{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T02:19:58Z","timestamp":1789093198996,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,5,20]],"date-time":"2015-05-20T00:00:00Z","timestamp":1432080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Cranial bleeding at birth can result in significant neurological morbidity in newborns with haemophilia. The optimum mode of delivery (\n                      <jats:styled-content style=\"fixed-case\">MOD<\/jats:styled-content>\n                      ) of a potentially affected foetus remains controversial.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      The aim of this review is to ascertain overall incidence of cranial bleeding in newborns with haemophilia compared to the general population and the impact of\n                      <jats:styled-content style=\"fixed-case\">MOD<\/jats:styled-content>\n                      on rates of intracranial haemorrhage (\n                      <jats:styled-content style=\"fixed-case\">ICH<\/jats:styled-content>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      An\n                      <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content>\n                      \/\n                      <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>\n                      search using key terms revealed the relevant studies. Studies included report the incidence of cranial bleeding by\n                      <jats:styled-content style=\"fixed-case\">MOD<\/jats:styled-content>\n                      within a newborn population. The heterogenicity across studies was assessed using Cochrane's\n                      <jats:italic>Q<\/jats:italic>\n                      test and\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistic and studies were assigned appropriate weight based on a fixed\u2010effect model. Odds ratio (\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      ) is the primary effect measure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Newborns with haemophilia are 44 times (95% CI: 34.7\u201357.1,\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      &lt;\u00a00.01) more likely to experience symptomatic\n                      <jats:styled-content style=\"fixed-case\">ICH<\/jats:styled-content>\n                      , and 8 times (95% CI: 5.38\u201312.6,\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      &lt;\u00a00.01) more likely to experience extracranial haemorrhage at birth, compared to the general population. In newborns with haemophilia the\n                      <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n                      of experiencing\n                      <jats:styled-content style=\"fixed-case\">ICH<\/jats:styled-content>\n                      are 4.4 (95% CI: 1.46\u201313.7,\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      =\n                      <jats:italic>\u00a0<\/jats:italic>\n                      0.008) following an assisted vaginal delivery (\n                      <jats:styled-content style=\"fixed-case\">AVD<\/jats:styled-content>\n                      ) and 0.34 (95% CI: 0.14\u20130.83,\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      =\n                      <jats:italic>\u00a0<\/jats:italic>\n                      0.018) following caesarean section (\n                      <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n                      ), compared to vaginal delivery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Cranial bleeding occurs with a significantly higher frequency in newborns with haemophilia compared to the general population. In newborns with haemophilia, delivery by a\n                      <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\n                      is associated with the lowest risk of\n                      <jats:styled-content style=\"fixed-case\">ICH<\/jats:styled-content>\n                      .\n                      <jats:styled-content style=\"fixed-case\">AVD<\/jats:styled-content>\n                      significantly increases the risk of\n                      <jats:styled-content style=\"fixed-case\">ICH<\/jats:styled-content>\n                      and should be avoided.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.12726","type":"journal-article","created":{"date-parts":[[2015,5,20]],"date-time":"2015-05-20T04:10:05Z","timestamp":1432095005000},"page":"32-38","source":"Crossref","is-referenced-by-count":45,"title":["Mode of delivery and cranial bleeding in newborns with haemophilia: a systematic review and meta\u2010analysis of the literature"],"prefix":"10.1111","volume":"22","author":[{"given":"J.","family":"Davies","sequence":"first","affiliation":[{"name":"Katharine Dormandy Haemophilia Centre and Thrombosis Unit Department of Obstetrics and Gynaecology Royal Free Hospital NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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