{"title":"Public Versus Private Obstetric Care: Methodological and Costing Considerations.","authors":"Andrew Bisits,Mark B Tracy,Hannah Dahlen,Yu Gao","doi":"10.1111/1471-0528.70028","DOIUrl":"https://doi.org/10.1111/1471-0528.70028","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126995","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":"Neutrophil-To-Lymphocyte Ratio in Preterm Premature Rupture of Membranes.","authors":"Xiaoe Jiang,Yuelan Liu,Jingrui Huang","doi":"10.1111/1471-0528.70035","DOIUrl":"https://doi.org/10.1111/1471-0528.70035","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"156 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127295","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}
Paolo Vercellini,Veronica Bandini,Noemi Salmeri,Paola Viganò,Edgardo Somigliana
{"title":"Optimising Hormonal Therapy Before Declaring Failure in Endometriosis-Associated Pain.","authors":"Paolo Vercellini,Veronica Bandini,Noemi Salmeri,Paola Viganò,Edgardo Somigliana","doi":"10.1111/1471-0528.70020","DOIUrl":"https://doi.org/10.1111/1471-0528.70020","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127294","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}
María Loreto Hernández-Martínez,Alonso Molina-Rodríguez,Marta Maes-Carballo,Aurora Bueno-Cavanillas,Naomi Cano-Ibáñez,Carmen Amezcua-Prieto
BACKGROUNDClinical Practice Guidelines (CPGs) are essential for promoting evidence-based maternal and neonatal care, but inconsistencies in recommendations can be confusing.OBJECTIVESTo analyse the quality and reporting of international CPGs for normal birth and summarise the recommendations.SEARCH STRATEGYRegistered on PROSPERO (CRD42021269488), the study identified CPGs on normal birth through systematic searches in databases like MEDLINE, Cochrane, Scopus and WOS, along with direct outreach to international organisations.SELECTION CRITERIACPGs published from 2010 to December 2024 were included, with no language restrictions.DATA COLLECTION AND ANALYSISThe quality and reporting of CPGs were evaluated using the AGREE II and RIGHT tools, and recommendations were summarised.MAIN RESULTSOf the 25 CPGs analysed, the median AGREE II quality score was 54%, and the median RIGHT reporting score was 50%. The highest scores were from WHO (2018), CINETS (2013) and the Spanish normal childbirth CPG (2010). Notably, 56% of CPGs had poor reporting, while only 8% were adequately informed. Common recommendations included the presence of support persons, avoiding routine interventions (e.g., enemas, shaving), encouraging fluid intake, allowing movement during labour and promoting skin-to-skin contact.CONCLUSIONSMost CPGs on normal childbirth are outdated and exhibit poor quality and reporting. There is a pressing need for improvements to ensure valid, consistent and updated recommendations that enhance maternal and neonatal health.
{"title":"Clinical Practice Guidelines on Normal Labour and Childbirth: A Systematic Review.","authors":"María Loreto Hernández-Martínez,Alonso Molina-Rodríguez,Marta Maes-Carballo,Aurora Bueno-Cavanillas,Naomi Cano-Ibáñez,Carmen Amezcua-Prieto","doi":"10.1111/1471-0528.70001","DOIUrl":"https://doi.org/10.1111/1471-0528.70001","url":null,"abstract":"BACKGROUNDClinical Practice Guidelines (CPGs) are essential for promoting evidence-based maternal and neonatal care, but inconsistencies in recommendations can be confusing.OBJECTIVESTo analyse the quality and reporting of international CPGs for normal birth and summarise the recommendations.SEARCH STRATEGYRegistered on PROSPERO (CRD42021269488), the study identified CPGs on normal birth through systematic searches in databases like MEDLINE, Cochrane, Scopus and WOS, along with direct outreach to international organisations.SELECTION CRITERIACPGs published from 2010 to December 2024 were included, with no language restrictions.DATA COLLECTION AND ANALYSISThe quality and reporting of CPGs were evaluated using the AGREE II and RIGHT tools, and recommendations were summarised.MAIN RESULTSOf the 25 CPGs analysed, the median AGREE II quality score was 54%, and the median RIGHT reporting score was 50%. The highest scores were from WHO (2018), CINETS (2013) and the Spanish normal childbirth CPG (2010). Notably, 56% of CPGs had poor reporting, while only 8% were adequately informed. Common recommendations included the presence of support persons, avoiding routine interventions (e.g., enemas, shaving), encouraging fluid intake, allowing movement during labour and promoting skin-to-skin contact.CONCLUSIONSMost CPGs on normal childbirth are outdated and exhibit poor quality and reporting. There is a pressing need for improvements to ensure valid, consistent and updated recommendations that enhance maternal and neonatal health.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127005","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":"Evidence Based Maternity Care Using Routinely Collected Data-We Need to Think Differently.","authors":"Per Kempe,Michael Robson","doi":"10.1111/1471-0528.70000","DOIUrl":"https://doi.org/10.1111/1471-0528.70000","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077855","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 estimate the effect on healthcare resource use after introducing the World Health Organization diagnostic criteria (WHO-2013) for gestational diabetes mellitus (GDM) compared to former criteria in Sweden (SWE-GDM).DESIGNA cost-analysis alongside the Changing Diagnostic Criteria for Gestational Diabetes (CDC4G) randomised controlled trial.SETTINGSweden, with risk-factor based screening for GDM.POPULATION47 080 pregnant women and their infants.METHODSA register-based cost-analysis from a healthcare perspective alongside a stepped-wedge cluster RCT of switching from SWE-GDM to WHO-2013 criteria in 2018. Analyses were made on the population level and repeated in the subgroup affected by the intervention, that is, those with plasma glucose values between SWE-GDM and WHO-2013 criteria. Sensitivity analysis by bootstrapping was performed.MAIN OUTCOME MEASURESEstimated costs for obstetric surveillance (including GDM-management), delivery and neonatal healthcare until 28 days postpartum.RESULTSOn a population level, the WHO-2013 criteria were associated with increased costs of obstetric surveillance (adjusted mean [bootstrap confidence interval]) €94.0 [24.5-169.1], delivery care €20.4 [-33.5 to 75.4] and neonatal care €331.0 [75.1-589.0] per pregnancy, and in the affected subgroup €606.9 [377.7-872.4], €348.5 [126.0-542.0] and €129.3 [-559.0 to 980.9] respectively.CONCLUSIONSImplementation of the WHO-2013 criteria in Sweden was associated with increased costs for obstetric surveillance and delivery on a population level, driven by the affected subgroup. The increased costs for neonatal care were associated with large uncertainty. A detailed understanding of the changes in resource use can guide decisions to mitigate cost increases.
{"title":"Implications of Changing the Diagnostic Criteria for Gestational Diabetes Mellitus (CDC4G): A Healthcare Cost Analysis Alongside a Stepped Wedge Cluster Randomised Trial.","authors":"Maryam de Brun,Naimi Johansson,David Simmons,Scott Montgomery,Kerstin Berntorp,Stefan Jansson,Ulla-Britt Wennerholm,Anna-Karin Wikström,Helena Strevens,Fredrik Ahlsson,Verena Sengpiel,Elisabeth Storck-Lindholm,Martina Persson,Kerstin Petersson,Carina Ursing,Linda Ryen,Helena Backman","doi":"10.1111/1471-0528.18364","DOIUrl":"https://doi.org/10.1111/1471-0528.18364","url":null,"abstract":"OBJECTIVETo estimate the effect on healthcare resource use after introducing the World Health Organization diagnostic criteria (WHO-2013) for gestational diabetes mellitus (GDM) compared to former criteria in Sweden (SWE-GDM).DESIGNA cost-analysis alongside the Changing Diagnostic Criteria for Gestational Diabetes (CDC4G) randomised controlled trial.SETTINGSweden, with risk-factor based screening for GDM.POPULATION47 080 pregnant women and their infants.METHODSA register-based cost-analysis from a healthcare perspective alongside a stepped-wedge cluster RCT of switching from SWE-GDM to WHO-2013 criteria in 2018. Analyses were made on the population level and repeated in the subgroup affected by the intervention, that is, those with plasma glucose values between SWE-GDM and WHO-2013 criteria. Sensitivity analysis by bootstrapping was performed.MAIN OUTCOME MEASURESEstimated costs for obstetric surveillance (including GDM-management), delivery and neonatal healthcare until 28 days postpartum.RESULTSOn a population level, the WHO-2013 criteria were associated with increased costs of obstetric surveillance (adjusted mean [bootstrap confidence interval]) €94.0 [24.5-169.1], delivery care €20.4 [-33.5 to 75.4] and neonatal care €331.0 [75.1-589.0] per pregnancy, and in the affected subgroup €606.9 [377.7-872.4], €348.5 [126.0-542.0] and €129.3 [-559.0 to 980.9] respectively.CONCLUSIONSImplementation of the WHO-2013 criteria in Sweden was associated with increased costs for obstetric surveillance and delivery on a population level, driven by the affected subgroup. The increased costs for neonatal care were associated with large uncertainty. A detailed understanding of the changes in resource use can guide decisions to mitigate cost increases.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032130","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}
Natasha Hirschhorn-Edwards,Hannah Dahlen,Sue Kildea,Sally K Tracy
{"title":"Are Private Obstetric Services Safer and More Cost Effective Than Midwife-Led Care in Australia?","authors":"Natasha Hirschhorn-Edwards,Hannah Dahlen,Sue Kildea,Sally K Tracy","doi":"10.1111/1471-0528.18365","DOIUrl":"https://doi.org/10.1111/1471-0528.18365","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008729","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 Growth Dynamics and Clinical Translation of Machine Learning-Based Prediction of Adverse Perinatal Outcomes.","authors":"Ronghuang Li,Yuehua Yan,Qianyu Chen","doi":"10.1111/1471-0528.18369","DOIUrl":"https://doi.org/10.1111/1471-0528.18369","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008727","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}
Josca M Schoonejans,Hanns-Ulrich Marschall,M Martineau,David McCance,Catherine Williamson
{"title":"Serum Bile Acid Composition in Women With Gestational Diabetes and Fasting Hyperglycaemia (HAPO): A Cohort Study.","authors":"Josca M Schoonejans,Hanns-Ulrich Marschall,M Martineau,David McCance,Catherine Williamson","doi":"10.1111/1471-0528.18363","DOIUrl":"https://doi.org/10.1111/1471-0528.18363","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960274","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}
Rhianna Davies, Ashwin Goyal, Zachary Nash, Sarah Hillman, Melanie Davies, Nick Panay, Jane Daniels, Tim Hillard, Bonnie Grant, Paula Briggs, Lynne Robinson, Haitham Hamoda, Channa N. Jayasena
ObjectiveTo investigate the factors associated with non‐vasomotor menopause symptoms among women in the UK, focusing on the perceived importance of specific symptoms and their association with demographic and treatment‐related factors.DesignA cross‐sectional online survey.SettingUK‐wide national survey conducted from February to March 2023.Population or SampleA total of 7285 women completed the survey.MethodsParticipants provided anonymised demographic data and rated the importance of five menopause symptoms (‘low mood’, ‘brain fog’, ‘aches and pains’, ‘feeling tired’, and ‘weight gain’) using a 10‐point Likert scale. The full questionnaire is provided in . Univariable and multivariable linear regression analyses were performed to assess the association between symptom importance scores and specific characteristics, including age, HRT and non‐HRT treatment, ethnicity, and geographical location.Main Outcome MeasuresImportance scores of menopause symptoms stratified by demographic and treatment factors.ResultsSignificant differences were identified in perceived symptom importance across age groups, geographic locations, ethnic backgrounds, and treatment status. Brain fog was the most frequently prioritised symptom overall. Several moderate‐strength associations were observed: for example, HRT use was associated with higher importance ratings for brain fog, tiredness, low mood, and aches and pains. Ethnic minority women (Asian and Black) also gave higher importance ratings to brain fog.ConclusionsThe findings highlight the prominence of cognitive and psychological symptoms during menopause and the influence of demographic and treatment variables on symptom prioritisation. These results support the need for personalised and inclusive menopause care that addresses a wider range of symptom concerns beyond vasomotor issues. These findings have implications for public health policy and financial investment.
{"title":"Factors Associated With Non‐Vasomotor Menopause Symptoms Experienced by 7285 Women: A UK‐Wide National Survey","authors":"Rhianna Davies, Ashwin Goyal, Zachary Nash, Sarah Hillman, Melanie Davies, Nick Panay, Jane Daniels, Tim Hillard, Bonnie Grant, Paula Briggs, Lynne Robinson, Haitham Hamoda, Channa N. Jayasena","doi":"10.1111/1471-0528.18353","DOIUrl":"https://doi.org/10.1111/1471-0528.18353","url":null,"abstract":"ObjectiveTo investigate the factors associated with non‐vasomotor menopause symptoms among women in the UK, focusing on the perceived importance of specific symptoms and their association with demographic and treatment‐related factors.DesignA cross‐sectional online survey.SettingUK‐wide national survey conducted from February to March 2023.Population or SampleA total of 7285 women completed the survey.MethodsParticipants provided anonymised demographic data and rated the importance of five menopause symptoms (‘low mood’, ‘brain fog’, ‘aches and pains’, ‘feeling tired’, and ‘weight gain’) using a 10‐point Likert scale. The full questionnaire is provided in . Univariable and multivariable linear regression analyses were performed to assess the association between symptom importance scores and specific characteristics, including age, HRT and non‐HRT treatment, ethnicity, and geographical location.Main Outcome MeasuresImportance scores of menopause symptoms stratified by demographic and treatment factors.ResultsSignificant differences were identified in perceived symptom importance across age groups, geographic locations, ethnic backgrounds, and treatment status. Brain fog was the most frequently prioritised symptom overall. Several moderate‐strength associations were observed: for example, HRT use was associated with higher importance ratings for brain fog, tiredness, low mood, and aches and pains. Ethnic minority women (Asian and Black) also gave higher importance ratings to brain fog.ConclusionsThe findings highlight the prominence of cognitive and psychological symptoms during menopause and the influence of demographic and treatment variables on symptom prioritisation. These results support the need for personalised and inclusive menopause care that addresses a wider range of symptom concerns beyond vasomotor issues. These findings have implications for public health policy and financial investment.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144928096","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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