Joscelyn Gan, Michelle Steeper, Tim Hillard, Monica Christmas, Jan Shifren, Nick Panay, Martha Hickey, Sarah Lensen
Assess uptake of the Core Outcomes in Menopause (COMMA) core outcome sets (COS) and examine whether frontline treatments for vasomotor and genitourinary symptoms have been evaluated against these key outcomes.
{"title":"Modern Management of the Menopause: Are We Measuring What Matters?","authors":"Joscelyn Gan, Michelle Steeper, Tim Hillard, Monica Christmas, Jan Shifren, Nick Panay, Martha Hickey, Sarah Lensen","doi":"10.1111/1471-0528.70175","DOIUrl":"https://doi.org/10.1111/1471-0528.70175","url":null,"abstract":"Assess uptake of the Core Outcomes in Menopause (COMMA) core outcome sets (COS) and examine whether frontline treatments for vasomotor and genitourinary symptoms have been evaluated against these key outcomes.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138372","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}
Helyett Ollivier, Valentine Faure Bardon, Leo Froelicher Bournaud, Isidore Gaubert, Tiffany Guilleminot, Marianne Leruez‐Ville, Jean‐Marc Treluyer, Yves Ville, Gabrielle Lui, Julien Stirnemann
Objective To quantify the transplacental transfer of aciclovir at an amount equivalent to 2 g of valaciclovir corresponding to the fractionated dosing regimen given four times daily used to reduce congenital cytomegalovirus (CMV) transmission and to treat the CMV‐infected fetus. Design Experimental ex vivo study. Setting Dual closed‐loop perfusion of isolated human placental cotyledons. Population Placentas collected at term. Methods Placental transfer was assessed using the dual closed‐loop ex vivo perfusion. Aciclovir was perfused in the maternal compartment at a concentration corresponding to the oral dose of 2 g of valaciclovir taken every 6 h (8 g/day). Samples from maternal and fetal compartments were collected at regular intervals over a 3‐h period. Aciclovir concentrations were measured using chromatographic techniques. The transfer rate was calculated as the ratio of the number of moles of fetal aciclovir to the number of fetal and maternal moles at 3 h. Results Nine perfusion experiments met the criteria for success and could be used for interpretation. The mean transplacental transfer rate of aciclovir was 17.4% (SD: 7.8%). With a single 2 g dose, fetal exposure to aciclovir remained below the IC50 for CMV. Conclusion The transplacental transfer of aciclovir is low. Despite aciclovir's low molecular weight and hydrophilicity, moderate plasma protein binding and rapid renal elimination may limit placental availability, and the observed transfer was lower than expected for passive diffusion, suggesting involvement of facilitated uptake or efflux mechanisms. These results support the current rationale for high‐dose valaciclovir regimens in pregnancy and suggest a potential role for transporter‐mediated drug transfer.
{"title":"Congenital CMV Infection: Determination of Transplacental Passage of Aciclovir by Ex Vivo Placental Perfusion","authors":"Helyett Ollivier, Valentine Faure Bardon, Leo Froelicher Bournaud, Isidore Gaubert, Tiffany Guilleminot, Marianne Leruez‐Ville, Jean‐Marc Treluyer, Yves Ville, Gabrielle Lui, Julien Stirnemann","doi":"10.1111/1471-0528.70168","DOIUrl":"https://doi.org/10.1111/1471-0528.70168","url":null,"abstract":"Objective To quantify the transplacental transfer of aciclovir at an amount equivalent to 2 g of valaciclovir corresponding to the fractionated dosing regimen given four times daily used to reduce congenital cytomegalovirus (CMV) transmission and to treat the CMV‐infected fetus. Design Experimental ex vivo study. Setting Dual closed‐loop perfusion of isolated human placental cotyledons. Population Placentas collected at term. Methods Placental transfer was assessed using the dual closed‐loop ex vivo perfusion. Aciclovir was perfused in the maternal compartment at a concentration corresponding to the oral dose of 2 g of valaciclovir taken every 6 h (8 g/day). Samples from maternal and fetal compartments were collected at regular intervals over a 3‐h period. Aciclovir concentrations were measured using chromatographic techniques. The transfer rate was calculated as the ratio of the number of moles of fetal aciclovir to the number of fetal and maternal moles at 3 h. Results Nine perfusion experiments met the criteria for success and could be used for interpretation. The mean transplacental transfer rate of aciclovir was 17.4% (SD: 7.8%). With a single 2 g dose, fetal exposure to aciclovir remained below the IC50 for CMV. Conclusion The transplacental transfer of aciclovir is low. Despite aciclovir's low molecular weight and hydrophilicity, moderate plasma protein binding and rapid renal elimination may limit placental availability, and the observed transfer was lower than expected for passive diffusion, suggesting involvement of facilitated uptake or efflux mechanisms. These results support the current rationale for high‐dose valaciclovir regimens in pregnancy and suggest a potential role for transporter‐mediated drug transfer.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146098176","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}
Eric O. Ohuma, Simon R. Parker, Sara Strout, Bancy Ngatia, Linda Vesel
Objective To demonstrate when, for whom, and how to apply the INTERGROWTH−21st (IG‐21st) and WHO Child Growth Standards (WHO GS) using a scenario‐based approach with illustrations utilising a sub‐set of data from a multi‐country low birthweight infant prospective cohort. Design Scenario‐based methodological study illustrating application of existing international growth standards. Setting Global; applicable across public health, clinical, research, and epidemiological contexts where child growth monitoring is key. Population or Sample Neonates and children under 5 years. Methods Scenario‐based analyses were illustrated using a sub‐set of data from the Low birthweight Infant Feeding Exploration (LIFE) study. Weight‐for‐age z‐scores (WAZ) were computed and compared across two existing international growth standards for illustration. Main Outcome Measures Differences in infant growth assessment outcomes when applying WHO GS and IG‐21st, including effects of gestational age correction, are demonstrated through WAZ trajectories and classification differences across preterm and term infants. Results Scenario‐based analyses showed that applying growth standards inappropriately can substantially misclassify infant growth. The GIGS‐recommended approach, using IG‐21st at birth and for preterm growth, and WHO GS for term and later postnatal growth, provides consistent and accurate assessment. Conclusion The scenario‐based analysis presented in this paper illustrates how growth assessment outcomes can vary depending on the standard used, highlighting the importance of selecting the appropriate growth chart based on gestational age or age at measurement and targeted population. This guidance promotes standardised application of existing international growth standards in research and programmatic settings to facilitate resource allocation and tracking towards global nutrition targets.
{"title":"Scenario‐Based Guidance for International Growth Standards ( GIGS ): For Whom, When, and How to Apply the INTERGROWTH ‐21st and WHO Child Growth Standards","authors":"Eric O. Ohuma, Simon R. Parker, Sara Strout, Bancy Ngatia, Linda Vesel","doi":"10.1111/1471-0528.70159","DOIUrl":"https://doi.org/10.1111/1471-0528.70159","url":null,"abstract":"Objective To demonstrate when, for whom, and how to apply the INTERGROWTH−21st (IG‐21st) and WHO Child Growth Standards (WHO GS) using a scenario‐based approach with illustrations utilising a sub‐set of data from a multi‐country low birthweight infant prospective cohort. Design Scenario‐based methodological study illustrating application of existing international growth standards. Setting Global; applicable across public health, clinical, research, and epidemiological contexts where child growth monitoring is key. Population or Sample Neonates and children under 5 years. Methods Scenario‐based analyses were illustrated using a sub‐set of data from the Low birthweight Infant Feeding Exploration (LIFE) study. Weight‐for‐age z‐scores (WAZ) were computed and compared across two existing international growth standards for illustration. Main Outcome Measures Differences in infant growth assessment outcomes when applying WHO GS and IG‐21st, including effects of gestational age correction, are demonstrated through WAZ trajectories and classification differences across preterm and term infants. Results Scenario‐based analyses showed that applying growth standards inappropriately can substantially misclassify infant growth. The GIGS‐recommended approach, using IG‐21st at birth and for preterm growth, and WHO GS for term and later postnatal growth, provides consistent and accurate assessment. Conclusion The scenario‐based analysis presented in this paper illustrates how growth assessment outcomes can vary depending on the standard used, highlighting the importance of selecting the appropriate growth chart based on gestational age or age at measurement and targeted population. This guidance promotes standardised application of existing international growth standards in research and programmatic settings to facilitate resource allocation and tracking towards global nutrition targets.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101440","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":"Refining the Prediction Model for Adverse Outcomes in Dichorionic Twin Pregnancies.","authors":"Wang Yi,Zongyu Yang,Songjie Liao","doi":"10.1111/1471-0528.70165","DOIUrl":"https://doi.org/10.1111/1471-0528.70165","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069988","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}
OBJECTIVETo examine the association of gestational weight gain (GWG) z-scores and their trajectories with neurodevelopmental delays in children aged 0-24 months.DESIGNProspective study.SETTINGShenzhen, China.POPULATION19 702 mother-singleton child pairs.METHODSGWG z-score trajectories were established using group-based trajectory modelling. Associations of GWG z-scores and their trajectories with neurodevelopmental delays were assessed by multivariable logistic regression.MAIN OUTCOME MEASURESNeurodevelopmental delays assessed using the parent-completed Ages and Stages Questionnaire, third edition. Most assessments (63.51%) were conducted at child age 0-6 months.RESULTSCompared with children whose mothers had average GWG (z-score ≥ -0.5 and < 0.5), those with very low GWG (z-score < -1.5) had higher risks of delay in communication (OR: 1.30, 95% CI: 1.09, 1.56), gross motor (OR: 1.34, 95% CI: 1.07, 1.68), problem-solving (OR: 1.32, 95% CI: 1.06, 1.65) and personal-social skills (OR: 1.25, 95% CI: 1.03, 1.51). Among children of overweight/obese mothers, very high GWG (z-score > 1.5) was associated with higher risks of delay in problem-solving (OR: 2.66, 95% CI: 1.20, 5.90) and personal-social skills (OR: 2.68, 95% CI: 1.39, 5.15). Compared with children whose mothers followed GWG trajectories that started at high levels and ended at average levels, those with GWG trajectories ending at low levels had higher risks of neurodevelopmental delays.CONCLUSIONVery low GWG and GWG trajectories ending at low levels were associated with modestly higher risks of neurodevelopmental delays in early childhood. Very high GWG in mothers with overweight/obesity was also associated with higher risks of neurodevelopmental delays in children.
{"title":"Gestational Weight Gain and Early Child Neurodevelopment: Prospective Cohort Study.","authors":"Weiying Liu,Xuanshu Wang,Feng Wu,Xiaomin Ye,Jialin Su,Huiling Xu,Lin Li,Fang Fang,Miao Liu,Quanfu Zhang,Liya Ma,Xu Chen,Ruoqing Chen","doi":"10.1111/1471-0528.70172","DOIUrl":"https://doi.org/10.1111/1471-0528.70172","url":null,"abstract":"OBJECTIVETo examine the association of gestational weight gain (GWG) z-scores and their trajectories with neurodevelopmental delays in children aged 0-24 months.DESIGNProspective study.SETTINGShenzhen, China.POPULATION19 702 mother-singleton child pairs.METHODSGWG z-score trajectories were established using group-based trajectory modelling. Associations of GWG z-scores and their trajectories with neurodevelopmental delays were assessed by multivariable logistic regression.MAIN OUTCOME MEASURESNeurodevelopmental delays assessed using the parent-completed Ages and Stages Questionnaire, third edition. Most assessments (63.51%) were conducted at child age 0-6 months.RESULTSCompared with children whose mothers had average GWG (z-score ≥ -0.5 and < 0.5), those with very low GWG (z-score < -1.5) had higher risks of delay in communication (OR: 1.30, 95% CI: 1.09, 1.56), gross motor (OR: 1.34, 95% CI: 1.07, 1.68), problem-solving (OR: 1.32, 95% CI: 1.06, 1.65) and personal-social skills (OR: 1.25, 95% CI: 1.03, 1.51). Among children of overweight/obese mothers, very high GWG (z-score > 1.5) was associated with higher risks of delay in problem-solving (OR: 2.66, 95% CI: 1.20, 5.90) and personal-social skills (OR: 2.68, 95% CI: 1.39, 5.15). Compared with children whose mothers followed GWG trajectories that started at high levels and ended at average levels, those with GWG trajectories ending at low levels had higher risks of neurodevelopmental delays.CONCLUSIONVery low GWG and GWG trajectories ending at low levels were associated with modestly higher risks of neurodevelopmental delays in early childhood. Very high GWG in mothers with overweight/obesity was also associated with higher risks of neurodevelopmental delays in children.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146070078","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}
OBJECTIVETo examine ethnic disparities in perinatal outcomes and the role of migration factors.DESIGNRetrospective cohort.SETTINGTwo maternity services in South London, UK.POPULATION OR SAMPLEWomen birthing singleton infants between 24 and 43 weeks' gestation (2018-2023).METHODSLinked electronic health records were analysed using generalised linear mixed models (GLMMs) with Poisson distribution to estimate adjusted risk ratios (aRR) and 95% confidence intervals (CI) by ethnicity, migration, interpreter need, and country-of-origin income, adjusting for socioeconomic deprivation and medical risk.MAIN OUTCOME MEASURESEmergency caesarean, haemorrhage, preterm birth, low birthweight, low Apgar score, stillbirth or neonatal death.RESULTSAmong 44 634 births, compared with White women, emergency caesarean risk was higher for Asian (aRR 1.22, 95% CI 1.14-1.30, p < 0.001) and Black women (1.16, 1.10-1.23, p < 0.001). Haemorrhage was higher for Asian women (1.12, 1.02-1.23, p = 0.021), those needing interpretation (1.16, 1.06-1.27, p < 0.001), and lower for Mixed ethnicity women (0.86, 0.74-0.99, p = 0.038). Infants of Black women had elevated risks of preterm birth (1.23, 1.13-1.34, p < 0.001), low birthweight (1.74, 1.60-1.89, p < 0.001), low Apgar (2.06, 1.71-2.48, p < 0.001), and stillbirth/neonatal death (1.57, 1.21-2.05, p < 0.001). Asian infants had increased risks of preterm birth (1.19, 1.07-1.33, p = 0.002) and low birthweight (1.69, 1.52-1.87, p < 0.001). Foreign-born women had lower risks of low birthweight (0.71, 0.62-0.81, p < 0.001) but higher risks of low Apgar (1.24, 1.06-1.46, p = 0.009) and stillbirth/neonatal death (1.33, 1.07-1.65, p = 0.011). Risks were highest for ethnic minority, foreign-born women, though effect sizes were modest.CONCLUSIONSEthnic minority and foreign-born women, particularly from LMICs or needing interpreters, face elevated risks with modest clinical impact.
目的探讨围产期结局的种族差异及移民因素的作用。DESIGNRetrospective队列。英国伦敦南部的两家产科服务机构。人口或样本：妊娠24至43周的单胎婴儿的妇女（2018-2023）。方法使用泊松分布的广义线性混合模型（glmm）对相关电子健康记录进行分析，根据种族、迁移、译员需求和原籍国收入估算调整后的风险比（aRR）和95%置信区间（CI），并对社会经济剥夺和医疗风险进行调整。主要结局指标：紧急剖腹产、出血、早产、低出生体重、低阿普加评分、死产或新生儿死亡。结果在44634例分娩中，与白人妇女相比，亚洲妇女（aRR 1.22, 95% CI 1.14-1.30, p < 0.001）和黑人妇女（1.16,1.10-1.23,p < 0.001）的紧急剖腹产风险更高。亚洲女性的出血量较高（1.12,1.02-1.23,p = 0.021），需要解释的女性出血量较高（1.16,1.06-1.27,p < 0.001），混血女性出血量较低（0.86,0.74-0.99,p = 0.038）。黑人妇女的婴儿早产（1.23,1.13-1.34,p < 0.001）、低出生体重（1.74,1.60-1.89,p < 0.001）、低Apgar （2.06, 1.71-2.48, p < 0.001）和死产/新生儿死亡（1.57,1.21-2.05,p < 0.001）的风险较高。亚洲婴儿早产（1.19,1.07-1.33,p = 0.002）和低出生体重（1.69,1.52-1.87,p < 0.001）的风险增加。外国出生妇女低出生体重的风险较低（0.71,0.62-0.81,p < 0.001），但低Apgar （1.24, 1.06-1.46, p = 0.009）和死产/新生儿死亡（1.33,1.07-1.65,p = 0.011）的风险较高。少数民族、外国出生的女性患乳腺癌的风险最高，尽管效应值不大。结论：少数民族和外国出生的妇女，特别是来自低收入国家或需要口译员的妇女，面临较高的风险，但临床影响不大。
{"title":"The Role of Ethnicity and Migration in Perinatal Inequalities: A Retrospective Cohort Study.","authors":"Hannah Rayment-Jones,Sam Burton,Laura Bridle,Yahye Mohamud,Abigail Easter,Paul Seed, ,Jane Sandall","doi":"10.1111/1471-0528.70169","DOIUrl":"https://doi.org/10.1111/1471-0528.70169","url":null,"abstract":"OBJECTIVETo examine ethnic disparities in perinatal outcomes and the role of migration factors.DESIGNRetrospective cohort.SETTINGTwo maternity services in South London, UK.POPULATION OR SAMPLEWomen birthing singleton infants between 24 and 43 weeks' gestation (2018-2023).METHODSLinked electronic health records were analysed using generalised linear mixed models (GLMMs) with Poisson distribution to estimate adjusted risk ratios (aRR) and 95% confidence intervals (CI) by ethnicity, migration, interpreter need, and country-of-origin income, adjusting for socioeconomic deprivation and medical risk.MAIN OUTCOME MEASURESEmergency caesarean, haemorrhage, preterm birth, low birthweight, low Apgar score, stillbirth or neonatal death.RESULTSAmong 44 634 births, compared with White women, emergency caesarean risk was higher for Asian (aRR 1.22, 95% CI 1.14-1.30, p < 0.001) and Black women (1.16, 1.10-1.23, p < 0.001). Haemorrhage was higher for Asian women (1.12, 1.02-1.23, p = 0.021), those needing interpretation (1.16, 1.06-1.27, p < 0.001), and lower for Mixed ethnicity women (0.86, 0.74-0.99, p = 0.038). Infants of Black women had elevated risks of preterm birth (1.23, 1.13-1.34, p < 0.001), low birthweight (1.74, 1.60-1.89, p < 0.001), low Apgar (2.06, 1.71-2.48, p < 0.001), and stillbirth/neonatal death (1.57, 1.21-2.05, p < 0.001). Asian infants had increased risks of preterm birth (1.19, 1.07-1.33, p = 0.002) and low birthweight (1.69, 1.52-1.87, p < 0.001). Foreign-born women had lower risks of low birthweight (0.71, 0.62-0.81, p < 0.001) but higher risks of low Apgar (1.24, 1.06-1.46, p = 0.009) and stillbirth/neonatal death (1.33, 1.07-1.65, p = 0.011). Risks were highest for ethnic minority, foreign-born women, though effect sizes were modest.CONCLUSIONSEthnic minority and foreign-born women, particularly from LMICs or needing interpreters, face elevated risks with modest clinical impact.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146070008","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}
OBJECTIVETo evaluate the effectiveness of a face-to-face supervised, individualised exercise programme and pelvic belt in women with pregnancy-related low back and pelvic girdle pain (PLBP/PPGP) from pregnancy through the postpartum period.DESIGNMulticentre, non-randomised, site-allocated pragmatic cluster trial.SETTINGTertiary care hospitals and obstetrics and gynaecology clinics.POPULATIONPregnant women with PLBP/PPGP at ≥ 28 weeks' gestation.METHODSParticipants were allocated by study site to one of three groups: (1) leaflet; (2) exercise; (3) exercise plus belt. All groups received exercise leaflets. The exercise and exercise plus belt groups received three 30-min, face-to-face, supervised sessions-during late pregnancy, 5 days postpartum, and 1 month postpartum. The exercise plus belt group additionally received a pelvic belt.MAIN OUTCOME MEASURESFunctional impairment was assessed by the Oswestry Disability Index (ODI) at 5 days, 1 month, and 3 months postpartum.RESULTSA total of 127 participants were enrolled; 107 completed follow-up. At 1 month postpartum, lower ODI scores were observed in the exercise group (mean difference 5.4; 95% CI 3.3 to 7.6), and similarly in the exercise plus belt group (mean difference 4.9; 95% CI 2.6 to 7.2), compared with the leaflet group. At 3 months postpartum, mean differences were 4.4 (95% CI -7.1 to 15.9) for the exercise group and 3.7 (95% CI -7.9 to 15.2) for the exercise plus belt group. No clear differences were observed between the exercise and exercise plus belt groups.CONCLUSIONSA face-to-face supervised, individualised exercise programme was associated with lower functional impairment at 1 month postpartum.TRIAL REGISTRATIONUMIN Clinical Trials Registry (UMIN000057866); https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000066135.
目的评价面对面监督的个体化运动方案和骨盆带对妊娠期至产后腰痛（PLBP/PPGP）妇女的疗效。设计多中心、非随机、现场分配的实用群试验。三级保健医院和妇产科诊所。人群：妊娠≥28周伴有PLBP/PPGP的孕妇。方法按研究地点将受试者分为三组：(1)传单组；(2)运动;(3)运动加带。所有组均收到运动单张。运动组和运动加腰带组分别在怀孕后期、产后5天和产后1个月接受三次30分钟的面对面指导。运动加腰带组另加骨盆带。主要观察指标：在产后5天、1个月和3个月采用Oswestry功能障碍指数（ODI）评估功能损害。结果共纳入受试者127例；107例完成随访。产后1个月，与小叶组相比，运动组的ODI评分较低（平均差异5.4;95% CI 3.3至7.6），运动加腰带组的ODI评分也较低（平均差异4.9;95% CI 2.6至7.2）。产后3个月，运动组的平均差异为4.4 (95% CI -7.1至15.9)，运动加腰带组的平均差异为3.7 （95% CI -7.9至15.2）。在运动组和运动加腰带组之间没有明显的差异。结论面对面监督的个体化运动方案与产后1个月的功能损害较低相关。临床试验注册（UMIN000057866）；https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000066135。
{"title":"Supervised, Individualised Exercise Across Pregnancy and Postpartum for Pregnancy-Related Lumbopelvic Pain: A Multicentre Pragmatic, Site-Allocated Cluster Trial.","authors":"Keiichi Oishi,Jota Maki,Tomohiro Mitoma,Hikaru Ooba,Shujiro Sakata,Hikari Nakato,Ayano Suemori,Moe Yorozu,Yorie Mieda,Tomoaki Kusume,Hisashi Masuyama","doi":"10.1111/1471-0528.70171","DOIUrl":"https://doi.org/10.1111/1471-0528.70171","url":null,"abstract":"OBJECTIVETo evaluate the effectiveness of a face-to-face supervised, individualised exercise programme and pelvic belt in women with pregnancy-related low back and pelvic girdle pain (PLBP/PPGP) from pregnancy through the postpartum period.DESIGNMulticentre, non-randomised, site-allocated pragmatic cluster trial.SETTINGTertiary care hospitals and obstetrics and gynaecology clinics.POPULATIONPregnant women with PLBP/PPGP at ≥ 28 weeks' gestation.METHODSParticipants were allocated by study site to one of three groups: (1) leaflet; (2) exercise; (3) exercise plus belt. All groups received exercise leaflets. The exercise and exercise plus belt groups received three 30-min, face-to-face, supervised sessions-during late pregnancy, 5 days postpartum, and 1 month postpartum. The exercise plus belt group additionally received a pelvic belt.MAIN OUTCOME MEASURESFunctional impairment was assessed by the Oswestry Disability Index (ODI) at 5 days, 1 month, and 3 months postpartum.RESULTSA total of 127 participants were enrolled; 107 completed follow-up. At 1 month postpartum, lower ODI scores were observed in the exercise group (mean difference 5.4; 95% CI 3.3 to 7.6), and similarly in the exercise plus belt group (mean difference 4.9; 95% CI 2.6 to 7.2), compared with the leaflet group. At 3 months postpartum, mean differences were 4.4 (95% CI -7.1 to 15.9) for the exercise group and 3.7 (95% CI -7.9 to 15.2) for the exercise plus belt group. No clear differences were observed between the exercise and exercise plus belt groups.CONCLUSIONSA face-to-face supervised, individualised exercise programme was associated with lower functional impairment at 1 month postpartum.TRIAL REGISTRATIONUMIN Clinical Trials Registry (UMIN000057866); https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000066135.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"93 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146072886","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}
Ka Wang Cheung, Tiffany Sin-Tung Au, Tat On Chan, Annie Shuk Yi Hui, Po Lam So, Daniel Wong, Tsz Kin Lo, Wai Lam Lau, Choi Wah Kong, Teresa Wei Ling Ma, Ying Rong Li, Mimi Tin-Yan Seto
Evaluate the rate and trend of preterm birth (PTB) and the associated perinatal survival in Hong Kong.
评估香港早产的比率及趋势及相关的围生期存活率。
{"title":"Temporal Patterns in Preterm Birth Subtypes and Perinatal Survival, 2000–2023: Population-Based, Repeated Cross-Sectional Time-Series","authors":"Ka Wang Cheung, Tiffany Sin-Tung Au, Tat On Chan, Annie Shuk Yi Hui, Po Lam So, Daniel Wong, Tsz Kin Lo, Wai Lam Lau, Choi Wah Kong, Teresa Wei Ling Ma, Ying Rong Li, Mimi Tin-Yan Seto","doi":"10.1111/1471-0528.70166","DOIUrl":"https://doi.org/10.1111/1471-0528.70166","url":null,"abstract":"Evaluate the rate and trend of preterm birth (PTB) and the associated perinatal survival in Hong Kong.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146048674","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}
Andrea M F Woolner,Konstantin Shestopaloff,Alexander E P Heazell
OBJECTIVETo investigate if second trimester pregnancy loss (second trimester miscarriage [STM] or termination for medical reasons [TFMR]) was associated with subsequent adverse pregnancy outcomes.DESIGNRetrospective cohort study.SETTINGConducted using the Aberdeen Maternity and Neonatal Databank [AMND] in Aberdeen, United Kingdom.POPULATIONWomen with and without a history of STM or TFMR (between 13 + 0 and 23 + 6 weeks' gestation).METHODSLogistic and linear regression were used to determine associations between exposed (prior STM or TFMR) and unexposed women (women with prior livebirth).MAIN OUTCOME MEASURESThe primary outcome was subsequent spontaneous preterm birth, defined as spontaneous onset of labour and birth between 24 + 0 and 36 + 6 weeks' gestation.RESULTSThe study included 65 592 women with first and second pregnancies recorded from 1950 to 2017. Women who had a STM in their first pregnancy (n = 935) were at significantly greater risk of spontaneous preterm birth in the next pregnancy (4.3% vs. 1.5%; adjusted Odds Ratio [aOR] 2.55 (95% CI 1.81 to 3.50); p < 0.01). Women with STM in their first pregnancy were two-fold more likely to have a repeat second trimester miscarriage (3.7% vs. 1.1%; aOR 2.25 (95% CI 1.53 to 3.19); p < 0.01). Women who had a first TFMR (n = 177) were significantly more likely to have a repeat TFMR (adjusted OR [aOR] 6.59 (3.4% vs. 0.3%, 95% CI 2.54 to 13.99); p < 0.01). There was no observed increased risk of spontaneous preterm birth after TFMR detected in this sample (aOR 1.06 (95% CI 0.39 to 2.87); p = 0.91) though the sample size was too small to be conclusive.CONCLUSIONSWomen with a history of second trimester pregnancy loss have an increased risk of adverse pregnancy outcomes in a subsequent pregnancy. Consequently, antenatal care surveillance and counselling may need to be increased for women with a prior STM, who are at risk of spontaneous preterm birth and other adverse obstetric outcomes including pre-eclampsia. Women after TFMR can be reassured by our findings; however, larger cohorts are needed to confirm these results.
目的探讨妊娠中期流产（妊娠中期流产[STM]或医学原因终止妊娠[TFMR]）是否与随后的不良妊娠结局相关。设计回顾性队列研究。背景：使用英国阿伯丁的阿伯丁产妇和新生儿数据库[AMND]进行。人群：有或没有STM或TFMR病史的女性（妊娠13 + 0至23 + 6周）。方法采用logistic回归和线性回归来确定暴露妇女（既往STM或TFMR）和未暴露妇女（既往活产妇女）之间的关系。主要结局指标：主要结局指标为随后的自发性早产，定义为妊娠24 + 0 ~ 36 + 6周的自发性分娩和分娩。结果该研究包括1950年至2017年记录的65592名首次和第二次怀孕的女性。首次妊娠有STM的妇女（n = 935）在下次妊娠发生自发性早产的风险显著增加(4.3% vs. 1.5%；调整后优势比[aOR] 2.55 (95% CI 1.81 ~ 3.50)；p < 0.01)。首次妊娠时患有STM的妇女再次妊娠中期流产的可能性是前者的两倍(3.7% vs. 1.1%; aOR 2.25 (95% CI 1.53 ~ 3.19)；p < 0.01)。首次发生TFMR的女性（n = 177）再次发生TFMR的可能性显著增加(调整OR [aOR] 6.59 (3.4% vs. 0.3%, 95% CI 2.54 ~ 13.99)；p < 0.01)。在该样本中检测到TFMR后，未观察到自发性早产的风险增加(aOR 1.06 (95% CI 0.39至2.87)；P = 0.91)，但样本量太小，无法得出结论。结论有妊娠中期流产史的妇女在后续妊娠中出现不良妊娠结局的风险增加。因此，可能需要增加对先前有性传播感染的妇女的产前保健监测和咨询，这些妇女有自然早产和其他不良产科结局的风险，包括先兆子痫。我们的研究结果可以让接受TFMR治疗的女性放心；然而，需要更大的队列来证实这些结果。
{"title":"Pregnancy Outcomes After Second Trimester Pregnancy Loss and Termination for Medical Reasons Before 24 Weeks: A Historical Cohort Study [PASTeL-2].","authors":"Andrea M F Woolner,Konstantin Shestopaloff,Alexander E P Heazell","doi":"10.1111/1471-0528.70161","DOIUrl":"https://doi.org/10.1111/1471-0528.70161","url":null,"abstract":"OBJECTIVETo investigate if second trimester pregnancy loss (second trimester miscarriage [STM] or termination for medical reasons [TFMR]) was associated with subsequent adverse pregnancy outcomes.DESIGNRetrospective cohort study.SETTINGConducted using the Aberdeen Maternity and Neonatal Databank [AMND] in Aberdeen, United Kingdom.POPULATIONWomen with and without a history of STM or TFMR (between 13 + 0 and 23 + 6 weeks' gestation).METHODSLogistic and linear regression were used to determine associations between exposed (prior STM or TFMR) and unexposed women (women with prior livebirth).MAIN OUTCOME MEASURESThe primary outcome was subsequent spontaneous preterm birth, defined as spontaneous onset of labour and birth between 24 + 0 and 36 + 6 weeks' gestation.RESULTSThe study included 65 592 women with first and second pregnancies recorded from 1950 to 2017. Women who had a STM in their first pregnancy (n = 935) were at significantly greater risk of spontaneous preterm birth in the next pregnancy (4.3% vs. 1.5%; adjusted Odds Ratio [aOR] 2.55 (95% CI 1.81 to 3.50); p < 0.01). Women with STM in their first pregnancy were two-fold more likely to have a repeat second trimester miscarriage (3.7% vs. 1.1%; aOR 2.25 (95% CI 1.53 to 3.19); p < 0.01). Women who had a first TFMR (n = 177) were significantly more likely to have a repeat TFMR (adjusted OR [aOR] 6.59 (3.4% vs. 0.3%, 95% CI 2.54 to 13.99); p < 0.01). There was no observed increased risk of spontaneous preterm birth after TFMR detected in this sample (aOR 1.06 (95% CI 0.39 to 2.87); p = 0.91) though the sample size was too small to be conclusive.CONCLUSIONSWomen with a history of second trimester pregnancy loss have an increased risk of adverse pregnancy outcomes in a subsequent pregnancy. Consequently, antenatal care surveillance and counselling may need to be increased for women with a prior STM, who are at risk of spontaneous preterm birth and other adverse obstetric outcomes including pre-eclampsia. Women after TFMR can be reassured by our findings; however, larger cohorts are needed to confirm these results.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044646","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}
OBJECTIVETo identify factors associated with HRT uptake among women.DESIGNA systematic review and meta-analysis to identify factors associated with HRT uptake.SETTINGRetrospective and prospective cohort studies, case-control studies and cross-sectional studies from any country and in any language.POPULATIONThe study population was women aged 40-60 years old.METHODSWe searched Medline, Embase, CINAHL and Cochrane databases to identify studies reporting associations between demographic, behavioural or health-related factors and HRT uptake. Studies were selected if they reported numbers or odds ratios of the factors and HRT uptake. Studies were combined for meta-analysis, reporting odds ratios and 95% confidence intervals. Quality assessment was performed to quantify the risk of bias.MAIN OUTCOME MEASURESHRT uptake, defined as 'ever' versus 'never' users.RESULTS5124 papers were identified for title and abstract screening; 136 full texts were screened; 53 were included in meta-analyses. HRT uptake was 53% lower in Black (OR 0.47, 0.30-0.73) compared to White women. Diabetes, obesity and history of stroke or venous thromboembolism were associated with lower HRT uptake (OR 0.71, 0.59-0.85; 0.67, 0.56-0.81; 0.75, 0.63-0.89; 0.78, 0.74-0.0.83 respectively). Osteoporosis and depression were associated with higher HRT uptake (OR 1.64, 1.10-2.45 and 1.69, 1.17-2.43, respectively).CONCLUSIONSThere are differences in HRT uptake by ethnicity and health characteristics. However, findings are not generalisable globally. Our results could aid healthcare professionals and policymakers to address the gaps in HRT uptake and promote healthcare equity.
{"title":"Factors Associated With Hormone Replacement Therapy Use: A Systematic Review and Meta-Analysis.","authors":"Wema Meranda Mtika,Deborah Allen,Eve Tranter,Grace Glover,Janice Hoang,Sarah Hillman,Carol Coupland,Julia Hippisley-Cox,Lynn Tatnell,Jennifer A Hirst","doi":"10.1111/1471-0528.70160","DOIUrl":"https://doi.org/10.1111/1471-0528.70160","url":null,"abstract":"OBJECTIVETo identify factors associated with HRT uptake among women.DESIGNA systematic review and meta-analysis to identify factors associated with HRT uptake.SETTINGRetrospective and prospective cohort studies, case-control studies and cross-sectional studies from any country and in any language.POPULATIONThe study population was women aged 40-60 years old.METHODSWe searched Medline, Embase, CINAHL and Cochrane databases to identify studies reporting associations between demographic, behavioural or health-related factors and HRT uptake. Studies were selected if they reported numbers or odds ratios of the factors and HRT uptake. Studies were combined for meta-analysis, reporting odds ratios and 95% confidence intervals. Quality assessment was performed to quantify the risk of bias.MAIN OUTCOME MEASURESHRT uptake, defined as 'ever' versus 'never' users.RESULTS5124 papers were identified for title and abstract screening; 136 full texts were screened; 53 were included in meta-analyses. HRT uptake was 53% lower in Black (OR 0.47, 0.30-0.73) compared to White women. Diabetes, obesity and history of stroke or venous thromboembolism were associated with lower HRT uptake (OR 0.71, 0.59-0.85; 0.67, 0.56-0.81; 0.75, 0.63-0.89; 0.78, 0.74-0.0.83 respectively). Osteoporosis and depression were associated with higher HRT uptake (OR 1.64, 1.10-2.45 and 1.69, 1.17-2.43, respectively).CONCLUSIONSThere are differences in HRT uptake by ethnicity and health characteristics. However, findings are not generalisable globally. Our results could aid healthcare professionals and policymakers to address the gaps in HRT uptake and promote healthcare equity.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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