Background:Gestational breast cancer (GBC) is defined as a breast cancer diagnosis during pregnancy or within 12 months post-partum. The incidence of GBC varies between 1:1000 and 1:3000 pregnancies. Breast cancer is the most frequent malignant tumour in women and the leading cause of cancer-related female mortality worldwide.Objectives:The main objective of this study was to better understand the experiences of women diagnosed with GBC and their interactions with the healthcare system. By exploring their perspectives, the study aimed to contribute to further research and knowledge to improve care and outcomes for these women.Design:A qualitative exploratory study.Methods:The study involved one-on-one semi-structured interviews conducted in Australia between November 2021 and June 2022. Participants were women diagnosed with GBC. Interviews were recorded digitally, transcribed verbatim, and analysed thematically following Braun and Clarke’s (2006) six steps.Results:Six women diagnosed with GBC participated in the study. Analysis determined three central themes. First: My happiness was stolen. Upon receiving a GBC diagnosis, women described feeling terrified, overwhelmed, concerned for their baby, distressed, yet feeling fortunate at the same time. Second: It really knocked me around. Women expressed their unique circumstances and difficulties in comprehending having a cancer diagnosis while being pregnant, the different treatment modalities, limited information on surgical and fertility preservation options, and being unprepared for the side effects. Third: I wanted control; the importance of being able to take charge of their circumstances and decision-making was important to these women, especially as options were frequently restricted due to the urgency to commence treatment.Conclusion:The findings provide an understanding of the unique challenges of women diagnosed with GBC. Empowering women through personalised knowledge about their disease, understanding their needs, discussing surgical options, addressing fertility preservation, and providing psychological support is essential.

Background:Veterans using Department of Veterans Affairs (VA) healthcare have a high burden of pre-pregnancy chronic disease that likely contributes to the observed high rate of pregnancy-related morbidity. Many common diseases frequently co-occur; understanding patterns of multimorbidity may inform the design and delivery of pre-pregnancy interventions to lower pregnancy morbidity risk.Objective:The current study sought to identify patterns of co-occurrence of pre-pregnancy chronic disease among Veterans.Design:We conducted a retrospective cohort study using VA administrative data.Methods:Our population included Veterans ages 18–45 with ⩾1 pregnancy outcome (ectopic, spontaneous abortion, stillbirth, and/or live birth) during fiscal years 2010–2019. Presence of common chronic diseases with implications for pregnancy was detected using encounter International Classification of Diseases, 9th and 10th Revision (ICD-9 and ICD-10) codes in the 2 years prior to pregnancy. Patients were grouped based on latent class models of diagnosis patterns; two to seven latent groups were examined for model fit and clinical interpretability.Results:We identified 56,853 pregnancies from 41,034 Veterans. More than half of pregnancies were complicated by an array of pre-pregnancy medical and mental health conditions that may negatively impact pregnancy health and contribute to adverse pregnancy outcomes. The most frequently occurring conditions included chronic pain (51.2% of pregnancies), depression (31.4%), anxiety (25.9%), and post-traumatic stress disorder (22.8%). A five-group model demonstrated the best balance between model fit and clinical interpretability. Groups included: “Pain and Mental Health” (28%), with high prevalence of chronic pain, depression, and anxiety; “Pain and Metabolic” (17%), high prevalence of chronic pain, obesity, and migraines; “Substance Use and Mental Health” (7%), high prevalence of alcohol use disorder, depression, and post-traumatic stress disorder; “Low Diagnosis” (43%), lower than average prevalence of diagnoses; and “High Complexity” (5%), high prevalence of conditions across multiple physiologic systems.Conclusions:We identified five distinct, clinically meaningful groups of Veterans based on co-occurring pre-pregnancy diseases. Tailoring interventions to these groups may address Veterans’ complex pre-pregnancy health risks effectively and efficiently.

Background:Women who have undergone mastectomy and do not undergo reconstruction often face challenges with existing bras and prostheses. Mismatches between generic prostheses and individual mastectomy cases result in physical and mental discomfort, such as pain, sweating, asymmetry, and concerns about prosthesis movement. Existing solutions are limited in their ability to address these challenges effectively.Objectives:This study aims to develop a workflow for designing and fabricating a lightweight post-mastectomy bra with an incorporated prosthesis to improve fit, symmetry, and comfort.Design:We developed a customization and fabrication workflow based on a three-dimensional (3D) scan and the manipulation of its geometry to achieve fit and symmetry. We leverage the 3D-printed spacer fabric technique to produce a lightweight, breathable structure.Methods:We conducted mechanical tests to determine printing parameters and evaluate the compression properties of the prosthesis and the bra materials. Additionally, we conducted a wear test for 10 women who underwent a mastectomy. A personalized bra was printed for each, and their feedback on fit and comfort was collected weekly over a 3-week test period.Results:The printed bras were lightweight (150–250 g), breathable, and provided improved symmetry. The mechanical tests confirmed comparable softness to silicone prostheses at significantly lower weight. The user study results show that the custom bras offer several advantages, including reduced weight and improved symmetry, though some participants noted mild fit and texture issues.Conclusion:Integrating the prosthesis into a 3D-printed bra offers a promising personalized solution for post-mastectomy women. This approach enhances comfort, symmetry, and emotional well-being, however, further improvements need to be made to improve the material and tactility.

Background:Postpartum hemorrhage (PPH) is a global health concern and remains the leading cause of maternal death worldwide. Studies assessing the prevalence of PPH and related maternal risk factors in the United Arab Emirates are scarce.Objectives:This study aims to evaluate the prevalence of PPH and associated maternal risk factors in women in the Emirate of Abu Dhabi.Design:Prospective mother and child cohort study.Methods:This analysis was based on data from the Mutaba’ah Study. The sample composed of 2937 women who underwent normal vaginal delivery (2017–2023). Descriptive analysis was performed to compare the characteristics between patients with PPH and those without PPH. Logistic regression analysis was performed to identify maternal characteristics associated with PPH.Results:Overall prevalence of PPH was 4.3% (n = 125, 95% CI: 3.6%–5.1%). The median total blood loss among women with PPH was 700 mL (interquartile range (IQR): 600–1000), and 20% of affected women required blood transfusion. No observed significant difference between those with and without PPH regarding maternal education, body mass index, and comorbidities (p > 0.05). Women with PPH were younger at pregnancy (median (IQR): 28.4 (23.8, 34.3) versus 29.8 (25.4, 34.6), p = 0.022), and had higher proportions of assisted vaginal delivery (13% versus 3.7%, p < 0.001) compared to those without PPH. Women with PPH had significantly greater neonate weight compared to women without PPH (median (IQR): 3210 (2975, 3490) versus 3140 (2865, 3430), p = 0.029). In the adjusted analysis, women who underwent assisted vaginal delivery (adjusted odds ratio, aOR (95% CI): 2.82 (1.60, 4.97)), and those with increased neonate weight (aOR per 100 g: 1.06 (1.01, 1.10)) remained significantly associated with developing PPH.Conclusion:Findings of this study underscore the importance of early identification of women at increased risk of PPH to provide tailored obstetric care. Improved management protocols and increased awareness among healthcare providers are essential to mitigate the risk of PPH and ultimately enhance maternal outcomes.

Background:Optimal treatment and support in family planning for women with type 1 diabetes (T1D) and follow-up during pregnancy are important, however, there is limited knowledge from the women’s perspective on their considerations of family planning, pregnancy, and motherhood.Objectives:To explore expectations and experiences of family planning, pregnancy, and motherhood among women with T1D.Design:We employed a qualitative study design with semi-structured interviews.Methods:We conducted semi-structured individual interviews (June to November 2022) with 17 women with T1D aged 18–45 at a diabetes outpatient clinic in Norway. We analyzed the data using thematic analysis.Results:Four main themes, each with sub-themes, linked to a timeline from planning the pregnancy to becoming a mother were identified: (1) Existential considerations in family planning; (2) Ambiguous information sources and the need for individualized guidance about pregnancy and T1D; (3) Preparations for pregnancy and balancing uncertainties during pregnancy; and (4) Motherhood intertwined with diabetes. Overall, the women expressed a need for support in handling and managing their glucose control in the phase of family planning, during pregnancy, and when preparing for the role of mother.Conclusion:Women with T1D reported many worries and concerns related to family planning, pregnancy, and motherhood, and thus, individualized information and support related to diabetes and reproductive health should be an integrated part of follow-up care. Women with T1D seem to have high expectations and strong commitment to their diabetes self-management during pregnancy, conditional on support and guidance from health care providers (HCPs). A sensitive approach from HCPs in clinical consultations is vital to meet the individual woman’s need for support. More research about reproductive health in women with T1D is needed, especially regarding how motherhood and diabetes intersect in everyday life.

Background:Health-related quality of life (HRQoL) measures may help incorporate patient preferences and deliver individualized care for older breast cancer survivors. However, few studies have used clinically meaningful thresholds to evaluate the various characteristics associated with HRQoL in older women.Objectives:To examine sociodemographic and clinical characteristics associated with HRQoL and minimal clinically important differences (MCIDs) among female breast cancer survivors aged ⩾65 years.Design:A cross-sectional study.Methods:We used 2006–2015 Surveillance, Epidemiology, and End Results data linked to the Medicare Health Outcomes Survey (SEER-MHOS) for U.S. women aged ⩾65 years diagnosed with stages I–III invasive breast cancer. Descriptive statistics were used to summarize data. Generalized linear regression models were fitted to identify characteristics associated with the HRQoL physical component summary (PCS) and mental component summary (MCS) scores from the Veterans RAND 12-Item Health Survey scale. Missing values were imputed using chained equations. A threshold of two points was used to identify clinically meaningful between-group differences.Results:The median age at diagnosis was 72 years (interquartile range: 68–76) among 3218 breast cancer survivors. Obesity (mean difference (MD): −2.42; 95% confidence interval (CI): −3.34, −1.49), older age (⩾80 years; MD: −2.05; 95% CI: −3.15, −0.96), difficulty with ⩾1 activities of daily living (ADL; MD: −11.70; 95% CI: −12.42, −10.99), and cardiovascular (MD: −2.27; 95% CI: −3.02, −1.53) and musculoskeletal disease (MD: −3.88; 95% CI: −4.67, −3.09) were associated with clinically meaningful lower PCS scores. Less than high school education (MD: −3.43; 95% CI: −4.53, −2.33), annual household income ≤$19,999 (MD: −4.08; 95% CI: −6.00, −2.16) and $20,000–$39,999 (MD: −2.71; 95% CI: −4.63, −0.79), no surgery (MD: −3.03; 95% CI: −5.33, −0.72), difficulty with ≥1 ADL (MD: −6.71; 95% CI: −7.52, −5.89), and obesity (MD:2.06; 95% CI: 1.00, 3.12) were associated with MCIDs in MCS scores.Conclusion:Clinically meaningful differences in HRQoL were observed across sociodemographic and clinical characteristics in older female breast cancer survivors. These results may help identify women in need of interventions to improve HRQoL post-diagnosis.

Background: Despite being regarded as the gold standard, outpatient hysteroscopy (OPH) is associated with inconsistent outcomes and pain, while the clinical, organisational, and personal determinants shaping patient-centred experience remain poorly characterised. Objectives: This study aimed to harness the authenticity and richness of naturally occurring online qualitative data to explore the clinical, organisational, and personal factors that shape women’s hysteroscopy experiences, offering vital insights for service improvement. Design: An in-depth qualitative investigation of hysteroscopy experiences, as shared by individuals on a publicly accessible online discussion forum. Methods: Four thousand seven hundred sixty-nine posts across 277 discussion threads published between 2018 and 2024 were collected from Mumsnet.com, representing 1971 forum users discussing their personal hysteroscopy experiences. Posts were analysed using reflexive thematic analysis, informed by a constructivist epistemology and a latent, inductive analytic orientation, to capture both the depth and diversity of online contributions. Results: Five themes captured women’s specific hysteroscopy experiences: (1) Contingent Consent, (2) Unacknowledged Vulnerability, (3) Analgesia Roulette, (4) Gynaecological Pain Gaslighting, and (5) Gendered Pain Gap. These themes delineate a hysteroscopy pathway where consent is shaped by limited choices and misinformation, vulnerability is heightened by procedural exposure, pain relief is inconsistently applied, women's suffering is routinely dismissed, and gender biases reinforce unequal standards of care. Conclusion: This study identifies clinical blind-spots that contribute to perceptions of systemic neglect in women’s gynaecological health care, evidenced by inconsistent pain management, inadequate consent, and gendered biases in OPH. These findings present an opportunity to inform structural reforms that advance equitable, patient-centred gynaecological care and improve clinical accountability.

Background:Obstetrics and gynecology emergency rooms (OB-GYN ERs) are crucial for treating acute women’s health issues. However, utilization of ER services for non-urgent complaints is a challenging issue in the healthcare system and could reflect gaps in the primary healthcare (PHC) setting.Objectives:To evaluate the epidemiology of OB-GYN ER visits and identify the patterns and predictors of hospital admissions in a referral university hospital in the Eastern Province of Saudi Arabia.Design:A retrospective, record-based, epidemiological study.Methods:All OB-GYN ER visits from January to December 2022 were included. Data on patient demographics, triage levels, timing of visits, chief complaints, and admission status were collected. Logistic regression models were used to assess factors associated with hospital admission.Results:Among 8781 ER visits, the median patient age was 30 years (Interquartile range: 26–36), and 85.30% were Saudi nationals. The majority of visits were triage level IV (71.84%), with only 12.46% resulting in admission. Obstetric complaints (47.44%) were the most common, followed by gastrointestinal and gynecological symptoms. Older age, higher acuity triage levels, the winter season, and visits during night or morning shifts were significantly associated with increased odds of admission. Most presenting complaints had a lower odd of admission when compared to the obstetrics complaints.Conclusion:The study demonstrates a substantial number of non-urgent OB-GYN ER visits, underscoring gaps in continuity of care. Strengthening PHC services and optimizing referral pathways for women’s health may help reduce unnecessary ER utilization and ensure more appropriate use of emergency resources.

Background:Due to minimal effects, new directions for behavioral (non-pharmacologic/non-surgical) obesity interventions are required. Previous research suggests that physical activity and exercise (PA/exercise) might have considerable merit for weight reduction via impacts on mood and other psychosocial correlates of controlled eating. Although as few as 3 bouts/week of low-moderate intensity PA/exercise are associated with improved mood—with no dose–response effect beyond that frequency—it is unknown if mood improvements may be leveraged when participants already complete ⩾3 bouts/week by treatment start.Objectives:The present research addressed gaps in the available PA/exercise–psychosocial change–weight management research.Design:This study combined group contrasts with mediation analyses.Methods:Women participating in a community-based cognitive-behavioral obesity treatment emphasizing the increase of PA/exercise and exercise-related self-regulation and self-efficacy (N = 99) were divided for separate analyses into groupings of <3 bouts/week, and ⩾3 bouts/week, of light (e.g., easy walking) and moderate (e.g., fast walking) PA/exercise regularly completed prior to treatment start. The participants were assessed on psychosocial and PA/exercise changes from baseline to month 3.Results:Reductions in total mood disturbance (TMD), depression, and anxiety scores were overall significant, with no significant difference by exercise-frequency grouping. PA/exercise increases were significantly greater in the <3 bouts/week groupings. Change in self-regulatory skills usage mediated relations between groupings and changes in TMD, depression, and anxiety. In subsequent serial mediation models, significant paths from grouping → self-regulation change → self-efficacy change → TMD and depression changes were found.Conclusion:Whether or not ⩾3 bouts/week of PA/exercise are completed at intervention start, TMD, depression, and anxiety may be reduced through treatment foci on increasing PA/exercise, self-regulation, and self-efficacy. Findings might be useful for informing scalable obesity treatments.

Background:Polycystic ovary syndrome (PCOS) is the most common female endocrine disorder. However, current lifestyle recommendations may not be appropriate for all individuals with PCOS. To best tailor an intervention for individuals with PCOS, an understanding of their preferred intervention characteristics is needed.Objectives:To describe preferred intervention characteristics of a weight-neutral lifestyle approach and explore the acceptability of intuitive eating for individuals with PCOS.Design:Convergent mixed methods analysis.Methods:Preferred intervention characteristics were explored through an online survey, with semi-structured interviews conducted with a purposively selected group of survey participants. Descriptive statistics were calculated. Qualitative data were analyzed using reflexive thematic analysis. Joint displays were used for mixed methods integration.Results:Two hundred sixty-seven participants (77.7% white, 86.0% non-Hispanic, mean age 29.7 ± 5.1 years) were included in the analysis. Participants reported interest in a lifestyle program (66.3%) consisting of individual and group (57.7%) sessions, delivered in-person and remotely (46.2%). Although a registered dietitian was the preferred provider to administer the intervention (80.5%), many participants (54.9%) desired an interdisciplinary team. Interest in intuitive eating was high (mean score 7.1 ± 2.7, scale 1–10, higher scores indicate higher interest). The average scores for acceptability, appropriateness, and feasibility of an intuitive eating intervention were 3.7 ± 0.9, 3.3 ± 1.0, and 3.8 ± 0.8, respectively (scale 1–5, higher scores indicate higher acceptability, appropriateness, and feasibility). While intuitive eating was perceived to have several benefits, concerns over letting go of food rules and navigating cravings were heard. A need for an individualized approach, with practical guidance, education, and peer support was identified.Conclusions:Individuals with PCOS prefer an individualized lifestyle approach. Intuitive eating may be an acceptable weight-neutral lifestyle intervention for PCOS. However, concerns over implementing intuitive eating should be considered in the design of an intervention. Future research should incorporate these findings when developing treatment approaches for PCOS.