Isaac Erasto Mlay, Samwel Damian Ngungulu, Naillah Ally Said, Florida Munseri, Nashaat David Majo, Scholastica Mathew Malangalila, Janeth Nollascoh Msagala, Tatu Seif Mbotoni
{"title":"Transportation services for neonates referred to a secondary level health care facility in rural Tanzania: a cross-sectional study.","authors":"Isaac Erasto Mlay, Samwel Damian Ngungulu, Naillah Ally Said, Florida Munseri, Nashaat David Majo, Scholastica Mathew Malangalila, Janeth Nollascoh Msagala, Tatu Seif Mbotoni","doi":"10.1080/14767058.2025.2458595","DOIUrl":"10.1080/14767058.2025.2458595","url":null,"abstract":"<p><strong>Background: </strong>Neonatal transportation, when done adequately, has been associated with reduced morbidity and mortality among referred neonates. In many developing countries, safe and specialized system for neonatal transportation has not been adequately considered and this has a contribution to a burden of neonatal morbidity and mortality specifically in sub-Saharan Africa. This study describes attributes of neonatal transportation services from primary to secondary health care facility in rural Tanzania and predictors of short-term outcome.</p><p><strong>Methods: </strong>This was part of the larger study conducted in Iringa Regional Referral hospital conducted from April - June 2023 looking at neonatal mortality and associated factors. Participants were consecutively recruited into study including those who were referred from primary health care facilities across the region and whose parents or care giver provided a written consent. Data were collected by a structured questionnaire and inspection of the transportation vehicle used on arrival. Frequency tables were used to summarize the data with logistic regression performed to assess predictors of poor condition on arrival.</p><p><strong>Results: </strong>Most of the participants were male neonates (61.3%) weighing more than 2500 g at birth with the gestation age of 37 weeks or more (58.7%). Upon arrival, over half of the participants (53.3%) had referral notes readily available. Majority of the neonates were transported by a public ambulance (72%) but only 1.9% of these had respiratory and cardiovascular system supporting equipment. Two-third of the escorting health personnel had no training on neonatal resuscitation and essential newborn care. Neonates who traveled for over 30 min were more likely to arrive in critical condition, AOR = 6, 95%CI (1.44-18.18) compared to those who used less time.</p><p><strong>Conclusion: </strong>Enhancing neonatal transportation services in rural Tanzania is crucial for specialized care and safety, ultimately impacting morbidity and mortality rates.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2458595"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081903","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}
Cassandra Wauer, Carolina Thorlund-Diaz, Abbas Hakim, Morgan Meads, Anelizze Castro-Martinez, Mana M Parast, Louise C Laurent, Marni B Jacobs
{"title":"A pilot study of apolipoprotein E genotype and associations with maternal lipid levels and small for gestational age outcomes in non-hypertensive pregnancies.","authors":"Cassandra Wauer, Carolina Thorlund-Diaz, Abbas Hakim, Morgan Meads, Anelizze Castro-Martinez, Mana M Parast, Louise C Laurent, Marni B Jacobs","doi":"10.1080/14767058.2025.2506006","DOIUrl":"https://doi.org/10.1080/14767058.2025.2506006","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the present pilot study was to determine associations between maternal Apolipoprotein E (ApoE) genotype, lipid levels during pregnancy, fetal growth, and placental pathology.</p><p><strong>Methods: </strong>In this case-control study, serum samples from pregnant women without hypertension who delivered small-for-gestational age (SGA) infants (<i>n</i> = 50) were matched on gestational age at sample collection with non-SGA infants (<i>n</i> = 100). ApoE allele distributions and lipid levels were compared between cases and controls and among placental pathological findings.</p><p><strong>Results: </strong>No differences in ApoE genotypes were noted between groups. High density lipoprotein (HDL) cholesterol levels were higher in ε2 carriers versus ε3/ε3 and ε4 carriers (78.1 vs. 67.7 vs. 64.0 mg/dL, <i>p</i> < 0.01 and <i>p</i> < 0.001, respectively), and in SGA pregnancies (73.2 vs 65.1 mg/dL, <i>p</i> = 0.003).</p><p><strong>Conclusion: </strong>Findings suggest increased HDL in pregnancy may be associated with the ε2 allele and decreased fetal growth. These findings provide a useful starting point for further research and should be explored in larger population-based studies.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2506006"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144228","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}
Joseph Repicky, Jyoti Gur, Steven Fishberger, Craig Byrum, Lauren Tague
{"title":"Spontaneous conversion of fetal heart block to sinus rhythm post externalized pacemaker placement in an undiagnosed mother with lupus antibodies.","authors":"Joseph Repicky, Jyoti Gur, Steven Fishberger, Craig Byrum, Lauren Tague","doi":"10.1080/14767058.2024.2428390","DOIUrl":"10.1080/14767058.2024.2428390","url":null,"abstract":"<p><p>The incidence for congenital heart block is estimated as high as 1 in 15,000 live births. Up to 90% of cases of congenital heart block, in which there is no anatomical abnormalities, are attributed to maternal systemic lupus erythematous or Sjögren's disease. 50% of these mothers are asymptomatic at time of diagnosis. The post-natal cardiac manifestations have been felt to be irreversible. In this article we present, to our knowledge, the first case of spontaneous conversion of immune mediate 3<sup>rd</sup> degree heart block to sinus rhythm postnatally.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2428390"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973065","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 and prediction model for postpartum psychiatric disorders: a retrospective cohort study of 1418 Chinese women from 2020 to 2022.","authors":"Wenxi Chen, Huan Ge, Jing Cong, Wenjie Zhou, Xiaoxia Chang, Xiaojie Quan, Jing Xia, Xincheng Tao, Danhua Pu, Jie Wu","doi":"10.1080/14767058.2024.2438756","DOIUrl":"10.1080/14767058.2024.2438756","url":null,"abstract":"<p><strong>Background: </strong>Postpartum psychiatric disorders (PPDs) have been deemed as a significant public health concern, affecting both maternal health and family dynamics. This study aimed to examine the current status of PPDs, identify the potential risk factors of PPDs, and further develop a clinical nomogram model for predicting PPDs in Chinese women.</p><p><strong>Method: </strong>In this retrospective cohort study, 1418 postpartum women attending the routine postpartum examination at the 42nd day after delivery in Jiangsu Women and Children Health Hospital were recruited as participants from December 2020 to December 2022. The Symptom Checklist-90 (SCL-90) was utilized to assess the status of postpartum psychiatric disorders. A prediction model was constructed by multivariate logistic regression and presented as a nomogram. The performance of nomogram was measured by the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). The relationships between predictive factors of PPDs and SCL-90 were also evaluated using Pearson correlation analysis. The relationships between predictive factors of PPDs and SCL-90 were evaluated using Pearson correlation analysis.</p><p><strong>Results: </strong>With the SCL-90 cutoff value of 160, the incidence of postpartum psychiatric disorders was 9.17% among Chinese urban women. The univariate and multivariate logistic regression analyses indicated that age ≤ 25 years old (OR = 10.07, 95%CI = 1.83-55.33), prenatal mood disorder (OR = 4.12, 95%CI = 1.99-8.53), invasive prenatal diagnostic procedures (OR = 4.39, 95%CI = 1.16-16.56), poor relationship with husband (OR = 2.86, 95%CI = 1.58-5.16) and poor relationship with mother-in-law (OR = 5.10, 95%CI = 2.70-9.64) were significantly associated with PPDs. A nomogram prediction model for PPDs was further constructed based on these five independent risk factors, and the area under the receiver operating characteristic curve (AUC) of the nomogram model was 0.823 (95% CI = 0.781-0.865). The calibration curves showed remarkable accuracy of the nomogram and the DCA exhibited high clinical net benefit of the nomogram. Besides, we also explored the relationships between the five risk factors and different symptom dimensions of PPDs and found that the five risk factors were almost associated with increased levels of all symptom dimensions.</p><p><strong>Conclusions: </strong>Five psychosocial risk factors for PPDs were identified in Chinese women and the nomogram prediction model constructed based on these five risk factors could predict the risk of PPDs intuitively and individually. Systematic screening these risk factors and further conducting psychosocial interventions earlier during the pregnancy period are crucial to prevent PPDs. For future research, we intend to incorporate additional risk factors, including blood biomarkers and facial expression indicators, to refine our risk model.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2438756"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819873","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":"Statement of Retraction: A sandwich technique (N&H variation technique) to reduce blood loss during cesarean delivery for complete placenta previa: a randomized controlled trial.","authors":"","doi":"10.1080/14767058.2025.2440150","DOIUrl":"https://doi.org/10.1080/14767058.2025.2440150","url":null,"abstract":"","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2440150"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808470","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}
Linyan He, Xihong Zhou, Jiajun Tang, Min Yao, Li Peng, Sai Liu
{"title":"Risk prediction of excessive gestational weight gain based on a nomogram model: a prospective observational study in China.","authors":"Linyan He, Xihong Zhou, Jiajun Tang, Min Yao, Li Peng, Sai Liu","doi":"10.1080/14767058.2024.2440774","DOIUrl":"10.1080/14767058.2024.2440774","url":null,"abstract":"<p><strong>Background: </strong>Excessive Gestational Weight Gain is a global public health problem with serious and long-term effects on maternal and offspring health. Early identification of at-risk groups and interventions is crucial for controlling weight gain and reducing the prevalence of excessive gestational weight gain. Currently, tools for predicting the risk of excessive gestational weight gain are lacking in China. This study aimed to develop a risk-prediction model and screening tool to identify high-risk groups in the early stages.</p><p><strong>Methods: </strong>A total of 306 pregnant women were randomly selected who underwent regular obstetric checkups at a tertiary-level hospital in China between January and March 2023. Logistic regression analysis was used to construct the risk-prediction model. The goodness of fit of the model was assessed using the Hosmer-Lemeshow test, and the predictive performance was evaluated using the area under the receiver operating characteristic (ROC) curve, calibration plots, and k-fold cross-validation. R4.3.1 software was used to create a nomogram.</p><p><strong>Results: </strong>The prevalence of excessive gestational weight gain was 50.32%. Logistic regression analysis revealed that pre-pregnancy overweight (OR = 2.563, 95% CI: 1.043-6.299), obesity (OR = 4.116, 95% CI: 1.396-12.141), eating in front of a screen (OR = 6.230, 95% CI: 2.753 - 14.097); frequency of weekly consumption of sugar-sweetened beverages/desserts/western fast food (OR = 1.948, 95% CI: 1.363-2.785); and pregnancy body image (OR = 1.030, 95% CI: 1.014-1.047) were risk factors for excessive gestational weight gain. Parity (OR = 0.452, 95% CI: 0.275 - 0.740), protective motivation to manage pregnancy body mass (OR = 0.979, 95% CI: 0.958-1), and the time of daily moderate-intensity physical activity (OR = 0.228, 95% CI: 0.113-0.461) were protective factors against excessive gestational weight gain. The area under the ROC curve of the model was 0.885, the mean value of ten-fold cross-validation was 0.857 for AUC.</p><p><strong>Conclusion: </strong>The nomogram model developed in this study has a good degree of discrimination and calibration, providing a valuable basis for early identification and precise intervention in individuals at risk of excessive gestational weight gain.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2440774"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899729","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}
Ismini Tzanaki, Antonis Makrigiannakis, Charoula Lymperopoulou, Zeyad Al-Jazrawi, Aris P Agouridis
{"title":"Pregnancy-associated plasma protein A (PAPP-A) as a first trimester serum biomarker for preeclampsia screening: a systematic review and meta-analysis.","authors":"Ismini Tzanaki, Antonis Makrigiannakis, Charoula Lymperopoulou, Zeyad Al-Jazrawi, Aris P Agouridis","doi":"10.1080/14767058.2024.2448502","DOIUrl":"https://doi.org/10.1080/14767058.2024.2448502","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to systematically examine the role of the pregnancy-associated plasma protein A (PAPP-A) serum biomarker in the first trimester screening of preeclampsia (PE).</p><p><strong>Materials and methods: </strong>A systematic search of the literature was conducted on PubMed via Medline, and Cochrane Library up to 8 November 2022, for prospective studies evaluating PAPP-A serum levels in first trimester pregnant women as a screening biomarker for PE. Eligible were all prospectively designed case-control or cohort studies, published in English. Two investigators independently examined the studies and the studies' characteristics were extracted. Newcastle-Ottawa Scale (NOS) for case-control and cohort studies were applied to assess the risk of bias. For the quantitative analysis of the studies, a meta-analysis was also performed.</p><p><strong>Results: </strong>A total of 22 studies including 33,651 pregnant women were assessed, of whom, 2001 were diagnosed with PE. A meta-analysis was performed, showing that PAPP-A levels in the first trimester were significantly lower in early onset preeclamptic women (MD: -0.24, 95% CI: -0.37, -0.11, <i>p</i> = .0002), late onset (MD: -0.15, 95% CI: -0.25, -0.05, <i>p</i> = .03), and total preeclamptic cases (MD = -0.17, 95% CI = -0.23, -0.11, <i>p</i> < .00001) when compared with controls.</p><p><strong>Conclusions: </strong>Our results suggest that PAPP-A can be a promising predictor in early screening for PE; hence, women at risk can be diagnosed early in their pregnancy stage and benefit from individualized PE treatment before it progresses.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2448502"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933417","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}
Petra Psenkova, M Veliskova, D Dzubinska, I Waczulikova, M Tedla, P Peskovicova, J Zahumensky
{"title":"Mode of birth in nulliparous term singleton pregnancies in vertex presentation before and after implementation of an evidence-based intervention: quality-improvement study.","authors":"Petra Psenkova, M Veliskova, D Dzubinska, I Waczulikova, M Tedla, P Peskovicova, J Zahumensky","doi":"10.1080/14767058.2024.2443968","DOIUrl":"https://doi.org/10.1080/14767058.2024.2443968","url":null,"abstract":"<p><strong>Purpose: </strong>The main objective of this study was to assess the impact of a composite quality improvement intervention on mode of birth in nullipara term singleton vertex (NTSVs).</p><p><strong>Material and methods: </strong>This was an ambidirectional study following the implementation of the intervention to reduce cesarean section rate in NSTV by comparing two birth cohorts, pre-composite quality improvement intervention cohort (January 2013-December 2015) and post-composite quality improvement intervention cohort (January 2018-December 2020).</p><p><strong>Results: </strong>In the studied periods, there was a total of 7713 NTSV births. Compared to pre-composite quality improvement intervention, there was a post-composite quality improvement intervention reduction in NTSV cesarean section rate from 30.89% to 13.31% (<i>p</i> < 0.0001). Obstetric and non-obstetric indications for elective cesarean sections decreased from 5.52% to 1.04% (<i>p</i> < 0.0001) and from 4.82% to 0.52% (<i>p</i> < 0.0001), respectively. The frequency of emergency cesarean sections in this group decreased from 20.56% to 11.75% (<i>p</i> < 0.0001), especially those performed for failure to progress in labor (from 13.69% to 7.30%; <i>p</i> < 0.0001). There has been a rising trend with regards to maternal age. However, the proportion of mothers aged 35 years and more giving birth by cesarean section reduced from 46.94% to 20.28%. These reductions in cesarean section rates occurred without any negative impact on core fetal outcomes.</p><p><strong>Conclusions: </strong>This quality improvement study demonstrates that it is feasible to significantly reduce cesarean section rate in NTSV by adopting specific composite measures. However, this requires the understanding of the inherent problems and barriers within the unit and the involvement of all stake holders.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2443968"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923472","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}
Maria Goretti Policarpo Barreto, Cláudia Silva, Renata Policarpo Barreto, Roberta Policarpo Barreto, Lara Moreira Teles de Vasconcelos, Maria Conceição Manso
{"title":"Perinatal asphyxia-prevalence and risk factors: a cohort study in a neonatal intensive care unit in northeast Brazil.","authors":"Maria Goretti Policarpo Barreto, Cláudia Silva, Renata Policarpo Barreto, Roberta Policarpo Barreto, Lara Moreira Teles de Vasconcelos, Maria Conceição Manso","doi":"10.1080/14767058.2025.2493731","DOIUrl":"https://doi.org/10.1080/14767058.2025.2493731","url":null,"abstract":"<p><strong>Objective: </strong>Even with all the worldwide effort in the care of pregnant women and newborns in the last 10 years, perinatal asphyxia remains a crucial public health problem worldwide, being responsible for the high rates of morbidity and mortality in term and preterm newborns. In this perspective, research was carried out which aimed to investigate the prevalence and analyze the environmental and maternal-fetal risk factors associated with perinatal asphyxia.</p><p><strong>Methods: </strong>This cohort study (2013-2018), corresponding to six years, was conducted in Fortaleza, Ceará, Brazil. The study involved 480 postpartum women living in a capital in the Northeast of Brazil, whose newborns were admitted to the neonatal intensive care unit of a private referral hospital for high-risk pregnancies. Perinatal asphyxia in live births was taken as the dependent variable. To identify risk factors associated with perinatal asphyxia, bivariate and multivariate analyses were performed.</p><p><strong>Results: </strong>The research showed a high prevalence of perinatal asphyxia. The final multivariate analysis showed a significant association between perinatal asphyxia and eclampsia and complications in labor (<i>p</i> < 0.05), these being preventable causes of this outcome. The research demonstrated a high prevalence of perinatal asphyxia and a significant association between perinatal asphyxia and complications in labor, eclampsia, and cesarean sections (<i>p</i> < 0.05), being preventable causes of this outcome.</p><p><strong>Conclusion: </strong>The study gave greater visibility to prenatal care, and understanding complications during pregnancy and childbirth care. The publication of the results signaled to managers the need to implement public and private politics to face this problem, which promoted improvements in the living conditions of the population and the care of pregnant women, to reduce the births of babies with perinatal asphyxia, consequently, reducing neonatal and infant mortality.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2493731"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043409","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 of bronchopulmonary dysplasia depending on the severity of the disease in very preterm infants.","authors":"Anna O Menshykova, Dmytro O Dobryanskyy","doi":"10.1080/14767058.2025.2501697","DOIUrl":"https://doi.org/10.1080/14767058.2025.2501697","url":null,"abstract":"<p><strong>Objective: </strong>Bronchopulmonary dysplasia (BPD) remains a common pathology in very preterm infants. The risk of complications increases with the severity of the disease.The study aimed to determine the factors affecting the formation of moderate/severe BPD in the modern population of very preterm infants.</p><p><strong>Methods: </strong>Data from 201 very low birth weight infants < 32 weeks of gestation were used in a retrospective cohort study. Infants were retrospectively divided into two groups based on the type of respiratory support at 36 weeks of postmenstrual age (PMA) - mild BPD (133 infants) and moderate/severe BPD (68 infants). The influence of major perinatal risk factors, neonatal morbidity, and medical interventions on the development of moderate/severe BPD was assessed.</p><p><strong>Results: </strong>The groups were different in the incidence of intrauterine growth restriction (5% vs. 15%; <i>p</i> = 0.02), maternal hypertension (5% vs. 18%; <i>p</i> = 0.004), cesarean section (29% vs. 43%; <i>p</i> = 0.04), severe intraventricular hemorrhage (9% vs. 19%; <i>p</i> = 0.04), and retinopathy of prematurity (5% vs. 18%; <i>p</i> = 0.002), as well as in need for chest compressions during resuscitation at birth (2% vs. 9%; <i>p</i> = 0.01) for mild and moderate/severe BPD, respectively. Infants in the moderate/severe BPD group had lower Apgar scores at 1 and 5 min, required longer mechanical ventilation (220 (10-1904) hours vs. 72 (1-614) hours; <i>p</i> < 0.0001), CPAP duration (456 (16-1320) hours vs. 278 (10-1200) hours; <i>p</i> = 0.0002), oxygen supply (50 (3-146) days vs. 29 (2-68) days; <i>p</i> < 0.0001), as well as antibacterial therapy (61 (16-177) days vs. 52 (9-121) days; <i>p</i> = 0.0001) and hospital stay (109 (59-321) days vs. 85 (45-205) days; <i>p</i> < 0.0001). Infants with more severe BPD were also significantly more likely to die after reaching the PMA of 36 weeks (12% vs. 1%; <i>p</i> = 0.0003).According to the multivariable logistic regression analysis, the moderate/severe BPD was reliably and independently determined by maternal hypertension (aOR 4.53, 95% CI 1.48-13.91) and genitourinary infections (aOR 4.41, 95% CI 1.41-13.78), as well as the duration of CPAP (aOR 1.002, 95% CI 1.001-1.004) and mechanical ventilation (aOR 1.006, 95% CI 1.004-1.009).</p><p><strong>Conclusions: </strong>Duration of respiratory support is the main risk factor that determines the development of moderate/severe BPD in the modern population of very preterm infants. Maternal hypertension and genitourinary infections may influence the severity of lung injury.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2501697"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048388","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}