BJOG: An International Journal of Obstetrics & Gynaecology最新文献

{"title":"Reproductive Challenges of the Ageing Female: A Comprehensive Narrative Review.","authors":"Sofia Bitzika,Meletios P Nigdelis,Angelos Daniilidis,Erich-Franz Solomayer,Irene Lambrinoudaki,Efstratios M Kolibianakis,Dimitrios G Goulis","doi":"10.1111/1471-0528.70197","DOIUrl":"https://doi.org/10.1111/1471-0528.70197","url":null,"abstract":"Changes in societal norms over the last few decades have resulted in novel family planning trends, notably delayed childbearing and increased maternal age at the birth of the first child. Despite advances in reproductive medicine, ageing poses significant challenges. Natural conception in women ≥ 45 years of age is rare, with high rates of pregnancy loss, and assisted reproduction using autologous oocytes yields limited success. Oocyte donation offers higher live birth rates, exceeding 50%. Elective oocyte cryopreservation could aid in family planning; nevertheless, its success depends on the age at which cryopreservation is performed. These facts highlight the correlation between advancing age and a decline in oocyte quality and quantity. An age-related decline in endometrial receptivity could pose an additional barrier, although the evidence remains controversial. Furthermore, pregnancies in older women carry high risks for both the mother and child, which should be considered before assisted conception attempts. This comprehensive narrative review examines the advancements in assisted reproductive technology that have expanded the possibilities for delayed childbearing, while underlining at the same time the major challenges in the field. Innovations such as ovarian tissue cryopreservation and stem cell-based therapies have the potential to reshape reproductive options for these women. However, thorough counselling and tailored management remain of paramount importance.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147381354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Effects of Clinical Pilates Training and Aerobic Exercise on Menopausal Symptoms, Quality of Life, Sleep and Depression: A Randomised Controlled Trial.","authors":"Başak Can,Serkan Usgu,Günseli Usgu","doi":"10.1111/1471-0528.70203","DOIUrl":"https://doi.org/10.1111/1471-0528.70203","url":null,"abstract":"OBJECTIVETo examine the effects of Clinical Pilates (CP) training and aerobic exercise (AE) on menopausal symptoms, depressive symptoms, quality of life (QoL), and sleep quality in postmenopausal women.DESIGNParallel-group randomised controlled trial.SETTINGA Healthy Life Center in Bitlis, Turkey.POPULATION OR SAMPLEThirty postmenopausal women were randomly allocated to CP (n = 15) or AE (n = 15) groups.METHODBoth exercise interventions were performed twice weekly for 8 weeks (40-min/session). Assessments were conducted before and after the intervention period.MAIN OUTCOME MEASURESThe primary outcome was menopausal symptom severity assessed using the Menopause Rating Scale (MRS). Secondary outcomes included sleep quality, depressive symptom severity, and health-related QoL, assessed using the Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and Short Form-36 (SF-36), respectively.RESULTSBaseline characteristics were comparable between groups (p > 0.05), although BMI was significantly higher in the CP group (p < 0.05). Both groups demonstrated improvements in depressive symptoms, sleep quality, and several QoL subdomains post-intervention. No significant between-group differences were observed in pre- to post-change scores for primary or secondary outcomes. Effect size analysis indicated greater reductions in menopausal symptom severity in the CP group, while changes in urogenital symptoms were minimal in both groups. Improvements in depressive symptoms and sleep quality were comparable.CONCLUSIONBoth CP and AE demonstrated improvements in psychological outcomes, QoL, and sleep quality in postmenopausal women. Pilates may offer additional short-term benefits for the management of menopausal symptoms. Exercise selection may be guided by individual preference and accessibility. Larger long-term trials are needed to clarify comparative effects.TRIAL REGISTRATIONClinical.gov: NCT05764031.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147381355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications of Pregnancy and Birth in Women With Vascular Malformations: A Nationwide Cross-Sectional Study.","authors":"Delano J de Oliveira Marreiros,Max M Lokhorst,Sophie E R Horbach,Merel L E Stor,Naomi van Hout,Victor E A Gerdes,Wessel Ganzevoort,Chantal M A M van der Horst","doi":"10.1111/1471-0528.70205","DOIUrl":"https://doi.org/10.1111/1471-0528.70205","url":null,"abstract":"OBJECTIVETo investigate risks of pregnancy and birth in patients with peripheral vascular malformations (VMs).DESIGNNationwide cross-sectional study.SETTINGTertiary referral centre and Dutch national patient organisation.POPULATIONWomen aged ≥ 15 years diagnosed with peripheral VM of any subtype or anatomical location.METHODSPatients were invited to complete a comprehensive questionnaire about obstetric history and VM-related symptoms during pregnancy.MAIN OUTCOME MEASURESPrevalence of complications, specifically worsening of VM-related symptoms during pregnancy, deep venous thrombosis (DVT), pulmonary embolism (PE) and postpartum haemorrhage (PPH).RESULTSTwo-hundred-six women completed the questionnaire. Among 108 patients, 248 pregnancies and 204 births were reported; 98 patients were nulligravid. DVT and PE occurred in 2.5% and 0.5% of total pregnancies, respectively and only occurred in patients with extensive VMs (> 30 cm) involving at least the lower extremities (predominantly Klippel-Trenaunay). PPH occurred in 19.6% of births, including in 63.6% of those with uterine involvement and 47.8% with genital involvement of the VM. VM-related symptom worsening and volume increase during pregnancy occurred in 47.6% and 45.4% of patients, respectively. In multivariable regression, AVM subtype (OR 4.0, 95% CI 1.0-15.1), genital region involvement (OR 4.6, 95% CI 1.5-13.8), and a history of puberty-related symptom progression (OR 2.6, 95% CI 1.1-6.2) were independently associated with VM-related symptom worsening during pregnancy.CONCLUSIONSWomen with VMs appear to have a significant risk of PPH and worsening of VM-related symptoms during pregnancy, especially if the genital region is involved. Increased thromboembolic risk appears confined to patients with extensive VMs involving the lower extremities.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147371038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Obesity, Gestational Diabetes Mellitus and Offspring's Body Mass Index Trajectories From Birth to Age 6 Years: Glucose in Relation to Women and Babies' Health (GrownB) Study.","authors":"Cheng-Tzu Hsieh,Xinyue Liu,Xiang Li,Rana F Chehab,Yeyi Zhu,Liwei Chen","doi":"10.1111/1471-0528.70204","DOIUrl":"https://doi.org/10.1111/1471-0528.70204","url":null,"abstract":"OBJECTIVETo examine whether offspring born to mothers with overweight/obesity, gestational diabetes mellitus (GDM) or both exhibit different body mass index (BMI) trajectories from birth to 6 years old.DESIGNRetrospective cohort study.SETTINGThe Glucose in Relation to Women and Babies' Health (GrownB) Study at the University of California, Los Angeles (UCLA) Medical Center.POPULATION OR SAMPLETwenty thousand four hundred fifty six mother-offspring pairs.METHODSMothers were classified as normal-weight & non-GDM (NWN), normal-weight & GDM (NWG), overweight/obesity & non-GDM (OWN) or overweight/obesity & GDM (OWG). Offspring BMI trajectories were estimated using linear mixed-effects models in two age periods (0-24 months and 2-6 years), adjusting for confounding.MAIN OUTCOME MEASURESWe extracted offspring's birth weight, recumbent length (age < 2 years) or standing height (age ≥ 2 years), and weight data from routine clinical encounters and physical examinations from the UCLA electronic health records.RESULTSOffspring of mothers with overweight/obesity had higher BMI trajectories than those of normal-weight mothers across both 0-24 months (BMI mean differences overall 0-24 months: 0.28 [0.17, 0.39] kg/m2 for OWN vs. NWN; 0.53 [0.21, 0.85] kg/m2 for OWG vs. NWG) and 2-6 years (0.58 [0.45, 0.70] kg/m2 for OWN vs. NWN; 0.53 [0.20, 0.87] kg/m2 for OWG vs. NWG). No significant differences were observed by GDM status (i.e., NWG vs. NWN; OWG vs. OWN, all p > 0.21).CONCLUSIONSMaternal pre-pregnancy overweight/obesity was associated with higher offspring BMI trajectories from birth to age of 6 years, while the association was not observed for GDM.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147371041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Comparing the Psychological Outcomes of Donor and Non-Donor Conceived People: A Systematic Review\".","authors":"","doi":"10.1111/1471-0528.70202","DOIUrl":"https://doi.org/10.1111/1471-0528.70202","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147329566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient‐Centred Perspectives on Diagnostic Strategies for Endometriosis: A Qualitative Study","authors":"Tiffany Yeretsian, Paola Romeo, Shay M. Freger, Jacques Maas, Mathew Leonardi","doi":"10.1111/1471-0528.70188","DOIUrl":"https://doi.org/10.1111/1471-0528.70188","url":null,"abstract":"Objective To explore diagnostic preferences among individuals with confirmed or suspected endometriosis to inform the development of patient‐centred diagnostic strategies. Design Qualitative study using semi‐structured focus group discussions analysed with grounded theory methodology. Setting A tertiary gynaecology clinic and a specialised diagnostic imaging centre in Canada. Focus group discussions were conducted by videoconference. Population Twenty‐five individuals aged 21–56 years with confirmed or suspected endometriosis. Methods Semi‐structured focus group discussions were audio recorded, transcribed verbatim, anonymised, and analysed using open, axial, and selective coding. Two researchers independently coded all transcripts, resolving discrepancies through discussion or adjudication by a third researcher. Thematic saturation guided study completion. Main Outcome Measures Patient‐identified themes describing diagnostic experiences, preferences, facilitators, barriers, and trade‐offs. Results Eight major themes were identified: (1) diagnostic challenges and delays, (2) patient advocacy and self‐advocacy, (3) importance of provider expertise and trust, (4) desire for visual confirmation and tangible validation, (5) emotional and psychological impact of the diagnostic journey, (6) diagnostic preferences and risk tolerance, (7) practical and institutional needs for formal diagnosis, and (8) educational needs and knowledge gaps among healthcare professionals and health service users. Participants described weighing the benefits and limitations of non‐invasive and invasive diagnostic modalities in light of symptom severity, access, and diagnostic uncertainty, with preferences varying across individuals. Conclusion This study provides patient‐centred insights into how individuals with confirmed or suspected endometriosis perceive and navigate the current diagnostic landscape. The findings contextualise and reinforce existing evidence on patient experiences of endometriosis diagnosis and highlight opportunities to align patient values with diagnostic strategies. These insights offer foundational direction for the subsequent development of a discrete choice experiment within the IPEDT project.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146777362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Clinical Practice Guidelines on Timing and Onset of Labour in Gestational Diabetes Mellitus: A Scoping Review","authors":"Kathy Lynch, Amanda Poprzeczny, Jennifer Fereday, Tracy Humphrey","doi":"10.1111/1471-0528.70191","DOIUrl":"https://doi.org/10.1111/1471-0528.70191","url":null,"abstract":"Background Gestational diabetes mellitus (GDM) is the most common pregnancy complication globally, yet recommendations for the timing and onset of labour vary. Clinical practice guidelines (CPGs) aim to improve safety and quality by guiding decision making through evidence‐based recommendations. Objectives Scoping review with embedded guideline appraisal to assess the consistency of recommendations regarding the timing and onset of labour for women with GDM and whether variation was associated with guideline quality. Search Strategy Databases (MEDLINE, CINAHL, EBSCO, Scopus, Embase, JBI Guidelines) and websites of relevant professional organisations were searched. Selection Criteria Guidelines and consensus statements published from 2015 to January 2025, available in English from high‐income countries, were included. Data Collection and Analysis Guideline quality was assessed using the AGREE‐II tool, and recommendations were analysed descriptively. Main Results Of 1422 records screened, 24 CPGs met the inclusion criteria. The quality of the included CPGs varied, with inconsistent applicability and stakeholder involvement (mean AGREE‐II domain scores 55%), developmental rigour (43%), and editorial independence (37%). On the basis of the AGREE‐II scores, only 3 CPGs were recommended for use without modifications. Even among higher quality guidelines, recommendations for the onset and timing of labour varied, from 37 to 40+ 6 weeks. Conclusions Considerable variation exists with regard to the quality of CPGs and recommendations about the timing of birth for women with GDM. These findings highlight the importance of shared decision making and the need for further research to assist women and their maternity care providers in discussing optimal birth timing.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"233 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146777361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Centralised Identification of Early‐Gestation Biospecimens to Support Early‐Onset Pre‐Eclampsia Prediction","authors":"Chris E. Philip, Hani Faysal, Sara K. Quinney, Shaohong Feng, David M. Haas","doi":"10.1111/1471-0528.70196","DOIUrl":"https://doi.org/10.1111/1471-0528.70196","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146231117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Adverse Outcomes Become Public Trials in China","authors":"Rui‐Hong Xue","doi":"10.1111/1471-0528.70187","DOIUrl":"https://doi.org/10.1111/1471-0528.70187","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implications for Newborn and Child Growth Classification Using INTERGROWTH‐21st and WHO Child Growth Standards","authors":"Linda Vesel, Sara Strout, Simon Parker, Audencio Victor, Bancy Ngatia, Eric O. Ohuma","doi":"10.1111/1471-0528.70186","DOIUrl":"https://doi.org/10.1111/1471-0528.70186","url":null,"abstract":"Objective The aim of this study was to assess how the use of the WHO Child Growth Standards (WHO GS) and the INTERGROWTH‐21st Standards (IG‐21st) affect the classification and interpretation of growth trajectories. Design A secondary data analysis of an observational cohort study. Setting Five health facilities participating in the Low Birthweight Infant Feeding Exploration (LIFE) study in Malawi and Tanzania. Population or Sample 608 moderately low birthweight (1.5 to &lt; 2.5 kg) infants. Methods <jats:italic>Z</jats:italic> ‐scores for weight‐for‐age (WAZ), length‐for‐age (LAZ), and head circumference‐for‐age (HCAZ) were calculated at birth using both the WHO GS and the IG‐21st Newborn Size Standard (IG‐21st NBS). Longitudinal trajectories were assessed over three periods (birth–6 months, 6–12 months and 12–24 months) using WHO GS and IG‐21st Preterm Postnatal Standards (IG‐21st PPS). Between 12 and 24 months, all infants were assessed using WHO GS. Conditional growth models were constructed to evaluate deviation from mean growth patterns within GA subgroups. Main Outcome Measures WAZ, LAZ and HCAZ <jats:italic>z</jats:italic> ‐scores; prevalence of <jats:italic>z</jats:italic> ‐scores &lt; −2, and absolute and conditional growth trajectory differences between WHO and IG‐21st standards across three postnatal intervals. Results At birth, IG‐21st NBS <jats:italic>z</jats:italic> ‐scores were higher than WHO GS values especially in lower GA subgroups, particularly for LAZ and HCAZ. The proportion of infants with &lt; −2 <jats:italic>z</jats:italic> ‐scores was substantially lower with IG‐21st PPS than WHO GS in preterm infants for weight (6.1% vs. 95.6%), length (14.4% vs. 89.2%) and head circumference (4.2% vs. 53.5%), respectively. From birth to 6 months, between‐standard <jats:italic>z</jats:italic> ‐score differences (IG‐21st PPS minus WHO GS) were largest in preterm infants (preterm overall: WAZ: +1.78, LAZ: +1.64, HCAZ: +1.80). From 6 to 12 months, differences persisted but were smaller (preterm overall: WAZ: +0.57, LAZ: +0.79, HCAZ: +0.54), while term infants showed minimal differences between the two standards. Conclusions The application of the WHO GS alone may misclassify preterm and term infants' growth status, particularly at birth and during early infancy. The use of the IG‐21st standards provides GA‐specific classifications that may more closely align with expected growth patterns in term and preterm infants and could support more accurate monitoring during the first year of life. Based on these implications analyses, we recommend the use of the IG‐21st NBS for cross‐sectional assessment at birth, the IG‐21st PPS from 27 to 64 weeks postmenstrual age, and the WHO GS for all babies thereafter.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"319 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}