Women Of Childbearing Age Research Articles

Safety and effectiveness of a recombinant hepatitis E vaccine in women of childbearing age in rural Bangladesh: a phase 4, double-blind, cluster-randomised, controlled trial

Hepatitis E virus (HEV) leads to high mortality in pregnant women in low-income countries. We aimed to evaluate the safety of a HEV vaccine and its effectiveness in preventing hepatitis E during pregnancy. In this phase 4, double-blind, cluster-randomised trial, 67 villages in Matlab, Bangladesh, were randomised 1:1 to receive HEV239 (a recombinant HEV vaccine) or a control vaccine (Hepa-B, a hepatitis B vaccine), using block randomisation with random number tables and blocks of size eight, stratified by cluster population size. Eligible non-pregnant women (aged 16-39 years) were vaccinated intramuscularly on day 0, at 1 month, and at 6 months, and followed up for 2 years after the last immunisation. The primary endpoint was hepatitis E in the pregnant, per-protocol population (those who received all three doses within 2 days of the scheduled dates), while safety was a secondary endpoint, assessed in the intention-to-treat (ITT) population (participants who received at least one dose). Solicited adverse events were recorded for the first 7 days after each dose, and unsolicited events until 2 years after a participant's final dose. Pregnancy-related safety outcomes were assessed in the pregnant ITT population. This study is registered with ClinicalTrials.gov (NCT02759991). Between Oct 2, 2017, and Feb 28, 2019, 19 460 participants were enrolled and received either HEV239 (9478 [48·7%] participants, 33 clusters) or Hepa-B (9982 [51·3%] participants, 34 clusters), of whom 17 937 (92·2%) participants received three doses and 17 613 (90·5%) were vaccinated according to protocol (8524 [48·4%] in the HEV239 group and 9089 [51·6%] in the control group). No pregnant participants were confirmed to have hepatitis E in either treatment group. HEV239 showed a mild safety profile, similar to Hepa-B, with no difference in the proportion of solicited adverse events between groups and no severe solicited events. Pain was the most common local symptom (1215 [12·8%] HEV239 recipients and 1218 [12·2%] Hepa-B recipients) and fever the most common systemic symptom (141 [1·5%] HEV239 recipients and 145 [1·5%] Hepa-B recipients). None of the serious adverse events or deaths were vaccine related. Among pregnant participants, the HEV239 group had a higher risk of miscarriage (136 [5·7%] of 2407 pregnant participants) compared with the control group (102 [3·9%] of 2604; adjusted odds ratio 1·54 [95% CI 1·15-2·08]). The effectiveness of HEV239 in pregnant women remains uncertain. HEV239 was safe and well tolerated in non-pregnant women, but findings regarding miscarriage warrant further investigation. Research Council of Norway; Innovax.

Challenges towards an AIDS-free generation in Africa and Asia.

To review the latest data on prevention of HIV vertical transmission in Asia and Africa and discuss strategic directions to achieve an AIDS free generation by 2030. Progress in vertical transmission elimination efforts in Africa and Asia have stalled in the last decade, with 130 000 new infections in 2022. Main causes of vertical transmissions vary; in Asia-Pacific due to its low-burden, thus low testing coverage, but high overall vertical transmission rates, in South and East Africa due to new HIV infections during pregnancy and breast/chestfeeding, whereas in Western and Central Africa due to low antiretroviral therapy (ART) coverage. Long-acting injectable ART and neutralizing antibodies for treatment and prevention show promise in supporting efforts to further reduce vertical transmissions. Integrated and more accessible pre- and postnatal care is needed to achieve an AIDS-free generation. Much can be implemented to address existing HIV service gaps; including strengthening of HIV prevention services for youth and women of childbearing age and pregnant people, early detection and treatment, and the delivery of integrated services that can reach and retain pregnant and postpartum people living with HIV in care.

Medication use patterns in pregnant women with psoriasis: A nationwide study in Taiwan.

Psoriasis, an autoimmune skin condition, affects 2%-4% of the global population, with significant prevalence among women of childbearing age. Pregnancy presents challenges in managing psoriasis due to hormonal changes and treatment safety concerns. Understanding treatment patterns in pregnant women is crucial, given limited real-world evidence. Explore the utilization patterns of medications among pregnant women diagnosed with psoriasis within a real-world data, utilizing data sourced from a nationwide database in Taiwan. This nationwide study utilized Taiwan's National Health Insurance (NHI) database and Birth Certificate Application. It included registered pregnant women diagnosed with psoriasis from 2005 to 2014. Medication usage was tracked three years before conception to three years after delivery. Medications were categorized based on Anatomical Therapeutic Chemical (ATC) codes, and statistical analyses were conducted using SAS software. A total of 30,267 pregnant women with psoriasis were studied. 11,651 (38.49%) mothers had received at least one prescription during follow-up (exposed group), and >60% had never received medication (unexposed group). Demographics and comorbidities were similar between these two groups. Topical corticosteroids were the most prescribed treatment, followed by phototherapy, with systemic drugs and biologics less common. During the study period, 11,096 women with psoriasis had used topical corticosteroids, 3,376 had used non-steroidal topical agents, 218 had used systemic agents or biologics, and 519 had received treatment with phototherapy. Medication usage declined during pregnancy, reaching its lowest in the third trimester but rebounded postpartum. Psoriasis medications, systemic, biological, or topical, were largely discontinued during pregnancy, sometimes up to 2 years before and extending postpartum. Research is needed to understand its impact on maternal and child health.

Effect Of Coffee Drinking Habit to Blood Pressure and Hemoglobin Levels on Women of Childbearing Age

Background: Tenggerese people, especially women, have a habit of drinking coffee, and it has become a daily habit. Coffee is often associated with risk factors for diseases in the community such as anemia and hypertension. This study aims to determine the effect of coffee drinking quantity (1-2 cups, 3-4 cups, and ≥ 5 cups of coffee per day) on hemoglobin levels and blood pressure. Subjects and Method: A quantitative study with a cross-sectional study design was done. This study population was women of reproductive age (15 to 49 years) in Ngadipuro Hamlet, Tengger, East Java, Indonesia. The independent variable of this study is the of daily coffee drinking per cup and the dependent variable of this study is the hemoglobin levels in women of childbearing age. The study instrument used was a questionnaire to screen for those who were a daily coffee drinker and a blood hemoglobin rapid test kit was used to measure the level of hemoglobin.The number of samples in this study was 193 respondents which was chosen using the random sampling technique. Analysis of the quantity of coffee drinking on hemoglobin levels by the Annova test while on blood pressure by the Kruskal Wallis test through SPSS software. Results: The result showed that the quantity of coffee per day on hemoglobin levels had a significance p<0.001. While the quantity of coffee per day on blood pressure had a significance p=0.361. Conclusion: It can be concluded that drinking 1-2 cups of coffee, 3-4 cups, and ≥ 5 cups of coffee daily simultaneously affects hemoglobin levels. In this case, the more quantity of coffee per day, the lower the hemoglobin level. However, the quantity of coffee had no significant effect on blood pressure.

Obstetric and perinatal outcomes in women with cerebrovascular accident vs. transient ischemic attack: an evaluation of a population database.

Cerebrovascular accidents (CVAs) and transient ischemic attacks (TIAs) are uncommon neurologic events in women of childbearing age. We aimed to compare pregnancy, delivery, and neonatal outcomes between women who suffered from a CVA and those who experienced a TIA. A retrospective population-based cohort study was performed using the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample. Included were all pregnant women who delivered or had a maternal death in the US between 2004 and 2014. We compared women with an ICD-9 diagnosis of a CVA before or during pregnancy to those diagnosed with a TIA before, during the pregnancy, or during the delivery admission. Pregnancy and perinatal outcomes were compared between the two groups, using multivariate logistic regression to control for confounders. Among 9,096,788 women in the database, 898 met the inclusion criteria. Of them, 706 women (7.7/100,000) had a CVA diagnosis, and 192 (2.1/100,000) had a TIA diagnosis. Women with a CVA, compared to those with a TIA, had a higher rate of pregnancy-induced hypertension (aOR 3.82,95%CI 2.14-6.81, p < 0.001); preeclampsia (aOR 2.6,95%CI 1.3-5.2, p = 0.007), eclampsia (aOR 13.78,95% CI 1.84-103.41, p < 0.001); postpartum hemorrhage (aOR 4.52,95%CI 1.31-15.56, p = 0.017), blood transfusion (aOR 5.57,95%CI 1.65-18.72, p = 0.006), and maternal death (54 vs. 0 cases, 7.6% vs. 0%), with comparable neonatal outcomes. Women diagnosed with a CVA before or during pregnancy had a higher incidence of myriad maternal complications, including hypertensive disorders of pregnancy, postpartum hemorrhage, and death, compared to women with a TIA diagnosis, with comparable neonatal outcomes, stressing the different prognoses of these two conditions, and the importance of these patients' diligent follow-up and care.

Investigation of some fertility indicators in Iraqi women with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a complex, heterogeneous, multigenic disorder in women of childbearing age with multiple consequences. The exact mechanism of PCOS is not yet fully understood; There are several factors have a role such as genetic, environmental, nutritional, metabolic and other interactions Therefore, the existing study designed to estimate the levels of some biochemical tests and the sex hormones that have a role in PCOS progress. 100 Iraqi women were agreed to participate in the current study, divided into two groups included 50 clinically diagnosed with PCOS women that compared with 50 healthy women without PCOS as a control group (CTRL). The results showed different significant differences of the studied parameters between the PCOS and the CTRL. There was a significant increased level of FBG, HbA1c, insulin resistant, TG and LDL in the PCOS group in comparison to the CTRL, while a significant decreased level of HDL was appeared in PCOS group in comparison to the CTRL. Regarding the results of sex hormones, there were significant increased levels of LH, FSH, testosterone, estradiol hormones in the PCOS group in comparison to the CTRL. In addition, the results of thyroid hormones appeared a significant increased level of T3 hormone in the PCOS group in comparison to the CTRL. Also, the results of leptin hormone showed a significant increased level in the PCOS group in comparison to the CTRL. In conclusion, there was a significant relationship between FBG, HbA1c, insulin resistant, TG, LDL, HDL, LH, FSH and T3 parameters with PCOS.

Prevalence of Seroconversion Toxoplasmosis and Pregnancy Outcome among Childbearing Age Women in Thi-Qar

Prevalence of Seroconversion Toxoplasmosis and Pregnancy Outcome among Childbearing Age Women in Thi-Qar

Effective strategies for pregnancy and lactation-associated osteoporosis: teriparatide use in focus.

Pregnancy and lactation-associated osteoporosis (PLO) is a rare condition characterized by fragility fractures occurring during late pregnancy or lactation, primarily affecting the spine and causing significant morbidity and back pain. PLO can lead to mobility impairment and work incapacity, with recovery taking up to several years. Due to the lack of clinical trials, treatment strategies remain poorly defined, historically focusing on calcium supplements, vitamin D, and weaning from breastfeeding. However, recent attention has turned to teriparatide (TPD) as an option due to its anabolic properties and potential suitability for women of childbearing age. This review evaluates TPD's use in PLO treatment, using published systematic reviews and case studies. Over 300 cases with PLO were identified through PubMed, Google Scholar, and Cochrane searches until August 2023. We identified 175 cases with PLO treated with TPD alone or followed by antiresorptive therapy. Most women (85.7%) were primiparas. The mean ± SD duration of TPD use was 15 ± 6 months. Among the study patients, 91.4% used TPD alone, while 8.6% (15/175) utilized sequential therapy. Approximately 93% of our cohort exhibited potential risk factors for PLO. Despite the increased risk of recurrent fractures in PLO, only 14.7% (20/175) of those treated with TPD sustained new fractures during a 9-month to 9 years' follow-up period. The mean ± SD percent increase in BMD at the LS was 21.14% ± 7.4%, and at the FN it was 12.1% ± 9.3%. The baseline Z-scores at the LS ranged from -3.3 (-3.7 to -2.7), while the baseline Z-scores at the FN ranged from -2.0 (-2.7 to -1.5). This review emphasizes PLO severity, advocating for increased awareness and timely interventions. TPD emerges as a promising therapeutic option in certain cases.

Childbirth preparation and its facilitating and inhibiting factors from the perspectives of pregnant and postpartum women in Tabriz-Iran: a qualitative study

BackgroundThe World Health Organization recognizes childbirth preparation as an essential component of antenatal care, as it plays a crucial role in reducing maternal mortality and improving women's childbirth experience. Countries worldwide have implemented various interventions to assist women in preparing for childbirth, based on their own resources. This study was conducted with the aim of exploring the perspectives of pregnant and postpartum women on childbirth preparation and the facilitating and inhibiting factors, in Tabriz, Iran.MethodsThis qualitative study was conducted with 25 participants, selected purposively among pregnant women in weeks 37 to 40 of gestation and postpartum women within 10 days to 6 weeks after childbirth. Data collection was done through semi-structured, in-depth individual interviews using an interview guide. The data was analyzed using content analysis method with conventional approach.ResultsThe perspectives of pregnant and postpartum women regarding childbirth preparation revealed that factors such as maternal health during pregnancy, having an antenatal care plan, improving health literacy, and developing a birth plan were identified as crucial elements for effective childbirth preparation. Additionally, mental and emotional preparation, support, financial planning, participation in preparation classes, and awareness of childbirth methods were recognized as facilitators. On the other hand, insufficient mental and emotional preparedness, inadequate support, weak antenatal care, information deficiencies, insufficient physical activity, and a lack of a birth plan were identified as barriers.ConclusionThe findings highlight the multifaceted nature of childbirth preparedness, necessitating the involvement of families, the healthcare system, and the entire community. Utilizing the study results in strategic planning for pre-pregnancy, during pregnancy, and inter-pregnancy care can enhance childbirth preparedness and contribute to achieving Iran's population rejuvenation policy goals.

The role of maternal and child healthcare providers in identifying and supporting perinatal mental health disorders.

Perinatal depression (PND) is underdiagnosed in the clinical setting. This study explores the role of obstetricians, and other primary care providers of maternal and child healthcare in detecting, screening, and referring women during the perinatal period identified as depressed, anxious, or exhibiting other symptoms of mental health disorders. Information was gathered from obstetricians (n = 16), and other primary care providers (pediatricians, nurse practitioners, physician assistants) (n = 85), on identifying and supporting childbearing women with symptoms of perinatal depression using an online survey. Statistical comparisons across participant groups were adjusted for years of practice in the profession. Statistically significant differences were noted. Obstetricians inquired more about the mother's social support network (p = .011) and addressed mothers that appeared sad, upset, or unhappy (p = .044) compared to other primary care providers. Other primary care providers were more likely to refer patients to mental health support services (p = .005), provide PND-related information in their waiting rooms (p = .008), and use the Edinburgh Postnatal Depression Scale (EPDS) (p = .027). There was also a significant difference in positively identifying eight symptoms of PND between provider groups. Obstetricians had higher rates of identifying the following symptoms: excessive crying (p < .001), feeling little or no attachment to the infant (p < .001), little feeling of enjoyment (p = .021), feelings of failure (p < .001), hopelessness (p < .001), agitation with self and infant (p < .001), fear of being alone with the infant (p = .011), and fear that these symptoms would last (p < .001). Although certain screening practices were performed well, especially by the obstetrician group, screening deficits were noted within each group, and screening practices differed between groups. Training offered to maternal child health primary care providers on addressing perinatal mental health disorders may help improve provider screening practices and detection of PND symptoms in perinatal women. PND screening that combines face-to-face open-ended interviews with standardized screening tools can enhance patient-provider communication, potentially improving PND detection rates and follow-up care in perinatal women.

Excessive weight in pregnant women increases the chance of diagnosing periodontitis combined with tooth loss.

Excess weight (EW), especially in women of childbearing age, those who are pregnant, as well as postpartum, is a problem worldwide. Fat accumulation deregulates the inflammatory response, contributing to the development of health problems, such as periodontitis. This study investigated the association between EW and periodontitis during pregnancy. A cross-sectional, multicenter study involved 1745 postpartum women in Brazil. Socioeconomic-demographic data, gestational history, lifestyle behavior, and general and oral health conditions were obtained. Pre-pregnancy body mass index (BMI) was collected from medical records with EW being the exposure. Both tooth loss and clinical attachment level (CAL) were evaluated, and the presence of periodontitis was the outcome. Logistic regression, odds ratio (OR) and 95% confidence interval (95% CI), and quantile regression, beta coefficient and 95% CI, estimated the association between EW (BMI) and periodontitis and its combined effect with tooth loss ≥3, as dichotomous and continuous variables (CAL and tooth loss), with 5% significance level. The EW was 27.7% prevalent and periodontitis was 11.7%. There was a positive association between EW and periodontitis: ORadjusted:1.39; 95% CI:1.01;1.92 and between EW and periodontitis combined with tooth loss ≥3: ORadjusted:1.73; 95% CI:1.36;2.20. The adjusted association between EW and periodontitis as continuous variables was also positive, showing that for each unit of increased BMI, there was an elevation in the mean CAL (p=0.04) and tooth loss (p<0.01), with statistical significance. There was a moderate association between EW and periodontitis during pregnancy, with an even greater association of pregnant women with EW presenting periodontitis combined with tooth loss.

Knowledge and Awareness of Myocardial Infarction among Child Bearing Women in Zaria Metropolis, Kaduna State, Nigeria

Knowledge and Awareness of Myocardial Infarction among Child Bearing Women in Zaria Metropolis, Kaduna State, Nigeria

RhD-Alloimmunization in Adult and Pediatric Trauma Patients

The actual risk of providing RhD-positive units to RhD-negative recipients remains debatable. There is no standard of care in the United States (US) to guide transfusion decisions regarding RhD type for patients with an unknown blood type, except for women of childbearing age and neonates. The risk of alloantibody formation by an RhD-negative patient exposed to RhD-positive blood is reported to be from 3% to 70%. Due to such wide variations, this review was undertaken to determine the prevalence of anti-D alloimmunization in trauma patients who are RhD-negative and were transfused RhD-positive blood products. This study used the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA) approach to answer the question, “In trauma patients who were transfused blood, what is the prevalence of alloimmunization to the D-antigen?” The review included all published articles through April 3, 2022 in databases. Articles published after the search period found by the authors were added to the manuscript if they addressed the primary question and there was unanimous consensus. There were 1683 full-text articles that met the search criteria, with 19 studies meeting eligibility criteria. In addition, 57 references were added after the search period had closed. The incidence of anti-D alloimmunization in adult trauma patients receiving whole blood varied from 7.8% to 42.7%. In contrast, incidence varied in patients receiving red blood cells (RBCs), from 0 to 94%, depending on number of categories analyzed. Anti-D alloimmunization with platelet transfusions varied from 0% to 19%. The alloimmunization rate increased with age and was detected only in children older than 5 years. Recent guidelines recommend the administration of Rh immune globulin (RhIG) to all traumatically injured patients who are both RhD-negative and pregnant. However, there is no specific guidance focused on the RhD-negative patient, pregnant or nonpregnant, and who have received RhD-positive red blood cells (RBC) and platelets. While numerous studies have attempted to evaluate the frequency of RhD alloimmunization rate in trauma settings, emerging data suggests that many factors affect this phenomenon. Additionally, the role of RhIG administration in cases of RhD-incompatible transfusions within the trauma setting adds complexity. As our trajectory propels us towards precision medicine and tailored transfusion practices, gaining a big data approach becomes indispensable.

Prevalence and associated factors of schistosomiasis among pregnant women in northern Senegal

BackgroundSchistosomiasis remains a public health concern worldwide. It is responsible for more than 240 million cases in 78 countries, 40 million of whom are women of childbearing age. In the Senegal River basin, both Schistosoma haematobium and Schistosoma mansoni are very prevalent in school-age children. However, there is a lack of information on the burden of schistosomiasis in pregnant women, which can cause complications in the pregnancy outcome. This study aimed to determine the prevalence and associated factors of schistosomiasis in pregnant women.MethodsWe conducted a prospective cross-sectional study of pregnant women attending antenatal clinics at the health center of the Senegalese Sugar Company and at the hospital of Richard Toll between August and December 2021. The urine and stool samples collected were examined using microscopy techniques and quantitative polymerase chain reaction (qPCR) to detect the presence of S. haematobium and S. mansoni. The urines were previously tested using urine reagent strips to detect hematuria and proteinuria. Socio-demographical, clinical, and diagnostically data were recorded by the midwife and the gynaecologist. The data were analyzed using a logistic regression model.ResultsAmong the 298 women examined for the infection by microscopic, 65 (21.81%) were infected with urogenital schistosomiasis, 10 (3.36%) with intestinal schistosomiasis, and 4 (1.34%) were co-infected with both types of schistosomiasis. Out of the 288 samples tested by qPCR, 146 (48.99%) were positive for S. haematobium, 49 (35.51%) for S. mansoni and 22 (15.94%) for both species (co-infection). Pregnant women having microscopic haematuria and proteinuria were significantly more infected (p < 0.05).ConclusionThis study has revealed a high prevalence of schistosomiasis in pregnant women in Senegal. The qPCR allowed us to detect more cases compared to the microscopy. There is a need to conduct more studies to understand the real burden of the disease and to set up a surveillance system to prevent pregnancy-related complications.

EFFECTIVENESS OF RED BETEL (PIPER CROCATUM) EXTRACT ON LEUCORRHEA IN WOMEN OF CHILDBEARING AGE

Introduction: Reproductive health problems exist in Asia; 76% of women experience vaginal discharge. Vaginal discharge symptoms are also experienced by women of childbearing age (around 31.8%). Women of childbearing age are more at risk of fluor albus, which can be a trigger for reproductive organ infections. One of the treatments is to use betel leaves, which contain natural antiseptics and antibiotics. Objectives: This study aimed to determine the effectiveness of red betel leaf extract (Piper crocatum) against leucorrhea in women of childbearing age. Method: This research method uses a quasi-experiment design with one pre-and post-test design technique group. The research was conducted at the Independent Midwife Practice in Bandung City. The population in the study were all women of childbearing age in Bandung City. The sample consisted of women of childbearing age, according to the inclusion criteria of 36 people. The data obtained were primary data from the measurement of vaginal pH with Neco test litmus paper. The data analysis used was the Wilcoxon test to test the difference in pH scores before and after the intervention. Result: The results showed a significant difference in the use of 0.5% red betel leaf extract in women of childbearing age before and after the intervention. Conclusion: Red betel leaf extract 0.5% is effective in reducing the incidence of leucorrhea. There is a decrease in vaginal pH before and after the use of red betel leaf extract 0.5% by 1.78 (p &lt;0.05).

Adverse Pregnancy and Child Outcomes in Oral Retinoid-Exposed Pregnancies: A Nationwide Population-Based Study.

Oral retinoids are used to treat various dermatological conditions, and their use is increasing in women of childbearing age. However, there is limited knowledge on the incidence of adverse outcomes after retinoid exposure during pregnancy. We aimed to evaluate the risk of adverse outcomes associated with oral retinoid exposure during pregnancy. We conducted a retrospective cohort study using the NHIS mother-child linked healthcare database in South Korea. We included all women who gave live birth from April 1, 2009 to December 31, 2020 and their children. The exposure was defined as having ≥ 1 prescription of isotretinoin, alitretinoin, and acitretin from one month before pregnancy to the delivery. The outcomes of interest were adverse child outcomes including major congenital malformations, low birth weight, and neurodevelopmental disorders (autism spectrum disorder and intellectual disorder), and adverse pregnancy outcomes including gestational diabetes mellitus, preeclampsia, and postpartum hemorrhage. Propensity score-based matching weights were used to control for various potential confounders. For congenital malformation, low birth weight, and adverse pregnancy outcomes, we calculated relative risk (RR) with 95% confidence interval (CI) using a generalized linear model and for neurodevelopmental disorders, we estimated hazard ratio (HR) with 95% CI using the Cox proportional hazard model. Of 3,894,184 pregnancies, we identified 720 pregnancies (0.02%) as the oral retinoid-exposed group. The incidence of major congenital malformation was 400.6 per 10,000 births for oral retinoid-exposed group and 357.9 per 10,000 births for unexposed group and the weighted RR was 1.10 (95% CI, 0.65-1.85) in oral retinoid-exposed group compared with unexposed group. The neurodevelopmental disorder showed a potential increased risk, with the weighted HR of 1.63 (95% CI, 0.60-4.41) for autism spectrum disorder and 1.71 (95% CI, 0.60-4.93) for the intellectual disorder, although it did not reach statistical significance. For low birth weight and adverse pregnancy outcomes, no association was observed with oral retinoid exposure during pregnancy. This study found no significantly increased risk of congenital malformations, autism spectrum disorders, and intellectual disability associated with oral retinoid exposure during pregnancy; however, given the limitations such as including only the live births and increased point estimate, potential risk cannot be fully excluded.

Factors Associated with the Utilisation of Family Planning Services among Women of Reproductive Age (15-49 Years) Attending Hoima Regional Referral Hospital

Family planning is defined as the ability for individuals and couples to attain their desired number of children and plan the spacing and timing of their births through the use of contraceptive methods. Promoting family is one of the main targets to reach the SDGs, and timely achievement of family planning targets is expected to accelerate achievement across the 5 SDG themes of people, planet, prosperity, peace, and partnership. Despite the enormous benefits of family planning services, the uptake of the service remains low Uganda. This has resulted in high rates of unwanted pregnancies, unplanned deliveries, unsafe abortions, and maternal mortalities in Uganda. Several factors play an important role in the use of contraceptives among women of childbearing age. The identification of these factors is crucial to the planning and implementation of a suitable family planning programme. The study was designed to determine the factors associated with the utilisation of family planning among women of reproductive age (15–49) attending Hoima Regional Referral Hospital, Western Uganda. This was a hospital-based cross-sectional study. Quantitative and qualitative methods of data collection were utilised to collect data from 251 participants. From the results of the study majority, 182(72.5%) had never used family planning services and 68 (27.5%) had ever used family planning services. Therefore, the level of utilizing family planning services was found to be 27.5%. Thus, the level of utilisation of family planning services among women of reproductive age (15–49) attending Hoima Regional Referral Hospital, Western Uganda, was low, which is significantly associated with the education level and perceived skills of health workers. There is a need to promote and effectively implement policies in support of girls’ education to increase FP service utilisation. Keywords: Family Planning, Women, SDGs, Contraceptives, HIV/AIDS

A pilot integrated model nurse clinic increases the uptake of antiviral treatment for the prevention of mother-to-child transmission of HBV.

Mother-to-child-transmission (MTCT) of hepatitis B virus (HBV) may still occur despite birth-dose HBV vaccinations when pregnant women are positive for hepatitis B surface antigen (HBsAg) with high viral loads (HBV DNA ≥ 200 000 IU/mL). A pilot integrated model nurse clinic (IMNC) was started in 2020 to implement the pre-emptive antiviral therapy with tenofovir disoproxil fumarate (TDF). We aimed to evaluate the performance of IMNC on uptake of TDF. This was a territory-wide retrospective cohort of all consecutive HBsAg-positive women of child-bearing age with pregnancy records in public hospitals 2019-2022. Demographic characteristics, liver biochemistries and virologic parameters, and TDF use were collected. Concurrently, data from a prospective audit in Union Hospital, the private hospital with the highest number of deliveries in Hong Kong, from June 2022 to May 2023 were compared. The prevalence rate of HBV DNA ≥ 200 000 IU/mL in pregnant women with available HBV DNA records was 29.2% (66/226) in 2019, 27.3% (99/363) in 2020, 15.9% (125/784) in 2021 and 17.2% (117/679) in 2022 (p < .001), out of 2052 pregnant women who had their HBV DNA checked within 1 year prior to delivery. An increasing uptake rate of TDF by highly viraemic pregnant women (i.e. ≥ 200 000 IU/mL) was noted after the commencement of IMNC in public hospitals, with 67% (45/67) in 2019, 83% (88/106) in 2020, 91% (117/128) in 2021 and 89% (149/167) in 2022. Moreover, all highly viraemic pregnant women from Union Hospital received TDF. Continuous use of TDF was associated with a reduced risk of postpartum biochemical flare. IMNC increases the uptake of antiviral treatment in pregnant women at risk of MTCT of HBV. IMNC contributes to hepatitis elimination through a structured care plan to prevent MTCT of HBV.

The Influence of Employment Status, Education, and Age at First Marriage on Fertility in South Kuta District

High fertility can cause an increase in population which can have negative impacts such as social and economic inequality, increased competition for resources and jobs if it is not balanced with quality human resources. The aim of this research is to analyze the influence of employment status, education and age at first marriage on the fertility of women of childbearing age in South Kuta District. Determining the sample in this study used a purposive sampling technique with a sample size of 99 people. The types of data used are quantitative and qualitative data with primary and secondary data sources. The data collected was then analyzed using multiple linear regression analysis with the SPSS 29 program. The results of the study found that 1) Employment status, education and age at first marriage simultaneously influence the fertility of women of childbearing age in South Kuta District. 2) Employment status, education and age at first marriage have a partial negative effect on the fertility of women of childbearing age in South Kuta District. The implications of this research consist of theoretical and practical implications. Theoretically, this research supports the concept of time allocation theory and family economics which explains that decisions regarding fertility are influenced by economic considerations. The practical implications of the results of this research are that it can be used as material for consideration and input in managing population issues more effectively so as to improve the overall welfare of society in South Kuta District.

A biobehavioral observational study to understand the multilevel determinants of cardiovascular health in Black women: the BLOOM Study protocol

BackgroundThe racial/ethnic and gender disparities in cardiovascular disease (CVD) morbidity and mortality in the United States are evident. Across nearly every metric, non-Hispanic Black women have poorer overall cardiovascular health. Emerging evidence shows a disproportionately high burden of increased CVD risk factors in Black women of childbearing age, which has a far-reaching impact on both maternal and child outcomes, resulting in premature onset of CVD and further widens the racial disparities in CVD. There is growing recognition that the fundamental driver of persistent racial/ethnic disparities in CVD, as well as disparities in behavioral risk factors such as physical activity and sleep, is structural racism. Further, the lived personal experience of racial discrimination not only has a negative impact on health behaviors, but also links to various physiological pathways to CVD risks, such as internalized stress resulting in a pro-inflammatory state. Limited research, however, has examined the interaction between daily experience and health behaviors, which are influenced by upstream social determinants of health, and the downstream effect on biological/physiological indicators of cardiovascular health in non-pregnant Black women of childbearing age.Methods/DesignThe BLOOM Study is an observational study that combines real-time ambulatory assessments over a 10-day monitoring period with in-depth cross-sectional lab-based physiological and biological assessments. We will use a wrist-worn actigraphy device to capture 24-h movement behaviors and electronic ecological momentary assessment to capture perceived discrimination, microaggression, and stress. Blood pressure will be captured continuously through a wristband. Saliva samples will be self-collected to assess cortisol level as a biomarker of psychological stress. Lab assessments include a fasting venous blood sample, and assessment of various indices of peripheral and cerebral vascular function/health. Participants’ address or primary residence will be used to obtain neighborhood-level built environmental and social environmental characteristics. We plan to enroll 80 healthy Black women who are between 18 and 49 years old for this study.DiscussionResults from this study will inform the development of multilevel (i.e., individual, interpersonal, and social-environmental levels) lifestyle interventions tailored to Black women based on their lived experiences with the goal of reducing CVD risk.ClinicalTrials.gov IdentifierNCT06150989.