AJOG global reports最新文献

{"title":"Husband’s involvement in maternal antenatal care and associated factors among pregnant women’s: study protocol for systematic review and meta-analysis","authors":"Aster Shiferaw MSc,&nbsp;Mulunesh Minale MSc","doi":"10.1016/j.xagr.2025.100532","DOIUrl":"10.1016/j.xagr.2025.100532","url":null,"abstract":"<div><h3>Background</h3><div>The evidence of husband’s involvement in maternal antenatal care (ANC) is scant and inconsistence across each study. Therefore this systematic review and meta-analysis will be to examine (1) the characteristics of published studies on husband involvement in maternal ANC; (2) estimate the nationwide magnitude of husband involvement in maternal ANC;(3) show the significant association between husband involvement in maternal ANC and reported associated factors in published articles.</div></div><div><h3>Method</h3><div>This systematic review and meta-analysis will be conducted by publishing and unpublishing articles, which will be searched online through Google Scholar, PubMed, Cochrane Library, EMBASE, HINARI, and Africa Journals. The Preferred Reporting Item for Systematic Review and Meta-Analysis (PRISMA) guideline will be used to review articles. Repeated articles will be removed by EndNote version X7.1. The data will be extracted by using the 2014 Joanna Briggs Institute Reviewers’ Manual data extraction. Critical appraisal of the studies will be done by the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) for cross-sectional studies tool. Begg-Mazumdar rank correlation tests and Egger’s regression tests will be used to check the presence of publication bias. The presence of heterogeneity will be assessed by Cochran’s Q statistics.</div></div><div><h3>Discussion</h3><div>This systematic review and meta-analysis will be the only study that investigates the magnitude and associated factors of husband’s involvement in maternal ANC. Through gathering information, the possible outcome will be to investigate and show those interested to utilize it.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100532"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549509","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":"Predicting in vitro fertilization success: the role of hyperglycosylated human chorionic gonadotropin to beta-human chorionic gonadotropin ratio in implantation and early pregnancy outcomes at a private in vitro fertilization center in Baghdad","authors":"Rasha Fadhil Abas MRCOG, CABOG, JMCOG, MSc-ART, DGO, D.MAS, MBChB,&nbsp;Maad Mahdi Shallal FICOG","doi":"10.1016/j.xagr.2025.100531","DOIUrl":"10.1016/j.xagr.2025.100531","url":null,"abstract":"<div><h3>Background</h3><div>This study explores the role of human chorionic gonadotropin (hCG) isoforms in predicting implantation success and early pregnancy outcomes in in vitro fertilization (IVF) patients. Despite advances in reproductive medicine, implantation failure, and early pregnancy loss remain significant challenges. Hyperglycosylated hCG (hCG-H) facilitates trophoblast invasion and angiogenesis, while beta-hCG (β-hCG) supports progesterone production, crucial for pregnancy maintenance. This study assesses the predictive value of these biomarkers in IVF success.</div></div><div><h3>Methods</h3><div>A prospective cohort study was conducted at Al-Binuk Private IVF Center in Baghdad from January to December 2024, including 100 women aged 20 to 44 years with primary or secondary infertility and normal uterine cavities. Women with endocrine disorders or uterine abnormalities were excluded. All transferred embryos were frozen day 4 or day 5 embryos and were implanted into a prepared uterus. Serum hCG levels, including hCG-H and β-hCG, were measured 10 to 11 days after embryo transfer. Data were analyzed using SPSS, and logistic regression was performed to evaluate the predictive value of these biomarkers.</div></div><div><h3>Results</h3><div>The mean age of participants was 34.3 years, with 54% having a normal BMI. Primary infertility was more common (73%), with an average infertility duration of 5.9 years. Half of the participants underwent their first IVF attempt. Among pregnancies, 73% resulted in a single embryo, 13% in twins, and 14% experienced pregnancy failure. Higher hCG-H and β-hCG levels were significantly associated with implantation success, and an increased hCG-H to β-hCG ratio further enhanced prediction. Logistic regression showed that higher hCG levels improved implantation success, while age negatively affected outcomes.</div></div><div><h3>Conclusion</h3><div>Serum hCG-H and β-hCG levels measured postembryo transfer serve as strong predictors of IVF success. Their ratio further enhances predictive accuracy, emphasizing their role in assessing pregnancy viability. Further research is needed to refine diagnostic thresholds and enhance fertility treatment strategies.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100531"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517739","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":"TGF-β drives myofibroblast activation and inflammatory mediator production in vulvar lichen sclerosus","authors":"Sarah A. Fischer BS ,&nbsp;Zahra Mahamed MS ,&nbsp;Ashley Updike BS ,&nbsp;Briana Boachie BS ,&nbsp;Caitriona Greene BS ,&nbsp;Ruth Agwaze BS ,&nbsp;Kira Parr BS ,&nbsp;Tanzy Love PhD ,&nbsp;Adrienne D. Bonham MD ,&nbsp;Mitchell A. Linder MD ,&nbsp;Megan L. Falsetta PhD","doi":"10.1016/j.xagr.2025.100528","DOIUrl":"10.1016/j.xagr.2025.100528","url":null,"abstract":"<div><h3>Objective</h3><div>Vulvar lichen sclerosus (VLS) is a chronic inflammatory skin condition characterized by whitening of the external genitalia, debilitating pruritus (itching), and pain. As disease advances, loss of labia, burying of vulvar anatomy (ie, clitoris, urethra, vaginal opening), and vulvar cancer can occur, yet mechanistic understanding of these events remains limited. VLS lesions appear visibly similar to scars and are frequently referred to as such. Therefore, we investigated the role of fibrosis in the VLS disease mechanism with the goal of identifying targets for new therapeutic and diagnostic strategies.</div></div><div><h3>Study design</h3><div>6-mm biopsies were collected from 8 participants with VLS from regions of the vulva visibly affected by lichen sclerosus (“scarred”) and adjacent unaffected areas (“unscarred”), allowing each patient to serve as their own control thus diminishing biological noise. Specimens were also used to establish fibroblast strains, and cells were stimulated with TGF-β to assess fibroblast-to-myofibroblast transitions, extracellular matrix (ECM) production, and inflammatory responses in scarred versus unscarred areas.</div></div><div><h3>Results</h3><div>Fibroblasts from scarred areas expressed higher levels of cytoskeletal proteins (alpha-smooth muscle actin) and inflammatory mediators (interleukin 6, prostaglandin E2) upon TGF-β stimulation compared to their unscarred counterparts. Treatment with SB-431542, a TGF-β receptor inhibitor, quelled these responses (<em>P</em>≤.05), indicating that these effects are mediated through the TGF-β pathway. Fibroblasts isolated from scarred tissues exhibit myofibroblast morphologies, but so do fibroblasts from unscarred areas.</div></div><div><h3>Conclusion</h3><div>TGF-β activates myofibroblasts and exacerbates inflammation in VLS cells from scarred areas. However, fibroblasts from both scarred and unscarred areas show similarities in morphology and ECM production, suggesting molecular changes may occur in VLS skin before visible changes are detected, which could lead to new diagnostic strategies to treat disease before irreversible architectural changes occur.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100528"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522165","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 descriptive analysis of a fertility services waitlist in Eastern Canada","authors":"Hannah M. Murphy BSc ,&nbsp;Bailey P.S. Cox BSc ,&nbsp;Heather M. Manning BSc ,&nbsp;Zohreh Zeidy BSc ,&nbsp;Sarah Benson MD ,&nbsp;John D. Cullen MSc ,&nbsp;Deanna Murphy MD ,&nbsp;Sean Murphy MD ,&nbsp;Sarah Healey MD ,&nbsp;Laurie Twells PhD ,&nbsp;Katie P. Wadden PhD","doi":"10.1016/j.xagr.2025.100525","DOIUrl":"10.1016/j.xagr.2025.100525","url":null,"abstract":"<div><h3>Background</h3><div>Infertility is common and impacts quality of life. Maternal age is an important factor in fertility status, and therefore, timely access to care is critical. Long waits for specialist care remain a reality in Canada, representing an opportunity for early intervention.</div></div><div><h3>Objective</h3><div>This study aimed to characterize the population seeking infertility care in Newfoundland and Labrador (NL).</div></div><div><h3>Study Design</h3><div>A province-wide, cross-sectional analysis of referrals to Newfoundland and Labrador Fertility Services (NLFS) was conducted. Deidentified data were extracted from patient records. Descriptive analyses of the reason for referral, provincial geographical health zone, and female age, and a comparison of the age of patients referred across the province were completed. Historical live birth data were used to adjust for population differences.</div></div><div><h3>Results</h3><div>There were 317 eligible referrals received by NLFS over a 6-month period. The most common reason for referral was infertility (n=221, 70%). The overall mean age of referred females was 33.09 years (<em>SD</em>=5.03). The Eastern-Urban region had the highest number of referrals (n=145, 66%), which was greater than expected based on live birth rates (<em>P</em>≤.001). Patients referred from areas outside of the Eastern-Urban region were younger (<em>P</em>≤.001).</div></div><div><h3>Conclusion</h3><div>Infertility was the most common reason for referral. The age of females referred for infertility emphasizes the need for prompt intervention. There were differences in referral patterns across the province, including a disproportionately high referral rate in the Eastern-Urban region.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100525"},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549510","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":"Burden and risk factors of cervical cancer in Vietnam from 1990 to 2021 and forecasting to 2050—a systematic analysis from global burden disease","authors":"Bao Huy Le MD ,&nbsp;Thao-Ngan Nguyen Pham MD ,&nbsp;Huong-Dung Thi Nguyen MD ,&nbsp;Tri Cuong Phan MD ,&nbsp;Han My Nguyen Le ,&nbsp;Thien Tan Tri Tai Truyen MD ,&nbsp;Tam Duc Lam MD, PhD","doi":"10.1016/j.xagr.2025.100526","DOIUrl":"10.1016/j.xagr.2025.100526","url":null,"abstract":"<div><h3>Background</h3><div>Cervical cancer continues to be a significant global health challenge, with Vietnam facing similar concerns. Although there has been some progress in lowering its incidence and mortality rates, a comprehensive understanding of long-term trends and the factors driving these changes remains limited.</div></div><div><h3>Objective</h3><div>This study aimed to analyze the burden and risk factors of cervical cancer in Vietnam over a 3-decade period, from 1990 to 2021 with projection to 2050.</div></div><div><h3>Study design</h3><div>Our study used data from the Global Burden of Disease (GBD) 2021 estimates, developed by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. This dataset includes metrics such as incidence, prevalence, mortality, and disability-adjusted life years (DALYs), all presented as age-standardized rates (ASRs) per 100,000 individuals. We analyzed trends from 1990 to 2021 and projections for 2022 to 2050 using the Joinpoint regression model. Additionally, we examined ASRs for death and DALYs attributed to cervical cancer-related risk factors.</div></div><div><h3>Results</h3><div>In 2021, cervical cancer accounted for approximately 4369 deaths (95% UI: 3345–5713) in Vietnam, with ASRs for incidence, prevalence, and mortality at 16.50 per 100,000 (95% UI: 12.49–21.83), 88.11 per 100,000 (95% UI: 65.32–116.75), and 7.66 per 100,000 (95% UI: 5.90–9.94), respectively. From 1990 to 2021, trends in incidence, DALYs, and mortality followed 3 phases: a decrease in incidence from 1990 to 1992 (APC: –2.42%, 95% CI: –3.56 to –0.85), an increase from 1992 to 1996 (APC: 2.69%, 95% CI: 2.09–3.65), and a subsequent decrease from 1996 to 2008 (APC: -0.68%, 95% CI: –0.86 to –0.57), with no significant change from 2008 to 2021. Projections from 2022 to 2050 suggest an all-age DALYs rate of 147.55 (95% UI: 105.14–198.31) in 2050, with an expected rise until 2039 followed by a decline, reflecting an annual percent change of –0.2% (95% CI: –0.07 to –0.55). Major risk factors for cervical cancer in Vietnam include smoking and unsafe sexual practices, with associated age-standardized mortality rates of 0.31 (95% UI: 0.16–0.53) and 7.66 (95% CI: 5.89–9.80) per year, respectively.</div></div><div><h3>Conclusion</h3><div>The study reveals that, despite some progress in reducing the incidence, mortality, and DALYs associated with cervical cancer in Vietnam over the past 3 decades, the overall burden remains substantial. This study underscores the impact of key risk factors, including smoking and unsafe sex. Future research is needed to evaluate effective interventions and healthcare policies that could reduce the burden of cervical cancer and improve women’s health outcomes in Vietnam.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100526"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502371","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":"Prospective determination of heat shock protein serum levels in Saskatchewan women during pregnancy","authors":"Lindsey Broberg MD ,&nbsp;Ewa I. Miskiewicz PhD ,&nbsp;Jocelyne Martel MD ,&nbsp;Daniel J. MacPhee PhD","doi":"10.1016/j.xagr.2025.100533","DOIUrl":"10.1016/j.xagr.2025.100533","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND&lt;/h3&gt;&lt;div&gt;The stress proteins, heat shock protein 27, heat shock protein 70, and αB-crystallin, have all been detected in human serum under normal and disease conditions. Heat shock protein 70 serum levels are known to increase in women with advancing pregnancy, but heat shock protein 27, heat shock protein 70, and αB-crystallin have never been assessed prospectively in pregnancy and labor.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;div&gt;This study aimed to determine the serum levels of heat shock protein 27, heat shock protein 70, and αB-crystallin in women during pregnancy to assess whether the levels increase significantly over time and particularly at term and/or labor.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN&lt;/h3&gt;&lt;div&gt;A prospective cohort pilot study of serum levels of heat shock protein 27, heat shock protein 70, and αB-crystallin in Saskatoon-area women with singleton pregnancies using enzyme-linked immunosorbent assays was conducted. Serum samples were collected from each patient at 3 periods: &lt;14 weeks of gestation, 22 to 33 weeks of gestation at glucose screening, and at term nonlabor/active labor. The enzyme-linked immunosorbent assay data were subjected to D’Agostino and Pearson tests for normality. If data were not normally distributed, Friedman tests followed by Dunn multiple comparisons tests were performed. If data were normally distributed, they were subjected to repeated measures one-way analysis of variance, followed by Tukey multiple comparisons tests. In addition, a Spearman correlation analysis of heat shock protein levels with increasing gestational age was performed. All data were assessed and graphed using GraphPad Prism software.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;Heat shock protein 27 levels were significantly elevated at term/labor compared with the 2 earlier time points assessed (Dunn multiple comparisons test: &lt;em&gt;P&lt;/em&gt;&lt;.0001 compared with &lt;14 weeks of gestation and &lt;em&gt;P&lt;/em&gt;=.0014 compared with 22–33 weeks of gestation). In addition, heat shock protein 70 serum levels were significantly elevated at term/labor compared with earlier time points (Dunn multiple comparisons test: &lt;em&gt;P&lt;/em&gt;=.0005 compared with &lt;14 weeks of gestation and &lt;em&gt;P&lt;/em&gt;=.0179 compared with 22–33 weeks of gestation). In contrast, αB-crystallin levels were not significantly different throughout pregnancy. When the serum levels of the heat shock proteins throughout pregnancy were separately examined in the prospective cohorts who were sampled at term or at active spontaneous or induced labor, heat shock protein 27 levels were still significantly elevated at term (Tukey multiple comparisons test: &lt;em&gt;P&lt;/em&gt;=.003 compared with &lt;14 weeks of gestation and &lt;em&gt;P&lt;/em&gt;=.031 compared with 22–33 weeks of gestation) or at labor (Tukey multiple comparisons test: &lt;em&gt;P&lt;/em&gt;&lt;.0001 compared with &lt;14 and 22–33 weeks of gestation). Of note, heat shock protein 27 levels were significantly elevated at term compared with at labor (3.949±0","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100533"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588661","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":"Indiscriminate antibiotic prescribing for nonspecific symptoms perpetuates gender-based healthcare inequities","authors":"Alec Szlachta-McGinn MD ,&nbsp;Lynn Stothers MD, MHS ,&nbsp;A. Lenore Ackerman MD, PhD","doi":"10.1016/j.xagr.2025.100524","DOIUrl":"10.1016/j.xagr.2025.100524","url":null,"abstract":"<div><div>Urinary tract infection is among the most common bacterial infection among adults, and women are significantly more likely to experience urinary tract infection than men. The prevalence of urinary tract infection in women increases with age, as does the prevalence of noninfectious lower urinary tract symptoms and asymptomatic bacterial colonization of the urinary tract, known as asymptomatic bacteriuria. Distinguishing among these 3 entities is challenging without a complete clinical evaluation, including history, physical examination, and urine culture data. Existing literature demonstrates high misclassification of nonspecific symptoms, such as urinary tract infection, among women. In addition, less than one-fifth of diagnoses meet evidence-based criteria for urinary tract infection. Therefore, women are burdened by several healthcare inequities, including delays in care for potentially life-threatening conditions, antibiotic resistance and antibiotic-associated adverse events because of overreliance on antibiotics for noninfectious symptoms, and distrust of medical care. Profit-driven pressures imposed by our healthcare system, which reward providers for increasing clinical volume at the expense of quality patient-provider interactions, are a major culprit driving these inequities. In addition, lack of provider knowledge regarding urinary tract infection–confusable diagnoses, discomfort with pelvic examinations, and inappropriate use of automated question-based algorithms to diagnose and treat urinary tract infection are to blame. An evidence-based approach incorporating a focused history and physical examination that is concordant with the patient’s chief complaint in addition to urine culture data only in cases of suspected urinary tract infection is the only way to reduce urinary tract infection–related healthcare inequities unfairly confronting women.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100524"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522163","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":"Ultrasound-indicated cerclage: does expedited placement prolong gestation?","authors":"Sarah H. Abelman MD ,&nbsp;Frank I. Jackson DO ,&nbsp;Nathan A. Keller MD ,&nbsp;Julie Chen BBA ,&nbsp;Luis A. Bracero MD ,&nbsp;Cara S. Wetcher MD ,&nbsp;Matthew J. Blitz MD, MBA","doi":"10.1016/j.xagr.2025.100523","DOIUrl":"10.1016/j.xagr.2025.100523","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;There is no clear consensus on the urgency of ultrasound-indicated cerclage placement after sonographic diagnosis of a short cervix, and it remains uncertain whether immediate cerclage placement prolongs gestation and improves pregnancy outcomes compared to scheduling within a reasonable timeframe.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study aimed to determine whether the time interval between the sonographic diagnosis of a short cervix and transvaginal cerclage placement is associated with gestational age at delivery and preterm birth.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;This retrospective cohort study included all patients who received an ultrasound-indicated cerclage between January 2018 and December 2023 within a large New York health system. Patients were categorized into two groups: those with a history of preterm birth and a short cervix (&lt;25 mm) and those with no prior preterm birth but a very short cervix (&lt;10 mm). The primary exposure was the time interval between diagnosis of a short cervix (ie, decision for cerclage) and cerclage placement, with expedited placement defined as within 1 day for patients without prior preterm birth, and within 5 days for those with prior preterm birth. These cutoffs were determined based on the median time-to-cerclage (days) observed within our study population for each cohort and rounded to the nearest day. The primary outcome was gestational age at delivery, with secondary outcomes including latency to delivery, as well as preterm birth at &lt;37, &lt;34, and &lt;32 weeks. Statistical analyses included linear mixed model regression and multivariate logistic regression, adjusting for body mass index, gestational age at diagnosis, and shortest cervical length prior to cerclage. Data were analyzed using R version 4.3.1. Statistical significance was defined as &lt;em&gt;P&lt;/em&gt;&lt;.05.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 125 patients were included, with 83 having a cervical length &lt;10 mm and no prior preterm birth, and 42 having a cervical length &lt;25 mm with a history of preterm birth. In the group without a prior preterm birth, the mean cervical length before cerclage was 6.3±2.4 mm, and the mean gestational age at cerclage placement was 21.0±1.7 weeks. Overall, 74.7% received expedited cerclage placement (≤1 day), while 25.3% underwent routine placement. Gestational age at delivery and preterm birth rates were similar between the expedited and routine placement groups. In the group with a history of preterm birth, the mean cervical length before cerclage was 18.2±5.8 mm, with cerclage placed at a mean gestational age of 19.8±2.6 weeks. Overall, 45.2% underwent expedited placement (≤5 days), while 54.8% had routine placement. A statistically significant difference in gestational age at delivery was observed between groups (36.9±2.5 weeks vs 36.9±3.0 weeks, &lt;em&gt;P&lt;/em&gt;=.04), but this difference was not clinically meaningful.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Concl","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100523"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472210","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":"Prevalence of newly diagnosed essential hypertension within one year postpartum: a systematic review and meta-analysis","authors":"Jennifer D. Kaminker ,&nbsp;Alexandra MacMaster ,&nbsp;Jessica Pudwell ,&nbsp;Kira King ,&nbsp;Graeme N. Smith","doi":"10.1016/j.xagr.2025.100519","DOIUrl":"10.1016/j.xagr.2025.100519","url":null,"abstract":"<div><h3>Objective</h3><div>Pregnancy induces a state of cardiovascular stress and can lead to long-lasting effects irrespective of complications in pregnancy. However, the magnitude of these effects needs to be clarified. This study seeks to determine the prevalence of newly diagnosed essential hypertension within one year postpartum among the obstetric population who experienced uncomplicated pregnancies.</div></div><div><h3>Data sources</h3><div>A comprehensive search of the databases MEDLINE, Cochrane Central Register of Controlled Clinical Trials, EMBASE, Web of Science, and CINAHL was conducted for studies published up to March 2023.</div></div><div><h3>Study eligibility criteria</h3><div>Studies that assessed healthy individuals between 12 weeks and one year postpartum with newly diagnosed essential hypertension (≥140/90) and without pregnancy complications were included. Case studies, systematic reviews, and meta-analyses were excluded, along with studies involving pregnant patients who were either less than three months or more than one year postpartum, those with pre-existing hypertension or pregnancy complications, or those with pre-existing medical conditions.</div></div><div><h3>Study appraisal and synthesis methods</h3><div>Meta-analyses using random-effects models calculated pooled prevalence estimates and examined mean arterial pressure, systolic blood pressure, and diastolic blood pressure. Subgroup analyses considered the timing of blood pressure assessment, geographical location, and the presence of interventions.</div></div><div><h3>Results</h3><div>In eight studies with 3070 participants, the prevalence of newly diagnosed hypertension was 2.96% (95% confidence interval [CI], 1.15%–7.43%; I², 80%). No significant differences were observed in the subgroup analyses. Across 30 studies with 1782 individuals, the average systolic blood pressure was 109.88 mmHg (95% CI, 108–111.75; I², 92.2%), and diastolic blood pressure was 70.99 mmHg (95% CI, 68.84–73.14; I², 95.7%). In 12 studies with 339 individuals, the average mean arterial pressure was 82.01 mmHg (95% CI, 79.84–84.19; I², 93.6%).</div></div><div><h3>Conclusions</h3><div>These findings suggest that nearly 3 in 100 healthy individuals with uncomplicated pregnancies are diagnosed with de novo essential hypertension within one year postpartum. This underscores the need to extend cardiovascular screening to all postpartum individuals for one year, regardless of medical or pregnancy history.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100519"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480392","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":"Antenatal experiences of pregnant women with cardiac conditions: a systematic review and meta-synthesis","authors":"Jasmine X. Kiley BSc ,&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.2025.100522","DOIUrl":"10.1016/j.xagr.2025.100522","url":null,"abstract":"<div><h3>Objective</h3><div>Cardiovascular conditions are the leading cause of maternal mortality in high-income countries. We aim to inform supportive care that addresses the needs of pregnant women with cardiac conditions.</div></div><div><h3>Data Sources</h3><div>Medline via Ovid, Embase via Ovid, CINAHL via Ebsco, PsychINFO via Ebsco, Scopus, Web of Science Core Collection, and ASSIA via Proquest were searched, database inception-June 2024.</div></div><div><h3>Study Eligibility Criteria</h3><div>Studies with qualitative components describing experiences of pregnant women with any cardiac condition globally.</div></div><div><h3>Study Appraisal and Synthesis Methods</h3><div>The Critical Appraisal Skills Programme checklist for qualitative research was employed to perform quality assessment. Inductive coding and thematic analysis were conducted using NVivo software.</div></div><div><h3>Results</h3><div>Thirteen qualitative studies met the inclusion criteria for meta-synthesis. We identified 3 key themes pertaining to the pregnancy experience of women with cardiac conditions, including patient-provider risk perception matching, importance of communication, and peer influence. Women with established versus new cardiac diagnoses in pregnancy had differences in their experiences. Depending on their own perception of risk, women noted over-medicalization or dismissal by their providers. Our findings also showed that some women sought peer support through online support groups, which either provided a sense of community and hope, or were anxiety-inducing.</div></div><div><h3>Conclusions</h3><div>It is critical for women and providers to have nuanced and personalized discussions about the risk of cardiac conditions during pregnancy. Experience of pregnancy differs amongst women with new or pre-existing cardiac conditions and is based on women’s appraisal of their pregnancy’s risk level. Reaching an agreement in risk perception is crucial to strengthen the patient-provider relationship and provide a basis for women to feel secure during their pregnancy.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100522"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322263","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}