{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T15:08:15Z","timestamp":1784300895345,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Methotrexate is widely used to treat ectopic pregnancy (EP). Concerns about its teratogenicity have led to uncertainty regarding the optimal interval before attempting conception. Guidelines recommend a 3\u2010month washout period, while the manufacturer advises 6\u2009months. Evidence on the safety of early conception is limited. We aimed to evaluate whether conception within 1\u20133\u2009months after methotrexate treatment for EP is as safe as conception after longer intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of women treated with 30\u2013150\u2009mg methotrexate for ectopic pregnancy in Clalit Health Services hospitals (2010\u20132021). Subsequent pregnancies were categorized by time from treatment to conception. Outcomes included major congenital malformations, spontaneous abortion, preterm birth, and low birth weight. Adjusted odds ratios (aORs) were estimated using generalized estimating equations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 711 cases: 38 conceived within 1\u20133\u2009months, 111 within 3\u20136\u2009months, and 562 after &gt;6\u2009months. Major congenital malformations were diagnosed in 70 infants, with no significant difference between groups. Although numerically higher rates of congenital malformations associated with methotrexate embryopathy, preterm birth, and low birth weight were observed in the 1\u20133\u2009months group, these differences were not statistically significant. Adjusted ORs for congenital malformations were 0.87 (95% confidence interval [CI]: 0.245\u20133.14) for 1\u20133\u2009months and 1.01 (95% CI: 0.48\u20132.13) for 3\u20136\u2009months, compared to &gt;6\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Conception 1\u20133 and 3\u20136\u2009months after methotrexate treatment for ectopic pregnancy does not appear to increase the risk of major fetal malformations, or other unfavorable obstetric outcomes. Prospective studies in larger cohorts are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70938","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T07:10:11Z","timestamp":1773213011000},"page":"1061-1069","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Timing of conception after methotrexate and subsequent pregnancy outcomes: A retrospective cohort study"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5895-4320","authenticated-orcid":false,"given":"Bar","family":"Rosh","sequence":"first","affiliation":[{"name":"Ruth and Bruce Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology  Haifa Israel"},{"name":"Department of Obstetrics and Gynecology Rambam Health Care Campus  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joul","family":"Hadad","sequence":"additional","affiliation":[{"name":"Statistical Unit Lady Davis Carmel Medical Center  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Gronich","sequence":"additional","affiliation":[{"name":"Ruth and Bruce Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology  Haifa Israel"},{"name":"Department of Community Medicine and Epidemiology Lady Davis Carmel Medical Center  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/17455057231160349"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2013.06.013"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/OGX.0b013e31829cdbeb"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002464"},{"key":"e_1_2_10_6_1","unstructured":"Recommendations|Ectopic pregnancy and miscarriage: diagnosis and initial management|Guidance|NICE.2019https:\/\/www.nice.org.uk\/guidance\/ng126\/chapter\/Recommendations#management\u2010of\u2010miscarriage. Accessed February 18 2024"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70110-8"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200011303432204"},{"key":"e_1_2_10_9_1","volume-title":"Drinking Water and Health, Volume 8: Pharmacokinetics in Risk Assessment","author":"Assessment NRC (US) S on P in R","year":"1987"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198311033091805"},{"key":"e_1_2_10_11_1","unstructured":"Methotrexate Vial ()|Pfizer Medical Information\u2014US. n.d.https:\/\/www.pfizermedicalinformation.com\/methotrexate\u20100. Accessed March 14 2024"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(196003\/04)13:2<236::AID-CNCR2820130205>3.0.CO;2-R"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-9861(82)90235-1"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23003"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/92.10.551"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-011-9913-z"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.07.002"},{"key":"e_1_2_10_18_1","first-page":"37","article-title":"Effect of methotrexate treatment of ectopic pregnancy on subsequent pregnancy","volume":"57","author":"Hackmon R","year":"2011","journal-title":"Can Fam Physician"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2016.07.489"},{"key":"e_1_2_10_20_1","volume-title":"UpToDate","author":"Tulandi T","year":"2024"},{"key":"e_1_2_10_21_1","unstructured":"European Platform on Rare Disease Registration.https:\/\/eu\u2010rd\u2010platform.jrc.ec.europa.eu. Accessed August 4 2025 n.d."},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2008.11.055"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.therap.2015.12.005"},{"key":"e_1_2_10_24_1","unstructured":"CDC.About Birth Defects. Birth Defects 2024.https:\/\/www.cdc.gov\/birth\u2010defects\/about\/index.html. Accessed January 13 2025"},{"issue":"5","key":"e_1_2_10_25_1","first-page":"346","article-title":"Prenatal Diagnosis for Detecting Congenital Malformations: Acceptance among Israeli Arab Women","volume":"2","author":"Jaber L","year":"2000","journal-title":"Isr Med Assoc J"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.20229"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70938","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.70938","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70938","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T14:53:12Z","timestamp":1784299992000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.70938"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,11]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/ijgo.70938"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.70938","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,11]]},"assertion":[{"value":"2025-11-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}