Purpose-To examine the associations of neighborhood socioeconomic deprivation and triplenegative breast cancer (TNBC) subtype with causes of death (breast cancer [BC]-specific and non-BC-specific) among non-metastatic invasive BC patients.Methods-We identified 3,312 patients younger than 75 years (mean age 53.5 years; 621 [18.8%] TNBC) with first primary BC treated at an academic medical center from 1999-2010. We constructed a census-tract-level socioeconomic deprivation index using the 2000 U.S. Census data and performed a multilevel competing-risk analysis to estimate the hazard ratios (HR) and 95% confidence intervals (CI) of BC-specific and non-BC-specific mortality associated with neighborhood socioeconomic deprivation and TNBC subtype. The adjusted models controlled for patient sociodemographics, health behaviors, tumor characteristics, comorbidity, and cancer treatment.Results-With a median 62-month follow-up, 349 (10.5%) patients died; 233 died from BC. In the multivariate models, neighborhood socioeconomic deprivation was independently associated with non-BC-specific mortality (the most-vs. the least-deprived quartile: HR=2.98, 95% CI=1.33-6.66); in contrast, its association with BC-specific mortality was explained by the aforementioned Conclusions-Non-metastatic invasive BC patients who lived in more socioeconomically deprived neighborhoods were more likely to die as a result of causes other than breast cancer compared with those living in the least socioeconomically deprived neighborhoods. TNBC was associated with non-BC-specific mortality but not BC-specific mortality.

Background: Chlamydia trachomatis (CT) infection is common and largely asymptomatic in women. If untreated it can lead to sequelae such as pelvic inflammatory disease and infertility. It is unknown if a patient’s self-reported history of CT infection is a valid marker of past infection. Objective: Our objective was to evaluate the validity of women’s self-reported history of CT infection compared to CT serology, a marker for previous infection. Study Design: We analyzed data from the Fertility After Contraception study. We compared participants’ survey responses to the question, “Have you ever been told by a healthcare provider that you had Chlamydia?” to serological test results indicating the presence or absence of antibodies to CT as assessed by microimmunofluorescence (MIF) assay. Prevalence of past infection, sensitivity, specificity, predictive values, and likelihood ratios were calculated. Cohen’s kappa statistic was computed to assess agreement between self-report and serology. Results: Among 409 participants, 108 (26%) reported having a history of CT infection, whereas 146 (36%) had positive serological test results. Relative to positive MIF assay, the sensitivity and specificity of self-reported history of CT infection were 52.1% (95% CI, 43.6%, 60.4%) and 87.8% (95% CI, 83.3%, 91.5%), respectively. Positive predictive value of self-report was 70.4% (95% CI, 60.8%, 78.8%), and the negative predictive value was 76.7% (95% CI, 71.6%, 81.4%). The likelihood ratio was found to be 4.28. Agreement between self-report and serology was found to be moderate (kappa = 0.42, P < 0.001). Conclusion: Self-reported history of CT infection commonly yields false negative and false positive results. When definitive status of past CT infection is needed, serology should be obtained.

INTRODUCTION: Over one third of women have unfulfilled contraceptive needs during their first year postpartum, and women without health insurance are 30% less likely to use contraception. As states have begun to reimburse for immediate postpartum LARC placement (immediate post-placental IUD insertion and implant insertion before discharge), the objective of this study was to determine if LARC uptake increased in the Medicaid population after immediate postpartum reimbursement was instated. METHODS: Women receiving Medicaid were prospectively recruited from a postpartum service of a large, urban hospital before and after immediate postpartum reimbursement. They completed a survey regarding their contraceptive choices, and additional information was gathered from the medical record. A binary logistic regression was performed to determine if women receiving Medicaid were more likely to choose LARC as a contraceptive method after the policy took effect, adjusting for race, mode of delivery, and primiparity. RESULTS: 178 women were included in the analysis (70 before reimbursement, 108 after reimbursement). Women were 2.5 times more likely to use LARC as postpartum birth control after immediate postpartum reimbursement was instated (95% CI: 1.26-4.79). Of the 49 women who chose LARC after immediate postpartum reimbursement, 42 (86%) received their method before hospital discharge. CONCLUSION: Immediate postpartum reimbursement resulted in women being more than twice as likely to choose LARC as their postpartum contraceptive method. Removing this barrier to cost and access is particularly important in a population vulnerable to unintended pregnancy and loss of healthcare coverage.

weight change as BMI class increased. For the women who kept the EI for 3 years, the median weight change (interquartile range) per BMI class was: normal/underweight 3.2 kg (-0.5, 6.4), overweight 5.2 kg (-0.5, 9.3), class I obese 5.7 kg (0.2, 10.7), class II obese 9.1 kg (2.3, 13.6), and class III 5.0 kg (-2.3, 13.2).CONCLUSION: There was no trend in weight change after placement of the EI as BMI class increased. The greatest increase in weight occurred in the class II group at 3 years. This information will be useful in counseling obese women about the EI when discussing contraceptive options.

weight change as BMI class increased. For the women who kept the EI for 3 years, the median weight change (interquartile range) per BMI class was: normal/underweight 3.2 kg (-0.5, 6.4), overweight 5.2 kg (-0.5, 9.3), class I obese 5.7 kg (0.2, 10.7), class II obese 9.1 kg (2.3, 13.6), and class III 5.0 kg (-2.3, 13.2).CONCLUSION: There was no trend in weight change after placement of the EI as BMI class increased. The greatest increase in weight occurred in the class II group at 3 years. This information will be useful in counseling obese women about the EI when discussing contraceptive options.