{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T10:20:04Z","timestamp":1787653204180,"version":"build-2736575974"},"reference-count":13,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:00:00Z","timestamp":1786233600000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"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":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate reproductive and perinatal outcomes in patients who underwent trachelectomy for early\u2010stage cervical cancer, focusing on predictors of pregnancy achievement and early preterm birth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study included 37 patients who underwent trachelectomy between January 2010 and February 2025, with perinatal follow\u2010up and delivery management at Kyoto University Hospital. Reproductive outcomes were analyzed in 20 patients who desired pregnancy and received infertility treatment. Perinatal outcomes were assessed in 17 deliveries, comparing 22\u201333\u2009weeks and\u2009\u2265\u200934\u2009weeks. Clinical variables were compared between groups using the Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      test and Fisher's exact test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among patients who underwent infertility treatment, 15 (75.0%) achieved at least one clinical pregnancy and 12 (60.0%) achieved live birth. Higher gravida at treatment initiation was significantly associated with pregnancy achievement. Among 17 deliveries, 7 occurred between 22 and 33\u2009weeks and 10 at \u2265\u200934\u2009weeks. Cervical length before pregnancy and at 22\u2009weeks of gestation did not differ between groups. In contrast, the Nugent score was significantly higher in the 22\u201333\u2010week group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0414), and preterm premature rupture of membranes occurred in all pregnancies in this group versus 40% in the \u2265\u200934\u2010week group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0108).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Vaginal microbiota imbalance was significantly associated with early preterm birth after trachelectomy. These findings suggest that ascending infection due to impaired cervical barrier function may contribute to this risk. Prospective studies incorporating longitudinal microbiota profiling and targeted intervention are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70437","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T05:41:16Z","timestamp":1786340476000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reproductive and Perinatal Outcomes After Trachelectomy: Vaginal Microbiota and Early Preterm Birth"],"prefix":"10.1111","volume":"52","author":[{"given":"Hiromi","family":"Takemura","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine  Kyoto Japan"},{"name":"Department of Obstetrics and Gynecology Shizuoka General Hospital  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1540-0985","authenticated-orcid":false,"given":"Mana","family":"Taki","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruko","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asami","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics Kyoto University Graduate School of Medicine  Kyoto 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