Welcome to another edition of Countdown to 2026, and thank you for visiting the Contemporary OB/GYN website throughout 2025. Below, take a look at the top obstetrics stories published this year, and catch up on anything you may have missed.

1. Criminalizing prenatal drug use linked to reduced prenatal care

A study published in Social Science & Medicine evaluated the impact of laws that explicitly criminalize prenatal drug use on prenatal care and delivery patterns using US birth certificate data from 1989 to 2019. The analysis of more than 124 million births across Tennessee, South Carolina, and Alabama found 4396.29 fewer births per 100,000 individuals receiving any prenatal care and 1847.99 fewer facility-based deliveries in states with such laws.

No statistically significant changes were observed in measures of timely or adequate prenatal care, although decreases in early and first-trimester care initiation were noted. The findings indicate that explicit criminalization policies were associated with reduced engagement in prenatal care and higher rates of births occurring outside health care facilities.

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2. Hyperemesis gravidarum linked to mental health disorder risks

A retrospective cohort study of 476,857 pregnant women with hyperemesis gravidarum using electronic health records from 18 countries found greater risks of multiple neuropsychiatric and mental health outcomes within 1 year of diagnosis. More than 13 conditions demonstrated risk increases exceeding 50%, including postpartum psychosis and post-traumatic stress disorder, with a 2-fold increased risk of Wernicke encephalopathy also reported.

Patients with hyperemesis gravidarum had more than doubled risks of refeeding syndrome, eating disorders, and depression, and a 2.7-fold increased risk of postpartum depression. No consistent association was identified between hyperemesis gravidarum severity, defined by metabolic disturbance, and mental health risk, supporting the need for routine mental health screening irrespective of clinical severity.

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3. USPSTF reports gaps in evidence for iron deficiency screening in pregnancy

A US Preventive Services Task Force recommendation statement published in JAMA concluded that current evidence is insufficient to determine the balance of benefits and harms of screening for iron deficiency or providing iron supplementation in asymptomatic pregnant persons. The review noted that iron deficiency affects approximately 18% of pregnant women and iron deficiency anemia approximately 5%, but data linking screening or supplementation to improved maternal or infant outcomes are limited.

Reported practices included variable first-trimester hemoglobin screening rates and high use of iron supplements, with observed racial and ethnic disparities in screening and lower supplement intake associated with food insecurity. Potential harms of supplementation included gastrointestinal adverse effects, and the statement emphasized the need for high-quality research to clarify associations between maternal iron status and clinical outcomes.

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4. DM199 shows promise in phase 2 trial for treating preeclampsia

Part 1a of an open-label phase 2 study of DM199 (rinvecalinase alfa; DiaMedica Therapeutics) in patients with preeclampsia demonstrated achievement of safety and efficacy end points, with dose-dependent reductions in blood pressure and no evidence of placental transfer or drug-related serious adverse events. Among participants with a mean gestational age of 37 weeks and baseline mean systolic and diastolic blood pressures of 165 mm Hg and 102 mm Hg, the greatest dose produced reductions of −35 mm Hg and −15 mm Hg, respectively, with sustained decreases observed at 5 minutes, 30 minutes, and 24 hours after infusion.

Treatment-emergent adverse events were mild and included nausea, headache, and flushing, with no treatment discontinuations or induction of early labor. Statistically significant reductions in uterine artery pulsatility index were also observed, indicating improved uteroplacental blood flow and supporting further phase 2 evaluation.

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5. Intimate partner violence linked to shorter interpregnancy interval

A retrospective cohort study presented at the 2025 American College of Obstetricians and Gynecologists Annual Clinical and Scientific Meeting evaluated the association between intimate partner violence and interpregnancy interval using records from an urban community hospital. Among 218 multiparous patients, those reporting intimate partner violence had greater odds of a short interpregnancy interval of less than 18 months compared with those without reported violence (54.5% vs 35.6%; OR, 2.17).

No statistically significant differences were observed in rates of long-acting reversible contraception placement or postpartum visit attendance between groups, while mental health disorders were markedly more common in the intimate partner violence group (78.2% vs 20.2%; OR, 14.12). The findings indicate an association between intimate partner violence, shorter interpregnancy intervals, and greater prevalence of coexisting mental health conditions.

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