Journal of women's health
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Journal of women's health · Dec 2021
The Impact of Mammography Screening Guideline Changes in a Universally Insured Population.
Background: The U. S. Preventive Services Task Force (USPSTF) modified breast cancer screening guidelines in November 2009. ⋯ Comparative analysis revealed no differences in impact between age groups, blacks and whites, or military dependents and active-duty/retirees. Conclusions: This study determined that the USPSTF guideline updates had a small, but immediate and lasting impact that was not different across age groups, beneficiary type, or race. No racial disparities in the proportion screened or in the impact of the guideline change were noted in our universally insured population.
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Journal of women's health · Dec 2021
Racial/Ethnic Differences in Socioeconomic Status and Medical Correlates of Trial of Labor After Cesarean and Vaginal Birth After Cesarean.
Objectives: Black and Latinx women have higher rates of trial of labor after cesarean (TOLAC) compared with White women, but lower rates of vaginal birth after cesarean (VBAC). This study examined potential racial/ethnic differences in correlates of TOLAC and VBAC. Materials and Methods: The analytic sample includes term, singleton hospital births to women with one prior cesarean in birth certificate data for 2016. ⋯ Overweight and obesity were associated with lower probability of VBAC, but the magnitude of this association was smaller for Black and Latinx women than for White women. Conclusions: More research is needed to elucidate the underlying decision-making processes that lead to these associations. Future work should focus on ensuring equity in access to VBAC-supportive providers and hospitals and fostering informed decision-making after a prior cesarean.
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Journal of women's health · Dec 2021
Pathways from Maternal Adverse Childhood Experiences to Substance Use in Pregnancy: Findings from the All Our Families Cohort.
Background: Exposure to adverse childhood experiences (ACEs) is a risk factor for maternal substance use in pregnancy, however, mechanisms by which maternal ACEs may influence substance use in pregnancy have not been fully explored. The current study examines the association between maternal ACEs and substance use in pregnancy (i.e., alcohol, smoking, and drug use) and explores mediating pathways. Methods: A community sample of 1,994 women as part of the All Our Families Cohort were recruited in pregnancy in Calgary, Canada, between 2008 and 2011. ⋯ The direct effect of maternal ACEs on maternal substance in pregnancy remained significant after accounting for the indirect effects (β = 0.22, 95% CI = 0.15-0.29, p < 0.001). Conclusions: Exposure to adversity in childhood can lead to socioeconomic and mental health difficulties that increase risk for substance use in pregnancy. Addressing these difficulties before pregnancy may help to reduce the potential for substance use in pregnancy.
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Journal of women's health · Dec 2021
Sex and Gender-Related Differences in COVID-19 Diagnoses and SARS-CoV-2 Testing Practices During the First Wave of the Pandemic: The Dutch Lifelines COVID-19 Cohort Study.
Background: Although sex differences are described in Coronavirus Disease 2019 (COVID-19) diagnoses and testing, many studies neglect possible gender-related influences. Additionally, research is often performed in clinical populations, while most COVID-19 patients are not hospitalized. Therefore, we investigated associations between sex and gender-related variables, and COVID-19 diagnoses and testing practices in a large general population cohort during the first wave of the pandemic when testing capacity was limited. ⋯ Conclusions: We found no sex differences in COVID-19 diagnoses and testing in the general population. Among health care workers, a male preponderance in COVID-19 diagnoses and testing was observed. This could be explained by more pronounced COVID-19 symptoms in males or by gender inequities.
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Journal of women's health · Dec 2021
Assessing Perinatal Insurance Coverage at Time of Death: A National Survey of Maternal Mortality Review Committees.
Background: The objective of this study is to understand the proportion of Maternal Mortality Review Committees (MMRCs) that investigate insurance status at the time of maternal deaths occurring during three time periods: pregnancy, childbirth, and up to 12 months postpartum. Materials and Methods: We conducted a national survey of MMRCs between July and September of 2020. Jurisdictions were e-mailed a 17-item questionnaire that addressed whether the MMRCs document insurance status for each of the three time periods as well as facilitators and barriers to doing so. ⋯ Conclusions: MMRCs primarily focus on identifying insurance status during pregnancy and at childbirth. Information on insurance status in the postpartum period is more difficult to ascertain and less often determined. The findings from this work should inform efforts for MMRCs to improve data collection on insurance status and ultimately improve the capacity of MMRCs to identify targeted insurance policy reforms that could help reduce maternal mortality.