Archives of Gynecology and Obstetrics最新文献

{"title":"Melatonin: a potential target for regulating ovarian function.","authors":"Jiahui He, Tiantian Ye, Keyi Xu, Yuting Liu, Lingli Ren","doi":"10.1007/s00404-025-08079-3","DOIUrl":"https://doi.org/10.1007/s00404-025-08079-3","url":null,"abstract":"<p><strong>Objective: </strong>This review explores the important role of melatonin in ovarian function.</p><p><strong>Background: </strong>The main manifestations of ovarian dysfunction are a decline in oocyte quality and a reduction in the number of follicles and oocytes. Current evidence suggests that environmental pollution, fungi, mycotoxins, drugs, and lifestyle are risk factors affecting ovarian function. Melatonin (MT) is an endogenous hormone synthesized by pineal gland cells, which has strong endogenous effects on scavenging free radicals and antioxidant damage. Previous studies have shown that melatonin plays a beneficial role in oocyte maturation, fertilization, and embryonic development. It can protect these cells from oxidative damage by clearing excessive free radicals, thereby regulating ovarian function and delaying ovarian aging.</p><p><strong>Conclusions: </strong>This article reviews and discusses the relationship between melatonin and ovarian function regulation, including the synthesis and secretion of melatonin, the local synthesis and main role of melatonin in the ovaries, and the alleviating effect of melatonin on ovarian function decline caused by different injury factors.</p><p><strong>Significance: </strong>This review provides important theoretical basis for clinical regulation of ovarian function.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246179","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":"Vaginal natural orifice transluminal endoscopic surgery for malignant ovarian tumors: a single-institution study.","authors":"Khi Yung Fong, Yvonne Wong, Amanda Tan, Joella Ang, Ravichandran Nadarajah","doi":"10.1007/s00404-025-08080-w","DOIUrl":"https://doi.org/10.1007/s00404-025-08080-w","url":null,"abstract":"<p><strong>Background: </strong>Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is an established access technique for gynecological surgeries, but its utility in ovarian cancer surgery is not well-established.</p><p><strong>Methods: </strong>This was a single-institution retrospective cohort study of patients who underwent vNOTES surgery and had malignant tumors arising from or involving the ovary on final histology. Preoperative, intraoperative and immediate postoperative outcomes were collected. Oncological outcomes of recurrence and overall survival were also analyzed.</p><p><strong>Results: </strong>A total of 19 patients were included for analysis: 4 patients had fertility-sparing surgery, 12 had primary staging surgery, 1 had restaging surgery and 2 patients had interval debulking surgery. In the primary staging surgery group, hysterectomy was performed in all patients, omentectomy in a third of the patients, and pelvic lymph node dissection in a quarter of the patients. Only one intraoperative complication of high blood loss was seen, in a patient who was a known hemophilia carrier. Pain scores were mostly zero at 12 and 24 h post-operatively, and most patients were discharged on postoperative day 1 or 2. There were no readmissions for postoperative complications or disease recurrence within 30 days. Median follow-up time was 26.4 months in the whole cohort (interquartile range, 6.3 to 30 months), during which there were 4 cases of recurrence and no deaths.</p><p><strong>Conclusions: </strong>vNOTES is a feasible and versatile technique for ovarian cancer surgery, with low rates of intraoperative and postoperative complications, short length of stay, and favorable short- to medium-term oncological outcomes.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233002","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":"Evaluation of maternal and neonatal complications in preeclamptic twin versus singleton pregnancies: a retrospective study.","authors":"Javier Sánchez-Romero, María Rodríguez-Contreras, Valeria Rolle, Romina Sol Liandro, Miriam Pertegal-Ruiz, María Muñoz-Contreras, José Eliseo Blanco-Carnero, Catalina De Paco Matallana","doi":"10.1007/s00404-025-08068-6","DOIUrl":"https://doi.org/10.1007/s00404-025-08068-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to compare maternal and neonatal outcomes in singleton and twin pregnancies complicated by preeclampsia, emphasizing differences between preterm and term deliveries.</p><p><strong>Methods: </strong>This is a retrospective study conducted at \"Virgen de la Arrixaca\" University Hospital (Murcia, Spain), from 2009 to 2020. Maternal demographic data and maternal and neonatal outcomes were collected from hospital records. Pregnancies were stratified by delivery before and after 37 weeks of gestation.</p><p><strong>Results: </strong>The study included 161 singleton pregnancies and 77 twin pregnancies, all complicated by preeclampsia. Preterm delivery rates (< 37 weeks) were significantly higher in twin compared to singletons (79.2% vs. 48.4%). The mean maternal hospital stay was longer in twins (9.0 days) than for singletons (7.6 days). Maternal complications occurred in 13.7% of singleton pregnancies and 28.6% of twin pregnancies (p = 0.006), with maternal hemorrhage more frequent in twins (22.1% vs. 9.3%; p = 0.007). Maternal complications were more common in twin pregnancies (OR = 3.13; 95%CI 1.38-7.10). Cesarean delivery (OR = 2.00; 95%CI 0.85-4.66) and BMI (OR = 0.96; 95%CI 0.90-1.03) were not associated with the maternal composite outcome. Neonatal complications occurred in 29.2% of singleton pregnancies and 30.0% of first twin and 27.3% of second twin (p = 0.890 and 0.790 respectively). Factors associated with neonatal complications included birthweight (OR 0.99; 95%CI 0.99-0.99) and delivery between 34 and 37 weeks of gestation (OR = 0.08; 95%CI 0.01-0.59) and delivery after 37 weeks of gestation (OR = 0.04; 95%CI 0.01-0.46).</p><p><strong>Conclusions: </strong>Maternal complications were more frequent in twin pregnancies complicated by preeclampsia, while neoantal complications were more likely to occur in cases of preterm preeclampsia.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233001","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":"Distinguishing tubal rupture from tubal abortion in ectopic pregnancies after methotrexate treatment: a retrospective cohort study.","authors":"Asal Darwish, Sharon Avishalom, Inshirah Sgayer, Susana Mustafa Mikhail, Lior Lowenstein, Ala Aiob","doi":"10.1007/s00404-025-08069-5","DOIUrl":"https://doi.org/10.1007/s00404-025-08069-5","url":null,"abstract":"<p><strong>Purpose: </strong>To identify clinical, sonographic, and laboratory characteristics that distinguish between tubal rupture and tubal abortion following methotrexate (MTX) treatment for ectopic pregnancy (EP) and to compare the morbidity associated with these 2 outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study included women treated with MTX for EP at Galilee Medical Center between 2012 and 2024. Data on clinical presentation, ultrasound findings, and laboratory values were analyzed. Uregint surgical interventions were classified as tubal rupture or tubal abortion based on intraoperative findings. A comparative analysis between these groups was performed, and multivariable modeling was used to identify predictors of tubal rupture.</p><p><strong>Results: </strong>Among 280 women treated with MTX, 47 (16.7%) required urgent surgical intervention. Of these, 15 (34.9%) were confirmed as tubal rupture, while 28 (65.1%) were tubal abortion. Women with tubal rupture more frequently presented with free pelvic fluid on transvaginal ultrasound (64.3 vs. 28.6%, P = 0.045) and had significantly higher intraoperative blood loss (433 ± 143 mL vs. 250 ± 201 mL, P = 0.001). A multivariable logistic regression model identified free pelvic fluid as an independent predictor of tubal rupture (odds ratio: 6.09, 95% CI 1.23-30.09, P = 0.027). No significant differences in preoperative beta-hCG levels or other clinical symptoms were observed between the groups.</p><p><strong>Conclusion: </strong>Tubal rupture and tubal abortion share overlapping clinical features, making differentiation with current diagnostic tools challenging. Free pelvic fluid on ultrasound is a significant indicator of tubal rupture, underscoring the importance of timely surgical intervention. Recognizing that tubal abortion may be a self-limiting condition in some cases offers opportunities to preserve fallopian tube integrity and reduce unnecessary surgeries. Further research is needed to improve diagnostic accuracy and explore conservative management strategies for tubal abortion. Date and number of trial registration: December 2024, 0138-24-NHR.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224160","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":"Letter to the editor: 'the efficacy of progestins in managing pain associated with endometriosis, fibroids and pre-menstrual syndrome: a systematic review'.","authors":"Songjie Liao, Di Xiao, Liqiu Kou","doi":"10.1007/s00404-025-08032-4","DOIUrl":"https://doi.org/10.1007/s00404-025-08032-4","url":null,"abstract":"","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214712","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":"Development and validation of a predictive model for preeclampsia: a retrospective cohort study.","authors":"Changxiu Wang, Tao Zeng, Xiangyu Zhao, Cuiping You, Yucheng Lu, Guanqing Kong, Lingling Hu, Jinyan Huang, Yanxin Zhang","doi":"10.1007/s00404-025-08076-6","DOIUrl":"https://doi.org/10.1007/s00404-025-08076-6","url":null,"abstract":"<p><strong>Purpose: </strong>We conduct this study to develop and validate a predictive nomogram for preeclampsia (PE) to inform the development of early intervention strategies in clinical practice.</p><p><strong>Methods: </strong>In this analysis, we collected data from women with medium or high risk for PE who underwent placental growth factor (PlGF)-based testing between December 20, 2021 and December 31, 2022. The gestational age at the time of taking the PlGF-based test for the PE and non-PE groups was 20.0 weeks (range 16.1-26.1 weeks) and 22.2 weeks (range 16.2-27.3 weeks), respectively. The independent risk factors for PE were identified through both univariate and multivariate analyses. Based on these independent risk factors, a logistic regression model for risk prediction was developed. The model was validated using five-fold cross-validation. Moreover, the efficacy of the model was appraised using the area under the receiver operating characteristic curve (AUROC), while the calibration of the model was assessed through calibration curves. Additionally, decision curves and clinical impact curves were leveraged to evaluate the clinical applicability of the model.</p><p><strong>Results: </strong>In total, 2063 women were included. Of these, 108 had PE. Body mass index, mean arterial pressure, a ratio of soluble fms-like tyrosine kinase-1/PlGF, history of adverse pregnancy, family history of PE, previous history of PE, chronic hypertension, autoimmune disease, and polycystic ovary syndrome were independent risk factors for PE. The model constructed based on independent risk factors demonstrated that the AUROC in the training set was 0.883 (95% confidence interval [CI] 0.838-0.928), with a sensitivity of 0.827 and specificity of 0.816. In the validation set, the AUROC was 0.862 (95% CI 0.774-0.951), with a sensitivity of 0.815 and specificity of 0.772. The decision curve revealed that the model had a large probability interval for the net benefit threshold.</p><p><strong>Conclusion: </strong>The predictive nomogram for PE constructed based on common interpretable features has desirable efficacy, which informs the development of specialized preventive protocols in clinical practice.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198153","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":"Association of body mass index with surgical complications after minimally invasive hysterectomy.","authors":"Raanan Meyer, Jayne Caron, Kacey M Hamilton, Rebecca J Schneyer, Gabriel Levin, Kelly N Wright, Matthew T Siedhoff","doi":"10.1007/s00404-025-08073-9","DOIUrl":"https://doi.org/10.1007/s00404-025-08073-9","url":null,"abstract":"<p><strong>Purpose: </strong>To study the association between body mass index (BMI) and short-term postoperative complications of patients undergoing laparoscopic hysterectomy (LH).</p><p><strong>Study design: </strong>This is a cohort study of patients who underwent LH for benign conditions. We used prospectively collected data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database from 2012 to 2020. We categorized patients into BMI subgroups and compared 30-day postoperative complication rates, defined by the Clavien-Dindo classification.</p><p><strong>Results: </strong>206,944 patients met inclusion criteria. In multivariable regression analysis, when comparing lower and higher BMI subgroups, there was a statistically significant increase in any complications [< / ≥ 35.0 kg/m², aOR 95% CI 1.06(1.01-1.10)] and minor complications [< / ≥ 35.2 kg/m², aOR 95% CI 1.13(1.07-1.19)] in the higher BMI group but no differences in major complications. When comparing obesity categories to the normal BMI group, class I, II, and III categories had a lower likelihood of major complications [aOR 95% CI 0.87(0.80-0.93), 0.84(0.77-0.91), 0.82(0.75-0.90), and 0.83(0.75-0.91), respectively] compared to normal weight individuals. Patients in class II and III categories had a higher likelihood of minor complications [aOR 95% CI 1.12(1.03-1.21), and 1.17(1.08-1.28), respectively] compared to normal weight individuals. The mean operative time was significantly longer for each BMI group compared to lower BMI groups (range 115.2-144.5 min, p < 0.05).</p><p><strong>Conclusions: </strong>Higher BMI was associated with a higher risk of any and minor complications than lower BMI in patients undergoing LH, as well as increased operative time. When comparing specific BMI categories, overweight and obesity categories were associated with lower risks of major complications compared to the normal BMI category. WHAT DOES THIS STUDY ADDS TO THE CLINICAL WORK?: Among women undergoing minimally invasive hysterectomy for benign indications, higher BMI classes were associated with lower risk of short-term postoperative complication compared to the normal BMI class. This information can be used in preoperative planning, counseling, and shared-decision making.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198152","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":"Effectiveness of office hysteroscopy for retained products of conception: insights from 468 cases.","authors":"Giosuè Giordano Incognito, Katja Jakopič Maček, Mija Blaganje, Kristina Drusany Starič, Giuseppe Ettore, Carla Ettore, Maša Lukež Podgornik, Ivan Verdenik, Nataša Kenda Šuster","doi":"10.1007/s00404-025-08075-7","DOIUrl":"https://doi.org/10.1007/s00404-025-08075-7","url":null,"abstract":"<p><strong>Purpose: </strong>Retained products of conception (RPOC) are a common complication following pregnancy. Office hysteroscopy (OH) is increasingly used for diagnostics and management due to its minimally invasive nature. However, incidence of incomplete OH removal and procedures in which no RPOC are identified despite prior suspicion remains a concern. This study aimed to identify factors associated with these outcomes to improve patient selection and procedural success.</p><p><strong>Methods: </strong>A retrospective study was conducted on patients referred for OH for presumed RPOC between August 2015 and April 2023 at the Department of Gynecology and Obstetrics, University Medical Centre Ljubljana, Slovenia. Inclusion criteria included hemodynamically stable patients with prolonged bleeding and/or suspicious ultrasound (US) findings post-pregnancy. Patients with RPOC thickness of more than 30 mm or strong tissue vascularization on US were excluded. Data on patient demographics, US features, and procedural outcomes were analyzed.</p><p><strong>Results: </strong>Out of the 468 patients, RPOC removal was performed in 333 cases (71.2%), of which 225 (67.6%) were successfully completed, while in 135 cases (28.8%), the procedure was only diagnostic due to the absence of RPOC. Regarding procedural success, neither the pregnancy outcome, i.e., termination of pregnancy (TOP) vs delivery, nor gestational age significantly correlated with it. Longer time from pregnancy end to OH significantly improved procedural success in both groups, after TOP (p = 0.025) and in cases of large RPOC after delivery (p < 0.001). Parity significantly altered procedural success only in the delivery group (p < 0.007). The success rate of the procedure was significantly higher in cases when only small RPOC were observed (p < 0.001). Absence of RPOC occurred more frequently following TOP than after delivery (p < 0.001). Procedures in which no RPOC were confirmed were significantly associated with a longer interval between pregnancy end and OH in both TOP (p = 0.013) and delivery group (p = 0.003). Gestational age significantly correlated with the absence of RPOC only in the delivery group (p = 0.003). The likelihood of not confirming RPOC was higher where US thickness and length were lower (p = 0.007 and p = 0.011, respectively).</p><p><strong>Conclusion: </strong>OH is effective for managing RPOC with a high success rate, but the absence of RPOC in a considerable number of OH-treated patients stresses the need for better diagnostic criteria and patient selection to minimize overtreatments. Further prospective studies are needed to optimize the timing and indications for OH.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191416","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":"Impact of trophectoderm biopsy on serum β-hCG dynamics: PGT cycles vs. non-PGT cycles.","authors":"Gonul Ozer, Meryem Hocaoglu, Sabri Berkem Okten, Semra Kahraman","doi":"10.1007/s00404-025-08057-9","DOIUrl":"https://doi.org/10.1007/s00404-025-08057-9","url":null,"abstract":"<p><strong>Purpose: </strong>Pre-implantation genetic testing (PGT), which involves trophectoderm (TE) biopsy, is commonly used to detect genetic abnormalities in embryos. However, its impact on serum β-human chorionic gonadotropin (β-hCG) levels in early pregnancy remains a topic of debate. This study evaluated the effects of TE biopsy on β-hCG dynamics. Serum β-hCG levels on days 9 and 11 post-blastocyst transfer were compared between PGT and non-PGT cycles. Additionally, β-hCG thresholds were explored as potential prognostic markers for success in assisted reproductive technology (ART).</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at the Memorial Şişli Hospital, İstanbul, Türkiye, between January 2012 and January 2021. The patients undergoing frozen-thawed single blastocyst transfer were divided into PGT (1698 cycles) and non-PGT (1830 cycles) groups. The serum β-hCG levels on days 9 and 11 after embryo transfer (ET) and the rate of β-hCG increase were compared.</p><p><strong>Results: </strong>In both groups, higher baseline β-hCG levels and rates of increase were correlated with live birth outcomes than with clinical or biochemical pregnancy loss (p < 0.001). PGT cycles showed lower baseline β-hCG levels across all pregnancy outcomes, but no significant difference in β-hCG increase rates (p > 0.05). After adjusting for confounding factors, PGT cycles were not found to be significantly associated with β-hCG levels.</p><p><strong>Conclusion: </strong>Serum β-hCG dynamics strongly predict live birth and clinical pregnancy. PGT did not significantly affect β-hCG levels after adjustment for confounders.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191417","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":"A retrospective study on the impact of the timing of diabetes diagnosis on maternal and fetal outcomes.","authors":"Kaiyan Zhou, Wenting Chen, Shuzhen Wu, Lin Li, Yuting Xiang, Zhongjun Li","doi":"10.1007/s00404-025-08047-x","DOIUrl":"https://doi.org/10.1007/s00404-025-08047-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the impact of the timing of diabetes diagnosis on maternal and fetal outcomes.</p><p><strong>Methods: </strong>The data were collected from pregnant women diagnosed with pregestational diabetes mellitus (PGDM) who were hospitalized at Dongguan People's Hospital between June 2016 and December 2023. Based on the timing of diagnosis, women were categorized into two groups: those diagnosed before pregnancy and those diagnosed during pregnancy. General clinical characteristics, glycemic control, pregnancy complications, and maternal and fetal outcomes were compared between the two groups to assess the influence of diagnosis timing on pregnancy outcomes.</p><p><strong>Results: </strong>Between 2016 and 2023, a total of 415 pregnant women with PGDM were included in this study. Among them, 242 (58.31%) were diagnosed before pregnancy, while 173 (41.69%) were diagnosed during pregnancy, resulting in a preconception diabetes awareness rate of 58.31%. Education level was significantly associated with the timing of diabetes diagnosis (P = 0.002). In addition, women diagnosed during pregnancy had significantly higher HbA1c levels before delivery when compared with those diagnosed before pregnancy (6.70% vs. 6.20%, P < 0.001), indicating more severe glycemic dysregulation. Consequently, this group also exhibited a higher rate of diabetes-related hospitalizations during pregnancy (42.77% vs. 22.73%, P < 0.001) and an increased risk of macrosomia (20.23% vs. 10.74%, P = 0.007).</p><p><strong>Conclusion: </strong>Pregnant women diagnosed with diabetes during pregnancy exhibited more severe perinatal glucose metabolism disorders and a higher rate of macrosomia. Early diagnosis and management of diabetes-especially before conception-helped improve perinatal glycemic control, potentially reducing healthcare burdens and the incidence of macrosomia.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186413","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}