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Study shows pregnancy linked to lower rates of self-harm
The team hopes that identifying those at risk will allow doctors to target resources to those who need them
Study to examine self-harm risk around pregnancy has shown that most women are generally less likely to harm themselves during and after pregnancy.
A research team at the University of Manchester revealed that in 1000 women, four are likely to self-harm over a year. This risk halves when women are pregnant to two according to the research published in the British Journal of Psychiatry.
The study involved analysing over 58,000 self-harm events in women aged 15 to 45 years between January 1990 and December 2017. The data was linked to 1.1 million pregnancies and their outcomes using the Clinical Practice Research Datalink and the Pregnancy Register.
Women with a diagnosis of psychiatric disorders are at a higher background risk of self-harm but their risk is more than halved when pregnant.
Even after pregnancy, women over the age of 30 are at a lower risk of self-harm. The risk reduction at three to six months after pregnancy is 13 per cent of women who are aged 30 to 34. This rises to 27 per cent for women who are aged 35 to 45 in comparison to women of the same age who were not pregnant.
It also found that mothers under the age of 30 are more likely to self-harm between three to six months after giving birth.
Mothers aged 15 to 19 are 66 per cent more likely and 20 to 24-year-olds are more likely to self-harm between three to six months of giving birth. 25 to 29 years old were 15 per cent more likely in comparison to the same age groups who were not pregnant. The study also revealed that there was a small increase in risk posed in post-pregnancy by primarily younger women aged 15 to 29 years.
Adolescent women with a history of self-harm were likely to continue harming themselves during pregnancy.
Pregnancy and self-harm risk
The team noted that identifying those at risk will allow doctors to target resources at women who may need them most of all.
Lead author Dr Holly Hope said: “This study – which is the largest of its kind – makes important advances in our understanding of how pregnancy and the first year after giving birth affect self-harm risk. As we already know, self-harm among young women generally in the UK is increasing and self-harm is associated with up to 50 times higher risk of suicide in women.
Significantly, we find that the risk of self-harm is indeed higher among women under 30 after giving birth, but reassuringly, for women over 30, the risks of self-harm decrease both during and after pregnancy. Latterly, women are increasingly likely to wait a few years until they have a baby which could be down to a number of factors, including their education and employment choices.
Older women may be in a better financial and psychological position to care for themselves and their babies. Hormonal changes during pregnancy are intended to promote maternal attachment and increase a sense of wellbeing. However, this mechanism might be overridden by other factors in some younger women.”
She added: “Older women might also be in a better position to take advantage of health services which do a good job in signposting them to services if they need help.
This study shows us more clearly than before, in a contemporary population of women becoming pregnant, where the greatest risks of self-harm lie which means resources might be more focussed on those at-risk age groups so they can be monitored more effectively and referred for help more efficiently. The most deprived neighbourhoods where teenage pregnancy is more common might benefit from a similar focus.”
Dr Jo Black, chair of the Perinatal Faculty at the Royal College of Psychiatrists, said: “By highlighting where resources are needed most, the findings could help ensure funding is better targeted to reach those at greatest risk.”
AI may help speed breast cancer diagnosis for high-risk women after abnormal mammograms, a study suggests.
Women with abnormal mammograms often wait weeks to learn whether they have breast cancer.
Researchers at UC San Francisco and UC Berkeley said an AI-guided workflow could help reduce that wait by quickly identifying those most likely to have the disease. Some women could move from imaging to evaluation, and sometimes biopsy, in a single day.
Dr Maggie Chung, first author of the study, said: “This is a really an exciting time.
“This moves us closer to personalised care, where we can tailor a plan so that each patient gets the right intervention at the right time.”
The study used an open-source AI model called Mirai.
The model was trained on hundreds of thousands of mammograms linked to patients’ cancer outcomes.
A mammogram is an X-ray scan of the breast used to look for signs of cancer. A biopsy involves taking a small tissue sample to test for disease.
The AI tool is designed to detect subtle patterns in screening mammograms and predict a woman’s cancer risk.
Researchers at UC San Francisco and UC Berkeley applied the model to more than 4,100 screening mammograms at Zuckerberg San Francisco General Hospital and Trauma Center.
Mirai identified 525 women, about 12.7 per cent of screened patients, as high risk.
Those patients could receive an interpretation of their mammograms immediately after the scan and have additional diagnostic imaging for suspicious areas on the same day.
Some women who needed biopsies were also able to have them on the same day.
The researchers said Mirai reduced the wait time for diagnostic evaluation from several weeks to about an hour.
For women who were ultimately diagnosed with breast cancer, it reduced the average wait for biopsy from more than two months to fewer than 10 days.
The researchers stressed that Mirai does not replace radiologists or make diagnoses on its own.
Instead, it acts as a triage tool to help physicians identify the patients who can benefit most from accelerated care.
The team analysed more than 114,000 archival mammograms before launching the programme, to ensure the model would capture enough high-risk patients without overloading the clinic with too many expedited evaluations.
The researchers said they hope AI will support a more personalised approach to breast cancer screening tailored to each patient’s breast cancer risk.
Chung said: “Right now, many women follow the same screening schedule but their individual risk can be very different.
“AI risk assessment gives us the chance to identify the women most likely to benefit from expedited care and get them what they need.”
Adam Yala, senior author of the study and a data scientist at UC Berkeley, said: “This is a powerful example of how AI can be a collaborative partner for physicians.
“It shows how we can improve care when we bring clinicians and data scientists together to design these systems.”
Women with primary infertility may face a higher risk of early menopause and reach it about a year earlier, a study suggests.
The findings suggest women with primary infertility may be more likely to enter menopause before the age of 45.
The increased risk appeared most notable among women with unexplained infertility or a history of endometriosis.
Dr Stephanie Faubion, medical director for The Menopause Society, said: “This study shows that women with primary infertility, specifically those with unexplained infertility or a history of endometriosis, were at risk for early menopause.
“Given that early menopause is linked to adverse long-term health consequences, these women may benefit from counselling that they are at risk of early menopause.
“This will allow them to monitor for early menopause and to seek treatment with hormone therapy, if indicated.”
Early menopause is usually defined as menopause before age 45, while premature menopause is menopause before age 40.
Women who experience menopause earlier may face symptoms for longer and have a higher risk of long-term health problems.
These can include cardiovascular disease, osteoporosis and neurocognitive disorders. Osteoporosis weakens bones, while neurocognitive disorders affect memory, thinking or brain function.
The study, highlighted by The Menopause Society, involved nearly 700 people, roughly half of whom had been diagnosed with primary infertility.
It found that women with a history of primary infertility underwent natural menopause about one year earlier than those without such a history.
Researchers found no association between infertility and premature menopause.
Infertility affects around one in six people globally and can have consequences beyond family planning.
Previous research has linked infertility with higher rates of cancer and cardiovascular disease, although causes vary and may involve genetic, hormonal, in-utero or lifestyle factors.
In-utero factors are influences that occur while a baby is developing in the womb.
Earlier studies looking at links between infertility and early or premature menopause have produced mixed results, with some not accounting for different types of infertility.
The new study suggested that women with unexplained infertility or a history of endometriosis may have an increased risk of early menopause.
Endometriosis is a condition where tissue similar to the lining of the womb grows elsewhere in the body. It can cause pain, heavy periods and fertility problems.
Known risk factors for early or premature menopause include tobacco use, low body mass index, not having given birth and starting periods at a younger age.
Women who have had more childbirths and those with a history of oral contraceptive use have previously been linked to later menopause.
The researchers said women with primary infertility may benefit from additional counselling because of the systemic and long-term health effects of early menopause.
They also said women should be encouraged to seek evaluation and treatment if they experience a new loss of menstrual cycles.
A non-profit has launched an endometriosis documentary featuring Amy Schumer and Marilyn Monroe as it pushes for changes in how the condition is treated and understood.
The Endometriosis Collective has launched to change how endometriosis is researched, treated and understood, starting with a documentary featuring stories from people including Amy Schumer and Marilyn Monroe.
The feature-length documentary, “End of the Cycle”, will premiere in New York on Tuesday, and The Endometriosis Collective is making the film free to stream online.
Schumer, a comedian, writer and actor, has previously spoken of how endometriosis left her “on the floor in pain, vomiting from the pain, the pain that nobody can see.”
Schumer is one of several celebrities featured in the documentary. Other contributors include dancer Julianne Hough, Olympic medallist Brittany Brown and actors Janel Parrish and Folake Olowofoyeku.
The Endometriosis Collective timed the documentary premiere to coincide with the 100th anniversary of Marilyn Monroe’s birth.
Monroe, who died in 1962, starred in films such as “Some Like It Hot” and “Gentlemen Prefer Blondes.”
According to a biography published in 1985, Monroe’s endometriosis was so severe that it destroyed her marriages, her wish for children, her career and ultimately her life.
The Endometriosis Collective said the documentary shares newly uncovered information about Monroe’s experience with endometriosis.
The non-profit said the information connects Monroe’s story to the experiences of women across generations, highlighting how far awareness, research and care still have to go.
A representative of the Marilyn Monroe Estate said: “By sharing this part of her story through ‘End of the Cycle,’ we hope to honour her legacy in a way that brings visibility to endometriosis, encourages more open dialogue and helps inspire the research needed to create change.”
As part of the premiere, The Endometriosis Collective is holding a panel discussion.
Schumer, Brown and Olowofoyeku, the documentary’s co-directors Sammy Jaye and Soraya Simi, and medical experts are due to be part of the premiere.
AbbVie’s Orilissa and Sumitomo Pharma’s Myfembree are among the approved drugs for endometriosis pain.
Hough, one of the participants in the documentary, starred in an Orilissa campaign in 2017.
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