Women

Previous cross-sectional studies have investigated social determinants of health (SDOH) among pregnant women with COVID-19. However, there are scant data on the impact of these determinants on maternal outcomes from cohorts of pregnant women with COVID-19. We evaluated the association between social determinants of health and both COVID-19 severity and adverse pregnancy outcomes (APOs) in a cohort of pregnant women in Los Angeles (L.A.) County, California. The APOs considered were fetal loss, gestational hypertensive disorders, prolonged rupture of membranes, and maternal death. We recruited pregnant women with confirmed SARS-CoV-2 and collected data on maternal COVID-19 severity, trimester at diagnosis, comorbidities, mode of delivery, COVID-19 vaccination, APOs, maternal age, medical insurance type, race/ethnicity, and neighborhood income. Participants who were obese were more likely to experience severe COVID-19 (OR: 3.61, 95% CI: 1.44–9.46), while even one vaccine dose before COVID-19 infection was associated with reduced odds of severe disease (OR:0.14, 95% CI: 0.02–0.52). Pregnant participants living in low-income areas were more likely to experience APOs (p = 0.01) and severe COVID-19 (p = 0.009). This suggests that economic inequities could negatively impact maternal outcomes among pregnant women with COVID-19. We also found that SDOH moderated severity effects on APOs in Black women vs. non-Black women. These findings underscore the importance of considering social determinants of health to improve maternal health. Full article

Congenital CMV (cCMV) is the leading cause of hearing loss and neurodevelopmental disabilities in children, affecting 15–18% of births in the United States (U.S.). Despite its strong presence, the lack of routine prenatal screening limits its detection and prevention, especially in low-resource communities. The aim of this scoping review is to describe the scope of the CMV interventions and the policies on CMV screening in the United States, identify successful strategies for the implementation of improved CMV screening rates, and make recommendations for future efforts aimed at improving CMV screening in U.S. healthcare settings. The Joanna Briggs Institute recommendations for scoping reviews and the Arksey and O’Malley (2005) York methodology guided the different review steps. These included (1) identifying research questions; (2) searching for relevant studies; (3) selecting studies relevant to the research questions; (4) charting the data; (5) collating, summarizing, and reporting results. A total of six studies were retained for analysis. A common barrier reported across studies was the lack of generalizability of findings due to small sample size. Challenges encountered by patients often centered around awareness, emotional resistance, and cultural norms. Providers also faced significant barriers, particularly related to time constraints, knowledge gaps, and the prioritization of CMV education in prenatal care. Furthermore, a recurrent theme across included studies was the critical role of education in increasing awareness and reducing CMV transmission risks. Findings will contribute to the advancement of CMV prevention through the identification of gaps in education, policy, and practice, thus assuring better health outcomes for mothers and infants. Full article

The World Health Organization recommends Tranexamic acid (TXA) in the treatment of postpartum haemorrhage (PPH) as part of the PPH care bundle. We conducted integrative review of 36 studies from three databases namely PubMed, Google Scholar, and Dimensions. The integrative review followed PRISMA guidelines and evaluated clinical efficacy of TXA, prophylactic use, cost-effectiveness, alternative administration routes, and real-world implementation challenges and facilitators. The review found that early administration of TXA within three hours of PPH onset significantly reduces maternal mortality by 31%. Despite concerns about thrombosis, pooled data from large-scale cohorts demonstrate minimal thromboembolic risk which reinforces the safety profile of TXA. However, the WOMAN-2 trial revealed no significant benefit in women with moderate-to-severe anaemia which highlights the necessity for patient-specific TXA protocols. Economic evaluations reveal that integrating TXA into national guidelines requires a modest budget increase (approximately 2.3%) but promises substantial cost savings through reduced surgeries and hospital stays. While intravenous TXA remains recommended route by WHO, emerging evidence supports intramuscular and topical administration which is crucial in rural or primary-care settings lacking intravenous facilities. Yet, questions about bioavailability and rapid haemostatic efficacy persist, awaiting outcomes from ongoing trials such as I’M WOMAN, which is currently recruiting women aged 18 years from five countries with results anticipated by late 2025. Significant barriers to widespread adoption of TXA include limited healthcare provider training, lack of budgetary allocation by government and cultural misconceptions associating TXA with “dangerous clotting” in some settings. Successful initiatives, like China’s Strategies and Tools to Enhance Parturient Safety (STEPS) programme, illustrate how enhanced perinatal care bundles, interdisciplinary team training, and continuous monitoring using statistical process control (SPC) tools can overcome these obstacles. To accelerate progress towards reducing preventable maternal deaths globally, future research must address variable effectiveness when TXA is used as prophylaxis, clarify subpopulations most likely to benefit, and rigorously assess alternative routes of TXA administration. Full article

This study aimed to assess pregnant women’s knowledge regarding the benefits and practice of antenatal perineal massage (APM) and their acceptance of APM. A descriptive cross-sectional correlation design was applied to a convenience sample of 104 pregnant women who completed an online questionnaire. The online questionnaire was divided into four categories: (1) sociodemographic and obstetric history and general information about APM, (2) knowledge regarding the benefits of APM, (3) knowledge regarding the practice of APM, and (4) acceptance of APM. Data analysis was performed in SPSS v.26. Frequencies and percentages were taken from all qualitative variables. Most pregnant women had good knowledge: 78.8% had knowledge regarding the benefits of APM, 85.6% had knowledge regarding the practice of APM, and 54.8% reported acceptance of APM. There was a significant correlation between knowledge and practice of APM, indicating that a higher knowledge level leads to good practice of APM. This study highlighted participants’ significantly high amount of knowledge regarding the benefits and practice of APM. Additionally, based on the percentage of participants who had not heard about APM, the study revealed the failure of health-care providers to provide education regarding APM to pregnant women. Further research is needed to establish interventions that improve knowledge and encourage APM practice among pregnant women. Full article

Physical activity is recognized for its physical and mental health benefits, including reducing sedentary behavior and improving mood, anxiety, and self-esteem. Individuals with severe mental illness tend to be more sedentary, contributing to poorer health outcomes. Water aerobic exercise has shown promise in improving physical and mental health, but sex differences in response to such interventions remain underexplored. This study investigates the effects of a water aerobic exercise intervention on 74 individuals with severe mental illness, focusing on sex differences. Participants engaged in a 45–60 session, once a week for 6 months. Assessments were conducted before and after the intervention and included measures of clinical, functioning, quality of life, and sedentary behavior outcomes. Both men and women significantly reduced sedentary behavior. Men showed significant improvements in self-stigma, functioning, and general quality of life. In contrast, women demonstrated significant improvements in self-esteem. These findings suggest that water aerobic exercise may be effective in reducing sedentary behavior and improving mental health outcomes in individuals with severe mental illness. However, the benefits appear to differ by sex. These results underscore the importance of sex-tailored physical activity interventions in mental health care. Full article

Congenital cystic adenomatoid malformation (CCAM) is a rare fetal lung anomaly characterized by benign multicystic masses that can lead to severe complications, such as pulmonary hypoplasia, fetal hydrops, and neonatal death. This literature review examines current knowledge on antenatal therapies for CCAM, focusing on pharmacological, procedural, and surgical interventions. Betamethasone, the first-line pharmacological treatment, has shown efficacy in reducing lesion size and resolving hydrops, particularly in microcystic CCAM. Procedural options, such as thoracoamniotic shunting, are effective for macrocystic lesions but carry risks including preterm labor and thoracic deformities. Open fetal surgery remains a last-resort intervention for severe cases, while emerging techniques, like percutaneous laser ablation and sclerotherapy, offer promising minimally invasive alternatives. A proposed treatment algorithm emphasizes individualized care based on lesion type, gestational age, and the presence of complications. The authors searched the US National Library of Medicine Database, Google Scholar, and PubMed Central to gather information on antenatal therapies for CCAM. This review emphasizes that, despite significant advancements, considerable challenges persist, underscoring the need for prospective studies to refine therapeutic protocols and assess long-term outcomes. Full article

Human milk is recognized as the optimal nutrition for infants, with evidence showing it can prevent childhood death. While there are approximately 756 milk banks worldwide, predominantly located in high-income countries, human milk banking remains limited in Africa, where infant mortality rates are highest. The purpose of this review was to examine the current landscape of human milk banking in Africa, analyzing its potential to decrease infant mortality and enhance neonatal health outcomes. We explore implementation challenges, opportunities for expansion, and strategies for establishing sustainable milk banking systems across the continent. Following Arksey and O’Malley’s scoping review framework, we conducted a comprehensive analysis of peer-reviewed literature, case studies, and reports from the PubMed, Google Scholar, and African Journals Online databases through 2024. Results: South Africa leads the continent, with over 20 milk banks, while countries like Kenya, Nigeria, and Uganda have recently established programs. Significant challenges include cultural barriers and a lack of infrastructure and funding. Despite current limitations, evidence supports the significant potential of human milk banking to reduce infant mortality in Africa. Success requires addressing cultural barriers, strengthening healthcare infrastructure, and developing sustainable funding models by integrating existing maternal and child health services. Full article

Physical inactivity is a significant global health challenge, contributing to increased morbidity and mortality rates. Regular physical activity (PA) improves both physical and mental health, particularly for women, who are at higher risk of chronic conditions associated with inactivity. This study examines barriers and enablers to PA participation among women aged 18–65 in port and coastal communities in East England, a population disproportionately affected by socioeconomic and logistical challenges. Using a mixed-methods convergent parallel design, data were collected from 112 women recruited through local PA and weight loss programmes. Quantitative data were gathered using the International Physical Activity Questionnaire (IPAQ) and the Exercise Benefits and Barriers Scale (EBBS) and analysed using descriptive statistics and logistic regression in SPSS. Qualitative data obtained through scenario-based and open-ended questions were thematically analysed in NVivo. Key findings indicate that healthcare professionals were the primary source of PA information (40%), while health benefits (36%) were the most frequently cited motivator for participation. Barriers to engagement included family responsibilities (45%), low self-confidence (31%), and limited access to facilities (27%). Women with caregiving roles or chronic health conditions were significantly less likely to engage in PA. Qualitative analysis highlighted additional psychological and environmental barriers but also identified motivators such as social support, medical advice, and personal goals. The study concludes that addressing socioenvironmental and psychological barriers to PA requires community-based, multilevel interventions. Leveraging support networks and culturally relevant programming can play a crucial role in sustaining PA engagement among women in these underserved port and coastal communities. Full article

Perimenopause, the transitional phase leading up to menopause, affects millions of women worldwide, yet it remains poorly understood and under-addressed in healthcare. Despite the availability of treatment options like hormone replacement therapy (HRT) and non-hormonal alternatives, the awareness and utilization of these options vary significantly among women. Here, we conducted a cross-sectional survey with 1000 adults, both men and women, from the United States and Canada. We evaluated the perceived familiarity of participants with the timing, duration, and symptoms of perimenopause, as well as their satisfaction with their treatment options and communication with their healthcare providers. We found that, in general, women and older people were more likely to feel familiar with perimenopause, although the youngest age group surveyed also reported relatively high familiarity. We also found that there is a disconnect between people reporting high familiarity with perimenopause and its symptoms but overall middling and lower familiarity with the age and duration of onset and satisfaction with treatment options. Our results suggest further investigation into where people obtain their information concerning perimenopause, as well as into how knowledge of perimenopause may vary based on demographics. Full article

Black mothers with preterm infants face unique challenges during their stay in the NICU and after discharge. Racism-related barriers impact access to care for Black preterm infants. Understanding their experiences in caring for preterm infants is crucial to developing equity-focused interventions to address racism in the NICU and promote Black preterm infant health outcomes. The purpose of this scoping review is to shed light on Black mothers’ experiences of having a preterm infant. A search was conducted in CINAHL, Medline, Maternity and Infant Care, and Google Scholar. A total of 287 articles were retrieved and screened. Twelve (12) articles included in the final review were from the United States. The findings highlight the need to address racism among healthcare providers in the NICU through training and education. Gaps in understanding the experiences of Black parents with preterm infants from other Western contexts remain and require further research. Full article

Intrauterine devices (IUDs) are highly effective long-acting contraceptives. However, pain associated with insertion deters some women and impacts satisfaction. This systematic review critically evaluates the effectiveness of local anesthetics, misoprostol, nonsteroidal anti-inflammatory drugs (NSAIDs), and conscious sedation for managing pain associated with IUD insertion. A comprehensive database search including PubMed, Web of Science, Google Scholar, ClinicalTrials.gov, and ProQuest was conducted from inception to July 2023 for randomized controlled trials (RCTs). RCTs assessing interventions for IUD insertion pain were included. Case reports, non-randomized studies, and non-English papers were excluded. Two independent reviewers extracted data on pain outcomes and adverse effects. The risk of bias was assessed using Cochrane tools. Thirty-nine RCTs (n = 12,345 women) met the inclusion criteria. Topical lidocaine effectively reduced pain on consistent findings across multiple high-quality RCTs. Misoprostol pretreatment facilitated easier insertions through cervical ripening. However, evidence for NSAIDs was inconclusive, with some RCTs finding no additional benefits versus placebo. Results also remained unclear for nitrous oxide conscious sedation due to variability in protocols. Nulliparity predicted higher reported pain consistently. Lidocaine and misoprostol show promise for minimizing IUD insertion pain and difficulty. Further optimization is required to standardize conscious sedation and fully evaluate NSAIDs. Improving pain management may increase favorable experiences and uptake of this reliable method. Full article

Spontaneous rupture of the utero-ovarian vessels is an exceptionally rare but potentially life-threatening condition, especially in the case of non-pregnant women with a history of complex gynecological conditions. We report the case of a 45-year-old woman presenting with severe abdominal pain and hemoperitoneum, 15 years after surgical eradication of stage IV endometriosis. Diagnostic imaging revealed significant free fluid and vascular disruption near the uterus. Emergency laparotomy confirmed blood in the peritoneal cavity and identified a rupture of the left paracervical vessels. This case underscores the critical role of timely surgical intervention and the challenges of diagnosing spontaneous vascular rupture in the context of chronic conditions such as endometriosis and fibromyalgia. A review of the literature revealed very limited cases with similar presentations, emphasizing the rarity of such vascular events, although without active endometriotic lesions. This report highlights the importance of considering spontaneous vascular rupture in differential diagnoses for acute abdominal pain with hemoperitoneum. Advanced imaging and multidisciplinary management are pivotal in ensuring favorable outcomes. Full article

Geophagy is an ancient widespread practice that is common amongst women of childbearing age globally. Geophagy is one of the leading causes of iron deficiency and pregnancy complications amongst women of childbearing age resulting in maternal, neonatal, and child morbidities and mortalities globally. The concept of geophagy has yet to be incorporated in the reproductive health services in the healthcare facilities. A qualitative study was conducted using focus group discussions and in-depth interviews to explore the views/perspectives of nurses regarding geophagic women of childbearing age accessing healthcare in the reproductive healthcare services in Tshwane District, Gauteng Province. The findings revealed that nurses perceived geophagic women of childbearing age to be iron deficient and lack proper knowledge and understanding of the potential health risks and dangers of soil eating. Mental health and substance use disorders, food and nutrition deficiencies, absence of geophagy health education, and promotion programs were highlighted as some of the aspects that play a role towards the practice of geophagy amongst women of childbearing age accessing healthcare in Tshwane District, Gauteng Province. Thus, a conclusion can be made that geophagy health education and promotion programs in the antenatal care units must be prioritized by government. Full article

Anorexia nervosa is classified by the American Psychological Association as an eating-related mental disorder, which affects mostly young adult women and adolescent girls. Although refeeding programs are often used to recover bodyweight in patients with anorexia nervosa, treatment failures are high, and the determinants of the disorder remain unknown. The present paper uses a nutritional epidemiology perspective to examine determinants of anorexia nervosa from the patients’ point of view. A grounded-theory literature-review method was used to search and review research findings from the peer-reviewed literature related to the etiology of anorexia nervosa, including recent qualitative interviews with patients. Unlike a systematic review, a grounded theory method is more appropriate for developing a new theory to explain phenomena like the cause, recovery, and prevention of anorexia nervosa. Reviewed research suggests that anorexia nervosa may be a problematic body-change strategy rather than a mental disorder. Additionally, the present paper proposes that replacing the drive for thinness in anorexia nervosa with a drive for leanness may help patient recovery, especially when guided by easily accessible body-composition estimates. Fat-free mass restoration in the recovery of anorexia nervosa may also be facilitated by resistance training, which improves patients’ psychological status and body composition. Additionally, replacing a dysfunctional dieting strategy in anorexia nervosa with knowledge, skills, and experience in proper weight management has a potential preventive effect against the disorder. More research is needed to investigate the applied effects of the drive for leanness, body-composition assessments, resistance-training programs, and weight-management skills associated with the recovery and prevention of anorexia nervosa. Furthermore, successful application of the information in this paper may be adapted to peer role model programs to prevent anorexia nervosa. Full article

Although global neonatal mortality rates have significantly decreased, Black infant mortality in the US continues to be a major issue. This study identifies, assesses, and illustrates women’s views on infant mortality and the resources needed to address the problem. Women of diverse demographic backgrounds were recruited via purposive sampling, with 91 participating. Seventy percent of participants were aged 18 to 39 (n = 64), and forty three percent lived in Indiana (n = 39). Access to care, sleeping issues, supporting breastfeeding, awareness, affordability challenges, healthcare provider factors, and creating sustainable programs and policies to address infant mortality emerged as prominent themes in the data. This study highlights the importance of cultural congruency in addressing maternal and child health issues, emphasizing the need for stakeholder involvement to ensure interventions are acceptable, practical, and sustainable. Full article

Breast cancer incidence is on the rise regardless of several interventions available for its management. This scenario may be worse in resource-limited countries. This study, therefore, aimed to evaluate the knowledge and attitude of women towards Breast Cancer Screening (BCS) in Aminu Kano Teaching Hospital (AKTH), Kano State, a typically resource-limited state in Nigeria. This was a cross-sectional study. The study population comprised female individuals aged 18–45 years attending the Antenatal and Postnatal clinics of AKTH. An adopted questionnaire instrument was used to extract vital information on the knowledge and attitude of women towards breast cancer screening in the Antenatal and Postnatal clinics of AKTH. Our findings showed that there is much awareness about BCS, even though most participants’ knowledge about the methods and timing of the scan is low. Much enlightenment is achieved through the availability of print and electronic media on BCS. A better attitude is shown when trained personnel conduct BCS. A good number of participants who have knowledge are yet to translate their knowledge and attitudes into practice. Based on our findings, coordinated and timely awareness campaigns should be organized by local health authorities to improve knowledge and attitude towards BCS. Full article

Introduction: The COVID-19 pandemic brought myriad challenges and disruptions to societies worldwide. The impact of the pandemic on immigrant women living in Canada and who experience intimate partner violence (IPV) was very concerning during lockdowns specifically. As Canada implemented social distancing measures and stay-at-home orders to curb the spread of the virus, immigrant women—already at a heightened risk of IPV due to factors such as language barriers and immigration status—faced an increased likelihood of being trapped in abusive situations, with limited access to essential support services such as shelters, counseling centers, and legal aid. This narrative review aims to illuminate the experiences of IPV including the challenges and strategies used to cope during the pandemic among immigrant women. While this narrative review aims to obtain an extensive understanding of the IPV experiences among immigrant women during the pandemic, it also highlights the need for developing culturally sensitive interventions to address IPV challenges for immigrant women in similar contexts. A search was undertaken of multiple databases: Medline, CINHAL, Google Scholar, and PsycINFO. To identify studies related to IPV and COVID-19, various search terms were used including “abused women”, “COVID-19”, and “IPV” and their synonyms. This review employs the social–ecological model and intersectionality to illuminate the IPV experiences of immigrant women during the COVID-19 pandemic. Four themes emerged from this study including the realities of COVID-19 restrictions; IPV vulnerabilities during the COVID-19 pandemic; the impacts of IPV and the COVID-19 pandemic; and the strategies for addressing IPV (women and system perspectives). We draw on past research and the knowledge of our multidisciplinary team of researchers to recommend culturally sensitive resources and health services for abused women living in Canada as well as highlight effective intervention strategies to address the varied and complex needs of these women. Full article

The initial presentation of COVID-19 to the world left many in the medical community perplexed about its true nature and potential impact on individuals. Many investigations into the pathology of the virus resulted from this; however, studies were limited in the obstetric community, especially in high-risk communities. Each pandemic wave (Alpha, Delta, Omicron) had different transmission rates and inflicted different COVID-19 severity levels among those infected. This study aimed to determine if the effects of COVID-19 on maternal and infant outcomes varied by pandemic waves. This is an observational cohort study utilizing women enrolled in a COVID-19 pregnancy study. A review of 374 electronic medical records of women who received care at the University of Mississippi Medical Center after testing positive for SARS-CoV2 was conducted. During the Alpha pandemic wave, women contracted COVID-19 significantly earlier in pregnancy; however, higher rates of COVID-19 infection occurred during the Omicron pandemic wave. During the Delta pandemic wave, more women were morbidly obese and were likely to deliver significantly earlier, and, when compared to infants born during the Omicron pandemic wave, the infants born during the Delta wave weighed significantly less. The effects of COVID-19 on high-risk pregnant patients may deviate from previous reports, indicating a need for further investigation of the biological and social factors that may lead to these differences. Studies into the effects of COVID-19 in pregnancy remain limited and this study provides valuable insight into how varying COVID-19 strains affected a high-risk obstetric community. Full article

The world of science is increasingly looking for answers to the question of how specific dietary components affect the risk of chronic diseases and assessing their potential to alleviate the severity of individual diseases. This research concerns both the assessment of the benefits of using individual dietary components and those of nutritional models. Endometriosis, due to its chronic and inflammatory nature, is also a topic of interest among scientists, who seek to support its course through proper nutrition. In endometriosis, great interest is focused on dietary patterns such as an anti-inflammatory diet, a gluten-free diet, a low-FODMAP diet, or a Mediterranean diet. An anti-inflammatory diet primarily focuses on fresh vegetables, fruits, seeds, nuts, whole grain products, and healthy sources of protein and fats, including mono- and polyunsaturated fatty acids, eliminating highly processed products, meat products, trans fats, and refined sugars. It is believed that this type of diet may contribute to reducing the severity of endometriosis symptoms and help reduce inflammation. The aim of the review is to identify the main trends in the field of diets supporting the treatment of endometriosis in the last 5 years. Full article