{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:45:11Z","timestamp":1792176311281,"version":"4.4.0"},"reference-count":90,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Unconscious bias influences clinical judgment and communication across healthcare, but its effects in obstetric practice are particularly consequential due to time\u2010sensitive decision making, high emotional vulnerability, and longstanding maternal health inequities. When bias\u2010driven interactions escalate into coercion, non\u2010consented procedures, or normalized mistreatment, they constitute forms of gender\u2010based violence embedded within routine clinical care. This review synthesizes evidence on how unconscious bias shapes provider\u2013patient communication, shared decision making, autonomy, and obstetric outcomes. A systematic review with narrative synthesis was conducted using PubMed Central and Google Scholar from inception to August 2025. English\u2010language studies examining unconscious or implicit bias in obstetric communication or decision making were eligible. Dual screening, structured data extraction, and thematic synthesis were performed. A total of 89 studies met inclusion criteria, including qualitative, quantitative, mixed\u2010methods, and conceptual designs. Across settings, unconscious bias manifested through: (1) Dismissal of symptoms and credibility discounting; (2) selective or incomplete information exchange; (3) stereotyping and moral judgment; (4) differential clinical discretion, surveillance, and escalation; and (5) normalized mistreatment and non\u2010consented care. These mechanisms systematically undermined communication quality, restricted shared decision making, and reduced autonomy, particularly for Black, Indigenous, migrant, low\u2010income, uninsured, adolescent, and disabled patients. Quantitative and vignette studies demonstrated measurable effects on clinical decisions, including biased cesarean recommendations, disparities in pain management, and delays in recognizing deterioration. These processes contributed to documented inequities in severe maternal morbidity, intervention rates, and maternal near\u2010miss events. Notably, coercive consent practices, non\u2010consented procedures, and normalized disrespect emerged as manifestations of gender\u2010based violence within obstetric settings. Unconscious bias shapes obstetric interactions through interconnected communication and decision making pathways that constrain autonomy, reduce quality of care, and reinforce structural inequities. At its most severe, bias\u2010driven care constitutes a form of gender\u2010based violence that disproportionately affects racialised and socially marginalized women. Effective mitigation requires multi\u2010level strategies combining communication\u2010focused interventions, standardized protocols, interpreter support, reflective practice, and institutional accountability frameworks.<\/jats:p>","DOI":"10.1002\/ijgo.71111","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T12:51:09Z","timestamp":1780663869000},"page":"679-692","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["From assumptions to outcomes: How unconscious bias shapes obstetric care"],"prefix":"10.1002","volume":"175","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0491-3187","authenticated-orcid":false,"given":"Francisco Javier","family":"Ruiloba Portilla","sequence":"first","affiliation":[{"name":"Hospital Star Medica de Aguascalientes  Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7730-8252","authenticated-orcid":false,"given":"Adu","family":"Appiah\u2010Kubi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, School of Medicine University of Health and Allied Sciences  Ho Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2772-3684","authenticated-orcid":false,"given":"Evangelia","family":"Deligeoroglou","sequence":"additional","affiliation":[{"name":"1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailegiorgis Eskinder","family":"Girmachew","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, College of Medicine and Health Sciences University of Gondar  Gondar Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"Interlandi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Umberto I Hospital  Syracuse Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8343-6920","authenticated-orcid":false,"given":"Sezin Eda","family":"Karsl\u0131","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Sanliurfa Research and Training Hospital  Sanliurfa Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4751-5944","authenticated-orcid":false,"given":"Duygu Ucar","family":"Kartal","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Manisa Merkezefendi State Hospital  Manisa Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8478-5471","authenticated-orcid":false,"given":"Alessandro","family":"Libretti","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Hospital Maggiore della Carit\u00e0  Novara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7829-4026","authenticated-orcid":false,"given":"Chaima","family":"Mbarki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Bizerta Teaching Hospital Habib Bougatfa, Faculty of Medicine of Tunis University of Tunis El Manar  Bizerte Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8460-0052","authenticated-orcid":false,"given":"Odriy Precious","family":"Mukombwe","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Parirenyatwa Group of Hospitals University of Zimbabwe  Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Muslim","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine Australian Concept Infertility Medical Center  Islamabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0196-7005","authenticated-orcid":false,"given":"Mei Yee","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The Coombe Hospital  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6385-2504","authenticated-orcid":false,"given":"Sandra Ivonne","family":"Pacheco\u2010Ruiz","sequence":"additional","affiliation":[{"name":"Department of Materno\u2010Fetal Medicine Instituto Nacional de Perinatologia  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6287-5932","authenticated-orcid":false,"given":"Leopoldo","family":"Santiago Sanabria","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology Hospital de Gineco\u2010Obstetricia 4 Luis Castelazo Ayala  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9086-910X","authenticated-orcid":false,"given":"Oluwaseun O.","family":"Sowemimo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Calderdale and Huddersfield NHS Trust  West Yorkshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abuchi Chima","family":"Stephen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Perinatology Obafemi Awolowo University Teaching Hospitals Complex  Ile\u2010Ife Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akaninyene Eseme Bernard","family":"Ubom","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Perinatology Obafemi Awolowo University Teaching Hospitals Complex  Ile\u2010Ife Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kubra","family":"Ozpinar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Dogubayazit Dr. Yasar Eryilmaz State Hospital  A\u011fr\u0131 Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Agust\u00edn","family":"Zapata\u2010Caballero","sequence":"additional","affiliation":[{"name":"Cl\u00ednica de Uroginecolog\u00eda y Salud P\u00e9lvica del Sureste  M\u00e9rida M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif Goknur","family":"Topcu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Sisli Kolan International Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atziri","family":"Ramirez Negrin","sequence":"additional","affiliation":[{"name":"Department of Urogynecology Hospital Dr Manuel Gea Gonzalez  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-295X.102.1.4"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-013-2441-1"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000001794"},{"key":"e_1_2_11_5_1","first-page":"314","article-title":"The Institute of Medicine report \u201cunequal treatment\u201d: implications for academic health centers","volume":"71","author":"Betancourt JR","year":"2004","journal-title":"Mt Sinai J Med"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302903"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(18)30403-0"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-019-0729-2"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.112491"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1516047113"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.05.008"},{"key":"e_1_2_11_12_1","volume-title":"The Lived Experience of Black and African American Women When Interacting With Obstetrical Healthcare Providers","author":"Mustapha S","year":"2025"},{"key":"e_1_2_11_13_1","volume-title":"Black Wom(b)anhood: An Explorative Analysis of Black Women's Narratives of Healthcare Encounters During and After Pregnancy","author":"Baker JA","year":"2024"},{"key":"e_1_2_11_14_1","article-title":"A mixed\u2010methods analysis and personal narratives of black maternal health experiences in the American healthcare system","volume":"17","author":"Swaby ME","year":"2025","journal-title":"Cureus"},{"key":"e_1_2_11_15_1","article-title":"Examination of maternal near\u2010miss experiences in the hospital setting among black women in the United States","volume":"18","author":"Byrd TE","year":"2022","journal-title":"Womens Health"},{"key":"e_1_2_11_16_1","volume-title":"Black Women's Lived Experiences With Maternal Near Misses: A Qualitative Analysis","author":"Grant PA","year":"2023"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2024.108234"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.18865\/ed.30.4.533"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-022-07686-z"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-017-0687-7"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2022.115604"},{"key":"e_1_2_11_22_1","doi-asserted-by":"crossref","DOI":"10.1177\/10497323251357215","article-title":"The stories we tell: black Women's narratives of agency, (dis)respect, and resistance during prenatal care","author":"Harris NL","year":"2025","journal-title":"Qual Health Res"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2024-093696"},{"key":"e_1_2_11_24_1","volume-title":"Implicit Racial Bias in Prenatal Visit Patient\u2010Clinician Communication, Prenatal Screening, and Interventions","author":"Olaniyan A","year":"2021"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.3389\/fgwh.2024.1355375"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-021-01057-w"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2023.100927"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-025-02297-w"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-019-0837-z"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/13691058.2017.1384572"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rhm.2016.04.002"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000378"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001847"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.18249"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2024-017337"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732318792500"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12820"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2023.06.015"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-023-01604-0"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.15233"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000411"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.13700"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-025-02392-y"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.18332\/ejm\/147911"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-017-0617-8"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0290434"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmh503"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-024-07036-3"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1080\/13648470.2021.1938510"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12531"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czaa190"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732320942484"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1177\/14034948211004320"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.3389\/fgwh.2022.818062"},{"key":"e_1_2_11_55_1","article-title":"Factors influencing women's perceptions of shared decision making during labor and delivery: results from a large\u2010scale cohort study of first childbirth","volume":"28","author":"Kjerulff K","year":"2018","journal-title":"MIDIRS Midwifery Dig"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0274790"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1089\/heq.2021.0168"},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2018.10.023"},{"key":"e_1_2_11_59_1","doi-asserted-by":"publisher","DOI":"10.1089\/whr.2021.0148"},{"key":"e_1_2_11_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2023.103809"},{"key":"e_1_2_11_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2025.117720"},{"key":"e_1_2_11_62_1","doi-asserted-by":"publisher","DOI":"10.3390\/soc9020045"},{"key":"e_1_2_11_63_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-025-07765-z"},{"key":"e_1_2_11_64_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0106325"},{"key":"e_1_2_11_65_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-03586-y"},{"key":"e_1_2_11_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2017.10.014"},{"key":"e_1_2_11_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2024.04.001"},{"key":"e_1_2_11_68_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.124.23772"},{"key":"e_1_2_11_69_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-020-0721-2"},{"key":"e_1_2_11_70_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000006754"},{"key":"e_1_2_11_71_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-024-06310-8"},{"key":"e_1_2_11_72_1","doi-asserted-by":"publisher","DOI":"10.1080\/03630242.2023.2250466"},{"key":"e_1_2_11_73_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2020.8874"},{"key":"e_1_2_11_74_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-023-01816-x"},{"key":"e_1_2_11_75_1","doi-asserted-by":"publisher","DOI":"10.1111\/phn.13201"},{"key":"e_1_2_11_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2023.101145"},{"key":"e_1_2_11_77_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1913405117"},{"key":"e_1_2_11_78_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.12.016"},{"key":"e_1_2_11_79_1","doi-asserted-by":"publisher","DOI":"10.1002\/aet2.70118"},{"key":"e_1_2_11_80_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2401331121"},{"key":"e_1_2_11_81_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2023.03.016"},{"key":"e_1_2_11_82_1","doi-asserted-by":"publisher","DOI":"10.6004\/jadpro.2023.14.3.3"},{"key":"e_1_2_11_83_1","doi-asserted-by":"publisher","DOI":"10.15766\/mep_2374-8265.10858"},{"key":"e_1_2_11_84_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsurg.2021.06.010"},{"key":"e_1_2_11_85_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12910-017-0179-8"},{"key":"e_1_2_11_86_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000349"},{"key":"e_1_2_11_87_1","doi-asserted-by":"publisher","DOI":"10.2307\/1229039"},{"key":"e_1_2_11_88_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jesp.2012.06.003"},{"key":"e_1_2_11_89_1","first-page":"1","article-title":"Bias reduction strategies","volume":"17","author":"Payne BK","year":"2022","journal-title":"Perspect Psychol Sci"},{"key":"e_1_2_11_90_1","doi-asserted-by":"publisher","DOI":"10.1037\/pspa0000160"},{"key":"e_1_2_11_91_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-025-02464-9"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.71111","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.71111","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.71111","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:50:24Z","timestamp":1792173024000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.71111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,5]]},"references-count":90,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1002\/ijgo.71111"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.71111","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,5]]},"assertion":[{"value":"2026-02-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}