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Aabakke AJM, Petersen TG, Wøjdemann K, Ibsen MH, Jonsdottir F, Rønneberg E, Andersen CS, Hammer A, Clausen TD, Milbak J, Burmester L, Zethner R, Lindved B, Thorsen‐Meyer A, Khalil MR, Henriksen B, Jønsson L, Andersen LLT, Karlsen KK, Pedersen ML, Hedermann G, Vestgaard M, Thisted D, Fallesen AN, Johansson JN, Møller DC, Dubietyte G, Andersson CB, Farlie R, Skaarup Knudsen A, Hansen L, Hvidman L, Sørensen AN, Rathcke SL, Rubin KH, Petersen LK, Jørgensen JS, Krebs L, Bliddal M. Risk factors for and pregnancy outcomes after SARS-CoV-2 in pregnancy according to disease severity: A nationwide cohort study with validation of the SARS-CoV-2 diagnosis. Acta Obstet Gynecol Scand 2023; 102:282-293. [PMID: 36695168 PMCID: PMC9951376 DOI: 10.1111/aogs.14512] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/21/2022] [Accepted: 01/01/2023] [Indexed: 01/26/2023]
Abstract
INTRODUCTION We identified risk factors and outcomes associated with SARS-CoV-2 infection in pregnancy in a universally tested population according to disease severity and validated information on SARS-CoV-2 during pregnancy in national health registers in Denmark. MATERIAL AND METHODS Cohort study using data from national registers and medical records including all pregnancies between March 1, 2020 and February 28, 2021. We compared women with a validated positive SARS-CoV-2 test during pregnancy with non-infected pregnant women. Risk factors and pregnancy outcomes were assessed by Poisson and Cox regression models and stratified according to disease severity defined by hospital admission status and admission reason (COVID-19 symptoms or other). Using medical record data on actual period of pregnancy, we calculated predictive values of the SARS-CoV-2 diagnosis in pregnancy in the registers. RESULTS SARS-CoV-2 infection was detected in 1819 (1.6%) of 111 185 pregnancies. Asthma was associated with infection (relative risk [RR] 1.63, 95% confidence interval [CI] 1.28-2.07). Risk factors for severe COVID-19 disease requiring hospital admission were high body mass index (median ratio 1.06, 95% CI 1.04-1.09), asthma (RR 7.47, 95% CI 3.51-15.90) and gestational age at the time of infection (gestational age 28-36 vs < 22: RR 3.53, 95% CI 1.75-7.10). SARS-CoV-2-infected women more frequently had hypertensive disorders in pregnancy (adjusted hazard ratio [aHR] 1.31, 95% CI 1.04-1.64), early pregnancy loss (aHR 1.37, 95% CI 1.00-1.88), preterm delivery before gestational age 28 (aHR 2.31, 95% CI 1.01-5.26), iatrogenically preterm delivery before gestational age 37 (aHR 1.49, 95% CI 1.01-2.19) and small-for-gestational age children (aHR 1.28, 95% CI 1.05-1.54). The associations were stronger among women admitted to hospital for any reason. The validity of the SARS-CoV-2 diagnosis in relation to pregnancy in the registers compared with medical records showed a negative predictive value of 99.9 (95% CI 99.9-100.0) and a positive predictive value of 82.1 (95% CI 80.4-83.7). CONCLUSIONS Women infected with SARS-CoV-2 during pregnancy were at increased risk of hypertensive disorders in pregnancy, early pregnancy loss, preterm delivery and having children small for gestational age. The validity of Danish national registers was acceptable for identification of SARS-CoV-2 infection during pregnancy.
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Affiliation(s)
- Anna J. M. Aabakke
- Department of Obstetrics and GynecologyCopenhagen University Hospital—HolbækHolbækDenmark,Department of Obstetrics and GynecologyCopenhagen University Hospital—North ZealandHillerødDenmark,Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | | | - Karen Wøjdemann
- Department of Obstetrics and GynecologyCopenhagen University Hospital—BornholmRønneDenmark
| | - Mette H. Ibsen
- Department Obstetrics and GynecologyHospital of South West JutlandEsbjergDenmark
| | - Fjola Jonsdottir
- Department of Obstetrics and GynecologyCopenhagen University Hospital—Herlev and GentofteHerlevDenmark
| | - Elisabeth Rønneberg
- Department of Obstetrics and GynecologyCopenhagen University Hospital—Herlev and GentofteHerlevDenmark
| | | | - Anne Hammer
- Department of Obstetrics and GynecologyGødstrup HospitalHerningDenmark
| | - Tine D. Clausen
- Department of Obstetrics and GynecologyCopenhagen University Hospital—North ZealandHillerødDenmark,Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Julie Milbak
- Department of Obstetrics and GynecologyCopenhagen University Hospital—North ZealandHillerødDenmark
| | - Lars Burmester
- Department of Obstetrics and GynecologyThe North Denmark Regional Hospital HjørringHjørringDenmark
| | - Rikke Zethner
- Department of Obstetrics and GynecologyCopenhagen University Hospital—HolbækHolbækDenmark,Department of Obstetrics and GynecologyCopenhagen University Hospital—Herlev and GentofteHerlevDenmark
| | - Birgitte Lindved
- Department of Obstetrics and GynecologyHorsens Regional HospitalHorsensDenmark
| | - Annette Thorsen‐Meyer
- Department of Obstetrics and GynecologyCopenhagen University Hospital – Amager and HvidovreHvidovreDenmark
| | - Mohammed R. Khalil
- Department Obstetrics and GynecologyUniversity Hospital of Southern Denmark – KoldingKoldingDenmark
| | - Birgitte Henriksen
- Department Obstetrics and GynecologyUniversity Hospital of Southern Denmark – KoldingKoldingDenmark
| | - Lisbeth Jønsson
- Department Obstetrics and GynecologyNykøbing F. HospitalNykøbing FDenmark
| | - Lise L. T. Andersen
- Department of Obstetrics and GynecologyOdense University HospitalOdenseDenmark
| | - Kamilla K. Karlsen
- Department of Obstetrics and GynecologyOdense University HospitalOdenseDenmark
| | - Monica L. Pedersen
- Department of Obstetrics and GynecologyRanders Regional HospitalRandersDenmark
| | - Gitte Hedermann
- Department of Obstetrics and GynecologyCopenhagen University Hospital – RigshospitaletCopenhagenDenmark
| | - Marianne Vestgaard
- Department of Obstetrics and GynecologyCopenhagen University Hospital – RigshospitaletCopenhagenDenmark
| | - Dorthe Thisted
- Department of Obstetrics and GynecologyCopenhagen University Hospital—HolbækHolbækDenmark,Department of Obstetrics and GynecologyZealand University HospitalRoskildeDenmark
| | - Agnethe N. Fallesen
- Department of Obstetrics and GynecologyCopenhagen University Hospital – NæstvedSlagelseDenmark
| | - Josephine N. Johansson
- Department of Obstetrics and GynecologyCopenhagen University Hospital – NæstvedSlagelseDenmark
| | - Ditte C. Møller
- Department of Obstetrics and GynecologyHospital of South JutlandAabenraaDenmark
| | - Greta Dubietyte
- Department of Obstetrics and GynecologyHospital of South JutlandAabenraaDenmark
| | - Charlotte B. Andersson
- Department of Obstetrics and GynecologyThe North Denmark Regional Hospital ThistedThistedDenmark,Danish Center for Clinical Health Services Research (DACS)AalborgDenmark
| | - Richard Farlie
- Department of Obstetrics and GynecologyViborg Regional HospitalViborgDenmark
| | | | - Lea Hansen
- Department of Obstetrics and GynecologyAarhus University HospitalAarhusDenmark
| | - Lone Hvidman
- Department of Obstetrics and GynecologyAarhus University HospitalAarhusDenmark
| | - Anne N. Sørensen
- Department of Obstetrics and GynecologyAalborg University HospitalAalborgDenmark
| | - Sidsel L. Rathcke
- Department of Obstetrics and GynecologyAalborg University HospitalAalborgDenmark
| | - Katrine H. Rubin
- OPEN, Odense University HospitalOdenseDenmark,Research Unit OPEN, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Lone K. Petersen
- Department of Obstetrics and GynecologyOdense University HospitalOdenseDenmark,Research Unit OPEN, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Jan S. Jørgensen
- Department of Obstetrics and GynecologyOdense University HospitalOdenseDenmark
| | - Lone Krebs
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark,Department of Obstetrics and GynecologyCopenhagen University Hospital – Amager and HvidovreHvidovreDenmark
| | - Mette Bliddal
- OPEN, Odense University HospitalOdenseDenmark,Research Unit OPEN, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
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3
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Hornstrup LS, Kristensen SE, Nørgaard P, Sperling L, Sandager P, Ibsen MH, Jørgensen FS. How late in pregnancy can fetal physiological omphalocele be seen? Nationwide study of cases in Denmark over 4-year period. Ultrasound Obstet Gynecol 2022; 60:428-429. [PMID: 35561105 DOI: 10.1002/uog.24937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/26/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Affiliation(s)
- L S Hornstrup
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - S E Kristensen
- Center of Fetal Medicine and Pregnancy, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - P Nørgaard
- Department of Obstetrics and Gynecology, Nordsjaellands Hospital, Hillerød, Denmark
| | - L Sperling
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - P Sandager
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Aarhus University Hospital, Skejby, Denmark
| | - M H Ibsen
- Department of Obstetrics and Gynecology, Sydvestjysk Hospital, Esbjerg, Denmark
| | - F S Jørgensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
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4
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Aabakke AJM, Krebs L, Petersen TG, Kjeldsen FS, Corn G, Wøjdemann K, Ibsen MH, Jonsdottir F, Rønneberg E, Andersen CS, Sundtoft I, Clausen T, Milbak J, Burmester L, Lindved B, Thorsen-Meyer A, Khalil MR, Henriksen B, Jønsson L, Andersen LLT, Karlsen KK, Pedersen ML, Klemmensen Å, Vestgaard M, Thisted D, Tatla MK, Andersen LS, Brülle AL, Gulbech A, Andersson CB, Farlie R, Hansen L, Hvidman L, Sørensen AN, Rathcke SL, Rubin KH, Petersen LK, Jørgensen JS, Stokholm L, Bliddal M. SARS-CoV-2 infection in pregnancy in Denmark-characteristics and outcomes after confirmed infection in pregnancy: A nationwide, prospective, population-based cohort study. Acta Obstet Gynecol Scand 2021; 100:2097-2110. [PMID: 34467518 PMCID: PMC8652723 DOI: 10.1111/aogs.14252] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/23/2021] [Accepted: 08/13/2021] [Indexed: 12/11/2022]
Abstract
Introduction Assessing the risk factors for and consequences of infection with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) during pregnancy is essential to guide clinical care. Previous studies on SARS‐CoV‐2 infection in pregnancy have been among hospitalized patients, which may have exaggerated risk estimates of severe outcomes because all cases of SARS‐CoV‐2 infection in the pregnant population were not included. The objectives of this study were to identify risk factors for and outcomes after SARS‐CoV‐2 infection in pregnancy independent of severity of infection in a universally tested population, and to identify risk factors for and outcomes after severe infection requiring hospital admission. Material and methods This was a prospective population‐based cohort study in Denmark using data from the Danish National Patient Register and Danish Microbiology Database and prospectively registered data from medical records. We included all pregnancies between March 1 and October 31, 2020 and compared women with a positive SARS‐CoV‐2 test during pregnancy to non‐infected pregnant women. Cases of SARS‐CoV‐2 infection in pregnancy were both identified prospectively and through register linkage to ensure that all cases were identified and that cases were pregnant during infection. Main outcome measures were pregnancy, delivery, maternal, and neonatal outcomes. Severe infection was defined as hospital admission due to coronavirus disease 2019 (COVID‐19) symptoms. Results Among 82 682 pregnancies, 418 women had SARS‐CoV‐2 infection during pregnancy, corresponding to an incidence of 5.1 per 1000 pregnancies, 23 (5.5%) of which required hospital admission due to COVID‐19. Risk factors for infection were asthma (odds ratio [OR] 2.19, 95% CI 1.41–3.41) and being foreign born (OR 2.12, 95% CI 1.70–2.64). Risk factors for hospital admission due to COVID‐19 included obesity (OR 2.74, 95% CI 1.00–7.51), smoking (OR 4.69, 95% CI 1.58–13.90), infection after gestational age (GA) 22 weeks (GA 22–27 weeks: OR 3.77, 95% CI 1.16–12.29; GA 28–36 weeks: OR 4.76, 95% CI 1.60–14.12), and having asthma (OR 4.53, 95% CI 1.39–14.79). We found no difference in any obstetrical or neonatal outcomes. Conclusions Only 1 in 20 women with SARS‐CoV‐2 infection during pregnancy required admission to hospital due to COVID‐19. Risk factors for admission comprised obesity, smoking, asthma, and infection after GA 22 weeks. Severe adverse outcomes of SARS‐CoV‐2 infection in pregnancy were rare.
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Affiliation(s)
- Anna J M Aabakke
- Department of Obstetrics and Gynecology, Copenhagen University Hospital-Holbaek, Holbaek, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lone Krebs
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Obstetrics and Gynecology, Copenhagen University Hospital-Amager and Hvidovre, Hvidovre, Denmark
| | - Tanja G Petersen
- OPEN-Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Frank S Kjeldsen
- OPEN-Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Giulia Corn
- Department of Epidemiology Research and Division of Infectious Diseases Preparedness, Statens Serum Institut, Copenhagen, Denmark
| | - Karen Wøjdemann
- Department of Obstetrics and Gynecology, Copenhagen University Hospital-Bornholm, Rønne, Denmark
| | - Mette H Ibsen
- Department Obstetrics and Gynecology, Hospital of South West Jutland, Esbjerg, Denmark
| | - F Jonsdottir
- Department of Obstetrics and Gynecology, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
| | - Elisabeth Rønneberg
- Department of Obstetrics and Gynecology, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
| | - Charlotte S Andersen
- Department Obstetrics and Gynecology, Regional Hospital West Jutland, Herning, Denmark
| | - Iben Sundtoft
- Department Obstetrics and Gynecology, Regional Hospital West Jutland, Herning, Denmark
| | - Tine Clausen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Obstetrics and Gynecology, Copenhagen University Hospital-North Zealand, Hillerød, Denmark
| | - Julie Milbak
- Department of Obstetrics and Gynecology, Copenhagen University Hospital-North Zealand, Hillerød, Denmark
| | - Lars Burmester
- Department of Obstetrics and Gynecology, The North Denmark Regional Hospital Hjørring, Hjørring, Denmark
| | - Birgitte Lindved
- Department of Obstetrics and Gynecology, Horsens Regional Hospital, Horsens, Denmark
| | - Annette Thorsen-Meyer
- Department of Obstetrics and Gynecology, Copenhagen University Hospital-Amager and Hvidovre, Hvidovre, Denmark
| | - Mohammed R Khalil
- Department Obstetrics and Gynecology, University Hospital of Southern Denmark-Kolding, Kolding, Denmark
| | - Birgitte Henriksen
- Department Obstetrics and Gynecology, University Hospital of Southern Denmark-Kolding, Kolding, Denmark
| | - Lisbeth Jønsson
- Department Obstetrics and Gynecology, Nykøbing F. Hospital, Nykøbing F, Denmark
| | - Lise L T Andersen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Kamilla K Karlsen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Monica L Pedersen
- Department of Obstetrics and Gynecology, Randers Regional Hospital, Randers, Denmark
| | - Åse Klemmensen
- Department of Obstetrics and Gynecology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Marianne Vestgaard
- Department of Obstetrics and Gynecology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Dorthe Thisted
- Department of Obstetrics and Gynecology, Zealand University Hospital, Roskilde, Denmark
| | - Manrinder K Tatla
- Department of Obstetrics and Gynecology, Zealand University Hospital, Roskilde, Denmark
| | - Line S Andersen
- Department of Obstetrics and Gynecology, Copenhagen University Hospital-Slagelse, Slagelse, Denmark
| | - Anne-Line Brülle
- Department of Obstetrics and Gynecology, Hospital of South Jutland, Aabenraa, Denmark
| | - Arense Gulbech
- Department of Obstetrics and Gynecology, Hospital of South Jutland, Aabenraa, Denmark
| | - Charlotte B Andersson
- Department of Obstetrics and Gynecology, The North Denmark Regional Hospital Thisted, Thisted, Denmark.,Danish Center for Clinical Health Services Research (DACS), Aalborg, Denmark
| | - Richard Farlie
- Department of Obstetrics and Gynecology, Viborg Regional Hospital, Viborg, Denmark
| | - Lea Hansen
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Lone Hvidman
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Anne N Sørensen
- Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
| | - Sidsel L Rathcke
- Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
| | - Katrine H Rubin
- OPEN-Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lone K Petersen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jan S Jørgensen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lonny Stokholm
- OPEN-Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Mette Bliddal
- OPEN-Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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5
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Hyldig N, Vinter CA, Kruse M, Mogensen O, Bille C, Sorensen JA, Lamont RF, Wu C, Heidemann LN, Ibsen MH, Laursen JB, Ovesen PG, Rorbye C, Tanvig M, Joergensen JS. Prophylactic incisional negative pressure wound therapy reduces the risk of surgical site infection after caesarean section in obese women: a pragmatic randomised clinical trial. BJOG 2018; 126:628-635. [PMID: 30066454 PMCID: PMC6586160 DOI: 10.1111/1471-0528.15413] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2018] [Indexed: 12/15/2022]
Abstract
Objective To evaluate the reduction of surgical site infections by prophylactic incisional negative pressure wound therapy compared with standard postoperative dressings in obese women giving birth by caesarean section. Design Multicentre randomised controlled trial. Setting Five hospitals in Denmark. Population Obese women (prepregnancy body mass index (BMI) ≥30 kg/m2) undergoing elective or emergency caesarean section. Method The participants were randomly assigned to incisional negative pressure wound therapy or a standard dressing after caesarean section and analysed by intention‐to‐treat. Blinding was not possible due to the nature of the intervention. Main outcome measures The primary outcome was surgical site infection requiring antibiotic treatment within the first 30 days after surgery. Secondary outcomes included wound exudate, dehiscence and health‐related quality of life. Results Incisional negative pressure wound therapy was applied to 432 women and 444 women had a standard dressing. Demographics were similar between groups. Surgical site infection occurred in 20 (4.6%) women treated with incisional negative pressure wound therapy and in 41 (9.2%) women treated with a standard dressing (relative risk 0.50, 95% CI 0.30–0.84; number needed to treat 22; P = 0.007). The effect remained statistically significant when adjusted for BMI and other potential risk factors. Incisional negative pressure wound therapy significantly reduced wound exudate whereas no difference was found for dehiscence and quality of life between the two groups. Conclusion Prophylactic use of incisional negative pressure wound therapy reduced the risk of surgical site infection in obese women giving birth by caesarean section. Tweetable abstract RCT: prophylactic incisional NPWT versus standard dressings postcaesarean in 876 women significantly reduces the risk of SSI. RCT: prophylactic incisional NPWT versus standard dressings postcaesarean in 876 women significantly reduces the risk of SSI.
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Affiliation(s)
- N Hyldig
- Department of Plastic Surgery, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Gynaecology and Obstetrics, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,OPEN Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - C A Vinter
- Department of Gynaecology and Obstetrics, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - M Kruse
- Danish Centre for Health Economics (DaCHE), Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - O Mogensen
- Department of Pelvic Cancer, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
| | - C Bille
- Department of Plastic Surgery, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - J A Sorensen
- Department of Plastic Surgery, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - R F Lamont
- Department of Gynaecology and Obstetrics, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Division of Surgery, Northwick Park Institute of Medical Research Campus, University College London, London, UK
| | - C Wu
- Department of Gynaecology and Obstetrics, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - L N Heidemann
- Department of Plastic Surgery, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Gynaecology and Obstetrics, Lillebaelt Hospital, Kolding, Denmark
| | - M H Ibsen
- Department of Gynaecology and Obstetrics, Hospital of Southern Jutland, Esbjerg, Denmark
| | - J B Laursen
- Department of Gynaecology and Obstetrics, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - P G Ovesen
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Skejby, Aarhus, Denmark
| | - C Rorbye
- Department of Gynaecology and Obstetrics, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - M Tanvig
- Department of Gynaecology and Obstetrics, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Gynaecology and Obstetrics, Lillebaelt Hospital, Kolding, Denmark
| | - J S Joergensen
- Department of Gynaecology and Obstetrics, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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