Pub Date : 2024-12-12DOI: 10.1007/s00404-024-07867-7
Maria Kalliosaari, T Rikkonen, R Sund, M Tuppurainen
Objective: To study the association between breast cancer and work burden over 25 years.
Methods: The study was based on the Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) cohort (n = 14,220) and included women who had answered the questionnaire from the year 1994 and had no previous breast cancer. Breast cancer cases were recorded from the Finnish Cancer Registry during the study period: from 1st June 1994 till December 31, 2019. Using questionnaires, we collected information on work burden, body mass index (BMI), menopausal hormone therapy (MHT), alcohol consumption, parity, and family history of breast cancer. Work burden was categorized as low or high. Variables were used both in the univariate and multivariate Cox regression analyses to explore their associations with breast cancer.
Results: Altogether 825 women (6.9%) were diagnosed with breast cancer during the study period with a mean follow-up of 13.3 ± 7.2 years. Women with breast cancer were compared to those without breast cancer during the follow-up period (n = 11,117). A low work burden was associated with a 1.3-fold higher incidence of breast cancer (95% confidence interval 1.2-1.6) than a high work burden. Low work burden was associated with an increased breast cancer risk.
Conclusion: Low work burden is associated with elevated postmenopausal breast cancer risk in the 25-year follow-up period.
{"title":"Is work burden associated with postmenopausal breast cancer? A population-based 25-year follow-up.","authors":"Maria Kalliosaari, T Rikkonen, R Sund, M Tuppurainen","doi":"10.1007/s00404-024-07867-7","DOIUrl":"https://doi.org/10.1007/s00404-024-07867-7","url":null,"abstract":"<p><strong>Objective: </strong>To study the association between breast cancer and work burden over 25 years.</p><p><strong>Methods: </strong>The study was based on the Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) cohort (n = 14,220) and included women who had answered the questionnaire from the year 1994 and had no previous breast cancer. Breast cancer cases were recorded from the Finnish Cancer Registry during the study period: from 1st June 1994 till December 31, 2019. Using questionnaires, we collected information on work burden, body mass index (BMI), menopausal hormone therapy (MHT), alcohol consumption, parity, and family history of breast cancer. Work burden was categorized as low or high. Variables were used both in the univariate and multivariate Cox regression analyses to explore their associations with breast cancer.</p><p><strong>Results: </strong>Altogether 825 women (6.9%) were diagnosed with breast cancer during the study period with a mean follow-up of 13.3 ± 7.2 years. Women with breast cancer were compared to those without breast cancer during the follow-up period (n = 11,117). A low work burden was associated with a 1.3-fold higher incidence of breast cancer (95% confidence interval 1.2-1.6) than a high work burden. Low work burden was associated with an increased breast cancer risk.</p><p><strong>Conclusion: </strong>Low work burden is associated with elevated postmenopausal breast cancer risk in the 25-year follow-up period.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-10DOI: 10.1007/s00404-024-07859-7
Anna Kougioumtsidou, Aikaterini Karavida, Apostolos Mamopoulos, Themistoklis Dagklis, Ioannis Tsakiridis, Stergios Kopatsaris, Georgios Michos, Apostolos P. Athanasiadis, Ioannis Kalogiannidis
Objectives
To apply the International Ovarian Tumor Analysis (IOTA) predictive models, the logistic regression model 2 (LR2) and the IOTA Assessment of Different NEoplasias in the adneXa (ADNEX), in patients with ovarian masses and to compare their performance in preoperative discrimination between benign and malignant adnexal lesions.
Methods
This was a retrospective diagnostic accuracy study with prospectively collected data, performed between January 2019 and December 2022, in a single tertiary gynecologic oncology center in Greece. The study included women with an adnexal lesion which underwent surgery within 6 months after of using the LR2 and ADNEX protocol to assess the risk of malignancy. Correlation of the ultrasound findings with the postoperative histopathological analysis was performed. Receiver–operating characteristics (ROC) curve analysis was used to determine the diagnostic accuracy of the models to classify tumors; sensitivity and specificity were determined for each model and their performance was compared.
Results
Of the136 participants, 117 (86%) had benign ovarian masses and 19 (14%) had malignant tumors. The area under the ROC curve (AUC) of the LR2 model was 0.84 (95% CI 0.74–0.93), which was significantly higher than the AUC for ADNEX model: 0.78 (95% CI 0.67–0.89). At a cut off > 10%, the LR2 model had the highest sensitivity 89.5% (95% CI 66.9–98.7) and specificity 85.1% (95% CI 76.9–91.2) compared to ADNEX model [sensitivity 84.2% (95% CI 60.4–96.6) and specificity 71.8% (95% CI 62.7–79.7)].
Conclusions
IOTA LR2 had the highest accuracy in differentiating between benign and malignant ovarian masses. IOTA LR2 and ADNEX models were both useful tools in discriminating between benign and malignant ovarian masses.
目的：应用国际卵巢肿瘤分析（IOTA）预测模型、logistic回归模型2 （LR2）和IOTA评估附件不同肿瘤（ADNEX）在卵巢肿物患者中的应用，比较其术前鉴别附件良恶性病变的表现。方法：这是一项回顾性诊断准确性研究，前瞻性收集数据，于2019年1月至2022年12月在希腊的一个三级妇科肿瘤中心进行。该研究包括在使用LR2和ADNEX方案评估恶性肿瘤风险后6个月内接受手术的患有附件病变的妇女。将超声检查结果与术后组织病理学分析进行对比。采用受试者工作特征（ROC）曲线分析确定模型对肿瘤分类的诊断准确性；测定各模型的敏感性和特异性，并对其性能进行比较。结果：136例患者中，良性卵巢肿块117例（86%），恶性肿瘤19例（14%）。LR2模型的ROC曲线下面积（AUC）为0.84 (95% CI 0.74 ~ 0.93)，显著高于ADNEX模型的AUC 0.78 （95% CI 0.67 ~ 0.89）。与ADNEX模型相比，LR2模型在截断bb0 10%时具有最高的敏感性89.5% （95% CI 66.9-98.7）和特异性85.1% (95% CI 76.9-91.2)[敏感性84.2% （95% CI 60.4-96.6）和特异性71.8% (95% CI 62.7-79.7)]。结论：IOTA LR2对卵巢良恶性肿块的鉴别准确率最高。IOTA LR2和ADNEX模型都是鉴别卵巢良恶性肿块的有效工具。
{"title":"Performance of International Ovarian Tumor Analysis (IOTA) predictive models in preoperative discrimination between benign and malignant adnexal lesions: preliminary outcomes in a Tertiary Care Hospital in Greece","authors":"Anna Kougioumtsidou, Aikaterini Karavida, Apostolos Mamopoulos, Themistoklis Dagklis, Ioannis Tsakiridis, Stergios Kopatsaris, Georgios Michos, Apostolos P. Athanasiadis, Ioannis Kalogiannidis","doi":"10.1007/s00404-024-07859-7","DOIUrl":"10.1007/s00404-024-07859-7","url":null,"abstract":"<div><h3>Objectives</h3><p>To apply the International Ovarian Tumor Analysis (IOTA) predictive models, the logistic regression model 2 (LR2) and the IOTA Assessment of Different NEoplasias in the adneXa (ADNEX), in patients with ovarian masses and to compare their performance in preoperative discrimination between benign and malignant adnexal lesions.</p><h3>Methods</h3><p>This was a retrospective diagnostic accuracy study with prospectively collected data, performed between January 2019 and December 2022, in a single tertiary gynecologic oncology center in Greece. The study included women with an adnexal lesion which underwent surgery within 6 months after of using the LR2 and ADNEX protocol to assess the risk of malignancy. Correlation of the ultrasound findings with the postoperative histopathological analysis was performed. Receiver–operating characteristics (ROC) curve analysis was used to determine the diagnostic accuracy of the models to classify tumors; sensitivity and specificity were determined for each model and their performance was compared.</p><h3>Results</h3><p>Of the136 participants, 117 (86%) had benign ovarian masses and 19 (14%) had malignant tumors. The area under the ROC curve (AUC) of the LR2 model was 0.84 (95% CI 0.74–0.93), which was significantly higher than the AUC for ADNEX model: 0.78 (95% CI 0.67–0.89). At a cut off > 10%, the LR2 model had the highest sensitivity 89.5% (95% CI 66.9–98.7) and specificity 85.1% (95% CI 76.9–91.2) compared to ADNEX model [sensitivity 84.2% (95% CI 60.4–96.6) and specificity 71.8% (95% CI 62.7–79.7)].</p><h3>Conclusions</h3><p>IOTA LR2 had the highest accuracy in differentiating between benign and malignant ovarian masses. IOTA LR2 and ADNEX models were both useful tools in discriminating between benign and malignant ovarian masses.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 1","pages":"113 - 122"},"PeriodicalIF":2.1,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-09DOI: 10.1007/s00404-024-07868-6
M David
{"title":"Concerns the publication: Vitale SG, Giannini A, Carugno J et al. Hysteroscopy: where did we start, and where are we now? The compelling story of what many considered the \"Cinderella\" of gynecological endoscopy. Arch Gynecol Obstet 310, 1877-1888 (2024).","authors":"M David","doi":"10.1007/s00404-024-07868-6","DOIUrl":"https://doi.org/10.1007/s00404-024-07868-6","url":null,"abstract":"","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-05DOI: 10.1007/s00404-024-07833-3
Izabela Chudzicka-Strugała, Anna Kubiak, Beata Banaszewska, Ewa Wysocka, Barbara Zwozdziak, Martyna Siakowska, Leszek Pawelczyk, Antoni J Duleba
Purpose: To determine whether long-term administration of synbiotics affects clinical, endocrine and metabolic aspects of polycystic ovary syndrome (PCOS) in overweight and obese subjects undergoing intensive lifestyle modifications.
Methods: During six-month trial, all subjects underwent intensive lifestyle modifications (diet and exercise). The subjects were randomized (1:1) to receive synbiotic supplementation (Synbiotic Group) or placebo (Placebo Group).
Results: Subjects in the Placebo Group and the Synbiotic Group experienced significant reduction of BMI (- 8% and - 11%, respectively; both at P < 0.0001) and body fat percentage (- 11% and - 14%, respectively; both at P < 0.0001). These effects were statistically comparable for both groups. Total testosterone was not significantly changed in the Placebo Group (- 5%, P = 0.41) while it greatly declined in the Synbiotic Group (- 40%; P < 0.0001); the difference between these groups was significant (P = 0.0002). Synbiotic supplementation was superior to placebo in reducing LH (- 21%; P = 0.047), total cholesterol (- 6%; P = 0.002), low-density lipoprotein cholesterol (- 6%; P = 0.044), triglycerides (- 29%; P = 0.049), LPS (- 23%; P = 0.001) and LPS-binding protein (- 21%; P = 0.001).
Conclusions: Synbiotic supplementation led to a marked improvement of several key clinical and laboratory aspects of PCOS including an improvement of hyperandrogenism, lipid profile, and markers of endotoxemia.
Trial registration: Clinical Trial Registration Number: NCT03325023 (URL, clinicaltrials.gov; date of registration 10/26/2017).
{"title":"Six-month randomized, placebo controlled trial of synbiotic supplementation in women with polycystic ovary syndrome undergoing lifestyle modifications.","authors":"Izabela Chudzicka-Strugała, Anna Kubiak, Beata Banaszewska, Ewa Wysocka, Barbara Zwozdziak, Martyna Siakowska, Leszek Pawelczyk, Antoni J Duleba","doi":"10.1007/s00404-024-07833-3","DOIUrl":"https://doi.org/10.1007/s00404-024-07833-3","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether long-term administration of synbiotics affects clinical, endocrine and metabolic aspects of polycystic ovary syndrome (PCOS) in overweight and obese subjects undergoing intensive lifestyle modifications.</p><p><strong>Methods: </strong>During six-month trial, all subjects underwent intensive lifestyle modifications (diet and exercise). The subjects were randomized (1:1) to receive synbiotic supplementation (Synbiotic Group) or placebo (Placebo Group).</p><p><strong>Results: </strong>Subjects in the Placebo Group and the Synbiotic Group experienced significant reduction of BMI (- 8% and - 11%, respectively; both at P < 0.0001) and body fat percentage (- 11% and - 14%, respectively; both at P < 0.0001). These effects were statistically comparable for both groups. Total testosterone was not significantly changed in the Placebo Group (- 5%, P = 0.41) while it greatly declined in the Synbiotic Group (- 40%; P < 0.0001); the difference between these groups was significant (P = 0.0002). Synbiotic supplementation was superior to placebo in reducing LH (- 21%; P = 0.047), total cholesterol (- 6%; P = 0.002), low-density lipoprotein cholesterol (- 6%; P = 0.044), triglycerides (- 29%; P = 0.049), LPS (- 23%; P = 0.001) and LPS-binding protein (- 21%; P = 0.001).</p><p><strong>Conclusions: </strong>Synbiotic supplementation led to a marked improvement of several key clinical and laboratory aspects of PCOS including an improvement of hyperandrogenism, lipid profile, and markers of endotoxemia.</p><p><strong>Trial registration: </strong>Clinical Trial Registration Number: NCT03325023 (URL, clinicaltrials.gov; date of registration 10/26/2017).</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: When oncological waiting lists are prolonged, gynecological oncology units are forced to delay operations, especially for endometrial cancer (EC) due to its good prognosis among gynecological cancers. The aim of this study is to evaluate the impact of delay in the oncological outcomes of these patients.
Methods: This is a retrospective analysis of all women with EC treated in our clinic, 2012-2019. Delay was calculated as the time interval between histological diagnosis of endometrial biopsy and definite surgery. The cutoff point was set at 8 weeks. Patients' characteristics, treatment options and follow-up information were collected. Primary outcomes were the need of adjuvant treatment and survival rates.
Results: 259 Patients met the inclusion criteria. Based on the 8-week cutoff point, patients were divided into 2 groups: 119 underwent surgery up to 8 weeks (group A) and 140 over 8 weeks (group B). There was no statistical difference in the FIGO stage or the preoperative CA-125 levels between the two groups. However, patients in group A were younger, with lower body mass index (BMI) and less comorbidities. Furthermore, patients in group B had a significantly higher probability of receiving pelvic radiation with or without brachytherapy (p = 0.0053). Concerning survival rates, there was a statistically difference in disease-free (p = 0.0312), but no difference was found in overall survival (p = 0.146).
Conclusion: Delaying EC surgery over 8 weeks may not have an impact on the mortality of the patients, but increases the need of adjuvant pelvic radiation and worsens recurrence rates. As a result, patients experience more side effects which subsequently had negative impact on their quality of life.
{"title":"The impact of delay from diagnosis to surgery in endometrial cancer.","authors":"Dimitrios Zouzoulas, Dimitrios Tsolakidis, Tilemachos Karalis, Michalis Aristotelidis, Maria Topalidou, Grigorios Grimbizis","doi":"10.1007/s00404-024-07855-x","DOIUrl":"https://doi.org/10.1007/s00404-024-07855-x","url":null,"abstract":"<p><strong>Purpose: </strong>When oncological waiting lists are prolonged, gynecological oncology units are forced to delay operations, especially for endometrial cancer (EC) due to its good prognosis among gynecological cancers. The aim of this study is to evaluate the impact of delay in the oncological outcomes of these patients.</p><p><strong>Methods: </strong>This is a retrospective analysis of all women with EC treated in our clinic, 2012-2019. Delay was calculated as the time interval between histological diagnosis of endometrial biopsy and definite surgery. The cutoff point was set at 8 weeks. Patients' characteristics, treatment options and follow-up information were collected. Primary outcomes were the need of adjuvant treatment and survival rates.</p><p><strong>Results: </strong>259 Patients met the inclusion criteria. Based on the 8-week cutoff point, patients were divided into 2 groups: 119 underwent surgery up to 8 weeks (group A) and 140 over 8 weeks (group B). There was no statistical difference in the FIGO stage or the preoperative CA-125 levels between the two groups. However, patients in group A were younger, with lower body mass index (BMI) and less comorbidities. Furthermore, patients in group B had a significantly higher probability of receiving pelvic radiation with or without brachytherapy (p = 0.0053). Concerning survival rates, there was a statistically difference in disease-free (p = 0.0312), but no difference was found in overall survival (p = 0.146).</p><p><strong>Conclusion: </strong>Delaying EC surgery over 8 weeks may not have an impact on the mortality of the patients, but increases the need of adjuvant pelvic radiation and worsens recurrence rates. As a result, patients experience more side effects which subsequently had negative impact on their quality of life.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-04DOI: 10.1007/s00404-024-07816-4
Songwen Nian, Huixia Yang, Yumei Wei
Purpose: To explore the outcomes and factors influencing vaginal trial labor in primiparas with term singleton fetuses.
Methods: A retrospective analysis of 9174 first-time mothers who opted for a vaginal trial of labor at Peking University First Hospital from October 2019 to September 2022 was performed. The primary outcomes included the outcome of the trial of labor and influencing factors.
Results: Of the total population, the success rate of attempted vaginal delivery was 74.3% (6818/9174). Logistic regression analysis revealed that increasing maternal age (OR = 1.054; 95% CI = 1.239-2.316; p < 0.001), gestational weight gain (OR = 1.033; 95% CI = 1.022-1.045; p < 0.001), neonatal weight (OR = 1.971; 95% CI = 1.724-2.253; p < 0.001), prepregnancy body mass index (BMI) ≥ 24 kg/m2 (OR = 1.605; 95% CI = 1.411-1.825; p < 0.001), prenatal BMI ≥ 24 kg/m2 (OR = 1.326; 95% CI = 1.137-1.546; p < 0.001), and induced labor (OR = 2.434; 95% CI = 2.187-2.708; p < 0.001) increased the risk of failed vaginal delivery attempts, and labor analgesia reduced the risk of failed vaginal delivery attempts (OR = 0.356; 95% CI = 0.320-0.397; p < 0.001). However, the use of assisted reproductive technology had no significant effect on the outcome of attempted vaginal delivery (p = 0.137). According to the partial regression coefficient, the area under the ROC curve was 0.710 (95% CI = 0.698-0.723), and the model passed the Hosmer-Lemeshow test and had good discrimination and calibration (χ2 = 12.833, p = 0.118). The postpartum hemorrhage (PPH) rate and overall neonatal asphyxia rate differed significantly between women who had different outcomes of vaginal trial labor.
Conclusions: There are many factors affecting the occurrence of abnormal delivery in primiparas. These independent factors can be used for prenatal evaluation.
目的：探讨影响单胎足月初产妇阴道试产的因素及结局。方法：回顾性分析2019年10月至2022年9月北京大学第一医院9174例选择阴道试产的产妇。主要结局包括产程试验结果及影响因素。结果：阴道分娩成功率为74.3%（6818/9174）。Logistic回归分析显示，产妇年龄增加(OR = 1.054；95% ci = 1.239-2.316；p 2 (OR = 1.605；95% ci = 1.411-1.825；p 2 (OR = 1.326；95% ci = 1.137-1.546；P = 12.833, P = 0.118)。产后出血（PPH）率和新生儿窒息率在阴道试产不同结局的妇女之间有显著差异。结论：影响初产妇异常分娩的因素很多。这些独立因素可用于产前评估。
{"title":"Analysis of the outcomes and factors influencing vaginal trial labor in primiparas at term.","authors":"Songwen Nian, Huixia Yang, Yumei Wei","doi":"10.1007/s00404-024-07816-4","DOIUrl":"https://doi.org/10.1007/s00404-024-07816-4","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the outcomes and factors influencing vaginal trial labor in primiparas with term singleton fetuses.</p><p><strong>Methods: </strong>A retrospective analysis of 9174 first-time mothers who opted for a vaginal trial of labor at Peking University First Hospital from October 2019 to September 2022 was performed. The primary outcomes included the outcome of the trial of labor and influencing factors.</p><p><strong>Results: </strong>Of the total population, the success rate of attempted vaginal delivery was 74.3% (6818/9174). Logistic regression analysis revealed that increasing maternal age (OR = 1.054; 95% CI = 1.239-2.316; p < 0.001), gestational weight gain (OR = 1.033; 95% CI = 1.022-1.045; p < 0.001), neonatal weight (OR = 1.971; 95% CI = 1.724-2.253; p < 0.001), prepregnancy body mass index (BMI) ≥ 24 kg/m<sup>2</sup> (OR = 1.605; 95% CI = 1.411-1.825; p < 0.001), prenatal BMI ≥ 24 kg/m<sup>2</sup> (OR = 1.326; 95% CI = 1.137-1.546; p < 0.001), and induced labor (OR = 2.434; 95% CI = 2.187-2.708; p < 0.001) increased the risk of failed vaginal delivery attempts, and labor analgesia reduced the risk of failed vaginal delivery attempts (OR = 0.356; 95% CI = 0.320-0.397; p < 0.001). However, the use of assisted reproductive technology had no significant effect on the outcome of attempted vaginal delivery (p = 0.137). According to the partial regression coefficient, the area under the ROC curve was 0.710 (95% CI = 0.698-0.723), and the model passed the Hosmer-Lemeshow test and had good discrimination and calibration (χ<sup>2</sup> = 12.833, p = 0.118). The postpartum hemorrhage (PPH) rate and overall neonatal asphyxia rate differed significantly between women who had different outcomes of vaginal trial labor.</p><p><strong>Conclusions: </strong>There are many factors affecting the occurrence of abnormal delivery in primiparas. These independent factors can be used for prenatal evaluation.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-04DOI: 10.1007/s00404-024-07851-1
Laura Hahn, Marilena Thomann, Eva-Maria Dreyer, Susanne Beyer, Lucia Ehmann, Franziska Ganster, Nicole Topalov, Simon Keckstein, Sven Mahner, Thomas Kolben, Sarah Meister
Introduction
Postpartum depression (PPD) is a severe complication in the postpartum period and equals a major depression occurring in the first weeks after delivery. During the COVID-19 pandemic, an increased incidence of PPD was observed. For this reason, we conducted an intervention study to test the effectiveness of the “7mind”-app, an app-based mindfulness training program, in the prevention of PPD.
Methods
For this purpose, 145 women who gave birth between March and September 2021 were observed up to six months postpartum, with 80 women using the “7mind”-app. The BSF (Berlin Mood Questionnaire) and the EPDS (Edinburgh Postnatal Depression Scale) were used to measure depressive symptoms at different time points and were supplemented by questionnaires regarding COVID-related anxieties.
Results
The BSF showed a significant improvement over time in the categories “anxiety” (p < .001) and “fatigue” (p < .001). Regarding the EPDS, there were no significant differences between the intervention and control groups. With a mean EPDS of 7.6 prepartum and 7.4 postpartum, our sample group can be classified as a low-risk collective. Furthermore, there were no significant differences between the control and intervention groups with regard to COVID-19-related anxiety. However, a comparison of the correlation analysis of COVID-19-related fears over time showed a clear advantage of the intervention. In particular, fear of the consequences of maternal COVID-19 infection increased significantly in the control group over time (r = 0.98, p = 0.040), while there was no significant change in the intervention group (r = −0.39, p = 0.218).
Conclusions
In conclusion, the intervention with the app “7mind” seems to lead to a clear benefit in the prevention of general anxiety and COVID-19-related anxieties, but needs further research to represent a valid intervention for the prevention of PPD.
{"title":"Efficacy of the “7mind”-app as intervention to prevent postpartum depression in a low-risk sample group","authors":"Laura Hahn, Marilena Thomann, Eva-Maria Dreyer, Susanne Beyer, Lucia Ehmann, Franziska Ganster, Nicole Topalov, Simon Keckstein, Sven Mahner, Thomas Kolben, Sarah Meister","doi":"10.1007/s00404-024-07851-1","DOIUrl":"10.1007/s00404-024-07851-1","url":null,"abstract":"<div><h3>Introduction</h3><p>Postpartum depression (PPD) is a severe complication in the postpartum period and equals a major depression occurring in the first weeks after delivery. During the COVID-19 pandemic, an increased incidence of PPD was observed. For this reason, we conducted an intervention study to test the effectiveness of the “7mind”-app, an app-based mindfulness training program, in the prevention of PPD.</p><h3>Methods</h3><p>For this purpose, 145 women who gave birth between March and September 2021 were observed up to six months postpartum, with 80 women using the “7mind”-app. The BSF (Berlin Mood Questionnaire) and the EPDS (Edinburgh Postnatal Depression Scale) were used to measure depressive symptoms at different time points and were supplemented by questionnaires regarding COVID-related anxieties.</p><h3>Results</h3><p>The BSF showed a significant improvement over time in the categories “anxiety” (p < .001) and “fatigue” (p < .001). Regarding the EPDS, there were no significant differences between the intervention and control groups. With a mean EPDS of 7.6 prepartum and 7.4 postpartum, our sample group can be classified as a low-risk collective. Furthermore, there were no significant differences between the control and intervention groups with regard to COVID-19-related anxiety. However, a comparison of the correlation analysis of COVID-19-related fears over time showed a clear advantage of the intervention. In particular, fear of the consequences of maternal COVID-19 infection increased significantly in the control group over time (<i>r</i> = 0.98, <i>p</i> = 0.040), while there was no significant change in the intervention group (<i>r</i> = −0.39, <i>p</i> = 0.218). </p><h3>Conclusions</h3><p>In conclusion, the intervention with the app “7mind” seems to lead to a clear benefit in the prevention of general anxiety and COVID-19-related anxieties, but needs further research to represent a valid intervention for the prevention of PPD.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"310 6","pages":"3183 - 3193"},"PeriodicalIF":2.1,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To identify risk factors contributing to the development of postpartum hypothyroidism in women newly diagnosed with subclinical hypothyroidism (SCH) during the first trimester of pregnancy (T1). Additionally, this study aimed to explore the impact of thyroid peroxidase antibody (TPOAb) titers trajectories throughout pregnancy and postpartum.
Methods
Thyroid hormone levels and thyroid autoantibody titers were collected from T1 to the 12th month postpartum. Logistic regression analysis was employed to identify independent risk factors for hypothyroidism at the 12th month postpartum and to develop a prediction model. Model performance was assessed through discrimination, calibration, and clinical applicability, with internal validation using the bootstrap resampling method. Growth Mixture Modeling was applied to delineate the trajectory of TPOAb titers during pregnancy and postpartum, and logistic regression analysis was conducted to investigate the influence of these trajectories on the occurrence of postpartum hypothyroidism.
Results
At the 12th month postpartum, hypothyroidism was either newly diagnosed or persisted in 76 of 209 cases (36.36%). Several significant risk factors for postpartum hypothyroidism were identified, including multiparity, positive TPOAb in T1, positive TPOAb and thyroglobulin antibody in T1, serum thyroid-stimulating hormone levels at SCH diagnosis in T1, and the final dose of levothyroxine in the third trimester. A prediction model was constructed and presented with a nomogram. Furthermore, a higher trajectory of serum TPOAb titer during pregnancy and postpartum emerged as a predictive factor for hypothyroidism at the 12th month postpartum.
Conclusion
Women with elevated TPOAb titers during pregnancy and postpartum necessitate ongoing and vigilant monitoring of thyroid function, even after childbirth.
{"title":"Effect of thyroid peroxidase antibody titers trajectories during pregnancy and postpartum on postpartum thyroid dysfunction","authors":"Qiuhong Liu, Hao Yang, Yanrong Chen, Xiaoxiao He, Lun Dong, Xinya Zhang, Yu Yang, Mingyuan Tian, Wei Cheng, Dongfang Liu, Gangyi Yang, Ke Li","doi":"10.1007/s00404-024-07836-0","DOIUrl":"10.1007/s00404-024-07836-0","url":null,"abstract":"<div><h3>Objective</h3><p>To identify risk factors contributing to the development of postpartum hypothyroidism in women newly diagnosed with subclinical hypothyroidism (SCH) during the first trimester of pregnancy (T1). Additionally, this study aimed to explore the impact of thyroid peroxidase antibody (TPOAb) titers trajectories throughout pregnancy and postpartum.</p><h3>Methods</h3><p>Thyroid hormone levels and thyroid autoantibody titers were collected from T1 to the 12<sup>th</sup> month postpartum. Logistic regression analysis was employed to identify independent risk factors for hypothyroidism at the 12<sup>th</sup> month postpartum and to develop a prediction model. Model performance was assessed through discrimination, calibration, and clinical applicability, with internal validation using the bootstrap resampling method. Growth Mixture Modeling was applied to delineate the trajectory of TPOAb titers during pregnancy and postpartum, and logistic regression analysis was conducted to investigate the influence of these trajectories on the occurrence of postpartum hypothyroidism.</p><h3>Results</h3><p>At the 12<sup>th</sup> month postpartum, hypothyroidism was either newly diagnosed or persisted in 76 of 209 cases (36.36%). Several significant risk factors for postpartum hypothyroidism were identified, including multiparity, positive TPOAb in T1, positive TPOAb and thyroglobulin antibody in T1, serum thyroid-stimulating hormone levels at SCH diagnosis in T1, and the final dose of levothyroxine in the third trimester. A prediction model was constructed and presented with a nomogram. Furthermore, a higher trajectory of serum TPOAb titer during pregnancy and postpartum emerged as a predictive factor for hypothyroidism at the 12<sup>th</sup> month postpartum.</p><h3>Conclusion</h3><p>Women with elevated TPOAb titers during pregnancy and postpartum necessitate ongoing and vigilant monitoring of thyroid function, even after childbirth.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"310 6","pages":"3229 - 3238"},"PeriodicalIF":2.1,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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