Pub Date : 2025-11-03DOI: 10.1016/j.jogc.2025.103169
Emily N. Liu BHSc , Rebecca Keller MN, NP , Qixuan Li MSc , Ella Huszti PhD , Nigel Pereira MD
A chorionic bump (CB) is an uncommon finding in early first-trimester obstetric ultrasounds. The current study estimates the prevalence of CB and investigates its association with early pregnancy loss. We included 2589 pregnancies over a 3-year period. The overall prevalence of CB was 1.1% (28/2589). There were no differences in baseline demographics, obstetric measurements, or mode of conception in patients with or without CB. The presence of CB was not associated with statistically significant odds of early pregnancy loss in the current cohort (unadjusted OR 1.4; 95% CI 0.5–3.7; adjusted OR 1.3; 95% CI 0.4–3.6).
绒毛膜肿块（CB）是一种罕见的发现在早期妊娠早期产科超声（Ob US）。目前的研究估计了CB的患病率，并调查了其与早期妊娠丢失（EPL）的关系。我们纳入了3年期间的2589例怀孕。总流行率为1.1%（28/2589）。在有或没有CB的患者中，基线人口统计学、产科测量或受孕方式没有差异。在当前队列中，CB的存在与EPL的发生率无统计学意义相关（未校正的比值比，OR 1.4; 95% CI 0.5-3.7；校正后的OR 1.3; 95% CI 0.4-3.6）。
{"title":"Chorionic Bump as a Marker for Early Pregnancy Loss: A Retrospective Cohort Study","authors":"Emily N. Liu BHSc , Rebecca Keller MN, NP , Qixuan Li MSc , Ella Huszti PhD , Nigel Pereira MD","doi":"10.1016/j.jogc.2025.103169","DOIUrl":"10.1016/j.jogc.2025.103169","url":null,"abstract":"<div><div>A chorionic bump (CB) is an uncommon finding in early first-trimester obstetric ultrasounds. The current study estimates the prevalence of CB and investigates its association with early pregnancy loss. We included 2589 pregnancies over a 3-year period. The overall prevalence of CB was 1.1% (28/2589). There were no differences in baseline demographics, obstetric measurements, or mode of conception in patients with or without CB. The presence of CB was not associated with statistically significant odds of early pregnancy loss in the current cohort (unadjusted OR 1.4; 95% CI 0.5–3.7; adjusted OR 1.3; 95% CI 0.4–3.6).</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 1","pages":"Article 103169"},"PeriodicalIF":2.2,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454516","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 : 2025-11-03DOI: 10.1016/j.jogc.2025.103171
Selina Tsz Ching Lee MBBS , Rebecca Siu Fan Wan MBBS , Shui Fan Lai MBBS , Jennifer Ka Yee Ko MBBS , Raymond Hang Wun Li MD , Ernest Hung Yu Ng MD
Objectives
This study aimed to evaluate the predictive performance of antral follicle count (AFC) and anti-Mullerian hormone (AMH) on ovarian response and pregnancy rate during ovarian stimulation using the progestin protocol during in vitro fertilization.
Methods
This retrospective study included 779 infertile patients who had their first in vitro fertilization cycle using the progestin-priming protocol between May 2022 and December 2023. All patients had a transvaginal ultrasound scan for AFC measurement and blood taken for AMH measurement before the start of ovarian stimulation for an in vitro fertilization cycle. The number of oocytes retrieved, high and poor ovarian responses, and pregnancy rates were evaluated.
Results
Both AFC and AMH were significantly correlated with the number of oocytes retrieved (r = 0.53, P < 0.001; r = 0.644, P < 0.001, respectively). Multivariable linear regression analysis showed that both AMH and AFC were significant predictors of the number of oocytes retrieved (B = 0.18, P < 0.001 and B = 0.012, P = 0.008, respectively). AMH, but not AFC, was found to be a significant predictor of high ovarian response (OR 1.461; 95% CI 1.305–1.636, P < 0.001) and poor ovarian response (OR 0.51; 95% CI 0.38–0.69, P < 0.001). The receiver operating characteristic curve analysis of AMH in predicting high and low ovarian response showed an area under the curve of 0.901 (95% CI 0.875–0.928) and 0.872 (95% CI 0.829–0.916), respectively. As for pregnancy, both AFC and AMH were not significant predictors.
Conclusions
Both AFC and AMH were significant predictors on the number of oocytes retrieved in the progestin-primed cycle, while AMH but not AFC predicted both high and poor ovarian response. Neither AMH nor AFC were predictive of pregnancy.
目的：本研究旨在评估使用黄体酮方案体外受精过程中卵泡计数（AFC）和抗苗勒管激素（AMH）对卵巢刺激反应和妊娠率的预测作用。方法：这项回顾性研究包括779名在2022年5月至2023年12月期间使用孕激素启动方案进行第一次体外受精周期的不孕症患者。所有患者在同一IVF周期卵巢刺激开始前均行阴道超声扫描测定AFC，并采血测定AMH。评估取卵数量、卵巢反应高低以及妊娠率。结果：AFC和AMH均与卵母细胞数量有显著相关性（r = 0.53, P < 0.001; r = 0.644, P < 0.001）。多变量线性回归分析显示，AMH和AFC均是取卵数的显著预测因子（B = 0.18, P < 0.001, B = 0.012, P = 0.008）。AMH是卵巢高反应（OR为1.461 [95%CI 1.305-1.636], P < 0.001）和卵巢低反应（OR为0.51 [95%CI 0.38-0.69], P < 0.001）的重要预测因子，而非AFC。AMH预测卵巢高、低反应的受试者工作特征曲线分析显示，曲线下面积分别为0.901 （95% CI 0.875 ~ 0.928）和0.872 （95% CI 0.829 ~ 0.916）。对于妊娠，AFC和AMH均不是显著的预测因子。结论：AFC和AMH均是孕激素启动周期中取卵细胞数量的显著预测因子，而AMH而非AFC均能预测卵巢高反应和低反应。AMH和AFC都不能预测怀孕。
{"title":"Predictive Value of Antral Follicle Count and Anti-Mullerian Hormone on Ovarian Response and Pregnancy Rates in Progestin-Primed Cycle for IVF","authors":"Selina Tsz Ching Lee MBBS , Rebecca Siu Fan Wan MBBS , Shui Fan Lai MBBS , Jennifer Ka Yee Ko MBBS , Raymond Hang Wun Li MD , Ernest Hung Yu Ng MD","doi":"10.1016/j.jogc.2025.103171","DOIUrl":"10.1016/j.jogc.2025.103171","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the predictive performance of antral follicle count (AFC) and anti-Mullerian hormone (AMH) on ovarian response and pregnancy rate during ovarian stimulation using the progestin protocol during in vitro fertilization.</div></div><div><h3>Methods</h3><div>This retrospective study included 779 infertile patients who had their first in vitro fertilization cycle using the progestin-priming protocol between May 2022 and December 2023. All patients had a transvaginal ultrasound scan for AFC measurement and blood taken for AMH measurement before the start of ovarian stimulation for an in vitro fertilization cycle. The number of oocytes retrieved, high and poor ovarian responses, and pregnancy rates were evaluated.</div></div><div><h3>Results</h3><div>Both AFC and AMH were significantly correlated with the number of oocytes retrieved (r = 0.53, <em>P</em> < 0.001; r = 0.644, <em>P</em> < 0.001, respectively). Multivariable linear regression analysis showed that both AMH and AFC were significant predictors of the number of oocytes retrieved (B = 0.18, <em>P</em> < 0.001 and B = 0.012, <em>P</em> = 0.008, respectively). AMH, but not AFC, was found to be a significant predictor of high ovarian response (OR 1.461; 95% CI 1.305–1.636, <em>P</em> < 0.001) and poor ovarian response (OR 0.51; 95% CI 0.38–0.69, <em>P</em> < 0.001). The receiver operating characteristic curve analysis of AMH in predicting high and low ovarian response showed an area under the curve of 0.901 (95% CI 0.875–0.928) and 0.872 (95% CI 0.829–0.916), respectively. As for pregnancy, both AFC and AMH were not significant predictors.</div></div><div><h3>Conclusions</h3><div>Both AFC and AMH were significant predictors on the number of oocytes retrieved in the progestin-primed cycle, while AMH but not AFC predicted both high and poor ovarian response. Neither AMH nor AFC were predictive of pregnancy.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 1","pages":"Article 103171"},"PeriodicalIF":2.2,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454535","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 : 2025-10-31DOI: 10.1016/j.jogc.2025.103166
Iwona Gawron PhD, MD , Milosz Pietrus PhD, MD , Andrzej Zmaczynski MD , Robert Jach PhD, MD
Objectives
To compare the treatment outcomes of cesarean scar pregnancy (CSP) using a combined pharmacological and surgical approach with and without adjunct letrozole.
Methods
All women received 100 mg of methotrexate intravenously and 50 mg intra-amniotically. The intervention group also received 5 mg of letrozole orally for 10 days. After decreased CSP viability, hysteroscopic evacuation of trophoblastic remnants was performed. Biochemical indicators of efficacy and complications of pharmacotherapy, time interval to surgery, intraoperative blood loss, complications, and subsequent obstetric outcomes were compared across both study arms.
Results
Among 28 women, 16 received letrozole, whereas 12 received only methotrexate. There were no significant differences in serum β-human chorionic gonadotropin (β-hCG), hemoglobin, renal and liver parameters on days 0, 4, and 7 or in intraoperative blood loss, decrease in postoperative hemoglobin, red blood cell concentrate units transfused, uterine tamponade, complications, or obstetric outcomes. The day 0 β-hCG concentration correlated positively with postoperative hemoglobin reduction (P = 0.007), blood loss (P < 0.001), red blood cell concentrate units transfused (P = 0.012), and risk of uterine perforation or hemorrhage (P = 0.043). Cases with a positive fetal heartbeat experienced significantly greater blood loss (P = 0.019) and a higher number of red blood cell concentrate units transfused (P = 0.033).
Conclusions
The incorporation of letrozole in the studied regimen did not impact the final end points. The significant factors influencing intraoperative blood loss and complications were the initial concentration of β-hCG and the presence of a fetal heartbeat. Combined treatment of CSP with methotrexate, followed by hysteroscopy, is a safe method that ensures effective treatment while preserving the uterus.
{"title":"The Effectiveness of Letrozole Adjunct in the Combined Pharmacological and Surgical Treatment of Cesarean Scar Pregnancy: A Prospective Cohort Study","authors":"Iwona Gawron PhD, MD , Milosz Pietrus PhD, MD , Andrzej Zmaczynski MD , Robert Jach PhD, MD","doi":"10.1016/j.jogc.2025.103166","DOIUrl":"10.1016/j.jogc.2025.103166","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare the treatment outcomes of cesarean scar pregnancy (CSP) using a combined pharmacological and surgical approach with and without adjunct letrozole.</div></div><div><h3>Methods</h3><div>All women received 100 mg of methotrexate intravenously and 50 mg intra-amniotically. The intervention group also received 5 mg of letrozole orally for 10 days. After decreased CSP viability, hysteroscopic evacuation of trophoblastic remnants was performed. Biochemical indicators of efficacy and complications of pharmacotherapy, time interval to surgery, intraoperative blood loss, complications, and subsequent obstetric outcomes were compared across both study arms.</div></div><div><h3>Results</h3><div>Among 28 women, 16 received letrozole, whereas 12 received only methotrexate. There were no significant differences in serum β-human chorionic gonadotropin (β-hCG), hemoglobin, renal and liver parameters on days 0, 4, and 7 or in intraoperative blood loss, decrease in postoperative hemoglobin, red blood cell concentrate units transfused, uterine tamponade, complications, or obstetric outcomes. The day 0 β-hCG concentration correlated positively with postoperative hemoglobin reduction (<em>P</em> = 0.007), blood loss (<em>P</em> < 0.001), red blood cell concentrate units transfused (<em>P</em> = 0.012), and risk of uterine perforation or hemorrhage (<em>P</em> = 0.043). Cases with a positive fetal heartbeat experienced significantly greater blood loss (<em>P</em> = 0.019) and a higher number of red blood cell concentrate units transfused (<em>P</em> = 0.033).</div></div><div><h3>Conclusions</h3><div>The incorporation of letrozole in the studied regimen did not impact the final end points. The significant factors influencing intraoperative blood loss and complications were the initial concentration of β-hCG and the presence of a fetal heartbeat. Combined treatment of CSP with methotrexate, followed by hysteroscopy, is a safe method that ensures effective treatment while preserving the uterus.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 12","pages":"Article 103166"},"PeriodicalIF":2.2,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427290","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 : 2025-10-27DOI: 10.1016/j.jogc.2025.103165
Romina Levy MD , Sarah Coad MD , Jason Burrows MD
Objectives
To assess obstetrical and neonatal outcomes associated with isolated fetal intra-abdominal umbilical vein varix and review relevant literature.
Methods
A retrospective population-based review of singleton pregnancies with isolated fetal intra-abdominal vein varix between 2004 and 2020 at 3 tertiary centres was conducted. Outcomes included intrauterine fetal demise, varix ultrasound characteristics, and obstetrical and neonatal outcomes. Descriptive statistics were used for analysis.
Results
Among 85 cases of isolated umbilical vein varix, no fetal demise was observed. Median gestational age at diagnosis of varix was 323 weeks (IQR 201–340). Median varix diameter at diagnosis was 11 mm (IQR 10–13), and maximum diameter was 12 mm (IQR 11–14). Nine cases (10.59%) had an abdominal circumference <10th percentile. Induction of labour was initiated in 54 (63.5%) cases, with varix as primary indication in 35 (64.81%). Median age at delivery was 374 weeks (IQR 370–381), with 11 (12.64%) cases of preterm birth <370 weeks (none due to abnormal fetal monitoring). Median neonatal birthweight was 2975 grams (IQR 2674–3378), and 9 (11.11%) newborns underwent neonatal intensive care unit admission, none related to umbilical vein varix.
Conclusions
Our findings are consistent with recent studies demonstrating a favourable prognosis for isolated fetal intra-abdominal umbilical vein varix. In our literature review, of 511 cases of isolated umbilical vein varix, there were 11 cases of fetal demise (2.15%). In our study population, we did not observe any demise. As the largest Canadian cohort, these findings are extremely valuable in counselling patients with this rare diagnosis and support current recommendations for work-up and surveillance.
目的：评价孤立胎儿腹腔内脐静脉曲张的产科和新生儿结局，并回顾相关文献。方法：对2004年至2020年在三个三级中心进行的单胎妊娠孤立胎儿腹内静脉曲张的回顾性人群分析。结果包括宫内胎儿死亡、静脉曲张超声特征、产科和新生儿结局。采用描述性统计进行分析。结果：85例孤立性脐静脉曲张无死胎。静脉曲张诊断时的中位胎龄为323周（IQR 201-340）。诊断时中位静脉曲张直径为11 mm (IQR 10-13)，最大直径为12 mm （IQR 11-14）。9例（10.59%）腹部围为百分位。54例（63.5%）采用引产术，35例（64.81%）采用静脉曲张作为主要指征。中位分娩年龄为374周（IQR 370-381），早产11例（12.64%）。结论：我们的发现与最近的研究一致，表明孤立性胎儿腹腔内脐静脉曲张预后良好。在我们的文献回顾中，511例孤立性脐静脉曲张中有11例胎儿死亡（2.15%）。在我们的研究人群中，我们没有观察到任何死亡。作为加拿大最大的队列研究，这些发现在为患有这种罕见诊断的患者提供咨询方面非常有价值，并支持当前的检查和监测建议。
{"title":"Isolated Fetal Intra-Abdominal Umbilical Vein Varix: A Retrospective Review of Perinatal Outcomes and Review of the Literature","authors":"Romina Levy MD , Sarah Coad MD , Jason Burrows MD","doi":"10.1016/j.jogc.2025.103165","DOIUrl":"10.1016/j.jogc.2025.103165","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess obstetrical and neonatal outcomes associated with isolated fetal intra-abdominal umbilical vein varix and review relevant literature.</div></div><div><h3>Methods</h3><div>A retrospective population-based review of singleton pregnancies with isolated fetal intra-abdominal vein varix between 2004 and 2020 at 3 tertiary centres was conducted. Outcomes included intrauterine fetal demise, varix ultrasound characteristics, and obstetrical and neonatal outcomes. Descriptive statistics were used for analysis.</div></div><div><h3>Results</h3><div>Among 85 cases of isolated umbilical vein varix, no fetal demise was observed. Median gestational age at diagnosis of varix was 32<sup>3</sup> weeks (IQR 20<sup>1</sup>–34<sup>0</sup>). Median varix diameter at diagnosis was 11 mm (IQR 10–13), and maximum diameter was 12 mm (IQR 11–14). Nine cases (10.59%) had an abdominal circumference <10th percentile. Induction of labour was initiated in 54 (63.5%) cases, with varix as primary indication in 35 (64.81%). Median age at delivery was 37<sup>4</sup> weeks (IQR 37<sup>0</sup>–38<sup>1</sup>), with 11 (12.64%) cases of preterm birth <37<sup>0</sup> weeks (none due to abnormal fetal monitoring). Median neonatal birthweight was 2975 grams (IQR 2674–3378), and 9 (11.11%) newborns underwent neonatal intensive care unit admission, none related to umbilical vein varix.</div></div><div><h3>Conclusions</h3><div>Our findings are consistent with recent studies demonstrating a favourable prognosis for isolated fetal intra-abdominal umbilical vein varix. In our literature review, of 511 cases of isolated umbilical vein varix, there were 11 cases of fetal demise (2.15%). In our study population, we did not observe any demise. As the largest Canadian cohort, these findings are extremely valuable in counselling patients with this rare diagnosis and support current recommendations for work-up and surveillance.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 1","pages":"Article 103165"},"PeriodicalIF":2.2,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403672","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 : 2025-10-24DOI: 10.1016/j.jogc.2025.103161
Annabel K. Gravely BSc, Lori A. Brotto PhD
This communication examines the experience of menstruation and menopause, and the influence of gender identity. Gender affirming hormone therapy and sociocultural contributors in healthcare pose unique challenges for transgenderi and non-binaryii persons in the context of menstruation and menopause. Moreover, gender diverseiii persons experience a higher prevalence of chronic pelvic pain, and barriers to diagnosis of endometriosis and pre-menstrual dysphoric disorder. While there is much discussion surrounding menopause hormone therapy, there has been inadequate attention to this topic in the context of gender-diverse experiences. Here we provide clinical and research recommendations for a treatment approach in this population.
{"title":"The Non-Cisgender Experience of Menstruation and Menopause: Literature Review and Recommendations","authors":"Annabel K. Gravely BSc, Lori A. Brotto PhD","doi":"10.1016/j.jogc.2025.103161","DOIUrl":"10.1016/j.jogc.2025.103161","url":null,"abstract":"<div><div>This communication examines the experience of menstruation and menopause, and the influence of gender identity. Gender affirming hormone therapy and sociocultural contributors in healthcare pose unique challenges for transgender<span><span><sup>i</sup></span></span> and non-binary<span><span><sup>ii</sup></span></span> persons in the context of menstruation and menopause. Moreover, gender diverse<span><span><sup>iii</sup></span></span> persons experience a higher prevalence of chronic pelvic pain, and barriers to diagnosis of endometriosis and pre-menstrual dysphoric disorder. While there is much discussion surrounding menopause hormone therapy, there has been inadequate attention to this topic in the context of gender-diverse experiences. Here we provide clinical and research recommendations for a treatment approach in this population.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 1","pages":"Article 103161"},"PeriodicalIF":2.2,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145570896","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 : 2025-10-24DOI: 10.1016/j.jogc.2025.103162
Jessica Ramia BSc , Helena Piccinini-Vallis MD, PhD, CCFP
Objectives
Prenatal anxiety affects 10%–20% of pregnant Canadians and is linked to adverse maternal and neonatal outcomes. This study aimed to determine the prevalence of reported prenatal anxiety among primigravid persons with singleton pregnancies in Nova Scotia from 2004 to 2023 and explore potential predictors of reported prenatal anxiety, including birth year group, age, partner status, education level, pre-pregnancy BMI, smoking, and cannabis use.
Methods
A retrospective cohort study was conducted using the Nova Scotia Atlee Prenatal Database. The study sample consisted of 53 852 primigravid persons with singleton pregnancies.
Results
The overall prevalence of reported prenatal anxiety was 8.9%, rising significantly over time (χ2 = 3513.5(3), P < 0.001) from 1.2% in the 2004-2008 period to 21.8% in the 2019–2023 period. The bivariate analyses showed significant associations between reported anxiety and all variables. In the adjusted logistic regression, the absence of a partner, lower education level, BMI ≥30.0 kg/m2, smoking, and cannabis use were all independent predictors of reported prenatal anxiety, collectively explaining 17.5% of variance.
Conclusions
Reported prenatal anxiety among primigravid persons in Nova Scotia increased markedly over 2 decades and is associated with multiple sociodemographic factors. These findings highlight the importance of targeted screening and interventions to support pregnant persons at risk of prenatal anxiety.
目的产前焦虑影响了10%-20%的加拿大孕妇，并与孕产妇和新生儿的不良结局有关。本研究旨在确定2004年至2023年新斯科舍省单胎妊娠初孕者中报告的产前焦虑的患病率，并探讨报告产前焦虑的潜在预测因素，包括出生年份、年龄、伴侣状况、教育水平、孕前BMI、吸烟和大麻使用。方法采用新斯科舍省阿特利产前数据库进行回顾性队列研究。研究样本包括53 852名单胎妊娠的原孕妇女。结果报告的产前焦虑总体患病率为8.9%，随着时间的推移显著上升（χ2 = 3513.5(3), P < 0.001），从2004-2008年的1.2%上升到2019-2023年的21.8%。双变量分析显示，报告的焦虑与所有变量之间存在显著关联。在调整后的logistic回归中，缺少伴侣、低教育水平、BMI≥30.0 kg/m2、吸烟和大麻使用都是报告的产前焦虑的独立预测因素，共同解释了17.5%的方差。结论新斯科舍省初产妇的产前焦虑在过去20年中显著增加，并与多种社会人口因素有关。这些发现强调了有针对性的筛查和干预措施对支持有产前焦虑风险的孕妇的重要性。
{"title":"The Prevalence and Predictors of Reported Prenatal Anxiety Among Primigravid Individuals in Nova Scotia","authors":"Jessica Ramia BSc , Helena Piccinini-Vallis MD, PhD, CCFP","doi":"10.1016/j.jogc.2025.103162","DOIUrl":"10.1016/j.jogc.2025.103162","url":null,"abstract":"<div><h3>Objectives</h3><div>Prenatal anxiety affects 10%–20% of pregnant Canadians and is linked to adverse maternal and neonatal outcomes. This study aimed to determine the prevalence of reported prenatal anxiety among primigravid persons with singleton pregnancies in Nova Scotia from 2004 to 2023 and explore potential predictors of reported prenatal anxiety, including birth year group, age, partner status, education level, pre-pregnancy BMI, smoking, and cannabis use.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using the Nova Scotia Atlee Prenatal Database. The study sample consisted of 53 852 primigravid persons with singleton pregnancies.</div></div><div><h3>Results</h3><div>The overall prevalence of reported prenatal anxiety was 8.9%, rising significantly over time (χ<sup>2</sup> = 3513.5(3), <em>P</em> < 0.001) from 1.2% in the 2004-2008 period to 21.8% in the 2019–2023 period. The bivariate analyses showed significant associations between reported anxiety and all variables. In the adjusted logistic regression, the absence of a partner, lower education level, BMI ≥30.0 kg/m<sup>2</sup>, smoking, and cannabis use were all independent predictors of reported prenatal anxiety, collectively explaining 17.5% of variance.</div></div><div><h3>Conclusions</h3><div>Reported prenatal anxiety among primigravid persons in Nova Scotia increased markedly over 2 decades and is associated with multiple sociodemographic factors. These findings highlight the importance of targeted screening and interventions to support pregnant persons at risk of prenatal anxiety.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 12","pages":"Article 103162"},"PeriodicalIF":2.2,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526745","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 : 2025-10-24DOI: 10.1016/j.jogc.2025.103163
Rebeca C. Urizar BA , Light Uchechukwu BA , Kyla F. Wiens BA , Kaeley M. Simpson MA , Bhavya Arora BA , Tia Alsaidi BA , Patricia Furer PhD , Gillian M. Alcolado PhD , Leslie Roos PhD , Kristin A. Reynolds PhD
Objectives
Despite the increasing prevalence of anxiety in the perinatal period, limited access to providers and mental health services continues to prevent affected persons from receiving necessary support. Peer support programs may provide timely, accessible support by connecting persons with others who share lived experiences. This study aimed to identify and examine perinatal peer support programs available in Canada, with particular focus on those addressing perinatal anxiety.
Methods
We conducted an online environmental scan to identify and examine existing peer support programs available in Canada for persons experiencing perinatal anxiety. Websites were screened according to the inclusion and exclusion criteria, and eligible programs were analyzed for core components such as cost, delivery format, duration, targeted outcomes, and evidence of evaluation.
Results
The scan identified 180 websites, of which 8 met the inclusion criteria. Overall, the scan revealed a lack of readily available peer support programs specifically for perinatal anxiety. Program characteristics varied: several were delivered virtually, most were free or offered low-cost options, and few specified durations. Only 1 program reported undergoing scientific evaluation, and none included participant testimonials.
Conclusions
Findings highlight the limited availability of perinatal peer support programs in Canada, particularly those targeting perinatal anxiety. Expanding accessible, evidence-based peer support tailored to this population offers a meaningful way to strengthen perinatal mental health services while emphasizing the need for continued program development and broader availability.
{"title":"Assessing the Availability and Components of Perinatal Mental Health Support Programs","authors":"Rebeca C. Urizar BA , Light Uchechukwu BA , Kyla F. Wiens BA , Kaeley M. Simpson MA , Bhavya Arora BA , Tia Alsaidi BA , Patricia Furer PhD , Gillian M. Alcolado PhD , Leslie Roos PhD , Kristin A. Reynolds PhD","doi":"10.1016/j.jogc.2025.103163","DOIUrl":"10.1016/j.jogc.2025.103163","url":null,"abstract":"<div><h3>Objectives</h3><div>Despite the increasing prevalence of anxiety in the perinatal period, limited access to providers and mental health services continues to prevent affected persons from receiving necessary support. Peer support programs may provide timely, accessible support by connecting persons with others who share lived experiences. This study aimed to identify and examine perinatal peer support programs available in Canada, with particular focus on those addressing perinatal anxiety.</div></div><div><h3>Methods</h3><div>We conducted an online environmental scan to identify and examine existing peer support programs available in Canada for persons experiencing perinatal anxiety. Websites were screened according to the inclusion and exclusion criteria, and eligible programs were analyzed for core components such as cost, delivery format, duration, targeted outcomes, and evidence of evaluation.</div></div><div><h3>Results</h3><div>The scan identified 180 websites, of which 8 met the inclusion criteria. Overall, the scan revealed a lack of readily available peer support programs specifically for perinatal anxiety. Program characteristics varied: several were delivered virtually, most were free or offered low-cost options, and few specified durations. Only 1 program reported undergoing scientific evaluation, and none included participant testimonials.</div></div><div><h3>Conclusions</h3><div>Findings highlight the limited availability of perinatal peer support programs in Canada, particularly those targeting perinatal anxiety. Expanding accessible, evidence-based peer support tailored to this population offers a meaningful way to strengthen perinatal mental health services while emphasizing the need for continued program development and broader availability.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 12","pages":"Article 103163"},"PeriodicalIF":2.2,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576964","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 : 2025-10-24DOI: 10.1016/j.jogc.2025.103164
Hongwei Li MD , Zi-yun Liao MD , Zhenbo OuYang MD
{"title":"Uterine Rupture with Fetal Leg Extrusion","authors":"Hongwei Li MD , Zi-yun Liao MD , Zhenbo OuYang MD","doi":"10.1016/j.jogc.2025.103164","DOIUrl":"10.1016/j.jogc.2025.103164","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 12","pages":"Article 103164"},"PeriodicalIF":2.2,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145467996","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 : 2025-10-24DOI: 10.1016/j.jogc.2025.103160
Wiebren Tjalma MD, PhD (full Professor)
{"title":"HPV prevention is better than cure","authors":"Wiebren Tjalma MD, PhD (full Professor)","doi":"10.1016/j.jogc.2025.103160","DOIUrl":"10.1016/j.jogc.2025.103160","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 12","pages":"Article 103160"},"PeriodicalIF":2.2,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526746","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}
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