Journal of gynecology obstetrics and human reproduction最新文献_第10页

Prevalence of polycystic ovarian syndrome in South Asian countries and 21 global regions with Sociodemographic index: A systematic analysis of the Global Burden of Disease (1990–2021) 南亚国家和21个全球地区多囊卵巢综合征患病率与社会人口指数：全球疾病负担的系统分析（1990-2021）

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-08-27 DOI: 10.1016/j.jogoh.2025.103019

Prakasini Satapathy , Nasir Vadia , Soumya V Menon , Kattela Chennakesavulu , Rajashree Panigrahi , Ganesh Bushi , Mahendra Singh , Sanjit Sah , Awakash Turkar , S． Govinda Rao , Muhammed Shabil , Manya Soni

Background

This analysis examines both the prevalence and the disability-adjusted life years (DALYs) linked to polycystic ovary syndrome (PCOS) across South Asia and worldwide, drawing on data from the Global Burden of Disease (GBD) 1990–2021 study.

Methods

Data from GBD 2021 were analyzed using Joinpoint Regression to assess age-standardized prevalence rates (ASPR) and DALYs (ASDR). Sociodemographic index (SDI) was incorporated to evaluate the relationship between socioeconomic factors and PCOS burden. The analysis was conducted across 21 global regions, with Pearson's correlation assessing the association between SDI and PCOS outcomes.

Results

The prevalence of PCOS in South Asia increased significantly, with an average annual percentage change (AAPC) of 1.87 % (95 % CI: 1.85–1.88) from 1990 to 2021. India had the highest prevalence in 2021 (269.8 per 100,000), and the highest total percentage change (TPC) in prevalence (86.9 %). DALYs rate in India were similarly high (11.1 per 100,000. A positive correlation (r = 0.57, p < 0.001) between SDI and both prevalence and DALYs was observed.

Conclusion

PCOS prevalence and DALYs are rising across South Asia, with India experiencing the highest burden. Public health interventions should focus on improving awareness, diagnosis, and management, especially in lower SDI regions to mitigate the growing health challenge.

背景：本分析利用1990-2021年全球疾病负担（GBD）研究的数据，研究了南亚和世界范围内与多囊卵巢综合征（PCOS）相关的患病率和残疾调整生命年（DALYs）。方法：采用关节点回归分析2021年GBD的数据，评估年龄标准化患病率（ASPR）和DALYs （ASDR）。采用社会人口指数（SDI）评价社会经济因素与PCOS负担的关系。该分析在全球21个地区进行，Pearson相关性评估SDI和PCOS结果之间的关系。结果：南亚地区PCOS患病率显著上升，1990 - 2021年平均年变化百分比（AAPC）为1.87% （95% CI: 1.85-1.88）。印度2021年的患病率最高（每10万人中有269.8人），患病率的总百分比变化（TPC）最高（86.9%）。印度的DALYs比率同样高（每10万人中有11.1人）。SDI与患病率和DALYs呈正相关（r = 0.57,p < 0.001）。结论：PCOS患病率和DALYs在南亚地区呈上升趋势，其中印度负担最重。公共卫生干预措施应侧重于提高认识、诊断和管理，特别是在低SDI地区，以减轻日益严重的健康挑战。

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引用次数: 0

New challenges in operative vaginal delivery: the Odon device. A systematic review 阴道手术分娩的新挑战：Odon装置。系统回顾

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-08-27 DOI: 10.1016/j.jogoh.2025.103017

Mattia Dominoni , Gabriele Rasore , Martina Rita Pano , Alessia Scimeca , Barbara Gardella

Operative vaginal delivery is the best option for accelerating labor in the second stage labor; however, this technique requires precise clinical assessment, customized care, skilled and appropriately educated workers, in order to avoid both maternal and fetal complications. The aim of this systematic review is to analyze the innovation, design, and effectiveness of a new instrument for Operative Vaginal Delivery, the Odon device, in order to improve intrapartum obstetric care in clinical practice, to facilitate the instrumental vaginal birth, and increase maternal and neonatal outcomes.

A literature search was conducted thought electronic databases PubMed, EMBASE, Web Of Science. We considered papers published online from 2000 until January 2025, reporting the use of Odon device for operative vaginal delivery. The research was performed utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Two reviewers independently screened the abstracts of the selected studies and extracted data from full-text articles. The data were subsequently tabulated and evaluated. We selected 14 studies suitable for this systematic review.

The operative vaginal birth is expedited with the Odon Device, which reported a safe, feasible and effective profile, both for structural characteristics and clinical application. There are no serious maternal and neonatal adverse events related to the use of the device during birth. There are no serious adverse device effects. The operators reported elevated value of satisfaction about the use and application of this new instrument. A favorable evaluation and positive experience were reported also by pregnant women and obstetrics. In conclusion, phase I and II trials show that the Odon device has satisfactory safety, feasibility, and efficacy profile, so it may be considered for potential clinical uses in addition to existing procedures for operative vaginal delivery. Randomized clinical studies are required to clarify the potentials benefits associated with the use of the Odon device on newborns in comparison to other instruments for OVD.

手术阴道分娩是第二产程加速分娩的最佳选择；然而，这项技术需要精确的临床评估，定制的护理，熟练和受过适当教育的工人，以避免产妇和胎儿并发症。本系统综述的目的是分析一种用于阴道手术分娩的新型器械——Odon装置的创新、设计和有效性，以改善临床实践中的产中产科护理，促进器械阴道分娩，提高孕产妇和新生儿的预后。通过PubMed、EMBASE、Web Of Science等电子数据库进行文献检索。我们考虑了从2000年到2025年1月在线发表的关于使用Odon装置进行阴道手术分娩的论文。本研究采用系统评价和元分析首选报告项目（PRISMA）标准进行。两位审稿人独立筛选所选研究的摘要，并从全文文章中提取数据。随后将数据制成表格并进行评估。我们选择了14项适合本系统评价的研究。使用Odon装置可加快阴道分娩手术，其结构特点和临床应用均具有安全、可行和有效的特点。没有与分娩期间使用该装置相关的严重孕产妇和新生儿不良事件。没有严重的不良反应。操作者报告了对这种新仪器的使用和应用的满意度。孕妇和产科也报告了良好的评价和积极的体验。总之，I期和II期试验表明，Odon装置具有令人满意的安全性、可行性和有效性，因此除了现有的阴道分娩手术外，可以考虑将其用于潜在的临床应用。需要随机临床研究来明确与其他OVD器械相比，在新生儿中使用Odon装置的潜在益处。

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引用次数: 0

Impact of a National Public Health Plan on the time frame for moderate and severe endometriosis diagnosis 国家公共卫生计划对中度和重度子宫内膜异位症诊断时间框架的影响。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-08-14 DOI: 10.1016/j.jogoh.2025.103011

Emilie Gastineau , Laura Miquel , Antoine Netter , Aubert Agostini , Maeva Jego , Blandine Courbiere

Objective

to study the time from symptom onset to the diagnosis of moderate and severe endometriosis and to compare this delay before and after the implementation of the French National Endometriosis Public Health Plan.

Design

Monocentric retrospective cohort study.

Exposure

A comparison of diagnostic delays for moderate and severe endometriosis in women before and after the implementation of a National Public Health Plan in February 2022.

Main outcome measures

Diagnostic delay, defined as the time from symptom onset to a final diagnosis of moderate or severe endometriosis confirmed by imaging or surgery.

Results

The median diagnostic delay was 5.0 years (range 1.6–11.2) with no statistically significant difference observed before and after the implementation of the National Endometriosis Public Health Plan: median delay of 5.7 years (range 1.6–11.8) Vs. 4.2 years (range 1.5–11.1) (P = 0.70). The most common presenting symptom was dysmenorrhea (73 %), and 91 women (65 %) experienced primary infertility. Women whose initial symptom was infertility had a significantly shorter diagnostic delay compared to those with pain symptoms: median (IQR) of 1.5 (0.9–3.1) Vs. 6.9 (2.1–12.6) years, P ≤ 0.001. A younger age at symptom onset was associated with a longer diagnostic delay.

Conclusion

Despite increased awareness efforts by Public Health institutions, significant diagnostic delays for moderate and severe endometriosis persist, particularly among younger women. The objective of the National Endometriosis Public Health Plan was to raise awareness among healthcare providers to reduce diagnostic delays; however, further longitudinal studies are needed to confirm its long-term impact.

目的：研究中度和重度子宫内膜异位症从症状出现到诊断的时间，并比较实施国家子宫内膜异位症公共卫生计划前后的延迟时间。设计：单中心回顾性队列研究。暴露：比较2022年2月实施国家公共卫生计划前后妇女中度和重度子宫内膜异位症的诊断延迟。主要结局指标：诊断延迟，定义为从症状出现到经影像学或手术证实的中度或重度子宫内膜异位症最终诊断的时间。结果：中位诊断延迟为5.0年（范围1.6-11.2），实施国家子宫内膜异位症公共卫生计划前后无统计学差异：中位延迟为5.7年（范围1.6-11.8）Vs. 4.2年（范围1.5-11.1）（P=0.70）。最常见的症状是痛经（73%），91名妇女（65%）经历过原发性不孕。与有疼痛症状的女性相比，初始症状为不孕的女性诊断延迟明显更短：中位（IQR）为1.5（0.9-3.1）年Vs. 6.9（2.1-12.6）年，P≤0.001。出现症状的年龄越小，诊断延迟越长。结论：尽管公共卫生机构提高了认识，但中度和重度子宫内膜异位症的诊断延误仍然存在，特别是在年轻女性中。国家子宫内膜异位症公共卫生计划的目标是提高保健提供者的认识，减少诊断延误；然而，需要进一步的纵向研究来证实其长期影响。

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引用次数: 0

Does a second cervical ripening procedure improve vaginal delivery outcomes in primiparous women with an unfavourable Cervix? A before-and-after French study 第二次宫颈成熟手术是否能改善宫颈不佳的初产妇的阴道分娩结果？一项前后对比的法语研究。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-08-11 DOI: 10.1016/j.jogoh.2025.103008

Mathilde Frere , Clemence Klapczynski , Eric Verspyck , Sophia Braund

Objective

To evaluate the effectiveness of a second cervical ripening procedure in primiparous women with an unfavourable persistent cervix.

Methods

This retrospective, before-and-after, comparative study was conducted at Rouen University Hospital, France between January 1st, 2018, and August 15th, 2022. Inclusion criteria were women with indications for labour induction with singleton term pregnancies in cephalic presentation and with a Bishop score <6 who required an initial cervical ripening. All women underwent an initial cervical ripening procedure with either a balloon catheter or vaginal dinoprostone. In the before-protocol group, labour induction was mostly pursued with oxytocin regardless of cervical status. In the after-protocol group (post-November 2020), a second cervical ripening procedure was proposed if the Bishop score remained ≤ 4. The primary outcome was caesarean section rate. A sensitivity analysis was also performed in women with a Bishop score <6 after the first ripening.

Results

A total of 384 women were included in the study and were then divided in the before- protocol group (n=184) or in the after-protocol group (n=200). The caesarean section rate significantly decreased in the after-protocol group (31 % vs. 40.8 %; p=0.04). Bishop scores before oxytocin administration were significantly higher in the after-protocol group (median: 6 vs. 5; p=0.01). After adjustment, no significant association was found between the use of the new protocol and the caesarean section risk (OR 0.82; 95 % CI [0.58–1.34]). Factors independently associated with caesarean delivery were advanced maternal age, women not born in France, and lower Bishop scores both before and after cervical ripening. In the subgroup of women with persistent unfavourable cervix, the second procedure improved Bishop scores but was not associated with a significant reduction in caesarean section rate.

Conclusion

A second cervical ripening procedure for women with persistent low Bishop scores was not significantly associated with reduced caesarean section rates. Further studies are needed to evaluate whether combining cervical ripening methods can enhance vaginal delivery rates.

目的：评价第二次宫颈成熟手术对宫颈发育不佳的初产妇的疗效。方法：于2018年1月1日至2022年8月15日在法国鲁昂大学医院进行回顾性、前后比较研究。纳入标准为有引产指征的头位单胎足月妊娠且有Bishop评分的妇女。结果：共有384名妇女纳入研究，然后分为方案前组（n=184）和方案后组（n=200）。方案后组剖宫产率显著降低(31% vs 40.8%；p = 0.04)。方案后组给予催产素前的Bishop评分显著高于方案后组(中位数：6 vs. 5；p = 0.01)。调整后，使用新方案与剖宫产风险之间无显著关联(OR 0.82；95% ci[0.58-1.34])。与剖宫产相关的独立因素有高龄产妇、非法国出生的妇女以及宫颈成熟前后Bishop评分较低。在宫颈持续不良的妇女亚组中，第二种手术改善了Bishop评分，但与剖宫产率的显著降低无关。结论：对持续低Bishop评分的妇女进行第二次宫颈成熟手术与降低剖宫产率没有显著相关。需要进一步的研究来评估联合宫颈成熟方法是否可以提高阴道分娩率。

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引用次数: 0

Excessive gestational weight gain associated with higher risk of cesarean delivery across body mass index categories in the United States 在美国，体重指数类别中妊娠期体重增加过多与剖宫产的高风险相关。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-08-10 DOI: 10.1016/j.jogoh.2025.103010

Pearl A. Mcelfish , Nicola L. Hawley , Aaron R. Caldwell , James P. Selig , Donya Watson , Enrique Gomez-Pomar , Jennifer A. Andersen , Shashank Kraleti , Lanita White , Don E. Willis , Krista Langston , Nirvana Manning , Jennifer A. Callaghan-Koru , Austin Porter , Clare C. Brown

Objectives

This research investigated associations between rate of gestational weight gain (GWG; “below recommended rate,” “within recommended rate,” and “exceeding recommended rate”) and increased risk of cesarean delivery for women across a range of body mass index (BMI) categories (underweight, normal, overweight, obesity classes I, II, and III).

Study Design

We used vital records data from the National Center for Health Statistics to include nulliparous, singleton term births with cephalic presentation (n=7,891,653) to women who gave birth in the United States from 2014 through 2022. We evaluated the association of GWG on mode of birth (cesarean vs. vaginal delivery) using multivariable linear probability (categorical GWG) and generalized additive (continuous GWG) models.

Results

Approximately 26% of births were by cesarean delivery and 65% exceeded the recommended rate of GWG. Risk of cesarean delivery increased as BMI increased, and those in pre-pregnancy BMI above normal categories had higher risk of cesarean delivery. Excessive GWG (EGWG) increased the risk of cesarean delivery for all women, but the effect was more pronounced in those with a higher pre-pregnancy BMI. Among women whose BMI was underweight or normal, GWG had a J-shaped relationship with cesarean delivery risk, while women whose pre-pregnancy BMI was categorized as overweight or obese demonstrated a relatively linear increase in risk with any GWG.

Conclusions

Findings provide valuable insights on EGWG and increased risk of cesarean delivery for women across BMI categories. Additional efforts are needed at both the patient and provider level to reduce EGWG and the risk of cesarean delivery.

目的：本研究探讨妊娠期体重增加率(GWG；“低于推荐率”、“在推荐率之内”和“超过推荐率”)以及在一系列身体质量指数（BMI）类别（体重不足、正常、超重、I、II和III级肥胖）中女性剖宫产的风险增加。研究设计：我们使用来自国家卫生统计中心的重要记录数据，包括2014年至2022年在美国分娩的无产、单胎足月分娩的头位胎儿（n=7,891,653）。我们使用多变量线性概率（分类GWG）和广义加性（连续GWG）模型评估GWG与分娩方式（剖宫产与阴道分娩）的关系。结果：约26%的新生儿为剖宫产，65%超过推荐的GWG率。剖宫产的风险随着BMI的增加而增加，孕前BMI高于正常值者剖宫产的风险更高。对于所有女性来说，过量的GWG （EGWG）增加了剖宫产的风险，但对孕前BMI较高的女性影响更为明显。在体重指数过轻或正常的女性中，GWG与剖宫产风险呈j型关系，而孕前体重指数被归类为超重或肥胖的女性，其GWG与剖宫产风险呈相对线性增加。结论：研究结果为不同BMI类别女性的EGWG和剖宫产风险增加提供了有价值的见解。在患者和提供者层面都需要做出额外的努力，以减少EGWG和剖宫产的风险。

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引用次数: 0

Profile of pregnant women complying or not with physical activity recommendations during the second trimester of pregnancy: A French pilot study 孕妇在妊娠中期遵守或不遵守体育锻炼建议的概况：一项法国试点研究。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-08-09 DOI: 10.1016/j.jogoh.2025.103007

M. Gerard , R. Beranger , B. Pereira , N. Boisseau

Introduction

Insufficient physical activity (PA) during pregnancy is a global public health concern. The aims of this study were: i) to determine retrospectively PA and sedentary time in women in the second trimester of pregnancy, and ii) to identify factors that influence adherence to the French National College of Midwives guidelines on PA (≥150 minutes of moderate to high-intensity PA per week).

Methods

This cross-sectional, single-centre study, conducted at the University Hospital of Rennes, included 195 pregnant women. PA levels and sedentary time before and during the second trimester of pregnancy were determined using an anonymous self-report questionnaire. The self-reported PA levels were compared to the guidelines on PA. Bivariate analyses and Poisson generalized linear regression models were used to identify factors associated with non-compliance to such guidelines.

Results

Only 30.7 % of pregnant women reported the recommended PA levels in the second trimester of pregnancy. Sedentary time and adherence to the PA guidelines were not associated. Fatigue was the most frequently cited reason for insufficient PA (71.6 %). Preconception PA level was the strongest predictor of adherence. Body mass index >25 kg/m², <2 years of higher education, limited access to transportation and sports facilities, and living in a town with <2.000 inhabitants also were associated with lower PA levels.

Conclusion

Adherence to the PA recommendations is low among French pregnant women. Public health initiatives should emphasize PA importance before pregnancy and provide tailored support throughout gestation. Future studies should explore the interplay between PA, sedentary time and pregnancy outcomes.

孕期身体活动不足（PA）是一个全球性的公共卫生问题。本研究的目的是：1)回顾性地确定妊娠中期妇女的PA和久坐时间，2)确定影响法国国家助产士学院PA指南（每周≥150分钟的中高强度PA）依从性的因素。方法：这项横断面、单中心研究在雷恩大学医院进行，包括195名孕妇。研究人员使用匿名自我报告问卷来确定怀孕前和怀孕中期的PA水平和久坐时间。将自我报告的PA水平与PA指南进行比较。使用双变量分析和泊松广义线性回归模型来确定与不遵守此类指南相关的因素。结果：只有30.7%的孕妇在妊娠中期报告了推荐的PA水平。久坐时间与遵守PA指南无关。疲劳是最常见的PA不足的原因（71.6%）。孕前PA水平是依从性最强的预测因子。结论：法国孕妇对PA建议的依从性较低。公共卫生倡议应强调孕前PA的重要性，并在整个妊娠期间提供量身定制的支持。未来的研究应该探索PA、久坐时间和妊娠结局之间的相互作用。

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引用次数: 0

Factors affecting the MicroRNA expression pattern in the chorioamniotic membrane: From the perspective of preterm labor 影响绒毛膜羊膜MicroRNA表达模式的因素：从早产的角度。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-08-07 DOI: 10.1016/j.jogoh.2025.103009

Yu Yang , Shuhua Yi , Yaxin Zhang, Jun He, Tingting Chen, Hongyu Li

Preterm labor is a major contributor to neonatal mortality and morbidity worldwide. Despite extensive research, the molecular mechanisms driving preterm labor are not fully understood. Epigenetic modifications may play a role in the underlying mechanisms leading to adverse pregnancy outcomes, particularly preterm labor. Emerging evidence highlights the role of microRNAs (miRNAs), small non-coding RNAs that regulate gene expression post-transcriptionally, in the pathogenesis of preterm labor. This review focuses on the chorioamniotic membrane, a critical structure for fetal protection and development, and its involvement in miRNA-mediated pathways that contribute to preterm labor. The chorioamniotic membrane, composed of the amnion and chorion, plays a vital role in maintaining pregnancy through extracellular matrix (ECM) remodeling, immune regulation, and inflammatory responses. Dysregulation of miRNAs in this membrane, influenced by environmental stressors (e.g., oxidative stress, pollutants), maternal factors (e.g., age, obesity, diabetes), and fetal factors (e.g., sex, genetic disorders), disrupts these processes, leading to membrane weakening and preterm labor. Inflammation, particularly through Toll-like receptor (TLR) signaling and cytokine production, is a key driver of miRNA dysregulation in conditions like chorioamnionitis and preterm premature rupture of membranes (PPROM). This review summarizes the dysregulated expression of miRNAs in chorioamniotic membranes which are likely to play a role in premature birth.

早产是全世界新生儿死亡率和发病率的主要原因。尽管进行了广泛的研究，但导致早产的分子机制尚不完全清楚。表观遗传修饰可能在导致不良妊娠结局，特别是早产的潜在机制中发挥作用。新出现的证据强调了microRNAs （miRNAs）在早产发病机制中的作用，microRNAs是一种转录后调节基因表达的小非编码rna。本文综述了绒毛膜-羊膜这一胎儿保护和发育的关键结构及其参与的mirna介导的早产通路。绒毛膜-羊膜由羊膜和绒毛膜组成，通过细胞外基质（ECM）重塑、免疫调节和炎症反应在维持妊娠中起着至关重要的作用。受环境应激因素（如氧化应激、污染物）、母体因素（如年龄、肥胖、糖尿病）和胎儿因素（如性别、遗传疾病）的影响，该膜中mirna的失调会破坏这些过程，导致膜弱化和早产。炎症，特别是通过toll样受体（TLR）信号传导和细胞因子的产生，是绒毛膜羊膜炎和早产胎膜早破（PPROM）等疾病中miRNA失调的关键驱动因素。本文综述了绒毛膜羊膜中mirna表达异常可能在早产中起作用的研究进展。

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引用次数: 0

Engaging education: Boosting HPV vaccination through a serious game 参与教育：通过一个严肃的游戏促进HPV疫苗接种。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-08-06 DOI: 10.1016/j.jogoh.2025.103005

Pauline Ferreira , Julie Duclaud , Romane Tarrusson , Emmanuel Chirpaz , Antoine Bertolotti , Vincent Balaya , Phuong Lien Tran

引用次数: 0

Uterine transplantation and bioethical tensions in the post-2021 French Bioethic law: Reflections on a singular case 2021年后法国生物伦理法中的子宫移植和生物伦理紧张：对一个单一案例的反思。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-08-05 DOI: 10.1016/j.jogoh.2025.103004

Vincent Morel , Isis Carton , Ludivine Dion , Vincent Lavoué

引用次数: 0

Efficacy of non-pharmacological therapies in chronic pelvic pain of endometriosis: a systematic review and meta-analysis 非药物治疗子宫内膜异位症慢性盆腔疼痛的疗效：一项系统综述和荟萃分析。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-08-05 DOI: 10.1016/j.jogoh.2025.103006

Hegila da Silva Dantas , Maiara Costa de Oliveira , Tatiana CLA da Silva , Joyce MP de Oliveira , Maria LAS de Carvalho , Maria TABC Micussi

Introduction

Endometriosis is a condition that manifests through chronic pelvic pain and infertility. Current therapeutic options do not provide complete relief and may result in undesirable side effects.

Objective

To evaluate the efficacy of non-pharmacological therapies in relieving chronic pelvic pain compared to placebo therapies in women with endometriosis.

Methods

Developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and registered in Prospero (CRD42023455704). The searches were conducted in the Web of Science, PubMed, Scielo, Embase, and Pedro databases. We included clinical trials that employed non-pharmacological therapies and evaluated chronic pelvic pain as the primary outcome. The risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to evaluate the quality of the evidence.

Results

Nine studies were included. All studies addressed pain. The intervention group showed greater efficacy in reducing pain compared to the control group, except in one study. Five studies presented a high risk of bias, while four showed a low risk of bias. The meta-analysis for the pain outcome was conducted with five articles. The intervention was superior to the control, effectively reducing pain, with a mean difference of –1.40; 95 % CI –1.71, –1.09.

Conclusion

The studies showed improvements in pain relief and quality of through non-pharmacological therapies. However, evidence confidence was very low. This highlights the need for more rigorous studies to confirm the efficacy of non-pharmacological interventions in reducing pain in endometriosis.

简介：子宫内膜异位症是一种表现为慢性盆腔疼痛和不孕的疾病。目前的治疗方案不能提供完全缓解，并可能导致不良的副作用。目的：评价非药物治疗与安慰剂治疗在缓解子宫内膜异位症患者慢性盆腔疼痛方面的疗效。方法：根据系统评价和荟萃分析的首选报告项目（PRISMA）指南制定，并在Prospero注册（CRD42023455704）。检索在Web of Science、PubMed、Scielo、Embase和Pedro数据库中进行。我们纳入了采用非药物治疗的临床试验，并将慢性盆腔疼痛作为主要结局进行评估。采用Cochrane risk of bias 2 （RoB 2）工具评估偏倚风险，采用分级推荐评估、发展和评价（GRADE）评估证据质量。结果：纳入9项研究。所有的研究都涉及疼痛。除了一项研究外，干预组在减轻疼痛方面比对照组表现出更大的疗效。5项研究显示高偏倚风险，4项显示低偏倚风险。疼痛结果的荟萃分析由五篇文章进行。干预优于对照组，有效减轻疼痛，平均差值为-1.40；95% ci -1.71, -1.09。结论：通过非药物治疗，疼痛缓解和质量得到改善。然而，证据置信度非常低。这表明需要更严格的研究来证实非药物干预在减轻子宫内膜异位症疼痛方面的有效性。

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引用次数: 0