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Contraceptive preferences and unmet need for contraception in midlife women: where are the data?

This commentary discusses the limited availability of information on contraceptive preferences and unmet need for contraception among midlife women in both high and low income countries. Given that risk of pregnancy continues until women reach menopause and given the increased risk of pregnancy complications, elective abortion, and maternal mortality in women aged 45 to 54 years ...

It is not just menopause: symptom clustering in the Study of Women’s Health Across the Nation

Background Patterns of symptom clustering in midlife women may suggest common underlying mechanisms or may identify women at risk of adverse health outcomes or, conversely, likely to experience healthy aging. This paper assesses symptom clustering in the Study of Women’s Health Across the Nation (SWAN) longitudinally by stage of reproductive aging and estimates the probability of ...

Chronic vulvar pain in a cohort of post-menopausal women: Atrophy or Vulvodynia?

Background Although postmenopausal vulvar pain is frequently attributed to vaginal atrophy, such symptoms may be due to vulvodynia, a chronic vulvar pain condition. Given the limited research on vulvodynia in postmenopausal women, the objective of this study was to provide preliminary population-based data on the associations of vaginal symptoms, serum hormone levels and hormone ...

Risk Factors for Low Birthweight in Zimbabwean Women: A Secondary Data Analysis

Background Low birth weight (LBW) remains the main cause of mortality and morbidity in infants, and a problem in the care of pregnant women world-wide particularly in developing countries. The purpose of this study was to describe the socio-demographic, nutritional, reproductive, medical and obstetrical risk factors for delivering a live LBW infant at Harare Maternity Hospital, ...

Environmental Risk Score as a New Tool to Examine Multi-Pollutants in Epidemiologic Research: An Example from the NHANES Study Using Serum Lipid Levels

Objective A growing body of evidence suggests that environmental pollutants, such as heavy metals, persistent organic pollutants and plasticizers play an important role in the development of chronic diseases. Most epidemiologic studies have examined environmental pollutants individually, but in real life, we are exposed to multi-pollutants and pollution mixtures, not single ...

Performance-based Physical Functioning and Peripheral Neuropathy in a Population-based Cohort of Women at Midlife

Peripheral neuropathy is underappreciated as a potential cause of functional limitations. In the present article, we assessed the cross-sectional association between peripheral neuropathy and physical functioning and how the longitudinal association between age and functioning differed by neuropathy status. Physical functioning was measured in 1996–2008 using timed performances on ...

Most women diagnosed with cervical cancer by a visual screening program in Tanzania completed treatment: evidence from a retrospective cohort study

Background Visual inspection with acetic acid (VIA) to identify and treat pre-cancerous lesions is effective for cervical cancer prevention. Screening programs also facilitate screening and diagnosis of invasive cancers that must be referred for radiation therapy or chemotherapy. This study compared characteristics of women diagnosed with invasive cervical cancer by a VIA screening ...

Distinguishing 6 Population Subgroups by Timing and Characteristics of the Menopausal Transition

Changes in women’s menstrual bleeding patterns precede the onset of menopause. In this paper, the authors identify population subgroups based on menstrual characteristics of the menopausal transition experience. Using the TREMIN data set (1943–1979), the authors apply a Bayesian change-point model with 8 parameters for each woman that summarize change in menstrual bleeding patterns ...

A Method for Longitudinal Prospective Evaluation of Markers for a Subsequent Event

In this paper, the authors describe a simple method for making longitudinal comparisons of alternative markers of a subsequent event. The method is based on the aggregate prediction gain from knowing whether or not a marker has occurred at any particular age. An attractive feature of the method is the exact decomposition of the measure into 2 components: 1) discriminatory ability, ...

Factors Related to Age at Natural Menopause: Longitudinal Analyses From SWAN

Early age at the natural final menstrual period (FMP) or menopause has been associated with numerous health outcomes and might be a marker of future ill health. However, potentially modifiable factors affecting age at menopause have not been examined longitudinally in large, diverse populations. The Study of Women's Health Across the Nation (SWAN) followed 3,302 initially ...

Bias Due to Left Truncation and Left Censoring in Longitudinal Studies of Developmental and Disease Processes

In longitudinal studies of developmental and disease processes, participants are followed prospectively with intermediate milestones identified as they occur. Frequently, studies enroll participants over a range of ages including ages at which some participants’ milestones have already passed. Ages at milestones that occur prior to study entry are left censored if individuals are ...

Ethnic Differences in the Duration and Amount of Menstrual Bleeding during the Postmenarcheal Period

In 1989, 125 African-American and 123 European-American girls aged 12–14 years living in Durham, North Carolina, were enrolled in a 2-year study in which they maintained a menstrual calendar, recording the date and amount of menstrual bleeding. Weight, exercise, and stress during the previous week were recorded at the start of the menstrual cycle. Ethnicity was the strongest ...

Incidence of stillbirth and perinatal mortality and their associated factors among women delivering at Harare Maternity Hospital, Zimbabwe: a cross-sectional retrospective analysis

Background Death of an infant in utero or at birth has always been a devastating experience for the mother and of concern in clinical practice. Infant mortality remains a challenge in the care of pregnant women worldwide, but particularly for developing countries and the need to understand contributory factors is crucial for addressing appropriate perinatal health. Methods Using ...

Sampling Strategies for Prospective Studies of Menstrual Function

Little information is available about optimal sampling strategies for prospective studies of menstrual function. Sample size and study duration for menstrual studies have often been driven as much by feasibility and cost as by statistical principles, with follow-up lasting 6 months to 2 years and sample size ranging from 100 to 500 women. Whether these studies are sufficiently ...

Characterizing Daily Urinary Hormone Profiles for Women at Midlife Using Functional Data Analysis

The availability of daily hormone values for entire menstrual cycles offers an opportunity to apply new analytic techniques that confirm current knowledge and provide new insights into patterns of changing hormone profiles in women as they transition to the menopause. The Study of Women's Health Across the Nation (SWAN) collected urine samples during 1997−1999 from one menstrual ...

Factors Associated with Prevalent and Incident Urinary Incontinence in a Cohort of Midlife Women: A Longitudinal Analysis of Data: Study of Women's Health Across the Nation

To compare the characteristics of and baseline factors associated with prevalent and incident urinary incontinence in a diverse cohort of midlife women, the authors analyzed the baseline and first five annual follow-up visits of the Study of Women's Health Across the Nation (SWAN), 1995–2001. From responses to annual questionnaires, the authors defined prevalent incontinence as at ...

Prevalence and Patterns of Gender-based Violence and Revictimization among Women Attending Antenatal Clinics in Soweto, South Africa

Gender-based violence is a key health risk for women globally and in South Africa. The authors analyzed data from 1,395 interviews with women attending antenatal clinics in Soweto, South Africa, between November 2001 and April 2002 to estimate the prevalence of physical/sexual partner violence (55.5%), adult sexual assault by nonpartners (7.9%), child sexual assault (8.0%), and ...