Journal of Perinatal Medicine最新文献

{"title":"Revisiting KANET in the context of fetal connectomics: defining optimal gestational windows for neurodevelopmental screening.","authors":"Wiku Andonotopo, Muhammad Adrianes Bachnas, Julian Dewantiningrum, Mochammad Besari Adi Pramono, I Nyoman Hariyasa Sanjaya, Ernawati Darmawan, Muhammad Ilham Aldika Akbar, Dudy Aldiansyah, Cut Meurah Yeni, Nuswil Bernolian, Sri Sulistyowati, Waskita Ekamaheswara Kasumba Andanaputra, Milan Stanojevic, Asim Kurjak","doi":"10.1515/jpm-2025-0234","DOIUrl":"https://doi.org/10.1515/jpm-2025-0234","url":null,"abstract":"<p><strong>Objectives: </strong>To introduce the KANET-connectome matrix (KANET-Con) as a conceptual framework linking fetal behaviors observed on four-dimensional (4D) ultrasound to underlying neural network maturation, and to evaluate optimal gestational timing for functional neurodevelopmental screening.</p><p><strong>Methods: </strong>A narrative review was conducted using a PRISMA-guided literature identification and screening process. PubMed, Scopus, and Web of Science were searched (January 2000-March 2025) for studies addressing fetal connectomics, fetal neurobehavior, KANET scoring, and developmental neuroimaging. Forty-two peer-reviewed studies met inclusion criteria. Observed fetal behaviors-including facial mimicry, eye blinking, limb movement, and overall gestalt coordination-were aligned with their most plausible neural substrates using evidence from developmental neuroscience and imaging.</p><p><strong>Results: </strong>Findings demonstrated clear temporal associations between specific fetal behaviors and neural circuit development. Eye blinking and facial expressions (24-26 weeks) correlated with brainstem-cortical integration; hand-to-face gestures (26-30 weeks) reflected emerging interhemispheric pathways; and complex limb coordination (28-32 weeks) was linked to corticospinal and basal ganglia maturation. Collectively, these data indicate that 24-32 weeks of gestation represents an optimal window for KANET-based neurobehavioral screening. Additionally, emerging artificial intelligence applications show potential to enhance scoring objectivity by detecting subtle movement features such as behavioral entropy, asymmetry, and latency.</p><p><strong>Conclusions: </strong>KANET, interpreted through a fetal connectomic lens, provides a functional window into early neural integration. The KANET-Con offers a clinically relevant, globally accessible conceptual model to support early detection of neurodevelopmental deviations and inform risk stratification, particularly in resource-limited settings.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596750","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 intrauterine microbiome-neurodevelopment axis: decoding the prenatal microbial imprint on lifelong mental health.","authors":"Wiku Andonotopo, Muhammad Adrianes Bachnas, Julian Dewantiningrum, Mochammad Besari Adi Pramono, I Nyoman Hariyasa Sanjaya, Ernawati Darmawan, Muhammad Ilham Aldika Akbar, Dudy Aldiansyah, Cut Meurah Yeni, Nuswil Bernolian, Waskita Ekamaheswara Kasumba Andanaputra, Sri Sulistyowati, Milan Stanojevic, Asim Kurjak","doi":"10.1515/jpm-2025-0242","DOIUrl":"https://doi.org/10.1515/jpm-2025-0242","url":null,"abstract":"<p><strong>Introduction: </strong>The traditional view of a sterile intrauterine environment has been challenged by sequencing studies detecting low-biomass microbial DNA in placenta, amniotic fluid, and fetal tissues. These findings suggest that maternal microbiota-derived signals may contribute to fetal brain development and influence long-term neuropsychiatric outcomes.</p><p><strong>Content: </strong>This narrative review synthesizes evidence from over 90 preclinical and clinical studies examining maternal microbiota-fetal brain interactions. Maternal immune activation - characterized by elevated cytokines such as interleukin (IL)-6 and IL-17A - has been shown in mouse models to disrupt cortical layering and synaptic organization, while human cohort studies involving more than 250,000 pregnancies link maternal inflammatory markers to increased autism spectrum disorder (ASD) risk. Microbial metabolites, including short-chain fatty acids (butyrate, acetate, propionate), bile acids, and tryptophan derivatives, regulate microglial maturation, blood-brain barrier integrity, and hippocampal neurogenesis. Epigenetic mechanisms - DNA methylation, histone acetylation, and chromatin remodeling - have been observed in placenta and cord blood from pregnancies affected by obesity or dysbiosis. Large-scale epidemiological studies also associate prenatal infection and antibiotic exposure with higher rates of ASD and attention-deficit/hyperactivity disorder (ADHD).</p><p><strong>Summary: </strong>Collectively, the evidence indicates that maternal microbiota influence fetal brain development through converging immune, metabolic, epigenetic, and hormonal pathways. Strong mechanistic insights come from animal models, whereas human data remain largely observational, limiting causal interpretation.</p><p><strong>Outlook: </strong>Recognizing the maternal microbiome as a modifiable prenatal factor highlights opportunities for prevention. Early translational approaches - including maternal microbiota profiling, dietary optimization, and probiotic supplementation - are under investigation, but require rigorous clinical validation before integration into prenatal care.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596798","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 mental health into obstetric practice: a review of collaborative care models for perinatal anxiety.","authors":"Julian Dewantiningrum, Wiku Andonotopo, Efendi Lukas, Mochammad Besari Adi Pramono, Wisnu Prabowo, Muhammad Adrianes Bachnas, I Nyoman Hariyasa Sanjaya, Anak Agung Gede Putra Wiradnyana, Anak Agung Ngurah Jaya Kusuma, Khanisyah Erza Gumilar, Ernawati Darmawan, Muhammad Ilham Aldika Akbar, Dudy Aldiansyah, Aloysius Suryawan, Ridwan Abdullah Putra, Anita Deborah Anwar, Laksmana Adi Krista Nugraha, Waskita Ekamaheswara Kasumba Andanaputra, Wibisana Andika Krista Dharma, Sri Sulistyowati, Milan Stanojevic, Asim Kurjak","doi":"10.1515/jpm-2025-0300","DOIUrl":"https://doi.org/10.1515/jpm-2025-0300","url":null,"abstract":"<p><strong>Objective: </strong>Perinatal anxiety is one of the most common yet least systematically addressed complications of preg- nancy and childbirth. Despite abundant evidence that collaborative and integrated care models improve maternal outcomes, obstetric practice still lacks a defined operational standard for addressing anxiety alongside routine obstetric care. Fragmented screening, insufficient referral systems, and financing barriers continue to delay intervention, widening inequities across populations and settings.</p><p><strong>Methods: </strong>This opinion article synthesizes recent evidence (2010-2025) from PubMed, Google Scholar, and professional guidelines to propose a practical framework for embedding mental health care within obstetric workflows. Drawing upon studies from high- and low-resource contexts, we outline a ten-point minimum standard for perinatal-anxiety management and a three-tier maturity model that describes the progressive integration of collaborative care-from basic screening to digitally supported, team-based systems. The model identifies measurable implementation metrics and policy levers that enable sustainability and equity.</p><p><strong>Results: </strong>Rather than advocating new research, this article translates two decades of findings into a clinically actionable standard. It emphasizes the central role of ob- stetric teams in early detection, stepped care, and follow-up through coordination with mental-health professionals.</p><p><strong>Conclusions: </strong>Integrating mental health into obstetric practice is both a moral and operational imperative. By adopting the proposed minimum standard and maturity model, health systems can transform perinatal anxiety care from discre- tionary innovation to routine expectation-achieving faster response, broader access, and better maternal-infant out- comes worldwide.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145556954","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":"Ureaplasma parvum detected in umbilical cord tissues diagnosed with funisitis associated with adverse pregnancy outcomes and neonatal pneumonia.","authors":"Wen Lei, Leijun Huo, Qiuping Chen, Yanxia Liao, Mi Li, Xiangcheng Zhou, Jiali Zhang, Shuai Zhou, Liang Zhang, Hongyi Gao, Hua Deng","doi":"10.1515/jpm-2025-0321","DOIUrl":"10.1515/jpm-2025-0321","url":null,"abstract":"<p><strong>Objectives: </strong>Existing studies yielded conflicting evidence regarding the associations between genital tract microbial and funisitis, chorioamnionitis and adverse pregnancy outcomes. This study aims to provide additional evidence for their association through systematic investigation.</p><p><strong>Methods: </strong>A total of 98 FFPE umbilical cord specimens confirmed as funisitis and chorioamnionitis through histopathological examination were tested for seven genital tract microorganisms using quantitative polymerase chain reaction (qPCR). Electronic medical records of mothers and neonates were retrieved to analyze the risk associations between microorganism-positive cases and chorioamnionitis as well as adverse pregnancy outcomes. The umbilical cord samples with <i>Ureaplasma parvum</i> positive had been sequenced for serovars analysis.</p><p><strong>Results: </strong><i>Ureaplasma parvum</i> (UP), <i>Ureaplasma urealyticum</i> (UU), Group B <i>Streptococcus</i> (GBS) and <i>Mycoplasma homini s</i> (MH) were all detected in the study with prevalence of 36.5 %, 7.9 %, 18.6 %, and 5.8 %, respectively, while <i>Mycoplasma genitalium</i> (MG), <i>Chlamydia trachomatis</i> (CT) and <i>Neisseria gonorrhoeae</i> (NG) were not detected. <i>Ureaplasma</i> spp. were identified as the predominant microorganisms detected in 98 umbilical cord cases by using qPCR, demonstrating concordance with clinical vaginal swab findings from pregnant women. Genital microorganisms infection was associated with high stage chorioamnionitis (p = 0.0254) and adverse pregnant outcomes (p = 0.0053). In addition, the prevalence of <i>U. parvum</i> demonstrated a strong significant association with neonatal pneumonia (p = 0.0037).</p><p><strong>Conclusions: </strong>Umbilical cord specimens tested positive for <i>U. parvum</i> demonstrated a significant association with adverse perinatal outcomes and neonatal pneumonia. Additional studies are warranted to investigate the determinants enabling commensal <i>U. parvum</i> in the genital tract to ascend and induce intrauterine infection, thereby leading to adverse clinical outcomes.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"273-281"},"PeriodicalIF":1.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145541056","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":"Abnormal Doppler and perinatal outcomes according to the placental lesions of maternal and fetal vascular malperfusion in preterm fetal growth restriction.","authors":"Young Eun Chung, You-Ri Lee, Sooji Ham, Boram Park, Kyunga Kim, Ji-Hee Sung, Yun Dan Kang, Suk-Joo Choi, Soo-Young Oh, Jung-Sun Kim, Cheong-Rae Roh","doi":"10.1515/jpm-2025-0140","DOIUrl":"10.1515/jpm-2025-0140","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to identify the associations between specific pathologic placental findings and abnormal Doppler results as well as perinatal outcomes in preterm fetal growth restriction (FGR).</p><p><strong>Methods: </strong>This retrospective study included 465 consecutive singleton pregnancies with FGR delivered between 22+0 and 36+6 weeks of gestation. Abnormal Doppler was defined as absent or reversed end-diastolic flow in the umbilical artery (UA) and a pulsatility index less than the 10th percentile in the middle cerebral artery (MCA). Placental pathology was evaluated focusing on villous or vascular findings of maternal (MVM) and fetal vascular malperfusion (FVM) based on Amsterdam criteria.</p><p><strong>Results: </strong>The average gestational age at delivery and neonatal birth weight were 32 weeks (±4 weeks) and 1,299 g (±575 g), respectively. Placental MVM lesions were observed in the majority of cases (90.3 %) and were significantly related to abnormal UA and MCA Doppler. Meanwhile, FVM lesions was observed in about half of the cases (44.8 %) and were significantly related to abnormal MCA Doppler, but not abnormal UA Doppler. Both villous and vascular lesions of MVM and FVM were associated with lower neonatal birth weight. Among specific key findings of MVM and FVM, distal villous hypoplasia was highly associated with abnormal UA Doppler (crude OR 5.01, 95 % CI 1.27-19.68), while intramural fibrin deposition in large fetal vessels was significantly associated with abnormal MCA Doppler (crude OR 2.49, 95 % CI 1.01-6.13). Of note, intramural fibrin deposition of large fetal vessels was associated with neonatal mortality (crude OR 3.25, 95 % CI 1.52-6.92).</p><p><strong>Conclusions: </strong>We identified key findings among placental MVM and FVM associated with abnormal UA and MCA Doppler as well as neonatal mortality in preterm FGR.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"371-380"},"PeriodicalIF":1.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145540963","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":"Longitudinal changes of left ventricular hypoplasia and ventricular disproportion in congenital diaphragmatic hernia neonates.","authors":"Flaminia Pugnaloni, Bartolomeo Bo, Judith Leyens, Irma Capolupo, Andrea Dotta, Pietro Bagolan, Andreas Mueller, Neil Patel, Florian Kipfmueller","doi":"10.1515/jpm-2025-0327","DOIUrl":"10.1515/jpm-2025-0327","url":null,"abstract":"<p><strong>Objectives: </strong>Ventricular disproportion, defined as a ratio of right ventricle (RV) end-diastolic diameter to left ventricle (LV) end-diastolic diameter (RV_D/LV_D) ≥ 1.1 is commonly observed in neonates with congenital diaphragmatic hernia (CDH) and it is independently associated with adverse outcome. Longitudinal postnatal data on ventricular disproportion of CDH neonates are poorly studied and we aimed to evaluate changes in RV_D/LV_D through serial echocardiographic studies at selected timepoints in the neonatal period.</p><p><strong>Methods: </strong>This retrospective observational study included CDH neonates admitted to the University Children's Hospital of Bonn between January 2011 and March 2021. RV_D/LV_D was measured via apical 4-chamber echocardiographic views at admission, 48 h of life, pre-surgical repair, pre-extubation, and on day 5 of ECMO support, if applicable. Patients receiving palliative care, experiencing early death, or lacking follow-up echocardiographic data were excluded.</p><p><strong>Results: </strong>Of 248 CDH neonates, 80 were excluded, leaving 168 in the final cohort. At baseline, 41.7 % had an RV_D/LV_D ≥1.1. Mortality (34.3 %) and ECMO rates (62.9 %) were significantly higher in these patients compared to those with RV_D/LV_D <1.1. Ventricular disproportion decreased over time: 41.7 % at admission, 23.1 % at 48 h, 15.7 % pre-repair, and 9.1 % pre-extubation. For ECMO patients, RV_D/LV_D ≥1.1 was found in 62.9 % at admission, decreasing over time. Non-survivors had significantly higher RV_D/LV_D at 48 h (p=0.020) and pre-extubation (p=0.001).</p><p><strong>Conclusions: </strong>In CDH neonates, ventricular disproportion improves over time, but RV_D/LV_D≥1.1 remains strongly associated with mortality, particularly in ECMO patients, where non-survivors exhibit persistently elevated RV_D/LV_D.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"415-423"},"PeriodicalIF":1.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145541087","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":"Community births in the United States, 2016-2024: post-pandemic patterns across racial and ethnic groups.","authors":"Amos Grünebaum, Frank A Chervenak","doi":"10.1515/jpm-2025-0521","DOIUrl":"10.1515/jpm-2025-0521","url":null,"abstract":"<p><strong>Objectives: </strong>Community births in the United States - including planned home and freestanding birth center deliveries - have increased in recent years. Understanding how these patterns have evolved across racial and ethnic groups, particularly in the post-pandemic period, is essential for clinical practice and health policy. Objective: To analyze national trends in community births from 2016 through 2024 by race and ethnicity, and to discuss clinical, ethical, and policy implications.</p><p><strong>Methods: </strong>Birth certificate data from the CDC natality database were examined for 2016-2024. Community births were defined as intended home or freestanding birth center births. Trends were assessed overall and stratified by race/ethnicity, with relative changes indexed to 2016.</p><p><strong>Results: </strong>From 2016 to 2024, community births increased overall but diverged by group. Non-Hispanic White and Hispanic women demonstrated sustained increases relative to 2016, while non-Hispanic Black women showed an increase during the pandemic followed by decline, and non-Hispanic Asian women displayed a modest upward trend. These shifts occurred against the backdrop of declining total births in some groups, affecting proportional comparisons. International comparisons are limited by the distinctive U.S. context, where midwifery is less integrated and credentialing standards are variable.</p><p><strong>Conclusions: </strong>Community birth patterns since the pandemic reveal both growth and divergence across racial and ethnic groups. These findings highlight the need for policy interventions to address maternity care deserts and harmonize midwifery credentialing. Clinically, professional responsibility requires fully informed consent leading to directive counseling, which should not be misinterpreted as paternalism but as an ethical duty to recommend hospital birth as the safest option while respecting patient autonomy.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"258-264"},"PeriodicalIF":1.4,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534742","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":"Associations between previous cesarean section and maternal and neonatal complications: the modification of long inter-pregnancy interval.","authors":"Yuxin Xiang, Qing Zhao, Wenbin Dong, Yujiao Zhang, Xiaoping Lei","doi":"10.1515/jpm-2025-0280","DOIUrl":"10.1515/jpm-2025-0280","url":null,"abstract":"<p><strong>Objectives: </strong>We aim to explore whether the long inter-pregnancy interval (IPI) modifies the association between previous cesarean section (CS) and adverse maternal and neonatal outcomes in a population with a high rate of CS and a long IPI.</p><p><strong>Methods: </strong>Adverse maternal and neonatal outcomes were compared between the previous CS and previous vaginal delivery groups. Logistic models were used to adjust for potential confounding factors and calculate the odds ratios (ORs) and 95 % confidence intervals (CIs). The interaction model and stratified analyses were used to evaluate the modifications of IPIs on the associations between previous CS and maternal and neonatal outcomes.</p><p><strong>Results: </strong>Compared with previous vaginal delivery, previous CS was associated with increased risks of uterine-related complications (aOR=1.57, 95 % CI 1.25-1.98), but with decreased risks of preterm birth (aOR=0.73, 95 % CI 0.63-0.85) and severe neonatal adverse outcomes (aOR=0.59, 95 % CI 0.46-0.78). There are synergistic biological interaction effects of previous CS and a long IPI (>60 months) on the risks of placental-related complications (RERI=0.32, 95 % CI 0.05-0.58; AP=0.39, 95 % CI 0.03-0.76) but an antagonistic biological interaction effect on the risk of preterm birth (RERI=-0.35, 95 % CI -0.68 to -0.01; AP=-0.09, 95 % CI -0.68 to -0.03).</p><p><strong>Conclusions: </strong>Previous CS was associated with increased risks of adverse maternal outcomes but decreased risks of certain adverse neonatal outcomes. Prolonged IPIs might not attenuate the adverse effects of previous CS on mothers, and might adversely exert harm on newborns.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"354-361"},"PeriodicalIF":1.4,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534705","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 fetal exposome and preterm birth: a systematic synthesis of environmental exposures and multi-omics evidence.","authors":"Wiku Andonotopo, Muhammad Adrianes Bachnas, Julian Dewantiningrum, Mochammad Besari Adi Pramono, Nuswil Bernolian, Cut Meurah Yeni, Anak Agung Gede Putra Wiradnyana, I Nyoman Hariyasa Sanjaya, Muhammad Ilham Aldika Akbar, Ernawati Darmawan, Sri Sulistyowati, Milan Stanojevic, Asim Kurjak","doi":"10.1515/jpm-2025-0231","DOIUrl":"10.1515/jpm-2025-0231","url":null,"abstract":"<p><strong>Objectives: </strong>Preterm birth (PTB), defined as delivery before 37 weeks of gestation, is a leading cause of neonatal mortality and long-term developmental impairment. Its complex etiology, spanning environmental, genetic, psychosocial, and socio-economic domains, limits effective prediction and prevention. We systematically synthesized evidence on how environmental exposures influence PTB risk through multi-omic disruptions within a fetal exposome framework.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in major biomedical databases, following PRISMA guidelines. Ninety-five human studies published through May 2025 were included, encompassing exposures such as ambient air pollution, endocrine-disrupting chemicals, maternal stress, nutrition, occupational hazards, climate variability, and microbiome alterations. Two reviewers independently extracted data (exposure type, omics platform, biospecimen, PTB subtype) with inter-rater reliability assessment, and study quality was evaluated using the Newcastle-Ottawa Scale. Findings were narratively stratified by exposure category, study design, and spontaneous vs. indicated PTB.</p><p><strong>Results: </strong>Environmental exposures were consistently associated with disruptions in oxidative stress, inflammation, immune regulation, hormonal signaling, placental aging, and microbial ecology, mediated by multi-omic signatures in maternal, placental, and fetal tissues. Candidate biomarkers show promise for early risk stratification but lack validation and population-level predictive performance due to heterogeneous exposure assessment and study design.</p><p><strong>Conclusions: </strong>Integrating fetal exposome concepts with multi-omics enhances mechanistic insight into PTB risk and may support biomarker discovery and precision-guided prenatal interventions. Clinical translation requires standardized exposure measurement, biomarker validation, and equity-focused implementation.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"391-407"},"PeriodicalIF":1.4,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145533865","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":"Pregnancy-associated anemia and its effects in term neonates.","authors":"Rita P Verma, Neeti Luke, Zhe Zhou","doi":"10.1515/jpm-2025-0386","DOIUrl":"10.1515/jpm-2025-0386","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the implications of maternal anemia in term neonates.</p><p><strong>Methods: </strong>In a population-based retrospective cohort study, standard demographic and clinical variables noted during post-birth hospitalization in term neonates were compared across groups stratified by maternal anemia in a racially diverse population.</p><p><strong>Results: </strong>Of 474 maternal-neonatal dyads, 66.03 % were Hispanic (H), 15.8 % Black (B), 7.3 % non-Hispanic White (NHW), and 10.7 % Asian/Pacific Islanders (AP). 39.6 % of H, 57.3 % of B, 65.7 % of NHW, and 37 % of AP mothers were anemic, with significantly higher prevalence in NHW and B compared to H. 12.8 % of all anemia cases had moderately severe anemia (hematocrit<30 %). Body mass index was lower, and gravidity, hypertension, and Cesarean-section rates were higher in anemic mothers, while feeding difficulty, hospitalization duration, and Neonatal intensive care unit admission rate were higher in the neonates born to them. Mothers with moderately severe anemia were younger, had higher parity, and a higher prevalence of antepartum hemorrhage compared to the mild anemia group. Their offspring, although not small for gestational age, had lower birth weights. The adverse maternal-neonatal outcomes associated with anemia were less common in the Hispanic mother-infant dyads compared to the B and NHW.</p><p><strong>Conclusions: </strong>Maternal anemia is associated with significant complications in term neonates and their mothers. There is a racial disparity in its prevalence and associated maternal-neonatal complications. The cultural-biological etiopathogenesis of this observation warrants further investigation. Optimization of antenatal care and targeted interventions could improve the outcomes and prevalence in at-risk populations.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":"408-414"},"PeriodicalIF":1.4,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145504965","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}