Obstetrics & Gynecology

Multilevel reproductive-health intervention increases goal-concordant survivorship care

In a 17-site cluster randomized trial (n=379 analyzed), the EROS multilevel intervention increased reproductive health goal-concordant management to 65.7% versus 47.3% with standard care. Overall effect size favored intervention (OR 2.07, 90% CI 1.29–3.31) within 3 months of diagnosis. Benefit was concentrated among women who had completed childbearing (OR 2.92, 90% CI 1.65–5.17). Apply this model in community oncology settings to improve adherence to oncofertility and oncocontraception guidance. 1

Film-based education did not reduce adverse perinatal outcomes from gestational diabetes

Two parallel cluster randomized trials in Uganda and India tested seven educational films versus usual care across 60 facilities. Pooled prevalence ratio for the composite adverse perinatal outcome was PR 1.03 (95% CI 0.97–1.10), showing no reduction. Loss to follow-up differed between countries and staff/participants were unblinded, which may affect implementation fidelity. Educational films alone should not be relied on to reduce GDM perinatal complications without added clinical interventions. 2

Periconceptional GLP‑1 RA exposure not clearly linked to major fetal or obstetric harms

Systematic review and meta-analysis of 22 studies (49,395 pregnancies) found no significant association with major congenital, cardiac malformations, preterm birth, or hypertensive disorders. A small increased odds for renal malformations (OR 1.23, 95% CI 1.09–1.39) was observed, largely driven by one large, imbalanced cohort. Heterogeneity and potential residual confounding limit causal inference. These data provide cautious reassurance after inadvertent exposure but are not definitive enough to alter prescribing without individualized risk discussion. 3