Journal of Perinatal Medicine最新文献

{"title":"Impact of high maternal body mass index on fetal cerebral cortical and cerebellar volumes.","authors":"Emiko Takeoka, April A Carlson, Neel Madan, Afshin Azimirad, Taysir Mahmoud, Rie Kitano, Shizuko Akiyama, Hyuk Jin Yun, Richard Tucker, Kiho Im, Perrie O'Tierney-Ginn, Tomo Tarui","doi":"10.1515/jpm-2024-0222","DOIUrl":"https://doi.org/10.1515/jpm-2024-0222","url":null,"abstract":"<p><strong>Objectives: </strong>Maternal obesity increases a child's risk of neurodevelopmental impairment. However, little is known about the impact of maternal obesity on fetal brain development.</p><p><strong>Methods: </strong>We prospectively recruited 20 healthy pregnant women across the range of pre-pregnancy or first-trimester body mass index (BMI) and performed fetal brain magnetic resonance imaging (MRI) of their healthy singleton fetuses. We examined correlations between early pregnancy maternal BMI and regional brain volume of living fetuses using volumetric MRI analysis.</p><p><strong>Results: </strong>Of 20 fetuses, there were 8 males and 12 females (median gestational age at MRI acquisition was 24.3 weeks, range: 19.7-33.3 weeks, median maternal age was 33.3 years, range: 22.0-37.4 years). There were no significant differences in clinical demographics between overweight (OW, 25≤BMI<30)/obese (OB, BMI≥30 kg/m²) (n=12) and normal BMI (18.5≤BMI<25) (n=8) groups. Fetuses in the OW/OB group had significantly larger left cortical plate (p=0.0003), right cortical plate (p=0.0002), and whole cerebellum (p=0.049) compared to the normal BMI group. In the OW/OB BMI group, cortical plate volume was larger relative to other brain regions after 28 weeks.</p><p><strong>Conclusions: </strong>This pilot study supports the concept that maternal obesity impacts fetal brain volume, detectable via MRI in living fetuses using quantitative analysis.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927430","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":"Proposal of a novel index in assessing perinatal mortality in prenatal diagnosis of Sacrococcygeal Teratoma.","authors":"Pedro Llancarí, Diego Velarde-García, Rommy H Novoa, Walter Ventura","doi":"10.1515/jpm-2024-0202","DOIUrl":"https://doi.org/10.1515/jpm-2024-0202","url":null,"abstract":"<p><strong>Objectives: </strong>To describe obstetric characteristics and perinatal outcomes in a serie of fetuses with Sacrococcygeal Teratoma (SCT) and propose a novel index to assess postnatal mortality based on the THC ratio and the addition of the presence of polyhydramnios.</p><p><strong>Methods: </strong>A retrospective study in a referral teaching hospital between 2013 and 2023. A descriptive analysis and a receiver operating characteristic (ROC) curve were performed to the determine the optimal cutoff value of the THC plus polyhydramnios based on optimal sensitivity and specificity.</p><p><strong>Results: </strong>Eleven out of 15 fetuses were included in our series during the study period. The median gestational age at prenatal diagnosis was 30.9 weeks and the median gestational age at birth was 35.8 weeks. Seven patients developed polyhydramnios. There was no intrauterine death. There were four deaths after birth (36.4 %). A cutoff value of THC plus polyhydramnios higher than 3.0 was associated with postnatal mortality with 100 % sensitivity and 86 % specificity. There was no significant difference comparing TFR with THC plus polyhydramnios.</p><p><strong>Conclusions: </strong>We report a high postnatal mortality of 36 % among fetuses with diagnosis of Sacrococcygeal Teratoma. Additionally, we propose a potential useful index associated with postnatal mortality based on the THC and the addition of polyhydramnios with a sensitivity of 100 %.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927433","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":"Benefits of yoga in pregnancy: a randomised controlled clinical trial.","authors":"Lucija Kuder, Dejan Dinevski, Izidora Vesenjak Dinevski, Iztok Takač, Faris Mujezinović, Vesna Elveđi Gašparović","doi":"10.1515/jpm-2024-0422","DOIUrl":"https://doi.org/10.1515/jpm-2024-0422","url":null,"abstract":"<p><strong>Objectives: </strong>Modern obstetrics confronts a rise in caesarean sections (CS). Prevention of unnecessary primary CS is a global priority. Women face intense psychological and physiological challenges during childbirth. Fear and anxiety during labour reduce women's self-confidence and empowerment. Yoga is a body-mind practice that lowers maternal fear and anxiety and helps relax pelvic floor muscles during labour. The study examined whether yoga practice in pregnancy influences CS rate in primiparous singleton pregnant women, labour pain intensity and epidural analgesia requests at delivery ward admission.</p><p><strong>Methods: </strong>We conducted a single-blind, randomised, controlled clinical trial comparing yoga to standard obstetric care in pregnancy. A total of 214 participants were randomised, 106 in yoga and 108 in controls. Weekly 90-min yoga classes were led by a certified yoga teacher's supervision. Every pregnant woman in the interventional group completed 12 yoga sessions.</p><p><strong>Results: </strong>Yoga group had a lower total CS due to less frequent In-labour CS (p=0.004) and a higher rate of spontaneous vaginal birth (p=0.009). They experienced less pain intensity during labour (p<0.001), and there was no difference in epidural analgesia requests.</p><p><strong>Conclusions: </strong>Engaging in yoga during pregnancy reduces the rate of In-labour CS, decreases discomfort and encourages spontaneous vaginal birth in primiparous singleton pregnant women.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895416","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":"Determinants of pregnancy outcomes in early-onset intrahepatic cholestasis of pregnancy.","authors":"Xiufang Shao, Haiyan Tang, Yingling Xiu, Kunhai Ren, Mian Pan","doi":"10.1515/jpm-2024-0440","DOIUrl":"https://doi.org/10.1515/jpm-2024-0440","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze pregnancy outcomes and factors influencing early-onset intrahepatic cholestasis of pregnancy (ICP), offering insights to improve the management, diagnosis, and treatment of ICP during pregnancy.</p><p><strong>Methods: </strong>We categorized 127 pregnant women with ICP into two groups based on a gestational age cutoff of 28 weeks. The analysis centered on biochemical markers, pregnancy complications, and outcomes to identify factors influencing early-onset ICP.</p><p><strong>Results: </strong>We found that biochemical markers including alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase (GGT), alkaline phosphatase, total bilirubin, direct bilirubin (DBIL), indirect bilirubin, and cholesterol were significantly lower in early-onset ICP compared to late-onset ICP. Importantly, premature birth rates were higher in the early-onset ICP group. Through univariate and multivariate logistic regression analyses of these biochemical markers, GGT and DBIL emerged as significant predictive factors (OR=0.84 and 0.54).</p><p><strong>Conclusions: </strong>Early-onset ICP is characterized by its early onset, prolonged duration, and a higher incidence of premature births compared to late-onset ICP, leading to adverse perinatal outcomes. This research underscores the protective role of GGT and DBIL in early-onset ICP.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895405","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":"Trends and variations in admissions for cannabis use disorder among pregnant women in United States.","authors":"Maria C Mejia, Lea Sacca, Allison H Ferris, Charles H Hennekens, Panagiota Kitsantas","doi":"10.1515/jpm-2024-0487","DOIUrl":"https://doi.org/10.1515/jpm-2024-0487","url":null,"abstract":"<p><strong>Objectives: </strong>Cannabis use disorder (CUD) among pregnant women is increasing, yet limited information exists on admissions for treatment in this population. This study examined trends in CUD admissions among pregnant women in publicly funded U.S. treatment facilities from 2000 to 2021.</p><p><strong>Methods: </strong>Using the Treatment Episode Data Set-Admissions, we analyzed 33,729 admissions of pregnant women with CUD. Descriptive statistics were used to assess patterns by race/ethnicity, age, and co-substance use.</p><p><strong>Results: </strong>CUD admissions increased 2.7-fold, from 2.3 % in 2000 to 6.2 % in 2009, followed by a decrease to 4.3 % in 2014, a peak of 6.7 % in 2018, and a decline to 3.0 % in 2021. In 2021, racial/ethnic disparities were noted, with higher proportions of admissions among White (48.8 %) and Black (32.5 %) non-Hispanic women compared to Hispanic women (9.6 %). Admissions decreased for women aged ≤20 years old (y/o), but increased for women aged ≥30 y/o from 2010 to 2021, with the highest prevalence in those aged 21-29 y/o. Co-substance use, particularly narcotics, stimulants, depressants, and hallucinogens, was prevalent from 2017 to 2021.</p><p><strong>Conclusions: </strong>CUD admissions among pregnant women have fluctuated over two decades, with variations by race/ethnicity and age. These findings highlight the need for tailored interventions and ongoing adaptation of treatment services for pregnant women with CUD.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881820","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":"Selective termination: a life-saving procedure for complicated monochorionic gestations.","authors":"Ali Javinani, Ramesha Papanna, Tim Van Mieghem, Julie S Moldenhauer, Anthony Johnson, Enrico Lopriore, Amos Grünebaum, Frank A Chervenak, Alireza A Shamshirsaz","doi":"10.1515/jpm-2024-0386","DOIUrl":"https://doi.org/10.1515/jpm-2024-0386","url":null,"abstract":"<p><p>Monochorionic twin pregnancies are a subset of twin pregnancies that face potential complications related to a shared circulation between the fetuses. These complications are related to anastomotic placental vessels connecting the cardiovascular systems of the two fetuses, which can result in significant sequela if one twin experiences intrauterine death. The sudden cardiovascular collapse in this scenario leads to a massive blood shift away from the healthy co-twin, significantly jeopardizing its life and long-term neurodevelopmental outcome. Such conditions include selective fetal growth restriction with abnormal Doppler findings, twin-twin transfusion with impending death in one twin and discordant fetal anomalies, for which fetal interventions are ineffective in improving outcomes or preventing the imminent death of the abnormal twin. Obstetricians have a professional obligation to respect the autonomy of pregnant patients and to maximize beneficence-based obligations to both pregnant and fetal patients. The goal of a selective termination is to maximize the health and life of the surviving fetal patient. It is recommended that policymakers consider including selective termination as an exemption to abortion ban laws.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881815","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":"Maternal and neonatal short-term outcome after vaginal breech delivery >36 weeks of gestation with and without MRI-based pelvimetric measurements: a Hannover retrospective cohort study.","authors":"Sabine K Maschke, Lena Steinkasserer, Diane Renz, Constantin von Kaisenberg, Peter Hillemanns, Lars Brodowski","doi":"10.1515/jpm-2024-0173","DOIUrl":"https://doi.org/10.1515/jpm-2024-0173","url":null,"abstract":"<p><strong>Objectives: </strong>Planning the mode of delivery of a full-term breech singleton remains a challenging task. The aim of this work is to compare the neonatal and maternal short-term outcomes after planned vaginal delivery and caesarean section and to evaluate the influence of an MRI pelvimetry on the short-term outcomes in order to provide appropriate advice to pregnant women with breech presentation.</p><p><strong>Methods: </strong>This is a retrospective monocentric analysis of all deliveries with singleton pregnancies from breech presentation >36 + 0 weeks of gestation between 08/2021 and 09/2023. Short-term maternal and neonatal morbidity data were collected for intended vaginal deliveries and caesarean sections. Neonatal and maternal short-term outcomes of intended vaginal deliveries with and without MRI pelvimetry were compared.</p><p><strong>Results: </strong>In the planned vaginal delivery group, APGAR scores and arterial umbilical cord pH were significantly lower than in the planned caesarean group. The rate of asphyxia was similar in both groups. Although not significant, the rate of NICU admission was higher in the vaginal birth group (6.7 % vs. 2.7 %; p=0.27), and infants born by caesarean remained in the NICU longer (1.3 % vs. 1.8 %; p=1.0). Neonates born to women who underwent MRI prior to attempted vaginal delivery had better short-term neonatal outcomes and shorter NICU stays compared with women who did not undergo MRI, after multivariate analysis for fetal birth weight, parity, and gestational age.</p><p><strong>Conclusions: </strong>Vaginal breech delivery is associated with lower APGAR scores and umbilical arterial pH compared with caesarean section but does not result in increased neonatal asphyxia or NICU admission. Length of stay in the NICU is shorter when a newborn is admitted after vaginal delivery. MRI pelvimetry may improve the outcome of the newborn by further selection.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877476","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":"Learning curve for the perinatal outcomes of radiofrequency ablation for selective fetal reduction: a single-center, 10-year experience from 2013 to 2023.","authors":"Shuang Li, Yu Sun, Zhe Liu","doi":"10.1515/jpm-2024-0201","DOIUrl":"https://doi.org/10.1515/jpm-2024-0201","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the perinatal outcomes of SR using radiofrequency ablation (RFA) in MC pregnancies, identified factors affecting these outcomes, and assessed the associated learning curve.</p><p><strong>Methods: </strong>This retrospective cohort study included all consecutive MC pregnancies that required RFA from September 2013 to April 2023 at our institution. The perinatal outcomes were compared on the basis of various indications, and binary logistic regression analysis was performed to identify the risk factors for cotwin loss. Clinical datas of two periods (2013-2018 vs. 2019-2023) were compared to demonstrate the learning curve.</p><p><strong>Results: </strong>The 107 cases composed of 40 (37.4 %) twin-twin transfusion syndrome (TTTS), 17 (15.9 %) selective intrauterine growth restriction (sFGR), 12 (11.2 %) twin reversed arterial perfusion sequence (TRAPS), 25 (23.4 %) fetal discordant anomalies, 10 (9.3 %) elective fetal reduction (EFR), and three (2.8 %) twin anemia polycythemia sequence (TAPS) cases. The overall live birth rate for cotwins was 83.2 %. The earliest gestational age at delivery was noted in the TTTS group (p=0.021). The procedure-to-delivery interval was the shortest in the TTTS group and the longest in the EFR group (p<0.001). Comparing the 2013-2018 period with the 2019-2023 period, we noted a significant increase in the live birth rate (p=0.01) and the procedure-to-delivery interval (p=0.003), mainly due to improved outcomes in TTTS cases.</p><p><strong>Conclusions: </strong>RFA for SR is a safe and effective method for managing complicated MC pregnancies. The type of indication affects postoperative perinatal outcomes, with TTTS showing the most adverse effects. With the increasing number of cases and accumulation of experiences with simultaneous enhancement of technique proficiency, the postprocedural outcomes can be further improved.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869344","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":"Placental growth factor as a predictive marker of preeclampsia in twin pregnancy.","authors":"Guijie Qi, Ling Yao, Zhiming Liu, Wanru Guo, Heng Liu, Jinghua Zhang, Yulian He, Tiancong Jiang","doi":"10.1515/jpm-2024-0184","DOIUrl":"https://doi.org/10.1515/jpm-2024-0184","url":null,"abstract":"<p><strong>Objectives: </strong>Placental growth factor (PlGF) has been reported as a good biomaker for the prediction of preeclampsia occurring in the short term in singleton pregnancies, in women presenting with clinical suspicion of preeclampsia. This study aims to evaluate the predictive value of the PlGF in twin pregnancies.</p><p><strong>Methods: </strong>Twin pregnancies with clinically suspected preeclampsia (24 weeks 0 days-36 weeks 6 days of gestation) were enrolled in this study. The threshold of PlGF for predicting preeclampsia was determined on the basis of a receiver-operating characteristic curve to predict preeclampsia and the short-term occurrence of preeclampsia.</p><p><strong>Results: </strong>Within 1 week, 2 weeks, and 4 weeks of testing respectively, a cutoff value of 215 pg/mL for PlGF to predict preeclamsia in twin pregnancies suspected to have preeclampsia has a specificity of 100 %[51.7 %, 100 %], 100 %[62.9 %, 100 %], 93.8 %[667.6 %, 99.7 %], and a negative predictive value of 100 %[94.8 %, 100 %], 100 %[95.0 %, 100 %], and 98.9 %[93.0 %, 99.9 %].</p><p><strong>Conclusions: </strong>A cutoff value of 215 pg/mL for PlGF is a useful tool to exclude the development of preeclampsia within 4 weeks of measurement.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869346","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":"Impact of screening for large-for-gestational-age fetuses on maternal and neonatal outcomes: a prospective observational study.","authors":"Benjamin Birene, Alexandre Ferreira, Emilie Raimond, Olivier Graesslin, Uzma Ishaque, René Gabriel","doi":"10.1515/jpm-2024-0522","DOIUrl":"https://doi.org/10.1515/jpm-2024-0522","url":null,"abstract":"<p><strong>Objectives: </strong>Debates on the management of macrosomia are still current. We have to consider the consequences of screening to contribute to these discussions. Our aim is to study the consequences of the 3rd trimester fetal macrosomia screening protocols used in several centres in the same French region in order to determine whether this screening affects maternal and neonatal outcomes: mode of delivery, maternal complications (haemorrhage, perineal lesions), neonatal health (pH, Apgar score) and the occurrence of neonatal trauma during delivery.</p><p><strong>Methods: </strong>Prospective observational, multicenter cohort study (Reims, Châlons en Champagne and Charleville-Mézières hospitals). All women with low-risk pregnancies who could benefit from screening for fetal macrosomia were included. Neonatal macrosomia was defined as a weight above the 90th percentile according to AUDIPOG adjusted growth curves. The principal outcome was the cesarean section rate. Secondary outcomes were instrumental deliveries and maternal and neonatal morbidity and mortality.</p><p><strong>Results: </strong>2,217 women were included. Rates of cesarean section and instrumental delivery were higher if macrosomia had been screened, whether rightly, in large-for-gestational-age newborns (respectively 9,802 [1.638-190.290], p=0.038 and 3,021 [1.099-8.846], p=0.036) or wrongly, in newborns who were ultimately appropriate-for-date (respectively ORa 3.562 [1.377-10.128], p=0.01 and 3.042 [1.139-8.596], p=0.36). This screening did not reduce maternal and neonatal morbidity and mortality.</p><p><strong>Conclusions: </strong>Screening for fetal macrosomia may be associated with increased rates of cesarean section and instrumental delivery for large-for-gestational-age and appropriate-for-date newborns. These results do not show any impact of these variations on maternal or neonatal health, and do not allow us to change practices directly. They do, however, alert us to the consequences of widespread screening for LGA and its possible side effects, which could be better targeted to high-risk populations or improved according to other criteria.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846908","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}