Contraceptive Use Research Articles

Estrogen administration enhances the adverse effects of cigarette smoking on the heart in cycling female mice

Smoking, particularly chronic smoking (CS), is a threat to global health, contributing to increased mortality and morbidity associated with cardiovascular disease (CVD). CS induces oxidative stress and endothelial dysfunction, which has a profound impact on cardiac structure and function. While the protective effects of estrogen, particularly 17β-estradiol (E2), on cardiovascular health are well-documented in premenopausal women, the interaction between estrogen and CS remains poorly understood. The aim of this study is to investigate the impact of chronic cigarette smoking on cardiac health in relation to ethinylestradiol (EE) oral contraceptive (OC) usage in premenopausal females. Female mice were exposed to chronic cigarette smoke and co-administered EE. Cardiac structural and functional parameters were assessed alongside inflammatory markers, oxidative stress indicators, and histological changes. Results revealed that the combination of EE and CS led to adverse cardiac remodeling characterized by increased left ventricular end-diastolic volume and elevated left ventricular mass. In addition, an inflammatory state was evident, marked by increased expression of IL-4, IL-1β, IL-13, IL-10, and PARP-1, as well as increased interstitial collagen deposition. These findings suggest a progression towards adverse cardiac remodeling resembling dilated cardiomyopathy. Furthermore, our observations highlight the complexity of the inflammatory response triggered by smoking, potentially exacerbated by estrogen supplementation. The main finding of this study is that the combination of CS and EE enhanced adverse cardiac remodeling, which was shown structurally, histologically, and biochemically.

Association of metalloestrogens exposure with depression in women across reproductive lifespan

BackgroundExposure to metal could impact women’s depression risk. However, the connection and mechanisms between metalloestrogens exposure and depression are still not fully understood. We aim to explore the associations between metalloestrogens and the risk of depression in women across reproductive lifespan.MethodsUsing data from NHANES 2011-2018, we employed logistic regression and baknernel machine regression (BKMR) to study links between metalloestrogen exposure and depression in US women. We analyzed how contraceptive use affects this relationship.ResultsThe study involved 3,374 adult women, with 345 of them experiencing depression. Our research revealed that certain metalloestrogens like Ba, Ca, Pb, Sb, and Sn were linked to higher depression risk in women, while Hg was associated with lower depression risk in older women. For women aged 18-44, a blend of metalloestrogens showed a significant positive correlation with depression risk, and the likelihood of depression in later years notably rose when the metal mixture concentration reached or exceeded the 60th percentile. Oral contraceptives would have an effect on the impact of metalloestrogen mixture exposure on depression in women during the reproductive stage.ConclusionsOur study indicates a significant link between metalloestrogen exposure and a higher risk of depression in adult women in the United States. This finding can aid in identifying the connection and enhancing women’s mental well-being.

Contraceptive Coercion in Pre-Abortion Counseling: A Conversation Analysis

We explored how contraception is addressed in pre-abortion counseling, with a focus on the conversational strategies used by healthcare providers. We recorded 28 pre-abortion counseling sessions at three South African public hospitals and analyzed them using conversation analysis. In discussions about past contraceptive use, patients were often positioned as irresponsible and required to account for assumed inadequate contraceptive practices. This framing laid the groundwork for the coercive provision of post-abortion contraception, particularly long-acting reversible contraceptives (LARCs). Short-term users and younger patients were singled out, receiving repeated warnings about daily adherence or parental enforcement. Providers’ efforts to prevent the perceived “mistake” of abortion led to the use of coercive conversational tactics.

Contraceptive Care Visit Objectives and Outcomes: Evidence From Burkina Faso, Pakistan, and Tanzania.

Globally, care experiences of the growing population of contraceptive users are not well-understood. We leverage a large client dataset (n = 71,602) from three countries (Burkina Faso, Pakistan, and Tanzania) to characterize contraceptive services sought (visit objective and method preference), assess whether these visit objectives were met and for whom, and explore if visit objective fulfillment was associated with care quality. Most people in all three countries said they were seeking to continue their current method or adopt a method for the first time. Clients seeking to change their method were least likely to have their objective met: 63.7 percent of clients in Burkina Faso, 73.3 percent in Pakistan, and 61.1 percent in Tanzania who wanted to switch actually achieved this during the visit. In Burkina Faso, people with lower socioeconomic standing, lower educational attainment, and lower parity less commonly had their switching objective, fulfilled. Method preference fulfillment was generally high, although approximately 15 percent of Tanzanian clients were given implants despite wanting another method. Among those seeking to adopt or restart a method in Pakistan and Tanzania, having this visit objective fulfilled, was correlated with better perceived treatment and higher person-centeredness of care.

Intentions, Barriers and Attitudes towards Improving Postpartum Long-acting Reversible Contraceptive Usage among Pregnant Women in Urban Ghana

Aims: Long-acting reversible contraceptives (LARCs) are the most effective reversible methods of contraception with a failure rate of less than 1%. Despite their safety and effectiveness, LARCs are underutilized. This study investigated postpartum LARC use intentions and suggestions to improve postpartum LARC usage among pregnant women seeking antenatal care services in a Ghanaian Urban municipality. Study Design: A facility-based cross-sectional design. Place and Duration of Study: The study was conducted at the antenatal care unit of the Ashanti Regional Hospital in the Kumasi Metropolis of Ghana among 298 pregnant women from August to September, 2018. Methodology: A systematic sampling technique was conducted. A 55-item questionnaire containing socio-demographic, reproductive, intention and attitude, barriers and contraceptive knowledge characteristics was used to gather responses. A multivariable logistic regression analysis was done using (IBM-SPSS version 22.0) to determine predictors of the women’s intention and attitude towards postpartum LARC use. Results: Out of 298 pregnant women included for analysis, 33.9% had postpartum intentions to use LARCs. “I like implant for myself” (AOR=9.00, 95% CI: 4.75-17.05), “I like IUD for myself” (AOR=7.38, 95% CI: 2.93-18.58) and previous use of LARC (AOR=7.03, 95% CI: 2.41-20.52) were predictors of postpartum intentions to use LARC. Intensive education and “worried about the side effects” were the main recommendations and barriers to postpartum LARC usage respectively. Conclusion: Postpartum intention to use LARC was minimal. I like implant for myself”, “I like IUD for myself” and previous use of LARC were associated with intentions to use LARC postpartum. Intensive education and “worried about the side effects” were the main recommendations and barriers to postpartum LARC usage respectively. Attitudinal change towards LARC use through intensive education, easy accessibility of LARC and religious body involvement is key to increase postpartum LARC usage in Ghana and clearing its myths and misconceptions could advance modern contraceptive usage.

Young men's everyday life experiences with contraception and unintended pregnancy in Papua New Guinea.

Unintended adolescent pregnancy is a public health priority in Papua New Guinea (PNG), where national policies specify need for easier access to reliable modern contraceptives. To reduce young people's experiences of unintended pregnancy in PNG, improved understandings of use of modern and other forms of contraception within young people's relationships is required to support the development of new sexual and reproductive health (SRH) programs and policies. The aim of this paper is to understand young men's use of modern and other contraceptives. This qualitative study involved semi-structured interviews with 35 sexually active young men aged 15-24 years, who were sampled purposively from the general population within community-based settings. Data were analysed using inductive thematic analysis techniques. Our analysis of young men's everyday experiences of using condoms and other contraceptives highlights clear drivers of unintended adolescent pregnancies. Across three settings, these included non-use of any modern method at first sex or during early sexual experiences; inconsistent use of condoms, often only after first pregnancy experiences; difficulties accessing condoms from health service providers, pharmacies and stores; a lack of understanding of other modern contraceptive strategies; inconsistent use of the withdrawal method; and inconsistent and incorrect use of calendar approaches due to misunderstandings about women's fertile period. Ten young men had never used any form of contraception. These occurred largely because young men's sexual agency is constrained within sexual and peer relationships, and community, school and health service settings, in ways that inhibit pregnancy prevention. It is important to engage meaningfully with young men to build sexual and reproductive health policies and programs that pay honest, respectful attention to young people's everyday sexual and social lives. Young men's everyday stories provide a unique lens through which we can identify mechanisms of change required to address the health and social inequities associated with unintended pregnancy among young men and young women in PNG and beyond.

Analysis of risk factor microflora colonization on pregnancy vagina in makassar

Introduction: Worldwide infection rates based on estimated 20-30 % colonization at 35 weeks gestation. During normal pregnancy colonization transient, intermittent, or chronic infection and the spectrum varies from asymptomatic colonization to the sepsis. Intrapartum transmission of bacteria from mother to neonatal, will cause the infection develops into neonatal sepsis during childbirth. This study aimed to determine the proportion of the colonization of gram positive and negative bacteria in pregnant women over 31 weeks of age. Research Methodology: This research uses vaginal swab samples from pregnant women and blood samples from babies who are born, then these samples will be examined in the Unhas Hospital laboratory. Vaginal swab samples via transport medium will be placed in BHIB medium then incubated at 270 C for 24 hours. Result: Prevalence of gram-positive bacterium identified Streptococcus species (0.9%), S. Aureus (11.8%) and S. Epidermidis (78.4%). For gram-negative bacteria had identified; Enterobacter Sp (32.3%), Providencia Sp (12.7%), Proteus Sp (8.8%), Acinetobacter sp (5.9%) and E. Coli (6.9%). Candida Sp obtained on SDA culture and gram staining followed by a number of 54 samples (55.1%). The symptom was to be is Discharge Vagina over 30% cases. Among 76.6% with habitually antiseptic usual. Based on data statistical analysis can be concluded that the age have a significance level 0:01 (ρ < 0.05) .and contraceptive used have a significance level of 0.038 (ρ < 0.05), had a relationship with a potential fetomaternal infection to infant. Conclusion: that maternal age and history of contraceptive use are significantly associated with bacterial colonization in pregnant women. These findings underscore the need to consider demographic and behavioral factors when assessing and managing vaginal health during pregnancy. Effective educational interventions focusing on proper hygiene practices and the risks associated with antiseptic soap use, coupled with targeted monitoring of older pregnant women and those with a history of contraceptive use, are recommended to reduce the risks associated with vaginal microbial colonization

Association of the number of pregnancies and births with cognitive performance in older postmenopausal women: a cross-sectional study.

Cognitive impairment in the elderly is a serious public health problem. However, the effect of the number of pregnancies and births in the early years of life on cognitive function in postmenopausal women remains controversial. This study aims to investigate the relationship between these two factors. We used the National Health and Nutrition Examination Survey 2011-2014 data on women aged ≥60 years. This study included sociodemographic data, history of estrogen use, and contraceptive use as confounding variables. The combined scores of the Consortium to Establish a Registry for Alzheimer's Disease Word Learning (CERAD-WL), delayed word recall (CERAD-DR), the Animal Fluency test (AF), and the Digit Symbol Substitution Test (DSST) were used to assess the cognitive performance of participants. Hierarchical multiple regression analysis explored the relationship between the number of pregnancies and births and cognitive function. The study screened 1,259 postmenopausal women and found that 24.3% had low cognitive performance. The study found a significant increase in low cognitive performance among older adults, Mexican Americans, those with a lower education level and poverty-income ratio, those who were widowed, and those with diabetes and hypertension (P < 0.001). In the multiple regression analysis, the number of pregnancies remained a significant determinant of cognitive performance (B = -0.188, P < 0.001). The number of pregnancies was associated with cognitive performance in a population of postmenopausal women in the United States. A lower number of pregnancies is associated with better cognitive performance.

Increase in Lipid Levels With Oral Contraceptive Use

Increase in Lipid Levels With Oral Contraceptive Use

Evolution of contraceptive methods usage among women aged 15-49: comparative analysis between regions of Northern Argentina, 2011-2012 and 2019-2020

Introducción: El acceso a métodos anticonceptivos modernos constituye un determinante clave en la salud sexual y reproductiva, particularmente en regiones con desigualdades socioeconómicas. En Argentina, diversas políticas públicas han buscado garantizar este acceso, especialmente en las regiones del Norte del país. Objetivo: Analizar las variaciones en el uso de métodos anticonceptivos entre mujeres de 15-49 años en Argentina, con énfasis en las regiones NOA y NEA durante 2011-2012 y 2019-2020, examinando su distribución según estratos socioeconómicos. Materiales y métodos: Estudio cuantitativo, transversal descriptivo. Se analizaron datos de las Encuestas Nacionales de Indicadores Múltiples por Conglomerados (MICS) 2011-2012 (n=20844) y 2019-2020 (n=11763). Se realizó análisis comparativo de prevalencias con intervalos de confianza del 95%. Resultados: Se observó un incremento significativo en el uso de métodos anticonceptivos en Argentina (57,69% a 61,33%) y NOA (43,78% a 57,46%) entre 2011-2012 y 2019-2020. Los implantes subdérmicos mostraron el mayor aumento en adolescentes del NOA (0% a 35,24%) y NEA (0% a 32,59%). En los quintiles más pobres, el uso de anticonceptivos aumentó significativamente, especialmente en el NEA (31,04% a 52,30%). Conclusión: El incremento en el uso de métodos anticonceptivos modernos, particularmente en poblaciones vulnerables del Norte argentino, sugiere un impacto positivo de las políticas públicas implementadas, especialmente del Plan ENIA, en la mejora del acceso a la anticoncepción.

From Menarche to Menopause: Exploring reproductive health awareness among pakistani women

Introduction: Women's reproductive health knowledge is crucial for their well-being, particularly in LMICs like Pakistan, where cultural barriers often prevent open discussions. This study explores the reproductive health awareness among Pakistani women, focusing on menstruation, contraception, STD prevention, pregnancy, and menopause. Methods: Data were collected from 125 Pakistani women aged 15–49, covering demographics, menstrual knowledge, STD awareness, contraception, AIDS awareness, menopause, and general reproductive health knowledge. Results: Participants, aged 17–46, were mostly married, urban, educated, and from middle-income backgrounds. Only 45.6% knew about menarche before it occurred, and 54% received counseling at its onset. Medical help was preferred for fertility issues, but traditional methods were used for pregnancy termination. While 65.6% were aware of STDs, awareness was higher in urban areas. Only 37% were aware of menopause-related health risks. Contraceptive use was low, with educated women showing better timing knowledge. About 59% knew about AIDS, with media as a primary source. The term “reproductive health” was unfamiliar to 78% of participants. Cultural norms, shyness, and limited sources were reported as major barriers. Discussion: Significant gaps in reproductive health knowledge highlight urban-rural disparities and the influence of cultural barriers. Women sought medical advice for fertility but relied on traditional practices for terminations. Effective educational initiatives could address misconceptions, especially around STDs, contraception, and menopause. Conclusion: Reproductive health education in Pakistan is essential for empowering women. Enhanced programs, culturally sensitive approaches, and accessible platforms are needed to address knowledge gaps, enabling informed decisions and better health outcomes.

Risk beyond the pap: A review of key epidemiological studies on cervical cancer risk factors and populations at highest risk

Cervical cancer remains a significant public health concern, with notable mortality rates worldwide despite advancements in screening technologies such as the Pap smear. While screening has substantially reduced the disease's incidence, understanding risk factors that extend beyond regular screening practices is essential for comprehensive cervical cancer prevention. This review synthesizes key epidemiological studies focused on the various biological, lifestyle, and demographic factors influencing cervical cancer risk, thereby identifying the populations at the highest risk. The methodology encompasses rigorous selection criteria, including studies from renowned databases such as PubMed and Scopus, and evaluates the strengths and limitations of common epidemiological study designs like case-control and cohort studies. The review categorizes risk factors into four primary areas: HPV infection, smoking, sexual behavior and contraceptive use, and genetic predisposition, each substantiated by evidence from recent epidemiological research. Additionally, it assesses populations facing elevated risk, such as those influenced by socioeconomic, geographic, and ethnic disparities, as well as immunocompromised and age-defined groups, to outline how these variables affect cervical cancer susceptibility. The findings underscore persistent disparities in cervical cancer incidence, especially among underserved and minority populations, where access to healthcare and awareness of risk factors remain limited. This review emphasizes the importance of addressing these disparities through targeted public health policies and enhanced screening protocols. Finally, the paper recommends future research directions, highlighting the need for longitudinal and multi-population studies to better understand the complex interplay of risk factors. Insights from this review can inform public health initiatives and shape preventative measures that extend beyond screening to reduce cervical cancer risk across vulnerable populations.

Ischemic Stroke in Women: Understanding Sex-Specific Risk Factors, Treatment Considerations, and Outcomes

Ischemic stroke is a major cause of mortality and disability and has become a significant public health concern among women. Overall, women have more ischemic stroke events than men, in part due to their longer life span, and also suffer from more severe stroke-related disabilities compared to men. Women are also more likely than men to present with atypical non-focal neurological symptoms, potentially leading to delayed diagnosis and treatment. Female-specific risk factors, especially those related to pregnancy, are often under-recognized. A woman’s risk for ischemic stroke evolves throughout her lifespan, influenced by various factors including the age of menarche, pregnancy and its complications (such as parity, pre-eclampsia/eclampsia, and preterm delivery), postpartum challenges, oral contraceptive use, and menopause. Additionally, vascular risk factors like hypertension, diabetes, and atrial fibrillation are more prevalent among older women. Despite comparable treatment efficacies, women generally experience poorer outcomes after stroke. They also face higher rates of post-stroke depression, further complicating recovery. Although significant strides have been made in reducing the incidence of ischemic stroke, our understanding of the unique risks, underlying causes, and long-term consequences for women remains limited. While sex hormones may explain some differences, a lack of awareness regarding sex-related disparities can result in suboptimal care. This review aims to illuminate the unique risks and burdens of ischemic stroke faced by women, advocating for a more nuanced understanding to enhance prevention and treatment strategies.

HUBUNGAN PEMAKAIAN KONTRASEPSI SUNTIK 3 BULAN DENGAN KENAIKAN BERAT BADAN AKSEPTOR KB DI BPM ENDAH SETIATI, SST DESA TONGAS WETAN

Injection contraception is a contraceptive method that is widely used in Indonesia. The proportion of injection contraception use was 62.77%. Most acceptors of 3-month injection KB experience an increase in body weight. This is because progesterone stimulates the appetite control center in the hypothalamus, thereby influencing eating behavior. One study showed that many injecting contraceptive users stopped due to side effects such as menstrual disturbances, weight gain, headaches, and stomach discomfort. The purpose of this study was to determine the correlation between the use of 3-month s injection contraception and the increase in the weight of family planning acceptors at Endah Setiati, SST Independent Midwife Practice Tongas Wetan village. This study used a retrospective, using secondary data. With correlation research design with a cross sectional study approach. The population in this study was the number of acceptors of 3-month s injectable family planning at Endah Setiati, SST Independent Midwife Practice. From January to December, 90 people using the total sampling technique and statistical tests used the Chi square test. The results of this study revealed that of the 90 acceptors of the 3-month s injection, most of the acceptors used it for a long time and experienced weight gain, namely 40 people (44.4%). The results of the Chi Square statistical test obtained p-value = 0.126. However, it can be concluded that there is no correlation between the use of 3-month s injectable birth control and weight gain in Endah Setiati, SST Independent Midwife Practice in Tongas Wetan village. The suggestion of this research, will be able to have an impact on midwifery services in the community, especially in providing explanations to patients about the side effects of using 3-month injectable birth control.

Steroid hormones, vitamin D and melatonin in rapidly rotating shift female hospital workers

Disruption of circadian rhythm caused by night-shift work has been associated with several disorders, including cancer. Health care personnel often works at night to insure the continuity of care. Aim of this study was to evaluate the influence of night-shift work on serum and saliva levels of steroid hormones, vitamin D, and melatonin in hospital female workers. Ninety-seven female hospital workers were recruited: 46 nurses performing clockwise rapid rotating shift schedule on a 5-day cycle, including one night, and 51 day workers. Thirteen steroid hormones and vitamin D were assessed in morning serum samples; cortisol, cortisone and melatonin were assessed in morning and evening saliva samples. We fitted multiple regression models adjusted for age, BMI, sampling month, ovarian cycle phase, and use of oral contraceptives (OC). Rapidly rotating clockwise shift work was associated with increased levels of serum corticosterone, 11-deoxycortisol, dehydroepiandrosterone (DHEA), and androstenedione, and decreased levels of estradiol and vitamin D. OC modulated the association between serum cortisol, corticosterone and 11-deoxycortisol and work shift. The normal circadian phase of salivary melatonin, cortisol and cortisone was not affected by shift work. In female hospital nurses, the clockwise rapid rotating shift schedule increases the level of some hormones, likely associated with stress. No increase of estradiol, nor modification of salivary hormones was observed.

Sociodemographic and maternal health-related factors associated with mortality among children under three in Bangladesh: an analysis of data from Bangladesh Demographic and Health Survey 2017-18

BackgroundChild mortality remains remarkably high in many low- and middle-income countries (LMICs), including Bangladesh. This study aimed to identify the sociodemographic and maternal health-related factors associated with under three (U3) child mortality in Bangladesh.MethodsWe extracted data of 5299 U3 children from Bangladesh Demographic and Health Survey (BDHS) 2017-18. We used descriptive statistics to summarize the data. The chi-square (χ2) test, simple and multiple Firth logistic regression were performed to test the associations between priori-defined factors and U3 mortality.ResultsIn Bangladesh, the U3 child mortality rate was 35 deaths per 1,000 live births, with a median age at death of less than one month. The adjusted model revealed that the odds of U3 child mortality were higher among children born to mothers aged between 30 and 39 years [adjusted odds ratio (AOR) = 2.01, 95% confidence interval (CI): 1.30–3.11; p-value (p) = 0.002], those who did not use any contraceptive [AOR = 2.57, 95% CI: 1.90–3.47; p < 0.001], with first pregnancy [AOR = 14.91, CI: 4.60–48.30; p < 0.001], had birth interval less than 24 months [AOR = 2.10, CI: 1.23–3.60; p = 0.007], children born to mothers who delivered vaginally [AOR = 3.18, 95% CI: 2.07–4.87; p < 0.001]. However, lower odds of mortality were observed among children of mothers with higher education levels [AOR = 0.50, 95% CI: 0.28–0.90; p = 0.021] and families with more than five members [AOR = 0.61, 95% CI: 0.45–0.83; p < 0.01]. In addition, religion, birth attendant during delivery, and the child’s birth order were significantly associated with U3 child mortality, whereas mortality did not vary significantly across the divisions.ConclusionsHigher odds of U3 child mortality were associated with mothers who did not use contraceptives, delivered vaginally, and were aged 30–39 years in Bangladesh. Conversely, higher maternal education and larger family size were associated with lower odds of U3 child mortality. The findings suggest that community-based family planning awareness programs focused on contraceptive use, as it prevents childbirth and is also a marker of health service usage.

Knowledge, attitudes and strategies on contraceptive utilization among adolescents: views from beneficiaries and parents in City of Kigali

IntroductionPregnancy among adolescents is a significant public health concern worldwide, particularly in developing countries, including Rwanda. Although contraception could be an effective tool to prevent unintended pregnancy, its utilization among adolescents is often low.AimThis study explored knowledge, attitudes and strategies on contraceptive utilization among adolescents.MethodsMixed method research (MMR) using a cross-sectional design, Sequential explanatory design was used to explore the views from 394 participants in Gitega Sector. This approach was chosen to first quantify the prevalence and patterns of contraceptive use through the questionnaire-based survey, and then to deepen understanding by exploring attitudes, beliefs, and experiences of adolescents and parents through in-depth interviews and focus group discussions. This sequential approach allowed quantitative findings to guide qualitative inquiry, providing richer context to the statistical data. For the quantitative phase, convenience sampling facilitated by the in charge of Health at the sector level and community health workers at the cell level ensured effective access to the study’s target demographic. Qualitative participants were purposively chosen to gain detailed insights from those identified with unique or significant experiences in the initial survey. Data were analyzed using SPSS version 25.0 for quantitative analysis and ATLAS.ti 23 for qualitative analysis.ResultsThe study found that both adolescents and parents (59.1%) have a low level of knowledge about contraceptive utilization, with adolescents (75.5%) showing significantly lower knowledge than parents (46.4%). A majority of the participants, 195 (56.7%), had a positive attitude towards contraceptive utilization among adolescents. Bivariate analysis revealed significant associations between knowledge and socio-demographic factors such as education (P = 0.00) and marital status (P = 0.00), indicating higher knowledge levels among those with higher educational attainment and married individuals. Additionally, attitudes towards contraceptive utilization were significantly influenced by occupation (P = 0.005) and religion (P = 0.00). However, challenges such as the lack of parent-child communication and low knowledge contributed to the low contraceptive usage despite the existing initiatives such as the INGOBYI Activity.ConclusionThe findings highlight a need for targeted interventions that address the specific challenges identified, including the lack of knowledge and communication barriers. Improved education and awareness programs for both adolescents and parents, along with supportive community strategies, may enhance contraceptive utilization. A concerted effort involving parents, healthcare providers, and community leaders may foster a supportive environment that encourages responsible and informed contraceptive use among adolescents.

Nonuse of Contraception at Conception Due to Partner Objection and Pregnancy-Related Health Care Utilization, Postpartum Health, and Infant Birth Outcomes.

Objective: Reproductive coercion has been associated with adverse reproductive health experiences. This study examined the relationship between nonuse of contraception due to partner objection, one aspect of reproductive coercion, and selected pregnancy-related outcomes. Methods: We used 2016-2020 data from the Pregnancy Risk Assessment Monitoring System in 22 jurisdictions to assess the prevalence of nonuse of contraception due to a partner objection by select characteristics among individuals with a recent live birth who reported an unintended pregnancy. We calculated adjusted prevalence ratios (aPRs) to understand associations with health care utilization, postpartum behaviors and experiences, postpartum contraceptive use, and infant birth outcomes. Results: Among people with a recent live birth in the study jurisdictions (n = 29,071), approximately 5% reported nonuse of contraception due to a partner objection and unintended pregnancy. This experience was associated with lower prevalence of attending a health care visit before pregnancy (aPR 0.8, 95% confidence interval [CI] 0.7-0.9), first trimester prenatal care, and attending a postpartum checkup (aPR 0.7, 95% CI 0.6-0.9 for both). Higher prevalence was observed for postpartum depressive symptoms (aPR 1.3, 95% CI 1.1-1.6) and partner objecting to using birth control postpartum (aPR 2.8, 95% CI 2.1-3.9). Conclusions: Nonuse of contraception due to a partner objection at conception was associated with poor mental health and lower health care utilization around the time of pregnancy. Prevention efforts may include strategies that ensure provider screening for intimate partner violence, and evidence-based approaches that teach about healthy relationships, enhance self-efficacy, and address underlying drivers of violence.

Risk factors for ectopic pregnancy occurrence: Systematic review and meta-analysis.

Given the high incidence of ectopic pregnancy (EP) in the general population and the high maternal morbidity and mortality rates associated with it, determining risk factors for the occurrence of EP is essential for directing attention and care to risk groups, aiming for early diagnosis, favorable outcomes, and the development of prevention strategies. The aim of this study was to identify risk factors for the occurrence of EP. A systematic review with meta-analysis was performed on the electronic databases MEDLINE/PubMed, LILACS, The Cochrane Library, and Virtual Health Library (VHL), searching the following terms "Ectopic Pregnancy" or "Ectopic Gestation" and "Risk Factors" or "Predisposing Factors". The inclusion criteria were observational studies published in English and Portuguese. We excluded studies with undefined methodology and those published before the year 2000. The authors independently read the titles, abstracts, and full texts, using pre-defined inclusion and exclusion criteria, and discussed any differences. Data extraction and assessment of methodological quality were performed by each author in a standardized way. Sixteen risk factors were evaluated. The meta-analysis calculations were performed using the Reviewer Manager 5.3 software (RevMan 5.3). The study found 715 studies, of which 11 were selected for review. The surveys were conducted between 2003 and 2019 and included 25 051 patients. The study revealed that several factors were strongly associated with the occurrence of EP. These included EP history (OR 9.03; 95% CI: 7.18-11.35; I2 = 67%), pelvic inflammatory disease (OR 4.00; 95% CI: 3.46-4.61; I2 = 0%), infertility (OR 3.70; 95% CI: 3.23-4.23; I2 = 48%), abdominal and pelvic surgeries (OR 5.60; 95% CI: 4.83-6.49; I2 = 81%), and previous tubal ligation (OR 5.59; 95% CI: 2.49-12.55; I2 = 0%). Furthermore, the study showed that advanced maternal age, smoking, number of partners exceeding one, history of spontaneous and induced abortion, previous use of emergency contraception, and intrauterine device, demonstrated a slightly increased risk. Advanced maternal age within the range of 30-34 years (OR 1.13; 95% CI: 1.03-1.24; I1 = 11%) and ≥ 40 years (OR 1.46; 95% CI: 1.19-1.78; I1 = 88%), marital status (OR 1.19; 95% CI: 1.03-1.37; I2 = 88%), and the use of oral contraceptives (OR 0.77; 95% CI: 0.66-0.90; I2 = 86%) were also found to be associated with a slightly increased or decreased risk of EP, respectively. The impact of condom use on the occurrence of EP seems to be very limited (OR 0.93; 95% CI: 0.83-1.05; I2 = 83%). Based on the study findings, it is suggested that the presence of strong risk factors warrants the implementation of a screening policy for EP among these women.

Metabolic syndrome and related factors in Cameroonian women under contraceptive use.

Contraceptive is a device or drug that prevents a woman from becoming pregnant. Some types of contraceptive can cause a myriad of secondary effects such as overweight, increase of blood pressure triglycerides, and glucose intolerance. The combination of these secondary effects could, in the long term, develop metabolic syndrome in these women. The purpose of this study was to determine the prevalence of metabolic syndrome and related factors in Cameroonians women on contraceptives. This was a cross-sectional study that included 231 Cameroonians fasting women from 18 to 49 years of age, on contraceptives. Sociodemographic, lifestyle, anthropometric and biochemical characteristics were collected. Metabolic syndrome was diagnosed using the criteria of the National Cholesterol Education Program- Adult Treatment Panel III. After validation of the data, statistical analysis was performed using Epi-Info software version 7.2.2.16 and the statistical level of significance was set at 5.0%. 231 were using a modern contraceptive method, 28 were not using a contraceptive method, and 12 were non-consenting. The contraceptive method use rate was 89.19% and the most commonly used method was injectable contraception (49.35%). According to National Cholesterol Education Program criteria, almost 38.96% of these women were overweight and 50.65% had a serum high density lipoproteins cholesterol level of less than 0.50 g/L. Among women on contraceptives, the prevalence of metabolic syndrome was 22.08%. However, there was no significant association between contraceptive use and the occurrence of metabolic syndrome (p = 0.63). Contraceptive use was certain in all the participants, it's reported that, according to the NCEP-ATPIII a prevalence of 22.08% of metabolic syndrome among women using modern contraceptive methods in Douala, Republic of Cameroon. The high-risk groups were women using injectable method. Therefore, lipid profiles should be assessed in those women in order to manage them better.