American journal of obstetrics and gynecology最新文献

{"title":"The relationship between gestational age at delivery and fetal size, and neurodevelopmental outcomes from infancy to adolescence.","authors":"Xuan Zhao, Siobhan Quenby, Ragnhild E Brandlistuen, Stian B Valand, Alexandra K S Havdahl, Helga Ask, Dieter Wolke","doi":"10.1016/j.ajog.2026.08.025","DOIUrl":"10.1016/j.ajog.2026.08.025","url":null,"abstract":"<p><strong>Background: </strong>The timing of delivery requires shared decision-making between pregnant women and obstetricians, balancing perinatal and long-term outcomes. Although prematurity and fetal growth restriction are recognized risk factors for adverse neurodevelopment, it remains unclear whether gestational age within the term period or fetal size at birth has the more enduring association with long-term neurodevelopment among term-born children.</p><p><strong>Objective: </strong>To compare the persistence of associations of gestational age (37-41 weeks) and fetal size (defined as birth weight for gestational age) with early childhood neurodevelopment and adolescent academic performance.</p><p><strong>Study design: </strong>Term-born children without congenital malformation from the Norwegian Mother, Father and Child Cohort Study were included in the study. Primary outcomes were parent-reported language and motor development at 6 months, 18 months, 3 years, and 5 years, and national test scores (math, reading, and English) at fifth grade (age 10-11 years), eighth grade (age 13-14 years), and ninth grade (age 14-15 years). Exposures were gestational age at term (37-41 weeks) and fetal size categories at birth: small-for-gestational-age (<10^th percentile), appropriate-for-gestational-age (10-90^th percentile), large-for-gestational-age (>90^th percentile).</p><p><strong>Results: </strong>Among 92,551 term-born children, gestational age and fetal size showed distinct patterns of association with neurodevelopmental outcomes from infancy to adolescence. Earlier birth within the term range was associated with less favorable language and motor development in early childhood, but these associations diminished rapidly by 18 months and were minimal by age 5. In contrast, smaller fetal size (ie, small-for-gestational-age) was associated with poorer academic performance that persisted throughout adolescence, including lower math scores at ages 10 to 11 years (β = -2.32, 95% confidence interval: -3.15, -1.49), 13 to 14 years (β = -1.79, 95% confidence interval: -2.52, -1.06), and 14 to 15 years (β = -1.85, 95% confidence interval: -2.69, -1.02). The associations of gestational age and fetal size were statistically independent of each other.</p><p><strong>Conclusion: </strong>Among term-born children, fetal size showed more enduring associations with long-term neurodevelopment than differences in gestational age within the term period. These findings suggest that gestational age and fetal size represent distinct, noninterchangeable sources of information when counseling families about long-term neurodevelopment after term births.</p>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148824014","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":"Endometriosis risk factors and comorbidities by endometriosis lesion macrophenotypes: an analysis from the What is Endometriosis (WisE) study.","authors":"Naoko Sasamoto, Amy L Shafrir, Christine B Sieberg, Allison F Vitonis, Nan Lin, Mary DePari, Sara R Till, Amy D DiVasta, Kurtis Garbutt, Katy Vincent, Christian Becker, Krina T Zondervan, Kathryn L Terry, Stacey A Missmer","doi":"10.1016/j.ajog.2026.08.026","DOIUrl":"10.1016/j.ajog.2026.08.026","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;While endometriosis is thought to be a heterogeneous disease, the pathophysiologic heterogeneity across the 3 visualized lesion macrophenotypes (ie, superficial peritoneal endometriosis lesions, endometriomas, and deep lesions) remains unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to investigate associations between known and putative risk factors and coexisting comorbidities with odds of endometriosis lesion macrophenotypes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;We conducted a pooled, cross-sectional analysis using data from 1244 participants surgically diagnosed with endometriosis and 1271 without endometriosis who participated in 3 World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonization Project compliant population-based studies from North America and Europe. Multivariable logistic regression models adjusting for age at questionnaire completion and studies were used to calculate odds ratios and 95% confidence intervals for the associations between participant characteristics of known and putative risk factors and coexisting comorbidities and surgically-confirmed endometriosis. Polytomous logistic regression was used to examine the associations among case groups defined by endometriosis macrophenotype, with likelihood ratio tests used to evaluate statistically significant differences between macrophenotypes presented as p-heterogeneity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among endometriosis cases, 834 (71%) had superficial peritoneal endometriosis only, 92 (8%) had at least one endometrioma, 129 (11%) had deep lesions, and 111 (10%) had both endometrioma and deep lesions. Younger age at menarche was associated with significantly higher odds for having superficial peritoneal endometriosis only and deep + endometrioma macrophenotypes (≤11 vs 12 years-old, odds ratio = 1.29, confidence interval = 1.01-1.65 and odds ratio = 2.07, confidence interval = 1.11-3.86, respectively), but not associated with endometrioma or deep lesions alone (P-heterogeneity = .05). Presence of chronic overlapping pain conditions was associated with greater odds of endometriosis overall (odds ratio = 1.66, confidence interval = 1.49-1.85 per condition) and of superficial peritoneal endometriosis only (odds ratio = 1.80, confidence interval = 1.59-2.04 per condition) and deep lesions (odds ratio = 1.76, confidence interval = 1.44-2.15 per condition), but not with macrophenotypes including endometrioma (P-heterogeneity = .0001). Unsupervised clustering by risk factors and coexisting conditions showed distinct associative patterns by surgically-visualized lesion macrophenotypes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;These results showing heterogeneity of individual risk factors and coexisting conditions across endometriosis macrophenotypes support the concept that endometriosis macrophenotypes may have different etiologies and underscores the importance of evaluating risk factors and biomarkers by endo","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometriosis-related chronic pelvic pain: role of integrated supportive and palliative care (letter to the editor).","authors":"Devina Juneja","doi":"10.1016/j.ajog.2026.08.023","DOIUrl":"10.1016/j.ajog.2026.08.023","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787157","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":"Persistent, resolved, and absent fetal growth restriction: a comparison of neonatal outcomes.","authors":"Leshae A Cenac, Sascha Wodoslawsky, Virali Patel, Rodney McLaren, Zubair H Aghai, Mona M Makhamreh, Huda B Al-Kouatly","doi":"10.1016/j.ajog.2026.08.022","DOIUrl":"10.1016/j.ajog.2026.08.022","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787219","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 mifepristone and misoprostol in minors.","authors":"Karen S Greiner, Nicole E Johns, Erin Shiv, Sarah H Averbach","doi":"10.1016/j.ajog.2026.08.021","DOIUrl":"10.1016/j.ajog.2026.08.021","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787109","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":"Trends in US gynecologic cancers (2001-2019): influence of social determinants, geographic disparities, and specialist access on stage at diagnosis.","authors":"Michael R Desjardins, Nerlyne Desravines, Visha Patel, Charles A Leath, Rebecca Stone, Frank C Curriero, Amanda N Fader","doi":"10.1016/j.ajog.2026.08.020","DOIUrl":"10.1016/j.ajog.2026.08.020","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Disparities in gynecologic cancer stage at diagnosis, driven by race/ethnicity, socioeconomic disadvantage, and geographic barriers to specialty care, contribute to worse outcomes in marginalized populations. The combined influence of social vulnerability and access to gynecologic oncologists on stage at diagnosis remains incompletely characterized at the national level.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To examine trends in gynecologic cancer stage at diagnosis from 2001 to 2019 and evaluate the effects of race/ethnicity, social vulnerability, and geographic access to gynecologic oncologists on late-stage diagnosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Population-based cross-sectional study using the United States Cancer Statistics restricted-use database. A total of 1,398,959 individuals diagnosed with endometrial cancer, ovarian cancer, cervical cancer, or uterine sarcoma from 2001 to 2019 were included. Exposures included race/ethnicity, age, and calendar period of diagnosis at the individual level, and Social Vulnerability Index quartile (low, low-medium, medium-high, high) and geographic access to gynecologic oncologists categorized into quintiles via the 2-step floating catchment area method at the county level. The primary outcome was late-versus early-stage diagnosis per International Federation of Gynecology and Obstetrics criteria. Multilevel logistic regression estimated adjusted odds ratios and 95% confidence intervals for each cancer type.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Late-stage diagnosis was significantly more likely among non-Hispanic Black women across all cancer types (adjusted odds ratio range: 3.22-6.80; all P&lt;.05) compared to non-Hispanic White women, as well as among Hispanic women (adjusted odds ratio range: 2.89-3.50) and Asian/Pacific Islander women (adjusted odds ratio range: 2.71-3.22). Residence in high social vulnerability counties was associated with increased odds of late-stage diagnosis (adjusted odds ratio range: 2.64-3.11; all P&lt;.05) relative to low vulnerability counties. Women in the lowest geographic access quintile, representing counties with no gynecologic oncologist within 100 miles, had higher odds of late-stage diagnosis than those in the highest quintile (adjusted odds ratio range: 2.23-2.86; all P&lt;.05). Race/ethnicity and social vulnerability interactions were identified for endometrial and cervical cancers, indicating that race/ethnicity associations with late-stage diagnosis were further elevated in higher versus low vulnerability counties. Late-stage cervical cancer diagnoses declined over the study period, while late-stage endometrial cancer and uterine sarcoma diagnoses increased.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Disparities in gynecologic cancer stage at diagnosis are driven by race/ethnicity, social vulnerability, and poor geographic access to specialty care. Targeted strategies, including gynecologic oncology workforce expansion in underserved areas and cultu","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787192","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":"First-round human papillomavirus screening findings remain clinically relevant amid ongoing global implementation (reply to letter to the editor).","authors":"Joona Hulmi, Ilkka Kalliala, Annu Heinonen","doi":"10.1016/j.ajog.2026.08.017","DOIUrl":"10.1016/j.ajog.2026.08.017","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787146","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":"Host factors and the interpretation of genotype-specific persistent high-risk human papillomavirus infection (letter to the editor).","authors":"Shweta Thusoo","doi":"10.1016/j.ajog.2026.08.018","DOIUrl":"10.1016/j.ajog.2026.08.018","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787179","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":"Host characteristics and genotype-specific risks of human papillomavirus in cervical cancer screening (reply to letter to the editor).","authors":"Eero Numminen, Karolina Louvanto","doi":"10.1016/j.ajog.2026.08.019","DOIUrl":"10.1016/j.ajog.2026.08.019","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787198","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":"Prevalent enrichment bias: distinguishing accumulated backlog from incident persistence in human papillomavirus screening (letter to the editor).","authors":"Jianing Zhang, Wenjuan Wei","doi":"10.1016/j.ajog.2026.08.016","DOIUrl":"10.1016/j.ajog.2026.08.016","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787152","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}