Journal of women's health
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Journal of women's health · Feb 2022
Predictive Performance of the International Takotsubo Registry Score in the Diagnosis of Takotsubo Syndrome Among Women with Non-ST Segment Elevation Myocardial Infarction.
Background: The International Takotsubo Registry (InterTAK) score was developed to assess the probability of takotsubo syndrome (TTS) and to distinguish it from acute coronary syndrome, which has a similar clinical presentation. A European Society of Cardiology (ESC) consensus statement suggests invasive coronary angiography may be deferred in patients with non-ST segment elevation myocardial infarction (NSTEMI) and high probability of TTS. We aimed to determine the predictive performance of the InterTAK score in a real-world population of NSTEMIs. ⋯ The InterTAK score had an area under the receiver operating characteristics curve (AUC) of 0.82 (95% confidence interval, 0.75-0.88) for TTS, with 21% sensitivity and 98% specificity at score >70. Conclusions: In this real-world sample of consecutive female NSTEMI patients, the InterTAK score was predictive of TTS but a high score was rare, and use of the score to obviate invasive angiography could have resulted in delay of revascularization and missed diagnosis of SCAD for a small number of patients. The InterTAK score should be used in conjunction with other clinical variables for angiographic referral.
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Journal of women's health · Feb 2022
A Field Placement Approach to Enhance State and Local Capacity for Opioid-Related Issues Affecting Pregnant and Postpartum People and Infants Prenatally Exposed to Opioids and Other Substances.
Opioid use disorder (OUD) poses a significant public health concern impacting maternal and infant outcomes. In 2018, the Centers for Disease Control and Prevention (CDC) partnered with the Association of State and Territorial Health Officials (ASTHO) to develop the Opioid use disorder, Maternal outcomes, and Neonatal abstinence syndrome Initiative Learning Community (OMNI LC) to identify and disseminate best practices and strategies for implementing systems-level changes in state health departments to address OUD affecting pregnant and postpartum persons and infants prenatally exposed to opioids. ⋯ Written responses from the participating OMNI LC states on these implementation outcome measures were analyzed to (1) highlight key strategies used by field placement staff, (2) assess the implementation of the OMNI LC field placement approach within the context of implementation science, and (3) identify implementation barriers. This report describes the implementation of a temporary field placement approach and suggests that this approach could be replicated to enhance state and local capacity to respond to the opioid crisis or other high-consequence events.
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Journal of women's health · Feb 2022
Are Experiences of Racial Discrimination Associated with Postpartum Depressive Symptoms? A Multistate Analysis of Pregnancy Risk Assessment Monitoring System Data.
Background: Postpartum depression (PPD) is a serious public health crisis disproportionately affecting women of color. We examine whether interpersonal racial discrimination is associated with higher odds of postpartum depressive symptoms (PPDS) among women of color and how it may vary by race/ethnicity and maternal educational attainment. ⋯ Among women of color with at least some college education, the higher odds of PPDS associated with racial discrimination were greater than threefold, and for women with less than a high school education were less than twofold. Conclusion: Addressing risk factors for PPD, including racial discrimination, may inform strategies to reduce racial disparities in maternal mental health.