{"id":468,"date":"2022-12-27T23:32:49","date_gmt":"2022-12-27T22:32:49","guid":{"rendered":"https:\/\/antikoncepcia.org\/?p=468"},"modified":"2022-12-29T10:53:01","modified_gmt":"2022-12-29T09:53:01","slug":"problematika-pouzivania-lng-iud-u-adolescentiek","status":"publish","type":"post","link":"https:\/\/antikoncepcia.org\/?p=468","title":{"rendered":"Problematika pou\u017e\u00edvania LNG-IUD u adolescentiek"},"content":{"rendered":"

Americk\u00e9 kol\u00e9gium p\u00f4rodn\u00edkov a gynekol\u00f3gov<\/i> a Americk\u00e1 akad\u00e9mia pediatrov<\/i> aktu\u00e1lne odpor\u00fa\u010daj\u00fa dlhodobo p\u00f4sobiacu reverzibiln\u00fa antikoncepciu \u2212 vn\u00fatromaternicov\u00e9 telieska a implant\u00e1ty \u2212 ako antikoncepciu prvej vo\u013eby pre v\u0161etky adolescentky (American Academic of Pediatry, 2020<\/i>i<\/sup><\/a>,<\/i>The American College of Obstetricians and Gynecologists, 2012<\/i><\/span>ii<\/sup><\/a>). Tieto odpor\u00fa\u010dania v skuto\u010dnosti poskytuj\u00fa mand\u00e1t na do\u010dasn\u00fa steriliz\u00e1ciu adolescentiek prostredn\u00edctvom dlhodobo p\u00f4sobiacich reverzibiln\u00fdch antikoncep\u010dn\u00fdch prostriedkov, a to v\u00a0priemere na p\u00e4\u0165 a\u017e desa\u0165 rokov.<\/span><\/p>\n

Je zn\u00e1me, \u017ee deti a adolescentky s\u00fa zvl\u00e1\u0161\u0165 zranite\u013enou popul\u00e1ciou so \u0161pecifick\u00fdmi v\u00fdvojov\u00fdmi, fyziologick\u00fdmi a psychologick\u00fdmi potrebami. Pre adolescentky s\u00fa \u0161peci\u00e1lnymi probl\u00e9mami t\u00fdkaj\u00facimi sa zavedenia LNG\u2212IUD (vn\u00fatromaternicov\u00e9 teliesko uvo\u013e\u0148uj\u00face levonorgestrel\u00a0 (LNG)) panenstvo <\/b>alebo nuliparita (nulipara je \u017eena, ktor\u00e1 e\u0161te nerodila), ako aj vysok\u00e1 \u00farove\u0148 \u00fazkosti. LNG-IUD sa zav\u00e1dza do maternice u\u017e aj diev\u010dat\u00e1m vo veku 12-13 rokoviii<\/sup><\/a> iv<\/sup><\/a>, publikovan\u00e9 bolo zavedenie IUD-LNG 9-ro\u010dn\u00e9mu diev\u010datku.v<\/sup><\/a> Be\u017en\u00e9 s\u00fa nepr\u00edjemn\u00e9 a\u00a0bolestiv\u00e9 pocity pri zav\u00e1dzan\u00ed vn\u00fatromaternicov\u00e9ho telieska a zavedenie cez \u00fazky kr\u010dek maternice m\u00f4\u017ee by\u0165 technicky n\u00e1ro\u010dn\u00e9 a bolestiv\u00e9.vi<\/sup><\/a> Objem maternice sa v\u00a0obdob\u00ed dospievania men\u00ed a\u00a0v\u00fdznamne sa zv\u00e4\u010d\u0161uje s\u00a0n\u00e1stupom men\u0161tru\u00e1cie, rast\u00facim vekom a\u00a0po\u010dtom p\u00f4rodov. Adolescentky mlad\u0161ie ako 18 rokov, ktor\u00e9 e\u0161te nerodili, maj\u00fa v\u00fdznamne men\u0161\u00ed objem maternice ako \u017eeny vo veku 20 a\u017e 40 rokov, ktor\u00e9 e\u0161te nerodili, alebo porodili 1 die\u0165a (P<\/i><0.001).vii<\/sup><\/a> viii<\/sup><\/a> Viacer\u00e9 \u0161t\u00fadie pozorovali vy\u0161\u0161iu nezn\u00e1\u0161anlivos\u0165 vn\u00fatromaternicov\u00fdch teliesok u\u00a0adolescentiek v\u00a0porovnan\u00ed s dospel\u00fdmi \u017eenami, \u010do malo za n\u00e1sledok v\u00fdznamne vy\u0161\u0161ie riziko vypudenia alebo odstr\u00e1nenia<\/b> vn\u00fatromaternicov\u00e9ho telieska (Alton a\u00a0kol., 2012<\/i>ix<\/sup><\/a>, Behringer a\u00a0kol., 2011<\/i>x<\/sup><\/a>), abnorm\u00e1lne krv\u00e1canie <\/b>nes\u00favisiace s\u00a0men\u0161tru\u00e1ciou a\u00a0nepravideln\u00fd men\u0161trua\u010dn\u00fd cyklus<\/b> (Berenson a\u00a0kol., 2015<\/i>xi<\/sup><\/a>). <\/span><\/p>\n

V\u00a0s\u00favislosti s\u00a0pou\u017e\u00edvan\u00edm LNG-IUD po\u010das adolescencie je d\u00f4le\u017eit\u00e9 upozorni\u0165 na proces tzv. hypotalamickej kontroly puberty. <\/b>Jedn\u00e1 sa <\/b>o\u00a0zlo\u017eit\u00fd proces, ktor\u00e9ho naru\u0161enie m\u00f4\u017ee ohrozi\u0165 nielen reproduk\u010dn\u00fd potenci\u00e1l dospievaj\u00facich diev\u010dat, ale aj v\u00e1\u017ene ohrozi\u0165 ich zdravie. Ned\u00e1vno bolo objaven\u00e9, \u017ee pribli\u017ene 10% hypotalamick\u00fdch g\u00e9nov, ktor\u00e9 zvy\u0161uj\u00fa svoju aktivitu v\u00a0\u010dase puberty s\u00fa z\u00e1rove\u0148 zapojen\u00e9 do tvorby alebo potl\u00e1\u010dania n\u00e1dorov. Tieto v\u00fdznamn\u00e9 g\u00e9ny boli pomenovan\u00e9 ako \u201eg\u00e9ny s\u00favisiace s\u00a0n\u00e1dorom\u201c<\/b> (Tumor Related Genes \u2212TRG). Roth a\u00a0kol. <\/i>(2008) identifikovali 11 g\u00e9nov s\u00favisiacich s\u00a0TRG sie\u0165ou a z\u00e1rove\u0148 zahrnut\u00fdch do regul\u00e1cie diev\u010denskej puberty, z\u00a0ktor\u00fdch 6 bolo identifikovan\u00fdch ako g\u00e9ny potl\u00e1\u010daj\u00face n\u00e1dory (napr. p53<\/i>, SASH1<\/i>, CUTL1<\/i>) a\u00a05 ako g\u00e9ny sp\u00f4sobuj\u00face n\u00e1dory (napr. CCND1<\/i> a\u00a0AF1Q<\/i>, ktor\u00fdch naru\u0161en\u00e1 expresia bola pozorovan\u00e1 napr. pri rakovine prsn\u00edkaxii<\/sup><\/a> xiii<\/sup><\/a> xiv<\/sup><\/a>). Predpoklad\u00e1 sa, \u017ee pohlavn\u00e9 horm\u00f3ny (estrog\u00e9ny, gestag\u00e9ny) m\u00f4\u017eu v\u00a0puberte aktivova\u0165 g\u00e9ny podporuj\u00face n\u00e1dory, ale z\u00e1rove\u0148 zv\u00fd\u0161en\u00e1 aktivita TRG siete udr\u017eiava v\u00fdvinov\u00fd proces tak, aby bol zameran\u00fd sk\u00f4r na diferenci\u00e1ciu funkcie buniek ako na ich mno\u017eenie. T\u00e1to prec\u00edzne regulovan\u00e1 rovnov\u00e1ha medzi stimula\u010dn\u00fdmi a\u00a0inhibi\u010dn\u00fdmi impulzmi s\u00favis\u00ed s\u00a0morfologick\u00fdmi zmenami v\u00a0mozgu, ktor\u00e9 sa vyskytuj\u00fa v\u00a0mediobaz\u00e1lnom hypotalame po\u010das pohlavn\u00e9ho v\u00fdvinu.xv<\/sup><\/a> V\u00a0tejto s\u00favislosti je d\u00f4le\u017eit\u00e9 ned\u00e1vno publikovan\u00e9 zistenie, \u017ee \u017eeny u\u017e\u00edvaj\u00face hormon\u00e1lne antikoncep\u010dn\u00e9 tablety maj\u00fa v\u00fdznamne men\u0161\u00ed objem hypotalamu (Lipton a\u00a0kol., 2021<\/i>).xvi<\/sup><\/a> Vplyv hormon\u00e1lnej antikoncepcie na \u0161trukt\u00fary mozgu preuk\u00e1zali aj \u010fal\u0161ie \u0161t\u00fadie (Petersen a\u00a0kol., 2021<\/i>xvii<\/sup><\/a>,<\/i> Petersen a kol. 2015<\/i>xviii<\/sup><\/a>,<\/i> Lisofsky <\/a> a kol., 2016<\/i>xix<\/sup><\/a>). Uveden\u00e9 zistenia s\u00fa varuj\u00face, preto\u017ee m\u00f4\u017eu ma\u0165 pre \u017eeny, ktor\u00e9 za\u010dali pou\u017e\u00edva\u0165 LNG-IUD u\u017e po\u010das dospievania, celo\u017eivotn\u00e9 n\u00e1sledky.<\/span><\/p>\n

Navy\u0161e predch\u00e1dzaj\u00faca anal\u00fdza ne\u017eiaducich \u00fa\u010dinkov uk\u00e1zala, \u017ee pou\u017e\u00edvanie LNG-IUD v\u00fdznamne zvy\u0161uje riziko rakoviny prsn\u00edkaxx<\/sup><\/a> xxi<\/sup><\/a> xxii<\/sup><\/a>, psychick\u00fdch ochoren\u00ed (zvl\u00e1\u0161\u0165 u\u00a0adolescentiek)xxiii<\/sup><\/a> xxiv<\/sup><\/a> xxv<\/sup><\/a> xxvi<\/sup><\/a> xxvii<\/sup><\/a> a\u00a0samovra\u017edy.xxviii<\/sup><\/a> LNG-IUD patr\u00ed medzi tzv. invaz\u00edvne (prenikaj\u00face do tela) met\u00f3dy antikoncepcie. LNG-IUD je potrebn\u00e9 do maternice zavies\u0165 a nemo\u017eno ho vo v\u0161eobecnosti odstr\u00e1ni\u0165 bez lek\u00e1rskej pomoci. T\u00e1to z\u00e1vislos\u0165 od poskytovate\u013ea LNG-IUD odn\u00edma \u017een\u00e1m kontrolu nad za\u010dat\u00edm a\u00a0ukon\u010den\u00edm tejto met\u00f3dy, \u010do je hodnota, ktor\u00e1 je zvl\u00e1\u0161\u0165 d\u00f4le\u017eit\u00e1 pre podstatn\u00fa \u010das\u0165 \u017eien, a\u00a0jeden z\u00a0d\u00f4vodov odmietania tejto met\u00f3dy.<\/span><\/p>\n

V\u00a0neposlednom rade, propag\u00e1cia LARC pred in\u00fdmi antikoncep\u010dn\u00fdmi met\u00f3dami m\u00f4\u017ee vies\u0165 k\u00a0n\u00e1tlakovej\/donucovacej praxi.xxix<\/sup><\/a> Napr\u00edklad postupy prijat\u00e9 niektor\u00fdmi americk\u00fdmi \u0161t\u00e1tmi poskytuj\u00fa bu\u010f stimuly alebo prek\u00e1\u017eky, aby obmedzili p\u00f4rody u\u00a0\u017eien, ktor\u00e9 dost\u00e1vaj\u00fa verejn\u00fa pomoc (soci\u00e1lne d\u00e1vky). Medzi \u010fal\u0161ie pr\u00edklady diskrimin\u00e1cie patria predpojat\u00e9 pon\u00fakanie LNG-IUD niektor\u00fdm marginalizovan\u00fdm skupin\u00e1m \u017eien, najm\u00e4 \u017een\u00e1m s\u00a0inou ako bielou farbou pleti a chudobn\u00fdm \u017een\u00e1m. Jemn\u00e9 diskrimina\u010dn\u00e9 sklony sa prejavili aj v nedostatku financi\u00ed v niektor\u00fdch \u0161t\u00e1tnych programoch \u201eMedicaid\u201c na odstr\u00e1nenie IUD, ak mala \u017eena v \u00famysle otehotnie\u0165.xxx<\/sup><\/a><\/span><\/p>\n

Odborn\u00e9 pramene<\/strong><\/em><\/p>\n

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i<\/a> Menon S. Long-Acting Reversible Contraception: Specific Issues for Adolescents. Pediatrics. 2020 August. 146 (2) e2020007252.\u00a0\u00a0<\/span><\/p>\n<\/div>\n

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ii<\/a> Committee on Adolescent Health Care Long-Acting Reversible Contraception Working <\/span>Group, The American College of Obstetricians and Gynecologists. Committee opinion no. 539: adolescents and long-acting reversible contraception: implants and intrauterine devices. <\/span>Obstetrics and Gynecology. 2012 Oct;120(4):983-8.<\/span><\/span><\/p>\n<\/div>\n

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iii<\/a> Schwartz BI, Alexander M, Breech LL. Levonorgestrel Intrauterine Device Use for Medical Indications in Nulliparous Adolescents and Young Adults.<\/span> The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine. 2021 Feb;68(2):357-363. <\/span><\/span><\/p>\n<\/div>\n

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iv<\/a> Aslam N, Blunt S, Latthe P. Effectiveness and tolerability of levonorgestrel intrauterine system in adolescents. <\/span>Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2010;30(5):489-91.<\/span><\/span><\/p>\n<\/div>\n

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v<\/a> Schwartz BI, Alexander M, Breech LL. Intrauterine Device Use in Adolescents With Disabilities. Pediatrics. 2020;146(2):e20200016.<\/span><\/p>\n<\/div>\n

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vi<\/a> Aslam N, Blunt S, Latthe P. Effectiveness and tolerability of levonorgestrel intrauterine system in adolescents. <\/span>Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2010;30(5):489-91.<\/span><\/span><\/p>\n<\/div>\n

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vii<\/a> Gadelha Da Costa A<\/a>, Filho FM<\/a>, Ferreira AC<\/a>. et al. Uterine volume in adolescents. Ultrasound in Medicine & Biology. 2004 Jan;30(1):7-10.<\/span><\/p>\n<\/div>\n

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viii<\/a> Kelsey TW, Ginbey E, Chowdhury MM, et al. A Validated Normative Model for Human Uterine Volume from Birth to Age 40 Years. Lambalk CB, ed. PLoS ONE. 2016;11(6):e0157375. <\/span><\/p>\n<\/div>\n

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ix<\/a> Alton TM<\/a>, Brock GN<\/a>, Yang D<\/a>. et al. Retrospective review of intrauterine device in adolescent and young women. Journal of Pediatric and Adolescent Gynecology. 2012 Jun;25(3):195-200.<\/span><\/p>\n<\/div>\n

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x<\/a> Behringer T, Reeves MF, Rossiter B, Chen BA, Schwarz EB. Duration of use of a levonorgestrel IUS amongst nulliparous and adolescent women. Contraception. 2011 Nov;84(5):e5-e10. <\/span><\/p>\n<\/div>\n

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xi<\/a> Berenson AB, Tan A, Hirth JM. Complications and continuation rates associated with 2 types of long-acting <\/span>contraception. American Journal of Obstetrics and Gynecology. 2015 Jun;212(6):761.e1-8. <\/span><\/p>\n<\/div>\n

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xii<\/a> Colaprico A, Olsen C, Bailey MH, et al. Interpreting pathways to discover cancer driver genes with Moonlight. Nature Communications. <\/i>2020;11(1):69. <\/span><\/p>\n<\/div>\n

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xiii<\/a> Mohammadizadeh F, Hani M, Ranaee M, Bagheri M. Role of cyclin D1 in breast carcinoma. Journal of Research in Medical Sciences : the Official Journal of Isfahan University of Medical Sciences. <\/i> 2013;18(12):1021-1025.<\/span><\/p>\n<\/div>\n

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xiv<\/a> Park J, Schlederer M, Schreiber M, et al. AF1q is a novel TCF7 co-factor which activates CD44 and promotes breast cancer metastasis. Oncotarget. 2015;6(24):20697-20710. <\/span><\/p>\n<\/div>\n

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xv<\/a> Roth ChL and Mastronardi C. Early Puberty Onset and Female Cancers\u2013Is There a Link? In: Moorland MT(ed.). Cancer in Female Adolescents. New York: Nova Science Publishers; 2008:212.<\/span><\/p>\n<\/div>\n

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xvi<\/a> Lipton ML, Chen K, Worley S, et al. <\/b>Oral Contraceptive Use Is Associated with Smaller Hypothalamic Volumes in Healthy Women. <\/span>1<\/b><\/span>05th Scientific Assembly and Annual Meeting of the Radiological Society of North America-RSNA 2019.<\/span><\/span><\/p>\n

https:\/\/press.rsna.org\/timssnet\/media\/pressreleases\/14_pr_target.cfm?id=2136. Accessed 3 March 2021.<\/span><\/span><\/p>\n<\/div>\n

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xvii<\/a> Petersen N, Kearley NW, Ghahremani DG, et al. Effects of oral contraceptive pills on mood and magnetic resonance imaging measures of prefrontal cortical thickness. Molecular Psychiatry. 2021 Jan 8.<\/span><\/p>\n<\/div>\n

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xviii<\/a> Petersen N, Touroutoglou A, Andreano JM, Cahill L. Oral contraceptive pill use is associated with localized decreases in cortical thickness. Human Brain Mapping. 2015;36(7):2644-54.<\/span><\/p>\n<\/div>\n

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xix<\/a> Lisofsky N<\/a>, Riediger M<\/a>, Gallinat J<\/a>, et al. Hormonal contraceptive use is associated with neural and affective changes in healthy young women. NeuroImage.<\/a> 2016 Jul 1;134:597-606.<\/span><\/p>\n<\/div>\n

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xx<\/a> Siegelmann-Danieli N, Katzir I, Landes JV, et al. Does levonorgestrel-releasing intrauterine system increase breast cancer risk in peri-menopausal women? An HMO perspective. Breast Cancer Research and Treatment. 2018 Jan;167(1):257-262.<\/span><\/p>\n<\/div>\n

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xxi<\/a> M\u00f8rch LS, Skovlund CW, Hannaford PC, et al. Contemporary Hormonal Contraception and the Risk of Breast Cancer. The New England Journal of Medicine. 2017 Dec 7;377(23):2228-2239.<\/span><\/p>\n<\/div>\n

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xxii<\/a> Ellingjord-Dale M, Vos L, Tretli S, Hofvind S, dos-Santos-Silva I, Ursin G. Parity, hormones and breast cancer subtypes – results from a large nested case-control study in a national screening program. Breast Cancer Research\u202f: BCR. 2017;19:10. <\/span><\/p>\n<\/div>\n

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xxiii<\/a> Slattery J, Morales D, Pinheiro L, Kurz X. Cohort Study of Psychiatric Adverse Events Following Exposure to Levonorgestrel-Containing Intrauterine Devices in UK General Practice. Drug Safety. 2018 Oct;41(10):951-958.<\/span><\/p>\n<\/div>\n

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xxiv<\/a> Bosco-L\u00e9vy P, Gouverneur A, Langlade C, et al. Safety of levonorgestrel 52 mg intrauterine system compared to copper intrauterine device: a population-based cohort study. Contraception. 2019 Jun;99(6):345-349. <\/span><\/p>\n<\/div>\n

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xxv<\/a> Zettermark S, Perez Vicente R, Merlo J. Hormonal contraception increases the risk of psychotropic drug use in adolescent girls but not in adults: A pharmacoepidemiological study on 800 000 Swedish women. PLoS One. 2018;13(3):e0194773. <\/span><\/p>\n<\/div>\n

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xxvi<\/a> Skovlund CW<\/a>, M\u00f8rch LS<\/a>, Kessing LV<\/a>, Lidegaard \u00d8<\/a>. Association of Hormonal Contraception With Depression. JAMA Psychiatry.<\/a> 2016 Nov 1;73(11):1154-1162.<\/span><\/p>\n<\/div>\n

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xxvii<\/a> Lindberg M<\/a>, Foldemo A<\/a>, Josefsson A<\/a>, Wir\u00e9hn AB<\/a>. Differences in prescription rates and odds ratios of antidepressant drugs in relation to individual hormonal contraceptives: a nationwide population-based study with age-specific analyses. The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception. 2012 Apr;17(2):106-18.<\/span><\/p>\n<\/div>\n

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xxviii<\/a> Skovlund CW<\/a>, M\u00f8rch LS<\/a>, Kessing LV<\/a>, et al. Association of Hormonal Contraception With Suicide Attempts and Suicides. The American Journal of Psychiatry. 2018 Apr 1;175(4):336-342.<\/span><\/p>\n<\/div>\n

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xxix<\/a> Rowlands S, Ingham R. Long-acting reversible contraception: conflicting perspectives of advocates and potential users<\/span>.<\/i><\/span> BJOG. 2017 Sep;124(10):1474-1476. <\/span><\/span><\/p>\n<\/div>\n

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xxx<\/a> Kaitz M, Mankuta D, Mankuta L. Long-acting reversible contraception: A route to reproductive justice or injustice. Infant Mental Health Journal. 2019;40(5):673-689.<\/span><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Americk\u00e9 kol\u00e9gium p\u00f4rodn\u00edkov a gynekol\u00f3gov a Americk\u00e1 akad\u00e9mia pediatrov aktu\u00e1lne … <\/p>\n","protected":false},"author":1,"featured_media":469,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[155,1,2,53,57,43],"tags":[198,197,188,189,195,196,3,187],"class_list":["post-468","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-clanky","category-psychika","category-rakovina","category-tinedzerky","category-zdravie","category-zmeny-na-sliznici-maternice","tag-adolescentky","tag-diskriminacia","tag-iud","tag-lng","tag-nepravidelny-menstruacny-cyklus","tag-psychicke-ochorenia","tag-rakovina-prsnika","tag-vnutromaternicove-teliesko"],"_links":{"self":[{"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=\/wp\/v2\/posts\/468","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=468"}],"version-history":[{"count":2,"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=\/wp\/v2\/posts\/468\/revisions"}],"predecessor-version":[{"id":497,"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=\/wp\/v2\/posts\/468\/revisions\/497"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=\/wp\/v2\/media\/469"}],"wp:attachment":[{"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=468"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=468"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/antikoncepcia.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=468"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}