American Journal of Obstetrics & Gynecology Mfm最新文献

{"title":"Longitudinal trends in physical activity and sleep before, during, and after pregnancy using Fitbit and EHR data from the All of Us research program.","authors":"Claire Lo, Jeffrey Annis, Hiral Master, Adnan Cakar, Sarah Osmundson, Douglas Ruderfer, Evan Brittain","doi":"10.1016/j.ajogmf.2025.101744","DOIUrl":"10.1016/j.ajogmf.2025.101744","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101744"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676035","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":"Bridging the gap: why women's health equity benefits everyone.","authors":"Holly Horan, Samantha Martin, Lynda Ugwu, Alan Tita","doi":"10.1016/j.ajogmf.2025.101740","DOIUrl":"10.1016/j.ajogmf.2025.101740","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 9","pages":"101740"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812539","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":"Reproductive Outcomes Following Open Maternal-Fetal Surgery for Myelomeningocele Closure: Analysis of MOMS Trial Participants.","authors":"Julie S Moldenhauer, Cora MacPherson, Elizabeth A Thom, Amy J Houtrow, N Scott Adzick","doi":"10.1016/j.ajogmf.2025.101765","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101765","url":null,"abstract":"<p><strong>Background: </strong>In utero closure of myelomeningocele has become an accepted alternative in the management of prenatally diagnosed spina bifida. Maternal reproductive risk has been previously described based on registry data and institutional outcomes. Here we aim to provide maternal reproductive outcomes from participants in the Management of Myelomeningocele Study.</p><p><strong>Objective: </strong>Open maternal fetal surgery (OMFS) for in utero closure of myelomeningocele (MMC) is associated with childhood benefit through school age, however obstetric and maternal reproductive risk are also factors to consider. The objective of this analysis was to evaluate reproductive outcomes after OMFS compared to standard postnatal MMC closure.</p><p><strong>Study design: </strong>The Management of Myelomeningocele Study (MOMS) was a randomized trial comparing prenatal versus postnatal closure of MMC. Women in the prenatal closure arm underwent OMFS at 21-26 weeks and were delivered by cesarean at 37 weeks if not delivered prior to that. In the postnatal closure arm, cesarean delivery was performed at 37 weeks and neonates underwent surgical closure soon after birth. Families returned for follow-up at 30 months and again at school age between 6-10 years. Maternal reproductive questionnaires were administered at the time of the follow-up visits to assess menstruation, fertility, gynecologic issues, and subsequent pregnancy outcomes. We compared continuous variables using the Wilcoxon test and categorical variables using the chi-square or Fisher's exact test, as appropriate.</p><p><strong>Results: </strong>174 randomized women (86 in the prenatal closure group and 88 in the postnatal closure group) completed reproductive questionnaires with 91 women reporting no subsequent pregnancies since MOMS. 36 women in the prenatal closure group reported 60 subsequent, of which 45 (75%) progressed ≥ 20 weeks. 43 women in the postnatal closure group reported 71 pregnancies, of which 50 (70%) progressed ≥ 20 weeks. The prenatal closure group was more likely to deliver < 37 weeks (p < 0.001). One uterine rupture (2.2%) and two uterine dehiscence cases (4.4%) were reported among the prenatal closure group; none in the postnatal closure group (p<0.001). Use of fertility treatments or gynecologic surgeries were not different between the groups.</p><p><strong>Conclusions: </strong>Preterm delivery was more common in subsequent pregnancies after OMFS. The risk for uterine rupture and dehiscence in the prenatal group was higher than the postnatal group, but lower than what has been previously reported with OMFS. Reproductive outcomes were otherwise similar between women undergoing OMFS for MMC closure compared to the postnatal closure group in the MOMS trial.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101765"},"PeriodicalIF":3.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972503","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":"The Impact of Watching an Educational Video on Possible Obstetric Emergencies Before Labor: A Randomized Controlled Trial.","authors":"Eliel Kedar Sade, Ilia Kleiner, Shir Lev, Shiran Rona, Daniel Tairy, Hadas Miremberg, Jacob Bar, Eran Weiner, Noa Gonen","doi":"10.1016/j.ajogmf.2025.101774","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101774","url":null,"abstract":"<p><strong>Background: </strong>While the importance of providing detailed information about potential obstetric emergencies is widely acknowledged, it is often inconsistently addressed in routine care for nulliparous women.</p><p><strong>Objective: </strong>To evaluate the effect of an educational video of possible obstetric emergencies during labor on maternal anxiety and childbirth experience among nulliparous women anticipating vaginal delivery.</p><p><strong>Study design: </strong>This randomized controlled trial enrolled nulliparous women at term, who were randomly assigned to an intervention group or a control group. The intervention group watched a 5-minute educational video, developed by our department, which covered the management of labor and common obstetric emergencies. The control group received standard obstetric care. Anxiety was evaluated at three distinct time points using the State-Trait Anxiety Inventory (STAI): At recruitment (STAI 1), upon admission to the delivery room (STAI 2), and the postpartum (STAI 3). Both groups completed an 11-item Childbirth Experience Questionnaire (CEQ).</p><p><strong>Results: </strong>A total of 161 participants were approached, with 127 completing the study questionnaires and included in the final analysis (63 intervention, 64 control). Baseline anxiety (STAI 1) and anxiety at admission (STAI 2) were comparable between groups. Immediate postpartum anxiety (STAI 3) was significantly lower in the video group (28 [22-33] vs. 33 [26-38]; p = 0.01), with this reduction remaining significant in multivariable analysis (adjusted coefficient: -5.1; 95% CI: -9.2 to -1.1; p = 0.01). Greater anxiety reductions were observed in the video group from recruitment to postpartum (Δ STAI 3-1: -15.5 [-24 to -5] vs. -9 [-18 to 0]; p = 0.02) and from admission to postpartum (Δ STAI 3-2: -12.5 [-20 to -3] vs. -7 [-12 to 0]; p = 0.01). CEQ scores were similar between groups.</p><p><strong>Conclusion: </strong>A pre-labor educational video significantly reduced postpartum anxiety, highlighting its potential as a simple and scalable intervention to enhance maternal mental health.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101774"},"PeriodicalIF":3.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972450","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":"A Simple Data-Driven Dietary Pattern Associated with Lower Risk for Adverse Pregnancy Outcomes.","authors":"Andrew Batuure, George I Austin, William A Grobman, Karen L Lindsay, David M Haas, Samuel Parry, George R Saade, Hyagriv N Simhan, Robert M Silver, Uma M Reddy, Aya Brown Kav, Shuang Wang, Natalie A Bello, Tal Korem","doi":"10.1016/j.ajogmf.2025.101773","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101773","url":null,"abstract":"<p><strong>Background: </strong>Periconceptional diet has been associated with the risk of adverse pregnancy outcomes (APOs). Various types of diets have been studied to evaluate their potential protective effect against APOs. However, many of these diets are based on regional dietary preferences, are complex, and are composed of many different food categories. A simpler index may increase compliance and facilitate better clinical translation.</p><p><strong>Objective: </strong>Evaluate whether alignment to a parsimonious index derived from periconceptional diet data is associated with reduced risk for APOs.</p><p><strong>Design: </strong>We analyzed prospective data from 7,798 pregnant individuals from the USA in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b) study. We applied a sparse regression model to data from food frequency questionnaires and used it to select a small number of food categories that were jointly associated with low risk. We validated this index internally in the nuMoM2b cohort and externally on similar data on 2,240 participants from the Environmental influences on Child Health Outcomes (ECHO) study.</p><p><strong>Results: </strong>The data-driven dietary index (DDI) included legumes, citrus fruits, dark green vegetables, and whole grains as food categories associated with lower risk for APOs versus processed meats, potatoes, and refined grains as associated with higher risk. High alignment with the DDI was associated with 22% relative risk (RR) reduction for one or more APO (adjusted RR (aRR) [CI] of 0.78 [0.70,0.87]), preeclampsia (0.74 [0.56,0.99]), and gestational hypertension (0.81 [0.67,0.98]). Validation in the ECHO dataset showed that high alignment to the DDI was associated with a 31% reduction in APOs (crude RR of 0.69 [0.50,0.89]).</p><p><strong>Conclusions: </strong>We demonstrated an approach for devising a simple data-driven dietary index, showed that it is associated with reduced APO risk when accounting for confounders, and validated it in an independent dataset. Future studies could validate the DDI for prospective interventions, as well as apply our approach to other populations or clinical settings.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101773"},"PeriodicalIF":3.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972531","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":"SEQUENTIAL USE OF FOLEY CATHETER AND MISOPROSTOL VERSUS MISOPROSTOL ALONE FOR INDUCTION OF LABOR: A MULTICENTER RANDOMIZED CONTROLLED TRIAL.","authors":"Prof Saule Issenova, Dr Dilfuza Sultanmuratova, Prof Gulzhan Issina, Associate Prof Nakhanova Zhupar Karibekovna, Anel Kenzhegaliyeva, PhD Associate Prof Rukset Attar","doi":"10.1016/j.ajogmf.2025.101769","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101769","url":null,"abstract":"<p><strong>Background: </strong>Labor induction is a critical intervention used when prolonging pregnancy poses risks to maternal or fetal health. While combined methods of cervical ripening have been studied, evidence specifically regarding sequential use (as opposed to simultaneous administration) remains limited.</p><p><strong>Objective: </strong>To compare the efficacy and safety of a sequential labor induction method (Foley catheter followed by misoprostol) versus misoprostol alone in term pregnancies.</p><p><strong>Study design: </strong>This multicenter, randomized controlled trial ([Trial registration number blinded for review])was conducted at two hospitals in Almaty, Kazakhstan. A total of 400 women with singleton term pregnancies, cephalic presentation, and unfavorable cervices (Modified Bishop Score ≤6) requiring labor induction were enrolled. Participants were randomly assigned to:• Group A (n=200): Foley catheter insertion for 12-18 hours followed by oral misoprostol.• Group B (n=200): Oral misoprostol alone.</p><p><strong>Primary outcome: </strong>Vaginal delivery.</p><p><strong>Secondary outcomes: </strong>Cesarean delivery, uterine hyperstimulation, fetal distress, Apgar scores, postpartum hemorrhage, chorioamnionitis, perineal trauma, operative vaginal birth, blood transfusion, and labor augmentation.</p><p><strong>Results: </strong>The sequential method significantly increased the probability of vaginal delivery compared to misoprostol alone (77.5% vs. 69.5%; adjusted RR = 1.16; 95% CI: 1.04-1.29; p = 0.009). The total dose of misoprostol required was significantly lower in the sequential group (p < 0.001). A higher incidence of chorioamnionitis was observed in the sequential group (OR = 3.82; 95% CI: 1.05-13.9; p = 0.03).</p><p><strong>Conclusion: </strong>The sequential method increases the probability of vaginal delivery while requiring a lower total misoprostol dose, without increasing the rate of major maternal or neonatal complications. However, it may be associated with a higher risk of chorioamnionitis, which warrants further investigation. These findings support its consideration as a clinically effective and pharmacologically conservative alternative for labor induction in women with an unfavorable cervix.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101769"},"PeriodicalIF":3.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972506","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":"Corrigendum to ‘Oral progesterone for the prevention of recurrent preterm birth: systematic review and metaanalysis.’ American Journal of Obstetrics & Gynecology MFM/ Volume 1, Issue 1, March 2019, Pages 50-62","authors":"Rupsa C. Boelig MD ,&nbsp;Luigi Della Corte MD ,&nbsp;Sherif Ashoush MD ,&nbsp;David McKenna MD ,&nbsp;Gabriele Saccone MD ,&nbsp;Shalini Rajaram MD ,&nbsp;Vincenzo Berghella MD","doi":"10.1016/j.ajogmf.2025.101752","DOIUrl":"10.1016/j.ajogmf.2025.101752","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 10","pages":"Article 101752"},"PeriodicalIF":3.1,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889410","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":"Cesarean delivery: virtual special issue","authors":"Vincenzo Berghella MD","doi":"10.1016/j.ajogmf.2025.101745","DOIUrl":"10.1016/j.ajogmf.2025.101745","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 9","pages":"Article 101745"},"PeriodicalIF":3.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878709","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":"A Randomized Trial of Clustered Versus Spaced Simulation in Forceps Assisted Vaginal Deliveries.","authors":"Andrew T Greene, Matthew Zuber, Joshua Nitsche, Mark Newman, Brian Brost","doi":"10.1016/j.ajogmf.2025.101755","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101755","url":null,"abstract":"<p><strong>Background: </strong>The rates of forceps assisted vaginal deliveries (FAVD) in management of the second stage of labor are decreasing. This decline is mirrored by fewer learning opportunities for resident trainees in obstetrics. Prior studies have demonstrated an increase in trainee skill and confidence in performing FAVD with simulation. The optimum timing and frequency of simulation sessions to improve retention of skill is currently unknown.</p><p><strong>Objective: </strong>We tested the effects of clustered versus spaced training sessions to teach trainees FAVD and hypothesized that spaced training sessions would lead to superior retention of skill. We used a commercially available pelvic trainer (Lucy's Mum, MODEL-med®) and measured objective structured assessment of technical skills (OSATS) scores at >1-month post-intervention.</p><p><strong>Study design: </strong>This was a randomized controlled trial of clustered versus spaced FAVD simulation sessions. Thirty-five (n=35) enrolled participants gave us 80% power to detect a difference of OSATS score of 6. Trainees and obstetric providers who do not independently perform FAVD were randomized in blocks to a single learning session (clustered/30 minutes of hands-on teaching with a model; n=17) or three individual learning sessions (spaced/10 minutes each x3; n=18) spaced one week apart. Participants completed an online module introducing FAVD and completed skillset questionnaires pre- and post- simulation. We used a chest-mounted GoPro™ camera to capture first person point-of-view technique in order to blind expert adjudicators to participants' identities and this blinded footage was used to grade average OSATS scores.</p><p><strong>Results: </strong>Both clustered and spaced simulation training led to improved FAVD OSATS score post-intervention (+4.8 vs. +5.9 from baseline), however the median change was not different between randomization group (p = 0.78, Wilcoxon Rank Sum). Both simulation groups had higher confidence to apply forceps, perform safety checks, and independently/safely perform FAVD (p < 0.05, t test).</p><p><strong>Conclusion: </strong>We describe a novel use of point-of care video and simulator application to improve FAVD simulation training. OSATS scores and provider self-assessment of training improved regardless of clustered vs. spaced simulation sessions.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101755"},"PeriodicalIF":3.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972478","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 corticosteroids for fetal congenital pulmonary airway malformation: a systematic review","authors":"Benedetta Bina MD ,&nbsp;Federica Bellussi MD, PhD ,&nbsp;Shelly Soni MD ,&nbsp;Vincenzo Berghella MD","doi":"10.1016/j.ajogmf.2025.101763","DOIUrl":"10.1016/j.ajogmf.2025.101763","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 11","pages":"Article 101763"},"PeriodicalIF":3.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883927","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}