American journal of perinatology最新文献

{"title":"Loss to Follow-up and Developmental Delay in the Neonatal High-Risk Infant Follow-up Clinic.","authors":"Lilia P Christner, Emman Dabaja, Mohammad Attar","doi":"10.1055/a-2551-4622","DOIUrl":"10.1055/a-2551-4622","url":null,"abstract":"<p><p>Neonatal follow-up (NFU) clinics provide developmental assessments for infants at high risk for developmental delays. Disparities in NFU attendance and loss to follow-up (LTF) are well documented, but it is not known whether patients who are LTF have different developmental outcomes. The population of patients LTF from the NFU clinic is assumed to be homogenous, but we hypothesize there is a subpopulation of patients LTF who are receiving developmental care elsewhere. Our objective was to compare the baseline characteristics and developmental outcomes of infants who completed follow-up, infants who were LTF but seen by others in the community, and infants who were LTF but not seen by others (true LTF).Retrospective cohort study at a regional specialty center, including 262 patients referred to the NFU clinic who were born between 2014 and 2017, with a 24-month total follow-up period, such that assessment of all follow-up outcomes (NFU clinic attendance outcome, and clinician assessed developmental delay) was complete prior to March 2020. Multivariable logistic regression was used to model the odds of developmental delay, true LTF, and referral to developmental services at initial hospital discharge.Of 262 patients, 86 (33%) were LTF from the NFU clinic. Of these, 55 (64%) had developmental assessments by other providers. Of those LTFs from NFU but seen by other providers, the prevalence of clinician-assessed developmental delay at 24 months was 67%, compared with 45% of those who completed the NFU clinic (<i>p</i> < 0.001). Social risk factors (younger mothers, late or no prenatal care, maternal smoking, or referral for a social reason) were associated with higher odds of true LTF, but no different odds of referral to developmental services at hospital discharge.A majority of patients LTF from the NFU clinic had developmental assessments by others (64%). Social risk factors were associated with true LTF and missed developmental assessments. · Sixty-four percent of patients with LTF had developmental assessments by other providers.. · Social risk factors were associated with higher odds of true LTF.. · Infants with social risk factors were not referred to developmental services early..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1908-1917"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Induction Start Time and Labor Duration in Nulliparous Women Undergoing Elective Induction of Labor.","authors":"Francesca L Facco, Cora MacPherson, Uma M Reddy, Alan T N Tita, Robert M Silver, Yasser Y El-Sayed, Ronald J Wapner, Dwight J Rouse, George R Saade, John M Thorp, Suneet P Chauhan, Maged M Costantine, Edward K Chien, Kent D Heyborne, Sindhu K Srinivas, Geeta K Swamy, William A Grobman","doi":"10.1055/a-2547-4196","DOIUrl":"10.1055/a-2547-4196","url":null,"abstract":"<p><p>This study aimed to examine the association between elective induction of labor (EIOL) start time and labor duration among nulliparous women.The ARRIVE trial was a multicenter randomized controlled trial of induction of labor at 39^0/7 to 39^4/7 weeks versus expectant management in low-risk nulliparous women. In this secondary analysis, we included participants randomized to the induction group who had an EIOL without spontaneous labor or rupture of membranes prior to the induction start. The start time of EIOL was categorized as: early a.m. (midnight to 5:59 a.m.), late AM (6 AM-11:59 a.m.), early p.m. (noon-5:59 p.m.), or late p.m. (6 p.m.-11:59 p.m.). The primary outcome was labor duration. Cesarean delivery rates by induction start time were also examined. Multivariable analysis was conducted controlling for age, body mass index, insurance status, and modified Bishop score on admission (<5 or ≥5).Of 3,062 women randomized to EIOL, 2,197 were included in this analysis. EIOL occurred in the early a.m. in 13%, in late a.m. in 28%, in early p.m. in 13%, and in late p.m. in 45%. Participants induced in the late a.m. had the shortest mean labor durations (21.5 ± 11.3 hours) and the highest frequency of delivery at < 24 hours (68%). In adjusted analyses, induction in the late a.m. (vs. grouped other time periods) remained significantly associated with shorter labor duration (-1.5 hours; confidence interval: -2.5 and -0.4; <i>p</i> = 0.006), and there was no interaction between Bishop score and time of EIOL. Cesarean delivery rates did not differ by start time.Induction of labor starting between 6 a.m. and 11:59 a.m. was associated with shorter labor durations, independent of baseline maternal characteristics including cervical status on admission. · Women were associated with shorter labor durations. · Cesarean delivery rates did not differ by EIOL start time.. · Differences in labor management by time of day may in part explain these findings..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1864-1870"},"PeriodicalIF":1.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Placental Abruption: Temporal Trends, Risk Factors, and Associated Adverse Maternal Outcomes.","authors":"Gillian L Wright, Alexander Friedman, Cande V Ananth, Timothy Wen","doi":"10.1055/a-2699-9371","DOIUrl":"10.1055/a-2699-9371","url":null,"abstract":"<p><p>This study aimed to evaluate trends in placental abruption during delivery hospitalizations and associated risk factors and adverse outcomes.Delivery hospitalizations with and without placental abruption were identified using billing codes in the 2000 to 2020 National Inpatient Sample for this serial cross-sectional study. Temporal trends in abruption were analyzed with Joinpoint regression to determine the average annual percentage change (AAPC) in abruption. The association between hospital, demographic, and clinical factors and abruption was analyzed with adjusted logistic regression models with adjusted odds ratios (ORs) with 95% confidence interval (CI) as measures of association. Logistic regression models were then performed to assess the odds of adverse outcomes, including transfusion and severe maternal morbidity associated with abruption, accounting for demographic, hospital, and patient factors. Associations between changes in abruption and trends in the risk for adverse outcomes were then analyzed.Of 80.2 million deliveries from 2000 to 2020, 1.1 million had an abruption diagnosis. Placental abruption risk increased from 1.2% of deliveries in 2000 to 1.6% in 2020 (AAPC: 1.6%, 95% CI: 1.3%, 2.0%). Abruption was associated with multiple gestations, hypertensive diagnoses, diabetes, asthma, and Medicaid insurance. In adjusted analyses, abruption was associated with a range of adverse outcomes including transfusion (OR = 6.86, 95% CI: 6.70, 7.03), non-transfusion severe maternal morbidity (OR = 4.05, 95% CI: 3.93, 4.17), postpartum hemorrhage (OR = 1.76, 95% CI: 1.72, 1.80), disseminated intravascular coagulation (OR = 6.30, 95% CI: 6.00, 6.61), and critical care procedures (OR = 4.76, 95% CI: 4.26, 5.32). The increase in abruption accounted for 1.1% of the population change in transfusion risk over the study period.The risk for abruption increased over the study period and was associated with several adverse outcomes. Abruption accounted for a modest increase in population-level adverse outcomes. Given the increasing incidence, placental abruption will likely continue to be a significant source of adverse obstetric outcomes. · Abruption risk increased over the study period and was associated with several adverse outcomes.. · Abruption accounted for a modest increase in population-level adverse outcomes.. · Placental abruption will likely continue to be a significant source of adverse obstetric outcomes..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress in Preclinical Research on Mesenchymal Stem Cell-Derived Exosomes for the Treatment of Bronchopulmonary Dysplasia.","authors":"Shimeng Zhao, Shuang Han","doi":"10.1055/a-2704-7823","DOIUrl":"10.1055/a-2704-7823","url":null,"abstract":"<p><p>Bronchopulmonary dysplasia (BPD) is the most common chronic respiratory disease in premature infants and affects their survival rate and quality of life. There are no reliable interventions for the prevention or treatment of BPD, but the emergence of mesenchymal stem cell (MSC) therapies has brought new hope. Research has shown that paracrine may be the therapeutic mechanism of action underlying physiological improvements in the lungs of BPD patients treated with MSC therapy. The therapeutic vector in the MSC secretome comprises exosomes with low immunogenicity and stability, and that can easily cross the blood-brain barrier. In the future, exosomes may become the preferred treatment for BPD in clinical settings. Here, we review the progress of preclinical research on the use of MSC-derived exosomes as a promising treatment option for BPD. · There is a lack of effective treatment for BPD.. · MSCs' therapeutic effect is exerted through paracrine.. · MSC-derived exosomes (MSC-Exos) possess similar biological functions to MSCs.. · MSC-Exos can repair lung injury in BPD animal models..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Survey of Program Directors on Neonatal-Perinatal Medicine Fellowship Training in the United States: Programmatic Structure, Learning Environment, and Wellness Activities.","authors":"Erynn M Bergner, Kristen Glass, Elizabeth A Hillman, Cindy Crabtree, Christie J Bruno, Megan M Gray","doi":"10.1055/a-2701-6697","DOIUrl":"10.1055/a-2701-6697","url":null,"abstract":"<p><p>We aim to describe the current programmatic structure and learning environment of US neonatal-perinatal medicine (NPM) fellowship programs.All U.S. NPM program directors (PDs) and associate program directors (APDs) were surveyed. Descriptive statistics for quantitative questions and thematic qualitative analysis of free-text responses were used to summarize findings.Out of 102 programs 99 (97%) responded. Out of 99 PDs 25 (25%) reported not receiving minimum ACGME full-time equivalent (FTE) for program administration. Fellows perform a median of 52 weeks (48-54) and 150 (120-165) night calls during training, with clinical time skewing more toward the 1st year. All programs report interaction with front-line clinicians (FLCs), and 81% (80/99) of fellowships reported conflict between fellows and FLCs. A minority of programs formally evaluated or instructed FLCs on teaching skills. PDs and APDs most commonly lead the planning of wellness activities, with only 37% of programs describing a fellow wellness leader. A minority of programs reported wellness committees at the university (40%), department (19%), or division (17%) level. About 25% of programs reported no wellness budget.Broadened institutional support toward program requirements and administration and further collaborative efforts with trainees and multidisciplinary providers are opportunities for growth in NPM fellowship programs. · Program administration time varies in NPM fellowships, with 25% below ACGME FTE standards.. · Benchmarking clinical service time shows varied exposure, with more clinical focus in year one.. · Fellow and front-line clinician conflict exists; efforts to improve this dynamics are needed.. · Many programs support fellow wellness, but limited funding and support remain key barriers..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Study on the Dual Role of ADAMTS-1, -4, and -5 in Necrotizing Enterocolitis: Linking Tissue Pathology and Serum Biomarker Discovery.","authors":"Cüneyt Tayman, Ufuk Çakır, Yavuz Yılmaz, Mahmure Ayşe Tayman, İsmail Koyuncu","doi":"10.1055/a-2702-5520","DOIUrl":"https://doi.org/10.1055/a-2702-5520","url":null,"abstract":"<p><p>Necrotizing enterocolitis (NEC) is an inflammatory and destructive disease of the gastrointestinal system, predominantly affecting premature infants. Despite being associated with multifactorial causes, its etiopathogenesis has not yet been clearly elucidated. This study aims to investigate the role of matrix metalloproteinases, particularly the thrombospondin motif-containing proteins ADAMTS-1, -4, and -5, in the pathogenesis of NEC.Intestinal tissue samples were obtained from 31 patients incluiding preterm infants with surgically confirmed NEC. The mRNA expression levels of ADAMTS-1, -4, and -5 were analyzed using RT-qPCR. In addition, immunohistochemical analyses were performed to evaluate the expression of ADAMTS-1, -4, and -5 proteins in tissue samples. Serum levels of these proteins were measured using the ELISA method.RT-qPCR analyses revealed significantly higher expression levels of ADAMTS-1, -4, and -5 in NEC tissue samples compared with the control tissue samples (<i>p</i> < 0.05). Immunohistochemical analysis demonstrated increased expression patterns of these proteins in the NEC group relative to controls (<i>p</i> < 0.05). Furthermore, serum levels of ADAMTS-1, -4, and -5 were found to be elevated in NEC patients (<i>p</i> < 0.05). ROC analysis revealed excellent diagnostic performance of ADAMTS proteins, particularly for ADAMTS-4 (AUC: 1.00), indicating their potential as a non-invasive biomarker for NEC. ADAMTS levels significantly correlated with CRP and IL-6, supporting their involvement in the inflammatory cascade of NEC.The observed upregulation of ADAMTS-1, -4, and -5 in NEC-affected tissues and serum may provide new insights into the disease's pathogenesis and diagnosis. ADAMTS proteins may serve as novel diagnostic biomarkers and therapeutic targets for early identification and treatment of NEC. Targeting members of the ADAMTS protein family could represent a promising therapeutic strategy for the treatment of NEC. · ADAMTS-1, -4, and -5 were significantly overexpressed in NEC tissue samples.. · Serum levels of ADAMTS proteins were markedly elevated in NEC patients.. · ADAMTS proteins may serve as potential therapeutic targets in NEC..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Ghrelin Effects in Experimental Necrotizing Enterocolitis.","authors":"Sabriye Korkut, Ahmet Özdemir, Sara Erol, Mahmut Güzel, Arzu Hanım Yay, Levent Korkmaz, Selim Kurtoğlu","doi":"10.1055/a-2693-0478","DOIUrl":"https://doi.org/10.1055/a-2693-0478","url":null,"abstract":"<p><p>This study was aimed to investigate the effects of exogenous ghrelin pretreatment in an experimental necrotizing enterocolitis (NEC) model.Neonatal rats were randomized into four groups: NEC, GH-NEC, Control, and GH-Control. Experimental NEC was induced in the NEC groups using hypoxia, hypothermia, and hyperosmolar formula. Ghrelin was administered intraperitoneally to the GH-NEC and GH-Control groups. Throughout the experiment, pups were monitored using clinical scoring. On day 4, they were sacrificed, followed by macroscopic scoring, and tissue samples were collected for histopathological and biochemical analysis.The NEC groups had significantly higher mean clinical, macroscopic, and histological scores compared with the control groups (<i>p</i> < 0.05). The GH-NEC group exhibited both a higher mean clinical score and a higher mean macroscopic score than the NEC group (<i>p</i> < 0.05). The mean survival time was significantly lower in the GH-NEC group compared with the NEC group (<i>p</i> = 0.003). However, histopathological scores and apoptotic cell counts were similar between the GH-NEC and NEC groups (<i>p</i> > 0.05).In this experimental NEC model, ghrelin pretreatment worsened clinical outcomes, negatively affected the macroscopic appearance of intestinal segments, and was associated with a decreased survival rate up to the time of sacrifice. Further studies are needed to determine the effects of ghrelin in experimental NEC. · The effects of ghrelin in NEC remain largely unknown.. · Ghrelin pretreatment decreased survival in NEC model.. · Ghrelin pretreatment worsened clinical and macroscopic intestinal scores.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Neurodevelopmental Outcomes at 5 Years in Preterm Infants Born At <27 Weeks' Gestational Age following Preterm Premature Rupture of Membranes.","authors":"Sarah Tougas, Harkirat Bhullar, Amelie Stritzke, Selphee Tang, Sue Makarchuk, Abhay Lodha","doi":"10.1055/a-2698-0900","DOIUrl":"https://doi.org/10.1055/a-2698-0900","url":null,"abstract":"<p><p>This study aimed to determine the association between preterm premature rupture of membranes (PPROM) and neurodevelopmental outcomes at 5 years of age in infants born before 27 weeks of gestation.Infants born before 27 weeks of gestational age (GA) between 2005 to 2014 and 2017 to 2018 and evaluated at the neonatal follow-up clinic at age 5 years were included. Outcomes were assessed based on abnormal muscle tone, hearing and vision assessments, and cognitive assessment on standardized testing. Perinatal/neonatal characteristics and outcomes were compared between the PPROM (ruptured membranes >1 hour prior to onset of contractions) and No PPROM groups using univariate tests and multivariable regression models. The primary outcome was a composite of death or neurodevelopmental impairment (NDI) at 5 years of age. NDI was considered present if a child had any of cerebral palsy, full-scale intelligence quotient >1 standard deviation below the mean, sensorineural hearing loss, or corrected visual acuity < 20/60 in the better eye.A total of 566 eligible infants were followed up in our regional follow-up clinic at 5 years of age. A total of 226 (40%) were in the PPROM group and 340 (60%) were in the No PPROM group. Infants in the PPROM and No PPROM groups had mean birth weights of 758 (±141) and 740 (±159) grams, respectively, and a median GA of 25 (range: 22-26) weeks for both groups. After adjusting for confounders, the odds ratio of death or NDI in the PPROM group were 1.14 (95% confidence interval: 0.82-1.58). The study also provided comprehensive evaluations of the primary and secondary outcomes through propensity score-matched analyses.Our study suggests that PPROM may not be associated with an increased risk of a composite outcome of death or NDI at 5 years of age in preterm infants born before 27 weeks of GA. · We compared infants born < 27 weeks GA with and without PPROM.. · Infants were assessed at 5 years of age for NDI.. · There was no difference in death or NDI between groups..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145123917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and Perinatal Outcomes following Trial of Labor After Cesarean in Women with previous Term Cesarean Delivery and Chorioamnionitis.","authors":"Maayan Bas Lando, Aviya Dror, Rivka Farkash, Misgav Rottenstreich, Tehila Avitan, Sorina Grisaru-Granovsky, Hen Y Sela","doi":"10.1055/a-2699-9313","DOIUrl":"https://doi.org/10.1055/a-2699-9313","url":null,"abstract":"<p><p>This study aimed to evaluate maternal and neonatal outcomes of women who had chorioamnionitis during their primary term cesarean delivery (CD), in their subsequent delivery.This multicenter retrospective cohort study (2005-2022) included women who attempted trial of labor after CD (TOLAC) following a primary term emergency CD. Women were grouped by the presence or absence of chorioamnionitis at the primary CD. Primary outcome was mode of delivery in the subsequent delivery. Secondary outcomes included adverse maternal and neonatal outcomes, including uterine rupture and adhesions. Multivariable logistic regression identified predictors of recurrent chorioamnionitis and adverse outcomes.Of 2,626 women included, 258 (9.8%) had chorioamnionitis during their primary CD (Chorio-PCD). In the subsequent delivery, this group as opposed to women without chorioamnionitis, had higher rates of emergency repeat CD (31.4 vs. 24.3%, <i>p</i> = 0.012), recurrent chorioamnionitis (14.3 versus 5.1%, <i>p</i> < 0.001), and postpartum readmission (2.3 vs. 0.5%, <i>p</i> = 0.006). Nevertheless, having previous chorioamnionitis did not impact the rate of uterine rupture among women who attempted TOLAC. Among women undergoing repeat non-elective CD, rates of severe adhesions (38.3 vs. 25.6%, <i>p</i> = 0.016) and postpartum hemorrhage (13.6 vs. 6.9%, <i>p</i> = 0.034) were significantly higher in the Chorio-PCD group. Chorio-PCD in previous pregnancy independently predicted composite adverse maternal outcome (aOR = 1.50, 95% CI: 1.13-1.99, <i>p</i> = 0.005).Chorioamnionitis at primary term CD is associated with increased maternal morbidity in subsequent delivery. These findings support the need for careful delivery planning and postpartum management in this population. · Chorio-PCD linked to emergency CD in univariate, but not in multivariate, analysis.. · Chorio-PCD was significantly associated with adverse maternal outcomes at the subsequent delivery.. · Chorio-PCD was not associated with increased risk of preterm delivery or uterine rupture..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145123891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in the Prevalence of Fetal Macrosomia in the United States, 2004 to 2022.","authors":"Peipei Hu, Guodong Ding, Chutian Shi, Angela Vinturache, Yongjun Zhang","doi":"10.1055/a-2696-3320","DOIUrl":"https://doi.org/10.1055/a-2696-3320","url":null,"abstract":"<p><p>Globally, the prevalence of macrosomia varies widely, and the trends in macrosomia prevalence are controversial. We aim to analyze temporal changes in fetal macrosomia prevalence from 2004 to 2022.This study included 72,879,544 singleton deliveries from the U.S. National Vital Statistics System Natality Files. We used Joinpoint regression to assess annual trends in fetal macrosomia (birth weight: 4,000 g), further classified into Grade 1 (4,000-4,499 g), Grade 2 (4,500-4,999 g), and Grade 3 (5,000 g).The overall prevalence of fetal macrosomia declined overall from 8.85% (95% CIs: 8.83, 8.88) in 2004 to 7.42% (95% CIs: 7.40, 7.45) in 2022, representing an average annual relative decrease of 0.89% (95% CIs: -1.17%, -0.61%). The temporal trend was nonlinear: a sharp decrease from 2004-2007 (APC: -3.63; 95% CIs: -4.92, -2.32), a modest increase during 2007-2015 (APC: 0.79; 95% CIs: 0.41, 1.16), and a steady decline from 2015-2022 (APC: -1.59; 95% CIs: -1.98, -1.20). Subgroup analyses revealed consistent declines, with more pronounced reductions among women aged > 30 years, those with a college education, primiparous women, and Asian/Pacific Islander mothers. When stratified by severity, the prevalence of Grade 1 macrosomia decreased from 7.53% to 6.42% (AAPC: -0.80; 95% CIs: -1.06, -0.53), Grade 2 decreased from 1.13% to 0.84% (AAPC:-1.50; 95% CIs: -1.94, -1.06), and Grade 3 from 0.20% to 0.16% (AAPC: -0.85; 95% CIs: -1.42, -0.27).The prevalence of fetal macrosomia has varied over time, showing an overall downward trend over the past 20 years, with two periods of rapid decline (2004-2007 and 2015-2022) and one period of moderate increase (2007-2015). The changes observed were significant for Grade 1 and Grade 2 macrosomia, while Grade 3 macrosomia also showed a downward trend, but without distinct segment slopes. · The overall prevalence of fetal macrosomia in the United States declined from 8.85% in 2004 to 7.42% in 2022, with a non-linear trend marked by two periods of decline and one of moderate increase.. · The trend was more pronounced among women aged >30 years, with college education, primiparous women, and Asian/Pacific Islander mothers.. · Severity-stratified analyses revealed significant declines in Grade 1 and Grade 2, while Grade 3 demonstrated a modest decrease without distinct Joinpoint segments..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}