Women Age Research Articles

"Hit a bottleneck": a convergent mixed-methods approach to the Influencing factors and experience of fertility intention among mothers of childbearing age with two children in mainland China.

Fertility rates have been decreasing both worldwide and in China. Although current policies have been aimed at raising the birth rate in China, their overall effects have been unclear. Therefore, exploration of fertility intention and related influencing factors is crucial. This study used a convergent parallel mixed methods combining descriptive and cross-sectional designs with a framework analysis. Convenience sampling was used to select mothers of childbearing age with two children (n = 603), living in Guangdong Province, China. Participants completed an online questionnaire investigating sociodemographic characteristics, as well as determinants and attitudes regarding the third-child fertility intention. Correlation coefficients and multivariate regression analyses were used to present quantitative findings. Eleven interviews were conducted, and a framework analysis method was used for data analysis. The results for the qualitative and quantitative study components were analyzed separately and were subsequently integrated through side-by-side comparison and joint display. Attitudes toward fertility intention were negative, and the rate of fertility intention was 10.4% in Guangdong Province. In the quantitative component, women's age, perceived value of having a third child, and attitudes were found to be factors promoting the intention to have a third child, whereas monthly family income, grandparents' health status, and policy support were found to be factors hindering the intention to have a third child. Four major themes emerged regarding the perceptions and experiences regarding fertility intention in the qualitative component. After integrated analysis, younger age, knowledge regarding policy support, and access to childcare support were found to be factors significantly affecting the intentions of mothers with two children regarding having a third child. Fertility issues require continued attention. Our findings provide a reference for optimizing existing policies to increase fertility intentions. Providing policy support, such as public childcare support, flexible working hours for mothers, affordable childcare, and greater psychological support, would enable mothers to improve their parenting. In addition, increasing the dissemination of knowledge regarding policies is necessary to improve the level of public understanding and promote fertility intention.

Reflections on timing of motherhood - a qualitative online study with women of reproductive age

BackgroundThe age of Danish women giving birth to their first child has risen throughout the last 50 years, and the number of women and men who are having their first child when they are at advanced maternal or paternal age is increasing worldwide. Postponing parenthood is not unique to Denmark, as the same pattern is seen especially in other European and Western countries. The aim of this study was in a social media setting to explore reflections on the timing of motherhood among Danish women of reproductive age who not yet had children.MethodThis study was a qualitative study based on three online focus groups on Facebook. Twenty-six women of reproductive age discussed the timing of motherhood for three days in January 2020. Data were analyzed using Systematic Text Condensation.ResultsThree main themes were identified: ‘Life before parenthood’, ‘To plan for a child’ and ‘A life without children’. Several external and internal conditions influence whether and if so when women consider becoming mothers. Regarding the biological capacity for having children, women compare themselves with their female relatives and friends and colleagues regarding the social norms surrounding motherhood. Women with no children often experience either positive or negative pressure from family, friends, and colleagues regarding when to have children.ConclusionSeveral internal and external considerations influence when and if women become mothers. Social surroundings such as family, friends, and colleagues have an impact on women’s reproductive considerations in terms of pressure to have children in the future. Danish women tend to compare their reproductive capacity to their female relatives and compare the social norms surrounding motherhood to their female friends. Women in this study were positive towards discussing the timing of motherhood with other women of reproductive age on social media.

Knowledge of pelvic floor muscles in community-dwelling women aged over 60: its relationship with urinary incontinence.

To investigate the awareness of the pelvic floor muscles (PFMs) and PFM exercises (PFME) knowledge, training and experience in community-dwelling women aged 60 and over and its relationship with urinary incontinence (UI). This is a questionnaire based study which was carried out in 9 Physical Medicine and Rehabilitation Centers, including a total of 500 women aged 60 and over and living in the community. The questionnaire included questions about awareness of PFMs, UI complaints and PFME knowledge, training and experience. Knowledge and awareness of PFMs and PFME knowledge, training and experience were compared in subgroups with or without urinary incontinence. The mean age of the women included in the study was 67.8 ± 6.1 (60-88). Knowledge and awareness of PFMs and PFME knowledge, training and experience were low in the study population. Knowledge and awareness of PFMs were significantly low in the subgroup with urinary incontinence (p < 0.05). Kegel exercise training and experience were significantly low in the subgroup without urinary incontinence (p = 0.01, p < 0.01). Knowledge and awareness of PFMs and PFME knowledge, training and experience are low in community-dwelling women aged 60 and over and training programs should be organized to teach the function of the PFMs and to perform PFME correctly in this population.

Common mental health diagnoses arising from or coinciding with menopausal transition and prescribing of SSRIs/SNRIs medications and other psychotropic medications.

Women with menopausal transition (MT) have an elevated risk of experiencing common mental health diagnoses (CMHD: depression or anxiety). There is no recent data comparing the rate, and treatment, of CMHD between men and women. In this population-based study, incidence rates (IR) per 100 person-years-at-risk (PYAR) for men and women ≥45years registered with an UK primary care practice between 2010 and 2021 were estimated. Incidence rate ratios (IRR) with 95% confidence intervals (CIs) of CMHD were estimated using men as a reference. We measured first prescriptions for psychotropic medications received within 12months after CMHD. For selective serotonin reuptake inhibitors (SSRIs) /selective norepinephrine reuptake inhibitors (SNRIs), we measured the IR of prescribing per 100 PYAR, by 10-year bands. Proportion of SSRIs/SNRIs prescribing was estimated per 100 persons. Rates of anxiety and depressive disorders were 1.68 and 1.69 per 100 PYAR in women aged 45-54years-old compared to 0.91 and 1.20 per 100 PYAR in men, with IRR of 1.84 (95% CI 1.72-1.97) and 1.44 (1.35-1.53) respectively. SSRIs/SNRIs were the most prescribed medication; in 2021, IRs for SSRIs/SNRIs were 13.4 per 100 PYAR in both sexes. In 2021, the proportion of SSRIs/SNRIs prescribing was 50.67 per 100 women and 41.91 per 100 men. MT is assumed based on women's age as menopause onset is rarely recorded in primary care databases. Women ≥45years experienced more CMHD compared to men, especially 45-54years-olds, which coincides with MT. The proportion of SSRIs/SNRIs prescribing was higher in women.

Determinants of fertility experience among reproductive women age (15-49) in Ethiopia: Application of count regression models.

Fertility refers to the average number of children born to a woman over her reproductive years. Due to cultural norms, economic development, education, access to healthcare, and government policies, fertility rates vary significantly across different countries and regions of the world. Ethiopia is one of the developing countries in Sub-Sahara Africa and its fertility rate has consistently been one of the highest in the world. Hence the main goal of this study was to identify the leading factors for the total number of children born per mother in Ethiopia. This study used the most recent secondary data obtained from the 2019 Ethiopia Mini Demographic and Health Survey. A total weighted sample of 8885 women aged 15 to 49 was included in the study. The primary outcome variable in this study was the number of children born per mother, and different socio-demographic and economic factors that could influence fertility experience were included. The analysis was performed using STATA version 17 software. Negative Binomial regression model was used to assess the association between outcome and predictor variables. A p-value <0.05 was considered to be statistically significant. From a total of 8885 women, on average approximately 2.73 children were born per mother. Age of mothers (IRR = 1.08, 95% CI: (1.077, 1.082)), religion for Muslim (IRR = 1.13, 95% CI: (1.08, 1.18)) and others (IRR = 1.16, 95% CI: (1.11, 1.22)), level of education secondary and above (IRR = .61, 95% CI: (.58, .65)) and primary (IRR = .84, 95% CI: (.81, .87)), household member of six to nine (IRR = 1.24, 95% CI: (1.20, 1.28)) and household members more than nine people (IRR = 1.14, 95% CI: (1.07, 1.21)), wealth index for rich (IRR = .94, 95%, CI: (.91, .98)), marital status for not married (IRR = .49, 95%, CI: (.48, .51)), pregnant mothers (IRR = 1.08, 95%, CI: (1.02, 1.13)) and contraceptive users (IRR = 1.12, 95%, CI: (1.09, 1.16)) were the signficant variables for number of children ever born per mother. In Ethiopia, the average number of children born per mother was approximately 2.73. Poisson and Negative Binomial regression models were compared, and we found the Negative Binomial regression model to be better to identify the determinants of fertility experience in Ethiopia. Age of mothers, religion, current pregnancy, use of contraceptive methods, mothers' education level, household members, wealth index, number of children aged five and under, region (Somali, Gambela, and Addis Ababa), and marital status were the determinants responsible for fertility experience among mothers in Ethiopia. These findings are helpful for policymakers and healthcare professionals for developing targeted interventions and programs aimed at improving the high fertility rate experience in Ethiopia.

Purdah:opportunity or Adversity: Fromattia Hosain’s Fictions

In every day language gender refers to the biological differences between male and female which shows as superiority and inferiority. If that is male then he is made for outdoor work and if that is female she will remain at home for her house work course. Since the age of stone women at home does so many things and taking care of children but she never appreciated for that because we suppose she is born to do so. This what society construct the ideology. After observation of this stereotypes feminism moments take its place. Its roots are very undergoing and its stems and branches are exceeding with a never ending fruit full solution. Feminism is just about equality, nothing else. Everyone thinks feminism is about making women stronger but no, she is already very strong. It’s just about changing the way the world perceive their strength. Religion take very countable role of women in society. The myth which is in very lime light that if the women is Muslim and observes Purdah then she must be unfortunate and not able to built her choice for her career and husband. Islam teaches equal treatment and equal rights The glamming example of it is wife of the prophet Muhammad (PBUH) she was a successful businesswoman. Which is a clear massage that women are allowed to go and to do what she wants.

Different degrees of summed difference perfusion score in women: influence on the prognostic variables associated with cardiac events.

Evaluating the predictive models (PM) for a major adverse cardiac event (MACE) only in women with abnormal summed difference score (SDS ≥ 1), borderline myocardial ischemia (borderline-MIsch: SDS = 1), MIsch (SDS ≥ 2), mild-MIsch (SDS = 2-4), and moderate-severe MIsch (ms-MIsch: SDS ≥ 5). Between January 2000 and January 2018, of 25 943 consecutive patients who underwent gated single-photon emission computed tomography myocardial perfusion imaging (gSPECT-MPI) for coronary risk stratification; 717 women (age 68.37 ± 3.4 years) with an abnormal SDS ≥ 1 were included. During the follow-up (mean 4 ± 2.9 years) post-gSPECT-MPI, MACE (unstable angina, nonfatal myocardial infarction, coronary revascularization, cardiac death) was assessed. In the global women cohort with abnormal SDS (n = 717), the PM was angina [hazard ratio (HR): 1.65, P = 0.016], diabetes (HR: 1.72, P = 0.004), beta-blockers (HR: 1.61, P = 0.009), pharmacological stress (HR: 1.74, P = 0.007), ↓ segment (ST) mm ≥ 1 (HR: 1.54, P = 0.039), and moderate-to-severe abnormal summed stress score (ms-SSS) (HR: 2.92, P = 0.001). In borderline-MIsch group (n = 208), the PM was previous myocardial infarction (HR: 3.8, P = 0.001), nitrates (HR: 2.13, P = 0.047), pharmacological stress (HR: 4.81, P < 0.001), and ↓ST mm ≥ 1 (HR: 3.07, P = 0.014). In MIsch group (n = 509), the PM model was ms-SSS (HR: 2.25, P = 0.001), diabetes (HR: 1.73, P = 0.011), angina (HR: 1.68, P = 0.029), beta-blockers (HR: 1.59, P = 0.026), and ms-MIsch (HR: 1.62, P = 0.044). In mild-MIsch group (n = 399), the PM was ms-SSS (HR: 2.55, P = 0.003), diabetes (HR: 2.17, P = 0.004), angina (HR: 1.89, P = 0.037), and beta-blockers (HR: 2.01, P = 0.011). In ms-MIsch group (n = 110), the predictive variable for MACE was ms-SSS (HR: 2.27, P = 0.016). The ms-SSS significantly increases the prognostic value of the ms-MIsch (P = 0.001). Women with different degrees of abnormal SDS have different PMs of MACE. The ms-SSS stands out as the most significant predictive variable.

Utilization of cervical cancer screening services among women aged 18 to 59 years in Laikipia East Sub-County, Kenya

INTRODUCTION Cervical cancer, a preventable disease, continues to be the leading cause of death resulting from cancers in Kenya. Despite free cervical cancer screening services in all government hospitals in Laikipia County, the screening uptake remains low at 19% compared to the WHO target of 70%. Hence, understanding the barriers and facilitators is important in informing targeted interventions. MATERIALS AND METHODS A mixed-method cross-sectional study was done in Laikipia East Sub-County, Kenya, between July and August 2022. The participants were women aged between 18 to 59 years. Data was collected on demographic factors and cervical cancer screening utilization. Also, qualitative data was collected using 5 FGDs and 6 KIIs to get more insights. Chi-square tests and odds ratios were calculated using STATA version 15 to assess associations and determine the level of significance. RESULTS Out of the 272 participants, 32.4% (n=88) had ever screened for cervical cancer. The logistic regression analysis indicates that as women age, their likelihood of undergoing screening increases, particularly for those aged 50-59, who show a tenfold higher likelihood of screening [ OR 10.40 (3.20-33.82), p-value &lt;0.001]. Conversely, unemployment is associated with a reduced likelihood of screening [OR 0.42 (0.18-0.99), p-value 0.047] while individuals earning 50-200 USD per month exhibit an increased likelihood [OR 2.25 (1.30-3.87) p-value 0.004]. However, religion, marital status, and education level factors do not show a significant association with the utilization of cervical cancer screening as indicated by p-values of 0.735, 0.069, and 0.765, respectively. CONCLUSION AND RECOMMENDATIONS Laikipia county government offers free cervical cancer screening in all government-run facilities but many, especially those aged 25-49, lack awareness. It is vital to boost awareness through community education on cervical cancer causes and prevention, emphasizing screening as preventive. Affordable treatment is also crucial for community reassurance post-diagnosis.

Molecular Diagnosis of Vaginal Microbiota Associated with Spontaneous Abortion in Women

Spontaneous abortion (SA) is a sever disease in which a women losses her foetus usually before 24 weeks of the pregnancy. About 10% -50% of pregnancy cases are run out with SA for reasons related with women's age and health. This condition occurrence may increases if the patient has a history of bacterial vaginosis. This study aimed at the characterization and isolation of vaginal microbiota generally and highlight on commensal bacteria becoming opportunistic when circumstances are favourable. From October to December 2022, about 100 samples were collected, 50 specimens from women with SA and 50 specimens from healthy pregnant outcomes (control). The high vaginal swabs samples were collected from Babylon Teaching Hospital for Maternity and Children and Imam Sadiq Teaching Hospital in Babylon, Iraq. To culture the samples, they were transported by media swab to laboratory. The culture of bacteria was done on 4 types of agar media: UTI chromogenic agar, MRS agar, MacConkey agar and blood agar. The first identification of bacteria was based on phenotypic traits of colonies, using manual biochemical tests and gram stain. Finally, the diagnosis was confirmed genetically by extracting bacterial genomic DNA for 20 of bacterial isolates under study and using PCR technique for 16S rRNA Loci gene and sequencing. The current study results showed difference in bacterial genera in women with SA compared with healthy women. It was also noted that embroilment of Enterococcus faecalis occurred in most cases of SA with an estimated percentage of 56% (28/50), thus defeating Escherichia coli by 32% (16/50) and 4% (2/50) for Klebsiella pneumonia and 4% (2/50) for Enterococcus gallinarum. In this study, some very rare bacteria species were identified including Acinetobacter junii at 2% (1/50) and Corynebacterium coyleae at 2% (1/50). While the percentage of bacteria associated with healthy women was: 30% (15/50) for E. faecalis, 26% (13/50) for E. coli, 18% (9/50) for K. pneumonia, 24% (12/50) for Staphylococcus epidermidis, and 2% (1/50) for Metabacillus niabensis (which was diagnosed for the first time in Iraq as well as the rest of the world in a clinical sample).

Predicting factors for social oocyte cryopreservation intention among unmarried Korean women

In 2023, the average age of Korean women for the first marriage and giving birth was reported to 31.45 and 33.6, respectively. Due to the late marriage, the number of patients undergoing infertility treatment per 100,000 in Korea increased by 16.9% over the past five years to 27.3. Recently, interest in social oocyte cryopreservation (SOC) has been growing in Korea as a strategy to address the low birth rate. This study is descriptive research to determine the influence of unmarried women's knowledge of fertility preservation, tendency toward late marriage, and awareness of fertility preservation on intention to SOC. This study aims to identify predictors of unmarried women's intention to SOC. Data were collected from July 20 to 26, 2024, through a online self-reported survey from unmarried women in their 20s to 40s. 234 copies were collected, but 211 copies were used for the analysis after excluding 23 insincere responses. The data were analyzed using descriptive statistical analysis and logistic regression analysis using the SPSS/PC 29.0 program. In this study, 41.7% of unmarried women intended to SOC, while 58.3% did not. In addition, the intention to SOC was higher when they wanted children (p=.041, exp(B)=2.35), were aware of SOC (p=.015, exp(B)=2.98), and had a high awareness of fertility preservation (p&lt;0.001, exp(B)=1.47). But the higher the tendency to marry late (p=.044, exp(B)=.92), the lower the intention to SOC. The findings can serve as foundational data to increase social awareness of SOC for unmarried women and to help develop supportive policies.

Pregnancy Outcomes in Grand Multiparity Women With Antiphospholipid Antibodies.

In recent years antiphospholipid syndrome (APS) as well as antiphospholipid antibodies (aPL) prevalence has demonstrated an upward trend in women during reproductive age. There is a lack of data concerning its effects on women with grand multiparity (GMP) (parity ≥5). Hence, this study aimed to assess pregnancy outcomes among GMP aPL/APS patients. We retrospectively assembled the births of GMP women with aPL/APS, between 2017 and 2022 in the Sheba Medical Center. We compared their deliveries with those of two control groups: (1) the "aPL/APS-controls"-of pregnant women with aPL/APS and parity <5. (2) The "GMP-controls"- parity ≥5 without aPL/APS. We examined demographics, aPL characteristics, pregnancy, and neonatal outcomes between the groups. In total, 42 deliveries in the study group were compared to 461 deliveries in the "aPL/APS-controls" group and 84 deliveries of the "GMP-controls." Most parameters were similar across groups. However, the study group had a higher rate of obstetric APS diagnosis (64.64%vs. 83.33%, p<0.01) and showed significant differences such as older maternal age, higher BMI, more polyhydramnios cases, and larger babies compared to controls (33.91vs. 36.19, p=0.05; 23.2vs. 28.89, p=0.02; 3.68vs. 11.9, p=0.01; and 2.17vs. 14.28, p<0.01, respectively). Our findings reveal that perinatal outcomes in aPL/APS GMP women are comparable and not inferior to those in aPL/APS women with <5 pregnancies or in comparison to the general GMP population. The minor differences observed may all be related to GMP women's older age and higher BMI.

Clinical validated risk prediction model for development of heart failure after contemporary breast cancer treatment

Abstract Background Patients receiving breast cancer (BC) treatment are at risk for heart failure and cardiomyopathy (HF/CM). European Society of Cardiology (ESC) cardio-oncology guidelines recommend baseline cardiovascular (CV) assessment, however, there is limited data about cardiotoxicity risk specific to patients with BC. Our aim was to develop and validate model for prediction of HF/CM in women receiving contemporary treatment for invasive early-stage BC. Methods We assembled a cohort women diagnosed with Stage I-III BC from 2008-2020 and followed through 2021 in a large health care plan. Women age &amp;gt;80, with history of HF/CM, and women who received both anthracyclines and trastuzumab were excluded, leaving N=26,044 for analysis. Study cohort was randomly split into derivation (60%) and validation (40%) datasets. Elastic-net penalized Cox proportional hazard model was created using the derivation dataset to select risk factors and to calculate the panelized coefficient which defined the HF/CM risk score. Risk score system was assessed by Hosmer-Lemeshow goodness-of-fit test and area under the ROC curve (AUC). Event rates of &amp;lt;5% constituted low risk; 5-14% moderate; and &amp;gt;15% high risk category. Incident HF/CM events were examined using Kaplan-Meier approach in derivation and validation datasets. Results HF/CM risk score had high discrimination ability and sufficiently good model of fit regarding HF/CM events (P value=0.163 and 0.667 from Hosmer–Lemeshow test;AUC 0.751 and 0.764, in derivation and validation sets, respectively). There were 10% of women in the high risk; 30% in moderate; and 60% in low-risk group. Variables associated with the higher HF/CM risk score included age, receipt of anthracycline-based chemotherapy or anti-HER2 therapy, presence of hypertension, diabetes, or history of other CV conditions at baseline. The score pattern showed major effect of age, with anthracycline and anti-HER2 therapy increasing the risk across all age groups (Figure 1). Kaplan-Meier analysis of incident HF/CM over 14 years after BC diagnosis showed significantly lower number of HF/CM events in low risk compared to moderate and high-risk score groups (p&amp;lt;0.0001, Figure 2). Conclusion Our robust risk prediction model for HF/CM among women with early-stage BC provides a new tool to identify women at higher CV risk and inform cardiac function monitoring during and after BC treatment. Our findings may guide further validation studies and build evidence for the cardiotoxicity risk stratification in patients with BC.Risk Score for HF/CM by Age/ChemoTxK-M curves of freedom from HF/CM

Influence of socio-economic factors on obstetric morbidity in Eastern India: A study based on NFHS 5

Abstract Background Obstetric morbidity encompasses health issues related to pregnancy or childbirth, excluding accidental causes. The whole process of childbearing is not just a biological phenomenon, rather it is governed by personal, social, cultural, and institutional factors. The entire eastern region of India including the four provinces of Bihar, Jharkhand, Odisha, and West Bengal is susceptible to high maternal mortality and morbidity. It presents a strong background to further envisage the factors responsible for such situation. Thus, the study aims to explore regional variations and socio-economic factors associated with obstetric morbidity among women in eastern India. Methods This study uses data from the 2019-2021 National Family and Health Survey (NFHS 5). The explanatory variable, obstetric morbidity, includes issues during pregnancy and delivery- vision difficulties, bleeding, swelling, convulsions, fever, breech presentation, and prolonged labor. Predictor variables include age, age at marriage and first birth, wealth index, residence, toilet facility, caste, working status, media exposure, religion, birth order, and education level. Bivariate and binary logistic regression analyses have been used as a methodological tool. Results In the eastern region, 53.76% women experience obstetric issues. Women belonging to 15-24 years with higher educational attainment increases the prevalence of obstetric morbidity. The probable reason is, with education, awareness about reproductive morbidity increases and in turn the reporting for morbidity increases. Therefore, the findings showed age, educational attainment, wealth quintile, media exposure, residence, work status, birth order and toilet facilities are highly associated with obstetric morbidity among women. Conclusions Implementing of targeted interventions, and awareness campaigns are crucial to reducing obstetric complications and maternal mortality in the eastern region of India Key messages • Socioeconomic correlates impact obstetric morbidity in eastern India in manifolds especially education, age, and wealth quintile of women in eastern India. • Obstetric morbidity is a growing concern in eastern India, thus implementing targeted interventions and awareness campaigns are much needed.

Comorbidities and risk of death in atrial fibrillation: a nationwide cohort study

Abstract Background Atrial fibrillation (AF) is associated with increased mortality, cardiovascular morbidity, and risk of stroke. With aging population, the number of AF patients is increasing, and they present with more comorbidities representing a major public health challenge. Purpose The influence of concomitant diseases on survival of patients with AF is not well established. Using data from a comprehensive nationwide cohort study, we studied the influence of several comorbidities on one-year mortality after the diagnosis of new-onset AF. Methods All patients with newly diagnosed AF in Finland 2007-17 were identified from nationwide registries. Individualized data on concomitant diseases were gathered from ICD-10 diagnoses during hospitalizations and outpatient visits in primary and specialist care and from drug reimbursements registries. Patients were followed until the end of 2018 from the causes of death registry, which records every death in the country. All-cause mortality associated with several comorbidities per 1000 person-years was determined, and relative risk (RR) of death was calculated. Results A total of 229,321 patients (mean age 73 ± 13.2 years, 50.0% male) with new-onset AF were identified. Mean age of men and women with new-onset AF was 69.4 ± 13.4 and 77.1 ± 11.8 years, respectively. During the one-year follow-up, 11.6% of men and 13.7% of women died. Heart failure, kidney disease and dementia were the strongest predictors of mortality and were associated with an over threefold risk of death within one year. Cancer, history of bleeding and vascular disease carried over twofold risk of death. In addition, hypertension, diabetes, alcohol abuse and history of stroke predicted mortality. The risk of death associated with these comorbidities is presented in Table. Conclusions Several comorbidities were associated with significantly increased risk of death within one year of the AF diagnosis. Heart failure, kidney disease and dementia were strongest predictors of subsequent mortality with over threefold risk. These data will inform the treatment decisions regarding AF patients with comorbidities.

Angina pectoris after coronary angiography or revascularization in pre- and postmenopausal women with coronary artery disease

Abstract Background Menopause is a known risk factor of coronary artery disease (CAD) in women. Earlier studies indicate that the incidence of angina pectoris (AP) increases with age. Some studies suggest that menopause would be a risk factor for AP in women with history of myocardial infarction (MI). However, the evidence is still incomplete. Purpose The aim of this study was to determine whether pre- or postmenopausal women are more symptomatic after revascularization using Canadian Cardiovascular Society (CCS) grading and New York Heart Association (NYHA) classification. We also wanted to evaluate whether the presence of type two diabetes (T2D) had an impact of the volume of the symptoms of CAD. Methods ARTEMIS Study contains 1,947 subjects with angiographically documented CAD with or without T2D (women 31.8%). Nondiabetic patients were matched with T2D patients for age, sex, prior MI and revascularization. Information of the menopause was from 610 women. Results Total of 584 women were at postmenopausal stage and only 26 were at premenopausal stage. The mean age of the premenopausal women was 57.5±10.8 years (P&amp;lt;0.001) and 69.4±7.5 years in postmenopausal women (P&amp;lt;0.001). Among premenopausal women 46.2% were active or ex-smokers and 26.8% of postmenopausal women still smoked or had smoked in the past (P=0.031). There was not statistically significant difference in other baseline characteristics: BMI, LDL or BNP levels, systolic or diastolic blood pressure, syntax score prior or after the revascularization and prevalence of prior MI. Over half of the postmenopausal women (57.4%, p&amp;lt;0.001) reported to suffer chest pain CCS grade ≥ 2 after the revascularization whereas only one fifth of the premenopausal women (23.1%, P&amp;lt;0.001) reported the same level of AP. T2D seemed to increase the symptoms of CAD as 33.3% of the premenopausal and 61.7% of the postmenopausal women with T2D reported AP with severity of CCS grade ≥ 2 (P=0.050). CCS 2 symptoms were reported by 45.7% of the postmenopausal and 19.2% of the premenopausal women, and CCS 3 symptoms by 11.6% of the postmenopausal women, yet only 3.8% of the premenopausal women (p=0.001 for both, respectively). Three quarter of the premenopausal women reported CCS 1 level of symptoms but only 42.6% of the postmenopausal women (P=0.003). Prevalence of each of CCS grade reported within pre- and postmenopausal women with and without T2D are shown in the Table 1. None of the premenopausal women reported NYHA ≥ 2 dyspnea, and the same level of shortness of breath was reported also only from 4.3 % of the postmenopausal women (p=0.005). Among postmenopausal women with T2D, NYHA ≥ 2 symptoms were more common, though statistical significance was not obtained (9.2%, P=0.196). Conclusion Postmenopausal women seem to experience more CAD-related symptoms after angiography or revascularization compared premenopausal women. Presence of T2D seems to associate with higher CCS grade after revascularization.

Long-term prognosis and predictors of death in chronic Chagas cardiomyopathy in women and men

Abstract Background Chronic Chagas cardiomyopathy (CCC) is one of the leading causes of heart failure (HF) in Latin America and carries high morbidity and mortality. Previous studies showed conflicting results in epidemiological and clinical evidence of a gender-associated risk of death in patients with HF due to CCC. Purpose This study analysed the long-term prognosis and the main predictors of death in women and men with HF due to CCC. Methods From March 2009 to January 2023, we followed a cohort of outpatients with HF due to CCC. Specific serological tests diagnosed Chagas disease. Baseline data included clinical characteristics and echocardiographic findings. Statistical analyses were performed using the Kaplan-Meier (K-M) method to analyse time-to-event data and Cox proportional hazards methods to search for predictors of death. Results We studied 739 patients, with a mean age of 57.0 ± 12.1 years, 387 (52%) male. Women had a higher mean age (58.4 ± 11.7 vs. 55.8 ± 12.3 years; p=0.001), had a higher mean baseline left ventricular ejection fraction (LVEF) (44.3±14.5 % vs. 37.0±14.5%; p&amp;lt;0.001) and a smaller left ventricular diastolic diameter (LVDD) (56.8±8.9 vs. 62.5±9.4 mm; p&amp;lt;0.001). Over a median follow-up period of 10 years, 213 (56%) men and 169 (44%) women died (K-M: log-rank p=0.043; Figure). Men received more beta-blocker therapy (52.4% vs. 47.6%; p=0.040) and had a higher prevalence of chronic kidney disease (CKD) (p=0.003) and stroke (p=0.007). HFpEF was more prevalent in women and HFrEF in men (p&amp;lt;0.001). Device implantation and transplant were similar between women and men. Cox regression analysis for death adjusted for age, sex, myocardial infarction, diabetes, CKD, stroke, atrial fibrillation (AF), and LVEF showed LVEF (HR= 0.98;95%CL:0.97-0.98), age (HR=1.03;95%CL1.02-1.04) and CKD (HR= 1.32;95%CL:1.10-1.64) as the main predictors of death. In men, the main predictors were age (HR=1.02;95%CL:1.01-1.04), CKD (HR=1.409;95%CL:1.07-1.86), and LVEF (HR=0.98;95%CL:0.97-0.99), and in women AF (HR=1.41;95%CL:1.03-1.91), age (HR=1.03;95%CL:1.01-1.04), and LVEF (HR=0.97;95%CL:0.96 -0.98). Conclusion women had a better prognosis than men, but gender was not an independent predictor of death. Prevention of comorbidities, especially CKD in men and AF in women, and higher beta-blocker therapy can significantly reduce the death rate in women and men with HF from CCC.

Associations between maternal health literacy and prenatal micronutrient intake in Hungarian women

Abstract Background Adequate level of health literacy (HL) is an important factor in pregnancy. Low HL may increase the risk of maternal and fetal complications (e.g., gestational diabetes mellitus, low birth weight). This study aimed to measure the levels of maternal HL and its associations with the consumption of folic acid (FoA), vitamin D (VD), and omega-3 fatty acids (FAs) during pregnancy in Hungarian women. Methods The questionnaire-based study was conducted at the Department of Obstetrics and Gynecology, University of Szeged among women who gave birth between June and September 2023 (N = 294). Sociodemographic, lifestyle, conception and pregnancy related questions were asked. HL was measured by the Maternal Health Literacy Inventory in Pregnancy (MHELIP) questionnaire (after the Hungarian adaptation); it contains 48 items representing four subscales (maternal health knowledge, search for maternal health information, assessment of maternal health information, and maternal health decision making and behavior). Data analysis was performed by SPSS 29.0. (Ethical permission: 5351) Results The mean age of women was 31.53 +-4.75 years. During pregnancy 84.5% of women consumed FoA, 61.8% VD and 41.8% omega-3 FAs. The total mean score of MHELIP on a scale 0-100 was 78.93 (95%CI: 77.77-80.08); the score of “search for maternal health information” subscale was the lowest [57.68 (95%CI: 56.20-59.16)], and the score of “maternal health decision making and behavior” was the highest [86.75 (95%CI: 85.62-87.87)]. Omega-3 FAs and VD consumption was significantly higher in women with higher total and subscales mean scores (except “search for maternal health information”), while FoA consumption was significant in case of “assessment of maternal health information”. (The results are preliminary.) Conclusions The association between micronutrient consumption and HL supports that using this tool during pregnancy the mothers who needs more support and health information can be identified. Key messages • The Maternal Health Literacy Inventory in Pregnancy questionnaire is a reliable tool for measuring health literacy in Hungarian pregnant women. • Maternal health literacy plays an important role in the healthier lifestyle, including prenatal vitamin/micronutrient consumption.

Comparison of clinical symptoms and prognosis of non-post-menopausal women to age matched men admitted with ST-elevation myocardial infarctions

Abstract Background Although ST-elevation-myocardial infarctions (STEMI) in women before menopause are relatively uncommon, previous studies have shown that women in general are more likely to present with atypical symptoms and to show higher adverse event rates, which might at least be attributable to the on average higher age of women during the index event. Aim of the present study was therefore to compare in an age-matched cohort of STEMI-patients younger 55 years the likelihood of atypical symptoms between genders and to investigate the impact of female gender on short and long-term-outcome. Methods Patients &amp;lt;55 years of age with STEMI admitted between 2006 and 2022 to a German heart center were included in the analysis and women were compared to men with regard to clinical symptoms and outcome. To exclude local bias women of all ages with STEMI from the registry were compared to men in a control group. Results Of 12094 STEMI-patients in the total cohort 3343 (28%) were women and 8751 (72%) were men. Women had a mean age of 69.7±13 yrs. compared to 62.2±12 in men. Women with STEMI had a 40% higher chance to present without typical chest pain (no CP, 12.0% vs. 8.5%, p&amp;lt;0.01) and were more likely to present with dyspnea (26.1% vs. 22.7% p&amp;lt;0.01). While rates of late STEMI-presenters were numerically higher in women, this difference failed to reach significance (12.8% vs. 11.9%, p=0.16). When focusing however on the study group (&amp;lt;55 yrs. of age) there was no more age difference (women 47.2±6 yrs. vs. 47.5±6 yrs. in men, p&amp;lt;0.3) and rates of no CP were not different between genders: 5.7%(women) vs. 5.4% (men), p=0.79, nor were rates of dyspnea : 20.0% (women) vs. 18.5% (men), p=0.45. There was even a trend towards lower rates of late STEMI-presenters in women: 8.3% vs. 10.9% in men, p=0.077, although diabetes-rates were higher in women (16.9% vs. 11.8%, p&amp;lt;0.01). Despite similar initial symptom presentations, women showed a marked 60% increase in 30-day- (6.9% vs. 4.3%, p=0.017) and 1-year-mortality (8.7% vs. 5.3%, p&amp;lt;0.01). The disadvantage for women remained, when adjusting mortality rates for confounders (age, diabetes, anterior STEMI, multivessel disease, PCI result) in a Cox regression model (table, upper part). This could be confirmed in a subgroup multivariate analysis excluding patients with no CP or not undergoing emergency PCI (table, lower part). Conclusions In STEMI-patients younger 55 years women showed a more than 60% higher short- and long-term-mortality compared to their male peers. This disadvantage, at least with our data, cannot be sufficiently explained by higher rates of delayed STEMI-presentations or absence of typical chest pain. Further studies are needed to identify possible causes for this higher vulnerability of young women to acute myocardial infarctions.Table:Mortality in Women vs. men&amp;lt;55 yrs

Physical Activity And Obesity With Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is an emerging endocrine condition that affects women of reproductive age all over the world. Physical activity (PA) is an evidence-based approach in the management of PCOS patients. Methods: This hospital-based case-control study was conducted to find out the association between physical activity and obesity with PCOS among the conveniently selected 172 women. Results: The mean age of PCOS women was 25.0±5.8 years and non-PCOS women was 28.1±7.5 years. The majority of cases (84.9%) were in the 15-30 age groups, in comparison to controls (64.0%). There was a significant association between age and PCOS (p&lt;0.05). The chance of developing of PCOS was 3.1 times higher in the younger age group. More than half of cases (65.5%) had no child, in comparison to controls (72.4%) had a child. There was a significant association between the number of children and PCOS (p&lt;0.05). The chance of infertility among PCOS women was 2.01 times higher than among non-PCOS women. About one-third of the cases (39.5%) had a normal BMI and 37.2% were overweight. In contrary among controls, about half (59.3%) had a normal BMI, and one-fourth (25.6%) were overweight. The association between BMI and PCOS was statistically significant (p&lt;0.05). The chance of developing of PCOS was 3.38 times higher in overweight women. The mean total sitting time/week in PCOS women (3179.76±1511.46) was higher than in non-PCOS women (2647.67±1687.74). There was a statistically significant association between total sitting time and PCOS in women (p&lt;0.05). Conclusion: There was a significant association between PCOS and BMI, indicating that overweight women are at greater risk to develop PCOS. However, no association was found between physical activity and PCOS, whereas PCOS patients sitting longer per week. J Dhaka Med Coll. 2023; 32(1) : 16-24

Effects of eHealth literacy on maternal and neonatal outcomes

ABSTRACT eHealth literacy plays a crucial role during pregnancy, as maternal health behavior can influence health outcomes for both mother and child. This study assessed the impact of eHealth literacy on maternal-fetal health outcomes through a cross-sectional analysis of 1,265 pregnant women admitted to a tertiary maternity hospital in Turkey between April and July 2022. Data on sociodemographic information, obstetric variables, birth outcomes, Internet usage, and eHealth Literacy Scale (eHEALS) were collected. Kolmogorov-Smirnov, Mann – Whitney U, Kruskal-Wallis, and Spearman correlation were used for data analysis. The median age of women was 28 years, and the mean gestational age was 38.6 weeks. Median eHealth literacy score was 21 (range:8-40). Pregnant women who had planned pregnancies, received spousal support, attended 9–12 antenatal care visits, received vaccinations, adhered to iron and folic acid supplementation, engaged in regular physical activity, and maintained regular sleep patterns exhibited higher eHealth scores (all p < .001). eHEALS scores were higher in women who experienced normal vaginal deliveries (p < .001), while lower eHEALS scores were noted in those with comorbidities (p = .001). The study suggested that higher eHealth literacy among pregnant women was associated with improved health-promoting behaviors, more favorable health perceptions, increased utilization of health services, and better maternal and fetal outcomes.