Journal of Perinatal Medicine最新文献

{"title":"Maternal and neonatal outcomes among pregnant women with eating disorders.","authors":"Asmaa El Mouden, Ethan Bendayan, Haim Arie Abenhaim","doi":"10.1515/jpm-2025-0605","DOIUrl":"https://doi.org/10.1515/jpm-2025-0605","url":null,"abstract":"<p><strong>Objectives: </strong>Eating disorders (ED), most prevalent among women of reproductive age, may negatively impact both maternal and fetal health during pregnancy. However, their effects remain inadequately explored. This study aimed to evaluate the associations between maternal ED and perinatal outcomes.</p><p><strong>Methods: </strong>A retrospective population-based cohort study of all delivery admissions from 2016 to 2021 was conducted using the United States' Healthcare Cost and Utilization Project-National Inpatient Sample. Pregnancies complicated by maternal ED were identified using ICD-10 codes F50.x. Associations between antenatal ED and adverse maternal and neonatal outcomes were assessed using multivariable logistic regression. Potential confounders adjusted for include baseline maternal demographics and relevant clinical factors.</p><p><strong>Results: </strong>Among 4,337,612 delivery admissions, 1,262 involved an ED diagnosis, with prevalence increasing from 23.9 to 37.6/100,000 (p<0.0001) over the study period. Patients with an ED were more likely to use tobacco, cannabis, and alcohol. Anxiety disorders, bipolar affective disorder, and depression were also more common among the ED group. Maternal ED was associated with higher risks of anemia (aOR 2.8, 95 % CI 2.6-3.3), preterm labor (1.4, 1.1-1.7), disseminated intravascular coagulation (6.2, 1.5-24.7), postpartum hemorrhage (1.9, 1.6-2.4), uterine rupture (4.4, 1.6-11.6), genitourinary tract infection (1.9, 1.1-3.3), and prolonged hospitalization (2.3, 1.7-3.1). Neonates of affected mothers were more likely to present with congenital anomalies (2.3, 1.6-3.4), IUGR (1.7, 1.4-2.1), fetal distress (1.3, 1.1-1.5), and preterm birth (1.4, 1.2-1.7).</p><p><strong>Conclusions: </strong>Pregnant individuals with ED constitute a high-risk group with elevated susceptibility to maternal and neonatal complications. Early recognition and integrated multidisciplinary care are crucial to improve outcomes.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355376","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":"Algorithm for RhD immune globulin shortage yields over 50 % dosage savings.","authors":"Gillian Piltch, Frank Jackson, Sarika Arora, Burton Rochelson, Matthew J Blitz, Jennifer Kidd","doi":"10.1515/jpm-2025-0610","DOIUrl":"https://doi.org/10.1515/jpm-2025-0610","url":null,"abstract":"<p><strong>Objectives: </strong>Our institution developed an evidence-based algorithm to guide administration of RhD immune globulin (RhIG) to RhD-negative pregnant and postpartum people in periods of shortage. This study aims to quantify potential RhIG dosage savings with implementation of this algorithm.</p><p><strong>Methods: </strong>This was a quality improvement study that incorporated all dosages of RhIG administered in the inpatient and outpatient settings of a large metropolitan health system in 2023. We calculated potential dosage savings by applying the algorithm to the 2023 RhIG data.</p><p><strong>Results: </strong>We estimated that implementation of this algorithm would result in a greater than 50 % RhIG dosage savings. Omitting RhIG for threatened, spontaneous, or induced abortion prior to 12 weeks gestation could result in up to 85 % dosage savings in the first trimester; incorporating non-invasive prenatal screening for fetal RhD status into clinical care would lead to a 39 % dosage savings in the second and third trimesters; and administering 150 µg (750 IU) RhIG to postpartum people would save 50 % of postpartum dosages.</p><p><strong>Conclusions: </strong>This algorithm can help healthcare systems maintain RhIG reserves during shortages while balancing patient safety.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365753","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":"Antenatal fetal surveillance and iatrogenic delivery.","authors":"Hannah S Foster, Jessica Wu, Markolline Forkpa, Jesse Chittams, Nehemiah Weldeab, Jennifer McCoy, Nadav Schwartz","doi":"10.1515/jpm-2025-0709","DOIUrl":"https://doi.org/10.1515/jpm-2025-0709","url":null,"abstract":"<p><strong>Objectives: </strong>Antenatal testing is routinely recommended for high-risk pregnancies to reduce the risk of stillbirth, yet limited data guide counseling about likelihood of unscheduled iatrogenic delivery. We explored factors associated with clinical recommendations for unscheduled iatrogenic delivery prompted by antenatal testing and examined variables that influence obstetric outcomes.</p><p><strong>Methods: </strong>In this retrospective cohort study, we identified singleton pregnancies undergoing serial testing in an academic system from January 2022-May 2023. Indications for testing, recommendations made at the final testing visit before delivery, and obstetric outcomes were obtained. Primary outcomes were unscheduled iatrogenic delivery <39 weeks and unscheduled iatrogenic delivery <37 weeks recommended at the final visit. Stepwise regression models assessed associations between demographics, testing indications, and outcomes.</p><p><strong>Results: </strong>A total of 3,959 patients were included. 11.3 % (n=447) were recommended for delivery based on findings identified at their final testing visit. Of these, 352 patients (8.9 %) underwent unscheduled iatrogenic term delivery <39 weeks, and 156 (3.9 %) underwent unscheduled iatrogenic preterm delivery <37 weeks. After adjustment for confounders, chronic hypertension, hypertensive disorders of pregnancy, fetal growth restriction, and other fetal indications were associated with both primary outcomes. Only 40 % of delivery recommendations were triggered by an abnormal test (NST, mBPP, BPP); most were prompted by other clinical concerns identified during testing encounters.</p><p><strong>Conclusions: </strong>Patients undergoing antenatal testing should be counseled about the meaningful likelihood of an unscheduled iatrogenic delivery recommendation. Because most recommendations arise from clinical issues unrelated to the testing results themselves, our findings may help clinicians guide shared decision-making around testing frequency and protocols.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326546","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":"<i>In vivo</i> therapy for prenatal repair of the ovine fetal myelomeningocele model using human umbilical cord-derived mesenchymal stem cells: proof of principle.","authors":"Christian Bamberg, Christian Tomuschat, Kurt Hecher, Mario Rüdiger, Marius A Möbius, Christian Hagel, Aline Reitmeier, Marie-Luise Schröder, Anke Diemert, Konrad Reinshagen","doi":"10.1515/jpm-2025-0577","DOIUrl":"https://doi.org/10.1515/jpm-2025-0577","url":null,"abstract":"<p><strong>Objectives: </strong>Animal models suggest that combining mesenchymal stromal cells (MSCs) with prenatal myelomeningocele (MMC) repair may help preserve spinal cord function. This study assessed the feasibility of administration human umbilical cord-derived MSCs during prenatal repair of MMC in a sheep model.</p><p><strong>Methods: </strong>MMC (L1-L5) were surgically created in 11 fetal lambs at 75 days. Seven underwent repair 25 days later - five with and two without MSCs. A high-dose, ready-to-use MSCs product (Desacell^®), derived from healthy human neonatal umbilical cord tissue was administered in five cases. Each received 1 mL of Desacell^® gel containing 30 million MSCs directly to the spinal cord. All fetuses underwent multilayer dural myofascial patching and skin closure.</p><p><strong>Results: </strong>Of the seven treated lambs, three (two with MSCs, one without) survived to term (144-147 days gestation). Motor function was evaluated using the sheep locomotor rating scale before euthanasia. MMC sites were excised en-bloc. Mean large neuron densities in gray matter were 20.4, 15, and 13.1 per mm², respectively.</p><p><strong>Conclusions: </strong>This is the first report of successful local administration of MSCs during <i>in utero</i> MMC repair in a sheep model using Desacell^®, a ready-to-use stem cell product. MSCs administration was feasible in all intended cases, however, the limited sample size restricted comparative outcomes analyses.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258515","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":"Fighting preterm birth with the scalpel: lessons from a decade of total cervical occlusion.","authors":"Franka Lindel, Lena Steinkasserer, Vivien Dütemeyer, Alexandros Rahn, Peter Hillemanns, Lars Brodowski, Constantin von Kaisenberg","doi":"10.1515/jpm-2025-0409","DOIUrl":"https://doi.org/10.1515/jpm-2025-0409","url":null,"abstract":"<p><strong>Objectives: </strong>Preterm birth remains a leading cause of neonatal morbidity and mortality worldwide. Despite medical advances, effective prevention remains challenging. Surgical interventions like total cervix occlusion (TCO) show promise in high-risk groups.</p><p><strong>Methods: </strong>This was a retrospective study including patients with singleton pregnancies who had undergone Saling's TCO at the Medical School of Hannover from 2011 to 2021. Data on maternal characteristics, obstetric history, intervention details, and outcomes were collected. Patients were stratified into two groups: classic Saling indication (≥2 late miscarriages or preterm births <32 weeks) and extended indication (1 such event). Primary outcomes were live birth and preterm birth after 28 + 0 weeks.</p><p><strong>Results: </strong>The analysis is based on a sample of 99 pregnant women, pregnancy and outcome data was available of 67 patients. The median delivery time was 36 weeks. 92.5 % of the neonates were born alive, with 88.1 % of these births occurring after the 28th week of gestation. Patients with extended indication showed longer gestation than those with classic indication. Maternal age, BMI, and conception mode had no impact. Higher parity increased chances of live birth, prior preterm birth lowered it. Previous late abortions raised the risk of delivery before 28 weeks.</p><p><strong>Conclusions: </strong>TCO may prolong gestation and improve outcomes, independent of maternal factors. Women with extended indications appear to benefit as well. Given the lack of prospective data and varied international practices, further randomized, multicenter trials are urgently needed to better define indications and assess efficacy.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201827","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":"Declining but uneven: global evolution of maternal hemorrhage burden and its future trajectory.","authors":"Hongqiao Wang","doi":"10.1515/jpm-2025-0601","DOIUrl":"https://doi.org/10.1515/jpm-2025-0601","url":null,"abstract":"<p><strong>Objectives: </strong>Maternal hemorrhage is a leading cause of maternal morbidity and mortality worldwide, with significant regional disparities. This study utilizes the most recent Global Burden of Disease (GBD) 2021 data to examine global and regional trends in maternal hemorrhage from 1990 to 2021.</p><p><strong>Methods: </strong>We analyzed the incidence, mortality, and disability-adjusted life years (DALYs) attributable to maternal hemorrhage across 204 countries and territories. We calculated the Estimated Annual Percentage Change (EAPC) for key indicators and projected future trends using Bayesian age-period-cohort models.</p><p><strong>Results: </strong>From 1990 to 2021, global maternal hemorrhage incidence declined from 14.17 million to 13.96 million cases, and age-standardized incidence rate (ASIR) decreased from 245.34 to 176.89 per 100,000 (EAPC: -0.835 %), with particularly high rates in Central and Western Sub-Saharan Africa. DALYs attributed to maternal hemorrhage dropped from 7.1 million to 2.96 million, with the age-standardized DALYs rate (ASDR) falling from 125.29 to 37.47 per 100,000 (EAPC: -3.975 %). Mortality also decreased from 114,112 to 46,874 deaths, and the age-standardized mortality rate (ASMR) declined from 2.04 to 0.59 per 100,000 (EAPC: -4.055 %), with the largest reductions in East Asia and South Asia. Regions with lower socio-demographic index experienced high incidence, DALYs, and mortality rates. Projections to 2050 suggest a continued global decline in all indicators.</p><p><strong>Conclusions: </strong>Despite overall reductions in the global burden of maternal hemorrhage, significant regional disparities persist, particularly in low-resource settings. Targeted interventions in high-burden regions, such as Sub-Saharan Africa, are crucial to further reduce maternal morbidity and mortality.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052483","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":"Therapeutic trials of maternal position therapy are needed to clarify the causes of abnormal maternal hemodynamic profiles and reduced umbilical vein flow in fetal growth restriction.","authors":"Thomas L Archer","doi":"10.1515/jpm-2025-0684","DOIUrl":"10.1515/jpm-2025-0684","url":null,"abstract":"","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"431-432"},"PeriodicalIF":1.4,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145958728","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":"The additional value of fetal MRI to ultrasonography in prenatal diagnosis: an evaluation based on postnatal confirmation.","authors":"Elif Yasar, Ozge Kahramanoglu, Cigdem Kunt Isguder, Nur Betul Unal Ozdemir, Yunus Yasar, Koray Gok","doi":"10.1515/jpm-2025-0398","DOIUrl":"10.1515/jpm-2025-0398","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the additional diagnostic value of fetal magnetic resonance imaging (MRI) compared to prenatal ultrasonography (US) in fetal anomaly evaluation, using postnatal confirmation as the reference standard.</p><p><strong>Methods: </strong>In this retrospective cross-sectional study, we evaluated 104 fetal cases who underwent fetal MRI following suspicious or abnormal second- or third-trimester US findings between January 2022 and January 2025. US and MRI findings were compared, and diagnostic concordance was categorized. Postnatal confirmation was based on imaging, surgical, clinical, or pathological follow-up. Diagnostic accuracy rates were calculated using postnatal outcomes as the gold standard, and modality agreement was assessed using the kappa coefficient and McNemar test.</p><p><strong>Results: </strong>Postnatal confirmation data were available for 99 of the 104 cases, comprising 149 anomalies. MRI and US showed complete agreement in 79.8 % of cases. MRI provided additional diagnostic information over US in 10.6 % and showed discrepant findings in 9.6 %. Postnatal data confirmed that US correctly diagnosed 76.8 % of cases, while MRI reached 92.9 % diagnostic accuracy, a statistically significant difference (p=0.0015). The agreement between modalities was moderate (κ=0.54). MRI notably enhanced diagnostic accuracy, especially for central nervous system anomalies, and influenced postnatal clinical management.</p><p><strong>Conclusions: </strong>Fetal MRI significantly improves prenatal diagnostic accuracy over US, particularly in complex or ambiguous cases, with the most significant added value seen in central nervous system pathologies. Its complementary role enhances prenatal counseling and postnatal planning. Larger multicenter studies are warranted to evaluate its contribution across different organ systems.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"381-390"},"PeriodicalIF":1.4,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917923","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":"Let's use diverse technologies to assess maternal hemodynamics-- both <i>before</i> and <i>during</i> labor and to both <i>predict</i> and <i>prevent</i> bad outcomes!","authors":"Thomas L Archer","doi":"10.1515/jpm-2025-0733","DOIUrl":"10.1515/jpm-2025-0733","url":null,"abstract":"","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"433-434"},"PeriodicalIF":1.4,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933554","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 for primary cesarean delivery in women with gestational diabetes mellitus: a predictive model for clinical risk assessment.","authors":"Lili Zheng, Hongfang Kong, Fang Wang, Yuan Su, Yaqing Chang, Hong Xin","doi":"10.1515/jpm-2025-0245","DOIUrl":"10.1515/jpm-2025-0245","url":null,"abstract":"<p><strong>Objectives: </strong>Gestational diabetes mellitus (GDM) is associated with complications such as fetal macrosomia, shoulder dystocia, and prolonged labor, making cesarean section an important delivery option to reduce maternal and neonatal risks. This study aims to identify factors associated with cesarean delivery in women with GDM and to develop a predictive model for clinical risk assessment.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 2,276 GDM patients who were delivered at a tertiary hospital from January 2020 to December 2023. Data on age, BMI, gravidity, abortion history, and family history of diabetes were collected. Patients were grouped by delivery mode. ANOVA/Kruskal-Wallis, chi-square test, Pearson correlation, and stepwise logistic regression were used to identify independent predictors. Two prediction models were developed and evaluated using ROC curves.</p><p><strong>Results: </strong>Among all included GDM patients, 200 (8.79 %) underwent cesarean section. The average age and BMI were 30.8 ± 3.9 years and 23.658 ± 4.221, respectively. Cesarean section rates increased with rising BMI (p<0.05). Significant differences among BMI groups were observed in age, number of pregnancies, miscarriage history, family history of diabetes, HbA_1c, hemoglobin (HGB), and platelet count (PLT) (all p<0.05). BMI was correlated with adjusted BMI, HbA_1c, HGB, and PLT. Logistic regression identified six independent predictors of cesarean section: BMI, adjusted BMI, HGB, PLT, prothrombin time (PT), and D-dimer. Model one showed good predictive ability (AUC=0.792). After optimization, Model two (including BMI grouping, number of miscarriages, and HbA_1c) performed better (AUC=0.842).</p><p><strong>Conclusions: </strong>A multi-parameter model demonstrates strong potential for predicting cesarean risk in GDM patients and may assist clinical decision-making.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":"54 2","pages":"325-332"},"PeriodicalIF":1.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147325995","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}