Gynecological Variables Research Articles

Prenatal exposure to pesticide mixture in Argentina: A pilot study in puerperal women from Santa Fe province

AbstractIntroductionThe epidemiological investigation of congenital anomalies (CA) represents a challenge due to the multiplicity of associated risk factors, notably environmental ones. The monitoring of genotoxic effects in different populations is a useful tool in human biomonitoring and has great biological importance in estimating the exposure risks to complex mixtures of chemical substances.ObjectiveThis study aimed to determine the presence of environmental xenobiotics and evaluate their genotoxic effect, in mothers of newborns with and without CA, and the possible association/correlation between those biomarkers and CA.Materials and methodsA descriptive case and control cross‐sectional study was developed on 290 postpartum women from Santa Fe, Argentina.ResultsSignificant differences were observed between both groups, for places of residence and gynecological variables. Metabolites of organochlorine (OC), organophosphate (OP), and pyrethroid (PYR) pesticides were detected. The most frequently detected compounds were atrazine (ATZ) (57.14%), carbendazim (CBZ) (46.42%), and methylparaben (46.42%), among others. A positive correlation was found between the number of pesticides in blood and genotoxic variables. On the other hand, mothers of children with genitourinary anomalies were the ones with the highest concentrations of ATZ and OP.Discussion and conclusionThese results showed a deep background in the health reality of Santa Fe, which could greatly impact the health of future adults, who have been born preterm. On the other hand, the mixture of pesticides detected confirms the environmental living conditions of women and the transplacental exposure to these compounds in each pregnancy. The potential effects on long‐term descendent health are unknown and unpredictable.

Early adulthood and current physical activity and their association with symptoms of pelvic floor disorders in middle-aged women: An observational study with retrospective physical activity assessment.

To investigate associations of early and middle adulthood physical activity (PA) with symptoms of pelvic floor disorders (PFDs), i.e. stress urinary incontinence (SUI), urge urinary incontinence (UUI), faecal incontinence (FI), constipation or defecation difficulties (CDDs) and feeling of pelvic organ prolapse (POP) among middle-aged women. A cross-sectional, observational study with retrospective PA assessment. University Research Laboratory. A random population sample of 1098 Finnish women aged 47-55 years. Early adulthood PA, current PA, and demographic and gynaecological variables were assessed using self-report questionnaires. Logistic regression analyses were applied to study associations of PA variables with symptoms of PFDs. Potential confounding effects of demographic and gynaecological variables were controlled in multiple logistic regression models. Structured questionnaire-assessed retrospective PA assessment at the age of 17-29 years, current PA at middle age, and prevalence of symptoms of CDD, FI, POP, SUI and UUI. Current PA was not independently associated with the occurrence of the symptoms of PFDs. Middle-aged women with an early adulthood history of competitive sports were more likely to experience symptoms of UUI (OR2.16, 95%CI 1.10-4.24, p=0.025) but not symptoms of SUI, FI, CDD or POP, whereas women with a history of regular PA were more likely to experience symptoms of FI (OR4.41, 95%CI 1.05-18.49, p=0.043) but no other symptoms of PFDs. Competitive sports during early adulthood may increase the risk of UUI in middle age. Regular PA during early adulthood may increase the risk of FI.

Monitoring Sexually Transmitted Infections in Cervicovaginal Exfoliative Samples in Mexican Women.

Background. Globally, Sexually Transmitted Infections (STIs) are a major cause of morbidity in sexually active individuals, having complications in reproduction health and quality of life. In concordance with the Sustainable Development Goals (SDG), the study aimed to investigate the prevalence of Candida spp., Ureaplasma spp., Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, HSV, and Mycoplasma spp. from cervicovaginal samples and to correlate them with the gynecological history of the patients. Methods. Our analytical, prospective, and cross-sectional study included 377 women who participated in a reproductive health campaign during 2015–2016. Anthropometric and gynecological variables were obtained. Cervicovaginal specimens were collected and analyzed with a multiplex in-house PCR to detect Candida spp., Ureaplasma spp., Trichomonas vaginalis, Neisseria gonorrhoeae, HSV, Mycoplasma spp., and Chlamydia trachomatis. Results. The positive cases were 175/377 (46.4%) to at least one of the microorganisms. The most frequent pathogen detected in this population was Ureaplasma spp. (n = 111, 29.4%), followed by Mycoplasma spp. (n = 56, 14.9%) and Candida spp. (n = 47, 12.5%); 33.7% of the positive cases were single infections, whereas 12.7% had coinfection. The multiplex PCR assay was designed targeting nucleotide sequences. Conclusions. Our data demonstrated that monitoring STIs among asymptomatic patients will encourage target programs to be more precisely and effectively implemented, as well as make these programs more affordable, to benefit society by decreasing the prevalence of STIs.

Relationship of breastfeeding duration with joint pain and knee osteoarthritis in middle-aged Korean women: a cross-sectional study using the Korea National Health and Nutrition Examination Survey

BackgroundThe effect of joint health on the quality of life of middle-aged and older women is becoming more widely recognized with the aging of the world’s population. However, the association of long-term breastfeeding with joint pain and knee osteoarthritis has not been fully examined. The aim of this study was to determine the association of prior breastfeeding duration with current joint pain and knee osteoarthritis in middle-aged Korean women.MethodsThis cross-sectional study was conducted among 3454 women aged ≥50 years who underwent knee radiography and answered a questionnaire on breastfeeding and joint pain for the 5th Korea National Health and Nutrition Examination Survey (2010–2011). After adjusting for confounding sociodemographic, medical history, and obstetric and gynecologic variables, logistic regression analysis was conducted to analyze the prevalence of joint pain and knee osteoarthritis according to breastfeeding and its duration.ResultsAmong the 3454 participants, 298 had not breastfed and 1042, 815, and 1299 had breastfed for 1–24, 25–48, and ≥ 49 months, respectively. Of all participants, 1731 had joint pain and 739 were diagnosed with knee osteoarthritis after radiography.Using the non-breastfeeding group as a reference, the odds ratio (OR) for joint pain among women who breastfed ≥1 month was 1.49 (95% confidence interval [CI] 1.01–2.21). As the breastfeeding duration increased, the OR of joint pain prevalence also increased (p for trend; p = 0.002). For knee osteoarthritis, the OR was 2.30 in the 25–48 months group (95% CI 1.09–4.86). The OR of knee osteoarthritis in the ≥49 months group was 2.17 (95% CI 1.01–4.64). Sensitivity analysis after selecting only participants aged ≥60 years showed that the prevalence of joint pain and knee osteoarthritis was more positively correlated with extended breastfeeding duration (joint pain, p for trend; p = 0.005) (knee osteoarthritis, p for trend; p = 0.012).ConclusionsLong-term feeding for more than 25 months was associated with an increased prevalence of joint pain and degenerative arthritis in Korean women aged ≥50 years.

Management of Primary Dysmenorrhea among University Students in the South of Spain and Family Influence.

The present study analyses the management of primary dysmenorrhea by university students in the south of Spain. In this cross-sectional observational study, 224 women participated, using an ad hoc self-report questionnaire about menstrual pain and self-care and including sociodemographic and gynecological variables. Some 76.8% of participants consumed analgesics and the majority self-medicated with non-steroidal anti-inflammatory drugs (NSAIDs) without consulting a health professional, with a correlation between pain intensity and the number of pills ingested during menstruation (r = 0.151, p < 0.05). The higher proportion of women who found their analgesia effective were those who took medication after being prescribed by a health care provider (60.8%) compared to those who self-medicated (40%; p < 0.01). Only 43.8% employed non-pharmaceutical methods, most commonly antalgic positions, massages and local heat. These choices were not related to the intensity of menstrual pain nor with the severity of the dysmenorrhea, nor did these most common methods prove to be the most effective. However, a higher percentage of women using non-pharmacological methods was identified in women with family members suffering from dysmenorrhea (73.2%) compared to those without (60%; p = 0.040), which may indicate that the choice of remedies is more related to learning self-care in the family context. This study identifies the need for education on self-care and management of menstrual pain.

Type 1 diabetes mellitus associated or not with primary hypothyroidism and women’s fertility

The aim of this study is to evaluate the prevalence of infertility and other reproductive parameters in women with type 1 diabetes mellitus (DM1) with and without primary hypothyroidism (PH). This is a cross-sectional study conducted at Division of Endocrinology. We evaluated 110 female, aged over 18 years, 79 had DM1 and 31 had DM1 plus PH. They were interviewed to obtain data on their gynecological and obstetric history; medical charts were reviewed to determine the characteristics of the diseases and to assess clinical/laboratory data. Infertility was defined as 12 months of unprotected sexual intercourse without conception. We used the chi-square and Mann–Whitney’s tests, and logistic regression analysis. The prevalence of infertility in the total sample was 24.5%, no differences were found between groups regarding obstetric outcomes and gynecologic variables. Factors associated with infertility were microvascular complication (OR: 11.36; 95% CI: 2.488–52.632; p = .029), polycystic ovary syndrome (OR: 9.80; 95% CI: 2.247–43.478; p = .016), PH (OR: 3.38; 95% CI: 1.078–10.638; p = .047), and older age at onset of DM1 (OR: 1.12; 95% CI: 1.029–1.215; p = .019). The presence of PH in women with DM1 was a predictive factor for infertility. Women with DM1 showed poorer reproductive outcomes compared to the general population.

Physical Activity and Menstrual Disorders Аmong School Girls in Southern Egypt

Introduction: Menstrual disorders are the most frequent gynecological diagnoses among young girls.Aim: This study was conducted to investigate whether physical activity could reduce menstrual disorders among schoolgirls.Methods: In this cross-sectional study, 970 schoolgirls in Southern Egypt were assessed, using a questionnaire, for their socio-demographic characteristics, gynecological history, physical activity, and menstruаl disorders during the previous 6 months. Results: The mean аge of schoolgirls was 15.5 ± 0.8 yeаrs, menarche аge 13.2 ± 1.2 years, menstrual cycle durаtion 28.8 ± 7.3 dаys, and 76.1% were circumcised. After аdjustment for the socio-demographic and gynecological variables, physical activity wаs shown to be not associated with all premenstrual symptoms аnd dysmenorrheа (р -value &gt; 0.05).Conclusion: No substantial associаtions between physical activities and menstruаl/premenstrualal symptoms can be concluded.Recommendations: Future cohort and interventional studies are needed to explain whether the risk of dysmenorrhea and premenstrual symptoms can be reduced by physical activity.

Prevalence of urinary incontinence in high-impact sports athletes and their association with knowledge, attitude and practice about this dysfunction

ABSTRACTObjective: To evaluate the prevalence of urinary incontinence (UI) in female athletes practising high-impact sports and its association with knowledge, attitude and practice (KAP).Design: Observational study.Methods: A semi-structured evaluation form, KAP survey and the International Consultation on Incontinence Questionnaire – Short Form were used. Univariate and multivariate analyses were performed to verify the association of UI with KAP, sociodemographic, gynaecological and sports-related variables, with significant variables remaining in the model (p < .05), through a stepwise strategy.Results: The prevalence of UI in 118 athletes was 82 (70%), of which 19 (23%) had pure stress UI, 19 (23%) had pure urgency UI and 44 (54%) had mixed UI; with 50 (61%) athletes losing urine during training and 37 (45%) during competitions. Regarding the KAP survey, 37 athletes (31%) demonstrated adequate knowledge, 63 (53%) adequate attitude and zero adequate practice. In the multivariate analysis, a sports practice time of over 8 years and dyspareunia presented significant values, with odds ratios (OR) of 2.66 and 2.99, respectively. Knowledge was significantly associated with UI (OR 0.43). UI had a slight impact on QOL.Conclusions: There is a high prevalence of UI yet low levels of adequate knowledge and practice regarding the occurrence of UI in sports, with sports practice time over 8 years and dyspareunia factors predisposing female athletes to UI by 2.7 and 3 times, respectively. Athletes with adequate knowledge were 57% less likely to develop UI.

Co-infection of sexually transmitted pathogens and Human Papillomavirus in cervical samples of women of Brazil

BackgroundSome sexually transmitted infectious agents, such as Chlamydia trachomatis and Herpes simplex, cause local inflammation, and could contribute to Human Papillomavirus (HPV) and cervical lesion progression. Thus, the aim of this study was to determine any association between the presence of microorganisms of gynecological importance, sexual behavior, clinical and demographical variables to the development and progress of cervical lesions.MethodsOne hundred and thirty-two women between 14 and 78 years and living at Vitória da Conquista, Bahia, Brazil, were included (62 individuals with cervical lesions and 70 without lesions). They answered a questionnaire to provide data for a socioeconomic and sexual activity profile. Samples of cervical swabs were collected and analyzed by PCR to detect genital microorganisms and HPV. Quantitative PCR was used to detect and quantify Ureaplasma urealyticum and Ureaplasma parvum. Univariate and multiple logistic regression were performed to measure the association with the cervical lesions, and an odds ratio (OR) with 95% confidence intervals (95%CI) were calculated. The Mann-Whitney U test was also used to compare the microorganism load in the case and control groups. The significance level was 5% in all hypotheses tested.ResultsCervical lesions were associated with: women in a stable sexual relationship (OR = 14.21, 95%CI = 3.67–55.018), positive PCR for HPV (OR = 16.81, 95%CI = 4.19–67.42), Trichomonas vaginalis (OR = 8.566, 95%CI = 2.04–35.94) and Gardnerella vaginalis (OR = 6.13, 95%CI = 1.53–24.61), adjusted by age and qPCR for U. parvum. U. parvum load showed a statistical difference between the case and control groups (p-value = 0.002).ConclusionVariables such as stable relationship, HPV, T. vaginalis, G. vaginalis were associated with cervical lesions in epidemiological studies. U. parvum load was higher in woman with cervical lesions compared with women without lesions. Additional studies are needed to better understand the role of these factors in cervical lesion development.

The Association of Family History of Premature Cardiovascular Disease or Diabetes Mellitus on the Occurrence of Gestational Hypertensive Disease and Diabetes.

BackgroundGestational hypertensive diseases (GHD) and gestational diabetes mellitus (GDM) increase the risk of cardiovascular disease (CVD) later in life. However, the association between gestational medical diseases and familial history of CVD has not been investigated to date. In the present study, we examined the association between familial history of CVD and GHD or GDM via reliable questionnaires in a large cohort of registered nurses.MethodsThe Korean Nurses’ Survey was conducted through a web-based computer-assisted self-interview, which was developed through consultation with cardiologists, gynecologists, and statisticians. We enrolled a total of 9,989 female registered nurses who reliably answered the questionnaires including family history of premature CVD (FHpCVD), hypertension (FHH), and diabetes mellitus (FHDM) based on their medical knowledge. Either multivariable logistic regression analysis or generalized estimation equation was used to clarify the effect of positive family histories on GHD and GDM in subjects or at each repeated pregnancy in an individual.ResultsIn this survey, 3,695 subjects had at least 1 pregnancy and 8,783 cumulative pregnancies. Among them, 247 interviewees (6.3%) experienced GHD and 120 (3.1%) experienced GDM. In a multivariable analysis adjusted for age, obstetric, and gynecologic variables, age at the first pregnancy over 35 years (adjusted OR 1.61, 95% CI 1.02–2.43) and FHpCVD (adjusted OR 1.60, 95% CI 1.16–2.22) were risk factors for GHD in individuals, whereas FHH was not. FHDM and history of infertility therapy were risk factors for GDM in individuals (adjusted OR 2.68, 95% CI 1.86–3.86; 1.84, 95% CI 1.05–3.23, respectively). In any repeated pregnancies in an individual, age at the current pregnancy and at the first pregnancy, and FHpCVD were risk factors for GHD, while age at the current pregnancy, history of infertility therapy, and FHDM were risk factors for GDM.ConclusionsThe FHpCVD and FHDM are significantly associated with GHD and GDM, respectively. Meticulous family histories should be obtained, and women with family histories of these conditions should be carefully monitored during pregnancy.

Reproductive variables and gynaecological service use in delusional disorder outpatients

IntroductionOestrogens have been hypothesized to have a protective effect in psychotic disorders. Women with schizophrenia have a later age of menarche, fewer pregnancies and earlier age of menopause. However, little information is available focusing on delusional disorder (DD). We aimed to evaluate gynaecological variables and psychopathology, and rates of gynaecological service use in female DD outpatients. MethodsFourty-six outpatients with DD (DSM-IV-TR) were attended at the Hospital Clinic of Barcelona, from 2008 to 2013. Demographic and clinical variables, as well as gynaecological features were recorded in 25 women with DD. Hamilton Rating Scale for Depression-17 for depression, Positive and Negative Syndrome Scale for psychopathology, Personal and Social Performance for functionality, and Columbia Suicide Severity Rating Scale were assessed. ResultsMean age of menarche (SD) was 12.83(1.54) years, mean age of menopause 48.73(2.69), mean age at onset of DD was 48.70(13.03). 48% of the sample did not receive gynaecological attention in the last 2–3 years. No statistically significant correlations were found between age at menopause and age at onset of DD. Age at menopause showed a tendency to be negatively correlated with Personal and Social Performance total scores (r=−0.431; P=.074), and was positively associated with suicidal ideation intensity (r=0.541; P=.038). However, after controlling for social support variables, this relationship was no longer significant. ConclusionsAlthough a small sample size, this is the first study to specifically examine gynaecological variables in DD. Low compliance rates in gynaecological service use were found. No correlations between age at menopause and clinical variables were statistically significant.

Clinical course of illness in women with early onset puerperal psychosis: a 12-year follow-up study.

To complete a follow-up analysis at a mean of 12 years after patients had presented with an early onset puerperal psychotic index episode. A retrospective design was used. Patients with puerperal psychosis and onset within 4 weeks after childbirth who had been referred to the Psychiatric Department of the Ludwig Maximilian University of Munich, Munich, Germany, between 1975 and 1995 (maximum: 24 years, minimum: 7 years) were followed up after a mean of 12 years post index episode. Ninety patients were included in the study. Before the index episode, 35 of the patients had previous nonpuerperal psychoses, while 55 patients presented their index episode as the first manifestation of a psychotic illness. Diagnostic evaluation at follow-up was performed by the Structured Clinical Interview for DSM-IV Axis I Disorders according to DSM-IV-TR. Differential rates of risk of psychotic relapse were calculated. Data on some gynecologic variables (postpartum blues, premenstrual tension, psychiatric symptoms triggered perimenstrually, mood symptoms while taking oral contraceptives) were collected. Clinical and psychosocial outcomes were measured by the Global Assessment Scale and Disability Assessment Scale. Patients who presented with major depression and bipolar affective disorder with psychotic features at the initial index episode showed overall diagnostic stability. Many patients with initial brief psychosis (cycloid psychosis) shifted to a clear bipolar affective disorder. The general risk of a psychotic relapse was high (previous psychosis = 0.77 vs first psychotic manifestation = 0.56; not significant). The risk after further pregnancies was 0.57 versus 0.48, respectively (not significant), and the risk regarding at least 1 other psychotic nonindex episode was 0.71 versus 0.44, respectively (P = .015). Gynecologic variables did not significantly discriminate between the groups. In some patients, a possible link to a hormonal susceptibility was discussed. Patients who remained without any further psychotic relapse (n = 24) had a favorable outcome. Puerperal psychosis of an early onset seemed to be of a prevailing affective nature. Brief psychosis (cycloid psychosis) during a puerperal index episode showed a strong link to bipolar affective disorder in the further course of illness. Outcome was excellent in patients without a further psychotic relapse.

Variables reproductivas y uso de consulta ginecológica en pacientes con trastorno delirante

Oestrogens have been hypothesized to have a protective effect in psychotic disorders. Women with schizophrenia have a later age of menarche, fewer pregnancies and earlier age of menopause. However, little information is available focusing on delusional disorder (DD). We aimed to evaluate gynaecological variables and psychopathology, and rates of gynaecological service use in female DD outpatients.Fourty-six outpatients with DD (DSM-IV-TR) were attended at the Hospital Clinic of Barcelona, from 2008 to 2013. Demographic and clinical variables, as well as gynaecological features were recorded in twenty-five women with DD. Hamilton Rating Scale for Depression-17 for depression, Positive and Negative Syndrome Scale for psychopathology, Personal and Social Performance for functionality, and Columbia Suicide Severity Rating Scale were assessed.Mean age of menarche (SD) was 12.83(1.54) years, mean age of menopause 48.73(2.69), mean age at onset of DD was 48.70(13.03). 48% of the sample did not receive gynaecological attention in the last 2-3 years. No statistically significant correlations were found between age at menopause and age at onset of DD. Age at menopause showed a tendency to be negatively correlated with Personal and Social Performance total scores (r = -0.431; P = .074), and was positively associated with suicidal ideation intensity (r = 0.541; P = .038). However, after controlling for social support variables, this relationship was no longer significant.Although a small sample size, this is the first study to specifically examine gynaecological variables in DD. Low compliance rates in gynaecological service use were found. No correlations between age at menopause and clinical variables were statistically significant.

Treatment of anterior vaginal wall prolapse with and without polypropylene mesh: a prospective, randomized and controlled trial - Part II

To compare the effects of two surgical procedures for the correction of anterior vaginal wall prolapse (AVWP) on the lower urinary tract symptoms (LUTS) using symptom questionnaires and quality of life (QoL). One hundred women with Pelvic Organ Prolapse Quantification stage (POP-Q) ≥ 2 were randomly distributed in two preoperatory groups. The first group (mesh) (n = 45) received a polypropylene mesh (PM) implant and the control group (n = 55) was submitted to anterior colporraphy with or without synthetic sling. Postoperatory follow-up was done after 12 months. The primary objective was to compare the effect of the surgeries on LUTS using the final scores of the International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) and Overactive Bladder Questionnaire (OAB-V8), as well as the analysis of the incapacitating urinary symptoms and ″de novo″ urinary symptoms after 12 months of surgery in both groups. Although there was a different number of women in each group, randomization was adequate, resulted in homogeneous groups that could be compared regarding socio demographic, clinical and gynecological (POP-Q) variables. Patients of both groups showed improvements regarding LUTS and QoL, whether using polypropylene mesh or not, based on the final scores of the ICIQ-UI SF and OAB-V8 questionnaires after 12-month follow-up. There were few incapacitating and ″de novo ″ urinary symptoms, without any significant statistical difference between both groups after 12 months of surgery. There was a general improvement of LUTS and QoL in both groups after 12-month follow-up. However, there was no significant difference of LUTS, as well as the more incapacitating and ″de novo ″ urinary symptoms between both groups after 12 months of surgery.

1229 – What about antenatal depressive symptoms correlates/risk factors?

Introduction In comparison with postnatal depressive symptoms, few studies considered antenatal depressive symptoms risk factors/correlates. Objectives/aims In a multidimensional work our aim was to explore the associations/predictive role of lifetime and current pregnancy variables for antenatal depressive symptoms. Methods Two hundred and thirty six women (M = 30.5; SD =4.02; variation = 19-41), at the third pregnancy trimester were interviewed with the DIGS/OPCRIT (to make lifetime/current depression diagnoses) and answered a booklet about sociodemographic variables, lifetime/current insomnia, current stress perception, perception of being an anxious person, gynecological variables, past health perception and pregnancy health problems, among others. They filled in the Profile of Mood States to assess anxious symptoms, Negative and Positive affect and the Postpartum Depression Screening Scale (PDSS) to assess antenatal depressive symptoms at pregnancy. Women with a depression diagnosis (DSM-IV/ICD-10, n =5) and on sleep medication at pregnancy were excluded from the analyses. Results We found significant associations between antenatal depressive symptoms (PDSS total score), current job situation, perception of being an anxious person, lifetime history of depression (DSM-IV/ICD-10), past health perception, health problems at current pregnancy, stress perception at pregnancy, lifetime and current insomnia, anxious symptoms at pregnancy, Negative and Positive affect. In an hierarquical multiple regression past health perception, negative affect, positive affect and current insomnia were significant predictors of antenatal depressive symptoms. Conclusions Past health perception, negative affect (anxious and depressive symptoms) and insomnia at current pregnancy seem to be risk factors/correlates for the outcome. Positive affect seems to work as a protective correlate.

2280 – Oestrogen related features and gynaecological service use in delusional disorder

Introduction Oestrogens may be a protective factor in psychosis. Women with schizophrenia have a later age of menarche, fewer pregnancies and earlier age of menopause. However, little information is available focusing on delusional disorder (DD). Objectives To evaluate gynaecological variables and psychopathology in women with DD. Aim To investigate the relationship between age of menarche and onset, and psychopathology in DD. Methods Forty-five outpatients with DD (DSM-IV-TR) were recruited at the Hospital Clinic of Barcelona, from 2008 to 2012. Twenty-five females underwent a demographic and gynaecological questionnaire. HRSD-17 for depression, PANSS for psychopathology, PSP for functionality and C-SSRS for suicide were assessed. The sample was divided into two groups according to the age of menarche: 12 years or less and more than 12. Results Mean age of menarche (SD) was 12.6(1.4) years, mean age of menopause 49.1(3.15), mean age at onset of DD was 49.9(12.58). 33.3% of the sample did not receive gynaecological service in the last 3 years. The group with the earliest age of menarche was older [67.33(11.67) vs.56(9.6); p=0.026], presented an earlier age of menopause [46.80(2.84) vs.50.71(2.29) p=0.018] and latest onset of DD (53.50(14.32) vs.47.44(11.5); p=NS], than those with later age of menarche. No differences were found regarding psychopathology, suicidal behaviour or functionality. Conclusions Although a small sample size, this is the first study to specifically examine gynaecological variables in DD. A low compliance rate in gynaecological service use was found. An earlier age of menarche was associated to an earlier age of onset of DD.

Stress urinary incontinence in climacteric women in a northeastern Brazilian municipality: a household survey

Low socioeconomic factors may influence the development of stress urinary incontinence (SUI). Thus far, there is little research available on SUI in developing countries. We aimed to determine whether the prevalence of SUI in a northeastern Brazilian municipality was higher or lower than in the general female population. Cross-sectional household cluster study of 1,180 climacteric women in the São Luís municipality (Maranhão state, Brazil) was conducted using a standardized questionnaire that was previously tested in a pilot study and administered by interviewers to obtain socioeconomic and cultural information, climacteric aspects, and life habits related to SUI. From this population, 15.34% (n = 181) had SUI; this prevalence did not change with age. More than half (57.92%) of the patients replied that they had not consulted a physician for their SUI. The presence of SUI was not associated with any socioeconomic or gynecological variables after multivariate analysis. The prevalence of SUI in São Luís was similar to the rates observed in the general global female population. Socioeconomic and gynecological variables were not associated with SUI.

¿Cómo perciben las puérperas inmigrantes la atención recibida en el servicio de Obstetricia del complejo hospitalario de Albacete?

To describe the level of satisfaction of women who come to the University Hospital of Albacete (CHUA), as regards the health carereceived upon admission for giving birth and during the immediate postnatal period, and to evaluate if the socio-demographic variable has an influence on user satisfaction of the delivery room service.Descriptive and cross-sectional study carried out through an interview in order to obtain data on the socio-demographic, obstetric and gynaecological variables, together with a satisfaction questionnaire for women in the puerperium period at the CHUA, reference hospital of the Health Area in Albacete, in the Obstetrics Service. The selection was made by systematic sampling, in which immigrants and Spanish born women were enrolled according to the inclusion criteria.We found that 92.1% (164) of Spanish-born women carry out a proper integral control of pregnancy, compared to 63.4% (109) of immigrants (χ(2)=42.172; gl=1; P=.000). The majority (87.5%, 287) of the total number of satisfied women thought that the midwife interest was better or much better than they expected (χ(2)=102.466; gl=4; P=.000). The large majority of satisfied women (95.81%, 320) would recommend the hospital, while the number of unsatisfied women had doubts (χ(2)=93.680; gl=2; P=.000).The socio-demographic variables did not appear to have an influence on the overall satisfaction of the women, except for the age. In general, both the autochthonous and immigrant women were satisfied with the attention received in the CHUA Delivery room.

Predictors of intimate partner violence in women seeking medication abortion

Background High rates of intimate partner violence (IPV) have been reported among women seeking surgical abortion. Women seeking medication abortion differ from surgical abortion patients on many measures. The rate of IPV among medication abortion patients is unknown. Study Design The Modified Abuse Assessment Questionnaire was administered to 1128 women at enrollment into a prospective, multicenter medication abortion trial. Results Twenty-three percent of subjects reported ever experiencing IPV. Women reporting IPV were significantly more likely to be white and less likely to be married. They were more likely to have had previous spontaneous and induced abortions, and were more likely to incorrectly estimate their gestational age (GA). Conclusion The rate of IPV in this study was similar to the background US rate. Few demographic variables are predictive of IPV among women seeking medication abortion. Gynecologic variables associated with IPV are consistent with less control over reproductive health.

The diurnal course of salivary alpha-amylase in nurses: An investigation of potential confounders and associations with stress

In psychoneuroendocrinology research, salivary measures have become increasingly important. While several studies focus on determinants of salivary cortisol such as age, gender, and gynaecological variables, less research has focused on confounding variables of salivary alpha-amylase (sAA). In a large sample of nurses (N=215) we analyzed the impact of age, gender, intake of oral contraceptives, smoking, coffee consumption as well as psychological parameters, such as work stress and burnout, on basal diurnal sAA release. Saliva was collected at 07:00h, 11:30h, 17:30h, and 20:00h on a working day during early shift. Only gender could be identified to have an impact on sAA, with females having a more pronounced sAA increase over the course of the day. Whereas depression, anxiety, work stress and burnout were not associated with sAA, a small negative correlation between social difficulties, measured with the Chronic Stress Screening Scale, and sAA could be identified.