Contemporary OB/GYN week in review: iron deficiency, IBD guidelines, and more

This week at Contemporary OB/GYN®, we covered topics ranging from gaps in iron deficiency screening to racial gaps in endometriosis care. Click the links below to read anything you might have missed from Monday, September 01, to September 05, 2025.

USPSTF reports gaps in evidence for iron deficiency screening in pregnancy

The US Preventive Services Task Force (USPSTF) has found current evidence comparing the benefits and risks of iron deficiency and iron deficiency anemia screening to be insufficient, publishing a recommendation statement in JAMA to recap the current data.

While these recommendations apply to asymptomatic patients, the authors noted they do not apply to those with severe malnourishment, iron deficiency or iron deficiency anemia symptoms, specific hematologic conditions, or nutritional deficiencies. Iron is vital for oxygen transportation and metabolic pathway function, making supplementation necessary in some patients.

According to the USPSTF, clinicians should consider the potential preventable burden when deciding whether to screen or supplement for iron deficiency. Current methods of identifying risk, such as questionnaires and risk prediction tools, have limited evidence supporting their use based on 3 studies assessing these strategies.

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New guidelines set for managing IBD in pregnancy

On August 28, 2025, the Helmsley PIANO Expert Global Consensus was published in 6 international journals to provide standardized guidelines for providing care to women with inflammatory bowel disease (IBD).

The guidelines were developed based on data from the Pregnancy Inflammatory Bowel Disease And Neonatal Outcomes study, assessing the safety of IBD medications in pregnancy alongside short- and long-term offspring outcomes. These new findings include continuing all biologics throughout pregnancy and universal pre-conception counseling.

“Some of the findings were expected, but others were novel,” said Uma Mahadevan, MD, director of the Colitis and Crohn’s Disease Center at the University of California, San Francisco. “The goal of our study and consortium has been to provide hope, comfort, and the same high-level care to current and future mothers with IBD.

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Racial gaps in diagnosis and care for endometriosis reported

A cross-sectional qualitative review published in BMC Women’s Health highlights the need for culturally responsive, patient-centered care in Black women with endometriosis.

The first theme identified was physical symptoms, which included vomiting, pelvic pain, headaches, pain during sex, heavy bleeding, rectal pain, constipation, and blood clots. Many patients experienced these symptoms as teenagers and later linked them to endometriosis. Additionally, symptoms were often intense and radiated to areas of the body beyond the uterus.

Psychosocial impacts were discussed as a second theme. Following a diagnosis, many patients were frustrated about the duration between symptom onset and diagnosis, alongside the severe health concerns that may have been prevented with earlier diagnosis.

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Hormonal contraception linked to emotional regulation

Alongside preventing pregnancy, hormonal contraceptives (HCs) may be effective for managing endometriosis, polycystic ovary syndrome, and irregular cycles, according to a recent study published in Hormones and Behavior.

These contraceptive methods have also been linked to mood changes, weight fluctuations, and emotional ups and downs. Overall, stronger emotional responses were found in women using HC vs those without contraception, which may help this population move past negative emotional experiences.

“For women, the findings highlight what many have long suspected: Birth control can affect more than reproductive health,” said Beatriz Brandao, lead study author and graduate student at Rice University. “Hormonal birth control does more than prevent pregnancy—it also influences brain areas involved in emotions and memory.”

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Severe burden and treatment gaps reported for hyperemesis gravidarum

Researchers from Flinders University have found a severe emotional and physical burden among pregnant women with extreme morning sickness, publishing their findings in PLOS One.¹

The data also indicated significant rates of considering pregnancy termination, alongside 9 in 10 pregnant women with extreme morning sickness considering not having more children. This highlights the debilitating nature of the condition and the inconsistent efficacy of common treatment methods.

“Women are often prescribed multiple medications in an attempt to manage their symptoms, but the reality is that many of these treatments come with their own burdens,” said Luke Grzeskowiak, PhD, associate professor at Flinders University.

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