Population Of Reproductive Age Research Articles

Suicide among Reproductive-Age Women in Northwest Ethiopia: A Community-Based Cross-Sectional Study

Background. Suicide is one of the global burdens of morbidity and mortality in all reproductive-age women population groups across the world. It is one of the most significant contributors to the global burden of illness and a cause of morbidity. This study is aimed at finding out how it occurred and what risk factors were related to suicidal ideation and attempts among women in the reproductive-age group. Methods. A community-based cross-sectional study design was conducted using a multistage cluster sampling technique to get a total of 590 study participants from March to April 2021. Data were entered into EpiData version 3.1 and analyzed in bivariate and multivariable logistic regression models using Statistical Package for Social Science (SPSS) version 20. Variables with a p value <0.05 were declared to be associated risk factors with the outcome variable. Results. A total of 590 of the 598 sampled women participated, with a response rate of 98.7%. A one-month prevalence of suicidal ideation and attempt was 2.9% (95% CI: 1.5%, 4.4%) and 2.5% (95% CI: 1.4%, 3.7%), respectively. Intimate partner violence (AOR=4.69, 95% CI: 1.53, 14.45), depression (AOR=3.11, 95% CI: 1.11, 9.85), and history of mental illness (AOR=5.18, 95% CI: 1.55, 17.32) were associated risk factors for suicide ideation. Anxiety (AOR=3.55, 95% CI: 1.17, 10.81), being unmarried (AOR=4.39, 95% CI: 1.49, 12.87), and history of mental illness (AOR=7.95, 95% CI: 2.42, 26.15) were associated risk factors for suicide attempts. Conclusion. SI and SA are prevalent in reproductive-age women. Intimate partner violence, depression, anxiety, a history of mental illness, and being single were associated factors. This implies that providing relevant information, education, and continuing support is very crucial for reproductive-age group women to decrease the incidence and risk factors of suicide.

Increasing utilization of intrauterine device insertion at hysteroscopic endometrial evaluation for patients with endometrial hyperplasia.

To examine the utilization and characteristics related to the use of hysteroscopy at the time of endometrial evaluation for endometrial hyperplasia in the outpatient surgery setting. This cross-sectional study queried the Healthcare Cost and Utilization Project's Nationwide Ambulatory Surgery Sample. The study population was 3218 patients with endometrial hyperplasia who underwent endometrial evaluation from January 2016 to December 2019. Performance and clinical characteristics of hysteroscopic endometrial evaluation were assessed with multivariable binary logistic regression models. A total of 2654 (82.5%) patients had hysteroscopic endometrial tissue evaluation. Patients with postmenopausal bleeding, heavy menstrual bleeding, and polycystic ovary syndrome were more likely to undergo hysteroscopic endometrial evaluation in multivariable analysis (all, adjusted-P < 0.001). Uterine injury occurred in 4.9 per 1000 hysteroscopic endometrial evaluations; none had uterine injury in the non-hysteroscopy cohort. Among the 2654 patients who had hysteroscopic endometrial evaluation, 106 (4.0%) patients had intrauterine device insertion at surgery, and the utilization increased from 2.9 to 5.8% during the study period (P-trend < 0.001). Younger age, more recent year surgery, and obesity were independently associated with increased utilization of intrauterine device insertion at hysteroscopic endometrial evaluation (all, adjusted-P < 0.05). Among 2023 reproductive-age patients with endometrial hyperplasia, 1666 (82.4%) patients underwent hysteroscopic endometrial evaluation. On multivariable analysis, patients with heavy menstrual bleeding were more likely to have hysteroscopic endometrial evaluation (adjusted-P < 0.05). Intrauterine device insertion increased from 3.7% in 2016 to 8.0% in 2019 (P-trend = 0.007). This nationwide analysis suggests that the insertion of intrauterine devices at the time of hysteroscopic endometrial tissue evaluation for endometrial hyperplasia is increasing among reproductive-age population.

Assessment of Sexual Health and Use of Cervical Cancer Screening among the Female Working Population.

Cervical cancer occupies a significant place in the overall structure of morbidity and mortality in developing countries. We focused on the sexual health and use of cervical cancer screening among the female working population of reproductive age in Central Serbia. The research was conducted as a cross-sectional study, according to the methodology Stepwise approach to noncommunicable disease risk factor surveillance WHO. The study population consisted of 1182 female working population aged 18-49 years, living on the territory of Central Serbia. The method of simple random sampling was utilized in the research itself. An anonymous standardized questionnaire was used as a research tool. During the first sexual intercourse, 38.9% of the participants reported not having used any of the contraceptives, whereas 74.5% of the participants reported not having used them during their last sexual intercourse and 26.1% of the respondents reported not having had a single Pap smear in their lifetime. The multivariate logistic regression analysis singled out the following factors in women who reported not having done a Pap smear in their lifetime as the most significant ones: age - the youngest age group (OR = 3.30, CI = 1.80-6.04), unemployment (OR = 2.87, CI = 0.07-3.40), women who had never been married or had never been in a common-law marriage (OR = 2.55, CI = 1.40-4.66) and individuals with a medium education level (OR = 2.63, CI = 1.67-4.14). In Serbia, all the activities should be directed towards increasing the levels of awareness and knowledge on sexual health and cervical cancer screening services.

Сельская медицина в Республике Башкортостан: современное состояние и тенденции развития

The subject of the study is the regional healthcare system. The purpose of the study is the problems and prospects for the development of rural medicine in the Republic of Bashkortostan. The objectives of the study are to consider problems, analyze the current state and identify prospects for the development of healthcare in rural areas. Novelty of the research: the ranking of the main indicators of the functioning of rural medical institutions of the Republic of Bashkortostan in the context of the Russian Federation and the regions of the Volga Federal District was carried out. Conclusions: The reasons for the deterioration of the demographic situation in rural areas are low birth rates, high mortality, migration outflow of the rural population (intraregional, interregional, intercountry), reduction in the female population of reproductive age in comparison with urban ones, etc. One of the significant factors that has a negative impact The impact on the demographic situation in rural areas is also the state of health care in municipalities. Along with federal support, regional authorities need their own initiatives to attract and retain medical specialists in rural areas and improve the quality of medical services provided.

The Carolina hysterectomy cohort (CHC): a novel case series of reproductive-aged hysterectomy patients across 10 hospitals in the US south

BackgroundHysterectomy is a common surgery among reproductive-aged U.S. patients, with rates highest among Black patients in the South. There is limited insight on causes of these racial differences. In the U.S., electronic medical records (EMR) data can offer richer detail on factors driving surgical decision-making among reproductive-aged populations than insurance claims-based data. Our objective in this cohort profile paper is to describe the Carolina Hysterectomy Cohort (CHC), a large EMR-based case-series of premenopausal hysterectomy patients in the U.S. South, supplemented with census and surgeon licensing data. To demonstrate one strength of the data, we evaluate whether patient and surgeon characteristics differ by insurance payor type.MethodsWe used structured and abstracted EMR data to identify and characterize patients aged 18–44 years who received hysterectomies for non-cancerous conditions between 10/02/2014–12/31/2017 in a large health care system comprised of 10 hospitals in North Carolina. We used Chi-squared and Kruskal Wallis tests to compare whether patients’ socio-demographic and relevant clinical characteristics, and surgeon characteristics differed by patient insurance payor (public, private, uninsured).ResultsOf 1857 patients (including 55% non-Hispanic White, 30% non-Hispanic Black, 9% Hispanic), 75% were privately-insured, 17% were publicly-insured, and 7% were uninsured. Menorrhagia was more prevalent among the publicly-insured (74% vs 68% overall). Fibroids were more prevalent among the privately-insured (62%) and the uninsured (68%). Most privately insured patients were treated at non-academic hospitals (65%) whereas most publicly insured and uninsured patients were treated at academic centers (66 and 86%, respectively). Publicly insured and uninsured patients had higher median bleeding (public: 7.0, uninsured: 9.0, private: 5.0) and pain (public: 6.0, uninsured: 6.0, private: 3.0) symptom scores than the privately insured. There were no statistical differences in surgeon characteristics by payor groups.ConclusionThis novel study design, a large EMR-based case series of hysterectomies linked to physician licensing data and manually abstracted data from unstructured clinical notes, enabled identification and characterization of a diverse reproductive-aged patient population more comprehensively than claims data would allow. In subsequent phases of this research, the CHC will leverage these rich clinical data to investigate multilevel drivers of hysterectomy in an ethnoracially, economically, and clinically diverse series of hysterectomy patients.

National features of the new Chinese pronatalism

In 2016 the Chinese demographic policy, as a result of improving the regulation of population development, was radically reoriented to increase the birth rate. The rejection of «one-child policy» began with permission to have a second child, and soon was supplemented by second births stimulation. Taking into account the world pronatalism, socio-economic measures were applied. They showed that the most effective results can be achieved with the help of socio-economic tools that prevent deterioration of living conditions of families after childbirth. The regional diversity of China determines variability of such measures, but everywhere they begin with targeted «child» payments and the creation of conditions, which do not interrupt women’s professional career after pregnancy and delivery, then they are expanded through social help to families with children, tax relief, reduction of housing and education costs, as well as measures relevant for specific population groups (large families, single mothers, etc.). The main criterion of the assistance targeting is the number of children, but its size and forms depend on local capabilities. The importance of material factors of reproductive choice decreases with an increase of living standards, the conditions making it possible to combine parenthood and profession, large family traditions, gender of children, fertility preservation with safe contraception become more important. Measures, taking into account national specifics, include availability of assisted reproduction programs and promoting a modern three-child family among the population of reproductive age, a significant part of which belongs to the generation consciously focused on small family.

Understanding seminal plasma in male infertility: emerging markers and their implications.

Infertility affects a significant proportion of the reproductive-aged population, with male-associated factors contributing to over half of the cases. However, current diagnostic tools have limitations, leading to an underestimation of the true prevalence of male infertility. While traditional semen parameters provide some insights, they fail to determine the true fertility potential in a substantial number of instances. Therefore, it is crucial to investigate additional molecular targets responsible for male infertility to improve understanding and identification of such cases. Seminal plasma, the main carrier of molecules derived from male reproductive glands, plays a crucial role in reproduction. Amongst its multifarious functions, it regulates processes such as sperm capacitation, sperm protection and maturation, and even interaction with the egg's zona pellucida. Seminal plasma offers a non-invasive sample for urogenital diagnostics and has shown promise in identifying biomarkers associated with male reproductive disorders. This review aims to provide an updated and comprehensive overview of seminal plasma in the diagnosis of male infertility, exploring its composition, function, methods used for analysis, and the application of emerging markers. Apart from the application, the potential challenges of seminal plasma analysis such as standardisation, marker interpretation and confounding factors have also been addressed. Moreover, we have also explored future avenues for enhancing its utility and its role in improving diagnostic strategies. Through comprehensive exploration of seminal plasma's diagnostic potential, the present analysis seeks to advance the understanding of male infertility and its effective management.

Infertility Burden Across Indian States: Insights from a Nationally Representative Survey Conducted During 2019-21.

Infertility is an escalating global concern, impacting approximately one-sixth of the reproductive age population worldwide. Employing data from the National Family Health Survey-5 (NFHS-5, 2019-21), this study assessed the prevalence of primary infertility at both national and state levels in India. The data of the study was extracted from the National Family Health Survey and Individual file (women file) of the fifth round of NFHS encompassing a sample of 491,484 currently married women in the age group of 15-49 years. The findings showed that the prevalence of infertility is 18.7 per 1,000 women among those married for at least five years and currently in union. This prevalence increases as the duration of marriage decreases. On a state-level analysis, regions such as Goa, Lakshadweep, and Chhattisgarh exhibit the highest burdens. These findings underscore the growing challenge posed by primary infertility in India, calling for targeted interventions and policy measures. The establishment of a national infertility surveillance system is of pivotal importance in addressing this pressing public health issue.

Gravidity modifies the associations of age and spousal age difference with couple's fecundability: a large cohort study from China.

Do couple's age ranges for optimal fecundability, and the associations with fecundability of couple's age combinations and age differences differ with gravidity? The couple's age range of optimal fecundability and age combinations differed with gravidity, and gravidity might modify the associations of age and spousal age difference with couple's fecundability. Age is one of the strongest determinants of fecundability, but the existing studies have certain limitations in study population, couple's extreme age combinations and age differences, and have not explored whether the association between age and fecundability differs with gravidity. Retrospective cohort study. 5 407 499 general reproductive-aged couples (not diagnosed with infertility) participated in the National Free Pre-conception Check-up Projects during 2015-2017. They were followed up for pregnancy outcomes through telephone interviews every 3 months until they became pregnant or were followed up for 1 year. The main outcome was time to pregnancy, and the fecundability odds ratios and 95% CIs were estimated using the Cox models for discrete survival time. The associations of age and spousal age difference with fecundability were evaluated by restricted cubic splines. In this large cohort of general reproductive-aged population, the age of optimal fecundability of multigravida couples was older than that of nulligravida couples, but their subsequent fecundability declined more sharply with age. The decline in female fecundability was more pronounced with age, with fecundability dropping by ∼30% in both nulligravida and multigravida couples whose female partners aged ≥35 years. In the nulligravida group, the fecundability of couples who were both ≤24 years with the same age was the highest, which decreased steadily with the increase of spousal age difference, and younger male partners did not seem to contribute to improving couple's fecundability. In the multigravida group, couples with female partners aged 25-34 years and a spousal age difference of -5 to 5 years showed higher fecundability, and the effect of spousal age difference on couple's fecundability became suddenly apparent when female partners aged around 40 years. Young male partners were unable to change the decisive effect of female partner's age over 40 years on couple's reduced fecundability, regardless of gravidity. Lacking the time for couples to attempt pregnancy before enrollment, and some couples might suspend pregnancy plans during follow-up because of certain emergencies, which would misestimate the fecundability. Due to the lack of information on sperm quality and sexual frequency of couples, we could not adjust for these factors. Moreover, due to population characteristics, the extrapolation of our results required caution. The couple's age range of optimal fecundability, age combinations, and spousal age difference on fecundability varied with gravidity. Female age-related decline in fecundability was more dominant in couple's fecundability. Targeted fertility guidance should be provided to couples with different age combinations and gravidities. This research received funding from the Project of National Research Institute for Family Planning (Grant No. 2018NRIFPJ03), the National Key Research and Development Program of China (Grant No. 2016YFC1000307), and the National Human Genetic Resources Sharing Service Platform (Grant No. 2005DKA21300), People's Republic of China. The funders had no role in study design, analysis, decision to publish, or preparation of the manuscript. The authors report no conflict of interest. N/A.

Contemporary Demographic Development of the Republic of Bashkortostan: Review of the Regional Demographic Report

The article presents an overview of the collective scientific work revealing the features of the socio-demographic development of the region – the Demographic Report of the Republic of Bashkortostan. Based on official statistics and sociological research, the publication provides a comprehensive analysis of the processes of natural and migration movement of the population of the republic, examines some aspects of socio-economic development, as well as measures of regional social and demographic policy. The Demographic Report notes that the main trends of the Republic of Bashkortostan take place in the all-Russian context. These are the aging of the population, a decrease in the number of people of active working age; a decrease in the intensity of fertility, a decrease in the population of reproductive age, the dominance of reproductive attitudes towards childlessness; a change in the structure of mortality for reasons; transformation processes in the spheres of family and marriage (changes in value attitudes, marital behavior, etc.); centripetal, the nature of migration processes, high migration decline of young age groups. At the same time, the Demographic Report emphasizes that the general trends in the demographic development of Russia and Bashkortostan do not exclude that the processes of natural and migration movement of the population in the republic have their own specifics. This is due to the age, socio-territorial, ethnic structure of the population; the level of urbanization in the region; the existing system of urban and rural settlement; the peculiarities of socio-economic development of the republic and other factors. Socio-demographic indicators in Bashkortostan are also differentiated within the region, which is manifested at the sub-regional and municipal levels. The Demographic Report suggests measures in the areas of social and demographic policy. According to the authors, measures in the field of family and fertility, mortality and health, migration and employment should be closely interrelated and complement each other.

Assessment of Prior Infection With Hepatitis B Virus and Fecundability in Couples Planning Pregnancy

The association of hepatitis B virus (HBV) infection with reduced fecundability among reproductive-aged couples lacks large-population, in-depth study evidence. To investigate the association of HBV infection with time to pregnancy in couples planning pregnancy, and to explore whether this association varied by gravidity, health statuses, or lifestyles. This is a population-based cohort study of Chinese couples participating in the National Free Preconception Check-up Projects during 2015 to 2017. They were planning pregnancy and were followed-up every 3 months until getting pregnant, as confirmed by gynecologic ultrasonography, or were followed-up for 1 year. Data were analyzed between March 1, 2022, and September 30, 2022. The main outcome was time to pregnancy, assessed using fecundability hazard ratios (HRs). The Cox proportional hazards regression models were used to estimate the association of HBV infection with fecundability. Among 2 419 848 couples (mean [SD] age, 27.87 [5.20] years for women and 29.58 [5.50] years for men), 126 728 women (5.24%) and 156 572 men (6.47%) were infected with HBV. Compared with the HBV-negative group, the fecundability of both women and men in the HBV-positive group decreased by 5% (HR, 0.95; 95% CI, 0.94-0.95). Compared with couples in which both partners were HBV negative, the fecundability of those in which both partners were HBV positive declined by 6% (HR, 0.94; 95% CI, 0.93-0.96) among all couples, by 3% (HR, 0.97; 95% CI, 0.95-0.99) among nulligravidas couples, and by 7% (HR, 0.93; 95% CI, 0.91-0.95) among multigravidas couples. Both the female-male and couple models suggested that the association of HBV infection with decreased fecundability was more pronounced in couples with multigravidas. The negative association was greater in people with overweight and obesity and was inconsistent in certain subgroups; in particular, it was more pronounced in women with reproductive tract infections, normal fasting plasma glucose, and no alcohol intake and in men with normal blood pressure. In this population-based cohort study, HBV infection was associated with decreased fecundability in a general reproductive-aged population, especially in couples with multigravidas. For women and men with certain health statuses and lifestyles, a comprehensive consideration of this association is recommended to provide personalized fertility guidance.

Clinical characteristics and pathologic complete response (pCR) rate after neoadjuvant chemotherapy in postpartum women with breast cancer

PurposeBreast cancer (BC) is currently the leading cause of death in women worldwide. Studies have confirmed that pregnancy is an independent factor affecting the survival of BC patients. BC found during pregnancy, lactation, or shortly after delivery is what we used to think of as pregnancy-associated breast cancer (PABC). The current expert definition of this concept is not uniform; however, there is growing evidence that postpartum breast cancer (PPBC) differs from other types of BC in terms of both biological features and prognosis, with a slightly different focus on diagnosis and treatment. With the increase of female reproductive age population and changes in fertility policies in China, patients with PPBC are receiving increasing attention. Here, we systematically analyzed the clinicopathological characteristics and chemotherapeutic response of patients with PPBC. We retrospectively analyzed the clinicopathological data, molecular subtypes, chemotherapy regimens, and pathological complete remission (pCR) rates of 1343 patients with non-metastatic BC at Harbin Medical University Cancer Hospital from January 1, 2012 to May 31, 2023. The categorical data were compared by chi-square test and Fisher exact test using logistic regression model. Predictor variables with P < 0.05 in the univariate analysis were included in the multivariate regression analysis to investigate the relationship between different age groups and pCR.ResultsA total of 714 patients were eligible for analysis in this study, and 667 patients had a history of pregnancy, 40 (5.6%) of whom were PPBC patients. When diagnosed with BC, patients with PPBC were younger, more likely to undergo breast-conserving surgery (BCS), and more likely to achieve pCR (P < 0.05). In molecular typing, human epidermal growth factor receptor 2 (HER-2)-positive and triple-negative breast cancer (TNBC) were more frequent. In the entire cohort, HER-2 expression and delivery status were independent predictors of pCR rates in BC patients after neoadjuvant chemotherapy (NAC).ConclusionOur findings suggest that postpartum status is an independent predictor of pCR attainment in BC patients. PPBC is more sensitive to chemotherapy than other patients.We need to pay more attention to this group and achieve individualized treatment, which will help us treat BC better and provide new targets and blueprints for our clinical therapy.

The Diagnostics and Treatment of Recurrent Pregnancy Loss.

Recurrent pregnancy loss is a common problem in the reproductive age population of women. It can be caused by many different conditions. This problem is addressed in international guidelines that take a slightly different approach to its diagnosis and treatment. The guidelines used in this review mainly use the guidelines of the Royal College of Obstetricians and Gynaecologists (RCOG), American Society of Reproductive Medicine (ASRM) and European Society of Human Reproduction and Embryology (ESHRE). This review shows how much the approach to miscarriages has changed and how much more needs to be explored and refined. The review also addresses the topic of unexplained pregnancy loss, which continues to be a challenge for clinicians.

სოციალურ-ეკონომიკური ფაქტორების გავლენა შობადობის თანამედროევე ტენდენციებზე

სოციალურ-ეკონომიკური ფაქტორების გავლენა შობადობის თანამედროევე ტენდენციებზე

Aberrations in the progesterone pathway and the Th1/Th2 cytokine dichotomy - An evaluation of RPL predisposition in the northeast Indian population.

Recurrent pregnancy loss (RPL) is the spontaneous loss of two or more consecutive pregnancies prior to 20weeks of gestation, occurring in 1% of the reproductive-age population. It is a major cause of infertility in India with a staggering 7.46% prevalence rate. Blood and product of conception (POCs) from RPL cases (n=65) were enrolled for this study, along with cases of medically terminated pregnancy (MTP, n=80) and term delivery cases (n=90) as control. ELISA for progesterone and progesterone induced blocking factor (PIBF) levels was carried out, followed by mRNA expression analysis of progesterone receptor isoform B (PR-B) and its downstream immunomodulatory effectors, namely, PIBF, IL-10 and IL-12. Screening of PROGINS haplotype of PR gene and PIBF polymorphism were also conducted to correlate with their respective gene expression profiles. Serum progesterone level was found to be comparable in the RPL and MTP cases. Although the mRNA expression of PR-B was found to be downregulated in the RPL cases, no significant PROGINS haplotype was observed. Presence of a single nucleotide polymorphism (SNP) in the PIBF gene (rs1372000) was more in healthy controls compared to RPL cases. Serum PIBF levels were found to be lower in the RPL cases with a resultant increase in IL-12 and a decrease in IL-10 mRNA expression in these cases. This study indicates that progesterone, acting through PIBF, modulates the immunological state of pregnancy to be Th1-biased in RPL, indicative of a pro-inflammatory, labour-like state not desired for a healthy pregnancy.

P-573 What are Greek adults’ and teenagers’ knowledge and attitudes to having children?

Abstract Study question What is the level of fertility awareness and attitudes to having children among Greek teenagers and adults? Summary answer Fertility awareness among Greek teenagers and adults is limited with fundamental misconceptions which may be defining attitudes and may impact family planning and reproductive autonomy. What is known already According to the Organization for Economic Co-operation and Development, Greece is among the countries with the highest maternal age at first birth worldwide, while the total fertility rate has decreased alarmingly. The shift towards delayed parenthood is attributed to the lack of education concerning fertility issues and family planning options within the reproductive age population. This leads to dramatic misinterpretations regarding reproductive dynamic and respective choices. This study aimed to present current data and identify knowledge gaps. This will indicate where future initiatives should be focused to improve fertility awareness and education while respecting reproductive autonomy and individualism. Study design, size, duration This was a mixed methods study using an anonymous, online questionnaire. A 41-item questionnaire for adults and a 46–item questionnaire for teenagers were developed originating from a validated questionnaire from a previously published survey conducted in the UK. A total of 780 respondents completed the survey, which was live between the 11th and 26th of May 2022. Participants/materials, setting, methods Participants were adults and teenagers aged 17-45, who had not yet had children but wanted to in the future. Online Survey Software &amp; Tools for WEB design was employed to generate a friendly-format questionnaire for the respondents. The methodology employed was via CAWI (Computer Assisted Web Interviews). The questionnaire addressed demographics, knowledge on fertility matters, opinions and attitudes towards childbearing. Respondents were also offered the “prefer not to say”, and “don’t know” options. Main results and the role of chance The ideal age to have the first child differed significantly between men and women (32.33±4.50 vs 30.64±3.94; p &amp;lt; 0.001), as did the ideal age to have competed a family (38.71±5.18 vs 36.97±4.71; p &amp;lt; 0.001). Teenagers preferred to have completed their family at a younger age than the adults (33.82±5.87 vs 37.64±4.96; p &amp;lt; 0.001). The desired children number was 2.30±0.7 for men, 2.37±0.71 for women and 2.38±0.7 for teenagers. One third overestimated dramatically the start of fertility decline identifying it as age 46. Over 50% of men and teenagers were not aware of the timing of a women’s fertile window. Women seemed to be more informed on fertility and choose the physician as the educational resource (69%, 261/392), while men were mainly informed from their partners, and choose internet as the educational resource (67%,163/244). Women appeared more concerned with their fertility (191/392 vs 64/244) and felt more pressure to have children compared to men (135/392 vs 54/244; p = 0.02) mainly by their family. Interestingly, relating to reasons that my affected the decision to have children, the most common response for women was “I am not financially ready” (45%, 175/392), compared to men’s “I am ready to have children now” (39%, 96/244). Limitations, reasons for caution The fact that more women than men were included in the teenagers’ group posed a limitation. This study portrays knowledge and attitudes of a population of reproductive age that wants to have children, and hence cannot reflect on knowledge and attitudes on fertility of the general population. Wider implications of the findings Findings identify misinterpretations that may jeopardize family-planning, and lead to unintentional childlessness and age-related infertility. The desired number of children was greater than the actual number reported by OECD. This data calls the scientific community to enable informed reproductive choices by working interdisciplinary towards all-inclusively educating the general population. Trial registration number Not applicable

Vaginal carriage of Haemophilus influenzae in a non-pregnant reproductive-age population

BackgroundHaemophilus influenzae (Hi) is an emerging cause of early onset neonatal sepsis, but mechanisms of transmission are not well understood. We aimed to determine the prevalence of vaginal carriage of Hi in reproductive age women and to examine behavioral and demographic characteristics associated with its carriage.MethodsWe performed a secondary analysis of stored vaginal lavage specimens from a prospective cohort study of nonpregnant reproductive-age women. After extraction of bacterial genomic DNA, samples were tested for the presence of the gene encoding Haemophilus protein d (hpd) by quantitative real-time polymerase chain reaction (PCR) using validated primers and probe. PCR for the V3-V4 region of the 16 S rRNA gene (positive control) assessed sample quality. Samples with cycle threshold (CT) value < 35 were defined as positive. Sanger sequencing confirmed the presence of hpd. Behavioral and demographic characteristics associated with vaginal carriage of Hi were examined.Results415 samples were available. 315 (75.9%) had sufficient bacterial DNA and were included. 14 (4.4%) were positive for hpd. There were no demographic or behavioral differences between the women with Hi vaginal carriage and those without. There was no difference in history of bacterial vaginosis, vaginal microbiome community state type, or presence of Group B Streptococcus in women with and without vaginal carriage of Hi.ConclusionHi was present in vaginal lavage specimens of 4.4% of this cohort. Hi presence was unrelated to clinical or demographic characteristics, though the relatively small number of positive samples may have limited power to detect such differences.

Risk assessment of dietary exposure to trace elements that are reproductive toxicants: Lead, molybdenum and nickel. The case study of Armenia

The research aimed to assess dietary exposure to developmental toxicants (Mo, Ni, Pb) among the Armenian adult female population of reproductive age (18–49 years). Commonly consumed foods with a daily intake of more than 1 g in Armenia have been selected to assess the occurrence of Mo, Ni, and Pb. Food consumption data among the adult population in Armenia were collected in the frame of the national survey via 24-h recall method. Estimated daily intakes (EDI) and associated potential health risks for both mean and high (95 percentile) consumers were assessed based on the health-based guidance values (HBGVs). None of the EDI values for the developmental toxicants via individual food consumption exceeded the HBGVs, however, the EDI of Pb in the case of aggregate consumption of all food products exceeded HBGV of 0.5 μg/kg b.w./day, indicating possible concerns for the neurodevelopmental effects. Noticeably, the intake of Pb through some individual food items (cheese curd, beef and veal, pelmeni and khinkali, black coffee, tap water) and the aggregate consumption of all the studied foods led to a Margin of Exposure lower than 10 compared to HBGV.This study is the first one carried out on dietary exposure to developmental toxicants among women of fertile age in a Caucasus country. The outcomes prompt the need to investigate sources of Pb pollution in foods consumed in Armenia (natural or human-derived environmental pollution, as well as food contact materials, etc.) and may pave the way for similar studies in the Caucasus region.

Depopulation in Moldova: The main challenge in the context of extremly high emigration

In Moldova, there has been a long-term decline in the population, mainly due to high levels of emigration. The article presents an analysis of population dynamics in Moldova over the last three decades, and estimates the contributions of fertility, mortality and migration to this process. Using population censuses, data on the population with usual residence, vital statistics and data on Moldovan immigrants from the host countries’ statistical institutes,we estimate population changes between 1991–2021, and present demographic projections up to 2040. The results show that migration outflows account for more than 90% of the depopulation trend, with high levels of premature mortality accelerating the natural decline. The fall in births is associated with a decrease in the reproductive-age population. The total fertility rate has been decreasing gradually, while the cohort fertility rates have not fallen below 1.75 live births per woman. Past migration and low fertility are projected to result in long-term population decline. Demographic ageing is expected to increase. While population decline cannot be stopped, its scale can be limited through reductions in emigration and mortality. This study on population decline in Moldova helps to complete the demographic picture of Europe in the 20th century and into the 21st century.

МИГРАЦИОННЫЕ ПОТОКИ ВЫПУСКНИКОВ ШКОЛ И ВУЗОВ В РЕГИОНАХ РОССИЙСКОЙ АРКТИКИ: ОБЪЕМЫ, ВЕКТОРА И ОЦЕНКА СОРАЗМЕРНОСТИ

As the Russian Arctic regions have geopolitical importance, it is vital to study their social and human capital regeneration processes, including the role and influence of school graduates’ educational migration from the Arctic and university graduates’post-educational migration into the Arctic. The study’s scientific novelty lies in presenting a comprehensive assessment of school graduates’ outgoing flows from the Arctic regions and university graduates’ incoming flows from other areas using a single methodology across the country’s nine Arctic regions. Through statistical analysis and information comparison, it was revealed that most school graduates from the Arctic pursue higher education outside of this region, which is largely due to the restructuring of the higher education system, including the reduction of the number of branch campuses in the Arctic. The analysis of post-educational migration showed that the flow of university graduates coming to work in the Arctic from other regions slightly exceeds the outflow of graduates from Arctic universities. Still, this trend is not uniform across all Arctic regions. School graduates’ educational migration is not balanced as the outflow of high-school graduates from the Arctic regions is not fully compensated for by young professionals coming to the Arctic after graduation. This uncompensated educational migration poses significant risks such as a loss of qualified workers and a decline in the population of reproductive age, which may ultimately accelerate the depopulation process of this strategically important macro-region. As measures to address this issue, the authors propose creating a favorable environment for the younger generation’s development and holding events aimed at motivating young people to live, study, and work in the Russian Arctic. A relevant analytical base in the field of youth migration is necessary for regulating migration processes in the Arctic regions.