Contemporary OB/GYN week in review: Abortion access, menopause impact, and more

2025-04-11 - 2025-04

Abortion access limited for majority of US teen girls
A new study has found that two-thirds of teenage girls in the United States live in states with abortion bans, strict gestational limits, or parental involvement laws that may restrict their ability to access abortion services. The analysis highlights how recent legal changes, particularly after the 2022 Supreme Court decision in Dobbs v. Jackson Women’s Health Organization, are affecting adolescents across the country.

The Dobbs decision overturned the constitutional right to abortion, allowing individual states to set their own policies. As a result, about half of all reproductive-age women now live in states that ban or severely limit abortion access. While much of the public discussion has focused on adults, adolescents face unique challenges that can further limit their access to care, including legal, logistical, and financial barriers.

"Minors are often targeted by restrictive policies and less able to use routes to abortion care common for adults–traveling to another state or using telehealth–leaving them disproportionately impacted," said Laura Lindberg, PhD, professor, Rutgers School of Public Health. "Without access to abortion, these girls have lost the ability to control their lives and their futures."

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Shayna Mancuso, DO, highlights the real impact of menopause
The Menopause Experience and Attitudes Study, as explained by Shayna Mancuso, DO, FACOG, from Astellas Pharma, is a comprehensive, bi-yearly global research initiative designed to better understand societal perceptions, individual experiences, and the persistent stigma surrounding menopause and perimenopause.

Conducted by Astellas in collaboration with global menopause experts and advocates, the study collected data from approximately 13,800 participants across 6 countries. Notably, each country contributed approximately 2,300 participants, with the US segment focusing on 1,800 women aged 40 to 55 years.

The study yielded several critical findings. One of the most striking revelations was that 67% of respondents felt menopause symptoms are not taken seriously, and 55% still view menopause as a taboo subject. These statistics emphasize the ongoing cultural silence and misunderstanding surrounding the menopausal transition. In addition, 60% of women who had experienced menopause, or were close to someone who had, reported psychological effects such as anxiety, depression, shame, and embarrassment.
Neighborhood disadvantage tied to higher breast cancer mortality in black women
The odds of breast cancer mortality among Black women are increased by residing in a disadvantaged neighborhood, according to a recent study published in JAMA Network Open.

Indices assessed included the neighborhood concentrated disadvantage (nDIS), neighborhood SES (nSES), and the Index of Concentration at the Extremes (ICE). Neighborhood level indices were assessed based on the most recent address following breast cancer diagnosis.

A hazard ratio (HR) of 1.62 was reported for living in the most disadvantaged nDIS quartile vs the least disadvantaged nDIS quartile. When adjusting for stage and ER status, the HR was 1.57.

Additionally, an HR of 1.19 was reported for living in extreme economic deprivation vs economic privilege based on ICE score, but this was not statistically significant. The HR for nSES quartiles was also not statistically significant.
First-trimester anomaly scan shows high accuracy for major birth defects
A first-trimester anomaly scan (FTAS) among low-risk patients has high sensitivity for first-trimester major congenital anomalies and lower sensitivity for all anomalies combined, according to a recent study published in the American Journal of Obstetrics & Gynecology.

True positive results were reported in 40.9% of cases, with 332 being structural anomalies, 117 genetic anomalies, 82 other findings, and 6 intrauterine fetal demise (IUFD). Termination of pregnancy (TOP) was performed in 50.1% of these cases.

Multiple congenital anomalies were the most common structural anomalies, identified in 21.7% of cases. This was followed by heart defects in 19.9%. A median 20 days was reported to diagnosis for structural anomalies, with a median gestational age of 16+3 weeks. Of these cases, 49.4% led to TOP, 6.6% IUFD, and 42.8% live births.
Jihong Liu, ScD, explains how to improve perinatal outcomes in COVID patients
In a recent discussion with Contemporary OB/GYN, Jihong Liu, ScD, from the University of South Carolina, addressed how clinicians can improve patient outcomes for pregnant women infected with COVID-19.

Liu emphasized that the severity and timing of COVID-19 infection play critical roles in pregnancy outcomes. Specifically, moderate to severe infections, especially when contracted during the later stages of pregnancy, are associated with a greater risk of adverse outcomes. Therefore, she recommended that clinicians encourage pregnant patients to take preventive measures against COVID-19 throughout pregnancy, particularly during the third trimester. These measures include vaccination, social distancing, and wearing masks.

Liu also highlighted the importance of telehealth services, which became more accessible during the pandemic because of changes in insurance coverage. She advocated for the continued use of virtual visits via audio or video calls to maintain prenatal care during public health emergencies or other situations that may limit in-person visits. This approach not only provides medical support but also helps address social and emotional needs, particularly for vulnerable populations.

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Contemporary OB/GYN week in review: Abortion access, menopause impact, and more