AJOG global reports最新文献

{"title":"Balancing religious obligations and cultural integration—female foreign Muslims’ healthcare experiences in Japan: a qualitative study","authors":"Ayako Kohno PhD ,&nbsp;Maznah Dahlui PhD ,&nbsp;Inge Dhamanti ,&nbsp;David Koh PhD ,&nbsp;Hanif Abdul Rahman PhD ,&nbsp;Takeo Nakayama PhD","doi":"10.1016/j.xagr.2025.100477","DOIUrl":"10.1016/j.xagr.2025.100477","url":null,"abstract":"<div><h3>Background</h3><div>When foreign Muslim women living in Japan seek healthcare, they may encounter some issues about their Islamic obligations. Their experiences are not well studied to date. This study aimed to describe the experiences of foreign Muslim women when receiving healthcare at clinics and hospitals in Japan.</div></div><div><h3>Materials and Methods</h3><div>This is a qualitative study using in-depth interviews with 28 foreign Muslim women from Indonesia and Malaysia who were living in Japan at the time of the study. Data were transcribed and phenomenological analysis was performed to describe their lived experiences.</div></div><div><h3>Result</h3><div>Three themes emerged: (1) meeting religious obligations as a female Muslim, (2) pregnancy and childbirth-related experiences, and (3) experiences of accessing healthcare in Japan.</div></div><div><h3>Conclusion</h3><div>Foreign Muslim women were not sure how to balance their religious obligations and culturally integrate into the Japanese healthcare system by conveying their needs and wishes to Japanese healthcare providers. The findings of this study may be useful for Japanese healthcare providers when interacting with foreign Muslim patients.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100477"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726275","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":"Depression and associated factors among human immunodeficiency virus-positive pregnant women in sub-Saharan Africa: systematic review and meta-analysis","authors":"Yeshiwas Ayale Ferede MPH ,&nbsp;Agerie Mengistie Zeleke MSc ,&nbsp;Getaw Wubie Assefa MSc ,&nbsp;Getanew Kegne Nigate MPH ,&nbsp;Worku Chekol Tassew MSc","doi":"10.1016/j.xagr.2025.100475","DOIUrl":"10.1016/j.xagr.2025.100475","url":null,"abstract":"<div><h3>Background</h3><div>Despite its severe impact on both maternal and fetal health, antenatal depression has not received as much attention in the healthcare community as postnatal depression. Comprehensive evidence is very important to suggest informed decisions and strategies to the Ministry of Health. Therefore, this study aims to estimate the pooled prevalence of depression and to identify associated factors among pregnant women living with human immunodeficiency virus (HIV)/AIDS in sub-Saharan Africa.</div></div><div><h3>Method</h3><div>Between May 15, 2024, and June 21, 2024, a systematic and thorough literature search was conducted using reputable electronic databases (PubMed, Cochrane Library) and web sources (Science Direct, African Journals Online, Google Scholar). The quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal checklist for analytical cross-sectional studies, which includes 9 criteria. Heterogeneity among the studies was examined using Cochrane's Q and <em>I</em>² statistics. A random-effects model was employed to compute the pooled estimate of depression among pregnant women living with HIV/AIDS.</div></div><div><h3>Result</h3><div>The initial database search yielded 39,000 articles. The pooled prevalence of depression among pregnant women living with HIV/AIDS in sub-Saharan Africa was estimated to be 39.86% (95% confidence interval [CI]: 34.89–44.83, <em>P</em>=.000). Factors associated with depression included experiencing intimate partner violence (pooled odd ratio [POR]=1.98; 95% CI: 1.56, 32.51), poor adherence to antiretroviral therapy (POR=2.16; 95% CI: 1.70, 2.74), and household food insecurity (POR=2.40; 95% CI: 1.69, 3.42).</div></div><div><h3>Conclusion</h3><div>Over one-third of pregnant women with HIV/AIDS experience depression, linked to factors like intimate partner violence, food insecurity, and poor adherence to antiretroviral therapy. Prioritize tailored mental health services and peer support groups. Increase education on intimate partner violence and implement nutritional support programs. Promote community initiatives and simplify ART regimens for improved health outcomes.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100475"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833153","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":"Socioeconomic risk factors and obstetric outcomes of adolescent pregnancies in Vietnam","authors":"Tam Duc Lam PhD ,&nbsp;Nhung Thi Tuyet Dau MD ,&nbsp;Thao-Ngan Nguyen Pham MD ,&nbsp;Bao Huy Le MD ,&nbsp;Loc Dac Pham MD ,&nbsp;Nghi Vinh Phan MD ,&nbsp;Thu Thi Nguyen MD ,&nbsp;Hung Tan Nguyen MD ,&nbsp;Phung Kim Quan MD ,&nbsp;Dien Thanh Doan MD ,&nbsp;Huong-Dung Thi Nguyen MD ,&nbsp;Thien Tan Tri Tai Truyen MD","doi":"10.1016/j.xagr.2025.100473","DOIUrl":"10.1016/j.xagr.2025.100473","url":null,"abstract":"<div><h3>Background</h3><div>Adolescent pregnancy remains a pressing concern in the Pacific and Southeast Asia, with birth rates of 51 and 43 per 1000 girls. Teenage mothers face a heightened risk of complications and mortality, while their newborns are more likely to experience challenges such as preterm birth, low birth weight, and poor Apgar scores. In Vietnam, however, evidence on this issue remains limited.</div></div><div><h3>Objective</h3><div>Our research aims to examine the socioeconomic characteristics and outcomes of adolescent pregnancy in Vietnam.</div></div><div><h3>Study Design</h3><div>We conducted a cross-sectional study recruiting pregnant women aged 10 to 19 hospitalized for delivery at Can Tho Gynecology Obstetrics Hospital from September 1st, 2022, to March 31, 2024. For reference, we established a cohort of pregnant women aged 20 to 34 years who presented at our hospital during the same study period. This cohort was randomly selected (1:1 ratio) and matched with our adolescent cohort based on the delivery date and parity. Primary outcomes included maternal and neonatal outcomes.</div></div><div><h3>Results</h3><div>Our final analysis included 432 adolescents and 432 adults with mean ages of 18.1±1.1 years and 26.7±3.7 years, respectively. Adolescent pregnancies were more likely to have disadvantageous sociodemographic backgrounds with limited resources, including ethnic minorities, rural residences, and low education. Adolescent individuals had lower prepregnancy weight (48 [43–53] kg vs 50 [46–55] kg, <em>P</em>&lt;.001) and BMI (19.2 [17.7–21.8] vs 20 [18.7–22], <em>P</em>&lt;.001) compared to adults. Their weight gain during pregnancy was also lower (12.8±5.2 kg vs 15.6±6.8 kg, <em>P</em>&lt;.001). Regarding comorbidities, adolescents had fewer chronic conditions (14.4% vs 34.3%, <em>P</em>&lt;.001). However, they tended to have a higher percentage of thyroid disease (1.6% vs 0.5%, <em>P</em>=.09) and anemia (5.6% vs 3.0%, <em>P</em>=.07) compared to adults. Adolescents experienced a higher percentage of maternal adverse outcomes (4.2% vs 1.6%, <em>P</em>=.03), particularly infection/sepsis (3.2% vs 1.2%, <em>P</em>=.04). Regarding indications for cesarean delivery, adolescents had a higher proportion of nonreassuring fetal status (56.3% vs 46.2%) and labor arrest (19.8% vs 11.6%) but lower percentages of fetal malpresentation (5.1% vs 24.9%) and cephalopelvic disproportion (10.2% vs 14.1%) compared to adults. Their newborns had higher rates of preterm birth (15.0% vs 7.2%, <em>P</em>&lt;.001), low birth weight (12.0% vs 6.3%, <em>P</em>&lt;.001), and a 1-minute Apgar score of less than 7 (3.9% vs 1.2%, <em>P</em>&lt;.001).</div></div><div><h3>Conclusion</h3><div>Adolescent pregnancies had more adverse maternal and neonatal outcomes than adult pregnancies. Further policies and studies are warranted to address socioeconomic disadvantages and develop specific pregnancy care standards for this group.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100473"},"PeriodicalIF":0.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726279","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":"An attractive alternative to prenatal diagnosis: a case report of preimplantation genetic testing in familial cardiomyopathy","authors":"Shubhra Pandey MBBS, DGO, FRM ,&nbsp;Parth Khandhedia MBBS, DGO","doi":"10.1016/j.xagr.2025.100476","DOIUrl":"10.1016/j.xagr.2025.100476","url":null,"abstract":"<div><div>Familial hypertrophic cardiomyopathy is an autosomal dominant familial inherited heart disease caused by mutations in the sarcomere protein that affects nearly 1 in 500 people. Genetic testing is of immense importance for familial inherited diseases. This study aimed to determine a way to allow couples with either partner or both partners with familial disease to achieve a healthy biological child. Preimplantation genetic testing for monogenic disorders of the embryos is a new technique that identifies the causative mutation in the genome of family members. The embryo trophectoderm is biopsied at the blastocyst stage of development. Subsequently, embryos are made via in vitro fertilization, and 6 to 8 cells are biopsied from the trophectoderm of the day 5 blastocyst. A couple in their early 20s consulted the hospital for preconceptional counseling for a second child. Their first child was a girl who had a heterozygous variant of chr7:128844078C&gt;T; (HET); c.3004C&gt;T; p.Arg1002Trp on Exon 20 with a gene transcript of filamin C (+) ENST00000 325888.13. Preconceptional pretest genetic counseling of the couple regarding the genetic aspects of the severity of the mutation and its inheritance was conducted. A heterozygous missense variation was present in the asymptomatic father, whereas the mother was normal. Posttest genetic counseling was conducted using a multidisciplinary approach, and the parents were informed about the clinical implications and the possibility of risk of transmission. Preimplantation genetic testing for monogenic disorders was performed, and 6 of 10 embryos were abnormal. A frozen-thawed embryo transfer was performed that resulted in a singleton pregnancy and the term delivery of a healthy male child. Genetic testing of embryos assists clinicians in managing couples at risk of transmission of serious genetic disorders. For couples with familial disease in either partner, medically assisted reproduction with preimplantation genetic testing for monogenic disorders is a promising strategy to achieve a healthy biological child.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100476"},"PeriodicalIF":0.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726280","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":"Exercise during pregnancy (frequency, intensity, type, time, volume): birth outcomes in women at risk of hypertensive disorders of pregnancy","authors":"Alex Claiborne PhD ,&nbsp;Breanna Wisseman MS ,&nbsp;Kara Kern MS ,&nbsp;Dylan Steen MS ,&nbsp;Filip Jevtovic MS ,&nbsp;Samantha Mcdonald PhD ,&nbsp;Cody Strom PhD ,&nbsp;Edward Newton MD ,&nbsp;James Devente MD ,&nbsp;Steven Mouro DO ,&nbsp;James Whiteside MD ,&nbsp;Jacqui Muhammad MD ,&nbsp;David Collier MD ,&nbsp;Devon Kuehn MD ,&nbsp;George A. Kelley ,&nbsp;Linda E. May PhD","doi":"10.1016/j.xagr.2025.100472","DOIUrl":"10.1016/j.xagr.2025.100472","url":null,"abstract":"<div><h3>Background</h3><div>Hypertensive disorders of pregnancy (HDP) hold negative health implications for mothers and offspring. While the beneficial influence of prenatal exercise on reducing HDP risk has been previously shown, there is a lack of specific information on the effect on birth outcomes in at-risk women, and in-depth analysis of appropriate exercise dose is lacking.</div></div><div><h3>Objective</h3><div>We aimed to elucidate the effects of exercise training FITT-V (frequency, intensity, type, time, volume) on hypertension and birth outcomes in pregnant women.</div></div><div><h3>Study Design</h3><div>This study is a retrospective, secondary analysis of pooled data from three blinded, prospective, randomized controlled trials. Women at risk of HDP (11 control, 27 exercise) were identified from the population and monitored in supervised exercise sessions throughout pregnancy. Upon delivery, birth measures were obtained. Pearson correlations and stepwise regressions determined associations. Tests for outcomes between exercise types were completed using one-way ANOVA.</div></div><div><h3>Results</h3><div>Women at risk of HDP with higher total exercise volume trended lower systolic blood pressure during pregnancy (<em>P</em>=.07). In at-risk women, total and weekly exercise volume were then associated with gestational age at birth (<em>R</em>=0.42, <em>P</em>=.03; <em>R</em>=0.46, <em>P</em>=.02) and increased birthweight (<em>R</em>=0.43, <em>P</em>=.03). Weekly exercise duration predicted birthweight (<em>P</em>=.02) independent of gestational age at birth.</div></div><div><h3>Conclusion</h3><div>The current findings add to a body of literature showing the beneficial influence of exercise during pregnancy on HDP risk, and importantly the effect on exposed offspring. Prenatal exercise improved birth outcomes in women with higher HDP risk in a dose-dependent manner, whereby higher exercise volume and duration are associated with improvements in birth outcomes.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100472"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726278","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":"Hypertensive pregnancy deaths: a three-year review at Ghana's largest referral hospital","authors":"Theodore K. Boafor ,&nbsp;Perez Sepenu FGCS ,&nbsp;Ama Tamatey ,&nbsp;Promise Sefogah ,&nbsp;Alim Swarray-Deen ,&nbsp;Naa Akushia Sepenu ,&nbsp;Kwadwo Asiedu ,&nbsp;Joshua Waliu Kamal ,&nbsp;Winfred K. Baah ,&nbsp;Emma Lawrence ,&nbsp;Jerry Coleman","doi":"10.1016/j.xagr.2025.100471","DOIUrl":"10.1016/j.xagr.2025.100471","url":null,"abstract":"<div><h3>Background</h3><div>Maternal mortality continues to be a significant public health challenge in sub-Saharan Africa. Even though the leading causes, such as hypertensive disorders in pregnancy and obstetric hemorrhage have remained unchanged, associated factors continue to significantly impact reduction efforts in the maternal mortality ratio. Despite efforts, Ghana's maternal mortality ratio has not significantly decreased since 2015, the end of the Millennium Development Goals (MDGs). To achieve Sustainable Development Goal (SDG) targets, it is essential to understand and focus on reducing deaths from leading causes such as hypertensive disorders of pregnancy and emerging associated factors that contribute to maternal mortality.</div></div><div><h3>Objective</h3><div>This study aimed to examine the contributors to maternal deaths related to hypertensive disorders at Korle Bu Teaching Hospital, Accra, Ghana.</div></div><div><h3>Study Design</h3><div>The study was a hospital-based retrospective review of 162 audited maternal deaths occurring at the Korle Bu Teaching Hospital from January 2021 to December 2023. Data was collected using a review of medical records and clinical notes of maternal deaths as well as maternal death audit reports. The direct and indirect causes of death were analyzed, with a focus on hypertensive disorders in pregnancy. Data on socio-demographic characteristics, parity, referral status, and length of hospital stay were extracted. Maternal mortality ratio and case fatality rates were calculated. Statistical analyses were conducted to compare hypertensive-related deaths with nonhypertensive maternal deaths.</div></div><div><h3>Results</h3><div>Hypertensive disorders in pregnancy accounted for 40.7% of all audited maternal deaths, decreasing from 52.2% in 2021 to 30.5% in 2023. Women aged 30 to 34 years had the highest number of deaths, while women over 45 had the highest maternal mortality ratio (1754.4 per 100,000 live births). Case fatality rates for hypertensive disorders decreased from 2.4% in 2021 to 1.5% in 2023. Lower parity (≤2) was associated with significantly higher mortality. Most women (77.3%) who died from hypertensive disorders were referred from other facilities. Length of hospital stay varied, with a majority of 40.9% staying seven or more days before death. The top four immediate causes of hypertensive-related maternal deaths were Eclampsia (43.9%), HELLP Syndrome (22.7%), Acute Kidney Injury (12.2%) and Pulmonary edema (9.1%).</div></div><div><h3>Conclusion</h3><div>Hypertensive disorders are a major cause of maternal mortality at Korle Bu Teaching Hospital. Despite declining case fatality rates, the burden of hypertensive-related deaths remains significant. Improved antenatal care, efficient referral systems, and better emergency obstetric care are essential to reducing maternal mortality.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100471"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681048","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":"Accuracy of ultrasound in prediction of abnormal placental adherence: a systematic review and meta-analysis","authors":"Ekramy A. Mohamed MD ,&nbsp;Ruqayyah Ali Ahmed MBBS ,&nbsp;Nada Yasser Metwali MBBS ,&nbsp;Jumana Hussain Timraz MBBS ,&nbsp;Ahmed Mohamed MBBS ,&nbsp;Hossam Abdelfatah Mansour MD","doi":"10.1016/j.xagr.2025.100467","DOIUrl":"10.1016/j.xagr.2025.100467","url":null,"abstract":"<div><h3>Background</h3><div>The accuracy of ultrasound in detecting invasive placentation, such as placenta accreta spectrum (PAS), remains a topic of debate. Accurate prenatal diagnosis is crucial to improve maternal outcomes, especially in women with high-risk factors..</div></div><div><h3>Objective</h3><div>This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of ultrasonography in predicting invasive placentation among at-risk pregnant women.</div></div><div><h3>Study Design</h3><div>A comprehensive search of multiple databases (MEDLINE, EMBASE, Cochrane Library, etc.) was conducted to identify studies assessing the diagnostic accuracy of ultrasound in detecting PAS. A total of 24 studies, including 1,509 high-risk pregnancies, met the inclusion criteria. Data on sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), and diagnostic odds ratio (DOR) were extracted and analyzed.</div></div><div><h3>Results</h3><div>The meta-analysis demonstrated that ultrasound has a high diagnostic performance, with a pooled sensitivity of 91.73% (95% CI: 88.3–94.7%) and specificity of 97.95% (95% CI: 97.4–98.6%). The DOR was 99.6 (95% CI: 49.9–200.1). Among ultrasound modalities, color Doppler showed the highest predictive accuracy with a sensitivity of 91.75% (95% CI: 86.3–95.6%) and specificity of 87.69% (95% CI: 85.7–91.5%).</div></div><div><h3>Conclusion</h3><div>Ultrasound, especially with the use of color Doppler, is highly effective in the prenatal diagnosis of PAS disorders in high-risk pregnancies. Early detection through ultrasound allows for better clinical management, reducing maternal morbidity by enabling planned interventions.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100467"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681045","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":"Using linked data to explore medical complications associated with Robson classification of cesarean deliveries in Massachusetts, 2011 to 2018","authors":"Ruby Barnard-Mayers MPH ,&nbsp;Eugene Declercq PhD ,&nbsp;Eleanor J. Murray ScD ,&nbsp;Tina D. Yarrington MD, FACOG ,&nbsp;Martha M. Werler DSc","doi":"10.1016/j.xagr.2025.100470","DOIUrl":"10.1016/j.xagr.2025.100470","url":null,"abstract":"<div><h3>Background</h3><div>Cesarean delivery rates in the United States far exceed the World Health Organization (WHO)’s recommended population cesarean rate of 15%. This has resulted in calls from experts to reduce cesarean delivery rates. However, crude cesarean delivery rates are not necessarily comparable across populations since different birthing populations have different distributions of underlying cesarean delivery risk factors. WHO recommends using the Robson classification system to compare standardized cesarean delivery rates across populations, though it has been rarely used within the U.S.</div></div><div><h3>Objective</h3><div>The objectives of this study were to understand the distribution of cesarean deliveries using the Robson Classification system and to identify associated conditions (and potential drivers) of cesarean delivery across Robson groups.</div></div><div><h3>Study Design</h3><div>Our data comes from the Pregnancy and Early Life Longitudinal Data System from the Massachusetts Department of Health, which contains all birth certificate records for Massachusetts from 2011 to 2018. Using the WHO Robson Classification System Implementation guide, we categorized births into one of its 10 categories based on data from birth certificate records and ICD-9 and ICD-10 codes from billing records. Using the linked birth certificate records and hospital discharge records we went beyond the Robson classifications and examined patterns in maternal comorbidities and labor and delivery complications of cesarean deliveries across Robson groups.</div></div><div><h3>Results</h3><div>Among the 25% of birthing people who had singleton, term, vertex births with spontaneous labor, the cesarean delivery rate was 15% for nulliparous and 3% for multiparous (with no prior cesarean). The prevalence of maternal risk factors was 28% in the former and 30% in the latter. Labor and delivery complications were present in 46% and 35% of births, respectively. Birthing people with breech or transverse fetal presentation had the highest cesarean delivery rates around 95%. Multiparous birthing people with a prior cesarean delivery and cephalic, singleton, term births were the largest contributor to the cesarean delivery rate (38% of all cesareans). Almost all births for malpresentation or malposition of fetus had at least one labor and delivery complication but much lower rates of risk factors (between 25% and 46%).</div></div><div><h3>Conclusion</h3><div>While cesarean delivery rates, maternal risk factors, and labor and delivery complications followed similar patterns across Robson groups, there were notable discrepancies, especially in births with noncephalic presentations where maternal comorbidity rates matched lower cesarean-risk groups like the nulliparous single-term cephalic births.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100470"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681046","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":"“I'm supposed to be a helper”: Spiritual distress of abortion providers after the Dobbs decision","authors":"Leah M Bode BS,&nbsp;Komal A Kumar MD,&nbsp;Josie C McQuillan BS,&nbsp;Nicole P Scott MD,&nbsp;Caitlin Bernard MD, MSCI","doi":"10.1016/j.xagr.2025.100469","DOIUrl":"10.1016/j.xagr.2025.100469","url":null,"abstract":"<div><h3>Background</h3><div>The <em>Dobbs v. Jackson Women's Health Organization</em> decision has undoubtably affected the practice of abortion providers nationally. We hypothesized that <em>Dobbs</em> has also impacted the ways in which providers experience meaning and purpose through their work, which are elements of spirituality.</div></div><div><h3>Objective</h3><div>We sought to describe the spectrum of spirituality of abortion providers and understand whether and how the <em>Dobbs</em> decision caused spiritual distress.</div></div><div><h3>Study Design</h3><div>For this qualitative study, we conducted video interviews with 26 abortion providers from 17 states between November 2022 and February 2023. States were classified according to the Guttmacher Institute classifications from most restrictive to very protective as of December 2022. Interviews included questions such as, <em>“Can you describe your own sense of spirituality or spiritual identity?”</em> and <em>“How does your spiritual belief inform your response to the</em> Dobbs <em>decision?”</em></div></div><div><h3>Results</h3><div>Participants’ states of practice were well-distributed across the abortion restrictive-protective spectrum. The majority of participants were spiritual, while less than half identified as part of an organized religion. Many participants felt a spiritual <em>call</em> or <em>obligation</em> to provide abortion care and 46% described abortion as a <em>spiritual act</em> for provider and/or patient. Most participants experienced spiritual distress (74%), including those practicing in states across the restrictive-protective spectrum. Of note, 92% of participants described their spirituality as helpful in coping with the effects of the fall of <em>Roe v. Wade</em>. Sources of strength included advocacy, agency, legislative work, and community; over half specifically cited the abortion provider community.</div></div><div><h3>Conclusions</h3><div>The <em>Dobbs</em> decision—and subsequent state-level abortion restrictions—impacts abortion providers by causing spiritual distress. While many abortion-restrictive laws are influenced by religious or spiritual beliefs, it is important to recognize that abortion providers are also spiritual individuals.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100469"},"PeriodicalIF":0.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620876","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":"Effect of different combinations of serum antimüllerian hormone levels and body mass index on pregnancy outcomes in women with polycystic ovary syndrome","authors":"Yue Niu MD ,&nbsp;Xinwei Han MD ,&nbsp;Huiying Xiao MD ,&nbsp;Ruolan Miao MD ,&nbsp;Gege Ouyang MD ,&nbsp;Qian Wang MD, PhD ,&nbsp;Daimin Wei MD, PhD","doi":"10.1016/j.xagr.2025.100461","DOIUrl":"10.1016/j.xagr.2025.100461","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Both antimüllerian hormone and body mass index are associated with the pregnancy outcomes in women with polycystic ovary syndrome undergoing in vitro fertilization.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to explore the effect of different combinations of antimüllerian hormone and body mass index on pregnancy outcomes in women with polycystic ovary syndrome undergoing in vitro fertilization.</div></div><div><h3>STUDY DESIGN</h3><div>This was a post hoc secondary analysis of a multicenter randomized trial. A total of 625 women from 1 center with antimüllerian hormone levels measured before in vitro fertilization treatment were classified into 6 groups: group A (normal weight and low antimüllerian hormone group), group B (normal weight and intermediate antimüllerian hormone group), group C (normal weight and high antimüllerian hormone group), group D (overweight/obese and low antimüllerian hormone group), group E (overweight/obese and intermediate antimüllerian hormone group), and group F (overweight/obese and high antimüllerian hormone group).</div></div><div><h3>RESULTS</h3><div>After adjustment via multivariate logistic regression, the overweight/obese and high antimüllerian hormone group (group F) had a higher risk of clinical pregnancy miscarriage (adjusted odds ratio, 3.30; 95% confidence interval, 1.35–8.07) than the normal weight and intermediate antimüllerian hormone group (group B). Both the normal weight and high antimüllerian hormone group (group C; adjusted odds ratio, 3.74; 95% confidence interval, 1.06–13.24) and the overweight/obese and high antimüllerian hormone group (group F; adjusted odds ratio, 3.61; 95% confidence interval, 1.05–12.38) had higher risks of ovarian hyperstimulation syndrome than the normal weight and intermediate antimüllerian hormone group (group B).</div></div><div><h3>CONCLUSION</h3><div>In women with polycystic ovary syndrome, high serum antimüllerian hormone levels were associated with an increased risk of clinical pregnancy miscarriage in women who were overweight/obese but not in those with normal weight.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100461"},"PeriodicalIF":0.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611034","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}