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

{"title":"Author Reply.","authors":"Abay Woday Tadesse, Kim Betts, Berihun Assefa Dachew, Getinet Ayano, Rosa Alati","doi":"10.1111/1471-0528.18169","DOIUrl":"https://doi.org/10.1111/1471-0528.18169","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052299","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 “Time to Diagnose Endometriosis: Current Status, Challenges and Regional Characteristics—A Systematic Literature Review”","authors":"","doi":"10.1111/1471-0528.18149","DOIUrl":"10.1111/1471-0528.18149","url":null,"abstract":"<p>\u0000 <span>De Corte, P.</span>, <span>Klinghardt, M.</span>, <span>Stockum, S.</span> and <span>Heinemann, K.</span> (<span>2025</span>), <span>Time to Diagnose Endometriosis: Current Status, Challenges and Regional Characteristics—A Systematic Literature Review</span>. <i>BJOG</i>, <span>132</span>: <span>118</span>–<span>130</span>. https://doi.org/10.1111/1471-0528.17973\u0000 </p><p>In the Affiliation, the corresponding author, Pauline De Corte should be affiliated to both “Berlin Center for Epidemiology and Health Research, Berlin, Germany” and “Institute of Public Health, Charité – Universitätsmedizin Berlin, Berlin Germany”.</p><p>We apologize for this error.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 7","pages":"1018"},"PeriodicalIF":4.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723653","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":"Author Reply.","authors":"Hitomi Okubo, Shoji F Nakayama, Asako Mito, Naoko Arata, Yukihiro Ohya","doi":"10.1111/1471-0528.18130","DOIUrl":"https://doi.org/10.1111/1471-0528.18130","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651751","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 Association Between Medically Assisted Reproduction and Postpartum Depression: A Register-Based Cohort Study","authors":"Sofie Egsgaard,&nbsp;Mette Bliddal,&nbsp;Line Riis Jølving,&nbsp;Xiaoqin Liu,&nbsp;Heidi Sonne,&nbsp;Trine Munk-Olsen","doi":"10.1111/1471-0528.18127","DOIUrl":"10.1111/1471-0528.18127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Undergoing medically assisted reproduction (MAR) has been linked to mixed mental health outcomes in women. We investigated the risk of postpartum depression (PPD) among mothers conceiving with MAR compared to mothers conceiving spontaneously.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Register-Based Study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Denmark.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>125 870 mothers with a PPD screening record who gave birth between 2015 and 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We linked mothers' PPD screening records to national health registers and defined MAR conception linking childbirths to MAR treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>We defined PPD as an Edinburgh Postnatal Depression Scale score of ≥ 11. We performed logistic regression on the risk of PPD among mothers who conceived with MAR compared to spontaneous conception and further assessed variations according to duration, type, and indication for MAR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study population included 10 977 mothers with MAR conception and 114 893 with spontaneous conception, of which 767 (7%) and 8767 (8%) had PPD. We found a lower risk (adjusted risk ratio 0.87, 95% CI [0.80–0.93]) of PPD among mothers with MAR conception compared to spontaneous conception, with smaller variations according to type, duration and indication for MAR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We observed a lower risk of PPD among mothers with MAR conception compared to mothers with spontaneous conception. While it is unlikely that MAR itself is protective of PPD, women who seek MAR may have a strong desire and psychological preparedness for parenthood, which could explain the observed findings. Among mothers conceiving with MAR, PPD risk may vary depending on the type of MAR treatment and underlying reasons for seeking MAR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 7","pages":"991-999"},"PeriodicalIF":4.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143640804","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":"Risk Factors for Adverse Pregnancy Outcomes in Reduced Fetal Movement: An IPD Meta-Analysis","authors":"Yongyi Lu,&nbsp;Victoria Palin,&nbsp;Alexander Heazell","doi":"10.1111/1471-0528.18132","DOIUrl":"10.1111/1471-0528.18132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Women experiencing reduced fetal movements (RFM) have an increased risk of adverse pregnancy outcomes (APO). This study aimed to identify factors most associated with APO in RFM pregnancies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Individual participant data meta-analysis (IPD-MA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Multiple maternity units across the UK.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population or Sample</h3>\u0000 \u0000 <p>1175 singleton pregnancies with RFM between 28⁺⁰ and 41⁺⁰ weeks' gestation from four prospective cohorts and two randomised controlled trials (RCTs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Factors associated with APO were assessed using two-stage IPD-MA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>A composite adverse pregnancy outcome, including: adjusted Odds Ratio, stillbirth, fetal growth restriction (FGR, birthweight ≤ 3rd centile) and neonatal intensive care unit (NICU) admission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Results</h3>\u0000 \u0000 <p>APO occurred in 7.7% of RFM pregnancies, with FGR being the most common complication (4.6%). The strongest associations with APO were observed for abnormal fetal heart rate (adjusted Odds Ratio (aOR) = 3.65, 95% CI: 1.84–7.23), cigarette smoking (aOR = 2.96, 95% CI: 1.36–6.44) and maternal past medical history (aOR = 2.35, 95% CI: 1.14–4.82). Lower estimated fetal weight (EFW) centile was also significantly associated with APO (aOR = 0.97, 95% CI: 0.95–0.99), though substantial heterogeneity was present between studies (<i>I</i>² = 80.74%, <i>Q</i>-statistic: <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>IPD-MA enabled the synthesis of individual-level data across studies, allowing for more accurate and reliable associations by accounting for heterogeneity. Further work is required to investigate the model's generalisability across diverse populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 7","pages":"1000-1009"},"PeriodicalIF":4.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635323","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":"Antenatal Corticosteroids and Neurodevelopmental Outcomes: Some Reassuring Data","authors":"Annie M. Dude","doi":"10.1111/1471-0528.18136","DOIUrl":"10.1111/1471-0528.18136","url":null,"abstract":"<p><b>Linked Article:</b> This is a mini commentary on Frier et al., pp. 902–915 in this issue To view this article, visit https://doi.org/10.1111/1471-0528.18101.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 7","pages":"916-917"},"PeriodicalIF":4.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143640802","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":"Pregnancy Outcomes in Women With Liver Cirrhosis: A National Prospective Cohort Study Using the UK Obstetric Surveillance System","authors":"Melanie Nana,&nbsp;Agata Majewska,&nbsp;Mussarat Rahim,&nbsp;Victoria Geenes,&nbsp;Caroline Ovadia,&nbsp;Marian Knight,&nbsp;Michael Heneghan,&nbsp;Catherine Williamson","doi":"10.1111/1471-0528.18107","DOIUrl":"10.1111/1471-0528.18107","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;Describe maternal/fetal outcomes of pregnant women with cirrhosis.&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;Prospective, national cohort study utilising the UK Obstetric Surveillance System between 1st June 2017 and 30th November 2020.&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;UK.&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;Pregnant women with cirrhosis.&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;Rates of adverse perinatal outcomes were compared with published rates for uncomplicated pregnancies. The prediction of adverse pregnancy outcomes by albumin-bilirubin (ALBI) score was determined.&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;Maternal and fetal outcomes.&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;52 eligible cases were reported (denominators represent available data for each outcome). Commonest causes included autoimmune hepatitis (12/50 (24.0%)), cholestatic disease (9/50 (18.0%)) and viral disorders (8/50 (18.0%)). Maternal decompensation occurred in seven women. Worst ALBI score predicted decompensation and maternal ICU admission (AUROC 0.80 (&lt;i&gt;p&lt;/i&gt; = 0.03) and 0.81 (&lt;i&gt;p&lt;/i&gt; = 0.03), respectively). Untreated varices were associated with increased rates of variceal bleed (&lt;i&gt;p&lt;/i&gt; = 0.01). No women died. There were 42 live births (51.2% preterm), one stillbirth, and two neonatal deaths. The worst ALBI score in pregnancy predicted pre-term birth (AUROC 0.74 (&lt;i&gt;p&lt;/i&gt; = 0.03)). Compared to a healthy population, women with cirrhosis were at increased risk of cholestasis in pregnancy (OR 29.4, 95% CI 13.8–61.6, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), ICU admission (OR 42.5,95% CI 15.2–118.8, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), pre-term birth (OR 13.2, 95% CI 7.1–24.4, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), and babies with low birth weight (OR 12.0, 95% CI 6.5–22.0, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), neonatal intensive care unit admission (OR 4.4, 95% CI 2.4–8.2, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and perinatal mortality (OR 15.8, 95% CI 4.9–51.3, p &lt; 0.001).&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 cirrhosis and their babies are at increased risk during pregnancy. The ALBI score predicts maternal decompensation, ICU admi","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 7","pages":"935-943"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618974","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":"Risk Prediction Models for Stress Urinary Incontinence in Pregnant and Postpartum Women: A Systematic Review and Critical Appraisal","authors":"Yuqing Hou,&nbsp;Suwen Feng,&nbsp;Baoqin Tong,&nbsp;Shuping Lu,&nbsp;Hongyan Wang","doi":"10.1111/1471-0528.18119","DOIUrl":"10.1111/1471-0528.18119","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Many studies have developed or validated prediction models to estimate the risk of stress urinary incontinence (SUI) in pregnant and postpartum women, but the quality of the model development and model applicability remains unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To systematically review and critically evaluate currently available prediction models for SUI in pregnant and postpartum women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search Strategy</h3>\u0000 \u0000 <p>Cochrane Library, EBSCO, PubMed, Web of Science, EMBASE, Chinese CNKI, Wanfang and VIP databases were searched from inception until February 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection Criteria</h3>\u0000 \u0000 <p>Prospective cohort or retrospective studies were considered eligible if they developed or validated prediction models for SUI in pregnant or postpartum women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Collection and Analysis</h3>\u0000 \u0000 <p>Two reviewers independently screened the literature, extracted data and evaluated the quality of the included studies using PROBAST.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Results</h3>\u0000 \u0000 <p>A total of 15 models were included. Eleven models were internally validated, including cross-validation and bootstrap and four models were externally validated. The most commonly used predictors were age, body mass index (BMI) and mode of delivery. The area under the curve or C-statistics reported by the modelling and validation groups ranged from 0.602 to 0.888. Only one study had a low risk of bias and 14 studies had a high risk of bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Fourteen models for predicting SUI in pregnant and postpartum women had a high risk of bias according to the PROBAST. Future research should focus on improving the methodological quality of the existing prediction models and developing new models.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 7","pages":"880-891"},"PeriodicalIF":4.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143608311","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":"Author Reply.","authors":"Yuhang Liang, Jie Ou, Jing Fu, Yijing Wang, Yanping Li, Jinchen Li, Yan Yi","doi":"10.1111/1471-0528.18131","DOIUrl":"https://doi.org/10.1111/1471-0528.18131","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606416","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":"Predicting Adverse Perinatal Outcomes in Dichorionic Twin Pregnancies: A Multicentre Cohort Study","authors":"Veronica Giorgione,&nbsp;Mariarita Trapani,&nbsp;Miriam Lopian,&nbsp;Mariafrancesca Brutto,&nbsp;Maria Giulia Ferrante,&nbsp;Amarnath Bhide,&nbsp;Jacques C. Jani,&nbsp;Dominique A. Badr,&nbsp;Tullio Ghi,&nbsp;Basky Thilaganathan,&nbsp;Alessandra Familiari,&nbsp;Elisa Bevilacqua","doi":"10.1111/1471-0528.18125","DOIUrl":"10.1111/1471-0528.18125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Dichorionic twin pregnancies are associated with increased risks of stillbirth or medically indicated early preterm birth (ePTB) to avoid stillbirths. This study evaluated the predictive value of fetal estimated weight (EFW) and Doppler indices before adverse perinatal outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective multicentre cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Three tertiary centres in the UK, Italy and Belgium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>The study included 1294 dichorionic twin pregnancies managed between 2013 and 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Univariable and multivariable analyses assessed the association and the predictive accuracy between EFW and Doppler indices taken within 2 weeks of birth or adverse perinatal outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Stillbirths (of one or both twins) or medically indicated ePTB before 34 weeks' gestation for fetal indications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study identified 58 pregnancies (4.5%) complicated by adverse perinatal outcomes. There were significant differences (all <i>p</i> &lt; 0.001) between twins with adverse perinatal outcomes and liveborn twins for small for gestational age foetuses (89.5% vs. 59.3%), EFW discordance (31.8% vs. 8.4%), umbilical artery (UA) pulsatility index (PI) discordance (39.7% vs. 12.6%) and middle cerebral artery PI discordance (27.6% vs. 13.3%). These associations remained significant after adjusting for maternal characteristics and gestational age. The best predictive model included EFW discordance and UA PI discordance, with an area under the curve of 0.90.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The integration of intertwin EFW and UA PI discordance can effectively predict stillbirths or the need for medically indicated ePTB. After external validation in larger populations, this model could provide effective risk stratification of dichorionic pregnancies to enable targeted interventions to improve clinical outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 7","pages":"983-990"},"PeriodicalIF":4.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569453","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}