American journal of obstetrics and gynecology最新文献

{"title":"Deep learning to predict fetal acidemia.","authors":"Emerson Keenan, Antoniya Georgieva, Fiona C Brownfoot","doi":"10.1016/j.ajog.2024.07.031","DOIUrl":"10.1016/j.ajog.2024.07.031","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":"e45"},"PeriodicalIF":8.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141858770","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}

{"title":"Defining mode of delivery as \"instrumental vaginal delivery\".","authors":"Alma Larsdotter Zweygberg, Viktor H Ahlqvist, Cecilia Magnusson","doi":"10.1016/j.ajog.2024.08.022","DOIUrl":"10.1016/j.ajog.2024.08.022","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":"e54-e55"},"PeriodicalIF":8.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016086","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}

{"title":"Nationwide introduction of first-trimester anomaly scan in the screening program: a response.","authors":"Eline E R Lust, Kim Bronsgeest, Monique C Haak, Mireille N Bekker","doi":"10.1016/j.ajog.2024.08.035","DOIUrl":"10.1016/j.ajog.2024.08.035","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":"e82"},"PeriodicalIF":8.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091390","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}

{"title":"Repeated birth injuries lead to long-term pelvic floor muscle dysfunction in the preclinical rat model.","authors":"Pamela Duran, Emma I Zelus, Lindsey A Burnett, Karen L Christman, Marianna Alperin","doi":"10.1016/j.ajog.2024.08.036","DOIUrl":"10.1016/j.ajog.2024.08.036","url":null,"abstract":"<p><strong>Background: </strong>Vaginal childbirth is a key risk factor for pelvic floor muscle injury and dysfunction, and subsequent pelvic floor disorders. Multiparity further exacerbates these risks. Using the rat model, validated for the studies of the human pelvic floor muscles, we have previously identified that a single simulated birth injury results in pelvic floor muscle atrophy and fibrosis.</p><p><strong>Objective: </strong>To test the hypothesis that multiple birth injuries would further overwhelm the muscle regenerative capacity, leading to functionally relevant pathological alterations long-term.</p><p><strong>Study design: </strong>Sprague-Dawley rats underwent simulated birth injury and were allowed to recover for 8 weeks before undergoing additional birth injury. Animals were sacrificed at acute (3 and 7 days postinjury), subacute (21, 28, and 35 days postinjury), and long-term (8 and 12 weeks postinjury) time points post second injury (N=3-8/time point), and the pubocaudalis portion of the rat levator ani complex was harvested to assess the impact of repeated birth injuries on muscle mechanical and histomorphological properties. The accompanying transcriptional changes were assessed by a customized NanoString panel. Uninjured animals were used as controls. Data with a parametric distribution were analyzed by a 2-way analysis of variance followed by post hoc pairwise comparisons using Tukey's or Sidak's tests; nonparametrically distributed data were compared with Kruskal-Wallis test followed by pairwise comparisons with Dunn's test. Data, analyzed using GraphPad Prism v8.0, San Diego, CA, are presented as mean ± standard error of the mean or median (range).</p><p><strong>Results: </strong>Following the first simulated birth injury, active muscle force decreased acutely relative to uninjured controls (12.9±0.9 vs 25.98±2.1 g/mm<sup>2</sup>, P<.01). At 4 weeks, muscle active force production recovered to baseline and remained unchanged at 8 weeks after birth injury (P>.99). Similarly, precipitous decrease in active force was observed immediately after repeated birth injury (18.07±1.2 vs 25.98±2.1 g/mm<sup>2</sup>, P<.05). In contrast to the functional recovery after a single birth injury, a long-term decrease in muscle contractile function was observed up to 12 weeks after repeated birth injuries (18.3±1.6 vs 25.98±2.1 g/mm<sup>2</sup>, P<.05). Fiber size was smaller at the long-term time points after second injury compared to the uninjured group (12 weeks vs uninjured control: 1485 (60.7-5000) vs 1989 (65.6-4702) μm<sup>2</sup>, P<.0001). The proportion of fibers with centralized nuclei, indicating active myofiber regeneration, returned to baseline at 8 weeks post-first birth injury, (P=.95), but remained elevated as far as 12 weeks post-second injury (12 weeks vs uninjured control: 7.1±1.5 vs 0.84±0.13%, P<0.0001). In contrast to the plateauing intramuscular collagen content after 4 weeks post-first injury, fibrotic degeneration","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":"198.e1-198.e23"},"PeriodicalIF":8.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142078861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accurate prediction of growth-restricted neonates at term using machine learning.","authors":"Miriam Lopian, Can Ozan Ulusoy, Smriti Prasad, Ella Segal, Asma Khalil","doi":"10.1016/j.ajog.2025.01.024","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.01.024","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045524","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}

{"title":"Effect of aspirin on biomarker profile in women at high-risk for preeclampsia.","authors":"Long Nguyen-Hoang, Daljit S Sahota, Liona C Poon","doi":"10.1016/j.ajog.2025.01.023","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.01.023","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045487","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}

{"title":"Menstrual cycle characteristics across the reproductive lifespan and cognitive function in midlife women.","authors":"Diana C Soria-Contreras, Siwen Wang, Makiko Mitsunami, Jiaxuan Liu, Rebecca B Lawn, Jan L Shifren, Alexandra C Purdue-Smithe, Emily Oken, Jorge E Chavarro","doi":"10.1016/j.ajog.2025.01.025","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.01.025","url":null,"abstract":"<p><strong>Background: </strong>Menstrual cycle characteristics are potential indicators of hormonal exposures and may also signal cardiovascular disease risk factors, both of which are relevant to cognitive health. However, there is scarce epidemiological evidence on the association between cycle characteristics and cognitive function.</p><p><strong>Objectives: </strong>We studied the associations of menstrual cycle characteristics at three stages of a woman's reproductive lifespan with cognitive function in midlife.</p><p><strong>Study design: </strong>We studied participants from the Nurses' Health Study II, an ongoing longitudinal cohort of female nurses initially enrolled in 1989. Exposures were cycle regularity at 14-17 and 18-22 years, and cycle length (the interval between two consecutive cycles) at 18-22 years (all retrospectively reported at enrollment), and current cycle regularity and length at 29-46 years (reported in 1993). Outcomes were composite z-scores measuring psychomotor speed/attention and learning/working memory obtained with one self-administered Cogstate Brief Battery assessment, measured among a subset of participants in 2014-2022. We included 19,904 participants with data on at least one menstrual cycle characteristic and a cognitive assessment. We estimated mean differences (β, 95% confidence intervals [CIs]) using linear regression models adjusted for age at cognitive assessment, race and ethnicity, participants' education, wave of cognitive assessment, parental education and occupation, neighborhood socioeconomic status, age at menarche, adiposity, oral contraceptive use, and lifestyle factors (smoking, alcohol intake, physical activity, diet quality).</p><p><strong>Results: </strong>In the analytical sample, the mean (SD) age at cognitive assessment was 62.0 (4.9) years. Women with irregular cycles at 29-46 years scored lower in learning/working memory (β, -0.05 SD; 95% CI, -0.08 to -0.01) than those with very regular cycles. We did not observe associations for cycle regularity at 14-17 or 18-22 years. Women with cycle length ≤25 days at 18-22 years scored lower in learning/working memory in later life (β, -0.05 SD; -0.09 to -0.02) than those with cycles 26-31 days. We did not observe associations of cycle length at 29-46 years with later cognitive function. In a secondary analysis, women whose cycles were regular at 14-17 or 18-22 years but became irregular by 29-46 years also had lower learning/working memory scores, compared to women whose cycles remained regular across timepoints.</p><p><strong>Conclusions: </strong>In this large longitudinal study, cycles ≤25 days at 18-22 years and irregular cycles at 29-46 years were associated with lower performance in learning/working memory. Future studies in other populations should confirm our findings and investigate the biological processes underlying these associations.</p>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143035874","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}

{"title":"The desire for parenthood and biological children among adult transgender and gender diverse individuals seeking gender-affirming care.","authors":"Mohammad A Parvez, Shalem Y Leemaqz, Michael S Irwig","doi":"10.1016/j.ajog.2025.01.027","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.01.027","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143035542","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}

{"title":"Racial and ethnic enrollment disparities in clinical trials leading to FDA approvals for gynecologic malignancies.","authors":"Gabriel Levin, Bradley J Monk, Bhavana Pothuri, Robert Coleman, Thomas Herzog, Lucy Gilbert, Laurance Bernard, Xing Zeng, Peter Scalia, Brian Slomovitz","doi":"10.1016/j.ajog.2025.01.026","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.01.026","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Black women and other minorities have higher age adjusted incidence risk for cervical and endometrial cancer than White women. However, the extent of racial and ethnic disparities in clinical trial enrollment among studies performed mainly in North America and Europe for gynecologic malignancy is unknown.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study analyzed enrollment rates by race/ethnicity in trials that led to Food and Drug Administration (FDA) approvals for gynecological cancers from 2010 to 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;This cross-sectional study examined clinical trials registered with ClinicalTrials.gov that resulted in new FDA approvals for gynecologic malignancies between 2010 and 2024. Exclusion criteria were studies not conducted in North America or Europe. Enrollment fractions were obtained by dividing the number of trial participants segregated by the racial/ethnic group by the corresponding U.S. cancer prevalence (uterine, ovarian, and cervical cancer) for 2016-2020 for each racial/ethnic group. Odds ratios (OR) and 95% confidence intervals (CI) were calculated to compare enrollment fractions of minority groups to non-Hispanic (NH) Whites.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 31 studies met the inclusion criteria, with 21 reporting race/ethnicity data. Three (3/21) studies dichotomized race as NH-White and Non-White, and Seven (7/21) reported ethnicity. The median number of participants was 494 [interquartile range 150-674]. Fifteen studies were phase III, and six were phase IB/II trials. Treatments included immune checkpoint inhibitors (seven studies), PARP inhibitors (five), VEGF inhibitors (four), antibody-drug conjugates (four), and an imaging marker (one). Across all studies, 11,258 patients were included, 5,563 (49.4%) in ovarian cancer studies, 2,963 (26.3%) in endometrial cancer studies, and 2,732 (24.3%) in cervical cancer studies. Three studies (n=1,734) dichotomized participants into NH-White and Non-White (NH-White 1,291 [74.4%] and Non-White 443 [25.6%], and enrollment fractions were 0.51% for NH-White and 0.43% for No-White, with Non-White being underrepresented odds ratio (OR) 0.85. 95% confidence interval (CI) [0.76-0.95], p=.004. In an Analysis of 18 studies reporting race categories, NH-Black patients were significantly underrepresented (OR 0.50, 95% CI [0.45-0.54], p&lt;.001), while Asian patients were overrepresented (OR 2.81, 95% CI [2.64-2.99], p&lt;.001). In the four studies reporting ethnicity, Hispanic patients were also significantly underrepresented (OR 0.69, 95% CI [0.61-0.78], p&lt;.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In clinical trials, performed in North America and Europe mainly, leading to FDA approvals for gynecologic malignancies - NH-Black and Hispanic patients are significantly underrepresented compared to NH-White participants when enrollment is benchmarked to the U.S. female population with gynecological cancer. These trials do not adequately ref","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143035877","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}

{"title":"Should Müllerian duct abnormalities be diagnosed in early pregnancy?","authors":"Yvette S Groszmann, Sarah C Lassey, Thomas D Shipp","doi":"10.1016/j.ajog.2025.01.020","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.01.020","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143035540","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}