American journal of obstetrics and gynecology最新文献

{"title":"ASSOCIATION BETWEEN ENLARGED GENITAL HIATUS AND PROLAPSE WITH OVERACTIVE BLADDER 1 YEAR AFTER VAGINAL DELIVERY.","authors":"Whitney K Hendrickson,Amanda Allshouse,Ingrid E Nygaard,Carolyn W Swenson","doi":"10.1016/j.ajog.2025.04.019","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.04.019","url":null,"abstract":"BACKGROUNDGenital hiatus enlargement is associated with pelvic organ prolapse and overactive bladder 5-10 years after first delivery. It is unknown if this association is present earlier postpartum.OBJECTIVE(S)To understand the association between overactive bladder within 1 year after first vaginal delivery and 1) enlarged genital hiatus, 2) anatomic pelvic organ prolapse, and 3) bulge symptoms.STUDY DESIGNThis is a secondary analysis of a prospective cohort study of primiparous women with a singleton term vaginal delivery who completed symptom questionnaires and physical exams at the 3rd trimester, 8 weeks and 1 year postpartum. We defined overactive bladder as the presence of urinary urgency, plus urinary frequency or nocturia, or urgency incontinence on the Epidemiology of Prolapse and Incontinence Questionnaire. Enlarged genital hiatus was > 4 cm and anatomic pelvic organ prolapse was vaginal descent at or beyond the hymen. We evaluated associations of overactive bladder with genital hiatus, and pelvic organ prolapse at 1 year postpartum using Poisson regression.RESULTSWe included 579 people with mean age of 29yo and 17% Hispanic. In separate models, enlarged genital hiatus and anatomic pelvic organ prolapse at 1 year postpartum were each associated with increased overactive bladder prevalence at 1 year postpartum (genital hiatus: adjusted risk ratio 1.5, 95% CI 1.1-2.1; pelvic organ prolapse: adjusted risk ratio 1.8, 95% CI 1.2-2.6). These effects were greater in women >30 years (genital hiatus: adjusted risk ratio 2.1, 95%CI 1.3-3.4; pelvic organ prolapse: adjusted risk ratio 2.2, 95% CI 1.3-3.7) and were not significant in women <30 years.CONCLUSION(S)Enlarged genital hiatus and pelvic organ prolapse at 1 year postpartum are associated with overactive bladder as early as 1 year postpartum, particularly in women >30 years. Genital hiatus may be a marker of pelvic floor function that, when impaired, increases the risk of pelvic organ prolapse and overactive bladder after delivery.","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"19 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851034","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":"The association between serum sFlt-1, PlGF and sFlt-1/PlGF ratio in singleton pregnancy and placental abruption: a systematic review and meta-analysis.","authors":"Katarzyna Kosińska-Kaczyńska,Iwona Szymusik,Robert Brawura Biskupski Samaha,Dorota Sys","doi":"10.1016/j.ajog.2025.04.020","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.04.020","url":null,"abstract":"OBJECTIVEThe study aimed to evaluate whether women with singleton pregnancies who experienced subsequent placental abruption had lower serum PlGF concentrations, higher serum sFlt-1 concentrations, and a higher sFlt-1/PlGF ratio compared to women with singleton pregnancies without placental abruption.DATA SOURCESPubMed/MEDLINE, Scopus and the Web of Science and Clinicaltrial.gov databases had been searched electronically until March 2025, using combinations of relevant medical subject heading terms, keywords and word variants considered suitable for the topic.STUDY ELIGIBILITY CRITERIAProspective and retrospective comparative cohort studies and case-control studies were included. Case reports, editorials, letters to the editor and conference abstracts were excluded from the systematic review.STUDY APPRAISAL AND SYNTHESIS METHODSThe outcome of the study included differences in PlGF, sFlt-1 concentrations or the sFlt-1/PlGF ratio between placental abruption cases and a group without placental abruption. The quality assessment of the included studies was performed using the Newcastle-Ottawa Scale. Continuous data were expressed as the mean difference (MD) with a 95% confidence interval when the units of measurement for the outcome variable were the same. When conducting the meta-analysis, a random effects model was consistently employed.RESULTSThe main findings of this systematic review and meta-analysis are as follows: (1) maternal serum PlGF concentration did not differ between women with and without placental abruption; (2) maternal serum sFlt-1 concentration was higher in women with placental abruption, especially when assessed in the second half of gestation; (3) maternal serum sFlt-1/PlGF ratio was higher in women with placental abruption, both in the first and second half of pregnancy, with the difference being no longer significant in women with the diagnosis or symptoms of preeclampsia.CONCLUSIONThe results presented in this systematic review may improve the risk stratification for placental abruption. Understanding the changes of the above markers in placental abruption may support clinical guideline development with regard to prediction models of the above complication.","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"68 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849562","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":"Perinatal use of non-alcoholic beverages that mirror alcohol.","authors":"Molly A Bowdring,Meryl M Sperling,Xi D Plummer,Judith J Prochaska","doi":"10.1016/j.ajog.2025.04.016","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.04.016","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"74 5 Pt 1 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836532","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":"Wearable devices likely pose minimal biological risk to female reproductive health.","authors":"Sarah C Cromack,Jessica R Walter","doi":"10.1016/j.ajog.2025.04.013","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.04.013","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"40 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827095","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":"The biological effects of smart devices and wearables on reproductive health.","authors":"Rasha A Al-Lami","doi":"10.1016/j.ajog.2025.04.012","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.04.012","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"77 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827106","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":"The association of cytomegalovirus hyperimmune globulin with adverse pregnancy outcomes.","authors":"Dwight J Rouse,Cora MacPherson,George R Saade,Mara J Dinsmoor,Uma M Reddy,Robert Pass,Donna Allard,Gail Mallett,Rebecca G Clifton,Cynthia Gyamfi-Bannerman,Michael W Varner,William H Goodnight,Alan T N Tita,Maged M Costantine,Geeta K Swamy,Kent D Heyborne,Edward K Chien,Suneet P Chauhan,Yasser Y El-Sayed,Brian M Casey,Samuel Parry,Hyagriv N Simhan,Peter G Napolitano,George A Macones,Brenna L Hughes,","doi":"10.1016/j.ajog.2025.04.014","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.04.014","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"21 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827096","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":"Survival effect of adjuvant therapy for low-risk endometrial cancer with isolated tumor cells.","authors":"Koji Matsuo,Matthew W Lee,X Mona Guo,Aaron D Masjedi,Bonnie B Song,Maximilian Klar,Shinya Matsuzaki,Lynda D Roman,Jason D Wright","doi":"10.1016/j.ajog.2025.04.015","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.04.015","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"23 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827094","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: a systematic review and network meta-analysis.","authors":"Rosalie J Hup,Johanna A A Damen,Jonne Terstappen,Mirthe J Klein Haneveld,Fieke Terstappen,Laura A Magee,A Titia Lely,Martine Depmann","doi":"10.1016/j.ajog.2025.04.011","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.04.011","url":null,"abstract":"OBJECTIVEConsidering safety and effectiveness of oral antihypertensive agents when treating hypertensive disorders of pregnancy, no preference can be stated between the three agents currently available. Therefore, this systematic review and network meta-analysis aims to determine the effects of antenatal treatment with methyldopa, labetalol or nifedipine for hypertensive disorders of pregnancy regarding maternal or fetal/neonatal morbidity and mortality.DATA SOURCESOn August 25th, 2023, an electronic search in PubMed/Medline, Embase and CENTRAL was performed.STUDY ELIGIBILITY CRITERIARCTs reporting on perinatal outcomes in hypertensive pregnancies treated with oral antihypertensive agents of interest (methyldopa, labetalol or nifedipine) or placebo/no treatment were identified.STUDY APPRAISAL AND SYNTHESIS METHODSQuality assessment was performed using the Cochrane Risk-of-Bias tool for RCTs and trustworthiness was assessed with the Trustworthiness in RAndomised Controlled Trials Checklist. Data on our predefined outcomes was extracted and relative risks were calculated in network estimates if possible.RESULTS23 trials (3989 women) were included in our network meta-analysis with an overall low-to-moderate quality. Compared to placebo/no treatment, labetalol and methyldopa significantly reduced the incidence of severe hypertension (including 8 studies, relative risk 0.20 (95% confidence interval 0.09-0.48); and 0.44 (0.20-0.99); respectively. In the network meta-analysis labetalol versus nifedipine was associated with a reduction in preeclampsia (relative risk 0.50 (0.28-0.87); 15 studies) and preterm birth (relative risk 0.68 (0.52-0.90); 14 studies). No significant differences could be detected for any of the other outcomes of interest.CONCLUSIONWhen comparing the oral antihypertensive agents currently available head-to-head no significant differences on the primary outcome severe hypertension could be detected as well as on most of the secondary outcomes of interest. Considering the preference of labetalol over nifedipine regarding the outcomes preeclampsia and preterm birth a modest favor for labetalol could be stated. Included studies however were of low overall quality warranting caution when interpretating results.","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"118 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824821","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":"Evidence for improved glucose metrics and perinatal outcomes with continuous glucose monitoring compared to self-monitoring in diabetes during pregnancy.","authors":"Jessica Burk,Glynis P Ross,Teri L Hernandez,Stephen Colagiuri,Arianne Sweeting","doi":"10.1016/j.ajog.2025.04.010","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.04.010","url":null,"abstract":"OBJECTIVEContinuous glucose monitoring (CGM) is recommended for pregnant women with type 1 diabetes (T1D), due to associations with decreased HbA1c and large-for-gestational age (LGA). However, its benefit in type 2 diabetes (T2D) and gestational diabetes (GDM) is not established. This systematic review and meta-analysis compared usage of CGM to self-monitoring of blood glucose (SMBG) both across and within diabetes in pregnancy (DIP), and determined which glucose metrics are associated with perinatal outcomes, to potentially inform treatment targets in DIP.DATA SOURCESWe searched Medline, Embase, CENTRAL, CINAHL and Scopus, from January 2003 to August 2024.STUDY ELIGIBILITY CRITERIARandomized controlled trials and quasi-experimental studies comparing CGM with SMBG in DIP were included.STUDY APPRAISAL AND SYNTHESIS METHODSRCTs and quasi-experimental studies were analyzed separately. Data were extracted on CGM glucose metrics, HbA1c, rates of cesarean delivery, LGA, small-for-gestational age (SGA), neonatal hypoglycemia and neonatal intensive care unit (NICU) admission, summarized as mean differences (MD) or odds ratios (OR) with 95% Confidence Intervals (95%CI) and 95% Prediction Intervals (95%PI). Prespecified subgroup analyses were undertaken by DIP subtype, including duration of CGM use (continuous vs intermittent) for LGA. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework.RESULTSAcross DIP, CGM (vs SMBG) decreased HbA1c (MD -0.22% [95%CI: -0.37, -0.08]) (7 RCTs, moderate-certainty evidence). Within DIP, CGM use (vs SMBG) showed similar but stronger benefits in both T1D when used throughout pregnancy (HbA1c MD -0.18% [95%CI: -0.36, 0.00], LGA OR 0.51 [0.28, 0.90]) (1 RCT, high-certainty evidence), and GDM when used intermittently (HbA1c MD -0.18 [95%CI: -0.33, -0.02]) (5 RCTs, moderate-certainty evidence) and LGA (OR 0.46 [0.26, 0.81]) (1 quasi-experimental study, low-certainty evidence), with insufficient data for CGM benefit in T2D. Increased pregnancy %time-in-range (T1D) and decreased mean sensor glucose (T1D/GDM) were associated with decreased LGA.CONCLUSIONSUsage of CGM (vs SMBG) reduces HbA1c and possibly LGA across DIP. Greatest benefit was evidenced in T1D, followed by GDM, although CGM duration differed. Mean sensor glucose and pregnancy %time-in-range are important CGM metrics for reducing LGA.","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"37 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824817","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":"Female reproductive factors and metabolic dysfunction-associated steatotic liver disease: an integrated analysis of population cohort, liver imaging, and genetic data.","authors":"Meng-Yuan Miao,Wen-Wen Han,Jie-Qiong Lyu,Zhong-Yue Liu,Wei Jiang,Zheng Zhang,Zhengbao Zhu,Li-Qiang Qin,Guo-Chong Chen","doi":"10.1016/j.ajog.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.04.007","url":null,"abstract":"BACKGROUNDWhile premenopausal women are at a lower risk for metabolic dysfunction-associated steatotic liver disease (MASLD) than men within the same age group, the sex advantage becomes minimal after menopause, suggesting a role for female hormones.OBJECTIVETo elucidate the role of reproductive factors in the development of female MASLD, using an integrated analysis.STUDY DESIGNUp to 269,607 women without MASLD during baseline recruitment (2006-2010) of the UK Biobank were included. Among these, there were 21,017 women who did not develop MASLD across the follow-up period (through December 2021) and had the measure of liver proton density fat fraction (PDFF) quantified by magnetic resonance imaging since 2014. Multivariable Cox regression models were applied to assess the prospective relationships of various reproductive factors with incident MASLD. Multiple linear regression models were used to explore the relationships of reproductive factors with liver PDFF. A two-sample Mendelian randomization (MR) analysis was further carried out to investigate the causality for the relationships of certain reproductive factors with MASLD.RESULTSDuring a median of 12.65 years of follow-up, 3077 incident cases of MASLD were identified. Early menarche, a greater number of live births, younger age at first live birth, and oral contraceptive or hormone replacement therapy (HRT) initiated at a young age were associated with an elevated risk of MASLD and higher levels of liver PDFF. Several other reproductive factors (i.e., a greater number of miscarriages, surgical menopause at a young age, and prolonged use of HRT) were associated with incident MASLD but not with liver PDFF. In the MR analysis, genetically determined earlier age at menarche and younger age at first live birth were significantly associated with an increased risk of MASLD.CONCLUSIONSSeveral reproductive factors were associated with the risk of and histological feature for MASLD, supporting the role of female hormones in the pathogenesis of MASLD.","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"107 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143819079","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}