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Managing Impacted Fetal Head: Insights From a Simulation Study of Applied Forces 管理冲击胎头:从模拟研究应用的力量的见解
Pub Date : 2026-01-14 DOI: 10.1111/1471-0528.70150
Lawrence Devoe
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引用次数: 0
Risk Factors and Outcomes Associated With Delayed Villous Maturation in Placenta: A Systematic Review and Meta‐Analysis 与胎盘绒毛成熟延迟相关的危险因素和结果:一项系统回顾和荟萃分析
Pub Date : 2026-01-13 DOI: 10.1111/1471-0528.70125
Muhammad Pradhiki Mahindra, Muhammad Pradhika Mapindra, Hadi Waheed, Owen Vaughan, John Ciaran Hutchinson, Sara L. Hillman, Dimitrios Siassakos
Background Delayed villous maturation (DVM) is a placental maturation disorder that mainly affects maternal‐to‐foetal oxygen transfer. Objectives We conducted a systematic review, meta‐analysis, and sensitivity analysis exploring study heterogeneities ( I 2 ) of risk factors and outcomes associated with histopathological findings of DVM. Search Strategy Medline, EMBASE, Web of Science, and MIDIRS databases were searched from inception to December 2023. Selection Criteria Peer‐reviewed, observational studies including cohort, case–control, and cross‐sectional studies reported the histopathological findings of DVM after placenta delivery. All eligible studies were included and assessed for their risk of bias using the Newcastle‐Ottawa scale (NOS) for cohort and case–control studies. Data Collection and Analysis Two reviewers independently performed the systematic article screening, bias assessment, and data extraction. Senior authors resolved the disagreement between reviewers. The risk of bias was assessed by two reviewers using NOS criteria. The random‐effects model was used for meta‐analysis due to heterogeneity across studies. Sensitivity analyses were performed according to the NOS risk of bias assessment and the DVM definition per the Amsterdam criteria. Main Results Fifty‐two eligible studies reporting DVM and linked risk factors and outcomes were included. The risk factors associated with DVM were gestational diabetes (GDM) (OR = 4.90; 95% CI = 2.98, 8.06; I 2 = 39%), pregestational diabetes (PGDM) (OR = 2.77; 95% CI = 1.56, 4.92; I 2 = 0%), and maternal obesity (OR = 1.88; 95% CI = 1.20, 2.96; I 2 = 0%). DVM was also associated with congenital foetal malformations (OR = 5.22; 95% CI =2.39, 11.39; I 2 = 40), stillbirth (OR = 4.89; 95% CI = 3.55, 6.72; I 2 = 0) and preterm birth (OR = 17.41; 95% CI = 10.14, 29.90; I 2 = 0). The association between DVM and stillbirth (OR = 12.06; 95% CI =3.40, 42.78; I 2 = 50; 2/5 studies) persisted in analyses limited to studies that used Amsterdam criteria exclusively for DVM. Conclusion DVM is a placental abnormality associated with congenital foetal malformations and maternal dysmetabolism, including GDM, PGDM, and maternal obesity; and with adverse outcomes including stillbirth and preterm birth. In studies using Amsterdam criteria, placenta with DVM was associated with stillbirth and congenital malformations. Optimising metabolism could prevent harm to the baby.
背景:绒毛成熟延迟(DVM)是一种胎盘成熟障碍,主要影响母体对胎儿的氧转移。我们进行了一项系统综述、荟萃分析和敏感性分析,探讨与DVM组织病理学结果相关的危险因素和结果的研究异质性。检索策略Medline、EMBASE、Web of Science和MIDIRS数据库,检索时间从成立到2023年12月。同行评议的观察性研究,包括队列研究、病例对照研究和横断面研究报告了胎盘分娩后DVM的组织病理学结果。纳入所有符合条件的研究,并使用纽卡斯尔-渥太华量表(NOS)对队列研究和病例对照研究进行偏倚风险评估。两名审稿人独立进行系统的文章筛选、偏倚评估和数据提取。资深作者解决了审稿人之间的分歧。两名审稿人采用NOS标准评估偏倚风险。由于研究间存在异质性,我们采用随机效应模型进行meta分析。根据NOS偏倚风险评估和阿姆斯特丹标准的DVM定义进行敏感性分析。主要结果纳入了52项符合条件的研究,报告了DVM及其相关的危险因素和结果。与DVM相关的危险因素是妊娠期糖尿病(GDM) (OR = 4.90; 95% CI = 2.98, 8.06; I 2 = 39%)、妊娠期糖尿病(PGDM) (OR = 2.77; 95% CI = 1.56, 4.92; I 2 = 0%)和产妇肥胖(OR = 1.88; 95% CI = 1.20, 2.96; I 2 = 0%)。DVM还与先天性胎儿畸形(OR = 5.22; 95% CI =2.39, 11.39; i2 = 40)、死产(OR = 4.89; 95% CI = 3.55, 6.72; i2 = 0)和早产(OR = 17.41; 95% CI = 10.14, 29.90; i2 = 0)相关。DVM和死产之间的关联(OR = 12.06; 95% CI =3.40, 42.78; I 2 = 50; 2/5研究)在仅限于使用阿姆斯特丹标准的DVM研究的分析中仍然存在。结论DVM是一种与先天性胎儿畸形和母体代谢异常相关的胎盘异常,包括GDM、PGDM和母体肥胖;以及包括死胎和早产在内的不良后果。在使用阿姆斯特丹标准的研究中,胎盘与DVM与死产和先天性畸形有关。优化新陈代谢可以防止对婴儿造成伤害。
{"title":"Risk Factors and Outcomes Associated With Delayed Villous Maturation in Placenta: A Systematic Review and Meta‐Analysis","authors":"Muhammad Pradhiki Mahindra, Muhammad Pradhika Mapindra, Hadi Waheed, Owen Vaughan, John Ciaran Hutchinson, Sara L. Hillman, Dimitrios Siassakos","doi":"10.1111/1471-0528.70125","DOIUrl":"https://doi.org/10.1111/1471-0528.70125","url":null,"abstract":"Background Delayed villous maturation (DVM) is a placental maturation disorder that mainly affects maternal‐to‐foetal oxygen transfer. Objectives We conducted a systematic review, meta‐analysis, and sensitivity analysis exploring study heterogeneities ( <jats:italic>I</jats:italic> <jats:sup> <jats:italic>2</jats:italic> </jats:sup> ) of risk factors and outcomes associated with histopathological findings of DVM. Search Strategy Medline, EMBASE, Web of Science, and MIDIRS databases were searched from inception to December 2023. Selection Criteria Peer‐reviewed, observational studies including cohort, case–control, and cross‐sectional studies reported the histopathological findings of DVM after placenta delivery. All eligible studies were included and assessed for their risk of bias using the Newcastle‐Ottawa scale (NOS) for cohort and case–control studies. Data Collection and Analysis Two reviewers independently performed the systematic article screening, bias assessment, and data extraction. Senior authors resolved the disagreement between reviewers. The risk of bias was assessed by two reviewers using NOS criteria. The random‐effects model was used for meta‐analysis due to heterogeneity across studies. Sensitivity analyses were performed according to the NOS risk of bias assessment and the DVM definition per the Amsterdam criteria. Main Results Fifty‐two eligible studies reporting DVM and linked risk factors and outcomes were included. The risk factors associated with DVM were gestational diabetes (GDM) (OR = 4.90; 95% CI = 2.98, 8.06; <jats:italic>I</jats:italic> <jats:sup>2</jats:sup> = 39%), pregestational diabetes (PGDM) (OR = 2.77; 95% CI = 1.56, 4.92; <jats:italic>I</jats:italic> <jats:sup>2</jats:sup> = 0%), and maternal obesity (OR = 1.88; 95% CI = 1.20, 2.96; <jats:italic>I</jats:italic> <jats:sup>2</jats:sup> = 0%). DVM was also associated with congenital foetal malformations (OR = 5.22; 95% CI =2.39, 11.39; <jats:italic>I</jats:italic> <jats:sup> <jats:italic>2</jats:italic> </jats:sup> = 40), stillbirth (OR = 4.89; 95% CI = 3.55, 6.72; <jats:italic>I</jats:italic> <jats:sup> <jats:italic>2</jats:italic> </jats:sup> = 0) and preterm birth (OR = 17.41; 95% CI = 10.14, 29.90; <jats:italic>I</jats:italic> <jats:sup>2</jats:sup> = 0). The association between DVM and stillbirth (OR = 12.06; 95% CI =3.40, 42.78; <jats:italic>I</jats:italic> <jats:sup>2</jats:sup> = 50; 2/5 studies) persisted in analyses limited to studies that used Amsterdam criteria exclusively for DVM. Conclusion DVM is a placental abnormality associated with congenital foetal malformations and maternal dysmetabolism, including GDM, PGDM, and maternal obesity; and with adverse outcomes including stillbirth and preterm birth. In studies using Amsterdam criteria, placenta with DVM was associated with stillbirth and congenital malformations. Optimising metabolism could prevent harm to the baby.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954970","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}
引用次数: 0
Interpreting ERAP2 as an Ageing-Derived Biomarker for Premature Ovarian Insufficiency. 解释ERAP2作为卵巢早衰的衰老衍生生物标志物。
Pub Date : 2026-01-12 DOI: 10.1111/1471-0528.70148
Xiaowen Feng,Yidan Jin,Ruijin Wu
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引用次数: 0
Aim Low: The Benefits of Low-Field Magnetic Resonance Imaging During Pregnancy. 低目标:低场磁共振成像在怀孕期间的好处。
Pub Date : 2026-01-12 DOI: 10.1111/1471-0528.70149
Lindsay S Cahill
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引用次数: 0
Supporting Physiological Labour and Childbirth in Modern Maternity Services. 现代妇产服务对生理分娩的支持。
Pub Date : 2026-01-12 DOI: 10.1111/1471-0528.70152
Soo Downe
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引用次数: 0
A Core Outcome Set for Studies of Intrahepatic Cholestasis of Pregnancy: Results of International e-Delphi and Consensus Processes. 妊娠期肝内胆汁淤积研究的核心结果集:国际e-Delphi和共识过程的结果。
Pub Date : 2026-01-09 DOI: 10.1111/1471-0528.70144
Nadejda Capatina,William Hague,Jenny Chambers,Catherine Williamson,Caroline Ovadia
OBJECTIVETo define standardised outcomes, the Core Outcome Set (COS) for reporting in studies of Intrahepatic Cholestasis of Pregnancy (ICP).DESIGNe-Delphi survey and consensus process.SETTINGInternational.POPULATION155 individuals from Asia, Europe, Oceania, North and South America: 31 patients (20%), 121 clinicians (78%), and 3 researchers (2%).METHODSMaternal and perinatal outcomes reported in studies of ICP were collated. Stakeholders in ICP research and clinical care scored the importance of each outcome using a 9-point Likert scale over three rounds; short-listed outcomes were ranked during face-to-face consensus meetings. The final COS was agreed by the Study Steering Committee. The study was registered prospectively with Core Outcome Measures in Effectiveness Trials. Ethical approval was granted by the King's College London Research Ethics Committee (KCL MRA-23/24-39574).MAIN OUTCOME MEASURESFrom 54 manuscripts, 97 individual clinical outcomes were attributed to ICP. Twenty three outcomes were shortlisted by the e-Delphi surveys, the ranking of which enabled selection of 10 core outcomes.RESULTSMaternal core outcomes comprise: total maternal bile acid (BA) concentration (maximum), gestational age at peak BA concentration, and itch impact on maternal wellbeing. Birth core outcomes comprise: stillbirth, gestational age at birth, and spontaneous preterm birth versus induced preterm birth. Neonatal core outcomes comprise: perinatal death within 7 days of birth, perinatal asphyxia, neonatal unit admission, and mechanical ventilation.CONCLUSIONSGiven the heterogeneity of reported outcomes, we have confirmed the need for a COS in ICP, standardising the minimum reported outcomes to reduce outcome reporting bias and research wastage.
目的定义妊娠肝内胆汁淤积(ICP)研究报告的标准化结局,即核心结局集(COS)。设计-德尔菲调查和共识过程。人口155人,来自亚洲、欧洲、大洋洲、北美和南美:31名患者(20%),121名临床医生(78%),3名研究人员(2%)。方法对ICP研究报告的孕产妇和围产儿结局进行整理。ICP研究和临床护理的利益相关者在三轮中使用9分李克特量表对每个结果的重要性进行评分;在面对面的共识会议上对入围结果进行排名。研究督导委员会通过了最终的COS。该研究在有效性试验的核心结局指标中进行了前瞻性登记。经伦敦国王学院研究伦理委员会(KCL MRA-23/24-39574)批准。从54篇文献中,97个个体临床结果归因于ICP。通过e-Delphi调查,共有23个结果入围,并对其进行排序,选出10个核心结果。结果母体核心结局包括:母体总胆汁酸(BA)浓度(最大值)、BA浓度峰值时的胎龄以及瘙痒对母体健康的影响。分娩核心结局包括:死产、出生胎龄、自然早产与诱发早产。新生儿核心结局包括:出生后7天内围产期死亡、围产期窒息、新生儿住院和机械通气。鉴于报告结果的异质性,我们已经确认在ICP中有必要进行COS,对最低报告结果进行标准化,以减少结果报告偏倚和研究浪费。
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引用次数: 0
Interpreting Maternal Myo‐Inositol Intake and Congenital Heart Defects: Methodological Considerations 解释母体肌醇摄入与先天性心脏缺陷:方法学考虑
Pub Date : 2026-01-09 DOI: 10.1111/1471-0528.70146
Rüyam Ercenk, Selma Beyza Bilgiç, İbrahim Karaca
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引用次数: 0
Universal Cytomegalovirus Screening in the First Trimester of Pregnancy: The Multicentre Observational Cohort Study in the Area of Barcelona (CITEMB Study). 妊娠前三个月巨细胞病毒筛查:巴塞罗那地区的多中心观察队列研究(CITEMB研究)
Pub Date : 2026-01-09 DOI: 10.1111/1471-0528.70137
María Ángeles Sánchez-Durán,Juliana Esperalba,Elena Scazzocchio,Irene Fernández-Torm,Eva Vázquez-Segura,Olga Gracia-Salazar,Marta Calveiro-Hermo,Jordina Munrós-Feliu,Astrid Francesch-Campi,Laia Alcoverro-Bedos,Aleida Ribas-Tristany,Cristina Del Viso-Lajara,Julia Mitjans-Carrasco,Mercedes Guerrero-Martínez,Gema Fernández-Rivas,Aneta Monika Zientalska,Liudmila Liutsko,Gemma Falguera-Puig,Cristina Martínez-Bueno,Nerea Maiz,Roser Gol,
OBJECTIVETo determine the CMV seroprevalence among pregnant women and assess the rate of primary CMV infections during the first trimester.DESIGNProspective multicentre observational cohort study.SETTINGFour primary care centres (ASSIRs) and two tertiary hospitals in Barcelona and its metropolitan area.PUPULATION OR SAMPLEPregnant women attending first-trimester antenatal visits between October 2022 and September 2024.METHODSAll participants underwent CMV IgG and IgM serological testing at the first antenatal visit. Women with positive IgM and low or intermediate IgG avidity were diagnosed with primary CMV infection and managed according to local protocols, including treatment with valaciclovir and fetal follow-up.MAIN OUTCOME MEASURESCMV screening acceptance rate, seroprevalence, rate of primary infection, fetal infection, and neonatal outcomes up to one year of age.RESULTSOf 3 677 pregnant women recruited, 3 357 were included in the final analysis. CMV screening acceptance was high. Seroprevalence was 77.7% (95% CI 76.2%-79.1%), and 743 women (22.1%, 95% CI 20.7%-23.6%) were seronegative. Five cases (0.15%, 95% CI 0.05%-0.37%) of primary CMV infection were identified and treated. No fetal infections were detected by amniocentesis. One newborn tested positive for CMV but remained asymptomatic at birth and at 6 months. Women who were seronegative were generally older, of European origin, and had higher education and employment rates.CONCLUSIONSUniversal first-trimester CMV screening is feasible and well accepted in a public healthcare setting. While the rate of primary infection was low, early identification of seronegative women offers opportunities for preventive counselling and targeted follow-up.
目的了解妊娠早期孕妇巨细胞病毒(CMV)的血清阳性率及原发性感染情况。前瞻性多中心观察队列研究。在巴塞罗那及其大都市区设有四家初级保健中心和两家三级医院。人口或样本:在2022年10月至2024年9月期间参加妊娠早期产前检查的孕妇。方法所有参与者在首次产前检查时进行巨细胞病毒IgG和IgM血清学检测。IgM阳性和低或中等水平IgG阳性的妇女被诊断为原发性巨细胞病毒感染,并根据当地方案进行管理,包括使用伐昔洛韦治疗和胎儿随访。主要结局指标cmv筛查接受率、血清阳性率、原发感染率、胎儿感染率和1岁以下新生儿结局。结果入选的3 677名孕妇中,有3 357名纳入最终分析。CMV筛查接受度高。血清阳性率为77.7% (95% CI 76.2% ~ 79.1%),血清阴性743例(22.1%,95% CI 20.7% ~ 23.6%)。发现并治疗原发性巨细胞病毒感染5例(0.15%,95% CI 0.05% ~ 0.37%)。羊膜穿刺术未发现胎儿感染。一名新生儿巨细胞病毒检测呈阳性,但在出生时和6个月时仍无症状。血清检测呈阴性的妇女一般年龄较大,是欧洲裔,受教育程度和就业率较高。结论在公共卫生机构中,普遍进行妊娠早期巨细胞病毒筛查是可行的,并且被广泛接受。虽然原发感染率很低,但对血清阴性妇女的早期识别为预防性咨询和有针对性的后续行动提供了机会。
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引用次数: 0
Patients as Partners in Perinatal Health Research: A Scoping Review 围生期健康研究中作为伙伴的患者:范围综述
Pub Date : 2026-01-08 DOI: 10.1111/1471-0528.70145
Lucy Zhao, Lauren S. Tailor, Yanara Marks, Renee G. Fajardo, Sabrina Chiodo, Olivia M. Novosel, Jessie Cunningham, Sonia M. Grandi
Methods for effective patient engagement (PE) are continually emerging. Previous studies examining barriers, challenges and knowledge gaps for PE in research are not specific to women/individuals with lived experiences of pregnancy or those trying to conceive.
有效的患者参与(PE)方法不断涌现。先前的研究考察了体育研究中的障碍、挑战和知识差距,这些研究并不针对有怀孕经历或试图怀孕的女性/个人。
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引用次数: 0
Registration of Stillbirth After Early Fetal Death: A National Population-Based Analysis. 早期胎儿死亡后死产的登记:一项基于全国人口的分析。
Pub Date : 2026-01-06 DOI: 10.1111/1471-0528.70133
Ruth J Matthews,K Sruthi Vydyula,Ian D Gallimore,Bradley N Manktelow,Lucy K Smith
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引用次数: 0
期刊
BJOG: An International Journal of Obstetrics & Gynaecology
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