BMC Pregnancy and Childbirth最新文献

{"title":"Comparative study of 2D vs. 3D AI-enhanced ultrasound for fetal crown-rump length evaluation in the first trimester.","authors":"Yuanji Zhang, Yuhao Huang, Chaoyu Chen, Xing Hu, Wenxiong Pan, Huanjia Luo, Yankai Huang, Haixia Wang, Yan Cao, Yan Yi, Yi Xiong, Dong Ni","doi":"10.1186/s12884-025-07823-6","DOIUrl":"https://doi.org/10.1186/s12884-025-07823-6","url":null,"abstract":"<p><strong>Background: </strong>Accurate fetal growth evaluation is crucial for monitoring fetal health, with crown-rump length (CRL) being the gold standard for estimating gestational age and assessing growth during the first trimester. To enhance CRL evaluation accuracy and efficiency, we developed an artificial intelligence (AI)-based model (3DCRL-Net) using the 3D U-Net architecture for automatic landmark detection to achieve CRL plane localization and measurement in 3D ultrasound. We then compared its performance to that of experienced radiologists using both 2D and 3D ultrasound for fetal growth assessment.</p><p><strong>Materials and methods: </strong>This prospective consecutive study collected fetal data from 1,326 ultrasound screenings conducted at 11-14 weeks of gestation (June 2021 to June 2023). Three experienced radiologists performed fetal screening using 2D video (2D-RAD) and 3D volume (3D-RAD) to obtain the CRL plane and measurement. The 3DCRL-Net model automatically outputs the landmark position, CRL plane localization and measurement. Three specialists audited the planes achieved by radiologists and 3DCRL-Net as standard or non-standard. The performance of CRL landmark detection, plane localization, measurement and time efficiency was evaluated in the internal testing dataset, comparing results with 3D-RAD. In the external dataset, CRL plane localization, measurement accuracy, and time efficiency were compared among the three groups.</p><p><strong>Results: </strong>The internal dataset consisted of 126 cases in the testing set (training: validation: testing = 8:1:1), and the external dataset included 245 cases. On the internal testing set, 3DCRL-Net achieved a mean absolute distance error of 1.81 mm for the nine landmarks, higher accuracy in standard plane localization compared to 3D-RAD (91.27% vs. 80.16%), and strong consistency in CRL measurements (mean absolute error (MAE): 1.26 mm; mean difference: 0.37 mm, P = 0.70). The average time required per fetal case was 2.02 s for 3DCRL-Net versus 2 min for 3D-RAD (P < 0.001). On the external testing dataset, 3DCRL-Net demonstrated high performance in standard plane localization, achieving results comparable to 2D-RAD and 3D-RAD (accuracy: 91.43% vs. 93.06% vs. 86.12%), with strong consistency in CRL measurements, compared to 2D-RAD, which showed an MAE of 1.58 mm and a mean difference of 1.12 mm (P = 0.25). For 2D-RAD vs. 3DCRL-Net, the Pearson correlation and R² were 0.96 and 0.93, respectively, with an MAE of 0.11 ± 0.12 weeks. The average time required per fetal case was 5 s for 3DCRL-Net, compared to 2 min for 3D-RAD and 35 s for 2D-RAD (P < 0.001).</p><p><strong>Conclusions: </strong>The 3DCRL-Net model provides a rapid, accurate, and fully automated solution for CRL measurement in 3D ultrasound, achieving expert-level performance and significantly improving the efficiency and reliability of first-trimester fetal growth assessment.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"766"},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The criteria to classify body-proportionality of the small for gestational age newborn: a scoping review.","authors":"Aziz Berkay Karadavut, Ilke Smits, Jeroen van Dillen, Marije Hogeveen","doi":"10.1186/s12884-025-07870-z","DOIUrl":"https://doi.org/10.1186/s12884-025-07870-z","url":null,"abstract":"<p><strong>Purpose: </strong>To create an overview of the criteria used to classify small for gestational age (SGA) newborns according to their body-proportionality as either asymmetric SGA or symmetric SGA, and to create an overview of the clinical outcomes related to body-proportionality.</p><p><strong>Methods: </strong>A scoping review was conducted using PubMed, Embase and the Cochrane Library databases. Studies were included if they described SGA newborns regardless of gestational age and if their classification on body-proportionality was given for both aSGA and sSGA. Data were screened and extracted by two independent reviewers.</p><p><strong>Results: </strong>Of the 38,265 studies identified after deduplication, 45 were included. Body-proportionality was classified by the ponderal index (PI) in 55.6% of studies (n = 25), head circumference (HC) in 24.4% (n = 11), birth length in 11.1% (n = 5), birth length and HC in 4.4% (n = 2), birth length and PI in 2.2% (n = 1), and PI, brain-to-body ratio and HC/length ratio in 2.2% (n = 1). The most commonly reported outcomes were asphyxia, hyperbilirubinemia, hypoglycemia, mortality and respiratory distress syndrome. The results regarding the outcomes were inconsistent and contradictory.</p><p><strong>Conclusion: </strong>Large heterogeneity in the published classifications and clinical outcomes regarding body-proportionality in the SGA newborns exists. Consensus on terms, methods and cut-off values used for body-proportionality is needed to improve future comparison of study results.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"763"},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and acceptability of conducting a birth cohort study during the COVID-19 pandemic: a mixed-methods study.","authors":"Allison M Grech, Nathalie Kizirian, Marjan Mosalman Haghighi, Sweekriti Sharma, Reeja Nasir, Roslyn Muirhead, Angelika Zankl, Clare Collins, Andrew Holmes, Adrienne Gordon","doi":"10.1186/s12884-025-07850-3","DOIUrl":"https://doi.org/10.1186/s12884-025-07850-3","url":null,"abstract":"","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"767"},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of transcutaneous bilirubin levels in healthy and preeclamptic pregnancies: a pilot study.","authors":"Miray Onat, Ebru Celik Kavak, Cigdem Akcabay, Zubeyde Malkan, Tugba Kaya, Ibrahim Batmaz, Cengiz Sanli, Bunyamin Cim, Mesut Ali Haliscelik, Ahmet Senocak, Salih Burcin Kavak","doi":"10.1186/s12884-025-07878-5","DOIUrl":"https://doi.org/10.1186/s12884-025-07878-5","url":null,"abstract":"<p><strong>Background: </strong>Preeclampsia is a complex, multisystem obstetric disorder characterized by heterogeneous clinical manifestations, often requiring enhanced strategies for early detection, management, and risk stratification. This study aimed to evaluate potential alterations in non-invasive transcutaneous bilirubin levels measured at various maternal body sites in pregnant women diagnosed with preeclampsia.</p><p><strong>Methods: </strong>A total of 86 pregnant women who delivered at our institution were enrolled and classified into three groups: healthy pregnant women (Group 1, n = 30), women with preeclampsia (Group 2, n = 30), and women with pre-eclampsia with severe features (Group 3, n = 26). In addition to routine pre-delivery laboratory assessments, transcutaneous bilirubin levels were measured at two anatomical sites-the forehead and the abdominal skin overlying the uterine fundus-using a standard bilirubinometer. Each site was measured three times, and the mean of the three readings was recorded for analysis. Complete Blood Count and biochemical blood parameters of the women were evaluated. Relevant obstetric and demographic data were also collected and recorded.</p><p><strong>Results: </strong>There were no statistically significant differences among the three groups in terms of maternal age, gravidity, parity, or body mass index (p > 0.05). Similarly, total serum bilirubin levels were comparable across the groups (Group 1: 0.45 mg/dL; Group 2: 0.39 mg/dL; Group 3: 0.44 mg/dL; p > 0.05). In contrast, transcutaneous bilirubin levels were significantly elevated in Group 3 compared to Groups 1 and 2. The mean transcutaneous bilirubin values for the forehead, uterine fundus, and overall (combined sites) were as follows: Group 1-3.07 ± 0.85, 2.35 ± 0.97, and 2.71 ± 0.76; Group 2-6.09 ± 1.94, 4.94 ± 1.64, and 5.52 ± 1.59; Group 3-7.12 ± 1.81, 6.12 ± 2.25, and 6.63 ± 1.69, respectively. All pairwise comparisons demonstrated statistically significant differences (p < 0.05).</p><p><strong>Conclusions: </strong>Transcutaneous bilirubin levels were significantly elevated in women with preeclampsia, particularly among those with severe disease. As a non-invasive, rapid, and cost-effective approach, TcB measurement may function as an adjunctive tool for the initial clinical assessment and risk stratification of preeclamptic patients.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"764"},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-trimester triglyceride-glucose index and birth weight: a retrospective cohort mediation analysis of preterm birth and gestational complications.","authors":"Jinhui Cui, Hui Jiang, Fei Huang, Mengjun Xie, Ziyi Cui, Xinyuan Chen, Liping OUYang, Ping Li, Yanling Wang","doi":"10.1186/s12884-025-07885-6","DOIUrl":"https://doi.org/10.1186/s12884-025-07885-6","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance during pregnancy, while physiologically adaptive to enhance fetal nutrient supply, becomes pathological when excessive, contributing to low birth weight (LBW). The triglyceride-glucose (TyG) index, a biomarker of insulin resistance, predicts gestational complications, but its pathways to birth weight disparities remain unclear. This study investigates whether and to what extent first-trimester TyG index influences birth weight through preterm birth and gestational complications.</p><p><strong>Methods: </strong>In this retrospective cohort study, 8,605 singleton pregnancies from a Chinese hospital (2015-2021) were analyzed. TyG index was calculated from first-trimester fasting glucose and triglycerides. Outcomes included gestational diabetes mellitus (GDM), hypertension, preeclampsia, preterm birth, LBW, macrosomia, and small/large-for-gestational-age (SGA/LGA). Logistic/multinomial regression assessed associations, followed by causal mediation analysis (R medflex package) to decompose direct/indirect effects. Models adjusted for maternal age, body mass index, education, parity, and diabetes family history.</p><p><strong>Results: </strong>A 1-standard deviation TyG index increase was associated with elevated risks of gestational complications (i.e., GDM, gestational hypertension, and preeclampsia). Higher TyG index level also showed positive associations with adverse birth outcomes: preterm birth (OR = 1.20, 95% CI: 1.08-1.34), LBW (OR = 1.11, 95% CI: 1.00-1.24), and LGA (OR = 1.12, 95% CI: 1.05-1.21), but not with macrosomia or SGA. Mediation analysis revealed that individual gestational complications mediated 17.7% (GDM), 11.1% (gestational hypertension), and 18.9% (preeclampsia) of the TyG-LBW association, with a joint mediation effect of 37.5%. Preterm birth alone mediated 89.0% of the TyG index-LBW association. When considering all mediators together (preterm birth and gestational complications), the joint natural indirect effect was 1.12 (95% CI 1.05-1.18) with a null natural direct effect being 1.00 (95% CI 0.90-1.11), indicating full mediation. These mediation patterns were primarily evident among women with normal pre-pregnancy weight. Quartile-based comparisons (4th vs. 1st ) yielded similar results.</p><p><strong>Conclusion: </strong>Our findings highlight a significant association between the first-trimester TyG index and LBW with preterm birth emerging as the primary mediating pathway and gestational complications contributing partially to this relationship. Future research should explore whether interventions aimed at preventing preterm birth and gestational complications can mitigate the LBW risk.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"765"},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metformin use in gestational diabetes is not associated with an increased risk of preterm labor and small for gestational age infants compared to diet control alone.","authors":"Ashton D'Souza, Hala Abdullahi, Fariada Badri, Ibrahim Ibrahim","doi":"10.1186/s12884-025-07869-6","DOIUrl":"10.1186/s12884-025-07869-6","url":null,"abstract":"<p><strong>Aims: </strong>Given the limited data on the effects of metformin exposure in pregnancy, this study aims to investigate the association between metformin use in Gestational Diabetes (GDM) and the risk of short-term maternal and neonatal outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study included women with GDM who sought prenatal care at Sidra Medicine, Qatar, between January 2019 and December 2020 and compared maternal and neonatal outcomes in patients treated with metformin to those treated with diet control alone.</p><p><strong>Results: </strong>Six hundred forty nine GDM patients were included, of which 438 were treated with diet only, and 211 were treated with metformin. At baseline, the metformin-treated group was older (33.3 ± 4.8 vs. 31.2 ± 5.0 years), had higher pre-pregnancy Body Mass Index (BMI) (27.9 ± 4.6 vs. 26.0 ± 4.7 kg/m²), but had lower gestational weight gain (0.28 ± 0.20 vs. 0.34 ± 0.17 kg/week) than the diet group (p <.001). When adjusted for age, fasting glucose at diagnosis, pre-pregnancy weight, and gestational weight gain, metformin treatment was not associated with an increased risk of any adverse pregnancy outcomes.</p><p><strong>Conclusions: </strong>Treatment with metformin was not associated with an increased risk of adverse outcomes, including small for gestational age and preterm labor in women with GDM.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"762"},"PeriodicalIF":2.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic evaluation of albumin-associated inflammatory indices (LAR, NAR, MAR, FAR, SII/Alb, SIRI/Alb, NPAR, and CAR) in preterm premature rupture of membranes (PPROM) pregnancies.","authors":"Ruken Dayanan, Burak Bayraktar, Gulsan Karabay, Ahmet Arif Filiz, Nazan Vanli Tonyali, Betul Tokgoz Cakir, Gizem Aktemur, Zeynep Seyhanli, Ismail Burak Gultekin, Sevki Celen","doi":"10.1186/s12884-025-07877-6","DOIUrl":"10.1186/s12884-025-07877-6","url":null,"abstract":"","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"759"},"PeriodicalIF":2.8,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-based doulas and medicaid expansion: a resource-based approach to support the well-being of low-income postpartum women.","authors":"Charlotte V Farewell, Jennifer Gahrns, Julia Pangalangan, Emily Curl, Anna Pangalangan","doi":"10.1186/s12884-025-07855-y","DOIUrl":"10.1186/s12884-025-07855-y","url":null,"abstract":"","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"757"},"PeriodicalIF":2.8,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating acceptability and experiences of pregnant women at high risk of developing gestational diabetes who take part in antenatal intervention trials: a qualitative systematic review.","authors":"Gözde Sultan Çakır, Manar Abduljalil Bakhsh, Ola F Quotah, Olivia Righton, Catherine V George, Lucilla Poston, Sara L White, Angela C Flynn, Zoë Bell","doi":"10.1186/s12884-025-07854-z","DOIUrl":"10.1186/s12884-025-07854-z","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is associated with short- and longer-term adverse outcomes for both mother and child. The success of randomised controlled trials (RCTs) assessing interventions to prevent GDM depends in part on participant adherence to and acceptability of the intervention. A review of the nested-qualitative components of antenatal RCTs to prevent GDM is lacking. This qualitative systematic review aimed to evaluate the experiences of pregnant women at higher risk of developing GDM who took part in preconception and/or pregnancy interventions which aimed to reduce GDM.</p><p><strong>Methods: </strong>Electronic databases (MEDLINE, EMBASE, Cochrane Library), and reference and citation lists were searched up to February 2025. Studies were eligible if they included qualitative research methods to examine the experiences of pregnant women following an intervention to reduce GDM. We used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework, and the Critical Appraisal Skills Programme (CASP) qualitative checklist was used to assess the quality of the studies.</p><p><strong>Results: </strong>Of the 38,812 studies initially identified, 102 trials were screened for eligibility, and four met the inclusion criteria and were included. All were pilot RCTs using semi-structured interviews in high-income countries (UK n = 3, USA n = 1). Data were synthesised into three themes: (1) acceptability of the interventions, (2) adherence to the interventions, and (3) perceived change in knowledge, attitude and behaviour. Acceptability of interventions was influenced by awareness of GDM, extra support and antenatal care, and natural pharmacological supplements. Adherence to interventions was facilitated by the intervention content and delivery. Perceived change in knowledge, attitude and behaviour was facilitated by intervention specific components and perceived improvements in health.</p><p><strong>Discussion: </strong>This review identified factors influencing adherence and acceptability of interventions for pregnant women at high risk of GDM. It also highlighted a lack of embedded qualitative studies exploring women's experiences of participating in antenatal interventions. The findings suggest that improving the design and implementation of pregnancy interventions requires greater attention to participants' experiences and support systems. This study highlights the need for nested qualitative studies in RCTs to improve acceptability and adherence to pregnancy interventions.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"754"},"PeriodicalIF":2.8,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stepwise risk stratification of early-onset preeclampsia: integrating mid-trimester uterine artery doppler and maternal comorbidities.","authors":"Mevlut Bucak, Sifa Turan, Ozhan M Turan","doi":"10.1186/s12884-025-07864-x","DOIUrl":"10.1186/s12884-025-07864-x","url":null,"abstract":"","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"758"},"PeriodicalIF":2.8,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}