Journal of women's health
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Journal of women's health · Aug 2020
Violence As a Direct Cause of and Indirect Contributor to Maternal Death.
Background: Death during pregnancy and postpartum in the United States is an issue of urgent and growing concern. Mortality from obstetric-related causes is on the rise, and pregnancy-associated homicide remains a leading cause of death. It is unknown how the context in which women live contributes to their risk of obstetric or violent death during pregnancy and the postpartum period. ⋯ Poisson regression models estimated associations between violent crime and maternal death, adjusting for area-level socioeconomic conditions. Results: Both pregnancy-related mortality and pregnancy-associated homicide ratios were higher in states with higher rates of violent crime (relative risk [RR] = 1.05, 95% confidence interval [CI] = 1.01-1.12; RR = 1.17, 95% CI = 1.01-1.34, respectively). Conclusion: Broad population-wide violence prevention efforts may help reduce incidence of maternal mortality from both obstetric and violent causes.
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Journal of women's health · Aug 2020
Social Determinants of Health Associated with Mental Health Among U.S. Mothers with Children Aged 0-5 Years.
Background: Maternal mental illness is a significant public health problem during the perinatal period and beyond. Little is known about how social determinants of health (SDOH) affect maternal mental health. Materials and Methods: We used cross-sectional data from the 2016 to 2017 National Survey of Children's Health with 19,127 mothers of a nationally representative sample of U. S. children aged 0-5. ⋯ Postadjustment and mothers' poor mental health were significantly associated with age (adjusted odds ratio [AOR]: 18-20 years: 2.77, 95% confidence interval [CI]: 1.35-5.67; 21-24 years AOR: 2.14, 95% CI: 1.22-3.73, and 30-34 years AOR: 1.97, 95% CI: 1.13-3.43), U. S.-born status (AOR: 2.31, 95% CI: 1.48-3.63), poor physical health (AOR: 8.69, 95% CI: 5.81-13.02), having a child with a special health care need (AOR: 1.65, 95% CI: 1.03-2.64), experiencing food insecurity (afford enough food, yet, unhealthy [AOR: 2.74, 95% CI: 1.59-4.70] and sometimes/often not afford enough food [AOR: 3.20, 95% CI: 1.76-5.84]), and low social capital (AOR: 1.97, 95% CI: 1.04-3.73). Conclusion: Mothers with children aged 0-5 who had poor physical health and experienced food insecurity were at the greatest risk for poor mental health. Integrated perinatal and behavioral health models, screening, and referrals may help identify and treat mothers experiencing these issues.
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Journal of women's health · Aug 2020
Randomized Controlled Trial Multicenter StudyEffects of Estradiol Dose and Serum Estradiol Levels on Metabolic Measures in Early and Late Postmenopausal Women in the REPLENISH Trial.
Background: To identify the association of estradiol (E2) dose and serum E2 levels with metabolic measures in early (<6 years) compared with late (≥10 years) postmenopausal women from the REPLENISH trial. Material and Methods: This is a post hoc analysis of a multicenter randomized clinical trial in the United States. Four doses of TX-001HR, an oral combination of E2 and progesterone (P4), and placebo were tested. ⋯ Conclusion: E2 dose differentially affects metabolic measures among early compared with late postmenopausal women. No significant main effect of the serum P4 level was found. As the metabolic parameters studied are risk factors for cardiovascular events, these results support the timing hypothesis of E2 therapy and its cardiovascular benefits.
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Journal of women's health · Aug 2020
Disparities in Chronic Health Outcomes and Health Behaviors Between Lesbian and Heterosexual Adult Women in Pittsburgh: A Longitudinal Study.
Background: Compared to heterosexual women, lesbian women experience higher rates of many chronic diseases, including depression, obesity, hypertension, and diabetes. Lesbian women report higher rates of risky health behaviors such as hazardous drinking and cigarette smoking. However, little longitudinal research has been done to examine changes in disparities between lesbian and heterosexual adult women. ⋯ We found no differences in any other outcomes of interest. Conclusions: To our knowledge, this is the first study to report a resolution in obesity or depression disparities between lesbian and heterosexual women. Future research is necessary to determine if other disparities, such as respiratory conditions, appear over time and how lesbian women's health may continue to improve relative to heterosexual women and stem this public health inequity.