Burden Of Women Research Articles

Prevalence of dysmenorrhea in adolescents in France: Results of a large cross-sectional study

BackgroundsDysmenorrhea is the most common gynecological complaint in young women but is overlooked by recent studies. Our objective was to evaluate the prevalence of dysmenorrhea in adolescents in France and its impact on daily living. MethodsIt was a cross-sectional study conducted between April–May 2019, in eight randomly selected high schools in France. Participants were randomly selected post-menarche girl pupils 15–19 years who completed a 50-item questionnaire. Dysmenorrhea severity was assessed with the Numerical Rating Scale (NRS) and Verbal Multidimensional Scoring System Scale (VMSS). ResultsQuestionnaires from 953 girls were analyzed (mean age: 16.9 years). The prevalence of dysmenorrhea was 92.9% with 8.9% describing their pain as severe. Impact on quality of life was significant: 43.3% reported school absences because of dysmenorrhea, 74.9% difficulties in attending classes and 77.2% difficulties in sports activities. Risk factors of severe dysmenorrhea in multivariate analysis were heavy menstrual bleeding (OR 2.02, 95%CI [1.12; 3.63] p = 0.0192), early menarche (OR 0.68, 95%CI [0.57; 0.81] p<0.0001), chronic pelvic pain (OR 2.60, 95%CI [1.10; 6.11] p = 0.0274), BMI (BMI<18, OR 1.94, 95%CI [1.03; 3.66] p = 0.0335). Of the 50.4% who had consulted a physician, 45.4% had seen a general practitioner. Among the girls who had not consulted, 55.1% reported that menstruation was a “woman's burden”. ConclusionsDysmenorrhea is highly prevalent in adolescents in France and has a real impact on daily living with social repercussions. As such, it should be treated as a public health problem with educational and information campaigns targeting the girls themselves, their families and healthcare professionals.

OUT OF POCKETS SPENDING AMONG BREAST CANCER WOMEN RECEIVING OUT-PATIENT TREATMENT IN A TERTIARY TEACHING HOSPITAL IN KUALA LUMPUR MALAYSIA

There is lack of information about the estimates of out-of-pocket (OOP) spending among women diagnosed with breast cancer and effects on their family’s financial situation in Malaysia. This study is to determine estimates of out-of-pocket spending among women with breast cancer in HCTM and identify factors that significantly associated with high OOP spending. This cross-sectional study assessed out of pockets spending among breast cancer women in HCTM for breast cancer as out-patient. Sampling unit is a woman who has been diagnosed breast cancer and receiving treatment and follows up in HCTM. A 189 breast cancer women were identified for a 6 months period between July to December 2017. Only those patients who received at least 6 months treatment in HCTM were recruited. Out of pocket spending for treatments for adjuvant therapy and follow up, consultations with other practitioners, care taker fee, equipment and traditional/complementary treatment were collected by face-to-face interview using structured questionnaires. The dependent variable was OOP, analyzed using SSPS v23 for descriptive analysis and both univariate and multivariate analysis.173 out of 186 women were recruited and only 172 were considered for cost calculation (participation rate, 93.0 %) in this study. Total out of pocket spending for breast cancer treatment in 2017 was RM 1,037,446.23 with women’s total means out of pocket spending was RM6031.66 (SD =/- 495.58). The highest percentage of cost component contributed by cost of adjuvant therapy, RM334,056.00 (30.2%) followed by traditional/complementary medicine, RM268,278.00 (24.3%), other expenses/private hospital, RM224,887.00 (20.4%), transportation RM 79,772.52 (7.2%), chemotherapy RM67,300.00 (6.1%), dressing RM54,850.00 (5.0%), equipment/prosthesis RM50,550.00 (4.6%) and care taker cost RM24,661.43 (2.2%). Out of pockets costs from breast cancer in HCTM for 2017 are a burden for women and their family. Financial support provides assistance to the out-of-pocket spending in breast cancer treatment and is able to reduce the financial burden among patients and families.&#x0D;

Abstract 12286: Pregnancy Outcomes in Pulmonary Hypertension With Congenital Heart Disease: A Multicenter Experience From 2220 Cases

Background: Cardiovascular disease is a global burden for women’s health. Pregnancy with pulmonary hypertension associated with congenital heart disease (CHD-PH) is related to prohibitive maternal mortality. According to the latest AHA scientific statement, their pregnancies are contraindicated, regardless of their CHD diagnosis and PH severity. Considering the emerging population of CHD-PH reaching the child-bearing age, how to balance the maternal risk and patients’ reproductive rights remains understudied and under-recognised. Hypothesis: We assessed the hypothesis that if the mild CHD-PH patients have better pre-pregnancy cardiac situation, their pregnancies shouldn’t all be contraindicated. Methods: Patients were retrospectively included before March 2017 and 205 cases were prospectively collected after that time. Pregnancy with CHD-PH was subdivided into two subgroups based on the estimated SPAP measured by non-invasive echocardiography (30-50 mmHg as mild and &gt;50 mmHg as moderate-to-severe). Results: Of 2220 completed pregnancies with CHD from 7 tertiary institutions, 729 women had CHD-PH (398 mild CHD-PH). Of PH patients, the main CHD diagnosis is shunt lesion (70.92%) and only 26.89% were surgically repaired. The mortality and incidence of heart failure were 2.60% and 21.81%, respectively. No dead case happened in mild CHD-PH. Independent risk factors of maternal cardiac events included brain natriuretic peptide level, NYHA class, ejection fraction (EF), unrepaired CHD, strict supervision, late antenatal visit, without MDT and the severity of PH(except for mild CHD-PH). Furthermore, after propensity score matching analysis, the no-PH and mild PH groups have no significant difference in the maternal and offspring outcomes. Consistency Analysis indicated that mild CHD-PH had lower cardiac incidence than level IV of the modified WHO, except when they were associated with NYHA III-IV or EF&lt;50%. Conclusion: To conclude, pregnancy in women with CHD-PH continues to be associated with significant morbidity, although their mortality is relatively low. If the mild CHD-PH patients have better pre-pregnancy cardiac situation (EF&gt;50% and NYHA I-II), their pregnancies shouldn’t all be contraindicated.

Expenditure on complementary and alternative medicine and productivity losses in patients with primary dysmenorrhea: A survey of women in Korea

In women with primary dysmenorrhea (PD), the use of complementary and alternative medicine (CAM) and productivity losses at both workplaces and schools have not been comprehensively assessed. In this study, researchers evaluated the disease burden in women with PD in patients’ perspective in two categories: direct cost (the use of CAM and associated costs) and indirect cost (productivity losses). Women with PD aged 16–49 years were asked to fill an online survey in 2017. The survey consisted of 49 questions. CAM included traditional Korean medicines, over-the-counter products, dietary supplements, and traditional remedies. All costs were expressed in US dollars in this study. The survey data from 86 patients with PD were analyzed. The total mean annual cost per patient with PD was $4053, comprising direct costs ($1245) and indirect costs ($2807). PD causes considerable expenditure on CAM and impairs work productivity (especially in presenteeism).

Males and Tertiary Education in Jamaica by Herbert Gayle &amp; Peisha Bryan

It is vexing. This review may be dismissed as an “angry feminist rant” about the recently published ode to hegemonic masculinity, Males and Tertiary Education in Jamaica. The book continues a rather curious peregrination into the so-called “crisis” of Jamaican masculinity. The authors, Herbert Gayle (a social anthropologist) and Peisha Bryan (a social sector specialist) examine the “plight of males” as it relates to their level of “investment” in education. Building on existing scholarly research on the low participation of men in tertiary education specifically, they dub this problematic in the book’s preface a “clash between Jamaican males and education” (p. xiv). But, are we dealing with a clash between Jamaican males and education, or the conflict-tending relationship between males and their sacredly held cow—the institution of patriarchy? Did the authors miss an opportunity to see the problem for what it truly is: patriarchy chipping away at its construction of masculinity as always and already manifested through independence and the shouldering of the economic burdens of women and families?

Life Expectancy and Healthy Life Expectancy of Adults in Oman: Does Women’s Longer Life Expectancy than Men Mean Success or Burden for Women?

Objectives: The objective of this study was to examine the life expectancy (LE) and healthy life expectancy (HLE) of Omani adults with age and gender differentials, focusing on whether the higher LE of women than men is a gain or burden for women. Method: Data for the study come from multiple sources such as the 2010 population census, the 2008 World Health Survey in Oman, and secondary data published in the Statistical Yearbook of Oman. The life table and the modified life table proposed by Sullivan were used for estimating the LE and HLE of adult people of age 20 and above, respectively. Results: LE in Oman reached 76 years for both sexes in recent times. However, since 2010 LE has been stalled in the vicinity of 76 years in Oman. Women had higher LE than men (79 years versus 74 years). In terms of HLE, men outweighed women in Oman. At the age of 20, the gap between male-female LE was found to be 4.7 years in favor of females, whereas the gap between male-female HLE was found to be 5.8 years in favor of males. Females spent a relatively long time in poor health status than males (20.8 years versus 10.8 years) and the proportion of life spent in poor health was greater for females than males (35.0% vs. 19.3%). This revealed the paradox of less mortality but higher morbidity among women, supporting the “Failure of Success” hypothesis. Conclusion: Appropriate health policy and strategy need to be taken to reduce the gender gap in LE and HLE in Oman.

Gender, malice, obligation and the state: Separated mothers’ experiences of administrative burdens with Australia's child support program

AbstractThis article provides an empirical account of Herd and Moynihan's theory of administrative burdens as they apply to Australian child support recipients. Interviews with 41 separated mothers revealed how they were compelled to engage in the child support system and then required to expend significant time and effort undertaking administrative work on behalf of the state, often for little financial benefit. Unlike the examples provided by Herd and Moynihan, in this study, it was found that child support system burdens could be used by aggrieved fathers to inflict financial and psychological harms on their ex‐partners. The state accepted fathers’ imposition of costs on mothers as they shared a financial interest in maintaining women's burdens. As a result, this paper provides three conceptual advancements on the existing theory, by articulating: how administrative burdens can be created and applied by non‐government third parties, in this case individual ex‐family members; how the state can acquiesce to the imposition of harms if these align with their interests; and how the state distributes obligations and autonomy along social lines, such as, in this case, along the lines of class and gender.

Beyond the AJR: Screening Breast MRI Is Associated With Substantial Financial Burden in Women With Private Insurance Due to Lack of Coverage by the Affordable Care Act.

Beyond the AJR: Screening Breast MRI Is Associated With Substantial Financial Burden in Women With Private Insurance Due to Lack of Coverage by the Affordable Care Act.

Posttraumatic Stress Symptoms Among Polyvictimized Women in the Colombian Armed Conflict: The Mediating Role of Social Acknowledgment.

For decades, in a situation of armed conflict in Colombia, women have suffered polyvictimization and discrimination with severe consequences that last even during the post-war peace process. This study analyzes the impact on posttraumatic stress and recovery of war-related violence against women, discrimination, and social acknowledgment. A cross-sectional study was conducted in 2019–2020. Participants were 148 women with a mean age of 47.66years (range 18–83), contacted through the NGO Ruta Pacifica de las Mujeres who had experienced significant personal violence. Results show that levels of perceived discrimination and lack of social acknowledgment are mediators in the relationship between polyvictimization and posttraumatic stress symptoms. Recognition by significant others, disapproval by family and the larger social milieu affects different posttraumatic stress disorder (PTSD) dimensions and therefore how these women adapt to the effects of trauma. Findings provide strong evidence that the way society and family treats women after a traumatic event affects how the victim recovers from this event. Recognition as a victim and disapproval can coexist and be a burden for women if not adequately addressed. Results stress the importance of understanding and intervening in PTSD recovery through the analysis of social processes, and not only through and individual focus.

Strengthening Gender Justice in a Just Transition: A Research Agenda Based on a Systematic Map of Gender in Coal Transitions

For climate change mitigation, a rapid phase-out of fossil fuels such as coal is necessary. This has far-reaching gender-specific consequences. This paper presents a systematic map of the literature that examines the impact of historical coal phase-out processes on women and their role in these processes. The search process consisted of screening over 3100 abstracts and reading 247 full-text studies. The analysis of the 73 publications ultimately included in the systematic map shows that past coal phase-outs meant both opportunities (e.g., increased labour market participation) as well as burdens for women (e.g., double burden of job and household). It becomes clear that agency within coal transitions was also gendered. For example, it was difficult for women to gain access to union structures, which led them to organise themselves into grassroots movements. Our research shows that policies aiming for a just sustainability transition should always be explicitly gender-responsive. However, the impact of sustainability transitions on women’s lives remains largely under-researched. Therefore, we propose a research agenda based on our findings containing six key issues that need to be addressed scientifically.

Science, Medicine, and the Anesthesiologist

Science, Medicine, and the Anesthesiologist

Complex methods to assess complex problems: using Natural Language Processing to explore Health Related Qualitiy of Life in endometriosis

Background and Objectives: Endometriosis is a benign, although chronic painful condition that represents a major burden in women’s life, affecting all the domains of their health related quality of life (HRQL). The objective of this work is to conduct a Systematic Review of Systematic Reviews assessing HRQL of women with endometriosis, and to test a methodology based on Natural Language Processing (NLP) to assess factors associated with losses of HRQL linked with the most relevant clinical symptoms that women with endometriosis experience: pain and dyspareunia.Methods:We extracted free text from articles included in the Systematic Reviews with 'Pain' and 'dyspareunia' as keywords, and we used NLP to identify their occurrences, grammatical variants and meaningful context words. Our model used a word2vec skip-gram approach to predict context following our keywords.Results: Text data included 6,430 context words corresponding to 1,655 unique words in the 17 different systematic reviews that were included for review.Conclusions: The method we have tested using NLP has demonstrated to be valid to capture the complexity of issues that surround endometriosis and affects women´s HRQL. Among the diversity of symptoms that women with endometriosis experience, chronic pelvic pain has the highest impact on their HRQL. Pain affects their physical health, but also the social and functioning dimensions of women’s life. Painful intercourse has also a significant impact on the sexual life of women with endometriosis, and disturbing the emotional wellbeing of women. HRQL is also affected by the clinical complexities of endometriosis, the difficulties to reach to a diagnosis as well as to provide women with effective medical care. Different measurements, instruments and approaches have been proposed to measure HRQL in endometriosis, but it seems necessary the use of common instruments to facilitate comparisons across studies.

Pandangan Buruh Gendong di Yogyakarta terhadap Peran Ganda Perempuan

Unskilled female labourer (buruh gendong) is a manifestation of Javanese female workers disrupting the inferiority boundary. They lift heavy goods in the market to help in providing livelihood for their family. This research aimed to analyze how the unskilled female labourers defend their existence as Javanese women who are able to fullfil double burden as the way to provide financial help to their family. This research also analyzed how they view of the women's double roles. This research was a field study using qualitative data collected from detailed interviews, observations, and documentations. Analyzes were done using philosophical approaches, i.e. induction, deduction, comparation, description, and reflection. The results showed that Javanese women were not only refined in character and submissive, but also tough, strong, and decisive in making choice. They viewed the women's double burden as part of their lives which should be ventured with willingess and sincerity. They tackled the conflict arising from the double burden by efficiency in time management and load-sharing in domestic chores. Gender deconstruction was shown as women who also can contribute economically by capitalizing their abilities. Women and men are all in the same level and have the same chances in working side by side with other men. From this research, a new knowledge has been revealed that women's double burden was not always restricting women to contribute to their family. It was depicted by this case in female unskilled labourers in helping their family willingly.

Collective Rural Women Access, Use, and Control Over Communal Land in Mexico: A Post-capitalist Feminist Political Ecology Approach

Rural women's access to land is fundamental for their individual and household well-being, equity, and empowerment. In Mexico, the agrarian reform of 1992 and customary gendered rights shaped land use, access, and control. Rural women's access to collective land is relevant since social property—ejidoandagrarian communities—represents 52% of the national territory. As an expression of the collective organization, commons were also performed to use and control communal land and biophysical resources collectively. This paper examines the collective peasant women's bargaining process to access, use, and control communal land. The post-capitalist feminist political ecology approach allowed us to distinguish and analyze gendered strategies employed by a cooperative led by women at different levels—household, community, and government—to access and use communal land and biophysical resources by the process of commons—commoning. Rural women's collective efforts are located in Hidalgo, central Mexico. Firstly, the Agrarian Reform modifications related to gender equality issues are investigated, followed by examining rural women's socioeconomic conditions. The case study permitted us to identify and analyze critical factors that enhanced long-term agreements to control communal land beyond the Agrarian Law scope by the commoning examination. The collective rural women's strategies to use communal land improved well-being based on gendered peasant knowledge, organization, and stakeholder support. Nevertheless, the strategies increased women's burden and reinforced the existing gendered norms such as female altruism. Furthermore, the need to discuss the bargaining process over communal land concerning a diversity of commons is argued: knowledge, social, and biophysical, in which gender and care are critical variables.

Women’s Vulnerability and State Responsibility in China’s Family-planning Policy

Reproductive vulnerability is a pervasive social issue that requires efforts from multiple government departments and social groups to solve. However, China has traditionally focused on the reproduction function of the family and marginalized women's reproductive autonomy and related rights. Based on the overview of the existing literature, we have a better understanding of the fertility experience of Chinese women when facing the fertility policy, focusing on their continued harm, neglect and vulnerability during the process of changes in the fertility policy. Through research, we can not only analyze the work-family dilemma that women have been in for a long time but also an in-depth analysis of low fertility intentions of Chinese women under the pronatalism policy. The vulnerability of Chinese women to childbearing is caused by the following factors: women’s socio-economic status, the concept of marriage and childbirth in society, the control of the national fertility policy, and the availability of fertility support system arrangements. We suggest the amendment of the family-planning policy should be accompanied by a series of arrangements for family support, such as establishing a reproduction-friendly environment, promoting social gender consciousness in all aspects, reducing women's household burden, and actively eliminating gender discrimination in the workplace. Then, women's reproductive vulnerability can be mitigated, and the gender structure can be balanced.

Factors associated with gynaecological morbidities and treatment-seeking behaviour among adolescent girls residing in Bihar and Uttar Pradesh, India.

Gynaecological morbidities are more common than reproductive and contraceptive morbidities and constitute a substantial proportion of disease burden in women. This study aimed to examine the prevalence and factors associated with gynaecological morbidities and the treatment-seeking behaviour among adolescent girls residing in Bihar and Uttar Pradesh, India. The study utilized data from the Understanding the Lives of Adolescents and Young Adults (UDAYA) survey with a sample size of 14,625 adolescents girls aged 10-19 years. We defined gynaecological morbidity in dichotomous form, created from five questions on different morbidities. Further, the treatment-seeking behaviour was assessed for reported gynaecological morbidities three months prior to the survey. Univariate and bivariate analysis was used to perform analysis to carve out the preliminary results. Additionally, the study employed the heckprobit selection model, a two-equation model, to identify the determinants of outcome variables. Overall, about one-fourth (23.6%) of the adolescent girls reported suffering from gynaecological morbidities, and only one-third of them went for treatment. Non-Scheduled Caste/Scheduled Tribe (Non-SC/ST) adolescents were significantly less likely to have gynaecological morbidities (β: -0.12; CI: -0.18, -0.06) compared to SC/ST counterparts; however, they were more likely to go for the treatment (β: 0.09; CI: 0.00, 0.19). The adolescents who had 8-9 (β: 0.17; CI: 0.05, 0.29) or ten and above years of education (β: 0.21; CI: 0.09, 0.34) had a higher likelihood of going for the treatment than adolescents with no education. Moreover, adolescents who belonged to rural areas were less likely to go for the treatment of gynaecological morbidities (β: -0.09; CI: -0.17, -0.01) than urban counterparts. Multi-pronged interventions are the need of the hour to raise awareness about the healthcare-seeking behaviour for gynaecological morbidities, especially in rural areas. Adolescent girls shall be prioritized as they may lack the knowledge for gynaecological morbidities, and such morbidities may go unnoticed for years. Mobile clinics may be used to disseminate appropriate knowledge among adolescents and screen asymptomatic adolescents for any possible gynaecological morbidity.

Sleep Disruption and Depression, Stress and Anxiety Levels in Women With Polycystic Ovary Syndrome (PCOS) During the Lockdown Measures for COVID-19 in the UK.

Background: Lockdown measures have been enforced globally in response to the COVID-19 pandemic. Given the comorbidity burden in women with polycystic ovary syndrome (PCOS), these lockdown measures may have a particularly negative impact on sleep health, quality of life (QoL), and depression/stress levels in this population. The aim of this study was to explore whether such potential problems were present in women with PCOS during the COVID-19 lockdown in the UK.Methods: UK women with PCOS were recruited through social media into a cross-sectional study during the COVID-19 lockdown. The study survey was delivered online, and included demographic and COVID-19 relevant questions, as well as validated questionnaires/scales, namely the Insomnia Severity Index (ISI), Depression Anxiety and Stress Scale (DASS-21), and PCOSQOL questionnaire.Results: Three hundred and thirty-three women with PCOS [median age: 30.0 (9.0) years] were recruited. Participants were dichotomized based on responses regarding the impact of COVID-19 restrictions on their sleep [negative (N = 242) vs. no/positive (N = 91) impact]. No differences were noted between groups regarding age, time since PCOS diagnosis, body mass index, or number of comorbidities. Based on the ISI, 44.2% of participants reporting a negative impact on sleep exhibited at least moderately severe clinical insomnia. Compared to those who reported no/positive effect on sleep, the participants reporting a negative impact on sleep also reported poorer QoL, based on the total PCOSQOL score, with a greater impact of PCOS and poorer mood in the corresponding PCOSQOL domains. Based on the DASS-21, the latter also had statistically higher depression and stress levels compared to the former. Finally, for this cohort significant inverse correlations were noted between the ISI and PCOSQOL scores (total and domain scores), whilst the DASS-21 and ISI scores were positively correlated (all p-values <0.001).Conclusion: The majority of recruited UK women with PCOS reported that the COVID-19 lockdown had a negative impact on their sleep, which was also associated with impaired QoL and higher depression/stress levels. Whilst further research is required, women with PCOS should be considered a vulnerable population that may experience an adverse impact on sleep, QoL and mental health well-being due to lockdown measures during the COVID-19 pandemic.

Ectopic Fat Depots and Cardiometabolic Burden: A Possible Dangerous Liaison in Women Planning Assisted Reproduction.

Objective: We evaluated cardiometabolic burden in women planning assisted reproduction in order to identify subgroups at higher risk of pregnancy complications and cardiovascular disease. Materials and methods: In this cross-sectional study we investigated 60 infertile women with BMI≥25 kg/m2 referred to the Center for Assisted Reproduction. All women underwent metabolic, anthropometric parameters and ultrasound evaluation of ectopic fat depots. Results: All women had waist ≥80 cm. We found that 93.3% of women had pathological subcutaneous, 58.3% visceral and 80% para-perirenal fat; all women had fatty liver. Visceral fat and severity of steatosis were significantly related to the presence of metabolic syndrome (OR =5.7; p=0.03).A significant negative correlation between low HDL-c and para-perirenal fat (p<0.0001), a significant positive correlation with fasting plasma glucose and para-perirenal fat (p=0.001) were found. We observed a significant positive correlation between visceral fat and hs-CRP (p=0.002), HOMA-IR (p=0.04) and triglycerides (p=0.002), a significant negative correlation with HDL-c (p=0.05). Conclusion: This study by highlighting a clinically “dangerous liaison” between ectopic fat depots and metabolic/inflammatory markers, might permit to identify women with a worse metabolic phenotype and encourage lifestyle changes for improving their general and reproductive health together.

MicroRNA Profiles of Maternal and Neonatal Endothelial Progenitor Cells in Preeclampsia.

Preeclampsia is associated with an increased cardiovascular morbidity of mother and offspring, thus contributing to a substantial burden in women and children’s health. It has been proven that endothelial progenitor cell (EPC) numbers and functional characteristics are impaired in cardiovascular disease and preeclampsia, although causative factors for the latter have remained elusive. MicroRNA (miRNA) modifications are a potential mechanism through which exposure to an altered environment translates into the development of chronic disease. In this study, we examined whether development of preeclampsia corresponds to alterations of miRNAs in maternal- and cord-blood-derived EPC. To test this end, we analyzed maternal and neonatal miRNAs via RNA sequencing from endothelial cells of preeclamptic and healthy controls in different cell culture passages. We were able to demonstrate differentially represented miRNAs in all groups. Hsa-miR-1270 showed significantly different levels in cord blood EPC from preeclampsia versus control and was negatively correlated with mRNA levels of its predicted targets ANGPTL7 and TFRC. Transfection with an hsa-miR-1270 inhibitor decreased the tube formation capacity and chemotactic motility but did not change proliferation in vitro. Target predictions and gene set enrichment analyses identified alternative splicing as a significantly enriched pathway for hsa-miR-1270. The top miRNAs in three other groups were predicted to target transcriptional and developmental pathways. Here, we showed for the first time significantly different levels of miRNAs and differently represented mRNA levels of predicted target genes in EPC derived from preeclampsia. Understanding the effects of preeclampsia on the epigenetic mechanisms of EPC will be crucial and may provide initial insights for further evaluation of the benefits of therapies targeting this cell population.

Coronary artery disease burden in women poorly explained by traditional risk factors: Sex disaggregated analyses from the BioHEART-CT study

Background and aimsTargeting the modifiable risk factors for coronary artery disease (CAD) has substantial impact at the community level. However, it is not uncommon for individuals to present with atherosclerosis related events without identified risk factors. We examined sex differences in the association of risk factors and atherosclerotic burden assessed by CT coronary angiography (CTCA). MethodsWe analysed clinical and imaging data in 1002 individuals in the BioHEART cohort. Results45% were female, 35% had no CAD identified. Median coronary calcium score was 9.9 Agatston units (IQR: 0–146), and median Gensini Score was 3.5 (IQR: 0–11.5). 26% had a calcified plaque predominant phenotype, and 18% had a non-calcified plaque predominant phenotype. There were no sex differences in the prevalence of risk factors. However, there were notable sex differences in the adjusted associations of risk factors with CAD. Age and hypercholesterolaemia (OR 1.56, 95% CI 1.03–2.36, p = 0.04 in males, and OR 1.75, 95% CI 1.09–2.78, p = 0.02 in females) were associated with the presence of CAD in both genders (p < 0.05). Diabetes and smoking were associated with presence of CAD, calcified CAD, and non-calcified plaque in males (p < 0.05) but not females. In women, none of the standard modifiable risk factors were associated with the amount of plaque present when adjusted for age, BMI, and family history of premature CAD. ConclusionsCTCA provides an important opportunity for improving the stratification of cohorts to assess underlying biology and risk. We demonstrate sex-specific differences in associations of risk factors with atherosclerosis burden.