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- Akram, Frida Hosseini, et al.
(author)
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Incidence of Subclinical Hypothyroidism and Hypothyroidism in Early Pregnancy
- 2017
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In: Journal of Women's Health. - : Mary Ann Liebert Inc. - 1540-9996 .- 1931-843X. ; 26:11, s. 1231-1235
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Journal article (peer-reviewed)abstract
- Background: Untreated and subclinical hypothyroidism (SCH) has been associated with adverse pregnancy complications such as increased risk of miscarriage, hypertension, preeclampsia, and preterm delivery. However, in Sweden, screening for thyroid dysfunction during pregnancy is only recommended for women with a high risk of thyroid disease. Therefore, the aim of this study was to determine the incidence of clinical and SCH in women in the first trimester of pregnancy.Materials and Methods: In this prospective study, 1298 pregnant women were divided into three groups: one unselected general screening group (n=611), one low-risk group comprising women without risk factors for thyroid disorder (n=511), and one high-risk group comprising women with an inheritance or suspicion of thyroid disease or undergoing treatment for thyroid disease (n=88). Serum was obtained up to gestational week 13, and thyrotropin (TSH) was analyzed.Results: The incidences of thyroid dysfunction in the three screening groups were 9.8% in the general screening group, 9.6% in the low-risk group, and 10.2%, p=0.948, in the high-risk group. In the women with known hypothyroidism on levothyroxine treatment, 50.6% had serum TSH levels above 2.0mIU/L.Conclusions: High-risk screening is not useful in predicting which women are at risk of thyroid disease in early pregnancy since approximate to 10% of women with SCH or hypothyroidism could not be diagnosed in this way.
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| 2. |
- Grundström, Hanna, et al.
(author)
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Impact of Pelvic Pain and Endometriosis on Patient-Reported Outcomes and Experiences of Benign Hysterectomy: A Study from the Swedish National Register for Gynecological Surgery
- 2018
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In: Journal of Women's Health. - : MARY ANN LIEBERT, INC. - 1540-9996 .- 1931-843X. ; 27:5, s. 691-698
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Journal article (peer-reviewed)abstract
- Background: The study objective was to analyze and compare patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs) after hysterectomy in women with and without a preoperative complaint of pelvic pain associated with and without a confirmed diagnosis of endometriosis. Methods: Retrospective nationwide register study. Data on 28,776 hysterectomies performed on benign indication between 2004 and 2016 were retrieved from the Swedish National Register for Gynecological Surgery. Multivariable logistic regression models were used to compare the PREMs and PROMs items. The results are presented as adjusted odds ratios (aORs) and 95% confidence intervals (CI). Results: Regardless of the occurrence of pelvic pain preoperatively and a diagnosis of endometriosis, 1 year after surgery, the women were satisfied or very satisfied (amp;gt;90%) with the hysterectomy, and their medical condition was improved or much improved (amp;gt;95%). The women with a preoperative complaint of pelvic pain and endometriosis more often reported excessively short hospital stays (aOR 1.45, 95% CI 1.17-1.79), more severe complications after discharge (aOR 2.02, 95% CI 1.59-2.66) at the 8-week follow-up and at the 1-year follow-up (aOR 2.31, 95% CI 1.57-3.39), and more dissatisfaction with the operation (aOR 1.83, 95% CI 1.35-2.48) than preoperative pelvic pain-free women without endometriosis at the 1-year follow-up. Conclusions: The majority of the women were satisfied after their hysterectomy. The women with pelvic pain and endometriosis were at a higher risk of being dissatisfied. Pelvic pain per se seemed to be the main factor affecting the rating in the PREMs and PROMs, and the endometriosis was a significant contributing factor.
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| 3. |
- Gutke, Annelie, et al.
(author)
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The Severity and Impact of Pelvic Girdle Pain and Low-Back Pain in Pregnancy: A Multinational Study.
- 2018
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In: Journal of Women's Health. - : Mary Ann Liebert Inc. - 1931-843X .- 1540-9996. ; 27:4
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Journal article (peer-reviewed)abstract
- Pelvic girdle pain (PGP) and low-back pain (LBP) are the most common musculoskeletal disorders experienced during pregnancy, yet they are not familiar to healthcare providers in some countries. The objective was to compare prevalence, severity, and impact of PGP and LBP among pregnant women in the United States, the United Kingdom, Norway, and Sweden. Women's desires for, access to, and experience of treatment were also examined.This is a cross-sectional self-reported questionnaire study of pregnant women, recruited at maternity care units in gestational weeks 30-38. Main outcome measures were presence and impact of PGP and/or LBP.A total of 869 pregnant women from the United States (n=214), the United Kingdom (n=220), Norway (n=220), and Sweden (n=215) were included. PGP and/or LBP were reported by 70%-86%, with lowest prevalence in Scandinavia. Severity and impact differed significantly across countries (p<0.001), with U.K. women reporting the highest pain intensity (Numeric Rating Scale [NRS] 7/10) and highest mean total score on the Pelvic Girdle Questionnaire (PGQ) (46/100). U.S. women were significantly less afflicted, with mean PGQ total score 35/100 (p≤0.001). The countries differed regarding concern about PGP and/or LBP (p<0.001), with U.K. women being most affected (NRS 5/10). Norwegian women were most likely to receive treatment (53%) and U.S. women least likely (24%) (p<0.001). Among women receiving treatment, 68%-87% reported a positive effect.PGP and/or LBP during pregnancy are common in the United States, the United Kingdom, Norway, and Sweden. Severity, concern, and treatment experiences differed across countries. The majority of women who received treatment reported a positive effect.
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| 4. |
- Lövkvist, Lena, et al.
(author)
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Age-Related Differences in Quality of Life in Swedish Women with Endometriosis
- 2016
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In: Journal of Women's Health. - : Mary Ann Liebert Inc. - 1540-9996 .- 1931-843X. ; 25:6, s. 646-653
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Journal article (peer-reviewed)abstract
- Objective: The purpose of this observational study was to evaluate the impact of endometriosis on quality of life (QoL) in different age groups of Swedish women with endometriosis. Recruitment occurred through the Endometriosis Association (Sweden) (n = 400) and five gynecology departments of five Swedish hospitals (n = 400). All voluntary female members of the patient organization and patients attending specialist clinics due to endometriosis (n = 800) were invited by sending them a questionnaire. An age-and gender-matched sample of the general Swedish population was used as a control group when analyzing SF-36 data. Methods: A postal questionnaire (including SF-36) was distributed to 800 women. The questionnaire was evaluated by using descriptive statistics, and SF-36 was evaluated according to standard methods. Results: Of the 449 (56%) self-administered questionnaires returned, 431 (96%) contained evaluable answers. Women with endometriosis have significantly lower SF-36 scores than the general female Swedish population, and the score depends on the women's age. Younger women experience more symptoms and have a lower QoL score compared with women in the older age group. Conclusion: Women with endometriosis have significantly lower QoL than the general female Swedish population and it depends on the women's age, where younger women express more symptoms and have a lower QoL compared with women in the older age group. Our results highlight that more healthcare resources should be focused on younger women with endometriosis.
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| 6. |
- Ramö Isgren, Anna, et al.
(author)
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Obstetric Outcomes in Adolescents Related to Body Mass Index and Compared with Low-Risk Adult Women
- 2017
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In: Journal of Women's Health. - : MARY ANN LIEBERT, INC. - 1540-9996 .- 1931-843X. ; 26:5, s. 426-434
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Journal article (peer-reviewed)abstract
- Objective: To evaluate in adolescents the association between body mass index (BMI) and obstetric outcomes and to determine whether the outcomes in the BMI groups of adolescents differ from those of a low-risk population of adult women. Materials and Methods: This is a nationwide population-based register study. Obstetric outcomes of 31,386 singleton primiparous adolescents were evaluated in relation to BMI classes. Furthermore, the outcomes of the adolescents and 178,844 normal weight, nonsmoking, singleton primiparous women, 25-29 years old with no known comorbidity, defined as standard women, were compared. Multiple logistic regression models were used. Results are presented as crude odds ratios (ORs) or adjusted ORs and with a 95% confidence interval. Results: Compared with normal weight adolescents, obese adolescents had a lower chance of a normal vaginal delivery (VD)76% versus 85% [adjusted OR 0.61 (0.55-0.68)], a higher risk for acute cesarean section (CS)8.9% versus 4.5% [adjusted OR 2.45 (2.08-2.88)], and stillbirth0.7% versus 0.2% [adjusted OR 3.17 (1.74-5.77)]. Compared with standard women, overweight adolescents had a higher chance of a normal VD82% versus 75% [crude OR 1.53 (1.44-1.64)] and a lower risk for acute CS6.3% versus 7.1% [crude OR 0.85 (0.76-0.95)]. Obese adolescents had a lower risk for instrumental VD8% versus 13% [crude OR 0.61 (0.53-0.71)] and obstetric anal sphincter injury1% versus 3% [crude OR 0.38 (0.26-0.57)]. Conclusion: Several adverse obstetric outcomes were obesity related among adolescents. Overweight adolescents seemed to have better obstetric outcomes than standard women, something to consider when optimizing resources for women during pregnancy and delivery.
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