Journal of women's health
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Journal of women's health · Feb 2021
How Implicit Bias Contributes to Racial Disparities in Maternal Morbidity and Mortality in the United States.
Over the past two decades, maternal mortality rates have declined around the world. In the United States, however, 700 women die each year as a result of pregnancy or delivery complications. This represents a 50% increase in the U. ⋯ Multiple studies suggest that implicit bias-defined as the attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner-is most likely a contributing factor to this alarming racial health disparity. The failure to recognize the pain of African American patients, regardless of whether it is conscious or unconscious, has the potential to affect the way obstetrician/gynecologists counsel patients about treatment options when it comes to chronic conditions, contraception, vaginal birth after cesarean delivery, and the management of fibroids. In this article, we will review implicit bias and the impact it can have on health care and health disparities.
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Journal of women's health · Jan 2021
Prescription Opioids and Patient Sex: A National Cross-Sectional Study.
Background: Surveillance data suggest that women are prescribed more opioid analgesics than men. It remains unclear whether these sex-related differences solely reflect the associations with other characteristics more prevalent among women (e.g., adverse socioeconomic and health status-related factors, and more contact with the health system). Materials and Methods: We examined the factors associated with opioid prescriptions and sex in a large, nationally representative U. ⋯ Conclusions: In this nationally representative sample, women received higher rates of prescription opioids, consistent with prior surveillance data. However, this relationship was attenuated with adjustment for sociodemographic and health status-related factors, and nonsignificant with adjustment for higher rates of nonnarcotic prescriptions among women. Higher opioid prescription rates in women may simply be reflective of these other factors, and the overall greater use of health care among women.
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Journal of women's health · Jan 2021
Night Shift Work and Fecundability in Late Reproductive-Aged African American Women.
Background: We estimated the association between night shift work and fecundability among African American women. Methods: Black Women's Health Study participants (n = 560) aged 30-45 years reported their history of night shift work in 2005. Time to pregnancy for all pregnancies resulting in a livebirth was reported in 2011. ⋯ The FR for women reporting night shift work with a frequency of ≥1 time per month and a duration of ≥2 years was 0.65 (95% CI: 0.47-0.94) relative to women reporting no shift work. We observed a decrease in fecundability associated with ever working night shifts (FR = 0.74, 95% CI: 0.56-0.96) among women aged ≥35 years, but not among younger women (FR = 1.33, 95% CI: 0.78-2.28). Conclusion: A history of working night shifts was associated with reduced fecundability among older reproductive-aged African American women attempting pregnancy.
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Journal of women's health · Jan 2021
Women's Report of Health Care Provider Advice and Gestational Weight Gain: A Systematic Review.
Background: Inadequate and excessive gestational weight gain (GWG) is associated with adverse health outcomes for mother and child. Health care providers are well positioned to help women achieve appropriate GWG. This systematic review examined associations between women's report of provider advice on GWG and women's compliance with the Institute of Medicine (IOM) GWG guidelines. Materials and Methods: In March 2019, PubMed, EMBASE, and Cochrane CENTRAL databases were searched. ⋯ The evidence examining associations of provider advice and women's compliance with guidelines is mixed and limited by methodological concerns. Future studies using more robust methods in diverse populations are needed to confirm the role of provider advice in optimizing GWG. Intervention studies are also necessary to increase the proportion of providers who accurately counsel their patients on appropriate GWG to improve health outcomes.