BMC Pregnancy and Childbirth最新文献

{"title":"Multidimensional predictors of preterm birth risk among black and white primiparous women in the U.S.: insights from machine learning.","authors":"Sangmi Kim, Zahra Barandouzi, Sophie Grant, Athena D F Sherman, Brenice Duroseau, Monique S Balthazar","doi":"10.1186/s12884-025-08021-0","DOIUrl":"10.1186/s12884-025-08021-0","url":null,"abstract":"","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"916"},"PeriodicalIF":2.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942096","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 use of echocardiography to identify acute and chronic changes in left ventricular function in hypertensive disorder of pregnancy.","authors":"Ricardo Luiz de Medeiros Lima, Eduardo Gabriel de Azevedo Cortez, Cleanderson Romualdo Fidelis, Lucas Nobrega de Lima, Esther Cecin Mamere, Rafael Andrade Rego, Josivan Gomes de Lima, Selma Maria Bezerra Jeronimo","doi":"10.1186/s12884-025-08006-z","DOIUrl":"10.1186/s12884-025-08006-z","url":null,"abstract":"<p><strong>Background: </strong>Hypertensive disorders of pregnancy, including preeclampsia, are common in socioeconomic vulnerable populations worldwide. Approximately one third of women who have those disorders will maintain with hypertension, after pregnancy. This work aimed to determine the prevalence of hypertensive disorder of pregnancy in Natal, Brazil, and to use echocardiography to study cardiac function: (1) during pregnancy, and (2) at post partum in those who developed severe preeclampsia.</p><p><strong>Methods: </strong>A prospective study after the 7th week of gestation (n = 107) and a cross-sectional study of preeclampsia cases (n = 18) were performed in Natal, Brazil. Data included clinical history, weight, height, age, and transthoracic echocardiogram. Descriptive and exploratory, paired and unpaired Student t-tests, univariate and logistic regression analyses were performed.</p><p><strong>Results: </strong>Among the 87 women who were fully studied prospectively, age varied between 15.2 - 43.2 years (28.1 ± 6.3) and 9.2% of participants developed hypertension. Notably, 61 (70.1%) had a high body mass index (BMI) of > 25 kg/m². There was myocardial hypertrophy or left ventricular remodeling in 12 subjects (13.8%); ejection fraction under 50% in 4 subjects (4.6%) and echocardiographic evidence of reduced left ventricular global longitudinal strain in 6 (6.9%). Women who developed hypertension had higher BMIs and larger left ventricular mass index. Post-partum women who had severe preeclampsia showed increase in the mean left ventricle relative wall thickness (p = 0.0167) and mean left ventricular isovolumic relaxation time (p = 0.0004) after a mean of a month post-delivery.</p><p><strong>Conclusions: </strong>There is high prevalence of hypertensive disorder of pregnancy in underprivileged women from Natal, Brazil. Transthoracic echocardiography can identify early ventricular dysfunction in pre- and post-pregnancy and it may be a useful tool to guide in therapeutic strategies to prevent complications.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"923"},"PeriodicalIF":2.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941622","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":"Partner involvement and emotional and informational support gaps as predictors of postpartum birth trauma symptoms: a multi-center cross-sectional study of 230 women at 42 days postpartum.","authors":"Lingling Li, Lanlan Xiao, Xu Yuan, Jie Wu, Jinxiao Li, Xiuping Chen, Xiaohui Zhai, Bei Wang","doi":"10.1186/s12884-025-08084-z","DOIUrl":"10.1186/s12884-025-08084-z","url":null,"abstract":"<p><strong>Background: </strong>Postpartum birth trauma symptoms, encompassing psychological and physical sequelae related to childbirth experiences, pose a significant threat to maternal well-being. These symptoms, as measured in this study, are not equivalent to a clinical diagnosis of post-traumatic stress disorder (PTSD) but reflect self-reported experiences based on the City Birth Trauma Scale.</p><p><strong>Methods: </strong>This multi-center cross-sectional survey enrolled 230 women at 42 days postpartum from four hospitals in Shanghai between February and July 2024. Birth trauma symptoms were assessed using the Chinese City Birth Trauma Scale. Emotional and informational support expectation gaps were calculated as the difference between the importance score and the actual support score in each domain of the Postpartum Social Support Scale (gap = importance - actual), with larger positive values indicating greater unmet needs. Partner involvement was classified as high, medium, or low. Multiple linear regression identified independent predictors of trauma severity.</p><p><strong>Results: </strong>Birth trauma symptoms were assessed using the Chinese City Birth Trauma Scale. The full sample was analyzed for symptom severity, while the proportion of participants scoring above the ≥ 28 cut-off (Brazilian validation study) was used to estimate the prevalence of clinically significant symptoms. Of all participants, 54.3% scored ≥ 28, indicating clinically significant childbirth-related PTSD symptom levels on the City Birth Trauma Scale, with a mean trauma score of 45.12 ± 16.25. Larger emotional (β = 0.102, p = 0.018) and informational (β = 0.158, p = 0.024) support gaps were independently associated with greater trauma severity, as were low education (β = 0.281, p < 0.001), low household income (β = 0.172, p = 0.014), formula feeding (β = 0.180, p = 0.010), and low partner involvement (β = 0.165, p = 0.018). High partner involvement demonstrated a protective effect comparable to socioeconomic factors. The final model explained 29% of the variance in trauma scores.</p><p><strong>Conclusions: </strong>Inadequate partner involvement and larger emotional and informational support gaps are significantly associated with greater postpartum birth trauma severity. Interventions should prioritize partner-inclusive care and targeted support to address unmet informational and emotional needs. Routine psychosocial screening at postpartum follow-up may facilitate early identification and intervention for at-risk women.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"918"},"PeriodicalIF":2.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942149","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":"Pelvic packing as a life-saving intervention in the referral of patients with obstetric hemorrhage: comparing outcomes in referred and non-referred patients.","authors":"Ahmet Beyazıt, Kenan Serdar Dolapçıoğlu, Oya Soylu Karapınar, Selen Beyazıt, Hasan Cem Sevindik","doi":"10.1186/s12884-025-08055-4","DOIUrl":"10.1186/s12884-025-08055-4","url":null,"abstract":"<p><strong>Background: </strong>Obstetric hemorrhage continues to be a major contributor to maternal deaths and health complications globally. Pelvic packing, a method used in trauma surgery to control severe bleeding, has been successfully applied to treat obstetric hemorrhages. This research aimed to evaluate the appropriateness and effectiveness of pelvic packing for patients with obstetric hemorrhage, especially in the context of patient referrals.</p><p><strong>Materials and methods: </strong>A comparative observational study was carried out on 45 patients who received pelvic packing for obstetric hemorrhage at a hospital in southern Turkey from 2010 to 2024. The patients were divided into two groups: those who had the procedure at the study hospital (non-referred group, n = 27) and those who were referred from other facilities (referred group, n = 18). Demographic, clinical, and laboratory data were examined using descriptive statistics and comparative tests.</p><p><strong>Results: </strong>There were no significant differences in complications and mortality between the two groups. The overall survival rate was 82.2%. Sepsis was more common in patients referred from Syria, likely due to inadequate conditions.</p><p><strong>Conclusion: </strong>The pelvic packing technique is a simple, quick, and effective method for managing obstetric hemorrhage, particularly in resource-limited developing countries. Mastery of this technique is essential for all gynecologists, both for initial patient care and in referral situations.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"920"},"PeriodicalIF":2.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942162","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":"Application of the health belief model to explain pre-conception care among women with sickle cell disease: a cross-sectional study.","authors":"Asiyeh Pormehr-Yabandeh, Teamur Aghamolaei, Zahra Hosseini, Nasibeh Roozbeh, Amin Ghanbarnezhad","doi":"10.1186/s12884-025-08070-5","DOIUrl":"10.1186/s12884-025-08070-5","url":null,"abstract":"<p><strong>Background: </strong>Pre-conception care (PCC) in mothers with sickle cell disease (SCD) is essential to reduce the risk of morbidity and mortality. PCC is not commonly utilized by women of reproductive age. The reason behind this should be assessed using health education theories. This study aims to apply the health belief model (HBM) to explain the adoption of PCC among SCD women.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in Iran from March 2021 to June 2021. Women with SCD were selected through a systematic sampling framework using the Iranian integrated health system. A demographic, knowledge, HBM, and PCC questionnaire were used as instruments. Pearson's correlation was used to investigate the relationship between HBM constructs and PCC. The effect of health beliefs on PCC was analyzed using a path model, in which the observed HBM variables predicted PCC behavior.</p><p><strong>Results: </strong>Out of 413 participants, 13 incomplete questionnaires were excluded (Response rate 96.8%). A significant association was observed between women's and husbands' education with the PCC adoption. Pearson correlation test revealed a significant relationship between PCC and HBM constructs; with positive and significant correlation coefficients of 0.651 and 0.599, self-efficacy and perceived susceptibility had the highest correlation with the PCC. Based on the path model analysis, perceived susceptibility (0.26) and self-efficacy (0.36) substantially influenced adopting PCC. The fit indices of this model were acceptable (GFI = 0.98, AGFI = 0.95, CFI = 0.99, and RMSEA = 0.04).</p><p><strong>Conclusions: </strong>Knowledge, perceived susceptibility, and self-efficacy are the most important determinants of performing PCC. Knowing PCC's most influential and decisive components will help us plan educational content and effective interventions.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"922"},"PeriodicalIF":2.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941969","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":"Determinants of puerperal sepsis among mothers who give birth at Jigjiga Public Hospitals, Jigjiga, Somali Regional State, Eastern Ethiopia: a facility-based unmatched case-control study.","authors":"Hassan Nur Ali, Abdullahi Ahmed Tahlil, Mahad Ali Mohamud, Fuad Ismail Daud, Tesfaye Gobena, Chukwuma David Umeokonkwo, Ahmed Mohammed Ibrahim","doi":"10.1186/s12884-025-08054-5","DOIUrl":"10.1186/s12884-025-08054-5","url":null,"abstract":"","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"919"},"PeriodicalIF":2.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941808","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 development and validation of postpartum hemorrhage prediction models for pregnancies with placenta previa totalis based on coagulation function indexes: a retrospective cohort study.","authors":"Shibin Hong, Chang Liu, Xin Kang, Ka U Lio, Yiping Le, Ting Zhang, Haoting Shi, Lan Dai, Wen Di, Ning Zhang","doi":"10.1186/s12884-025-08066-1","DOIUrl":"10.1186/s12884-025-08066-1","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study is to establish and validate models that can accurately predict postpartum hemorrhage (PPH) in women with placenta previa totalis prior to undertaking cesarean delivery.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 306 pregnancies with placenta previa totalis delivered between January 2011 and June 2022. The pregnancies were classified into two groups, PPH group and non-PPH group, based on bleeding volume and red blood cell transfusion. Clinical features and pre-operative coagulation function indexes were recorded. The entire cohort was randomly divided into a development cohort (n = 214) and a test cohort (n = 92). Least absolute shrinkage and selection operator (LASSO) was implemented to select significant predictors, followed by step-wise logistic regression analysis to build the prediction model. Additionally, machine learning-based models were compared with the proposed model.</p><p><strong>Results: </strong>Among 306 participants, 115 (53.74%) and 50 (54.35%) cases of PPH were observed in the development and test cohorts, respectively. The LASSO-Logistic regression model incorporated preoperative serum fibrinogen level, history of prior cesarean delivery and history of antepartum bleeding as predictors. The model yielded an area under the receiver operating characteristic (ROC) curve of 0.721 (95% CI 0.652-0.790) in the development cohort and 0.706 (95% CI 0.600-0.813) in the test cohort. Additionally, the model demonstrated a specificity of 70.7% (95% CI 61.7-79.7%) and a positive predictive value of 72.1% (95% CI 63.5-80.7%) for distinguishing between PPH and non-PPH cases. The LASSO-Logistic regression model outperformed the machine learning based model in the test cohort, confirming its efficiency in predicting PPH in patients with placenta previa totalis.</p><p><strong>Conclusions: </strong>This study successfully developed and validated a LASSO-Logistic regression model incorporating coagulation indicators to predict PPH in patients with placenta previa totalis. Further large-scale prospective studies are warranted to externally validate the three-variate-based model and assess its practical application in real-time practice.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"925"},"PeriodicalIF":2.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942113","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":"Comorbidities in pregnant South African women living with HIV and associations with adverse birth outcomes: a prospective cohort study.","authors":"Amohelang J Lehloa, Emma Kalk, Mary-Ann Davies, Dorothy Nyemba, Ushma Mehta, Thokozile Malaba, Gregory Petro, Andrew Boulle, Landon Myer, Hlengiwe P Madlala","doi":"10.1186/s12884-025-08086-x","DOIUrl":"10.1186/s12884-025-08086-x","url":null,"abstract":"<p><strong>Background: </strong>Despite improved health and survival due to lifelong antiretroviral therapy (ART), women living with HIV (WHIV) still face lower life expectancy, partly due to increased non-communicable disease (NCD) risk. Both HIV and NCDs are linked to adverse birth outcomes, yet data on their combined impact are limited. We investigated NCD burden by HIV status and compared adverse birth outcomes in pregnant WHIV only versus HIV-NCD comorbidity in Cape Town, South Africa.</p><p><strong>Methods: </strong>Pregnant WHIV (n = 479) and without HIV (n = 510) were enrolled and prospectively followed for pregnancy outcome. Weight and height measurements were serially collected by a study nurse, and diagnoses of hypertension and diabetes mellitus (DM) were made by healthcare providers as part of routine care (ANC). Birth outcomes were abstracted from health records. Proportions described adverse outcomes between groups. Logistic regression was used to estimate associations between HIV and HIV-NCD with small for gestational age (SGA), large for gestational age (LGA), preterm delivery (PTD), low birthweight (LBW), and high birthweight (HBW) (reference: group with neither HIV nor NCDs).</p><p><strong>Results: </strong>Among 989 pregnant women, 48% (n = 479) with HIV (median age 29 years, IQR 25-34), the prevalence of obesity (BMI ≥ 30 kg/m²) was 43%, hypertension 15% and DM 2%. The NCD prevalence did not differ by HIV status. HIV co-occurred with obesity in 31% of pregnancies, with hypertension in 5% and with DM in 0.2%. HIV with hypertension and HIV with hypertension and obesity were associated with increased odds of PTD compared to those with neither HIV-NCD (aOR 3.03, 95% CI 1.01, 8.05 and aOR 2.67, 95% CI 1.08, 6.23, respectively). However, HIV and obesity together were associated with lower odds of SGA (aOR 0.39, 95% CI 0.16, 0.97). Likewise, in women without HIV, obesity protected against SGA and LBW, but hypertension increased PTD and LBW.</p><p><strong>Conclusion: </strong>There was no difference in the prevalence of NCD in pregnant women by HIV status. Increased risk of adverse birth outcomes was demonstrated with concurrent NCD regardless of HIV status. Integration of NCD screening and management within ANC could minimise excess adverse outcomes in high HIV burden settings.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"924"},"PeriodicalIF":2.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941639","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":"Dynamic birth position, awareness and practice by midwives in Ethiopia: a parallel mixed-methods study.","authors":"Osman Yimer Mohammed, Kerstin Erlandsson, Tewodros Seyoum, Solomon Hailemeskel, Lemma Derseh, Helena Lindgren","doi":"10.1186/s12884-025-08051-8","DOIUrl":"10.1186/s12884-025-08051-8","url":null,"abstract":"<p><strong>Background: </strong>Respectful maternity care, as recommended by the World Health Organization, includes allowing women to give birth in the position of their choice. Dynamic birth positions, which enable women to adopt various positions during labor and delivery, are associated with improved obstetric outcomes. However, the extent of knowledge and practice regarding dynamic birth positions among Ethiopian midwives remains poorly understood.</p><p><strong>Objective: </strong>To assess midwives' awareness and practice of dynamic birth positions and explore their perspectives and experiences.</p><p><strong>Methods: </strong>A convergent parallel mixed-methods design was employed to evaluate midwives' knowledge, attitudes, and practices regarding dynamic birth positions. Quantitative data were analyzed using stepwise backward elimination logistic regression to identify key predictors, while qualitative data were examined through thematic analysis.</p><p><strong>Results: </strong>The study included 483 midwives, with 473 participating in the quantitative survey and 10 in the qualitative interviews. Fewer than half of the midwives demonstrated good levels of knowledge (45%) and attitude (49.5%), while only 22.6% reported regular practice of dynamic birth positions. Participation in training emerged as the strongest predictor of knowledge, attitude, and practice. Thematic analysis revealed six key themes: routine practices, awareness, clinical implementation, barriers, facilitators, and user needs.</p><p><strong>Conclusion: </strong>Awareness and practice of dynamic birth positions among Ethiopian midwives are notably low. Key barriers include limited awareness and suboptimal working conditions, whereas targeted training significantly enhances all assessed domains. To promote the adoption of dynamic birth positions, efforts should focus on increasing awareness, modifying delivery equipment, and improving the clinical environment.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"926"},"PeriodicalIF":2.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941922","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":"Prenatal diagnosis and pregnancy outcomes of mosaicism detected by CMA-seq.","authors":"Jiazhen Chang, Mengmeng Li, Yulin Jiang, Xiya Zhou, Na Hao, Yiqing Yu, Yan Lü, Qingwei Qi","doi":"10.1186/s12884-025-08018-9","DOIUrl":"10.1186/s12884-025-08018-9","url":null,"abstract":"","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"912"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942125","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}