Obstetrical & Gynecological Survey最新文献

{"title":"The Role of Humoral Autoimmunity in the Pathophysiology of Preeclampsia.","authors":"Brian Wong, Justin Lee, Raymond Liang, Yan Hu, Ivan Velickovic, Samantha Cavusoglu, Mudar Dalloul, Ming Zhang","doi":"10.1097/OGX.0000000000001479","DOIUrl":"10.1097/OGX.0000000000001479","url":null,"abstract":"<p><strong>Importance: </strong>Preeclampsia (PE) remains a leading cause of maternal mortality worldwide. Research has shown multifactorial contributions to its pathophysiology. With recent evidence suggesting that humoral autoimmunity plays a crucial role, autoantibodies targeting vascular and immune pathways contribute to disease progression. Further research into the role of humoral autoimmunity in the etiology of PE and potential treatments could significantly improve maternal and fetal health.</p><p><strong>Objective: </strong>This study aims to provide an overview of current research on the role of autoantibodies in humoral autoimmunity and their contribution to the pathophysiology of PE.</p><p><strong>Evidence acquisition: </strong>A comprehensive search was conducted in the PubMed database using the keywords \"preeclampsia\" and \"autoantibody\" to identify potentially pathogenic autoantibodies in preeclampsia. We performed follow-up searches with the keywords \"preeclampsia\" and identified autoantibodies such as \"AT1-AA.\"</p><p><strong>Results: </strong>Autoantibodies, particularly angiotensin II type 1 receptor autoantibodies (AT1-AA) and endothelin-1 type A receptor autoantibodies (ETAR-AA), play a crucial role in PE by directly modulating vascular tone and promoting inflammation through mechanisms such as vasoconstriction and oxidative stress. Preeclampsia is also associated with other autoantibodies, including anti-beta-2-glycoprotein and lupus anticoagulant. Emerging research suggests that targeting these autoantibodies or their downstream receptors may be a promising therapeutic strategy for reducing disease severity.</p><p><strong>Conclusions and relevance: </strong>Humoral autoimmunity plays a significant role in the pathophysiology of PE, offering novel diagnostic and potential therapeutic avenues. Emerging treatments targeting these pathways show promise in alleviating PE symptoms. Further research into autoantibody mechanisms and targeted interventions is essential for improving outcomes in PE-affected pregnancies.</p>","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 3","pages":"127-137"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Penicillin Allergy in Pregnancy: A Practical Review for the Obstetrician.","authors":"Jennifer J M Cate, Allison Chu, Celeste Prado, Jeffrey A Kuller, Sarah K Dotters-Katz, Samuel T Bauer","doi":"10.1097/OGX.0000000000001480","DOIUrl":"10.1097/OGX.0000000000001480","url":null,"abstract":"<p><strong>Importance: </strong>Penicillin allergies are commonly reported in pregnancy, yet patients are rarely truly allergic. Identification of pregnant patients who would benefit from penicillin allergy testing is an important public health initiative to reduce alternative antibiotic usage and reduce associated adverse outcomes.</p><p><strong>Objective: </strong>This article reviews the epidemiology of penicillin allergy, the pathophysiology of allergy in general, in addition to penicillin allergy, the safety of penicillin allergy testing in pregnancy, the impact of penicillin allergy testing on maternal and neonatal outcomes, and considerations for quality improvement interventions.</p><p><strong>Evidence acquisition: </strong>Original research articles, review articles, and professional society guidelines on penicillin allergy evaluation in pregnancy were reviewed.</p><p><strong>Results: </strong>Penicillin allergy in pregnancy is associated with increased risks of adverse neonatal and maternal outcomes. The reviewed literature demonstrates that penicillin allergy testing in pregnancy is efficacious, with the majority of individuals undergoing penicillin allergy delabeling with low rates of allergy testing complications. In addition, penicillin allergy testing has been shown to be associated with a reduction in second-line antibiotic usage, although future studies are required to elucidate the full reduction in adverse outcomes associated with delabeling.</p><p><strong>Conclusions and relevance: </strong>Penicillin allergy in pregnancy is associated with increased risk of adverse outcomes. Given that the majority of individuals can be safely delabeled, efforts to explore opportunities for increased penicillin allergy assessment should be an ardent goal.</p>","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 3","pages":"138-146"},"PeriodicalIF":4.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antenatal Corticosteroids for Fetal Maturation: A Comprehensive Review of Major Guidelines.","authors":"Sonia Giouleka, Lampriana Grigoropoulou, Georgios Michos, Antonios Siargkas, Eirini Boureka, Anastasios Liberis, Apostolos Mamopoulos, Ioannis Kalogiannidis, Ioannis Tsakiridis, Themistoklis Dagklis","doi":"10.1097/OGX.0000000000001468","DOIUrl":"10.1097/OGX.0000000000001468","url":null,"abstract":"<p><strong>Importance: </strong>The administration of corticosteroids before anticipated preterm delivery represents a crucial antenatal intervention that enhances fetal lung maturity and reduces neonatal morbidity and mortality.</p><p><strong>Objective: </strong>This review aims to evaluate and compare the most recently published influential guidelines on the use of antenatal corticosteroids (ACS).</p><p><strong>Evidence acquisition: </strong>A comparative review of guidelines from the American College of Obstetricians and Gynecologists (ACOG), the Royal College of Obstetricians and Gynaecologists (RCOG), the International Federation of Gynecology and Obstetrics (FIGO), the European Association of Perinatal Medicine (EAPM), the World Association of Perinatal Medicine (WAPM), the World Health Organization (WHO), the Society of Obstetricians and Gynaecologists of Canada (SOGC), and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) was carried out.</p><p><strong>Results: </strong>All the reviewed guidelines recommend the use of ACS between 24+0 and 33+6 weeks of gestation, when preterm delivery is anticipated and endorse the consideration of their use at the periviable period. In addition, there is an overall agreement regarding the recommended regimens and the use of ACS in case of pregnancies with existing comorbidities, such as preterm prelabor rupture of membranes, obesity, multiple pregnancy, fetal growth restriction, and diabetes. In contrast, the recommendations for the use of ACS in the late preterm period, in women with chorioamnionitis and in cases of recurrent or persistent threatened preterm delivery vary. Moreover, RCOG is the only medical society supporting that the administration of ACS in case of planned cesarean delivery should be considered up to 38+6 weeks of gestation.</p><p><strong>Conclusions: </strong>The favorable role of corticosteroids in improving the outcomes of preterm neonates is clearly outlined. However, the explicit articulation of the potential benefits and harms stemming from their use at different stages of pregnancy and in different delivery contexts is yet to be elucidated. Thus, it seems of paramount importance to develop consistent recommendations for the use of this antenatal intervention to maximize its beneficial effects and eliminate the associated risks.</p>","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 2","pages":"75-83"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Dysfunction-Associated Steatotic Liver Disease in Pregnancy: A Review.","authors":"Daniel Core, Layne Landry, Christopher Menefee, Michael Mahoney, Shruti Vaidyanathan, David Lewis","doi":"10.1097/OGX.0000000000001481","DOIUrl":"10.1097/OGX.0000000000001481","url":null,"abstract":"<p><strong>Importance: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease, is characterized by fatty deposits in the liver, with histologic features like alcohol-induced liver injury, without associated alcohol misuse. This condition is associated with other metabolic comorbidities, particularly obesity and insulin resistance. MASLD is also associated with the development of pregnancy-related complications such as gestational diabetes mellitus and hypertensive disorders of pregnancy. MASLD is one of the most common liver diseases today, with a prevalence of 14% in pregnant individuals.</p><p><strong>Objective: </strong>The goal of this review was to explore the topic of MASLD with a discussion of its pathophysiology, diagnosis, clinical management, and complications related to pregnancy.</p><p><strong>Evidence acquisition: </strong>A literature search was conducted utilizing Rayyan to review 180 articles published between 2000 and 2024 for inclusion or exclusion in the review.</p><p><strong>Results: </strong>MASLD is an increasingly prevalent disease process likely underdiagnosed in pregnancy. Evidence suggests a synergistic pathway between obesity and the physiological changes of pregnancy, which can initiate or exacerbate liver steatosis. MASLD is associated with adverse outcomes in pregnancy and in the offspring of affected pregnancies.</p><p><strong>Conclusions and relevance: </strong>Further research is needed to demonstrate optimal screening, diagnosis, and management in pregnancy. If detected early, early diabetes screening and low-dose aspirin may be appropriate, given the significant association with gestational diabetes and gestational hypertensive disorders. Patients should be counseled on the increased risk of maternal morbidity, preterm birth, miscarriage, macrosomia, pregnancy-induced hypertension, cesarean delivery, gestational diabetes, and metabolic disease in the offspring.</p>","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 2","pages":"84-92"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Furcate Cord Insertions: A Comprehensive Review of Reported Cases, Outcomes, and Management Implications.","authors":"Brooke E Schroeder, Jeffrey A Kuller, Lillian Boettcher, Sarah K Dotters-Katz","doi":"10.1097/OGX.0000000000001478","DOIUrl":"10.1097/OGX.0000000000001478","url":null,"abstract":"<p><strong>Importance: </strong>Furcate umbilical cord insertion is a rare anomaly in which the umbilical vessels separate and lose Wharton jelly before placental insertion. This condition increases the risk of complications such as vessel avulsion and intrauterine fetal demise (IUFD). Despite these risks, data on this condition are limited, and no formal management guidelines exist for prenatally diagnosed cases.</p><p><strong>Objective: </strong>To provide an overview of abnormal umbilical cord insertions, with a focus on furcate cord insertions, as well as the evidence for the management of patients with furcate cord insertions.</p><p><strong>Evidence acquisition: </strong>Articles were identified through a PubMed and OVID literature search and reviewed for relevance.</p><p><strong>Results: </strong>We identified 158 cases of furcate cord insertion. Prenatal diagnosis occurred in only 20 cases (12.7%). IUFD was reported in 6 cases (3.8%), all where furcate cord went undiagnosed prenatally and nearly all (5/6) occurring after 37 weeks' gestation. Cesarean delivery was frequently performed when furcate cord insertion was detected prenatally, especially when co-occurring other comorbidities. Cord avulsion was reported in all cases of labor after 37 weeks, underscoring the risks associated with vaginal delivery.</p><p><strong>Conclusion: </strong>Furcate cord insertion is a rare placental anomaly associated with significant perinatal risk. Improved prenatal recognition may support evidence development and guide peripartum care. According to the limited available evidence, early-term cesarean delivery may be a reasonable option in prenatally diagnosed cases, though further research is needed.</p><p><strong>Relevance: </strong>This review offers an overview of the evidence for the detection and management of furcate cord insertions.</p>","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 2","pages":"93-98"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Birth Outcomes Among Women With Syphilis During Pregnancy in Six U.S. States, 2018-2021: Erratum.","authors":"Jeffrey M Carlson, Christina L Sancken, Khue Nguyen, Elizabeth L Lewis, Aisha Praag, Kourtney Pulliam, Teri' Willabus, Zacharie Eric Bakwa, Nicole D Longcore, Kevin P O'Callaghan, Kathryn Miele, Alison Fountain, Van T Tong, Kate R Woodworth","doi":"10.1097/OGX.0000000000001492","DOIUrl":"10.1097/OGX.0000000000001492","url":null,"abstract":"","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 2","pages":"74"},"PeriodicalIF":3.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal Cannabis Use and Neonatal Outcomes: A Systematic Review and Meta-Analysis.","authors":"Jamie O Lo, Chelsea K Ayers, Snehapriya Yeddala, Beth Shaw, Shannon Robalino, Rachel Ward, Devan Kansagara","doi":"10.1097/01.ogx.0001179556.80297.a5","DOIUrl":"https://doi.org/10.1097/01.ogx.0001179556.80297.a5","url":null,"abstract":"<p><p>Over the last 20 years, rates of cannabis use among pregnant people have increased significantly, making cannabis the most commonly used illegal substance in the antenatal period. THC, the active ingredient in cannabis, crosses the placental barrier and binds to endocannabinoid receptors on fetal organs. However, because definitive data on the risks of prenatal cannabis use remain limited, many clinicians do not counsel patients on this topic. This study provides an updated assessment of the association between prenatal cannabis use and pregnancy, fetal, and neonatal outcomes, adjusting for tobacco use and other confounders. The authors updated their previous systematic review and meta-analysis to include cohort or case-control studies published between November 2021 and April 2024 in MEDLINE, CINAHI, PsycInfo, Global Health, and the Cochrane Database of Systematic Reviews. Studies were included if they compared cannabis use versus no or less use during pregnancy and adjusted for confounders. Two independent researchers assessed each study for eligibility, risk of bias, and certainty-of-evidence ratings. Primary outcomes were preterm birth (PTB), small for gestational age (SGA), low birth weight (LBW), and perinatal morbidity. The results were analyzed to determine effect sizes and adjusted odds ratios, incorporating frequency of cannabis use when possible. Fifty-one publications were included, 8 of which were new additions since the prior analysis, yielding a total sample of 21,146,938 patients. Among the 20 studies evaluating LBW (N=1,763,753), cannabis use was associated with higher odds of LBW (OR, 1.75; 95% CI, 1.41-2.18). In 5 studies reporting dosage, heavy users had an even greater risk (OR, 2.36; 95% CI, 1.50-3.7). Twenty studies evaluated PTB (N=20,938,125), showing increased risk among cannabis users (OR, 1.52; 95% CI, 1.26-1.83), with a stronger association among heavy users (OR, 1.95; 95% CI, 1.40-2.73). Six studies assessed perinatal mortality (N=16,868,920), finding elevated odds among users (OR, 1.29; 95% CI, 1.07-1.55), though this association was not significant in analyses restricted to heavy use, leading to a low certainty-of-evidence rating. Four studies evaluated SGA (N=4,520,474) and reported increased odds among cannabis users (OR, 1.57; 95% CI, 1.36-1.81), with similar findings in heavy-use analyses (OR, 1.63; 95% CI, 1.35-1.96). Overall, the findings suggest with moderate certainty that prenatal cannabis use increases the risk of LBW, PTB, and SGA, and with low certainty that it increases perinatal mortality. The addition of recent studies expanded the sample size and supported a dose-dependent association, strengthening confidence in the results. The strengths of the review include its clinically relevant outcomes, strict exclusion criteria, and adjustment for key confounders such as tobacco. The limitations included heterogeneity between studies and gaps in collected data.</p>","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 1","pages":"9-10"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146011437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and Preoperative Management of Adolescent Patients With Pathology-Confirmed Endometriosis: A Multi-Institutional Study.","authors":"Katherine C Bergus, Brenna Rachwal, Lindsey Asti, Lesley L Breech, Yuan Y Gong, S Paige Hertweck, Holly R Hoefgen, Anne H Horne, Ashli Lawson, Seema Menon, Kathleen E O'Brien, Shashwati Pradhan, Yolanda R Smith, Priya Suvarna, Sarah Van Son, Geri Hewitt","doi":"10.1097/01.ogx.0001179564.81631.80","DOIUrl":"10.1097/01.ogx.0001179564.81631.80","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Endometriosis affects an estimated 25% to 75% of adolescent patients with chronic pelvic pain; the diagnosis is made surgically and treatment typically consists of hormone suppression and pain management strategies. The methods to address symptoms can vary from hormonal contraceptives, levonorgestrel-releasing intrauterine systems, and gonadotropin-releasing hormone therapy to nonhormonal medications for pain, pelvic floor physical therapy, and psychological support. Previous studies of endometriosis in adolescent patients have mainly been case series or single-institution studies, and there is little evidence surrounding preoperative management. This study was designed to characterize demographics and preoperative management of patients who underwent laparoscopy and were diagnosed with pathologically confirmed endometriosis. This was a multi-institutional retrospective cohort study. The inclusion criteria were patients under the age of 22, who had undergone laparoscopic surgical biopsy and had a diagnosis of endometriosis based on pathologic findings between January 1, 2011, and December 31, 2021. A total of 305 patients were included in this descriptive study, with a median age of 15.6 years at the time of first presentation to a pediatric and adolescent gynecology (PAG) clinic. The median age at first menstruation was 12 years, and a large proportion of patients had a family history of endometriosis (45.3%), many of these in first-degree relatives (68.1%). In terms of medical history, the median number of providers seen before presentation to PAG was 1, and these providers ranged from primary care physicians and adolescent medicine specialists to adult gynecologists, gastroenterologists, and physical therapists. Abnormalities in menstrual cycle patterns were uncommon, with only 15% reporting frequent cycles and 11% reporting infrequent cycles. Heavy bleeding was reported in 50.8% of cases, and 50.5% of individuals reported cramping before bleeding, with 58.2% reporting severe pain during menstruation. Progressive dysmenorrhea was reported in 76.7% of cases. More than half of patients missed school or activities due to dysmenorrhea, and many reported other symptoms, including nausea/vomiting, diarrhea, appetite changes, and headaches. The management before surgery consisted of several approaches, with many patients trying one or more methods before surgical diagnosis. These included hormonal menstrual suppression (70.8%), including combined hormonal contraception, medroxyprogesterone acetate injection, progestin-only oral medication, hormonal intrauterine devices, contraceptive implants, and gonadotropin-releasing hormone analogs. Comorbidities in this patient population included psychiatric (mood or anxiety) disorders and neurologic, gastrointestinal, and musculoskeletal comorbidities, with most patients reporting at least one (73.4%). Physical examination in this cohort primarily showed a presentation of pelvic pain or bilateral lower q","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 1","pages":"19-20"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146011406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Pre-Pregnancy Body Mass Index and Gestational Age-Specific Risk of Stillbirth and Perinatal Death in Women With Chronic Hypertension.","authors":"Jeffrey N Bone, K S Joseph, Laura A Magee, Chantal Mayer, Sarka Lisonkova","doi":"10.1097/OGX.0000000000001488","DOIUrl":"https://doi.org/10.1097/OGX.0000000000001488","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Obesity is an important risk factor for adverse birth outcomes. Its prevalence has steadily increased over the past decades, with nearly half of pregnant women in the United States considered overweight or obese in 2019. A higher pre-pregnancy body mass index (BMI) is associated with an elevated risk of stillbirth, and obesity is associated with chronic hypertension, diabetes mellitus, and other comorbidities that are independent risk factors for stillbirth and perinatal death. Because of these risks, earlier delivery for women with high BMI is being considered; however, the data on specific risks related to gestational age (GA) are limited. Currently, recommendations for women with high BMI differ across professional bodies. The Canadian Society of Obstetricians and Gynaecologists recommends delivery at 39 to 40 weeks' gestation for women with extreme obesity and at 38 to 40 weeks' gestation for those with chronic hypertension. In contrast, the American College of Obstetricians and Gynecologists and the Royal College of Obstetricians and Gynaecologists provide no GA-specific recommendations for obesity. The aim of this study was to evaluate the association between pre-pregnancy BMI and GA-specific risk of stillbirth, and whether chronic hypertension modifies these associations.This was a retrospective cohort study, using data from the National Center for Health Statistics on women who had a singleton live- or stillbirth at ≥20 weeks' gestation between 2016 and 2017. Excluded were live births and fetal deaths at &lt;20 or ≥43 weeks of gestation and women with missing data on pre-pregnancy BMI. The primary and secondary outcomes were stillbirth and perinatal death, respectively. The primary exposure was pre-pregnancy BMI. BMI categories included underweight (BMI &lt;18.5 kg/m2), normal weight (18.5 to &lt;25 kg/m2), overweight (25 to &lt;30 kg/m2), obesity class I (30 to &lt;35 kg/m2), obesity class II (35 to &lt;40 kg/m2), and obesity class III (≥40 kg/m2). Chronic hypertension was evaluated as a modifier on the relationship between BMI and GA-specific stillbirth.A total of 7,365,797 women were included in the study, with 3.5% classified as underweight, 43.9% as normal weight, 26.1% as overweight, 14.5% as obesity class I, 7% as class II, and 5% as class III. Women with elevated BMI had higher rates of chronic hypertension and pre-pregnancy diabetes mellitus. They were also more likely to deliver at an earlier GA. While the stillbirth rate among those at normal weight was 3.86 per 1000 total births, the rate increased with elevated BMI both with and without hypertension. Overall, women who also had chronic hypertension had a higher stillbirth rate in all BMI categories, with the highest rate of perinatal death among underweight women (27.6 per 1000 total births).Women without hypertension saw an increase in the GA-specific risk of stillbirth and perinatal death after 37 weeks of gestation. Regardless of whether hypertension was present, the differences in th","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 1","pages":"1-2"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying the Spectrum of Early Motor and Language Milestones in Sex Chromosome Trisomy.","authors":"Talia Thompson, Samantha Bothwell, Jennifer Janusz, Rebecca Wilson, Susan Howell, Shanlee Davis, Karli Swenson, Sydney Martin, Karen Kowal, Chijioke Ikomi, Maria Despradel, Judith Ross, Nicole Tartaglia","doi":"10.1097/OGX.0000000000001485","DOIUrl":"https://doi.org/10.1097/OGX.0000000000001485","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The sex chromosome trisomies (SCT), including XXY, XYY, and XXX, are common chromosomal aneuploidies associated with increased risk for early developmental delays and later neurodevelopmental disorders. Precise data on the timing and variability of early milestones in this population remain limited, so despite rising rates of prenatal SCT diagnosis, clinicians and families lack clear, evidence-based expectations for early motor and language development. This study aims to quantify the spectrum of early developmental milestones in infants with SCT and compare their timing with well-established standards for unaffected children to better contextualize early developmental risk. This analysis used data from the eXtraordinarY Babies Natural History Study, a prospective cohort of prenatally identified infants with SCT followed from infancy through early childhood. Between 2 and 36 months of life, parents reported easily observable gross motor and expressive language milestones, and clinicians validated these findings at regularly scheduled study visits as part of a broader assessment of development and health trajectories. A total of 12 milestones were collected for each participant: 8 gross motor skills and 4 expressive communication milestones. To compare these values with a normative reference group, data were retrieved from the Denver II Scales, the WHO Motor Development Study, and the Primitive Reflex Profile. Analyses assessed the median age of acquisition, variance, and differences across SCT karyotypes, as well as the proportion of children who fell outside CDC milestone expectations. Among 298 infants with SCT (174 with XXY, 50 with XYY, and 74 with XXX), results showed a later median age of acquisition for 9 of the 12 milestones evaluated, including rolling front to back, sitting, cruising, walking, running, cooing, babbling, first words, and 2-word phrases. There was also greater variance in milestone timing for the SCT group compared with the reference population, with extended upper percentiles across most skills indicating a wider range of typical achievement. While these delays were statistically significant, there was considerable overlap between the SCT group and the general pediatric population, and only a minority of infants met the CDC criteria for developmental delay. Differences across SCT karyotypes were small and generally not significant, although children with XXY achieved several skills slightly earlier than those with XYY or XXX. These findings provide an evidence-based schedule for early motor and language milestones in infants with SCT to aid early childhood surveillance and counseling. The later median age of acquisition and greater variability observed across all SCT conditions support the need for periodic developmental assessment beyond guidelines for the general population to identify children requiring additional support earlier. Although many infants with SCT will experience developmental trajectories similar ","PeriodicalId":19409,"journal":{"name":"Obstetrical & Gynecological Survey","volume":"81 1","pages":"12-14"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146011009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}