Reproductive Health of Women Veterans: A Systematic Review of the Literature from 2008 to 2017

AbstractThe literature on the reproductive health and healthcare of women Veterans has increased dramatically, though there are important gaps. This article aims to synthesize recent literature on reproductive health and healthcare of women Veterans. We updated a literature search to identify manuscripts published between 2008 and July 1, 2017. We excluded studies that were not original research, only included active-duty women, or had few women Veterans in their sample. Manuscripts were reviewed using a standardized abstraction form. We identified 52 manuscripts. Nearly half (48%) of the new manuscripts addressed contraception and preconception care (n = 15) or pregnancy (n = 10). The pregnancy and family planning literature showed that (1) contraceptive use and unintended pregnancy among women Veterans using VA healthcare is similar to that of the general population; (2) demand for VA maternity care is increasing; and (3) women Veterans using VA maternity care are a high-risk population for adverse pregnancy outcomes. A recurrent finding across topics was that history of lifetime sexual assault and mental health conditions were highly prevalent among women Veterans and associated with a wide variety of adverse reproductive health outcomes across the life course. The literature on women Veterans' reproductive health is rapidly expanding, but remains largely observational. Knowledge gaps persist in the areas of sexually transmitted infections, infertility, and menopause.

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Sexually Transmitted Infections and Behavioral Determinants of Sexual and Reproductive Health in the Allahabad District (India) Based on Data from the ChlamIndia Study

Microorganisms ◽

10.3390/microorganisms7110557 ◽

2019 ◽

Vol 7 (11) ◽

pp. 557 ◽

Cited By ~ 1

Author(s):

Pierre P. M. Thomas ◽

Jay Yadav ◽

Rajiv Kant ◽

Elena Ambrosino ◽

Smita Srivastava ◽

...

Keyword(s):

Reproductive Health ◽

Sexually Transmitted Infections ◽

Sexual And Reproductive Health ◽

Uttar Pradesh ◽

Positive Association ◽

Vaginal Swab ◽

P Value ◽

Behavioral Determinants ◽

Sexually Transmitted ◽

Adverse Pregnancy

Background: Sexually transmitted infections (STIs), like Chlamydia trachomatis and Neisseria gonorrhoeae (CT and NG, respectively) are linked to an important sexual and reproductive health (SRH) burden worldwide. Behavior is an important predictor for SRH, as it dictates the risk for STIs. Assessing the behavior of a population helps to assess its risk profile. Methods: Study participants were recruited at a gynecology outpatient department (OPD) in the Allahabad district in Uttar Pradesh India, and a questionnaire was used to assess demographics, SRH, and obstetric history. Patients provided three samples (urine, vaginal swab, and whole blood). These samples were used to identify CT and NG using PCR/NAAT and CT IgG ELISA. Results: A total of 296 women were included for testing; mean age was 29 years. No positive cases of CT and NG were observed using PCR/NAAT. A 7% (22/296) positivity rate for CT was observed using IgG ELISA. No positive association was found between serology and symptoms (vaginal discharge, abdominal pain, dysuria, and dyspareunia) or adverse pregnancy outcomes (miscarriage and stillbirth). Positive relations with CT could be observed with consumption of alcohol, illiteracy, and tenesmus (p-value 0.02–0.03). Discussion: STI prevalence in this study was low, but a high burden of SRH morbidity was observed, with a high symptomatic load. High rates of miscarriage (31%) and stillbirth (8%) were also observed among study subjects. No associations could be found between these ailments and CT infection. These rates are high even for low- and middle-income country standards. Conclusion: This study puts forward high rates of SRH morbidity, and instances of adverse reproductive health outcomes are highlighted in this study, although no associations with CT infection could be found. This warrants more investigation into the causes leading to these complaints in the Indian scenario and potential biases to NAAT testing, such as consumption of over-the-counter antimicrobials.

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Modern Contraceptive and Dual Method Use among HIV-Infected Women in Lusaka, Zambia

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/2011/261453 ◽

2011 ◽

Vol 2011 ◽

pp. 1-8 ◽

Cited By ~ 25

Author(s):

Carla J. Chibwesha ◽

Michelle S. Li ◽

Christine K. Matoba ◽

Reuben K. Mbewe ◽

Benjamin H. Chi ◽

...

Keyword(s):

Reproductive Health ◽

Contraceptive Use ◽

Sub Saharan Africa ◽

Dual Method ◽

Modern Contraceptive ◽

Reproductive Health Services ◽

Sexually Transmitted ◽

Counseling Intervention ◽

Substantial Risk ◽

Sub Saharan

HIV-infected women in sub-Saharan Africa are at substantial risk of unintended pregnancy and sexually transmitted infections (STIs). Linkages between HIV and reproductive health services are advocated. We describe implementation of a reproductive health counseling intervention in 16 HIV clinics in Lusaka, Zambia. Between November 2009 and November 2010, 18,407 women on antiretroviral treatment (ART) were counseled. The median age was 34.6 years (interquartile range (IQR): 29.9–39.7), and 60.1% of women were married. The median CD4+cell count was 394 cells/uL (IQR: 256–558). Of the women counseled, 10,904 (59.2%) reported current modern contraceptive use. Among contraceptive users, only 17.7% reported dual method use. After counseling, 737 of 7,503 women not previously using modern contraception desired family planning referrals, and 61.6% of these women successfully accessed services within 90 days. Unmet contraceptive need remains high among HIV-infected women. Additional efforts are needed to promote reproductive health, particularly dual method use.

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History of unintended pregnancy and patterns of contraceptive use among racial and ethnic minority women veterans

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2020.02.042 ◽

2020 ◽

Vol 223 (4) ◽

pp. 564.e1-564.e13

Author(s):

Deirdre A. Quinn ◽

Florentina E. Sileanu ◽

Xinhua Zhao ◽

Maria K. Mor ◽

Colleen Judge-Golden ◽

...

Keyword(s):

Ethnic Minority ◽

Unintended Pregnancy ◽

Contraceptive Use ◽

Women Veterans ◽

Minority Women ◽

Ethnic Minority Women ◽

History Of ◽

Racial And Ethnic Minority

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Influence of Sexually Transmitted Infections in Pregnant Adolescents on Preterm Birth and Chorioamnionitis

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/2020/1908392 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Esther Fuchs ◽

Maggie Dwiggins ◽

Erica Lokken ◽

Jennifer A. Unger ◽

Linda O. Eckert

Keyword(s):

Preterm Birth ◽

Sexually Transmitted Infections ◽

Trichomonas Vaginalis ◽

High Rate ◽

High Risk Population ◽

Urban Hospital ◽

Pregnant Adolescents ◽

Sexually Transmitted ◽

Increased Risk ◽

Adverse Pregnancy

Background. Adolescents have an increased risk of preterm birth (PTB) and sexually transmitted infections (STIs). We examined the prevalence and impact of STIs (gonorrhea, chlamydia, and trichomonas) on PTB and chorioamnionitis in pregnant adolescents. Methods. This retrospective cohort study utilized the first pregnancy delivered at an urban hospital among patients≤19 years old over a 5-year period. Poisson regression with robust standard errors was used to estimate prevalence ratios (PR) and 95% confidence intervals (CI) of the association between STIs and PTB (<37 weeks) and chorioamnionitis identified by clinical or placental pathology criteria. Results. 739 deliveries were included. 18.8% (n=139) of births were preterm. The overall prevalence of STIs during pregnancy was 16.5% (Chlamydia trachomatis: 13.1%, n=97; Trichomonas vaginalis: 3.7%, n=27; and Neisseria gonorrheae: 3.1%, n=23). Detection of C. trachomatis, T. vaginalis, or N. gonorrheae was not associated with increased PTB. While infection with N. gonorrheae and C. trachomatis did not increase the likelihood of any chorioamnionitis, infection with T. vaginalis significantly increased the likelihood of any chorioamnionitis diagnosis (aPR 2.19, 95% CI 1.26-3.83). Conclusion. In this adolescent population with a high rate of PTB, in whom most received appropriate STI treatment, we did not find an association between STI during pregnancy and an increased rate of PTB. However, an infection with T. vaginalis was associated with an increased likelihood of chorioamnionitis. Early detection of STIs may prevent adverse pregnancy outcomes. Continued vigilance in STI screening during pregnancy, including consideration of universal Trichomonas vaginalis screening, is merited in this high-risk population.

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Impact of Deployment on Reproductive Health in U.S. Active-Duty Servicewomen and Veterans

Seminars in Reproductive Medicine ◽

10.1055/s-0039-1678749 ◽

2018 ◽

Vol 36 (06) ◽

pp. 361-370

Author(s):

Lori Gawron ◽

April Mohanty ◽

Jennifer Kaiser ◽

Adi Gundlapalli

Keyword(s):

Reproductive Health ◽

Women Veterans ◽

The United States ◽

Active Duty ◽

Reproductive Age ◽

Sexually Transmitted ◽

Unintended Pregnancies ◽

Healthcare Needs ◽

Reproductive Services ◽

Broad Array

AbstractReproductive-age women are a fast-growing component of active-duty military personnel who experience deployment and combat more frequently than previous service-era women Veterans. With the expansion of the number of women and their roles, the United States Departments of Defense and Veterans Affairs have prioritized development and integration of reproductive services into their health systems. Thus, understanding associations between deployments or combat exposures and short- or long-term adverse reproductive health outcomes is imperative for policy and programmatic development. Servicewomen and women Veterans may access reproductive services across civilian and military or Veteran systems and providers, increasing the need for awareness and communication regarding deployment experiences with a broad array of providers. An example is the high prevalence of military sexual trauma reported by women Veterans and the associated mental health diagnoses that may lead to a lifetime of high risk-coping behaviors that increase reproductive health risks, such as sexually transmitted infections, unintended pregnancies, and others. Care coordination models that integrate reproductive healthcare needs, especially during vulnerable times such as at the time of military separation and in the immediate postdeployment phase, may identify risk factors for early intervention with the potential to mitigate lifelong risks.

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Best Practices in Counseling Young Female Cancer Survivors on Reproductive Health

Seminars in Reproductive Medicine ◽

10.1055/s-0037-1603770 ◽

2017 ◽

Vol 35 (04) ◽

pp. 378-389 ◽

Cited By ~ 7

Author(s):

Ksenya Shliakhtsitsava ◽

Deepika Suresh ◽

Tracy Hadnott ◽

H. Su

Keyword(s):

Reproductive Health ◽

Cancer Survivors ◽

Health Care Providers ◽

Chromosomal Abnormalities ◽

The United States ◽

Reproductive Age ◽

Care Providers ◽

History Of ◽

Adverse Pregnancy ◽

History Of Cancer

AbstractIn the United States, there are more than 400,000 girls and young women of reproductive-age with a history of cancer. Cancer treatments including surgery, chemotherapy, targeted therapy, and radiation can adversely impact their reproductive health. This review discusses infertility, contraception, and adverse pregnancy and child health outcomes in reproductive-aged cancer survivors, to increase awareness of these health risks for survivors and their health care providers. Infertility rates are modestly higher, while rates of using contraception and using highly effective contraceptive methods are lower in cancer survivors than in women without a history of cancer. During pregnancy, preterm births are also more common in survivors, resulting in more low-birth-weight offspring. Children of cancer survivors do not have more childhood cancers, birth defects, or chromosomal abnormalities than the general population, with the exception of families with hereditary cancer. Reproductive risks in survivors depend on cancer treatment exposures. For example, women with prior abdominal or pelvic radiation have additional risks of spontaneous abortions, small-for-gestational-age offspring and stillbirths, while those with prior chest radiation or anthracycline exposures have higher risks of cardiomyopathy. To help survivors achieve their reproductive goals safely, family planning and preconception counseling are central to survivorship care.

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Chiamydia trachomatis Infection in Sexually Active Adolescents: Prevalence and Risk Factors

PEDIATRICS ◽

10.1542/peds.73.6.836 ◽

1984 ◽

Vol 73 (6) ◽

pp. 836-840

Author(s):

Mariam R. Chacko ◽

Judith C. Lovchik

Keyword(s):

Sexually Transmitted Disease ◽

Chlamydial Infection ◽

Contraceptive Use ◽

Past History ◽

Transmitted Disease ◽

Female Adolescents ◽

Sexually Active ◽

Sexually Transmitted ◽

Oral Contraceptive Use ◽

History Of

The prevalence of Chlamydia trachomatisgenital infection was studied in a sexually active urban Baltimore adolescent population. Possible risk factors such as age, past history of sexually transmitted disease, number of sexual partners, contact with sexually transmitted disease, oral contraceptive use, and concomitant gonococcal infection were also evaluated. The prevalence of chlamydial infection in the 280 adolescents studied was 26%: 35% in male adolescents, 27% in pregnant female adolescents, and 23% in nonpregnant female adolescents. Chiamydia was almost three times as prevalent as gonorrhea in the same population. Age, past history of sexually transmitted disease, oral contraceptive use, and concomitant gonorrhea were not significantly associated with chlamydial infection. However, multiple current sexual partners, contact with sexually transmitted disease, genitourinary symptoms, and cervical ectopy were significantly associated with chlamydial infection. Testing for chlamydial infection in sexually active urban teenagers is recommended for those with genitourinary symptoms, those with cervical ectopy, or those who are contacts of persons with sexually transmitted disease. Considering the reservoir of infection in the asymptomatic female adolescents, screening for chlamydial infections in family planning clinics warrants consideration.

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Optimalisasi Pendidikan Kesehatan Kepada Remaja Melalui Aplikasi Android Profoteen

Jurnal Kepemimpinan dan Manajemen Keperawatan ◽

10.32584/jkmk.v2i2.380 ◽

2019 ◽

Vol 2 (2) ◽

pp. 74

Author(s):

Sudiarto Sudiarto ◽

Fayruz Zahrotin Niswah ◽

Rizka Eka Putri Pranoto ◽

Iffah Hanifah ◽

Aprilia Aldila Enggardini ◽

...

Keyword(s):

Reproductive Health ◽

Mobile Application ◽

Positive Impact ◽

Human Life ◽

Research Articles ◽

Original Research ◽

Literature Study ◽

Sexually Transmitted ◽

Technological Advances ◽

Publication Period

The adolescent is at risk of having unhealthy behaviors such as premarital sex, which will result in the occurrence of pregnancies, abortions, and sexually transmitted diseases (STDs). One of these technological advances is information technology (IT) which has applied in various aspects of human life. Technology information is important for the millennial generation, one of which is inseparable from the use of smartphones. The objectives of this review are identifying and develop an android-based educational application so that teenagers can use the technologies to knowledge especially about the reproductive health of girls in an attractive manner with existing features. The literature review refers to 5 articles obtained from e Pubmed, Undip E-journal, and Google Scholar databases over the past 5 years. Keywords in article search are mobile application, education, reproductive health, adolescent knowledge, health, and smartphone applications. Data analysis techniques that have been done are compare, contrast, criticize, syntesize and summarize. Inclusion criteria for articles are scientific articles with the last 5 years publication period, reliable and accredited articles, types of original research articles, and case studies. The exclusion criteria are undergraduate student research articles. From the literature study shows that those applications are much helpful in reducing problems that often occur in adolescents, for example: The Girl Talk application significantly increases the knowledge of adolescent girls (35.3% vs. 94.1%; p <0.001) respectively. Each application has a positive impact on improving adolescent health.

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The Effect of Changing Policies to Increase the Birth Rate on Reproductive Health Rate over a Twelve-Year Period in Islamshahr

International Journal of Multicultural and Multireligious Understanding ◽

10.18415/ijmmu.v7i6.1750 ◽

2020 ◽

Vol 7 (6) ◽

pp. 197

Author(s):

Morteza Gharibi ◽

Simin Najafgholian ◽

Fatemeh Rafiee ◽

Seyed Arash Yazdanbakhsh ◽

Mojtaba Ahmadlou

Keyword(s):

Reproductive Health ◽

Birth Rate ◽

Contraceptive Use ◽

Population Control ◽

Public Awareness ◽

National Policy ◽

Reproductive Age ◽

Early Marriage ◽

Sexually Transmitted ◽

Control Programs

Introduction: In recent years, population growth, birth rate promotion and reproductive health policies have been the main approach of population control programs. In this study, the researcher was going to investigate and got a close look to this important issue in the city of Islamshahr. The comparative study of prophylactic methods and their prevalence was conducted among fertile women in 2004 and 2016 to examine how their approach change following the changes in national policy has affected on reproductive health.Materials and Methods: Two thousand reproductive-age women who reside in Islamshahr voluntarily and confidential participated using a questionnaire. All data were analyzed using SPSS software.Results: The findings indicated that despite the decrease in contraceptive use in 2016 compared to 2004 (from 90.8% to 42%), the level of public awareness has been increased about their benefits and reproductive health So that we observed an increased awareness of sexually transmitted diseases and ways to fight them (from 27% to 56%). A decline in illegal abortion rate (from 60% to 22%) and an increase in the knowledge of appropriate lactation methods (from 25.8% to 40%) observed during the study period. Natural methods had the highest prevalence among contraceptive methods at both times of the survey. The knowledge of women about the proper methods for early marriage (from 25.3 to 11%) and emergencies showed a decrease (from 12.2% to 5.6%).

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A Systematic Review of Point of Care Testing forChlamydia trachomatis,Neisseria gonorrhoeae, andTrichomonas vaginalis

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/2016/4386127 ◽

2016 ◽

Vol 2016 ◽

pp. 1-17 ◽

Cited By ~ 49

Author(s):

Sasha Herbst de Cortina ◽

Claire C. Bristow ◽

Dvora Joseph Davey ◽

Jeffrey D. Klausner

Keyword(s):

Systematic Review ◽

Neisseria Gonorrhoeae ◽

Test Performance ◽

Trichomonas Vaginalis ◽

Point Of Care ◽

Cost Effective ◽

Future Research ◽

Original Research ◽

Sexually Transmitted ◽

Adverse Pregnancy

Objectives. Systematic review of point of care (POC) diagnostic tests for sexually transmitted infections:Chlamydia trachomatis(CT),Neisseria gonorrhoeae(NG), andTrichomonas vaginalis(TV).Methods. Literature search on PubMed for articles from January 2010 to August 2015, including original research in English on POC diagnostics for sexually transmitted CT, NG, and/or TV.Results. We identified 33 publications with original research on POC diagnostics for CT, NG, and/or TV. Thirteen articles evaluated test performance, yielding at least one test for each infection with sensitivity and specificity ≥90%. Each infection also had currently available tests with sensitivities <60%. Three articles analyzed cost effectiveness, and five publications discussed acceptability and feasibility. POC testing was acceptable to both providers and patients and was also demonstrated to be cost effective. Fourteen proof of concept articles introduced new tests.Conclusions. Highly sensitive and specific POC tests are available for CT, NG, and TV, but improvement is possible. Future research should focus on acceptability, feasibility, and cost of POC testing. While pregnant women specifically have not been studied, the results available in nonpregnant populations are encouraging for the ability to test and treat women in antenatal care to prevent adverse pregnancy and neonatal outcomes.

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