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How AI and software can make a positive difference to maternity outcomes – report

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Women are more likely to receive good care during pregnancy where AI and other clinical software tools are used, a large review of research has found.

Researchers conducted a review of over 12,000 papers and 87 articles for different AI and related software tools, investigating the impact of their use in maternity settings.

A meta-analysis of 35 included studies found the odds of improved outcomes was 1.69 times higher in women cared for using CDSS, with data from over 5.2 million pregnancies in both high-income and low-and-middle-income countries.

The findings revealed that although there were variations in each situation and implementation of CDSS that they reviewed, most showed improvements in outcomes for the pregnancies.

Academics from the University of Birmingham, Birmingham Health Partners, Keele University, Warwick University and the Shrewsbury and Telford Hospitals NHS Trust evaluated almost 50 different types of CDSS across 49 High-Income and 38 Low-and-Middle-Income Countries.

Neil Cockburn, health informatics research fellow at the University of Birmingham, said: “The [UK] government has made digital transformation of the NHS a top priority to improve quality of care and reduce costs, and clinical decision support systems will be a key technology in delivering these improvements. However, there needs to be systematic, rigorous, and rapid evaluation of the tools being used in order to ensure they are doing what is expected while keeping up with the pace of change in technology.

“”Maternity services are under huge pressure in the UK and internationally, and that makes it challenging to offer safe services. We can see this in the huge rise in hospitals receiving support from the Maternity Safety Support Programme.”

“One solution is the use of AI and related software tools called clinical decision support systems to help expecting families and healthcare workers to make safe decisions, so we looked at every evaluation of these kinds of software ever published in academic literature.”

In one study led by the Bristol University which was reviewed, a software programme trialled was designed to help women decide if they wanted a vaginal birth after previously having a c-section. This CDSS supported women in feeling more confident about their decisions by providing them with useful information about risks and benefits, while reducing the rate of c-section overall.

Another study supported by the Tommy’s National Centre for Miscarriage Research trialled a risk-prediction model to accurately triage women as at low risk of having an ectopic pregnancy, which can be life-threatening in some cases. These examples highlighted the possibility for CDSS to support both clinical and individual decision-making concerning maternity care; an important step for supporting safe pregnancies in the future.

The researchers note that while substantial contributions can be made to maternity care with CDSS, it relies on appropriateness to each unique situation. As the first systematic review of CDSS, it is hoped that this will encourage evaluations of different CDSS to continue aiding clinicians, developers, and researchers in maternity care.

Fertility

Infertility may be risk factor for early menopause, study suggests

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Women with primary infertility may face a higher risk of early menopause and reach it about a year earlier, a study suggests.

The findings suggest women with primary infertility may be more likely to enter menopause before the age of 45.

The increased risk appeared most notable among women with unexplained infertility or a history of endometriosis.

Dr Stephanie Faubion, medical director for The Menopause Society, said: “This study shows that women with primary infertility, specifically those with unexplained infertility or a history of endometriosis, were at risk for early menopause.

“Given that early menopause is linked to adverse long-term health consequences, these women may benefit from counselling that they are at risk of early menopause.

“This will allow them to monitor for early menopause and to seek treatment with hormone therapy, if indicated.”

Early menopause is usually defined as menopause before age 45, while premature menopause is menopause before age 40.

Women who experience menopause earlier may face symptoms for longer and have a higher risk of long-term health problems.

These can include cardiovascular disease, osteoporosis and neurocognitive disorders. Osteoporosis weakens bones, while neurocognitive disorders affect memory, thinking or brain function.

The study, highlighted by The Menopause Society, involved nearly 700 people, roughly half of whom had been diagnosed with primary infertility.

It found that women with a history of primary infertility underwent natural menopause about one year earlier than those without such a history.

Researchers found no association between infertility and premature menopause.

Infertility affects around one in six people globally and can have consequences beyond family planning.

Previous research has linked infertility with higher rates of cancer and cardiovascular disease, although causes vary and may involve genetic, hormonal, in-utero or lifestyle factors.

In-utero factors are influences that occur while a baby is developing in the womb.

Earlier studies looking at links between infertility and early or premature menopause have produced mixed results, with some not accounting for different types of infertility.

The new study suggested that women with unexplained infertility or a history of endometriosis may have an increased risk of early menopause.

Endometriosis is a condition where tissue similar to the lining of the womb grows elsewhere in the body. It can cause pain, heavy periods and fertility problems.

Known risk factors for early or premature menopause include tobacco use, low body mass index, not having given birth and starting periods at a younger age.

Women who have had more childbirths and those with a history of oral contraceptive use have previously been linked to later menopause.

The researchers said women with primary infertility may benefit from additional counselling because of the systemic and long-term health effects of early menopause.

They also said women should be encouraged to seek evaluation and treatment if they experience a new loss of menstrual cycles.

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Endometriosis documentary profiles stars including Marilyn Monroe and Amy Schumer

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A non-profit has launched an endometriosis documentary featuring Amy Schumer and Marilyn Monroe as it pushes for changes in how the condition is treated and understood.

The Endometriosis Collective has launched to change how endometriosis is researched, treated and understood, starting with a documentary featuring stories from people including Amy Schumer and Marilyn Monroe.

The feature-length documentary, “End of the Cycle”, will premiere in New York on Tuesday, and The Endometriosis Collective is making the film free to stream online.

Schumer, a comedian, writer and actor, has previously spoken of how endometriosis left her “on the floor in pain, vomiting from the pain, the pain that nobody can see.”

Schumer is one of several celebrities featured in the documentary. Other contributors include dancer Julianne Hough, Olympic medallist Brittany Brown and actors Janel Parrish and Folake Olowofoyeku.

The Endometriosis Collective timed the documentary premiere to coincide with the 100th anniversary of Marilyn Monroe’s birth.

Monroe, who died in 1962, starred in films such as “Some Like It Hot” and “Gentlemen Prefer Blondes.”

According to a biography published in 1985, Monroe’s endometriosis was so severe that it destroyed her marriages, her wish for children, her career and ultimately her life.

The Endometriosis Collective said the documentary shares newly uncovered information about Monroe’s experience with endometriosis.

The non-profit said the information connects Monroe’s story to the experiences of women across generations, highlighting how far awareness, research and care still have to go.

A representative of the Marilyn Monroe Estate said: “By sharing this part of her story through ‘End of the Cycle,’ we hope to honour her legacy in a way that brings visibility to endometriosis, encourages more open dialogue and helps inspire the research needed to create change.”

As part of the premiere, The Endometriosis Collective is holding a panel discussion.

Schumer, Brown and Olowofoyeku, the documentary’s co-directors Sammy Jaye and Soraya Simi, and medical experts are due to be part of the premiere.

AbbVie’s Orilissa and Sumitomo Pharma’s Myfembree are among the approved drugs for endometriosis pain.

Hough, one of the participants in the documentary, starred in an Orilissa campaign in 2017.

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Bridging the metabolic wealth gap: The telehealth platform bypassing insurance to democratise care

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As weight-loss treatments remain locked behind prohibitive paywalls, a new direct-pay initiative is cutting costs in half for low-income patients, and it could provide a new blueprint for health equity.

It is one of the most persistent, frustrating paradoxes in modern healthcare: the medical innovations most capable of addressing widespread chronic conditions are overwhelmingly priced out of reach for the populations most vulnerable to them.

Nowhere is this more evident than in the current landscape of metabolic health and weight management.

As state governments and insurance providers increasingly restrict coverage for advanced weight-loss medications due to skyrocketing costs, a stark dividing line has emerged. Clinical need is no longer the primary factor in who receives treatment. Affordability is.

This financial barrier disproportionately impacts women, who not only face high rates of metabolic conditions but also frequently serve as the primary caregivers in their households.

For a single mother managing childcare, grueling work hours, and the relentlessly rising cost of living, personal well-being is often the first casualty of a tight budget.

These patients are forced into a holding pattern, watching their conditions progress year after year while highly effective, life-changing treatments remain separated from them by a paywall.

Now, a telehealth platform called Amble Health is attempting to dismantle that wall by bypassing the traditional insurance apparatus entirely.

A Structural Shift for Access

Today, Amble Health announced the launch of the Amble Cares Program, a national initiative designed to cut the cost of medical weight-loss treatments in half for low-income Americans.

The programme arrives at a critical inflection point.

Today, roughly one in eight U.S. adults have utilized advanced metabolic medications, according to a recent KFF Health Tracking Poll.

This surge in adoption has driven a fundamental shift in preventative care, but the distribution of that care has been deeply uneven.

Through the Amble Cares Program, eligible patients can access comprehensive medical weight-loss programmes, which may include prescription medications if clinically appropriate, at up to 50 per cent below standard rates.

To ensure the discounts reach the intended demographic, eligibility is determined by an independent, third-party verification partner, based on verified financial need.

The programme explicitly prioritises individuals and families with limited disposable income, including parents and guardians whose financial flexibility is tied up in providing for dependents.

Once verified, patients are connected directly to licensed clinicians to begin treatment immediately, stripping away the friction of waiting periods.

“Healthcare should not be a luxury item,” said Joey Stiver, CEO of Amble Health. At Amble, we believe that a patient’s zip code or income shouldn’t dictate their metabolic health outcomes.

“The Amble Cares Program is our direct response to the cost of living crisis, moving beyond talk of ‘affordability’ to actually delivering it to the people the traditional system has left behind.”

The Direct-Pay Trade-Off

However, this rapid, lower-cost access comes with a significant structural trade-off.

To achieve these price reductions and eliminate the administrative delays, denials, and red tape associated with traditional healthcare, Amble Health operates strictly as a direct-pay platform.

This means participants cannot use outside coverage. The programme does not accept Medicaid, Medicare, commercial insurance, or even HSA/FSA funds.

For some patients, being entirely locked out of utilizing their existing health benefits may present a new kind of hurdle.

But for those who have already found themselves abandoned by traditional coverage networks, facing outright denials, unnavigable prior authorisations, or insurmountable deductibles, the direct-pay model offers a predictable, transparent alternative to a broken system.

Ultimately, the Amble Cares Program is making a bold bet: that the most efficient way to deliver equitable healthcare to disenfranchised populations isn’t to fix the traditional insurance system, but to innovate entirely around it.

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