Acta Obstetricia et Gynecologica Scandinavica最新文献

{"title":"A novel multiple marker microarray analyzer and methodology to predict major obstetric syndromes using surface markers of circulating extracellular vesicles from maternal plasma.","authors":"Malene Møller Jørgensen, Rikke Bæk, Jenni K Sloth, Rami Sammour, Adi Sharabi-Nov, Manu Vatish, Hamutal Meiri, Marei Sammar","doi":"10.1111/aogs.15020","DOIUrl":"10.1111/aogs.15020","url":null,"abstract":"<p><strong>Introduction: </strong>Placental-derived extracellular vesicles (EVs) are nano-organelles that facilitate intercellular communication between the feto-placental unit and the mother. We evaluated a novel Multiple Microarray analyzer for identifying surface markers on plasma EVs that predict preterm delivery and preeclampsia compared to term delivery controls.</p><p><strong>Material and methods: </strong>In this prospective exploratory cohort study pregnant women between 24 and 40 gestational weeks with preterm delivery (n = 16), preeclampsia (n = 19), and matched term delivery controls (n = 15) were recruited from Bnai Zion Medical Center, Haifa, Israel. Plasma samples were tested using a multiple microarray analyzer. Glass slides with 17 antibodies against EV surface receptors - were incubated with raw plasma samples, detected by biotinylated secondary antibodies specific to EVs or placental EVs (PEVs), and labeled with cyanine 5-streptavidin. PBS and whole human IgG served as controls. The fluorescent signal ratio to negative controls was log 2 transformed and analyzed for sensitivity and specificity using the area under the receiver operating characteristics curves (AUROC). Best pair ratios of general EVs/PEVs were used for univariate analysis, and top pairs were combined for multivariate analysis. Results were validated by comparison with EVs purified using standard procedures.</p><p><strong>Results: </strong>Heatmaps differentiated surface profiles of preeclampsia, preterm delivery, and term delivery receptors on total EVs and PEVs. Similar results were obtained with enriched EVs and EVs from raw plasma. Univariate analyses identified markers predicting preterm delivery and preeclampsia over term delivery controls with AUC >0.6 and sensitivity >50% at 80% specificity. Combining the best markers in a multivariate model, preeclampsia prediction over term delivery had an AUC of 0.89 (95% CI: 0.72-1.0) with 90% sensitivity and 90% specificity, marked by inflammation (TNF RII), relaxation (placenta protein 13 (PP13)), and immune-modulation (LFA1) receptors. Preterm delivery prediction over term delivery had an AUC of 0.97 (0.94-1.0), 84% sensitivity, and 90% specificity, marked by cell adhesion (ICAM), immune suppression, and general EV markers (CD81, CD82, and Alix). Preeclampsia prediction over preterm delivery had an AUC of 0.91 (0.79-0.99) with 80% sensitivity and 90% specificity with markers for complement activation (C1q) and autoimmunity markers.</p><p><strong>Conclusions: </strong>The new, robust EV Multi-Array analyzer and methodology offer a simple, fast diagnostic tool that reveals novel surface markers for major obstetric syndromes.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"151-163"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142737979","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":"Analysis of self-monitoring of blood glucose metrics in gestational diabetes mellitus and their association with infants born large for gestational age: A historical observational cohort study of 879 pregnancies.","authors":"Nael Shaat, Omar Akel, Karl Kristensen, Anton Nilsson, Kerstin Berntorp, Anastasia Katsarou","doi":"10.1111/aogs.14997","DOIUrl":"10.1111/aogs.14997","url":null,"abstract":"<p><strong>Introduction: </strong>Self-monitoring of blood glucose (SMBG) is the standard of care for women with gestational diabetes mellitus (GDM). This study aimed to review SMBG profiles in women with GDM and to examine how glucose metrics derived from SMBG relate to fetal overgrowth and infants born large for gestational age (LGA, >90th percentile).</p><p><strong>Material and methods: </strong>This was a single-center, historical, observational cohort study of 879 GDM pregnancies in Sweden. The diagnosis of GDM was based on a universal 75 g oral glucose tolerance test at gestational week 28 or 12 in high-risk women. The glucose metrics derived from the SMBG profiles were calculated. Treatment targets for glucose were <5.3 mmol/L fasting, and ≤7.8 mmol/L 1-h postprandial. The median (interquartile range) number of glucose measurements in the analysis for each woman was 318 (216-471), including 53 (38-79) fasting glucose measurements. Associations between glucose metrics and LGA were analyzed using binary logistic regression analysis adjusted for maternal age, body mass index, smoking, nulliparity, and European/non-European origin. Receiver operating characteristic (ROC) curves were used to evaluate glucose levels for LGA prediction. Differences in means were tested using analysis of variance.</p><p><strong>Results: </strong>The proportion of LGA infants was 14.6%. Higher mean glucose levels and smaller proportion of readings in target (glucose 3.5-7.8 mmol/L) were significantly associated with LGA (odds ratio [95% confidence interval]: 3.06 [2.05-4.57] and 0.94 [0.92-0.96], respectively). The strongest association was found with mean fasting glucose (3.84 [2.55-5.77]). The ability of mean fasting glucose and overall mean glucose to predict LGA infants in the ROC curves was fair, with areas under the curve of 0.738 and 0.697, respectively (p < 0.001). The corresponding discriminating thresholds were 5.3 and 6.1 mmol/L, respectively. Mean glucose levels increased and readings in target decreased with increasing body mass index category and at each step of adding pharmacological treatment, from diet alone to metformin and insulin (p < 0.001).</p><p><strong>Conclusions: </strong>Higher mean glucose levels and a smaller proportion of readings within the target range were associated with an increased risk of LGA. Suboptimal glucose control is associated with obesity and the need for pharmacological treatment.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"109-118"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492696","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":"Decreased expression of Syndecan- 1 (CD138) in the endometrium of adenomyosis patients suggests a potential pathogenetic role.","authors":"Walid Shaalan, Mohamed Gamal Ibrahim, Ariana Plasger, Nourhan Hassan, Ludwig Kiesel, Andreas N Schüring, Martin Götte","doi":"10.1111/aogs.15012","DOIUrl":"10.1111/aogs.15012","url":null,"abstract":"<p><strong>Introduction: </strong>Adenomyosis is a special subtype of endometriosis, affecting the myometrium, affecting about 20% of women in the reproductive age period. Clinical symptoms and intensity are diverse and can vary from heavy menstrual bleeding and dysmenorrhea to infertility and repeated pregnancy losses. Thus, patients often present with a long history of illness pending presumptive clinical or surgical diagnosis. A definitive diagnosis of adenomyosis is made upon histopathological examination verifying ectopic endometrial tissue (endometrial glands and/or stroma) within the myometrium, surrounded by hyperplastic and hypertrophic smooth muscles. However, nowadays ultrasonographic and/or MRI signs can precisely detect it as well. The precise etiology and pathogenesis remain unclear. One theory assumes that adenomyosis occurs through metaplastic transformation or migration of stem cell-like cells.</p><p><strong>Material and methods: </strong>Our study examined the immunohistochemical expression of the transmembrane proteoglycan Syndecan-1 (CD 138), a multifunctional matrix receptor and signaling co-receptor, in the endometrium of 35 patients (n = 21 with adenomyosis and n = 14 as a control group) in the period 2016-2017.</p><p><strong>Results: </strong>As a pilot study, we concluded that Syndecan-1 is downregulated in adenomyosis patients compared to the control group, supporting its potential role in the development of adenomyosis. Our study did not find a correlation between the immune-expression of Syndecan-1 and the menstrual cycle phase.</p><p><strong>Conclusions: </strong>For clinical significance in relation to our results, the investigated data showed that the downregulation of Syndecan-1 in adenomyotic patients in our study may suggest a role in promoting the invasiveness of endometriotic islands within the myometrium. However, further studies are still needed to understand the mechanistic contribution of Syndecan-1 to the pathogenesis of adenomyosis.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"77-85"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680485","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":"Surgical outcomes of women undergoing radical resection of deep endometriosis of the sacral plexus: A prospective cohort study.","authors":"Gernot Hudelist, Ezgi Darici Kurt, Gábor Szabó, Dominika Miklos, Theresa Hudelist, Attila Bokor","doi":"10.1111/aogs.15015","DOIUrl":"10.1111/aogs.15015","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical resection of sacral plexus endometriosis (SPE) is contemplated in severely symptomatic patients not responding to medical or hormonal therapy. However, there is only limited data on the effects of surgery on pain and neurological symptoms. This study aims to report on the surgical outcomes in terms of pain and neurological symptom reduction in women undergoing surgical resection of SPE.</p><p><strong>Material and methods: </strong>Thirty premenopausal patients with histologically confirmed SPE who underwent surgical resection of the disease between 2018 and 2024 were included in this multicenter prospective analysis. The primary outcome was the change in neurological symptoms reflected by sacral radiculopathy including dysaesthesia, paraesthesia, hyperaesthesia, and pain. The secondary outcome was post-surgical morbidity reflected by rates of major intra- and postoperative complications.</p><p><strong>Results: </strong>All patients exhibited DE affecting the sacral roots S1-S4, whereas no case of isolated supracardinal sciatic nerve involvement was observed. Out of 30 patients, one was lost to follow-up leaving 29 patients for final analysis. Six (20%) of the 30 patients underwent partial resection of the sacral root because of endometriotic infiltration of the nerval tissue. In all other patients, dissection and shaving with cold scissors were sufficient to remove DE affecting the sacral root. Dysaesthesia was observed in 13/30 (43.3%), paraesthesia in 16/30 (53.3%), hyperaesthesia in 5/30 (16.7%), and secondary motor dysfunction in 4/30 (13.3%), preoperatively. The mean follow-up interval was 25.5 ± 20.2 months showing an overall improvement in sacral radiculopathy in 93.1% (27/29) of the patients. A significant decrease in numeric rating scale (NRS) scores of dysaesthesia (p = 0.003), paraesthesia (p ≤ 0.001) and hyperaesthesia (p = 0.068) were observed post-surgically. Equally, reduced pain symptoms including dysmenorrhea, dyspareunia and dyschezia (all p ≤ 0.001) with a relevant increase in post-surgical quality of life scores (p ≤ 0.001) were recorded. De novo hyperaesthesia and paraesthesia occurred in 6.8% (2/29) and 3.4% (1/29) of the patients, respectively. Major Clavien-Dindo grade III complications occurred in 13.3% (4/30) of the cases.</p><p><strong>Conclusions: </strong>Radical resection of symptomatic deep endometriosis affecting the sacral plexus reduces neurological and pain symptoms and leads to an increase in quality of life but is associated with high surgical morbidity.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"95-101"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749686","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":"Predicting vaginal delivery after labor induction using machine learning: Development of a multivariable prediction model.","authors":"Iolanda Ferreira, Joana Simões, João Correia, Ana Luísa Areia","doi":"10.1111/aogs.14953","DOIUrl":"10.1111/aogs.14953","url":null,"abstract":"<p><strong>Introduction: </strong>Induction of labor, often used for pregnancy termination, has globally rising rates, especially in high-income countries where pregnant women present with more comorbidities. Consequently, concerns on a potential rise in cesarean section (CS) rates after induction of labor (IOL) demand for improved counseling on delivery mode within this context.</p><p><strong>Material and methods: </strong>We aim to develop a prognostic model for predicting vaginal delivery after labor induction using computational learning. Secondary aims include elaborating a prognostic model for CS due to abnormal fetal heart rate and labor dystocia, and evaluation of these models' feature importance, using maternal clinical predictors at IOL admission. The best performing model was assessed in an independent validation data using the area under the receiver operating curve (AUROC). Internal model validation was performed using 10-fold cross-validation. Feature importance was calculated using SHAP (SHapley Additive exPlanation) values to interpret the importance of influential features. Our main outcome measures were mode of delivery after induction of labor, dichotomized as vaginal or cesarean delivery and CS indications, dichotomized as abnormal fetal heart rate and labor dystocia.</p><p><strong>Results: </strong>Our sample comprised singleton term pregnant women (n = 2434) referred for IOL to a tertiary Obstetrics center between January 2018 and December 2021. Prediction of vaginal delivery obtained good discrimination in the independent validation data (AUROC = 0.794, 95% CI 0.783-0.805), showing high positive and negative predictive values (PPV and NPV) of 0.752 and 0.793, respectively, high specificity (0.910) and sensitivity (0.766). The CS model showed an AUROC of 0.590 (95% CI 0.565-0.615) and high specificity (0.893). Sensitivity, PPV and NVP values were 0.665, 0.617, and 0.7, respectively. Labor features associated with vaginal delivery were by order of importance: Bishop score, number of previous term deliveries, maternal height, interpregnancy time interval, and previous eutocic delivery.</p><p><strong>Conclusions: </strong>This prognostic model produced a 0.794 AUROC for predicting vaginal delivery. This, coupled with knowing the features influencing this outcome, may aid providers in assessing an individual's risk of CS after IOL and provide personalized counseling.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"164-173"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724625","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":"AOGS in 2025: Opportunities and challenges.","authors":"Amarnath Bhide","doi":"10.1111/aogs.15044","DOIUrl":"10.1111/aogs.15044","url":null,"abstract":"","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"4-5"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142875726","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 postpartum infection risk following induction of labor: A Danish national cohort study.","authors":"Sidsel Hogh-Poulsen, Sif Emilie Carlsen, Jane M Bendix, Tine D Clausen, Ellen C L Lokkegaard, Paul Vignir Bryde Axelsson","doi":"10.1111/aogs.15035","DOIUrl":"https://doi.org/10.1111/aogs.15035","url":null,"abstract":"<p><strong>Introduction: </strong>Induction of labor is a common procedure, and in Denmark, approximately one in four vaginal deliveries are induced. The association between induction and maternal postpartum infections such as endometritis, surgical site infection after cesarean section, urinary tract infection, and sepsis has been sparsely investigated. Our objective was to investigate the association between induction of labor and risk of maternal postpartum infection and to identify potential risk factors for infection.</p><p><strong>Material and methods: </strong>In a nationwide cohort study, all deliveries with live-born singletons from January 1, 2007, to December 31, 2017 (n = 546 864) were included. Deliveries were grouped into categories of spontaneous onset of labor, induction of labor, and elective cesarean section. The primary outcome was any infection within 30 days postpartum based on discharge diagnosis codes and redeemed antibiotic prescriptions for endometritis, surgical site infection, urinary tract infection, and sepsis. Analyses were done using logistic regression.</p><p><strong>Results: </strong>Infection within 30 days postpartum was found among 8.5% of the women undergoing induction of labor compared to 6.8% of the women with spontaneous onset of labor. In adjusted logistic regression analyses, the risk of postpartum infection was significantly increased after induction of labor compared to spontaneous onset of labor (adjusted ORs [aOR], 1.24; 95% confidence interval [CI], 1.21-1.27). Women with rupture of membranes were not at increased risk of postpartum infection (aOR 1.01; 95%CI 0.94-1.09). The risk of postpartum maternal sepsis was not significantly associated with induction of labor. Antibiotic treatment during pregnancy, pre-eclampsia, and long education were all associated with increased risk of maternal postpartum infection, while either a low or high body mass index and previous deliveries were associated with decreased risk.</p><p><strong>Conclusions: </strong>Induction of labor was associated with an increased risk of maternal postpartum infection. However, the absolute risk was 1.7% higher for the women with induced labor compared to spontaneous onset of labor, which we believe should not be a cause for concern. Unexpectedly, low and high body mass index was associated with decreased risk of infection, and rupture of membranes was not associated with increased risk after induction of labor, which might reflect actual clinical management.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906194","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":"Psychological evaluation of candidates for the uterus transplantation French trial.","authors":"Léa Karpel, Margaux Nicaise, Marie Carbonnel, Mathilde Le Marchand, Catherine Racowsky, Paul Pirtea, Jean-Marc Ayoubi","doi":"10.1111/aogs.15004","DOIUrl":"https://doi.org/10.1111/aogs.15004","url":null,"abstract":"<p><strong>Introduction: </strong>Since 2017, women with absolute uterine infertility due to Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome have been eligible to participate in a uterine transplantation clinical trial conducted by Foch Hospital in France. The aim of this study is to assess the psychological state of potential candidates, including recipients, their partners, and their living-related donors.</p><p><strong>Material and methods: </strong>Sixteen potential uterus transplant candidates, including recipients, partners, and living-related donors, participated in the study. The psychological evaluation of these candidates was conducted using three validated questionnaires: the Dyadic Adjustment Scale (DAS-16), the Hospital Anxiety and Depression Scale (HADS), and the Fertility Quality of Life (FertiQoL) questionnaire.</p><p><strong>Results: </strong>No depression symptoms were observed in any participant according to the HADS. Most recipients did not exhibit signs of anxiety; however, three partners and three donors reported moderate to high anxiety levels. A positive correlation was found between the recipient's psychological distress related to infertility (FertiQoL) and the anxiety scores of their donors. The emotional aspect of infertility was identified as the most distressing factor for the recipients.</p><p><strong>Conclusions: </strong>While the overall psychological state of the participants was generally good, anxiety was notably present among donors and partners. Therefore, providing psychological support throughout the uterine transplantation process is essential for not only the recipients but also their partners and donors.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906209","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":"Association of hemoglobin levels with metabolic traits in women with PCOS.","authors":"Nikke Virtanen, Emilia Pesonen, Ulla Saarela, Elisa Hurskainen, Riikka K Arffman, Peppi Koivunen, Terhi Piltonen","doi":"10.1111/aogs.15047","DOIUrl":"https://doi.org/10.1111/aogs.15047","url":null,"abstract":"<p><strong>Introduction: </strong>Within normal variation, higher hemoglobin (Hb) levels are associated with poorer metabolic profile in population cohorts, underlying the link between oxygen delivery and cell metabolism. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women and is commonly accompanied by metabolic derangements. In this study we sought to investigate Hb levels, and their metabolic associations, in women with PCOS.</p><p><strong>Material and methods: </strong>We used data from Northern Finland Birth Cohort 1966 to evaluate Hb levels in women with or without PCOS at the ages of 31 and 46 years. Linear regression models were used to investigate associations between Hb levels and essential metabolic parameters in both groups.</p><p><strong>Results: </strong>Women with PCOS had higher Hb levels than controls at the age of 31 years but not at the age of 46 years. Hb levels were associated positively with most of the metabolic parameters tested (body mass index, waist circumference, fasting insulin, homeostatic model assessment-insulin resistance (HOMA-IR), blood pressure, inflammatory markers, and blood lipids), with stronger associations in women with PCOS than in non-PCOS controls. There were fewer associations at the age of 46 than at 31 years, and body mass index seemed to explain many, though not all, differences between the PCOS and non-PCOS groups.</p><p><strong>Conclusions: </strong>Women with PCOS have higher Hb levels at the age of 31 years. In both women with and without PCOS, Hb levels associate with poorer metabolic profile.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909114","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":"Pregnancy and perinatal outcomes in women with recurrent pregnancy loss-A case-control study.","authors":"Hanna Hautamäki, Mika Gissler, Jenni Heikkinen-Eloranta, Aila Tiitinen, Pirkko Peuranpää","doi":"10.1111/aogs.15039","DOIUrl":"https://doi.org/10.1111/aogs.15039","url":null,"abstract":"<p><strong>Introduction: </strong>Recurrent pregnancy loss (RPL), defined as two or more pregnancy losses, might be associated with elevated obstetrical and perinatal risks in the following pregnancies. RPL and pregnancy problems related to placental development may have similar etiological features. This study explores the incidences of pregnancy and perinatal outcomes in women with RPL.</p><p><strong>Material and methods: </strong>This retrospective case-control study investigated the outcomes of the next subsequent singleton pregnancy after thorough RPL examination (n = 360) in Helsinki University Hospital, Finland, in 2007-2016. Data for cases and four control women for each case, matched for age, parity, delivery month, year, and hospital (n = 1440), were retrieved from the Medical Birth Register. Primary outcomes were pregnancy and delivery complications, perinatal outcomes, and characteristics of pregnancy follow-up. Secondary outcomes were maternal and neonatal diagnoses. Associations between RPL and outcomes were estimated with risk ratios with 95% confidence intervals (CI). In sub-analyses, we compared the outcomes of secondary RPL with multipara controls and women with unexplained or explained RPL.</p><p><strong>Results: </strong>Women with RPL had a higher risk for gestational hypertension (3.1% vs. 1.4%, risk ratio [RR] 2.20 [Confidence interval (CI) 1.06-4.55], p = 0.03), preterm birth (8.9% vs. 5.8%, RR 1.54 [CI 1.04-2.28], p = 0.04), malpresentation of the fetus (3.3% vs. 1.5%, RR 2.18 [CI 1.09-4.37], p = 0.02), premature rupture of membranes (5.6% vs. 2.4%, RR 2.35 [CI 1.37-4.04], p = 0.002), and had more prenatal visits than controls. Mode of delivery was comparable between the study groups, although RPL women had more induced labor (28.1% vs. 22.2%, RR 1.26 [CI 1.04-1.53], p = 0.02). Mean birthweight was lower (3387 ± 680 g) in RPL women's newborns than in the control group (3482 ± 564 g, p = 0.02), and the risk of umbilical artery pH <7.10 (6.7% vs. 3.6%, RR 1.85 [CI 1.15-2.95], p = 0.03) was higher. Risk ratio for small for gestational age was higher in the secondary RPL group than in multipara controls (5.1% vs. 2.0%, RR 2.50 [CI 1.15-5.42], p = 0.02).</p><p><strong>Conclusions: </strong>Women with a history of RPL seem to have higher risks in their subsequent pregnancies and should therefore be monitored carefully. These findings support the theory of placental development being the common nominator behind hypertensive pregnancy disorders and RPL.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142875729","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}