Journal of women's health
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Journal of women's health · Aug 2022
ReviewPerinatal Incontinence Assessment Tools: A Psychometric Evaluation and Scoping Review.
Background: Approximately 40% of women report incontinence during pregnancy and postpartum (known as the perinatal period). Due to the lack of an established measurement standard, this scoping review aimed to investigate the psychometric properties of tools, which assess incontinence-related symptoms and quality of life (QOL) during this period. Materials and Methods: Articles in English, which assessed psychometric properties of tools for perinatal incontinence-related symptoms or QOL, were included and evaluated by a 16-item checklist. ⋯ Responsiveness to change was described for the ICIQ-UI SF and mPFQ. Conclusions: The mPFQ and ICIQ-UI SF demonstrated acceptable reliability, validity, and responsiveness to change, therefore suggesting good clinical utility. Since most studies included primiparous women, future research in heterogeneous samples of women with perinatal incontinence may be needed.
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Journal of women's health · Aug 2022
Cervical Cancer Screening Among Patients with Physical Disability.
Background: Pap smear has a central role in cervical cancer screening. Previous studies have found that female patients with disabilities are less likely to receive a Pap smear as recommended by guidelines. The aim of our study was to examine the association between physical disability and Pap smear receipt in Israel. ⋯ A history of nongynecologic oncologic disease was associated with increased odds of Pap smear receipt. Conclusion: Our study highlights the disparities between patients with and without physical disability with regard to screening for cervical cancer by receipt of Pap smear. Creating an appropriate practice with adequate access to patients with disability should be a focus for health care providers and policy makers.
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Journal of women's health · Aug 2022
Deferring Risk: Limitations to the Evidence in Product Labels for Vaccine Use in Pregnancy.
Background: The gaps in clinical trial evidence about vaccination in pregnancy have serious implications for health care worker and public misunderstandings. Contradictions between National Immunization Technical Advisory Group (NITAG) recommendations and regulatory product labeling information contribute to misinformation about vaccine safety and effectiveness. Methods: A mixed methods approach that included a stakeholder consensus decision-making workshop and a national survey of Canadian health care providers (HCPs). ⋯ Conclusions: Applying social risk theories, we show how such gaps in information defer responsibility for decisions about disease risk and vaccine safety from regulatory agencies and vaccine manufacturers onto HCPs and their clients. This may be especially relevant for COVID-19 and other emerging vaccines that are initially authorized for conditional or emergency use, and especially in understudied populations such as pregnant people. More frequent updating and alignment of robust, unbiased, and independently reviewed clinical trial and postmarket safety and effectiveness evidence with NITAG recommendations would allay HCP and public misunderstandings.
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Journal of women's health · Aug 2022
Sex Differences in Long-Term Mortality of Patients with Hypertensive Crisis Visiting the Emergency Department.
Background: There are limited data on sex difference in patients with hypertensive crisis. We investigated sex differences in characteristics and long-term mortality in patients with hypertensive crisis visiting the emergency department (ED). Materials and Methods: This cross-sectional study at a tertiary referral center included patients ≥18 years of age who were admitted to the ED between 2016 and 2019 with hypertensive crisis, defined as systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg. ⋯ Moreover, the 3-year all-cause mortality was significantly higher in men than in women among patients with hypertensive urgency (HR, 1.59; 95% CI, 1.34-1.90; p < 0.001), which was reversed in patients with hypertensive emergency (HR, 0.71; 95% CI, 0.60-0.84; p < 0.001). Conclusions: Men ≥50 years of age with hypertensive crisis, men with hypertensive urgencies, and women with hypertensive emergencies have a high risk of all-cause mortality. Thus, it is necessary to consider sex differences when predicting subsequent prognosis and determining the appropriate treatment for patients with hypertensive crisis.
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Journal of women's health · Aug 2022
Socioeconomic Disparity in Birth Rates During the COVID-19 Pandemic in New York City.
Background: The differential impact of the coronavirus disease 2019 (COVID-19) pandemic across race, ethnicity, and socioeconomic status remains poorly understood. While recent explorations into birthrates during the pandemic have revealed significant declines, how birthrates may have differed between racial and socioeconomic subgroups during the pandemic remains to be detailed. Methods: Using electronic health records from a large hospital network in New York serving a racially and socioeconomically diverse population, we explored birthrates associated with conceptions that occurred during the COVID-19 pandemic lockdown for demographic and obstetric differences. ⋯ Although the full impact of the COVID-19 pandemic on reproductive health and outcomes remains largely unknown, the decreased birthrate associated with the initial COVID-19 wave in New York was not entirely unexpected. While the mechanisms that drive health disparities are complex and multifactorial, most of the decrease occurred among those living in higher socioeconomic status. This finding has important implications for understanding health behaviors and disparities among minorities living in low socioeconomic status.