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The scale of migration has increased exponentially in recent decades in much of Southeast Asia. Emerging longitudinal evidence suggests lasting impacts of parental migration on their children's education and well-being. However, little is known about how parental migration during childhood shapes youth's transition to adulthood. This study thus used two waves of survey data collected in 2008–2010 and 2019 from households (N = 872) in Thailand to assess 1) the long-term impacts of parental migration on young adults' labour activities, marriage, and childbearing, and 2) how these impacts vary based on which parent(s) migrated and whether they are international or internal migrants. We found that maternal/biparental migration, compared with paternal migration, more significantly affected young people's labour activities and age at marriage. Moreover, these effects appear to be more pronounced for males than females. Additionally, parental migration's impacts on youths' transitional outcomes vary by internal or international migration of their parents. These results highlight the gender-specific and context-dependent nature of the long-term implications of parental migration. This study thus provides new empirical evidence to advance the understanding of the diverse patterns of transitions among Asian youth in the context of parental migration. [ABSTRACT FROM AUTHOR]

Thyroid cancer more commonly affects women than men and is the third most frequently diagnosed cancer among women of reproductive age. We conducted a nested case–control study within the Finnish Maternity Cohort to evaluate pre‐diagnostic sex steroid and thyroid function markers in relation to subsequent maternal papillary thyroid cancer. Cases (n = 605) were women ages 18–44 years, who provided an early‐pregnancy (<20 weeks gestation) blood sample and were diagnosed with papillary thyroid cancer up to 11 years afterward. Controls (n = 1185) were matched to cases 2:1 by gestational age, mother's age, and date at blood draw. Odds ratios (ORs) for the associations of serum thyroid peroxidase antibodies (TPO‐Ab), thyroglobulin antibodies (Tg‐Ab), thyroid stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), progesterone, and estradiol with papillary thyroid cancer were estimated using conditional logistic regression. TPO‐Ab and Tg‐Ab positivity (>95th percentile among controls) were associated with more than 3‐fold (OR = 3.32, 95% confidence interval [CI] 2.33–4.72) and 2‐fold (OR = 2.03, 95% CI 1.41–2.93) increased odds of papillary thyroid cancer, respectively. These associations were similar by time since blood draw, parity, gestational age, smoking status, and age and stage at diagnosis. In models excluding TPO‐Ab or Tg‐Ab positivity, TPO‐Ab (quartile 4 vs. 1: OR = 1.66, 95% CI 1.17–2.37, p‐trend =.002) and Tg‐Ab (quartile 4 vs. 1: OR = 1.74, 95% CI 1.22–2.49, p‐trend =.01) levels were positively associated with papillary thyroid cancer. No associations were observed for estradiol, progesterone, TSH, fT3, or fT4 overall. Our results suggest that thyroid autoimmunity in early pregnancy may increase the risk of maternal papillary thyroid cancer. [ABSTRACT FROM AUTHOR]

This study aimed to assess the prevalence of inadequate micronutrient intake and its risk factors among women one year after giving birth. 240 women of reproductive age were assessed. Micronutrient intake was assessed from two 24-hour records at three stages (3-6-12 months after childbirth). A generalized linear mixed-effect model was used to assess the factors associated with food intake. A prevalence of inadequate micronutrient intake was observed, with the exception of iron. Intake was lower among food-insecure women (zinc: β -0.13; iron: β -0.09; vitamin C: β -0.44). The postpartum period and food insecurity remained statistically associated with lower food consumption in the explanatory models tested. [ABSTRACT FROM AUTHOR]

Background: Ethiopia has made strides in reducing maternal mortality, but significant discrepancies in maternal health service utilization exist across socioeconomic levels. According to studies, women from higher-income households are far more likely to use essential services such as antenatal care, delivery care, and postnatal care than poorer women. This wealth disparity is a primary contributor to persistently high maternal mortality, particularly among poor populations. The study's goal was to assess wealth disparities in maternal health service uptake and identify contributing factors. Methods and materials: We used the Ethiopian Mini Demographic Health Survey (EMDHS), conducted in 2019 on women aged 15–49 living in selected census areas, with a weighted sample size of 3,909. The Erreygers Concentration Index (ECI) was used to measure wealth inequalities in maternal health care, and the ECI decomposition was used to identify factors contributing to inequality in maternal health services. Results: Maternal health service utilization was pro-rich among women in Ethiopia. The prevalence of antenatal care service (ANC), delivery, and postnatal care (PNC) service utilization showed a pro-rich distribution among Ethiopian women, with ECI = 0.115 (95% CI: 0.091–0.137), ECI = 0.223 (95% CI: 0.191–0.276), and ECI = 0.121 (95% CI: 0.041-0.200), respectively. The ECI indices were decomposed to examine the contributing factors to disparities in maternal service utilization in Ethiopia. Mother's current age, household family size, region, birth order, and parity were contributors to maternal health service utilization. Conclusion: The ANC service, delivery service and PNC service utilization showed a pro-rich distribution among Ethiopian women. Mother's current age, household family size, region, birth order, and parity are important contributors of maternal health service inequality. To improve access and usage among low-income women, policymakers can develop programs including increasing the number of free or subsidized services and providing transportation. [ABSTRACT FROM AUTHOR]

Introduction. The pattern of diet intake is associated with food availability and the intake of nutrients from different food groups and is an important component of nutritional status. The dietary habits of individuals are integral to understanding their nutritional wellbeing, making this assessment crucial for public health interventions. The objective of the study was to assess the dietary intake pattern and nutritional status among women of reproductive age in slum areas of Pokhara Metropolitan. Methodology. A cross‐sectional analytical study was conducted to assess the dietary intake pattern and nutritional status among 404 women of reproductive age in the slum area of Pokhara from June 2019 to December 2019. A simple random sampling technique was used to select the wards while a purposive sampling technique was used to collect the samples. 24‐hour recall meal‐based questions and anthropometric measurements were used for collecting data. Data were entered into EpiData and analyzed using SPSS version 16 software for analysis. Frequency and mean, median, chi‐square test, and logistic regression were performed. Results. The mean (±SD) age (SD) of the participants was 31 (±9.25) years, and most of the participants belonged to the age group 25–35 years. Out of 404 women of reproductive age, 99% of the participants consumed starchy staple foods daily, while 56.7% ate vegetables daily, and nearly half frequently consumed prepackaged foods and soft drinks. Among the total participants, 41.3% were found with a normal BMI, 37.6% were overweight, and only 12.4% were underweight. There was a significant association between underweight and age, women's occupation, and frequency of food consumption per day. Age, knowledge of nutrition, and frequency of food consumption per day were found to be associated factors with being overweight at a p value <0.05. Conclusion. Age, occupation status, and frequency of food consumption were the key predictors of being underweight, and age, knowledge regarding nutrition, and frequency of meals were the key predictors of being overweight. Developing countries must emphasize the importance of considering these factors in public health interventions and strategies aimed at promoting healthy weight management. More studies are needed. [ABSTRACT FROM AUTHOR]

Background: Maternal-foetal transmission of Chagas disease (CD) affects newborns worldwide. Although Benznidazole and Nifurtimox therapies are the standard treatments, their use during pregnancy is contra-indicated. The effectiveness of trypanocidal medications in preventing congenital Chagas Disease (cCD) in the offsprings of women diagnosed with CD was highly suggested by other studies. Methods: We performed a systematic review and meta-analysis of studies evaluating the effectiveness of treatment for CD in women of childbearing age and reporting frequencies of cCD in their children. PubMed, Scopus, Web of Science, Cochrane Library, and LILACS databases were systematically searched. Statistical analysis was performed using Rstudio 4.2 using DerSimonian and Laird random-effects models. Heterogeneity was examined with the Cochran Q test and I2 statistics. A p-value of <0.05 was considered statistically significant. Results: Six studies were included, comprising 744 children, of whom 286 (38.4%) were born from women previously treated with Benznidazole or Nifurtimox, trypanocidal agents. The primary outcome of the proportion of children who were seropositive for cCD, confirmed by serology, was signigicantly lower among women who were previously treated with no congenital transmission registered (OR 0.05; 95% Cl 0.01–0.27; p = 0.000432; I2 = 0%). In women previously treated with trypanocidal drugs, the pooled prevalence of cCD was 0.0% (95% Cl 0–0.91%; I2 = 0%), our meta-analysis confirms the excellent effectiveness of this treatment. The prevalence of adverse events in women previously treated with antitrypanocidal therapies was 14.01% (95% CI 1.87–26.14%; I2 = 80%), Benznidazole had a higher incidence of side effects than Nifurtimox (76% vs 24%). Conclusion: The use of trypanocidal therapy in women at reproductive age with CD is an effective strategy for the prevention of cCD, with a complete elimination of congenital transmission of Trypanosoma cruzi in treated vs untreated infected women. Author summary: Chagas Disease (CD), a neglected tropical disease (NTD), is a global public health issue with an estimated 70 million people being at risk of infection. Congenital transmission is currently the main mode of transmission of T. cruzi in both endemic and non-endemic countries. Most women of gestational age in endemic countries are chronically infected, having acquired the infection during infancy. Vertical transmission happens in 5% of them, and thus approximately 9,000 newborns infected with CD in Latin America are born annually. The available data on preventive treatments for pregnant women and the rate of congenital transmission is still limited with existing epidemiological information predominantly based on estimations. Therefore, our meta-analysis confirms the evidence for the use of trypanocidal agents in infected women of reproductive age to prevent congenital Trypanosoma cruzi (Tc) infection. [ABSTRACT FROM AUTHOR]

This paper investigates the association between family formation and the labour market trajectories of immigrants' descendants over the life course. Using rich data from the Trajectories and Origins survey from France, we apply multilevel event history models to analyse the transitions in and out of employment for both men and women by parity. We account for unobserved co-determinants of childbearing and employment by applying a simultaneous-equations modelling. Our analysis shows that women's professional careers are negatively associated with childbirth. There are differences across descendant groups. The female descendants of Turkish immigrants are more likely to exit employment and less likely to re-enter employment following childbirth than women from other groups. The negative impact of childbearing on employment is slightly overestimated among women due to unobserved selection effects. Among men, the descendants of European immigrants are less likely to exit employment after having a child than other descendant groups. The study demonstrates the negative effect of childbearing on women's employment, which is pronounced for some minority groups suggesting the need for further policies to help women reconcile work with family life. [ABSTRACT FROM AUTHOR]

Postpartum depression (PPD) is a mental health disorder that affects 10%–15% women globally. Longitudinal and meta-analyses have consistently demonstrated the negative impacts of PPD on both the affected mothers and subsequent infant development. Given the consideration that antidepressant side effects in breastfeeding infants and the cost-effectiveness considerations of psychotherapies, attention has been paid towards the promising role of social support interventions in order to prevent and reduce the PPD symptoms. Confirming the assertion, this narrative review examines the potential of five social support interventions to ameliorate PPD-related maternal and infant outcomes. The wide implications of psychoeducational strategy, nurses' supportive and non-directive counselling and home-visiting approach are outlined. Furthermore, the evidence underlying the role of peer support, culturally tailored intervention and community-based participatory approach in PPD is elucidated. In clinical practice, this review reinforce the roles of discharge educational intervention led by the experienced nurse during the postpartum stay, in order to maintain psychological mental health among the postpartum mothers. More importantly, the skilled and competence public health nurses act as valuable assets in treating PPD, and this effective treatment alternative should be considered by healthcare planners. In future, major investigations will be strategized to discover the synergistic effects of combined social support approaches to yield a better outcome in the prevention and treatment of PPD. [ABSTRACT FROM AUTHOR]

Background: The use of antioxidant-rich foods to treat female infertility has received significant attention in recent years. The aim of this study was to investigate the potential correlation between the composite dietary antioxidant index (CDAI) and female infertility. Methods: The participants in the cross-sectional data were women between the ages of 20 and 45 who had complete CDAI-related data and infertility information, which were taken from the National Health and Nutrition Examination Survey (NHANES) conducted between 2013 and 2020. The independent association between CDAI and infertility was investigated using multivariate logistic regression analysis. Trends between the two variables were examined using smoothed curve fitting, and subgroup analysis and interaction tests were conducted. Results: The prevalence of infertility was 12.57% of the 3,259 participants included in the study; individuals in higher CDAI quartiles tended to have a lower percentage of infertility. The risk of infertility was 44% lower among individuals in the highest quartile of the CDAI compared to those in the lowest quartile (OR = 0.56, 95%CI: 0.36–0.85, P = 0.0072), and the test for trend was also significant (P for trend = 0.0235). Smoothed curve fitting showed a negative non-linear relationship between CDAI and infertility. Subgroup analysis and interaction tests showed that there was an interaction of BMI in the relationship between CDAI and infertility risk (P for interaction = 0.0497) and that education, PIR, marital status, smoking status, hypertension, diabetes, age at menarche, ever having been treated for pelvic infection, ever having used female hormones, and ever been pregnant had no significant dependence on this negative association (all P for interaction > 0.05). Conclusion: There was a negative non-linear correlation between CDAI and infertility among reproductive-aged women in the US. The risk of infertility may be reduced by increasing the intake of antioxidant-rich foods. [ABSTRACT FROM AUTHOR]

Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by vascular thrombosis and obstetric morbidity, with accurate laboratory examination of antiphospholipid antibodies (aPLs) being crucial for diagnosis. This study focused on anti-β2 glycoprotein I (aβ2GPI) antibodies and aimed to establish the first population-based cutoff values for aβ2GPI IgA/IgM/IgG antibodies in non-pregnant women of reproductive age in Southwest China. The study cohort comprised 181 healthy women of reproductive age for study. Blood samples were collected on an early morning fast. Anti-β2GPI antibodies including IgA, IgM and IgG were measured in serum using the HOB® BioCLIA kit. According to the Clinical and Laboratory Standards Institute (CLSI) guidelines, the study used non-parametric percentile methods to calculate the 95th, 97.5th, and 99th percentiles cutoff values for aβ2GPI IgA/IgM/IgG antibodies, along with corresponding 90% confidence intervals (CI), while excluding outliers. A total of 168 independent samples were collected for verification, including 85 samples from healthy subjects and 83 samples from APS patients, in order to evaluate the analytical performance of the obtained cutoff values. The 99th percentile cutoff values were 3.36 RU/mL for aβ2GPI IgA, 27.54 RU/mL for aβ2GPI IgM and 1.81 RU/mL for aβ2GPI IgG, which indicated that the levels of aβ2GPI IgM antibodies were generally higher compared to those of IgA and IgG antibodies. Our established reference range was confirmed to be successful in validating the detected values of aβ2GPI antibodies in all healthy controls. With the 99th percentile cutoff value, the sensitivity was 14.46% for aβ2GPI IgA, 22.89% for aβ2GPI IgG, and 9.64% for aβ2GPI IgM in APS patients. This study established population-based cutoff values that are applicable to the local population for the accurate laboratory examination of aβ2GPI antibodies in non-pregnant women of reproductive age. The study also recommends paying more attention to IgM positivity in women of reproductive age. [ABSTRACT FROM AUTHOR]

Endometriosis and provoked vestibulodynia (PVD) are prevalent pain conditions among women of reproductive age, significantly impacting their quality of life and psychological well-being. However, comprehensive evidence regarding the lifelong health and socioeconomic outcomes for these individuals remains scarce. Additionally, many prior studies rely on limited and sometimes unrepresentative samples. This study aims to inform on the long-term consequences of these disorders by examining health, fertility, and employment outcomes in a cohort of women diagnosed with endometriosis and/or PVD, tracing their experiences from childhood to their 40s. Leveraging nationwide administrative data from Sweden and employing a matched case-control design, we investigate both similarities and differences between women with these diagnoses and those without. Our findings indicate that women diagnosed with endometriosis and/or PVD demonstrate elevated healthcare utilization patterns, commencing in their early teenage years and progressively increasing over time. Notably, disparities in labor market outcomes emerge in their 20s, showcasing lower labor earnings and a rise in sickness benefit receipt. Moreover, our results show a higher likelihood among these women to experience mental health disorders and concurrent chronic pain diseases, as well as infertility. While the association between endometriosis and infertility is well-documented, this study offers novel insights into a potential similar link between PVD and infertility. Our study informs healthcare professionals and policymakers about the considerable burden of compromised health, adverse psychosocial well-being, and reduced productivity in the labor market faced by young women with these common pain conditions. These findings underscore the urgency of addressing the multifaceted challenges encountered by individuals diagnosed with endometriosis and PVD across their lifespan. [ABSTRACT FROM AUTHOR]

Background: The incidence of chronic diseases, which are significant contributors to maternal deaths and adverse new-born outcomes, is increasing among women of reproductive age in northern Ghana. This emerging health issue raises serious concerns about the potential exacerbation of adverse birth outcomes in this setting, given that it is one of the regions in the country with a high incidence of such outcomes. We investigated the risks of preterm birth (PTB), low birth weight (LBW), and concurrent PTB and LBW among women with preexisting chronic conditions prior to conception in the Tamale Metropolis of northern Ghana. Methods: A facility-based cross-sectional study was conducted among 420 postpartum women randomly selected from five public health facilities. Information was collected electronically on participants' self-reported experience of chronic conditions, namely, hypertension, diabetes, asthma, heart disease, and sickle cell disease, prior to their most recent pregnancy. Information on gestational age at delivery and birth weight was also collected. Regression modeling was used to quantify the risk of adverse newborn outcomes among women who reported preexisting chronic conditions prior to pregnancy. Results: Chronic diseases affected 31.2% of our sample. Of these, 28.6% had a single chronic condition, while 2.6% had comorbid chronic conditions. The prevalence of PTB was 24.0% (95% CI: 20.2, 28.4), 27.6% (95% CI: 23.5, 32.1) of the newborns were born LBW, and 17.4% (95% CI: 14.0, 21.3) of the pregnancies resulted in both PTB and LBW. Compared with those without chronic conditions, women with chronic conditions prior to conception had a greater risk of PTB (aOR = 6.78, 95% CI: 3.36, 13.68), LBW (aOR = 5.75, 95% CI: 2.96, 11.18), and the co-occurrence of PTB and LBW (aOR = 7.55, 95% CI: 3.32, 17.18). Conclusions: We observed significant rates of PTB, LBW, and the co-occurrence of PTB and LBW among women who were already aware that they had preexisting chronic conditions prior to conception. Our findings highlight a potential gap in the quality of prenatal care provided to these women before delivery. Preconception care may offer an opportunity to address preexisting chronic conditions in women before pregnancy and potentially improve maternal and newborn health outcomes. [ABSTRACT FROM AUTHOR]

Micronutrient deficiencies affect growth and development and are critical for maintaining health at all ages. Their critical role in exacerbating complications of infections and chronic diseases continues to impact morbidity, mortality, and quality of life for many. Raising awareness and advocating for micronutrient deficiencies in Latin America is urgent to reduce this preventable burden. Globally, an estimated 372 million preschool-aged children and 1.2 billion non-pregnant women of reproductive age suffer deficiency from 1 or more micronutrient. Data is limited and often old, and the true burden of problem in the region remains unclear. There are also limited data on dietary intake and on the double burden of malnutrition. Latin America has been a leader in the design and implementation of innovative and effective actions to reduce excess energy intake and curb the consumption of unhealthy Actions to address deficiency have been implemented in many countries in the region over the years, but current evidence suggests that micronutrient deficiencies have fallen off the public health agenda in Latin America. Effective programming can be developed / appropriately adapted only with knowledge of the current burden. Such data can also help guide and predict future areas of risk and priorities to missing upcoming nutrition issues in the population. Renewed commitment to quantify and monitor micronutrient deficiencies in the region is essential. Abundant evidence and guidance exist to inform effective program selection, design and implementation to address this public health problem. [ABSTRACT FROM AUTHOR]

Background: Women's Dietary Diversity Score (WDDS) is an indicator of dietary diversity, a key component of diet quality in women of reproductive age (WRA). Limited information is available regarding its applicability in other population groups. Objective: To examine the ability of the Minimum Dietary Diversity for Women (MDD-W) of 5-food groups cutoff to predict micronutrient adequacy in men and women 15 to 65 years old from 8 Latin American countries. Methods: We used a 24-hour recall from 9216 participants in the Latin American Study on Nutrition and Health (ELANS) to determine Dietary Diversity Score (DDS) based on the consumption of 10 food groups. The Mean Probability of Adequacy (MPA) was associated with DDS for the overall sample, for men, WRA, and women of nonreproductive age (WNRA). Sensitivity and specificity analyses were performed to determine if the 5-food groups cutoff point for MDD can be used to correctly identify men, WRA, and WNRA with adequate micronutrient adequacy (MPA ≥ 0.70). Results: We found a mean DDS of 4.78 ± 1.33 and an MPA of 0.64 ± 0.16, with 59% of participants showing a diverse diet (DDS ≥ 5). The 5-food groups-cutoff point showed a better balance between sensitivity and specificity predicting an MPA ≥0.70 in men, WRA, and WNRA. MPA was significantly associated with DDS in WRA and for men and WNRA, as well. Conclusion: The 5-food group MDD, originally intended to be used in WRA, performed equally well in predicting MPA ≥0.70 in men, WRA, and WNRA, and can be used as a proxy of micronutrient adequacy in Latin American population. Plain language title: Assessment of the FAO Minimum Dietary Diversity Index to Estimate Micronutrients Intake in Urban Cities of 8 Latin America Countries Plain language summary: The Women's Dietary Diversity Score (WDDS) proposed by the Food and Agriculture Organization is an indicator that measures the variety of foods consumed by women of reproductive age (WRA), and it has been reported in several studies that the more diverse the diet, the greater the probability of meeting micronutrients requirements. This indicator has not been validated in other population, but few studies have been conducted in the Latin American region. So, we aimed to investigate whether the Minimum Dietary Diversity for Women (MDD-W) established for WRA could also predict sufficient micronutrient intake in men and women aged 15 to 65 years in the Latin American population. To accomplish this objective, we used data from the Latin American Study of Nutrition and Health (Estudio Latino Americano de Nutrición y Salud—ELANS) that collected dietary data from 24-h recalls from 9216 participants and analyzed the association between DDS and the Mean Probability of Adequacy (MPA). Additionally, we determined if the MDD cutoff point could correctly identify individuals with appropriate vitamin and mineral intake. We found that the overall mean DDS was 4.78 ± 1.33, the MPA was 0.64 ± 0.16, and approximately 59% of participants had a diverse diet. The MDD of 5-food groups cutoff point was demonstrated to be useful in predicting sufficient micronutrient intake for men, WRA, and women over 50 years. Respondents with a DDS ≥5 had higher micronutrient adequacy. These findings suggest that DDS can serve as a proxy for assessing micronutrient adequacy in urban populations beyond WRA. The effect of promoting diverse diets on micronutrient adequacy as part of intervention programs can be captured by the DDS in urban Latin American populations. [ABSTRACT FROM AUTHOR]

Background: Micronutrient deficiencies in Latin America are a public health concern, nonetheless, lack of information still exists in many countries, so that the true magnitude of the problem remains uncertain. Objective: To summarise experiences that can inform the development of policies and programs to address micronutrient deficiencies throung supplementation in pregnant women and chlidren under five years of age in Latin American. Methods: Review of the most evidence on the effects of micronutrients supplementation, focusing on pregnant women and children under five years of age. Results: Certain population groups, as women of reproductive age and children under 2 years of age, are at increased risk for deficiency due to their high micronutrient requirements. This is compounded by the limited access to micronutrient-rich foods for many people living in vulnerable situations. Micronutrient supplementation is an effective intervention to prevent and treat deficiency and to mitigate its adverse effects on health, nutrition, and pregnancy outcomes in micronutrient-deficient populations. The potential benefits of supplementation programs, however, are realized only when they reach those who have the potential to benefit, that is, with inadequate intakes of micronutrients from dietary sources, and when the quality of design and delivery of the programs aresufficient to reach that population timely, regularly, and effectively to enable and motivate consumption. Conclusions: Several resources and experiences exist that can help favor the development of programs that can realize this biological and programmatic potential. There is need for continuous efforts to augment coverage and achieve results that can translate into economic benefits for individuals, families, and nations. Plain language title: Correcting Vitamin and Mineral Deficiencies in Pregnant Women and Children in Latin America Plain language summary: Previous articles in this supplement have highlighted the importance of micronutrient (vitamin and mineral) deficiencies in Latin America, their causes and effects in different population groups, and some alternatives for their prevention and control. At certain stages of life, particularly during the first 1000 days (from pregnancy to 2 years of age), high nutrient requirements predispose to nutritional deficiencies. This is exacerbated by the limited access to healthy foods for populations living in vulnerable situations. Dietary supplements are therefore an effective strategy for preventing and treating deficiencies and mitigating their adverse effects on the nutrition and health of the population. In this article, we review the most recent estimates on the prevalence of nutrient deficiencies, with a focus on pregnant women and children under 2 years of age; the types of supplements available, and the international recommendations for supplementation during this period of life. There is strong evidence for several benefits of short-term supplementation. In pregnant women, vitamin and mineral levels are improved and a healthy pregnancy is achieved. In children, vitamin and mineral levels are also improved, and some (such as iron and zinc) improve growth and development. In the long term, there are economic benefits for individuals, families, and nations. Several recommendations from studies and supplementation programs are also discussed. Although nutritional supplementation can be cost-effective, benefits will only be achieved if the types and formulations of supplements meet the assessed nutritional needs of the population and if a program is properly designed and implemented. Similarly, programs that include supplements need to be monitored and evaluated to ensure that supplements are taken regularly and for long enough to achieve these benefits. [ABSTRACT FROM AUTHOR]

BACKGROUND Awareness of the age-related decline in fertility potential has increased the popularity of planned oocyte cryopreservation (POC). However, data regarding outcomes of POC, including rates of women returning to thaw oocytes, as well as pregnancy and live birth rates, are scarce and based mostly on small case series. OBJECTIVE AND RATIONALE POC was defined as cryopreservation exclusively for prevention of future age-related fertility loss. The primary outcome was live birth rate per patient. The secondary outcomes included the return to thaw rate and laboratory outcomes. A meta-regression analysis examining the association between live birth and age above 40 or below 35 was conducted. SEARCH METHODS We conducted a systematic database search from inception to August 2022. The search included PubMed (MEDLINE) and EMBASE. Our search strategies employed a combination of index terms (Mesh) and free text words to compile relevant concepts. The systematic review and meta-regression were undertaken following registration of systematic review (PROSPERO registration number CRD42022361791) and were reported following guidelines of Preferred Reporting Items for Systematic Review and Meta-Analyses 2020 (PRISMA 2020). OUTCOMES The database search yielded 3847 records. After the selection process, 10 studies, conducted from 1999 to 2020, were included. Overall, 8750 women underwent POC, with a mean cryopreservation age of 37.2 (±0.8). Of those, 1517 women returned to use their oocytes with a return rate of 11.1% (± 4.7%). The mean age at the time of cryopreservation for women who returned to use their oocytes was 38.1 (±0.4), with an average of 12.6 (±3.6) cryopreserved oocytes per woman. In a meta-analysis, the oocyte survival rate was 78.5% with a 95% CI of 0.74–0.83 (I 2 = 93%). The live birth rate per patient was 28% with a 95% CI of 0.24–0.33 (I 2 = 92%). Overall, 447 live births were reported. In a sub-group analysis, women who underwent cryopreservation at age ≥40 achieved a live birth rate per patient of 19% (95% CI 0.13–0.29, I 2 = 6%), while women aged ≤35 years old or younger had a higher live birth rate per patient of 52% (95% CI 0.41–0.63, I 2 = 7%). WIDER IMPLICATIONS POC emerges as a feasible option for women aiming to improve their chances of conceiving at a later reproductive age. Nonetheless, it must be acknowledged that the overall success rates of POC are limited and that the likelihood of successful live birth declines as the age at cryopreservation rises. With increasing interest in POC, the collation of comprehensive and high-quality data is imperative to clearly define the outcomes for various age groups. REGISTRATION NUMBER CRD42022361791. [ABSTRACT FROM AUTHOR]

STUDY QUESTION What is the estimated prevalence and incidence of uterine fibroids diagnosed in Australian women of reproductive age? SUMMARY ANSWER An estimated 7.3% of Australian women had a diagnosis of uterine fibroids by the age of 45–49 years, with age-specific incidence highest in women aged 40–44 years (5.0 cases per 1000 person-years). WHAT IS KNOWN ALREADY Uterine fibroids are associated with a high symptom burden and may affect overall health and quality of life. Studies in different countries show a wide variation in both the prevalence (4.5–68%) and incidence (2.2–37.5 per 1000 person-years) of uterine fibroids, which may be partly explained by the type of investigation, method of case ascertainment, or the age range of the study population, necessitating the reporting of country-specific estimates. STUDY DESIGN, SIZE, DURATION This observational prospective cohort study using self-report survey and linked administrative data (2000–2022) included 8066 women, born between 1973 and 1978, in the Australian Longitudinal Study on Women's Health. PARTICIPANTS/MATERIALS, SETTING, METHODS A combination of self-report survey and linked administrative health data (hospital, emergency department, the Medicare Benefits Schedule, and the Pharmaceutical Benefits Scheme) were used to identify women with a report of a diagnosis of uterine fibroids between 2000 and 2022. MAIN RESULTS AND THE ROLE OF CHANCE Of the 8066 Australian women followed for 22 years, an estimated 7.3% of women (95% CI 6.9, 7.6) had a diagnosis of uterine fibroids by the age of 45–49 years. The incidence increased with age and was highest in women aged 40–44 years (5.0 cases per 1000 person-years, 95% CI 4.3, 5.7 cases per 1000 person-years). Women with uterine fibroids were more likely to experience heavy or painful periods. They were also more likely to report low iron levels, endometriosis, and poor self-rated health and to have two or more annual visits to their general practitioner. LIMITATIONS, REASONS FOR CAUTION Our estimates are based on self-report of doctor diagnosis or treatment for fibroids and/or data linked to treatment and procedure administrative records. This predominantly captures women with symptomatic fibroids, but has the potential for misclassification of asymptomatic women and an underestimate of overall prevalence and incidence. In addition, questions on fibroids were only asked in surveys when women were 37–42 years of age to 43–48 years of age, so cases at younger ages may have been underestimated (particularly in women with less severe symptoms) as these were only ascertained through data linkage. WIDER IMPLICATIONS OF THE FINDINGS These are the first population-based estimates of the prevalence and incidence of uterine fibroids in women of reproductive age in Australia. Establishing these first estimates will help inform health policy and health care provision in the Australian context. STUDY FUNDING/COMPETING INTEREST(S) The ALSWH is funded by the Australian Government Department of Health and Aged Care. L.FW. was supported by an Australian National Health and Medical Research Council (NHMRC) Centres for Research Excellence grant (APP1153420) and G.D.M. was supported by an NHMRC Leadership Fellowship (APP2009577). The funding bodies played no role in the design, the collection, analysis or interpretation of data, the writing of the manuscript, or the decision to submit the manuscript for publication. There are no competing interests. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

Objective: Polycystic ovary syndrome (PCOS) is a common disorder among women of reproductive age. The goal of the current study was to evaluate the effect of evening primrose oil (EPO) (Oenothera biennis) in adolescent girls with PCOS. Materials and Methods: In the current double-blind and randomized controlled research, 76 patients completed the study in two groups (38 in the placebo and 38 in the EPO groups). The patients were asked to take oral placebo or EPO (1000 mg/day) for 12 weeks. Biochemical, clinical, and ultrasonography assessments were performed. The data was analyzed using SPSS statistical software. Results: After the intervention, the regulation of the menstrual cycle in the EPO group was different from that of the placebo group (p=0.04). The levels of insulin, testosterone, and free androgen index (FAI) in the EPO group were lower than those of the placebo group (p<0.05). The sex hormone binding globulin (SHBG) levels in the EPO group were higher than those of the placebo group (p=0.01). While the number of immature follicles decreased in the EPO group, this difference was not statistically significant (p=0.8). Conclusion: Overall, EPO administration for 12 weeks in young women with PCOS regulated the irregular menstrual cycle. In addition, the levels of insulin, testosterone, FAI, and SHBG changed. Therefore, EPO may be effective in improving hormonal and menstrual irregularities. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS) is the most common metabolic disorder among women of reproductive age. Many factors are involved in the development of PCOS, among which genetic predisposition is probably the main contributor that is also influenced by lifestyle and environmental factors. This study aims to determine the prevalence of PCOS in different continents based on Rotterdam, AES and NIH diagnostic criteria. Methods: We conducted a systematic review and meta-analysis to evaluate the prevalence of polycystic ovary syndrome in women according to (Preferred Reporting Items for Systematic Review and Meta-Analysis) PRISMA guidelines. PubMed, Scopus, Science Direct, Web of Science and Google Scholar databases were comprehensively searched until February 2021 for relevant articles. Heterogeneity between the studies was assessed using the I2 index. Begg and Mazumdar's test was used to evaluate publication bias. Results: A total of 35 studies with 12,365,646 subjects were retrieved. The mean age ranged from 10–45 years. Global prevalence of PCOS was 9.2% (95% CI: 6.8–12.5%) based on meta-analysis, our results showed that the global prevalence of PCOS was 5.5% (95% CI: 3.9–7.7%) based on NIH criteria, 11.5 (95% CI: 6.6–19.4) based on Rotterdam criteria, and 7.1% (95% CI: 2.3–20.2%) based on AES criteria. According to self-report subgroup analysis, the prevalence of PCOS was found to be 11% (95% CI: 5.2–21.8%). Conclusion: Based on the results of the present study, the prevalence of PCOS in the world was 9.2% (95% CI: 6.8–12.5%). According to the results of the present study and the high prevalence of PCOS, especially in the Africa continent, it is necessary for health systems to implement measures to timely prevent and treat this syndrome. [ABSTRACT FROM AUTHOR]

Background: Knowledge about fertility and factors affecting it, for example, the impact of age, seem to be lacking, even in highly educated populations. The same applies to fertility preservation knowledge, pointing to the relevance of increasing fertility preservation awareness and education among young women. Objective: To describe general fertility knowledge and factors affecting fertility, fertility preservation knowledge and attitudes, and the desire to access more information on this topic in a sample of reproductive-age Portuguese women. Methods: The sample comprised 257 Portuguese women aged 18–45, mostly single and nulliparous. A questionnaire was developed explicitly for this study and disseminated through social media advertisements. Results: Career building/development and financial stability were the more endorsed options for delaying childbearing, with 90 (35%) and 68 (26.5%), respectively. Most participants considered becoming a mother important (n = 185; 72%). More than halve provided an incorrect answer regarding the age range of women being more fertile (n = 132; 51.4%) and the age range of fertility decline (n = 168; 65.4%). Participants were aware of the influence of lifestyle and sexual health factors as well as the effect of age. Oocytes cryopreservation was the technique participants knew more (n = 206; 80.1%), but 177 (68.9%) showed no interest in using it. Most participants agreed that fertility and fertility preservation information should be provided during medical consultations or at school. Conclusions: More information regarding fertility and fertility preservation is relevant to ensure that more women can make informed decisions concerning their reproductive life. [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]

Objective: To compare the cost‐effectiveness of different treatments for cervical intraepithelial neoplasia (CIN). Design: A cost‐effectiveness analysis based on data available in the literature and expert opinion. Setting: England. Population: Women treated for CIN. Methods: We developed a decision‐analytic model to simulate the clinical course of 1000 women who received local treatment for CIN and were followed up for 10 years after treatment. In the model we considered surgical complications as well as oncological and reproductive outcomes over the 10‐year period. The costs calculated were those incurred by the National Health Service (NHS) of England. Main outcome measures: Cost per one CIN2+ recurrence averted (oncological outcome); cost per one preterm birth averted (reproductive outcome); overall cost per one adverse oncological or reproductive outcome averted. Results: For young women of reproductive age, large loop excision of the transformation zone (LLETZ) was the most cost‐effective treatment overall at all willingness‐to‐pay thresholds. For postmenopausal women, LLETZ remained the most cost‐effective treatment up to a threshold of £31,500, but laser conisation became the most cost‐effective treatment above that threshold. Conclusions: LLETZ is the most cost‐effective treatment for both younger and older women. However, for older women, more radical excision with laser conisation could also be considered if the NHS is willing to spend more than £31,500 to avert one CIN2+ recurrence. [ABSTRACT FROM AUTHOR]

Background: The increasing prevalence of overweight and obesity worldwide represents a (chronic) complex public health problem. This is also seen among women of childbearing age despite increased efforts to promote physical activity (PA) interventions. Excessive gestational weight gain (GWG) is associated with negative health outcomes for both mothers and offspring. Objectives: To summarize current systematic reviews (SRs) on PA interventions during pregnancy and postpartum to prevent excessive GWG and identify the most effective approaches. Search Strategy: A literature search was conducted on major electronic databases (MEDLINE/Pubmed, Cochrane, Web of Science, Epistemonikos) from inception to March 2023. Selection Criteria: This study included SRs and meta‐analyses of studies involving women aged 18 years or older from diverse ethnic backgrounds, who were either in the preconception period, pregnant, or within 1 year postpartum and who had no contraindications for exercise. Women with chronic diseases, such as pre‐existing diabetes (type 1 or type 2) were excluded. Data Collection and Analysis: Two reviewers extracted data from selected studies assessing the impact of PA in preconception, pregnancy, and postpartum. Methodologic quality was assessed with the AMSTAR‐2 tool. A narrative summary of results addresses relationships between PA and weight before, during, and after pregnancy, informing future research priorities for preventing excessive weight gain. This study is registered on PROSPERO (CRD420233946666). Main Results: Out of 892 identified articles, 25 studies were included after removing duplicates, unrelated titles, and screening titles and abstracts for eligibility. The results demonstrate that PA can help prevent excessive GWG and postpartum weight retention. Structured and supervised moderate‐intensity exercise, at least twice a week, and each session lasting a minimum of 35 min seems to provide the greatest benefits. Conclusions: Women who comply with the PA program and recommendations are more likely to achieve adequate GWG and return to their pre‐pregnancy body mass index after delivery. Further research is warranted to explore how preconception PA influences pregnancy and postpartum outcomes given the absence of identified preconception‐focused interventions. Synopsis: There is evidence that interventions of physical activity during pregnancy and postpartum to control/reduce weight gain in women. There are no systematic reviews before pregnancy. [ABSTRACT FROM AUTHOR]

Introduction: Active surveillance for cervical intraepithelial neoplasia grade 2 (CIN2) has been implemented recently in many countries, including the Nordic countries. In Denmark, the only eligibility criterion for active surveillance for CIN2 is that the woman should be of reproductive age. With this study, we aimed to evaluate clinical and socioeconomic characteristics in women with CIN2 managed by active surveillance or large loop excision of the transformation zone (LLETZ) and to evaluate temporal changes in the clinical management of CIN2. Material and Methods: We conducted a Danish nationwide study using data from healthcare registries. All female residents aged 18–40 years, diagnosed with incident CIN2 from January 1, 1998, to February 29, 2020, were included. We collected data on age, index cytology result, year of CIN2 diagnosis, region of residence, civil status, HPV vaccination status, and socioeconomic position indicators. The variables were tabulated overall and by management group (active surveillance vs. LLETZ). To evaluate time trends, we used joinpoint regression to calculate the annual percentage change (APC), including 95% confidence intervals (CI). Results: Of the 27 536 women with CIN2 included, 12 500 (45.4%) underwent active surveillance, and 15 036 (54.6%) underwent a LLETZ. Women undergoing active surveillance were younger, more often HPV‐vaccinated, and more likely to have a normal/low‐grade index cytology result than women undergoing LLETZ. Socioeconomic position indicators did not differ. Over time, the proportion of women undergoing active surveillance increased from 21.7% in 2004 to 73.6% in 2019 (APC 9.7, 95% CI 8.1–11.4). The proportion of women undergoing active surveillance aged <30 declined over time (APC −2.2, 95% CI −2.9 to −1.5). The proportion of women with normal/low‐grade index cytology increased slightly to 51.6% in 2019 (APC 0.8, 95% CI 0.4–1.3). Conclusions: The use of active surveillance for CIN2 has increased over the past two decades in Denmark. Observed differences in characteristics between women undergoing active surveillance vs LLETZ are likely related to indications for clinical management. [ABSTRACT FROM AUTHOR]

We examined rural and urban prevalence and correlates of overweight/obesity among women of reproductive age using survey data from Nigeria. Overweight and obesity prevalence increased from 16.1% and 6.1% in 2008 to 18.2% and 10.0% in 2018, while underweight prevalence consistently averaged at 12%. Regardless of the residential setting, age, marital status, education, occupation, wealth, and year were associated with higher risk of overweight/obesity, whereas breastfeeding showed a protective effect. Unique risk factors for overweight/obesity in urban areas were higher parity and female-headed households, while ethnicity, media exposure, and state of residence were unique risk factors in rural areas. [ABSTRACT FROM AUTHOR]

Women's health is determined by a wide range of personal, biological, social and environmental factors. Health depends not only on individual characteristics - gender, age, heredity, genetic characteristics and on lifestyle - smoking, alcohol abuse, drug use, nutrition, physical activity, but also on social and economic factors - education, conditions of work, unemployment, poverty, access to health services, violence, discrimination and human rights. The factors of this complex do not act in isolation, but have a combined effect on a woman's health throughout her life. Women's health and their reproductive behavior are of utmost importance for healthy children. Good women's health is important for the development of future human capital, for the development of children. Healthier women and their children contribute to better educated societies. Women's health is of utmost importance for the health of future generations. Therefore, there is a need for investments aimed at women's health. Those societies that invest in women's health are likely to enjoy better health for generations to come. The problem of women's health in fertile age is extremely relevant and significant against the background of the serious demographic crisis in the Republic of Bulgaria, which is the result of unfavorable demographic processes - the reduced birth rate, which does not ensure the simple reproduction of the population, the higher mortality rates and intensive external migration - women of childbearing age emigrate, which lowers the potential future birth rate. [ABSTRACT FROM AUTHOR]

Background: There is limited epidemiological evidence on outcomes associated with dupilumab exposure during pregnancy; monitoring pregnancy outcomes in large populations is required. Objective: To investigate the potential association between exposure to dupilumab in pregnant women with atopic dermatitis and any adverse pregnancy, neonatal, congenital and post‐partum outcomes. Methods: We performed a multicentre retrospective cohort study across 19 Italian tertiary referral hospital. Childbearing women were eligible if aged 18–49 years and carried out the pregnancy between 1 October 2018 and 1 September 2022. Results: We retrospectively screened records of 5062 patients receiving dupilumab regardless of age and gender, identifying 951 female atopic dermatitis patients of childbearing age, 29 of whom had been exposed to the drug during pregnancy (3%). The median duration of dupilumab treatment prior to conception was 22.5 weeks (range: 3–118). The median time of exposure to the drug during pregnancy was 6 weeks (range: 2–24). All the documented pregnancies were unplanned, and the drug was discontinued in all cases once pregnancy status was reported. The comparison of the study cohort and the control group found no significant drug‐associated risk for adverse pregnancy, congenital, neonatal or post‐partum outcomes. The absence of a statistically significant effect of exposure on the event was confirmed by bivariate analysis and multivariate analysis adjusted for other confounding factors. Conclusions: This cohort of pregnant patients exposed to dupilumab adds to the existing evidence concerning the safety of biologic agents in pregnancy. No safety issues were identified regarding the primary outcome assessed. In clinical practice, these data provide reassurance in case of dupilumab exposure during the first trimester. However, the continuous use of dupilumab throughout pregnancy warrants further research. [ABSTRACT FROM AUTHOR]

The present study aimed to explore the lived experience of fertile Iranian mothers who adopted children. In a qualitative phenomenological method, 13 participants were selected by purposive sampling and interviewed in depth. Data were analyzed by Colaizzi's method. The results showed that although adoption was reported to be a positive experience for most mothers, it is still a kind of social stigma in Iran, and adoptive mothers face many challenges due to insufficient support and help from society and families. Also, the results will help professionals design pre-adoption interventions, prevent the termination of adoption, and help adoptive mothers solve their issues. [ABSTRACT FROM AUTHOR]

• Megacolon is a rare clinical condition consisting of an abnormally dilated colon in the absence of mechanical obstruction. • Megacolon can complicate pregnancy in terms of maternal morbidity and mortality and obstetrical outcomes. Pregnancy, on the other hand, can exacerbate chronic constipation through hormonal and mechanical mechanisms. • A case of megacolon is reportedpresenting accidentally during the routine mid-trimester fetal ultrasound as a suspicious pelvic mass of unknown aetiology (mean diameter > 10 cm). • Chronic constipation in women of reproductive age should receive greater clinical attention during pre- and periconception care. • A multi-disciplinary approach, timely diagnosis and delivery planning are fundamental to ensure favourable outcomes for both the mother and fetus when dealing with megacolon during pregnancy. Megacolon is a rare clinical condition consisting of an abnormally dilated colon in the absence of mechanical obstruction. Megacolon can complicate pregnancy in terms of maternal morbidity and mortality (volvulus, ileus, systemic toxicity, bowel perforation, sepsis) and obstetrical outcomes (preterm birth, premature rupture of membranes, dystocia). Pregnancy, on the other hand, can exacerbate chronic constipation through hormonal and mechanical mechanisms. A case of megacolon, first detected during pregnancy in an otherwise healthy nulliparous woman, is reported. The diagnosis was suspected on observation of a pelvic mass of unknown aetiology (mean diameter > 10 cm) constricting and dislocating the gravid uterus contralaterally during a routine mid-trimester fetal ultrasound. The diagnostic work-up and management are discussed. Chronic constipation in women of reproductive age should receive greater clinical attention during pre- and periconception care. A multi-disciplinary approach, timely diagnosis and delivery planning are fundamental to ensure favourable outcomes for both the mother and fetus when dealing with megacolon during pregnancy. [ABSTRACT FROM AUTHOR]

This article aims to describe contemporary parental leave among obstetrics and gynecology trainees and early-career faculty. Here, we present results of a survey that collected information about parental leave policies and contemporary practice, as well as beliefs about surgical and clinical experience for those who take leave. Faculty and trainees were equally well represented among respondents, with half of each group self-identifying as a parent. Most reported that childbearing trainees currently take 6 weeks or less of parental leave and believed that childbearing and nonchildbearing residents should be able to take 12 weeks of leave without extending training. [ABSTRACT FROM AUTHOR]

La mammoplastie de réduction concerne en grande partie des femmes en âge de procréer et peut théoriquement interférer avec les capacités d'allaitement maternel (AM), alors que les bénéfices de l'AM ont bien été démontrés. Les données actuelles de la littérature ne permettent pas de fournir une information précise sur les possibilités d'AM après mammoplastie de réduction. L'objectif de cette étude est d'évaluer la capacité d'AM sur le long terme chez les femmes après mammoplastie de réduction réalisée dans le service de chirurgie plastique de l'hôpital Saint-Louis (AP-HP). Il s'agit d'une étude rétrospective, comparative, concernant des patientes ayant bénéficié d'une mammoplastie de réduction à l'hôpital Saint Louis entre 2010 et 2017 et ayant eu des enfants avant ou après chirurgie. Les données concernant l'intervention ont été recueillies dans le dossier médical, et la capacité à allaiter a été évaluée à l'aide d'un questionnaire standardisé lors d'un entretien téléphonique. L'allaitement des enfants nés avant chirurgie a été comparé à l'allaitement des enfants nés après chirurgie. Nous avons analysé l'AM sur 21 naissances avant chirurgie et 35 naissances après chirurgie. Le taux d'initiation à l'AM était similaire entre les deux groups (83 % vs 90 %, p = 0,7), la durée médiane d'AM était significativement réduite après chirurgie (10 semaines vs 3 semaines, p < 0,01), ainsi que le taux d'enfants allaités à 3 mois (43 % vs 11 %, p < 0,01). Le taux d'utilisation de préparations infantiles était plus élevé après chirurgie (74 % vs 100 %, p < 0,01), ainsi que le taux d'arrêt d'allaitement pour cause d'hypogalactie (11 % vs 69 %, p < 0,001) L'allaitement après mammoplastie de réduction est possible, mais plus difficile à maintenir sur le long terme. Les patientes doivent en être informées avant la chirurgie, et celles qui souhaitent allaiter après la chirurgie doivent y être encouragées à la maternité. Breast reduction surgery often concern women of childbearing age. However, it can interfere with the ability to breastfeed, whereas the benefits of breastfeeding are well known. Current data in the literature do not provide precise information on the possibilities of breastfeeding after breast reduction surgery. The aim of this study was to assess long-term breastfeeding ability of women after breast reduction performed in our centre. This is a retrospective comparative study including patients treated with breast reduction at Saint-Louis Hospital between 2010 and 2017 and who have had children before or after surgery. Operative details were retrieved from medical records and ability to breastfeed was assessed during a phone interview. Breastfeeding before surgery was compared to breastfeeding after surgery. We analysed 21 births before and 35 births after breast reduction. Breastfeeding initiation was similar in the two groups (90% vs. 83%, P = 0.7), but the median duration was significantly shorter after breast reduction compared with before (3 weeks vs. 10 weeks; P < 0.01), the rate of breastfed child at 3 months was lower after surgery (11% vs. 43%; P < 0.01), the use of infant formula was higher after surgery (100% vs. 74%, P < 0.01), and we found a higher rate of discontinuation caused by hypogalactia (69% vs. 11%; P < 0.001). Breastfeeding is possible but more difficult to sustain over time after breast reduction. Patients need to be made aware of that before surgery, and patients who still want to breastfeed should be encouraged at the maternity. [ABSTRACT FROM AUTHOR]

Background With the success of free autologous breast reconstruction, the abdominal donor site is now an important consideration, especially in patients of childbearing age. In our institution, there are increasing patients who have successfully undergone the deep inferior epigastric artery perforator (DIEP) flap despite previous pregnancy. This study aims to answer questions on the effect of the donor site on pregnancy and vice versa. Methods A retrospective cohort study was conducted to identify breast cancer patients who received a free DIEP flap for breast reconstruction from January 2018 to August 2020. Patients were allocated to two groups according to whether they had prior pregnancies with successful deliveries. Demographics, flap-related parameters, surgical outcomes on breast and abdomen, and patient-reported outcome (Breast-Q questionnaire) were analyzed. Patients were excluded if follow-up time was less than 1 year, or if there was incomplete medical records or Breast-Q replies. Results Ninety-nine of 116 patients had had successful pregnancies with delivery, 17 of them remained nulliparous. No statistically significant differences existed between groups regarding demographic data, flap-related parameters, surgical outcomes on breast and abdomen. Nulliparous patients exhibited significantly lower score in physical well-being in the abdomen domain compared with delivery-experienced patients (62.1 vs. 73.4, p = 0.025). Significantly, nulliparous patients felt more tightness and pulling of the abdominal wall than the delivery-experienced patients (2.9 vs. 3.7; p = 0.05 and 3.5 vs. 4.0; p = 0.04). Conclusion Free DIEP flap can be transferred safely in nulliparous patients despite a slight increase in abdominal tightness and abdominal pulling. Precise flap design and surgical approaches may help to minimize the abdominal discomfort especially on young, normal body mass index, and nonchildbearing patients. [ABSTRACT FROM AUTHOR]

In 2019, 1.74 billion people worldwide had anemia. In Nigeria, women of reproductive age are the most affected. Domestic violence affects the anemia prevalence, but few studies have examined the influence of urbanization on women in heterosexual unions (currently married, and cohabiting between). Using the social determinants of health framework, we argue that food-based violence and anemia vary among women residing in rural and urban areas. We used the Chi-square test and logistic regression to analyze the 2018 Nigeria Demographic and Health Survey records (n = 10,499). The study showed that anemia occurs more among women in rural (66%) than in urban (34%) areas. In rural areas, anemia was 29% higher among women who approved food-based domestic violence (OR: 1.29, CI 1.15–1.57) than those who did not. In urban areas, food-based domestic violence was not significantly associated with anemia. This study emphasizes the urgent need for culturally sensitive maternal health interventions aimed at re-orienting individuals and families on violence in rural areas. Key messages: Anemia occurs more frequently among women in rural settings than in urban locations. Food-based domestic violence was associated with the incidences of anemia among women in rural areas but not significant in urban settings. Violence is normalized in rural areas, calling for an urgent need for culturally sensitive maternal health interventions. [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]

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Introduction: By studying the dietary habits of patients with bacterial vaginosis (BV) and the controls, we aim to find out whether the dietary intakes of phytochemicals could reduce the odds of BV. To the best of our knowledge, no study has ever examined the matter before. Therefore, we decided to conduct this secondary analysis of case-control study to examine the association between dietary phytochemicals and BV. Method: This case-control study was conducted at the gynecological clinic of Imam Hossein Hospital using a convenience sampling method from November 2020 to June 2021. To diagnose BV, all participants underwent examination by a gynecologist, assessing the presence of 3 or 4 criteria from the Amsel criteria. A validated semi-quantitative food frequency questionnaire was used. The phytochemical index was determined using McCarty's method. To assess the association between dietary phytochemical intake and the odds of BV, binary logistic regression was utilized. Results: After adjusting for potential confounders, the association between phytochemical index and BV remained significant (odds ratio (OR) = 0.349, 95% confidence interval (CI): 0.176–0.695, p-value = 0.003). Furthermore, each unit increase in fat intake was associated with higher odds of BV (OR = 1.008, 95% CI: 1.002–1.014, p-value = 0.006), and a positive family history of BV continued to show significantly increased odds of BV (OR = 3.442, 95% CI: 2.068–5.728, p-value < 0.001). Conclusion: In summary, the findings of this study indicate that increased consumption of dietary phytochemicals is associated with a reduced risk of BV among Iranian women of reproductive age. Additional research, especially longitudinal dietary studies, is required to explore the potential impact of dietary modifications on BV. [ABSTRACT FROM AUTHOR]

Balanced energy protein supplementation (BEP) is recommended for contexts of high maternal undernutrition by the World Health Organization. Despite recent improvements in undernutrition, Bangladesh remains a context where BEP could help accelerate progress towards nutrition goals. In preparation for an effective trial testing a fortified BEP, a qualitative study was undertaken to better understand sociocultural factors influencing dietary behaviours in pregnancy. Married women of reproductive age (n = 23), their husbands (n = 6) and mothers‐in‐law (n = 6) were interviewed, and focus group discussions were conducted with women (n = 4). Women had a clear understanding of which nutritious foods are important to consume during pregnancy, including green leafy vegetables, dairy and other animal‐source foods. Many explained affordability as a barrier to consuming those foods with the desired frequency. Women acquired information about diet and nutrition in pregnancy from community health workers as well as other women in the community. Most preferred to seek information from their own networks before formal health care providers. Women and husbands generally had positive views about micronutrient supplements, although some mothers‐in‐law were more hesitant. Some food taboos relating to the consumption of certain foods like duck and pigeon meat persist, mainly stemming from concerns for the unborn child. Opportunities exist to build on existing perceptions of healthy diets, potentially framing food or nutrient supplements as a beneficial ‘add‐on’ to promote a healthy pregnancy. There is a scope to strengthen nutrition counselling, especially for the family members, to dispel myths and misconceptions and promote dietary and other support for pregnant women. [ABSTRACT FROM AUTHOR]

Background: Despite global, regional, and national efforts to address intimate partner violence (IPV), physical IPV persists as a significant challenge in Kenya. This study employs geospatial analysis to examine the spatial distribution and determinants of physical intimate partner violence among women, aiming to inform targeted interventions and policies. Methods: The study used a secondary analysis of a cross-sectional study design based on the 2022 Kenya demographic and health survey. Analyses were conducted using Stata version 17.0 and ArcMap version 10.8. Spatial autocorrelation and hotspot assessment were conducted in the geospatial analysis, while a multilevel logistic regression model was used to examine determinants of physical violence among reproductive-aged women. Results: The study found 28.8% (10,477) of the surveyed women reported experiencing physical intimate partner violence. The spatial analysis identified significant clusters in the southwest and central regions, with women in sub-counties like Chepaluugu, Konion, Sotik, Bumula, and Metayos among others experiencing more violence. Conversely, women in areas in the North East and South East corners such as Kisauni, Tarabaj, Waijir North, Lafey, and Mandera North and South among others showed little or no physical intimate partner violence. Multivariable logistic regression identified age, education, wealth index, partner domineering indicators, and justification of wife beating to be associated with physical intimate partner violence. Higher education and wealth were associated with lower violence odds, while partner domineering indicators and justification of wife beating increased odds. Conclusion: Spatial variations in intimate partner violence risk for women in Kenya underscore the need for targeted government interventions. Focusing on hotspot regions, especially among women with the poorest wealth index, no formal education, and older age, is crucial. Implementing behavior change campaigns addressing violence justification and partner dominance is vital. Active involvement of male partners in programs aiming to eliminate intimate partner violence is essential for comprehensive impact. [ABSTRACT FROM AUTHOR]

Background: Menstruation is a normal biological process experienced by more than 300 million women globally every day. Women require clean menstrual absorbents that can be changed as often as needed in a private and safe place with proper hygiene and disposal facilities. These needs must be met consistently throughout the duration of the menstrual cycle. Access to menstrual needs is crucial for women's health, wellbeing, and dignity. This study assessed the prevalence and factors associated with unmet need for menstrual hygiene management (MHM) in Ethiopia, Kenya, Uganda, Burkina Faso, Ghana, and Niger. Methods: We used data from the Performance Monitoring for Action (PMA) 2020 surveys. We defined the unmet need for MHM as the "lackof resources, facilities and supplies for MHM." Sample characteristics were summarised using frequencies and percentages, while prevalence was summarised using proportions and their respective confidence intervals (CI). Factors associated with unmet need for MHM were assessed using multilevel logistic regression models. Results: The study included 18,048 women of reproductive age from the six countries. The prevalence of unmet need for MHM was highest in Burkina Faso (74.8%), followed by Ethiopia (69.9%), Uganda (65.2%), Niger (57.8%), Kenya (53.5%), and lowest in Ghana (34.2%). Unmet need for MHM was consistently higher among uneducated and multiparous women, those who reused MHM materials, practiced open defecation, and lived in rural areas across all six countries. The odds of unmet need for MHM were higher among younger women under 35 years, unmarried women, those with lower education levels, and those from poorer households. Similarly, the reuse of MHM materials, use of shared or non-improved toilet facilities, and open defecation increased the odds of unmet need for MHM. In contrast, the presence of handwashing facilities reduced the odds of unmet need for MHM. Conclusion: More than half of the women in five of the six countries have an unmet need for MHM, with significantly higher odds among younger women, those with low wealth status, the unmarried, and those with inadequate access to sanitary facilities. This study highlights the state of period poverty in Sub-Saharan Africa. Efforts to end period poverty should consider MHM needs as an integrated whole, as addressing each need in isolation is insufficient. [ABSTRACT FROM AUTHOR]

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder characterized by a variety of both signs and symptoms; it mainly affects women of childbearing age, with an estimated prevalence of 24/ 100,000 people in Europe and North America. SLE is often described as an antibodies-driven disease as its clinical manifestations are usually associated with the presence or the absence of specific antibodies. Objectives: To evaluate clinical manifestations in patients with SLE and to assess the relationship with the presence of specific antibodies by using real-world data. Methods: A retrospective study was performed; the 2019 EULAR/ACR Classification Criteria for Systemic Lupus Erythematosus were used to classify patients with SLE. Data concerning serological profiles (which included Antinuclear antibodies -- ANA, anti dsDNA, anti-Ro/SS-A, anti-La/SS-B, anti- Smith) were gathered along with medical records of clinical manifestations. Complement levels were also tested for possible clinical correlations. c² or Fisher's exact tests were utilized to establish associations between autoantibodies and symptoms. The odds ratios (OR) and their 95% confidence intervals (CI) were computed. No correction was made for multiple testing; only a p-value 0.01 ≤ was considered significant. Results: One-hundred and twenty-seven patients (n=127, mean age 53.43 ± 14.02) were enrolled in this study. Anti-dsDNA antibodies were found to be statistically significant for both malar rash and proteinuria; anti-Ro/SSA antibodies showed an association with photosensitivity and pericarditis; furthermore, a strong association was found between anti-Ro antibodies and proteinuria, but only if anti-dsDNA antibodies were present as well. Patients who tested positive for anti-La/SSB antibodies correlated with a threefold increase in the risk of developing pericarditis. Lastly, anti-Smith appeared to be associated with NPSLE as well as an increased risk for both autoimmune hemolytic anemia and thrombocytopenia. [ABSTRACT FROM AUTHOR]

Context: Polycystic ovary syndrome (PCOS), a common endocrine disorder in women of reproductive age, is closely associated with chronic low-grade inflammation and metabolic disturbances. In PCOS mice, dietary inulin has been demonstrated to regulate intestinal flora and inflammation. However, the efficacy of dietary inulin in clinical PCOS remains unclear. Objective: The intestinal flora and related metabolic indexes of obese patients with polycystic ovary syndrome (PCOS) after 3 months of inulin treatment were analyzed. Setting and design: To analyze the intestinal flora and related metabolic indexes in healthy controls and obese patients with polycystic ovary syndrome after 3 months of inulin treatment. Results: The results showed that dietary inulin improved sex hormone disorders, reduced BMI and WHR levels in obese women with PCOS. In addition, the inulin intervention reduced plasma TNF-α, IL-1β, IL-6, and MCP-1levels. Inulin intervention increased the abundance of Actinobacteria, Fusobacteria, Lachnospira, and Bifidobacterium, as well as decreased the ratio of F/B and the abundance of proteobacteria, Sutterella, and Enterobacter. Correlation analyses showed a strong relationship among plasma inflammatory factors, sex steroid hormones, and the intestinal flora of patients. Conclusions: Dietary inulin may improve obese PCOS women disease through the gut flora–inflammation–steroid hormone pathway. The clinical trial registration number: ChiCTR-IOR-17012281. [ABSTRACT FROM AUTHOR]

Introduction: Electroconization of the uterine cervix (LEEP/LLETZ) is an appropriate and sufficient procedure for high-grade squamous epithelial lesion -- HSIL. Negative margins are considered fundamental for confirming the absence of residual disease. Further management after incomplete excision among women who have not completed their procreative plans is difficult because subsequent cervical procedures may cause issues with carrying a pregnancy to term. Since almost one-third of the untreated patients with HSIL will develop cervical carcinoma, it is essential to balance the desire to radicalize treatment with its obstetric consequences. We compared the further clinical course of the patients after complete and incomplete procedures to observe whether completeness of excision is necessary for a successful outcome. We aim to identify risk factors that influence persistent or recurrent HSIL. Methods: The study has comprised 781 patients aged 18-85 -- the research group was composed of 140 (17.93%) patients after incomplete conization and the control group of 641 (82.17%) patients after the complete one. Patients were scheduled for follow-up examinations every 6 months -- including cytology, HPV typing, and colposcopy with tissue sampling. The Chi-square test or Fisher's exact test was performed as a tool for group comparisons for variables on the qualitative scale. Univariable and multivariable logistic regression models have been used to determine factors associated with the risk of persistent or recurrent HSIL. To evaluate the discriminatory ability of the logistic regression models, the Area Under the Curve (AUC) was calculated. Results: The statistical analysis results don't indicate a statistical significance between the frequency of HSIL in groups. HPV infection has increased the risk of persistent/recurrent lesions by 38 times, constituting the most important factor. Discussion: Close follow-up instead of inconsiderate repeat procedures should be taken under consideration among patients of reproductive age after incomplete conization of the cervix. HPV typing may be an essential method to predict recurrent cervical dysplasia. Promoting HPV typing and vaccination can reduce the number of invasive procedures and improve quality of life and obstetrics outcomes. [ABSTRACT FROM AUTHOR]

Background: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder that affects women of reproductive age, characterized by chronic anovulation, hyperandrogenism, and polycystic ovarian morphology. Emerging evidence indicates that neurological disorders play a significant role in the etiology of PCOS, highlighting the complex interplay between the central nervous system (CNS) and ovarian function. Yulinzhu, a traditional Chinese medicine (TCM) formulation, has been traditionally used to regulate menstrual cycles and improve fertility. This study aims to investigate the efficacy and mechanisms of Yulinzhu in treating PCOS induced by neurological disorders. Methods: An extensive literature search was performed across electronic databases such as PubMed, EMBASE, Cochrane Library, and China National Knowledge Infrastructure (CNKI), covering publications up to 1 June 2024. The review included randomized controlled trials (RCTs) that compared Yulin Zhu with placebo, standard care, or other active treatments in patients with PCOS. Two reviewers independently carried out data extraction and quality assessment. Meta-analyses were conducted using both fixed and random- effects models, with heterogeneity evaluated using the I² statistic. Results: We screened 891 records and included 6 studi es in the meta-analysis. The meta-analysis revealed that Yulinzhu about effective rate [RR = 1.19, 95% CI (1.10, 1.29), p <0.0001], pregnancy rate [RR = 2.80, 95% CI (1.65, 4.76), p <0.0001] and ovulation rate [RR = 1.33, 95% CI (1.10, 1.62), p = 0.04]. Meta-analysis shows the results of follicle estrogen [WMD = 0.69, 95% CI (-0.39, 1.78), p = 0.21], luteinizing hormone [WMD = -2.27, 95% CI (-3.86, -0.67), p = 0.005], testosterone [WMD = -0.44, 95% CI (-0.64, -0.25), p < 0.0001], estradiol [WMD = 16.20, 95% CI (2.74, 29.67), p < 0.0001]. Conclusion: This study demonstrates that plant medicine compund Yulinzhu may effectively treats PCOS including hormonal regulation, anti-inflammatory actions, and neuroprotection. We expect further research with larger, well- designed clinical trials to substantiate our conclusions. [ABSTRACT FROM AUTHOR]

Background: Inadequate food intake is the most common cause of malnutrition worldwide. There is paucity of knowledge on the influence of farming systems, a proxy for contextualizing community-based food networks, and sociocultural perspectives necessary for creating impactful nutritional programs and policies for young children from infancy to early childhood in Kenya and their mothers, especially in Kenya. This study sought to evaluate nutrient intakes of young children and their mothers from Pastoral, Agro-pastoral and Mixed farming system in Kenya. Methods: Mothers and their children were recruited from households in Narok south as part of the Animal Health Innovation Study. One day multiple pass 24-h dietary recall was completed for a sample of infants 6-11 months, and toddlers aged 12-48 months (n = 161), and women of reproductive age (15-49 years) (n = 161) via face-to-face interviews with the primary caregiver. Nutrient intakes were estimated using CS Dietary Software and compared with the Adequate Intakes, Recommended Dietary Allowance and/or Estimated Average Requirement. Results: The mean intake of key nutrients varied across farming systems. Children aged 6-11 months, met the Adequate Intake and Recommended Dietary Allowance levels for protein and Vitamin A. However, deficiencies were noted in thiamine, vitamin C, vitamin B6, selenium, and niacin across different farming systems, with insufficient Iron intake, particularly in pastoral and agro-pastoral systems (3 mg/d vs. 7 mg/d and 5 mg/d vs. 7 mg/d respectively. Folate intake was significantly lower in pastoral and mixed farming systems, with levels below the recommended 100 Îg dfe/d. Calcium intake was sufficient across all farming systems, while phosphorus intake was consistently below the AI of 180 mg/d in children aged 12-48 months. In the mixed farming group, intake exceeded the Recommended Nutrient Intake for calcium, while phosphorus intake remained low across all age groups in agro-pastoral and mixed farming systems. Magnesium intake fell below AI levels in all groups (<65AI). Among women of reproductive age (15-49 years), the agro-pastoral group exhibited the highest carbohydrate intake, while the mixed farming group had the highest protein intake (51.07 ± 6.5). Women met vitamin A recommendations, with zinc, iron, and selenium intake felling below the Adequate Intake in all groups. Conclusion: While certain nutrients such as protein and vitamin A intake were met in children and mothers, deficiencies were noted in crucial nutrients like iron and folate across various farming systems. These findings underscore the importance of considering local contextual factors when designing nutrition interventions. To address nutritional disparities and improve overall health outcomes and wellbeing for children and mothers in diverse agricultural settings in Kenya, it is important to prioritize an understanding sociocultural contexts and/or regional variations in designing and implementation of targeted interventions. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the epidemiological characteristics and antibiotic resistance patterns of Ureaplasma urealyticum (UU) infection among women and children in southwest China. Methods: A total of 8,934 specimens, including urogenital swabs and throat swabs were analyzed in this study. All samples were tested using RNA-based Simultaneous Amplification and Testing (SAT) methods. Culture and drug susceptibility tests were performed on UU positive patients. Results: Among the 8,934 patients, the overall positive rate for UU was 47.92%, with a higher prevalence observed among women of reproductive age and neonates. The majority of UU positive outpatients were women of reproductive age (88.03%), while the majority of UU positive inpatients were neonates (93.99%). Overall, hospitalization rates due to UU infection were significantly higher in neonates than in women. Further analysis among neonatal inpatients revealed a higher incidence of preterm birth and low birth weight in UU positive inpatients (52.75% and 3.65%, respectively) than in UU negative inpatients (44.64% and 2.89%, respectively), especially in very preterm and extremely preterm neonates. Moreover, the incidence rate of bronchopulmonary dysplasia (BPD) among hospitalized neonatal patients was significantly higher in the UU positive group (6.89%) than in the UU negative group (4.18%). The drug susceptibility tests of UU in the neonatology, gynecology and obstetrics departments exhibited consistent sensitivity patterns to antibiotics, with high sensitivity to tetracyclines and macrolides, and low sensitivity to fluoroquinolones. Notably, UU samples collected from the neonatology department exhibited significantly higher sensitivity to azithromycin and erythromycin (93.8% and 92.9%, respectively) than those collected from the gynecology and obstetrics departments. Conclusions: This study enhances our understanding of the current epidemiological characteristics and antibiotic resistance patterns of UU infection among women and children in southwest China. These findings can aid in the development of more effective intervention, prevention and treatment strategies for UU infection. [ABSTRACT FROM AUTHOR]

Influenza A virus (IAV) infection can increase the risk of neuroinflammation, and subsequent neurodegenerative diseases. Certain IAV strains, such as avian H7N7 subtype, possess neurotropic properties, enabling them to directly invade the brain parenchyma and infect neurons and glia cells. Host sex significantly influences the severity of IAV infections. Studies indicate that females of the reproductive age exhibit stronger innate and adaptive immune responses to IAVs compared to males. This heightened immune response correlates with increased morbidity and mortality, and potential neuronal damage in females. Understanding the sex-specific neurotropism of IAV and associated mechanisms leading to adverse neurological outcomes is essential. Our study reveals that primary hippocampal cultures from female mice show heightened interferon-β and pro-inflammatory chemokine secretion following neurotropic IAV infection. We observed sex-specific differences in microglia activation: both sexes showed a transition into a hyper-ramified state, but only male-derived microglia exhibited an increase in amoeboid-shaped cells. These disparities extended to alterations in neuronal morphology. Neurons derived from female mice displayed increased spine density within 24 h post-infection, while no significant change was observed in male cultures. This aligns with sex-specific differences in microglial synaptic pruning. Data suggest that amoeboid-shaped microglia preferentially target postsynaptic terminals, potentially reducing neuronal hyperexcitability. Conversely, hyper-ramified microglia may focus on presynaptic terminals, potentially limiting viral spread. In conclusion, our findings underscore the utility of primary hippocampal cultures, incorporating microglia, as an effective model to study sex-specific, virus-induced effects on brain-resident cells. [ABSTRACT FROM AUTHOR]

Background: Despite the intended 50% reduction in anemia in women of reproductive age, this tendency has only worsened. Even though iron deficiency is the most prevalent cause of anemia, anemia and chronic illnesses like HIV are closely associated; in fact, 48.6% of people living with HIV who were 15 years of age or older had anemia. However, the burden of anemia among HIV-positive women in sub-Saharan African (SSA) countries is not well documented. Therefore, the goal of our research was to investigate anemia and the factors that are linked to it in SSA women who had HIV infections. Methods: A cross-sectional study was conducted using demographic and health survey datasets from 18 SSA countries. A total of 7823 weighted samples were included. STATA version 16 software was used for analysis. A multilevel logistic regression model was fitted. An adjusted odds ratio with a 95% CI and a p-value < 0.05 was used to declare significantly associated factors. Result: The overall prevalence of anemia was found to be 45.1% [95% CI: 43.97–46.18%]. Of those 5.05%, 37.97%, and 56.97% were severely, moderately, and mildly anemic, respectively. Education level of primary [AOR = 0.74, 95% CI: 0.62, 0.89], secondary [AOR = 0.81, 95% CI: 0.68, 0.98], and higher [AOR = 0.74, 95% CI: 0.55, 0.99], as well as current contraceptive use [AOR = 0.74, 95% CI: 0.63, 0.87] were negatively associated with anemia. While pregnancy [AOR = 1.51, 95% CI: 1.17, 1.94], breast feeding [AOR = 1.38, 95% CI: 1.17, 1.64], health insurance [AOR = 1.50, 95% CI: 1.25, 1.80], and menstruation within six weeks prior to data collection [AOR = 1.36, 95% CI: 1.20, 1.54] had a significant positive relation with anemia among HIV-infected women in SSA countries. Conclusion: Anemia is a serious public health problem among HIV-infected women in SSA countries. Pregnancy, breast feeding, health insurance, and menstruation within six weeks prior to data collection were significant risk factors. On the other education and current contraceptive use were significant protective factors for anemia among HIV-infected women in SSA countries. Therefore, strategies aimed at early identification of anemia may lead to an improvement in the health of HIV-infected women. [ABSTRACT FROM AUTHOR]

Introduction: Intimate partner violence (IPV) is a major public health issue in Nepal. IPV has social and economic impacts on women, family, and the wider society. In this study, we aimed to determine factors associated with IPV among currently partnered women aged 15–49. Methods: We conducted a secondary data analysis of the Nepal Demographic and Health Survey (NDHS) 2022. The study examines the lifetime prevalence of IPV. IPV was measured in three domains: experience of physical violence, emotional violence, and sexual violence. Weighted univariate and multivariable logistic regression analysis were applied to determine factors associated with IPV. The results of logistic regression were presented as crude odds ratio (COR) and adjusted odds ratio (AOR) and their 95% confidence interval (CI). Results: Of 3853 women, 27.2% had experienced any form of IPV. The lifetime prevalence of physical violence, emotional violence, and sexual violence were 23.2%, 12.8%, and 7.1%, respectively. Higher odds of physical violence were reported among women aged 35–49 years (AOR: 2.13, 95% CI: 1.58–2.87), women without formal education (AOR: 1.51, 95% CI: 1.10–2.06), and women who justified wife-beating (AOR: 1.23, 95% CI: 1.00–1.52). Women from poor households (AOR: 1.61, 95% CI: 1.12–2.35) and women with uneducated partners (AOR: 1.66, 95% CI: 1.08–2.58) were at higher risk of experiencing sexual violence. Women with unemployed husbands reported a higher risk of physical violence (AOR: 2.72, 95% CI: 1.45–5.06) and emotional violence (AOR: 1.61, 95% CI: 1.12–2.35). Conclusion: Almost one in three currently partnered women experienced some form of IPV in their lifetime. Various sociodemographic, partner-related, and women's empowerment-related factors were associated with experiencing IPV. Acknowledging and addressing these factors is essential to mitigating the high rates of IPV among reproductive aged women. [ABSTRACT FROM AUTHOR]

Weight loss can positively alter female physiology; however, whether dietary carbohydrate- or fat- restriction confer unique effects is less studied. Precisely designed, hypocaloric well-formulated ketogenic diets (KD; ~75% energy for weight maintenance) were compared to isocaloric/isonitrogenous low-fat diet (LFD) on self-reported menses in pre-menopausal overweight and obese women (mean ± SD: 34 ± 10 years, BMI: 32.3 ± 2.7 kg/m2). Women received a precisely-weighed and formulated KD with either twice-daily with ketone salts (KS; n = 6) or a flavor-matched placebo (PL; n = 7) daily for six-weeks. An age and BMI-matched cohort (n = 6) was later assigned to the LFD and underwent the same testing procedures as the KD. Self-reported menses fluctuations were assessed bi-weekly along with measures of body weight, body composition, and fasting serum clinical chemistries using repeated measures ANOVA with Bonferroni post-hoc corrections. Both diets elicited clinically-significant weight-loss (Δ: -7.0 ± 0.5 kg; p < 0.001), primarily from fat-mass (Δ: -4.6 ± 0.3 kg; p < 0.001), and improved insulin-sensitivity and serum lipids (all p < 0.05). Fasting plasma glucose and inflammatory markers were not different between diets. Fasting capillary beta-hydroxybutyrate (R-βHB) increased significantly during the KD, independent of supplementation (Δ: 1.2 ± 0.3 mM R-βHB; p < 0.001). Women randomized to the KD+KS (30%) and KD+PL (43%) reported subjective increases in menses frequency and intensity after 14 days, whereas another third reported a regain of menses (>1 year since the last period) after 28 days. No LFD participants reported menses changes. Nutrient-dense, whole-food KDs and LFD improved weight, BMI, body composition, and blood parameters in pre-menopausal women after six-weeks. Changes in self-reported menses were described by most of the KD participants, but none of the LFD women suggesting there may be unique effects of nutritional ketosis, independent of weight loss. [ABSTRACT FROM AUTHOR]

Background: Lymphangioleiomyomatosis (LAM) is a rare multisystemic disorder characterized by the proliferation of abnormal smooth muscle-like cells. Although serum vascular endothelial growth factor-D (VEGF-D) is currently used as a diagnostic biomarker for LAM, its diagnostic value in Korean patients is unclear. Objectives: To evaluate the diagnostic value of serum VEGF-D for LAM in Korean patients. Design: A multicenter prospective cohort study Methods: Serum samples were prospectively collected from five medical institutions, from patients with LAM (n = 40) and controls (n = 24; healthy participants = 3, other cystic lung diseases = 13, idiopathic pulmonary fibrosis = 4, idiopathic nonspecific interstitial pneumonia = 4). Serum VEGF-D levels were measured using the enzyme-linked immunosorbent assay, and the diagnostic value was evaluated using receiver operating characteristic (ROC) curve analysis. Results: The mean age of patients with LAM was 44.5 years, and all were female (controls: 47.8 years; female: 70.8%, p < 0.001). The serum VEGF-D levels were significantly higher in patients with LAM than those in the control group (median: 708.9 pg/mL vs 325.3 pg/mL, p < 0.001). In the ROC curve analysis, serum VEGF-D levels showed good predicting performance for LAM diagnosis (area under the curve = 0.918) with an optimal cut-off value of 432.7 pg/mL (sensitivity = 85.0%, specificity = 87.5%). When 800 pg/mL was used as the cut-off value, the specificity of serum VEGF-D for LAM diagnosis increased to 100.0%. Conclusion: Our results suggest that serum VEGF-D may be a useful biomarker for diagnosing LAM in Korean patients, similar to previous reports. Plain Language Summary: Blood test for diagnosis of lymphangioleiomyomatosis in Korea: role of vascular endothelial growth factor-D In this study, we discuss a blood test to diagnose a rare lung disease, called lymphangioleiomyomatosis (LAM). LAM primarily affects women, especially during their childbearing years, and can cause serious lung problems such as damage and cyst (air-filled sac) formation. The blood test looks for a special protein in the blood, called vascular endothelial growth factor-D (VEGF-D). If someone has a lot of this protein, it usually means that they have LAM. We have found that when VEGF-D levels are high, the test can effectively separate LAM from other lung diseases. We also found that raising this threshold to higher levels made it much more likely to correctly distinguish a group of people who do not have the disease from patients with LAM. Our study is important because it's the first to show the usefulness of blood VEGF-D testing in Korean LAM patients, and because it suggests an easier and less inconvenient way for physicians to diagnose LAM in Koreans. Our findings are an important step in improving the management of Korean patients with LAM. [ABSTRACT FROM AUTHOR]