American Journal of Obstetrics & Gynecology Mfm最新文献

{"title":"Development and external validation of a nomogram for predicting spontaneous preterm birth in singleton pregnancies with a short cervix","authors":"Xinyue Han MSc,&nbsp;Qidi Zhang PhD,&nbsp;Yuli Ke MSc,&nbsp;Yuchun Zhu PhD,&nbsp;Huixia Yang PhD,&nbsp;Yumei Wei PhD","doi":"10.1016/j.ajogmf.2025.101859","DOIUrl":"10.1016/j.ajogmf.2025.101859","url":null,"abstract":"<div><h3>Background</h3><div>Spontaneous preterm birth (sPTB) is a major cause of neonatal morbidity and mortality. Women with a short cervix (≤25 mm) are at particularly high risk; prediction based solely on this single measurement is often insufficient. There is an urgent need for more accurate, externally validated tools to stratify risk in this high-risk population.</div></div><div><h3>Objective</h3><div>To develop and externally validate a dynamic, multivariable nomogram for predicting individualized, time-dependent risks of sPTB in singleton pregnancies with a short cervix.</div></div><div><h3>Study Design</h3><div>We conducted a retrospective training cohort (<em>n</em>=591) of singleton pregnancies with a short cervix identified before 24 weeks of gestation from our Xicheng campus (2016–2022) and a prospective external validation cohort (<em>n</em>=215) from our Daxing campus (2024–2025). A multivariable Cox proportional hazards model was used to identify independent predictors. The model’s performance was rigorously evaluated for discrimination (time-dependent area under the curve [AUC]), calibration (calibration plots and Brier scores), and clinical utility (decision curve analysis [DCA]).</div></div><div><h3>Results</h3><div>Three independent predictors were incorporated into the final nomogram: a history of prior preterm birth (hazard ratios [HR]=3.94), cervical length (HR=0.91), and the gestational week at diagnosis (HR=1.18). The nomogram demonstrated good discrimination, with time-dependent AUCs for sPTB before 32, 34, and 37 weeks of 0.774, 0.740, and 0.724 in the training cohort, and 0.757, 0.734, and 0.719 in the external test cohort, respectively. The model was well-calibrated in both cohorts, confirmed by low Brier scores and nonsignificant Hosmer–Lemeshow tests. DCA showed a consistent net benefit across a wide range of risk thresholds. The model’s performance was maintained despite the validation cohort representing a demographically distinct and higher-risk population.</div></div><div><h3>Conclusion</h3><div>This study established and externally validated a simple, clinically practical nomogram for predicting sPTB in singleton pregnancies with a short cervix. This robust, clinically applicable tool can aid in patient counseling and the stratification of high-risk pregnancies to guide personalized management strategies.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 4","pages":"Article 101859"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606400","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":"CTA as preferred imaging modality for pulmonary embolism in pregnancy: an update on diagnostic imaging rates","authors":"Suzanne O’Nan MD,&nbsp;Julia Burd MD,&nbsp;Nandini Raghuraman MD, MSCI,&nbsp;Antonina Frolova MD, PhD,&nbsp;Michael Dombrowski MD,&nbsp;Roxane Rampersad MD,&nbsp;Alison Cahill MD, MSCI,&nbsp;Jeannie Kelly MD, MS","doi":"10.1016/j.ajogmf.2026.101892","DOIUrl":"10.1016/j.ajogmf.2026.101892","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 4","pages":"Article 101892"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041619","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":"Induction at 38 weeks for large-for-gestational-age or macrosomic fetuses decreases the incidence of cesarean delivery: meta-analysis of randomized controlled trials","authors":"Ilaria Paladino MD ,&nbsp;Vincenzo Berghella MD","doi":"10.1016/j.ajogmf.2026.101897","DOIUrl":"10.1016/j.ajogmf.2026.101897","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Several studies compared induction of labor to expectant management in singleton pregnancies with suspected large-for-gestational-age (LGA) or macrosomic fetuses. However, the most appropriate management, including the option of induction of labor, and at what gestational age, remains unclear.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To evaluate the effects of labor induction for pregnancies with LGA or macrosomic fetuses on mode of delivery, and maternal and perinatal morbidity, and to evaluate the best gestational age for such induction if beneficial.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study design&lt;/h3&gt;&lt;div&gt;A systematic literature search of electronic databases was conducted through November 1, 2025. Randomized controlled trials (RCTs) including term singleton pregnancies with suspected large-for-gestational-age (LGA) or macrosomic fetuses comparing induction of labor (IOL) with expectant management were included. The primary outcome was cesarean delivery, with secondary maternal and neonatal outcomes assessed. Pooled estimates were initially calculated using a fixed-effects model; random-effects analyses using a restricted maximum likelihood (REML) estimator were subsequently performed and heterogeneity was assessed using the I² and τ² statistics.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Five randomized trials including 4083 pregnant individuals were analyzed. Baseline characteristics were comparable between groups. Most participants underwent induction at 38 weeks with the largest RCT (71% of the total sample of this meta-analysis), inducing labor at 38 0/7 to 38 4/7 weeks, for LGA &gt; 90th percentile. For the primary outcome, IOL was associated with significant lower risk of cesarean delivery (27.9% vs 31.9%; risk ratio 0.87, 95% confidence interval 0.79 to 0.96) with no heterogeneity. Among secondary outcomes, induction of labor reduced the incidence of macrosomia ≥4000 g (RR 0.53, 95% CI, 0.48 to 0.59) and ≥4500 g (RR 0.22, 95% CI, 0.12 to 0.39). Shoulder dystocia (RR 0.73, 95% CI, 0.50 to 1.03) and fetal fracture (RR 0.35, 95% CI, 0.12 to 1.05) showed a trend toward risk reduction without reaching statistical significance in random-effects analyses. Phototherapy was more frequent following induction of labor (RR 1.62, 95% CI, 1.17 to 2.25), whereas other neonatal and maternal outcomes did not differ significantly between groups.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Induction of labor between 38 0/7 to 38 4/7 weeks for suspected LGA (EFW &gt;90th percentile) or macrosomic fetuses may be a reasonable management option, as it is associated with significant reductions in cesarean delivery, and a potential reduction in shoulder dystocia, and neonatal fractures, compared to expectant management. As the strongest evidence derives from induction at 38 0/7 to 38 4/7 weeks, counseling should emphasize this gestational window. Approximately 25 inductions of labor for EFW &gt;90th percentile at 38 0/7 to 38 4/7 weeks would be required to ","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 4","pages":"Article 101897"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041641","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":"Cardiogenic hydrops and placental thickening are independent predictors of maternal mirror syndrome","authors":"Brian A. Burnett MD,&nbsp;Christian M. Parobek MD, PhD,&nbsp;Ahmed A. Nassr MD PhD","doi":"10.1016/j.ajogmf.2025.101871","DOIUrl":"10.1016/j.ajogmf.2025.101871","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 3","pages":"Article 101871"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709988","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 regarding “The feasibility and effectiveness of using an adhesion barrier in preventing dysmenorrhea, pain, and niche-related problems after cesarean sections”","authors":"Qirun Li MMed","doi":"10.1016/j.ajogmf.2025.101842","DOIUrl":"10.1016/j.ajogmf.2025.101842","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 3","pages":"Article 101842"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318686","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 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":"Yang Zhang MD,&nbsp;Qingling Kang MD,&nbsp;Rirong Qu MD, PhD","doi":"10.1016/j.ajogmf.2025.101882","DOIUrl":"10.1016/j.ajogmf.2025.101882","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 3","pages":"Article 101882"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318684","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":"Artificial intelligence in academic research publishing: updates, controversies, and considerations for pregnancy and perinatal research","authors":"Mariam Ayyash MD, MSCR ,&nbsp;Amir Aviram MD ,&nbsp;Nicole Krenitsky MD, MBA ,&nbsp;Timothy Wen MD, MPH ,&nbsp;Vincenzo Berghella MD","doi":"10.1016/j.ajogmf.2025.101885","DOIUrl":"10.1016/j.ajogmf.2025.101885","url":null,"abstract":"<div><div>Artificial intelligence (AI) has rapidly transformed academic writing and publishing, progressing from simple grammar checkers and citation tools to sophisticated large language models capable of generating, synthesizing, and critically evaluating scientific content. A recent advancement in this space is the rise of deep research AI—agentic models that autonomously conduct structured reasoning to produce evidence-backed research outputs. While AI opens vast opportunities to enhance academic productivity, it also introduces significant ethical challenges. The challenge isn’t just to use AI; rather, to use it responsibly. As AI continues to reshape scholarly communication, it must be guided by clear oversight and ethical frameworks. This article explores AI’s expanding role in academic publishing, with a focus on its applications in manuscript preparation, peer review, and quality assessment. It also addresses the growing concerns surrounding authorship, research integrity, and accountability. We additionally outline key considerations unique to obstetrics and maternal–fetal medicine to guide responsible and field-appropriate AI use in perinatal research and publishing. Ultimately, the responsible integration of AI, balanced with human judgment and governed by rigorous standards, will be critical to ensuring both innovation and credibility in academic research.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 3","pages":"Article 101885"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896711","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":"Lighting the way: indocyanine green–guided laparoscopic transabdominal cerclage in pregnancy","authors":"Matteo Pavone MD ,&nbsp;Chiara Innocenzi MD ,&nbsp;Nicola Macellari MD ,&nbsp;Chiara Cantarini MD ,&nbsp;Nazario Foschi PhD ,&nbsp;Angela Botta MD ,&nbsp;Chiara Tersigni PhD ,&nbsp;Tullio Ghi PhD ,&nbsp;Anna Fagotti PhD ,&nbsp;Denis Querleu MD ,&nbsp;Francesco Fanfani PhD ,&nbsp;Nicolò Bizzarri PhD","doi":"10.1016/j.ajogmf.2025.101788","DOIUrl":"10.1016/j.ajogmf.2025.101788","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 3","pages":"Article 101788"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253013","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 positions reduce occiput posterior malposition and improve vaginal birth: a systematic review and meta-analysis of randomized controlled trials","authors":"Meilin Yang MD ,&nbsp;Cheng Zhao MD ,&nbsp;Shaojun Lin MS ,&nbsp;Xiaoyue Guo MD ,&nbsp;Jing Yang MD ,&nbsp;Shenglian Ni BSc ,&nbsp;Yan Zhao MS ,&nbsp;Chunyang Ai MS ,&nbsp;Yangyu Zhao MD","doi":"10.1016/j.ajogmf.2025.101880","DOIUrl":"10.1016/j.ajogmf.2025.101880","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of changing maternal position in late pregnancy and the first stage of labor on rotation from occiput posterior (OP) to occiput anterior (OA) and subsequent maternal-fetal outcomes.</div></div><div><h3>Data sources</h3><div>We systematically searched randomized controlled trials (RCTs) from the databases including PubMed, Embase, and Cochrane Library without language restriction, spanning from their inception to May 11, 2025. Registration PROSPERO (CRD420251050400).</div></div><div><h3>Study eligibility criteria</h3><div>The following PICOS criteria were included:(1) Population (P): singleton pregnancies in late pregnancy (≥37 weeks of gestation) or the first stage of labor. (2) Intervention (I): maternal positions. (3) Comparison (C): non-intervention position or unrestricted maternal activities. (4) Outcomes (O): number of participants who attained OA. (5) Study design (S):RCTs.</div></div><div><h3>Study appraisal and synthesis methods</h3><div>Separate meta-analyses were conducted for all RCTs and for trustworthy RCTs identified using the OBGYN Editors' Integrity Group criteria. Pooled relative risks (RR) and standard mean differences (SMD) with 95% CIs were calculated. Publication bias was assessed.</div></div><div><h3>Results</h3><div>A meta-analysis of four trustworthy RCTs (n=922) from the first stage of labor demonstrated that positional intervention significantly increased OP to OA rotation (pooled RR=1.68, 95% CI=1.09−2.60; I²=66.3%). Moreover, when initiated at 3-5 cm dilation with a prolonged protocol (targeted hourly or continuous duration), the intervention yielded even greater benefits for rotation (pooled RR=2.45, 95% CI=1.63−3.67; I²=0.0%), and also significantly increased rates of both vaginal delivery (pooled RR=1.22, 95% CI=1.06−1.41; I²=0.0%) and spontaneous vaginal delivery (SVD) (pooled RR=1.39, 95% CI=1.05−1.84; I²=0.0%). Consistent benefits persisted in an analysis of all ten RCTs, remaining significant after adjustment for publication bias. Subgroup analyses of these ten RCTs indicated that the lateral position with upper thigh flexed benefited SVD. Additionally, two late-pregnancy studies (n=2647) assessed maternal position for OP fetuses, but methodological differences precluded meta-analysis.</div></div><div><h3>Conclusions</h3><div>Intrapartum maternal position can promote OP to OA rotation and vaginal delivery, but antenatal evidence remains inconclusive and lacking.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 3","pages":"Article 101880"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783015","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":"Effect of dental treatments on reduction of preterm birth: a systematic review and meta-analysis","authors":"Camille Thomas MD, MPH ,&nbsp;Shakil Ahmed MPH ,&nbsp;Vincenzo Berghella MD ,&nbsp;Romina Brignardello-Petersen DDS, PhD ,&nbsp;Mohamed El-Rabbany DDS, PhD ,&nbsp;Catherine Devion MLS ,&nbsp;Stefania Ronzoni MD, PhD","doi":"10.1016/j.ajogmf.2025.101884","DOIUrl":"10.1016/j.ajogmf.2025.101884","url":null,"abstract":"<div><h3>Objective</h3><div>Periodontal disease is associated with increased risk of preterm birth. Effective management during pregnancy may reduce preterm birth, though clinical trial evidence has been inconsistent. This study aimed to assess whether treating dental disease during pregnancy reduces preterm birth.</div></div><div><h3>Data Sources</h3><div>A systematic search was performed of EMBASE, MEDLINE, PubMed, Cochrane Library, and trial registries up to December 2023 and re-run in January 2025.</div></div><div><h3>Study Eligibility Criteria</h3><div>Randomized controlled trials (RCTs) enrolling pregnant persons with any dental disease randomized to receive dental treatment vs no treatment were included. No language restriction was applied.</div></div><div><h3>Study Appraisal and Synthesis Methods</h3><div>Data were independently extracted by two researchers and assessed for risk of bias using the Cochrane Risk of Bias tool, RoB 2. A random effect meta-analysis was performed with the Mantel–Haenszel variance estimate. Certainty of evidence (COE) was assessed using GRADE. The main outcome was preterm birth (&lt;37 weeks’ gestation). Data on low birth weight were also collected.</div></div><div><h3>Results</h3><div>Fourteen RCTs (8316 participants) were included. Interventions included scaling and root planing (SRP) alone (8 RCTs), SRP with chlorhexidine mouthwash (4 RCTs), and cetylpyridinium chloride mouthwash (2 RCTs). Meta-analysis and GRADE assessment found moderate-certainty evidence suggesting that periodontal treatment results in a 15% relative risk reduction of preterm birth (risk ratio [RR] 0.85; 95% CI 0.71–1.02) compared to minimal periodontal treatment or no treatment (absolute difference 20 fewer preterm births per 1000 individuals; 95% CI from 39 fewer to 3 more). It is uncertain whether the addition of chlorhexidine mouthwash to SRP reduces preterm birth rates (RR 0.49, 95% CI 0.23–1.04, very low COE).</div></div><div><h3>Conclusion</h3><div>This meta-analysis, the largest and most up-to-date on this topic, suggests that treating periodontal disease during pregnancy may reduce the risk of preterm birth. However, limitations, such as the risk of bias and variations in populations and treatment, highlight the need for well-powered RCTs with low risk of bias to evaluate the most effective dental treatment strategies. Future studies should focus on established dental disease severity and explore different dental treatment strategies, including antimicrobial mouthwash.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 3","pages":"Article 101884"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800651","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}