Journal of Maternal-Fetal & Neonatal Medicine最新文献

{"title":"Role of periodontal treatment in pregnancy gingivitis and adverse outcomes: a systematic review and meta-analysis.","authors":"HaiHong Xu, Minqiu Cai, Hongmiao Xu, Xuan-Jiang Shen, Jia Liu","doi":"10.1080/14767058.2024.2416595","DOIUrl":"https://doi.org/10.1080/14767058.2024.2416595","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy gingivitis is a common oral health issue that affects both maternal and fetal health. This study aims to evaluate the effectiveness of periodontal treatment in preventing pregnancy gingivitis, preterm birth, and low birth weight through a systematic review and meta-analysis of randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA guidelines. A comprehensive literature search was performed across CINAHL, Scopus, Cochrane, and PubMed/Medline databases from 2000 to the present. Study selection and data extraction were independently carried out by two reviewers. Statistical analyses, including heterogeneity tests, sensitivity analysis, and publication bias assessment, were conducted using RevMan 5.4 and R software.</p><p><strong>Results: </strong>A total of 13 studies were included. The meta-analysis indicated that periodontal treatment might have a potential effect on preventing pregnancy gingivitis, but this was not statistically significant (OR = 0.85, 95% CI [0.68, 1.06], I² = 51%). Subgroup analysis revealed that periodontal treatment significantly reduced the rates of preterm birth and low birth weight in lower-quality studies, but no significant effects were observed in higher-quality studies. Sensitivity analysis and publication bias tests confirmed the stability and reliability of the results.</p><p><strong>Conclusion: </strong>While lower-quality studies suggest that periodontal treatment may positively impact pregnancy gingivitis, preterm birth, and low birth weight, these effects were not supported by higher-quality evidence. Further well-designed RCTs are needed to confirm these findings and ensure their reliability. Periodontal treatment could potentially be considered as part of prenatal care to improve maternal oral health and pregnancy outcomes.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2416595"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899700","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":"Novel therapeutic targets uncovered by genome-wide integrative analysis in bronchopulmonary dysplasia.","authors":"Zhenyu Xiong, Qingxiong Zhu, Lei Hang","doi":"10.1080/14767058.2025.2469837","DOIUrl":"https://doi.org/10.1080/14767058.2025.2469837","url":null,"abstract":"<p><strong>Background: </strong>Bronchopulmonary dysplasia (BPD) is the most common chronic respiratory disease in extremely premature infants. This study aims to identify gene expression dysregulation and explore various molecular pathways implicated in BPD.</p><p><strong>Methods: </strong>This study integrated BPD genome-wide association study (GWAS), single-cell transcriptomics (scRNA-seq), and Mendelian randomization (MR) analysis to investigate the causal relationship between gene expression and BPD.</p><p><strong>Results: </strong>Cell annotation and ligand-receptor analysis highlighted myofibroblasts as the most interactive cell type. Key genes, including CDH4, ENC1, and PAM, were identified as protective factors against BPD, while GRB10 was associated with increased disease risk. Immune metabolism-related pathways showed elevated activity of PAM, GRB10, and ENC1 in epithelial-mesenchymal transition. The Drug-Gene Interaction Database (DGIdb) predicted three drugs-LM10, navoximod, and ziprasidone-that potentially interact with these key genes.</p><p><strong>Conclusion: </strong>This integrative genome-wide analysis provides valuable insights into the genetic mechanisms underlying BPD. The findings facilitate the identification of novel therapeutic targets and pave the way for personalized treatment strategies for affected neonates.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2469837"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484564","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":"Fetoscopic repair of open spina bifida between 26 0/7 and 27 6/7 gestational weeks and postnatal cerebrospinal fluid diversion.","authors":"Ramen H Chmait, Jason K Chu, Alexander L Van Speybroeck, Ms Arlyn S Llanes, Lisa M Korst, HaiThuy N Nguyen, Eftichia V Kontopoulos, Rubén A Quintero","doi":"10.1080/14767058.2025.2477770","DOIUrl":"https://doi.org/10.1080/14767058.2025.2477770","url":null,"abstract":"<p><strong>Objective: </strong>To assess the rate and risk factors for cerebrospinal fluid (CSF) diversion among cases of prenatal repair of open spina bifida (OSB) performed from 26 0/7 to 27 6/7 gestational weeks, given a traditional cutoff of 25 6/7 weeks.</p><p><strong>Methods: </strong>This is a descriptive study of patients who underwent fetoscopic OSB repair (2019-2023) from 26 0/7 to 27 6/7 gestational weeks. Data were collected prospectively and examined as predictors of CSF diversion (ventriculoperitoneal shunt or endoscopic third ventriculostomy) within the first 12 months of life.</p><p><strong>Results: </strong>Of 42 study patients, CSF diversion was required in 12 cases (28.6%). In bivariate analysis, only preoperative ventricular size was associated with the CSF diversion procedure (largest ventricle 14.5 ± 3.0 vs 11.9 ± 2.5 mm, <i>p</i> = .015). Multiple logistic regression showed that cases with preoperative ventriculomegaly ≥15 mm appeared more likely to have CSF diversion (OR 5.23, 95% CI 0.98-28.09, <i>p</i> = .054). Neither level of the lesion nor myeloschisis was associated with CSF diversion.</p><p><strong>Conclusion: </strong>Prenatal OSB repair from 26 0/7 to 27 6/7 gestational weeks was associated with a 28.6% risk of postnatal CSF diversion at 12 months of life. Results are similar to those in which repair is performed ≤25 6/7 weeks.</p><p><strong>What’s already known about this topic?: </strong>Approximately 40% of patients undergoing prenatal open spina bifida (OSB) repair need CSF diversion at 1 year of life.The upper limit for percutaneous fetoscopic OSB repair has been 25 6/7 gestational weeks; few data exist regarding outcomes of prenatal repair after 25 weeks.</p><p><strong>What does this study add?: </strong>OSB repair at 26 0/7-27 6/7 gestational weeks appeared to provide a similar benefit in reducing CSF diversion risk at 1 year of life.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2477770"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626641","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":"Time of day/unit busyness at birth and perinatal hypoxia and or moderate to severe hypoxic ischemic encephalopathy a cohort study.","authors":"Stephen Wood, Selphee Tang, Khorsid Mohammad, Matt Hicks","doi":"10.1080/14767058.2025.2483422","DOIUrl":"https://doi.org/10.1080/14767058.2025.2483422","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the potential link between nighttime births, unit busyness, and the incidence of perinatal hypoxia or moderate-to-severe hypoxic-ischemic encephalopathy.</p><p><strong>Methods: </strong>Retrospective cohort study with nested case control study of all singleton births ≥ 35-week gestation for the years 2010-20, in Alberta, a province of Canada. Perinatal Hypoxia was defined as intrapartum stillbirth or neonatal death from asphyxia or Neonatal Intensive Care Unit admission and at least two of the following: a. Apgar score of ≤ 5 at 10 min; b. mechanical ventilation or chest compressions for resuscitation within 10 min; c. cord pH < 7.00 (venous or arterial), or arterial base deficit ≥ 12 at birth. Moderate-severe hypoxic ischemic encephalopathy was defined as per Sarnat criteria. Nighttime birth was defined as between 2000 and 0559 h. Unit busyness was characterized by number of births by site per shift and was described by quartiles.</p><p><strong>Results: </strong>The risk of perinatal hypoxia was higher for nighttime births, risk difference 0.5/1000 births, 95% confidence interval (0.2-0.8), but moderate-severe hypoxic ischemic encephalopathy was not, risk difference 0.2/1000 births 95% confidence interval (0.0-0.3). We did not observe an increase in the risk of perinatal hypoxia or moderate-severe hypoxic ischemic encephalopathy with delivery in the highest quartile of unit busyness.</p><p><strong>Conclusions: </strong>We observed a small increase in the risk of birth with perinatal hypoxia for nighttime births but not for moderate-severe hypoxic ischemic encephalopathy. Neither perinatal hypoxia or moderate-severe hypoxic ischemic encephalopathy was associated with unit busyness.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2483422"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765621","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 causal relationship between gut microbiota and preterm birth: a two-sample Mendelian randomization study.","authors":"Tao Zhu, Dandan Shen, Xiao Cai, Yuanling Jin, Haixia Tu, Shouxing Wang, Qianglong Pan","doi":"10.1080/14767058.2024.2432528","DOIUrl":"https://doi.org/10.1080/14767058.2024.2432528","url":null,"abstract":"<p><strong>Background: </strong>Preterm birth, a significant global health concern, has been associated with alterations in the gut microbiota. However, the causal nature of this relationship remains uncertain due to the limitations inherent in observational studies.</p><p><strong>Purpose: </strong>To investigate the potential causal relationship between gut microbiota imbalances and preterm birth.</p><p><strong>Methods: </strong>We conducted a two-sample Mendelian randomization (MR) study using genome-wide association study (GWAS) data from the MiBioGen consortium focusing on microbiota and preterm birth. Single nucleotide polymorphisms (SNPs) associated with the microbiota were selected as instrumental variables. The inverse variance weighting (IVW) method was used to estimate causality. We confirmed pleiotropy and identified and excluded outlier SNPs using MR-PRESSO and MR-Egger regression. Cochran's Q test was applied to assess heterogeneity among SNPs, and a leave-one-out analysis was performed to evaluate the influence of individual SNPs on overall estimates.</p><p><strong>Results: </strong>Our findings provide evidence for a causal link between specific components of the gut microbiota and preterm birth, with the identification of relevant metabolites.</p><p><strong>Conclusion: </strong>This study highlights the causal role of gut microbiota imbalances in preterm birth, offering novel insights into the development of preterm birth and potential targets for prevention strategies.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2432528"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899812","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":"Predictive efficacy of machine-learning algorithms on intrahepatic cholestasis of pregnancy based on clinical and laboratory indicators.","authors":"Jianhu He, Xiaojun Zhu, Xuan Yang, Hui Wang","doi":"10.1080/14767058.2024.2413854","DOIUrl":"https://doi.org/10.1080/14767058.2024.2413854","url":null,"abstract":"<p><strong>Objectives: </strong>Intrahepatic cholestasis of pregnancy (ICP), a condition exclusive to pregnancy, necessitates prompt identification and intervention to improve the perinatal outcomes. This study aims to develop suitable machine-learning models for predicting ICP based on clinical and laboratory indicators.</p><p><strong>Methods: </strong>This study retrospectively analyzed data from 1092 pregnant women, with 537 diagnosed with ICP and 555 healthy cases as a control. Two study schemes were devised. For scheme 1, 62 indicators from the first period of gestation were utilized to establish predictive models. For scheme 2, 62 indicators from at least two periods of gestation were utilized to establish predictive models. Under each scheme, three different machine-learning models were developed based on the Arya Privacy Computing Platform, encompassing Support Vector Machine (SVM), Deep Neural Network (DNN), and Xgboost for Scheme 1, and Recurrent Neural Network (RNN), Long Short-Term Memory Network (LSTM), and Gated Recurrent Unit (GRU) for Scheme 2. The predictive efficacy of each model on ICP was evaluated and compared.</p><p><strong>Results: </strong>Under Scheme 1, the cohort comprised 1092 pregnant women (537 with ICP, 555 healthy). The SVM model exhibited a sensitivity, specificity, and accuracy of 85.5%, 47.50%, and 67.90%, respectively, while DNN showed 65.70%, 92.70%, and 79.40%, respectively, and Xgboost achieved 65.60%, 81.90%, and 73.40%, respectively. In Scheme 2, 899 pregnant women were analyzed (466 with ICP, 433 healthy). RNN demonstrated a sensitivity, specificity, and accuracy of 97.60%, 82.10%, and 90.50%, respectively; LSTM presented 90.70%, 81.70%, and 86.60%, respectively; and GRU achieved 89.90%, 83.80%, and 89.40%, respectively.</p><p><strong>Conclusion: </strong>DNN and RNN are the two most suitable models to predict ICP in a convenient and available way. It provides flexible choice for medical staff and helps them optimize the therapeutic strategies to meet different clinical setting and improve the clinical prognosis of ICP.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2413854"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774341","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":"Neonatal survival rate after expectant management of periviable preterm premature rupture of membranes at gestational age 15-23⁺⁶ weeks.","authors":"Phunyaporn Nipastpong, Vorapong Phupong","doi":"10.1080/14767058.2024.2434066","DOIUrl":"https://doi.org/10.1080/14767058.2024.2434066","url":null,"abstract":"<p><strong>Objective: </strong>To assess the neonatal survival rates, maternal complications, neonatal complications, and factors associated with survival rates following periviable premature rupture of membranes (PROM) between 15 and 23⁺⁶ weeks of gestation.</p><p><strong>Materials and methods: </strong>The retrospective study included patients with periviable PROM between 15 and 23⁺⁶ weeks of gestation from January 1, 2008, to December 31, 2022. Multivariate regression analysis was performed to identify factors influencing neonatal survival.</p><p><strong>Results: </strong>A total of 71 cases of periviable PROM between 15 and 23⁺⁶ weeks of gestation were included in the study, and the neonatal survival rate was found to be 26.8%. Maternal complications occurred in 59.2% of cases. Of the 19 surviving newborns, 89.5% experienced neonatal complications. Univariate analysis showed that gestational age at delivery, duration of latency and antenatal steroid administration were the factors significantly associated with increased survival rates after periviable PROM before 24 weeks of gestation.</p><p><strong>Conclusion: </strong>The survival rate of periviable PROM between 15 and 23⁺⁶ weeks of gestation was 26.8% with neonatal complications of 89.5%. This information may be useful for counseling pregnant women experiencing periviable PROM.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2434066"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830689","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":"Obstetric and neonatal outcomes of extremely obese pregnant women after late preterm gestation.","authors":"Harshitha Kallubhavi Choodinatha, Hyun Joon Im, Jin Lee, Min Jung Lee, Bo Young Choi, Hyeon Ji Kim, Jee Yoon Park","doi":"10.1080/14767058.2025.2470416","DOIUrl":"https://doi.org/10.1080/14767058.2025.2470416","url":null,"abstract":"<p><strong>Objective: </strong>To determine the obstetric and neonatal outcomes of pregnant women with extreme obesity at birth after late preterm gestation.</p><p><strong>Methods: </strong>This was a retrospective study on extremely obese pregnant women with body mass index (BMI) ≥ 40.0 kg/m² (obesity stage III according to the BMI classification of the World Health Organization) who had delivered at Seoul National University Bundang Hospital between September 2003 and February 2023. Fetal death in utero and preterm births before 34 weeks of gestation were excluded. Obstetric and neonatal outcomes were reviewed.</p><p><strong>Results: </strong>A total of 94 extremely obese pregnant women were included and the median value of BMI at delivery was 42.4 kg/m². When analyzed according to the obesity II category of pre-pregnancy BMI, the rate of chronic hypertension was higher in the alleged extreme obese women than those with lower pre-pregnancy BMI (34% vs. 10%, <i>p</i> = 0.012). However, preterm labor with tocolytics was higher in the group with lower BMI than 35.0 kg/m² (26% vs. 5%, <i>p</i> = 0.007). The proportion of adverse neonatal outcomes such as neonatal intensive care unit admission, the use of respiratory support (including positive pressure ventilation, continuous positive airway pressure, and mechanical ventilator), and jaundice were higher in the group with pre-pregnancy BMI < 35.0 kg/m² than that with BMI ≥ 35.0 kg/m² group (all <i>p</i>-value < 0.05). The use of neonatal respiratory support increased as the category of pre-pregnancy BMI was lower and as the degree of weight gain during pregnancy was higher.</p><p><strong>Conclusions: </strong>In extremely obese women (stage III) at delivery in late preterm gestation, the obstetric outcomes such as use of tocolytics for preterm labor and adverse neonatal respiratory outcomes seemed to be higher for the women who were not that much obese before pregnancy than those who were already extremely obese. Therefore, weight gain during pregnancy needs to be closely monitored for pregnant women especially when obese.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2470416"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524853","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":"Stress hyperglycemia ratio: a novel predictor of left ventricular dysfunction in peripartum cardiomyopathy.","authors":"Jiajia Zhu, Wenxian Liu, Liying Chen, Baoli Liu","doi":"10.1080/14767058.2025.2464181","DOIUrl":"https://doi.org/10.1080/14767058.2025.2464181","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the predictive value of the stress hyperglycemia ratio (SHR) for left ventricular (LV) systolic dysfunction in patients with peripartum cardiomyopathy (PPCM).</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 78 consecutive PPCM patients from January 2007 to March 2023. Their clinical, laboratory, and auxiliary examination data were collected. The estimated average glucose (eAG) was calculated using the formula: eAG = [1.59 × hemoglobin A1c (%) -%2.59]. The SHR was determined by the formula: SHR = (blood glucose at admission)/eAG. The primary outcome measured was the recovery of LV systolic function. A receiver operating characteristic (ROC) curve was used to evaluate the SHR. Logistic regression analysis was performed to identify risk factors for LV systolic dysfunction in PPCM patients.</p><p><strong>Results: </strong>The mean random blood glucose level in the PPCM patients was 6.38 mmol/L, with an SHR of 1.16. Among these patients, 37 (47.4%) exhibited persistent LV systolic dysfunction during follow-up. The SHR was significantly higher in the non-recovery group than in the recovery group (1.45 vs. 0.91, <i>p</i> < .001). An SHR cutoff of 1.079 predicted persistent LV systolic dysfunction with a sensitivity of 81.1% and a specificity of 90.2%, yielding a Youden index of 0.713. Logistic regression identified an SHR ≥ 1.079, a left ventricular end-diastolic diameter (LVEDD) > 55 mm, and digoxin usage as risk factors for LV systolic dysfunction.</p><p><strong>Conclusions: </strong>PPCM patients with an SHR of 1.079 or higher should receive increased scrutiny for persistent LV systolic dysfunction.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2464181"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537863","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":"Economic and clinical outcomes of cesarean deliveries with skin closure using 2-octyl cyanoacrylate plus polymer mesh tape versus conventional smooth sutures plus waterproof wound dressings.","authors":"Stephen S Johnston, Najmuddin Gunja, Aakash Jha, Jörg Tomaszewski, Walter Danker","doi":"10.1080/14767058.2025.2463390","DOIUrl":"https://doi.org/10.1080/14767058.2025.2463390","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Cesarean delivery is the most common major operating room procedure performed in the United States. Wound closure after cesarean delivery includes suturing for uterine closure and to close the fascial-and sometimes subcutaneous-tissue layer followed by skin closure. Optimal skin closure is critical as it affects the risk of both cesarean wound infection and dehiscence. To our knowledge, however, no clinical or real-world studies comparing 2OPMT with conventional sutures for skin closure following cesarean delivery have been published to date. We sought to compare the economic and clinical outcomes of cesarean deliveries with skin closure using 2-octyl cyanoacrylate plus polymer mesh tape (2OPMT) versus conventional smooth sutures plus waterproof wound dressings (CS-WWD).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a retrospective, observational study using a database derived from hospital electronic health records and billing data from over 1,000 U.S. hospitals (PINC AI&lt;sup&gt;™&lt;/sup&gt; Healthcare Database). Eligible patients were aged 18-49 who underwent cesarean delivery between 1 October 2015 and 30 June 2022. From records of medical supplies used during deliveries, we identified deliveries for which skin closure was performed using either 2OPMT or CS-WWD. Outcomes included: post-surgical length of stay (LOS), total hospital costs for the cesarean delivery stay, 30-day readmissions of various acuity to the same hospital in which the cesarean delivery occurred, and two 30-day clinical/wound complication outcomes (occurrence during the initial cesarean delivery stay or within 30 days thereafter), which included: (a) a composite endpoint of cesarean wound surgical site infection and/or dehiscence; and (b) a composite endpoint of cesarean wound surgical site infection and/or dehiscence, puerperal infection, endometritis, urinary tract infection, hematoma of the skin, cellulitis, and/or other unspecified skin infection. We compared outcomes between the groups after stable balance weighting the CS-WWD group to mimic the 2OPMT group on numerous patient, provider, and hospital characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After weighting, the CSWWD (&lt;i&gt;N&lt;/i&gt; = 13,551) and 2OPMT (&lt;i&gt;N&lt;/i&gt; = 16,068) groups were well-balanced on all characteristics (standardized mean differences for balancing covariates &lt;|0.10|). Compared with the CS-WWD group, the 2OPMT group had statistically significant shorter mean post-surgical LOS (1.56 days for 2OPMT vs. 1.73 days for CS-WWD, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), lower mean hospital costs for the cesarean delivery stay ($9,499 vs. $10,362, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), lower incidence proportions of 30-day inpatient readmission (1.43% vs. 1.83%, &lt;i&gt;p&lt;/i&gt; = 0.009), 30-day emergency room visits (5.22% vs. 6.18%, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), 30-day composite of inpatient readmission/emergency room visits (6.47% vs. 7.70%, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), 30-day visits of other kinds, such as outpatient (5.32% vs. 9.50%, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), 30-da","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"38 1","pages":"2463390"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469823","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}