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5.
BMC Public Health ; 19(1): 1142, 2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31429733

RESUMO

BACKGROUND: Adolescent pregnancy poses risks to the life of a young mother and her baby, and can affect their health, educational and future employment outcomes. In many low- and middle-income countries like the Philippines, the Demographic and Health Surveys (DHS) Program is among the most reliable and easily accessible sources of demographic and health data for researchers, development workers, and policymakers. Data on adolescent sexual and reproductive health (SRH) are often limited, but in the absence of other sources, there is room to make the most of the adolescent health data gathered by the DHS. The aim of this study is to explore what more can be learned about adolescent sexual initiation and pregnancy through the further analysis of demographic and health data, using DHS data from the Philippines as an example. METHODS: This study conducted trend analysis of DHS data over three survey rounds (2003, 2008 and 2013) to explore the context of adolescent sexual initiation and pregnancy over time. Bivariate and multivariate logistic regression were then used to study associations between adolescent pregnancy experience and selected demographic, socioeconomic and SRH variables using data from the 2013 DHS. RESULTS: This study found that between 2003 and 2013, proportions of Filipino young women experiencing adolescent sexual initiation and adolescent pregnancy have increased. Multivariate logistic regression affirmed the protective effect of education and belonging to higher wealth quintiles on the risk of adolescent pregnancy. Ever use of contraception was positively associated with adolescent pregnancy but is likely indicative of use after a prior pregnancy, and/or other factors relating to improper/inconsistent contraceptive use. CONCLUSIONS: In the absence of reliable, easily accessible data on adolescent SRH, the DHS data can provide important insights about adolescent reproductive transitions such as sexual initiation and first pregnancy. However, there are limited variables in the datasets that could proxy for other important social determinants which prior studies have linked to adolescent SRH outcomes. There remains a need for timely and targeted collection of quantitative and qualitative data on adolescent SRH that can guide programming and policy intended to foster positive health outcomes during this crucial transition period to adulthood.


Assuntos
Demografia/tendências , Gravidez na Adolescência/estatística & dados numéricos , Saúde Reprodutiva/tendências , Comportamento Sexual/estatística & dados numéricos , Saúde Sexual/tendências , Adolescente , Comportamento Contraceptivo/estatística & dados numéricos , Feminino , Humanos , Renda , Modelos Logísticos , Masculino , Filipinas/epidemiologia , Gravidez
6.
Reprod Health ; 16(1): 41, 2019 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-30944010

RESUMO

BACKGROUND: In order to set research priorities for reproductive health in the occupied Palestinian territory, it is vital to know what current research has been done in the field of reproductive health. The purpose of this scoping review is to examine the range and nature of reproductive health research in the occupied Palestinian territory and to identify research gaps in the existing literature. METHODS: We searched four databases: EMBASE, PubMed, CINAHL, and Popline. We included studies that: (i) are published (with an abstract); (ii) relevant to reproductive health; (iii) Palestinians living in Palestine; (iv) participants over the age of 15 years; and (v) restricted to human research. Three independent reviewers screened title and abstracts, and extracted data from included articles. We conducted quantitative and qualitative analyses. RESULTS: Of 1025 titles and abstracts screened, 145 articles were included. 52 (36%) articles were conducted in community setting and 34 (24%) were conducted in hospitals. There were 5 (3%) experimental studies. 15 articles had more than one main theme; 160 subthemes overall were identified. The most frequently studied theme was labor and delivery (n = 19; 12%). One article discussed adolescent reproductive health and menopause while no articles discussed men's reproductive health. CONCLUSIONS: 91% of the research conducted is observational. The focus of reproductive health research was to understand the topic, community and providers' perceptions and knowledge. Articles related to the quality of services were limited. It is also important to research the reproductive health of women outside of reproductive age, men, and adolescents.


Assuntos
Saúde Reprodutiva/tendências , Árabes , Pesquisa Biomédica/tendências , Feminino , Humanos , Oriente Médio , Estudos Observacionais como Assunto
7.
Int J Epidemiol ; 48(Suppl 1): i16-i25, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30883655

RESUMO

BACKGROUND: Brazil experienced important progress in maternal and child health in recent decades. We aimed at describing secular trends as well as socioeconomic and ethnic inequalities in reproductive history indicators (birth spacing, previous adverse perinatal outcome, parity and multiple births) over a 33-year span. METHODS: Four population-based birth cohort studies included all hospital births in 1982, 1993, 2004 and 2015 in Pelotas, Southern Brazil. Information on reproductive history was collected through interviews. Indicators were stratified by family income quintiles and skin colour. Absolute and relative measures of inequality were calculated. RESULTS: From 1982 to 2015, the proportion of primiparae increased from 39.2% to 49.6%, and median birth interval increased by 23.2 months. Poor women were more likely to report short intervals and higher parity, although reductions were observed in all income and ethnic groups. History of previous low birthweight was inversely related to income and increased by 7.7% points (pp) over time-more rapidly in the richest (12.1 pp) than in the poorest quintile (0.4 pp). Multiple births increased from 1.7% to 2.7%, with the highest increase observed among the richest quintile and for white women (220% and 70% increase, respectively). Absolute and relative income and ethnic-related inequalities for short birth intervals increased, whereas inequalities for previous low birthweight decreased over time. CONCLUSIONS: In this 33-year period there were increases in birth intervals, multiple births and reports of previous low-birthweight infants. These trends may be explained by increased family planning coverage, assisted reproduction and a rise in preterm births, respectively. Our results show that socioeconomic and ethnic inequalities in health are dynamic and vary over time, within the same location.


Assuntos
Intervalo entre Nascimentos/estatística & dados numéricos , Prole de Múltiplos Nascimentos/estatística & dados numéricos , Trabalho de Parto Prematuro/epidemiologia , Resultado da Gravidez/epidemiologia , Saúde Reprodutiva/tendências , Brasil/epidemiologia , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Modelos Logísticos , Paridade , Vigilância da População , Gravidez , Fatores Socioeconômicos
8.
PLoS One ; 14(1): e0209675, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30650100

RESUMO

RATIONALE: Adolescent pregnancy in Lao PDR is the highest in Southeast Asia. It leads to negative health and social consequences in young people. It is anticipated that this problem is partly caused by limited sexual and reproductive health literacy (SRHL), leading to poor sexual and reproductive health (SRH) decisions. Based on the concept of health literacy, SRHL goes beyond knowledge and behavior and is the self-perceived ability of an individual to access the needed information, understand the information, appraise and apply the information into informed decision making for a good way to contribute to sexual and reproductive health. It is not only knowing (knowledge) and doing (behavior), but it is the process of individual's thought on an SRH problem before taking an action. The aim of this study was to measure SRHL among school-going adolescents aged 15-19 and to determine factors associated with SRHL. METHOD: We conducted a cross-sectional study in rural and urban areas of Lao PDR in 2017. Respondents completed a self-administered questionnaire with five parts: socio-demographic, personal health, SRH knowledge and behavior, SRHL, and functional literacy. We calculated the SRHL score based on the HL-EU index and used descriptive statistics to determine the score and levels. Then we used bivariate statistics and multiple linear regression to identify factors associated with SRHL in these adolescents. RESULT: Among 461 respondents, 65.5% had inadequate SRHL. Scores were positively and significantly associated with several factors, including: school location (ß: 3.218; p<0.001), knowledge on SRH and attending SR class in school (p:0.010-p<0.001), and functional literacy on condoms, which reflected how respondents understood the use of condoms (ß: 0.871; p<0.001). CONCLUSION: Because most school adolescents had inadequate SRHL, comprehensive sexual education and enabling information as well as service access for adolescents are essential to ensure that adolescents can access, understand, appraise and apply good SRH knowledge in decision-making to benefit their own health.


Assuntos
Letramento em Saúde/métodos , Saúde Reprodutiva/educação , Saúde Sexual/educação , Adolescente , Preservativos , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Letramento em Saúde/tendências , Humanos , Laos/epidemiologia , Masculino , Gravidez , Gravidez na Adolescência/prevenção & controle , Saúde Reprodutiva/tendências , População Rural , Instituições Acadêmicas , Comportamento Sexual/ética , Comportamento Sexual/psicologia , Inquéritos e Questionários , População Urbana , Adulto Jovem
10.
Aliment Pharmacol Ther ; 48(11-12): 1202-1212, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30411389

RESUMO

BACKGROUND: High levels of voluntary childlessness and pregnancy-related fears have been reported amongst inflammatory bowel disease (IBD) patients. AIMS: To investigate what factors determine IBD patients' childbearing decisions; and to examine psychosocial consequences of IBD on various aspects of patients' reproductive health. METHODS: Six electronic databases were searched in a pre-specified and structured manner. RESULTS: A total of 41 articles with data on 7122 patients were included. Between one-fifth to one-third of IBD patients had chosen voluntary childlessness. Around 50% of all IBD patients have poor knowledge of pregnancy-related issues in IBD. Poor knowledge of pregnancy-related issues in IBD was associated with voluntary childlessness. Observational studies have found preconception counselling is associated with patients choosing parenthood. Pregnancy-related fears and concerns are multifaceted, stemming partly from lack of knowledge of pregnancy-related issues in IBD. Many female patients are considered at increased risk for pregnancy because between one-fifth to one-third of patients do not use contraception. Research evidence for sexual dysfunction after disease diagnosis and treatment is inconsistent. There are limited data on patients' pregnancy, postpartum and parenting experiences. A few shortcomings of the literature are evident; sample sizes were small, participation rates were low, use of non-validated questionnaires was common, and few studies included men and/or ethnic minority groups. The design of intervention studies is also weak. CONCLUSION: This review recommends pre-conception counselling for all IBD patients of childbearing age to tackle poor knowledge and allow patients to make an informed decision on their reproductive health.


Assuntos
Doenças Inflamatórias Intestinais/psicologia , Complicações na Gravidez/psicologia , Saúde Reprodutiva , Adulto , Estudos Transversais , Feminino , Fertilização/fisiologia , Humanos , Doenças Inflamatórias Intestinais/diagnóstico , Doenças Inflamatórias Intestinais/epidemiologia , Masculino , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/epidemiologia , Comportamento Reprodutivo/psicologia , Saúde Reprodutiva/tendências , Inquéritos e Questionários
12.
J Cancer Surviv ; 12(5): 702-711, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30128858

RESUMO

PURPOSE: Thyroid cancer is the most rapidly increasing cancer in the USA, affects a young, mostly female population, and has high survival. The aim of this study was to determine if there is an increased risk of reproductive system adverse events or pregnancy complications among women diagnosed with thyroid cancer under the age of 50. METHODS: Up to five female cancer-free individuals were matched to each female thyroid cancer survivor diagnosed before the age of 50 based on birth year, birth state, and follow-up time, within the Utah Population Database. Medical records were used to identify disease diagnoses stratified over three time periods: 0-1, > 1-5, and > 5-10 years after cancer diagnosis. Cox proportional hazards models were used to estimate hazard ratios (HR) with adjustment on matching factors, race, BMI, and Charlson Comorbidity Index. RESULTS: There were 1832 thyroid cancer survivors and 7921 matched individuals. Thyroid cancer survivors had higher rates of having multiple health conditions associated with the gynecological system (15.4% vs. 9.4%) and pregnancy (14.3% vs 9.5%) > 1-5 years after cancer diagnosis. Increased risks persisted > 5-10 years after cancer diagnosis for menopausal disorders (HR = 1.78, 99% CI = 1.37, 2.33) and complications related to pregnancy (HR = 2.13, 99% CI = 1.14, 3.98). Stratified analyses showed these risks remained increased across different treatment types. CONCLUSIONS: There were significant risk increases in reproductive system and pregnancy complications among female thyroid cancer survivors within this study. IMPLICATIONS FOR CANCER SURVIVORS: Although radiation has been linked to reproductive risks in previous studies, we found risks were increased in patients regardless of treatment.


Assuntos
Sobreviventes de Câncer/psicologia , Doenças dos Genitais Femininos/etiologia , Saúde Reprodutiva/tendências , Neoplasias da Glândula Tireoide/complicações , Adulto , Estudos Transversais , Feminino , Doenças dos Genitais Femininos/patologia , Humanos , Gravidez , Fatores de Risco , Neoplasias da Glândula Tireoide/mortalidade
13.
Cien Saude Colet ; 23(6): 1915-1928, 2018 Jun.
Artigo em Português, Inglês | MEDLINE | ID: mdl-29972499

RESUMO

This study presents an overview of public sector interventions and progress made on the women's and child health front in Brazil between 1990 and 2015. We analyzed indicators of antenatal and labor and delivery care and maternal and infant health status using data from the Live Birth Information System and Mortality Information System, national surveys, published articles, and other sources. We also outline the main women's and child health policies and intersectoral poverty reduction programs. There was a sharp fall in fertility rates; the country achieved universal access to antenatal and labor and delivery care services; access to contraception and breastfeeding improved significantly; there was a reduction in hospital admissions due to abortion and in malnutrition. The rates of congenital syphilis, caesarean sections and preterm births remain excessive. Under-five mortality decreased by more than two-thirds, but less pronounced for the neonatal component. The maternal mortality ratio decreased from 143.2 to 59.7 per 100 000 live births. Despite worsening scores or levelling off across certain health indicators, the large majority improved markedly.


Assuntos
Saúde da Criança/tendências , Saúde do Lactente/tendências , Saúde Materna/tendências , Saúde Reprodutiva/tendências , Adolescente , Adulto , Brasil , Criança , Pré-Escolar , Assistência à Saúde/tendências , Feminino , Acesso aos Serviços de Saúde/tendências , Indicadores Básicos de Saúde , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Mortalidade Materna/tendências , Pessoa de Meia-Idade , Programas Nacionais de Saúde/organização & administração , Pobreza , Gravidez , Adulto Jovem
14.
Nihon Eiseigaku Zasshi ; 73(2): 185-199, 2018.
Artigo em Japonês | MEDLINE | ID: mdl-29848871

RESUMO

In this paper, we describe the trends in research on adolescent sexuality education in Japan and other countries and on fertility awareness, as well as the possibility of life planning based on sex and reproductive health education. Mason-Jones AJ et al. reviewed the results of school-based intervention studies on the prevention of human immunodeficiency virus infection, sexually transmitted diseases, and pregnancy. There is little evidence supporting the idea that educational curriculum-based programs alone are effective in improving sex and reproductive health outcomes in adolescents. In another study, the effectiveness of school-based sexuality education for adolescents in Japan was evaluated. The Japan Medical Abstract Society was searched for articles published in the last 10 years. In many studies, the effects were compared before and after a single sexuality education lecture by professionals, such as doctors, midwives, and public health nurses. In Japan, effort has been directed toward sexuality education, but no systematic program based on behavior theory has been adopted. Therefore, sex education is insufficient. A third study clarified research on fertility awareness in adults and issues regarding improvements in related education and research. The Japan Medical Abstract Society and PubMed were searched for articles published in the last 10 years. The review suggested that awareness of female fertility is insufficient. Delaying childbearing based on inaccurate knowledge of the decline in female fertility could lead to unintended infertility. For males and females, sexual health education in schools and communities should include information on the age-related decline in female fertility. Although the determinants of the timing of childbearing are multifactorial, education on fertility issues is necessary to help adults make informed reproductive decisions based on accurate information. Finally, in this paper, we introduce examples of the pioneering efforts in sexual health education through collaboration between the governments of Oita and Okayama Prefectures and Oita and Okayama Universities.


Assuntos
Conscientização , Saúde Reprodutiva/educação , Saúde Reprodutiva/tendências , Educação Sexual/tendências , Sexualidade/psicologia , Adolescente , Feminino , Fertilidade , Planejamento em Saúde , Humanos , Japão , Masculino , Gravidez , Aprendizagem Baseada em Problemas , Comportamento Sexual
15.
Lancet ; 391(10129): 1538-1548, 2018 04 14.
Artigo em Inglês | MEDLINE | ID: mdl-29395268

RESUMO

Building upon the successes of Countdown to 2015, Countdown to 2030 aims to support the monitoring and measurement of women's, children's, and adolescents' health in the 81 countries that account for 95% of maternal and 90% of all child deaths worldwide. To achieve the Sustainable Development Goals by 2030, the rate of decline in prevalence of maternal and child mortality, stillbirths, and stunting among children younger than 5 years of age needs to accelerate considerably compared with progress since 2000. Such accelerations are only possible with a rapid scale-up of effective interventions to all population groups within countries (particularly in countries with the highest mortality and in those affected by conflict), supported by improvements in underlying socioeconomic conditions, including women's empowerment. Three main conclusions emerge from our analysis of intervention coverage, equity, and drivers of reproductive, maternal, newborn, and child health (RMNCH) in the 81 Countdown countries. First, even though strong progress was made in the coverage of many essential RMNCH interventions during the past decade, many countries are still a long way from universal coverage for most essential interventions. Furthermore, a growing body of evidence suggests that available services in many countries are of poor quality, limiting the potential effect on RMNCH outcomes. Second, within-country inequalities in intervention coverage are reducing in most countries (and are now almost non-existent in a few countries), but the pace is too slow. Third, health-sector (eg, weak country health systems) and non-health-sector drivers (eg, conflict settings) are major impediments to delivering high-quality services to all populations. Although more data for RMNCH interventions are available now, major data gaps still preclude the use of evidence to drive decision making and accountability. Countdown to 2030 is investing in improvements in measurement in several areas, such as quality of care and effective coverage, nutrition programmes, adolescent health, early childhood development, and evidence for conflict settings, and is prioritising its regional networks to enhance local analytic capacity and evidence for RMNCH.


Assuntos
Saúde Global/tendências , Cobertura Universal do Seguro de Saúde/tendências , Saúde da Criança/estatística & dados numéricos , Saúde da Criança/tendências , Conservação dos Recursos Naturais/tendências , Saúde Global/estatística & dados numéricos , Equidade em Saúde/estatística & dados numéricos , Equidade em Saúde/tendências , Humanos , Saúde do Lactente/estatística & dados numéricos , Saúde do Lactente/tendências , Saúde Materna/estatística & dados numéricos , Saúde Materna/tendências , Mortalidade/tendências , Estado Nutricional , Saúde Reprodutiva/estatística & dados numéricos , Saúde Reprodutiva/tendências , Cobertura Universal do Seguro de Saúde/estatística & dados numéricos
17.
MedEdPORTAL ; 14: 10772, 2018 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-30800972

RESUMO

Introduction: Sexual health is influenced by a myriad of social factors including health care access, social and cultural norms, insurance status, educational level and health literacy, economic status, sex, gender identity, and sexual orientation and behavior. It is pivotal to educate future physicians about these social determinants so that they can work to mitigate the resulting disparities and thereby improve the health of patients and their communities. Methods: This 2-hour, large-group session for second-year medical students was first given in the fall of 2017. It included a 1-hour, case-based lecture followed by a patient panel. Panelists discussed their interactions with the medical system and how these related to their sex and gender identity. Ninety students (77.5% response rate) completed both pre- and postsurveys and an overall assessment of the session. Results: Students reported high levels of satisfaction with the session. Eighty-seven percent felt they would benefit from more classes including a patient panel, and 93% reported specifically that the panel helped them to identify their own biases related to sexual orientation and gender. In the postsurvey, there was a significant (p < .05) increase in the number of students reporting increased comfort regarding various aspects of sexual history taking and interacting with patients of different sexual orientations and gender identities. Discussion: This instructional format provided an effective way to teach medical students about the social determinants of sexual and reproductive health. Students both appreciated the session format and reported increased comfort and confidence related to the subject matter.


Assuntos
Saúde Reprodutiva/tendências , Determinantes Sociais da Saúde , Estudantes de Medicina/psicologia , Currículo/tendências , Educação de Graduação em Medicina/métodos , Feminino , Humanos , Masculino , Saúde Reprodutiva/normas , Educação Sexual/métodos , Comportamento Sexual/psicologia , Doenças Sexualmente Transmissíveis/prevenção & controle , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos
18.
Hum Exp Toxicol ; 37(3): 247-255, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28413887

RESUMO

PURPOSE: To investigate whether the sperm concentration of European men is deteriorating over the past 50 years of time. MATERIALS AND METHODS: We analysed the data published in English language articles in the past 50 years in altering sperm concentration in European men. RESULTS: A time-dependent decline of sperm concentration ( r = -0.307, p = 0.02) in the last 50 years and an overall 32.5% decrease in mean sperm concentration was noted. CONCLUSION: This comprehensive, evidence-based meta-analysis concisely presents the evidence of decreased sperm concentration in European male over the past 50 years to serve the scientific research zone related to male reproductive health.


Assuntos
Fertilidade , Saúde Reprodutiva/tendências , Contagem de Espermatozoides/tendências , Espermatozoides/fisiologia , Adulto , Europa (Continente) , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
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