Females Of Reproductive Age Research Articles

OA24 Age-associated T-bet+ B cells in healthy and autoimmune pregnancy

Abstract Background/Aims Inflammatory rheumatic diseases (IRD), including systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), affect females of reproductive age and are characterised by loss of immune tolerance and an increased burden of adverse pregnancy outcomes (APO). Mechanisms by which IRD may affect immune adaptations of healthy pregnancy to maintain host and fetal defence whilst tolerating male fetal antigens are poorly characterised. This study aimed to investigate B cell subpopulations in healthy and IRD in pregnancy, with a focus on IgD-CD27- (double negative, DN) T-bet+ B cells, considered pathogenic in IRD. Given disparate relationships between disease activity and risk of APO in SLE and RA pregnancy, the objective of this pilot study was to determine if pregnancy alters the frequency and/or the phenotype of DN T-bet+ B cells in IRD compared with healthy control pregnancies. Methods Peripheral blood mononuclear cells were obtained from IRD pregnancy (SLE n = 5; RA n = 8), IRD non-pregnancy (SLE n = 12; RA n = 10), and healthy pregnant (n = 8) people at University College London Hospital by informed consent. Cells were analysed by flow cytometry to identify B cell subpopulations and their expression of multiple markers including T-bet, IFN-γR, TLR7, TLR9, Ki67, CD38 and CD19 was assessed. Results There were no significant differences in B cell subpopulations, categorised based on the expression of IgD and CD27, between the cohorts. In healthy pregnancy, the median frequency (%) of CD19+T-bet+, IgD-CD27+T-bet+, DNT-bet+ cells was 5, 1.3 and 2, respectively. In contrast, the median frequency of CD19+T-bet+ cells was significantly elevated in SLE pregnancy at 13% compared with 5% (p < 0.05) in healthy pregnancy[GI3] [RV4] . Similarly, the median frequency of DNT-bet+ B cells was elevated in SLE pregnancy at 6% compared with 2% (p = 0.009) in healthy pregnancy. RA pregnancy, but not SLE pregnancy, had significantly lower frequency of Ki67+ DN T-bet+ cells compared to non-pregnant RA (p=0.04) and SLE (p=0.07). ROC analysis demonstrated that for both RA (p = 0.016, AUC = 0.84, 95% CI [0.65, 1.00]) and SLE (p = 0.015, AUC=0.88) the frequency of DN T-bet+ Ki67+ B cells can discriminate between pregnancy and non-pregnancy samples. In pooled analysis (n = 43), but not in single cohorts, DN T-bet+ cells had significantly high TLR7 and TLR9 expression. High frequencies of CD19hi DN T-bet+ cells were found but were unaffected by pregnancy. Clustering revealed canonical DN T-bet+ clusters and CD38hi T-bet+ clusters enriched in SLE and pregnancy-altered. Conclusion We have immunophenotyped B cell populations in healthy pregnancy and identified different patterns of alteration in frequency and proliferation of DNTbet+ cells in IRD compared with healthy pregnancy that are disease specific. This pilot study reveals previously unrecognized immunological changes in disease pregnancy warranting further larger studies of their mechanistic basis and clinical relevance. Disclosure S. Benton: None. C. Raine: None. K. Shah: None. S. Luong: None. A. Venkatkrishnan: None. M. Leandro: None. M. Castelino: None. D. Sen: None. D.A. Isenberg: None. A. Akbar: None. I. Giles: Grants/research support; IG has received an unrestricted research grant, travel and speaker fees from UCB Pharma. V.R. Reddy: None.

V736A (rs855791) polymorphism in the TMPRSS6 gene is associated with iron deficiency anemia in females of reproductive age: A meta-analysis

BackgroundSeveral studies suggested that mutations in the TMPRSS6 gene affect hepcidin production, which may lead to iron deficiency anemia (IDA). Hence, this meta-analysis explored the association of the V736A or the rs855791 polymorphism in the TMPRSS6 gene with IDA development. MethodsRelated studies were searched as of December 24, 2023. Two authors screened the resulting studies, and data were extracted and collated in a customized spreadsheet. Review Manager 5.4 and Meta-Essentials were used to compute the odds ratios (ORs) and 95% confidence intervals (CIs). ResultsA total of 187 studies were screened. From this, only six studies satisfied the inclusion criteria and were included in the meta-analysis. Analysis of the allelic model showed a high degree of inter-study heterogeneity, which prompted us to determine the cause through sub-group analysis. Sub-groups were conceptualized based on the participant characteristics. Based on this, homogenous findings were observed for the allelic, co-dominant, and dominant models of the association between the polymorphism and the development of IDA among females of reproductive age still experiencing menstruation. Non-significant and highly heterogeneous outcomes were noted for the other sub-groups. ConclusionOverall, based on the pooled findings, the V736A polymorphism is associated with IDA development in females of reproductive age still experiencing menstruation. However, further studies are needed to verify these claims.

Gut Microbes in Polycystic Ovary Syndrome and Associated Comorbidities; Type 2 Diabetes, Non-Alcoholic Fatty Liver Disease (NAFLD), Cardiovascular Disease (CVD), and the Potential of Microbial Therapeutics.

Polycystic ovary syndrome (PCOS) is one of the most common endocrine anomalies among females of reproductive age, highlighted by hyperandrogenism. PCOS is multifactorial as it can be associated with obesity, insulin resistance, low-grade chronic inflammation, and dyslipidemia. PCOS also leads to dysbiosis by lowering microbial diversity and beneficial microbes, such as Faecalibacterium, Roseburia, Akkermenisa, and Bifidobacterium, and by causing a higher load of opportunistic pathogens, such as Escherichia/Shigella, Fusobacterium, Bilophila, and Sutterella. Wherein, butyrate producers and Akkermansia participate in the glucose uptake by inducing glucagon-like peptide-1 (GLP-1) and glucose metabolism, respectively. The abovementioned gut microbes also maintain the gut barrier function and glucose homeostasis by releasing metabolites such as short-chain fatty acids (SCFAs) and Amuc_1100 protein. In addition, PCOS-associated gut is found to be higher in gut-microbial enzyme β-glucuronidase, causing the de-glucuronidation of conjugated androgen, making it susceptible to reabsorption by entero-hepatic circulation, leading to a higher level of androgen in the circulatory system. Overall, in PCOS, such dysbiosis increases the gut permeability and LPS in the systemic circulation, trimethylamine N-oxide (TMAO) in the circulatory system, chronic inflammation in the adipose tissue and liver, and oxidative stress and lipid accumulation in the liver. Thus, in women with PCOS, dysbiosis can promote the progression and severity of type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), and cardiovascular diseases (CVD). To alleviate such PCOS-associated complications, microbial therapeutics (probiotics and fecal microbiome transplantation) can be used without any side effects, unlike in the case of hormonal therapy. Therefore, this study sought to understand the mechanistic significance of gut microbes in PCOS and associated comorbidities, along with the role of microbial therapeutics that can ease the life of PCOS-affected women.

Does a Healthy Weight Body Mass Index at Onset of Idiopathic Intracranial Hypertension Change the Outcomes? A United Kingdom Prospective Cohort Study

ABSTRACT Idiopathic intracranial hypertension (IIH) predominantly affects reproductive-aged females with obesity. However, the prevalence and impact of a healthy weight body mass index (BMI) at disease presentation is not known. This study aimed to evaluate the visual and headache outcomes stratified by the presenting BMI. This was a longitudinal prospective cohort study (IIH Life) based on a tertiary neuro-ophthalmology IIH service, University Hospitals Birmingham NHS Trust, United Kingdom, recruiting consecutive patients living with IIH between 2012 and 2021. Those with a presenting BMI were included. The outcome measures included visual outcomes of LogMAR visual acuity, Humphrey visual field perimetric mean deviation (PMD), optical coherence tomography (OCT) measurements, and headache outcomes of frequency, severity, and Headache Impact Test-6 score. Three hundred seventy-five people with IIH and a documented baseline BMI. About 3.7% of the entire cohort had a healthy weight BMI at IIH presentation and 15.5% BMI < 30 kg/m2. The baseline PMD was worse in patients without obesity; however, OCT papilloedema measures were similar. The presence of obesity was associated with a small but significant greater worsening in visual acuity but slower macular ganglion cell layer loss. There was no impact on PMD or papilloedema prognosis related to baseline obesity. The headache outcomes showed heterogeneity, with worse baseline headache frequency in patients with obesity. No BMI group was associated with worse headache outcomes. Patients with a healthy weight BMI or those without obesity at baseline make up a small proportion of IIH patients. BMI at presentation does not appear to influence long-term visual or headache outcomes.

Management of Polycystic Ovarian Syndrome: A Qualitative Inquiry among Complementary and Alternative Medicine Practitioners in South Africa.

Polycystic ovarian syndrome (PCOS) is a complex reproductive endocrinopathy affecting 4-20% of females of reproductive age. PCOS and its consequent complications such as infertility, diabetes mellitus and cardiovascular disease significantly impact clinical management. Complementary and alternative medicine (CAM), including homeopathy, is gaining recognition in PCOS management. There remains a paucity of formal protocols for managing PCOS within homeopathy and other CAM systems. This study aimed to explore and document existing therapeutic practices in the management of PCOS from diagnosis to treatment used by practitioners within various disciplines of CAM: viz., homeopathy, ayurveda, unani tibb, traditional Chinese medicine (TCM) and naturopathy, in the context of their unique philosophical background. In this explorative, descriptive study, data were collected from CAM practitioners in eThekwini Municipality, KwaZulu Natal, South Africa, using semi-structured interviews and analysed using Tesch's and Creswell's methods for qualitative analysis. Four themes emerged from the data, namely: CAM philosophical perspectives on PCOS, contributing factors, diagnosis of PCOS, and management of PCOS. Five sub-themes emerged: clinical diagnosis of PCOS, CAM-specific characterisation of PCOS, CAM-specific treatment of PCOS, adjunctive therapies, and lifestyle interventions. Homeopathic management comprised several prescribing methods, the most common ones being miasmatic/constitutional, keynote and clinical, alongside adjunctive therapies and lifestyle interventions. Other CAM modalities adopted similar holistic approaches. This paper offers a comprehensive exploration of the perceptions, clinical investigations and management practices in PCOS by homeopaths and four other CAM modalities - ayurveda, unani tibb, TCM and naturopathy - as documented in the study. Homeopaths and other CAM practitioners employed CAM-specific therapies, along with adjunctive therapies and lifestyle interventions, adopting holistic approaches. Enhancing the quality of life through emotional counselling, stress reduction and lifestyle improvements emerged as shared objectives across modalities. Our findings underscore the need to further explore inter-disciplinary collaboration in PCOS management among registered CAM practitioners, with the potential to expand the scope of comprehensive care for PCOS patients.

Endometrial Cancer in Reproductive-Aged Females: Etiology and Pathogenesis.

Endometrial cancer is the most common gynecologic malignancy in developed countries, and the incidence is rising in premenopausal females. Type I EC is more common than Type II EC (80% vs. 20%) and is associated with a hyperestrogenic state. Estrogen unopposed by progesterone is considered to be the main driving factor in the pathogenesis of EC. Studies show that BMI > 30 kg/m2, prolonged duration of menses, nulliparity, presence of polycystic ovarian syndrome, and Lynch syndrome are the most common causes of EC in premenopausal women. Currently, there are no guidelines established to indicate premenopausal patients who should be screened. This review aims to synthesize current data on the etiology, risk factors, presentation, evaluation, and prognosis of endometrial cancer in this population.

Iron Insights: Exploring Age-Specific Variations In Anaemia Prevalence In Islamabad

Background &amp; Introduction: Blood, a specialized connective tissue, facilitates the vital transport of oxygen, carbon dioxide, minerals, hormones, and salts throughout the body. Anemia, characterized by reduced oxygen-carrying capacity, often stems from factors such as diminished red blood cell (RBC) synthesis or excessive blood loss. Notably, iron deficiency stands out as a prominent cause, particularly among females of reproductive age, due to factors like inadequate dietary iron intake and menstrual blood loss. Objectives: This study aims to assess the prevalence of iron deficiency anemia (IDA) in both males and females across different age groups. Specifically, we seek to determine the frequency of IDA and its distribution among age cohorts spanning 6-12 years, 13-19 years, and 20-50 years. Methodology: Employing a cross-sectional study design, we surveyed a population of 2071 individuals, selecting a sample of 3[1]24 participants through non-probability convenient sampling methods. Descriptive statistics, facilitated by SPSS, guided our analysis. Hematological parameters including hemoglobin (HB) levels, RBC count, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) were evaluated to ascertain the hematological status of the study cohort. Results: Our findings reveal notable trends in IDA prevalence across age groups. Among participants aged 16-30 years, IDA incidence stood at 51%, whereas the 31-35 years age group exhibited a 26% prevalence, and the 46-60 years age group recorded a 23% incidence of IDA. Additionally, our analysis indicates a higher prevalence of IDA among females, constituting 65% of all IDA cases, particularly pronounced in the reproductive age bracket of 16-30 years. Conclusion: The study underscores a gender-based discrepancy in IDA prevalence, with females exhibiting a higher incidence compared to males. Notably, females within the reproductive age range of 16-30 years emerge as a particularly vulnerable demographic. These findings emphasize the importance of targeted interventions to address iron deficiency, especially among at-risk populations.

Fuzzy machine learning logic utilization on hormonal imbalance dataset

In this research work, a novel fuzzy data transformation technique has been proposed and applied to the hormonal imbalance dataset. Hormonal imbalance is ubiquitously found principally in females of reproductive age which ultimately leads to numerous related medical conditions. Polycystic Ovary Syndrome (PCOS) is one of them. Treatment along with adopting a healthy lifestyle is advised to mitigate its consequences on the quality of life. The biological dataset of hormonal imbalance “PCOS” provides limited results that is whether the syndrome is present or not. Also, there are input variables that contain binary responses only, to deal with this conundrum, a novel fuzzy data transformation technique has been developed and applied to them thus leading to their fuzzy transformation which provides a broader spectrum to diagnose PCOS. Due to this, the output variable has also been transformed. Hence, a novel fuzzy transformation technique has been employed due to the limitation of the dataset leading to the transition of binary classification output into three classes. An adaptive fuzzy machine learning logic model is developed in which the inference of the transformed biological dataset is performed by the machine learning techniques that provide the fuzzy output. Machine learning techniques have also been applied to the untransformed biological dataset. Both implementations have been compared by computation of the relevant metrics. Machine learning employment on untransformed biological dataset provides limited results whether the syndrome is present or absent however machine learning on fuzzy transformed biological dataset provides a broader spectrum of diagnosis consisting of a third class depicting that PCOS might be present which would ultimately alert a patient to take preventive measures to minimize the chances of syndrome development in future.

Unmet need for alcohol use disorder treatment in reproductive-age females, with emphasis on pregnant and parenting populations in the United States: Findings from NSDUH 2015-2021.

The negative effects of alcohol use can transmit intergenerational harm if alcohol use disorder (AUD) occurs during pregnancy and/or while parenting a child. Prenatal alcohol exposure is the leading preventable cause of congenital anomalies in the USA, and heavy drinking in women has been on the rise, further accelerated by the COVID-19 pandemic. This study describes the most recent patterns in the past year AUD prevalence and treatment among reproductive-aged women, with a specific focus on pregnant and parenting women, and barriers to treatment among those affected. We analyzed data on reproductive-age women from the National Survey on Drug Use and Health (2015-2021). We used generalized linear models to estimate prevalence ratios (PR) for past 12-month AUD and its treatment based on DSM-V criteria. We considered sociodemographic characteristics, including age, race/ethnicity, income, health insurance type, and arrest history. Pregnant and parenting women displayed lower risk for AUD (PR = 0.48, 95% CI:0.41-0.57; PR = 0.5 95% CI:0.48-0.54, respectively) relative to non-pregnant/non-parenting women. Excess risk for AUD was associated with education (some college vs. college graduates, PR = 1.07, 95% CI:1.01-1.13) and history of arrests (PR = 2.93, 95% CI:2.67-3.21). There were no clear differences in AUD treatment use based on parenting or pregnancy status. Among those with AUD, the prevalence of treatment was higher among individuals aged 35-49 years compared to those 18-25 years (PR = 1.6, 95% CI: 1.19-2.14) and in those enrolled in Medicaid vs. private insurance (PR = 2.62, 95%CI:1.97-3.47). Financial barriers and treatment not being a priority were the most frequently reported barriers to treatment. To promote well-being among parents and their children, healthcare providers should prioritize reproductive-age women at higher AUD risk. Decreasing the stigma attached to AUD and intensifying efforts to educate women about the dangers of AUD may improve treatment use among pregnant and parenting women.

Trends in Utilization of Emergency Contraceptives in Tanzania: A Retrospective Longitudinal Study From 2018 to 2023.

Introduction Emergency contraceptives (ECs) are a critical method for preventing unwanted pregnancies following unprotected sexual intercourse. However, Tanzania is experiencing an alarming surge in the misuse ofECs among reproductive-aged females, particularly younger girls and women. Reports of their use as regular contraceptives are a rising concern. Deviations from their intended use in emergencies may not only increase the risk of contraceptive failure but also increase the risk of adverse health events. This study aims to delineate and evaluate the utilization patterns of ECs over six consecutive years using importation data obtained from the Tanzania Medicines and Medical Devices Authority (TMDA). Materials and methods We analyzed the ECdata collected by TMDA over six consecutive years using a retrospective longitudinal design. Microsoft Power BI (Microsoft® Corp., Redmond, WA) was used to clean, organize, and aggregate the data. IBMSPSSStatistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States)was used to analyze annual trend utilization using linear regression. Results We analyzed 114 importation consignments for ECs, identifying 95.6% (109 records) as oral ECs and 4.4% (five records)as intrauterine devices (IUDs) between 2018 and 2023. This data revealed a significant increase in the volume of EC imports, with its contribution increasing from 1.9% in 2018 to 60.1% in 2023. This highlights the marked increase in EC consumption in Tanzania. In 2023, the defined daily dose per 1000 inhabitants per year (DID) peaked at 3.917826, indicating an unprecedented increase of 4,983.06% compared to the lowest DID observed in 2019 at 0.0873552. The year 2023 alone accounted for 41.63% of the total DID (9.43) over the entire study period. In 2019 and 2020, there was a decrease in EC consumption, followed by a rapid increase from 2021 to 2023. The reduction in EC consumption from 2019 to 2020 was 36.9% compared to that between 2021 and 2022. Conclusions The significant rise in EC importation and utilization in Tanzania between 2018 and 2023, marked by fluctuating consumption trends and a notable surge, highlights the urgent need for targeted educational and policy intervention. This will guide the rational and informed use of ECs, ensuring access aligns with best practices for reproductive health.

Pregnancy-Related Decision-Making and Perceptions of Risk among Reproductive-Age Females Undergoing Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Single-Surgeon Cross-Sectional Study

Females of reproductive age constitute one of the largest demographics of the hip arthroscopy population, but it is unclear as to how pregnancy planning affects decision-making regarding surgery or vice versa. The purpose of this study was to assess perceived risks to pregnancy from hip pain and/or hip arthroscopy among reproductive-age females who underwent arthroscopic treatment of femoroacetabular impingement syndrome (FAIS). A cross-sectional study was conducted involving females aged 18–44 years who underwent hip arthroscopy for the treatment of FAIS, with a single surgeon included in the study. Subjects completed a survey that assessed obstetric and gynecologic history, decision-making regarding the planning and timing of hip surgery and pregnancy, and perceived risks to pregnancy from hip pain and/or hip surgery. Subjects were classified as nulligravid (Group 1), pregnant at least once before hip surgery but never again following hip surgery (Group 2), or pregnant at least once following hip surgery (Group 3). A total of 85 patients were enrolled with a mean age of 32.3 ± 6.5 years at the time of surgery. The mean follow-up time was 51.9 ± 34.5 months. There were 39 subjects in Group 1 (45.9%), 20 in Group 2 (23.5%), and 26 in Group 3 (30.6%). About half of all subjects expressed “some” to “a lot of” concern that their hip pain could get worse during pregnancy (49.4%), and about half had “no concern” that hip arthroscopy would affect the health of their fetus/baby (54.1%). Reproductive-age females undergoing hip arthroscopy for FAIS generally consider the procedure to be safe with respect to future pregnancy outcomes.

The impact of complementary therapies on dysmenorrhea in young women

HIGHLIGHTS Complementary treatments have been shown to greatly reduce the intesity of dysminorrhea pain. The use of medicinal plants, herbal concoctions, or compresses might reduce dysmenorrhea discomfort more effectively than taking medications like mefenamic acid, ibuprofen, piroxicam, etc. ABSTRACT Objective: The study's objective was to obtain latest data on alternative therapy for dysmenorrhea in adolescent females of reproductive age. Materials and Methods: A scoping review was conducted using the PRISMA ScR protocol. A search was conducted on PubMed, Science Direct, and Wiley, yielding 848 studies. Ten literature studies were identified that satisfied the criteria for population, exposure, and outcome. The studies also incorporated inclusion criteria, focusing on women of reproductive age who had dysmenorrhea. Results: Out of 848 articles, 32 were considered potentially relevant and met the inclusion criteria. The articles indicated that teenagers commonly used warm compresses and herbal drinks as supplementary therapies to alleviate dys-menorrhea due to their perceived effectiveness and comfort. Other complement-ary therapies for the condition included massage, relaxation, herbal products, self-care practices, acupuncture, and therapeutic methods. Conclusion: Herbal and warm water compress are the most commonly applied alternative therapies for treating dysmenorrhea.

Reproductive justice in pediatric health care: a scoping review protocol.

The objective of this scoping review is to identify the barriers and facilitators of reproductive justice in pediatric health care. Reproductive justice is defined as the right to maintain personal bodily autonomy, to have or not have children, and to parent children in safe and sustainable communities. The reproductive justice framework is often applied to adult women in conventional care settings; however, the need for health care guided by the framework should extend to all females of reproductive age in all care settings, including pediatric settings. This review will consider studies from 1994 to the present that report on the barriers and facilitators of reproductive justice in pediatric health care. Studies from any setting or geographic location will be included. This scoping review will include pediatric patients up to 21 years of age of any gender identity or sexual orientation who may birth a child, and their health care providers. Database searches will include CINAHL (EBSCOhost), MEDLINE (PubMed), Embase (Elsevier), and Web of Science Core Collection. Sources of unpublished studies and gray literature to be searched include MedNar and ProQuest Dissertation and Theses Science and Engineering Collection (ProQuest). The JBI methodology for scoping reviews will be followed. Data extracted will include details about the title, authors, year of publication, type of evidence, participants, context, and concept. The extracted data will be presented in diagrammatic or tabular format in a manner that aligns with the objective and questions of the scoping review. Open Science Framework https://osf.io/d5vf9.

Evaluation of Electromagnetic Therapy in the Treatment of Severe Dysmenorrhea in Young Women of Basrah.

Primary dysmenorrhea (PD) is a public disease of young female worldwide, it affects their daily performances. Severe recurrent uterine cramps are the main complaints in 90% of adolescents and 50% of reproductive-age females. This study aimed to evaluate the use of magnetic field therapy in the treatment of severe dysmenorrhea grade 3 and provide an encouraging goal to continue daily work without pain. Two hundred and fifty female patients were recruited in this study from gynecological clinics in Basrah, southern Iraq. All had severe dysmenorrhea, patients were subjected to a questionnaire form, Visual Analog Scale, and verbal multidimensional scoring system to determine the pain intensity and grade of dysmenorrhea. Only 38 young females had severe dysmenorrhea grade 3 with ages ranging from 16 to 28 years with a mean age of 22.04 ± 1.43 years and body mass index 23.81 ± 1.94, patients subjected to electromagnetic field therapy (EMFT), two sessions per week for 20 min each for 6 weeks. Three categories were assessed, working ability, associated symptoms, and drugs used. Data were collected and statistically analyzed using SPSS version 22. The present study showed statistically significant progress (P < 0.05) in reducing pain, rare physical and mental complaints, and improved working ability with no need for drugs in majority of patients. EMFT has better results than other methods in relieving pain and symptoms of dysmenorrhea with a settled lifestyle.

Social Determinants Associated with Substance Use and Treatment Seeking in Females of Reproductive Age in the United States.

Introduction: Females of reproductive age (FoRA; 15-49 years) are the demographic most likely to be diagnosed with a substance use disorder. Preventative treatment prior to or during pregnancy is critical. Stigma and social inequities can delay access to care. There is limited research examining social determinants of health (SDoH) and how they are related to substance use and treatment seeking in this demographic. Methods: We analyzed the 2016-2019 data from the United States National Survey on Drug Use and Health using multivariable logistic regression models. Statistically significant variables were conceptually linked to the Office of Disease Prevention and Health Promotion's (ODPHP's) SDoH framework's five domains. Results: From a total sample of 1,477,336 (weighted) pregnant people and 39,600,523 (weighted) FoRA, substance use was reported by 879,209 (2.14% [95% confidence interval = 2.13-2.15]). Pregnancy status was not associated with substance use or treatment seeking. Past-month substance use was associated with high educational attainment, an annual income <$20,000, a history of criminality, low religiosity, and having health insurance. Past-month treatment-seeking behavior was associated with older age, an annual income >$20,000, a history of criminality, and greater religiosity. Behavioral health support seeking in the past month was associated with some college education. Higher depression severity was associated with all the three models. Conclusions: Using the ODPHP's SDoH framework, we begin to elicit critical connections that can describe substance use and treatment-seeking practices in FoRA. We encourage additional research to inform public health, health care, behavioral health, and other support service programming.

Intramuscular endometriosis of the forearm: a case report

Endometriosis is a disorder that commonly affects females of reproductive age and is defined as the presence of endometrial glands or stroma outside the uterine cavity. Patients typically present with cyclical pain during menses. Endometriosis can be characterized as endopelvic or extrapelvic depending on the sites involved. We report a case of a 40-year-old, right-hand-dominant, female who presented with a painful mass in her right proximal forearm. She was ultimately diagnosed with intramuscular endometriosis and underwent surgical excision.

Abstract 3393: Deciphering colorectal cancer: A model to study sex-based differences and role of estrogen amidst obesity

Abstract Worldwide statistics indicate that obesity is increasing globally, mostly due to the consumption of Western diet. The literature points out that obesity is a potent risk factor for the development of colorectal cancer (CRC). Interestingly, CRC incidence is higher in men compared to women, and the sex hormone estrogen protects reproductive-age females from CRC despite obesity. In this project, we aim to understand the sex-based differences and protective role of estrogen in obesity-influenced CRC. An improved mouse model was devised where the effects of obesity and estrogen in CRC could be meticulously studied. We deployed 4-5-week-old male and female FVB/NJ mice and performed either sham surgery (males and females) or bilateral ovariectomy (OVX) (females). Post one week of recovery, all mice were randomly sub-grouped into either low-fat diet (LFD, 10% fat) or high-fat diet (HFD, 60% fat) groups, weekly injected with a colon-specific carcinogen azoxymethane (AOM; 5 mg/kg for week 1, 10 mg/kg for weeks 2-6), and cyclically every 4-5 days injected 17-beta-estradiol (E2; 4 μg/mouse) to a group of OVX mice for the study period of 22 weeks. The body weight of all mice was tracked every week. A whole-body composition analysis after 22 weeks showed that males and OVX females are more obese compared to females with sham surgery and OVX females with E2 injection (OVX+E2), respectively. Additionally, mice on HFD had a higher body weight compared to those on LFD; however, the absence of estrogen in OVX females led them to have higher body weight compared to sham and OVX+E2 females. Moreover, a significant difference was observed in the tumor size between males and females, females and OVX females, and OVX and OVX+E2 females. Study models have rarely incorporated both sex-dependent differences and diet-induced obesity in understanding CRC. With the current study model, it is anticipated to learn more about these differences at molecular, cellular, and metabolic levels. Acknowledgments: 1) NIH/NCI R15 [To HS, XW]; 2) Miami University CFR Faculty Research Grants [To HS, XW, JZ]; 3) Miami University's College of Education, Health, and Society Interdisciplinary Research Seed Grant [To HS, XW, JZ]; 4) Sigma Xi Grants in Aid Research [To PW]; and 5) We thank Jazzminn Hembree (Director of Laboratory Animal Resources, Miami University) and Laboratory Animal Resources, Dr. Jiangjiang Zhu (Department of Human Sciences, Ohio State University), Dr. Jing Zhang (Department of Statistics), and Dr. Ramiro Malgor (Director of Histology Core Facility, Ohio University) Citation Format: Prachi Wele, Haifei Shi, Xian Wu. Deciphering colorectal cancer: A model to study sex-based differences and role of estrogen amidst obesity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3393.

The Effect of Iron Supplements on the Gut Microbiome of Females of Reproductive Age: A Randomized Controlled Trial

BackgroundIron deficiency is the most common nutritional deficiency worldwide, particularly for young children and females of reproductive age. Although oral iron supplements are routinely recommended and generally considered safe, iron supplementation has been shown to alter the fecal microbiota in low-income countries. Little is known about the effect of iron supplementation on the fecal microbiota in high-income settings. ObjectivesTo assess the effect of oral iron supplementation compared with placebo on the gut microbiome in nonpregnant females of reproductive age in a high-income country. MethodsA 21-d prospective parallel design double-blind, randomized control trial conducted in South Australia, Australia. Females (18–45 y) were randomly assigned to either iron (65.7 mg ferrous fumarate) or placebo. Fecal samples were collected prior to commencing supplements and after 21 d of supplementation. The primary outcome was microbiota β-diversity (paired-sample weighted unique fraction metric dissimilarity) between treatment and placebo groups after 21 d of supplementation. Exploratory outcomes included changes in the relative abundance of bacterial taxa. ResultsOf 82 females randomly assigned, 80 completed the trial. There was no significant difference between the groups for weighted unique fraction metric dissimilarity (mean difference: 0.003; 95% confidence interval: –0.007, 0.014; P = 0.52) or relative abundance of common bacterial taxa or Escherichia-Shigella (q > 0.05). ConclusionsIron supplementation did not affect the microbiome of nonpregnant females of reproductive age in Australia.This trial was registered at clinicaltrials.gov as NCT05033483.

Harnessing the power within: engineering the microbiome for enhanced gynecologic health.

Although numerous studies have demonstrated the impact of microbiome manipulation on human health, research on the microbiome's influence on female health remains relatively limited despite substantial disease burden. In light of this, we present a selected review of clinical trials and preclinical studies targeting both the vaginal and gut microbiomes for the prevention or treatment of various gynecologic conditions. Specifically, we explore studies that leverage microbiota transplants, probiotics, prebiotics, diet modifications, and engineered microbial strains. A healthy vaginal microbiome for females of reproductive age consists of lactic acid-producing bacteria predominantly of the Lactobacillus genus, which serves as a protective barrier against pathogens and maintains a balanced ecosystem. The gut microbiota's production of short-chain fatty acids, metabolism of primary bile acids, and modulation of sex steroid levels have significant implications for the interplay between host and microbes throughout the body, ultimately impacting reproductive health. By harnessing interventions that modulate both the vaginal and gut microbiomes, it becomes possible to not only maintain homeostasis but also mitigate pathological conditions. While the field is still working toward making broad clinical recommendations, the current studies demonstrate that manipulating the microbiome holds great potential for addressing diverse gynecologic conditions. Manipulating the microbiome has recently entered popular culture, with various diets thought to aid the microbes that live within us. These microbes live in different locations of our body and accordingly help us digest food, modulate our immune system, and influence reproductive health. The role of the microbes living in and influencing the female reproductive tract remains understudied despite known roles in common conditions such as vulvovaginal candidiasis (affecting 75% of females in their lifetime), bacterial vaginosis (25% of females in their lifetime), cervical HPV infection (80% of females in their lifetime), endometriosis (6-10% of females of reproductive age), and polycystic ovary syndrome (10-12% of females of reproductive age). Here, we review four different approaches used to manipulate the female reproductive tract and gastrointestinal system microbiomes: microbiota transplants, probiotics, prebiotics, and dietary interventions, and the use of engineered microbial strains. In doing so, we aim to stimulate discussion on new ways to understand and treat female reproductive health conditions.

Estradiol mediates greater germinal center responses to influenza vaccination in female than male mice.

Adult females of reproductive age develop greater antibody responses to inactivated influenza vaccines (IIV) than males. How sex, age, and sex steroid concentrations impact B cells and durability of IIV-induced immunity and protection over 4 months post-vaccination (mpv) was analyzed. Vaccinated adult females had greater germinal center B cell and plasmablast frequencies in lymphoid tissues, higher neutralizing antibody responses 1-4 mpv, and better protection against live H1N1 challenge than adult males. Aged mice, regardless of sex, had reduced B cell frequencies, less durable antibody responses, and inferior protection after challenge than adult mice, which correlated with diminished estradiol among aged females. To confirm that greater IIV-induced immunity was caused by sex hormones, four core genotype (FCG) mice were used, in which the testes-determining gene, Sry, was deleted from chromosome Y (ChrY) and transferred to Chr3 to separate gonadal sex (i.e., ovaries or testes) from sex chromosome complement (i.e., XX or XY complement). Vaccinated, gonadal female FCG mice (XXF and XYF) had greater numbers of B cells, higher antiviral antibody titers, and reduced pulmonary virus titers following live H1N1 challenge than gonadal FCG males (XYM and XXM). To establish that lower estradiol concentrations cause diminished immunity, adult and aged females received either a placebo or estradiol replacement therapy prior to IIV. Estradiol replacement significantly increased IIV-induced antibody responses and reduced morbidity after the H1N1 challenge among aged females. These data highlight that estradiol is a targetable mechanism mediating greater humoral immunity following vaccination among adult females.IMPORTANCEFemales of reproductive ages develop greater antibody responses to influenza vaccines than males. We hypothesized that female-biased immunity and protection against influenza were mediated by estradiol signaling in B cells. Using diverse mouse models ranging from advanced-age mice to transgenic mice that separate sex steroids from sex chromosome complement, those mice with greater concentrations of estradiol consistently had greater numbers of antibody-producing B cells in lymphoid tissue, higher antiviral antibody titers, and greater protection against live influenza virus challenge. Treatment of aged female mice with estradiol enhanced vaccine-induced immunity and protection against disease, suggesting that estradiol signaling in B cells is critical for improved vaccine outcomes in females.