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女性退伍军人的生殖健康:2008 年至 2017 年文献的系统评价。

Reproductive Health of Women Veterans: A Systematic Review of the Literature from 2008 to 2017.

机构信息

US Department of Veterans Affairs (VA) Puget Sound Health Care System, Health Services Research and Development (HSR&D) Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, Washington.

Department of Health Services, University of Washington School of Public Health, Seattle, Washington.

出版信息

Semin Reprod Med. 2018 Nov;36(6):315-322. doi: 10.1055/s-0039-1678750. Epub 2019 Apr 19.

Abstract

The literature on the reproductive health and healthcare of women Veterans has increased dramatically, though there are important gaps. This article aims to synthesize recent literature on reproductive health and healthcare of women Veterans. We updated a literature search to identify manuscripts published between 2008 and July 1, 2017. We excluded studies that were not original research, only included active-duty women, or had few women Veterans in their sample. Manuscripts were reviewed using a standardized abstraction form. We identified 52 manuscripts. Nearly half (48%) of the new manuscripts addressed contraception and preconception care ( = 15) or pregnancy ( = 10). The pregnancy and family planning literature showed that (1) contraceptive use and unintended pregnancy among women Veterans using VA healthcare is similar to that of the general population; (2) demand for VA maternity care is increasing; and (3) women Veterans using VA maternity care are a high-risk population for adverse pregnancy outcomes. A recurrent finding across topics was that history of lifetime sexual assault and mental health conditions were highly prevalent among women Veterans and associated with a wide variety of adverse reproductive health outcomes across the life course. The literature on women Veterans' reproductive health is rapidly expanding, but remains largely observational. Knowledge gaps persist in the areas of sexually transmitted infections, infertility, and menopause.

摘要

关于女性退伍军人生殖健康和医疗保健的文献数量显著增加,但仍存在重要空白。本文旨在综合近期关于女性退伍军人生殖健康和医疗保健的文献。我们更新了文献检索,以确定 2008 年至 2017 年 7 月 1 日期间发表的手稿。我们排除了非原始研究、仅包括现役女性或样本中退伍军人人数较少的研究。使用标准化的摘要表格对论文进行了审查。我们确定了 52 篇论文。近一半(48%)的新论文涉及避孕和备孕护理( = 15)或妊娠( = 10)。妊娠和计划生育文献表明:(1)在使用 VA 医疗保健的女性退伍军人中,避孕措施的使用和意外怀孕与普通人群相似;(2)对 VA 产妇护理的需求正在增加;(3)使用 VA 产妇护理的女性退伍军人是不良妊娠结局的高风险人群。所有主题都反复出现的一个发现是,终生性侵犯和心理健康状况在女性退伍军人中非常普遍,并且与整个生命周期中各种不良生殖健康结果相关。关于女性退伍军人生殖健康的文献正在迅速增加,但仍主要是观察性的。在性传播感染、不孕和更年期等领域仍存在知识空白。

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