Abortion is one of the major public health problems among women during pregnancy and is regarded as the third cause of death in many societies such as Iran. To this end, this systematic review aimed to estimate the prevalence of induced abortion and its causes in Iran. PubMed, Scopus, Web of Science, and national Persian databases such as SID, Magiran, and Elmnet were searched from inception to March 11, 2023. In addition, the relevant conference abstracts in Elmnet, Scopus, and Embase were searched. The pooled prevalence of abortions (induced, spontaneous, and therapeutic) and related factors were calculated at a 95% confidence interval. Of 310 papers retrieved from seven electronic databases, 34 were included in the quantitative synthesis (meta-analysis). The pooled prevalence of abortion 18.1% (95% CI: 14.5%-21.7%). The prevalence of induced abortion was 27.4% in the central areas of Iran. A short preceding birth interval, economic hardship situation, adequate number of previous alive children, low level of education, academic education, younger parents, maternal occupation, older age (>35), and low knowledge about contraceptive use were the most frequent reasons for induced abortion. The prevalence of induced abortion was 18%, showing a high rate for a religious country. Thus, policies and programs to reduce unwanted pregnancies should focus on increasing women's knowledge and access to suitable contraceptives, especially for women with a low socio-economic status.

Can reporting mood swings during oral contraceptive use predict peripartum depression? Results from the Swedish longitudinal cohort study Mom2B.

Estrogen-containing contraceptive use and blood lead concentrations in a cohort of premenopausal individuals.

Replicating the use of motivational interviewing and facilitated contraceptive access to reduce repeat adolescent pregnancy: A randomized trial.

Trajectories of contraception before pregnancy and after medication abortion among women accessing clinic vs pharmacy services in Ghana.

Objective: To explore variations in postpartum contraception in the United States by race and ethnicity among patients receiving publicly versus privately funded health care. Study Design: We analyzed Phase 8 (2016-2021) Pregnancy Risk Assessment Monitoring System (PRAMS) data using multivariate logistic regression models with interaction terms to examine relationships between maternal race and ethnicity, health insurance, and postpartum contraceptive use, controlling for maternal age, education, marital status, parity, prepregnancy depression, and whether ever breastfed. Results: Of U.S. birthing individuals, 60.3% had privately funded births and 39.7% had publicly funded births. Tubal sterilization was more common after publicly funded than privately funded births (13.3% versus 7.0%, p < 0.001). Among postpartum patients with private insurance, tubal sterilization was more common among Black (10.6%) and Hispanic/Latine (9.6%) than White (6.4%) birthing people. However, with publicly funded insurance, tubal sterilization was less common among Black (12.3%) and Hispanic/Latine (13.7%) than White birthing people (14.6%). After publicly funded births, implant use (8.9% versus 2.8%, p < 0.001) and injectable contraception (11.4% versus 2.7%, p < 0.001) were more common, whereas reliance on vasectomy was less common (2.1% versus 5.5%, p < 0.001) than after privately funded births, for all racial/ethnic groups. Intrauterine device (IUD) use was less common with public than private insurance among Black birthing people (11.9% versus 16.0%, p < 0.001). Significant interactions between race and ethnicity and insurance type were observed. Adjusted odds ratios indicated that, compared with private insurance, public insurance was associated with higher odds of tubal sterilization, implant, and injectable use but lower odds of vasectomy for White individuals; higher implant and DMPA use but lower IUD and vasectomy use for Black individuals; and higher tubal sterilization, IUD, and implant use but lower vasectomy use for Hispanic/Latine individuals. Conclusion: Racial and ethnic variation in postpartum contraception use differs for publicly and privately insured births in the United States.

An in-depth interview study of women's perspectives on the effects of contraceptive use on future fertility in Ethiopia and Kenya

Clinical characterization and predictors of poor outcome in patients with cerebral venous thrombosis: Experience from a Latin American cohort.

Posterior Cerebral Artery Stroke in a Pediatric Patient.

Knowledge of fertile period among adolescent girls and young women (AGYW; 15-24 years) is crucial for understanding and managing reproductive health, yet it remains under explored. Many AGYW possess limited knowledge about their reproductive systems and the menstrual cycle, which can lead to misconceptions regarding fertile period and contraceptive use. In regions like Tanzania, where early and unintended pregnancies are prevalent, enhancing fertile period awareness through tailored educational initiatives becomes increasingly vital. This study aimed to assess the knowledge of the fertile period and associated factors among AGYW in Tanzania for evidence-based interventions. An analytical cross-sectional study was conducted using secondary data from the 2022 Tanzania demographic and health survey. Given the survey's complex design, weighted binary logistic regression model was used to determine factors associated with knowledge of the fertile period. Adjusted odds ratio (AOR) with corresponding 95% confidence intervals (CI) were used to estimate the strength of the association. A p-value of < 0.05 was declared statistically significant. The overall prevalence of knowledge about the fertile period was 19.4% (95% CI: 17.9-20.9). Several factors were associated with a higher likelihood of having knowledge about the fertile period; being aged 20-24 years (AOR = 1.43, 95% CI: 1.16-1.76), having secondary education (AOR = 3.15, 95% CI: 2.23-4.45), exposure to media (AOR = 1.28, 95% CI: 1.02-1.59), visiting a health facility in the past 12 months (AOR = 1.40, 95% CI: 1.29-1.66), and residing in the central (AOR = 2.55, 95% CI: 1.67-3.89) or southern zones of mainland Tanzania (AOR = 1.67, 95% CI: 1.11-2.48). This study revealed the factors impacting knowledge of fertile period among AGYW, highlighting the roles of educational attainment, media exposure, healthcare access, and geographical location. Increased education and health service access correlate with better knowledge. To address these challenges, tailored interventions that account for above would be essential. ​Ultimately, enhancing fertile period awareness necessitates engaging educational programs across various platforms, empowering AGYW to make informed reproductive health choices. Further research needs to be conducted to monitor the knowledge on fertile periods.

Menstrual irregularity (MI) is a common reason for gynecological visits and significantly affects adolescents’ physical health, psychosocial well-being, and academic performance. However, most studies in Ethiopia have predominantly focused on university students, creating a critical gap in understanding MI among younger secondary school students, particularly in Southern Ethiopia. This study aimed to assess the magnitude of MI and its associated factors among secondary school students in Areka Town, Southern Ethiopia. An institution-based cross-sectional study was conducted from December 18 to 31, 2023, involving 402 secondary school students selected through stratified random sampling. Data were collected using a pre-tested, semi-structured, self-administered questionnaire and anthropometric measurements. Data were entered into EpiData version 4.2, and analyzed using Statistical Package for Social Science version 25. Descriptive statistics summarized the variables. Bi-variable and multivariable logistic regression analyses were conducted to identify factors associated with MI. Results were presented in text, tables, and charts. The magnitude of MI among respondents was 59.5% (95% confidence interval (CI): 55–64%). Factors significantly associated with MI included: younger age ≤ 16 years [adjusted odds ratio (AOR) = 8.72, 95% CI: 2.73–27.81], being unmarried [AOR = 4.03, 95% CI: (1.19, 19.57)], hormonal contraceptive use [AOR = 6.07, 95% CI: 1.16–28.19], family history of MI [AOR = 4.03, 95% CI: 1.05–14.03], circumcision [AOR = 7.26, 95% CI: 2.87–18.35], and menarche at age ≤ 12 years [AOR = 3.62, 95% CI: 1.55–8.47]. Additionally, behavioral factors such as alcohol consumption [AOR = 4.72, 95% CI: 1.34–16.68], sleeping <7 hours per 24 hours [AOR = 2.94, 95% CI: 1.17–7.39], severe stress [AOR = 1.51, 95% CI: 1.01–4.24] and extremely severe stress [AOR = 3.08, 95% CI: 1.08–8.80] were independently associated with MI. More than half of the secondary school students experienced MI, which were associated with a mix of socio-demographic, reproductive, and modified behavioral factors. These findings strongly recommend the urgent implementation of comprehensive school-based menstrual health programs that integrate education on healthy lifestyle practices, stress management, and early screening for MI to mitigate its negative health and academic impact on young adolescents.

Reproductive coercion (RC) broadly encompasses behaviors that interfere with a person's reproductive choices, including control over contraception, pregnancy, and pregnancy outcomes, and can pose considerable health risks. However, its full impact on health remains insufficiently understood. This scoping review systematically examined empirical literature on the health consequences of RC published between 2010 and 2024. Following JBI methodology and Preferred Reporting Items of Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines, we searched five databases (MEDLINE, CINAHL, Embase, PsycINFO, and Scopus) for peer-reviewed studies reporting on RC and associated health outcomes. Sixty-two studies across 18 countries met inclusion criteria, the majority from high-income settings, revealing adverse effects on reproductive, sexual, and mental health. Most studies focused on pregnancy coercion and contraceptive sabotage perpetrated by male partners. RC was consistently associated with adverse mental health outcomes, including post-traumatic stress disorder, anxiety, and depression. Studies associated RC with an increased risk of unintended pregnancy and sexually transmitted infections. Contraceptive use patterns varied: some studies reported reduced uptake among those experiencing RC, while others described increased use of covert long-acting methods and emergency contraception as protective strategies. Few studies examined physical health outcomes or healthcare utilization following RC. Evidence gaps remain regarding the health consequences of other RC behaviors, including coerced continuation or termination of pregnancy and forced contraception, as well as from low- and middle-income contexts. Clarifying the health consequences linked to current or past experiences of different RC behaviors may support healthcare providers in recognizing and responding to RC, to promote reproductive autonomy and improve health outcomes for RC victim-survivors.

Retinal microvasculature and macular-choroidal thickness in oral contraceptive users: an OCTA and OCT comparative study.

Unintended pregnancy continues to be a major global public health challenge, with over three-fifths resulting in induced abortion. To reduce unintended pregnancies and associated consequences, providing effective postpartum contraception is crucial. Despite the high rates of unintended pregnancies and low postpartum contraceptive use in Ethiopia, the influence of pregnancy intention on postpartum contraceptive use remains inadequately explored. This study aimed to examine the effect of pregnancy intention on postpartum contraceptive use in Ethiopia at six weeks, six months, and one year postpartum. Longitudinal survey data from the Performance Monitoring for Action (PMA) Ethiopia survey were used for this analysis. The analysis included randomly selected pregnant women and those in the early postpartum period who participated in the baseline survey and completed the follow-up surveys. The data were collected from selected regions of Ethiopia between 2019 and 2021. We used inverse probability of treatment weighting based on propensity scores to address the imbalance of baseline confounders between women with intended pregnancies and those with unintended pregnancies. Odds ratios (OR) with 95% confidence intervals (CI) were estimated using a logistic regression model with inverse probability of treatment weights. Women with intended pregnancies had higher odds of using postpartum contraceptives at six weeks (OR = 1.51, 95%CI: 1.05-2.17), and at six months postpartum (OR = 1.29, 95% CI: 1.06-1.57). Similarly, women with intended pregnancies had a higher likelihood of using postpartum contraceptives at one year postpartum (OR = 1.49, 95% CI: 1.13-1.96) compared with women with unintended pregnancies. Postpartum modern contraceptive use remained suboptimal across the postpartum period, regardless of pregnancy intention. Women with intended pregnancies demonstrated higher odds of contraceptive uptake at six weeks, six months, and one year postpartum. Sexual and reproductive health services, particularly family planning access for all women, should be strengthened. Targeted strategies such as early identification and linkage to care are needed to address the specific contraceptive needs of those who have experienced unintended pregnancy.

Introduction This study examined the determinants of the demand for and use of modern contraception among young women aged 15–24 years in Malawi, focusing on the met demand for family planning with modern methods (mDFPS). Previous studies in Malawi have primarily assessed contraceptive prevalence or intentions to use, while limited attention has been given to mDFPS, a key indicator of reproductive autonomy. Data and methods The analysis used data from the 2015–16 Malawi Demographic and Health Survey (MDHS). After excluding cases with missing values, the final analytical sample comprised 7,643 young women aged 15–24 who had a demand for family planning. Weighted descriptive, bivariate, and probit regression analyses were conducted to identify factors associated with modern contraceptive use, demand for contraception, and mDFPS. Results Bivariate analysis showed significant associations between mDFPS and age, education, marital status, parity, employment, and exposure to health workers ( p &amp;lt; 0.001). Multivariate probit regression indicated that higher education, employment, and later sexual debut increased the probability of mDFPS by 11%, 3%, and 7%, respectively, while being married reduced it by 14% ( p &amp;lt; 0.01). Parity remained the strongest predictor, with women having one or more children being 44%–55% more likely to have mDFPS. Factors such as wealth, residence, and information exposure were not significant after adjustment. Conclusion By focusing on mDFPS rather than overall contraceptive prevalence, this study advances understanding of reproductive autonomy among young Malawian women. The findings suggest that educational attainment, empowerment, and gender-sensitive service delivery are more decisive than economic access alone. Efforts to improve mDFPS should therefore address social norms, marital dynamics, and health system barriers to youth-friendly contraceptive services.

Female sex is a risk factor for differentiated thyroid carcinoma (DTC), potentially due to reproductive influences. However, data on the association between parity and DTC risk remain inconsistent. To assess the association between parity and DTC risk in a high-multiparity population. Population-based case-control study (1982-2022). A single tertiary medical center. The study included 300 female DTC patients and 900 controls, matched by birth year and ethnicity. The primary exposure was the number of deliveries before DTC diagnosis. Association between parity and DTC risk evaluated by logistic regression, adjusted for socioeconomic status, thyroid-stimulating hormone (TSH) levels, oral contraceptive use, and autoimmune thyroid diseases. The median age at DTC diagnosis was 39 years, 60% of participants were Jewish and 40% were Arab. Baseline characteristics were comparable, except for higher rates of autoimmune thyroid diseases in cases: Hashimoto thyroiditis (9.7% vs. 1.8%, p < 0.001) and Graves' disease (6.3% vs. 2.7%, p = 0.005). Parity was associated with increased DTC risk starting at four deliveries (OR = 1.70, 95% CI: 1.051-2.741, p = 0.030), with the highest risk at six or more (OR = 1.89, 95% CI: 1.052-3.393, p = 0.033). This association was largely driven by Arab women, who had significantly higher grand multiparity rates (62.6% vs. 13.4%; median 5 vs. 3 deliveries; p < 0.001). High parity, primarily among Arab women, was associated with increased DTC risk, with significance observed at four or more deliveries.

Abstract The low prevalence of contraceptive use in sub-Saharan Africa has been largely ascribed to a lot of factors. Among such factors is false impression about family planning use. This study examined misconceptions as determinants of contraceptive uptake among married women in Southwest, Nigeria. A cross sectional study was carried out among 1187 women of reproductive age (15-49) years in Southwest, Nigeria. The study adopted a multi-stage sampling procedure to select the study participants and questionnaire method was employed to elicit responses from them. The study employed statistical product for services solution (SPSS version 20) to analyze the data collected. Frequency distribution was employed to explain the socio-demographic characteristics of the study participants, while chi-square test and logistic regression analysis were employed at the bivariate and multivariate level. The study showed that the mean age of the respondents was 33.7 ± 7.7 S. D, while the mean age at first marriage was 24 years. The study further showed that contraceptive use is still low in the region despite marginal improvement. Moreover, there were significant positive relationships between misconceptions such as family planning causes promiscuity, embarrassment at the point of uptake and contraceptive use. However, there were significant negative relationship between women who believe that contraception causes cultural inhibition/lack of openness among spouses as well as irregular menstruation. The study concludes that misconceptions such as family planning causes promiscuity, infertility, weight gain, irregular menstruation, cultural inhibition and lack of openness between couples and lead to embarrassment at the points of uptakes still exist in the study area. The study recommends that to witness improved contraceptive use in the area, program interventions tailored to contraceptive needs of married women such as health education and awareness campaign at both the national and local level should be embarked upon.

ABSTRACT Purpose Internal female migrant workers (FMWs) in Asia, often employed in low-paid informal sectors, face unique vulnerabilities concerning sexual and reproductive health (SRH). Limited access to services, sociocultural taboos, and workplace discrimination contribute to adverse health outcomes. Aim To synthesize available evidence on knowledge, attitudes, practices, and access to SRH services among internal FMWs in Asia, and to identify gaps for future research and policy reform. Materials and Methods: A scoping review was conducted following Arksey & O’Malley’s six-stage framework. A literature search across six databases – Pubmed, Scopus, Web of Science, EBSCO, Cochrane Reviews and Google Scholar (2010–2024) – yielded 41 eligible studies across eight Asian countries. Inclusion criteria focused on internal FMWs aged 15 to 49 years working in informal sectors. Results The findings reveal poor SRH knowledge, liberalizing sexual attitudes, and risky sexual and reproductive practices. Barriers to SRH access were cultural, structural, institutional, and interpersonal. Contraceptive use was inconsistent; high rates of unplanned pregnancies and unsafe abortions were reported. Conclusion The review highlights the urgent need for culturally sensitive, gender-responsive SRH interventions for internal FMWs. Targeted education, employer involvement, improved policy enforcement, and stakeholder collaboration are essential to advance SRH equity in Asia.

This study examines the relationship between community violence and the use and provision of contraception in Mexico, where family planning is a long-standing policy priority and the "war on drugs" has led to chronically high levels of violence. We adopt a two-step approach. First, we investigate the association between women's exposure to violence and first contraceptive use. Combining individual-level data (n = 86,219) from two waves of the National Survey of Demographic Dynamics (ENADID) with information on monthly municipality-level homicides in event-history models, we analyze the timing and method of women's first contraceptive use and the source of first contraception. Second, leveraging rare data from Mexico's Ministry of Health in clinic fixed-effects models, we study the association between homicides and contraceptive provision from public clinics. Results show strong positive associations between community violence and both the transition to first contraceptive use and the contraceptive provision of reversible methods. These relationships are stronger in the long term; one more homicide per 10,000 population during the past five years is associated with triple the risk of initiating contraceptive use and two to three more reversible contraception users served in each public clinic per month. The findings suggest increasing contraceptive vigilance and fertility regulation preferences-but also healthcare system resilience-in times of insecurity.

ObjectivesUnder-five mortality (U5M) remains a major global challenge, particularly in low-and lower-middle- income countries (LLMICs) where healthcare disparities are prevalent. This study evaluates the prevalence of U5M and examines the relative importance of its associated factors across 32 LLMICs.MethodsData from the Demographic and Health Survey (2011–2024) were used for analysis. A total of 266,333 children under five years of age were included to assess the association of 20 factors at both individual and community levels with U5M. The chi-square test and multivariate logistic regression model were applied to determine the association of these factors with U5M.ResultsAmong the children aged 0−59 months, the prevalence of U5M was 40.5 per 1,000 (95% CI: 39.8–41.2). In the pooled sample, at the individual level, family member (>7) was the strongest factor associated with U5M (adjusted odds ratio (AOR):1.27; 95% CI:1.22–1.33, p < 0.001), followed by maternal age ≥ 35 years (AOR: 1.25; 95% CI:1.20–1.30, p < 0.001), being a female child (AOR:1.19; 95% CI:1.15–1.24, p < 0.001), and maternal unemployment (AOR:1.10; 95% CI:1.05–1.14, p < 0.001). At the community level, high maternal illiteracy (AOR:1.52; 95% CI:1.35–1.70, p < 0.001) was the most significant factor, followed by rural residence (AOR:1.26; 95% CI:1.15–1.38, p < 0.001), high paternal illiteracy (AOR:1.20; 95% CI:1.10–1.30, p < 0.001), and high maternal unemployment (AOR: 1.10; 95% CI:1.02–1.20, p < 0.001). Furthermore, large family members at individual levels and high maternal illiteracy at the community level consistently rank among the top two strongest factors across most countries, with a few exceptions.ConclusionsIn LLMICs, U5M remains high, strongly associated with large family size and high maternal illiteracy. Governments and non-governmental organizations should promote maternal education and contraception use to facilitate birth spacing and family planning, while tailoring interventions to country-specific contexts.