Revista Brasileira De Ginecologia E Obstetricia[JOURNAL]
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200 papers
Accuracy of self-collection versus cervical sampling for the molecular diagnosis of and in women attending gynecological services.
Vasco G, Cruz C, Peñaherrera P … +6 more , Tipán K, Pila S, Guzmán K, Cabascango M, Logacho K, Jácome P
Rev Bras Ginecol Obstet · 2025 · PMID 40673035 · Full text
OBJECTIVE: Successful measures to address the increasing prevalence of sexually transmitted infections (STIs) require practical and accessible education and detection programs. METHODS: The ability to detect and may be...
OBJECTIVE: Successful measures to address the increasing prevalence of sexually transmitted infections (STIs) require practical and accessible education and detection programs. METHODS: The ability to detect and may be hindered by a lack of adherence to proper cervical sampling. To address this, we compared the sensitivity and specificity of self-obtained samplings, such as self-collection and first-catch urine samples, to cervical samples taken by a practitioner using the nucleic acid amplification test (NAAT) cobas 4800 for and in 244 women attending gynecological services in Quito, Ecuador. Regardless of sampling method, only 12 patients tested positive for (4.9% prevalence, 95% CI 2.8 to 8.4%), and no samples tested positive for . RESULTS: The analysis revealed that self-collection was 100% sensitive (95% CI 66.4% to 100.0%) and 100% specific (95% CI 98.25%-100%), and first-catch urine was 90% sensitive (95% CI 55.5% to 99.8%), and 99% specific (95% CI 96.5% to 99.9%) compared to cervical brushing for the detection of . No symptoms were associated with a positive result, highlighting the need for testing even in asymptomatic patients. Furthermore, having a stable intimate relationship in the past year was associated with a negative result for (χ 14.01, < 0.001). CONCLUSION: This study demonstrates the feasibility and reliability of self-collection and first-catch urine samples as alternative methods for detecting and has practical implications for improving STI detection and management programs.
A 10-year cesarean section rate analysis in a Brazilian referral maternity hospital using the Robson's ten group classification system.
Silva MLAM, Guida JPS, Lajos GJ … +2 more , Costa ML, Luz AG
Rev Bras Ginecol Obstet · 2025 · PMID 40673034 · Full text
OBJECTIVE: The Robson Ten Group Classification System categorizes women into groups based on obstetric characteristics. For each group there is a suggested cesarean section rate. Robson Ten Group Classification System al...
OBJECTIVE: The Robson Ten Group Classification System categorizes women into groups based on obstetric characteristics. For each group there is a suggested cesarean section rate. Robson Ten Group Classification System allows for surveillance and evaluation of increasing cesarean section rate. This study aimed to evaluate deliveries in a Brazilian referral maternity hospital in the last decade using the Robson Ten Group Classification System. METHODS: This was a retrospective cross-sectional study performed in a referral hospital, analyzing deliveries from January 2009 to August 2022. Women were classified into Robson's 10 groups based on electronic medical charts. Overall rates per year and cesarean section rate within each group were calculated and compared. RESULTS: There was an increasing cesarean section rate over time (46.23% in 2009 vs 62.99% in 2022) in all groups. Groups 1-4, 5 and 10 had a significant increase. Among Groups 1-4 cesarean section rate increased from 34.06% to 38.59% (PR 1.132, CI 1.007-1.274), group 5 from 67.66% to 83.53% (PR 1.234, CI 1.151-1.323) and group 10 from 51.55% to 60% (PR 1.163, CI 1.017-1.332). In global analysis, groups 1-4 corresponded to 57.3% of included cases and its relative contribution to cesarean section rate was 31.6%, while group 5 represented 18.9% of cases and its relative contribution to cesarean section rate was 28.5%. CONCLUSION: Groups 1-4 and 5 contributed significantly to cesarean section rate in our analysis and group 10 (preterm birth) also had a major impact, considering the high risk setting. Cesarean section rate increased over time. Groups 1, 2, 5, and 10 contribute significantly to such an increase.
Sexual Quality of Life-Female (SQoL-F): Translation, cultural adaptation and validation of the Brazilian Portuguese version in postpartum women.
Barbosa DMV, Nicodemo D, Moura EH … +3 more , Archangelo SCV, Ferreira LM, Veiga DF
Rev Bras Ginecol Obstet · 2025 · PMID 40673033 · Full text
OBJECTIVE: Sexuality plays an important role in quality of life, and the postpartum period may negatively affect women's sexual function. This study aimed to translate, culturally adapt, and validate the Sexual Quality o...
OBJECTIVE: Sexuality plays an important role in quality of life, and the postpartum period may negatively affect women's sexual function. This study aimed to translate, culturally adapt, and validate the Sexual Quality of Life - Female (SQoL-F) for use for use in Brazilian women in the postpartum period. METHODS: The original version of the SQoL-F was translated and back translated by four independent sworn translators. A sample of 125 women in the late postpartum phase participated in the cultural adaptation (n=30) and convergent validation (n=95) phases. For the latter, the instrument was compared with the Brazilian version of the Female Sexual Function Index (FSFI). To assess reproducibility, 25 of the 95 women who participated in the validation phase completed the SQoL-F twice, at different times (two interviewers administered the SQoL-F, 15 to 20 days apart). RESULTS: Cronbach's alpha was 0.905 (intraclass correlation=0.974; 95%CI: 0.943-0.988; p<0.001). Significant, moderate, positive correlations were observed between the SQoL-F score and the FSFI total score (r=0.572; p<0.001) and domains 'Desire' (r=0.502; p<0.001), 'Arousal' (r =0.576; p<0.001), and 'Satisfaction' (r=0.637; p<0.001). Excellent reproducibility was obtained for the SQoL-F score (intraclass correlation=0.974; 95%; CI: 0.943-0.988; p<0.001). CONCLUSION: The SQoL-F was adapted to the cultural context of Brazilian postpartum women, proved reproducible, and exhibited face, content, and construct validity.
Exploring endometriosis before surgical treatment: unraveling pain, sexual function and quality of life patterns.
Pereira JO, Kulak J
Rev Bras Ginecol Obstet · 2025 · PMID 40673032 · Full text
OBJECTIVE: To identify pain, sexual function, and quality of life patterns in women with endometriosis, taking into consideration the American Society for Reproductive Medicine (ASRM) classification for endometriosis. ME...
OBJECTIVE: To identify pain, sexual function, and quality of life patterns in women with endometriosis, taking into consideration the American Society for Reproductive Medicine (ASRM) classification for endometriosis. METHODS: A cross-sectional study of quantitative descriptive nature was conducted, including women with surgical recommendation due to endometriosis. The Numeric Pain Rating Scale, Endometriosis Health Profile, and Female Sexual Function Index tools were used for data collection. Descriptive and frequency analysis were employed. Using the K-means algorithm, cluster analysis was performed to group participants based on response similarities. RESULTS: 104 women with endometriosis were included with a median age of 35 years. The majority were classified as grade III (57.69%) and IV (25.96%) for endometriosis. There was a significant difference in the division of two clusters concerning ASRM, with ASRM IV women more frequently associated with Cluster B, while Cluster A being predominantly formed by ASRM III women. Cluster B showed significantly worse data for dyspareunia and dysuria pain levels and for all variables in the FSFI and EHP-30 instruments, except for infertility, which did not differ between the groups. CONCLUSION: ASRM classification is not directly related to clustering. Women diagnosed with endometriosis, mostly ASRM III and IV, exhibit two distinct patterns, with one group having worse pain, sexual function and quality of life scores compared to the other group. Infertility is a crucial aspect to study concerning the quality of life of women living with the disease and aspiring for motherhood irregardless of the clustering.
Asthma and pregnancy.
Souza RT, Bonomi IBA, Maganha CA … +7 more , Ferreira EC, Solha STG, Vetorazzi J, Mattar R, de Carvalho-Pinto RM, Bártholo TP, Caetano LSB
Rev Bras Ginecol Obstet · 2025 · PMID 40673031 · Full text
•Asthma is the most common lung disease during pregnancy and its diagnosis is determined in the same way in pregnant and non-pregnant women. •Spirometry is a simple test used to confirm and monitor the disease, and has n...
•Asthma is the most common lung disease during pregnancy and its diagnosis is determined in the same way in pregnant and non-pregnant women. •Spirometry is a simple test used to confirm and monitor the disease, and has no contraindications for use during pregnancy both in the pre- and post-bronchodilator phase. •The control of asthma before pregnancy is the main predictor of disease severity during pregnancy. Other predictors of asthma attacks include smoking, overweight and obesity. •Inadvertent interruption of maintenance medication is one of the factors most associated with exacerbation and complications related to asthma during pregnancy. •In general, treatment of pregnant women with asthma should be similar to that of non-pregnant women. Inhaled corticosteroids (ICS) are the main medication to achieve and maintain control of the disease during pregnancy. •Corticosteroids prescribed for maintenance treatment of chronic asthma have no effect on accelerating fetal maturity. The usual protocol should be used when this acceleration is necessary. •Moderate asthma exacerbation includes at least one of the following criteria: 1) worsening of respiratory symptoms; 2) worsening of lung function; 3) increased use of inhaled pump medication (e.g., salbutamol; at least two-day duration). •Severe asthma exacerbation includes at least one of the following criteria: 1) use of systemic corticosteroids or increased dose of maintenance oral corticosteroids for at least three days; 2) hospitalization or visit to the emergency room (ER) due to asthma requiring the use of systemic corticosteroids. •Asthma does not normally affect labor or the choice of delivery route.
Pathophysiological mechanisms in severe preeclampsia: role of upregulated proteins in blood pressure, extracellular matrix and immunity.
Pinto-Souza CC, Kaihara JNS, Rossini BC … +3 more , Cavalli RC, Dos Santos LD, Sandrim VC
Rev Bras Ginecol Obstet · 2025 · PMID 40673030 · Full text
OBJECTIVE: This study aims to compare the plasma protein profiles between 7 preeclampsia patients with severe features (PE+) and 7 preeclampsia patients without severe features (PE-) and 10 healthy pregnancies (HP); iden...
OBJECTIVE: This study aims to compare the plasma protein profiles between 7 preeclampsia patients with severe features (PE+) and 7 preeclampsia patients without severe features (PE-) and 10 healthy pregnancies (HP); identify differentially expressed proteins among these groups and explore the altered signaling pathways and their association with the severity of this cardiovascular condition. METHODS: Plasma proteins were quantified using mass spectrometry, followed by comprehensive bioinformatics and statistical analyses. Protein identification and annotation were performed using UniProt and PatternLab for Proteomics. Multivariate statistical analyses, including PLS-DA and sPLS-DA, as well as VIP score evaluation and Volcano plot visualization, were conducted with MetaboAnalyst to assess group separation and identify key discriminative features. Functional enrichment and pathway analyses were carried out using Metascape. RESULTS: Using a fold change and volcano plot validation of 1.2, comparisons between HP and PE+ revealed that proteins such as AMBP (inter-alpha trypsin inhibitor light chain), VTN (vitronectin), CLU (clusterin), F2 (prothrombin), and PZP (pregnancy zone protein) were upregulated in PE+. Conversely, ITIH4 (inter-alpha trypsin inhibitor heavy chain H4), APOL1 (apolipoprotein 1) and SERPIND1 (heparin cofactor II) were downregulated in PE+ relative to HP. When comparing HP with PE-, SERPINA3 (alpha-1-antichymotrypsin) and HBB (hemoglobin subunit beta) were downregulated in PE-. Between PE- and PE+, APCS (serum amyloid P component) and HBB were upregulated in PE+; whereas SERPINC1 (antithrombin), PSG1 (pregnancy-specific beta-1-glycoprotein 1), ITIH4, and C5 (complement C5) were downregulated in PE+ compared to PE-. CONCLUSION: These findings offer valuable insights into the different pathophysiological mechanisms underlying the two subgroups of PE. The upregulated proteins in PE+ (AMBP, VTN, CLU, F2, PZP, APCS, and HBB) play key roles in regulating blood pressure, modulating the extracellular matrix and influencing immune responses. Overall, this research deepens our understanding of the complexity and clinical significance of PE.
Prevalence and risk factors for placenta previa in a specialty hospital.
Monterde-Fernández ME, Díaz-Vallejo JJ, Rodríguez-Parissi I … +2 more , Venegas-Espinoza B, Cruz-Perez E
Rev Bras Ginecol Obstet · 2025 · PMID 40673029 · Full text
OBJECTIVE: Placenta previa is a risk factor for obstetric hemorrhage, which, if not managed, can lead to maternal and neonatal death. Most cases are diagnosed after 28 weeks of gestation; in many cases, prenatal diagnosi...
OBJECTIVE: Placenta previa is a risk factor for obstetric hemorrhage, which, if not managed, can lead to maternal and neonatal death. Most cases are diagnosed after 28 weeks of gestation; in many cases, prenatal diagnosis is not timely. The objective of this study was to estimate the prevalence of placenta previa and its risk factors. METHODS: A retrospective case-control study was carried out with a total of 35 cases and 138 controls among pregnant women. The variables studied were previous cesarean section, BMI, abortions, uterine surgeries and maternal age, among others. The chi-square test was used to examine differences between groups; the OR was calculated for each factor via univariate and multivariate analyses. RESULTS: The prevalence of placenta previa was 0.57%. The risk factors identified were advanced maternal age (OR 3.0; 95% CI 1.3-7.1) and previous cesarean section (OR 10.7; 95% CI 1.7-68.5). CONCLUSION: The prevalence of placenta previa was similar to that reported in the literature, and the most prevalent risk factors were advanced maternal age and previous cesarean section. The identification of risk factors in women with placenta previa makes it possible to establish action plans for personalized care during pregnancy and childbirth and to reduce complications.
Family counseling after prenatal diagnosis of congenital heart disease: the role of a multidisciplinary and humanized approach.
Amorim LADR, Araujo Júnior E
Rev Bras Ginecol Obstet · 2025 · PMID 40673028 · Full text
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Comment on: The experience of pregnancy in the COVID-19 pandemic.
Roy B
Rev Bras Ginecol Obstet · 2025 · PMID 40673027 · Full text
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Impact of legal regulation on elective cesarean sections in a secondary complexity maternity hospital in São Paulo state.
Mainardi GLC, Aniceto V, de Assumpção JVZ … +3 more , Prado CAC, Mantovi ACTZ, Moisés ECD
Rev Bras Ginecol Obstet · 2025 · PMID 40673026 · Full text
OBJECTIVE: To evaluate the impact of São Paulo State Law n° 17.137/2019 on the cesarean section rate at a public secondary-level maternity hospital and to analyze predictive factors and complications associated with cesa...
OBJECTIVE: To evaluate the impact of São Paulo State Law n° 17.137/2019 on the cesarean section rate at a public secondary-level maternity hospital and to analyze predictive factors and complications associated with cesarean under request. This law was enacted to allow pregnant women in São Paulo to request a cesarean section without medical indication. METHODS: This retrospective study analyzed medical records of pregnant women ≥ 39 weeks gestation attended at the Ribeirão Preto Women's Health Reference Center (CRSMRP-Mater). Two groups were evaluated: 1,999 patients before the law (July 2018-July 2019) and 3,207 after its implementation (August 2019-July 2021, excluding the suspension period). Descriptive and analytical statistical methods were applied. RESULTS: The overall cesarean rates increased significantly from 23.6% to 27.7% (p < 0.01), with 15,1% of cesareans during the law period being under maternal request (134 patients). A previous cesarean was the only factor significantly associated with electing a new cesarean. Hospital length of stay was significantly longer in the law period (p < 0.01), possibly reflecting the increased cesarean rate. No significant differences were observed in maternal or neonatal complications between cesareans under request and those conducted for medical reasons. CONCLUSION: São Paulo State Law n°. 17.137/2019 was associated with an increased cesarean rate in CRSMRP-Mater. The findings highlight the need for robust educational approaches and evidence-based obstetric practices to reduce unnecessary elective cesareans.
Leptin receptor polymorphism increases the risk of painful symptoms in Brazilian women with endometriosis.
Cardoso JV, Machado DE, de Almeida FN … +3 more , Berardo PT, Medeiros R, Perini JA
Rev Bras Ginecol Obstet · 2025 · PMID 40673025 · Full text
OBJECTIVE: Endometriosis pain is associated with inflammatory cytokines, such as leptin (LEP), through activation with its receptor (LEPR), and its expression can be influenced by the presence of genetic polymorphisms. T...
OBJECTIVE: Endometriosis pain is associated with inflammatory cytokines, such as leptin (LEP), through activation with its receptor (LEPR), and its expression can be influenced by the presence of genetic polymorphisms. Therefore, this study aims to evaluate the role of the rs7799039 and rs1137100 polymorphisms in the painful symptoms of endometriosis in Brazilian women. METHODS: A retrospective study was carried out in two Brazilian public hospitals with 237 cases of endometriosis, divided into two comparison groups according to the painful symptoms associated with the disease (absence or presence of severe and disabling symptoms). Genetic analysis was performed by real-time PCR technique, and association analyses were estimated using odds ratio (OR) and 95% confidence interval (CI), using a non-conditional logistic regression model. RESULTS: Endometriosis cases showed a high prevalence of painful symptoms: 82% dysmenorrhea, 67% dyspareunia, 53% chronic pelvic pain, and 52% cyclical intestinal and 25% urinary complaints. Regarding genetic analyses, cases had 32.7% of the A allele and 11.4% of the AA genotype for the rs7799039 G>A SNP, and 17.5% of the G allele and 2.5% for of GG genotype for the rs1137100 A>G SNP. There is a significant association of the rs1137100 polymorphism with chronic pelvic pain (OR=1.75; CI 95%=1.05-2.89) and dyspareunia (OR=1.78; CI 95%=1.01-3.12) in women with endometriosis. CONCLUSION: Our findings suggest that the rs1137100 polymorphism is associated with increased endometriosis-related gynecological pain and may be a potential target for molecular diagnosis of the disease and development of individualized treatment strategies.
Voiding urodynamics parameters for women with and without symptomatic pelvic organ prolapse.
Martins JTC, Marquini GV, de Abreu LAX … +2 more , Bella ZIKJD, Sartori MGF
Rev Bras Ginecol Obstet · 2025 · PMID 40673024 · Full text
OBJECTIVE: This study aims to characterize voiding urodynamics parameters suggestive of bladder outlet obstruction (BOO) diagnosis in women with and without symptomatic pelvic organ prolapse (POP). METHODS: Cross-section...
OBJECTIVE: This study aims to characterize voiding urodynamics parameters suggestive of bladder outlet obstruction (BOO) diagnosis in women with and without symptomatic pelvic organ prolapse (POP). METHODS: Cross-sectional research. Patients were selected and clinically evaluated with anamnesis, pelvic organ prolapse quantification system and standard Urodynamic Testing, performed according to International Continence Society and International Urogynecological Association guidelines (noninvasive uroflowmetry, followed by invasive cystometry and a Pressure/Flow Study). Included criteria: women aged 18 to 94 years with and without symptomatic POP and lower urinary tract symptoms . Exclusion criteria: patients who were not clinically feasible, undesirable, or impossible urodynamic test, or patients with urinary tract infection or neurological lower urinary tract dysfunction. RESULTS: Voiding urodynamics parameters suggestive of BOO diagnosis found in women with POP were: maximum flow rate (Qmax) in the uroflowmetry ≤12mL/s; detrusor pressure at maximum flow (PdetQmax) >20cmH2O. When evaluating the differences between patients with and without POP, it was observed that those who presented some type of pPOP were mean age (y) older (67.6 × 58.9); had higher post-void residue volume (mL) (85.9 × 33.9); higher PdetQmax (cmHO) values (41.3 × 28.5); lower Qmax (mL/s) values on uroflowmetry (8.5 × 20.4), lower maximum cystometric capacity (mL) (325.7 × 381.2), lower bladder compliance (mL/cmH2O) (39.8 × 46.1) and lower Qmax (mL/cmH2O) in the flow/pressure study (8.4 × 18.0) (<0.001). CONCLUSION: The voiding urodynamics parameters listed in this study allows the evaluation of variables suggestive of BOO diagnosis in women with and without POP.
Translation and Cultural Adaptation of the Creighton Model FertilityCare™ System Follow-up Form to Brazilian Portuguese.
Faria CSD, Fernandes CFK, Ruano JMC … +1 more , Sartori MGF
Rev Bras Ginecol Obstet · 2025 · PMID 40673023 · Full text
OBJECTIVE: To develop the Brazilian Portuguese version of the Follow-up Form for the Creighton Model FertilityCare™ System. METHODS: Translation and cultural adaptation of the Follow-up Form for use in Brazil, in 6 steps...
OBJECTIVE: To develop the Brazilian Portuguese version of the Follow-up Form for the Creighton Model FertilityCare™ System. METHODS: Translation and cultural adaptation of the Follow-up Form for use in Brazil, in 6 steps: Translation, Expert Panel, Back-Translation, Pre-test, Review, and Final Version, according to the World Health Organization methodology. RESULTS: The 25 sections comprising the Follow-up Form were translated with 14 sections undergoing an adaptation process in one of the stages. In order to maximize semantic, idiomatic, experiential, and conceptual equivalence of the items from the original English version to Portuguese. The need for adaptation was due to four reasons: first, the format of paired and seemingly repetitive questions. Second, the difference in cultural reality, such as hygiene and consumption habits, between the United States and Brazil. Third, the use of technical terms, medical vocabulary. And fourth, sentences that contain many concepts related to the use of the Creighton Model FertilityCare™ System. The sample included 127 Creighton Model FertilityCare™ System users, with an average age of 33.7 years, and 88.2% were married. The majority, 68 (53.5%), were not using any family planning method when they started Creighton Model FertilityCare™ System 49.2% were trying to conceive in the past year. CONCLUSION: The translation of the Follow-up Form into Brazilian Portuguese resulted in a final version that maintained the intercultural and conceptual equivalence to the original English version. This instrument can be used by all practitioners in Brazil with the assurance that the standardization in the application of Creighton Model FertilityCare™ System reflects the original purpose of the method.
Unraveling the frequency of intestinal constipation in woman with urinary incontinence: a descriptive observational study.
Thomé BI, Scharan KO, Assis GM … +1 more , Moser ADL
Rev Bras Ginecol Obstet · 2025 · PMID 40673022 · Full text
OBJECTIVE: To identify the frequency of functional constipation in women with urinary incontinence. METHODS: A cross-sectional, quantitative, descriptive, and exploratory study was conducted from September 2019 to Januar...
OBJECTIVE: To identify the frequency of functional constipation in women with urinary incontinence. METHODS: A cross-sectional, quantitative, descriptive, and exploratory study was conducted from September 2019 to January 2020 with 227 women (over 18 years old) at the . A structured form collected sociodemographic and general health data, while bowel habits were assessed using the Rome IV criteria, the Bristol Stool Scale, and the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). Comparisons between women with and without constipation involved χ, Fisher's Exact, Student's t-test, Mann-Whitney U, and univariate logistic regression was performed to assess the association between sociodemographic/personal factors and the risk factor constipation. All women had a clinical diagnosis of urinary incontinence, and the analysis also compared those with and without constipation. Odds ratios and their respective 95% confidence intervals were estimated for each univariate model. A 5% significance level was adopted. RESULTS: The participants had a median age of 62 years (range 23-97). Functional constipation was identified in 80.2%(n=182), and mixed urinary incontinence was predominant in this group (88.5%, n=161). Physical activity emerged as a protective factor against constipation (OR=0.47; 95% CI=0.22-1.01; p=0.05), though only 22.5%(n=41) reported regular exercise. Conclusion: The high frequency of functional constipation in women with urinary incontinence highlights a significant impact on quality of life and underscores the importance of integrated, conservative therapeutic strategies, including early lifestyle interventions such as regular physical activity, to prevent worsening of both conditions. Longitudinal investigations are recommended.
Early menarche and current nutritional status of the adolescents from a birth cohort.
Costa ICM, Alves MTSSBE, Vieira AC … +5 more , de Sá CMS, Fonsêca NC, Santos JMCF, Pinho JRO, Chagas DCD
Rev Bras Ginecol Obstet · 2025 · PMID 40673021 · Full text
OBJECTIVE: To assess the association between early menarche and the nutritional status of the adolescents from the RPS - Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís) birth cohort in São Luís,...
OBJECTIVE: To assess the association between early menarche and the nutritional status of the adolescents from the RPS - Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís) birth cohort in São Luís, Maranhão. METHODS: A longitudinal study with data from the first and third follow-up of the cohort was conducted. A total of 1,225 adolescents aged 18 to 19 years were surveyed and analyzed for age at menarche, defined as early if <12 years old, and for the variable body mass index (BMI) for age, classified into z-scores by sex, as underweight (z-score <-2), adequate weight (z-score ≥-2 and ≤+1), and excess weight (z-score >+1). Directed acyclic graphs were constructed using the DAGitty program to select confounding variables for adjustment. Multinomial logistic regression adjusted for confounding variables such as parental obesity (yes or no), skin color (white or non-white), and birth weight (low birth weight, adequate birth weight, and high birth weight) was used to assess the association between early menarche and nutritional status. Statistical analyses were performed using STATA 15.0 software. RESULTS: Out of the 1,225 adolescents investigated, 32.6% experienced early menarche, and the majority had a BMI appropriate for their age (75.2%). Among adolescents with early menarche, 28.3% were classified as excess weight for their age. Multinomial logistic regression revealed an association between early menarche and excess weight (OR = 1.80; 95% CI = 1.21-2.69; p-value = 0.004). CONCLUSION: Thus, the results indicate an association between the occurrence of early menarche and excess weight in the investigated adolescents.
Comparison of different testosterone formulations discontinuation and dose spacing on hematocrit and testosterone levels in transgender individuals with erythrocytosis.
Okano SHP, Franceschini SA, Brito LGO … +1 more , Lara LADS
Rev Bras Ginecol Obstet · 2025 · PMID 40673020 · Full text
OBJECTIVES: This study aimed to compare the effect of Gender Affirming Hormone Therapy with Testosterone (GAHT-T) discontinuation and dose spacing on Hct, hemoglobin (Hb) and total testosterone levels in users of testost...
OBJECTIVES: This study aimed to compare the effect of Gender Affirming Hormone Therapy with Testosterone (GAHT-T) discontinuation and dose spacing on Hct, hemoglobin (Hb) and total testosterone levels in users of testosterone cypionate and testosterone undecanoate. METHODS: This retrospective cohort analyzed data collected from the medical records of trans men older than 18 years who developed erythrocytosis during GAHT-T between 2020 and 2023. Participants were divided into three groups according to formulation in use when the diagnosis of erythrocytosis occurred and analyzed according to therapeutic approaches: discontinuation of GAHT-T for 3 months or, for the testosterone cypionate fourthly users, dose spacing. RESULTS: A total of 49 trans men (mean age, 28.0 ± 7.8 years) were diagnosed with erythrocytosis, totalizing 104 tests. After discontinuing GAHT-T, a greater decrease in Hct, Hb and total T levels was observed in the testosterone cypionate (Cip 14 and Cip 28) users than in the testosterone undecanoate users (Und90). In Und90, discontinuation resulted in decrease of Hct and Hb levels, without difference in total T levels. Cip14 and Cip28 exhibited greater reductions in the Hct level than Und90 did with discontinuation. In Cip14, dose spacing had no effect on decreasing Hb, Hct and total T levels. CONCLUSION: Discontinuation of testosterone undecanoate for 3 months in trans men undergoing GAHT-T who had developed erythrocytosis reduces hemoglobin and hematocrit levels without a significant reduction in testosterone levels. Dose spacing in fortnightly testosterone cypionate users was not effective to reduce hematocrit and hemoglobin.
Exploring awareness and attitudes toward oocyte cryopreservation among women of reproductive age.
Brandão P, Cândido R, Carvalho F … +4 more , Nunes L, Matos P, Frias P, Coelho M
Rev Bras Ginecol Obstet · 2025 · PMID 40673019 · Full text
OBJECTIVE: This study aimed to evaluate awareness, perceptions, and attitudes toward oocyte cryopreservation among a diverse group of women. METHODS: A cross-sectional study was conducted in November 2023 using snowball...
OBJECTIVE: This study aimed to evaluate awareness, perceptions, and attitudes toward oocyte cryopreservation among a diverse group of women. METHODS: A cross-sectional study was conducted in November 2023 using snowball sampling to distribute a structured questionnaire. The target population included women aged 18+ with childbearing potential, proficient in English. An anonymous online survey with 22 questions collected data on demographics, education, occupation, relationship status, reproductive intentions, and perceptions of oocyte cryopreservation. RESULTS: A total of 502 responses were analyzed. Most participants were in their thirties, had higher education, and were in committed relationships. They represented 24 countries, mainly in Europe. Over 60% planned to have children, but 85% were unfamiliar with oocyte cryopreservation. Social media (56%) was the primary information source, followed by acquaintances (33%) and healthcare professionals (25%). Only 4.6% were actively considering the procedure, while 41.3% showed potential interest. Barriers included perceived lack of necessity, age concerns, and limited information. Women considering cryopreservation were typically younger and childless. Financial constraints and information gaps significantly influenced decision-making, with about one-third suggesting better information and cost reduction could increase willingness to pursue the procedure. CONCLUSION: Despite relatively high awareness of oocyte cryopreservation, actual consideration and uptake remain low. Addressing financial and informational barriers could improve acceptance, especially among younger women and those uncertain about their reproductive plans.
Maternal and perinatal characteristics associated with congenital anomalies: a case-control study.
Scandolara AH, Bagatini RM, Starck ALG … +5 more , Bregonde RB, Pascotto CR, Treco FR, Perondi AR, Ferreto LED
Rev Bras Ginecol Obstet · 2025 · PMID 40673018 · Full text
OBJECTIVE: This study aimed to identify the patterns and factors associated with congenital anomalies in newborns from a tertiary hospital maternity ward. METHODS: A case-control study was conducted at the Hospital Regio...
OBJECTIVE: This study aimed to identify the patterns and factors associated with congenital anomalies in newborns from a tertiary hospital maternity ward. METHODS: A case-control study was conducted at the Hospital Regional do Sudoeste Walter Alberto Pecóits in Francisco Beltrão (PR), between December 2023 and September 2024. Among the 1,400 births that occurred in the hospital's delivery room between December 1, 2023, and the end of September 2024, 37 newborns (2.6%) with congenital anomalies were identified during the study period. A total of 37 case mothers and 120 controls were included (a ratio of approximately 1:3). The sociodemographic variables included maternal age, residence, marital status, race, education level, family income, and maternal occupation. The behavioral variables considered smoking, alcohol consumption, and the use of drugs or medications during pregnancy. The fetal variables included the number of pregnancies, gestational age, type of delivery, miscarriage, Apgar score, birth weight, sex, fetal status, congenital anomalies, and the number of prenatal visits, with a minimum of six (one in the first trimester, two in the second, and three in the third), following the Ministry of Health guidelines. RESULTS: Among 1,400 live births, 37 cases of congenital anomalies were identified (2.6%, 95% CI: 1.80-3.48), while the control group included 120 women with newborns without congenital anomalies. Among cases, isolated anomalies were most common (62.2%), predominantly affecting the cardiovascular system (27.0%), followed by recognized syndromes (21.6%) and multiple malformations (16.2%). Data were collected through face-to-face interviews and medical record reviews. Bivariate analysis revealed significant associations between congenital anomalies and a family history of congenital anomalies (p = 0.02), low apgar scores at the 1st and 5th minutes (p < 0.01), and fetal status at birth (p < 0.01). Model 1, which integrates family history of congenital anomalies, apgar score at the 5th minute, and fetal status, showed the best predictive fit, consistent with previous findings. Bayesian logistic regression highlighted this model with the lowest AIC (295.98) and BIC (326.22) values, achieving 89% predictive accuracy. CONCLUSION: These results reinforce the importance of family history and neonatal vitality in the context of congenital anomalies, indicating the need for future studies to confirm these findings and improve prevention strategies.
Emotional reactions and psychological responses expressed by adolescent and adult women survivors of sexual violence during outpatient follow-up.
Teixeira AL, de Lima SO, Godoi DO … +4 more , Becerra-Torres AS, Guida JP, Azevedo RC, Fernandes A
Rev Bras Ginecol Obstet · 2025 · PMID 40673017 · Full text
OBJECTIVE: To evaluate psychological support data for survivors of sexual violence (SV) and compare the attitudes, responses, and feelings in adolescent and adult women. METHODS: This was a retrospective study with two c...
OBJECTIVE: To evaluate psychological support data for survivors of sexual violence (SV) and compare the attitudes, responses, and feelings in adolescent and adult women. METHODS: This was a retrospective study with two cohorts of female survivors of sexual violence, treated between 2011 and 2022. Women who had at least one psychological evaluation were included. The variables were sociodemographic; characteristics of violence; feelings; attitudes; symptoms observed/reported during support; time until emergency care; and indication of psychotropic medications. We calculated the mean and standard deviation (SD) and used the λ-Square or Fisher's Exact test and the Mann-Whitney test for comparative analysis. The significance level adopted was 5%. RESULTS: Five hundred and twenty-one adolescents, mean age 14.8 (SD±2.0) and 312 adult women, mean age 31.7 years (SD±10.7), were compared. Two-thirds of all women reported themselves as white; adolescents took longer to seek care (p<0.001) more frequently than the adult group. Adult women had more histories of sexual abuse (p<0.001), penetration attacks (p<0.001), reported greater perception and disclosed violence more frequently (p<0.001) than the adolescent group. Adolescents reported more shame (p<0.001) while the group of adults more frequently expressed feelings of insecurity, anguish, expressions of crying, revolt, anger, humiliation and apathy. Anxious symptoms were expressed by 60% of adults and 44% of adolescents and the prescription of psychotropic medications was higher in the adult group compared to adolescents (p<0.001). CONCLUSION: Both groups of survivors suffered psychological impacts after SV, expressing/reporting different reactions to distress. These results highlight the importance of access to psychological support after SV.
Prevalence of vaginal laxity in primiparous women six months after birth.
Godoy MR, Pereira GMV, Viegas CV … +1 more , Monteiro MVC
Rev Bras Ginecol Obstet · 2025 · PMID 40673016 · Full text
OBJECTIVE: To assess the prevalence of VL in primiparous women undergoing vaginal birth or caesarean section; and its association with obstetric, urinary, intestinal and sexual factors for its occurrence. METHODS: This i...
OBJECTIVE: To assess the prevalence of VL in primiparous women undergoing vaginal birth or caesarean section; and its association with obstetric, urinary, intestinal and sexual factors for its occurrence. METHODS: This is a cross-sectional study carried out between July 2021 and January 2023. Primiparous women who underwent vaginal birth or caesarean section without complaints of VL during pregnancy were included. Clinical and obstetric data were collected and participants completed questionnaires on the impact of urinary incontinence (ICIQ-SF), vaginal symptoms (ICIQ-VS) and sexual distress (FSDS-R) at recruitment and six-months postpartum. Univariate and multivariate logistic regression was performed, considering VL as the outcome and p=0.05. RESULTS: One hundred participants were included for data analysis. The prevalence of VL was 8%. In the univariate analysis, SUI, urgency urinary incontinence (UUI), coital incontinence, constipation and the ICIQ-VS and ICIQ-SF scores were associated with VL. The ICIQ-VS, FSDS-R and ICIQ-SF scores increased the risk of VL by one-fold. However, only UUI (OR 10.50(CI 95% 1.90-58.10), coital incontinence (OR 42.00(CI 95% 3.11-566.38), and ICIQ-VS (vaginal symptoms OR 1.32(CI 95% 1.05-1.66) and ICIQ-SF (OR 1.25(CI 95% 1.02-1.54), scores remained associated with VL in multivariate-analysis. CONCLUSION: The prevalence of VL in primiparous women was lower than that reported in other studies and showed an association with the occurrence of vaginal symptoms, UUI and coital incontinence, six- months postpartum.
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