AJOG global reports最新文献

{"title":"Postnatal experiences of women with cardiac conditions: a systematic review and meta-synthesis","authors":"Jasmine X. Kiley BS ,&nbsp;Annabelle Corlett BA ,&nbsp;Emma Mitchell-Sparke MPhil ,&nbsp;Brittany Jasper MD ,&nbsp;Tabitha Wishlade MSc ,&nbsp;Catriona Bhagra MD ,&nbsp;Sara Wetzler MD ,&nbsp;Catherine E. Aiken MBBChir, PhD","doi":"10.1016/j.xagr.2025.100564","DOIUrl":"10.1016/j.xagr.2025.100564","url":null,"abstract":"<div><h3>Objective</h3><div>The leading cause of maternal mortality in high-income countries is cardiovascular conditions. The highest risk period for women with cardiac conditions is usually the early postnatal phase; however, postnatal care is often under-resourced. We aim to inform supportive care pathways that address the medical and emotional needs of women with cardiac disease during the postnatal period.</div></div><div><h3>Data Sources</h3><div>To identify studies, Medline via Ovid, Embase via Ovid, CINAHL via EBSCO, PsycINFO via EBSCO, Scopus, Web of Science Core Collection, and ASSIA via ProQuest were searched (database inception—June 2025).</div></div><div><h3>Study Eligibility Criteria</h3><div>Studies reporting qualitative data about the postnatal experiences of women with any cardiac condition globally were included. The postnatal period was defined as the events occurring between delivery and 1 year postpartum.</div></div><div><h3>Study Appraisal and Synthesis Methods</h3><div>The Critical Appraisal Skills Programme checklist for qualitative research was used to perform quality assessment and reduce risk of bias. Inductive coding and thematic analysis were performed using NVivo v.15.</div></div><div><h3>Results</h3><div>Eleven qualitative studies were included in the meta-synthesis. We identified a chronological framework to describe the postnatal experiences of women with cardiac conditions. We identified key themes of (1) initial fragmentation of attention, (2) physical and psychosocial transitions, and (3) planning for the future. Women described a fragmentation of attention after delivery of their infant, as their own mindset frequently shifted toward motherhood, while their care team focused more on the infant and maternal cardiac recovery. Their experience of motherhood often differed from their expectations, adding to feelings of stress around their postnatal experience. Emotional recovery from complex pregnancies was influenced by desire for future pregnancies and by the degree of support available from family and wider community.</div></div><div><h3>Conclusion</h3><div>Cardiac conditions profoundly influence postnatal emotional and psychosocial well-being. During the early postnatal phase, care must balance the needs of mother, infant, and maternal cardiac condition. Postnatal cardio-obstetric care should include debriefing appointments with providers, with thorough, sensitive discussion of the risks of potential future pregnancies. Supporting women’s transition into motherhood is critical to help them process experiences and engage with care to improve their long-term cardiac prognosis.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100564"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal death at 28 weeks gestation due to vascular rupture of placenta accreta","authors":"Khaoula Magdoud MD ,&nbsp;Ons Hmandi MD ,&nbsp;Sana Menjli MD ,&nbsp;Ines Ben Hassen MD ,&nbsp;Imen Labidi MD ,&nbsp;Eya Azouz MD ,&nbsp;Bilel Arfaoui MD ,&nbsp;Hassine Saber Abouda MD","doi":"10.1016/j.xagr.2025.100562","DOIUrl":"10.1016/j.xagr.2025.100562","url":null,"abstract":"<div><div>Placenta accreta spectrum (PAS) is becoming increasingly common and is associated with significant morbidity and mortality. Prenatal diagnosis and timely referral to centers have been shown to improve outcomes. We present a case of maternal death at 28 weeks of gestation due to massive internal bleeding caused by the rupture of abnormal blood vessels from placenta accreta. The diagnosis of PAS was suspected by morphological ultrasound at 23 weeks of gestation. Expectant management was decided for this patient since she had no children. The patient was transported to the emergency room at 28 weeks of gestation after having a sudden loss of consciousness without other signs (no pelvic pain, no metrorrhagia). After preliminary assessment, maternal death was noted. Hemoperitoneum associated with a placental vascular rupture was found at the autopsy. In the absence of a therapeutic consensus, this case highlights the challenges in managing pregnant women with suspected PAS disorders in the second trimester.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100562"},"PeriodicalIF":0.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145097551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sacral Tarlov cysts and spontaneous persistent genital arousal: 2 unrecognized and underappreciated health conditions with an uncertain relationship","authors":"Randa Yosef MD ,&nbsp;Gaylene Pron PhD ,&nbsp;Nucelio Lemos MD ,&nbsp;Kieran Murphy MD","doi":"10.1016/j.xagr.2025.100563","DOIUrl":"10.1016/j.xagr.2025.100563","url":null,"abstract":"<div><div>Tarlov cysts commonly occur in women but are often thought to be asymptomatic findings. However, recent studies have suggested that Tarlov cysts can be a contributing factor to various pain and neurologic dysfunctions with a significant effect on health-related quality of life. Tarlov cysts and various intrapelvic pathologies can result in compression or impairment of peripheral and spinal nerve roots and can potentially affect women’s sexual function, particularly by causing persistent genital arousal disorder. Persistent genital arousal disorder is characterized by spontaneous and often unrelenting sensations of genital arousal in the absence of sexual desire or stimulation and, by definition, is intrusive, unwanted, and distressing. This review details the prevalence, characteristics, and treatments of persistent genital arousal disorder and Tarlov cysts and evaluates potential relationships between these conditions.</div><div>The prevalence of persistent genital arousal disorder ranges from 1.6% to 11.1% in community-based surveys, and 33% of women who are referred to a sexual health clinic report at least 1 persistent genital arousal disorder screening question. The prevalence of Tarlov cysts ranges from 1.5% to 13.2% and is higher among women referred to pain centers, ranging from 16% to 39%. Despite the already high prevalence, these numbers for both conditions are likely underestimated as sexual dysfunction. Therefore, persistent genital arousal disorder is not readily disclosed, and optimal sacral magnetic resonance imaging is infrequently performed to detect Tarlov cysts. Persistent genital arousal disorder is a symptom complex for which psychological, vascular, central, and peripheral neurologic factors have been proposed as possible causes.</div><div>When peripheral nerve entrapments are believed to be the cause of persistent genital arousal disorder, mechanical release of the nerve or nerve root is the generally accepted treatment. Several surgical and minimally invasive percutaneous procedures are effective treatments when Tarlov cysts are symptomatic, although evidence for their effectiveness for persistent genital arousal disorder is limited. For surgical/interventional failures to decompress nerves and decrease symptoms in patients with Tarlov cysts or persistent genital arousal disorder, neuromodulation is increasingly being performed as a rescue therapy.</div><div>Because of the weak evidence base, the relationship between Tarlov cysts and persistent genital arousal disorder remains uncertain, and healthcare professionals are encouraged to inquire more broadly about the symptoms related to these conditions, conduct neurologic examinations, and order relevant sacral imaging to clarify the relationship further.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100563"},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145097550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital waterbirth for low-risk birthing people: findings of a randomized controlled trial","authors":"Emily Malloy PhD, CNM ,&nbsp;Jessica J.F. Kram MPH ,&nbsp;James O. Adefisoye PhD ,&nbsp;Marie Forgie DO ,&nbsp;Diana Kleber RN ,&nbsp;MaryAnne Scherer CNM ,&nbsp;Anna Anklam CNM ,&nbsp;Natasha Hernandez MD ,&nbsp;Lisa Hanson PhD, CNM","doi":"10.1016/j.xagr.2025.100558","DOIUrl":"10.1016/j.xagr.2025.100558","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Waterbirth is the act of giving birth submerged in a tub of warm water, with the baby born underwater. Support for widespread adoption of waterbirth in the United States (US) has been limited by predominantly retrospective study designs, the underutilization of interdisciplinary citations, and disagreement between professional organizations. No randomized controlled trials of waterbirth have been conducted in the US.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The purpose of this randomized controlled trial was to compare pain management, maternal and neonatal outcomes, and maternal satisfaction between low-risk water and land group study participants.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;Low-risk pregnant adults were offered study participation between 25 to 34 weeks of gestation during routine prenatal care. Participants who met the inclusion criteria were consented, enrolled, and randomly assigned to waterbirth or land birth in a 2:1 unblinded fashion, to achieve a sample size of n=120 (80 waterbirth: 40 land birth). The sample size was adjusted for attrition and increased to n=186 (124 waterbirth: 62 land birth) based on an interim analysis. Participants in both arms were excluded if they developed intrapartum risk factors prior to delivery using a modified intention-to-treat model. Study participants received routine intrapartum care, including all available pain relief options. Only those assigned to the waterbirth group were given the option of giving birth in water. Prior to discharge, participants completed &lt;em&gt;The US Birth Satisfaction Scale Revised&lt;/em&gt;. The primary study outcome was the use of any intravenous narcotics and/or epidural anesthesia. Secondary outcomes included predetermined composite maternal and neonatal outcomes and overall birth satisfaction. Using a modified intention-to-treat approach, outcomes were analyzed using Chi-square, Fisher’s Exact, or Wilcoxon-Mann-Whitney test as appropriate. Relative risks (RR) were computed where applicable.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;From January 2022 to December 2023, 186 participants were enrolled (n=124 waterbirth, n=62 land birth). Following enrollment, 106 participants (n=74 waterbirth, and n=32 land birth) remained eligible for the study. Attrition was 39%. Compared to the land birth group, waterbirth participants were significantly less likely to use intravenous narcotics [RR: 0.36 (95% confidence interval [CI], 0.17−0.75), &lt;em&gt;P&lt;&lt;/em&gt;.01] and epidural analgesia [RR: 0.38 (95% CI, 0.24−0.58), &lt;em&gt;P&lt;&lt;/em&gt;.01] and had shorter average first stage labor duration [median difference -2.00 hours (95% CI, -3.00 to 1.00), &lt;em&gt;P&lt;/em&gt;=.43]. One cord avulsion occurred in the waterbirth group. Additional maternal and neonatal outcomes were not significantly different between groups. Waterbirth participants experienced higher overall birth satisfaction [median difference 3.50 (95% CI, 1.00-5.00), &lt;em&gt;P&lt;/em&gt;=.01].&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100558"},"PeriodicalIF":0.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145057210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monkeypox virus infection in a 23-year-old woman with a genital rash and global skin lesions: evidence for spouse-to-spouse transmission","authors":"Wen-Shuang Li MSc ,&nbsp;Rong-Jing Dong PhD ,&nbsp;Shui-Tao Yi MSc ,&nbsp;Ru-Qin Zhang BSc ,&nbsp;Rui-Xia Chen MSc ,&nbsp;Yan-Jie Ning MSc ,&nbsp;Dian-Jiang Xiao BSc","doi":"10.1016/j.xagr.2025.100550","DOIUrl":"10.1016/j.xagr.2025.100550","url":null,"abstract":"<div><div>We report one case in China of a couple simultaneously infected with the monkeypox. Both spouses developed genital skin lesions successively and the female partner had widespread skin lesions all over her body, while the male partner is HIV-positive, had a history of homosexual behavior before the onset of symptoms.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100550"},"PeriodicalIF":0.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145121148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective study to correlate the cervical length by transvaginal ultrasound with preterm labor and perinatal outcomes","authors":"Nina Mahale MD ,&nbsp;Devangi Panchal MS ,&nbsp;Ajit Mahale MDRD ,&nbsp;Sonali Ullal MDRD ,&nbsp;Merwyn Fernandes DMRD, DNB, FRCR ,&nbsp;Sonali Prabhu MDRD","doi":"10.1016/j.xagr.2025.100561","DOIUrl":"10.1016/j.xagr.2025.100561","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>This study aimed to investigate the role of transvaginal ultrasound as a screening tool to assess cervical length and improve perinatal outcomes to prevent preterm labor through appropriate interventions.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to determine the mean cervical length at 11 to 14 and 18 to 22 weeks of gestation and to estimate the rate of cervical length shortening and its correlation with birth outcomes.</div></div><div><h3>STUDY DESIGN</h3><div>This prospective study was conducted at Lady Goschen Hospital and KMC Hospital, Attavar, both of which are affiliated with Manipal Academy of Higher Education. This study included 93 pregnant women who came for antenatal care at Lady Goschen Hospital and KMC Hospital, Attavar, from December 2022 to August 2024. All participants provided consent to participate in the study. The formula is a follows: n = Zα2 (Sn)(1-Sn) / L2 × p, where Zα = 1.96 at a 95% confidence level, Sn = sensitivity, l = allowable error, and p = negative prevalence (Sn = 75% [reference article], L = 20% [80% power], and p = 50% (assumption) with 95% confidence interval and 80% power with respect to reference [prediction of preterm labor by cervical length]). Convenient sampling was performed. Data analysis was performed using descriptive statistics. Changes in follow-up were estimated using analysis of variance and the Bonferroni <em>t</em> test. Sensitivity, specificity, positive predictive value, and negative predictive value were estimated. Statistical analysis was performed using SPSS (version. 2.0; IBM, Armonk, New York). A <em>P</em> value of &gt;.05 was considered statistically significant.</div></div><div><h3>RESULTS</h3><div>Cervical length measured using transvaginal ultrasound at 18 to 22 weeks of gestation was found to be more sensitive and to have better positive predictive value in predicting preterm labor than cervical length measured at 11 to 13 weeks of gestation. Cervical length between 18 and 22 weeks of gestation and the reduction of cervical length were found to be statistically significant in predicting preterm labor (<em>P</em>=.001).</div></div><div><h3>CONCLUSION</h3><div>Transvaginal ultrasound is a noninvasive and comparatively affordable modality for identifying women at risk of preterm labor. In addition, this technology could help identify women at risk of preterm labor, thereby reducing morbidity and mortality.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100561"},"PeriodicalIF":0.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145021056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare complication after common obstetric procedure: rectus sheath hematoma after amniocentesis treated with embolization case report","authors":"Anna R. Ilivicky MD ,&nbsp;Shreya S. Katwala BA ,&nbsp;Julie A. Vircks DO, MBA ,&nbsp;Teresa A. Orth MD, PhD","doi":"10.1016/j.xagr.2025.100551","DOIUrl":"10.1016/j.xagr.2025.100551","url":null,"abstract":"<div><div>Rectus sheath hematomas are becoming more commonly diagnosed but are typically associated with high-risk patients, such as older adult patients, patients on anticoagulation, or patients with recent trauma. This case describes a woman who underwent genetic amniocentesis at 20 1/7 weeks of gestation with a resultant rectus sheath hematoma that began expanding after an exacerbation of the patient’s chronic obstructive pulmonary disease approximately 2 weeks after the patient’s amniocentesis procedure. Ultimately, embolization and coiling of the right inferior epigastric artery were required due to the expanding hematoma and worsening pain. Antibiotics were administered due to concern for a late complication of amniocentesis and a prolonged recovery with a large hematoma.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100551"},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of education on endometriosis and mediating effects: a mendelian randomization study","authors":"Luhongyuan Jin ,&nbsp;Chi Chi ,&nbsp;Qin Zhang ,&nbsp;Yueming Zhang ,&nbsp;Guorong Han M.D. ,&nbsp;Jun Lin M.D. ,&nbsp;Wenjie Hou M.D.","doi":"10.1016/j.xagr.2025.100559","DOIUrl":"10.1016/j.xagr.2025.100559","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the potential impact of years of education, which serves as a measure of socioeconomic inequality, on the occurrence of endometriosis, and to quantify the potential influence of modifiable factors as mediators.</div></div><div><h3>Methods</h3><div>The study used SNPs as genetic tools for genetic association. Analysis using 2-sample univariate and multivariate Mendelian randomization methods. Primary analyses were performed using an inverse variance weighted MR method. Data were obtained from publicly available genome-wide association studies (GWAS) from European populations. Data for ending endometriosis were obtained from the Neale lab.</div></div><div><h3>Results</h3><div>Each SD increase in years of education (4.2 years) has a protective effect on endometriosis (OR 0.9975; 95% CI 0.9958–0.9951). For individuals, the most significant contribution is the depression factor (mediation effect 53%, 95% CI: 3–102%). After combining, the mediator variable explains 64% (95% CI: 55%–290%) of the education—endometriosis association.</div></div><div><h3>Summary</h3><div>Higher education attainment potentially has a causal protective effect on endometriosis, while lower education levels may increase the risk of endometriosis through modifiable factors such as depression, insomnia, and anxiety.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100559"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum care screenings by care modality among US mothers, 2020–2021","authors":"Don E. Willis PhD ,&nbsp;Cari A. Bogulski PhD ,&nbsp;Clare C. Brown PhD ,&nbsp;Nirvana A. Manning MD ,&nbsp;Lanita S. White PharmD ,&nbsp;James P. Selig PhD ,&nbsp;Ji Li MS ,&nbsp;Pearl A. McElfish PhD","doi":"10.1016/j.xagr.2025.100541","DOIUrl":"10.1016/j.xagr.2025.100541","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Postpartum care is critical to preventing pregnancy-associated deaths. Virtual modes of care have potential to improve access to postpartum care; however, the impact on postpartum screenings for cigarette smoking, emotional/physical abuse, and depression is unknown.</div></div><div><h3>OBJECTIVE</h3><div>The purpose of this study was to compare receipt of these screenings between mothers who received any virtual postpartum care and those whose care was exclusively in-person.</div></div><div><h3>STUDY DESIGN</h3><div>Using the Pregnancy Risk Assessment Monitoring System Phase 8 data, we estimated receipt of postpartum care screenings for smoking, emotional/physical abuse, and depression for US mothers during COVID-19 (2020–2021) and assessed differences by mode of care. The analytical sample (n=21,815) included mothers from 28 Pregnancy Risk Assessment Monitoring System study sites who had postpartum care and answered the mode of care question and all 3 postpartum screening questions.</div></div><div><h3>RESULTS</h3><div>Over half of all mothers were screened for cigarette smoking (56.45%) and emotional/physical abuse (59.28%) during their postpartum care, whereas screening for depression was much more prevalent (87.63%). A higher percentage of screenings for smoking, emotional/physical abuse, and depression was reported for mothers who received any virtual postpartum care compared with those who attended exclusively in-person care (all <em>P</em>&lt;.001). After adjusting for covariates, the prevalence of screening for cigarette smoking, emotional/physical abuse, and depression was 14%, 18%, and 6% higher, respectively, among mothers who received any virtual (vs. exclusively in-person) postpartum care.</div></div><div><h3>CONCLUSION</h3><div>Virtual postpartum care may improve the percentage of women receiving screenings for important maternal health risks and behaviors, such as cigarette smoking, emotional/physical abuse, and depression. Further research is needed to determine whether mothers receiving virtual postpartum care are more likely to receive screenings because of the mode of care itself.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100541"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers predicting adverse pregnancy outcomes in women living with obesity: a systematic review and meta-analysis","authors":"Tabitha Wishlade MSc ,&nbsp;Sara Wetzler MPhil ,&nbsp;Catherine E. Aiken PhD","doi":"10.1016/j.xagr.2025.100527","DOIUrl":"10.1016/j.xagr.2025.100527","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically review the literature on associations between antenatal biomarkers and adverse pregnancy outcomes in women with BMI ≥30 kg/m². <em>Data sources</em>: Systematic literature searches used predefined search terms in PubMed, Ovid Embase, Ovid MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials. Databases were searched from inception to August 2024.</div></div><div><h3>Study eligibility criteria</h3><div>Interventional and observational studies comparing pregnancy outcomes amongst women with a pre- or early-pregnancy (&lt;20 weeks’ gestation) BMI ≥30 kg/m² according to presence or amount of any antenatally measured biomarker were included.</div></div><div><h3>Study appraisal and synthesis methods</h3><div>Two reviewers independently assessed studies for inclusion against predefined inclusion and exclusion criteria. Risk of bias assessment was performed on included studies using the Newcastle-Ottawa Risk of Bias Tool. A narrative synthesis of eligible studies was constructed and data were meta-analysed, where possible, using random effects models. Certainty of evidence was assessed by GRADE rating.</div></div><div><h3>Results</h3><div>Total 49 studies were included in the review, representing &gt;500 different biomarkers in 7479 pregnancies across 16 countries. Adiponectin was the only biomarker with sufficient data to meta-analyse with respect to the composite outcome. Lower adiponectin was associated with increased risk of the composite outcome (SMD −0.52, 95% CI −0.63, −0.41; <em>P</em>&lt;.001, I² 0%). Lower adiponectin was also associated with increased risk of gestational diabetes (SMD −0.57, 95% CI −0.70, −0.43; <em>P</em>&lt;.001, I² 0%) and pre-eclampsia (OR 0.65, 95% CI 0.44, 0.99; <em>P</em>=.047, I² 61.5%). Increased insulin concentrations were associated with gestational diabetes (SMD 0.35, 95% CI 0.22, −0.47; <em>P</em>&lt;.001, I² 0%). Certainty of evidence regarding all associations was low or very low.</div></div><div><h3>Conclusions</h3><div>Decreased adiponectin and increased insulin are associated with increased risk of adverse pregnancy outcomes in women with BMI ≥30 kg/m². However, the low number of studies available for inclusion and low certainty of evidence mean that biomarker-based risk-stratification within pregnant women with BMI ≥30 kg/m² is not currently feasible. Further research is required to find ways of reliably targeting investigations during maternity care towards the subset of women living with obesity who are at highest risk of adverse outcomes.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100527"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}