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Williams N, Griffin G, Wall M, Bradfield Z. The sexual and reproductive health knowledge of women in Australia: A scoping review. Health Promot J Austr 2024. [PMID: 39097983 DOI: 10.1002/hpja.908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 05/28/2024] [Accepted: 07/18/2024] [Indexed: 08/06/2024] Open
Abstract
ISSUE ADDRESSED Sexual and reproductive health (SRH) knowledge influences health literacy and promotes positive health behaviours. This scoping review explores the SRH knowledge of women in Australia and reports on knowledge assessment, ways of learning, enablers and barriers, and interventions to improve knowledge. METHODS Seven databases were searched for eligible articles published in English between 2012 and 2022. RESULTS Eighty-five sources were included for analysis. Data were mapped by knowledge topic and population group and charted against four review objectives. Assessment of knowledge was the primary focus in 59% of sources. Two sources used a validated knowledge assessment tool. Knowledge was assessed using self-assessment, a measurement of correctness, or both. Women learnt about SRH through a range of sources, including healthcare providers, peers, family, internet, and school. Enablers and barriers spanned information content, delivery, timing, accessibility, interactions with those providing information, cultural and gendered norms, pre-migration experiences, and functional health literacy. Nine sources reported on interventions to facilitate SRH knowledge. CONCLUSIONS This review identified topics, population groups, and gaps in assessment of SRH knowledge of women in Australia. Overall, the measurement of women's SRH knowledge is largely conducted using unvalidated tools focusing on specific topics. SO WHAT?: It is recommended a validated tool be developed to comprehensively assess the SRH knowledge of women in Australia allowing for intersectional population analysis and exploration of knowledge conceptualisation. This would enable assessment of interventions aiming to improve SRH knowledge thereby facilitating improved health literacy and outcomes.
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Affiliation(s)
- Natalie Williams
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
- School of Nursing, Curtin University, Bentley, Western Australia, Australia
| | - Georgia Griffin
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
| | - Megan Wall
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
| | - Zoe Bradfield
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
- School of Nursing, Curtin University, Bentley, Western Australia, Australia
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Haines AJ, Mackenzie L, Honey A, Middleton PG. Occupations and balance during the transition to motherhood with a lifetime chronic illness: A scoping review examining cystic fibrosis, asthma, and Type-1 diabetes. Aust Occup Ther J 2023; 70:730-744. [PMID: 37524324 DOI: 10.1111/1440-1630.12899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 06/30/2023] [Accepted: 07/08/2023] [Indexed: 08/02/2023]
Abstract
INTRODUCTION Throughout the transition to motherhood, changes are experienced across a woman's physical, mental, social, and occupational self. Maternal chronic illness adds the complexity of increased healthcare needs and navigating a high-risk, medicalised pregnancy, birth, and post-natal period. Literature concerning motherhood transitions in chronic illness generally focusses on the mother's medical health and pregnancy outcomes; little is known about the impacts on women's occupations, balance, and quality of life. Understanding these issues may help support women in a more tailored and holistic way. OBJECTIVE This scoping review aims to gather, analyse, and synthesise existing empirical research on occupational engagement and occupational balance as they impact on wellbeing and quality of life in women with a lifetime chronic illness before and during pregnancy and in early motherhood. METHOD The review follows the nine-stage framework described in the Joanna Briggs Institute Manual for Evidence Synthesis (2020). Five databases were searched: Embase, Medline, PsycINFO, CINAHL, Scopus, and OT Seeker. Data were extracted and examined via content analysis, described in narrative synthesis, summarised into a conceptual framework, and tabulated. FINDINGS A total of 8,655 papers were discovered on initial search. Following title and abstract screening, 220 full-text studies were assessed for eligibility, and 46 papers were finally included. Analysis generated four major themes: The Disrupted Transition Journey; Adaptation, Compromise and Choice; Outcomes; and Drawing on What's Available. The themes were conceptualised into a framework to explain how women sought to balance motherhood and illness-related occupations. Adequate access to information, social support, expert care, and financial resources improved both quality of life and healthcare compliance. CONCLUSION Findings of this scoping review deepen the understanding of occupational balance during the transition to motherhood in the context of lifetime chronic illness. Healthcare providers and supportive family and friends can use this knowledge to adapt their approach to assisting women with chronic illness on the motherhood journey. These findings may also inform further inquiry into the scope of occupational therapy practice with this population.
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Affiliation(s)
- Alena Jane Haines
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Lynette Mackenzie
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Anne Honey
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Peter G Middleton
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Centre for Investigation and Treatment of Respiratory Infections in Children and Adults, Westmead Campus, Westmead, New South Wales, Australia
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Matthiesson HK, Berdoukas V, Briganti EM. Experiences, Knowledge Gaps and Information Needs of Women in Australia with Transfusion Dependent Thalassaemia in Regard to Fertility and Pregnancy. Matern Child Health J 2023; 27:1961-1967. [PMID: 37273135 PMCID: PMC10564654 DOI: 10.1007/s10995-023-03683-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Transfusion dependent β-thalassaemia can have significant effects on fertility and is also associated with significant risks in pregnancy. However, little is known about the perspectives of women living with the condition with regards to reproductive issues. The aim of this study was to assess the experience, knowledge and information needs of Australian women living with transfusion dependent β-thalassaemia in relation to fertility and pregnancy. METHODS A cross sectional study using an online anonymous survey, self-administered through REDCap, addressing key issues related to the experience, knowledge and information needs of women with transfusion dependent β-thalassaemia. Descriptive and inferential analysis was conducted using STATA. RESULTS Sixty participants were included in the analysis. Two-thirds of sexually active, pre-menopausal women were using contraception. Just under half of the participants who were sexually active had children and half had required some form of assisted reproductive technology to achieve a pregnancy. Less than half identified the importance of contraception as part of ensuring optimised pre-pregnancy care, and less than half had accessed pre-pregnancy care. Although there was good understanding of the increased risk of infertility and pregnancy complications, the specific risks and causes of these risks were poorly understood. Around half of the participants indicated they wanted more information on these medical issues. CONCLUSIONS FOR PRACTICE Our study demonstrated significant concerns and knowledge gaps in Australian women with transfusion dependent β-thalassaemia with regards to disease-specific issues related to fertility and pregnancy, and a desire for related patient information.
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Affiliation(s)
- Hannah K Matthiesson
- Department of Epidemiology and Preventive Medicine, School of Public Health, Monash University, 553 St Kilda Road, Melbourne, VIC 3004 Australia
| | - Vasili Berdoukas
- Department of Pediatrics, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA 90033 USA
| | - Esther M Briganti
- Department of Epidemiology and Preventive Medicine, School of Public Health, Monash University, 553 St Kilda Road, Melbourne, VIC 3004 Australia
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Bizuayehu HM, Harris ML, Chojenta C, Cavenagh D, Forder PM, Loxton D. Patterns of Labour Interventions and Associated Maternal Biopsychosocial Factors in Australia: a Path Analysis. Reprod Sci 2023; 30:2767-2779. [PMID: 36973581 PMCID: PMC10480095 DOI: 10.1007/s43032-023-01219-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/09/2023] [Indexed: 03/29/2023]
Abstract
In Australia, nearly half of births involve labour interventions. Prior research in this area has relied on cross-sectional and administrative health data and has not considered biopsychosocial factors. The current study examined direct and indirect associations between biopsychosocial factors and labour interventions using 19 years of population-based prospective data. The study included singleton babies among primiparous women of the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health. Data from 5459 women who started labour were analysed using path analysis. 42.2% of babies were born without intervention (episiotomy, instrumental, or caesarean delivery): Thirty-seven percent reported vaginal birth with episiotomy and instrumental birth interventions, 18% reported an unplanned caesarean section without episiotomy and/or instrumental interventions, and 3% reported unplanned caesarean section after episiotomy and/or instrumental interventions. Vaginal births with episiotomy and/or instrumental interventions were more likely among women with chronic hypertension (RRR(95%-CI):1.50(1.12-2.01)), a perceived length of labour of more than 36 h (RRR(95%-CI):1.86(1.45-2.39)), private health insurance (RRR(95%-CI):1.61(1.41-1.85)) and induced labour (RRR(95%-CI):1.69(1.46-1.94)). Risk factors of unplanned caesarean section without episiotomy and/or instrumental birth intervention included being overweight (RRR(95%-CI):1.30(1.07-1.58)) or obese prepregnancy (RRR(95%-CI):1.63(1.28-2.08)), aged ≥ 35 years (RRR(95%-CI):1.87(1.46-2.41)), having short stature (< 154 cm) (RRR(95%-CI):1.68(1.16-2.42)), a perceived length of labour of more than 36 h (RRR(95%-CI):3.26(2.50-4.24)), private health insurance (RRR(95%-CI):1.38(1.17-1.64)), and induced labour (RRR(95%-CI):2.56(2.16-3.05)). Prevention and management of hypertension, diabetes, and obesity during preconception and/or antenatal care are keys for reducing labour interventions and strengthening the evidence-base around delivery of best practice obstetric care.
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Affiliation(s)
- Habtamu Mellie Bizuayehu
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, Centre for Women's Health Research, The University of Newcastle, Newcastle, Australia.
- Descriptive Epidemiology, Cancer Council Queensland, Brisbane, Australia.
- Department of Public Health, Debre Markos University, Debre Markos, Ethiopia.
- The First Nations Cancer & Wellbeing Research (FNCWR) Program, School of Public Health, The University of Queensland, Brisbane, Australia.
| | - Melissa L Harris
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, Centre for Women's Health Research, The University of Newcastle, Newcastle, Australia
| | - Catherine Chojenta
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, Centre for Women's Health Research, The University of Newcastle, Newcastle, Australia
| | - Dominic Cavenagh
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, Centre for Women's Health Research, The University of Newcastle, Newcastle, Australia
| | - Peta M Forder
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, Centre for Women's Health Research, The University of Newcastle, Newcastle, Australia
| | - Deborah Loxton
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, Centre for Women's Health Research, The University of Newcastle, Newcastle, Australia
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Harris ML, Egan N, Forder PM, Bateson D, Loxton D. Patterns of contraceptive use through later reproductive years: A cohort study of Australian women with chronic disease. PLoS One 2023; 18:e0268872. [PMID: 37134070 PMCID: PMC10155986 DOI: 10.1371/journal.pone.0268872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 04/11/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Pregnancies among women with chronic disease are associated with poor maternal and fetal outcomes. There is a need to understand how women use or don't use contraception across their reproductive years to better inform the development of preconception care strategies to reduce high risk unintended pregnancies, including among women of older reproductive age. However, there is a lack of high-quality longitudinal evidence to inform such strategies. We examined patterns of contraceptive use among a population-based cohort of reproductive aged women and investigated how chronic disease influenced contraceptive use over time. METHODS AND FINDINGS Contraceptive patterns from 8,030 women of reproductive age from the Australian Longitudinal Study on Women's Health (1973-78 cohort), who were at potential risk of an unintended pregnancy were identified using latent transition analysis. Multinomial mixed-effect logistic regression models were used to evaluate the relationship between contraceptive combinations and chronic disease. Contraception non-use increased between 2006 and 2018 but was similar between women with and without chronic disease (13.6% vs. 12.7% among women aged 40-45 years in 2018). When specific contraceptive use patterns were examined over time, differences were found for women with autoinflammatory diseases only. These women had increased odds of using condom and natural methods (OR = 1.20, 95% CI = 1.00, 1.44), and sterilisation and other methods (OR = 1.61, 95% CI = 1.08, 2.39) or no contraception (OR = 1.32, 95% CI = 1.04, 1.66), compared to women without chronic disease using short-acting methods and condoms. CONCLUSION Potential gaps in the provision of appropriate contraceptive access and care exist for women with chronic disease, particularly for women diagnosed with autoinflammatory conditions. Development of national guidelines as well as a clear coordinated contraceptive strategy that begins in adolescence and is regularly reviewed during care management through their main reproductive years and into perimenopause is required to increase support for, and agency among, women with chronic disease.
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Affiliation(s)
- Melissa L Harris
- Centre for Women's Health Research, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Nicholas Egan
- Centre for Women's Health Research, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Peta M Forder
- Centre for Women's Health Research, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Deborah Bateson
- Family Planning NSW, Ashfield, New South Wales, Australia
- Discipline of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Deborah Loxton
- Centre for Women's Health Research, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
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Harris ML, Egan N, Forder PM, Bateson D, Sverdlov AL, Murphy VE, Loxton D. Patterns of contraceptive use among young Australian women with chronic disease: findings from a prospective cohort study. Reprod Health 2022; 19:111. [PMID: 35525995 PMCID: PMC9078003 DOI: 10.1186/s12978-022-01413-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Given chronic disease is increasing among young women and unintended pregnancies among these women are associated with poor maternal and fetal outcomes, these women would benefit from effective preconception care. However, there is a lack of understanding of how these women use or don't use contraception to inform such interventions. This study examined patterns of contraceptive use among an Australian cohort of young women and investigated the influence of chronic disease on contraceptive use over time. METHODS Using data from 15,244 young women from the Australian Longitudinal Study on Women's Health (born 1989-1995), latent transition analysis was performed to identify distinct contraceptive patterns among women who were at risk of an unintended pregnancy. Multinomial mixed-effect models were used to evaluate the relationship between contraceptive combinations and chronic disease. RESULTS Contraceptive use for women with cardiac and autoinflammatory diseases differed to women without chronic disease over the observation period. Compared to women without chronic disease using the pill, women with cardiac disease had double the odds of using 'other' contraception and condoms (OR = 2.20, 95% CI 1.34, 3.59) and a modest increase in the odds of using the combined oral contraceptive pill and condoms (OR = 1.39, 95% CI 1.03, 1.89). Compared to women without chronic disease who used the pill, women with autoinflammatory disease had increased odds of using LARC and condoms (OR = 1.58, 95% CI 1.04, 2.41), using 'other' contraception and condoms (OR = 1.69, 95% CI 1.11, 2.57), and using the combined oral contraceptive pill and condoms (OR = 1.38, 95% CI 1.09, 1.75). No differences in contraceptive patterns over the observation period were found for women with asthma or diabetes when compared to women without chronic disease. CONCLUSION The findings identified a need for effective contraceptive counselling as part of routine chronic disease care and improved communication between health care providers and women with chronic disease to improve young women's contraceptive knowledge and agency in contraceptive choice, particularly for those with cardiac or autoinflammatory conditions. This may be the key to reducing high-risk unintended pregnancies among this vulnerable population.
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Affiliation(s)
- Melissa L Harris
- Centre for Women's Health Research, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW, Australia.
- Hunter Medical Research Institute, Newcastle, NSW, Australia.
| | - Nicholas Egan
- Centre for Women's Health Research, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Peta M Forder
- Centre for Women's Health Research, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Deborah Bateson
- Family Planning NSW, Ashfield, NSW, Australia
- Discipline of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Aaron L Sverdlov
- Hunter Medical Research Institute, Newcastle, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
- Cardiovascular Department, John Hunter Hospital, Hunter New England Local Health District, Newcastle, NSW, Australia
| | - Vanessa E Murphy
- Hunter Medical Research Institute, Newcastle, NSW, Australia
- Priority Research Centre for Healthy Lungs, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW, Australia
| | - Deborah Loxton
- Centre for Women's Health Research, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
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Cortés AE, Realpe O, Fuerte MI, Tello PA, Becerra CE. Contraceptives, chronic illness, pregnancy and health care costs in one health insurance in Colombia. Rev Salud Publica (Bogota) 2022. [DOI: 10.15446/rsap.v24n2.89316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetive Evaluation of the impact of pregnancy on women with a high disease burden, especially with Chronic Non-Communicable Diseases (CNCD) in the costs of a health insurer.
Materials and Methods Retrospective costing study conducted at Famisanar EPS between 2016 and 2018. We used multiple linear regression models to evaluate; the overall costs were calculated for each patient. The insurer's perspective was taken into account for the analysis.
Results The study universe was made up of 458 249 women of childbearing age affiliated to Famisanar EPS between 15 and 49 years, of which 24 030 (5.2%) women have some relationship with the CNCD, of these, 2 454 (10.2%) went to childbirth and caesarean section. We had determined the costs of pregnancy healthy´s women in U$200.41 and pregnancy CNCD´s women U$519.95 (97.5%) in terms of the costs for the complication’s gestation care. Using multinomial regression, we compared the pregnancy with CNCD with the other groups of women. We did not observe any significant differences in ingress and zone. However, we observe signicant differences in the age.
Conclusion Pre-existing CNCD in pregnant women can lead to the use of additional resources in the health system. CNCD in society represent a severe burden for a health system due to high costs and especially when talking about women who have an CNCD and are in pregnant. The study also indicates that female infertility treatments are important for cost containment in health systems.
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Shteinberg M, Taylor-Cousar JL, Durieu I, Cohen-Cymberknoh M. "Fertility and Pregnancy in Cystic fibrosis". Chest 2021; 160:2051-2060. [PMID: 34284004 DOI: 10.1016/j.chest.2021.07.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/22/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022] Open
Abstract
People with Cystic fibrosis (pwCF) have experienced increased survival and wellbeing in recent decades, such that more than half of those living with CF are adults. Consequently, sexual and reproductive health is increasingly important for pwCF as many are considering parenthood. Most men and some women with CF (wwCF) will have reduced fertility, which in both sexes is multifactorial. However, unplanned pregnancies in women are not rare, and contraception and its interaction with CF complications need to be addressed by the CF team. Reduced fertility may be overcome in most pwCF through use of assisted reproductive technologies; however, the risk of having offspring with CF must be considered. Most wwCF will have normal pregnancies, but premature birth is common especially in the setting of reduced lung function and CF related diabetes (CFRD); optimization of treatment is recommended during pregnancy planning. Parenting imposes an increased burden on pwCF, with the challenges of caring for the newborn, postpartum physiologic changes and maintaining CF treatments. Most drugs used to treat CF are considered safe in pregnancy and lactation, but exceptions need to be acknowledged, including the limited data regarding safety of CF transmembrane conductance regulator (CFTR) modulators during conception, pregnancy, and lactation. As most pwCF are eligible for highly effective CFTR modulators, fertility, contraception, and pregnancy in people with CF is changing. Prospective studies regarding these issues in people treated with CFTR modulators are paramount to provide evidence-based guidance for management in the current era of CF care.
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Affiliation(s)
- Michal Shteinberg
- Pulmonology Institute and CF Center, Carmel Medical Center and the Technion-Israel Institute of Technology, Haifa, Israel.
| | - Jennifer L Taylor-Cousar
- Divisions of Pulmonary, Critical Care and Sleep Medicine and Pediatric Pulmonary Medicine, National Jewish Health, Denver, CO
| | - Isabelle Durieu
- RESearch on HealthcAre PErformance (RESHAPE), Lyon University, Lyon, and Hospices Civils de Lyon, Lyon Sud Hospital, Cystic Fibrosis Center, Lyon, France
| | - Malena Cohen-Cymberknoh
- Pediatric Pulmonology Unit and Cystic Fibrosis Center, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
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Flanagan EK, Richmond J, Thompson AJ, Desmond PV, Bell SJ. Addressing pregnancy-related concerns in women with inflammatory bowel disease: Insights from the patient's perspective. JGH OPEN 2021; 5:28-33. [PMID: 33490610 PMCID: PMC7812482 DOI: 10.1002/jgh3.12442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 10/07/2020] [Accepted: 10/18/2020] [Indexed: 12/17/2022]
Abstract
Background and Aim Therapeutic options for inflammatory bowel disease (IBD) have expanded, as has the use of IBD medications in women during the reproductive period. However, no qualitative data exist that examine the pregnancy‐related concerns of women with IBD in the current era of widespread immunomodulator and biologic use. Hence, we aimed to explore in detail the impact of IBD on pregnancy from the patient's perspective. Methods This qualitative study used semistructured interviews to explore participants' experiences regarding IBD and pregnancy until no new themes emerged. Key themes were identified using thematic analysis. Results Fifteen women with IBD were interviewed. The majority of participants reported lingering concerns regarding their IBD medications, despite advice from their gastroenterologist that the drugs were considered safe in pregnancy. Participants more often reported medication‐related fears, such as potential negative effects on their child's immune system, than concerns regarding the effect of the disease itself on their pregnancy outcomes. A common theme was a perceived lack of knowledge among non‐IBD clinicians regarding IBD medications during pregnancy, which augmented pre‐existing anxiety. Conclusions This study is the first of its kind to provide an in‐depth assessment of female patients' perspectives of IBD in relation to conception, pregnancy, and caring for offspring. In particular, this research characterizes the unique fears and persisting anxieties regarding IBD medications in pregnancy. The study has unearthed important insights into the specific concerns and support needs of women with IBD in order to facilitate nonjudgmental counseling designed around patient concerns and beliefs.
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Affiliation(s)
- Emma K Flanagan
- Department of Gastroenterology St Vincent's Hospital Melbourne Victoria Australia
| | - Jacqui Richmond
- Disease Elimination The Burnet Institute Melbourne Victoria Australia.,The Australian Research Centre in Sex, Health and Society La Trobe University Melbourne Victoria Australia
| | - Alexander J Thompson
- Department of Gastroenterology St Vincent's Hospital Melbourne Victoria Australia
| | - Paul V Desmond
- Department of Gastroenterology St Vincent's Hospital Melbourne Victoria Australia
| | - Sally J Bell
- Department of Gastroenterology St Vincent's Hospital Melbourne Victoria Australia.,Department of Gastroenterology, Monash Health Melbourne Victoria Australia
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Papalia N, Metcalfe A. Can we estimate the prevalence of co-morbidities from delivery hospitalisation records? Paediatr Perinat Epidemiol 2020; 34:386-387. [PMID: 32026487 DOI: 10.1111/ppe.12625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 11/17/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Nicholas Papalia
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB, Canada
| | - Amy Metcalfe
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB, Canada.,Department of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
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Litt JS, Tiemeier H. Positive health: rebranding an old package with a new name? Pediatr Res 2019; 86:688-689. [PMID: 31200388 DOI: 10.1038/s41390-019-0454-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 05/29/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Jonathan S Litt
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA. .,Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Henning Tiemeier
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, USA
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Holton S, Fisher J, Button B, Williams E, Wilson J. Childbearing concerns, information needs and preferences of women with cystic fibrosis: An online discussion group. SEXUAL & REPRODUCTIVE HEALTHCARE 2019; 19:31-35. [DOI: 10.1016/j.srhc.2018.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 11/27/2018] [Indexed: 01/13/2023]
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Young K, Kirkman M, Holton S, Rowe H, Fisher J. Fertility experiences in women reporting endometriosis: findings from the Understanding Fertility Management in Contemporary Australia survey. EUR J CONTRACEP REPR 2018; 23:434-440. [DOI: 10.1080/13625187.2018.1539163] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Kate Young
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Maggie Kirkman
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Sara Holton
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Heather Rowe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Holton S, Papanikolaou V, Hammarberg K, Rowe H, Kirkman M, Jordan L, McNamee K, Bayly C, McBain J, Sinnott V, Fisher J. Fertility management experiences of women with polycystic ovary syndrome in Australia. EUR J CONTRACEP REPR 2018; 23:282-287. [DOI: 10.1080/13625187.2018.1483020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Sara Holton
- Jean Hailes Research Unit, Monash University, Melbourne, VIC, Australia
| | | | - Karin Hammarberg
- Jean Hailes Research Unit, Monash University, Melbourne, VIC, Australia
| | - Heather Rowe
- Jean Hailes Research Unit, Monash University, Melbourne, VIC, Australia
| | - Maggie Kirkman
- Jean Hailes Research Unit, Monash University, Melbourne, VIC, Australia
| | - Lynne Jordan
- Family Planning Victoria, Box Hill, VIC, Australia
| | - Kathy McNamee
- Family Planning Victoria, Box Hill, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| | - Chris Bayly
- The Royal Women’s Hospital, Parkville, VIC, Australia
| | - John McBain
- Melbourne IVF, East Melbourne, VIC, Australia
| | - Vikki Sinnott
- Victorian Government Department of Health, Melbourne, VIC, Australia
| | - Jane Fisher
- Jean Hailes Research Unit, Monash University, Melbourne, VIC, Australia
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