International Journal of Women's Health最新文献

{"title":"Age-Stratified Modeling of Clinical Heterogeneity in Polycystic Ovary Morphology Using Ultrasound-Based Machine Learning.","authors":"Chenke Kuang, Qiao Wei, Zichao Liu, Yanfen Zhang, Zhuomin Zhong, Nian Hu, Chun Xiao, Liang Bao, Yaocheng Xiao, Meng Du, Zhiyi Chen","doi":"10.2147/IJWH.S592244","DOIUrl":"https://doi.org/10.2147/IJWH.S592244","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to employ machine learning for automated age stratification in patients with polycystic ovary morphology (PCOM) and to clarify the age-specific contributions of key clinical characteristics, thereby improving diagnostic accuracy.</p><p><strong>Patients and methods: </strong>A total of 192 ovaries with corresponding clinical and ultrasound data were analyzed. Automated age stratification was performed using the K-means unsupervised clustering model along with the elbow method. XGBoost, Random Forest (RF), Support Vector Machine (SVM), and Artificial Neural Network (ANN) algorithms were applied to compare full and selected feature sets. Model performance was evaluated using five-fold cross-validation with metrics including accuracy, sensitivity, F1-score, and area under the curve (AUC), validating the stratification robustness and feature selection strategy.</p><p><strong>Results: </strong>Automated age stratification categorized PCOM patients into three distinct age groups. A stable positive correlation was observed between ovarian volume and follicle count across all strata; however, key diagnostic drivers varied significantly by age. Beyond ovarian volume, follicle count, and BMI, the 18-22 years group was primarily influenced by menstrual cycle phase. The 23-29 years group was characterized by the number of pregnancies and the ovarian stromal artery blood flow RI. In the 30-40 years group, the ovarian stromal artery blood flow S/D ratio and the number of live births showed increasing importance.</p><p><strong>Conclusion: </strong>This study highlights the differential role of age-sensitive indicators in ultrasound-based diagnosis of PCOM and provides a framework for more personalized diagnostic assessment.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"592244"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771337","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":"Genitourinary Syndrome of the Menopause in Jordanian Women: A Cross-Sectional Study in a Tertiary Hospital in Jordan.","authors":"Ayman Qatawneh, Lana A AlRaie, Ragda Mihdawi, Ghaidaa Alassaf, Dar'a Meqdady, Yasmine AlHurani, Sereen Ahmad Bani-Said, Dana Alqatawneh, Fida Thekrallah","doi":"10.2147/IJWH.S583748","DOIUrl":"https://doi.org/10.2147/IJWH.S583748","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the prevalence of genitourinary syndrome of the menopause (GSM) signs and symptoms and their severity in postmenopausal Jordanian women attending a tertiary care hospital in Jordan.</p><p><strong>Methodology: </strong>A cross-sectional study was conducted on women with medical records at the University of Jordan Hospital complaining of symptoms related to the GSM. The participants were contacted by phone, briefed about the study, and asked if they would like to enroll. The study included demographic questions and validated assessments of Urinary Distress Inventory-6 (UDI-6) and Vulvar Disease Quality of Life Index (VQLI). Differences in the mean scores were assessed based on data normality and association assessment was performed using Pearson's chi-square test.</p><p><strong>Results: </strong>GSM was reported by 84.9% of 325 postmenopausal women enrolled in the study with an average of 5.1 symptoms per person. Most of the reported urinary symptoms were stress urinary incontinence (54.8%), followed by urge incontinence (48.6%). Furthermore, most reported genital complaints were vulva itching and/or burning sensations (41.2%) and vaginal discharge (40.3%). GSM interfered with the participants' sexual activity in 44% of the population studied. Smoking was associated with higher UDI-6 scores (p =0.045), and with stress urinary incontinence (1.74 versus 2.19; p = 0.004) and painful intercourse (1.66 versus 2.27; p = 0.011). Furthermore, high BMI was associated with higher UDI-6 and VQDL1 scores (p = 0.029 and p = 0.043). Dysuria was higher (p = 0.007) in women with shorter years of postmenopause (5 years or less), whereas difficulty in emptying the bladder and GSM interference with sexual activity scores were higher in women who had been postmenopausal for more than 5 years (p = 0.041, p = 0.053).</p><p><strong>Conclusion: </strong>The present study showed that a high percentage of postmenopausal Jordanian women developed GSM, with several symptoms per person. Furthermore, the severity of GSM interfered with sexual activity. Smoking and obesity were associated with overall GSM symptoms in Jordanian women.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"583748"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771256","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":"Hemoglobin Trajectory During Pregnancy and Postpartum Hemorrhage: A Retrospective Cohort Study.","authors":"Ge Mu, Hong Li, Jiang Du, Yingying Jian, Xin Shen, Yani Su","doi":"10.2147/IJWH.S601942","DOIUrl":"https://doi.org/10.2147/IJWH.S601942","url":null,"abstract":"<p><strong>Background: </strong>Studies on the association between anemia and postpartum hemorrhage (PPH) mostly use the hemoglobin (Hb) levels in a single trimester, thereby failing to capture the dynamic changes of Hb levels during pregnancy. This study aims to assess the trajectories of Hb during pregnancy and evaluate their association with PPH.</p><p><strong>Methods: </strong>The study population consisted of 4296 women who gave birth in a tertiary hospital after 28 weeks of gestation between January 2024 and February 2025. Group-based trajectory modelling was used to identify hemoglobin trajectories. Logistic regression models were applied for evaluating the associations between hemoglobin trajectories and PPH.</p><p><strong>Results: </strong>Three trajectories of maternal Hb were identified. In trajectory 1 (decline-stable, 20.41%), maternal Hb levels were higher than those in trajectory 2 in the first trimester, and rapidly declined across pregnancy with the lowest point at 35 weeks. In trajectory 2 (decline-rise, 73.16%), maternal Hb decreased during the first and second trimesters, and slightly increased during the third trimester. In trajectory 3 (stable-rise, 6.42%), maternal Hb remained stable in early and mid-pregnancy and increased in late pregnancy. Compared with trajectory 2, trajectory 1 was associated with a 2.36-fold higher risk of PPH (95% CI: 1.59-3.47), while trajectory 3 showed no significant association (OR: 0.79, 95% CI: 0.27-1.81), after adjustment. The area under the receiver operating characteristic curve was 0.74 (95% CI: 0.70-0.79). Compared with women with Hb ≥116 g/L at 28-32 weeks, women with Hb <116 g/L had a 1.64-fold higher risk of PPH (95% CI: 1.08-2.52).</p><p><strong>Conclusion: </strong>Women who are not anemic in early pregnancy but experience a rapid decline in Hb during pregnancy, especially those with Hb <116 g/L in the early third trimester, are at high risk for PPH.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"601942"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771331","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":"Psychometric Validation of a Patient-Reported Measure of Pregnancy and Motherhood Experiences in Turkish Women with Physical Disabilities.","authors":"Mehmet Çopuroğlu, Özge B A Y K A N Çopuroğlu, Hanife Abakay, Ayşe Güç","doi":"10.2147/IJWH.S601748","DOIUrl":"https://doi.org/10.2147/IJWH.S601748","url":null,"abstract":"<p><strong>Objective: </strong>Women with physical disabilities experience distinct physical, psychological, and social challenges during pregnancy and motherhood, yet culturally appropriate and psychometrically validated patient-reported outcome measures remain limited. The Pregnancy and Motherhood Evaluation Questionnaire (PMEQ) was developed to address this gap. No validated instrument currently captures these experiences in the Turkish context. This study aimed to translate, culturally adapt, and comprehensively validate the PMEQ for use in the Turkish population.</p><p><strong>Methods: </strong>The PMEQ was translated and culturally adapted in line with internationally accepted cross-cultural adaptation procedures for self-report instruments, including forward-backward translation, expert review, and cognitive debriefing. The study included 160 Turkish women with chronic physical disabilities who had experienced pregnancy and early motherhood. Internal consistency was assessed using Cronbach's alpha and McDonald's omega. Construct validity was examined using exploratory and confirmatory factor analyses, and test-retest reliability was evaluated over a 10-day interval using intraclass correlation coefficients (ICCs).</p><p><strong>Results: </strong>The Turkish PMEQ demonstrated excellent internal consistency (Cronbach's α = 0.90; ω = 0.92). Exploratory factor analysis identified a four-factor structure explaining 64.1% of the total variance. Confirmatory factor analysis supported this structure, showing good model fit (χ²/df = 2.1, RMSEA = 0.056, CFI = 0.94, TLI = 0.91, SRMR = 0.045). Test-retest reliability was high, with ICCs ranging from 0.79 to 0.86 across subscales and 0.88 for the total score. The factor structure was consistent with the original PMEQ framework.</p><p><strong>Conclusion: </strong>The Turkish version of the PMEQ is a valid and reliable patient-reported outcome measure for assessing pregnancy and motherhood experiences among women with physical disabilities. This study provides the first culturally validated tool for this population in Turkey, addressing a critical gap in disability-inclusive maternal health assessment.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"601748"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771174","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":"Concordance of AI-Assisted and Hybrid AI-Assisted Cervical Imaging Systems with Visual Inspection with Acetic Acid for Cervical Precancer Screening in West Bandung, Indonesia.","authors":"Kemala Isnainiasih Mantilidewi, Rizky Ramadhan Sayyid Zenyda, Muhammad Riza Vikar Akbar Alhayat, Rajendra Maheswara Wisnu Wardhana, Qonita Adzkia, Nadiyah An Nabiylah, Muhammad Gifary Syah Zahran, Hilmi Mukhayadi, Dodi Suardi, Dwi Agustian, Yudi Mulyana Hidayat","doi":"10.2147/IJWH.S585614","DOIUrl":"https://doi.org/10.2147/IJWH.S585614","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer remains a major cause of morbidity and mortality among women, particularly in low- and middle-income countries (LMICs) where screening access is limited. Visual Inspection with Acetic Acid (VIA) is widely used but subject to inter-observer variability. Artificial intelligence (AI)-assisted cervical imaging may improve standardization; however, real-world community evidence is limited.</p><p><strong>Objective: </strong>To evaluate the concordance of AI-assisted and hybrid AI-assisted cervical imaging systems (CIS) relative to VIA findings in a community-based cervical precancer screening program in West Bandung, Indonesia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 71 women to assess concordance and operational performance of two AI-based approaches: an AI-assisted CIS (Cerviray AI^®, AIDOT Inc., Seoul, South Korea) and a hybrid AI-assisted CIS incorporating expert review within a VIA-based workflow.</p><p><strong>Results: </strong>The AI-assisted CIS showed sensitivity of 66.7% (95% CI 20.8-93.9) and specificity of 95.6% (95% CI 87.8-98.5), with PPV 40.0% and NPV 98.5%. The hybrid approach demonstrated similar sensitivity (66.7%; 95% CI 20.8-93.9) and slightly higher specificity (97.1%; 95% CI 89.9-99.2), with PPV 50.0% and NPV 98.5%. VIA positivity was low (4.2%; 8.5% using a composite definition), likely inflating specificity and NPV. All metrics were calculated against VIA rather than histopathology. Agreement with VIA was moderate (κ = 0.472 and κ = 0.550).</p><p><strong>Conclusion: </strong>AI-assisted and hybrid CIS showed moderate agreement with VIA. Interpretation is limited by small sample size, wide confidence intervals for sensitivity, low disease prevalence, and use of VIA as the reference standard. These preliminary findings suggest a potential supportive role for AI-assisted imaging in LMIC screening, warranting validation in larger studies using histopathologic reference standards.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"585614"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771283","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":"Comparison of Surgical Outcomes Among Open, Laparoscopic, and Robotic Surgeries in Women with Obesity Diagnosed with Endometrial Cancer: Results from a Quaternary Hospital in Thailand.","authors":"Thitisak Vanichpakorn, Athithan Rattanaburi, Yuthasak Suphasynth, Kulisara Nanthamongkolkul, Ingporn Jiamset","doi":"10.2147/IJWH.S598487","DOIUrl":"https://doi.org/10.2147/IJWH.S598487","url":null,"abstract":"<p><strong>Purpose: </strong>We compared the surgical outcomes of robotic surgery (RS), laparoscopic surgery (LS), and open surgery (OS) in Asian women with obesity diagnosed with endometrial cancer.</p><p><strong>Patients and methods: </strong>In this retrospective cohort study, the data of 248 patients with a body mass index (BMI) of ≥25 kg/m², who were treated between 2019 and 2024 (129 OS, 66 LS, and 53 RS), were analyzed. Clinical and surgical information was extracted from the electronic health records and compared between the OS, LS, and RS groups using the chi-square test or Fisher's exact test for categorical variables and the Student's t-test or Kruskal-Wallis test, as applicable, for continuous variables.</p><p><strong>Results: </strong>Compared with the OS and LS groups, the RS group had a significantly higher median BMI and higher rates of obstructive sleep apnea, yet demonstrated superior perioperative outcomes. Sentinel lymph node dissection was performed predominantly in the RS group, whereas systemic lymphadenectomy was more commonly undertaken in the OS and LS groups. However, after adjusting for the type of lymphadenectomy, no significant effect on estimated blood loss (EBL) was observed. RS was associated with the lowest EBL, no transfusion requirements, and significantly reduced postoperative pain and opioid consumption compared with LS and OS (p < 0.001). Furthermore, RS resulted in the shortest median hospital stay (42 h) compared to LS (64 h) and OS (86 h). The overall complication rates were markedly lower in the RS group (9.4%) than in the LS (30.3%) and OS (44.2%) groups, with no high-grade complications or conversions to laparotomy observed in the robotic cases.</p><p><strong>Conclusion: </strong>These findings suggested that robotic surgery is a safe and highly effective approach for Asian women with obesity, offering reduced morbidity and accelerated recovery, despite higher baseline patient complexity.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"598487"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771309","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":"Temporal Trends in Vulvar Cancer Cases and Associated Factors of Adverse Clinical Features: A 6-year Retrospective Study From a Tertiary Hospital in Indonesia.","authors":"Muhammad Habiburrahman, Danny Maesadatu Syaharutsa, Tofan Widya Utami, Andi Darma Putra, Fitriyadi Kusuma, Laila Nuranna, Hariyono Winarto","doi":"10.2147/IJWH.S578027","DOIUrl":"https://doi.org/10.2147/IJWH.S578027","url":null,"abstract":"<p><strong>Purpose: </strong>Vulvar cancer (VC) is a rare malignancy with limited data in Southeast Asia. This 6-year retrospective cohort study aims to characterize temporal trends in VC cases in Indonesia, describe patients' sociodemographic, obstetric, and clinicopathological features, and identify predictors of advanced stage and distant metastasis (DM).</p><p><strong>Patients and methods: </strong>We analyzed 86 VC cases diagnosed between 2015 and 2020 at a tertiary hospital in Indonesia. Patients' sociodemographic and obstetric characteristics were described, and clinicopathological and treatment-related features were compared by stage and DM status. Temporal trends were assessed using Joinpoint regression, expressed as annual percentage change (APC). Subgroup analyses were conducted by age (<60 vs ≥60 years), residential status (rural vs urban), and DM presence (negative vs positive). Univariate and multivariate logistic regression identified predictors of advanced-stage VC and DM, with model performance evaluated using the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>The number of VC cases increased significantly over six years (APC +21.43%, p=0.034), with the highest growth observed among older patients, rural residents, and cases without DM (+25.53% vs +19.61%; +22.25% vs +19.08%; +30.50% vs +9.95%, respectively). Multivariate analysis identified urban residence (OR 5.12), right-sided lesion (OR 7.93), bilateral lesions (OR 10.25), and tumor volume ≥70 cm³ (OR 10.88) as independent predictors of advanced-stage VC (AUC 0.81, p<0.001). Predictors of DM included normal/underweight nutritional status (OR 5.50), presence of pain (OR 4.88), right-sided lesion (OR 13.80), and non-keratinized tumor subtype (OR 5.72) (AUC 0.80, p<0.001).</p><p><strong>Conclusion: </strong>The experience from an Indonesian referral hospital shows that the number of VC cases treated is rising, particularly among older adults, rural populations, and patients without DM. Specific clinicopathological features, including tumor laterality, bilaterality, volume, nutritional status, pain, and histological subtype, predict adverse outcomes, providing a foundation for improved risk stratification, early detection, and targeted management in underrepresented populations.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"578027"},"PeriodicalIF":2.6,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771221","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":"Analyzing the Risk Factors for Recurrence of Endometrioma and Dysmenorrhea in Patients with Endometriosis.","authors":"Jichan Nie, Han Yan, Wei Jiang","doi":"10.2147/IJWH.S587383","DOIUrl":"https://doi.org/10.2147/IJWH.S587383","url":null,"abstract":"<p><strong>Background: </strong>Recurrence of endometrioma and dysmenorrhea after surgery remains a major clinical challenge. Identifying reliable risk factors is essential to optimize individualized treatment and follow-up strategies. However, large-scale data from Chinese populations are limited.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 1,598 reproductive-aged women with pathologically confirmed endometriosis who underwent surgery between 2009 and 2010 and were followed for up to 7 years. Clinical, surgical, and follow-up data were collected. Kaplan-Meier survival analysis and Cox proportional hazards models were used to assess recurrence and identify independent predictors.</p><p><strong>Results: </strong>During follow-up, 348 patients (21.8%) developed endometrioma recurrence, and 187 of 846 with baseline dysmenorrhea (22.1%) experienced recurrence. The cumulative recurrence rates were 12%, 38%, 55%, and 65% for endometrioma at 1, 3, 5, and 7 years, and 28%, 52%, 68%, and 75% for dysmenorrhea at 1, 3, 5, and 7 years. Multivariable Cox regression identified bilateral ovarian cysts (HR 1.36, 95% CI 1.06-1.74, P = 0.015), older age at surgery (HR 1.04, 95% CI 1.00-1.08, P = 0.029), lack of postoperative medical therapy (HR 2.10, 95% CI 1.28-3.46, P = 0.003), and higher postoperative VAS scores (HR 1.10, 95% CI 1.05-1.15, P < 0.001) as independent risk factors for endometrioma recurrence. For dysmenorrhea recurrence, significant predictors were a history of endometriosis (HR 2.06, 95% CI 1.19-3.57, P = 0.010), higher preoperative VAS scores (HR 1.14, 95% CI 1.02-1.28, P = 0.026), and higher postoperative VAS scores (HR 1.27, 95% CI 1.18-1.39, P < 0.001).</p><p><strong>Conclusion: </strong>Recurrence of endometrioma and dysmenorrhea is common after surgery. Bilateral cysts, older age, lack of postoperative therapy, and higher postoperative pain scores independently increase the risk of endometrioma recurrence, while both preoperative and postoperative pain severity, as well as a history of endometriosis, are strong predictors of dysmenorrhea recurrence.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"587383"},"PeriodicalIF":2.6,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13105200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771314","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":"Predictive Potential of Red Blood Cell Distribution Width and Platelet Ratio (RDW/PLT) in Early Pregnancy Loss.","authors":"Çağlayan Ateş, Mustafa Bakırcı","doi":"10.2147/IJWH.S593786","DOIUrl":"https://doi.org/10.2147/IJWH.S593786","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the diagnostic value of the ratio of red blood cell distribution width (RDW) to platelet count (PLT) in the diagnosis of incomplete abortion in patients presenting to obstetric practice.</p><p><strong>Methods: </strong>This retrospective study includes 289 patients. Of these, 126 were in the incomplete abortion group and 163 were in the elective abortion group, which was terminated without medical indication. Patients who were not between 5 and 12 weeks of gestation, those with signs of infection, those with chronic disease or those taking regular medication, and those without complete blood count data were excluded from the study. Hemoglobin, RDW and PLT values recorded at the time of the initial pregnancy diagnosis were examined. Blood samples were obtained during the initial pregnancy visit before the diagnosis of incomplete abortion and prior to curettage in the elective abortion group. The RDW/PLT ratio was subsequently calculated and included in the statistical analyses. Receiver operating characteristic (ROC) analysis was used to assess the risk of incomplete abortion, and binary logistic regression analysis was used to examine independent predictors. The level of statistical significance was set at p<0.050.</p><p><strong>Results: </strong>A total of 289 patients were included in the study, comprising 126 patients with incomplete abortion and 163 women undergoing elective abortion. The incomplete abortion and elective abortion groups showed similar baseline characteristics. In binary logistic regression analysis, gestational age, RDW, PLT, and the RDW/PLT ratio were significant predictors of incomplete abortion in the univariate model. In the multivariate model, only maternal age, gestational age, and the RDW/PLT ratio remained independently associated with incomplete abortion. ROC analysis demonstrated no diagnostic value for hemoglobin, while RDW and PLT showed moderate predictive performance. The RDW/PLT ratio exhibited the highest discriminatory ability (AUC = 0.824), with a cut-off value of ≥0.054 yielding 71.4% sensitivity and 79.1% specificity. The overall diagnostic accuracy of the RDW/PLT ratio index was 75.78%.</p><p><strong>Conclusion: </strong>This study demonstrates that the RDW/PLT ratio is a simple and accessible hematological marker that may represent a complementary hematological marker associated with early pregnancy loss risk. The findings suggest that this index may provide complementary support to clinical decision-making processes.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"593786"},"PeriodicalIF":2.6,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771171","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":"The Relationship Between Immune Cells and Uterine Fibroids: A Bidirectional Mendelian Randomization Study.","authors":"Xiaoxiao Deng, Shaoli Zhuang, Yanping Chen, Fangfang Chen, Zhang Zhang, Wu Chen","doi":"10.2147/IJWH.S591986","DOIUrl":"https://doi.org/10.2147/IJWH.S591986","url":null,"abstract":"<p><strong>Objective: </strong>This research applied a bidirectional Mendelian randomization (MR) framework to investigate potential two-way causal associations between immune cell phenotypes and uterine fibroids (UF).</p><p><strong>Methods: </strong>This research drew upon publicly available data from large-scale genome-wide association studies (GWAS), encompassing 731 immune cell phenotypes from 3757 participants and UF data from 21,024 cases and 237,694 controls. Primary causal estimates were derived using the inverse-variance weighted (IVW) approach, with additional validation through MR-Egger, weighted median, and related methods. To ensure the reliability of the results, MR-PRESSO analysis, leave-one-out analysis, and false discovery rate (FDR) correction were also performed.</p><p><strong>Results: </strong>Forward MR analyses initially identified 39 immune phenotypes significantly associated with UF (IVW P < 0.05), comprising 23 risk factors and 16 protective factors. Applying stringent selection criteria-IVW P < 0.001, consistent odds ratio (OR) directions across five analytical methods, and pleiotropy P > 0.05-three phenotypes demonstrated strong causal links with UF: CD39⁺ CD8⁺ T cells, CD25 expression on IgD^- CD27^- B cells, and HLA-DR expression on CD14⁺ CD16^- monocytes (all IVW P < 0.001). The reverse MR analysis indicated a negative causal effect of UF on the proportion of CD39⁺ CD8⁺ T cells (IVW OR = 0.895, P = 0.037). Sensitivity analyses ruled out interference from horizontal pleiotropy and heterogeneity, supporting the reliability of the study's conclusions. However, after FDR correction, none of the causal associations remained statistically significant.</p><p><strong>Conclusion: </strong>Our research offers compelling genetic evidence supporting a forward causal link between CD39⁺ CD8⁺ T cells, CD25 on IgD^- CD27^- B cells, and HLA-DR on CD14⁺ CD16^- monocytes and UF, and a reverse causal link between CD39⁺ CD8⁺ T cells and UF, highlighting immune regulation as a potentially pivotal factor in UF pathogenesis.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"591986"},"PeriodicalIF":2.6,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771168","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}