Aim: This study aimed to investigate sex differences in the occurrence of Esophagogastric Variceal Re-Bleeding (EVR), Portal Vein Thrombosis (PVT), and Hepatocellular Carcinoma (HCC) among patients with cirrhosis. Methods: Between April 2012 and April 2022, 797 patients diagnosed with Cirrhotic Portal Hypertension (CPH) were enrolled at the Hepatobiliary and Pancreatic Center and followed retrospectively for up to 10 years. Quantitative analyses were conducted using logistic regression models, supplemented by subgroup interaction analyses, to elucidate the impact of sex differences on disease prognosis. Additionally, the restricted cubic spline technique was employed to further investigate the nonlinear relationship. Results: Laparoscopic splenectomy and azygoportal disconnection (LSD) demonstrated a more significant protective effect in females in reducing the risk of EVR. Conversely, an increased portal vein diameter significantly heightened the risk of PVT in both males and females, with a more pronounced effect observed in male patients (OR=1.21, P=0.015). In predicting the occurrence of HCC, an elevated lymphocyte ratio emerged as a significant risk factor specifically in male patients, while LSD exhibited a protective effect. In female patients, however, the protective effect of LSD was noted exclusively. Lymphocyte levels may have obscured the protective effect of LSD in male patients, particularly in the subgroup of males receiving LSD treatment. A significant non-linear relationship between lymphocyte levels and HCC was also identified (P=0.004). Discussion: Sex‑specific differences were evident across all endpoints. LSD protected against EVR in both sexes, with a more pronounced effect in females, while larger portal vein diameter conferred greater PVT risk in males. For HCC, LSD showed clear protection in females, but in males this benefit was masked by elevated lymphocyte levels, which exhibited a non‑linear relationship with HCC. These findings highlight the interplay between sex, immune status, and treatment response, supporting the need for sex‑tailored management in decompensated cirrhosis. Conclusion: The observation that males and females demonstrate significant sex differences in various prognostic outcomes of CPH underscores the importance of sex-specific characteristics in the prognosis of cirrhotic disease.
Background: Varicose veins (VV), characterized by swollen veins that disrupt blood flow, pose health and aesthetic concerns. The estimated regional prevalence is 45.6% in women. However, there is a lack of national references about the VV awareness levels among adult women in the UAE. Materials and Methods: This cross-sectional questionnaire-based study included 472 females aged between 18 and 50 years to assess awareness about the risk factors, complications, prevention, and treatment of VV in the UAE. The total awareness level was evaluated on a 31-point scale and was classified as high (>70%), intermediate (40-70%), and limited awareness (<40%). Results: The participants included students (38.8%), housewives (27.3%), employed (24.8%), and unemployed (9.1%). About 50% of women reported standing daily for more than 4 hours, while 33.7% reported no physical activity. The overall knowledge was intermediate in 74.2% of the participants. The results suggest significant knowledge gaps, with 56.7% having intermediate knowledge of “risk factors”, 47.6% demonstrating poor awareness of “complications”, and 57.7% achieving high knowledge of “prevention and treatment”. Medical/Health study fields, Sedentary lifestyle, previous diagnosis of VVs, and awareness of VVs are independent predictive factors associated with increased total knowledge about VVs. Age, education, field of occupation, or working hours were not associated with knowledge disparities. Although most participants demonstrated moderate awareness, considerable gaps still exist, particularly regarding the complications of VV. Discussion: We identified a moderate-to-poor level of awareness, which aligns with regional and international levels among women. Uniquely, our cohort showed higher awareness among women reporting low physical activity. Such a finding may be alarming, as these women might give less attention to VV. Conclusion: Our findings emphasize the unique context of VV awareness among women in the UAE. This calls for targeted public health campaigns to promote preventive strategies and improve overall regional health outcomes.
Introduction: Non-invasive prenatal testing (NIPT) is widely used for early screening of chromosomal abnormalities, including Down syndrome (DS). However, data on public knowledge and attitudes toward NIPT and DS in Saudi Arabia, particularly the Madina region, remain limited. Methods: A cross-sectional online survey was conducted between April and May 2025 to assess knowledge and attitudes toward NIPT and DS among 678 Saudi adults using a Madina-centered convenience sampling. Results: Participants were predominantly urban (97.5%) and highly educated (58.8%). Only 35.4% had heard of NIPT, and 9% cited healthcare professionals as their main information source. Approximately 40% identified the appropriate timing of DS screening, and 42.8% incorrectly believed that a positive NIPT result was diagnostic. A total of 57% believed DS was curable or were unsure, and 38% attributed its cause to environmental factors. Overall, 65.8% expressed willingness to undergo NIPT, although cost (34%) and anxiety (32%) were common concerns. Knowledge and attitudes were moderately correlated (r= 0.364, p< 0.001). In multivariable analyses, knowledge was independently associated with the number of children (β= 0.21, p= 0.006) and income (β= 0.15, p= 0.002), whereas attitudes were associated with age (β= −0.28, p< 0.001), consanguinity (β= −0.13, p= 0.036), and marital status (β= 0.18, p= 0.008). The explanatory power of the model was modest (adjusted R² = 0.047–0.102). Discussion: Substantial knowledge gaps and variability in attitudes persisted even among predominantly urban and educated participants. Conclusion: These findings suggest unmet educational and counseling needs; however, given the convenience sampling approach, the results should be interpreted as descriptive of an urban, highly educated group rather than representative of the general population.
Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects about 8-13% of women worldwide. Many cases remain unrecognized because clinical features vary across individuals. In addition to reproductive effects, PCOS is also associated with metabolic and cardiovascular complications. Materials and Methods: This cross-sectional study included 97 women of reproductive age recruited through social media platforms. Data were collected using a self-reported online questionnaire. When available, participants reported prior clinical measurements and test results, including BMI, ultrasound findings, and hormonal or metabolic laboratory results. No new examinations or tests were performed for this survey. results: Results: Of the total sample, 22.6% (n=22) were diagnosed with PCOS. A significant association was found between PCOS and obesity (42.9% vs. 11.9%, p=0.007), irregular menstrual cycles (52.4% vs. 13.4%, p<0.001), and infertility (70% vs. 9.1%, p<0.001). Hormonal profiles revealed elevated LH (p=0.005) and FSH (p=0.001) among PCOS participants. Non-significant findings included associations between PCOS and exercise habits (p=0.878) and psychological diseases (p=0.889). Results: Of the 97 participants, 22 (22.6%) reported a diagnosis of PCOS. PCOS was more frequent among participants with obesity (42.9% vs. 11.9%, p = 0.007), irregular menstrual cycles (52.4% vs. 13.4%, p < 0.001), and infertility (70.0% vs. 9.1%, p < 0.001). Participants with PCOS also had higher LH and FSH levels (p = 0.005 and p = 0.001, respectively). Discussion: These findings suggest that, within this sample, PCOS was most strongly associated with obesity, menstrual disturbance, and infertility. Similar patterns have been reported in other populations. However, the findings should be interpreted cautiously because the data were self-reported and the sample was relatively small and non-random. Conclusion: In this sample, PCOS was associated with reproductive problems and obesity. These findings support the need for greater awareness, earlier recognition, and lifestyle-based approaches, particularly weight management. Larger population-based studies are needed to better define the burden of PCOS and inform targeted management strategies.
Ovarian cancer (OC) ranks as the third most frequently occurring gynecological cancer and is associated with a high rate of mortality despite advances in conventional therapies. Current diagnostic and treatment strategies lack specificity, sensitivity, and long-term clinical effectiveness. Recently, nanotechnology has aimed to overcome these limitations. Patients have a poor prognosis mainly due to late diagnosis, with a high rate of therapy resistance and recurrence. Due to the shortcomings of conventional drug therapies and diagnostic strategies, alternative nanotechnology-based approaches have been developed to overcome the drawbacks of typical methods. This paper provides an updated and comparative analysis of multiple nanoparticle platforms, including lipidbased, inorganic, and polymeric nanoparticles, as well as biosensors, for OC treatment and diagnosis. Nanotechnology has evolved as a promising strategy for targeted therapeutic delivery, enhancing efficacy and safety while reducing side effects and resistance associated with typical treatments. Nanotechnology also addresses challenges, such as early-stage disease detection and the identification of tumor biomarkers with high specificity and sensitivity. This article also covers recent and high-impact studies. This review provides a critical evaluation of challenges, including toxicity, targeting efficiency, and stability issues, as well as regulatory barriers that hinder the clinical progress of these nanotechnologies.
Background: Gestational Diabetes Mellitus (GDM) is a metabolic disorder that develops during pregnancy. Research indicates that sleep disturbances are a contributing factor to GDM. Objectives: This study investigates the effect of Cognitive-Behavioral Therapy for Insomnia (CBTI) on sleep quality and Glycemic Control in GDM. Methods: This clinical trial involved the selection of 80 women diagnosed with gestational diabetes mellitus (GDM) through convenience sampling from healthcare centers in Arak, Iran, after obtaining their written informed consent. The participants were divided into two groups: the intervention group (n=40) underwent six weekly sessions of cognitive behavioral therapy for insomnia (CBT-I), each session lasting between 30 and 45 minutes, while the control group (n=40) received standard prenatal care. Both groups were assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and their fasting blood sugar (FBS) and two-hour postprandial glucose levels were recorded at the start of the study and one month after the intervention. The data collected were analyzed using T-tests, chi-square tests, analysis of covariance (ANCOVA), and both independent and paired ttests. Results: The study revealed significantly improved sleep quality in the intervention group compared to the control group after the intervention (8.19 vs. 10.44; p=0.002). Additionally, mean fasting blood sugar was 93.68 ± 7.03 mg/dl in the intervention group versus 102.29 ± 7.32 mg/dl in the control group( p=0.001). The mean two-hour postprandial glucose level was 112.83 ± 2.02 mg/dl in the intervention group versus 118.32 ± 1.65 mg/dl in the control group ( p=0.001). Discussion: The study indicated that this intervention not only had positive effects on sleep quality, but also contributed to lowering blood glucose. Conclusion: This study suggests that the CBT-I can be used as a complementary method to enhance the quality of sleep and glycemic control in this population.
Introduction: Korean women experience unpleasant odors caused by women’s health issues, such as menstruation and vaginitis. To relieve these discomforts and increase confidence, there is growing interest in and use of inner perfumes to mask odors. Therefore, this study aims to verify the preferences and perceptions of Korean women regarding the use of inner perfumes. Methods: This study collected data through an online survey of a total of 507 Korean women in their 20s to 40s. All study participants were aware of the purpose of the study, voluntarily participated, and agreed. The collected data were statistically processed using the Statistical Package for the Social Sciences, version 25. As a major analysis method, exploratory factor analysis was conducted to identify the potential structure of the measurement tool. In addition, Cronbach's ⍺ coefficient was calculated to verify the internal consistency and reliability of the measurement variables. The significance level of all statistical tests was set at 5%. Results: A study on the validity and reliability of preference and perception scales found that quality, brand, price, price, and advertising were the most important to the study participants, and the higher the product preference quality and advertising, the greater the preference. Discussion: Recognition of the use of inner-perfume suggests a high rate of use among married women in their 40s and those living in large cities, and that women's social status has changed as a cause of increased use. With product quality (t=7.458) and advertising (t=5.738) having a significant positive impact on preference and purchase over price (p<.001), safe product research and improved awareness of women's reproductive care education are needed considering the sensitivity of the vulva. Conclusion: Korean women tend to value the quality of inner perfume, expectations for reproductive health care, and positive about the use of inner perfume. This study suggests that it can contribute to the improvement of women's quality of life. It is meaningful to provide basic data for women's practical development of reproductive care products if it improves women's awareness of inner perfume and secures data on product satisfaction.
Background:: Vulvar fibroepithelial polyps are common benign vulvar lesions, mainly originating from the submucosal layer. Usually, they are small and asymptomatic; however, they can rarely reach sizes exceeding 5 cm, at which point they are classified as “giant”. Differential diagnosis includes angiomyxoma, angiomyofibroblastoma, sarcoma, and squamous cell carcinoma. Case Presentation:: In May 2024, a 30-year-old multiparous woman (G4P4) presented with a complaint of vulvar burning. She reported a vulvar mass present since her last childbirth. At clinical examination, a 7.5 cm pedunculated, soft, epithelialized mass was noted on the right major labium. The patient elected to undergo surgical removal of the lesion. Under local-regional anesthesia, the peduncle was clamped and excised using bipolar energy. The final histopathological evaluation identified a fibroepithelial polyp characterized by a hyperplastic squamous epithelium with acanthosis. The postoperative course was uneventful, and no recurrence has been identified after 18 months. Conclusion:: Fibroepithelial polyps are rare benign tumors characterized by a possible grow to over 20 cm. It is important to make a differential diagnosis from malignant lesions and perform a complete excision surgery to reduce the possibility of recurrence.
Introduction: Sandwich generation caregivers, simultaneously responsible for aging parents and children, face a culturally shaped and complex caregiving process. Despite their growing number, little is known about this phenomenon in Iran. This study explored the caregiving process among sandwich generation caregivers. Methods: A qualitative grounded theory study was conducted in Tehran (2021–2022) with 18 female caregivers recruited through purposive and theoretical sampling. Data were collected via semistructured interviews and field notes and analyzed using Corbin and Strauss’s (2015) approach with MAXQDA 2020. Results: Analysis revealed 16 main categories, highlighting challenges, such as cumulative caregiving burden, intergenerational conflicts, neglect of self and children, alongside growth-related outcomes like resilience and caregiving expertise. “Sacrifice” emerged as the core concept shaping caregivers’ strategies and outcomes. Conclusion: Multigenerational caregiving disrupts family balance yet also fosters adaptation and growth. Recognizing the central role of sacrifice can inform policies and interventions tailored to the needs of sandwich generation caregivers.
Background:: Endometriosis affects 1 in 10 women of childbearing age. White middleclass women with pelvic pain are over-represented in research and clinical settings, while little is known about the experiences of women from other ethnic and sociodemographic groups. Methods:: We conducted community listening workshops, which facilitated discussions regarding people’s experiences and understanding of pelvic pain, including endometriosis. Researchers encouraged reflections on healthcare interactions and health beliefs from the perspective of women from the global majority ethnic groups living in the greater Bristol area. A total of 54 women from Somali, Black African, and Black Caribbean backgrounds participated, with the support of community leaders who acted as cultural and language interpreters. Notes from the workshops underwent thematic analysis, with triangulation from the research team and group leaders Results:: All 54 participants raised concerns about racial bias influencing their care and health outcomes relating to pelvic pain. Inductive thematic analysis led to four key themes, which were consistent across participant groups. First, pelvic pain is understood in its cultural context; in many cases, female pain is normalised. Second, there is limited culturally appropriate education or material on endometriosis, third, patients had low confidence in healthcare professionals, and fourth, this leads to a higher threshold for seeking medical care and a potential for poorer health outcomes due to delayed presentation. Discussion:: In keeping with other studies, we found that participant attitudes towards pelvic pain and other symptoms of endometriosis were influenced by cultural, ethnic, and religious factors. There may be stigma or cultural taboo around menstrual problems, which can originate from women and healthcare professionals alike, leading to dismissal or normalisation of pelvic pain. Conclusion:: These workshops demonstrate clear unmet informational and relational needs for women from global majority ethnic groups with endometriosis and pelvic pain. Co-produced educational materials for women were a core study output. However, the disparities highlighted must also be addressed through impactful clinician cultural training and further research to identify additional ways to bring about meaningful change.
Introduction: Pregnancy and childbirth are distinct periods in a woman's life that involve significant hormonal and physical changes. These changes can impact sexual satisfaction for both partners. The present study aimed to evaluate the effect of couple-centered counseling, based on the EX-PLISSIT model, on the sexual satisfaction of couples during pregnancy in comprehensive health centers in Hamadan city in 2021. Methods: A randomized controlled trial was conducted in Hamadan city in 2021, involving 30 couples. The sample size was estimated based on information from previous studies and divided into two groups. Participants were assigned to either the intervention or control group using a randomized block design. The intervention group received four weekly counseling sessions based on the EX-PLISSIT model, with one face-to-face session per week for each couple. The control group received routine antenatal care in accordance with local guidelines. Sexual satisfaction was assessed using Linda Berg's Sexual Satisfaction Scale. Data analysis was performed using Stata version 13, including descriptive statistics and inferential tests, such as paired t-tests, independent t-tests, and ANCOVA. The significance level for all statistical tests was set at p < 0.05. Results: ANCOVA results, controlling for duration of marriage and pre-intervention scores, showed that the mean (SD) sexual satisfaction score in women was 57.21 (2.18) in the intervention group and 54.81 (2.18) in the control group, indicating a statistically significant difference (Cohen’s d = 1.24; 95% CI: 0.69–1.79; p < 0.001). In men, after adjusting for the same variables, the mean (SD) sexual satisfaction score was 60.95 (1.56) in the intervention group and 59.55 (1.56) in the control group, also showing a significant difference (Cohen’s d = 0.89; 95% CI: 0.36–1.42; p = 0.001). Conclusion: The findings of this study suggest that EX-PLISSIT-based counseling has a positive effect on couples' sexual satisfaction during pregnancy. Implementing this counseling model may be recommended as a strategy to enhance sexual satisfaction in expectant couples.
Background: Intrauterine devices (IUDs) such as copper and levonorgestrel (LNG) are widely used as reversible contraceptive methods. Their potential effects on women's sexual function and quality of life (QoL) remain inadequately explored. This study aimed to compare the impact of copper and LNG-IUDs on sexual function and QoL among women of reproductive age at Jahrom Health Centers. Materials and Methods: A cross-sectional study was conducted involving 84 women attending Jahrom Health Centers from October 2023 to April 2024; 42 women used copper IUDs and 42 used LNG-IUDs. Data collection involved standardized questionnaires: the Female Sexual Function Index (FSFI) and the Sexual Quality of Life-Female (SQOL-F). Statistical analyses compared total scores and subdomains between groups using independent t-tests, with significance set at p < 0.05. results: The mean FSFI total score was 82.48±17.99 for the copper IUD group and 81.26±15.73 for the LNG-IUD group (p=0.743), indicating no significant difference in sexual function. The LNG-IUD group demonstrated a higher mean SQOL-F score (52.00±10.61) compared to the copper IUD group (48.55±12.15), but this difference was not statistically significant (p=0.169). Subdomain analyses of FSFI—including arousal, lubrication, orgasm, satisfaction, pain, and sexual desire—revealed no significant differences between the two groups (p>0.05). Results: The mean FSFI total score was 29.69 ± 0.921 for the copper IUD group and 29.87 ± 0.921 for the LNG-IUD group (p = 0.923), indicating no significant difference in sexual function. The LNG-IUD group demonstrated a higher mean SQOL-F score (52.00 ± 10.61) compared to the copper IUD group (48.55 ± 12.15), but this difference was not statistically significant (p = 0.169). Subdomain analyses of FSFI—including arousal, lubrication, orgasm, satisfaction, pain, and sexual desire— revealed no significant differences between the two groups (p > 0.05). Discussion: No significant differences were observed between copper IUD and LNG-IUD users in total FSFI and SQOL-F scores or in any FSFI domains (p > 0.05). These findings suggest that both contraceptive methods have comparable effects on women’s sexual function and sexual quality of life. Conclusion: This study found no significant differences in sexual function or sexual quality of life between users of copper and levonorgestrel IUDs. The results indicate that both types of IUDs appear to have a comparable impact on these aspects of women's health, highlighting the need for personalized contraceptive counseling based on women's preferences and individual experiences rather than assumed effects on sexual well-being.
Introduction: Maternal and pregnancy health is one of the vital priorities of societal health, and a complicated combination of biological, environmental, psychological, and social factors condition. Although maternal mortality rates have decreased, and prenatal care has been extended, systemic disparities continue to emerge, and new health issues are developing on the globe demand alternative models of maternal health evaluation and intervention. Methods: PubMed, Scopus, Web of Science, and Google Scholar were used to conduct a detailed literature review of publications from 2000 to 2025. The study included peer-reviewed articles, clinical guidelines, and policy documents on the subject of maternal health strategies, digital health solutions, environmental and occupational risks, and mental health in pregnancy. The consideration of equity was in place, involving studies conducted in the global south and diverse populations. Limitations were non-English publications, non-editorials, and research that were not related to maternal or pregnancy outcomes. The data were collected, condensed, and classified under thematic themes of healthcare innovations, environmental exposures, and community engagements. Results: There were five thematic drivers of maternal health outcomes identified. The models of digital and individualized care, such as telemedicine and remote monitoring, enhance access, allow early risk detection, and continuity of care, e.g., virtual prenatal visits, wearable health monitoring devices, and symptom-tracking applications during high-risk pregnancies. The predisposing factors affecting preterm birth, hypertensive disorders, and fetal growth retardation include environmental exposures, including air pollution, endocrine-disrupting chemicals, high temperatures, and climaterelated infections. Psychological and social influences such as chronic stress, absence of social support, intimate partner violence, and socioeconomic disadvantage continue to be good predictors of poor maternal and neonatal outcomes. Occupational risks are disproportionately faced by women in the informal or low-wage sector, whereas rare medical conditions can be treated only through a multidisciplinary approach. Discussion: Results identify the significance of holistic, technology-based, and equity-driven solutions to maternal healthcare. There is a great potential in telemedicine and the digital innovations to close the access gaps and make the care personalized, and it is important to consider the environmental, occupational, and psychosocial factors. The timing between births and maternal health changes to preceding births is needed to maximize the outcome, especially in an environment where there is less birth spacing or social restrictions on births. Conclusion: This review highlights the necessity of multidisciplinary, community-based, and comprehensive approaches to enhance the health outcomes of mothers in the world. The future studies need to focus on the underrepresented groups, factors in the environment and at work, and use the advancements of digital technologies to promote equitable and sustainable maternal healthcare.
no abstract because it is a letter to editor
Background: Lower-Limb Lymphedema (LLL) is a chronic and debilitating condition that may develop after treatment for gynecologic cancers. Despite its impact on physical function and quality of life, evidence supporting standardized preventive strategies remains limited. Complex Decongestive Therapy (CDT) is among the preventive and rehabilitative interventions used and includes a structured, multimodal physiotherapy program. This narrative review aims to summarize the current evidence on the prevention and secondary management of LLL. Materials and Methods: A literature search was conducted in PubMed for studies published between 2017 and 2025 using keywords related to “gynecologic cancer,” “lymphedema,” “prevention,” and “exercise.” Five Randomized Controlled Trials (RCTs) were included. Studies focusing on breast cancer-related lymphedema were excluded. Results: Early preventive interventions initiated after surgery or during chemotherapy reduced the incidence of lymphedema or prolonged the lymphedema-free interval. In patients with established lymphedema, multimodal rehabilitation improved limb volume, physical function, symptoms, and quality of life. Follow-up ranged from 4 weeks to 5 years. Discussion: This narrative review highlights the important role of rehabilitative and preventive interventions in the management of lower-limb lymphedema in patients with gynecologic cancers. As reported in the literature, early postoperative CDT significantly prolonged lymphedema-free survival and reduced the incidence of lymphedema (p < 0.05). Exercise and physiotherapy may improve both patient well-being and functional outcomes. Conclusion: Preventive and rehabilitative strategies, despite the heterogeneity of protocols and study designs, appear important for reducing risk and improving quality of life, and early intervention seems crucial. Future research should focus on larger, high-quality trials with standardized diagnostic criteria and outcome measures to establish evidence-based prevention protocols.
Introduction/Objective: Polycystic Ovarian Syndrome (PCOS) is considered a heterogeneous disorder of clinical and biochemical manifestations. There is little evidence confirming the correlation between PCOS and Preeclampsia (PE), as some suggest that both have shared risk factors. Therefore, this study aimed to determine the risk of developing PE in pregnant women with a history of PCOS in addition to other pregnancy complications. Methods: A retrospective case-control study included 200 singleton pregnancies presented at delivery, of which 100 were diagnosed with PE (cases) and the other 100 without PE (controls), at the Kirkuk Maternity Teaching Hospital, Kirkuk, Iraq, from the 1st April 2023 to 1st April 2025. Demographic information, PCOS history, pregnancy complications, and status of the current delivery were used to analyze the risk of PE and pregnancy complications in women with PCOS. Results: In comparing to control group, cases were significantly older (33.3 ± 5.2 vs. 31.4 ± 2.3 years, p=0.002), had higher body mass index (26.7 ± 5.0 vs. 24.4 ± 1.8 kg/m2, p< 0.001), multiple pregnancies (10% vs. 0%, p=0.001), Assisted Reproductive Technology (ART) with ovarian stimulation (31% vs. 19%, OR=1.92, 95% CI: 1.00-3.68, p=0.049), and showed more PCOS-related features, including menstrual irregularity (33% vs. 14%, OR=3.06, 95% CI: 1.50-6.23, p=0.002) and polycystic ovaries on ultrasound (37% vs. 20%, OR=2.33, 95% CI: 1.24-4.38, p=0.008). PCOS prevalence was higher in cases than controls (67% vs. 57%, OR=1.53, 95% CI: 0.86-2.72, p=0.145), but the association was not significant after adjustment (OR=1.47, 95% CI: 0.80-2.70, p=0.218). Cases had significantly increased risks of preterm birth (adjusted OR=13.45, 95% CI: 1.67-7.12, p=0.001) and gestational diabetes mellitus (GDM) (adjusted OR=2.89, 95% CI: 0.92-9.08, p=0.006). Discussion: Patients’ age, weight, use of ART with ovarian stimulation, together with menstrual irregularity and polycystic ovaries, were identified as risk factors for PE development. Conclusion: Concurrent PCOS and PE were significantly associated with patients’ age, body mass index, and menstrual irregularities. Also, these conditions increase the risk of preterm birth and GDM.
Background: Antenatal Depression (AD) is associated with sociocultural, economic, and structural stressors and remains underdiagnosed across Middle Eastern and Arabic-speaking countries. Dearth of empirical evidence limits coordinated prevention and service planning. Methods: A scoping review was conducted across five databases (Scopus, Web of Science, PubMed, EBSCOhost, Cochrane Library). Searches were completed on 10 July 2025. Eligible studies (2020–2025) reported factors associated with AD and/or health-promotion strategies among pregnant women in Middle Eastern/Arabic-speaking countries. Screening, data charting, and thematic synthesis followed PRISMA-ScR guidance. Meta-analysis was considered but deemed infeasible due to heterogeneity in designs and outcomes. Results: Fifty studies (predominantly cross-sectional) were included, from which frequently reported correlates included psychological vulnerability, poor social support, unintended pregnancy, and socioeconomic strain. Displacement and conflict exposure intensified risk where reported. 41% of studies mentioned health promotion, largely limited to screening recommendations, with minimal real-world implementation evaluation. Discussion: AD in this region reflects the interaction of psychological, social, and structural stressors. Nutrition, adverse childhood experiences, and partner mental health emerged as underexamined contributors. Health-promotion research remains largely descriptive, with limited attention to implementation fidelity and sustainability. Conclusion: Strengthening maternal mental health promotion in Middle Eastern and Arabicspeaking contexts requires integrated screening, clear referral pathways, culturally adapted counselling options, and longitudinal research to inform scalable policy and service planning.
