Health Outcomes For Women Research Articles

Managing menopause in women with diabetes

The impact of the current diabetes pandemic on the menopause experiences and health outcomes of women with diabetes is under-researched and poorly understood. Type 2 diabetes mellitus (T2DM) often emerges during midlife and, in women, frequently presents synchronously with menopause, which independently increases the cardiometabolic risk. Recent interest in menopause has highlighted the lack of clinical evidence upon which to base menopause management recommendations for women with diabetes. Most evidence relating to safety and efficacy of menopause hormone therapy (MHT), the first-line treatment for menopause symptoms, is based mainly on Caucasian, socially advantaged women with low rates of co-morbidity. The dearth of data relating to MHT in women with diabetes means that much evidence for women with diabetes relies on extrapolation. A nuanced and judicious approach to the management of menopause in women with diabetes and associated co-morbidities is, therefore, crucial. This review focuses on the postmenopausal health risks in women with diabetes and the impact of different types of MHT. It highlights areas of uncertainties and unmet need in menopause care for this cohort of women.

Trauma and Risk of Adverse Mental Health Outcomes in Women

Trauma and Risk of Adverse Mental Health Outcomes in Women

The impact of high-intensity interval training on insulin sensitivity and quality of life in women with overweight polycystic ovary syndrome

Background Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder in women of reproductive age, characterized by menstrual irregularities, hyperandrogenism, and polycystic ovaries. Insulin resistance is central to its pathophysiology, contributing to metabolic disturbances and increased cardiometabolic risks. High-Intensity Interval Training (HIIT) has emerged as a promising intervention to improve metabolic health. Objective This study aimed to investigate the specific effects of HIIT on insulin sensitivity, body composition, metabolic profile, and quality of life in women with overweight PCOS. Methods A retrospective analysis was conducted on 107 female patients with overweight PCOS who were divided into two groups: the Regular Interval Training Group (n = 54) and the HIIT Group (n = 53). Baseline data, including insulin sensitivity, glucose metabolism, body composition, metabolic profile, and quality of life, were measured and compared between the two groups. Results The HIIT Group demonstrated significantly improved insulin sensitivity, reduced fasting glucose levels, lower HOMA-IR index, lower body fat percentage, decreased waist and hip circumferences, improved favorable changes in metabolic profile, and significant improvements in quality of life compared to the Regular Interval Training Group. These findings suggest that HIIT led to beneficial outcomes across various metabolic and clinical parameters in women with overweight PCOS. Conclusion The findings of this study highlight the potential of personalized exercise prescriptions, such as HIIT, in optimizing health outcomes in women with overweight PCOS. The observed improvements in insulin sensitivity, body composition, metabolic profile, and quality of life underscore the promising role of HIIT in addressing the multifaceted implications of PCOS and its associated metabolic and reproductive implications.

Obstetrics and gynecology devices designed for low- andmiddle-income countries: A narrative review.

There are many barriers contributing to poor health outcomes for women in low- and middle-income countries (LMICs), one of which is the lack of necessary medical devices. Presently, the development of various kinds of devices intended to improve women's health outcomes specifically in LMICs remains underrepresented in the literature; therefore, we performed a narrative review to understand this current state of literature. A literature search was conducted in Scopus and Overton between December 2023 to February 2024, and PubMed in October 2024 to broadly explore peer-reviewed publications focusing on understanding the development of devices used specifically in obstetrics and gynecology (OBGYN) care in LMICs. The initial search identified 132 published manuscripts: 114 non-duplicates from 1993 to 2024. After a two-research team member independent review, 22 manuscripts from 2011 to 2023 were included, and 18 devices identified. Nine devices focus on postpartum hemorrhage, four on general obstetrics, one on fetal monitoring, one on vaginal deliveries, one on gynecology hemorrhage, one on gynecology screening, and one on OBGYN anesthesia. This review provides recommendations for areas of improvement of key gaps affecting the development and implementation of OBGYN devices for use in LMICs. Recommendations are provided for various stages of the development to early commercialization phases. We believe future incorporation of these recommendations can aid in equitable and implementable medical device design for OBGYN care in LMICs.

Mitochondria: the epigenetic regulators of ovarian aging and longevity.

Ovarian aging is a major health concern for women. Ovarian aging is associated with reduced health span and longevity. Mitochondrial dysfunction is one of the hallmarks of ovarian aging. In addition to providing oocytes with optimal energy, the mitochondria provide a co-substrate that drives epigenetic processes. Studies show epigenetic alterations, both nuclear and mitochondrial contribute to ovarian aging. Both, nuclear and mitochondrial genomes cross-talk with each other, resulting in two ways orchestrated anterograde and retrograde response that involves epigenetic changes in nuclear and mitochondrial compartments. Epigenetic alterations causing changes in metabolism impact ovarian function. Key mitochondrial co-substrate includes acetyl CoA, NAD+, ATP, and α-KG. Thus, enhancing mitochondrial function in aging ovaries may preserve ovarian function and can lead to ovarian longevity and reproductive and better health outcomes in women. This article describes the role of mitochondria-led epigenetics involved in ovarian aging and discusses strategies to restore epigenetic reprogramming in oocytes by preserving, protecting, or promoting mitochondrial function.

Gender equity and women’s health: a comparative analysis on governmental strategies in Central America

Gender inequalities manifest when one gender intentionally exercises or obtains some form of advantage through internalized social means, which are typically oppressive and disparate. In the field of health, gender inequalities provide a rationale for the observed disparities in women's health outcomes and the greater difficulties they face in achieving comprehensive development. The present study sought to undertake a descriptive analysis of strategies designed to combat gender inequalities and promote women's health in Continental Central America. This entailed a documentary analysis of official documents published by national and regional organizations with a specialization in gender equality and women's health. The analysis revealed that all countries have a national action plan to combat gender inequalities and promote fairer and more inclusive societies in all spheres of human life. From a regional perspective, the countries have had the Regional Gender Equality and Equity Policy of the Central American Integration Scheme since 2013. This is the principal instrument used to advance the well-being of women in the region. With respect to health promotion, documents such as a technical report and a regional policy have been identified, which delineate the pathways that Central American countries should pursue to achieve optimal well-being for their female populations.

Gender equity and women’s health: a comparative analysis on governmental strategies in Central America

Gender inequalities manifest when one gender intentionally exercises or obtains some form of advantage through internalized social means, which are typically oppressive and disparate. In the field of health, gender inequalities provide a rationale for the observed disparities in women's health outcomes and the greater difficulties they face in achieving comprehensive development. The present study sought to undertake a descriptive analysis of strategies designed to combat gender inequalities and promote women's health in Continental Central America. This entailed a documentary analysis of official documents published by national and regional organizations with a specialization in gender equality and women's health. The analysis revealed that all countries have a national action plan to combat gender inequalities and promote fairer and more inclusive societies in all spheres of human life. From a regional perspective, the countries have had the Regional Gender Equality and Equity Policy of the Central American Integration Scheme since 2013. This is the principal instrument used to advance the well-being of women in the region. With respect to health promotion, documents such as a technical report and a regional policy have been identified, which delineate the pathways that Central American countries should pursue to achieve optimal well-being for their female populations.

Long-Term Effects of Fertility Treatments on Maternal Health.

Background The long-term health effects of assisted reproductive technologies, including in vitro fertilization (IVF) and hormonal therapies, remain poorly understood. This highlights the need to investigate potential chronic conditions that may arise following treatment. Objective The objective of this study was to investigate the long-term effects of fertility treatments on maternal health, with a focus on the incidence of chronic conditions and overall health outcomes in women who have undergone such treatments. Methodology This cross-sectional study included 180 women, aged 20-45, who had received fertility treatments and successfully delivered a live child. The research was conducted at Rehman Medical Institute and Hayatabad Medical Complex in Peshawar, Pakistan, from January to December 2023. Data were collected through medical record reviews and structured interviews to assess long-term health outcomes, including cancer, metabolic disorders, and cardiovascular diseases. Descriptive statistics and logistic regression were applied using IBM SPSS Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, NY, USA), with a significance threshold set at p < 0.05. Results The study included 180 participants with an average age of 34.5 years. Among them, 73 (40.56%) underwent hormone therapy, 81 (45.00%) used IVF, and 26 (14.44%) used intracytoplasmic sperm injection. All participants delivered live births, with 21 (11.67%) experiencing premature deliveries and 33 (18.33%) having multiple pregnancies. Key findings showed that nine (5.00%) developed cancer, 31 (17.22%) had metabolic disorders, and 24 (13.33%) developed cardiovascular disease. Overall, 146 (81.11%) participants reported excellent long-term health, while 34 (18.89%) had new diagnoses, including 12 (6.67%) with cardiovascular disease, 18 (10.00%) with metabolic disorders, and four (2.22%) with cancer. Additionally, 36 (20.00%) had preeclampsia, 21 (12.00%) experienced OHSS, and 12 (7.00%) developed gestational diabetes. Conclusions Despite most participants reporting excellent overall health, the study underscores the need for ongoing monitoring and management, as it reveals significant long-term health risks associated with fertility treatments.

The Effect of Job Insecurity on Women’s Mental Health

Job insecurity on women’s mental health is a growing concern in these days in labour market, where economic instability. Women often experience heightened jobs insecurity due to factors like gender discrimination, caregiving responsibilities and the prevalence of part time or temporary positions. This insecurity can lead to significant psychological distress, manifesting as anxiety, depression and diminished self- esteem. The objective is to examine how job insecurity influences mental health outcomes in women, to identify the specific factors contributing to job insecurity for women. The study is based on secondary data such as books, journals, newspaper, government reports and internet etc. The main finding of the study is to increase psychological distress, organizational role to support for reduce negativity, stress and insecurity in women workplace and enhance their capability in workplace. The study suggests that increased job securities, fair wages and transparent communication regarding job expectations and security. The government should take steps for them maintain mantle health, supporting program, including counseling services and stress management workshops. They should equal rights to women in workplace to maintain women’s mental health.

8699 ​​Efficacy of Glucagon-like Peptide-1 Analogs In Women With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Abstract Disclosure: F.A. Kelly: None. A.D. Lôbo: None. I.P. da Silva: None. J.C. Cardoso: None. M.S. Barros: None. F.D. Pessôa: None. M.G. Leite: None. R.Y. Ura Sudo: None. A.M. De Almeida: None. F.A. Moraes: None. V. Morbach: None. M.C. Souza: None. P.G. Lima: None. M.P. Lima: None. I.B. Andrade: None. M.B. Jardine: None. L.M. Lopes: None. Polycystic ovary syndrome (PCOS) affects one in ten women of reproductive age, painting a complex picture of metabolic dysfunction. Its hallmark triad includes irregular menstrual cycles, androgen excess, and polycystic ovaries. Beyond infertility concerns, PCOS carries a heavy burden of metabolic imbalances, often characterized by insulin resistance, dyslipidemia, and chronic low-grade inflammation. These intertwined factors place women with PCOS at increased risk for type 2 diabetes and cardiovascular disease, posing a significant long-term health challenge. Current first-line treatments like metformin focus mainly on managing insulin resistance and regulating menstrual cycles. However, unmet needs remain in addressing the broader metabolic derangements and preventing associated health complications. In light of this, glucagon-like peptide-1 (GLP-1) analogs have emerged as potential game-changers in the PCOS treatment landscape. Their multifaceted effects on metabolism beyond blood sugar regulation offer a promising avenue for optimizing care and improving long-term health outcomes in women with PCOS. This meta-analysis aims to evaluate the use of GLP-1 analogs on patients with PCOS to reduce body mass index (BMI), glycated hemoglobin (HbA1C), fasting blood glucose (FBG), high density lipid (HDL), low density lipid (LDL) and triglyceride. PubMed, Embase, and Cochrane databases were systematically searched for randomized controlled trials (RCT) comparing the use of GLP-1 analogs to placebo or other therapies in patients with PCOS. Treatment effects for continuous endpoints were pooled through mean differences (MD) with 95% confidence intervals. Heterogeneity was evaluated with the Cochran Q test, the prediction interval and I² statistics. Statistical analysis was performed in Revman 5.4. The results were reported following the Preferred Reporting Items for Systematic Review (PRISMA) guidelines.A total of 4 RCTs with 228 patients were included, of whom 137 were randomized to GLP-1 therapy, 58 to placebo, and 33 to other treatments. Over a mean follow-up time of 24 weeks, patients submitted to GLP-1 analogs presented significant decreases in HbA1C (MD -1.40%; 95% CI -1.64 to -1.16; p&amp;lt;000001; I²=0% ), FBG (MD -4.40 mg/dL; 95% CI -7.63 to -1.17; p=0.008; I²=0%) and HDL-c (MD -0.82 mg/dL; 95% CI -1.33 to -0.31; p=0.002; I²=3%); and a nonsignificant increase in LDL-c (MD 0.37 mg/dL; 95% CI -1.30 to 2.03; p=0.67; I²=0%); and nonsignificant decrease in BMI (MD -1.28 Kg/m²; 95% CI -3.18 to 0.63; p=0.19; I²=98%), and triglyceride (MD -10.50 mg/dL; 95% CI -22.81 to 1.81; p=0.09; I²=0%).In this meta-analysis of RCTs of patients with PCOS, the use of GLP-1 analogs showed a significant reduction in HbA1C, FBG, and HDL-c. A larger sample size of people are needed for further statistical analyses. Presentation: 6/3/2024

Analysis of breast health outcomes in women on oral 5-alpha reductase inhibitors: A single-center retrospective cohort study

Analysis of breast health outcomes in women on oral 5-alpha reductase inhibitors: A single-center retrospective cohort study

Association between exposure to perfluoroalkyl substances (PFAS) and endometriosis in the ENDEA case-control study

BackgroundPerfluoroalkyl substances (PFAS) are environmental contaminants present in a wide range of consumer products and frequently detected in drinking water. They have been linked to adverse reproductive health outcomes in women, but there is limited human evidence on the association of PFAS exposure with endometriosis. Objective/AimTo explore the association between plasma concentrations of several PFAS, considered individually and as a mixture, and the risk of endometriosis in women of childbearing age. MethodsBetween 2018 and 2020, 42 patients with endometriosis and 90 controls undergoing abdominal surgery were recruited at two public hospitals in Granada, Spain. The presence or absence of endometriosis was ascertained by laparoscopic inspection of the pelvis and biopsy of suspected lesions (histological diagnosis). Concentrations of 10 PFAS were quantified in plasma samples from participants. Unconditional logistic regression was employed to examine associations of individual PFAS and summed concentrations of short (∑SC) and long-chain (∑LC) PFAS with odds of endometriosis, and quantile g-computation was used to assess their mixture effect. ResultsIn models adjusted for age, schooling, and parity, perfluorotridecanoic acid (PFTrDA) was associated with higher odds of endometriosis (odds ratio [OR] = 1.74; 95 % CI = 1.11–2.73 per 2-fold increase in plasma concentrations), while marginally significant associations were found for perfluorohexane sulfonate (PFHxS) (OR = 1.45, 95 % CI = 0.94–2.21) and ∑SC PFAS (OR = 1.48; 95 % CI = 0.96–2.30). No associations were found for the remaining PFAS. The PFAS mixture was non-significantly associated with 1.7-fold higher odds of endometriosis (95 % CI = 0.73–3.80), with perfluorononanoic acid (PFNA), PFHxS, and PFTrDA being the major contributors to this effect. ConclusionsThese findings suggest that exposure to certain PFAS may increase the odds of endometriosis. However, given the modest sample size, further studies are warranted to verify these results.

The effect of long-term care insurance on women’s health outcomes in China: evidence from a disability inclusion action

BackgroundLong-term care insurance (LTCI) in China provides financial and care security for persons with disabilities and includes caregivers in the paid labour workforce. However, it is unclear how the LTCI affects health outcomes in female recipients, female caregivers, and female non-recipients and female non-caregivers.MethodsUsing the China Health and Retirement Longitudinal Study data and staggered difference-in-differences method, we evaluated the effect of LTCI on health outcomes in women with different roles, including female recipients, female caregivers, and female non-recipients and female non-caregivers, and discussed the heterogeneity of the effect on women’s health outcomes.ResultsLTCI statistically significant increased self-rated health and reduced depression in women and improved the health in women with different roles by increasing self-rated health in female recipients, reducing chronic diseases in female caregivers, and reducing depression in female non-recipients and female non-caregivers. There was a more pronounced improvement in health outcomes among women in the west and northeast and women in rural village.ConclusionsAfter the implementation of LTCI, health outcomes in female recipients, female caregivers, and female non-recipients and female non-caregivers were improved. LTCI’ improvement on women’s health outcomes was heterogeneous geographically and socially. Our findings highlight the importance of delivering differentiated health interventions for women with different roles in the implementation process of LTCI and minimizing women’s health inequalities in geography and society.

Artificial Intelligence in Obstetrics and Gynecology: Transforming Care and Outcomes.

The integration of artificial intelligence (AI) in obstetrics and gynecology (OB/GYN) is revolutionizing the landscape of women's healthcare. This review article explores the transformative impact of AI technologies on the diagnosis, treatment, and management of obstetric and gynecological conditions. We examine key advancements in AI-driven imaging techniques, predictive analytics, and personalized medicine, highlighting their roles in enhancing prenatal care, improving maternal and fetal outcomes, and optimizing gynecological interventions. The article also addresses the challenges and ethical considerations associated with the implementation of AI in clinical practice. This paper highlights the potential of AI to greatly improve the standard of care in OB/GYN, ultimately leading to better health outcomes for women, by offering a thorough overview of present AI uses and future prospects.

Associations of parity and cognitive decline, depression, and chronic comorbidity in West China: Results from WCHAT study.

To investigate the associations between parity (the number of offspring a female has borne) and cognitive function, depression, and chronic comorbidity in Western China. A total of 846 women aged 50-55 years were included in the current analysis. Cognitive status was measured using a 10-item short portable mental status questionnaire (SPMSQ). Depressive symptoms were assessed using the 15-item geriatric depression scale (GDS-15). Other characteristics were self-reported. The associations between parity and cognitive decline, depression, and chronic comorbidity were analyzed using univariable and multivariable models. Multivariable models were adjusted for age, ethnic group, occupation, marital status, educational level, lifestyle factors, and sleeping time. Among the enrolled women, 26.71% were either childless or had one child, 47.40% had two children, 18.32% had three children, and 7.57% had ≥4 children. Compared to women with low parity, women with two or more children exhibited a higher risk of cognitive decline. Moreover, having four or more children was significantly associated with depression and chronic comorbidity. After adjusting covariates, women with three or more children exhibited a higher risk of cognitive decline than those with low parity. However, high parity was not significantly associated with depression or chronic comorbidity after adjustment for covariates. Our study showed that ≥3 children was associated with cognitive decline in women. Longitudinal studies are needed to evaluate this conclusion and to investigate the mechanisms involved. More importantly, families and societies should pay more attention to women's long-term health outcomes related to fertility.

Modulatory Effects of Vitamin D: A Possible Approach to Mitigate Air Pollution Related Pregnancy Complications.

Approximately 99% of people on the planet breathe air that exceeds the World Health Organization's permitted threshold for pollution. South Asia is home to the world's most polluted cities. Population-based studies have suggested that women's reproductive health outcomes are worsening due to air pollution. Preeclampsia, miscarriage, gestational diabetes, high blood pressure, and unfavorable birth outcomes, including preterm birth, low birth weight, or even stillbirth are all linked to exposure to air pollution during pregnancy. It is estimated that 0.61 million deaths in India alone were related to indoor air pollution. Females frequently cook in the household using solid fuel as a primary combustion source. Women in the regions with the highest population density are disproportionately affected by high levels of poor-quality indoor air. Recently, it has been proposed that air pollution has a distinct role in the onset of vitamin D deficiency. Numerous studies have explored associations between low vitamin D level and various female reproductive health conditions since the discovery of the vitamin D receptor. It is worthy to note that some of these reproductive health conditions positively correlate with the severity of air pollution. In this study, the evidence has been synthesized on vitamin D's protective properties and dietary and pharmaceutical interventions have been discussed to show their beneficial effects in decreasing the long-term negative impacts of air pollution on women's health.

What is known about the use of weight loss medication in women with overweight/obesityon fertility and reproductive health outcomes? A scoping review.

Pregnancy during or soon after treatment with weight loss medication, particularly glucagon-like peptide-1 receptor agonists (GLP-1 RAs), is contraindicated due to potential teratogenicity. The aim of this scoping review is to investigate what is known about the use of weight loss medication in women of childbearing age in relation to reproductive health outcomes, focusing on the three medications licenced in the United Kingdom at the time of the search. A systematic search of studies that assessed reproductive health outcomes in women taking either orlistat, liraglutide or semaglutide was undertaken in July 2023 and updated in January 2024 across MEDLINE, Embase, CINAHL, Scopus, ClinicalTrials.gov, PROSPERO, Epistemonikos and OpenGrey. Studies focused on polycystic ovarian syndrome, diabetes or animals were excluded. Titles and abstracts were screened, and data from included articles were extracted. After removal of duplicates, 341 titles remained, of which 318 were excluded. Of the final 18 articles included, there were five interventional trials, one retrospective case-control study, six narrative reviews, two systematic reviews, three systematic review protocols and one registry protocol yet to start recruitment. All five interventional trials involved orlistat given preconceptionally, showing no improvement in live birth rate, despite improvement in reproductive hormone levels. There were no studies with primary data about GLP-1 RAs. There were no qualitative studies. There is an absence of primary data about the role of GLP-1 RAs on the reproductive health of women of childbearing age without polycystic ovarian syndrome. Future research should explore short- and long-term effects on reproductive health, pregnancy outcomes and experiences.

Disparity by caste and tribe: Understanding women's empowerment and health outcomes in India

AimWomen's empowerment status varies greatly in India according to caste, class, ethnicity and region. This paper aims to investigate the caste/tribe disparity in women's empowerment by region, the main correlates of each domain of empowerment, and the association of women's empowerment with nutritional and health care access outcomes, specifically anaemia, menstrual hygiene, and institutional delivery. MethodologyUsing National Family Health Survey-5 (2019–2021) data, we have created a modified survey-based women's empowerment index (SWPER) using principal component analysis with Oblique varimax rotation. The first four components are interpreted as an attitude to violence, freedom of movement, decision-making power and social independence. Several multivariate regression models were used to understand the factor associated with empowerment and the association of women's empowerment with different health outcomes. ResultsThe results indicate that women from the forward castes are the most empowered in most domains except decision-making. However, after controlling other background variables, the forward castes women are found to be the most empowered in attitude to violence, whereas Scheduled Castes and Scheduled Tribes women were found to be the most empowered women in decision-making. With regards to social independence, deprived castes women are more empowered than the forward castes women. The likelihood of empowerment in social independence domain increases with increasing wealth. There are wide regional variations in empowerment level between different social groups. Caste/tribe identity plays a significant role in determining health outcomes in India. Among all empowerment domains, social independence emerges as the most significant associated factor with improved health across all caste/tribe groups. ConclusionThe path to women's empowerment in India must recognize the intersectionality of caste/tribe identities, and address regional disparities. Social independence emerges as a critical determinant across all caste/tribe groups for improving health. Measures should be taken to empower women through the underlying factors of social independence.

(112) SEXUAL HEALTH AFTER RISK REDUCING SALPINGO-OOPHERECTOMY FOR BRCA PATIENTS

Abstract Introduction There is no study assessing the changes in sexual health after risk reducing oopherectomy in premenopausal women. Objective Objective: To evaluate the effect of risk-reducing salpingo-oophorectomy (RRSO) on change in sexual function in women aged 34-50 years with pathogenic variants in BRCA1 or BRCA2 (BRCA1/2). Methods Methods: The PROSper (Prospective Research of Outcomes after Salpingo-oophorectomy) study is a prospective cohort of women aged 34-50 years with BRCA1 or two germline pathogenic variants that compares health outcomes after RRSO to a non-RRSO control group with ovarian conservation. Women aged 34-50 years, who were planning either RRSO or ovarian conservation, were enrolled for 3 years of follow-up. Sexual Function was measured using the Sexual Health Outcomes in Women (SHOW-Q) a validated survey tool that measures sexual desire, frequency, satisfaction, orgasm, and discomfort specifically in patients with a history of a pelvic condition, including oophorectomy. Differences in sexual function between the RRSO and non-RRSO groups, were determined by using mixed effects multivariable linear regression models. Results Results: Of 100 PROSper participants, all completed SHOW Q. At baseline patients who had undergone RRSO before enrollment had lower SHOW-Q scores (71 vs 64). Across all 60 months of the study the SHOW-Q scores remained persistently lower in those undergoing RRSO raging from 6-13 points across the time studied (p &amp;lt;0.05) controlling for age, depression, partner, menopausal symptoms and hormone therapy Conclusions Conclusion: Women with pathogenic variants in BRCA1/2 who undergo RRSO before the age of 50 years have greater effects on sexual function than those that do not. The detrimental effect of rRRSO is not otherwise explained by hormone therapy, depression or menopausal symptoms. This information should be incorporated into counseling and post op management to consider options to improve sexual health post surgery Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: sprout pharma.

Time to initiation of antenatal care and its predictors among pregnant women who delivered in Arba Minch town public health facilities, Gamo Zone, southern Ethiopia, 2023: a retrospective follow-up study

BackgroundEarly antenatal care visit is important for optimal care and health outcomes for women and children. In the study area, there is a lack of information about the time to initiation of antenatal care. So, this study aimed to determine the time to initiation of antenatal care visits and its predictors among pregnant women who delivered in Arba Minch town public health facilities.MethodsAn institution-based retrospective follow-up study was performed among 432 women. A systematic random sampling technique was employed to select the study participants. The Kaplan-Meier survival curve was used to estimate the survival time. A Multivariable Cox proportional hazard regression model was fitted to identify predictors of the time to initiation of antenatal care. An adjusted hazard ratio with a 95% confidence interval was used to assess statistical significance.ResultsThe median survival time to antenatal care initiation was 18 weeks (95% CI = (17, 19)). Urban residence (AHR = 2.67; 95% CI = 1.52, 4.71), Tertiary and above level of education of the women (AHR = 1.90; 95% CI = 1.28, 2.81), having pregnancy-related complications in a previous pregnancy (AHR = 1.53; 95% CI = 1.08, 2.16), not having antenatal care for previous pregnancy (AHR = 0.39; 95% CI = 0.21, 0.71) and unplanned pregnancy (AHR = 0.66; 95% CI = 0.48, 0.91) were statistically significant predictors.ConclusionHalf of the women initiate their antenatal care visit after 18 weeks of their pregnancy which is not in line with the recommendation of the World Health Organization. Urban residence, tertiary and above level of education of the women, having pregnancy-related complications in a previous pregnancy, not having previous antenatal care visits and unplanned pregnancy were predictors of the time to initiation of antenatal care. Therefore, targeted community outreach programs including educational campaigns regarding antenatal care for women who live in rural areas, who are less educated, and who have no previous antenatal care experience should be provided, and comprehensive family planning services to prevent unplanned pregnancy are needed.