Journal of women's health
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Journal of women's health · May 2020
Postpartum Breastfeeding and Cardiovascular Risk Assessment in Women Following Pregnancy Complications.
Background: Breastfeeding is associated with lower cardiovascular (CV) risk over the long-term, however, less is known about its immediate effects among women with a recent complicated pregnancy. The objective of this study is to investigate the short-term effects of breastfeeding on markers of cardiovascular disease risk among women ∼6 months after a pregnancy complicated by a hypertensive disorder, gestational diabetes, intrauterine growth restriction, abruption, or preterm birth. Materials and Methods: Our cross-sectional analysis includes 622 women seen at 6 months postpartum (interquartile range: 5.7-6.7) between November 2011 and December 2017 at a tertiary care center. ⋯ CV risk factors were compared between women who did not breastfeed (n = 100, 16%), those who breastfed for less than 6 months (n = 315, 51%), and those who breastfed for 6 months or more (n = 207, 33%) using multivariate logistic and linear regression. Results: Increased breastfeeding duration significantly decreased the likelihood of metabolic syndrome (adjusted odds ratio [95% confidence interval; CI]: 0.89 [0.79-0.99]), abnormal fasting glucose (0.79 [0.64-0.96]), and ratio of total cholesterol to high-density lipoprotein-cholesterol (HDL-C) (0.86 [0.78-0.95]). Furthermore, body mass index (estimated beta coefficients [95% CI] -0.10 [-0.18 to -0.02]), fasting glucose (-0.05 [-0.08 to -0.02]), triglycerides (-0.07 [-0.10 to -0.04]), and ratio of total cholesterol to HDL-C (-0.06 [-0.10 to -0.03]) also decreased with increased breastfeeding duration, while HDL-C increased (0.02 [-0.01 to -0.04]). Conclusions: Our findings suggest that breastfeeding is associated with decreased indicators of CV risk in a cohort of women with recent pregnancy complication.
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Journal of women's health · May 2020
Lumbar Intervertebral Disc Degeneration as a Common Incidental Finding in Young Pregnant Women as Observed on Prenatal Magnetic Resonance Imaging.
Background: Obstetric imaging, subserving fetal evaluation, may yield incidental maternal findings. Based on prenatal magnetic resonance (MR) imaging, this study aims to investigate incidental intervertebral disc degeneration and displacement in young, pregnant women. Methods: This retrospective study included the sagittal 1.5 Tesla, T2-weighted lumbar spine images of 943 pregnant Central Europeans (age range, 18-47 years), who initially had undergone MR imaging because of sonographically suspected fetal abnormalities. ⋯ Of 943 women, 57 (6%) had disc displacements, of which 97% were in conjunction with high-grade degeneration. There was a statistically significant relationship (p < 0.001) between degeneration and age, and between degeneration and body weight. Conclusions: In young pregnant women, lumbar intervertebral disc degeneration is a ubiquitous, incidental finding, increasing from the late second decade of life onward, which may be part of physiological aging, as opposed to a small percentage of incidental disc displacements.
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Journal of women's health · May 2020
Identifying a Golden Opportunity: Adolescent Interest in Contraceptive Initiation in a Pediatric Emergency Department.
Objectives: Contraception use reduces teen pregnancy, and long-acting reversible contraception is recommended as first-line treatment. Since many adolescents use the emergency department (ED) as a primary source of health care, it is a potential site of contraceptive counseling and provision. We surveyed female adolescents to assess desire for contraceptive counseling and initiation/change during an ED visit. Materials and Methods: This was a cross sectional study of a convenience sample of female ED patients aged 16-21 years in an urban pediatric ED. ⋯ Two-thirds were interested in discussing contraception and 22.5% were likely to start or change contraception during the ED visit. Those who wanted to start or change contraception were more likely to be sexually active with a male partner (93% vs. 82%, p = 0.02) and to report that they were not satisfied with their current contraception (44% vs. 21%, p = 0.0003). Fifteen (17%) of the adolescents likely to start or change contraception were interested in progestin implant initiation in the ED. Conclusions: Adolescents were interested in initiating or changing contraception during the ED visit, providing an important opportunity to discuss and initiate effective contraception.