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| 2. |
- Agosti, Madelaine Törnquist, et al.
(författare)
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"the importance of awareness, support and inner strength to balance everyday life" - A qualitative study about women's experiences of a workplace health promotion program in human service organizations in Sweden
- 2019
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Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: In many European countries, women have a higher sickness absence rate than men. Women also report higher levels of work-life conflict, which has a negative impact on women's self-perceived health. Interventions studies on work-life balance literature are scarce. This research adds knowledge about work-life balance by examining female employees' experiences of a newly developed intervention program, the BELE program (Balance in Everyday Life Empowerment program), aiming to enhance the work-life balance and wellbeing of female employees. Methods: All participants in the BELE program were included in the sample (n = 55) of the study. The methods used for gathering data were focus group interviews (n = 8) and semi-structured individual interviews (n = 8). A qualitative content analysis was used for the analyses. Results: The results showed that a majority of the participants experienced a process of change for enhancement of wellbeing and balance in their everyday life when taking part in the BELE program. In the analyses, three main themes emerged. Reflecting and strengthening inner resource, Trying to change everyday patterns and habits and Experiencing more balance and well-being. Conclusions: The results point out the importance of awareness and reflection on everyday life to promote work-life balance and wellbeing. The BELE program was described as a wakeup call to one's own life and as an enhancer of empowerment processes and equality in the homes. Moreover, the results showed the need for health education in the workplace focusing on both work and private life to enhance balance and wellbeing among female employees'. The findings indicate that it is important to work at individual and group levels in work-life balance interventions and not merely at the organizational level or in the workplace setting.
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| 3. |
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| 5. |
- Benebo, Faith Owunari, et al.
(författare)
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Intimate partner violence against women in Nigeria : a multilevel study investigating the effect of women's status and community norms
- 2018
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Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Intimate partner violence (IPV) against women has been recognised as a public health problem with far-reaching consequences for the physical, reproductive, and mental health of women. The ecological framework portrays intimate partner violence as a multifaceted phenomenon, demonstrating the interplay of factors at different levels: individual, community, and the larger society. The present study examined the effect of individual- and community-level factors on IPV in Nigeria, with a focus on women's status and community-level norms among men.METHODS: A cross-sectional study based on the latest Nigerian Demographic Health Survey (2013) was conducted involving 20,802 ever-partnered women aged 15-49 years. Several multilevel logistic regression models were calibrated to assess the association of individual- and community-level factors with IPV. Both measures of association (fixed effect) and measures of variations (random effect) were reported.RESULTS: Almost one in four women in Nigeria reported having ever experienced intimate partner violence. Having adjusted for other relevant covariates, higher women's status reduced the odds of IPV (OR = 0.47; 95% CI = 0.32-0.71). However, community norms among men that justified IPV against women modified the observed protective effect of higher women's status against IPV and reversed the odds (OR = 1.89; 95% CI = 1.26-2.83).CONCLUSIONS: Besides women's status, community norms towards IPV are an important factor for the occurrence of IPV. Thus, addressing intimate partner violence against women calls for community-wide approaches aimed at changing norms among men alongside improving women's status.
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| 6. |
- Carlsson, Isabelle, et al.
(författare)
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Complications related to induced abortion: a combined retrospective and longitudinal follow-up study
- 2018
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Ingår i: BMC Women's Health. - : BMC. - 1472-6874. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Induced abortion is one of the most common gynecological procedures in Sweden, but there is still little knowledge about the adverse effects. The aims of this study are to provide an overview of complications of medical and surgical abortions and to evaluate the impact of bacterial screening to prevent postabortal infections. Methods: All women who underwent induced abortion at Skaraborg Hospital between 2008 and 2015 are included in the study. Bacterial screening for chlamydia, gonorrhea, mycoplasma, and bacterial vaginosis was performed prior to the abortions. Abortion complications, categorized as bleeding, infection, or incomplete abortion were assessed in women who came in contact with the gynecological clinic within 30 days after the procedure. Results: A total of 4945 induced abortions were performed during the study period. Nearly all, 4945 (99.7%) were eligible for inclusion in the study. Medical abortions amp;lt; 12 weeks were the most common procedure (74.7%), followed by surgical abortions (17.5%), and medical abortion amp;gt; 12 weeks (7.8%). Complications were registered in 333 (6.7%) of all abortions. Among medical abortions amp;lt; 12 weeks, the complication frequency increased significantly, from 4.2% in 2008 to 8.2% in 2015 (RR 1.49, 95% 1.04-2.15). An incomplete abortion was the most common complication related to medical abortions amp;lt; 12 weeks. Of all women who tested positive for one or several bacteria at the screening and therefore received antibiotics, 1.4% developed a postabortal infection. Among those who tested negative at the screening, 1.7% developed infectious complications. Conclusions: The share of complications related to medical abortions amp;lt; 12 weeks increased significantly during 2008-2015 without any evident cause. Women who tested positive for one or several bacteria upon screening and received antibiotics experienced almost an equal proportion of postabortal infections compared to women who tested negative upon screening. The screening process seems to fulfill its purpose of reducing the risk of infectious complications.
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| 7. |
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| 8. |
- Ek, Malin, et al.
(författare)
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Gastrointestinal symptoms among endometriosis patients : A case-cohort study
- 2015
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Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background Women with endometriosis often experience gastrointestinal symptoms. Gonadotropin-releasing hormone (GnRH) analogs are used to treat endometriosis; however, some patients develop gastrointestinal dysmotility following this treatment. The aims of the present study were to investigate gastrointestinal symptoms among patients with endometriosis and to examine whether symptoms were associated with menstruation, localization of endometriosis lesions, or treatment with either opioids or GnRH analogs, and if hormonal treatment affected the symptoms. Methods All patients with diagnosed endometriosis at the Department of Gynecology were invited to participate in the study. Gastrointestinal symptoms were registered using the Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS); socioeconomic and medical histories were compiled using a clinical data survey. Data were compared to a control group from the general population. Results A total of 109 patients and 65 controls were investigated. Compared to controls, patients with endometriosis experienced significantly aggravated abdominal pain (P = 0.001), constipation (P = 0.009), bloating and flatulence (P = 0.000), defecation urgency (P = 0.010), and sensation of incomplete evacuation (P = 0.050), with impaired psychological well-being (P = 0.005) and greater intestinal symptom influence on their daily lives (P = 0.001). The symptoms were not associated with menstruation or localization of endometriosis lesions, except increased nausea and vomiting (P = 0.010) in patients with bowel-associated lesions. Half of the patients were able to differentiate between abdominal pain from endometriosis and from the gastrointestinal tract. Patients using opioids experienced more severe symptoms than patients not using opioids, and patients with current or previous use of GnRH analogs had more severe abdominal pain than the other patients (P = 0.024). Initiation of either combined oral contraceptives or progesterone for endometriosis had no effect on gastrointestinal symptoms when the patients were followed prospectively. Conclusions The majority of endometriosis patients experience more severe gastrointestinal symptoms than controls. A poor association between symptoms and lesion localization was found, indicating existing comorbidity between endometriosis and irritable bowel syndrome (IBS). Treatment with opioids or GnRH analogs is associated with aggravated gastrointestinal symptoms.
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| 9. |
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| 10. |
- Hadgu, Endale, et al.
(författare)
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Breast cancer in Ethiopia : evidence for geographic difference in the distribution of molecular subtypes in Africa
- 2018
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Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Breast cancer is a heterogeneous disease with several morphological and molecular subtypes. Widely accepted molecular classification system uses assessment of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and proliferation marker Ki67. Few studies have been conducted on the incidence and molecular types of breast cancer in Sub-Saharan Africa. Previous studies mainly from Western and Central Africa, showed breast cancer to occur at younger ages and to present with aggressive features, such as high-grade, advanced stage and triple-negative phenotype (negative for ER, PR and HER2). Limited data from East Africa including Ethiopia however shows hormone receptor negative tumors to account for a lower proportion of all breast cancers than has been reported from elsewhere in Africa.METHODS: In this study from Tikur Anbessa Specialized Hospital, 114 breast cancer patients diagnosed between 2012 and 2015 were enrolled. ER, PR, Ki67 and HER2 receptor status were assessed using immunohistochemistry from tissue microarrays. FISH was used for assessment of gene amplification in all equivocal tumor samples and for confirmation in HER2-enriched cases.RESULTS: The distribution of molecular subtypes was: Luminal A: 40%; Luminal B: 26%; HER2-enriched: 10%; TNBC: 23%. ER were positive in 65% of all tumors and 43% the cases were positive for PR. There was statistically significant difference in median age at diagnosis between the molecular subtypes (P < 0.05). There was a bimodal distribution of molecular subtypes in different age ranges with Luminal B subtype being more common at younger ages (median = 36) and Luminal A subtype more prevalent at older ages (median = 42). There were no statistically significant differences in tumor grade, histology, and stage between the molecular subtypes of breast cancer.CONCLUSION: The present study detected Luminal A breast cancer to be the most common subtype and reveals a relatively low rate of hormone receptor negative and TNBC. Our findings and results from other East African studies suggest geographic variability in the distribution of the molecular subtypes of breast cancer in Africa and hence have important clinical and policy implications for breast cancer control and treatment in Ethiopia.
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| 11. |
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| 12. |
- Hjelm, Katarina, et al.
(författare)
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A qualitative study of developing beliefs about health, illness and healthcare in migrant African women with gestational diabetes living in Sweden
- 2018
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Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Gestational diabetes (GDM) is associated with health risks for both mother and child, and is particularly relevant to migrant women and women of African origin. With today's extensive global migration, contact with the new society and health system confronts the migrant's culture of origin with the culture of the host country. The question is whether immigrants' patterns of beliefs about health, illness, and health-related behaviour change over time, as no previous studies have been found on this topic. The purpose was to explore development over time, during and after pregnancy, of beliefs about health, illness and healthcare in migrant women with GDM born in Africa living in Sweden, and study the influence on self-care and care seeking. Methods: Qualitative prospective study. Semi-structured interviews, with 9 women (23-40 years), on three different occasions: during pregnancy (gestational weeks 34-38), and 3 and 14 months after delivery managed at an in-hospital diabetes specialist clinic in Sweden. Results: Beliefs were rather stable over time and mainly related to individual and social factors. GDM was perceived as a transient condition as health professionals had informed about it, which made them calm. None, except one, expressed worries about relapse and the health of the baby. Instead women worried about being unable to live an ordinary life and being bound to lifestyle changes, particularly diet, developing diabetes and needing insulin injections. Over time knowledge of appropriate diet improved, although no advice was experienced given by the clinic after delivery. The healthcare model was perceived as well functioning with easy access but regular follow-ups were requested as many (decreasing over time) were unsure whether they still had GDM and lacked information about GDM and diet. During pregnancy information was also requested about the healthcare system before/after delivery. Conclusions: Beliefs changed to a limited extent prospectively, indicated low risk awareness, limited knowledge of GDM, irrelevant worries about future health, and being unable to live a normal life, associated with problematic lifestyle changes. Beliefs about the seriousness of GDM in health professionals influenced patients' beliefs and health-related behaviour. The healthcare organisation urgently needs to be improved to deliver appropriate and timely information through competent staff.
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| 13. |
- Husseini-Akram, Frida, et al.
(författare)
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Hyaluronan-binding protein 2 (HABP2) gene variation in women with recurrent miscarriage
- 2018
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Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background:Idiopathic recurrent miscarriage, defined as three or more consecutive miscarriages, is a distressing early pregnancy complication. Although, the etiology of recurrent miscarriage is still unknown, an aberrant regulation of the endometrial receptivity marker hyaluronan-binding protein 2 (HABP2) has been suggested. The objective of the present study was to investigate the effect of genetic variations of HABP2 in women with idiopathic recurrent miscarriage compared to fertile women.Methods:This study was designed as a case-control study. In total, 165 women who had three or more consecutive miscarriages and 289 fertile women were included in the study. Polymorphisms in the HABP2 gene were analyzed using TaqMan SNP Genotyping Assays. Three polymorphisms in the HABP2 gene, rs1157916, rs2240879 and rs7080536 (Marburg I) were studied.Results:Polymorphism in HABP2 showed no significant difference in women with recurrent miscarriage compared to fertile women, except for rs1157916 minor A allele that was more prevalent among RM patients (p = 0.058). Significantly higher live birth rate was observed among women with three to four miscarriages compared to those with more miscarriages (p = 0.001).Conclusions:Variations in the HABP2 gene did not seem to be involved in the etiology of recurrent miscarriage, while, the number of previous miscarriages had an impact on the live birth rate.
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| 14. |
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| 15. |
- Kumakech, Edward, 1977-, et al.
(författare)
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Cervical cancer risk perceptions, sexual risk behaviors and sexually transmitted infections among Bivalent Human Papillomavirus vaccinated and non-vaccinated young women in Uganda-5 year follow up study
- 2017
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Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous studies were conflicting regarding the associations between HPV vaccination, cervical cancer risk perceptions, high-risk sexual behaviors and STIs. This study compared the HPV-vaccinated and non-vaccinated young women in Uganda regarding cervical cancer risk perceptions, high-risk sexual behaviors, syphilis and HIV infections 5 years after vaccine implementation.Methods: This was a population-based comparative cross-sectional survey conducted in Uganda. The 438 participants were sexually active young women aged 15-24 years and mean age was 18.6 (SD 1.4). The majority (53.0%) were HPV-vaccinated in 2008 without assessment of sexual activity prior to HPV vaccination. Upon verbal assessment of sexual activity at the time of follow-up, data were collected using a questionnaire and laboratory testing of blood samples for syphilis and HIV infections.Results: There were no significant differences between the HPV-vaccinated and non-vaccinated groups regarding the prevalence of high-risk sexual behaviors, syphilis and HIV infections. Cervical cancer risk perceptions and age at sexual debut were nonetheless significantly lower among the vaccinated group compared to their non-vaccinated counterparts. However, HPV vaccination was not significantly associated to cervical cancer risk perceptions and early age at sexual debut in multivariate logistic regression analysis.Conclusions: We found no associations between HPV vaccination, cervical cancer risk perceptions, high-risk sexual behaviors, syphilis and HIV infections among young women in Uganda 5 years after vaccine implementation. Young girls in the study population were found to be sexually active at a young age, affirming the importance of targeting girls of younger age for HPV vaccination.
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| 16. |
- Kumakech, Edward, 1977-, et al.
(författare)
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Integration of HIV and cervical cancer screening perceptions and preferences of communities in Uganda
- 2015
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Ingår i: BMC Women's Health. - London, United Kingdom : BioMed Central. - 1472-6874. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite the fact that HIV-positive women carry an increased risk of developing cervical cancer (CC) in comparison with HIV-negative women, HIV and CC screening programs in many developing countries have remained unintegrated. The objective of this study is to explore perceptions and preferences of community members in Uganda, including women, men, and village health teams, regarding the integration of HIV and CC screening services in a single-visit approach.Methods: This qualitative study was conducted in three districts in Uganda. Data were collected through focus group discussions with women and village health teams, and individual interviews with men. Respondents were purposely selected from among those linked to three CC clinics in the three districts. The content analysis method was used to analyze the data.Results: Three themes emerged from the data, namely appreciating the benefits of integration, worrying about the challenges of integration, and preferences for integration. The women endorsed the benefits. However, there were worries that integration would prolong the waiting time at the health facility and induce tiredness in both the healthcare providers and the women. There were also fears of being found positive for both HIV and CC and the consequences such as stress, self-isolation, and social conflicts. Participants, particularly the women, considered the challenges of screening integration to be manageable by, for example, taking a day off work to visit the hospital, delegating house chores to other family members, or taking a packed lunch on visiting the hospital.Conclusions: The community members in Uganda perceive the benefits of HIV and CC screening integration to outweigh the challenges, and expect that the challenges can be minimized or managed by the women. Therefore, when considering HIV and CC screening integration, it is important to not only recognize the benefits but also take into consideration the perceived challenges and preferences of community members.
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| 17. |
- Lagergren, Katarina, et al.
(författare)
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The prevalence of primary ovarian insufficiency in Sweden; a national register study
- 2018
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Ingår i: BMC Women's Health. - : BMC. - 1472-6874. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe current estimates of the prevalence of primary ovarian insufficiency (POI) are very variable, but are in most studies believed to be around 1%. It is also very likely tat the prevalence of POI differs between countries and over time. We therefore aimed to assess the prevalence of primary ovarian insufficiency in Sweden.MethodsAll 1,036,918 women born between 1973 and 1993 in Sweden were included. The prevalence of POI was based on data from the Swedish Patient Register through the diagnosis code or through the Prescribed Drug Register. The number of women below 40years of age diagnosed with the ICD-10 diagnoses E28.3 or E89.4, and women who had been dispensed drugs for treatment of climacteric symptoms were included.ResultsOut of the 1,036,918 women, 19,253 (1.9%) had POI. The prevalence of spontaneous POI was 1.7% and the prevalence of iatrogenic POI was 0.2%. Most women (98.8%) with POI were identified from the Prescribed Drug Register; only 4.1% were found in the Patient Register, whereas 2.9% were identified in both registers.ConclusionsThe total prevalence of POI was 1.9%, 95% CI: 1.7-2.1, indicating a higher prevalence than often previously reported.
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| 18. |
- Leonardsson, Malin, et al.
(författare)
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Prevalence and predictors of help-seeking for women exposed to spousal violence in India - a cross-sectional study
- 2017
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Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: Spousal violence against women is prevalent in India (29%). Studies from various countries have shown that few women exposed to intimate partner violence or spousal violence seek help, especially in low-income countries. The objective of this study was to estimate the prevalence and predictors of help-seeking among women in India who have experienced various types of spousal violence.Methods: Cross-sectional data on 19,125 married, separated, divorced or widowed women in India who had experienced physical or sexual violence at the hands of their husbands were obtained from the India National Family Health Survey III 2005–2006. Bivariate and multivariate logistic regression analyses were carried out.Results: Less than one fourth (23.7%) of married, separated, divorced or widowed women in India who had experienced some form of physical or sexual spousal violence had sought help, but only 1% had sought help from formal institutions. Help-seeking was most prevalent in women who had been exposed to a combination of physical, sexual and emotional abuse (48.8%) and the least prevalent in women who had experienced sexual violence only (1.5%). Experience of severe violence and violence resulting in injury were the strongest predictors of help-seeking. Having education, being Christian or an acknowledged adherent of another minority religion - mainly Buddhism and Sikhism (Islam not included), getting married after the age of 21 and living in the South region were also associated with seeking help. Women in the North and Northeast regions were less likely to seek help, as were women with children and women who thought that a husband could be justified in hitting his wife.Conclusions: Very few Indian women who experience spousal violence seek help. The characteristics of the violence are the strongest predictors of help-seeking, but sociodemographic factors are also influential. We recommend efforts to ensure educational attainment for girls, prevention of child marriages, and that police officers and health care staff should be educated about intimate partner violence and in how to respond to women who seek help. It is important to tackle norms and attitudes surrounding violence against women, as well as attitudes to women who disclose violence.
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| 19. |
- Lindström, Suzanne, et al.
(författare)
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Treatment of Provoked Vulvodynia in a Swedish cohort using desensitization exercises and cognitive behavioral therapy.
- 2015
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Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Problems related to pain during vaginal penetration are complex and the etiology is multi-factorial. It was the aim of the present study to measure whether treatment using desensitization exercises and cognitive behavioral therapy (CBT) for women with provoked vulvodynia (PVD) could increase sexual interest, sexual satisfaction and response whilst decreasing experiences of sexual pain.
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| 20. |
- Liyew, Ewnetu Firdawek, et al.
(författare)
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Distant and proximate factors associated with maternal near-miss: : a nested case-control study in selected public hospitals of Addis Ababa, Ethiopia
- 2018
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Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Ethiopia is one of the sub-Saharan Africa countries with the highest maternal mortality. Maternalnear-misses are more common than deaths and statistically stronger for a comprehensive analysis of thedeterminants. The study aimed to identify the factors associated with maternal near-miss in selected publichospitals of Addis Ababa, Ethiopia.Methods: We conducted a nested case-control study in five selected public hospitals of Addis Ababa, Ethiopiafrom May 1, 2015 to April 30, 2016. Participants were interviewed by well-trained data collectors using pre-testedquestionnaire. Medical records were also reviewed to gather relevant information. World Health Organizationcriteria were used to identify maternal near-miss cases. A total of three controls matched for age and study areawas selected for each maternal near-miss case. Bivariate and multivariable conditional logistic regressions wereperformed using Stata version 13.0.Results: A total of 216 maternal near-miss cases and 648 controls were included in the study. The main factorsassociated with maternal near-miss were: history of chronic hypertension (AOR = 10.80,95% CI; 5.16–22.60), ruralresidency (AOR = 10.60,95% CI;4.59–24.46), history of stillbirth (AOR = 6.03,95% CI;2.09–17.41), no antenatal careattendance (AOR = 5.58,95% CI;1.94–16.07) and history of anemia (AOR = 5.26,95% CI;2.89–9.57).Conclusions: There is a need for appropriate interventions in order to improve the identified factors. The factorscan be modified through a better access to medical and maternity care, scaling up of antenatal care in rural areas,improve in infrastructure to fulfill referral chain from primary level to secondary and tertiary health care levels, andhealth education to pregnant women.
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| 21. |
- Mangrio, Elisabeth, et al.
(författare)
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Refugee women's experience of the resettlement process : a qualitative study.
- 2019
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Ingår i: BMC Women's Health. - : BioMed Central (BMC). - 1472-6874. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Resettlement can be particularly challenging for women as having a lower socioeconomic status and language barriers, may impede women's access to education, employment opportunities, health-care services, as well as the cultural, social, material and resilience factors that facilitate adjustment and adaption. Thus, the aim of this study is to further explore the perception of refugee women in Sweden concerning their situation during active participation in the resettlement process in the country. METHODS: Qualitative interview study with 11 recently arrived refugee women who had received their residence permits and were enrolled in the resettlement process. The interviews were conducted in Swedish with the support of an authorized Arabic translator present by telephone. RESULTS: Refugee women suffered from being separated from their loved ones and felt compelled to achieve something of value in the host country. All experienced both physical and mental anguish. CONCLUSIONS: Stakeholders in societies that receive refugee women should stress the importance of finding opportunities for and fast entrance into employment in the host countries. This would be beneficial for the integration and well-being of refugee women after migration.
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| 22. |
- Martin-Merino, Elisa, et al.
(författare)
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The reporting and diagnosis of uterine fibroids in the UK : an observational study
- 2016
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Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: Uterine fibroids (UFs) are the most common benign tumour in women, and many undergo hysterectomy or uterus-preserving procedures (UPPs) to manage their symptoms. We aimed to validate the recording of UFs in a primary care database, The Health Improvement Network (THIN), and to determine the incidence of UFs in the UK. Methods: In this observational study, women in THIN aged 15-54 years between January 2000 and December 2009 with no previous record of UFs, hysterectomy or UPPs were identified. Individuals were followed up until there was a Read code indicating UFs, they reached 55 years of age or died, or the study ended. Among those without a UF code, women were identified with a code for hysterectomy, UPPs or heavy menstrual bleeding (HMB). Anonymized patient profiles from each category were randomly selected and reviewed. Subsequently, primary care physicians were asked to complete questionnaires to verify the diagnosis for a randomly selected subgroup. Results: In total, 737,638 women were identified who met the initial inclusion criteria. The numbers of women with a code for UFs, hysterectomy, UPPs and HMB were 9380, 11,002, 3220 and 60,915, respectively; the proportions of confirmed cases of UFs were 88.8, 29.7, 57.7 and 15.9 %. The estimated number of women with UFs was 23,140 (64. 0 % without a recorded UF diagnosis). The overall incidence of UFs was 5.8 per 1000 woman-years. Conclusions: UFs were confirmed in a high proportion of women with UF Read codes. However, almost two-thirds of cases were identified among women with a code for hysterectomy, UPPs or HMB. These results show that UFs are under-recorded in UK primary care, and suggest that primary care physicians tend to code the symptoms of UFs more often than the diagnosis.
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| 23. |
- Mirskaya, Maria, 1972-, et al.
(författare)
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Online reported women’s experiences of symptomatic pelvic organ prolapse after vaginal birth
- 2019
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Ingår i: BMC Women's Health. - London, UK : BioMed Central. - 1472-6874. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pelvic organ prolapse (POP) is a major public health problem with a relative high lifetime risk of surgery. The main risk factor for developing POP is vaginal birth. Many women become symptomatic later in life and most of the existing research on symptomatic pelvic organ prolapse (sPOP) predominantly concentrates on the effects of the condition on postmenopausal women. However bothersome symptoms of POP can be reported as early as in women’s 20s and may occur shortly after vaginal birth. Limited studies provide an insight into daily life of fertile women with sPOP. Thus, we aimed to explore fertile women’s experiences of symptomatic pelvic organ (sPOP) after vaginal birth.Methods: An inductive, text-driven approach was taken by selecting thread posts from an internet forum written by 33 Swedish fertile women who had experienced sPOP after vaginal birth.Results: The overarching theme “being irreparably damaged” was identified as representing an experience of being disabled by sPOP after vaginal birth. The fertile women experienced that their lives were ruined because of physical and psychological limitations caused by this unexpected, unfamiliar and unexplained condition. Living with sPOP impinged on sexual health, restricted daily and sports activities and affected the women’s ability to fulfill everyday parental duties. This in turn compromised women’s psychological health. In addition, the negligence of healthcare professionals who tended to trivialize and normalize the symptoms led to the belief that there were no sustainable treatments and that women would have to live with bothersome symptoms of POP for rest of their lives.Conclusions: This study found that sPOP had a significant negative impact on fertile women’s lives. The women indicated that they had not had the opportunity to voice their concerns and had not been taken seriously by healthcare professionals. It is of the utmost importance to acknowledge this problem and develop guidelines for prevention and management of sPOP to improve the quality of life for women. © Mirskaya, Lindgren & Carlsson. 2019
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| 24. |
- Pakbaz, Mojgan, et al.
(författare)
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Are women adequately informed before gynaecological surgery?
- 2017
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Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Surgery for pelvic organ prolapse, urinary incontinence, and hysterectomy are the most common gynaecological surgeries that can affect the function of the bladder and bowel as well as one's sexual life. There is evidence that adequate patient information given preoperatively regarding expected outcomes of surgery is important because well-informed patients are more satisfied with the results of surgery and recover faster. However, there is little known about the amount and quality of information given to women before surgery. This study investigates whether women received information before gynaecological surgery on the effect of surgery with respect to the functioning of the bladder (micturition, ability to stay continent) and the bowel (empty bowel) as well as the surgery's effect on sexual functioning.METHODS: A prospective, cross-sectional study was conducted. Women undergoing hysterectomy, surgery for vaginal prolapse, or surgery for urinary incontinence (n = 972) and included in the Swedish National Register for Gynaecological Surgery participated in the study. A questionnaire was developed and distributed to the women along with the preoperative questionnaire from the register.RESULTS: About 50% of the women undergoing prolapse surgery were supplied with information regarding the effect of the surgery with respect to remaining continent, to emptying bowels, micturitaion, and sexual life. One out of four women undergoing hysterectomy received information about the effect of the surgery on the sexual life and bladder function. In the incontinence group, the given information about the surgery's effect on bladder function and sexual function was 80 and 30%, respectively.CONCLUSION: Surgery in the vagina and the genital organs may affect function of the organs close to the surgical area (i.e., bladder and bowel) and may affect sexual function. According to this study, women are inadequately informed before surgery. Access to information via oral and written counselling needs to be improved.
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| 25. |
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| 26. |
- Rask, Marie, 1974-, et al.
(författare)
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The Swedish translation and cross-cultural adaptation of the functional assessment of Ccronic illness therapy - cervical dysplasia (FACIT-CD) : linguistic validity and reliability of the Swedish version
- 2017
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Ingår i: BMC Women's Health. - 1472-6874 .- 1472-6874. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cervical dysplasia is a precancerous condition, which has been shown to create anxiety in women. To be able to investigate these women's health-related quality of life, a disease-specific instrument is required. There does not seem to be a Swedish version of an instrument to screen for this specific disease. Therefore, this study aims to translate and cross-culturally adapt the Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia (FACIT-CD) into a Swedish context and evaluate its linguistic validity and reliability.METHODS: The Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology was used, which consists of several steps including pilot testing of the FACIT-CD instrument through cognitive debriefing interviews. Ten women diagnosed with cervical dysplasia participated in the cognitive debriefing interviews. The internal consistency reliability of the Swedish FACIT-CD was estimated by Cronbach's alpha coefficient. Homogeneity of the items was evaluated by corrected item-total correlations. The sample consists of 34 women who were diagnosed with cervical dysplasia.RESULTS: The translation and cross-cultural adaptation went smoothly without any problems for the majority of the items. The cognitive debriefing interviews indicated that the Swedish FACIT-CD consists of relevant items, is easy to understand and complete, and has unambiguous and comprehensive response categories. The translation and cross-cultural adaptation resulted in a Swedish FACIT-CD, which is conceptually and semantically equivalent to the English version and linguistically valid. The total scale of the Swedish FACIT-CD exhibited good internal consistency reliability with a Cronbach's alpha coefficient of 0.84, and all of the subscales exhibited acceptable value between 0.71 and 0.81 except the Relationships subscale, which had a value of 0.67. Finally, all but four items exceeded the acceptable level for the corrected item-total correlations of ≥ 0.20.CONCLUSIONS: The Swedish FACIT-CD is conceptually and semantically equivalent to the English version and linguistically valid; further, it exhibits good internal consistency reliability.
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| 27. |
- Rask, Marie, et al.
(författare)
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The Swedish translation and cross-cultural adaptation of the Functional Assessment of Chronic Illness Therapy – Cervical Dysplasia (FACIT-CD) : linguistic validity and reliability of the Swedish version
- 2017
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Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 17:1, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundCervical dysplasia is a precancerous condition, which has been shown to create anxiety in women. To be able to investigate these women’s health-related quality of life, a disease-specific instrument is required. There does not seem to be a Swedish version of an instrument to screen for this specific disease. Therefore, this study aims to translate and cross-culturally adapt the Functional Assessment of Chronic Illness Therapy – Cervical Dysplasia (FACIT-CD) into a Swedish context and evaluate its linguistic validity and reliability.MethodsThe Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology was used, which consists of several steps including pilot testing of the FACIT-CD instrument through cognitive debriefing interviews. Ten women diagnosed with cervical dysplasia participated in the cognitive debriefing interviews. The internal consistency reliability of the Swedish FACIT-CD was estimated by Cronbach’s alpha coefficient. Homogeneity of the items was evaluated by corrected item-total correlations. The sample consists of 34 women who were diagnosed with cervical dysplasia.ResultsThe translation and cross-cultural adaptation went smoothly without any problems for the majority of the items. The cognitive debriefing interviews indicated that the Swedish FACIT-CD consists of relevant items, is easy to understand and complete, and has unambiguous and comprehensive response categories. The translation and cross-cultural adaptation resulted in a Swedish FACIT-CD, which is conceptually and semantically equivalent to the English version and linguistically valid. The total scale of the Swedish FACIT-CD exhibited good internal consistency reliability with a Cronbach’s alpha coefficient of 0.84, and all of the subscales exhibited acceptable value between 0.71 and 0.81 except the Relationships subscale, which had a value of 0.67. Finally, all but four items exceeded the acceptable level for the corrected item-total correlations of ≥ 0.20.ConclusionsThe Swedish FACIT-CD is conceptually and semantically equivalent to the English version and linguistically valid; further, it exhibits good internal consistency reliability.
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| 28. |
- Rindner, Lena, 1959, et al.
(författare)
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Prevalence of somatic and urogenital symptoms as well as psychological health in women aged 45 to 55 attending primary health care: a cross-sectional study.
- 2017
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Ingår i: BMC women's health. - : Springer Science and Business Media LLC. - 1472-6874. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Women's physical and mental ill-health such as stress-related symptoms, depression, pain, hypertension and urogenital health shows a marked increase around the ages 45-55years. These women are an important group for Primary Health Care (PHC) due to their prevalent symptoms and illnesses. The aim of this study was to estimate the prevalence of somatic, psychological and urogenital symptoms in women aged 45-55 attending PHC and evaluate factors associated with severe symptoms.One hundred and thirty-one women were recruited from PHC in southwestern Sweden. Data were obtained from two self-reported questionnaires, the Menopause Rating Scale (MRS) and the Montgomery-Asberg Depression Rating Scale (MADRS).Exhaustion, depressive mood, muscle and joint problems, sleep and sexual problems were the most prevalent reported symptoms. Half of the women reported heart discomfort. Depression and increasing age were correlated to more severe symptoms.We recommend that cardiovascular risk factors, musculoskeletal symptoms, sexual problems, sleeping problems and mental health should be actively asked for when women aged 45 to 55 attend PHC. We propose that preventive counselling of women in PHC before the age 45 should be evaluated in future studies.
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| 29. |
- Schückher, Fides, 1956-, et al.
(författare)
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History of childhood abuse is associated with less positive treatment outcomes in socially stable women with alcohol use disorder
- 2019
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Ingår i: BMC Women's Health. - : BMC. - 1472-6874. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: To examine the relationship between treatment outcome, as measured according to change in alcohol consumption, and a history of childhood abuse (emotional, physical, sexual) in socially stable women undergoing treatment for alcohol use disorder (AUD).Methods: Participants were assessed using the Addiction Severity Index and the Mini International Neuropsychiatric Interview at the beginning of treatment (n = 75), end of treatment (n = 59) and 12 month follow-up after treatment (n = 57). Self-report data on alcohol consumption were obtained at all three time-points using the Alcohol Habits Inventory-Revised 2. Self-report data on childhood maltreatment were obtained at the beginning of treatment using the Childhood Trauma Questionnaire-short form. Study outcomes were changes in alcohol consumption (grams of pure alcohol per week), risk-drinking and reported abstinence.Results: Of the 75 women enrolled, 38 (50.7%) reported a history of childhood abuse and the rest did not. Both groups showed a significant improvement in all three outcomes at the end of treatment and at 12-month follow-up. At the end of treatment, a significant inter-group difference was found for reported abstinence (non-abused group, 39.3% vs abused, 12.9%; p < 0.05). At 12-month follow-up, significant inter-group differences were observed for all treatment outcomes, with superior outcomes being found for the non-abused group, including a higher proportion of women with reported abstinence (55.6% vs 13.3%; p < 0.01).Conclusion: The present findings suggest that an evaluation of a possible history of childhood abuse is warranted in all women seeking treatment for AUD, irrespective of social stability. In terms of clinical practice, the results suggest that additional interventions may be warranted in this population.
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| 30. |
- Sydsjö, Gunilla, et al.
(författare)
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Women born with very low birth weight have similar menstrual cycle pattern, pregnancy rates and hormone profiles compared with women born at term
- 2019
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Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIndividuals born very preterm or with very low birth weight (VLBW) have a reduced likelihood to reproduce according to population-based register studies. Extremely low-birth weight born adults had a lower reproduction rate for both men and women in a follow-up study.AimTo investigate if being born with VLBW is associated with differences in the reproductive health, i.e. age of menarche, menstrual cycle pattern, pregnancy rates and hormone profile compared with women born at term.MethodsA prospective long-term follow-up of a cohort of live-born VLBW children and their controls studied repeatedly since birth and now assessed at 26–28 years of age. Of the totally 80 girls enrolled from birth 49 women (24 VLBW women and 25 controls) participated in the current follow-up. The women’s anthropometric data and serum hormone levels were analysed.ResultsThe reproductive hormone levels, including Anti-Mullerian Hormone, did not differ significantly between VLBW women and their controls. Both groups reported menstrual cycle irregularities and pregnancies to the same extent but the VLBW women reported 1.5 years later age of menarche. The VLBW subjects had a catch-up growth within 18 months of birth but remained on average 5 cm shorter in adult height. There were no significant differences in BMI, sagittal abdominal diameter, blood pressure or in their answers regarding life style between the VLBW women and the controls.ConclusionNo differences in the reproductive hormone levels were found between VLBW women and their controls. Although age at menarche was somewhat higher in the VLBW group menstrual cycles and pregnancy rates were similar in the VLBW and control groups. Further follow-up studies are required to elucidate the health outcomes of being born VLBW.
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| 31. |
- Taghavi, K., et al.
(författare)
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Colposcopy telemedicine: live versus static swede score and accuracy in detecting CIN2+, a cross-sectional pilot study
- 2018
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Ingår i: Bmc Womens Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: This cross-sectional pilot study evaluates diagnostic accuracy of live colposcopy versus static image Swede-score evaluation for detecting significant precancerous cervical lesions greater than, or equal to grade 2 severity (CIN2+). Methods: VIA or HrHPV positive women were examined using a mobile colposcope, in a rural clinic in Kolkata, India. Live versus static Swede-score colposcopy assessments were made independently. All assessments were by gynecologists, junior or expert. Static image assessors were blinded to live scoring, patient information and final histopathology result. Primary outcome was the ability to detect CIN2+ lesions verified by directed biopsies. Diagnostic accuracy was calculated for live versus static Swede-score in detecting CIN2+ lesions, as well as for interclass correlation. Results: 495 images from 94 VIA positive women were evaluated in this study. Thirteen women (13.9%) had CIN2+ on biopsy. No significant difference was found in the detection of CIN2+ lesions between live and static assessors (area under curve = 0.69 versus 0.71, p = 0.63). A Swede-score of 4+, had a sensitivity of 76.9% (95% CI 46.2-95.0%) and 84.6% (95% CI 54.6-98.1%), for live-and static-image assessment respectively. The corresponding positive predictive values were found to be 90.9% (95% CI 75.7-98.1%) and 92.6% (95% CI 75.7-99.1%). The interclass correlation was good (kappa statistic = 0.60) for the senior static assessors. Conclusions: Swede-score evaluation of static colposcopy images was found to reliably detect CIN2+ lesions in this study. Larger studies are needed to further develop the colposcopy telemedicine concept which may offer reliable guidance in management where direct specialist input is not available. Trial registration: Ethical approval of the study was obtained by the Chittaranjan National Cancer Institute (CNCI) Human Research Ethics Committee (4.311/27/2014).
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| 32. |
- Torstensson, Thomas, 1961-, et al.
(författare)
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Anatomical landmarks of the intra-pelvic side-wall as sources of pain in women with and without pregnancy-related chronic pelvic pain after childbirth : a descriptive study
- 2018
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Ingår i: BMC Women's Health. - : BioMed Central. - 1472-6874. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic pelvic pain (CPP) affects 15-24% of women and can have a devastating impact on quality of life. Laparoscopy is often used in the investigation, although in one third of the examinations there is no visible pathology and the women may be dismissed without further investigation. Also, the contribution of skeletal, muscular, periosteal and ligamentous tissues to CPP remains to be further elucidated. The objective of the present study was to compare pain intensity provoked from anatomical landmarks of the intra-pelvic side-wall in women with pregnancy-related CPP after childbirth and women without such pain. Methods: This is a descriptive study of 36 non-randomly selected parous women with CPP after childbirth and 29 likewise selected parous women after childbirth without CPP. Pain was determined by questionnaire and clinical examination. The primary outcome measure was reported pain intensity provoked on 13 anatomical landmarks of the intra-pelvic side-wall. All women reported their perceived pain intensity for each anatomical landmark on Likert scales and an individual sum score was calculated. Results: Women with chronic pelvic pain were older than women without CPP. At several intra-pelvic landmarks high intensity pain was provoked in women with CPP compared with less intense pain provoked at fewer landmarks in women without low back or pelvic pain (p < 0.0001). The average sum of pain intensity scores was about 4 times higher in women with CPP (1.3) as compared with those without low back or pelvic pain (0.3), p < 0. 0001. This association remained when adjusting for the age difference between the pain groups in linear regression analysis. In addition, reported pain intensity at worst past week was independently associated with sum of pain intensity scores. The maximum individual sum of pain intensity scores among women without CPP was exceeded by that of 85% of the women with CPP. Conclusions: Parous women with CPP after childbirth had a heightened pain intensity over 13 anatomical landmarks during pelvic examination compared with parous women without CPP. These results need to be confirmed in a larger cohort with different types of CPP.
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| 33. |
- Täufer Cederlöf, Elin, et al.
(författare)
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Do self-reported pregnancy complications add to risk evaluation in older women with established cardiovascular disease?
- 2019
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Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In postmenopausal women with established cardiovascular disease (CVD), it is unknown whether a history of pregnancy complications are related to multisite artery disease (MSAD), defined as atherosclerotic lesions in at least two major vascular beds. Pregnancy complications are an established risk factor for CVD. This study aimed to investigate the frequency of pregnancy complications and their association to specific atherosclerotic manifestations and prediction of MSAD in older women with and without CVD.METHODS: In total, 556 women were invited to participate in the study. Of these women 307 reported former pregnancy from a cohort of women with (n = 233) and without CVD (n = 74). The self-reported frequency of pregnancy complications were surveyed retrospectively by a questionnaire that included miscarriage, subfertility, gestational hypertension (GHT) and/or preeclampsia (PE), low birth weight, preterm birth, bleeding in late pregnancy, gestational diabetes mellitus and high birth weight. Three vascular beds were examined, the peripheral, carotid and coronary arteries.RESULTS: The mean age was 67.5 (SD 9.5) years. GHT and/or PE tended to be more common, but not significant, in women with CVD than in women without (20.3% vs 10.8%, p = 0.066). Among women with GHT and/or PE, hypertension later in life were more frequent than in women without (66.7% vs 47.4%, p = 0.010). GHT and/or PE were not associated with specific atherosclerotic manifestations or prediction of MSAD.CONCLUSIONS: In older women with established CVD, pregnancy complications was not associated to specific atherosclerotic manifestations and may not provide additional value to the risk evaluation for MSAD.
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| 34. |
- Törnquist Agosti, Madelaine, et al.
(författare)
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"The importance of awareness, support and inner strength to balance everyday life" : a qualitative study about women's experiences of a workplace health promotion program in human service organizations in Sweden
- 2019
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Ingår i: BMC Women's Health. - 1472-6874 .- 1472-6874. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In many European countries, women have a higher sickness absence rate than men. Women also report higher levels of work-life conflict, which has a negative impact on women's self-perceived health. Interventions studies on work-life balance literature are scarce. This research adds knowledge about work-life balance by examining female employees' experiences of a newly developed intervention program, the BELE program (Balance in Everyday Life Empowerment program), aiming to enhance the work-life balance and wellbeing of female employees.METHODS: All participants in the BELE program were included in the sample (n = 55) of the study. The methods used for gathering data were focus group interviews (n = 8) and semi-structured individual interviews (n = 8). A qualitative content analysis was used for the analyses.RESULTS: The results showed that a majority of the participants experienced a process of change for enhancement of wellbeing and balance in their everyday life when taking part in the BELE program. In the analyses, three main themes emerged. Reflecting and strengthening inner resource, Trying to change everyday patterns and habits and Experiencing more balance and well-being.CONCLUSIONS: The results point out the importance of awareness and reflection on everyday life to promote work-life balance and wellbeing. The BELE program was described as a wakeup call to one's own life and as an enhancer of empowerment processes and equality in the homes. Moreover, the results showed the need for health education in the workplace focusing on both work and private life to enhance balance and wellbeing among female employees'. The findings indicate that it is important to work at individual and group levels in work-life balance interventions and not merely at the organizational level or in the workplace setting.
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| 35. |
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| 36. |
- Wallin Lundell, Inger, et al.
(författare)
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Neuroticism-related personality traits are associated with posttraumatic stress after abortion : findings from a Swedish multi-center cohort study
- 2017
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Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Most women who choose to terminate a pregnancy cope well following an abortion, although some women experience severe psychological distress. The general interpretation in the field is that the most consistent predictor of mental disorders after induced abortion is the mental health issues that women present with prior to the abortion. We have previously demonstrated that few women develop posttraumatic stress disorder (PTSD) or posttraumatic stress symptoms (PTSS) after induced abortion. Neuroticism is one predictor of importance for PTSD, and may thus be relevant as a risk factor for the development of PTSD or PTSS after abortion. We therefore compared Neuroticism-related personality trait scores of women who developed PTSD or PTSS after abortion to those of women with no evidence of PTSD or PTSS before or after the abortion.METHODS: A Swedish multi-center cohort study including six Obstetrics and Gynecology Departments, where 1294 abortion-seeking women were included. The Screen Questionnaire-Posttraumatic Stress Disorder (SQ-PTSD) was used to evaluate PTSD and PTSS. Measurements were made at the first visit and at three and six month after the abortion. The Swedish universities Scales of Personality (SSP) was used for assessment of Neuroticism-related personality traits. Multiple logistic regression analyses were performed to investigate the risk factors for development of PTSD or PTSS post abortion.RESULTS: Women who developed PTSD or PTSS after the abortion had higher scores than the comparison group on several of the personality traits associated with Neuroticism, specifically Somatic Trait Anxiety, Psychic Trait Anxiety, Stress Susceptibility and Embitterment. Women who reported high, or very high, scores on Neuroticism had adjusted odds ratios for PTSD/PTSS development of 2.6 (CI 95% 1.2-5.6) and 2.9 (CI 95% 1.3-6.6), respectively.CONCLUSION: High scores on Neuroticism-related personality traits influence the risk of PTSD or PTSS post abortion. This finding supports the argument that the most consistent predictor of mental disorders after abortion is pre-existing mental health status.
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| 37. |
- Wiik, Johanna, et al.
(författare)
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Cervical microbiota in women with cervical intra-epithelial neoplasia, prior to and after local excisional treatment, a Norwegian cohort study
- 2019
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Ingår i: Bmc Womens Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundLocal treatment for cervical intraepithelial neoplasia (CIN) by Loop Electrosurgical Excision Procedure (LEEP) has been correlated with reproductive morbidity, while the cervicovaginal microbiota is also known to affect the risk of preterm delivery. CIN and treatment by LEEP might change the cervical microbiota. The main aim of this study was to describe the cervical microbiota before and after LEEP and assess its associaton with cone depth and HPV persistence. Further, we aimed to compare the microbiota to references with normal cervical cytology.MethodsBetween 2005 and 2007, we prospectively identified 89 women planned for LEEP in a Norwegian hospital and recruited 100 references with a normal cervical cytology. Endocervical swabs were collected prior to treatment and at six (n=77) and 12months (n=72) post LEEP for bacterial culture and PCR, and post LEEP for DNA testing for human papillomavirus (HPV). We compared the cervical microbiota composition before and after treatment and between women planned for LEEP vs references.ResultsThere was a reduction in the number of non-Lactobacillus bacterial species six and 12months after LEEP compared to before treatment and a tendency towards a concomitant increase in Lactobacillus. No association between the detection of cervical bacteria, HPV persistence or cone depth was found.Women planned for LEEP carried significantly more Bacteroides spp., Gardnerella vaginalis, Mycoplasma hominis and Ureaplasma parvum as well as a greater number of bacterial species than the references.ConclusionsLocal excisional treatment appears to alter the cervical microbiota towards a less diverse microbiota. Women with CIN have a more diverse cervical microbiota compared to women with normal cervical cytology.
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