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
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.
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Journal of women's health · May 2020
Disparities in the Prevalence of Excess Heart Age Among Women with a Recent Live Birth.
Background: Understanding and addressing cardiovascular disease (CVD) risk has implications for maternal and child health outcomes. Heart age, the modeled age of an individual's cardiovascular system based on risk level, and excess heart age, the difference between a person's heart age and chronological age, are alternative simplified ways to communicate CVD risk. Among women with a recent live birth, we predicted heart age, calculated prevalence of excess heart age (≥5 years), and examined factors associated with excess heart age. ⋯ Prevalence of excess heart age was highest among women who were without health insurance, obese or overweight, engaged in physical activity less than thrice per week, or were smokers in the prepregnancy period. Among women with less than high school education, non-Hispanic black women had a higher prevalence of excess heart age than Hispanic women (PR, 95% CI: 4.01, 3.15-5.10). Conclusions: Excess heart age may be an important tool for decreasing disparities and encouraging CVD risk reduction among certain groups of women.