Journal of women's health
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Journal of women's health · Sep 2019
Pre- and Early Pregnancy Onset Depression and Subsequent Rate of Gestational Weight Gain.
Background: Depression is associated with weight change outside of pregnancy. We assessed associations of prepregnancy or early pregnancy onset depression with gestational weight gain (GWG) rate overall and according to Institute of Medicine (IOM) recommendations. Materials and Methods: Depression from 6 months prepregnancy through 20 weeks gestation was identified in a health care system in northern California with perinatal depression screening (2011-2016; n = 87,600). GWG rate (lbs/week) was calculated using weight at delivery and at diagnosis or depression screening ≤20 weeks. Results: Compared to women without prepregnancy or early pregnancy depression, women with prepregnancy onset depression had 11% greater risk of GWG rate
IOM recommendations (95% CI: 1.01-1.05), with a stronger association for >IOM in normal weight women. ⋯ Women with early onset prenatal depression may be at slightly higher risk for GWG rate above recommendations. Our results suggest that the relationship between depression and GWG may vary based on timing of depression onset, prepregnancy body mass index category, and antidepressant use. Additional research should identify factors that predict how a woman's lifestyle behaviors and weight change after depression diagnosis. -
Journal of women's health · Sep 2019
Lifetime Trauma and Cardiometabolic Risk in Sexual Minority Women.
Background: Sexual minority women (SMW; such as lesbian, bisexual, and mostly lesbian) exhibit excess cardiometabolic risk, yet factors that contribute to cardiometabolic risk in this population are poorly understood. Trauma exposure has been posited as a contributor to cardiometabolic risk in SMW. Materials and Methods: An analysis of data from Wave 3 of the Chicago Health and Life Experiences of Women Study was conducted. Multinomial logistic regression was used to examine correlates of trauma. ⋯ Logistic regression models examining the association of trauma and cardiometabolic risk revealed that childhood trauma was an independent risk factor for diabetes. Adulthood and lifetime trauma were significantly associated with obesity and hypertension. Conclusions: Trauma emerged as an independent risk factor for cardiometabolic risk in SMW. These findings suggest that clinicians should screen for trauma as a cardiovascular risk factor in SMW, with special attention to SMW most at risk.
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Journal of women's health · Sep 2019
Using Inside Knowledge Campaign Materials to Improve Gynecologic Cancer Knowledge in Underserved Women.
Purpose: About 30,000 U. S. women die each year from gynecologic cancer, which disproportionately affects underserved and minority populations. This project aimed at increasing and assessing awareness of risk, symptoms, and recommended screenings and prevention activities in underserved women, through unique collaboration between the Centers for Disease Control and Prevention's (CDC) Inside Knowledge (IK) campaign, which was designed to educate women about gynecologic cancer, and the CDC's national network of organizations to reduce cancer-related disparities. Materials and Methods: CDC's national network and the IK campaign partnered to deliver tailored educational sessions about gynecologic cancer to three populations of women served by the participant organizations. ⋯ Pre- and post-session questionnaires were administered to assess knowledge changes. Results: Knowledge changes for risk factors, screening, and HPV vaccination varied by network organization, but all sessions increased correct identification of some symptoms. Baseline knowledge also varied among organization participants. Conclusions: Sessions were effective in increasing awareness of gynecologic cancer among underserved women; however, organizational information uptake differed. Additional resources containing specific interventions appropriate to particular underserved populations may be beneficial in increasing healthy behaviors, leading to a reduction in gynecologic cancer disparities.
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Journal of women's health · Sep 2019
Strategies to Promote Postpartum Visit Attendance Among Medicaid Participants.
Background: Postpartum care is important for promoting maternal and infant health and well-being. Nationally, less than 60% of Medicaid-enrolled women attend their postpartum visit. The Strong Start for Mothers and Newborns II Initiative, an enhanced prenatal care program, intended to improve birth outcomes among Medicaid beneficiaries, enrolled 45,599 women, and included a variety of approaches to increasing engagement in postpartum care. Methods: This study analyzes qualitative case studies that include coded notes from 739 interviews with 1,074 key informants and 133 focus groups with 951 women; 4 years of annual memos capturing activities by each of 27 awardees and 24 Birth Center sites; and a review of interview and survey data from Medicaid officials in 20 states. Results: Strong Start prenatal care included education and support regarding postpartum care and concerns. ⋯ They also identified ongoing barriers to postpartum visit attendance. Conclusions: Postpartum care is essential to maternal and infant health. Medicaid enrolls many high-risk women and is the largest payer for postpartum care. Using lessons from Strong Start, providers who serve Medicaid-enrolled women can advance strategies to improve postpartum visit access and attendance.
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Journal of women's health · Sep 2019
Correlates of Trial of Labor and Vaginal Birth After Cesarean in the United States.
Background: Little is known about trial of labor after cesarean (TOLAC) uptake and vaginal birth after cesarean (VBAC) success on the national level, which is important as national-level data may help shape future clinical guidelines. This study examined correlates of trial of labor and successful VBAC among women with one prior cesarean in the United States in 2016. Materials and Methods: We used publically available birth certificate data for 2016. ⋯ Black women had higher odds of TOLAC relative to White women, but lower odds of successful VBAC. Women without a high school degree had higher odds of TOLAC and of successful VBAC compared to women who completed high school or beyond, as did women with inadequate prenatal care utilization. Conclusions: Understanding correlates of TOLAC and successful VBAC at the population level is important for developing national guidelines that can be considered and individualized at the patient/provider level.