M. Alix Murphy MD, MASc , Lauren Clarfield MD , Laura Diamond MD, MSc , Elizabeth Miazga MD, LLM , Sari Kives MD
{"title":"Comparative Analysis of Venous Thromboembolism Prophylaxis Guidelines after Cesarean Delivery","authors":"M. Alix Murphy MD, MASc , Lauren Clarfield MD , Laura Diamond MD, MSc , Elizabeth Miazga MD, LLM , Sari Kives MD","doi":"10.1016/j.jogc.2025.103022","DOIUrl":"10.1016/j.jogc.2025.103022","url":null,"abstract":"<div><div>Venous thromboembolism (VTE) is a leading cause of maternal morbidity and mortality in Canada. Expanding candidacy for VTE prophylaxis in the peripartum period has been associated with decreased maternal mortality; however, there are inconsistencies in society recommendations for postpartum thromboprophylaxis, and the literature shows poor adherence to guidelines. This brief communication examines VTE prophylaxis prescribing in patients who underwent cesarean delivery at a tertiary hospital in Toronto, Ontario and highlights high variance in risk stratification from national regulatory organizations. Ultimately, future work should be done to improve appropriate thromboprophylaxis prescribing practices to reduce the risk of adverse outcomes related to thromboembolism.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103022"},"PeriodicalIF":2.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565537","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":"Evaluation of a Postpartum Cardiovascular Prevention Clinic After Hypertensive Disorders of Pregnancy: A Mixed-Methods Study","authors":"Lisa Dubrofsky MD , Lisa Boesch , Conor Cox MD , Ahraaz Wyne MD , Tharani Anpalaga MD , Serena Gundy MD","doi":"10.1016/j.jogc.2025.103024","DOIUrl":"10.1016/j.jogc.2025.103024","url":null,"abstract":"<div><h3>Objectives</h3><div>After experiencing a hypertensive disorder of pregnancy, women are at increased risk of developing cardiovascular (CV) risk factors and premature CV disease. A dedicated postpartum clinic is 1 potential solution to educate patients on how to reduce their long-term health risks but there are limited data from the patient perspective regarding the utility and quality of such interventions.</div></div><div><h3>Methods</h3><div>We performed a mixed-methods study using questionnaire data and focus group interviews to assess the patient’s perspective regarding the timing, content, modality (virtual vs. in-person) and perceived effectiveness of the Postpartum CV Prevention Clinic in Ontario, Canada.</div></div><div><h3>Results</h3><div>Participants reported improved understanding of their health condition and healthy behaviours, as well as concrete behavioural changes because of their experience in the clinic. Participants reported a need for more mental health resources as part of their postpartum follow-up. A combination of in-person and virtual care was the preferred modality of follow-up.</div></div><div><h3>Conclusions</h3><div>A dedicated Postpartum CV Prevention Clinic is an effective means to educate patients on health behaviours and the need for follow-up after pregnancy, but gaps remain in care, and future research is needed to determine the long-term health impacts.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103024"},"PeriodicalIF":2.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565539","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}
Nikki L. Stephenson PhD , Deborah A. McNeil PhD , Kassi Prisnie MSc , Eliana Castillo MD , Verena Kuret MD , Kara Nerenberg MD, MSc , Radhmila Parmar MD , Gary F. Teare PhD , Kristin Klein MD , Amy Metcalfe PhD
{"title":"Impact of COVID-19 Public Health Restrictions on the Home Birth Trends in Alberta: An Observational Retrospective Cohort Study","authors":"Nikki L. Stephenson PhD , Deborah A. McNeil PhD , Kassi Prisnie MSc , Eliana Castillo MD , Verena Kuret MD , Kara Nerenberg MD, MSc , Radhmila Parmar MD , Gary F. Teare PhD , Kristin Klein MD , Amy Metcalfe PhD","doi":"10.1016/j.jogc.2025.103021","DOIUrl":"10.1016/j.jogc.2025.103021","url":null,"abstract":"<div><div>This study examined the association between public health restrictions and the point prevalence of home birth in Alberta between January 1, 2017 and December 31, 2021 using administrative health data. Monthly home birth prevalences were examined over the pre-pandemic (n = 161 225), pandemic (n = 77 563), and pandemic wave periods via interrupted time series analysis. Logistic regression modelling estimated the association between home birth and monthly averaged Government Response Stringency Index. During the pandemic, home birth prevalence increased (pre-pandemic: 24.82, <em>P</em> < 0.001; slope: −0.02, <em>P</em> = 0.332; pandemic: level change:7.51, <em>P</em> = 0.006; slope change: −0.40, <em>P</em> = 0.061). Only the first pandemic wave showed an association between Government Response Stringency Index and the probability of home birth (OR 1.17; 95% CI 1.03–1.33).</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103021"},"PeriodicalIF":2.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565541","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":"Socioeconomic Status and Choice of Primary Management of Stress Urinary Incontinence: A Retrospective Cohort Study","authors":"Sarah Wozney MD , Finlay Maguire PhD , Jocelyn Stairs MD, MPH","doi":"10.1016/j.jogc.2025.103020","DOIUrl":"10.1016/j.jogc.2025.103020","url":null,"abstract":"<div><h3>Objectives</h3><div>Stress urinary incontinence (SUI) affects 25% of Canadian women. Characterizing socioeconomic barriers is essential for advocacy and patient-centred counselling. Our objective was to estimate the association between socioeconomic status and the primary management strategy among patients presenting for consultation for management of SUI.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used billing and diagnostic data from 2019 to 2022 to identify all patients with SUI presenting to a tertiary urogynaecology clinic in Nova Scotia, Canada. Socioeconomic status was estimated using after tax neighbourhood income quintiles derived using postal codes from 2021 Canadian census data and the PCCF+ 8A1 tool. The primary outcome was a composite of interventions not covered by our provincial health care plan. Logistic regression models were used to estimate the association between neighbourhood income and choice of patient cost-incurring interventions.</div></div><div><h3>Results</h3><div>A total of 293 patients had a diagnosis of SUI and met criteria for inclusion: 4.4% chose expectant, 71.7% chose a conservative intervention that incurred patient cost, and 17.1% chose surgery. There was no difference in the odds of choosing a conservative intervention that incurred patient cost between those from low- and high-income neighbourhoods (OR 1.33; 95% CI 0.75–2.34). Fewer patients from low-income neighbourhoods presented for consultation.</div></div><div><h3>Conclusions</h3><div>There was no difference in the likelihood of choosing a conservative intervention that incurred patient cost among patients with SUI from low- and high-income neighbourhoods. However, fewer patients from low-income neighbourhoods presented for care. Advocacy for equitable access to consultation and treatment may reduce barriers to access.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103020"},"PeriodicalIF":2.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565542","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":"Letter to the Editor: Turning the Tide on Maternal Mortality: A Call to Action Against Maternal Sepsis","authors":"Ana Werlang MD, MSc , Megan Gomes MD, MSc","doi":"10.1016/j.jogc.2025.102788","DOIUrl":"10.1016/j.jogc.2025.102788","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 7","pages":"Article 102788"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631615","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}
Ann E. Sprague RN, PhD , Carolina Lavin Venegas BScN, MSc , Mark Walker MD, MSc, MSHCM , Janet Brownlee RN, MSCNPNC(C) , Joel Ray MD
{"title":"Reply to a Letter Regarding “Mortality Following Childbirth in Ontario: A 20-Year Analysis of Temporal Trends and Causes”","authors":"Ann E. Sprague RN, PhD , Carolina Lavin Venegas BScN, MSc , Mark Walker MD, MSc, MSHCM , Janet Brownlee RN, MSCNPNC(C) , Joel Ray MD","doi":"10.1016/j.jogc.2025.102932","DOIUrl":"10.1016/j.jogc.2025.102932","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 7","pages":"Article 102932"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133368","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}
Kristyn Reeves MPH , Helena Piccinini-Vallis MD, PhD
{"title":"Examining the Relationship Between Eating Disorders and Gestational Weight Gain: A Systematic Review","authors":"Kristyn Reeves MPH , Helena Piccinini-Vallis MD, PhD","doi":"10.1016/j.jogc.2025.102964","DOIUrl":"10.1016/j.jogc.2025.102964","url":null,"abstract":"<div><h3>Objective</h3><div>Pregnant women face significant changes in their body image, weight, and overall appearance, potentially leading to the development of an eating disorder or exacerbation of a pre-existing eating disorder during pregnancy. Despite the known risks of insufficient or excess gestational weight gain (GWG), few studies have examined the relationship between eating disorders and GWG. The objective of this study was to examine the relationship between GWG and eating disorders in women with anorexia nervosa, bulimia nervosa, and binge eating disorder.</div></div><div><h3>Data Sources</h3><div>CINAHL, Embase, PsycInfo, and PubMed.</div></div><div><h3>Study Selection</h3><div>A search strategy was developed and entered into CINAHL, Embase, PsycInfo, and PubMed for studies published since 1994 that included participants with a singleton pregnancy; a clinical diagnosis of anorexia nervosa, bulimia nervosa, or binge eating disorder; and ≥18 years of age.</div></div><div><h3>Data Extraction and Synthesis</h3><div>Titles and abstracts were reviewed, followed by full-text review and a quality assessment. An integrated approach was undertaken, including line-by-line coding of eligible papers, development of preliminary descriptive themes based on these codes, and amalgamation of the themes to describe the relationship between eating disorders and GWG. A total of 1471 articles were identified, 14 of which met the inclusion criteria for the study. Three themes emerged: body image concerns, fear of GWG and postpartum weight retention, and prioritizing the health of the baby.</div></div><div><h3>Conclusion</h3><div>The identified themes inform the relationship between anorexia nervosa, bulimia nervosa, and binge eating disorder and guideline-discordant GWG. These findings are relevant for persons who provide prenatal care to patients with previous or current eating disorders.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 102964"},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337428","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":"Voigt-Futcher Pigmentary Demarcation Lines in Postpartum Patient","authors":"Vincent Williams M.D., MMED","doi":"10.1016/j.jogc.2025.102965","DOIUrl":"10.1016/j.jogc.2025.102965","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 8","pages":"Article 102965"},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337433","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":"Limited Impact of COVID-19 on Pre-existing Trends in Postpartum Infection","authors":"Ruxandra Andronache MD , Jessica Healy-Profitós MPH , Fiona Young MD, PhD , Antoine Lewin PhD , Nathalie Auger MD, MSc","doi":"10.1016/j.jogc.2025.102961","DOIUrl":"10.1016/j.jogc.2025.102961","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess whether postpartum infection rates decreased among hospital deliveries during the pandemic.</div></div><div><h3>Methods</h3><div>We designed a pre-post pandemic comparison study of postpartum infection rates among hospital births in Québec, Canada between 2017 and 2022. We calculated postpartum infection rates per 10 000 deliveries and compared the prepandemic and pandemic periods using risk ratios (RRs) and 95% CIs from log-binomial multivariable regression models. We stratified the analysis by mode of delivery and adjusted the models for maternal age, parity, comorbidity, and socioeconomic deprivation. We used autoregressive interrupted time series analysis to verify whether the pandemic impacted pre-existing trends in postpartum infection rates.</div></div><div><h3>Results</h3><div>Postpartum infections were less frequent during the pandemic. Among patients who underwent cesarean deliveries, there was a 30% reduction in the risk of postpartum infection during the pandemic compared with the prepandemic period (RR 0.70; 95% CI 0.62–0.79, <em>P</em> < 0.001). Among patients who underwent vaginal deliveries, there was a 12% reduction in risk (RR 0.88; 95% CI 0.81–0.97, <em>P</em> <em>=</em> 0.008). However, interrupted time series analysis indicated that the reduction in postpartum infections began as early as 2010 and that these pre-existing trends persisted during the pandemic.</div></div><div><h3>Conclusions</h3><div>Infection rates have decreased over time, especially among cesarean deliveries. The pandemic did not significantly alter the long-term trend in decreasing postpartum infection rates.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 8","pages":"Article 102961"},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337429","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}