AJOG global reports最新文献

{"title":"Metabolic syndrome in perimenopausal and postmenopausal women attending gynaecology outpatient department at a tertiary institution in South Africa","authors":"Lawrence Marapo MBChB, FCOG (SA) , Lineo Matsela PhD, Mmed, MD , ME Chabalala MBChB, FCOG(SA), Mmed , Olakunle Adewunmi Towobola PhD (Endocrinology & Contraception)","doi":"10.1016/j.xagr.2025.100560","DOIUrl":"10.1016/j.xagr.2025.100560","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of metabolic syndrome in menopause varies globally. There is a paucity of data regarding knowledge of metabolic syndrome in menopause in South Africa.</div></div><div><h3>Objective(s)</h3><div>The study was designed to describe the prevalence of metabolic syndrome in perimenopausal and postmenopausal and the lipid changes that occur during the menopause transition.</div></div><div><h3>Study Design</h3><div>A prospective cross-sectional study was conducted at Dr George Mukhari Academic Hospital, the gynaecological outpatient department, Pretoria, South Africa. Perimenopausal and postmenopausal women were included. Six hundred ninety menopausal women were enrolled in this study. The participants were evaluated by physical examination. Blood samples were also taken for biochemical assay. The researcher also took their blood pressure. Data compiled from the study were analyzed using the Statistical Package for Social Sciences version 21. Descriptive statistical analysis established the range, mean (including 95% confidence interval), and standard deviation for quantitative variables. Categorical variables were analysed using Fisher's exact test, and risk analysis of factors associated with Metabolic syndrome was performed by calculating the odds ratio (OR) and its 95% confidence interval for both perimenopausal and postmenopausal women. A 2-tailed statistical analysis yielding a p-value <.05 was taken as statistically significant.</div></div><div><h3>Results</h3><div>The study consisted of 690 women (n=690), including 338 perimenopausal women (n=338; 49.0%) and 352 postmenopausal women (n=352; 51.0%). The prevalence of metabolic syndrome was noted to be 47% and 61.4% in the perimenopausal and postmenopausal groups, respectively. The mean waist circumference was higher than the cut-off value of 88cm for perimenopausal and postmenopausal women. There were no statistically significant differences in lipid profiles between perimenopausal and postmenopausal women. The odds ratio for elevated triglycerides was 0.65 (95% CI: 0.32–1.01) and for low HDL levels was 0.83 (95% CI: 0.41–0.98). Perimenopausal women had significantly higher odds (OR 2.19, <em>P<.</em>0001) of experiencing hot flushes compared to postmenopausal women. Multivariate logistic regression analysis demonstrated that age (<em>P=.</em>3789) was not significantly associated with metabolic syndrome. However, the prevalence of metabolic syndrome was higher in postmenopausal women compared to perimenopausal women. Sleep disorders (<em>P<.</em>0001) and vasomotor symptoms (<em>P=.</em>0198) showed significant correlations with the presence of metabolic syndrome. When comparing women with and without metabolic syndrome, both perimenopausal (HDL; <em>P<.</em>0001, triglycerides; <em>P<.</em>0001) and postmenopausal groups (HDL; <em>P<.</em>0001, triglycerides; <em>P<.</em>0001) demonstrated significant associations between dyslipidae","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100560"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221674","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":"Patient vs. clinician-collected cervical cytology for screening for CIN: a systematic review and meta-analysis","authors":"Greg Marchand MD, FACS, FICS, FACOG , Daniela Gonzalez Herrera BS , Brooke Hamilton BS , McKenna Robinson BS , Emily Kline BS , Sarah Mera BS , Michelle Koshaba BS , Greenley Jephson BS , Nidhi Pulicherla BS , Ali Azadi MD, FACOG, FPMRS","doi":"10.1016/j.xagr.2025.100575","DOIUrl":"10.1016/j.xagr.2025.100575","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review and meta-analysis aimed to compare the diagnostic accuracy of self-collected versus clinician-collected cervical cytology for screening for cervical intraepithelial neoplasia (CIN), using cervical biopsy histopathology as the reference standard. The study sought to evaluate self-collection’s potential to enhance cervical cancer screening participation, particularly among under-screened women, by addressing barriers such as discomfort and logistical challenges.</div></div><div><h3>Data Sources</h3><div>We searched PubMed (MEDLINE), Web of Science, Scopus, and Cochrane databases from their inception to March 1, 2024, to identify relevant studies comparing self-collected and clinician-collected cervical cytology.</div></div><div><h3>Study Eligibility Criteria</h3><div>Eligible studies included adult women (≥18 years) undergoing both self-collected and clinician-collected cervical cytology (conventional Pap smear or liquid-based cytology), with cervical biopsy as the reference standard. Studies were required to report diagnostic outcomes (e.g., sensitivity, specificity) and include a clinician-collected comparator. Non-English studies, those lacking biopsy as the reference standard, or single-arm studies were excluded.</div></div><div><h3>Study Appraisal and Synthesis Methods</h3><div>Two independent reviewers screened studies, extracted data, and assessed methodological quality using the QUADAS-2 tool. A diagnostic meta-analysis was conducted with Review Manager 5.4 to calculate pooled sensitivity and specificity with 95% confidence intervals, using both unweighted and weighted methods. Summary receiver operating characteristic (SROC) curves were generated to visualize diagnostic performance.</div></div><div><h3>Results</h3><div>Five studies were included, revealing that self-collected cytology had a pooled sensitivity of 0.698 and specificity of 0.805, while clinician-collected cytology showed a higher sensitivity of 0.765 but lower specificity of 0.613, with variation in sensitivity and specificity observed across different self-collection methods (e.g., brushes, tampons, lavages). QUADAS-2 assessment identified methodological concerns, particularly in patient selection and flow and timing, suggesting risks of bias and limited generalizability to primary screening settings. Methodological limitations in studies, including wide variation in self-collection methods, highlight the need for further research.</div></div><div><h3>Conclusions</h3><div>Self-collected cervical cytology demonstrates reasonable diagnostic accuracy, offering a promising approach to increase screening uptake among under-screened populations by overcoming barriers to traditional clinician-based methods. However, its lower sensitivity compared to clinician-collected cytology underscores the need for careful implementation, including optimized assay selection and targeted population strategies. Heterogeneity in self-collection me","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100575"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416965","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":"2025-11-01","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":"Heart failure in pregnancy and postpartum: a nationwide study over 6.3 million of pregnancies in France between 2010 and 2018","authors":"Amélie Gabet PhD ,&nbsp;Lise Legrand MD ,&nbsp;Richard Isnard MD, PhD ,&nbsp;Françoise Pousset MD ,&nbsp;Jacques Blacher MD, PhD ,&nbsp;Valérie Olié PhD","doi":"10.1016/j.xagr.2025.100540","DOIUrl":"10.1016/j.xagr.2025.100540","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular diseases became the first cause of maternal death in France, but only scarce epidemiological data have been published about heart failure (HF) in pregnancy/postpartum.</div></div><div><h3>Objective</h3><div>The aim of the present study was to describe the epidemiology of HF in pregnancy or until 6 weeks postpartum in France.</div></div><div><h3>Study Design</h3><div>This is an observational cohort study. Using the French National Health Insurance Information System database (Système National des Données de Santé), all women who gave birth in France after 22 weeks of gestation between January 1, 2010, and December 31, 2018, were selected. HF hospitalizations occurring during the pregnancies or 6 weeks postpartum were identified.</div></div><div><h3>Results</h3><div>On 6293,367 deliveries analyzed, 2241 (35.6/100,000) had at least one hospitalization for HF. This rate remained quite stable between 2010 and 2018. A total of 22.6% of these cases had heart disease history, including HF before pregnancy, and 49.0% had preceding or concomitant heart disease. Compared to women without HF, those with HF were older (32.0 [6.1] vs 29.9 [5.3] years), had more frequently multiple pregnancy (14.6% vs 1.7%), history of medically assisted reproduction (7.9% vs 3.2%), cardiovascular risk factors (arterial hypertension [17.0% vs 1.7%], gestational diabetes [15.5% vs 9.6%], obesity [14.9% vs 4.7%], tobacco smoking [12.4% vs 9.4%]), and had a lower socio-economic level with 23.4% living in the French most deprived area against 18.1% living in the least deprived area. The most frequent cardiac condition found were cardiomyopathy (29.5%), arrhythmias (14.0%), and valvulopathy (8.5%). The rate of pre-eclampsia reached 29.4% in pregnancies with HF against 2.0% in pregnancies without HF. Fetal complications were much higher in pregnancies with HF than without HF, with 11.5% vs 0.9% very/extremely preterm birth, and 5.3% vs 0.8% fetus/child death. One year after delivery, maternal death was observed in 2.2% of women with HF against &lt;0.01% in those without HF.</div></div><div><h3>Conclusion</h3><div>Despite occurring in only 1 in 2808 pregnancies, HF during pregnancy or the postpartum period has a significant impact on maternal and fetal outcomes.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100540"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049898","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":"Hypertensive disorders of pregnancy and gestational diabetes mellitus affect fetal growth and perinatal outcomes in women undergoing in vitro fertilization","authors":"Yaxin Su MS ,&nbsp;Yue Niu MD, PhD ,&nbsp;Binbin Zhao MS ,&nbsp;Shizhen Su MS ,&nbsp;Cameron Klein MD, PhD ,&nbsp;Xiaoyang Hou MD, PhD ,&nbsp;Xiao Li MD, PhD ,&nbsp;Hong Lv MD, PhD","doi":"10.1016/j.xagr.2025.100571","DOIUrl":"10.1016/j.xagr.2025.100571","url":null,"abstract":"<div><h3>Background</h3><div>Hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) are common complications that adversely affect pregnancy outcomes. However, data on their independent and combined impacts on fetal growth and perinatal outcomes in <em>in vitro</em> fertilization (IVF) pregnancies are limited.</div></div><div><h3>Objectives</h3><div>To investigate risks of abnormal fetal growth and perinatal outcomes following conventional IVF treatment across distinct groups categorized by GDM-affected, HDP-affected, HDP/GDM comorbidity (HDP/GDM), and those unaffected by neither disorder (unaffected).</div></div><div><h3>Study design</h3><div>In this retrospective cohort study, we analyzed data from 20,907 women who achieved singleton deliveries during their first IVF cycles. Multivariate logistic regression analysis was performed to evaluate the effects of HDP and GDM on fetal and perinatal outcomes, adjusting for confounding factors.</div></div><div><h3>Results</h3><div>Compared to unaffected IVF pregnancies, those complicated by HDP alone showed significantly increased risks of small for gestational age (SGA) infants (aOR 5.67, 95% CI 4.56–7.04, <em>P&lt;.</em>001), low birthweight (aOR 7.37, 95% CI 6.00–9.06, <em>P&lt;.</em>001), preterm delivery, and cesarean section. Pregnancies affected by GDM alone were associated with increased risks of SGA (aOR 1.34, 95% CI 1.04–1.72, <em>P=.</em>023), low birthweight (aOR 1.55, 95% CI 1.20–1.99, <em>P&lt;.</em>001), large for gestational age (LGA) infants (aOR 1.24, 95% CI 1.11–1.39, <em>P&lt;.</em>001), macrosomia (aOR 1.24, 95% CI 1.06–1.45, <em>P=.</em>005), preterm delivery, and cesarean section. The co-occurrence of HDP and GDM further elevated the risk of SGA (aOR 6.37, 95% CI 3.63–11.18, <em>P&lt;.</em>001), low birthweight (aOR 7.77, 95%CI 4.70–12.84, <em>P&lt;.</em>001), preterm delivery, and cesarean section.</div></div><div><h3>Conclusions</h3><div>IVF pregnancies affected by HDP or GDM exhibit risk profiles for abnormal fetal growth and adverse perinatal outcomes similar to those observed in naturally conceived pregnancies. The combined impact of HDP and GDM significantly exacerbates these risks. Importantly, these adverse outcomes are consistent regardless of whether the embryos transferred were fresh or frozen.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100571"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416964","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":"The feasibility and surgical outcomes of robotic vaginal natural orifice transluminal endoscopic single port hysterectomy for benign gynecologic diseases: a systematic review and meta-analysis","authors":"Greg Marchand MD, FACS, FICS, FACOG ,&nbsp;Hollie Ulibarri BS ,&nbsp;Amanda Arroyo BS ,&nbsp;Daniela Gonzalez Herrera BS ,&nbsp;Brooke Hamilton BS ,&nbsp;Kate Ruffley BS ,&nbsp;Mckenna Robinson BS ,&nbsp;Ali Azadi MD, FACOG, FPMRS","doi":"10.1016/j.xagr.2025.100512","DOIUrl":"10.1016/j.xagr.2025.100512","url":null,"abstract":"<div><h3>Objective</h3><div>Vaginal natural orifice transluminal endoscopic surgery (vNOTES) combines vaginal surgery with single-port laparoscopy, providing a minimally invasive technique designed to overcome the challenges in traditional vaginal surgery. Several authors have now described techniques for performing these procedures with robotic assistance (R-vNOTES). We aim to evaluate the surgical outcomes and the safety of R-vNOTES hysterectomy in patients with benign diseases.</div></div><div><h3>Data Sources</h3><div>We searched six major databases from their inception through October 2024 for studies analyzing the surgical outcomes of hysterectomy by R-vNOTES in cases with benign gynecologic diseases.</div></div><div><h3>Study eligibility criteria</h3><div>We included all primary research studies that included at least one of our selected outcomes and did not include surgeries for malignant conditions.</div></div><div><h3>Study appraisal and synthesis methods</h3><div>Study quality was appraised using the National Heart, Lung, and Blood Institute quality assessment tools. Data synthesis was accomplished using OpenMetaAnalyst and RevMan software. Mean difference and 95% confidence intervals were used for continuous outcomes following inverse variance analyses. Dichotomous outcomes were analyzed using an odds ratio and 95% confidence intervals.</div></div><div><h3>Results</h3><div>Ultimately 10 eligible studies were included in our synthesis, including two studies that compared the R-vNOTES technique to robot-assisted laparoscopic hysterectomy (RALH) performed for the same indications. Our overall pooled analysis demonstrated that the operation time of R-vNOTES was 142 minutes, with an estimated blood loss of 67 mL. The overall length of hospital stay among the included studies was 2.04 days. We found an approximate decrease of 1.4 grams of hemoglobin after surgery. The incidence of conversion was 1.3%, and the complication rate was 13.3%. We found, R-vNOTES was to have a shorter operative time (<em>P</em>&lt;.001) and lower blood loss than RALH (<em>P</em>=.002), with no significant differences seen between the cohorts in total hospital stay (<em>P</em>=.29) or complication rates (<em>P</em>=.98).</div></div><div><h3>Conclusion</h3><div>Initial data shows that R-vNOTES seems to be a feasible minimally invasive technique with comparable outcomes and a favorable safety profile. Compared to RALH, R-vNOTES was associated with a shorter operation time and less blood loss.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100512"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255306","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":"Does obstetric violence influence institutional delivery utilization? Prevalence of fear of institutional delivery on subsequent pregnancy among mothers who gave birth in the past 12 months at Honkolo Wabe District, Arsi Zone Ethiopia, 2023","authors":"Solomon Seyife Alemu MSc ,&nbsp;Getu Amsalu Erqu MSc ,&nbsp;Dereje Diriba Woyessa MSc ,&nbsp;Lema Fikadu Wedajo MSc","doi":"10.1016/j.xagr.2025.100520","DOIUrl":"10.1016/j.xagr.2025.100520","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>One of the issues that contribute to the increase in home births among mothers is the fear of giving birth in an institution. Although delivery services are free in Ethiopia, about half of women chose not to use them because they were afraid of giving birth in a hospital. Home deliveries are the leading cause of morbidity and mortality among mothers and newborns in Ethiopia. One of the major reasons why mothers choose not to give birth in medical facilities is due to fear of an institutional delivery. Nevertheless, no research has been conducted on Ethiopians’ fear of institutional delivery.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to assess the prevalence of fear of institutional delivery and associated factors among postnatal mothers.</div></div><div><h3>STUDY DESIGN</h3><div>Between May 1, 2023, and June 1, 2023, 423 postpartum mothers in Ethiopia’s Honkolo Wabe district participated in a cross-sectional survey. A straightforward random sampling procedure was used to choose study participants. Data were gathered using a standardized questionnaire that was pretested and given by an interviewer in person. To find factors linked to the fear of institutional delivery, bivariate and multivariate analyses were performed. A <em>P</em> value of &lt;.05 with a 95% confidence interval was designated as the level of statistical significance.</div></div><div><h3>RESULTS</h3><div>The overall prevalence of fear of institutional delivery was 43.9% (95% confidence interval, 39.9%–48.2%). Obstetrical violence (adjusted odds ratio, 2.42 [95% confidence interval, 1.20–4.19]), number of children (adjusted odds ratio, 0.39 [95% confidence interval, 0.19–0.82]), poor knowledge on the importance of intuitional delivery (adjusted odds ratio, 2.20 [95% confidence interval, 1.39–3.49]), and a negative attitude toward skilled healthcare services (adjusted odds ratio, 2.13 [95% confidence interval, 1.15–3.94]) were significantly associated factors for fear of childbirth at health facilities.</div></div><div><h3>CONCLUSION</h3><div>Our study found that the prevalence of fear of institutional delivery is high. Therefore, healthcare providers, health extension workers, and other concerned bodies should work on increasing mothers’ knowledge the importance of institutional delivery and their awareness of skilled birth. Similarly, respectful maternity care should be performed in accordance with attracting mothers to health institutions.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100520"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144306493","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":"Racial, ethnic, and neighborhood disparities in diagnosis of perinatal psychiatric illness","authors":"Jessica C. Rohr PhD ,&nbsp;Pedro T. Ramirez MD ,&nbsp;Farhaan S. Vahidy PhD, MBBS, MPH, FAHA ,&nbsp;Alok Madan PhD, MPH","doi":"10.1016/j.xagr.2025.100511","DOIUrl":"10.1016/j.xagr.2025.100511","url":null,"abstract":"<div><h3>Background</h3><div>Rates of maternal morbidity and mortality are a global health crisis, and perinatal psychiatric illness is the most common morbidity in pregnancy. Racial, ethnic, and socioeconomic disparities in perinatal psychiatric illness contribute to disparities in maternal morbidity and mortality. There is limited data on diagnosis rates across race/ethnicity and neighborhood deprivation.</div></div><div><h3>Objective</h3><div>To identify prevalence of perinatal psychiatric illness diagnosis and determine differences based on race, ethnicity, and neighborhood deprivation.</div></div><div><h3>Study design</h3><div>This cross-sectional study included women who gave birth between 2020 and 2023 at a Houston Methodist hospital. Houston Methodist is a hospital system serving the greater Houston area. During the study period, 20 015 women received perinatal care from and delivered at a Houston Methodist system hospital. The first birth per individual was used for analyses. 2 women were removed due to missing data. A final 20 013 were eligible for inclusion. Variables of interest included neighborhood deprivation, defined as a score on the Area Deprivation Index, a validated socioeconomic measure, and self-reported race and ethnicity as reported in electronic health record. The main a priori outcome was any psychiatric illness diagnosed between estimated date of conception and 3 months postpartum.</div></div><div><h3>Results</h3><div>The sample was distributed across race and ethnicity, with 2 098 (10.5%) Asian, 2 893 (14.5%) Black, 5 208 (26.0%) Hispanic White, 8 218 (41.1%) non-Hispanic White, and 1596 (8.0%) other. Mean age of women included in our analyses was 30.50 years (SD= 5.33). Perinatal psychiatric illness was diagnosed in 19.1% of patients. Non-Hispanic White women were diagnosed at the highest rates (24.8%), while Asian women were diagnosed at the lowest rates (9.1%). Rates trended higher as area deprivation increases across the total sample. However, this trend only held for non-Hispanic White women, for whom higher deprivation has significantly higher prevalence rates than lower deprivation (30.6% vs 18.7%, <em>P</em>&lt;.001).</div></div><div><h3>Conclusions</h3><div>One in five women in our study was diagnosed with perinatal psychiatric illness. Our stratified findings were inconsistent with previous reports of higher symptom burden in women of color. Neighborhood deprivation has differential impact depending on race/ethnicity, highlighting the importance of accounting for sociocultural variables when analyzing prevalence.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100511"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255249","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":"Contraceptive utilization and associated factors among reproductive age women attending psychiatric outpatient services, at northwest Amhara regional referral hospitals, Ethiopia","authors":"Getanew Kegnie Nigate MPH ,&nbsp;Yohannes Ayanaw Habitu PhD ,&nbsp;Worku Chekol Tassew MSc ,&nbsp;Yeshiwas Ayale Ferede MPH ,&nbsp;Elsa Awoke Fentie MPH","doi":"10.1016/j.xagr.2025.100530","DOIUrl":"10.1016/j.xagr.2025.100530","url":null,"abstract":"<div><h3>Introduction</h3><div>Family planning is essential for all reproductive age women, and it is particularly Important for women with mental illness. Women with mental illness have a special need for Family planning as they carry a high risk of unplanned or unwanted pregnancy, sexual violence And poor obstetric outcomes. However, regarding contraceptive utilization and associated Factors among women with mental illness in low–income countries including Ethiopia is not Adequately explored.</div></div><div><h3>Objective</h3><div>To assess the magnitude of contraceptive utilization and associated factors among reproductive age women attending psychiatric outpatient services, at the northwest Amhara regional referral hospitals, Ethiopia</div></div><div><h3>Methods</h3><div>An institutional–based cross-sectional study was conducted among 810 study participants. A systematic random sampling technique was employed to recruit study participants. A structured and pretested questionnaire was used to collect the data. Data was entered in Epi data 3.1 and then exported to Stata version 14 for analysis. Model fitness was checked by using Hosmer and Lemeshow goodness. Both bivariable and multivariable logistic regressions were used to identify factors associated with contraceptive utilization among psychiatric outpatients. In multivariable logistic regression variables having a <em>P</em>-value less than 0.05 with 95% CI were considered as independently associated factors for the outcome Variable.</div></div><div><h3>Result</h3><div>About 42.59% (CI: 39.18–46.0) of the respondents were using family planning Contraceptive methods at the time of the study. Higher educational level (AOR=3.84 [95% CI: 1.81–8.16]), women who had no intention to have children in the future (AOR=1.53 [95% CI:1.02–2.30]), women counseled about family planning contraceptive method by a clinician (AOR=4.06 [95% CI:2.53–6.49]), good knowledge of family planning (AOR=2.77 [95% CI:1.90–4.03]), fear of side effect of psychiatric medication (AOR=1.57 [95% CI:1.09–2.25]) were factors associated with contraceptive utilization.</div></div><div><h3>Conclusion and recommendation</h3><div>Approximately 42.59% of women with psychiatric illnesses were using modern family planning methods. Significant predictors included having a higher education, good knowledge of family planning, not planning to have children in the future, believing that psychiatric medications are compatible with family planning, and receiving counseling on modern methods from healthcare providers. It is essential for healthcare providers to enhance family planning counseling in mental health clinics to improve knowledge and utilization of these methods.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100530"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094730","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}