BMC global and public health最新文献

{"title":"Overcoming barriers to neurosurgical care with technology and innovation.","authors":"Jay J Park, Michael Lee, Evelyn Wong, Priya Bhanot, Audrey H Limb, Omar Ceesay, Alexandra Sakamoto, Andrew Lin, Vivek P Buch","doi":"10.1186/s44263-026-00310-w","DOIUrl":"10.1186/s44263-026-00310-w","url":null,"abstract":"<p><p>Technological advancements show great potential in transforming and advancing global surgery. Compared to general medicine, technology in neurosurgery has seen an explosive growth in recent years in ways that directly address accessibility. New, rapidly developing innovations pave the way for the expansion of neurosurgical care worldwide, particularly in areas with historically limited access to such facilities, personnel, clinical expertise, or financial means. Here, we present promising innovations like telemedicine, online collaborative platforms (OCPs), immersive technology (IT), and clinical artificial intelligence (AI) and their implementation in mitigating barriers to neurosurgical care. We argue how these tools enhance communications between providers and patients, streamline intraoperative workflows, and democratise access to neurosurgical education and training by reducing resource demands such as time, travel, and human labour. It is necessary, though, to identify how these technologies can be most successful in the context of global neurosurgery. In addition to reviewing these various technological avenues, we explore the nuances associated with the implementation and reported outcomes for each tool-highlighting challenges and opportunities for further innovation.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation of the global burden of tungiasis in endemic countries using a disability adjusted life-years modelling approach.","authors":"Alistair Antonopoulos, Lynne Elson, Jürgen Krücken, Marlene Thielecke, Francis Mutebi, Richard B Yapi, Ulrike Fillinger, Hermann Feldmeier, Ruth Nyangacha, Nono-Raymond Swar Kuispond, Eddy Kakiese Laken, Renata Santiago Alberto Carlos, Johannes Charlier, Georg von Samson-Himmelstjerna","doi":"10.1186/s44263-026-00318-2","DOIUrl":"10.1186/s44263-026-00318-2","url":null,"abstract":"<p><strong>Background: </strong>Tungiasis is a neglected tropical zoonotic skin disease which is endemic to Sub-Saharan Africa and Latin America, caused by sand fleas of the genus Tunga, which burrow into the skin of affected humans and animals, most commonly when the feet come in contact with infested soil. Sand flea infection leads to inflammation, severe itching, and pain, with the potential for secondary bacterial or viral infections, gangrene, and disfigurement. Tungiasis disproportionately affects poor rural communities, and individuals living in unhygienic settlements. To date, the existing burden of tungiasis has never been estimated, despite being included in the World Health Organisation Neglected Tropical Diseases roadmap since 2021.</p><p><strong>Methods: </strong>We applied a prevalence-based Disability Adjusted Life Year (DALY) approach focusing on Years Lived with Disability (YLD) to model the burden of human tungiasis in endemic countries. Prevalence range estimates were derived using a Bayesian hierarchical Beta-Binomial model, with probability distributions applied to represent uncertainty in estimates based on highly heterogeneous local reports, capture local and regional variation, and reflect fluctuations in symptom severity among affected individuals. A discrete time point model was implemented over a 52-week period to estimate annual DALYs lost per country included in the analysis. Monte Carlo simulation with 1000 iterations was used to generate mean DALY estimates.</p><p><strong>Results: </strong>Globally, we estimate that up to 379,645 (95% UI 361,792-398,309) DALYs are lost annually, with the bulk of the burden in Sub-Saharan Africa. When comorbidities are included, this increases to 575,298 (95% UI 548,948-602,597). When adjusted for population size, we estimate that 24.2 DALYs (36.4 with comorbidities included) are lost annually per 100,000 people. In terms of DALYs lost, the disease burden is disproportionately concentrated in Sub-Saharan Africa, and Brazil.</p><p><strong>Conclusions: </strong>Our estimates suggest tungiasis exerts a substantial burden of disease in endemic countries, comparable in absolute terms to that of soil-transmitted helminths and echinococcosis, and greater than that of toxocariasis, fascioliasis. Furthermore, we observe marked regional concentration of disease burden within Sub-Saharan Africa, with the disease burden in this region driven by large at-risk rural, and urban slum-dwelling, populations living within the ecological zone of transmission.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation components and delivery structures of adolescent peer navigation as a workforce model: a scoping review.","authors":"Ashley Chory, Ava Boal, Annabel Azziz, Carrie Levinson, Lonnie Embleton, Mary Ott, Rachel Vreeman, Edith Apondi","doi":"10.1186/s44263-026-00323-5","DOIUrl":"10.1186/s44263-026-00323-5","url":null,"abstract":"<p><strong>Background: </strong>Adolescents face persistent barriers to accessing health services, particularly among vulnerable populations such as those living with HIV, adolescent mothers, and youth experiencing mental health or substance use challenges. Peer navigation has emerged as a promising strategy to address these gaps by leveraging shared lived experience to support engagement across health and social systems. However, existing literature has primarily focused on intervention effectiveness, with limited attention to how these programs are implemented. This scoping review aims to characterize the implementation architecture of adolescent peer navigation programs globally, with a focus on peer eligibility, training, supervision, and support systems.</p><p><strong>Methods: </strong>Following PRISMA-ScR guidelines, we systematically searched four databases for studies published between 2005 and 2025. Twenty-one programs met inclusion criteria. Data were extracted using a standardized, piloted template capturing study characteristics, peer navigator characteristics, training and supervision, navigator roles and responsibilities, health services and domains addressed, delivery modalities, and program focus. Given heterogeneity across studies, data were synthesized narratively using descriptive tables and iterative thematic coding. Two reviewers independently reviewed extracted data, developed and refined codes through discussion, and identified recurring implementation components and patterns to characterize program typologies and inform a conceptual model of adolescent peer navigation.</p><p><strong>Results: </strong>Across studies, peer navigation programs shared core design elements, including selection based on lived experience, structured training, supervision, and multidimensional roles spanning psychosocial support, health education, and service navigation. However, substantial variability was observed in how these components were operationalized. Training and supervision were widely implemented but inconsistently specified, and few studies examined peer navigator well-being or workforce sustainability. Programs were predominantly clinic-based and concentrated in countries in Africa, with emerging hybrid and community-based models.</p><p><strong>Conclusions: </strong>Adolescent peer navigation is best understood as a flexible workforce and service delivery model rather than a standardized intervention. Strengthening reporting and standardization of implementation components is critical to support replication, optimization, and scale-up.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is generative AI use causing mental health problems?","authors":"Christian Montag, Benjamin Becker","doi":"10.1186/s44263-026-00320-8","DOIUrl":"10.1186/s44263-026-00320-8","url":null,"abstract":"","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Divergent stakeholder perspectives on antimicrobial resistance and One Health in Ghana: a qualitative study.","authors":"Maresa Neuerer, Carine Baxerres, Anastasia A Seferiadis, Daniel K Arhinful, Alexander Amponsah, Leslie Mawuli Aglanu, Valérie R Louis, John H Amuasi, Aurélia Souares","doi":"10.1186/s44263-026-00319-1","DOIUrl":"https://doi.org/10.1186/s44263-026-00319-1","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) is a global threat to human, animal, and environmental health driven by natural processes and human practices. One Health, originating from biomedical concerns about zoonoses, links human, animal, and ecosystem health and frames AMR as a systemic issue.</p><p><strong>Methods: </strong>This qualitative study, conducted in the Asante Akim North Municipality of Ghana, aimed to assess how community members, farmers, and institutional actors across animal, environmental, and human health sectors understand AMR and One Health in the context of AMR. Data were collected between November 2021 and October 2023 through ethnographic fieldwork (participant observation, unstructured and in-depth interviews) and socio-epidemiological methods (key-informant interviews, customer-exit interviews). Data were analysed using thematic analysis in NVivo 14, with integration through collaborative cross-coding and interdisciplinary team review.</p><p><strong>Results: </strong>A total of 103 participants were included. Three overarching themes emerged: divergent awareness of AMR, contrasting explanatory models of antibiotic ineffectiveness, and uneven recognition of cross-sectoral health interconnections. Community members and farmers had little known prior exposure to AMR, and thus rarely perceived it as a problem. After the concept was explained, they drew on experiential models that attribute antibiotic ineffectiveness to physiological differences such as blood-drug incompatibility or the body \"getting used\" to drugs. Institutional actors framed AMR as an urgent global health threat with health and economic consequences, using language closely aligned with international policy discourse, yet reported limited personal experience of it. Regarding cross-sectoral dimensions of AMR, community members and farmers described links between health, animals, and environments through everyday concerns about hygiene, close contact with animals, and disease transmission. These insights resonate with One Health principles without using the term itself. Institutional actors strongly endorsed One Health at the policy level but described fragmented implementation and the persistent marginalisation of the environmental health sector.</p><p><strong>Conclusions: </strong>These contrasting explanatory models carry implications for AMR intervention design. Integrating pluralistic explanatory models may strengthen the contextual relevance and sustainability of One Health-based AMR interventions.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's perspectives on gestational diabetes mellitus screening services during antenatal care in Tanzania.","authors":"Amani Kikula, Haika Osaki, Nathanael Sirili, Kaushik Ramaiya, José L Peñalvo, Lenka Beňová, Andrea B Pembe","doi":"10.1186/s44263-026-00315-5","DOIUrl":"https://doi.org/10.1186/s44263-026-00315-5","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is the most common medical condition occurring during pregnancy. Screening for GDM during antenatal care (ANC) provides an opportunity to prevent its progress and complications. Women's experiences should help shape how GDM screening guidelines are implemented, which will further influence uptake and adherence to screening services. We aimed to explore women's experiences of receiving ANC at two hospitals in Tanzania where we introduced GDM screening services.</p><p><strong>Methods: </strong>We employed an exploratory case study design in two district hospitals of Tanzania. We purposively recruited 22 women in 2024 who received ANC, which included GDM screening services. We conducted in-depth interviews using semi-structured interview guides, tape-recorded the interviews, transcribed verbatim, and analyzed the data using qualitative content analysis. Texts were condensed to meaningful units, abstracted to codes which were linked to the social-ecological model, developed sub-categories and categories.</p><p><strong>Results: </strong>Participants described the suboptimal quality of health education and care provided during and after the GDM screening test. They expressed how the experience of receiving GDM screening services influenced their personal and community adaptations to a healthy lifestyle. Women suggested having GDM education in routine ANC health education sessions and to improve the timing and format of delivery of health education provided during ANC. Women expressed the need to simplify the logistics in doing the blood glucose tests, reduce user fees, and improve quality of care provided following the GDM screening test.</p><p><strong>Conclusions: </strong>GDM screening services should be offered as part of routine ANC services. Receiving GDM care within routine ANC improved women's perception of quality health care provided. Counselling and health education on GDM need to be strengthened to improve the quality of GDM care provided. Hospital health management teams should systematically engage the community and improve hospital logistics in offering quality GDM services during ANC.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author Correction: Women engaged in commercial sex living with Human Immunodeficiency Virus and viral non-suppression in Uganda: analysis of multiple respondent-driven sampling surveys, 2021-2023.","authors":"George Aluzimbi, Geofrey Musinguzi, Wilford L Kirungi, Moses Ogwal, Kafeero W Bikokye, Sheila Kyobutungi, Rhoda K Wanyenze, Christiana Nöstlinger","doi":"10.1186/s44263-026-00317-3","DOIUrl":"https://doi.org/10.1186/s44263-026-00317-3","url":null,"abstract":"","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing alignment of Swiss diets with the EAT-Lancet Planetary Health Diet recommendations.","authors":"Selina Randegger, Nele Endner, Carla Wunderle, Nina Kaegi-Braun, Philipp Schuetz","doi":"10.1186/s44263-026-00306-6","DOIUrl":"10.1186/s44263-026-00306-6","url":null,"abstract":"<p><strong>Background: </strong>In 2019, the global EAT-Lancet Planetary Health Diet (PHD) introduced specific recommendations to promote sustainable, health-focused dietary changes in response to the increasing prevalence of diet-related diseases and escalating environmental challenges. We assessed the alignment of Swiss dietary habits with these recommendations.</p><p><strong>Methods: </strong>We analysed data from 2057 adults (18-75 years) from the 2014-2015 national nutrition survey menuCH. We matched different food categories with the PHD classification and calculated mean intakes (g and kcal) per food category, standardised to 2500 kcal, expressed as a percentage of the PHD recommendations (PHD = 100%). We also calculated the Planetary Health Diet Index (PHDI), with higher scores indicating higher adherence.</p><p><strong>Results: </strong>Of the 14 food categories, adherence was highest for fish and seafood (menuCH vs. PHD; mean intake in kcal/day: 41 vs. 40; 103% of the PHD recommendations), followed by grains (775 vs. 811; 96%). The highest level of overconsumption was observed for meat (all types excluding poultry; 255 vs. 30; 850%) and dairy foods (556 vs. 153; 363%). The largest underconsumption was found for legumes (11 vs. 284; 4%) and unsaturated oils (138 vs. 354; 39%). Males consumed significantly more meat than females (298 vs. 214). The overall PHDI was 82.2 out of 140 points, with women showing higher scores than men (84.7 vs. 79.3).</p><p><strong>Conclusions: </strong>Swiss dietary intakes exceeded PHD recommendations, particularly for meat and dairy foods, while legumes remain underconsumed. A shift towards more plant-based foods could improve alignment with health and environmental sustainability goals.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148724085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the impact and cost-effectiveness of antenatal care approaches in 24 low- and middle-income countries: a modelling study.","authors":"Nisaa Wulan, Debra Ten Brink, Tharindu Wickramaarachchi, Sam Ali, Aris T Papageorghiou, Nick Scott","doi":"10.1186/s44263-026-00312-8","DOIUrl":"10.1186/s44263-026-00312-8","url":null,"abstract":"<p><strong>Background: </strong>Antenatal care (ANC) is a critical intervention for improving maternal and newborn health outcomes, particularly in low- and middle-income countries (LMICs). This study modelled the potential impact and cost-effectiveness of a theoretical community-based and risk-stratified model of ANC in LMICs.</p><p><strong>Methods: </strong>A decision-analytical model was developed to estimate health outcomes (maternal anemia, maternal deaths, newborn deaths, preterm births, stillbirths, low birth weight cases, and small for gestational age births) for 24 LMICs with demographic and health surveys conducted between 2018-2024. Three ANC scenarios were considered for the 2025-2034 period; status-quo (no changes in ANC-delivered intervention coverage); no ANC (a counterfactual where ANC-delivered intervention coverage was set equivalent to women reporting no ANC contacts); and a new ANC scenario (a community-based ANC delivery with risk stratification, assuming a 20% reduction in women with no ANC contacts, and equivalent quality/coverage of interventions for women with at least one ANC contact as those currently receiving four to seven contacts). Economic costs were estimated for each scenario from a healthcare provider's perspective using an ingredient-based approach, and the cost per disability-adjusted life year (DALY) averted was calculated relative to the status-quo. Probabilistic sensitivity analyses were conducted to reflect parameter uncertainty.</p><p><strong>Results: </strong>Compared to the no ANC scenario, the status-quo scenario was estimated to cost US$75.16 per DALY averted across the 24 sample countries. Compared to the status-quo, the new ANC scenario was estimated to avert 11.9 million (4.1%) of maternal anemia cases, 0.1 million (4.1%) of maternal deaths, 0.3 million (1.9%) newborn deaths, 0.4 million (0.7%) preterm births, <0.1 million (<0.1%) stillbirths, 7.7 million (6.3%) low birth weight cases, and 8.0 million (5.4%) small for gestational age births. This was estimated to cost US$133.76 per DALY averted compared to the status-quo across the 24 sample countries, varying between 4% and 52% of gross domestic product per capita.</p><p><strong>Conclusions: </strong>A community-based risk-stratified ANC delivery model could be cost-effective in LMICs if it can achieve greater ANC coverage and consistency of interventions within ANC contacts. This analysis supports continued investigation of innovative ANC delivery approaches to improve maternal and newborn health outcomes in LMICs.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13465528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148724238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal, perinatal, neonatal, and postpartum outcomes following Severe Acute Respiratory Syndrome - Coronavirus-2 infection in pregnancy: a World Health Organization multi-country prospective cohort study.","authors":"","doi":"10.1186/s44263-026-00292-9","DOIUrl":"10.1186/s44263-026-00292-9","url":null,"abstract":"<p><strong>Background: </strong>Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has raised global concerns regarding its impact on pregnant women and their infants, particularly across evolving variants. This study aimed to determine if infection during pregnancy increased the risk of adverse maternal, perinatal, neonatal, or postpartum outcomes during pre-Omicron and Omicron periods.</p><p><strong>Methods: </strong>We conducted a prospective cohort study in 10 primarily low- and middle-income countries, comprising public and private maternity hospitals in rural and urban areas. Maternal age and comorbidity adjusted mixed-effects models with country-specific random intercepts were used to estimate relative risks (RRs) comparing participants with and without infection during pregnancy and assess differences by variant period (pre-Omicron vs. Omicron). A total of 16,005 pregnant women were consecutively recruited (all eligible women were enrolled in sequence as they presented at the study facilities) between January 2021 and October 2023 and followed from enrollment through delivery and to six weeks postpartum. Main outcomes included maternal outcomes (haemorrhage, hypertensive disorders of pregnancy, emergency caesarean delivery, maternal death, and modified maternal morbidity and mortality index (MMMI)), and perinatal and neonatal outcomes (preterm birth, congenital anomalies, neonatal intensive care unit (NICU) admission, and severe perinatal morbidity and mortality index (SPMMI)).</p><p><strong>Results: </strong>Based on reverse transcription polymerase chain reaction (RT-PCR) or antigen (Ag) testing and serial serology, 2,187 participants had confirmed SARS-CoV-2 infection during pregnancy, 116 were classified as probable infection, 7,332 as possible infection, 402 participants were probably uninfected, 1,053 had no evidence of infection, and 4,915 had unknown infection status. During the pre-Omicron era, infected women had higher risks of emergency caesarean delivery (RR 1.26, CI 1.03-1.55); MMMI (RR 1.28, CI 1.13-1.45), preterm birth < 37 weeks (RR 1.73, CI 1.31-2.28), < 34 weeks (RR 3.67, CI 1.92-7.04), < 32 weeks (RR 7.62, CI 2.16-26.85), NICU admission (RR 1.90, CI 1.28-2.83) and SPMMI (RR 1.76, CI 1.01-3.06). During the Omicron era, only preterm birth < 34 weeks remained at significantly elevated risk (RR 1.88, CI 1.04-3.05).</p><p><strong>Conclusions: </strong>SARS-CoV-2 infection during pregnancy was associated with an increased risk of adverse maternal, perinatal, and neonatal outcomes in the pre-Omicron era, with attenuation during the Omicron period. Persistent elevated risk for preterm birth < 34 weeks underscores the need for ongoing evaluation with emerging variants.</p>","PeriodicalId":519903,"journal":{"name":"BMC global and public health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}