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*Editors' Note: As of January 2017, the Monthly Women's Health Research Review has been discontinued. Below are archived articles for your reference.

Labor Interventions Associated With Lower Chance of Late Preterm Birth, Study Finds

March 28, 2014

To test speculation that obstetrical interventions, such as cesarean sections and induced labor, are driving the increase in late preterm (LP) births, researchers studied a cohort of nearly one million women who gave birth in Ontario hospitals. They found that interventions were associated with a lower likelihood of preterm birth relative to term birth when risk factors were the same, suggesting "that obstetrical care providers may be preferentially avoiding interventions to bring about LP birth in the setting of equivalent maternal and obstetrical risk." The study also identified "potentially modifiable risk factors," such as maternal smoking, that were independently associated with LP birth.

Ob-Gyn Groups Issue Recommendations on Screening for Age-Related Fertility Decline

March 28, 2014

In a committee opinion, the American College of Obstetricians and Gynecologists and the American Society for Reproductive Medicine offer recommendations for education, screening and treatment related to age-related fertility decline. Specifically, women older than age 35 should be evaluated and treated if they have failed to conceive after six months, while "immediate evaluation and treatment are warranted" in women over age 40, the opinion says. It also urges practitioners to educate patients about age-related fertility decline.

Most Abortion Clients Support Over-the-Counter Access to Oral Contraceptives

March 28, 2014

While research suggests many U.S. women are interested in over-the-counter access to oral contraceptives, no studies have examined such interest among abortion patients, a group that is at high risk of unintended pregnancies. In this study, Kate Grindlay of Ibis Reproductive Health and colleagues surveyed abortion clients' interest in OTC access, finding that the vast majority supported it. Interest in OTC access and likelihood of using it was especially highest among uninsured women and those older than age 19. The researchers suggested that OTC access to birth control pills could help reduce unintended pregnancies among women seeking abortions.

Addressing Neonatal Mortality Also Requires Focus on Adolescent Pregnancy, Editorial States

March 28, 2014

Citing a report from Save the Children that outlines eight interventions to end preventable neonatal deaths worldwide, an editorial in The Lancet argues that a ninth area "deserves more attention": adolescent pregnancy. The editorial argues that investing in girls -- including through education and prevention of child marriage -- will produce "not only an acceleration of progress towards ending maternal, neonatal, and child mortality, but also a better educated future generation of women who will contribute to the skilled workforce and so the economic development of their countries."

Review Examines Effects of Natural, Synthetic Oxytocin on Transition to Motherhood

February 27, 2014

Synthetic oxytocin is widely used during childbirth, but much is unknown about how it affects the endogenous oxytocin system and molecular pathways that influence maternal mood, stress reactivity and mothering behaviors, according to a research review. Because of this lack of clarity, physicians and midwives should take caution when deciding whether to administer the drug, the authors suggest, adding that more study is needed to better understand the long-term effects of administering the drug during labor.

Research Review Explores Link Between Intimate Partner Violence, Abortion

February 27, 2014

Researchers from the Women's Health Academic Centre at King's College conducted a meta-analysis of 74 past studies to assess the relationship between intimate partner violence (IPV) and termination of pregnancy (TOP). The researchers found a correlation between IPV and TOP and repeat TOP, as well as an association between a partner not knowing about a TOP and IPV. They called for strategies to test interventions to address IPV in settings that provider abortion services.

Commentary Examines Evidence on HPV-Based Screening for Cervical Cancer

February 27, 2014

In a commentary, experts from McGill University review the findings of a large study that pooled data comparing conventional cytology-based cervical cancer screening with human papillomavirus DNA testing. "HPV-based screening resulted in a 60-70% reduction in invasive cervical cancer incidence, compared with cytology-based screening," they note. Although HPV testing is likely the "future of cervical cancer screening in high-resource settings," countries "need to consider important logistical challenges," such as deciding which HPV test to use and how often women should be screened.

Editorial Urges Clinicians To Promote Long-Acting Reversible Contraception

February 27, 2014

Long-acting reversible contraception "may not be a magic bullet, but it is as close to one as currently exists" in the nation's efforts to reduce unintended pregnancies, according to an editorial by Frances Likis, editor-in-chief of the Journal of Midwifery & Women's Health. Likis reviews available LARC methods and offers three steps clinicians can take to ensure their patients are well informed about them.

Cancer Survivors Have Triple the Risk of Unintended Pregnancy, Study Finds

February 27, 2014

In an analysis of contraceptive use and unintended pregnancy risk among cancer survivors of reproductive age, researchers found that these women's risk of unintended pregnancy is three times that of women in the general population. There was no difference in unintended pregnancy risk among cancer survivors who had received pre-treatment counseling about fertility and those who had not, suggesting that such counseling is not effective at influencing women's post-treatment contraceptive use. "Practitioners caring for survivors should counsel about contraception post-treatment in order to decrease this unacceptably high risk of unintended pregnancy," the study said.

Pregnancy Should Not Override Women's End-of-Life Wishes, Commentary Argues

February 27, 2014

In a commentary, Harvard Medical School's Jeffery Ecker explores the "wrongful usurpation" of women's rights in the case of Marlise Muñoz, a Texas woman who was kept on a ventilator and related support to sustain her body's functions against her wishes because she was pregnant. Women's right to determine their end-of-life care should be "unaffected by whether or not they may be pregnant," he argues. He urges physicians to conscientiously object if faced with a situation in which they are asked to violate patients' end-of-life wishes.

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