Educational outcomes associated with prenatal exposure to antiseizure medications: A systematic literature review and meta-Analysis.

Objective: To systematically review and meta-analyse evidence of the associations between prenatal exposure to antiseizure medications (ASMs) and educational outcomes in childhood, including educational difficulties, learning difficulties and academic performance.

Methods: We conducted a systematic review following the PICOS framework and PRISMA guidelines. MEDLINE (Ovid), CINAHL, PubMED, ERIC, and PsycINFO databases, along with Google Scholar, were searched from inception to 28 June 2024.

Effect of comprehensive tobacco control policies on maternal and child outcomes: a population-based linkage study.

Objectives: To assess the impact of comprehensive tobacco control policies on maternal smoking during pregnancy and perinatal outcomes over a 20-year period.

Design: Population-based cohort study using linked Scottish National Health Service. We assessed the impact of tobacco control measures on maternal smoking and perinatal outcomes over four distinct time periods.

Maternal fever, epidural analgesia, and genetics: implications for the neonate.

Epidural-related maternal fever affects 15-25% of labouring women, but its mechanisms remain uncertain. In a prospective observational study, the EPIFEVER-2 investigators found no firm link between interleukin-1Ra concentrations and epidural-related maternal fever, suggesting other aetiological factors. Clinically, the main challenge lies in distinguishing epidural-related maternal fever from infectious fever to avoid unnecessary antibiotic use and neonatal interventions.

Maternal pre-pregnancy diabetes and risk of all-cause and cause-specific infant mortality.

Background: Maternal pre-pregnancy diabetes is associated with a higher risk of adverse pregnancy outcomes. Few large, cohort studies have assessed associations with a wide large range of causes of infant death.

Methods: This retrospective cohort study included all singleton live births to women aged 18-49 years in the US National Vital Statistics System from 2011 to 2020.

Explainable artificial intelligence to identify follicles that optimize clinical outcomes during assisted conception.

Infertility affects one-in-six couples, often necessitating in vitro fertilization treatment (IVF). IVF generates complex data, which can challenge the utilization of the full richness of data during decision-making, leading to reliance on simple 'rules-of-thumb'. Machine learning techniques are well-suited to analyzing complex data to provide data-driven recommendations to improve decision-making.

Deep learning versus manual morphology-based embryo selection in IVF: a randomized, double-blind noninferiority trial.

To assess the value of deep learning in selecting the optimal embryo for in vitro fertilization, a multicenter, randomized, double-blind, noninferiority parallel-group trial was conducted across 14 in vitro fertilization clinics in Australia and Europe. Women under 42 years of age with at least two early-stage blastocysts on day 5 were randomized to either the control arm, using standard morphological assessment, or the study arm, employing a deep learning algorithm, intelligent Data Analysis Score (iDAScore), for embryo selection. The primary endpoint was a clinical pregnancy rate with a noninferiority margin of 5%.

Defining Gestational Thyroid Dysfunction Through Modified Nonpregnancy Reference Intervals: An Individual Participant Meta-analysis.

Background: Establishing local trimester-specific reference intervals for gestational TSH and free T4 (FT4) is often not feasible, necessitating alternative strategies. We aimed to systematically quantify the diagnostic performance of standardized modifications of center-specific nonpregnancy reference intervals as compared to trimester-specific reference intervals.

Methods: We included prospective cohorts participating in the Consortium on Thyroid and Pregnancy.

Antimüllerian hormone levels are associated with time to pregnancy in a cohort study of 3,150 women.

Objective: To study the association between antimüllerian hormone (AMH) levels and time of pregnancy. Although it has been hypothesized that serum AMH levels may indicate the chance of conception, findings have been mixed. Given that any association is expected to be modest, and it is possible that previous studies have been underpowered, we investigated this relationship in the largest prospective cohort to date.

Epidural analgesia during labour and severe maternal morbidity: population based study.

Objectives: To determine the effect of labour epidural on severe maternal morbidity (SMM) and to explore whether this effect might be greater in women with a medical indication for epidural analgesia during labour, or with preterm labour.

Design: Population based study.

Setting: All NHS hospitals in Scotland.

Individualized dosing of follitropin delta affects live birth and safety in in vitro fertilization treatment: an individual participant data meta-analysis of randomized controlled trials.

Objective: To undertake a one-stage meta-analysis of individual patient data from randomized trials comparing individualized dosing of follitropin delta vs. other forms of follitropin (alpha and beta) for live birth (LB) rates (LBR) and safety parameters in women undergoing ovarian stimulation for in vitro fertilization treatment.

Design: Systematic review with individual patient data meta-analysis.

Luteal phase support in assisted reproductive technology.

Infertility affects one in six couples, with in vitro fertilization (IVF) offering many the chance of conception. Compared to the solitary oocyte produced during the natural menstrual cycle, the supraphysiological ovarian stimulation needed to produce multiple oocytes during IVF results in a dysfunctional luteal phase that can be insufficient to support implantation and maintain pregnancy. Consequently, hormonal supplementation with luteal phase support, principally exogenous progesterone, is used to optimize pregnancy rates; however, luteal phase support remains largely 'black-box' with insufficient clarity regarding the optimal timing, dosing, route and duration of treatment.

Beyond the Umbrella: A Systematic Review of the Interventions for the Prevention of and Reduction in the Incidence and Severity of Ovarian Hyperstimulation Syndrome in Patients Who Undergo In Vitro Fertilization Treatments.

Ovarian hyperstimulation syndrome (OHSS) is the main severe complication of ovarian stimulation for in vitro fertilization (IVF) cycles. The aim of the current study was to identify the interventions for the prevention of and reduction in the incidence and severity of OHSS in patients who undergo IVF not included in systematic reviews with meta-analyses of randomized controlled trials (RCTs) and assess and grade their efficacy and evidence base. The best available evidence for each specific intervention was identified, analyzed in terms of safety/efficacy ratio and risk of bias, and graded using the Oxford Centre for Evidence-Based Medicine (CEBM) hierarchy of evidence.

Association between perinatal mortality and morbidity and customised and non-customised birthweight centiles in Denmark, Finland, Norway, Wales, and England: comparative, population based, record linkage study.

Objectives: To compare the risk of adverse perinatal outcomes according to infants who are born small for gestational age (SGA; <10th centile) or large for gestational age (LGA; >90th centile), as defined by birthweight centiles that are non-customised (ie, standardised by sex and gestational age only) and customised (by sex, gestational age, maternal weight, height, parity, and ethnic group).

Design: Comparative, population based, record linkage study with meta-analysis of results.

Setting: Denmark, Finland, Norway, Wales, and England (city of Bradford), 1986-2019.

Interventions to prevent or reduce the incidence and severity of ovarian hyperstimulation syndrome: a systematic umbrella review of the best clinical evidence.

Ovarian hyperstimulation syndrome (OHSS) is a potentially life-threating iatrogenic complication of the early luteal phase and/or early pregnancy after in vitro fertilization (IVF) treatment. The aim of the current study was to identify the most effective methods for preventing of and reducing the incidence and severity of OHSS in IVF patients. A systematic review of systematic reviews of randomized controlled trials (RCTs) with meta-analysis was used to assess each potential intervention (PROSPERO website, CRD 268626) and only studies with the highest quality were included in the qualitative analysis.

Setting a tariff for IVF and ICSI treatment: a cost analysis.

In-vitro fertilisation (IVF) and intra-cytoplasmatic sperm injection (ICSI) are available in Scotland through the National Health Service (NHS) according to specific criteria. There is no standardised NHS tariff for these treatments in Scotland, and variation exists amongst different centres providing NHS services. The aim of this study was to calculate the mean cost of IVF and ICSI cycles for NHS-funded treatment in Scotland.

Contraceptive-specific antimüllerian hormone values in reproductive-age women: a population study of 42,684 women.

Objective: To determine how the contraceptive-specific serum antimüllerian hormone (AMH) levels compare across ages and percentiles in a reproductive-age cohort.

Design: Cross-sectional analysis of a prospectively recruited cohort.

Setting: Community.