Journal of obstetrics and gynaecology Canada最新文献

{"title":"Fertility Self-Testing Kits: Innovation or Illusion?","authors":"Roland Antaki MD","doi":"10.1016/j.jogc.2026.103463","DOIUrl":"10.1016/j.jogc.2026.103463","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 9","pages":"Article 103463"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148538059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 2026 Society of Obstetricians and Gynaecologists of Canada Annual Clinical and Scientific Conference Highlights","authors":"Graeme N. Smith MD, PhD","doi":"10.1016/j.jogc.2026.103478","DOIUrl":"10.1016/j.jogc.2026.103478","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 9","pages":"Article 103478"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjusting Guidelines to Clinical Practice: How to Work in the Grey Zone","authors":"Giuliana Guarna HBSc, MD, DRCPSC, Andrea Mosher MD, PhD","doi":"10.1016/j.jogc.2026.103461","DOIUrl":"10.1016/j.jogc.2026.103461","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 9","pages":"Article 103461"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148538054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forced and Coerced Sterilization of Indigenous Women in Canada: Lack of Consent, Criminalization, and Bill S-228","authors":"Amy Nakajima MD, MSc","doi":"10.1016/j.jogc.2026.103462","DOIUrl":"10.1016/j.jogc.2026.103462","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 9","pages":"Article 103462"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Transfusion: Evolving Strategies in the Management of Red Cell Alloimmunization","authors":"Karen Wong MD, MSc, Karen Fung-Kee-Fung MD","doi":"10.1016/j.jogc.2026.103460","DOIUrl":"10.1016/j.jogc.2026.103460","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 9","pages":"Article 103460"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148538004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Maternal Iron Deficiency and Iron Deficiency Anemia on the Developing Fetal and Neonatal Brain","authors":"Michael K. Georgieff MD","doi":"10.1016/j.jogc.2026.103269","DOIUrl":"10.1016/j.jogc.2026.103269","url":null,"abstract":"<div><div>Iron is an essential micronutrient for fetal and postnatal neurodevelopment because of its role in critical neurologic processes, including myelination, monoamine neurotransmitter metabolism, neuronal adenosine triphosphate generation and structural development, and epigenetic modification of synaptic plasticity genes and networks. All these processes begin in the fetal stage and are at risk when the fetus is iron-deficient. Pregnancy places a tremendous negative strain on maternal iron status because of the expansion of her blood volume, coupled with placental and fetal iron demand. Fetal iron deficiency occurs as a function of multiple common gestational conditions, including maternal iron deficiency, intrauterine growth restriction, premature delivery, and maternal glucose intolerance. Maternal iron deficiency in the first 2 trimesters increases the risk of low birthweight, which, irrespective of fetal iron status, is a risk to neurodevelopment. It also increases the risk of autism and schizophrenia, whereas third trimester iron deficiency is associated with long-term neurocognitive deficits. Fetal iron underloading also increases the risk of postnatal iron deficiency and its attendant short and long-term neurodevelopmental consequences. Current studies are attempting to establish maternal iron status action thresholds early in pregnancy to trigger iron interventions that would better ensure adequate fetal iron status and protect the developing fetal brain. One study demonstrates that a maternal serum ferritin &gt;60 mcg/L is necessary at 15 weeks gestation to ensure adequate fetal loading throughout pregnancy and protect neurodevelopment. In low- and middle-income countries, where moderate to severe iron deficiency is common, early pregnancy iron interventions generally improve maternal status, but it is unclear whether the improvement is sufficient to protect the fetal brain and the child’s neurodevelopment.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 8","pages":"Article 103269"},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Placental Growth Factor Associated with Perinatal Outcomes: An Urban-Rural Analysis in Western Canada","authors":"Adrielle P. Souza Lira BSN, RN, MSc (Candidate),&nbsp;Juan-Nicolás Peña-Sánchez MD, MSc, PhD,&nbsp;YiChen Li BMSc,&nbsp;Fatima Afzal MD (Student),&nbsp;Eman Ramadan BSc, MD,&nbsp;Adewumi Adanlawo BS, MD, RDMS,&nbsp;Ernesto Figueiro-Filho MD, PhD","doi":"10.1016/j.jogc.2026.103414","DOIUrl":"10.1016/j.jogc.2026.103414","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the association between low placental growth factor (PlGF) levels and adverse maternal and neonatal outcomes, and to assess whether rural residence modifies these associations in a high-risk obstetric population.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted, including 189 high-risk pregnant persons who underwent second-trimester PlGF testing between December 2021 and December 2025. PlGF was categorized as low (&lt;10th centile) or normal (≥10th centile). Outcomes included preeclampsia, preterm birth, low birthweight, small for gestational age, and neonatal intensive care unit (NICU) admission. Multivariable logistic regression models were used to estimate adjusted odds ratios. Rural residence was included as an exposure of interest in all models, and interaction terms between low PlGF level and rural residence were assessed to evaluate effect modification.</div></div><div><h3>Results</h3><div>Low PlGF level was strongly associated with increased odds of preeclampsia, preterm birth, and low birthweight. No association was observed with small for gestational age. Rural residence did not modify the relationship between PlGF level and adverse outcomes. An initial interaction between PlGF and rural residence was observed for NICU admission; however, this interaction was attenuated and no longer statistically significant after adjustment for gestational age. Gestational age was a strong independent predictor of NICU admission.</div></div><div><h3>Conclusions</h3><div>Low PlGF level is a robust marker of placental dysfunction and is strongly associated with adverse perinatal outcomes across both rural and urban populations. While rural residence influences baseline risk, it does not modify the biological effect of PlGF. These findings support the clinical utility of PlGF for risk stratification across diverse geographic settings.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 8","pages":"Article 103414"},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SFlt-1/PlGF Testing in a Canadian Low-Resource Setting: A Prospective Study Evaluating Implementation and Cost-Effectiveness","authors":"Shifana Lalani MD, MSc,&nbsp;Katie Luiker BSc,&nbsp;Cameron Bruce MSc,&nbsp;Jo-Ann K. Brock MD, PhD,&nbsp;Lori A. Beach PhD,&nbsp;Prosper Koto PhD,&nbsp;Victoria M. Allen MD, MSc","doi":"10.1016/j.jogc.2026.103426","DOIUrl":"10.1016/j.jogc.2026.103426","url":null,"abstract":"<div><h3>Objectives</h3><div>Testing for placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) is known to reduce time to diagnosis of preeclampsia and identify patients at increased risk of adverse perinatal outcomes. We implemented testing of sFlt-1/PlGF and sought to compare the time to diagnosis of preeclampsia before and after implementation, as well as selected outcomes and estimated costs.</div></div><div><h3>Methods</h3><div>Singleton pregnancies between 20⁰ and 34⁶ weeks gestation with suspected preeclampsia or placental dysfunction were identified by the hospital databases retrospectively from 2019 to 2021 and prospectively after implementation of sFlt-1/PlGF from 2022 to 2023. Outcomes were compared using negative binomial and Poisson regression models with entropy balancing to adjust for confounding.</div></div><div><h3>Results</h3><div>Before and after the implementation of sFlt-1/PlGF testing, a total of 494 and 145 patients were identified, respectively. Among the 206 patients with confirmed preeclampsia, those identified after implementation had an earlier mean gestational age at the time of diagnosis (31.8 weeks vs. 33.1 weeks, <em>P</em> = 0.001). The post-implementation cohort had a higher risk of neonatal intensive care unit admission ≥24 hours (risk ratio 3.85; 95% CI 2.07–7.17). All fetal deaths (5.0%) recorded after implementation had a positive sFlt-1/PlGF result.</div></div><div><h3>Conclusion</h3><div>Among patients with suspected preeclampsia, sFlt-1/PlGF testing did not decrease the time to diagnosis of preeclampsia; it was associated with an earlier gestational age at time of diagnosis, identified patients with increased risk of neonatal intensive care unit admission and adverse fetal outcomes, and supports optimization of access to biochemical marker testing in regional centres.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 8","pages":"Article 103426"},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"N° 469 Carence en fer et anémie ferriprive en obstétrique et en gynécologie","authors":"Innie Chen MD, MPH,&nbsp;Karima Khamisa MD,&nbsp;Ally Murji MD, MPH,&nbsp;Jillian Coolen MD,&nbsp;Devon Evans MD, MPH,&nbsp;Ryan Lett MD,&nbsp;David Rittenberg M.D.,&nbsp;Christine Lett MD","doi":"10.1016/j.jogc.2026.103429","DOIUrl":"10.1016/j.jogc.2026.103429","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectif&lt;/h3&gt;&lt;div&gt;L'objectif de ces lignes directrices de pratique clinique est de fournir un cadre fondé sur les données probantes aux professionnel(le)s de la santé pour reconnaître, prendre en charge et prévenir la carence en fer et l'anémie ferriprive tout au long de la vie des femmes, en mettant particulièrement l'accent sur les périodes de vulnérabilité, telles que la grossesse, les menstruations et la période périopératoire.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Population cible&lt;/h3&gt;&lt;div&gt;Ces lignes directrices de pratique clinique visent à améliorer la vie des femmes à toutes les étapes de leur vie reproductive, de la ménarche à la ménopause, qui présentent une carence en fer et une anémie ferriprive dans le contexte des soins obstétricaux et gynécologiques.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Options&lt;/h3&gt;&lt;div&gt;Ces lignes directrices passent en revue les options disponibles pour la prévention, l'évaluation et le traitement de la carence en fer et de l'anémie ferriprive. Bien que ces lignes directrices portent principalement sur la thérapie de remplacement en fer par voie orale et intraveineuse, l'importance de réduire les pertes de sang menstruel est également soulignée.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Résultats&lt;/h3&gt;&lt;div&gt;En synthétisant les meilleures données probantes disponibles à ce jour et les avis d’experts issus des disciplines de l’obstétrique et de la gynécologie, de l’hématologie et de l’anesthésiologie, nous proposons des recommandations et des algorithmes thérapeutiques destinés à orienter le diagnostic et le traitement de la carence en fer et de l’anémie ferriprive chez les patientes relevant de notre spécialité.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Avantages, inconvénients et coûts&lt;/h3&gt;&lt;div&gt;La prévention, le dépistage précoce et le traitement de la carence en fer et de l’anémie ferriprive sont considérés comme une stratégie rentable pour améliorer la santé et le bien-être des femmes en âge reproductif. Il a également été démontré que cette approche proactive face à la carence en fer et de l’anémie ferriprive réduit le recours aux transfusions sanguines, ainsi que les effets indésirables et les coûts associés à ces transfusions. Les coûts potentiels du traitement par perfusion de fer doivent être évalués en regard des répercussions négatives importantes sur la qualité de vie, de la baisse du rendement au travail et de la diminution de la productivité économique des patientes atteintes de carence en fer et d’anémie ferriprive.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Données probantes&lt;/h3&gt;&lt;div&gt;À l’aide de mots-clés MeSH pertinents (liés aux concepts d’anémie, stratégies d’épargne sanguine, de transfusion, d’obstétrique, de grossesse, de post-partum et de gynécologie), la littérature publiée a été identifiée à l’aide de recherches dans PubMed et les revues systématiques Cochrane de janvier 2015 à décembre 2025. La littérature grise a été identifiée par des recherches sur les sites Web d’organismes d’évaluation des technologies de la santé et d’agences liées aux technologies de la santé, dans des recueils","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 8","pages":"Article 103429"},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148428313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No. 469 Iron Deficiency and Iron Deficiency Anemia in Obstetrics and Gynaecology","authors":"Innie Chen MD, MPH,&nbsp;Karima Khamisa MD,&nbsp;Ally Murji MD, MPH,&nbsp;Jillian Coolen MD,&nbsp;Devon Evans MD, MPH,&nbsp;Ryan Lett MD,&nbsp;David Rittenberg MD,&nbsp;Christine Lett MD","doi":"10.1016/j.jogc.2026.103428","DOIUrl":"10.1016/j.jogc.2026.103428","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The purpose of this guideline is to provide an evidence-based framework for healthcare professionals to recognize, manage, and prevent iron deficiency and iron deficiency anemia across the lifecycle of women, with particular emphasis on time periods of vulnerability, such as pregnancy, menstruation, and perioperatively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Target Population&lt;/h3&gt;&lt;div&gt;This clinical practice guideline seeks to improve the lives of women at all reproductive life stages, from menarche to menopause, with iron deficiency and iron deficiency anemia in the context of obstetrical and gynaecologic care.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Options&lt;/h3&gt;&lt;div&gt;This guideline reviews the available options for the prevention, assessment, and treatment of iron deficiency and iron deficiency anemia. While the focus of this guideline pertains to oral and intravenous iron replacement therapy, the importance of reducing menstrual blood loss is also emphasized.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcomes&lt;/h3&gt;&lt;div&gt;By consolidating the best evidence to date with expert opinion across the disciplines of obstetrics and gynaecology, hematology, and anaesthesiology, we provide recommendations and treatment algorithms to guide the diagnosis and treatment of iron deficiency and iron deficiency anemia for patients within our specialty.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Benefits, Harms, and Costs&lt;/h3&gt;&lt;div&gt;The prevention, early identification, and treatment of iron deficiency and iron deficiency anemia is assessed to be a cost-effective strategy to improve the health and well-being of women of reproductive age. This proactive approach to iron deficiency and iron deficiency anemia has also been shown to reduce the need for blood transfusion, along with the associated harms and costs of transfusion. The potential costs of iron infusion therapy must be assessed in the context of the profound adverse impacts on quality of life, reduced work performance and decreased economic productivity of patients with iron deficiency and iron deficiency anemia.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Evidence&lt;/h3&gt;&lt;div&gt;Using relevant MeSH headings and keywords (related to concepts of anemia, iron deficiency, blood management, blood conservation, transfusion, obstetrics, pregnancy, postpartum, and gynaecology), published literature was retrieved through searches of PubMed and Cochrane Systematic Reviews from January 2015 to December 2025. Grey literature was identified through searching the websites of health technology assessment and health technology–related agencies, clinical practice guideline collections, and national and international medical specialty societies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Validation Methods&lt;/h3&gt;&lt;div&gt;This guideline was developed through consensus by a multidisciplinary team of authors with representation from obstetrics, gynaecology, anaesthesiology, and hematology. The content and recommendations were drafted and agreed upon by the authors. The SOGC’s Clinical Obstetrics and Gynaecology Committee reviewed the guideline ","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 8","pages":"Article 103428"},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148428327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}