International Journal of Gynecology & Obstetrics最新文献

{"title":"Risk of early childhood overweight/obesity following cesarean section: A systematic review and meta-analysis.","authors":"Chuhui Zhou, Linghong Tang, Lepeng Zhou, Ravi Retnakaran, Daniel Krewski, Shi Wu Wen, Ri-Hua Xie","doi":"10.1002/ijgo.70301","DOIUrl":"https://doi.org/10.1002/ijgo.70301","url":null,"abstract":"<p><strong>Background: </strong>Cesarean section is considered as a potential risk factor for early childhood (0-6 years) overweight/obesity; however, the precise magnitude of this risk remains unclear.</p><p><strong>Objectives: </strong>To estimate the risk of early childhood overweight/obesity in children delivered by cesarean section through a systematic review.</p><p><strong>Search strategy: </strong>MEDLINE, Embase, Web of Science, CNKI and Wanfang databases were searched using a combination of relevant terms for cesarean section, overweight/obesity and children.</p><p><strong>Selection criteria: </strong>Cohort studies on cesarean section deliveries in children under 6 years of age and overweight/obesity were included.</p><p><strong>Data collection and analysis: </strong>Two authors independently screened articles and extracted data. The quality of studies was assessed using the Newcastle-Ottawa Scale. Meta-analyses were conducted to estimate the pooled rates and relative risks (RR) of overweight/obesity.</p><p><strong>Main results: </strong>Twenty cohort studies were included. Cesarean section delivery was associated with significantly increased risks of early childhood overweight/obesity (RR 1.18, 95% confidence interval [CI]: 1.13-1.24), overweight (RR 1.11, 95% CI: 1.04-1.19), and obesity (RR 1.23, 95% CI: 1.12-1.34) compared to vaginal delivery. Subgroup analyses showed low heterogeneity among all subgroups.</p><p><strong>Conclusions: </strong>Our study suggests that children delivered by cesarean section may have an increased risk of developing overweight/obesity during early childhood compared to those delivered vaginally. These findings highlight the potential impact of delivery mode on the long-term health outcomes of children.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302093","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":"Intravenous ketamine to prevent post-partum depression following cesarean under neuraxial anesthesia: A systematic review and meta-analysis of randomized controlled trials.","authors":"Mohamed Aziz Daghmouri, Mohamed Ali Chaouch, Laurent Ben Ayoun, Amine Gouader, Konstantinos Chatzistergiou, Georges Mion, Cherifa Cheurfa, Matthieu Camby","doi":"10.1002/ijgo.70190","DOIUrl":"https://doi.org/10.1002/ijgo.70190","url":null,"abstract":"<p><strong>Background: </strong>Postpartum depression (PPD) significantly affects well-being and the ability to function normally, making preventive strategies crucial. The role of intravenous ketamine in preventing PPD, especially after cesarean sections under neuraxial anesthesia, remains unclear and controversial.</p><p><strong>Objectives: </strong>This systematic review and meta-analysis aimed to assess the efficacy and safety of perioperative intravenous ketamine administration in preventing postpartum depression among women undergoing cesarean section under neuraxial anesthesia.</p><p><strong>Search strategy: </strong>A comprehensive electronic search was conducted for literature published from 2000 to January 1, 2023, in multiple databases, including PubMed/MEDLINE and the Cochrane Database of Systematic Reviews, using relevant keywords. Language restrictions were not applied.</p><p><strong>Selection criteria: </strong>The included studies were randomized controlled trials (RCTs) that met the following criteria: adult patients (<18 years) undergoing elective cesarean section under neuraxial anesthesia, peripartum intravenous administration of ketamine, placebo as a comparison group, and postpartum depression as the primary outcome.</p><p><strong>Data collection and analysis: </strong>Data were extracted on various parameters, including study characteristics, ketamine protocol, control group details, results, and quality assessment scores. Meta-analysis was performed using the RevMan 5.4 statistical package, and outcomes were assessed using odds ratios (ORs) for dichotomous data and mean differences (MD) for continuous data, using a random effects model.</p><p><strong>Main results: </strong>Ten studies involving 2219 patients (1094 in the ketamine group and 1125 in the control group) were included. The meta-analysis did not show significant differences in the incidence of PPD or EPDS scores between the ketamine and control groups postoperatively. However, ketamine administration resulted in a reduction in postoperative pain scores and total opioid consumption but increased the incidence of headaches.</p><p><strong>Conclusion: </strong>Perioperative intravenous administration of ketamine does not have a prophylactic effect on postpartum depression in patients undergoing cesarean section under neuraxial anesthesia but does reduce postoperative pain and total opioid consumption. The increased incidence of side effects, such as headaches, dizziness, and drowsiness, warrants further investigation. Additional large RCTs are necessary to further explore ketamine's potential prophylactic effect on PPD.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293749","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":"Robotic versus open hysterectomy for very large uterus (more than 1000 g): A bicentric retrospective study of 150 patients.","authors":"Thien-Kim Do, Juan Pablo Estevez, Geoffroy Canlorbe, Clémentine Gonthier, Martin Koskas","doi":"10.1002/ijgo.70310","DOIUrl":"https://doi.org/10.1002/ijgo.70310","url":null,"abstract":"<p><strong>Objective: </strong>To compare robotic (RAL) and open abdominal (OA) hysterectomy for very large uteri in terms of perioperative outcomes, complications, and costs.</p><p><strong>Methods: </strong>Data from patients undergoing total hysterectomy between 2015 and 2021 for benign indications with a uterus weighing 1000 g or more according to the pathology report in two French Academic hospitals were retrospectively collected. All patients with a malignant pathology were excluded.</p><p><strong>Results: </strong>Among 150 patients included, 44 (30%) patients underwent RAL and 106 (70%) underwent OA hysterectomies. Mean uterus weights were 1844 g in the OA group and 1710 g in the RAL group. Mean operative time was longer in the RAL group (217 vs. 124 min; P < 0.001). No difference was found in terms of intraoperative (P = 0.951) and postoperative complications (P = 0.680). Hospital stay was shorter in the RAL group (1.6 vs. 3.8 days; P < 0.001). The RAL route was more expensive than the OA route regarding operating room occupancy (€1339 vs. €2370; P < 0.001) and disposable instruments (€390 vs. €654; P < 0.001); but cheaper, regarding the cost of hospital stay (€5042 vs. €9119; P < 0.001), which led to a lower global cost with the RAL route (€8211 vs. €10 901; P < 0.001).</p><p><strong>Conclusion: </strong>Robotic hysterectomy for uteri weighing more than 1000 g is comparable with open hysterectomy in terms of complications. The robotic approach allows for a shorter hospital stay, which leads to a lower overall cost.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293750","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":"Uterine \"twisting sign\": A new potential ultrasonographic soft marker for deep endometriosis.","authors":"Fabio Barra, Simone Ferrero, Umberto Perrone, Giulio Evangelisti, Alessandra Pulliero, Alberto Izzotti, Umberto Leone Roberti Maggiore, Stefano Bogliolo","doi":"10.1002/ijgo.70274","DOIUrl":"10.1002/ijgo.70274","url":null,"abstract":"<p><strong>Objective: </strong>The objective of the current study was to evaluate the \"twisting sign,\" defined as uterine fundus rotation observed on transvaginal sonography (TVS), as a potential soft marker for deep endometriosis (DE) and its association with specific DE localizations and indirect signs.</p><p><strong>Methods: </strong>A prospective observational study was conducted at an endometriosis referral center. We enrolled 158 reproductive-aged women with pelvic pain requiring specialist evaluation. Exclusion criteria included prior endometriosis diagnosis or conditions affecting uterine positioning, such as large myomas, uterine malformations, or previous pelvic surgery. Standardized TVS assessments, following IDEA (International Deep Endometriosis Analysis) criteria, were performed by a single experienced operator. The twisting sign was defined as a uterine rotation angle between 15° and 90° in the fundal transverse section.</p><p><strong>Results: </strong>The twisting sign was detected in 24.1% of participants and was significantly associated with posterior compartment DE, particularly rectosigmoid nodules (44.8.7% vs. 14.0%, P < 0.001) and uterosacral ligament involvement (41.4% vs. 23.3%, P = 0.046). It was also linked to indirect DE markers, including ovarian fixation to the uterine wall (37.9% vs. 19.4%, P = 0.031) and absence of the posterior sliding sign (37.9% vs. 9.3%, P < 0.001). Multivariate analysis confirmed the twisting sign as an independent predictor of rectosigmoid junction nodules (odds ratio [OR], 9.84 [95% confidence interval [CI], 1.69-58.83], P = 0.012) and absence of the posterior sliding sign (OR, 6.63 [95% CI, 1.88-24.34], P = 0.004).</p><p><strong>Conclusion: </strong>The twisting sign may represent a novel and potentially valuable ultrasonographic marker of DE, particularly in the posterior pelvic compartment. It likely reflects mechanical distortion of the uterine axis due to DE nodules and adhesions. Multicenter validation is warranted.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293751","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":"Prenatal screening for trisomy 21 in the first trimester: A comparison of a Thai non-biochemical predictive model and the Fetal Medicine Foundation algorithm.","authors":"Fuanglada Tongprasert, Chayanid Kunanukulwatana, Suchaya Luewan, Theera Tongsong","doi":"10.1002/ijgo.70305","DOIUrl":"https://doi.org/10.1002/ijgo.70305","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the performance of a newly developed Thai non-biochemical predictive model compared with the established Fetal Medicine Foundation (FMF) algorithm for prenatal screening of trisomy 21 in Southeast Asian pregnant women at 11-13⁺⁶ weeks of pregnancy.</p><p><strong>Methods: </strong>A secondary analysis was conducted on data from pregnant women attending Maharaj Nakorn Chiang Mai Hospital, Thailand, between 2011 and 2023. Trisomy 21 risk estimates were calculated using maternal characteristics and ultrasound parameters-crown-rump length (CRL), nuchal translucency (NT), and fetal heart rate (FHR)-via the FMF algorithm. The Thai model was developed using generalized linear regression incorporating maternal age, NT, and FHR. Risk classification thresholds were set at <1:250 (low-risk) and >1:250 (high-risk), and the models' diagnostic performances were compared.</p><p><strong>Results: </strong>Among 8473 participants, 28 cases of trisomy 21 were identified (0.33%). The Thai model demonstrated comparable diagnostic accuracy to the FMF algorithm, with an area under the receiver operating characteristic curve (AUC) of 0.890 (95% confidence interval [CI] 0.819-0.961) versus 0.882 (95% CI 0.797-0.969) (P = 0.736). At a 1:250 cut-off, the FMF algorithm achieved 60.7% sensitivity and a 2.4% false-positive rate, whereas the Thai model performed optimally at a 1:100 cut-off, yielding 67.9% sensitivity with a 3.5% false-positive rate.</p><p><strong>Conclusions: </strong>The Thai non-biochemical predictive model demonstrated similar performance to the FMF algorithm for trisomy 21 screening in Southeast Asian populations. The FMF algorithm remains a practical screening tool in low-resource settings, facilitating early and accurate risk stratification where advanced biochemical screening is unavailable.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284309","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":"Pelvic congestion syndrome due to central venous outflow obstruction: A single-center experience with may-Thurner and nutcracker syndromes.","authors":"Wen-Chi Wu, Wen-Hsien Hsu, Ting-Chen Chang, Lee-Wen Huang","doi":"10.1002/ijgo.70268","DOIUrl":"https://doi.org/10.1002/ijgo.70268","url":null,"abstract":"<p><strong>Objective: </strong>Pelvic congestion syndrome (PCS) due to central venous outflow obstruction (CVOO) such as May-Thurner syndrome (MTS) and nutcracker syndrome (NCS) is a significant cause of chronic pelvic pain (CPP) in women. This study aimed to investigate the clinical presentation, imaging characteristics, and outcomes of interventional treatments in patients with PCS with MTS and/or NCS.</p><p><strong>Methods: </strong>This retrospective study included the data of consecutive female patients diagnosed with PCS from 2019 to 2024 in our institution. The collected patient data included age, CPP duration, imaging-diagnosed causes (MTS, NCS, or both), procedure type performed (bilateral iliac vein balloon angioplasty, stent placement, left renal vein balloon angioplasty, left ovarian vein embolization), and use of intraoperative ultrasound. Outcomes assessed included changes in pain scores (Numeric Rating Scale [NRS]), analgesic use, and quality of life (QOL). Included patients' preoperative and postoperative outcomes were compared statistically using nonparametric tests.</p><p><strong>Results: </strong>Data of 45 women were included (mean age, 40.9 years; median duration of CPP, 3 years), with 37.8% diagnosed with MTS alone and 53.3% with both MTS and NCS. Among these, 22 had undergone bilateral iliac vein balloon angioplasty, nine (40.9%) had received stent placement, and nine (40.9%) had received embolization of left ovarian vein additionally. NRS pain scores and postoperative analgesic use were significantly reduced and QOL improvement increased (all P < 0.001).</p><p><strong>Conclusion: </strong>Interventions for PCS due to CVOO yield significant symptom relief and QOL improvements. Embolization may offer additional benefits in enhancing QoL in this patient population.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284308","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":"Cultural abdominal massage in pregnancy and obstetric outcomes in a sub-county hospital in Kenya.","authors":"Rukia Gang'ombe, Alfred Osoti, Zahida Qureshi, Omondi Ogutu","doi":"10.1002/ijgo.70304","DOIUrl":"https://doi.org/10.1002/ijgo.70304","url":null,"abstract":"<p><strong>Objective: </strong>To determine the association between cultural abdominal massage (CAM) in pregnancy and adverse maternal and perinatal outcomes.</p><p><strong>Methods: </strong>In this prospective cohort study, eligible term pregnant women who underwent CAM (exposed, n = 160) and those who did not undergo CAM (unexposed, n = 160) in the index pregnancy were enrolled during labor. Participants were followed up and immediate adverse maternal outcomes, including abruptio placenta, primary postpartum hemorrhage (PPH), uterine rupture, cesarean hysterectomy, admission to a high-dependency unit (HDU), and maternal death, and adverse perinatal outcomes, including intrauterine fetal demise (IUFD), stillbirth, 5-min Apgar score below 7, admission to neonatal HDU, and neonatal death, were evaluated within the first 72 h of delivery. The association between CAM and adverse maternal and perinatal outcomes was assessed using binomial logistic regression adjusted for potential confounders to obtain adjusted risk ratios (aRRs) with corresponding 95% confidence intervals (CIs). Statistical significance was two-tailed at P ≤ 0.05.</p><p><strong>Results: </strong>Compared with those who did not undergo CAM, women who underwent CAM in the index pregnancy had increased risk of primary PPH (adjusted risk ratio [ARR] 3.04, 95% CI 2.49-3.72, P < 0.001), uterine rupture (aRR 1.61, 95% CI 1.04-2.49, P = 0.031), stillbirth (aRR 1.54, 95% CI 1.09-2.16, P = 0.013) and 5-min Apgar score below 7 (aRR 2.11, 95% CI 1.78-2.51, P < 0.001). There was no association between CAM and abruptio placenta, cesarean hysterectomy, admission to HDU, or death.</p><p><strong>Conclusion: </strong>Women who underwent CAM were at increased risk of primary PPH, uterine rupture, stillbirth, and 5-min Apgar score below 7.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284293","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":"Usefulness of video explanation for informed consent in gynecologic surgery.","authors":"Riku Suzui, Mana Taki, Koji Yamanoi, Sachiko Kitamura, Masumi Sunada, Asuka Okunomiya, Yoshimi Kitawaki, Ryusuke Murakami, Ken Yamaguchi, Akihito Horie, Junzo Hamanishi, Masaki Mandai","doi":"10.1002/ijgo.70248","DOIUrl":"https://doi.org/10.1002/ijgo.70248","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of a video-assisted informed consent in gynecologic surgery to determine which aspects of verbal explanations could be replaced by videos, which have shown promise to augment verbal explanations in enhancing patient comprehension and satisfaction.</p><p><strong>Methods: </strong>This quasi-experimental study included patients aged 18 or older undergoing surgery for benign gynecologic conditions. The patients watched videos explaining their condition, surgical procedures, possible complications, and other relevant information followed by a verbal explanation from their provider. Pre- and postoperative questionnaires were used to assess patient satisfaction, understanding, and the need for additional verbal explanations.</p><p><strong>Results: </strong>A total of 32 patients were included, 30 of whom viewed the video and reported reduced anxiety and improved postoperative recovery. Additionally, nine patients shared the video with their families to communicate the details of the surgery. Older patients (≥50 years) required verbal explanations as well as the video and relevant documents, whereas younger patients (<50 years) were satisfied with the video alone before surgery but required verbal explanations after surgery, particularly regarding their medical condition. Furthermore, longer verbal explanations (≥30 min) improved patients' understanding of their medical condition(s).</p><p><strong>Conclusion: </strong>Video-assisted informed consent improved patient understanding of and satisfaction with routine surgical information. However, personalized verbal explanations were necessary to address each individual patient's medical needs. Future research, therefore, should focus on optimizing the video content to meet each patient's needs.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274835","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":"Prevalence, clinical patterns, and associated risk factors of polycystic ovarian syndrome among women seeking fertility treatment at Kilimanjaro Christian Medical Centre Hospital, Northern Tanzania.","authors":"Hanaan S Omar, Nasra Batchu, Asya M Ali, Felister G Uisso, Eusebius Maro, Baltura Msuya, Shangwe Mfugale, Simon Opondo, Bariki Mchome, Pendo Mlay","doi":"10.1002/ijgo.70131","DOIUrl":"https://doi.org/10.1002/ijgo.70131","url":null,"abstract":"<p><strong>Objective: </strong>To assess the prevalence, clinical patterns, and risk factors of polycystic ovary syndrome (PCOS) among women seeking fertility treatment at Kilimanjaro Christian Medical Centre, Northern Tanzania.</p><p><strong>Methodology: </strong>Hospital-based analytical cross-sectional studies were used, involving 367 women obtained through convenience sampling. Data collection was conducted using Swahili-translated questionnaires. Data were analyzed using SPSS version 26, using descriptive statistics, Fisher's exact test, and logistic regression, considering P < 0.05 as statistically significant.</p><p><strong>Results: </strong>The study found a 36% prevalence of PCOS among participants, with the highest occurrence in women aged 18-24 years 72.7%. Statistical analysis revealed significant associations between PCOS and age, with women aged 25-32 having significantly lower odds of PCOS compared to the 18-24 age group (adjusted odds ratio [AOR] = 0.24, 95% confidence interval [CI] 0.09-0.65, P = 0.005). Multiparous women also had lower odds of PCOS (AOR = 0.33, 95% CI 0.19-0.75, P = 0.001). Approximately 59.7% of women with PCOS had a menstrual cycle duration greater than 35 days.</p><p><strong>Conclusion: </strong>The prevalence of PCOS was 36% among the study population, primarily affecting younger women aged 18-24. The study underscores the need for further research to enhance the understanding of PCOS and improve treatment and reproductive outcomes.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266180","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":"Clustering in gestational diabetes mellitus: A systematic review.","authors":"Wesley Hannah, Balaji Bhavadharini, Viswanathan Baskar, Ranjit Mohan Anjana, Suchitra Chandrasekaran, Ram Uma, Polina Popova, Mohan Deepa, Viswanathan Mohan","doi":"10.1002/ijgo.70267","DOIUrl":"https://doi.org/10.1002/ijgo.70267","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is a heterogenous disease with significant clinical variation. Studies of GDM clusters that are distinctive in terms of maternal characteristics could pave the way for more personalized treatments.</p><p><strong>Aim: </strong>We aimed to collate studies dealing with clusters of GDM published in the literature.</p><p><strong>Methods: </strong>A search strategy was developed and databases such as PubMed, EMBASE, Scopus, and Ovid were searched until August 2024. Two reviewers (with a third if there was disagreement) screened the title/abstract and full text of articles and identified studies that performed clustering analysis or reported different clusters of GDM. The findings from the included studies were summarized.</p><p><strong>Results: </strong>From the comprehensive literature search, 1579 studies were identified. After removal of duplicate studies, 990 studies were screened based on title/abstract, from which 24 full-text studies were selected, with 14 studies finally included in this systematic review. From these studies, it can be seen that clustering was performed mainly based on values of oral glucose tolerance tests. Other means of clustering in the literature also included metabolic, insulin, genetic and continuous glucose monitoring parameters.</p><p><strong>Conclusion: </strong>There are several studies reporting on clustering of GDM. However, future studies should identify the most appropriate way to stratify women diagnosed with GDM in order to improve pregnancy outcomes and beyond.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266178","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}