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

{"title":"Maternal morbidity and death associated with pregnancy loss before 28 weeks in Nigeria","authors":"Saturday J. Etuk,&nbsp;Ngozi Orazulike,&nbsp;Aniekan M. Abasiattai,&nbsp;Lawrence O. Omo-Aghoja,&nbsp;Anthonia Njoku,&nbsp;Adedapo B. Ande,&nbsp;Charles Uwagboe,&nbsp;Solomon Igbarumah,&nbsp;Isa Ayuba Ibrahim,&nbsp;Patrick Ekpebe,&nbsp;Sunny Ochigbo,&nbsp;Eno Etim Nyong,&nbsp;Amarabia Ibeawuchi,&nbsp;Ebe Idemudia,&nbsp;Joyce Okagua,&nbsp;Andrew Eigbedion,&nbsp;Bose Ezekwe,&nbsp;Oyedeji Oladele Adeyemi,&nbsp;Tina Lavin,&nbsp;Jamilu Tukur","doi":"10.1111/1471-0528.17864","DOIUrl":"10.1111/1471-0528.17864","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the prevalence of maternal morbidity and death from pregnancy loss before 28 weeks in referral-level hospitals in Nigeria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Secondary analysis of a nationwide cross-sectional study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Fifty-four referral-level hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Women admitted for complications arising from pregnancy loss before 28 weeks between 1 September 2019 to 31 August 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Frequency and type of pregnancy loss were calculated using the extracted data. Multilevel logistic regression was used to determine sociodemographic and clinical factors associated with early pregnancy loss. Factors contributing to death were also analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures</h3>\u0000 \u0000 <p>Prevalence and outcome of pregnancy loss at &lt;28 weeks; sociodemographic and clinical predictors of morbidity after early pregnancy loss; contributory factors to death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 4798 women who had pregnancy loss at &lt;28 weeks of pregnancy, spontaneous abortion accounted for 49.2%, followed by missed abortion (26.9%) and ectopic pregnancy (15%). Seven hundred women (14.6%) had a complication following pregnancy loss and 99 women died (2.1%). Most complications (26%) and deaths (7%) occurred after induced abortion. Haemorrhage was the most frequent complication in all types of pregnancy loss with 11.5% in molar pregnancy and 6.9% following induced abortion. Predictors of complication or death were low maternal education, husband who was not gainfully employed, grand-multipara, pre-existing chronic medical condition and referral from another facility or informal setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pregnancy loss before 28 weeks is a significant contributor to high maternal morbidity and mortality in Nigeria. Socio-economic factors and delays in referral to higher levels of care contribute significantly to poor outcomes for women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17864","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141302076","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":"Polybrominated diphenyl ethers and gestational weight gain: a multi-center prospective cohort study","authors":"Zifan Wang,&nbsp;Paige L. Williams,&nbsp;Andrea Bellavia,&nbsp;Blair J. Wylie,&nbsp;Kurunthachalam Kannan,&nbsp;Michael S. Bloom,&nbsp;Kelly J. Hunt,&nbsp;Michele R. Hacker,&nbsp;Cuilin Zhang,&nbsp;Tamarra James-Todd","doi":"10.1111/1471-0528.17860","DOIUrl":"10.1111/1471-0528.17860","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the associations of plasma polybrominated diphenyl ether (PBDE) concentrations in early pregnancy with gestational weight gain (GWG).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>US-based, multicentre cohort of pregnant women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>We used data from 2052 women without obesity and 397 women with obesity participating in the NICHD Fetal Growth Studies – Singleton Cohort, with first-trimester plasma PBDE concentrations and weight measurements throughout pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We applied generalised linear models and Bayesian kernel machine regression (BKMR) to evaluate both the individual and joint associations of PBDEs with measures of GWG, adjusting for potential confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures</h3>\u0000 \u0000 <p>Total GWG (kg), total and trimester-specific GWG velocities (kg/week), and GWG categories and trajectory groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean pre-pregnancy BMIs were 23.6 and 34.5 kg/m² for women without and with obesity, respectively. Among women without obesity, there were no associations of PBDEs with any GWG measure. Among women with obesity, one standard deviation increase in log-transformed PBDE 47 was associated with a 1.87 kg higher total GWG (95% CI 0.39–3.35) and a 0.05 kg/week higher total GWG velocity (95% CI 0.01–0.09). Similar associations were found for PBDE 47 in BKMR among women with obesity, and PBDE 47, 99 and 100 were associated with lower odds of being in the low GWG trajectory group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PBDEs were not associated with GWG among individuals without obesity. Among those with obesity, only PBDE 47 showed consistent positive associations with GWG measures across multiple statistical methods. Further research is needed to validate this association and explore potential mechanisms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17860","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297172","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 pyelonephritis hospitalisation trends, risk factors and associated adverse outcomes: A retrospective cohort study.","authors":"Christy Gandhi, Timothy Wen, Lilly Y Liu, Whitney A Booker, Mary E D'Alton, Alexander M Friedman","doi":"10.1111/1471-0528.17875","DOIUrl":"https://doi.org/10.1111/1471-0528.17875","url":null,"abstract":"<p><strong>Objective: </strong>To analyse trends, risk factors and adverse outcomes associated with antenatal pyelonephritis hospitalisations.</p><p><strong>Design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>A national sample of US delivery hospitalisations with associated antenatal hospitalisations.</p><p><strong>Population: </strong>US delivery hospitalisations in the Nationwide Readmissions Database from 2010 to 2020.</p><p><strong>Methods: </strong>Antenatal hospitalisations with a pyelonephritis diagnosis within the 9 months before delivery hospitalisation were analysed. Clinical, demographic and hospital risk factors associated with antenatal pyelonephritis hospitalisations were analysed with unadjusted and adjusted logistic regression models with unadjusted and adjusted odds ratios as measures of effect. Temporal trends in antenatal pyelonephritis hospitalisations were analysed with Joinpoint regression to determine the relative measure of average annual percent change (AAPC). Risk for severe maternal morbidity and sepsis during antenatal pyelonephritis hospitalisations was similarly analysed with Joinpoint regression.</p><p><strong>Results: </strong>Of an estimated 10.2 million delivery hospitalisations, 49 140 (0.48%) had an associated antenatal pyelonephritis hospitalisation. The proportion of deliveries with a preceding antenatal pyelonephritis hospitalisation decreased by 29% from 0.56% in 2010 to 0.40% in 2020 (AAPC -2.9%, 95% CI -4.0% to -1.9%). Antenatal pyelonephritis decreased, but risk for sepsis diagnoses increased during these hospitalisations from 3.7% in 2010 to 18.0% in 2020 (AAPC 17.2%, 95% CI 14.2%-21.1%). Similarly, risk for severe morbidity increased from 2.6% in 2010 to 4.4% in 2020 (AAPC 5.5%, 95% CI 0.8%-10.7%).</p><p><strong>Conclusion: </strong>Antenatal pyelonephritis admissions appear to be decreasing in the USA. However, these hospitalisations are associated with a rising risk for sepsis and severe maternal morbidity.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261194","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 Use of Expanded Carrier Screening in Reproductive Medicine","authors":"J. Elson,&nbsp;A. Drakeley,&nbsp;C. Achilli,&nbsp;N. Canham,&nbsp;C. Kulke,&nbsp;the Royal College of Obstetricians and Gynaecologists","doi":"10.1111/1471-0528.17832","DOIUrl":"10.1111/1471-0528.17832","url":null,"abstract":"<p>Expanded carrier screening (ECS) is a genetic screening test carried out by analysing a blood sample. This screen can be used to detect whether the individual unknowingly carries gene variants associated with common genetic conditions, such as cystic fibrosis, that may be passed on to their children. It is typically performed in reproductive medicine for those who are considering having a family either naturally or via fertility treatment. Many donor sperm and egg banks, particularly in the USA and Europe, also perform blanket ECS testing on all their prospective sperm and egg donors. ECS is not currently routine practice in the UK, but a growing number of patients are requesting it before treatment.</p><p>All of us carry gene variants of some sort that may cause autosomal recessive disease in their children if their partner or donor also carry a variant in the same gene. An autosomal recessive disease means two copies of an abnormal gene must be present in order for the disease or trait (such as cystic fibrosis or sickle cell disease) to develop. One copy of the variant means the person is a carrier but does not have the condition. Two copies, i.e. from the mother and father, means the child has a 25% chance of having the genetic disease. Carrying a gene variant does not mean that the individual would necessarily have any symptoms of the disease or any features of the condition.</p><p>Genetic tests for specific conditions are currently available either before or during pregnancy for prospective parents who have a family or personal history of a genetic condition, or for those from ethnic backgrounds where certain conditions – such as haemoglobinopathies (blood disorders) – are common, prompting referral to a clinical genetics department.</p><p>Expanded carrier screens may test for more than 100 genetic conditions. The list of conditions screened for is called a panel. Common panels are 250 or 600 genes. Not all expanded carrier screens that are available analyse the same genes. Some may test for genes that do not cause serious disease, or cause diseases that occur in later life; others test for genes that cause severe conditions in childhood. There is no agreement as to which panel of genes should be tested for in an ECS.</p><p>Understanding the screening that is being offered, and the meaning of any results, is complicated and requires support from appropriately trained professionals to best inform the prospective parent or parents.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17832","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261740","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":"First do no (net) harm","authors":"Emma J. Crosbie","doi":"10.1111/1471-0528.17858","DOIUrl":"10.1111/1471-0528.17858","url":null,"abstract":"<p>The quote above highlights the well-used medical phrase “<i>Primum non nocere</i>” or “<i>First do no harm</i>” and is advice used to warn against over treatment.<span>²</span> In Obstetrics and Gynaecology there are many historic examples that highlight the importance of this advice. In this issue of BJOG the controversy surrounding the transvaginal tape (TVT) procedure for urinary incontinence is revisited, with <b>Solhaug and colleagues</b> highlighting the need to evaluate long-term subjective and objective cure rates, treatment satisfaction and pain indices to better understand the impact of TVT procedures on the health and wellbeing of the women we treat. They found that TVT provided high rates of subjective and objective cure at 10 and 20 years after surgery, however obesity was a risk factor for procedural failure. Although 3%–5% of women experienced chronic pain, the majority were satisfied with their procedural outcome, calling into question the decision by many healthcare settings to abandon TVT as an option for managing stress urinary incontinence. Related to this, <b>Tian and colleagues</b> perform a systematic review and meta-analysis of the difference in extracellular matrix metabolism in women with and without pelvic organ prolapse furthering our understanding of the pathophysiology of this common and important disease.</p><p>Escalating intervention rates within the field of Obstetrics is alarming and in this issue of BJOG, <b>Lumbiganon and colleagues</b> warn that “<i>globally, a worrying trend is arising</i>: <i>caesarean delivery rates are skyrocketing</i>”. This represents an important geographic and socio-economic health inequity with 44% of babies born by caesarean delivery in Latin America and the Caribbean but only 4% of babies in sub-Saharan Africa. Wealthier, more urban populations experience higher rates than people from socio-economically deprived, rural areas. <b>Khalaf and colleagues</b> present important data highlighting the significant negative long-term impact of pre-labour caesarean delivery on stillbirth rates in subsequent pregnancies. With an increasing rate of non-medically indicated caesarean deliveries globally this is of particular concern.</p><p>Long term impacts of pregnancy and subsequent interventions must be further understood and considered. <b>Lumbiganon and colleagues</b> highlight how children delivered by caesarean are at higher risk of respiratory tract infections, obesity and asthma compared to children delivered vaginally.<span>³</span> <b>Patey and colleagues</b> present data on the impact of maternal health on fetal and infant cardiac health, showing no association between previous maternal bariatric surgery and adverse cardiac outcomes in her offspring, however in no-bariatric pregnancies they found an inverse correlation between maternal glucose control and fetal cardiac systolic function.</p><p>Prematurity is the leading cause of disability and death in infants ","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17858","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201155","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":"Accuracy of sonographic lower segment thickness and prediction of vaginal birth after caesarean in a resourced-limited setting; Prospective study.","authors":"Charles Adu-Takyi, Rafique Munazzah, Yaw Gyanteh Owusu, Atta Owusu-Bempah, Bernard Arhin, Henry Sakyi Opare-Addo, Amponsah Peprah, Sally L Collins, Theophilus Adu-Bredu","doi":"10.1111/1471-0528.17872","DOIUrl":"https://doi.org/10.1111/1471-0528.17872","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the accuracy of ultrasound measurement of the lower uterine segment (LUS) thickness against findings at laparotomy, and to investigate its correlation with the success rate of vaginal birth after one previous caesarean delivery (CD) in a resource-limited setting.</p><p><strong>Design: </strong>Prospective study.</p><p><strong>Setting: </strong>Obstetrics and Gynaecology department in a tertiary hospital in Ghana.</p><p><strong>Population: </strong>Women with one previous CD undergoing either a trial of labour (TOLAC) or elective CD.</p><p><strong>Methods: </strong>Myometrial lower uterine segment thickness (mLUS) and full lower uterine segment thickness (fLUS) were measured with transvaginal ultrasound (TVUS). The women were managed according to local protocols with the clinicians blinded to the ultrasound measurements. The LUS was measured intraoperatively for comparison with ultrasound measurements.</p><p><strong>Main outcome measures: </strong>Lower uterine segment findings at laparotomy, successful vaginal birth.</p><p><strong>Results: </strong>A total of 311 pregnant women with one previous CD were enrolled; 147 women underwent elective CD and 164 women underwent a TOLAC. Of the women that underwent TOLAC, 96 (58.5%) women had a successful vaginal birth. The mLUS was comparable to the intraoperative measurement in the elective CD group with LUS thickness <5 mm (bias of 0.01, 95% CI -0.10 to 0.12 mm) whereas fLUS overestimated LUS <5 mm (bias of 0.93, 95% CI 0.80-1.06 mm). Successful vaginal birth rate correlated with increasing mLUS values (odds ratio 1.30, 95% CI 1.03-1.64). Twelve cases of uterine defect were recorded. LUS measurement ≤2.0 mm was associated with an increased risk of uterine defects with a sensitivity of 91.7% (95% CI 61.5-99.8%) and specificity of 81.8% (95% CI 75.8-86.8%).</p><p><strong>Conclusion: </strong>Accurate TVUS measurement of the LUS is technically feasible in a resource-limited setting. This approach could help in making safer decisions on mode of birth in limited-resource settings.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201152","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":"Improving trustworthiness in research in women's health is a joint effort.","authors":"Janneke van 't Hooft, Bassel H Ai Wattar, Khalid S Khan","doi":"10.1111/1471-0528.17861","DOIUrl":"https://doi.org/10.1111/1471-0528.17861","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181145","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":"Determinants and outcomes of preterm births in Nigerian tertiary facilities","authors":"Iretiola Bamikeolu Fajolu,&nbsp;Iyabode Olabisis Florence Dedeke,&nbsp;Timothy A. Oluwasola,&nbsp;Lawal Oyeneyin,&nbsp;Zainab Imam,&nbsp;Ezra Ogundare,&nbsp;Ibijoke Campbell,&nbsp;Bola Akinkunmi,&nbsp;Ekundayo O. Ayegbusi,&nbsp;Efeturi Agelebe,&nbsp;Ayodeji K. Adefemi,&nbsp;David Awonuga,&nbsp;Olusoji Jagun,&nbsp;Qasim Salau,&nbsp;Bankole Kuti,&nbsp;Olukemi Oluwatoyin Tongo,&nbsp;Tajudeen Adebayo,&nbsp;Damilola Adebanjo-Aina,&nbsp;Emmanuel Adenuga,&nbsp;Idowu Adewumi,&nbsp;Tina Lavin,&nbsp;Jamilu Tukur,&nbsp;Olubukola Adesina","doi":"10.1111/1471-0528.17869","DOIUrl":"10.1111/1471-0528.17869","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe the incidence, and sociodemographic and clinical factors associated with preterm birth and perinatal mortality in Nigeria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Secondary analysis of data collected through the Maternal Perinatal Database for Quality, Equity and Dignity (MPD-4-QED) Programme.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Data from births in 54 referral-level hospitals across Nigeria between 1 September 2019 and 31 August 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>A total of 69 698 births.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Multilevel modelling was used to determine the factors associated with preterm birth and perinatal mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcome measures</h3>\u0000 \u0000 <p>Preterm birth and preterm perinatal mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 62 383 live births, 9547 were preterm (153 per 1000 live births). Maternal age (&lt;20 years – adjusted odds ratio [aOR] 1.52, 95% CI 1.36–1.71; &gt;35 years – aOR 1.23, 95% CI 1.16–1.30), no formal education (aOR 1.68, 95% CI 1.54–1.84), partner not gainfully employed (aOR 1.94, 95% CI 1.61–2.34) and no antenatal care (aOR 2.62, 95% CI 2.42–2.84) were associated with preterm births. Early neonatal mortality for preterm neonates was 47.2 per 1000 preterm live births (451/9547). Father's occupation (manual labour aOR 1.52, 95% CI 1.20–1.93), hypertensive disorders of pregnancy (aOR 1.37, 95% CI 1.02–1.83), no antenatal care (aOR 2.74, 95% CI 2.04–3.67), earlier gestation (28 to &lt;32 weeks – aOR 2.94, 95% CI 2.15–4.10; 32 to &lt;34 weeks – aOR 1.80, 95% CI 1.3–2.44) and birthweight &lt;1000 g (aOR 21.35, 95% CI 12.54–36.33) were associated with preterm perinatal mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Preterm birth and perinatal mortality in Nigeria are high. Efforts should be made to enhance access to quality health care during pregnancy, delivery and the neonatal period, and improve the parental socio-economic status.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17869","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181133","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":"Implication of United States abortion policies on quantity and impact of abortion-related research.","authors":"Gabriel Levin, Yoav Brezinov, Kacey M Hamilton, Raanan Meyer","doi":"10.1111/1471-0528.17876","DOIUrl":"https://doi.org/10.1111/1471-0528.17876","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176850","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":"Retraction: Management of Impacted Fetal Head at Caesarean Birth","authors":"","doi":"10.1111/1471-0528.17879","DOIUrl":"10.1111/1471-0528.17879","url":null,"abstract":"<p>K. Cornthwaite, R. Bahl, C. Winter, Wright, J. Kingdom, K. Walker, G. Tydeman, A. Briley, M. Schmidt-Hansen, T. Draycott, and the Royal College of Obstetricians &amp; Gynaecologists. Management of Impacted Fetal Head at Caesarean Birth. BJOG<i>.</i> 2023;130(12):e40–e64, https://doi.org/10.1111/1471-0528.17534.</p><p>The above article, published on June 12, 2023, in Wiley Online Library (Wiley Online Library), has been retracted by agreement between the authors, journal Editor-in-Chief, Aris Papageorghiou, the Royal College of Obstetricians and Gynaecologists, and John Wiley &amp; Sons Ltd.</p><p>The retraction has been agreed following the retraction of (1), a key paper cited in the above article. The retraction of (1) notes concerns regarding discrepancies between the retrospective trial registration and the published article. In light of this, the Royal College of Obstetricians &amp; Gynaecologists has determined that the data and subsequent results in the above article are now implicated due to the discrepancies found in (1), particularly regarding the benefits of Fetal Pillow in relation to both maternal and neonatal outcomes.</p><p>\u0000 <b>Reference:</b>\u0000 </p><p>(1) S.L. Seal, A. Dey, S.C. Barman, G. Kamilya, J. Mukherji, and J.L. Onwude, <i>Retracted:</i> “Randomized controlled trial of elevation of the fetal head with a fetal pillow during cesarean delivery at full cervical dilatation,” <i>International Journal of Gynecology &amp; Obstetrics</i> 133, no. 2 (2016): 178-182, https://doi.org/10.1016/j.ijgo.2015.09.019.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17879","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176853","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}