Maternal health, neonatology and perinatology最新文献

{"title":"Prevalence and associated factors of stillbirth among women at extreme ages of reproductive life in Sub-Saharan Africa: a multilevel analysis of the recent demographic and health survey.","authors":"Alebachew Ferede Zegeye, Enyew Getaneh Mekonen, Tadesse Tarik Tamir, Berhan Tekeba, Tewodros Getaneh Alemu, Mohammed Seid Ali, Almaz Tefera Gonete, Alemneh Tadesse Kassie, Mulugeta Wassie, Belayneh Shetie Workneh","doi":"10.1186/s40748-025-00205-y","DOIUrl":"10.1186/s40748-025-00205-y","url":null,"abstract":"<p><strong>Background: </strong>Stillbirth is one of the biggest adverse pregnancy outcomes in countries with low and middle incomes. If current trends continue, 15.9 million babies will be stillborn; nearly half of these (7.7 million, or 48%) will occur in sub-Saharan Africa. Although stillbirth is one of the health care indicators, its prevalence and determinates are not well studied in low- and middle-income countries (LMIC). Therefore, this study aims to assess the prevalence and associated factors of stillbirth among people at extreme ages of reproductive life in Sub-Saharan Africa.</p><p><strong>Methods: </strong>Data from the most recent Demographic and Health Surveys, which covered 23 Sub-Saharan African countries from 2015 to 2022, were used for secondary data analysis. The study used a total of 76,451 women. STATA 14 was used to analyze the data. The associated factors of stillbirth were determined using a multilevel mixed-effects logistic retrogression model. Significant factors associated with stillbirth were declared significant at p- value < 0.05.</p><p><strong>Results: </strong>The prevalence of stillbirth in Sub-Saharan Africa was 6.18% (95% CI: 6.01, 6.35). Higher odds of stillbirth were observed among women at advanced age (35-49 years) (AOR = 3.72, 95% CI: 2.57, 5.41), those who consumed alcohol during pregnancy (AOR = 1.58, 95% CI: 1.24, 2.00), and those who underwent cesarean section delivery (AOR = 1.23, 95% CI: 1.11, 1.37). Additionally, rural residence (AOR = 1.11, 95% CI: 1.01, 1.23), high community levels of illiteracy (AOR = 1.19, 95% CI: 1.07, 1.32), and residing in South sub-Saharan Africa (AOR = 1.19, 95% CI: 1.03, 1.38) were positively associated with stillbirth.</p><p><strong>Conclusions: </strong>This study concludes that stillbirth among women at extreme ages of reproductive life is high compared to the UNICEF 2022 report. The study identified that both individual and community-level variables were associated factors of stillbirth. Therefore, the ministries of health in Sub-Saharan African countries should give attention to those women at the extreme ages of reproductive life and to women from rural areas while designing policies and strategies targeting reducing stillbirth rates.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"11 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774745","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":"Overview of thyroid disorders in pregnancy.","authors":"Mohammed Ashraf Puthiyachirakal, Maeve Hopkins, Tala AlNatsheh, Anirudha Das","doi":"10.1186/s40748-025-00208-9","DOIUrl":"10.1186/s40748-025-00208-9","url":null,"abstract":"<p><p>Thyroid disorders rank as the second most common endocrine abnormalities during pregnancy, posing significant challenges for clinical diagnosis due to overlapping symptoms with normal pregnancy. Thyroid hormones play a critical role in fetal growth and neurocognitive development, necessitating precise interpretation of maternal thyroid function tests, which differ from non-pregnant states. Proper management of thyroid dysfunction can significantly reduce morbidity in both mothers and their fetuses.This review explores the physiological changes in thyroid function during pregnancy, the epidemiology of thyroid disorders, and current guidelines for diagnosis and management. Pregnancy induces anatomical and physiological changes in the thyroid gland, including an increase in gland size and alterations in hormone levels influenced by factors such as hCG and estrogen. These changes necessitate trimester-specific reference ranges for thyroid function tests, as the American Thyroid Association and the American College of Obstetricians and Gynecologists recommended. Hyperthyroidism, primarily caused by Graves' disease and gestational transient thyrotoxicosis, can lead to complications like preeclampsia, preterm birth, and fetal hyperthyroidism. Management includes antithyroid drugs, with careful monitoring to balance maternal and fetal risks. Hypothyroidism, including subclinical and overt forms, is predominantly due to autoimmune thyroiditis and poses risks such as spontaneous abortion, preterm delivery, and impaired neurodevelopment in offspring. The review discusses the debated benefits of levothyroxine treatment for subclinical hypothyroidism, highlighting the need for further research to establish clear guidelines.Given the complex interplay between thyroid function and pregnancy outcomes, this comprehensive review underscores the importance of tailored, evidence-based approaches to managing thyroid disorders in pregnant women.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"11 1","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766151","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":"Determinants of stillbirth among women who gave birth in public hospitals in Northwest Ethiopia, 2022.","authors":"Ayal Gizachew Melaku, Mengistu Abebe Messelu, Mulunesh Alemayehu, Tadesse Yirga Akalu, Gashaw Kerebeh, Roza Belayneh Dessalegn, Moges Agazhe","doi":"10.1186/s40748-024-00199-z","DOIUrl":"10.1186/s40748-024-00199-z","url":null,"abstract":"<p><strong>Introduction: </strong>Stillbirth is still a major public health problem in middle- and low-income countries. However, there has been limited research conducted to identify determinants of stillbirth in Ethiopia. Therefore, this study aimed to identify the determinants of stillbirth among women who gave birth in public hospitals in the West Gojjam Zone, Northwest Ethiopia.</p><p><strong>Methods: </strong>An unmatched case-control study was conducted among 418 mothers who gave birth from March 1-30, 2022. Consecutive and systematic sampling techniques were used to select the cases and controls, respectively. The collected data were entered into Epidata and exported into SPSS version 16 for analysis. Numerical descriptive statistics were expressed by using the mean with standard deviation (SD) and/or median with interquartile range (IQR), whereas categorical variables were expressed by proportions. Bivariable and multivariable binary logistic regression analyses were used to identify determinants of stillbirth. The model goodness of fit test was checked using the Hosmer-Lemeshow test. Variables having a P-value ≤ 0.25 in the bivariable analysis were entered into the multivariable analysis model. Adjusted odds ratio with 95% confidence intervals (CIs) was used to report the strength of association, and variables with a P-value < 0.05 were considered statistically significant.</p><p><strong>Results: </strong>A total of 105 cases and 313 controls were included in this study. The odds of having stillbirth were higher among women who were illiterate (AOR: 1.6, 95% CI: 1.34, 7.55), had first ANC visit in the second trimester (AOR: 11.4, 95% CI: 2.99, 43.71), had an induced mode of delivery (AOR: 8.7, 95% CI: 2.10, 36.03), history of stillbirth (AOR: 1.5, 95% CI: 1.45, 4.90), bad obstetric history (AOR: 4.8, 95% CI: 1.44, 15.89), history of preterm (AOR: 7.6, 95% CI: 1.57, 37.21), not vaccinated for TT (AOR: 8.8, 95% CI: 2.23, 35.17), labor not followed by using partograph (AOR: 3.1, 95% CI: 1.10, 8.42), and history of abortion (AOR: 11, 95% CI: 2.91, 41.31).</p><p><strong>Conclusion: </strong>The determinants of stillbirth included women who were illiterate, started ANC visits in the second trimester, had an induced mode of delivery, history of stillbirth, bad obstetric history, history of preterm, history of abortion, not vaccinated for TT, and not followed by partograph. It is better to improve partograph utilization during intrapartum care and screen mothers who had a higher risk of adverse birth outcomes during their pregnancy to avert the problem.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"11 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756372","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":"Intrauterine intestinal obstruction in a preterm infant with severe mevalonate kinase deficiency - a case report.","authors":"Henrike Hoermann, Julia Franzel, Juliane Tautz, Prasad T Oommen, Elke Lainka, Ertan Mayatepek, Thomas Hoehn","doi":"10.1186/s40748-025-00207-w","DOIUrl":"10.1186/s40748-025-00207-w","url":null,"abstract":"<p><strong>Background: </strong>Mevalonate kinase deficiency is an inherited autoinflammatory disorder that can present with a wide clinical spectrum, ranging from mild forms with recurrent episodes of fever, lymphadenopathy, splenomegaly and skin rash to the much rarer severe form, which is characterized by additional occurrences of psychomotor impairment, cholestatic jaundice, ophthalmological symptoms, and failure to thrive. The few cases described with perinatal onset often showed a very severe clinical course.</p><p><strong>Case presentation: </strong>Here, we report the case of a preterm infant born at 30 + 2 weeks of gestation with a prenatal genetic diagnosis of mevalonate kinase deficiency presenting with intrauterine bowel dilatation, mild hydrops fetalis, and microcephaly. Laparotomy on the second day of life revealed intestinal obstruction necessitating partial ileum resection and ileostomy. The neonate had recurrent inflammatory reactions with elevated C-reactive protein levels, severe cholestasis, a progressive liver dysfunction, and an increasingly distended abdomen with subsequent respiratory insufficiency. Urinary mevalonic acid was highly elevated. The patient received anti-inflammatory therapy with prednisone and anakinra. Unfortunately, the patient died at the age of 77 days due to cardiorespiratory failure.</p><p><strong>Conclusions: </strong>This case shows that intestinal obstruction with dilated fetal bowel loops can be an initially leading clinical symptom of severe mevalonate kinase deficiency. Diagnostics should be considered at an early stage, especially in the presence of other anomalies such as hydrops fetalis, growth restriction, or microcephaly. Data on the neonatal course of severe mevalonate kinase deficiency are still scarce and further studies are needed, particularly on treatment in neonates and young infants.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"11 1","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143559825","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":"Global call to understand intersectionality between heat exposure and perinatal mental health.","authors":"Ashish Kc, Lea Kreyenbaum","doi":"10.1186/s40748-025-00206-x","DOIUrl":"10.1186/s40748-025-00206-x","url":null,"abstract":"<p><p>Increasing heat events, due to human induced climate change have shown to affect vulnerable populations such as pregnant and postpartum women and their mental health. Moreover, consequences of heat events can be unevenly distributed, affecting communities with existing structural discrimination and socially and economically disadvantaged populations. The risk of perinatal depression might be higher in pregnant and postpartum women. In this commentary, we argue, based on the review of literature, that there is a quintessential need for scientific research to investigate the interlinkage between heat events and perinatal depression.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"11 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544974","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":"Safety and efficacy of double plastic wrap in reducing insensible water loss in preterm infants in first week of life - a pilot randomized controlled trial from a low-to-middle-income country.","authors":"Sreetama Das, Somnath Pal, Syamal Sardar","doi":"10.1186/s40748-025-00204-z","DOIUrl":"10.1186/s40748-025-00204-z","url":null,"abstract":"<p><strong>Background: </strong>Preterm infants experience excessive insensible water loss in postnatal period. Established practices like cling film might not be sufficient alone in reducing this loss. Being expensive, humidified incubators might not be affordable in developing countries. Hence, we tried to explore double plastic wrap (cling film attached to the bassinet wall and occlusive plastic wrap covering the baby) as a low-cost solution of increased insensible water loss in postnatal period.</p><p><strong>Methods: </strong>In this pilot trial 63 inborn infants of less than 32 weeks of gestation or birth weight less than 1200 g were enrolled and randomized to either single wrap (only cling film attached to the bassinet wall) or double wrap (cling film covering the bassinet and occlusive plastic wrap covering the baby) group after birth. This practice was allowed in addition to radiant warmer care and other routine thermoregulatory measures followed in the unit. Intervention was continued till first 7 days of life unless they met any pre-specified withdrawal criteria. The primary outcome was a difference in total insensible water loss (g/m2) in first seven days of life between two groups. The secondary outcomes were difference in cumulative insensible water loss (g/m2) in the first 72 h of life, 4-7 days of life, average daily insensible water loss in the first week (g/m2/h), neonatal morbidities, mortality and time to event analysis.</p><p><strong>Results: </strong>Of 63 randomized infants, 32 were allocated to single wrap and 31 to double wrap groups. Cumulative insensible water loss in first 72 h and first week were significantly lower in the double wrap group (2786.5 ± 576 g/m2 in single wrap and 2376.8 ± 626 g/m2 in double wrap, p value 0.012 for 0-3 days and 6225.48 ± 951 g/m2 in single wrap and 5260.61 ± 1091 in double wrap, p value 0.034 for 0-7 days of life respectively). Apart from increased incidence of patent ductus arteriosus in double wrap group (41.94% vs. 15.62%, p 0.027) no other clinically significant outcomes were different between 2 groups. Median times to wean off respiratory support, regain birth weight and discharge from health facility were also similar between the two groups.</p><p><strong>Conclusion: </strong>Double plastic wrap has been found to reduce cumulative insensible water loss in first week of life compared to cling film alone in the setting of a low-to-middle income-country.</p><p><strong>Trial registration number: </strong>CTRI/2024/03/063749.</p><p><strong>Trial registration date: </strong>07.03.2024. LINK TO CTRI: https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MTAwMzk5&Enc=&userName=CTRI/2024/03/063749 .</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"11 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538125","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":"Acceptability of telemedicine for early surgical site infection diagnosis after cesarean delivery in rural Rwanda: a qualitative study.","authors":"Laban Bikorimana, Eve Hiyori Estrada, Anne Niyigena, Robert Riviello, Fredrick Kateera, Bethany Hedt-Gauthier, Vincent K Cubaka","doi":"10.1186/s40748-024-00200-9","DOIUrl":"10.1186/s40748-024-00200-9","url":null,"abstract":"<p><strong>Background: </strong>Telemedicine interventions, while promising for enhancing healthcare access, require an evaluation of feasibility and acceptability to inform field implementation. This qualitative study explored the acceptability of a telemedicine intervention in which surgical incision photos taken by community health workers (CHWs) were sent to hospital-based general practitioners to diagnose surgical site infections (SSIs) following cesarean section in rural Rwanda. As the study timeline coincided with the beginning of the COVID-19 pandemic we additionally asked about their perceptions of telemedicine in this context .</p><p><strong>Methods: </strong>We conducted qualitative, semi-structured in-depth interviews in Kinyarwanda among 26 individuals (14 women and 12 CHWs) who participated in the telemedicine intervention. The interviews were transcribed verbatim and translated into English. Thematic analysis was applied and parallel inductive coding was used to develop English and Kinyarwanda codebooks. These were consolidated into a master codebook for final coding.</p><p><strong>Results: </strong>All women and CHWs found the photo-based telemedicine program acceptable, though some concerns were raised. One woman voiced concerns about the reliability of photos in detecting SSIs compared to in-person visits. Women and CHWs reported perceived faster healing associated with the intervention, enhanced access to postoperative care from home, and cost savings as notable benefits of the telemedicine program. Trust in CHWs emerged as a critical factor for community acceptance. While one CHW expressed reservations about implementing the intervention during COVID-19, the majority of CHWs and patients indicated strong acceptance, with some even preferring it.</p><p><strong>Conclusion: </strong>These findings highlight the acceptance - from both caregivers and patients - of the photo-based telemedicine intervention in a resource-limited context, even amid crises like the COVID-19 pandemic. This acceptance was reinforced with recognized benefits, with trust in CHWs serving as a crucial factor. These insights can inform the development of telemedicine interventions in similar settings.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"11 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191527","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":"Charting a new course: advancing maternal and neonatal health through collaborative innovation.","authors":"Sreekanth Viswanathan","doi":"10.1186/s40748-025-00202-1","DOIUrl":"10.1186/s40748-025-00202-1","url":null,"abstract":"<p><p>This article discusses the strategic vision and recent advancements of the Maternal Health, Neonatology, and Perinatology (MHNP) journal in promoting maternal and neonatal health. Emphasizing its alignment with the United Nations Sustainable Development Goals (SDG), particularly SDG3, the journal is committed to reducing maternal and neonatal mortality through rigorous peer-reviewed research. Implementation of our intelligent, AI-powered Reviewer Finder Tool within Snapp, Springer Nature's next generation peer review platform, and a diverse editorial board enhance publication quality. The journal's future goals include expanding its editorial team and focusing on emerging global health issues in maternal and neonatal health. By fostering collaborative innovation, MHNP aims to significantly impact maternal and neonatal health research and practice.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"11 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082431","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":"Safety of antenatal breastmilk expression from week 34 of pregnancy: a randomized controlled pilot study (The Express-MOM study).","authors":"Marie Bendix Simonsen, Sarah Bjerrum Bentzen, Sören Möller, Kristina Garne Holm, Christina Anne Vinter, Gitte Zachariassen","doi":"10.1186/s40748-024-00197-1","DOIUrl":"10.1186/s40748-024-00197-1","url":null,"abstract":"<p><strong>Background: </strong>Mother's own milk (MOM) is important as the first nutrition for preterm infants, but mothers often struggle to initiate milk production right after preterm birth. If antenatal breastmilk expression (aBME) does not induce preterm labor when performed before term age, it could promote nutrition with MOM right after preterm birth. In this pilot study, we aimed to investigate whether aBME induces preterm labor among healthy nulliparous women from week 34 of pregnancy, to examine if aBME promotes the availability of MOM right after birth and affects breastfeeding outcomes.</p><p><strong>Methods: </strong>Women were randomized to aBME (10 min 2 × daily) from week 34 of pregnancy until birth or to the control group. Both groups had a breastfeeding consultation between week 33 and 34 of pregnancy and were followed until eight weeks after birth. The primary outcome was gestational age (GA) at birth. Secondary outcomes were the availability of MOM and exclusive breastfeeding rates from 24 h to eight weeks after birth. Ranksum test and a posterior plot for the probability of non-inferiority were applied to the primary outcome. The availability of MOM is reported as medians and IQR. Breastfeeding outcomes were analyzed with mixed effects logistic regression.</p><p><strong>Results: </strong>One hundred forty-four pregnant women were eligible for participation, 51 were excluded, and 33 declined participation/did not answer inclusion phone calls. 60 women were included and randomized. Primary outcome data were available in 55 women (28 in intervention, 27 in control). We found no difference in GA at birth between the two groups: median (IQR), 40 + 1(39 + 5:41 + 2) in intervention vs. 40 + 2 (39 + 4:41 + 1) in control, p = 0.98. Antenatal expressed MOM was available at birth in most women in the intervention group (23/28, 82%), with a median of 52 mL during pregnancy. There was no statistically significant difference in breastfeeding outcomes. No adverse events were reported.</p><p><strong>Conclusions: </strong>aBME performed by healthy nulliparous women from gestational week 34 did not induce preterm labor. In most women in the intervention group, MOM was available right after birth. The study results provide the basis for a trial among women at high risk for preterm birth.</p><p><strong>Trial registration: </strong></p><p><strong>Clinicaltrials: </strong>gov (NCT05516199).</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"11 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924070","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 severe maternal morbidity a risk factor for postpartum hospitalization with mental health or substance use disorder diagnoses? Findings from a retrospective cohort study in Maryland: 2016-2019.","authors":"Carrie L Wolfson, Jessica Tsipe Angelson, Andreea A Creanga","doi":"10.1186/s40748-024-00198-0","DOIUrl":"10.1186/s40748-024-00198-0","url":null,"abstract":"<p><strong>Background: </strong>Perinatal mental health conditions and substance use are leading causes, often co-occurring, of pregnancy-related and pregnancy-associated deaths in the United States. This study compares odds of hospitalization with a mental health condition or substance use disorder or both during the first year postpartum between patients with and without severe maternal morbidity (SMM) during delivery hospitalization.</p><p><strong>Methods: </strong>Data are from the Maryland's State Inpatient Database and include patients with a delivery hospitalization during 2016-2018 (n = 197,749). We compare rate of hospitalization with a mental health condition or substance use disorder or both at 42 days and 43 days to 1 year postpartum by occurrence of SMM during the delivery hospitalization. We use multivariable logistic regression to derive the odds of hospitalization with each outcome for patients by SMM status, adjusted for patient sociodemographic characteristics, presence of mental health condition or substance use disorder diagnoses during the delivery hospitalization, and delivery outcome. All SMM, mental health conditions, and substance use disorders are identified using ICD-10 diagnosis and procedure codes.</p><p><strong>Results: </strong>Overall, 5,793 patients (2.9%) who delivered during 2016-2018 experienced hospitalization in the year following delivery. Among these patients, 24.3% (n = 1,410) had a mental health condition diagnosis, 10.6% (n = 619) had a substance use disorder diagnosis, and 9.8% (n = 570) had co-occurring mental health condition and substance use disorder diagnoses. Patients with SMM had 3.7 times the adjusted odds (95% CI 2.7, 5.2) of hospitalization with a mental health condition diagnosis, 2.7 times the odds (95% CI 1.6, 4.4) of a hospitalization with substance use disorder diagnosis, and 3.0 times the odds (95% CI 1.8, 4.8) of hospitalization with co-occurring mental health condition and substance use disorder diagnoses during the first-year postpartum.</p><p><strong>Conclusion: </strong>Patients who experience SMM during their delivery hospitalization had higher odds of hospitalization with a mental health condition, substance use disorder, and co-occurring mental health condition and substance use disorder in the one-year postpartum period. Treatment and support resources for mental health and substance use providers --including enhanced screening and personal introduction of providers -- should be made available to patients with SMM upon discharge after delivery, and evidence-based interventions to improve mental health and reduce substance use should be prioritized in these patients.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"11 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924064","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}