Journal of Perinatal Medicine最新文献

{"title":"Prediction of gestational diabetes mellitus using clinical and ultrasonographic parameters: development of independent maternal and fetal models.","authors":"Sinem Tekin, Aydın Ocal, Filiz Yarsilikal Guleroglu, Cagseli Göksu Ozgün Selcuk, Omer Gökhan Eyisoy, Emine Ufuk Büyükkaya Ocal, Ali Cetin","doi":"10.1515/jpm-2025-0135","DOIUrl":"https://doi.org/10.1515/jpm-2025-0135","url":null,"abstract":"<p><strong>Objectives: </strong>To develop predictive models for gestational diabetes mellitus (GDM) using maternal clinical and ultrasonographic parameters, as well as fetal ultrasonographic measurements obtained during routine second-trimester obstetric examination.</p><p><strong>Methods: </strong>Our prospective case-control study included 80 pregnant participants (32 with GDM and 48 healthy controls) between 24 and 28 weeks of gestation. We evaluated maternal parameters including anthropometric measurements such as neck circumference and waist-hip ratio, ultrasonographic measurements like maternal adipose thickness, as well as fetal ultrasonographic parameters including pancreatic hyperechogenicity, soft tissue measurements, and cardiac parameters. Following ultrasonographic examination, all participants underwent a 75-g oral glucose tolerance test (OGTT). Two separate logistic regression models were developed for maternal and fetal parameters to evaluate their association with the presence or absence of GDM.</p><p><strong>Results: </strong>The maternal model achieved 90.0 % accuracy through a stepwise integration of suprapubic subcutaneous adipose tissue thickness (OR=1.35, 95 % CI: 1.11-1.64), visceral adipose tissue (OR=1.68, 95 % CI: 1.18-2.40), gravidity (OR=2.09, 95 % CI: 1.32-3.33), and family history of diabetes. The fetal model reached 82.5 % accuracy using two parameters: pancreatic hyperechogenicity (OR=0.02, 95 % CI: 0.00-0.14) and fetal abdominal subcutaneous tissue thickness (OR=5.09, 95 % CI: 1.75-14.78). The maternal model demonstrated excellent discriminative ability with an AUC of 0.95.</p><p><strong>Conclusions: </strong>Both maternal and fetal ultrasonographic parameters can serve as effective predictors of GDM when combined with clinical risk factors. These models, which can be easily incorporated into routine second-trimester ultrasound examinations, offer potential for early identification of high-risk patients without additional patient visits or invasive testing.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration of copy number variations and candidate genes in fetal congenital heart disease using chromosomal microarray analysis.","authors":"Di Yao, Ruyu Xia, Xu Jiang, Caiqin Guo, Nan Shi, Hehua Tao, Lan Yang","doi":"10.1515/jpm-2024-0599","DOIUrl":"https://doi.org/10.1515/jpm-2024-0599","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate copy number variations (CNVs) and potential candidate genes associated with fetal congenital heart disease (CHD) and to compare the prevalence of CNVs among different CHD subtypes.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 391 fetuses diagnosed with CHD between 2019 and 2023. 391 fetuses with case were divided into three groups: isolated CHD (Group 1), complex CHD (Group 2), and CHD with extracardiac anomalies (Group 3). Amniocentesis was performed for all pregnant women, with both karyotyping and CMA conducted. Gene Ontology (GO) annotation and KEGG pathway analyses were conducted for isolated and complex CHD cases.</p><p><strong>Results: </strong>CMA and karyotype detected total abnormalities in 22 % of all CHD fetuses, including a chromosomal aneuploidy rate of 7.2 %, a pathogenic CNV (pCNV) rate of 6.1 %. The overall detection rates for Groups 1, 2, and 3 were 11.6 %, 12.5 %, and 50 %, respectively. Group 3 exhibited significantly higher rates of chromosomal aneuploidy (23.7 %) and pCNV (17.8 %) compared to Groups 1 and 2 (p < <i>0.001</i>). No significant differences in maternal age were observed among the three CHD groups. KEGG pathway analysis identified the top three enriched pathways for complex CHD were nucleocytoplasmic transport, cell adhesion molecules, and the mRNA surveillance pathway.</p><p><strong>Conclusions: </strong>The rates of chromosomal aneuploidy and CNV abnormalities in CHD cases with extracardiac anomalies were significantly higher than in the other two groups. Maternal age was not associated with the chromosomal abnormalities observed in CHD cases. KEGG pathway analysis indicated more intricate molecular pathways in complex CHD.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of oral hydration therapy on amniotic fluid index and maternal-neonatal outcomes in pregnant women with oligohydramnios: a systematic review and meta-analysis.","authors":"Anita Yadav, Priyanka Yadav, Kalyani P Deshmukh, Anusha Kamath, Chanchal Goyal, Avinash Prakash, Aravind P Gandhi","doi":"10.1515/jpm-2025-0176","DOIUrl":"https://doi.org/10.1515/jpm-2025-0176","url":null,"abstract":"<p><strong>Objectives: </strong>Maternal oral hydration therapy is a non-invasive approach to improving AFI, but its effectiveness remains uncertain. This systematic review and meta-analysis were therefore undertaken to assess the effectiveness of maternal oral hydration therapy in increasing AFI in pregnancies complicated by oligohydramnios and to evaluate its impact on maternal and neonatal outcomes.</p><p><strong>Methods: </strong>A systematic search of Cochrane Library, Embase, PubMed, Scopus, and Web of Science was conducted. Eligible studies included randomized controlled trials (RCTs), quasi-experimental studies, and analytical observational studies. All studies published till 22 November 2024 in the above databases were included. No restrictions were placed on geographic location or study setting. Two reviewers independently undertook the screening. Relevant studies were identified, screened, and duplicates removed using NESTED Knowledge. Risk of bias was assessed using NOS, JBI, and ROBINS-I tools. Statistical analyses, including meta-analysis using a random-effects model, were conducted in R Studio and Comprehensive Meta-Analysis (CMA) software. Heterogeneity was assessed using the I² statistic.</p><p><strong>Results: </strong>Out of the 12 included studies four qualified for meta-analysis. Pooled results showed a significant increase in AFI at 2 hours (mean difference: 0.996; 95 % CI: 0.781-1.210), 1 day (0.853; 95 % CI: 0.532-1.174), 2 days (1.649; 95 % CI: 0.943-2.356), and 1 week (2.232; 95 % CI: 0.943-3.520). However, high heterogeneity was observed due to variations in fluid type, volume, and frequency.</p><p><strong>Conclusions: </strong>It can be concluded that oral hydration therapy significantly increases AFI and is a simple intervention for managing oligohydramnios, especially in resource-limited settings.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and adverse outcomes associated with hepatitis C virus in pregnancy.","authors":"Moti Gulersen, Erez Lenchner, Amos Grunebaum, Frank A Chervenak, Eran Bornstein","doi":"10.1515/jpm-2025-0146","DOIUrl":"https://doi.org/10.1515/jpm-2025-0146","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate maternal sociodemographic factors and adverse pregnancy outcomes associated with hepatitis C virus (HCV) infection during pregnancy in a large population of live births.</p><p><strong>Methods: </strong>Retrospective analysis of the United States (US) Centers for Disease Control and Prevention Natality Live Birth database (2016-2021). All births were eligible for inclusion. Deliveries with missing data on HCV infection were excluded. Multiple sociodemographic factors and adverse pregnancy and neonatal outcomes were compared between pregnancies complicated by maternal HCV infection and those without HCV. Multivariable logistic regression was utilized to evaluate the association of sociodemographic factors with HCV and adjust outcomes for potential confounders.</p><p><strong>Results: </strong>Of the 22,604,938 live births included, 107,761 (0.48 %) were complicated by maternal HCV. Patients with HCV in pregnancy were more likely to be advanced maternal age, have Medicaid insurance, or smokers. In addition, HCV in pregnancy was associated with higher risks of concurrent infections with hepatitis B virus, syphilis, gonorrhea, or chlamydia. HCV was associated with an increased risk of preterm birth <37 weeks, low birthweight, congenital anomalies at birth, low 5-min Apgar scores, NICU admission, antibiotic treatment for suspected neonatal sepsis, as well as immediate and prolonged ventilation.</p><p><strong>Conclusions: </strong>Based on this recent, large US population cohort, HCV in pregnancy is more commonly associated with certain sociodemographic factors and several adverse pregnancy and neonatal outcomes. These data are an important step in the attempt to identify at-risk patients and employ strategies to better manage and optimize care for these pregnancies.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gestational diabetes insipidus. A systematic review of case reports.","authors":"Mónica Bermúdez González, Esther Alvarez Silvares, Gonzalo Rubio Pérez","doi":"10.1515/jpm-2024-0499","DOIUrl":"https://doi.org/10.1515/jpm-2024-0499","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the clinical characteristics and etiopathogenic factors associated with gestational diabetes insipidus (GDI), analyzing maternal and perinatal outcomes.</p><p><strong>Methods: </strong>A systematic review was performed in PubMed, Embase and Scopus of articles on GDI published from January 1, 1980 to April 3, 2024. The review included 55 case reports on GDI, with a total of 64 women. Data on age, parity, diagnosis, management, and maternal and perinatal morbidity and mortality were collected. Descriptive statistical analysis was performed with SPSS version 17.0, considering a p value <0.05 as significant. Study quality was assessed with the Joanna Briggs Institute critical appraisal checklist.</p><p><strong>Results: </strong>Of the 64 women studied, 65.6 % were primiparous and the mean gestational age at diagnosis was 32.7 weeks. There was a high prevalence of twin gestations (21.9 %) and a significant percentage of cesarean deliveries (54 %). Preeclampsia, Acute fatty liver of pregnancy and HELLP syndrome were significantly more prevalent. The incidence of prematurity was 54.7 % and the perinatal mortality rate was 78.1 ‰. These complications showed statistical significance (p<0.05), indicating the severity of GDI and its impact on obstetric outcomes.</p><p><strong>Conclusions: </strong>GDI represents a complex clinical challenge with important implications for maternal-fetal health. The understanding of its aetiology, linked to vasopressinase activity and its relationship with various obstetric pathologies, is crucial for the diagnosis and proper management of this condition.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating NIPT and ultrasound for detecting fetal aneuploidies and abnormalities.","authors":"Wiku Andonotopo, Muhammad Adrianes Bachnas, Adhi Pribadi, Muhammad Alamsyah Azis, Muhammad Ilham Aldika Akbar, Ernawati, I Nyoman Hariyasa Sanjaya, Anak Agung Gede Putra Wiradnyana, Dudy Aldiansyah, Julian Dewantiningrum, Mochammad Besari Adi Pramono, John Wantania, Sri Sulistyowati, Milan Stanojevic, Asim Kurjak","doi":"10.1515/jpm-2025-0005","DOIUrl":"https://doi.org/10.1515/jpm-2025-0005","url":null,"abstract":"<p><p>The advent of non-invasive prenatal testing (NIPT) utilizing cell-free fetal DNA (cfDNA) has transformed the landscape of early chromosomal anomaly detection. When paired with high-resolution ultrasound imaging, it establishes a robust framework for prenatal diagnostics. This study explores the efficacy of merging NIPT findings with detailed ultrasound markers to enhance the identification of both chromosomal and structural fetal abnormalities. Data from 190 cases demonstrated a cfDNA efficacy rate of 91.58 % (cfDNA ≥4 %) and a detection rate of 4.74 % for aneuploidies. The investigation delves into key findings for trisomies, monosomies, and physical malformations, backed by state-of-the-art diagnostic benchmarks. Markers such as nuchal translucency (NT), craniofacial characteristics, and cardiac irregularities were analyzed alongside genetic results. This integrative strategy significantly refines diagnostic precision, paving the way for personalized prenatal care and management.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal responsibility in a fragmented world: reflections from the 2024 international academy of perinatal medicine New York meeting.","authors":"Milan Stanojević, Frank A Chervenak, Ivica Zalud, Joachim W Dudenhausen","doi":"10.1515/jpm-2025-0241","DOIUrl":"https://doi.org/10.1515/jpm-2025-0241","url":null,"abstract":"<p><p>This editorial introduces the Special Issue of the Journal of Perinatal Medicine dedicated to the 2024 New York meeting of the International Academy of Perinatal Medicine (IAPM). Held from June 27-29, the meeting brought together global leaders in perinatal health to discuss advances in prenatal care, equity in maternal and neonatal outcomes, professional ethics, and the role of emerging technologies. This reflection highlights key themes from the conference, including the importance of fetal life in shaping lifelong health, the impact of global inequities, the tension between evidence-based governance and misinformation, and the promise and limits of artificial intelligence. It calls for renewed commitment to scientific integrity, ethical responsibility, and global solidarity in safeguarding the health of mothers and newborns.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social vulnerability and triage acuity among pregnant people seeking unscheduled hospital care.","authors":"Lakha Prasannan, Alejandro Alvarez, Disha Shahani, Matthew J Blitz","doi":"10.1515/jpm-2025-0095","DOIUrl":"https://doi.org/10.1515/jpm-2025-0095","url":null,"abstract":"<p><strong>Objectives: </strong>This study examines the association between census tract-linked social vulnerability index (SVI) and maternal-fetal triage index (MFTI), a standardized score used to classify obstetric triage visit acuity.</p><p><strong>Methods: </strong>This retrospective cohort study included patients at 20 weeks of gestational age or greater presenting to a New York City obstetric triage unit from March 2019 to April 2021, analyzing only the first pregnancy per patient. Exclusions included missing SVI or MFTI data and MFTI-5 (scheduled services). The primary exposure was SVI, and the primary outcome was MFTI score at the first triage visit. Multinomial logistic regression modeled the odds of MFTI-1 (stat) and MFTI-2 (urgent) visits relative to prompt/non-urgent visits, adjusting for potential confounders.</p><p><strong>Results: </strong>Among 11,388 pregnant patients, most triage visits were classified as prompt or non-urgent (61.5 %), while 35.1 % were urgent, and 3.4 % were stat. Patients from neighborhoods with very high SVI had increased odds of an urgent visit (aOR 1.22, 95 % CI 1.06-1.41), as did those with chronic hypertension (aOR 1.46, 95 % CI 1.18-1.81), though SVI was not associated with stat visits. Stat visits were more likely during the COVID-19 pandemic (aOR 5.42, 95 % CI 4.04-7.28) and among patients with chronic hypertension (aOR 1.84, 95 % CI 1.15-2.94), while nulliparity and term presentation were associated with lower odds of a stat visit.</p><p><strong>Conclusions: </strong>Patients living in areas with a very high SVI score had increased odds of urgent triage visits but not stat visits. No racial or ethnic disparities were observed.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between macronutrient content and donation characteristics in Croatian human milk bank.","authors":"Vladimira Rimac, Jurjana Novoselac, Branka Golubić Ćepulić, Ines Bojanić","doi":"10.1515/jpm-2024-0361","DOIUrl":"https://doi.org/10.1515/jpm-2024-0361","url":null,"abstract":"<p><strong>Objectives: </strong>Optimal macronutrient (protein, fat, carbohydrate) values in human milk (HM) are essential for the healthy growth of infants, particularly those with very low birth weight. This study aimed to investigate the correlations between macronutrient content in HM and the characteristics of donations in the Croatian HM bank.</p><p><strong>Methods: </strong>A total of 211 pools of HM from 51 donors were included. Analysis of HM was performed on MIRIS Human Milk Analyzer (Miris AB, Uppsala, Sweden). Prior to routine use, a brief verification of MIRIS was performed (between-run and within-run precision).</p><p><strong>Results: </strong>In precision study the coefficients of variation were all below 10 %, as well as bias, with the exception of the between-run for crude proteins high control level (bias was 12 %). Storage temperature in the donor's home positively correlated with fat (p=0.004) and energy content (p=0.009) and negatively correlated with carbohydrates (p=0.003). The duration of lactation (p<0.001) and the duration of HM storage (in donor's home p=0.022; in the bank p=0.001; total duration of HM storage p<0.001) negatively correlated with proteins in HM. Statistically significant difference was obtained for all components (fat p=0.008, proteins p=0.006, carbohydrates p<0.001, energy content p=0.002) when comparing infant's sex and milk macronutrients, with male infants having higher values.</p><p><strong>Conclusions: </strong>This study demonstrates that various factors can affect the macronutrient content of donated HM. It is important to monitor all factors that may impact on the quality of HM.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and awareness of tobacco smoking and second-hand smoke exposure among pregnant women in Taiwan.","authors":"Ching-Feng Chang, Lin-Hua Wang, Hsin-Yi Kuo, Ching-Chiang Lin","doi":"10.1515/jpm-2024-0516","DOIUrl":"https://doi.org/10.1515/jpm-2024-0516","url":null,"abstract":"<p><strong>Objectives: </strong>Tobacco smoking during pregnancy is a significant public health concern, posing serious risks to both maternal and fetal health. This study aimed to identify factors associated with smoking, second-hand smoke (SHS) exposure, and knowledge of smoking hazards and cessation counseling services during pregnancy.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 3,052 pregnant women receiving prenatal care from 2016 to 2022. Maternal characteristics, smoking status, SHS exposure, and knowledge of smoking risks and cessation services were analyzed using multivariable logistic regression models.</p><p><strong>Results: </strong>Approximately 5.6 % of participants were current smokers. Smoking was more prevalent among unmarried women, those with low income, multigravida, and women with overweight/obesity (p<0.05). SHS exposure was reported by 19.9 % of participants, with higher rates among women with low income and immigrant status (p<0.05). While 99.2 % of participants were aware of the risks of smoking to maternal and infant health, awareness was significantly lower among immigrant women (p<0.05). Additionally, 96.3 % of participants were aware of smoking cessation counseling services, but lower awareness levels were observed in women aged≥35 years, unmarried women, and immigrant women (p<0.05).</p><p><strong>Conclusions: </strong>Sociodemographic factors such as low income and immigrant status are strongly associated with smoking and SHS exposure during pregnancy. To address these disparities, hospitals should prioritize tailored prenatal education and counseling services. Emphasizing the risks of smoking to maternal and infant health can promote healthier pregnancies, especially in underserved rural areas.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}