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

{"title":"Impact of Displacement on Refugee Women's Sexual and Reproductive Health: A Participatory Study Using Photovoice.","authors":"Jamilah Sherally, Franceska Dnestrianschii, Zainab Alshamari, Ekram Beshir, Habibe Jafari, Masume Jafari, Kowthar Mohamed, Semira Mohammadyasin, Maria van den Muijsenbergh, Thomas van den Akker, Marielle Le Mat, Saskia Elise Duijs","doi":"10.1111/1471-0528.18328","DOIUrl":"10.1111/1471-0528.18328","url":null,"abstract":"<p><strong>Objective: </strong>To explore how displacement impacts the sexual and reproductive health (SRH) of refugee women.</p><p><strong>Design: </strong>Participatory photovoice study integrating photography with qualitative inquiry.</p><p><strong>Setting: </strong>Conducted online between February and May 2024.</p><p><strong>Population: </strong>Six refugee women formerly residing in Moria Reception and Identification Centre or Mavrovouni Closed Controlled Access Centre on Lesbos, Greece, now seeking asylum across Europe and the United States.</p><p><strong>Methods: </strong>During the participatory photovoice study, participants (N = 6) took photographs reflecting the impact of displacement on their SRH and mental health. Visual data were explored in three focus groups and five in-depth interviews. Participants grouped photographs into themes, with additional thematic coding by the academic researchers. An intersectional lens guided the analysis.</p><p><strong>Results: </strong>Thirty-six photographs, many including nature symbolism, illustrated how displacement shaped SRH experiences, healthcare-seeking behaviour and access to care for gender-based violence, female genital mutilation/cutting, family planning and menstrual, maternal, and gynaecological health. Eight themes emerged: bodily autonomy, instability, living conditions, social support, celebrations, healthcare access, resilience, and finding purpose. While displacement exacerbated SRH needs and undermined bodily autonomy, the instability of the asylum process led to deprioritisation of healthcare-seeking. Illness was only experienced until a sense of safety was established. Access to healthcare was compromised by language barriers, undignified treatment, and financial constraints. Despite challenges, narratives highlighted resilience, community, and personal growth.</p><p><strong>Conclusions: </strong>Trauma-informed, culturally sensitive healthcare is essential for SRH equity among refugee women. Refugee-led visual research offers a transformative tool for knowledge production and advocacy.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876637","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 ‘Trustworthiness Criteria for Meta-Analyses of Randomized Controlled Studies: OBGYN Journal Guidelines’","authors":"","doi":"10.1111/1471-0528.18336","DOIUrl":"10.1111/1471-0528.18336","url":null,"abstract":"<p>The OBGYN Editors' Integrity Group (OGEIG) “Trustworthiness Criteria for Meta-Analyses of Randomized Controlled Studies: OBGYN,” Journal Guidelines BJOG 132(2025): 1–5 10.1111/1471-0528.17945.</p><p>In the list of participating members of the OBGYN Editors' Integrity Group (OGEIG), Dr Luis Sanchez-Ramos’ affiliation was incorrectly stated as <i>Am J Obstet Gynecol MFM</i>, and should have been given as <i>Am J Obstet Gynecol</i>.</p><p>The online version of the article has now been rectified.</p><p>We apologize for this error.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 12","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18336","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BGCS—ASM 2025 London Publication of Abstracts","authors":"","doi":"10.1111/1471-0528.18309","DOIUrl":"10.1111/1471-0528.18309","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S7","pages":"3-101"},"PeriodicalIF":4.3,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conversations About Stillbirth Risk in Routine Antenatal Care: A Qualitative Study Post-Implementation of the Safer Baby Bundle","authors":"Christine Andrews,&nbsp;Ashley Pade,&nbsp;Fran Boyle,&nbsp;Dan Richard Fernandez,&nbsp;Laura Singline,&nbsp;Ann Lancaster,&nbsp;David Alan Ellwood,&nbsp;Adrienne Gordon,&nbsp;Vicki J. Flenady","doi":"10.1111/1471-0528.18330","DOIUrl":"10.1111/1471-0528.18330","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study explores women's and healthcare professionals' experiences and attitudes towards stillbirth risk and prevention conversations following Safer Baby Bundle (SBB) implementation. The SBB aimed to normalise these conversations within the antenatal healthcare setting.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A qualitative interview study.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Maternity services in two states in Australia.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Population of Sample&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Eighteen postnatal women and 22 healthcare professionals at services that participated in the SBB.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Qualitative study using semi-structured interviews analysed using a deductive approach to thematic analysis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main Outcome Measures&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Themes identified around experiences of and attitudes towards antenatal care and conversations related to stillbirth risk and prevention.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Three key themes related to conversations about stillbirth in antenatal care were identified. First, ‘the importance of information that reassures and empowers’ through respectful communication, emphasising the ‘why’ of preventive actions, prioritising conversations over written information and positive framing. Second, ‘normalising sensitive conversations’ by reducing silence and stigma around stillbirth, having a standard way of doing things and shifting perceptions about the difficulty of raising this topic during pregnancy. Third, ‘steps towards respectful and supportive woman-centred care’ influence the efficacy and responsiveness of conversations through continuity of care and carer for trust-building and an ethos of addressing what matters most to women.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Integrating conversations about stillbirth into routine antenatal care is facilitated by the SBB. Key considerations for effective, woman-centred conversations about stillbirth include multidisciplinary collaboration, targeted HCP training and co-designed resources to promote open communication, reducing fragmentation of c","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 12","pages":"1856-1865"},"PeriodicalIF":4.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18330","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The UK Maternity Crisis: Analysing the Underlying Causes to Find Solutions","authors":"Andrew D. Weeks,&nbsp;Sarah Espenhahn,&nbsp;Susie Crowe","doi":"10.1111/1471-0528.18326","DOIUrl":"10.1111/1471-0528.18326","url":null,"abstract":"&lt;p&gt;Lord Darzi, in his recent report, concludes that ‘too many women, babies and families are being let down’ by UK maternity services [&lt;span&gt;1&lt;/span&gt;]. Complex underlying factors have put UK maternity units under significant pressure with repeated reports of poor work cultures, over-stressed staff leaving the NHS, stories of birth trauma and calls for a national maternity inquiry. Whilst maternal and perinatal outcomes are significantly better than those in the United States [&lt;span&gt;2&lt;/span&gt;], they lag behind those in many comparator countries in Scandinavia and the rest of Europe [&lt;span&gt;3&lt;/span&gt;]. Whilst the proportion of obstetric related negligence claims sits at around 10% of the total, the costs of maternity negligence payments are soaring and at £1.1 billion per year are over a third of the total UK maternity budget [&lt;span&gt;4&lt;/span&gt;]. The perception might be that standards have fallen and that outcomes are worsening. But despite decreasing births rates, whole time equivalent doctors and midwives have been increasing for many years [&lt;span&gt;5&lt;/span&gt;], and term stillbirth and neonatal mortality and morbidity rates are steadily improving [&lt;span&gt;6&lt;/span&gt;]. Judging by the most commonly used important outcome, perinatal mortality, you could argue that the standard of care has never been better. So, why does UK maternity care appear to be in crisis?&lt;/p&gt;&lt;p&gt;First, there is increasing medicalisation of birth caused by multiple interrelated factors (Figure 1). Pregnant women in the UK are becoming older, increasingly overweight, have more complex medical problems—all risk factors for adverse outcomes. The increased ability of fetal medicine to detect fetal abnormalities and identify women as ‘high risk’ mean that more parents are approaching birth with anxieties about the outcome. Meanwhile, recent studies have found that induction of labour can reduce many adverse medical outcomes, not least by preventing stillbirths [&lt;span&gt;7-9&lt;/span&gt;]. Combining this with the national ambition around maternity safety [&lt;span&gt;10&lt;/span&gt;] and the legal requirement to inform women of all options that can reduce stillbirth [&lt;span&gt;11&lt;/span&gt;], means that many practitioners and women feel pressurised into labour induction. The increase in induction rates (to 33% nationally [&lt;span&gt;12&lt;/span&gt;]) has led to delays [&lt;span&gt;13&lt;/span&gt;] and poor experience, resulting in more women opting for a caesarean birth instead. The NHS maternity staffing and estate, designed to support high numbers of ‘low risk’ births, has yet to fully adapt to the increased numbers on ‘high risk’ care pathways, further exacerbating the problem.&lt;/p&gt;&lt;p&gt;Second, there is a shift in who controls birth. Traditionally, providers have adopted a very medical model in which the doctor was in charge, and this remains the case in societies with marked social hierarchies or in specialisms that deal with acute specialist pathologies such as oncology or general surgery. But society has moved on. The information revolution means","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 12","pages":"1713-1715"},"PeriodicalIF":4.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18326","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144825226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scientific Abstracts from the British Maternal & Fetal Medicine Society Annual Conference 8th-9th May 2025, ICC, Belfast, UK","authors":"","doi":"10.1111/1471-0528.18234","DOIUrl":"10.1111/1471-0528.18234","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S6","pages":"3-109"},"PeriodicalIF":4.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18234","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144824868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metformin Treatment in PCOS Pregnancies Reduces Maternal Infections and Increases the Risk of Allergies and Eczema in the Offspring: Post Hoc Analyses of Two Randomised Controlled Trials and One Follow-Up Study","authors":"Mariell Ryssdal,&nbsp;Johanne E. Skage,&nbsp;Anders H. Jarmund,&nbsp;Liv Guro E. Hanem,&nbsp;Tone S. Løvvik,&nbsp;Guro F. Giskeødegård,&nbsp;Ann-Charlotte Iversen,&nbsp;Eszter Vanky","doi":"10.1111/1471-0528.18320","DOIUrl":"10.1111/1471-0528.18320","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To evaluate the effect of metformin on immunological outcomes in pregnant women with polycystic ovary syndrome (PCOS) and their offspring.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Post hoc analyses of two randomised controlled trials (PregMet and PregMet2) and one follow-up study (PedMet).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Women followed at multiple hospitals in Norway, Sweden and Iceland, and offspring followed at multiple hospitals in Norway.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Population or Sample&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Pregnant women with PCOS, randomised to metformin or placebo from the first trimester to delivery, and offspring exposed to metformin or placebo in utero.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Maternal infections and allergic diseases in offspring were compared using logistic regression. Maternal body mass index (BMI), offspring BMI &lt;i&gt;z&lt;/i&gt;-score and maternal infections were evaluated as effect modifiers or mediators.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main Outcome Measures&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Incidence of maternal infections during pregnancy, delivery, and postpartum, and allergic diseases in offspring at 8-year follow-up.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Altogether 634 women and 145 offspring were included. Women treated with metformin experienced fewer overall infections during pregnancy (OR = 0.68, 95% CI: 0.50–0.93), particularly viral infections (OR = 0.71, 95% CI: 0.51–0.99). Offspring exposed to metformin in utero had a higher incidence of allergies (OR = 4.83, 95% CI: 1.47–21.8) and eczema (OR = 2.42, 95% CI: 1.14–5.33). Maternal BMI did not modify the effect of metformin, and offspring BMI &lt;i&gt;z&lt;/i&gt;-score or maternal infections did not mediate the relationship between metformin treatment and increased allergies and eczema in offspring.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Metformin treatment in pregnant women with PCOS reduced maternal infections during pregnancy and increased the incidence of allergies and eczema in offspring at 8-year follow-up.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Trial Registration&lt;/h3&gt;","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 12","pages":"1823-1832"},"PeriodicalIF":4.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18320","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144813191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Interventions and Women's Perceptions of Respectful Intrapartum Care: A National Survey-Based Cohort Study","authors":"Karin Johnson,&nbsp;Charlotte Elvander,&nbsp;Kari Johansson,&nbsp;Sissel Saltvedt,&nbsp;Malin Edqvist","doi":"10.1111/1471-0528.18329","DOIUrl":"10.1111/1471-0528.18329","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To investigate whether women's perceptions of respectful intrapartum care are influenced by the use of epidural, oxytocin, or episiotomy.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;National survey-based cohort study using data from the Swedish Pregnancy Survey 8 weeks postpartum (NPS-8) merged with Swedish Pregnancy Register (SPR) data.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Sweden, 2022–2023.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Population&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Primiparous women with a singleton pregnancy, cephalic presentation, spontaneous onset of labour, a live fetus at ≥ 37 weeks gestation, and a vaginal birth.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Associations between respectful care and epidural analgesia, oxytocin, or episiotomy and their combinations were analysed using logistic regression to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main Outcome Measures&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Four NPS-8 items assessing women's perceptions of being treated respectfully, receiving support, being informed, and being involved in decision-making during childbirth.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Of 34 111 women, 20 363 (59.7%) responded, with the majority feeling respected during childbirth. Compared with women who had spontaneous vaginal births, those with instrumental births more frequently reported inadequate support (17.7% vs. 11.0%), insufficient information (25.1% vs. 16.2%), and lack of involvement in decision-making (29.2% vs. 17.1%). Among women with spontaneous vaginal births, those subjected to an episiotomy were less likely to report being involved in decision-making (77.8% vs. 83.8%; aOR 0.60, 95% CI 0.50–0.73). The combination of episiotomy and oxytocin was associated with the lowest adjusted odds of involvement in decision-making (77.0% vs. 84.6%; aOR 0.54, 95% CI 0.43–0.69).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Women with spontaneous vaginal births were less likely to report being involved in decision-making when they underwent an episiotomy, or if oxytocin augmentation was followed by an episiotomy.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 ","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 12","pages":"1844-1855"},"PeriodicalIF":4.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18329","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144813190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety and Arterial Stiffness in High-Risk Pregnancies: A Secondary Analysis of a Prospective Cohort Study","authors":"Mekayla Forrest,&nbsp;Maria Matossian,&nbsp;Helena Papacostas Quintanilla,&nbsp;Isabelle Malhamé,&nbsp;Tina Montreuil,&nbsp;Stella S. Daskalopoulou","doi":"10.1111/1471-0528.18325","DOIUrl":"10.1111/1471-0528.18325","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In a high-risk pregnant population with singleton pregnancies, the primary objective was to evaluate the association between anxiety and arterial stiffness (AS) and the secondary objective was to investigate whether anxiety is associated with the incidence of preeclampsia.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Secondary analysis of a prospective cohort study (2012–2016).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Two tertiary care antenatal clinics in Montreal, Canada.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;High-risk pregnant individuals with pre-existing hypertension, diabetes, renal dysfunction, previous preeclampsia, or age ≥ 35 years were included. Exclusion criteria were excessive alcohol or drug use and cardiovascular disease. People with pregnancy loss, incomplete questionnaires and loss to follow-up were excluded from analysis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Participants were enrolled before 14-weeks' gestation, with follow-up assessments of AS every 4 weeks until delivery. Anxiety symptoms were assessed every trimester by the Beck Anxiety Inventory and by self-reported history of emotional disorders (anxiety/depression).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main Outcome Measures&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;AS and wave reflection parameters, primarily carotid-femoral pulse wave velocity and preeclampsia diagnosis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Of 235 individuals recruited, 161 were included in this secondary analysis. Baseline anxiety symptoms were present in 35.4% of participants. Anxiety was associated with a significant increase in carotid-femoral pulse wave velocity across gestation, which persisted after adjustments for relevant confounders, in a combined mixed-effects model (&lt;i&gt;B&lt;/i&gt; = 0.27, 95% confidence interval [CI] = 0.008–0.530, &lt;i&gt;p&lt;/i&gt; = 0.04). A severity-response relationship was observed, where greater anxiety severity correlated with higher AS. Twelve participants (7.5%) developed preeclampsia. The association between anxiety and preeclampsia risk showed a non-significant trend (odds ratio [OR] = 2.77, 95% CI = 0.84–9.18). However, a history of emotional disorders significantly elevated preeclampsia risk (OR = 3.91, 95% CI = 1.14–13.40), independent of other ","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 12","pages":"1833-1843"},"PeriodicalIF":4.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Prophylactic Oxytocin or Carbetocin on Troponin Release and Postpartum Haemorrhage at Planned Caesarean Delivery: A Double-Blind Randomised Controlled Trial","authors":"Maria E. Bekkenes,&nbsp;Marte M. Jørgensen,&nbsp;Anne F. Jacobsen,&nbsp;Morten W. Fagerland,&nbsp;Helene Rakstad-Larsen,&nbsp;Lars Aaberge,&nbsp;Olav Klingenberg,&nbsp;Trude Steinsvik,&nbsp;Lars Asphaug,&nbsp;Leiv Arne Rosseland","doi":"10.1111/1471-0528.18312","DOIUrl":"10.1111/1471-0528.18312","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Oxytocin may cause dose-dependent myocardial side effects. We investigated if carbetocin, a long-acting oxytocin analogue, causes similar changes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Double-blind randomised trial.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;University Hospitals, Oslo, Norway.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Population&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;240 singleton pregnant women, 18–50 years, undergoing planned caesarean delivery.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Participants, randomised 1:1, received oxytocin 2.5 IU or carbetocin 100 μg intravenously immediately after delivery.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main Outcome Measures&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The primary endpoint was change from baseline in cardiac troponin I (cTnI) serum concentration at 6–10 h postpartum. Secondary endpoints included blood loss, uterine tone (numerical rating scale 0–10), rescue treatment, and healthcare costs 48 h postpartum.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;215 patients underwent a planned caesarean delivery and received their allocated study drug (oxytocin group, &lt;i&gt;n&lt;/i&gt; = 112; carbetocin group, &lt;i&gt;n&lt;/i&gt; = 103). We detected no difference in median change from baseline cTnI concentration at 6–10 h postpartum (0.0 [95% CI –1.09 to 1.09] ng/L; &lt;i&gt;p&lt;/i&gt; = 1.00). Median (interquartile range [IQR]) estimated blood loss was similar: oxytocin, 395 (96 to 627) mL; carbetocin, 335 (127 to 570) mL (group difference: −41 mL [95% CI –158 to 76]; &lt;i&gt;p&lt;/i&gt; = 0.49). Rescue treatment utilisation was higher with oxytocin (46.4%) versus carbetocin (27.2%); risk difference. (−19.2% [95% CI –31.2 to −6.3]; &lt;i&gt;p&lt;/i&gt; = 0.004). Median (IQR) uterine tone at 5 min after delivery was lower with oxytocin (7 [6 to 8]) versus carbetocin (8 [7 to 9]; group difference 1.0 NRS [95% CI 1.0 to 1.0]; &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Despite carbetocin costing 10 times more than oxytocin, mean total healthcare costs were similar, adjusted group difference 31 NOK ($3 USD; €3; [95% CI –361 to 298 NOK]; &lt;i&gt;p&lt;/i&gt; = 0.85).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Ischaemic myocardial risk and healthcare costs were comparable for both drugs. Patients receiving carbetocin maintained better uterine tone and required fewer rescue treatments.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; T","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 12","pages":"1742-1752"},"PeriodicalIF":4.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144792130","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}