AJOG global reports最新文献

{"title":"Hospital waterbirth for low-risk birthing people: findings of a randomized controlled trial","authors":"Emily Malloy PhD, CNM , Jessica J.F. Kram MPH , James O. Adefisoye PhD , Marie Forgie DO , Diana Kleber RN , MaryAnne Scherer CNM , Anna Anklam CNM , Natasha Hernandez MD , Lisa Hanson PhD, CNM","doi":"10.1016/j.xagr.2025.100558","DOIUrl":"10.1016/j.xagr.2025.100558","url":null,"abstract":"<div><h3>Background</h3><div>Waterbirth is the act of giving birth submerged in a tub of warm water, with the baby born underwater. Support for widespread adoption of waterbirth in the United States (US) has been limited by predominantly retrospective study designs, the underutilization of interdisciplinary citations, and disagreement between professional organizations. No randomized controlled trials of waterbirth have been conducted in the US.</div></div><div><h3>Objective</h3><div>The purpose of this randomized controlled trial was to compare pain management, maternal and neonatal outcomes, and maternal satisfaction between low-risk water and land group study participants.</div></div><div><h3>Study Design</h3><div>Low-risk pregnant adults were offered study participation between 25 to 34 weeks of gestation during routine prenatal care. Participants who met the inclusion criteria were consented, enrolled, and randomly assigned to waterbirth or land birth in a 2:1 unblinded fashion, to achieve a sample size of n=120 (80 waterbirth: 40 land birth). The sample size was adjusted for attrition and increased to n=186 (124 waterbirth: 62 land birth) based on an interim analysis. Participants in both arms were excluded if they developed intrapartum risk factors prior to delivery using a modified intention-to-treat model. Study participants received routine intrapartum care, including all available pain relief options. Only those assigned to the waterbirth group were given the option of giving birth in water. Prior to discharge, participants completed <em>The US Birth Satisfaction Scale Revised</em>. The primary study outcome was the use of any intravenous narcotics and/or epidural anesthesia. Secondary outcomes included predetermined composite maternal and neonatal outcomes and overall birth satisfaction. Using a modified intention-to-treat approach, outcomes were analyzed using Chi-square, Fisher’s Exact, or Wilcoxon-Mann-Whitney test as appropriate. Relative risks (RR) were computed where applicable.</div></div><div><h3>Results</h3><div>From January 2022 to December 2023, 186 participants were enrolled (n=124 waterbirth, n=62 land birth). Following enrollment, 106 participants (n=74 waterbirth, and n=32 land birth) remained eligible for the study. Attrition was 39%. Compared to the land birth group, waterbirth participants were significantly less likely to use intravenous narcotics [RR: 0.36 (95% confidence interval [CI], 0.17−0.75), <em>P<</em>.01] and epidural analgesia [RR: 0.38 (95% CI, 0.24−0.58), <em>P<</em>.01] and had shorter average first stage labor duration [median difference -2.00 hours (95% CI, -3.00 to 1.00), <em>P</em>=.43]. One cord avulsion occurred in the waterbirth group. Additional maternal and neonatal outcomes were not significantly different between groups. Waterbirth participants experienced higher overall birth satisfaction [median difference 3.50 (95% CI, 1.00-5.00), <em>P</em>=.01].</div></div><div><h3>Conclusion</h3>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100558"},"PeriodicalIF":0.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145057210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monkeypox virus infection in a 23-year-old woman with a genital rash and global skin lesions: evidence for spouse-to-spouse transmission","authors":"Wen-Shuang Li MSc ,&nbsp;Rong-Jing Dong PhD ,&nbsp;Shui-Tao Yi MSc ,&nbsp;Ru-Qin Zhang BSc ,&nbsp;Rui-Xia Chen MSc ,&nbsp;Yan-Jie Ning MSc ,&nbsp;Dian-Jiang Xiao BSc","doi":"10.1016/j.xagr.2025.100550","DOIUrl":"10.1016/j.xagr.2025.100550","url":null,"abstract":"<div><div>We report one case in China of a couple simultaneously infected with the monkeypox. Both spouses developed genital skin lesions successively and the female partner had widespread skin lesions all over her body, while the male partner is HIV-positive, had a history of homosexual behavior before the onset of symptoms.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100550"},"PeriodicalIF":0.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145121148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective study to correlate the cervical length by transvaginal ultrasound with preterm labor and perinatal outcomes","authors":"Nina Mahale MD ,&nbsp;Devangi Panchal MS ,&nbsp;Ajit Mahale MDRD ,&nbsp;Sonali Ullal MDRD ,&nbsp;Merwyn Fernandes DMRD, DNB, FRCR ,&nbsp;Sonali Prabhu MDRD","doi":"10.1016/j.xagr.2025.100561","DOIUrl":"10.1016/j.xagr.2025.100561","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>This study aimed to investigate the role of transvaginal ultrasound as a screening tool to assess cervical length and improve perinatal outcomes to prevent preterm labor through appropriate interventions.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to determine the mean cervical length at 11 to 14 and 18 to 22 weeks of gestation and to estimate the rate of cervical length shortening and its correlation with birth outcomes.</div></div><div><h3>STUDY DESIGN</h3><div>This prospective study was conducted at Lady Goschen Hospital and KMC Hospital, Attavar, both of which are affiliated with Manipal Academy of Higher Education. This study included 93 pregnant women who came for antenatal care at Lady Goschen Hospital and KMC Hospital, Attavar, from December 2022 to August 2024. All participants provided consent to participate in the study. The formula is a follows: n = Zα2 (Sn)(1-Sn) / L2 × p, where Zα = 1.96 at a 95% confidence level, Sn = sensitivity, l = allowable error, and p = negative prevalence (Sn = 75% [reference article], L = 20% [80% power], and p = 50% (assumption) with 95% confidence interval and 80% power with respect to reference [prediction of preterm labor by cervical length]). Convenient sampling was performed. Data analysis was performed using descriptive statistics. Changes in follow-up were estimated using analysis of variance and the Bonferroni <em>t</em> test. Sensitivity, specificity, positive predictive value, and negative predictive value were estimated. Statistical analysis was performed using SPSS (version. 2.0; IBM, Armonk, New York). A <em>P</em> value of &gt;.05 was considered statistically significant.</div></div><div><h3>RESULTS</h3><div>Cervical length measured using transvaginal ultrasound at 18 to 22 weeks of gestation was found to be more sensitive and to have better positive predictive value in predicting preterm labor than cervical length measured at 11 to 13 weeks of gestation. Cervical length between 18 and 22 weeks of gestation and the reduction of cervical length were found to be statistically significant in predicting preterm labor (<em>P</em>=.001).</div></div><div><h3>CONCLUSION</h3><div>Transvaginal ultrasound is a noninvasive and comparatively affordable modality for identifying women at risk of preterm labor. In addition, this technology could help identify women at risk of preterm labor, thereby reducing morbidity and mortality.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100561"},"PeriodicalIF":0.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145021056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation between epidural analgesia and perinatal outcomes on Robson class 2a.","authors":"Serena Lecis, Giulia Bonfiglioli, Francesco Cannistrà, Sara Verra, Lucia Lisotti, Letizia Ramovecchi, Antonio Saddò, Giuseppe Chiossi, Riccardo Cuoghi Costantini, Roberto D'Amico, Sara Lazzarin, Fabio Facchinetti, Isabella Neri, Lara Donno, Massimo Girardis, Antonio La Marca, Francesca Monari","doi":"10.1016/j.xagr.2025.100554","DOIUrl":"https://doi.org/10.1016/j.xagr.2025.100554","url":null,"abstract":"<p><strong>Background: </strong><b>:</b> The use of epidural analgesia represents the gold standard for pain management during labor, however, the influence of the use of epidural analgesia on delivery mode and neonatal outcomes is not fully understood. Moreover, the rate of induction of labor worldwide is increasing dramatically.</p><p><strong>Objective: </strong><b>:</b> This study aimed to analyze the impact of epidural analgesia on the mode of parturition and perinatal outcomes among individuals classified as Robson class 2a.</p><p><strong>Study design: </strong>A retrospective cohort study was conducted on every Robson class 2a individual who delivered from January 1, 2022, to December 31, 2023, at the University Hospital of Modena in the north of Italy. The primary outcome was the delivery mode (cesarean delivery, vaginal delivery, and operative vaginal delivery rates), and the secondary outcomes were the effect of epidural analgesia on the duration of labor, duration of the second stage of labor, Apgar score, and neonatal intensive care unit admission.</p><p><strong>Results: </strong>Overall, 809 individuals were included in the final analysis, and 456 of them (56.4%) received epidural analgesia on request. Among individuals with and those without epidural analgesia, the cesarean delivery rate was 25% and 20.4% (<i>P</i>=.12), the vaginal delivery rate was 65.6% and 69.4% (<i>P</i>=.25), and the operative vaginal delivery rate was 9.4% and 10.2% (<i>P</i>=.72), respectively, without statistically significant differences. Furthermore, no significant difference was found in the neonatal outcomes between the 2 groups. Individuals with epidural analgesia had longer induction (<i>P</i><.001) and second stage (<i>P</i>=.004) times than those without. These findings were confirmed by multivariable logistic and multinomial regression analyses. In the multivariable logistic regression, the increased induction time was associated not only with epidural analgesia (<i>P</i><.001) but also with body mass index at delivery (<i>P</i>=.027), the gestational age at induction (<i>P</i><.001), post-term pregnancy (<i>P</i><.001), and induction indications of gestational diabetes or an estimated fetal weight >95th percentile (<i>P</i><.001). Similarly, the increased duration of the second stage was associated not only with epidural analgesia (<i>P</i>=.026) but also with neonatal weight (<i>P</i>=.005) and induction indication for gestational diabetes or estimated fetal weight >95th percentile (<i>P</i>=.034).</p><p><strong>Conclusion: </strong>Epidural analgesia was among the factors that increased both the induction and second stage of delivery times. However, epidural analgesia did not impact the mode of delivery and perinatal outcomes in Robson class 2a individuals.</p>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"100554"},"PeriodicalIF":0.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12886058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare complication after common obstetric procedure: rectus sheath hematoma after amniocentesis treated with embolization case report","authors":"Anna R. Ilivicky MD ,&nbsp;Shreya S. Katwala BA ,&nbsp;Julie A. Vircks DO, MBA ,&nbsp;Teresa A. Orth MD, PhD","doi":"10.1016/j.xagr.2025.100551","DOIUrl":"10.1016/j.xagr.2025.100551","url":null,"abstract":"<div><div>Rectus sheath hematomas are becoming more commonly diagnosed but are typically associated with high-risk patients, such as older adult patients, patients on anticoagulation, or patients with recent trauma. This case describes a woman who underwent genetic amniocentesis at 20 1/7 weeks of gestation with a resultant rectus sheath hematoma that began expanding after an exacerbation of the patient’s chronic obstructive pulmonary disease approximately 2 weeks after the patient’s amniocentesis procedure. Ultimately, embolization and coiling of the right inferior epigastric artery were required due to the expanding hematoma and worsening pain. Antibiotics were administered due to concern for a late complication of amniocentesis and a prolonged recovery with a large hematoma.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100551"},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of education on endometriosis and mediating effects: a mendelian randomization study","authors":"Luhongyuan Jin ,&nbsp;Chi Chi ,&nbsp;Qin Zhang ,&nbsp;Yueming Zhang ,&nbsp;Guorong Han M.D. ,&nbsp;Jun Lin M.D. ,&nbsp;Wenjie Hou M.D.","doi":"10.1016/j.xagr.2025.100559","DOIUrl":"10.1016/j.xagr.2025.100559","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the potential impact of years of education, which serves as a measure of socioeconomic inequality, on the occurrence of endometriosis, and to quantify the potential influence of modifiable factors as mediators.</div></div><div><h3>Methods</h3><div>The study used SNPs as genetic tools for genetic association. Analysis using 2-sample univariate and multivariate Mendelian randomization methods. Primary analyses were performed using an inverse variance weighted MR method. Data were obtained from publicly available genome-wide association studies (GWAS) from European populations. Data for ending endometriosis were obtained from the Neale lab.</div></div><div><h3>Results</h3><div>Each SD increase in years of education (4.2 years) has a protective effect on endometriosis (OR 0.9975; 95% CI 0.9958–0.9951). For individuals, the most significant contribution is the depression factor (mediation effect 53%, 95% CI: 3–102%). After combining, the mediator variable explains 64% (95% CI: 55%–290%) of the education—endometriosis association.</div></div><div><h3>Summary</h3><div>Higher education attainment potentially has a causal protective effect on endometriosis, while lower education levels may increase the risk of endometriosis through modifiable factors such as depression, insomnia, and anxiety.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100559"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers predicting adverse pregnancy outcomes in women living with obesity: a systematic review and meta-analysis","authors":"Tabitha Wishlade MSc ,&nbsp;Sara Wetzler MPhil ,&nbsp;Catherine E. Aiken PhD","doi":"10.1016/j.xagr.2025.100527","DOIUrl":"10.1016/j.xagr.2025.100527","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically review the literature on associations between antenatal biomarkers and adverse pregnancy outcomes in women with BMI ≥30 kg/m². <em>Data sources</em>: Systematic literature searches used predefined search terms in PubMed, Ovid Embase, Ovid MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials. Databases were searched from inception to August 2024.</div></div><div><h3>Study eligibility criteria</h3><div>Interventional and observational studies comparing pregnancy outcomes amongst women with a pre- or early-pregnancy (&lt;20 weeks’ gestation) BMI ≥30 kg/m² according to presence or amount of any antenatally measured biomarker were included.</div></div><div><h3>Study appraisal and synthesis methods</h3><div>Two reviewers independently assessed studies for inclusion against predefined inclusion and exclusion criteria. Risk of bias assessment was performed on included studies using the Newcastle-Ottawa Risk of Bias Tool. A narrative synthesis of eligible studies was constructed and data were meta-analysed, where possible, using random effects models. Certainty of evidence was assessed by GRADE rating.</div></div><div><h3>Results</h3><div>Total 49 studies were included in the review, representing &gt;500 different biomarkers in 7479 pregnancies across 16 countries. Adiponectin was the only biomarker with sufficient data to meta-analyse with respect to the composite outcome. Lower adiponectin was associated with increased risk of the composite outcome (SMD −0.52, 95% CI −0.63, −0.41; <em>P</em>&lt;.001, I² 0%). Lower adiponectin was also associated with increased risk of gestational diabetes (SMD −0.57, 95% CI −0.70, −0.43; <em>P</em>&lt;.001, I² 0%) and pre-eclampsia (OR 0.65, 95% CI 0.44, 0.99; <em>P</em>=.047, I² 61.5%). Increased insulin concentrations were associated with gestational diabetes (SMD 0.35, 95% CI 0.22, −0.47; <em>P</em>&lt;.001, I² 0%). Certainty of evidence regarding all associations was low or very low.</div></div><div><h3>Conclusions</h3><div>Decreased adiponectin and increased insulin are associated with increased risk of adverse pregnancy outcomes in women with BMI ≥30 kg/m². However, the low number of studies available for inclusion and low certainty of evidence mean that biomarker-based risk-stratification within pregnant women with BMI ≥30 kg/m² is not currently feasible. Further research is required to find ways of reliably targeting investigations during maternity care towards the subset of women living with obesity who are at highest risk of adverse outcomes.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100527"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraceptive utilization and associated factors among reproductive age women attending psychiatric outpatient services, at northwest Amhara regional referral hospitals, Ethiopia","authors":"Getanew Kegnie Nigate MPH ,&nbsp;Yohannes Ayanaw Habitu PhD ,&nbsp;Worku Chekol Tassew MSc ,&nbsp;Yeshiwas Ayale Ferede MPH ,&nbsp;Elsa Awoke Fentie MPH","doi":"10.1016/j.xagr.2025.100530","DOIUrl":"10.1016/j.xagr.2025.100530","url":null,"abstract":"<div><h3>Introduction</h3><div>Family planning is essential for all reproductive age women, and it is particularly Important for women with mental illness. Women with mental illness have a special need for Family planning as they carry a high risk of unplanned or unwanted pregnancy, sexual violence And poor obstetric outcomes. However, regarding contraceptive utilization and associated Factors among women with mental illness in low–income countries including Ethiopia is not Adequately explored.</div></div><div><h3>Objective</h3><div>To assess the magnitude of contraceptive utilization and associated factors among reproductive age women attending psychiatric outpatient services, at the northwest Amhara regional referral hospitals, Ethiopia</div></div><div><h3>Methods</h3><div>An institutional–based cross-sectional study was conducted among 810 study participants. A systematic random sampling technique was employed to recruit study participants. A structured and pretested questionnaire was used to collect the data. Data was entered in Epi data 3.1 and then exported to Stata version 14 for analysis. Model fitness was checked by using Hosmer and Lemeshow goodness. Both bivariable and multivariable logistic regressions were used to identify factors associated with contraceptive utilization among psychiatric outpatients. In multivariable logistic regression variables having a <em>P</em>-value less than 0.05 with 95% CI were considered as independently associated factors for the outcome Variable.</div></div><div><h3>Result</h3><div>About 42.59% (CI: 39.18–46.0) of the respondents were using family planning Contraceptive methods at the time of the study. Higher educational level (AOR=3.84 [95% CI: 1.81–8.16]), women who had no intention to have children in the future (AOR=1.53 [95% CI:1.02–2.30]), women counseled about family planning contraceptive method by a clinician (AOR=4.06 [95% CI:2.53–6.49]), good knowledge of family planning (AOR=2.77 [95% CI:1.90–4.03]), fear of side effect of psychiatric medication (AOR=1.57 [95% CI:1.09–2.25]) were factors associated with contraceptive utilization.</div></div><div><h3>Conclusion and recommendation</h3><div>Approximately 42.59% of women with psychiatric illnesses were using modern family planning methods. Significant predictors included having a higher education, good knowledge of family planning, not planning to have children in the future, believing that psychiatric medications are compatible with family planning, and receiving counseling on modern methods from healthcare providers. It is essential for healthcare providers to enhance family planning counseling in mental health clinics to improve knowledge and utilization of these methods.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100530"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum care screenings by care modality among US mothers, 2020–2021","authors":"Don E. Willis PhD ,&nbsp;Cari A. Bogulski PhD ,&nbsp;Clare C. Brown PhD ,&nbsp;Nirvana A. Manning MD ,&nbsp;Lanita S. White PharmD ,&nbsp;James P. Selig PhD ,&nbsp;Ji Li MS ,&nbsp;Pearl A. McElfish PhD","doi":"10.1016/j.xagr.2025.100541","DOIUrl":"10.1016/j.xagr.2025.100541","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Postpartum care is critical to preventing pregnancy-associated deaths. Virtual modes of care have potential to improve access to postpartum care; however, the impact on postpartum screenings for cigarette smoking, emotional/physical abuse, and depression is unknown.</div></div><div><h3>OBJECTIVE</h3><div>The purpose of this study was to compare receipt of these screenings between mothers who received any virtual postpartum care and those whose care was exclusively in-person.</div></div><div><h3>STUDY DESIGN</h3><div>Using the Pregnancy Risk Assessment Monitoring System Phase 8 data, we estimated receipt of postpartum care screenings for smoking, emotional/physical abuse, and depression for US mothers during COVID-19 (2020–2021) and assessed differences by mode of care. The analytical sample (n=21,815) included mothers from 28 Pregnancy Risk Assessment Monitoring System study sites who had postpartum care and answered the mode of care question and all 3 postpartum screening questions.</div></div><div><h3>RESULTS</h3><div>Over half of all mothers were screened for cigarette smoking (56.45%) and emotional/physical abuse (59.28%) during their postpartum care, whereas screening for depression was much more prevalent (87.63%). A higher percentage of screenings for smoking, emotional/physical abuse, and depression was reported for mothers who received any virtual postpartum care compared with those who attended exclusively in-person care (all <em>P</em>&lt;.001). After adjusting for covariates, the prevalence of screening for cigarette smoking, emotional/physical abuse, and depression was 14%, 18%, and 6% higher, respectively, among mothers who received any virtual (vs. exclusively in-person) postpartum care.</div></div><div><h3>CONCLUSION</h3><div>Virtual postpartum care may improve the percentage of women receiving screenings for important maternal health risks and behaviors, such as cigarette smoking, emotional/physical abuse, and depression. Further research is needed to determine whether mothers receiving virtual postpartum care are more likely to receive screenings because of the mode of care itself.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100541"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expulsion rates 12 months after early versus interval postpartum intrauterine device placement: a randomized trial","authors":"Sarah Averbach MD, MAS ,&nbsp;Florin Vaida PhD ,&nbsp;Erica Hinz MD, MPH ,&nbsp;Gennifer Kully MSc ,&nbsp;Arnab K. Dey PhD, MBA ,&nbsp;Monica A. Lutgendorf MD ,&nbsp;Sadia Haider MD, MPH ,&nbsp;Lisa G. Hofler MD, MPH, MBA","doi":"10.1016/j.xagr.2025.100547","DOIUrl":"10.1016/j.xagr.2025.100547","url":null,"abstract":"<div><h3>Objective</h3><div>The early postpartum period, 2 to 4 weeks postpartum, is an optimal time for intrauterine device (IUD) initiation; placement can be co-located with early postpartum or infant visits. We aimed to compare expulsion rates at 12 months postpartum for IUDs placed early compared to the standard interval 6-week visit.</div></div><div><h3>Study Design</h3><div>This is a randomized controlled trial conducted at four U.S. medical centers. Participants were randomly assigned to early (14–28 days) or interval (42–56 days) postpartum IUD placement after vaginal or cesarean birth. We used transvaginal ultrasound to confirm IUD presence and position at 6 months. Chart review and telephone surveys were used to verify IUD presence and position at 12 months.</div></div><div><h3>Results</h3><div>Between March 2018 and June 2021, 203 participants were assigned to early and 201 to interval IUD placement; 238 (58.9%) contributed outcome data by phone survey (and electronic medical record review) at 12-months postpartum. Among participants who received an IUD and provided 12-month outcome data, complete expulsion rates were 4 in 124 (3.2%; 95% confidence interval [CI], 0.90 to 8.2) and 0 in 114 (0%; 95% CI, 0 to 3.2) in the early and interval groups; a between-group difference of 3.2 percentage points (95% CI, −0.01 to 8.0, <em>P</em>=.054). Partial expulsion counts and rates were 16 (12.9%; 95% CI, 7.6 to 20.1) and 13 (11.4%; 95% CI, 6.2 to 18.7) in the early and interval groups; a difference of 1.5 percentage points (95% CI, −7.2 to 10.2, <em>P</em>=.75). Among all 404 participants, IUD utilization rates at 12-month follow-up were 113 (55.7%; 95% CI, 48.5 to 62.6 among participants in the early group) compared to 95 (47.3%; 95% CI, 40.2 to 54.1, <em>P</em>=.10 among participants in the interval group). Participants were more satisfied with early compared to interval placement, 107 (86.3%; 95% CI 79.0 to 91.8) vs 87 (76.3%, 95% CI 67.4 to 83.8 95%) <em>P</em>=.048<strong>.</strong></div></div><div><h3>Conclusion</h3><div>Complete expulsion rates at 12 months are low (&lt;5%) when IUDs are placed in the early and interval postpartum period. Satisfaction is higher with early postpartum IUD placement.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100547"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144841432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}