International Journal of Women's Health最新文献

{"title":"Ovarian Low-Grade Mucinous Tumor Combined with Pseudo-Meigs' Syndrome: Report of Two Cases and Literature Review.","authors":"Hongshuang Shi, Xiaoyan Pang, Yi Zhang","doi":"10.2147/IJWH.S587154","DOIUrl":"https://doi.org/10.2147/IJWH.S587154","url":null,"abstract":"<p><strong>Background: </strong>Pseudo-Meigs syndrome (PMS) is a rare condition in which the primary tumor is most commonly ovarian teratoma, struma ovarii, ovarian metastatic tumor, or leiomyoma. Cases of PMS associated with ovarian borderline mucinous tumors or early-stage mucinous cystadenocarcinomas are exceedingly rare, with only two reported to date.</p><p><strong>Case presentation: </strong>This article presents the cases of two young women in 30s who sought medical attention due to progressively worsening dyspnea or abdominal distension. Preoperative serum tumor marker levels and imaging suggested advanced ovarian cancer; however, pathological examination of tissue and effusion fluid showed no evidence of malignancy. Postoperative pathological examination revealed stage IA ovarian borderline mucinous cystadenoma and stage IIB ovarian mucinous cystadenocarcinoma (microinvasive carcinoma). Postoperatively, the pleural effusion disappeared within a few months and there were no signs of recurrence.</p><p><strong>Conclusion: </strong>Primary borderline mucinous ovarian tumors or early mucinous cystadenocarcinomas associated with PMS are rare and can be easily confused with advanced ovarian cancer. To avoid unnecessary chemotherapy, it is essential to obtain histological or liquid-based cytological confirmation of malignant tumors before treatment. This case report highlights the importance for clinicians to consider the possibility of low-grade ovarian malignant mucinous tumors associated with PMS.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"587154"},"PeriodicalIF":2.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771244","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":"Long-Term Survival Outcomes of HPV DNA-Negative Cervical Cancer Compared with HPV DNA-Positive Disease in a Thai Tertiary Cohort.","authors":"Thidarat Phisalmonhkhon, Nuttavut Kantathavorn, Thanita Wetcho, Jidapa Samrarn, Ruai Kittikhun, Hathaipat Sukjariangporn, Man Thongaram","doi":"10.2147/IJWH.S601452","DOIUrl":"https://doi.org/10.2147/IJWH.S601452","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate 5-year progression-free survival (PFS) among patients with human papillomavirus (HPV) DNA-negative cervical cancer treated at a tertiary referral center in Thailand, and to compare survival outcomes with HPV DNA-positive patients.</p><p><strong>Methods: </strong>This retrospective cohort study included Thai women diagnosed with cervical cancer between 2012 and 2014 at Chulabhorn Hospital, Bangkok. HPV genotyping was performed using an HPV DNA genotyping test (Linear Array, Roche Molecular Systems). HPV status was determined solely by HPV DNA testing without p16 immunohistochemical confirmation. After excluding 14 patients with incomplete data, 150 women were analyzed. Patients were classified as HPV DNA-positive or HPV DNA-negative based on genotyping results. The primary outcome was 5-year PFS. Secondary outcomes included overall survival (OS) and prevalence of HPV DNA-negative disease. Survival outcomes were evaluated using Kaplan-Meier analysis and Cox proportional hazards regression.</p><p><strong>Results: </strong>Among 150 patients (mean age 54.2 years), 139 (92.7%) were HPV DNA-positive and 11 (7.3%) HPV DNA-negative. HPV DNA-negative tumors were more frequently associated with adenosquamous histology and earlier-stage disease, while HPV DNA-positive cases were more often diagnosed at stages II-III. Groups also differed significantly in primary treatment modality, with higher rates of surgery in HPV DNA-negative patients and chemoradiotherapy in HPV DNA-positive patients. During a median follow-up of 9.8 years, 54 patients experienced recurrence, metastasis, or death within 5 years. The overall 5-year PFS rate was 62.2%. Five-year PFS was 62.0% in HPV DNA-positive patients and 70.0% in HPV DNA-negative patients (HR 1.06; 95% CI 0.38-2.93; p=0.916). Corresponding 5-year OS rates were 66.7% and 63.6%, respectively (HR 0.93; 95% CI 0.33-2.58; p=0.885). These results should be interpreted cautiously given the small HPV DNA-negative subgroup and resulting wide confidence intervals.</p><p><strong>Conclusion: </strong>In this exploratory analysis, HPV DNA-negative cervical cancer patients did not demonstrate significantly different survival outcomes compared with HPV DNA-positive patients; however, these findings should be interpreted with caution given the small HPV DNA-negative sample size (n=11) and resulting limited statistical power. The absence of p16 immunohistochemistry precludes definitive WHO-based classification. Larger prospective multicenter studies incorporating both HPV DNA testing and p16 immunohistochemistry are required to clarify prognostic implications.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"601452"},"PeriodicalIF":2.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815233","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":"Interpregnancy Interval and the Degree of Cystocele Across Two Vaginal Deliveries: A Retrospective Self-Controlled Cohort Study Using Transperineal Ultrasound.","authors":"Xiuyan Liu, Meifang Deng, Yuyu Zhou, Chunchun Jin, Shiya Wang, Yitong He, Lvhuan Qiu, Shun Yang, Kaiju Luo, Qiuxiang Chen","doi":"10.2147/IJWH.S584134","DOIUrl":"https://doi.org/10.2147/IJWH.S584134","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association between interpregnancy interval (IPI) and the risk of worsening cystocele between two consecutive vaginal deliveries.</p><p><strong>Methods: </strong>In this retrospective cohort study, 314 women who underwent transperineal ultrasound (TPUS) within six months postpartum after each of two consecutive vaginal deliveries were included. Multivariable linear regression was used to assess the association between first-delivery cystocele severity and second-delivery outcomes, with IPI categorized as ≤24, >24-≤36, and >36 months to evaluate its potential modifying effect.</p><p><strong>Results: </strong>Cystocele severity after the first delivery strongly predicted worsening at the second delivery (β = 0.5; 95% CI: 0.4-0.6; p < 0.001). Longer IPI was associated with less progression of cystocele, showing a significant linear trend across IPI categories (p for trend = 0.04). After adjusting for obstetric factors, the position of the most dependent point of the posterior bladder wall after the first delivery was independently associated with cystocele severity after the second delivery (β = 0.5; 95% CI: 0.4-0.6; p < 0.001). IPI was negatively associated with cystocele severity. Although the formal test for interaction was not statistically significant (p for interaction = 0.11), the test for linear trend across IPI strata was significant (p for trend = 0.04).</p><p><strong>Conclusion: </strong>Cystocele severity after the first vaginal delivery strongly predicts that after the second, and this association weakens with longer IPI. TPUS enables early identification of high-risk women, supporting individualized birth spacing counseling with potential public health implications for the prevention of pelvic floor disorders.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"584134"},"PeriodicalIF":2.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771303","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":"Closing the Referral Gap During Prolonged Labour in Somalia: From Traditional Birth Attendance to Emergency Obstetric Care.","authors":"Lul Khalif Sheik Yusuf","doi":"10.2147/IJWH.S596934","DOIUrl":"https://doi.org/10.2147/IJWH.S596934","url":null,"abstract":"<p><p>Prolonged labour in Somalia becomes dangerous not only because of the clinical risks of obstructed or non-progressive labour, but because the pathway from community-based labour care to facility-based emergency obstetric and newborn care is often slow, fragmented, and unreliable. Although maternal health literature has long described the \"three delays\", the specific implementation gap between trusted community birth attendants and functionally ready emergency obstetric care remains insufficiently emphasized in discussions of prolonged labour in fragile settings. This commentary argues that delayed referral during prolonged labour in Somalia should be understood as a systems failure at the interface between community childbirth support and emergency obstetric care, rather than simply as a problem of home birth or poor knowledge. Studies describe low and unequal use of antenatal and facility-based delivery care, transport and referral barriers in displaced and urban populations, negative prior experiences of facility-based birth, and weaknesses in hospital collaboration and referral readiness. These findings support a more operational interpretation of maternal delay: one that links community recognition, transport feasibility, communication, and facility functionality into a single time-critical continuum. Drawing on Somalia-specific evidence, comparable referral literature, and WHO guidance on emergency obstetric care signal functions, intrapartum care, and the Labour Care Guide, this commentary proposes five operational commitments: standardized community referral triggers for prolonged labour; formalized traditional birth attendant (TBA)-to-facility communication and feedback; transport financed as part of clinical care; verification of referral destinations by actual emergency obstetric functionality; and respectful maternity care as a prerequisite for timely care-seeking. The commentary's contribution is therefore not to restate known barriers, but to provide an implementation-oriented framework for closing the referral gap during prolonged labour in Somalia.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"596934"},"PeriodicalIF":2.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771285","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":"Identifying Potential Drivers of the Polycystic Ovary Syndrome Burden in the European Union: GBD 2023 SEV Exposure Profiling and Mendelian Randomization.","authors":"Shengnan Lu, Sha Ye, Xiaofang Luo, Biyun Zhang","doi":"10.2147/IJWH.S593314","DOIUrl":"https://doi.org/10.2147/IJWH.S593314","url":null,"abstract":"<p><strong>Background: </strong>The Global Burden of Disease (GBD) study quantifies the burden of polycystic ovary syndrome (PCOS) but does not include PCOS-specific attributable risks. We combined GBD 2023 Summary Exposure Value (SEV) profiling with Mendelian randomization (MR) to identify and prioritize potential drivers of PCOS burden.</p><p><strong>Methods: </strong>We analyzed PCOS incidence, prevalence, disability-adjusted life years (DALYs), and age-standardized rates (ASRs) from 1990 to 2023. Temporal trends were assessed using Estimated Annual Percentage Change (EAPC) and Joinpoint regression. Within the European Union (EU), we evaluated associations between disease burden and Socio-demographic Index (SDI) and cross-checked these findings against Human Development Index (HDI) and Universal Health Coverage (UHC). Expert-screened SEVs were correlated with country-level age-standardized incidence rate (ASIR) using Pearson correlation with Benjamini-Hochberg adjustment; significant exposures were then clustered. Two-sample MR was used to test the effect of nitrogen dioxide (NO₂) on PCOS risk, accompanied by standard sensitivity analyses.</p><p><strong>Results: </strong>In 2023, the EU ASIR exceeded the global level despite a smaller EAPC, with marked heterogeneity across countries. SDI was positively correlated with PCOS ASRs. SEV screening identified eight exposures associated with ASIR, of which childhood sexual abuse and NO₂ pollution most clearly distinguished high- from low-ASIR countries. MR analysis supported a positive association between genetically predicted NO₂ exposure and PCOS risk (IVW OR 6.60, 95% CI 1.85-23.58; P = 0.00365), with broadly consistent results across sensitivity analyses.</p><p><strong>Conclusion: </strong>Combining SEV profiling with MR offers a practical approach for prioritizing modifiable drivers of PCOS burden within the GBD framework. NO₂ demonstrated a causal signal, suggesting that air pollution control may represent a viable target for PCOS prevention.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"593314"},"PeriodicalIF":2.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771291","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":"Population‑Specific Diversity of Dominant Vaginal <i>Lactobacillus</i> Species in Healthy Iranian Women and Those with Vaginitis: A Molecular Case‑Control Study.","authors":"Nasrin Asadi, Somayeh Yaslianifard, Maryam Hasheminejad, Mostafa Qorbani, Mohammad Mohammadzadeh","doi":"10.2147/IJWH.S586988","DOIUrl":"https://doi.org/10.2147/IJWH.S586988","url":null,"abstract":"<p><strong>Background: </strong><i>Lactobacillus</i> species play a key role in maintaining vaginal microbial homeostasis and protecting against genital infections. Disruption of this microbial balance can increase susceptibility to vaginitis. Population-specific variations in the composition of vaginal <i>Lactobacillus</i> communities may influence disease risk and therapeutic responses. This study aimed to evaluate the distribution of major vaginal <i>Lactobacillus</i> species in healthy Iranian women and those with vaginitis using species-specific molecular assays.</p><p><strong>Methods: </strong>In this case-control study, 100 women with clinically confirmed vaginitis and 100 healthy controls were enrolled. Vaginal swabs were examined by Gram staining, followed by DNA extraction and PCR amplification using universal and species-specific 16S rRNA primers targeting <i>L. iners, L. crispatus, L. acidophilus, L. gasseri</i>, and <i>L. jensenii</i>. Associations between bacterial species and clinical status were evaluated using Odds Ratio (OR), Relative Risk (RR), Phi coefficient (Φ), and Chi-square tests.</p><p><strong>Results: </strong><i>Lactobacillus</i> spp. were detected in 97% of healthy women compared with 53% of symptomatic participants. <i>L. jensenii</i> and <i>L. acidophilus</i> were significantly more prevalent in healthy individuals, demonstrating strong protective associations with vaginal health. In contrast, <i>L. iners</i> was more frequently detected in women with vaginitis, consistent with its proposed role as a transitional species associated with microbiome instability. Although <i>L. crispatus</i> is often reported as protective in other populations, it did not show a statistically significant protective association in this study population.</p><p><strong>Conclusion: </strong>Our findings highlight the protective association of dominant <i>Lactobacillus</i> species, particularly <i>L. jensenii</i> and <i>L. acidophilus</i>, in maintaining vaginal microbial balance. The higher prevalence of <i>L. iners</i> among symptomatic women further supports its association with disturbed vaginal microbiota. These results suggest the presence of population-specific microbial patterns and underscore the importance of considering regional microbiome characteristics when developing diagnostic approaches and probiotic-based interventions.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"586988"},"PeriodicalIF":2.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771226","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":"Mediating Role of Dyadic Coping Between Social Support and Oral Frailty Cross-Sectional Study of Elderly Ovarian Cancer Patients in China.","authors":"JiaoJiao Jin, DanDan Zhao, Yi Chen","doi":"10.2147/IJWH.S594341","DOIUrl":"https://doi.org/10.2147/IJWH.S594341","url":null,"abstract":"<p><strong>Background: </strong>Oral frailty is a major global public health issue faced by the elderly, significantly affecting the rehabilitation of elderly patients. The relationships among the three variables-social support, dyadic coping, and oral frailty-remain unclear, especially the mediating role of dyadic coping, which has not been adequately studied and explored in the context of elderly ovarian cancer patients.</p><p><strong>Patients and methods: </strong>This cross-sectional study adopted consecutive sampling to select elderly ovarian cancer patients treated at a Grade-A Tertiary Hospital in Hangzhou, China, from January 1, 2023 to December 31, 2025. The survey was conducted using a general information questionnaire, Oral Frailty Index-8, Social Support Rating Scale, and Dyadic Coping Scale.</p><p><strong>Results: </strong>This study included a total of 311 elderly ovarian cancer patients. The oral frailty score is 5.31±0.98 (57.4% prevalence), 37.82±7.98 in social support, 112.18±21.21 in dyadic coping. Logistic regression analysis revealed that non-residence with children, chronic disease history (≥3), polypharmacy, and lack of oral health education were significant predictors of oral frailty (P<0.05). The total social support score showed positive correlations with dyadic coping, positive dyadic coping, and negative dyadic coping. Conversely, the total oral frailty score exhibited negative correlations with all three dyadic coping dimensions. Social support showed a negative correlation with oral frailty. The mediating effect of positive dyadic coping between social support and oral frailty was-0.023, accounting for 23.8% of the total effect. The mediating effect of Negative dyadic coping was 0.01, contributing 10.8% to the total effect.</p><p><strong>Conclusion: </strong>The incidence of oral frailty is higher in elderly ovarian cancer patients in China. Do not live with their children, a history of chronic diseases (≥3), use multiple medications, lack of oral health education are more prone to oral frailty. Social support maybe affect the level of oral frailty through dyadic coping. Suggesting that healthcare professionals may actively attempt to establish intervention programs based on dyadic coping levels with good social support, improve the dyadic coping levels of elderly ovarian cancer patients, may be linked to decreased risk of oral frailty.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"594341"},"PeriodicalIF":2.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771306","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":"Spontaneous Heterotopic Pregnancy and Its Clinical Implications.","authors":"Yue Zhao, Yun Bai, Chao Feng, Rubin Ke, Yanying Lu","doi":"10.2147/IJWH.S601063","DOIUrl":"https://doi.org/10.2147/IJWH.S601063","url":null,"abstract":"<p><strong>Background: </strong>Heterotopic pregnancy is a rare but potentially life-threatening gynecologic emergency and is particularly uncommon in natural conceptions. Heterotopic pregnancies are prone to misdiagnosis due to the atypical clinical manifestations, especially after an intrauterine pregnancy has been confirmed.</p><p><strong>Case presentation: </strong>A case involving a 31-year-old female who presented with persistent abdominal pain and tenesmus after a medical abortion for a naturally conceived pregnancy is discussed. The initial ultrasound confirmed an early intrauterine pregnancy but a repeat ultrasound revealed a right adnexal mass with an accumulation of pelvic fluid accumulation. Laparoscopic exploration confirmed a right tubal heterotopic gestation. The hysteroscopic examination revealed retained products of conception within the uterine cavity.The patient underwent hysteroscopic removal of the retained intrauterine products of conception and a laparoscopic right salpingectomy. The postoperative histopathologic evaluation corroborated the diagnosis. The patient recovered uneventfully.</p><p><strong>Conclusion: </strong>This case is a reminder that confirmation of an intrauterine pregnancy does not exclude the coexistence of an ectopic pregnancy. Clinicians should maintain a high index of suspicion in patients with ectopic pregnancy risk factors, such as a history of multiple abortions, pelvic inflammatory disease, and/or endometriosis, or in patients who develop persistent or recurrent abdominal pain following an abortion. Early diagnosis and treatment of a heterotopic pregnancy can avert potentially life-threatening complications.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"601063"},"PeriodicalIF":2.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771185","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":"A CFIR-Guided Qualitative Process Evaluation of a Health Insurance-Based Lifestyle Counseling Intervention During Pregnancy in Germany.","authors":"Nicola Alexandra Litke, Charlotte Ullrich, Laura Wohlhüter, Michel Wensing, Manuela Bombana","doi":"10.2147/IJWH.S595070","DOIUrl":"https://doi.org/10.2147/IJWH.S595070","url":null,"abstract":"<p><strong>Purpose: </strong>In Germany, knowledge of pregnant women as well as standards for health workers to conduct consultations on lifestyle-related risk factors (LRRFs) are suboptimal. This study aimed to identify factors influencing implementation of the \"AOK Family Happiness Plus\", a counselling intervention for LRRFs during pregnancy within a health insurance setting.</p><p><strong>Patients and methods: </strong>This process evaluation included semi-structured interviews and a focus group with n = 16 consultants involved in delivering the intervention. Interviews lasted approximately 30-60 minutes. Interviews were conducted in autumn 2023 during and the focus group at the end of the intervention phase, in summer 2024. Data were analysed using thematic analysis using the Consolidated Framework for Implementation Research (CFIR).</p><p><strong>Results: </strong>Consultants highlighted the perceived benefits of the one-on-one counselling format including the four main topics of LRRF prevention during pregnancy: healthy diet, physical exercise, alcohol and tobacco use, and mental health. A strong alignment with existing prevention activities within the health insurance setting was noticed, while recruitment challenges and technical barriers in digital consultations were reported. Consultants mainly saw themselves in the role of innovation deliverers with strong self-efficacy and high capability. The involvement of gynaecologists and midwives was perceived as crucial for engaging innovation participants. Participating pregnant women were largely described as having prior knowledge of LRRF prevention. Consultants perceived that the consultation contributed to improving participants' understanding of LRRFs during pregnancy. The intervention deliverers faced significant obstacles, including technical difficulties and recruitment issues. Suggested adaptations included the introduction of group and online formats and including postnatal follow-up.</p><p><strong>Conclusion: </strong>The findings suggest that lifestyle counselling during pregnancy can be implemented within a health insurance setting, while highlighting important implementation challenges and contextual determinants. However, the findings reflect the perspectives of consultants delivering the intervention and should therefore be interpreted with caution. Future research should examine its effectiveness.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"595070"},"PeriodicalIF":2.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771272","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":"Linking Neonatal Birth Weight with AMH Levels in Umbilical Cord and Maternal Blood: A Prospective Study.","authors":"Chen Nahshon, Nir Kugelman, Yael Liel, Wisam Assaf, Nadav Cohen, Sivan Skvirsky, Eiman Shalabna, Maayan Lahav Sher, Shiran Kleifeld, Mirit Toledano Hacohen, Maya Gruber, Rooya Nejem, Rachel Fried, Dana Meretyk, Reuven Kedar, Amit Damti, Ofer Lavie, Galia Oron","doi":"10.2147/IJWH.S575181","DOIUrl":"https://doi.org/10.2147/IJWH.S575181","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to study the correlation between umbilical cord anti-mullerian hormone (AMH) levels and neonatal birth weight as well as the correlation between maternal and neonatal AMH levels.</p><p><strong>Patients and methods: </strong>A prospective observational single center cohort study, conducted at the Carmel Medical Center delivery room from March 2022 to December 2024. Two hundred and one patients and their female newborns were recruited and had umbilical cord and maternal blood AMH levels obtained. Small for gestational age (SGA) was defined as birthweight up to the 10th percentile according to the Hadlock equations. Associations with AMH levels were assessed using linear regression with logarithmic transformation of AMH. Variables significant in univariable analyses (<i>P</i> < 0.05) were included in multivariable models. Analyses were performed using IBM SPSS Statistics version 26.</p><p><strong>Results: </strong>In the SGA group 42 women and their female newborns were included with a mean (SD) birth weight of 2708 (<b>±</b> 218) g, while the appropriate for gestational age (AGA) group included 159 women and their female newborns, with a mean (SD) birth weight of 3362 (<b>±</b>322) g. Median (interquartile range (IQR)) newborn AMH levels were found to be 0.18 (0.07-0.57) in the SGA group, and 0.15 (0.06-0.68) in the AGA group. No differences were found between neonatal AMH levels of the SGA and AGA group (p=0.78). A correlation was found between maternal and neonatal AMH levels (r=0.35, p=0.001), that remained significant in an adjusted multivariate model that included adjustment to age, gravidity, parity, maternal body mass index (BMI), paternal BMI, smoking status and comorbidities.</p><p><strong>Conclusion: </strong>Female newborns born SGA were found to have comparable levels of AMH as female AGA newborns. A correlation between maternal and neonatal AMH levels was observed, implying AMH genetic predisposition of ovarian reserve, yet more research is needed to conclude clinical applications of this finding.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"575181"},"PeriodicalIF":2.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771350","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}