{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T14:03:34Z","timestamp":1785333814696,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T00:00:00Z","timestamp":1694995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100012283","name":"Chiayi Chang Gung Memorial Hospital","doi-asserted-by":"publisher","award":["CLRPG6L0081"],"award-info":[{"award-number":["CLRPG6L0081"]}],"id":[{"id":"10.13039\/501100012283","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the impact of repeated dilatation and curettage or hysteroscopic biopsy on fetomaternal outcomes in patients receiving progestin treatment for endometrial hyperplasia or early\u2010stage carcinoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This was a population\u2010based study using the Taiwan National Health Insurance Research Database between 2009 and 2017 of women who gave birth and had a history of endometrial hyperplasia and early\u2010stage carcinoma treated with progestins. Logistic regression analysis was used to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs) reflecting the association between repeated procedures and fetomaternal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 6956 women with 8690 deliveries were identified. Compared with those who had two or fewer procedures, women who received more than two procedures had a significantly higher risk for cervical insufficiency (aOR, 5.09 [95 CI, 2.31\u201311.24]). Furthermore, women who had more than two procedures were prone to have adverse neonatal outcomes, including Apgar score\u2009&lt;\u20097 at 1\u2009min (aOR, 1.97 [95% CI, 1.13\u20133.43]) and 5\u2009min (aOR, 3.11 [95% CI, 1.33\u20137.23]) and preterm delivery &lt;32\u2009weeks (aOR, 2.86 [95% CI, 1.50\u20135.45]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Undergoing more than two procedures was associated with subsequent maternal cervical insufficiency, preterm delivery &lt;32\u2009weeks, and low neonatal Apgar score. Health care providers should be aware of the potential risks and balance the benefits and harms of repeated procedures.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.15108","type":"journal-article","created":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T06:44:12Z","timestamp":1695105852000},"page":"605-612","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Does repetitive dilatation and curettage or hysteroscopic biopsy in patients treated with progestins for endometrial hyperplasia or carcinoma affect subsequent fetomaternal outcomes? A population\u2010based study using the National Health Insurance Research Database of Taiwan"],"prefix":"10.1002","volume":"164","author":[{"given":"Hao","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Hsin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Chiayi Chang Gung Memorial Hospital  Chiayi Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao\u2010Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Chiayi Chang Gung Memorial Hospital  Chiayi Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao\u2010Hsu","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Traditional Chinese Medicine Chiayi Chang Gung Memorial Hospital  Chiayi Taiwan"},{"name":"School of Traditional Chinese Medicine, College of Medicine Chang Gung University  Taoyuan Taiwan"},{"name":"Health Information and Epidemiology Laboratory Chang Gung Memorial Hospital  Chiayi Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan\u2010Pin","family":"Lee","sequence":"additional","affiliation":[{"name":"Health Information and Epidemiology Laboratory Chang Gung Memorial Hospital  Chiayi Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ko\u2010Jung","family":"Chen","sequence":"additional","affiliation":[{"name":"Health Information and Epidemiology Laboratory Chang Gung Memorial Hospital  Chiayi Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2849-5661","authenticated-orcid":false,"given":"Yu\u2010Che","family":"Ou","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung Taiwan"},{"name":"Department of Obstetrics and Gynecology Chiayi Chang Gung Memorial Hospital  Chiayi Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.2374"},{"issue":"678","key":"e_1_2_10_3_1","first-page":"e1","article-title":"Incidence of endometrial hyperplasia","volume":"200","author":"Reed SD","year":"2009","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1396256"},{"key":"e_1_2_10_5_1","unstructured":"Management of endometrial hyperplasia.Green\u2010top guideline No. 67. 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