Mifepristone before term induction was linked to fewer caesareans across 15 trials

The edition in brief

Across 15 randomised trials of term induction (1,063 women given mifepristone, 811 controls), mifepristone was associated with lower odds of caesarean delivery: 33.1% vs 41.9%, OR 0.67 (95% CI 0.54-0.82), holding at OR 0.58 in placebo-controlled and high-quality trials. Bishop scores were higher at 24 hours and less prostaglandin and oxytocin was needed. Safety outcomes were reported by too few trials to be reassuring on their own. A Ugandan double-blind trial following 871 infants found that monthly dihydroartemisinin-piperaquine in pregnancy, alone or with sulfadoxine-pyrimethamine, did not change infant malaria in the first year compared with sulfadoxine-pyrimethamine alone (IRR 1.04, 0.78-1.38); wasting at birth was about twice as common with DP-containing regimens but resolved by 3-6 months. A meta-analysis of 22 observational studies found low placental growth factor before 29 weeks was the most consistent early marker of later growth restriction without pre-eclampsia, but with sensitivity of only 0.29 it is not a stand-alone screen. And a meta-analysis covering 49,395 pregnancies exposed to GLP-1 receptor agonists around conception found no consistent link with major malformations, preterm birth or pregnancy loss; a small renal malformation signal (OR 1.23) probably reflects confounding. That supports calm counselling after inadvertent exposure, not use in pregnancy.