American journal of obstetrics and gynecology最新文献

{"title":"Enhancing the understanding of female sexual function in fertility research.","authors":"Hongnan Shen, Jinguo Cheng","doi":"10.1016/j.ajog.2025.06.003","DOIUrl":"10.1016/j.ajog.2025.06.003","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetics of female pelvic organ prolapse.","authors":"Si-Yun Li, Dong-Zhi Li","doi":"10.1016/j.ajog.2025.06.001","DOIUrl":"10.1016/j.ajog.2025.06.001","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Active surveillance of cervical intraepithelial neoplasia grade 2 is not associated with an increased risk of noncervical anogenital human papillomavirus-related cancer and precancer: a population-based cohort study.","authors":"Dina O Eriksen, Kathrine D Lycke, Johnny Kahlert, Eva B Ostenfeld, Pernille T Jensen, Nicolas Wentzensen, Megan A Clarke, Anne Hammer","doi":"10.1016/j.ajog.2025.05.039","DOIUrl":"10.1016/j.ajog.2025.05.039","url":null,"abstract":"<p><strong>Background: </strong>In recent years, many countries have implemented active surveillance (ie, leaving the lesion untreated) as an option in younger women with cervical intraepithelial neoplasia grade 2 instead of excisional treatment. This is mainly due to the high regression rates of cervical intraepithelial neoplasia grade 2 and the observed increased risk associated with excisional treatment. Women with a previous history of excisional treatment for cervical precancer are at an increased risk of subsequent anogenital cancer and precancer. For a full assessment of the benefits and harms of active surveillance for cervical intraepithelial neoplasia grade 2, we investigated the risk of noncervical anogenital cancers and precancers in women undergoing active surveillance.</p><p><strong>Objective: </strong>We aimed to investigate whether women undergoing active surveillance for cervical intraepithelial neoplasia grade 2 are at an increased risk of vulva, vaginal, or anal cancer and precancer compared to women treated with loop electrosurgical excision procedure.</p><p><strong>Study design: </strong>We conducted a nationwide population-based cohort study in Denmark. We included all female residents diagnosed with incident cervical intraepithelial neoplasia grade 2 at age 18 to 40 years from 1998 to 2020. The primary outcome was vulva, vaginal, or anal cancer or precancer. We stratified by age at cervical intraepithelial neoplasia grade 2 diagnosis (<30 years and ≥30 years), calendar year (1998-2012 and 2013-2020), and index cytology (nonhigh-grade and high-grade). As a secondary outcome, we considered low-grade lesions of the vulva, vagina, and anus. We used Cox regression to estimate hazard ratios of the outcomes with loop electrosurgical excision procedure as the reference group. We used inverse probability treatment weighting to calculate adjusted hazard ratios, considering age, calendar year, and index cytology as confounders.</p><p><strong>Results: </strong>Overall, 27,505 women with cervical intraepithelial neoplasia grade 2 were included; 12,507 (45.5%) underwent active surveillance and 14,998 (54.5%) underwent loop electrosurgical excision procedure. A total of 162 women had a subsequent diagnosis of vulva, vaginal, or anal cancer or precancer. The cumulative risk after 10 years was 0.5% (95% confidence interval, 0.3-0.6). We found no difference in risk between women undergoing active surveillance and those having a loop electrosurgical excision procedure (adjusted hazard ratio, 1.00 [95% confidence interval, 0.71-1.40]). Similar findings were observed when stratifying by age, year of diagnosis, and index cytology. We found that the risk of low-grade lesions of the vulva, vagina, and anus was lower in women undergoing active surveillance than in women treated with loop electrosurgical excision procedure (adjusted hazard ratio, 0.75 [0.62-0.91]).</p><p><strong>Conclusion: </strong>Active surveillance for cervical intraepithelial n","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preconception and first-trimester metformin on pregnancy outcomes in women with polycystic ovary syndrome: a systematic review and meta-analysis.","authors":"James Cheshire, Akanksha Garg, Paul Smith, Adam J Devall, Arri Coomarasamy, Rima K Dhillon-Smith","doi":"10.1016/j.ajog.2025.05.038","DOIUrl":"10.1016/j.ajog.2025.05.038","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the effects of preconception and first-trimester metformin use on pregnancy outcomes in women with polycystic ovary syndrome.</p><p><strong>Data sources: </strong>MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from database inception to August 1, 2024.</p><p><strong>Study eligibility criteria: </strong>Randomized controlled trials of metformin started before conception and continued at least until a positive pregnancy test compared with either placebo or no treatment in women with polycystic ovary syndrome were included.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted. Pooled odds ratios with 95% confidence intervals were calculated for the following key outcomes: miscarriage (primary) and clinical pregnancy and live birth (secondary). The studies were assessed for quality using the Cochrane risk-of-bias tool for randomized trials (RoB 2) and the Grading of Recommendations, Assessment, Development, and Evaluation approach. Indirect comparisons were performed for all key outcomes on the timing of metformin treatment using the Bucher technique.</p><p><strong>Results: </strong>A total of 12 trustworthy studies (involving 1708 women) were included in the meta-analysis, all of which were graded low to moderate quality. Women who received preconception metformin that was continued throughout the first trimester of pregnancy showed higher clinical pregnancy rates (odds ratio, 1.57 [95% confidence interval, 1.11-2.23]), a possible reduction in miscarriage (odds ratio, 0.64 [95% confidence interval, 0.32-1.25]), and possible increase in live birth (odds ratio, 1.24 [95% confidence interval, 0.59-2.61]) than women who received either a placebo or no treatment. Women who stopped metformin once pregnant not only had an increase in clinical pregnancy rate (odds ratio, 1.35 [95% confidence interval, 1.01-1.80]) but also had an indication of an increase in miscarriage rate (odds ratio, 1.46 [95% confidence interval, 0.73-2.90]) compared with those who received a placebo or no treatment. Indirect comparisons between metformin continued through the first trimester of pregnancy and metformin stopped once pregnant consistently demonstrated a trend favoring the continuation of metformin: clinical pregnancy odds ratio of 1.16 (95% confidence interval, 0.74-1.83), miscarriage odds ratio of 0.44 (95% confidence interval, 0.17-1.16), and live birth odds ratio of 1.14 (95% confidence interval, 0.41-3.13).</p><p><strong>Conclusion: </strong>Continuing metformin treatment throughout the first trimester of pregnancy may reduce the risk of miscarriage and increase live birth rates in women with polycystic ovary syndrome. Continuation of metformin seems to have greater clinical benefit than discontinuation of metformin after a positive pregnancy test. There is a need for further high-quality research.</p>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amniocentesis in pregnancies at or beyond 24 weeks.","authors":"Shehbano Syed","doi":"10.1016/j.ajog.2025.05.036","DOIUrl":"10.1016/j.ajog.2025.05.036","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological treatment of hypertension in pregnancy: one does not fit all hemodynamic subtypes.","authors":"Michael Ceulemans, Wilfried Gyselaers","doi":"10.1016/j.ajog.2025.05.024","DOIUrl":"10.1016/j.ajog.2025.05.024","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining the utility of late amniocentesis in high-risk pregnancies.","authors":"Roni Zemet, Ronald J Wapner, Ignatia B Van den Veyver","doi":"10.1016/j.ajog.2025.05.037","DOIUrl":"10.1016/j.ajog.2025.05.037","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanded discussion of limitations for impact of glucagon-like peptide-1 receptor agonist use association with decreased risk of adverse obstetrical outcomes.","authors":"Marisa R Imbroane, Felicia LeMoine, Christopher T Nau","doi":"10.1016/j.ajog.2025.05.029","DOIUrl":"10.1016/j.ajog.2025.05.029","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concerns regarding calculator validation and health equity.","authors":"Ann Ledbetter","doi":"10.1016/j.ajog.2025.05.033","DOIUrl":"10.1016/j.ajog.2025.05.033","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral antihypertensive treatment during pregnancy: can individualized treatment improve maternal and perinatal outcomes?","authors":"Rosalie J Hup, A Titia Lely, Martine Depmann","doi":"10.1016/j.ajog.2025.05.025","DOIUrl":"10.1016/j.ajog.2025.05.025","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}