Publications by authors named "Rachel P Urrutia"
Introduction: Pregnancy-associated complaints are a common reason for emergency department visits for women of reproductive age. Emergency department utilization during pregnancy is associated with worse birth outcomes for both mothers and infants. We used statewide North Carolina emergency department surveillance data between 2016 and 2021 to describe the sociodemographic factors associated with the use of emergency department for pregnancy-associated problems and subsequent hospital admission.
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- Neural tube defects are prevalent birth defects in the US, prompting the need for research on preventive measures, particularly folic acid supplementation.
- A comprehensive review examined studies from 2015 to 2021, focusing on the benefits and risks of folic acid in preventing these defects, involving over a million participants.
- Findings indicated a significant reduction in the risk of neural tube defects with folic acid use before and during pregnancy, although this effectiveness was noted primarily in more recent years and requires careful interpretation of possible associated harms.
Racial and Ethnic Differences in Self-Reported COVID-19 Exposure Risks, Concerns, and Behaviors Among Diverse Participants in the Women's Health Initiative Study.
J Gerontol A Biol Sci Med Sci
December 2023
Background: Racial and ethnic disparities in coronavirus disease 2019 (COVID-19) risk are well-documented; however, few studies in older adults have examined multiple factors related to COVID-19 exposure, concerns, and behaviors or conducted race- and ethnicity-stratified analyses. The Women's Health Initiative (WHI) provides a unique opportunity to address those gaps.
Methods: We conducted a secondary analysis of WHI data from a supplemental survey of 48 492 older adults (mean age 84 years).
Background: The Billings Ovulation Method®(the Billings Method) is a fertility awareness-based method (FABM) of family planning that relies on the observation of patterns of fertility and infertility based on vulvar sensations and appearance of discharges. This allows people to choose when to have intercourse, depending on whether they want to avoid or achieve pregnancy. Few studies have documented user experiences with FABMs.
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- The study aimed to explore reproductive health care experiences of Black and Native American women with chronic conditions, focusing on how to improve care through patient-centric strategies.
- Conducted through virtual focus groups in North Carolina, 34 women shared their experiences, revealing key themes like distrust in providers, lack of knowledge among healthcare staff, and the emotional toll of navigating their health.
- The findings led to six proposed strategies for improvement, such as enhancing care coordination, better training for providers, and creating materials that support patient advocacy and education.
Article Synopsis
- The study aimed to evaluate the effectiveness of fertility awareness-based methods for preventing pregnancy in the postpartum period, considering both breastfeeding and non-breastfeeding individuals.
- It involved a systematic review of various studies, assessing their quality and outcomes, with a focus on those that included at least 50 participants using specific methods to avoid pregnancy post-childbirth.
- The findings revealed that while some data was available, the overall quality of evidence was low, indicating a need for more high-quality research to better understand the effectiveness of these methods for postpartum individuals.
One key strategy to reduce maternal morbidity and mortality involves optimizing prepregnancy health. Although nine core indicators of preconception wellness (PCW) have been proposed by clinical experts, few studies have attempted to assess the preconception health status of a population using these indicators. We conducted a retrospective chart review study of patients who received prenatal or primary care, identified by pregnancy-related ICD-10 codes, at either of two health systems in geographically and socioeconomically different areas of North Carolina between October 1, 2015, and September 30, 2018.
View Article and Find Full Text PDFIntroduction: Hypertensive disorders of pregnancy (HDP) are rising in prevalence, and increase risk of adverse maternal and fetal outcomes. Physiologic changes occur during pregnancy that alter drug pharmacokinetics. However, antihypertensive drugs lack pregnancy-specific dosing recommendations due to critical knowledge gaps surrounding the extent of gestational changes in antihypertensive drug pharmacokinetics and underlying mechanisms.
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- The study analyzed the link between hysterectomy and bilateral salpingo-oophorectomy (BSO) and the risk of diabetes in postmenopausal women, using data from the Women's Health Initiative which tracked 67,130 women from 1993 to 1998.
- Results showed that women who had a hysterectomy had a 13% higher risk of developing diabetes compared to those who did not have the procedure, regardless of whether they also underwent BSO.
- Despite the findings, the study concluded that the increased risk of diabetes wasn't linked to early loss of ovarian estrogens, suggesting that other factors, like the reasons for the surgery, might explain the diabetes risk.
Importance: More than two-thirds of US women are overweight or obese, placing them at increased risk for postmenopausal breast cancer.
Objective: To investigate in this secondary analysis the associations of overweight and obesity with risk of postmenopausal invasive breast cancer after extended follow-up in the Women's Health Initiative (WHI) clinical trials.
Design, Setting, And Participants: The WHI clinical trial protocol incorporated measured height and weight, baseline and annual or biennial mammography, and adjudicated breast cancer end points in 67 142 postmenopausal women ages 50 to 79 years at 40 US clinical centers.
Article Synopsis
- * They showed basic knowledge of CVD risk factors and healthy lifestyle recommendations, but often received insufficient guidance from healthcare providers.
- * Misunderstandings and incorrect information were common, which sometimes resulted in less healthy choices, highlighting the need for better education and resources for these women.
Oral contraceptive use for the primary prevention of ovarian cancer.
Evid Rep Technol Assess (Full Rep)
June 2013
Article Synopsis
- The study aimed to evaluate the risks and benefits of oral contraceptives (OCs) in relation to ovarian cancer prevention, analyzing data from various medical sources published between 1990 and 2012.
- Findings showed that OC use significantly reduced the incidence of ovarian, colorectal, and endometrial cancers, but it was associated with a slight increase in breast cancer risk and higher cervical cancer risk for women with HPV.
- The analysis also indicated that the longer the duration of OC use, the greater the protective effect against ovarian cancer, while there was a notable risk for vascular complications among current users of OCs.
Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: a systematic review.
Cancer Epidemiol Biomarkers Prev
November 2013
Article Synopsis
- Oral contraceptives are linked to varying cancer risks, with some studies suggesting they may increase the likelihood of breast cancer while decreasing the risk of cervical, colorectal, and endometrial cancers.
- A systematic review included 44 studies on breast cancer and various studies on other cancers, conducting randomized analyses to assess the effects of oral contraceptive use.
- Results indicated a slight increase in breast cancer risk (OR 1.08), particularly with recent use, while colorectal (OR 0.86) and endometrial cancer (OR 0.57) risks were significantly lower among users.
Article Synopsis
- - The study aimed to determine how much using oral contraceptive pills (OCPs) lowers the risk of ovarian cancer and if specific factors like the type of pill or how long it's used influence this risk reduction.
- - Researchers reviewed over 6,400 studies and included 55 that met their criteria, finding a significant decrease in ovarian cancer rates among those who used OCPs, with odds ratio indicating a 27% lower risk compared to non-users.
- - Results indicated that using OCPs for 10 years or more can reduce ovarian cancer incidence by over 50%, suggesting that OCPs provide meaningful protection against ovarian cancer with a lifetime risk reduction of about 0.54%.
Unlabelled: Abstract Background: Identifying and treating chronic diseases, their precursors, and other cardiovascular disease (CVD) risk factors during family planning visits may improve long-term health and reproductive outcomes among low-income women. A cross-sectional study design was used to describe the prevalence of chronic diseases (hypertension, high cholesterol, and diabetes), their precursors (pre-hypertension, borderline high cholesterol, and pre-diabetes), and related CVD risk factors (such as obesity, smoking, and physical inactivity) among low-income women of reproductive age.
Methods: Prevalence of chronic diseases, their precursors, and related CVD risk factors were assessed for 462 out of 859 (53.
Purpose Of Review: Vitamin D is part of a complex steroid hormone system long known to be involved in bone metabolism. Recently, vitamin D has been implicated in physiologic processes as diverse as vascular health, immune function, metabolism and placental function. This review summarizes the current evidence for the role of vitamin D in pregnancy and perinatal outcomes A systematic review of articles published in PubMed between May 2010 and October 2011 was undertaken using key words for vitamin D and pregnancy.
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