Obstetrics and gynecology最新文献

{"title":"Role of Operative Reports in Surgical Learning and Memory: A Randomized Controlled Trial.","authors":"Erin E Mowers,Megan Bradley","doi":"10.1097/aog.0000000000005985","DOIUrl":"https://doi.org/10.1097/aog.0000000000005985","url":null,"abstract":"OBJECTIVETo evaluate the effect of operative report documentation on surgeons' ability to remember procedural steps.METHODSWe conducted a randomized controlled trial of obstetrician-gynecologist trainee and attending surgeons at University of Pittsburgh Magee-Womens Hospital. During the learning phase, participants were guided through a 50-step procedure that used a Montessori lockbox, lighted switchboard, and simple tools. After the procedure, participants were stratified by training level and block randomized to one of three writing exercises: control, templated operative report, and freestyle operative report. During the testing phase 1 week later, participants were asked to complete the procedure from memory. The primary outcome was the testing phase performance score (out of 100 possible points), and secondary outcomes include operative report accuracy, procedure time, predicted future performance, and perceived influence of documentation.RESULTSForty-eight participants were randomized to 16 participants per group, with 0% dropout. Completion of a templated or freestyle operative note resulted in significantly improved performance during the testing phase (control: mean 50.9, SD 13.6; template: mean 60.9, SD 11.9; freestyle: mean 62.1, SD 13.3; P <.05). In addition, participants who completed an operative report completed the procedure more quickly than those in the control group ( P <.05). Operative report accuracy during the learning phase was significantly correlated with testing day performance ( P <.005). Although the majority of participants who completed an operative report perceived that the documentation had a positive influence on their performance, this did not translate into differences in the perceived difficulty of the task or in their predictions for testing day performance.CONCLUSIONOperative report documentation significantly improved surgeons' procedural memory and task completion time 1 week after learning a new procedure. Trainee-written operative reports may be one means of promoting surgical memory and learning, and formal operative report education should be incorporated into surgical training programs.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"24 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Timing of Venous Thromboembolism in Patients With Advanced Endometrial Cancer.","authors":"Josie D Llanora,Shitanshu Uppal,Hannah D McLaughlin","doi":"10.1097/aog.0000000000005978","DOIUrl":"https://doi.org/10.1097/aog.0000000000005978","url":null,"abstract":"Patients with advanced endometrial cancer (EC) are at risk for venous thromboembolism (VTE), though risk by treatment phase remains unclear. This single-institution retrospective study evaluated 84 patients receiving neoadjuvant chemotherapy (NACT, n=34) or adjuvant chemotherapy (n=50) for stage III-IV EC. Overall VTE incidence was 27.4% (95% CI, 18.8-38.0%). Among patients receiving NACT, VTE occurred in 14.3% during NACT and in 16.7% during ongoing chemotherapy. Postoperative and adjuvant treatment rates were less than 10.0%. Khorana score was a poor predictor of VTE, with 52.0% of intermediate-risk patients developing VTE. These findings highlight the need for improved VTE risk-reduction strategies, including larger studies to evaluate optimization of risk stratification and VTE prophylaxis during systemic therapy for advanced EC.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"75 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Burden of Maternal Disorders and Mortality Among Female Individuals Aged 15-49 Years, 1990-2021.","authors":"Mengxi Wang,Lina Zhou,Wenyi Tang,Lingyun Zou","doi":"10.1097/aog.0000000000005980","DOIUrl":"https://doi.org/10.1097/aog.0000000000005980","url":null,"abstract":"OBJECTIVETo quantify mortality trends among female individuals of childbearing age (15-49 years) across global regions from 1990 to 2021, systematically evaluating persistent geographic inequities in preventable deaths.METHODSWe analyzed data from the GBD (Global Burden of Diseases, Injuries, and Risk Factors Study) 2021, focusing on five leading causes of maternal mortality: hemorrhage, hypertensive disorders, sepsis and infections, obstructed labor and uterine rupture, and abortion and miscarriage. We calculated estimated annual percent change (APC) in age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for these conditions, stratified by age group and sociodemographic index, to examine temporal trends. Joinpoint regression identified trends and inflection points in age and sociodemographic index stratification. Spearman correlation analysis assessed the relationship between ASIRs and sociodemographic index levels.RESULTSGlobally, an estimated 102,854,299 new incident cases of the five major maternal disorders and 129,331 deaths were reported in 2021. Between 1990 and 2021, the ASIR declined annually by -1.4% (95% CI, -1.5% to -1.3%) (estimated APC), and the ASMR decreased even more substantially at -3.6% (95% CI, -3.7% to 3.4%) per year. Annual declining trends in ASIR and ASMR were observed across all leading causes of maternal mortality. However, regions such as Central Sub-Saharan Africa still reported persistently high rates. Epidemiologic curves revealed peak mortality in the age stratum of 20-24 years, with progressive attenuation to nadir levels in individuals aged 45-49 years. Although abortion or miscarriage became increasingly prevalent as a cause of death worldwide over three decades, maternal hemorrhage remained the leading cause of death, accounting for 35.8% of deaths globally. Higher sociodemographic index correlated with declining ASIR and ASMR trends overall. Notably, sepsis-related mortality increased in younger cohorts, and high-middle-sociodemographic index regions achieved the steepest ASMR and ASIR reductions from 1990 to 2006. Joinpoint regression identified inflection points in incidence and mortality trends in age- and sociodemographic index-stratified populations over time.CONCLUSIONThere was a substantial global reduction in maternal mortality between 1990 and 2021; however, Central Sub-Saharan Africa persists as the most critical regional hotspot. Maternal hemorrhage was the leading cause of death. The Sociodemographic index serves as a robust predictor of mortality, necessitating precision-targeted interventions that prioritize geographic regions with both elevated risk and obstetric complications.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"24 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural-Urban Differences in Maternal Syphilis Trends in the United States, 2016-2023.","authors":"Clara E Busse,Danielle R Gartner,Katy B Kozhimannil","doi":"10.1097/aog.0000000000005984","DOIUrl":"https://doi.org/10.1097/aog.0000000000005984","url":null,"abstract":"Cases of syphilis during pregnancy (maternal syphilis) have risen dramatically in the United States in recent years, with racially minoritized groups experiencing high rates and large increases. Rural residents face diminishing access to maternity care, but prior research has not examined rural-urban differences in maternal syphilis. Using expanded natality data from the Centers for Disease Control and Prevention, we compared maternal syphilis rates among rural and urban residents (2016-2023) and showed that, since 2021, rural rates have exceeded urban rates. From 2016 to 2023, maternal syphilis rates quintupled in rural areas and tripled in urban areas. Rates and increases are particularly high among American Indian and Alaska Native and Black rural residents compared with their urban counterparts.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"16 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144320211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardized Counseling Tool for Returning to Sexual Activity After Pelvic Reconstructive Surgery.","authors":"Lauren Caldwell, Shunaha Kim-Fine, Danielle D Antosh, Katherine Husk, Kate V Meriwether, Jaime B Long, Christine A Heisler, Patricia L Hudson, Svjetlana Lozo, Shilpa Iyer, Emily E Weber LeBrun, Rebecca G Rogers","doi":"10.1097/AOG.0000000000005938","DOIUrl":"https://doi.org/10.1097/AOG.0000000000005938","url":null,"abstract":"<p><strong>Objective: </strong>To create a standardized counseling tool for return to sexual activity after pelvic reconstructive surgery.</p><p><strong>Methods: </strong>An expert panel created an initial counseling tool based on the conceptual framework previously developed in a rigorous qualitative analysis of women's experience of their first sexual encounters after pelvic reconstructive surgery. This instrument was then refined through cognitive patient interviews. Women who had previously undergone reconstructive surgery for pelvic organ prolapse or urinary incontinence and returned to sexual activity were recruited from four clinical sites across the United States and Canada for participation in cognitive interviews. Participants reviewed proposed counseling statements and were asked to describe their meaning, suggest any necessary changes, and rate their importance. Summaries of the ongoing cognitive interviews were periodically presented to the working group for discussion, and the instrument was revised accordingly. Interviews were conducted until no new substantive comments were made.</p><p><strong>Results: </strong>Nineteen cognitive patient interviews were conducted, and three rounds of modifications were made to the initial counseling tool. Modifications included merging multiple counseling statements to avoid redundancy and eliminating statements that were not considered important by patients. Patients consistently rated statements about the safety of resuming intercourse and anticipated discomfort with initial sexual encounters as very important.</p><p><strong>Conclusion: </strong>We developed a novel, patient-centered counseling tool for the return to sexual activity after pelvic reconstructive surgery using a previously established conceptual framework and cognitive patient interviews. It addresses an important surgical outcome for patients and offers surgeons a concise, high-value counseling tool.</p>","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Human Immunodeficiency Virus and Preeclampsia Among a Combined Cohort of Zambian Women.","authors":"Katelyn J Rittenhouse, Margaret P Kasaro, M Bridget Spelke, Yuri V Sebastião, Humphrey Mwape, Kenneth Chanda, Nelly Mandona, Ntazana Sindano, Stephen R Cole, Elizabeth M Stringer, Bellington Vwalika, Jeffrey S A Stringer","doi":"10.1097/AOG.0000000000005970","DOIUrl":"https://doi.org/10.1097/AOG.0000000000005970","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between maternal HIV infection and preeclampsia. We hypothesized that maternal HIV infection would be associated with a lower risk of preeclampsia, potentially due to HIV-related immunomodulatory effects.</p><p><strong>Methods: </strong>We combined participants from one observational cohort and two randomized trials conducted at the same facilities in Lusaka, Zambia between 2015 and 2022. The exposure of interest was maternal HIV infection, and the primary outcome was preeclampsia, defined as 1) new-onset (at or after 20 weeks of gestation) hypertension (systolic blood pressure [BP] 140 mm Hg or higher or diastolic BP 90 mm Hg or higher) with concurrent proteinuria (1+ or higher), 2) new onset proteinuria (1+ or higher) in participants with chronic hypertension in the absence of urinary tract infection, or 3) diagnosis of severe preeclampsia. We defined severe preeclampsia as 1) new-onset severe-range BP (systolic 160 mm Hg or higher or diastolic 110 mm Hg or higher), 2) eclamptic seizure, or 3) clinician-initiated preterm delivery (before 37 weeks of gestation) for preeclampsia. Using marginal standardization (parametric g-formula), we estimated the risk of preeclampsia associated with HIV infection. Antiretroviral therapy (ART) exposure and HIV disease severity (viral load, CD4 counts) were assessed as effect modifiers.</p><p><strong>Results: </strong>Of 4,078 women included in the combined cohort, 186 (4.6%) were diagnosed with preeclampsia, including 43 (2.7%) of 1,590 women with HIV infection and 143 (5.8%) of 2,488 women without HIV infection. Of those with HIV infection, 73.2% were on prepregnancy ART, and 56.7% had an undetectable viral load at study enrollment (median 15 weeks). In analyses standardizing for maternal age, nulliparity, and calendar time of enrollment, HIV infection was associated with lower preeclampsia risk (relative risk 0.42; 95% CI, 0.26-0.59; risk difference -3.5%; 95% CI, -4.9 to -2.1). This reduced risk persisted when stratifying by prepregnancy ART exposure, detectable viral load, and CD4 count at enrollment; findings were similar when applying the more stringent definition of severe preeclampsia.</p><p><strong>Conclusion: </strong>In this well-phenotyped cohort, women with HIV infection were less likely to have preeclampsia compared with those without HIV infection.</p>","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not Closing Compared With Closing the Endometrial Layer During Cesarean Delivery: A Systematic Review and Meta-analysis.","authors":"Gabriel Moreira Lino, Pauliana Valéria Machado Galvão, Maria Luíza Ferreira da Silva, George Alessandro Maranhão Conrado","doi":"10.1097/AOG.0000000000005974","DOIUrl":"https://doi.org/10.1097/AOG.0000000000005974","url":null,"abstract":"<p><strong>Objective: </strong>To perform a meta-analysis of randomized and quasi-randomized trials investigating whether endometrial closure is associated with the risk of uterine scar defects, menstrual symptoms, and associated surgical morbidity.</p><p><strong>Data sources: </strong>The Medline, EMBASE, Cochrane Library, and ClinicalTrials.gov databases were searched until February 10, 2025. Only randomized controlled trials (RCTs) or quasi-randomized trials comparing not closing with closing the endometrium during cesarean delivery were included.</p><p><strong>Methods of study selection: </strong>We identified 266 records in our search and two records by citation searching. Of these, 106 were considered for eligibility, and six were ultimately included in the review.</p><p><strong>Tabulation, integration, and results: </strong>We used a random-effects meta-analysis reporting relative risk (RR) and absolute risk and 95% CIs. The risk of bias was evaluated with the Cochrane risk-of-bias tool for randomized trials 2, and findings were presented according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. We included six RCTs (491 women). Not including the endometrium in uterine closure reduces the risk of intermenstrual bleeding (RR 0.34, 95% CI, 0.15-0.77; two RCTs, 272 women; 6 months of follow-up; high-certainty evidence) and uterine scar defect (RR 0.53, 95% CI, 0.34-0.82; four RCTs, 392 women; I2=0.0%; 3-12 months of follow-up; high-certainty evidence). There were no differences in heavy uterine bleeding, dysmenorrhea, pelvic pain, postpartum endometritis, and residual myometrial thickness (low- to very low-certainty evidence).</p><p><strong>Conclusion: </strong>Not suturing the endometrium reduces the risk of intermenstrual bleeding and uterine scar defect after cesarean delivery.</p><p><strong>Systematic review registration: </strong>PROSPERO, CRD42025650124.</p>","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of an Extended Maternal Comorbidity Index for Prediction of Severe Maternal Morbidity.","authors":"Ann M Bruno, Grecio J Sandoval, Brenna L Hughes, William A Grobman, George R Saade, Tracy A Manuck, Monica Longo, Hyagriv N Simhan, Dwight J Rouse, Hector Mendez-Figueroa, Cynthia Gyamfi-Bannerman, Jennifer L Bailit, Maged M Costantine, Harish M Sehdev, Alan T N Tita","doi":"10.1097/AOG.0000000000005971","DOIUrl":"https://doi.org/10.1097/AOG.0000000000005971","url":null,"abstract":"<p><p>The expanded maternal comorbidity index developed by Leonard et al uses pre-existing maternal health conditions (eg, hypertension, asthma) to produce a risk score that predicts severe maternal morbidity (SMM). This tool has been adopted into clinical and research use without external validation in a data source not reliant on administrative codes. We assessed the validity of the maternal comorbidity index to predict SMM in a modern obstetric cohort using data derived from detailed medical record abstraction. In this secondary analysis of a multicenter cohort of patients delivering at 17 U.S. hospitals (2019-2020), the maternal comorbidity index risk score was applied to all individuals and the performance of the score to predict SMM was assessed using the area under the receiver operating curve (AUC). Of 20,898 individuals in this cohort, 668 (3.2%) experienced SMM. The AUC for the maternal comorbidity index was 0.72 (95% CI, 0.70-0.74) to predict SMM and 0.83 (95% CI, 0.79-0.86) to predict SMM without transfusion. The expanded maternal comorbidity index for prediction of SMM was externally valid, and findings support the ongoing use of this tool.</p>","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrauterine Lidocaine Instillation and Pain Scores Among Women Undergoing Hysteroscopy-Guided Biopsy: A Randomized Controlled Trial.","authors":"Aishwarya Thalappan Puliyullaveettil, Murali Subbaiah, Chitra Thyagaraju, Divya Bhukya","doi":"10.1097/AOG.0000000000005972","DOIUrl":"https://doi.org/10.1097/AOG.0000000000005972","url":null,"abstract":"<p><strong>Objective: </strong>To compare the visual analog scale (VAS) score for pain and assess patient satisfaction and complications in women receiving intrauterine anesthesia with those receiving placebo during hysteroscopic-guided biopsy.</p><p><strong>Methods: </strong>The study was conducted in a tertiary care hospital over 17 months, from August 2021 to December 2022. One hundred twenty-six women scheduled for outpatient hysteroscopy-guided biopsy were included in this study and randomized either to the lidocaine (2% 5-mL solution) group or placebo group (63 individuals each). The study adopted a novel approach of vaginoscopic hysteroscopy that employed an intrauterine insemination catheter insertion and administered 2% (5 mL) lidocaine to the lidocaine group or saline (5 mL) to the placebo group. Pain scoring was carried out using the VAS scoring scale at hysteroscope insertion, during hysteroscopic-guided biopsy and after 10 minutes, 30 minutes, and 60 minutes of biopsy. Patient satisfaction level was assessed using the Likert scale. The primary objective was to compare the VAS score for pain between the groups during hysteroscopic-guided biopsy. Power analysis was performed in OpenEpi v3.01 software, using the log-transformed mean difference and standard deviation of the primary outcome (VAS score) of the study groups.</p><p><strong>Results: </strong>The median [interquartile range] VAS pain scores during hysteroscopic-guided biopsy were significantly higher in the placebo group (5 [5-6]) compared with the anesthesia group (4 [3-5]) (P<.001). Similar results were noted during insertion of hysteroscope and at 10, 30, and 60 minutes after biopsy. Patients' satisfaction levels were significantly higher in the anesthesia group (30.2% were very satisfied) compared with the placebo group (1.6% were very satisfied) (P<.001).</p><p><strong>Conclusion: </strong>Intrauterine lidocaine instillation during vaginoscopic hysteroscopy-guided biopsy significantly reduced the pain during and after the procedure. It also improved the satisfaction of the patients after office hysteroscopy. No complications or side effects were associated with intrauterine lidocaine.</p><p><strong>Clinical trial registration: </strong>Clinical Trials Registry India (CTRI), CTRI/2021/07/034679.</p>","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antenatal Corticosteroids and Child Neurodevelopment: A Systematic Review and Meta-analysis.","authors":"Jessica Liauw, Kayleigh S J Campbell, Hannah Foggin, Ruth E Grunau, Julie Petrie, Anila Qasim, Romina Brignardello-Petersen, Ram A Mishaal, Jennifer A Hutcheon","doi":"10.1097/AOG.0000000000005950","DOIUrl":"https://doi.org/10.1097/AOG.0000000000005950","url":null,"abstract":"<p><strong>Objective: </strong>To determine the effect of antenatal corticosteroid administration on childhood neurodevelopmental outcomes from studies that have a design that minimized the risk of confounding.</p><p><strong>Data sources: </strong>We searched the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases from inception to July 24, 2024, without language restrictions.</p><p><strong>Methods of study selection: </strong>Two reviewers independently selected randomized and observational comparative studies with a strong design to control for unmeasured confounding (ie, quasi-experimental studies), which evaluated neurodevelopmental outcomes among offspring aged 1-18 years who were exposed to one course of antenatal corticosteroid administration compared with placebo or no treatment.</p><p><strong>Tabulation, integration, and results: </strong>Two reviewers independently extracted data and assessed risk of bias. We used random-effects meta-analyses to synthesize outcomes based on blinded adjudication of appropriateness for pooling by clinical experts in child neurodevelopment. We evaluated the certainty of evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation). A total of 14 studies (eight randomized controlled trial follow-up studies [n=2,233] and six quasi-experimental studies [n=277,679]) were included. Most neurodevelopmental outcomes examined (19/23) showed no association with antenatal corticosteroid administration. We found modestly decreased risks of nonverbal intelligence and visual memory scores among children exposed to antenatal corticosteroids. For general development and general behavior, randomized trial follow-up studies showed a nonsignificant trend toward a small protective and null effect, respectively, but quasi-experimental studies showed an increased risk. Among studies with low or moderate risk of bias, we found no association between antenatal corticosteroid administration and adverse child neurodevelopment.</p><p><strong>Conclusion: </strong>There is no consistent evidence that antenatal corticosteroids are associated with an increased risk of impaired childhood neurodevelopment among studies with a strong design to control for confounding.</p><p><strong>Systematic review registration: </strong>PROSPERO, CRD42021238558.</p>","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}