搜索结果：Reproductive health

Women in Sudan face significant challenges in access to healthcare due to financial hardship, male decision-making influence and geographic limitations, contributing to delayed care-seeking barriers to maternal and reproductive healthcare, and persistent health inequities. A community-based cross-sectional study was conducted among 760 Sudanese women aged 18 years and above using a structured interviewer-administered questionnaire. Data were collected through face-to-face interviews across urban and rural areas, and associations with healthcare accessibility were examined using binary logistic regression analysis. Financial limitations were a major barrier, with 24.8% of women reporting rare or no financial ability to access healthcare. Additionally, 32.1% always required male permission to seek care and 7.6% experienced healthcare delays due to male family members' decisions. Women living more than 10 km from a healthcare facility were 7.1 times more likely to report inadequate access. Nearly half of the participants 49.6% strongly disagreed that male family members understood the importance of timely healthcare. Women's access to healthcare in Sudan remains constrained by interconnected economic, sociocultural, and geographic barriers. The findings highlight that urgent policy reforms are needed to expand affordable and geographically accessible healthcare services, strengthen women's financial and decision-making autonomy, and promote community-based interventions that engage men in supportive healthcare practices. Not applicable.

Pregnancy is a critical period that significantly affects the health and well-being of both the mother and the fetus. Maintaining a healthy lifestyle during this time is essential for preventing complications and promoting overall health. This project aimed to promote evidence-based practices for healthy lifestyle considerations during pregnancy. This project was guided by the JBI Evidence Implementation Framework and utilized the JBI Practical Application of Clinical Evidence System (PACES) and the JBI Getting Research into Practice (GRiP) tools. Compliance with best practices was assessed through baseline and follow-up audits, and tailored strategies were implemented to address identified barriers. The baseline audit revealed significant gaps between current prenatal education practices and recommended best practices. Zero compliance was reported for the first six criteria, which included verbal and written education on healthy lifestyles, individualized tailoring of information, goal-setting, task planning, and progress monitoring. However, full compliance was observed in the criterion related to opportunities for discussion and questions. Following the implementation of the best evidence, compliance significantly improved across all criteria. Notable improvements were observed in nutritional habits, interpersonal support, and stress management behaviors, which corresponded with increased compliance in tailored education, goal-setting, and progress monitoring. A statistically significant positive correlation was also found between healthy lifestyle scores and compliance with educational guidelines (Spearman's &#x3c1; ranging from 0.32 to 0.66, p<0.001), indicating that healthier lifestyle behaviors were associated with higher compliance. Implementing evidence-based practices effectively promotes healthy lifestyles among pregnant women. Researchers, health system policymakers, and health care providers are encouraged to prioritize the implementation of evidence-based healthy lifestyle education during pregnancy. http://links.lww.com/IJEBH/A592.

The postmenopausal bone health reflects the influence of various factors that have been in effect throughout life and hormonal regulation is among them. The aim of the current study is to investigate the effect of pregnancies and other factors related to female reproductive health on bone mineral density and the incidence of fractures in the postmenopausal period. We performed a case-control retrospective analysis in a group of 977 postmenopausal women from the RACOST-POL cohort. In the study group, there were 894 (91.5%) women who had at least one delivery and breastfeeding was reported by 845 (86.5%) women. Bone mineral density (FN T-score) was not related to pregnancies and history of lactation, but correlated positively with age at menopause and with time of reproductive period. Low-energy fractures were reported by 286 women, which consists 29.3% of the study group. There was no difference in fracture prevalence between women who delivered (29.4%) or not (27.7%). Also the breastfeeding status was not related to fracture prevalence (28.9% in the subgroup declaring lactation and 31.8% in the others). Women with fractures had earlier age of menopause and shorter time of reproductive period in comparison to subjects without fractures (48.3 &#xb1; 5.2 vs. 49.5 &#xb1; 4.7 ys.; p < 0.001; OR 0.95 (95% CI: 0.93 - 0.98), and 34.1 &#xb1; 5.5 vs. 35.5 &#xb1; 4.9 ys.; p < 0.001; OR 0.95 (95% CI: 0.93 - 0.98), respectively). Additionally, fracture prevalence in the 'early menopause' (below 45 ys) subgroup was significantly higher (39.1%) than in all the others (27.8%) with OR 1.66 (95% CI: 1.13 - 2.42). Our study did not show a significant association between history of pregnancies or lactation and the skeletal status in the postmenopausal period. However, a shortened period between menarche and menopause and an earlier age at menopause may have a negative impact on bone health in later life. Presented results complement the knowledge on a wide and diverse spectrum of factors modifying bone health in postmenopausal women.

Abnormal vaginal discharge is a common and clinically important presenting complaint and reason for specimen submission, often suggesting lower genital tract disorders such as vaginal infections, and may adversely affect women's reproductive health and pregnancy outcomes. This study aimed to investigate the distribution and antimicrobial susceptibility profiles of common bacteria isolated from vaginal discharge specimens submitted from hospitalized patients at Longgang District Maternity & Child Healthcare Hospital of Shenzhen City, in order to provide a reference for the interpretation of clinical specimen results and empirical antimicrobial therapy. Non-duplicate bacterial isolates recovered from vaginal discharge specimens collected from hospitalized patients between January 1, 2021 and December 31, 2025 were retrospectively analyzed, and the composition of common vaginal bacterial isolates, the age distribution of patients, and the antimicrobial susceptibility profiles of major isolates to commonly used antibiotics were assessed. A total of 1,094 non-duplicate positive bacterial isolates were identified during 2021-2025, with Gram-positive bacteria predominating (65.2%). The major isolates were Streptococcus agalactiae, Escherichia coli, and Klebsiella pneumoniae subsp. pneumoniae. Most cases were from the obstetrics department, and the majority of patients were women aged 25-34&#x202f;years. Antimicrobial susceptibility testing showed marked differences in antimicrobial susceptibility profiles among bacterial species: Streptococcus agalactiae remained highly susceptible to penicillins and vancomycin, but showed high resistance rates to clindamycin and tetracycline; Escherichia coli and Klebsiella pneumoniae subsp. pneumoniae had relatively high rates of extended-spectrum &#x3b2;-lactamase (ESBL) positivity, while remaining highly susceptible to amikacin, carbapenems, and tigecycline; some isolates also exhibited notable resistance to trimethoprim-sulfamethoxazole, fluoroquinolones, and certain &#x3b2;-lactam antibiotics. Vaginal bacterial isolates from hospitalized patients were predominantly composed of Streptococcus agalactiae and members of the Enterobacteriaceae family, and were mainly derived from the obstetrics department and women of reproductive age. Marked differences in antimicrobial susceptibility profiles were observed among bacterial species, suggesting that maternal and child healthcare hospitals should strengthen local surveillance of isolate distribution and antimicrobial susceptibility in order to support more precise empirical therapy and antimicrobial stewardship.

Aquatic environments increasingly experience the co-occurrence of endocrine-disrupting contaminants and declining oxygen levels, yet their combined influence on reproductive fitness remains insufficiently understood. Here, we examined the reproductive consequences of developmental exposure to hypoxia and the synthetic estrogen 17&#x3b1;-ethinylestradiol (EE2) in marine medaka (Oryzias melastigma). Embryos were exposed to environmentally relevant (71 ng/L) or elevated (668 ng/L) EE2 under normoxic or hypoxic (1.8 mg O&#x2082;/L) conditions until hatching and subsequently reared in seawater to adulthood. EE2 induced feminization of sex ratios, while hypoxia altered several physiological responses during estrogenic exposure. Co-exposure resulted in distinct endpoint-specific patterns, including increased hepatosomatic and gonadosomatic indices. Although fecundity increased under combined EE2 high dose and hypoxia exposure, hatching success declined across all the EE2 treatments, indicating a shift between reproductive output and offspring viability. Transcriptomic profiling revealed stronger gene expression perturbations under co-exposure than under either stressor alone, with enriched pathways related to steroid hormone biosynthesis, progesterone-mediated oocyte maturation, extracellular matrix organization, and PI3K-Akt signaling. These molecular responses provide biological context for the observed physiological changes. Collectively, these findings demonstrate that transient developmental hypoxia can modify estrogen driven reproductive outcomes later in life, linking early life oxygen limitation with altered endocrine susceptibility. This study highlights the importance of considering co-occurring chemical and environmental stressors when evaluating reproductive risks in increasingly deoxygenated coastal ecosystems.

Alkaline phosphatases (ALPs) are enzymes involved in bone mineralisation, liver function, and intestinal health. In cattle, the activity of ALPs varies with age, nutrition, and physiological or pathological status. Despite decades of research, the understanding of isozyme-specific roles and diagnostic applications remains fragmented. This bibliometric and narrative review synthesised 473 peer-reviewed studies that measured ALPs in cattle, published between 1948 and 2025, retrieved from the Scopus database. Bibliometric analysis revealed a marked increase in publications over the past decade, with most studies focused on dairy cattle during pregnancy, lactation, and metabolic adaptation. Bone-associated ALP is consistently associated with skeletal growth and mineral metabolism, whereas hepatic- and placental-associated ALPs are linked to metabolic stress and reproductive processes. Altered activity of ALPs in serum or milk has been reported in conditions such as mastitis, milk fever, ketosis, parasitic infections, and respiratory disease, supporting its potential as a biomarker of health and disease. However, major limitations remain across the literature, including the underrepresentation of beef cattle and the frequent lack of isozyme and isoform differentiation. These limitations constrain biological interpretation and clinical applicability of measuring ALPs. Overall, ALPs have potential as tools for monitoring cattle health, supporting nutritional management and veterinary care. Future research should prioritise isozyme and isoform specific analyses and expand investigations across diverse breeds and production systems to improve the diagnostic utility of ALPs and drive its potential use in cattle systems.

Pregnancy loss is the terminated pregnancy before the completed pregnancy time. Spatial location can significantly influence pregnancy outcomes, yet geographic disparities in the risk of pregnancy loss remain poorly studied in East Africa. This study is aimed at examining the spatial variation and determinants of time to pregnancy loss among women of reproductive age in the region. A Bayesian spatial survival model with an intrinsic conditional autoregressive approach was utilized to identify factors related to time to pregnancy loss across 169 regions in 9 East African countries using secondary data from recent demographic and health surveys (2015-2023). A spike-and-slab prior was used for variable selection. Model comparison utilized deviance information criteria, Watanabe-Akaike information criterion, and log pseudo marginal likelihood, with diagnostics from Cox and Snell residuals. Pregnancy loss showed significant spatial clustering. Earlier occurrence was observed among women aged 25-34 years (&#x3d5; = 0.712; 95% CrI: 0.680-0.744) and &#x2265;&#x2009;35 years (&#x3d5; = 0.326; 95% CrI: 0.307-0.344), those living with their husbands (&#x3d5; = 0.893; 95% CrI: 0.856-0.932), with primary education (&#x3d5; = 0.939; 95% CrI: 0.892-0.987), regular media exposure (&#x3d5; = 0.854; 95% CrI: 0.819-0.889), employed (&#x3d5; = 0.818; 95% CrI: 0.788-0.850), and attending antenatal care (&#x3d5; = 0.964; 95% CrI: 0.933-0.996). In contrast, college-educated women (&#x3d5; = 1.109; 95% CrI: 1.024-1.203), rural residents (&#x3d5; = 1.144; 95% CrI: 1.102-1.190), low parity (&#x3d5; = 14.93; 95% CrI: 13.853-16.132), and grand multiparity (&#x3d5; = 22.088; 95% CrI: 20.131-24.247) were associated with longer time to pregnancy loss. After adjusting for individual-level factors, residual variation in the hazard of pregnancy loss remained. Pregnancy loss remains a significant public health challenge in East Africa, with significant geographic variation. Spatial analysis can guide region-specific healthcare strategies and targeted interventions.

The female reproductive tract (FRT) is susceptible to sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), which negatively impact and threaten the lives of women worldwide. While the hormonal regulation of innate and adaptive immunity in the FRT during the menstrual cycle is well-studied, changes in mucosal immune protection throughout the FRT that occur with aging after menopause remain largely unknown. This review summarizes hormonal and age-related immune changes throughout the FRT, focusing on their effects on the function of epithelial cells and immune cells in the uterus, cervix and vagina, highlighting implications for HIV infection. After menopause, as reproductive function ceases, two interconnected processes, menopause and immunosenescence, drive alterations in immune protection. As women age following menopause, significant aspects of innate and adaptive immunity in the FRT are compromised in a site-specific manner. At some FRT sites, as cell numbers decline, immunological compensation characterized by increased immunological activity is observed. Overall, these changes in mucosal immune protection contribute to a heightened risk of STIs and HIV acquisition. Further research is essential to establish a basis for developing new therapeutic interventions to restore immune protection and mitigate conditions that endanger the health and lives of aging women.

This study aimed to identify lifestyle and biological factors associated with body image among reproductive-aged women, focusing on physical activity, sedentary time, sleep, BMI, premenstrual symptoms (PMS), and sleep quality. A secondary aim was to explore interrelationships among these factors to contextualise their combined association with body image. In this cross-sectional online survey, 291 women aged 18-45 years participated (mean age: 27.16&#x2009;&#xb1;&#x2009;0.36 years). Validated questionnaires were used to assess body image (Body Appreciation Scale), physical activity (Global Physical Activity Questionnaire), sleep quality (Sleep Quality Scale), BMI, and PMS (Premenstrual Assessment Form-Short Form). Data were analysed with IBM SPSS 28.0 using multivariable linear regression and correlation analyses (p&#x2009;<&#x2009;0.05). Higher BMI, greater PMS severity, poorer sleep quality and longer sedentary time were significantly associated with lower body appreciation. Correlations were found between PMS and sleep quality (r&#x2009;=&#x2009;0.309; p&#x2009;<&#x2009;0.001), PMS and work-related moderate activity (r&#x2009;=&#x2009;0.119; p&#x2009;=&#x2009;0.043), and sleep quality and work-related moderate activity (r&#x2009;=&#x2009;0.169; p&#x2009;=&#x2009;0.004). No significant associations were observed for recreational physical activity with PMS (r=-0.041; p&#x2009;=&#x2009;0.544) or sleep quality (r=-0.040; p&#x2009;=&#x2009;0.498). Body image in reproductive-aged women was associated with both lifestyle behaviours and biological symptom burden. The findings suggest that supporting positive body image may benefit from integrated approaches addressing sedentary behaviour, sleep quality and menstrual health alongside weight-related factors.

Perceived discrimination can undermine healthcare system trust and contribute to medical mistrust, creating barriers to effective survivorship care. Endometrial cancer survivors, who experience intersecting social, reproductive, and aging-related challenges, remain understudied, and population-level evidence on the relationship between discrimination and medical mistrust in this group is limited. We analyzed enrollment survey data from the population-based Carolina Endometrial Cancer Study. Perceived discrimination was measured using the 9-item Everyday Discrimination Scale, categorized into tertiles (low, moderate, high). Medical mistrust was assessed using the 7-item Medical Mistrust Index (MMI), dichotomized as &#x2265;&#x2009;1 item endorsed. Modified Poisson regression models estimated adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs), adjusting for age at diagnosis, region, education, and caregiving support. Analyses were conducted overall and stratified by race, education, and geography, with sensitivity analyses of frequency- and chronicity-based discrimination measures. Among 907 survivors (35% Black, mean age 60.9&#x2009;years), nearly half reported moderate or high perceived discrimination, and more than 80% endorsed &#x2265;&#x2009;1&#x2009;MMI item. Compared with low discrimination, moderate (aPR&#x2009;=&#x2009;1.20, 95% CI: 1.12-1.30) and high discrimination (aPR&#x2009;=&#x2009;1.26, 95% CI: 1.17-1.34) were associated with a higher prevalence of mistrust. Associations were consistent across racial, educational, and geographic subgroups. Sensitivity analyses confirmed that both the frequency and intensity of discrimination were positively associated with mistrust. Perceived discrimination was common and strongly associated with mistrust among endometrial cancer survivors. Our findings highlight the need for culturally responsive survivorship care and equity-focused interventions to strengthen trust and engagement.

Male infertility, particularly severe oligozoospermia, presents a significant challenge in reproductive health, often associated with high oxidative stress and poor lifestyle practices. This case report highlights the potential therapeutic role of a structured yoga regimen in improving semen quality, reducing stress, and enhancing quality of life in a male with long-standing infertility. The novelty lies in documenting comprehensive improvements across semen parameters and psychological well-being following a nonpharmacological intervention. A 30-year-old Indian male diagnosed with severe oligozoospermia presented with a four-year history of primary infertility. His 30-year-old Indian female partner had no identifiable reproductive abnormalities. The couple sought consultation at a tertiary care centre. The male patient reported a high-stress lifestyle due to his occupation as an architectural researcher involving extensive travel and irregular routines. He underwent a six-month structured yoga intervention (five days per week) comprising guided sessions involving breathing exercises, meditation, and specific physical postures, supervised by a certified yoga therapist. Pre- and post-intervention assessments included semen analysis, sperm DNA integrity, oxidative stress markers in seminal fluid, and quality of life using a standardized assessment tool. Post-intervention, the patient exhibited notable improvements in semen parameters, including increased sperm count and motility, reduced morphological abnormalities, and decreased seminal oxidative stress levels leading to sperm DNA fragmentation index decline. Improvements were also observed in quality-of-life scores across physical, psychological, social, and environmental domains. Following these outcomes, intrauterine insemination was advised as a fertility treatment option. This case illustrates the potential of yoga as an adjunctive, noninvasive therapy for managing male infertility, particularly in individuals with stress-related reproductive dysfunction. The structured yoga program led to substantial improvement in semen quality and quality of life, suggesting a mind-body connection that may influence reproductive health. This single case provides preliminary insight into the potential link between lifestyle factors and reproductive health, though broader studies are required. Further studies involving larger cohorts are needed to validate and expand upon these promising results.

This study aimed to investigate the role of low-density lipoprotein cholesterol as a key parameter in improving pregnancy outcomes after assisted reproductive technology treatments in women with diabetes mellitus. To investigate the relationship between low-density lipoprotein cholesterol and pregnancy outcomes after assisted reproductive technology treatments in women with diabetes and infertility. 474 female patients diagnosed with diabetes were included in this study. The patients were divided into the high LDL-C group (&#x2265;3 mmol/L) and the low LDL-C group (<3 mmol/L). According to the protocol of ovarian stimulation, the clinical characteristics in ART cycles and pregnancy outcomes were compared separately. The data were analyzed after propensity score matching. In the GnRH antagonist protocol group, there were no significant differences in baseline characteristics between the high- and low-LDL-C groups. Nevertheless, ART treatment characteristics and pregnancy outcomes did not differ significantly between the 2 groups (P>.05). However, the rate of early miscarriage in GnRH antagonist protocol-FET cycles had a significantly positive association with LDL-C level (P=.0004).In the long-acting GnRH agonist protocol group, there were no significant differences in baseline characteristics between the high- and low-LDL-C groups; however, total cholesterol, triglycerides, and AST/ALT levels were significantly higher in the high-LDL-C group (P<.05). Although the clinical pregnancy rate of fresh embryo cycles in the high-LDL-C group was considerably higher than that of the low-LDL-C group (P=.001), there was a statistical difference in the early miscarriage rate between the 2 groups. (P<.05). This study demonstrates that in infertile women with diabetes mellitus undergoing ART, elevated pretreatment LDL-C is a significant and modifiable marker associated with an increased risk of early miscarriage and a reduced live birth rate. The impact of LDL-C varies by ovarian stimulation protocol. These findings underscore the importance of integrating preconception lipid management into the clinical pathway and adopting a protocol-specific risk assessment to optimize pregnancy outcomes.

Social vulnerability during pregnancy correlates with an increased risk of negative maternal and neonatal outcomes. The World Health Organization (WHO) and the International Confederation of Midwives (ICM) endorse the implementation of continuous care strategies to enhance outcomes. This project aims to implement and evaluate the effectiveness of a continuous midwifery care model during pregnancy and delivery, as well as its impact on various maternal and neonatal outcomes for socially disadvantaged women in Iran. This research will utilize a convergent parallel mixed-methods framework. The study will be executed in two simultaneous phases: a quantitative randomized controlled trial and a qualitative descriptive analysis. In the quantitative phase, 92 socially disadvantaged pregnant women facing poverty or domestic violence or unplanned pregnancies will be recruited from health centers in Bonab, Iran, and randomly allocated to either an intervention group (n&#x2009;=&#x2009;46) or a control group (n&#x2009;=&#x2009;46). The intervention group will receive continuous midwifery care from 14 weeks of gestation until 6 weeks postpartum, whereas the control group will receive standard care. The primary outcomes encompass the experiences related to pregnancy and childbirth, as well as evaluations of maternal depression. Secondary outcomes encompass the mode of delivery, maternal and neonatal complications, and satisfaction with care. The qualitative phase will employ conventional content analysis of comprehensive, semi-structured interviews with women in the intervention group to investigate their perceptions and experiences regarding the care model. The outcomes from both phases will be amalgamated to yield a holistic comprehension of the model's influence. This study is the inaugural investigation in Iran assessing a continuous midwifery care model designed for socially disadvantaged women, utilizing a mixed-methods approach. The findings are expected to yield substantial evidence to inform the formulation of national policies and clinical guidelines designed to mitigate health disparities and enhance maternal and child health outcomes in at-risk communities. Iranian Registry of Clinical Trials (IRCT) (IRCT20120718010324N84/ Date of registration 20250823). URL https://irct.behdasht.gov.ir/trial/74,206. Women encountering social challenges, including poverty, domestic violence, or unplanned pregnancies, experience an elevated risk of complications for themselves and their infants. These may encompass an increased probability of cesarean delivery, the occurrence of postpartum depression, and additional health complications. The standard maternity care provided to these women is frequently fragmented, resulting in interactions with multiple healthcare providers, which complicates the establishment of a trusting relationship. The continuous midwifery care model is a promising approach in which a woman receives support from the same midwife throughout her pregnancy, during birth, and in the early postpartum period. This approach emphasizes the establishment of a trusting, supportive, and empowering relationship. Nonetheless, research on the effectiveness of this model for socially vulnerable women, particularly in Iran, is limited. This study aims to implement and evaluate the continuous midwifery care model for socially vulnerable pregnant women in Iran, thereby addressing the identified research gap. This study will employ a dual approach: a clinical trial to evaluate health outcomes between women receiving the new model and those receiving standard care, alongside in-depth interviews to gain insights into the women&#x2019;s personal experiences. This research contributes to understanding how to support vulnerable women, improve self-care, and enhance the overall experience of pregnancy and childbirth.

Maternal and neonatal mortality and morbidity rates uncover major global health disparities. Despite ongoing efforts, the rates of maternal and neonatal complications remain substantially higher in low- and middle-income countries (LMICs) compared to high-income countries (HICs). These high rates are the result of several unmet needs in LMICs, including limited access to quality antenatal care, health worker shortages, unreliable infrastructure, sociocultural barriers, low health literacy, environmental and nutritional challenges, and affordability. In addition, while the greatest burden of these complications lies in LMICs, it is crucial to recognize that similar disparities exist in rural and remote areas of large, higher-income countries. FemTech (female technology), which refers to a wide range of digital tools and technologies designed specifically to support women's health, has the potential to address these unmet needs in LMICs. In many LMIC settings, mobile connectivity may represent the most scalable digital infrastructure available to women, often reaching communities long before formal health system expansion. However, the uptake of these in LMICs remains limited by infrastructure, regulatory, affordability, and sociocultural constraints. Introducing these digital solutions to LMICs without careful adaptations to these unique factors is more likely to widen rather than narrow inequities. Many international guidelines advocating the implementation of advanced technologies have not taken into account these unique LMIC-specific challenges. This gap underscores the need to develop strategies for the implementation of FemTech in LMIC settings. FIGO and its partners are well placed to coordinate the development of dedicated global guidance tailored to resource-limited settings. This document is a first step toward this goal.

Home delivery continues to be a significant factor contributing to maternal mortality in Africa, particularly among rural women with limited access to skilled birth attendants and healthcare facilities. Factors influencing home delivery operate at individual, household, and community levels. Therefore, this study aimed to examine the prevalence and risk factors of home delivery among rural women in 28 African countries. This retrospective cross-sectional study analyzed the most recent Demographic and Health Surveys (2011-2024) from 28 African countries. The weighted sample included 103,011 rural women of reproductive age. We performed descriptive analysis, chi-square tests, and binary logistic regression. Results are presented as frequencies, percentages, and odds ratios (ORs) with 95% confidence intervals (CIs). Statistical significance was set at p&#x2009;<&#x2009;0.05. The overall prevalence of home delivery among rural women in Africa was 34.01% [95% CI: 23.33%-35.26%], ranging from 5.91% in Rwanda to 85.19% in Chad. Women with mistimed pregnancy [aOR&#x2009;=&#x2009;0.79, 95% CI&#x2009;=&#x2009;0.76-0.82] and those with unwanted pregnancy [aOR&#x2009;=&#x2009;0.86, 95% CI&#x2009;=&#x2009;0.81-0.92] had lower odds of home delivery. Risk factors included having four or more births [aOR&#x2009;=&#x2009;2.04, 95% CI&#x2009;=&#x2009;1.91-2.17], no/other religion [aOR&#x2009;=&#x2009;2.41, 95% CI&#x2009;=&#x2009;2.24-2.56] and those in Central Africa [aOR&#x2009;=&#x2009;2.09, 95% CI&#x2009;=&#x2009;1.98-2.19]. This research reveals that home delivery remains prevalent among rural women in Africa, with significant between-country disparities. Key risk factors include high parity, no/other religion, and Central African residence. Programs should prioritize multiparous women and expand maternal health services across all religious groups. Additionally, context-specific policies and targeted investments are needed in Central Africa to address regional disparities.

Endocrine-disrupting chemicals (EDCs) are ubiquitous and highly persistent environmental contaminants. Human exposure occurs through multiple routes, including dietary ingestion, water consumption, inhalation, and dermal contact, posing sustained health risks characterized by chronic, low-dose, and cumulative mixture exposure. Through interference with endocrine signaling and related biological pathways, EDCs have been implicated in the development and progression of several health outcomes, particularly reproductive, metabolic, neurodevelopmental, and hormone-related disorders. Of particular concern is their involvement in oncogenesis; throughout tumor progression, EDCs facilitate immune dysregulation and metabolic reprogramming via complex interactions across multiple targets and signaling pathways. Elucidating these underlying regulatory mechanisms is imperative for developing robust preventive strategies. This review synthesizes evidence regarding bisphenols, per- and polyfluoroalkyl substances (PFAS), heavy metals, pesticides, phthalates, polychlorinated biphenyls (PCBs), and other emerging pollutants. We specifically highlight their mechanistic roles across three critical domains: carcinogenesis, immune modulation, and metabolic reprogramming. Given the long latency periods, significant inter-individual variability, and synergistic mixture effects associated with EDC exposure, current risk assessments and causal inferences remain constrained. Future research must integrate high-precision exposure science, prospective longitudinal cohorts, and multi-omic mechanistic validation, while incorporating critical developmental windows and mixture-exposure frameworks. Ultimately, such advancements will provide a more reliable evidence base for exposure prevention, regulatory decision-making, and risk stratification and intervention strategies for exposure-related malignancies.

CAR T-cell therapy has become a highly effective treatment for hematological malignancies, and emerging evidence indicates promising benefits for non-oncohematological conditions. As its clinical use broadens, understanding long-term outcomes and late complications is crucial. One critical yet understudied area is fertility, for which current evidence remains limited and no formal guidelines provide direction for patients undergoing CAR T-cell therapy. To address this gap, we conducted a cross-sectional survey on behalf of the Cellular Therapy and Immunobiology Working Party (CTIWP) of the European Society for Blood and Marrow Transplantation (EBMT) focusing on current practices, existing challenges, and reported reproductive outcomes. Questionnaires were distributed electronically (via SurveyMonkey) between Jan 8, 2025 and April 18, 2025 to 247 EBMT-affiliated centers assessing current fertility-related practices and procedures around CAR T-cell therapy. A second, complementary questionnaire was circulated between Dec 23, 2025 and April 9, 2026 to gather detailed information on reported pregnancies following CAR T treatment. 99 of 247 (40%) centers answered and were included in the analysis. At data censoring, 24 pregnancies were reported in 19 patients, resulting in 18 live births, 2 ongoing pregnancy (one with twins), and 4 miscarriages. Eighteen pregnancies occurred in female CAR T-cell recipients, and six were reported by male recipients through their partners. In patients achieving pregnancy, B cell lymphoma was the most common indication for treatment. Pregnancies in the female cohort occurred naturally in 83% of cases (15/18). Among patients with data, the median time between CAR T-cell infusion and delivery or miscarriage was 3 years (range 4 months-6 years). Although both low- and high-grade Cytokine Release Syndrome (CRS) and Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS) were reported among these patients, these events did not appear to influence pregnancy outcomes, acknowledging the small sample size. While most centers (52/63, 83%) reported offering fertility counselling before CAR T-cell infusion, 11 centers (17%) indicated that they do not routinely inform patients of the potential reproductive risks. Most centers (79%) offered fertility preservation procedures to male and female patients. The most common barriers to fertility preservation referral were the urgency of initiating bridging therapy to CAR T-cell infusions due to active or rapidly progressive disease in aggressive disease and extensive prior chemotherapy exposure, defined as more than three previous treatment lines. For female patients, the predominant approaches were oocyte cryopreservation (63%) and ovarian tissue cryopreservation (59%). Among male patients, semen collection and cryopreservation was the most frequently used method (93%). Endocrinologic follow-up practices after CAR T-cell therapy varied substantially across centers. We report the largest series of pregnancies and live births after CAR T in patients with hematological malignancies and autoimmune diseases, and the first within Europe. As CAR T-cell therapy is increasingly administered earlier in the treatment algorithms and to younger populations, integrating standardized fertility counselling and preservation strategies into routine care will be essential. The reproductive success highlights the urgent need for robust research and formalized guidelines in this evolving field. None.

Aging in mammals is a complex, multifaceted process involving the progressive decline of physiological functions, in which energy metabolism plays a pivotal role. &#x3b2;-oxidation-the primary pathway for converting fatty acids into energy-is tightly linked to aging and to female reproductive senescence. In the present study, we investigated how ovarian tissue remodels hepatic proteins central to the &#x3b2;-oxidation pathway. Liver proteomes were analyzed in CBA/J control mice at 4, 13, 23, and 27 months of age and compared with those of 23-month-old mice that received transplants of young ovarian tissue at 13 months. &#x3b2;-oxidation proteins were quantified using high-resolution mass spectrometry. Serum triglycerides were measured enzymatically, and metabolic cage analyses were performed to assess substrate utilization and energy balance. Ovarian tissue transplantation substantially modulates the expression of &#x3b2;-oxidation-related proteins and reduces systemic lipid accumulation in aged mice. These proteomic shifts are consistent with enhanced metabolic efficiency and decreased oxidative stress-mechanisms well-established as drivers of extended health span and longevity. Results apply to menopause dyslipidemia, insulin resistance, metabolic syndrome, NAFLD, and aging. Transplants reduce &#x3b2;-oxidation proteins and triglycerides, improving hepatic lipid clearance and steatosis risk. Identifying ovarian signals enables non-surgical mimics via peptides or modulators. Changes align with PPAR&#x3b1; agonists, CPT1 modulators, mitochondria-targeted antioxidants (MitoQ), and NAD+/sirtuin pathways-offering testable routes to replicate ovarian benefits. Ovarian-derived signals induce metabolic reprogramming in aged mice, characterized by reduced &#x3b2;-oxidation protein expression, decreased triglyceride accumulation, and improved metabolic efficiency. These findings provide a molecular framework for understanding how ovarian-derived factors may govern metabolism and organismal health during aging, with potential implications for interventions targeting age-related metabolic decline.

Polycystic Ovary Syndrome (PCOS), a prevalent metabolic and reproductive disorder, significantly impacts women of reproductive age. The conventional approach offers various symptomatic pharmacological interventions for PCOS, but some of them have adverse effects too. In this context, yoga has emerged as a promising non-pharmacological complementary approach. This systematic review aims to explore the therapeutic potential of yoga for managing PCOS with a focus on anthropometric, metabolic, endocrine, and psychological outcomes. A systematic search was conducted across three databases i.e., PubMed, Web of Science and Scopus on 17.1.2025. Screening of articles was performed by two authors in two step process. Risk of Bias (RoB) of each study was assessed using Cochrane Risk of Bias version 2.0 (RoB 2). Due to high heterogeneity among studies in terms of type of intervention, duration, outcomes measured etc., meta-analysis could not be performed. Of the 303 studies initially identified, 9 randomized controlled trials (RCTs) met the inclusion criteria for the systematic review. However, four of these were conducted by the same research group and were considered as a single study in the analysis. Yoga interventions, such as asanas (physical postures) and pranayama (breathing exercises), demonstrated improvement in PCOS symptoms including anthropometric (weight, BMI, hip circumference), metabolic (insulin resistance, serum insulin, fasting blood glucose and lipid profile), endocrine (hirsutism, free testosterone, Anti-mullerian hormone, Luteinizing hormone, Dehydroepiandrosterone etc.), menstrual and psychological outcomes. Meditation and mindfulness-based interventions may help to improve mainly psychological symptoms such as body image, stress, anxiety, depression and quality of life etc. However, it is important to note that there were very few number of studies, that too with lots of heterogeneity, low sample size, diverse outcomes; therefore generalizability of this evidence are limited. Yoga is a promising non-pharmacological complementary intervention for PCOS management that may offer diverse benefits for anthropometric, endocrine, metabolic and psychological health. However, further clinical trials with robust protocol, large sample size and standardized yoga protocol are essential to establish its long-term efficacy and integration into routine PCOS care. https://www.crd.york.ac.uk/PROSPERO/view/CRD420261286708, identifier CRD420261286708.