среда, 19 июня 2013 г.

Recommendations for Contraceptive Use

CDC с целью уморить раисю и подложить свинушку мими выпустил новые контрацептивные рекомендации, на этот год (так што полгода жыли по 100 ринке), для учота: пдфнег 1.4 мб

U.S. Selected Practice Recommendations for Contraceptive Use, 2013

Adapted from 
the World Health Organization Selected Practice Recommendations for Contraceptive Use, 2nd Edition
Prepared by
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion

понедельник, 17 июня 2013 г.

Domestic Violence and Perinatal Mental Disorders

These findings suggest that women with high levels of symptoms of perinatal mental health disorders—antenatal and postnatal anxiety, depression, and post-traumatic stress disorder—have a high prevalence and increased odds of having experienced domestic violence both over their lifetime and during pregnancy. However, these findings cannot prove causality, they fail to show a two-way association (that is, perinatal mental health disorders leading to subsequent domestic violence), and no information on other perinatal mental disorders, such as eating disorders and puerperal psychosis, was available. The variation of the quality of the included studies also limits the results, highlighting the need for high-quality data to suggest how maternity and mental health services could address domestic violence and improve health outcomes for women and their infants in the future. Nevertheless, this study emphasizes the importance of identifying and responding to possible domestic violence among women attending antenatal and mental health services.

Howard LM, Oram S, Galley H, Trevillion K, Feder G (2013) 

Domestic Violence and Perinatal Mental Disorders: A Systematic Review and Meta-Analysis

PLoS Med 10(5): e1001452. doi:10.1371/journal.pmed.1001452

Effects of Abortion Legalization

The authors conducted retrospective medical chart review of all gynecological cases presenting at four large public referral hospitals in Nepal. For the years 2001–2010, all cases of spontaneous and induced abortion complications were identified, abstracted, and coded to classify cases of serious infection, injury, and systemic complications. We used segmented Poisson and ordinary logistic regression to test for trend and risks of serious complications for three time periods: before implementation (2001–2003), early implementation (2004–2006), and later implementation (2007–2010).

23,493 cases of abortion complications were identified. A significant downward trend in the proportion of serious infection, injury, and systemic complications was observed for the later implementation period, along with a decline in the risk of serious complications (OR 0.7, 95% CI 0.64, 0.85). Reductions in sepsis occurred sooner, during early implementation (OR 0.6, 95% CI 0.47, 0.75).

Over the study period, health care use and the population of reproductive aged women increased. Total fertility also declined by nearly half, despite relatively low contraceptive prevalence. Greater numbers of women likely obtained abortions and sought hospital care for complications following legalization, yet we observed a significant decline in the rate of serious abortion morbidity. The liberalization of abortion policy in Nepal has benefited women’s health, and likely contributes to falling maternal mortality in the country. The steepest decline was observed after expansion of the safe abortion program to include midlevel providers, second trimester training, and medication abortion, highlighting the importance of concerted efforts to improve access. Other countries contemplating changes to abortion policy can draw on the evidence and implementation strategies observed in Nepal.

Henderson JT, Puri M, Blum M, Harper CC, Rana A, et al. (2013)

Effects of Abortion Legalization in Nepal, 2001–2010. 

PLoS ONE 8(5): e64775. doi:10.1371/journal.pone.0064775