Journal of women's health
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Journal of women's health · Jun 2022
Excessive Gestational Weight Gain and Long-Term Maternal Cardiovascular Risk Profile: The Study of Women's Health Across the Nation.
Background: Excessive gestational weight gain (GWG) is consistently linked with maternal risk of obesity. However, the literature on its long-term cardiovascular risk is minimal and conflicting. We evaluated whether excessive GWG is associated with a high-risk cardiovascular profile among parous women in midlife. ⋯ Longitudinal models estimated that at a mean age of 67, women with a history of excessive GWG had a 9.8% (9.2, 10.5) 10-year ASCVD risk, compared to 9.5% (8.9, 10.1) for those without, and mean CRP of 2.20 mg/L (1.89, 2.57) versus 1.85 mg/L (1.61, 2.14), respectively, adjusted for participant characteristics. Conclusions: In this multiethnic cohort of parous women, a history of excessive GWG was associated with a small, but statistically significant difference in ASCVD risk, and a moderate, statistically significant difference in CRP across midlife. More research is necessary to understand the mechanistic pathway between excessive GWG and long-term maternal cardiovascular health.
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Journal of women's health · Jun 2022
Cardiovascular Risk Factor Profiles, Emergency Department Visits, and Hospitalizations for Women and Men with a History of Stroke or Transient Ischemic Attack: A Cross-Sectional Study.
Background: The relationship between cardiovascular disease risk factors (CVD-RFs) and health care utilization may differ by sex. We determined whether having more CVD-RFs was associated with all-cause emergency department (ED) visits and all-cause hospitalizations for women and men with prior stroke/transient ischemic attack (TIA). Materials and Methods: In this cross-sectional study, we used nationally representative Medical Expenditure Panel Survey (2012-2015) data for persons aged ≥18 years with a prior stroke/TIA. ⋯ There was no association between CVD-RF scores and either outcome for men. Conclusions: Women, but not men, with high and intermediate CVD-RF profiles had increased odds of all-cause ED visits; women with high CVD-RF profiles had increased odds of all-cause hospitalizations. The burden of CVD-RFs may be a sex-specific predictor of higher health care utilization in women with a history of stroke/TIA.
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Journal of women's health · Jun 2022
Evaluating the Impact of the COVID-19 Pandemic on Postpartum Depression.
Objective: Studies examining the impact of natural disasters noted that in the setting of stable rates of depression, postpartum depression (PPD) increased in vulnerable subgroups. Coronavirus disease 2019 (COVID-19) may similarly impact maternal health. This study aimed to characterize the effect of COVID-19 on the incidence of PPD and to identify vulnerable subgroups. ⋯ However, incidence proportion of PPD decreased among women with current mental health diagnoses (41.5% to 31.3%, p = 0.19). Conclusions: A stable PPD incidence despite increased prevalence of current mood disorders highlights the complexity of the biopsychosocial milieu contributing to PPD. Further study of psychiatric care access and treatment is an important next step in understanding relationships between current mood disorders and PPD during the pandemic.
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Journal of women's health · Jun 2022
Screening and Intervention for Psychosocial Needs by U.S. Obstetrician-Gynecologists.
Objectives: To determine the psychosocial needs screening and intervention practices of obstetrician-gynecologists (OBGYNs) and elucidate characteristics associated with screening and resource availability. Methods: We administered a cross-sectional paper and online survey to 6288 U. S. office-based OBGYNs from March 18 to September 1, 2020, inquiring about screening and intervention practices for intimate partner violence, depression, housing, and transportation. ⋯ Working in health centers/clinics (PR = 3.99, 95% CI = 2.56-6.22), large practices (PR = 3.37, 95% CI = 1.63-6.95), Medicaid expansion states (PR = 2.60, 95% CI = 1.45-4.65), and practices with >11% uninsured patients (PR 2.30, 95% CI = 1.31-4.04) were associated with having resources onsite for all four needs. Conclusion: Most OBGYN practices appeared underresourced to address psychosocial needs within clinical care. Innovative financial models or collaborative care models may help incentivize this work.
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Journal of women's health · Jun 2022
Influence of Increasing Age and Body Mass Index of Gender in COVID-19 Patients.
Background: The impact of gender on outcomes in patients suffering from coronavirus disease 2019 (COVID-19) is frequently debated. However, the synchronous influence of additional risk factors is seldom mentioned. With increasing emphasis on identifying patients who are at risk of complications from COVID-19, we decided to conduct a retrospective review to assess the influence of age and body mass index (BMI) on gender-based differences in outcomes. ⋯ Obesity has a stronger bearing on outcomes in women, and age has a more pronounced effect on outcomes in men. Conclusion: Extremes of BMI and older age are associated with worse outcomes in both men and women. Obesity has a stronger bearing on outcomes of COVID-19 infection in women, while the effect of older age on outcomes is more pronounced in men.