Journal of women's health
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Journal of women's health · Nov 2022
Severe Maternal Morbidity and 30-Day Postpartum Readmission in the Military Health System.
Background: The Centers for Disease Control and Prevention (CDC) cite an increase of 200% in severe maternal morbidity (SMM) in the United States from 1993 to 2014. This study aims to identify the incidence of SMM in the Military Health System (MHS), along with factors that may be correlated with the risk of SMM and 30-day readmissions among universally insured, ethnically diverse women who delivered in military treatment facilities (MTFs). Methods: Using the MHS Data Repository, we conducted a cross-sectional study on all women 15 to 54 years of age who delivered at a MTF during fiscal years 2016 to 2018. ⋯ Conclusions: The low rate of SMM in this population, compared with national data, is a significant finding. The overall 30-day readmission rate in this population is also lower than what has been reported in prior studies. In this study population, women 30-34 are also at higher risk for readmission, which is an area for further study to assess for potential risk factors and underlying causes that may be impacting the higher rates in this age group.
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Journal of women's health · Nov 2022
Association of Prepregnancy Substance Use and Substance Use Disorders with Pregnancy Timing and Intention.
Background: Limited research exists on the association between substance use disorders (SUDs) and dimensions of pregnancy intention. This study sought to examine the independent relationships between prepregnancy substance use and SUDs with pregnancy timing and intentions. Materials and Methods: Secondary analysis of data from three prenatal care sites in Connecticut, Massachusetts, and Michigan, 2016-2017. ⋯ After adjustment, any prepregnancy substance use was associated with a reduced likelihood of a well-timed (aPR 0.85; 95% CI: 0.77-0.93) and intended (aPR 0.80; 95% CI: 0.72-0.89) pregnancy; similarly, any SUD was associated with a reduced likelihood of a well-timed (aPR 0.66; 95% CI: 0.55-0.80) and intended (aPR 0.79; 95% CI: 0.67-0.93) pregnancy. Conclusions: Women with prepregnancy substance use or SUD have decreased prevalence of well-timed and intended pregnancies. Greater efforts are needed to address substance use and family planning in routine, well-woman, prenatal, and postpartum care.
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Journal of women's health · Nov 2022
ReviewA Scoping Review of Published Intimate Partner Violence Curricula for Medical Trainees.
Intimate partner violence (IPV) affects many, and health care has the potential to provide a safe space for individuals experiencing IPV. However, physicians cite lack of time and education as barriers. The aim of this study is to complete a review of published IPV curricula in medical school, residency training, and postresidency training. ⋯ There was great variation in the methods of assessing effectiveness of IPV curricula. Published IPV curricula are varied, without consistent validated tools for assessing efficacy. Future initiatives to establish a standard of competency for medical students regarding IPV, including a standard curriculum, may better ensure that physicians are capable of identifying and caring for individuals who have experienced IPV.
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Journal of women's health · Nov 2022
Association of ST2 Elevation in the Early Third Trimester with Heart Failure and Pre-Eclampsia in the Peripartum Period.
Background: Although high-risk pregnancies are common in clinical practice, there are limited data on the association of soluble suppression of tumorigenicity 2 (ST2) with pregnancy-related complications. The rates of maternal complications, including heart failure (HF) during the peripartum period, were evaluated according to the ST2 level. Materials and Methods: A single-center retrospective cohort study included and stratified 259 women with high-risk pregnancies in their early third trimester according to the ST2 levels. ⋯ Those with ST2 ≥ 35 ng/mL were more likely to have the secondary endpoints (40.6% vs. 5.8%, p < 0.001). After adjustment, ST2 ≥ 35 ng/mL was associated with a six-fold occurrence of peripartum HF and a four-fold increase in the secondary endpoints. Conclusions: In women with high-risk pregnancies, peripartum HF and pre-eclampsia were not uncommon, and ST2 ≥ 35 ng/mL in the third trimester was independently related to maternal complications.
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Journal of women's health · Nov 2022
A Multidisciplinary Pelvic Pain Clinic: Integrated Health Psychology in a Specialty Care Setting.
Purpose: Chronic pelvic pain (CPP) is a relatively common health problem, impacting around 25 million women globally. This study details the development of a multidisciplinary women's CPP clinic at a major U. S. academic medical center, and examines associations between mood, pain symptoms, and trauma history. ⋯ Many reported pain duration of >2 years. Conclusions: Study findings related to mental health and trauma support a multidisciplinary CPP approach that includes a clinical health psychology component. Future research may investigate the therapeutic processes that apply to this population to identify targeted efficacious interventions.