Seminars in perinatology最新文献

Preface. 前言。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-05-04 DOI: 10.1016/j.semperi.2026.152238

Fernando Moya, Brenda B Poindexter

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Landmark clinical trials on preterm birth prevention that have changed clinical practice 具有里程碑意义的早产预防临床试验改变了临床实践。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-05-01 Epub Date: 2025-12-11 DOI: 10.1016/j.semperi.2025.152196

Wanlin Li , Maya Reddy , Martijn A Oudijk , Ben W Mol

{"title":"Landmark clinical trials on preterm birth prevention that have changed clinical practice","authors":"Wanlin Li , Maya Reddy , Martijn A Oudijk , Ben W Mol","doi":"10.1016/j.semperi.2025.152196","DOIUrl":"10.1016/j.semperi.2025.152196","url":null,"abstract":"<div><div>Spontaneous preterm birth remains a leading global cause of neonatal morbidity and mortality, with lasting health socioeconomic consequences. Despite substantial research efforts over the past decades, preterm birth rates are not declining.</div><div>Large cohort studies have shown that measurement of cervical length by transvaginal ultrasound is the best predictor for identifying women at risk of preterm birth, although sensitivity stays limited. While this has guided randomised clinical trials, preventive strategies remain suboptimal. Progestogens trials have long dominated the research landscape, and evidence synthesis though individual participant data indicates a potential reduction in preterm birth of approximately 30 % for women with a singleton pregnancy and a short cervix.</div><div>Relative to progestogens, other potentially effective interventions, such as cervical cerclage and pessary have received limited attention, and were evaluated later or not at all. The optimal management of twin pregnancies, an important cause of preterm birth, remains uncertain. Our knowledge base on the prevention of preterm birth can be improved by research with greater uniformity in outcome measures, better prioritization, better evidence synthesis, more balanced resource allocation, and enhanced global collaboration.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 3","pages":"Article 152196"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Clinical trials in fetal surgery - changing care for complex pregnancies 胎儿手术的临床试验-改变复杂妊娠的护理。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-05-01 Epub Date: 2025-12-13 DOI: 10.1016/j.semperi.2025.152199

Jessian L. Munoz, Michael A. Belfort

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Advancing evidence for maternal and fetal health: Clinical trials that changed practice 推进母胎健康的证据：改变实践的临床试验。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-05-01 Epub Date: 2026-01-21 DOI: 10.1016/j.semperi.2026.152211

Catherine Y. Spong

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Transformative trials in cesarean delivery: Antibiotic prophylaxis, tranexamic acid, and uterine closure 剖宫产的变革性试验：抗生素预防、氨甲环酸和子宫闭合。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-05-01 Epub Date: 2025-10-10 DOI: 10.1016/j.semperi.2025.152145

Ellen M Murrin, Scott A Sullivan, George Larry Maxwell, Antonio F Saad

{"title":"Transformative trials in cesarean delivery: Antibiotic prophylaxis, tranexamic acid, and uterine closure","authors":"Ellen M Murrin, Scott A Sullivan, George Larry Maxwell, Antonio F Saad","doi":"10.1016/j.semperi.2025.152145","DOIUrl":"10.1016/j.semperi.2025.152145","url":null,"abstract":"<div><div>Cesarean delivery (CD), performed in nearly one in three U.S. births, is the most common surgical procedure. As utilization has increased, advances in surgical technique and perioperative management, guided by landmark trials, have refined the procedure and improved outcomes. Some of the most significant trials have focused on antibiotic prophylaxis, prevention of postpartum hemorrhage, and standardization of surgical techniques. For example, pre-incision prophylactic cefazolin has reduced the risk of postoperative infectious morbidity up to 60% compared to administration at the time of cord clamping. Additionally, the introduction of TXA to the treatment of obstetric hemorrhage has been shown to reduce maternal mortality related to hemorrhage. Future research should prioritize continuing reduction of maternal morbidity as CD still incurs increased risk of infectious and bleeding morbidity. Another important focus in the era of increased CD rates is research into the optimal closure of the hysterotomy. Identification of patients at risk of uterine rupture in future pregnancies can improve the safety of trial of labor after cesarean delivery (TOLAC); further investigation into how hysterotomy closure may contribute to the development of placenta accreta spectrum can significantly decrease maternal morbidity from an increasingly common and life-threatening placental disorder.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 3","pages":"Article 152145"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Improving perinatal outcomes: A review of landmark trials that have changed obstetric practice 改善围产期结局：对改变产科实践的里程碑式试验的回顾。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-05-01 Epub Date: 2025-12-13 DOI: 10.1016/j.semperi.2025.152208

Mary Marchese, Victoria Adewale, Dwight J. Rouse

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Trials that have changed maternal care 改变产妇护理的试验。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-05-01 Epub Date: 2025-12-20 DOI: 10.1016/j.semperi.2025.152195

Kevin S Shrestha , Alan TN Tita

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Prediction of preterm birth: past, present, and future approaches to an ongoing challenge 预测早产：过去，现在和未来的方法，一个持续的挑战。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-05-01 Epub Date: 2025-12-06 DOI: 10.1016/j.semperi.2025.152197

Christine Henricks , David Nelson

{"title":"Prediction of preterm birth: past, present, and future approaches to an ongoing challenge","authors":"Christine Henricks , David Nelson","doi":"10.1016/j.semperi.2025.152197","DOIUrl":"10.1016/j.semperi.2025.152197","url":null,"abstract":"<div><div>Preterm birth is the leading cause of neonatal morbidity and mortality worldwide and contributes to substantial long-term health and economic burdens. Despite decades of research, overall rates remain largely unchanged, highlighting the urgent need for more effective predictive and preventative strategies. Traditional approaches, including risk-factor scoring, cervical length measurement, and fetal fibronectin testing, provide limited predictive value.</div><div>Given the limitations of traditional approaches, emerging technologies provide new opportunities to elucidate mechanisms and improve prediction. Proteomic analyses have identified pathways, such as inflammation and angiogenesis, while metabolomics has revealed small-molecule alterations reflecting biochemical and microbial processes. Genetic investigations highlight complex contributions from both maternal and fetal genomes. Artificial intelligence and machine learning are being applied to integrate multi-omics data with clinical variables with early studies suggesting improved predictive accuracy compared with conventional models.</div><div>Despite these advancements, significant challenges remain. Many prediction studies are constrained by heterogeneous definitions of preterm birth, small sample sizes, and lack of validation across diverse populations. Beyond research limitations, system-level factors such as social determinants of health, environmental exposure, and inequities in access to prenatal care contribute to disparities in both risk and outcomes. These realities underscore the need for predictive tools that are not only scientifically robust but also applicable across diverse populations and care settings. Although clinical translation of novel approaches remains limited, continued innovation, longitudinal research, and commitment to equity will be essential to achieving meaningful improvements in the prediction of preterm birth. Understanding the pathophysiology and applying proven interventions is essential to improving perinatal health outcomes.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 3","pages":"Article 152197"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preeclampsia trials that changed practice 子痫前期试验改变了实践。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-05-01 Epub Date: 2025-12-25 DOI: 10.1016/j.semperi.2025.152210

Eniola R. Ibirogba, Jennifer Grasch, Maged M. Costantine

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Maternal medical conditions part II: Diabetes, asthma, and factor V Leiden studies that changed practice 产妇医疗条件第二部分：糖尿病，哮喘和因子V莱顿研究改变实践。

IF 3.2 3区医学

Seminars in perinatology Pub Date : 2026-05-01 Epub Date: 2026-03-04 DOI: 10.1016/j.semperi.2026.152218

Mark B. Landon

{"title":"Maternal medical conditions part II: Diabetes, asthma, and factor V Leiden studies that changed practice","authors":"Mark B. Landon","doi":"10.1016/j.semperi.2026.152218","DOIUrl":"10.1016/j.semperi.2026.152218","url":null,"abstract":"<div><div>Maternal medical conditions are associated with significant obstetric complications including preterm birth and hypertensive disorders of pregnancy as well as impacting maternal health. This manuscript focuses on the evidence based advances in diabetes, asthma, and the presence of Factor V Leiden mutation in pregnancy that have changed practice. Large randomized controlled trials of mild gestational diabetes addressed the longstanding controversy concerning the benefit for the identification and treatment of GDM by demonstrating the benefit of treatment in pregnancy. Trials of medical management of diabetes in pregnancy provided the data for glyburide and metformin as compared to insulin. Addressing the need for evidence based data for treatment of asthma in pregnancy, a large trial demonstrated the benefit of inhaled steroids for the treatment of asthma in pregnancy. The Factor V Leiden study provided the needed data that the risk of thromboembolic events in untreated heterozygotes for the FVL mutation without evident risk factors for thrombosis is low and is not different from noncarriers. pivoting providers from routine universal screening for FVL mutation. These seminal trials demonstrate that evidence based management in pregnancy is not only feasible, but is essential to ensure the interventions are beneficial.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"50 3","pages":"Article 152218"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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