Risk In Women Research Articles

Assessing the Link between Vitamin D Levels and Miscarriage Risk in Women

Background: The issue of miscarriage, sometimes known as missed abortion, is a contemporary concern in the field of obstetrics and gynecology. This condition is characterized by a cluster of clinical symptoms, one of which is the inability of the embryo to survive. Through the process of its metabolism of 1.25(OH) vitamin D, vitamin D has a significant role in promoting the reproductive health of women. Aim of the Study: This study aims to investigate the correlation between Vitamin D deficiency and idiopathic miscarriage in women. Materials and Methods: There were 180 miscarriage survivors who took part in this study.; and only forty-three women with idiopathic miscarriage included in this study. They were attended to private clinics in Karbala Province from the period of May-August/ 2024, and their ages range between (17- 43) years. The confident diagnosis was confirmed according to examination by gynaecologists. Results: The female patients with miscarriage were evaluated to exclude all other potential reasons of miscarriage, including age, body mass index, hypertension, endometrial abnormalities, and smoking. Out of 180 women who experienced miscarriage, only 43 were included in the current study. The study assessed infectious agents and other autoimmune disorders in all participating women to eliminate those with Toxoplasma gondii, Rubella, Chlamydia, Herpes (TORCH), and autoimmune diseases. The findings revealed that only 43 women experienced idiopathic miscarriage, and no women exhibited a significant correlation or positive outcomes for any of the aforementioned characteristics. The study revealed a strong association between the trimester of pregnancy and miscarriage among the patients, indicating notable fetal losses In the first and second trimesters, a substantial association was identified; however, no such relationship was evident in the third trimester. The findings indicated that Vitamin D insufficiency was substantially correlated with miscarriage in all women experiencing miscarriage in the research. In conclusion: The role of Vitamin D deficiency significantly affected the losses of pregnancy in women with idiopathic miscarriage.

Evaluation of Pregnancy Risks in Women with Subchorionic Hematoma Using Machine Learning Models

Evaluation of Pregnancy Risks in Women with Subchorionic Hematoma Using Machine Learning Models

Syphilis in pregnant women and congenital syphilis from 2012 to 2021 in Switzerland: a multicentre, retrospective study.

Congenital syphilis is a rare complication of syphilis in pregnant women. Vertical transmission may occur at any time during pregnancy. The incidence of congenital syphilis has been increasing worldwide. Congenital syphilis has been a notifiable disease for many years in Switzerland but reporting does not include maternal features associated with syphilis in pregnancy or infant's subsequent development. We described syphilis cases among pregnant women screened over a 10-year period in Switzerland and subsequent cases of congenital syphilis, in order to identify maternal risk profiles and to optimise prevention. Second, we compared the characteristics of pregnant women screened early (1st trimester) vs late in pregnancy (2nd or 3rd trimester). Finally, we assessed the risk factors for premature birth among these women with syphilis. A multicentre retrospective study conducted in Swiss hospitals from 2012 to 2021, including pregnant women who screened positive for syphilis (Treponema pallidumhaemagglutination assay [TPHA] /T. pallidumparticle agglutination assay [TPPA ] ≥1:80) and newborns exposed toT. pallidumin utero and/or congenitally infected and with a positive syphilis serology at birth. Data were collected from medical records. A total of 147 syphilis-positive pregnant women and 102 infants were included. A history of treated syphilis was known for 44% (65/147) of the mothers corresponding to a serological scar and the remaining 56% (82/147) were newly identified syphilis cases. Syphilis screening was done during the first trimester in 54%, second trimester in 29% and third trimester in 13% of cases. Two babies were diagnosed with congenital syphilis (1.96%). Several potential factors that could contribute to women's risk of syphilis during pregnancy were identified such as a foreign origin (93% of mothers), lack of healthcare insurance (25%), no employment status (37%), drug use (5%), co-infection with other sexually transmitted infections (24%) and a late first antenatal consultation (42%). The number of pregnant women without insurance was higher in women diagnosed in the second or third trimester than in those diagnosed in the first trimester (odds ratio 0.41; 95% CI 0.19-0.89; p = 0.024). Syphilis diagnosed in the second or third trimester was associated with a late first antenatal consultation (odds ratio 77.82; 95% CI 9.81-617.21; p <0.001). A high rate of intrauterine growth retardation and of preterm birth was observed in newborns (18% versus 6% in Switzerland in 2022). Congenital syphilis remains rare in Switzerland. However, we found potential maternal factors associated with a positive syphilis serology during pregnancy, which can help to improve future prevention measures. The study protocol was registered on ClinicalTrials.gov (ID NCT05975502).

Willingness of Women at Increased Risk of Breast Cancer to Participate in Prevention Trials.

The factors affecting women's willingness to participate (WTP) in breast cancer (BC) prevention trials are poorly understood. This study aimed to identify the characteristics of interventions associated with a higher WTP among high BC risk women. Women who self-identified as being at an increased risk of BC were recruited to a cross-sectional study of WTP in BC prevention trials. Responses were dichotomized into more willing (a lot and moderately) and less willing (some, a little, and not at all), and responses were compared by patient characteristics and intervention type. Of 143 participants, 81.2% (116) completed ≥30% of a Likert-type scale questionnaire on WTP in various intervention types for BC prevention. Overall, WTP in BC prevention studies was high, with 82.7% more willing, including 69.0% and 70.7%, respectively, for unspecified physical activity and dietary interventions. WTP differed significantly by the duration of diet-based and physical activity behavior change interventions: decreasing with 12- versus 3-month diet-based interventions (P < .0001) and decreasing for 1 hour versus 30 minutes of low-intensity exercise/day (P < .0001). For interventions involving medication, only 18.1% expressed being more willing to participate, and WTP decreased significantly when side effects were presented. WTP was influenced by BC risk gene mutation status, with WTP among gene carriers higher compared with nongene carriers (52.6% v 30.2%, P = .018). WTP in BC prevention trials was the highest for women with known genetic risk and for interventions involving a behavior change. Medications with side effects had the lowest WTP. For behavior change, WTP was negatively influenced by intervention duration beyond a few months, indicating that individual perception of BC risk and inconvenience strongly influence WTP.

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

High SHBG and Low Bioavailable Testosterone are Strongly Causally Associated with Increased Forearm Fracture Risk in Women: An MR Study Leveraging Novel Female-Specific Data

The effects of androgens on women’s bone health are not fully understood. Mendelian randomization (MR) studies using sex-combined data suggest that sex hormone-binding globulin (SHBG) and bioavailable testosterone (BioT) causally affect bone traits. Given significant sex differences in hormone regulation and effects, female-specific MR studies are necessary. In the current study, we explored the causal relationships of SHBG, BioT, and total testosterone (TT) with forearm fracture (FAFx) risk in women using two-sample MR analyses. We utilized a unique female-specific FAFx outcome dataset from three European biobanks (UFO, HUNT, Estonian Biobank) comprising 111,351 women and 8823 FAFx cases, along with female-specific genetic instruments of SHBG, BioT, and TT identified in the UK Biobank. We also assessed bone mineral density (BMD) at the forearm (FA), femoral neck (FN), and lumbar spine (LS) using female-specific GWAS data from the GEFOS consortium. High SHBG (odds ratio per standard deviation increase (OR/SD): 1.53, 95% confidence intervals (CIs): 1.34–1.75), low BioT (OR/SD: 0.77, 0.71–0.84) and low TT (OR/SD 0.90, 0.83–0.98) were causally associated with increased FAFx risk. BioT was positively, and SHBG inversely, causally associated with especially FA-BMD, but also LS-BMD and FN-BMD, while TT was only significantly positively associated with FA-BMD and LS-BMD. We propose that endogenous androgens and SHBG are important for women’s bone health at distal trabecular-rich bone sites such as the distal forearm and may serve as predictors for FAFx risk.

New Insights into the Assessment of Peri-Operative Risk in Women Undergoing Surgery for Gynecological Neoplasms: A Call for a New Tool

Existing tools for predicting postoperative complications in women undergoing surgery for gynecological neoplasms are evaluated in this narrative review. Although surgery is a very efficient therapy for gynecological tumors, it is not devoid of the possibility of negative postoperative outcomes. Widely used tools at present, such as the Surgical Apgar Score and the Modified Frailty Index, fail to consider the complex characteristics of gynecological malignancies and their related risk factors. A thorough search of the PubMed database was conducted for our review, specifically targeting studies that investigate several aspects impacting postoperative outcomes, including nutritional status, obesity, albumin levels, sodium levels, fluid management, and psychological well-being. Research has shown that both malnutrition and obesity have a substantial impact on postoperative mortality and morbidity. Diminished sodium and albumin levels together with compromised psychological well-being can serve as reliable indicators of negative consequences. The role of appropriate fluid management in enhancing patient recovery was also investigated. The evidence indicates that although current mechanisms are useful, they have limitations in terms of their range and do not thoroughly address these recently identified risk factors. Therefore, there is a need for a new, more comprehensive tool that combines these developing elements to more accurately forecast postoperative problems and enhance patient results in gynecological oncology. This paper highlights the need to create such a tool to improve clinical practice and the treatment of patients.

The women's cardiovascular disease risk perception after hypertensive disorders of pregnancy: A qualitative meta-synthesis

BackgroundHypertensive disorders of pregnancy is associated with increased risk of cardiovascular disease later in life, but studies suggest that women with previous hypertensive disorders of pregnancy are not aware of this. Little is known about how these women perceive the condition and the associated long-term risks. ObjectivesThis study aims to examine and synthesize qualitative evidence on the perceptions and awareness of women with hypertensive disorders of pregnancy following perceived cardiovascular disease risk. MethodsComputer searches of Pub Med, Embase, Web of Science, Cochrane Library, CINAHL, CNKI, Wanfang database, Vip and SinoMed for all qualitative studies that met the inclusion criteria. The time frame for the search was from the establishment of the database to April 2024. Literature quality was assessed using the Australian Joanna Briggs Institute Centre for Evidence-Based Health Care Qualitative Research quality assessment criteria, and results were summarised and integrated using a pooled integration approach. ResultsEleven studies that fulfilled the inclusion criteria and quality assessment were included in the meta synthesis. Three themes were identified during the analysis: (1)Factors affecting perceived cardiovascular risk in women with hypertensive disorders of pregnancy; (2)Women with hypertensive disorders of pregnancy use different strategies to cope with cardiovascular risk; (3)Needs and expectations for coping with cardiovascular disease risk. ConclusionsBoth women with hypertensive disorders of pregnancy and healthcare providers lack knowledge of the link between hypertensive disorders of pregnancy and cardiovascular risk. Healthcare professionals should establish a multidimensional support model, pay timely attention to postpartum women's psycho-emotional and risk awareness, and give individualised health education to promote health behaviour change. At the same time, professionals should be given standardised training and personalised follow-up services to reduce the incidence of cardiovascular disease in the future.

The Cardiometabolic Risk in Women with Polycystic Ovarian Syndrome (PCOS): From Pathophysiology to Diagnosis and Treatment.

Polycystic Ovarian Syndrome (PCOS) is a prevalent endocrine disorder affecting women of reproductive age, with significant variations in presentation characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. Beyond reproductive health, it may also pose crucial long-term cardiometabolic risks, especially for women with specific types of PCOS, contributing to early subclinical cardiovascular atherosclerotic alterations such as endothelial dysfunction, increased arterial stiffness, and coronary artery calcium levels, respectively. Moreover, the precise relationship between clinical cardiovascular disease (CVD) and PCOS remains debated, with studies demonstrating an elevated risk while others report no significant association. This review investigates the pathophysiology of PCOS, focusing on insulin resistance and its link to subclinical and clinical cardiovascular disease. Diagnostic challenges and novel management strategies, including lifestyle interventions, medications like metformin and glucagon-like peptide-1 receptor agonists (GLP-1RAs), hormonal contraceptives, and bariatric surgery, are further discussed. Recognizing the cardiometabolic risks associated with PCOS, a comprehensive approach and early intervention should address both the reproductive and cardiometabolic dimensions of the syndrome.

Are women's breast cancer risk appraisals in line with updated clinical risk estimates communicated? Results from a UK Family History Risk and Prevention Clinic.

The incorporation of breast density and a polygenic risk score (PRS) into breast cancer risk prediction models can alter previously communicated risk estimates. Previous research finds that risk communication does not usually change personal risk appraisals. This study aimed to examine how women from the Family History Risk (FH-Risk) study appraise their breast cancer risk following communication of an updated risk estimate. In the FH-Risk study 323 women attended a consultation to receive an updated breast cancer risk estimate. A subset (n=190) completed a questionnaire, assessing their subjective breast cancer risk appraisals, satisfaction with the information provided and cancer related worry. One hundred and three were notified of a decrease risk, 34 an increase and 53 an unchanged risk. Women's subjective risk appraisals were in line with the updated risk estimates provided, with age, a PRS and breast density explaining most of the variance in these appraisals. Those notified of an increased risk demonstrated higher subjective risk perceptions compared to those whose risk remained unchanged or decreased. Women's subjective breast cancer risk appraisals are amenable to change following updated risk feedback, with new information breast density and a PRS accepted and integrated into existing risk appraisals. Trust in the service, the analogies and visual communication strategies used may have positively influenced the integration of this new information. Further research is warranted to assess whether similar patterns emerge for other illnesses and in different clinical contexts to determine the best strategies for communicating updated risk estimates.

Changes in Chlamydia trachomatis risk before and after union formation and separation among women of reproductive age.

Not having an established relationship is associated with an elevated risk of Chlamydia trachomatis (CT) infection, but this might reflect selection into and out of unions. Although union formation and union separation are common events in reproductive age, little is known about changes in CT risk before and after these transitions. We linked Finnish Population Register data to the National Register of Infectious Diseases and used fixed-effects linear probability models that account for all time-invariant confounders to examine changes in women's 6-month CT risk 3 years before and 3 years after entry into first cohabitation (n = 293554), non-marital separation (n = 201647) or marital separation (n = 92232) during 2005-14. From 3 years to 1 year before first union formation, the 6-month risk of CT increased slightly, peaking at 1.27% immediately prior to union formation (95% confidence interval 1.22-1.31). It declined sharply following union formation, being only 0.40% (0.34-0.46) 6-12 months after union formation with little changes thereafter. Among women separating from non-marital unions, the risk increased from 0.50% (0.42-0.57) to 1.45% (1.40-1.49) around the time of separation and decreased following separation. The pattern of findings was relatively similar for marital separation, although the observed risks and changes were smaller in magnitude. Our results based on longitudinal data and individual fixed-effects models indicate that the period immediately after separation may be causally associated with an elevated risk of CT. This suggests that recently separated women should be identified as a high-risk group for CT.

Racialized Gender Stress and Mental Health Among Black Women: a Test of the Vance-wade Intersectional Suicide Risk Model with Longitudinal Data.

The recent shift in Black women's suicide risk calls for a new paradigm focused on unique factors specific to Black womanhood. The Vance-Wade Intersectional Suicide Risk Model (VWISRM) was introduced to contextualize this unexpected spike. According to the VWISRM, for Black women, psychosocial risk factors, gendered racism, and the Strong Black Woman script (SBW) lead to racialized gender stress (RGS) which results in mental health outcomes which are established predictors of suicide-related behaviors. The National Longitudinal Study of Adolescent Health (Add Health) was used to test for empirical evidence supporting the VWISRM. Our sample consisted of 418 Black female adolescent respondents who fully participated in data collection during Waves 1, 3, and 4. We ran bivariate analyses to examine both (1) what psychosocial factors of Black women are associated with SBW traits, gendered racism, and racialized gendered stress and (2) what mental health outcomes are predicted by SBW traits, gendered racism, and racialized gendered stress. Our analysis showed having both lower scores on the SBW traits and experiencing gendered racism are associated with a PTSD diagnosis. Specifically, the analysis explained 30% of the variation in PTSD diagnoses among Black women. Having both lower scores on the SBW traits predicted anxiety, PTSD, and contemplating suicide, and having experienced RGS linked to depression anxiety and contemplating suicide. Importantly, there were no moderating effects among SBW traits and RGS on PTSD, anxiety, or suicidality. Findings highlight important research and clinical implications for Black women's mental health. The Gendered Racism Intersectional Trauma model (GRIT) is introduced to better understand the breadth of mental health outcomes for Black women. Notably, our findings make a new contribution to the scientific inquiry of PTSD in Black women.

Parity and post-reproductive mortality among U.S. Black and White women: Evidence from the health and retirement study.

Population health research finds women's mortality risk associated with childlessness, low parity (one child), and high parity (6+ children) in a U-shaped pattern, although U.S. studies are inconsistent overall and by race/ethnicity. Parity, however, is contingent on women's biophysiological likelihood of (in)fecundity as well as voluntary control practices that limit fertility. No studies have empirically examined infecundity differentials among women and their potential contribution to the parity-post-reproductive mortality relationship or the race/ethnic-related mortality gap. We examine 7,322 non-Hispanic Black and White women, born 1920-1941, in the Health and Retirement Study, using zero-inflation methods to estimate infecundity risk and parity by race/ethnicity. We estimate proportional hazards models [t0 1992/1998, t1 2018] to examine associations of infecundity risk, parity, early-life-course health and social statuses, and post-reproductive statuses with all-cause mortality. We find Black women's infecundity probability to be twice that of White women and their expected parity 40% higher. Infecundity risk increases mortality risk for all women, but parity-post-reproductive mortality associations differ by race/ethnicity. White women with one and 5+ children (U-shaped curve) have increased mortality risk, adjusting for infecundity risk and early-life factors; further adjustment for post-reproductive health and social status attenuates all parity-related mortality risk. Black women's parity-post-reproductive mortality associations are not statistically significant. Black women's post-reproductive mortality risk is anchored in earlier-life conditions that elevate infecundity risk. Results suggest a need to focus upstream to better elucidate race/ethnic-related social determinants of reproductive health, infecundity, parity, and mortality.

Unplanned births and their effects on maternal Health: Findings from the Constances Cohort

Unplanned births remain relatively common, even in regions with high contraceptive prevalence and accessible abortion services, such as contemporary France. Previous studies have shown that unplanned births can have numerous negative consequences for the well-being of mothers and children, including poorer maternal health behaviors, delayed and insufficient prenatal care, and depression during or immediately after pregnancy. However, these studies do not provide conclusive evidence on whether the observed outcomes are a consequence of unplanned births or of the conditions in which they likely occur. Furthermore, scant attention has been given to other dimensions of maternal well-being, such as physical health.This study uses longitudinal data from the French Constances Cohort and applies fixed-effects event study models to examine how women's self-rated general health and risk of depressive symptoms are affected in the years following an unplanned birth. Results show that women who had an unplanned birth reported a sudden, significant drop in their general health in the year following the birth, particularly among the youngest, while health outcomes following planned births showed a gradual, slight decrease over the time-period considered. The risk of depressive symptoms increased similarly after birth for both unplanned and planned births. This study contributes to the literature by using a longitudinally constructed measure of unplanned births based on pre-birth fertility intentions, rather than commonly used retrospective measures prone to ex post rationalization. It also distinguishes between unwanted and mistimed births while further examining their consequences on medium-term maternal health.

Endometriosis as a risk factor for ovarian cancer: an update on screening, risk reduction, treatment and prognosis

Key content: Endometriosis affects up to 10% of women. While many regard endometriosis as a benign (non‐cancerous) disease, there are well‐established links to epithelial ovarian cancer (EOC). Proposed mechanisms for malignant transformation include chronic inflammation, hyperestrogenism and oxidative stress. Mutations in the tumour suppressor gene ARID1A have also been implicated in the development of endometriosis‐associated ovarian cancer (EAOC). Endometriosis is reported to almost double a woman's background risk of ovarian cancer. Risk reduction strategies are effective in reducing the incidence of EAOC. These include tubal ligation, excision of endometriosis and combined hormonal contraception. Novel therapies targeting tumour suppressor gene mutations present in EAOC are undergoing phase I &amp; II clinical trials. Learning objectives: To increase knowledge of the association between endometriosis and EOC. To understand the updated evidence for screening, risk and risk reduction strategies. To be informed of potential novel therapies currently in the clinical trial stage of development. Ethical issues: Increased public awareness and improved clinician knowledge may lead to more and earlier‐stage disease detection. Women are more informed, necessitating clinicians to deliver evidence‐based counselling to meet their informational needs.

Opinion of Women on Possession of Land and Risk Handling Capacity

Abstract: This study shows that and ownership affects women's risk management abilities. This study was conducted in the two upazilas (Sub-districts) namely Delduar, and Nagorpur of Tangail district in Bangladesh. In this study, data were collected during the period of February 2024 to March 2024 from the studies areas. We found a favorable correlation between women's land ownership and risk management. Larger landholding women were more confident and competent in managing financial, environmental, and social hazards. This higher risk handling capability is due to land assets' financial stability, the ability to invest in risk-reducing technology or practices, and community bargaining power. This study shows that property ownership gives women a greater buffer against economic uncertainty and allows them to take proactive risk mitigation strategies. Data also shows that landowner women are more likely to have diverse income sources, minimizing their market susceptibility. They also use support networks and community risk management efforts more. The study concludes that land ownership improves women's risk management. Women acquire economic stability and risk management leverage by obtaining land holdings. This shows that land access regulations might boost women's resilience and risk management. Future study should examine how land ownership affects risk management and how to give disadvantaged women land access.

Effect of Comprehensive Educational Program on Preeclamptic Women's Risk Perception of Cardiovascular Disease, Self-Efficacy, and Adherence to Healthy Lifestyle Behaviors.

To evaluate the effect of a comprehensive educational program on preeclamptic women's knowledge, risk perception of cardiovascular disease, self-efficacy, and adherence to healthy lifestyle behaviors. This study employed a pretest-posttest design. One hundred and two women who previously had preeclampsia were enrolled from July 2022 to December 2022 from outpatient obstetrics, gynecology, and family planning clinics. The primary and secondary outcomes were measured at baseline, after eight weeks, and after three months of the educational intervention. The data were analyzed using SPSS version 23, descriptive and inferential statistics, specifically the Chi-square test, independent t-tests, and repeated measures ANOVA. A statistically significant difference was found between the two groups immediately post-intervention and the three-month follow-up, with a significant improvement among the intervention group than control group regarding cardiovascular disease knowledge (p < 0.001), risk perception (p < 0.001), self-efficacy (p < 0.001), and healthy lifestyle behaviors (p < 0.001). There was a statistically significant interaction between group and time regarding total cardiovascular disease risk perception (F = 203.67, p < 0.001, η2 = 0.673), self-efficacy (F = 70.06, p < 0.001, η2 = 0.405), and adherence to healthy lifestyle behaviors (F = 145.08, p < 0.001, η2 = 0.597). This study concluded that the comprehensive educational program had a positive effect on improving preeclamptic women's knowledge and risk perception of CVD, self-efficacy, and adherence to healthy lifestyle behaviors following preeclampsia.

Balancing risk and reward: exploring women’s transactional sexual relationships with Blessers in South Africa

Transactional sexual relationships (TSRs) take varied forms, with research emphasizing TSRs’ inherent risks, primarily to women. In South Africa, Blessed relationships have emerged as a prominent type of TSR. Blessers have become coveted male partners due to their relative wealth and willingness to ‘bless’ female partners with financial and material gifts, as well as the improved social status that accompanies such partnerships. Given the limited literature on Blesser partnerships, we investigated women’s implicit and explicit negotiated rewards and their perceived risk and ability to employ risk mitigation strategies, utilizing risk as a sociological concept to enhance understanding of risks women assume, and subsequent gendered implications. This qualitative study was conducted in 2017-2018 in KwaZulu-Natal (KZN) province, South Africa, a high HIV prevalence setting, with 22 women, using purposive and snowball sampling methods. We found that women in relationships with a Blesser recognize and navigate a number of risks, including: the threat of HIV acquisition, falling pregnant, experiencing an emotional void following a TSR, and expressed feelings of guilt and shame, as segments of South African society remain judgmental of TSRs. These risks are then weighed against the pursuit of sustained financial and social rewards achieved through such relationships.

Implementation of A Fuzzy Logic for Early Detecting of A Pregnant Women Risk of Hypertension

Hypertension is one of the diseases that can cause fatal effects to health, especially for pregnant women. Hypertension during pregnancy can cause serious effects such as pre-eclampsia and eclampsia which can threaten the lives of pregnant women and fetuses. The purpose of this study is to determine the input and output variables related to hypertension during pregnancy and used for analysis using Tsukamoto FIS to determine risk factors for hypertension in pregnant women. This study uses input variables in the form of maternal age, systolic blood pressure (SBP), diastolic blood pressure (DBP), history of hypertension and genetic. Furthermore, it is analyzed using fuzzy logic through the process of fuzzyfication, inference engine and defuzzyfication. The examination of data samples of pregnant women with systolic and diastolic blood pressure categories included in the high category or potentially have hypertension. The Z value (defuzzyfication) shows that the output is in the category of severe hypertension so that the patient needs immediate treatment by medical personnel. The results showed that the risk of a mother having hypertension can be obtained through Tsukamoto FIS in the form of concrete values that can describe risk factors in the form of normal, hypertension and severe hypertension as well as recommended actions related to these risk factors.

Development, validation and reliability of scales and items for heat wave risk assessment of pregnant women.

The 1.2°C rise of global ambient temperature since the pre-industrial era has led to an increase the intensity and frequency of heatwaves. Given the heightened vulnerability of pregnant women to heat stress, there is an urgent need for tools which accurately assess the knowledge, risk, and perception of pregnant woman toward heatwaves, enabling effective policy actions. In this research, we developed and validated tools to evaluate pregnant women's perceptions of heat wave risks and behaviors. We developed 50 items across seven constructs using the Health Belief Model, identified through a systematic literature review. The constructs comprised 8 Knowledge(K) items, 4 in Perceived Vulnerability (PV), 5 in Perceived Severity (PS), 6 in Perceived Benefit (PB), 4 in Perceived Barrier (PBa), 5 in Cue to Action(Cu) and 18 in Adaptation(A). Cognitive testing was performed with a separate group of pregnant women(n = 20). The tested tools were then administered to 120 pregnant women residing during the spring-summer 2023. Construct validation utilized exploratory factor analysis. The Principal Axis Factoring Method was employed in the EFA with oblimin rotation for 51 items, considering communality > 0.20, and aiming to extract three factors. Across the three factors with Cronbach's alpha > 0.70, a total of 11 items were distributed. Factor 1 included Perceived Severity (PS1, PS2, PS3 and PS5); Factor 2 included Cue to Action (Cu1, Cu2, Cu3, and Cu4); and Factor 3 encompassed Perceived Vulnerability (PV1, PV2, PV4). Only two of the retained items had factor loadings > 0.50, namely PV4 and PS5. Consequently, the three constructs measuring Perceived Severity, Cues to Action, and Perceived Vulnerability using the HBM among pregnant women were deemed valid. Our study has successfully validated a highly reliable tool which stands ready for application in assessing pregnant women's risk perception regarding heatwaves.