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

{"title":"Advancements in Fetal Heart Rate Monitoring: A Report on Opportunities and Strategic Initiatives for Better Intrapartum Care","authors":"Aimée Lovers,&nbsp;Martin Daumer,&nbsp;Martin G. Frasch,&nbsp;Austin Ugwumadu,&nbsp;Philip Warrick,&nbsp;Rik Vullings,&nbsp;Nicolò Pini,&nbsp;John Tolladay,&nbsp;Olav Bjørn Petersen,&nbsp;Christian Lederer,&nbsp;Liu Yang,&nbsp;Petar M. Djurić,&nbsp;Farhad Abtahi,&nbsp;Malin Holzmann,&nbsp;Samuel Boudet,&nbsp;Agathe Houzé de l'Aulnoit,&nbsp;Antoniya Georgieva","doi":"10.1111/1471-0528.18097","DOIUrl":"10.1111/1471-0528.18097","url":null,"abstract":"<p>Cardiotocography (CTG), introduced in the 1960s, was initially expected to prevent hypoxia-related deaths and neurological injuries. However, more than five decades later, evidence supporting the evidence of intrapartum CTG in preventing neonatal and long-term childhood morbidity and mortality remains inconclusive. At the same time, shortcomings in CTG interpretation have been recognised as important contributory factors to rising caesarean section rates and missed opportunities for timely interventions. An important limitation is its high false-positive rate and poor specificity, which undermines reliably identifying foetuses at risk of hypoxia-related injuries. These shortcomings are compounded by the technology's significant intra- and interobserver variability, as well as the subjective and complex nature of fetal heart rate interpretation. However, human factors and other environmental factors are equally significant. Advancements in fetal heart rate monitoring are crucial to support clinicians in improving health outcomes for newborns and their mothers, while at the same time avoiding unnecessary operative deliveries. These limitations highlight the clinical need to enhance neonatal outcomes while minimising unnecessary interventions, such as instrumental deliveries or caesarean sections. We believe that achieving this requires a paradigm shift from subjective interpretation of complex and nonspecific fetal heart rate patterns to evidence-based, quantifiable solutions that integrate hardware, engineering and clinical perspectives. Such transformation necessitates an international, multidisciplinary effort encompassing the entire continuum of pregnancy care and the broader healthcare ecosystem, with emphasis on well-defined, actionable health outcomes. Achieving this will depend on collaborations between researchers, clinicians, medical device manufacturers and other relevant stakeholders. This expert review paper outlines the most relevant and promising directions for research and strategic initiatives to address current challenges in fetal heart rate monitoring. Key themes include advancements in computerised fetal heart rate monitoring, the application of big data and artificial intelligence, innovations in home and remote monitoring and consideration of human factors.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 7","pages":"853-866"},"PeriodicalIF":4.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460406","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":"Standardised Methods for Developing Conceptual Frameworks for Placental Disorders of Pregnancy: Pre-Eclampsia and Stillbirth.","authors":"Terteel Elawad, Mai-Lei Woo Kinshella, Ellie Stokes, Kelly Pickerill, Elisa Dalle Piagge, Marianne Vidler, Ella Stanley, Marie-Laure Volvert, Jeffrey N Bone, Helen Elwell, Hiten D Mistry, Violet Mateljan, Eleni Tsigas, Veronique Filippi, Peter von Dadelszen, Hannah Blencowe, Laura A Magee","doi":"10.1111/1471-0528.18083","DOIUrl":"https://doi.org/10.1111/1471-0528.18083","url":null,"abstract":"<p><strong>Background: </strong>Risk factors for the placental disorders of pregnancy (pre-eclampsia, fetal growth restriction, preterm birth, and stillbirth) are complex, frequently involving the interplay between clinical factors and wider social and environmental determinants of health. Biomarkers modulate the maternal and fetal responses to biological processes that underlie the development of placental disorders.</p><p><strong>Objectives: </strong>To develop a standardised methodology to assess the importance of, and inter-relationships between, candidate risk factors for the various placental disorders.</p><p><strong>Search strategy: </strong>Systematic searches were conducted using Medline, Embase, Health Technology Assessments, Database of Abstracts of Reviews of Effects, Cochrane Library databases, Google Scholar, and reference lists of retrieved papers.</p><p><strong>Selection criteria: </strong>We deployed a hierarchy of reviews, systematic reviews, and cohort studies with at least 1000 participants (100 for biomarker studies), published in the prior decade.</p><p><strong>Data collection and analysis: </strong>We assessed the strengths of association and quality of evidence linking risk factors with individual placental outcomes.</p><p><strong>Conclusions: </strong>We have developed a standardised approach to assess the importance and inter-relatedness of putative risk factors for the placental disorders of pregnancy.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460459","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 Need for Understanding Beliefs and Barriers Around Physical Activity Postpartum Among South Asian Immigrant Women to Improve Health Equity: A Commentary.","authors":"I A Lesser, B Mahmood, S A Lear, C Bean","doi":"10.1111/1471-0528.18121","DOIUrl":"https://doi.org/10.1111/1471-0528.18121","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460462","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":"Towards the Development of a Conceptual Framework of the Determinants of Pre-Eclampsia: A Hierarchical Systematic Review of Social Determinants.","authors":"Mai-Lei Woo Kinshella, Kelly Pickerill, Sarina Prasad, Olivia Campbell, Jalila Devji, Lívia Vieira Lopes, Rosa Balleny, Terteel Elawad, Rachel Craik, Marie-Laure Volvert, Hiten D Mistry, Hannah Blencowe, Véronique Filippi, Peter von Dadelszen, Laura A Magee, Marianne Vidler","doi":"10.1111/1471-0528.18082","DOIUrl":"https://doi.org/10.1111/1471-0528.18082","url":null,"abstract":"<p><strong>Background: </strong>Existing reviews of pre-eclampsia determinants have focused on clinical and genetic risk factors.</p><p><strong>Objective: </strong>To evaluate social determinants for pre-eclampsia prevention.</p><p><strong>Search strategy: </strong>Systematic searches were conducted from relevant electronic databases from inception of each database to 30th December 2024.</p><p><strong>Selection criteria: </strong>Reviews and large cohort studies (≥ 1000 participants), published between 2013 and 2024, reporting quantitative associations between social determinant exposures and pre-eclampsia outcomes.</p><p><strong>Data collection and analysis: </strong>Titles and abstracts, then relevant full-texts were reviewed by two reviewers, independently. Strength of association was evaluated as 'definite' (odds ratios [OR] or relative risk [RR] ≥ 3.00 or < 0.33), 'probable' (OR or RR 1.50-2.99 or 0.33-0.67), 'possible' (OR or RR 1.10-1.49 or 0.68-0.89), or 'unlikely' (OR or RR 0.90-1.09). Quality of the evidence was high, moderate, low, or very-low, using GRADE.</p><p><strong>Main results: </strong>Twenty-seven publications found 24 associations of pre-eclampsia with socioeconomic status, social support/exclusion, healthcare access, and occupational and physical environmental factors. One association (polygamy) was definite (low-quality evidence). Probable associations included: work stress, lack of antenatal care and heat exposure in early pregnancy (high-quality evidence); prolonged occupational exposure to whole body vibrations or bending, distance to health facility, and UV-B radiation exposure (protective factor), all based on moderate-quality evidence; and neighbourhood deprivation, rotating work shifts, and Asian/Oceanian origins (protective factor), all based on low-quality evidence. There were 13 possible associations, which did not include education.</p><p><strong>Conclusion: </strong>Our findings support recommendations to address climate change, strengthen occupational protection, and promote early antenatal attendance. Social determinants may be indicative of upstream factors (e.g., obesity) that increase likelihood of clinical risk factors for pre-eclampsia incidence and severity.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460468","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":"Management of Monochorionic Twin Pregnancy Green-Top Guideline No. 51 (2024 Partial Update)","authors":"Mark D. Kilby,&nbsp;Leanne Bricker,&nbsp;Royal College of Obstetricians and Gynaecologists","doi":"10.1111/1471-0528.18055","DOIUrl":"10.1111/1471-0528.18055","url":null,"abstract":"&lt;p&gt;This guideline provides evidence-based recommendations and advice on best practices for the clinical care of monochorionic twin (and much rarer higher order) pregnancies. The use of ultrasound to determine chorionicity and amnionicity is key to the management of multiple pregnancies and the interpretation of potential risks to the fetuses. This guideline will outline the best evidence to guide clinical care, including fetal surveillance, the screening for, and treatment of complications associated with monochorionic multiple pregnancy. It is important to emphasise that this guideline is focused on the management of monochorionic multiple pregnancies rather than all multiple pregnancies.&lt;/p&gt;&lt;p&gt;It is also recognised that women carrying a monochorionic pregnancy (most commonly twins) may have concerns and anxieties surrounding their pregnancy. This requires accurate and evidence-based information given in a sensitive manner by healthcare professionals and supported by a multidisciplinary team, ideally within a multiple-pregnancy clinic [&lt;span&gt;1, 2&lt;/span&gt;]. In the UK, support is also often given in conjunction with the Twins Trust (formally the Twins And Multiple Births Association [TAMBA]) and The Multiple Births Foundation.&lt;/p&gt;&lt;p&gt;A monochorionic pregnancy is a multiple pregnancy, most commonly a twin pregnancy (99% of cases), in which babies are dependent on a single, shared placenta and where there are placental anastomoses conjoining the fetal circulations. Approximately 20% of twin pregnancies in the UK are monochorionic. Monochorionic placentation can also occur in rarer, higher-order multiples, especially triplets (i.e., dichorionic or monochorionic triplets).&lt;/p&gt;&lt;p&gt;There has been an increase in all types of multiple pregnancies with the use of assisted reproductive technology and the choice of individuals to defer pregnancy to a later maternal age (especially pronounced in high/middle-income countries). Although the rates of twining and higher order pregnancies are increased in people of Nigerian ethnicity, the rate of monochorioncity is not significantly increased in this group. Assisted reproductive technology increases the prevalence of both dichorionic and monochorionic twinning. However, using day 5 blastocyst transfers seems to be associated with a significantly higher rate of monozygotic twinning compared with cleavage stage day 3 transfers (adjusted OR 2.04, 95% CI 1.29–4.48) [&lt;span&gt;3-5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;All multiple pregnancies have increased risks of preterm birth, fetal growth restriction (FGR), pre-eclampsia, postpartum haemorrhage, and additional postnatal potentially morbid complications, such as infant feeding difficulties and adverse puerperal mood change [&lt;span&gt;1, 2, 6, 7&lt;/span&gt;]. These complications are not addressed further in this guideline as they are not specific to monochorionic placentation.&lt;/p&gt;&lt;p&gt;The challenges of monochorionic pregnancies arise from the single, shared placenta and placental vascular anastomoses that ","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 6","pages":"e98-e129"},"PeriodicalIF":4.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450780","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":"Feasibility of a Standardised Mid-Trimester Ultrasound Protocol: A National Multicenter Study","authors":"Thierry Bultez,&nbsp;Laurent Julien Salomon,&nbsp;Houman Mahallati,&nbsp;Nicolas Fries,&nbsp;the CNEOFT2 Study Group","doi":"10.1111/1471-0528.18102","DOIUrl":"10.1111/1471-0528.18102","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;Evaluate the feasibility and quality of a national standardised mid-trimester ultrasound protocol using a consensus-based quality assessment (QA) scoring system.&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;Multicenter prospective observational ‘FLASH’ 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;(i) Assessing the feasibility of a standardised protocol of 24 views at the mid-trimester scan, with 21 recommended and 3 additional views, in routine practice.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;(ii) Assessing the quality of these images by evaluating the presence of conformity criteria.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;(iii) Analysing the reliability between self-assessment and peer-assessment of the images.&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;A total of 440 mid-trimester scans.&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;A consensus-based QA scoring system comprising 73 conformity criteria was established with 28 experts using a 3-round Delphi method. Secondly, we asked operators to record 5 consecutive routine mid-trimester scans. Images were analysed by the sonographer themselves and by a qualified expert according to the scoring system. The frequency of recorded images was calculated for each of the views. Factors associated with missing images per scan were evaluated. The robustness of conformity criteria was assessed by reliability between self-evaluation and peer-evaluation.&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;Based on 9849 images, we observed feasibility of the 21 recommended standardised views for mid-trimester scan ranging from 88.5% to 100%.&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;Most conformity criteria (64/73, 88%) were met in over 90% of cases. Gwet's AC1 correlation between expert evaluation (peer-evaluation) and participant evaluation (self-evaluation) was greater than 0.80 for 70/73 (96%) criteria.&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;This large-scale 2-month ‘flash’ observational study demonstrates the feasibility and quality of a national standardised mid-trimester ultrasound protocol using a consensus-based QA scoring syste","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 8","pages":"1065-1073"},"PeriodicalIF":4.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415858","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":"Correction to “The Hayman Technique: A Simple Method to Treat Postpartum Haemorrhage”","authors":"","doi":"10.1111/1471-0528.18099","DOIUrl":"10.1111/1471-0528.18099","url":null,"abstract":"<p>F. Ghezzi, A. Cromi, S. Uccella, L. Raio, P. Bolis, and D. Surbek, “The Hayman Technique: A Simple Method to Treat Postpartum Haemorrhage,” <i>BJOG: An International Journal of Obstetrics &amp; Gynaecology</i> 114, no. 3 (2007): 362–365, https://doi.org/10.1111/j.1471-0528.2006.01204.x.</p><p>Concerns were raised by a third party regarding Figure 1B of the article [<span>1</span>]. Firstly, that the image was previously published by Habek et al. (2006) and was used without permission or appropriate attribution, and secondly, that it originally depicts a different operative method, the B-Lynch procedure.</p><p>The authors admitted to the unintentional reuse of the figure, which they erroneously believed was their own. The authors now provide an original image from their own cases that accurately represents the Hayman technique for correction.</p><p>The authors apologise for this oversight.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 6","pages":"850"},"PeriodicalIF":4.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415847","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":"Regarding the Association Between Polycystic Ovary Syndrome and Risk of Pre-Eclampsia.","authors":"Hong Li, Jue He, Yan Xu, Minhui Yi, Yan Qin","doi":"10.1111/1471-0528.18087","DOIUrl":"https://doi.org/10.1111/1471-0528.18087","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415868","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":"Association of Zona Pellucida Gene Variants With Female Infertility: A Retrospective Genetic Analysis","authors":"Sha-wei Sa,&nbsp;Li-li Wang,&nbsp;Qian-hong Ma","doi":"10.1111/1471-0528.18094","DOIUrl":"10.1111/1471-0528.18094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We investigated the clinical characteristics and pregnancy outcomes of patients with zona pellucida (ZP) gene variants undergoing assisted reproductive technology (ART) treatment, to identify variants associated with female infertility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>University-based reproductive medicine centre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Twelve patients in whom only empty follicles or degenerated oocytes were retrieved after controlled ovulation stimulation and for whom no successful pregnancies were achieved after ART treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Next-generation sequencing (NGS) and Sanger sequencing were performed on DNA obtained from peripheral blood of the patients. The VCF files generated by the Genome Analysis Toolkit were functionally annotated using SnpEff with reference to the refSeq, gnomAD, dbSNP, InhouseSNP, ClinVar and dbNSFP databases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>American College of Medical Genetics and Genomics (ACMG) annotation of the SnpEff results was performed using InterVar.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 14 ZP variants, including eight novel variants. These included heterozygous variants in <i>ZP1</i>, <i>ZP2</i> and <i>ZP3</i>. These findings contribute to the understanding of ZP gene variants and their roles in the diagnosis of an abnormal ZP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ZP gene variants are associated with female infertility, which can potentially affect ART outcomes. Therefore, ZP gene variant screening should be performed in female patients experiencing ART failure with pertinent clinical and laboratory indicators to guide personalised treatment and enhance fertility outcomes. However, further research is required to confirm the functional impact of these variants.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S2","pages":"75-82"},"PeriodicalIF":4.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143385810","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":"Maternal Calcium Intake at 36 Weeks' Gestation and Pre-Eclampsia Risk—A Cohort Study","authors":"Anastasija Arechvo,&nbsp;Argyro Syngelaki,&nbsp;Laura A. Magee,&nbsp;Sophie E. Moore,&nbsp;Andrew Doel,&nbsp;Alan Wright,&nbsp;Kypros H. Nicolaides,&nbsp;Peter von Dadelszen","doi":"10.1111/1471-0528.18091","DOIUrl":"10.1111/1471-0528.18091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study is to examine the association between dietary calcium intake (Ca) and pre-eclampsia (PE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Inner-city hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>A total of 2838 women with singleton pregnancies at 35⁺⁰–36⁺⁶ weeks' gestation, including 96 (3.4%) who subsequently developed PE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Online 24-h dietary recall questionnaire was used to measure Ca intake. In the low (&lt; 700 mg/d) vs. adequate (≥ 700 mg/d) Ca intake groups, we compared the prevalence of PE-associated maternal risk factors and the incidence of PE. In multivariate regression, we examined the low Ca intake and PE relationship, adjusted for established PE risk factors (including blood pressure and angiogenic biomarkers) and any additional factors associated with low Ca intake specifically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measure</h3>\u0000 \u0000 <p>PE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 405 (14.3%) women had low Ca intake. Low (vs. adequate) Ca intake was associated with a higher incidence of PE (6.2% vs. 2.9%; odds ratio 2.2, 95% confidence interval 1.3–3.7), as well as more prevalent risk factors for PE, including Black ethnicity (34.1% vs. 11.8%), South Asian ethnicity (10.1% vs. 7.2%), high body mass index (29.8 vs. 28.3 kg/m²) and more deprived index of multiple deprivation (54.3% vs. 35.5%). In multivariate regression adjusting for other PE risk factors, low Ca intake was no longer associated with PE (OR 1.7, 95% CI 0.9–3.2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although some contribution from low Ca to the development of PE cannot be ruled out, after accounting for maternal characteristics, medical history and deprivation, low Ca intake did not make an independent contribution to the development of PE in this population of mixed-ethnicity women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 6","pages":"816-825"},"PeriodicalIF":4.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143385816","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}