Journal of women's health
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Journal of women's health · Jan 2025
Maternal Chronic Physical Conditions and Alcohol and Substance Use Disorders in the Preconception and Perinatal Periods.
Background: Chronic physical conditions (CPC) and alcohol and substance use disorders (SUD) frequently co-occur, but this has not been examined perinatally. We explored the combined effects of CPC and prepregnancy SUD on perinatal SUD-related adverse events and outpatient care. Materials and methods: This population-based study comprised 77,474 people with and 664,751 without CPC with a birth in Ontario, Canada, 2013-2020. ⋯ There was evidence of positive interaction for CPC + SUD (aRERI: 3.69, 95% CI: 1.13, 6.46). Similar elevated aRRs were observed for perinatal outpatient care for SUD, but without a positive interaction for people with CPC + SUD. Conclusion: As people with both CPC and SUD have the highest risk of perinatal SUD-related adversity, they may need greater preconception and perinatal support.
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Background: The United States is proposing to ban menthol cigarettes. Our objective is to examine the extent of menthol smoking among pregnant women and its association with their health. Methods: Nationally representative study of 14,226 pregnant women aged 18-44 years using the 2004-2022 National Survey on Drug Use and Health. ⋯ Among those smoking menthol, 73.7% reported mental health issues compared with 64.4% for nonmenthol. Conclusions: Women who smoke menthols report worse health compared with those smoking nonmenthol. Policies designed to reduce menthol smoking would improve maternal health, especially for minoritized women and those at higher risk for poor birthing outcomes.
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This clinical update serves as a brief summary of recently published and potentially practice changing journal articles. We review recent publications related to contraceptive safety and efficacy. The article discusses updated medical eligibility recommendations, effectiveness of progestin-only pills (including the newly approved over-the-counter pill), safety of estrogen containing contraceptives in those with migraine, topiramate interactions with hormonal contraception, and the use of nonsteroidal antiinflammatory drugs (NSAIDs) with oral emergency contraception to improve efficacy.
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Journal of women's health · Jan 2025
Exploring Reasons for Loss to Follow-up in Pregnancy of Unknown Location: A Mixed-Methods Study.
Objective: To quantify proportions of loss to follow-up in patients presenting with a pregnancy of unknown location and explore patients' perspectives on follow-up for pregnancy of unknown location. A pregnancy of unknown location is a scenario in which a patient has a positive pregnancy test but the pregnancy is not visualized on transvaginal ultrasound. Study Design: We conducted a retrospective cohort study of patients with pregnancy of unknown location who presented to an urban academic emergency department or complex family planning outpatient office. ⋯ Participants felt a burden of responsibility to learn about their condition and to self-advocate for their follow-up and communication of results. Conclusions: These data indicate that Black patients are more likely to experience loss to follow-up compared with White patients during monitoring for pregnancy of unknown location. Patients identified many barriers to follow-up and felt that successful follow-up required substantial self-efficacy.
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Journal of women's health · Jan 2025
Traumatic Brain Injury and Posttraumatic Stress Disorder Are Associated with Physical Health Burden among Post-9/11 Women Veterans.
Background: Little research focuses on physical health outcomes of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) among post-9/11 women veterans (WVs). This study examined lifetime TBI, current PTSD, and their associations with biomarkers of cardiometabolic health, sleep, pain, and functional disability among post-9/11 WVs. Methods: WVs (n = 90) from the Translational Research Center for TBI and Stress Disorders longitudinal cohort study were included in this study. ⋯ PTSD was significantly associated with lower total functioning and each of its subdomains (βs = -0.58 to 0.63; ps = <0.001 to 0.02). Lifetime TBI was significantly associated with total functioning, mobility, and life/work (βs = -0.20 to 0.30; ps = <0.01 to 0.02). Conclusions: These findings highlight the importance of screening for lifetime TBI and cardiovascular disease for WVs and support transdiagnostic treatment approaches targeting physical health outcomes.