The role of smoking in the relationship between intimate partner violence and age at natural menopause: a mediation analysis

Childhood adversity and accelerated reproductive events: a systematic review and meta-analysis

OBJECTIVE

Accelerated female reproductive events represent the early onset of reproductive events involving puberty, menarche, pregnancy loss, first sexual intercourse, first birth, parity, and menopause. This study aimed to explore the association between childhood adversity and accelerated female reproductive events.

DATA SOURCES

PubMed, Web of Science, and Embase were systematically searched from September 22, 2022 to September 23, 2022.

STUDY ELIGIBILITY CRITERIA

Observational cohort, cross-sectional, and case-control studies in human populations were included if they reported the time of reproductive events for female individuals with experience of childhood adversity and were published in English.

METHODS

Two reviewers independently screened studies, obtained data, and assessed study quality, and conflicts were resolved by a third reviewer. Dichotomous outcomes were evaluated using meta-analysis, and pooled odds ratios and 95% confidence intervals were generated using random-effects models. Moderation analysis and meta-regression were used to investigate heterogeneity.

RESULTS

In total, 21 cohort studies, 9 cross-sectional studies, and 3 case-control studies were identified. Overall, female individuals with childhood adversity were nearly 2 times more likely to report accelerated reproductive events than those with no adversity exposure (odds ratio, 1.91; 95% confidence interval, 1.33-2.76; I2=99.6%; P<.001). Moderation analysis indicated that effect sizes for the types of childhood adversity ranged from an odds ratio of 1.61 (95% confidence interval, 1.23-2.09) for low socioeconomic status to 2.13 (95% confidence interval, 1.14-3.99) for dysfunctional family dynamics. Among the 7 groups based on different reproductive events, including early onset of puberty, early menarche, early sexual initiation, teenage childbirth, preterm birth, pregnancy loss, and early menopause, early sexual initiation had a nonsignificant correlation with childhood adversity (odds ratio, 2.70; 95% confidence interval, 0.88-8.30; I2=99.9%; P<.001). Considerable heterogeneity (I2>75%) between estimates was observed for over half of the outcomes. Age, study type, and method of data collection could explain 35.9% of the variance.

CONCLUSION

The literature tentatively corroborates that female individuals who reported adverse events in childhood are more likely to experience accelerated reproductive events. This association is especially strong for exposure to abuse and dysfunctional family dynamics. However, the heterogeneity among studies was high, requiring caution in interpreting the findings and highlighting the need for further evaluation of the types and timing of childhood events that influence accelerated female reproductive events.

Impact of violence against women on quality of life and menopause-related disorders

Violence against women is a pressing global issue that poses a number of significant health risks. The influence of violence on women's health during the menopause has been underestimated, especially its impact on the early onset of menopause and on the exacerbation of symptoms that determine quality of life. The objectives of our study were to analyse whether experiencing any type of violence increases the risk of early menopause, worsens menopausal symptoms, and results in a lower quality of life. This cross-sectional observational study recruited 29 postmenopausal women who had experienced violence from a partner in their lifetimes. Additionally, 89 postmenopausal who had not suffered from violence were included as a control group. All the women who had experienced violence from a partner reported psychological and economic violence, 75 % reported physical violence, 57.1 % reported sexual violence, and 39.3 % reported all types of violence. Violence was found to be associated with menopausal symptoms and poorer quality of life. These associations persisted after adjustment for multiple factors, and women who had experienced any form of violence reported a worse quality of life during menopause. Moreover, violence-exposed women reached menopause approximately 20 months earlier (p < 0.05), and 20.7 % of these women developed premature ovarian insufficiency (p < 0.001).

Magnitude of Spousal Violence and Associated Factors among Midlife Women in Ethiopia

Background

Intimate partner violence is the most common form of gender-based violence and has enormous maternal health consequences. There is limited evidence concerning the magnitude and determinants of intimate partner violence amongst midlife women. Thus, this study aimed to determine the extent of and the factors contributing to spousal violence amongst midlife Ethiopian women.

Methods

The 2016 Ethiopia Demographic and Health Survey (EDHS) data were examined, and a sample of 1628 ever-married midlife women was included. The analysis was performed using SPSS version 20. Bivariate and multivariable logistic regression analysis was conducted to examine the determinants of intimate partner violence. All statistical significance was declared at p value < 0.05.

Results

The prevalence of spousal violence among midlife women in Ethiopia was 31.8%. Age of women, divorced, and working status were significantly associated with spousal violence. The likelihood of spousal violence is increase among midlife women who had no formal education, less decision-making power in household, and had partner who had drinking habit.

Conclusion

This study showed that nearly one-thirds of midlife Ethiopian women have experienced spousal violence in their lifetime. Empowering midlife women by giving them decision-making tools and educating them to deal with, and prevent spousal violence may be effective strategies in reducing this problem.

Racial/ethnic differences in social support and health among Asian American and non-Hispanic White midlife women: Results from the Study of Women's Health Across the Nation (SWAN)

OBJECTIVE

Although prior research suggests Asian Americans experience physical health advantages relative to other racial/ethnic groups, increasing evidence points to health inequalities within Asian American subgroups. Disparities are especially pronounced among middle-aged Asian American women, who remain an understudied population, despite studies showing that midlife corresponds with distinct social stressors and changes in the availability of protective resources, such as social support. Thus, the purpose of the study was to examine racial/ethnic differences in social support and self-rated health (SRH) among middle-aged women.

DESIGN

With data from the Study of Women's Health Across the Nation (SWAN; N = 1258), we used modified Poisson regression models to estimate incidence rate ratios (IRR), examining how social support shaped the risk of fair-to-poor SRH by race/ethnicity. We tested interactions between perceived stress, social support and race/ethnicity to determine whether the stress-buffering role of social support varies by group.

RESULTS

Results demonstrate racial/ethnic differences in SRH. Higher levels of social support were linked to higher fair-to-poor SRH among Chinese American women (IRR = 1.24; 95% CI [1.02, 1.52]); while greater social support conferred lower risk among White women. Interaction analyses revealed additional nuances in the stress-buffering effects of social support among Chinese American women, such that the health benefits of social support depended on levels of perceived stress (IRR = 0.75; 95% CI [0.57, 1.00]).

CONCLUSIONS

These findings highlight important distinctions in the ways that psychosocial factors shape health across racial/ethnic groups. In particular, this study helps advance our understanding of important subgroup differences in the stress-buffering role of social support for Asian American midlife women. Interventions should focus on identifying sources of social strain among Asian American women that can increase the risk for poor health and identify alternative sources of support that mitigate stressors to improve health.

Changes in Life Circumstances and Mental Health Symptoms during the COVID-19 Pandemic among Midlife Women with Elevated Risk for Cardiovascular Disease

Cardiovascular disease (CVD) remains the leading cause of death among women. During midlife (ages 40-60), universal aging processes, sex-specific factors such as menopause, psychological distress, and conditions such as hypertension substantially increase women's risk for CVD. The onset of the COVID-19 pandemic has impacted employment, social interactions, caregiving responsibilities, and overall well-being worldwide; however, little research has investigated how COVID-19 has affected women in midlife. The present study was designed to determine how COVID-19 has affected women in midlife with elevated risk for CVD, by examining changes in their mental health symptoms and life domains across three time points: prior to COVID-19 (2019), during stay-at-home orders (April-June 2020), and during initial reopening (August 2020). Women in midlife with one or more CVD risk conditions (e.g., hypertension; n = 35) responded to questions related to COVID-19, changes in life circumstances, and mental health symptoms at each time point. Findings showed meaningful changes in caregiving, medical visits, and employment status, as well as significant changes in depression and sleep quality scores across time. However, the findings also showed that women were distressed prior to COVID-19 and did not exhibit changes in perceived stress, body dissatisfaction, or anxiety symptoms over time. Findings from this study highlight the impact of the COVID-19 pandemic on an at-risk group of women, which may be used to help guide future health promotion efforts specifically tailored to this population.

Clinical profile and quality of life in climacteric women

BACKGROUND

The Quality of Life in climacteric women is intrinsically related to signs and symptoms influenced by the decrease of estrogen and psychosocial factors linked to the natural aging process. Thus, this study aimed to trace the sociodemographic and clinical profiles of climacteric women working at the State University of Rio Grande do Norte (UERN) and evaluate their Quality of Life.

METHODS

It is a descriptive, exploratory, and quantitative study. The population consisted of female workers from UERN, aging between 40 and 65 years. The total sample consisted of 63 women who answered the forms. Data collection was completely online, which allowed the women to have free choice to choose the most appropriate time to answer the questions.

RESULTS

The majority of the participants were older than 50 years (53.97%, n = 34), were married or in a stable union (55.56%, n = 35), and lived in Mossoró-RN (82.53%, n = 52). Regarding skin color, white and brown women had the same percentage of 44.44% (n = 28). The pain, general health status, and vitality domains evidence the predominance of poor quality of life in the SF-36 questionnaire. Regarding the level of satisfaction with their current health status, 4.76% (n = 3) stated that they fit the level considered excellent, 44.44% (n = 28) very good, 46, 03% (n = 29) were good, and 4.77% (n = 3) stated unsatisfied with their current health status. The intensity of symptoms related to estrogen deficiency established by the Kupperman menopause index is as Mild 55.56% (n = 35), moderate 41.27% (n = 26), and severe 3.17% (n = 2).

CONCLUSIONS

The occurrence of symptoms and perception of these symptoms differs from woman to woman, to a greater or lesser extent. These findings emphasize the need for qualified and individualized care for the needs of these women in health services and the development of applicable solutions for solving problems based on each woman profile.

A gender-specific assessment of tobacco use risk factors: evidence from the latest Pakistan demographic and health survey

BACKGROUND

The high prevalence of tobacco use in Pakistan poses a substantial health and economic burden to Pakistani individuals, families, and society. However, a comprehensive assessment of the key risk factors of tobacco use in Pakistan is very limited in the literature. A better understanding of the key risk factors of tobacco use is needed to identify and implement effective tobacco control measures.

OBJECTIVES

To investigate the key socioeconomic, demographic, and psychosocial determinants of tobacco smoking in a recent large nationally representative sample of Pakistani adults.

METHODS

N = 18,737 participants (15,057 females and 3680 males) from the 2017-18 Pakistan Demographic Health Survey, aged 15-49 years, with data on smoking use and related factors were included. Characteristics of male and female participants were compared using T-tests (for continuous variables) and χ2-tests (for categorical variables). Multivariable logistic regression models were used to identify gender-specific risk factors of tobacco use. The Receiver Operating Characteristic Curve test was used to evaluate the predictive power of models.

RESULTS

We found that the probability of smoking for both males and females is significantly associated with factors such as their age, province/region of usual residence, education level, wealth, and marital status. For instance, the odds of smoking increased with age (from 1.00 [for ages 15-19 years] to 3.01 and 5.78 respectively for females and males aged 45-49 years) and decreased with increasing education (from 1.00 [for no education] to 0.47 and 0.50 for females and males with higher education) and wealth (from 1.00 [poorest] to 0.43 and 0.47 for richest females and males). Whilst the odd ratio of smoking for rural males (0.67) was significantly lower than that of urban males (1.00), the odds did not differ significantly between rural and urban females. Finally, factors such as occupation type, media influence, and domestic violence were associated with the probability of smoking for Pakistani females only.

CONCLUSIONS

This study identified gender-specific factors contributing to the risk of tobacco usage in Pakistani adults, suggesting that policy interventions to curb tobacco consumption in Pakistan should be tailored to specific population sub-groups based on their sociodemographic and psychosocial features.

Association between intergenerational violence exposure and maternal age of menopause

OBJECTIVE

To investigate whether maternal violence exposure personally and through her child is associated with an earlier age of menopause, controlling for covariates.

METHODS

Analyses used merged data from two related sources. Although mothers (n = 1,466) were interviewed in 1995 and then 20 years later (2015-17), their children were interviewed in the National Longitudinal Study of Adolescent to Adult Health repeatedly (Waves 1-4, 1994/5 to 2008-2009). Mothers reported their own age of menopause, and mothers and adolescents each reported their own exposure to violence as children and adults.

RESULTS

A mother's own childhood physical abuse (b = -1.60, P < .05) and her child's sexual abuse (b = -1.39, P < .01) both were associated with an earlier age of menopause. Mothers who were physically abused in childhood and have a child who experienced regular sexual abuse reached menopause 8.78 years earlier than mothers without a history of personal abuse or abuse of their child.

CONCLUSIONS

Our study is the first to find that age of natural menopause is associated with intergenerational violence exposures.

Exploring the Linkages between Substance Use, Natural Disasters, Pandemics, and Intimate Partner Violence against Women: A Rapid Review in the Context of COVID-19

Rates of intimate partner violence (IPV) and substance use have risen during the COVID-19 pandemic, with potentially enduring effects on women’s health. A rapid review was conducted on IPV and women’s substance use in the context of the COVID-19 pandemic. The rapid review explored two separate research questions with a view to integrate the literature related to: (1) containment, social isolation, pandemics, disasters, lockdowns, and IPV; and (2) the relationships between substance use and IPV. Two different searches for each question were conducted between May and October 2020 and n = 47 articles were included. Women experience multiple physical and mental health consequences related to IPV that can be exacerbated by public health crises such as pandemics and disasters. Perpetrators may use these events as a tactic to threaten, isolate, or use coercive control. Similar tactics are reported in the complex relationship between IPV and substance use, where substance use can accompany IPV and/or be used as a coping mechanism for survivors. The findings highlight long standing women’s health concerns made further visible during the COVID-19 pandemic. Additional research is needed to identify actions required to reduce gender inequities and harms associated with IPV and substance use, and to adequately tailor and prepare effective responses in the context of future public health crises.

Gender differences in the acceptance of wife-beating in Nigeria: evidence from the 2018 Demographic and Health Survey

The world over, more than one-third of women have been victims of either physical or sexual violence, or both, most of which are perpetrated by intimate partners. Intimate partner violence (IPV) has negative consequences for women's health, socio-economic and psychological wellbeing. Similarly, acceptance of IPV has negative implications for its spread, sympathy for victims, and utilisation of antenatal and postnatal healthcare services among women. This study investigates the influence of age, education, location, religion, marriage type, employment, wealth level, extramarital sex, smoking, internet use, media exposure and decision making on the justification of IPV, and how the associations vary between men and women. The study utilised the 2018 Nigeria's Demographic and Health Survey. The data analysed was comprised of 8,018 men and 28,888 women who were married or living with a partner. It was found that women are more likely to accept IPV than men (AOR: 1.627). Educational difference between spouses influences women's experience of and acceptance of IPV. Overall, being young, being uneducated, living in the north, being Muslim, being polygamous, being employed, being poor, having extra-marital sex, being a smoker, not having access to internet, and not being exposed to the media increased the odds of IPV justification. However, while Muslim women had higher odds of accepting IPV than Christians (AOR: 1.587), Muslim men have lower likelihood of IPV justification than Christian men (AOR: 0.759). Gender differences also exist in the influence of age, marriage type, employment, extra-marital sex, smoking, media exposure and decision making. This study underscores the importance of applying differing intervention programmes to men and women where necessary.

The future excess fraction of cancer due to lifestyle factors in Australia

BACKGROUND

Many cancers are caused by exposure to lifestyle, environmental, and occupational factors. Earlier studies have estimated the number of cancers occurring in a single year which are attributable to past exposures to these factors. However, there is now increasing appreciation that estimates of the future burden of cancer may be more useful for policy and prevention. We aimed to calculate the future number of cancers expected to arise as a result of exposure to 23 modifiable risk factors.

METHODS

We used the future excess fraction (FEF) method to estimate the lifetime burden of cancer (2016-2098) among Australian adults who were exposed to modifiable lifestyle, environmental, and occupational risk factors in 2016. Calculations were conducted for 26 cancer sites and 78 cancer-risk factor pairings.

RESULTS

The cohort of 18.8 million adult Australians in 2016 will develop an estimated 7.6 million cancers during their lifetime, of which 1.8 million (24%) will be attributable to exposure to modifiable risk factors. Cancer sites with the highest number of future attributable cancers were colon and rectum (n = 717,700), lung (n = 380,400), and liver (n = 103,200). The highest number of future cancers will be attributable to exposure to tobacco smoke (n = 583,500), followed by overweight/obesity (n = 333,100) and alcohol consumption (n = 249,700).

CONCLUSION

A significant proportion of future cancers will result from recent levels of exposure to modifiable risk factors. Our results provide direct, pertinent information to help determine where preventive measures could best be targeted.

Prevalence of Intimate Partner Violence Among Pregnant Women in the Poor Neighborhoods of Hamadan, Iran

Intimate partner violence (IPV) occurs in all settings, especially in poor neighborhoods. It is considered to be a serious public health concern with serious consequences in the short and long term for abused women because of distinct barriers in obtaining support sources. Therefore this cross-sectional study focuses on the prevalence and the determinants of IPV among pregnant women residents in poor neighborhoods. Overall, 63.8% experienced at least one type of IPV. Also, educational status, family's monthly income, husband's employment status, and having a smoker husband were found to be important predictors of IPV against pregnant women. A better understanding of social determinants of violence can help decision-makers in developing effective policies. It is crucial to prioritize the poor neighborhoods for future interventions to reduce IPV imposed during pregnancy.