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Koldeweij CJM, Dibbets AC, Ceulemans M, de Vries LC, Franklin BD, Scheepers HCJ, de Wildt SN. Willingness-to-use and preferences for model-informed antenatal doses: a cross-sectional study among European healthcare practitioners and pregnant women. Front Pharmacol 2024; 15:1403747. [PMID: 39211781 PMCID: PMC11358599 DOI: 10.3389/fphar.2024.1403747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 07/29/2024] [Indexed: 09/04/2024] Open
Abstract
Background: Physiological changes in pregnancy may affect drug safety and efficacy, sometimes requiring dose adjustments. Pregnancy-adjusted doses, however, are missing for most medications. Increasingly, pharmacokinetic models can be used for antenatal dose finding. Given the novelty of this technique and questions regarding dose credibility, the acceptability of model-informed antenatal doses should be explored. Objective: We aimed to assess the willingness-to-use and preferred features for model-informed antenatal doses among healthcare practitioners (HCPs) and pregnant women in European countries. Methods: A cross-sectional, web-based study drawing on two open surveys was performed between 8 September and 30 November 2022. Each survey comprised statements drawn from prior focus groups, associated with Likert-scales. Themes included respondents' information needs, search behaviours along with their willingness-to-use and preferred features for model-informed antenatal doses. The surveys were disseminated through professional societies, pregnancy websites and social media. A descriptive analysis was performed. Results: In total, 608 HCPs from different specialties and 794 pregnant women across 15 countries participated, with 81% of respondents across both groups in the Netherlands or Belgium. Among pregnant women, 31% were medical professionals and 85% used medication during pregnancy. Eighty-three percent of HCPs found current antenatal pharmacotherapy suboptimal and 97% believed that model-informed antenatal doses would enhance the quality of antenatal care. Most HCPs (93%) and pregnant women (75%) would be willing to follow model-informed antenatal doses. Most HCPs desired access to the evidence (88%), including from pharmacokinetic modelling (62%). Most pregnant women (96%) wanted to understand antenatal dosing rationales and to be involved in dosing decisions (97%). Conclusion: The willingness-to-use model-informed antenatal doses is high among HCPs and pregnant women provided that certain information needs are met.
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Affiliation(s)
- C. J. M. Koldeweij
- Division of Pharmacology and Toxicology, Department of Pharmacy, Radboud University Medical Center, Nijmegen, Netherlands
| | - A. C. Dibbets
- Division of Pharmacology and Toxicology, Department of Pharmacy, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - M. Ceulemans
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KULeuven, Belgium
- IQ Health, Radboud University Medical Center, Nijmegen, Netherlands
- L-C&Y, KU Leuven Child and Youth Institute, Leuven, Belgium
| | - L. C. de Vries
- Teratology Information Service, Netherlands Pharmacovigilance Centre Lareb, S’Hertogenbosch, Netherlands
| | - B. D. Franklin
- Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, United Kingdom
- Department of Practice and Policy, UCL School of Pharmacy, London, United Kingdom
| | - H. C. J. Scheepers
- Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, Maastricht, Netherlands
- Grow, School for Oncology and Reproduction, Maastricht, Netherlands
| | - S. N. de Wildt
- Division of Pharmacology and Toxicology, Department of Pharmacy, Radboud University Medical Center, Nijmegen, Netherlands
- Department of Paediatric and Neonatal Intensive Care, Erasmus MC-Sophia Children’s Hospital, Rotterdam, Netherlands
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Ihenetu G, Aylin P, Novov V, Skirrow H, Saxena S, Majeed A, Woodcock T. Uptake of COVID-19 vaccines and association with hospitalisation due to COVID-19 in pregnancy: Retrospective cohort study. Vaccine 2024:126214. [PMID: 39142904 DOI: 10.1016/j.vaccine.2024.126214] [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: 08/23/2023] [Revised: 04/26/2024] [Accepted: 08/07/2024] [Indexed: 08/16/2024]
Abstract
OBJECTIVES To determine demographic and clinical characteristics associated with uptake of COVID-19 vaccines among pregnant women, and quantify the relationship between vaccine uptake and admission to hospital for COVID-19. BACKGROUND Pregnant women are at increased risk of severe adverse outcomes from COVID-19. Since April 2021, COVID-19 vaccines were recommended for pregnant women in the UK. Despite this, evidence shows vaccine uptake is low. However, this evidence has been based only on women admitted to hospital, or on qualitative or survey-based studies. METHODS Retrospective cohort study including all pregnancies ending between 18 June 2021 and 22 August 2022, among adult women registered with a Northwest London general practice. Statistical analyses were mixed-effects multiple logistic regression models. We conducted a nested case-control analysis to quantify the relationship between vaccine uptake by end of pregnancy and hospitalisation for COVID-19 during pregnancy. RESULTS Our study included 47,046 pregnancies among 39,213 women. In 26,724 (57%) pregnancies, women had at least one dose of vaccine by the end of pregnancy. Uptake was lowest in pregnant women aged 18-24 (33%; reference group), Black women compared with White (37%; OR 0.55, 95% CI: 0.51 to 0.60), and women in more deprived areas (50%; reference group). Women with chronic conditions were more likely to receive the vaccine than women without (Asthma OR 1.21, 95% CI: 1.13 to 1.29). Patterns were similar for the second dose. Women admitted to hospital were much less likely to be vaccinated (22%) than those not admitted (57%, OR 0.22, 95% CI: 0.15 to 0.31). CONCLUSIONS Women who received the COVID-19 vaccine were less likely to be hospitalised for COVID-19 during pregnancy. COVID-19 vaccine uptake among pregnant women is suboptimal, particularly in younger women, Black women, and women in more deprived areas. Interventions should focus on increasing uptake in these groups to improve health outcomes and reduce health inequalities.
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Affiliation(s)
- Gloria Ihenetu
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom.
| | - Paul Aylin
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Vesselin Novov
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Helen Skirrow
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Sonia Saxena
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | - Thomas Woodcock
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
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Soos A, Plegue M, Darwiche A, Oshman L, Frank CJ. Racial Disparities in Newborn Drug Testing After Implementation of Question-Based Screening for Prenatal Substance Use. Obstet Gynecol 2024; 144:233-240. [PMID: 38843536 DOI: 10.1097/aog.0000000000005631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 04/11/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVE To examine the association of universal question-based screening for prenatal substance use on racial inequities in prenatal and newborn drug testing. METHODS We conducted a retrospective cohort study of 32,802 live births of patients receiving prenatal care at an academic medical center in the midwestern United States from 2014 to 2022, before and after implementation of question-based screening in 2018. Primary outcomes included prenatal and newborn drug test orders. Logistic regression models using a generalized estimating equation framework assessed associations with question-based screening and results, birthing parent age, race, ethnicity, marital status, and insurance type. Charts of patients who indicated difficulties stopping substance use were audited for guideline-directed care. RESULTS A total of 12,725 of 14,992 pregnant people (85.3%) received question-based screening. Implementation of question-based screening was associated with a decrease in prenatal urine test orders (5.0% [95% CI, 4.6-5.3%] before implementation, 3.1% [95% CI, 2.8-3.4%] after implementation; P <.001), with Black birthing parents having the largest reduction in prenatal urine drug testing (10.3% [95% CI, 9.0-11.7%] before implementation, 4.9% [95% CI, 3.9-5.9%] after implementation). However, rates of newborn drug testing did not change (4.7% [95% CI, 4.4-5.0%] before implementation, 4.5% [95% CI, 4.2-4.8%] after implementation; P =.46), and clinicians continued to order significantly more newborn drug tests for newborns of Black birthing parents compared with other race and ethnicity groups. CONCLUSION Implementation of question-based screening for substance use in pregnancy was associated with decreased prenatal urine drug testing but no change in overall newborn drug testing or racial inequities in newborn drug testing for Black birthing people. Further policy efforts are warranted to improve substance use treatment and to eliminate racial inequities in punitive policies such as newborn drug testing and subsequent child protective services reporting.
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Affiliation(s)
- Alexandra Soos
- Department of Family Medicine, the Susan B. Meister Child Health Evaluation and Research Center, and the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
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Abdul-Fatah A, Bezanson M, Lopez Steven S, Tippins E, Jones S, MacDonald H, Ysseldyk R. COVID-19 Public Health Restrictions and New Mothers' Mental Health: A Qualitative Scoping Review. QUALITATIVE HEALTH RESEARCH 2024:10497323241251984. [PMID: 39030700 DOI: 10.1177/10497323241251984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/21/2024]
Abstract
Public health restrictions to protect physical health during the COVID-19 pandemic had unintended effects on mental health, which may have disproportionately affected some potentially vulnerable groups. This scoping review of qualitative research provides a narrative synthesis of new mothers' perspectives on their mental health during COVID-19 pandemic restrictions through pregnancy to the postpartum period. Database searches in PubMed, CINAHL, and PsycINFO sought primary research studies published until February 2023, which focused on new mothers' self-perceived mental health during the pandemic (N = 55). Our synthesis found that new mothers' mental health was impacted by general public health restrictions resulting in isolation from family and friends, a lack of community support, and impacts on the immediate family. However, public health restrictions specific to maternal and infant healthcare were most often found to negatively impact maternal mental health, namely, hospital policies prohibiting the presence of birthing partners and in-person care for their infants. This review of qualitative research adds depth to previous reviews that have solely examined the quantitative associations between COVID-19 public health restrictions and new mothers' mental health. Here, our review demonstrates the array of adverse impacts of COVID-19 public health restrictions on new mothers' mental health throughout pregnancy into the postpartum period, as reported by new mothers. These findings may be beneficial for policy makers in future public health emergency planning when evaluating the impacts and unintended consequences of public health restrictions on new mothers.
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Affiliation(s)
| | - Michelle Bezanson
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | | | - Emily Tippins
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | - Sarah Jones
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | | | - Renate Ysseldyk
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
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Rice AR, Durowaye TD, Konkle ATM, Phillips KP. Exploring online reproductive health promotion in Canada: a focus on behavioral and environmental influences from a sex and gender perspective. BMC Public Health 2024; 24:1647. [PMID: 38902656 PMCID: PMC11188500 DOI: 10.1186/s12889-024-19159-5] [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: 01/12/2024] [Accepted: 06/14/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Reproductive health promotion can enable early mitigation of behavioral and environmental risk factors associated with adverse pregnancy outcomes, while optimizing health of women + (all genders that can gestate a fetus) and babies. Although the biological and social influences of partners on pregnancy are well established, it is unknown whether online Canadian government reproductive health promotion also targets men and partners throughout the reproductive lifespan. METHODS Reproductive health promotion, designed for the general public, was assessed in a multi-jurisdictional sample of Canadian government (federal, provincial/territorial, and municipal) and select non-governmental organization (NGO) websites. For each website, information related to environmental and behavioral influences on reproductive health (preconception, pregnancy, postpartum) was evaluated based on comprehensiveness, audience-specificity, and scientific quality. RESULTS Government and NGO websites provided sparse reproductive health promotion for partners which was generally limited to preconception behavior topics with little coverage of environmental hazard topics. For women + , environmental and behavioral influences on reproductive health were well promoted for pregnancy, with content gaps for preconception and postpartum stages. CONCLUSION Although it is well established that partners influence pregnancy outcomes and fetal/infant health, Canadian government website promotion of partner-specific environmental and behavioral risks was limited. Most websites across jurisdictions promoted behavioral influences on pregnancy, however gaps were apparent in the provision of health information related to environmental hazards. As all reproductive stages, including preconception and postpartum, may be susceptible to environmental and behavioral influences, online health promotion should use a sex- and gender-lens to address biological contributions to embryo, fetal and infant development, as well as contributions of partners to the physical and social environments of the home.
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Affiliation(s)
- Alexandra R Rice
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 Université Private, Ottawa, ON, K1N 6N5, Canada
| | - Toluwanimi D Durowaye
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 Université Private, Ottawa, ON, K1N 6N5, Canada
| | - Anne T M Konkle
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 Université Private, Ottawa, ON, K1N 6N5, Canada
- University of Ottawa Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, K1H 8M5, Canada
| | - Karen P Phillips
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 Université Private, Ottawa, ON, K1N 6N5, Canada.
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Santaularia NJ, Hunt SL, Bonilla Z. Exploring the Links Between Immigration and Birth Outcomes Among Latine Birthing Persons in the USA. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01999-x. [PMID: 38713369 DOI: 10.1007/s40615-024-01999-x] [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: 10/10/2023] [Revised: 03/22/2024] [Accepted: 04/07/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Birth outcomes are worse for birthing people and infants in the USA than other high-income economies and worse still for underprivileged communities. Historically, the Latine community has experienced positive birth outcomes, despite low socioeconomic status and other socio-political disadvantages, leading to what has been termed as the Hispanic birth paradox. However, this perinatal advantage and protective effect appears to have been shattered by unfavorable policies, structural conditions, societal attitudes, and traumatic events impacting Latine immigrants, leading to negative effects on the health and well-being of birthing Latines-regardless of citizenship status and increasing rates of preterm birth and low birth weight infants. METHODS AND RESULTS We conducted a comprehensive literature review and identified two pathways through which birth outcomes among Latine birthing persons may be compromised regardless of citizenship status: (1) a biological pathway as toxic levels of fear and anxiety created by racialized stressors accumulate in the bodies of Latines and (2) a social pathway as Latines disconnect from formal and informal sources of support including family, friends, health care, public health programs, and social services during the course of the pregnancy. CONCLUSION Future research needs to examine the impact of immigration climate and policies on health and racial equity in birth outcomes among Latines regardless of citizenship status. Attaining health and racial equity necessitates increased awareness among health providers, public health practitioners, and policy makers of the impact of larger socio-political pressures on the health of Latine birthing persons.
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Affiliation(s)
- N Jeanie Santaularia
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Shanda Lee Hunt
- University Libraries, University of Minnesota, Minneapolis, MN, USA
| | - Zobeida Bonilla
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Choy CC, McAdow ME, Rosenberg J, Grimshaw AA, Martinez-Brockman JL. Dyadic care to improve postnatal outcomes of birthing people and their infants: A scoping review protocol. PLoS One 2024; 19:e0298927. [PMID: 38625992 PMCID: PMC11020692 DOI: 10.1371/journal.pone.0298927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/30/2024] [Indexed: 04/18/2024] Open
Abstract
INTRODUCTION Dyadic care, which is the concurrent provision of care for a birthing person and their infant, is an approach that may improve disparities in postnatal health outcomes, but no synthesis of existing dyadic care studies has been conducted. This scoping review seeks to identify and summarize: 1) dyadic care studies globally, in which the birthing person-infant dyad are cared for together, 2) postnatal health outcomes that have been evaluated following dyadic care interventions, and 3) research and practice gaps in the implementation, dissemination, and effectiveness of dyadic care to reduce healthcare disparities. MATERIALS AND METHODS Eligible studies will (1) include dyadic care instances for the birthing person and infant, and 2) report clinical outcomes for at least one member of the dyad or intervention outcomes. Studies will be excluded if they pertain to routine obstetric care, do not present original data, and/or are not available in English or Spanish. We will search CINAHL, Ovid (both Embase and Medline), Scopus, Cochrane Library, PubMed, Google Scholar, Global Health, Web of Science Core Collection, gray literature, and WHO regional databases. Screening will be conducted via Covidence and data will be extracted to capture the study design, dyad characteristics, clinical outcomes, and implementation outcomes. The risk of bias will be assessed using the Joanna Briggs Institute Critical Appraisal Tool. A narrative synthesis of the study findings will be presented. DISCUSSION This scoping review will summarize birthing person-infant dyadic care interventions that have been studied and the evidence for their effectiveness. This aggregation of existing data can be used by healthcare systems working to improve healthcare delivery to their patients with the aim of reducing postnatal morbidity and mortality. Areas for future research will also be highlighted. TRAIL REGISTRATION This review has been registered at Open Science Framework (OSF, https://osf.io/5fs6e/).
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Affiliation(s)
- Courtney C. Choy
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Molly E. McAdow
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Julia Rosenberg
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Alyssa A. Grimshaw
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut, United States of America
| | - Josefa L. Martinez-Brockman
- Department of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
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Ahlqvist VH, Sjöqvist H, Dalman C, Karlsson H, Stephansson O, Johansson S, Magnusson C, Gardner RM, Lee BK. Acetaminophen Use During Pregnancy and Children's Risk of Autism, ADHD, and Intellectual Disability. JAMA 2024; 331:1205-1214. [PMID: 38592388 PMCID: PMC11004836 DOI: 10.1001/jama.2024.3172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/22/2024] [Indexed: 04/10/2024]
Abstract
Importance Several studies suggest that acetaminophen (paracetamol) use during pregnancy may increase risk of neurodevelopmental disorders in children. If true, this would have substantial implications for management of pain and fever during pregnancy. Objective To examine the associations of acetaminophen use during pregnancy with children's risk of autism, attention-deficit/hyperactivity disorder (ADHD), and intellectual disability. Design, Setting, and Participants This nationwide cohort study with sibling control analysis included a population-based sample of 2 480 797 children born in 1995 to 2019 in Sweden, with follow-up through December 31, 2021. Exposure Use of acetaminophen during pregnancy prospectively recorded from antenatal and prescription records. Main Outcomes and Measures Autism, ADHD, and intellectual disability based on International Classification of Diseases, Ninth Revision and International Classification of Diseases, Tenth Revision codes in health registers. Results In total, 185 909 children (7.49%) were exposed to acetaminophen during pregnancy. Crude absolute risks at 10 years of age for those not exposed vs those exposed to acetaminophen were 1.33% vs 1.53% for autism, 2.46% vs 2.87% for ADHD, and 0.70% vs 0.82% for intellectual disability. In models without sibling control, ever-use vs no use of acetaminophen during pregnancy was associated with marginally increased risk of autism (hazard ratio [HR], 1.05 [95% CI, 1.02-1.08]; risk difference [RD] at 10 years of age, 0.09% [95% CI, -0.01% to 0.20%]), ADHD (HR, 1.07 [95% CI, 1.05-1.10]; RD, 0.21% [95% CI, 0.08%-0.34%]), and intellectual disability (HR, 1.05 [95% CI, 1.00-1.10]; RD, 0.04% [95% CI, -0.04% to 0.12%]). To address unobserved confounding, matched full sibling pairs were also analyzed. Sibling control analyses found no evidence that acetaminophen use during pregnancy was associated with autism (HR, 0.98 [95% CI, 0.93-1.04]; RD, 0.02% [95% CI, -0.14% to 0.18%]), ADHD (HR, 0.98 [95% CI, 0.94-1.02]; RD, -0.02% [95% CI, -0.21% to 0.15%]), or intellectual disability (HR, 1.01 [95% CI, 0.92-1.10]; RD, 0% [95% CI, -0.10% to 0.13%]). Similarly, there was no evidence of a dose-response pattern in sibling control analyses. For example, for autism, compared with no use of acetaminophen, persons with low (<25th percentile), medium (25th-75th percentile), and high (>75th percentile) mean daily acetaminophen use had HRs of 0.85, 0.96, and 0.88, respectively. Conclusions and Relevance Acetaminophen use during pregnancy was not associated with children's risk of autism, ADHD, or intellectual disability in sibling control analysis. This suggests that associations observed in other models may have been attributable to familial confounding.
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Affiliation(s)
- Viktor H. Ahlqvist
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Hugo Sjöqvist
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Håkan Karlsson
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Olof Stephansson
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Women’s Health, Division of Obstetrics, Karolinska University Hospital, Stockholm, Sweden
| | - Stefan Johansson
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Neonatology, Sachs’ Children and Youth Hospital, Stockholm, Sweden
| | - Cecilia Magnusson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
| | - Renee M. Gardner
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Brian K. Lee
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania
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Silva GC, Puccia MIR, Barros MNDS. Transsexual men and pregnancy: an integrative literature review. CIENCIA & SAUDE COLETIVA 2024; 29:e19612023. [PMID: 38655969 DOI: 10.1590/1413-81232024294.19612023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/19/2023] [Indexed: 04/26/2024] Open
Abstract
Promoting sexual and reproductive health in the context of transmasculinity constitutes a new issue for health service organisation. This integrative review sought to understand the current evidence on pregnancy in transsexual men in the context of sexual and reproductive health care. From a search of the BVS, PubMed, Science Direct, Scopus, Capes, SciELO and PEPSIC databases, from 2010 to 2020, a sample of 11 articles was selected, treated by content analysis and grouped into four analytical categories: health services - positive experiences; cis heteronormative health services; implications of pregnancy for transsexual bodies; and repercussions of gender-affirming therapy and pregnancy. A cis heteronormative logic was found to predominate in health care, leading to negative experiences during antenatal care and childbirth among transsexual men. Their unique health needs during the pregnancy-puerperium cycle should include mental health care. It is suggested that strategies be adopted to build capacity in health professionals with a view to respectful, inclusive perinatal care for this population group, as well as further studies on the subject.
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Affiliation(s)
- Gislaine Correia Silva
- Policlínica Regional de Saúde de Brumado. R. Osvaldo Marciel de Souza, Centro. 46100-000 Brumado BA Brasil.
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Freeman M, Fischer O, Lebel C, Giesbrecht GF, Tomfohr-Madsen L. Making diversity visible: collecting gender identity and sexual orientation data in perinatal research. Am J Obstet Gynecol 2024; 230:269-271. [PMID: 37788718 DOI: 10.1016/j.ajog.2023.09.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/05/2023]
Affiliation(s)
- Makayla Freeman
- Department of Educational and Counselling Psychology, and Special Education, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada V6T 1Z4.
| | - Olivia Fischer
- Department of Educational and Counselling Psychology, and Special Education, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada V6T 1Z4
| | - Catherine Lebel
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gerald F Giesbrecht
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lianne Tomfohr-Madsen
- Department of Educational and Counselling Psychology, and Special Education, Faculty of Education, University of British Columbia, Vancouver, British Columbia, Canada
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Janssen P, Lecke S, Renner R, Zhang W, Vedam S, Norman WV, Bayrampour H, Tough S, Murray J, Muhajarine N, Dennis CL. Teaching by texting to promote positive health behaviours in pregnancy: a protocol for a randomised controlled trial of SmartMom. BMJ Open 2024; 14:e081730. [PMID: 38238058 PMCID: PMC10806627 DOI: 10.1136/bmjopen-2023-081730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 12/15/2023] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION Prenatal education is associated with positive health behaviours, including optimal weight gain, attendance at prenatal care, acceptance of routine screening tests, smoking cessation, decreased alcohol consumption and breast feeding. Adoption of these behaviours has been associated with reduced rates of caesarean birth, preterm birth and low birth weight. Barriers to prenatal class attendance faced by parents in Canada include geography, socioeconomic status, age, education, and, among Indigenous peoples and other equity-deserving groups, stigma. To address the need for easily accessible and reliable information, we created 'SmartMom', Canada's first prenatal education programme delivered by short message service text messaging. SmartMom provides evidence-based information timed to be relevant to each week of pregnancy. The overall goal of SmartMom is to motivate the adoption of positive prenatal health behaviours with the ultimate goal of improving health outcomes among women and their newborns. METHODS AND ANALYSIS We will conduct a two-arm single-blinded randomised controlled trial. Blinding of participants to trial intervention will not be possible as they will be aware of receiving the intervention, but data analysts will be blinded. Our primary research questions are to determine if women experiencing uncomplicated pregnancies randomly assigned to receive SmartMom messages versus messages addressing general topics related to pregnancy but without direction for behaviour change, have higher rates of: (1) weight gain within ranges recommended for prepregnancy body mass index and (2) adherence to Canadian guidelines regarding attendance at prenatal care appointments. ETHICS AND DISSEMINATION The study has been granted a Certificate of Approval, number H22-00603, by the University of British Columbia Research Ethics Board. To disseminate our findings, we are undertaking both integrated and end-of-grant knowledge translation, which will proactively involve potential end-users and stakeholders at every phase of our project. TRIAL REGISTRATION NUMBER NCT05793944.
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Affiliation(s)
- Patricia Janssen
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
- SmartMom Mobile Health Education, Vancouver, British Columbia, Canada
| | - Sara Lecke
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Regina Renner
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Wei Zhang
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation & Outcome Sciences, St. Paul's hospital, Vancouver, British Columbia, Canada
| | - Saraswathi Vedam
- Birth Place Lab, Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Wendy V Norman
- Dept of Family Practice, The University of British Columbia, Vancouver, British Columbia, Canada
- Public Health, Environments & Society, London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - Hamideh Bayrampour
- Family Practice, Midwifery Program, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Suzanne Tough
- Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Jennifer Murray
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - Nazeem Muhajarine
- Dept of Community Health and Epidemiology, U of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Cindy Lee Dennis
- Lawrence S. Bloomburg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Fernandez-Sanchez H, Marfo EA, Santa Maria D, Mumba M. Language Matters: Exploring Preferred Terms for Diverse Populations. Glob Qual Nurs Res 2024; 11:23333936241275266. [PMID: 39233769 PMCID: PMC11372770 DOI: 10.1177/23333936241275266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 07/29/2024] [Accepted: 07/30/2024] [Indexed: 09/06/2024] Open
Abstract
This article explores the significance of employing preferred terms and inclusive language in research practices concerning diverse populations. It highlights how inappropriate terminology can lead to labeling, stereotyping, and stigma, particularly for equity-denied groups. The study aimed to identify and analyze terminology preferences for diverse communities by major international organizations. Through a systematic environmental scan methodology, data were collected from 12 prominent organizations. The results indicate a concerted effort toward adopting inclusive language, with organizations favoring respectful and accurate terminology. For instance, terms like "people made vulnerable by systemic inequities" and "migrant workers" were preferred over outdated or stigmatizing alternatives. The discussion emphasizes the importance of identifying conflicting terms and trends in terminology preferences over time. We recommend prioritizing the use of preferred terms to promote respectful and accurate discourse, with a focus on person-centered language. Ultimately, the findings underscore the critical role of language in shaping perceptions and attitudes toward diverse communities, and advocate for continued efforts to promote inclusivity and equity in research, policy, and practice.
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Rioux C, Fulp DC, Haley PN, LaBelle JL, Aasted ME, Lambert KK, Donohue MT, Mafu NT. Phenotypic Environmental Sensitivity and Mental Health During Pregnancy and Post Partum: Protocol for the Experiences of Pregnancy Longitudinal Cohort Study. JMIR Res Protoc 2023; 12:e49243. [PMID: 38055312 PMCID: PMC10733836 DOI: 10.2196/49243] [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: 05/23/2023] [Revised: 10/15/2023] [Accepted: 11/09/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Mental health problems during pregnancy and post partum are common and associated with negative short- and long-term impacts on pregnant individuals, obstetric outcomes, and child socioemotional development. Socio-environmental factors are important predictors of perinatal mental health, but the effects of the environment on mental health are heterogeneous. The differential susceptibility theory and the environmental sensitivity framework suggest that individuals differ in their degree of sensitivity to positive and negative environments, which can be captured by individual phenotypes such as temperament and personality. While there is strong evidence for these models in childhood, few studies examined them in adults, and they were not examined in pregnancy. OBJECTIVE The primary objective of the Experiences of Pregnancy study is to explore whether childhood and current environments are associated with mental health and well-being in pregnancy and whether these effects depend on individual sensitivity phenotypes (personality). This study also aims to gather important psychosocial and health data for potential secondary data analyses and integrative data analyses. METHODS We will conduct a longitudinal cohort study. The study was not registered elsewhere, other than this protocol. Participants will be recruited through social media advertisements linking to the study website, followed by an eligibility call on Zoom (Zoom Video Communications). Participants must be aged 18 years or older, currently residing in the United States as citizens or permanent residents, and currently planning to continue the pregnancy. A minimum of 512 participants will be recruited based on power analyses for the main objectives. Since the data will also be a resource for secondary analyses, up to 1000 participants will be recruited based on the available budget. Participants will be in their first trimester of pregnancy, and they will be followed at each trimester and once post partum. Data will be obtained through self-reported questionnaires assessing demographic factors; pregnancy-related factors; delivery, labor, and birth outcomes; early infant feeding; individual personality factors; childhood and current environments; mental health and well-being; attachment; and infant temperament. A series of measures were taken to safeguard the study from web robots and fraudulent participants, as well as to reduce legal and social risks for participants following Dobbs v. Jackson. RESULTS The study received ethics approval in April 2023 from the University of Oklahoma-Norman Campus Institutional Review Board. Recruitment occurred from May to August 2023, with 3 follow-ups occurring over 10 months. CONCLUSIONS The Experiences of Pregnancy study will extend theories of environmental sensitivity, mainly applied in children to the perinatal period. This will help better understand individual sensitivity factors associated with risk, resilience, plasticity, and receptivity to negative and positive environmental influences during pregnancy for pregnant individuals. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/49243.
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Affiliation(s)
- Charlie Rioux
- Department of Psychology, University of Oklahoma, Norman, OK, United States
| | - Delaney C Fulp
- Department of Psychology, University of Oklahoma, Norman, OK, United States
| | - Parker N Haley
- Department of Psychology, University of Oklahoma, Norman, OK, United States
| | - Jenna L LaBelle
- Department of Psychology, University of Oklahoma, Norman, OK, United States
| | - Mary E Aasted
- Department of Psychology, University of Oklahoma, Norman, OK, United States
| | - Kasie K Lambert
- Jeannine Rainbolt College of Education, University of Oklahoma, Norman, OK, United States
| | - Madison T Donohue
- Department of Psychology, University of Oklahoma, Norman, OK, United States
| | - Nkatheko T Mafu
- Department of Psychology, University of Oklahoma, Norman, OK, United States
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Dunn MC, Ananth CV, Brandt JS. It's time to make adherence to gender-inclusive research practices a required part of the peer review process. Am J Obstet Gynecol MFM 2023; 5:101180. [PMID: 37813305 DOI: 10.1016/j.ajogmf.2023.101180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 10/03/2023] [Indexed: 10/11/2023]
Affiliation(s)
- Morgan C Dunn
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Cande V Ananth
- Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ; Cardiovascular Institute of New Jersey and Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Environmental and Occupational Health Sciences Institute, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ
| | - Justin S Brandt
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, 159 East 53rd Street, New York, NY 10022.
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Yong MQY, Yeo Y, Shorey S. Factors affecting unintended pregnancy resolution from the perspectives of pregnant women and people: A systematic review of qualitative evidence. Midwifery 2023; 127:103866. [PMID: 37931463 DOI: 10.1016/j.midw.2023.103866] [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: 05/23/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Unintended pregnancy is a global issue with significant consequences for individuals and society. It impacts maternal and neonatal health, educational attainment, and interpersonal relationships. The decision-making process surrounding unintended pregnancies is complex, influenced by factors like ambivalence, societal norms, and maternal responsibilities. Understanding pregnant women and people's experiences is crucial to providing support and addressing barriers to access. Therefore, this systematic review aimed to consolidate and synthesize qualitative evidence regarding individual's experiences and the factors influencing their decision-making in unintended pregnancies. METHOD(S) Ten databases (PubMed, Embase, CINAHL Complete, Cochrane Library, PsycINFO (Ovid), Scopus, Web of Science Core Collection and Social Science Database (ProQuest), MedNar and ProQuest Dissertations and Theses Global) were systematically searched for published and unpublished primary qualitative studies from their inception to December 2022. Relevant qualitative data were extracted and meta-summarized using Sandelowski and Barroso's approach and analyzed using Thomas and Harden's thematic analysis framework. RESULTS Eighteen studies met the inclusion criteria and were included in the review. Four themes were identified from the meta-synthesis: 1) Navigating the head and heart, 2) Involvement and influence of others, 3) Hindrance and help in decision-making, and 4) Growing and gaining. CONCLUSION This review emphasized the significance of both internal and external factors in shaping pregnant women and people's experiences, and influencing their choices when faced with unintended pregnancies. Recognizing and addressing the multifaceted nature of these decisions; is crucial for different stakeholders such as healthcare professionals, and policymakers to better support pregnant women and people, and promote their well-being. This review sets the stage for future research and practice, emphasizing the ongoing need to empower pregnant women and people, ensure accessible and safe reproductive healthcare services, and promote informed decision-making.
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Affiliation(s)
- Megan Qing Yi Yong
- Division of Nursing, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229889, Singapore
| | - Yumi Yeo
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Rioux C, London-Nadeau K, Tomfohr-Madsen L, Juster RP. Gender-inclusive research instructions in author submission guidelines: insufficient for gender-inclusive obstetrics and gynecology research. Am J Obstet Gynecol MFM 2023; 5:101179. [PMID: 37813306 DOI: 10.1016/j.ajogmf.2023.101179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 10/11/2023]
Affiliation(s)
- Charlie Rioux
- Department of Psychology, University of Oklahoma, 455 W. Lindsey St., Dale Hall Tower Room 705, Norman, OK 73019-2007.
| | - Kira London-Nadeau
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada; Ste-Justine University Hospital Research Centre, Montreal, Quebec, Canada
| | - Lianne Tomfohr-Madsen
- Department of Educational and Counselling Psychology and Special Education, The University of British Columbia, Vancouver, British Colombia, Canada
| | - Robert-Paul Juster
- Department of Psychiatry and Addiction, Montreal, Quebec, Canada; Montreal Mental Health University Institute Research Centre, Montreal, Quebec, Canada
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Lapping-Carr L, Dennard A, Wisner KL, Tandon SD. Perinatal Depression Screening Among Sexual Minority Women. JAMA Psychiatry 2023; 80:1142-1149. [PMID: 37531104 PMCID: PMC10398540 DOI: 10.1001/jamapsychiatry.2023.2619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 05/31/2023] [Indexed: 08/03/2023]
Abstract
Importance A substantial number of births in the US are to sexual minority women (17% based on a nationally representative survey), yet there is little research on perinatal depression screening rates or symptom endorsement among sexual minority women (including women who identify as lesbian, bisexual, queer, pansexual, asexual, demisexual, and kinky as well as other-identified women who have sex with women). High rates of risk factors for perinatal depression (eg, intimate partner violence and history of mental illness) among sexual minority individuals magnify this gap in the literature. Objective To describe the prevalence of female-identified sexual minority people giving birth in an academic medical center and compare perinatal depression screening rates and scores among sexual minority women and heterosexual cisgender women. Design, Setting, and Participants This retrospective cohort study used deidentified medical record review of 18 243 female-identified individuals who gave birth at an academic medical center in Chicago, Illinois, between January 1 and December 31, 2019. Data were analyzed from April 5, 2021, to August 1, 2022. Main Outcomes and Measures Proportion of women identified as having sexual minority status in the medical record, rates of standard care administration of the 9-item Patient Health Questionnaire between sexual minority women and heterosexual women, and depression screening scores and rates of positive depression screening results for sexual minority and heterosexual women. Results Among 18 243 women (mean [SD] age, 33.8 [5.1] years; 10 453 [57.3%] of non-Hispanic White race and ethnicity), only 280 (1.5%; 95% CI, 1.3%-1.7%) were identified as having sexual minority status in the medical record. Significantly more sexual minority women vs heterosexual women attended at least 1 prenatal care visit (56 [20.0%] vs 2459 [13.7%]; P = .002) and at least 1 postpartum care visit (52 [18.6%] vs 2304 [12.8%]; P = .004). Sexual minority women were more likely to be screened for depression during postpartum care (odds ratio, 1.77; 95% CI, 1.22-2.52; P = .002) and more likely to screen positive for depression during the postpartum period (odds ratio, 2.38; 95% CI, 0.99-5.02; P = .03) than heterosexual women. Conclusions and Relevance In this cohort study, sexual minority women identified in the medical record were highly engaged in obstetric care yet at high risk of postpartum depression. In addition, their sexual orientation was largely undocumented in medical records. These results highlight the need for investigations that include strategies for measuring sexual orientation because medical record review is unlikely to reliably capture these sexual identities during the perinatal period.
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Affiliation(s)
- Leiszle Lapping-Carr
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ashley Dennard
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Katherine L. Wisner
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - S. Darius Tandon
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
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Peters JR, Stumper A, Schmalenberger KM, Taubman AJ, Eisenlohr-Moul TA. Improving rigor through gender inclusivity in reproductive psychiatric science. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2023; 16:100194. [PMID: 37560411 PMCID: PMC10407113 DOI: 10.1016/j.cpnec.2023.100194] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/15/2023] [Accepted: 07/16/2023] [Indexed: 08/11/2023] Open
Abstract
Accurately defining the individuals that research involves and generalizes to is critical for rigorous and reproducible science. In reproductive psychiatry, which historically focuses on the impact of the menstrual cycle, pregnancy, and menopause on mental health, this means moving beyond characterizing samples and relevant populations as "women" in favor of language that precisely identifies the physiological characteristics pertinent to the research being conducted and accurately reflects the varied genders represented in those populations. Concrete recommendations are provided for precise use of sex and gender terminology and gender inclusivity throughout the scientific process, including study conceptualization, etiquette in research environments, recruitment, methods, and dissemination. Recommendations are discussed in depth and presented in a checklist format for ease of use by research teams. Suggested items for assessing gender and relevant sex-related physiology in the context of reproductive psychiatry are also provided.
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Affiliation(s)
- Jessica R. Peters
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA
| | - Allison Stumper
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA
| | - Katja M. Schmalenberger
- Department of Psychiatry, University of Illinois at Chicago, 912 S. Wood Street, M/C 913, Chicago, IL 60612, USA
| | - Andy J. Taubman
- Youth Pride Inc, 743 Westminster St, Providence, RI 02903, USA
| | - Tory A. Eisenlohr-Moul
- Department of Psychiatry, University of Illinois at Chicago, 912 S. Wood Street, M/C 913, Chicago, IL 60612, USA
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Rioux C. Sex and gender measurement for scientific rigor and data harmonization across studies. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2023; 16:100199. [PMID: 38108030 PMCID: PMC10724730 DOI: 10.1016/j.cpnec.2023.100199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 12/19/2023] Open
Affiliation(s)
- Charlie Rioux
- Department of Psychology, University of Oklahoma, Norman, OK, USA
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Hall MS, Talge NM, Upson K. Urinary cadmium and endometriosis prevalence in a US nationally representative sample: results from NHANES 1999-2006. Hum Reprod 2023; 38:1835-1842. [PMID: 37487110 PMCID: PMC10477936 DOI: 10.1093/humrep/dead117] [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] [Revised: 05/15/2023] [Indexed: 07/26/2023] Open
Abstract
STUDY QUESTION Is exposure to toxic metal cadmium associated with increased endometriosis prevalence among a nationally representative sample of the US population? SUMMARY ANSWER Concentrations of urinary cadmium, a long-term biomarker (10-30 years) of cadmium exposure, were associated with an increased prevalence of endometriosis. WHAT IS KNOWN ALREADY Cadmium exhibits estrogenic properties and may increase the risk of endometriosis, a gynecologic condition associated with substantial morbidity, for which estrogen has a central pathogenic role. Previous epidemiological studies of cadmium and endometriosis have yielded mixed results, with null, positive, and inverse associations being reported. STUDY DESIGN, SIZE, DURATION We conducted a cross-sectional study using data from four cycles of the National Health and Nutrition Examination Survey (NHANES) 1999-2006. PARTICIPANTS/MATERIALS, SETTING, METHODS The study population comprised participants aged 20-54 years who had an endometriosis diagnosis, available data on urinary cadmium, and a glomerular filtration rate ≥60 ml/min/1.73 m2 (unweighted n = 1647). Urinary cadmium was measured by inductively coupled plasma-mass spectrometry, and we used urinary creatinine concentrations and covariate-adjusted standardization to account for urinary dilution. Self-reported diagnosis of endometriosis was ascertained by interview. We examined the association between quartiles of urinary cadmium and endometriosis using log-binomial regression to estimate adjusted prevalence ratios (aPRs) and 95% CIs. MAIN RESULTS AND THE ROLE OF CHANCE We observed twice the prevalence of endometriosis for participants with cadmium concentrations in the second quartile (versus the first quartile) (aPR 2.0, 95% CI: 1.1, 3.9) and the third quartile (versus the first quartile) (aPR 2.0, 95% CI: 1.1, 3.7). Our data also suggested a 60% increased prevalence of endometriosis with urinary cadmium concentrations in the fourth quartile (versus the first quartile) (aPR 1.6, 95% CI: 0.8, 3.2). In a sensitivity analysis, restricting the study population to premenopausal participants with an intact uterus and at least one ovary (unweighted n = 1298), stronger associations accompanied by wider CIs were observed. LIMITATIONS, REASONS FOR CAUTION We were limited by the ascertainment of urinary cadmium and endometriosis diagnosis at a single time point, given the cross-sectional study design, and we relied on self-report of endometriosis diagnosis. However, urinary cadmium characterizes long-term exposure and findings from validation studies suggest that misclassification of self-reported endometriosis diagnosis may be minimal. WIDER IMPLICATIONS OF THE FINDINGS This study suggests that cadmium is associated with an increased endometriosis prevalence. Given the substantial morbidity conferred by endometriosis and that the general population is ubiquitously exposed to cadmium, further research is warranted to confirm our findings. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the National Institute of Nursing Research (grant R00NR017191 to K.U.) of the National Institutes of Health. The authors report no conflict of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Mandy S Hall
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Nicole M Talge
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Kristen Upson
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
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Joachim GE, Bohnert KM, As-Sanie S, Harris HR, Upson K. Cannabis smoking, tobacco cigarette smoking, and adenomyosis risk. Fertil Steril 2023; 119:838-846. [PMID: 36716812 PMCID: PMC10900224 DOI: 10.1016/j.fertnstert.2023.01.035] [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: 09/09/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To investigate cannabis smoking and tobacco cigarette smoking in relation to adenomyosis risk. DESIGN We used data from a case-control study of adenomyosis conducted among enrollees ages 18-59 years of an integrated health care system in Washington State. The case-control study used 2 control groups given the challenge of selecting noncases when cases are diagnosed by hysterectomy. SUBJECTS Cases (n = 386) were enrollees with incident, pathology-confirmed adenomyosis diagnosed between April 1, 2001, and March 31, 2006. The 2 control groups comprised hysterectomy controls (n = 233) with pathology-confirmed absence of adenomyosis and population controls (n = 323) with an intact uterus selected randomly from the health care system population and frequency matched to cases on age. EXPOSURE Detailed data on cannabis and tobacco cigarette smoking history were ascertained through in-person structured interviews, allowing estimation of joint-years of cannabis smoking and pack-years of tobacco cigarette smoking. MAIN OUTCOME MEASURES Odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between cannabis smoking, tobacco cigarette smoking, and adenomyosis were estimated using multivariable unconditional logistic regression. Analyses were adjusted for age, reference year, menarche age, education, and pack-years of cigarette smoking (or joint-years of cannabis smoking). RESULTS No association was observed between cannabis smoking history and adenomyosis risk. However, we did observe the suggestion of an association between ever tobacco cigarette smoking and adenomyosis risk, comparing cases to hysterectomy controls (OR, 1.3; 95% CI, 0.9-1.9) and population controls (OR, 1.2; 95% CI, 0.8-1.8). Our data suggested a 50% increased odds of adenomyosis with >15 pack-years of smoking (vs. never smoking), comparing cases to hysterectomy controls (OR, 1.5; 95% CI, 0.9-2.6; Ptrend=.135). The suggestion of a 40% increased adenomyosis odds was observed with smoking >5-15 pack-years (vs. never smoking), comparing cases to population controls (OR, 1.4; 95% CI, 0.8-2.4; Ptrend=0.136). CONCLUSION In the first study of cannabis smoking and adenomyosis risk, no association was observed. However, our data suggested an increased odds of adenomyosis with history of tobacco cigarette smoking. Further research is warranted to replicate our results given the substantial morbidity with adenomyosis and frequency of cigarette smoking and recreational and medical cannabis use.
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Affiliation(s)
- Grace E Joachim
- Department of Microbiology and Molecular Genetics, Lyman Briggs College, Michigan State University, East Lansing, Michigan; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
| | - Kipling M Bohnert
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan
| | - Sawsan As-Sanie
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Holly R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington; Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington
| | - Kristen Upson
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan
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Hall MS, Holt VL, Holzman C, Vazquez AI, Harris HR, As-Sanie S, Upson K. Breastfeeding history and adenomyosis risk using a novel case-control study design. Fertil Steril 2023; 119:644-652. [PMID: 36563837 PMCID: PMC10079609 DOI: 10.1016/j.fertnstert.2022.12.028] [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: 08/05/2022] [Revised: 11/04/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the association between breastfeeding history, including lifetime exclusive breastfeeding, and risk of adenomyosis. DESIGN We used data from a case-control study designed with 2 control groups to address the challenge of selecting noncases for a valid epidemiologic study when cases are identified by hysterectomy. The case-control study was conducted among premenopausal and postmenopausal enrollees aged 18-59 years in a large, integrated health care system in western Washington state. PATIENT(S) Cases were enrollees with incident, pathology-confirmed adenomyosis diagnosed during 2001-2006 (n = 386). The 2 control groups were as follows: (1) randomly selected age-matched enrollees with intact uteri ("population controls," n = 323) and (2) hysterectomy controls (n = 233). INTERVENTION(S) Data on breastfeeding history were collected by in-person interviews. For each reported live birth, participants were asked whether they breastfed, along with infant age at supplemental feeding introduction and breastfeeding discontinuation. MAIN OUTCOME MEASURE(S) Among participants with at least 1 live birth (330 cases, 246 population controls, and 198 hysterectomy controls), we used unconditional logistic regression to estimate adjusted odds ratios and 95% confidence intervals (CIs) for the associations between the following: (1) ever breastfeeding, (2) ever breastfeeding for ≥8 weeks, (3) lifetime breastfeeding, and (4) lifetime exclusive breastfeeding and risk of adenomyosis. Analyses were adjusted for age, reference year, smoking, education, and parity. RESULT(S) In analyses comparing cases with population controls, we observed a 40% decreased odds of adenomyosis with a history of ever breastfeeding (adjusted odds ratio, 0.6; 95% CI, 0.3-1.0) and breastfeeding for ≥8 weeks (adjusted odds ratio, 0.6; 95% CI, 0.4-0.8). The strongest associations, 60%-70% decreased odds of adenomyosis, were observed with ≥12 months of lifetime breastfeeding (vs. <3 months) (adjusted odds ratio, 0.4; 95% CI, 0.2-0.6) and 9 to <12 months of lifetime exclusive breastfeeding (vs. <3 months) (adjusted odds ratio, 0.3; 95% CI, 0.2-0.6), comparing cases to population controls. In analyses using hysterectomy controls, we observed similar patterns of associations slightly attenuated in magnitude. CONCLUSION(S) Breastfeeding history was associated with a 40% decreased odds of adenomyosis, a condition that can confer substantial morbidity and requires hysterectomy for definitive treatment. The consistency of our findings with that of a previous study lends support that breastfeeding may modify risk of adenomyosis.
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Affiliation(s)
- Mandy S Hall
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan.
| | - Victoria L Holt
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
| | - Claudia Holzman
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan
| | - Ana I Vazquez
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan; Institute for Quantitative Health Science and Engineering (IQ), Michigan State University, East Lansing, Michigan
| | - Holly R Harris
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington; Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Sawsan As-Sanie
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Kristen Upson
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan
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23
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Wilkie AA, Richardson DB, Luben TJ, Serre ML, Woods CG, Daniels JL. Sulfur dioxide reduction at coal-fired power plants in North Carolina and associations with preterm birth among surrounding residents. Environ Epidemiol 2023; 7:e241. [PMID: 37064422 PMCID: PMC10097570 DOI: 10.1097/ee9.0000000000000241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/05/2023] [Indexed: 02/17/2023] Open
Abstract
Coal-fired power plants (CFPP) are major contributors of air pollution, including the majority of anthropogenic sulfur dioxide (SO2) emissions, which have been associated with preterm birth (PTB). To address a 2002 North Carolina (NC) policy, 14 of the largest NC CFPPs either installed desulfurization equipment (scrubbers) or retired coal units, resulting in substantial reductions of SO2 air emissions. We investigated whether SO2 air emission reduction strategies at CFPPs in NC were associated with changes in prevalence of PTB in nearby communities. Methods We used US EPA Air Markets Program Data to track SO2 emissions and determine the implementation dates of intervention at CFPPs and geocoded 2003-2015 NC singleton live births. We conducted a difference-in-difference analysis to estimate change in PTB associated with change in SO2 reduction strategies for populations living 0-<4 and 4-<10 miles from CFPPs pre- and postintervention, with a comparison of those living 10-<15 miles from CFPPs. Results With the spatial-temporal exposure restrictions applied, 42,231 and 41,218 births were within 15 miles of CFPP-scrubbers and CFPP-retired groups, respectively. For residents within 4-<10 miles from a CFPP, we estimated that the absolute prevalence of PTB decreased by -1.5% [95% confidence interval (CI): -2.6, -0.4] associated with scrubber installation and -0.5% (95% CI: -1.6, 0.6) associated with the retirement of coal units at CFPPs. Our findings were imprecise and generally null-to-positive among those living within 0-<4 miles regardless of the intervention type. Conclusions Results suggest a reduction of PTB among residents 4-<10 miles of the CFPPs that installed scrubbers.
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Affiliation(s)
- Adrien A Wilkie
- Oak Ridge Institute for Science and Education (ORISE) Postdoctoral Fellow at US EPA, Research Triangle Park, North Carolina
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - David B Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- Program in Public Health, University of California at Irvine, Irvine, California
| | - Thomas J Luben
- United States Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, Research Triangle Park, North Carolina
| | - Marc L Serre
- Department of Environmental Science and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Courtney G Woods
- Department of Environmental Science and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Julie L Daniels
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
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24
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Williams ADN, Hood K, Bracken K, Shorter GW. The importance of NOT being Other: Time to address the invisibility of nuanced gender and sexuality in clinical trials. Trials 2023; 24:242. [PMID: 36998055 PMCID: PMC10064725 DOI: 10.1186/s13063-023-07278-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/24/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Representation of all members of society within research, especially those typically underserved, is needed to ensure that trial evidence applies to the relevant population, and that effective interventions are available to all. The lack of appropriate and representative options in demographic questions around sex, gender and sexuality may result in the exclusion of LGBTQIA + people from health research. MAIN BODY Sex and gender are not the same, yet this is rarely recognised in trial data collection, with the terms sex and gender often being used interchangeably. Sex or gender is often used as a stratification factor at randomisation and/or to define sub-groups at the time of data analysis, so correct data collection is essential for producing high-quality science. Sexuality also suffers from 'othering' with identities not being acknowledged but simply provided as an alternative to the perceived main identities. When collecting sexuality information, it is important to consider the purposes of collecting this data. CONCLUSION We call on those involved in trials to consider how sex, gender and sexuality data are collected, with an active consideration of inclusivity. Through the description of all non-straight, non-cisgender people as 'other' you may be ignoring the needs of these populations and doing science, yourself, and them a disservice. Inclusivity may require small but important changes to ensure your research findings are inclusive and develop the evidence base for often overlooked populations.
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Affiliation(s)
| | - Kerenza Hood
- Centre for Trials Research, Cardiff University, Cardiff, Wales, UK
| | - Karen Bracken
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia
| | - Gillian W Shorter
- Drug and Alcohol Research Network, Queen's University Belfast, Belfast, Northern Ireland, UK
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25
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Paul KJ, Murosko D, Smith VC, Montoya-Williams D, Parga-Belinkie J. Defining Gender in Infant Care. Neoreviews 2023; 24:e199-e205. [PMID: 36854845 DOI: 10.1542/neo.24-3-e199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Affiliation(s)
- Kathryn J Paul
- Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Daria Murosko
- Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Vincent C Smith
- Division of Newborn Medicine, Boston Medical Center, Boston, MA
| | - Diana Montoya-Williams
- Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA
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26
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Garad RM, Bahri-Khomami M, Busby M, Burgert TS, Boivin J, Teede HJ. Breaking Boundaries: Toward Consistent Gender-Sensitive Language in Sexual and Reproductive Health Guidelines. Semin Reprod Med 2023; 41:5-11. [PMID: 38052243 DOI: 10.1055/s-0043-1777323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
This review assesses gender-sensitive language in sexual and reproductive health (SRH) guidelines, including a guideline for polycystic ovary syndrome. We conducted a systematic search across databases like Medline, EMBASE, and Cochrane until July 31, 2023, using terms related to gender-inclusivity, SRH, and guideline protocols. Criteria for inclusion were gender-sensitive language, SRH focus, and guideline relevance, excluding non-English articles or those without policy considerations. Our search yielded 25 studies, with 6 included for qualitative synthesis. Results showed significant gaps in using gender-sensitive language in SRH guidelines. The debate on this language mirrors broader societal discourse. Recognizing gender diversity is essential for research, clinical practices, and societal norms. While promoting inclusion, drawbacks like unintended erasure or miscommunication should also be addressed. A gender-additive approach balances inclusivity and biological accuracy. Precise and inclusive discourse is crucial. Future research should focus on systemic approaches in the SRH sector.
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Affiliation(s)
- Rhonda M Garad
- Monash Centre for Health Research and Implementation, Monash University and Monash Health, Melbourne, Victoria, Australia
| | - Mahnaz Bahri-Khomami
- Monash Centre for Health Research and Implementation, Monash University and Monash Health, Melbourne, Victoria, Australia
| | - Maureen Busby
- Department CEO, PCOS Vitality, Ireland, United Kingdom
| | | | - Jacky Boivin
- Cardiff Fertility Studies Research Group, School of Psychology (College of Biomedical and Life Sciences), Cardiff University, Cardiff, Wales, United Kingdom
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, Monash University and Monash Health, Melbourne, Victoria, Australia
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27
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Schoneich S, Plegue M, Waidley V, McCabe K, Wu J, Chandanabhumma PP, Shetty C, Frank CJ, Oshman L. Incidence of Newborn Drug Testing and Variations by Birthing Parent Race and Ethnicity Before and After Recreational Cannabis Legalization. JAMA Netw Open 2023; 6:e232058. [PMID: 36884249 PMCID: PMC9996400 DOI: 10.1001/jamanetworkopen.2023.2058] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
IMPORTANCE Thirty-seven US states and the District of Columbia mandate reporting newborns with suspected prenatal substance exposure to the state, and punitive policies that link prenatal substance exposure to newborn drug testing (NDT) may lead to disproportionate reporting of Black parents to Child Protective Services. The impact of recreational cannabis legalization on racial disproportionality in NDT is unknown. OBJECTIVES To examine variations in the incidence and results of NDT by birthing parent race and ethnicity, variables associated with variation, and changes after statewide legalization of recreational cannabis. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study was conducted from 2014 to 2020 with 26 366 live births to 21 648 birthing people who received prenatal care at an academic medical center in the Midwestern United States. Data were analyzed from June 2021 to August 2022. EXPOSURES Variables included birthing parent age, race, ethnicity, marital status, zip code, insurance type, prenatal and newborn diagnoses codes, and prenatal urine drug test orders and results. MAIN OUTCOME AND MEASURES The primary outcome was an NDT order. Secondary outcomes were substances detected. RESULTS Among 26 366 newborns of 21 648 birthing people (mean [SD] age at delivery, 30.5 [5.2] years), most birthing parents were White (15 338 [71.6%]), were non-Hispanic (20 125 [93.1%]), and had private insurance coverage (16 159 [74.8%]). The incidence of NDT ordering was 4.7% overall (1237 newborns). Clinicians ordered more NDTs for Black compared with White newborns (207 of 2870 [7.3%] vs 335 of 17 564 [1.9%]; P < .001) when the birthing parent had no prenatal urine drug test, a presumably low-risk group. Overall, 471 of 1090 NDTs (43.3%) were positive for only tetrahydrocannabinol (THC). NDTs were more likely to be positive for opioids in White compared with Black newborns (153 of 693 [22.2%] vs 29 of 308 [9.4%]; P < .001) and more likely to be positive for THC in Black compared with White newborns (207 of 308 [67.2%] vs 359 of 693 [51.8%]; P < .001). Differences remained consistent after state recreational cannabis legalization in 2018. Newborn drug tests were more likely to be positive for THC after legalization vs before legalization (248 of 360 [68.9%] vs 366 of 728 [50.3%]; P < .001) with no significant interaction with race and ethnicity groups. CONCLUSIONS AND RELEVANCE In this study, clinicians ordered NDTs more frequently for Black newborns when no drug testing was done during pregnancy. These findings call for further exploration of how structural and institutional racism contribute to disproportionate testing and subsequent Child Protective Services investigation, surveillance, and criminalization of Black parents.
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Affiliation(s)
| | - Melissa Plegue
- Department of Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor
| | - Victoria Waidley
- Department of Family Medicine, University of California, San Diego
| | - Katharine McCabe
- Reilly Center for Science, Technology, and Values, University of Notre Dame, South Bend, Indiana
| | - Justine Wu
- Department of Family Medicine, University of Michigan, Ann Arbor
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - P. Paul Chandanabhumma
- Department of Family Medicine, University of Michigan, Ann Arbor
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - Carol Shetty
- Department of Family Medicine, University of Michigan, Ann Arbor
| | | | - Lauren Oshman
- Department of Family Medicine, University of Michigan, Ann Arbor
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
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28
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Bird A, Zavaletta V, Carroll EF, McGinnis H, Newsome J, Gichoya J, Oakden‐Rayner L. Fostering an inclusive workplace for
LGBTQIA
+ people in radiology and radiation oncology. J Med Imaging Radiat Oncol 2022; 67:193-199. [PMID: 36517994 DOI: 10.1111/1754-9485.13498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/27/2022] [Indexed: 12/23/2022]
Abstract
The inclusion and celebration of LGBTQIA+ staff in radiology and radiation oncology departments is crucial in developing a diverse and thriving workplace. Despite the substantial social change in Australia, LGBTQIA+ people still experience harassment and exclusion, negatively impacting their well-being and workplace productivity. We need to be proactive in creating policies that are properly implemented and translate to a safe and inclusive space for marginalised groups. In this work, we outline the role we all can play in creating inclusive environments, for both individuals and leaders working in radiology and radiation oncology. We can learn how to avoid normative assumptions about gender and sexuality, respect people's identities and speak out against witnessed discrimination or slights. Robust policies are needed to protect LGBTQIA+ members from discrimination and provide equal access across other pertinent parts of work life such as leave entitlements, representation in data collection and safe bathroom access. We all deserve to feel safe and respected at work and further effort is needed to ensure this extends to LGBTQIA+ staff in the radiology and radiation oncology workforces.
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Affiliation(s)
- Alix Bird
- School of Public Health The University of Adelaide Adelaide South Australia Australia
| | | | - Evelyn F Carroll
- NYU Grossman School of Medicine, New York, New York, USA New York City New York USA
| | | | | | - Judy Gichoya
- Emory University School of Medicine Atlanta Georgia USA
| | - Lauren Oakden‐Rayner
- School of Public Health The University of Adelaide Adelaide South Australia Australia
- Royal Adelaide Hospital Adelaide South Australia Australia
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29
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Soled KRS, Clark KD, Altman MR, Bosse JD, Thompson RA, Squires A, Sherman ADF. Changing language, changes lives: Learning the lexicon of LGBTQ+ health equity. Res Nurs Health 2022; 45:621-632. [PMID: 36321331 PMCID: PMC9704510 DOI: 10.1002/nur.22274] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Kodiak R. S. Soled
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Kristen D. Clark
- Department of Nursing, University of New Hampshire, Durham, New Hampshire, USA
| | - Molly R. Altman
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington, USA
| | - Jordon D. Bosse
- School of Nursing, Northeastern University, Boston, Massachusetts, USA
| | - Roy A. Thompson
- Sinclair School of Nursing, University of Missouri, Colombia, Missouri, USA
| | - Allison Squires
- Rory Meyers College of Nursing, New York University, New York City, New York, USA
| | - Athena D. F. Sherman
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
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30
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Montoya-Williams D, Duncan AF, Burris HH. Racial and ethnic perinatal and infant disparities: a comprehensive, diverse and actionable compendium. Semin Perinatol 2022; 46:151655. [PMID: 36153271 DOI: 10.1016/j.semperi.2022.151655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Diana Montoya-Williams
- Roberts Center for Pediatric Research at the Children's Hospital of Philadelphia, 2716 South Street, Office 19-361, Philadelphia, PA 19146, United States.
| | - Andrea F Duncan
- Roberts Center for Pediatric Research at the Children's Hospital of Philadelphia, 2716 South Street, Office 19-361, Philadelphia, PA 19146, United States
| | - Heather H Burris
- Roberts Center for Pediatric Research at the Children's Hospital of Philadelphia, 2716 South Street, Office 19-361, Philadelphia, PA 19146, United States
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31
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Probst Y, Sulistyoningrum DC, Netting MJ, Gould JF, Wood S, Makrides M, Best KP, Green TJ. Estimated Choline Intakes and Dietary Sources of Choline in Pregnant Australian Women. Nutrients 2022; 14:nu14183819. [PMID: 36145195 PMCID: PMC9503354 DOI: 10.3390/nu14183819] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 11/29/2022] Open
Abstract
(1) Background: Despite the postulated importance of choline during pregnancy, little is known about the choline intake of Australians during pregnancy. In this study, we estimated dietary intakes of choline in early and late pregnancy, compared those intakes to recommendations, and investigated food sources of choline in a group of pregnant women in Australia. (2) Methods: 103 pregnant women enrolled in a randomized controlled trial. In early pregnancy (12−16 weeks gestation) and late pregnancy (36 weeks gestation), women completed a food frequency questionnaire designed to assess dietary intake over the previous month. (3) Results: Choline intakes and sources were similar in early and late pregnancy. Median choline intake in early pregnancy was 362 mg/day. Of the women, 39% and 25% had choline intakes above the Australian National Health and Medical Research Council (NHMRC) adequate intake (AI) of >440 mg/day and the European Food Safety Authority (EFSA) AI of >480 mg/day for choline in pregnancy, respectively. Eggs, red meat, nuts, legumes, and dairy accounted for 50% of choline intake, with eggs being the most significant contributor at 17%. (4) Conclusions: Few pregnant women in our study met the AI recommended by the NHMRC and EFSA. In Australia, choline intake in pregnancy may need to be improved, but further work to define choline requirements in pregnancy is required.
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Affiliation(s)
- Yasmine Probst
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia
| | - Dian C. Sulistyoningrum
- Discipline of Paediatrics, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Merryn J. Netting
- Discipline of Paediatrics, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Jacqueline F. Gould
- Discipline of Paediatrics, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Simon Wood
- Factors Group of Nutritional Products Inc. Research & Development, Burnaby, BC V3K 6Y2, Canada
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
| | - Maria Makrides
- Discipline of Paediatrics, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Karen P. Best
- Discipline of Paediatrics, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Tim J. Green
- Discipline of Paediatrics, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- Correspondence: ; Tel.: +61-45-244-8438
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