Acta Obstetricia et Gynecologica Scandinavica最新文献

{"title":"Kristeller misunderstood?","authors":"Matthias David","doi":"10.1111/aogs.70030","DOIUrl":"https://doi.org/10.1111/aogs.70030","url":null,"abstract":"","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726427","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":"Survey of practices in the European Federation for Colposcopy: HPV vaccination after treatment for cervical precancerous lesions.","authors":"Annu Heinonen, Ilkka Kalliala, Anne Hammer, Maggie Cruickshank, Xavier Carcopino, Björn Strander, Pekka Nieminen","doi":"10.1111/aogs.70027","DOIUrl":"https://doi.org/10.1111/aogs.70027","url":null,"abstract":"<p><strong>Introduction: </strong>Patients treated for cervical precancerous lesions have a long-term increased risk for cervical cancer compared with the general population. As human papillomavirus (HPV) vaccination is effective in preventing cervical cancer and its precursors when given prior to sexual debut, adjuvant HPV vaccination in relation to the treatment of precursor lesions has been of great interest. Existing supporting data are of low quality, and recent meta-analyses called for high-quality randomized controlled trials. The European Federation for Colposcopy (EFC) observed a heterogeneity in clinical practices of adjuvant vaccination, and this survey aimed to assess potential differences in vaccination practices across Europe.</p><p><strong>Material and methods: </strong>A survey was sent out to 100 representatives of the 32 member countries of the EFC. The survey was in English and contained questions on current general HPV vaccination programs, whether guidelines on vaccination after treatment exist, and questions on respondents' own practices of recommending vaccination after treatment. The survey was constructed using the Google Forms web platform and sent by email to representatives of each National Colposcopy Society.</p><p><strong>Results: </strong>In total, 44 answers from 32 different European countries were received. Overall, 12 countries (12/32, 37.5%) reported having a national guideline on HPV vaccination at the time of treatment for precursor lesions, and in nine of these countries, adjuvant HPV vaccination is recommended. A third, 31.8%, of respondents (14/44) found the available evidence sufficient to recommend vaccination at the time of treatment, and 54.5% (24/44) found the evidence to be nearly sufficient. Only 13.6% (6/44) of the respondents found the current evidence insufficient to be able to recommend vaccination. Altogether, 29.5% (13/44) of respondents would recommend vaccination, even if future randomized controlled trials would not show benefits.</p><p><strong>Conclusions: </strong>The varying practices regarding adjuvant HPV vaccination across European countries are concerning and call for ethical evidence-based practices across Europe and reliance on high-quality evidence to assess whether vaccination at the time of treatment is effective.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726428","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":"Endometriosis—The scapegoat for pelvic pain?","authors":"Gernot Hudelist,&nbsp;Ezgi Darici Kurt,&nbsp;Davor Jurkovic,&nbsp;Tina Tellum","doi":"10.1111/aogs.70014","DOIUrl":"10.1111/aogs.70014","url":null,"abstract":"<p>Cyclic and noncyclic chronic pelvic pain (CPP) represent a major problem for both affected patients and healthcare providers due to its effects on physical and mental health. In times of social media and digitalization, awareness of endometriosis as a leading cause of CPP is increasing. However, a close look at the current literature does not support endometriosis as the predominant and most common cause of pelvic pain syndromes and associated morbidities. Consequently, other or additional factors may be overlooked, complex pain mechanisms simplified, and symptoms misunderstood, resulting in less optimal treatment concepts. This commentary underlines the necessity to evaluate patients with CPP and suspected endometriosis in a multifactorial and holistic context to provide a better framework of patient care.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 9","pages":"1599-1602"},"PeriodicalIF":3.1,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717162","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":"Linear association between endometrial thickness and live birth in single blastocyst transfers: A dual-center retrospective cohort study.","authors":"Lidan Liu, Qiuying Gan, Qianyi Huang, Bin Zeng, Mujun Li, Huimei Wu","doi":"10.1111/aogs.70024","DOIUrl":"https://doi.org/10.1111/aogs.70024","url":null,"abstract":"<p><strong>Introduction: </strong>Our objective was to investigate the linear relationship between endometrial thickness (EMT) and live birth rates (LBR) in single vitrified-warmed blastocyst transfer (SVBT) cycles, and evaluate EMT's independent effect on LBR.</p><p><strong>Material and methods: </strong>A retrospective cohort study analyzed 3375 SVBT cycles conducted at two reproductive centers between June 2016 and December 2022. EMT was stratified into tertiles (<7 mm, 7-8.8 mm, 8.8-10.0 mm, >10.0 mm). Generalized linear models and restricted cubic splines were used to assess the EMT-LBR relationship, adjusting for potential confounders, including maternal age, body mass index, gravidity, parity, and blastocyst quality. Subgroup analyses examined interactions with demographic and clinical variables.</p><p><strong>Results: </strong>Significant positive associations were observed between EMT and LBR across all subgroups. For each 1 mm increase in EMT, the likelihood of live birth increased by 7% (OR = 1.07, 95% CI: 1.03-1.11, p = 0.001). The highest improvements in LBR were seen in women with EMT between 8.8 and 10 mm (OR = 2.37), with a plateau effect observed beyond 10 mm. Subgroup analyses confirmed the consistency of this association across clinical subgroups, with no significant interactions with variables such as maternal age, gravidity, and hormonal profiles. The restricted cubic spline analysis further supported a robust linear positive correlation, remaining stable even after adjusting for potential confounders. These findings emphasize the significant role of EMT in predicting live birth outcomes in assisted reproductive technology.</p><p><strong>Conclusions: </strong>The study confirms a significant linear association between EMT and live birth in SVBT cycles. Higher EMT is consistently linked to improved LBRs, with the most benefit observed around 10 mm. These findings highlight EMT as a key predictor in assisted reproductive technology and emphasize the need for further research to optimize endometrial preparation strategies.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717163","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":"Pattern of unreported negative birth experiences in the maternity ward","authors":"Mette Kring Clausen,&nbsp;Søren Bie Bogh,&nbsp;Søren Fryd Birkeland,&nbsp;Lars Morsø","doi":"10.1111/aogs.70008","DOIUrl":"10.1111/aogs.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Denmark is one of the safest places for childbirth, yet some women report dissatisfaction with their maternity care. However, some negative birth experiences may remain unreported due to thresholds for complaining. The study aimed to identify patterns of unreported negative birth experiences and to quantify the extent of these dark figures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>A survey was distributed to 3081 women who gave birth at a Danish hospital in 2022, resulting in 1022 responses (response rate = 33.2%). The women reported their birth experiences in categories based on the <i>Healthcare Complaints Analysis Tool</i> (HCAT), specifying problems, harm caused, and whether they had filed a complaint or intended to. Dark figure ratios regarding problems and harm levels were calculated by comparing unreported negative experiences to formally filed complaints based on the survey responses, covering each problem type and harm level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 1022 respondents, 336 (32.9%) women reported negative birth experiences, yet only 26 women had filed complaints. The remaining 310 unreported cases comprised 787 problems across HCAT categories. The most frequent problems were about communication and quality. The highest dark figure ratios were found within the management domain comprising institutional processes (13.0) and environment (9.9). The dark figure ratios showed an inverse relationship with harm severity, being highest for minimal (19.5) and minor (21.2) harm levels and decreasing for moderate (5.5), major (4.8) and catastrophic (0.3) harm levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrates a substantial underestimation of negative birth experiences when relying solely on formal complaints, with dark figure ratios ranging from 4.8 to 13, depending on the issue. The inverse relationship between harm severity and dark figure ratios suggests a threshold for filing a complaint, as the likelihood of reporting increases with greater harm. These findings provide novel insights into unreported maternity care experiences, highlighting the need to integrate patient experiences into healthcare improvements.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 9","pages":"1759-1765"},"PeriodicalIF":3.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144705962","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":"Association between intimate partner violence and birth outcomes among pregnant women in the STOP-VIO-PREG cohort: A cohort study utilizing Patient-Reported Outcome and Danish registers data","authors":"Lea B. S. Ankerstjerne,&nbsp;Ditte Linde,&nbsp;Berit Schei,&nbsp;Chunsen Wu,&nbsp;Kristina Martha Renault,&nbsp;Hanne Kristine Hegaard,&nbsp;Janet Fanslow,&nbsp;Vibeke Rasch","doi":"10.1111/aogs.15175","DOIUrl":"10.1111/aogs.15175","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Adverse birth outcomes, such as preterm birth, low birthweight, and small for gestational age, are critical indicators of neonatal health. While the impact of biomedical risk factors is well established, the role of psychosocial stressors, including intimate partner violence, remains less understood. This study investigates the association between intimate partner violence among pregnant women and adverse birth outcomes in a Danish context.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Based on routinely collected Patient-Reported Outcomes, we conducted a cohort study, including 28 697 pregnant individuals. Enrolled in the period from November 2019 to September 2022, the women were followed until childbirth, leading to 22 799 mothers–offspring pairs with valid data. Data on IPV exposure were collected through the Abuse Assessment Screen, detecting physical, psychological, and sexual violence and fear of partner. Birth outcomes were obtained from the Danish registries, including the Danish medical birth registry. Generalized linear models (GLMs) were used to calculate risk ratios (RRs) and 95% confidence intervals (CIs), adjusting for confounders, such as maternal age, socioeconomic position, smoking status, and psychiatric disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 22 799 mothers, 5.3% screened positive for intimate partner violence, and 1.9% reported intimate partner violence within the last year. Intimate partner violence was positively associated with preterm birth and low birthweight, with an increased risk of preterm birth (adjusted RR: 1.24, 95% CI 1.06, 1.45) and increased risk for low birthweight (adjusted RR: 1.35, 95% CI 1.04, 1.75) but showed no significant association with small for gestational age (adjusted RR: 0.93, 95% CI 0.78, 1.11).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our analysis demonstrates a significantly heightened risk of preterm birth and low birthweight among pregnant women who screened positive for intimate partner violence. These results underscore the need for targeted intimate partner violence screening and intervention strategies during prenatal care to reduce the burden of adverse birth outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 9","pages":"1731-1741"},"PeriodicalIF":3.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715045","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":"Long-term outcomes of fertility-sparing treatment in endometrial carcinoma and endometrial intraepithelial neoplasia: Recurrence risk factors over a 9-year follow-up.","authors":"Ya-Ting Hsu, Heng-Cheng Hsu, Chia-Yi Lee, Wan-Ting Hung, Chi-Hau Chen","doi":"10.1111/aogs.70028","DOIUrl":"https://doi.org/10.1111/aogs.70028","url":null,"abstract":"<p><strong>Introduction: </strong>Fertility-sparing treatments using oral progestins have demonstrated promising oncologic outcomes for endometrial intraepithelial neoplasia and early-stage endometrial cancer. However, the high recurrence rate remains a major concern, and the literature on long-term follow-up outcomes is limited. This study aimed to identify recurrence risk factors by analyzing clinicopathological and molecular profiles in a cohort with a median follow-up of 9 years.</p><p><strong>Material and methods: </strong>This retrospective study included patients under 45 years of age who were diagnosed with endometrial intraepithelial neoplasia or endometrial cancer and received fertility-sparing treatments at our center between 2010 and 2021. Patients who achieved complete responses were categorized according to recurrence status. Demographic, clinical, and molecular data were compared between groups. The primary endpoint was to identify risk factors for recurrence; secondary endpoints assessed obstetric and oncologic outcomes in patients with relapse.</p><p><strong>Results: </strong>Out of 40 patients, 8 underwent hysterectomy within 1.5 years, while 32 responded to treatment and continued follow-up. The recurrence and non-recurrence groups contained 20 and 12 patients, respectively, with a median follow-up of 107.5 months (range, 35-175 months). Multivariate analysis showed that a family history of cancer (HR = 2.597, p = 0.039) and treatment with megestrol acetate as the initial therapy (HR = 3.130, p = 0.021) were independent risk factors for shorter time to recurrence. Although mismatch repair deficiency was positively correlated with recurrence, the association did not reach statistical significance (p = 0.057). Four out of 24 patients were upstaged after hysterectomy, and all were in the recurrence group. Nine patients (22.5%) achieved pregnancy, with three successfully conceiving after achieving complete response following retreatment.</p><p><strong>Conclusions: </strong>In patients with long-term follow-up after fertility-sparing treatment, a family history of cancer and initial treatment with megestrol acetate were significantly associated with recurrence.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688581","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":"Real-time telementoring in gynecology ultrasound: Impact on patient pathway and postgraduate training.","authors":"Sughashini Murugesu, Jennifer Barcroft, Alex Novak, Bara'a Elhag, Srdjan Saso, Tom Bourne","doi":"10.1111/aogs.70029","DOIUrl":"https://doi.org/10.1111/aogs.70029","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to determine the value of real-time telementoring for transvaginal ultrasound scan (TVUSS) supervision in gynecology, when compared with current practice in an acute gynecology unit in a London teaching hospital.</p><p><strong>Material and methods: </strong>A prospective cohort study was conducted to compare the timing of ultrasound scans by trainees in current practice (control cohort, n = 100) and compared with a trainee-matched series of cases with telementoring (n = 100). The telementoring cohort used technology (TIMS, Chelmsford MA, USA) to real-time livestream the ultrasound scan to a remote supervisor with an audio connection between the trainee and trainer. Data collected included key scan time points and outcomes. The clinicians completed a questionnaire to evaluate usability, feasibility, and acceptability of the telementoring technology.</p><p><strong>Results: </strong>The prospective trainee TVUSS timing in the control cohort found a 6-min average time to call for a second opinion and a 4.4-min mean wait time, range 1-35 min. The control trainee cohort mean length of TVUSS was 14.2 min, with 62% reporting management changed as a result of senior input. The evaluation of direct livestreaming supervision involved five supervisors and 16 trainees. All participants were satisfied with image quality and 14.2% (3/21) had issues with audio. Once set up effectively, users were satisfied with the ability to communicate. The average length of the gynecology trainee TVUSS with telementoring was 9.1 min, thus on average a 5.1-min reduction (p < 0.001) in the length of the patient scan. The average System Usability Scale score was 81.7. All reported they would be confident using the technology for remote supervision, and qualitative feedback was positive.</p><p><strong>Conclusions: </strong>This comparative cohort study demonstrates the feasibility and usability of TVUSS telementoring as a supervision tool for live scans. The data demonstrate a reduction in the length of the TVUSS when using telementoring, compared with needing to call in a senior colleague midway through the scan, as is current practice. The technology holds the potential to set up a hub with one senior supervising multiple sites remotely, improving access to expert opinion, training, and out-of-hours TVUSS to optimize time to diagnosis and patient management.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688583","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":"Placental growth factor before 11 weeks for screening of preterm preeclampsia: The PreMoM study.","authors":"Rocío López Mármol, José Alejandro Ávila Cabreja, Teresa de Haro Romero, Catalina de Paco Matallana, Olga Ocón Hernández, Otilia González-Vanegas, Pilar Carretero Lucena, María Paz Carrillo, Juan Luis Delgado, Valeria Rolle, Uzay Gormus, Liza Oraha, María M Gil, Francisca S Molina","doi":"10.1111/aogs.70026","DOIUrl":"https://doi.org/10.1111/aogs.70026","url":null,"abstract":"<p><strong>Introduction: </strong>Our objective was to compare the predictive performance of the Fetal Medicine Foundation (FMF) competing-risk model for preterm preeclampsia (PE) screening using placental growth factor (PlGF) measurements obtained at 11-13⁺⁶ weeks versus before 11 weeks of gestation.</p><p><strong>Material and methods: </strong>This multicenter prospective cohort study included women with singleton pregnancies attending their routine first-trimester assessment (11⁺⁰ to 13⁺⁶ weeks) in four hospitals across Spain from 2021 to 2023. Maternal characteristics, biophysical parameters (mean arterial pressure and uterine artery pulsatility index), and biochemical markers (PlGF measured twice in each woman, before 11 weeks and between 11 and 13⁺⁶ weeks) were assessed. Risk assessment for preterm PE was estimated by the FMF algorithm. Predictive performance was evaluated by comparing detection rates (DR) at different fixed screen-positive rates (SPR), area under the receiver-operating characteristic curve (AUROC), and calibration plots. Statistical adjustments were made to account for prophylactic aspirin use.</p><p><strong>Results: </strong>The study population comprised 3448 women, including 19 (0.55%) who developed preterm preeclampsia and 47 (1.36%) who developed term preeclampsia. At 10% SPR, the detection rates (adjusted for aspirin use) were highest for the model incorporating PlGF between 11 and 13⁺⁶ weeks (72.9%; 95% CI, 42.2%-90.9%), compared to models with PlGF before 11 weeks (66.4%; 95% CI, 39.9%-85.4%) and without PlGF (66.0%; 95% CI, 39.3%-85.3%). Similar trends were observed at higher SPR thresholds. The best discrimination (AUROC: 0.863; 95% CI, 0.754-0.971) and calibration were also achieved by the model using PlGF between 11 and 13⁺⁶ weeks.</p><p><strong>Conclusions: </strong>PlGF measured before 11 weeks did not improve preterm PE screening performance. Due to the small number of cases, further validation is needed. Maternal and biophysical markers remain a viable alternative when PlGF is unavailable.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688582","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":"Educational and occupational outcomes during early adulthood following surgically verified endometriosis at a young age-A register-based study.","authors":"Elina Rasp, Liisu Saavalainen, Kristiina Rönö, Mika Gissler, Päivi Härkki, Anna But, Oskari Heikinheimo","doi":"10.1111/aogs.70022","DOIUrl":"https://doi.org/10.1111/aogs.70022","url":null,"abstract":"<p><strong>Introduction: </strong>Endometriosis is associated with educational and occupational challenges, including absenteeism and reduced capacity to study and work. We aimed to investigate long-term educational and occupational outcomes among women diagnosed with endometriosis at a young age. We also assessed whether depression, anxiety, and pain affected these outcomes.</p><p><strong>Material and methods: </strong>We conducted a historical, register-based cohort study of 4532 women diagnosed surgically with endometriosis before age 25 between 1987 and 2012, identified from the Finnish Hospital Discharge Register. Data on education, socioeconomic status, and occupation were available until 2019. We compared outcomes across age groups (25, 26-30, 31-35, and 36-40) between women with endometriosis and references (N = 9014), and within the endometriosis cohort by subtype and mental health status. Categorical and continuous variables were analyzed using Pearson's chi-squared and Wilcoxon tests. Occupational attainments were examined using multinomial logistic regression to assess odds ratios (OR) and mediation analysis to assess the contribution of parity, depression, anxiety, and pain.</p><p><strong>Results: </strong>Median age at diagnosis was 22.9 years (interquartile range 21.3-24.1). Follow-up data were available at ages 26 (n = 13 323, 98.4%), 31 (n = 12 465, 92.0%), and 36 (n = 10 293, 76.0%). Across all ages, women with endometriosis more often had primary or secondary education and were employed in lower-level positions (p < 0.001). Ovarian-only endometriosis was associated with a higher likelihood of tertiary education by ages 31-40 (p < 0.001). Women with endometriosis and preindex depression or anxiety had lower education at younger ages and were more often students or pensioners from age 26 onward (p < 0.001). In multinomial regression, women with endometriosis appeared to attain their highest occupational statuses earlier but at a lower level than matched references. Compared to blue-collar workers, they had lower crude odds of being managers and professionals (OR 0.88, 95% CI [0.81-0.96]). But this association reversed when pain was included in the model (OR 1.15, [1.04-1.28]). Depression/anxiety and pain significantly appeared to be mediating factors via suppressing occupational advancement.</p><p><strong>Conclusions: </strong>Endometriosis diagnosed at a young age is associated with lower educational and occupational attainment, highlighting the long-term socioeconomic impacts. Painful subtypes and preexisting depression or anxiety were associated with poorer outcomes.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688580","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}