Non-pregnant Women Of Reproductive Age Research Articles

Establishment of cutoff values for anti-β2 glycoprotein I antibodies in women of reproductive age in Southwest China

Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by vascular thrombosis and obstetric morbidity, with accurate laboratory examination of antiphospholipid antibodies (aPLs) being crucial for diagnosis. This study focused on anti-β2 glycoprotein I (aβ2GPI) antibodies and aimed to establish the first population-based cutoff values for aβ2GPI IgA/IgM/IgG antibodies in non-pregnant women of reproductive age in Southwest China. The study cohort comprised 181 healthy women of reproductive age for study. Blood samples were collected on an early morning fast. Anti-β2GPI antibodies including IgA, IgM and IgG were measured in serum using the HOB® BioCLIA kit. According to the Clinical and Laboratory Standards Institute (CLSI) guidelines, the study used non-parametric percentile methods to calculate the 95th, 97.5th, and 99th percentiles cutoff values for aβ2GPI IgA/IgM/IgG antibodies, along with corresponding 90% confidence intervals (CI), while excluding outliers. A total of 168 independent samples were collected for verification, including 85 samples from healthy subjects and 83 samples from APS patients, in order to evaluate the analytical performance of the obtained cutoff values. The 99th percentile cutoff values were 3.36 RU/mL for aβ2GPI IgA, 27.54 RU/mL for aβ2GPI IgM and 1.81 RU/mL for aβ2GPI IgG, which indicated that the levels of aβ2GPI IgM antibodies were generally higher compared to those of IgA and IgG antibodies. Our established reference range was confirmed to be successful in validating the detected values of aβ2GPI antibodies in all healthy controls. With the 99th percentile cutoff value, the sensitivity was 14.46% for aβ2GPI IgA, 22.89% for aβ2GPI IgG, and 9.64% for aβ2GPI IgM in APS patients. This study established population-based cutoff values that are applicable to the local population for the accurate laboratory examination of aβ2GPI antibodies in non-pregnant women of reproductive age. The study also recommends paying more attention to IgM positivity in women of reproductive age.

Alterations of Placental Sodium in Preeclampsia: Trophoblast Responses.

Evidence suggests that increasing salt intake in pregnancy lowers blood pressure, protecting against preeclampsia. We hypothesized that sodium (Na+) evokes beneficial placental signals that are disrupted in preeclampsia. Blood and urine were collected from nonpregnant women of reproductive age (n=26) and pregnant women with (n=50) and without (n=55) preeclampsia, along with placental biopsies. Human trophoblast cell lines and primary human trophoblasts were cultured with varying Na+ concentrations. Women with preeclampsia had reduced placental and urinary Na+ concentrations, yet increased urinary angiotensinogen and reduced active renin, aldosterone concentrations, and osmotic response signal TonEBP (tonicity-responsive enhancer binding protein) expression. In trophoblast cell cultures, TonEBP was consistently increased upon augmented Na+ exposure. Mechanistically, inhibiting Na+/K+-ATPase or adding mannitol evoked the TonEBP response, whereas inhibition of cytoskeletal signaling abolished it. Enhanced Na+ availability induced osmotic gradient-dependent cytoskeletal signals in trophoblasts, resulting in proangiogenic responses. As placental salt availability is compromised in preeclampsia, adverse systemic responses are thus conceivable.

Waste as a Sustainable Source of Nutrients for Plants and Humans: A Strategy to Reduce Hidden Hunger

Worldwide, over half of all preschool-aged children and two-thirds of non-pregnant women of reproductive age suffer from hidden hunger. This situation may worsen due to the expected increase in the world population and the effects of climate change. The objective of this paper is to conduct a review of the relationship between soil, plants, and humans at the nutritional level, factors that affect the availability of nutrients, and sustainable strategies to reduce hidden hunger from an organic waste utilization point of view. Nutritional deficiency in people begins with nutrient-deficient soil, followed by crops that do not meet humans’ nutritional needs. According to previous studies, most agricultural soils are deficient in nutrients; however, organic residues containing high concentrations of minerals are present in the non-edible parts that are discarded. New opportunities (based on the circular economy strategy) are opening up to take advantage of the nutrient pool of organic residues, such as the preparation of substrates (technosols) or amendments. Their incorporation into the soil may consider various circumstances to ensure the mineralization and bioavailability of nutrients for crops. Several agronomic practices and methods to monitor soil and crop nutrient depletion can be considered among the best strategies to mitigate and reduce hidden hunger through determining which foods and which parts should be ingested, and how to process them to ensure mineral bioavailability.

Plasma volume is associated with micronutrient mass but not concentration in healthy US women of reproductive age

BackgroundPlasma transports nutrients and composes more than half of the volume of blood. A few prior studies suggest that plasma volume fluctuations may impact certain micronutrient concentrations. We hypothesized a slight negative correlation between plasma volume and micronutrient biomarkers throughout the menstrual cycle in healthy women of reproductive age (n = 45). MethodsThe study involved three visits during one menstrual cycle where fasting blood samples were taken to measure biomarker concentrations for zinc, copper, magnesium, manganese, iron, ferritin, retinol, and hemoglobin. A bolus dose of indocyanine green (ICG; equivalent to 0.25 mg.kg-1 of body weight) was injected to measure plasma volume. The total circulating micronutrient biomarker mass was calculated using the plasma volume and biomarker concentration. We used Spearman's correlation and fractional polynomial regression techniques to assess the relationship between plasma volume and biomarker concentration and mass. ResultsPlasma volume ranged from 1210 to 3520 mL. During all three visits, the correlation between micronutrient biomarker concentrations and plasma volume ranged from -0.05 to 0.10 (all P > 0.05); However, there was a strong positive correlation between biomarker mass and plasma volume, ranging from 0.26 to 0.95 (all P < 0.05). Five of the eight biomarkers examined (zinc, copper, magnesium, retinol, and hemoglobin) showed a correlation coefficient > 0.70 (P < 0.001) between mass and plasma volume. ConclusionOur findings indicate that biomarker concentrations are maintained across a range of plasma volume, suggesting that plasma volume may not be necessary to interpret micronutrient status in healthy non-pregnant women of reproductive age.

Analysis of Pain in Lower Abdomen among Non-pregnant Reproductive-age Women

Analysis of Pain in Lower Abdomen among Non-pregnant Reproductive-age Women

Persistent Challenges of Micronutrient Deficiencies in Latin America Need Action.

Micronutrient deficiencies affect growth and development and are critical for maintaining health at all ages. Their critical role in exacerbating complications of infections and chronic diseases continues to impact morbidity, mortality, and quality of life for many. Raising awareness and advocating for micronutrient deficiencies in Latin America is urgent to reduce this preventable burden. Globally, an estimated 372 million preschool-aged children and 1.2 billion non-pregnant women of reproductive age suffer deficiency from 1 or more micronutrient. Data is limited and often old, and the true burden of problem in the region remains unclear. There are also limited data on dietary intake and on the double burden of malnutrition. Latin America has been a leader in the design and implementation of innovative and effective actions to reduce excess energy intake and curb the consumption of unhealthy Actions to address deficiency have been implemented in many countries in the region over the years, but current evidence suggests that micronutrient deficiencies have fallen off the public health agenda in Latin America. Effective programming can be developed / appropriately adapted only with knowledge of the current burden. Such data can also help guide and predict future areas of risk and priorities to missing upcoming nutrition issues in the population. Renewed commitment to quantify and monitor micronutrient deficiencies in the region is essential. Abundant evidence and guidance exist to inform effective program selection, design and implementation to address this public health problem.

Effect of COVID-19 infection on female sexual function: A prospective controlled study.

This prospective controlled study investigates the effects of coronavirus disease 2019 (COVID-19) on female sexual function, comparing recovered COVID-19-positive women with those uninfected by the virus. It aims to elucidate the broader impacts on sexual health and psychological well-being. This prospective controlled study included nonpregnant women of reproductive age and their partners, divided into COVID-19- positive (recovered) and negative groups. Data collection took place on average 6 months after COVID-19 recovery. Information was collected on the number of people exposed to COVID-19 and the severity of infection (mild, moderate or severe). Participants completed validated questionnaires assessing sexual function (female sexual function index [FSFI]), anxiety (state-trait anxiety inventory [STAI]) and depressive symptoms (Beck Depression Inventory). We compared sexual function, psychological well-being and demographic characteristics between the groups using statistical analyses to identify significant differences. The study reveals significant resilience in sexual function, psychological well-being, and demographic characteristics among the participants, regardless of COVID-19 status. No marked differences were found in sexual desire, arousal, lubrication, orgasm, satisfaction, or pain during sexual activity between the groups. Psychological assessments indicated uniform anxiety levels across both cohorts, underscoring a theme of psychological resilience. The analysis of partners' sexual function highlighted minimal indirect impacts of the pandemic on intimate relationships. Despite the extensive global health implications, this study demonstrates resilience in female sexual function and psychological health among those affected by the virus. These findings emphasize the need for ongoing research and targeted interventions to support individuals navigate the pandemic-evolving challenges, highlighting resilience and adaptability as key factors in maintaining well-being.

Retrospective audit compares screening and treatment of pregnancy-related anaemia in regional New South Wales with Australian guidelines

BackgroundAnaemia during pregnancy is common worldwide. In Australia, approximately 17% of non-pregnant women of reproductive age have anaemia, increasing to a rate of 25% in pregnant women. This study sought to determine the rate of screening for anaemia in pregnancy in regional New South Wales, and to determine whether screening and treatment protocols followed the recommended guidelines.MethodsThis retrospective study reviewed antenatal and postnatal (48 h) data of women (n = 150) who had a live birth at Bathurst Hospital between 01/01/2020 and 30/04/2020. Demographic data, risk factors for anaemia in pregnancy, antenatal bloods, treatments provided in trimesters one (T1), two (T2) and three (T3), and postpartum complications were recorded. These were compared to the Australian Red Cross Guidelines (ARCG) using descriptive statistics.ResultsOf the women with screening data available (n = 103), they were mostly aged 20-35yrs (79.6%), 23.3% were obese, 97.1% were iron deficient, 17% were anaemic and only a few (5.3%) completed the full pregnancy screening as recommended by the ARCG while a majority completed only partial screenings specifically Hb levels in T1 (56.7%), T2 (44.7%) and T3 (36.6%). Compliance to oral iron was largely undocumented, but constipation was a common side effect among the women. IV iron was administered in 14.0% of women, approximately 1.75x higher than the recommended rate.ConclusionsThis study provided useful information about compliance to screening and treatment guidelines for anaemia in pregnancy. We identified the need for improved documentation and communication between various health providers to ensure adequate antenatal care to prevent maternal complications during pregnancy. This will improve patient care and encourage further developments in maternal care, bridging the rural health gap.

Associations Between Selected Micronutrient Deficiencies and Cognitive Function and Symptoms of Depression Among Non-pregnant Women of Reproductive Age in Punjab, India

Associations Between Selected Micronutrient Deficiencies and Cognitive Function and Symptoms of Depression Among Non-pregnant Women of Reproductive Age in Punjab, India

Effect of Quintuply-Fortified Salt on Micronutrient Status of Non-pregnant Women of Reproductive Age in Punjab, India

Effect of Quintuply-Fortified Salt on Micronutrient Status of Non-pregnant Women of Reproductive Age in Punjab, India

Sociodemographic Factors Associated With Anemia Among Non-pregnant Women of Reproductive Age in Punjab, India

Sociodemographic Factors Associated With Anemia Among Non-pregnant Women of Reproductive Age in Punjab, India

Фактори ризику аденоміозу в жінок репродуктивного віку

The problem of adenomyosis is of particular relevance to patients of reproductive age since these diseases are accompanied by significant violations of the menstrual and generative functions. Aim - determine the risk factors for the development of adenomyosis in women of reproductive age in order to improve a complex pathogenetically based approach in the selection of treatment. Materials and methods. Analysis of anamnestic data and examination of 90 women of reproductive age with adenomyosis, which made up the main group, was carried out. The control group - 30 gynecologically healthy non-pregnant women of reproductive age. Results. The article provides data on the results of clinical-statistical analysis among reproductive-age women with the adenomyosis. The risk factors of development of adenomyosis in investigated group are determined. Those are: complicated heredity, high frequency of the clinical abortions, spontaneous miscarriages, pathological deliveries in the past. The low index of health is observed in such category of women: high sick rate of gynecological or extragenital pathology, 3 times higher frequency of child's and respiratory illnesses, the surgical intervention on uterus and ovarium promotes the progress of the endometriosis. That the most frequent clinical manifestations of adenomyosis are pain and hemorrhagic syndrome. Conclusions. The clinical and statistical analysis of the examined patients made it possible to identify risk factors for the development of adenomyosis in women of reproductive age: burdened heredity (60%), unmarried and single women (58.5%); employees with intellectual and mental and neuropsychological stress (63.3%), high infection index, accompanying extragenital pathology (37.4%), menstrual cycle disorders (93.3%) and reduced reproductive and sexual function; aggravated gynecological history: chronic inflammatory processes of the uterus and appendages (44.2%), pathology of the cervix (36.5%), artificial (66.6%) and involuntary (14.4%) abortions; intrauterine surgical interventions (76.3%). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Differences in Associated Factors of Underweight and Overweight According to Rural-Urban Residence Strata among Ever-Married Non-Pregnant Women of Reproductive Age in Bangladesh.

This study sought to compare the prevalence of underweight and overweight among ever-married, non-pregnant women of reproductive age in Bangladesh by urban or rural residency status. This study used Bangladesh Demographic and Health Survey (BDHS), 2017 data. Cross-sectional study design with two-stage stratified sampling method was employed. A sample of ever-married non-pregnant women of reproductive age was selected and multinomial logistic regression was utilised in analysis. It was found that around half of rural women (45.0%, N = 4,934) and more than half of urban women (60.3%, n = 3,913) were overweight. Nearly one in seven rural women (14.0%, n = 1,537) and 1 in 12 urban women (9.0%, n = 564) were reported as underweight. Our analyses revealed that being overweight was substantially connected with age, husband's occupation, economic status, television access, and division for both urban and rural areas. Women from poor households were significantly more likely to be underweight than women from middle- income households for both urban (P < 0.05; OR: 1.41; 95% CI: 1.03, 1.94) and rural (P < 0.05; OR: 1.23; 95% CI: 1.04, 1.46) areas. Interestingly, women without television access both in urban (P < 0.001; OR = 0.78; 95% CI: 0.67, 0.91) and rural (P < 0.001; OR = 0.75; 95% CI: 0.68, 0.84) areas had an inverse association with overweight/obesity compared to women with television access. In both areas, women in Sylhet and Mymensingh had higher likelihood of being underweight than Barisal division. Additionally, in both residential zones, women in Sylhet had lower likelihood of being overweight than Barisal division. This study reveals that multiple characteristics are linked to both overweight and underweight among ever-married, non-pregnant women of reproductive age in Bangladesh. Addressing these variables should be a priority in public health efforts to combat the dual challenge of malnutrition in Bangladesh.

Modern approaches to restoring vaginal microbiocenosis

The article presents literary data on the morphology and types of vaginal lactobacilli, pathological changes in the vaginal environment, as well as modern possibilities of restoring the vaginal microflora of a woman’s organism. Certain regularities regarding the connection of bacterial vaginosis with intestinal dysbiosis have been observed, which indicates a single dysbiotic process in the organism with a dominant manifestation either in the sexual or digestive system.A review of scientific publications of recent years shows the significant influence of intestinal dysbiosis, infectious and inflammatory diseases of the stomach and intestines, as well as the oral use of antibacterial drugs on the quantitative and qualitative composition of the vaginal microflora in women. It was found that an increased number of opportunistic microorganisms (85%) and a decreased number of lactobacilli and bifidobacteria (less than 70%) in the intestine are associated with a rise in the content of opportunistic microorganisms in the vaginal biota in women with infectious and inflammatory diseases of the reproductive system. This is explained by the ability of saprophytes and opportunistic microorganisms to penetrate into the reproductive organs of women by increasing the permeability of the mucous membrane of the intestinal wall, as well as into the vascular bed, which can be observed, for example, on the background of antibiotic use. The antibiotic use in a number of cases leads to a closed circle, when the need for antibacterial therapy to eliminate one infection leads to a deepening of dysbiosis and an increased number of other pathogens.Numerous studies have demonstrated the effectiveness of selective decontamination (selective elimination of pathogens) in combination with a probiotic, prebiotic or synbiotic to restore vaginal microbiocenosis.Our experience of using an oral synbiotic (1 capsule contains 5 billion colony-forming units of Lactobacillus plantarum lyophilizate pcs. 8Р-AZ, Lactobacillus fermentum pcs. 90Т-С4 and prebiotic inulin, once a day 30 minutes before meal for 7–10 days) in a complex therapy of bacterial vaginosis in non-pregnant women of reproductive age indicates faster elimination of systemic dysbiosis and restoration of normal intravaginal flora. Thus, regression of complaintsand normalization of objective data was determined on average for 2.9 days versus 4.7 days in women who were not administered the drug.The obtained data show that a systemic synbiotic containing a lyophilized microbial mass of probiotic lactobacteria, products of their metabolism and inulin (prebiotic) creates an additional effect in restoring normal biocenosis and the immune mechanism of ensuring colonization resistance of the body’s mucous membranes.

Estimation of haemoglobin using non-invasive portable device with spectroscopic signal application

An estimated 52% of non-pregnant women of reproductive age in India are estimated to be affected by anaemia, which is categorised as a chronic condition. In 2019–2021, the National Family Health Survey–5 (NFHS–5) which was undertaken revealed the following statistics about the prevalence of anaemia in the state of Karnataka. To estimate haemoglobin levels using non-invasive portable device among nursing students. A cross sectional study was done among students of Nursing college in central Karnataka for a period of 3 months. Total of 140 students were included in the study. EzeCheck haemoglobin estimation was done twice and was recorded in the same Google form. The frequency and percentage of variation of results between Haematology Analyzer and EzeCheck devices was presented with a range of difference such as 0, less than 1, 1.0 to 1.9, 2.0 to 2.9, 3.0 to 3.9, and 4.0 and above. The total prevalence of anaemia among nursing students was 57.8% and most of the students had moderate degree of anaemia (28.6%). Two readings of haemoglobin were taken and difference of readings were calculated and majority of the students had difference of < 0.5 gm/dl (61.4%) and only 1.4% of the students had difference of > 2 gm/dl. The mean difference of haemoglobin of two readings was 0.5 ± 0.5 gm/dl. The technology employed in this study bridges the gap between patients and anaemia diagnosis by providing screening services. The device provides the diagnosis via a non-invasive, IoT-enabled service at a low cost.

Imbalance of gut microbiota in gestational diabetes

AimTo investigate the differences in gut microbiota composition among nonpregnant women of reproductive age, healthy pregnant women, and gestational diabetes (GD) patients.MethodsA total of 45 outpatients were enrolled and divided into three groups: nonpregnant women of reproductive age (control group, n = 23), healthy pregnant women (normal group, n = 10), and GD patients (GD group, n = 12). Faecal samples were collected and sequenced using 16S rRNA gene sequencing to analyse the microbial composition.Results(1) Pregnant patients exhibited an increase in the abundance of Streptococcus (Pnormal = 0.01286, PGD = 0.002965) and Blautia (Pnormal = 0.0003924, PGD = 0.000246) but a decrease in the abundance of Roseburia (Pnormal = 0.0361, PGD = 0.007075), Phascolarctobacterium (Pnormal = 0.0003906, PGD = 0.02499) and Lachnoclostridium (Pnormal = 0.0003906, PGD = 0.03866). (2) Compared with healthy pregnant women, GD patients had an excessive increase in Streptococcus abundance and decrease in Roseburia abundance. The increase in Blautia abundance and the decrease in Phascolarctobacterium and Lachnoclostridium abundance in GD patients were less than those in healthy pregnant women. (3) The abundance of Faecalibacterium prausnitzii decreased significantly in GD patients (PGD = 0.02985) but not in healthy pregnant patients (Pnormal = 0.1643).ConclusionsAbnormal increases and decreases in the abundances of gut microbiota components, especially Faecalibacterium prausnitzii, were observed in GD patients.Trial registrationThe cross-sectional research was conducted in accordance with the Declaration of Helsinki, and approved by Sir Run Run Shaw Hospital Clinical Trials and Biomedical Ethics Committee. The study has been registered in the Chinese Clinical Trial Registry (ChiCTR1900026164, 24/09/2019, http://www.chictr.org.cn/showproj.aspx?proj=43,455).

Clinicopathological Pattern of Endometrial Specimens in Women with Abnormal Uterine Bleeding and Ultrasonography Correlation.

Abnormal uterine bleeding (AUB) refers to any symptomatic deviation from normal menstruation. AUB is a common gynecological disorder in non-pregnant women of reproductive age, accounting for approximately 33% of gynecological outpatient visits. The early diagnosis and management cause of AUB is important because of increased incidence of endometrial carcinoma with rapid growth. Transvaginal ultrasound is non-invasive imaging technique used to find endometrial carcinoma before referring patients for invasive techniques. Dilatation and curettage (D&C) and endometrial biopsy are surgical procedures that scrape the endometrial lining of the uterus for diagnosis and treatment. The aim of this study is to describe the clinicopathologic pattern of endometrial specimens in women with AUB and ultrasonographic correlation. Tissues from endometrial biopsy and curettage of 411 patients with AUB who referred to Shahid Mohammadi hospital were prospectively selected from 2021 to 2023. Patients were divided into three groups based on age and menstrual status including: premenopausal (18-39 years), perimenopausal (40-49 years) and postmenopausal (≥50 years). The results were correlated to patient's age and other data and evaluated with statistical analysis. During the two-year study period, a total of 411 endometrial specimens with clinical diagnosis of AUB were submitted and the results were analyzed. The youngest patient presenting with AUB was 21 years old, while the oldest was 77 years old. The most common complaint was menorrhagia in 201 (48.0%) out of 411 patients. The most common pathology finding in three groups was polyp in 100 (24.3%) cases. Hormonal effect was the next commonly observed pattern seen in 70 (17.0%) cases. P value was calculated as 0.003 which was significant using chi-square for the trend seen in age. Endometrial sampling is a useful tool for evaluation of women with AUB and referring patients for treatment. Histopathological evaluation of the endometrium is very useful in detecting the etiology of AUB. Transvaginal sonography has high sensitivity in detecting polyps.

Folate and vitamin B12 status and predicted neural tube defects risk among nonpregnant women of reproductive age from the Malawi National Micronutrient Survey, 2015-2016.

Maternal folate and vitamin B12 deficiency can lead to serious adverse pregnancy outcomes. There are no nationally representative estimates on folate and vitamin B12 status among women of reproductive age (WRA) in Malawi. We assessed folate and vitamin B12 status among nonpregnant WRA in Malawi and predicted the risk of folate-sensitive neural tube defects (NTDs) were they to become pregnant. Using data from the cross-sectional, nationally representative 2015-2016 Malawi Micronutrient Survey, we calculated the proportion of folate and vitamin B12 deficiency and insufficiency by demographic characteristics among 778 nonpregnant WRA (15-49 years). We predicted NTD prevalence using red blood cell (RBC) folate distributions and a published Bayesian model of the association between RBC folate and NTD risk. Analyses accounted for complex survey design. Among WRA, 8.5% (95% CI: 6.2, 11.6) and 13.3% (10.0, 17.4) had serum (<7 nmol/L) and RBC folate (<305 nmol/L) deficiency, respectively. The proportion of vitamin B12 deficiency (<148 pmol/L) and insufficiency (≤221 pmol/L) was 11.8% (8.6, 16.0) and 40.6% (34.1, 47.4), respectively. RBC folate insufficiency (<748 nmol/L, defined as the concentration associated with the threshold for elevated NTD risk: >8 cases per 10,000 births) was widespread: 81.4% (75.0, 86.4). The predicted NTD risk nationally was 24.7 cases per 10,000 live births. RBC folate insufficiency and higher predicted NTD risk were more common among WRA living in urban areas or with higher education. These findings highlight the importance of nutritional and NTD surveillance in Malawi and the opportunity for improving folate and vitamin B12 nutrition among Malawian WRA.

Naloxone access in perinatal substance use disorder

BackgroundRisk of fatal drug overdose is higher in pregnant and postpartum people with substance use disorder (SUD) than for nonpregnant women of reproductive age. It is recommended that naloxone is prescribed for pregnancies complicated by opioid or stimulant use disorder. ObjectiveThe purpose of this study was to assess the rates of naloxone coprescribing with buprenorphine in a perinatal SUD (PSUD) specialty clinic and identify opportunities for pharmacist-led interventions to improve communication and documentation surrounding naloxone access to achieve a rate of 100% coprescribing of naloxone with buprenorphine. Practice descriptionA clinical pharmacist practitioner is embedded on the Project CARA (Care that Advocates Respect/Resilience/Recovery for All) team, which provides outpatient SUD care integrated with perinatal care in Western North Carolina. Practice innovationThe clinical pharmacist practitioner assessed baseline rates of naloxone coprescribing with medications for opioid use disorder. Interventions to improve rates of coprescribing include provider education, electronic health record (EHR) documentation templates, and direct patient outreach. Evaluation methodsBaseline rates of naloxone coprescribing were assessed and then re-evaluated after different interventions to measure pharmacist impact. ResultsEach intervention improved rates of naloxone coprescribing in a PSUD clinic. EHR documentation templates had the largest impact on baseline efforts, although the long-term benefits derived from these efforts have not yet been demonstrated. Substantial time investment from the pharmacist was required to address patients’ barriers to obtaining naloxone after their visits. ConclusionFurther process improvement should address barriers to naloxone access for both patients and providers. This may include proactive identification of patients in need of naloxone and a “meds-to-beds” pilot to assist patients in navigating logistical challenges.

Perioperative Exercise Testing in Pregnant and Non-Pregnant Women of Reproductive Age: A Systematic Review.

Women have classically been excluded from the development of normal data and reference ranges, with pregnant women experiencing further neglect. The incidence of Caesarean section in pregnant women, and of general operative management in young women (both pregnant and non-pregnant), necessitates the formal development of healthy baseline data in these cohorts to optimise their perioperative management. This systematic review assesses the representation of young women in existing reference ranges for several functional exercise tests in common use to facilitate functional assessment in this cohort. Existing reference range data for the exercise tests the Six Minute Walk Test (6MWT), the Incremental Shuttle Walk Test (ISWT) and Cardiopulmonary Exercise Testing (CPET) in young women of reproductive age were assessed using the MEDLINE (Ovid) database, last searched December 2023. Results were comparatively tabulated but not statistically analysed given underlying variances in data. The role of exercise testing in the perioperative period as an assessment tool, as well as its safety during pregnancy, was evaluated using 65 studies which met inclusion criteria. There is a significant lack of baseline data regarding these tests in this population, especially amongst the pregnant cohort, which limits the application of exercise testing clinically.