Maternal health, neonatology and perinatology最新文献

{"title":"Factors associated with mortality among neonates admitted to Special Care Baby Unit: evidence from a matched case-control study in a rural general hospital in Northern Uganda.","authors":"Robert Kidega, Rosemary Ahabwenki, Richard Justin Odong, Joseph Amooti Arike, Ronald Nsubuga, Nestor Mbabazi, Jessica Nakibuka, Sabrina Kitaka, Richard Idro","doi":"10.1186/s40748-026-00304-4","DOIUrl":"10.1186/s40748-026-00304-4","url":null,"abstract":"<p><strong>Background: </strong>Neonatal mortality remains a major public health challenge in sub-Saharan Africa. Despite the high burden, few studies have examined the risk factors linked to these deaths. This study aims to explore factors associated with neonatal mortality in a rural setting of a low-income country.</p><p><strong>Method: </strong>A case-control study matched in the ratio 0f 1:1 by age at admission was conducted at Anaka General Hospital Special Care Baby Unit (SCBU) in Northern Uganda between June 1, 2020, and May 31, 2023. Cases were neonates who died during hospitalization and controls were those discharged alive within 28 days of life. Data was retrospectively extracted from hospital records. Multivariable logistic analysis was conducted to identify factors associated with mortality.</p><p><strong>Results: </strong>Overall, 1,282 were recruited, of which 118(9.2%) died. A 1:1 case-control matching yielded 94 cases and 94 controls. In multivariable analysis, male sex, Complications during birth[OR, 63.31( 95% CI, 4.77-840.50), p = 0.002], APGAR score at 5 min < 7[OR, 3.71( 95% CI, 1.03-13.33), p = 0.045], Prematurity[OR, 19.19( 95% CI, 13.75-98.4), p < 0.001], Respiratory distress syndrome system (OR, 8.24( 95% CI, 1.25-54.1), p = 0.028], First antenatal care visit > 4 month [OR, 7.64( 95% CI, 1.51-38.80), p = 0.014], Resuscitation at birth [OR, 5.81( 95% CI, 1.02-33.08), p = 0.047], and Oxygen therapy[OR, 6.39( 95% CI, 11.10-37.26), p = 0.039] associated with mortality.</p><p><strong>Conclusion: </strong>We found that male sex, complications during birth, APGAR score of less than 7 at 5 min, prematurity, respiratory distress syndrome, late first antenatal Care visit, resuscitation at birth, and oxygen therapy were associated with increased risk of mortality, reflecting a mismatch between neonatal needs and the available care.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169301","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":"Predictors of mortality and severity of hypoxic-ischemic encephalopathy among neonates with birth asphyxia at Jimma University Medical Center, Southwest Ethiopia: a retrospective cohort study.","authors":"Tefera Fufa Kulute, Lencho Kajela Solbana","doi":"10.1186/s40748-026-00309-z","DOIUrl":"10.1186/s40748-026-00309-z","url":null,"abstract":"<p><strong>Background: </strong>Hypoxic-ischemic encephalopathy is a major cause of neonatal mortality and long-term neurodevelopmental impairment, particularly in low- and middle-income countries. Evidence regarding HIE severity, survival outcomes, and predictors of mortality remains limited in Ethiopia. This study assessed the severity, survival outcomes, and predictors of mortality among neonates with HIE admitted to Jimma University Medical Center (JUMC), Southwest Ethiopia.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted among 373 neonates diagnosed with HIE following birth asphyxia and admitted to Jimma University Medical Center(JUMC). Data were extracted from medical records using a structured checklist. Kaplan-Meier survival analysis and the log-rank test were used to estimate and compare survival experiences. Cox proportional hazards regression identified predictors of mortality, while ordinal logistic regression was employed to determine factors associated with increasing HIE severity. Statistical significance was declared at p < 0.05.</p><p><strong>Results: </strong>Among the 373 neonates, 121 (32.4%) had Stage I HIE, 169 (45.3%) had Stage II HIE, and 83 (22.3%) had Stage III HIE. The overall mortality rate was 9.1%, and the median event-free survival time was 30.6 days. Kaplan-Meier analysis showed survival probabilities of 0.99 (95% CI: 0.99-1.00) at day 1, 0.75 (95% CI: 0.65-0.86) at day 20, and 0.29 (95% CI: 0.15-0.59) at day 40. Survival differed significantly across HIE stages (log-rank χ² = 45.4, p = 0.00). Factors independently associated with increasing HIE severity included outborn status (AOR = 1.50; 95% CI: 1.00-2.26), acute kidney injury (AOR = 1.93; 95% CI: 1.21-3.08), macrosomia (AOR = 2.54; 95% CI: 1.29-5.07), and hypoglycemia (AOR = 1.59; p = 0.01). Maternal gestational diabetes showed a borderline association with severity (AOR = 1.99; 95% CI: 0.97-4.10). Predictors of mortality included Stage II HIE (AHR = 3.24; 95% CI: 2.55-4.13), acute kidney injury (AHR = 3.27; 95% CI: 2.47-4.31), Apgar score ≤ 3 (AHR = 3.71; 95% CI: 2.59-5.31), Apgar score 4-6 (AHR = 1.67; 95% CI: 1.30-2.13), outborn status (AHR = 1.62; 95% CI: 1.29-2.04), and neonatal sepsis (AHR = 2.12).</p><p><strong>Conclusion: </strong>Hypoxic-Ischemic Encephalopathy remains a substantial contributor to neonatal mortality at Jimma University Medical Ceneter. Survival declined markedly with increasing disease severity. Mortality was independently associated with HIE stage, acute kidney injury, low Apgar score, outborn status, and neonatal sepsis, while HIE severity was associated with outborn status, acute kidney injury, macrosomia, and hypoglycemia. Strengthening referral systems, improving perinatal care, and ensuring early detection and management of neonatal complications are essential to improve neonatal outcomes.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171259","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":"The prevalence of harmful traditional umbilical cord care practices and associated factors in newborns: a systematic review and meta-analysis.","authors":"Abraham Dessie Gessesse, Jenberu Mekurianew Kelkay, Yabibal Asfaw Derso, Dagnew Tigabu, Bekalu Alemayehu Attinafu, Alemu Birara Zemariam, Desalegn Mitiku Kidie, Molla Azmeraw, Molalign Aligaz Adisu","doi":"10.1186/s40748-026-00307-1","DOIUrl":"10.1186/s40748-026-00307-1","url":null,"abstract":"<p><strong>Background: </strong>Harmful umbilical cord care practices remain a major public health concern in various developing countries, contributing significantly to neonatal sepsis, which accounts for approximately 15% of all neonatal deaths globally. Despite known health risks, many caregivers continue to rely on traditional methods. This systematic review and meta-analysis aimed to quantify the national prevalence of such practices and identify associated factors.</p><p><strong>Methods: </strong>A systematic literature search was conducted using PubMed Central, Cochrane Library, Web of Science, Scopus, and Google Scholar for publications from 2012 to September 2025. The quality of studies was evaluated using the Joanna Briggs Institute (JBI) criteria. Heterogeneity was assessed with I² statistics and Cochran's Q test, and a random-effects model was applied. Publication bias was evaluated using funnel plots and Egger's test, with subgroup analyses conducted to explore heterogeneity among studies.</p><p><strong>Results: </strong>A total of 15 studies with 15,368 study participants were used for analysis. The overall pooled prevalence of harmful traditional umbilical cord care practices in newborns was 31.63% (95% CI: 25.07, 38.19). Types of harmful substances applied on the cord: the pooled prevalence of butter is 34.24%; Vaseline petroleum jelly, 25.14%; body lotion, 6.64%; ash, 26.28%; food oil, 35.05%; cow dung, 8.81%; and ointment, 42.08%, respectively. Being delivered at home (pooled adjusted odds ratio, AOR = 3.74 (95% CI: 1.33, 7.15)) and uneducated mothers (AOR = 3.22 (95% CI: 2.13, 4.31)) were significantly associated with the prevalence of harmful traditional umbilical cord care practices.</p><p><strong>Conclusion and recommendation: </strong>The prevalence of harmful traditional cord care was notably high as compared to WHO recommendations. Home delivery and uneducated mothers contribute significantly to the prevalence of harmful traditional cord care practices in the nation. These findings revealed that combating neonatal sepsis requires moving beyond hospital walls; we must bridge the health literacy gap for uneducated mothers and aggressively encourage institutional deliveries to replace lethal traditions with lifesaving cord care.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149805","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":"Timing of umbilical cord clamping and its predictors among neonates in Northeast Ethiopia: a multicenter prospective observational study.","authors":"Zenebe Tefera, Mandefro Assefaw, Lemlem Chanyalew Melese, Molla Kassa, Abdulkadir Kassaw, Nigusie Abebaw, Atrsaw Dessie Liyew, Mengistu Abate Belay","doi":"10.1186/s40748-026-00301-7","DOIUrl":"https://doi.org/10.1186/s40748-026-00301-7","url":null,"abstract":"<p><strong>Background: </strong>Optimal umbilical cord clamping, defined as clamping between one and three minutes after birth, is recommended by the World Health Organization to improve infant health and nutritional outcomes through placental transfusion. Despite these recommendations, early cord clamping remains prevalent in many settings, depriving neonates of up to 30% greater blood volume and increasing the risk of iron deficiency anemia., Evidence on the time to cord clamping and its predictors is limited in Ethiopia. The study aim to assess the time to umbilical cord clamping and its predictors among neonates in Northeast Ethiopia.</p><p><strong>Methods: </strong>A facility-based prospective observational study was conducted among 264 neonates from February 1 to March 2, 2025. The study participants were selected using systematic sampling technique. Data were collected via observation and structured checklists and analyzed using STATA 17. Each neonate was observed for a fixed maximum of 60 s from birth. Cord clamping within 60 s was considered the event of interest; neonates not clamped by 60 s were right-censored at that time point. Survival analysis was performed using Kaplan‒Meier estimates, and the Cox proportional hazards regression model was used to identify independent predictors of early cord clamping. Adjusted hazard ratios with 95% confidence intervals are reported, and variables with p values < 0.05 in the multivariable analysis were considered significant predictors.</p><p><strong>Results: </strong>The overall incidence rate of early cord clamping was 8.27 per 1000 person-seconds (95% CI: 6.88-9.94). A history of preeclampsia (AHR = 3.06, 95% CI: 1.81-5.19), cesarean delivery (AHR = 3.08, 95% CI: 1.90-5.01), episiotomy (AHR = 3.48, 95% CI: 2.01-6.07), the presence of a nuchal cord (AHR = 4.08, 95% CI: 2.09-7.96), the need for neonatal resuscitation (AHR = 2.98, 95% CI: 1.20-7.37), and a first-minute Apgar score < 7 (AHR = 2.22, 95% CI: 1.05-4.67) were independent predictors of a shorter time to cord clamping. The log-rank test revealed statistically significant differences in the number of clamps across all these predictors (p < 0.001).</p><p><strong>Conclusion and recommendations: </strong>Early cord clamping remains highly prevalent in the study area, with more than two-fifths of neonates clamped within the first minute. Therefore, strengthening adherence to the recommendations through targeted training, institutional protocol reinforcement, and quality improvement initiatives is recommended.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119630","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":"Impact of live music therapy compared with storytelling on maternal depression and psychological distress in mothers of preterm infants: a secondary analysis of a randomized controlled trial.","authors":"Susann Kobus, Nina Jacqueline Klasen, Alisa Weinkoetz, Felicia Schneider, Ursula Felderhoff-Mueser, Nora Bruns","doi":"10.1186/s40748-026-00300-8","DOIUrl":"https://doi.org/10.1186/s40748-026-00300-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Music therapy in neonatology is becoming increasingly important and is now considered an evidence-based intervention that effectively complements standard medical care for preterm infants and their mothers in accordance with family-centered care. This study aimed to compare the effects of live-performed music therapy (MT) and storytelling (ST) in the neonatal intensive care unit (NICU) on psychological distress and depression among mothers of preterm infants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The study was conducted as a secondary analysis of a randomized controlled trial (RCT), enrolling 60 preterm infants born between 32+0 to 36+6 weeks of gestation. Infants were block-randomized 1:1 to receive either MT or ST. Both interventions were delivered live to the preterm infants three to four times per week from birth until hospital discharge from hospital. The degree of depressive symptoms, anxiety and acute stress reactions of their mothers were measured using the German version of the Center for Epidemiologic Studies Depression Scale (CES-D) and the Impact of Event Scale-Revised (IES-R). Assessments were conducted on the first day of delivery prior to randomization (Timepoint 1 [T1]), at infants discharge from hospital (Timepoint 2 [T2]) and around the infants' first birthday (Timepoint 3 [T3]).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The infants of 30 mothers [mean age 33.8 ± 6.1 years (range 21-47)] received MT and the infants of an additional 30 mothers [mean age 32.9 ± 5.3 years (range 21-45)] received ST. A total of 552 sessions were conducted, including 303 live music therapy sessions with a mean duration of 24 ± 2.5 minutes and 249 live storytelling sessions with a mean duration of 23 ± 4.1 minutes. Mothers whose infants received music therapy demonstrated greater reductions of depressive and stress symptoms between T1 and T2 compared to mothers whose infants received storytelling (MT: CES-D mean difference in total score -22.4, IES-R mean difference of total score -3.9; ST: mean difference in CES-D total score -10.7, mean difference of IES-R total score -1.1). Effect sizes (Cohen's d) for the differences between T1 and T2 were large for total CES-D (1.0) and total IES-R (1.5), but weak for the differences between T1 and T3 (total CES-D 0.4, total IES-R 0.4). The absolute values at T3 did not differ as much as those at T2 between the two groups, but remained slightly more favorable in mothers whose infants received MT (mean total CES-D 6.7, 95% Confidence Interval (CI) 5.9-7.6; mean total IES-R -1.8, 95% CI -2.2-(-1.4)) than in mothers whose infants received ST (mean total CES-D 10.8, 95% CI 9.1-12.4; mean total IES-R -1.7, 95% CI -1.9-(-1.2)).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;These findings indicate that mothers of preterm infants may benefit from music therapy as a supportive, non-medical intervention in alleviating psychological symptoms and distress during their infants' NICU stay and may continue to support mat","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119664","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":"The effect of nighttime or weekend births on perinatal outcomes in Africa, 2025: Systematic review and meta-analysis.","authors":"Yilkal Dagnaw Melesse, Getachew Tilaye Mihiret, Mamaru Getie Fetene, Haile Amha, Asmamaw Getnet, Menberu Gete, Atsede Alle Ewunetie, Aysheshim Asnake Abneh, Getnet Gedif, Anteneh Lamesgen, Tadele Derbew Kassie, Mequanent Dessie Bitewa, Alehegn Aderaw Alamneh, Melkamu Siferih, Abebaw Abeje Muluneh","doi":"10.1186/s40748-026-00297-0","DOIUrl":"https://doi.org/10.1186/s40748-026-00297-0","url":null,"abstract":"<p><strong>Background: </strong>Differences in staffing, clinical supervision, emergency preparedness, and the organization of services outside normal working hours may be related to variations in perinatal outcomes for off-hours and weekend deliveries. Evidence from Africa is sparse and conflicting, with some studies reporting increased neonatal morbidity or mortality for births occurring at nighttime/off-hours or weekends while others have reported no significant differences. Hence, this systematic review and meta-analysis aimed to estimate the association between nighttime/off-hours or weekend births and adverse perinatal outcomes in African health facilities.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guideline. An internet-based search of noninterventional studies in Africa was performed in CINAHL, EMBASE, PubMed/MEDLINE, Cochrane Library, Scopus, Web of Science, African Index Medicus, African Journals Online, Africa-Wide Information (EBSCOhost) and Google Scholar. A total of 3430 studies were screened, and only 8 studies satisfied the inclusion criteria. The Newcastle-Ottawa Scale and Joanna Briggs Institute critical appraisal checklist were used. The random- and fixed-effects meta-analyses were done in Stata version 17, and forest plots, tests of heterogeneity, and funnel plots were all generated.</p><p><strong>Results: </strong>Eight studies were included. The majority of single-centric studies report increasing risk of early neonatal death (OR ≈ 1.70), fresh stillbirths (OR ≈ 1.95), low Apgar scores, and neonatal intensive care unit admissions with off-hour deliveries. Meta-analyses showed the borderline relationship of fresh stillbirth (OR 1.33; 95% CI 0.99-1.67) with I² = 88.7%, early neonatal death (OR 1.62; 95% CI 1.20-2.05; I² = 0%), but not with a 5-minute Apgar score of < 7 (OR 1.13; 95% CI 0.86-1.40; I² = 0%) with night/weekend birth. No evidence for publication bias was demonstrated.</p><p><strong>Conclusion: </strong>Off-hour delivery within African hospitals is associated with increased risk of early neonatal death and possibly fresh stillbirth, but the impact on Apgar score and other outcomes is heterogeneous. Staffing, case mix, and service organization were the explanations for differences.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119692","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 health, neonatology and perinatology towards a standardized outcome set for clinical trials in Hemolytic Disease of the Fetus and Newborn (HDFN): preliminary findings from two European advisory boards.","authors":"Enrico Lopriore, Maartje Mangelaars, Tom Verbiest, Wim Noel, Alexandra Starry, E J T Verweij, Katie Morris","doi":"10.1186/s40748-026-00302-6","DOIUrl":"10.1186/s40748-026-00302-6","url":null,"abstract":"<p><p>Hemolytic Disease of the Fetus and Newborn (HDFN) remains a serious perinatal condition worldwide despite major advances in antenatal and postnatal care. A key gap in HDFN research is the absence of a standardized outcome set, leading to inconsistent reporting and limited comparability across studies identified during systematic literature review (SLR). Outcomes important to families, such as long-term neurodevelopment and emotional impact, are often overlooked. 2 separate European advisory boards with 7 HDFN experts were conducted to explore expert perspectives on outcomes that may inform future core outcome set (COS) development. The findings should be interpreted as a preliminary, descriptive outcome prioritization exercise rather than a finalized COS, as no joint consensus meeting, Delphi process, pre-specified consensus threshold, or patient/parent involvement was undertaken. Establishing a formal COS through a structured multi-stakeholder process could enhance research quality, support future evidence generation, and promote more consistent care.Clinical trial number: Not applicable.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066555","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":"Six-month mental health outcomes among participants in a postpartum care in the NICU (PeliCaN) trial: secondary analysis of a randomized controlled trial.","authors":"Kelly B Zafman, Niesha Darden, Laura Walker, Maggie Power, Rachel Ledyard, Sara L Kornfield, Sheila Shanmugan, Celeste Durnwald, Heather H Burris","doi":"10.1186/s40748-026-00303-5","DOIUrl":"10.1186/s40748-026-00303-5","url":null,"abstract":"<p><strong>Introduction: </strong>Parents of infants admitted to the neonatal intensive care unit (NICU) face barriers to postpartum care and are at risk for adverse mental health outcomes. The Postpartum Care in the Neonatal Intensive Care Unit (PeliCaN) study evaluated a novel doula-coordinated, midwife-delivered care model for NICU parents. This secondary analysis compared mental health outcomes between participants randomized to the PeliCaN intervention versus usual postpartum care.</p><p><strong>Methods: </strong>Postpartum parents of preterm infants < 34 weeks admitted to the NICU with an anticipated stay > 1 week were included. Doulas provided individualized emotional and informational support and coordinated a postpartum midwifery visit within the NICU. Mental health outcomes were compared between groups, including Edinburgh Postnatal Depression Scale (EPDS) scores at enrollment and 6 months postpartum and Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) scores at 6 months postpartum.</p><p><strong>Results: </strong>Of 37 participants enrolled in the parent trial, 34 completed mental health screening and were included. At 6 months postpartum, intervention participants had lower mean EPDS scores (4.82 vs. 5.82; P = 0.56) and PCL-5 scores (18.7 vs. 22.2; P = 0.40) compared with usual care, though not statistically significant. No participants endorsed thoughts of self-harm on EPDS screening at baseline or 6 months postpartum. However, two intervention participants experienced neonatal deaths and disclosed acute suicidality to their doulas outside of screening. Both were connected to emergency psychiatric care.</p><p><strong>Conclusion: </strong>Although screening scores did not differ significantly between groups, doulas identified and facilitated intervention for acute suicidal crises in two high-risk NICU parents, an important exploratory clinical finding that highlights the value of doula-led postpartum support models.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov registration information (for the original PeliCaN Trial) Date of registration: August 22, 2022. Date of initial participant enrollment: November 29, 2022. Clinical trial identification number: NCT05510284. URL: https://clinicaltrials.gov/study/NCT05510284 .</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042342","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":"The risk of late-onset fetal growth restriction and unfavorable neonatal outcomes among fetuses within the 10th-25th weight percentile: a prospective cohort study.","authors":"Mahtab Motevasselian, Ameneh Ranjbar, Maryam Kashanian, Nooshin Eshraghi, Neda Hashemi, Tahmineh Ezazi Bojnordi, Maryam Salari, Fakhri Khalighi, Negar Esmaeili","doi":"10.1186/s40748-026-00299-y","DOIUrl":"10.1186/s40748-026-00299-y","url":null,"abstract":"<p><strong>Background: </strong>While negative neonatal outcomes are more frequent in fetuses with estimated fetal weight (EFW) < 10%, they also occur often in fetuses with appropriate-for-gestational-age. This study aimed to evaluate the neonatal outcomes in 10th-25th percentile weight fetuses versus > 25th-<90th percentile.</p><p><strong>Methods: </strong>This prospective cohort study took place at the Maternal-Fetal Medicine Department of a tertiary center in Tehran, Iran, from May 2024- March 2026. Low risk pregnant mothers aged 18-39 years, with singleton pregnancies, exhibiting EFW of 10th-90th percentile, were classified into: 10th-25th percentile group and > 25th-<90th percentile group. Both groups underwent biometric ultrasound at 32-33 weeks of gestation and additionally received biometric and fetal vascular Doppler ultrasound three weeks afterwards. We evaluated the two groups on: (1) Doppler parameters including umbilical artery pulsatility index (UA-PI), middle cerebral artery pulsatility index (MCA-PI), average uterine artery PI, and cerebroplacental ratio (CPR), (2) adverse perinatal and neonatal outcomes including fetal growth restriction (FGR), intrauterine fetal demise, oligohydramnios, meconium-stained liquor, low birth weight (LBW), cesarean section due to fetal distress, abnormal cord arterial blood gas (ABG), low APGAR score, neonatal intensive care unit (NICU) admission, respiratory distress syndrome (RDS), and neonatal mortality. We examined whether the Doppler indices had any predictive value for adverse outcomes in 10th-25th percentile weight fetuses.</p><p><strong>Results: </strong>Of 402 individuals, 320 (79.6%) were in the > 25th-<90th percentile group, while 82 (20.4%) were in the 10th-25th percentile group. The incidence of negative perinatal and neonatal outcomes like FGR (25.60% vs. 2.81%), LBW (20.73% vs. 0.31%), RDS (13.41% vs. 5.31%), low APGAR scores (14.63% vs. 5.31%), abnormal ABG (13.41% vs. 3.75%), and NICU admission (28.04% vs. 9.37%) was higher in the 10th-25th percentile group compared to the > 25th-<90th percentile group. Although abnormal UA-PI, abnormal MCA-PI, and abnormal CPR were more frequently found in fetuses weighing in the 10th-25th percentile group; however, fetal Doppler indices did not successfully predict negative outcomes for fetuses in this weight range.</p><p><strong>Conclusions: </strong>Adverse perinatal and neonatal outcomes were higher in fetuses within 10th-25th percentile for birth weight, with abnormal Doppler indices more common, but these indices did not predict negative outcomes effectively.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992846","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":"Comparison of microdrop administration using a bottle adapter of 2.5% phenylephrine and 0.8% tropicamide with standard drop for ROP examination: a randomized controlled noninferiority trial.","authors":"Vivetha Elango, Narayanan E, Muthukumaran N","doi":"10.1186/s40748-026-00296-1","DOIUrl":"10.1186/s40748-026-00296-1","url":null,"abstract":"<p><strong>Background: </strong>Pharmacologic mydriasis is essential for retinopathy of prematurity (ROP) screening; however, conventional ophthalmic drops substantially exceed neonatal conjunctival sac volume, leading to systemic absorption and potential adverse effects. Microdrop administration may reduce drug exposure while preserving adequate pupillary dilation. This study aimed to determine whether microdrop administration of phenylephrine and tropicamide is noninferior to standard drops in achieving adequate mydriasis for ROP screening via a bottle adapter.</p><p><strong>Methods: </strong>This single-center, randomized, parallel-group noninferiority trial was conducted in a tertiary neonatal unit in Chennai, India. Preterm infants undergoing routine ROP screening were randomized to receive either microdrops (10.26 µL) or standard drops (26.58 µL) of 2.5% phenylephrine and 0.8% tropicamide. Three doses were administered at 10-minute intervals. The primary outcome was the mean pupil diameter at 45 min after the first instillation. The secondary outcomes included physiological parameters (heart rate, oxygen saturation, and blood pressure), systemic and local adverse events, and the adequacy of ROP examination. A noninferiority margin of - 0.5 mm was prespecified.</p><p><strong>Results: </strong>Among the 127 infants assessed for eligibility, 102 were randomized (microdrop group, n = 52; standard group, n = 50), and all completed the study. Baseline characteristics were comparable between the groups. At 45 min, mean pupil diameter was 6.54 ± 0.52 mm in the microdrop group and 6.38 ± 0.63 mm in the standard-drop group (mean difference, 0.16 mm; 95% CI, - 0.07 to 0.38 mm; p for noninferiority < 0.001). As the lower bound of the 95% CI (- 0.07 mm) was above the prespecified noninferiority margin of - 0.5 mm, noninferiority was established. Physiological parameters, including heart rate, oxygen saturation, and blood pressure, remained stable and comparable between the groups. Systemic adverse events were rare and similar across groups, and no local ocular complications were observed. ROP examination was successfully completed in all infants.</p><p><strong>Conclusion: </strong>Microdrop administration of phenylephrine and tropicamide achieved mydriasis comparable to standard drops, with no significant difference in adverse effects between the groups. This approach may represent a safer, clinically feasible and more physiologically appropriate strategy for ROP screening by reducing drug exposure in vulnerable preterm infants.</p><p><strong>Trial registration: </strong>The study protocol was approved by the Institutional Ethics Committee of Madras Medical College, Chennai (IEC No. MMC/Approval/12052025). The trial was registered with the Clinical Trials Registry of India (CTRI/REF/2025/03/101681)on 10-03-2025.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908084","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}