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 videos published this year, and catch up on anything you may have missed.

1. Genevieve Neal-Perry, MD, PhD, discusses new nonhormonal treatments for hot flashes

The management of menopausal vasomotor symptoms has evolved with the introduction of nonhormonal neurokinin receptor antagonists that target hypothalamic pathways involved in thermoregulation. Estrogen therapy remains effective but is not appropriate for all patients, particularly those with contraindications such as hormonally sensitive cancers or thrombotic risk.

Fezolinetant, approved in 2023, and elinzanetant, a dual neurokinin-1 and neurokinin-3 receptor antagonist, have demonstrated efficacy in reducing hot flashes, with differences in sedation, liver monitoring requirements, and insurance coverage influencing clinical use. Ongoing research is evaluating whether treatment of vasomotor symptoms with these agents may affect long-term risks such as cardiovascular disease and cognitive decline, particularly in populations unable to use hormonal therapy, while emerging real-world data continue to inform safety, effectiveness, and individualized treatment strategies.

2. United States receives D+ on 2025 March of Dimes Report Card

The 2025 March of Dimes Report Card indicates persistent challenges in US maternal and infant health, assigning an overall national grade of D+ driven largely by a preterm birth rate of 10.4%. The report evaluates multiple indicators, including preterm birth, infant and maternal mortality, severe maternal morbidity, and access to prenatal care, and identifies ongoing gaps in perinatal outcomes.

Marked racial and ethnic disparities persist, with higher rates of adverse outcomes among non-Hispanic Black, American Indian, and Alaska Native populations. Infant mortality remained unchanged at 5.6 deaths per 1000 live births, while access to prenatal care declined, with more than one-quarter of pregnant people initiating care after the first trimester and 16% receiving inadequate care. The findings highlight the need for coordinated, system-level approaches addressing access, equity, and care infrastructure to improve maternal and infant outcomes nationwide.

3. Moe Takenoshita, MBBCh, links c-section to sleep issues

New research from Stanford Medicine demonstrates an association between cesarean delivery and an increased risk of postpartum sleep disorders. Analysis of insurance claims from over 1.5 million US mothers found that those who delivered via cesarean were 16% more likely to develop a sleep disorder within the first year compared with vaginal deliveries.

Patient interviews suggested that postoperative pain contributes to impaired sleep, though it does not fully account for the increased risk. Postpartum sleep disorders, which remain underdiagnosed, can affect mood, daily functioning, and cardiovascular health. Early discussion of sleep health and evidence-based interventions, including sleep hygiene and cognitive behavioral therapy for insomnia, may help mitigate these risks.

4. Melissa Furlong, PhD, links neighborhood deprivation to gestational diabetes risk

Recent research from the University of Arizona links neighborhood deprivation to increased risk of gestational diabetes mellitus (GDM). Analysis of nearly a decade of Arizona birth certificate data, combined with the Neighborhood Deprivation Index, showed that women living in socioeconomically disadvantaged areas had higher odds of developing GDM.

Contributing factors include limited access to healthy food, safe spaces for physical activity, and adequate health care, which may exacerbate pre-existing vulnerabilities. Findings highlight opportunities for targeted interventions, such as early screening and tailored lifestyle guidance, to mitigate GDM risk.

5. Jessica Shepherd, MD, clarifies cervical cancer screening guidelines

Jessica Shepherd, MD, MBA, highlighted current cervical cancer screening guidelines and emerging strategies to improve detection. Women should begin Pap testing at age 21 every 3 years, with co-testing for HPV recommended every 5 years starting at age 30.

HPV self-collection may improve access for underserved populations but is not recommended as a replacement for clinician-collected tests due to potential missed diagnoses. Shepherd emphasized the importance of patient education, clear communication about testing options, and use of reliable resources to navigate screening recommendations. Adherence to guidelines, combined with informed patient participation, remains key to reducing cervical cancer incidence and addressing disparities in care.