Journal of Maternal-Fetal & Neonatal Medicine最新文献

{"title":"The umbilical cord as a potential culprit in cases of perinatal asphyxia. A case-control study.","authors":"Luisa Natalia Gutiérrez Alfonso, Ana María Bertolotto, Yaris Vargas, Claudia Granados, Mercedes Olaya-C","doi":"10.1080/14767058.2026.2660010","DOIUrl":"https://doi.org/10.1080/14767058.2026.2660010","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the pathological features of placentas from neonates with perinatal asphyxia and to compare them with those from neonates without asphyxia.</p><p><strong>Methods: </strong>An observational case-control study was conducted, including a group of patients diagnosed with perinatal asphyxia and a comparison group without this condition.</p><p><strong>Setting: </strong>A high-complexity neonatal unit.</p><p><strong>Participants: </strong>83 neonates were included: 28 with perinatal asphyxia and 55 without asphyxia, all of whom had placental examination available.</p><p><strong>Results: </strong>Umbilical cord abnormalities were significantly associated with perinatal asphyxia, particularly cervical entanglements-both tight and loose, and increased cord diameter; also, when comparing the presence of at least one anatomical abnormality of the umbilical cord. Among maternal complications, gestational diabetes showed a significant association; among fetal complications, major malformations and non-reassuring fetal status were significantly associated.</p><p><strong>Conclusion: </strong>Intrauterine factors are closely associated with perinatal asphyxia. We highlight the role of placental pathology-particularly anatomical alterations of the umbilical cord-in elucidating its underlying mechanisms. The evidence generated may contribute to enhancing early detection and informing the development of preventive strategies.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2660010"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787598","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 impact of composite maternal & fetal ultrasound assessment on the mode of delivery in large-for-gestational-age fetuses: the macrodia trial.","authors":"Ilma F Carbone, Rasha Kamel, Francesca M P Gigli, Valentina Romagnoli, Shaimaa S Yousef, Rana M Abdella, Ibrahim F Ibrahim, Enrico Iurlaro, Vittorio Parodi, Giovanna Esposito, Enrico M Ferrazzi","doi":"10.1080/14767058.2026.2661441","DOIUrl":"https://doi.org/10.1080/14767058.2026.2661441","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate maternal and fetal determinants of unplanned operative delivery in large-for-gestational-age fetuses.</p><p><strong>Design: </strong>Prospective, non-randomized, multicenter study.</p><p><strong>Setting: </strong>Hospital-based.</p><p><strong>Population: </strong>Singleton pregnancy, not affected by gestational diabetes, with an ultrasound diagnosis of large fetuses, but not within the ACOG criteria for macrosomia.</p><p><strong>Methods: </strong>Per protocol, early induction of labor was scheduled when estimated fetal weight (EFW) and/or abdominal circumference (AC) >95^th or when EFW and/or AC between 80^th and 95^th with unfavorable maternal indices, height < 155 cm and/or subpubic angle (SPA) < 100°. Expectant management was planned in cases without these maternal unfavorable indices.</p><p><strong>Main outcome measures: </strong>Unplanned operative delivery (vacuum-assisted or cesarean section). The proportion of unplanned operative delivery was compared between groups managed per protocol. The proportion of unplanned operative delivery of recruited women who were managed in violation of protocol was also analyzed and compared with that of those managed per protocol. The EFW to subpubic angle ratio (EFW/SPA) and the head circumference to subpubic angle ratios (HC/SPA) were evaluated by ROC analysis, and adjusted relative risks (RRs) for unplanned operative delivery were estimated using Poisson regression on the entire study population.</p><p><strong>Results: </strong>Of the 223 patients included, 127 were managed per protocol (102 early induction, 25 expectant), while 96 were managed at clinicians discretion. Unplanned operative deliveries were more frequent among women induced per protocol than among those managed expectantly (52.9% vs. 12.0%; <i>p</i> < 0.01). We also found that women who should have been induced per protocol, but underwent expectant management had a similar higher proportion of unplanned operative deliveries (59.6%). In multivariable analysis, EFW/SPA ratio ≥34.78 (RR = 1.71) and HC/SPA ratio ≥3.30 (RR = 1.39) - the optimal ROC-derived cutoffs - were associated with a higher risk of unplanned operative delivery.</p><p><strong>Conclusions: </strong>Unplanned operative delivery was associated with unfavorable fetal biometry/maternal-subpubic-angle ratios, which may help identify women at higher risk, providing a promising additional support for individualized delivery management.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2661441"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787648","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":"Vaginal trial outcomes and emergency cesarean section factors among women with different classifications of hypertensive disorders of pregnancy.","authors":"Yu Zhang, Jingli Sun, Jian Shen","doi":"10.1080/14767058.2026.2648161","DOIUrl":"https://doi.org/10.1080/14767058.2026.2648161","url":null,"abstract":"<p><strong>Background: </strong>Hypertensive disorders of pregnancy (HDP) are a prevalent complication and a leading cause of maternal and perinatal mortality. While vaginal delivery is generally possible for most women with HDP, there is no standardized framework detailing variations in vaginal delivery outcomes across different HDP classifications or identifying the factors influencing emergency cesarean section (EmCS).</p><p><strong>Objective: </strong>To explore the vaginal trial outcomes and risk factors associated with emergency cesarean section among women with different classifications of HDP.</p><p><strong>Methods: </strong>This was a single-center retrospective cohort study of 894 pregnant women with HDP who underwent a vaginal trial. Of these, 584 were diagnosed with gestational hypertension, 216 with pre-eclampsia, and 94 with chronic hypertension. The study collected and compared detailed maternal and perinatal outcomes.</p><p><strong>Results: </strong>(1) The success rate of vaginal delivery ranged from 85.1% to 90.8% across various classifications of HDP without significant differences. (2) Chronic hypertension was four times more likely to lead to intrapartum poorly controlled blood pressure than gestational hypertension. (3) Factors influencing EmCS in HDP included parity, antepartum BMI, labor induction, intrapartum fever, intrapartum antihypertensive use, and oxytocin during stages of labor. Parity served as an independent protective factor across all HDP classifications. Stratified analysis revealed that for gestational hypertension, risk factors included antepartum BMI ≥ 30 kg/m², labor induction, and intrapartum antihypertensive use. For pre-eclampsia, oxytocin and intrapartum fever were risk factors. In chronic hypertension, antepartum BMI ≥ 30 kg/m² and intrapartum fever were identified as risk factors, although the former was not significant.</p><p><strong>Conclusion: </strong>The success rate of vaginal trials across various classifications of HDP is high. Vaginal trial can impact intrapartum blood pressure, particularly for women with chronic hypertension. Tailored management strategies should include encouraging vaginal trial for multiparous women, control of antepartum BMI, judicious use of labor induction, and vigilant monitoring of hypertension and fever, with individualized evaluation and treatment based on HDP classification.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2648161"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845468","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":"Ultrasonographic characteristics and outcome of fetal intrahepatic umbilical-porto-systemic venous shunts: a single-center study.","authors":"Jianjun Liu, Ying Chen, Yafang Xue, Mei Qiu, Yanli Guo","doi":"10.1080/14767058.2025.2603040","DOIUrl":"https://doi.org/10.1080/14767058.2025.2603040","url":null,"abstract":"<p><strong>Objective: </strong>To investigate fetal intrahepatic umbilical-portal-systemic venous shunts (IHUPSVS).</p><p><strong>Methods: </strong>The study retrospectively analyzed cases of IHUPSVS at a single center from January 2015 to December 2024. Ultrasonographic features, IHUPSVS types, and postnatal outcomes were recorded and followed up.</p><p><strong>Results: </strong>Overall, 30 IHUPSVS cases, including 22 Type I (17 Ia and five Ib), two Type II, three Type III, and three Type IV cases, were identified. As gestational age increased, compensatory dilation of the hepatic artery (HA), cardiomegaly, fetal growth restriction (FGR), and abnormal hemodynamics became more prevalent. Type I was mainly linked to FGR. Types II and III showed compensatory dilation of the HA and cardiomegaly. All types were associated with fetal structural malformations, with Type IV being the most prominent. Eleven pregnancies were terminated, and 19 live births occurred, with natural closure.</p><p><strong>Conclusion: </strong>Prenatal ultrasound is useful for diagnosing IHUPSVS, monitoring fetal growth and hemodynamics, and predicting prognosis by IHUPSVS types.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2603040"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890339","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 needs of women with normal vaginal deliveries during the postpartum period in China: a longitudinal qualitative study.","authors":"Li Binxia, Yin Lina, Lv Xingxing, Yuan Yufan","doi":"10.1080/14767058.2026.2626660","DOIUrl":"https://doi.org/10.1080/14767058.2026.2626660","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the changes in needs among postpartum women and provide a reference for the development of scientific and effective targeted nursing interventions.</p><p><strong>Methods: </strong>We conducted a longitudinal qualitative study of 18 postpartum women who initially experienced normal vaginal deliveries in China. Participants were selected using a purposive sampling method, and semi-structured interviews were conducted at twenty-four hours, three days, two weeks, and forty-two days during the postpartum period. The study was designed using a phenomenological approach and the data were analyzed using a social-ecological framework.</p><p><strong>Results: </strong>The study extracted three main themes and eleven subthemes: the micro system (including needs for scientific newborn care guidance, needs for nursing of maternal physiological discomfort, needs for breastfeeding guidance, and Needs for dynamic psychological care of Postpartum), the meso system (including needs for single - room of the ward environment, needs for online consultation after discharge, needs for health education for family members), and the macro system (including needs for birth certificate policy optimization, needs for comprehensive guidance on vaccination, needs for home visit to optimize, and needs for standardized education implementation and personalized, dynamic learning).</p><p><strong>Conclusion: </strong>This study indicates that the needs of women who have undergone normal vaginal delivery undergo a dynamic change process. Consequently, clinical medical staff should develop health education programs and provide personalized and precise interventions based on varying needs at different stages of the postpartum period.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2626660"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144317","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":"Incidence and outcome of major perinatal comorbidities of all hospitalized neonates requiring intensive and critical care: a livebirth population-based survey.","authors":"Xiaoxue Zhang, Shufen Zhai, Zhimin Zhao, Liujun Li, Baojun Qiao, Zhijie Wen, Jinxia Li, Meifang Wang, Peng Wei, Yaling Xu, Xiaojing Guo, Bo Sun, Limin Ma, Hongxin Wang, Xiaoling Zhao, Zhihong Wang, Xueliang Li, Suying Du, Xianjie Wang, Shuying Shi, Yongshuang Dong, Hongchao Zhang, Pingchang Fang, Ming Yue, Yunze Guo, Shuli Zhang, Jianying Zhang, Heai Han, Qiaoling Li, Bingchen Wang, Shuyi Feng, Yun Yang, Hongwei Ning, Libin Dong, Tao Liu, Zhaohua Wen, Xingyu He, Zhengang Zhao, Jing Guo, Yan Wang, Yanling Ma, Jianying Li, Xiaojuan He, Yuhua Yin, Jingli Gao, Xiaoyun Jia, Xinguo Miao","doi":"10.1080/14767058.2025.2540470","DOIUrl":"https://doi.org/10.1080/14767058.2025.2540470","url":null,"abstract":"<p><strong>Objectives: </strong>Prevalence, outcome and causal implication of neonatal survival-associated major morbidities remain the central focus of quality improvement of maternal-fetal and neonatal medicine. We aimed to estimate baseline information of neonatal intensive and critical care by analyzing surviving data of all hospitalized neonates from livebirth population.</p><p><strong>Subjects and methods: </strong>We prospectively collected a datafile consisting of 10,840 (13.72%) cases as all hospitalized neonates from 79,012 livebirths in Handan in 2020, a sub-provincial region with 9.41 million population and intermediate-to-high level of socioeconomic development in north China. The diagnoses of diseases requiring intensive and/or critical care, and causes of deaths, were categorized, and perinatal and disease-specific risks of death were estimated by multivariable logistic regression models.</p><p><strong>Results: </strong>Livebirth-based incidence of major perinatal comorbidities were 19.7‰ for congenital pneumonia/early onset sepsis, 12.1‰ intraventricular hemorrhage, 8.7‰ birth asphyxia, 8.7‰ respiratory distress syndrome (RDS), 7.7‰ sepsis and 6.8‰ congenital anomalies (CA). Case-fatality rate (cause-specific mortality rate referring to livebirths) of major diseases were 47.1% (0.2‰) pulmonary hemorrhage, 26.9% (0.1‰) necrotizing enterocolitis, 15.6% (0.2‰) late onset sepsis, 14.1% (1.2‰) RDS, 11.3% (0.8‰) CA, and 11% (1.0‰) asphyxia. There were 242 (2.2%) died in hospital (3.1‰ of all livebirths), 52.1% being in the preterm, 49.2% in low birthweight, and <40% in those <28 weeks of gestation, or <1000 g birthweight, respectively. Death risks associated with the perinatal and neonatal morbidities were markedly declined with variable magnitudes as estimated by multivariable logistic regression models.</p><p><strong>Conclusions: </strong>The incidence rates of major perinatal comorbidities, neonatal mortality rates, and major risks to the overall and specific outcome of all the hospitalized neonates in Handan, denote baseline characteristics and efficiency of the regional perinatal-neonatal care system.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2540470"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144341","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":"Baseline serum AMH‑to‑FSH ratio, menstrual pattern, and risk of intra‑uterine adhesion recurrence: a prospective multi‑state Markov model study.","authors":"Jiying Li, Jin Yan, Hongwen Hu, Yin Li, Xiao Yang, Chaoyu Dong, Ziyu Guo, Huanhuan Shen","doi":"10.1080/14767058.2025.2606539","DOIUrl":"https://doi.org/10.1080/14767058.2025.2606539","url":null,"abstract":"<p><strong>Background: </strong>Intra-uterine adhesion (IUA) frequently recurs after hysteroscopic adhesiolysis, undermining menstruation and fertility. We aimed to determine whether baseline serum anti‑Müllerian hormone (AMH)‑to-follicle‑stimulating hormone (FSH) ratio and menstrual pattern independently and jointly predict IUA severity transitions after adhesiolysis using a multi‑state Markov model.</p><p><strong>Methods: </strong>We conducted a single-center prospective study of 210 women (18-45 years) undergoing first adhesiolysis for moderate-to-severe IUA. Baseline serum AMH and FSH were measured and menstrual pattern was classified as normal, hypomenorrhea, or amenorrhea. Hysteroscopy at 3, 6, 12, and 24 months defined four severity states (none, mild, moderate, severe) and two absorbing outcomes (pregnancy ≥ 12 weeks, repeat surgery). Continuous-time multi-state Markov models estimated transition-specific adjusted hazard ratios (HRs) with 95% confidence intervals (CIs), controlling for age, body-mass index (BMI), baseline adhesion severity, and adjuvant therapy. Internal validation used 200-bootstrap c-index and calibration.</p><p><strong>Results: </strong>Of 210 participants, 83 women (39.5%) had any recurrence and 28 (13.3%) progressed to severe adhesions. Pregnancy ≥ 12 weeks occurred in 54 (25.7%) and repeat surgery in 36 (17.1%). Each one-standard-deviation decrease in AMH/FSH increased hazards from mild to moderate (adjusted HR 1.81, 95% CI 1.29-2.54) and from moderate to severe (HR 2.15, 95% CI 1.41-3.28), with a non-significant trend from none to mild (HR 1.20, 95% CI 0.95-1.52). Amenorrhea versus normal was associated with higher hazards for none to mild (HR 1.88, 95% CI 1.23-2.99) and mild to moderate (HR 1.55, 95% CI 1.10-2.18). An interaction suggested that amenorrhea amplified the adverse effect of a low AMH/FSH ratio on progression to severe disease (HR 1.39, 95% CI 1.03-1.88). The model showed good performance, with bootstrap‑corrected C‑index 0.78 (95% CI 0.74-0.82), optimism‑corrected C‑index 0.76, and optimism‑corrected calibration slope 0.94.</p><p><strong>Conclusions: </strong>Baseline endocrine status summarized by the AMH/FSH ratio and menstrual pattern independently and jointly predict IUA dynamics after adhesiolysis. A biomarker-based, multi-state risk tool may help personalize severity-anchored surveillance and re-intervention after adhesiolysis.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2606539"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047343","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":"Perceptual distortions during simultaneous continuous monitoring of fetal and maternal heart rate in laboring patients.","authors":"Elisabeth J Ploran, Lizelle Comfort, Andrew Rausch, Jackson T Snellings, Burton Rochelson","doi":"10.1080/14767058.2026.2614837","DOIUrl":"https://doi.org/10.1080/14767058.2026.2614837","url":null,"abstract":"<p><strong>Objective: </strong>Our previous work examined the effect on assessment of fetal well-being when presenting twin fetal heart rate tracings (FHRT) simultaneously on screen. To further examine the potential impact of subconscious perceptual influences on fetal well-being, the current study presented singleton FHRT with and without simultaneous presentation of maternal heart rate in a within-subjects design. Tracings were taken from archival cases with either normal or abnormal Apgar scores to identify differential impact depending on final outcome. All tracings were evaluated for variability, accelerations, decelerations, and overall concern.</p><p><strong>Study design: </strong>Obstetrical medical professionals (nurses, physician assistants, and physicians; <i>N</i> = 32) assessed FHRTs from 20 singleton gestations that resulted in live births (half with normal Apgar scores (control group), half with a 5-minute Apgar < 7 (at-risk group)) presented either alone or with maternal heart rate on the same tracing. Nurses were naïve to the fact that the fetal heart rate tracings presented in the unpaired condition were the same as those presented in the paired condition. Within-subjects assessments were then compared between the two conditions.</p><p><strong>Results: </strong>Each nurse participant completed ratings on four metrics for each of 20 singleton gestations across two conditions, plus rated three tracings per condition again to determine test-retest reliability within each condition (52 FHRT assessments, 208 metrics total per participant). The intraobserver impact of visual context was calculated as the frequency of changed opinions regarding an individual metric (e.g. variability) between the paired and unpaired contexts for control versus at-risk FHRT. Participants demonstrated substantial self-agreement when assessing variability, accelerations, and decelerations for control FHRT, but only moderate agreement for the same metrics when assessing at-risk FHRT. In addition, assessment of level of concern demonstrated moderate intraobserver agreement for control FHRT but lowered to only slight agreement for at-risk FHRT.</p><p><strong>Conclusions: </strong>The simultaneous presentation of fetal heart rate tracings with maternal heart rate tracings introduces both intraobserver and interobserver variances in interpretation of decelerations and overall level of concern, particularly for at-risk FHRT. These changes in interpretation are likely due to the influence of subconscious perceptual decision-making and additional cognitive load in separating multiple streams of information. This may theoretically affect outcomes in cases in which visual information is nuanced. Medical professionals may want to exercise caution when adding more than one tracing to the visual array, as it may affect decision-making.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2614837"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999686","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":"Early essential newborn care for late preterm and term infants delivered by cesarean section: a randomized controlled trial on neonatal hypoglycemia and breastfeeding.","authors":"Jie Liu, Wen-Jun Ji, Zhi-Tong Qu, Jia Qiao","doi":"10.1080/14767058.2026.2612852","DOIUrl":"https://doi.org/10.1080/14767058.2026.2612852","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of Early Essential Newborn Care (EENC) on neonatal hypoglycemia and breastfeeding in late preterm and term cesarean-born infants.</p><p><strong>Methods: </strong>In this RCT, infants were randomly assigned to the EENC group (immediate skin-to-skin contact and early breastfeeding) or the control group (standard care). Blood glucose was measured at 1, 3, and 6 h post-birth. Breastfeeding outcomes included the onset of lactogenesis II and exclusive breastfeeding at discharge. Time to first breastfeeding was recorded solely as a process fidelity check to confirm intervention adherence. We used multiple imputation as the primary analysis for missing data and conducted pre-specified sensitivity analyses, including a complete-case analysis.</p><p><strong>Results: </strong>Infants in the EENC group had significantly higher blood glucose levels at 1 h (aMD = 11.56 mg/dL [95%CI: 8.85, 14.27]), 3 h (aMD = 9.06 mg/dL [95%CI: 7.08, 11.04]), and 6 h (aMD = 6.83 mg/dL [95%CI: 5.31, 8.36]) post-birth, compared to the control group (all <i>p</i> < 0.001). The RR for hypoglycemia was significantly lower in the EENC group (RR = 0.88, [95%CI: 0.80, 0.96], <i>p</i> = 0.006). Additionally, mothers in the EENC group experienced earlier onset of lactogenesis II (aMD=-8.82 h [95%CI: -10.23, -7.41], <i>p</i> < 0.001), and had a higher rate of exclusive breastfeeding (RR = 1.31 [95% CI: 1.02, 1.26], <i>p</i> = 0.022). Sensitivity analyses yielded consistent directions for primary glycemic and breastfeeding outcomes.</p><p><strong>Conclusion: </strong>The EENC improves neonatal glucose regulation and breastfeeding in cesarean-born late preterm and term infants, potentially enhancing neonatal health, maternal-infant bonding, and postpartum transition.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2612852"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960790","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":"Clinical value of magnetic resonance imaging in the early diagnosis of cervical insufficiency in pregnancy.","authors":"Zhili Zheng, Neng Wang, Yijiang Huang, Guoqun Mao, Shuangshuang Zhao, Gaofeng Tu, Lili Weng, Zhiping Zhang, Fuquan Wei","doi":"10.1080/14767058.2026.2629084","DOIUrl":"https://doi.org/10.1080/14767058.2026.2629084","url":null,"abstract":"<p><strong>Background: </strong>Cervical insufficiency (CI) is a leading cause of mid-to-late trimester pregnancy loss, making early and accurate diagnosis critical. While clinical diagnosis primarily relies on transvaginal ultrasound (TVUS), its limitations in visualizing cervical microstructure are recognized. High-resolution magnetic resonance imaging (MRI) offers exceptional soft-tissue contrast, potentially enabling a detailed assessment. This study aimed to explore the descriptive imaging features of MRI in suspected CI.</p><p><strong>Materials and methods: </strong>This retrospective study enrolled 77 pregnant women with clinically suspected CI between June 2021 and October 2023. All patients underwent TVUS, and a subset (<i>n</i> = 43) also received MRI. Imaging features, including anatomical visualization quality, endocervical dimensions, and specific MRI findings, were evaluated and described.</p><p><strong>Results: </strong>MRI demonstrated significantly superior anatomical visualization compared to TVUS, with satisfaction rates of 100% vs. 67.53% for internal os depiction, 100% vs. 83.11% for external os, and 65.12% vs. 54.55% for amniotic sac protrusion (all <i>p</i> < 0.05). Quantitative measurements revealed a greater endocervical width on MRI (23.47 ± 14.83 mm) compared to ultrasound (12.78 ± 8.41 mm; <i>p</i> = 0.001). Furthermore, MRI detected specific features not visualized by ultrasound, including pericervical defects (88.4%), stromal changes (83.7%), and the \"dirty sign\" (53.5%). Due to inherent incorporation bias in the reference standard, comparative diagnostic accuracy metrics between modalities were not calculated or reported.</p><p><strong>Conclusion: </strong>MRI demonstrates particular promise as a complementary diagnostic tool for cervical insufficiency when ultrasound findings are inconclusive, providing superior anatomical visualization and detecting unique imaging features. The observed association between cervical canal width and CI requires validation in prospective studies designed to mitigate verification and incorporation biases.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"39 1","pages":"2629084"},"PeriodicalIF":1.6,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203677","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}