Journal of Maternal-Fetal & Neonatal Medicine最新文献

{"title":"Mendelian randomization analysis of blood uric acid and risk of preeclampsia: based on GWAS and eQTL data.","authors":"Jiao Wang, Xiaohu Liu, Youmou Fu, Baosheng Zhu, Jinman Zhang","doi":"10.1080/14767058.2024.2443673","DOIUrl":"https://doi.org/10.1080/14767058.2024.2443673","url":null,"abstract":"<p><strong>Background: </strong>The causal association between blood uric acid and preeclampsia (Preeclampsia, PE) has not been conclusively established based on the literature reviewed to date. This bi-directional Mendelian randomization study aimed to investigate the bi-directional causal association between blood uric acid concentration and PE at different genetic levels.</p><p><strong>Methods: </strong>Pooled data on preeclampsia (sample size = 82,085) and blood uric acid (sample size = 129,405) were conducted based on publicly available genome-wide association analysis (Genome-Wide Association Study, GWAS) on the East Asian populations regarding preeclampsia and blood uric acid, respectively. We assessed blood uric acid and PE associations using two-sample Mendelian randomization (TSMR) analyses based on GWAS pooled statistics using inverse variance weighted (Inverse variance weighted), MR-Egger, and Weighted median (Weighted median) to examine the association between blood uric acid and pre-eclampsia. Causal relationship between blood uric acid and pre-eclampsia.Cochran's Q statistic was used to quantify the heterogeneity of instrumental variables among other methods. Subsequently, we extracted the expression quantitative trait loci (eQCTL, Expression quantitative trait loci) data corresponding to each gene as the instrumental variables using the genes corresponding to the intersecting instrumental variables of the exposure and the outcome in the respective analyses of the forward and backward TSMR respectively, so as to analyze the genetic causality of the genes with the different forward and backward TSMR methods further. Inverse variance weighted (IVW) was used to analyze the genetic causality of genes with different positive and negative outcomes.</p><p><strong>Results: </strong>Genetically determined blood uric acid level IVW method, ratio (OR) 1.30, 95% confidence interval (CI): [0.6, 2.83], <i>p</i> = 0.51 was not risk associated with PE. In addition according to the inverse MR analysis, we found an OR of 0.99, 95% CI [0.99, 1.0], <i>p</i> = 0.999) for PE on blood uric acid level IVW method and no significant heterogeneity in instrumental variables or level polytropy was found. (ii) Although GWAS data suggested no risk association between PE and uric acid, gene association analysis of eQTL data at blood uric acid levels with PE suggested a risk effect of the TP53INP1 gene for PE (IVW, OR = 11.476, 95% CI 2.511-52.452, <i>p</i> = 1.648 × 10<sup>-3</sup>) and a protective effect of CTSZ (IVW, OR = 0.011, 95% CI 0.001-0.189, <i>p</i> = 1.804 × 10<sup>-3</sup>), while a risk effect of ETV7 on hyperuricemia was suggested in a genetic association analysis of PE eQTL data with blood uric acid levels (OR = 1.018, 95% CI 1.007-1.029, <i>p</i> = 1.289 × 10<sup>-3</sup>).</p><p><strong>Conclusion: </strong>Our MR (Mendelian Randomization) study based on the GWAS database did not support a bidirectional causal effect between blood uric acid leve","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2443673"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923318","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 cord serum levels of sFlt-1 and PlGF in pregnancies complicated by gestational diabetes mellitus: a prospective cohort study.","authors":"Saniye Merve Gul Kara, Gul Alkan Bulbul, Emine Kirtis, Hulya Kandemir, Ikbal Ozen Kuçukcetin, Sebahat Ozdem, Nasuh Utku Doğan, Cem Yasar Sanhal","doi":"10.1080/14767058.2025.2491454","DOIUrl":"https://doi.org/10.1080/14767058.2025.2491454","url":null,"abstract":"<p><strong>Introduction: </strong>Given the limited and conflicting evidence about maternal and fetal angiogenic/antiangiogenic factors in gestational diabetes mellitus (GDM) that exists in the known literature. The aim of this study is to evaluate the association of maternal and cord soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) serum levels and sFlt-1/PlGF ratios in normotensive pregnancies complicated by GDM.</p><p><strong>Materials and methods: </strong>This prospective cohort study consists of 51 pregnant women diagnosed with GDM and 57 control groups. Maternal and cord serum sFlt-1 and PlGF levels were measured at 30th and 34th weeks of gestation and at the time of delivery. The maternal and cord sFlt-1/PlGF ratios were calculated. Obstetric and perinatal outcomes were evaluated.</p><p><strong>Results: </strong>No significant differences were found in maternal serum levels of PlGF and sFlt-1 between the control and GDM groups (median 0.2 pg/mL vs. 0.2 pg/mL, <i>p</i> = .106; median 6.1 pg/mL vs. 5.27 pg/mL, <i>p</i> = .017, respectively); cord serum PlGF and sFlt-1 levels were significantly lower in the GDM group than control group (median 0.3 pg/mL vs. 0.2 pg/mL, <i>p</i> = .017; median 11.0 pg/mL vs. 8.1 pg/mL, <i>p</i> = .003, respectively). No significant difference was observed between maternal and cord serum sFlt-1/PlGF ratio (median 31.7 vs. 27.0 <i>p</i> = .394; median 29.0 vs. 26.9 <i>p</i> = .408, respectively). In pregnancies complicated by GDM and normal pregnancies, cord maternal/cord serum PlGF, sFlt-1 levels were not significantly associated with any of the variables such as fetal weight, body mass index (BMI), oral glucose tolerance test (OGTT) results, neonatal intensive care unit (NICU) admission and umbilical cord pH.</p><p><strong>Conclusions: </strong>Results revealed that maternal sFlt-1, PlGF, and sFlt-1/PlGF ratios are not vital biomarkers of endothelial dysfunction and angiogenic imbalance in GDM, but low cord serum PlGF and sFlt-1 levels may reflect the chronic fetal hypoxia and increased placental angiogenesis in diabetic pregnancies.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2491454"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046062","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":"Urinary cotinine levels versus self-reported smoking status for assessing placental abruption risk: the Japan Environment and Children's study.","authors":"Toma Fukuda, Hyo Kyozuka, Tsuyoshi Murata, Shun Yasuda, Akiko Yamaguchi, Akiko Sato, Yuka Ogata, Mitsuaki Hosoya, Seiji Yasumura, Koichi Hashimoto, Hidekazu Nishigori, Keiya Fujimori","doi":"10.1080/14767058.2025.2497059","DOIUrl":"https://doi.org/10.1080/14767058.2025.2497059","url":null,"abstract":"<p><strong>Introduction: </strong>Placental abruption is a serious complication of pregnancy, and smoking is a well-known risk factor thereof. However, evaluations of the effects of smoking mostly rely on self-reported questionnaires, resulting in incorrect representation of smoke exposure owing to incorrect reporting and missing data on passive smoking. Cotinine is a major nicotine metabolite and a sensitive biomarker in smokers. However, to date, there have been no reports on the relationship between urinary cotinine levels and onset of placental abruption. Hence, this study aimed to compare smoking status assessed using self-reports and urinary cotinine levels with placental abruption.</p><p><strong>Material and methods: </strong>We analyzed data from the largest nationwide Japanese birth cohort study conducted between January 2011 and March 2014. Women with multiple pregnancies and insufficient data were excluded, leaving 82,637 women eligible for the study. Participants were classified as nonsmokers (<0.31 µg/gCr), passive smokers (0.31-36.7 µg/gCr), or active smokers (≥36.8 µg/gCr) based on comparable cutoffs for urinary cotinine levels, as reported previously. Participants were also classified as never-smokers, quitting before pregnancy, quitting after pregnancy, or current smokers according to a self-reported questionnaire. Logistic regression was used to calculate the adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for the association of urinary cotinine levels and self-reported smoking status with placental abruption.</p><p><strong>Results: </strong>Among 82,637 participants (mean age: 31.3 years), 346 (0.42%) had placental abruption. Based on urinary cotinine-assessed smoking status, active smokers had a higher incidence of placental abruption (aOR, 1.70; 95% Cl, 1.20-2.40) than nonsmokers. In contrast, based on self-reports, there was no significant difference between current smokers and never-smokers after adjusting for established confounding factors (aOR, 1.54; 95% CI, 0.98-2.36).</p><p><strong>Conclusions: </strong>Elevated urinary cotinine levels during pregnancy were significantly associated with an increased risk of placental abruption, whereas self-reported smoking status was not. Urinary cotinine levels are a more accurate and clinically reliable biomarker to assess smoking-related risks during pregnancy than self-reported smoking status. Future research should explore the relationship between urinary cotinine levels and other obstetric complications to validate its utility as a comprehensive pregnancy biomarker.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2497059"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043410","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":"Angle of progression for predicting second-stage cesarean delivery complications.","authors":"Yossi Geron, Asaf Romano, Anat Shmueli, Ran Matot, Sharon Sigal-Kaplun, Sharon Daniel, Ron Charach, Yinon Gilboa","doi":"10.1080/14767058.2025.2463394","DOIUrl":"10.1080/14767058.2025.2463394","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the correlation between the angle of progression (AOP) and maternal surgical complications following a second-stage cesarean delivery.</p><p><strong>Methods: </strong>We retrospectively evaluated singleton pregnancies at term (≥37 weeks) who underwent cesarean delivery for arrest of descent at the second stage of labor from January 2022 to December 2023. Only cases with recorded AOP were included. The fetal head position was confirmed by transabdominal ultrasound, and the fetal head station was assessed manually by digital examination. The main outcome was defined as a composite adverse maternal outcome, including challenging fetal extraction, uterine extension, requirement for blood transfusions, postpartum fever, ileus, and re-hospitalization due to endometritis or surgical site infection.</p><p><strong>Results: </strong>Twenty-five cases met the inclusion criteria, of whom 10 (40%) experienced the composite adverse maternal outcome. These patients had wider mean AOP compared to those without maternal morbidity (136.7 ± 7.4 vs. 124.7 ± 12.5, <i>p</i> = .017<b>).</b> Univariate logistic regression analysis showed a significant correlation between measured AOP and composite adverse maternal outcome (OR = 1.15, 95% CI 1.01-1.30, <i>p</i> = .028). The predicted probability for composite adverse maternal outcome by receiver-operating characteristics curve yielded an area under the curve of 0.79 (95% CI 0.60-0.98) for AOP, compared to an area under the curve of 0.53 (95% CI 0.30-0.75) for the manually measured fetal head station.</p><p><strong>Conclusions: </strong>We found a correlation between the angle of progression and maternal complications following second-stage cesarean delivery. Assessing the angle of progression before surgery may be of help to the obstetrical team to better identify susceptible cases and allow for appropriate preparation.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2463394"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383938","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":"Exploring the impact of nano platinum-hydrogen saline on oxygen-induced retinopathy in neonatal rats.","authors":"Yangcan Ming, Wanyi Xu, Zhe Yang, Zi Wang, Na Wang","doi":"10.1080/14767058.2025.2454374","DOIUrl":"10.1080/14767058.2025.2454374","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to assess the impact of nano platinum-hydrogen saline (Pt NPs + H₂) on oxygen-induced retinopathy (OIR) in neonatal rats, with the goal to contribute new insights into the therapeutic strategies for retinopathy of prematurity.</p><p><strong>Methods: </strong>Pt NPs + H₂ formulation was synthesized to address OIR in a rat model. Subsequent examination included the assessment of retinal blood vessel distribution and morphology through hematoxylin and eosin (HE) and isolectin B4 (IB4) staining techniques. The levels of reactive oxygen species (ROS), malondialdehyde(MDA), and superoxide dismutase (SOD) were measured to reflect the oxidative stress in rats. Additionally, the protein expression of vascular endothelial growth factor (VEGF) in each experimental group was assessed using western blot analysis, while the gene expression of VEGF in retinal neovascularization tissues was assessed using reverse transcription-polymerase chain reaction (RT-PCR). Furthermore, the extent of retinal cell apoptosis was measured using a TdT-mediated dUTP Nick-End Labeling (TUNEL) apoptosis kit.</p><p><strong>Results: </strong>HE staining and IB4 staining revealed positive retinal neovascularization in the OIR group, whereas neovascularization in the Pt NPs + H₂ group exhibited reduced severity. Significantly fewer capillary globules and capillary tubules were observed in the Pt NPs + H₂ group compared to the OIR group (<i>p</i> < 0.05). Also, the Pt NPs + H₂ group demonstrated significant reductions in ROS and MDA levels within retinal tissues (<i>p</i> < 0.05, <i>p</i> < 0.001), along with a significant increase in SOD level (<i>p</i> < 0.05). Notably, the MDA level in the Pt NPs + H₂ group was notably lower than that in the OIR group (<i>p</i> < 0.01, <i>p</i> < 0.05), and even lower than that in the H₂ group. Pt NPs + H₂ intervention was associated with decreased protein and mRNA expression of VEGF, with statistical significance (<i>p</i> < 0.05). While the H₂ group exhibited a decreasing trend in apoptotic cell count in the retinal ganglion cell layer (<i>p</i> < 0.05), the Pt NPs + H₂ group demonstrated a more pronounced reduction, with a significant difference (<i>p</i> < 0.01). No significant discrepancy in apoptosis within the inner nuclear layer was observed (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>The synergistic effect of hydrogen saline and nano platinum manifests as enhanced antioxidant, anti-apoptotic, and anti-neovascular properties. Nano platinum-hydrogen saline demonstrates inhibitory effects on OIR in rats.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2454374"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030256","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 significance of ultrasound parameters and clinical factors in predicting successful labor induction among nulliparous women.","authors":"Laura Rācene, Līva Ķīse, Ieva Pitkēviča, Zane Rostoka, Beāte Sārta, Maija Priedniece, Agnija Vecvagare, Ļubova Lapidus, Anda Ķīvīte-Urtāne, Dace Rezeberga, Natālija Vedmedovska","doi":"10.1080/14767058.2025.2450405","DOIUrl":"10.1080/14767058.2025.2450405","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the values of ultrasound and clinical parameters for predicting outcomes of induction of labor (IOL) among healthy nulliparous women with a singleton, term cephalic pregnancy.</p><p><strong>Methods: </strong>The cervical length, cervical strain elastography, posterior cervical angle, head-perineum distance, Bishop score, and maternal parameters were assessed before IOL with a combined method-Foley catheter and Misoprostol perorally. The main outcome was vaginal delivery.</p><p><strong>Results: </strong>Variation in cervical tissue elasticity, represented by elasticity index (E), was significantly different between outcome groups-vaginal delivery and cesarean section (CS) in internal os, in the anterior lip near the cervical canal and the midpoint of the anterior and posterior lip (<i>p</i> < 0.05). The E was higher-softer in the vaginal delivery group. The overall elasticity was significantly higher in the middle part of the cervix in the vaginal delivery group. However, other ultrasound metrics did not differ significantly across the outcome groups. Overall, women who delivered vaginally were taller and had a lower pre-pregnancy BMI (<i>p</i> = 0.02 for both variables). Univariate and multivariate analyses showed maternal height was the significant independent predictor of CS (AOR 0.91, 95% CI 0.84-0.98). The prognostic value for vaginal delivery, based on cervical length, maternal height, Bishop score, and parameters of cervical strain elastography, was poor (AUC < 0.7).</p><p><strong>Conclusion: </strong>The study underscores the importance of cervical tissue elasticity in predicting vaginal delivery outcomes, while also highlighting that maternal height is a significant independent predictor of cesarean delivery. However, evaluated metrics in the study have limited prognostic value for predicting vaginal delivery. This suggests a need for further research to identify more reliable predictors of delivery outcomes.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2450405"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973067","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":"Prenatal diagnosis and pregnancy outcomes in fetuses with vertebral abnormalities.","authors":"Jian Hu, Ling Zeng, Ting Wang, Meiqi Yi, Jieping Song","doi":"10.1080/14767058.2025.2468000","DOIUrl":"10.1080/14767058.2025.2468000","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the genetic risk and pregnancy outcomes of fetuses who had the sonographic diagnosis of vertebral abnormalities (VA).</p><p><strong>Methods: </strong>Fifty-two fetuses with sonographically detected VA (excluding neural tube defects) were included in the study. Data on prenatal ultrasound scan, prenatal genetic testing by amniocentesis, and pregnancy outcomes were collected and reviewed.</p><p><strong>Results: </strong>Four types of VA were identified among 52 fetuses: butterfly vertebrae (26.9%, 14/52), hemivertebrae (59.6%, 31/52), hemivertebrae combined with butterfly vertebrae (9.6%, 5/52), and block vertebrae (3.9%, 2/52). Of the 52 fetuses, 33 presented VA as the sole sonographic anomaly, while the remaining 19 had associated anomalies. The positive rate of prenatal diagnosis for fetuses with VA was 19.2% (10/52). Chromosomal analysis, including karyotyping and chromosomal microarray analysis (CMA), detected one case of mosaic trisomy 9 and six cases of (likely) pathogenic copy number variants (CNVs). Whole exome sequencing (WES) identified four likely pathogenic variants in three cases with negative CMA results, specifically c.5110-1G > A in FLNB, c.8366G > A in KMT2D, and c.1275_1283dup as well as c.870 + 2T > C in DLL3. Among the 10 cases with diagnostic genetic testing results, seven fetuses exhibited isolated VA. There was no significant difference in the diagnostic rates between the isolated VA group (21.2%, 7/33) and the non-isolated VA group (15.8%, 3/19) (odds ratio [OR] 0.696, 95% confidence interval [CI] 0.157-3.087, <i>p</i> = 0.910). However, the live birth rate was significantly higher in the isolated VA group (71.9%, 23/32) compared to the non-isolated VA group (38.9%, 7/18) (OR 4.016, 95% CI 1.184-13.622, <i>p</i> = 0.022). Among the 30 live birth cases, two underwent spinal surgery and another two were identified with additional abnormalities. Following appropriate interventions, no apparent abnormalities were observed in the growth and development of 30 live birth cases.</p><p><strong>Conclusion: </strong>Invasive prenatal diagnosis is recommended for all fetuses diagnosed with VA, regardless of whether associated anomalies are present. WES can enhance the diagnostic yield for fetuses with negative CMA results. Fetuses with isolated VA can have favorable pregnancy outcomes when genetic testing results are negative. However, long-term follow-up remains necessary for the assessment of the prognosis of these fetuses.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2468000"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469752","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":"It is time for midwives to perform intrapartum ultrasonography for fetal head station, position and cervical dilation.","authors":"Mehmet Akif Sargın, Pınar Bırol Ilter, Furkan Kayabasoglu, Antonio Malvası, Ozan Dogan, Ecem Eren, Arzu Bilge Tekin, Murat Yassa","doi":"10.1080/14767058.2025.2493192","DOIUrl":"https://doi.org/10.1080/14767058.2025.2493192","url":null,"abstract":"<p><strong>Objective: </strong>Digital vaginal examination (DVE) is a commonly used method in delivery wards to monitor the progress of labor, but it is considered uncomfortable by pregnant women and can lead to infectious complications, such as chorioamnionitis. At the same time, the performance of intrapartum ultrasonography (IPU) is increasing. IPU has a higher inter-observer and intra-observer agreement than DVE. In this study, we evaluated the agreement between IPU and DVE measurements performed by midwives trained in ultrasonography and a specialist obstetrician. Using these data, we assessed the feasibility of midwives administering IPU in delivery rooms for fetal head station and position and cervical dilation.</p><p><strong>Methods: </strong>This prospective study was conducted on the delivery ward at a tertiary healthcare hospital between 1 March and 1 May 2021. The study included women with low-risk pregnancies with a singleton vertex presentation who were admitted to the delivery ward after 37 weeks of gestation. The two midwives underwent a theoretical and practical training program on patients led by an expert obstetric consultant. Cervical dilation, fetal head station and position were recorded through IPU and DVE measurements conducted by two midwives and one expert obstetrician. Cohen's kappa with squared weights was used to assess the agreement between observers. The discomfort score during the examinations was also obtained from the pregnant women and recorded (0 = no discomfort, 10 = very uncomfortable).</p><p><strong>Results: </strong>The study included 196 pregnant women. There was mostly moderate or substantial agreement between the midwives and obstetric consultant in the variables of cervical dilation, fetal head level and position determined by DVE. In all IPU measurements, these agreements were perfect among all observers. While the intra-observer agreement of the obstetric consultant in IPU and DVE was perfect, in midwives, it was analyzed as substantial in cervical dilation, fair and moderate in the head station, and moderate and perfect in head position. The mean discomfort scores of the pregnant women due to IPU and DVE were 2.89 ± 1.49 and 5.98 ± 2.02, respectively. The differences in discomfort scores between the two examinations were detected to be statistically significant (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>IPU can be used by midwives in delivery wards to accurately determine the fetal head position and station and cervical dilation without causing discomfort to pregnant women.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2493192"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058395","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":"Artificial intelligence predicts pregnancy complications based on cytokine profiles.","authors":"Fawaz Azizieh, Bulent Yilmaz, Raj Raghupathy","doi":"10.1080/14767058.2025.2498549","DOIUrl":"https://doi.org/10.1080/14767058.2025.2498549","url":null,"abstract":"<p><strong>Background: </strong>Early prediction of pregnancy complications is important for adequate and timely prevention, management, and reducing maternal/fetal pathogenesis.</p><p><strong>Objective: </strong>To study the prognostic value of cytokines as predictors of pregnancy complications using unbiased artificial intelligence/machine learning (AI/ML) methods.</p><p><strong>Methods: </strong>For this study, we used our previously published data on 127 women with pregnancy complications and 97 women with a history of normal delivery and undergoing a normal delivery. A panel of seven cytokines were analyzed from activated peripheral blood mononuclear cells (PBMC). AI/ML methods such as kNN, SVM, decision tree, and ensemble classification were applied to explore the possible use of AI/ML to compare and predict normal gestation and normal delivery as opposed to different pregnancy complications such as recurrent spontaneous miscarriage (RSM), preterm delivery (PTD), pregnancy-induced hypertension (PIH), and premature rupture of fetal membranes (PROM).</p><p><strong>Results: </strong>The study examined cytokine levels in various pregnancy conditions, revealing significant differences, particularly in the levels of IL-2 and IFN-γ, across age-matched comparisons. Additionally, binary classification tasks demonstrated notable accuracies and f-measures for methodologies such as Ensemble (Bagged), QDA, and SVM (Cubic), showcasing their effectiveness in distinguishing between normal delivery and different pregnancy complications.</p><p><strong>Conclusion: </strong>The study provides a machine learning-based methodology for the prediction of pregnancy complications based on levels of cytokines produced by peripheral blood cells.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2498549"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036949","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":"Association between hyperuricemia and adverse perinatal outcomes among women with preeclampsia at a tertiary hospital in Southwestern Uganda: a prospective cohort study.","authors":"Hani Omar Wehlie, Yarine Fajardo Tornes, Julius Businge, Onesmus Byamukama, Musa Kayondo, Paul Kato Kalyebara, Joseph Ngonzi, Henry Mark Lugobe, Brenda Ainomugisha, Leevan Tibaijuka","doi":"10.1080/14767058.2025.2496394","DOIUrl":"https://doi.org/10.1080/14767058.2025.2496394","url":null,"abstract":"<p><strong>Background: </strong>Pre-eclampsia is a major cause of adverse perinatal outcomes, such as preterm birth and perinatal deaths, at Mbarara Regional Referral Hospital (MRRH). While serum uric acid is a crucial marker for predicting adverse outcomes, it is not routinely assessed. This study aimed to compare the incidence of adverse perinatal outcomes between women with and without hyperuricemia and determine the association between hyperuricemia and adverse perinatal outcomes among women with preeclampsia at MRRH.</p><p><strong>Methods: </strong>We conducted a prospective cohort study from March 2024 to June 2024 at the maternity ward of MRRH. We consecutively enrolled women diagnosed with preeclampsia who were at least 26 weeks gestational age and assessed their serum uric acid levels upon admission. The primary exposure was hyperuricemia (>6mg/dl) while the primary outcome was adverse perinatal outcomes. We compared the incidence of adverse perinatal outcomes among those with and without hyperuricemia using Chi-square and used multivariable modified Poisson regression analysis to determine the association between hyperuricemia and adverse perinatal outcomes among women with preeclampsia.</p><p><strong>Results: </strong>Among the 111 women enrolled (mean age 28.3 ± 6.5 years), 43 (38.7%) had hyperuricemia. Adverse perinatal outcomes occurred in 55.9% (62/111). Women with hyperuricemia had higher rates of adverse outcomes (88%, <i>n</i> = 38/43) than those without (35%, <i>n</i> = 24/68). Specific outcomes were significantly more frequent among hyperuricemic women: fresh stillbirth (21% vs. 0%), low birth weight (49% vs. 26%), Apgar score <7 at 5 min (26% vs. 1%), NICU admission (76% vs. 26%), and early neonatal death (32% vs. 0%), <i>p</i> < 0.05. Hyperuricemia was linked to a two-fold increased risk of one or more adverse outcomes (aRR 2.42, 95% CI: 1.54-3.80), fresh stillbirth (aRR 3.14, 95% CI: 1.79-5.48), low Apgar score (aRR 31.5, 95% CI: 3.8-260.9), NICU admission (aRR 2.44, 95% CI: 1.86-4.49), and early neonatal death (aRR 12.1, 95% CI: 4.22-33.98).</p><p><strong>Conclusion: </strong>Hyperuricemia is common in preeclamptic women at MRRH and is associated with significantly higher rates of complications. Routine serum uric acid testing is recommended for early detection and timely intervention to improve maternal and neonatal health outcomes.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2496394"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003805","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}