American Journal of Obstetrics & Gynecology Mfm最新文献

{"title":"Unwanted pregnancies are associated with preterm birth, but not low birth weight.","authors":"Annie Dude, Jocelyn Wascher","doi":"10.1016/j.ajogmf.2025.101713","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101713","url":null,"abstract":"<p><strong>Background: </strong>Prior studies indicate that unintended and unwanted pregnancies can be associated with poor obstetric outcomes.</p><p><strong>Objective: </strong>This study examined whether an unintended or unwanted pregnancy was associated with a preterm delivery and with low birth weight.</p><p><strong>Study design: </strong>We conducted a secondary analysis of the 2017-19 cycle of the National Survey of Family Growth, a nationally-representative population- based survey of reproductive-aged people identifying as female in the United States. The sample consisted of respondents who had at least one prior live birth. Respondents were asked whether their most recent pregnancy was wanted (either at that time or prior to that time), unintended (wanted, but too soon, or unwanted at any time), or unwanted (did not want to be pregnant at any time). The primary outcomes were preterm delivery, defined as a live birth prior to 37 weeks' gestation, and low birth weight, defined as a birthweight less than 2500 grams. We also examined early preterm delivery (defined as a live birth prior to 34 weeks' gestation) as a secondary outcome, as well as restricting the sample to term deliveries only to examine low birth weight. We used chi square and Wilcoxon rank sum analysis for bivariable comparisons and logistic regression for multivariable models.</p><p><strong>Results: </strong>Our sample consisted of 3,299 unique deliveries, 35.4% of which resulted from unintended pregnancies and 16.9% of which resulted from unwanted pregnancies. Overall, 12.7% of respondents had any preterm delivery, including 11.3% of those with intended pregnancies, 15.4% of those with unintended pregnancies (p = 0.02), 11.9% of those with wanted pregnancies and 16.9% of those with unwanted pregnancies (p = 0.01). Of the overall sample, 3.7% had a preterm delivery prior to 34 weeks gestation, including 3.0% of those with an intended pregnancy, 4.9% of those with an unintended pregnancy (p = 0.10), 3.1% of those with wanted pregnancies, and 6.3% of those with unwanted pregnancies (p = 0.01). Unwanted pregnancies remained associated with preterm delivery and early preterm delivery after adjusting for confounders (adjusted odds ratio 1.42, 95% confidence interval 1.02 - 1.98 for any preterm delivery, adjusted odds ratio 1.84, 95% confidence interval 1.10 - 3.08 for early preterm delivery). In our sample, 8.0% of respondents had a low birth weight neonate, including 6.6% of those with an intended pregnancy, 10.5% of those with an unintended pregnancy (p = 0.02), 7.4% of those with wanted and 10.5% of those with unwanted pregnancies (p = 0.10). These results were insignificant among those with term deliveries and after adjusting for confounders.</p><p><strong>Conclusion: </strong>Unwanted pregnancies are associated with an increased risk of preterm delivery, but not low birth weight.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101713"},"PeriodicalIF":3.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250059","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":"Intrapartum Continuous Glucose Monitor Metrics and Neonatal Hypoglycemia.","authors":"Gianna Wilkie, Shani Snow, Nillani Anandakugan, Heidi Leftwich","doi":"10.1016/j.ajogmf.2025.101712","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101712","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101712"},"PeriodicalIF":3.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250050","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":"Letter to the Editor Re: Quantifying placenta accreta spectrum severity and its associated blood loss: a novel transvaginal ultrasound scoring system.","authors":"Rozi Aditya Aryananda, Theophilus Adu-Bredu, Hans Duvekot","doi":"10.1016/j.ajogmf.2025.101721","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101721","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101721"},"PeriodicalIF":3.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250056","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":"Management of twin-to-twin transfusion syndrome: update and current challenges: Current Challenges for Twin-to-Twin Transfusion Syndrome.","authors":"Hanane Bouchghoul, Hugo Madar, Aurélien Mattuizzi, Frédéric Coatleven, Marie Vincienne, Perrine Prier, Alizée Froeliger, Loïc Sentilhes","doi":"10.1016/j.ajogmf.2025.101714","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101714","url":null,"abstract":"<p><p>Since a 2004 randomized trial established fetoscopy as the gold standard for the treatment for twin-to-twin transfusion syndrome (TTTS), advancements in surgical technique and expert training have considerably improved survival rates to 89% for at least one fetus and 65% for both fetuses. However, many challenges remain. This review provides an update on the current principles, issues, and debates. The Solomon technique has helped improve neonatal outcomes by reducing the risks of postoperative twin anemia-polycythemia sequence (TAPS) and TTTS recurrence. Nevertheless, fetoscopic laser photocoagulation is associated with significant obstetrical risks, including preterm premature rupture of membranes, preterm delivery, and even placental abruption. Additionally, fetal growth restriction, observed in 30-50% of cases, may adversely affect double survival rates following fetoscopy, particularly when abnormal Doppler indices are present. Gestational age at the time of fetoscopy is a critical prognostic factor, as earlier gestational age is associated with lower survival rates. This consideration raises questions about the optimal timing of the procedure after TTTS diagnosis. Emerging evidence supports expectant management with close ultrasound monitoring for asymptomatic patients with stage I TTTS. In stage III and IV TTTS, laser photocoagulation should not be delayed, whereas stage II TTTS diagnosed at very early gestational ages might benefit from expectant management until 16-17 weeks of gestation. Further advancements, such as flexible video fetoscopy and computer-assisted fetal laser surgery, represent the next frontier in addressing these challenges.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101714"},"PeriodicalIF":3.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250058","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":"Letter in Reply re: Breast stimulation vs low dose oxytocin for labor augmentation in women with a previous cesarean delivery, a randomized controlled trial.","authors":"Raneen Abu Shqara, Lior Lowenstein, Maya Frank Wolf","doi":"10.1016/j.ajogmf.2025.101718","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101718","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101718"},"PeriodicalIF":3.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250051","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 dexamethasone versus betamethasone on glycemic control in mild gestational diabetes: A randomized clinical trial.","authors":"Fathimath Shamaa Shareef, Jesrine Hong, Rahmah Saaid, Mukhri Hamdan, Siti Zawiah Omar, Peng Chiong Tan","doi":"10.1016/j.ajogmf.2025.101715","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101715","url":null,"abstract":"<p><strong>Background: </strong>Preterm births and gestational diabetes are common complications in pregnancy. A widely known side effect of antenatal corticosteroids (ACS) for fetal maturity in preterm births is maternal hyperglycemia. The choice of ACS regimens between dexamethasone and betamethasone highly depends on local availability and cost as current but inconclusive evidence show similar neonatal outcomes for both regimes.</p><p><strong>Objective: </strong>To compare four 6-mg doses 12 hours apart antenatal dexamethasone versus two 11.4-mg doses 24 hours apart antenatal betamethasone regimens in medical nutrition therapy controlled gestational diabetes mellitus (GDM) cases on maternal glycemic response for up to three consecutive days after administration.</p><p><strong>Methods: </strong>This is a randomized controlled clinical trial conducted between February 2021-August 2023 in a tertiary university hospital in Malaysia. Pregnant participants with diet-controlled GDM and prescribed ACS were randomized to either four 6-mg doses 12 hours apart dexamethasone or two 11.4-mg doses 24 hours apart betamethasone regimens. Self-monitoring of capillary blood glucose monitoring (6-points per 24 hours: pre- and 2 hours post-meal for the three main meals) was started after the first dose of allocated ACS. Hyperglycemia was defined as fasting or pre-meal glucose ≥5.3mmol/L (≤95mg/dL) or 2-hour post-meal glucose ≥6.7mmol/L (120 mg/dL). The primary outcomes were the number hyperglycemic episodes in the first and second 24 hours following ACS. Analyses were performed using t-test, Mann-Whitney-U test, and Chi-square test as appropriate.</p><p><strong>Results: </strong>Median [interquartile range (IQR)] hyperglycemic episodes were similar 4 [2.3-5.0] vs. 4 [3.5-5.0], p=0.168 on Day-1, significantly lower on Day-2 (4 [3.0-5.0] vs. 5 [4.0-5.0], p=0.002) and Day-3 (1 [0.0-2.0] vs. 2.0 [1.0-3.0], p<0.001) in dexamethasone arm compared to betamethasone arm respectively. Median blood glucose levels were also significantly lower in dexamethasone group on Day-1 (Median [IQR] 6.3 [5.8-7.0] vs. 6.7 [6.3-7.0], p=0.016), Day-2 (6.4 [6.0-6.9] vs. 6.7 [6.3-7.2], p=0.001), and Day-3 (5.2 [4.8-5.5] vs. 5.7 [5.4-6.0], p<0.001) compared to betamethasone group. Mean blood glucose levels were higher throughout the 3-day study period in the betamethasone arm (6.2 mmol/L 97.5% CI 6.0-6.4 vs. 6.6 mmol/L 97.5% CI 6.4-6.7, mean difference -0.374 97.5% CI -0.521 to -0.226), p<0.001). Other maternal and neonatal outcomes were not significantly different across groups.</p><p><strong>Conclusions: </strong>In GDM on medical nutrition therapy, dexamethasone ACS therapy could be preferred over betamethasone as hyperglycemic episodes on Day 2 and 3 post-treatments were fewer and median blood glucose levels were lower through to Day 3.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101715"},"PeriodicalIF":3.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235442","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":"Erratum to 'High- vs low-dose oxytocin regimens for labor augmentation: a systematic review and meta-analysis'. American Journal of Obstetrics & Gynecology MFM/ Volume 7 Issue 2 (February 2025)/ 101604.","authors":"Teresa C Logue, Fabrizio Zullo, Fiamma van Biema, Moeun Son, Lauren London, Sneha Paranandi, Anthony C Sciscione, Giuseppe Rizzo, Daniele Di Mascio, Suneet P Chauhan","doi":"10.1016/j.ajogmf.2025.101685","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101685","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101685"},"PeriodicalIF":3.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250049","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":"\"Regarding: Tugging the Foley catheter balloon every three hours in induction of labor after one previous cesarean: a randomized controlled trial\".","authors":"M Abdelkarim, S Quenby, J Odendaal","doi":"10.1016/j.ajogmf.2025.101707","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101707","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101707"},"PeriodicalIF":3.8,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192363","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":"Pregnancy outcomes following diabetic ketoacidosis: A systematic review.","authors":"Gabriella D Cozzi-Glaser, Allison M Davis, Megan Bell, Ashley N Battarbee","doi":"10.1016/j.ajogmf.2025.101711","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101711","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of this systematic review was to evaluate pregnancy outcomes following at least one episode of diabetic ketoacidosis (DKA) in patients with gestational or pregestational diabetes mellitus.</p><p><strong>Data sources: </strong>An electronic search of English-language publications in PubMed, EMBASE, Web of Science, and Google Scholars covered the period from January 1990 to June 2023.</p><p><strong>Study eligibility criteria: </strong>The eligibility criteria included randomized clinical trials or observational studies (i.e., cohort studies, case control studies) of patients with DKA in pregnancy and evaluation of maternal or neonatal outcomes. Systematic reviews, expert reviews, case reports, case series, animal studies, or non-peer reviewed publications were excluded; additionally, those publications of abstracts-only or without full text manuscripts available were excluded.</p><p><strong>Study appraisal and synthesis methods: </strong>Each study was reviewed in detail by two co-authors. The quality of each study was appraised using the Cochrane risk-of-bias tool for randomized trials and the Joanna Briggs Institute (JBI) appraisal tool for cohort and case control analyses.</p><p><strong>Results: </strong>Of 1,313 studies identified on data search, 7 met final inclusion criteria. Study heterogeneity precluded any meta-analysis. High rates of adverse maternal and neonatal outcomes were found among those with at least one episode of DKA in pregnancy, with incidence of stillbirth ranging: 7-35%, cesarean: 49-64%, preterm birth: 25-83%, and neonatal ICU admission: 40-65%. The most recent studies note a stillbirth rate of 7-31%, with the majority of analyses finding a rate <17%.</p><p><strong>Conclusions: </strong>There is a paucity of well-designed studies evaluating pregnancy outcomes in DKA. Maternal and fetal outcomes following DKA remain poor, although stillbirth may be incrementally decreasing over time. As diabetes care and DKA management advance, future retrospective and prospective analyses should evaluate management and outcomes of DKA.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101711"},"PeriodicalIF":3.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188232","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":"Letter to Editor Reply to : Regarding \"Tugging the Foley catheter balloon every three hours in induction of labor after one previous cesarean: a randomized controlled trial\".","authors":"Mukhri Hamdan, Thai Ying Wong, Peng Chiong Tan","doi":"10.1016/j.ajogmf.2025.101708","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101708","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101708"},"PeriodicalIF":3.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188209","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}