International Journal of Gynecology & Obstetrics最新文献

Objective: To estimate the environmental waste footprint impact of disposable waste from contraceptive packaging and menstrual hygiene products among users of long-acting reversible contraceptives (LARCs).

Methods: This mathematical modeling study was conducted at the University of Campinas, Brazil, to assess the potential environmental waste footprint generated from cardboard and plastic packaging and the use of menstrual hygiene products among 169 097 copper intrauterine device (Cu-IUD), 69 601 levonorgestrel 52 mg IUD (hormonal-IUD), and 4857 etonogestrel implant (ENG-implant) users. The duration of use was estimated using couple-years of protection: 4.6, 4.8, 2.5, and 0.06 years for the Cu-IUD, hormonal-IUD, ENG-implant, and combined oral contraceptives (COCs), respectively. The number of menstrual hygiene products potentially used by each group was estimated. For comparison, a theoretical group of 100 000 COC users and nonusers of contraception were included to estimate the annual waste footprint.

Results: On an annual basis, Cu-IUD users generated minimal plastic waste (0.6 g) but used approximately 344.8 menstrual pads. Hormonal-IUD users produced 13.8 g of cardboard and 6.9 g of plastic packaging waste and used an estimated 127.0 pads. ENG-implant users generated 25.7 g of cardboard and 28.3 g of plastic waste and used 89.7 pads. Nonusers of contraception were estimated to use 325 pads annually and generated no contraceptive packaging waste.

Conclusion: Use of hormonal LARCs is associated with a substantially lower annual environmental waste footprint impact compared with COCs and nonuse of contraception, owing to reduced solid waste generation and fewer disposable menstrual hygiene products used.

RETRACTION: Nasr A, Shahin AY, Elsamman AM, Zakherah MS, Shaaban OM. Rectal Misoprostol Versus Intravenous Oxytocin for Prevention of Postpartum Hemorrhage. Int J Gynecol Obstet. 2009;105(3): 244–247. https://doi.org/10.1016/j.ijgo.2009.01.018.

The above article, published online on 03 June 2015 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Michael Geary; and John Wiley & Sons Ltd. UK. Concerns were raised by a third party that many of the reported p-value results for difference in age, BMI, and weight are incorrect. Additionally, the third party expressed concern that the inconsistent baseline results reported in Table 1 suggest that the study may not be a legitimate randomized controlled trial, as is claimed in the methods section. The authors responded to a request for clarification, but they were unable to provide their raw study data. Their responses to questions regarding their reported statistical results did not allay the concerns of the editorial team and publisher. As a result, the data and conclusions are considered unreliable, and therefore the article must be retracted. Speaking on behalf of the authors, A. Nasr does not agree with the decision to issue an retraction.

Objective: To develop and internally validate a nomogram for predicting the likelihood of depression among adult women with urinary incontinence (UI) using data from a nationally representative survey.

Methods: This study included 6308 women with UI aged 20 years or older from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. The women were selected at random: 75% were the training set and the remaining 25% comprised the testing set. Least absolute shrinkage and selection operator (LASSO) binomial and logistic regression models were used to select the optimal predictive variables. The depression probability was calculated using a predictor-based nomogram. Receiver operating characteristics area under the curve (ROC-AUC), calibration curve, and decision curve analysis (DCA) were used to evaluate the nomogram's performance.

Results: The nomogram included 11 predictors: age, education, ratio of family income to poverty, smoking, stroke, sleep time, trouble sleeping, leakage bother level, daily activities affected, number of nighttime urinations, and moderate-vigorous recreational activity. A nomogram model for depression risk was established based on these predictors. The AUC of the nomogram was 0.811 (95% confidence interval [CI] 0.793-0.829) in the training set and 0.810 (95% CI 0.780-0.839) in the testing set. The nomogram was well calibrated according to the calibration curve. The DCA demonstrated that the nomogram was clinically useful.

Conclusions: This study established a nomogram that is helpful for screening indivudals with UI at high risk of depression and assisting gynecologists in identifying signs of depression in patients and providing treatment.

Objective: To investigate associations between daily caffeine intake and uterine fibroids (UF) among US women of reproductive age.

Methods: This cross-sectional analysis used NHANES data from 1999 to 2006. The sample included 4712 women aged 20-50 years. Daily caffeine intake was assessed through 24-h dietary recalls. Caffeine consumption was categorized using the FDA-recommended threshold of 400 mg per day. UF diagnosis was based on physician confirmation. Multivariable logistic regression was used to explore relationships. Restricted cubic spline (RCS) analysis was also performed.

Results: The mean age was 34.04 ± 8.90 years. UF were reported by 12% of participants (n = 524). High caffeine consumers (>400 mg/day) showed elevated UF risk. This elevated risk disappeared after age adjustment. RCS analysis revealed a biphasic relationship. Protective effects occurred at low doses (<71.5 mg/day). Risk elevation appeared beyond this threshold, which was much lower than FDA guidelines.

Conclusion: This study demonstrates a dose-dependent relationship between caffeine and UF. Risk elevation occurs above 71.5 mg per day. These findings suggest a need to reconsider caffeine guidelines for hormone-dependent conditions. The results support personalized dietary counseling for UF prevention.

The editors of the International Journal of Gynecology and Obstetrics (IJGO) are pleased to announce a prize award for the best clinical research paper from a low- or middle-income country published in the IJGO during 2026.

All clinical research articles from low- and middle-income countries published in 2026 will be considered for this prize. Selection will be made by the editors and the decision will be announced in IJGO in 2027. The winning corresponding author will receive a £1000 stipend, a certificate of recognition, and complimentary access to the online version of IJGO for a period of 1 year from the date the prize is awarded. Notification will be made to the corresponding author, who will be responsible for determining distribution of the winnings.

This award has been established for the purpose of encouraging investigators, especially young scientists, from low- and middle-income countries to submit their very best clinical research articles for publication in IJGO.

IJGO is the official publication of the International Federation of Gynecology and Obstetrics (FIGO), the primary international organization for the specialty of obstetrics and gynecology. FIGO is dedicated to enhancing the health care of women worldwide, and the prize award is intended to encourage authors to work toward the FIGO mission, which is, in part, to serve an international audience by publishing original scientific articles and communications originating in low-income countries, emphasizing important obstetric and gynecologic problems, issues, and perspectives, such as maternal mortality and family planning.

RETRACTION: Abdallah, A., Khairy, M., Tawfik, M., Mohamed, S., Abdel-Rasheed, M., Salem, S., and Khalifa, E., “Role of First-Trimester Three-Dimensional (3D) Power Doppler of Placental Blood Flow And 3D Placental Volume in Early Prediction of Pre-Eclampsia,” International Journal of Gynecology & Obstetrics 153, no. 3 (2021): 466-473, https://doi.org/10.1002/ijgo.13572.

The above article, published online on 23 December 2020 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Michael Geary; and John Wiley & Sons Ltd. UK. Concerns were raised by a third party regarding the reported results, particularly the mean gestational age at delivery of the normotensive group, which is stated in the article as 36.67 weeks. In light of these concerns, the authors were asked to provide their raw data. The authors did not provide the requested study data but responded that rounding accounted for the short duration of pregnancy, as well as cultural healthcare practices in the study region. However, the editorial team and publisher did not feel that this was an adequate response to the concerns. Lacking the study data for further analysis and the inconsistencies present in several places in the article, including the odds ratios in Tables 1 and 3, the editors consider the data and conclusions to be unreliable. Therefore, the article must be retracted. When informed of the decision to retract, M. Abdel-Rasheed, on behalf of the authors, disagreed with our decision to retract.

Background: Stress urinary incontinence (SUI) is the predominant form of urinary incontinence in women. While not life-threatening, this condition significantly affects quality of life through social embarrassment, withdrawal, and anxiety. Magnetic stimulation, a non-invasive and convenient intervention, has gained considerable attention. However, its efficacy in SUI is still controversial. Hence, its clinical value needs to be further explored through systematic reviews and meta-analyses.

Objective: To clarify the efficacy of magnetic stimulation therapy for SUI in women.

Search strategy: Chinese and English studies were searched in PubMed, EMbase, Cochrane Library, Web of Science, CNKI, and Wanfang Databases up to August 2024.

Selection criteria: Randomized controlled trials of female SUI were included, focusing on urinary incontinence status, quality of life, urine pad test, urodynamics, pelvic floor muscle strength, and poor pelvic floor electromyographic signal.

Data collection and analysis: Information, such as author, study period, study type, age, intervention measures, intervention time, intervention frequency, and outcome indicators was extracted. Review Manager 5.4 and StataSE15.0 were adopted for data analyses. Sensitivity analyses and subgroup analyses were also implemented.

Main results: In total, 17 studies with 1389 patients were included. The results demonstrated that magnetic stimulation-centered treatment significantly improved urinary incontinence, quality of life, 1-hour pad test results, maximum urethral closure pressure, and fast-twitch contraction potential difference of the pelvic floor muscles. However, the therapy did not show a statistical difference in the 24-hour pad test and pelvic floor muscle strength compared with the control measure.

Conclusion: Magnetic stimulation-based therapeutic strategy can be used to improve SUI in women. However, it could not significantly improve pelvic floor muscle strength. In addition, the limited number and high heterogeneity of some research indicators may undermine the accuracy of the results. Therefore, caution is needed when translating the conclusions into clinical practice. These findings can be further corroborated through large-scale, high-quality multicenter randomized controlled trials.

Objective: Bacterial vaginosis, defined by Nugent score (Nugent-BV), has been associated with preterm birth and other adverse pregnancy outcomes. However, few studies have longitudinally described the associations between Nugent-BV and adverse pregnancy outcomes at varying times in pregnancy.

Methods: We assessed associations between Nugent-BV at two separate time points in pregnancy and preterm birth (<37 weeks of gestation), low birth weight (LBW, <2500 g), and small-for-gestational-age (SGA, <10th percentile) using data from a community-based randomized trial in rural northwestern Bangladesh from 2001 to 2007. Pregnant women provided self-collected vaginal swabs in early (first or second trimester) and late (third trimester) pregnancy for Nugent scoring. Nugent-BV was categorized as 7-10 (ref: 0-6) or 4-10 (ref: 0-3). We used multivariable regression techniques to model relationships between Nugent-BV and incidence of preterm birth, LBW, and SGA, adjusted for the trial intervention and demographic, socioeconomic, and pregnancy history factors.

Results: A total of 1243 women provided ≥1 vaginal swab with a Nugent score and had a live birth. Preterm birth incidence was 23.5% (n = 271/1151). Nugent-BV 7-10 in early (adjusted relative risk (aRR): 0.84, 95% confidence interval [CI]: 0.42, 1.66) and late (aRR: 1.04, 95% CI: 0.44, 2.41) pregnancy were not associated with preterm birth. Nugent-BV 4-10 at either time point was not associated with preterm birth in the final adjusted models. From early to late pregnancy, a transition from Nugent score category 4-10 to 0-3, relative to 0-3 at both timepoints, was associated with decreased risk of preterm birth (aRR 0.20, 95% CI: 0.06, 0.63). In early and late pregnancy, neither Nugent-BV categorization was associated with LBW or SGA in the final models.

Conclusion: Resolution of Nugent-BV between early and late pregnancy might be associated with a decreased risk of preterm birth. Longitudinal studies with frequent sampling in pregnancy and using molecular techniques are needed to better describe changes in the vaginal microbiota and associated risk for adverse pregnancy outcomes.

Background: Subglottic stenosis (SS) is a type of laryngotracheal stenosis defined by a location of less than 1.5 cm below the glottis or the vocal cords. Approximately 20% of cases are idiopathic.

Objective: We performed a systematic literature review of idiopathic subglottic stenosis (ISS) complicating pregnancy.

Search strategy: PubMed, Scopus, and clinicaltrials.gov databases were queried from inception through August 10, 2023 with the following terms: idiopathic subglottic tracheal stenosis, subglottic stenosis, subglottic stenoses, tracheal stenosis, tracheal stenoses, and pregnancy. This systematic review was conducted according to the methods described in the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines for reporting systematic reviews.

Selection criteria: Studies detailing cases of ISS affecting pregnancy were included and studies reporting SS in pregnancy from a known etiology were excluded.

Data collection and analysis: Our search identified 31 peer-reviewed published cases of ISS complicating pregnancy that met the inclusion criteria. We also included two additional cases from our institution. Publication bias was checked by the Joanna Briggs Institute critical appraisal tools. Descriptive statistical analyses were performed using Excel.

Main results: A majority of patients (26/33, 79%) were diagnosed with ISS during the reported pregnancy. Prior to pregnancy, 20/33 (61%) patients had a working diagnosis or reported symptoms of airway obstruction. Of these patients, 9/20 (45%) carried a diagnosis of asthma, and 6/20 (30%) carried a diagnosis of ISS. Specific symptoms prior to pregnancy were reported in 10/33 (30%) patients. The most common symptoms in these patients were dyspnea (10/10, 100%) and stridor (4/10, 40%). During pregnancy, all patients experienced worsening respiratory symptoms, with dyspnea (31/33, 94%), stridor (18/33, 55%), cough (13/33, 39%), hoarseness (7/33, 21%), and wheeze (5/33, 15%) being the most common symptoms. A total of 22/33 (67%) patients required medical and/or surgical management with dilation and/or excision during pregnancy. Postpartum outcomes were reported in 27/33 (82%) patients, and 1/27 (3.7%) required a tracheostomy immediately postpartum. The majority (18/27, 67%) of these patients required intervention postpartum, while 9/27 (33.3%) were asymptomatic.

Conclusion: ISS should be considered in pregnant patients with worsening respiratory symptoms despite medical management of asthma. If high clinical suspicion for upper airway obstruction exists, an otolaryngology referral for evaluation with bronchoscopy is recommended.