Individuals Of Childbearing Age Research Articles

Ayurvedic Interventions For PCOS: A Single-Case Analysis

Polycystic ovarian syndrome (PCOS) is a multifaceted disorder marked by elevated androgen levels, as well as irregular menstrual patterns or the presence of small cysts on either one or both ovaries. It manifests 20-30% more commonly in individuals of childbearing age. The condition gets its name because there are often more small painless cysts within the ovaries. It is also a metabolic problem that affects various body systems. In contemporary systems that provide short-term relief, it is very difficult to cure. In Ayurveda, PCOS is considered Yonivyapad, Rajo dosha, and Arthava dusti, depending on its clinical presentation. A case of a 29-year-old female complaining of irregular menstruation, prolonged bleeding, Dysmenorrhoea, acne, facial hair growth, and weight gain confirmed PCOS based on symptoms and USG. She was treated based on Ayurveda principles with Shamana oushadis and lifestyle changes for 3 months. The analysis of results was based on the alleviation of clinical symptoms and the findings from the USG report. The results demonstrate a notable improvement in both clinical symptoms and USG reports post-treatment. Adherence to Ayurvedic principles is found to be helpful in PCOS for a healthy and fruitful life.

British Society for Haematology guideline for anticoagulantmanagement of pregnant individuals with mechanical heart valves.

British Society for Haematology guideline for anticoagulantmanagement of pregnant individuals with mechanical heart valves.

Years of life lost due to unintentional drug overdose among perinatal individuals in the United States

BackgroundThe United States has one of the highest maternal mortality rates of developing countries, but the contribution of perinatal drug overdose is not known. Communities of color also have higher rates of maternal morbidity and mortality when compared to White communities, however the contribution due to overdose has not yet been examined in this population. ObjectivesTo quantify the years of life lost due to unintentional overdose in perinatal individuals from 2010 to 2019 and assess for disparity by race.Study Design: This was a cross-sectional retrospective study with summary-level mortality statistics for the years 2010–2019 obtained from the Centers for Disease Control (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) mortality file. A total of 1,586 individuals of childbearing age (15–44 years) who died during pregnancy or six weeks postpartum (perinatal) from unintentional overdose in the United States from January 1, 2010 to December 31, 2019 were included. Total years of life lost (YLL) was calculated and summated for White, Black, Hispanic, Asian/Pacific Islander, and American Indian/Native Alaska women. Additionally, the top three overall causes of death were also identified for women in this age group for comparison. ResultsUnintentional drug overdose accounted for 1,586 deaths and 83,969.78 YLL in perinatal individuals from 2010 to 2019 in the United States. Perinatal American Indian/Native American individuals had a disproportionate amount of YLL when compared to other ethnic groups, with 2.39% of YLL due to overdose, while only making up 0.80% of the population. During the last two years of the study, only American Indian/Native American and Black individuals had increased rates of mortality when compared to other races. During the ten-year study period, when including the top three causes of mortality, unintentional drug overdoses made up 11.98% of the YLL overall and 46.39% of accidents. For the years 2016–2019, YLL due to unintentional overdose was the third leading cause of YLL overall for this population. ConclusionsUnintentional drug overdose is a leading cause of death for perinatal individuals in the United States, claiming nearly 84,000 years of life over a ten-year period. When examining by race, American Indian/Native American women are most disproportionately affected.

Optimising the screening for haemoglobinopathies in pregnancy planning

Haemoglobinopathies are among the most common inherited disorders around the world. In the United States the diagnosis of haemoglobinopathy or a carrier state is made by universal newborn screening. However, many individuals of childbearing age do not know they are a haemoglobinopathy carrier. Screening for common haemoglobinopathies is generally offered as a part of pregnancy planning so that prospective parents can be counselled regarding the risk of having a child with a haemoglobinopathy. Multiple tests exist to screen patients for presence of haemoglobinopathy carrier or disease state; however, it is crucial to order and interpret the results correctly to appropriately counsel couples. In this case series, we describe clinical scenarios where prospective parents were surprised to unexpectedly have a child with sickle cell disease, a haemoglobinopathy that causes severe clinical complications. Through these cases we demonstrate that deficiencies in testing can occur at different levels which may lead to incorrect estimation of the risk of having a child affected by a haemoglobinopathy. Consultation with a haematologist, laboratory medicine specialist, or genetic counsellor should be considered to select the appropriate test and interpret its results.

Autoimmune disease and risk of postpartum venous thromboembolism

BackgroundThe risk of pregnancy-related mortality in the United States has nearly doubled since 1990, with venous thromboembolism (VTE) accounting for approximately 10% of these deaths. ObjectivesThe objective of this study was to assess whether preexisting autoimmune disease is a risk factor for postpartum VTE. MethodsUsing the MarketScan Commercial and Medicare Supplemental administrative databases, a retrospective cohort study analyzed whether postpartum persons with autoimmune disease had a higher risk of postpartum VTE incidence than postpartum persons without autoimmune disease. Using International Classification of Diseases codes, we identified 757,303 individuals of childbearing age who had a valid delivery date with at least 12 weeks of follow-up. ResultsIndividuals were, on average, 30.7 years old (SD, 5.4), and 3.7% (N = 27,997 of 757,303) of them had evidence of preexisting autoimmune disease. In covariate-adjusted models, postpartum persons with preexisting autoimmune disease had higher rates of postpartum VTE than postpartum persons without autoimmune disease (hazard ratio [HR], 1.33; 95% CI, 1.07-1.64). When analyzed by individual autoimmune disease, those with systemic lupus erythematosus (HR, 2.49; 95% CI, 1.47-4.21) and Crohn’s disease (HR, 2.49; 95% CI, 1.34-4.64) were at an elevated risk of postpartum VTE compared with those without autoimmune disease. ConclusionAutoimmune disease was associated with a higher rate of postpartum VTE, with evidence that the association was most pronounced among individuals with systemic lupus erythematosus and Crohn’s disease. These findings suggest that postpartum persons of childbearing age with autoimmune disease may require more monitoring and prophylactic care after delivery to prevent potentially fatal VTE events.

Valproate Prescribing Practices in Individuals of Childbearing Age at a Tertiary Care Women's Hospital.

Valproate Prescribing Practices in Individuals of Childbearing Age at a Tertiary Care Women's Hospital.

Ionising radiation in urology: consideration of individuals of childbearing age

Nurse referrers of medical ionising radiation (X-ray) are educated to refer appropriately. One particular cohort of patients who warrant special consideration regarding the risks associated with X-ray are individuals of childbearing age. In the context of advanced nurse practitioner practice in urology, these patients attend for removal of ureteric stents and may require an abdominal X-ray. In reaching a decision, ANPs undertake a systematic assessment considering the individual's pregnancy status, as an X-ray of the abdomen, although low dose, carries a much higher risk of teratogenic effects than an X-ray of the extremities. This article considers the risks of ionising radiation in individuals of childbearing age, while paying attention to legislation and the application of the principles of justification, optimisation and dose limitation.

Transgenerational transfer of gene-modified T cells

Tumor immunotherapy using gene-modified T cells has already met with considerable success in the treatment of metastatic melanoma and B cell lymphoma. With improving patient prognoses, new questions arise. In particular, the long-term consequences of treatment among individuals of childbearing age could now be considered. Former patients can carry a cohort of transgenic memory T cells long after treatment has ceased and the effector T cell population has contracted. When patients become parents well after treatment is completed, expectant mothers may still pass transgenic T cells to their unborn children. Consequences should be more measurable if the mother also breastfeeds the baby. Maternal T cells may shape immune responses in the child, can tolerize the child to maternal antigens, and might cause either beneficial or adverse effects in the offspring. The hypothesis put forth is that transgenic T cells transferred from mother to child during and after pregnancy might have consequences that have not been adequately considered to date. Depending on the targeted antigen and the MHC eventually required to present it, such transfer may be beneficial, uneventful or even damaging. Such potential consequences are addressed in this paper. The transgenic T cells might form a pocket of memory T cells in secondary lymphoid organs of the child, expand upon antigen stimulation, and react. However, simple measures might be devised to avoid any reason for concern. These considerations provide ample incentive to probe transgenerational transfer of transgenic T cells.

Children of Parents with Eating Disorders.

Our primary goal in this article is to review recent findings (from 2015 and on) concerning children of parents with eating disorders. This review addresses the question of whether the offspring of parents with past or present eating disorders have adverse outcomes. This update is timely and informative because recent research includes controlled studies and large cohort designs and earlier reviews relied on case report evidence. Despite substantial diversity in study design, sample size, and parental eating disorder definition, overall, existing research suggests that the children of parents with eating disorders exhibit compromised development: a greater risk of perinatal complications; a tendency toward extremes of growth at birth; greater problems in feeding and eating behaviors and greater incidence of eating disorder symptoms; more psychological and socioemotional difficulties; and more negative qualities to parent-child interactions. Data on children's cognitive outcomes is thus far inconsistent. Given the relatively high incidence of eating disorder history in individuals of childbearing age, research into its potential effects on children is necessary. However, the methodological shortcomings and a limited evidence base caution in drawing conclusions. Nevertheless, mental health services should address the possible problems that these children face and offer tailored programs.

Rubella metapopulation dynamics and importance of spatial coupling to the risk of congenital rubella syndrome in Peru

Rubella is generally a mild childhood disease, but infection during early pregnancy may cause spontaneous abortion or congenital rubella syndrome (CRS), which may entail a variety of birth defects. Consequently, understanding the age-structured dynamics of this infection has considerable public health value. Vaccination short of the threshold for local elimination of transmission will increase the average age of infection. Accordingly, the classic concern for this infection is the potential for vaccination to increase incidence in individuals of childbearing age. A neglected aspect of rubella dynamics is how age incidence patterns may be moulded by the spatial dynamics inherent to epidemic metapopulations. Here, we use a uniquely detailed dataset from Peru to explore the implications of this for the burden of CRS. Our results show that the risk of CRS may be particularly severe in small remote regions, a prediction at odds with expectations in the endemic situation, and with implications for the outcome of vaccination. This outcome results directly from the metapopulation context: specifically, extinction–re-colonization dynamics are crucial because they allow for significant leakage of susceptible individuals into the older age classes during inter-epidemic periods with the potential to increase CRS risk by as much as fivefold.

Oncology physicians' knowledge, attitudes, and practices regarding fertility preservation.

e19525 Background: More than 2.5 million individuals of child-bearing age are currently survivors of cancer. Many of these patients wish to become parents after treatment, and are concerned about p...

No Longer Intending: The Relationship Between Relinquished Fertility Intentions and Distress

We use data from both waves of the National Survey of Families and Households to assess whether relinquishing a serious intention to have (more) children leads to greater increases in depressive symptoms than continuing confidence in childbearing intentions. Our sample includes 2,200 individuals of childbearing age, men and women, all parities, and all marital statuses. Change score analysis shows that individuals who relinquished a serious intent to have children had elevated distress at Time 2 and that the association is conditioned by gender, health, and education. We find that fertility potential can be important to psychosocial well‐being and that closing the door on future fertility, especially for women, those in ill health, and the better educated, leads to increased distress.

Cascade carrier-testing in cystic fibrosis

It is good medical practice to offer carrier tests and counselling to the relatives of those affected by recessive disorders. Many are concerned about their own chances of having affected offspring. Cystic fibrosis carrier tests have been feasible since the discovery of the gene in 1989. It was generally agreed that although population screening was not practical, testing should be offered to relatives and their partners. There is evidence that such offers have not always been made and relatives have sometimes found it difficult to be tested. An active cascade programme of the counselling and testing of cystic fibrosis patients' relatives and their partners has operated from Royal Manchester Children's Hospital since 1993. The service operates with dedicated staff, backed up by a specialist cystic fibrosis molecular genetics laboratory and a specialist genetic counselling service. The main target groups are couples or individuals of child-bearing age. There is discouragement of the testing of young children and of grandparents beyond reproductive age, although, if parents or individuals are insistent, testing is often performed, after counselling. An audit of users has shown satisfaction, very few feeling that they were pressured into having the tests. The experience of other centres with cascade-testing in cystic fibrosis is summarised. Cascades can start whenever a sufferer or carrier is identified, although care should be exercised in instituting active cascades in the extended families of newborns identified as carriers in neonatal screening programmes.

Herpes simplex virus infections of women and their offspring: implications for a developed society.

Herpes simplex virus infections of humans have been known since ancient times. Contemporary society has witnessed a series of devastating manifestations of herpes simplex virus infections--namely, genital herpes simplex virus infection and neonatal herpes simplex virus infection. With the evolution of society, particularly advances in birth control and increasing promiscuity, the seroprevalence of herpes simplex virus type 2 infections has increased worldwide, however, more so in developed societies. As a consequence, individuals of child-bearing age are at risk for either reactivation of herpes simplex virus at termination of gestation or acquisition of a new primary infection at that time. The consequences of vertical transmission of herpes simplex virus from mother to child, resulting in neonatal herpes simplex virus infection, can be devastating. Current efforts, which are directed toward the treatment of neonatal herpes, have established the value of drugs such as vidarabine and acyclovir. However, the real emphasis for future programs is the prevention of herpes simplex virus infections to avoid person-to-person transmission either horizontally or vertically. The development of vaccines directed against herpes simplex virus may be of value toward this end.

Characteristics of the Biopsychosocial Crisis of Infertility

As many as 5 to 12 million individuals of childbearing age in the United States may now be infertile. For couples who wish to conceive but cannot do so, discovery of physical infertility, coupled with strong expectations about conceiving and raising children, sets the stage for a complex series of reactions labeled here as the crisis of infertility. Infertile couples frequently struggle with strong feelings, ranging from disbelief and denial to isolation, guilt, and grief. Problems coping with infertility are worsened by physical and psychological stresses accompanying medical procedures. The marital relationship may be severely tested as well. For many individuals, the infertility crisis is resolved with virtually no support from anyone. With empathy and understanding, counselors can help infertile individuals to work through this crisis productively.

Prenatal toxicity of simultaneously administered ethanol and pentobarbital in the rat

The use and abuse of drugs has reached epidemic proportions among individuals of child-bearing age. The frequency with which alcohol and pentobarbital are used in our society increases the probability that they will be taken simultaneously. Experiments were designed to investigate the prenatal toxicity of alcoho and pentobarbital interaction in the rat. Pregnant Sprague-Dawley rats were treated intraperitoneally with one of three doses of ethanol (0.56 to 1.4 g/kg) in combination with 5, 15, or 25 mg/kg pentobarbital on days 9 through 12 of gestation. Maternal and fetal toxicities were evaluated and compared with the results of previous studies using the same doses of ethanol and pentobarbital. In pregnant rats treated with combinations of the two drugs, there was no consistent pattern of response. With respect to the offspring, there was no evidence that combinations of ethanol and pentobarbital, at the dose levels used here, had any more deleterious effect on fetal development than either drug acting independently.