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Markowitz MA, Lundsberg LS, Gariepy AM. A Multidimensional and Longitudinal Exploratory Study of the Stability of Pregnancy Contexts in the United States. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:211-222. [PMID: 38516649 PMCID: PMC10956533 DOI: 10.1089/whr.2024.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/23/2024]
Abstract
Objective Evaluate the longitudinal stability of six pregnancy contexts, including intention, in a diverse cohort of individuals experiencing delivery, abortion, or miscarriage. Methods We enrolled individuals 16-44 years of age with pregnancies <24 weeks gestation in this longitudinal study between June 2014 and June 2015 in four US urban clinics. We assessed six pregnancy contexts (intention, wantedness, planning, timing, desirability, and happiness) at enrollment and 3-month follow-up. We constructed three-level categorical measures for each context defined as favorable, ambivalent, or unfavorable. We used Wilcoxon sign tests to evaluate changes in paired observations between pregnancy context measures over time and by pregnancy outcome. Results Among 121 participants at median gestational age of 7 weeks and 3 days, we found intention, wantedness, planning, timing, and happiness remained unchanged from enrollment in early pregnancy to 3-month follow-up. Individuals demonstrated changes in desirability; pregnancy assessments shifted toward less desirable from enrollment to follow-up (p = 0.01) (i.e., desired to ambivalent, or ambivalent to undesired). Among participants choosing delivery (57%), assessments shifted toward more favorable planning (i.e., unplanned to ambivalent, or ambivalent to planned) (p < 0.01), and less favorable desirability (i.e., desired to ambivalent or ambivalent to undesired) (p < 0.01) at follow-up. Among participants choosing abortion (28%), assessments shifted toward more unfavorable planning (i.e., planned to ambivalent, or ambivalent to unplanned) at follow-up (p < 0.01). Conclusion In multidimensional, longitudinal assessment, pregnant participants' perspectives on five of six pregnancy contexts remained unchanged between enrollment and 3-month follow-up; only desirability shifted. Pregnancy planning perspectives differed by pregnancy outcome.Human Research Subjects Protection Program: 1310012926.
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Affiliation(s)
- Melissa A. Markowitz
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA
| | - Lisbet S. Lundsberg
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA
| | - Aileen M. Gariepy
- Department of Obstetrics and Gynecology, Weill Cornell Medicine and New York Presbyterian Hospital, New York, New York, USA
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Din HN, Strong D, Singh-Carlson S, Corliss HL, Hartman SJ, Madanat H, Su HI. The effect of changing pregnancy intentions on preconception health behaviors: a prospective cohort study. J Cancer Surviv 2023; 17:1660-1668. [PMID: 36289184 PMCID: PMC10539193 DOI: 10.1007/s11764-022-01281-1] [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: 07/30/2022] [Accepted: 10/18/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Pregnancy intentions are associated with preconception health behaviors but are understudied among female adolescent and young adult (AYA) cancer survivors. Preconception health is critical for survivors because they face unique risks to fertility and pregnancy from late effects of cancer treatments. This study prospectively assessed the effect of pregnancy intention on physical activity (PA) and smoking behaviors among female AYA survivors. METHODS A cohort of 1049 female AYA survivors were recruited between 2013 and 2017. Participants were 18-39 years and had completed primary cancer treatment. Longitudinal mixed effects analysis was conducted on participants who completed at least 2 of 4 questionnaires over 1.5 years. Two measures were used to capture multiple dimensions of pregnancy intention. The pregnancy intention score (PIS) captured wanting and planning dimensions and represented a scaled response of low to high intention. The trying dimension captured urgent intention and ranged from not trying, ambivalent (neither attempting nor avoiding pregnancy), and trying now. Intention change was assessed between each consecutive time points. Final analysis was conducted with multiple imputations. RESULTS Survivors with increased intention measured by trying was associated with increased PA over time (adjusted B [95%CI]: 0.3 [0.01, 0.5]) compared to survivors with no changes or decreased trying intention. PIS was not significantly associated with preconception behaviors. No measure of intention was associated with smoking behavior. CONCLUSIONS Increasingly urgent pregnancy intention (trying dimension) was associated with higher preconception PA. IMPLICATIONS FOR CANCER SURVIVORS Screening for immediate intentions can identify AYA survivors in need of early preconception health promotion.
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Affiliation(s)
- Hena Naz Din
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA.
- School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA.
| | - David Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Dr., La Jolla, CA, 92037, USA
| | - Savitri Singh-Carlson
- School of Nursing, San Diego State University, 5500 Campanile Mall, San Diego, CA, 92182, USA
| | - Heather L Corliss
- School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA
- Center for Research On Sexuality and Sexual Health, Institute for Behavioral and Community Health, San Diego State University, 9245 Sky Park Court, Suite 221, San Diego, CA, 92123, USA
| | - Sheri J Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Dr., La Jolla, CA, 92037, USA
| | - Hala Madanat
- School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA
- Division of Research & Innovation, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA
- Institute for Behavioral and Community Health, San Diego State University, 9245 Sky Park Court, Suite 221, San Diego, CA, 92123, USA
| | - H Irene Su
- Division of Reproductive Endocrinology and Infertility, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
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Alcohol Withdrawal and the Associated Mood Disorders-A Review. Int J Mol Sci 2022; 23:ijms232314912. [PMID: 36499240 PMCID: PMC9738481 DOI: 10.3390/ijms232314912] [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: 10/17/2022] [Accepted: 11/02/2022] [Indexed: 11/30/2022] Open
Abstract
Recreational use of alcohol is a social norm in many communities worldwide. Alcohol use in moderation brings pleasure and may protect the cardiovascular system. However, excessive alcohol consumption or alcohol abuse are detrimental to one's health. Three million deaths due to excessive alcohol consumption were reported by the World Health Organization. Emerging evidence also revealed the danger of moderate consumption, which includes the increased risk to cancer. Alcohol abuse and periods of withdrawal have been linked to depression and anxiety. Here, we present the effects of alcohol consumption (acute and chronic) on important brain structures-the frontal lobe, the temporal lobe, the limbic system, and the cerebellum. Apart from this, we also present the link between alcohol abuse and withdrawal and mood disorders in this review, thus drawing a link to oxidative stress. In addition, we also discuss the positive impacts of some pharmacotherapies used. Due to the ever-rising demands of life, the cycle between alcohol abuse, withdrawal, and mood disorders may be a never-ending cycle of destruction. Hence, through this review, we hope that we can emphasise the importance and urgency of managing this issue with the appropriate approaches.
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Stotts AL, Villarreal YR, Green C, Berens P, Blackwell S, Khan A, Suchting R, Velasquez M, Markham C, Klawans MR, Northrup TF. Facilitating treatment initiation and reproductive care postpartum to prevent substance-exposed pregnancies: A randomized bayesian pilot trial. Drug Alcohol Depend 2022; 239:109602. [PMID: 35987083 DOI: 10.1016/j.drugalcdep.2022.109602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND For non-treatment-seeking women who use substances during pregnancy, immediately postpartum may be an optimum time for intervention. Our study tested a novel, brief, hospital-initiated, adaptive motivational interviewing plus acceptance and commitment therapy (MIACT) intervention to facilitate treatment initiation and reproductive planning postpartum among mothers who used substances during pregnancy. METHODS Mothers (N = 64) with an infant admitted to a neonatal intensive care unit were enrolled if they or their infant tested positive for an illicit substance at delivery or had a documented positive drug screen during pregnancy. A parallel group, randomized controlled design assigned participants to MIACT or conventional care (CC), with assessments at week 2 and 4 during treatment and follow-up at 2 and 6 months post treatment. Bayesian generalized linear modeling was used to evaluate outcomes as a function of treatment. RESULTS Results indicated that during treatment the MIACT group demonstrated an 84% probability of benefit relative to CC with regard to initiating treatment (RR=1.5), however the effect was not seen at follow-up. MIACT was also associated with an increased probability of attending a postpartum obstetrics visit (RR=1.4), and receiving contraception during treatment and at both follow-ups, with posterior probabilities of 96% or higher and relative risks ranging from 1.5 to 5.1 at varying timepoints. Substance use rates for the MIACT versus CC were higher at follow-up. CONCLUSIONS Brief, hospital-initiated interventions can assist postpartum mothers who use substances to enter treatment and obtain contraception in order to reduce future substance-exposed pregnancies.
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Affiliation(s)
- Angela L Stotts
- UTHealth McGovern Medical School, 6431 Fannin, Houston, TX 770030, USA.
| | | | - Charles Green
- UTHealth McGovern Medical School, 6431 Fannin, Houston, TX 770030, USA
| | - Pamela Berens
- UTHealth McGovern Medical School, 6431 Fannin, Houston, TX 770030, USA
| | - Sean Blackwell
- UTHealth McGovern Medical School, 6431 Fannin, Houston, TX 770030, USA
| | - Amir Khan
- UTHealth McGovern Medical School, 6431 Fannin, Houston, TX 770030, USA
| | - Robert Suchting
- UTHealth McGovern Medical School, 6431 Fannin, Houston, TX 770030, USA
| | - Mary Velasquez
- The University of Texas at Austin, 1823 Red River St, Austin, TX 78712, USA
| | - Christine Markham
- UTHealth School of Public Health, 1200 Pressler, Houston, TX 77030, USA
| | | | - Thomas F Northrup
- UTHealth McGovern Medical School, 6431 Fannin, Houston, TX 770030, USA
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Wahyuningsih W, Putri D, Endriyani L, Nurunniyah S, Misali SACA, Hadi H. Parity and Pregnancy Intention related to the Use of Contraceptives in Women of Reproductive. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: The use of contraceptives in reproductive women is still a problem today. The association between contraceptive use and parity and pregnancy intention amongs legally married reproductive women has never been studied
Objectives: To determine the relationship between parity and pregnancy intention with contraceptive use among legally married women.
Methods: A cross-sectional study was conducted with the involvement of 262 legally-married reproductive women, aged 15-49 years, in Bantul District, Indonesia. Socio-demographic data including age, education, income, parity, pregnancy intentions, and use of contraceptives were collected using a structured questionnaire by trained enumerators. Chi-square test was used to test the association between socio-demographic data and parity and pregnancy intention, while simple logistic regression models were used to examine the relationship between contraceptive use and parity and pregnancy intention. Data analysis was performed using statistical software by SPSS.
Results: Thirty-eight point five per cent of women of reproductive age who have ≥ 3 children and 16.5% of women of reproductive age who do not want to have children do not use contraception. Parity in women of childbearing age was not related to contraceptives (OR=2.58; 95%:0.67-1.76). Women of reproductive age who had intention of getting pregnant were 61% less likely (OR= 0.39; 95%: 0.37-0.74) to use contraceptives than those who did not have intention of getting pregnant.
Conclusions: The pregnancy intention is associated with a low contraceptive use in reproductive-age women. Thus, it is necessary to educate women in the reproductive age, their partners and family regarding the importance of birth spacing.
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Bolarinwa OA, Boikhutso T. Mapping evidence on predictors of adverse sexual and reproductive health outcomes among young women in South Africa: A scoping review. Afr J Prim Health Care Fam Med 2021; 13:e1-e10. [PMID: 34797120 PMCID: PMC8661283 DOI: 10.4102/phcfm.v13i1.3091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/30/2021] [Accepted: 10/06/2021] [Indexed: 12/02/2022] Open
Abstract
Background Globally, most young women have an unmet need for sexual and reproductive health (SRH), which remains a public health concern. Identifying the predictors can help reduce this challenge. Aim This scoping review maps evidence on predictors of adverse sexual and reproductive health outcomes among young women in South Africa. Method Askey and O’Malley’s framework guided this review. We searched five databases from January 2000 to December 2020 using relevant keywords, Boolean terms and medical subject heading terms. All relevant extracted data were organised into the study themes, and summary of all the findings were reported in a narrative format. Results Nine studies met the inclusion criteria out of 1219 studies identified. Four out of the nine studies were national-based studies, while the remaining five studies were conducted in Western Cape (two), Eastern Cape (two) and KwaZulu-Natal (one). Out of the nine studies included, three reported predictors of unintended pregnancy, while six reported predictors of sexually transmitted infections and HIV among young women in South Africa. The most prevailing predictors of adverse sexual and reproductive health outcomes were gender-based violence and alcohol use, while other predictors were lower socio-economic status, place of residence, multiple sexual partnerships, low education and being between the ages of 20–24 years. Conclusion We conclude that gender-based violence and alcohol abuse are the most prevailing predictors of adverse sexual and reproductive health outcomes among young women in South Africa.
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Affiliation(s)
- Obasanjo A Bolarinwa
- Discipline of Public Health Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban.
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