Dietary Folate Intake and Fecundability in Two Preconception Cohorts

Abstract

bias, although in regard to this question, the authors note that if anything this would likely minimize any association rather than increase it, because women tend to underreport prior IPV.The findings of this study provide evidence of the lifetime impact of prior experience, even without the prerequisite of a diagnosis of bladder pain or other associated pelvic condition. It is really interesting to posit multiple potential pathologic mechanisms whereby adverse experiences could ultimately manifest in BPS or UTI-like symptoms. The authors speculate on a number of these from activation of nociceptive C-fibers to pelvic floor myofascial trigger point development or activation of the hypothalamic-pituitary axis. Altered immune reaction might beget changes in microbiome, possibly increasing the risk of BPS or UTI. Because this is a retrospective cohort study, the findings show associations, not causality, but these associations are strong and coherent and support a significant opportunity for further investigation to better inform our care for these patients. Regardless of whether trauma begets symptoms or vice versa, providers caring for women presenting with these symptoms must be informed about the high rates of prior trauma and the need to screen for such history. It is important to be cognizant of the likelihood of prior trauma as we approach the care of women with these conditions.-ACW)