Birth Control Research Articles

Polycystic ovary syndrome increases risks of infertility: Role of a well-planned diet and other factors

Polycystic ovary syndrome (PCOS) is a hormonal disorder causing menstrual irregularities, insulin resistance, and infertility. Treatment options include medical treatments and lifestyle modifications. The guideline suggests various balanced strategies, including diet, exercise, behavioral interventions, and sleep. This article aimed to review the multiple diets, nutrients, and other factors responsible for PCOS-induced infertility, which is growing nowadays. The primary motive to recover PCOS is to reduce the risk of infertility among women. PCOS treatment involves birth control pills, diabetes medication, and estrogen receptor modulators. Lifestyle changes like resistance training and yoga can improve body composition and reduce fat. Traditional lifestyles, such as alcohol and tobacco, can hinder fertility. Weight loss improves PCOS status regardless of dietary composition. Low glycemic index diets reduce weight gain, improve insulin sensitivity, and reduce risk factors. The DASH diet, rich in fruits, vegetables, whole grains, nuts, legumes, and low-fat dairy, is recommended for managing PCOS. In conclusion, PCOS should be taken care of for young women with the help of diet, exercise, and medication, if needed, to avoid infertility under the supervision of a dietitian and physician.

“Sex Out of Boredom”: Key Stakeholders’ Perspectives on Teen Pregnancy Prevention in Emerging Immigrant Latino Rural Communities

Abstract Introduction Teen pregnancy (TP) rates are 1.5 times higher among Latina youth than the United States national average and one-third times higher in rural counties. The Socio-Ecological framework recognizes the myriad of issues that impact TP, including four bidirectional levels of influence on teenagers’ behaviors: macro, community, institutional, and interpersonal levels. We aim to fill critical knowledge gaps regarding the influence of key community stakeholders living in rural, Latino-majority communities shaping Latino/a, immigrant adolescents’ TP-related environments. Methods A purposive sample of 48 key stakeholders was drawn from three rural counties (Finney, Ford, and Seward) in southwestern Kansas from 2016 to 2017; participants completed a brief demographic survey and a semi-structured qualitative interview. Qualitative data analysis followed grounded theory within a Socio-Ecological framework, and we used descriptive statistics to analyze survey data. Results Respondents (N = 48) included 5 public health department staff, 8 community health workers, 8 healthcare workers, 9 community members, and 18 high school/college administrators. The mean age was 43 years (SD = 15.5) and 50% self-identified as Latino/a. Recommendations included developing TP prevention education programs for parents, utilizing ongoing events and familiar venues, and keeping content consistent with local culture and norms. Conclusions Key stakeholders’ perceptions regarding TP are often unaccounted for but play a role in shaping youth’s decision-making environments. Policy Implications This information could inform the development of culturally specific TP prevention interventions, especially considering the controversial politics centered on immigration to the U.S. and its negative impact on the overall health of Immigrant Latinos living in the U.S.

Prevention of Anaemia in Pregnancy: A Five-Year Scoping Review

Abstract: Approximately 50% of pregnant women globally suffer from pregnancy-related anaemia, which is a serious issue for reproductive health and can lead to a number of complications, including low birth weights, premature deliveries, foetal deformities, and feto-maternal mortality. Aim: This study aimed to evaluate the suggested strategies to prevent anaemia in pregnancy through a 5-year scoping review (November, 2017 to November, 2022). Methods: A comprehensive list of keyword combinations linked to anemia prevention in pregnancy and pertinent approaches to inform the search strategy were evaluated. Significant events, including pregnancy and anemia, were cross-referenced with the frequency and variability of terms across time. Literature from Pubmed (MEDLINE), Google Scholar, PLOS One, and Cochrane database were reviewed. Results: Evidence-based preventative therapy options for iron deficiency anaemia in pregnancy include prophylactic iron supplementation, food fortification with iron and folate, and health education. There is a wealth of research on the effects of these therapies on the occurrence of anaemia during pregnancy. However, these prospects are endangered by several variables, such as inadequate health facilities, low maternal health literacy, low utilisation of maternal health care in developing countries, a dearth of resources for health education, and lack of a government policy that prevents anaemia during pregnancy. Conclusion: If the highlighted challenges are appropriately addressed through the provision of health education material, the effectiveness of anaemia prevention in pregnancy could be sustained.

Reproductive behaviors among school-based health center clients in New Mexico

IntroductionSchool-based health centers (SBHCs) are an evidence-based model for providing contraceptives to adolescents. SBHCs ability to provide reproductive health services is often limited by school district policies, state laws, and health center policies.MethodsWe used data from the Teens Exploring and Managing Prevention (TEMPO) study to document demographic characteristics and birth control methods among patients at four SBHCs in New Mexico. A total of 264 teens were included in the baseline data collection at SBHCs in New Mexico. A baseline survey was administered via iPad, that specifically focused on questions related to sexual experiences and sexual health topics. Baseline questions included demographic questions, gender identity, sexual orientation, reasons for visits, reproductive practices, and birth control methods. Descriptive statistics were calculated, including means and standard deviations for continuous variables and categorical frequencies.ResultsOur findings present reproductive health behaviors among New Mexican patients attending schools with SBHCs. More than 74% of respondents were Hispanic or Latino. The most common reason teens went to the SBHC was for birth control, and just 62% of teens reported using birth control methods in the past.DiscussionThese behaviors are essential for policymakers to consider as they address policy gaps, the complex landscape of parental permission, reproductive rights, and health as a human right.

Breaking the misery wheel? Fertility control, social mobility, and biological well-being in rural Spain (1835–1959)

Abstract Fertility control strategies became widespread in rural Spain through the twentieth century: a significant number of parents decided to reduce their marital fertility once the advantages of control strategies became widely known. This paper explores the impact of those practices on children through a comparative study of the heights and occupations of grandparents, parents, and children. We analyze more than 1,200 individuals from three different generations born between 1835 and 1959 in 14 rural Spanish villages, studying whether the advantages associated with fertility control were maintained over time favoring a better family status or whether they were diluted in the next generation. The largest increases in height were among children whose parents controlled their fertility by stopping having children before the mother's 36th birthday. However, it does not seem that this increase in biological well-being was accompanied by major episodes of upward social mobility.

Enhancing nutrient uptake and grapefruit (Citrus paradisi) growth through soil application of beneficial bacteria (Bacillus spp.)

The term plant growth-promoting rhizobacteria (PGPR) refers to a root-associated bacteria that possesses several benefits for soil and the plant. The increasing demand for sustainable food production necessitates a shift towards agricultural practices that mitigate adverse environmental impacts. Excessive use of chemical fertilizers and pesticides has raised concerns, prompting a surge of interest in harnessing the potential of beneficial soil microorganisms, particularly plant growth-promoting rhizobacteria. This study explores the impact of soil inoculation with PGPR treatments on grapefruit seedlings, including a commercial strain of Bacillus velezensis, a fresh inoculum of Bacillus amyloliquefaciens, a mixture of three selected citrus endophytic Bacillus spp. isolates, inorganic fertilizers, and combinations thereof. The aim was to test their ability to enhance growth and nutrient uptake reducing the input of chemical fertilization. Results indicated that the combination of Bacillus velezensis and inorganic fertilization significantly improved soil nutrient availability and enhanced plant growth, surpassing both negative (water) and positive (inorganic fertilization) controls. Shoot and root system biomass showed significant increases from Bacillus velezensis plus inorganic fertilization compared to other treatments. These findings provide insights into management methods that can reduce chemical inputs while promoting plant productivity. The demonstrated benefits of PGPR on grapefruit seedlings highlight a promising approach for future research and applications in sustainable citrus cultivation.

Linkages between economic growth, health expenditures, education, and environment: dynamic analysis of Nigeria

The study comprehensively analyzed the nexus between economic growth, health expenditures, education, and the environment in Nigeria, using data obtained from Central bank of Nigeria and World Bank. By utilizing a robust dataset spanning from 1981 to 2021, the study employed autoregressive distributed lag (ARDL) approach to uncover intricate relationships. Results, both short-run and long-run analyses, reveal that health and education spending, and gross fixed capital formation positively correlated with economic growth. Conversely, the findings demonstrated that population growth and carbon dioxide emissions (CO2) exerted detrimental effects on economic growth due to the negative impact on the health of the working population. Additionally, the inverted U-shaped relationship between the macroeconomic footprint and income confirms the validity of Nigeria's Environmental Kuznets Curve (EKC) phenomenon. Lastly, the findings of this study hold important policy implications, emphasizing the need for technological advancements and innovative solutions to address the challenges associated with economic growth, health expenditures, education, and the environment in Nigeria. Policy measures promoting birth control through contraception and family planning should be embraced to effectively manage the country's rapidly growing population.

“My IUD is expiring”: A national U.S. mystery client study regarding use of the LNG 52-mg IUD for pregnancy prevention beyond five years after multiple FDA extensions

ObjectiveSince 2020, the FDA has approved multiple extensions to the use of the levonorgestrel (LNG) 52-mg intrauterine device (IUD) for pregnancy prevention beyond five years. The accessibility of this information to patients calling a reproductive health clinic to schedule replacement remains unknown. We assess the patient experience in accessing information via phone call to a clinic on the duration of pregnancy prevention for LNG 52-mg IUD. Study DesignWe utilized a mystery client study design before and after the 2022 extension to inquire about LNG 52-mg IUD use beyond five years. Purposeful sampling ensured clinic diversity. ResultsIn June 2022, 18 (32%) clinics offered extended use beyond five years, 25 (44%) recommended replacement at five years, and 14 (25%) could not provide information. The number of clinics offering extended LNG 52-mg IUD use did not significantly increase in August 2023 (n=22, 39%, p=0.27). ConclusionPatients scheduling a replacement of the LNG 52-mg IUD may not receive information about use beyond five years. Reproductive health clinic’s scheduling staff need further training on updated guidelines.

College Student Perceptions of Pharmacist-provided Hormonal Contraception

BackgroundNorth Carolina immunizing pharmacists are authorized to provide oral and transdermal hormonal contraception to eligible patients. In March 2022, implementation of this enhanced patient care service began statewide, following approval of standing orders and published training from the North Carolina Association of Pharmacists. Two pharmacy locations on a college campus began offering pharmacist-provided hormonal contraception shortly after approval. ObjectiveThe objective of this study was to assess the willingness of students to seek pharmacist-provided hormonal contraception and the willingness of students to pay for this service. MethodsThis cross-sectional study was conducted on the campus of a public, research-intensive University. To be included, individuals must have been 18 years of age or older, an enrolled student, and used prescribed hormonal birth control within the last year. Individuals who declined consent or surveys that were not at least 90% complete were excluded. The survey was administered via Qualtrics and distributed via email and printed flyers with a QR code. The survey opened February 10, 2023, and closed April 24, 2023. ResultsIn total, 170 survey responses were analyzed. Almost three-fourths of participants (72.9%) were not aware that pharmacists could provide hormonal contraception in North Carolina. All participants identified at least one benefit to pharmacist-provided contraception, with the most common responses being “I believe it would save time” (85.3%) and “appointment not needed” (89.4%). Almost two-thirds of participants (65.3%) identified at least one barrier that would prevent them from seeking pharmacist-provided contraception. The most common barrier identified was privacy at the pharmacy (20.0%). Most participants (81.8%) reported that they are willing to pay for this service, with the majority willing to pay up to $29. ConclusionStudents on this campus appear to have a receptive attitude towards pharmacist-provided hormonal contraception and are willing to pay for a consultation.

Knowledge, Attitude, and Dispensing Practice of Emergency Contraceptive Pills among Community Pharmacists: A Cross-sectional Survey

Background: The improper or incorrect usage of birth control results in unintended pregnancy. In India, 78% of pregnancies are accidental, with unwanted pregnancies accounting for about 25% of all pregnancies. The family, society, and country may all be financially impacted by such pregnancies. Community pharmacists must have a good attitude and sufficient knowledge of emergency contraception pills (ECPs) in order for women to receive them in a timely manner and as a result, have fewer unintended pregnancies. The purpose of this study is to investigate the knowledge, attitude, and, practices of community pharmacy practitioners towards ECPs. Methods: A cross-sectional study was carried out on retail pharmacies located in Madhya Pradesh, Mumbai. A standardized questionnaire was used in 164 community pharmacies to interview about CPPs using a convenience sampling technique. The survey evaluated the CPP's dispensing procedures, knowledge, attitude, and demographic profile. Data analysis was carried out by using the statistical package for the social sciences (SPSS) version 18 (SPSS Inc., Chicago, IL, USA). Results: A total of 164 registered pharmacists participated in the study, which included 76.1 % (n=124) males and 23.9% (n=39) females. Among all the participants, 73.0% of them had a diploma in pharmacy (D Pharm) education, and half of the study participants had a working experience between 1-5 years. In this study, 56.64 %, 27.6%, and 16% of participants had average knowledge, sound knowledge, and poor knowledge, respectively. Results showed that 90.2% (147) of pharmacists came under the positive attitude category, 5.5% of pharmacists had a negative attitude, and 4.3% had a neutral attitude. A moderate positive linear relationship (0.401) existed between the knowledge and attitude of the pharmacist in this study. Attitude and dispensing of emergency OC as OTC to people older than 18 years old and less than 18 years old showed a moderate negative linear relationship. After adjusting the possible confounder variables, age and years of experience significantly affected the knowledge, attitude, and practice of EC. Conclusion: In conclusion, the present study has shown that there is generally a lack of knowledge and poor attitude toward emergency contraceptive medicines among community pharmacists. Therefore, it is recommended that improving pharmacist's knowledge, attitude, and practice (KAP) through proper training and counseling about EC can enhance the appropriate use of drugs.

How to decrease teenage pregnancy: rural perspectives in Ecuador

IntroductionThis study aimed to understand the sociocultural context of teenage pregnancy in an Ecuadorian city with a large indigenous population, to gauge the acceptability of a multifaceted pregnancy prevention program for adolescents, and to elicit perspectives on the optimal program design from adolescents and adult key informants.MethodsWe ascertained qualitative data via an online, electronic survey administered from August to September 2020. Open- and closed-ended questions elicited perspectives relating to burden of adolescent pregnancies, acceptability of pregnancy prevention programs, and optimal design of future programs. Twenty-four adolescents (13–19 years of age) and 15 adult key informants working in the healthcare, business, and education sectors in Cotacachi completed the survey. Survey responses were analyzed using a structural and in vivo coding, and an inductive approach to consensus-building around key themes.ResultsMost adolescent survey respondents (75%) believed that teen pregnancy is “fairly common” in Cotacachi, and 41.7% believed differences in teen pregnancy rates are not associated with ethnicity. In comparison, 66.7% of adult survey respondents said teen pregnancy disproportionately occurs among indigenous teenagers. Additionally, 45.8% of adolescent and 80% of adult survey respondents believed that a comprehensive sexual education program would help reduce teenage pregnancy rates by imparting reliable sexual health knowledge. Adult respondents noted that the past programs were unsuccessful in preventing teenage pregnancy because of these programs’ inability to fully engage teenagers’ attention, very short time duration, or inappropriate consideration of cultural context.DiscussionIn Cotacachi, Ecuador, a sexual health education program is both desired and feasible according to adult and teenager key informants. A successful program must adapt to the cultural context and engage youth participation and attention.

Prescription retinoid and contraception use in women in Australia: A population-based study.

Oral retinoids are teratogenic, and pregnancy avoidance is an important part of retinoid prescribing. Australia does not have a standardised pregnancy prevention programme for women using oral retinoids, and the contraception strategies for women who use oral retinoids are not well understood. The objectives were to determine trends in the use of prescription retinoids among Australian reproductive-aged women and whether women dispensed oral retinoids used contraception concomitantly. This was a population-based study using Australian Pharmaceutical Benefits (PBS) dispensing claims for a random 10% sample of 15-44-year-old Australian women, 2013 - 2021. We described rates and annual trends in dispensing claims for PBS-listed retinoids and contraceptives. We also estimated concomitant oral retinoid and contraceptive use on the day of each retinoid dispensing and determined if there was a period of contraceptive treatment that overlapped. Estimates were then extrapolated to the national level. There were 1,545,800 retinoid dispensings to reproductive-aged women; 57.1% were oral retinoids. The rate of retinoid dispensing to reproductive-aged women increased annually, from 28 dispensings per 1000 population in 2013 to 41 per 1000 in 2021. The rate of oral retinoid dispensing doubled over the study period, from 14 dispensings per 1000 population in 2013 to 28 per 1000 in 2021, while topical retinoid dispensing did not change. Only 25% of oral retinoid dispensings had evidence of concomitant contraceptive use in 2021. Rates of oral retinoid dispensing have doubled among reproductive-aged women over the past decade. A large percentage of oral retinoid use does not appear to have concomitant contraception use, posing a risk of teratogenic effects in pregnancies.

Sulfur dioxide- resistant platinum-based intermetallic nanocatalysts encaged by porous nitrogen-doped carbon for oxygen reduction reaction

SO2, one of the considerable air pollutants, exhibits a stronger binding affinity with Pt when compared to O2, thereby inducing irreversible degradation of the Oxygen Reduction Reaction (ORR) catalyzed by Pt-based catalysts. Despite this detrimental phenomenon, scarce investigations have delved into the realm of contaminant-tolerant catalysts, and so far, no effective SO2-tolerant catalysts have been proposed. To meet this challenge, we designed and synthesized a core–shell structure catalyst equipped with a dual protection mechanism. This was achieved through the in-situ polymerization of aniline monomers, concomitantly reducing Pt2+. The resulting shell effectively hinders the transmission of SO2 to the active sites of Pt, while permitting the unimpeded transmission of O2. Simultaneously, the intermetallic core inhibits the adsorption of SO2. Therefore, this catalyst exhibits exemplary ORR activity coupled with exceptional resistance to SO2 resistance. In particular, the PtFe@FeNC/C-10 catalyst, optimized in terms of the quantity of added aniline, demonstrates a mass activity 1.84 times greater and a specific activity 4.03 times higher than that of commercial Pt/C catalysts. Following exposure to SO2-induced poisoning, the E1/2 value of the PtFe@FeNC/C-10 catalyst undergoes a decrease of only 51.7 mV, lower than that observed for the commercial Pt/C catalyst (92.0 mV). Moreover, the results of an accelerated durability test affirm the superior stability of PtFe@FeNC/C-10 in comparison to commercial Pt/C. This stability advantage is attributed to the protective carbon shell, which effectively prevents the detachment and agglomeration of Pt nanoparticles.

Microplastics and 17α Ethinylestradiol: How Do Different Aquatic Invertebrates Respond to This Combination of Contaminants?

The synthetic hormone 17α ethinyl estradiol (EE2) is a molecule widely used in female contraceptives and recognized as a contaminant of attention (Watch List) in the European Union due to its high consumption, endocrine effects and occurrence in aquatic environments. Its main source of introduction is domestic sewage where it can be associated with other contaminants such as microplastics (MPs). Due to their characteristics, they can combine with each other and exacerbate their isolated effects on biota. This study evaluated the combined effects of microplastics (MPs) and 17α ethinylestradiol (EE2) on two tropical estuarine invertebrate species: Crassostrea gasar and Ucides cordatus. Polyethylene particles were spiked with EE2 and organisms were exposed to three treatments, categorized into three groups: control group (C), virgin microplastics (MPs), and spiked microplastics with EE2 (MPEs). All treatments were evaluated after 3 and 7 days of exposure. Oysters exhibited changes in phase 2 enzymes and the antioxidant system, oxidative stress in the gills, and reduced lysosomal membrane stability after exposure to MPs and MPEs. Crabs exposed to MPs and MPEs after seven days showed changes in phase 1 enzymes in the gills and changes in phases 1 and 2 enzymes in the hepatopancreas, such as disturbed cellular health. The combined effects of microplastics and EE2 increased the toxicity experienced by organisms, which may trigger effects at higher levels of biological organization, leading to ecological disturbances in tropical coastal ecosystems.

Medication for Birth Control in Bitch at Battambang City, Battambang Province, Cambodia

Medication for Birth Control in Bitch at Battambang City, Battambang Province, Cambodia

Exploring actors' collaborations and involvement in the Namibian learner pregnancy policy

IntroductionThe Namibia Education Sector Policy on the Prevention and Management of Learner Pregnancy (ESPPMLP) aims to reduce the cases of learners falling pregnant and increase learner-parent completion of education. The ESPPMLP addresses the fact that learner pregnancy and school drop-out are collaborative efforts between parents, the community, schools, and non-governmental organizations. However, Namibia continues to have had a problem with the high rate of learner pregnancy and school drop-out for many years. Previous studies reported the absences and limitations of both internal and external actors' collaboration in its implementation. This paper aims to clarify the lack of stakeholder involvement and cooperation in the ESPPMLP activities within selected rural schools in Namibia.MethodsUsing the qualitative approach mixed with phenomenological and content data analysis, the study conducted 19 individual interviews with schoolteachers, one school board member, one NGO representative, and six focus group discussions with 27 parents.Results and findingsAmong others, results show the limited life skills of teachers in schools, the attitude of the community toward schoolteachers, making them feel devoid of influence in collaborations, and the lack of sexual reproductive activities programs in school settings. The findings reveal the reliance of the activities of prevention and management of learner pregnancy on donor-driven initiatives, the lack of task forces at the community level, the shortage of knowledge and understanding about the ESPPMLP and the lack of policy implementation guidelines. Establish learner pregnancy leadership structures at the community level for coordination, introduce community parenting, and execute partnership of monitoring activities to boost stakeholder collaborations.

A facile dual isolation and protection strategy for preparation of PtFe intermetallic compound in biomass-derived carbon with high activity and durability for pH-universal bifunctional electrocatalysts

A facile dual isolation and protection strategy is developed to prepare PtFe intermetallic electrocatalyst (PtFe–N–C@bioC) on porous biomass carbon (bioC) derived from peanut shell. In preparation, meso-tetraphenylporphyrine (H2TPP) together with platinum (II)-tetraphenylporphyrin (PtTPP) are in-situ fabricated on the porous peanut shell-derived bioC matrixes and then further absorbed Fe (III) tetraphenyl porphyrin (FeTPP) molecules through π−π interactions between PtTPP/H2TPP and FeTPP to form a mixed precursor of FeTPP/PtTPP/TPP-bioC. Upon pyrolysis of FeTPP/PtTPP/TPP-bioC, PtFe bimetallic-containing N-doped carbon formed on bioC (PtFe–N–C@bioC). The resultant PtFe–N–C@bioC showed excellent oxygen reduction reaction (ORR) and hydrogen evolution reaction (HER) activity across a wide pH range. In particular, under alkaline medium, PtFe–N–C@bioC shows the ORR performance with an onset potential (Eonset) of 0.989 V, a half-wave potential (E1/2) of 0.901 V and a limiting current density (JL) of −6.214 mA cm−2. Meanwhile, PtFe–N–C@bioC delivers an enhanced mass activity (1.197 A mg−1Pt), which is 13 times larger than commercial Pt/C. For HER, PtFe–N–C@bioC shows an impressive overpotential (η10) of 17 mV at a current density of 10 mA cm−2 under acidic medium. Further, it is applied to Zn-Air batteries with a power density performance of 98.7 mW cm−2 and good durability.

Reversible Contraception in Males: An Obtainable Target?

The last few decades have brought contraception to the forefront of research, with great strides made in effectively targeting and optimizing the physiology, pharmacology, and delivery processes that prevent pregnancy. However, these advances still predominantly target female contraceptives for the prevention of contraception, whereas targeting the male sex has lagged far behind. This has led to a marked deficiency in safe and effective male contraceptive agents, resulting in a heavy dependence on female contraceptives to prevent unwanted and unplanned pregnancies. Current research in the veterinary field and in rodents highlights several promising avenues whereby novel, safe, and effective male contraceptive alternatives are being developed—with an emphasis on reduced side effects and reversibility potential. This review aims to discuss current and novel male contraceptives (both human and veterinary formulations) while highlighting their efficacy, advantages, and disadvantages.

Maternal red blood cell alloimmunization prevalence in the United States

Hemolytic disease of fetus and newborn (HDFN) is a life-threatening disease mediated by maternal alloimmunization to red blood cell (RBC) antigens. Studies of maternal alloimmunization prevalence in the United States (U.S.) lack national data. This study describes prevalence and trends in alloimmunization in pregnancy in the U.S. RBC antibodies (abs) were identified in a large, nationwide, commercial laboratory database from 2010-2021. The cohort comprised pregnancies for which the year of lab collection and patient's state of residence were available. Data were normalized based on U.S. Centers for Disease Control and Prevention estimates of live births and weighted by year and U.S. Census Division. Cochrane-Armitage tests assessed temporal trends of alloimmunization. Of 9,876,196 pregnancies, 1.5% (147,262) screened positive for RBC abs, corresponding to an estimated prevalence of 1,518/100,000 pregnancies. Of identified RBC abs, anti-D comprised 64.1% (586/100,000 pregnancies). Prevalence of other high-risk RBC abs for HDFN included anti-K (68/100,000) and anti-c (29/100,000). Incidence of all three high-risk abs increased from 2010-21 (all p<0.001). Among almost 10 million pregnancies in the US, comprising an estimated 14.4% of all pregnancies, 1.5% screened positive for RBC abs. Almost three-quarters (74.3%; 683/100,000) of RBC abs identified were high-risk for HDFN. Though prevalence of anti-D is difficult to interpret without the ability to distinguish alloimmunization from passive immunity, it remains problematic in HDFN, ranking second only to anti-K in critical titers. Given the sequelae of HDFN, new initiatives are required to reduce the incidence of alloimmunization in patients of reproductive potential.

Perceived associations between the menstrual cycle and Attention Deficit Hyperactivity Disorder (ADHD): A qualitative interview study exploring lived experiences

BackgroundThe research gap regarding Attention Deficit Hyperactivity Disorder (ADHD) in people who were assigned female at birth has led to a lack of knowledge and adequate approaches in clinical practice, as well as diagnosis processes. Recent studies report potential associations between reproductive hormones and ADHD, but existing research remains scarce. AimThis study aims to explore the experiences of people who perceive an association between their menstrual cycle and their ADHD symptoms. MethodologyDesign and Method.A qualitative research design with an inductive approach was used. Ten participants were interviewed, using semi-structured, in-depth interviews. The data was transcribed, coded, and analyzed using reflexive thematic analysis according to Braun and Clarke. ResultsFindings show participant’s perceived associations between their ADHD and their menstrual cycle: participants reported experiencing ADHD symptom mor severe during the mid-luteal phase of the menstrual cycle. Other results showed uncertainty around ADHD medication in relation to the cycle and varied experiences with health care encounters as well as heightened challenged around menstrual health management. ConclusionsThis study provides insights to how perceived associations between ADHD and the menstrual cycle might be experienced. This report highlights the need for further research and theory about the potential associations between ADHD and reproductive hormones. The researchers strongly suggested that forthcoming ADHD studies consider times of key hormonal changes, such as puberty and menarche, menopause, hormonal birth control, pregnancy, hormone treatment, and more.