Anne-Sophie Boucherie, Anne Rousseau, Patrick Rozenberg, Catherine Deneux-Tharaux, Thibaud Quibel
Objective
A randomised controlled trial found no significant reduction in severe postpartum haemorrhage (≥ 3 packed red blood cell units and/or total blood loss > 1000 mL) when intrauterine balloon tamponade and second-line uterotonics were used simultaneously compared with balloon use after failure of second-line uterotonics. However, one quarter of participants had already lost more than 1000 mL at randomisation, increasing heterogeneity and coagulopathy risk. This may have obscured a potential benefit in women with moderate bleeding (500–1000 mL). We aimed to assess the effect of early versus later balloon use in this subgroup.
Design
Exploratory analysis of a randomised controlled trial.
Setting
Maternity units across France.
Population
Women with 500–1000 mL of blood loss at the time of second-line uterotonic administration after vaginal delivery (n = 264).
Methods
Outcomes were compared between women randomised to early intrauterine balloon tamponade (n = 128) and those who received balloon after failure of second-line uterotonics (n = 136). Risk ratios were estimated using multivariate Poisson regression with robust variance.
Main Outcome Measures
Severe postpartum haemorrhage (≥ 3 packed red blood cell units and/or total blood loss > 1000 mL).
Results
Severe postpartum haemorrhage occurred in 57.8% of the early group and 70.6% of the later group (adjusted risk ratio 0.83; 95% CI 0.69–1.01; p = 0.06).
Conclusions
Early intrauterine balloon tamponade was not associated with a statistically significant reduction in severe haemorrhage among women with moderate bleeding; estimates are compatible with a modest benefit and should be considered hypothesis-generating.
目的：一项随机对照试验发现，与宫内球囊填塞和宫内二次宫内强直失败后球囊使用相比，宫内球囊同时使用宫内二次宫内强直的严重产后出血（红细胞堆积量≥3个和/或总失血量≥1000 mL）发生率无显著降低。然而，四分之一的参与者在随机分组时已经损失超过1000毫升，增加了异质性和凝血障碍风险。这可能掩盖了中度出血妇女（500-1000毫升）的潜在益处。我们的目的是评估在这个亚组中早期和晚期球囊使用的效果。设计：一项随机对照试验的探索性分析。法国各地的产科病房。阴道分娩后第二线子宫扩张给药时失血500- 1000ml的妇女（n = 264）。方法比较早期宫内球囊填塞（n = 128）和二线子宫强张术失败后球囊填塞（n = 136）的结果。风险比的估计使用多元泊松回归稳健方差。主要观察指标：重度产后出血（≥3个充血红细胞单位和/或总失血量100ml）。结果重度产后出血早期组占57.8%，后期组占70.6%（校正风险比0.83;95% CI 0.69 ~ 1.01; p = 0.06）。结论早期宫内球囊填塞与中度出血妇女严重出血发生率降低无统计学意义；估计与适度的收益相一致，应被视为假设产生。
{"title":"Timing of Intrauterine Balloon Tamponade for Postpartum Haemorrhage After Vaginal Delivery Among Women With Moderate Bleeding: Exploratory Analysis of a Randomised Trial","authors":"Anne-Sophie Boucherie, Anne Rousseau, Patrick Rozenberg, Catherine Deneux-Tharaux, Thibaud Quibel","doi":"10.1111/1471-0528.70109","DOIUrl":"10.1111/1471-0528.70109","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>A randomised controlled trial found no significant reduction in severe postpartum haemorrhage (≥ 3 packed red blood cell units and/or total blood loss > 1000 mL) when intrauterine balloon tamponade and second-line uterotonics were used simultaneously compared with balloon use after failure of second-line uterotonics. However, one quarter of participants had already lost more than 1000 mL at randomisation, increasing heterogeneity and coagulopathy risk. This may have obscured a potential benefit in women with moderate bleeding (500–1000 mL). We aimed to assess the effect of early versus later balloon use in this subgroup.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Exploratory analysis of a randomised controlled trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Maternity units across France.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Women with 500–1000 mL of blood loss at the time of second-line uterotonic administration after vaginal delivery (<i>n</i> = 264).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Outcomes were compared between women randomised to early intrauterine balloon tamponade (<i>n</i> = 128) and those who received balloon after failure of second-line uterotonics (<i>n</i> = 136). Risk ratios were estimated using multivariate Poisson regression with robust variance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Severe postpartum haemorrhage (≥ 3 packed red blood cell units and/or total blood loss > 1000 mL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Severe postpartum haemorrhage occurred in 57.8% of the early group and 70.6% of the later group (adjusted risk ratio 0.83; 95% CI 0.69–1.01; <i>p</i> = 0.06).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early intrauterine balloon tamponade was not associated with a statistically significant reduction in severe haemorrhage among women with moderate bleeding; estimates are compatible with a modest benefit and should be considered hypothesis-generating.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 4","pages":"788-795"},"PeriodicalIF":4.3,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752711","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}
Kelly Robinson, Clemence Due, Annette Briley, Siobhan A. Loughnan
Background
Continuity of care during the perinatal period often leads to better psychosocial wellbeing for parents. Midwifery continuity of care (MCoC) is one such continuity of care model; however, there is little evidence regarding MCoC for the psychosocial wellbeing of bereaved parents in subsequent pregnancies.
Objective
To synthesise perceptions of care related to psychosocial wellbeing where MCoC has been provided in a subsequent pregnancy.
Search Strategy
Eight databases and Google Scholar were searched using ‘psychosocial wellbeing’, ‘midwifery continuity of care’ and ‘subsequent pregnancies after perinatal loss’ as search terms.
Selection Criteria
Studies containing primary data regarding parents' experiences of MCoC in a subsequent pregnancy after loss were included.
Data Collection and Analysis
Relevant data were analysed using a meta-aggregative approach, guided by JBI methodology.
Main Results
Aggregation of four studies generated an overarching finding of ‘Compassionate, trauma-informed care should be a key component of pregnancy after loss care’, with four lines of action: ‘Relationships in MCoC are key to supporting parents’ psychosocial wellbeing in pregnancy after loss', ‘Parents value midwives with bereavement expertise and knowledge of pregnancy after loss care’, ‘MCoC can restore confidence and empower parents in a pregnancy after loss’ and ‘MCoC that prioritises accessibility, attentiveness and care coordination will support parents in pregnancies after loss’.
Conclusions
The trauma-informed, compassionate care principles found in MCoC show significant potential to support bereaved parent's psychosocial wellbeing in pregnancy after loss.
{"title":"Midwifery Continuity of Care in a Subsequent Pregnancy After Perinatal Loss: A Scoping Review of Qualitative Evidence","authors":"Kelly Robinson, Clemence Due, Annette Briley, Siobhan A. Loughnan","doi":"10.1111/1471-0528.70112","DOIUrl":"10.1111/1471-0528.70112","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Continuity of care during the perinatal period often leads to better psychosocial wellbeing for parents. Midwifery continuity of care (MCoC) is one such continuity of care model; however, there is little evidence regarding MCoC for the psychosocial wellbeing of bereaved parents in subsequent pregnancies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To synthesise perceptions of care related to psychosocial wellbeing where MCoC has been provided in a subsequent pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search Strategy</h3>\u0000 \u0000 <p>Eight databases and Google Scholar were searched using ‘psychosocial wellbeing’, ‘midwifery continuity of care’ and ‘subsequent pregnancies after perinatal loss’ as search terms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection Criteria</h3>\u0000 \u0000 <p>Studies containing primary data regarding parents' experiences of MCoC in a subsequent pregnancy after loss were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Collection and Analysis</h3>\u0000 \u0000 <p>Relevant data were analysed using a meta-aggregative approach, guided by JBI methodology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Results</h3>\u0000 \u0000 <p>Aggregation of four studies generated an overarching finding of ‘Compassionate, trauma-informed care should be a key component of pregnancy after loss care’, with four lines of action: ‘Relationships in MCoC are key to supporting parents’ psychosocial wellbeing in pregnancy after loss', ‘Parents value midwives with bereavement expertise and knowledge of pregnancy after loss care’, ‘MCoC can restore confidence and empower parents in a pregnancy after loss’ and ‘MCoC that prioritises accessibility, attentiveness and care coordination will support parents in pregnancies after loss’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The trauma-informed, compassionate care principles found in MCoC show significant potential to support bereaved parent's psychosocial wellbeing in pregnancy after loss.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 4","pages":"598-608"},"PeriodicalIF":4.3,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752712","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}
Siân Bullough, Michelle Dower, Richard Jackson, Alexander E. P. Heazell, Kerry Woolfall, Lazaros Andronis, Louise Kenny, Zarko Alfirevic, Andrew Sharp, The PLANES study group
Objective
To determine the feasibility of a trial investigating the optimal timing for the birth of women with a suspected late preterm and term SGA baby using either angiogenic biomarker-led care or standard care.
Design
A mixed methods study including a randomised feasibility trial, interviews, questionnaires and economic analysis.
Setting
Two tertiary maternity hospitals in the UK.
Population
Women with suspected SGA pregnancies between 32+0 weeks gestation and 37+6 weeks gestation.
Methods
Women were randomised in a 3:1 ratio to biomarker-led care versus standard care. Biomarker tests were either revealed, with birth delayed until 40 weeks if normal (sFlt-1/PlGF < 38 pg/mL) and considered from 37 weeks if abnormal (sFlt-1/PlGF ≥ 38 pg/mL), or concealed alongside standard care.
Main Outcome Measures
Primary outcome was the feasibility of the study measured through the recruitment rate and adherence. Secondary outcomes were the qualitative, proof-of-concept and economic analyses.
Results
Out of 128 women invited to participate 78 women were recruited giving a recruitment rate of 60.1% (95% confidence interval 52%–69%). Sixty-seven of the 78 women consented to randomisation. Sixteen parents and 12 clinicians were interviewed. Fourty parents completed a questionnaire. Participants, partners and clinicians viewed the study as acceptable but experienced challenges in participation and delivering the study. There were no significant adverse events or differences in neonatal outcomes. Collection of health economics data was feasible.
Conclusions
The clinical, qualitative and economic results support the acceptability of utilising sFlt-1/PlGF to refine SGA management after 32+0 weeks but the feasibility is less certain.
{"title":"Placental Growth Factor Led Management of the Small for Gestational Age Fetus: Randomised Controlled Feasibility Study","authors":"Siân Bullough, Michelle Dower, Richard Jackson, Alexander E. P. Heazell, Kerry Woolfall, Lazaros Andronis, Louise Kenny, Zarko Alfirevic, Andrew Sharp, The PLANES study group","doi":"10.1111/1471-0528.70106","DOIUrl":"10.1111/1471-0528.70106","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the feasibility of a trial investigating the optimal timing for the birth of women with a suspected late preterm and term SGA baby using either angiogenic biomarker-led care or standard care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A mixed methods study including a randomised feasibility trial, interviews, questionnaires and economic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Two tertiary maternity hospitals in the UK.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Women with suspected SGA pregnancies between 32<sup>+0</sup> weeks gestation and 37<sup>+6</sup> weeks gestation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Women were randomised in a 3:1 ratio to biomarker-led care versus standard care. Biomarker tests were either revealed, with birth delayed until 40 weeks if normal (sFlt-1/PlGF < 38 pg/mL) and considered from 37 weeks if abnormal (sFlt-1/PlGF ≥ 38 pg/mL), or concealed alongside standard care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Primary outcome was the feasibility of the study measured through the recruitment rate and adherence. Secondary outcomes were the qualitative, proof-of-concept and economic analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 128 women invited to participate 78 women were recruited giving a recruitment rate of 60.1% (95% confidence interval 52%–69%). Sixty-seven of the 78 women consented to randomisation. Sixteen parents and 12 clinicians were interviewed. Fourty parents completed a questionnaire. Participants, partners and clinicians viewed the study as acceptable but experienced challenges in participation and delivering the study. There were no significant adverse events or differences in neonatal outcomes. Collection of health economics data was feasible.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The clinical, qualitative and economic results support the acceptability of utilising sFlt-1/PlGF to refine SGA management after 32<sup>+0</sup> weeks but the feasibility is less certain.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 4","pages":"626-637"},"PeriodicalIF":4.3,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.70106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145732756","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}
Genevieve P. G. Fung, Hugh S. Lam, Kathy Y. Y. Chan, Isabella Y. M. Wah, Caitlyn S. L. Lau, Long Nguyen-Hoang, Daljit S. Sahota, Liona C. Poon
<div> <section> <p>Placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt1) are two biomarkers associated with placental function and the sFlt-1/PlGF ratio is frequently used for risk assessment and prediction of preeclampsia in pregnancy.</p> </section> <section> <h3> Objective</h3> <p>To assess the association between elevated sFlt-1/PlGF ratio and adverse neonatal outcomes in pregnancies with suspected preeclampsia.</p> </section> <section> <h3> Design</h3> <p>Retrospective cohort study.</p> </section> <section> <h3> Setting</h3> <p>A tertiary centre in Hong Kong.</p> </section> <section> <h3> Population</h3> <p>162 singleton neonates delivered between January 2020 and May 2023 from pregnancies complicated by suspected preeclampsia and sFlt-1/PlGF taken within 4 weeks before delivery.</p> </section> <section> <h3> Methods</h3> <p>Pregnant women with suspected preeclampsia were recruited with analysis of serum Flt-1 and PlGF. Neonatal outcomes were compared between neonates from pregnancies with sFlt-1/PlGF ratio ≥ 85 (high-risk group) and < 85 (low-risk group).</p> </section> <section> <h3> Main Outcome Measures</h3> <p>Neonatal outcomes including growth, respiratory, gastrointestinal, and metabolic complications.</p> </section> <section> <h3> Results</h3> <p>Logistic regression analysis showed that after adjustment for gestational age, preeclampsia and newborn sex, sFlt-1/PlGF ratio ≥ 85 was significantly associated with small-for-gestation (SGA; aOR = 2.52, 95% C.I. = 1.12–5.60), feeding intolerance (aOR = 3.03, 95% C.I. = 1.01–9.09), need for parenteral nutrition (PN; aOR = 11.19, 95% C.I. = 2.23–56.29), prolonged PN (aOR = 6.92, 95% C.I. = 1.43–33.39), hospitalisation over 7 and 30 days (aOR = 3.62, 95% C.I. = 1.20–10.87 and aOR = 7.04, 95% C.I. = 1.08–45.80 respectively). Linear regression showed a significant association between sFlt-1/PlGF ratio and duration of respiratory support, PN and duration of hospital stay.</p> </section> <section> <h3> Conclusions</h3> <p>An elevated maternal sFlt-1/PlGF ratio within 4 weeks of delivery is significantly
{"title":"Angiogenic Biomarkers and Neonatal Outcomes in Suspected Preeclampsia: Retrospective Cohort Study","authors":"Genevieve P. G. Fung, Hugh S. Lam, Kathy Y. Y. Chan, Isabella Y. M. Wah, Caitlyn S. L. Lau, Long Nguyen-Hoang, Daljit S. Sahota, Liona C. Poon","doi":"10.1111/1471-0528.70104","DOIUrl":"10.1111/1471-0528.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 (sFlt1) are two biomarkers associated with placental function and the sFlt-1/PlGF ratio is frequently used for risk assessment and prediction of preeclampsia in pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the association between elevated sFlt-1/PlGF ratio and adverse neonatal outcomes in pregnancies with suspected preeclampsia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>A tertiary centre in Hong Kong.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>162 singleton neonates delivered between January 2020 and May 2023 from pregnancies complicated by suspected preeclampsia and sFlt-1/PlGF taken within 4 weeks before delivery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pregnant women with suspected preeclampsia were recruited with analysis of serum Flt-1 and PlGF. Neonatal outcomes were compared between neonates from pregnancies with sFlt-1/PlGF ratio ≥ 85 (high-risk group) and < 85 (low-risk group).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Neonatal outcomes including growth, respiratory, gastrointestinal, and metabolic complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Logistic regression analysis showed that after adjustment for gestational age, preeclampsia and newborn sex, sFlt-1/PlGF ratio ≥ 85 was significantly associated with small-for-gestation (SGA; aOR = 2.52, 95% C.I. = 1.12–5.60), feeding intolerance (aOR = 3.03, 95% C.I. = 1.01–9.09), need for parenteral nutrition (PN; aOR = 11.19, 95% C.I. = 2.23–56.29), prolonged PN (aOR = 6.92, 95% C.I. = 1.43–33.39), hospitalisation over 7 and 30 days (aOR = 3.62, 95% C.I. = 1.20–10.87 and aOR = 7.04, 95% C.I. = 1.08–45.80 respectively). Linear regression showed a significant association between sFlt-1/PlGF ratio and duration of respiratory support, PN and duration of hospital stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>An elevated maternal sFlt-1/PlGF ratio within 4 weeks of delivery is significantly","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 4","pages":"779-787"},"PeriodicalIF":4.3,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.70104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696618","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}
Okwaraji YB, Bradley E, Ohuma EO, Yargawa J, Suarez-Idueta L, Requejo J, et al. National routine data for low birthweight and preterm births: Systematic data quality assessment for United Nations member states (2000–2020). BJOG. 2024;131(7):917–928. https://doi.org/10.1111/1471-0528.17699
This article was intended for this supplement issue, 132:S8, but was inadvertently published in an earlier issue of BJOG: An International Journal of Obstetrics & Gynaecology, issue 131:7 https://obgyn.onlinelibrary.wiley.com/toc/14710528/2024/131/7.
The publisher apologises for this error and any confusion it may cause.
{"title":"Correction to National Routine Data for Low Birthweight and Preterm Births: Systematic Data Quality Assessment for United Nations Member States (2000–2020)","authors":"","doi":"10.1111/1471-0528.70096","DOIUrl":"https://doi.org/10.1111/1471-0528.70096","url":null,"abstract":"<p>Okwaraji YB, Bradley E, Ohuma EO, Yargawa J, Suarez-Idueta L, Requejo J, et al. National routine data for low birthweight and preterm births: Systematic data quality assessment for United Nations member states (2000–2020). BJOG. 2024;131(7):917–928. https://doi.org/10.1111/1471-0528.17699</p><p>This article was intended for this supplement issue, 132:S8, but was inadvertently published in an earlier issue of BJOG: An International Journal of Obstetrics & Gynaecology, issue 131:7 https://obgyn.onlinelibrary.wiley.com/toc/14710528/2024/131/7.</p><p>The publisher apologises for this error and any confusion it may cause.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S8","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.70096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666192","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}
Marianne Jacques, Anne Alice Chantry, Sarah Tebeka, Anne Evrard, Alexandra Doncarli, Nathalie Lelong, Camille Le Ray, the ENP2021 Study Group
Objective
To assess the association between maternity care experienced as disrespectful and postpartum depression (PPD) symptoms 2 months after childbirth.
Design
Nationwide, population-based, cross-sectional study from the 2021 Enquête Nationale Périnatale (ENP) survey.
Setting
All maternity units in metropolitan France.
Population
Women who gave birth during 1 week in March 2021 and completed the 2-month follow-up questionnaire.
Methods
The experience of disrespectful maternity care was retrospectively assessed at follow-up. The association with 2-month PPD symptoms was estimated using Poisson regression with robust variance, adjusted for confounders and weighted to account for attrition.
Main Outcome Measures
Two-month PPD symptoms, defined as an Edinburgh Postnatal Depression Scale score ≥ 13.
Results
Among the 7189 women analysed, 24.9% (95% confidence interval [CI], 23.8–26.0) reported experiencing disrespectful maternity care, and the prevalence of 2-month PPD symptoms was 16.6% (95% CI, 15.7–17.6). After adjustment, women reporting disrespectful maternity care were more likely to have 2-month PPD symptoms (adjusted relative risk [aRR] 1.37; 95% CI 1.20–1.56).
Conclusions
One-quarter of women reported experiencing disrespectful maternity care. After adjustment for most of the known vulnerability factors, this experience was associated with a higher prevalence of PPD symptoms at 2 months. Improving respectful maternity care may be a modifiable factor in reducing PPD, whose incidence and consequences are concerning.
目的评估分娩后2个月不尊重产妇护理与产后抑郁（PPD）症状的关系。设计：2021年Enquête全国psm （ENP）调查的全国性、基于人群的横断面研究。法国大城市的所有妇产单位。2021年3月1周内分娩并完成2个月随访问卷的妇女。方法回顾性评价不尊重产妇护理的经验。与2个月PPD症状的关联使用泊松回归进行稳健方差估计，调整混杂因素并加权以考虑损耗。主要结局测量：两个月PPD症状，定义为爱丁堡产后抑郁量表得分≥13。结果在分析的7189名妇女中，24.9%（95%可信区间[CI]， 23.8-26.0）报告经历了不尊重的产科护理，2个月PPD症状的患病率为16.6% （95% CI, 15.7-17.6）。调整后，报告不尊重产妇护理的妇女更有可能出现2个月PPD症状（调整后相对风险[aRR] 1.37; 95% CI 1.20-1.56）。结论四分之一的妇女报告说她们经历过不尊重产妇的护理。在对大多数已知易感因素进行调整后，这种经历与2个月时PPD症状的较高患病率相关。改善尊重的产妇护理可能是减少产后抑郁症的一个可改变的因素，产后抑郁症的发病率和后果令人担忧。
{"title":"Disrespectful Maternity Care and Postpartum Depression at 2 Months: A Population-Based Study","authors":"Marianne Jacques, Anne Alice Chantry, Sarah Tebeka, Anne Evrard, Alexandra Doncarli, Nathalie Lelong, Camille Le Ray, the ENP2021 Study Group","doi":"10.1111/1471-0528.70093","DOIUrl":"10.1111/1471-0528.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the association between maternity care experienced as disrespectful and postpartum depression (PPD) symptoms 2 months after childbirth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Nationwide, population-based, cross-sectional study from the 2021 <i>Enquête Nationale Périnatale</i> (ENP) survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>All maternity units in metropolitan France.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Women who gave birth during 1 week in March 2021 and completed the 2-month follow-up questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The experience of disrespectful maternity care was retrospectively assessed at follow-up. The association with 2-month PPD symptoms was estimated using Poisson regression with robust variance, adjusted for confounders and weighted to account for attrition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Two-month PPD symptoms, defined as an Edinburgh Postnatal Depression Scale score ≥ 13.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 7189 women analysed, 24.9% (95% confidence interval [CI], 23.8–26.0) reported experiencing disrespectful maternity care, and the prevalence of 2-month PPD symptoms was 16.6% (95% CI, 15.7–17.6). After adjustment, women reporting disrespectful maternity care were more likely to have 2-month PPD symptoms (adjusted relative risk [aRR] 1.37; 95% CI 1.20–1.56).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>One-quarter of women reported experiencing disrespectful maternity care. After adjustment for most of the known vulnerability factors, this experience was associated with a higher prevalence of PPD symptoms at 2 months. Improving respectful maternity care may be a modifiable factor in reducing PPD, whose incidence and consequences are concerning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 4","pages":"751-760"},"PeriodicalIF":4.3,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.70093","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644851","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}
Bita Tristani-Firouzi, Lisa Pappas, Merry Joseph, Maryam Zeinomar, Michelle P. Debbink, Joseph Mims, Rafael Guerrero, Barry Moore, Robert M. Silver, Tsegaselassie Workalemahu, David Haas, Jonathan G. Steller, George Saade, Nathan R. Blue
<div> <section> <h3> Objective</h3> <p>Maternal genotypes may be useful to customise foetal growth assessment, but generalisability across diverse racial and ancestral groups remains uncertain. We assessed the generalisability of a genetic risk score for birth weight (GRS<sub>BW</sub>), derived from participants of predominantly European ancestry, within a diverse U.S. cohort.</p> </section> <section> <h3> Design</h3> <p>Secondary analysis of a prospective observational cohort of nulliparous patients.</p> </section> <section> <h3> Setting</h3> <p>Eight U.S. recruitment centers.</p> </section> <section> <h3> Population or Sample</h3> <p>Participants in the parent study with available maternal DNA.</p> </section> <section> <h3> Methods</h3> <p>We used log-linear modelling to test the association of maternal GRS<sub>BW</sub> with infant birth weight. We then assessed the robustness of the association by self-identified race and genetically predicted continental ancestry (GPA) groups.</p> </section> <section> <h3> Main Outcome Measures</h3> <p>Birth weight.</p> </section> <section> <h3> Results</h3> <p>Among 8147 eligible participants, GRS<sub>BW</sub> was positively associated with birth weight (<i>p</i> < 0.001). Across self-identified racial groups, the association was significant in White (<i>n</i> = 5394, mean ratio 1.04, 95% CI 0.97–1.11, <i>p</i> = 0.007) and multiracial (<i>n</i> = 508, mean ratio 1.10, CI 1.01–1.2, <i>p</i> = 0.03) groups but not in Black (<i>n</i> = 1139), Asian (<i>n</i> = 358), or unknown race groups (<i>p</i> > 0.09 for all). Among GPA groups, the association was significant among European (mean ratio 1.04, CI 1.02–1.07, <i>p</i> = 0.001) and American (mean ratio 1.08, CI 1.01–1.14, <i>p</i> = 0.02) ancestry groups but not African, East or South Asian, or unknown ancestry (<i>p</i> > 0.05 for all).</p> </section> <section> <h3> Conclusions</h3> <p>This GRS<sub>BW</sub> is not generalisable across self-described racial identities or GPA groups, highlighting the need for globally representative genetic discovery cohorts as well as further investigation into the complex role of race, ethnicity, and epigenetic influen
目的母体基因型可能有助于定制胎儿生长评估，但在不同种族和祖先群体中的普遍性仍不确定。我们评估了出生体重遗传风险评分（GRSBW）的普适性，该评分主要来自欧洲血统的参与者，来自美国不同的队列设计，对未生育患者的前瞻性观察队列进行了二次分析。8个美国招聘中心。人群或样本父母研究中具有可用母亲DNA的参与者。方法采用对数线性模型检验产妇GRSBW与婴儿出生体重的关系。然后，我们通过自我认定的种族和基因预测的大陆祖先（GPA）群体评估了这种关联的稳健性。主要结局指标：出生体重。结果在8147名符合条件的参与者中，GRSBW与出生体重呈正相关（p均为0.09）。在GPA组中，欧洲（平均比值1.04,CI 1.02-1.07, p = 0.001）和美洲（平均比值1.08,CI 1.01-1.14, p = 0.02）祖先组的相关性显著，但非洲、东亚或南亚或未知祖先组的相关性不显著（p < 0.05）。结论：该GRSBW不能在自我描述的种族身份或GPA群体中推广，强调需要全球具有代表性的遗传发现队列，并进一步研究种族、民族和表观遗传对胎儿生长的复杂作用。
{"title":"Generalisability of Maternal Genetic Risk Score for Birth Weight Across Racial Identity and Ancestry: A Secondary Analysis of a Prospective Cohort Study","authors":"Bita Tristani-Firouzi, Lisa Pappas, Merry Joseph, Maryam Zeinomar, Michelle P. Debbink, Joseph Mims, Rafael Guerrero, Barry Moore, Robert M. Silver, Tsegaselassie Workalemahu, David Haas, Jonathan G. Steller, George Saade, Nathan R. Blue","doi":"10.1111/1471-0528.70088","DOIUrl":"10.1111/1471-0528.70088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Maternal genotypes may be useful to customise foetal growth assessment, but generalisability across diverse racial and ancestral groups remains uncertain. We assessed the generalisability of a genetic risk score for birth weight (GRS<sub>BW</sub>), derived from participants of predominantly European ancestry, within a diverse U.S. cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Secondary analysis of a prospective observational cohort of nulliparous patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Eight U.S. recruitment centers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population or Sample</h3>\u0000 \u0000 <p>Participants in the parent study with available maternal DNA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used log-linear modelling to test the association of maternal GRS<sub>BW</sub> with infant birth weight. We then assessed the robustness of the association by self-identified race and genetically predicted continental ancestry (GPA) groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Birth weight.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 8147 eligible participants, GRS<sub>BW</sub> was positively associated with birth weight (<i>p</i> < 0.001). Across self-identified racial groups, the association was significant in White (<i>n</i> = 5394, mean ratio 1.04, 95% CI 0.97–1.11, <i>p</i> = 0.007) and multiracial (<i>n</i> = 508, mean ratio 1.10, CI 1.01–1.2, <i>p</i> = 0.03) groups but not in Black (<i>n</i> = 1139), Asian (<i>n</i> = 358), or unknown race groups (<i>p</i> > 0.09 for all). Among GPA groups, the association was significant among European (mean ratio 1.04, CI 1.02–1.07, <i>p</i> = 0.001) and American (mean ratio 1.08, CI 1.01–1.14, <i>p</i> = 0.02) ancestry groups but not African, East or South Asian, or unknown ancestry (<i>p</i> > 0.05 for all).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This GRS<sub>BW</sub> is not generalisable across self-described racial identities or GPA groups, highlighting the need for globally representative genetic discovery cohorts as well as further investigation into the complex role of race, ethnicity, and epigenetic influen","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 4","pages":"708-715"},"PeriodicalIF":4.3,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644858","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}
Ruiqi Cen, L. Joseph Su, Jun Ying, Mohammed S. Orloff, Elijah H. Bolin, Xiangyang Lou, Lynn M. Almli, Lorenzo D. Botto, Marilyn L. Browne, Richard H. Finnell, Mary M. Jenkins, Eirini Nestoridi, Andrew F. Olshan, Paul A. Romitti, Gary M. Shaw, Wendy N. Nembhard, the National Birth Defects Prevention Study
Objective
To investigate associations between maternal periconceptional (three months prior through the third pregnancy month) myo-inositol intake and the odds of selected congenital heart defects in offspring.
Design
A population-based case–control study using the National Birth Defects Prevention Study (NBDPS) database.
Setting
United States.
Population or Sample
Women with singleton live births without major birth defects (controls) and women with singleton live births, stillbirths, or terminations with selected nonsyndromic congenital heart defects (CHD; cases).
Methods
Descriptive analyses, logistic regression models, ascertainment of myo-inositol intake from supplements and food using a shortened food frequency questionnaire and survey.
Main Outcome Measures
Odds of CHD.
Results
11 752 cases and 11 415 controls were included. Compared to women not taking myo-inositol supplements, women with any supplemental intake were less likely to have a pregnancy with the selected congenital heart defects as a group (adjusted odds ratio [aOR] = 0.79; 95% confidence interval [CI] 0.66–0.94) or with septal defects alone (aOR = 0.61; 95% CI 0.46–0.81). Compared to women with low total myo-inositol intake from food or supplements, women with high total myo-inositol intake (≥ 500 mg/day) were less likely to have a pregnancy with the selected CHD as a group (aOR = 0.88; 95% CI 0.84–0.93) or conotruncal defects (aOR = 0.87; 95% CI 0.79–0.96); left ventricular outflow tract defects (aOR = 0.87; 95% CI 0.78–0.96); right ventricular outflow tract defects (aOR = 0.85; 95% CI 0.77–0.95); or atrial septal defects (aOR = 0.91; 95% CI 0.83–0.99).
Conclusions
An inverse association was observed between maternal myo-inositol intake during the periconceptional period and the odds of selected CHDs in offspring.
目的探讨母体围孕期（妊娠前3个月至妊娠第3个月）肌醇摄入量与子代先天性心脏缺陷的关系。设计一项基于人群的病例对照研究，使用国家出生缺陷预防研究（NBDPS）数据库。SETTINGUnited状态。人群或样本：无重大出生缺陷的单胎活产妇女（对照组）和单胎活产、死产或因选定的非综合征性先天性心脏缺陷（CHD；病例）而流产的妇女。方法采用描述性分析、logistic回归模型，采用缩短的食物频率问卷和调查方法，确定膳食补充剂和食物中肌醇的摄入量。冠心病的主要结局指标。结果共纳入病例11 752例，对照组11 415例。与不服用肌醇补充剂的女性相比，服用任何补充剂的女性患先天性心脏缺陷的可能性更小（调整优势比[aOR] = 0.79； 95%可信区间[CI] 0.66-0.94）或仅患有室间隔缺陷的女性怀孕的可能性更小（aOR = 0.61； 95%可信区间[CI] 0.46-0.81）。与从食物或补充剂中总肌醇摄入量低的妇女相比，总肌醇摄入量高（≥500毫克/天）的妇女怀孕时所选择的冠心病组（aOR = 0.88; 95% CI 0.84-0.93）或锥体缺陷（aOR = 0.87; 95% CI 0.79-0.96）的可能性较小；左室流出道缺损（aOR = 0.87; 95% CI 0.78 ~ 0.96）；右心室流出道缺损（aOR = 0.85; 95% CI 0.77 ~ 0.95）；或房间隔缺损（aOR = 0.91; 95% CI 0.83-0.99）。结论围孕期母体肌醇摄入量与子代冠心病发生率呈负相关。
{"title":"Maternal Myo-Inositol Intake and Congenital Heart Defects in Offspring: A Population-Based Case–Control Study","authors":"Ruiqi Cen, L. Joseph Su, Jun Ying, Mohammed S. Orloff, Elijah H. Bolin, Xiangyang Lou, Lynn M. Almli, Lorenzo D. Botto, Marilyn L. Browne, Richard H. Finnell, Mary M. Jenkins, Eirini Nestoridi, Andrew F. Olshan, Paul A. Romitti, Gary M. Shaw, Wendy N. Nembhard, the National Birth Defects Prevention Study","doi":"10.1111/1471-0528.70045","DOIUrl":"10.1111/1471-0528.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate associations between maternal periconceptional (three months prior through the third pregnancy month) myo-inositol intake and the odds of selected congenital heart defects in offspring.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A population-based case–control study using the National Birth Defects Prevention Study (NBDPS) database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population or Sample</h3>\u0000 \u0000 <p>Women with singleton live births without major birth defects (controls) and women with singleton live births, stillbirths, or terminations with selected nonsyndromic congenital heart defects (CHD; cases).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Descriptive analyses, logistic regression models, ascertainment of myo-inositol intake from supplements and food using a shortened food frequency questionnaire and survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Odds of CHD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>11 752 cases and 11 415 controls were included. Compared to women not taking myo-inositol supplements, women with any supplemental intake were less likely to have a pregnancy with the selected congenital heart defects as a group (adjusted odds ratio [aOR] = 0.79; 95% confidence interval [CI] 0.66–0.94) or with septal defects alone (aOR = 0.61; 95% CI 0.46–0.81). Compared to women with low total myo-inositol intake from food or supplements, women with high total myo-inositol intake (≥ 500 mg/day) were less likely to have a pregnancy with the selected CHD as a group (aOR = 0.88; 95% CI 0.84–0.93) or conotruncal defects (aOR = 0.87; 95% CI 0.79–0.96); left ventricular outflow tract defects (aOR = 0.87; 95% CI 0.78–0.96); right ventricular outflow tract defects (aOR = 0.85; 95% CI 0.77–0.95); or atrial septal defects (aOR = 0.91; 95% CI 0.83–0.99).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>An inverse association was observed between maternal myo-inositol intake during the periconceptional period and the odds of selected CHDs in offspring.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 3","pages":"442-453"},"PeriodicalIF":4.3,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.70045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145609933","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}
Simrit Nijjar, Ilan E. Timor-Tritsch, Andrea Kaelin Agten, Jin Li, Krystle Y. Chong, Munira Oza, Rosanna Acklom, Francesco D'antonio, Lan N. Vuong, Ben Mol, Cecilia Bottomley, Davor Jurkovic
Objective
To develop a core outcome set (COS) for research on caesarean scar ectopic pregnancy (CSEP) treatment.
Design
Consensus development study.
Setting
International.
Population
Healthcare professionals, researchers, patient advocates, or individuals with lived experience of CSEP.
Methods
The Delphi process was conducted from July to November 2024 following a systematic review and interviews with individuals with lived experience of CSEP, which identified potential outcomes. This process followed COMET guidance. Outcomes were presented in a two-round online Delphi survey. Round one included 287 healthcare professionals, 50 researchers, and 69 patient advocates and individuals with lived experience from 51 countries. In round two, 281 participants from 43 countries contributed. The final COS was developed at a consensus meeting of the steering committee, comprising all key stakeholders.
Results
346 outcomes were initially identified, reduced to 62 in round one, then 40 in round two of the Delphi survey. The final COS comprises 19 core outcomes across seven domains: (1) Treatment success in early CSEP; (2) Complications in early treated CSEP; (3) Success of expectantly managed advanced live CSEP; (4) Complications of expectantly managed advanced live CSEP; (5) Mortality and severe morbidity; (6) Future reproductive health; and (7) Patient experience. Additionally, 15 non-mandatory outcomes and four essential reporting items were recommended. Clear definitions were provided for each core outcome.
Conclusion
Through international consensus, we have developed a COS that reflects the perspectives of healthcare professionals, researchers, and individuals with lived experience of CSEP. This COS allows for standardised outcome reporting in future research, fostering a new generation of high-quality evidence that can inform clinical guidelines and ultimately improve patient outcomes.
{"title":"A Core Outcome Set to Guide Future Research on Caesarean Scar Ectopic Pregnancy: COSCAR Consensus Study","authors":"Simrit Nijjar, Ilan E. Timor-Tritsch, Andrea Kaelin Agten, Jin Li, Krystle Y. Chong, Munira Oza, Rosanna Acklom, Francesco D'antonio, Lan N. Vuong, Ben Mol, Cecilia Bottomley, Davor Jurkovic","doi":"10.1111/1471-0528.70090","DOIUrl":"10.1111/1471-0528.70090","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To develop a core outcome set (COS) for research on caesarean scar ectopic pregnancy (CSEP) treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Consensus development study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>International.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Healthcare professionals, researchers, patient advocates, or individuals with lived experience of CSEP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Delphi process was conducted from July to November 2024 following a systematic review and interviews with individuals with lived experience of CSEP, which identified potential outcomes. This process followed COMET guidance. Outcomes were presented in a two-round online Delphi survey. Round one included 287 healthcare professionals, 50 researchers, and 69 patient advocates and individuals with lived experience from 51 countries. In round two, 281 participants from 43 countries contributed. The final COS was developed at a consensus meeting of the steering committee, comprising all key stakeholders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>346 outcomes were initially identified, reduced to 62 in round one, then 40 in round two of the Delphi survey. The final COS comprises 19 core outcomes across seven domains: (1) Treatment success in early CSEP; (2) Complications in early treated CSEP; (3) Success of expectantly managed advanced live CSEP; (4) Complications of expectantly managed advanced live CSEP; (5) Mortality and severe morbidity; (6) Future reproductive health; and (7) Patient experience. Additionally, 15 non-mandatory outcomes and four essential reporting items were recommended. Clear definitions were provided for each core outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Through international consensus, we have developed a COS that reflects the perspectives of healthcare professionals, researchers, and individuals with lived experience of CSEP. This COS allows for standardised outcome reporting in future research, fostering a new generation of high-quality evidence that can inform clinical guidelines and ultimately improve patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 4","pages":"725-738"},"PeriodicalIF":4.3,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.70090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145611110","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 Kapp et al., pp. 553–561 in this issue. To view this article visit https://doi.org/10.1111/1471-0528.18344.
{"title":"Improving Access to Medical Abortion Services: Results From Ghana and Cambodia","authors":"John Reynolds-Wright, Jacqueline Quinn","doi":"10.1111/1471-0528.70097","DOIUrl":"10.1111/1471-0528.70097","url":null,"abstract":"<p><b>Linked article:</b> This is a mini commentary on Kapp et al., pp. 553–561 in this issue. To view this article visit https://doi.org/10.1111/1471-0528.18344.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"133 4","pages":"647-648"},"PeriodicalIF":4.3,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145609855","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}
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