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Infertility and poor reproductive outcomes as potential predictors of early and premature menopause: lets act before it would be too late!

Por: Etrusco · A. · Lagana · A. S.

Commentary on: Liang C, Chung HF, Dobson AJ, Cade JE, Greenwood DC, Hayashi K, Hardy R, Kuh D, Schouw YTV, Sandin S, Weiderpass E, Mishra GD. Is there a link between infertility, miscarriage, stillbirth, and premature or early menopause? Results from pooled analyses of 9 cohort studies. Am J Obstet Gynecol. 2023 Jul;229(1):47.e1-47.e9. doi: 10.1016/j.ajog.2023.04.009. Epub 2023 Apr 13.

Implications for practice and research

  • Women with a history of recurrent miscarriages, infertility, or stillbirths should be informed of their increased risk of early or premature or menopause.

  • Future studies should aim to evaluate whether a tailored counselling and management strategies considering this risk can improve patient outcomes and overall quality of care.

  • Context

    Menopause is a significant milestone for women, marking the permanent cessation of menstruation after 12 months of amenorrhoea. The onset of menopause is influenced by various factors, including genetics, lifestyle and...

    Scoping review suggests that reasons for choosing unassisted birth ('freebirth) vary depending on income, previous negative health care experiences and personal and cultural beliefs

    Por: Sperlich · M.

    Commentary on: Shorey S, Jarašiūnaite-Fedosejeva G, Akik BK, Holopainen A, Isbir GG, Chua JS, Wayt C, Downe S, Lalor J. Trends and motivations for freebirth: A scoping review. Birth. 2023 Mar;50(1):16-31. doi: 10.1111/birt.12702. Epub 2023 Jan 4.Commentary

    Implications for practice and research

    Providing maternity care that is trauma informed, respectful, supportive and promotes patient autonomy, agency and cultural beliefs may encourage lower rates of freebirth.

    More research is needed to articulate motivations for freebirth among diverse populations and translate trauma informed and respectful maternity care principles across systems and service providers.

    Context

    Unassisted childbirth (outside a hospital facility with no professional attendant) is common in low-income and middle-income countries (LMICs), where barriers to access and poverty delimit engagement in maternity healthcare services. However, even in high-income countries (HICs) where maternity healthcare services are more attainable, a small percentage of birthing people are choosing unassisted birth, a...

    Evidence to support targeted investment in breastfeeding education among families of low socioeconomic status

    Por: Brockway · M. · Azad · M. B.

    Commentary on: Kopp SJ, Kelly EA, DeFranco EA. Influence of social determinants of health on breastfeeding intent in the USA. Birth. 2023 Jul 3. doi: 10.1111/birt.12740. Epub ahead of print.

    Implications for practice and research

  • Healthcare providers should focus on improving knowledge around breastfeeding guidelines and the benefits of breast feeding for mothers in low socioeconomic status (SES) groups.

  • Focusing research on breastfeeding intention (rather than rates) in low SES groups may help to improve breastfeeding outcomes as breastfeeding intentions are a significant predictor of breastfeeding initiation.

  • Context

    Breastfeeding sets the foundation for healthy growth and development, with many recognised benefits for both infant and maternal health. Thus, socioeconomic disparities in breastfeeding—which are widely reported in the USA and many other Western countries1—contribute significantly to socioeconomic health disparities across the lifespan. Breastfeeding intentions are an established predictor of breastfeeding outcomes, yet most...

    We need more evidence to inform community-based health services for women, and transgender and nonbinary people who experience incarceration

    Por: McLeod · K. · Kouyoumdjian · F. G.

    Commentary on: Paynter M, Heggie C, Low C, McKibbon S, Martin-Misener R. Community-based models of health care for women, trans and nonbinary people released from prisons: An international scoping review with implications for Canada. J Clin Nurs. 2023 Jul;32(13-14):3277-3294. doi: 10.1111/jocn.16464. Epub 2022 Aug 8.

    Implications for practice and research

  • Women, transgender and non-binary people who experience incarceration often have complex healthcare needs and require dynamic, trauma-informed care in the community.

  • Research is needed to understand how to address the diverse health needs of women, transgender and non-binary people leaving prison.

  • Context

    On any given day, approximately 740 000 women and girls1 and an unknown number of transgender, non-binary and gender diverse people are incarcerated globally. Intersecting social and structural factors impact incarceration and healthcare experiences, requiring community-based interventions that address the specific needs of women, transgender and non-binary people leaving prison.

    ...

    Increased prevalence of chronic medical conditions linked to higher rates of adverse perinatal outcomes in Dutch women

    Por: Melekoglu · R.

    Commentary on: Rosman AN, van der Vliet-Torij HWH, Hilberink SR. Trends in perinatal outcomes of women with chronic medical conditions: a 10-year population-based study in the Netherlands. Midwifery. 2023 Mar;118:103572. doi: 10.1016/j.midw.2022.103572. Epub 2022 Dec 13.

    Implications for practice and research

  • Due to the heightened risk of preterm birth, caesarean deliveries, NICU admission of neonates and increased perinatal mortality among pregnant women with chronic medical conditions, it is essential that midwives and nurses receive comprehensive training to deliver personalised care for these women.

  • To enhance perinatal outcomes among pregnant women with chronic medical conditions, future research should prioritise identifying the contributing factors to such outcomes and developing novel interventions targeted at optimising perinatal outcomes during both the prepregnancy and pregnancy periods.

  • Context

    Chronic diseases can impact pregnancy and lead to long-term consequences for women during and after childbirth, causing anxiety. However, medical advancements and...

    It is time for healthcare professionals to engage with social media

    Por: Hundley · V. · Marsh · A.

    Commentary on: Chee RM, Capper TS, Muurlink OT. The impact of social media influencers on pregnancy, birth, and early parenting experiences: A systematic review. Midwifery. 2023 May;120:103623. doi: 10.1016/j.midw.2023.103623. Epub 2023 Feb 19.

    Implications for practice and research

  • Social media is one of the fastest growing commercial determinants of health.

  • Healthcare professionals need a better understanding of social media and its impact.

  • Context

    Social media has rapidly become a key source of advice and support for women during childbirth. The growth of influencers, popular users credited with knowledge and expertise, can be seen in the numerous social posts, blogs, podcasts and videos about pregnancy, birth and parenting. Social media influencers provide responsive and relatable content to their network of followers; but there are concerns about the potential to spread misinformation.1

    Methods

    This systematic literature review2 sought to identify...

    Prison is a barrier to high-quality, comprehensive midwifery care

    Por: Paynter · M. J.

    Commentary on: Abbott L, Scott T, Thomas H. Experiences of midwifery care in English prisons. Birth. 2023 Mar;50(1):244-251. doi: 10.1111/birt.12692. Epub 2022 Nov 12.

    Implications for practice and research

  • Incarceration presents barriers to best midwifery practices, restricting patient choice in care provider and place of birth. Midwives play an important role advocating for incarcerated patients.

  • Prison staff misunderstand midwifery and conceptualise access to care as a reward for good behaviour. Future research should assess outcomes of alternatives to incarceration.

  • Context

    Women continue to be one of the fastest growing populations experiencing incarceration, with significant consequences for their newborns and children. Despite international and national requirements for equivalent care to what is available in community, existing research in the field of prison perinatal health has found delays and gaps in care and poor neonatal outcomes associated with pregnancy in prison.1 This study by...

    Cardiomyopathy and pregnancy: a high-risk combination

    Por: Ntiloudi · D. · Giannakoulas · G.

    Commentary on: Eggleton EJ, McMurrugh KJ, Aiken CE. Maternal pregnancy outcomes in women with cardiomyopathy: a systematic review and meta-analysis. Am J Obstet Gynecol. 2022 Oct;227(4):582–592. doi: 10.1016/j.ajog.2022.05.039. Epub 2022 May 2021

    Implications for practice and research

  • Pregnant patients with cardiomyopathy have a risk of complications and should be advised accordingly.

  • Prospective data focusing on pregnancy outcomes in patients with various subtypes of cardiomyopathies are warranted to ensure proper counselling of these patients.

  • Context

    Haemodynamic changes, especially blood volume, heart rate and cardiac output augmentation, during pregnancy can exacerbate symptoms in patients with cardiomyopathy or unmask a preexisting asymptomatic condition.1 Peripartum cardiomyopathy, which also belongs in the cardiomyopathy group, presents with left ventricular (LV) dysfunction towards the end of pregnancy and in the postpartum period, when no other cause of heart failure is evident.1 All these patients are at high...

    Mental state, well-being and coping are affected by a high-risk pregnancy

    Por: Holness · N. · Barfield · L.

    Commentary on: Williamson SP, Moffitt RL, Broadbent J, Neumann DL, Hamblin PS. Coping, wellbeing, and psychopathology during high-risk pregnancy: A systematic review. Midwifery. 2023 Jan;116:103556. doi: 10.1016/j.midw.2022.103556. Epub 2022 Nov 14.

    Implications for practice

  • Awareness of negative impacts of high-risk pregnancies on mental health will help to identify women in need of support.

  • Strategies can be created to improve coping and well-being for high-risk pregnant women.

  • Context

    Pregnancy is a period of major physiological changes. Psychological adjustments occur, more so with a high-risk diagnosis in pregnancy. In their systematic review, the authors outlined the state of the science of pregnant women’s psychopathology, coping and well-being when high-risk conditions including hypertension, diabetes and kidney disease develop during pregnancy. Pregnant women with these conditions can experience ineffective coping, poor well-being, anxiety and depression among other negative symptoms. Provider’s awareness, culturally appropriate education and support can reduce...

    Commentary on a Turkish kangaroo care study

    Por: Clarkson · G.

    Commentary on: Toprak FÜ, Erenel AS. The effect of kangaroo care practice after caesarean section on paternal-newborn interaction: A mixed-methods study in Turkey. Midwifery. 2022 Dec; 115:103489. doi: 10.1016/j.midw.2022.103489. Epub 2022 Sep 15.

    Implications for practice and research

  • Turkish fathers should be encouraged to hold their infants by kangaroo care (KC) after maternal caesarean section.

  • Future research in Turkey could focus on the facilitators and barriers to paternal skin-to-skin holding.

  • Context

    Newborns, when consoled with skin-to-skin holding, or KC, are better able to adapt physiologically after caesarean delivery. KC in Turkey is a desired practice, but when the mother has caesarean section, this delays the practice. In Turkey, fathers are not routinely offered KC. Since there is a high rate of caesarean sections in Turkey, the nursing staff do not offer KC to many infants. There are two hypotheses in this study: (1) newborns...

    Womens perceptions of risk, safety and autonomy drive what we (providers and society) consider non-normative choices in pregnancy and childbirth

    Por: Benyamini · Y.

    Commentary on: Madeley AM, Earle S, O'Dell L. Challenging norms: Making non-normative choices in childbearing. Results of a meta ethnographic review of the literature. Midwifery. 2023 Jan;116:103532. doi: 10.1016/j.midw.2022.103532. Epub 2022 Oct 30

    Implications for research and practice

  • Nurses should strive to understand women’s needs, past experiences and sociocultural background as a basis for discussing their choices in a non-judgemental way.

  • Research on non-normative choices in childbearing should include ethnic and sexual minorities, and evaluate protocols for sensitive, women-centred discussion of birthing choices.

  • Context

    Preferences about childbirth range along a wide continuum from physiological, sometimes even unassisted births, to caesarean sections by maternal request. Despite this wide range, most births in the western world take place in medical settings, making it in practice a medical event, reflecting society’s and health professionals’ views of risk and safety that define birth choices which are considered normative....

    Overview of the role of different conservative interventions as first-line treatment in the management of urinary incontinence in women

    Por: Rajan · K. · Nambiar · A. K.

    Commentary on: Todhunter-Brown A, Hazelton C, Campbell P, Elders A, Hagen S, McClurg D. Conservative interventions for treating urinary incontinence in women: an Overview of Cochrane systematic reviews. Cochrane Database Syst Rev. 2022 Sep 2;9(9):CD012337. doi: 10.1002/14651858.CD012337.pub2.

    Implications for practice and research

  • Pelvic floor muscle training is an effective conservative treatment option for managing all types of urinary incontinence (UI) in women in isolation or combined with other measures and should be considered first-line treatment in women with UI.

  • Further research is needed on long-term outcomes of conservative interventions and their impact on quality of life.

  • Context

    Urinary incontinence (UI) is a highly prevalent condition affecting nearly 25% of women, especially in older age groups.1 It is characterised by involuntary leakage of urine and can have a significant impact on quality of life, leading to psychological distress and placing a financial burden...

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