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Insights into the impact of body mass index on post-treatment CIN3+ risk 研究BMI对治疗后CIN3+风险的影响(致编辑信)。
IF 8.4 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.ajog.2025.09.005
Kuan-Ju Huang MD, MS
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引用次数: 0
Clarifying the complex relationship between obesity and posttreatment CIN3+: evidence gaps and clinical research priorities (reply to letter to the editor) 澄清肥胖与治疗后CIN3+之间的复杂关系:证据差距和临床研究重点(回复编辑信)。
IF 8.4 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.ajog.2025.09.004
Megan A. Clarke PhD, Nicolas Wentzensen MD, PhD
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引用次数: 0
Persistent isolated hyperlordosis in the fetal and neonatal period: clinical course and outcome 胎儿和新生儿期持续性孤立性前凸:临床过程和结果。
IF 8.4 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.ajog.2025.09.047
Hana Okamoto MD , Kuniaki Ota MD, PhD , Toshifumi Takahashi MD, PhD , Yoshiaki Ota MD, PhD , Koichiro Shimoya MD, PhD
{"title":"Persistent isolated hyperlordosis in the fetal and neonatal period: clinical course and outcome","authors":"Hana Okamoto MD , Kuniaki Ota MD, PhD , Toshifumi Takahashi MD, PhD , Yoshiaki Ota MD, PhD , Koichiro Shimoya MD, PhD","doi":"10.1016/j.ajog.2025.09.047","DOIUrl":"10.1016/j.ajog.2025.09.047","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"234 2","pages":"Pages 579-581"},"PeriodicalIF":8.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The California infertility insurance mandate: another step toward reproductive justice? 加州不孕保险:迈向生殖公正的又一步?
IF 8.4 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.ajog.2025.10.014
Alexander M. Quaas MD, PhD , Eli Y. Adashi MD, MS
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引用次数: 0
Diabetes in pregnancy and major new advances in diabetes care using long-acting and ultralong-acting insulins 妊娠期糖尿病及长效和超长效胰岛素在糖尿病护理中的重大新进展
IF 8.4 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.ajog.2025.08.088
Rosa F. Drummond MD, Karl E. Seif MD, Arielle J. Higgs MD, E. Albert Reece MD, PhD, MBA
Pregestational diabetes complicates 1% to 2% of all pregnancies. Achievement of euglycemia prevents adverse maternal, fetal, and neonatal outcomes. Insulin is the first line and the backbone of diabetes treatment in and out of pregnancy, but the delicate balance between stringent control and hypoglycemia, along with the complexity and interruption of multiple injections per day, continues to make glycemic control challenging. The ideal basal insulin has a flat pharmacodynamic profile with minimal variability and is relatively easy for patients and clinicians to use. Insulin analogs, such as insulins glargine and detemir, are the most common basal insulins used in pregnancy at this time, but insulin degludec, which has advantages like prolonged duration of action in the nonpregnant population, was recently shown to be equally as effective as detemir in pregnancy. The ease of a once-daily injection without an increased risk of hypoglycemia is attractive to patients and clinicians who wish to simplify insulin regimens. Furthermore, there are current clinical trials evaluating once-weekly basal insulin regimens in the general population. This would decrease basal injections from a minimum of 365 per year to 52 per year, potentially increasing adherence and improving glycemic control. This review will discuss the evidence for insulin degludec in pregnancy as well as discuss the potential benefits and drawbacks of once-weekly ultralong-acting basal insulins in pregnancy.
妊娠期糖尿病并发症占所有妊娠的1-2%。实现高血糖可防止不良的产妇、胎儿和新生儿结局。胰岛素是妊娠期和妊娠期糖尿病治疗的第一线和支柱,但严格控制和低血糖之间的微妙平衡,以及每天多次注射的复杂性和中断,继续使血糖控制具有挑战性。理想的基础胰岛素具有平坦的药效学特征,具有最小的可变性,并且对患者和临床医生来说相对容易使用。胰岛素类似物,如甘精胰岛素和地替米胰岛素,是孕期最常用的基础胰岛素,但在非孕期人群中具有延长作用时间等优点的地替米胰岛素,最近被证明与地替米胰岛素在孕期同样有效。对于希望简化胰岛素治疗方案的患者和临床医生来说,每日注射一次而不增加低血糖风险的便利性是有吸引力的。此外,目前有临床试验评估一般人群每周一次的基础胰岛素治疗方案。这将使基础注射从每年至少365次减少到每年52次,潜在地增加依从性并改善血糖控制。本综述将讨论妊娠期降糖糖胰岛素的证据,以及妊娠期一周一次的超长效基础胰岛素的潜在益处和缺点。
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引用次数: 0
Elective fertility preservation: a national database study on trends in oocyte cryopreservation and oocyte utilization over a 5- to 7-year follow-up period 选择性生育保存:一项5-7年随访期间卵母细胞冷冻保存(OC)和卵母细胞利用趋势的SART-CORS研究。
IF 8.4 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.ajog.2025.08.032
Mabel B. Lee MD , Mehrnaz Siavoshi MS, MPH , Lorna Kwan MPH , Lindsay Kroener MD
<div><h3>Background</h3><div>In 2012, oocyte cryopreservation was no longer deemed experimental by the American Society of Reproductive Medicine. Since then, awareness and utilization of planned oocyte cryopreservation have become much more widespread. However, little is known regarding current national trends and the rate of warming and utilization of cryopreserved oocytes.</div></div><div><h3>Objective</h3><div>To assess national trends in planned oocyte cryopreservation, subsequent oocyte utilization, and outcomes of oocyte warming cycles.</div></div><div><h3>Study Design</h3><div>Retrospective cohort study with data from all patients reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System undergoing cryopreservation of autologous oocytes for fertility preservation only between the years 2014 and 2021 and all linked oocyte warming cycles. Statistical analyses were performed using linear regression tests.</div></div><div><h3>Results</h3><div>The number of patients undergoing planned oocyte cryopreservation has increased exponentially, with 4153 patients in 2014 compared to 16,436 in 2021 (<em>P</em><.01). There is a decrease in the age of patients undergoing planned oocyte cryopreservation over time, with a mean age of 36.0 years in 2014 compared to 34.9 years in 2021 (<em>P</em><.01). Subsequent return for utilization of cryopreserved oocytes within a 5- to 7-year follow-up period from planned oocyte cryopreservation cycles occurring between 2014 and 2016 was low, with only 852 patients (5.7%) returning for oocyte warming. The likelihood of returning increased with advancing patient age at the time of oocyte cryopreservation, while the mean time to oocyte warming significantly decreased with increasing patient age at the time of oocyte cryopreservation, except in patients >42 years (<em>P</em><.01). Of patients who returned for oocyte warming, 78.5% (n=669) obtained a usable embryo, while 21.5% (n=183) had no usable embryos. Of those with usable embryos, 64.2% (n=547) had a fresh embryo transfer, 46.1% (n=393) had embryos for cryopreservation, and only 14.3% of patients (n=122) opted for a freeze-all approach. Of the 393 patients with cryopreserved embryos, 115 (29.3%) returned for a frozen embryo transfer. The cumulative live birth rate of all patients undergoing oocyte warming was 28.9%, with live birth rate decreasing with an increasing age at the time of oocyte cryopreservation.</div></div><div><h3>Conclusion</h3><div>Since the availability of oocyte cryopreservation reporting for fertility preservation only, planned oocyte cryopreservation has increased exponentially. Mean age at the time of oocyte retrieval has decreased, reflecting interest in the procedure among younger patients, but there has been minimal change in distribution by race/ethnicity and geographic region. Despite the increase in oocyte cryopreservation, return for oocyte warming over a 5- to 7-year follow-up period was low,
背景:2012年,美国生殖医学学会不再认为卵母细胞冷冻保存是实验性的。从那时起,有计划的卵母细胞冷冻保存的意识和应用变得更加广泛。然而,关于目前的国家趋势和冷冻保存卵母细胞的升温和利用速度知之甚少。目的:评价我国计划卵母细胞冷冻保存、后续卵母细胞利用和卵母细胞升温周期的发展趋势。研究设计:回顾性队列研究,数据来自2014年至2021年期间向辅助生殖技术临床结果报告系统(SART-CORS)报告的所有接受自体卵母细胞冷冻保存以保存生育能力的患者,以及所有相关的卵母细胞升温周期。采用线性回归检验进行统计分析。结果:接受计划卵母细胞冷冻保存的患者数量呈指数级增长,2014年为4153例,而2021年为16436例(p42年)。结论:自卵母细胞冷冻保存报告仅用于生育能力保存以来,计划卵母细胞冷冻保存呈指数级增长。提取卵母细胞时的平均年龄有所下降,反映了年轻患者对该手术的兴趣,但在种族/民族和地理区域的分布变化很小。尽管卵母细胞冷冻保存的数量有所增加,但在5-7年的随访期间,卵母细胞升温的回报很低,有很大一部分冷冻保存的卵母细胞未被使用。卵母细胞冷冻保存时年龄较大的患者返回的可能性更大,卵母细胞冷冻保存与升温之间的间隔时间更短。虽然卵母细胞升温率很低,但返回使用冷冻卵母细胞的患者的结果令人放心。大多数患者在卵母细胞升温后都有一个可用的胚胎,活产率令人放心,并显示出预期的年龄相关下降。然而,由于回报率低,预先计划的卵母细胞冷冻保存周期的产量非常低。
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引用次数: 0
Abbreviated version of the Bladder Health Scales for women's research 女性膀胱健康量表的缩写版。
IF 8.4 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.ajog.2025.10.015
Todd Rockwood PhD, Kyle Rudser PhD, Leslie Rickey MD, Alayne D. Markland DO, Peter Scal PhD, Jerry L. Lowder MD, Emily S. Lukacz MD, Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium
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引用次数: 0
Intricacies of studying doula care 研究导乐护理的复杂性。
IF 8.4 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.ajog.2025.05.046
Lara S. Lemon PharmD, PhD, Beth Quinn RN, Hyagriv N. Simhan MD, MS
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引用次数: 0
Human papillomavirus infection of endocervical reserve cells is underestimated in the natural history of cervical cancer HPV感染宫颈内储备细胞在宫颈癌的自然史被低估。
IF 8.4 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.ajog.2025.06.044
Olaf Reich MD, Sigrid Regauer MD
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引用次数: 0
Predelivery maternal circulating neutrophil extracellular traps and deoxyribonuclease in placental dysfunction and preeclampsia 产前母体循环中性粒细胞胞外陷阱和脱氧核糖核酸酶在胎盘功能障碍和先兆子痫中的作用。
IF 8.4 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2026-02-01 DOI: 10.1016/j.ajog.2025.10.003
Birgitte K. Sundet MD , Meryam Sugulle MD, PhD , Daniel P. Jacobsen PhD , Vibeke Bratseth PhD , Sheryl Palmero MSc , Kristine M. Kindberg MD , Ragnhild M. Helseth MD, PhD , Tove Lekva PhD , Thor Ueland PhD , Shahana Balakumaran , Heidi E. Fjeldstad MD, PhD , Ida G. Lunde PhD , Anne Cathrine Staff MD, PhD
<div><h3>Background</h3><div>Neutrophil extracellular traps consist of DNA and protein and are secreted by neutrophils upon activation. They are stable structures but may be degraded by deoxyribonucleases. Neutrophil extracellular traps can induce endothelial dysfunction, an important feature of the preeclampsia pathophysiology. However, the levels of neutrophil extracellular traps biomarkers and deoxyribonuclease in the maternal circulation during preeclampsia, gestational hypertension, and fetal growth restriction, as well as potential associations to placental dysfunction, remain to be elucidated.</div></div><div><h3>Objective</h3><div>We aimed to investigate levels of circulating neutrophil extracellular traps biomarkers and deoxyribonuclease in women with early-onset and late-onset preeclampsia, gestational hypertension, and isolated fetal growth restriction compared to clinically healthy pregnancies. Additionally, we aimed to compare these biomarkers with circulating placental dysfunction biomarkers and maternal as well as fetal clinical proxies of placental dysfunction in women with preeclampsia.</div></div><div><h3>Study design</h3><div>Plasma and serum samples from women categorized as having early-onset preeclampsia (n=49), late-onset preeclampsia (n=202), gestational hypertension (n=105), isolated fetal growth restriction (n=50), and normotensive, euglycemic controls (n=1126) were analyzed by immunoassays for the circulating neutrophil extracellular traps biomarkers citrullinated histone H3 and myeloperoxidase-DNA and deoxyribonuclease and for the placental dysfunction biomarkers soluble fms-like tyrosine kinase-1 and placental growth factor. The Kruskal-Wallis H test was used to compare biomarker levels across groups. Post hoc pairwise comparisons were conducted using Dunn's test, with Bonferroni correction applied to adjust for multiple comparisons. In women with early-onset and late-onset preeclampsia, the residuals were not normally distributed. Therefore, univariable and multivariable quantile (median) regression for estimating models for the conditional median function were used to study associations between our biomarkers of interest and proxies for placental dysfunction. A 2-sided <em>P</em> value of <.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Women with early-onset and late-onset preeclampsia, but not gestational hypertension or isolated fetal growth restriction, had lower median levels of circulating citrullinated histone H3 (both adjusted <em>P</em><.001) and deoxyribonuclease (both adjusted <em>P</em><.001) compared to controls. Women with late-onset preeclampsia had lower myeloperoxidase-DNA (adjusted <em>P</em><.001) compared to controls. Univariable regression analyses within the preeclampsia group revealed positive associations between citrullinated histone H3 and placental growth factor (<em>P</em>=.004) and negative associations between citrullinated histone H3 and s
中性粒细胞胞外陷阱(NETs)由DNA和蛋白质组成,由中性粒细胞激活后分泌。它们是稳定的结构,但可能被脱氧核糖核酸酶降解。NETs可诱导内皮功能障碍,这是子痫前期病理生理的一个重要特征。然而,NETs生物标志物和脱氧核糖核酸酶在子痫前期、妊娠期高血压和胎儿生长受限期间母体循环中的水平,以及与胎盘功能障碍的潜在关联,仍有待阐明。目的:研究早发型和晚发型先兆子痫、妊娠期高血压和孤立胎儿生长受限孕妇与临床健康孕妇的循环NETs生物标志物和脱氧核糖核酸酶水平。此外,我们旨在比较这些生物标志物与循环胎盘功能障碍生物标志物,以及母体和胎儿胎盘功能障碍在子痫前期妇女中的临床指标。研究设计:采用循环NETs生物标志物瓜氨酸化组蛋白H3和髓过氧化物酶dna的免疫分析方法,分析了来自早发性子痫前期(n=49)、晚发性子痫前期(n=202)、妊娠高血压(n=105)、分离的胎儿生长受限(n=50)和正常血糖控制(n=1126)妇女的血浆和血清样本。以及脱氧核糖核酸酶和胎盘功能障碍生物标志物可溶性蛋白样酪氨酸激酶-1 (sFlt-1)和胎盘生长因子(PlGF)。采用Kruskal-Wallis H检验比较各组生物标志物水平。采用Dunn检验进行事后两两比较,采用Bonferroni校正对多重比较进行调整。在早发型和晚发型先兆子痫的女性中,残差不是正态分布的。因此,单变量和多变量分位数(中位数)回归用于估计条件中位数函数模型,以研究我们感兴趣的生物标志物与胎盘功能障碍代理之间的关联。双侧p值<0.05认为有统计学意义。结果:与对照组相比,早发型和晚发型先兆子痫,但没有妊娠期高血压或孤立性胎儿生长受限的妇女,循环瓜氨酸组蛋白H3(调整后p<0.001)和脱氧核糖核酸酶(调整后p<0.001)的中位水平较低。与对照组相比,迟发性先兆子痫妇女髓过氧化物酶- dna较低(校正p<0.001)。子痫前期组的单变量回归分析显示瓜氨酸组蛋白H3与PlGF呈正相关(p=0.004),瓜氨酸组蛋白H3与sFlt-1呈负相关(p=0.034), DNase与sFlt-1呈负相关(p=0.038)。在多变量回归分析中,瓜氨酸组蛋白H3和PlGF (p=0.009)与脱氧核糖核酸酶和采血时胎龄(p=0.001)呈正相关,而瓜氨酸组蛋白H3 (p=0.027)和脱氧核糖核酸酶(p=0.034)与收缩压呈负相关。最后,瓜氨酸组蛋白H3与新生儿体重≤10百分位数相关,代表胎盘功能障碍的胎儿代理(p=0.036)。结论:妊高征和分离性胎儿生长受限患者血液中NETs和脱氧核糖核酸酶水平较低,且瓜氨酸组蛋白H3与胎盘功能障碍生物标志物之间存在相关性,表明NETs可能在子痫前期特有的胎盘功能障碍中发挥作用。此外,低瓜氨酸组蛋白H3、低脱氧核糖核酸酶和产妇高血压之间的关联可能表明,循环脱氧核糖核酸酶存在不足导致子痫前期妇女血管过度炎症。
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American journal of obstetrics and gynecology
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