Women & Health

Carneiro, Márcia Mendonça

doi: 10.1080/03630242.2021.1970502pmid: 34517781

Escobar, María; Mosquera, Claudia; Hincapie, María Antonia; Nasner, Daniela; Carvajal, Javier Andrés; Maya, Juliana; De Mucio, Bremen; Sosa, Claudio Gerardo; Rojas, José Antonio

doi: 10.1080/03630242.2021.1959492pmid: 34328063

Maternal near-miss (MNM) is a maternal quality care indicator. The World Health Organization (WHO) defines it as a state in which a woman nearly dies but survives due to a complication during pregnancy, birth, or puerperium. The Latin American Federation of Obstetrics and Gynecology (FLASOG) and the Colombian National Health Institute (INS) established recommendations for the event’s epidemiological surveillance; nonetheless, the operational definitions of the cases are different. This retrospective study examined the approaches of FLASOG and INS versus the WHO approach (gold standard) for the assessment of MNM in a high obstetric risk unit. Patients admitted with at least one criterion of the WHO, FLASOG, or INS approach for the definition of MNM from March 2016 to March 2017 were included. Sensitivity, specificity, positive and negative predictive value (PPV, NPV) were evaluated, as well as the Receiver Operating Characteristics (ROC) curve of the FLASOG and INS. MNM classification compared to WHO system as reference. The results highlight that the WHO classification establishes very high boundaries for some of the diagnostic criteria and the lack of standardization of the MNM criteria among the different proposals in Latin America hinders the applicability in Colombia and other countries with a similar situation.

Dutra Ponce, Talita; León, Erika Gisseth; de Vargas, Divane

doi: 10.1080/03630242.2021.1965692pmid: 34488548

This study assesses the feasibility of a brief intervention among women with hazardous alcohol use at a primary health care service in Brazil. A two-arm randomized pilot study was carried out from July 2017 to January 2018 with 44 women aged 18 years or older with hazardous alcohol use. The intervention group completed a brief intervention in a single session lasting 20 to 30 minutes. The control group received five minutes of brief advice. Alcohol use was assessed by the Alcohol Use Disorders Identification Test (AUDIT), and the frequency and quantity of alcohol consumed in the previous month were assessed at baseline and the first and third months of follow-up in both groups. The AUDIT score was decreased in both groups at baseline (intervention group 12.89, control group 10.64), the 1st month (intervention group 12.78 p = .9; control group 7.9 p = .01) and the 3rd month (intervention group 10.11 p = .13; control group 7.09 p < .01). The intervention group continued using alcohol after the brief intervention, although the quantity of alcohol consumed was reduced compared with that at baseline (p < .01). Finally, the brief intervention delivered in a primary health care service in Brazil showed the potential to reduce women’s pattern of alcohol consumption.

Casalechi, Maíra; Coimbra, Bruna B.; Rocha, Débora M.; Carvalho, Fernanda R.; Clarizia, Alessandra D.; Assis, Wiviane A.; Aguiar, Regina Amelia Lopes Pessoa; Reis, Fernando M.

doi: 10.1080/03630242.2021.1965693pmid: 34376125

The aim of the present study was to investigate serum and urine levels of activin A in different moments of gestation, in primigravidae and in multigravidae, to understand whether these variables (biological sample and first gestation) affect activin A as a biomarker in pregnancy. We prospectively included 43 pairs of serum and urine samples from 25 women examined at different gestational ages (range 45 to 268 days). In the group of primigravidae (n = 16 samples from 9 participants), there was no significant change in serum activin A levels across gestation. Conversely, the group of multigravidae (n = 27 samples from 16 women) had higher serum activin A levels in the third trimester (2676 ± 840 pg/ml) compared to the first (583 ± 408 pg/ml) and second (1040 ± 384) trimesters (p = .025). Urine activin A concentrations did not differ between the two groups and did not change according to the gestation phase. There was no correlation between serum and urinary levels of activin A (r = 0.149, p = .359). These data suggest that activin A secretion may vary less during the first pregnancy, while urine activin A is unlikely to be a surrogate for the systemic levels of this hormone in pregnant women.

Vézina-Im, Lydi-Anne; Beaulieu, Dominique; Thompson, Debbe; Nicklas, Theresa A.; Baranowski, Tom

doi: 10.1080/03630242.2021.1966159pmid: 34392814

There is little information on the determinants of healthy sleep habits (HSH) among women of childbearing age (WOCBA). The objective was to identify WOCBA’s beliefs on HSH based on the Reasoned Action Approach. Thirty WOCBA (18–41 years) were randomly assigned to answer questions regarding one of three HSH: avoiding screen use in bed; avoiding caffeine, alcohol and cigarettes before bedtime; and having a regular bedtime and wake up time even on weekends. A content analysis was performed independently by two experts to identify the most important beliefs using a 75% cumulative frequency of mention. Participants reported that adopting the HSH would improve sleep, avoid side effects, help them relax before bedtime and make them feel like they were missing out on things. Adopting the HSH was associated with feeling relaxed and satisfied, but also qualified as unpleasant and abnormal. WOCBA mentioned their parents, partner, siblings and children would approve/disapprove if they adopted the HSH and were the most/least likely to adopt them. Barriers were having activities in the evening and social situations. Facilitating factors were putting their electronic devices away from bed, having alternatives and a regular schedule. These results can guide the development of interventions promoting HSH among WOCBA.

Kealy, David; Spidel, Alicia; Sandhu, Sharan

doi: 10.1080/03630242.2021.1968097pmid: 34404333

Although childhood maltreatment is known to elevate women’s risk for suicidal ideation and behavior, research concerning the mechanisms involved remains limited. While borderline personality disorder (BPD) has been implicated as mediating this association, such effects may differ depending on women’s age. The present study examined borderline personality features as a dispositional mediator of the relationship between childhood maltreatment and suicidality, with the moderating effect of age, among help-seeking women. A sample of 151 women attending community mental health clinics completed measures of childhood maltreatment, BPD features, suicidality, and psychological distress. Regression analyses tested moderated mediation, controlling for psychological distress across each path. Results indicated a significant interaction between childhood maltreatment and age in predicting borderline personality features, and significant moderated mediation in predicting suicidality. Borderline personality features significantly mediated the association between maltreatment and suicidality among younger––but not among older––women, with the mediation effect becoming stronger as women were younger. The findings indicate borderline personality features as particularly salient among young women in accounting for the maltreatment-suicidality association. Thus, interventions addressing BPD may warrant consideration for young women with suicidal ideation and history of childhood adversity.

Erbıyık, Halil Ibrahim; Palalıoğlu, Rabia Merve

doi: 10.1080/03630242.2021.1969612pmid: 34425732

Our purpose was to examine the level of knowledge and awareness about HPV (Human papillomavirus) infection, HPV vaccines, and cervical cancer of participants. This study was conducted at students and healthcare workers of Uskudar University as well as the healthcare workers of Umraniye Training and Research Hospital and patients admitted to the gynecology outpatient clinics. A 41-question survey was conducted that investigated the 700 participants’ demographic characteristics, HPV infection and cervical cancer status, and attitudes toward vaccination. 44.1% of the participants stated that they knew the cause of cervical cancer, 42.8% did not. 55.9% of those who went to regular doctor control, 38.5% of those who did not, knew that the HPV vaccine prevented warts and cervical cancer. 63.4% of men and 75.4% of women stated that they did not know whether the vaccine was effective against penile, anal and laryngeal cancer. All these were found to be statistically significant (P < .05). Lack of knowledge on vaccine protection, insufficient knowledge regarding HPV, prevalence of prejudices, and overall opinions about health are the most prevalent public health concerns in Turkey.

da Silva, Jordana Barbosa; Padilha, Juliana Falcão; Rocha Rodrigues, Ana Paula; Reis, Bianca Manzan; Driusso, Patricia

doi: 10.1080/03630242.2021.1970081pmid: 34433387

Urinary incontinence (UI) is directly correlated with the risk of death and negatively affects the quality of life of women. During the COVID-19 pandemic, women had to adapt their lifestyles to get accustomed to the restrictive measures. The present study aimed to investigate the association between lifestyle habits, anxiety, and depression symptoms during the COVID-19 pandemic between incontinent and continent women. Seventy-seven Brazilian participants aged >18 years were assessed through semi-structured telephonic interviews from July to August 2020. The interview included a questionnaire to investigate lifestyle habit changes and two questions from the King’s Health Questionnaire (KHQ) to identify the presence of UI and the Hospital Anxiety and Depression Scale (HADS). Women were allocated into two groups according to their answers to the KHQ: incontinent and continent. The chi-square test was applied, the significance level was set at 5%. Significant differences were found between groups regarding the habit to study and the time spent talking to relatives/friends (p < .05). Neither anxiety nor depression symptoms showed a significant association between the groups. It seems that women with UI changed specific lifestyle habits during the COVID-19 pandemic compared to continent women, while anxiety and depression symptoms did not differ between the groups.

Romano, Kelly A.; Heron, Kristin E.; Ebener, Deborah

doi: 10.1080/03630242.2021.1970082pmid: 34433381

The present study aimed to clarify existing research that has inconsistently shown that weight suppression (differences between individuals’ highest and current body weights) is associated with worse eating disorder (ED) behaviors and negative body image among women with lifetime EDs, by examining whether an understudied client-supported protective factor for ED pathology – self-acceptance – moderates these associations. Currently symptomatic women with lifetime EDs (N = 108) completed measures assessing self-acceptance and ED symptoms via an online survey. Moderated regressions examined whether self-acceptance moderated associations between weight suppression and both body image (weight/shape preoccupation, overvaluation, dissatisfaction) and ED behavior (dietary restraint, compensatory behaviors, binge eating) outcomes. Results indicated that weight suppression was associated with more severe negative body image and dietary restraint, but not compensatory behaviors or binge eating. In contrast, self-acceptance consistently emerged as a protective factor relative to all negative body image and ED behavior indices. This protective effect did not offset apparent risk factor associations between weight suppression, and negative body image and ED behavior outcomes. These results support further assessment of self-acceptance as an understudied protective factor for women’s ED symptoms and as a mechanism of change in EDs intervention research. Women’s weight suppression should be assessed during ED prevention initiatives.

Laufer, Avital; Shechory Bitton, Mally

doi: 10.1080/03630242.2021.1970083pmid: 34445941

Since December 2019, COVID-19, has affected many aspects of people’s lives – women and men alike. The current study examined gender differences due to the pandemic-resultant-lockdown in psychiatric symptomatology (depression, anxiety, and somatization), coping strategies, levels of resilience, and belief in a just world (BJW). One-thousand-and-sixty-five Israeli adults (309 men and 756 women) were interviewed online during the time Israel was under its first mandatory lockdown (March 2020). Results indicated higher levels of anxiety, depression, and somatization among women (t (635.238) = -8.86, p < .001; t (606.414) = -5.31, p < .001; t (743.856) = -6.80; p < .001; respectively). More women stopped working due to the lockdown (Z = 2.08, p = .037), and fewer women reported their jobs being considered „essential„ (Z = 2.76, p = .006).  Women were more concerned than men regarding the health of others (t (1063) = -2.71, p = .007) and regarding finances (t (1062) = -2.99, p = .003), but no gender differences were found regarding concerns for one’s own health.  Women used more coping tactics, both emotion-focused (t (1062) = -8.20, p < .001) and problem-focused (t (1062) = -5.21, p < .001), than did men. Higher levels of resilience (t (1057) = 3.11, p = .002) and BJW (t (1047) = 5.19, p < .001) were found among men than among women. Being a woman, younger age, use of emotion-focused coping, lower levels of resilience, worries about the economic situation, and worries about family members’ health explained 43% of the variance in psychological distress. No significant interactions between gender, study variables, and psychological distress were found. These findings indicate that gender differences in psychological reactions may be due to the heavier toll taken by the pandemic and lockdown on the lives of women rather than to gender differences in coping tactics or resilience.