Experience of contraceptive denial, perceived ease of future access to contraception, and adverse mental health outcomes in Polish women

Purpose: While several studies demonstrate an association between reproductive coercion or a lack of reproductive autonomy and decreased mental health in women, little is known about potential mental health impacts when women are denied prescription contraceptives. The aim of this research was to explore associations between prescription contraceptive denial and perceived ease of future access to contraception, and self-assessed mental health.Patients and Methods: Polish women (N=424) completed an anonymous online survey with demographic questions; perceived stress (PSS-10), state anxiety (STAI-X1), and depression (CESD-R) assessments, and contraceptive access questions.Results: Eighty-eight participants (21%) had experienced at least one episode of prescription contraceptive denial from a doctor or pharmacist. There were no differences in stress, anxiety, and depression scores between women who had and had not ever experienced denial. However, women who had experienced contraceptive denial within the last six months, had higher depression scores. In addition, women who perceived future access as very easy had the lowest stress, anxiety and depression scores.Conclusion: These results suggest that experiences and attitudes related to contraceptive access are related to perceived stress, anxiety, and depression. Contraceptive denial and other access barriers constitute a significant public health issue that may impact the health of women

Cigarette smoke exposure as a potential risk factor for sleep problems in pregnant women

Cigarette smoking and exposure to cigarette smoke during pregnancy have detrimental effects on the health of expectant mothers, increasing the likelihood of respiratory diseases or infections. Due to the stimulant effect of smoking, the negative effect on diurnal rhythm and sleep is also observed. Sleep quantity and quality are directly related to health and well-being, especially during times of excess stress, such as the perinatal period. This prospective study aimed to examine the relationship between cigarette smoking and exposure to cigarette smoke during pregnancy and sleep patterns in pregnant women. An online survey was conducted among Polish women from May 2020 to September 2021, during the COVID-19 pandemic. Participants reported smoking during pregnancy and rated sleep in three categories (difficulty falling asleep, waking up too early, and difficulty staying asleep). Data from 3365 mothers aged 18-43 (mean 30.7; SD 3.87) were analyzed using multivariate logistic regression. Passive smoking was associated with one of the three variables used to assess sleep problems (waking up too early) while controlling for a range of individual variables (age, education, place of residence, satisfaction with the woman's life, and economic situation, pregnancy complications, levels of state anxiety and depressive symptoms, trimester of pregnancy, nausea or vomiting during pregnancy, and COVID-19 infections). Interestingly, results showed no evidence of an association between active smoking and sleep difficulties. Our findings suggest that passive smoking is a potential risk factor for sleeping problems in pregnant women, especially in the aspect of waking up too early. These results are worth considering when formulating pro-health measures for pregnant women and their close ones

Experience of Contraceptive Denial, Perceived Ease of Future Access to Contraception, and Adverse Mental Health Outcomes in Polish Women

Morgan Jade,1 Magdalena Ewa Mijas,2 Grazyna Jasienska,2 Andrzej Galbarczyk2,3 1School of Health and Related Research, University of Sheffield, Sheffield, UK; 2Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland; 3Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, GermanyCorrespondence: Andrzej Galbarczyk, Department of Environmental Health, Jagiellonian University Medical College, 8 Skawinska St., Krakow, 31-066, Poland, Tel +48 693 02 55 27, Fax +48 12 632 48 81, Email [email protected]: While several studies demonstrate an association between reproductive coercion or a lack of reproductive autonomy and decreased mental health in women, little is known about potential mental health impacts when women are denied prescription contraceptives. The aim of this research was to explore associations between prescription contraceptive denial and perceived ease of future access to contraception, and self-assessed mental health.Patients and Methods: Polish women (N=424) completed an anonymous online survey with demographic questions; perceived stress (PSS-10), state anxiety (STAI-X1), and depression (CESD-R) assessments, and contraceptive access questions.Results: Eighty-eight participants (21%) had experienced at least one episode of prescription contraceptive denial from a doctor or pharmacist. There were no differences in stress, anxiety, and depression scores between women who had and had not ever experienced denial. However, women who had experienced contraceptive denial within the last six months, had higher depression scores. In addition, women who perceived future access as very easy had the lowest stress, anxiety and depression scores.Conclusion: These results suggest that experiences and attitudes related to contraceptive access are related to perceived stress, anxiety, and depression. Contraceptive denial and other access barriers constitute a significant public health issue that may impact the health of women.Keywords: conscientious objection, reproductive autonomy, sexual health, reproductive coercio

Cycle effects are not universal: A case study of urinary C‐reactive protein concentrations in rural Polish and Polish American aamples

Objectives: We need to better understand how the menstrual cycle interacts with other biological systems, such the inflammation and immune response. One way to study this interaction is through C-reactive protein (CRP). Studies of CRP concentrations across the menstrual cycle have been inconsistent. This study explores menstrual cycle CRP variation in two geographically different samples of Polish and Polish American individuals. Methods: Analyses were conducted on 76 Polish and 22 Polish American daily urine samples collected on the first day of menstruation until the start of their next period. CRP, estrone-3-glucuronide, and pregnanediol-3-glucuronide were assayed. Sample-specific linear mixed models were used to examine cycle effects and median CRP concentrations across cycle phases and between the start of menses and remainder of the cycle were compared using Kruskal-Wallace and Dunn tests. Results: Polish and Polish American samples had distinct menstrual cycle CRP phenotypes. The Polish sample did not show cycle effects. The Polish American LMM demonstrated that CRP decreases after the first 3 days of menses (estimate −0.17, t-value −5.2). The KW and Dunn tests supported this. CRP concentrations were higher during the early follicular (median 0.406, p < 0.05), specifically the first 3 days of menstruation (median 0.466, p < 0.01), and lower in the luteal (median 0.277, p < 0.05). Conclusions: Results suggest that changes in CRP during menstrual cycle are not universal across populations. In the Polish American sample, CRP was highest during the early follicular, specifically the first 3 days of menstruation, suggesting a potential relationship between the menstrual cycle and inflammation. © 2025 The Author(s). American Journal of Human Biology published by Wiley Periodicals LLC

Community-level education accelerates the cultural evolution of fertility decline.

Explaining why fertility declines as populations modernize is a profound theoretical challenge. It remains unclear whether the fundamental drivers are economic or cultural in nature. Cultural evolutionary theory suggests that community-level characteristics, for example average education, can alter how low-fertility preferences are transmitted and adopted. These assumptions have not been empirically tested. Here, we show that community-level education accelerates fertility decline in a way that is neither predicted by individual characteristics, nor by the level of economic modernization in a population. In 22 high-fertility communities in Poland, fertility converged on a smaller family size as average education in the community increased-indeed community-level education had a larger impact on fertility decline than did individual education. This convergence was not driven by educational levels being more homogeneous, but by less educated women having fewer children than expected, and more highly educated social networks, when living among more highly educated neighbours. The average level of education in a community may influence the social partners women interact with, both within and beyond their immediate social environments, altering the reproductive norms they are exposed to. Given a critical mass of highly educated women, less educated neighbours may adopt their reproductive behaviour, accelerating the pace of demographic transition. Individual characteristics alone cannot capture these dynamics and studies relying solely on them may systematically underestimate the importance of cultural transmission in driving fertility declines. Our results are inconsistent with a purely individualistic, rational-actor model of fertility decline and suggest that optimization of reproduction is partly driven by cultural dynamics beyond the individual

Factors related to knowledge, attitudes, and behaviors regarding cervical cancer among Yemeni women

Background Cervical cancer (CxCa), although preventable, is still among the most prevalent cancers in women. Mortality from this cancer is high, especially in low-income countries where preventive strategies are often lacking. We studied the knowledge, attitudes, and practices regarding CxCa among Yemeni women. Methods This cross-sectional study was conducted in 2019 among 399 women in five major hospitals in Sanaa, the capital city of Yemen. Data were collected through face-to-face interviews using structured questionnaires. We used logistic regression models to analyze the likelihood of hearing about CxCa, believing that CxCa is treatable and preventable, awareness of the Pap smear test, and ever having this test, in relation to participant’s age, education level, working outside the household, and family history of CxCa. Results Only 66.7% of the women had heard of CxCa. Women with higher education, working outside the household, and with a family history of CxCa were more likely to be aware of CxCa. Working outside the household was the only variable related to a higher likelihood of knowing that CxCa is a treatable and preventable. Furthermore, women with a family history of CxCa were more likely to have knowledge about Pap smear test and were more likely to have Pap smear test in the past. Conclusion This study identified a low awareness of CxCa and its prevention among Yemeni women. In order to reduce the burden of CxCa in Yemen and save women’s lives, it is necessary to raise women’s awareness of this disease, especially among those with lower education and those not involved in work outside their homes

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income&nbsp;countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was &lt;1.1 kg m–2 in the vast majority of&nbsp;countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified

General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7•5 million participants

Background: Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hypertension. Methods: We used data from studies carried out from 1990 to 2023 on BMI, WHtR and hypertension in people aged 20–64 years in representative samples of the general population in eight world regions. We graphically compared the regional distributions of BMI and WHtR, and calculated Pearson's correlation coefficients between BMI and WHtR within each region. We used mixed-effects linear regression to estimate the extent to which WHtR varies across regions at the same BMI. We graphically examined the prevalence of hypertension and the distribution of people who have hypertension both in relation to BMI and WHtR, and we assessed how closely BMI and WHtR discriminate between participants with and without hypertension using C-statistic and net reclassification improvement (NRI). Findings: The correlation between BMI and WHtR ranged from 0·76 to 0·89 within different regions. After adjusting for age and BMI, mean WHtR was highest in south Asia for both sexes, followed by Latin America and the Caribbean and the region of central Asia, Middle East and north Africa. Mean WHtR was lowest in central and eastern Europe for both sexes, in the high-income western region for women, and in Oceania for men. Conversely, to achieve an equivalent WHtR, the BMI of the population of south Asia would need to be, on average, 2·79 kg/m2 (95% CI 2·31–3·28) lower for women and 1·28 kg/m2 (1·02–1·54) lower for men than in the high-income western region. In every region, hypertension prevalence increased with both BMI and WHtR. Models with either of these two adiposity metrics had virtually identical C-statistics and NRIs for every region and sex, with C-statistics ranging from 0·72 to 0·81 and NRIs ranging from 0·34 to 0·57 in different region and sex combinations. When both BMI and WHtR were used, performance improved only slightly compared with using either adiposity measure alone. Interpretation: BMI can distinguish young and middle-aged adults with higher versus lower amounts of abdominal adiposity with moderate-to-high accuracy, and both BMI and WHtR distinguish people with or without hypertension. However, at the same BMI level, people in south Asia, Latin America and the Caribbean, and the region of central Asia, Middle East and north Africa, have higher WHtR than in the other regions. Funding: UK Medical Research Council and UK Research and Innovation (Innovate UK)

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI &lt;18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school&#x2;aged children and adolescents, we report thinness (BMI &lt;2 SD below the median of the WHO growth reference) and obesity (BMI &gt;2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit