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

{"title":"Development and preliminary evaluation of a machine learning model for predicting low birth weight using placental IVIM-MRI and maternal clinical characteristics","authors":"Wei Bian,&nbsp;Wenting Zhang,&nbsp;Hui Liu,&nbsp;Linping Wang,&nbsp;Fang Wei,&nbsp;Yuan Yao","doi":"10.1016/j.ejogrb.2025.114930","DOIUrl":"10.1016/j.ejogrb.2025.114930","url":null,"abstract":"<div><h3>Objective</h3><div>To identify key placental intravoxel incoherent motion (IVIM) MRI parameters and maternal factors associated with low birth weight (LBW), and develop a prenatal predictive model for LBW risk assessment.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 113 term neonates (January 2023–December 2024), categorized as LBW or normal birth weight. Twenty-one antenatal metrics, including maternal characteristics and region-specific placental IVIM MRI parameters (perfusion fraction [f], true diffusion coefficient [D], pseudo-diffusion coefficient [D*]), were evaluated. Feature importance was ranked using Shapley Additive Explanations (SHAP) analysis in a Random Forest algorithm. Key predictors were used to build a multivariable logistic regression nomogram. Discrimination (ROC-AUC), calibration, and clinical utility (DCA) were assessed. Internal validation employed bootstrap resampling (1000 iterations).</div></div><div><h3>Results</h3><div>SHAP identified f values from maximal placental section (f_MPS), central zone (f_CPZ), and fetal side (f_FS) as top predictors. The nomogram showed good discrimination (AUC = 0.86, 95 % CI: 0.74–0.98). Bootstrap validation yielded an AUC of 0.82 (95 % CI: 0.61–0.98), with high sensitivity and specificity. The calibration curve showed good model fit. DCA demonstrated considerable clinical benefit.</div></div><div><h3>Conclusion</h3><div>Placental IVIM MRI f values from distinct placental regions are significant LBW predictors. The model provides accurate prenatal risk assessment, guiding early interventions to optimize perinatal outcomes.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114930"},"PeriodicalIF":1.9,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145881266","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":"Inside Back Cover - Editors with images","authors":"","doi":"10.1016/S0301-2115(25)01194-7","DOIUrl":"10.1016/S0301-2115(25)01194-7","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"317 ","pages":"Article 114918"},"PeriodicalIF":1.9,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145880089","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":"Factors influencing the size of the urogenital hiatal area assessed by ultrasound","authors":"Jordi Cassadó,&nbsp;Eva Huguet,&nbsp;Anna Carmona,&nbsp;Marta Hinarejos,&nbsp;Mercè Tarragó,&nbsp;Antoni Pessarrodona,&nbsp;Oriol Porta","doi":"10.1016/j.ejogrb.2025.114922","DOIUrl":"10.1016/j.ejogrb.2025.114922","url":null,"abstract":"<div><h3>Background</h3><div>The urogenital hiatus, as assessed by MRI, has been associated with risk factors for pelvic organ prolapse and its severity. However, there is limited evidence regarding the feasibility of assessing the urogenital hiatus using ultrasound.</div></div><div><h3>Objective</h3><div>To identify the factors associated with urogenital hiatal enlargement, after confirming the interobserver reproducibility of ultrasound measurements obtained using the <em>OmniView</em> software.</div></div><div><h3>Study Design</h3><div>This retrospective observational pilot study analyzed a cohort of women who attended the pelvic floor unit of our hospital for any pelvic floor disorder between December 24 and May 25. Epidemiological, clinical, and ultrasound variables were assessed. Transperineal ultrasound was performed using <em>OmniView</em> software to measure the area of the urogenital hiatus during the Valsalva maneuver. The levator hiatal area was measured in the rendered volume during Valsalva, and levator avulsion was evaluated using a multislice system during contraction. Interobserver reproducibility was assessed. Multivariate linear regression was used to identify variables independently associated with the size of the urogenital hiatus.</div></div><div><h3>Results</h3><div>Overall, 120 women were evaluated. Interobserver correlation assessed by <em>OmniView</em> was strong for the urogenital hiatal area (rs = 0.82). In univariate analysis, levator hiatal area, prolapse stage, parity and levator avulsion were associated with the urogenital hiatal area. However, in multivariate analysis, only levator hiatal area and prolapse stage remained independently associated with the urogenital hiatal area.</div></div><div><h3>Conclusions</h3><div>Ultrasound assessment of the urogenital hiatal area using <em>OmniView</em> software is reproducible. Both the levator hiatal area and prolapse stage are independently associated with urogenital hiatus size.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114922"},"PeriodicalIF":1.9,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145881306","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 and perinatal outcomes in women with different phenotypes of adenomyosis: A retrospective cohort study","authors":"Wan Yang ,&nbsp;Xiaoyan Liu ,&nbsp;Lin Zeng ,&nbsp;Piaoe Zeng ,&nbsp;Yan Zhang ,&nbsp;Rong Li","doi":"10.1016/j.ejogrb.2025.114926","DOIUrl":"10.1016/j.ejogrb.2025.114926","url":null,"abstract":"<div><h3>Background</h3><div>To evaluate maternal and perinatal outcomes in women with different adenomyosis phenotypes and to assess the impact of placental attachment site in patients with intrinsic adenomyosis.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analysed 255 patients with adenomyosis who delivered between January 2014 and December 2019. Patients were classified into diffuse (n = 119), intrinsic (n = 89) and extrinsic (n = 47) phenotypes. Within the intrinsic group, patients were further subdivided into lesion-attached (n = 49) and lesion-unattached (n = 40) subgroups according to placental location relative to the adenomyotic lesion. To identify independent risk factors for key outcomes while adjusting for potential confounders, multivariable logistic regression analysis was employed.</div></div><div><h3>Results</h3><div>The rates and volume of postpartum haemorrhage (PPH) were significantly higher in the diffuse group compared to the focal phenotypes, with uterine atony identified as a key contributing factor. Among patients with intrinsic adenomyosis, the lesion-attached subgroup exhibited significantly greater blood loss, a lower mean gestational age at delivery (37.4 ± 2.9 vs. 38.8 ± 1.3 weeks, P = 0.006), and a higher preterm birth rate (26.5 % vs. 5.0 %, P = 0.009) compared to the lesion-unattached subgroup. Multivariate analysis confirmed placental attachment site as an independent predictor of preterm delivery, although the estimate was imprecise due to wide confidence intervals. A post hoc power analysis indicated 82 % power to detect the observed difference in preterm birth rates between these subgroups.</div></div><div><h3>Conclusions</h3><div>Diffuse adenomyosis and lesion-attached intrinsic adenomyosis are associated with an increased risk of postpartum hemorrhage. Furthermore, placental attachment to an adenomyosis lesion significantly elevates the risk of preterm delivery in patients with intrinsic disease. These findings underscore the importance of phenotype-specific and placental-site assessment for antenatal risk stratification.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114926"},"PeriodicalIF":1.9,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145881267","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":"Longitudinal ultrasound-based follow up of non-surgically treated endometriosis using #Enzian classification","authors":"Sara Valeriani ,&nbsp;Aikaterini Selntigia ,&nbsp;Consuelo Russo ,&nbsp;Myriam Adele Traulo ,&nbsp;Elvira Nocita ,&nbsp;Federica Iacobini ,&nbsp;Daniele Farsetti ,&nbsp;Giorgia Soreca ,&nbsp;Caterina Exacoustos","doi":"10.1016/j.ejogrb.2025.114923","DOIUrl":"10.1016/j.ejogrb.2025.114923","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to compare clinical and ultrasound outcomes over 24 months in premenopausal women with ultrasound-diagnosed endometriosis/adenomyosis, never treated surgically, and managed with or without hormonal therapy. We specifically assessed ultrasonographically disease progression progression, symptom control, and lesion dynamics using the compartment-based #Enzian classification.</div></div><div><h3>Materials and methods</h3><div>This single-center retrospective study included patients with endometriosis/adenomyosis who underwent transvaginal ultrasound (TVUS) and clinical assessment at baseline, 12, and 24 months. All lesions were classified according to #Enzian compartments. Patients were divided into Group A, receiving continuous hormonal therapy, and Group B managed without hormonal treatment.</div></div><div><h3>Results</h3><div>A total of 125 patients were included (Group A: n = 95; Group B: n = 30). In Group A, endometrioma prevalence declined from 87.4 % at baseline to 66.3 % at 24 months (p = 0.001), with O2 lesions decreasing from 45.3 % to 6.3 % and O1 lesions increasing from 42.1 % to 60.0 %, reflecting lesion shrinkage. Group B showed no significant changes in the O compartment (p = 0.7). FA (adenomyosis) lesions remained stable in Group A (p = 0.3) but increased from 53.0 % to 73.0 % in Group B over 24 months (p = 0.01). Compartments A, B, and C of deep endometriosis showed no significant changes in either group. Symptom prevalence decreased significantly in Group A compared with Group B.</div></div><div><h3>Conclusions</h3><div>#Enzian-based ultrasound provides a standardized approach for non-invasive longitudinal monitoring of endometriosis/adenomyosis. Hormonal therapy mainly improved symptoms, with significant lesion changes limited to O compartment, supporting its use ad a conservative management strategy while reserving surgery for selected cases.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114923"},"PeriodicalIF":1.9,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877561","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":"The impact of total laparoscopic excision of deep endometriosis (DE) on bladder and bowel dysfunction: a prospective longitudinal study","authors":"James S. Morris ,&nbsp;Smita Rajshekhar ,&nbsp;Giulia Gremmo ,&nbsp;Katie Keane ,&nbsp;Saikat Banerjee","doi":"10.1016/j.ejogrb.2025.114924","DOIUrl":"10.1016/j.ejogrb.2025.114924","url":null,"abstract":"<div><div>Deep endometriosis (DE) is established to cause chronic pelvic pain (CPP), lower urinary tract symptoms (LUTS) and altered bowel function. Although the aim of surgical excision is often to relieve CPP, evidence suggests it could also affect LUTS and bowel symptoms, especially where DE affects the bowel or urinary tract. We assessed the prevalence and improvements in CPP, LUTS and bowel symptoms in 130 patients preoperatively and 6 months following total excision of endometriosis using the British Society for Gynaecological Endoscopy (BSGE) Pelvic Pain Questionnaire. Pain symptoms and LUTS are graded 0–10 whilst bowel function is scored 0–4, each using Likert scales. Patients with urinary tract DE reported median bladder pain and bladder voiding dysfunction of 7/10 (95 % CI: 3–8) and 7/10 (95 % CI: 0–9), respectively. Improvements at follow-up did not reach statistical significance at the Šidák-adjusted significance threshold, although 80.0 % and 60.0 % of patients reported clinically important improvements to these respective symptoms. There were also no cases of <em>de novo</em> LUTS following excision of urinary tract DE. Patients with bowel DE reported CPP and menstrual dyschezia of 7/10 (95 % CI: 6–8) and 8/10 (95 % CI: 4–8), respectively. Although a significant proportion of patients with bowel DE reported clinically important improvements in bowel symptoms, the difference in symptomatic severity failed to reach statistical significance. Whilst excision of DE can produce clinically important improvements in LUTS and bowel symptoms in a large proportion of patients, there is also a considerable risk of occasioning <em>de novo</em> bowel symptoms.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114924"},"PeriodicalIF":1.9,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145881264","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":"Does the abdominal entry method in laparoscopy really matter? A network meta-analysis of rare events in randomized trials","authors":"Barbara Gardella ,&nbsp;Mattia Dominoni ,&nbsp;Chiara Cassani ,&nbsp;Martina Rita Pano ,&nbsp;Cristina Angela Camnasio ,&nbsp;Arsenio Spinillo","doi":"10.1016/j.ejogrb.2025.114925","DOIUrl":"10.1016/j.ejogrb.2025.114925","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the risk of major injuries associated with Veress, open (Hasson), direct and optical abdominal entry methods in laparoscopy.</div></div><div><h3>Methods</h3><div>Network <em>meta</em>-analysis was performed using penalized logistic regression. Pairwise <em>meta</em>-analysis was carried-out using Bayesian binomial-normal hierarchical models with weakly informative priors. Risk of bias was evaluated by ROB-2 method<strong>.</strong> NMA protocol was recorded in PROSPERO (n. CRD42024583526).</div></div><div><h3>Results</h3><div>Vascular lesions occurred in 14/2832 of Veress, 1/1661 of direct, 2/426 of optical and 0/2030 of open entry methods in 26 studies of 7250 laparoscopies. In NMA, direct and open entry methods were associated with a reduced risk of vascular lesions compared to Veress (OR = 0.17,95 %CI = 0.04–0.67 and OR = 0.09,95 %CI = 0.01–0.68,respectively). Overall, pooled rates of major injuries were 0.76/1000 (95 % CI = 0.06–2.05) in 29 studies of 7584 subjects. Major injuries were less common in direct as compared to either Veress (OR = 0.21,95 %CI = 0.08–0.56) or open method (OR = 0.23,95 %CI = 0.07–0.73). According to a ranking evaluation of absence of major complications, direct entry (SUCRA = 84.3 %) had the highest cumulative proportion of success, followed by optical entry (SUCRA = 68.5 %). Minor complications including extraperitoneal insufflation, multiple attempts, omental injury, trocar bleeding or infection or incisional hernia were studied in a network of 8984 subjects in 33 studies with a pooled prevalence of 30/1000 (95 %CI = 26.7–34.7). The risk of minor injuries was lower in direct (OR = 0.33,95 %CI = 0.23–0.46) as opposed to Veress entry. Direct entry was also the method with the lowest cumulative proportion of minor injuries (SUCRA = 97.75).</div></div><div><h3>Conclusion</h3><div>The open entrance method prevents vascular but not visceral injury. Overall, direct entry into the abdomen causes fewer severe and minor complications than Veress. In a hierarchy of procedures with fewer complications, direct entrance ranks first among the four most common methods of abdominal entry to establish pneumoperitoneum.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114925"},"PeriodicalIF":1.9,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145881258","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":"Confirming age before MTP in minors: reconciling POCSO mandates with adolescent reproductive rights","authors":"Pragnesh Parmar ,&nbsp;Gunvanti Rathod","doi":"10.1016/j.ejogrb.2025.114920","DOIUrl":"10.1016/j.ejogrb.2025.114920","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114920"},"PeriodicalIF":1.9,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145838112","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":"Caesarean section rates in public vs private hospitals in Europe: a systematic review and meta-analysis using the Robson ten group classification system","authors":"Sara Ebadi ,&nbsp;Viktoria El Radaf ,&nbsp;Tahir Mahmood ,&nbsp;Charles Savona-Ventura ,&nbsp;Mehreen Zaigham","doi":"10.1016/j.ejogrb.2025.114921","DOIUrl":"10.1016/j.ejogrb.2025.114921","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Since the last two decades, there has been a dramatic rise in caesarean sections (CS) throughout the world. This increase has been seen even in Europe, where rates vary significantly from 17% in Northern Europe to 56% in the South. Although, CS can be a lifesaving intervention when medically necessary, non-essential CS are associated with short- and long-term complications for both the mother and newborn. To curb this rising trend, it is important to understand underlying causes behind regional disparities, including differences between public and private hospitals.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To investigate variations in CS rates between public and private hospitals across European regions and at a country level using the Robson Ten Group Classification.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A systemic review of studies published between 1st January 2000 and 12th March 2025 was conducted using MEDLINE/PubMed, CINAHL, EMBASE, Global Index Medicus, Web of Science and Cochrane library, analysing CS rates in 25 European countries. All studies reporting births in Europe, Robson group, written in English or Swedish were included. The developed protocol was prospectively registered in PROSPERO (Registration number 513579). Meta-analysis using absolute numbers and percentages was conducted to compare the birth rates at country and regional levels. To assess the risk of bias, two reviewers independently evaluated the quality of the studies included using a modified Newcastle–Ottawa Scale adapted for cohort studies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of 1385 articles, 46 were eligible for inclusion in the final analysis. A total of 12 505&lt;!--&gt; &lt;!--&gt;939 births were analysed, with 8 543&lt;!--&gt; &lt;!--&gt;803 (68.3%) occurring in public hospitals and 3 962&lt;!--&gt; &lt;!--&gt;136 (31.7%) in private hospitals. Overall, Southern Europe illustrated the highest CS rate (54.9% of all births) as compared to Northern Europe (16.9%). There was a lack of reporting from private hospitals, with data only for Southern Europe, where CS rates were significantly higher in private (73.1%) as compared to public (40.9%) hospitals. The largest differences were seen for low-risk women Robson Group 1, 2, 3 and 4 (private vs public: 67.8 vs 28%, 67.6 vs 39.7, 26.9 vs 9.1% and 38 vs 18% respectively).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;High CS rates were observed across Europe, with Southern Europe reporting the highest levels. Rates were consistently higher in private compared to public hospitals. In both settings, Group 5 (women with a previous CS) was the largest contributor to the overall CS rate. However, low-risk women in private hospitals (Groups 1 and 2) had twice the CS rates compared with public hospitals. These findings highlight that the excess CS burden in private hospitals is largely driven by unnecessary procedures in low-risk groups. There is an urgent need for interventions that promote evidence-based care and reduce unnecessary CS es","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114921"},"PeriodicalIF":1.9,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921949","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":"Trends over years and maternal characteristics associated with use of recommended drugs during pregnancy: A cross-sectional study in France","authors":"Margaux Louchet ,&nbsp;Mathis Collier ,&nbsp;Jean-Marc Treluyer ,&nbsp;Jeanne Sibiude ,&nbsp;Laurent Chouchana","doi":"10.1016/j.ejogrb.2025.114903","DOIUrl":"10.1016/j.ejogrb.2025.114903","url":null,"abstract":"<div><h3>Aim</h3><div>Pregnant women require different nutritional intake such as folic acid, iron and cholecalciferol, and specific vaccination to prevent fetal abnormalities and improve outcomes. This study aims to analyze usage trends for these recommended drugs over the last decade, and to identify maternal factors associated with their use.</div></div><div><h3>Methods</h3><div>The nationwide cross-sectional study is based on data from the French National Health Data System (SNDS) including pregnancies from 2012 to 2022. Folic acid, iron, cholecalciferol, and influenza vaccination use were analyzed according to the relevant periods based on WHO and French guidelines. Multivariable logistic regression assessed maternal characteristics associated with drug use.</div></div><div><h3>Results</h3><div>Analyzing 8,979,173 pregnancies, the study found that 46.0% of pregnancies used folic acid during the periconceptional period, rising from 33.8% in 2012 to 52.6% in 2022. Women with chronic disease and higher financial resources were more likely to use it. 64.1% used iron during pregnancy with exposure increasing with age. 35.5% used cholecalciferol, with higher socioeconomic status associated with increased use. Only 5.1% were vaccinated against influenza, with the rate increasing until 2020, before declining. Vaccination was positively associated with maternal age, the presence of a chronic disease, and higher financial resources.</div></div><div><h3>Conclusion</h3><div>This study revealed increasing trends of use in recommended drugs during pregnancy over the last decade in France, although overall prevalence remains not optimal, and concerning for influenza vaccination. The identified risk factors for non-use include young maternal age, low income, and deprived areas, emphasizing the need for targeted interventions to improve maternal health outcomes.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114903"},"PeriodicalIF":1.9,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911023","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}