ANZJOG in 2024

Welcome to the 64th volume of the Australian and New Zealand Journal of Obstetrics and Gynaecology. We are now well into a new year which brings much work to progress for our Journal in 2024. It is my hope that during this year we will continue to grow ANZJOG as a leading source of clinically relevant scientific literature, providing guidance to those in clinical roles and driving the work of those undertaking research in obstetrics and gynaecology and related disciplines. I wish to diversify the ways in which our community interacts with our publication by providing content which is more accessible in an increasingly media-saturated world and to provide clinical context to the published research, allowing it to drive evidence-based practice at the bedside.

This issue features several invited editorials to draw attention to current topics of relevance to our field. In the first, a group of world-leading journal editors, led by Vincenzo Berghella, discuss the problem of trustworthiness in women's health and how to address it.¹ Poor experimental design, flawed statistical analysis, and deliberate research fraud, among other factors, contribute to erroneous conclusions being drawn from published research. This is not just of academic significance, with flawed studies contributing to inappropriate clinical practice, either in response to the individual studies themselves, to the systematic reviews and meta-analyses in which they are included, or to the clinical guidelines developed based on this evidence. Deliberate research misconduct is difficult to detect even with the most robust peer-review processes, but poor research design and statistical methodology errors can be reduced with appropriate research training and support, a task for those of us in senior academic positions to take on and implement.

Endometriosis remains a topical and potentially contentious issue, and Jason Abbott reflects on the Australian National Action Plan in his editorial discussing recent achievements and the remaining challenges in this area.² Endometriosis is a common and potentially debilitating condition which has traditionally been (and may continue to be) underdiagnosed or delayed in diagnosis due to societal expectations of what is normal, steeped in what was a misogynistic view of women's health. The National Action Plan aims to address the ongoing challenges in endometriosis care, and RANZCOG has key roles in the Plan, particularly in terms of evidence review, guideline development, and clinical implementation, all of which are currently in progress.

Kothari et al³ discuss the importance of considering fathers in maternity care, highlighting the important contributions paternal factors make to fertility, obstetric, perinatal, and longer-term offspring outcomes. This editorial also acknowledges the benefits from paternal involvement in maternity care and also the risks to the father from psychological morbidity related to witnessing obstetric complications and in the potentially stressful period of neonatal family transition. We have, quite rightly, placed the mother as a unique individual at the focal point of ‘woman-centred care’, and Kothari et al make the case for expanding this to include fathers in what could be termed ‘family-centred care’, acknowledging the special status of fathers in pregnancy and birth. It is also clear that such models should encompass and be individualised for those navigating pregnancy, birth, and parenthood in various personal circumstances such as single women and gender and sexually diverse couples rather than contribute to problematic heteronormativity.

This issue has several articles relating to public health and equitable access to health care. Lu et al discuss the barriers to screening for intimate partner violence in pregnancy.⁴ Thomas et al explore the healthcare experiences of LGBTQI individuals assigned female sex at birth, identifying barriers to accessing skilled and sensitive care for this group of the community with unique and varied healthcare needs.⁵ Blazé et al discuss the impact of parental smoking upon breastfeeding, identifying these offspring as doubly disadvantaged by the increased perinatal complications and the missed benefits of breastfeeding, both associated with parental smoking during and after pregnancy.⁶ Lai and Cohn assess the efficacy and safety of early medical abortion in regional primary care, an important body of work given the increasing use of medical approaches to early abortion and the recent Australian changes to mifepristone-misoprostol prescribing restrictions.⁷

Two articles explore educational interventions in obstetrics and gynaecology. The first, by Medeiros et al, evaluates the online adaptation of the successful IMPROVE program for the management of perinatal deaths.⁸ The second, by Obermair et al, reports a pilot trial of a surgical training program in total laparoscopic hysterectomy, providing important insights into the capacity to acquire new surgical skills outside of specialist or fellowship training positions.⁹

I trust that you will find these and the other articles interesting. I wish you all the best for a successful new year and look forward to your continued support of ANZJOG in 2024.

The author reports no conflicts of interest.