Journal of Maternal-Fetal & Neonatal Medicine最新文献

{"title":"Risk factor analysis and nomogram predictive model construction for neonatal hypospadias: a large-scale multicenter study in East China.","authors":"Wen Hu, Jian Zhao, Cheng Chen, Zixing Zhong, Peiwen Zheng, Juan Wei, Ping Liang, Qiumin Zhu, Qiong Luo","doi":"10.1080/14767058.2026.2663413","DOIUrl":"https://doi.org/10.1080/14767058.2026.2663413","url":null,"abstract":"<p><strong>Objective: </strong>To conduct a retrospective multicenter study using objective data from a large sample size, which in order to identify reliable risk factors for hypospadias and establish a practical predictive model.</p><p><strong>Methods: </strong>We retrospectively studied the medical records of the mothers who gave birth at Women's Hospital of Zhejiang University, School of Medicine, which was the obstetric treatment center in East China, and Xinchang Maternal and Child Health Hospital, and Quzhou Maternal and Child Health Hospital, from January 2019 to December 2021.</p><p><strong>Results: </strong>42809 male babies were born in the three hospitals, including 139 of which were diagnosed with hypospadias. The incidence of hypospadias was 0.325%. 33591 mothers and 35517 newborns were finally included to the statistical analysis. Among them, there were 121 newborns diagnosed with hypospadias and 121 mothers who gave birth to the hypospadias newborns. Premature birth, multiple pregnancies, gestational hypertension, fetal distress and abnormal placental morphology were set as the predictor to construct the nomogram model. The internal verification results displayed the area under the curve (AUC) was 0.834 (95% CI = 0.769-0.900), with a specificity of 85.6% and a sensitivity of 68.9%. The temporal verification results displayed the AUC was 0.857 (95% CI = 0.795-0.919), with a specificity of 74.2% and a sensitivity of 85.0%. The slope of the calibration curves were both close to 1, indicating high fitting degree of the model.</p><p><strong>Conclusion: </strong>Our findings suggested that premature birth, multiple pregnancies, gestational hypertension, fetal distress and abnormal placental morphology were independent risk factors for hypospadias in newborns. We successfully established a nomogram predictive model for hypospadias, which can effectively, conveniently, clearly and visually predict the risk of hypospadias occurrence.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2663413"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787567","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":"Thickness analysis of the retinal nerve fiber layer, macula, and choroid in children born preterm stratified by birth weight.","authors":"YuWei He, Yi Liu","doi":"10.1080/14767058.2026.2660011","DOIUrl":"https://doi.org/10.1080/14767058.2026.2660011","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether birth weight influences retinal development in children born preterm, we analyzed the thickness of the retinal nerve fiber layer (RNFL), fovea centralis, and choroid.</p><p><strong>Methods: </strong>Participants born preterm were categorized as extremely low birth weight (ELBW, <1000 g), very low birth weight (VLBW, 1000-1500 g), and low birth weight (LBW, 1500-2500 g). RNFL thickness, fovea centralis thickness (macular center), and subfoveal choroidal thickness were measured using optical coherence tomography. Linear regression was used to evaluate associations between OCT parameters and birth weight.</p><p><strong>Results: </strong>Of the 54 preterm-born children included, 34 were diagnosed with retinopathy of prematurity (ROP) (stage 1: 7; stage 2: 19; stage 3: 7), with 5 receiving laser treatment. Inferior and global mean RNFL thicknesses were lower in the ROP cohort than in the non-ROP cohort (<i>p</i> = 0.0012 and <i>p</i> = 0.003, respectively). Fovea centralis thickness and choroidal thickness did not differ between the ROP and non-ROP cohorts (<i>p</i> = 0.16 and <i>p</i> = 0.97, respectively). In adjusted regression models, birth weight was associated with inferior RNFL thickness (β 0.09; 95% CI 0.01-0.11; <i>p</i> = 0.001), nasal RNFL thickness (β 0.06; 95% CI 0.01-0.10; <i>p</i> = 0.001), and fovea centralis thickness (β 0.04; 95% CI 0.01-0.08; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>In children born preterm, lower birth weight is associated with thinner inferior and nasal RNFL. OCT-derived RNFL measurements may help inform long-term monitoring of retinal development in preterm-born children, particularly those with low birth weight and/or ROP history.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2660011"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787751","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 of weekend delivery with adverse neonatal outcomes: a systematic review and meta-analysis.","authors":"Pratima Pandey, Muhammed Shabil, Huma Sulthana, Amogh Verma, Ranjana Sah","doi":"10.1080/14767058.2026.2666478","DOIUrl":"https://doi.org/10.1080/14767058.2026.2666478","url":null,"abstract":"<p><strong>Background: </strong>Maternal and neonatal outcomes are key indicators of healthcare quality. However, disparities in outcomes related to hospital staffing patterns and resource availability during weekends, commonly referred to as the \"weekend effect,\" remain a global concern. This systematic review and meta-analysis aimed to evaluate the association between weekend delivery and adverse neonatal outcomes using adjusted estimates from diverse healthcare settings worldwide.</p><p><strong>Methods: </strong>A systematic search of major databases was conducted to identify observational studies published up to January 2026. Studies were eligible if they reported adjusted effect estimates for neonatal outcomes comparing weekend and weekday deliveries. Nine high-quality studies, with Newcastle-Ottawa Scale scores ranging from 7 to 9, were included. A random-effects meta-analysis was performed to calculate pooled adjusted odds ratios (aORs) with 95% confidence intervals (CIs). All analyses were conducted using R software version 4.4.</p><p><strong>Results: </strong>Nine studies were included. For neonatal mortality, weekend delivery was associated with a 4.5% increase in adjusted odds; however, this association was not statistically significant (aOR 1.045, 95% CI 0.994-1.099; I² = 0.0%). In contrast, weekend delivery was significantly associated with higher odds of neonatal intensive care unit (NICU) admission (aOR 1.199, 95% CI 1.027-1.399; I² = 94.3%), maternal obstetric infection (aOR 1.078, 95% CI 1.045-1.112; I² = 0.0%), and preterm birth among high-risk populations, including women with pregestational diabetes or advanced maternal age (aOR 1.632, 95% CI 1.518-1.756; I² = 0.0%).</p><p><strong>Conclusion: </strong>Although contemporary obstetric care systems appear effective in preventing excess neonatal mortality after adjustment for case mix, significant disparities remain in important morbidity outcomes. These findings suggest that modifiable health system factors during off-hours care continue to influence perinatal outcomes and underscore the need for standardized seven-day clinical coverage to improve maternal and neonatal safety.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2666478"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845463","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 cigarette smoke exposure increases vulnerability to chronic retinal hypoperfusion in adult rats.","authors":"Barbara Mammel, Timea Kvarik, Dora Werling, Zsofia Szabo, Judit Gyarmati, Tibor Ertl, Zsuzsanna Helyes, Peter Kiss, Tamas Atlasz, Dora Reglodi","doi":"10.1080/14767058.2026.2661443","DOIUrl":"https://doi.org/10.1080/14767058.2026.2661443","url":null,"abstract":"<p><strong>Background: </strong>Numerous studies indicate that smoking during pregnancy has harmful effects on the offspring. Prenatal smoke exposure (PSE) may lead to fetal hypoxia and ischemia, which negatively affect brain development and increase the risk of neurological deficits. However, its long‑term impact on retinal vulnerability in adulthood is less well understood.</p><p><strong>Objective: </strong>To investigate the effects of prenatal smoke exposure on retinal structure and vulnerability in a chronic retinal hypoperfusion model in adult rats.</p><p><strong>Methods: </strong>Wistar rats were mated and exposed to whole‑body tobacco smoke for 2 hours daily from mating until delivery, using a closed‑chamber manual smoking system with four research cigarettes per occasion, modelling passive smoking. Neurobehavioral development was assessed in newborn rats during the first weeks of life. At 5 months of age, permanent bilateral common carotid artery occlusion (BCCAO) was performed under isoflurane anaesthesia via midline neck incision. Two weeks after BCCAO, all animals were sacrificed with an overdose of anaesthetic, and eyes were processed for histological analysis. Retinal layer thickness (outer and inner nuclear and plexiform layers) and cell counts per 100 µm in the ganglion cell layer (GCL) were measured.</p><p><strong>Results: </strong>BCCAO resulted in markedly reduced retinal layer thickness and morphological signs of degeneration with individual variation in all layers compared to sham‑operated controls. The number of cells in the GCL decreased by approximately 50%. Prenatal smoke exposure alone also led to a significant reduction in GCL cell number. While our previous work had shown only minor retardation of neurobehavioral development in prenatally smoke‑exposed neonatal rats, the present study demonstrated pronounced histological damage in the retina of adult rats subjected to PSE, with further exacerbation after chronic hypoperfusion.</p><p><strong>Conclusions: </strong>Prenatal exposure to tobacco smoke induces long‑lasting structural alterations in the retina and increases susceptibility to later hypoperfusion‑induced retinal injury in adult rats. These findings support the concept that adverse intrauterine exposures have persistent consequences for neural tissues and underscore the importance of avoiding smoking during pregnancy.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2661443"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845539","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":"Breech presentation in the third trimester: factors influencing spontaneous cephalic version and delivery outcome differences between spontaneous and non-spontaneous cephalic presentations.","authors":"Sara Derisbourg, Mathilde Lancelle, An Vercoutere, Michel Boulvain, Caroline Daelemans","doi":"10.1080/14767058.2025.2602299","DOIUrl":"10.1080/14767058.2025.2602299","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of breech presentation ranges from 6.9% to 10.0% between weeks 32 and 36 of gestation, gradually declining to 3.0-5.0% by the time an external cephalic version (ECV) can be offered. The primary objective of our study was to identify the factors favoring a spontaneous version between the routine third-trimester ultrasound and the proposal of external cephalic version. We also compared the maternal and neonatal outcomes at delivery between fetuses who spontaneously turned to the cephalic presentation and those who were in the cephalic presentation after external cephalic version.</p><p><strong>Method: </strong>This retrospective observational study included pregnant women with a breech fetus at their third trimester ultrasound scan (around 32 WG), who were under the care of a tertiary hospital between 2003 and 2022.</p><p><strong>Results: </strong>A total of 2,439 women were included in the study. The rate of spontaneous version between 32 and 36-37 weeks was 65%. The favoring factors, after adjustment, were multiparity, maternal age under 25 years, polyhydramnios. No difference was found in the incidence of cesarean section (12.6% vs. 13.2% <i>p</i> = 0.32) or assisted vaginal delivery (12.1% vs. 13.0% <i>p</i> = 0.72) for fetuses lying in the cephalic presentation after external cephalic version, compared to those with spontaneous version into the cephalic presentation after third trimester scan.</p><p><strong>Conclusion: </strong>The risk factors for a fetus remaining in the breech presentation after 32 weeks of gestation were similar to those associated with breech presentation in general. There was no difference in maternal or fetal outcomes between fetuses that were spontaneously or non-spontaneously versed fetuses (after external cephalic version).</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2602299"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776357","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":"Retraction Statement: Ultrasound markers for prediction of gestational diabetes mellitus in early pregnancy in Egyptian women: observational study.","authors":"","doi":"10.1080/14767058.2026.2607752","DOIUrl":"https://doi.org/10.1080/14767058.2026.2607752","url":null,"abstract":"","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2607752"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919063","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":"Fetal hemoglobin fraction is correlated to the risk of prematurity complications.","authors":"Carlo Dani, Giulia Remaschi, Matilde Ulivi, Niccolò Monti, Simone Pratesi","doi":"10.1080/14767058.2026.2614192","DOIUrl":"https://doi.org/10.1080/14767058.2026.2614192","url":null,"abstract":"<p><strong>Background: </strong>Fetal hemoglobin (HbF) plays a critical role in the progressive adaptation to the postnatal oxygen-rich environment in preterm infants due to its peculiar properties and its postnatal decrease has been associated to the combined adverse effects of increasing tissue hyperoxia and decreasing antioxidant defenses in preterm infants.</p><p><strong>Purpose: </strong>We aimed to assess the association between HbF fractions and the risk of bronchopulmonary dysplasia (BPD) intraventricular hemorrhage (IVH), and retinopathy of prematurity (ROP).</p><p><strong>Methods: </strong>We studied 166 preterm infants with a gestational age of 27.1 ± 1.6 weeks. One hundred and twenty-six infants (74%) had no or mild BPD, and 40 (24%) moderate to severe BPD. One hundred and forty-three infants (86%) had no or grade 1 IVH, and 23 (14%) grade 2-4 IVH. One hundred and thirty (80%) had no ROP, and 32 (20%) had any grade ROP. HbF fractions were recorded during the first seven days of life, at 14, 21, and 28 days of life, and 31, 34, and 36 weeks of postmenstrual age. Mean values during the first week of life (HbF_{1st week}) and at 31, 34, and 36 weeks (HbF_{31-36 weeks}) were calculated.</p><p><strong>Results: </strong>Logistic regression analysis showed that: HbF_{31-36 weeks} decreased the risk of moderate to severe BPD (OR 0.944, 95% CI 0.911-0.977; <i>p</i> = 0.001); female sex (OR 0.278, 95% CI 0.093-0.832; <i>p</i> = 0.022) and HbF_{1st week} (OR 0.949, 95% CI 0.901-0.999; <i>p</i> = 0.048) decreased the risk of grade 2-4 IVH; and HbF_{1st week} (OR 0.958, 95% Cl 0.919-0.998; <i>p</i> = 0.042) and HbF_{31-36 weeks} (OR 0.956, 95% CI 0.927-0.986; <i>p</i> = 0.004) decreased the risk of any grade ROP.</p><p><strong>Conclusion: </strong>Low HbF fractions were associated with increased risk of moderate-to severe BPD, grade 2-4 IVH, and any grade ROP. These results confirm previous findings and support the importance of minimizing blood sampling from these fragile patients.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2614192"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999737","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":"Variation in neonatal antibiotic management for patients undergoing fetal myelomeningocele repair across Children's Hospitals Neonatal Consortium (CHNC) centers.","authors":"Nicole L Welke, Stephanie A Eyerly-Webb, Amy M Linabery, Ann G Downey, Kyle G Halvorson, Andrea L Lampland","doi":"10.1080/14767058.2026.2621485","DOIUrl":"https://doi.org/10.1080/14767058.2026.2621485","url":null,"abstract":"<p><strong>Objective: </strong>Limited data informing evidence-based regimens for antibiotic use in neonates undergoing fetal myelomeningocele (fMMC) repair have been published to date, and no standard of care has been established across centers. The goal of this study was to describe current neonatal antibiotic use practices following fMMC repair within the Children's Hospitals Neonatal Consortium (CHNC), a collaborative network of North American institutions with Level IV neonatal intensive care units.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of site sponsors at all 48 CHNC centers from April 2024 to January 2025, and invited CHNC Fetal Therapy Focus Group members in May 2024, with one response requested per center.</p><p><strong>Results: </strong>A neonatologist at 34 centers (center response rate = 71%) completed the survey, of which 30 (88%) reported performing fMMC repair surgery (15/34, 44%) or delivering/receiving fMMC neonates (15/34, 44%) at their center. One-quarter of responding centers (7/30, 23%) reported having an existing clinical protocol for antibiotic management for fMMC neonates after birth. Notably, there was heterogeneity across existing protocols with respect to criteria for antibiotic use, the specific antibiotics used, and the duration of use. Responding centers reported administering antibiotics with guidance from infectious disease, neurosurgery, and fetal specialists. Two responding centers (6%) reported performing beta-2 transferrin testing on dehisced wounds when there is a suspected cerebrospinal fluid (CSF) leak, while the majority did not do so (20/30, 67%), and the remainder did not know their institutional practice (7/30, 23%).</p><p><strong>Conclusions: </strong>Current antibiotic use in fMMC neonates after birth varies widely between centers in North America, highlighting the need for evidence-based data to inform the development of best practice guidelines.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2621485"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114635","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":"Effects of depression and relative fat mass on gestational diabetes mellitus history: evidence from NHANES 2007-2020.","authors":"Xinxin Yang, Rui Jiang, Guangya Wang, Nairui Zhao, Xiuping Yin, Cuiliu Li","doi":"10.1080/14767058.2026.2621484","DOIUrl":"https://doi.org/10.1080/14767058.2026.2621484","url":null,"abstract":"<p><strong>Background: </strong>The growing prevalence of gestational diabetes mellitus (GDM) presents a significant clinical concern. In parallel, obesity has escalated to epidemic levels, and the mental health-GDM connection has been increasingly documented. Against this backdrop, the present study primarily investigates the independent and joint contributions of relative fat mass (RFM) and depression to GDM risk.</p><p><strong>Methods: </strong>Data were collected from the National Health and Nutrition Examination Survey (NHANES) covering the years 2007-2020. The separate associations of RFM and depression with GDM history were analyzed using a weighted logistic regression model, while interaction analysis was conducted to explore their combined effect. Subgroup analyses were conducted for further validation.</p><p><strong>Results: </strong>Among 8622 eligible participants, 775 (9.00%) had a history of GDM. The median age at first live birth was 22.00 years (19.00, 26.00). After adjusting for confounding variables, both increased RFM (OR = 1.07; 95% CI: 1.05-1.09) and depression scores (OR = 1.04; 95% CI: 1.02-1.06) were linked to an elevated risk of GDM. The coexistence of obesity (RFM ≥ 40%) and depression yielded a synergistic effect greater than their individual impacts (RERI = 0.87; ROR = 1.33). These findings were consistent across subgroup and sensitivity analyses.</p><p><strong>Conclusions: </strong>Concurrent elevation in RFM and depressive symptoms significantly heightens the likelihood of GDM history. These results support the integration of metabolic and psychological factors into preventive frameworks targeting GDM history.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2621484"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100925","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 maternal stress hormone levels during labor induction and the occurrence of neonatal hyperbilirubinemia.","authors":"Shoufu Liu, Huiqin Xiao, Yulin Wang, Hongxiu Liu, Xing Qi, Yunyao Fang, Li Zhang","doi":"10.1080/14767058.2026.2622232","DOIUrl":"https://doi.org/10.1080/14767058.2026.2622232","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between changes in maternal stress hormone levels during labor induction and the occurrence of neonatal hyperbilirubinemia (NNH), and to identify potential independent risk factors.</p><p><strong>Methods: </strong>A prospective cohort study was conducted involving 1,000 pregnant women who underwent labor induction at our hospital between June 2022 and May 2025. Maternal plasma levels of cortisol, epinephrine (EPI), and norepinephrine (NE) were measured before induction (T₀), during induction (T₁), and 30 min after delivery (T₂). Neonatal total bilirubin concentrations were measured at 24, 48, and 72 h after birth. According to the occurrence of NNH, subjects were divided into the NNH group (<i>n</i> = 95) and the non-NNH group (<i>n</i> = 905). Hormonal and bilirubin changes were compared between the two groups. Point-biserial correlation and multivariate logistic regression analyses were performed to explore associations and identify independent predictors.</p><p><strong>Results: </strong>Maternal plasma levels of cortisol, EPI, and NE at T₁ and T₂ were significantly higher in the NNH group. All three hormones at T₂ showed moderate positive correlations with the occurrence of NNH (<i>r</i> = 0.28-0.31, <i>p</i> < 0.001). Cortisol, EPI, and NE at T₂ were independently associated with the occurrence of NNH, while gestational age served as a protective factor. Male sex, cephalohematoma, direct antiglobulin test (DAT) positivity, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and exclusive breastfeeding were all associated with a higher risk of NNH. The regression model showed strong discriminatory power and predictive performance.</p><p><strong>Conclusion: </strong>Elevated maternal stress hormone levels during labor induction may serve as potential predictive indicators for assessing the risk of NNH.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2622232"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108205","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}