Raya Vinogradov

Objective: Low‐dose aspirin is proven to reduce the incidence of pre‐eclampsia, yet adherence remains low. This systematic review synthesises qualitative evidence on barriers and facilitators to low‐dose aspirin adherence in pregnancy and uses a co‐production approach to develop an explanatory model of this complex behaviour. The overall aim is to contribute to the development of a theory of adherence, targeting this health issue. Methods: Data sources: A search of electronic databases (Medline, Web of Science, CINAHL, PsycINFO, Embase, Scopus, Open Grey, Google Scholar, Prospero), charity and professional organisations’ archives was conducted using predefined terms. Citation searching was also performed. Searches were not time‐limited or language‐specific and completed in November 2024. Eligibility Criteria: Studies, which included qualitative data on low‐dose aspirin determinants of adherence in pregnancy were included. Study Appraisal and Synthesis Methods: Quality was assessed using the Critical Appraisal Skills Programme checklist. A meta‐ethnography approach with reciprocal translation and line‐of‐argument synthesis was used. The co‐production approach was utilised to streamline future intervention development by engaging key stakeholders in evidence synthesis, enabling them to translate evidence into action, support implementation and overcome the subjectivity inherent in meta‐ethnography. Co‐production activities followed the nominal group technique and structured discussions. Results: Out of 3757 items identified through systematic searches of published studies and grey literature, six studies were included in the review. No studies were excluded based on quality. Four 3rd‐order constructs with a total of 10 sub‐themes were identified: informational gap, verbal and non‐verbal health system communication, personal assets and autonomous control. In an explanatory model, we demonstrate that women are advised to take low‐dose aspirin in a context of lack of information and misconceptions (informational gap) with patchy and inconsistent messages from the health care system. Women ultimately control their decision about the use of low‐dose aspirin, however, the arrival at a decision depends on the utilisation of individual assets (unique personal or social characteristics inherited or acquired). Conclusions: Improving the quality and delivery of information for women and their support networks can reduce the strain on personal resources and make this essential preventive treatment more accessible and equitable. Patient or Public Contribution: A group consisting of representatives from two national charities and a service user worked alongside an academic team, contributing to all aspects of this work, including formulating the research question, participating in the selection of the search terms, conducting screening of the abstracts, data extraction, quality assessment, synthesis, drafting a graphic representation and this manuscript.

Background/objectives: Maternal adiposity is a known risk factor for adverse pregnancy outcomes, yet routine antenatal care primarily relies on body mass index (BMI), which has limitations. This study aimed to explore the acceptability of incorporating a broader range of adiposity measurements into early pregnancy antenatal care, assessing pregnant women’s perceptions to inform implementation strategies. Methods: A qualitative study using semi-structured interviews was conducted with 14 pregnant women purposively sampled to capture variation in BMI, age, and parity. Interviews occurred approximately 4–5 months post-measurement experience. The Theoretical Framework of Acceptability (TFA) guided thematic analysis of transcribed data, with independent coding to ensure rigour. Results: Participants generally viewed the current reliance on BMI as outdated and expressed neutral to positive attitudes toward the use of more detailed adiposity measurements. Most reported little emotional discomfort with the process. However, some reflected likelihood of more body self-consciousness had it been their first pregnancy. Time involved in measurements was not seen as burdensome, however waiting between procedures was a minor inconvenience. Self-assessing body shape was described as difficult. Women emphasised the importance of choice, autonomy, and informed consent, especially in relation to partner involvement, the gender of the anthropometrist, and the nature of the procedures. Clear, advance communication and supportive explanations during appointments were seen as essential to ensuring a positive experience. Conclusions: Expanding adiposity assessments in early pregnancy is acceptable to women if implemented ethically, prioritising consent, privacy, emotional safety, and effective communication. Integration into routine care requires staff training and pre-appointment guidance.

Background: Gastroschisis is a congenital anomaly of the umbilical ring with increasing prevalence, especially amongst younger mothers. There is increasing evidence that exposure to genitourinary infections (GUTI) may play an important role in the etiology of gastroschisis. This systematic review and meta‐analysis aimed to identify, appraise, and summarize the literature on exposure to GUTI and gastroschisis.Methods: Six electronic databases (MEDLINE, EMBASE, Web of Science, Scopus, Cochrane Library electronic databases, and Prospero) were searched using a comprehensive search strategy. Citations and cited articles for all included studies were searched. Peer‐reviewed, quantitative studies reporting an association of urinary tract infections (UTI) and/or sexually transmitted infections (STI) with gastroschisis were included. Prospero registration CRD42022377420.Results: A total of 2392 papers were identified via the searches of which 15 met our inclusion criteria and were included after title and abstract and full text screening. The study period for included studies ranged from 1995 to 2016, most were from the USA. Four studies considering exposure to STIs and five to UTIs were eligible to progress to meta‐analysis. Meta‐analysis identified a significantly increased risk of gastroschisis in association with periconceptional exposure to UTI [OR 1.54 (95% CI 1.29, 1.8)], STI [OR 1.4 (95% CI 1.01, 1.79)].Conclusions: Periconceptional exposure to GUTI is associated with an increased risk of gastroschisis. The prevention and timely treatment of GUTI amongst women of childbearing age may help to reduce the occurrence of gastroschisis.