Menstrual Age Research Articles

Longitudinal evaluation of hemodynamic blood and echocardiographic biomarkers for the prediction of BPD and BPD-related pulmonary hypertension in very-low-birth-weight preterm infants.

Mainly at an early stage of postnatal neonatal care in VLBW preterm infants, several biomarkers were found to be associated with the combined endpoint BPD/death and BPD-PH. New candidates of blood biomarkers (NTproBNPZlog, ET-1, and CA125) and echocardiographic markers (TAPSE, PAAT/RVET) might serve as innovative predictors for BPD, BPD-PH, and adverse outcomes in VBLW infants. • VLBW infants are at risk for the development of BPD and BPD-related PH, which both are main contributors for short and long-term morbidity and mortality. Several studies in the past focused on the evaluation of circulating blood biomarkers and biomarkers from echocardiographic assessment of these infants. But to date, there is still a lack on longitudinal prospective studies especially in VLBW infants. • For the first time, this set of selected blood biomarkers (with the first description of Zlog-transformed NTproBNP and CA125 in preterm infants) and several echocardiographic markers were analyzed in a prospective longitudinal study from birth until 36 weeks post menstrual age in VLBW infants. Our data help clinicians to identify preterm infants at risk for BPD, BPD-PH and death and to offer new candidates of biomarkers. This might help to facilitate decision making and guidance of therapy in these highly vulnerable patients.

Red cell distribution width and mean platelet volume detection in patients with endometrial cancer and endometrial hyperplasia.

Endometrial cancer is the most common malignancy in women in developed countries, and its incidence is increasing annually. Due to the availability and cost-effectiveness of serum markers of red cell distribution width (RDW), and mean platelet volume (MPV), we decided to investigate these two important markers in patients with endometrial cancer and assess their role in diagnosing the tumor and differentiate it from endometrial hyperplasia and other causes of bleeding. This is a case-control study that examined the data of patients who were referred to Al-Zahra Hospital during 2022-2023 with complaints of abnormal bleeding and underwent diagnostic curettage. Based on the pathology findings, the patients were divided into 3 groups, including endometrial cancer, endometrial hyperplasia, and control. The clinical characteristics and results of MPV and RDW were compared in these three groups. The IBM SPSS Statistics for Windows, Version 21.0. was used for data analysis. In this study, 87 women were examined in three groups endometrial cancer, endometrial hyperplasia, and control with a mean age of 52.70 ± 11.63 years. The results showed that the endometrial cancer group, had higher gravida, underlying disease, history of radiation therapy, anticoagulant therapy, blood transfusion, surgery, and family history of cancer (p < 0.05). Meanwhile, the endometrial cancer group had lower menstrual age and history of using contraceptives than other groups (p < 0.05). In addition, in this study, the results indicated that the levels of MPV and RDW in the endometrial cancer group were significantly higher than in the endometrial hyperplasia and control groups (p < 0.05). Since MPV and RDW are cheap and accessible and can be easily obtained from complete blood count panels, they can be used as suitable diagnostic markers for endometrial cancer. However, conducting comprehensive multicenter prospective studies with a larger sample size can be helpful.

The Best Start Trial: A randomised controlled trial of ultra-early parent-administered physiotherapy for infants at high risk of cerebral palsy or motor delay

BackgroundIt is unknown whether ultra-early physiotherapy commenced during neonatal intensive care unit admission is of value for optimising developmental outcomes in preterm/term infants at high-risk of cerebral palsy or motor-delay. AimsTo determine whether ultra-early parent-administered physiotherapy to preterm/term high- risk infants commenced at earliest from 34-weeks post menstrual age, improves motor outcomes at 16-weeks corrected age (CA) compared to usual care. MethodsSingle-blind randomised controlled pilot study with 30 infant participants. The primary outcome was the Alberta Infant Motor Scale (AIMS) total score at 16-weeks CA. Secondary outcomes included (i) parent Depression Anxiety and Stress Score and Parent Perceptions Survey at 16-weeks CA; and (ii) Bayley Scales of Infant Development at 12-months CA. ResultsThere were no clinically worthwhile effects at 16-weeks CA on the AIMS (mean between-group difference, 95% CI: -0.2, -2.4 to 2.0) or most secondary outcomes. However, the parents' “perception of treatment effectiveness” and “perception of change” favoured the experimental group. ConclusionsIn this pilot trial, there was no clinically worthwhile effect of ultra-early parent-administered physiotherapy over usual care on the AIMS. However, the intervention was feasible for infants, acceptable to parents and parents perceived a benefit of treatment. Whilst this trial did not demonstrate treatment effectiveness using the AIMS, these findings should be interpreted cautiously because of the small sample size, the low responsivity of the AIMS to change in motor performance and the heterogeneity of the participants. Therefore, the intervention should not be abandoned on the basis of this trial, but rather further evaluated in a larger trial that addresses some of the learnings from this one.

A RESSIGNIFICAÇÃO DA SEXUALIDADE FEMININA EM IDADE MENSTRUAL NA POPULAÇÃO INTERIORANA BAIANA

Introduction - The redefinition of female sexuality at menstrual age in the interior population of Bahia has been observed and directly related to puberty and the period of menarche. In addition to these factors, there is also interference from living conditions, such as socioeconomic issues. Objective - To evaluate the redefinition of sexuality among young women, of menstrual age, in the interior population of Bahia. Method - Qualitative and quantitative study, whose study population is female, living in the interior of Bahia, of menstrual age. Its inclusion classifications include women of menstrual age and exclusion criteria include girls who have not yet experienced menstruation. The chosen study location was the interior of Bahia. Data collection will be through a form (GOOGLE FORMS) individual structure, which will use a questionnaire as an instrument, will be applied to 30 female people, in the period from April 30, two thousand and twenty one to July sixth, two thousand and twenty one. The variables will be women of menstrual age with an active sexual life. Results - In the period considered, the survey was carried out through a questionnaire carried out with 34 women anonymously. The age range ranges from 20 to 51 years, from different cities, including Salvador, Lauro de Freitas, Santo Antônio de Jesus, Jiquiriçá, Guanambi, among others, all in the state of Bahia. Regarding education level, 29.4% of women had completed higher education, 58.8% had incomplete higher education. The socioeconomic level varied greatly with only 3% of women classifying themselves as upper class, 30% of them middle class and 32% lower class and 35% of women did not answer the questions. Conclusion - It is concluded that the data developed in the study in question revealed that despite the majority of women having had a reasonable education and 100% of them knowing the risks of not using condoms, they still choose not to use them. This number is worrying because between 2009 and 2019 alone, the percentage of people between 13 and 17 years old who obtained a condom during their last sexual encounter fell from 72.5% to 59%. Among girls alone, the drop was from 69.1% to 53.5%, which is reflected in our research.

Menstrual Cycle Variations in Wearable-Detected Finger Temperature and Heart Rate, But Not in Sleep Metrics, in Young and Midlife Individuals.

Most studies about the menstrual cycle are laboratory-based, in small samples, with infrequent sampling, and limited to young individuals. Here, we use wearable and diary-based data to investigate menstrual phase and age effects on finger temperature, sleep, heart rate (HR), physical activity, physical symptoms, and mood. A total of 116 healthy females, without menstrual disorders, were enrolled: 67 young (18-35 years, reproductive stage) and 53 midlife (42-55 years, late reproductive to menopause transition). Over one menstrual cycle, participants wore Oura ring Gen2 to detect finger temperature, HR, heart rate variability (root mean square of successive differences between normal heartbeats [RMSSD]), steps, and sleep. They used luteinizing hormone (LH) kits and daily rated sleep, mood, and physical symptoms. A cosinor rhythm analysis was applied to detect menstrual oscillations in temperature. The effect of menstrual cycle phase and group on all other variables was assessed using hierarchical linear models. Finger temperature followed an oscillatory trend indicative of ovulatory cycles in 96 participants. In the midlife group, the temperature rhythm's mesor was higher, but period, amplitude, and number of days between menses and acrophase were similar in both groups. In those with oscillatory temperatures, HR was lowest during menses in both groups. In the young group only, RMSSD was lower in the late-luteal phase than during menses. Overall, RMSSD was lower, and number of daily steps was higher, in the midlife group. No significant menstrual cycle changes were detected in wearable-derived or self-reported measures of sleep efficiency, duration, wake-after-sleep onset, sleep onset latency, or sleep quality. Mood positivity was higher around ovulation, and physical symptoms manifested during menses. Temperature and HR changed across the menstrual cycle; however, sleep measures remained stable in these healthy young and midlife individuals. Further work should investigate over longer periods whether individual- or cluster-specific sleep changes exist, and if a buffering mechanism protects sleep from physiological changes across the menstrual cycle.

Early Antibiotic Exposure and Bronchopulmonary Dysplasia in Very Preterm Infants at Low Risk of Early-Onset Sepsis

The overutilization of antibiotics in very preterm infants (VPIs) at low risk of early-onset sepsis (EOS) is associated with increased mortality and morbidities. Nevertheless, the association of early antibiotic exposure with bronchopulmonary dysplasia (BPD) remains equivocal. To evaluate the association of varying durations and types of early antibiotic exposure with the incidence of BPD in VPIs at low risk of EOS. This national multicenter cohort study utilized data from the Chinese Neonatal Network (CHNN) which prospectively collected data from January 1, 2019, to December 31, 2021. VPIs less than 32 weeks' gestational age or with birth weight less than 1500 g at low risk of EOS, defined as those born via cesarean delivery, without labor or rupture of membranes, and no clinical evidence of chorioamnionitis, were included. Data analysis was conducted from October 2022 to December 2023. Early antibiotic exposure was defined as the total number of calendar days antibiotics were administered within the first week of life, which were further categorized as no exposure, 1 to 4 days of exposure, and 5 to 7 days of exposure. The primary outcome was the composite of moderate to severe BPD or mortality at 36 weeks' post menstrual age (PMA). Logistic regression was employed to assess factors associated with BPD or mortality using 2 different models. Of the 27 176 VPIs included in the CHNN during the study period (14 874 male [54.7%] and 12 302 female [45.3%]), 6510 (23.9%; 3373 male [51.8%] and 3137 female [48.2.%]) were categorized as low risk for EOS. Among them, 1324 (20.3%) had no antibiotic exposure, 1134 (17.4%) received 1 to 4 days of antibiotics treatment, and 4052 (62.2%) received 5 to 7 days of antibiotics treatment. Of the 5186 VPIs who received antibiotics, 4098 (79.0%) received broad-spectrum antibiotics, 888 (17.1%) received narrow-spectrum antibiotics, and 200 (3.9%) received antifungals or other antibiotics. Prolonged exposure (5-7 days) was associated with increased likelihood of moderate to severe BPD or death (adjusted odds ratio [aOR], 1.23; 95% CI, 1.01-1.50). The use of broad-spectrum antibiotics (1-7 days) was also associated with a higher risk of moderate to severe BPD or death (aOR, 1.27; 95% CI, 1.04-1.55). In this cohort study of VPIs at low risk for EOS, exposure to prolonged or broad-spectrum antibiotics was associated with increased risk of developing moderate to severe BPD or mortality. These findings suggest that VPIs exposed to prolonged or broad-spectrum antibiotics early in life should be monitored for adverse outcomes.

Morbidity and neurodevelopmental outcomes at 2 years in preterm infants undergoing percutaneous transcatheter closure vs. surgical ligation of the PDA.

Review a cohort of preterm infants ≤29 weeks of gestation at birth and compare morbidities and neurodevelopmental outcomes based on PDA status and type of PDA closure. Single center observational retrospective-prospective case control study of premature infants who had no hsPDA, underwent surgical ligation or percutaneous transcatheter closure of the PDA. Neurodevelopmental testing was done using the Bayley Scales of Infant Development 3rd ed. The percutaneous transcatheter closure group had an older post menstrual age and greater weight at the time of procedure, and started enteral feeds and achieved room air status at an earlier post procedure day. Infants in the surgical ligation group were more likely to experience vocal cord paralysis. There was no difference in neurodevelopmental outcomes between groups. Waiting for infants to achieve the appropriate size for percutaneous transcatheter closure of the PDA may lead to reduced short-term complications without increasing the risk of neurodevelopmental impairment.

여대생의 학업스트레스, 신체존중감, 자기자애가 월경전증후군에 미치는 영향

Menstruation is a normal female reproductive function but many women experience physical, mental, and behavioral discomfort related to menstruation, therefore the significance of the active intervention is highlighted. Accordingly, this study attempted to provide the basis for the development of a program for managing premenstrual syndrome by identifying the correlations between academic stress, body esteem, self-compassion, and premenstrual syndrome and influencing factors of premenstrual syndrome among female college students. The study subjects were 180 female college students at a university in Gyeonggi-do, and the collected data were analyzed by frequency, percentage, average, standard deviation, t-test, Pearson's Correlation Coefficients, and Multiple Regression using the SPSS Win 28.0 statistical program. The results showed that the average score of premenstrual syndrome was 1.86, academic stress was 2.68, body esteem was 2.65, and self-compassion was 3.22. Analyzing the premenstrual syndrome according to the general characteristics and menstrual-related characteristics of the subjects, there were significant differences in age(F=3.05, p=.049), exercise frequency(F=3.53, p=.030), amount of menstruation(F=4.48, p=.013), and menstrual pain(F=13.81, p=.001). Premenstrual syndrome had a notable positive correlation with academic stress (r=.26, p&lt;.001), and a significant negative correlation with body esteem (r=-.27, p&lt;.001) and self-compassion (r=-.23, p&lt;.001). Academic stress had a significant negative correlation with body esteem (r=-.50, p&lt;.001) and self-compassion (r=-.56, p&lt;.001), and body esteem had a significant positive correlation with self-compassion (r=.57, p&lt;.001). Multiple regression analysis was implemented to identify the factors affecting premenstrual syndrome of female college students, and the result showed that severe menstrual pain(β=.46, p&lt;.001), normal menstrual pain(β=.38, p&lt;.001), heavy menstrual flow(β=.38, p&lt;.001), age((β=.18 p=.029), academic stress(β=.18 p=.022), and body esteem (β=-.17, p=.026), and the level of explanation was 26.0%. In other words, more intense or regular menstrual pain, heavier menstrual flow, older age(≥24), higher academic stress, and lower body esteem were correlated with more serious premenstrual syndrome in female college students. Based on the findings, it is necessary to develop and apply various programs not only for managing menstrual symptoms but also for managing academic stress and enhancing body esteem to alleviate menstrual symptoms and improve menstrual health among female college students.

Longitudinal effects of early exposure to intermittent hypoxia on autonomic cardiovascular control in very preterm infants

IntroductionCardiorespiratory control is immature in infants born preterm compared to those born at term. Animal studies have shown that repetitive hypoxia associated with periodic breathing can alter autonomic control. We aimed to elucidate if the amount of time spent with apnoea and periodic breathing in the neonatal unit was associated with longitudinal changes in autonomic control assessed using heart rate variability. MethodsTwenty-nine very preterm infants (10 M 19F) were studied during supine daytime sleep on 4 occasions. Study 1: 32–36 weeks post menstrual age (PMA) (n = 29), Study 2: 36–40 weeks PMA (n = 27), Study 3: 3-months corrected age (CA) (n = 20) and Study 4: 6-months CA (n = 26). The percentage total sleep time (%TST) spent having apnoeas in active (AS) and quiet sleep (QS) at each study was calculated. Total power, low frequency (LF, sympathetic + parasympathetic activity) high frequency (HF, parasympathetic activity), and LF/HF (sympathovagal balance) were calculated. Infants were divided into two groups based on the %TST spent with apnoeas above and below the median in AS and QS at Study 1. Data were normalised and compared with two-way ANOVA with Bonferroni post-hoc tests. ResultsWhen apnoeas were included in the analysis, in QS Total power and HF power were higher, and when apnoeas were excluded HF power was higher in QS but lower in AS in the above median group at Study 4. ConclusionThis study provides new evidence that short apnoeas, particularly periodic breathing, which is currently not detected or treated in the neonatal unit can affect autonomic cardiovascular control.

Association Between Polymorphisms in DNA Damage Repair Pathway Genes and Female Breast Cancer Risk.

Breast cancer risk have been discussed to be associated with polymorphisms in genes as well as abnormal DNA damage repair function. This study aims to assess the relationship between genes single nucleotide polymorphisms (SNPs) related to DNA damage repair and female breast cancer risk in Chinese population. A case-control study containing 400 patients and 400 healthy controls was conducted. Genotype was identified using the sequence MassARRAY method and expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER-2) in tumor tissues was analyzed by immunohistochemistry assay. The results revealed that ATR rs13091637 decreased breast cancer risk influenced by ER, PR (CT/TT vs. CC: adjusted odds ratio [OR] = 1.54, 95% confidence interval [CI]: 1.04-2.27, p = 0.032; CT/TT vs. CC: adjusted OR = 1.63, 95%CI: 1.14-2.35, p = 0.008) expression. Stratified analysis revealed that PALB2 rs16940342 increased breast cancer risk in response to menstrual status (AG/GG vs. AA: adjusted OR = 1.72, 95%CI: 1.13-2.62, p = 0.011) and age of menarche (AG/GG vs. AA: adjusted OR = 1.54, 95%CI: 1.03-2.31, p = 0.037), whereas ATM rs611646 and Ku70 rs132793 were associated with reduced breast cancer risk influenced by menarche (GA/AA vs. GG: adjusted OR = 0.50, 95%CI: 0.30-0.95, p = 0.033). In a summary, PALB2 rs16940342, ATR rs13091637, ATM rs611646, and Ku70 rs132793 were associated with breast cancer risk.

Apnea, Intermittent Hypoxemia, and Bradycardia Events Predict Late-Onset Sepsis in Infants Born Extremely Preterm

ObjectiveTo examine the association of cardiorespiratory events, including apnea, periodic breathing, intermittent hypoxemia (IH), and bradycardia, with late-onset sepsis for extremely preterm infants (<29 weeks’ gestational age [GA]) on versus off invasive mechanical ventilation. Study designThis is a retrospective analysis of data from infants enrolled in Pre-Vent (ClinicalTrials.gov identifier NCT03174301), an observational study in five level IV neonatal intensive care units. Clinical data were analyzed for 737 infants (mean GA 26.4 weeks, SD 1.71). Monitoring data were available and analyzed for 719 infants (47,512 patient-days), of whom 109 had 123 sepsis events. Using continuous monitoring data, we quantified apnea, periodic breathing, bradycardia, and IH. We analyzed the relationships between these daily measures and late-onset sepsis (positive blood culture >72 hours after birth and ≥5d antibiotics). ResultsFor infants not on a ventilator, apnea, periodic breathing, and bradycardia increased before sepsis diagnosis. During times on a ventilator, increased sepsis risk was associated with longer events with oxygen saturation <80% (IH80) and more bradycardia events before sepsis. IH events were associated with higher sepsis risk, but did not dynamically increase before sepsis, regardless of ventilator status. A multivariable model including post menstrual age, cardiorespiratory variables (apnea, periodic breathing, IH80, and bradycardia), and ventilator status predicted sepsis with an AUC of 0.783. ConclusionWe identified cardiorespiratory signatures of late-onset sepsis. Longer IH events were associated with increased sepsis risk but did not change temporally near diagnosis. Increases in bradycardia, apnea, and periodic breathing preceded the clinical diagnosis of sepsis.

Correlation of 25-Hydroxyvitamin D Deficiency with Ferritin, Thyroid-Stimulating Hormone, and Other Biochemical Parameters of Women in Baghdad Province

Abstract Background: The importance of vitamin D in facilitating the absorption of calcium and phosphorus from the intestines and maintaining appropriate levels of these minerals in the blood for normal bone mineralization is well-established. Objectives: Beyond its role in bone health, vitamin D has been shown to exert a significant influence on various biochemical processes and may impact the development of certain diseases, including infections, obesity, heart disease, and certain cancers. This study aimed to investigate the differences in vitamin D levels among women from Baghdad province and its potential associations with ferritin and thyroid-stimulating hormone (TSH). Materials and Methods: This cross-sectional study involved 171 apparently healthy women, categorized into two age groups: the menstrual age group (group A, mean age 36.4 ± 9.2) and the menopausal age group (group B, mean age 57.7 ± 8.4). Vitamin D levels, serum ferritin levels, and hemoglobin levels were assessed to understand the interplay between these parameters. Results: The results revealed that both groups exhibited low levels of vitamin D (group A: 916.56 ± 8.33; group B: 16.86 ± 10.45), low serum ferritin (group A: 11.9 ± 10.66; group B: 28.2 ± 13.67), and low hemoglobin levels (group A: 10.97 ± 1.74; group B: 11.42 ± 1.68). Notably, the results observed no significant differences in all studied parameters between these groups, except for serum ferritin (P &lt; 0.05). Additionally, the finding demonstrated a significant positive association between vitamin D and serum ferritin levels in both groups (group A, r = +0.569, P &lt; 0.000; group B, r = +0.405, P &lt; 0.01). Also, there was a significant moderate positive correlation between vitamin D and hemoglobin levels (group A, r = +0.43, P &lt; 0.001; group B, r = +0.312, P &lt; 0.04). However, no significant correlation was found between vitamin D and TSH, urea, and creatinine levels. Conclusion: The implications of this study suggest that vitamin D deficiency may serve as a useful predictor and have an adverse effect on anemia in women.

Oral feeding trajectories and neurodevelopmental outcomes at 12 and 24 month follow-up for preterm infants.

Few studies characterize feeding performance in the NICU when predicting neurodevelopmental outcomes. Our objective was to investigate the relationship between time to full oral feeds (FULL-PO) and neurodevelopmental and feeding outcomes in the first 2 years in preterm infants admitted to the NICU. This retrospective study included infants born between 01/01/2014-07/31/2017, gestational age < 32 weeks and/or birth weight < 1500 g. We examined feeding difficulties, cerebral palsy, and Bayley scores for those reaching FULL-PO at a post menstrual age (PMA)≤38.0 weeks (EARLY) vs.>38.0 weeks (LATE). Additionally, the oral feeding achieved at various timepoints between 36- and 42-weeks postmenstrual age (PMA) was measured to construct a timeline of oral feeding acquisition. Of 192 infants, 147(77%) achieved FULL-PO EARLY and 45(23%) LATE. Comorbidities and length of stay were higher and unadjusted Bayley scores were lower at 12 months corrected age (CA) and 24 months chronological age (CH) in the LATE group. Feeding difficulties were higher in the LATE group at 24 months CH. Infants born < 27-28 weeks GA were more likely to achieve oral feeding at a later PMA. Infants with bronchopulmonary dysplasia (BPD) had significant feeding and developmental delays. Establishing full oral feeds by 38.0 weeks PMA may be used as a predictor for feeding difficulties at 24 months CH. Infants born < 27-28 weeks GA and those with BPD are more likely to take extended amounts of time to achieve full oral feeding and need additional feeding support. Infants with BPD are high risk for neurodevelopmental delays.

Profile of metabolic bone disease in extremely low birth weight (ELBW) and very low birth weight (VLBW) neonates

BackgroundMetabolic bone disease (MBD) is an important cause of morbidity in premature, very low birth weight (VLBW), and sick infants and, if left undiagnosed, may lead to structural deformities and spontaneous fractures. The objective of the present study was to study the profile of MBD and to determine the incidence of MBD in infants ≤ 32 weeks/≤ 1250 g at birth.MethodA total of 57 infants ≤ 32 weeks/≤ 1250 g at birth admitted in our NICU from October 2020 to July 2021 were included in the study. These infants underwent screening for MBD at 4 weeks of age. They were stratified into three groups based on their gestation (≤ 28 weeks, 29–30 weeks, 31–32 weeks).ResultsMBD was observed in 100% of extreme preterm babies and 69% of very preterm babies. Overall, the incidence of MBD was 73%. Serum phosphorus level normalized by 42–44 weeks post menstrual age (PMA) across all gestations. Alkaline phosphatase (ALP) levels normalized by 42–44 weeks only in very preterm babies. Seventeen babies ≤ 30 weeks required inorganic phosphorus supplementation in addition to calcium phosphate supplementation in order to correct the MBD. Drugs like caffeine, steroids, and furosemide have significant impact on the development of MBD. The time to reach full feeds with fortification had no statistically significant effect on the incidence of MBD as detected by serum phosphorus level and serum ALP level.ConclusionThe profile outlined in the present study matches the literature reports in many aspects, revealing the importance of characterizing this group for the prognosis and short- and long-term follow-up of newborns with bone metabolic disease.

Menstrual Blood Donation for Endometriosis Research: A Cross-Sectional Survey on Women’s Willingness and Potential Barriers

An anonymous online survey in French was used to assess if endometriosis patients would be as ready as unaffected women to donate their menstrual blood for biological research on endometriosis and evaluate potential barriers to such donation. It was distributed in September 2022 by social media and two mailing lists, including a French patient organization. The questionnaire assessed participant age and brief medical history (hormonal contraception, endometriosis diagnosis, type of endometriosis), menstrual experience (menstrual blood abundance, dysmenorrhea), and whether participants would donate menstrual blood. Women who self-declared with an established endometriosis diagnosis versus no endometriosis were compared. Seven hundred seventy-eight women answered the survey. Among women with menstruation (n = 568), 78% are willing to donate menstrual blood for research. Importantly, this proportion was higher in women who declared having an established endometriosis diagnosis (83%, n = 299) compared to self-declared unaffected women (68%, n = 134, p < 0.001). The previous use of a menstrual cup and dysmenorrhea were significantly associated with the willingness to donate menstrual blood, while the use of hormonal contraception was significantly associated with an unwillingness to donate. Only the previous use of the menstrual cup had a predictive value for menstrual blood donation. No significant relationship was observed between menstrual blood donation and age, heavy menstrual bleeding and in endometriosis patients, endometriosis subtypes. In conclusion, women affected or not by endometriosis are largely willing to donate their menstrual blood for research on endometriosis, dysmenorrhea is not a barrier for donation, and women who use a menstrual cup are the more likely to donate.

Preterm infants experience a nadir in cerebral oxygenation during sleep three months after hospital discharge.

Preterm infants are at increased risk of Sudden Infant Death Syndrome (SIDS) and frequently experience short central apnoeas which can occur in isolation or a repetitive pattern (periodic breathing). We investigated the relationship between central apnoeas experienced before and over the 6 months after hospital discharge and cerebral oxygenation. Preterm infants born between 28 and 32 weeks gestational age (GA) were studied during supine daytime sleep at 32-36 weeks post menstrual age (PMA) (n = 40), 36-40 weeks PMA (n = 27), 3-months corrected age (CA) (n = 20) and 6-months CA (n = 26). Cerebral tissue oxygenation (TOI), peripheral oxygenation (SpO2) and heart rate were recorded continuously. The percentage total sleep time (%TST) spent having central apnoeas at each study and cerebral fractional oxygen extraction (SpO2-TOI/SpO2) were calculated. %TST spent with central apnoeas decreased with increasing age in both active sleep (AS) and quiet sleep (QS). TOI tended to be lower and cerebral fractional oxygen extraction higher at 3 months compared to the other studies and this reached statistical significance compared to 32-36 weeks in QS. The nadir in cerebral tissue oxygenation at 3 months of age coincides with the peak risk period for SIDS and this may contribute to increased risk in these infants.

Enteral supplementation with arachidonic and docosahexaenoic acid and pulmonary outcome in extremely preterm infants

Enteral supplementation with arachidonic acid (AA) and docosahexaenoic acid (DHA) in extremely preterm infants has shown beneficial effects on retinopathy of prematurity and pulmonary outcome whereas exclusive DHA supplementation has been associated with increased pulmonary morbidity. This secondary analysis evaluates pulmonary outcome in 204 extremely preterm infants, randomized to receive AA (100 mg/kg/day) and DHA (50 mg/kg/day) enterally from birth until term age or standard care. Pulmonary morbidity was primarily assessed based on severity of bronchopulmonary dysplasia (BPD). Serum levels of AA and DHA during the first 28 days were analysed in relation to BPD. Supplementation with AA:DHA was not associated with increased BPD severity, adjusted OR 1.48 (95 % CI 0.85–2.61), nor with increased need for respiratory support at post menstrual age 36 weeks or duration of oxygen supplementation. Every 1 % increase in AA was associated with a reduction of BPD severity, adjusted OR 0.73 (95 % CI 0.58–0.92). In conclusion, in this study, with limited statistical power, enteral supplementation with AA:DHA was not associated with an increased risk of pulmonary morbidity, but higher levels of AA were associated with less severe BPD. Whether AA or the combination of AA and DHA have beneficial roles in the immature lung needs further research.

Retrospective Comparative Analysis of Neonatal Mortality and Morbidity in Preterm Singleton and Multiple Births -Single Center Experience.

Objective. To compare mortality and major neonatal morbidities between singleton preterm infants and preterm infants of multiple gestations born <33 weeks' gestation. Method. Case-control study of preterm multiples and singletons <33 weeks' born at King Abdul-Aziz Medical City Riyadh (KAMC-R) between January 2017 and December 2020. Out-born infants and infants with lethal congenital abnormalities were excluded from the study. Mortality and major neonatal morbidities including bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), sepsis and surgical necrotizing enterocolitis (NEC) were compared between preterm singletons and multiples. Results. A total of 803 preterm infants were included: 567 (70.6%) were singletons, 158 (19.6%) were twins and 36 (4.5%) infants were higher multiples. Adjusted mortality before hospital discharge was significantly higher among preterm infants of multiple gestations compared to preterm singletons (12.3% vs 7.9%; P = .003; AOR, 2.2; 95% CI, 1.3-3.7). Retinopathy of prematurity (ROP) needing treatment was significantly higher among preterm infants of multiple pregnancies compared to preterm singletons (11% vs 6.5%, P = .033, AOR 1.1, 95% CI, 1.04-2.99). In addition, the incidence of bronchopulmonary dysplasia (BPD) at 36 weeks post menstrual age (PMA) (29.7% vs 20.5%; P = .003; AOR, 1.7; 95% CI, 1.2-2.5) and culture positive sepsis (24.2% vs 17.5%; P = .044; AOR, 1.5; 95% CI, 1.01-2.2) were significantly higher among preterm infants of multiple pregnancy. There were no differences in mortality and adverse neonatal outcomes between twins and higher multiples. Conclusion. Preterm infants of multiple gestations suffered higher mortality and neonatal morbidities compared to preterm singleton infants despite a higher utilization of maternal antenatal steroids and better antenatal care.

Menstrual Patterns and Age of Menarche in Young Women from the United States

Background Menarche is a salient event for adolescents that marks the beginning of reproductive life and the commencement of menstrual cycles. Despite this, much less is known about how the timing of menarche is related to menstrual patterns. Methods To that end, a cross-sectional sample of 523 young women in college from the United States provided data on menarcheal age, menses and cycle length, blood loss during menses, dysmenorrhea, and menstrual cycle regularity. Sociodemographic data such as age of first sexual intercourse, presence of biological father while growing up, self-reported body weight, and urban versus rural place of residence were also obtained. Results Mean menarcheal age was 12.89±1.31-years. Regarding cycle length, 42 (8.2%) of the women had cycles shorter than 21-days, 402 (78.2%) between 21 and 35-days, and 70 (13.6%) had cycles longer than 35-days. Concerning menorrhagia, 61 (11.8%) reported a small quantity of blood loss, 363 (70.1%) a medium quantity, and 94 (18.1%) reported a large loss of blood (menorrhagia). Duration of menstrual bleeding also showed variability with 33 (6.4%), 280 (54.2%), and 204 (39.5%) reporting menstrual bleeding lasting less than 3-days, 2 to 5-days, and greater than 5-days, respectively. The overall prevalence of dysmenorrhea was 61.7% (n=319) of the sample, while 36.3% (n=187) reported irregular menstrual cycles. Logistic regression indicated that early menarche, long menses duration, large self-reported amount of blood loss, and early age of first sexual intercourse were significant predictors of dysmenorrhea, while women with small self-reported amount of blood loss, a short menses duration, and long cycles were less likely to have dysmenorrhea. Concerning the timing of menarche, participants who were over-weight, grew up in urban environments, had dysmenorrhea, had early first consensual sexual intercourse, and grew up without a biological father, were more likely to have early menarche. Conclusion These findings suggest that menstrual disorders are common among a sample of young women from the United States and also identify sociodemographic variables that are related to menarcheal age.

A study of risk factors for breast cancer in Al-Anbar province: a case- control study

Background: Globally, breast cancer is a widespread malignancy among women, ranking as the second leading cause of female mortality. This study investigates risk factors for breast cancer in AL-Anbar province, Iraq, emphasizing their significance in disease development. Methods: An investigation was carried out at Al-Anbar Cancer Center in Al-Anbar province, Iraq, employing a case-control design. The study comprised 60 confirmed breast cancer cases and 120 controls without breast issues. Data was collected through direct interviews using a semi-structured questionnaire, and subsequent analyses included descriptive, bivariate, and multivariate approaches. Results: About 48.0% aged 41-49, and 25% aged 50-59. Case and control groups were matched in age, but varied in marital, education, occupation, menopausal status. Women with benign breast diseases have a 1.7 times higher breast cancer risk (OR=1.7, CI=0.063-4.53). Positive family history triples the risk (OR=3, CI=1.21-7.80, P=0.002), and the sedentary lifestyle exhibits 5 times higher risk of breast cancer (OR=5.67, CI=2.89-4.13, P &lt; 0.001). Menstrual age, parity, and reproductive factors influence breast cancer risk. Menarche at ≤12 years triples the risk (OR=3.05, CI=1.82-5.05, P&lt;0.001), while menarche at ≥16 decreases it (OR=0.89, CI=0.06-5.12, P&lt;0.001). Nulliparity increases risk 2.1 times (OR=2.1, CI=0.8-4.89, P=0.002), and more live births provide significant protection. Preterm delivery before the eighth month triples the risk (OR=2.9, CI=1.32-6.53, P=0.002). Multiple children prevent breast cancer, while mother's age at first full birth ≥30 raises the risk 3.5 times (OR=3.4, CI=1.45-7.88, P=0.014). Women who never breastfed had a significant twofold higher risk of breast cancer (OR=2, CI=0.8-4.38, P=0.003). Postmenopausal women at ≥50 years faced a threefold higher risk than their counterparts (OR=3.25, CI=1-1.11, P=0.004). Hormonal use showed a marginal risk increase (OR=1.2, CI=0.5-1.8, P&lt;0.001). Conclusion: Breast cancer susceptibility arises from diverse factors like genetics, nutrition, environment, and lifestyle. Effectively managing and preventing breast cancer involves implementing strategic control measures.