Journal of Maternal-Fetal & Neonatal Medicine最新文献

{"title":"The association of persistent maternal hypotension with abnormal uterine Dopplers.","authors":"Stephanie Pearson, Baillie Bronner, Annie Dude, Samantha de Los Reyes","doi":"10.1080/14767058.2025.2482662","DOIUrl":"10.1080/14767058.2025.2482662","url":null,"abstract":"<p><strong>Objective: </strong>We aim to evaluate the association of persistent hypotension and abnormal placental hypoperfusion.</p><p><strong>Methods: </strong>We performed a secondary analysis of the Nulliparous Pregnancy Outcomes Study of patients with a singleton gestation with persistent hypotension and complete uterine artery (UtA) data. Persistent hypotension was defined as systolic blood pressure <100 mmHg and/or diastolic blood pressure <60 mmHg at all three study visits between 6 0/7 and 29 6/7 weeks gestation. The primary outcome was abnormal UtA Dopplers (pulsatility index >95th percentile for gestational age or presence of a diastolic notch) measured between 18 0/7 and 23 6/7 weeks gestation. Univariable analyses were performed to evaluate demographic and clinical associations with the primary outcome. Multivariable analyses (MVAs) were performed to adjust for potential confounders selected a priori (age, insurance status, pre-pregnancy body mass index (BMI), and history of chronic hypertension).</p><p><strong>Results: </strong>Five thousand two hundred and eighteen patients met inclusion criteria; 140 (2.7%) had persistent hypotension, 5078 (97.3%) did not. Patients in the hypotension group were less likely to be of White race and Asian ethnicity, and more likely to have public insurance and have a lower pre-pregnancy BMI, and more likely to use tobacco within 3 months of pregnancy. In unadjusted analysis, patients with persistent hypotension were more likely to have abnormal UtA Dopplers (45.0 vs. 35.3%, <i>p</i> value .017) but these findings did not persist in MVA (aOR 1.39, 95%CI 0.98, 1.95).</p><p><strong>Conclusions: </strong>Patients with persistent hypotension were not at an increased risk of abnormal UtA Dopplers.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2482662"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774488","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":"Effectiveness of the Triple P Procedure and its modifications on reducing the blood loss and peripartum hysterectomy rates in women with Placenta Accreta Spectrum (PAS): a review of published literature.","authors":"Ilenia Mappa, Silvia Espuelas Malon, Francesco D'Antonio, Edwin Chandraharan","doi":"10.1080/14767058.2025.2452920","DOIUrl":"https://doi.org/10.1080/14767058.2025.2452920","url":null,"abstract":"<p><strong>Background: </strong>Placenta Accreta Spectrum (PAS) disorders has been reported to be associated with a maternal mortality rate of 7-10%, worldwide, and many women who survive, experience life changing morbidity. Triple P procedure (<b>p</b>- perioperative placental localization and incision on the myometrium above the upper border of the placenta; <b>p</b>- pelvic devascularisation; and <b>p</b>-placental non-separation and myometrial excision) was developed in 2010 as a novel conservative alternative to peripartum hysterectomy to avoid severe maternal morbidity and mortality). There have been several modifications to the original Triple P Procedure to achieve \"pelvic devascularisation\" based on locally available resources.</p><p><strong>Objective: </strong>To determine the effectiveness of the Triple P Procedure and its modifications on reducing the blood loss and the rate of peripartum hysterectomy in women who were diagnosed to have placental accreta spectrum (PAS) by reviewing the published literature.</p><p><strong>Materials and methods: </strong>PubMed, Embase and Google Scholar Search searches were made using \"Triple P\" and \"Modified Triple P.\" Papers selected were assessed independently for content, data extraction and analysis. The following parameters were included for the analysis: total number of cases, total EBL, need for blood transfusion, injury to adjacent pelvic organs (urinary bladder, ureter, bowel), need for embolization, admission to intensive care unit (ICU), post-operative in-patient hospital stay, peripartum Hysterectomy, for \"Modified\" Triple P Procedure, the nature of the modification.Study characteristics were extracted using a predesigned data extraction table.</p><p><strong>Results: </strong>The literature search identified 6 articles on the Triple P Procedure and 8 articles on the modified Triple P Procedure which were deemed eligible for analysis and comparison, based on the inclusion criteria. 75 patients had the Triple P procedure with an estimated mean blood loss of 2.31 L and a blood transfusion rate of 52%. The bladder injury rate was only 1.3%. None of the patients had a peripartum hysterectomy. Overall, 654 patients had the Modified Triple P procedure with an estimated mean blood loss of 1.4 L and a blood transfusion rate of 64.5%. The mean hospital stay was 3.86 days and 6.1% had a peripartum hysterectomy.</p><p><strong>Conclusion: </strong>The Triple P Procedure and the Modified Triple P procedure are associated with lower estimated blood loss as compared to the reported rates with a peripartum hysterectomy. The Triple P Procedure was associated with lower rates of inadvertent injuries to the bladder and ureters as compared to the Modified Triple P Procedure and reported rates with peripartum hysterectomy. Both the Triple P and the Modified Triple P Procedure are associated with very low rates of peripartum hysterectomy (0% and 6.1%, respectively).</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2452920"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015378","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":"Extracorporeal membrane oxygenation in pregnancy and the post-partum period: a systematic review and meta-analysis.","authors":"Sijie Lu, Yantao Zhang, Shilin Wei, Jian Li, Mingming Li, Junjie Ying, Dezhi Mu, Yujun Shi, Yongnan Li, Xiangyang Wu","doi":"10.1080/14767058.2025.2457002","DOIUrl":"https://doi.org/10.1080/14767058.2025.2457002","url":null,"abstract":"<p><strong>Objective: </strong>There is an increase in the application data of Extracorporeal Membrane Oxygenation (ECMO) in perinatal women, particularly since the outbreak of coronavirus disease 2019. Therefore, we reviewed publications on the use of ECMO in pregnant and postpartum women and analyzed the maternal and fetal outcomes, updated the progress of ECMO in perinatal women.</p><p><strong>Methods: </strong>We conducted a systematic literature search across PubMed, EMBASE, Cochrane Library, and the International Clinical Trials Registry (ICTRP), yielding 30 eligible clinical studies that investigated the application of ECMO during pregnancy. A comprehensive data extraction process was implemented to retrieve information from these selected studies. A single rate analysis on material survival, material harmonic compilations, and fetus survival were performed by R software.</p><p><strong>Results: </strong>Of the 1460 women included, our primary outcome was maternal survival: 74.4% (95% confidence interval [CI]: 67.8%-81.1%). Among them, the survival rate of VV ECMO patients was 83.6% (95% confidence interval [CI]: 76.4%-90.8%); the survival rate of VA ECMO patients was 62.8% (95% confidence interval [CI]: 48.7%-76.8%). The secondary outcomes were maternal hemorrhagic complications: 34.8% (95% [CI]: 24.1%-45.5%), and fetal survival: 73.2% (95% [CI]: 62.0%-84.4%).</p><p><strong>Conclusions: </strong>Our analysis revealed that the outcomes of ECMO (both type) use in pregnant patients may be comparable or superior to those observed in non-pregnant cohorts. Moreover, patients treated with VV ECMO exhibited a significantly higher survival rate compared to those on VA ECMO.</p><p><strong>Details of registration: </strong>The protocol for this systematic review was registered on INPLASY (2022110036) in 11 November 2022.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2457002"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068876","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 ultrasound for the diagnosis of the cerebellar abnormalities: a meta-analysis.","authors":"Zhen Sun, Yanqiu Chen, Qichen Su","doi":"10.1080/14767058.2025.2453997","DOIUrl":"https://doi.org/10.1080/14767058.2025.2453997","url":null,"abstract":"<p><strong>Objective: </strong>Fetal cerebellar abnormalities are associated with neurodevelopmental disorders and structural brain malformations. Accurate and early diagnosis is crucial for prenatal counseling and planning postnatal interventions. While prenatal ultrasound is a key tool for detecting fetal brain abnormalities, variations in diagnostic accuracy across studies necessitate a systematic evaluation of its effectiveness in diagnosing cerebellar abnormalities.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across major databases to identify relevant studies on prenatal ultrasound for diagnosing cerebellar anomalies. Inclusion criteria included studies with clear diagnostic outcomes, diverse patient populations, and standardized ultrasound protocols. Meta-analytic techniques were employed to assess overall diagnostic accuracy, sensitivity, specificity, and heterogeneity using Meta Disk. The quality of the included studies was evaluated using the QUADAS-2 tool.</p><p><strong>Results: </strong>The meta-analysis included fifteen studies involving 1,902 fetuses with suspected cerebellar abnormalities. The pooled sensitivity and specificity of prenatal ultrasound were 0.83 (95% CI: 0.80-0.86) and 0.97 (95% CI: 0.96-0.98), respectively. The positive likelihood ratio was 7.96 (95% CI: 3.23-19.64), the negative likelihood ratio was 0.18 (95% CI: 0.09-0.36), and the odds ratio was 46.76 (95% CI: 14.06-155.53). The combined area under the curve (AUC) reached 0.93, indicating robust diagnostic performance. Heterogeneity was observed, influenced by factors such as gestational age at screening, operator expertise, and ultrasound equipment quality.</p><p><strong>Conclusions: </strong>Prenatal ultrasound is a reliable tool for detecting cerebellar abnormalities with high sensitivity and specificity. However, variability in diagnostic performance suggests the need for standardized protocols and advanced imaging techniques to enhance accuracy. Future research should focus on integrating multiple imaging modalities to optimize prenatal screening outcomes.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2453997"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048197","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":"Recurrent pregnancy loss: risk factors and predictive modeling approaches.","authors":"Xiaoyu Zhang, Jiawei Gao, Liuxin Yang, Xiaoling Feng, Xingxing Yuan","doi":"10.1080/14767058.2024.2440043","DOIUrl":"10.1080/14767058.2024.2440043","url":null,"abstract":"<p><strong>Purpose: </strong>This review aims to identify and analyze the risk factors associated with recurrent pregnancy loss (RPL) and to evaluate the effectiveness of various predictive models in estimating the risk of RPL. The review also explores recent advancements in machine learning algorithms that can enhance the accuracy of these predictive models. The ultimate goal is to provide a comprehensive understanding of how these tools can aid in the personalized management of women experiencing RPL.</p><p><strong>Materials and methods: </strong>The review synthesizes current literature on RPL, focusing on various risk factors such as chromosomal abnormalities, autoimmune conditions, hormonal imbalances, and structural uterine anomalies. It also analyzes different predictive models for RPL risk assessment, including genetic screening tools, risk scoring systems that integrate multiple clinical parameters, and machine learning algorithms capable of processing complex datasets. The effectiveness and limitations of these models are critically evaluated to provide insights into their clinical application.</p><p><strong>Results: </strong>Key risk factors for RPL were identified, including chromosomal abnormalities (e.g. translocations and aneuploidies), autoimmune conditions (e.g. antiphospholipid syndrome), hormonal imbalances (e.g. thyroid dysfunction and luteal phase defects), and structural uterine anomalies (e.g. septate or fibroid-affected uteri). Predictive models such as genetic screening tools and risk scoring systems were shown to be effective in estimating RPL risk. Recent advancements in machine learning algorithms demonstrate potential for enhancing predictive accuracy by analyzing complex datasets, which may lead to improved personalized management strategies.</p><p><strong>Conclusions: </strong>The integration of risk factors and predictive modeling offers a promising approach to improving outcomes for women affected by RPL. A comprehensive understanding of these factors and models can aid clinicians and researchers in refining risk assessment and developing targeted interventions. The review underscores the need for further research into specific pathways involved in RPL and the potential of novel treatments aimed at mitigating risk.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2440043"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856538","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":"Real-world use of a vacuum-induced hemorrhage-control device in births <34 weeks gestational age.","authors":"Kara M Rood, Angela Bianco, Joseph R Biggio, Marcela C Smid, Hyagriv N Simhan, James Li, Candice Yong, Patricia I Carney, Damien J Croft, Dena Goffman","doi":"10.1080/14767058.2025.2451658","DOIUrl":"https://doi.org/10.1080/14767058.2025.2451658","url":null,"abstract":"<p><strong>Introduction: </strong>The Jada System^® is an FDA-cleared vacuum-induced hemorrhage-control device for the control and treatment of abnormal postpartum uterine bleeding or hemorrhage when conservative management is warranted. The instructions for use for Jada contain a warning stating that the safety and effectiveness of the Jada System in delivery at a gestational age less than 34 weeks or, if multiples, uterus judged less than 34 weeks size, have not been established. While the primary analysis of the RUBY registry, an 800 subject post-approval RWE study of the usage of Jada, included 50 individuals who had preterm births less than 34 weeks gestational age (wGA), the safety and outcomes were not evaluated specifically for less than 28 wGA and 28 to less than 34 wGA subgroups.</p><p><strong>Methods: </strong>We conducted a descriptive subgroup analysis of the real-world RUBY registry to assess the safety and effectiveness of Jada for postpartum hemorrhage management in preterm births less than 34 weeks (less than 28 wGA and 28 to less than 34 wGA). Of the 50 individuals treated, 24 had vaginal births and 26 had cesarean births.</p><p><strong>Results: </strong>Treatment success rates were 85.7% at less than 28 wGA (81.8% vaginal [9/11], 100% cesarean [3/3]) and 88.9% at 28 to less than 34 wGA (100% vaginal [13/13], 82.6% cesarean [19/23]). No maternal deaths, uterine perforations, device expulsions, or serious adverse device effects (ADEs) were reported in either subgroup. Two nonserious ADEs were reported in 1 individual (endometritis and bacterial vaginosis); 2 individuals required hysterectomy (1 vaginal, 1 cesarean).</p><p><strong>Conclusion: </strong>Results for the less than 28 wGA and 28 to less than 34 wGA subgroups were consistent with the overall less than 34 wGA subgroup, which was previously shown to be consistent with births ≥34 wGA; however, continued attention to uterine size is warranted before device placement in births less than 34 wGA.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov; NCT04995887.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2451658"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383940","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":"Feasibility of fetal cardiac biometry measurement at 11-14 weeks scan - a cross-sectional study.","authors":"Shwetha K S, Roopa P S, Akhila Vasudeva","doi":"10.1080/14767058.2025.2477774","DOIUrl":"https://doi.org/10.1080/14767058.2025.2477774","url":null,"abstract":"<p><strong>Objective: </strong>To study the feasibility of fetal cardiac biometry measurement between 11 and 14 weeks in low-risk singleton pregnancies.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at a single tertiary care center between June 2022 and March 2024 in 129 singleton low-risk mothers in the South Indian population. All subjects included in the study underwent early fetal echocardiography at 11-14 weeks of gestation. The parameters interrogated were the heart length, heart width, heart circumference and area, chest circumference, ventricular chamber length and width, the transverse diameter of aortic and pulmonary annulus, and the transverse diameter of aortic isthmus.</p><p><strong>Results: </strong>In our study, the success rate of measuring the fetal heart biometry was 33% at 11 weeks, 72% at 12 weeks, and 77% at 13 weeks, respectively. Measurements of outflow tracts and aortic isthmus were difficult. The exclusion of aortic isthmus diameter from the biometric parameters increased the success rate to 50% at 11; weeks, and 80% at 12 and 13 weeks, respectively. Maternal body mass index, any abdominal scar from previous surgeries, and position of placenta had no statistically significant correlation with feasibility of cardiac biometry.</p><p><strong>Conclusions: </strong>Our study showed early fetal cardiac biometry is feasible. These measurements can be a helpful tool in the generation of nomograms for the population which can aid early identification of congenital cardiac defects, their follow-up and prognostication.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2477774"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659291","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 utility of a glycosylated fibronectin test (Lumella^TM) for assessment of impending preeclampsia.","authors":"Gian Carlo Di Renzo, Maurizio Arduini, Jose Luis Bartha, Alizee Froeliger, Jan Stener Jorgensen, Marian Kacerovsky, Pawel Stanirowski, Miroslaw Wielgos, Lina Gao, Michael G Gravett","doi":"10.1080/14767058.2025.2474674","DOIUrl":"https://doi.org/10.1080/14767058.2025.2474674","url":null,"abstract":"<p><strong>Objective: </strong>Preeclampsia is a major pregnancy complication that results in significant maternal and infant mortality and morbidity, yet difficulties remain in the diagnosis of preeclampsia based on clinical parameters alone. The objective was to assess the performance of a hand-held point-of-care (POC) immunoassay in a clinical environment for glycosylated fibronectin (GlyFn) for the prediction of preeclampsia within 4 weeks of sampling.</p><p><strong>Methods: </strong>Multinational European prospective observational pilot study of predominantly high-risk patients in the second half of pregnancy to assess a point-of-care immunoassay for GlyFn in predicting preeclampsia within 4 weeks of sampling. GlyFn was measured using a second generation hand held POC immunoassay. Results were considered normal for GlyFn concentrations of < 350 µg/mL, positive for GlyFn concentrations of 351-600 µg/mL, and high-positive for GlyFn concentrations > 600 µg/mL.</p><p><strong>Results: </strong>Preeclampsia developed in 16 (19%) of 84 subjects and was associated with a shorter gestational age at delivery 35.3 weeks vs. 37.3 weeks for non-preeclamptics, <i>n</i> = 82; <i>p</i> = 0.001), a higher risk of fetal growth restriction (FGR; 31.2% vs. 10.3% for non-preeclamptics, <i>p</i> = 0.046), and an increased risk of preterm birth < 37 weeks gestation (83.3% vs. 33.3% for non-preeclamptics, (<i>n</i> = 78; <i>p</i> = 0.003). GlyFn positive or high positive was seen in 13/16 (81%) and in 35/68 (51.5%), yielding a sensitivity of 81%, a specificity of 49%, a positive predictive value of 27%, and a negative predictive value of 92%. GlyFn positive or high positive was also associated with preterm birth < 37 weeks in singleton pregnancy non-preeclamptic patients. Preterm birth occurred in 4.8% of those with normal GlyFn, in 26.7% with positive GlyFn, and in 50% of those with high GlyFn in singleton gestations without preeclampsia (<i>p</i> = 0.008).</p><p><strong>Conclusion: </strong>The ability to use this test in a POC format provides a method for practitioners to quickly determine risk for preeclampsia in their pregnant patients and offers an affordable alternative, as a single analyte to other diagnostic or screening tests that require laboratory-based testing or ultrasound equipment. Independent of preeclampsia, an elevated GlyFn was also correlated with preterm delivery and requires further study.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2474674"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574491","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":"Characteristics in patients with unexplained recurrent spontaneous abortion and the impact on immune, coagulation, and inflammatory profiles.","authors":"Xi Wen, Xiaoying Yan, Yu Xiao, Jingyi Wang, Shan Jiang, Tong Liu, Liane Zhou","doi":"10.1080/14767058.2025.2477069","DOIUrl":"https://doi.org/10.1080/14767058.2025.2477069","url":null,"abstract":"<p><strong>Objective: </strong>Unexplained Recurrent Spontaneous Abortion (RSA) impacts the physical and psychological well-being of women of reproductive age. This study aimed to reveal the potential mechanisms behind unexplained RSA from the perspective of glucose and lipid metabolic profiles before conception and their relationship with immune, coagulation, and inflammatory markers.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 100 patients with unexplained recurrent spontaneous abortion at our gynecology department from June 2022 to June 2023. According to whether abnormal glucose and lipid metabolism exist, patients were grouped into normal group and abnormal group. The study compared the glucose and lipid metabolic characteristics, immune status, coagulation, and inflammatory parameters between two groups.</p><p><strong>Results: </strong>The Abnormal Group exhibited higher fasting blood glucose, 2-hour oral glucose tolerance test, homeostatic model assessment of insulin resistance, total cholesterol, and LDL cholesterol, along with lower levels of HDL cholesterol. Additionally, alterations in immune profile parameters, including lower levels of CD4+ T cells, CD8+ T cells, B cells, NK cells, and elevated IL-6, were observed in the Abnormal Group. Regarding coagulation and inflammatory profile parameters, the Abnormal Group demonstrated prolonged prothrombin time, activated partial thromboplastin time, elevated fibrinogen and D-dimer levels, and increased platelet count, along with elevated C-reactive protein, TNF-α, and IL-1β levels. Correlation analysis revealed significant associations between the pre-pregnancy metabolic characteristics and immune, coagulation, and inflammatory profile parameters.</p><p><strong>Conclusion: </strong>Abnormal glucose and lipid metabolism may lead to or exacerbate unexplained RSA in some patients, and therapeutic interventions targeting glucose and lipid metabolism hold promise for improving pregnancy outcomes in this population.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2477069"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634781","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":"\"Increasing body mass index is associated with intensive care unit admission and severe maternal morbidity\".","authors":"Nicholas Baranco, Sameer Khan, Pamela Parker, Dimitrios S Mastrogiannis","doi":"10.1080/14767058.2024.2431098","DOIUrl":"https://doi.org/10.1080/14767058.2024.2431098","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the relationship between increased body mass index (BMI) with severe maternal morbidity (SMM).</p><p><strong>Study design: </strong>We obtained data for a retrospective cohort of singleton live births using an electronic birth certificate database from 2010 to 2022 in Central New York. Institutional review board exemption was obtained. Pre-pregnancy BMI was assessed as a continuous variable and a categorical variable with groups of BMI <18.5 kg/m², 30-39.9 kg/m², 40-49.9 kg/m², and ≥50 kg/m² compared to patients with BMI 18.5-29.9 kg/m². Primary outcomes were maternal intensive care unit (ICU) admission and composite SMM defined as ICU admission, unplanned hysterectomy, reoperation, eclampsia, and blood transfusion. Secondary outcomes were the individual SMM components, 5-minute APGAR score <7, and neonatal intensive care unit (NICU) admission. ANOVA and χ² were used to compare continuous and categorical variables respectively, and logistic regression was used to obtain adjusted odds ratios for primary and secondary outcomes.</p><p><strong>Results: </strong>There were 223,837 patients with singleton live births with mean BMI 27.86 kg/m². 54,385 (24.3%) had BMI 30-39.9 kg/m², 13,299 (5.9%) had BMI 40-49.9 kg/m², and 1,958 (0.87%) had BMI ≥50 kg/m². 3,203 (1.4%) patients experienced SMM, and 423 (0.2%) patients were admitted to ICU. For each 1-point increase in BMI the adjusted odds ratio (aOR) of SMM increased by 0.8% (aOR 1.008, 95% CI 1.002-1.013) and ICU admission increased by 2.0% (aOR 1.02, 95% CI 1.005-1.034). Odds of ICU admission for those with BMI 40-49.9 kg/m² increased by 69% (aOR 1.69, 95% CI 1.16-2.47); BMI ≥50 kg/m² increased by 300% (aOR 3.01, 95% CI 1.53-5.91), but those with BMI 30-39.9 kg/m² did not have significantly higher odds of ICU admission (aOR 1.09, 95% CI 0.84-1.42).</p><p><strong>Conclusion: </strong>Increasing BMI was significantly associated with increased SMM and maternal ICU admission.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2431098"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774386","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}