International Journal of Women's Health最新文献

{"title":"A Case Report of a Giant Mucinous Cystadenoma Suspected to Be Associated with Ovarian Remnant Syndrome After Bilateral Adnexectomy: Diagnostic Pitfalls and Implications for Clinical Management.","authors":"Jie Chen, Li Yang","doi":"10.2147/IJWH.S643646","DOIUrl":"10.2147/IJWH.S643646","url":null,"abstract":"<p><strong>Background: </strong>Mucinous cystadenoma of the ovary is one of the common benign ovarian neoplasms. Nevertheless, when a huge pelvic mass develops years after bilateral adnexectomy, determining its tissue origin and establishing a differential diagnosis poses substantial challenges, complicating the clinical management of such secondary pelvic lesions.</p><p><strong>Case presentation: </strong>This study reports a rare case of a giant pelvic mass occurring many years after bilateral adnexectomy in a 65-year-old Han Chinese female. Intraoperative exploration and postoperative histopathology confirmed the lesion as an ovarian mucinous cystadenoma, which was presumed to arise from residual ovarian tissue after previous surgery, consistent with ovarian remnant syndrome (ORS). However, the ovarian origin of this lesion was comprehensively determined based on prior surgical records, intraoperative findings, and histopathological morphology, without further confirmation by definitive immunohistochemical staining.</p><p><strong>Conclusion: </strong>Ovarian remnant syndrome should be considered in the differential diagnosis of de novo pelvic masses following bilateral salpingo-oophorectomy. A review of prior surgical records is essential for tracing the origin of such lesions. For pelvic mucinous lesions, gastrointestinal and appendiceal origins should be prioritized for exclusion, accompanied by comprehensive characterization of pathological features. To minimize the risk of long-term postoperative lesions, complete resection of all ovarian tissue should be pursued during bilateral salpingo-oophorectomy in routine clinical practice.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"643646"},"PeriodicalIF":2.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional and Sex-Specific Trends in the Burden of Pancreatitis in Asia, 1990-2021: A Global Burden of Disease Study 2021 Analysis.","authors":"Haoran Lu, Qianhua Wang, Qichen Liang, Ran Li, Weikang Zhong, Jianping Gao, Rui Zhang","doi":"10.2147/IJWH.S644927","DOIUrl":"10.2147/IJWH.S644927","url":null,"abstract":"<p><strong>Purpose: </strong>Long-term patterns of pancreatitis burden across Asian subregions, sexes, and age groups remain incompletely characterized. We assessed temporal changes and identified populations with divergent trends.</p><p><strong>Patients and methods: </strong>We analyzed Global Burden of Disease Study 2021 estimates for pancreatitis from 1990 to 2021. Outcomes included incidence, prevalence, deaths, and disability-adjusted life-years (DALYs) globally, in Asia, and across three Asian subregions, namely East Asia, South Asia, and Southeast Asia. Joinpoint regression was used to estimate average annual percentage changes (AAPCs) and 95% confidence intervals for temporal trends, stratified by location, sex, and 5-year age group. Subgroup findings were interpreted descriptively because of the ecological design and multiple stratified comparisons. We also examined the burden attributable to alcohol use and the relative contributions of years lived with disability (YLDs) and years of life lost (YLLs) to DALYs among Asian females aged 15-24 years.</p><p><strong>Results: </strong>Absolute numbers of incident cases, prevalent cases, deaths and DALYs increased globally and across Asia, whereas most age-standardised rates declined. In Asia, AAPCs for age-standardised incidence, prevalence, mortality and DALY rates were -0.33%, -0.45%, -1.00% and -0.94%, respectively. Alcohol-attributable fractions were substantially lower among females than males in Asia (1.6% vs 16.1% for deaths and 1.6% vs 17.0% for DALYs), suggesting that non-alcohol-related hypotheses require further individual-level evaluation. All four rates declined markedly in East Asia. Incidence and prevalence increased annually by 0.33% and 0.13% in South Asia. Prevalence increased annually by 0.25% in Southeast Asia. Overall burden and alcohol-attributable fractions were higher among males. Incidence increased among females aged 15-19 and 20-24 years, with AAPCs of 0.80% and 0.71%, respectively. Among women aged 15-24 years, the YLD share increased from 8.51% to 10.62%. The YLL share declined from 91.49% to 89.38%.</p><p><strong>Conclusion: </strong>Regional and demographic disparities persisted despite declining age-standardized rates. Rising incidence among young Asian females warrants further surveillance and etiological research. Biliary, metabolic, and other explanations require individual-level evaluation; these ecological findings cannot establish causation.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"644927"},"PeriodicalIF":2.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Sedentary Behavior in Pregnant Women: Insights from Multiple Linear Regression and Random Forest Model.","authors":"Lei Zeng, Rongrong Han, Jiayuan Ma, Lingling Gao","doi":"10.2147/IJWH.S640910","DOIUrl":"10.2147/IJWH.S640910","url":null,"abstract":"<p><strong>Purpose: </strong>High levels of sedentary behavior (sitting for more than 6 hours a day) during pregnancy are a public health concern. Understanding the prevalence, patterns, and associated factors of sedentary behavior is important to develop targeted interventions, yet contemporary evidence remains limited. This study aimed to investigate the prevalence and patterns of sedentary behavior and identify its associated factors among pregnant women using the Systems of Sedentary Behavior framework.</p><p><strong>Patients and methods: </strong>A cross-sectional study was conducted in Guangzhou, China, from October 2024 to April 2025. We recruited 655 pregnant women from a single tertiary hospital who completed the sedentary behavior subscale and physical activity subscale of the Pregnancy Physical Activity Questionnaire, the Pregnancy Discomforts Questionnaire, the Physical Activity Neighborhood Environment Scale, and a sociodemographic and obstetrics data sheet. Multiple linear regression and random forest models were conducted to explore the associated factors.</p><p><strong>Results: </strong>The prevalence of high sedentary behavior in pregnant women was 57.3%, with a mean sedentary time of 44.11 (27.71) hours per week. Occupational sedentary behavior consumed the most time. Both models identified household physical activity, pregnancy discomfort, access to destinations, occupation, and insurance as significant factors. Additionally, age and residence were specific to the multiple linear regression model, while income was unique to the random forest model.</p><p><strong>Conclusion: </strong>Healthcare providers should focus on younger, employed, high-income, and urban women who are at high risk for high sedentary behavior. Increasing household physical activity and alleviating pregnancy-related discomfort may be associated with less sedentary time, while improving access to exercise facilities and insurance coverage may also warrant consideration; however, these should be framed as potential targets requiring further prospective evaluation.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"640910"},"PeriodicalIF":2.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical Cancer Elimination in India: Progress, Gaps, and the Priorities.","authors":"Ravivarman Lakshmanasamy, Sathishrajaa Palaniraja, Anbumathi Suriyamoorthy, Anu Mary Oommen, Julia M L Brotherton, Partha Basu","doi":"10.2147/IJWH.S635866","DOIUrl":"10.2147/IJWH.S635866","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer is the second most common cancer and cause of cancer death among women in India, with an estimated 79,000 new cases and 43,000 deaths in 2024. Following the February 2026 nationwide HPV vaccination rollout, this review assesses India's progress toward the WHO 90-70-90 elimination targets and identifies the gaps most likely to determine further progress.</p><p><strong>Methods: </strong>We conducted a critical narrative review informed by the authors' program experience and targeted searches from publicly available databases, including national program documents, government reports, national surveys and WHO guidelines until September 2026. We selected evidence relevant to vaccination, screening, and treatment in India and synthesised it thematically.</p><p><strong>Results: </strong>The national program targets over 10 million girls aged 14 years with a single HPV vaccine dose. About 8 million were vaccinated till September 2026with very few serious adverse events reported. Facility-only delivery, mandatory written consent and limited supply for additional cohorts are major barriers to achieve the 90% target. Screening coverage remains low [<2%], with continued reliance on VIA, no harmonised performance indicators and weak linkage to care. Randomised trials support primary HPV testing, and newly validated indigenous assays could make this transition affordable, although triage requirements and overtreatment need attention. Limited colposcopy, loss to follow-up and insufficient radiotherapy capacity constrain treatment.</p><p><strong>Conclusion: </strong>India has the health-system architecture, manufacturing capacity and digital tools needed for elimination, but remains substantially short of all three targets. Progress will depend mainly on: i) extending vaccination beyond facilities and to more cohorts ii) moving to organised, self-sampled HPV-based screening iii) closing the gap between screening and treatment.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"635866"},"PeriodicalIF":2.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Transcriptomic and Single-Cell Analyses Identify a T Cell-Mediated Tumor Killing Gene Signature for Prognostic Stratification and Immune Characterization in Breast Cancer.","authors":"Yuhao Zhu, Yiyun Chen, Jundong Wu","doi":"10.2147/IJWH.S628386","DOIUrl":"10.2147/IJWH.S628386","url":null,"abstract":"<p><strong>Background: </strong>T cell-mediated tumor killing (TTK) is a central mechanism for antitumor immunity. However, the prognostic value of genes regulating TTK sensitivity (GSTTKs) in breast cancer (BC), along with their impact on the immune microenvironment and T-cell dynamics, remains to be systematically elucidated.</p><p><strong>Methods: </strong>Using gene expression data from public databases, we identified prognosis-related key GSTTKs. A risk model was developed through LASSO regression and validated in an independent external dataset. We then evaluated the independent prognostic value of the risk score and clinical features, and constructed a nomogram for survival prediction. Immune characteristics and immunotherapy response were assessed using CIBERSORT and TIDE algorithms. Furthermore, scRNA-seq data were integrated to elucidate T-cell communication networks and differentiation trajectories. Immunohistochemistry was performed to validate the protein expression patterns of the key GSTTKs.</p><p><strong>Results: </strong>We constructed a stable prognostic risk model comprising 5 GSTTKs (KCTD5, COL17A1, LRTM2, DOK7, and CXCR3). Patients were classified into high- and low-risk groups, with significantly different survival outcomes. Risk score, age, stage, and M were independent prognostic factors, and integrating them into a nomogram effectively predicted 1-, 3-, and 5-year survival. The two risk groups differed significantly in immune infiltration and immune checkpoint expression, with high-risk group showing elevated TIDE scores. scRNA-seq analysis further revealed a higher T-cell proportion in the low-risk group, interacting with macrophages via the CCL5-CCR1 pathway. Additionally, CXCR3 was dynamically expressed along T-cell differentiation trajectories.</p><p><strong>Conclusion: </strong>This study identified five GSTTK-related signatures in BC, revealing their association with immune heterogeneity and T-cell-specific regulation. These preliminary findings may inform prognostic evaluation, but warrant further validation before clinical translation, given the retrospective design, reliance on public datasets, lack of functional validation, and limited immunohistochemical samples.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"628386"},"PeriodicalIF":2.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scaling HPV Self-Sampling in Low-Resource Settings: From Evidence to Sustainable Implementation.","authors":"Federica Inturrisi, Beatriz Serrano, Silvia de Sanjosé","doi":"10.2147/IJWH.S633156","DOIUrl":"https://doi.org/10.2147/IJWH.S633156","url":null,"abstract":"<p><p>Profound global inequities in cervical cancer burden persist, with nearly 90% of deaths occurring in low- and middle-income countries (LMICs). High-performance human papillomavirus (HPV) testing is the recommended primary screening method, but its scale-up remains constrained by resource and infrastructure limitations. HPV self-sampling optimizes health system resources by eliminating universal speculum examinations during primary screening, yet a critical implementation gap remains regarding how programs transition from pilot projects to routine national practice. To examine this transition, a literature search was conducted through May 2026, focusing on implementation of cervical screening using vaginal self-sampling and molecular DNA amplification techniques within resource-limited settings. While policy endorsement in LMICs expanded from 10 countries in 2020 to 29 in 2026-with 23 recommending self-sampling for all women-real-world implementation lags significantly, as reflected in an estimated five-year HPV-based screening coverage of only 2% in LMICs in 2022. Selected country case studies illustrate diverse delivery models and varying stages of implementation scale, ranging from localized research projects and regional campaigns to scaled national programs: community health worker home visits increased screening uptake four-fold in Argentina, digital health platforms and electronic registries are supporting national scale-up in Malaysia and Rwanda, and single-day near-point-of-care projects achieved very high follow-up rates in remote Amazonian populations. Beyond these country experiences, the review evaluates key considerations along the clinical care cascade, highlighting the importance of triage and treatment capacity, active tracing strategies to minimize loss to follow-up, and supply chain management. Ultimately, self-sampling serves as a promising equity strategy whose success relies on sustained political, financial, and structural commitment across the full clinical pathway.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"633156"},"PeriodicalIF":2.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13677284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual Dysfunction and Associated Factors in Iranian Women with Systemic Lupus Erythematosus: A Cross-Sectional Study.","authors":"Mahdieh Kiani, Shadab Shahali, Fazlollah Ahmadi, Ali Montazeri, Zahra Mirfeizi","doi":"10.2147/IJWH.S643942","DOIUrl":"10.2147/IJWH.S643942","url":null,"abstract":"<p><strong>Background: </strong>Sexual dysfunction is a prevalent yet under-investigated dimension of quality of life in women with systemic lupus erythematosus (SLE). This study aimed to determine the prevalence of sexual dysfunction and its associated demographic, reproductive, and SLE-related clinical factors among Iranian women with SLE.</p><p><strong>Methods: </strong>This cross-sectional study enrolled women with SLE recruited from private rheumatology practices in two Iranian cities between December 2025 and June 2026. Data were collected via a clinical-demographic questionnaire and the Female Sexual Function Index (FSFI). Of 116 recruited women, 97 participants were included in the final analysis. Univariable and multivariable (backward elimination) linear regression models were used to identify factors associated with total and subdomain FSFI scores.</p><p><strong>Results: </strong>The mean (±SD) age of participants was 39.31 (±8.11) years, and sexual dysfunction was identified in 68 of 97 women (70.1%). Arousal 2.65 (±0.59) and desire 3.02 (±1.16) were the most impaired domains, while pain 5.06 (±1.08) was the least affected. In multivariable analysis, active lupus showed the strongest association with poorer sexual function, with significantly lower total FSFI scores (β=-5.33; 95% CI: -6.83, -3.82; P<0.001) and all subdomains (P≤0.009). Longer disease duration and older age at SLE diagnosis were independently associated with lower total, arousal, and satisfaction scores. Current infertility in a small subgroup (n=11/97), higher intercourse frequency, and unemployment were associated with better sexual outcomes in specific domains, while higher parity and chronic comorbidities were associated with worse orgasm and pain scores, respectively.</p><p><strong>Conclusion: </strong>Sexual dysfunction is highly prevalent among Iranian women with SLE, particularly affecting arousal and desire. Disease activity, duration, and age at diagnosis are independently associated factors. These findings suggest the potential value of integrating routine sexual health assessments into comprehensive SLE care.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"643942"},"PeriodicalIF":2.5,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Characterization of <i>Listeria monocytogenes</i> Associated with Adverse Pregnancy Outcomes in Iraq with Whole-Genome Analysis of a Representative Isolate.","authors":"Noor Abdulla Hamad, Muntaha Maddah Hassan Al-Alouci, Susan Abed Zaidan","doi":"10.2147/IJWH.S622311","DOIUrl":"https://doi.org/10.2147/IJWH.S622311","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy-associated listeriosis can cause severe fetal and obstetric complications, yet molecular epidemiological data from Iraq remain limited. This study integrated clinical and epidemiological data with PCR-based virulence profiling of <i>Listeria monocytogenes</i> isolates and whole-genome sequencing (WGS) of one representative clinical isolate.</p><p><strong>Methods: </strong>In this prospective cross-sectional study, 150 pregnant women presenting with spontaneous abortion, stillbirth/intrauterine fetal death, or preterm labor were enrolled. <i>L. monocytogenes</i> isolates were characterized by culture, biochemical testing, 16S rRNA PCR, and PCR screening of hlyA, actA, inlA, and inlB. One representative isolate (A125-2) was subjected to WGS on the BGISEQ-500 platform for sequence typing, virulence and antimicrobial-resistance gene profiling, and phylogenomic placement.</p><p><strong>Results: </strong><i>L. monocytogenes</i> was isolated from 18/150 participants (12.0%; 95% CI, 7.3-18.1%), with the highest positivity among spontaneous abortion cases (14.3%). PCR detected hlyA, actA, and inlA in all 18 isolates and inlB in 12/18 (66.7%). The sequenced representative isolate A125-2 was assigned to Sequence Type 1 (ST1) and Clonal Complex 1 (CC1) and carried LIPI-1, LIPI-3, multiple internalin genes, stress-response determinants, and several antimicrobial-resistance-associated genes. WGS also detected inlB in A125-2 despite the PCR discrepancy. Descriptively, 28.7% of participants reported unpasteurized dairy exposure, and 61.1% of <i>L. monocytogenes</i>-positive cases occurred during winter.</p><p><strong>Conclusion: </strong>The clinical and PCR findings support an association between <i>L. monocytogenes</i> and adverse pregnancy outcomes in this Iraqi cohort. Genomic characterization of one representative isolate demonstrated an ST1/CC1 background with multiple virulence and stress-adaptation determinants and illustrated the added resolution of WGS for investigating PCR discrepancies. Because only one isolate underwent WGS, the genomic findings should be interpreted as isolate-specific and not as population-level evidence for Iraqi <i>L. monocytogenes</i> strains. Broader multi-isolate genomic surveillance is warranted.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"622311"},"PeriodicalIF":2.5,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Umbilical Vein Elastic Fiber Deficiency as an Emerging Risk Factor for Catastrophic Umbilical Cord Hemorrhage: A Case Report.","authors":"Tianshui Yu","doi":"10.2147/IJWH.S630801","DOIUrl":"https://doi.org/10.2147/IJWH.S630801","url":null,"abstract":"<p><strong>Background: </strong>Umbilical cord hemorrhage (UCH) is a rare and fatal event involving the rupture of the umbilical vein. UCH is associated with mechanical reasons, such as cord entanglement, but new evidence suggests congenital structural weakness such as a lack of elastic fibers in the vein wall (umbilical vein dysplasia) as a predisposing factor, though it is not well understood clinically. This case report describes a term breech neonate who died from umbilical cord hemorrhage; autopsy revealed a marked deficiency of elastic fibers in the umbilical vein wall, suggesting a potential association with spontaneous umbilical vein rupture.</p><p><strong>Case report: </strong>A 27-year-old woman (G2P0) was admitted at 37⁺² weeks due to premature rupture of membranes (PROM). Ultrasound showed a breech fetus with a nuchal cord. After fetal bradycardia (90 bpm), an emergency cesarean section delivered a live female infant through III-degree meconium-stained amniotic fluid. The Apgar score was 10 at 1, 5 and 10 minutes. At 12 minutes, she developed cyanosis and dyspnea with an SpO₂ of 80%. Endotracheal suctioning yielded 2 mL of meconium; however, heart sounds remained weak and spontaneous respiration was inadequate. Resuscitation failed, and she died on day 2. Autopsy revealed umbilical cord hemorrhage secondary to umbilical vein rupture, and histochemical staining demonstrated a significant deficiency or absence of elastic fibers in the umbilical vein wall.</p><p><strong>Conclusions: </strong>This case suggests that congenital elastic fiber deficiency may predispose to spontaneous umbilical vein rupture and sudden neonatal death, even in the presence of initially reassuring Apgar scores. It highlights the potential value of routine elastin staining in perinatal autopsies and supports further research into the prevalence and genetic basis of this dysplasia.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"630801"},"PeriodicalIF":2.5,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden, Trends, and Future Projections of Polycystic Ovary Syndrome in the Gulf Cooperation Council Countries, 1990-2023, with Projections to 2050: A Global Burden of Disease Study.","authors":"Raseel B Almutairi, Renad S Alrebh, Raghad M Alotaibi, Somayah H Almaimouni, Batol H Boheliga, Danah M Al-Awad, Batool H Alsadig, Salma M Alawadhi, Lamar A Alghanmi, Anwar N Alsadah, Fatimah M Alsayegh, Adel S Almutairi, Layan S Alwadei, Nourah H Al Qahtani","doi":"10.2147/IJWH.S644317","DOIUrl":"https://doi.org/10.2147/IJWH.S644317","url":null,"abstract":"<p><strong>Introduction: </strong>Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age, with reproductive, metabolic, and long-term health consequences. Data on PCOS burden in the Gulf Cooperation Council (GCC) remain limited and inconsistent. This study evaluated temporal trends, determinants, and future projections of PCOS across the GCC.</p><p><strong>Methods: </strong>We estimated PCOS prevalence, incidence, and disability-adjusted life-years in the six GCC countries from 1990 to 2023 using Global Burden of Disease (GBD) 2023 data. Trends were assessed using annual percentage change and joinpoint regression, and case-number changes were decomposed into population growth, ageing, and epidemiological change. Associations with the Socio-demographic Index and socioeconomic inequality were assessed, alongside ecological correlations with metabolic risk indicators, and future trends to 2050 were projected using ARIMA/ETS models validated by backtesting.</p><p><strong>Results: </strong>The age-standardized prevalence of PCOS in 2023 ranged from 2377 per 100,000 women in Oman to 2679 in Kuwait, exceeding regional and global benchmarks; affected women rose from 173,203 in 1990 to 621,812 in 2023. All GCC countries showed increasing trends, with burden highest among women aged 20-24 years. Population growth accounted for 71% of the case-number rise, rising age-specific rates for 26%, and age structure for 3%. Prevalence and DALY rates were positively associated with SDI (<i>r</i> = 0.69-0.70); socioeconomic inequality narrowed substantially (RCI 0.037 to 0.003), and obesity exposure was the strongest ecological correlate of prevalence (<i>r</i> = 0.95-0.92), with increases projected through 2050.</p><p><strong>Conclusion: </strong>PCOS is an emerging, increasingly shared public health problem across the GCC, with a burden exceeding international benchmarks, driven predominantly by population growth and associated with rising obesity; forecasting models suggest continued increases in the coming decades. Increased surveillance, standardized early diagnosis, and integrated reproductive-metabolic health strategies are needed across the region.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"644317"},"PeriodicalIF":2.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}