Maternal health, neonatology and perinatology最新文献

{"title":"Determinants of tetanus-unprotected births in Tanzania: a multilevel analysis using the 2022 Tanzania Demographic and Health Survey data.","authors":"Yohannes Mekuria Negussie, Beminate Lemma Seifu, Angwach Abrham Asnake, Bezawit Melak Fente, Hiwot Atlaye Asebe, Mamaru Melkam, Meklit Melaku Bezie, Sintayehu Simie Tsega, Zufan Alamrie Asmare, Alemayehu Kasu Gebrehana","doi":"10.1186/s40748-026-00257-8","DOIUrl":"10.1186/s40748-026-00257-8","url":null,"abstract":"<p><p>BACKGROUND: Tetanus is a preventable bacterial disease that poses a significant public health challenge, particularly in low-income regions where immunization rates are low and hygienic birth practices are often inadequate. Neonates are especially vulnerable when their mothers lack sufficient antitoxins due to incomplete vaccination. Although Tanzania has achieved the elimination of maternal and neonatal tetanus, challenges in attaining high vaccination coverage persist. Therefore, this study aimed to investigate the determinants of tetanus-unprotected births in Tanzania. METHODS: The study was based on a secondary analysis of data from the 2022 Tanzanian Demographic and Health Survey (DHS). A weighted sample of 5,745 women was used for analysis. Multilevel mixed-effects models with robust Poisson regression were applied to identify the determinants of tetanus-unprotected births. In the multivariable regression model, adjusted prevalence ratios (APR) with 95% confidence intervals (CI) were used to estimate the strength of associations, with a p-value of < 0.05 considered statistically significant. RESULT: The prevalence of tetanus-unprotected births was 20.52% (95% CI: 19.49–21.55). Maternal age (35–49 years: APR = 1.62, 95% CI: 1.31–1.99), being employed (APR = 0.84, 95% CI: 0.75–0.93), currently being in a union or living with a man (APR = 1.47, 95% CI: 1.09-2.00), living in households with five or more members (APR = 1.22, 95% CI: 1.06–1.41), not wanting the last child (APR = 1.26, 95% CI: 1.13–1.40), having a birth order of four or more for the index child (APR = 2.18, 95% CI: 1.68–2.82), attending only one antenatal care visit (APR = 1.89, 95% CI: 1.45–2.48), and a history of pregnancy termination (APR = 1.17, 95% CI: 1.03–1.32) were identified as significant determinants of tetanus-unprotected births. CONCLUSION: Efforts to reduce tetanus-unprotected births should target older mothers, unemployed women, those in unions, and women with high birth orders or a history of pregnancy termination. Key strategies include promoting comprehensive antenatal care visits, expanding vaccination education to target older women, empowering women through employment, involving male partners in maternal health decisions, and supporting women with unintended pregnancies. </p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13041112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596428","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 critical gap in prevention: knowledge of periconception folic acid supplementation and its predictors among pregnant women in Ethiopia.","authors":"Timsel Girma, Desalegn Tsegaw Hibstu, Befikadu Amare, Geracho Garolla","doi":"10.1186/s40748-026-00254-x","DOIUrl":"10.1186/s40748-026-00254-x","url":null,"abstract":"<p><p>INTRODUCTION: Folic acid deficiency is the most common pregnancy-related micronutrient deficiency, leading to fetal neural tube defects (NTDs). Periconceptional folic acid supplementation is highly effective in reducing NTDs by 72%-86%. However, awareness of this essential prevention method remains limited in lower-income countries, contributing to a high rate of preventable birth defects. Therefore, this study aims to evaluate the knowledge and factors associated with periconceptional folic acid supplementation among pregnant women attending the Antenatal care clinic at Dilla University Teaching Hospital in 2024. METHOD: This institution-based cross-sectional study was conducted at Dilla University Teaching Hospital from January to December 2024. A systematic random sampling technique was used to enroll 337 eligible pregnant mothers attending Antenatal Care. Bivariate and multiple logistic regression analyses were performed to identify associated factors. The strength of association was reported using the Adjusted Odds Ratio (AOR) with a Confidence Interval (CI), with p-values considered statistically significant. RESULT: Only 8.9% (95% CI: 5.85%-11.96%) of pregnant mothers demonstrated good knowledge of periconceptional folic acid supplementation. Factors significantly associated with improved knowledge included higher education (AOR 5.13), current family planning use (AOR 4.06), having a planned pregnancy (AOR 3.59), being in the 26–30 age group (AOR 2.33), and employment status (AOR 1.63). CONCLUSION: Knowledge of periconceptional folic acid supplementation is extremely poor (8.9%) among pregnant women in the study area. Factors like higher education, family planning use, and planned pregnancy are strong determinants of awareness. There is an urgent need to implement targeted health education programs integrated within Antenatal Care and Family Planning services to improve knowledge and reduce the incidence of preventable NTDs. </p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12961768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367489","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":"Pulmonary arteriovenous malformation in pregnancy: a case report and literature review.","authors":"Pradip Kumar Saha, Abhay Kumar, Bharti Joshi, Anuj Prabhakar, Rashmi Bagga","doi":"10.1186/s40748-026-00251-0","DOIUrl":"10.1186/s40748-026-00251-0","url":null,"abstract":"<p><p>BACKGROUND: Pulmonary arteriovenous malformations (PAVMs) are rare vascular anomalies often linked to hereditary hemorrhagic telangiectasia (HHT). Pregnancy-related hemodynamic and hormonal changes may exacerbate PAVMs and lead to serious maternal and fetal complications. CASE: A 26-year-old multipara at 25 weeks’ gestation presented with fever, cough, progressive dyspnea and left chest pain. Imaging demonstrated bilateral PAVMs with a loculated left pleural effusion. She was managed conservatively (intercostal drainage, transfusion, thromboprophylaxis) and monitored closely. Embolization was discussed but deferred after multidisciplinary discussion because of insufficient finances and the patient’s clinical stability; elective cesarean section at 39 weeks resulted in a healthy newborn. The patient was referred to interventional radiology for planned postpartum embolization. OBJECTIVE: To report an unusual presentation of bilateral large PAVMs in pregnancy and to review the literature on diagnostic strategies, antenatal management (embolotherapy vs. surgery vs. conservative), and maternal–fetal outcomes. METHODS: We searched PubMed/MEDLINE, Embase and Scopus (Jan 1, 1997–Sep 30, 2025) using combinations of MeSH/keywords: “pulmonary arteriovenous malformation”, “PAVM”, “pulmonary AVM”, “pregnancy”, “pregnant”, “embolization”, “embolotherapy”, “hemothorax” (English, human). Case reports, case series and observational studies reporting PAVM in pregnancy were included; reviews and animal studies were excluded. Bibliographies of included articles were hand searched. RESULTS: A total of 21 published cases of PAVM in pregnancy were identified; after excluding the cases summarized in the earlier review up to 1997, we focused on 12 subsequent reports (Table 1). Dyspnea and chest pain were the most frequent presentations. Antenatal embolization was performed in several cases with generally favorable outcomes, though recanalization/persistence has been reported. No maternal deaths were reported among the cases included in our review. CONCLUSION: PAVM in pregnancy can present emergently and requires individualized, multidisciplinary management. Transcatheter embolization is the preferred treatment when feasible, but case-by-case decisions — accounting for clinical stability, gestation, and patient factors — are essential. </p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345975","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":"Improvement in Th1/Th2 balance and endometrial receptivity after hysteroscopic surgery in patients with cesarean scar disorder: a case report.","authors":"Yuji Orita, Tokiko Iwakawa, Kazuhiro Takeuchi","doi":"10.1186/s40748-026-00255-w","DOIUrl":"10.1186/s40748-026-00255-w","url":null,"abstract":"<p><p>CASE: Cesarean scar disorders (CSDi) are a cause of secondary infertility. However, their etiology remains unclear. There are no reports describing the association between CSDi and Th1/Th2 balance or endometrial receptivity analysis. In this case, a 37-year-old G1P1 woman with a history of cesarean section was referred to our clinic for the treatment of secondary infertility and was treated with artificial reproductive technology. Despite five attempts of good blastocyst transfer, the patient did not become pregnant. The patient was finally diagnosed with CSDi and underwent hysteroscopic surgery. OUTCOME: After surgery, the Th1/Th2 ratio improved from 25.6 to 10.8, and endometrial receptivity returned to receptive. Five months after the operation, the patient underwent frozen embryo transfer, which led to live birth. CONCLUSION: This report provides new insights into the etiology of CSDi. CSDi causes anatomical changes and can evoke a Th1/Th2 imbalance and inflammation in the uterine cavity, leading to secondary infertility. </p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328324","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":"Improving team performance in neonatal resuscitation: a systematic review of training programs.","authors":"Johandi Neethling, Welma Lubbe, Suegnèt Scholtz, Jessica Botha","doi":"10.1186/s40748-026-00253-y","DOIUrl":"10.1186/s40748-026-00253-y","url":null,"abstract":"<p><p>BACKGROUND: Neonatal resuscitation is time-sensitive and critical for reducing neonatal mortality. While training programs improve technical skills, their clinical impact is limited by poor retention and inconsistent emphasis on team-based competency. Given the high-pressure and collaborative nature of resuscitation, strong communication, coordination, and teamwork are essential. There is a growing need to integrate structured teamwork training into neonatal resuscitation training programs to strengthen team cohesion, reduce errors, and improve neonatal outcomes. METHODS: A systematic review was conducted to synthesise evidence on how neonatal resuscitation training programs can be designed to improve team performance. The review question was formulated using the PIOS framework, and an adapted five-step systematic review approach was followed to conduct the review. A comprehensive search of 11 databases and supplementary sources identified 1,871 records, of which 19 met the inclusion criteria and scored ≥ 75% on the Johns Hopkins Evidence Critical Appraisal Tool. Data were extracted and thematically analysed by two independent reviewers. RESULTS: Two overarching themes emerged: (1) teamwork skills and behaviours, namely leadership, communication, joint decision-making, clearly defined roles and responsibilities, and safe practice; and (2) strategies for teaching teamwork, namely simulation, debriefing, and multidisciplinary team training. Most studies have been conducted in high-resource environments, with only a few conducted in resource-restricted healthcare contexts. CONCLUSIONS: Effective team performance is critical for successful neonatal resuscitation. Training programs should integrate teamwork skills, behaviours, and structured team-based teaching strategies to improve team performance. Future research should focus on developing adaptable and resource-sensitive training models that incorporate these elements to enhance neonatal outcomes on a global scale. </p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12892560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159626","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":"Associations of cumulative adversity on Hispanic mothers' perceived stress with infants admitted to the Neonatal Intensive Care Unit (NICU).","authors":"Polaris González Barrios, Edmarie Sánchez Cintrón, José Martínez González, Cynthia García Coll, Keimarisse Colon, Roberto Y Rodríguez Lozada, Paula C Román Villamil, Andrea C Morales Dávila, Lourdes García Fragoso, Zayhara Reyes Bou, Inés García García","doi":"10.1186/s40748-026-00248-9","DOIUrl":"10.1186/s40748-026-00248-9","url":null,"abstract":"<p><p>BACKGROUND: Mothers with a history of cumulative adversity (adverse experience throughout a lifetime) can face unique challenges in maintaining mental stability when compounded with other stressors during the perinatal period (pregnancy and postpartum). Such stressors can be having infants admitted to the Neonatal Intensive Care Unit (NICU), where stress levels often escalate due to the separation from their newborn and feelings of uncertainty regarding their child’s health. This study assessed cumulative adversity levels among 200 Latina mothers with NICU-admitted infants between 2017 and 2022 in Puerto Rico. METHODS: Mothers were contacted between 1 to 8 weeks after their infants’ NICU admission and interviewed using a structured psychological assessment protocol that included the 6-item Spielberger State Trait Anxiety Index (STAI-6), the Parental Stressor Scale: NICU (PSS: NICU), the Patient Health Questionnaire (PHQ-9) for depression severity, and the Cumulative Stressor Inventory (CSI) for cumulative adversity in the 12 months before childbirth. RESULTS: Most participants were low-income, high school-educated mothers receiving government assistance. While anxiety (STAI-6, M = 6.26, SD = 3.9) and depression levels (PHQ-9, Mean = 5.4, SD = 4.8) were low, moderate NICU-related stress was reported (PSS: NICU, Mean = 90.7, SD = 44.06). Regression analyses revealed that cumulative stress is moderately associated with maternal psychological symptoms, including anxiety, depression, and NICU-related stress (R = 0.47, R2 = 0.22, p < 0.05; f (1,173) = 9.44, p < 0.001). CONCLUSION: Higher cumulative adversity (environmental hazards, economic hardships, unsafe neighborhoods, among others) is associated with NICU-related stress within this population. Early psychological interventions and continuous support are essential to mitigating effects of the NICU experience in mothers that have faced cumulative adversity experiences prior to childbirth and postpartum. </p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12870413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121291","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":"Reaching the most vulnerable: A study of factors affecting enrolment in nurse-led home visiting in very remote communities of Australia's Northern Territory.","authors":"Gary Robinson, Danielle Aquino, Jiunn-Yih Su, Katherine Taylor, Kiarna Brown","doi":"10.1186/s40748-025-00245-4","DOIUrl":"10.1186/s40748-025-00245-4","url":null,"abstract":"<p><p>BACKGROUND: This study reports preliminary findings of an evaluation of the implementation of maternal and early childhood sustained nurse home visiting (the MECSH program) by three Aboriginal Community Controlled Health Services (ACCHS) in very remote communities of Australia’s Northern Territory (NT). MECSH was available to all women who were pregnant regardless of age and parity. There is a need to understand differences in access to the program among those eligible. METHODS: A prospective evaluation cohort study gathered data for all women in three regions who were pregnant and eligible to be offered enrolment in MECSH over the period from 2019–2024. Using de-identified primary healthcare service records, demographic characteristics, perinatal risk factors and services used by women eligible to join the program are described. Differences in potential vulnerability to adverse birth and health outcomes are identified. Multivariable modified Poisson regression is used to identify characteristics of women that are associated with offer of enrolment. RESULTS: In total, 1412 women were eligible to join MECSH from 2019–2024: of these, 45% were offered enrolment in the program, while 55% were not offered a place. There were differences in perinatal outcomes, psychosocial and behavioural risk factors and antenatal healthcare utilisation patterns within the cohort both by age and by enrolment in the program. Women offered MECSH were higher users of antenatal care than those not offered MECSH. Young women, women with other children, those with mental health concerns, who used drugs, had a chronic condition or who experienced domestic violence had somewhat increased likelihood of program offer. CONCLUSIONS: This study provides support for sustained nurse home visiting to be implemented at scale and made available regardless of age and parity. There is no evidence to justify focusing exclusively on teenage or first-time mothers at the expense of older and multiparous women, although there are likely to be significant differences in needs for support within the cohort. Assertive engagement of clients should identify those at risk of being missed through low use of antenatal services and should proactively consider both psychosocial needs and quality of family support in assessment of potential for benefit from the program. </p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100921","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":"Change in maternal income status following stillbirth, neonatal death and severe neonatal morbidity.","authors":"Jennifer A Jairam, Hilary K Brown, Christina Diong, Howard Berger, Jun Guan, Eyal Cohen, Joel G Ray","doi":"10.1186/s40748-026-00249-8","DOIUrl":"10.1186/s40748-026-00249-8","url":null,"abstract":"<p><p>AIM: We evaluated whether stillbirth, neonatal death or severe neonatal morbidity is associated with a mother’s change in residential neighbourhood income between two consecutive births. METHODS: This population-based cohort included all mothers in Ontario, Canada with two consecutive births at 20–42 weeks’ gestation, 2003–2023. The study exposure at the first birth was: (i) livebirth unaffected by severe neonatal morbidity or neonatal death (referent); (ii) livebirth with severe neonatal morbidity but no neonatal death; (iii) livebirth with neonatal death; and (iv) stillbirth. The study outcome was a mother’s change in residential neighbourhood income quintile (Q) between two consecutive births: (i) downward income mobility, (ii) upward income mobility, or (iii) persistently residing in the lowest income Q1 at each birth. -- each relative to iv) no change in neighbourhood income Q between births (referent). RESULTS: There were 720,119 mothers included. Among those initially residing in income Q2-5, relative to those with an unaffected livebirth, there was a higher likelihood of downward income mobility between births if their child was affected by non-fatal severe neonatal morbidity (aOR 1.05, 95% CI 1.02-1.08). Among mothers initially residing in income Q1, the aOR for remaining in income Q1 was 1.05 (95% CI 1.01-1.08) following a livebirth affected by severe neonatal morbidity, 1.29 (95% CI 1.12-1.48) after a neonatal death, and 1.35 (95% CI 1.24-1.46) after a stillbirth – each compared to mothers with an unaffected birth. CONCLUSIONS: Mothers with a newborn affected by severe morbidity were more likely to have a decline in neighbourhood income Q, or to persist in the lowest-income area. Those experiencing stillbirth or neonatal death were more likely to remain in a lowest-income neighbourhood or have no income mobility. </p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12822015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020820","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":"Why & where perinatal deaths: trends and determinants in Pakistan.","authors":"Qudsia Uzma, Farid Midhet, Samina Naeem Khalid, Sayema Awais, Ellen Thom","doi":"10.1186/s40748-025-00246-3","DOIUrl":"10.1186/s40748-025-00246-3","url":null,"abstract":"<p><p>BACKGROUND: The perinatal mortality rate is a proxy indicator of healthcare quality for mothers and newborns. Unfortunately, Pakistan faces poor pregnancy outcomes, which are significantly worse than those of many other low-resource countries worldwide. Recognizing the need to achieve a substantial reduction in perinatal mortality in Pakistan, the set of targets under Sustainable Development Goal 3 demands a significant decrease in this metric. METHODS: SPSS data files from the Pakistan Maternal Mortality Survey 2019 (1), with a sample of 136,226 households, was used. The PNMR was computed for urban and rural areas for the regions and provinces of Pakistan and for each category of the common risk factors (independent variables). We applied the chi-square test to determine whether the correlations between the PNMR and the independent variables were statistically significant. Finally, binary logistic regression analysis was conducted via SPSS version 19.0 to compute the adjusted odds ratio (AOR). RESULTS: The PNMR for the entire sample was 70.1 per 1000 live births. Geographical differences were not statistically significant, except in the Gilgit-Baltistan (GB) region, which had a lower PNMR. We identified the lowest PNMR among the highest quintile, primigravida women with 3–5 pregnancies, aged 24–35 years, with at least 10 years of education, who received adequate antenatal care, and who delivered at home without skilled birth attendants. Binary logistic regression analysis showed a twofold higher risk among the lowest wealth quintile: 1.37 times higher among women over 35 years old and 1.5 times higher among women who had skilled birth attendance. After adjusting for socioeconomic and demographic variables, parity and antenatal care were not associated with perinatal deaths. DISCUSSION & CONCLUSION: We found no increase in the risk of PNMR among women younger than 25 years and using antenatal care, whereas other studies reported a greater risk of PNMR among younger and adolescent mothers. Therefore, more robust primary studies are needed to determine the associations of the key variables with perinatal mortality in Pakistan. </p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12781463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936621","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":"Stuck in transition - admission to the neonatal intensive care unit after shoulder dystocia: analysis of risk factors and assessment of postnatal care.","authors":"Alexandros Rahn, Carolin Böhne, Bettina Bohnhorst, Sabine Pirr, Corinna Peter, Svea Kleiner, Charlotte Mindermann, Patrick Galland, Vivien Dütemeyer, Constantin von Kaisenberg, Lars Brodowski","doi":"10.1186/s40748-025-00244-5","DOIUrl":"10.1186/s40748-025-00244-5","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess frequency and causes of neonatal intensive care unit (NICU) admissions in neonates with shoulder dystocia (SD).</p><p><strong>Methods: </strong>A retrospective analysis of 116 SD cases at a tertiary perinatal center was performed (2007 - 2023). Maternal and neonatal parameters were evaluated in relation to NICU admission.</p><p><strong>Results: </strong>Seventeen neonates (14.7%) were admitted to the NICU. All showed respiratory distress; five required cardiopulmonary resuscitation, two of them received therapeutic hypothermia for hypoxic-ischemic encephalopathy. Compared to non-admitted infants, NICU neonates had significantly lower umbilical artery pH and base deficit, lower Apgar scores, and higher rate of birth injuries. They also had a significantly longer median head-to-body delivery interval (HBDI, 5.0 vs. 2.0 minutes, p < 0.0001). No neonatal deaths occurred before discharge.</p><p><strong>Conclusion: </strong>SD can lead to severe postnatal adaptation problems in newborns, requiring timely and structured interdisciplinary management. Our findings suggest that a HBDI of ≥ five minutes serve as a clinically applicable parameter to identify neonates at increased risk of NICU admission and appears to be associated with a higher likelihood of brachial plexus injury. Furthermore, greater fetal size, reflected by higher birth weight and body surface area, was related to the occurrence of birth injuries overall, underscoring the relevance of both extraction time and fetal dimensions for postnatal outcomes after SD.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"12 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12781657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919420","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}