Archives of Gynecology and Obstetrics最新文献

{"title":"Should all cervical cancer patients with positive lymph node receive definitive radiotherapy: a population-based comparative study.","authors":"Yang Wang, Xingyu Liu, Jing Liu, Liying Liu, Yue Ma","doi":"10.1007/s00404-024-07896-2","DOIUrl":"https://doi.org/10.1007/s00404-024-07896-2","url":null,"abstract":"<p><strong>Objective: </strong>The optimal initial management strategy for cervical cancer with lymph node metastases (LNM) remains a topic of ongoing debate. This study aimed to explore the correlation between surgery followed by postoperative radiotherapy (PORT) and definitive radiotherapy (RT), as well as their impact on the prognosis of patients with LNM.</p><p><strong>Methods: </strong>Patients with positive lymph nodes (PLNs) in 2009 FIGO stage I-III cervical cancer were selected from SEER database. Kaplan-Meier and log-rank analysis were utilized to assess survival outcomes. Cox and Interaction analyses were employed to compare the survival benefits.</p><p><strong>Results: </strong>2936 patients were included in this study. Multivariate analysis revealed the choice of primary treatment significantly impacted both cancer-specific survival (CSS) and overall survival (OS), serving as an independent prognostic factor for patients with LNM. After adjusting for imbalanced variables, surgery plus PORT exhibited significant improvements in CSS and OS in the stage I-II and PLNs ≤ 5 subgroups. However, no statistically significant difference was observed between the two treatment modalities in stage III and PLNs > 5 subgroups. Through interaction analysis, it was observed that stage I-II and PLNs ≤ 5 subgroups exhibited a significant survival benefit from surgery plus PORT.</p><p><strong>Conclusion: </strong>Surgery plus PORT could lead to improved outcomes for cervical cancer in patients with stage I-II or PLNs ≤ 5. However, this approach did not apply to patients with stage III or PLNs > 5. Therefore, a comprehensive assessment of LNM and local tumor spread should guide rationalized treatment modalities when managing patients presenting LNM.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920389","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":"Long-term effects of endometrial resection or ablation in combination with levonorgestrel intrauterine device on bleeding patterns.","authors":"Signe Engholm Straarup, Ina Isabell Kathleen Heinemeier, Pernille Darre Haahr, Martin Rudnicki","doi":"10.1007/s00404-024-07879-3","DOIUrl":"https://doi.org/10.1007/s00404-024-07879-3","url":null,"abstract":"<p><strong>Objective: </strong>Endometrial resection and ablation are minimal invasive surgeries used to treat women with abnormal uterine bleeding (AUB). Both may be followed by a high reoperation rate up to 24%. However, some studies suggest that this may be improved by adding a levonorgestrel intrauterine device (LNG-IUD) immediately following surgery. The aim of this studyPl was to evaluate the long-term (12 months) effect of combined LNG-IUD and endometrial resection (TCRE) or ablation (NovaSure) on the rate of amenorrhea in women treated for AUB.</p><p><strong>Study design: </strong>This study was conducted as a prospective cohort study. A total of 119 women answered the questionnaire regarding bleeding patterns 12 months postoperatively and were eligible for statistical analysis.</p><p><strong>Results: </strong>The rate of amenorrhea 12 months postoperatively was 11% for TCRE and 58% for TCRE in combination with LNG-IUD (OR 24.71; 95% CI 2.32-262.94; p = 0.008). For the group of women, who underwent NovaSure alone, the incident of amenorrhea 12 months postoperatively was 48, and 62% in combination with an LNG-IUD (OR 1.24; 95% CI 0.34-4.58; p = 0.744).</p><p><strong>Conclusion: </strong>Our study disclosed a low effect of TCRE in respect to the amenorrhea rate, whereas the combination with LNG-IUD increased the effect thereby comparable to NovaSure, where no significant beneficial effect was observed from the combination with LNG-IUD.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909233","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":"Comparing combined paravaginal repair with pubocervical fascia plication versus standard anterior colporrhaphy for the treatment of stress urinary incontinence in women with anterior vaginal wall prolapse: a randomised controlled trial.","authors":"Yujie Cai, Ke Su, Aiping Bian","doi":"10.1007/s00404-024-07864-w","DOIUrl":"https://doi.org/10.1007/s00404-024-07864-w","url":null,"abstract":"<p><strong>Background: </strong>Stress urinary incontinence (SUI) is prevalent among women, often occurring alongside anterior vaginal wall prolapse. This study compares the efficacy and safety of an improved vaginal wall repair technique with pubocervical fascia fixation versus standard anterior colporrhaphy for treating SUI in women with anterior vaginal wall prolapse.</p><p><strong>Methods: </strong>A single-centre, parallel-group, randomised controlled trial was conducted between September 2021 and June 2024. Women aged 40-70 years with symptomatic SUI and stage 2-3 anterior vaginal wall prolapse were randomised to either the improved repair group or the standard repair group. The primary outcome was patient-reported success at 12 months post-surgery, defined as 'very much improved' or 'much improved' on the Patient Global Impression of Improvement scale. Secondary outcomes included objective cure rates, quality of life scores, urodynamic parameters, anatomical outcomes, perioperative outcomes and adverse events.</p><p><strong>Results: </strong>A total of 102 women were randomised (51 in each group). At 12 months, the patient-reported success rate was significantly higher in the improved repair group (94.1% vs 78.4%, p = 0.019). The objective cure rate was also higher in the improved repair group (90.2% vs 74.5%, p = 0.038). Quality of life scores and urodynamic parameters showed greater improvements in the improved repair group. Anatomical success was achieved in 92.2% of the improved repair group compared with 80.4% in the standard repair group (p = 0.048). The improved repair technique was associated with longer operative time but lower estimated blood loss, shorter hospital stay and quicker return to normal activities. The overall complication rate was lower in the improved repair group (11.8% vs 23.5%, p = 0.043).</p><p><strong>Conclusions: </strong>The improved vaginal wall repair with pubocervical fascia fixation demonstrates superior outcomes compared with standard anterior colporrhaphy, with higher patient-reported success rates, improved quality of life and fewer complications.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902470","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":"Predictors of anxiety in endometriosis patients.","authors":"Tomas Kupec, Lisa Wagels, Rebecca Caspers, Philipp Meyer-Wilmes, Laila Najjari, Elmar Stickeler, Julia Wittenborn","doi":"10.1007/s00404-024-07878-4","DOIUrl":"https://doi.org/10.1007/s00404-024-07878-4","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the main factors influencing anxiety in endometriosis patients presenting to an endometriosis centre in Germany.</p><p><strong>Methods: </strong>One hundred and eighty-two patients were asked to complete the German version of the STAI (state anxiety and trait anxiety) questionnaire prior to examination for diagnosis and treatment of pelvic pain or suspected endometriosis. Typical endometriosis symptoms, main complaints, operations, type of endometriosis and planned treatment were analyzed as influencing factors of anxiety in endometriosis patients. We performed linear multiple regression analyses using the forward stepwise method to test which characteristics associated with endometriosis symptoms were associated with trait anxiety and state anxiety.</p><p><strong>Results: </strong>Analysis of the STAI results showed that higher levels of trait anxiety were found in patients with ovarian endometriosis: t (177) = 3.06, p = 0.003 and in patients with symptoms of dyspareunia: t (177) = 2.36, p < 0.020). On the other hand, patients with recurrent endometriosis showed lower levels of trait anxiety: t (177) = - 2.39, p = 0.018. Significantly higher levels of state anxiety were found in patients with persistent endometriosis: t (177) = - 2.45, p = 0.015 and in women with endometriosis who were indicated for surgical therapy: t (177) = 3.89, p < 0.001.</p><p><strong>Conclusions: </strong>We were able to show that higher levels of ongoing anxiety in endometriosis patients are associated with dyspareunia and ovarian endometriosis, which may have a negative impact on partnership and desire to have children. On the other hand, patients with persistent endometriosis or a type of disease that requires surgery have higher levels of immediate situational anxiety.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891536","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":"First-trimester screening and small for gestational age in twin pregnancies: a single center cohort study.","authors":"Alexandra Queirós, Ana Bernardo, Cláudia Rijo, Ana Carocha, Leonor Ferreira, Ana Teresa Martins, Álvaro Cohen, Marta Alves, Ana Luísa Papoila, Teresinha Simões","doi":"10.1007/s00404-024-07884-6","DOIUrl":"https://doi.org/10.1007/s00404-024-07884-6","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the association between maternal factors and first-trimester biophysical and biochemical markers with small for gestational age (SGA) neonates in twin pregnancies (TwPs).</p><p><strong>Methods: </strong>Single-center retrospective cohort study of TwPs followed from January 2010 to December 2022 at a tertiary perinatal center, Portugal. Maternal and pregnancy characteristics, mean arterial pressure, pregnancy-associated plasma protein-A (PAPP-A), β-human chorionic gonadotropin (β-HCG), and uterine artery pulsatility index (UtA-PI) were analyzed. Univariable, multivariable logistic regression (LR) and receiver-operating characteristic curve analyses were performed. The main outcome measures considered were: SGA < 3rd, < 5th and < 10th percentile, the composite outcome of SGA combined with preterm birth (PTB) (< 32, < 34, and < 36 weeks).</p><p><strong>Results: </strong>572 TwPs were included, 450 (78.7%) DC and 122 (21.3%) MC. TwPs affected with SGA < 3rd, < 5th or < 10th percentiles were 120/572 (20.9%), 157/572 (27.4%) and 190/572 (33.2%), respectively. SGA < 3rd percentile was associated with a higher rate of PTB, 59.0% of cases < 32 weeks, OR 6.4 (95% CI: 3.2-12.7, p < 0.001). Shorter maternal height, UtA-PI ≥ 95th percentile, and low PAPP-A were identified as significant independent risk factors associated with SGA and SGA combined with PTB. The best LR model was obtained for the composite outcome SGA < 3rd percentile and PTB < 32 weeks, with an AUC of 0.834, a sensitivity rate of 77%, and a false positive rate of 17%.</p><p><strong>Conclusion: </strong>The majority of pregnancies at risk for SGA combined with prematurity can be detected in the first trimester. However, larger datasets are necessary to develop robust predictive models.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891533","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":"Magnesium sulfate for fetal neuroprotection in preterm labor: an updated systematic review and meta-analysis of randomized controlled trials.","authors":"Uzair Jafar, Ahmad Nawaz, Muhammad Zain Ahmad Zahid, Samavia Saddiqah, Fakiha Zainab, Shaharyar Naeem, M Uzair Siddique, Momina Butt, Andrea Etrusco, Mislav Mikuš, Antonio Simone Laganà","doi":"10.1007/s00404-024-07891-7","DOIUrl":"https://doi.org/10.1007/s00404-024-07891-7","url":null,"abstract":"<p><strong>Objective: </strong>Antenatal magnesium sulfate has been reported to reduce the risk of neurological impairment in fetuses born to women at risk of preterm labor. However, the evidence to support its use is conflicting. We conducted this meta-analysis to assess the efficacy and safety of magnesium sulfate in women at risk of preterm labor as new research is available from RCTs giving insights into MgSO4 treatment among differing gestational age groups.</p><p><strong>Study design: </strong>We searched various electronic databases, including MEDLINE (via PubMed), Embase, the Cochrane Library, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform portal from 1990 till 31st March 2024 to retrieve all randomized controlled trials (RCTs) that investigated the use of magnesium sulfate in women at risk of preterm labor with or without intent of fetal neuroprotection We used the revised Cochrane Risk of Bias tool (RoB 2.0) to assess the quality of the included randomized controlled trials. RevMan 5.4 was used to conduct all statistical analyses using a random-effects model. Our Meta-analysis was registered with the PROSPERO International Register of Systematic Reviews (CRD42024532421).</p><p><strong>Results: </strong>Our meta-analysis including eight RCTs showed that magnesium sulfate reduced the risk of cerebral palsy without a significant change in pediatric mortality. The change was evident in moderate to severe cerebral palsy. Magnesium sulfate showed no beneficial effect in most of the secondary outcomes.</p><p><strong>Conclusions: </strong>This meta-analysis found antenatal magnesium sulfate reduces the risk of cerebral palsy with no difference in pediatric mortality between the magnesium or no magnesium treatment groups, which is a positive finding. However, there is still substantial heterogeneity between the studies, so there is a need for further exploration and discussion. The implications of this review include a concern for developing nations where resources and availability of magnesium sulfate are limited. Hence, further studies are needed to determine the exact dosage, timing, and whether maintenance dosage of magnesium sulfate is required or not and for how long.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891534","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":"Role of minimally invasive surgery in the management of misplaced IUCDS and their complications, a case series.","authors":"Bushra Shakeel, Duri Sameen, Syed Nawaz Ahmad, Waafia Muzafar, Subh-Un-Nisa Yetoo","doi":"10.1007/s00404-024-07874-8","DOIUrl":"https://doi.org/10.1007/s00404-024-07874-8","url":null,"abstract":"<p><p>Intrauterine contraceptive devices (IUCDs) are a measure of temporary sterilization. Misplacement of IUCD is fairly common and most of these women remain asymptomatic. We report a clustered case series of misplaced, mal-positioned, and transmigrated IUCDs with serious complications and their management by minimally invasive surgery in a newly established medical school in North India.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891471","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":"Safety of vaginal breech delivery following an unsuccessful external cephalic version: a comparative study.","authors":"Danit Aviv, Amir Weintraub, Gal Issakov, Yael Pasternak, Rachel Griffin, Tzipora Shochat, Miriam Lopian, Yael Yekel, Sharon Perlman","doi":"10.1007/s00404-024-07873-9","DOIUrl":"https://doi.org/10.1007/s00404-024-07873-9","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether patients undergoing a trial of labor with a breech presentation following a failed attempt of external cephalic version (ECV) are at increased risk of adverse maternal and neonatal outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at a single university-affiliated medical center. The study group comprised women with singleton pregnancies at term, categorized into three groups: those who underwent a failed external cephalic version (ECV) and subsequently attempted a trial of breech delivery (Breech-failed-ECV group), those who attempted an assisted vaginal breech delivery without a prior ECV attempt (Breech-no-ECV group), and those with vertex presentation following a successful ECV (Vertex-ECV). The primary outcome measured was the mode of delivery. Secondary outcomes included adverse maternal and neonatal outcomes.</p><p><strong>Results: </strong>The study group consisted of 229 patients who attempted a vaginal delivery during the study period following a diagnosis of non-cephalic presentation at term. There were 42 women in the Breech failed-ECV group, 102 in the Breech-no-ECV group, and 85 in the Vertex-ECV group. Among patients undergoing a trial of labor with a breech presentation, there were no significant differences in successful vaginal delivery rates between those who had an attempted ECV and those who did not (80.39% vs. 80.95%, p > 0.05), nor in the rate of adverse maternal or neonatal outcomes between the groups. However, the Vertex-ECV were more likely to have a vaginal delivery (91.78 vs 80.56%, p = 0.03) and less likely to experience adverse neonatal outcomes, including meconium-stained amniotic fluid, non-reassuring fetal heart rate (NRFHR), compared to those who underwent labor with a breech presentation (p < 0.05).</p><p><strong>Conclusions: </strong>A failed external cephalic version does not adversely affect maternal or neonatal outcomes in patients undergoing a trial of labor with a breech presentation and meet the criteria of our study.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891472","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":"Individualized dosing of rec-FSH for ovarian stimulation in women with PCOS reduces asynchronous follicle growth.","authors":"Milan Perovic, Zeljko Mikovic, Nebojsa Zecevic, Tatjana Zecevic, Bojana Salovic, Stefan Dugalic, Mladen Mihailovic, Jovana Radakovic-Cosic, Ivan Soldatovic","doi":"10.1007/s00404-024-07890-8","DOIUrl":"https://doi.org/10.1007/s00404-024-07890-8","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to evaluate if ovarian stimulation with individualized dosing of recombinant follicle-stimulating hormone (rec-FSH) with follitropin delta compared with standard gonadotropin dosing reduce occurrence of follicular asynchrony in women with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization (IVF).</p><p><strong>Methods: </strong>Matched case-control study analyzed occurrence of follicular growth asynchrony during ovarian stimulation and IVF outcomes in women with PCOS. Follicular growth was considered to be asynchronous when one or two leading follicles were at least 4 mm larger in diameter than the rest of the cohort on day 5 and 9 of stimulation. Analysis encompassed 44 women stimulated with individualized rec-FSH dosing, and 88 women treated with standard dosing. The patients were matched in terms of age, Anti-Müllerian hormone levels and body weight.</p><p><strong>Results: </strong>Early and late follicular asynchrony were present less frequently in individualized dosing compared to standard dosing group (4.5% vs 17%, p = 0.04 and 2.3% vs 37.5%, p < 0.001, on stimulation day 5 and 9, respectively). Multivariate logistic regression on follicular asynchrony revealed that individualized dosing significantly decreases the occurrence and chances for late follicular asynchrony (Odds Ratio 0.28, p < 0.001). Shorter duration of stimulation (9.6 vs 10.4 days, p = 0.001), lower total gonadotropin dose (1118 vs 1940 IU, p < 0.001), higher number of metaphase II oocytes (7.1 + 4.3 vs 5.4 ± 3.0, p = 0.001), good quality embryos (3.8 vs 2.0, p < 0.001), and implantation rates (31.0 vs 23.4, p = 0.04) were observed in the individualized dosing group.</p><p><strong>Conclusion: </strong>Individualized rec-FSH dosing reduces asynchronous follicular growth and improves ovarian stimulation efficiency in women with PCOS undergoing IVF.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885181","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":"Pre-pregnancy body mass index and lactational mastitis: The Japan Environment and Children's Study.","authors":"Tsuyoshi Murata, Karin Imaizumi, Hirotaka Isogami, Toma Fukuda, Hyo Kyozuka, Shun Yasuda, Akiko Yamaguchi, Miyuki Mori, Akiko Sato, Yuka Ogata, Kosei Shinoki, Mitsuaki Hosoya, Seiji Yasumura, Koichi Hashimoto, Hidekazu Nishigori, Keiya Fujimori","doi":"10.1007/s00404-024-07872-w","DOIUrl":"https://doi.org/10.1007/s00404-024-07872-w","url":null,"abstract":"<p><strong>Purpose: </strong>The association between maternal physique and prevalence of lactational mastitis (LM) in a large study population has not been reported. In this study, we aimed to evaluate the association between pre-pregnancy body mass index (BMI) and LM prevalence.</p><p><strong>Methods: </strong>We analyzed data collected from participants enrolled in the Japan Environment and Children's Study, a nationwide birth cohort study conducted between 2011 and 2014. Data from women with singleton births at and after 22 weeks of gestation were analyzed. LM occurrence was identified from medical record transcripts obtained 1-month post-childbirth. Based on the pre-pregnancy BMI, participants were categorized into Group 1 (< 18.5 kg/m²), Group 2 (18.5-24.9 kg/m²), and Group 3 (≥ 25.0 kg/m²). Excluding participants who were not breastfeeding, multivariable logistic regression models were used to evaluate the odds ratios (ORs) for LM in women who were breastfeeding in each BMI category. Group 2 was designated as the reference group. Maternal demographic and socio-economic characteristics were used as confounding factors.</p><p><strong>Results: </strong>We analyzed 83,170 participants. The adjusted OR for LM in Group 3 was 0.752 (95% confidence interval, 0.606-0.932). The adjusted OR for LM in Group 1 was not significantly changed.</p><p><strong>Conclusions: </strong>High pre-pregnancy BMI was associated with decreased LM prevalence compared with that in the reference group. The maternal preconception physique may be associated with LM prevalence.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885209","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}