Journal of Maternal-Fetal & Neonatal Medicine最新文献

{"title":"Statement of Retraction: Urinary tract injuries during cesarean section in patients with morbid placental adherence: retrospective cohort study.","authors":"","doi":"10.1080/14767058.2026.2619043","DOIUrl":"https://doi.org/10.1080/14767058.2026.2619043","url":null,"abstract":"","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2619043"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031399","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":"Efficacy and safety assessment of pliant forceps in assisted vaginal delivery.","authors":"Suiwen Lin, Shuyi Liu, Xiaoqing Huang, Songqing Deng, Malie Wang, Zilian Wang, Anfu Chen, Bin Liu","doi":"10.1080/14767058.2026.2637921","DOIUrl":"10.1080/14767058.2026.2637921","url":null,"abstract":"<p><strong>Background: </strong>Forceps delivery often leads to increased maternal and neonatal complications, primarily attributed to the rigidity of traditional steel forceps, a major contributor to birth injury.</p><p><strong>Aims: </strong>This study aims to develop obstetric forceps with reduced rigidity and assess the safety and effectiveness of the newly designed pliant forceps.</p><p><strong>Methods: </strong>Pliant forceps with varying materials and shapes were produced by three-dimensional printing, and a pilot simulation determined the optimal design. Three fetal mannequins were developed to measure force changes exerted on the fetal head. Simulated births with several resistance intensities, were conducted to compare the real-time force between pliant forceps and Simpson forceps. Perineal distension was assessed by recording maximum perineal distention during a simulated forceps delivery using pliant forceps and Simpson forceps.</p><p><strong>Findings: </strong>The pliant forceps, constructed from polylactic acid with solid blades and angled shanks, featured foam tape on the fetal sides. In simulation studies on term fetal head model, pliant forceps achieved successful assisted vaginal delivery across all resistance levels. Compared to Simpson forceps, pliant forceps consistently exerted lower force on the fetal head during assisted vaginal delivery. The maximum force applied by pliant forceps occurred at RA1 site on fetal head (67.11 ± 4.35 N, Simpson forceps: 99.12 ± 10.53 N, <i>p</i> < 0.001), and Simpson forceps reached its peak at RP2 site (177.37 ± 19.28 N, pliant forceps: 12.87 ± 5.11 N, <i>p</i> < 0.001). Similar results were obtained in simulation experiments on large and small fetal head models. Perineal distension was determined to be smaller in births with pliant forceps compared with that in births with Simpson forceps (lateral perineal distension: 76.6 mm vs. 92.6 mm, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The three-dimensional-printed pliant forceps demonstrated reduced force on the fetal head and less perineal distension compared to Simpson forceps in simulated births, which holds potential for decreasing birth injuries and maternal birth canal injuries during forceps delivery. Further research is required to ensure the safety and efficacy of pliant forceps before clinical application.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2637921"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366838","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 use of intrapartum ultrasound by Italian midwives: training, knowledge, practice, and perceived barriers: a cross-sectional study.","authors":"Alessia Selmin, Erich Cosmi, Angela Veneri, Pierpaolo Zorzato, Ilenia Mappa, Martina Derme, Aly Mohamed Alaaeldin Kamaleldin Aly Youssef, Silvia Visentin","doi":"10.1080/14767058.2026.2635875","DOIUrl":"https://doi.org/10.1080/14767058.2026.2635875","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the integration of Intrapartum Ultrasound (IUS) into midwifery practice across different regions of Italy, with particular focus on midwives' training, knowledge, clinical use, and perceived barriers to implementation.</p><p><strong>Materials and methods: </strong>A cross-sectional survey was conducted among 104 midwives working in various Italian regions. The questionnaire assessed participants' formal education and training in IUS, level of knowledge, extent of clinical application, and perceived obstacles to its broader adoption in clinical practice. Descriptive analyses were performed to evaluate regional differences and identify gaps in education and implementation.</p><p><strong>Results: </strong>Although IUS appears to be widely utilized in clinical settings, a substantial proportion of midwives reported insufficient formal training. Significant barriers to broader implementation included cultural resistance within maternity care settings, limited access to structured educational programs, and regional disparities in clinical practice. Many respondents highlighted the need for improved competencies, particularly in the management of dystocic labor.</p><p><strong>Conclusions: </strong>This survey highlights the urgent need for standardized and comprehensive training programs to strengthen midwives' competencies in intrapartum ultrasound. Addressing educational gaps, reducing regional inequalities, and promoting cultural change within maternity care environments are essential steps to support the effective and consistent integration of IUS into midwifery practice.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2635875"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391728","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":"A retrospective comparison of hysteroscopic resection and curettage in the treatment of retained products of conception: surgical and reproductive outcomes.","authors":"Gulnur Coban, Ayşe Yaren Biber Ak, Ayse Zehra Ozdemir, Enes Furkan Coban","doi":"10.1080/14767058.2026.2624937","DOIUrl":"https://doi.org/10.1080/14767058.2026.2624937","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy, safety, and reproductive outcomes of hysteroscopic resection versus conventional dilation and curettage (D&C) in the management of retained products of conception (RPOC) following delivery or abortion.</p><p><strong>Materials and methods: </strong>This retrospective cross-sectional study included 55 patients diagnosed with RPOC at a tertiary care center between January 2015 and December 2025. The surgical intervention selected for each patient was determined by clinical indications, with either hysteroscopic resection or dilation and curettage (D&C) being the preferred option. The diagnosis was confirmed by transvaginal ultrasonography and histopathological examination. A comprehensive analysis encompassing demographic characteristics, clinical manifestations, surgical outcomes, and fertility outcomes was conducted between the two groups.</p><p><strong>Results: </strong>Hysteroscopy was performed in 28 patients (50.9%). D&C was performed in 27 patients (49.1%). The median time from pregnancy termination to intervention was significantly longer in the hysteroscopy group (28 vs. 7.5 days; <i>p</i> = 0.036). Residual tissue size and operative time were also significantly greater in the hysteroscopy group (<i>p</i> = 0.017 and <i>p</i> < 0.001, respectively). Although not statistically significant, time to conception was shorter in the hysteroscopy group (5 vs. 9.4 months), and the rate of pregnancy desire was significantly higher (82.1% vs. 66.7%; <i>p</i> = 0.021). Pregnancy was observed to be more prevalent in the D&C group during the follow-up period. However, this difference did not attain statistical significance.</p><p><strong>Conclusion: </strong>Hysteroscopy and dilation and curettage (D&C) have been demonstrated to be both effective and safe options for RPOC. The use of hysteroscopy, with its capacity for direct visualization and targeted removal, is supported by its efficacy in precise intrauterine assessment. The fertility outcomes observed in this cohort were comparable between the study groups.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2624937"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151147","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":"Impact of fetal and maternal genetically predicted birth weight on cardiometabolic risk: a Mendelian randomization study of cytokine mediation in Europeans.","authors":"Ningning Hou, Yonghui Jiao, Runju Zhang, Aixia Liu, Hangying Lou, Yimin Zhu, Hefeng Huang","doi":"10.1080/14767058.2026.2629082","DOIUrl":"https://doi.org/10.1080/14767058.2026.2629082","url":null,"abstract":"<p><strong>Background: </strong>Birth weight (BW) is influenced by both fetal and maternal genetic factors and is correlated with cardiometabolic outcomes later in life. Investigating these factors can clarify whether the association between BW and health risk arises from fetal, maternal, or shared genetic factors. Inflammation likely plays a key role in cardiometabolic risk related to BW. This study examined the causal effects of fetal and maternal genetically predicted BW on cardiometabolic outcomes, focusing specifically on the mediating role of inflammatory cytokines.</p><p><strong>Methods: </strong>We used a two-sample Mendelian randomization (MR) framework to estimate the causal effects of fetal-specific and maternal-specific BW on ten cardiometabolic and autoimmune outcomes. Additionally, we conducted a two-step MR mediation analysis to assess the role of 41 core inflammatory cytokines in these effects. Exposure data for fetal-specific BW (<i>n</i> = 298,142) and maternal-specific BW (<i>n</i> = 210,267) were sourced from the EGG Consortium and UK Biobank. Outcome data were mainly obtained from GWAS consortia including FinnGen, Pan-UKBB, and DIAGRAM. Cytokine data were collected from Finnish cohorts. Genetic instruments (Single nucleotide polymorphisms, SNPs) were selected at <i>p</i> < 5 × 10^-8, with F-statistics > 10 ensuring robustness. Primary analyses used inverse-variance weighted MR and conducted sensitivity analyses to evaluate pleiotropy.</p><p><strong>Results: </strong>Fetal-specific BW was inversely associated with type 2 diabetes (T2D, OR = 0.585, 95% CI: 0.491-0.697), fasting glucose (FG, 0.918, 0.886-0.951), fasting insulin (FI, 0.907, 0.878-0.937), coronary artery disease (CAD, 0.782, 0.701-0.873), myocardial infarction (MI, 0.746, 0.650-0.855), and systemic lupus erythematosus (SLE, 0.432, 0.228-0.818), but positively associated with venous thromboembolism (VTE, 1.252, 1.108-1.416). Maternal-specific BW was inversely associated with FI (0.927, 0.889-0.966), hypertension (0.697, 0.564-0.861), CAD (0.775, 0.652-0.921), and MI (0.730, 0.593-0.897). Cytokines such as PDGF-BB, MIP-1β, SDF-1α, and IL-4 partially mediated the associations between fetal-specific BW, maternal-specific BW, and cardiometabolic outcomes, but their mediation proportions were limited.</p><p><strong>Conclusions: </strong>This study provides evidence that both fetal and maternal genetically predicted BW independently influence cardiometabolic outcomes, with fetal genetic effects having a broader impact. Although inflammatory cytokines (PDGF-BB, MIP-1β, SDF-1α, IL-4) partially explain these effects, their contributions are limited, suggesting additional biological pathways underlie these lifelong associations.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2629082"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214485","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":"Long-term indomethacin therapy and cervical stabilization in dichorionic twin pregnancies.","authors":"Mevlut Bucak, Karl Seif, Katherine Goetzinger, Sifa Turan, Christopher Harman, Ozhan Turan","doi":"10.1080/14767058.2026.2630526","DOIUrl":"https://doi.org/10.1080/14767058.2026.2630526","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of long-term indomethacin therapy (LIT) in stabilizing cervical length in dichorionic-diamniotic (DCDA) twin pregnancies with a short cervix.</p><p><strong>Methods: </strong>This retrospective cohort study included 54 dichorionic-diamniotic twin pregnancies with a short cervix (≤25 mm), managed with LIT between 18 and 26 weeks of gestation age (GA) at a single quaternary medical center from 2014 to 2024. LIT was initiated with a 100 mg oral loading dose, followed by 50 mg every 6 h for 48 h, and continued at 25 mg every 6 h until 32 weeks or delivery. Weekly monitoring included transvaginal ultrasound, amniotic fluid assessment, and fetal Doppler studies. The expected cervical length (E_LCL) was modeled by applying an assumed physiologic cervical shortening rate of 0.9 mm per week to the observed first cervical length (O_FCL) in twin pregnancies without intervention. E_CL = O_FCL - [(GA at O_LCL - GA at O_FCL (weeks)) × 0.9 (mm/week)]. Cervical stabilization was defined as the observed last cervical length (O_LCL) exceeding the expected last cervical length (E_LCL) at the last examination. The primary outcome was cervical stabilization, while the secondary outcome was gestational age at delivery.</p><p><strong>Results: </strong>LIT was successful in stabilizing the cervix in 81.5% (<i>n</i> = 44/54) of cases. The mean GA at LIT onset was 22.9 ± 1.9 weeks, with a median O_FCL of 14.5 mm (IQR: 10.0-18.0). The mean duration of LIT was 48 days (IQR: 25-61). Final O_LCL was significantly longer than E_LCL (15.9 ± 6.1 mm vs. 9.3 ± 5.9 mm, <i>p</i> < .001). Median gestational age at delivery was higher in stabilized vs. non-stabilized patients (34.6 weeks [IQR: 31.7-36.6] vs. 30.8 weeks [IQR: 26.1-32.3], <i>p</i> = .004). No difference was observed in initial cervical length between groups (<i>p</i> = .282). LIT was discontinued in 11.2% due to ductus arteriosus constriction or oligohydramnios; no adverse neonatal outcomes were reported.</p><p><strong>Conclusion: </strong>These findings suggest an association between LIT and cervical stabilization in DCDA twin pregnancies with a short cervix; this exploratory, hypothesis-generating analysis warrants confirmation in prospective studies.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2630526"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214468","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 the cumulative duration of abnormal cardiotocography patterns and fetal acidemia.","authors":"Kazuhiro Kajiwara, Kohei Ogawa, Ohara Reiko, Nagayoshi Umehara, Akutsu Hidenori, Aikou Okamoto, Seiji Wada","doi":"10.1080/14767058.2026.2651460","DOIUrl":"https://doi.org/10.1080/14767058.2026.2651460","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between the cumulative duration of abnormal cardiotocography (CTG) findings, classified using the Japan Society of Obstetrics and Gynecology (JSOG) five-tier cardiotocography (CTG) classification system, and fetal acidemia, with analyses performed separately for the first and second stages of labor.</p><p><strong>Methods: </strong>We conducted a single-center retrospective cohort study at the National Center for Child Health and Development between 1 May 2015 and 1 May 1 2022, including women with planned vaginal delivery at ≥37 0/7 weeks of gestation. Cases with an umbilical artery blood pH <7.15 were categorized as the acidemia group; those with pH ≥7.15 served as controls. For each participant, all CTG tracings were reviewed and classified using the JSOG five-tier system (LEVELS 1-5). The cumulative duration of LEVELS 3-5 abnormalities and fetal tachycardia was calculated separately for the first and second stages of labor. Associations with acidemia were evaluated using multivariable logistic regression, adjusting for maternal body mass index, hypertensive disorders of pregnancy, gestational diabetes mellitus, fetal growth restriction, and chorioamnionitis.</p><p><strong>Results: </strong>A total of 648 deliveries were analyzed (141 acidemia, 507 non-acidemia). During the first stage of labor, LEVELS 3 and 4 abnormalities showed a duration-related association with acidemia, whereas fetal tachycardia was significantly associated when lasting ≥30 min. During the second stage of labor, LEVEL 3 abnormalities showed no significant associations; however, LEVELS 4 and 5 abnormalities and fetal tachycardia lasting >60 min remained significantly associated with acidemia, demonstrating progressively higher odds with longer durations.</p><p><strong>Conclusion: </strong>Incorporating the cumulative duration of CTG abnormalities into the JSOG five-tier classification may improve the assessment of fetal acidemia risk. Our time-based analysis demonstrated that LEVEL-specific CTG abnormalities and fetal tachycardia showed duration-related associations with acidemia, particularly during the first stage of labor. LEVEL 3 abnormalities and fetal tachycardia during the first stage of labor were more associated, whereas LEVELS 4 and 5 abnormalities during the second stage were more associated with acidemia. These findings may facilitate more informed intrapartum decision-making by identifying fetuses at risk earlier in labor, potentially reducing unnecessary emergency cesarean deliveries and preventing severe acidemia.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2651460"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647187","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":"Exploration of the relationship between miR-146a rs2910164 polymorphisms and the efficacy of epidural fentanyl in labor analgesia among pregnant women.","authors":"Yiyi Shen, Bei Wang, Jie Liu","doi":"10.1080/14767058.2026.2650241","DOIUrl":"https://doi.org/10.1080/14767058.2026.2650241","url":null,"abstract":"<p><strong>Background: </strong>miR-146a influences an individual's pain sensitivity through the regulation of inflammation-related pathways, and its genetic polymorphism may play a role in labor analgesia.</p><p><strong>Objectives: </strong>This study aimed to investigate the impact of the miR-146a rs2910164 polymorphism on the efficacy of epidural fentanyl in labor analgesia.</p><p><strong>Materials and methods: </strong>In this study, a total of 142 primiparas who received epidural fentanyl analgesia were enrolled. Genotyping was conducted using the SNPscan^™ Kit, and the miR-146a expression was measured by RT-qPCR. The 24-hour Visual Analogue Scale (VAS) score was utilized as an indicator to assess analgesic efficacy, and a logistic regression was employed to analyze the association between different genotypes and the effectiveness of pain relief.</p><p><strong>Results: </strong>At the rs2910164 locus, the miR-146a expression in individuals with the CC genotype was significantly lower than that in those with the GG and GC genotypes, whereas no significant difference was observed between the GG and GC genotypes. Regarding clinical characteristics, the 24-hour VAS pain score was significantly higher in the CC genotype group compared to the GG and GC genotype groups. When the GG and GC genotypes were combined and compared against the CC genotype, the difference in VAS scores remained statistically significant. Logistic regression analysis revealed a significant association between the rs2910164 polymorphism and the 24-hour VAS score (OR = 3.189, 95% CI: 1.142-8.901, <i>p</i> = 0.027).</p><p><strong>Conclusion: </strong>The CC genotype at the rs2910164 locus served as an independent risk factor associated with decreased efficacy of epidural fentanyl analgesia. However, further validation in larger multicenter studies is required before any clinical application can be considered.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2650241"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647275","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 association between mode of delivery and severe intraventricular hemorrhage in very preterm infants.","authors":"Eva Keel, Stylianos Kalimeris, Mark Adams, Beate Grass","doi":"10.1080/14767058.2026.2650951","DOIUrl":"https://doi.org/10.1080/14767058.2026.2650951","url":null,"abstract":"<p><strong>Background: </strong>Infants born before 32 weeks of gestation are at high risk of developing intraventricular hemorrhage (IVH), which is associated with significant mortality and morbidity as well as long-term neurodevelopmental impairment. There is currently a lack of consensus regarding the impact of delivery mode on these infants. Therefore, the aim of this study was to determine the association between mode of delivery and the incidence of severe intraventricular hemorrhage (sIVH) in very to extremely preterm infants born before 32 weeks of gestation.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at the University Hospital Zurich, Switzerland, using integrated obstetric and neonatal databases. Live births born between 23 + 0 and 31 + 6 weeks from 2015 to 2023 were included. Confounders were selected a priori based on a direct acyclic graph, and severe IVH incidence was compared between vaginal and cesarean delivery using univariable and multivariable logistic regression models.</p><p><strong>Results: </strong>A total of 683 infants were eligible for analysis. The proportion of children born by cesarean section was 77.5%. The incidence of sIVH in preterm infants delivered by cesarean section was 4.7% compared to 3.9% in vaginal deliveries. The univariable logistic regression analysis demonstrated no significant association between cesarean section and sIVH (OR 1.32, 95% CI 0.53-3.28, <i>p</i> = 0.529).</p><p><strong>Conclusion: </strong>In this cohort of very and extremely preterm infants, there was no significant association between the incidence of severe IVH and mode of delivery. These findings do not support cesarean sections as a preventive measure for sIVH and highlight the importance of optimizing pre-, peri-, and postnatal factors that impact haemodynamic stability.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2650951"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy-related complications and live-birth outcomes in pregnancies conceived by <i>in vitro</i> fertilization versus spontaneous conception.","authors":"Dario Colacurci, Laura Sarno, Caterina Fulgione, Laura Letizia Mazzarelli, Salvatore Tagliaferri, Gabriele Saccone, Ilenia Mappa, Martina Derme, Cristina Pajno, Ida Strina, Mirko Martirani, Carlo Alviggi, Pietro D'Alessandro, Angelo Sirico, Raffaella Di Girolamo, Luigi Carbone, Giuseppe Bifulco, Giuseppe Maria Maruotti","doi":"10.1080/14767058.2026.2654342","DOIUrl":"https://doi.org/10.1080/14767058.2026.2654342","url":null,"abstract":"<p><strong>Background: </strong><i>In vitro</i> fertilization (IVF) pregnancies are associated with an increased risk of maternal and perinatal complications. Advanced maternal age and multiple gestations are more common in IVF and may contribute to adverse outcomes. Evaluating the interaction between mode of conception and maternal age may help clarify risk profiles in IVF pregnancies.</p><p><strong>Methods: </strong>This single-center, retrospective observational study included nulliparous women who delivered from 26 weeks' gestation onward. A total of 144 IVF and 106 spontaneously conceived pregnancies were analyzed. IVF pregnancies included cycles with fresh or frozen embryo transfer and homologous or heterologous fertilization. Maternal characteristics, pregnancy complications, fetal and neonatal outcomes were compared between groups.</p><p><strong>Results: </strong>IVF pregnancies were associated with a significantly higher incidence of hypertensive disorders (17.9% vs 7.3%), and multiple pregnancies (25.9% vs 4.6%). Fetal complications, including fetal growth restriction (20% vs 7.3%), oligohydramnios (10.6% vs 2.8%), polyhydramnios (7.3% vs 0%), preterm premature rupture of membranes (6.4% vs 3%), and non-reassuring fetal heart rate patterns (17.1% vs 8%), were more frequent in IVF pregnancies. IVF pregnancies delivered at a lower gestational age (35.98 vs 37.99 weeks, <i>p</i> < .001), with lower birth weight (2244 vs 3074 g, <i>p</i> < .001), lower Apgar scores at 1 and 5 min, higher cesarean section rate (70.7% vs 52.8%), and higher NICU admission (38.8% vs 5.1%).</p><p><strong>Conclusion: </strong>IVF pregnancies were associated with increased maternal morbidity and adverse fetal and neonatal outcomes compared to spontaneous pregnancies, including hypertensive disorders, fetal growth restriction, preterm birth, cesarean delivery, and NICU admission.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2654342"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678074","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}