European journal of obstetrics, gynecology, and reproductive biology最新文献

{"title":"Impact of smoking or second-hand smoke exposure on metabolic and hormonal levels in women with polycystic ovary syndrome: A systematic review and meta-analysis","authors":"Ruyu Yan ,&nbsp;Dengxin He ,&nbsp;Wenru Xu ,&nbsp;Fen Yang ,&nbsp;Xinhong Zhu ,&nbsp;Lin Li","doi":"10.1016/j.ejogrb.2026.114973","DOIUrl":"10.1016/j.ejogrb.2026.114973","url":null,"abstract":"<div><h3>Background</h3><div>Evidence on the effects of smoking or second-hand smoke (SHS) exposure on metabolic and hormonal parameters in women with Polycystic Ovary Syndrome (PCOS) remains inconsistent. We systematically reviewed and meta-analyzed these associations.</div></div><div><h3>Methods</h3><div>Six databases (CNKI, PubMed, Web of Science, Cochrane Library, Ovid, EMBASE) were searched from inception to 24 April 2025 for observational studies reporting smoking/SHS exposure and ≥1 metabolic or hormonal outcome in PCOS patients. Study quality was assessed using the Newcastle-Ottawa and AHRQ scales. Random-effects models in Stata pooled SMD with 95% CI. Subgroup analyses evaluated SHS-only exposure; sensitivity analyses assessed robustness; publication bias was examined by funnel plots, Egger’s regression, and Begg’s test. Evidence certainty was graded using GRADE.</div></div><div><h3>Results</h3><div>Nine studies were included. Compared with non-exposed participants, smoking or SHS exposure was associated with higher Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) (<em>SMD</em> = 0.16, 95% <em>CI</em> [0.05, 0.27]), Triglyceride (TG) (<em>SMD</em> = 0.25, 95% <em>CI</em> [0.08, 0.42]), Low-Density Lipoprotein Cholesterol (LDL-C) (<em>SMD</em> = 0.16, 95% <em>CI</em> [0.003, 0.33]), Total Testosterone (TT) (<em>SMD</em> = 0.21, 95% <em>CI</em> [0.12, 0.29]) and Free Androgen Index (FAI) (<em>SMD</em> = 0.34, 95% <em>CI</em> [0.14, 0.53]), and lower High-Density Lipoprotein Cholesterol (HDL-C) (<em>SMD</em> = −0.15, 95% <em>CI</em> [-0.25, −0.05]) and Sex Hormone-Binding Globulin (SHBG) (<em>SMD</em> = −0.19, 95% <em>CI</em> [-0.34, −0.04]) (<em>P</em> &lt; 0.05). No significant difference was found in Luteinizing Hormone to Follicle-Stimulating Hormone Ratio (LH/FSH). TG and TT associations persisted in SHS-only groups, whereas HOMA-IR, HDL-C, FAI, and SHBG differences were mainly driven by active smoking. Findings were robust, with no publication bias; GRADE certainty was “very low”.</div></div><div><h3>Conclusion</h3><div>Smoking or SHS exposure was significantly associated with metabolic and hormonal profiles in women with PCOS. Despite observational limitations and absent e-cigarette data, the evidence supports advising PCOS patients to avoid smoking and SHS exposure. Registration: CRD42025633516.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114973"},"PeriodicalIF":1.9,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which body region’s fat accumulation increase the risk of stress urinary incontinence?","authors":"Ana Jéssica dos Santos Sousa ,&nbsp;Stela Márcia Mattiello ,&nbsp;Ana Paula Rodrigues Rocha ,&nbsp;Alessander Danna-Dos-Santos ,&nbsp;Patricia Driusso","doi":"10.1016/j.ejogrb.2026.114957","DOIUrl":"10.1016/j.ejogrb.2026.114957","url":null,"abstract":"<div><div>The objective of this cross-sectional study was to examine the association between fat mass distribution and stress urinary incontinence (SUI) symptoms, as well as the impact of SUI on daily activities. We assessed sociodemographic characteristics, urinary symptoms, and fat mass (total, android, gynoid, and visceral adipose tissue [VAT]). Descriptive statistics, independent t tests, and univariable and multivariable regression analyses were conducted. Women with SUI exhibited significantly higher total, android, gynoid, and VAT fat mass than women without urinary incontinence (p &lt; 0.05). Increases in total, android, gynoid, and VAT fat mass were associated with higher odds of SUI by 0.4%, 4.4%, 2.6%, and 31.4%, respectively. VAT fat mass was particularly influential, increasing the likelihood of SUI by 51% (odds ratio [OR] 1.51; 95% CI). Greater VAT accumulation was also associated with a 16.0% increase in discomfort related to urinary symptoms and a 9.3% increase in the impact on daily activities among women with SUI. In summary, higher adiposity in the android, gynoid, and especially VAT regions are associated with an increased likelihood of SUI and with greater symptom-related discomfort and functional impact.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114957"},"PeriodicalIF":1.9,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-incision slings in stress urinary incontinence: impact of intrinsic sphincter deficiency on surgical success","authors":"Tsia-Shu Lo ,&nbsp;Chean Wen Li ,&nbsp;Irene Balonzo Villaflor ,&nbsp;Ai-Leen Ro ,&nbsp;Chien-Chien Yu ,&nbsp;Tzu Hsiang Hsieh","doi":"10.1016/j.ejogrb.2026.114968","DOIUrl":"10.1016/j.ejogrb.2026.114968","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the outcome of single-incision sling (SIS) kits available on the market in women with intrinsic sphincter deficiency (ISD) and identify predictors of surgical failure.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study in a tertiary referral hospital, involving 685 women with urodynamic stress incontinence (USI), including 56 ISD preoperatively. The primary outcome was objective cure of USI, defined as the absence of demonstrable involuntary urine leakage upon increased abdominal pressure in filling cystometry. Subjective cure was a negative response to the UDI-6 question 3. The secondary outcome was to identify predictors of surgical failure.</div></div><div><h3>Results</h3><div>Overall, the primary outcome of objective cure for SIS was 89.5 % (613/685), and the subjective cure rate was 87.0 % (596/685) at the 1-year post-operative follow-up. Success rates were similar across the SIS types: Ophira™, 89.8 % (114/127); Solyx™, 89 % (299/336); and I-Stop-Mini™, 90.1 % (200/222). Multivariate logistic regression model identified age (OR 1.88 1.17–3.01), postmenopausal status (OR 1.42 1.07–2.05), angle &lt; 30° (OR 2.96 1.50–4.87), MUCP (OR 2.35 1.55–3.93), tape percentile (OR 1.60 1.19–3.11) as independent factors associated with postoperative failure of SIS in women with ISD.</div></div><div><h3>Conclusion</h3><div>SIS has a high cure rate for SUI but shows lower success in women with ISD. Careful patient selection and consideration of surgical predictors may optimize outcomes. Predictors of failure identified include older age, postmenopausal status, low MUCP, tape percentile, and a bladder neck angle &lt; 30°. Additionally, routine preoperative assessment of bladder neck mobility is suggested as a practical tool for managing women with ISD.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114968"},"PeriodicalIF":1.9,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between cardiometabolic index and prevalence of ovarian cancer among US adults: A cross-sectional NHANES study","authors":"Xinyan Gao ,&nbsp;Xiaoxiang Jiang ,&nbsp;Junming Chen ,&nbsp;Bin Du ,&nbsp;Xiaojiao Weng ,&nbsp;Jinhuo Lai ,&nbsp;Riping Wu","doi":"10.1016/j.ejogrb.2026.114954","DOIUrl":"10.1016/j.ejogrb.2026.114954","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the possible link between ovarian cancer and cardiometabolic index (CMI).</div></div><div><h3>Methods</h3><div>A cross-sectional investigation was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 1999–2018. Sensitivity analysis, smooth curve fitting, and weighted multivariate logistic regression were employed to explore the relationship between CMI and ovarian cancer. The effectiveness of CMI in detecting ovarian cancer was also assessed using eXtreme Gradient Boosting and receiver operating characteristic analysis. Furthermore, subgroup analysis and interaction tests were employed to examine the stability of the connection across different populations.</div></div><div><h3>Results</h3><div>In this study involving 8814 individuals aged ≥ 20 years, CMI was found to be positively correlated with ovarian cancer. Each unit increase in CMI was associated with 10 % increased odds of ovarian cancer in the fully adjusted model {odds ratio [OR] 1.10 [95 % confidence interval (CI) 1.02–1.17]}. The prevalence of ovarian cancer was higher in individuals in the highest CMI tertile [OR 3.68 (95 % CI 1.10–12.35)] compared with those in the lowest CMI tertile. There was a non-linear dose–response association (<em>p</em> for non-linearity = 0.004) between the odds of ovarian cancer and CMI. The results of subgroup analysis and interaction tests show that, apart from race, the relationship between CMI and ovarian cancer was consistent across subgroups.</div></div><div><h3>Conclusions</h3><div>Increased prevalence of ovarian cancer is associated with elevated CMI levels. Improving cholesterol levels and management of dyslipidaemia may help reduce the odds of ovarian cancer.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114954"},"PeriodicalIF":1.9,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146043298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 practices regarding human papillomavirus vaccine amongst secondary school girls and mothers in North India","authors":"A. Anand ,&nbsp;Y.M. Mala ,&nbsp;S. Tyagi ,&nbsp;P. Sharma","doi":"10.1016/j.ejogrb.2026.114945","DOIUrl":"10.1016/j.ejogrb.2026.114945","url":null,"abstract":"<div><h3>Background</h3><div>Lack of awareness about cervical cancer, its aetiology and preventive measures are barriers to disease control.</div></div><div><h3>Objectives</h3><div>To study the knowledge, attitudes and practices of adolescent girls and their mothers regarding cervical cancer, human papillomavirus (HPV) vaccine, and preventive strategies.</div></div><div><h3>Design</h3><div>A quasi-experimental study<!--> <!-->amongst girls aged 15–18 years and their mothers. In total, 110 girls and 100 mothers, who gave their consent, were given a pre-intervention questionnaire to assess baseline knowledge and attitudes towards cervical cancer, HPV vaccine, and preventive strategies. Printed educational material was provided. A post-intervention survey was undertaken after a minimum gap of 2 weeks.</div></div><div><h3>Results</h3><div>Ninety-one girls and 82 mothers with a diverse demographic profile completed the study. Pre-intervention findings revealed notable baseline awareness of cervical cancer, albeit with limited understanding of associated symptoms and preventive measures, including HPV vaccination. Post-intervention, knowledge regarding the symptoms of cervical cancer increased significantly among girls (<em>p</em> = 0.000), and awareness of early detection of cervical cancer increased significantly among mothers (<em>p</em> = 0.002). Knowledge about Pap smear tests increased among girls (<em>p</em> = 0.000). An increase in vaccination was seen in girls at the end of the study, but the difference was not significant (pre-intervention 23.1 %, post-intervention 31.9 %; <em>p</em> = 0.045).</div></div><div><h3>Conclusion</h3><div>Significant improvements were observed in adolescent girls and mothers regarding awareness of symptoms and early detection of cervical cancer.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114945"},"PeriodicalIF":1.9,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classification of patients with adenomyosis based on clusters of coexisting diseases: An illustration of clinical diversity","authors":"Xin Wang ,&nbsp;YuDan Fu ,&nbsp;RuoXi Zhao ,&nbsp;Yong Liu,&nbsp;RuiHua Zhao","doi":"10.1016/j.ejogrb.2026.114962","DOIUrl":"10.1016/j.ejogrb.2026.114962","url":null,"abstract":"<div><h3>Objective</h3><div>Adenomyosis (AM) is a complex disease with poorly understood pathogenesis and considerable clinical phenotypic heterogeneity. Cluster analysis of coexisting diseases may help identify distinct clinical subtypes of AM and explore the potential association between AM and its coexisting diseases.</div></div><div><h3>Methods</h3><div>In this study, data were extracted from a cross-sectional questionnaire. AM patients were clustered by Ward’s method according to the coexisting diseases. Cluster of patients with similar coexisting diseases pattern was captured and characterized. Subsequently, the clinical characteristics of these clusters were compared.</div></div><div><h3>Results</h3><div>Data from 2080 AM patients were collected. Sixteen types of coexisting diseases were included in the cluster analysis, resulting in six distinct clusters: cluster 1 (leiomyoma of the uterus); cluster 2 (endometrial lesions); cluster 3 (benign breast and thyroid masses); cluster 4 (pelvic inflammatory disease); cluster 5 (benign ovarian cyst); cluster 6 (low burden of comorbidity).</div></div><div><h3>Conclusion</h3><div>Identifying patient clusters with similar coexisting diseases pattern can improve our understanding of the multidimensional nature of AM, reveal the complex inter-disease relationship, aid in early screening for specific diseases in particular subgroups, support the identification of risk factors for AM prevention, and guide the development of tailored management strategies for different subgroups.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114962"},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of AI-generated responses to common pregnancy questions: A blinded expert evaluation","authors":"Arif Onur Atay ,&nbsp;Feride Atay ,&nbsp;Oguzcan Corlu","doi":"10.1016/j.ejogrb.2026.114960","DOIUrl":"10.1016/j.ejogrb.2026.114960","url":null,"abstract":"<div><h3>Introduction</h3><div>We conducted a cross-sectional, blinded expert evaluation of AI-generated answers to 22 frequently asked pregnancy questions to characterize content quality and potential clinical utility.</div></div><div><h3>Methods</h3><div>Five obstetricians (not involved in rating) compiled the questions; ChatGPT produced responses using a minimal prompt with a fresh session per item. Forty board-certified OB/GYNs rated each answer on 5-point Likert scales for accuracy, comprehensiveness, safety, and understandability; two deliberately incorrect attention-check items were embedded and excluded.</div></div><div><h3>Results</h3><div>We obtained 879/880 expected rating blocks (&lt;0.1% missing). Domain means clustered tightly (accuracy 3.95 ± 0.20, safety 3.94 ± 0.16, understandability 3.94 ± 0.19, comprehensiveness 3.91 ± 0.17), with no overall domain difference (Friedman χ²(3) = 3.13, p = 0.372). Question-level means ranged 3.71–4.31, highest for routine daily-life topics (air travel, sexual activity, sleep position, exercise) and lowest for context-dependent items (e.g., (non-stress test) NST 3.71; heartburn 3.72; edema 3.79; vaginal bleeding 3.81). Pre-specified subgroups showed a small but significant difference (Kruskal–Wallis p = 0.033): daily life scored higher than follow-up/testing/procedures (adjusted p &lt; 0.05), whereas daily life vs symptoms and symptoms vs follow-up were not significant. In domain × subgroup analyses, only understandability differed (p = 0.020), with daily life &gt; symptoms (adjusted p = 0.043); safety’s global difference did not yield significant pairwise contrasts. Overall inter-rater reliability was moderate, supporting consistent expert evaluation while underscoring increased variability in symptom-based assessments.</div></div><div><h3>Conclusions</h3><div>Experts rated the AI-generated answers as moderate-to-high overall; however, inter-rater reliability was only moderate and varied markedly by question type (highest for daily life questions and very low for symptom-related questions) indicating heterogeneous clinician judgments and supporting cautious interpretation of these findings.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114960"},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy outcomes after laparotomic or laparoscopic myomectomy: A multicenter retrospective cohort study","authors":"Bernies J. Bos ,&nbsp;Elisabeth R. Knorren Loes ,&nbsp;Cathy van de Graaf ,&nbsp;Marjan van den Berg ,&nbsp;Jeroen R. Dijkstra ,&nbsp;Mirjam J.A. Apperloo ,&nbsp;Jorien M. Woolderink","doi":"10.1016/j.ejogrb.2026.114964","DOIUrl":"10.1016/j.ejogrb.2026.114964","url":null,"abstract":"<div><h3>Objective</h3><div>Expend knowledge about pregnancy rate, live birth rate and outcomes after laparotomic or laparoscopic myomectomy.</div></div><div><h3>Methods</h3><div>In four hospitals in the Netherlands patients with a FIGO type 3–7 myoma who underwent laparoscopic or laparotomic myomectomy between January 2007 and April 2022, were retrospectively identified. Indication for the myomectomy was abnormal uterine bleeding, bulk-related symptoms and/or infertility. Baseline characteristics, data of the myomectomy and outcomes including pregnancy rates, live birth rates and complications during pregnancy or delivery, were extracted from electronic patient records. Logistic regression analysis was used to identify factors influencing the live birth rate.</div></div><div><h3>Results</h3><div>One hundred sixty four patients were included. Sixty one patients had 94 pregnancies after the myomectomy (pregnancy rate: 37 %), resulting in 64 deliveries in 50 patients (30 %). The most common mode of delivery was caesarean section (CS) (n = 40, 62 %). Forty-six patients had a live birth after the myomectomy (live birth rate: 28 %), together they had 60 children. No major complications related to the myomectomy occurred during pregnancy or delivery. Patients who had been pregnant before the myomectomy and patients with infertility as primary symptom, had a higher probability of live birth after myomectomy.</div></div><div><h3>Conclusion</h3><div>Patients who underwent a laparotomic or laparoscopic myomectomy have a live birth rate of 28%, with a pregnancy rate of 37%. The most common mode of delivery is CS. No major complications were found during delivery. Patients with a pregnancy prior to the myomectomy or with infertility as primary symptom had an increased probability of live birth after myomectomy.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114964"},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurocognitive function, psychosocial characteristics, and occupational performance across menstrual phases in young adults with and without primary dysmenorrhea","authors":"Aysenur Karakus ,&nbsp;Semanur Inanc ,&nbsp;Gokcen Akyurek","doi":"10.1016/j.ejogrb.2026.114965","DOIUrl":"10.1016/j.ejogrb.2026.114965","url":null,"abstract":"<div><h3>Objective</h3><div>To examine phase-related variations in cognitive, emotional, and occupational functioning among women with and without primary dysmenorrhea (PD).</div></div><div><h3>Study design</h3><div>A repeated-measures case-control study was conducted at a university-based research laboratory and hospital outpatient unit.</div></div><div><h3>Participants</h3><div>Seventy-nine women with PD and fifty-nine asymptomatic women aged 17-25 years participated.</div></div><div><h3>Main outcome measures</h3><div>Menstrual pain intensity (Visual Analog Scale), menstrual attitudes (Menstrual Attitudes Questionnaire), body awareness (Body Awareness Questionnaire), occupational performance and satisfaction (Canadian Occupational Performance Measure), and self-esteem (Rosenberg Self-Esteem Scale) were assessed across three menstrual phases. Cognitive functions (attention, processing speed, and executive control) were evaluated using the Stroop Test and the Paced Auditory Serial Addition Test. Mann-Whitney U and Friedman tests were used for between- and within-group analyses, and regression models identified predictors of occupational performance and self-esteem.</div></div><div><h3>Results</h3><div>Women with PD reported higher pain intensity (p&lt;0.001), lower BMI (p=0.022), and a more frequent family history of dysmenorrhea (p = 0.016). They also had more negative and proactive menstrual attitudes (p=0.01-0.04), lower occupational performance and satisfaction (p&lt;0.001), and reduced self-esteem (p&lt;0.001). Cognitive performance significantly declined during the luteal phase (p=0.01-0.004). No significant differences were observed in body awareness (p&gt;0.05).</div></div><div><h3>Conclusion</h3><div>Women with PD experience cognitive, emotional, and occupational challenges that extend beyond menstrual pain. Integrative, multidisciplinary interventions addressing both physical and psychosocial domains are recommended to improve overall functioning and well-being.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114965"},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expectant management of tubal ectopic pregnancy: Updated decision tree analysis for the prediction of successful outcomes","authors":"Natasha Graham ,&nbsp;Sanem Atakan ,&nbsp;Jemma Johns ,&nbsp;Jackie A. Ross","doi":"10.1016/j.ejogrb.2026.114966","DOIUrl":"10.1016/j.ejogrb.2026.114966","url":null,"abstract":"<div><h3>Objectives</h3><div>To re-analyse and update a decision tree developed 20 years ago to counsel women regarding the likelihood of successful expectant management of tubal ectopic pregnancies. The original model was developed using the data from 179 cases.</div></div><div><h3>Study design</h3><div>A retrospective observational analysis spanning a 14-year period was undertaken at the early pregnancy unit of an inner-city teaching hospital. Data were collected for all women who had expectant management when first diagnosed with their tubal ectopic pregnancies. Initial serum human chorionic gonadotropin (hCG) and progesterone levels, gestational age, ectopic morphology and mean diameter of the ectopic were recorded. Data were analysed using decision tree analysis on SPSS (IBM).</div></div><div><h3>Results</h3><div>A total of 798/1968 (40.5%) women with tubal ectopic pregnancies had expectant management and a new decision tree was developed using data from these 798 cases. Expectant management was successful in 512/798. This was 64% of women embarking on expectant management and 26% of all women with tubal ectopic pregnancies. Initial serum hCG level remains the best predictor of success for expectant management. Combined with progesterone level and diameter measurement, the decision tree has been updated.</div></div><div><h3>Conclusion</h3><div>Biochemical and clinical markers can be used to help counsel women about the likelihood of successful expectant management in our early pregnancy unit using decision tree analysis.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114966"},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}