Search Results (374)

In the last two decades, metabolic and bariatric surgery (MBS) has become the mainstay of treatment for severe and complex obesity. The majority of patients undergoing MBS are women of childbearing age. Coupled with the dramatic increase in the utilization of MBS, caregivers are likely to encounter patients who have undergone MBS in routine practice. From this perspective, we highlight the different reproductive health challenges and issues encountered throughout the pre-operative, peri-operative, and postoperative phases. Full article

Idiopathic intracranial hypertension (IIH) with (IIHWP) and without papilledema (IIHWOP) is characterized by increased cerebrospinal fluid (CSF) pressure and no evident cause, mostly affecting obese women of childbearing age and possibly leading to vision loss. However, in neonates, infants, and toddlers, these conditions remain understudied entities. This review investigates clinical features, risk factors, treatments, and outcomes to inform their care. From 2278 publications found in PubMed, 2974 in Scopus, and 1684 in the Web of Science Core Collection, 104 relevant articles were analyzed. Among 300 cases, 48.3% were male and 26.0% female, with 43.0% meeting the modified Dandy criteria. Typical signs and symptoms, besides papilledema (23.0%) or its absence (49.0%), included bulging fontanelle (67.7%), irritability (34.3%), vomiting (33.0%), and fever (18.3%). The most triggering factors were medications (35.3%) and infections (15.0%). The mean CSF opening pressure was 35.1 cm H₂O, ranging from 9.5 to 77 cm H₂O. Main treatment options were lumbar punctures (72.7%), discontinuation of triggering medications (26.3%), acetazolamide (18.7%), and corticosteroids (7.7%); 3.0% required shunting. Unlike in adults, males were more commonly affected, and papilledema was less frequent. Most cases resolved with conservative treatment. A nosological distinction between IIHWP and IIHWOP seems unlikely. Considering our findings and age-specific CSF pressure limits, new diagnostic criteria are proposed. Full article

Background/Objectives: Worldwide, men experience a higher incidence of pancreatic cancer (PC) than women. Methods: To increase understanding of the underlying reasons for this sex-related difference, we analysed general and sex-related risk factors for PC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (women/men No. = 293,682/136,728; 717/577 PC-cases). Results: Cox proportional hazards models showed a 1.31-fold higher risk of developing PC for men compared to women (HR, 95% CI 1.15–1.49) after adjustment for age, smoking history, BMI, diabetes, and alcohol consumption. Associations of PC with established risk factors did not differ between men and women, with the exception of a greater risk of PC among women with greater attained body height, meat consumption and cigarettes smoked (1.12 (1.05–1.19) per 5 cm, 1.18 (1.02–1.36) per 100 g/d, 1.42 (1.27–1.59) per 10/d; respectively). Among child-bearing women, long cumulative duration of breastfeeding was inversely associated with risk of PC (HR 0.74, 95% CI 0.61–0.89) for >5.7 months of breastfeeding (median) relative to ≤5.7 months and among HRT users, cumulative duration of HRT use was inversely associated with PC risk (HR 0.71, 95% CI 0.53–0.95, >2.4 versus ≤2.4 years). Further reproductive and hormonal factors, such as age at menarche, number of full-term pregnancies, age at menopause, or use of oral contraceptives, were not significantly associated with PC risk. Conclusions: Pooled analyses of large cohort studies are needed to confirm these results, and detailed data on the type and intensity of HRT are required to better evaluate its effect. Full article

Background/Objectives: Measles, mumps, and rubella (MMR) continue to pose a significant public health challenge due to insufficient immunization coverage. This study aimed to provide the first seroprevalence data against MMR and to explore self-reported immunity among future healthcare workers (HCWs) in Serbia, including women of childbearing age. Methods: We included 1296 future health care workers (HCWs) aged 19 to 29, born in Serbia. All HCWs supplied a blood sample for serology and filled in a questionnaire. Antibodies were measured using an enzyme immunoassay against measles, mumps, and rubella (MMR). Results: Anti-measles, -mumps, and -rubella seronegativity rates were 25.6%, 26.5%, and 4.4%, respectively, among future HCWs in Serbia. The mumps seronegativity rate was significantly higher in the oldest (27–29-year) age group, accompanied by significantly lower anti-mumps IgG GMCs in the same age group compared to younger participants (p = 0.035 and p < 0.001, respectively). Anti-mumps seronegativity also increased significantly across birth cohorts, from the youngest to the oldest (p = 0.004). Furthermore, anti-mumps IgG antibody GMCs were significantly higher among females, those who attended nursery/kindergarten, and unvaccinated individuals (p = 0.050, p = 0.020, and p = 0.005, respectively). Finally, older age and unvaccinated status were identified as independent factors associated with anti-measles and anti-mumps seronegativity among future HCWs in Serbia. Conclusions: The cross-sectional seroprevalence data revealed insufficient seroprotection in this population of particular importance, i.e., future HCWs, and women of childbearing age. These results strongly support the national recommendations for the mandatory vaccination of these populations. Identified immunity gaps should be closed promptly by strategic, targeted serologic screening, followed by vaccination of those lacking MMR antibodies. Full article

Cervical cancer continues to be a major global public health problem, with 661,021 estimated new cases and 348,189 deaths reported in 2022. Approximately 53% of women in Jordan reported not being screened for CC in recent years. This study aimed to investigate the determinants associated with not being screened for CC amongst Jordanian women of child-bearing age. This was a cross-sectional study derived from the 2023 Jordanian Demographic Health Survey (JDHS) with 12,580 women aged 15–49 years. The study employed a non-informative Bayesian binary logistic regression approach to identify the factors that are associated with not being screened for CC. Results showed that the prevalence of not being screened for CC was 83.8% (95% CI: 83.3–84.3). The determinants identified in this study were women’s age group (OR = 0.46; 95% CI: 0.34–0.62), education level (OR = 0.56; 95% CI: 0.34–0.91), smoking status (OR = 0.75; 95% CI: 0.63–0.91), women’s nationality (OR = 4.30; 95% CI: 1.03–27.74), breastfeeding status (OR = 1.64; 95% CI: 1.31–2.07), wealth index (OR = 0.61; 95% CI: 0.53–0.71), self-reported health status (OR = 0.74; 95% CI: 0.64–0.87), marital status (OR = 1.45; 95% CI: 1.08–1.96), and HIV testing status (OR = 0.55; 95% CI: 0.40–0.75). The prevalence of not being screened for CC amongst Jordanian women of child-bearing age was found to be very high: a red flag for attention. There is a need for interventions such as community awareness campaigns and education programmes focusing on women younger than 25 years, especially women living in rural and underserved areas. Additionally, incorporating policy interventions into public health facilities and having easy accessibility to tools or screening tests may improve rates of CC screening, and thus reduce the prevalence of CC. Full article

Background/Objectives: Currently, the type of population reproduction in China has changed to “low birth, low death, low growth”. Additionally, as the number of single people has increased and the number of women of childbearing age has decreased, the growth of the total population was bound to show a negative trend. Therefore, this study aimed to understand what factors influence fertility intentions from the perspective of single, unmarried women. Methods: We designed our own online questionnaire and collected information on fertility intentions from single, unmarried women of childbearing age (18–49 years). A total of 741 questionnaires were collected, with a valid response rate of 92.6%, and the Theory of Planned Behavior model was integrated into the questionnaire survey. Statistical analysis was performed via SPSS 24.0, and AMOS 24.0 software’s analysis of variance was used to determine whether there were differences in attitudes towards fertility intentions among respondents. Structural equation models were constructed via AMOS software for validation factor analysis and path analysis. Results: There was a significant difference (p < 0.05) in “monthly income”, “net family income”, “health status”, and “only-child status”. Structural equation modelling revealed that fertility attitudes (β₁ = 0.301, p < 0.05), subjective norms (β₂ = 0.295, p < 0.05), and perceived behavioural control (β₃ = 0.146, p < 0.05) positively influence fertility intentions. Conclusions: The fertility intentions of single, unmarried women of childbearing age in China are influenced by many factors. Therefore, society should pay more attention to the rights and interests of single, unmarried women and provide a better social environment for childbearing; in addition, it is possible to appropriately relax the fertility policy of single births to improve the low fertility rate in China. Full article

Background: Adult granulosa cell tumours (AGCT) of the ovary account for 2–5% of ovarian tumours, with 30% occurring in women of childbearing age. Despite a good prognosis, up to 25% recur. There is a paucity of high-quality evidence to guide management. Objective: To describe management of AGCT across multiple gynaecological cancer centres. Methods: Retrospective analysis of electronic patient records from six gynaecological cancer centres in Southwest England between 2000 and 2021 (n = 119). Results: We included 107 patients with a median follow-up of 60 months (0–261 months). Most (97/107; 90.7%) were diagnosed with stage I disease (31.8% stage Ic). Primary management was staging surgery in 33/107 (30.8%), hysterectomy and bilateral salpingo-oophorectomy (BSO) (28/107; 26.2%), or conservation of an ovary (17/107; 15.9%). Three had a subsequent pregnancy. A quarter (27/107; 25.2%) were diagnosed with recurrent disease. Fifteen patients (15/107; 14%) had multiple recurrences. Recurrence was more likely if cyst rupture was reported at surgery (38.7%) compared with no rupture (14.3%; p < 0.001). The recurrence rate was higher with ovarian conservation (6/17; 35.3%) compared with BSO (21/90; 23.3%; p < 0.01), and all recurrences involved the residual ovary. Of the 11 deaths, 6 (54.5%) were attributed to progressive disease. Conclusions: Although survival with early-stage disease is good, ovarian cystectomy or unilateral ovarian conservation was associated with increased risk of recurrence. There is no conclusive evidence to support a contralateral oophorectomy in pre-menopausal women, but completion surgery should at least be considered, either immediately or after childbearing/assisted reproductive treatment. Full article

The Yanomami Indigenous Land (YIL) is heavily impacted by illegal gold mining, leading to significant contamination by methylmercury, a neurotoxin that poses severe risks to human health. The fetal brain is particularly susceptible to the neurotoxic effects of methylmercury, which can result in mild mental retardation (MMR). The goal of this study was to estimate the burden of disease (BoD) associated with methylmercury exposure in the YIL and its economic implications. The BoD calculations followed World Health Organization (WHO) methodologies. To estimate the local BoD, hair samples were collected from women of childbearing age in the Waikás, Mucajaí, Paapiu, and Maturacá regions. For broader estimates, data from the scientific literature were used. The average hair methylmercury concentrations in these investigated regions were 6.21 µg/g, 3.86 µg/g, 3.53 µg/g, and 2.96 µg/g, respectively. The MMR incidence rate (IR) in children ranged from 2.08 to 4.47 per 1000 in these regions. The Disability-Adjusted Life Years (DALYs) per 1000 births varied from 24.8 to 53.4. In the Worst-Case Scenario, MMR-IR reached 9 per 1000, with DALYs per 1000 births rising to 109.6. The estimated economic impact of methylmercury exposure ranged from USD 716,750 to USD 3,153,700. This study is the first to quantify the MMR incidence due to mercury in the YIL, highlighting the severe threat posed by gold mining to the health and survival of the Yanomami people. Full article

Background: Urogenital schistosomiasis is endemic in Gabon. Our study aimed to detect the prevalence of urinary schistosomiasis and to evaluate the diagnostic performance of the qPCR technique compared to microscopy for the detection of Schistosoma haematobium at the community level in a semi-rural area. Method: A cross-sectional survey was carried out. Urine samples were examined using Urine TICK test strips, a filtration technique, and qPCR. Schistosoma haematobium was detected by targeting the Dra1 gene. Results: The prevalence of urogenital schistosomiasis was determined and the performance of real-time PCR and urine strips was compared with that of urinary filtration. A total of 281 participants were enrolled in the study. The prevalence of urogenital schistosomiasis was increased slightly with the molecular technique (40.9%) compared to microscopy (36.7%), and the hematuria rate with Urine STICK was 33.5%. SAC (5–14 years old), Pre-SAC (>5 years old), and adolescents (15–17 years old) were the most affected group according to, respectively, whatever method was used. qPCR showed good agreement with microscopy, as well as excellent sensitivity (99.03%) and specificity (93.3). There was a good correlation between the number of eggs per 10 mL and the cycle threshold range. Conclusion: These results show the importance of using a combination of diagnostic tools in the surveillance of schistosomiasis, particularly in preschool children, adolescents, women of childbearing age, and chronic and asymptomatic cases. Full article

Background/Objectives: Recent advancements have significantly enhanced our understanding of the interplay between inflammatory bowel disease (IBD) and reproductive health. While international organizations provide guidelines for best practices, translating them into actionable strategies is crucial. This study aimed to develop a comprehensive care pathway to enhance preconception counselling and support for patients with IBD in the perinatal period, ensuring they receive optimal expert care. Methods: We used the 7-phase model for the development of the care pathway. Results: The resulting care pathway, structured as a time–task matrix, outlines the required actions at preconception, during pregnancy, and in the postpartum period for women with IBD. The pathway provides a structured and multidisciplinary approach that addresses the unique needs of patients with IBD of childbearing age. It emphasizes holistic and personalized support throughout the preconception, pregnancy, and postpartum period. Conclusions: The development of this care pathway represents a significant advancement in the perinatal management of IBD. By offering multidisciplinary and individualized care, optimal maternal and infant outcomes are pursued, while establishing a new global standard for reproductive health and perinatal management. Full article

Background/Objectives: Romania remains endemic for measles due to suboptimal vaccine coverage rates. During the last three epidemics, the highest incidence of measles was recorded in children younger than 1 year, who should have been partially protected by maternal antibodies. A nationwide cross-sectional seroprevalence study was conducted on persons of fertile age, to evaluate potential immunity gaps in the population. Methods: Between June and October 2020, 959 serum samples were collected from individuals aged 25–44 years (46.5% females) from all the geographic regions in Romania. Measles IgG antibodies were assessed using an enzyme-linked immune assay (DIA.PRO-Diagnostic Bioprobes Srl, Italy). Statistical analysis was performed in IBM SPSS Statistics 27.0, using Fisher’s exact and chi-squared tests to test for associations between seropositivity and demographic factors, with p < 0.05 considered statistically significant. Results: The overall measles seroprevalence was 77%, without gender- or geographic region-related differences. Both the seropositivity rate and the measles antibodies titers increased with age, with the highest difference between the oldest and the youngest age group (p = 0.057), suggesting persistent immunity after natural infection in older individuals or anamnestic responses in vaccinated persons, caused by repeated exposures to the circulating virus. An additional confirmatory pilot study on 444 pregnant women confirmed the low level of measles seroprevalence (68.4%), with a significant upward trend in older ages (75% in those aged >40 years old vs. 65% in those aged 25–29 years, p = 0.018 and mean reactivity of measles antibodies 3.05 ± 1.75 in those aged >40 years vs. 2.28 ± 1.39 in those aged 25–29 years, p = 0.037). Conclusions: This study signals critical immunity gaps in the population that contribute to the accumulation of susceptible individuals and recurrent measles outbreaks. The absence of measles antibodies in women of childbearing age increases the newborn’s susceptibility to infection, with potentially severe complications. Full article

Toxoplasmosis is a globally prevalent zoonotic parasitic disease. Neonates with congenital infection can develop severe long-term sequelae, which can be mitigated or prevented through early diagnosis and therapeutic approaches. In this context, the main objective of this study was to describe the main treatments and evaluate the effectiveness of the current treatment protocols for gestational and congenital toxoplasmosis to prevent vertical transmission and to reduce clinical manifestations in neonates. This systematic review with a meta-analysis searched digital databases (PUBMED, SCOPUS, WEB OF SCIENCE, EMBASE, and COCHRANE) for observational cohort studies published between 1 January 2013 and 29 January 2025, evaluating treatment effectiveness in gestational and congenital toxoplasmosis. Risk ratios (RRs) were calculated using random effects models to assess infection risk and clinical manifestations in neonates. The study quality was assessed following the Joanna Briggs Institute protocol and fifty-six studies from 16 countries were included, comprising 11,090 pregnant women and 4138 children. Studies were predominantly from Brazil (38%), France, and Italy. Only 9% of the studies indicated knowledge of the serological status of the pregnant woman before the gestational stage. Of 10,148 women with confirmed toxoplasmosis, 8600 received treatment, with 18% of their children infected, compared to a 58% infection rate in untreated mothers’ children. Meta-analysis showed that treatment reduced infection risk (RR = 0.34 [0.21; 0.57]) and clinical manifestations (RR = 0.30 [0.17; 0.56]). While spiramycin or triple therapy showed similar effects, triple therapy demonstrated more consistent results (RR: 0.22 [0.15; 0.32]) compared to spiramycin alone (RR: 0.54 [0.06; 4.67]). In conclusion, treatment protocols for congenital or gestational toxoplasmosis have proven to be effective in reducing the risk of infection and clinical manifestations in neonates. Regarding the type of treatment, although they have similar responses, the use of triple therapy shows more consistent responses than isolated spiramycin. It can be also concluded that prevention and mitigation of congenital toxoplasmosis require standardized treatment protocols, improved diagnostic methods, and educational programs for women of childbearing age, as treatment initiation timing and protocol choice are crucial factors in determining outcomes. Full article

Biomedical sciences have made immense progress and numerous discoveries aimed at improving the quality of life and life expectancy in modern times. Anesthesiology is typically tailored to individual patients as its clinical effects depend on multiple factors, including a patient’s physiological and pathological states, age, environmental exposures, and genetic variations. Sex differences are also paramount for a complete understanding of the effects of specific anesthetic medications on men and women. However, women-specific research and the inclusion of women in clinical trials, specifically during child-bearing years, remain disproportionately low compared to the general population at large. This review describes and summarizes genetic variations, including sex differences, that affect responses to common anesthetic medications such as volatile anesthetics, induction agents, neuromuscular blocking drugs, opioids, and local anesthetics. It also discusses the influence of genetic variations on anesthesia outcomes, such as postoperative nausea and vomiting, allergic reactions, pain, depth of anesthesia, awareness under anesthesia and recall, and postoperative delirium. Full article

Background: Ovarian follicular cysts often resolve spontaneously, with giant forms being a rarity. Cases of giant ovarian follicular cysts in biological sisters without clear familial predisposition are even exceptional. Cases Presentation: Two biological sisters presented to our hospital with large pelvic masses in the setting of a clinical and biological hyperandrogenism. After surgical removal, pathology confirmed the diagnosis of ovarian follicular cysts. Recurrence was detected shortly after surgery, with both sisters displaying similar clinical courses. Chromosomal screening showed no abnormalities. Hormonal analysis revealed elevated anti-Müllerian hormone (AMH), prolactin (PRL), and testosterone, alongside low FSH and LH levels. Family exome sequencing also showed no significant findings. After treatment with bromocriptine and short-acting contraceptive pills, the recurrent ovarian cysts resolved spontaneously, and hormonal levels returned to normal ranges. Conclusions: In women of childbearing age, it is important to conduct thorough endocrine evaluations and genetic screenings following the occurrence of large ovarian follicular cysts. Once endocrine levels are balanced, follicular cysts may decrease in size substantially, which helps to avoid unnecessary ovarian surgery. Full article

The specificity of the life cycle of T. gondii, the causative agent of toxoplasmosis, determines its relevance in some patient groups; especially in women of childbearing age. The objective of this study was to ascertain the prevalence of this parasitic infection in Bulgaria between 2014 and 2023, focusing on pregnant women and those applying for an in vitro procedure or after an abortion. During the period, 115,053 individuals were tested for toxoplasmosis in the country, with an average seropositivity rate of 16.96%. At the NRL for the Diagnosis of Parasitic Diseases, ELISA tests were utilized to ascertain specific Toxoplasma IgG, IgM, and IgA antibodies, IgG avidity, and PCR to substantiate the DNA of the parasite. Between 2014 and 2023, the laboratory conducted tests on 631 pregnant women, and 161 women applying for in vitro fertilization or after an abortion. In 24.7% of pregnant women, data demonstrated the presence of IgG antibodies only, and Toxoplasma IgG and IgM or IgG, IgM, and IgA antibodies were found in 16.6% and 8% of women, respectively. In the subset of individuals examined after an abortion or for an in vitro procedure, IgG was detected in 28%, IgG and IgM in 13%, and IgG, IgM, and IgA antibodies in 3.7%. Seroprevalence rises with increasing age, but does not show any dynamic compared to our previous studies. Our results show a higher seropositivity for toxoplasmosis in pregnant women in Bulgaria than in neighboring countries. Full article