American journal of obstetrics and gynecology最新文献

{"title":"Flash glucose monitoring addition to self-monitoring of blood glucose and perinatal outcomes in gestational diabetes: a randomized controlled trial","authors":"Klara Zorko, Ana Munda, Andrej Janež, Draženka Pongrac Barlovič","doi":"10.1016/j.ajog.2026.03.030","DOIUrl":"https://doi.org/10.1016/j.ajog.2026.03.030","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"2 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597989","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":"Differences in epigenetic age acceleration according to a diagnosis of endometriosis/adenomyosis: the Norwegian Mother, Father and Child Cohort Study.","authors":"Maria C Magnus,Karoline Skåra,Hans Ivar Hanevik,Dorte Rytter,Kim Christian Danielsson,Gemma Sharp,Stacey A Missmer,Yunsung Lee","doi":"10.1016/j.ajog.2026.03.022","DOIUrl":"https://doi.org/10.1016/j.ajog.2026.03.022","url":null,"abstract":"BACKGROUNDWomen with endometriosis and adenomyosis have an increased risk of age-dependent diseases such as cardiovascular disease and cancer. Whether this reflects differences in biological age is unknown.OBJECTIVETo compare the epigenetic age acceleration between women with endometriosis or adenomyosis to those without these conditions.STUDY DESIGNWe studied 234 women with endometriosis or adenomyosis and 3 508 women without these conditions enrolled while pregnant into the Norwegian Mother Father and Child Cohort Study. Epigenetic age acceleration, estimated using seven different established clocks based on peripheral blood DNA methylation, was compared between those with and without endometriosis or adenomyosis using linear regression, with adjustment for the woman's chronological age, educational level, smoking status, body-mass index, and batch at the time of blood sampling.RESULTSIn the unadjusted analysis, we observed modest epigenetic age deceleration estimated using the Horvath pan-tissue clock among those with endometriosis/adenomyosis compared to those without (mean difference in the z-score -0.15; 95% confidence interval [CI]: -0.28, -0.02). No notable differences were observed in the estimates of epigenetic age acceleration using the other established clocks, where the mean differences in the z-scores ranged between -0.10 and 0.06. After multivariable adjustment, the significant difference in the Horvath pan-tissue clock was attenuated (mean difference in the z-score 0.00 ; 95% CI: -0.13 to 0.13).CONCLUSIONSWe did not find evidence of meaningful differences in epigenetic age acceleration measured in peripheral blood collected during pregnancy by diagnosis with endometriosis or adenomyosis.","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"18 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585648","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":"Multi-dose Ibuprofen Prior to IUD insertion (MIPI): A Triple Blinded Randomized Controlled Trial.","authors":"Chensi Ouyang,Georgine Lamvu,Helena Quach,Jorge Carrillo,Mario Castellanos,Alexander Wang,Hannah Lewis,Stefanie Barish,Jessica Feranec","doi":"10.1016/j.ajog.2026.03.028","DOIUrl":"https://doi.org/10.1016/j.ajog.2026.03.028","url":null,"abstract":"BACKGROUNDIntrauterine device (IUD) insertion is often associated with moderate to severe pain, which poses a significant barrier to its widespread use. While single-dose Ibuprofen has shown limited efficacy, its pharmacokinetics suggest a multi-dose, preemptive approach might be more effective by achieving sustained therapeutic concentrations.OBJECTIVETo determine if a preemptive, multi-dose Ibuprofen regimen reduces pain during IUD insertion, decreases pain levels 24 hours post-insertion, and minimizes the need for additional pain relief within 24 hours after insertion.STUDY DESIGN/Methods: We conducted a triple-masked, randomized controlled trial. Participants were randomized to receive three doses of Ibuprofen 800 mg or placebo over approximately 24 hours before IUD insertion. The primary outcome was pain severity during IUD insertion, measured by the 0-10 Numerical Pain Rating Scale (NPRS). Secondary outcomes included 24-hour post-insertion pain and use of additional pain relief. We targeted 34 participants per group (total 68) for 80% power, analyzing data via intention-to-treat. Ibuprofen superiority was defined as a ≥30% reduction in mean NPRS levels compared to placebo. The primary outcome was compared between the Ibuprofen and placebo groups using the Mann-Whitney U test (for non-normally distributed data), Chi-square testing and Fisher's exact test.RESULTSEighty-three participants agreed to participate and were randomized, with 42 assigned to placebo and 41 to Ibuprofen. Of these, 66 participants presented for and underwent IUD insertion. Insertion-related pain was substantial, with 39.4% (26/66) reporting severe pain and 42.4% (28/66) reporting moderate pain. Participants receiving preemptive multi-dose Ibuprofen experienced significantly lower insertion pain compared with placebo (median NPRS 5 [IQR 4-7] vs 7 [IQR 5-8], p=0.01), representing a clinically and statistically meaningful difference. Follow-up data at 24 hours post-insertion were available for 80.3% (53/66) of participants. At 24 hours, there were no significant differences between groups in pain severity (p=0.96) or use of additional analgesia (p=0.76).CONCLUSIONCompared to placebo, a preemptive multi-dose Ibuprofen regimen significantly reduces pain during IUD insertion.","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"21 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585635","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":"Response to the necessity of algorithm version control in preeclampsia risk screening (Reply to Letter-to-the-Editor).","authors":"Núria Mans-Gallart,Daniel Axelsson,Caroline Lilliecreutz","doi":"10.1016/j.ajog.2026.03.026","DOIUrl":"https://doi.org/10.1016/j.ajog.2026.03.026","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"61 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585639","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":"Response to concerns about Early risk assessment and aspirin prophylaxis in Sweden (Reply to Letter-to-the-Editor).","authors":"Núria Mans-Gallart,Daniel Axelsson,Caroline Lilliecreutz","doi":"10.1016/j.ajog.2026.03.025","DOIUrl":"https://doi.org/10.1016/j.ajog.2026.03.025","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"81 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585637","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":"Routine 36-week scan: optimizing delivery timing of large for gestational age fetuses.","authors":"A Farina,P I Cavoretto,A Syngelaki,I Mitrogiannis,R Akolekar,K H Nicolaides","doi":"10.1016/j.ajog.2026.03.023","DOIUrl":"https://doi.org/10.1016/j.ajog.2026.03.023","url":null,"abstract":"BACKGROUNDLarge for Gestational Age (LGA) fetuses present increased risk of labour and delivery complications, potentially preventable through timely childbirth.OBJECTIVETo evaluate the risk for caesarean due to fetal compromise and/or failure to progress in pregnancies with LGA detected at routine 36-weeks ultrasound scan and to identify optimal birth timing.STUDY DESIGNAnalysis of prospectively collected data from two UK Fetal Medicine centers including ultrasonographic estimated fetal weight (EFW) at 35-36 weeks' gestation and outcomes. Of 107,875 pregnancies, 84,397 were analyzed after excluding prelabour caesareans and EFW <10th percentile. The final cohort included 7,695 LGA (EFW >90th percentile): of which 3,384 were inductions and 4,311 were spontaneous labours. A competing risks model examined labour type (spontaneous vs. induced) and caesarean for fetal compromise and/or failure to progress, assessing cumulative incidence and instantaneous hazard curves.RESULTSThis study showed that: first, the hazard of caesarean delivery due to fetal compromise and/or failure to progress increases progressively with advancing gestational age with steeper rise after 40 weeks; second, at a given gestational age the hazard is higher in nulliparous vs. parous and in induction vs. spontaneous labour; third, there is a gradient of hazard progression when EFW increases from the 90th to above the 95th percentile; fourth, a policy of induction at 38-39 weeks for fetuses with EFW ˃95th or 90-95th percentile approximates the hazard and cumulative incidence of LGA fetuses delivering spontaneously at 40 weeks; and fifth, induction beyond 41 weeks is associated with substantially increased risk.CONCLUSIONThe findings support induction of labour at 38 weeks in cases of EFW above the 95th percentile and at 39 weeks for EFW between the 90th and 95th percentile, as this strategy achieves a risk of caesarean delivery due to fetal compromise and/or failure to progress comparable to that of spontaneous labour at 40 weeks, while avoiding the progressive increase in risk observed beyond 40 weeks. Alternatively, conservative management until 41 weeks may be considered, followed by elective caesarean delivery if spontaneous labor has not occurred by then, to avoid potentially harmful effects of induction at that stage, associated with a marked increase in cesarean risk.","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"111 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578142","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":"Early risk assessment and aspirin prophylaxis did not reduce preterm preeclampsia (Letter-to-the-Editor).","authors":"Farah H Amro,Baha M Sibai","doi":"10.1016/j.ajog.2026.03.024","DOIUrl":"https://doi.org/10.1016/j.ajog.2026.03.024","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"37 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578143","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 necessity of algorithm version control in preeclampsia risk screening (Letter-to-the-Editor).","authors":"Anders Hagen Jarmund,Åse Turid Rossevatn Svoren,Ann-Charlotte Iversen","doi":"10.1016/j.ajog.2026.03.027","DOIUrl":"https://doi.org/10.1016/j.ajog.2026.03.027","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"104 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578144","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":"Towards a point of care approach for intra-amniotic infection or early delivery using minimally invasive prediction models in women with preterm labor.","authors":"Teresa Cobo,David Boada,Xavier P Burgos-Artizzu,María Goya,Marian Kacerovsky,Silvia Ferrero,Xavier Filella,Anna Sellarés,Bernardino González,Natalia Mouriz,Noah Mohedano,Queralt Ampurdanes,Eva Roldán,Ester Del Barco,Clara Murillo,Judit Hidalgo,Sandra Garbí,Ivana Musilova,Aleix Fabregat,Andrea Vergara,Montse Palacio,Eduard Gratacos","doi":"10.1016/j.ajog.2026.03.021","DOIUrl":"https://doi.org/10.1016/j.ajog.2026.03.021","url":null,"abstract":"INTRODUCTIONAmong women with preterm labor and intact membranes, those with intra-amniotic infection or inflammation represent the highest risk group of spontaneous delivery and worse adverse outcome. Identification of this group requires amniocentesis, which is perceived as too invasive by both patients and physicians.OBJECTIVEThis study aimed to develop a minimally invasive prediction model for intra-amniotic infection or early delivery, thereby better stratifying patients (low or high-risk) and rationalizing the use of amniocentesis limiting the indications to the highest-risk group of spontaneous preterm delivery.STUDY DESIGNWe performed external validation of 4 prediction models using data from 2022-2024 of women diagnosed with preterm labor below 34 weeks admitted to the Hospital Clinic, Hospital Sant Joan de Déu, and the Hospital Vall Hebron in Barcelona (Spain), and the Hradec Kralove University Hospital, in Kradec Kralove (Czech Republic), who underwent amniocentesis to rule in/out intra-amniotic infection or inflammation. Different prediction models, including ultrasound (US) transvaginal cervical length, serum C-reactive protein (CRP), vaginal IL-6, vaginal pH, vaginal lactic acid, and vaginal Lactobacillus genus, were validated in these patients.RESULTSDiagnostic performance was done in 114 women with PTL below 34 weeks, 42 (36.8%) of whom had intra-amniotic infection or spontaneous delivery within 7 days. The areas under the curve (AUC) of the different models ranged from ranging from 84 (95% confidence interval (CI) 78.8-89.2%) to 89.9% (88.4-91.4%), sensitivities ranging from 78.6 (33/42) to 90.5% (38/42). and specificities from 70.8% (51/72) to 84.7% (61/72). The most feasible and efficient model was formed by combining US cervical length, serum CRP and vaginal IL-6, showing an AUC of 84% with a sensitivity of 78.6% (33/42), specificity of 84.7% (61/72), positive predictive value of 75% (33/44), and negative predictive value of 87.1% (61/70).CONCLUSIONSWe developed minimally invasive models to screen women at high risk of intra-amniotic infection or early delivery and guide the selective use of amniocentesis, thereby improving both antenatal counseling and the clinical management of high-risk patients.","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"43 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147536338","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":"Mechanisms and Clinical Implications of Endometriosis-Associated Reductions in Anti-Müllerian Hormone (Letter-to-the-Editor).","authors":"Chunyan Xu,Ning Ding,Jing Sun","doi":"10.1016/j.ajog.2026.03.019","DOIUrl":"https://doi.org/10.1016/j.ajog.2026.03.019","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"30 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147536339","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}