Archives of Gynecology and Obstetrics最新文献

{"title":"The prognostic importance of features of myometrial invasion in endometrial endometrioid carcinoma.","authors":"Maya Pasternak, Roy Kessous, Benzion Samueli, Jacob Dreiher, Mihai Meirovitz, Sharon Davidesko, Ruthy Shaco Levy","doi":"10.1007/s00404-025-08103-6","DOIUrl":"https://doi.org/10.1007/s00404-025-08103-6","url":null,"abstract":"<p><strong>Purpose: </strong>The depth of myometrial invasion (MI) is known to have a prognostic value in endometrial carcinoma (EC), and the FIGO 50% cutoff is widely accepted; however, recent studies have suggested other measurements such as the absolute depth of invasion and tumor-free distance (TFD) from the serosal surface to also be predictive. The aim of this study was to assess the association between the FIGO cutoff and other measures with overall survival and disease-free survival of patients.</p><p><strong>Methods: </strong>This is a retrospective analysis of a cohort of 248 women diagnosed with stage I endometrioid endometrial carcinoma, treated at Soroka University Medical Center between 2006 and 2020. Clinical and pathological data were collected and analyzed. ROC analysis was used to define the best cutoffs in all three categories (MI, absolute depth and TDF). Survival analyses were then conducted using Kaplan-Meier curves, log-rank tests, and Cox proportional hazards regression.</p><p><strong>Results: </strong>Absolute myometrial invasion (MI) to the depth of 1 cm significantly predicted overall survival (log-rank, p = 0.009) in univariate analysis; however, this significance was not maintained in multivariate analysis. Additionally, a 33% MI cutoff demonstrated potential for better outcome prediction as compared to the commonly used 50% MI threshold, though it did not reach statistical significance. Tumor-free distance (TFD) from the serosal surface was not significantly associated with outcome.</p><p><strong>Conclusions: </strong>MI depth of more than 1 cm may serve as a meaningful prognostic indicator. Additionally, a cutoff of 33% MI probably has a better prognostic value than the current 50% cutoff. These findings show a promising direction for future research, emphasizing the need for larger cohorts and multicenter studies to confirm our findings.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of factors influencing ovarian reserve in patients with endometriosis.","authors":"Huiyan Feng, Wenwei Li, Caini Zhan, Xiaomao Li, Qingjian Ye","doi":"10.1007/s00404-025-08114-3","DOIUrl":"https://doi.org/10.1007/s00404-025-08114-3","url":null,"abstract":"<p><strong>Background: </strong>To discover the related factors of ovarian reserve function and explore the relationship between AFC and AMH.</p><p><strong>Methods: </strong>In this study, a retrospective analysis of endometriosis cases from January 2022 to December 2023 was performed with DIE ultrasound or surgical procedures. The association of AFC and AMH with age, single or bilateral cysts, healthy or affected side, cyst size, BMI, pregnancy history, recurrence, standard medication, comorbidities, four ultrasound sliding signs, presence or absence of deep nodules, and size of deep nodules were analyzed, and then multivariate analysis was performed.</p><p><strong>Result: </strong>Correlation analysis results show significant factors influencing: Total AFC with age (R = -0.242, P < 0.001), Unilateral/bilateral (Z = -4.095, P < 0.001), the largest cyst diameter on the left side (R = -0.181, P = 0.004), the largest cyst diameter on the right side (R = -0.286, P < 0.001), AMH (R = 0.543, P < 0.001), recurrence (R = -2.007, P = 0.038), associated adenomyosis (R = -2.667, P = 0.007), posterior uterine wall sliding sign (R = -4.324, P < 0.001), rectouterine pouch sliding sign (R = -2.098,P = 0.036), largest diameter of deep nodules (Z = -0.175, P = 0.023). AMH shared associations with age (R = -0.432, P < 0.001), BMI (Z = -0.203, P < 0.001), left AFC, right AFC, total AFC, gravidity (R = -0.795, P < 0.001), recurrence (R = -2.203, P = 0.028), associated adenomyosis (R = -4.518, P < 0.001), associated uterine fibroids (R = -3.504, P < 0.001), posterior uterine wall sliding sign (R = -2.927, P = 0.003), and rectouterine pouch sliding sign (R = -1.995, P = 0.046). AFC on the healthy side was significantly higher than that on the affected side (Z = -9.786, P < 0.001). The results of the multivariate analyses showed the following: Larger cyst diameters on the left side were associated with lower left AFC (OR = -0.547, P < 0.001). Larger cyst diameters on the right side were associated with lower right AFC (OR = -0.601, P < 0.001). Higher AMH levels were associated with higher left AFC (OR = 0.775, P < 0.001), right AFC (OR = 0.778, P < 0.001), and total AFC (OR = 0.667, P < 0.001). AMH levels were influenced only by a history of recurrence (OR = 1.436, P = 0.047).</p><p><strong>Conclusion: </strong>In OEM, compared to AMH, AFC may serve as a more suitable marker for assessing ovarian reserve.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of spontaneous preterm birth in pregnant women using machine learning.","authors":"Xiaoxue Yang, Xuewu Song, Kun Yang, Peng Gao, Shuai Wang, Simin Zhang, Rong Qiang, Zhibin Li, Xinru Gao","doi":"10.1007/s00404-025-08117-0","DOIUrl":"https://doi.org/10.1007/s00404-025-08117-0","url":null,"abstract":"<p><strong>Purpose: </strong>Spontaneous preterm birth (sPTB) is a significant global health concern, contributing to adverse outcomes for both pregnant women and newborns. Early identification of women with risk of sPTB is essential for mitigating these negative effects and improving maternal and neonatal health outcomes. The aim of this study is to explore the feasibility of using machine learning to predict sPTB risk and to analyze the contribution of variables.</p><p><strong>Methods: </strong>All data were collected retrospectively. Prediction models were developed using eight different machine learning algorithms combined with six variable selection methods. The models' predictive performance was evaluated using area under the receiver operating characteristic curve (AUROC), area under the precision recall curve (AUPRC), accuracy, sensitivity, F1-score, positive predictive value, and negative predictive value.</p><p><strong>Results: </strong>A total of 1122 pregnant women, of whom 187 had preterm birth and 935 had term birth, were enrolled. The model by combining the categorical boosting algorithm and backward elimination had the best predictive performance with the highest AUROC (0.8762) and AUPRC (0.7061), and the Brier score was 0.12 on the test set. The top 5 variables for predicting sPTB risk in this study were free triiodothyronine, albumin/globulin, thyroglobulin antibody, total thyroxine, red cell volume distribution width.</p><p><strong>Conclusions: </strong>The machine learning model may help identify pregnant women at high risk of sPTB, and individual risk factor analysis could provide reference for clinical decision. However, as some key variables are not part of routine laboratory tests during pregnancy worldwide, the model's generalizability and clinical applicability require further study.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural rearrangements affect blastocyst development.","authors":"Yizi Wang, Yuanlin Ma, Yanling Tan, Jing Wang, Jiafu Pan, Junli Song, Yali Wang, Yanwen Xu","doi":"10.1007/s00404-025-08101-8","DOIUrl":"https://doi.org/10.1007/s00404-025-08101-8","url":null,"abstract":"<p><strong>Purpose: </strong>It is disputable whether chromosomal translocations lead to an inferior embryo development. The purpose of this study was to evaluate whether structural rearrangements (SR) affect blastocyst formation as compared to monogenic disorders in preimplantation genetic testing (PGT) cycles.</p><p><strong>Methods: </strong>A total of 791 PGT-SR cycles and 757 PGT-M cycles from January 2021 to May 2023 were included.</p><p><strong>Results: </strong>Lower blastocyst formation (graded 3BB or higher) rate was detected in the PGT-SR group compared with the control PGT-M group. In addition, lower proportion of day 5 blastocysts was found in the PGT-SR group compared with the control PGT-M group. Overall, a comparatively 12.7% lower proportion of eligible blastocysts in PGT-SR cycles. As expected, there were fewer balanced/normal blastocysts for transfer in the PGT-SR group (balanced/normal blastocysts rate, 32.3 vs. 59.9%, P = 0.02). The estimated curve by inverse model showed that yields of transferrable balanced/normal blastocyst per cycle came to a plateau stage followed with a rapid rise once the oocytes retrieved reached to the number of 20.4 in PGT-M cycle and 28.3 in PGT-SR cycle respectively.</p><p><strong>Conclusions: </strong>Our results demonstrated that patients with SR had a high chance of obtaining lower blastocyst development and significantly fewer usable blastocysts available for transfer compared to PGT-M in their first ovarian stimulation cycle.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fertility preservation in females requiring gonadotoxic therapy should be more than freezing measures before therapy - secondary fertility preservation and menopause care management after therapy should also be considered.","authors":"Michael von Wolff, Sara Imboden, Petra Stute","doi":"10.1007/s00404-025-08104-5","DOIUrl":"https://doi.org/10.1007/s00404-025-08104-5","url":null,"abstract":"<p><p>To date, fertility preservation has mainly been offered to patients prior to gonadotoxic treatment. Ovarian reserve is assessed by analysing blood levels of anti-müllerian hormone (AMH), and gonadal cells or tissue are cryopreserved if indicated and requested by the patient. If primary fertility preservation (Primary FertiProtekt) before gonadotoxic treatment was not performed or was ineffective, secondary fertility preservation should be considered approximately one year after treatment based on a more extensive ovarian reserve analysis including menstrual cycle pattern, antral follicle count, and serum levels of AMH, estradiol and follicle stimulating hormone. Ovarian reserve analysis is also required to consider endocrine treatment in (pre) menopausal patients. Both approaches require the fertility preservation treatment to be tailored to the ovarian reserve status, type of gonadotoxic therapy. For secondary fertility preservation (Secondary FertiProtekt), oocyte freezing may be considered if ovarian reserve is not too low. Monthly treatment cycles, natural cycle or minimal stimulation protocols and follicle aspiration without anesthesia should be preferred. Menopause care management (MenoProtekt) involves acute menopausal symptom relief and prevention of chronic non-communicable diseases. The management needs to be individualized based on type of disease (hormone-dependent or -independent).</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Earlier is not always better: Optimal time to initiate adjuvant chemotherapy after surgery for ovarian cancer.","authors":"Philipp Meyer-Wilmes, Lieven Nils Kennes, Atanas Ignatov, Franziska Goetz, Julia Wittenborn, Elmar Stickeler, Svetlana Nikolayevna Tchaikovski","doi":"10.1007/s00404-025-08095-3","DOIUrl":"https://doi.org/10.1007/s00404-025-08095-3","url":null,"abstract":"<p><strong>Objective: </strong>Tumor resection followed by adjuvant chemotherapy constitutes the cornerstone of ovarian cancer (OC) treatment. This study aimed to evaluate the impact of the time to chemotherapy (TTC) after primary surgery on the survival outcomes of patients with OC.</p><p><strong>Methods: </strong>Patients with OC at any stage who underwent primary surgery followed by adjuvant chemotherapy between 2000 and 2021 were included in the analysis. Data were obtained from the Cancer Registries of Aachen and nine hospitals in Saxony-Anhalt. Patients were stratified into three subgroups based on the timing of chemotherapy initiation: early (≤ 21 days), intermediate (22-35 days) and late (> 35-180 days). The impact of TTC on progression-free survival (PFS) and overall survival (OS) was assessed using multivariate Cox proportional hazard models, both in complete case analysis and with multivariate imputation by chained equations to account for missing data.</p><p><strong>Results: </strong>A total of 1699 patients with OC (mean age: 61.4 ± 12 years) started adjuvant chemotherapy 32.2 ± 24.6 days after surgery. For OS, the optimal TTC was identified at 26 days post-surgery. Compared with the intermediate group, both earlier and later initiation of chemotherapy were associated with worsened OS (Hazard Ratio (HR) = 1.34, 95%CI 1.23-1.60, p < 0.05 and HR = 1.38 95%CI 1.14 -1.68; p < 0.001, respectively).</p><p><strong>Conclusion: </strong>The optimal timing for initiating adjuvant chemotherapy appears to be between 22 and 35 days after primary surgery for ovarian cancer. Remarkably, an earlier start of chemotherapy did not confer a survival advantage, possibly due to the need for adequate recovery after surgery.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of true knot of umbilical cord on obstetric outcomes-true or not?","authors":"Shay Porat, Doron Kabiri, Gilad Karavani, Hagai Amsalem, Michal Lipschuetz, Joshua I Rosenbloom","doi":"10.1007/s00404-025-08110-7","DOIUrl":"https://doi.org/10.1007/s00404-025-08110-7","url":null,"abstract":"<p><strong>Objectives: </strong>To quantify the risk of true cord of the umbilical cord for perinatal death and identify additional risk factors.</p><p><strong>Methods: </strong>This retrospective study included singleton deliveries between 24 and 42 weeks of gestation that took place between 2003 and 2017 in two medical centers. For patients with true knot, data regarding the number of cord knots as well as the location and number of loops of cord were obtained. The rest of the birth data set comprised the control group. The primary outcome was fetal demise. Secondary outcomes included mode of delivery and perinatal outcomes.</p><p><strong>Results: </strong>The final data set included 139,458 deliveries, of which 364 cases (0.26%) comprised the study group (true knot group) and 139,094 cases (99.74%) the control group. Higher rated of unfavorable outcomes were found among cases than controls, including perinatal death, delivery mode, lower Apgar and cord blood umbilical artery pH as well as higher rates of NICU admission and perinatal death. Multivariate analysis showed that true knot of cord (aOR 15.46, 95% CI 9.30-25.70) was a strong predictor of perinatal death. Analysis of predictors of perinatal death within the study group showed that only four or more nuchal loops of cord was an independent predictor (four loops OR 13.40 95% CI 1.12-160.34).</p><p><strong>Conclusions: </strong>True knot of the umbilical cord is a strong predictor of perinatal death. Fetuses with true knot of cord and four or more nuchal cord loops are at significantly increased risk of perinatal death. If diagnosed before onset of labor, delivery before 37 weeks may prevent perinatal death.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, awareness and recommendation on micronutrition during pregnancy-a survey of healthcare providers.","authors":"Anna Elisabeth Hentrich, Doerthe Brueggmann, Eileen Deuster, Anne Kristina Kämpf, Lukas Jennewein, Wiebke Schaarschmidt, Frank Louwen, Samira Catharina Hoock","doi":"10.1007/s00404-025-08111-6","DOIUrl":"https://doi.org/10.1007/s00404-025-08111-6","url":null,"abstract":"<p><strong>Background: </strong>The market for dietary supplements targeting women of reproductive age and pregnant individuals is rapidly expanding. Despite accumulating evidence regarding the benefits of specific micronutrients during pregnancy, there is considerable variability in international and national guidelines, compounded by knowledge gaps among healthcare professionals.</p><p><strong>Objective: </strong>This study aimed to assess the knowledge, attitudes, and counseling practices of midwives and physicians in Germany concerning micronutrient supplementation during pregnancy.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted among healthcare professionals in Frankfurt and surrounding regions in April to May 2024. A newly developed 24-item questionnaire was utilized to gather demographic data, assess counseling practices related to micronutrients and knowledge concerning of the roles of folic acid, vitamin D, vitamin B12, and omega-3 fatty acids in fetal development. Data were analyzed using descriptive statistics and Fisher's exact test (p < 0.05).</p><p><strong>Results: </strong>Of the 360 individuals who accessed the survey, 107 completed it (33 midwives, 72 physicians). While 96.8% recommended supplementation during pregnancy, only 48.1% rated their knowledge as moderate. Folic acid was most frequently recommended supplement (78.7%), followed by omega-3 fatty acids (68%) and vitamin B12 (notably for vegan diets, 96.1%). Gaps in knowledge were identified, particularly regarding the biochemical forms of folate (34.5% unaware), sources and function of omega-3 fatty acids (20% lacked knowledge), and the role of vitamin B12 in fetal development (19% unaware). Only 41.8% explicitly recommended vitamin D, despite strong evidence of its importance. The majority of respondents expressed a strong interest in further education (91.0%).</p><p><strong>Conclusion: </strong>Although healthcare professionals are generally engaged in counseling on prenatal supplementation, substantial knowledge gaps and inconsistent practices persist, particularly regarding newer recommendations beyond folic acid. To improve maternal and fetal health outcomes, there is a pressing need for improved educational initiatives and the broader implementation of tools such as the FIGO nutrition checklist.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Counseling prior to cfDNA screening: are we giving the right numbers?","authors":"Tania Elger, Jiri Sonek, Natalia Prodan, Markus Hoopmann, Francesca Romana Grati, Karl Oliver Kagan","doi":"10.1007/s00404-025-08108-1","DOIUrl":"https://doi.org/10.1007/s00404-025-08108-1","url":null,"abstract":"<p><strong>Objective: </strong>In this modeled study, we aim to evaluate the test performance of cfDNA screening for trisomy 21, 18, and 13 individually and in combination to help with pre-test counseling.</p><p><strong>Methods: </strong>We used the German birth statistics 2023 and calculated the expected number of trisomy 21, 18, and 13 for each maternal age. The number of screen-positive tests (true and false) for trisomy 21, 18, and 13 was estimated based on maternal and gestational age-related risks for the three trisomies. The positive predictive value was calculated for each trisomy individually and in combination according to maternal age. In addition, we applied an uninformative test rate of 1.2%.</p><p><strong>Results: </strong>In 2023, 692,730 children were born in Germany and the predicted number of trisomy 21, 18, and 13 fetuses are 2,521.71, 1,084.70, and 344.31, respectively. In total, cfDNA screening in all pregnancies would result in 4,940.9 screen-positive pregnancies (screen-positive rate of 0.7%) and 13,253.69 uninformative tests. Up to 34 years of age, the screen-positive rate would be between 0.3 and 0.5%, but for older women, the screen-positive rate would be between 0.9 and 11.3%. The combined PPV for the three trisomies would be 48.7% in women of less than 20 years of age and increases to 98.8% in women who are 45 years old or older.</p><p><strong>Conclusion: </strong>cfDNA screening is an excellent screening test for the most common trisomies. However, counseling prior to the screening test is essential. Our study provides useful numbers which can be used for this purpose.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for adverse pregnancy outcomes in systemic lupus erythematosus: a meta-analysis and systemic review.","authors":"Chen Sun, Ximin Li, Xia Li","doi":"10.1007/s00404-025-08106-3","DOIUrl":"https://doi.org/10.1007/s00404-025-08106-3","url":null,"abstract":"<p><strong>Purpose: </strong>Systemic lupus erythematosus (SLE) is a prominent autoimmune disease highly linked to adverse pregnancy outcomes (APOs). Previous research on the risk factors for APOs in SLE pregnancies has been limited by regional constraints or inadequate sample sizes. Comprehensive systematic reviews on this topic remain scarce. To address these research gaps, we conducted a rigorous meta-analysis and systematic review to elucidate the risk factors for APOs in SLE pregnancies.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, and the Cochrane Library systematically searched for articles on risk factors for APOs in SLE pregnancy from initiation to March 25, 2025. Pooled odds ratios (ORs) were calculated using fixed-effect or random-effects models based on heterogeneity (I²). Egger's test was used to assess publication bias.</p><p><strong>Results: </strong>A total of 43 studies were reviewed. Patients with hypertension, lupus nephritis (LN), high disease activity, low complements, and antiphospholipid syndrome (APS)/positive antiphospholipid antibodies (aPL) were identified as having a higher risk for adverse pregnancy outcomes (APOs). Risk factors for preterm birth included LN, hypertension, disease flares, high disease activity, and APS/aPL. Risk factors for pregnancy loss included APS/aPL, low complements, disease flares, LN, hypertension, thrombocytopenia, and high disease activity. LN was also associated with an increased risk of intrauterine growth restriction and low birth weight.</p><p><strong>Conclusions: </strong>This study identified risk factors for APOs in SLE pregnancies. These findings may support early identification of high-risk patients and guide timely interventions to improve maternal and fetal outcomes.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}