Ruth C. E. Hughes, Pippa Kyle, Ian Phillips, Chris M. Florkowski, Joanna Gullam
We investigated the value of measuring sFlt-1/PlGF in people with suspected fetal growth restriction (sFGR) without signs of preeclampsia at recruitment. Angiogenic biomarkers were considered positive when sFlt-1/PlGF > 38 or PlGF < 100 pg/mL. Clinicians were blinded to the sFlt-1/PlGF results. In sFGR presenting < 32 weeks, but not ≥ 32–37 weeks, positive angiogenic biomarkers vs. NZ FGR criteria had increased risk of preterm birth RR 5.32 [2.04–13.88] vs. 2.19 [0.89–5.37], respectively, and birthweight < 3rd centile RR 2.11 [1.24–3.58] vs. 1.83 [0.92–3.63], respectively. Larger studies are needed to establish whether routine testing of angiogenic biomarkers in sFGR is recommended for risk stratification.
{"title":"In Suspected Fetal Growth Restriction, sFlt-1/PlGF and PlGF May Have Value in Risk Stratification for Preterm Birth and Birthweight < 3rd Centile: A Blinded Cohort Study","authors":"Ruth C. E. Hughes, Pippa Kyle, Ian Phillips, Chris M. Florkowski, Joanna Gullam","doi":"10.1111/ajo.70003","DOIUrl":"10.1111/ajo.70003","url":null,"abstract":"<p>We investigated the value of measuring sFlt-1/PlGF in people with suspected fetal growth restriction (sFGR) without signs of preeclampsia at recruitment. Angiogenic biomarkers were considered positive when sFlt-1/PlGF > 38 or PlGF < 100 pg/mL. Clinicians were blinded to the sFlt-1/PlGF results. In sFGR presenting < 32 weeks, but not ≥ 32–37 weeks, positive angiogenic biomarkers vs. NZ FGR criteria had increased risk of preterm birth RR 5.32 [2.04–13.88] vs. 2.19 [0.89–5.37], respectively, and birthweight < 3rd centile RR 2.11 [1.24–3.58] vs. 1.83 [0.92–3.63], respectively. Larger studies are needed to establish whether routine testing of angiogenic biomarkers in sFGR is recommended for risk stratification.</p>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 5","pages":"703-708"},"PeriodicalIF":1.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adriana Suker, Ying Li, Anthony Marren, Danielle Robson, the Australasian CREI (Certificate of Reproductive Endocrinology and Infertility) Consensus Expert Panel on Trial evidence (ACCEPT) group
Recurrent pregnancy loss (RPL) is when a woman experiences two or more pregnancy losses. Investigating for causes of RPL can provide an explanation and possible treatment options. This is a summary of Parts 1 and 2 of Australasian Recurrent Pregnancy Loss Clinical Management Guidelines in an easy-to-read patient friendly format. These original publications can be found with a digital object identifier (DOI) 10.1111/ajo.13821 and DOI 10.1111/ajo.13820.
{"title":"Plain Language Summary of the ACCEPT Guideline for the Management of Recurrent Pregnancy Loss","authors":"Adriana Suker, Ying Li, Anthony Marren, Danielle Robson, the Australasian CREI (Certificate of Reproductive Endocrinology and Infertility) Consensus Expert Panel on Trial evidence (ACCEPT) group","doi":"10.1111/ajo.70000","DOIUrl":"10.1111/ajo.70000","url":null,"abstract":"<p>Recurrent pregnancy loss (RPL) is when a woman experiences two or more pregnancy losses. Investigating for causes of RPL can provide an explanation and possible treatment options. This is a summary of Parts 1 and 2 of Australasian Recurrent Pregnancy Loss Clinical Management Guidelines in an easy-to-read patient friendly format. These original publications can be found with a digital object identifier (DOI) 10.1111/ajo.13821 and DOI 10.1111/ajo.13820.</p>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 5","pages":"586-588"},"PeriodicalIF":1.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Systematic, multi-disciplinary review of Severe Acute Maternal Morbidity (SAMM) can improve maternal outcomes. Routinely collected data, collated into the Queensland SAMM Dashboard, may facilitate local case review. We wanted to understand how SAMMs are reviewed locally and how centrally collated data supports review processes.
Aims
The purpose of this survey was to assess local SAMM recording and review practices in Queensland.
Materials and Methods
A cross-sectional online survey, using multiple choice and free-text response formats, sampled multi-disciplinary health care workers (HCW) involved in SAMM review in Queensland public maternity units. Responses were analysed for content, with thematic analysis performed on free-text comments.
Results
Twenty HCW responded from a mix of tertiary, regional and rural maternity facilities. HCW responses identified a lack of clarity around the terms ‘maternal morbidity’, ‘SAMM’ and ‘Near-Miss’. HCW reported various approaches for recording and reviewing SAMM. The commonest structures were Root Cause Analysis and Human Error and Patient Safety incident analysis. Reviews commonly involved: patient safety teams (50%); staff involved in the case (45%); independent/external reviewers (40%) and hospital management (40%). Few responses (10%) indicated consumers were involved. 30%–80% reviewed the ACSQHC defined SAMM, 70% Near-Miss cases and up to 70% reviewed other severe maternal morbidity indicators. 20% of HCW stated lessons learned during reviews were shared with other hospitals.
Conclusions
In Queensland, we have found variability in: HCW understanding of SAMM definitions, how cases are recorded, reviewed and improvements facilitated. A standardised approach to SAMM review and collaboration to share lessons learned may benefit maternity care.
{"title":"Maternity Healthcare Worker Perspectives of Severe Acute Maternal Morbidity Recording, Reporting and Case Review in Queensland, Australia","authors":"Joanne Frost, Edward Weaver, Leonie Callaway","doi":"10.1111/ajo.13945","DOIUrl":"10.1111/ajo.13945","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Systematic, multi-disciplinary review of Severe Acute Maternal Morbidity (SAMM) can improve maternal outcomes. Routinely collected data, collated into the Queensland SAMM Dashboard, may facilitate local case review. We wanted to understand how SAMMs are reviewed locally and how centrally collated data supports review processes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The purpose of this survey was to assess local SAMM recording and review practices in Queensland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A cross-sectional online survey, using multiple choice and free-text response formats, sampled multi-disciplinary health care workers (HCW) involved in SAMM review in Queensland public maternity units. Responses were analysed for content, with thematic analysis performed on free-text comments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty HCW responded from a mix of tertiary, regional and rural maternity facilities. HCW responses identified a lack of clarity around the terms ‘maternal morbidity’, ‘SAMM’ and ‘Near-Miss’. HCW reported various approaches for recording and reviewing SAMM. The commonest structures were Root Cause Analysis and Human Error and Patient Safety incident analysis. Reviews commonly involved: patient safety teams (50%); staff involved in the case (45%); independent/external reviewers (40%) and hospital management (40%). Few responses (10%) indicated consumers were involved. 30%–80% reviewed the ACSQHC defined SAMM, 70% Near-Miss cases and up to 70% reviewed other severe maternal morbidity indicators. 20% of HCW stated lessons learned during reviews were shared with other hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In Queensland, we have found variability in: HCW understanding of SAMM definitions, how cases are recorded, reviewed and improvements facilitated. A standardised approach to SAMM review and collaboration to share lessons learned may benefit maternity care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 5","pages":"607-614"},"PeriodicalIF":1.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The widespread and rapid adoption of private payments for non-invasive prenatal testing (NIPT) in Australia has introduced complexities to the decision-making process for the public regarding prenatal screening. NIPT has the potential to be a useful screening tool, but concerns have been raised about its cost, the psychological consequences of testing and the information available to support informed decision-making.
Objective
To explore the attitudes, values and beliefs around prenatal screening in Australia, and how perspectives may differ between people living in metropolitan locations versus rural/regional locations.
Materials and Methods
Three focus groups were conducted in New South Wales (NSW), Australia. Participants (N = 25) were recruited by a market research group. Focus groups took place face-to-face in metropolitan and rural/regional areas, and online via videoconference. Discussions were transcribed and analysed thematically.
Results
Participants generally expressed interest in undertaking prenatal screening but held misconceptions about the purpose of NIPT (i.e. screening, not diagnosis) and the conditions assessed. There were varied opinions among participants on expanding the scope of screening: some felt additional information provided reassurance, whilst others thought it would increase stress due to the decreased accuracy. People living in rural/regional areas had greater concerns over access to screening (cost, wait times and distance) than people living in metropolitan areas.
Conclusion
Our findings demonstrate different approaches are needed to improve understanding of NIPT (to ensure informed consent), and to improve access to NIPT for people living in rural/regional areas. The pre-test information needs to account for the range of perspectives observed across geographic locations.
{"title":"Public Perspectives Around Prenatal Screening of Chromosomal Abnormalities: A Focus Group Study Comparing Metropolitan and Rural/Regional Areas in Australia","authors":"Amber Salisbury, Hovea Winston, Alexis Johnson, Alison Pearce, Kirsten Howard, Sarah Norris","doi":"10.1111/ajo.13935","DOIUrl":"10.1111/ajo.13935","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The widespread and rapid adoption of private payments for non-invasive prenatal testing (NIPT) in Australia has introduced complexities to the decision-making process for the public regarding prenatal screening. NIPT has the potential to be a useful screening tool, but concerns have been raised about its cost, the psychological consequences of testing and the information available to support informed decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the attitudes, values and beliefs around prenatal screening in Australia, and how perspectives may differ between people living in metropolitan locations versus rural/regional locations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Three focus groups were conducted in New South Wales (NSW), Australia. Participants (<i>N</i> = 25) were recruited by a market research group. Focus groups took place face-to-face in metropolitan and rural/regional areas, and online via videoconference. Discussions were transcribed and analysed thematically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants generally expressed interest in undertaking prenatal screening but held misconceptions about the purpose of NIPT (i.e. screening, not diagnosis) and the conditions assessed. There were varied opinions among participants on expanding the scope of screening: some felt additional information provided reassurance, whilst others thought it would increase stress due to the decreased accuracy. People living in rural/regional areas had greater concerns over access to screening (cost, wait times and distance) than people living in metropolitan areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings demonstrate different approaches are needed to improve understanding of NIPT (to ensure informed consent), and to improve access to NIPT for people living in rural/regional areas. The pre-test information needs to account for the range of perspectives observed across geographic locations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 4","pages":"506-517"},"PeriodicalIF":1.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13935","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica Dunning, Amy Burrows, Michael Wynn-Williams, Simon Edmonds, Keryn Harlow, Whitney Rowland, Lynn Sadler
Background
In Aotearoa New Zealand, there are limited data on ethnicity-specific prevalence and management of endometriosis and persistent pelvic pain. In the international literature, there appears to be a wide variation in both diagnosis and treatment access for these common conditions.
Aims
To explore ethnicity-specific referral data for people with symptoms of endometriosis and pelvic pain referred to two tertiary hospitals in Aotearoa New Zealand.
Materials and Methods
Referrals to two gynaecology departments, in the North and South Islands of New Zealand, for women aged 16–52 during 2021 were screened and included if the primary referral reason was pelvic pain > 3 months, abdominal pain, dysmenorrhea, endometriosis or dyspareunia. Denominator data were obtained from Statistics NZ.
Results
There was a significantly lower referral rate at the North Island unit for Māori, Pacific and Asian people compared to European/MELAA; and a significantly lower referral rate in the South Island unit for Pacific and Asian people compared to European/MELAA and Māori, per 1000 women aged 16–52 years per year. Similar patterns occurred in the rates of waitlisting for surgery.
Conclusions
European women are privileged in Aotearoa compared to Māori, Pacific and Asian people in secondary referral and population waitlisting for surgery. This privilege was not evident in waitlisting for surgery from the gynaecology clinic. We suggest that a nationally consistent approach to the management of endometriosis and persistent pelvic pain is required.
{"title":"Ethnicity Variations in Pathways to Care and Diagnosis of Endometriosis and Persistent Pelvic Pain in Aotearoa New Zealand","authors":"Jessica Dunning, Amy Burrows, Michael Wynn-Williams, Simon Edmonds, Keryn Harlow, Whitney Rowland, Lynn Sadler","doi":"10.1111/ajo.13942","DOIUrl":"10.1111/ajo.13942","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In Aotearoa New Zealand, there are limited data on ethnicity-specific prevalence and management of endometriosis and persistent pelvic pain. In the international literature, there appears to be a wide variation in both diagnosis and treatment access for these common conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To explore ethnicity-specific referral data for people with symptoms of endometriosis and pelvic pain referred to two tertiary hospitals in Aotearoa New Zealand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Referrals to two gynaecology departments, in the North and South Islands of New Zealand, for women aged 16–52 during 2021 were screened and included if the primary referral reason was pelvic pain > 3 months, abdominal pain, dysmenorrhea, endometriosis or dyspareunia. Denominator data were obtained from Statistics NZ.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was a significantly lower referral rate at the North Island unit for Māori, Pacific and Asian people compared to European/MELAA; and a significantly lower referral rate in the South Island unit for Pacific and Asian people compared to European/MELAA and Māori, per 1000 women aged 16–52 years per year. Similar patterns occurred in the rates of waitlisting for surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>European women are privileged in Aotearoa compared to Māori, Pacific and Asian people in secondary referral and population waitlisting for surgery. This privilege was not evident in waitlisting for surgery from the gynaecology clinic. We suggest that a nationally consistent approach to the management of endometriosis and persistent pelvic pain is required.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 4","pages":"498-505"},"PeriodicalIF":1.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Polly R. Britten, Darcy L. McNaughton, Samantha L. Moore, Shelby A. Edwards, Leanne J. Brown, Natasha Weaver, Tracy L. Schumacher
Background
Low birth weight (LBW) is associated with adverse short-term and long-term health outcomes for neonates. The impact of maternal geographical location on rates of LBW in Australia is conflicted in existing literature.
Aims
The aim was to identify if a difference in rates of LBW exist between neonates born to rural versus metropolitan maternal residence. Secondary aim was to identify any associated factors influencing LBW.
Materials and Methods
A secondary data analysis of retrospective health surveillance data from all births from 2018 to 2022 in the Hunter New England Local Health District (New South Wales, Australia) was performed. Logistic regression was used to determine odds ratio and adjusted odds ratio of LBW for rural versus metropolitan residence.
Results
A total of 39,579 neonates were included in this analysis, with 50.9% of the maternal cohort residing rurally. Median maternal was age 29.2 years. Rates of LBW were higher in rural maternal residence (5.7%) compared to metropolitan residence (5.2%). Odds of neonatal LBW did not differ between rural and maternal metropolitan residence after adjusting for confounders (adjusted Odds Ratio (aOR) = 0.90, 95% CI 0.79–1.01, p = 0.07). Socioeconomic disadvantage was significantly identified as an issue associated with LBW.
Conclusions
LBW neonates were more likely to be born to rural maternal residence and LBW risk factors disproportionately affected those living in rural locations. To reduce LBW in neonates, it is imperative that access to safe and affordable healthcare is available, and resources addressing LBW risk factors are specific to geographical locations.
背景：低出生体重（LBW）与新生儿不良的短期和长期健康结局相关。在澳大利亚，产妇地理位置对LBW率的影响在现有文献中是相互矛盾的。目的：目的是确定在农村和都市母亲居住的新生儿中是否存在LBW率的差异。次要目的是确定影响LBW的任何相关因素。材料和方法：对澳大利亚新南威尔士州亨特新英格兰地方卫生区2018年至2022年所有新生儿的回顾性健康监测数据进行二次数据分析。采用Logistic回归方法确定农村居民与都市居民的体重优势比和调整优势比。结果：共有39,579名新生儿被纳入本分析，其中50.9%的产妇队列居住在农村。产妇的中位年龄为29.2岁。农村孕产妇的LBW率（5.7%）高于城市孕产妇（5.2%）。调整混杂因素后，农村地区和城市地区新生儿低体重的几率没有差异（调整后的优势比(aOR) = 0.90, 95% CI 0.79-1.01, p = 0.07）。社会经济劣势被显著认定为与低体重相关的一个问题。结论：低体重新生儿更有可能出生在农村孕产妇居住地，低体重危险因素对农村孕产妇的影响不成比例。为了减少新生儿的低体重，必须提供安全和负担得起的医疗保健，并且针对低体重风险因素的资源是针对地理位置的。
{"title":"Does Maternal Location of Residence Affect Low Birth Weight Outcomes in Hunter New England Local Health District?","authors":"Polly R. Britten, Darcy L. McNaughton, Samantha L. Moore, Shelby A. Edwards, Leanne J. Brown, Natasha Weaver, Tracy L. Schumacher","doi":"10.1111/ajo.13944","DOIUrl":"10.1111/ajo.13944","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Low birth weight (LBW) is associated with adverse short-term and long-term health outcomes for neonates. The impact of maternal geographical location on rates of LBW in Australia is conflicted in existing literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim was to identify if a difference in rates of LBW exist between neonates born to rural versus metropolitan maternal residence. Secondary aim was to identify any associated factors influencing LBW.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A secondary data analysis of retrospective health surveillance data from all births from 2018 to 2022 in the Hunter New England Local Health District (New South Wales, Australia) was performed. Logistic regression was used to determine odds ratio and adjusted odds ratio of LBW for rural versus metropolitan residence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 39,579 neonates were included in this analysis, with 50.9% of the maternal cohort residing rurally. Median maternal was age 29.2 years. Rates of LBW were higher in rural maternal residence (5.7%) compared to metropolitan residence (5.2%). Odds of neonatal LBW did not differ between rural and maternal metropolitan residence after adjusting for confounders (adjusted Odds Ratio (aOR) = 0.90, 95% CI 0.79–1.01, <i>p</i> = 0.07). Socioeconomic disadvantage was significantly identified as an issue associated with LBW.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>LBW neonates were more likely to be born to rural maternal residence and LBW risk factors disproportionately affected those living in rural locations. To reduce LBW in neonates, it is imperative that access to safe and affordable healthcare is available, and resources addressing LBW risk factors are specific to geographical locations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 5","pages":"596-606"},"PeriodicalIF":1.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Monica Sarofim, Xu Huilan, Li Ming Wen, Louise A. Baur
Background
Maternal obesity-risk behaviours during pregnancy have a direct impact on the weight trajectory of their children. Targeting these behaviours may help improve birth outcomes and child health. This study aimed to identify sociodemographic factors associated with unhealthy dietary behaviours and insufficient physical activity in pregnant women.
Materials and Methods
We undertook a cross-sectional secondary analysis using data from the Communicating Healthy Beginnings Advice by Telephone (CHAT) trial conducted in NSW, Australia in 2017–2019. Multiple logistic regression models were built to determine associations.
Results
A total of 1155 pregnant mothers attended antenatal clinics from 28 to 34 weeks gestation. Younger age (< 30 years, adjusted odds ratio [AOR] 2.01, 95% confidence interval [CI] 1.53–2.64) and paternal unemployment (AOR1.86, 95% CI1.44–2.39) were associated with a cluster of unhealthy dietary behaviours. Excessive intake of discretionary foods (processed meat, fast food, potato crisps) was associated with: younger age (AOR1.62, 95% CI 1.24–2.11), being Australian-born (AOR1.55, 95% CI 1.20–2.01), paternal unemployment (AOR1.57, 95% CI 1.01–2.43) and lower paternal education level (AOR1.77, 95% 1.37–2.28). Insufficient physical activity behaviours were associated with maternal employment (AOR1.55, 95% CI 1.21–1.98) and those with tertiary-level education (AOR1.39, 95% CI 1.08–1.79).
Conclusions
Mothers aged under 30 years and those born in Australia were more likely to have a cluster of obesity-risk behaviours. Maternal and paternal employment status, and education level were also associated with such clusters.
{"title":"Associations of Sociodemographic Factors With Clusters of Obesity-Risk Behaviours Among Pregnant Women in Australia","authors":"Monica Sarofim, Xu Huilan, Li Ming Wen, Louise A. Baur","doi":"10.1111/ajo.70002","DOIUrl":"10.1111/ajo.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Maternal obesity-risk behaviours during pregnancy have a direct impact on the weight trajectory of their children. Targeting these behaviours may help improve birth outcomes and child health. This study aimed to identify sociodemographic factors associated with unhealthy dietary behaviours and insufficient physical activity in pregnant women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We undertook a cross-sectional secondary analysis using data from the Communicating Healthy Beginnings Advice by Telephone (CHAT) trial conducted in NSW, Australia in 2017–2019. Multiple logistic regression models were built to determine associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1155 pregnant mothers attended antenatal clinics from 28 to 34 weeks gestation. Younger age (< 30 years, adjusted odds ratio [AOR] 2.01, 95% confidence interval [CI] 1.53–2.64) and paternal unemployment (AOR1.86, 95% CI1.44–2.39) were associated with a cluster of unhealthy dietary behaviours. Excessive intake of discretionary foods (processed meat, fast food, potato crisps) was associated with: younger age (AOR1.62, 95% CI 1.24–2.11), being Australian-born (AOR1.55, 95% CI 1.20–2.01), paternal unemployment (AOR1.57, 95% CI 1.01–2.43) and lower paternal education level (AOR1.77, 95% 1.37–2.28). Insufficient physical activity behaviours were associated with maternal employment (AOR1.55, 95% CI 1.21–1.98) and those with tertiary-level education (AOR1.39, 95% CI 1.08–1.79).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Mothers aged under 30 years and those born in Australia were more likely to have a cluster of obesity-risk behaviours. Maternal and paternal employment status, and education level were also associated with such clusters.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 5","pages":"615-625"},"PeriodicalIF":1.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EXPRESSION OF CONCERN: S. A. M. Shazly, L. H. O. Embaby, and S. S. Ali. “The Labour Scale—Assessment of the Validity of a Novel Labour Chart: A Pilot Study†.” Australian and New Zealand Journal of Obstetrics and Gynaecology 54, no. 4 (2014): 322–326. https://doi.org/10.1111/ajo.12209.
This Expression of Concern for the above article published online on 17 May 2014 in Wiley Online Library (wileyonlinelibrary.com) has been published by agreement between the journal Editor-in-Chief, Scott White; The Royal Australian and New Zealand College of Obstetricians and Gynaecologists; and John Wiley & Sons Australia Ltd. The Expression of Concern has been agreed due to concerns raised about the accuracy of the mean age of nullipara and multipara presented in Table 1. Furthermore, the feasibility of the 1-min APGAR scores listed in Table 1 was also questioned. The authors provided an explanation and an incomplete data set excluding some of the results flagged as implausible. This was not considered satisfactory, thus the journal has decided to issue an Expression of Concern to alert the readers.
关注表达：S. A. M. Shazly， L. H. O. Embaby和S. S. Ali。劳动量表-评估一种新型劳动图表的有效性：一项试点研究*《澳大利亚和新西兰妇产科杂志》，第54期。4(2014): 322-326。https://doi.org/10.1111/ajo.12209.This对上述文章的关注表达于2014年5月17日发表在Wiley在线图书馆（wileyonlinelibrary.com）上，经期刊主编Scott White同意，该文章已被发表；澳大利亚和新西兰皇家妇产科学院；约翰·威利&；澳大利亚之子有限公司由于对表1所列无明文规定者和有明文规定者的平均年龄的准确性表示关注，因此同意发表关注声明。此外，表1所列的1分钟APGAR评分的可行性也受到质疑。作者提供了一个解释和一个不完整的数据集，排除了一些被标记为不可信的结果。这并不令人满意，因此该杂志决定发布一份关注表达，以提醒读者。
{"title":"EXPRESSION OF CONCERN: The Labour Scale—Assessment of the Validity of a Novel Labour Chart: A Pilot Study†","authors":"","doi":"10.1111/ajo.13938","DOIUrl":"10.1111/ajo.13938","url":null,"abstract":"<p><b>EXPRESSION OF CONCERN:</b> S. A. M. Shazly, L. H. O. Embaby, and S. S. Ali. “The Labour Scale—Assessment of the Validity of a Novel Labour Chart: A Pilot Study†.” <i>Australian and New Zealand Journal of Obstetrics and Gynaecology</i> 54, no. 4 (2014): 322–326. https://doi.org/10.1111/ajo.12209.</p><p>This Expression of Concern for the above article published online on 17 May 2014 in Wiley Online Library (wileyonlinelibrary.com) has been published by agreement between the journal Editor-in-Chief, Scott White; The Royal Australian and New Zealand College of Obstetricians and Gynaecologists; and John Wiley & Sons Australia Ltd. The Expression of Concern has been agreed due to concerns raised about the accuracy of the mean age of nullipara and multipara presented in Table 1. Furthermore, the feasibility of the 1-min APGAR scores listed in Table 1 was also questioned. The authors provided an explanation and an incomplete data set excluding some of the results flagged as implausible. This was not considered satisfactory, thus the journal has decided to issue an Expression of Concern to alert the readers.</p>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13938","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Melvin B. Marzan, Daniel L. Rolnik, Jason Jiang, Joanne M. Said, Kirsten R. Palmer, Stephanie Potenza, Natasha Pritchard, Clare L. Whitehead, Penelope M. Sheehan, Jolyon Ford, Ben W. Mol, Susan P. Walker, Lisa Hui
Background
Research has linked postcode-level sociodemographic, food and built environment factors to maternal and perinatal outcomes like overweight (BMI > 25 kg/m2), gestational diabetes mellitus (GDM) and large for gestational age (LGA) birthweight. However, little is known about how these factors were influenced by the COVID-19 pandemic. We examine how postcode-level indicators and lockdown conditions are associated with the prevalence of maternal overweight, GDM and LGA.
Materials and Methods
We analysed birth records from 12 public maternity hospitals in Melbourne, integrating postcode-level environmental indicators. Spatial regression models assessed associations between these indicators and maternal health outcomes, distinguishing between (a) the COVID-19 lockdown and (b) post-lockdown periods.
Results
We included 31 083 singleton birth records from 2020 to 2023 across 235 postcodes in Greater Melbourne. The prevalence of maternal overweight, GDM and LGA were 496, 178 and 103 per 1000 births, respectively. Maternal overweight was less prevalent in postcodes with higher median ages and socioeconomic scores, with disparities intensifying during lockdowns. GDM was more common in areas with younger, overseas-born populations, while LGA correlated with higher median age and fewer overseas-born residents. Notably, maternal overweight mediated the effect of socioeconomic status on GDM and LGA.
Conclusions
The prevalence of maternal overweight, GDM and LGA varies significantly across Melbourne, shaped by postcode-level factors. The pandemic lockdown amplified existing health disparities. The food and built-environment factors independently influence maternal and perinatal outcomes.
{"title":"Geospatial Determinants of Maternal Overweight, Gestational Diabetes and Large for Gestational Age Birthweight in Melbourne During and After COVID-19 Lockdowns","authors":"Melvin B. Marzan, Daniel L. Rolnik, Jason Jiang, Joanne M. Said, Kirsten R. Palmer, Stephanie Potenza, Natasha Pritchard, Clare L. Whitehead, Penelope M. Sheehan, Jolyon Ford, Ben W. Mol, Susan P. Walker, Lisa Hui","doi":"10.1111/ajo.13943","DOIUrl":"10.1111/ajo.13943","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Research has linked postcode-level sociodemographic, food and built environment factors to maternal and perinatal outcomes like overweight (BMI > 25 kg/m<sup>2</sup>), gestational diabetes mellitus (GDM) and large for gestational age (LGA) birthweight. However, little is known about how these factors were influenced by the COVID-19 pandemic. We examine how postcode-level indicators and lockdown conditions are associated with the prevalence of maternal overweight, GDM and LGA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We analysed birth records from 12 public maternity hospitals in Melbourne, integrating postcode-level environmental indicators. Spatial regression models assessed associations between these indicators and maternal health outcomes, distinguishing between (a) the COVID-19 lockdown and (b) post-lockdown periods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 31 083 singleton birth records from 2020 to 2023 across 235 postcodes in Greater Melbourne. The prevalence of maternal overweight, GDM and LGA were 496, 178 and 103 per 1000 births, respectively. Maternal overweight was less prevalent in postcodes with higher median ages and socioeconomic scores, with disparities intensifying during lockdowns. GDM was more common in areas with younger, overseas-born populations, while LGA correlated with higher median age and fewer overseas-born residents. Notably, maternal overweight mediated the effect of socioeconomic status on GDM and LGA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prevalence of maternal overweight, GDM and LGA varies significantly across Melbourne, shaped by postcode-level factors. The pandemic lockdown amplified existing health disparities. The food and built-environment factors independently influence maternal and perinatal outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 4","pages":"489-497"},"PeriodicalIF":1.7,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13943","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ektoras X. Georgiou, Yossi Mizrachi, Rebecca Kelley, Sharyn Stock-Myer, John Stevens, David K. Gardner, Alex Polyakov
Background
Modern assisted reproductive technology (ART), including pre-implantation genetic testing for aneuploidy (PGT-A), has opened new avenues in understanding early embryonic events and has simultaneously raised questions about the impact of ART itself on sex ratios.
Aims
The primary aim was to investigate whether patient demographic characteristics, ovarian stimulation protocols or laboratory characteristics in ART influence sex ratios. The secondary aim was to relate the blastocyst sex ratio (BSR) to the corresponding secondary sex ratio (SSR) in our patient cohort.
Materials and Methods
We conducted a retrospective single-centre cohort study on consecutive PGT-A cycles from January 2019 to February 2022. We analysed demographic data, stimulation protocols, laboratory characteristics and pregnancy outcomes.
Results
The euploidy rate was 45.1% (2608/5777), BSR 1.07 and euploid BSR 1.03. There was no statistical difference in the ploidy status of XX and XY blastocysts and on multivariate logistic regression analysis, there was no association between euploidy and BSR or any other variables examined, including female age and stimulation protocol. The SSR was 1.02 (1294 embryo transfers) with no statistical difference in biochemical pregnancy (p = 0.41), clinical pregnancy (p = 0.56), miscarriage (p = 0.65) or live birth rates (p = 0.40) based on embryo sex.
Conclusions
Our study indicates that the euploid BSR is not skewed by sex, and there is no relationship between BSR and euploidy, patient characteristics or stimulation protocols. Pregnancy outcomes did not vary by sex, and the SSR was consistent with the SSR of the general Australian population at birth.
{"title":"The Effect of Assisted Reproductive Technologies on Human Sex Ratios","authors":"Ektoras X. Georgiou, Yossi Mizrachi, Rebecca Kelley, Sharyn Stock-Myer, John Stevens, David K. Gardner, Alex Polyakov","doi":"10.1111/ajo.13940","DOIUrl":"10.1111/ajo.13940","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Modern assisted reproductive technology (ART), including pre-implantation genetic testing for aneuploidy (PGT-A), has opened new avenues in understanding early embryonic events and has simultaneously raised questions about the impact of ART itself on sex ratios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The primary aim was to investigate whether patient demographic characteristics, ovarian stimulation protocols or laboratory characteristics in ART influence sex ratios. The secondary aim was to relate the blastocyst sex ratio (BSR) to the corresponding secondary sex ratio (SSR) in our patient cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a retrospective single-centre cohort study on consecutive PGT-A cycles from January 2019 to February 2022. We analysed demographic data, stimulation protocols, laboratory characteristics and pregnancy outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The euploidy rate was 45.1% (2608/5777), BSR 1.07 and euploid BSR 1.03. There was no statistical difference in the ploidy status of XX and XY blastocysts and on multivariate logistic regression analysis, there was no association between euploidy and BSR or any other variables examined, including female age and stimulation protocol. The SSR was 1.02 (1294 embryo transfers) with no statistical difference in biochemical pregnancy (<i>p</i> = 0.41), clinical pregnancy (<i>p</i> = 0.56), miscarriage (<i>p</i> = 0.65) or live birth rates (<i>p</i> = 0.40) based on embryo sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study indicates that the euploid BSR is not skewed by sex, and there is no relationship between BSR and euploidy, patient characteristics or stimulation protocols. Pregnancy outcomes did not vary by sex, and the SSR was consistent with the SSR of the general Australian population at birth.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 4","pages":"483-488"},"PeriodicalIF":1.7,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13940","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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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