Pub Date : 2026-03-01Epub Date: 2026-01-20DOI: 10.1016/j.jogc.2026.103209
Andi Camden PhD, MPH , Astrid Guttmann MDCM, MSc , Jonathan Zipursky MD, PhD
Objectives
To synthesize literature on the epidemiology of substance use in pregnancy, characteristics and risk factors associated with drug toxicity in pregnancy, and treatment of substance use in pregnancy.
Methods
We performed a narrative literature review. We searched PubMed, Google Scholar, and Google from inception to February 2024 using keywords and MeSH terms related to substance use, toxicity, risk factors, and pregnancy. We included English-language studies and focused on the most recent, Canadian studies (where available).
Results
First, we described the epidemiology of substance use in pregnancy, highlighted groups at disproportionately higher risk, reviewed drug toxicity contribution to perinatal deaths, risk factors for drug toxicity in pregnancy, treatment for substance use disorders in pregnancy, neonatal abstinence syndrome, and identified gaps in knowledge. Key findings include that rates of substance use in pregnancy have increased substantially over the past 2 decades in Canada. Drug toxicity in pregnancy is increasingly common, with nearly 1 in 4 pregnancy-associated deaths involving substance use. Opioids are involved in the majority of pregnancy-associated drug toxicity events; however, opioid use combined with stimulant and benzodiazepine use is increasing.
Conclusions
Comprehensive, individualized, and trauma-informed care is needed to address the complex health and social needs of people with substance use in pregnancy and their children.
{"title":"Substance Use and Toxicity Deaths in Pregnancy","authors":"Andi Camden PhD, MPH , Astrid Guttmann MDCM, MSc , Jonathan Zipursky MD, PhD","doi":"10.1016/j.jogc.2026.103209","DOIUrl":"10.1016/j.jogc.2026.103209","url":null,"abstract":"<div><h3>Objectives</h3><div>To synthesize literature on the epidemiology of substance use in pregnancy, characteristics and risk factors associated with drug toxicity in pregnancy, and treatment of substance use in pregnancy.</div></div><div><h3>Methods</h3><div>We performed a narrative literature review. We searched PubMed, Google Scholar, and Google from inception to February 2024 using keywords and MeSH terms related to substance use, toxicity, risk factors, and pregnancy. We included English-language studies and focused on the most recent, Canadian studies (where available).</div></div><div><h3>Results</h3><div>First, we described the epidemiology of substance use in pregnancy, highlighted groups at disproportionately higher risk, reviewed drug toxicity contribution to perinatal deaths, risk factors for drug toxicity in pregnancy, treatment for substance use disorders in pregnancy, neonatal abstinence syndrome, and identified gaps in knowledge. Key findings include that rates of substance use in pregnancy have increased substantially over the past 2 decades in Canada. Drug toxicity in pregnancy is increasingly common, with nearly 1 in 4 pregnancy-associated deaths involving substance use. Opioids are involved in the majority of pregnancy-associated drug toxicity events; however, opioid use combined with stimulant and benzodiazepine use is increasing.</div></div><div><h3>Conclusions</h3><div>Comprehensive, individualized, and trauma-informed care is needed to address the complex health and social needs of people with substance use in pregnancy and their children.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 3","pages":"Article 103209"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032650","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}
Pub Date : 2026-02-01Epub Date: 2026-02-12DOI: 10.1016/j.jogc.2025.103177
Marlon Danilewitz MD , Laura Freitag JD
{"title":"A Call to Action on Preventing Stillbirth and Supporting Families with Late Pregnancy Losses","authors":"Marlon Danilewitz MD , Laura Freitag JD","doi":"10.1016/j.jogc.2025.103177","DOIUrl":"10.1016/j.jogc.2025.103177","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 2","pages":"Article 103177"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189613","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}
The aim of this cross-sectional study was to examine trends in gendered language use in abstracts pertaining to obstetrics and gynaecology and use of language specific to the transgender population. Of 4.8 million MEDLINE records, 955 626 abstracts met inclusion criteria and were classified using a natural language processing analysis. A total of 59% contained gendered language, 0.03% transgender, and 40.6% gender-neutral. The proportion of obstetrics and gynecology abstracts containing gender-neutral and transgender language has rapidly increased. This shift may represent a response to journal policies on language, and the growing recognition of the applicability of “women’s” health to a broader population than cis-gendered women.
{"title":"Beyond “Women’s” Health: A Natural Language Processing Analysis of Trends in Gender-Neutral Language Use","authors":"Yann Guérin , Finlay Maguire PhD , Aisling Clancy MD, MPH , Jocelyn Stairs MD, MPH","doi":"10.1016/j.jogc.2025.103199","DOIUrl":"10.1016/j.jogc.2025.103199","url":null,"abstract":"<div><div>The aim of this cross-sectional study was to examine trends in gendered language use in abstracts pertaining to obstetrics and gynaecology and use of language specific to the transgender population. Of 4.8 million MEDLINE records, 955 626 abstracts met inclusion criteria and were classified using a natural language processing analysis. A total of 59% contained gendered language, 0.03% transgender, and 40.6% gender-neutral. The proportion of obstetrics and gynecology abstracts containing gender-neutral and transgender language has rapidly increased. This shift may represent a response to journal policies on language, and the growing recognition of the applicability of “women’s” health to a broader population than cis-gendered women.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 2","pages":"Article 103199"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835954","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}
Pub Date : 2026-02-01Epub Date: 2026-01-14DOI: 10.1016/j.jogc.2025.103200
Jenny Crick MSc
{"title":"Gendered Language in the Journal of Obstetrics and Gynaecology Canada","authors":"Jenny Crick MSc","doi":"10.1016/j.jogc.2025.103200","DOIUrl":"10.1016/j.jogc.2025.103200","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 2","pages":"Article 103200"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981004","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}
Pub Date : 2026-02-01Epub Date: 2025-11-29DOI: 10.1016/j.jogc.2025.103195
Francisca Ferreira MD , Marta Henriques Costa MD , Hélio Alves MD , Ana Rute Costa PhD , Joana Costa MD , Antónia Costa PhD
Objectives
To evaluate the effect of incisional negative pressure wound therapy (iNPWT) on surgical outcomes in patients undergoing wide vulvar surgical excision with simultaneous plastic reconstruction.
Methods
We conducted a single-centre retrospective cohort study at a São João Local Health Unit. The study included 21 patients diagnosed with vulvar malignancy who underwent wide vulvar surgical excision with immediate reconstruction with flaps between 2017 and 2024. Patients were divided into 2 groups based on postoperative wound management: the iNPWT group (N = 7), who received incisional negative pressure wound therapy, and the conventional care group (N = 14), submitted to standard wound management.
The study’s primary outcome was the occurrence of postoperative wound complications. Secondary outcomes assessed the occurrence of specific complications, such as wound infection, dehiscence, necrosis and hematoma, and length of hospital stay.
Results
Overall wound complications occurred in 12 cases of conventional care patients (85.7%) but in none of the iNPWT group patients (P < 0.001). Compared to those submitted to incisional negative pressure wound therapy, the conventional care group had significantly higher prevalence of wound dehiscence (0.0% vs. 64.3%, P = 0.007) and infection (0.0% vs. 78.6%, P = 0.001). There was no significant difference (P = 0.521) in the necrosis rate. Median hospital stay was similar between groups (21.00 vs. 25.50 days, P = 0.488).
Conclusions
Fewer postoperative complications were observed in the iNPWT group compared to the conventional care group, particularly wound dehiscence and infection. These findings suggest that iNPWT may be a valuable tool in improving surgical outcomes and reducing postoperative morbidity in patients undergoing wide vulvar surgical excisions.
目的：探讨切口负压创面治疗（iNPWT）对外阴大面积切除同时整形重建患者手术效果的影响。方法：我们在 o jo o地方卫生单位进行了一项单中心回顾性队列研究。该研究包括21名被诊断为外阴恶性肿瘤的患者，他们在2017年至2024年间接受了广泛的外阴手术切除并立即用皮瓣重建。根据术后创面处理将患者分为两组：iNPWT组（N = 7）采用切口负压创面治疗，常规护理组（N = 14）采用标准创面处理。该研究的主要结果是术后伤口并发症的发生。次要结局评估特定并发症的发生，如伤口感染、裂开、坏死和血肿，以及住院时间。结果：常规护理组有12例（85.7%）出现整体伤口并发症，而iNPWT组无一例（P < 0.001）。常规护理组创面裂开发生率（0.0%比64.3%,P = 0.007）和感染发生率（0.0%比78.6%,P = 0.001）明显高于切口负压治疗组。两组坏死率差异无统计学意义（P = 0.521）。两组住院时间中位数相似（21.00 vs 25.50天，P = 0.488）。结论：与常规护理组相比，iNPWT组术后并发症较少，尤其是伤口开裂和感染。这些发现表明，iNPWT可能是一个有价值的工具，在改善手术结果和减少术后发病率的患者接受外阴手术切除。
{"title":"The Role of Incisional Negative Pressure Wound Therapy in Vulvar Surgical Outcomes","authors":"Francisca Ferreira MD , Marta Henriques Costa MD , Hélio Alves MD , Ana Rute Costa PhD , Joana Costa MD , Antónia Costa PhD","doi":"10.1016/j.jogc.2025.103195","DOIUrl":"10.1016/j.jogc.2025.103195","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the effect of incisional negative pressure wound therapy (iNPWT) on surgical outcomes in patients undergoing wide vulvar surgical excision with simultaneous plastic reconstruction.</div></div><div><h3>Methods</h3><div>We conducted a single-centre retrospective cohort study at a São João Local Health Unit. The study included 21 patients diagnosed with vulvar malignancy who underwent wide vulvar surgical excision with immediate reconstruction with flaps between 2017 and 2024. Patients were divided into 2 groups based on postoperative wound management: the iNPWT group (N = 7), who received incisional negative pressure wound therapy, and the conventional care group (N = 14), submitted to standard wound management.</div><div>The study’s primary outcome was the occurrence of postoperative wound complications. Secondary outcomes assessed the occurrence of specific complications, such as wound infection, dehiscence, necrosis and hematoma, and length of hospital stay.</div></div><div><h3>Results</h3><div>Overall wound complications occurred in 12 cases of conventional care patients (85.7%) but in none of the iNPWT group patients (<em>P</em> < 0.001). Compared to those submitted to incisional negative pressure wound therapy, the conventional care group had significantly higher prevalence of wound dehiscence (0.0% vs. 64.3%, <em>P</em> = 0.007) and infection (0.0% vs. 78.6%, <em>P</em> = 0.001). There was no significant difference (<em>P</em> = 0.521) in the necrosis rate. Median hospital stay was similar between groups (21.00 vs. 25.50 days, <em>P</em> = 0.488).</div></div><div><h3>Conclusions</h3><div>Fewer postoperative complications were observed in the iNPWT group compared to the conventional care group, particularly wound dehiscence and infection. These findings suggest that iNPWT may be a valuable tool in improving surgical outcomes and reducing postoperative morbidity in patients undergoing wide vulvar surgical excisions.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 2","pages":"Article 103195"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650677","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}
Pub Date : 2026-02-01Epub Date: 2026-02-12DOI: 10.1016/j.jogc.2025.103178
Lynn Murphy-Kaulbeck MD, Msc, MMgmt
{"title":"Reply to Letter to the Editor: A Call to Compassionate Care for Pregnancy Loss","authors":"Lynn Murphy-Kaulbeck MD, Msc, MMgmt","doi":"10.1016/j.jogc.2025.103178","DOIUrl":"10.1016/j.jogc.2025.103178","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 2","pages":"Article 103178"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189612","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}
Pub Date : 2026-02-01Epub Date: 2025-11-29DOI: 10.1016/j.jogc.2025.103193
Christina Antinora MD, BSc , M. Anne Harris BSc(H), MSc, PhD , Claire Mazzia MSc , Anne Berndl MD, MSc
Objectives
Women comprise approximately 20% of all adults living with spinal cord injury (SCI), and incidence of SCI among women continues to increase annually. Despite the profound impact of SCI on women in their reproductive years, there is a paucity of literature on the unique health care needs and concerns in this population. We examined the health care experiences of these patients, spanning the preconception to postpartum period.
Methods
Data was obtained from a large online observational questionnaire examining reproductive health outcomes of people with SCI between 2019 and 2021. Overall, 167 women with pre-pregnancy SCI were surveyed across a total of 257 singleton pregnancies resulting in live birth. Quantitative and qualitative survey questions were statistically analyzed.
Results
Over half of respondents felt they had little to no access to informational resources about SCI in pregnancy, and over 34% requested a pre-pregnancy consultation with a health care provider. The most frequently reported positive experiences in the perinatal period revolved around feeling supported by their health care team and having access to specialized, knowledgeable obstetrical providers. The most frequently cited negative experiences were judgment by the health care team and physical accessibility issues in clinics and labour and delivery units. Postpartum, a minority of respondents indicated feeling stigmatized due to their SCI.
Conclusions
Women with SCI face unique challenges and concerns in interacting with the health care system during pregnancy and pregnancy planning. Understanding what health care providers are doing to foster and hinder a positive experience for these patients is the first step in creating a more supportive environment.
{"title":"Health Care Experiences of Patients With Spinal Cord Injury in the Preconception, Antepartum, and Postpartum Period","authors":"Christina Antinora MD, BSc , M. Anne Harris BSc(H), MSc, PhD , Claire Mazzia MSc , Anne Berndl MD, MSc","doi":"10.1016/j.jogc.2025.103193","DOIUrl":"10.1016/j.jogc.2025.103193","url":null,"abstract":"<div><h3>Objectives</h3><div>Women comprise approximately 20% of all adults living with spinal cord injury (SCI), and incidence of SCI among women continues to increase annually. Despite the profound impact of SCI on women in their reproductive years, there is a paucity of literature on the unique health care needs and concerns in this population. We examined the health care experiences of these patients, spanning the preconception to postpartum period.</div></div><div><h3>Methods</h3><div>Data was obtained from a large online observational questionnaire examining reproductive health outcomes of people with SCI between 2019 and 2021. Overall, 167 women with pre-pregnancy SCI were surveyed across a total of 257 singleton pregnancies resulting in live birth. Quantitative and qualitative survey questions were statistically analyzed.</div></div><div><h3>Results</h3><div>Over half of respondents felt they had little to no access to informational resources about SCI in pregnancy, and over 34% requested a pre-pregnancy consultation with a health care provider. The most frequently reported positive experiences in the perinatal period revolved around feeling supported by their health care team and having access to specialized, knowledgeable obstetrical providers. The most frequently cited negative experiences were judgment by the health care team and physical accessibility issues in clinics and labour and delivery units. Postpartum, a minority of respondents indicated feeling stigmatized due to their SCI.</div></div><div><h3>Conclusions</h3><div>Women with SCI face unique challenges and concerns in interacting with the health care system during pregnancy and pregnancy planning. Understanding what health care providers are doing to foster and hinder a positive experience for these patients is the first step in creating a more supportive environment.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 2","pages":"Article 103193"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650679","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}
Pub Date : 2026-02-01Epub Date: 2026-01-23DOI: 10.1016/j.jogc.2026.103221
Naana Jumah MD, FRCSC, Janet Christie, Victoria M. Allen MD, FRCPC, Bing Guthrie MD, FRCPC, Lisa Graves MD, CCFP (AM), Suzanne Turner MD, CCPF (AM), Jocelynn Cook PhD.
<div><h3>Objective</h3><div>To provide health care providers with the best evidence for using virtual models of care for pregnant or post-partum patients using substances.</div></div><div><h3>Target Population</h3><div>The target population includes all women with a history of substance use, current substance use disorder, or risk of substance use disorder during pregnancy or the post-partum period.</div></div><div><h3>Outcomes</h3><div>Improved access, engagement, and continuity of care for individuals affected by substance use during the perinatal period through the integration of virtual care models into clinical practice.</div></div><div><h3>Benefits, Harms, and Costs</h3><div>Virtual care offers enhanced accessibility, reduced stigma, and greater flexibility, particularly for underserved populations. However, challenges include variable access to technology, privacy concerns, and the need for provider training. The cost of implementing digital infrastructure may be offset by long-term improvements in maternal and neonatal outcomes.</div></div><div><h3>Evidence</h3><div>This technical update is based on a systematic review of current literature evaluating the effectiveness, acceptability, and feasibility of virtual care for substance use and substance use disorder in pregnancy. Studies covered clinical outcomes, patient engagement, provider experiences, and system-level considerations from 2015 to 2025.</div></div><div><h3>Validation Methods</h3><div>The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online <span><span>Appendix A</span></span> (<span><span>Tables A1</span></span> for definitions and <span><span>A2</span></span> for interpretations).</div></div><div><h3>Intended Audience</h3><div>All health care providers who care for pregnant and/or post-partum women.</div></div><div><h3>X Abstract</h3><div>Virtual care improves access to substance use treatment during pregnancy. Hybrid models of care reduce stigma, enhance engagement, and improve outcomes.</div></div><div><h3>Summary Statements</h3><div><ul><li><span>1.</span><span><div>Virtual care via telemedicine requires technologic and human resource infrastructure and training for clinicians and patients (<em>high</em>).</div></span></li><li><span>2.</span><span><div>Virtual care mitigates stigma and fear of judgment compared to in-person care, and improves access for geographically isolated patients, enhancing patient engagement (<em>moderate</em>).</div></span></li><li><span>3.</span><span><div>Virtual care is a complementary tool to in-person services for substance use disorders during pregnancy and postpartum, offering accessible and flexible care options to reduce disparities and improve access to multidisciplinary substance use disorder treatment within maternal healthcare (<em>moderate</em>).</div></span></li><li><span>4.</span><span><div>Many virtual care pla
{"title":"Technical Update No. 466: Virtual Care for Substance Use in Pregnancy and Post-Partum","authors":"Naana Jumah MD, FRCSC, Janet Christie, Victoria M. Allen MD, FRCPC, Bing Guthrie MD, FRCPC, Lisa Graves MD, CCFP (AM), Suzanne Turner MD, CCPF (AM), Jocelynn Cook PhD.","doi":"10.1016/j.jogc.2026.103221","DOIUrl":"10.1016/j.jogc.2026.103221","url":null,"abstract":"<div><h3>Objective</h3><div>To provide health care providers with the best evidence for using virtual models of care for pregnant or post-partum patients using substances.</div></div><div><h3>Target Population</h3><div>The target population includes all women with a history of substance use, current substance use disorder, or risk of substance use disorder during pregnancy or the post-partum period.</div></div><div><h3>Outcomes</h3><div>Improved access, engagement, and continuity of care for individuals affected by substance use during the perinatal period through the integration of virtual care models into clinical practice.</div></div><div><h3>Benefits, Harms, and Costs</h3><div>Virtual care offers enhanced accessibility, reduced stigma, and greater flexibility, particularly for underserved populations. However, challenges include variable access to technology, privacy concerns, and the need for provider training. The cost of implementing digital infrastructure may be offset by long-term improvements in maternal and neonatal outcomes.</div></div><div><h3>Evidence</h3><div>This technical update is based on a systematic review of current literature evaluating the effectiveness, acceptability, and feasibility of virtual care for substance use and substance use disorder in pregnancy. Studies covered clinical outcomes, patient engagement, provider experiences, and system-level considerations from 2015 to 2025.</div></div><div><h3>Validation Methods</h3><div>The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online <span><span>Appendix A</span></span> (<span><span>Tables A1</span></span> for definitions and <span><span>A2</span></span> for interpretations).</div></div><div><h3>Intended Audience</h3><div>All health care providers who care for pregnant and/or post-partum women.</div></div><div><h3>X Abstract</h3><div>Virtual care improves access to substance use treatment during pregnancy. Hybrid models of care reduce stigma, enhance engagement, and improve outcomes.</div></div><div><h3>Summary Statements</h3><div><ul><li><span>1.</span><span><div>Virtual care via telemedicine requires technologic and human resource infrastructure and training for clinicians and patients (<em>high</em>).</div></span></li><li><span>2.</span><span><div>Virtual care mitigates stigma and fear of judgment compared to in-person care, and improves access for geographically isolated patients, enhancing patient engagement (<em>moderate</em>).</div></span></li><li><span>3.</span><span><div>Virtual care is a complementary tool to in-person services for substance use disorders during pregnancy and postpartum, offering accessible and flexible care options to reduce disparities and improve access to multidisciplinary substance use disorder treatment within maternal healthcare (<em>moderate</em>).</div></span></li><li><span>4.</span><span><div>Many virtual care pla","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 2","pages":"Article 103221"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047708","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}
Pub Date : 2026-02-01Epub Date: 2026-01-23DOI: 10.1016/j.jogc.2026.103222
Naana Jumah MD, FRCSC, Janet Christie, Victoria M. Allen MD, FRCPC, Bing Guthrie MD, FRCPC, Lisa Graves MD, CCFP (AM), Suzanne Turner MD, CCPF (AM), Jocelynn Cook PhD.
<div><h3>Objectif</h3><div>Fournir aux professionnel·le·s de la santé les meilleures données probantes pour l'utilisation de modèles de soins virtuels pour les patientes enceintes ou en post-partum qui consomment des substances.</div></div><div><h3>Population cible</h3><div>La population cible comprend toutes les femmes ayant des antécédents de consommation de substances, souffrant actuellement d'un trouble lié à la consommation de substances ou présentant un risque de trouble lié à la consommation de substances pendant la grossesse ou la période post-partum.</div></div><div><h3>Résultats</h3><div>Amélioration de l'accès, de l'engagement et de la continuité des soins pour les personnes touchées par la consommation de substances pendant la période périnatale grâce à l'intégration de modèles de soins virtuels dans la pratique clinique.</div></div><div><h3>Avantages, inconvénients et coûts</h3><div>Les soins virtuels offrent une meilleure accessibilité, une réduction de la stigmatisation et une plus grande flexibilité, en particulier pour les populations défavorisées. Cependant, les défis à relever comprennent l'accès variable à la technologie, les préoccupations en matière de confidentialité et la nécessité de former les équipes cliniques. Le coût de la mise en place d'une infrastructure numérique peut être compensé par l'amélioration à long terme des résultats maternels et néonataux.</div></div><div><h3>Preuves</h3><div>Cette mise à jour technique est basée sur une revue systématique de la littérature actuelle évaluant l'efficacité, l'acceptabilité et la faisabilité des soins virtuels pour la consommation de substances et les troubles liés à la consommation de substances pendant la grossesse. Les études ont porté sur les résultats cliniques, l'engagement des patientes, les expériences des équipes cliniques et les considérations au niveau du système entre 2015 et 2025.</div></div><div><h3>Méthodes de validation</h3><div>Les auteurs ont évalué la qualité des preuves et la force des recommandations à l'aide de l'approche GRADE (Grading of Recommendations Assessment, Development and Evaluation). Voir l'<span><span>annexe A</span></span> (<span><span>tableaux A1</span></span> pour les définitions et <span><span>A2</span></span> pour les interprétations).</div></div><div><h3>Public visé</h3><div>Tout le professionnel·le·s de la santé qui s'occupent de femmes enceintes et/ou en post-partum.</div></div><div><h3>Résumé sur les réseaux sociaux</h3><div>Les soins virtuels améliorent l'accès au traitement de la toxicomanie pendant la grossesse. Les modèles de soins hybrides réduisent la stigmatisation, renforcent l'engagement dans le suivi des soins et à améliorer les résultats cliniques pour la mère et l’enfant.</div></div><div><h3>Déclarations Sommaires</h3><div><ul><li><span>1.</span><span><div>Les soins virtuels par télémédecine nécessitent une infrastructure technologique et des ressources humaines, ainsi qu'une formation pour les équipes cliniques et le
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