{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T14:30:09Z","timestamp":1792420209366,"version":"4.5.0"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T00:00:00Z","timestamp":1729641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T00:00:00Z","timestamp":1729641600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["23AA2003"],"award-info":[{"award-number":["23AA2003"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["22AA2003"],"award-info":[{"award-number":["22AA2003"]}],"id":[{"id":"10.13039\/501100003478","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":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare conservative management and appendectomy for acute appendicitis during pregnancy by trimester.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study used data from a national inpatient database from July 2010 to March 2022. Pregnant women diagnosed with acute appendicitis were included. Multivariable analysis using generalized estimating equations was performed to compare outcomes between conservative management and appendectomy across trimesters. The main outcomes were preterm labor, preterm delivery, or abortion; antepartum hemorrhage; duration of hospitalization; and duration of antibiotic use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 3158 individuals from 632 acute\u2010care hospitals were eligible. The proportion of conservative management versus appendectomy by trimester were 507 (49.1%) versus 525 (50.9%) in the first, 690 (44.6%) versus 856 (55.4%) in the second, and 337 (58.1%) versus 243 (41.9%) in the third. In the second trimester, appendectomy was associated with a higher rate of preterm delivery, preterm labor, or abortion (odds ratio [OR], 2.91 [95% confidence interval (CI), 1.62\u20135.25]). Antepartum hemorrhage occurred more frequently for appendectomy in the first (OR, 2.12 [95% CI, 1.31\u20133.43]) and third (OR, 2.43 [95% CI, 1.79\u20133.31]) trimesters. Appendectomy was associated with a longer duration of hospitalization in the second (2.15\u2009days; 95% CI, 1.14\u20133.17\u2009days) and third (3.97\u2009days; 95% CI, 2.22\u20135.71\u2009days) trimesters. Antibiotic use duration was shorter for appendectomy in the first (\u22121.20\u2009days [95% CI \u22121.51 to \u22120.90\u2009days]) and second (\u22120.61\u2009days [95% CI \u22120.90 to \u22120.32\u2009days]) trimesters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinical outcomes of acute appendicitis during pregnancy vary by trimester. Considering the appendectomy risks, conservative management may be viable depending on the clinical context and trimester.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.15953","type":"journal-article","created":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T10:38:28Z","timestamp":1729679908000},"page":"1047-1054","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of gestational age on the management of acute appendicitis during pregnancy: A nationwide observational study"],"prefix":"10.1002","volume":"168","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5245-2311","authenticated-orcid":false,"given":"Shunya","family":"Sugai","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Niigata University Medical and Dental Hospital  Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Sasabuchi","sequence":"additional","affiliation":[{"name":"Department of Real\u2010World Evidence, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideo","family":"Yasunaga","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shotaro","family":"Aso","sequence":"additional","affiliation":[{"name":"Department of Health Services Research, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Matsui","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyohide","family":"Fushimi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Informatics Institute of Science Tokyo Graduate School of Medical and Dental Sciences  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Yoshihara","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Niigata University Medical and Dental Hospital  Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2050-5543","authenticated-orcid":false,"given":"Koji","family":"Nishijima","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Niigata University Medical and Dental Hospital  Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2007.05.025"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12736"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2006.05.005"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(05)80748-2"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-014-3810-5"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.7555"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2017.04.046"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ases.12851"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-021-06010-w"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-017-5637-3"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005893"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-022-09625-9"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.37737\/ace.1.3_76"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.31662\/jmaj.2023-0151"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.je.2016.09.009"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0260991"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-005-0304-6"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2014320"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.6154"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10147"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12807"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12093277"}],"container-title":["International Journal of Gynecology &amp; 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