Women's Reproductive Health Research Articles

The impact of intimate partner violence on adverse birth outcomes in 20 sub-Saharan African countries: propensity score matching analysis

BackgroundIntimate partner violence (IPV) is a significant public health problem, with serious consequences on women's physical, mental, sexual, and reproductive health, as well as birth outcomes. Women who encounter IPV are more likely to experience adverse birth outcomes such as low birth weight, premature delivery, and stillbirth. Although numerous studies are exploring the association between IPV and adverse birth outcomes, they merely used classical models and could not control for potential confounders. The purpose of this study was to ascertain whether there was a causation between IPV and adverse birth outcomes in sub-Saharan Africa (SSA) using a quasi-experimental statistical technique [i.e., propensity score matching (PSM) analysis].MethodThis study used the most recent (2015–22) Demographic and Health Survey (DHS) data from 20 SSA countries. A total weighted sample of 13,727 women was included in this study. IPV (i.e., sexual, physical, emotional, and at least one form of IPV) was the exposure/treatment variable and adverse birth outcomes (preterm delivery, low birth weight, stillbirth, and macrosomia) were the outcome variables of this study. PSM was employed to estimate the impact of IPV on adverse birth outcomes.ResultsThe average treatment effects (ATE) of sexual, physical, emotional, and at least one form of IPV were 0.031, 0.046, 0.084, and 0.025, respectively. Sexual, physical, emotional, and at least one form of IPV increased adverse birth outcomes by 3.1%, 4.6%, 8.4%, and 2.5%, respectively. Findings from the average treatment effect on treated (ATT) showed that women who experienced sexual, physical, emotional, and at least one form of IPV had an increased risk of adverse birth outcomes by 3.6%, 3.7%, 3.3%, and 3.0%, respectively, among treated groups.ConclusionThis study demonstrates a causal relationship between IPV and adverse birth outcomes in SSA countries, indicating a need for programs and effective interventions to mitigate the impact of IPV during pregnancy to reduce related adverse pregnancy outcomes. Furthermore, we suggest further research that investigates the causal effect of IPV on adverse birth outcomes by incorporating additional proximal variables not observed in this study.

Call attention to the comprehensive diagnosis and treatment strategies of infertility caused by chronic endometritis

Chronic endometritis (CE) is a persistent inflammation of the endometrium caused by microbial infection, which is characterized by the infiltration of plasma cells into the endometrial stromal area. CE emerges as a critical determinant in the etiology of female infertility and is closely associated with adverse pregnancy outcomes, such as recurrent spontaneous abortion and repeated implantation failure, imposing a heavy burden on patients and their families. However, current understanding of CE-induced infertility remains superficial, leading to delays and inconsistent approaches in the diagnosis and treatment of the condition. Emphasizing the diagnosis and treatment of CE can help improve women's reproductive health, alleviate the economic and psychological pressures of patients and their families, resolve family conflicts and promote family and social harmony. This article provides an in-depth analysis of the diagnostic criteria and current application status of CE, its impact on endometrial receptivity and fallopian tubal function, as well as its interplay with other gynecological disorders. In alignment with clinical practice, we propose suggestions including enhancing the understanding of CE, strengthening publicity and education, standardizing the diagnostic process for CE, exploring the molecular mechanisms of CE and optimizing treatment strategies, in order to improve the comprehensive diagnosis and treatment strategies of CE-induced infertility and make greater contributions to the reproductive health of women in China.

Vitamin B12 is correlated with insulin resistance and metabolism disorder markers in women with recurrent pregnancy loss

ObjectivesRecurrent pregnancy loss (RPL) seriously affects women's reproductive and mental health, and the incidence has increased in recent years. Insulin resistance (IR) acts as a significant contributing factor to RPL. Studies suggest that vitamin B12, folate intake, and homocysteine are correlated with IR, but the exact nature remains controversial and requires further investigation. In this study, we aimed to assess the levels and correlations between vitamin B12-folate-homocysteine and insulin resistance in RPL patients. Study design73 control subjects and 256 RPL patients (144 RPL patients without IR and 112 RPL patients with IR) were included in this observational retrospective cross-sectional study. The differences in vitamin B12, folate, and homocysteine levels between RPL patients with and without IR were analyzed using a Student's t-test. Pearson correlations were utilized to examine the correlation between vitamin B12-folate-homocysteine and glucose and lipid metabolism parameters. Multivariable linear regressions were used to assess the independent correlation of each factor with HOMA-IR. ResultsCompared to the control subjects, RPL patients exhibited lower vitamin B12 (p < 0.001) and folate (p < 0.001), and higher homocysteine (p = 0.001). RPL patients with IR described decreases in vitamin B12 (p = 0.003) and folate (p = 0.028), and increases in homocysteine (p = 0.033) as RPL patients without IR. Vitamin B12 in RPL patients was significantly negatively correlated with homocysteine (r = −0.348, p < 0.001), HOMA-IR (r = −0.214, p < 0.001), BMI (r = −0.160, p = 0.017), TG (r = −0.148, p = 0.039) and CHO (r = −0.149, p = 0.038) and positively correlated with folate (r = 0.217, p < 0.001). In multivariable linear regressions, after adjusting for age, strong correlations were observed between vitamin B12 (β = −0.197, p = 0.010), BMI (β = 0.466, p < 0.001), and HOMA-IR in RPL patients. ConclusionVitamin B12 is significantly correlated with IR in RPL patients. Circulating vitamin B12-folate-homocysteine metabolism could be a window of the pathological process of IR, obesity, and lipid metabolism disorders in RPL patients.

Ultrasound-Responsive Hydrogel Incorporated with TGF-β Mimetic Peptides for Endometrium Recovery to Restore Fertility.

Unavoidable damage to the basal layer of the endometrium has a huge negative impact on a woman's reproductive health and menstrual cycle. However, it is difficult for medicine to penetrate a series of biological barriers toward the basal layer in the deeper area of the endometrium. To meet this challenge, we developed an ultrasound-responsive hydrogel incorporated with a transforming growth factor-beta (TGF-β) mimetic peptide to enhance pregnancy outcomes by restoring the function of a wounded endometrium due to its deep-tissue-penetration capability. In vitro studies revealed that the TGF-β-mimetic-peptide-loaded hydrogel could achieve 64.35% of cell migration under ultrasound stimulation even in phosphate-buffered saline of pH 6.0. Upon in situ sonication at the uterus, carboxymethyl chitosan can be released from degraded hydrogel to open tight junctions with reduced interstitial pressure by ultrasound to promote deep penetration. Rat studies revealed that the penetration capability of TGF-β-mimetic-peptide-loaded hydrogel with sonication was 1.6 times higher than that of the control group. Besides the rat uterine model, ex vivo human uterine tissue was also collected and imaged, demonstrating up to ∼700 μm of tissue penetration depth. In addition, compared to control groups, effective uterus recovery without intrauterine stenosis and endometrial cavity fluid was observed from rats with severe uterine injury treated by TGF-β-mimetic-peptide-loaded hydrogel. In addition, fertility restoration in the endometrial injury model was observed after treatment with such an ultrasound-responsive hydrogel incorporated with TGF-β mimetic peptides. Overall, this work provides an effective approach to treating endometrial injury for enhanced pregnancy outcomes.

Effects of Thyroid Hormones on Cellular Development in Human Ovarian Granulosa Tumor Cells (KGN).

Ovarian cancer is a common malignant tumor in the female reproductive system, and Granulosa cell tumor (GCT) of the ovary is a rare type of ovarian cancer, which significantly threatens women's reproductive health. It has been reported that dysregulation of thyroid hormones (THs) may be closely related to the progression and prognosis of ovarian cancer. Moreover, THs regulate phosphorylation of signal transducer and activator of transcription (STAT3) and Octamer-binding transcription factor 4 (OCT4) expression. It has been reported that STAT3 and OCT4 play important roles in cellular development and tumorigenesis. However, the mechanisms by which THs affect the development of GCT are still remained unclear. To evaluate the effect of THs on human ovarian granulosa tumor cells (KGN), cells were treated with 3,5,3' -triiodothyronine (T3). Oct4 small interfering (Oct4 siRNA) or STAT3 inhibitor C188-9 was also co-cultured with cells in some experiments, respectively. The cell viability, proliferation, and proteins content were detected by CCK-8, EdU, and Western Blotting, respectively. The results showed that T3 enhanced cell viability and proliferation. Moreover, T3 also increased the expression of thyroid hormone receptor (TR), p-STAT3, and OCT4 proteins. The effects of T3 on both p-STAT3 and OCT4 expression were blocked by TR antagonist 1-850. Meanwhile, C188-9, an inhibitor of STAT3, decreased T3-induced cellular viability, proliferation, and OCT4 expression, highlighting that p-STAT3 can regulate the expression of OCT4 and affect cellular viability, and proliferation. Furthermore, T3-induced cellular growth was reduced by Oct4 siRNA, which indicates that T3 regulates cellular development through OCT4. These findings suggest that T3 increases cellular development via OCT4, which is mediated by phosphorylation of STAT3, and TR is also involved in these processes.

Metabolomic analysis reveals potential role of immunometabolism dysregulation in recurrent pregnancy loss.

Recurrent pregnancy loss (RPL) affects women's reproductive health seriously, with immune dysfunction playing a key role in its cause, yet the exact mechanisms remain elusive. We aim to investigate potential mechanisms and identify biomarkers linked to RPL. Immune cytokine testing and metabolomic profiling were conducted on the serum of 34 RPL patients and 30 healthy individuals. The metabolic pathways of the differential metabolites were analyzed, and specific metabolites were validated through targeted profiling. Potential biomarkers were identified, and the relationships between immune cytokines and differential metabolites were explored. In the RPL group, serum interleukin-6 and interleukin-10 levels were significantly higher, while interleukin-2 and interferon-γ were significantly lower. A total of 296 differential metabolites were detected by untargeted metabolomic profiling between the RPL and control groups, with most linked to amino acid metabolism. Targeted metabolomic profiling of amino acid metabolism revealed upregulation of indole-3-acetic acid, tyrosine, glycine, isoleucine, tryptophan, lysine, aspartic acid, arginine, leucine, threonine, glutamic acid, cystine, and phenylpyruvic acid (PPA) in the RPL group. Moreover, PPA and 5-hydroxy-L-tryptophan showed great potential in predicting RPL in a diagnostic model. Cystine and tyrosine were associated with immune cytokines in correlation analysis. The study highlights the role of amino acid metabolism in RPL pathogenesis, suggesting that PPA and 5-HTP may be potential predictive indicators, while cystine and tyrosine may potentially regulate immune responses related to RPL. Further investigation into the molecular mechanisms underlying these findings could potentially result in the creation of novel diagnostic and therapeutic approaches for RPL.

Work Situation of Midwives in Spain: Perception of Autonomy and Intention to Leave the Profession: A Cross-Sectional Study.

Developed countries report specific issues regarding the declining midwifery workforce, and their shortage could have serious consequences for women's sexual and reproductive health. The aim was to understand the perception of autonomy among midwives working in Spain, as well as factors related to their intention to leave the profession and their work environment. A descriptive and cross-sectional study using an online questionnaire. midwives working in Spain in any field (clinical, research, teaching, or management). A sample of 1060 midwives was obtained. Of these, 53.7% (n = 569) feel autonomous in their work, 92.4% (n = 978) perceive that their profession frequently suffers from external interference, 46.6% (n = 494) have experienced sexist behaviors at work, and 53% (n = 561) have considered leaving the profession in the last year. Midwives with less than 10 years of experience (57.7%), those aged 31-45 years (59.8%), those with temporary contracts (38.3%), and those working in hospital care (71.9%) show a higher rate of considering leaving the profession (p < 0.001). Considering the current midwifery workforce crisis in Spain, it seems urgent to improve the working conditions of midwives to ensure the continuity and quality of women's sexual and reproductive healthcare.

Therapeutic Potential of Pomegranate Extract for Women's Reproductive Health and Breast Cancer.

Pomegranate extract has potential benefits for women's reproductive health, including fertility enhancement, menstrual cycle regulation, pregnancy support, and polycystic ovary syndrome (PCOS) treatment. It possesses antioxidant properties, reducing oxidative stress and improving fertility. Pomegranate extract may help regulate hormonal imbalances and promote regular menstrual cycles. The extract's rich nutrient profile supports placental development and fetal growth and may reduce the risk of preterm birth. Additionally, pomegranate extract shows promise in improving insulin sensitivity and reducing inflammation and oxidative damage in PCOS. Some studies suggest its potential anticancer properties, particularly against breast cancer. However, further research, including human clinical trials, is necessary to establish its effectiveness and safety. The current evidence is limited and primarily based on in vitro studies, animal studies, and clinical trials. This review provides a comprehensive summary of the benefits of pomegranate extract for women's reproductive health and breast cancer, serving as a reference for future research.

CUPPING AND FEMALE REPRODUCTIVE PROBLEMS: A NARRATIVE REVIEW

Al-hijamah, or cupping therapy, uses a cupping device to vacuum suction the skin. The recommendation and virtues of cupping are found in various hadiths of the Messenger of Allah (peace and blessings of Allah be upon him). It has been used traditionally for centuries and is gaining recognition for its potential health benefits, especially in women's reproductive health. The aim of this review is to map the research results on the cupping method (Al-hijamah) as an evidence-based treatment method for addressing reproductive problems in women. This narrative review uses databases, including PubMed, ScienceDirect, EBSCO, and Grey Literature, as well as Google Scholar and Research Rabbit. Based on the results of the inclusion and exclusion criteria, 13 articles were retrieved, and 2 themes were obtained, namely the role of cupping therapy for women's reproductive health and various combinations of cupping with other methods. Cupping therapy can have a positive impact on various aspects of female reproductive health, including menstrual disorders and infertility. Studies have shown improvements in menstrual cycles, reduction in menstrual pain, and increased fertility rates in women who undergo cupping therapy. In addition, cupping therapy has also shown promise in treating conditions such as Polycystic Ovarian Syndrome (PCOS) and anemia associated with excessive menstrual bleeding.

SmartScanPCOS: A feature-driven approach to cutting-edge prediction of Polycystic Ovary Syndrome using Machine Learning and Explainable Artificial Intelligence

PolyCystic Ovarian Syndrome (PCOS) poses significant challenges to women's reproductive health due to its diagnostic complexity arising from a variety of symptoms, including hirsutism, anovulation, pain, obesity, hyperandrogenism, and oligomenorrhea, necessitating multiple clinical tests. Leveraging Artificial Intelligence (AI) in healthcare offers several benefits that can significantly impact patient care, streamline operations, and improve medical outcomes overall. This study presents an Explainable Artificial Intelligence (XAI)-driven PCOS smart predictor, structured as a hierarchical ensemble consisting of two tiers of Random Forest classifiers following extensive analysis of seven conventional classifiers and two additional stacking ensemble classifiers. An open-source data set comprising numerical parametric features linked to PCOS for classifier training was used. Moreover, to identify essential features for PCOS prediction three feature selection methods: Threshold-driven Optimized Principal Component Analysis (TOPCA), Optimized Salp Swarm (OSSM), and Threshold-driven Optimized Mutual Information Method (TOMIM) were fine-tuned through thresholding and improvisation to detect diverse attribute sets with varying numbers and combinations. Notably, the two-level Random Forest classifier model outperformed others with a remarkable 99.31 % accuracy by employing the top 17 features selected through the Threshold-driven Optimized Mutual Information Method (TOMIM) along with anoverallaccuracy of 99.32 % with 8 fold cross validation for 25 runs. The Smart predictor, constructed using Shapash - a Python library for Explainable Artificial Intelligence - was utilized to deploy the two-level Random Forest classifier model. Ensuring transparency and result reliability, visualizations from robust Explainable AI libraries were employed at different prediction stages for all considered classifiers in this study.

Untold Stories of Displaced Rohingya Pregnant Women Exposed to Intimate Partner Violence in Camp Settings

Intimate partner violence (IPV) strongly impacts the physical, sexual, social, and reproductive health of women, causing an array of psychological and behavioural problems. During pregnancy, the detrimental effects of violence extend to both the mother and the child. Rates of IPV are frequently higher among those in conflict‐affected and displaced communities, most of whom live in low and middle‐income countries. IPV against Rohingya women is common due to relocation, family breakups, patriarchal norms, and deep‐seated gender roles. Despite the high prevalence of IPV in Rohingya refugees in Bangladesh, the matter is often under‐examined. This qualitative study aims to explore and understand pregnant IPV victims’ unique experiences and hardships among the displaced population in a camp setting. A sample of six pregnant homemakers with no formal education was recruited from a healthcare service provider in Leda Camp 24, a remote camp in Cox’s Bazar, Bangladesh. Semi‐structured, in‐depth, face‐to‐face interviews were conducted. Participants reported diverse manifestations of IPV victimisation. Physical abuse, emotional abuse, economic abuse, sexual abuse, pregnancy‐related consequences, and impact on mental health were commonly experienced by participants of this study. The current research investigates the recurrent abuse experienced by this demography, providing detailed narrative information beyond quantitative descriptions of IPV experiences. This article contributes to the existing knowledge on the intersection of IPV, pregnancy, and mental health among displaced populations. Governmental and non‐governmental stakeholders must contextualise these findings in policies and practices by integrating IPV and violence screening, prevention, and treatment protocols into refugee camps and healthcare service providers.

A multicentre, randomized, double-blind, placebo-controlled trial of topical oestradiol gel for endometrial regeneration after induced abortion.

Is topical oestradiol gel effective in promoting endometrial regeneration after a surgical abortion? Topical oestradiol gel is effective in promoting endometrial regeneration after a surgical abortion with few side-effects. Oestrogen is effective in promoting endometrial regeneration. Transdermal oestrogen has been widely used in clinical practice for endometrial regeneration after induced abortion, but high-level evidence is limited. We conducted a multicentre, superiority, randomized, double-blind, placebo-controlled trial. Between 9 March 2022 and 21 February 2023, 200 women were assigned in a 1:1 ratio to receive either oestradiol gel (treatment) and or oestradiol gel simulant (control) for 28 days. The participants were scheduled to have their endometrial thickness (mm) measured by ultrasonographic scan at 21-23 days post-abortion. The trial was blinded for participants, investigators, medical staff, and statistical analysts until final unblinding. Participants were women undergoing induced abortion within 10 weeks of gestation. A total of 200 participants were enrolled, with 100 in each group. Eighty-eight (88%) in the treatment group and 82 (82%) in the control group completed the study as per the protocol and were included in the per-protocol set (PPS). The intent-to-treat (ITT) analysis included all participants randomized to the study groups and used inverse probability weighting to account for loss to follow-up. The ITT analysis showed revealed significantly greater endometrial thickness in the treatment group (mean 8.1 ± 2.5 mm) compared to the control group (mean 6.9 ± 2.1 mm) 21-23 days postabortion (mean difference 1.2 mm, 95% CI 0.7 to 1.9; P < 0.001). The median time to menstrual return was shorter in the treatment group (34 days, inter-quartile range [IQR] 30-38) than in the control group (35 days, IQR 32-42), with a difference of -1 day (95% CI -2.3 to -0.9; P = 0.036). No differences were observed in the timing or volume of bleeding in the first post-abortion cycle. The PPS analysis mirrored the ITT findings. Adverse events were minimal (6% versus 8%), and the blood profile, liver, kidney and coagulation test results were comparable between groups (all P > 0.05). Loss to follow-up was 11% in the treatment group and 15% of controls, with no significant difference (P > 0.05). Inconsistencies in the timing of the ultrasonographic scans may have affected the accuracy of endometrial thickness measurements. Our findings suggest that topical oestrogen supplementation immediately after abortion within the first 10 weeks of gestation improves endometrial regeneration and growth, thereby potentially increasing the chances of a successful subsequent pregnancy. Clinical application of these findings may improve endometrial health management practices and provide a perspective on fertility treatment and women's reproductive health. This study was supported by a grant (FW-HKKT2021111501900) from Jianmin Pharmaceutical Group Co., Ltd (JMPG), Wuhan, Hubei, China. Both the oestradiol gel and the simulant were provided by JMPG. The funding source had no role in the study. X.Y.L. reports JMPG grant funding paid to their institutions. All other authors declare no competing interests. CHiCTR2100053565. 24 November 2021. 9 March 2022.

Marriage Dispensation of Minors by Religious Courts in Relation to Women's Reproductive Health Rights

Marriage Dispensation of Minors by Religious Courts in Relation to Women's Reproductive Health Rights

Correction: Gender-Based Violence and Women Reproductive Health in War Affected Area.

Correction: Gender-Based Violence and Women Reproductive Health in War Affected Area.

Associations between dietary patterns and parameters of ovarian reserve in Polish women of reproductive age.

Research investigating the association between reproductive health and diet has predominantly focused on the antenatal and prenatal periods, as well as childbirth in women, and semen quality in men. There is a limited amount of research addressing female fertility assessed as ovarian reserve in relation to diet. The main aim of this study was to evaluate the association between dietary patterns and the parameters of ovarian reserve, such as antral follicle count (AFC), anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), and estradiol (E2) - predictors of reproductive health in women of childbearing age. Women aged 24-39 years (N = 511) were enrolled from fertility clinic in central Poland. The count of antral follicles was determined using ultrasonography (USG), FSH and E2 levels were measured using a chemilumi- nescence method and for determination of AMH level, an enzyme-linked immunosorbent assay method was employed. Diet was assessed according to food frequency questionnaire and dietary patterns were identified by factor analysis. Women were classified into 3 groups according to scores of each dietary pattern: Western, mixed, prudent. Higher adherence to the prudent dietary pattern in obese women was associated with significantly higher AFC (p = 0.03) and AMH (p = 0.05) as compared to participants with the Western dietary pattern. The results were adjusted for age, BMI, smoking and duration of fertility. Increased consumption of mixed dietary pattern was not statistically significant associated with any of examined ovarian reserve parameters. The prudent dietary pattern is positively associated with ovarian reserve in a cohort of women seeking fertility care. Continued research in this area will provide nutritional guidance for clinicians and their patients and provide novel insight on potential modifiable lifestyle factors which can be associated with ovarian reserve. Int J Occup Med Environ Health. 2024;37(4).

Reproductive health in women with ankylosing spondylitis: contraception and fertility. A narrative review.

The knowledge of ankylosing spondylitis is rising, and more and more attention is being paid to the diagnosis of this pathology in females. The purpose of this narrative review is to emphasize the role of reproductive health in women with ankylosing spondylitis, with particular attention to contraception and fertility. A comprehensive review of the literature was performed to evaluate the reproductive health of women with ankylosing spondylitis. Oral contraception has been shown to be safe in women with ankylosing spondylitis, with no contraceptive benefits that should be evaluated during counseling. In the literature, there is no strong data regarding fertility in women with ankylosing spondylitis. It seems that these women may have impaired fertility due to reduced ovarian reserve, pharmacological treatments, and reduced sexual activity due to the concern that offspring may contract the disease. A multidisciplinary approach is needed in these women to ensure an adequate evaluation of sexual activity as an important aspect of quality of life and to counsel regarding family planning to address patients' concerns on contraception, fertility desire, and fertility preservation. Lifestyle factors should be investigated to improve fertility and disease activity without medications. Further trials are needed to investigate the reproductive health of women with ankylosing spondylitis.

What it takes to develop self-confidence and competence in midwifery students for midwifery practice

BackgroundMidwifery practice is multidimensional and complex in supporting women's reproductive health. Midwives provide care through pregnancy, birth, and the puerperium and may extend to sexual and reproductive health. Midwifery education must develop self-confidence and competence within each midwifery student. This must be learned before registering as a midwife and entering midwifery practice. Little is known about how educational experiences influence midwifery students' confidence. AimThe aim of this study was to understand the educational experiences that influence self-confidence and competence development among midwifery students. Design and methodsA qualitative descriptive design was used in this study. Data were collected through seven focus group discussions with 37 midwifery students. The discussions were recorded and professionally transcribed. Data were analysed using thematic analysis. ResultsThe analysis resulted in four themes: (1) Understanding the concept of competence, (2) developing competence in midwifery practice, (3) obstacles to developing competence, and (4) the importance of self-confidence to be competent. The development of self-confidence and competence is gained through acquiring knowledge and skills, participating in research, undertaking clinical and simulated practice, attending seminars, and engaging in independent learning. ConclusionMidwifery students described how the increase in self-confidence can lead to an increase in competence, enabling the provision of high-quality midwifery services.

Determinants of the desire to avoid pregnancy after the disaster of the century in Türkiye

BackgroundAfter natural disasters, the occurrence of mental health problems and adverse effects on reproductive health in women of reproductive age can be attributed to a multitude of factors, including the deterioration of health facilities, a shortage of qualified health professionals, a lack of socio-economic stability, and a paucity of familial and community support.MethodsThe descriptive correlational study was conducted through social networks with 405 women who had experienced the disaster of the century 8 months after (between November and December 2023) the earthquake. The snowball sampling method was used to obtain the research data. The questionnaire form, developed for the purpose of data collection, was disseminated to women who consented to participate in the study through social networks. The data were evaluated using a variety of statistical techniques, including number, percentage, mean, standard deviation, independent sample t-test, one-way analysis of variance, and structural equation modeling.ResultsAccording to the results of linear regression analysis, these were found to be predictors of the desire to avoid pregnancy: having housing problems (β-coefficient 0.173; p = .008), having a damaged home (β-coefficient. 276; p = .009), sleep patterns (β-coefficient 0.433; p = .022), eating habits (β-coefficients 0.248, 0.044), use of psychiatric medication (β-coefficient 0.436, p = .003), and problems related to the food and water supply (β-coefficient 0.127, p = .003). In addition, a structural equation model (SEM) was established to examine the relationship between these variables and mental well-being and pregnancy avoidance. Only the model constructed with mental well-being demonstrated significance in the SEM analysis.ConclusionsThis study shows that women’s mental health is negatively affected in unpredictable emergencies such as earthquakes and that poor mental health negatively affects pregnancy planning. The findings of the study may help to guide health professionals working in the field of women’s health to protect women’s mental health in emergency situations, to provide counseling about pregnancy planning, and to provide social and psychological support programs.

Reproductive Health and Domestic Violence: An Evidence Based Study from District Gujrat (Pakistan)

Domestic violence is generally part of the patterns of violent behavior and control rather than an isolated act of physical aggression. Domestic violence can take a variety of forms, including physical assault, psychological apprehension, constant belittling, intimidation, humiliation, and coercive sex, among others. It frequently can include controlling behavior such as isolating women from family, friends, self-esteem, and movements and restricting their access to fundamental human rights that are significantly associated with the psycho-social and reproductive health of women. Keeping in consideration the importance and sensitivity of the issue, the researcher tries in this study to explore the primary motives behind domestic violence that leads to aggressive behaviors and its impacts on women's reproductive health in our society. The researcher approached the researcher's district police office and obtained the list of registered cases regarding domestic violence in the district of Gujrat, Punjab. The findings of the study indicated that most of the women are the victims of domestic violence (physically, mentally, and sexually) and face discrimination and limited access to reproductive health services and pregnancy-related morbidity and mortality. Results highlighted that domestic violence intensively influenced women's physical as well as psychological conditions that led them towards mental, social, and economic disruptions. The sexual violence, including forced or coerced relationships and unwilling pregnancies, among others, significantly affected the reproductive health and well-being of women.

Early Marriage Age Trends in Magetan Regency, Indonesia: A Review of 2021-2023

Background: Early marriage is a significant women's reproductive health issue, especially because of its association with the risk of abortion, stunting, malnutrition and infection in infants. The aim of the study was to describe the age trend of early marriage in Magetan Regency from 2021 to 2023. Methods: This type of research is descriptive quantitative with the population of all couples who married in Magetan Regency during the period. The sample of this study included all married individuals with a total of 12,772 people. The main variable was age at marriage. Data were collected through a documentation study of age of marriage reports recorded at the PPKBPP and PA Office of Magetan Regency using a data recapitulation table. Data analysis was conducted with descriptive statistics, in the form of frequency distribution and percentage. Results: The results showed an increasing trend of early marriage in most sub-districts, with a predicted prevalence that tends to increase until the end of 2024. Between 2021 and 2023, the trend of early marriage age in Magetan Regency showed a varied pattern, with some years increasing and others decreasing. The main factors influencing this trend include economic factors, education, and local policies. The impacts of early marriage include challenges in health and education, which require continued attention in mitigation and response efforts. Conclusion: The conclusion of this study is that there is a need for serious attention to this problem, including prevention efforts through education, counseling, and improving the quality of education and policies to prevent early marriage from the government and related institutions.