BMC Pregnancy and Childbirth最新文献

{"title":"The impact of early pregnancy disease control in systemic lupus erythematosus patients receiving comprehensive pharmaceutical care on pregnancy outcomes and offspring long-term health.","authors":"Lian Zheng, Xixuan Yu, Shiran Li, Jinfeng Huang, Yuanyuan He, Lin Zhang, Xiaolan Xia, Jing Zhu, Jun Yue, Yan Wang, Yue Zhuang, Chao Zhou, Yue Wu","doi":"10.1186/s12884-025-08149-z","DOIUrl":"10.1186/s12884-025-08149-z","url":null,"abstract":"","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1035"},"PeriodicalIF":2.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243889","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 rates and factors associated with cesarean section and inpatient cost among low-risk deliveries in selected U.S. states.","authors":"Chen Dun, Shijia Zhang, Shixiong Wei, Khyzer B Aziz, Hadi Kharrazi","doi":"10.1186/s12884-025-08148-0","DOIUrl":"10.1186/s12884-025-08148-0","url":null,"abstract":"<p><strong>Introduction: </strong>Cesarean sections are commonly performed in the United States, including among patients for whom vaginal delivery may be clinically feasible. This study aimed to evaluate rates and factors associated with cesarean section use and inpatient cost among low-risk deliveries in selected U.S. states.</p><p><strong>Methods: </strong>This was a retrospective, cross-sectional analysis using Healthcare Cost and Utilization Project (HCUP) State Inpatient database for Maryland, Florida, and Wisconsin between January 1, 2017, and December 31, 2020. American Hospital Association (AHA) data and median household income quartiles based on the Agency for Healthcare Research and Quality's (AHRQ) 2018 estimates were included in this study to assess hospital and patient neighborhood characteristics. AHA data was linked to HCUP data using the hospital identifier number. Median household income quartiles were linked to HCUP using ZIP codes. A multivariable generalized estimating equations regression model including a random intercept for hospitals was used to identify patient- and hospital-level characteristics associated with the use of cesarean section.</p><p><strong>Results: </strong>245,383 women who underwent a delivery between 2017 and 2020 were included in the analysis. Of these women, 8.1% had cesarean section and 91.9% had vaginal delivery. Mean age was 26.9 (SD ± 4.41) years for cesarean section and 26.9 (SD± 4.37) years for vaginal delivery. An increasing rate of cesarean section was detected during the study period. Higher rates of cesarean section were found among Black and Hispanic women compared to White and Asian, and among women with lower income. Hospitals in Florida had the highest cesarean section rate of 9.4% among low-risk women while Maryland and Wisconsin had rates of 6.3% and 5.3%, respectively. Being Hispanic or Black, having private insurance, and giving birth in a for-profit hospital were associated with higher cesarean section utilization after controlling patient- and hospital-level factors.</p><p><strong>Discussion: </strong>A range of clinical and policy interventions have been implemented over the past decade to reduce cesarean sections among low-risk deliveries; however, we still identified an increasing rate of cesarean section among low-risk women between 2017 and 2020 in select U.S. states. There is an emergent need to revisit policies and interventions that impact cesarean section in these states. Women with low socioeconomic status were more vulnerable to have cesarean sections. Identifying variation in cesarean delivery rates among low-risk populations may inform future efforts to improve maternal care quality.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1036"},"PeriodicalIF":2.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243833","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":"A prediction model of preterm birth in singleton pregnancy after assisted reproduction therapy.","authors":"Zhaorui Wang, Hanjie Mo, Liqiong Zhu, Jing Tang, Jia Huang, Zhuoyao Mai, Xuedan Jiao, Menglan Zhu, Xiaohui Ji, Nengyong Ouyang, Hui Chen","doi":"10.1186/s12884-025-08221-8","DOIUrl":"10.1186/s12884-025-08221-8","url":null,"abstract":"<p><strong>Objective: </strong>Preterm birth is a major global health issue, with higher rates observed in pregnancies following assisted reproductive technology (ART). This study aimed to develop and validate via the validation set a prediction model for preterm birth in singleton pregnancies following ART, by identifying key clinical and ART-related risk factors.</p><p><strong>Methods: </strong>This retrospective study included 268 women who underwent ART and delivered singleton Live births at Sun Yat-sen Memorial Hospital between 2013 and 2021. Data on demographic characteristics, medical history, ART-related factors, pregnancy complications, and delivery outcomes were extracted from medical records. The study cohort was randomly divided into a training set (160 participants) and an internal validation set (108 participants). The training set was used to identify predictors and construct a nomogram using multivariable logistic regression. The model's performance was evaluated through discrimination (area under the curve, AUC), calibration (calibration curves), and clinical usefulness (decision curve analysis). The relationship between cervical length and gestational age was also assessed using restricted cubic splines.</p><p><strong>Results: </strong>The total preterm birth rate was 23.5% (63/268). Independent risk factors for preterm birth in singleton pregnancies after ART included the number of embryos implanted (OR = 3.54, 95% CI: 1.29-9.69, p = 0.014), gestational hypertensive disease (GHD) (OR = 3.07, 95% CI: 1.36-6.93, p = 0.007), premature rupture of membranes (PROM) (OR = 4.70, 95% CI: 1.90-11.61, p < 0.001), polycystic ovary syndrome (PCOS) (OR = 2.27, 95% CI: 1.04-4.93, p = 0.039), and intrauterine adhesion (IA) (OR = 3.32, 95% CI: 0.67-16.59, p = 0.043). The nomogram developed from these factors demonstrated acceptable discrimination (AUC = 0.77 in the training set, AUC = 0.71 in the validation set) and calibration in both sets. Decision curve analysis showed that the model provided net benefits across a wide range of threshold probabilities (0.00 to 0.83). The analysis of cervical length indicated significant differences between the preterm and full-term groups, with a higher reduction rate in cervical length observed in the preterm group after 16 weeks of gestation.</p><p><strong>Conclusions: </strong>The prediction model developed in this study is effective for predicting preterm birth risk in ART pregnancies. This model can help clinicians identify high-risk pregnancies early and implement targeted interventions. Cervical length monitoring may be a useful tool in predicting preterm birth, especially after the second trimester.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1037"},"PeriodicalIF":2.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243774","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":"Associations between maternal abortion history and neonatal outcome among very preterm infants: a multicenter cohort study.","authors":"Min Yang, Jie Yang, Dianna Wang, Jiale Dai, Xiaobo Fan, Yun Cao, Wenhao Zhou, Shoo K Lee, Jimei Wang, Liyuan Hu","doi":"10.1186/s12884-025-08196-6","DOIUrl":"10.1186/s12884-025-08196-6","url":null,"abstract":"<p><strong>Background: </strong>It is unclear whether there is an association between maternal abortion history and neonatal outcomes of singleton very preterm infants (VPIs). We assess the association between maternal abortion history and neonatal outcome of VPIs in China.</p><p><strong>Methods: </strong>All first parity singleton VPIs born at < 32 weeks gestational age (GA) who were admitted to neonatal intensive care units (NICU) participating in the Chinese Neonatal Network (CHNN) from 2019 to 2021 were included in the study. Multivariable logistic regression models were constructed to compare neonatal outcomes among infants with different maternal abortion histories after adjusting for confounders.</p><p><strong>Results: </strong>A total of 7256 VPIs were included in this analysis. Overall, 3133 (43.2%) infants had positive maternal abortion history. The incidence of mortality or any major morbidity including respiratory distress syndrome (RDS), patent ductus arteriosus (PDA), intraventricular haemorrhage (IVH), IVH stage 3 or 4, moderate or severe bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), ROP stage 3, 4, or 5 tended to increase significantly with increasing number of maternal abortion histories from non-abortion group to ≥ 2 abortions group. Multivariable analysis showed that maternal abortion history was significantly associated with higher risks of mortality or any major morbidity (adjusted odds ratio [aOR] 1.15, 95% confidence interval [CI] 1.03-1.29), RDS (aOR 1.22, 95%CI 1.08-1.38), IVH (aOR 1.17, 95% CI 1.05-1.31), and IVH stage 3 or 4 (aOR 1.27, 95% CI 1.01-1.59). Risk increased with the number of abortions. VPIs of mothers with two or more abortions had the highest risk of mortality or any major morbidity (aOR 1.18, 95% CI 1.02-1.36), RDS (aOR 1.35, 95% CI 1.18-1.56), IVH (aOR 1.23, 95% CI 1.07-1.43) and moderate or severe BPD (aOR 1.17, 95% CI 1.01-1.36), compared to the non-abortion group.</p><p><strong>Conclusions: </strong>In China, VPIs born to mothers with previous abortion history may have a greater risk of adverse outcomes. Based on the potential impact of maternal abortion history on newborns, it is necessary to provide additional information on related risks during antenatal counseling for these mothers.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1033"},"PeriodicalIF":2.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237533","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":"Association between maternal anemia and cord blood hemoglobin and ferritin concentrations in newborns: a Single-center study in Turkey.","authors":"Asli Gunes Arica, Gorkem Arica, Didem Arman, Nursu Kara, Serdar Comert","doi":"10.1186/s12884-025-08218-3","DOIUrl":"10.1186/s12884-025-08218-3","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to evaluate the effect of third-trimester maternal iron deficiency and iron deficiency anemia on neonatal cord-blood hemoglobin (Hgb), and serum ferritin levels.</p><p><strong>Methods: </strong>Pregnant women who gave birth between 37^0/7 and 40^6/7 weeks of gestation, and their neonates were included. Maternal hemoglobin and ferritin levels were assessed. They were divided into two groups based on Hgb values as anemic and non-anemic. Furthermore, the anemic group was classified as mild, moderate, and severe anemia. Maternal and cord Hgb, hematocrit and ferritin levels were compared between groups. The study population was stratified into two groups according to iron supplementation status.</p><p><strong>Results: </strong>Among 627 women included, 226(36%) were diagnosed as anemic, of which 130(57.5%) had mild, 94(41.6%) moderate, and 2(0.9%) severe anemia. Mean maternal Hb levels were 9.9±0.9 g/dl and 12.1±0.9 g/dl in the anemic and non-anemic groups, respectively. The mean maternal serum ferritin of anemic and non-anemic mothers were 11.7 ng/ml and 15.8 ng/ml, respectively (p < 0.001). The mean cord-blood serum ferritin of neonates born from anemic and non-anemic mothers was 113±68.8 ng/ml and 134±95.0 ng/ml, respectively (p = 0.012). Cord-blood Hb levels of neonates born from anemic and non-anemic mothers were 15.1±1.8 g/dl and 15.5±2.0 g/dl, respectively (p = 0.006). The 5th, 25th, 50th, 75th, and 95th percentiles of cord blood serum ferritin concentrations were 32.6, 72.2, 107.5, 154.1, and 272.6 ng/ml, respectively. Among neonates born from mild, moderate, and severe anemic mothers, there was no significant difference regarding cord-blood serum ferritin and blood count parameters (p > 0.05). Cord-blood serum ferritin concentrations were found to be 119 ± 85.7 ng/ml and 136.4 ± 87.9 ng/ml in the low and normal maternal serum ferritin groups, respectively (p = 0.015).</p><p><strong>Conclusion: </strong>Maternal anemia is common and associated with lower neonatal cord blood hemoglobin and ferritin levels. However, lack of iron supplementation during pregnancy, rather than anemia itself, was the strongest independent predictor of neonatal anemia. These findings highlight the importance of routine antenatal iron supplementation to support fetal iron status and improve perinatal outcomes. Further randomized controlled trials are needed to evaluate the effects of maternal iron supplementation on fetal iron stores and long-term outcomes.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1022"},"PeriodicalIF":2.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237564","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":"Experiences of Respectful Maternity Care among postnatal women at a tertiary care hospital in new Delhi.","authors":"Irena Mandal, Mongjam Meghachandra Singh, Bratati Banerjee, Nidhi Bhatnagar, Shakun Tyagi, Anjali Jha","doi":"10.1186/s12884-025-08211-w","DOIUrl":"10.1186/s12884-025-08211-w","url":null,"abstract":"<p><strong>Background: </strong>Compassionate support and a nurturing environment are essential for a positive, dignified birthing experience. A dearth of respectful maternity care not only undermines the overall quality of services but also has far-reaching implications on women's healthcare-seeking behaviour and trust in the health system. Despite increasing institutional deliveries in India, evidence suggests that mistreatment and lack of respectful care persist in healthcare settings. This study assesses the experiences of RMC among postnatal women in a tertiary care hospital in New Delhi and explores its associations with socio-demographic factors.</p><p><strong>Methods: </strong>A hospital-based cross-sectional study was conducted among 300 postnatal women at Lok Nayak Hospital, New Delhi. Participants were selected using a simple random sampling technique. Data were collected using a pre-tested interview which consisted of questions related to their socio-demographic details, obstetric history, domestic or intimate partner violence history and the Person-centered Maternity care (PCMC) scale. Descriptive statistics, chi-square tests, and multivariate logistic regression were used to examine associations between socio-demographic and obstetric factors and RMC scores using Statistical Package for Social Science (SPSS) version 25, and p-value < 0.05 was considered significant.</p><p><strong>Results: </strong>All women (100%) reported overall satisfaction with their delivery experience while significant gaps in RMC were observed. Primigravida women were more likely to receive an episiotomy compared to multigravida. Only 33.3% had a birth companion present, despite LaQshya guidelines, and a significant association was found between the presence of a birth companion during the current delivery and the PCMC scores. Multivariate analysis revealed that the presence of a birth companion (AOR = 4.593; 95% CI: 2.393-8.815; p < 0.001) and having a male baby (AOR = 1.718; 95% CI: 1.028-2.87; p = 0.039) were significantly associated with higher RMC scores.</p><p><strong>Conclusions: </strong>The findings highlight critical gaps in RMC implementation, despite high institutional delivery rates. Strengthening provider training, ensuring birth companionship, and fostering policy enforcement are recommended for improving maternity care quality.</p><p><strong>Trial registration: </strong>This study was registered in the Clinical Trials Registry - India (CTRI) on 31st July 2023 under the postgraduate thesis as CTRI/2023/07/055918.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1023"},"PeriodicalIF":2.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237624","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":"Exploring the experience of birth trauma from the midwife's perspective.","authors":"Dan Xu, Mengyan Xu, Liuxu Fang, Hong Chen, Junhua Ye, Caixian Huang","doi":"10.1186/s12884-025-08205-8","DOIUrl":"10.1186/s12884-025-08205-8","url":null,"abstract":"<p><strong>Background: </strong>Childbirth is a complex process, and midwives involved in assisting or witnessing it often experience psychological trauma, which can impact their well-being and professional performance. Psychological trauma in midwives is under-researched, despite its implications for their mental health and the quality of childbirth services. Addressing this issue is critical for ensuring safe and compassionate care. This study aimed to explore the psychological trauma experienced by midwives during childbirth and identify key influencing factors to enhance the safety and humanization of childbirth services.</p><p><strong>Methods: </strong>This descriptive qualitative study involved in-depth interviews with 13 midwives selected based on preset criteria. Data were analyzed using a qualitative content analysis framework, and thematic analysis was applied to identify recurring themes from the data.</p><p><strong>Results: </strong>Four primary themes emerged from the data. First, midwives reported persistent emotional trauma, including ongoing fear, guilt, and self-blame associated with traumatic childbirth experiences. Second, they faced multifaceted professional challenges, including high expectations and systemic pressures. Emotional exhaustion was more closely associated with persistent trauma and vicarious exposure, as reflected in other themes. Third, participants described feelings of helplessness and powerlessness when managing critical or life-threatening situations. Fourth, vicarious trauma was common, stemming from deep empathy and emotional engagement with laboring women and their families.</p><p><strong>Conclusion: </strong>Strategies to address these challenges include strengthening midwives' psychological resilience and professional competencies, optimizing team collaboration, and enhancing psychological and emotional support. Implementing these measures can safeguard the mental health of midwives, promote humanistic care, and improve childbirth safety.</p><p><strong>Trial registration: </strong>ChiCTR2400088104 August 12th, 2024.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1031"},"PeriodicalIF":2.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237673","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":"Predictors of birth interval among childbearing-age women in East Africa: Weibull gamma shared frailty model.","authors":"Melsew Setegn Alie, Gossa Fetene Abebe, Yilkal Negesse, Desalegn Girma, Amanuel Adugna","doi":"10.1186/s12884-025-08220-9","DOIUrl":"10.1186/s12884-025-08220-9","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization (WHO) recommends a minimum of 24 months from birth to conception and 33 months from birth to birth interval to reduce the incidence of adverse maternal and child health outcomes. Birth intervals can significantly affect the health of both women and children, impacting them in both the short and long term. Regional-level aggregated data analysis is essential for programs and policy. Therefore, this study aimed to determine the duration of the birth interval and identify the predictors in East Africa.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from the Demographic and Health Survey, encompassing a weighted sample of 86,619 women of reproductive age. We employed a Weibull gamma shared frailty model to identify predictors of birth intervals. They utilized the theta value and Akaike Information Criteria (AIC) for model selection. Adjusted hazard ratios (AHR) with 95% confidence intervals (CI) were reported to show the strength and the association.</p><p><strong>Results: </strong>In East Africa, the median interbirth interval was reported to be 34 months (95%CI: 28, 36). Rural residents (AHR = 1.21 (95% CI: 1.18, 1.24), Muslim religion (AHR = 0.9 (95% CI: 0.88, 0.93), Protestant religion (AHR = 1.03 (95% CI: 1.01, 1.05), other religion (AHR = 1.12(1.1-1.2), women in the age group of 20-29(AHR = 0.54 (CI: 0.50, 0.60), age groups of 30-39(AHR = 0.33 (95% CI: 0.31, 0.36), age group 40-49(AHR = 0.23 (95% CI: 0.21, 0.25), Being in the rich (AHR = 0.83 (95% CI: 0.81, 0.85), women attending secondary education (AHR = 0.87 (95% CI: 0.85, 0.90), attending tertiary education (AHR = 0.82 (95% CI: 0.77, 0.86), having a female household (AHR = 0.87 (95% CI: 0.85, 0.90), women who had their own work (AHR = 1.08 (95% CI: 1.04, 1.10), having a living child (AHR = 0.83 (95% CI: 0.80, 0.87), longer distances to health facilities (AHR = 1.03 (95% CI: 1.01, 1.04), women who used contraceptives (AHR = 0.87 (95% CI: 0.85, 0.88) were found the significant predictors of duration of birth interval.</p><p><strong>Conclusion: </strong>The median duration of birth intervals in East Africa is comparable the WHO's recommendations. Implementing tailored and multifaceted interventions that address the identified predictors could enhance birth intervals. Policymakers and program designers should take these predictors into account when developing strategies.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1025"},"PeriodicalIF":2.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237819","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":"Effectiveness of a nurse-led theory-based program on breastfeeding outcomes in women after cesarean section: a randomized controlled trial.","authors":"Yirong He, Xin He, Xinru Bao, Min Qiu, Juan Du, Ting Zhang, Min Shu, Lan Liu, Yu Wang","doi":"10.1186/s12884-025-08094-x","DOIUrl":"10.1186/s12884-025-08094-x","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding provides significant benefits for both mothers and infants, yet its rates remain suboptimal, particularly among women undergoing cesarean sections. Breastfeeding practices are determined by a wide range of socio-environmental, cultural, family and individual factors, but current breastfeeding promotion interventions that integrate these dimensions are limited. This study aimed to evaluate the effectiveness of a breastfeeding intervention based on Theory of Planned Behavior and the Interactive Theory of Breastfeeding in promoting breastfeeding outcomes in women after cesarean section.</p><p><strong>Methods: </strong>A total of 763 women were recruited and randomly divided into an intervention group (n = 383) and a control group (n = 380). The participants were women scheduled for elective cesarean sections due to medical indications. On the basis of theory, mothers in the intervention group received the breastfeeding promotion program, focusing on enhancing breastfeeding knowledge, fostering positive attitudes, increasing family support, strengthening perceived behavioral control, facilitating the transition from intention to action, and promoting mother-infant interaction through skin-to-skin contact, responsive feeding, and emotional bonding. The control group received routine nursing care. Outcomes were assessed using the Bristol Breastfeeding Assessment Tool and the Chinese Breastfeeding Attrition Prediction Tool, focusing on exclusive breastfeeding rates, breastfeeding frequency, duration, and complications.</p><p><strong>Results: </strong>The exclusive breastfeeding rates in the intervention group were significantly higher on day 1, day 2 And day 3 after cesarean section compared to the control group (P < 0.001). The intervention group exhibited higher Bristol Breastfeeding Assessment Tool and Chinese Breastfeeding Attrition Prediction Tool scores, improved breastfeeding frequency and duration, and a lower incidence of breastfeeding-related complications (P < 0.05).</p><p><strong>Conclusion: </strong>A theory-based nursing intervention integrating Theory of Planned Behavior and the Interactive Theory of Breastfeeding significantly enhanced exclusive breastfeeding rates and maternal breastfeeding behaviors in women after cesarean sections. This study highlights the value of combining psychological and contextual factors to design effective breastfeeding interventions, providing evidence for scalable and sustainable strategies to support breastfeeding in postpartum care.</p><p><strong>Trial registration: </strong>This trial was retrospectively registered with the Chinese Clinical Trial Registry on November 19th, 2024 (ChiCTR2400092869) .</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1030"},"PeriodicalIF":2.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237718","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":"Cost of implementation and maintenance of maternal and perinatal death surveillance and response: a scoping review.","authors":"Carly Malburg, Merlin Willcox, Tracey Sach, Mary Kinney, Patricia Akweongo, Animesh Biswas, Florina Serbanescu","doi":"10.1186/s12884-025-08181-z","DOIUrl":"10.1186/s12884-025-08181-z","url":null,"abstract":"<p><strong>Background: </strong>Globally, most countries have policies and guidelines requiring maternal and perinatal death surveillance and response (MPDSR), a system that can reduce avoidable maternal and perinatal deaths. Economic studies of MPDSR help inform resources to implement and sustain MPDSR at subnational and national levels. This review aims to scope the range of economic studies available and examine types of costs incurred by LMICs to implement and maintain MPDSR.</p><p><strong>Methods: </strong>We searched 11 electronic databases for key terms related to economics, maternal and/or perinatal death, health systems, surveillance, or audits/reviews. We included quantitative, qualitative, or mixed methods articles reporting costs of MPDSR, published in English, Spanish, or French during 2012-2023. Two independent authors screened titles and abstracts and extracted data. Costs were converted to the United States dollar price year 2024.</p><p><strong>Results: </strong>A total of 14,078 articles were systematically screened. Only 5 were included, as they reported costs of maternal and/or perinatal death surveillance and/or review. Of these only 3 reported itemized costs. None reported on costs of implementing recommendations. From the articles reporting itemized costs, in year 1 (start-up), the cost per death reviewed ranged from $113 to $5,758 and the cost per capita ranged from $0.40 to $1.11. In year 3, these declined to $86 to $577, and $0.26 to $0.66, respectively. The lowest cost per death was for conducting only maternal death reviews in health facilities. For community MPDSR, the lowest cost per capita was achieved by using a pre-existing functional household surveillance system to identify and investigate maternal and neonatal deaths. The highest cost was for establishing a new comprehensive death surveillance and review system, which investigated all deaths in women of reproductive age to identify maternal deaths only.</p><p><strong>Conclusion: </strong>Comparability was challenging because available literature was sparse and economic methods and study designs were heterogeneous. The cost-benefit of community death surveillance and review, compared to facility-based death notification and review, has not been clearly established. Better understanding of MPDSR costs is needed to prioritize and integrate MPDSR in health planning across system levels.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 Suppl 1","pages":"1016"},"PeriodicalIF":2.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237769","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}