Healthcare最新文献

{"title":"Prevalence and Risk Factors of Menstrual Disorders in Korean Women.","authors":"Ye-Lin Kim, Jun Young Chang, Suejin Kim, Mira Yoon, Jae-Na Ha, Kang Hyun Um, Boeun Lee, Kyoung Sook Jeong","doi":"10.3390/healthcare13060606","DOIUrl":"10.3390/healthcare13060606","url":null,"abstract":"<p><strong>Background: </strong>Some women experience menstrual disorders such as polymenorrhea, oligomenorrhea, and menorrhagia, which are not only influenced by biological factors but also by lifestyle and psychosocial factors. Understanding menstrual disorders is essential for women's health and quality of life.</p><p><strong>Objectives: </strong>To identify policies that are needed to prevent menstrual disorders, we investigated the prevalence and risk factors of menstrual disorders in this study.</p><p><strong>Methods: </strong>A web-based questionnaire survey evaluated menstrual characteristics and biological, lifestyle, and psychosocial risk factors in 13,943 South Korean females aged 15-45 years. A Chi-square test was used to compare the prevalence of menstrual disorders by general and psychosocial characteristics. A logistic regression analysis was utilized to determine odds ratios (ORs) of risk factors for menstrual disorders. Adjusted ORs of the risk factors for menstrual disorders, after adjusting for other risk factors, were calculated.</p><p><strong>Results: </strong>The prevalence of polymenorrhea, oligomenorrhea, and menorrhagia was 3.1%, 9.0%, and 5.4%, respectively. A significantly high prevalence of menstrual disorders was associated with the following risk factors: underweight (OR: 1.291) and current smoking (OR: 1.516) for polymenorrhea; overweight (OR: 1.354), obesity (OR: 2.164), current drinking (OR: 1.170), depression (OR: 1.416), and perceived stress (OR: 1.248) for oligomenorrhea; and depression (OR: 1.521) for menorrhagia.</p><p><strong>Conclusions: </strong>This cross-sectional study highlighted that menstrual disorders are significantly associated with lifestyle habits and psychosocial factors in South Korean women. These findings can serve as scientific evidence to support public health initiatives aimed at enhancing awareness and menstrual health management among women.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress and Prospects of Research on the Impact of Mental Health of Youth Sailors-A Bibliometric-Based Analysis.","authors":"Milena Lachowicz, Yang Xing, Tomasz Chamera","doi":"10.3390/healthcare13060608","DOIUrl":"10.3390/healthcare13060608","url":null,"abstract":"<p><p><b>Background:</b> The mental health of youth sailors has garnered increasing attention from both coaches and researchers, as evidenced by the growing appearance of related keywords in scientific literature. Despite this rising interest, no studies have yet specifically focused on the mental health of this population. <b>Methods:</b> This study conducted a bibliometric analysis of 315 articles retrieved from the Web of Science database. These articles were analyzed to identify trends, influential authors, institutions, and regions in the field of youth sailor mental health. <b>Results:</b> The analysis yielded several key findings: (1) Depression, anxiety, and mental health disorders are the primary areas of focus in the literature on youth sailors' mental health; (2) Rosemary Purcell is identified as the most influential author in this domain; (3) the University of Melbourne, Orygen, and Deakin University are the top three contributing institutions; (4) Australia, the USA, Canada, China, and England are the five most prominent regions involved in this research. <b>Conclusions:</b> This study provides a comprehensive overview of current research on the mental health of young sailors. By emphasising the most influential contributors and research trends, it aims to raise awareness amongst coaches and researchers, eventually supporting efforts to improve the mental health of young sailors.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of +PERTO^® in Rehabilitation for Total Knee Arthroplasty: A Pilot Study.","authors":"Tiago Emanuel Soares de Araújo, Elsa Paula Santos Rodrigues, Ana Raquel Varejão Files, João Miguel Almeida Ventura-Silva, Jorge Eduardo Ferreira Mendes, André Filipe Morais Pinto Novo, Olga Maria Pimenta Lopes Ribeiro","doi":"10.3390/healthcare13060605","DOIUrl":"10.3390/healthcare13060605","url":null,"abstract":"<p><strong>Background/objectives: </strong>Total knee Arthroplasty (TKA) is a prevalent treatment modality for degenerative knee diseases. Nevertheless, the success of the intervention is contingent on effective rehabilitation. The +PERTO^® program (a Technological Rehabilitation Nursing Program) was developed as a mobile application comprising three phases to support patients during the perioperative period by providing exercises, information, and direct communication with healthcare professionals. The present study aims to evaluate the effects and usability of the +PERTO^® program in patients undergoing total knee arthroplasty.</p><p><strong>Methods: </strong>In 2024, a hospital in northern Portugal conducted a pilot trial with eleven patients undergoing elective total knee arthroplasty. Researchers collected data both before surgery and six weeks after discharge. To evaluate effectiveness, software satisfaction, and usability, they used several assessment tools, including the Oxford Knee Score (OKS), SF-36v2, Visual Analog Scale (VAS), Short Physical Performance Battery (SPPB), QSEnf-10, and System Usability Scale (SUS). Researchers analyzed the data using both descriptive and inferential statistics. The hospital's ethics committee and board of directors approved the study.</p><p><strong>Results: </strong>There was a significant reduction in pain (<i>p</i> = 0.041) and improvement in knee functionality (<i>p</i> = 0.010), physical performance (<i>p</i> = 0.038), and quality of life (<i>p</i> < 0.05). Patient satisfaction was high (QSEnf-10: 3.8/4), and the usability of +PERTO^® was considered excellent (SUS: 96.6/100).</p><p><strong>Conclusions: </strong>The +PERTO^® program proved to be an effective and innovative solution to support rehabilitation after TKA, promoting improvements in pain, functionality, and quality of life. This digital program stands out for its high rate of usability and its ability to modernize healthcare by providing a patient-centered approach.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ways of Coping with Stress in Women Diagnosed with Breast Cancer: A Preliminary Study.","authors":"Agata Wypych-Ślusarska, Sandra Ociepka, Karolina Krupa-Kotara, Joanna Głogowska-Ligus, Klaudia Oleksiuk, Jerzy Słowiński, Antoniya Yanakieva","doi":"10.3390/healthcare13060609","DOIUrl":"10.3390/healthcare13060609","url":null,"abstract":"<p><p><b>Background:</b> Cancer diagnosis causes a range of different emotions. It is also a factor that causes feelings of severe stress. Coping with stress is individual and depends on the person's nature, environment, and support they receive. <b>Aim:</b> This study aimed to assess how women diagnosed with breast cancer cope with stress caused by the disease. <b>Methods:</b> A total of 111 women diagnosed with breast cancer participated in the study. The questionnaires were distributed electronically using Google Forms in online forums and groups on social media. The survey consisted of two parts: the original questions and the Mini-COPE questionnaire. The relationships between stress-coping strategies and age, having children, marital status, and life satisfaction were tested. The Mann-Whitney U test, Kruskal-Wallis test, and Dunn's post-hoc test with Bonferroni correction were used for the analyses (<i>p</i> < 0.05). <b>Results:</b> Of the surveyed women, 54.9% reported that the moment of diagnosis was the most stressful. Feelings of fear and anxiety accompanied 30.5% of the women, and 24.7% at the time of diagnosis could not provide information about the disease. The dominant strategies were seeking emotional support (mean 2.12 ± 0.56) and seeking instrumental support (mean 2.06 ± 0.48). Women in the older age group, married women, and women with children were most likely to adopt the strategy of turning to religion. <b>Conclusions:</b> The dominant strategies were seeking emotional and instrumental support. The strategy of turning to religion was used more often by older patients and patients with children.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Women's Education, Information and Communication Technologies, and Income on Maternal Mortality: Evidence from BRIICS Countries.","authors":"Adrian Teodor Moga Rogoz, Gamze Sart, Yilmaz Bayar, Marina Danilina, Marius Dan Gavriletea","doi":"10.3390/healthcare13060602","DOIUrl":"10.3390/healthcare13060602","url":null,"abstract":"<p><p>Maternal mortality has been among one of the most significant global health problems despite noteworthy decreases in maternal mortality during recent decades, and reducing maternal mortality is one of the targets of Sustainable Development Goal 3 (Good Health and Well-being). <b>Objectives</b>: This study investigates the effect of women's education, ICTs (information and communication technologies), and income level on maternal mortality in the BRIICS countries for the 2000-2020 period. <b>Methods</b>: Panel causality and regression approaches are employed to analyze the interaction amongst women's education, ICTs, income level, and maternal mortality. <b>Results</b>: The results of the causality test reveal that women's education, ICTs, and income have a significant influence on the maternal mortality ratio. Specifically, the regression results indicate that women's education, ICTs, and income have a negative effect on maternal mortality, but women's education has been identified as one of the most significant factors in reducing maternal mortality ratios. <b>Conclusions</b>: Institutional and legal measures to increase women's education would be useful to globally decrease maternal mortality.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Screen or Not to Screen: \"False Positive\" Cases-Can They Be Treated as Definitely False? Properly Selecting the Screening Age-Range Groups in Scoliosis Screening Programs.","authors":"Theodoros B Grivas, Elias Vasiliadis, Christina Mazioti, Aristea Mamzeri, Despina Papagianni, Galateia Katzouraki, Nikolaos Sekouris","doi":"10.3390/healthcare13060600","DOIUrl":"10.3390/healthcare13060600","url":null,"abstract":"<p><p><b>Background/Objectives:</b> This opinion paper provides a brief overview of the history of school scoliosis screening programs following the introduction. <b>Methods:</b> It outlines the international administrative policies of these programs, their impact on the frequency of surgical procedures, and the effects of discontinuing school-based scoliosis screenings. <b>Results:</b> The primary focus is on analyzing the role of \"false positive\" cases detected during the Adam's bending test, which has contributed to the discontinuation of these programs in certain countries. This focused discussion is based on the impact of growth on the relationship between spinal and rib cage deformities. Furthermore, we propose the selection of the optimal age range for screening, considering the correlation between idiopathic scoliosis prevalence and geographical latitude. <b>Conclusions:</b> Lastly, we emphasize the importance of continuing scoliosis screening programs in schools.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gait Disturbance in Patients with Schizophrenia in Relation to Walking Speed, Ankle Joint Range of Motion, Body Composition, and Extrapyramidal Symptoms.","authors":"Ryuichi Tanioka, Reiko Kamoi, Yoshihiro Mifune, Keita Nakagawa, Kaito Onishi, Krishan Soriano, Hidehiro Umehara, Hirokazu Ito, Leah Bollos, Rick Yiu Cho Kwan, Kyoko Osaka, Mai Sato, Eiji Takigawa, Kyoko Goda, Hironari Kamoi, Takeru Ishii, Shoko Edo, Kazushi Mifune, Tetsuya Tanioka","doi":"10.3390/healthcare13060604","DOIUrl":"10.3390/healthcare13060604","url":null,"abstract":"<p><strong>Background/objectives: </strong>In patients with schizophrenia, gait disturbances (e.g., reduced walking speed and stride length) are linked to neural dysfunction and extrapyramidal symptoms. To inform gait rehabilitation strategies, this study examines the relationships of walking speed with extrapyramidal symptoms, stride length, antipsychotic dosage, ankle joint range of motion, and body composition in patients with chronic schizophrenia.</p><p><strong>Methods: </strong>Sixty-eight patients with chronic schizophrenia were included. All variables were described based on their measurement levels using non-parametric methods. Spearman's rho was calculated to assess correlations. For multiple linear regression analyses, backward stepwise elimination was used to determine variables associated with walking speed. Statistical significance was set to <i>p</i> < 0.05.</p><p><strong>Results: </strong>Walking speed was positively correlated with stride length, chlorpromazine-equivalent dose, ankle plantar flexion, body mass index, bone mineral content, trunk muscle mass, and skeletal muscle mass index. In contrast, it was negatively correlated with drug-induced extrapyramidal symptoms scale (DIEPSS) scores for gait, bradykinesia, tremor, overall severity, and age. The multiple linear regression indicated that DIEPSS 2 bradykinesia level and ankle plantar flexion angle, adjusted for a 26% variance, best explained the walking speed.</p><p><strong>Conclusions: </strong>A lower bradykinesia severity and a higher ankle plantar flexion are associated with higher walking speeds. Thus, it is critical to assess stride length, bradykinesia, angle/limitation/torque of ankle plantar flexion, trunk and upper and lower limb muscle masses, and walking speed in patients with chronic schizophrenia. Specific strategies for gait rehabilitation should focus on stride training, plantar flexion strengthening exercises, and balance training.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review of Large Language Models in Medical Education, Clinical Decision Support, and Healthcare Administration.","authors":"Josip Vrdoljak, Zvonimir Boban, Marino Vilović, Marko Kumrić, Joško Božić","doi":"10.3390/healthcare13060603","DOIUrl":"10.3390/healthcare13060603","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Large language models (LLMs) have shown significant potential to transform various aspects of healthcare. This review aims to explore the current applications, challenges, and future prospects of LLMs in medical education, clinical decision support, and healthcare administration. <b>Methods</b>: A comprehensive literature review was conducted, examining the applications of LLMs across the three key domains. The analysis included their performance, challenges, and advancements, with a focus on techniques like retrieval-augmented generation (RAG). <b>Results:</b> In medical education, LLMs show promise as virtual patients, personalized tutors, and tools for generating study materials. Some models have outperformed junior trainees in specific medical knowledge assessments. Concerning clinical decision support, LLMs exhibit potential in diagnostic assistance, treatment recommendations, and medical knowledge retrieval, though performance varies across specialties and tasks. In healthcare administration, LLMs effectively automate tasks like clinical note summarization, data extraction, and report generation, potentially reducing administrative burdens on healthcare professionals. Despite their promise, challenges persist, including hallucination mitigation, addressing biases, and ensuring patient privacy and data security. <b>Conclusions:</b> LLMs have transformative potential in medicine but require careful integration into healthcare settings. Ethical considerations, regulatory challenges, and interdisciplinary collaboration between AI developers and healthcare professionals are essential. Future advancements in LLM performance and reliability through techniques such as RAG, fine-tuning, and reinforcement learning will be critical to ensuring patient safety and improving healthcare delivery.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Interplay Between Cervicovaginal Microbiota Diversity, <i>Lactobacillus</i> Profiles and Human Papillomavirus in Cervical Cancer: A Systematic Review.","authors":"Giosuè Giordano Incognito, Carlo Ronsini, Vittorio Palmara, Paola Romeo, Giuseppe Vizzielli, Stefano Restaino, Marco La Verde, Orazio De Tommasi, Marco Palumbo, Stefano Cianci","doi":"10.3390/healthcare13060599","DOIUrl":"10.3390/healthcare13060599","url":null,"abstract":"<p><p><b>Background and Objectives:</b> Interest in defining the characteristics of the cervicovaginal microbiota (CVM) in invasive cervical cancer (ICC) is growing, particularly concerning <i>Lactobacillus</i> species, as evidence suggests that these may differ in affected women and potentially interact with Human Papillomavirus (HPV) infection. Understanding these features could have important implications for disease management. Thus, this study aims to systematically review the main characteristics of available literature exploring the relationship between CVM diversity, <i>Lactobacillus</i> profiles, and HPV in ICC; <b>Methods:</b> A comprehensive bibliographic search was conducted across databases, including Medline, Embase, Scopus, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov, in accordance with the to the PRISMA guidelines. The review included studies that met the following inclusion criteria: studies comparing CVM in women with ICC to controls, focusing on Community State Types (CSTs), <i>Lactobacillus</i> profiles, and microbial diversity. Exclusion criteria included commentaries, letters, reviews, and studies without control groups. Variables were analyzed using the Kruskal-Wallis and Fisher's exact tests, with statistical significance level set at 0.05. Data analysis was conducted and reviewed in a blinded manner. <b>Results:</b> A total of 28 studies published between 2015 and 2024 met the inclusion criteria. A total of 2082 patients were included, with 323 (41.9%) of the 770 cases testing positive for HPV and 327 (24.9%) of the 1312 controls testing positive for HPV. A total of 18 studies specifically examined HPV genotypes. Cervical swabs were employed in 19 out of 28 studies (67.9%), while vaginal swabs were used in 17 studies (60.7%). Additionally, two studies included samples collected via cervical biopsy (7.1%), four studies utilized cervicovaginal lavage (14.3%), and one study used a cervical brush for sample collection (3.6%). Regarding microbiota profiling, 26 studies (92.9%) employed 16S rRNA analysis, while one study (3.6%) utilized whole-genome sequencing (WGS), and another (3.6%) used 16s rDNA. A total of 10 studies (35.7%) examined the distribution of CSTs. Five studies (17.9%) reported on <i>Lactobacillus</i> profiles. Different levels of <i>Lactobacillus crispatus</i> and <i>Lactobacillus iners</i> were observed, along with variations between <i>Lactobacillus</i>-dominant and <i>Lactobacillus</i>-depleted communities. A total of 22 studies (78.6%) assessed α-diversity, and 17 studies (60.7%) examined β-diversity; <b>Conclusions:</b> This study emphasizes the heterogeneous features of the studies exploring the association between alterations in the CVM, HPV, and the development of ICC, suggesting the need for further research to better understand this relationship. These findings could inform new strategies for prevention and treatment.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Placental Grading on Pregnancy Outcomes: A Retrospective Cohort Study.","authors":"Antonios Siargkas, Ioannis Tsakiridis, Georgios Michos, Anastasios Liberis, Sofoklis Stavros, Menelaos Kyriakakis, Ekaterini Domali, Apostolos Mamopoulos, Themistoklis Dagklis","doi":"10.3390/healthcare13060601","DOIUrl":"10.3390/healthcare13060601","url":null,"abstract":"<p><strong>Background: </strong>Placental grading remains underutilized in clinical practice despite its potential prognostic value. This study aimed to elucidate the relationship between premature placental calcification (PPC) and relevant perinatal outcomes in a large cohort.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study involving 3088 singleton pregnancies that underwent routine third-trimester ultrasound examinations (30⁺⁰ to 35⁺⁶ gestational weeks) at the Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece, between January 2018 and December 2023. Placental calcification was graded using the Grannum system, categorizing placentas into Grades 0-1 (control), Grade 2, and Grade 3. Primary outcomes assessed were small for gestational age neonates (SGA) and preeclampsia. Secondary outcomes included gestational hypertension, fetal growth restriction (FGR), stillbirth, gestational age at birth, and birthweight centile. Multiple logistic regression was employed to adjust for confounders, i.e., maternal age, BMI, smoking, conception via assisted reproductive technology, and uterine artery pulsatility index.</p><p><strong>Results: </strong>In total, 544 pregnancies (17.6%) had Grade 2 placentas, and 41 pregnancies (1.3%) had Grade 3 placentas. Compared to the control group, Grade 2 placentas were associated with increased odds of SGA (adjusted odds ratio [aOR] 1.80; 95% confidence intervals [CI]: 1.43-2.25) and FGR (aOR 1.81; 95% CI: 1.35-2.42). Grade 3 placentas showed even higher odds of SGA (aOR 3.09; 95% CI: 1.55-6.17) and FGR (aOR 3.26; 95% CI: 1.53-6.95). No significant associations were found between placental grading and preeclampsia or stillbirth. Additionally, PPC was linked to lower birthweight percentiles and earlier gestational age at birth.</p><p><strong>Conclusions: </strong>Premature placental calcification (before 36⁺⁰ weeks), particularly Grade 3, is significantly associated with adverse perinatal outcomes such as SGA and FGR. Incorporating placental grading into routine prenatal care may enhance risk stratification and guide clinical decision making beyond traditional assessment methods.</p>","PeriodicalId":12977,"journal":{"name":"Healthcare","volume":"13 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11942256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}