Andriana H. Velmahos BS, Stylianos Vagios MD, PhD, Michael House MD
{"title":"Assisted reproductive technology is not associated with a short cervix: secondary analysis of the nuMoM2b dataset","authors":"Andriana H. Velmahos BS, Stylianos Vagios MD, PhD, Michael House MD","doi":"10.1016/j.ajogmf.2025.101886","DOIUrl":"10.1016/j.ajogmf.2025.101886","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 3","pages":"Article 101886"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318624","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":"Reply to letter to the editor regarding “Effect of a mobility-encouragement protocol during induction of labor with an extra-amniotic balloon compared to routine care: a randomized controlled trial”","authors":"Liat Mor MD , Eran Weiner MD , Noa Gonen MD","doi":"10.1016/j.ajogmf.2025.101883","DOIUrl":"10.1016/j.ajogmf.2025.101883","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 3","pages":"Article 101883"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318627","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}
Britt L. Post MD, Judith A.F. Huirne MD, PhD, Robert A. de Leeuw PhD
{"title":"Reply to: Letter to the editor regarding “The feasibility and effectiveness of using an adhesion barrier in preventing dysmenorrhea, pain, and niche-related problems after cesarean sections”","authors":"Britt L. Post MD, Judith A.F. Huirne MD, PhD, Robert A. de Leeuw PhD","doi":"10.1016/j.ajogmf.2025.101843","DOIUrl":"10.1016/j.ajogmf.2025.101843","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 3","pages":"Article 101843"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318640","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}
Yvette Raymond PhD, MD, BMedSc(Hons) , Shavi Fernando PhD, MBBS(Hons), BMedSc(Hons) , Melody Menezes PhD, BSc(Hons), GDipGenetCouns , Ben W. Mol PhD, MD, MSc , Emma Brown BSc , Kirsten Arnold MD, BMedSc , Daniel L. Rolnik PhD, MD, MSc, MPH
{"title":"Placental cytogenetic testing for confined placental mosaicism and obstetrical outcomes after discordant cell-free DNA screening results","authors":"Yvette Raymond PhD, MD, BMedSc(Hons) , Shavi Fernando PhD, MBBS(Hons), BMedSc(Hons) , Melody Menezes PhD, BSc(Hons), GDipGenetCouns , Ben W. Mol PhD, MD, MSc , Emma Brown BSc , Kirsten Arnold MD, BMedSc , Daniel L. Rolnik PhD, MD, MSc, MPH","doi":"10.1016/j.ajogmf.2025.101887","DOIUrl":"10.1016/j.ajogmf.2025.101887","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>A false-positive cell-free DNA prenatal screening result may arise from confined placental mosaicism, however, the frequency and obstetrical ramifications of such cases are poorly understood.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to assess the prevalence of confined placental mosaicism among pregnancies with false-positive cell-free DNA results and the associated obstetrical outcomes.</div></div><div><h3>STUDY DESIGN</h3><div>This was a prospective, matched-cohort study with a 1:2 ratio of cases with false-positive cell-free DNA results and controls with low-risk cell-free DNA results that were matched by maternal age and body mass index. Participants were recruited between November 2022 and March 2025 at Monash Health and Monash Ultrasound for Women in Melbourne, Australia. Cytogenetic testing was conducted on 4 biopsies per placenta to investigate confined placental mosaicism. The cases and matched controls were compared using trio matching identifiers as random effect in conditional logistic regression and linear mixed-effects modelling.</div></div><div><h3>RESULTS</h3><div>A total of 60 cases with false-positive cell-free DNA results were matched with 120 controls. Confined placental mosaicism was observed in 20 of the 60 cases (33.3%) and in none of the controls. The prevalence of confined placental mosaicism was highest among those with rare autosomal trisomy (57.9%; 11/19) and monosomy X (75.5%; 3/4) results. Confined placental mosaicism was also observed following common autosomal trisomy results (21.4%; 3/14) and subchromosomal copy number variants (15.8%; 3/19). The median birth weight percentile was significantly lower among instances of confirmed confined placental mosaicism (20.1; interquartile range, 9.9–48.5) than among matched controls (43.5; interquartile range, 17.1–66.1; <em>P</em>=.049); however, there were no statistically significant increases in small-for-gestational-age neonates or other adverse pregnancy outcomes.</div></div><div><h3>CONCLUSION</h3><div>Confined placental mosaicism is a frequent contributor to false-positive cell-free DNA results, most often for monosomy X and rare autosomal trisomy results. Although the birth weight median percentiles were lower, the outcomes of cell-free DNA–detected confined placental mosaicism in this average-risk cohort were predominantly favorable.</div><div>El resumen está disponible en Español al final del artículo.</div></div><div><h3>Video Abstract</h3><div><span><span><span><span><video><source></source></video></span><span><span>Download: <span>Download video (8MB)</span></span></span></span><span><span><p>Video Raymond. Confined placental mosaicism and obstetrical outcomes after discordant cell-free DNA screening. Am J Obstet Gynecol MFM 2026.</p></span></span></span></span></div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 3","pages":"Article 101887"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953312","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}
Lina Youssef MD, PhD , Kenny Araujo MD , Lea Testa MD , Rommy Helena Novoa MD , Roger Borras MSc , Sara Castro-Barquero MD, PhD , Gabriel Bernardino PhD , Bart Bijnens MD, PhD , Francesca Crovetto MD, PhD , Eduard Gratacos MD, PhD , Fatima Crispi MD, PhD , study working group
{"title":"Effects of maternal Mediterranean diet on fetal cardiac function in high-risk pregnancies: a secondary analysis of the IMPACT BCN randomized trial","authors":"Lina Youssef MD, PhD , Kenny Araujo MD , Lea Testa MD , Rommy Helena Novoa MD , Roger Borras MSc , Sara Castro-Barquero MD, PhD , Gabriel Bernardino PhD , Bart Bijnens MD, PhD , Francesca Crovetto MD, PhD , Eduard Gratacos MD, PhD , Fatima Crispi MD, PhD , study working group","doi":"10.1016/j.ajogmf.2025.101875","DOIUrl":"10.1016/j.ajogmf.2025.101875","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Maternal suboptimal nutrition and high stress levels are associated with altered fetal cardiovascular function.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to assess the effect of structured maternal lifestyle interventions based on a Mediterranean diet or mindfulness-based stress reduction during pregnancy on fetal cardiac function.</div></div><div><h3>STUDY DESIGN</h3><div>This was a secondary analysis of the IMPACT BCN (Improving Mothers for a better PrenAtal Care Trial BarCeloNa) randomized clinical trial, which was conducted at a university hospital in Barcelona, Spain, from February 2017 to March 2020. A total of 1221 singleton pregnancies (19–23 weeks’ gestation) with high risk of delivering small-for-gestational-age newborns were randomly allocated into 3 groups in a 1:1:1 ratio: a Mediterranean diet intervention, a stress reduction program, or usual care. Participants in the Mediterranean diet group received monthly individual and group educational sessions and free provision of extra-virgin olive oil and walnuts. Those in the stress reduction group underwent an 8-week mindfulness-based stress reduction program adapted for pregnancy. Individuals in the usual care group received pregnancy care per institutional protocols. Fetal cardiac function was assessed using cord blood NT-proBNP (N-terminal probrain natriuretic peptide) and fetal echocardiography. NT-proBNP was measured in cord blood collected at delivery and considered high if >90<sup>th</sup> centile. Fetal echocardiography was performed at 33 to 34 weeks’ gestation. Data were analyzed from January to July 2024.</div></div><div><h3>RESULTS</h3><div>Fetal echocardiography and cord blood NT-proBNP measurements were obtained in 990 and 746 pregnancies, respectively. Whereas fetuses in the stress reduction group showed similar fetal cardiac results, the proportion of fetuses with high cord blood NT-proBNP concentrations was significantly lower in the Mediterranean diet group (6.4% vs 12%; <em>P</em>=.03) compared with the usual care group. Additionally, fetuses whose mothers followed the Mediterranean diet exhibited higher right ventricular fractional area change (mean [standard deviation], 30.4% [8.3] vs 28.1% [8.9]; <em>P</em>=.03) and thinner myocardial walls (mean [standard deviation], 2.95 [0.55] vs 3.16 [0.58] mm; <em>P</em>=.006) compared with the usual care group.</div></div><div><h3>CONCLUSION</h3><div>Promotion of a maternal Mediterranean diet intervention during pregnancy seems to be associated with a less overloaded and more efficient fetal heart. Future research is warranted to elucidate the mechanism(s) underlying these findings.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 2","pages":"Article 101875"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795001","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}
Giulia Zamagni MSc , Camilla Fregona MD , Moira Barbieri MD , Maria Sole Scalia MD , Lorenzo Monasta DSc , Christoph Lees MD, PhD , Tamara Stampalija MD, PhD , Giulia Barbati PhD
{"title":"Assessing adherence to TRIPOD+AI guidelines in machine learning models for predicting small for gestational age and fetal growth restriction: a systematic review","authors":"Giulia Zamagni MSc , Camilla Fregona MD , Moira Barbieri MD , Maria Sole Scalia MD , Lorenzo Monasta DSc , Christoph Lees MD, PhD , Tamara Stampalija MD, PhD , Giulia Barbati PhD","doi":"10.1016/j.ajogmf.2025.101862","DOIUrl":"10.1016/j.ajogmf.2025.101862","url":null,"abstract":"<div><h3>Objectives</h3><div>Fetal growth restriction (FGR) significantly contribute to perinatal morbidity, mortality, and long-term adverse health outcomes. While small for gestational age (SGA) is often used as a proxy for FGR, it does not necessarily indicate pathological growth restriction. Given the increasing interest in machine learning (ML) for predicting FGR/SGA, this study systematically reviews ML applications in this domain, evaluating their methodological rigor and reporting quality, following standardized guidelines.</div></div><div><h3>Data Sources</h3><div>The systematic search was conducted in MEDLINE and Scopus on June 21, 2024, following PRISMA 2020 guidelines.</div></div><div><h3>Study Eligibility Criteria</h3><div>Eligible studies implemented ML models for FGR/SGA prediction using routinely available clinical variables and reported at least one area under the receiver operating characteristic (AUROC) and/or accuracy. Exclusions included preprints, conference abstracts, systematic reviews, animal studies, and models relying exclusively on biomarkers or genomics, as not part of the clinical practice.</div></div><div><h3>Study Appraisal and Synthesis Methods</h3><div>Two independent reviewers screened articles with the help of the Rayyan software. Risk of bias was assessed using the PROBAST checklist. Adherence to the guidelines on the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis+artificial intelligence (TRIPOD+AI) was evaluated across methods, results, and discussion sections using a 4-point Likert scale. Sample size adequacy was assessed for each study, accounting for outcome type, predictors, and outcome prevalence.</div></div><div><h3>Results</h3><div>The search identified 272 studies, with 20 meeting the inclusion criteria. Definitions of FGR/SGA were inconsistent, particularly in technical journals. Adherence to TRIPOD+AI guidelines was variable, as no model reported on fairness or heterogeneity across relevant subgroups, and only 15% reported on calibration. Only 30% of studies met the minimum sample size required for ML models, indicating potential overfitting and limited generalizability.</div></div><div><h3>Conclusion</h3><div>Despite the potential of ML models in predicting FGR/SGA, key limitations persist, including inconsistent outcome definitions, underpowered models, and suboptimal reporting of calibration and clinical applicability. Future studies should emphasize standardized definitions, robust sample sizes, and comprehensive reporting to enhance model reliability and clinical translation.</div></div><div><h3>Video Abstract</h3><div><span><span><span><span><video><source></source></video></span><span><span>Download: <span>Download video (4MB)</span></span></span></span><span><span><p><span>Video</span>. </p></span></span></span></span></div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 2","pages":"Article 101862"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649119","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":"Beyond 23+6: rethinking cerclage eligibility in the age of early viability","authors":"Arielle J. Higgs MD , Karl E. Seif MD","doi":"10.1016/j.ajogmf.2025.101868","DOIUrl":"10.1016/j.ajogmf.2025.101868","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 2","pages":"Article 101868"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709976","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}