant (S4), time-varying (S4–S8) and lagged (S3–S7) covariates were performed. The mean (± standard deviation) of Alternative Healthy Eating Index-2010 (AHEI-2010) of participants (n = 8022) was 51·6 ± 11·0 (range: 19–91). Compared to women with the lowest DQ (AHEI-2010 quintile 1), those in quintile 5 had reduced odds of NCDs in time-invariant model (asthma: OR (95 % CI): 0·77 (0·62–0·96), time-varying model (HT: 0·71 (0·50–0·99); asthma: 0·62 (0·51–0·76); and MM: 0·75 (0·58–0·97) and lagged model (HT: 0·67 (0·49–0·91); and asthma: 0·70 (0·57–0·85). Temporal associations between diet and some NCDs were more prominent in lagged GEE analyses. Evidence of diet as NCD prevention in women aged 25–45 years is evolving, and more studies that consider different longitudinal analyses are needed. [ABSTRACT FROM AUTHOR]

Context Food insecurity is an important determinant of health and should be identified by clinicians during routine reproductive healthcare. The procedures used in reproductive healthcare settings to identify people experiencing food insecurity have not been fully researched. Objective The objective of this study was to synthesize evidence from published studies that describe the procedures implemented by clinicians in healthcare settings to identify food insecurity in pregnant women, or women of reproductive age (15 years–49 years). Data Sources Four databases were searched in April 2022 to identify studies that met the eligibility criteria. Data Extraction Studies that used tools that were both validated or newly developed were considered, as were studies that incorporated food insecurity screening as part of a multidomain screening tool. Two authors completed the screening, data extraction, and quality assessment independently. Data Analysis There were 1075 studies identified; after screening, 7 studies were included in the narrative synthesis, including studies relating to women who were pregnant or in the postpartum period; none of the included studies related to women in the preconception stage. Four screening tools were identified: 2- and 6-item tools specifically focused on food insecurity, a 58-item multidomain tool incorporating 4 food insecurity items, and a modified version of the 2-item tool. Methods of implementing screening varied across studies. Three described subsequent processes that supported food-insecure patients once identified. Conclusion Few published studies have investigated optimal screening tools and their implementation within reproductive healthcare settings to address food insecurity for this priority population group. Further research is required to determine: the optimal tool, preferable screening methods from the perspectives of both patients and clinicians, and potential strategies for implementation in countries outside of the United States. An additional evidence gap remains about referral pathways and appropriate supports for this population once food insecurity is identified. Systematic Review Registration PROSPERO registration no. CRD42022319687. [ABSTRACT FROM AUTHOR]

We aimed to examine associations between obstetrician-gynecologist (OBGYN) contraceptive recommendations and sociodemographic characteristics of patients and recommending physicians. OBGYNs affiliated with residency programs across the United States were recruited via email to participate in an online exploratory survey depicting scenarios of reproductive-age women of differing race and socioeconomic status, all other factors identical, and were asked to provide contraceptive recommendations. The χ2 test, Fisher's exact tests, and logistic regression were used to analyze recommendation differences based on physician and patient characteristics. Of 172 physician respondents, large proportions self-identified as white (74%) and attending physicians (56%) from the Mid-Atlantic (42%). In multivariate logistic regression, self-administered methods (odds ratio [OR], 0.5; 95% confidence interval [CI], 0.2–0.8) and condoms (OR, 0.5; 95% CI, 0.3–0.9) were recommended significantly less to Black high SES patients compared with white high SES patients. Non-white physicians recommended tubal ligation (OR, 0.7; 95% confidence interval [CI], 0.5–0.9) significantly less than white physicians, and recommended long-acting reversible contraception (OR, 3.3, CI 2.2–5.2) and condoms (OR, 1.4; 95% CI, 1.1–1.9) significantly more. Trainee physicians recommended self-administered methods (OR, 0.3; 95% CI, 0.2–0.4), condoms (OR, 0.2; 95% CI, 0.2–0.3), and tubal ligation (OR, 0.4; 95% CI, 0.3–0.6) significantly less than attending physicians. OBGYN contraceptive recommendations differed based on patients' perceived race and SES. Recommendations also differed based on race, training level, and geographic location of the recommending physician. Results suggest that physician bias contributes to contraceptive recommendations. OBGYNs should receive education about contraceptive coercion and patient-centered decision-making so that they provide high-quality counseling to all patients. [ABSTRACT FROM AUTHOR]

In the present cross-sectional study, the researchers aimed to assess the contraceptive knowledge, practice, and associated factors among 2228 women in Puducherry, India. National Family Health Survey questionnaire was adopted for data collection and about 1924 women participated. Current use of any contraceptive was 78.6% and female sterilization was 62%. The majority (99.8%) knew female sterilization, but below average for other contraceptive methods. About 10.4% were aware of more than three contraceptive methods. Age group, homemaker, with children or one son, aware of less than three methods, residing nearby to health facility were associated with the higher practice of contraceptive methods. [ABSTRACT FROM AUTHOR]

Objective: To describe the trends in the frequency of obesity and its relationship with some socioeconomic factors in women of childbearing age in Peru. Methods: Analytical cross-sectional study of secondary data, using the databases of the Encuesta Nacional Demográfica en Salud (ENDES) from 2005 to 2018. The frequency of women with obesity was estimated for each year and compared using the confidence intervals at 95% (95% CI). The magnitude of association was compared between place, age and parity, place of residence, level of education and wealth index. Results: An increase in obesity was observed in women of childbearing age from 17.72% (95% CI: 16.24-19.32) in 2005 to 32% (95% CI: 30.46-34.42) in 2018. The prevalence of type I obesity increased from 9.07% (95% CI 8.09-10.16) in 2005 to 22.15% (95% CI 15.19-16.48) in 2018. It was observed a continuous increase in the prevalence of type II obesity from 2.34% (95% CI 1.84-3.05) to 7.29% (95% CI 3.75-4.52). In women who were pregnant at the time of the interview, a prevalence of obesity was found to be 17.21% (95% CI 11.42-25.10) in 2005, reaching 38.61% (95% CI 20.25). -28.46) in 2018. A significant relationship was found between the possibility of being obese with age and parity. Conclusions: The prevalence of obesity in women of childbearing age in our country is high and continues to increase over time. The increased prevalence also occurs in pregnant women, increasing maternal-perinatal complications. [ABSTRACT FROM AUTHOR]

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Aim: This study aimed to determine whether the weight‐adjusted‐waist index (WWI) affected infertility in women of childbearing age in the United States. Methods: In this study, a database from the 2013 to 2018 National Health and Nutrition Examination Survey (NHANES) was used. We analyzed 3374 participants' data cross‐sectionally. The survey used WWI and fertility status as independent and dependent variables. To determine the effect of WWI, an analysis of the independent relationship between WWI and infertility was conducted using weighted multivariable logistic regression and a generalized additive mode (GAM). A smooth curve fitting test was used to calculate whether there was a linear association between WWI and the incidence rate of infertility, as well as subgroup analyses and interaction tests. Results: The prevalence of infertility was 10.19% among 3374 participants. Higher WWI quartiles were associated with higher infertility rates. Based on a fully adjusted model, the effects of WWI on fertility were positive (odds ratio = 1.39, 95% confidence interval: 1.17–1.66). As a result of smooth curve fitting, the association was linear across the entire WWI. Different characteristics were associated with different risks of infertility in subgroup analysis. Conclusion: Among women of reproductive age in the United States, WWI levels were positively associated with infertility. This relationship needs to be confirmed by further studies. [ABSTRACT FROM AUTHOR]

Background: Nipple–areolar complex (NAC) conditions affect reproductive-age women, yet it is not known how care of NAC complaints is distributed among medical specialties. There is a need to characterize all NAC conditions, including their treatment and the care team involved in their clinical management, of nonlactating and lactating patients to determine care gaps. Materials and Methods: This was a retrospective cohort study of reproductive-age females who presented to a large tertiary health system with an NAC complaint between 2015 and 2020. Data about the symptoms, diagnosis, specialty providing care, diagnostic considerations, and treatments were collected. Results: Nipple pain, dermatitis, and thrush were the most common diagnoses among 407 encounters (215 patients). Lactating patients represented half (204, 50%) of the study sample. Benign breast conditions like obstructed ductal openings, accessory nipples, nipple growth, inverted nipples, and chronic and bacterial infections represented a third of all encounters. Primary care physicians (167, 41%) and obstetricians (105, 26%) provided most of the care and referred a third and quarter of patients, respectively, to another provider. Conclusion: The care of patients with NAC complaints is not limited to obstetricians. Internal medicine, family medicine, emergency medicine, and obstetrician-gynecology, dermatology, and surgery resident physicians should receive training in benign breast conditions and clinical lactation. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer (BC) is caused by highly invasive and metastatic malignant tumors and affects a large number of women, threatening their health and quality of life. Previous studies have identified mixed evidence on the relationship between the use of hormonal contraceptives (HC) and the development and progression of breast cancer, especially in women of reproductive age. Our results suggest that there is a higher risk of BC in ever-users of HC, but attempting to determine the risk of developing BC among premenopausal women is difficult due to the high heterogeneity observed among the studies, indicating that our results should be approached with caution when translating them into practice. This study aims to summarize evidence from observational studies about the lifetime use of HC and the risk of BC in women of reproductive age. The PubMed, Cochrane, and EMBASE databases were searched for observational studies published from 2015 to February 2022. Meta-analyses were performed using adjusted odds ratios and relative risks with a random-effects model using the I2 statistic to quantify the heterogeneity among studies. Of the 724 studies identified, 650 were screened for title/abstract selection, 60 were selected for full-text revision, and 22 were included in the meta-analysis. Of these, 19 were case-control studies and 3 were cohort studies. The results of the meta-analysis indicate a significantly higher risk of developing BC in ever users of HC (pooled OR = 1.33; 95% CI = 1.19 to 1.49). This effect is larger in the subgroups of case-control studies (pooled OR = 1.44, 95% CI = 1.21 to 1.70) and in the subgroup of studies that strictly define menopausal status (pooled OR = 1.48; 95% CI, 1.10 to 2.00). Although our meta-analysis of observational studies (cohort and case-control) suggests a significantly increased overall risk of BC in users or ever-users of modern hormonal contraceptives, the high heterogeneity among studies (>70%) related to differences in study design, measurement of variables, confounders, among other factors, as well as publication biases should be considered when interpreting our results. [ABSTRACT FROM AUTHOR]

Background: Migraine is a primary headache, which has been producing heavy disease burden globally. There is no data on the incidence of migraine among women of childbearing age worldwide, including China. This study aimed to investigate the time trend in incidence rate of migraine among women of childbearing age in China from 1999 to 2019, and to make a prediction for 2030. Methods: Data on migraine incidence and population among women of childbearing age in China were derived from the Global Burden of Diseases Study 2019. Crude and age-standardized incidence rates of migraine (CIR, ASIR) were presented. The trend in migraine during 1990–2019 was examined using annual percent change and average annual percent change based on Joinpoint regression models. Age-period-cohort model was introduced to estimate the independent effect of age, period and cohort on migraine incidence rate among participants over the three decades. Bayesian age-period-cohort analysis was conducted to predict migraine incidence rate for 2030 among women of childbearing age in China. Results: For women of childbearing age in China, the case number, CIR and ASIR of migraine kept rising, with a cumulative percentage increase of 10.87%, 2.01% and 5.65%, respectively, from 1990 to 2019. An annual percent increase of 0.18% in the ASIR was observed over the three decades. As for the age, period and cohort effects, the adjusted cohort-specific relative risks constantly increased from 0.91 (95% CI: 0.90, 0.93) in the 1940–1949 cohort to 1.04 (95% CI: 1.03, 1.05) in the 1995–2004 cohort, while the period-specific relative risks initially declined from 1.00 (95% CI: 0.99, 1.00) in 1990–1994 cohort to 0.99 (95% CI: 0.98, 0.99) in 1995–1999 cohort, and then increased to 1.04 (95% CI: 1.03, 1.04) in 2015–2019 cohort. Moreover, the age-specific relative risks of migraine followed a bimodal pattern with peaks at the age-group of 25–29 years (CIR = 1718.27/100000) and 35–39 years (CIR = 1635.18/100000). Projection modeling showed that the CIR and ASIR of migraine will continue to significantly increase from 2020 to 2030. Conclusion: Migraine incidence remained an increasing trend from 1990 to 2019 and is projected to continually increase till 2030 among women of childbearing age in China. This study has important public health implication for population-level migraine prevention in China. Precision intervention strategies and approaches shall be considered in campaigns initiated for migraine prevention among Chinese women of childbearing age. [ABSTRACT FROM AUTHOR]

To evaluate associations between depression and/or anxiety disorders during pregnancy (DAP), delivery-related outcomes, and healthcare utilization among individuals with Michigan Medicaid-funded deliveries. We conducted a retrospective delivery-level analysis comparing delivery-related outcomes and healthcare utilization among individuals with and without DAP between January 2012 and September 2021. We used generalized estimating equation models assessing cesarean and preterm delivery; 30-day readmission after delivery; severe maternal morbidity within 42 days of delivery; and ambulatory, inpatient, emergency department or observation (ED), psychotherapy, or substance use disorders (SUD) visits during pregnancy. We adjusted models for age, race/ethnicity, urbanicity, federal poverty level, and obstetric comorbidities. Among 170,002 Michigan Medicaid enrollees with 218,890 deliveries, 29,665 (13.6%) had diagnoses of DAP. Compared to those without DAP, individuals with DAP were more often White, rural dwelling, had lower income, and had more comorbidities. In adjusted models, deliveries with DAP had higher odds of cesarean and preterm delivery OR = 1.02, 95% CI: [1.00, 1.05] and OR = 1.15, 95% CI: [1.11, 1.19] respectively), readmission within 30 days postpartum (OR = 1.14, 95% CI: [1.07, 1.22]), SMM within 42 days (OR = 1.27, 95% CI: [1.18, 1.38]), and utilization compared to those without DAP diagnoses (ambulatory: OR = 7.75, 95% CI: [6.75, 8.88], inpatient: OR = 1.13, 95% CI: [1.11, 1.15], ED: OR = 1.86, 95% CI: [1.80, 1.92], psychotherapy: OR = 172.8, 95% CI: [160.10, 186.58], and SUD: OR = 5.6, 95% CI: [5.37, 5.85]). Among delivering individuals in Michigan Medicaid, DAP had significant associations with adverse delivery-related outcomes and greater healthcare use. Early detection and intervention to address mental illness during pregnancy may help mitigate burdens of these complex yet treatable disorders. [ABSTRACT FROM AUTHOR]

The present study investigates the relationship between sexuality and spirituality with mental health among Iranian married women of reproductive age. It was a cross-sectional, correlational study with a sample size of 120 Iranian married women in 2022. Goldberg general health, Female Sexual Function Index, and Paloutzian and Ellison spiritual health questionnaires were used to collect data. The level of spiritual health scale (SWBS) in more than half of the married women was high (50.8%) and 49.2% at the average level. Sexual dysfunction was reported at 43.3%. Sexual function, religious and existential well-being was predictors of mental health and its dimensions. The risk of sexual dysfunction was 3.33-fold higher in people who had an unfavorable level of SWBS (β = 3.33, CI: 1.558–7.099, P = 0.002) compared to those who had a favorable level of SWBS. Therefore, adhering to sexual health and relying on spirituality are emphasized in preventing mental health problems. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the dental insurance coverage, dentist visits, self-perceived oral health status, and dental problems among Asian immigrant women of childbearing age in contrast to Canadian women of childbearing age and non-Asian immigrant women of childbearing age. Potential barriers to dental care services among Asian immigrant women were explored. Methods: This analysis utilized data from the combined Canadian Community Health Survey from 2011 to 2014. The analytical sample consisted of 5737 females whose age was between 20 and 39 years. Multivariable logistic regression models assessed immigrant status and other factors in relation to the indicators of dental health (i.e., dental visit, self-perceived oral health, acute teeth issue, and teeth removed due to decay). Results: Amongst Asian women immigrants of childbearing age, there was a significantly lower frequency of dentist visits compared to non-immigrant counterparts (OR = 0.53; 95% CI: 0.37–0.76). The most commonly reported reason for not seeking dental care in the last three years was that the "respondent did not think it was necessary". Relative to Canadian born women of same age bracket, Asian women of childbearing age reported fewer acute teeth issues (OR = 0.67; 95% CI: 0.49–0.91) and had a greater risk of tooth extracted due to tooth decay (OR = 3.31; 95% CI: 1.64–6.68). Furthermore, for Asian women immigrants, their major barriers to dental care included low household income (≤$39,999 vs. $40,000–$79,999 OR = 0.26) and a lack of dental insurance (no vs. yes OR = 0.33). Conclusions: Asian immigrant women showed lower utilization of dental services than non-immigrant women. A perceived lack of necessity, lower household income, and dental insurance coverage were major barriers to professional dental usage for most Asian immigrants of childbearing age. [ABSTRACT FROM AUTHOR]

Background: Complications of abortion are a major contributing factor to maternal mortality, especially in Africa. 31% of maternal deaths in Nairobi are attributed to abortions complications. While Post abortion Care (PAC) is a proven approach in addressing mortality and burden of abortion complications, determinants of use among women who need the service, PAC health seeking behaviours, the health systems capacity to provide PAC and experiences of women and providers on PAC is not well documented. This study sought to address this gap. Objective: To determine factors that influence utilization of PAC services among women of reproductive age in Nairobi County. Design: Cross-sectional survey design which employed a quantitative data collection approach. Setting: Mbagathi hospital and Mama Lucy Kibaki hospital. Subjects and Intervention: Women of reproductive age attending reproductive health services at selected health facilities. The intervention was post abortion care. Results: Single women are 62.5% (OR 0.375) less likely to seek PAC services than married women. Prior knowledge of post abortion care (PAC) services is a statistically significant determinant of seeking of PAC services (P <0.05). Women with prior knowledge about post abortion care (PAC) services are twice likely (O.R 2.318) to seek PAC services. Prior experiences, with Gender of health care provider while seeking PAC services (P-Value 0.044), waiting time (0.008) and service affordability (p<0.05) significantly determines whether one seeks PAC services or not. Conclusion: Utilization of PAC services in Nairobi County is determined by experiences, perceptions, as well as individual level factors such as marital status. [ABSTRACT FROM AUTHOR]

Background: Research suggests that doula support improves birth outcomes, contributing to lower rates of preterm birth, low birthweight, and nonindicated cesarean delivery. Few studies investigate whether doula support is associated with the quality of patient‐reported birth experiences in hospital settings. Methods: This study uses data from Listening to Mothers in California, a statewide representative survey of women who gave birth in 2016 in Californian hospitals. The analytic sample included 1345 English‐speaking participants. We used multivariable logistic regression to test for associations between doula support and self‐reported unfair treatment, abuse, and rapport with delivery staff. We also examined associations between these experiences and openness to doula support in a future birth. Models adjusted for maternal sociodemographic characteristics and views about medical intervention in birth. Results: Just over 9% of women had doula support during birth. During their hospital stay, 6.3% reported unfair treatment, 11.5% reported abuse by providers, and 5.7% reported no rapport with delivery room staff. There were no statistically significant relationships between doula support and unfair treatment, abuse, or delivery staff rapport in our models. Participants who reported no rapport with hospital staff were more likely to express openness to doula support in a future birth (AOR: 2.59; 95% CI: 1.15, 5.79). Conclusions: Despite their best efforts, doulas may not be able to mitigate all negative interactions between their clients and hospital staff. These experiences may also influence desires for additional support from doulas in future births. Hospital policies and practices should include doulas as valuable members of the care team to help ensure positive experiences during birth. [ABSTRACT FROM AUTHOR]

Background: Unplanned pregnancy continues to be a major public health concern in Sub-Saharan Africa (SSA). Understanding the ovulatory cycle can help women avoid unplanned pregnancy. Though a wide range of factors for ovulatory cycle knowledge in SSA countries has not been well assessed, the influence of health insurance on ovulatory cycle knowledge is largely unknown. As a result, we set out to investigate the relationship between health insurance enrollment and knowledge of the ovulatory cycle among women of childbearing age. This study aims to investigate the relationship between health insurance enrollment and knowledge of the ovulatory cycle among women of childbearing age in sub-Saharan Africa (SSA). Methods: Demographic and Health Surveys (DHSs) data from 29 SSA countries were analyzed. The association between health insurance and ovulatory cycle knowledge was investigated using bivariate and multivariate multilevel logistic regression models among 372,692 women of reproductive age (15–49). The findings were presented as adjusted odds ratios (AOR) with 95% confidence intervals (CI). A p-value of 0.05 was considered statistically significant. Results: The pooled result shows that the prevalence of knowledge of ovulatory cycle in the studied 29 SSA countries was 25.5% (95% CI; 24.4%-26.6%). Findings suggest higher odds of ovulatory cycle knowledge among women covered by health insurance (AOR = 1.27, 95% CI; 1.02–1.57), with higher education (higher-AOR = 2.83, 95% CI; 1.95–4.09), from the richest wealth quintile (richest-AOR = 1.39, 95% CI; 1.04–1.87), and from female headed households (AOR = 1.16, 95% CI; 1.01–1.33) compared to women who had no formal education, were from the poorest wealth quintile and belonged to male headed households, respectively. We found lower odds of ovulatory cycle knowledge among women who had 2–4 parity history (AOR = 0.80, 95% CI; 0.65–0.99) compared to those with history of one parity. Conclusions: The findings indicate that the knowledge of the ovulatory cycle is lacking in SSA. Improving health insurance enrollment should be considered to increase ovulatory cycle knowledge as an approach to reduce the region's unplanned pregnancy rate. Strategies for improving opportunities that contribute to women's empowerment and autonomy as well as sexual and reproductive health approaches targeting women who are in poorest quintiles, not formally educated, belonging to male headed households, and having high parity should be considered. [ABSTRACT FROM AUTHOR]

Simple Summary: Fertility-sparing treatment (FST) is the gold standard for the majority of young women with non-epithelial ovarian cancer (NEOC). Its rarity and wide histological diversity lead to difficulties in assessing the oncological and reproductive outcomes. The aim of the study was to assess the recurrence rates and obstetric results of patients with NEOC. In a group of 146 patients, there was no difference in disease-free survival between the women with sex cord-stromal tumors (SCST) and germ cell tumors (GCT). The recurrence risk in the first two years after treatment exceeded the chance of childbearing. The cumulative incidence rate of childbearing rose continuously since the diagnosis. Chemotherapy was not related to the chance of having a child. FST can be offered to young women with NEOC regardless of their histology (SCST vs. GCT); however, pregnancy should be delayed until 2 years after receiving the treatment due to the increased risk of recurrence. Purpose: To assess the recurrence and birth rates among patients with non-epithelial ovarian cancer. Methods: The study included 146 patients with germ cell (GCT, n = 84) and sex cord-stromal tumors (SCST, n = 62), who underwent fertility-sparing surgery. Adjuvant chemotherapy was administered to 86 (58.9%) patients. Most cases (133 out of 146) were staged FIGO I. Results: The 5- and 10-year disease-free survival rates were 91% and 83%, respectively. The recurrence risk was not associated with tumor histology, stage or age. Twenty-four months after the treatment, the rate of recurrence was higher than the rate of childbearing. The childbearing rates kept rising after the treatment and exceeded the rate of recurrence after 2 years. The cumulative incidence rates of birth 36, 60 and 120 months after treatment were 13.24%, 20.75%, and 42.37%, respectively. Chemotherapy was not related to childbearing. The patients' age was related to the chance of childbearing. Conclusions: The prognoses of GCT and SCST are similar. Close follow-ups along with contraception should be offered to women during the first two years after treatment due to the increased risk of recurrence. After this period, relapses are rare and women can safely become pregnant. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the socioeconomic inequalities and factors associated with the use of modern contraceptive methods (MCM) in the population of sexually active women of childbearing age in Ecuador. This was an analytical observational study, based on a secondary data analysis of the 2018 National Health and Nutrition Survey (ENSANUT). Information on 19,106 sexually active, married, or cohabiting women between the ages of 15 and 49 were included. Concentration curves (CC) and Erreygers concentration indices (ECI) were calculated, taking into account the use of MCM as the dependent variable and the wealth index as the independent variable. Crude and adjusted prevalence ratios with 95% confidence intervals were calculated using generalized linear models of the Poisson family. We found that 92.8% of the women surveyed used some type of MCM in the last month. A higher educational level presented a significant pro-rich concentration in the use of MCM (EIC: 0.05; p = 0.004). On the other hand, women belonging to the age group of 20 to 29 years (ECI: −0.027; p = 0.027), women with no job (ECI: −0.025; p = 0.004), and non-indigenous women (EIC: −0.031; p < 0.001), presented a pro-poor concentration. Factors significantly associated with MCM use were age, marital status, occupation, parity, ethnicity, area of residence, and living on the coast. In Ecuador, there are socioeconomic inequalities at different levels of population subgroups in women of childbearing age. Measures to promote the use of MCM are required, focusing on groups that present inequality, taking into account the factors associated with their use. [ABSTRACT FROM AUTHOR]

This article focuses on the link between past exposure to violence and a critical public health issue in sub-Saharan Africa: HIV-positive status in women of reproductive age. Specifically, we use biosocial data from the Rwandan Demographic and Health Survey (2005-2014) to assess how the timing and intensity of women's exposure to the war and genocide in Rwanda (1990-1994) may be associated with their HIV status. We find significant differences in risk across age cohorts, with the late adolescence cohort (women born in 1970-1974, who were aged 16-20 at the start of the conflict) having the highest risk of being HIV positive 10-20 years after the violence, even after controlling for current socioeconomic and demographic characteristics. Women who reported two or more sibling deaths, excluding those related to maternal mortality, during the conflict years also had higher odds of being HIV positive, net of cohort and control variables. Age at first sexual intercourse and number of lifetime sexual partners partially--but not fully--explain the associations between cohort and sibling deaths and HIV. These findings advance research related to armed conflict and population health and indicate that experiencing conflict during key stages of the life course and at higher intensity may affect women's long-term sexual health. [ABSTRACT FROM AUTHOR]