International Journal of Gynecology & Obstetrics最新文献

{"title":"Dienogest use and the risk of breast and gynecologic cancers: A nationwide population-based study.","authors":"Hoyol Jhang, Saerom Kim, Hyun-Tae Park, Ju-Young Shin, Seung-Ah Choe","doi":"10.1002/ijgo.70424","DOIUrl":"https://doi.org/10.1002/ijgo.70424","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether dienogest exposure is associated with the risk of breast, endometrial, or tubo-ovarian cancer in women with endometriosis.</p><p><strong>Methods: </strong>In this nationwide retrospective cohort study (January 2012 to December 2023), we used the Korean National Health Insurance Review & Assessment Service database. Women aged 20-49 years with endometriosis who received dienogest for at least 6 months were compared with an active control group treated with gonadotropin-releasing hormone (GnRH) agonists, with cohorts balanced by inverse probability of treatment weighting. Incident breast, endometrial, and tubo-ovarian cancers were ascertained, and adjusted hazard ratios (aHR) were estimated using Cox proportional hazards models.</p><p><strong>Results: </strong>Among 1 887 957 women with endometriosis, 14 647 dienogest users and 181 587 GnRH agonist users met the eligibility criteria for the breast cancer cohort; sample sizes were similar for endometrial and tubo-ovarian analyses. Compared with GnRH agonists, dienogest use was not associated with increased risk of breast cancer (aHR 1.01, 95% confidence interval [CI] 0.75-1.37), endometrial cancer (aHR 0.84, 95% CI 0.40-1.77), or tubo-ovarian cancer (aHR 0.92, 95% CI 0.30-2.80). Use of dienogest for 0.5-1.5 years was associated with a reduced breast cancer risk (aHR 0.72, 95% CI 0.53-0.99), whereas associations for longer durations were inconsistent.</p><p><strong>Conclusion: </strong>Dienogest use in women with endometriosis was not associated with higher or lower risks of breast, endometrial, or tubo-ovarian cancer compared with GnRH agonists, supporting its oncologic safety. Further longer-term studies are warranted to clarify duration-specific effects.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FIGO good practice recommendations for vaginal birth after cesarean section.","authors":"Eytan R Barnea, Diana Ramasauskaite, Akaninyene Eseme Ubom, Nicoletta Di Simone, Martin Mueller, Anderson Borovac-Pinheiro, Alice Guarano, Chiara Benedetto, Jolly Beyeza-Kashesya, Ines Nunes, Bo Jacobsson, Alison Wright","doi":"10.1002/ijgo.70406","DOIUrl":"https://doi.org/10.1002/ijgo.70406","url":null,"abstract":"<p><p>The rising global rate of cesarean section (CS) has prompted renewed focus on vaginal birth after cesarean (VBAC) as a safe and effective alternative to repeat CS in properly selected women. The FIGO good practice recommendations provide evidence-based recommendations to guide VBAC care. Success rates for VBAC range from 60% to 80%, with the highest likelihood in women with prior vaginal birth, non-recurrent CS indications, interbirth intervals ≥18 months, BMI <30 kg/m², and spontaneous labor onset. While uterine rupture is the primary concern, its risk remains low at approximately 0.3%-0.7% for women with one prior low transverse CS. Comparisons show that VBAC generally results in similar or better maternal and neonatal outcomes than planned repeat CS, including lower maternal mortality, fewer infections, and shorter hospital stays. This article emphasizes appropriate patient counseling, facility readiness for emergency CS, and continuous fetal monitoring during labor. With proper implementation, VBAC offers a valuable strategy to reduce unnecessary repeat surgeries, improve outcomes, and support informed maternal choice.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing endometriosis diagnosis and mapping: The important role of advanced transvaginal ultrasound.","authors":"Álvaro Ramos-Reyes, Carlos Hernandez-Nieto, Homero Flores-Tamez, Homero Flores-Mendoza","doi":"10.1002/ijgo.70410","DOIUrl":"https://doi.org/10.1002/ijgo.70410","url":null,"abstract":"<p><p>Endometriosis is estimated to affect 5%-10% of women of reproductive age, making timely diagnosis essential for initiating treatment, alleviating symptoms, and reducing the risk of disease progression. Unfortunately, the diagnostic delay in this disease is estimated to be approximately 10 years. The aim of this study is to present a case series of three patients assessed with both imaging modalities for endometriosis diagnosis and mapping, advanced transvaginal ultrasound (ATVUS) and magnetic resonance imaging (MRI). The findings obtained by performing the ATVUS imaging study protocol with different pelvic compartments according to the International Deep Endometriosis Analysis (IDEA) consensus are described and contrasted with those for MRI, along with their correlation to surgical and histological findings. A single gynecologist with specialized training in ATVUS performed a systematic pelvic evaluation in patients with clinical suspicion of endometriosis. The physician performed the anatomo-sonographic assessments described by the IDEA consensus. A retrospective analysis of the three cases was performed comparing both imaging modalities and surgical and histological findings. It was demonstrated in this case series that endometriosis is detectable in distinct pelvic compartments by ATVUS, with results comparable to MRI, while offering the benefits of lower cost and widespread accessibility. In contrast, individuals, insurance companies, and healthcare systems in some countries might be unable or unwilling to cover MRI costs for endometriosis diagnosis or presurgical mapping. In conclusion, given the high prevalence of endometriosis, mastering ATVUS is essential. Future studies should aim to robustly evaluate the role of ATVUS alongside other imaging modalities, including MRI, to maximize diagnostic accuracy.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in non-invasive diagnostic tools for endometriosis: A narrative review of the past ten years.","authors":"Lauren Cosgriff, Avni Mukker, Courtney Ford, Jovana Tavcar","doi":"10.1002/ijgo.70412","DOIUrl":"https://doi.org/10.1002/ijgo.70412","url":null,"abstract":"<p><p>Endometriosis is a chronic condition defined by endometrium-like tissue outside the uterus, with symptoms including pain, infertility, and fatigue. Despite the high prevalence of disease, diagnosis is frequently delayed, in part due to reliance on invasive procedures such as laparoscopy. Over the past decade, scientific research and international collaborations have focused on the development of non-invasive diagnostic tools to allow earlier detection and reduce the burden of surgical diagnosis. This narrative review summarizes key developments in non-invasive tools over the past decade. These advances include those in the biomarker space, imaging techniques and protocols, and artificial intelligence applications. While no single test has yet replaced laparoscopy, significant strides have been made toward safer, earlier diagnosis. Continued interdisciplinary collaboration, standardization of imaging and research protocols, and large-scale validation studies are essential for translating these findings into clinical practice.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging artificial intelligence for evidence-based recommendations in uterine fibroid therapy: Addressing the unmet need in German healthcare-A clinical trial.","authors":"Iason Psilopatis, Laura Lotz, Nadezda Sipulina, Felix Heindl, Georgia Levidou, Julius Emons","doi":"10.1002/ijgo.70407","DOIUrl":"https://doi.org/10.1002/ijgo.70407","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the potential of an artificial intelligence (AI)-driven large language model, ChatGPT 4.0, to provide personalized, evidence-based treatment recommendations for uterine fibroids.</p><p><strong>Methods: </strong>ChatGPT 4.0 was trained using evidence-based data from Uptodate and German medical literature. The algorithm generated individualized recommendations based on clinical characteristics and patient preferences. Usability and quality were assessed through questionnaires completed by 40 gynecologists and 45 women with fibroids.</p><p><strong>Results: </strong>Most gynecologists found the algorithm user-friendly and comprehensive, with 15 expressing a willingness to integrate it into practice and 24 acknowledging its potential to enhance healthcare efficiency. Although only half believed it would improve patient outcomes, the tool was generally well received. Patients found the algorithm easy to understand and helpful for exploring treatment options, with the majority feeling it empowered informed discussions with their healthcare providers. A minority expressed dissatisfaction with usability or helpfulness.</p><p><strong>Conclusion: </strong>ChatGPT 4.0 offers a promising AI-driven tool for personalized fibroid management in the absence of formal guidelines. Although not a substitute for official recommendations, it could support clinical decision making and enhance patient education. Further integration with standardized guidelines and prospective trials is needed to optimize its clinical utility.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rhesus testing and anti-D prophylaxis in RhD-negative women undergoing first-trimester abortion-Systematic Review and Opinion.","authors":"Kristina Gemzell-Danielsson, Sharon Cameron, Teresa Bombas, Mirella Parachini, Marek Lubusky, Aubert Agostini, Sandra Kroeze, Mary Favier, Myriam Chebbah, Varlet Alice-Anaïs, Linda Verhagen, Fiala Christian","doi":"10.1002/ijgo.70404","DOIUrl":"https://doi.org/10.1002/ijgo.70404","url":null,"abstract":"<p><strong>Background: </strong>The introduction of immunoglobulin G (IgG) anti-D prophylaxis for Rhesus D (RhD)-negative women has substantially reduced the incidence of RhD alloimmunization and hemolytic disease of the fetus and newborn in Europe by 85%, transforming fetal health outcomes. However, there is little evidence for the need of giving IgG anti-D prophylaxis to RhD-negative women in first-trimester abortions.</p><p><strong>Objectives: </strong>To analyze the international and national evidence-based guidelines on Rh testing and anti-D prophylaxis in first-trimester abortion, along with current literature both supporting and opposing this practice, to facilitate informed decision making in clinical practice.</p><p><strong>Search strategy: </strong>A systematic search was conducted in Pubmed/MEDLINE, EMBASE, Cochrane Library, Google Scholar, and Gry literature for publications from January 1, 2003 to January 17, 2024.</p><p><strong>Selection criteria: </strong>Guidelines, reviews, meta-analyses, observational and qualitative studies, randomized trials, real-world data, and cohort studies that addressed the use of IgG anti-D prophylaxis in first-trimester abortions were included.</p><p><strong>Data collection and analysis: </strong>Identified studies were screened and assessed independently by two authors. A standardized extraction grid was used to extract information from the selected articles.</p><p><strong>Main results: </strong>Guidelines published from 2022 onwards, such as those from the World Health Organization, recommend against anti-D for women undergoing first-trimester abortion. In contrast, most older guidelines recommend RhD testing and the administration of IgG anti-D prophylaxis in abortions even before 12 weeks of amenorrhea, although exact gestational age thresholds vary widely. These discrepancies in the management of RhD-negative women undergoing first-trimester abortion are caused by different interpretations of the available evidence, IgG anti-D availability, cultural and social influences, as well as legal and regulatory considerations.</p><p><strong>Conclusions: </strong>This review highlights the need for evidence-based, harmonized guidelines on IgG anti-D prophylaxis in first-trimester abortions. It is crucial for healthcare providers to stay informed on the latest recommendations and engage in shared decision-making with women undergoing first-trimester abortion.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating risk: Effect of counseling on contraception practice in urban Hispanic women with systemic lupus erythematosus.","authors":"Oleg Stens, Katherine Ruddy, Jack Rodman, Leanna Wise","doi":"10.1002/ijgo.70414","DOIUrl":"https://doi.org/10.1002/ijgo.70414","url":null,"abstract":"<p><strong>Objective: </strong>To examine the frequency of and associations among contraception counseling, contraception use, and the use of teratogenic medications in women of child-bearing age from the Hispanic Los Angeles systemic lupus erythematosus (SLE) population.</p><p><strong>Methods: </strong>A 28-Question Anonymous Survey, Based on the 2020 American College of Rheumatology Reproductive Health Guideline, Was Distributed to 151 Female SLE Patients of Child-Bearing Age in the Outpatient Setting. Pearson χ² Test, Fisher Exact Test, and Wilcoxon Rank Sum Test Were Used, with Multivariable Analysis Conducted Via Logistic Regression.</p><p><strong>Results: </strong>Contraception counseling significantly increased the likelihood of contraception use among sexually active patients on teratogenic medications (P = 0.009). However, no significant difference was found in the use of effective/highly effective contraception methods between patients on teratogenic medications and those not on them (P = 0.07). Spanish-speaking patients reported significantly less counseling in the past year compared with English-speaking patients (34.9% vs. 77.2%, P < 0.01), even after adjusting for age.</p><p><strong>Conclusions: </strong>Many patients with SLE on teratogenic medications do not use appropriate contraception. Among this high-risk Hispanic SLE population, contraception counseling was associated with increased contraception use. However, Spanish-speaking patients reported lower rates of counseling compared with their English-speaking counterparts, highlighting a disparity that warrants further investigation.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of maternal education on maternal and perinatal outcomes: An individual participant data meta-analysis of 2 356 402 pregnancies.","authors":"Laura-Margarita Bello-Álvarez, Borja M Fernández-Félix, Jhon Allotey, Shakila Thangaratinam, Javier Zamora","doi":"10.1002/ijgo.70401","DOIUrl":"https://doi.org/10.1002/ijgo.70401","url":null,"abstract":"<p><strong>Background: </strong>Maternal and perinatal mortality remain critical indicators of global health inequity. In 2020, an estimated 287 000 women died from preventable causes related to pregnancy, and in 2021, approximately 2.3 million neonatal deaths occurred within the first 28 days of life. A recently defined risk group, small vulnerable newborns (SVNs, including preterm, low birth weight, and small-for-gestational-age infants), highlights the compounded vulnerability of certain newborns. Maternal education is a key social determinant of health, yet its effect on maternal and perinatal outcomes across global settings remains insufficiently quantified.</p><p><strong>Aims: </strong>The primary aim of this study was to quantify the association between maternal education level and adverse maternal and perinatal outcomes. The secondary aim was to evaluate whether these associations vary by country income level.</p><p><strong>Methods: </strong>We conducted an individual participant data (IPD) meta-analysis using data from the International Prediction of Pregnancy Complications (IPPIC) Network. Eligible studies included those reporting maternal and perinatal outcomes stratified by at least two levels of maternal education (informal/primary, secondary, tertiary). Primary outcomes were maternal mortality, preeclampsia, stillbirth, and SVNs. Associations were estimated using a two-step random-effects IPD meta-analysis adjusted for maternal age and ethnicity. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported.</p><p><strong>Results: </strong>Compared to tertiary education, women with secondary education had a 27% higher risk of maternal death (OR 1.27, 95% CI 0.38; 4.30), and those with informal or primary education had approximately double the risk (OR 2.51, 95% CI 0.23; 26.95). Risk of stillbirth was also twofold higher in lower education groups. These association remained significant in analyses restricted to high-income countries.</p><p><strong>Discussion: </strong>Women with lower levels of education are at substantially greater risk of adverse maternal and perinatal outcomes. These findings reinforce the need for education-focused policy and health system strategies to reduce maternal and neonatal mortality, particularly in settings with high educational inequality.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between embryo cryopreservation duration and pregnancy outcomes in women receiving the freeze-all strategy: A multicentered retrospective study.","authors":"Wei'e Zhao, Panyu Chen, Xiaoping Liu, Lei Jin, Juanzi Shi, Yundong Mao, Cuilian Zhang, Xiaoyan Liang, Jingjie Li, Rui Huang","doi":"10.1002/ijgo.70394","DOIUrl":"https://doi.org/10.1002/ijgo.70394","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the impact of embryo cryopreservation duration on the clinical pregnancy rate (CPR) and live birth rate (LBR) in women undergoing their first frozen embryo transfer (FET) following the freeze-all strategy.</p><p><strong>Methods: </strong>This multicenter retrospective study included 32 838 women who were patients at the five large-scale assisted reproduction treatment (ART) centers in China. The subjects were divided into seven groups according to the duration of embryo cryopreservation, among which the CPRs and LBRs were compared. Multivariate logistic regression and restricted cubic spline (RCS) analysis were used to assess the association between the duration of cryopreservation and the CPR/LBR outcomes. Furthermore, we performed subgroup analyses within the cohort of women who underwent FET within 3 months to investigating whether the impact cryopreservation duration on clinical outcomes varied under different estradiol (E₂) level on the trigger day of the ovarian stimulation cycles (E₂ ≤ 1000 pg/mL, or E₂ > 1000 pg/mL).</p><p><strong>Results: </strong>The CPR and LBR increased to the highest values (64.2% and 54.5%, respectively) during the first early 3 months of cryopreservation, and subsequently decreased as the cryopreservation duration increased, exhibiting an inverted U-shaped pattern. Further subgroup analyses within the first 3 months revealed that the cryopreservation duration did not significantly affect the CPR and LBR in the group with E₂ ≤ 1000 pg/mL, whereas in the subgroup with E₂ > 1000 pg/mL, the CPR and LBR increased with the prolonged cryopreservation.</p><p><strong>Conclusion: </strong>Our results suggest that a 3-month cryopreservation duration is associated with better FET outcomes, especially for patients with E₂ > 1000 pg/mL. Moreover, performing FET too early or too long after embryo cryopreservation may adversely affect clinical outcomes.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal serum syndecan-1 levels in preterm prelabor rupture of membranes and potential predictor of adverse perinatal outcomes: A case-control study.","authors":"Recep Taha Ağaoğlu, Gülten Çirkin Tekeş, Yüksel Oğuz, Furkan Akın, Ayşe Çiğdem Bayrak, Ahmet Arif Filiz, Özgür Volkan Akbulut, Ramazan Erda Pay, Kadriye Yakut Yücel","doi":"10.1002/ijgo.70408","DOIUrl":"https://doi.org/10.1002/ijgo.70408","url":null,"abstract":"<p><strong>Objective: </strong>This study's primary objective was to compare the levels of maternal serum syndecan-1 (SYD-1) in pregnant women with preterm prelabor rupture of membranes (PPROM) and healthy controls. The secondary objectives involved measuring the predictive capacity of SYD-1 for composite adverse perinatal outcomes (CAPO) and examining the association between SYD-1 levels and CAPO within the PPROM cohort.</p><p><strong>Methods: </strong>This prospective observational study was conducted at the Perinatology Department of Ankara Etlik City Hospital between November 2024 and April 2025. The study comprised 64 patients diagnosed with PPROM at 24-34 weeks of gestation and 64 healthy pregnant women matched for gestational age (GA) at sampling, as well as for maternal age, gravidity, and parity. Maternal serum samples were collected, and SYD-1 levels were measured using ELISA. Clinical, laboratory, and neonatal data were compared between groups. In the PPROM group, predictors of CAPO were analyzed using univariable and multivariable logistic regression.</p><p><strong>Results: </strong>Maternal SYD-1 levels were significantly higher in the PPROM group (19.29 ± 3.13 ng/mL) compared to the control group (14.67 ± 3.67 ng/mL) (mean difference: 4.62 ng/mL, 95% confidence interval [CI]: 3.43-5.81, P < 0.001). Among PPROM patients who developed CAPO, SYD-1 levels were also significantly elevated (20.04 ± 2.78 ng/mL vs. 16.86 ± 3.06; mean difference: 3.18 ng/mL, 95% CI: 1.50-4.86, P < 0.001). ROC analysis demonstrated good predictive performance in predicting CAPO (AUC = 0.785). Multivariable logistic regression analysis suggested that SYD-1 was associated with CAPO after adjusting for GA at the time of PPROM, latency period, maternal inflammatory markers, and GA at delivery (adjusted odds ratio: 1.71, 95% confidence interval: 1.15-2.54, P = 0.008).</p><p><strong>Conclusion: </strong>Maternal serum SYD-1 levels are significantly higher in PPROM patients compared to controls and might be associated with the development of CAPO. However, the cross-sectional nature of SYD-1 measurement and the multifactorial etiology of CAPO necessitate cautious interpretation. Prospective studies with serial measurements and larger cohorts are needed to confirm these preliminary findings and to better define their clinical significance.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}