Journal of women's health
-
Journal of women's health · May 2021
Screening Mammography Utilization Among Female Medicare Beneficiaries and Breast Cancer Survivors in 2002-2016.
Background: The use of screening mammography varies by patient characteristics. This study examined the annual mammography utilization trends among female Medicare beneficiaries and breast cancer survivors, overall and by beneficiary characteristics. Materials and Methods: This retrospective, serial cross-sectional study used the 2002-2016 Medicare Current Beneficiary Survey (MCBS), including fee-for-service female Medicare beneficiaries who resided in community settings and who completed the survey (n = 53,788, weighted n = 206,259,890). Self-reported mammography utilization and breast cancer history were identified through the survey. ⋯ Trends also declined among the breast cancer survivors who were ≥70 years old, ≥40 years old, and in South region (all p < 0.05). Beneficiary's demographic and socioeconomic factors, comorbidity, smoking, and health status were associated with the likelihood of screening mammography utilization among female beneficiaries; however, such associations were limited among breast cancer survivors. Conclusions: In 2002-2016, the overall trends in mammography use among female Medicare beneficiaries and breast cancer survivors declined significantly. Variations in mammography use among different subgroups were observed.
-
Journal of women's health · May 2021
Intensive Approaches to Prenatal Care May Reduce Risk of Gestational Diabetes.
Objectives: To observe gestational diabetes mellitus (GDM) prevalence among participants receiving enhanced prenatal care through one of three care models: Birth Centers, Group Prenatal Care, and Maternity Care Homes. Materials and Methods: This study draws upon data collected from 2014 to 2017 as part of the Strong Start II evaluation and includes data from nearly 46,000 women enrolled across 27 awardees with more than 200 sites throughout the United States. Descriptive and statistical analyses utilized data from participant surveys completed upon entry to the program and a limited chart review. ⋯ Rates varied significantly and substantially by model. After adjusting for participant risk factors, we find that Birth Center participants of all races and ethnicities experienced significantly lower rates of GDM than women of the same race/ethnicity in Maternity Care Homes. Conclusions: The lower rates of gestational diabetes among women receiving Birth Center prenatal care suggest the need for further investigation of how prenatal care approaches can reduce GDM and address health disparities.
-
Journal of women's health · May 2021
Monogamy as a Barrier to Human Papillomavirus Catch-Up Vaccination.
Background: Human papillomavirus (HPV) is the most prevalent sexually transmitted infection (STI) in the United States. Although a vaccine to prevent HPV infection exists, only 53.7% of females 13-17 years of age were up-to-date on the HPV vaccination series in 2018. There is a catch-up period of vaccination for females 18-26 years of age that shows consistent underparticipation. ⋯ After adjusting for confounders, women who were in monogamous relationships were significantly less likely to have participated in HPV catch-up vaccination compared to women who were single and dating (adjusted odds ratio: 0.36, 95% confidence interval: 0.15, 0.87). Women in monogamous relationships had a lower average sexually transmitted disease (STD) risk perception compared to women who were single and dating (p < 0.0001). Conclusions: A decreased risk perception may present a barrier to participating in catch-up vaccination for monogamous women. Practitioners and the public health community should focus on communicating HPV risk to women in monogamous relationships, especially given the recently expanded age range for HPV vaccination.
-
Journal of women's health · May 2021
The Incidence of and Predictors for Severe Perineal Trauma and Intact Perineum in Women Having a Waterbirth in England: A Hospital-Based Study.
Background: To determine the incidence of and predictors for obstetric anal sphincter injuries (OASIS) and intact perineum in women giving birth in the water and compare with the general obstetric population. Materials and Methods: Data were retrospectively collected for women who had singleton cephalic presentation vaginal births in the water and the general obstetric population between August 2007 and December 2017. Results: We identified 1,007 women who had a waterbirth and 36,924 women from the general obstetric population. There was no significant difference in the incidence of OASIS between waterbirths and the general obstetric population (2.3% vs. 2.0%). Having a waterbirth was associated with a lower probability for an intact perineum (odds ratio [OR] = 0.83; confidence interval [95% CI]: 0.73-0.94) when compared with the general obstetric population (44.7% vs. 51.3%). ⋯ The risk for a higher degree of OASIS was associated with increased maternal age in the total sample (OR = 1.08; 95% CI: 1.06-1.11) and with a lower body mass index (BMI) at booking in multiparous women (OR = 0.96; 95% CI: 0.92-0.99). The risk for any type of perineal trauma was associated with increased maternal age in the total sample (OR = 1.10; 95% CI: 1.07-1.13) and with a lower BMI at booking in multiparous women (OR = 0.95; 95% CI: 0.91-0.99). Conclusions: We found that giving birth in the water reduced the chance of having an intact perineum. We have also shown that nulliparity, increased maternal age in all women, and a lower BMI at booking in multiparous were associated with OASIS and lower rates of intact perineum in waterbirths.
-
Journal of women's health · May 2021
Meta AnalysisMeta-Analysis Comparing Menstrual Regularity and Dysmenorrhea of Women Working Rotating Shifts and Fixed Day Shifts.
Background: Rotating shift work can cause abnormalities in their endocrine system. We conducted a meta-analysis to gain a better understanding of the differences between women working rotating shifts and fixed day shifts in menstrual regularity and dysmenorrhea. Methods: We searched for studies containing relevant keywords that were published between 1990 and 2019 in the Cochrane Library, EBSCO (including the Cumulative Index to Nursing and Allied Health Literature [CINAHL]), MEDLINE, and ProQuest. Data analysis was performed using the software package Comprehensive Meta-Analysis (CMA) Version 3.0. Results: A total of 14 studies met our selection criteria. ⋯ The pooled OR comparing the dysmenorrhea occurrence among women working rotating shifts and fixed day shifts was 1.51 (95% CI: 0.87-2.62, p = 0.139). The pooled OR of the women aged 30 years or older was 2.35 (95% CI: 1.63-3.39, p < 0.001); and for the women under 30 years old, the pooled OR was 1.20 (95% CI: 0.61-2.33, p = 0.601). Conclusions: The results indicate that regardless of age, women working rotating shifts were more likely to experience menstrual irregularity than those working fixed day shifts. With regard to dysmenorrhea, among women aged 30 years or older, those working rotating shifts were also more likely to experience dysmenorrhea than those working fixed day shifts.