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Global Women's Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: closed (31 August 2020) | Viewed by 73122

Special Issue Editor

Special Issue Information

Dear Colleagues,

I am organizing a Special Issue on "Global Women’s Health" in the International Journal of Environmental Research and Public Health, a peer-reviewed journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, please refer to https://www.mdpi.com/journal/ijerph.

Women’s health is a major concern all over the world. During pregnancies, women may encounter complications, including preterm births, spontaneous or artificial abortion, gestational hypertension and diabetes. For the rest of their lifetime, they may face problems that potentially threaten their health, such as endometriosis, polycystic ovarian syndrome, genital prolapse, and gynecologic cancers. In addition, fertility, contraception, the effect of environmental hormones (endocrine disruptors) on women’s diseases, and health disparities of females are all important issues. According to a WHO report, health disparities of females exist in many countries as a result of both biological and gender-related differences. In many countries, women are disadvantaged by discrimination rooted in sociocultural factors which prevent them from benefiting from quality health services, including unequal power relationships between genders, social norms that decrease education and paid employment opportunities, an exclusive focus on women’s reproductive roles, and potentially physical, sexual, and emotional violence.

This Special Issue solicits any original contributions and reviews that explore the natures of diseases and health impact on women in different countries and communities. Studies discussing health issues of global women mentioned above are welcomed. The listed keywords suggest just a few of the many possibilities.

Prof. Kuo-Hu Chen
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Preterm birth
  • Abortion, spontaneous or artificial
  • Gestational hypertension
  • Diabetes, overt or gestational
  • Gynecologic cancer
  • Endometriosis
  • Polycystic ovarian syndrome
  • Minimally invasive gynecologic surgery
  • Fertility and contraception
  • Genital prolapse
  • Environmental hormones (endocrine disruptor) and women’s diseases
  • Health disparities of females

Published Papers (17 papers)

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16 pages, 2019 KiB  
Article
A Meta-Analysis of Comparing Intermittent Epidural Boluses and Continuous Epidural Infusion for Labor Analgesia
by I-Shiang Tzeng, Ming-Chang Kao, Po-Ting Pan, Chu-Ting Chen, Han-Yu Lin, Po-Chun Hsieh, Chan-Yen Kuo, Tsung-Han Hsieh, Woon-Man Kung, Chu-Hsuan Cheng and Kuo-Hu Chen
Int. J. Environ. Res. Public Health 2020, 17(19), 7082; https://doi.org/10.3390/ijerph17197082 - 27 Sep 2020
Cited by 3 | Viewed by 3179
Abstract
With the development of medical equipment and techniques in labor anesthesia, it is a major issue to investigate the risks and treatment effects among techniques such as continuous epidural infusion (CEI) and intermittent epidural bolus (IEB). However, there is a controversial result regarding [...] Read more.
With the development of medical equipment and techniques in labor anesthesia, it is a major issue to investigate the risks and treatment effects among techniques such as continuous epidural infusion (CEI) and intermittent epidural bolus (IEB). However, there is a controversial result regarding two techniques. This study was conducted through meta-analysis of randomized controlled trials (RCTs) for labor analgesia between the CEI and IEB techniques. The pooled results were presented as weighted mean differences (WMDs) together with 95% confidence intervals (CIs) and odds ratios (ORs) together with 95% CIs, respectively. Eleven RCTs were included in this meta-analysis. Four hundred sixty-five parturients accepted CEI, whereas 473 parturients accepted IEB labor analgesia. Elven identified low- risk bias studies were recruited for meta-analysis. The results presented no statistical difference in cesarean delivery rate between IEB and CEI (OR, 0.96; 95% CI, 0.67–1.37) and duration of second stage of labor (WMD, −3.82 min; 95% CI, −8.28 to 0.64). IEB had statistically significant lessened risk of instrumental delivery (OR, 0.59; 95% CI, 0.39–0.90) and for the use in local anesthetic (WMD, −1.71 mg bupivacaine equivalents per hour; 95% CI, −1.88 and −1.55). Accepted IEB had a higher score of maternal satisfaction (WMD, −6.95 mm; 95% CI, −7.77 to −6.13). Based on evidence, IEB showed a greater benefit for slightly reducing the use in local anesthetic, reduced risk of instrumental delivery, and improved maternal satisfaction for the requirement of labor epidural analgesia for healthy women. In the future, more studies need to be conducted to practice the IEB regimen and explore its influence on labor analgesia. Full article
(This article belongs to the Special Issue Global Women's Health)
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9 pages, 463 KiB  
Article
Female Human Papillomavirus Infection Associated with Increased Risk of Infertility: A Nationwide Population-Based Cohort Study
by Li-Chuan Hsu, Kuan-Hao Tsui, James Cheng-Chung Wei, Hei-Tung Yip, Yao-Min Hung and Renin Chang
Int. J. Environ. Res. Public Health 2020, 17(18), 6505; https://doi.org/10.3390/ijerph17186505 - 07 Sep 2020
Cited by 7 | Viewed by 2681
Abstract
Objective. This study investigated whether women with a history of human papillomavirus (HPV) infection have an increased risk of infertility. Material and Methods. All patients with an HPV infection (n = 11,198) in Taiwan’s National Health Insurance Research Database (2000–2012) were propensity score [...] Read more.
Objective. This study investigated whether women with a history of human papillomavirus (HPV) infection have an increased risk of infertility. Material and Methods. All patients with an HPV infection (n = 11,198) in Taiwan’s National Health Insurance Research Database (2000–2012) were propensity score matched with control subjects (n = 11,198) without an HPV infection by age, sex, index year, and relevant co-morbidities. Both groups were tracked until a diagnosis of infertility was recorded. The Chi-square test was used to analyze the distribution of demographic characteristics in the HPV group and non-HPV group. A Cox proportional hazards regression was used to estimate the hazard ratios (HRs) for the development of infertility, adjusting for age, sex, and co-morbidities. The Kaplan–Meier method was used to plot the cumulative incidence curves. We also performed negative controls to test for possible unmeasured confounding. Results. The HPV cohort had a higher risk of infertility. The adjusted HR (aHR) was found to be 1.39 (95% CI = 1.19–1.63) after adjusting for demographic characteristics and relevant co-morbidities. In the age subgroup analysis, patients with an HPV infection had an increased risk of infertility compared to the non-HPV cohort in the group aged 26 to 35 years (aHR, 1.53; 95% CI = 1.24–1.88). As we used propensity score matching to treat measurable confounders and negative controls to access unmeasured confounders, the findings of the study are robust. Conclusions. Among females of reproductive age, HPV infection is a potential risk factor that predisposes individuals to subsequent infertility. Full article
(This article belongs to the Special Issue Global Women's Health)
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16 pages, 335 KiB  
Article
Diet Quality among Women with Previous Gestational Diabetes Mellitus in Rural Areas of Hunan Province
by Mingshu Li, Jingcheng Shi, Jing Luo, Qing Long, Qiping Yang, Yufeng OuYang, Hanmei Liu, Qian Lin and Jia Guo
Int. J. Environ. Res. Public Health 2020, 17(16), 5942; https://doi.org/10.3390/ijerph17165942 - 16 Aug 2020
Cited by 5 | Viewed by 2896
Abstract
Diet quality is critical for postpartum type 2 diabetes mellitus (T2DM) progression among women with a history of gestational diabetes mellitus (GDM). The Chinese Healthy Eating Index (CHEI) is a dietary index developed according to the latest Chinese Dietary Guidelines (CDG-2016). Our study [...] Read more.
Diet quality is critical for postpartum type 2 diabetes mellitus (T2DM) progression among women with a history of gestational diabetes mellitus (GDM). The Chinese Healthy Eating Index (CHEI) is a dietary index developed according to the latest Chinese Dietary Guidelines (CDG-2016). Our study aimed to assess the diet quality of women with previous GDM in rural areas of Hunan Province by applying the CHEI. Women with previous GDM in two counties of Hunan were enrolled. Their food intake data, which were used to calculate their CHEI scores, were collected by a 24-h dietary recall. The association of CHEI with sociodemographic and anthropometric variables was evaluated via linear regression models. 404 women were included in the final analysis. The mean score of the total CHEI was 54.9 (SD 7.9). The components of whole grains and mixed beans, seeds and nuts, tubers, dairy, and poultry scored extremely low. Ethnic minority groups and women younger than 30 years had lower CHEI scores. Our study observed an unsatisfactory diet quality among women with previous GDM in rural areas of Hunan Province. Future dietary education focusing on the CDG is needed to improve their diet quality and help in T2DM prevention among this population, especially young and ethnic minority women. Full article
(This article belongs to the Special Issue Global Women's Health)
13 pages, 801 KiB  
Article
Analysis of Health-Related Behaviors of Adult Korean Women at Normal BMI with Different Body Image Perceptions: Results from the 2013–2017 Korea National Health and Nutrition Examination Survey (KNHNES)
by Seyeon Park, Jieun Shin and Seunghui Baek
Int. J. Environ. Res. Public Health 2020, 17(15), 5534; https://doi.org/10.3390/ijerph17155534 - 31 Jul 2020
Cited by 6 | Viewed by 2609
Abstract
The tendency of misperceiving one’s body image was found to be higher among those at normal body mass index (BMI). Thus, the present study aims to provide basic data to seek solutions for ideal physical activities and right body image perception by comparing [...] Read more.
The tendency of misperceiving one’s body image was found to be higher among those at normal body mass index (BMI). Thus, the present study aims to provide basic data to seek solutions for ideal physical activities and right body image perception by comparing health-related behaviors of women at normal BMI. Among the 39,225 respondents from the Korea National Health and Nutrition Examination Survey (KNHNES) conducted from 2013 to 2017, 10,798 adult women with World Health Organization (WHO) BMI Classifications of 18.5 ≤ BMI < 25 (Asia-Pacific) were considered, from which pregnant and breast-feeding women and women whose body image perception was not identified were excluded, leading to a total of 9288 women. Data were analyzed utilizing SAS ver. 9.4 for frequency analysis, cross tabulation, GLM (generalized linear model), and logistic regression analysis with complex samples design, in conformity with the guidelines of the KNHNES. The results showed that approximately most (87.6%) of adult Korean women misperceived their body image. Misperception of body image was related to inappropriate health-related behaviors such as smoking, insufficient sleeping, and excessive body weight management; those who had underestimated their body image (≤64 odds ratio (OR) (0.718 (confidence interval (C.I.) 0.594–0.866))) carried out fewer health-related behaviors, while women aged 65 or above engaged in more health-related behaviors when they perceived themselves as obese (OR 1.683 (C.I. 1.260–2.248; overestimation)). To sum up, it was found that lack of health management, inappropriate body weight control, and health-related behaviors are related to body image misperception compared with real BMI. As such, it is necessary to have educational programs to encourage building proper perception of one’s body image and body weight, and to carry out health-related behaviors. Full article
(This article belongs to the Special Issue Global Women's Health)
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15 pages, 369 KiB  
Article
Ethiopian Health Care Workers’ Insights into and Responses to Intimate Partner Violence in Pregnancy—A Qualitative Study
by Bosena Tebeje Gashaw, Berit Schei, Kari Nyheim Solbraekke and Jeanette H. Magnus
Int. J. Environ. Res. Public Health 2020, 17(10), 3745; https://doi.org/10.3390/ijerph17103745 - 25 May 2020
Cited by 7 | Viewed by 3134
Abstract
Violence against women is a global pandemic, with the potential to spread through generations. Intimate partner violence has impacts on women’s sexual, reproductive, and psycho-social health. It can occur during pregnancy and adversely affect the health of both mother and child. Health care [...] Read more.
Violence against women is a global pandemic, with the potential to spread through generations. Intimate partner violence has impacts on women’s sexual, reproductive, and psycho-social health. It can occur during pregnancy and adversely affect the health of both mother and child. Health care workers involved in antenatal care can have a unique role in identifying intimate partner violence and in intervening, preventing, and mitigating its consequences. In this study, the objective was to explore Ethiopian health care workers’ insights of and responses to intimate partner violence in pregnancy. Using an exploratory design, this qualitative study includes ten semi-structured interviews of health care workers representing different antenatal care centers in Jimma, Ethiopia. The content analyses of translated interview notes were conducted with Atlas.ti7 software, (Atlas.ti Scientific Software Development Gmbh, Berlin). The health care workers shared their insights of the consequences of intimate partner violence during pregnancy in addition to their experience with and responses to the victims. There was a limited understanding of the extent of the adverse impacts of intimate partner violence on pregnancy outcomes, as well as the potential long-term health implications. The informants described how they only gave medical treatment for obstetric complications or visible trauma during pregnancy. There was no formal referral to or linkages with other resources. Women’s empowerment and systemic changes in the health care, including training and capacity building, clear guidelines addressing management of intimate partner violence in pregnancy, and inclusion of intimate partner violence screening tools in the Ethiopian antenatal care chart/card, were recommended by the informants. The adverse impacts of intimate partner violence on pregnancy outcomes were poorly understood by the Ethiopian health care workers in this study. They offered limited assistance to the victims and recommended changes in the routine antenatal care (ANC) and health care systems. They identified various policy initiatives focusing on women’s empowerment to reduce intimate partner violence and its complications especially during pregnancy. Full article
(This article belongs to the Special Issue Global Women's Health)
14 pages, 2071 KiB  
Article
Prepregnancy Endocrine, Autoimmune Disorders and the Risks of Gestational Hypertension-Preeclampsia in Primiparas: A Nationwide Population-Based Study in Taiwan
by Mei-Lien Pan, Li-Ru Chen, Hsiao-Mei Tsao and Kuo-Hu Chen
Int. J. Environ. Res. Public Health 2020, 17(10), 3657; https://doi.org/10.3390/ijerph17103657 - 22 May 2020
Cited by 8 | Viewed by 2601
Abstract
(1) Objective: To assess the risks of gestational hypertension/preeclampsia (GH-PE) in women with prepregnancy endocrine and autoimmune disorders such as polycystic ovarian syndrome (PCOS) and systemic lupus erythematosus (SLE). (2) Methods: In a nationwide population-based longitudinal study, data were retrieved from the 1998 [...] Read more.
(1) Objective: To assess the risks of gestational hypertension/preeclampsia (GH-PE) in women with prepregnancy endocrine and autoimmune disorders such as polycystic ovarian syndrome (PCOS) and systemic lupus erythematosus (SLE). (2) Methods: In a nationwide population-based longitudinal study, data were retrieved from the 1998 to 2012 Taiwan National Health Insurance Research Database. ICD9-CM codes 256.4, 710.0, and 642.X were identified for the corresponding diagnoses of PCOS, SLE, and GH-PE, respectively, which were further confirmed by inspection of medical claims data for ultrasonography findings, laboratory tests, blood pressure measurements and examinations of urine protein to ensure the accuracy of the diagnoses. To clarify the risks of primiparous GH-PE, the study excluded women diagnosed with PCOS or SLE at <15 or >45 years of age, pre-existing chronic hypertension, GH-PE before PCOS and SLE, and abortion or termination before 20 weeks’ gestation. For women affected by prepregnancy PCOS or SLE individually, each pregnant woman was age-matched to four pregnant women without PCOS or SLE. Logistic regression analyses were applied to report odds ratios (ORs) for the risks of GH-PE after adjustment for age, occupation, urbanization, economic status, and other co-morbidities. (3) Results: Among 8070 and 2430 women with prepregnancy PCOS and SLE retrieved from a population of 1,000,000 residents, 1953 (24.20%) and 820 (33.74%) had subsequent primiparous pregnancies that were analyzable and compared with 7812 and 3280 pregnancies without prepregnancy PCOS and SLE, respectively. GH-PE occurred more frequently in pregnancies with prepregnancy PCOS (5.79% vs. 2.23%, p < 0.0001) and SLE (3.41% vs. 1.80%, p < 0.01) as compared to those without PCOS and SLE. Further analysis revealed that prepregnancy PCOS (adjusted OR = 2.36; 95%CI: 1.83–3.05) and SLE (adjusted OR = 1.95; 95%CI: 1.23–3.10) were individually associated with GH-PE. The risk of GH-PE was not reduced in women with prepregnancy PCOS receiving metformin treatment (p = 0.22). (4) Conclusions: Prepregnancy PCOS and SLE are independent and significant risk factors for the occurrence of GH-PE. Because the peripartum complications are much higher among pregnancies with GH-PE, the at-risk woman should be informed and well-prepared during her pregnancy and delivery. Full article
(This article belongs to the Special Issue Global Women's Health)
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13 pages, 589 KiB  
Article
Chronic Fatigue, Physical Impairments and Quality of Life in Women with Endometriosis: A Case-Control Study
by Francisco Álvarez-Salvago, Ana Lara-Ramos, Irene Cantarero-Villanueva, Maryna Mazheika, Antonio Mundo-López, Noelia Galiano-Castillo, Carolina Fernández-Lao, Manuel Arroyo-Morales, Olga Ocón-Hernández and Francisco Artacho-Cordón
Int. J. Environ. Res. Public Health 2020, 17(10), 3610; https://doi.org/10.3390/ijerph17103610 - 21 May 2020
Cited by 23 | Viewed by 4857
Abstract
Aim: To explore endometriosis-related fatigue (ERF), health-related fitness, sleep quality, and health-related quality of life (HRQoL) in women with endometriosis in comparison with matched controls. Methods: Twenty-five affected women and twenty-five age and height-matched women without endometriosis were included. ERF was assessed through [...] Read more.
Aim: To explore endometriosis-related fatigue (ERF), health-related fitness, sleep quality, and health-related quality of life (HRQoL) in women with endometriosis in comparison with matched controls. Methods: Twenty-five affected women and twenty-five age and height-matched women without endometriosis were included. ERF was assessed through the Piper Fatigue Scale; health-related fitness was assessed through the Schöber, flamingo, and 6-min walking tests and dynamometry; and body composition was assessed through impedanciometry. Self-perceived physical fitness, sleep quality, and HRQoL were assessed through the International Fitness Scale, the Pittsburgh Sleep Quality Index, and the 12-item Short Form Health Survey, respectively. Results: Affected women exhibited higher levels of ERF than controls, increased fat mass, and physical deconditioning (reduced back strength, lumbar flexibility, body balance, and functional capacity, p-values < 0.050). Moreover, cases also had poorer perceived physical fitness, sleep quality, and HRQoL (p-value < 0.050). Finally, we observed deteriorated health-related fitness, sleep quality, and HRQoL in those women with endometriosis with higher levels of ERF. Conclusions: This study constitutes the first evidence that women with endometriosis describe a generalized physical deconditioning, even more pronounced in affected women with higher levels of ERF. Further studies assessing the efficacy of rehabilitation interventions to face these physical impairments in women with endometriosis are warranted. Full article
(This article belongs to the Special Issue Global Women's Health)
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19 pages, 1799 KiB  
Article
Neurocognitive Inhibitory Control Ability Performance and Correlations with Biochemical Markers in Obese Women
by Huei-Jhen Wen and Chia-Liang Tsai
Int. J. Environ. Res. Public Health 2020, 17(8), 2726; https://doi.org/10.3390/ijerph17082726 - 15 Apr 2020
Cited by 9 | Viewed by 2418
Abstract
Inhibitory control, the ability to suppress prepotent responses and resist irrelevant stimuli, is thought to play a critical role in the maintenance of obesity. However, electrophysiological performance related to different inhibitory control processes and their relationship with motor response inhibition and cognitive interference [...] Read more.
Inhibitory control, the ability to suppress prepotent responses and resist irrelevant stimuli, is thought to play a critical role in the maintenance of obesity. However, electrophysiological performance related to different inhibitory control processes and their relationship with motor response inhibition and cognitive interference and potential biochemical mechanisms in middle-aged, obese women are as yet unclear. This work thus compared different neurocognitive Go/Nogo and Stroop task performance in healthy sedentary normal-weight and obese women, as well as their correlation with biochemical markers. Twenty-six healthy, sedentary obese women (obese group) and 26 age-matched (21–45 years old) normal-weight women (control group) were the participants, categorized by body mass index and percentage fat, as measured with dual-energy X-ray absorptiometry. They provided a fasting blood sample and performed two cognitive tasks (i.e., Go/Nogo and Stroop tasks) with concomitant electrophysiological recording. The N2 and P3 waveforms of event-related potential (ERP) were recorded. Although the between-group behavioral performance was comparable, the obese group relative to the control group showed significantly longer N2 latency and smaller P3 amplitude in the Stroop task and smaller N2 and P3 amplitudes in the Go/Nogo task. Significant inflammation response indices (e.g., CRP, leptin, adiponectin/leptin ratio) were observed in the obese group. The Nogo P3 amplitude was significantly correlated with the adiponectin/leptin ratio. These findings indicate that healthy obese women still exhibit deviant neurophysiological performance when performing Go/Nogo and Stroop tasks, where the adiponectin/leptin ratio could be one of the influencing factors for the deficit in neural processes of motor response inhibition. Full article
(This article belongs to the Special Issue Global Women's Health)
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12 pages, 566 KiB  
Article
Psychological and Sleep Effects of Tryptophan and Magnesium-Enriched Mediterranean Diet in Women with Fibromyalgia
by Alejandro Martínez-Rodríguez, Jacobo Á. Rubio-Arias, Domingo J. Ramos-Campo, Cristina Reche-García, Belén Leyva-Vela and Yolanda Nadal-Nicolás
Int. J. Environ. Res. Public Health 2020, 17(7), 2227; https://doi.org/10.3390/ijerph17072227 - 26 Mar 2020
Cited by 27 | Viewed by 10825
Abstract
Anxiety, mood disturbance, eating and sleep disorders, and dissatisfaction with body image are prevalent disorders in women with fibromyalgia. The authors of this study aimed to determine the effects of tryptophan (TRY) and magnesium-enriched (MG) Mediterranean diet on psychological variables (trait anxiety, mood [...] Read more.
Anxiety, mood disturbance, eating and sleep disorders, and dissatisfaction with body image are prevalent disorders in women with fibromyalgia. The authors of this study aimed to determine the effects of tryptophan (TRY) and magnesium-enriched (MG) Mediterranean diet on psychological variables (trait anxiety, mood state, eating disorders, self-image perception) and sleep quality in women with fibromyalgia (n = 22; 49 ± 5 years old). In this randomized, controlled trial, the participants were randomly assigned to the experimental group and the placebo group. The intervention group received a Mediterranean diet enriched with high doses of TRY and MG (60 mg of TRY and 60 mg of MG), whereas the control group received the standard Mediterranean diet. Pittsburgh Sleep Quality Questionnaire, Body Shape Questionnaire, State–Trait Anxiety Inventory (STAI), Profile of Mood States (POMS-29) Questionnaire, Eating Attitudes Test-26, and Trait Anxiety Inventory were completed before and 16 weeks after the intervention. Significant differences were observed between groups after the intervention for the mean scores of trait anxiety (p = 0.001), self-image perception (p = 0.029), mood disturbance (p = 0.001), and eating disorders (p = 0.006). This study concludes that tryptophan and magnesium-enriched Mediterranean diet reduced anxiety symptoms, mood disturbance, eating disorders, and dissatisfaction with body image but did not improve sleep quality in women with fibromyalgia. Full article
(This article belongs to the Special Issue Global Women's Health)
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19 pages, 3075 KiB  
Article
Intracervical Foley Catheter Plus Intravaginal Misoprostol vs Intravaginal Misoprostol Alone for Cervical Ripening: A Meta-Analysis
by Howard Hao Lee, Ben-Shian Huang, Min Cheng, Chang-Ching Yeh, I-Chia Lin, Huann-Cheng Horng, Hsin-Yi Huang, Wen-Ling Lee and Peng-Hui Wang
Int. J. Environ. Res. Public Health 2020, 17(6), 1825; https://doi.org/10.3390/ijerph17061825 - 11 Mar 2020
Cited by 24 | Viewed by 4924
Abstract
Currently, there is no meta-analysis comparing intravaginal misoprostol plus intracervical Foley catheter versus intravaginal misoprostol alone for term pregnancy without identifying risk factors. Therefore, the purpose of this study is to conduct a systematic review and meta-analysis of randomized control trials (RCTs) comparing [...] Read more.
Currently, there is no meta-analysis comparing intravaginal misoprostol plus intracervical Foley catheter versus intravaginal misoprostol alone for term pregnancy without identifying risk factors. Therefore, the purpose of this study is to conduct a systematic review and meta-analysis of randomized control trials (RCTs) comparing concurrent intravaginal misoprostol and intracervical Foley catheter versus intravaginal misoprostol alone for cervical ripening. We systematically searched Embase, Pubmed, and Cochrane Collaboration databases for randomized controlled trials (RCTs) comparing intracervical Foley catheter plus intravaginal misoprostol and intravaginal misoprostol alone using the search terms “Foley”, “misoprostol”, “cervical ripening”, and “induction” up to 29 January 2019. Data were extracted and analyzed by two independent reviewers including study characteristics, induction time, cesarean section (C/S), clinical suspicion of chorioamnionitis, uterine tachysystole, meconium stain, and neonatal intensive care unit (NICU) admissions. Data was pooled using random effects modeling and calculated with risk ratio (RR) and 95% confidence interval (CI). Pooled analysis from eight studies, including 1110 women, showed that labor induction using a combination of intracervical Foley catheter and intravaginal misoprostol decreased induction time by 2.71 h (95% CI −4.33 to −1.08, p = 0.001), as well as the risk of uterine tachysystole and meconium staining (RR 0.54, 95% CI 0.30–0.99 and RR 0.48, 95% CI 0.32–0.73, respectively) significantly compared to those using intravaginal misoprostol alone. However, there was no difference in C/S rate (RR 0.93, 95% CI 0.78–1.11) or clinical suspicion of chorioamnionitis rate (RR 1.22, CI 0.58–2.57) between the two groups. Labor induction with a combination of intracervical Foley catheter and intravaginal misoprostol may be a better choice based on advantages in shortening induction time and reducing the risk of uterine tachysystole and meconium staining compared to intravaginal misoprostol alone. Full article
(This article belongs to the Special Issue Global Women's Health)
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12 pages, 358 KiB  
Article
Quality of Life in POP: Validity, Reliability and Responsiveness of the Prolapse Quality of Life Questionnaire (P-QoL) in Spanish Women
by Beatriz Sánchez-Sánchez, Maria José Yuste-Sánchez, Beatriz Arranz-Martín, Beatriz Navarro-Brazález, Helena Romay-Barrero and María Torres-Lacomba
Int. J. Environ. Res. Public Health 2020, 17(5), 1690; https://doi.org/10.3390/ijerph17051690 - 05 Mar 2020
Cited by 7 | Viewed by 3209
Abstract
The Prolapse Quality of Life Questionnaire (P-QoL) is a specific questionnaire created to assess the impact of pelvic organ prolapse on women’s quality of life. The aim of the present study was to cross-culturally adapt and assess the psychometric properties of the P-QoL [...] Read more.
The Prolapse Quality of Life Questionnaire (P-QoL) is a specific questionnaire created to assess the impact of pelvic organ prolapse on women’s quality of life. The aim of the present study was to cross-culturally adapt and assess the psychometric properties of the P-QoL for Spanish women. The cross-cultural adaptation was conducted by a standardized translation/back-translation method. Psychometric analysis was performed by assessing the validity, reliability, responsiveness and feasibility. A total of 200 Spanish women were recruited and assigned to symptomatic and asymptomatic groups. The Spanish P-QoL version demonstrated good content validity. Convergent validity showed high intercorrelations with the Pelvic Floor Distress Inventory short form and the Pelvic Floor Impact Questionnaire short form. The discriminant validity showed statistically significant differences between the symptomatic and the asymptomatic groups. The internal consistency was high and of acceptable values. The test-retest reliability was shown to be high in all the cases. Regarding responsiveness, the effect size and standardized response mean demonstrated moderate values. The average time for administration was 10 (3) min. The Spanish P-QoL showed considerable support for the appropriate metric properties of validity, reliability, responsiveness and feasibility to evaluate the symptom severity and its impact on the quality of life in Spanish women with urogenital prolapse. Full article
(This article belongs to the Special Issue Global Women's Health)
8 pages, 289 KiB  
Article
Women’s Health and Well-Being in the United Nations Sustainable Development Goals: A Narrative Review of Achievements and Gaps in the Gulf States
by Suhad Daher-Nashif and Hiba Bawadi
Int. J. Environ. Res. Public Health 2020, 17(3), 1059; https://doi.org/10.3390/ijerph17031059 - 07 Feb 2020
Cited by 24 | Viewed by 5432
Abstract
Background: In 2014, United Nations member states proposed a set of sustainable development goals (SDGs) to help further the millennium development goals that they had proposed in New York in 2000. Of these 13 SDGs, Goal 3 (i.e., SDG 3) was titled “Good [...] Read more.
Background: In 2014, United Nations member states proposed a set of sustainable development goals (SDGs) to help further the millennium development goals that they had proposed in New York in 2000. Of these 13 SDGs, Goal 3 (i.e., SDG 3) was titled “Good Health and Well-Being.” This goal highlighted women’s health and well-being via two key objectives. The first, SDG 3.1, aimed to reduce maternal mortality rates (MMR) and the second, SDG 3.7, aimed to ensure access to sexual and reproductive health care services. Drawing on all the latest reports, which have been released by Gulf Cooperation Council states (GCC), this paper sheds light on GCC states’ work on women’s wellbeing through SDG 3. Aim: the paper aims to review GCC states’ work on women’s wellbeing in SDG3, which achievements they obtained, which tools they used and which gaps still exist. The paper aims to explain the socio-cultural background behind these achievements, tools, and gaps. Methodology: For the purpose of this study, we used narrative review approach through which we reviewed reports from 2017 and 2018 on SDGs published online by the Ministry of Development and Planning of each GCC state, and latest reports of the WHO on the same states. Findings: the study found similarities and differences between different GCC states, which in turn reveals gaps and areas that are not meeting women’s needs. The findings show that MMR in GCC countries has declined by nearly half. The main strategies they adopted to address SDG 3.1 included awareness campaigns, improving access to healthcare systems and training professionals. The tools used to meet SDG 3.7 included training health professionals and raising awareness of consanguinity. The study reveals several gaps, such as a lack of discussion around challenges and barriers, and a lack of linkage between an SDG and the targets contained within it. Conclusion: The paper concludes that there is a much greater emphasis on reducing MMR, compared to providing access to sexual and reproductive healthcare. This difference is due to different socio-cultural framing of each of these two issues. Full article
(This article belongs to the Special Issue Global Women's Health)
12 pages, 1129 KiB  
Article
Trends and Age-Period-Cohort Effects of Fertility Rate: Analysis of 26,224 Married Women in Taiwan
by I-Shiang Tzeng, Kuo-Hu Chen, Yungling L. Lee and Wen-Shan Yang
Int. J. Environ. Res. Public Health 2019, 16(24), 4952; https://doi.org/10.3390/ijerph16244952 - 06 Dec 2019
Cited by 8 | Viewed by 3597
Abstract
Taiwan and a few Asian societies have had among the lowest fertility rates in the world for the past decade. Understanding the reasons behind the low fertility and designing policies accordingly to improve fertility has been a priority of governments in the region. [...] Read more.
Taiwan and a few Asian societies have had among the lowest fertility rates in the world for the past decade. Understanding the reasons behind the low fertility and designing policies accordingly to improve fertility has been a priority of governments in the region. It what follows we examine the low fertility rate in Taiwan by studying the trend of actual fertility rate and desired fertility rate in Taiwan using an age-period-cohort (APC) model. Using the Knowledge, Attitude, and Practice (KAP) of contraception survey data between 1973 and 2004, we applied APC analyses on the actual fertility rate and desired fertility rate of married women. We found that youngest cohorts (the mid-cohort year 1983) had 10% higher actual fertility and 15% higher desired fertility compared to those who were born in 1959–1965, respectively. Additionally, we attributed current lowest-low fertility (at or below 1.3) to late marriages. There is a lag between the actual and desired fertility rates in KAP survey due to tempo effect. Furthermore, the trends of the cohort effects of both fertility rates in KAP surveys are reversing in Taiwan. Consequently, increase total fertility rate (TFR) should encourage marriage among the marriageable population and reward married and childbearing households. Full article
(This article belongs to the Special Issue Global Women's Health)
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10 pages, 2627 KiB  
Article
Pyruvate Kinase M2 Expression: A Potential Metabolic Biomarker to Differentiate Endometrial Precancer and Cancer that is Associated with Poor Outcomes in Endometrial Carcinoma
by Yu-Ju Lai, Yu-Ching Chou, Yi-Jia Lin, Mu-Hsien Yu, Yu-Che Ou, Po-Wei Chu, Chia-Chun Wu, Yu-Chi Wang and Tai-Kuang Chao
Int. J. Environ. Res. Public Health 2019, 16(23), 4589; https://doi.org/10.3390/ijerph16234589 - 20 Nov 2019
Cited by 10 | Viewed by 2806
Abstract
Background: Pyruvate kinase M2 (PKM2) is a regulator of the processes of glycolysis and oxidative phosphorylation, but the roles that it plays in endometrial cancer remain largely unknown. This study evaluated the PKM2 expression in normal endometrium, endometrial hyperplasia, and endometrial carcinoma, and [...] Read more.
Background: Pyruvate kinase M2 (PKM2) is a regulator of the processes of glycolysis and oxidative phosphorylation, but the roles that it plays in endometrial cancer remain largely unknown. This study evaluated the PKM2 expression in normal endometrium, endometrial hyperplasia, and endometrial carcinoma, and its prognostic value was investigated in endometrial carcinoma patients. Methods: A hospital-based retrospective review was conducted to examine the immunohistochemical PKM2 distribution in 206 endometrium samples from biopsies or hysterectomies. The immunoreactivity of PKM2 was divided into groups of low and high scores according to the extent and intensity of staining. Results: Intense cytoplasmic staining was observed for the PKM2 protein in malignant endometrial lesions. A high PKM2 score was observed in many endometrial carcinoma samples (50.0%), but there was a low percentage in endometrial atypical hyperplasia (12.5%). High PKM2 expression was not found in the normal endometrium (0.0%) nor endometrial hyperplasia without atypia (0.0%). The PKM2 protein score was significantly higher in endometrial carcinoma samples than premalignant endometrial lesions (p < 0.001). Notably, higher PKM2 scores in cases of endometrial carcinoma correlated with poor overall survival (p = 0.006), and the hazard ratio for death was 3.40 (95% confidence interval, 1.35–8.56). Conclusions: Our results indicate that the prevalence of PKM2high tumor cells in endometrial carcinoma is significantly associated with worse prognostic factors and favors a poor prognosis. The expression of PKM2 is also a potential histopathological biomarker for use in the differential diagnosis of malignant and premalignant endometrial lesions. Full article
(This article belongs to the Special Issue Global Women's Health)
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Review

Jump to: Research

30 pages, 2579 KiB  
Review
Effectiveness of Non-Pharmacological Interventions for Overweight or Obese Infertile Women: A Systematic Review and Meta-Analysis
by Seo Yun Kim, Eun-Sun Park and Hae Won Kim
Int. J. Environ. Res. Public Health 2020, 17(20), 7438; https://doi.org/10.3390/ijerph17207438 - 13 Oct 2020
Cited by 9 | Viewed by 3210
Abstract
Obesity is a well-known risk factor for infertility, and nonpharmacological treatments are recommended as effective and safe, but evidence is still lacking on whether nonpharmacological interventions improve fertility in overweight or obese women. The aim of this study was to systematically assess the [...] Read more.
Obesity is a well-known risk factor for infertility, and nonpharmacological treatments are recommended as effective and safe, but evidence is still lacking on whether nonpharmacological interventions improve fertility in overweight or obese women. The aim of this study was to systematically assess the current evidence in the literature and to evaluate the impact of nonpharmacological interventions on improving pregnancy-related outcomes in overweight or obese infertile women. Seven databases were searched for randomized controlled trials (RCTs) of nonpharmacological interventions for infertile women with overweight or obesity through August 16, 2019 with no language restriction. A meta-analysis was conducted of the primary outcomes. A total of 21 RCTs were selected and systematically reviewed. Compared to the control group, nonpharmacological interventions significantly increased the pregnancy rate (relative risk (RR), 1.37; 95% CI, 1.04–1.81; p = 0.03; I2 = 58%; nine RCTs) and the natural conception rate (RR, 2.17, 95% CI, 1.41–3.34; p = 0.0004; I2 = 19%, five RCTs). However, they had no significant effect on the live birth rate (RR, 1.36, 95% CI, 0.94–1.95; p=0.10, I2 = 65%, eight RCTs) and increased the risk of miscarriage (RR: 1.57, 95% CI, 1.05–2.36; p = 0.03; I2 = 0%). Therefore, nonpharmacological interventions could have a positive effect on the pregnancy and natural conception rates, whereas it is unclear whether they improve the live birth rate. Further research is needed to demonstrate the integrated effects of nonpharmacological interventions involving psychological outcomes, as well as pregnancy-related outcomes. Full article
(This article belongs to the Special Issue Global Women's Health)
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16 pages, 1135 KiB  
Review
The Health Impact of Surgical Techniques and Assistive Methods Used in Cesarean Deliveries: A Systemic Review
by Li-Hsuan Wang, Kok-Min Seow, Li-Ru Chen and Kuo-Hu Chen
Int. J. Environ. Res. Public Health 2020, 17(18), 6894; https://doi.org/10.3390/ijerph17186894 - 21 Sep 2020
Cited by 1 | Viewed by 2493
Abstract
Cesarean delivery is one of the most frequently performed surgeries in women throughout the world. However, the most optimal technique to minimize maternal and fetal morbidities is still being debated due to various clinical situations and surgeons’ preferences. The contentious topics are the [...] Read more.
Cesarean delivery is one of the most frequently performed surgeries in women throughout the world. However, the most optimal technique to minimize maternal and fetal morbidities is still being debated due to various clinical situations and surgeons’ preferences. The contentious topics are the use of vacuum devices other than traditional fundal pressure to assist in the delivery of the fetal head and the techniques of uterine repair used during cesarean deliveries. There are two well-described techniques for suturing the uterus: The uterus can be repaired either temporarily exteriorized (out of abdominal cavity) or in situ (within the peritoneal cavity). Numerous studies have attempted to compare these two techniques in different aspects, including operative time, blood loss, and maternal and fetal outcomes. This review provides an overview of the assistive method of vacuum devices compared with fundal pressure, and the two surgical techniques for uterine repair following cesarean delivery. This descriptive literature review was performed to address important issues for clinical practitioners. It aims to compare the advantages and disadvantages of the assistive methods and surgical techniques used in cesarean deliveries. All of the articles were retrieved from the databases Medline and PubMed using the search terms cesarean delivery, vacuum, and exteriorization. The searching results revealed that after exclusion, there were 9 and 13 eligible articles for vacuum assisted cesarean delivery and uterine exteriorization, respectively. Although several studies have concluded vacuum assistance for fetal extraction as a simple, effective, and beneficial method during fetal head delivery during cesarean delivery, further research is still required to clarify the safety of vacuum assistance. In general, compared to the use of in situ uterine repairs during cesarean delivery, uterine exteriorization for repairs may have benefits of less blood loss and shorter operative time. However, it may also carry a higher risk of intraoperative complications such as nausea and vomiting, uterine atony, and a longer time to the return of bowel function. Clinicians should consider these factors during shared decision-making with their pregnant patients to determine the most suitable techniques for cesarean deliveries. Full article
(This article belongs to the Special Issue Global Women's Health)
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14 pages, 894 KiB  
Review
Girls’ Empowerment and Adolescent Pregnancy: A Systematic Review
by Dumisani Enricho Nkhoma, Chia-Ping Lin, Hexin Latumer Katengeza, Charles Jenya Soko, Wanda Estinfort, Yao-Chin Wang, Shing-Hwa Juan, Wen-Shan Jian and Usman Iqbal
Int. J. Environ. Res. Public Health 2020, 17(5), 1664; https://doi.org/10.3390/ijerph17051664 - 04 Mar 2020
Cited by 27 | Viewed by 11058
Abstract
Background: 21 million girls get pregnant every year. Many initiatives are empowering girls. Various studies have looked at girl empowerment, however, there is contradicting evidence, and even less literature from developing countries. Methods: We searched articles published between January 2000 to [...] Read more.
Background: 21 million girls get pregnant every year. Many initiatives are empowering girls. Various studies have looked at girl empowerment, however, there is contradicting evidence, and even less literature from developing countries. Methods: We searched articles published between January 2000 to January 2019. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered our protocol on the International Prospective Register of Systematic Reviews PROSPERO (CRD42019117414). Nine articles were selected for review. Quality appraisal was done using separate tools for qualitative studies, cohort and cross-sectional studies and randomized control trials. Results: Eight studies included educational empowerment, four studies included community empowerment, three studies included economic empowerment, while two studies discussed policy empowerment. Three studies were of fair quality; two qualitative and one cross-sectional study were of high quality, while three studies had low quality. Discussion. Studies showed a favorable impact of girl empowerment on adolescent pregnancies and risky sexual behaviors. Education empowerment came through formal education or health systems such as in family planning clinics. Community empowerment was seen as crucial in girls’ development, from interactions with parents to cultural practices. Economic empowerment was direct like cash transfer programs or indirect through benefits of economic growth. Policies such as contraceptive availability or compulsory school helped reduce pregnancies. Full article
(This article belongs to the Special Issue Global Women's Health)
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