International Journal of Gynecology & Obstetrics最新文献

{"title":"A prospective study of fractional limb volume for predicting fetal macrosomia in pregnancy affected by diabetes.","authors":"Ekaterina Kopteeva, Elizaveta Shelaeva, Elena Alekseenkova, Anna Modorskaya, Roman Kapustin","doi":"10.1002/ijgo.70252","DOIUrl":"https://doi.org/10.1002/ijgo.70252","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate fetal thigh (TVol) and arm (AVol) fractional volume in pregnant women with pregestational diabetes (PGD) and normal glucose tolerance and to assess its ability to predict fetal macrosomia, defined as a birth weight of 4000 g or greater.</p><p><strong>Methods: </strong>A single-center prospective cohort longitudinal study was conducted from February 2022 to November 2023. Women with a singleton pregnancy were enrolled in the study. Patients with severe extragenital pathology other than PGD, with fetal growth restriction, hemolytic disease, fetal malformations and anomalies, and gestational diabetes were excluded. The groups were those with PGD (n = 60) and the control group (n = 35). All patients underwent ultrasound examination three times during the third trimester, including standard biometry and assessment of fractional limb volume using 5D Limb Vol™ software (Samsung Medison). The primary outcome was a fetal macrosomia.</p><p><strong>Results: </strong>Fractional limb volumes in the PGD group (TVol 64.8, AVol 30.2 mL) exceeded those in the control group (TVol 51.7, AVol 22.5 mL, P < 0.001). Large-for-gestational age fetuses had significantly higher TVol and AVol compared with appropriate-for-gestational age fetuses in both the PGD and control groups. Fractional thigh volume (TVol) measured within 7 days before delivery can predict fetal macrosomia with a sensitivity of 81.82% and a specificity of 84.93% at a cut-off of 82.71 mL.</p><p><strong>Conclusion: </strong>Fetal limb fractional volume can be used as a predictor for fetal macrosomia in women having diabetes or normal glucose tolerance. Further investigation implementing automatized methods can improve estimated fetal weight assessment in birth weight extremes.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142494","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":"Perinatal mortality of singleton term breech deliveries in North Shoa Zone, Oromia Region, Ethiopia.","authors":"Adugna Alemu Desta, Fikadu Tolesa Alemu, Befekadu Tesfaye Oyato, Hussein Zakir Abasimel, Abdi Negash Motuma, Ifa Dereje Hordofa","doi":"10.1002/ijgo.70230","DOIUrl":"https://doi.org/10.1002/ijgo.70230","url":null,"abstract":"<p><strong>Objective: </strong>To assess perinatal mortality of singleton term breech deliveries and associated factors in selected hospitals in North Shoa Zone, Oromia Region, Ethiopia, during 2021-2022.</p><p><strong>Method: </strong>This institutional-based cross-sectional study was conducted from January 1, 2022 to March 30, 2022 among mothers who gave birth in selected hospitals. The lottery technique was employed with a total sample size of 390 among singleton term breech deliveries. Binary logistic regression was fitted and variables with a P-value <0.25 were identified and fitted to multivariable logistic regression. Variables with a P-value <0.05 at 95% confidence interval (CI) were considered significant.</p><p><strong>Result: </strong>The prevalence of perinatal mortality in the hospital was 6.4%. Adverse perinatal outcome of singleton term breech delivery was significantly associated with breech diagnosed during labor (adjusted odds ratio [AOR] 6.23, 95% CI 2.61-18.87), prolonged labor (AOR 4.51, 95% CI 1.15-15.62), rupture of membrane <12 h (AOR 0.06, 95% CI 0.01-0.28) and 5-min Apgar score of <7 (AOR 9.97, 95% CI 3.68-15.92).</p><p><strong>Conclusion and recommendation: </strong>Factors like the 5-min Apgar score < 7, prolonged labor, rupture of membrane <12 h, and breech diagnosed during labor were associated with increased Perinatal mortality. When labor begins, professionals should handle breech presentation as quickly as possible to minimize delays and enhance fetal outcomes.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142501","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":"Promoting respectful maternity care with the WHO labor care guide and the checklist mnemonic \"COPE\": A quality improvement project.","authors":"Mercy Nkuba Nassali, Jodie C Russell, Maipelo Tsuaneng, Aratwa Tumagole, Aamirah Mussa, Badani Moreri-Ntshabele, Chelsea Morroni, Thabo Moloi, Ndiwo B Memo, Sarah Hanson, Franciose D Rubgega, Leatile Sedabadi, Modimowame Jamieson, Lorato Matshitsa, Kago Ganagagabo, Roger Shapiro, Rebecca Luckett, G Justus Hofmeyr","doi":"10.1002/ijgo.70238","DOIUrl":"https://doi.org/10.1002/ijgo.70238","url":null,"abstract":"<p><strong>Objectives: </strong>To improve the quality of intrapartum care at Princess Marina Hospital, Gaborone, Botswana, through a champion-led educational intervention, introduction of the World Health Organization's Labor Care Guide (LCG), which highlights four key measures to promote respectful maternal care (RMC).</p><p><strong>Methods: </strong>In August 2022, we engaged medical and nursing staff in interactive training on the WHO LCG and implemented a mnemonic-based checklist-\"COPE\" (Companions, Oral fluids, Pain relief, Eliminate the supine position). Motivational posters were displayed in the labor ward. Surveys to assess client labor experiences were conducted in November 2022 (n = 204) and October 2024 (n = 211). An anonymous staff survey assessed personal practice changes before and after the training.</p><p><strong>Results: </strong>Over 2 years, significant improvements in reported maternal experience were observed. Reports of a \"very bad\" experience decreased from 116/204 (56.9%) to 13/211 (6.2%) and dissatisfaction with care reduced from 22/204 (10.8%) to 3/211 (1.4%). Adequate fluid provision increased from 108/204 (52.9%) to 159/211 (75.4%) and pain relief from 41/204 (20.1%) to 108/211 (51.2%). The reported presence of a labor companion increased from 14/204 (6.9%) to 133/211 (63.0%). Patient reports of exclusive supine positioning during the second stage of labor decreased from 106/204 (52.0%) to 11/211(5.2%). Staff questionnaires showed a consistent improvement in reported adoption of \"COPE\" practices compared with recollected practices before the intervention.</p><p><strong>Conclusions: </strong>Deeply entrenched labor care practices are difficult to change; however, sustained, champion-led quality improvement interventions using the LCG and with sustained supportive supervision can yield meaningful improvement in women's birth experiences.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136197","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":"Emerging trends in late maternal deaths: Insights from the global burden of disease 2021 estimates.","authors":"Madhur Verma, Moonis Mirza, Pritam Halder, Madhu Gupta, Minakshi Rohilla","doi":"10.1002/ijgo.70225","DOIUrl":"https://doi.org/10.1002/ijgo.70225","url":null,"abstract":"<p><strong>Objectives: </strong>The present study aimed to estimate the global burden and trends in late maternal deaths (LMDs). It also aimed to investigate the changing risk factor profiles across Socio-demographic Index (SDI) quintiles.</p><p><strong>Methods: </strong>We used Global Burden of Disease (GBD) 2021 data to examine global trends in LMDs from 1990 to 2021. Data on deaths and disability-adjusted life-years (DALYs) were extracted using the GBD Compare tool. Analyses included age-specific and regional comparisons, identification of countries with the highest annual percentage change over time, evaluations across SDI categories, and attribution to risk factors.</p><p><strong>Results: </strong>In 2021, there were 5589 LMDs, reflecting an 8.3% reduction since 1990. The DALY rate decreased from 6.95 to 4.21 per 100 000. The highest LMD rates were observed among women aged 25 to 29 years, with absolute numbers highest in the 30- to 34-year age group. Geographically, Rio Grande do Sul in Brazil (39.1 maternal deaths per 100 000 live births; 95% Uncertainty Interval, 29.43-51.8) had the highest burden in 1990, while Colombia (24.29; 95% Uncertainity interval, 16.98-33.21) was the highest in 2021. High-income North American regions showed rising trends (annual percentage change up to 5.91), while low SDI countries showed the most significant burden of age-standardized deaths per 100 000. Globally, high blood pressure and smoking were the leading risk factors for LMDs, whereas high body mass index and fasting glucose were predominant in high-income regions with rising trends.</p><p><strong>Conclusions: </strong>Despite a global decline in LMDs between 1990 and 2021, high-income regions exhibited rising trends, while low SDI countries bear the highest absolute burden, highlighting the need to monitor postpartum complications beyond 42 days.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136172","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":"Challenging rule of 30-min decision-to-delivery interval during emergency cesarean section in a low-middle income country: A prospective study.","authors":"Wondimu Gudu, Mekitie Wondafrash, Abraham Fessehaye Sium","doi":"10.1002/ijgo.70235","DOIUrl":"https://doi.org/10.1002/ijgo.70235","url":null,"abstract":"<p><strong>Objective: </strong>To determine the effect of the decision-to-delivery interval (DDI) on perinatal outcomes of emergency cesarean section (CS) deliveries at Karamara Hospital in the Somali region (Eastern Ethiopia).</p><p><strong>Methods: </strong>A cross-sectional study was conducted at Karamara General Hospital using data from STATA release 15. The χ²-test of association was conducted to assess the association between each categorical variable with the outcome variable and to identify candidate variables (with a P-value ≤0.25) to be included in the multivariable logistic regression model. The adjusted odds ratio and corresponding 95% confidence interval for the variables in the final model were reported.</p><p><strong>Results: </strong>Of the 258 cases of CS deliveries included in the study, only 25 cases (9.6%) had a CS DDI of 30 min or less. The perinatal outcomes in both groups (DDI ≤30 min and DDI >30 min) were comparable, except for meconium aspiration syndrome, which was observed to be higher in the DDI ≤30 min group (73% vs. 37%, P-value = 0.024). However, there was no difference in the composite perinatal outcome between both groups.</p><p><strong>Conclusion: </strong>The findings of this study show that a DDI of more than 30 min was not associated with poor perinatal outcome compared to DDI of 30 min or less.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136167","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":"Study on ultrasound microangiography of placenta in fetal growth restriction.","authors":"Shuangge Ye, Yanhong Luo, Jinyu Mei, Ming Chen, Jun He, Jiajian Zhang, Yangfeng Cui, Chengyuan Xu","doi":"10.1002/ijgo.70249","DOIUrl":"https://doi.org/10.1002/ijgo.70249","url":null,"abstract":"<p><strong>Objective: </strong>Reduced placental microvascular perfusion is the most important cause of fetal growth restriction (FGR), yet there are currently no effective tools available for assessing placental microcirculation. Ultrasound microangiography is an emerging technology capable of imaging vessels at the micron level. Currently, there is no research on the application of ultrasound microangiography technology for assessing placental microcirculation. This study innovatively explores the feasibility and practicality of using this new technology to evaluate microvascular changes in the placenta in cases of FGR.</p><p><strong>Methods: </strong>Ultrasound microangiography was used to image the microvascular structure and quantitatively analyze microvascular density in 10 FGR placentas and 10 normal placentas from Sprague-Dawley rats. Doppler ultrasound measurements were performed on the uterine arteries, the fetal umbilical arteries, and the middle cerebral arteries of pregnant rats. Placental area and thickness were measured, and hematoxylin and eosin (H&E)-stained placental sections were analyzed to assess the uterine spiral artery wall-to-lumen ratio. Histological determination of placental microvascular density served as the standard for validation.</p><p><strong>Results: </strong>In FGR cases, the remodeling of the uterine spiral arteries was obstructed, with the placenta exhibiting thinning and increased area. Both placental and fetal blood flow dynamics were altered. Using ultrasound microangiography, real-time dynamic imaging of blood flow from the large placental vessels to the micro-branching vessels was achieved. The shapes of the microvessels were rapidly visualized and reached peak visibility, displaying microvessels with slower flow rates. The boundaries between the microvessels and the placental background were sharply defined, and the placental vasculature formed an orderly, detailed vascular tree. Quantitative analysis of microvascular density in FGR placentas revealed a significant reduction compared with the control group (P < 0.01), a finding further confirmed by immunohistochemistry.</p><p><strong>Conclusions: </strong>Ultrasound microangiography demonstrates significant advantages in visualizing and quantifying the microvascular features of FGR placentas, enhancing the diagnostic capability for placental vascular diseases in FGR. This new technology provides a novel approach to the prenatal diagnosis of FGR.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136178","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":"Is amnioinfusion for intrapartum variable decelerations effective? Evaluation of the total deceleration area: A retrospective cohort study.","authors":"Gal Cohen, Nofar Bar Noy-Traub, Hanoch Schreiber, Tal Biron-Shental, Hila Shalev-Ram, Michal Kovo, Dorit Ravid","doi":"10.1002/ijgo.70239","DOIUrl":"https://doi.org/10.1002/ijgo.70239","url":null,"abstract":"<p><strong>Objective: </strong>Data regarding the efficiency of amnioinfusion in the presence of recurrent variable decelerations (VD) are limited. Total deceleration area (TDA) has been shown to be a useful indicator of both intrapartum fetal acid-base status and neonatal morbidity. The aim of the present study was to evaluate the effectiveness of amnioinfusion during labor for decreasing the TDA in deliveries complicated by recurrent VD.</p><p><strong>Methods: </strong>Departmental protocol is to perform amnioinfusion after 30 min of recurrent VD, if decelerations continue despite intrauterine resuscitation. Electronic fetal monitoring of these labors was analyzed. TDA was calculated for 30 min before and after amnioinfusion, as the sum of the area under the curve for each deceleration using the formula (heart rate change in BPM*time in seconds)/2.</p><p><strong>Results: </strong>Among 131 deliveries, 44.3% resulted in vaginal delivery, 22.1% in vacuum extraction, and 33.6% in cesarean delivery (CD). Patients who had CD had higher rates of nulliparity (P = 0.004), meconium (P = 0.017), and fever (P = 0.034). Median TDA before amnioinfusion was 8430 (505-14 321) versus 3591 (1297-7371) after amnioinfusion, P < 0.001. Amnioinfusion led to a 57.4% reduction in median TDA, regardless of umbilical cord entanglement, although the decrease was more substantial without cord entanglement (74.0% vs. 51.8%). Amnioinfusion reduced TDA in both nulliparas (59.4%, P < 0.001) and multiparas (59.0%, P < 0.001). In a subgroup of patients with normal amniotic fluid index upon admission to labor, amnioinfusion also decreased TDA (median TDA 9189 [5322-14 774] before amnioinfusion and 3621 [1321-7581] after, P < 0.001).</p><p><strong>Conclusions: </strong>Amnioinfusion effectively reduced TDA in deliveries complicated with recurrent VD and can be used to alleviate intrapartum VD regardless of parity, amniotic fluid volume or cord entanglement. Prospective trials would help elucidate the clinical significance of post-amnioinfusion reduction in the TDA and maternal and fetal outcomes.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119659","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":"Dynamic machine learning models for predicting cesarean delivery risk in women with no prior cesarean delivery: A retrospective nationwide cohort analysis.","authors":"Ido Givon, Nati Bor, Ran Matot, Lior Friedrich, Daya Gross, Gili Konforty, Arriel Benis, Eran Hadar","doi":"10.1002/ijgo.70234","DOIUrl":"https://doi.org/10.1002/ijgo.70234","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate advanced machine learning (ML) models for predicting unplanned intrapartum cesarean deliveries in women with no previous cesarean delivery, using both static and dynamic clinical data.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using nationwide data from a large integrated healthcare provider, including 262 632 women whose labor had started. Two ML models, logistic regression and decision tree algorithms, were employed to predict unplanned cesarean delivery. The models incorporated demographic, medical, and obstetric variables collected at multiple time points during labor. Model performance was evaluated based on accuracy, sensitivity, specificity, and the area under the receiver operating characteristics curve (AUC-ROC).</p><p><strong>Results: </strong>The logistic regression model demonstrated an accuracy of 95% with an AUC-ROC of 0.92. The decision tree model showed adaptability in highly variable labor conditions, achieving an F1 score of 0.91 and excelling in real-time prediction. Key predictors included maternal age, gestational age, body mass index, fetal heart rate patterns, and labor dynamics. Model performance remained robust across various demographic subgroups but was slightly reduced in nulliparous women.</p><p><strong>Conclusion: </strong>These ML models provide an innovative approach to predicting unplanned cesarean delivery by integrating diverse clinical parameters, enhancing decision making, and optimizing labor management. Prospective validation and seamless integration into clinical workflows are required to establish their utility in broader obstetric practice.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119657","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":"Lifetime breastfeeding and mortality among parous women in the Mexican Teacher's Cohort.","authors":"Susana Lozano-Esparza, Mishel Unar-Munguía, Britton Trabert, Liliana Gómez-Flores-Ramos, Marion Brochier, Juan Eugenio Hernández-Ávila, Dalia Stern, Martin Lajous","doi":"10.1002/ijgo.70183","DOIUrl":"https://doi.org/10.1002/ijgo.70183","url":null,"abstract":"<p><strong>Objective: </strong>To assess the relationship between lifetime breastfeeding and all-cause and cause-specific mortality in Mexican women.</p><p><strong>Methods: </strong>We used prospective data of 88 597 women from the Mexican Teachers' Cohort. Hazard ratios (HRs) were estimated from Cox regression models for total mortality, and a competing risk model was used for cause-specific mortality, adjusted for childhood/adolescence socioeconomic and lifestyle factors, age at first birth, and number of births. A dose-response relation was assessed using smoothed splines.</p><p><strong>Results: </strong>Participants, on average, breastfed for 6 months per birth, with a mean total breastfeeding duration of 13 months. After a mean follow-up of 11 years, 1556 deaths were found. Compared with parous women who did not breastfeed, all-cause mortality was lower for women who breastfed (<6 months: 0.78, 95% confidence interval [CI] 0.67-0.91; for 6-12 months: 0.76, 95% CI 0.64-0.90; for 12-24 months: 0.73, 95% CI 0.62-0.86; and for >24 months: 0.77, 95% CI 0.64-0.91). The dose-response relationship between breastfeeding and all-cause mortality was non-linear (P = 0.023). This trend was consistent when accounting for single live births and excluding women with gestational conditions. Those who breastfed >6 months had lower risk of cardiovascular and breast cancer-specific mortality.</p><p><strong>Conclusion: </strong>Breastfeeding was associated with reduced all-cause, cardiometabolic, and breast cancer mortality in Mexican women. The findings support the need for comprehensive policies to support breastfeeding, considering the potential for significant public health benefits. Additionally, the study highlighted a substantial gap in breastfeeding practices in Mexico, with average durations far below international recommendations.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119661","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":"Weight loss measures and their impact on the risk of developing endometrial cancer: A systematic review and meta-analysis.","authors":"Matheus de L Ruffini, Bruna L Fraga, Carlos E A G Moraes, Davi H G F Ribeiro, Leonardo J C Sei, Marina L Hartmann, Marina R Matos, Rhauani I L Lopes, Sérgio C Júnior, Samuel A F Toledo, Suzana A Pessini","doi":"10.1002/ijgo.70219","DOIUrl":"https://doi.org/10.1002/ijgo.70219","url":null,"abstract":"<p><strong>Background: </strong>Endometrial cancer (EC) is the most common gynecological malignancy, primarily affecting postmenopausal women. Obesity is a well-established risk factor for EC, yet the extent to which weight loss reduces this risk remains unclear.</p><p><strong>Objectives: </strong>This study systematically reviews and quantifies the impact of intentional weight loss, through lifestyle interventions and bariatric surgery, on EC risk in obese patients.</p><p><strong>Search strategy: </strong>A comprehensive search was conducted across Embase, LILACS, Web of Science, Scielo, and PubMed using the patient, intervention, comparison, outcome (PICO) strategy, with no restrictions on language or publication date. The review was registered in PROSPERO (CRD42024555555) and followed established methodological guidelines.</p><p><strong>Selection criteria: </strong>Included studies were clinical trials, cohort studies, and case-control studies assessing EC risk in obese women (body mass index ≥30), aged ≥18 years, without prior EC diagnosis, who underwent intentional weight loss interventions. Studies with unclear intervention definitions or non-relevant populations were excluded.</p><p><strong>Data collection and analysis: </strong>Two independent reviewers performed data extraction. ROBINS-E was used to assess study quality, and a meta-analysis synthesized hazard ratios (HR) and odds ratios (ORs).</p><p><strong>Main results: </strong>From 785 identified articles, 12 studies met inclusion criteria, with 307 020 participants in the weight loss group and 8 664 414 in the control group. Weight loss interventions included lifestyle modifications and bariatric surgery, both showing EC risk reduction. A meta-analysis of five studies showed a significant risk reduction (HR 0.56 [95% CI 0.46-0.68], P < 0.001). A second meta-analysis of 12 studies confirmed the protective effect of weight loss (OR 0.46 [95% CI 0.33-0.65], P < 0.001), with bariatric surgery demonstrating greater effectiveness. Although most studies did not specify subtypes, the findings likely reflect a greater impact on type 1 endometrial cancer, which is predominantly associated with obesity.</p><p><strong>Conclusions: </strong>Intentional weight loss achieved through structured interventions is associated with a significantly lower risk of developing EC, with surgical interventions showing stronger protective effects. However, study heterogeneity and biases highlight the need for more rigorous research. These findings reinforce weight loss as a preventive strategy for EC and underscore the necessity of further studies, particularly exploring modern pharmacological interventions.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101107","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}