AJOG global reports最新文献

{"title":"Temporal trends and clinical characteristics associated with pregnancy-related acute kidney injury in England: a population-based cohort study","authors":"Lisiane F. Leal PhD ,&nbsp;Kristian B. Filion PhD ,&nbsp;Robert W. Platt PhD ,&nbsp;K.S. Joseph MD, PhD ,&nbsp;Laura A. Magee MD, FRCPC, MSc, FACP, FRCOG ,&nbsp;Kate Bramham MRCP ,&nbsp;Anne-Marie Côté FRCPC, CSPQ ,&nbsp;Azar Mehrabadi PhD","doi":"10.1016/j.xagr.2025.100493","DOIUrl":"10.1016/j.xagr.2025.100493","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have reported an increase in pregnancy-related acute kidney injury, but the underlying reasons and patient characteristics associated with this trend are incompletely understood.</div></div><div><h3>Objective</h3><div>To describe temporal trends and identify clinical characteristics associated with pregnancy-related acute kidney injury in England.</div></div><div><h3>Study design</h3><div>This population-based cohort study included all live birth and stillbirth pregnancies to persons aged 15 to 45 years, between 1998 and 2017, using general practitioner practices in England linked to hospitalization data. The outcomes were overall acute kidney injury, postpartum acute kidney injury, severe acute kidney injury, and pulmonary oedema. Adjusted risk ratios were estimated for each 5-year period using Poisson regression models.</div></div><div><h3>Results</h3><div>Among 324,124 pregnancies (4.3% ≥ 40 years, 44.1% nulliparous), acute kidney injury increased from 2.9 to 11.2 per 10,000 pregnancies from 1998–2002 to 2013–2017. Severe acute kidney injury increased from 15.9 to 18.5 per 100,000 pregnancies from 1998–2007 to 2008–2017, while pulmonary oedema decreased from 16 to &lt;5 events per 100,000 pregnancies. Acute kidney injury incidence increased markedly among women with hypertensive disorders and the adjusted risk ratio (aRR) for acute kidney injury among those with hypertensive disorders (vs those without) increased from 1.7 (95% confidence interval [CI] 0.4–8.1) in 1998–2002 to 4.5 (95% CI 2.6–7.7) in 2013 to 2017. There was no notable change in postpartum acute kidney injury among those with postpartum hemorrhage and the aRR for the association of postpartum hemorrhage with acute kidney injury decreased from 18.4 (95% CI 4.3–79.0) in 1998–2002 to 2.5 (95% CI 0.9–6.1) in 2013 to 2017. Few (&lt;5) cases of acute kidney injury occurred among pregnancies with sepsis.</div></div><div><h3>Conclusions</h3><div>There was a marked rise in pregnancy-related acute kidney injury, particularly in last 5 years of the study. The steady rise among those with hypertensive disorders suggests ongoing vigilance is required to ensure optimal care. An investigation of other potential causes or changes in case ascertainment is also warranted given the rise in acute kidney injury among those without hypertensive disorders of pregnancy.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100493"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116974","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":"Effectiveness of expanded prenatal screening among consanguineous couples of Afghan descent","authors":"Noura Osman MSc ,&nbsp;Laila Rhee MSc ,&nbsp;Nina Boe MD ,&nbsp;Herman Hedriana MD ,&nbsp;Krishna Singh MD","doi":"10.1016/j.xagr.2025.100503","DOIUrl":"10.1016/j.xagr.2025.100503","url":null,"abstract":"<div><h3>Objective</h3><div>The American College of Medical Genetics recommends extensive carrier screening among consanguineous couples, yet limited information is available regarding its performance among specific populations. We describe the potential utility of a large expanded carrier screening panel (&gt;500 genes) for Afghan couples with consanguinity.</div></div><div><h3>Method</h3><div>A retrospective chart review was conducted of all patients who reported consanguinity and had genetic counseling consultation between 2010 and 2021 at our institution.</div></div><div><h3>Results</h3><div>Thirty-six women of Afghan descent reported consanguinity. Nineteen (53%) did not have known autosomal recessive disease risk (no prior fetus/child with suspected syndrome), 11 (31%) had apparent disease risk (fetus/child with symptoms suggesting syndrome but no specific diagnosis), and six (17%) had known molecular diagnosis for a prior child with a recessive syndrome. Of the six women with known molecular diagnosis for prior child with syndrome, five had known pathogenic variants confirming a genetic disorder, and one had highly suspicious variant of uncertain significance in the family. Among these six, five (83%) could have been identified with a 787-gene prenatal carrier screening panel.</div></div><div><h3>Conclusion</h3><div>Large, expanded carrier screening panel appears to be an effective method for identifying disorders among consanguineous Afghan couples and should ideally be considered preconceptionally.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100503"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144196305","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":"Efficacy of regular prophylaxis with a plasma-derived von Willebrand factor/factor VIII concentrate with a 1:1 activity ratio in reducing heavy menstrual bleeding in girls/women with von Willebrand disease","authors":"Csongor Kiss ,&nbsp;Zoltan Boda ,&nbsp;Claudia Djambas Khayat ,&nbsp;Ana Boban ,&nbsp;Leonid Dubey ,&nbsp;Robert F. Sidonio Jr","doi":"10.1016/j.xagr.2025.100501","DOIUrl":"10.1016/j.xagr.2025.100501","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Heavy menstrual bleeding is the dominant symptom in girls/women with von Willebrand disease (VWD), affecting ∼80 to 90%. Female patients with VWD are typically diagnosed later than males, despite the disproportionate impact of heavy menstrual bleeding. Although heavy menstrual bleeding has a substantial impact on patients, it is commonly undertreated in part because of the potential multifactorial causes in young girls/women, imprecise definition, and exclusion of this bleeding type as an indication for prophylaxis in previous studies. The WIL-31 study showed that prophylaxis with wilate (a plasma-derived von Willebrand factor/factor VIII concentrate with a 1:1 activity ratio) is highly efficacious in reducing bleeding rates in adults and children with VWD of all types. The impact of wilate prophylaxis on heavy menstrual bleeding was evaluated as an exploratory endpoint since it was not included as part of the primary endpoint.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective(s)&lt;/h3&gt;&lt;div&gt;To investigate the efficacy of regular prophylaxis with wilate in reducing the incidence of heavy menstrual bleeding in girls/women with VWD who had previously been treated on-demand.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study design&lt;/h3&gt;&lt;div&gt;WIL-31 (NCT04052698) was a prospective, non-controlled, international, multicenter Phase 3 trial that enrolled male/female patients, aged ≥ 6 years old with VWD. Prior to entering the WIL-31 study, all patients received on-demand treatment with a von Willebrand factor-containing product during a 6-month, prospective, observational, run-in study (WIL-29). Patients in WIL-31 received wilate prophylaxis 2–3 times per week at a dose of 20–40 IU/kg for 12 months. Prophylaxis was not tailored to time with menstruation. Heavy menstrual bleeding was defined as any menstrual bleed that impeded the ability to perform daily activities during menstrual periods. Criteria for heavy menstrual bleeding included changing pads more frequently than hourly, menstrual bleeding lasting 7 or more days, or the presence of clots &gt; 1 cm, combined with a history of flooding or a Pictorial Blood Assessment Chart score ≥ 185.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of the 33 patients evaluated in the study, 14 (42%) were female, of whom 5 (15%) were of childbearing age (13–43 years old). One of these had VWD type 1, the other 4 had VWD type 3. Prophylaxis with wilate reduced the mean annualized heavy menstrual bleeding rate by 75% compared with on-demand treatment (2.4 vs 9.7 in WIL-31 and WIL-29, respectively). During 6 months of on-demand treatment, all 5 female patients experienced at least 1 heavy menstrual bleed, whereas during 12 months of prophylaxis, 3 (60%) experienced no heavy menstrual bleeding episodes. During on-demand treatment, 5 patients experienced 26 heavy menstrual bleeding episodes, 3 (12%) of which required additional treatment. Under prophylaxis, 2 patients experienced 12 heavy menstrual bleeding episodes, of which only 1 (8%) impeded dai","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100501"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230060","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":"Providers' perceptions of implementing standardized postpartum family planning: a qualitative study of midwives and nurses in Ghana","authors":"Sarita Sonalkar ,&nbsp;Ernest Maya ,&nbsp;Chris Guure ,&nbsp;Arden McAllister ,&nbsp;Dzifa Adimle Puplampu ,&nbsp;Roseline Dansowaa Doe ,&nbsp;Mary Eluned Gaffield ,&nbsp;James Kiarie","doi":"10.1016/j.xagr.2025.100506","DOIUrl":"10.1016/j.xagr.2025.100506","url":null,"abstract":"<div><h3>Background</h3><div>The World Health Organization publishes and maintains evidence-based guidance for the delivery of essential family planning services in the postpartum period<strong>.</strong> Despite significant time and effort in the development of these guidelines in the past decades, a significant unmet need for postpartum family planning persists, exposing an implementation gap. Implementation strategies involving education and infrastructure support can improve family planning uptake and mobile health interventions are a feasible adjunct in improvement of health outcomes.</div></div><div><h3>Objective</h3><div>We sought to understand provider perceptions of feasibility, acceptability, and appropriateness of implementation of the Postpartum Family Planning Package, which involved provider use of the World Health Organization Medical Eligibility for Contraceptive Use Mobile Application with a one-on-one counseling strategy.</div></div><div><h3>Study Design</h3><div>We implemented the Postpartum Family Planning Package at three hospitals in Greater Accra and Eastern Regions, Ghana. We conducted in-depth interviews with 23 providers who used the Postpartum Family Planning Package for at least three months. Study design, data collection, analysis, and interpretation were guided by the Consolidated Framework for Implementation Research. We interpreted data using thematic analysis.</div></div><div><h3>Results</h3><div>Providers indicated that use of one-on-one counseling and the mobile application in hospital-based postpartum care delivery was acceptable, feasible, and appropriate. Respondents described the resultant increased perceived trust between patients and providers as well as more effective and efficient information exchange. Endorsement for the use of the World Health Organization Medical Eligibility for Contraceptive Use Mobile Application by the facility leadership motivated providers to use it. The primary barrier to incorporation of one-on-one counseling was lack of privacy on the postnatal wards.</div></div><div><h3>Conclusion</h3><div>Providers perceived the implementation of the Postpartum Family Planning Package as feasible, acceptable, and appropriate. Creation of private spaces on the postnatal ward for counseling and continued buy-in by the facility leadership would likely enhance the impact of the strategy. Given the widespread use of mobile technology and the continued unmet need for postpartum contraception, we recommend evaluating this strategy in a broad range of settings internationally, including in lower-resource settings.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100506"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222227","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":"Venous thromboembolism with contraceptive use in females with sickle cell trait","authors":"Angela K. Phillips PhD, APRN ,&nbsp;Candy Wilson PhD, APRN, FAAN ,&nbsp;Anwar E. Ahmed PhD ,&nbsp;Arun Shet MD, PhD ,&nbsp;Margaret Bevans PhD, RN, FAAN","doi":"10.1016/j.xagr.2025.100497","DOIUrl":"10.1016/j.xagr.2025.100497","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Sickle cell trait is the carrier state for sickle cell disease and occurs in 1 in 13 births in Black and African American families. Individuals with sickle cell trait are permitted to serve in the military. Some research studies have shown that individuals with sickle cell trait may be at increased risk for thromboembolic events. Contraceptive use, specifically combined hormonal contraceptives containing both estrogen and progesterone, has been linked to an increased risk of thromboembolic events. No research has been done to determine if there is an increased risk of venous thromboembolism in a population of females with sickle cell trait who do or do not take combined hormonal contraceptives.</div></div><div><h3>OBJECTIVE</h3><div>To determine if women with sickle cell trait who use combined hormonal contraceptives are at higher risk for venous thromboembolism compared with females with sickle cell trait who do not use combined hormonal contraceptives. Given the increased risk of venous thromboembolism in sickle cell trait individuals in the general population, we hypothesized that females with sickle cell trait exposed to combined hormonal contraceptives would experience higher venous thromboembolism rates than unexposed females with sickle cell trait.</div></div><div><h3>STUDY DESIGN</h3><div>Population-based retrospective cohort study of females with sickle cell trait identified from the Military Data Repository to evaluate venous thromboembolism after exposure to combined hormonal contraceptives or without exposure to combined hormonal contraceptives.</div></div><div><h3>RESULTS</h3><div>There were 15,440 unique females aged 18–44 years between 2005 and 2021 who had a diagnosis of sickle cell trait. Approximately 40% of females had an International Classification of Diseases code consistent with a prescription of a combined hormonal contraceptive. Thirty-three (0.2%) of the 15,440 females with sickle cell trait had experienced venous thromboembolism of any type. There was no difference in the prevalence of venous thromboembolism by combined hormonal contraceptive use (yes [0.18%] vs no [0.24%]; <em>P</em>=.454). Being older, married, nonactive-duty military status, smoking, and having a diagnosis of hypertension were associated with a higher prevalence of venous thromboembolism.</div></div><div><h3>CONCLUSION</h3><div>Although there was a small number of venous thromboembolism events, the findings of this study suggest that the use of combined hormonal contraceptives in females with sickle cell trait is not associated with a detectable signal for increased venous thromboembolism risk as an outcome. Given the potential clinical benefit of combined hormonal contraceptives in pregnancy prevention and menstrual regulation in females, the concerns about combined hormonal contraceptive-associated venous thromboembolism in this population with sickle cell trait seem to be minimal.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100497"},"PeriodicalIF":0.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873615","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":"International pregnancy loss/ miscarriage day posts shared on Instagram: a content analysis","authors":"Atikah Sayogo Putri ,&nbsp;Achmad Kemal Harzif ,&nbsp;Putri Nurbaeti ,&nbsp;Aisyah Retno Puspawardani ,&nbsp;Nafi'atul Ummah ,&nbsp;Shakira Amirah ,&nbsp;Muhammad Candrika Agyawisnu Yuwono ,&nbsp;Mila Maidarti ,&nbsp;Kanadi Sumapraja","doi":"10.1016/j.xagr.2025.100487","DOIUrl":"10.1016/j.xagr.2025.100487","url":null,"abstract":"<div><h3>Background</h3><div>Miscarriage refers to the loss of a fetus before the completion of 28 weeks of gestation. The prevalence of miscarriage across all age groups ranges from 12% to 20%. Despite the great incidence of miscarriage, public awareness and understanding about pregnancy loss remain inadequate. Currently, social media platforms, such as Instagram, are frequently utilised by the public as a mechanism to address their health-related concerns.</div></div><div><h3>Objective</h3><div>This study aims to determine the characteristics of content disseminated on Instagram regarding International Pregnancy Loss/Miscarriage Day over the preceding three-year period.</div></div><div><h3>Study Design</h3><div>This was an analytical-observational study to describe community participation on Instagram in commemorating International Pregnancy Loss Day 2022-2024. Hashtags used include #pregnancyloss, #pregnancylossawareness, and #pregnancylossjourney. Data were analysed using content analysis and simple nominal descriptive statistics to enable comparison.</div></div><div><h3>Results</h3><div>A total of 600 Instagram posts were deemed eligible and met the specified inclusion criteria for subsequent analysis. The data revealed that the predominant form of content consists of text/quotes, comprising 44.38% (n=248) of the total content. The most common content type was personal experience sharing, accounting for 55.6% (n=334), followed by education/information for 44.24% (n=265).</div></div><div><h3>Conclusion</h3><div>The utilization of social media platforms like Instagram to commemorate International Pregnancy Loss Day, particularly by health care provider, has huge potential benefit to spread awareness, information, as well as providing support for patients.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100487"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860684","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":"Healthcare professionals’ experiences of discussing sexual function with menopausal women using a vaginal pessary","authors":"Monica Quinlan BSc, MSc,&nbsp;Victor Olagundoye MBBS, MMedSci, MSc, MRCOG","doi":"10.1016/j.xagr.2025.100485","DOIUrl":"10.1016/j.xagr.2025.100485","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Pelvic organ prolapse is a common condition with high prevalence among postmenopausal women, many of whom are sexually active. A vaginal pessary is an effective, nonsurgical treatment alternative for well-selected, motivated patients and those unfit for surgical management. Open discussion on sexual function is a crucial part of counseling in these women to ensure that they are fitted with the most appropriate pessary and minimize complications.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to explore healthcare professionals’ experiences of discussing sexual function with postmenopausal women with pelvic organ prolapse receiving vaginal pessary management in a urogynecology clinic.</div></div><div><h3>STUDY DESIGN</h3><div>Semistructured, in-depth qualitative interviews were conducted in a tertiary university teaching hospital in England with an established urogynecology department. The sample comprised 10 volunteers (7 female and 3 male, consisting of 3 consultants, 1 advanced nurse practitioner, 2 clinical nurse specialists, and 4 specialist registrars). All volunteers were experienced in managing women with prolapse, including inserting and removing vaginal pessaries and discussing sexual intercourse and intimacy.</div></div><div><h3>RESULTS</h3><div>Postmenopausal women were found to be reluctant and embarrassed to engage in open discussion on sexual intimacy, which can be improved by building trust. Being seen by female healthcare professionals, having a female chaperone, and using appropriate interpreters (in cases of language barriers) significantly improved women's willingness to discuss sexual issues.</div></div><div><h3>CONCLUSION</h3><div>The study demonstrated that postmenopausal women found it difficult and were hesitant and embarrassed to openly discuss sexual issues, which is important in choosing the most suitable vaginal pessary. This problem can be alleviated by building trust between healthcare professionals and patients, by healthcare professionals remaining sensitive to patients’ ethnic and cultural backgrounds, and by respecting women's choice of healthcare professional.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100485"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856109","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":"Corrigendum to Effects of the sampling time on the vaginal microbiota in healthy pregnant women: a prospective observational study’ [AJOG Global Reports Volume 5, Issue 1, February 2025, 100460]","authors":"Hiroshi Mori MD ,&nbsp;Eiji Shibata PhD ,&nbsp;Emi Kondo MD ,&nbsp;Mitsumasa Saito PhD ,&nbsp;Kiyoshi Yoshino PhD ,&nbsp;Kazumasa Fukuda PhD","doi":"10.1016/j.xagr.2025.100483","DOIUrl":"10.1016/j.xagr.2025.100483","url":null,"abstract":"","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100483"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with a positive Tilburg Pregnancy Distress Scale among hospitalized Ghanaian obstetric patients","authors":"Dhanalakshmi Thiyagarajan MD, MPH ,&nbsp;Astrid Sarfo BS ,&nbsp;Alim Swarray-Deen MBChB, MS ,&nbsp;Sarah Compton PhD, MPH ,&nbsp;Emma Lawrence MD, MS ,&nbsp;Promise Sefogah MBChB, MPH","doi":"10.1016/j.xagr.2025.100486","DOIUrl":"10.1016/j.xagr.2025.100486","url":null,"abstract":"<div><h3>Background</h3><div>Psychological distress during the antenatal and postpartum period can negatively impact the quality of life and health of the pregnant person and fetus(es). But there is a discrepancy between Ghanaian community prevalence and engagement with mental health services leading to underdiagnosis and missed therapeutic opportunities. Therefore, it is important to identify factors that contribute to the gap of underdiagnosis and treatment, and screening for pregnancy distress is the first step in bridging this gap.</div></div><div><h3>Objective</h3><div>To identify factors associated with increased prenatal and postpartum pregnancy distress via the administration of the Tilburg Pregnancy Distress Scale (TPDS).</div></div><div><h3>Study Design</h3><div>We performed a cross-sectional study of obstetric patients who were admitted at the largest referral teaching hospital in urban Ghana between November 20, 2023, and December 22, 2023. Patients were eligible to participate if they were admitted to the 275-bed maternity block for an antepartum or postpartum indication, alert and oriented, and able to speak one of the following languages: English, Twi, or Ga. Patients below the age of 18 years, or critically ill or unstable were excluded. Participants were asked about their socioeconomics, medical history, current pregnancy and/or delivery outcomes, and satisfaction with care. All patients then completed the validated TPDS, a multiple-choice questionnaire to determine the level of pregnancy or postpartum-related distress.</div></div><div><h3>Results</h3><div>Among hospitalized obstetric patients in Ghana, less than 1% reported a diagnosed depression, anxiety, or mental health disorder. However, over 37% of our participants, both antepartum and postpartum, screened positive for pregnancy distress using the TPDS. Among antepartum participants, young age, low household income, and low parity were significantly associated with a positive pregnancy distress screen. Among postpartum participants, no factors were significantly associated with a positive screen in the final, controlled, model.</div></div><div><h3>Conclusion</h3><div>Our study is the first to identify factors associated with Ghanaian patients’ pregnancy distress, which can contribute to pregnancy, maternal, and child health consequences. Over one-third of obstetric patients screened positive on the TPDS with prevalence rates comparable across antepartum and postpartum patients. Our study identified antepartum patient factors of young age, low income, and low parity for increased positive screening on the TPDS. Identifying Ghanaian pregnant patients with these factors may help to target those at the greatest need for increased screening and monitoring, which is aligned with the Sustainable Development Goals.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100486"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843503","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":"Personal experience with abortion: a determining factor in Physician's attitudes towards abortion","authors":"Reagan M. Ingoma MD, MPH ,&nbsp;So Yoon Kim ,&nbsp;Erick N. Kamangu PhD","doi":"10.1016/j.xagr.2025.100478","DOIUrl":"10.1016/j.xagr.2025.100478","url":null,"abstract":"<div><h3>Background</h3><div>The increase in illegal abortions raises concerns about the role of physicians in providing safe abortion care. Understanding physicians' views in multicultural countries like the DRC is essential, even though the Maputo Protocol permits safe abortion care. The research aims to determine the impact of their experience with abortion on their attitudes towards abortion.</div></div><div><h3>Method</h3><div>This is cross-sectional study involving 265 physicians from The Democratic Republic of Congo, conducted between April 1st and June 30th, 2024, using a convenience sampling technique that determines doctors' attitudes toward abortion to lay the groundwork and pave the way for future research on this issue. The study used a chi-square test to analyze categorical variables, Spearman correlation with 2 hypotheses, and multinomial logistic regression to predict the connection between the explanatory, the confounding variables, and the physician attitudes towards abortion.</div></div><div><h3>Results</h3><div>On a scale of 1−5, the median score was 3, the mean was 2.95, and the standard deviation was 0.661. We found a significant correlation between physicians' personal experiences with abortion and their attitudes toward the practice (r_s 0.211, <em>P</em>.001). Doctors who have personally experienced abortion are more likely to support abortion rights than pro-life doctors (OR: 6.52, <em>P</em>.005).</div></div><div><h3>Conclusion</h3><div>Targeted training programs for healthcare providers on the medical, legal, and ethical aspects of abortion care are crucial for equipping them with essential knowledge and skills. Public health initiatives should create and share standardized protocols for abortion care to ensure consistent quality across all healthcare facilities, especially in rural and underserved areas, promoting equitable access to such services.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100478"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833340","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}