Female Population Of Childbearing Age Research Articles

Association of endometriosis with cardiovascular disease: Genetic aspects (Review).

Cardiovascular disease (CVD) comprises a broad spectrum of pathological conditions that affect the heart or blood vessels, including sequelae that arise from damaged vasculature in other organs of the body, such as the brain, kidneys or eyes. Atherosclerosis is a chronic inflammatory disease of the arterial intima and is the primary cause of coronary artery disease, peripheral vascular disease, heart attack, stroke and renal pathology. It represents a leading cause of mortality worldwide and the loss of human productivity that is marked by an altered immune response. Endometriosis is a heritable, heterogeneous, common gynecological condition influenced by multiple genetic, epigenetic and environmental factors, affecting up to 10% of the female population of childbearing age, causing pain and infertility; it is characterized by the ectopic growth of endometrial tissue outside the uterine cavity. Of note, epidemiological data obtained thus far have suggested a link between endometriosis and the risk of developing CVD. The similarities observed in specific molecular and cellular pathways of endometriosis and CVD may be partially explained by a shared genetic background. The present review presents and discusses the shared genetic factors which have been reported to be associated with the development of both disorders.

How does the regulation of abortion provision for pregnancies resulting from rape affect its supply in the municipalities?

The provision of abortion in pregnancies resulting from rape in Brazil is limited, restricted to a few facilities and concentrated in large urban centers. We aimed to estimate the potential for expansion of this service considering the installed capacity in the country's municipalities. From the data of June 2021 in the Cadastro Nacional de Estabelecimentos de Saúde (Brazilian National Registry of Health Facilities, CNES), three different scenarios of abortion provision provided by law in pregnancies resulting from rape were elaborated, and the percentage of female population of childbearing age living in the municipalities of each scenario was calculated by region. The first scenario included the municipalities with installed provision; the second, those with potential for provision considering the current regulations; and the third, those with potential for provision considering only the recommendations of the World Health Organization and the Penal Code of Brazil. The scenarios were composed of 55, 662 and 3,741 municipalities, respectively, and were home to 26.7%, 62.1%, and 94.3% of the country's females between the ages of 10 and 49. In all regions, there was installed capacity to expand provision, both in light of current regulations and international recommendations.

Como a normatização sobre o serviço de aborto em gravidez decorrente de estupro afeta sua oferta nos municípios?

Abstract The provision of abortion in pregnancies resulting from rape in Brazil is limited, restricted to a few facilities and concentrated in large urban centers. We aimed to estimate the potential for expansion of this service considering the installed capacity in the country’s municipalities. From the data of June 2021 in the Cadastro Nacional de Estabelecimentos de Saúde (Brazilian National Registry of Health Facilities, CNES), three different scenarios of abortion provision provided by law in pregnancies resulting from rape were elaborated, and the percentage of female population of childbearing age living in the municipalities of each scenario was calculated by region. The first scenario included the municipalities with installed provision; the second, those with potential for provision considering the current regulations; and the third, those with potential for provision considering only the recommendations of the World Health Organization and the Penal Code of Brazil. The scenarios were composed of 55, 662 and 3,741 municipalities, respectively, and were home to 26.7%, 62.1%, and 94.3% of the country’s females between the ages of 10 and 49. In all regions, there was installed capacity to expand provision, both in light of current regulations and international recommendations.

Trends in Mortality Among Pregnant and Recently Pregnant Women in the US, 2015-2019

This study uses National Center for Health Statistics data to assess mortality rates and their annual percentage changes for pregnancy-related and other causes among pregnant and recently pregnant women from 2015 to 2019, compared with cause-specific mortality rates in the total US female population of childbearing age.

P447 No severe neonatal and maternal complications in inflammatory bowel diseases patients treated with ustekinumab or vedolizumab during pregnancy

Abstract Background Inflammatory bowel diseases (IBD) have a high incidence in the female population of childbearing age. Ustekinumab (UST) and vedolizumab (VDZ) are used in IBD after failure of immunosuppressants and//or anti-TNF therapy. Data on the use and safety of these novel biologics in pregnancy are rare. Methods We conducted a retrospective cohort study in the GETAID and identified female IBD patients who received at least one injection of UST or VDZ during pregnancy or within the 2 months before conception. The aims of the study were to assess the maternal and neonatal complications in these patients and to assess the management of VDZ or UST during pregnancy. Results Seventy-three pregnancies in 68 patients were reported in 21 centres. The median time between UST or VDZ introduction and pregnancy was 11.8 months (IQR: 5.2–17.6) and 10 months (IQR: 5.7–19.5), respectively. Twenty-nine pregnancies occurred in 27 patients on UST resulting in 26 (90%) live births, two (7%) spontaneous abortions, and one (3%) elective termination. Maternal complications were reported in two patients (gestational diabetes and threat of preterm birth). Five (19%) neonatal complications were reported (3 preterm deliveries, one low birth weight and one cardiac malformation). Six (21%) patients received UST in the 2 months before conception and stopped UST with a relapse in one patient (17%). UST was maintained during pregnancy in 22 (79%) patients: 13 patients discontinued UST in the first trimester with a relapse in 4 (31%) patients and 9 patients maintained UST during all pregnancy with a relapse in 3 (33%) patients. Forty-four pregnancies occurred under VDZ resulting in 38 (86%) live births, 5 (11%) spontaneous abortions and one (3%) medical interruption. Maternal complications were reported in 5 women (4 pre-eclampsia and one pregnancy cholestasis). Fourteen (37%) neonatal complications were reported: 7 (18%) premature births, 6 (16%) low birth weights and one (3%) congenital corpus callosum hypoplasia. Fifteen (34%) patients received VDZ in the 2 months before conception and discontinued VDZ with a relapse in 8 (53%) patients. VDZ was maintained during pregnancy in 29 (66%) patients: 16 patients discontinued VDZ in the 1st trimester with a relapse in 8 (50%) patients and 13 patients maintained VDZ during all the pregnancy with a relapse in one (8%) patient. Conclusion We reported 73 pregnancies under VDZ or UST. Except one cardiac malformation on UST and one congenital corpus callosum hypoplasia on VDZ, no serious neonatal or maternal complications were observed. However, additional prospective evaluations regarding pregnancy outcomes with new biologics are needed.

Maternal Nutritional and Water Homeostasis as a Presage of Fetal Birth Weight.

Birth weight is a key determinant of perinatal outcomes which affect physical development and metabolic function. In this study, we evaluated the potential role of maternal body composition and nutritional status in programing fetal birth weight. This was a longitudinal study that included 29 pregnant women and their full-term newborns. Maternal dietary energy and fluid intake and body adipose tissue were assessed. In addition, we measured the serum content of copeptin, aldosterone, and angiotensin II in maternal and umbilical cord blood. The measurements were done across the three trimesters of pregnancy, on average, at 11.6weeks, 18.3weeks, and 30.2weeks. Each newborn's birth weight was determined at the percentile line, using the World Health Organization (WHO) standards based on the gestational age, gender, and weight. We found no appreciable relation of fetal birth weight to the maternal dietary and fluid intakes, and the content of angiotensin II, aldosterone, or copeptin. However, birth weight correlated with increases in body adipose tissue in early pregnancy stages. Further, birth weight correlated positively with copeptin and adversely with angiotensin II in cord blood. We conclude that the present findings may be helpful in the assessment of a critical level of body adipose tissue in women of child-bearing age, above which the potential risk of macrosomia appears. The female population of child-bearing age needs a continual update on the nutritional knowledge to prevent modifiable maternal and fetal perinatal complications.

Autoimmune thyroid diseases and pregnancy

Thyroid autoimmunity affects 5–20% of the female population of childbearing age. Even in the absence of overt maternal thyroid dysfunction, thyroid autoimmunity has been reported to be associated with an increased risk of adverse pregnancy outcomes and impaired fetal neurodevelopment. Present evidence indicates that thyroid autoimmunity poses a risk for miscarriage and preterm delivery. By contrast, with regard to infertility most studies failed to find significantly different likelihood of pregnancy in euthyroid women with and without thyroid antibodies undergoing assisted reproduction procedures. Finally, uncertainty surrounds the role of thyroid autoantibodies on fetal and neonatal outcomes, since an increased risk for perinatal death, intrauterine growth restriction (IUGR), and respiratory distress syndrome has been inconsistently reported, and only few studies addressed the impact of maternal thyroperoxidase antibodies (TPOAbs) during pregnancy on cognitive functioning of the child, once again providing mixed results. Whether thyroid antibodies have a direct effect on neonatal outcomes, including neurodevelopment in the progeny, or whether the observed associations are related to maternal autoimmune-related thyroid insufficiency needs to be still clarified.

BISPHENOL A EXPOSURE IS LINKED WITH UTERINE FIBROMA IN WESTERN ALGERIAN WOMEN OF CHILDBEARING AGE

Abstract Bisphenol A (BPA) is an endocrine disruptor chemical widely used in the manufacture of polycarbonate plastics and epoxy resins found in everyday consumer products including food and beverage containers. This molecule was recently incriminated as a potential initiator for a number of diseases such as uterine fibromas, a frequent gynecological benign tumor that affects women’s fertility and life quality. The present study aims to investigate the association between uterine leiomyoma and BPA plasma levels in a population of Algerian women. Eighty plasma samples were collected from women with confirmed uterine fibroids diagnosis (N=40) and healthy volunteers without uterine leiomyomas (N=40) recruited at the specialized Hospital of Gynecology and Obstetrics of Sidi Bel Abbes in the western region of Algeria. Uterine leiomyoma subjects were then divided into three groups according to tumor growth and severity. BPA plasma levels were detected and measured using an enzyme linked immunosorbent assay (ELISA) technique. Seventy five percent of uterine leiomyoma patients were exposed to BPA and were principally young nulliparous women aged from 31 to 40 years expressing significantly higher plasma BPA levels than controls (0.89 ± 1.65 vs 0.05 ± 0.12 ng/mL; P=0.0001). Concerning the relationship between tumor growth and BPA levels, even though mean concentration was slightly higher in the severe group than the moderate group, the difference was statistically insignificant (P=0.97). These preliminary results suggest an association between environmental exposure to BPA and the occurrence of uterine fibroids among an Algerian female population of child-bearing age. Nevertheless, further studies on larger populations are required to confirm these findings.

The role of IL‑16 gene polymorphisms in endometriosis.

Endometriosis is one of the most common gynecological diseases affecting up to 10% of the female population of childbearing age and a major cause of pain and infertility. It is influenced by multiple genetic, epigenetic and environmental factors. Interleukin-16 (IL-16) is a proinflammatory cytokine playing a pivotal role in many inflammatory and autoimmune diseases as well as in the pathogenesis of endometriosis. The aim of the present study was to evaluate the association of two IL-16 gene single nucleotide polymorphisms (SNPs), rs4072111 and rs11556218, with the risk of endometriosis in women from Greece as well as to gain insight about the structural consequences of these two exonic SNPs regarding development of the disease. A total of 159 women with endometriosis (stages I–IV) hospitalized for endometriosis, diagnosed by laparoscopic intervention and histologically confirmed, and 146 normal controls were recruited and genotyped. Subjects were genotyped using a polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) strategy. A significant association was detected regarding the GG and GT genotype as well as 'G' allele of rs11556218 in patients with endometriosis. The rs4072111 SNP of the IL-16 gene was not found to be associated with an increased susceptibility to endometriosis either for all patients (stages I–IV) or for stage III and IV of the disease only. Our results demonstrated that rs11556218 is associated with endometriosis in Greek women, probably by resulting in the aberrant expression of IL-16, as suggested by the bioinformatics analysis conducted on the SNP-derived protein sequences, which indicated a possible association between mutation and functional modification of Pro-IL-16.

Prescribing for schizophrenia and psychosis in pregnancy

Schizophrenia is a severe mental illness which often requires life-long treatment with antipsychotic medication. Women with schizophrenia are more likely to have an unplanned pregnancy than the rest of the female population of child-bearing age. There is little evidence to show the effects of antipsychotic use in pregnancy on the woman and fetus; however, there is guidance available written by experts in the field.

Effect of obesity on human reproduction

Obesity influences human reproduction in several ways. Obesity is associated with sub-fertility and this effect is noticeable already at BMI 25 kg/m2. As many as 6 - 9% of the female population of child-bearing age suffer from polycystic ovary syndrome, i.e. anovulatory infertility, among whom more than half are obese. Bariatric surgery has become increasingly common in women of childbearing ages, and poses specific problem when women later become pregnant. In addition, the obesity epidemic has also reached the pregnant population of developed countries. The challenge for clinicians within the obstetric field is three-fold; first, obesity is associated with a number of obstetric risks that may have fatal or long-term consequences for both mother and offspring such as preeclampsia, preterm birth, intrauterine death, and congenital malformations. Secondly, while the obvious cure for obesity is weight loss, this is not an appropriate strategy during pregnancy when fetal nutritional demands are at stake. Finally, Caesarean section delivery is not the answer to the problem; the adverse neonatal outcomes are unaffected by mode of delivery, and the anesthetic risks, that are generally elevated in pregnant women, are even more imminent in obese pregnant women.

The carrier rate and mutation spectrum of genes associated with hearing loss in South China hearing female population of childbearing age

BackgroundGiven that hearing loss occurs in 1 to 3 of 1,000 live births and approximately 90 to 95 percent of them are born into hearing families, it is of importance and necessity to get better understanding about the carrier rate and mutation spectrum of genes associated with hearing impairment in the general population.Methods7,263 unrelated women of childbearing age with normal hearing and without family history of hearing loss were tested with allele-specific PCR-based universal array. Further genetic testing were provided to the spouses of the screened carriers. For those couples at risk, multiple choices were provided, including prenatal diagnosis.ResultsAmong the 7,263 normal hearing participants, 303 subjects carried pathogenic mutations included in the screening chip, which made the carrier rate 4.17%. Of the 303 screened carriers, 282 harbored heterozygous mutated genes associated with autosomal recessive hearing loss, and 95 spouses took further genetic tests. 8 out of the 9 couples harbored deafness-causing mutations in the same gene received prenatal diagnosis.ConclusionsGiven that nearly 90 to 95 percent of deaf and hard-of-hearing babies are born into hearing families, better understanding about the carrier rate and mutation spectrum of genes associated with hearing impairment in the female population of childbearing age may be of importance in carrier screening and genetic counseling.

Diagnosis and treatment of deep-vein thrombosis and approach to venous thromboembolism in obstetrics and gynecology

Deep vein thrombosis (DVT) is a common condition in which the approach to its diagnosis has evolved over the years. Currently, an algorithm strategy combining pre-test probability, D-Dimer testing and compression ultrasound imaging allows for safe and convenient investigation of suspected lower-extremity thrombosis. Patients with low pre-test probability and a negative D-Dimer test result can have proximal DVT excluded without the need for diagnostic imaging. The mainstay of treatment of DVT is anticoagulation therapy, whereas interventions such as thrombolysis and placement of inferior vena cava filters are reserved for special situations. The use of low-molecular-weight heparin (LMW) allows for outpatient management of most patients with DVT. The duration of anticoagulation therapy depends on whether the primary event was idiopathic or secondary to a transient risk factor. More research is required to optimally define the factors that predict an increased risk of recurrent DVT to determine which patients can benefit from extended anticoagulant therapy. DVT is also a serious problem in the antenatal and postpartum period of pregnancy. Thromboembolic complications are the leading cause of both maternal and fetal morbidity and mortality. The incidence of venous thromboembolism during normal pregnancy is six-fold higher than in the general female population of childbearing age. The treatment of DVT during pregnancy deserves special mention, since oral anticoagulation therapy is generally avoided during pregnancy because of the teratogenic effects in the first trimester and the risk of fetal intracranial bleeding in the third trimester. LMW heparin is the treatment of choice for DVT during pregnancy. If acute DVT occurs near term, interrupting anticoagulation therapy may be hazardous because of the risk of pulmonary embolism. In this situation, placement of a retrievable inferior vena cava filter must be considered. However, there is no consensus as to what the appropriate dose should be and whether anti-Xa levels need to be monitored.

Fatores associados ao tipo de parto em mulheres brasileiras: PNDS 2006

The scope of this paper was to analyze the prevalence of the types of delivery and associated factors in Brazilian women of childbearing age studied in the last National Demographics and Health Survey (NDHS). The study is a national domicile-based cross-sectional analysis, seeking to establish the characteristics of the female population of child-bearing age and of children under 5 years of age. The prevalence of the type of delivery was described according to the following exposition variables: Brazilian macro-regions, location of residence, age, skin color, nutritional status, education, prenatal health unit and place of delivery. The statistical significance (p<0,05) was evaluated using the chi-square test. The population studied consisted of 6.125 women. It was revealed that 42.9% of the women had a caesarean section. Significantly, the prevalence of caesarean section was smaller, irrespective of macro-regions, location of residence, age, skin color, nutritional status, prenatal health unit and place of delivery. The need for further investigation into the factors behind the increase in caesarean sections in Brazil is required in order to reverse this situation, since caesarean section can lead to a series of health complications for both mother and child.

Haemostasis in normal pregnancy: a balancing act?

Pregnancy is a risk factor for venous thrombosis and the incidence of venous thromboembolism during normal pregnancy is 6-fold higher during pregnancy than in the general female population of child-bearing age. This incidence is, however, remarkably low given the increases in markers of haemostatic activation observed during normal pregnancy. During normal healthy pregnancy there are substantial changes in the haemostatic system, many of which are procoagulant and supposed to be in preparation for the haemostatic challenge of delivery. Normal haemostasis requires a balance between coagulation and fibrinolysis to maintain the integrity of the vasculature, and complex physiological changes are evident during pregnancy which appear to ensure a constant coagulation/fibrinolysis balance. This balance is maintained, at least partly, by an increase in fibrinolytic activity, but decreases in other factors such as factor XI and monocyte tissue factor expression may also serve to counterbalance procoagulant changes.

Costi della prevenzione della rosolia in gravidanza

Objectives: 1) To identify the proportion of pregnant women susceptible to rubella in a representative sample of the female population of childbearing age resident in Turin (1995–1999); 2) To estimate the probability of adverse events in relation to different vaccination strategies; 3) To evaluate the economic aspects of antirubella vaccination.

Health care implications of dysfunctional uterine bleeding

Objective menorrhagia (measured menstrual blood loss of >80 ml) affects approximately 10% of the population, while the subjective complaint of menorrhagia is experienced by almost a third of the female population of childbearing age. Consequently, large numbers of women consult their general practitioners annually and many are subsequently referred on for gynaecological opinion. Ineffective utilization of medical therapies may result in inappropriate referral and subsequently may result in operative intervention. The introduction of many minimally invasive techniques to manage menorrhagia has not brought about the expected reduction in surgical intervention rates but has merely increased the overall operative burden on the National Health Service (NHS). Recent advances in medical therapy may, for the first time, offer a rational and effective alternative to surgical therapy but long-term clinical and cost effectiveness studies are required. At present menorrhagia continues to be a major drain on health care resources.

Congenital Heart Block and Connective Tissue Disease

Editorial Notes1 October 1979Congenital Heart Block and Connective Tissue DiseaseEVELYN V. HESS, M.D., GEORGE SPENCER-GREEN, M.D.EVELYN V. HESS, M.D.Search for more papers by this author, GEORGE SPENCER-GREEN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-91-4-645 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSystemic Lupus Erythematosus (SLE) is an immunologically mediated disease occurring most frequently in a female population of child-bearing age with target organs potentially in any body system. Several recent publications have brought to attention the fact that the fetus of a mother with systemic lupus erythematosus is also at risk to develop complications of its mother's disease. Most offspring of the mothers are normal, but transient as well as permanent residua have been observed, including the well-recognized phenomenon of discoid rash, leukopenia, thrombocytopenia, and Coombs'-positive hemolytic anemia with LE cells and antinuclear antibodies. These transient phenomena occur at or soon...

The determinants of fertility: a theoretical forecasting model.

The conceptual framework of a fertility model for forecasting population changes is presented. Beginning with the individual state of a fecund woman in a given year, the model considers the impact of three factors on her decision-making process with respect to fertility in the following year. The model uses a four state Markov chain, with transitional probabilities based upon the decision process of each woman aged 14–45 as it is affected by the annual rate of change in real per capita income, in level of education and in rural-urban employment. From the Markov chain, the number of live births that can be expected in a future time period given the size of the female population of childbearing age and the impact of economic development can be estimated. Thus, the model attempts to develop a theory of fertility that conceptually interrelates significant socioeconomic factors, individual behavior and the process of economic development, thereby providing a tool for predicting future births. Provisions to refine the model by incorporating additional socioeconomic factors are suggested.