Maternal health, neonatology and perinatology最新文献

{"title":"Efficacy of perineal massage in second stage of labour for prevention of perineal trauma: a randomized controlled trial.","authors":"Kritika Gupta, Shikha Chadha, Sandhya Jain, Hima C Kille","doi":"10.1186/s40748-026-00282-7","DOIUrl":"10.1186/s40748-026-00282-7","url":null,"abstract":"<p><strong>Background: </strong>High-quality intra-partum care is crucial for all expectant mothers to ensure safe delivery and favourable postpartum recovery. Vaginal delivery when associated with perineal trauma makes postpartum period painful and increases risk of long-term morbidity. Perineal trauma has been reported to be more common among Asian women. Interventions which minimise the perineal trauma will enhance the experience of motherhood. Various strategies have been explored but there is no firm consensus on their usage. We conducted this study to evaluate the effectiveness of perineal massage during the second stage of labor in reducing perineal trauma.</p><p><strong>Methods: </strong>A randomised controlled study was conducted at a referral centre. Four hundred and fifty women were randomised into two groups of 225 women. Second stage of labor was managed with perineal massage along with fetal head flexion and perineal support in group A and only fetal head flexion and perineal support was given in group B. The rate of intact perineum, episiotomy, perineum tears, duration of second stage and acceptability of perineal massage were compared between the 2 groups.</p><p><strong>Results: </strong>Group A showed a significantly higher rate of intact perineum (p = 0.03) and a lower rate of episiotomies (p = 0.04). Overall rates of perineal tears between groups were not statistically different (p = 0.95). The duration of the second stage of labor was significantly shorter in Group A (p < 0.001). Women experienced significant perineal discomfort but 81.8% said they would opt for it in the subsequent delivery.</p><p><strong>Conclusion: </strong>Perineal massage is a simple, easily applicable and cost-effective technique. It reduced episiotomy rates and duration of second stage of labor significantly. Its routine use can be offered with appropriate counselling to all labouring women.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726665","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":"Fetal ultrasound parameters associated with N-terminal pro-B-type natriuretic peptide levels in umbilical cord blood: a cross-sectional study.","authors":"Shoko Saito, Mari Tadakawa, Hirotaka Hamada, Noriyuki Iwama, Masatoshi Saito","doi":"10.1186/s40748-026-00286-3","DOIUrl":"10.1186/s40748-026-00286-3","url":null,"abstract":"<p><strong>Background: </strong>Current Doppler and functional ultrasound parameters, such as the cardiovascular profile score, umbilical artery pulsatility index, and ductus venosus pulsatility index, are valuable for detecting advanced fetal cardiac decompensation; however, they have limited ability in identifying subtle hemodynamic changes. This critical gap in current fetal assessment highlights the need for reliable markers that can identify subtle cardiac stress before overt failure. In this study, we aimed to identify fetal ultrasound parameters associated with umbilical venous N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, a biomarker associated with fetal cardiac load.</p><p><strong>Methods: </strong>We conducted a single-center, cross-sectional study at a tertiary perinatal medical center, recruiting women with singleton pregnancies undergoing cesarean delivery at ≥22 weeks of gestation. Fetal ultrasonographic examinations were performed within 7 days before delivery, and NT-proBNP levels were measured in umbilical venous blood collected immediately after birth. NT-proBNP values were natural log-transformed (Ln NT-proBNP) to address the non-normality of the residuals in the regression models, and gestational age-adjusted linear regression analyses were performed.</p><p><strong>Results: </strong>A total of 202 pregnant women were included in the analyses. A higher left to right cardiac output (LCO/RCO) ratio was significantly associated with lower Ln NT-proBNP levels (estimate: -0.206; 95% confidence interval [CI]: -0.314 to -0.097), whereas a higher anterior tibial artery to renal artery peak systolic velocity (ATA-PSV/RA-PSV) ratio was significantly associated with higher Ln NT-proBNP levels (estimate: 0.149, 95% CI: 0.047 to 0.251).</p><p><strong>Conclusions: </strong>LCO/RCO and ATA-PSV/RA-PSV were associated with NT-proBNP levels. LCO/RCO consistently improved model performance. While ATA-PSV/RA-PSV may reflect aspects of peripheral circulation not captured by conventional indices, its incremental value beyond gestational age was modest. Further studies are needed to validate these findings and clarify their clinical significance.</p><p><strong>Trial registration: </strong>This study was prospectively registered for transparency in the UMIN Clinical Trials Registry (UMIN-CTR; ID: UMIN000047081, registered on March 4, 2022), as it was an observational cross-sectional study without any intervention or randomization.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714940","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":"A novel homozygous variant causing fatal neonatal adenylosuccinate lyase (ADSL) deficiency presenting with respiratory failure and encephalopathy.","authors":"Keisha Wolfe, Laura Armstrong, Caroline Wambach, Eyby Leon, Katelinn Ohrtman, Ilana Miller, Tucker Pyle, Jason Schroeder, Jamie Fraser, Youssef Kousa","doi":"10.1186/s40748-026-00285-4","DOIUrl":"10.1186/s40748-026-00285-4","url":null,"abstract":"<p><p>Neonatal adenylosuccinate lyase (ADSL) deficiency is a rare neurodegenerative disorder that is associated with epileptic encephalopathy, diffuse hypotonia, and respiratory failure. Loss of enzymatic function of ADSL leads to toxic buildup of succinylaminoimidazole carboxamide riboside (SAICAr) and succinyladenosine (S-Ado). We describe a female term neonate who presented with respiratory failure and encephalopathy. Neuroimaging revealed microencephaly, a simplified gyral pattern, and diffuse white matter edema. Genetic testing showed novel homozygous loss of function mutations of ADSL, the adenylosuccinate lyase gene, consistent with fatal neonatal ADSL deficiency. We find this to be one of less than a dozen cases reported of the fatal neonatal phenotype of ADSL deficiency. The case highlights ADSL deficiency as a rare cause of neonatal encephalopathy and respiratory failure. Clinical recognition of epileptic encephalopathy, pertinent findings on MRI, and testing for S-Ado can confirm the diagnosis and support discussions about goals of care.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708817","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":"Recalculation of the late fetal death rate in Mexico, 2013-2023 using ICD-11 criteria applied to national vital statistics.","authors":"Elia Lara Lona, Pierre Buekens, Joel Martínez Soto, Juana Rosalba García Ramírez, Gerardo Chávez Saavedra, Yessica Ivet Cienfuegos Martínez","doi":"10.1186/s40748-026-00284-5","DOIUrl":"10.1186/s40748-026-00284-5","url":null,"abstract":"<p><strong>Background: </strong>Cross-national comparability of fetal mortality indicators is limited by heterogeneous definitions and denominators. Mexico's official fetal death indicators include all gestational ages and use live births as the denominator, diverging from international standards. We recalculated late fetal death rates using ICD-11 criteria and compared them with published national and international data.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of national fetal death data from Mexico (2013-2023). Publicly available statistics on fetal deaths and registered live-birth datasets were used. All procedures followed ICD-11 recommendations for international reporting standards. Recalculated rates were compared with official Mexican publications, PAHO/WHO estimates for Mexico, and United States (US) rates.</p><p><strong>Results: </strong>From 2013 to 2023, 254,567 fetal deaths were recorded in Mexico. The recalculated ICD-11 late fetal death rate averaged 4.9 per 1,000 total births, increasing from 4.5 (2013-2015) to 5.5 (2020-2023). However, this increase should be interpreted with caution, as it is largely driven by a decline in the number of registered live births over the study period. Official Mexican fetal death rates ranged from 10.1 to 15.5 per 1,000. PAHO/WHO estimates for Mexico (2013-2023) were 7.0-7.9 per 1,000, and US rates (2014-2023) were 2.7-2.9 per 1,000. Most fetal deaths occurred before 28 weeks, with increasing proportions among cases ≤499 g. Most deaths were classified as antepartum (84%).</p><p><strong>Conclusions: </strong>The recalculated ICD-11 late fetal death rate increased from 2013 to 2023. While national late fetal death rates were lower than historical official rates, they were nearly twice as high as US rates.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702822","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 and fetal outcomes in women with uterine congenital abnormalities: a systematic review and meta-analysis.","authors":"Ibrahim Fahmo, Theoneste Hakizimana, Musa Kasujja, Wusa Makena, Chinyere Nkemjika Anyanwu, Chima Paul Okechukwu Ugwu, Emeka Godson Anyanwu","doi":"10.1186/s40748-026-00283-6","DOIUrl":"10.1186/s40748-026-00283-6","url":null,"abstract":"<p><strong>Background: </strong>Congenital uterine anomalies (CUA) are structural abnormalities resulting from disrupted Müllerian duct development and have been associated with adverse reproductive and obstetric outcomes. However, the magnitude of these risks and variation across anomaly subtypes remain incompletely defined.</p><p><strong>Objectives: </strong>To evaluate the association between CUA and adverse maternal and fetal outcomes and to examine subtype-specific risk patterns using contemporary evidence.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of studies identified from MEDLINE, Web of Science, and Cochrane CENTRAL. Eligible studies compared women with imaging- or surgically confirmed CUA to those with normal uterine anatomy and reported at least one predefined obstetric outcome. Random-effects meta-analyses were used to estimate pooled odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic, and certainty of evidence was evaluated using GRADE.</p><p><strong>Results: </strong>Thirty studies comprising over 3.3 million pregnancies were included. Compared with women with normal uterine anatomy, CUA were associated with increased odds of miscarriage (OR 1.45, 95% CI 1.13-1.86), preterm birth < 37 weeks (OR 3.74, 95% CI 1.99-7.02), fetal malpresentation (OR 19.28, 95% CI 6.27-59.24), and caesarean delivery (OR 3.52, 95% CI 1.11-11.09). Heterogeneity ranged from low to high across outcomes (I² 0.0-94.9%). Subtype-specific patterns were observed, with septate uterus more frequently associated with miscarriages, and unicornuate and didelphys uteri associated with higher risks of preterm birth and malpresentation. Sensitivity analyses supported the robustness of findings for preterm birth.</p><p><strong>Conclusions: </strong>Congenital uterine anomalies are associated with increased risks of adverse pregnancy outcomes, with distinct subtype-specific patterns. Septate uterus is primarily associated with early pregnancy loss, whereas unicornuate and didelphys uteri are more strongly associated with later gestational complications. These findings support classification of pregnancies complicated by CUA as high risk and highlight the need for tailored antenatal surveillance and subtype-specific clinical management.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686991","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":"Optimizing Eat, Sleep, Console in the NICU: a collaborative nursing education intervention.","authors":"Sonia Kapoor, Caroline Chua, Laurie Reyna, Timothy M Maul, Rochelle Sequeira Gomes","doi":"10.1186/s40748-026-00277-4","DOIUrl":"10.1186/s40748-026-00277-4","url":null,"abstract":"<p><strong>Background: </strong>The Eat, Sleep, Console (ESC) model of care offers a patient-centered approach for managing neonatal opiate withdrawal syndrome (NOWS), reducing hospital stay, need for pharmacologic treatment, and costs compared to the traditional Finnegan scoring system. Favorable nursing knowledge, attitudes, and practices (KAP) are critical to successful ESC implementation. A prior pilot survey in our neonatal intensive care unit (NICU) revealed inconsistent understanding and application of ESC, indicating a need for targeted education. This study assesses changes in NICU nursing KAP scores following a three-month multiphase educational intervention, and identifies behavioral shifts, barriers, and opportunities to optimize ESC integration.</p><p><strong>Methods: </strong>We conducted a pre-post quasi-experimental study in a Level IV NICU using anonymous 11 point surveys completed by NICU nurses assessing knowledge, attitudes, and perceptions towards ESC before and after the collaborative educational intervention. The intervention included (1) a didactic session with open discussion, (2) an ESC poster displayed in the NICU, and (3) a one-page ESC reference guide. Statistical analyses utilized analysis of variance (ANOVA).</p><p><strong>Results: </strong>Thirty-three NICU nurses completed the pre- and post-intervention surveys; samples were independent and unmatched with an unknown degree of overlap. The increase in mean total KAP scores from 14.8 ± 2.2 to 15.3 ± 2.5 was not statistically significant (p = 0.40). Nurses with less than five years of experience showed the greatest improvement in knowledge and total KAP scores, increasing from 6.3 ± 1.5 to 8.3 ± 1.0 and from 14.3 ± 3.4 to 16.5 ± 1.9, respectively. Perceived safety and effectiveness of ESC improved slightly post-intervention. Didactic attendance did not significantly influence KAP (p > 0.80). Reported barriers to ESC implementation included staff and workflow constraints, limited family presence and parental involvement, lack of interdisciplinary support and system-level resources, and subjectivity and limitations of ESC assessments. Nurses emphasized the importance of greater social and family support, followed by increased nursing education, provider education, and improved lactation support.</p><p><strong>Conclusions: </strong>Collaborative education was not associated with statistically significant changes in NICU nursing KAP scores related to the ESC approach for NAS and may be insufficient as a stand-alone measure. Additional system-level support strategies may be needed to support ESC implementation fidelity and facilitate favorable nursing perceptions and practices towards ESC. Additionally, minimizing barriers affecting families and staff through tailored interventions may promote feasibility of ESC practices, also leading to improved nursing KAP.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13445891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681056","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":"Bidirectional associations between maternal depressive symptomatology and parenting: moderating effects of breastfeeding and partner support.","authors":"Élisabeth Morin, Jean R Séguin, Sophie Parent, Catherine M Herba, Lise Dubois, Gina Muckle, Michel Boivin, William D Fraser, Natalie Castellanos Ryan","doi":"10.1186/s40748-026-00279-2","DOIUrl":"10.1186/s40748-026-00279-2","url":null,"abstract":"<p><p>Postpartum depression and parenting both play a role in shaping children's future behavior. However, there is limited understanding of the interaction and the evolving relationship between depressive symptoms and parenting practices. This study aimed to investigate the bidirectional associations between maternal depressive symptomatology and parenting (maternal self-efficacy, maternal warmth, and maternal hostile-reactive behaviors) in the postpartum period and to assess the moderating effect of breastfeeding and partner support on these associations. Latent growth curve and multigroup analyses were estimated in a sample of 1551 mothers of the 3D pregnancy cohort. Maternal depressive symptomatology and parenting practices were concurrently associated. Bidirectional associations were found between maternal depressive symptomatology and maternal self-efficacy, but not for warmth or hostile-reactive behaviors. Mothers with high perceived partner support showed a significant association between increased maternal warmth and lower depressive symptoms at 24 months. In contrast, mothers with lower perceived partner support demonstrated stronger associations between early hostile-reactive parenting and later depressive symptoms, as well as a greater impact of declining self-efficacy on maternal depressive symptoms. Breastfeeding showed limited moderating effects, with no significant buffering impact on the associations between depressive symptoms and parenting practices. These findings highlight the protective role of partner support in mitigating the adverse effects of depressive symptoms on parenting and vice versa, emphasizing the need for interventions that strengthen maternal self-efficacy and partner involvement to promote maternal mental health.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674677","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 fenugreek oral capsule on the sleep quality of primiparous women in the postpartum period: a triple‑blind randomized controlled trial.","authors":"Somayeh Mohammadi, Fatemeh Zahra Karimi, Roshanak Salari, Seyed Reza Mazloom","doi":"10.1186/s40748-026-00281-8","DOIUrl":"10.1186/s40748-026-00281-8","url":null,"abstract":"<p><strong>Background: </strong>In the first days after childbirth, women often sleep less and have poorer sleep because of physiological and psychological changes and their new responsibilities. Given the side effects of chemical medications, herbal remedies are increasingly considered. This study aimed to determine the effect of fenugreek oral capsules on the sleep quality of primiparous women during the postpartum period.</p><p><strong>Methods: </strong>This two-group, triple-blind, randomized controlled trial was conducted in 2023 on 60 primiparous women attending health centers in Sabzevar. Eligible women took either a 700 mg fenugreek seed extract capsule or a 700 mg placebo capsule containing Avicel powder once daily, starting on postpartum day 3,4, or 5 and continuing until day 60. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) before the intervention and on the 15th, 30th, and 60th days postpartum. Data were analyzed using SPSS (version 22) with descriptive and inferential statistical tests. A p-value of less than 0.05 was considered significant.</p><p><strong>Result: </strong>Before the intervention, the mean sleep quality score was 12.7 ± 1.7 in the fenugreek group and 11.3 ± 2.1 in the placebo group. This difference was statistically significant (p = 0.009), indicating that the two groups were not fully comparable at baseline. On the 15th day postpartum, sleep quality scores were 11.3 ± 1.9 in the fenugreek group and 12.1 ± 1.4 in the placebo group, demonstrating no significant difference between the two groups. However, after adjusting for baseline differences using analysis of covariance, the difference in mean sleep quality score between the two groups became statistically significant (F = 17.1, df = 2, p < 0.001). The average sleep quality scores in the intervention and placebo groups were 8.1 ± 1.5 and 10.0 ± 1.5, respectively, on the 30th day postpartum and 5.1 ± 1.4 and 8.9 ± 1.5, on the 60th day postpartum. The scores were significantly lower in the intervention group compared to the placebo group (p < 0.001). Because the two groups differed in sleep quality scores before the intervention, analysis of covariance was performed. This analysis confirmed significant differences between the groups on postpartum days 30 and 60 (day 30: F = 21.4, df = 2, p < 0.001; day 60: F = 54.6, df = 2, p < 0.001).</p><p><strong>Conclusion: </strong>Fenugreek oral capsule improved self-reported sleep quality of primiparous women during the postpartum period. Therefore, fenugreek may be an effective herbal option for improving sleep quality in primiparous postpartum women. However, future studies should use objective methods to assess sleep.</p><p><strong>Trial registration: </strong>The current study has been registered in the Iran registry of clinical trials ( http://www.irct.ir/ ) on the date 14-03-2023 with registration no. IRCT20230306057640N1.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671472","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 Johnsons, Inslers formula and ultrasound for estimating fetal weight.","authors":"Khadijeh Nasiri, Farzaneh Rashidi, Nasrin Akbari, Ayda EzzatiYazdani, Alireza Afshari-Safavi","doi":"10.1186/s40748-026-00280-9","DOIUrl":"10.1186/s40748-026-00280-9","url":null,"abstract":"<p><strong>Background: </strong>Accurate estimation of fetal weight is a crucial component of pregnancy management and plays a key role in reducing maternal and neonatal complications. Although ultrasonography is considered the gold standard, its limited availability and cost emphasize the need to assess alternative clinical methods.</p><p><strong>Methods: </strong>This cross-sectional study included 132 term pregnant women (37to 41 weeks) selected via non-probability sampling. Fetal weight was estimated prior to childbirth using three methods: ultrasonography (performed within the last two weeks of the third trimester to minimize the impact of rapid fetal weight gain closer to term), Johnson's formula, and Insler's formula and was compared with the actual birth weight immediately after childbirth. Data were analyzed using SPSS version 24, with descriptive statistics and regression.</p><p><strong>Results: </strong>The mean ± SD of estimated fetal weights (EFW) obtained via third-trimester ultrasonography and based on the Johnson and Insler formulas were 3164 ± 382.95 g, 3161.27 ± 302.90 g, and 3309.35 ± 374.05 g, respectively. Regarding diagnostic accuracy, the Johnson formula showed a precision of 69.70% for neonates < 3000 g and 71.21% for macrosomia (> 3500 g), the Insler formula showed a precision of 75.76% for neonates < 3000 g and 68.94% for macrosomia (> 3500 g). In the multivariate regression analysis of estimated fetal weight using the Johnson formula, only fundal height remained a significant independent predictor (β = 149.43, P < 0.001).</p><p><strong>Conclusion: </strong>Although ultrasound is the most accurate method for estimating fetal weight, with the smallest mean difference from the actual weight, clinical methods, particularly the Insler method for normal weight pregnancies and the Johnson method for ruling out macrosomia, have acceptable accuracy.</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":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665313","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 role of the vaginal microbiome in pregnancy loss and preterm birth: a commentary.","authors":"Ronald F Lamont, Theda U P Bartolomaeus, Leonora S Borum, Sofia K Forslund-Startceva, Jan S Jørgensen","doi":"10.1186/s40748-026-00276-5","DOIUrl":"10.1186/s40748-026-00276-5","url":null,"abstract":"<p><strong>Background: </strong>Eubiosis or dysbiosis of the vaginal microbiome may influence the rate of pregnancy loss and preterm birth, the major cause of neonatal and perinatal mortality worldwide.</p><p><strong>Methods: </strong>This was a comparison of two vaginal microbiome studies; one a cohort study and the other a multinational randomised controlled feasibility study. Both studies used cultivation-independent molecular microbiological techniques that together have implications on the risk of pregnancy loss and preterm birth in association with vaginal dysbiosis.</p><p><strong>Results: </strong>The cohort study identified a risk-associated vaginal microbiome signature in association with early pregnancy-loss that comprised an increase in the relative abundance of potentially dysbiotic organisms such as Lactobacillus iners, Sneathia and Prevotella spp and a concomitant decrease in the abundance of eubiotic microorganisms such as Lactobacillus crispatus. Convergent evidence across the two studies demonstrated that a synbiotic intervention was able to shift the vaginal microbiome from the signature demonstrated by Skafte-Holm et al., to a decrease in the abundance of Prevotella, Gardnerella and Atopobium spp, while simultaneously increasing the abundance of eubiotic vaginal Lactobacillus spp.</p><p><strong>Conclusions: </strong>We concluded that there is convergent evidence across the two studies which might otherwise have gone unnoticed. While neither study was powered to demonstrate clinical endpoints and did not establish causal relationships between microbiome modulation and pregnancy outcomes, when administered regularly, vaginal commensal probiotics in ice-cream were effective in optimizing both the vaginal and intestinal microbiota in pregnant women at increased risk of pregnancy loss, particularly preterm birth. This emphasises the need for adequately powered trials to test whether early pregnancy vaginal microbiome modulation can improve clinical outcomes.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407106","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}