European Journal of Obstetrics and Gynecology and Reproductive Biology: X最新文献

{"title":"To do or not to do? – Endometrial biopsy in younger women with abnormal uterine bleeding","authors":"Sandra Lynn Jaya-Bodestyne ,&nbsp;Marlene Samantha Goh ,&nbsp;Madeline Chan Hiu Gwan ,&nbsp;Sonali Prashant Chonkar ,&nbsp;Khurshid Merchant ,&nbsp;Manisha Mathur","doi":"10.1016/j.eurox.2025.100368","DOIUrl":"10.1016/j.eurox.2025.100368","url":null,"abstract":"<div><h3>Objective</h3><div>Abnormal uterine bleeding (AUB) can be associated with underlying endometrial pathology. The current existing guidelines discuss the role of endometrial biopsy in women 40 years old and above, however, there are no clear recommendations for younger women. This study aims to identify the factors that increase the risk of endometrial pathology in women below 40 years of age presenting with AUB for consideration of endometrial biopsy.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational study reviewing the records of 464 women aged under 40 years old who underwent endometrial biopsy for AUB. The data analysis included demographics, investigations undertaken, ultrasound findings, biopsy results, and treatment. Multivariable analysis was performed using modified Poisson regression models to compare women with endometrial hyperplasia (EH) (with or without atypia) and endometrial cancer (EC), to those with benign pathology, to identify risk factors for endometrial pathology.</div></div><div><h3>Results</h3><div>In our study, 71.3 % of women had a benign histology, 22.8 % had EH with and without atypia and 2.2 % of women had a diagnosis of EC. A BMI ≥ 30 (RR 1.76, p = 0.002), nulliparity (RR 1.84, p = 0.001), ultrasound findings of thickened endometrium ≥ 15 mm (RR 1.39, p = 0.048) and cystic spaces in the endometrium (RR 1.83, p &lt; 0.001) were identified as significant risk factors after a multivariate analysis. A combination of at least 3 of these risk factors had a cumulative increased risk of EH/EC (RR 3.80, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Endometrial biopsy in younger women with AUB should be carefully considered on a case-by-case basis and reserved for those with risk factors for a serious endometrial pathology.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100368"},"PeriodicalIF":1.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of menopausal hot flushes. Recommendations from the Spanish Menopause Society","authors":"M. Fasero ,&nbsp;M. Sanchez ,&nbsp;L. Baquedano ,&nbsp;I. Gippini ,&nbsp;D. Fuentes ,&nbsp;C. Navarro ,&nbsp;E. Beltrán ,&nbsp;M. Lilue ,&nbsp;I. Porcel ,&nbsp;C. Pingarrón ,&nbsp;M. Herrero ,&nbsp;P. Romero ,&nbsp;T. Ortega ,&nbsp;E. Carretero ,&nbsp;S. Palacios ,&nbsp;N. Mendoza ,&nbsp;P.J. Coronado","doi":"10.1016/j.eurox.2025.100366","DOIUrl":"10.1016/j.eurox.2025.100366","url":null,"abstract":"<div><div>This project aims to develop recommendations for treating vasomotor symptoms (VMS) based on the Cervantes short-form scale score (menopausal domain) using the best available evidence. A total of 166 studies were selected: 108 randomized controlled trials, 23 systematic reviews, 3 reviews, 3 meta-analyses, 11 case-control studies, 9 observational studies, and 12 transversal studies. To achieve this objective, a series of PICO (Patient, Intervention, Comparison, and Outcome) questions have been established for the treatment of VMS. We evaluate the quality of the scientific evidence and, with the findings, create a decision framework to treat hot flashes based on the Cervantes short-form scale score.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100366"},"PeriodicalIF":1.5,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of adult stem cells in obstetrics and gynecology: A scoping review","authors":"Andi Kurniadi ,&nbsp;Muhammad Ary Zucha ,&nbsp;Ardhanu Kusumanto ,&nbsp;Siti Salima ,&nbsp;Ali Budi Harsono","doi":"10.1016/j.eurox.2025.100367","DOIUrl":"10.1016/j.eurox.2025.100367","url":null,"abstract":"<div><h3>Background</h3><div>Advancements in regenerative medicine have led to the applicability of stem cell technology in various diseases. Stem cells that have self-renewable abilities may differentiate into several cell types to provide therapeutic potential. Among different stem cells, adult stem cells are considered as the safest with remarkable potential for therapeutic application. In this review, we provide current available evidence regarding the application of adult stem cells in medicine, especially in the field of obstetrics and gynecology.</div></div><div><h3>Objective</h3><div>This scoping review aims to map and describe the current research on adult stem cell application in obstetrics and gynecology.</div></div><div><h3>Methods</h3><div>We performed a systematic search on PubMed, Google Scholar, and Cochrane Library in August 2024 to identify research articles involving adult stem cells in the field of obstetrics and gynecology. We used the Deduplicate website to filter articles based on keywords that met our inclusion and exclusion criteria. The results were presented based on recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.</div></div><div><h3>Results</h3><div>We found 42 articles that met the inclusion criteria. Some studies were clinical studies, whereas the majority were preclinical studies. We categorized the articles into clinical and preclinical studies to understand their applicability in human subjects.</div></div><div><h3>Conclusions</h3><div>Adult stem cell therapy is a candidate treatment for several pathologies in obstetrics and gynecology. The promising results of adult stem cell therapy, especially in degenerative gynecologic diseases, may lead to further application of the technology in the near future.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100367"},"PeriodicalIF":1.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Apolipoprotein L1 genetic variants and risk of preeclampsia and preterm birth among U.S. Black women","authors":"Shanshan Sheehy ,&nbsp;David Friedman ,&nbsp;Chunyu Liu ,&nbsp;Kathryn L. Lunetta ,&nbsp;Gary Zirpoli ,&nbsp;Julie R. Palmer","doi":"10.1016/j.eurox.2025.100365","DOIUrl":"10.1016/j.eurox.2025.100365","url":null,"abstract":"<div><h3>Background</h3><div>Preeclampsia and preterm birth disproportionally affects Black women, but the current understanding of genetic predisposition to preeclampsia and preterm birth is rudimentary. It has been hypothesized that carriers of high-risk genetic variants in the apolipoprotein L1 gene (<em>APOL1</em>) may have an increased risk of preeclampsia and preterm birth. These genetic variants are found only among individuals of recent African ancestry. Previous studies have been small and have yielded inconsistent results.</div></div><div><h3>Objective</h3><div>To examine whether <em>APOL1</em> genetic variants are associated with risk of preeclampsia or preterm birth.</div></div><div><h3>Study design</h3><div>We conducted a retrospective case-control study of 6616 Black women from the Black Women’s Health Study, a cohort of self-identified Black women in the U.S. Genotype data on <em>APOL1</em> risk alleles for this case control study were obtained through new genotyping and existing genetic data from a prior case control study of breast cancer using the Illumina Infinium Global Diversity Array or Multi Ethnic Genotyping Array. Primary analyses evaluated risk based on a recessive model, comparing women who carried two <em>APOL1</em> risk alleles to women who carried zero or one risk allele. We used multivariable logistic regression models to examine associations among 1473 participants with a history of preeclampsia (cases) and 5143 parous women who had not experienced preeclampsia (controls), and among 1296 participants who had a history of preterm birth and 5320 without such history.</div></div><div><h3>Results</h3><div>The odds ratio (OR) of preeclampsia for two <em>APOL1</em> risk alleles vs. zero or one risk allele was 0.99 (95 % confidence interval (CI): 0.74, 1.32) after adjustment for principal components, genotype platform, and age in 1995. For preterm birth, the comparable multivariable OR was 1.04 (95 % CI: 0.86, 1.25).</div></div><div><h3>Conclusions</h3><div>This large prospective study from a general population of Black women found no evidence of an association of <em>APOL1</em> genotype with risk of either preeclampsia or preterm birth.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100365"},"PeriodicalIF":1.5,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A national survey on Thai medical students’ attitudes towards abortion and their confidence in providing abortion services following the amendment to abortion law","authors":"Hathaipat Leetrakool ,&nbsp;Thanathorn Wonglerttham ,&nbsp;Sornchaya Sonthyanonth ,&nbsp;Jen Sothornwit","doi":"10.1016/j.eurox.2024.100364","DOIUrl":"10.1016/j.eurox.2024.100364","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate medical students' attitudes towards abortion and their confidence in providing abortion services in the future.</div></div><div><h3>Material and methods</h3><div>A national cross-sectional online survey was conducted among fifth and sixth-year medical students from 10 Thai universities. A self-administered questionnaire assessed their knowledge, attitudes, and confidence regarding abortion services. Of 340 questionnaires sent, 234 responses were received. We used descriptive statistics and multivariable analysis to explore agreement with abortion and confidence.</div></div><div><h3>Results</h3><div>The mean attitude score towards abortion was 72.68 ± 7.46 out of 85, with 75.6 % of students indicated a favorable attitude toward abortion. The most widely accepted reasons for abortion were serious congenital anomalies in the fetus (99.6 %) and pregnancy resulting from sexual crimes (98.7 %). However, only 42.8 % of the students were willing to provide abortion services, and 33.8 % felt confident in doing so. Additionally, 77.8 % believed that participating in abortion procedures during medical school would increase their confidence in providing these services. No factors were found to be significantly associated with agreement on abortion.</div></div><div><h3>Conclusion</h3><div>Although most medical students had a positive attitude towards abortion, only a minority expressed willingness and confidence in providing abortion care. These findings underscore the importance of incorporating hands-on experience in abortion procedures in medical school curricula.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100364"},"PeriodicalIF":1.5,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, regional, and national prevalence and disability-adjusted life-years for endometriosis in 204 countries and territories, 1990–2019: Findings from a global burden of disease study","authors":"Dong Yi Shen ,&nbsp;Jing Li ,&nbsp;PanWei Hu ,&nbsp;Cong Qi ,&nbsp;Hong Yang","doi":"10.1016/j.eurox.2024.100363","DOIUrl":"10.1016/j.eurox.2024.100363","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to analyze the worldwide, regional burden of endometriosis and its trends from 1990 to 2019, utilizing the latest data from Global Burden of Disease (GBD) 2019. GBD 2019 is a global database tool for comprehensive analysis and an important result of long-term collaboration among governments worldwide.</div></div><div><h3>Methods</h3><div>We utilized the Global Health Data Exchange Query tool to analyze endometriosis in prevalence numbers, age-standardized prevalence rates (ASPR), and disability-adjusted life-years (DALYs) from 1990 to 2019 in 204 countries and regions. Additionally, this study investigated the impacts of period, age, and cohort on the prevalence and DALYs of endometriosis from the global perspective and in the five sociodemographic index (SDI) regions.</div></div><div><h3>Results</h3><div>Among the 21 regions, the most significant reduction in the prevalence of endometriosis between 1990 and 2019 occurred in Central Latin America. In 204 countries, the most pronounced decline was observed in Guatemala. At the SDI level, with the increase of SDI, the ASPR of endometriosis in all regions worldwide showed an overall decreasing trend. The prevalence of endometriosis peaked between the ages of 25 and 29.</div></div><div><h3>Discussion</h3><div>The findings of this study reflect the temporal and spatial tendency of the burden of endometriosis during the study period, and provide a reference for health agencies around the world to formulate policies on endometriosis, so as to reduce the harm of endometriosis to women worldwide.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100363"},"PeriodicalIF":1.5,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning applications in placenta accreta spectrum disorders","authors":"Mahsa Danaei ,&nbsp;Maryam Yeganegi ,&nbsp;Sepideh Azizi ,&nbsp;Fatemeh Jayervand ,&nbsp;Seyedeh Elham Shams ,&nbsp;Mohammad Hossein Sharifi ,&nbsp;Reza Bahrami ,&nbsp;Ali Masoudi ,&nbsp;Amirhossein Shahbazi ,&nbsp;Amirmasoud Shiri ,&nbsp;Heewa Rashnavadi ,&nbsp;Kazem Aghili ,&nbsp;Hossein Neamatzadeh","doi":"10.1016/j.eurox.2024.100362","DOIUrl":"10.1016/j.eurox.2024.100362","url":null,"abstract":"<div><div>This review examines the emerging applications of machine learning (ML) and radiomics in the diagnosis and prediction of placenta accreta spectrum (PAS) disorders, addressing a significant challenge in obstetric care. It highlights recent advancements in ML algorithms and radiomic techniques that utilize medical imaging modalities like magnetic resonance imaging (MRI) and ultrasound for effective classification and risk stratification of PAS. The review discusses the efficacy of various deep learning models, such as nnU-Net and DenseNet-PAS, which have demonstrated superior performance over traditional diagnostic methods through high AUC scores. Furthermore, it underscores the importance of integrating quantitative imaging features with clinical data to enhance diagnostic accuracy and optimize surgical planning. The potential of ML to predict surgical morbidity by analyzing demographic and obstetric factors is also explored. Emphasizing the need for standardized methodologies to ensure consistent feature extraction and model performance, this review advocates for the integration of radiomics and ML into clinical workflows, aiming to improve patient outcomes and foster a multidisciplinary approach in high-risk pregnancies. Future research should focus on larger datasets and validation of biomarkers to refine predictive models in obstetric care.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100362"},"PeriodicalIF":1.5,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of physical activity during pregnancy with labor and delivery in nulliparous patients","authors":"Shuqun Ren ,&nbsp;Qian Zhao ,&nbsp;Liyin Luo ,&nbsp;Xiaohong You ,&nbsp;Aihong Jin","doi":"10.1016/j.eurox.2024.100361","DOIUrl":"10.1016/j.eurox.2024.100361","url":null,"abstract":"<div><h3>Background</h3><div>Physical activity during pregnancy is a positive behavior for improving pregnancy outcomes, yet the relationship between physical activity during pregnancy and labor is still debated.</div></div><div><h3>Objective</h3><div>This study aimed to test our hypothesis that a higher level of physical activity during pregnancy is associated with a shorter labor duration.</div></div><div><h3>Study design</h3><div>This was a prospective cohort study of pregnant women with singleton pregnancies and no contraindications to physical activity during pregnancy. physical activity according to type and intensity were evaluated with the Chinese version of the Pregnancy Physical Activity Questionnaire. This questionnaire categorizes physical activities into different types and intensities and quantifies them. The primary study outcome was labor duration. The secondary outcomes were delivery mode, conversion from vaginal delivery to cesarean section, prolonged second stage of labor, perineal tears, episiotomy, and postpartum hemorrhage within 24 hours. Generalized additive models were used to identify both linear and nonlinear relationships between physical activity during pregnancy and labor. A segmented linear model was employed to calculate the saturation effect. Stratified logistic regression was used for subgroup analysis.</div></div><div><h3>Results</h3><div>In total, 226 women participated in the physical activity survey during pregnancy and gave birth at our hospital. The energy expenditure of physical activity during pregnancy was 145.70 (111.92, 181.69) weekly energy expenditure (MET-h•wk-1). After full adjustment for covariates, a nonlinear relationship was observed between physical activity during pregnancy and the duration of the first stage of labor. Different correlations were observed when the energy expenditure of physical activity during pregnancy was 142.28 MET-h•wk-1. In the two-part regression model, the inflection point of physical activity during pregnancy was at 142.28 MET-h•wk-1. When the energy expenditure of physical activity during pregnancy exceeded 142.28 MET-h•wk-1, each standard deviation increase in physical activity was associated with a decrease of 149.85 minutes in the duration of the first stage of labor (β:-149.85, 95 % CI: −247.54 to −52.17, P = 0.0080).</div></div><div><h3>Conclusions</h3><div>A nonlinear relationship between physical activity during pregnancy and duration of the first stage of labor ha been identified.When physical activity exceeds 142.28 MET-h•wk-1, each additional standard deviation reduces the first stage of labor by 149.85 minutes. Physical activity is not limited to exercise programs; daily activities such as cleaning, shopping, and walking to and from work are effective ways to increase energy expenditure and help individuals achieve the recommended level of physical activity.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100361"},"PeriodicalIF":1.5,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial womb technology – A more physiologic solution to treating extreme prematurity","authors":"Felix R. De Bie ,&nbsp;Chase C. Binion ,&nbsp;Ryan M. Antiel","doi":"10.1016/j.eurox.2024.100359","DOIUrl":"10.1016/j.eurox.2024.100359","url":null,"abstract":"<div><div>Treatment of extreme premature infants (EPI) is limited by developmental immaturity primarily of the lung. A paradigm shift towards a more physiologic treatment of EPI as fetal neonates or <em>fetonates</em>, by keeping them in a womb-like environment to allow continued organ maturation, is the rationale for artificial womb technology. In this review, we discuss the artificial placenta and womb technology, it’s rationale, the history of its development, the most recent preclinical models described in the literature and finally pertinent ethical considerations.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100359"},"PeriodicalIF":1.5,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological, economic and humanistic burden of cervical intraepithelial neoplasia in Europe: A systematic literature review","authors":"Ugne Sabale ,&nbsp;Miriam Reuschenbach ,&nbsp;Jitender Takyar ,&nbsp;Arju Dhawan ,&nbsp;Adam Hall ,&nbsp;D. Vittal ,&nbsp;Gurkiran Saggu ,&nbsp;Alessandro Ghelardi ,&nbsp;Marta del Pino ,&nbsp;Andrzej Nowakowski ,&nbsp;Stefano Valente","doi":"10.1016/j.eurox.2024.100360","DOIUrl":"10.1016/j.eurox.2024.100360","url":null,"abstract":"<div><h3>Introduction</h3><div>High-grade cervical intraepithelial neoplasia (CIN) is a premalignant lesion of the cervix caused by persistent human papillomavirus (HPV) infection, which can lead to cervical cancer. Despite ongoing primary prevention efforts, considerable burden of illness remains. This study assessed the epidemiological, economic, and humanistic burden associated with high-grade CIN among adult women in Europe.</div></div><div><h3>Methods</h3><div>Systematic literature reviews (SLRs) were conducted for epidemiological, economic, and humanistic burden, in adult women with high-grade CIN in the broader European region. Search strategies were aligned to Cochrane and PRISMA guidelines. Databases searched included Medline®, Embase®, and Cochrane databases (2012–2022). Conference proceedings were also searched (2018–2022). Outcomes of interest included incidence, prevalence, HPV genotype, cost burden, resource use and quality of life burden.</div></div><div><h3>Results</h3><div>Evidence from 41 epidemiological, 11 economic burden, and 8 humanistic burden studies was included. Incidence of high-grade CIN was 31–186/100,000 women-years in a screened population, with prevalence rates of 0.1–2.2 %. Incidence and prevalence of high-grade CIN peaked among women aged 25–39 years. In women with high-grade CIN, high-risk genotypes were among those most commonly identified, including HPV16/18 (57.0–58.7 %), HPV16 (47.4–52.0 %), HPV18 (4.0–15.0 %) and HPV 31/33/45 (38 %). Cost burden and healthcare resource utilization was higher for CIN3 vs. CIN2. High-grade CIN significantly impaired quality of life, across multiple domains vs. healthy population.</div></div><div><h3>Conclusion</h3><div>High-grade CIN was associated with considerable burden in Europe. These findings reveal the multifaceted nature of the impact incurred by women with high-grade CIN, and highlight some of the key areas of unmet need among this patient population.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100360"},"PeriodicalIF":1.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}