Journal of Obstetrics and Gynaecology最新文献

{"title":"Development of a lipid-glycaemic prediction model for gestational diabetes mellitus: a single-Centre retrospective study.","authors":"Xufeng Gong, Qian Zhu, Linlin Wang","doi":"10.1080/01443615.2026.2719766","DOIUrl":"https://doi.org/10.1080/01443615.2026.2719766","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is a common pregnancy complication. Although lipid parameters, the triglyceride-glucose (TyG) index, and TyG-body mass index (TyG-BMI) have been associated with GDM, their relative value within an integrated lipid-glycaemic prediction framework remains unclear. This study developed and internally validated an interpretable model for GDM risk estimation.</p><p><strong>Methods: </strong>This single-centre retrospective study included 287 pregnant women who underwent 75 g oral glucose tolerance testing and fasting lipid assessment at 24-28 gestational weeks, including 72 with GDM and 215 without GDM. Candidate predictors comprised maternal characteristics, fasting plasma glucose (FPG), routine lipid fractions, apolipoproteins, the TyG index, and TyG-BMI. Forward stepwise likelihood-ratio logistic regression was used to develop the original combined model. A structured alternative model replaced pre-pregnancy BMI, FPG, and triglycerides with TyG-BMI. Model performance was evaluated using receiver operating characteristic analysis, calibration measures, threshold-dependent diagnostic metrics, 1,000-resample bootstrap internal validation, paired DeLong testing, a nomogram, and decision curve analysis.</p><p><strong>Results: </strong>Eight variables were retained in the original combined model: maternal age, pre-pregnancy BMI, FPG, total cholesterol, triglycerides, non-high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B. Its apparent and optimism-corrected AUCs were 0.848 (95% CI: 0.786-0.909) and 0.830, respectively; the bootstrap-corrected calibration intercept was -0.03, calibration slope was 0.86, and Brier score was 0.147. The TyG-BMI alternative model had apparent and optimism-corrected AUCs of 0.831 (95% CI: 0.765-0.897) and 0.817. The AUC difference was 0.017 (95% CI: -0.011 to 0.045; <i>P</i> = 0.235). Decision curve analysis indicated potential net benefit for both models across clinically relevant thresholds.</p><p><strong>Conclusion: </strong>Both models showed good internally validated discrimination and acceptable calibration for GDM risk estimation at routine screening. The original model had a numerically higher AUC, but discrimination did not differ significantly between models. External validation is required before clinical implementation.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2719766"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of Concern: Incidence and sites of pelvic adhesions in women with post-caesarean infertility.","authors":"","doi":"10.1080/01443615.2026.2741499","DOIUrl":"https://doi.org/10.1080/01443615.2026.2741499","url":null,"abstract":"","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2741499"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of Concern: Medical vs. surgical treatment for clomiphene citrate-resistant women with polycystic ovary syndrome.","authors":"","doi":"10.1080/01443615.2026.2742040","DOIUrl":"https://doi.org/10.1080/01443615.2026.2742040","url":null,"abstract":"","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2742040"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio and endometriosis: a population-based study.","authors":"Ziyang Zheng, Jiaqi Wu, Zhonghua Sun, Xin Li, Qingyang Shi, Mingzhang Xu","doi":"10.1080/01443615.2025.2609485","DOIUrl":"https://doi.org/10.1080/01443615.2025.2609485","url":null,"abstract":"<p><strong>Background: </strong>The gamma-glutamyl transferase (GGT) to high-density lipoprotein (HDL) ratio (GGT/HDL) has recently emerged as a potential biomarker for metabolic and liver diseases. This study aimed to investigate the association between GGT/HDL ratio and endometriosis using a population-based dataset from the National Health and Nutrition Examination Survey (NHANES).</p><p><strong>Methods: </strong>Data from NHANES 1999 to 2006 were used to assess the relationship between the GGT/HDL ratio and endometriosis. The diagnosis of endometriosis was based on self-reported data from the Reproductive Health Questionnaire. The GGT/HDL ratio was calculated and Ln-transformed for analysis. Multivariable logistic regression and sensitivity analysis were used to estimate the odds ratio (OR) for endometriosis in relation to the GGT/HDL ratio.</p><p><strong>Results: </strong>A total of 3815 individuals were included, with 307 diagnosed with endometriosis. The Ln-transformed GGT/HDL ratio was positively associated with the endometriosis. Each unit increase in the Ln-GGT/HDL ratio was associated with a 22% higher likelihood of endometriosis (OR = 1.220, 95% CI: 1.003-1.483, <i>p</i> = 0.046). Sensitivity analyses including the use of original GGT/HDL value, the further adjustments of covariates, the exclusion of those with CVD and liver diseases confirmed the robustness of this association.</p><p><strong>Conclusions: </strong>This study found a significant positive association between the GGT/HDL ratio and endometriosis. Higher GGT/HDL levels may serve as a potential biomarker for identifying women at risk of endometriosis.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2609485"},"PeriodicalIF":1.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Success of oocyte retrieval in modified natural cycle assisted reproductive techniques: a retrospective cohort study.","authors":"Yonghuan Lv, Shan Wu, Miao Miao, Ye Tian, Haixia Chen, Jing Zhang, Wenyan Tian, Fengxia Xue","doi":"10.1080/01443615.2025.2579425","DOIUrl":"10.1080/01443615.2025.2579425","url":null,"abstract":"<p><strong>Background: </strong>This study investigates how clinical factors and hormonal levels affect oocyte retrieval in modified natural cycles, aiming to improve understanding and enhance treatment protocols.</p><p><strong>Methods: </strong>A retrospective analysis of data from 306 women undergoing <i>in vitro</i> fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) at a fertility clinic (2018-2023) was conducted. Clinical factors and hormonal levels were analysed. Follicular development was monitored via ultrasound.</p><p><strong>Results: </strong>Baseline comparisons between the oocyte retrieval and non-retrieval groups showed no significant differences in age, body mass index, infertility types, duration, associated conditions (e.g. tubal issues, ovulation disorders and endometriosis) or assisted reproductive methods (<i>p</i> > 0.05). After human chorionic gonadotropin (HCG) injection, both groups showed significant increases in progesterone, oestradiol and luteinising hormone levels (<i>p</i> < 0.0001). Before HCG injection, the retrieval group had significantly higher levels of progesterone, oestradiol and LH (<i>p</i> < 0.05), with oestradiol remaining higher afterward (<i>p</i> < 0.01). There were significant differences between the two groups on anti-Müllerian hormone levels (<i>p</i> ˂ 0.05). No significant differences were found in follicle-stimulating hormone, total testosterone, thyroid hormone levels and antral follicle count (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>In conclusion, the findings suggest that clinical factors do not impact oocyte retrieval in modified natural cycle assisted reproductive techniques. However, high hormone levels on the day of HCG injection in the study subjects may indicate a greater possibility of successful oocyte retrieval.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2579425"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental tobacco smoke exposure and pelvic inflammatory disease: a cross-sectional analysis of serum cotinine.","authors":"Mengmeng Ye, Haochan Wu, Fangfang Shan, Yiqin Zhou, Hui Zhou, Jinjin Yu, Zhaoxia Zhong, Yibo Wu","doi":"10.1080/01443615.2026.2617560","DOIUrl":"10.1080/01443615.2026.2617560","url":null,"abstract":"<p><strong>Background: </strong>Pelvic inflammatory disease (PID) is a common gynaecologic condition linked to infertility, ectopic pregnancy, and reproductive tract cancers. While active smoking has been associated with PID, the impact of environmental tobacco smoke (ETS) on non-smoking women remains unclear. Most studies rely on self-reported exposure, which may be inaccurate. Cotinine, a stable nicotine metabolite, serves as an objective biomarker of tobacco exposure. This study investigated the association between serum cotinine levels and PID risk in non-smoking women using data from the National Health and Nutrition Examination Survey (NHANES).</p><p><strong>Methods: </strong>This cross-sectional study included 3,718 non-smoking women aged ≥18 years from NHANES 2013-2020. ETS exposure was assessed using serum cotinine measured by isotope dilution high-performance liquid chromatography with tandem mass spectrometry. Cotinine levels were categorised as unexposed, low, or high exposure. PID was identified based on self-reported treatment for pelvic infections. Weighted logistic regression was used to examine associations between cotinine and PID, adjusting for confounders identified by a directed acyclic graph. Restricted cubic spline and subgroup analyses were also conducted.</p><p><strong>Results: </strong>Among participants, 3.1% reported a history of PID. Those with PID had higher serum cotinine levels. In fully adjusted models, each one-unit increase in log₂-transformed cotinine was associated with a 10% increase in PID risk (OR = 1.10; 95% CI: 1.02-1.19). High ETS exposure (≥3 ng/mL) was linked to a significantly higher risk of PID compared to unexposed individuals (OR = 2.53; 95% CI: 1.05-6.08). A linear dose-response relationship was observed. Subgroup analyses showed consistent results across all strata.</p><p><strong>Conclusion: </strong>Serum cotinine-defined ETS exposure was significantly associated with increased PID risk in non-smoking women. Reducing ETS exposure may help prevent reproductive tract infections.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2617560"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Gushen Antai recipe intervention and plasma cytokines during early pregnancy following IVF-ET: a cohort study.","authors":"Enuo Liu, Wenbin Li, Luyi Ye, Lin Yu, Hua Yan, Zai-Si Ji","doi":"10.1080/01443615.2026.2617562","DOIUrl":"10.1080/01443615.2026.2617562","url":null,"abstract":"<p><strong>Background: </strong>Gushen Antai recipe (GSAT), known herbal medicine, has long been used in China to treat early pregnancy loss. Several randomised controlled trials have demonstrated its efficacy in improving clinical pregnancy rates. This study aimed to elucidate the mechanism of GSAT in patients undergoing in vitro fertilisation-embryo transfer (IVF-ET).</p><p><strong>Methods: </strong>Patients undergoing IVF-ET were recruited on day 14 after embryo transfer. Participants either received GSAT alongside hormonal medication for 2 weeks (intervention group) or received hormonal treatment (control group). Plasma metabolites and inflammatory factors was analysed by gas chromatography-mass spectrometry and enzyme-linked immunosorbent assay, respectively. Faecal microbiota was assessed by 16S rRNA sequencing.</p><p><strong>Results: </strong>GSAT was found to contain 56.44% flavonoids, primarily come from Scutellariae Radix, including baicalin, baicalein, wogonoside, wogonin, oroxylin A and Chrysin 6-C-glucoside 8-C-arabinoside. At the end of the fourth week after embryo transfer, plasma levels of interleukin (IL)-2 and tumour necrosis factor-α were significantly lower in the intervention group than in the control group, whereas the anti-inflammatory cytokine IL-10 were markedly higher (687.3 vs. 448.5 pg/mL, <i>p</i> < 0.01). Moreover, the plasma IL-10 levels and proportion of four kinds of fatty acids (lauric acid, myristic acid, palmitic acid, linoleic acid) in plasma correlated with each other. These fatty acids were not directly detected in GSAT and may originate from biosynthesis by gut microbiota.</p><p><strong>Conclusions: </strong>The alteration of plasma cytokine levels (IL-10, TNF-α and IL-2) associated with GSAT intervention was linked to specific fatty acids produced by characteristic intestinal microbiota. These results provide insights into the mechanism underlying the role of the GSAT in improving clinical pregnancy rates.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2617562"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of Concern: Cardiac diseases during pregnancy: who will manage?","authors":"","doi":"10.1080/01443615.2026.2701519","DOIUrl":"https://doi.org/10.1080/01443615.2026.2701519","url":null,"abstract":"","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2701519"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic architecture shared between body shape phenotypes and preeclampsia-related diseases: a genome-wide cross-trait analysis.","authors":"Yuping Shan, Hong Hu, Chong Liu, Wenting Li, Yijing Chu","doi":"10.1080/01443615.2026.2706674","DOIUrl":"https://doi.org/10.1080/01443615.2026.2706674","url":null,"abstract":"<p><strong>Background: </strong>Observational studies have established a strong epidemiological connection between obesity and an increased risk of pre-eclampsia (PE). However, the genetic mechanisms underlying this comorbidity remain largely unexplored. In this study, we conducted a comprehensive cross-trait analysis to elucidate the shared genetic architecture between various adiposity-related traits and PE.</p><p><strong>Methods: </strong>Using the genome-wide association study (GWAS) statistics, we first evaluated the overall genetic overlap between adiposity-related traits and PE through multiple approaches, including linkage disequilibrium score regression (LDSC), high-definition likelihood inference (HDL), genetic covariance analysis, and pleiotropy and annotation methods. Causal relationships were then evaluated through bi-directional Generalised Summary-data-based Mendelian Randomisation (GSMR). Candidate pleiotropic loci were identified using a robust suite of analytical tools, including cross-phenotype association analysis, Multi-Trait Analysis of GWAS (MTAG), pleiotropic analysis under a composite null hypothesis, a pleiotropy-informed conditional false discovery rate (pleioFDR) framework, and Functional Mapping and Annotation (FUMA). Bayesian colocalisation (COLOC) was subsequently applied to these loci to pinpoint independent, significant causal single nucleotide polymorphisms (SNPs). To identify and validate shared genes, we performed tissue enrichment analysis, using Multi-marker Analysis of Genomic Annotation, and integrated SPrediXcan with COLOC. Finally, gene functional enrichment was characterised via Gene Ontology (GO) and Kyoto Encyclopaedia of Genes and Genomes (KEGG) enrichment analyses.</p><p><strong>Results: </strong>We identified significant positive genetic correlations and robust causal associations between adiposity-related traits and PE-related diseases. Our analyses revealed 35 independent significant causal SNPs, 32 enriched tissues, and 7 shared high-confidence genes supported by COLOC analysis.</p><p><strong>Conclusions: </strong>Collectively, our study indicates a genetic correlation and common risk genes, linking adiposity-related traits to PE-related diseases. These findings offer novel insights into the biological mechanisms underlying this comorbidity, highlighting promising targets for future mechanistic studies and stratified preventative strategies.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2706674"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact and sustainability of master trainer-led obstetric emergency skills training in Uganda: a qualitative study.","authors":"Rebecca Hakim, Helen Bailey, Nishel Mohan Shah, John Dalton","doi":"10.1080/01443615.2026.2744788","DOIUrl":"https://doi.org/10.1080/01443615.2026.2744788","url":null,"abstract":"<p><strong>Background: </strong>Maternal mortality remains a major challenge in Uganda, where the maternal mortality ratio is 189 per 100,000 births - fifty time higher than in the UK. The Royal College of Obstetricians and Gynaecologists' Excellence in Obstetric Skills (EOS) and Resilience in Obstetric Skills (ROS) courses used a train-the-trainer model, creating locally based Master Trainers (MTs), to strengthen management of obstetric emergencies in Uganda. This qualitative study explored the perceived impact, benefits and sustainability of these courses from the perspectives of Ugandan MTs and UK-based stakeholders.</p><p><strong>Methods: </strong>A descriptive, cross-sectional qualitative study using semi-structured interviews was conducted with seven purposively sampled participants: five Ugandan MTs and two UK-based stakeholders involved in the programme's development or support. Interviews were conducted via Zoom, transcribed, anonymised and analysed using inductive thematic analysis, following Braun and Clarke's approach, by two independent researchers, with disagreements resolved by discussion and input from senior authors.</p><p><strong>Results: </strong>Four overarching themes were identified: expected outcomes including improved clinical knowledge, escalation and knowledge cascading; unexpected outcomes including career development, improved patient communication and enhanced physical environments; challenges, including variable skills uptake, course duration, funding constraints and staff attrition; and sustainability, spanning funding, government accreditation, workforce retention, mentorship and integration into continuing professional development. Participants perceived increased confidence in managing emergencies and anecdotal reductions in maternal mortality, alongside persistent barriers including a lack of formal accreditation, inconsistent funding and understaffing that limited lasting impact.</p><p><strong>Conclusions: </strong>Participants perceived the EOS/ROS courses to have benefits beyond clinical skills. Reported improvements in maternal care and mortality were anecdotal and do not establish a causal relationship. Sustainable delivery of the Master Trainer model may require formal accreditation, dedicated funding and integration into continuing professional development and ongoing skills development.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2744788"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}