American journal of obstetrics and gynecology最新文献

{"title":"Risk of endometrial cancer after insufficient endometrial biopsy: A retrospective cohort study.","authors":"Chanella Vang, Kristine Juul Hare, Anna Arday, Reza Rafiolsadat Serizawa, Jeppe Bennekou Schroll","doi":"10.1016/j.ajog.2025.06.015","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.015","url":null,"abstract":"<p><strong>Background: </strong>Endometrial biopsies are used to diagnose abnormalities in the endometrium, but the biopsies are sometimes insufficient.</p><p><strong>Objective: </strong>To evaluate the risk of detecting endometrial cancer in individuals with an insufficient endometrial index biopsy compared to individuals with a normal index biopsy.</p><p><strong>Study design: </strong>In this retrospective cohort study, we used the Danish Pathology Register to identify individuals with endometrial biopsies between 2013 and 2017. We categorized initial and follow-up samples as either normal, insufficient, hyperplastic, or cancer by using SNOMED codes. We had 4 years of follow-up until December 31^st, 2021, and we compared categories with Kaplan-Meier analysis, a log-rank test, and Cox regression.</p><p><strong>Results: </strong>A total of 80,761 Danish individuals were included. Out of these, 13,964 (17.3%) had an insufficient endometrial index biopsy, meaning the index sample contained too little tissue for a definitive diagnosis. From this group, 6,130 (43.9%) individuals had a follow-up endometrial biopsy performed. Unadjusted for age (HR 3.7; 95% CI 3.56-3.84), the incidence of endometrial cancer (n=368; 2.6%) was higher in individuals with an insufficient index biopsy compared to those with a normal index biopsy (n=423; 0.7%). However, when we adjusted for age, the hazard for endometrial cancer was only slightly higher after an insufficient biopsy compared to a normal biopsy (HR 1.16; 95% CI 1.02-1.31).</p><p><strong>Conclusion: </strong>We found an increased risk of detecting endometrial cancer in individuals with an insufficient index biopsy compared to individuals with a normal index biopsy. After adjusting for age, the risk was only slightly increased.</p>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293200","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":"ASSESSMENT OF RISK FOR SMALL FOR GESTATIONAL AGE AT MID-GESTATION TO DEFINE SUBSEQUENT CARE.","authors":"Ioannis Papastefanou, Argyro Syngelaki, Vasileios Logdanidis, Ranjit Akolekar, Kypros H Nicolaides","doi":"10.1016/j.ajog.2025.06.016","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.016","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;We have previously demonstrated that a competing risks model for prediction of small for gestational age (SGA) neonates, has a superior performance to that of the traditional risk-scoring methods. The Fetal Medicine Foundation (FMF) fetal and neonatal population weight charts are derived from the sonographic estimated fetal weight (EFW), rather than birthweight, because a large proportion of babies born preterm arise from pathological pregnancy. The individualized risk assessment for SGA at mid-gestation could be the basis of an antenatal plan that aims to improve the management of preterm SGA pregnancies with minimum resources.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To stratify subsequent assessment after 24 weeks' gestation based on the estimated risk for SGA neonates delivering &lt;28, &lt;32 and &lt;36 weeks' gestation by the combination of maternal risk factors with EFW and uterine artery pulsatility index (triple test), assessed at mid-gestation. The rationale of the study is that those at high risk for SGA &lt;28, &lt;32 and &lt;36 weeks would require ultrasound examinations at 26, 30 and 33 weeks' gestation, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Our cohort was derived from a prospective, non-intervention study in women with singleton pregnancies attending for a routine ultrasound scan at 19&lt;sup&gt;+0&lt;/sup&gt; to 23&lt;sup&gt;+6&lt;/sup&gt; weeks' gestation in two UK maternity hospitals. The competing risks model was used to estimate the individual patient-specific risks of delivery with SGA at &lt;36 weeks' gestation from the triple test. Different risk cut-offs were used with the intention of detecting about 80%, 85% and 90% of cases of delivery with SGA at &lt;28, &lt;32 and &lt;36 weeks' gestation. Discrimination measures by means of sensitivity, specificity, positive and negative predictive values were computed for different risk cut-offs. Calibration for risks for delivery with SGA at &lt;36 weeks' gestation was assessed by plotting the observed incidence of SGA against the predicted incidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study population of 134,443 singleton pregnancies contained 16,813 (12.51%) pregnancies that subsequently delivered SGA neonates &lt;10&lt;sup&gt;th&lt;/sup&gt; percentile, as defined by the FMF chart, including 196 (0.15%), 566 (0.42%), and 1787 (1.33%) that delivered at &lt;28, &lt;32 and &lt;36 weeks, respectively. If the objective of screening was to identify about 80% of cases of delivery of SGA neonates &lt;10&lt;sup&gt;th&lt;/sup&gt; percentile at &lt;28, &lt;32 and &lt;36 weeks' gestation, using the FMF chart to define SGA, the respective screen positive rates would be 9.5%, 19.6% and 29.6%. If the objective of screening was to identify about 80% of cases of delivery of SGA neonates &lt;3&lt;sup&gt;rd&lt;/sup&gt; percentile at &lt;28, &lt;32 and &lt;36 weeks' gestation, using the FMF chart to define SGA, the respective screen positive rates would be 6.5%, 13.0% and 21.6%. The calibration plots demonstrated good agreement between the predicted risk and the observed incidence of SGA.&lt;/p&gt;&lt;","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293173","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":"Association Between Heavy Menstrual Bleeding and Depression Among Women in South Asia: A Cross-Sectional Study.","authors":"Isabel Charles, Madeleine Patrick, Thea Mink, Tanvir Ahmed, Y Malini Reddy, Marisa R Young, Rachel Waford, Bethany A Caruso, Sheela S Sinharoy","doi":"10.1016/j.ajog.2025.06.018","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.018","url":null,"abstract":"<p><strong>Objective: </strong>Heavy menstrual bleeding (HMB) - clinically defined as excessive menstrual blood loss that interferes with physical, emotional, social, and/or material quality of life - adversely affects health and functional outcomes among individuals who menstruate. However, the full extent of the relationships between HMB and health outcomes remains unknown, especially in low- and middle-income countries. To begin to fill this evidence gap, we investigated associations between HMB and depression symptomology among women in South Asia.</p><p><strong>Study design: </strong>We carried out a secondary analysis of cross-sectional data from household surveys conducted with 3,438 adult women between August 2021 and June 2022 in five cities: Meherpur and Saidpur, Bangladesh; and Narsapur, Tiruchirappalli, and Warangal, India. HMB was measured using the clinically validated SAMANTA scale, and depression symptomology was measured using the Center for Epidemiological Studies Short Depression scale (CESD-10). Regression analyses examined associations between HMB and depression symptomology among our analytic sample of 2,564 women who had experienced a menstrual period in the previous 12 months.</p><p><strong>Results: </strong>The prevalence of HMB was 45% across the pooled sample, with city-specific prevalences ranging from 41-46%. The median CESD-10 score was six (range: 4-29, out of a possible 30), with 30% of women scoring above the screening threshold for depression. Pooled analyses revealed a significant association between HMB and increased CESD-10 scores (β: 0.07; 95% CI: 0.03, 0.12) and a 15% increased risk of a binary depression outcome (95% CI: 1.03, 1.29) among women with HMB. City-level analyses showed variability in the strength and significance of these associations, with some cities demonstrating stronger associations than others.</p><p><strong>Conclusion: </strong>The findings highlight the significant burden of HMB on women's mental health in South Asia. Addressing HMB as part of comprehensive women's reproductive health care is crucial for improving overall well-being. The study underscores the need for further research to explore the mechanisms linking HMB and depression, and to develop effective interventions tailored to the specific needs of women in different contexts. Understanding these relationships can provide healthcare providers and policymakers with evidence to better support women's health and mental well-being.</p>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293174","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":"Analysis of Cerebral Palsy sub-types by intrapartum cardiotocography and postnatal neuroimaging.","authors":"Avir Sarkar, Bijoya Mukherjee, Priyanka Mondal, Subrat Panda, Suman Sandeep Samal","doi":"10.1016/j.ajog.2025.06.020","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.020","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293172","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":"FcγR3A polymorphism as a predictive marker for avelumab efficacy in gestational trophoblastic neoplasia.","authors":"Adrien Msika, Pierre-Adrien Bolze, Alice Koenig","doi":"10.1016/j.ajog.2025.05.043","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.05.043","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293197","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":"Effectiveness and safety of medication abortion with vs. without screening ultrasonography or pelvic exam.","authors":"Leah R Koenig, Elizabeth G Raymond, Ushma D Upadhyay, Laura J Frye, Bliss Kaneshiro, Christy M Boraas, Catherine E Oldenburg, David V Glidden","doi":"10.1016/j.ajog.2025.06.013","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.013","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Before the COVID-19 pandemic, clinicians in the United States (U.S.) routinely required in-person screening tests such as ultrasonography or pelvic examination for medication abortion care. To minimize physical contact during the pandemic, clinicians began providing \"no-test\" medication abortion care, which can improve access by facilitating care from a broader range of clinicians, lowering costs, and reducing wait times. Despite evidence that medication abortion without in-person screening tests is safe and effective, screening ultrasound and pelvic examination remain common when medication abortion care is provided in person.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;In this cohort study, we compared the effectiveness and safety of medication abortion provided with and without in-person screening tests, specifically ultrasonography or pelvic examination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;We conducted a retrospective cohort study of medication abortions provided as a part of regular clinical practice by 3 U.S. clinics from February 2020-January 2021. Clinics abstracted medical record data for all patients with gestations &lt;77 days who had neither screening ultrasonography nor pelvic examination (\"no-test\" group) and a random sample who had either test (\"screening test\" group). Participating clinics provided medication abortion care both with and without screening tests during the study period, and patients were screened either in person or via telehealth in both study groups. We imputed missing data and used inverse-probability-of-treatment-weighted logistic regression to compare abortion effectiveness (complete abortion without additional treatment), safety (abortions not involving major adverse events), emergency department visits, and abortions inadvertently provided beyond 77 days (a commonly used pregnancy duration limit for medication abortion) between study groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We included 649 abortions with and 1,727 abortions without screening tests. Patients who obtained medication abortion without screening ultrasonography or pelvic examination had lower average pregnancy durations (48 vs. 50 days, p&lt;0.001), were more likely to be White (43% vs. 32%, p&lt;0.001), were less likely to reside in urban areas (78% vs. 83%, p=0.004), were more likely to receive abortion medications by mail (35% vs. 1%, p&lt;0.001) and were more likely to pay out-of-pocket for abortion costs (62% vs. 55%, p=0.002). Abortion outcomes were documented for 72% of the screening test group and 58% of the no-test group (p&lt;0.001). After imputing missing outcome data, we found similar effectiveness (95.3% vs. 93.4%, Risk Difference [RD]: -1.9% [95% CI: -6.9%, 3.1%]) and safety (99.8% vs. 98.7%, RD: -1.1% [95% CI: -2.9%, 0.7%]) between the screening test and no-test groups. Complete case analyses also found similar effectiveness (95.8% vs. 94.1%, RD: -1.7% [-4.4%, 1.1%]) and safety (100.0% vs. 99.2%, RD: -0.81% [-1.74%, 0.11%]) ","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293196","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":"Obstetric anal sphincter injuries in spontaneous vaginal births in nulliparous pregnant individuals: a 21-year cohort study based on real-world data.","authors":"Laine K, Fodstad K, Räisänen S","doi":"10.1016/j.ajog.2025.06.014","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.014","url":null,"abstract":"<p><strong>Background: </strong>In 2005, the Norwegian Directorate of Health implemented a national care bundle of education and training on correct perineal protection during childbirth to reduce increasing incidence of obstetric anal sphincter injuries (OASIS). The intervention involved manual support of the perineum using one hand protecting the perineum, with the other hand controlling the expulsion speed of the baby's head, communicating with the individual in labor to avoid pushing during the last phase of fetal head crowning to reduce the risk of OASIS, and performing a lateral or mediolateral episiotomy with correct technique by indication when necessary.</p><p><strong>Objective: </strong>To determine the secular trends of OASIS incidence in nulliparous individuals with singleton spontaneous vaginal births at ≥22 weeks´ gestation in Norway during 2002‒2022.</p><p><strong>Study design: </strong>This was a population-based cohort study based on real-world data of 324,930 nulliparous pregnant individuals with singleton spontaneous vaginal births at ≥22 weeks gathered from Medical Birth Registry (MBR) of Norway. The main outcome measure was OASIS incidence during the 21-year time period from 2002 to 2022. Secular trends of OASIS were determined separately for the seven three-year time periods. Both descriptive statistics and multivariable analyses by logistic regression were performed. Both crude and adjusted odds ratios (aOR) with 95% confidence interval (CI) were determined.</p><p><strong>Results: </strong>We observed that the OASIS incidence reduced significantly from 5.4% during 2002‒2004 to 2.1% during 2020‒2022. After adjustment for the individual´s age and country of birth, infant birthweight, use of epidural analgesia and episiotomy, the OASIS incidence was reduced by 63% (adjusted odds ratio = 0.37, 95% confidence interval = 0.34-0.40) from 2002‒2004 to 2020‒2022. This reduction in OASIS incidence was independent of individual characteristics, episiotomy use and infant birthweight. The use of epidural analgesia during birth accounted for 7.8-15.8% of the observed reduction in OASIS incidence between 2002 and 2016.</p><p><strong>Conclusions: </strong>The substantial decrease in OASIS incidence among nulliparous individuals with singleton spontaneous vaginal births can be attributed to the widespread adoption of manual perineal protection techniques, following comprehensive staff training.</p>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293199","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":"A PRAGMATIC APPROACH TO ANTENATAL RISK STRATIFICATION OF LATE FETAL GROWTH RESTRICTION.","authors":"Piyanga Athauda, Raffaele Napolitano","doi":"10.1016/j.ajog.2025.06.008","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.008","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281967","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":"Associations between Parity, Age at Childbirth, and Later-life Mortality in Postmenopausal Women Mediated by Premature Menopause.","authors":"Zailing Xing, Russell S Kirby, Henian Chen, Mary Ashley Cain, Amy C Alman","doi":"10.1016/j.ajog.2025.06.005","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.005","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to examine the long-term effects of parity, age at first childbirth, and age at last childbirth on mortality in postmenopausal women.</p><p><strong>Methods: </strong>The data was from the Women's Health Initiative involving 106,760 postmenopausal women. We used propensity score matching to create matched samples, where each exposure group was matched with a reference group based on their propensity scores. We employed multilevel Cox proportional hazard models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) to examine the associations of parity and age at childbirth with mortality. We conducted multiple mediation analyses to estimate the effects of potential mediators on the associations.</p><p><strong>Results: </strong>Compared to parity of 2, the HRs (95% CIs) for the association of all-cause mortality with parity of 0, 1, 3, 4, and 5+ were 1.09(1.05-1.13), 1.11(1.06-1.16), 1.01(0.99-1.04), 1.00(0.97-1.03), and 1.00(0.96-1.03), respectively. Age at first childbirth of <20, age at last childbirth of <25, and age at last childbirth ≥40 years were associated with increased mortality risks, with the corresponding HRs (95% CIs) of 1.14(1.09-1.19), 1.06(1.02-1.11), and 1.07 (1.00-1.15). Women with parity of 0, 4+, or age at first childbirth <25 years had shorter lifespans than the reference groups. Premature menopause was a significant mediator in the associations of parity and age at first childbirth with mortality.</p><p><strong>Conclusions: </strong>We found long-term adverse impacts of nulliparity and young age at first childbirth on women's mortality risk and lifespan. Premature menopause may operate as a critical intermediate between childbirth and later-life mortality, underscoring the importance to identify at-risk women early.</p>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281969","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":"Association between urinary incontinence and device-measured physical activity: A cross-sectional study.","authors":"Michele O'Shea, Lynda H Powell, Kelly Karavolos, Bryce Daniels, Sheila Dugan, Kelley Pettee Gabriel, Carrie Karvonen-Gutierrez Phd, Sumihiro Suzuki, L Elaine Waetjen, Imke Janssen","doi":"10.1016/j.ajog.2025.06.006","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.006","url":null,"abstract":"<p><strong>Objectives: </strong>Determine the association between urinary incontinence (UI) and physical activity in a well-characterized and racially and ethnically diverse cohort of women. Secondarily, we aimed to determine the association between the frequency of symptoms of UI and UI type (stress, urge, mixed) and accelerometer-based measures of physical activity and sedentary behavior.</p><p><strong>Study design: </strong>Cross-sectional study of 1,098 women who were enrolled in the Study of Women's Health Across the Nation (SWAN), an epidemiologic study of community-dwelling women representing five racial/ethnic groups and seven geographic sites across the United States. For the primary analysis, presence of UI (<1 vs. >1 leakage episode/month) was the primary predictor of selected measures of physical activity including moderate-intensity physical activity (MVPA) minutes, number of MVPA bouts, duration of MVPA bouts, and sedentary minutes. Unadjusted models, and models adjusted age, race and ethnicity, body mass index (BMI), parity, smoking status, mental health status, total comorbidity score, and accelerometer wear time were performed using multivariate linear regression. The same analytic approach was repeated for frequency of episodes of UI and UI subtypes of stress (SUI), urge (UUI), and mixed (MUI) incontinence.</p><p><strong>Results: </strong>Average age was 65±2.7 years, and was comprised of 23.5% Black, 12.5% Chinese, 11.3% Japanese, 4.9% Hispanic/Latina, and 47.8% White women. Prevalence of UI was 65%. In unadjusted analyses, presence of any UI was associated with increased sedentary minutes, decreased MVPA bouts, and decreased amount of time spent in MVPA bouts, but these associations were eliminated when accounting for covariates, particularly age and body mass index. However, frequency of UI episodes (> 1/week) was inversely related to duration of MVPA bouts (beta coefficient: -3.0 minutes, 95% CI: -5.77, -0.24 minutes). This association was strengthened for urgency urinary incontinence (beta coefficient: -3.70, 95% CI: -6.64, -0.77). Any significant unadjusted associations in the remaining variables were primarily accounted for by BMI.</p><p><strong>Conclusions: </strong>Presence of UI was not associated with physical activity estimates. More frequent UUI episodes was associated with less time spent in MVPA. Longitudinal studies are needed to further understand impact of UUI on achievement of physical activity guidelines.</p>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281968","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}