Journal of Maternal-Fetal & Neonatal Medicine最新文献

{"title":"Dried blood spots-based metabolomic analysis in preterm infants with necrotizing enterocolitis.","authors":"Tiantian Zhang, Shimin Yang, Ruotong Li, Ruiqian Dong, Hui Zou","doi":"10.1080/14767058.2024.2416610","DOIUrl":"https://doi.org/10.1080/14767058.2024.2416610","url":null,"abstract":"<p><strong>Objective: </strong>Necrotizing enterocolitis (NEC) is the leading cause of death among premature infants, and there is a lack of specific early diagnostic markers. Blood sampling is expected to better reflect pathophysiological and metabolic changes in systematic illness, but there is a risk of iatrogenic anemia, especially in premature infants. Dried blood spots technique seems to have important advantages compared to whole blood sampling as it requires only 12-15 μL as sample volume. This study aimed to investigate the special metabolomics of preterm neonates at high risk of NEC using dried blood spots.</p><p><strong>Methods: </strong>Cases and controls were strictly matched 1:1. Dried blood spots (<i>n</i> = 32, 16 cases-16 controls) from newborn screening were subjected to LC-MS/MS. Metabolomic data were analyzed by orthogonal partial least squares-discriminant analysis (OPLS-DA) and univariate/multivariate statistical analysis.</p><p><strong>Results: </strong>Compared to the control group, the NEC group had a significant reduction in seven amino acids (glycine, alanine, threonine, proline, ornithine, lysine, and asparagine).</p><p><strong>Conclusions: </strong>The metabolic profile of neonates with NEC differs significantly from that of controls, making possible their separation with the use of targeted (LC-MS/MS) dried blood spots-based metabolomic analysis. Seven specific markers were identified for early detection and intervention.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2416610"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479414","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 mitochondrial regulator protein, MNRR1, is elevated in the maternal blood of women with preeclampsia.","authors":"Manaphat Suksai, Roberto Romero, Mariachiara Bosco, Francesca Gotsch, Eunjung Jung, Piya Chaemsaithong, Adi L Tarca, Dereje W Gudicha, Nardhy Gomez-Lopez, Marcia Arenas-Hernandez, Arun Meyyazhagan, Lawrence I Grossman, Siddhesh Aras, Tinnakorn Chaiworapongsa","doi":"10.1080/14767058.2023.2297158","DOIUrl":"10.1080/14767058.2023.2297158","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Preeclampsia, one of the most serious obstetric complications, is a heterogenous disorder resulting from different pathologic processes. However, placental oxidative stress and an anti-angiogenic state play a crucial role. Mitochondria are a major source of cellular reactive oxygen species. Abnormalities in mitochondrial structures, proteins, and functions have been observed in the placentae of patients with preeclampsia, thus mitochondrial dysfunction has been implicated in the mechanism of the disease. Mitochondrial nuclear retrograde regulator 1 (MNRR1) is a newly characterized bi-organellar protein with pleiotropic functions. In the mitochondria, this protein regulates cytochrome &lt;i&gt;c&lt;/i&gt; oxidase activity and reactive oxygen species production, whereas in the nucleus, it regulates the transcription of a number of genes including response to tissue hypoxia and inflammatory signals. Since MNRR1 expression changes in response to hypoxia and to an inflammatory signal, MNRR1 could be a part of mitochondrial dysfunction and involved in the pathologic process of preeclampsia. This study aimed to determine whether the plasma MNRR1 concentration of women with preeclampsia differed from that of normal pregnant women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective case-control study included 97 women with preeclampsia, stratified by gestational age at delivery into early (&lt;34 weeks, &lt;i&gt;n&lt;/i&gt; = 40) and late (≥34 weeks, &lt;i&gt;n&lt;/i&gt; = 57) preeclampsia and by the presence or absence of placental lesions consistent with maternal vascular malperfusion (MVM), the histologic counterpart of an anti-angiogenic state. Women with an uncomplicated pregnancy at various gestational ages who delivered at term served as controls (&lt;i&gt;n&lt;/i&gt; = 80) and were further stratified into early (&lt;i&gt;n&lt;/i&gt; = 25) and late (&lt;i&gt;n&lt;/i&gt; = 55) controls according to gestational age at venipuncture. Maternal plasma MNRR1 concentrations were determined by an enzyme-linked immunosorbent assay.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;1) Women with preeclampsia at the time of diagnosis (either early or late disease) had a significantly higher median (interquartile range, IQR) plasma MNRR1 concentration than the controls [early preeclampsia: 1632 (924-2926) pg/mL vs. 630 (448-4002) pg/mL, &lt;i&gt;p&lt;/i&gt; = .026, and late preeclampsia: 1833 (1441-5534) pg/mL vs. 910 (526-6178) pg/mL, &lt;i&gt;p&lt;/i&gt; = .021]. Among women with early preeclampsia, those with MVM lesions in the placenta had the highest median (IQR) plasma MNRR1 concentration among the three groups [with MVM: 2066 (1070-3188) pg/mL vs. without MVM: 888 (812-1781) pg/mL, &lt;i&gt;p&lt;/i&gt; = .03; and with MVM vs. control: 630 (448-4002) pg/mL, &lt;i&gt;p&lt;/i&gt; = .04]. There was no significant difference in the median plasma MNRR1 concentration between women with early preeclampsia without MVM lesions and those with an uncomplicated pregnancy (&lt;i&gt;p&lt;/i&gt; = .3). By contrast, women with late preeclampsia, regardless of MVM lesions, had a significantl","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2297158"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466774","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 outcomes of cerclage in twin gestations: a multicenter retrospective cohort study.","authors":"Jee Yoon Park, Kyong-No Lee, Hyeon Ji Kim, Kiroong Choe, Aeri Cho, Bohyoung Kim, Jinwook Seo, Hayan Kwon, Jong Woon Kim, Jin-Gon Bae, Ji-Hee Sung, Se Jin Lee, Young Mi Jung, You Jung Han, Subeen Hong, Jin-Hoon Chung, Hye-Sung Won, Jong Kwan Jun","doi":"10.1080/14767058.2024.2355495","DOIUrl":"10.1080/14767058.2024.2355495","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the effects of cerclage on twin pregnancies.</p><p><strong>Methods: </strong>A multicenter, retrospective, cohort study was conducted at 10 tertiary centers using a web-based data collection platform. The study population included twin pregnancies delivered after 20 weeks of gestation. Patients with one or two fetal deaths before 20 weeks of gestation were excluded. Maternal characteristics, including prenatal cervical length (CL) and obstetric outcomes, were retrieved from the electronic medical records.</p><p><strong>Results: </strong>A total of 1,473 patients had available data regarding the CL measured before 24 weeks of gestation. Seven patients without CL data obtained prior to cerclage were excluded from the analysis. The study population was divided into two groups according to the CL measured during the mid-trimester: the CL ≤2.5 cm group (<i>n</i> = 127) and the CL >2.5 cm group (<i>n</i> = 1,339). A total of 127 patients (8.7%) were included in the CL ≤2.5 cm group, including 41.7% (53/127) who received cerclage. Patients in the CL >2.5 cm group who received cerclage had significantly lower gestational age at delivery than the control group (hazard ratio (HR): 1.8; 95% confidence interval (CI): 1.11-2.87; <i>p</i> = .016). Patients in the CL ≤2.5 cm group who received cerclage had a significantly higher gestational age at delivery than the control group (HR: 0.5; 95% CI: 0.30-0.82; <i>p</i> value = .006).</p><p><strong>Conclusions: </strong>In twin pregnancies with a CL ≤2.5 cm, cerclage significantly prolongs gestation. However, unnecessary cerclage in women with a CL >2.5 cm may result in a higher risk of preterm labor and histologic chorioamnionitis although this study has a limitation originated from retrospective design.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2355495"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332385","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":"Letter to editor regarding the article: resolution of acute cervical insufficiency after antibiotics in a case with amniotic fluid sludge.","authors":"Katarzyna Kosińska-Kaczyńska, Magdalena Smyka, Katarzyna Bednarek","doi":"10.1080/14767058.2024.2349790","DOIUrl":"10.1080/14767058.2024.2349790","url":null,"abstract":"","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2349790"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946460","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":"Gestational diabetes mellitus: relationship of adverse outcomes with severity of disease.","authors":"Rebecca Karkia, Tara Giacchino, Frederick Hii, Charline Bradshaw, Ghada Ramadan, Ranjit Akolekar","doi":"10.1080/14767058.2024.2356031","DOIUrl":"https://doi.org/10.1080/14767058.2024.2356031","url":null,"abstract":"<p><strong>Aims: </strong>To derive accurate estimates of risk of maternal and neonatal complications in women with gestational diabetes mellitus (GDM) and to investigate the association of the effect size of these risks on subgroups of GDM managed with dietary modification, metformin and insulin therapy.</p><p><strong>Methods: </strong>This was a large retrospective cohort study undertaken at a large maternity unit in the United Kingdom between January 2010 and June 2022. We included singleton pregnancies that booked at our unit at 11-13 weeks' gestation. The rates of maternal and neonatal complications in pregnancies with GDM that were managed by a multidisciplinary team (MDT) in the specialist high-risk clinic were compared to those in non-diabetic pregnancies. We stratified pregnancies with GDM into those that were managed with diet, metformin and insulin to pregnancies without diabetes. Logistic regression analysis was carried out to determine risks of pregnancy complications in pregnancies with GDM and its treatment subgroups. Risks were expressed as absolute risks (AR) and odds ratio (OR) (95% confidence intervals [CI]). Forest plots were used to graphically demonstrate risks.</p><p><strong>Results: </strong>The study population included 51,211 singleton pregnancies including 2089 (4.1%) with GDM and 49,122 (95.9%) controls without diabetes. In pregnancies with GDM, there were 1247 (59.7%) pregnancies managed with diet, 451 (21.6%) with metformin and 391 (18.7%) who required insulin for maintaining euglycaemia. Pregnancies with GDM had higher maternal age, body mass index (BMI), higher rates of Afro-Caribbean and South Asian racial origin and higher rates of chronic hypertension. In pregnancies with GDM compared to non-diabetic controls, there was an increased rate of preterm delivery, delivery of LGA neonate, polyhydramnios, preeclampsia, need for IOL, elective and emergency CS and PPH whereas the rate of delivery of SGA neonates and likelihood of an unassisted vaginal delivery were lower. In pregnancies with GDM, there is significantly increased risk of maternal and neonatal complications in those that require insulin compared to those that are managed on dietary modification alone.</p><p><strong>Conclusions: </strong>There is a linear association between the risk of adverse outcomes and the severity of GDM with those on insulin treatment demonstrating an increased association with complications compared to those that have milder disease requiring only dietary modification.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2356031"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of different physical exercise types on health outcomes of individuals with hypertensive disorders of pregnancy: a prospective randomized controlled clinical study.","authors":"Cong Chen, Jinguo Zhai, Shuiwang Hu, Xuantian Liu, Xinzhi Tu, Bin Li, Kui Huang, Fu-Ying Tian, Haiyin Liu, Ruowang Hu, Jingjing Guo","doi":"10.1080/14767058.2024.2421278","DOIUrl":"https://doi.org/10.1080/14767058.2024.2421278","url":null,"abstract":"<p><strong>Objective: </strong>To explore the impacts of different types of physical exercise on health outcomes of individuals with hypertensive disorders of pregnancy (HDPs).</p><p><strong>Methods: </strong>Forty individuals with HDPs admitted to a tertiary hospital providing maternal and pediatric care between July 2023 and March 2024 were enrolled in this prospective randomized controlled clinical study and completed a ≥4-week intervention. Data were collected before the intervention and before delivery. Participants were assigned randomly to control (no exercise intervention), aerobic exercise (AE), resistance training (RT), and AE + RT groups. All participants downloaded a mobile health-education app for gestational hypertension developed by our research group. Exercise videos in the app guided participants' performance of different types of exercise. General information; physical activity and sleep quality data; morning blood pressure, lipid profiles, and urinary micro-albumin/creatinine ratios; serum soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PlGF), and advanced oxidation protein product (AOPP) concentrations; and pregnancy outcome data were collected and compared among groups.</p><p><strong>Results: </strong>After the intervention, the physical activity status, sleep quality, morning blood pressure, lipid profiles, urinary micro-albumin/creatinine ratios, and pregnancy outcomes differed significantly among all groups comparing with control (all <i>p</i> < .05). In the three exercise groups, the serum sFlt-1, PlGF, and AOPPs levels improved significantly (all <i>p</i> < .05). All differences were most pronounced in the AE + RT group.</p><p><strong>Limitations: </strong>The study period was relatively short. The further long-term follow-up research is needed. A larger sample size study is also needed.</p><p><strong>Conclusions: </strong>The study results suggest that AE + RT interventions are beneficial for individuals with HDPs in clinical settings, and could be implemented with careful consideration of individuals' specific conditions.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2421278"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631521","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":"Maternal super obesity is increasing and is associated with an increased risk of pregnancy complications-a call for concern.","authors":"Sameer Khan, Nicholas Baranco, Martha Wojtowycz, Pamela Parker, Dimitrios S Mastrogiannis","doi":"10.1080/14767058.2024.2396071","DOIUrl":"https://doi.org/10.1080/14767058.2024.2396071","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the relationship of increased body mass index (BMI) with pregnancy complications.</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. Institutional review board exemption was obtained. BMI was assessed as a continuous variable and a categorical variable with groups of BMI 18.5-29.9 kg/m², 40-49.9 kg/m², and ≥50 kg/m² compared to patients with BMI 30-39.9 kg/m². Primary outcomes were pregnancy and maternal outcomes. Secondary outcomes were neonatal outcomes. 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. Patients with BMI > 50 kg/m2 have a higher likelihood of APGAR scores <7 (aOR 1.38, 95% CI 1.05-1.83), and NICU admission or transfer out of facility (aOR 1.17, 95% CI 1.02-1.34). In the nulliparous subgroup analysis, For patients with BMI >50 kg/m2, there was a higher odds of preterm birth <37 weeks (aOR 1.57, 95% CI 1.23-2.00) and preterm birth <34 weeks (aOR 1.51 95% CI 1.00-2.30. There is also an increased odds of cesarean section in both of these BMI groups (aOR 1.68 95% CI 1.57-1.79 and aOR 2.30 95% CI 1.94-2.72).</p><p><strong>Conclusion: </strong>BMI ≥ 50 kg/m² was significantly associated with increased pregnancy complications.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2396071"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127211","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":"Which approach is better for labor induction: simultaneous or sequential administration of oxytocin and intrauterine balloon-a systematic review and a meta-analysis.","authors":"Qian Chen, Huihao Zhou, Yiqin Hu, Jingui Xue","doi":"10.1080/14767058.2024.2395490","DOIUrl":"10.1080/14767058.2024.2395490","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy of simultaneous and sequential administration of oxytocin and intrauterine balloons in labor induction.</p><p><strong>Methods: </strong>The databases of Cochrane Library, Web of Science, PubMed, ClinicalTrials.gov, and Embase were thoroughly searched from their inception to November 2023. Randomized controlled trials (RCTs) investigating the simultaneous and sequential use of oxytocin and intrauterine balloons for labor induction in pregnancy were included. The meta-analysis was performed using RevMan 5.3 statistical software. Heterogeneity among the selected studies was evaluated using the <i>I²</i> statistic. Dichotomous outcomes were estimated using relative risk (RR) with corresponding 95% confidence intervals (CI), while continuous outcomes were measured as the mean difference (MD).</p><p><strong>Results: </strong>A total of eight studies, involving a total of 1,315 nulliparous and multiparous women with an unfavorable cervix, were included in the systematic review. Moreover, a subgroup analysis was conducted, separately evaluating nulliparous and multiparous women. Compared with the sequential groups, simultaneous use of oxytocin and intrauterine balloons resulted in a significantly higher rate of delivery within 24h in nulliparas (RR = 1.30, 95%CI:1.04, 1.63, <i>p</i> = 0.02), a higher rate of vaginal delivery within 24h in multiparas (RR = 1.32, 95%CI:1.15,1.51, <i>p</i> < 0.00001), a superior rate of delivery within 12h and a shorter time to delivery in both nulliparas and multiparas. No statistically significant differences were observed in cesarean delivery and maternal and neonatal adverse outcomes between the sequential and simultaneous groups.</p><p><strong>Conclusions: </strong>These findings provide support for the simultaneous use of intrauterine balloons and oxytocin during labor induction in nulliparous women. Additionally, this approach may also prove beneficial for multiparas.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2395490"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114274","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":"Investigation of serum spexin concentrations in pregnant women diagnosed with hyperemesis gravidarum.","authors":"Işıl Ada Uçar, İbrahim Kale, Cem Yalçınkaya, Murat Muhcu","doi":"10.1080/14767058.2024.2398686","DOIUrl":"https://doi.org/10.1080/14767058.2024.2398686","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate the serum concentration of the spexin, which has been shown to have an anorexic effect in animal models, in pregnant women with hyperemesis gravidarum (HG).</p><p><strong>Methods: </strong>This case-control study was conducted with 80 pregnant women who applied to the Umraniye Training and Research Hospital Gynecology and Obstetrics Clinic between April 2022 and September 2022. The HG group consisted of 40 pregnant women who were diagnosed with HG in the first 14 weeks of pregnancy, and the control group consisted of 40 healthy pregnant women matched with the HG group in terms of age, BMI, and gestational week.</p><p><strong>Results: </strong>Both groups were similar in terms of demographic characteristics and gestational age at blood sampling for spexin (<i>p</i> > 0.05). While maternal serum spexin concentration was 342.4 pg/ml in the HG group, it was 272.8 pg/ml in the control group (<i>p</i> = 0.003). ROC analysis was performed to determine the value of maternal serum spexin concentration in terms of predicting HG. AUC analysis of maternal serum spexin for HG estimation was 0.693 (<i>p</i> = 0.003, 95% CI =0.577 - 0.809). The optimal cutoff value for maternal serum spexin concentration was determined as 305.90 pg/ml with 65% sensitivity and 65% specificity.</p><p><strong>Conclusions: </strong>High serum spexin concentration is thought to play a role in the etiopathogenesis of HG, and this should be supported by demonstrating changes in serum spexin concentrations in pregnant women with HG whose symptoms alleviated and weight regain started after treatment.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2398686"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of maternal posture and cognitive-behavioral interventions on labor outcomes in primigravidas with abnormal fetal head position: a randomized controlled clinical trial.","authors":"Xiaofeng Wan, Jinguo Zhai, Xiaoqin Lu, Xiuhong Wang, Hamza Saidi Lilenga, Mei Luo, Xiaochun Wang, Xueyan Wang, Yanli Zhou","doi":"10.1080/14767058.2024.2422448","DOIUrl":"10.1080/14767058.2024.2422448","url":null,"abstract":"<p><strong>Objective: </strong>Fetal head malposition can result in neonatal and maternal complications. Fetal head malposition occurs frequently in labor. Appropriate and timely managements are required. Maternal posture and cognitive-behavioral interventions could improve labor outcomes in primigravidas with fetal head malposition.</p><p><strong>Methods: </strong>A randomized controlled clinical trial was performed between January and December 2022 (Chinese Clinical Trial Registry, ChiCTR2100049359). Eligible primigravidas were randomly assigned into four groups. Group A received traditional perinatal care. Group B, C, and D received posture management, posture management with music therapy, and posture management with video education, respectively, in addition to traditional perinatal care. The maternal postures referred to place pregnant women in certain positions (lateral, lateral-prone, hands and knees, open knee-chest) to change the anatomical structure of pelvis, thus, to facilitate the fetal downward movement and birth. Maternal and neonatal outcomes were recorded and compared.</p><p><strong>Results: </strong>A total of 136 primigravidas were included, with 34, 35, 34, and 33 women in group A, B, C, and D, respectively. The incidences of cesarean section were lower in groups B, C, and D than that in group A (5.7%, 2.9%, and 3.0% versus 20.6%, <i>p</i> < 0.05). The fetal position correction rates at the time of full dilation of cervix were higher in groups B, C, and D than that in group A (66.7%, 63.6%, 68.8% versus 27.6%, <i>p</i> < 0.05). Primigravidas in groups B, C, and D had better experiences and a lower anxiety level than those in group A (<i>p</i> < 0.001). The four groups had no statistically significant differences in the total labor duration, operative vaginal delivery, umbilical artery blood pH, and neonatal Apgar scores.</p><p><strong>Conclusion: </strong>Fetal head malposition could happen in primigravidas. Maternal posture management and cognitive-behavioral interventions during labor could improve labor outcomes in primigravidas with fetal head malposition.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":"37 1","pages":"2422448"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631523","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}