Background Lipedema is a chronic adipose tissue disorder predominantly affecting women and is frequently misclassified as obesity. While its physical manifestations are increasingly recognized, less attention has been paid to eating attitudes and psychological well-being in this population. The objective of this study was to descriptively explore eating attitudes and psychological well-being in women with lipedema. Methods This exploratory cross-sectional study used an anonymous online survey to describe eating attitudes and psychological well-being in women with lipedema. A total of 47 participants completed the Eating Attitudes Test (EAT-26) and the World Health Organization-5 Well-Being Index (WHO-5). Descriptive statistics were used to summarize screening indicators of disordered eating risk and reduced psychological well-being. Results Approximately two-thirds of participants scored at or above the EAT-26 screening cut-off, reflecting elevated screening indicators of disordered eating risk. When behavioral risk indicators were included, over 70% screened positive according to EAT-26 criteria. Reduced psychological well-being (as indicated by a WHO-5 score of ≤50) was observed in about one-fifth of the sample. Conclusion In this exploratory sample of women with lipedema, elevated screening indicators of disordered eating risk and reduced psychological well-being were commonly observed. These findings offer preliminary insights suggesting that eating-related risk and reduced well-being may be prevalent in this population. Further research using larger, clinically verified samples is needed to better understand the psychological aspects of lipedema.

Objective To disentangle the independent and shared contributions of maternal general psychological distress (GPD) and COVID-19-specific fear (CSF) during pregnancy to gestational age at birth and infant birth weight. Methods This study utilized secondary data from the prospective Canadian “Pregnancy during the COVID-19 Pandemic” cohort. The final analytic sample comprised 5,658 pregnant individuals. GPD was a latent variable indicated by the Edinburgh Postnatal Depression Scale (EPDS) and Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety scores. CSF was a latent variable indicated by three items assessing pandemic-related fears for self and baby. Structural equation modeling (SEM) examined associations with gestational age and birth weight, controlling for maternal age, income, and education. Results The SEM demonstrated good fit. Higher GPD independently predicted shorter gestational age (standardized β = –.048, p = .002) but not lower infant birth weight ( p = .632) after accounting for CSF. Higher CSF independently predicted both shorter gestational age (standardized β = –.058, p < .001) and lower infant birth weight (standardized β = –.058, p < .001), controlling for GPD and covariates. GPD and CSF were positively correlated (standardized covariance = .419, p < .001). Conclusion COVID-19-specific fear is a unique and significant risk factor for shorter gestational age and lower infant birth weight, distinct from general psychological distress. These findings highlight the need to assess and address pandemic-specific fears in perinatal populations to mitigate adverse birth outcomes during public health crises. Targeted interventions for specific fears may be necessary beyond general mental health support.

Background Hypertensive disorders in pregnancy (HDP) include gestational hypertension, preeclampsia, and eclampsia. Not all cases of gestational hypertension or mild preeclampsia progress to severe conditions. However, once they develop into severe preeclampsia (SPE), the risks to both the mother and the fetus increase significantly. We aimed to establish a nomogram and train a machine learning (ML) model that could identify SPE, early in the course of HDP. Methods In this retrospective study, 593 patients with HDP were enrolled in the training cohort. For predicting SPE early, six supervised ML models were employed, such as XGBoost, K-nearest neighbors (KNN), random forest (RF), LightGBM (LGBM), Support Vector Machines (SVM), and Decision Trees (DT), which were evaluated by accuracy (ACC) and the areas under the receiver operating characteristic curve (AUC). The nomogram was established, and the predictive ability was assessed by AUC, the calibration curve and clinical decision curves (DCA). They were validated by a validation cohort of 255 patients with HDP. Results The nomogram model achieved an AUC of 0.934 in the training cohort, with a calibration curve Brier score of 0.083 and a clinical applicability probability threshold of 5%–95%. In the validation cohort, it showed an AUC of 0.882, a calibration curve Brier score of 0.115, and a clinical applicability probability threshold of 10%–95%. In the validation cohort, the AUC of XGBoost, KNN, RF, LGBM, SVM, DT, and multivariate logistic regression analysis models were 0.876, 0.822, 0.866, 0.866, 0.871, 0.784, and 0.847, the XGBoost model showed the highest AUC. Conclusions This study demonstrates that a family history of hypertension, urine protein, umbilical artery S/D ratio, WBC, TBIL, UA, LDL, TG, CRP, and blood Ca are predictors of HDP progression to SPE. A nomogram model for predicting the progression of HDP to SPE was constructed using these predictors. The model exhibited good discrimination, calibration, and clinical utility in both the training and validation cohorts. Additionally, a ML model was developed, with the XGBoost model identified as the optimal one, which can be applied clinically in conjunction with the nomogram prediction model.

Introduction Severe perineal trauma (SPT), defined as third- or fourth-degree lacerations during childbirth, is a known risk factor for adverse postpartum health-related quality of life (HRQoL). Although HRQoL may improve within six months postpartum, up to 30% of affected women in Sweden report long-term health problems beyond one year. While qualitative studies highlight the broad negative impact, quantitative findings remain inconclusive, particularly regarding the role of pelvic floor symptoms and the degree of SPT, underscoring the need for further research. The aim is to assess and compare HRQoL in a sample of women with SPT, and to identify predictors of physical and mental health at least 18 months postpartum. Methods A nationwide cross-sectional study was conducted in Sweden using an online questionnaire to assess HRQoL via the validated RAND-36 instrument. Linear regression analysis was employed to explore associations. Results Two hundred and twenty-one women with SPT and varying symptom bother from SPT, at least 18 months after the childbirth, responded. The study population exhibited worse-than-average RAND-36 scores across most dimensions (apart from physical functioning and pain) compared to normative data for women in Sweden. Further, the mean physical health score was significantly lower in our study sample ( M = 70.7, SD = 22.1) compared to the reference population of women in Sweden ( M = 73.63, SD = 29.45), t [ df (degrees of freedom) 220] = −1.99, p = 0.047, Cohen's d = 0.13. The mean mental health score was significantly lower in our study sample ( M = 63.2, SD = 21.4) compared to normative Swedish women ( M = 71.7, SD = 27.15), t ( df 220) = −5.90, p < 0.001, Cohen's d = 0.40. Health change over the past year remained relatively static with a slight trend towards improvement (mean 54.5; SD 21.6; CI 95% 51.6–57.4). Physical health was predicted by the extent of symptom bother, perceived work ability, educational attainment, and level of physical activity. Mental health was predicted by age, extent of symptom bother, and perceived work ability. Conclusions These findings underscore the need for individualized, multidisciplinary care strategies that address both physical and psychological dimensions of recovery after sustaining SPT at childbirth. Future research should investigate the barriers and facilitators influencing HRQoL, to enhance HRQoL and support the reintegration of women with SPT into their social and professional spheres. A deeper understanding of the socioeconomic and occupational contexts of affected women is essential to promote more equitable health outcomes.

Introduction Menstrual disorders—including premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), and dysmenorrhea—are highly prevalent among women of reproductive age and are associated with impaired academic performance, psychological distress, and reduced social functioning. Nursing students are particularly vulnerable due to the combined demands of intensive academic schedules and clinical training, yet prevalence estimates and institutional responses remain inconsistent. Methods A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251109363). PubMed, Scopus, Web of Science, CINAHL Ultimate, and APA PsycINFO were searched for studies published between 2016 and 2025. Eligible studies reported prevalence or impact of PMS, PMDD, or dysmenorrhea exclusively in nursing students. The Joanna Briggs Institute checklist for prevalence studies was used for quality appraisal. Random-effects meta-analysis was applied to calculate pooled prevalence estimates, and thematic synthesis was used to evaluate academic, social, and psychosocial impacts, coping strategies, and interventions. Results Twenty studies involving 5,131 nursing students were included. The pooled prevalence was 62% for PMS, 21% for PMDD (including severe PMS), and 72% for dysmenorrhea, with substantial heterogeneity ( I 2 > 80%). Reported impacts included absenteeism, reduced concentration, diminished clinical performance, and impaired quality of life. Coping strategies were largely self-directed, including analgesics, rest, and dietary modifications, while few students accessed formal healthcare or institutional support. Only a limited number of studies evaluated structured interventions such as exercise, yoga, or nutritional supplementation. Conclusion Menstrual disorders are highly prevalent among nursing students and carry significant academic, social, and psychological consequences. Nursing education programs should integrate routine screening, structured wellness initiatives, and evidence-based interventions to improve student wellbeing, reduce academic disruption, and strengthen workforce preparedness. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251109363 , PROSPERO CRD420251109363.

Women’s health concerns play a role in several of the UAE's major public health challenges, including cardiovascular disease, injuries, cancer, and respiratory conditions. The UAE's 2024 National Policy for improving Women’s health aims to lower cancer mortality rates to 23.24 per 100,000 females, with translational research projects utilizing bio-registries and biobanks supporting this goal. This article describes the protocol for the Dubai Women’s Health Study, a prospective cohort study aimed at investigating the feasibility of establishing a dedicated Women’s health biobank in Dubai to support translational research on improving Women’s health. Initial focus will be on polycystic ovarian syndrome (PCOS), endometriosis, pre-eclampsia, and endometrial cancer, which are prevalent health conditions in the UAE. Recruitment will start at the largest public Women’s hospital in Dubai (Latifa Women’s Hospital), with possible future inclusion of other private hospitals. The study will approach women diagnosed with PCOS, endometriosis, pre-eclampsia, and endometrial cancer over a 12-month period from April 2025 to April 2026, obtaining clinical details and biological samples for establishing a bio-registry and biobank. The feasibility will be evaluated based on recruitment rates, the willingness to contribute samples and logistical challenges. The biobank will support ongoing studies on endometrial cancer risk in PCOS and endometriosis, Co-enzyme A's role in pre-eclampsia, and genetic profiling of inherited endometrial cancer cases in Dubai. The study recruitment only commenced in July 2025 and there are no results yet. Aligned with the National Policy for Improving Women’s Health, the biobank provides a foundation for local and global Women’s health research, addressing historical gender neglect in medical research, and promoting health equity globally.

Background The National Institute of Health and Care Excellence in the United Kingdom have recommended the development of a patient-reported outcome measure (PROM) specific to surgery for pelvic organ prolapse (POP), stress urinary incontinence (SUI), and complications of pelvic mesh surgery (MC). Aims To identify all aspects of quality of life (QoL) that may be impacted by surgery for POP, SUI and MC, to inform the development of a new PROM. Method Thirty-one patients who had undergone surgery for POP, SUI and MC (ranging from <6 months to >5 years ago) were purposively recruited from various National Health Service (NHS) Trusts, as well as community support groups for the conditions. Semi-structured interviews were undertaken over the phone or via video-conferencing software, and a framework approach was employed to analyse the data. A Patient and Public Involvement group, comprising seven women who had undergone surgery for POP, SUI and/or MC, were consulted on various aspects of the study. Findings We identified nine themes for potential inclusion in the PROM. The themes are short-term impacts of surgery; long-term impacts on pre-surgery symptoms; pain and/or discomfort; impact on daily activities; social and leisure activities; emotional wellbeing; sexual activity; personal relationships; and work/education. While some participants showed improvements in these areas following surgery, it was also evident that for some, issues persisted, worsened, or developed post-surgery. Those in the sample who had previous surgery involving mesh reported worse QoL outcomes overall. Conclusion The impact of surgery for POP, SUI and MC on QoL is multidimensional and complex. It is recommended that a future PROM encompasses the potential for improvement of symptoms, the failure of surgery to improve symptoms, the development of new symptoms after surgery, and the consequential positive and negative impacts of surgery on activity, roles, psychological well-being and ultimately QoL, in both the short and long term.

Background Family planning (FP) is essential for sustainable development, maternal health, and women's reproductive well-being. Despite its critical role, Rwanda continues to experience a highly unmet need for FP. Women's experiences and perceptions of contraceptive methods can significantly affect their adoption and use. This study aimed to assess the sexual function and well-being of women using modern FP methods in Rwanda. Methodology A multicenter cross-sectional study involving 415 women aged ≥18 years who had used a modern FP method for at least ≥6 months was conducted across three urban and two rural FP clinics in Rwanda. Sexual function and well-being were evaluated via the Female Sexual Distress Scale-Revised (FSDS-R), with scores <11 indicating good sexual function. Utilizing R programming version 4.0.2, Logistic regression was used to examine associations between demographic/clinical factors and sexual distress. Results Overall, 79.5% of women had good sexual function (FSDS-R < 11). Copper intrauterine device (IUD) users (96%) and those with permanent sterilization (84%) reported the highest sexual satisfaction. In multivariable analysis, underweight women (BMI <18.5) had 3.08-fold higher odds of sexual distress than normal-weight women (OR = 3.08; 95% CI 1.10–8.69). Conversely, IUD users had 86% lower odds of distress than implant users (OR = 0.14; 95% CI 0.03–0.42). Other factors, such as education level, were not significantly associated after adjustment. Conclusion The majority of Rwandan FP users in this study reported satisfactory sexual function. Contraceptive method and BMI were key predictors. These findings underscore the importance of integrating sexual health counseling into FP programs to reassure women about contraceptive side effects and support informed method choices that optimize reproductive well-being.

Introduction There is currently a lack of comprehensive literature analysis on the global burden and trends of pulmonary arterial hypertension (PAH) among women of childbearing age (WCBA). We fill this evidence gap by evaluating the burden and temporal trends of PAH in WCBA at global, regional, and national levels from 1990 to 2021. Methods Data about PAH burden were extracted from the Global Burden of Disease Study (GBD) 2021. Moreover, PAH burden was explored across regions with different age, social development index (SDI) or health system. Results There was a significant global increase in incident and prevalent cases of PAH among WCBA. Disability-adjusted life years (DALYs) and deaths initially increased but began to decline after 2010. Age-standardized incident rate (ASIR) and age-standardized prevalent rate (ASPR) increased in all SDI regions except in low SDI. Low and low-middle SDI regions bore the heaviest burden. Basic and limited healthcare systems showing the most pronounced increases in cases, but with advanced healthcare systems demonstrating a sharp reduction in age-standardized rates (ASR) of DALYs and deaths. Geographically, the highest ASIR were observed in Sub-Saharan Africa regions. Meanwhile, Central Asia and Tropical Latin America had the highest ASR of DALYs and deaths. National-level analysis identified India and China with the highest case numbers, and Sweden with the highest ASPR. Mauritius, Mongolia and Tajikistan topped ASR of DALYs and deaths. Conclusion This study provides a comprehensive, time-series portrait of PAH burden and inequalities among WCBA worldwide. Addressing socioeconomic factors and strengthening healthcare systems are essential measures, especially in high-burden regions.

Background Menopause is a major transition in women's health and may be associated with vasomotor symptoms and increased risk of osteoporosis and cardiovascular disease. Hormone replacement therapy (HRT) is an effective treatment option, yet uptake is reported to be limited in many settings. This systematic review aimed to synthesise evidence on factors associated with HRT uptake and utilisation in Arab countries and to summarise proposed strategies to support informed decision-making. Methods We searched Embase, MEDLINE, WHO IRIS, Cochrane Library, PubMed, and Scopus for studies published up to March 2025. Eligible studies examined HRT uptake/utilisation, knowledge, perceptions, or attitudes among women in the 22 Arab countries. Two reviewers screened records using Covidence, with disagreements resolved by a third reviewer. Study quality was assessed using the Newcastle–Ottawa Scale adapted for cross-sectional studies. Findings were synthesised thematically. PROSPERO: CRD420251007430. Findings Fifteen cross-sectional studies met inclusion criteria. HRT uptake was generally low; in 11 studies fewer than 20% of participants reported use, with reported prevalence ranging from 0% to 48% across settings. Factors positively associated with uptake included higher educational attainment, employment, healthcare provider influence and access to consultation, and greater baseline knowledge of menopause and HRT. Barriers included risk concerns, cultural conservatism, and preference for herbal or “natural” remedies. In several studies, media was a primary source of menopause-related information, while physician-led counselling was less frequently reported. Conclusion Evidence from Arab countries indicates predominantly low HRT utilisation, shaped by knowledge gaps, risk perceptions, and socio-cultural factors, alongside variable healthcare-provider engagement. Studies most commonly recommended community education and strengthened clinician communication to support informed decision-making. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251007430 , PROSPERO CRD420251007430.