Georgina Forshall, Kirsty Budds, Victoria Fisher, Swati Jha, Thomas G. Gray, Stergios K. Doumouchtsis, Anne-Marie Bagnall, Georgina L. Jones
Background
This scoping review was undertaken as part of an NIHR-commissioned study, APPRAISE, to develop a patient-reported outcome measure (PROM) and experience measure (PREM) to assess outcomes relevant to surgery for pelvic organ prolapse (POP), stress urinary incontinence (SUI) and pelvic mesh complications surgery, with cross-cultural applicability.
Objectives
To identify PROMs and PREMs used to assess POP, SUI and mesh complication surgery; to compare the length, recall periods, response options of these tools and the outcomes/experiences assessed.
Search Strategy
Three databases searched from inception to September 2023 were screened by two independent reviewers.
Selection Criteria
Primary studies using subjective measures to assess POP, SUI and mesh complication surgery for women aged 16+ years were eligible for inclusion. Related systematic reviews were also reviewed.
Data Collection and Analysis
Data were extracted into a piloted electronic form by one reviewer and checked by a second. A narrative synthesis of the data was performed.
Main Results
Of the 2079 included primary studies, 1607 (77%) used a PROM with evidence of psychometric testing. Five hundred and twenty-two (25%) studies used one PROM; 1082 studies (52%) used two or more PROMs. One hundred and fifty-one measures were extracted; of these, condition-specific measures were the most highly cited. There was limited use of PROMs specific to surgery, mental health, body image and PREMs. Some outcomes (e.g., urinary symptoms, emotional wellbeing) are measured in a significantly higher proportion of PROMs than other outcomes.
Conclusions
Currently, no existing validated PROM evaluates all patient-reported outcomes relevant to surgery for POP, SUI or mesh complications.
{"title":"Patient-Reported Outcome Measures Used to Assess Surgical Interventions for Pelvic Organ Prolapse, Stress Urinary Incontinence and Mesh Complications: A Scoping Review for the Development of the APPRAISE PROM","authors":"Georgina Forshall, Kirsty Budds, Victoria Fisher, Swati Jha, Thomas G. Gray, Stergios K. Doumouchtsis, Anne-Marie Bagnall, Georgina L. Jones","doi":"10.1111/1471-0528.18355","DOIUrl":"10.1111/1471-0528.18355","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This scoping review was undertaken as part of an NIHR-commissioned study, APPRAISE, to develop a patient-reported outcome measure (PROM) and experience measure (PREM) to assess outcomes relevant to surgery for pelvic organ prolapse (POP), stress urinary incontinence (SUI) and pelvic mesh complications surgery, with cross-cultural applicability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To identify PROMs and PREMs used to assess POP, SUI and mesh complication surgery; to compare the length, recall periods, response options of these tools and the outcomes/experiences assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search Strategy</h3>\u0000 \u0000 <p>Three databases searched from inception to September 2023 were screened by two independent reviewers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection Criteria</h3>\u0000 \u0000 <p>Primary studies using subjective measures to assess POP, SUI and mesh complication surgery for women aged 16+ years were eligible for inclusion. Related systematic reviews were also reviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Collection and Analysis</h3>\u0000 \u0000 <p>Data were extracted into a piloted electronic form by one reviewer and checked by a second. A narrative synthesis of the data was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Results</h3>\u0000 \u0000 <p>Of the 2079 included primary studies, 1607 (77%) used a PROM with evidence of psychometric testing. Five hundred and twenty-two (25%) studies used one PROM; 1082 studies (52%) used two or more PROMs. One hundred and fifty-one measures were extracted; of these, condition-specific measures were the most highly cited. There was limited use of PROMs specific to surgery, mental health, body image and PREMs. Some outcomes (e.g., urinary symptoms, emotional wellbeing) are measured in a significantly higher proportion of PROMs than other outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Currently, no existing validated PROM evaluates all patient-reported outcomes relevant to surgery for POP, SUI or mesh complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 2","pages":"218-227"},"PeriodicalIF":4.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18355","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Author's Reply","authors":"Dimitrios Siassakos, Bethany Ann Atkins","doi":"10.1111/1471-0528.70031","DOIUrl":"10.1111/1471-0528.70031","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 1","pages":"187-188"},"PeriodicalIF":4.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cristina Gallego-Gómez, Sergio Núñez de Arenas-Arroyo, Ana Torres-Costoso, Eva Rodríguez-Gutiérrez, Vicente Martínez-Vizcaíno, Sandra Martínez-Bustelo, Claudia Andrea Quezada-Bascuñán, Julián Ángel Basco-López, Asunción Ferri-Morales
<div> <section> <h3> Background</h3> <p>Urinary incontinence (UI) is a common symptom after childbirth. Training interventions are recommended for its management.</p> </section> <section> <h3> Objectives</h3> <p>To evaluate the effects of abdominal and/or pelvic floor muscle training (PFMT) combined with other conservative tools.</p> </section> <section> <h3> Search Strategy</h3> <p>The MEDLINE, Scopus, Cochrane Library, Web of Science and Physiotherapy Evidence Database (PEDro) databases were searched from inception to November 6th, 2024.</p> </section> <section> <h3> Selection Criteria</h3> <p>Three reviewers independently reviewed titles, abstracts, and full texts.</p> </section> <section> <h3> Data Collection and Analysis</h3> <p>Experimental studies addressing the effects of training interventions on UI severity during the postpartum period were included. The Hartung–Knapp–Sidik–Jonkman method was used to calculate pooled estimates of the standardised mean differences (SMDs) and their respective 95% confidence intervals (CIs). Subgroup analyses and meta-regression models were performed according to population characteristics, intervention characteristics, and type of outcome measure. The protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42023489312).</p> </section> <section> <h3> Main Results</h3> <p>Nineteen published studies were included. There was no statistically significant difference in UI severity in the analyses comparing training interventions versus controls or education interventions (SMD = −1.08; 95% CI: −2.24 to 0.08). According to the pre–post analyses, PFMT (SMD = −1.45; 95% CI: −2.61 to −0.28), PFMT through electrical stimulation (ES)/biofeedback (BFB) (SMD = −2.16; 95% CI: −3.50 to −0.81), and PFMT combined with abdominal muscle training (AMT) (SMD = −1.73; 95% CI: −3.42 to −0.03) modalities showed a statistically significant reduction of UI in postpartum women.</p> </section> <section> <h3> Conclusions</h3> <p>This meta-analysis provides an overview of the evidence supporting PFMT alone or in combination with ES, BFB, or AMT as suitable conservative approaches for the treatment of UI in the postpartum period. Further studies are needed to establish recommendations for abdom
{"title":"Effects of Training Interventions to Treat Postpartum Urinary Incontinence: A Meta-Analysis","authors":"Cristina Gallego-Gómez, Sergio Núñez de Arenas-Arroyo, Ana Torres-Costoso, Eva Rodríguez-Gutiérrez, Vicente Martínez-Vizcaíno, Sandra Martínez-Bustelo, Claudia Andrea Quezada-Bascuñán, Julián Ángel Basco-López, Asunción Ferri-Morales","doi":"10.1111/1471-0528.70014","DOIUrl":"10.1111/1471-0528.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Urinary incontinence (UI) is a common symptom after childbirth. Training interventions are recommended for its management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the effects of abdominal and/or pelvic floor muscle training (PFMT) combined with other conservative tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search Strategy</h3>\u0000 \u0000 <p>The MEDLINE, Scopus, Cochrane Library, Web of Science and Physiotherapy Evidence Database (PEDro) databases were searched from inception to November 6th, 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection Criteria</h3>\u0000 \u0000 <p>Three reviewers independently reviewed titles, abstracts, and full texts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Collection and Analysis</h3>\u0000 \u0000 <p>Experimental studies addressing the effects of training interventions on UI severity during the postpartum period were included. The Hartung–Knapp–Sidik–Jonkman method was used to calculate pooled estimates of the standardised mean differences (SMDs) and their respective 95% confidence intervals (CIs). Subgroup analyses and meta-regression models were performed according to population characteristics, intervention characteristics, and type of outcome measure. The protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42023489312).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Results</h3>\u0000 \u0000 <p>Nineteen published studies were included. There was no statistically significant difference in UI severity in the analyses comparing training interventions versus controls or education interventions (SMD = −1.08; 95% CI: −2.24 to 0.08). According to the pre–post analyses, PFMT (SMD = −1.45; 95% CI: −2.61 to −0.28), PFMT through electrical stimulation (ES)/biofeedback (BFB) (SMD = −2.16; 95% CI: −3.50 to −0.81), and PFMT combined with abdominal muscle training (AMT) (SMD = −1.73; 95% CI: −3.42 to −0.03) modalities showed a statistically significant reduction of UI in postpartum women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This meta-analysis provides an overview of the evidence supporting PFMT alone or in combination with ES, BFB, or AMT as suitable conservative approaches for the treatment of UI in the postpartum period. Further studies are needed to establish recommendations for abdom","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 2","pages":"243-252"},"PeriodicalIF":4.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara Sorrenti, Smriti Prasad, Nouran Elbarbary, Fathima Fidha, Laura A. Magee, Peter von Dadelszen, Sergio A. Silverio, John Allotey, Shakila Thangaratinam, Asma Khalil
<div> <section> <h3> Background</h3> <p>Ethnic minority women face disproportionately higher risks of adverse perinatal outcomes, exacerbated by socio-economic and systemic barriers.</p> </section> <section> <h3> Objectives</h3> <p>This systematic review evaluates the effectiveness of interventions designed to improve perinatal outcomes in these populations.</p> </section> <section> <h3> Search Strategy</h3> <p>We conducted a systematic review according to a pre-designed protocol (PROSPERO CRD42024516616). MEDLINE, EMBASE and Cochrane Databases were searched up to February 2024 using relevant Medical Subject Headings (MeSH) terms and keywords.</p> </section> <section> <h3> Selection Criteria</h3> <p>We included studies involving interventions targeting pregnant women from ethnic minority groups. Outcome measures included maternal and perinatal outcomes, as well as qualitative assessments, when available.</p> </section> <section> <h3> Data Collection</h3> <p>Two reviewers independently performed data extraction and quality assessment, resolving discrepancies by consensus.</p> </section> <section> <h3> Main Results</h3> <p>Studies included (<i>n</i> = 36) were from the United Kingdom (<i>n</i> = 9), United States of America (<i>n</i> = 9), Australia (<i>n</i> = 12), Canada (<i>n</i> = 1), Denmark (<i>n</i> = 2), Sweden (<i>n</i> = 3), involving women (<i>n</i> = 72 527) of varied ethnicity: Asian (<i>n</i> = 16 274, 22.4%), Black (<i>n</i> = 11 458, 15.8%), Hispanic (<i>n</i> = 612, 0.8%), First Nations/Aboriginal (<i>n</i> = 19 406, 29.1%), Mixed (<i>n</i> = 873, 1.2%), ‘Other’ (as defined in the included studies) (<i>n</i> = 3354, 4.6%), and women belonging to an unspecified ethnic minority group (<i>n</i> = 15 232, 21%), and a group of Russian, Arabic, Tigrinya, Polish and Somali women in a foreign country (82 women; 0.1%). Interventions broadly included four categories: clinical management interventions, educational programmes, treatments, and models of care. Clinical management interventions like increased foetal surveillance after 39 weeks and implemented screening for preeclampsia showed positive results, with a 64% reduction in stillbirth rates among South Asian (aOR 0.36, 95% CI 0.13–0.90, <i>p</i> = 0.047) with the former intervention, and a decrease in perinatal deaths with the latter intervention. Educational initiatives demonstrated dive
{"title":"Interventions to Address Disparities in Perinatal Outcomes by Ethnicity: A Systematic Review","authors":"Sara Sorrenti, Smriti Prasad, Nouran Elbarbary, Fathima Fidha, Laura A. Magee, Peter von Dadelszen, Sergio A. Silverio, John Allotey, Shakila Thangaratinam, Asma Khalil","doi":"10.1111/1471-0528.70013","DOIUrl":"10.1111/1471-0528.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ethnic minority women face disproportionately higher risks of adverse perinatal outcomes, exacerbated by socio-economic and systemic barriers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This systematic review evaluates the effectiveness of interventions designed to improve perinatal outcomes in these populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search Strategy</h3>\u0000 \u0000 <p>We conducted a systematic review according to a pre-designed protocol (PROSPERO CRD42024516616). MEDLINE, EMBASE and Cochrane Databases were searched up to February 2024 using relevant Medical Subject Headings (MeSH) terms and keywords.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection Criteria</h3>\u0000 \u0000 <p>We included studies involving interventions targeting pregnant women from ethnic minority groups. Outcome measures included maternal and perinatal outcomes, as well as qualitative assessments, when available.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Collection</h3>\u0000 \u0000 <p>Two reviewers independently performed data extraction and quality assessment, resolving discrepancies by consensus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Results</h3>\u0000 \u0000 <p>Studies included (<i>n</i> = 36) were from the United Kingdom (<i>n</i> = 9), United States of America (<i>n</i> = 9), Australia (<i>n</i> = 12), Canada (<i>n</i> = 1), Denmark (<i>n</i> = 2), Sweden (<i>n</i> = 3), involving women (<i>n</i> = 72 527) of varied ethnicity: Asian (<i>n</i> = 16 274, 22.4%), Black (<i>n</i> = 11 458, 15.8%), Hispanic (<i>n</i> = 612, 0.8%), First Nations/Aboriginal (<i>n</i> = 19 406, 29.1%), Mixed (<i>n</i> = 873, 1.2%), ‘Other’ (as defined in the included studies) (<i>n</i> = 3354, 4.6%), and women belonging to an unspecified ethnic minority group (<i>n</i> = 15 232, 21%), and a group of Russian, Arabic, Tigrinya, Polish and Somali women in a foreign country (82 women; 0.1%). Interventions broadly included four categories: clinical management interventions, educational programmes, treatments, and models of care. Clinical management interventions like increased foetal surveillance after 39 weeks and implemented screening for preeclampsia showed positive results, with a 64% reduction in stillbirth rates among South Asian (aOR 0.36, 95% CI 0.13–0.90, <i>p</i> = 0.047) with the former intervention, and a decrease in perinatal deaths with the latter intervention. Educational initiatives demonstrated dive","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 13","pages":"2009-2023"},"PeriodicalIF":4.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel S. Ruderman, Alexa A. Freedman, Sunitha C. Suresh
Objective
To determine the association of self-assessed caffeine consumption with adverse pregnancy outcomes (APO).
Design
Secondary analysis of births in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b). Caffeine intake was assessed by the self-reported Food Frequency Questionnaire reflecting consumption in the three months prior to the first trimester visit.
Setting
nuMoM2b was a prospectively collected cohort.
Population
This is a large US-based cohort of pregnant patients.
Methods
High caffeine intake was defined as ≥ 200 mg/day. Logistic models assessed associations between high intake and APO, adjusted for confounders. We also grouped caffeine intake in 50 mg increments and tested whether increased consumption was associated with increased odds of APO.
Main Outcome Measures
APO were defined as a composite of intrauterine foetal demise > 20 weeks' gestation, hypertensive disorders of pregnancy, preterm birth and small for gestational age infant.
Results
The primary analysis included 7345 participants with live births or pregnancy loss > 20 weeks' gestation, for whom the median daily caffeine intake was 63.28 mg/day. 841 (11.4%) of patients had high intake and 2168 (29.5%) had an APO. When adjusted for confounders, high intake was not associated with increased odds of APO (aOR 0.99, 95% CI 0.84–1.16), nor was it associated with any individual APO. We found no significant increased odds of APO per 50 mg increase in caffeine intake.
Conclusions
High caffeine intake assessed in the periconceptual period was not associated with the risk of APO. Further research exploring biomarkers and longitudinal childhood outcomes is needed to clarify limitations with regard to intake.
目的探讨自评咖啡因摄入与不良妊娠结局（APO）的关系。设计：对未产妊娠结局研究中的新生儿进行二次分析：监测准妈妈（nuMoM2b）。通过自我报告的食物频率问卷来评估咖啡因的摄入量，该问卷反映了在孕早期就诊前三个月的摄入情况。SETTINGnuMoM2b是一个前瞻性收集的队列。这是一个来自美国的大型孕妇队列。方法高咖啡因摄入量定义为≥200mg /d。Logistic模型评估了高摄入量与APO之间的关系，并对混杂因素进行了调整。我们还将咖啡因摄入量按50毫克的增量分组，并测试摄入量的增加是否与APO的几率增加有关。主要结局指标apo被定义为妊娠20周宫内胎儿死亡、妊娠高血压疾病、早产和小于胎龄儿的组合。结果主要分析包括7345名妊娠20周以内活产或流产的参与者，他们的中位每日咖啡因摄入量为63.28毫克/天。841例（11.4%）患者有高摄入量，2168例（29.5%）患者有APO。当校正混杂因素后，高摄入量与APO的几率增加无关（aOR 0.99, 95% CI 0.84-1.16），也与任何个体APO无关。我们发现咖啡因摄入量每增加50毫克，APO的几率没有显著增加。结论围孕期高咖啡因摄入与APO风险无关。需要进一步的研究来探索生物标志物和纵向儿童结果，以澄清摄入的局限性。
{"title":"Periconceptual Caffeine Intake and Adverse Pregnancy Outcomes: Results From the nuMoM2b Cohort","authors":"Rachel S. Ruderman, Alexa A. Freedman, Sunitha C. Suresh","doi":"10.1111/1471-0528.70018","DOIUrl":"10.1111/1471-0528.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the association of self-assessed caffeine consumption with adverse pregnancy outcomes (APO).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Secondary analysis of births in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b). Caffeine intake was assessed by the self-reported Food Frequency Questionnaire reflecting consumption in the three months prior to the first trimester visit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>nuMoM2b was a prospectively collected cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>This is a large US-based cohort of pregnant patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>High caffeine intake was defined as ≥ 200 mg/day. Logistic models assessed associations between high intake and APO, adjusted for confounders. We also grouped caffeine intake in 50 mg increments and tested whether increased consumption was associated with increased odds of APO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>APO were defined as a composite of intrauterine foetal demise > 20 weeks' gestation, hypertensive disorders of pregnancy, preterm birth and small for gestational age infant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The primary analysis included 7345 participants with live births or pregnancy loss > 20 weeks' gestation, for whom the median daily caffeine intake was 63.28 mg/day. 841 (11.4%) of patients had high intake and 2168 (29.5%) had an APO. When adjusted for confounders, high intake was not associated with increased odds of APO (aOR 0.99, 95% CI 0.84–1.16), nor was it associated with any individual APO. We found no significant increased odds of APO per 50 mg increase in caffeine intake.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High caffeine intake assessed in the periconceptual period was not associated with the risk of APO. Further research exploring biomarkers and longitudinal childhood outcomes is needed to clarify limitations with regard to intake.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 2","pages":"326-333"},"PeriodicalIF":4.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.70018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Objective</h3> <p>To evaluate whether regular aerobic exercise during pregnancy reduces the incidence of postpartum depression in women with low-risk singleton pregnancies.</p> </section> <section> <h3> Design</h3> <p>Single-centre randomised controlled trial.</p> </section> <section> <h3> Setting</h3> <p>Department of Obstetrics and Gynaecology, University of Naples Federico II, Italy.</p> </section> <section> <h3> Population or Sample</h3> <p>A total of 398 women with low-risk singleton pregnancies enrolled during the first trimester of pregnancy.</p> </section> <section> <h3> Methods</h3> <p>Participants were randomly allocated in a 1:1 ratio to an exercise group or control group. The intervention consisted of a structured aerobic exercise programme (three 60-min sessions per week) from randomisation until 35 weeks' gestation, or earlier if delivery or obstetric complications occurred. The primary outcome was Edinburgh Postnatal Depression Scale (EPDS) score ≥ 12 3 months postpartum. Secondary outcomes included EPDS ≥ 9, clinical diagnosis of postpartum depression (DSM-V), and maternal/perinatal outcomes. Analyses were performed on an intention-to-treat basis, with relative risk (RR) and 95% confidence interval (CI) calculated.</p> </section> <section> <h3> Main Outcome Measures</h3> <p>Incidence of postpartum depression, defined as EPDS ≥ 12 at 3 months postpartum.</p> </section> <section> <h3> Results</h3> <p>Of the 398 participants, 199 were randomised to the exercise group and 199 to the control group. Women in the exercise group had a significantly lower incidence of EPDS ≥ 12 and ≥ 9 at 3 months postpartum compared with controls, as well as lower mean EPDS scores. No significant differences in adverse maternal or perinatal outcomes were observed.</p> </section> <section> <h3> Conclusions</h3> <p>Regular antenatal aerobic exercise significantly reduced the risk of postpartum depression, supporting its role as a preventive strategy in low-risk pregnancies.</p> </section> <section> <h3> Trial Registration</h3> <p>Clinical
{"title":"Exercise in Pregnancy and Risk of Postpartum Depression: A Randomised Controlled Trial","authors":"Gabriele Saccone, Giorgia Buonomo, Alessandra Ammendola, Luca Bardi, Mariarosaria Motta, Elisabetta Gragnano, Mariavittoria Locci","doi":"10.1111/1471-0528.70010","DOIUrl":"10.1111/1471-0528.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate whether regular aerobic exercise during pregnancy reduces the incidence of postpartum depression in women with low-risk singleton pregnancies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Single-centre randomised controlled trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Department of Obstetrics and Gynaecology, University of Naples Federico II, Italy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population or Sample</h3>\u0000 \u0000 <p>A total of 398 women with low-risk singleton pregnancies enrolled during the first trimester of pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were randomly allocated in a 1:1 ratio to an exercise group or control group. The intervention consisted of a structured aerobic exercise programme (three 60-min sessions per week) from randomisation until 35 weeks' gestation, or earlier if delivery or obstetric complications occurred. The primary outcome was Edinburgh Postnatal Depression Scale (EPDS) score ≥ 12 3 months postpartum. Secondary outcomes included EPDS ≥ 9, clinical diagnosis of postpartum depression (DSM-V), and maternal/perinatal outcomes. Analyses were performed on an intention-to-treat basis, with relative risk (RR) and 95% confidence interval (CI) calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Incidence of postpartum depression, defined as EPDS ≥ 12 at 3 months postpartum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 398 participants, 199 were randomised to the exercise group and 199 to the control group. Women in the exercise group had a significantly lower incidence of EPDS ≥ 12 and ≥ 9 at 3 months postpartum compared with controls, as well as lower mean EPDS scores. No significant differences in adverse maternal or perinatal outcomes were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Regular antenatal aerobic exercise significantly reduced the risk of postpartum depression, supporting its role as a preventive strategy in low-risk pregnancies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Clinical","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 2","pages":"211-217"},"PeriodicalIF":4.3,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.70010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Linked article: This is a mini commentary on Hutcheon et al., pp. 263–271 in this issue. To view this article, visit https://doi.org/10.1111/1471-0528.18252.
链接文章：这是本期对Hutcheon et al. 263-271页的迷你评论。要查看本文，请访问https://doi.org/10.1111/1471-0528.18252。
{"title":"A Rare Instance of Regression Discontinuity Design Application in Medicine","authors":"Alex C. Vidaeff","doi":"10.1111/1471-0528.70011","DOIUrl":"10.1111/1471-0528.70011","url":null,"abstract":"<p><b>Linked article:</b> This is a mini commentary on Hutcheon et al., pp. 263–271 in this issue. To view this article, visit https://doi.org/10.1111/1471-0528.18252.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 2","pages":"272-273"},"PeriodicalIF":4.3,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robert L. Goldenberg, Sidrah Nausheen, Shazia Masheer, Zeeshan Uddin, Carla M. Bann, Shivaprasad S. Goudar, Gowder Guruprasad, Imran Ahmed, Najia K. Ghanchi, Shiyam Sunder Tikmani, Sangpappa Dhaded, Vardendra Kulkarni, Haleema Yasmin, Sarah Saleem, Elizabeth M. McClure
Objective
To evaluate similarities in pathways leading to preterm stillbirth and preterm neonatal death.
Design
Prospective observational study.
Setting
Study hospitals in India and Pakistan.
Population
Preterm stillbirths and neonatal deaths ≥ 1000 g delivered in a study facility and evaluated by an expert panel for cause of death.
Methods
An observational study of stillbirths and preterm neonatal deaths.
There were 398 preterm stillbirths and 582 preterm neonatal deaths in our study population. Of these, the panel determined asphyxia as a cause of death for 80.2% of the preterm stillbirths and 57.4% of the preterm neonatal deaths. Of the 319 preterm stillbirths with asphyxia, 62.4% also had placental MVM, while only 38.0% of the preterm stillbirths without birth asphyxia had MVM. Maternal hypertension was present among 44.5% of the stillbirths and FGR in 35.2%. Among the stillbirths with hypertension, 64.4% had asphyxia and MVM compared to 38.5% among those without hypertension. Similar patterns were seen among neonatal deaths.
Conclusions
Both MVM and birth asphyxia were commonly present among stillbirths and neonatal deaths, especially those associated with hypertension and FGR compared to stillbirths and neonatal deaths without those conditions. These findings suggest that MVM and fetal asphyxia are part of a common pathway for stillbirth and preterm neonatal deaths.
{"title":"Shared Placental and Asphyxial Pathways in Preterm Stillbirths and Neonatal Deaths: The Prospective Observational PURPOSe Study","authors":"Robert L. Goldenberg, Sidrah Nausheen, Shazia Masheer, Zeeshan Uddin, Carla M. Bann, Shivaprasad S. Goudar, Gowder Guruprasad, Imran Ahmed, Najia K. Ghanchi, Shiyam Sunder Tikmani, Sangpappa Dhaded, Vardendra Kulkarni, Haleema Yasmin, Sarah Saleem, Elizabeth M. McClure","doi":"10.1111/1471-0528.70017","DOIUrl":"10.1111/1471-0528.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate similarities in pathways leading to preterm stillbirth and preterm neonatal death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective observational study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Study hospitals in India and Pakistan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Preterm stillbirths and neonatal deaths ≥ 1000 g delivered in a study facility and evaluated by an expert panel for cause of death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An observational study of stillbirths and preterm neonatal deaths.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Asphyxia, placental maternal vascular malperfusion (MVM), maternal hypertension, fetal growth restriction (FGR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 398 preterm stillbirths and 582 preterm neonatal deaths in our study population. Of these, the panel determined asphyxia as a cause of death for 80.2% of the preterm stillbirths and 57.4% of the preterm neonatal deaths. Of the 319 preterm stillbirths with asphyxia, 62.4% also had placental MVM, while only 38.0% of the preterm stillbirths without birth asphyxia had MVM. Maternal hypertension was present among 44.5% of the stillbirths and FGR in 35.2%. Among the stillbirths with hypertension, 64.4% had asphyxia and MVM compared to 38.5% among those without hypertension. Similar patterns were seen among neonatal deaths.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both MVM and birth asphyxia were commonly present among stillbirths and neonatal deaths, especially those associated with hypertension and FGR compared to stillbirths and neonatal deaths without those conditions. These findings suggest that MVM and fetal asphyxia are part of a common pathway for stillbirth and preterm neonatal deaths.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 2","pages":"320-325"},"PeriodicalIF":4.3,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bellad MB, Hoffman MK, Mallapur AA, Charantimath US, Katageri GM, Ganachari MS, Kavi A, Ramdurg UY, Bannale SG, Revankar AP, Sloan NL, Kodkany BS, Goudar SS, Derman RJ. “Clindamycin to Reduce Preterm Birth in a Low Resource Setting: A Randomised Placebo-Controlled Clinical Trial.” BJOG 2018; 125: 1601–1609. https://doi.org/10.1111/1471-0528.15290.
We note that for both Tables 1 and 2, the continuous data presented is not labelled as to whether it means with standard errors or with standard deviations. This should be added as means with standard errors to prevent confusion with means with standard deviations.
{"title":"Correction to ‘Clindamycin to Reduce Preterm Birth in a Low Resource Setting: A Randomised Placebo-Controlled Clinical Trial’","authors":"","doi":"10.1111/1471-0528.70003","DOIUrl":"10.1111/1471-0528.70003","url":null,"abstract":"<p>Bellad MB, Hoffman MK, Mallapur AA, Charantimath US, Katageri GM, Ganachari MS, Kavi A, Ramdurg UY, Bannale SG, Revankar AP, Sloan NL, Kodkany BS, Goudar SS, Derman RJ. “Clindamycin to Reduce Preterm Birth in a Low Resource Setting: A Randomised Placebo-Controlled Clinical Trial.” <i>BJOG</i> 2018; 125: 1601–1609. https://doi.org/10.1111/1471-0528.15290.</p><p>We note that for both Tables 1 and 2, the continuous data presented is not labelled as to whether it means with standard errors or with standard deviations. This should be added as means with standard errors to prevent confusion with means with standard deviations.</p><p>We apologise for this error.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Burden, A. Merriel, D. Bakhbakhi, A. Heazell, D. Siassakos. Care of late intrauterine fetal death and stillbirth, BJOG: An International Journal of Obstetrics & Gynaecology 132, no. 1 (2025): e1–e41. https://doi.org/10.1111/1471-0528.17844.
In Table 2, Column 4 (A summary of the investigations for late Intra-uterine fetal death (IUFD) and their indications), the text ‘Treponemal serology – usually known already’ was incorrect. This should have read: ‘Treponemal serology—repeated at presentation with an IUFD regardless of maternal status at booking’.
We apologise for this error.
C. Burden， A. Merriel， D. Bakhbakhi， A. Heazell， D. Siassakos。晚期宫内胎儿死亡和死产的护理，《国际妇产科杂志》132，第2期。1 (2025): e1-e41。https://doi.org/10.1111/1471-0528.17844.In表2，第4列（晚期宫内胎儿死亡（IUFD）及其指征的调查摘要），文本“螺旋体血清学-通常已知”是不正确的。这应该是：“在IUFD就诊时重复螺旋体血清学，无论预约时母亲的状况如何”。我们为这个错误道歉。
{"title":"Correction to ‘Care of Late Intrauterine Fetal Death and Stillbirth Green-Top Guideline No. 55’","authors":"","doi":"10.1111/1471-0528.70004","DOIUrl":"10.1111/1471-0528.70004","url":null,"abstract":"<p>C. Burden, A. Merriel, D. Bakhbakhi, A. Heazell, D. Siassakos. Care of late intrauterine fetal death and stillbirth, <i>BJOG: An International Journal of Obstetrics & Gynaecology</i> 132, no. 1 (2025): e1–e41. https://doi.org/10.1111/1471-0528.17844.</p><p>In Table 2, Column 4 (A summary of the investigations for late Intra-uterine fetal death (IUFD) and their indications), the text ‘<i>Treponemal serology – usually known already</i>’ was incorrect. This should have read: ‘<i>Treponemal serology—repeated at presentation with an IUFD regardless of maternal status at booking</i>’.</p><p>We apologise for this error.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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