Acta Obstetricia et Gynecologica Scandinavica最新文献

{"title":"Risk factors associated with progression from pre-eclampsia to eclampsia: A prospective cohort study and population-wide data analysis","authors":"Annettee Nakimuli,&nbsp;Brittany A. Jasper,&nbsp;Sarah Nakubulwa,&nbsp;Moses Adroma,&nbsp;Jackline Akello,&nbsp;Imelda Namagembe,&nbsp;Musa Sekikubo,&nbsp;Eve Nakabembe,&nbsp;Ashley Moffett,&nbsp;Catherine E. Aiken","doi":"10.1111/aogs.15154","DOIUrl":"10.1111/aogs.15154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Eclampsia is a life-threatening complication of pre-eclampsia. There are currently no means of reliably identifying women with pre-eclampsia who are at the highest risk of progression to eclampsia and would thus benefit from prioritization for intensive monitoring and urgent delivery. This is particularly challenging in obstetric settings where resources are limited. We identify risk factors for the progression of pre-eclampsia to eclampsia in low- and middle-income settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and methods</h3>\u0000 \u0000 <p>Women diagnosed with pre-eclampsia were prospectively recruited at a single tertiary referral centre in urban Uganda (2011–2016). Multivariable logistic regression models were used to identify risk factors that predicted the likelihood of progression to eclampsia. Key findings were validated in a geographically, socioeconomically, and ethnically distinct population using population-wide hospital admission data from Ecuador (2021–2023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In urban Uganda, progression from pre-eclampsia to eclampsia was associated with nulliparity (OR 2.4; 95% CI: 1.1–5.4, <i>p</i> = 0.03), Baganda ethnicity (OR 1.9; 95% CI: 1.1–3.9, <i>p</i> = 0.01), unskilled/unemployed paternal occupation (OR 2.8; 95% CI: 1.3–6.4, <i>p</i> = 0.03), and a trend toward younger maternal age (OR 0.9; 95% CI: 0.9–1.0 per year; <i>p</i> = 0.09). Risk of progression to eclampsia was not related to the severity of pre-eclampsia or the number of antenatal clinic visits. In Ecuador, population-wide analysis showed that progression to eclampsia was associated with younger maternal age (<i>p</i> &lt; 0.001) and a trend toward public vs privately funded obstetric care (<i>p</i> = 0.09).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Eclampsia risk extends beyond clinical markers of pre-eclampsia severity, with socioeconomic factors and maternal age playing crucial roles in disease progression. A targeted, context-specific approach prioritizing high-risk young women with socioeconomic vulnerabilities could optimize healthcare resources and mitigate severe hypertensive disorder risks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 8","pages":"1487-1495"},"PeriodicalIF":3.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15154","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143951703","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":"AI-driven simplification of surgical reports in gynecologic oncology: A potential tool for patient education","authors":"Maximilian Riedel,&nbsp;Bastian Meyer,&nbsp;Raphael Kfuri Rubens,&nbsp;Caroline Riedel,&nbsp;Niklas Amann,&nbsp;Marion Kiechle,&nbsp;Fabian Riedel","doi":"10.1111/aogs.15123","DOIUrl":"10.1111/aogs.15123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The emergence of large language models heralds a new chapter in natural language processing, with immense potential for improving medical care and especially medical oncology. One recent and publicly available example is Generative Pretraining Transformer 4 (GPT-4). Our objective was to evaluate its ability to rephrase original surgical reports into simplified versions that are more comprehensible to patients. Specifically, we aimed to investigate and discuss the potential, limitations, and associated risks of using these simplified reports for patient education and information in gynecologic oncology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>We tasked GPT-4 with generating simplified versions from <i>n</i> = 20 original gynecologic surgical reports. Patients were provided with both their original report and the corresponding simplified version generated by GPT-4. Alongside these reports, patients received questionnaires designed to facilitate a comparative assessment between the original and simplified surgical reports. Furthermore, clinical experts evaluated the artificial intelligence (AI)-generated reports with regard to their accuracy and clinical quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The simplified surgical reports generated by GPT-4 significantly improved our patients' understanding, particularly with regard to the surgical procedure, its outcome, and potential risks. However, despite the reports being more accessible and relevant, clinical experts highlighted concerns about their lack of medical precision.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Advanced language models like GPT-4 can transform unedited surgical reports to improve clarity about the procedure and its outcomes. It offers considerable promise for enhancing patient education. However, concerns about medical precision underscore the need for rigorous oversight to safely integrate AI into patient education. Over the medium term, AI-generated, simplified versions of these reports—and other medical records—could be effortlessly integrated into standard automated postoperative care and digital discharge systems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 7","pages":"1373-1381"},"PeriodicalIF":3.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958862","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 quality of life, vulvar symptoms, and sexual functioning: A cross-sectional study of Norwegian vulvar cancer survivors","authors":"Christin Julia Meltzer-Gunnes,&nbsp;Milada C. Hagen,&nbsp;Yun Wang,&nbsp;Pernille T. Jensen,&nbsp;Ingvild Vistad","doi":"10.1111/aogs.15155","DOIUrl":"10.1111/aogs.15155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Vulvar cancer survivors are at risk of experiencing impaired health-related quality of life and sexual functioning after treatment. However, studies on survivorship challenges, particularly several years after treatment, are scarce. Our aim was to assess health-related quality of life in Norwegian vulvar cancer survivors more than 5 years after treatment and to compare reported vulvar symptoms and sexual functioning with women from a normative sample of the general Norwegian female population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Patients treated primarily for early-stage vulvar squamous cell carcinoma at the Norwegian Radium Hospital between 2006 and 2016 were invited to participate. Health-related quality of life, vulvar symptoms, and sexual functioning were assessed using the EORTC QLQ-C30 and EORTC QLQ-VU34. To recruit a normative sample, the EORTC QLQ-VU34 was also distributed to a sample of Norwegian women with no prior history of cancer. EORTC QLQ-C30 scores among vulvar cancer survivors were compared to “thresholds for clinical importance.” EORTC QLQ-VU34 scores among cancer survivors were compared to those of the normative sample.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 44 (57%) of 77 vulvar cancer survivors completed the questionnaires, and 334 women from the general population were included for the normative sample. A considerable proportion of cancer survivors reported clinically relevant problems: 43% reported impaired physical functioning, while 30% experienced impaired emotional, cognitive, and social functioning. Genital and groin symptoms were significantly more common among cancer survivors than among women in the normative sample. Fewer vulvar cancer survivors were sexually active (9/44 (20%) versus 232/334 (69%)) and they reported a higher degree of sexual dysfunction compared to the normative sample.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Vulvar cancer survivors reported impaired health-related quality of life even several years after treatment. Vulvar complaints and impaired sexual functioning were more common among vulvar cancer survivors than among women from the normative sample.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 8","pages":"1505-1516"},"PeriodicalIF":3.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960667","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–fetal transfer and longitudinal trends of antibodies to Chlamydia trachomatis and Mycoplasma genitalium in early childhood","authors":"Nea Koskela,&nbsp;Julia Butt,&nbsp;Birgitta E. Michels,&nbsp;Kari Syrjänen,&nbsp;Seija Grenman,&nbsp;Tim Waterboer,&nbsp;Stina Syrjänen,&nbsp;Karolina Louvanto","doi":"10.1111/aogs.15105","DOIUrl":"10.1111/aogs.15105","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Sexually transmitted infections caused by <i>Chlamydia trachomatis</i> and <i>Mycoplasma genitalium</i> can have significant implications during early childhood. This study aimed to assess maternal antibodies to <i>C. trachomatis</i> and <i>M. genitalium</i> in newborns, their vanishing, and offspring's own seroconversion to these pathogens during the first 3 years of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Altogether, 309 mother-neonate pairs originally enrolled in the prospective Finnish Family HPV (FFHPV) cohort study at Turku University Hospital, Finland, were analyzed for serum IgG antibodies to plasmid protein gene 3 (pGP3) for <i>C. trachomatis</i> and <i>M. genitalium</i> protein of adhesion (MgPa N-term) and recombinant MgPa for <i>M. genitalium</i> using multiplex serology, by serial sampling during a 3-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A significant correlation between maternal and neonate antibodies to both <i>C. trachomatis</i> and <i>M</i>. <i>genitalium</i> was evident up to 2 months after birth and to <i>C. trachomatis</i> also at 6 months (<i>p</i> &lt; 0.001). During the first 3 years of life, three children seroconverted IgG antibodies to <i>C. trachomatis</i> and one to <i>M. genitalium</i>. At the last (36-month) follow-up visit, five (2.1%) children were seropositive for <i>C. trachomatis</i> and only one (0.4%) for <i>M. genitalium</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both <i>C. trachomatis</i> and <i>M. genitalium</i> IgG antibodies are transferred from the mother to her offspring during pregnancy; similarly, this is shown for nearly all maternal IgG antibodies. Seroconversion for both <i>C. trachomatis</i> and <i>M. genitalium</i> in early childhood was a rare event. Further studies are required to elucidate the significance of <i>C. trachomatis</i> and <i>M. genitalium</i> antibodies acquired in early life.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 7","pages":"1366-1372"},"PeriodicalIF":3.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960729","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":"High-sensitivity CRP is elevated in pregnant women with overweight and obesity and modulated by gestational weight gain","authors":"Ann-Christin Tallarek,&nbsp;Tanja Zeller,&nbsp;Alina Goßling,&nbsp;Caroline Kellner,&nbsp;Gudula Hansen,&nbsp;Mirja Pagenkemper,&nbsp;Charlotte Humke,&nbsp;Evelyn Annegret Huhn,&nbsp;Christopher Urbschat,&nbsp;Petra Clara Arck,&nbsp;Anke Diemert","doi":"10.1111/aogs.15135","DOIUrl":"10.1111/aogs.15135","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The global obesity epidemic presents a growing challenge in perinatal medicine and obstetrics, as it is associated with a higher risk of adverse maternal and perinatal outcomes. In addition to metabolic disturbances, obesity contributes to chronic low-grade inflammation. This study aims to investigate the relationship between maternal overweight, obesity, and excessive weight gain during pregnancy and high-sensitivity C-reactive protein (hs-CRP), an acute-phase reactant of inflammation and infection in maternal serum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>The PRINCE (Prenatal Identification of Children's Health) study is a prospective longitudinal pregnancy cohort conducted at the University Medical Centre Hamburg-Eppendorf in Germany. In this study, biosamples and metadata were collected from 2011 to 2023. Hs-CRP levels were measured in each trimester among 582 healthy, low-risk women. Participants were categorized into weight classes based on their body mass index. Weight gain during pregnancy was evaluated according to the recommendations of the Institute of Medicine. For statistical analysis, the Wilcoxon and Kruskal–Wallis tests were employed for continuous variables, whereas the Mann–Whitney test was used for binary groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Hs-CRP levels are significantly higher in overweight and obese pregnant women throughout their pregnancy. During the first trimester, hs-CRP compared to those of normal-weight individuals (mean 3.4 mg/L; 95% CI 3.1 to 3.7) showed a 1.7-fold increase in overweight (mean 5.9 mg/L; 95% CI 5.0 to 6.7; <i>p</i> &lt; 0.0001) and a 2.7-fold increase in obesity (mean 9.3 mg/L; 95% CI 7.6 to 11.0; <i>p</i> &lt; 0.0001). Excessive weight gain during pregnancy is more common among overweight women (67%) and is associated with 1.5-fold heightened hs-CRP levels in the third trimester (mean 5.6 mg/L; 95% CI 4.7 to 6.4), compared to overweight women who follow the recommended weight gain guidelines (mean 3.7 mg/L; 95% CI 2.9 to 4.4; <i>p</i> = 0.009).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overweight and obesity, along with excessive gestational weight gain in individuals with preexisting overweight status, correlate with elevated levels of hs-CRP during pregnancy. This phenomenon indicates chronic low-grade inflammation in adipose tissue.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 7","pages":"1339-1346"},"PeriodicalIF":3.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957864","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":"Frequency and determinants of words, gestures, and attitudes experienced as disrespectful during childbirth and postpartum: A national population-based study","authors":"Marianne Jacques,&nbsp;Anne Alice Chantry,&nbsp;Anne Evrard,&nbsp;Nathalie Lelong,&nbsp;Camille Le Ray,&nbsp;the ENP 2021 Study Group","doi":"10.1111/aogs.15119","DOIUrl":"10.1111/aogs.15119","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Disrespectful maternity care is receiving increasing attention but remains poorly assessed in high-income countries. The aim was to assess the frequency and determinants of professionals' words, gestures and attitudes experienced as disrespectful by women during childbirth and postpartum stays.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Material and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This national quantitative observational study used the population-based &lt;i&gt;Enquête Nationale Périnatale&lt;/i&gt; (&lt;i&gt;ENP&lt;/i&gt;) 2021 database, which provides a representative sample of women who gave birth in metropolitan France and includes a 2-month postpartum follow-up (&lt;i&gt;n&lt;/i&gt; = 7394). At the 2-month follow-up, women were asked about professionals' words, gestures, and attitudes that made them feel uncomfortable, shocked, or offended during childbirth or postpartum stays. Associations between disrespectful care and maternal, obstetric, and maternity ward characteristics were assessed by robust variance Poisson regression. Multiple imputation was used for missing data, and attrition was accounted for by weighting.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Among the 7332 women analyzed, 24.8% (95% confidence interval 23.8–26.0) reported they experienced disrespectful care (especially words or attitudes), predominantly during the postpartum stay. They were more frequently nulliparous, had a high education level, a birth plan (adjusted relative risk [aRR] 1.20, 95% CI 1.09–1.32) and an instrumental or cesarean birth. Women with a psychiatric history or antenatal psychological distress were more prevalent among women experiencing disrespectful care (aRR 1.43, 95% CI 1.26–1.63). Disrespectful care was reported more frequently when women breastfed. No other maternal (age, place of birth, marital status), obstetric (pregnancy's level of risk, delivery complication), neonatal (term of birth, poor neonatal outcome), postpartum (duration of the stay in the unit), or maternity ward characteristics showed an association.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A quarter of women delivering in France felt they had experienced disrespectful care during childbirth and/or postpartum stay. Support for psychological vulnerabilities and awareness campaigns for all maternity care professionals could improve women's experiences. Professionals should address women's expectations respectfully, especially in complex childbirth situations. The healthcare system may play a role in this phenomenon, although its impact is more challenging to quantify. Interventions are neces","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 6","pages":"1056-1069"},"PeriodicalIF":3.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955562","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":"Polycystic ovary syndrome: What to say when asked about the chance of pregnancy","authors":"Laure Morin-Papunen,&nbsp;Sari Pelkonen,&nbsp;Terhi Piltonen","doi":"10.1111/aogs.15149","DOIUrl":"10.1111/aogs.15149","url":null,"abstract":"&lt;p&gt;Polycystic ovary syndrome (PCOS) was described as early as 1844 by the French doctor Chereau and later by Stein and Leventhal in 1935. PCOS is the most common hormonal disorder in women and affects 11%–15% of the female population. The syndrome is lifelong, characterized by hyperandrogenism, chronic oligo-anovulation, and high risk for several morbidities, and was long considered as an exclusively gynecological condition mainly affecting fertility.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; This is true as PCOS covers about 30% of cases of infertility and 80% of cases with anovulatory infertility. Conversely, about 70%–80% of all women with PCOS have been estimated to suffer from infertility.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; In addition to anovulation, an endometrial component seems to contribute to infertility and poor reproductive outcomes in affected women.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;It is generally accepted that PCOS affects fertility, and many women with PCOS are highly concerned about their reproductive capacity, often having a fear of remaining childless. However, results in general population studies have displayed some uncertainty of results on fecundity in PCOS, mainly due to differences in study population, length of follow-up, and, in some studies, lack of adjustments for confounding factors, such as obesity, male infertility, or use of assisted reproductive technologies (ART).&lt;span&gt;&lt;sup&gt;4-7&lt;/sup&gt;&lt;/span&gt; In three population-based studies,&lt;span&gt;&lt;sup&gt;4-6&lt;/sup&gt;&lt;/span&gt; the overall fertility rate in women with PCOS was decreased,&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; and the women were more often nulliparous at an advanced age compared to other women.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; Moreover, the women ended up having their children older and eventually had fewer children compared to women without the syndrome, with a lower probability of having three or more children.&lt;span&gt;&lt;sup&gt;5, 6&lt;/sup&gt;&lt;/span&gt; However, a Swedish register study&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt; and a population study from Finland&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; showed that women with PCOS had a chance of having at least one child similar to that of other women and that their cumulative probability of childbirth was as high as in other women, especially if ART were available, as is the case in Nordic countries.&lt;/p&gt;&lt;p&gt;One explanation for the good reproductive capacity of women affected may be the increased ovarian reserve as shown by high serum anti-Müllerian hormone (AMH) levels. However, PCOS characteristics, including menstrual cycles and systemic AMH levels, change with aging as the ovarian reserve and hormonal activity decrease, enabling a new, more optimal hormonal balance. Women with PCOS start gaining more regular cycles around the age of 35 years and may have an improved chance to conceive naturally.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; Conversely, this feature should be better recognized in women with PCOS over 40 years of age, as it may also lead to unplanned pregnancies especially if the women have considered themselv","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 7","pages":"1228-1230"},"PeriodicalIF":3.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959355","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":"Induction at 41 weeks: Are we overestimating the benefit?","authors":"Anna E Seijmonsbergen-Schermers, Bahareh Goodarzi, Ank de Jonge","doi":"10.1111/aogs.15151","DOIUrl":"https://doi.org/10.1111/aogs.15151","url":null,"abstract":"","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054092","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":"Validation of data quality in the Swedish quality register of gynecologic cancer for cervical cancer and vulvar cancer—a Swedish gynecologic cancer group (Swe-GCG) study","authors":"Maria Bjurberg,&nbsp;Kristina Hellman,&nbsp;Tim A. Säll,&nbsp;Christian Staf,&nbsp;Christer Borgfeldt,&nbsp;Erik Holmberg,&nbsp;Jenny Jönsson,&nbsp;Gabriel Lindahl,&nbsp;Angelique Flöter Rådestad,&nbsp;Camilla Sköld,&nbsp;Katja Stenström Bohlin,&nbsp;Karin Stålberg,&nbsp;Elisabeth Åvall-Lundqvist,&nbsp;Preben Kjølhede,&nbsp;Pernilla Dahm-Kähler","doi":"10.1111/aogs.15152","DOIUrl":"10.1111/aogs.15152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Population-based registers provide an important source of real-world data. The growing number of large cohort studies using data from cancer registers makes validation of such registers important. The Swedish Quality Register of Gynecologic Cancer (SQRGC) is a nationwide population-based register containing data on patient and tumor characteristics, treatment, and follow-up. To ensure that the results from research and quality assurance reports using SQRGC data are robust and reliable, the accuracy and completeness of the register need to be validated. The aim of this study was to evaluate the quality of data on cervical cancer and vulvar cancer in the SQRGC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Quality of data in the SQRGC was investigated by evaluating completeness, timeliness, comparability, and validity in accordance with recommendations from the International Agency for Research on Cancer and the national Swedish guidelines on validation of cancer registers. Completeness was evaluated by coverage relative to the Swedish National Cancer Register, and timeliness as the time from diagnosis until entry into the SQRGC. We randomly selected 276 women diagnosed with cervical cancer (<i>n</i> = 138) and vulvar cancer (<i>n</i> = 138) between 2014 and 2019 for validation. An external monitor manually re-abstracted data on 10 core variables per sub-register from the patients' medical records. Comparability was assessed by reviewing the adherence to international standards regarding coding. Validity was evaluated by the agreement between re-abstracted data and original data in the SQRGC. Correlations were estimated using Pearson's correlation coefficient and Cohen's kappa coefficient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For cervical cancer, the completeness was 99% and the timeliness was 87.1% within 12 months. The corresponding figures for vulvar cancer were 100% and 87.9%, respectively. Adherence to international coding standards was satisfactory. The median degree of agreement between re-abstracted data and data in the SQRGC was 90.8% (range 73.2%–100%) for cervical cancer, and 85.4% (range 59.6%–98.2%) for vulvar cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The data on cervical and vulvar cancer in the SQRGC are of adequate quality and may well be used for research and clinical purposes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 8","pages":"1530-1538"},"PeriodicalIF":3.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960420","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":"Prenatal diagnostic accuracy and epidemiology of congenital lung malformations: A retrospective review of cases in a tertiary referral center in northern Finland in 2010–2020","authors":"Topias Puumalainen,&nbsp;Tuomas Kauppinen,&nbsp;Hilkka Nikkinen","doi":"10.1111/aogs.15100","DOIUrl":"10.1111/aogs.15100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Our objective was to investigate the accuracy of prenatal diagnoses of congenital lung malformations (CLM) compared to postnatal diagnoses in a population in northern Finland and to estimate the birth prevalence of CLMs in the same population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>A retrospective review of all CLM cases in a tertiary referral center, Oulu University Hospital, Finland, in 2010–2020. Data were collected from medical records. The final postnatal diagnosis was recorded as the pathologic-anatomic diagnosis, if available, and otherwise as the postnatal radiologic diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our case series comprises 37 CLM cases. The prenatal detection rate of CLMs was 100%. The prenatal diagnosis was congenital pulmonary airway malformation (CPAM) in 34/37 cases (92%). The accuracy of prenatal CLM diagnoses was 60% compared to postnatal radiologic diagnoses and 51% compared to final postnatal diagnoses. Relative frequencies of different diagnoses in postnatally confirmed CLM cases were CPAM 47% (16/34 cases), bronchopulmonary sequestration (BPS) 15% (5/34), hybrid CPAM/BPS 15% (5/34), congenital lobar overinflation (CLO) 15% (5/34), bronchial atresia 6% (2/34), and bronchogenic cyst 3% (1/34). Postnatally confirmed cases of CPAM were more likely to have a higher CPAM-volume ratio at diagnosis (<i>p</i> = 0.002), a higher maximum CPAM-volume ratio during pregnancy (<i>p</i> &lt; 0.001), macrocystic appearance on ultrasonography (<i>p</i> = 0.026), and mediastinal shift (<i>p</i> &lt; 0.001) compared with the rest of the cases in this study. The prevalence of all CLMs combined was 3.71 cases per 10 000 live births. The prevalences of CPAM, BPS, hybrid CPAM/BPS, and CLO were 1.69, 0.56, 0.56, and 0.56 cases per 10 000 live births, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We found that all CLMs were detected prenatally, but almost half of the prenatal diagnoses were inaccurate compared to postnatal diagnoses. Most lesions were diagnosed prenatally as CPAM, but postnatally many of them turned out to be BPS, hybrid CPAM/BPS, or CLO. Postnatally confirmed CPAM cases were more likely to have a high CPAM-volume ratio, mediastinal shift, and macrocystic appearance on prenatal ultrasonography compared with other CLMs. The prevalence of CLMs is still relatively poorly documented, but we provide new estimates in Finland.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 6","pages":"1120-1127"},"PeriodicalIF":3.5,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952489","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}