BMC Pregnancy and Childbirth最新文献

{"title":"Association of remifentanil analgesia with postpartum depression and birth experience: an observational study.","authors":"Fateme Shoureshi Jorbijarkali, Solmaz Ghanbari-Homaie, Mojgan Mirghafourvand, Mansour Rezaei, Jamileh Malakouti","doi":"10.1186/s12884-025-07704-y","DOIUrl":"10.1186/s12884-025-07704-y","url":null,"abstract":"<p><strong>Background: </strong>Pain is a risk factor for postpartum depression. This study aimed to determine the relationship between remifentanil analgesia and postpartum depression, as well as the birth experience among Iranian women.</p><p><strong>Methods: </strong>This observational study was conducted on 200 mothers who underwent vaginal birth at Taleghani Hospital in Tabriz, Iran, in 2023-4. The Edinburgh Postnatal Depression Scale and the Childbirth Experience Questionnaire were used to assess the outcomes. To compare the childbirth experience and postpartum depression between the exposure group (receiving remifentanil) and the non-exposure group, independent t-tests and Mann-Whitney U tests were employed, respectively.</p><p><strong>Results: </strong>The mean postpartum depression score in the remifentanil analgesia group was statistically significantly lower than that in the non-analgesia group (p = 0.002). The mean total childbirth experience score in the exposure group was statistically significantly higher than in the non-exposure group (p < 0.001). Additionally, a comparison of the subdomains of childbirth experience between the two groups showed that the mean scores for own capacity (p < 0.001), perceived safety (p < 0.001), and participation (p < 0.001) were statistically significantly higher in the remifentanil group compared to the non-analgesia group. However, there was no statistically significant difference between the two groups regarding the professional support subdomain (p = 0.434).</p><p><strong>Conclusion: </strong>These findings underscore the significance of using remifentanil analgesia as a potential approach for preventing postpartum depression and creating a positive childbirth experience. It is recommended that clinical trials be conducted to obtain more precise results.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"583"},"PeriodicalIF":2.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092745","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":"Closing-the-loop: a novel care coordination tool to reduce maternal healthcare utilization postpartum and collaboratively build interventions to address community needs.","authors":"Amanda Terry, Chelsea Arnold, Zackery White, Mary O'Connor, Gillian Feldmeth, Halima Ahmadi-Montecalvo","doi":"10.1186/s12884-025-07702-0","DOIUrl":"10.1186/s12884-025-07702-0","url":null,"abstract":"<p><strong>Background: </strong>In August 2020, Sarasota Memorial Health Care System (Sarasota Memorial) invested in Unite Us, a closed-loop referral platform, to address obstetric (OB) patients' non-medical needs. The platform was used to electronically refer patients delivering at Sarasota Memorial who screened positive for these needs to a local network of community-based organizations.</p><p><strong>Methods: </strong>A pre-post intervention study with a quasi-experimental, 1:1 matched design was used to measure the impact of implementing a technology-enabled care coordination platform on postpartum health care utilization. Deliveries were matched on patient and birth characteristics including age, race and ethnicity, marital status, insurance type, maternal comorbidities, and birth-specific factors. The impact of the Unite Us platform was assessed using conditional logistic regression, and results were stratified by insurance type, delivery method, low birthweight, preterm delivery, marriage status, infection complications, mental health diagnoses, and race/ethnicity.</p><p><strong>Results: </strong>The study consisted of 1,996 deliveries with a live birth, 998 of which were to patients referred for community care through Unite Us from August 27, 2020 to January 31, 2023. These were matched with 998 deliveries with a live birth prior to Unite Us implementation, from January 1, 2019 to August 26, 2020. Matches were predominantly Medicare or Medicaid insured (65.0%), White, Non-Hispanic (56.6%) or Hispanic (28.2%), and never married (62.6%). When stratified by insurance type, patients who were enrolled in Medicaid/Medicare insurance at delivery were 59% less likely (OR: 0.41; 95% CI: 0.17 to 0.99) to be readmitted to the hospital within thirty days of discharge and were 55% less likely (OR: 0.45; 95% CI: 0.21 to 0.99) to have any OB-related inpatient admission within six months of discharge when compared to those who received usual care before Unite Us' implementation.</p><p><strong>Conclusions: </strong>Using the Unite Us platform as a digital tool to advance care coordination, the OB Service line within Sarasota Memorial observed statistically significant reductions in postpartum healthcare utilization in Medicaid/Medicare beneficiaries indicating that addressing non-medical, health-related needs may improve postpartum outcomes and reduce costs. These referral data are also used to facilitate community discussions on ways to build a more supportive network to improve maternal and child health outcomes.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"580"},"PeriodicalIF":2.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092747","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":"Individualized intervention and growth dynamics assessment in TRAP sequence with conjoined twins based on radiofrequency ablation.","authors":"Hua Lai, Huiting Zhu, Jinliang Zhang, Juhua Xiao, Mengjiao Liu, Danping Liu, Zengming Li, Xin Zhou","doi":"10.1186/s12884-025-07658-1","DOIUrl":"10.1186/s12884-025-07658-1","url":null,"abstract":"<p><strong>Background: </strong>Twin reversed arterial perfusion (TRAP) sequence with conjoined twins (CTs) represents an exceedingly rare and critical complication in monochorionic monoamniotic (MCMA) twin pregnancies. High mortality rates are associated with this condition, making early diagnosis and management crucial for improving survival outcomes, particularly for the pump twin.</p><p><strong>Case presentation: </strong>This case report focuses on a unique instance of TRAP-associated CTs, diagnosed at 13 weeks and 1 day of gestation. Management involved detailed ultrasonography and radiofrequency ablation (RFA) at 18 weeks and 5 days to interrupt the blood supply to the non-viable acardiac twin. This intervention allowed the pump twin to continue normal development, culminating in a cesarean delivery at 35 weeks and 1 day. The newborn showed a healthy postnatal outcome with no significant neurodevelopmental deficits noted at follow-up.</p><p><strong>Conclusions: </strong>Early identification and tailored intervention are essential in cases of TRAP sequence associated with conjoined twins. This case exemplifies the potential of integrated multidisciplinary approaches and timely use of RFA, which significantly enhance the prognosis for the viable twin. These strategies are vital for managing complex MCMA pregnancies and can inform future clinical practices.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"584"},"PeriodicalIF":2.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092755","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":"Dual trajectory of insomnia and depressive symptoms in women from early pregnancy to 6 months postpartum: a prospective cohort study.","authors":"Xinlong Pan, Yang Chen, Chunli Chen, Jianfei Chen, Jiarun Wang, Yujia Chen, Wei Zhang, Jiaxin Wu, Wenhui Liu, Zhijie Zou, Luyang Zhu, Xiaoli Chen","doi":"10.1186/s12884-025-07649-2","DOIUrl":"10.1186/s12884-025-07649-2","url":null,"abstract":"<p><strong>Background: </strong>Perinatal insomnia and depression significantly impact maternal-infant health, but their co-developing trajectories are poorly understood. This study examines their heterogeneous progression, interrelationships, and predictive factors across the perinatal period.</p><p><strong>Methods: </strong>This was part of a mother-infant cohort study conducted in the obstetrics outpatient clinic of a tertiary hospital in Wuhan, Hubei Province. Pregnant women were enrolled (N = 1034) at early pregnancy (< 14 weeks) from July 2022 to September 2023. The perinatal depressive symptoms, insomnia severity, anxiety symptoms, and social capital were reassessed at 5-time points from enrollment (T0) to 6 months postpartum using the Edinburgh postnatal depression scale, the Insomnia Severity Index, the Pregnancy-related Anxiety Questionnaire, and the Personal Social Capital Scale 16, respectively. The follow-up time points were 16-20 weeks of gestation (T1), 28-36 weeks of gestation (T2), six weeks postpartum (T3) and six months postpartum (T4), respectively. Group-based trajectory modelling and binary logistic regression modelling were used to analyze the data (n = 436).</p><p><strong>Results: </strong>We identified three trajectories for perinatal insomnia and depression symptoms. Insomnia: no insomnia (27.7%), subclinical (54.5%), clinical (17.8%). Depression: low-stable (38.7%), moderate-stable (43.9%), high-improving (17.4%). The dual trajectory analysis revealed significant co-occurrence patterns between insomnia and depression trajectories (p < 0.001). Members of the high-improving depression group were more likely to have clinical insomnia trajectories. Baseline ISI ≥ 8, EPDS ≥ 10, and PRAQ ≥ 24 predicted the higher trajectories of perinatal insomnia and depressive symptoms (all p < 0.05).</p><p><strong>Conclusions: </strong>Perinatal insomnia and depression follow three distinct but interrelated trajectories, identifiable through early screening. Risk-stratified interventions should consider their co-occurrence patterns to optimize outcomes.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"582"},"PeriodicalIF":2.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092752","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":"\"Is that a policy thing or is that a guard thing?\": A qualitative study of providers' experiences supporting pregnant individuals incarcerated in Ontario, Canada.","authors":"Xaand Bancroft, Audrey Ferron Parayre, Amy McGee, Lisa Morgan, Wendy Peterson","doi":"10.1186/s12884-025-07696-9","DOIUrl":"10.1186/s12884-025-07696-9","url":null,"abstract":"<p><strong>Background: </strong>Incarcerated pregnant individuals face barriers to perinatal care and health disparities when compared to the general population. Social and healthcare providers serving incarcerated pregnant clients are uniquely positioned to identify systemic barriers which hinder clients' access to care and service delivery. This study explores the experiences of providers and the systemic challenges they encounter while delivering perinatal health and social services to individuals incarcerated in Ontario, Canada.</p><p><strong>Methods: </strong>We conducted a qualitative study using a descriptive design. We administered virtual, semi-structured interviews with social service and healthcare providers. Participants were recruited through purposeful and snowball sampling based on their experience delivering services to at least one individual who was pregnant while incarcerated in Ontario, Canada. All interviews were conducted individually to facilitate discussions and ensure confidentiality. We employed thematic analysis to identify and develop themes and subthemes.</p><p><strong>Results: </strong>Twenty-three participants (15 social service providers and eight healthcare providers) were interviewed. Participants explained how overlapping systems shaped their ability to deliver care, which we conceptualized as the carceral perinatal care system, composed of carceral, clinical, and community subsystems. Through thematic analysis, we also identified five themes, visually depicted as three concentric circles to reflect providers' layered and compounding experiences. The outermost circle, divided into three segments, represents the main challenges providers encountered when delivering perinatal care: (1) operating within a fragmented system, (2) knowing too little, and (3) witnessing dehumanization. These challenges contribute to the middle circle theme of (4) feeling powerless, which culminates in the centre circle theme of (5) enduring occupational stress.</p><p><strong>Conclusion: </strong>Participants provided insights about the challenges involved in delivering perinatal care to incarcerated individuals. This study underscores the multifaceted, systemic barriers providers encounter, enhancing our understanding of the complexities surrounding perinatal care in carceral settings. The knowledge generated forms a foundation for developing policies, guidelines, and training resources tailored to the carceral context. Such interventions may strengthen providers' capacity to deliver equitable care, improving perinatal experiences and health outcomes of pregnant individuals and their infants. Future research should explore perinatal care from incarcerated individuals' perspectives to inform evidence-based solutions and guide comprehensive reforms.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"575"},"PeriodicalIF":2.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085564","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":"Clinical analysis of 126 cases of stillbirth in high-altitude areas.","authors":"Yunbo Huang, Weijie Fan, Xinxin Xie, Donghua Yao","doi":"10.1186/s12884-025-07670-5","DOIUrl":"10.1186/s12884-025-07670-5","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to analyze the clinical characteristics of stillbirths in high-altitude areas, strengthen monitoring of high-risk pregnant women, improve maternal health care levels, and reduce perinatal mortality rates.</p><p><strong>Methods: </strong>A retrospective collection of 126 cases of stillbirth in Nyingchi People's Hospital from 2015 to 2021 was divided into an pre-stage group (2015-2019,87 cases) and a post-stage group (2020-2021,39 cases). The incidence of stillbirth and clinical characteristics were compared between the two groups. The cases were classified into maternal factors, fetal factors, placenta/membrane/umbilical cord factors, and unknown causes, and the clinical characteristics and possible etiologies of different gestational ages and antenatal examination situations were analyzed.</p><p><strong>Result: </strong>The overall incidence of stillbirth in the high-altitude area of this study was 2.36%, with2.07% in the pre-stage group and 3.43% in the post-stage group. There were significant differences between the two groups in gestational age and antenatal examination situation (P = 0.003 and 0.008). The main causes of stillbirth were maternal factors (45.28%), followed by placenta/membrane and umbilical cord factors (28.30%), unknown causes (17.61%), and fetal factors (8.81%). The main causes of stillbirth include hypertensive disorder complicating pregnancy, premature rupture of membranes, severe anemia, and fetal malformatiohypertensive disorder complicating pregnancyns.</p><p><strong>Conclusion: </strong>This study provides new insights into the prevention and management of stillbirths in high-altitude areas, particularly in terms of maternal factors such as gestational hypertension and severe anemia, by analyzing the clinical characteristics and influencing factors of 126 cases of stillbirths in high-altitude areas. Therefore, this study suggests strengthening prenatal and antenatal health care management to reduce the risk of stillbirth, improve pregnancy outcomes, and promote maternal and child health.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"576"},"PeriodicalIF":2.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085569","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":"The impact of social determinants of health on infant and maternal health using a reproductive justice lens.","authors":"Kathryn J Malin, Ashelee J Vance, Stephanie E Moser, Jessica Zemlak, Cherise Edwards, Rosemary White-Traut, Rebecca Koerner, Jacqueline McGrath, Kelly McGlothen-Bell","doi":"10.1186/s12884-025-07693-y","DOIUrl":"10.1186/s12884-025-07693-y","url":null,"abstract":"<p><strong>Background: </strong>Rates of preterm birth, low birth weight, and Neonatal Intensive Care Unit (NICU) admissions continue to rise in the United States (US). Social determinants of health (SDOH) are recognized as significant contributors to infant and maternal health, underscoring the need for use of research frameworks that incorporate SDOH concepts. The Restoring Our Own Through Transformation (ROOTT) theoretical framework is rooted in reproductive justice (i.e. reproductive rights and social justice-based framework) and emphasizes both structural and social determinants as root causes of health inequities. The impact of SDOH on maternal and infant mortality and morbidity can often be traced to structural determinants unique to the US, including slavery, Jim Crow laws, redlining, and the GI Bill.</p><p><strong>Aims: </strong>Using data from the Pregnancy Risk Assessment Monitoring System (PRAMS) 8 database, we aimed to evaluate relationships between SDOH (as guided by the ROOTT Framework) and maternal and infant health outcomes.</p><p><strong>Methods: </strong>Data were analyzed from 11 states that included the SDOH supplement in their PRAMS 8 data collection. We used bivariate analyses to examine relationships between SDOH measures guided by the ROOTT framework (e.g. abuse during pregnancy, access to prenatal care, housing stability and education) and maternal morbidity (i.e., gestational hypertension and gestational diabetes) and infant outcomes (i.e., preterm birth, NICU admission, breastfeeding). Pre-identified covariates were controlled for in the logistic and linear regression models.</p><p><strong>Results: </strong>Preterm birth, NICU admission, breastfeeding, and maternal morbidities were significantly associated with SDOH measures linked to structural determinants in the US. Abuse during pregnancy, access to prenatal care, housing, and education were all significantly associated with poorer infant health outcomes in the final regression models. Women who received prenatal care beginning in the 3^rd trimester were twice as likely to develop gestational hypertension.</p><p><strong>Conclusions: </strong>SDOHs rooted in structural determinants are important predictors of poorer maternal and infant health outcomes. Evaluating health outcomes using a reproductive justice framework reveals modifiable risk factors, including access to stable healthcare, safety, and housing. Comprehensive healthcare provision must ensure early and consistent access to healthcare and resources for safety and housing stability to support maternal and infant health.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"577"},"PeriodicalIF":2.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085722","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":"Oxidative stress biomarkers as novel screening tools for trisomy 21: a case-control study.","authors":"Sinem Tekin, Aydin Ocal, Filiz Yarsilikal Guleroglu, Emine Ufuk Büyükkaya Ocal, Mervenur Al, Cagseli Göksu Ozgün Selcuk, Ali Cetin","doi":"10.1186/s12884-025-07601-4","DOIUrl":"10.1186/s12884-025-07601-4","url":null,"abstract":"<p><strong>Objective: </strong>Oxidative stress plays a pivotal role in the pathogenesis of Down syndrome (Trisomy 21), as chromosome 21 harbors multiple genes involved in redox homeostasis and antioxidant defense mechanisms. This study aimed to evaluate the roles of transcription factors nuclear factor erythroid 2-related factor 2 (NRF2) and nuclear factor-kappa B (NFKB), along with antioxidant enzymes cystathionine-γ-lyase (CSE) and NAD(P)H dehydrogenase [quinone] 1 (NQO1) in amniotic fluid (AF) and maternal serum (MS) as potential biomarkers for prenatal screening of Down syndrome (DS).</p><p><strong>Methods: </strong>This prospective case-control study included singleton pregnant women undergoing amniocentesis between 16 and 24 weeks of gestation at Haseki Training and Research Hospital, Istanbul. Participants were divided into two groups: 28 pregnancies with DS confirmed by karyotype analysis (DS group) and 37 pregnancies with normal karyotype results (non-DS group). Amniotic fluid and maternal blood samples were analyzed using enzyme-linked immunosorbent assay (ELISA) kits to measure the levels of selected biomarkers.</p><p><strong>Results: </strong>NQO1 levels were significantly higher in the DS group compared to the non-DS group in both amniotic fluid (924.84 ± 475.94 vs. 505.62 ± 358.17 ng/ml, p < 0.001) and maternal serum (716.216 ± 242.91 vs. 394.87 ± 344.86 ng/ml, p < 0.001). NRF2 levels were significantly lower in the DS group in both amniotic fluid (3.77 ± 4.20 vs. 6.47 ± 5.53 ng/ml, p = 0.029) and maternal serum (7.54 ± 5.68 vs. 14.46 ± 16.53 ng/ml, p = 0.022).</p><p><strong>Conclusion: </strong>The study highlights the importance of further research to validate the use of these antioxidant enzymes and transcription factors in non-invasive prenatal testing, which may reduce the need for invasive procedures and associated complications.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"578"},"PeriodicalIF":2.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085720","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":"Mediating effect of osteocalcin underlying the link between insulin-like growth factor-I and gestational diabetes mellitus.","authors":"Lingling Cui, Yuting Gao, Ruijie Sun, Zhiqian Li, Zhengya Zhang, Linpu Ji, Yibo Wang, Hua Ye, Luying Qin","doi":"10.1186/s12884-025-07689-8","DOIUrl":"10.1186/s12884-025-07689-8","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the associations of serum insulin like growth factor I (IGF-I) and Osteocalcin (OC) concentrations with gestational diabetes mellitus (GDM) risk among Chinese women.</p><p><strong>Methods: </strong>A case-control study was conducted in China, involving 125 GDM and 153 healthy pregnant women at 24-28 gestational weeks from 2019 to 2022. The study was approved by the Clinical Trial Ethics Committee of the Third Afliated Hospital of Zhengzhou University in January 04, 2020, and the study had been registered with the Chinese Clinical Trial Registry (ChiCTR2000028811). Maternal serum IGF-I and OC levels were measured in the second trimester. Logistic regression models and restricted cubic spline (RCS) were employed to calculate the association of IGF-I and OC levels with the risk of GDM, and and receiver operating characteristic (ROC) curves were generated to evaluate the predictive capacity of IGF-I and OC for GDM. Mediation analyses were used to investigate the mediation effect of OC on the association between IGF-I and the risk of GDM.</p><p><strong>Results: </strong>Both serum IGF-I and undercarboxylated Osteocalcin (ucOC) concentration were positively associated with the risk of GDM. The relationship between serum IGF-I and the risk of GDM is not linear (P-value < 0.001, P-Nonlinear < 0.001). Mediation analyses suggested that 48.61% of the associations between IGF-I and GDM might be mediated by ucOC. The areas under the ROC curves for IGF-I and integrated model were 74.5% and 76.2%.</p><p><strong>Conclusions: </strong>Serum IGF-I might provide a new dimension in the diagnosis of GDM for clinical application, and ucOC might serve as a mediator between IGF-I and GDM.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"579"},"PeriodicalIF":2.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085588","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":"The prognostic nutritional index is associated with preeclampsia in twin pregnancies.","authors":"Qing Han, Shuisen Zheng, Xiaoling Chen, Yuting Gao, Huale Zhang, Na Lin","doi":"10.1186/s12884-025-07669-y","DOIUrl":"https://doi.org/10.1186/s12884-025-07669-y","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate the relationship between the prognostic nutritional index (PNI) during the third trimester and the risk of preeclampsia (PE) in twin pregnancies.</p><p><strong>Method: </strong>A total of 2998 twin pregnancies were enrolled in Fujian Maternal and Child Health Hospital from January 2015 to December 2021, including preeclampsia group (n = 421) and control group (n = 2577). The significance of the characteristic variables in predicting PE in twin pregnancies were calculated using the random forest algorithm (Boruta package) and the correlation between PNI and PE in twin pregnancies was examined in three distinct models using multivariable logistic regression corrected for confounders. Receiver operating characteristics (ROC) curves were used to evaluate the ability for PNI to predict PE in twin pregnancies.</p><p><strong>Results: </strong>PNI (37.92 ± 3.86 vs. 40.57 ± 3.63, P < 0.001) was significantly lower in the PE group than in the control group. After adjusting for all covariates, the PNI was negatively associated with PE in twin pregnancies (OR = 0.780; 95% CI: 0.753, 0.808). Meanwhile, the higher PNI remained an independent protective factor for PE in twin pregnancies compared to lower PNI (OR, 95% CI: 0.410, 0.438-0.530; 0.144, 0.103-0.201) in sensitivity analysis. ROC curve analysis revealed an area under curve (AUC) of 0.691 for PNI and the cut-off value of PNI was 40.162.</p><p><strong>Conclusion: </strong>PNI was negatively correlated with the risk of PE in twin pregnancies, which may help in risk assessment for twin pregnancies.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"568"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075794","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}