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Women's Health throughout Life Stages

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: closed (30 November 2020) | Viewed by 41563

Special Issue Editors


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Guest Editor
School of Public Health, Nanjing Medical University, Nanjing 210029, China
Interests: reproductive health; risk factors in early life; birth cohort; molecular epidemiology
1. Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
2. Department of Epidemiology & Biostatistics, University of California, San Francisco, CA 94158, USA
Interests: developmental origins of cardiometabolic impairments; reproductive and perinatal epidemiology; real-world clinical epidemiology; omics; machine learning

Special Issue Information

Dear Colleagues,

We are organizing a Special Issue on "Women's Health Throughout Life Stages" in the International Journal of Environmental Research and Public Health (IF 2.468), a peer-reviewed journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, please refer to https://www.mdpi.com/journal/ijerph.

Substantial progress has been made in the past two decades in improving women’s health, with a substantial reduction in maternal mortality. There has also been substantial increase in the utilization of healthcare and family planning among women in some countries. However, societies, especially in limited resource settings, are still facing the heavy burden of women’s morbidity. For instance, the prevalence of gestational diabetes mellitus, one of the most common pregnancy complications, has increased by more than 30% within one or two decades in a number of countries including developing countries, forming an emerging worldwide epidemic. Additionally, social, economic, and/or environmental disadvantages continue to contribute to sex disparities in women’s health.

For many diseases, women’s physiology and life-cycle hormonal changes demand important consideration when determining healthcare management options. At the same time, there are certain conditions that are more prevalent or differ in pathophysiology, symptoms and outcomes in women compared with men, and these may require special attention. Therefore, it is critical to consider both biological differences and sociocultural influences unique to women when tackling health issues and providing clinical care for women’s health conditions, including those that may be influenced by reproductive history. Moreover, interventions are needed to reduce sex inequities in healthcare access and improve quality of care.

This Special Issue seeks research papers on various aspects of women’s health such as physical and mental health issues, and healthcare access and utility throughout the lifespan in different communities and countries. In particular, we encourage submissions of interdisciplinary work and multi-country collaborative research. We welcome original research papers of different study designs as well as systematic reviews and meta-analysis. The listed keywords suggest just a few of the many possibilities.

Prof. Dr. Yuan Lin
Prof. Dr. Yeyi Zhu
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Maternal mortality and morbidities throughout the lifespan
  • Women's healthcare access and utility
  • Nutritional exposures
  • Environmental exposures (including endocrine disruptors)
  • Obstetric and gynecologic diseases
  • Fertility and contraception
  • Infertility
  • Women’s mental health and health promotion
  • Health disparities of women

Published Papers (11 papers)

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Research

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10 pages, 338 KiB  
Article
Maternal Prenatal Hair Cortisol Is Associated with Child Wheeze among Mothers and Infants with Tobacco Smoke Exposure and Who Face High Socioeconomic Adversity
by Ashley Scherman, Eliot R. Spindel, Byung Park, Robert Tepper, David W. Erikson, Cynthia Morris and Cindy T. McEvoy
Int. J. Environ. Res. Public Health 2021, 18(5), 2764; https://doi.org/10.3390/ijerph18052764 - 9 Mar 2021
Cited by 3 | Viewed by 2452
Abstract
The association of co-occurring prenatal stress and tobacco exposures on childhood wheezing and asthma are not well established. In this study, we compared maternal prenatal hair cortisol concentration (HCC) to the maternal report of infant wheezing (y/n) in the first year of life [...] Read more.
The association of co-occurring prenatal stress and tobacco exposures on childhood wheezing and asthma are not well established. In this study, we compared maternal prenatal hair cortisol concentration (HCC) to the maternal report of infant wheezing (y/n) in the first year of life among mother–infant dyads exposed to tobacco smoke and socioeconomic adversity. Data were obtained from the Vitamin C to Decrease Effects of Smoking in Pregnancy on Infant Lung Function study. Maternal adversity was defined by the level of education, household income, and health insurance provider. Hair was collected at delivery, representing average circulating third-trimester cortisol levels. HCC was log transformed and dichotomized into high/low cortisol groups that were placed into a multivariate model predicting wheeze. Subjects (n = 132) were primarily White with ≤high school education and receiving government-provided health insurance. Forty-five percent of infants wheezed. Average HCC was 3.39 pg/mg hair. Women with HCC > 3.55 pg/mg were more than twice as likely to report having a child who wheezed (odds ratio 2.56, 95% confidence interval 1.22–5.40; p = 0.01), adjusting for insurance provider and maternal asthma. Among this sample of dyads with prenatal smoke exposure, elevated maternal HCC was associated with child wheeze that was not diminished after consideration of covariates. Full article
(This article belongs to the Special Issue Women's Health throughout Life Stages)
21 pages, 384 KiB  
Article
A Decrease in Psycho-Emotional Health in Middle-Aged Russian Women Associated with Their Lifestyle
by Maria V. Saporovskaia, Tatiana L. Kryukova, Maria E. Voronina, Elena V. Tikhomirova, Anna G. Samokhvalova and Svetlana A. Khazova
Int. J. Environ. Res. Public Health 2021, 18(2), 388; https://doi.org/10.3390/ijerph18020388 - 6 Jan 2021
Viewed by 2297
Abstract
(1) Background: The present study is aimed to determine the predicting role of objective (lifestyle) and subjective factors of middle-aged women’s psycho-emotional health such as their relations with parents, attachment and separation types. Women who are overloaded with professional and family roles have [...] Read more.
(1) Background: The present study is aimed to determine the predicting role of objective (lifestyle) and subjective factors of middle-aged women’s psycho-emotional health such as their relations with parents, attachment and separation types. Women who are overloaded with professional and family roles have high stress level, their indicators of psychological well-being and emotional level decrease when they have to give everyday care to their elderly parents. (2) Methods: The research sample has two empirical groups. Sample of Study 1 includes middle-aged women (n = 61) aged 38–56 (M = 48.1, SD = 3.5); sample of Study 2 includes middle-aged women (n = 85) aged 33–52 (M = 40.6, SD = 3.1): married (70.5%) and divorced (29.5%), having children of 14–28 years old; giving everyday care to elderly parents for more than 1.5 yrs. Some live separately (62.3 %), or have to cohabitate with parents (37.7%). All women evaluate their life situation as difficult and manifest signs of high psycho-emotional stress. We used methods adapted for the Russian-speaking sample: getting socio-demographic information, an interview; The scales of psychological well-being; Attachment style and Interpersonal Guilt Questionnaires (study 1); Psychological Separation Inventory, Purpose-in-Life Test, projective methods (study 2), mathematical statistics. (3) Results: A number of factors and indicators of women’s psycho-emotional health decrease in the situation of role overload have been identified. Among the factors there are four main types of women’s relationships with parents: Anxious closeness; Ambivalence of feelings; Secondary relationship with parents; Alienation, predicting of psycho-emotional health that are reducing or enhancing their personal resources. Besides, a type of separation of an adult woman from her mother predicts her level of well-being. (4) Conclusions: The study confirms that middle-aged Russian women’s psycho-emotional health depends on contextual factors (difficult role-overloaded lifestyle) and factors integrating women‘s relations towards parents, attachment, guilt and separation. Types of middle-aged women’s relationships with parents contribute to their psychoemotional health in a different way. Full article
(This article belongs to the Special Issue Women's Health throughout Life Stages)
17 pages, 470 KiB  
Article
Preconception Care Program for Women with Inflammatory Bowel Disease Using Intervention Mapping: A Protocol for Program Development
by Young Jin Lee, Yeon Hee Kim and Hae Won Kim
Int. J. Environ. Res. Public Health 2020, 17(24), 9365; https://doi.org/10.3390/ijerph17249365 - 14 Dec 2020
Cited by 3 | Viewed by 2357
Abstract
The prevalence of inflammatory bowel disease in Korea is rapidly increasing. Women with inflammatory bowel disease have a higher risk of adverse birth outcomes than healthy women, and the magnitude of this risk is related to the severity of the disease at the [...] Read more.
The prevalence of inflammatory bowel disease in Korea is rapidly increasing. Women with inflammatory bowel disease have a higher risk of adverse birth outcomes than healthy women, and the magnitude of this risk is related to the severity of the disease at the time of pregnancy. For a woman with inflammatory bowel disease to have a healthy pregnancy, interventions are needed to manage the disease before pregnancy—implying a need for pregnancy planning. In this study, the intervention mapping protocol was used to develop a program for this purpose. This protocol contains the following stages: needs assessment, setting of program outcomes and performance objectives, selection of methods and strategies based on theory, and development of the program and its materials. Through individual in-depth interviews and a literature review, individual and environmental determinants were assessed and six change objectives of the program were set. The methods and practical strategies were developed based on the information-motivation-behavioral skills model, self-efficacy theory, and social support theory. The final program, consisting of four sessions and the corresponding materials, was completed by making revisions based on a content validity assessment by experts and a pilot test. Follow-up studies on the implementation of this program will be conducted in the future. Full article
(This article belongs to the Special Issue Women's Health throughout Life Stages)
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9 pages, 467 KiB  
Article
Stress Incontinence during Different High-Impact Exercises in Women: A Pilot Survey
by Iman Akef Khowailed, Joelle Pinjuv-Turney, Cathy Lu and Haneul Lee
Int. J. Environ. Res. Public Health 2020, 17(22), 8372; https://doi.org/10.3390/ijerph17228372 - 12 Nov 2020
Cited by 12 | Viewed by 3510
Abstract
The aim of this survey was to investigate the prevalence of stress urinary incontinence (SUI) among women (primigravida, multigravida, and nulligravida) in high-impact exercise groups—CrossFit, kickboxing, and boot camp. Incontinence Survey was modified to an anonymous online questionnaire. A total of 17 participants, [...] Read more.
The aim of this survey was to investigate the prevalence of stress urinary incontinence (SUI) among women (primigravida, multigravida, and nulligravida) in high-impact exercise groups—CrossFit, kickboxing, and boot camp. Incontinence Survey was modified to an anonymous online questionnaire. A total of 17 participants, 64.2% reported at least some urinary leakage during exercise. About 85.7% of participants in each of the 3 high-intensity exercise groups exercised >3 h/week. There was no significant difference in the likelihood of urinary leakage between participants who have had at least 1 pregnancy and those who had never been pregnant. CrossFit group were significantly more likely to report urinary leakage than those in the kickboxing and boot camp groups combined (p = 0.023). The participants did not exhibit typical risk factors, as they were premenopausal, active, and had an average body mass index within the normal range. This pilot survey indicates that all women those who do high-impact exercises are susceptible to stress urinary incontinence (SUI), and that CrossFit poses a greater risk for SUI in terms of more jumping resulting in increased intra-abdominal pressure and ground reaction forces compared to others. Our pilot study indicates that a higher risk of SUI during high impact exercises may exist associated with previous pregnancy but also in nulliparous women. Full article
(This article belongs to the Special Issue Women's Health throughout Life Stages)
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11 pages, 612 KiB  
Article
Investigation of the Association between Drinking Water Habits and the Occurrence of Women Breast Cancer
by Yael Keren, Racheli Magnezi, Moshe Carmon and Yona Amitai
Int. J. Environ. Res. Public Health 2020, 17(20), 7692; https://doi.org/10.3390/ijerph17207692 - 21 Oct 2020
Cited by 6 | Viewed by 2946
Abstract
Risk and protective factors for breast cancer (BC) include lifestyle, diet, reproduction, and others. Increased risk for colon cancer was linked with low water intake. The link between water consumption and BC was scarcely studied. We investigated the association between water and fluid [...] Read more.
Risk and protective factors for breast cancer (BC) include lifestyle, diet, reproduction, and others. Increased risk for colon cancer was linked with low water intake. The link between water consumption and BC was scarcely studied. We investigated the association between water and fluid consumption and the occurrence of BC in a retrospective case–control study in the Shaare Zedek Medical Center, Jerusalem, in 206 women aged 25–65 years (106 with newly diagnosed BC, and 100 controls). A food frequency questionnaire (FFQ), consumption of water, foods, and beverages, lifestyle, and other risk and protective factors were recorded. The age of women in both groups was comparable ((M ± SD) 52.7 ± 9.8 and 50.6 ± 11.4 years, respectively (p = 0.29)). Women with BC consumed 20.2% less water (M ± SD = 5.28 ± 4.2 and 6.62 ± 4.5 cups/day, respectively, p = 0.02) and 14% less total fluids than controls (M ± SD = 2095 ± 937 mL/day and 2431 ± 1087 mL/day, respectively, p = 0.018). Multiple stepwise logistic regression showed that the differences remained significant both for daily water consumption (p = 0.031, CI = 0.462–0.964) and for total daily liquid intake (p = 0.029, CI = 0.938–0.997). Low water and liquids intake as a risk factor for BC may be related to the younger age of our subjects. The effect of age on the potential role of water intake in decreasing BC risk should be investigated. Full article
(This article belongs to the Special Issue Women's Health throughout Life Stages)
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18 pages, 1361 KiB  
Article
Cultural Adaptation, Validation, and Primary Application of a Questionnaire to Assess Intentions to Eat Low-Glycemic Index Foods among Rural Chinese Women
by Mingshu Li, Fang Li, Qian Lin, Jingzheng Shi, Jing Luo, Qing Long, Qiping Yang, Yufeng Ouyang, Hanmei Liu, Rhonda C. Bell and Jia Guo
Int. J. Environ. Res. Public Health 2020, 17(20), 7577; https://doi.org/10.3390/ijerph17207577 - 18 Oct 2020
Cited by 4 | Viewed by 3678
Abstract
Different lines of evidence indicate that knowledge of low-glycemic index (GI) foods and the practice of eating them play important roles in blood glucose management and preventing T2DM in women with prior gestational diabetes mellitus (GDM). According to the theory of planned behavior [...] Read more.
Different lines of evidence indicate that knowledge of low-glycemic index (GI) foods and the practice of eating them play important roles in blood glucose management and preventing T2DM in women with prior gestational diabetes mellitus (GDM). According to the theory of planned behavior (TPB), intention is a critical factor in complying with health-related behaviors. However, an instrument for assessing the intention to eat low-GI foods is lacking in China. We aimed to (1) adapt and validate a Chinese version of the intentions to eat low-GI foods questionnaire (CIELQ) and (2) apply the CIELQ among rural Chinese women to explore the associations between CIELQ scores and glycemic status. A cross-sectional study was conducted on 417 nondiabetic, nonpregnant participants with a history of GDM in Hunan, China. After cultural adaptation and validation, the CIELQ was applied in a target population. Glycemic status, anthropometric variables, dietary intake, and physical activity were measured; a self-developed, standard questionnaire was applied to collect relevant information. The CIELQ showed good internal consistency; model fitness was acceptable based on the confirmatory factor analysis results. Awareness of the glycemic index was low among the study population. TPB factors were found to be associated with each other; education level and parents’ diabetes history were associated with specific factors. The score for instrumental attitude showed a positive association with the risk for a high level of the 2-h 75-g oral glucose tolerance test (odds ratio, OR = 1.330), while the score for perceived behavior control (PBC) showed a negative association with the risk for a high level (OR = 0.793). The CIELQ was determined to be a valid instrument for assessing the intention to eat a low-GI diet among the study population. The awareness of the GI was poor among the study population. The score for instrumental attitude showed a positive association with the risk of a high level on the 2-h 75-g oral glucose tolerance test (OGTT), and the score for PBC showed a negative association with the risk for a high level on OGTT. Full article
(This article belongs to the Special Issue Women's Health throughout Life Stages)
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13 pages, 1184 KiB  
Article
Association between Maternal Postpartum Depression, Stress, Optimism, and Breastfeeding Pattern in the First Six Months
by Andrea Gila-Díaz, Gloria Herranz Carrillo, Ángel Luis López de Pablo, Silvia M. Arribas and David Ramiro-Cortijo
Int. J. Environ. Res. Public Health 2020, 17(19), 7153; https://doi.org/10.3390/ijerph17197153 - 30 Sep 2020
Cited by 37 | Viewed by 8139
Abstract
Early breastfeeding cessation is a major public health problem. Several factors can affect breastfeeding pattern, and psychological aspects have been poorly explored. We hypothesize that psychological factors and breastfeeding pattern have a relationship. We have assessed in mothers during the first six months [...] Read more.
Early breastfeeding cessation is a major public health problem. Several factors can affect breastfeeding pattern, and psychological aspects have been poorly explored. We hypothesize that psychological factors and breastfeeding pattern have a relationship. We have assessed in mothers during the first six months of lactation if breastfeeding pattern is associated with maternal stress, postpartum depression, and dispositional optimism, and if these psychological factors play a role on breastfeeding adherence. In total, 711 women participated, answering online the following questionnaires: sociodemographic, perceived stress scale, Edinburgh postpartum depression scale, life orientation test, and breastfeeding adherence score. Women were categorized according to infant feeding practices as exclusive breastfeeding (EBF) or mixed breastfeeding (MBF). The EBF group had a lower score of perceived stress compared to those giving MBF (first month: EBF = 1.5 [1.1; 1.9], MBF = 1.8 [1.5; 2.0]; p-Value = 0.030; third month: EBF = 1.6 [1.2; 2.0], MBF = 1.8 [1.5; 2.4]; p-Value = 0.038) and also had a lower score of postpartum depression (third month: EBF = 8.0 [6.0; 11.0], MBF = 11.0 [9.0; 15.0]; p-Value = 0.001). The breastfeeding adherence score showed a positive correlation with maternal perceived stress (first month: ρ = 0.27; p-Value = 0.018), and postpartum depression (third month: ρ = 0.30; p-Value < 0.001), and a negative correlation with maternal dispositional optimism (second month: ρ = −0.20; p-Value = 0.028). MBF was positively associated with breastfeeding adherence score (odd ratio (OR) = 1.4 [1.2–1.6]; p-Value < 0.001) and with postpartum depression (OR = 1.1 [1.0; 1.1]; p-Value = 0.020). In the third month of breastfeeding, women with MBF exhibited higher perceive stress and postpartum depression compared to those with EBF and no difference in dispositional optimism. The maternal psychological aspects are associated with breastfeeding pattern. Evaluation of maternal psychological concerns and providing support to lactating mothers may help improving breastfeeding adherence. Full article
(This article belongs to the Special Issue Women's Health throughout Life Stages)
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10 pages, 506 KiB  
Article
Prevalence of Hypoproteinemia and Hypoalbuminemia in Pregnant Women from Three Different Socioeconomic Populations
by Sagrario Gómez-Cantarino, M. Teresa Agulló-Ortuño, Mercedes de Dios-Aguado, M. Idoia Ugarte-Gurrutxaga and Carmen Bouzas-Mosquera
Int. J. Environ. Res. Public Health 2020, 17(17), 6275; https://doi.org/10.3390/ijerph17176275 - 28 Aug 2020
Cited by 8 | Viewed by 4440
Abstract
Protein requirements of pregnant women are increased due to anatomical and physiological changes. However, optimal levels of plasma proteins do not receive adequate attention from health professionals and researchers. We aimed to evaluate the plasma protein status in pregnant women receiving care at [...] Read more.
Protein requirements of pregnant women are increased due to anatomical and physiological changes. However, optimal levels of plasma proteins do not receive adequate attention from health professionals and researchers. We aimed to evaluate the plasma protein status in pregnant women receiving care at health centers, with the intention of identifying potential deficiency states and their relationship with quality of life during pregnancy. This is a population-based, prospective, and observational study among a cohort of 215 pregnant women from three different socioeconomic areas (urban, semi-urban, and rural). Blood samples in the first (T1), second (T2), and third (T3) trimester of pregnancy were obtained to quantify the proteins and albumin levels. Statically significant differences regarding the age of pregnant women (p = 0.002), education status (p = 0.034), and socioeconomic level (p = 0.000), were found among groups. Prevalence of protein and albumin deficits was much higher in women from rural and semi-urban areas than in women from urban areas (p = 0.001). Moreover, these deficits were associated with the appearance of edema. Plasma total protein deficit could be an undervalued public health problem in pregnant women receiving prenatal care that could affect the quality of life in the gestational period. It would be important to establish reference intervals for plasma protein monitoring in each trimester of pregnancy, and protein levels should be measured routinely throughout pregnancy. Full article
(This article belongs to the Special Issue Women's Health throughout Life Stages)
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12 pages, 739 KiB  
Article
Health Services, Socioeconomic Indicators, and Primary Care Coverage in Mortality by Lower Genital Tract and Breast Neoplasias in Brazilian Women during Reproductive and Non-Reproductive Periods
by José Lucas Souza Ramos, Francisco Winter dos Santos Figueiredo, Lea Tami Suzuki Zuchelo, Flávia Abranches Corsetti Purcino, Fernando Adami, Rodrigo Goncalves, Carlos Alberto Ruiz, Edmund Chada Baracat, José Maria Soares Junior and Isabel Cristina Esposito Sorpreso
Int. J. Environ. Res. Public Health 2020, 17(16), 5804; https://doi.org/10.3390/ijerph17165804 - 11 Aug 2020
Cited by 2 | Viewed by 2582
Abstract
Women’s health assistance at the low-complexity level is focused on the most common diseases and can be affected by primary health care coverage, particularly in areas far away from large urban centers. Thus, in this work, we aim to analyze the relationship between [...] Read more.
Women’s health assistance at the low-complexity level is focused on the most common diseases and can be affected by primary health care coverage, particularly in areas far away from large urban centers. Thus, in this work, we aim to analyze the relationship between socioeconomic status, health care indicators, and primary care coverage in mortality from neoplasms of the lower genital tract and breast in Brazilian women during reproductive and non-reproductive periods. We conducted an ecological study at the Gynecology Discipline, Medicine School, University of São Paulo. Secondary data were collected from women according to reproductive periods and mortality data from the Mortality Information System based on International Classification of Disease—10th edition regarding breast and lower genital tract neoplasms in 2017. The health service and socioeconomic indicators were obtained from the Informatics Department of the Unified Health System and Brazilian Institute of Geography and Statistics. Our results showed that primary care coverage and health service indicators were not associated with mortality from breast cancer and the female lower genital tract, both in reproductive and non-reproductive periods. Sociodemographic indicators were found to be associated with mortality from breast cancer and the female lower genital tract, with income being associated with reproductive period (β = −0.4; 95% CI, −0.8 to −0.03) and educational level in the non-reproductive period (β = 9.7; 95% CI, 1.5 to 18.0). Full article
(This article belongs to the Special Issue Women's Health throughout Life Stages)
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12 pages, 296 KiB  
Article
Menopausal Symptoms and Perimenopausal Healthcare-Seeking Behavior in Women Aged 40–60 Years: A Community-Based Cross-Sectional Survey in Shanghai, China
by Li Du, Biao Xu, Cheng Huang, Liping Zhu and Na He
Int. J. Environ. Res. Public Health 2020, 17(8), 2640; https://doi.org/10.3390/ijerph17082640 - 12 Apr 2020
Cited by 39 | Viewed by 5599
Abstract
The aim of the study was to specify prevalence and severity of menopausal symptoms among middle-aged women and to understand the factors associated with women’s perimenopausal healthcare-seeking behavior in Shanghai, China. A community-based cross-sectional study was carried out involving 3147 participants aged 40–60 [...] Read more.
The aim of the study was to specify prevalence and severity of menopausal symptoms among middle-aged women and to understand the factors associated with women’s perimenopausal healthcare-seeking behavior in Shanghai, China. A community-based cross-sectional study was carried out involving 3147 participants aged 40–60 years. A combination of stratified sampling and quota sampling was used. Out of the total 16 districts in Shanghai, 7 were purposefully selected in consideration of covering both central and suburban areas, population distribution, and willingness to participate. Two communities were randomly selected in each of six districts. Four communities were randomly selected in the 7th district considering the relatively low coverage of central population in the sampling frame. Eligible women were recruited continuously according to the house number and invited to participate in the study until 200 participants were recruited in each community. A structured questionnaire was designed to collect information including sociodemographic data, menopausal symptoms, and experiences in seeking perimenopausal healthcare. The severity of menopausal symptoms was assessed with the modified Kupperman menopausal index (mKMI). The mean age of all the participants was 51 years. 33.13% of the participants were premenopausal, 14.52% were perimenopausal, and 52.35% were postmenopausal. The total prevalence of menopausal symptoms was 73.8%, while among the perimenopausal women, the symptoms were the most common (81.70%). The top three reported symptoms were fatigue (38.08%), hot flushes and sweating (33.65%), and joint ache (28.81%). Perimenopausal and postmenopausal participants had a higher score of the mKMI than premenopausal women (p < 0.01). Of the women who had symptoms, 25.97% had sought healthcare. A logistic regression model revealed that employment, menstruation status, and the mKMI were significantly associated with healthcare-seeking behaviors (p < 0.01). We concluded that prevalence of menopausal symptoms was relatively high among middle-aged women, with perimenopausal women showing the highest level. However, only a small percentage of the participants sought healthcare. Carrying out health education may be a measure to improve the healthcare-seeking behavior. Full article
(This article belongs to the Special Issue Women's Health throughout Life Stages)

Review

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15 pages, 727 KiB  
Review
Iodine Status of Women and Infants in Russia: A Systematic Review
by Rimma Korobitsyna, Andrey Aksenov, Tatiana Sorokina, Anna Trofimova, Nikita Sobolev, Andrej M Grjibovski, Valery Chashchin and Yngvar Thomassen
Int. J. Environ. Res. Public Health 2020, 17(22), 8346; https://doi.org/10.3390/ijerph17228346 - 11 Nov 2020
Cited by 3 | Viewed by 2790
Abstract
This systematic review presents a critical synthesis of the available information on the iodine status among women and infants in Russia. Literature search was performed in accordance with PRISMA guidelines using PubMed, Scopus Web of Science databases as well as eLIBRARY—the Russian national [...] Read more.
This systematic review presents a critical synthesis of the available information on the iodine status among women and infants in Russia. Literature search was performed in accordance with PRISMA guidelines using PubMed, Scopus Web of Science databases as well as eLIBRARY—the Russian national source. Altogether, 277 papers were identified and 19 of them were eligible for the review. The data on median urinary iodine concentration (UIC) in women and infants from 25 Russian regions were presented. A substantial variability in UIC across the country with no clear geographical pattern was observed. Despite substantial heterogeneity in research methodology and data presentation the results suggest that the iodine status among pregnant women and infants in Russia is below the recommended levels. Our findings demonstrate that iodine deficiency is a re-emerging public health problem in Russia. Urgent public health measures on national, regional and individual levels are warranted. Full article
(This article belongs to the Special Issue Women's Health throughout Life Stages)
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