Archives of Gynecology and Obstetrics最新文献

{"title":"Integrated bioinformatic identification and translational validation of key biomarkers and therapeutic candidates for preeclampsia-related acute kidney injury","authors":"Lina Gao,&nbsp;Dong Yan,&nbsp;Xiaohui Liu,&nbsp;De Chen,&nbsp;Xiaoling Liu,&nbsp;Jian Liu","doi":"10.1007/s00404-025-08282-2","DOIUrl":"10.1007/s00404-025-08282-2","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to identify and validate key biomarkers for PE-AKI and to explore potential therapeutic candidates through an integrated bioinformatic and experimental approach.</p><h3>Methods</h3><p>Data was obtained from transcriptome sequencing of 12 mouse tissue samples and 8 human cell samples. Differential expression analysis identified differentially expressed genes (DEGs) in mouse and human PE kidney injury. The intersection of DEGs was used to identify candidate genes. Key genes were further identified through protein–protein interaction (PPI) networks, followed by subcellular localization, functional enrichment, molecular regulatory network construction, drug prediction, and molecular docking. The expression of key genes was validated in LPS-induced PE mouse models and blood samples from PE and PE-AKI patients.</p><h3>Results</h3><p>IL-6, CXCL2, and CEBPB were identified as key genes. They were significantly upregulated in both experimental and clinical PE-AKI samples and were co-enriched in pivotal inflammatory pathways, including interferon-gamma/alpha response and TNF-α signaling via NF-κB. Immune infiltration analysis revealed significant alterations in 28 immune cell types in the PE-AKI model. A comprehensive molecular regulatory network, encompassing 35 transcription factors and 93 miRNAs, was constructed. Drug prediction and molecular docking identified deptropine and clotrimazole as high-affinity candidates capable of stably binding all three key genes. Clinically, CXCL2 and CEBPB demonstrated promising diagnostic value for PE-AKI, with AUCs of 0.770 and 0.790, respectively.</p><h3>Conclusion</h3><p>IL-6, CXCL2, and CEBPB are identified as key mediators in PE-AKI. Among them, CXCL2 and CEBPB show particular promise as diagnostic biomarkers, a finding that warrants further validation in larger, multi-center cohorts to confirm their utility in stratifying disease severity.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-08282-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145930619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of different ovulation induction protocols on pregnancy outcomes of fresh cycles in patients undergoing in vitro fertilization-embryo transfer with donor sperm","authors":"Lixiao Su,&nbsp;Xiangyang Jing,&nbsp;Lin Zeng,&nbsp;Li Luo,&nbsp;Haiyan Wang,&nbsp;Rong Li,&nbsp;Hongbin Chi","doi":"10.1007/s00404-025-08272-4","DOIUrl":"10.1007/s00404-025-08272-4","url":null,"abstract":"<div><h3>Objectives</h3><p>This study analyzed clinical pregnancy outcomes in patients undergoing in vitro fertilization-embryo transfer with donor sperm (IVF-D) using different ovulation induction protocols, to provide reference data for selecting appropriate protocols.</p><h3>Methods</h3><p>Data from 1801 cycles in patients who underwent IVF-D in Peking University Third Hospital between June 2010 and June 2021 were retrospectively analyzed. Participants were divided into three groups based on the controlled ovarian hyperstimulation protocol: follicular-phase ultralong gonadotropin-releasing hormone agonist (GnRH-a), luteal-phase GnRH-a long, and gonadotropin-releasing hormone antagonist (GnRH-ant) protocol groups.</p><h3>Results</h3><p>Significant differences were observed among the groups in gonadotropin (Gn) starting dose, Gn administration duration, total Gn dose, estradiol level on the day of human chorionic gonadotropin (hCG) administration (hCG day), progesterone level on hCG day, luteinizing hormone level on hCG day, endometrial thickness on hCG day, and number of embryos transferred (p &lt; 0.05). We also found significant group differences in the number of eggs retrieved, two pronucleizygotes, and cleavages (p &lt; 0.05), but not in high-quality embryos (p &lt; 0.05). Clinical pregnancy and live birth rates significantly differed among the three groups (p &lt; 0.05), whereas ectopic pregnancy, early miscarriage, and multiple pregnancy rates did not (p &lt; 0.05).</p><h3>Conclusion</h3><p>In fresh embryo transfer cycles, the GnRH-ant protocol required the shortest duration of Gn administration and lowest total Gn dose, whereas the GnRH-a long protocol had the highest clinical pregnancy rate. Therefore, the GnRH-a long protocol is considered the preferred method for female patients who can undergo fresh transfers during IVF-D cycles.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-08272-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145930616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of ımmune cells in the placenta of gestational diabetes patients: does ıt offer hope for targeted treatment?","authors":"Denizhan Bayramoğlu,&nbsp;Celal Akdemir,&nbsp;Sibel Özler,&nbsp;Zeynep Bayramoğlu","doi":"10.1007/s00404-025-08289-9","DOIUrl":"10.1007/s00404-025-08289-9","url":null,"abstract":"<div><h3>Background</h3><p>Gestational diabetes mellitus (GDM) is a prevalent metabolic complication that arises during pregnancy, posing significant health risks for both mother and fetus. The placenta is not only affected by GDM but also actively contributes to its pathogenesis and maternal–fetal outcomes. This complex interaction makes it difficult to fully understand the etiology of GDM and its effects on the placenta. In this study, we aimed to clarify the pathogenesis of GDM by evaluating the role of inflammation and describing the macroscopic and histopathological changes in placentas affected by GDM.</p><h3>Methods</h3><p>This study compared 50 singleton pregnancies complicated by GDM with 50 normoglycemic pregnancies. All deliveries occurred at term. Placentas were examined both macroscopically and microscopically. Immunohistochemical staining was performed for the following markers: CD4, CD8, CD68, CD80, CD86, and CD206.</p><h3>Results</h3><p>Placental weight and diameter were significantly higher in the GDM group compared to the control group (p &lt; 0.001). GDM placentas showed a significantly higher frequency of chorangiosis, villous edema, villous immaturity, and ischemic changes (p &lt; 0.001). Immunohistochemical analysis revealed increased expression of CD4, CD8, CD68, CD80, and CD86, while CD206 expression was significantly reduced in the GDM group (p &lt; 0.001).</p><h3>Discussion</h3><p>These findings support the central role of placental inflammation and macrophage polarization shifts in the pathogenesis of GDM. They also highlight potential targets for developing new diagnostic biomarkers and anti-inflammatory or immunomodulatory therapeutic strategies.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-08289-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to vitamin and dietary supplement intake in fertility and pregnancy care: insights into knowledge, information satisfaction, and formulation variability","authors":"Nele-Juliana Breuste,&nbsp;Cordula Schippert,&nbsp;Frauke von Versen-Höynck","doi":"10.1007/s00404-025-08288-w","DOIUrl":"10.1007/s00404-025-08288-w","url":null,"abstract":"<div><h3>Purpose</h3><p>This study investigated adherence to vitamin and dietary supplement intake, satisfaction with healthcare-provided information, and knowledge of essential micronutrients among women seeking fertility treatment and pregnant women in Germany.</p><h3>Methods</h3><p>An anonymous online survey (34 questions) assessed sociodemographics, supplement intake, knowledge and motivations. Adherence and satisfaction were measured by MARS-D (Medication Adherence Rating Scale) and SIMS-D (Satisfaction with Information about Medicines Scale).</p><h3>Results</h3><p>Among 254 participants, 93.7% reported supplement use, and 86.6% began intake preconceptionally. On average, participants consumed two (2.0 ± 1.36) supplements concurrently. Most multiple micronutrient supplements (MMS) contained folic acid (100%) and iodine (86.2%) at recommended doses, other nutrients varied considerably. Participants knew two (1.81 ± 1.43) out of six micronutrients prior to information provision, increasing to three (2.94 ± 1.65) afterwards. Satisfaction with information (SIMS-D: 7.46 ± 5.92) was low, whereas adherence was high (MARS-D: 27.16 ± 3.06). Higher information satisfaction was associated with pregnancy (<i>p</i> = 0.007), younger age (<i>p</i> = 0.009), and lower educational level (<i>p</i> = 0.024). Adherence was linked to trimester (<i>p</i> = 0.007) and region (<i>p</i> = 0.013), with higher MARS-D scores in the first trimester and among participants from North Rhine-Westphalia. Key motivations were protecting the child and preventing deficiencies; main barriers included lack of awareness and feeling overwhelmed by preparation oversupply.</p><h3>Conclusions</h3><p>Despite high adherence, knowledge and satisfaction with information remain limited. The wide variability in MMS formulations may pose risks of over- or underdosage. Combining personalized consultations with trustworthy media resources is essential to assess individual needs and provide detailed recommendations.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-08288-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of maternal age on the risk of perineal injury and obstetric anal sphincter injury in nulliparous women","authors":"Emmanuel Attali,&nbsp;Daniel Gabbai,&nbsp;Ronen Gold,&nbsp;Asnat Groutz,&nbsp;Yariv Yogev,&nbsp;Yoav Baruch","doi":"10.1007/s00404-025-08286-y","DOIUrl":"10.1007/s00404-025-08286-y","url":null,"abstract":"<div><h3>Objective</h3><p>We aimed to evaluate the association between maternal age and the incidence of perineal injury including obstetric anal sphincter injuries (OASI) in nulliparous women.</p><h3>Study design</h3><p>A retrospective cohort population-based study was conducted at a tertiary university-affiliated center from January 2011 to December 2020. This study included all nulliparous women with singleton pregnancies at term (37–41 weeks of gestation) in vertex and occiput anterior presentation who received epidural analgesia during labor. Exclusion criteria included stillbirth, chronic and obstetric maternal conditions (hypertension, diabetes mellitus, etc.), and deliveries complicated by instrumental vaginal delivery and episiotomy were excluded. The primary outcome was the incidence of perineal injury, defined as any spontaneous perineal tear, and/or OASI.</p><h3>Results</h3><p>During the study period, a total of 39,596 nulliparouss women delivered vaginally at our center. Of them 3410 (8.61%) met the inclusion criteria, with 843 (24.7%) in the 20–25 age group and 2567 (75.3%) in the 30–35 age group. Significant differences were observed between the two age groups in terms of ethnicity, maternal weight before pregnancy and at delivery, gestational glucose challenge test results, gestational age at delivery, duration of the second stage of labor, and birth weight. The incidences of perineal injury and OASI were significantly higher in the 20–25 age group compared to the 30–35 age group (perineal injuries: 58% vs. 53.2%; <i>p</i> value: 0.015; OASI: 0.9% vs 0.4%, <i>p</i> value: 0.04). In the multivariable logistic regression analysis assessing the association between maternal age and perineal injury, the overall odds ratio for perineal injury in relation to the younger age category was calculated as 1.22 (CI 1.03–1.44; <i>p</i> value: 0.023), indicating a higher risk of perineal injury in the 20–25 age group compared to the 30–35 age group.</p><h3>Conclusion</h3><p>This study suggests that younger maternal age is independently associated with an increased risk of perineal injury and OASI among nulliparous women.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-08286-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate induction versus expectant management in primiparas presenting with decreased fetal movements at 39 weeks","authors":"Raneen Abu Shqara,&nbsp;Kylie Ella Marcovich,&nbsp;Yara Nakhleh Francis,&nbsp;Yara Bishara,&nbsp;Nadir Ganem,&nbsp;Lior Lowenstein,&nbsp;Maya Frank Wolf","doi":"10.1007/s00404-026-08303-8","DOIUrl":"10.1007/s00404-026-08303-8","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate maternal and neonatal outcomes in primiparous patients presenting with decreased fetal movements (DFM), comparing immediate induction of labor with expectant management.</p><h3>Study design</h3><p>This retrospective cohort study included nulliparous patients with singleton pregnancies who presented to our obstetric triage unit between 39 + 0 and 39 + 6 weeks of gestation with a subjective complaint of DFM, a reassuring fetal assessment, and a normal biophysical profile. Patients were offered labor induction. Those who agreed formed the induction group, while those who declined and were discharged home comprised the control group. Maternal and neonatal outcomes were compared.</p><h3>Results</h3><p>A total of 413 patients were included: 282 in the induction group and 131 in the expectant management group. Gestational age at delivery was lower in the induction group (39.4 ± 0.3 vs. 40.1 ± 0.3 weeks, p &lt; 0.001). No significant differences were observed in birthweight, cesarean delivery rates, or neonatal intensive care unit (NICU) admission. The induction group had significantly fewer neonates with cord pH &lt; 7.15 (2.5% vs. 6.9%, p = 0.034), and a shorter duration of neonatal hospitalization (2.0 ± 0.2 vs. 2.3 ± 0.5 days, p = 0.034); however, 5-min Apgar scores were similar between the groups. Total maternal hospitalization duration was significantly longer in the induction group (3.6 ± 0.6 vs. 2.2 ± 0.5 days, p &lt; 0.001), though postpartum stay was slightly shorter (2.0 ± 0.2 vs. 2.2 ± 0.1 days, p &lt; 0.001).</p><h3>Conclusion</h3><p>Among primiparous patients presenting with DFM between 39 + 0 and 39 + 6 weeks, labor induction was associated with earlier delivery and improved umbilical cord pH without increasing maternal or neonatal complications.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08303-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Between research and introduction to clinical routine—Experience with niraparib from the compassionate use program in Germany (NOGGO Register Analysis)","authors":"Jacek P. Grabowski,&nbsp;Julia Welz,&nbsp;Sabine Heublein,&nbsp;Maja Krajewska,&nbsp;Jolijn D. Boer,&nbsp;Fabian Kraus,&nbsp;Tjadina Arndt,&nbsp;Nicolas Moosmann,&nbsp;Bernhard Heinrich,&nbsp;Tobias Engler,&nbsp;Saida Agabejli,&nbsp;Mustafa Celalettin Ugur,&nbsp;Ralf Witteler,&nbsp;Oliver Albrecht,&nbsp;Harald Müller-Huesmann,&nbsp;Gülten Oskay-Özcelik,&nbsp;Cristina Hettwer,&nbsp;Sabrina Kaiser,&nbsp;Elena Braicu,&nbsp;Jalid Sehouli","doi":"10.1007/s00404-025-08295-x","DOIUrl":"10.1007/s00404-025-08295-x","url":null,"abstract":"<div><h3>Purpose</h3><p>Ovarian cancer (OC) is frequently diagnosed at a late, advanced stage, resulting in poor survival outcomes. PARP inhibitors like niraparib have shown significant efficacy in high-grade OC, particularly in tumors with homologous recombination deficiency, including BRCA mutations. This study aimed to evaluate dose modifications, safety, tolerability, and the impact on quality of life associated with niraparib in real-world clinical practice.</p><h3>Methods</h3><p>This non-interventional, register-based study included patients with platinum-sensitive recurrent OC who received niraparib as part of the compassionate-use program (CUP) in Germany. Clinical baseline characteristics, treatment data, adverse events (AEs), and quality-of-life measures were collected both prospectively and retrospectively across 14 centers. Data analysis was performed using descriptive statistical methods.</p><h3>Results</h3><p>Overall, 68 female patients were enrolled in the CUP register. Most patients had good performance status, with no significant comorbidities or concomitant medications. The most frequently reported AEs associated with niraparib were thrombocytopenia, fatigue, and nausea. Approximately half of patients required dose adjustments. AEs were less common in patients with normal physical examination findings, better ECOG performance status, and absence of comorbidities. Prior use of PARP inhibitors or previous treatment-related side effects increased the likelihood of AEs during niraparib therapy. The median treatment duration was 182 days, with disease progression being the most common reason for discontinuation.</p><h3>Conclusion</h3><p>Niraparib treatment within the German CUP demonstrated favorable safety and tolerability profiles, supporting its effectiveness in a real-world setting for patients with recurrent OC. These findings are consistent with results from clinical trials, further reinforcing the role of niraparib in this patient population.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-08295-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure to maternal vaginal flora during labor and long-term infectious morbidity of the offspring","authors":"Ofek Ben-Dahan,&nbsp;Gil Gutvirtz,&nbsp;Tamar Wainstock,&nbsp;Eyal Sheiner","doi":"10.1007/s00404-025-08240-y","DOIUrl":"10.1007/s00404-025-08240-y","url":null,"abstract":"<div><h3>Purpose</h3><p>Cesarean delivery (CD) has been linked to increased long-term infectious morbidity in offspring, potentially due to limited exposure to the maternal vaginal microbiome, which may influence immune development. We hypothesized that the degree of exposure to vaginal microbiota during labor would be associated with differences in long-term infectious morbidity.</p><h3>Methods</h3><p>We conducted a population-based cohort study including 348,332 singleton deliveries. Offspring were classified into four groups: vaginal delivery (VD, reference), CD for non-progressive labor in the first stage (NPL1), CD for non-progressive labor in the second stage (NPL2), and elective (pre-labor) CD. Infectious-related hospitalizations up to age 18 were assessed. Kaplan–Meier curves compared cumulative incidence between the groups and a Cox proportional hazards model adjusted for various potential confounders.</p><h3>Results</h3><p>Of the cohort, 89.2% were VD, 1.4% NPL1, 0.6% NPL2, and 8.8% elective CD. Infectious-related hospitalization rates were higher for NPL1 and elective CD (26.2% each) compared to NPL2 (24.3%) and VD (23.8%) (<i>p</i> &lt; 0.001). Kaplan–Meier analysis demonstrated a dose–response pattern, with the lowest cumulative incidence in VD, followed by NPL2, NPL1, and highest in elective CD (log-rank <i>p</i> &lt; 0.001). In adjusted analysis, NPL1 (aHR 1.10) and elective CD (aHR 1.13) were associated with increased long-term infectious morbidity, whereas NPL2 was not significantly different from VD.</p><h3>Conclusion</h3><p>Reduced exposure to vaginal microbiota, as in elective CD and NPL1, is associated with increased long-term infectious morbidity in offspring, while exposure during the second stage of labor (NPL2) may confer immunological benefits.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-08240-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term neurological health of the term offspring born via cesarean section for non-reassuring fetal monitoring","authors":"Gil Gutvirtz,&nbsp;Gali Pariente,&nbsp;Tamar Wainstock,&nbsp;Eyal Sheiner","doi":"10.1007/s00404-025-08258-2","DOIUrl":"10.1007/s00404-025-08258-2","url":null,"abstract":"<div><h3>Purpose</h3><p>While some evidence suggests that intrapartum fetal heart rate (FHR) monitoring is associated with a reduction in intrapartum death, a reduction in long-term neurological impairment has not been proven. In this study, we sought to evaluate the offspring long-term neurological morbidity of children born via cesarean delivery (CD) for non-reassuring FHR (NRFHR) indication.</p><h3>Methods</h3><p>A population-based cohort analysis was performed comparing long-term neurological morbidity of term children born via CD for NRFHR as compared with children born via CD for non-progressive labor (NPL), at a single medical center. Neurological morbidity of the offspring was assessed using data from community-based clinics and/or hospitalizations up to 18 years involving neurological morbidity. A Kaplan–Meier survival curve was used to compare cumulative neurological morbidity incidence between the groups. A generalized estimating equations (GEE) model was used to control for possible confounders.</p><h3>Results</h3><p>14,333 term singleton intrapartum CDs met the inclusion criteria. Of those, 59.0% were for NRFHR indication and 41.0% for NPL. Rate of total long-term neurological morbidity was comparable between the groups. The Kaplan–Meier survival curve also shows comparable cumulative incidence of neurological morbidity in both groups (Log-rank, <i>p</i> = 0.390). In the GEE model, controlling for repeated deliveries of the same mother (siblings), child birth year, follow-up time and multiple other confounders, NRFHR leading to CD was not found as a risk factor for offspring long-term neurological morbidity (aHR 1.87, 95%CI 0.74–4.72, <i>p</i> = 0.184).</p><h3>Conclusions</h3><p>Intrapartum NRFHR leading to CD did not predict long-term neurological morbidity of the offspring, possibly due to prompt intervention.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-08258-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micronutrient therapy for pyrroluria: a retrospective analysis of patient acceptance","authors":"Lena Zingg,&nbsp;Elena Pavicic,&nbsp;Norman Bitterlich,&nbsp;Petra Stute","doi":"10.1007/s00404-025-08252-8","DOIUrl":"10.1007/s00404-025-08252-8","url":null,"abstract":"<div><h3>Purpose</h3><p>Pyrroluria is a proposed metabolic condition that remains controversial and insufficiently supported by empirical evidence within conventional medical practice and research. The present study evaluates patient acceptance of micronutrient therapy prescribed for pyrroluria in a clinical setting. The aim is not to validate the condition but to document patient experiences with a therapy commonly used in complementary practice.</p><h3>Methods</h3><p>This retrospective cohort study was conducted in the Department of Gynecology at the University Hospital of Bern in 2022/2023. The study included patients who tested positive for pyrroluria and received micronutrient therapy. The primary outcome was the overall acceptance of therapy, assessed using the validated ACCEPT© questionnaire.</p><h3>Results</h3><p>The mean score for overall therapy acceptance was 74 ± 34 out of a maximum of 100 points, indicating a high level of acceptance. Micronutrient therapy was also well accepted in terms of side effects (85 ± 27), treatment constraints (71 ± 24), long-term use (85 ± 20), and therapy regimen (84 ± 21). The perceived efficacy of the therapy received a score of 63 ± 34, which did not reach statistical significance (p = 0.7).</p><h3>Conclusions</h3><p>Micronutrient therapy was well tolerated and accepted by patients with pyrroluria, underscoring its potential as a low-risk adjunctive intervention. However, the perceived treatment efficacy was modest, and no conclusions about the biological validity of pyrroluria or the effectiveness of the therapy can be drawn. Rigorous, placebo-controlled trials are needed to evaluate the therapeutic value of micronutrients in this context. Furthermore, substantial scientific investigation is required to determine whether pyrroluria constitutes a valid clinical entity within conventional medicine.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-08252-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}