BJOG: An International Journal of Obstetrics & Gynaecology最新文献

{"title":"Impact of Aspirin on Timing of Birth in Pregnancies With Clinical Manifestations of Placental Dysfunction: Evidence From a Multicentre Randomised Clinical Trial.","authors":"Ioannis Papastefanou,Yunyu Chen,Long Nguyen-Hoang,Duy-Anh Nguyen,Linh Thuy Dinh,Ritsuko K Pooh,Arihiro Shiozaki,Mingming Zheng,Yali Hu,Yunping Wu,Aditya Kusuma,Piengbulan Yapan,Mahesh A Choolani,Mayumi Kaneko,Suchaya Luewan,Tung-Yao Chang,Noppadol Chaiyasit,Tongta Nanthakomon,Yanmin Jiang,Steven W Shaw,Wing Cheong Leung,Ainaa Syazana Mohamad,Angela Aguilar,So Ling Lau,Nikki M W Lee,Esther Wai Chi Tang,Daljit S Sahota,Marc K C Chong,Liona C Poon","doi":"10.1111/1471-0528.18211","DOIUrl":"https://doi.org/10.1111/1471-0528.18211","url":null,"abstract":"OBJECTIVETo examine whether aspirin delays gestational age at delivery (GAD) in pregnancies with placental dysfunction (PD) phenotypes (preeclampsia [PE], small-for-gestational-age [SGA], placental abruption and/or stillbirth).DESIGNA secondary analysis of a multicentre stepped-wedge cluster randomised trial.SETTING18 maternity/diagnostic units in Asia.POPULATIONSingleton pregnancies examined at 11-13+6 weeks.METHODSA model in which the effect of aspirin is to delay the GAD in pregnancies with PD was developed.MAIN OUTCOME MEASURESGAD in pregnancies with PD.RESULTSAspirin administration was associated with a significant reduction in PD < 32 weeks (adjusted relative risk 0.543, 95% CI: 0.330-0.864), with a trend for an increase of PD ≥ 32 weeks (test for trend, p-value = 0.0018). Similar findings were observed individually for PE, SGA and/or placental abruption. At 24 weeks, the aspirin-induced prolongation of pregnancies with PD was 2.85 weeks (95% CI: 0.44-5.40), and this effect was decreased by -0.19 weeks (95% CI: -0.33 to -0.05) for each week of gestation; therefore, at 28 and 32 weeks' gestation, the aspirin-induced prolongation was 2.09 and 1.33 weeks, respectively.CONCLUSIONSIn this secondary analysis of a cluster randomised trial, women at high risk of PE who are destined to develop a clinical spectrum of PD may benefit from longer pregnancy duration through aspirin administration in early pregnancy. Aspirin may delay the GAD due to PD, particularly benefiting those deliveries that would occur at earlier gestations without aspirin administration.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945302","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":"Psychological Distress, Post-Traumatic Stress and Emotional Suppression in a Pregnancy After a Perinatal Death: A Longitudinal Survey.","authors":"Joanna Beaumont,Debbie Smith,Emilie Bailey,Rebecca Barron,Emma Tomlinson,Alexander E P Heazell","doi":"10.1111/1471-0528.18212","DOIUrl":"https://doi.org/10.1111/1471-0528.18212","url":null,"abstract":"OBJECTIVETo evaluate parents' psychological distress and emotional suppression in the antenatal and postnatal periods of a pregnancy following a perinatal death.DESIGNQuestionnaire.SETTINGTertiary Maternity Unit in the UK.SAMPLEParents who were pregnant and attending a specialist antenatal clinic for pregnancy after loss.METHODSPartners and mothers completed questionnaire measures which evaluated their levels of depression, anxiety, post-traumatic stress (PTS) and emotional suppression at 23 and 32 weeks' gestation, and 6 weeks postnatally. Repeated measures ANOVA or Friedman tests were used to identify significant changes in scores. Independent samples t-tests or Mann-Whitney U tests were used to determine significant differences in partners' and mothers' group scores. The proportion of partners and mothers scoring above threshold for each measure was identified, and a one-sample t-test examined partners' and mothers' within-couple scores.MAIN OUTCOME MEASURESPsychological distress and emotional suppression.RESULTSFifty-one partners and 54 mothers completed the questionnaire. Partners', but not mothers', depression symptoms significantly decreased (p = 0.004; 95% CI 0.6-2.7) from 23 weeks' gestation (M = 11.32, SD = 5.35) to 32 weeks' gestation (M = 9.68, SD = 4.68). Mothers' depression symptoms significantly decreased (z = -3.91, p < 0.001) from 32 weeks gestation (median value of 13; IQR 8-17) to 6 weeks postnatal (median value of 10; IQR 5-13). Parents' anxiety levels did not change across the course of pregnancy. Mothers', but not partners', anxiety symptoms significantly decreased (z = -2.49, p = 0.013) from 32 weeks' gestation (median value of 7.5; IQR 4-14) to 6 weeks postnatal (median value of 6; IQR 2-13). PTS did not change across the course of a pregnancy, and mothers' symptoms continued into the postnatal period. Partners are more likely to hide their emotions during pregnancy than mothers (z = 3.35, p < 0.001).CONCLUSIONParents who have experienced a prior perinatal death are likely to experience symptoms of anxiety, depression and PTS in a subsequent pregnancy. Anxiety in partners and PTS in mothers may continue into the postnatal period. Specialist mental health support (e.g., counselling) offered within a dedicated pregnancy after loss service is one way to support parents. Further research is needed to determine whether psychological distress impacts negatively on parent-child bonding.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945190","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":"Misoprostol Versus Oxytocin for the Prevention of Postpartum Haemorrhage: A Systematic Review and Meta-Analysis Including Individual Participant Data.","authors":"Madeline Flanagan,Nicole Au,Malitha Patabendige,Arsheeya Rattan,Ritwik Samanta,Daljit Sahota,Enrique Teran,Vanita Jain,Abdulkarim O Musa,Munir'deen A Ijaiya,Daniel L Rolnik,Wentao Li,Ben W Mol","doi":"10.1111/1471-0528.18197","DOIUrl":"https://doi.org/10.1111/1471-0528.18197","url":null,"abstract":"BACKGROUNDPostpartum haemorrhage (PPH) is the leading cause of maternal mortality. Uterotonics are the mainstay of PPH prevention.OBJECTIVESTo compare the efficacy of misoprostol and oxytocin for the prevention of PPH and to evaluate the trustworthiness of these randomised controlled trials (RCTs).SEARCH STRATEGY AND SELECTION CRITERIASeven databases were searched for peer-reviewed literature meeting the inclusion criteria of RCTs comparing misoprostol and oxytocin for the prevention of PPH.DATA COLLECTION AND ANALYSISData were collected by two independent reviewers. Individual participant data (IPD) were meta-analysed for outcomes PPH ≥ 500 and ≥ 1000 mL. RCTs that did not share IPD were classified as trustworthy or not, and aggregate data were meta-analysed according to trustworthiness.MAIN RESULTSOf 79 eligible RCTs, 10 (12.7%) provided IPD, of which 6 were included. Analysis of IPD showed PPH ≥ 500 mL to be significantly higher in the misoprostol than in the oxytocin group (2022 participants, aOR 1.84, 95% CI 1.43-2.34). For PPH ≥ 1000 mL, analysis of IPD showed that misoprostol and oxytocin were comparable (2022 participants, OR 1.14, 95% CI 0.68-1.91). Of the 69 studies that did not provide IPD, 23 (33.3%) were assessed as trustworthy. Analysis of trustworthy data (IPD and 23 aggregate data RCTs) showed no difference between misoprostol and oxytocin for PPH ≥ 500 mL (24 334 participants, OR 1.01, 95% CI 0.69-1.49), while misoprostol was associated with a significantly increased risk of PPH ≥ 1000 mL compared to oxytocin (25 249 participants, OR 1.36, 95% CI 1.16-1.59).CONCLUSIONSOf 79 RCTs comparing misoprostol and oxytocin for the prevention of PPH, 36.7% met trustworthiness criteria. Oxytocin is comparable to misoprostol for preventing PPH and may be superior for preventing severe PPH.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945191","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":"Improve Health Equity Through Involving Stillbirth Parents in Research, Prevention and Care","authors":"","doi":"10.1111/1471-0528.18213","DOIUrl":"https://doi.org/10.1111/1471-0528.18213","url":null,"abstract":"<h2> Conflicts of Interest</h2>\u0000<p>The author declares no conflicts of interest.</p>","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932639","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":"Neutrophil-To-Lymphocyte Ratio and Delivery Within 24 h in Preterm Premature Rupture of Membranes: A Retrospective Cohort Study","authors":"Daniel Gabbai, Itamar Gilboa, Anat Lavie, Yariv Yogev, Emmanuel Attali","doi":"10.1111/1471-0528.18208","DOIUrl":"https://doi.org/10.1111/1471-0528.18208","url":null,"abstract":"To evaluate the association between maternal neutrophil-to-lymphocyte ratio (NLR) and delivery within 24 h in women with preterm premature rupture of membranes (PPROM).","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920650","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":"Towards the Development of a Conceptual Framework of the Determinants of Pre-eclampsia: A Hierarchical Systematic Review of Biomarkers","authors":"Terteel Elawad, Hiten D. Mistry, Mai-Lei Woo Kinshella, Marianne Vidler, Marie-Laure Volvert, Helen Elwell, Veronique Filippi, Kelly Pickerill, Rachel Craik, Joel Singer, Rosemary Townsend, Hannah Blencowe, Eleni Z. Tsigas, Jeffrey N. Bone, Peter von Dadelszen, Laura A. Magee","doi":"10.1111/1471-0528.18194","DOIUrl":"https://doi.org/10.1111/1471-0528.18194","url":null,"abstract":"Pre-eclampsia is a leading cause of maternal and perinatal morbidity and mortality. There are several determinants of individual pregnant women's risk of developing pre-eclampsia, including biomarkers and ultrasound markers.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143931077","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 Meta-Analysis: Anti-Inflammatory Medicinal Plants for Age-Related Menopause-Like Symptoms and Psychological Problems in Breast Cancer and Healthy Perimenopausal Women.","authors":"Fan Zhang,Dianhui Yang","doi":"10.1111/1471-0528.18209","DOIUrl":"https://doi.org/10.1111/1471-0528.18209","url":null,"abstract":"BACKGROUNDMedicinal plant supplements (MPS) have benefits in improving menopause-like symptoms (MLS).OBJECTIVESTo investigate the effectiveness of MPS in reducing MLS in healthy women and those with breast cancer (BC).SEARCH STRATEGYPubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang database and Chinese Scientific Journals Database were searched from the date of library construction until 30 January 2024.SELECTION CRITERIARandomised controlled trials were selected that involved healthy perimenopausal women, BC patients treated with herbal medicines, and the effects of plant-based compounds on MLS.DATA COLLECTION AND ANALYSISThe review included 12 studies with 917 patients with BC and 15 studies with 2104 healthy perimenopausal women. The data were analysed using the Meta-mar tool.MAIN RESULTSMPS improved Kupperman's Index (KMI) and menopause rating scale (MRS) scores compared with the comparator. Patients with BC experienced a greater reduction in KMI and MRS because of treatment than healthy perimenopausal women. Patients with BC had a more significant reduction in KMI than women who received hormone therapy. In both healthy perimenopausal women and women with BC, MPS treatment resulted in significantly higher response rates and fewer psychological problems. Women with BC experienced a decrease in anxiety and insomnia by MPS. Network analysis showed that the response rate was the factor most associated with MPS use.CONCLUSIONSAnti-inflammatory MPS may assist women with BC or healthy perimenopausal women experience less MLS.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"115 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143915090","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":"Propranolol may Increase the Effectiveness of Oxytocin In Vitro","authors":"Annie M. Dude","doi":"10.1111/1471-0528.18206","DOIUrl":"https://doi.org/10.1111/1471-0528.18206","url":null,"abstract":"<h2> Conflicts of Interest</h2>\u0000<p>The author declares no conflicts of interest.</p>","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143910852","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":"Pain Reduction in Linzagolix-Treated Patients With Uterine Fibroids: A Secondary Mediation Analysis of the PRIMROSE 1 and 2 Phase 3 Trials","authors":"Sven Becker, Marie-Madelaine Dolmans, Francisco Carmona Herrera, Felice Petraglia, Stefan P. Renner, Raluca Ionescu-Ittu, Julien St-Pierre, Mitra Boolell, Elke Bestel, Satoshi Hori, Jacques Donnez","doi":"10.1111/1471-0528.18190","DOIUrl":"https://doi.org/10.1111/1471-0528.18190","url":null,"abstract":"Among women with uterine fibroids (UFs), we assess the extent to which the linzagolix effect on pain alleviation is explained by its effect on reducing heavy menstrual bleeding (HMB) and fibroid volume (FV).","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"95 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143910853","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":"Predictive Value and Optimal Threshold of Follicle Size in IVF: Systematic Review and Multiple-Threshold Meta-Analysis.","authors":"Shuyue Zheng,Kai Zhu,Minyue Tang,Tianjing Wang,Xiaoling Liang,Xiaolu Xu,Jin Lin,Xuemei He,Haijie Gao,Yingying Shi,Bingbing Deng,Yaping Ye,Wanyi Xie,Jiahui Lin,Rongjuan Chen,Xiufang Gong,Ping Li,Guiquan Wang","doi":"10.1111/1471-0528.18203","DOIUrl":"https://doi.org/10.1111/1471-0528.18203","url":null,"abstract":"BACKGROUNDFollicle size was generally monitored during controlled ovarian stimulation, yet its predictive value for oocyte developmental potential and the discriminating threshold is debated.OBJECTIVESTo explore the predictive value of follicle size for oocyte developmental competency and establish the corresponding optimal threshold.SEARCH STRATEGYWe searched PubMed, Web of Science, EMBASE and Cochrane Library up to February 29th, 2024.SELECTION CRITERIAIncluded studies investigated the association between follicle size and oocyte developmental competency in IVF treatments.DATA COLLECTION AND ANALYSISData extraction followed the Cochrane Handbook. A multiple-threshold meta-analysis and standard bivariate meta-analysis were used.MAIN RESULTSThis meta-analysis included 14 studies comprising 25 528 follicles. Results showed follicle size is predictive for oocyte developmental competence, including oocyte maturity (area under the receiver operation characteristic curve [AUC]: 0.72, 95% confidence interval 0.66-0.77; n = 24 116; follicle size ≥ 15 mm), normal fertilisation (0.62, 0.55-0.69; n = 25 321; follicle size ≥ 16 mm), blastocyst formation (0.61, 0.53-0.69; n = 12 859; follicle size ≥ 15 mm) and good-quality embryo (0.64, 0.54-0.71; n = 16 631; follicle size ≥ 16 mm) per oocyte. Based on per mature oocyte or two-pronuclei zygote, follicle size showed little predictive capacity for embryological parameters.CONCLUSIONSFollicle size could predict oocyte developmental competence with corresponding optimal thresholds identified. However, the benefits for embryological fate may plateau at follicle sizes ≥ 15-16 mm once the oocytes achieve maturation or fertilisation.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914874","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}