Objects in a room add 50% to its surface area beyond the walls, ceiling, and floor.

population-based studies is needed to inform the treatment of SARS-CoV-2 infection during pregnancy and to provide health risk information to pregnant individuals. OBJECTIVE To assess the risk of perinatal complications associated with SARS-CoV-2 infection and to describe factors associated with hospitalizations. DESIGN, SETTING, AND PARTICIPANTSThis population-based cohort study included 43 886 pregnant individuals with longitudinal electronic health record data from preconception to delivery who delivered at Kaiser Permanente Northern California between March 1, 2020, and March 16, 2021. Individuals with diagnostic codes for COVID-19 that did not have a confirmatory polymerase chain reaction test for SARS-CoV-2 were excluded.EXPOSURES SARS-CoV-2 infection detected by polymerase chain reaction test (from 30 days before conception to 7 days after delivery) as a time varying exposure. MAIN OUTCOMES AND MEASURESSevere maternal morbidity including 21 conditions (eg, acute myocardial infarction, acute renal failure, acute respiratory distress syndrome, and sepsis) that occurred at any time during pregnancy or delivery; preterm birth; pregnancy hypertensive disorders; gestational diabetes; venous thromboembolism (VTE); stillbirth; cesarean delivery; and newborn birth weight and respiratory conditions. Standardized mean differences between individuals with and without SARS-CoV-2 were calculated. Cox proportional hazards regression was used to estimate the hazard ratios (HRs) and 95% CIs for the association between SARS-CoV-2 infection and perinatal complications and hospitalization and to consider the timing of SARS-CoV-2 infection relative to outcomes. RESULTSIn this study of 43 886 pregnant individuals (mean [SD] age, 30.7 [5.2] years), individuals with a SARS-CoV-2 infection (1332 [3.0%]) were more likely to be younger, Hispanic, multiparous individuals with a higher neighborhood deprivation index and obesity or chronic hypertension. After adjusting for demographic characteristics, comorbidities, and smoking status, individuals with SARS-CoV-2 infection had higher risk for severe maternal morbidity (HR, 2.45; 95% CI, 1.91-3.13), preterm birth (<37 weeks; HR, 2.08; 95% CI, 1.75-2.47), and VTE (HR, 3.08; 95% CI, 1.09-8.74) than individuals without SARS-CoV-2. SARS-CoV-2 infection was also associated with increased risk of medically indicated preterm birth (HR, 2.56; 95% CI, 2.06-3.19); spontaneous preterm birth (HR, 1.61; 95% CI, 1.22-2.13); and early (HR, 2.52; 95% CI, 1.49-4.24), moderate (HR, 2.18; 95% CI, 1.25-3.80), and late (HR, 1.95; 95% CI, 1.61-2.37) preterm birth. Among individuals with SARS-CoV-2 infection, 76 (5.7%) had a hospitalization; pregestational diabetes (HR, 7.03; 95% CI, 2.22-22.2) and Asian or Pacific Islander (HR, 2.33; 95% CI, 1.06-5.11) and Black (HR, 3.14; 95% CI, 1.24-7.93) race and ethnicity were associated with an increased risk of hospitalization. CONCLUSIONS AND RELEVANCEIn this cohort study, SARS-CoV-2 infection was associated with increased risk of severe maternal morbidity, preterm b...

Breast cancer (BC) is a commonly diagnosed cancer amongst women and the second leading cause of cancer deaths in the world. BC has created huge challenges to healthcare providers regarding the identification of main risk factors and how they contribute to the development of the disease. Several studies suggest that biological risk factors such as duration of breast feeding, age at menarche, menopausal status and the use of contraceptive pills have contributed to the increase of BC diagnoses. Moreover, psychological factors such as depression, stress and negative lifestyles are gaining more attention as a major contributor to this type of cancer. The role of psychological stress regarding BC has been widely demonstrated in the literature across several fields including but not exclusive to epidemiology, physiology, and molecular biology which all show a clear relationship between intracellular stress signaling and protumorigenic pathways within breast cells. Cortisol is primary stress hormone of the human body and a growing body of research both clinically and molecularly are revealing a positive correlation of high cortisol levels and the progression of BC. This review attempts to establish and highlight how cortisol levels impact breast cancer development and progression.

Objective: To test whether two interventions promote interest in diabetes prevention among women with a history of gestational diabetes mellitus (GDM), who face high lifetime risk for diabetes. Research Design and Methods:We designed an email outreach message promoting an existing preventive lifestyle program. The message incorporated values affirmation, a theory-based intervention that can improve openness to health information but typically relies on a writing exercise less practical in healthcare settings. In a 3-arm randomized study, 237 women with elevated BMI and a history of GDM were randomized to read an outreach message containing either no affirmation (control) or one of two affirmations, streamlined to remove the typical writing exercise: either a values affirmation prompting reflection on any personal value, or a parenting affirmation prompting reflection on caregiving-related values. Outcomes included demonstrating interest in the lifestyle program (seeking information about it or intending to join) and seeking publicly-available health information about diabetes prevention.Results: Compared to control, participants randomized to the values affirmation more frequently demonstrated interest in the lifestyle program (59.0% vs. 74.4%; adjusted relative risk [95% CI]: 1.31 [1.04-1.66]) and sought information about diabetes prevention (59.0% vs. 73.4%; 1.22 [0.97-1.54]). The parenting affirmation yielded no significant differences in either outcome. Conclusions:A streamlined values affirmation, designed for feasibility in a healthcare setting, can promote interest in diabetes prevention among women at high-risk. Research is needed to evaluate its effects on diabetes prevention program enrollment and clinical outcomes.