Bjog-An International Journal of Obstetrics and Gynaecology最新文献

{"title":"Authors' Reply.","authors":"Milla Juhantalo, Tuija Hautakangas, Outi Palomäki, Jukka Uotila","doi":"10.1111/1471-0528.18242","DOIUrl":"https://doi.org/10.1111/1471-0528.18242","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Pathways of Care Continue to Fail Those With a Diagnosis of Endometriosis.","authors":"Katy Vincent, Andrew W Horne","doi":"10.1111/1471-0528.18245","DOIUrl":"https://doi.org/10.1111/1471-0528.18245","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking the Cycle: Why Women of Reproductive Age Belong in All Areas of Health Research.","authors":"Rachel Hulme, Margherita Bielli, Kate Womersley, Edward Mullins","doi":"10.1111/1471-0528.18255","DOIUrl":"https://doi.org/10.1111/1471-0528.18255","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to 'Identification and Management of Maternal Sepsis During and Following Pregnancy'.","authors":"","doi":"10.1111/1471-0528.18259","DOIUrl":"https://doi.org/10.1111/1471-0528.18259","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antenatal Corticosteroid Administration and Childhood Respiratory Morbidity: A Regression Discontinuity Study.","authors":"Jennifer A Hutcheon, Sam Harper, M Claire Cordingley, Jessica Liauw, M Amanda Skoll, Peter M Socha, Myriam Srour, Joseph Y Ting, Erin C Strumpf","doi":"10.1111/1471-0528.18252","DOIUrl":"https://doi.org/10.1111/1471-0528.18252","url":null,"abstract":"<p><strong>Objective: </strong>To determine if routine administration of antenatal corticosteroids affects the risk of infant lower respiratory tract infection and/or childhood asthma.</p><p><strong>Design: </strong>Linked population-based cohort analysed using a regression discontinuity design, which better controls for confounding than standard observational studies.</p><p><strong>Setting: </strong>British Columbia, Canada.</p><p><strong>Population: </strong>Singleton pregnancies with a maternal admission for delivery between 31 + 0 and 36 + 6 weeks' gestation from 2000 to 2016, with follow-up to 2020.</p><p><strong>Methods: </strong>We estimated if risks of childhood respiratory outcomes differed between pregnancies admitted just before the Canadian recommended clinical cut-off for antenatal corticosteroid administration of 34 + 0 weeks gestation (i.e., with higher probability of exposure to antenatal corticosteroids; 'exposed') than those admitted just after this cut-off (i.e., with lower probability of exposure; 'unexposed') using log binomial regression (infant lower respiratory infection hospitalisation) and pooled log binomial regression (asthma).</p><p><strong>Main outcome measures: </strong>Infant lower respiratory tract infection hospitalisation, inpatient or outpatient asthma diagnosis at 1-18 years.</p><p><strong>Results: </strong>In our cohort of 21 965 children, 412 (1.9%) infants were hospitalised with a lower respiratory tract infection and 2287 (10.4%) were diagnosed with asthma. Routine administration of antenatal corticosteroids was not associated with infant lower respiratory tract infection (risk ratio = 0.95 [95% CI: 0.61, 1.37], risk difference = -0.15 excess cases per 100 [95% CI: -1.30, 0.99]) or childhood asthma (rate ratio = 1.08 [95% CI: 0.88, 1.24] 5.49 excess cases per 100 by age 13 years [95% CI: -1.78, 14.39]).</p><p><strong>Conclusions: </strong>We found no evidence that routine administration of antenatal corticosteroids affects the risk of later childhood respiratory illnesses.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnic Disparities in Severe Maternal Morbidity and the Contribution of Deprivation: A Population-Based Causal Analysis.","authors":"Dorothea Geddes-Barton, Raph Goldacre, Marian Knight, Nicola Vousden, Rema Ramakrishnan","doi":"10.1111/1471-0528.18254","DOIUrl":"https://doi.org/10.1111/1471-0528.18254","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between ethnicity and severe maternal morbidity (SMM) in England and the mediating effects of neighbourhood-level socio-economic deprivation across detailed ethnic groups.</p><p><strong>Design: </strong>Population-based nationwide cohort study using English Hospital Episode Statistics Admitted Patient Care (HES APC) data.</p><p><strong>Setting: </strong>All hospital births in NHS facilities in England between 1 January 2013 and 31 March 2023.</p><p><strong>Population: </strong>A cohort of 3 839 156 women aged 10- 55 years with births of ≥ 20 weeks' gestation.</p><p><strong>Methods: </strong>Multivariable fixed and mixed-effects Poisson regression models were used to estimate adjusted risk ratios (RR) for SMM across 10 ethnic groups compared to White women and for each ethnic group in different deprivation quintiles compared to White women in the least deprived neighbourhoods, respectively. Causal mediation analysis was used to calculate the proportion of the association mediated by deprivation.</p><p><strong>Main outcome measures: </strong>The modified English Maternal Morbidity Outcome Indicator (EMMOI), a composite outcome of SMM.</p><p><strong>Results: </strong>Minoritised ethnic groups experienced higher SMM risks than White women, with the highest risk for Black African women (RR 1.96, 95% CI: 1.82-2.02) and Bangladeshi women (RR 1.97, 95% CI: 1.88-2.07) compared to White women. The strength of the association varied across ethnic subgroups. Most of the effect of ethnicity on SMM was not mediated by deprivation (11%-29%).</p><p><strong>Conclusions: </strong>Deprivation plays a minor role in ethnic disparities in SMM. Policies must address the unique challenges faced by minoritised ethnic women.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic Factors and Perinatal Outcomes After Laser Surgery for Twin-Twin Transfusion Syndrome: A Retrospective Cohort Study.","authors":"Kedeja V Williams, Mara Rosner, Camille Shantz, Elena Taylor, Andrew J Satin, Michelle Kush, Jena Miller, Ahmet A Baschat","doi":"10.1111/1471-0528.18248","DOIUrl":"https://doi.org/10.1111/1471-0528.18248","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the relationship between socioeconomic status (SES) and race with perinatal survival following fetoscopic laser surgery (FLS) for Twin-Twin Transfusion Syndrome (TTTS).</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Setting: </strong>Fetal therapy referral center in the US Mid-Atlantic region.</p><p><strong>Population: </strong>Consecutive patients having FLS for TTTS between 2014 and 2024.</p><p><strong>Methods: </strong>SES was quantified by Distress Community Index (DCI) and Area Deprivation Index (ADI) with particular consideration of race and health insurance (commercial or government funded). The DCI and ADI scores reflect the community median income, housing vacancies, education level, poverty rate, business growth, and unemployment based on the ZIP code and patient address, respectively. Scores were stratified by quartiles which indicate prosperous (0-24.9), mid-tier (25-49.9), at-risk (50-74.9) and distressed (75-100) neighbourhoods. Maternal factors, DCI, ADI, self-reported race, insurance status, TTTS severity and peri-operative factors were analysed to determine if there was an association to procedure-related complications, individual twin survival, overall perinatal survival and delivery gestational age. Bivariate and logistic regression analyses were used to identify determinants of survival at discharge from the nursery.</p><p><strong>Main outcome measures: </strong>Double neonatal survival (DNS).</p><p><strong>Results: </strong>In 478 patients undergoing FLS, the median DCI was 31.6% [IQR 13%-52.9%] and ADI 33% [IQR 17%-54%] which is equivalent to mid-tier socioeconomic status. In our cohort, 75.5% (n = 361) were White, 78.7% (n = 342) had commercial insurance, 75.3% (n = 360) resided out of state, and 74.5% (n = 347) had DNS. Patients with DNS were more likely to reside in prosperous or mid-tier DCI (74.8 vs. 62%) and ADI quartile neighbourhoods (74% vs. 60.3%), more likely to be White (78.7% vs. 66.1%) and have commercial insurance (81.8% vs. 71.9%, all p < 0.05). Cases of stage III TTTS had higher rates of single or no neonatal survivors (58.7% vs. 37.0%) and estimated fetal weight discordance (EFWD) > 25% (51.2% vs. 29.4%, all p < 0.001). DNS was less likely with Quintero stage III and coexisting EFWD > 25%, with previable preterm birth or membrane rupture and non-White racial group as independent contributors (r² 0.33, p < 0.001).</p><p><strong>Conclusion: </strong>Patients with lower perinatal survival after fetoscopic laser surgery were more likely to reside in less affluent neighbourhoods, but the non-white racial group emerged as the key independent factor. Further research is needed to explore how individual sociodemographic factors influence outcomes in specialised fetal therapy.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Incidence, Characteristics, Management and Outcomes of Peripartum Hyponatraemia in the United Kingdom: A Prospective Study Using the UK Obstetric Surveillance System (UKOSS).","authors":"Arani Pillai, Laila J Tata, Nuala Lucas, Zoë Vowles, Catherine Nelson-Piercy","doi":"10.1111/1471-0528.18247","DOIUrl":"https://doi.org/10.1111/1471-0528.18247","url":null,"abstract":"<p><strong>Objective: </strong>To determine the national incidence, characteristics, management and outcomes of peripartum hyponatraemia.</p><p><strong>Design: </strong>Prospective, observational study using United Kingdom (UK) Obstetric Surveillance System (UKOSS) methodology.</p><p><strong>Setting: </strong>192 of the 194 consultant-led obstetric units in UK National Health Service (NHS) hospitals.</p><p><strong>Population: </strong>Peripartum UK obstetric admissions.</p><p><strong>Methods: </strong>Units submitted cases monthly to UKOSS (April 2019-September 2020). The case definition was symptomatic hyponatraemia (sodium < 125 mmol/L) in labour or ≤ 48 h postpartum, excluding other causes of symptoms. Pre-eclampsia was excluded as a separate aetiology of hyponatraemia and potential cause of symptoms. As symptom documentation varied, characteristics, management and outcomes were compared between cases with and without reported symptoms.</p><p><strong>Main outcome measures: </strong>Demographics, symptoms, labour details, management and outcomes.</p><p><strong>Results: </strong>Eighty cases were submitted. We excluded 23 cases (10 with sodium ≥ 125 mmol/L and 13 with pre-eclampsia). A further 25 had sodium < 125 mmol/L with no symptoms documented. Thirty-two met the UKOSS definition, resulting in an estimate of 3.0 cases of peripartum hyponatraemia with documented symptoms per 100 000 maternities (95% confidence interval 2.0-4.1), using a national estimate of 1 050 915 maternities across the study period. Characteristics and outcomes of cases with and without documented symptoms had some variation; 53% versus 24% had critical care admissions, 41% versus 40% had neonatal unit admissions, and 38% versus 20% had spontaneous vaginal birth.</p><p><strong>Conclusions: </strong>Peripartum hyponatraemia was associated with maternal morbidity. Neonatal morbidity and operative birth were high, even without documented maternal symptoms. Poor recognition and documentation of symptoms have likely underestimated the incidence.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' Reply.","authors":"Louise Lundborg","doi":"10.1111/1471-0528.18244","DOIUrl":"https://doi.org/10.1111/1471-0528.18244","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outpatient or Inpatient Setting for Cervical Ripening Before Induction of Labour: An Individual Participant Data Meta-Analysis.","authors":"Malitha Patabendige, Fei Chan, Michelle R Wise, John M D Thompson, Michael Beckmann, Antonio F Saad, George R Saade, Akila Subramaniam, Alan Tita, Catarina Policiano, Nuno Clode, Amanda Henry, Henna Haavisto, Kirsi Rinne, Vicky Chen, Penelope Sheehan, Katherine Kohari, Hillary Hosier, Rebecca Pierce-Williams, Vincenzo Berghella, Daniel L Rolnik, Ben W Mol, Wentao Li","doi":"10.1111/1471-0528.18253","DOIUrl":"https://doi.org/10.1111/1471-0528.18253","url":null,"abstract":"<p><strong>Background: </strong>The optimal methods and settings for induction of labour (IOL) in terms of effectiveness, safety, and women's experience are still not elucidated.</p><p><strong>Objective: </strong>To compare the effectiveness and safety of outpatient versus inpatient cervical ripening settings for IOL.</p><p><strong>Search strategy: </strong>MEDLINE, Embase, Emcare, CINAHL Plus, Scopus, Cochrane Library, WHO ICTRP and clinicaltrials.gov from inception to July 2024.</p><p><strong>Selection criteria: </strong>Randomised controlled trials, viable singleton gestation, no language restrictions, all the published and unpublished data.</p><p><strong>Data collection and analysis: </strong>An individual participant data meta-analysis.</p><p><strong>Main results: </strong>Eleven out of 18 (61.1%) eligible RCTs shared IPD, totalling 2593 pregnant individuals undergoing IOL (62.2% of all participants in the published RCTs). Among the shared RCTs, four used balloon catheters alone in both groups. Three RCTs compared outpatient balloon catheter with inpatient balloon catheter plus oxytocin. Another three RCTs compared outpatient balloon catheter to inpatient vaginal dinoprostone. One RCT used Dilapan-S in both groups. No trials evaluating outpatient use of vaginal prostaglandins were identified. Vaginal birth (11 RCTs, 2584 women, 67.8% vs. 70.2%, aOR 0.95, 95% CI 0.70; 1.30), composite perinatal outcome (9 RCTs, 2525 women, 11.1% vs. 11.7%, aOR 0.93, 95% CI 0.75; 1.16) and composite maternal (10 RCTs, 2480 women, 14.3% vs. 15.4%, aOR 0.89, 95% CI 0.65; 1.20) outcome did not differ between outpatient and inpatient groups. The outpatient group had a lower risk of acidosis, more epidural analgesia, and more oxytocin. There were no perinatal deaths in either group.</p><p><strong>Conclusions: </strong>Overall effectiveness, perinatal and maternal safety are comparable between outpatient setting cervical ripening with a mechanical method and inpatient with any method.</p><p><strong>Trial registration: </strong>PROSPERO: CRD42022313183.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}