Maternal health, neonatology and perinatology最新文献

{"title":"Prevalence, socio-demographic, obstetric, nutritional and birth factors associated with C-section among mothers attending primary health care facilities in selected councils of Njombe Region, Tanzania; Facility based cross-sectional analytical study.","authors":"Mariam John Munyogwa, Hans China, Bakari Mwakaghile, Kazi Maskati, Alexander Zawadiel Mchome, Jagadi Ntugwa, Secilia Ng'weshemi Kapalata, Mwajuma Bakari Mdoe, MariaAnjelica Rweyemamu, Nyasiro Sophia Gibore, Agatha Fabian Ngowi","doi":"10.1186/s40748-026-00293-4","DOIUrl":"10.1186/s40748-026-00293-4","url":null,"abstract":"<p><strong>Introduction: </strong>Advances in technology and reproductive health knowledge have increased the incidences of both emergency and elective C-section. In Tanzania the prevalence of C-section is lowest in Simiyu Region (1.5%) and highest in Njombe Region (33.2%). The objective of this study is to assess the prevalence and factors associated with C-section among mothers attending primary health care facilities in selected councils of Njombe Region, Tanzania.</p><p><strong>Methodology: </strong>The study was cross-sectional analytical study. Two councils in Njombe Region were selected by purposive and convenient sampling techniques. About 382 mothers with living children aged 0-2 years were interviewed from eight healthcare facilities. Questionnaire was developed by using previous studies, WHO guidelines and national surveys and installed into Kobo Toolbox software. The interview was conducted through face to face and review from Reproductive and Child Health Card No. 1 (RCH card 1) and Maternal Clinic Card (RCH card 4). SPSS software version 26 was used to analyse descriptive statistics, chi-square test and binary regression for this study. All statistical significant was considered at p < 0.05.</p><p><strong>Results: </strong>About 307(80.4%) were aged between 21 and 34 years currently. Majority 297 (77.7%), attended 4-7 antenatal clinic visits and 60 (15.7%) attended 8 visits. About 177(46.3%) had inadequate GWG and 75(19.6%) had excess GWG. About 25 (6.5%) of mothers were drinking alcohol during previous pregnant. The average gestation age at birth was 38.34 ± 1.62 weeks, most of children 357 (93.5%) were born with recommended birth weight ≥ 2500 g and 326 (85.4%) birth height ≥ 45 cm. Majority 378(99.7%) of respondents delivered at the health care facility. Prevalence of C-section was 154(40.3%). Mothers with the history of previous scar were 63(16.5%). For all C-section, 85(55.2%) were emergency and 69(44.8%) elective. Factors associated with C-section were; history of non-cephalic birth presentation (AOR = 26.24), history of large baby (> 3500 g) (AOR = 3.51), adequate GWG (AOR = 2.30) and excess GWG (AOR = 2.17) and unemployment (AOR = 2.20).</p><p><strong>Conclusion: </strong>Findings suggest high C-section prevalence, poor GWG and alcohol consumption during pregnancy in sampled facilities. Different factors are associated with C-section including; socio-demographic characteristics, obstetrics, nutritional and child birth characteristics. Future cohort studies to establish GWG and to assess factors associated with emergency C-section are recommended to bring more evidences on the current matter. Targeted public health initiatives to educate pregnant women on weight gain and alcohol use during pregnant should be emphasized.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901750","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":"Within- and between-country variation in gestational age thresholds for retinopathy of prematurity screening in Latin America.","authors":"Juan Carlos Silva, Alejandro Vasquez De Kartzow, Celia Cristina Lomuto, Claudia Zuluaga-Botero, Luz Gordillo, Consuelo Zepeda-Romero, Pedro Acevedo, Veronica Contreras, Guillermo Andrés Monteoliva, Gabriela Saidman, Graham E Quinn, Clare Gilbert","doi":"10.1186/s40748-026-00291-6","DOIUrl":"10.1186/s40748-026-00291-6","url":null,"abstract":"<p><strong>Background/objectives: </strong>Most Latin American countries have national retinopathy of prematurity (ROP) screening guidelines, but how consistently these thresholds are applied and whether the metric used affects cross-country comparability is poorly documented.</p><p><strong>Subjects/methods: </strong>We analysed data from the SPROP (Sociedad Panamericana de Retinopatía del Prematuro) database (2021-2024), including 333 of 343 registrants from 17 countries who provided gestational age (GA) and/or birth weight (BW) screening cutoffs. We assessed between- and within-country variation, guideline concordance, and relative variability of GA and BW thresholds using the coefficient of variation (CV). Hospital-level alignment was classified as wider, at, or narrower than the national guideline.</p><p><strong>Results: </strong>BW cutoffs were 3.6 to 5.1 times more variable than GA cutoffs across all countries. Mean GA cutoffs approximated national guidelines, but with marked country-level differences: Argentina applied broader cutoffs than recommended (Δ = +1.5 weeks; 50.5% permissive), Colombia and Peru applied narrower cutoffs (Δ = -1.9 and - 1.3 weeks; 62.7% and 45.5% restrictive, respectively). Mexico showed a mixed pattern (63.9% at guideline), and Paraguay had the highest adherence (80.0%). Overall deviation from guideline recommendations (permissive plus restrictive) ranged from 20.0% in Paraguay to 66.3% in Argentina.</p><p><strong>Conclusions: </strong>Variation in concordance with national ROP screening guidelines reflects differences in programme implementation as well as national recommendations. Organisational stewardship, coordinated implementation, and transparent institutional policies may support effective screening, while robust local outcome surveillance is essential to guide evidence-based adaptation and future refinement of screening criteria.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889758","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":"Challenges in implementing optimal perinatal regionalization: a scoping review.","authors":"Mohammad Heidarzadeh, Leila AbdollahiAbed, Majid Nakhaee, Elaheh Parnian, Amin Daemi","doi":"10.1186/s40748-026-00294-3","DOIUrl":"10.1186/s40748-026-00294-3","url":null,"abstract":"<p><strong>Background: </strong>Perinatal regionalization is a healthcare model designed to ensure that high-risk mothers and newborns receive care in facilities equipped with appropriate expertise and technology. While evidence supports its effectiveness in improving outcomes, the implementation of regionalized systems remains inconsistent and vulnerable to a range of clinical, structural, and financial barriers. This scoping review aimed to identify, categorize, and synthesize the reported challenges that hinder the effective functioning of perinatal regionalization systems across diverse settings.</p><p><strong>Methods: </strong>A scoping review methodology was used following the PRISMA-ScR guidelines. Studies were included if they reported on barriers to regionalized perinatal care. PubMed, Science Direct, and Web of Science were searched covering publications up to May 2024; updated in June 2026. Data were extracted and thematically analyzed, leading to the development of a structured framework of challenge domains.</p><p><strong>Results: </strong>After screening and reviewing the retrieved studies, 41 papers included in final synthesis from which 67 challenges of perinatal regionalization were identified. These challenges were organized into 27 subthemes within seven categories: (1) clinical and medical challenges, including unpredictability of high-risk childbirths and clinical contraindications to maternal transport; (2) socio-economic and geographic barriers, such as distance from tertiary centers and poverty; (3) cultural and patient-centered concerns, including loss of patient rights and connection, and cultural resistance; (4) provider-centered factors, such as loss of prestige, perceived viability, and practice behaviors; (5) organizational and financial disincentives, including competition between hospitals and misaligned reimbursement models; (6) transport and logistical limitations; and (7) structural constraints in low-resource settings, including inadequate infrastructure and weak referral networks.</p><p><strong>Conclusion: </strong>Perinatal regionalization is undermined by interrelated challenges across multiple levels of the health system. Addressing these barriers requires systemic reform, improved coordination, and context-specific strategies to ensure access to risk-appropriate care for all mothers and newborns. The framework of challenges developed in this review can inform policy, planning, and future research on strengthening regionalized perinatal care.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882867","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":"Spinal anesthesia for urgent cesarean section in a parturient with RYR1 mutation-associated malignant hyperthermia susceptibility: a case report.","authors":"Mohammed Abaalkhayl","doi":"10.1186/s40748-026-00288-1","DOIUrl":"10.1186/s40748-026-00288-1","url":null,"abstract":"<p><strong>Introduction: </strong>Malignant hyperthermia (MH) is a rare pharmacogenetic disorder triggered by volatile anesthetics and succinylcholine. MH susceptibility in pregnancy requires prospective anesthetic planning to ensure maternal and fetal safety. This case reports the successful management of an urgent cesarean section under spinal anesthesia in a parturient with pre-pregnancy genetic confirmation of MH susceptibility.</p><p><strong>Main symptoms and clinical findings: </strong>A 27-year-old primigravida (G1P0) at 38 weeks gestation presented with labor pain. She had a known pathogenic RYR1 variant (c.10561G > A) identified before pregnancy due to significant family history (grandfather's intraoperative death). Labor failed to progress in the first stage, necessitating an urgent (Category 2) lower segment cesarean section. Preoperative physical and neuromuscular examinations were normal.</p><p><strong>Main diagnoses, therapeutic interventions, and outcomes: </strong>The patient had autosomal dominant MH susceptibility confirmed by whole exome sequencing. Regional anesthesia was selected as the preferred trigger-free technique; a single-shot spinal anesthetic with 12 mg of 0.5% hyperbaric bupivacaine at L4-L5 achieved a T4 sensory level. Strict MH precautions were implemented: anesthesia machine flushed with 100% oxygen, vaporizers removed, activated charcoal filters applied, CO₂ absorbent replaced, and succinylcholine and volatile agents excluded. Dantrolene was immediately available. Hemodynamics were maintained with left uterine displacement, crystalloid colloid, and phenylephrine infusion. The decision-to-incision interval was 40 min and decision-to-delivery interval 45 min. The intraoperative and 48-hour postoperative course was uneventful, with stable end-tidal CO₂ (32-36 mmHg), normothermia (36.5-37.0 °C), heart rate 80-95 bpm, and no muscle rigidity. A healthy neonate (birth weight 3.1 kg, Apgar 8/9) was delivered. The patient was discharged on postoperative day three in stable condition.</p><p><strong>Conclusion: </strong>This case demonstrates that spinal anesthesia is a safe and effective trigger-free technique for urgent cesarean section in MH-susceptible parturient when strict precautions are followed. Pre-pregnancy genetic diagnosis enabled prospective multidisciplinary planning and contributed to excellent maternal and neonatal outcomes.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 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/PMC13536745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876913","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":"Massive subchorionic thrombohaematoma (Breus' mole) causing postpartum haemorrhage: a case series and management strategy.","authors":"Yin Wang, Xiaoying Liu, Yong Chen, Man Tang, Xianxia Chen","doi":"10.1186/s40748-026-00292-5","DOIUrl":"10.1186/s40748-026-00292-5","url":null,"abstract":"<p><strong>Background: </strong>Breus' mole (massive subchorionic thrombohaematoma, MST) is a rare placental disorder that can cause catastrophic postpartum haemorrhage due to acute rupture of a high-tension haematoma. However, the mechanism of this haemorrhage remains insufficiently understood in clinical practice.</p><p><strong>Case presentation: </strong>Case 1: A 31-year-old woman, G4P1, was admitted at 26⁺¹ weeks of gestation for intrauterine foetal death. She had a history of chronic hypertension and obesity. Serial ultrasound revealed progressive placental thickening (39→87→97 mm) with a massive subchorionic haematoma. Her haemoglobin concentration decreased rapidly from 112 to 48 g/L. During emergency forceps extraction of the placenta, acute rupture of the haematoma wall occurred, resulting in an instantaneous haemorrhage of approximately 1500 mL. The patient survived after massive blood transfusion. Placental pathology revealed a 9 × 7 × 2 cm haematoma beneath the chorionic plate, which was consistent with Breus' mole with maternal vascular malperfusion. Case 2: A 35-year-old primigravida was admitted at 26⁺³ weeks of gestation with threatened preterm labour. She had hypothyroidism, and the foetus had sex chromosome mosaicism. Serial ultrasound revealed progressive placental thickening (36→57→82→91 mm), with a haematoma covering 100% of the foetal surface and measuring up to 4.4 cm in thickness. Her haemoglobin concentration decreased in a stepwise manner from 118 to 78 g/L despite oral iron supplementation. Following multidisciplinary team assessment, labour was induced as planned, resulting in the spontaneous and complete delivery of the placenta, with an estimated blood loss of only 50 mL. Pathology confirmed Breus' mole.</p><p><strong>Conclusions: </strong>Postpartum haemorrhage caused by Breus' mole results from the acute physical rupture of a high-tension haematoma, a mechanism fundamentally different from that of uterine atony. \"Progressive placental thickening, massive subchorionic haematoma, and unexplained progressive decline in haemoglobin concentration\" constitute the core triad for prenatal warning. Proactive termination of pregnancy based on multidisciplinary assessment can effectively prevent catastrophic haemorrhage, enabling a paradigm shift from \"reactive rescue\" approach to a \"proactive defence\" approach.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876961","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":"Expanding evidence-based care for opioid-exposed mother-infant dyads: a mixed-methods study.","authors":"Rachel M Mayo, Jordyn C Sutton, Madison Edgar, Lori Dickes, Windsor W Sherrill, Leah A Holcomb, Elizabeth Charron, Bonnie Treado, Katie Howle, Jessica Boyd, Jennifer Hudson","doi":"10.1186/s40748-026-00290-7","DOIUrl":"10.1186/s40748-026-00290-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Prenatal opioid use continues to contribute to rising rates of neonatal opioid withdrawal syndrome (NOWS) and adverse maternal-infant outcomes in the United States. The Managing Abstinence in Newborns (MAiN) 2.0 model was implemented to expand evidence-based, family-centered NOWS care practices across hospitals in South Carolina (SC). This study evaluated the midpoint implementation of MAiN 2.0 by examining maternal and infant outcomes alongside healthcare provider perspectives on implementation facilitators and barriers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A convergent mixed-methods design was used. Quantitative and qualitative data were collected from opioid-exposed mother-infant dyads and healthcare providers at four rural SC hospitals participating in MAiN 2.0. Quantitative data were used to compare maternal and infant outcomes between the baseline and midpoint implementation periods using independent-samples t-tests and chi-square tests. Outcomes included NOWS severity, length of stay, discharge disposition, prenatal care utilization, rooming-in, and use of supportive services. Semi-structured interviews were conducted with 23 key informants in clinical and healthcare administrative hospital roles. Qualitative data were analyzed using deductive thematic analysis guided by the Consolidated Framework for Implementation Research (CFIR). Data were triangulated to contextualize findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Significant improvements were observed at the midpoint of implementation. Peak NOWS scores decreased significantly from baseline to midpoint (12.3 vs. 8.4, p &lt;.001). Infants were more likely to be discharged to their mothers (75.9% vs. 17.2%, p &lt;.001) and to be monitored throughout hospitalization (70.8% vs. 24.0%, p=.002) at the implementation midpoint than at baseline. Maternal prenatal visits increased significantly (5.5 vs. 9.4 visits, p=.002), as did rooming-in duration (2.7 vs. 5.5 days, p&lt;.001) and lactation consultation completion (14.8% vs. 60.8%, p=.001). Qualitative findings identified training, protocol standardization, organizational support, and reduced stigma as key facilitators of implementation. Persistent barriers included staffing shortages, workflow inconsistencies, pharmacy-related challenges, and broader social and structural constraints. Integrated findings suggested that improvements in outcomes were associated with increased adoption of standardized, family-centered care practices despite ongoing implementation challenges.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Implementation of the MAiN 2.0 model was associated with improvements in NOWS severity, maternal engagement, and family-centered care processes across expansion hospitals. Continued investment in provider training, interdisciplinary coordination, and structural support may strengthen sustained implementation and improve outcomes for opioid-exposed mother-infant dyads.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical trial number: &lt;/strong&gt;Not applicab","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868107","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":"Oxytocin discontinuation after the active phase of induced labour: an overview of systematic reviews.","authors":"Mojgan Mirghafourvand, Mahsa Maghalian, Leila Abdoli Najmi","doi":"10.1186/s40748-026-00295-2","DOIUrl":"10.1186/s40748-026-00295-2","url":null,"abstract":"<p><strong>Background: </strong>To synthesize the available evidence on the effects of discontinuing oxytocin after the onset of the active phase of induced labour.</p><p><strong>Methods: </strong>An overview of seven systematic reviews (SRs) and meta-analyses was conducted. Maternal and neonatal outcomes were extracted, and the methodological quality of reviews was assessed using AMSTAR. Primary study overlap among systematic reviews was quantified using the corrected covered area (CCA).</p><p><strong>Results: </strong>Discontinuation of oxytocin after the active phase was associated with a reduction in cesarean delivery in six SRs. Uterine tachysystole was significantly reduced across all SRs. Nonreassuring fetal heart rate (FHR) patterns were more frequent in the oxytocin continuation groups. Findings for postpartum hemorrhage were inconsistent. Neonatal outcomes, including Apgar score < 7 at 5 min, cord blood pH < 7.10, neonatal asphyxia, and NICU admission, showed no significant differences between groups. Discontinuation was also associated with a modest prolongation of the active phase. Using the AMSTAR tool, all SRs demonstrated high methodological quality (mean score 9.2; range 8-11). However, the seven systematic reviews were highly redundant, largely analyzing the same 15 unique primary RCTs (corrected covered area = 64.4%).</p><p><strong>Conclusion: </strong>Discontinuing oxytocin after the active phase of labour may reduce maternal complications, particularly uterine tachysystole, without compromising most neonatal outcomes. However, the certainty of the evidence is limited by heterogeneity in oxytocin protocols, substantial overlap among the included systematic reviews and their primary trials, and the relatively small number of unique randomized controlled trials. Further high-quality randomized controlled trials using standardized oxytocin regimens are needed to provide more definitive evidence.</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":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148852011","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":"Stromme syndrome presenting with classic microcephaly and apple-peel intestinal atresia in a neonate: a genetically confirmed case report.","authors":"Ketaki Nawlakhe, Prathik Bandiya, Prashanth Raghavendra, Niranjan Shivann","doi":"10.1186/s40748-026-00287-2","DOIUrl":"https://doi.org/10.1186/s40748-026-00287-2","url":null,"abstract":"<p><strong>Background: </strong>Stromme syndrome is an exceptionally rare autosomal recessive ciliopathy caused by biallelic pathogenic variants in the CENPF gene. It is classically characterized by microcephaly and apple-peel type intestinal atresia, often accompanied by ocular, cardiac, and genitourinary anomalies. Fewer than 30 genetically confirmed cases have been reported worldwide, with marked phenotypic heterogeneity. Reporting additional cases contributes to expanding the phenotypic and genotypic spectrum, improving recognition and early diagnosis of this severe disorder. The present case is noteworthy as one of the few antenatally diagnosed instances of Stromme syndrome confirmed by whole-exome sequencing and presenting with the classic combination of microcephaly and apple-peel intestinal atresia.</p><p><strong>Case presentation: </strong>A late preterm female neonate, born at 36 weeks' gestation to a non-consanguineous couple, was antenatally suspected to have intestinal atresia on routine ultrasound at 20 weeks. Amniocentesis followed by whole-exome sequencing identified a pathogenic homozygous variant in the CENPF gene (NM_016343.4: exon 18 c.8692 C > T), confirming Stromme syndrome. Postnatally, the neonate exhibited microcephaly (head circumference 30 cm) with otherwise normal systemic examination. Exploratory laparotomy on day 2 of life revealed duodenal and jejunal atresia with the classic apple-peel configuration and a hypoplastic superior mesenteric artery. Despite surgical intervention and intensive neonatal care, the infant developed progressive sepsis, multiorgan dysfunction, and succumbed on day 9 of life.</p><p><strong>Conclusions: </strong>This case represents the 27th genetically confirmed instance of Stromme syndrome and one of the few diagnosed prenatally. The combination of microcephaly and apple-peel intestinal atresia should alert clinicians to the possibility of CENPF-related ciliopathy. Early genetic confirmation enables accurate prognostication, multidisciplinary management, and informed reproductive counseling. Documentation of such cases is vital to enhance clinician awareness and broaden understanding of this devastating but under-recognized neonatal disorder.</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":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802685","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":"Breaking the cycle: a review of the impacts of maternal PTSD, adverse pregnancy outcomes, and health disparities among Black women.","authors":"Tiffany R Williams, Christina Scifres, David M Haas","doi":"10.1186/s40748-026-00289-0","DOIUrl":"10.1186/s40748-026-00289-0","url":null,"abstract":"<p><p>Posttraumatic stress disorder (PTSD) is an underrecognized contributor to maternal morbidity, infant health complications, and rising healthcare costs. This narrative review synthesizes interdisciplinary evidence on the pathways linking structural inequities, trauma exposure, and maternal PTSD to adverse maternal and infant outcomes, with particular attention to the disproportionate burden experienced by Black women. Structural racism and systemic inequities increase exposure to chronic stress and trauma, which in turn elevate risk for PTSD during the perinatal period. Maternal PTSD functions as a central mechanism linking upstream inequities to downstream health outcomes. Through dysregulation of stress-responsive biological systems and associated behavioral pathways, PTSD increases the risk of adverse maternal outcomes, including hypertensive disorders, preterm birth, and severe maternal morbidity, as well as infant outcomes such as low birth weight, neurodevelopmental and emotional regulation difficulties, and impaired mother-infant attachment. These relationships are bidirectional, with adverse pregnancy and birth experiences further contributing to the onset or exacerbation of PTSD symptoms, reinforcing a cycle of psychological and physiological vulnerability. These interconnected maternal and infant outcomes contribute to substantial healthcare utilization and economic burden at individual and societal levels. The cumulative impact of perinatal mental health conditions exceeds $14 billion annually in the United States, driven in part by adverse birth outcomes and downstream developmental consequences. Addressing this cycle requires trauma-informed, integrated care models that incorporate universal screening, improve access to evidence-based treatment, and address structural barriers to care. Developing scalable, culturally responsive interventions may help reduce disparities, improve maternal and infant outcomes, and mitigate long-term societal costs.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766572","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":"Factors associated with the uptake of intermittent preventive treatment of malaria in pregnancy in Nambale Sub-County Hospital, Kenya.","authors":"Collins Omondi Angute, Stephen Joram Olubulyera, Maurice Owiny, Elvis Oyugi, Diana Menya","doi":"10.1186/s40748-026-00278-3","DOIUrl":"https://doi.org/10.1186/s40748-026-00278-3","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains a significant public health problem globally, with highest morbidity and mortality reported in sub Saharan Africa. In 2022, 12.7 million (36%) Malaria in Pregnancy (MiP) cases in Sub Saharan Africa and 27% were reported from East Africa. In Kenya, 4,080,441 malaria cases and 5% MiP cases reported. Busia County, Kenya, reported 341,886 malaria cases and 22% MiP cases. WHO recommends administering intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) to prevent MIP in malaria-endemic zones. The objective of the study was to determine proportion of pregnant women utilizing IPTp-SP 3 and describe factors influencing utilization of IPTp-SP 3.</p><p><strong>Methods: </strong>A cross-sectional study was employed, pregnant women of nine months, aged 14-49 years were interviewed, using questionnaires on Kobo-collect. The dependent variable was the uptake of three doses of IPTp-SP, with sociodemographic, health facility and individual factors as the independent variables. Chi square test was used in bivariate analysis to determine association between independent variables and dependable variables, variable with p value of ≤ 0.2, were subjected to multivariable logistic regression analysis to identify significant factors (variables with p value of ≤ 0.05) RESULTS: 384 pregnant women were interviewed, 90% resided in rural areas; 93% aware of IPTp use, 68% were married, 67% unemployed, 60% utilized IPTp-SP3 and 47% had secondary education. In the bivariate analysis, participant age 21-30 years {cOR = 2.34, 95% CI = 1.4-3.7}, belief in > 3 doses of IPTp preventing MiP {cOR = 3.09, 95% CI = 1.5-6.2}and having tertiary education {cOR = 2.71, 95% CI = 1.4-5.1} were associated with uptake of ≥3doses of IPTp. On multivariable logistics regression analysis, attendance of ANC at least 4 times {aOR = 8.42, 95% CI = 4.4-16.0} and uptake of IPTp-SP at 14-17 gestation weeks {aOR = 7.79, 95% CI = 3.2-18.7} independently associated with optimal utilization of IPTp (IPTp-SP3).</p><p><strong>Conclusion and recommendation: </strong>A sub-optimal IPTp-SP 3 utilization (60%) way below WHO target of 80%. ≥4ANC attendance and first IPTp-SP uptake at 14-17 gestation weeks were independently associated with optimal utilization of IPTp. Pregnant women attending ANC at the facility should ensure that they attend ANC at least four times and take at least three doses of IPTp for maximum protection against malaria in pregnancy.</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":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765793","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}