Acta Obstetricia et Gynecologica Scandinavica最新文献

{"title":"AMH measurement is being overused-Are you guilty?","authors":"Antti Perheentupa","doi":"10.1111/aogs.70377","DOIUrl":"https://doi.org/10.1111/aogs.70377","url":null,"abstract":"","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unplanned out-of-hospital deliveries: Insights from 3473 births of a 13-year prospective cohort study in France.","authors":"Charlène Duchanois, Cédric Laurent, Kévin Duarte, François Javaudin, Philippe Pes, Agnès Ricard-Hibon, Thomas Bizouard, Nicolas Bounaud, Olivier Morel, Tahar Chouihed","doi":"10.1111/aogs.70357","DOIUrl":"10.1111/aogs.70357","url":null,"abstract":"<p><strong>Introduction: </strong>Although poorly researched, unplanned out-of-hospital deliveries are considered to carry a high risk of maternal and neonatal complications, with the primary suspected risk factor being the home-to-hospital travel time. The objective of this study was to describe the characteristics of unplanned out-of-hospital deliveries and to identify factors associated with maternal and neonatal complications.</p><p><strong>Material and methods: </strong>Data were collected from the French unplanned out-of-hospital deliveries registry (79 of 402 mobile intensive care units). Analysis included 3473 deliveries between October 2011 and June 2024.</p><p><strong>Results: </strong>Mean women maternal age was 32.0 ± 5.4 years (range 15-49). Median parity was 2.0 (IQR 2.0-3.0). Gestational age was 39.1 ± 2.3 weeks. Most pregnancies were low-risk (84%). Mean home-to-hospital travel time was 20.7 ± 13.6 min (range 0-200), with more than 45 min for only 3% of women (110/3221) and over 1 h for 1% (23/3221). Maternal complications accounted in 8.4% of women (290/3472), placental hemorrhage in 4.5% (156/3471) and maternal death in 0.1% (2/3471). Perinatal complications occurred in 4.4% (149/3393) of all deliveries, with neonatal deaths accounting for 1.1% (38/3456). Among unplanned out-of-hospital deliveries, factors associated with maternal and/or neonatal complications included birth at 32 + 0-33 + 6 weeks of gestation (adjusted OR 2.86, 95% CI 1.69 to 4.83; p < 0.0001), birth before 32 + 0 weeks of gestation (adjusted OR 25.21, 95% CI 12.13 to 52.40; p < 0.0001), and neonatal hypothermia upon hospital admission (adjusted OR 1.74, 95% CI 1.10 to 2.76; p = 0.019). Hypothermia affected 63% of newborns (1256/2002). Unplanned out-of-hospital deliveries prior to mobile intensive care unit arrival were significantly associated with neonatal hypothermia on-site (adjusted OR 2.02, 95% CI 1.57 to 2.61; p < 0.0001) and at hospital admission (adjusted OR 1.56, 95% CI 1.21 to 2.00; p = 0.0005).</p><p><strong>Conclusions: </strong>Severe outcomes of unplanned out-of-hospital deliveries were uncommon but did occur. Complications were associated with prematurity and hypothermia, but not with home-to-hospital travel time. These findings highlight the importance of universal prehospital preparedness, with particular attention to early prevention of neonatal hypothermia and initial hemorrhage management.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal deaths and severe maternal morbidity in the Nordic countries-Time to build collaborative routine surveillance and shared learning to improve healthcare.","authors":"Hilde Marie Engjom, Outi Äyräs, Anna Aabakke, Eva Jonasdottir, Teresia Svanvik, Lill Nyfløt","doi":"10.1111/aogs.70376","DOIUrl":"10.1111/aogs.70376","url":null,"abstract":"","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focusing on VaIN2+: Development and validation of a prediction nomogram based on a large colposcopy population.","authors":"Quanlong Lu, Yao Liu, Jing Li, Chenyao Guo, Ruifang Li, Bo Feng, Xun Gao, Lifang Gao, Zhilian Wang","doi":"10.1111/aogs.70371","DOIUrl":"https://doi.org/10.1111/aogs.70371","url":null,"abstract":"<p><strong>Introduction: </strong>Vaginal intraepithelial neoplasia 2 or worse (VaIN2+) has long remained in a largely passive diagnostic pattern due to the lack of specific clinical manifestations and routine screening strategies. This study aimed to explore its clinical characteristics and develop a prediction model for individualized risk assessment.</p><p><strong>Material and methods: </strong>We retrospectively analyzed the clinical characteristics and human papillomavirus (HPV) genotype distribution in 3259 women undergoing colposcopy at a single center between September 2012 and December 2024. A nomogram was developed based on predictors initially screened by least absolute shrinkage and selection operator regression and finalized through multivariable logistic regression. The model's discriminative ability, calibration, and clinical utility were assessed in both training and validation sets.</p><p><strong>Results: </strong>Among 1192 women with VaIN2+, older age, HPV infection, cytology worse than atypical squamous cells of undetermined significance (ASCUS), and concurrent cervical/vulvar lesions were more prevalent than in 2067 women without vaginal lesions. HPV16, HPV58, HPV52, HPV33, and HPV18 were the most common genotypes. A nomogram was developed based on 10 independent predictors identified by multivariable analysis, including age, hysterectomy history, specific HPV genotypes (16, 58, 56, 35, 39), cytological results (ASCUS and worse), concurrent cervical lesions (cervical intraepithelial neoplasia 1, cervical intraepithelial neoplasia 2 or 3, cervical squamous cell carcinoma), and concurrent vulvar lesions. The nomogram demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.771 in the training set and 0.791 in the validation set. Calibration was satisfactory, and decision curve analysis confirmed superior clinical net benefit across a wide threshold probability range.</p><p><strong>Conclusions: </strong>By profiling VaIN2+ characteristics, this study developed the first prediction model integrating specific HPV genotypes with multiple clinical factors. This model enables clinicians to proactively identify high-risk individuals, thereby facilitating earlier diagnosis and intervention for VaIN2+.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world implementation and acceptability of HPV self-sampling in routine cervical screening: Addressing methodological considerations.","authors":"Saara Kyllönen, Satu Saloranta, Saara Kares, Anu Mustila, Karolina Louvanto","doi":"10.1111/aogs.70373","DOIUrl":"10.1111/aogs.70373","url":null,"abstract":"","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between collagenopathies and the risk of spontaneous preterm birth: A systematic review with selective meta-analysis.","authors":"Kensie Treacy, Brenda F Narice, Denya Williams-Goss, Dilly O C Anumba","doi":"10.1111/aogs.70361","DOIUrl":"10.1111/aogs.70361","url":null,"abstract":"<p><strong>Introduction: </strong>Spontaneous preterm birth (sPTB) remains a leading cause of neonatal morbidity and mortality. Inherited collagenopathies, including Ehlers-Danlos syndrome (EDS) and Marfan syndrome (MFS), may predispose to sPTB through impaired connective tissue integrity; however, the available evidence has not been systematically synthesized according to collagenopathy subtype. We aimed to evaluate the association between inherited collagenopathies and sPTB through a systematic review, undertaking quantitative synthesis only where clinically appropriate and methodologically comparable.</p><p><strong>Material and methods: </strong>This systematic review followed PRISMA 2020 guidelines and was prospectively registered in PROSPERO (CRD420251021631). MEDLINE (PubMed), Embase (Ovid), Scopus, Web of Science, and the Cochrane Library were searched from inception to 30 April 2025. Observational studies comparing pregnancy outcomes in women with inherited collagenopathies and women without collagenopathies were eligible. The primary outcome was sPTB before 37 weeks' gestation. Findings were synthesized narratively according to collagenopathy subtype. Meta-analysis using a Mantel-Haenszel fixed-effect model was undertaken only for clinically comparable MFS studies.</p><p><strong>Results: </strong>Fourteen observational studies met the inclusion criteria. Four studies evaluated MFS, seven evaluated EDS, one assessed vascular EDS exclusively and two included mixed collagenopathy cohorts. Meta-analysis demonstrated that women with MFS had significantly higher odds of sPTB than controls (OR 2.71, 95% CI 2.23-3.30; p < 0.001; I² = 41%). Studies of EDS demonstrated substantial clinical and methodological heterogeneity, precluding meaningful primary quantitative synthesis. Nevertheless, narrative synthesis consistently identified increased frequencies of sPTB and obstetric complications.</p><p><strong>Conclusions: </strong>Inherited collagenopathies appear to be associated with an increased risk of sPTB, although the certainty of evidence differs across phenotypes. The strongest comparative evidence currently exists for MFS, whereas evidence for EDS syndrome remains limited by substantial clinical heterogeneity. These findings support phenotype-specific obstetric assessment and highlight the need for prospective studies with standardized subtype classification and outcome reporting.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-professional simulation training on prolonged labor in Tanzania: A quasi-experimental, pre-post interventional study.","authors":"Signe Egenberg, Lacatus Nyombi, Torbjørn Moe Eggebø, Adelaida Kavishe, Allen Lyimo, Anastasia Ushakova, Cecilia Mushi, Deodatus Massay, Godrule Lyimo, Upendo Kibona, Bariki Mchome","doi":"10.1111/aogs.70364","DOIUrl":"10.1111/aogs.70364","url":null,"abstract":"<p><strong>Introduction: </strong>In many middle-income countries, cesarean section rates have increased substantially and reached levels of more than 50% in urban regions. Prolonged labor and non-reassuring fetal heart rate are the most common indications for intrapartum cesarean section. This intervention can be a life-saving procedure; however, unnecessary cesarean sections can be harmful for the mother and the baby. Reducing the cesarean section rates is highly warranted. We aimed to investigate whether intrapartum cesarean section rates could be reduced by multiprofessional simulation training, and whether the training influenced labor duration and the timing of intrapartum cesarean section.</p><p><strong>Material and methods: </strong>A quasi-experimental, pre-post, interventional study comprising multiprofessional simulation training on prolonged labor and shared decision-making was carried out from May 2022 to September 2024. The training intervention in January 2023 was conducted by local faculty and maternity staff (n = 84) at Kilimanjaro Christian Medical Centre, Tanzania. Preintervention data were collected from May-December 2022, and post-intervention data from February 2023 to September 2024. The primary outcome measure was cesarean section rates during the active labor phase, while labor duration and timing of cesarean sections were secondary outcomes. Survival methods were used to estimate duration of labor and probability of delivery.</p><p><strong>Results: </strong>The study population comprised 3415 women; 1159 preintervention and 2256 post-intervention. The cesarean section rate during the active labor phase was significantly lower after the training: 7.4% preintervention and 2.7% post-intervention (p < 0.01). The overall cesarean section rate was 54.5% preintervention and 51.6% post-intervention (p = 0.11). Most cesarean sections were performed prelabor or during the latent phase. The estimated median duration until vaginal delivery was 330 min (95% CI, 310-350) preintervention and 435 min (95% CI, 426-443) post-intervention. The hazard ratio of cesarean section during the first 20 hours of the active labor phase was 0.33 (95% CI, 0.24-0.46), with preintervention as a reference.</p><p><strong>Conclusions: </strong>This study demonstrated a significant reduction in cesarean section rates during the active labor phase after multiprofessional simulation training on prolonged labor and shared decision-making. The median duration of the active labor phase was longer, and the probability of cesarean section within 20 h of active labor was three times lower.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertensive disorders of pregnancy and gestational diabetes mellitus by birth order: A descriptive study across lifetime reproductive history.","authors":"Sage Wyatt, Linn Marie Sørbye, Liv Grimstvedt Kvalvik, Aditi Singh, Rolv Skjærven","doi":"10.1111/aogs.70366","DOIUrl":"10.1111/aogs.70366","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertensive disorders of pregnancy and gestational diabetes mellitus are known to be strongly related, and underlying maternal cardiometabolic dysfunction has been proposed as a mechanism for both complications. A comparison of the trends by birth order for the two complications may reveal insights into their shared or different causes.</p><p><strong>Material and methods: </strong>We used data from the Medical Birth Registry of Norway from 1999 to 2020 with an aim to compare risk by birth order for hypertensive disorders of pregnancy and gestational diabetes mellitus. Visualizations of cross-sectional risks by birth order are stratified by mother's age, calendar year, and mother's body mass index.</p><p><strong>Results: </strong>The risk of gestational diabetes mellitus appeared to increase by birth order, while hypertensive disorders of pregnancy were most common in first birth. GDM was more common in one-child mothers than mothers with 2 to 4 lifetime births (OR 1.96, 95%CI 1.83, 2.10). For hypertensive disorders, we observed above 50 per 1000 births in first birth, but below 50 per 1000 births for later births, regardless of covariates. We no longer observed this trend by birth order for gestational diabetes (with risk around 60 per 1000 births for 40 year old mothers at any parity, for instance). Higher risk of diabetes in subsequent pregnancies reflects the older age of mothers. Mothers' body mass index is a known risk factor for both complications.</p><p><strong>Conclusions: </strong>The increase in gestational diabetes mellitus by birth order closely reflects trends in other chronological variables like year and age. One explanation for the distinctive rise in gestational diabetes prevalence in later births is secular trends, while secular trends do not fully explain trends by birth order for hypertensive disorders of pregnancy. Different relationships to birth order and secular trends indicate different contributing mechanisms besides maternal cardiometabolic dysfunction in these two complications.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-trimester aspirin allocation strategies and preterm preeclampsia in women with pregestational diabetes: A national multicenter observational cohort study.","authors":"María M Goya, Begoña Vega Guedes, Mónica Ballesteros Pérez, Verónica Perea Castilla, Irene Vinagre Torres, Fernando Bugatto, Ana M Wägner Fahlin, Anna Megía Colet, Judit Amigó Farrán, Manel Mendoza","doi":"10.1111/aogs.70363","DOIUrl":"10.1111/aogs.70363","url":null,"abstract":"<p><strong>Introduction: </strong>Women with pregestational diabetes mellitus (PGDM) are at increased risk of preeclampsia (PE) and are commonly prescribed aspirin prophylaxis based on clinical risk factors alone. First-trimester screening algorithms may allow a more individualized allocation of aspirin. We aimed to compare the association between three first-trimester aspirin allocation strategies and the incidence of preterm PE in women with PGDM in routine clinical practice.</p><p><strong>Material and methods: </strong>This retrospective multicenter observational cohort study included 519 singleton pregnancies with PGDM managed at six tertiary hospitals in Spain between January 2017 and December 2022. Women were classified according to the strategy used to allocate aspirin prophylaxis: clinical risk factor-based prophylaxis, first-trimester algorithm-based screening without placental growth factor (PlGF), or algorithm-based screening including PlGF. The primary outcome was preterm PE (<37 weeks). Secondary outcomes included overall and severe PE, gestational age at delivery, spontaneous preterm birth, birthweight, small-for-gestational-age infants, and neonatal intensive care unit admission. Multivariable regression models were adjusted for prespecified maternal characteristics.</p><p><strong>Results: </strong>Among 519 pregnancies, 255 were managed using clinical risk factor-based prophylaxis, 119 using the algorithm without PlGF, and 145 using the algorithm with PlGF. Aspirin was prescribed to 100%, 16.8%, and 28.3% of women, respectively. Preterm PE rates were 4.7%, 5.9%, and 4.2%, respectively. After multivariable adjustment, no statistically significant differences in preterm PE were observed for the algorithm without PlGF (adjusted odds ratio [aOR] 1.89, 95% confidence interval [CI] 0.62-5.45) or with PlGF (aOR 1.33, 95% CI 0.41-3.91) compared with clinical risk factor-based prophylaxis. Secondary maternal and perinatal outcomes were also comparable across groups.</p><p><strong>Conclusions: </strong>In women with PGDM, algorithm-based aspirin allocation strategies were associated with substantially lower aspirin exposure without evidence of increased preterm PE or adverse perinatal outcomes compared with clinical risk factor-based prophylaxis. However, given the observational design, baseline differences, and limited number of events, the study was not powered to demonstrate equivalence or exclude smaller clinically relevant differences. These findings should therefore be considered exploratory and require confirmation in adequately powered prospective studies.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for infection after hysterectomy for benign disease.","authors":"Sophia Ehrström, Karin Källén, Andrea Stuart","doi":"10.1111/aogs.70362","DOIUrl":"10.1111/aogs.70362","url":null,"abstract":"<p><strong>Introduction: </strong>Our objective was to identify risk factors for infections following hysterectomy for benign disease.</p><p><strong>Material and methods: </strong>This population-based cohort study included hysterectomies recorded in the Swedish National Quality Register for Gynecological Surgery (GynOP) between 2005 and 2022. Data were linked with the Swedish Prescribed Drug Register, the National Patient Register, and Statistics Sweden. Postoperative infection was defined as a dispensed systemic antibiotic prescription within 21 days postoperatively (i.e., not local antibiotics or injectables). Crude and adjusted risk ratios (aRRs) were estimated using modified Poisson regression, adjusting for preoperative medications, demographic and perioperative factors.</p><p><strong>Results: </strong>Among 50 601 hysterectomies, 7153 women (14.1%) had a dispensed prescription of antibiotics postoperatively. Younger age, antidepressant or psycholeptic use, and previous abdominal or cesarean surgery were associated with increased risk of dispensed antibiotics. Endometriosis (aRR 1.30, 95% CI 1.06-1.58), preoperative use of immunoregulatory drugs (aRR 1.48, 95% CI 1.09-2.00), and Body Mass Index (BMI) ≥40 kg/m² (aRR 1.42, 95% CI 1.20-1.68) were independent risk factors. Perioperative complication was the strongest predictor (aRR 2.19, 95% CI 1.97-2.44) for dispensed antibiotics.</p><p><strong>Conclusions: </strong>Prescribed and dispensed antibiotics after benign hysterectomy are common and influenced by several patient- and surgical factors. Identification of high-risk patients such as women with high BMI or using immunomodulating drugs, patients with endometriosis or previous abdominal surgery may support individualized preventive strategies and improve postoperative outcomes.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}