Australian & New Zealand Journal of Obstetrics & Gynaecology最新文献

{"title":"Problematic Periods Costing Young Women-The Impact of Menstrual Symptoms on Work and Study.","authors":"Amelia K Mardon, Sarah White, Danielle Howe, Michelle O'Shea, Allie Eathorne, Mark Gannott, Ally Schott, Mike Armour","doi":"10.1111/ajo.13926","DOIUrl":"https://doi.org/10.1111/ajo.13926","url":null,"abstract":"<p><p>Menstrual disorders are common, but their economic and social impact is still underreported. This study used a cross-sectional design to investigate menstrual symptom prevalence, impacts and economic burden in Australian women of reproductive age. One thousand two hundred thirty-eight responses were analysed (median age 33 years). Most respondents (77%) reported having bothersome menstrual symptoms, and almost half (44%) reported missed days of work or study because of their symptoms. Those aged 18-24 years were more likely to report bothersome menstrual symptoms, and time away from work and study, than those aged 35-44 years. The economic burden due to menstrual symptoms was approximately AUD $14.2 billion per year.</p>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of patients registered with the Queensland Trophoblast Centre diagnosed with gestational trophoblastic neoplasia who develop resistance to chemotherapy","authors":"Meg Welsh,&nbsp;Shona Morrison,&nbsp;David Baartz,&nbsp;Karen Sanday,&nbsp;Andrea Garrett","doi":"10.1111/ajo.13912","DOIUrl":"10.1111/ajo.13912","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To audit outcomes of patients registered in the Queensland Trophoblast Centre (QTC) database who develop resistance to primary chemotherapy. To determine any risk factors that may predict first-line chemotherapy resistance in patients diagnosed with gestational trophoblastic neoplasia (GTN).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients within the QTC who were diagnosed with GTN between January 2012 and December 2020 were reviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 138 patients with GTN registered in the QTC, 22 (15.9%) patients developed resistance to first-line chemotherapy. Three had high-risk GTN and 19 had low-risk GTN. Of the three high-risk patients, one patient died. This patient had an epithelioid trophoblastic tumour (ETT). The remaining two high-risk patients had complete hydatidiform moles (CHM) with GTN. Both achieved complete remission with salvage therapy. Of the 19 low-risk patients, one patient had a partial hydatidiform mole (PHM). This patient achieved remission following third-line treatment. The other 18 low-risk patients had CHM with GTN. All but two of these 18 patients were successfully treated with second-line chemotherapy, with the remaining two patients achieving remission with third-line chemotherapy. Five of the 18 patients received either actinomycin-D or methotrexate as salvage therapy. Thirteen patients were given multi-agent chemotherapy for second-line treatment. One patient in this group died but this was not due to her disease. Initial β human chorionic gonadotropin levels were not predictive of number of chemotherapy cycles or number of lines of chemotherapy required to achieve remission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GTN is a curable condition. If resistance to first-line chemotherapy occurred, most patients achieved remission with salvage therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 3","pages":"398-403"},"PeriodicalIF":1.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Worst-Case Scenario After AI Use in Academic Writing: A Clever User Wins?","authors":"Shigeki Matsubara, Daisuke Matsubara","doi":"10.1111/ajo.13928","DOIUrl":"https://doi.org/10.1111/ajo.13928","url":null,"abstract":"","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of using cannabis during pregnancy on the infant and mother: An overview of systematic reviews, evidence map, targeted updates, and de novo synthesis","authors":"Zachary Munn,&nbsp;Danielle Pollock,&nbsp;Jennifer Stone,&nbsp;Sabira Hasanoff,&nbsp;Andrea Gordon,&nbsp;Carrie Price,&nbsp;Michael Stark,&nbsp;Timothy Hugh Barker","doi":"10.1111/ajo.13916","DOIUrl":"10.1111/ajo.13916","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cannabis use during pregnancy is becoming more prevalent. While numerous studies have explored the relationship of cannabis use during pregnancy and outcomes for mothers and infants, uncertainty remains regarding the impact of cannabis use on pregnancy complications and later-life outcomes for offspring.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To produce a summary of the short and long-term effects of prenatal cannabis exposure on fetal growth and development, neonatal conditions, later-life, and maternal outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>An overview of systematic reviews, an evidence and gap map, targeted updates of previous reviews, and <i>de novo</i> evidence synthesis was conducted. The databases searched include PubMed (National Center for Biotechnology Information); MEDLINE (Ovid); Embase (Ovid) and CINAHL with Full Text (EBSCO). Assessment of risk of bias was conducted in duplicate for all studies. Relevant studies were coded and are presented as an evidence and gap map. Where possible, meta-analyses were conducted with a narrative synthesis of the results. Primary studies and systematic reviews examining the relationship between cannabis consumption in pregnancy and the effect on fetal/child development, antenatal, and obstetric outcomes during pregnancy were eligible for inclusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 89 studies/reviews eligible for inclusion in this review. There was a potentially harmful impact of prenatal cannabis exposure on all fetal growth and development outcomes, some neonatal outcomes, some later-life outcomes, and some maternal outcomes. The evidence regarding other neonatal conditions, later-life, and maternal outcomes was mixed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The evidence suggests cannabis should be avoided during pregnancy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 3","pages":"312-328"},"PeriodicalIF":1.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13916","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender equity in O&G leadership: Celebrating progress while navigating new challenges","authors":"Kirsten Connan","doi":"10.1111/ajo.13918","DOIUrl":"10.1111/ajo.13918","url":null,"abstract":"&lt;p&gt;Two decades ago, obstetrics and gynaecology within Australia and Aotearoa New Zealand was predominantly a male-led specialty. Today, we observe a dramatic shift in gender representation across our workforce. This transformation prompts us to examine the current state of gender equity in our O&amp;G leadership landscape and consider the implications of this demographic evolution.&lt;/p&gt;&lt;p&gt;The documentation of this transformation has been sparse. When commencing my own investigation and research into the gender landscape of O&amp;G in Australia and Aotearoa New Zealand as part of a Master of Clinical Education in 2017 [&lt;span&gt;1&lt;/span&gt;], I discovered little had been published on the situation. The first published article was written by our immediate past ANZJOG Editor-In-Chief, Professor Caroline de Costa [&lt;span&gt;2&lt;/span&gt;], reflecting on being one of only seven female specialists amongst several hundred male specialists in the early 1980s. De Costa followed this up in 2012 with publication of her RANZCOG ASM Arthur Wilson Oration [&lt;span&gt;3&lt;/span&gt;], “The Changing Roles of Women in Obstetrics and Gynaecology”. With females making up 80% of trainees in 2012 yet only 14% of the RANZCOG board, she highlighted the discordance between female membership and consequent leadership inequality.&lt;/p&gt;&lt;p&gt;By 2017, RANZCOG had undergone significant demographic change, mirroring trends in other local medical specialities and international O&amp;G programs. Women comprised 46% of RANZCOG specialists and 80% of trainees, positioning O&amp;G as one of the most gender-transformed specialities both locally and internationally. Despite this shift, a pronounced leadership gap persisted at the national level, with only one female member on the RANZCOG national board, and only one female College president since RANZCOG's inception in 1998 (though noting Dr Heather Munro AO was RACOG president from 1994–1996).&lt;/p&gt;&lt;p&gt;For many members, the lack of gender equity in leadership challenged the authenticity of representation by RANZCOG's leadership. This inequity contradicted the primary tenet of social justice that drives cultural reform for equity in all areas of society. This is particularly crucial in O&amp;G, where our specialty's focus on women's healthcare demands leadership that reflects both our workforce and the patients we serve. Beyond fundamental human rights, national and international research has consistently shown leadership gender equity improves workplace productivity, emotional wellbeing, economic growth, and organisational reputation, with leadership gender diversity also demonstrating improved financial and organisational performance [&lt;span&gt;4, 5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Following a call to action at the 2018 RANZCOG Annual Scientific Meeting [&lt;span&gt;6&lt;/span&gt;], then RANZCOG president Dr Vijay Roach announced the formation of the RANZCOG Gender Equity and Diversity Working Group (GEDWG).&lt;/p&gt;&lt;p&gt;Under the leadership of current RANZCOG president Dr Gillian Gibson, the committee wor","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"64 6","pages":"540-541"},"PeriodicalIF":1.4,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13918","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menstrual cup acceptability and functionality in real-world use: A cross-sectional survey of young people in Australia","authors":"Julie Hennegan,&nbsp;Ana Orozco,&nbsp;Alexandra Head,&nbsp;Jennifer L. Marino,&nbsp;Yasmin Jayasinghe,&nbsp;Megan S. C. Lim","doi":"10.1111/ajo.13910","DOIUrl":"10.1111/ajo.13910","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Menstrual cups offer a cost-effective and environmentally sustainable product for many young people. While clinical trials have shown their safety and effectiveness, no studies have investigated their performance in real-world use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To describe the acceptability and functionality (continuation, discomforts, leakage, and adverse events) of menstrual cups and investigate the supportive role of product knowledge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A cross-sectional online survey of 530 people aged 15–24 living in Australia who had ever used a menstrual cup, recruited via a menstrual cycle tracking application.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>More than half of participants (55%) were still using their first menstrual cup at the time of the survey, 16% had switched to an alternative cup, and 29% had discontinued use. In their first cycle of use, 54% of participants reported leakage and 25% reported pain or discomfort with the cup in place. Many participants (45%) reported being unable to remove the cup on their first attempt, with subsequently 17% requiring help to remove it, and 2% reported displacement of an intra-uterine device during removal. These figures decreased for subsequent cycles. Half of the participants were aware prior to using a cup that different cup models may offer a better fit for different individuals. This knowledge was associated with decreased odds of needing help to remove the cup (adjusted odds ratio 0.57, 95% CI 0.35–0.94) or discontinuing use (adjusted relative risk ratio 0.66, 95% CI 0.44–1.00).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Difficulties using menstrual cups are common in real-world use and higher than reported in clinical trials. Improved education provision may support more positive user experiences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 3","pages":"382-389"},"PeriodicalIF":1.4,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13910","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond pathology: Patient experiences of laparoscopy for persistent pelvic pain with no identifiable cause found","authors":"Tristan McCaughey,&nbsp;Melissa M Younes,&nbsp;Mooska Raoofi,&nbsp;Lauren Hicks,&nbsp;Michal Amir,&nbsp;Charlotte Reddington,&nbsp;Claudia Cheng,&nbsp;Martin Healey,&nbsp;Michelle Peate","doi":"10.1111/ajo.13905","DOIUrl":"10.1111/ajo.13905","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Laparoscopy has often been considered a core part of the workup for pelvic pain. However, many of these laparoscopies find no pathology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To evaluate the experiences of patients following laparoscopy for pelvic pain when there is no diagnosis found.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This descriptive qualitative study reviewed patients who underwent a diagnostic laparoscopy for persistent pelvic pain with no pathology found. Participants completed a written questionnaire and an in-depth semi-structured interview. Interview data were thematically analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen patients were interviewed with a median age of 30 years. Six themes were identified: desire for a diagnosis, hope as a coping strategy, inadequate communication, having ‘next steps’ of management offered, mental health impacts, and system issues. Participants wanted a diagnosis to help understand their condition, to enable connection with others, and believed that clinicians viewed pain with a diagnosis more seriously. Participants who were confident preoperatively that laparoscopy would lead to a diagnosis reported this contributing to poorer postoperative mental health. Participants discussed diagnoses not listed in the medical records, which provided hope for future management options. Participants reported worse mental health following the laparoscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides insight into the experiences of patients following a laparoscopy without an identifiable diagnosis. It highlights the importance of pre- and postoperative counselling, including discussing the potential for no findings at laparoscopy; the language used around other potential diagnoses; and the value in considering a patient's pre-existing mental health. The findings of this study are relevant for all clinicians counselling people with persistent pelvic pain where endometriosis is suspected.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 3","pages":"351-356"},"PeriodicalIF":1.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of pregnant and post-partum patients admitted to the intensive care unit with COVID-19 in Australia: An analysis of SPRINT-SARI Australia","authors":"Emma Barnes,&nbsp;Peinan Zhao,&nbsp;Andrew Udy,&nbsp;Nhi Nguyen,&nbsp;Aidan Burrell,&nbsp;the SPRINT-SARI Australia Investigators","doi":"10.1111/ajo.13908","DOIUrl":"10.1111/ajo.13908","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pregnant and post-partum (collectively peri-partum) women may be at increased risk of severe COVID-19 disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To describe the characteristics, interventions, and outcomes of peri-partum patients admitted to intensive care units (ICUs) in Australia with COVID-19.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>We conducted a prospective, multicentre observational study using the SPRINT-SARI Australia database across 63 ICUs in Australia. All women &lt;45 years of age, admitted to a participating Australian ICU, with laboratory-confirmed COVID-19 between 1 March 2020 and 1 June 2023 were included. Participants were categorised as either peri-partum, defined as pregnant or up to six weeks post-partum, or non-pregnant. The primary outcome was in-hospital mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 737 eligible female patients were admitted to ICUs over the study period: 168/737 (23%) were peri-partum, while 569/737 (77%) were non-pregnant. The median age of peri-partum women was 31 (interquartile range (IQR) 27–36) years old, and median gestation was 28.0 (IQR 4–40) weeks. When compared to non-pregnant women, peri-partum women had lower rates of comorbidities (1.8% vs 14.4% <i>P</i> &lt; 0.001), lower vaccination rates (27.4% vs 45.2%, <i>P</i> &lt; 0.001), similar rates of mechanical ventilation, and greater use of tocilizumab (29.2% vs 4.0%, <i>P</i> &lt; 0.001). Complications were low in both groups. In-hospital mortality was lower in peri-partum patients: 1/168 (0.6%) vs 24/569 (4.2%); <i>P</i> = 0.04.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Peri-partum patients made up ~25% of all women aged &lt;45 years old admitted to Australian ICUs with COVID-19, and nearly 30% required mechanical ventilation. Despite lower vaccination rates in peri-partum patients, in-hospital mortality was lower than in non-pregnant patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 3","pages":"372-381"},"PeriodicalIF":1.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cost of maternity and neonatal care in Aotearoa New Zealand: A cost analysis by plurality and gestation using a population-based cohort","authors":"Karyn Anderson,&nbsp;Lynn Sadler,&nbsp;Richard Edlin","doi":"10.1111/ajo.13903","DOIUrl":"10.1111/ajo.13903","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Maternity services in New Zealand are largely delivered by autonomously practising community midwives. This model of care is unique and may result in differences in the distribution of maternity healthcare utilisation and costs compared to other countries. New Zealand-specific cost data are needed to inform economic analyses, local policy and healthcare resource planning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To provide estimates of the average total cost of maternity and neonatal healthcare for New Zealand women and infants, including cost impacts of multiple and preterm births.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A whole-of-population linked dataset, including 262 687 pregnancies resulting in a live birth (from 1 January 2016 to 30 June 2020), was created by combining several sources of healthcare data to calculate an average per-pregnancy cost of healthcare, taking a public health system perspective, during antenatal, intrapartum, and postnatal periods to one year after birth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean cost of public healthcare was NZ$19 795 for both maternal and infant care to one year post-birth. The bulk of this cost was incurred during pregnancy and birth. Mean total cost to one year was NZ$69 895 for twin and NZ$201 448 for higher order multiple compared to singleton pregnancies at NZ$19 098. Mean total healthcare cost decreased as gestation increased.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most of the costs associated with pregnancy and childbirth were incurred during the birth and in the early neonatal period. Costs were disproportionately higher for multiple and preterm births.</p>\u0000 \u0000 <p>These cost data can usefully inform policy and assist healthcare decision-making around reproductive and neonatal technologies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 3","pages":"336-342"},"PeriodicalIF":1.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are assisted reproductive technology pregnancies more likely to be exposed to teratogenic medication? A whole-population study","authors":"Anna Kemp-Casey,&nbsp;Roger Hart,&nbsp;Elizabeth Milne,&nbsp;Carol Bower,&nbsp;Melanie L. Walls,&nbsp;John L. Yovich,&nbsp;Peter Burton,&nbsp;Yanhe Liu,&nbsp;Hamish Barblett,&nbsp;Michele Hansen","doi":"10.1111/ajo.13911","DOIUrl":"10.1111/ajo.13911","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Assisted reproductive technology (ART) pregnancies are at greater risk of birth defects than non-ART pregnancies. Teratogenic medication exposure is a potential cause of birth defects that has not been compared between ART and non-ART pregnancies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To determine whether the prevalence of exposure to teratogenic medicines during pregnancy varies by conception method (ART and three non-ART groups: ovulation induction (OI), subfertile untreated, and fertile naturally conceiving).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We linked state and commonwealth datasets for all live and stillbirths (≥20 weeks) in Western Australia with a conception date ≥1 July 2012 and date of birth ≤31 December 2014. We calculated the prevalence of exposure to teratogenic medicines (Therapeutic Goods Association Category D/X) across conception groups for the: (i) first trimester, and (ii) second and third trimesters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 2041 ART, 590 OI, 2063 subfertile and 52 987 fertile pregnancies (57 681). The overall prevalence of exposure to Category D/X medicines was 0.8% in the first trimester, and 0.7% in the second and third trimesters. Category X medicines exposure was &lt;0.5% for all conception groups and trimesters. The first trimesters of ART and OI pregnancies were more often exposed to Category D medicines than subfertile and fertile pregnancies, (ART = 4.9%, OI = 2.0% vs subfertile = 1.3%, fertile = 0.6%) as were later trimesters (ART = 3.4%, OI = 1.4% vs subfertile = 0.9%, fertile = 0.6%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The overall prevalence of exposure to teratogenic medicines is low; however, exposure was greatest in pregnancies arising from ART and may be a modest contributing factor to the higher rate of birth defects observed among ART babies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 3","pages":"390-397"},"PeriodicalIF":1.4,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}