Topics
Women's health
Temporal Trends in Preterm Birth Associated With Hypertensive Disorders of Pregnancy in Victoria, Australia: A Population-Based Interrupted Time-Series Study
Objectives Hypertensive disorders of pregnancy (HDP) are a leading reason for medically indicated preterm birth (PTB), yet their contribution to population-level PTB trends is poorly understood. We examined temporal trends in PTB overall and HDP-associated PTB in Victoria over an 11-year period spanning the COVID-19 pandemic, and distinguished changes in HDP prevalence from changes in preterm delivery among affected pregnancies.Study TypePopulation-based interrupted time-series study using seasonal autoregressive integrated moving average (SARIMA) models, with July 2018 (launch of a national preterm birth prevention program) pre-specified as a temporal reference point.SettingAll hospitals in Victoria, Australia.Participants779,325 singleton births at ≥ 20 weeks' gestation between 1 January 2012 and 31 March 2022.Main Outcome MeasuresMonthly rates (per 1000 singleton births) of overall PTB, HDP and HDP-associated PTB. Decomposition analyses separated changes in HDP prevalence from changes in preterm delivery among affected pregnancies.ResultsOverall PTB was lower after July 2018 (5.8%–5.6%), while HDP prevalence increased (6.4%–7.0%). HDP-associated PTB increased before mid-2018 (+0.75 per 1000 births per month; 95% confidence interval [CI], 0.50–1.00) but declined thereafter (−1.12 per 1000 births per month; 95% CI, −1.88 to −0.36). This reversal was driven predominantly by reduced iatrogenic PTB with HDP; spontaneous PTB with HDP showed no significant change. Despite rising HDP prevalence, decomposition analyses estimated 89 fewer HDP-associated PTB cases than expected under pre-2018 patterns, reflecting a decline in the proportion of HDP pregnancies delivered preterm. PTB without HDP showed no significant temporal change.ConclusionPTB among HDP-complicated pregnancies declined despite increasing HDP prevalence, consistent with a shift towards later gestational age at delivery rather than reduced disease incidence. These findings may reflect improvements in care and demonstrate that reductions in iatrogenic PTB are achievable even as major risk factors become more prevalent.
Melvin Marzan, Heng Jiang, Daniel Lorber Rolnik, Joanne M. Said, Lisa Hui
Linguistic Manoeuvres: Obstetric Violence Camouflages Harm and Loss of Consent From Birth
Liz Sutton, Harsha Ananthram, Rebecca Matthews
Linguistic Manoeuvres: Obstetric Violence Camouflages Harm and Loss of Consent From Birth
Bashi Kumar-Hazard, Andrew M. Bisits, Sharon L. Settecasse, Jenny Gamble, Hazel Keedle, Hannah G. Dahlen
Linguistic Manoeuvres: Obstetric Violence Camouflages Harm and Loss of Consent From Birth
Wendy Pollock, Alissa Fleming, Ensieh Fooladi, Joy Kloester, Anne Tremayne, Yasmin Zisin, Bethany Carr, Kym Davey, Suzanne Willey, Jenny Gamble
Getting on the Same Page: Why Australia Needs a National Maternity Early Warning System (MEWS) Chart
Observation charts are used to record and prompt responses for acutely deteriorating patients. Compared to non-pregnant observation charts, maternity charts reflect physiological changes of pregnancy and the immediate postpartum period. Maternity observation charts differ across Australian states and territories, resulting in a lack of comparable data, standardised care and optimisation of streamlining education and training. To improve maternity care across the country, we propose that the Australian Commission on Safety and Quality in Health Care, in the upcoming third edition of the National Safety and Quality Health Service Standards, review Standard 8 (recognising and responding to the acutely deteriorating patients) to generate a national Maternity Early Warning System (MEWS) Chart.
Briony A. Cutts, Lucy Bowyer, Nisha Khot, Sandra Lowe, Stefan C. Kane
Four Urgent Actions for the Rights to Culturally Safe Breastfeeding for Aboriginal and Torres Strait Islander Mothers and Babies to Breastfeed in Neonatal Intensive Care Environments
Breast milk provides both short-term and long-term health benefits and is critical for infants admitted to neonatal intensive care units (NICUs). Presently, there is a large focus on increasing breastfeeding rates among Aboriginal and Torres Strait Islander women; however, culturally safe breastfeeding support is under-recognised and inadequately addressed in the NICU setting. This perspective highlights cultural and structural barriers and calls for urgent action to include the following four proposed strategies: strengthening the Aboriginal lactation workforce, embedding culturally inclusive education, partnering with community-controlled services, and developing a culturally specific NICU breastfeeding policy to improve outcomes.
Jessica Bennett, Jamie Bryant, Kade Booth, Michelle Kennedy
Interpreting Australian Stillbirth Rate Trends: Implications for Surveillance and Continuous Quality Improvement
Reports of rising stillbirth rates in Australia have generated concern among affected parents and other stakeholders. Review of the national data suggests that much of the rise is being driven by an increase in terminations of pregnancy after 20 weeks' gestation. This increase coincides with legislative changes expanding access to terminations beyond 20 weeks. Alongside publishing stillbirth rates according to the legal definition (stillbirths from 20 weeks' gestation including terminations of pregnancy), national reporting bodies should routinely publish stillbirth rates among births from 28 weeks' gestation excluding terminations of pregnancy as the latter is most relevant to Australia's current stillbirth prevention initiatives.
Aleena M. Wojcieszek, Kirstine Sketcher-Baker, Christine Andrews, Michael Coory, Imogen Kettle, Melissa Malivoire, David Ellwood, Vicki Flenady
The clinical presentation, investigation, and management of women diagnosed with endometriosis in Australian general practices, 2011–2021: an open cohort study
Supporting general practitioners in the identification and management of endometriosis could reduce diagnostic delays and optimise clinical care
Danielle Mazza · Kailash Thapaliya · Sharinne B Crawford · Alissia Hui · Maryam Moradi · Luke E Grzeskowiak
The early implementation phase of the Omega‐3 Test‐and‐Treat Program for reducing the risk of preterm birth, South Australia, 2021–22: an implementation evaluation study
The program could be integrated into routine antenatal care to reduce the risk of preterm birth in Australia
Karen P Best · Celine Northcott · Lucy A Simmonds · Philippa Middleton · Lisa N Yelland · Vanessa Moffa · Khoa Lam · Penelope Coates · Cornelia Späth · Carol WK Siu · Karen Glover · Rhiannon Smith · Robert Gibson · Maria Makrides
Concurrent use of hormonal long‐acting reversible contraception by women of reproductive age dispensed teratogenic medications, Australia, 2013–2021
Aaron E Boyce · Tony Caccetta · Jo‐Ann See · Rosemary L Nixon AM
Concurrent use of hormonal long‐acting reversible contraception by women of reproductive age dispensed teratogenic medications, Australia, 2013–2021
Michelle KY Chen · Adrian Lim · Deshan F Sebaratnam
Sex‐ and gender‐responsive management of anxiety disorders: future pathways for research, education, policy and practice
Better integration of sex and gender considerations in health and medical research, in Australian clinical practice guidelines, and in health and medical education curricula, is needed to improve the quality of care for all people with anxiety disorders
Bronwyn M Graham
The first live term birth following uterus transplantation in Australia
Uterus transplantation could be adopted as an assisted reproductive technology for women with uterine factor infertility
Rebecca Deans · Brigitte Gerstl · Antonia W Shand · Sarah Lyons · Aaron Budden · Helen L Barrett · Grant Luxton · Mangalee Fernando · Kenneth Yong · Karen Keung · Kaushalya Arulpragasam · Henry Pleass · King Man Wan · Eva Kehag · Jana‐Emily Pittman · Mianna Lotz · Maria Fenn · Erin Nesbitt‐Hawes · Lily Byun · Katrina Tang · Mats Brannstrom · Jason Abbott
Alison Bush memorial oration: supporting First Nations community‐designed and led maternal health initiatives
This reflection honours Sister Alison Bush’s impact on First Nations health care, emphasising the ongoing fight for equity for First Nations women
Karel Williams
Incidence of GLP‐1 receptor agonist use by women of reproductive age attending general practices in Australia, 2011–2022: a retrospective open cohort study
Further evidence and guidelines are needed for safe, effective use of GLP-1 receptor agonists by women of reproductive age
Kailash Thapaliya · Arianne Sweeting · Kirsten I Black · Amanda Poprzeczny · Danielle Mazza · Luke E Grzeskowiak
An Aboriginal women‐led approach to design a maternal and child health model when cardiometabolic complications are experienced in pregnancy in South Australia
Culturally responsive, person-centred care can bridge gaps between Aboriginal knowledge systems and biomedical paradigms, improving maternal, child and family health outcomes holistically
Karrina DeMasi (Barkandji) · Dana Shen (Ngarrindjeri) · Phoebe McColl · Amanda Richards‐Satour (Adnyamathanha and Barngarla) · Carolyn Renehan (Central Arrernte) · Kim Morey (Anmatyerr and Eastern Arrernte) · Karen Glover (Mein:tnk and Wotjobaluk) · Cathy Leane (Dharug) · Kristine Woods‐Hampton (Anmatijerre) · Lorraine Garay (Anangu) · Eloise Baker (Adnyamathanha and Barngarla) · Rebecca Nielsen (Kalkadoon) · Katharine Brown
Linguistic manoeuvres: obstetric violence camouflages harm and loss of consent from birth
A discussion on birth trauma, informed consent and obstetric violence in Australia
Harsha Ananthram · Liz Sutton · Rebecca Matthews · Nadine Montgomery · James Titcombe · Ajay Rane
Reducing unprofessional practices in referrals to abortion care: proposing a minimum professional standard
This perspective applies the principles of medical professionalism to abortion referrals, presents a spectrum of referral practices, proposes a minimum standard for professional abortion referral, and identifies strategies to promote person-centred referrals
Shelly Makleff · Bronwen Merner · Kirsten I Black · Louise Keogh
The public health impacts of mining in Australia
A multisectoral approach and stronger multilevel government coordination are required to address the health impacts associated with proximity to mining and exposure to toxic chemicals
Javier Cortes‐Ramirez · Ruby N Michael · Leisa‐Maree Toms · Melissa Haswell
When may an adult woman with cognitive impairment still have capacity to consent to an abortion?
Capacity to consent to abortion is decision-specific, so that even when a woman is found to lack capacity to make decisions in other areas of her life, she may still have capacity to consent to an abortion
Julia P Duffy · Sam Boyle · Casey M Haining
Factors that affect the provision of medical abortion services in Australian primary care: a mixed methods systematic review
Financial and structural support is needed for the geographic decentralisation of medical abortion training and services
Greta Skahill · Mridula Shankar
Australasian Diabetes in Pregnancy Society (ADIPS) 2025 consensus recommendations for the screening, diagnosis and classification of gestational diabetes
Updated recommendations for the screening, diagnosis and classification of hyperglycaemia in pregnancy
Arianne Sweeting · Matthew JL Hare · Susan J Jersey · Alexis L Shub · Julia Zinga · Cecily Foged · Rosemary M Hall · Tang Wong · David Simmons
Respiratory syncytial virus preventives for children in Australia: current landscape and future directions
A review of advancements in respiratory syncytial virus (RSV) prevention within Australia, focusing on the recent introduction of nirsevimab, a long-acting monoclonal antibody, and Abrysvo, a maternal RSV vaccine.
Sam T Barnett · Jane Tuckerman · Ian G Barr · Nigel W Crawford · Danielle F Wurzel
The prevalence of intimate partner violence in Australia: a national survey
The lifetime prevalence of experiencing intimate partner violence is high, especially among women
Ben Mathews · Kelsey L Hegarty · Harriet L MacMillan · Monica Madzoska · Holly E Erskine · Rosana Pacella · James G Scott · Hannah Thomas · Franziska Meinck · Daryl Higgins · David M Lawrence · Divna Haslam · Sara Roetman · Eva Malacova · Timothy Cubitt
Updating the diagnosis and management of iron deficiency in the era of routine ferritin testing of blood donors by Australian Red Cross Lifeblood
Jason Abbott · Kirsten I Black · Elizabeth Marles