BMC Pregnancy and Childbirth最新文献

{"title":"Correlations between life course trauma on perinatal outcomes of women on community supervision - a retrospective cross sectional study.","authors":"Allison D Ihle, Karenna Thomas, Breann Wicks, Min Wang, Laura B Sisk, Jacqueline M McGrath","doi":"10.1186/s12884-026-09495-2","DOIUrl":"10.1186/s12884-026-09495-2","url":null,"abstract":"<p><strong>Background: </strong>Women on probation (community supervision) report high rates of adverse childhood experiences (ACEs) and ongoing trauma, yet little research has examined how trauma across the life course relates to perinatal outcomes during community supervision. This study examined associations between lifetime trauma and perinatal violence, infant separation, and postpartum mood symptoms among women who experienced pregnancy, childbirth, and postpartum while on probation.</p><p><strong>Methods: </strong>We conducted a cross-sectional secondary analysis from N = 60 women in South-Central Texas who had a pregnancy within the past five years while on community supervision. Trauma exposures included selected ACEs and adulthood/perinatal trauma (domestic, intimate partner, and sexual violence). Outcomes were perinatal violence, permanent infant removal after childbirth, and postpartum mood symptoms (PHQ-2/GAD-2). We used logistic regression to examine associations between trauma exposures and outcomes; given the ordinal structure of key trauma measures, we used Kendall's tau to estimate correlations between cumulative ACEs/lifetime trauma and perinatal outcomes.</p><p><strong>Results: </strong>Participants spent an average of 5 years (SD = 3) on community supervision, and most reported partner violence (n = 52, 87%); no mental health care in the year prior to their last arrest (n = 55, 92%); and possible major depressive disorder (n = 20, 33%) and generalized anxiety disorder (n = 34, 57%). ACE prevalence included caregiver incarceration (n = 34, 56%), physical abuse (n = 25, 42%), witnessing abuse (n = 27, 45%), foster care (n = 17, 8%), and childhood sexual abuse (n = 29, 48%); 25% reported four (n = 9, 16%) or five (n = 6, 10%) ACEs. Cumulative ACE exposure was correlated with perinatal violence (p = 0.03), and childhood forced sexual intercourse was associated with perinatal violence (p = 0.04). Trauma in adulthood was associated with permanent infant removal (p = 0.003). Sexual violence in adulthood was correlated with cumulative ACE exposure and postpartum mood symptoms (p = 0.006).</p><p><strong>Conclusions: </strong>Trauma across the life course is associated with perinatal violence, infant removal, and postpartum mood symptoms among women on community supervision. Trauma-informed, gender-responsive perinatal and community supervision interventions are needed to improve safety, mental health, and family stability.</p><p><strong>Trial registration: </strong>NA.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890759","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":"Integrating probiotics into a one-day diabetes clinic: outcomes in gestational diabetes.","authors":"Wei Wang, Nana Cai, Min Ma, Yanmin Cao, Hong Li, Jie Liu, Youxia Zhou, Sijia Liang","doi":"10.1186/s12884-026-09866-9","DOIUrl":"10.1186/s12884-026-09866-9","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of a one-day diabetes clinic management model combined with probiotic supplementation in patients with gestational diabetes mellitus (GDM).</p><p><strong>Methods: </strong>A total of 682 patients diagnosed with GDM who received prenatal care at our hospital between January 2023 and May 2024 were enrolled in this study. All participants underwent oral glucose tolerance test (OGTT) screening at 24-28 weeks of gestation and attended the one-day diabetes clinic management program. Patients were divided into a probiotic group and a control group based on oral probiotic administration. Propensity score matching (PSM) was performed to balance baseline characteristics between the two groups. Generalized estimating equations (GEE) were applied to analyze intergroup differences and temporal trends in blood glucose, lipid metabolism, and inflammatory markers. Pearson correlation analysis was used to examine maternal and neonatal perinatal outcomes.</p><p><strong>Results: </strong>After PSM, no statistically significant differences were observed in baseline characteristics between the two groups (P > 0.05). Generalized estimating equation (GEE) analyses revealed significant group-by-time interaction effects for fasting blood glucose (FPG) and C-reactive protein (CRP). After Benjamini-Hochberg false discovery rate (FDR) correction for multiple testing, lower levels of FPG and CRP were observed in the probiotic group at several follow-up time points, with group differences emerging gradually over the intervention period. Triglycerides showed only a nominally significant group effect without adjustment. Total gestational weight change differed statistically between the two groups. GEE analyses indicated weak crude associations between probiotic supplementation, maternal group B streptococcal colonization (GBS), and neonatal jaundice; however, these associations were no longer statistically significant following FDR correction.</p><p><strong>Conclusion: </strong>Probiotic supplementation combined with one-day diabetes clinic management was associated with lower FPG and CRP levels among women with GDM. Weak associations between probiotic use, maternal GBS colonization and neonatal jaundice disappeared after adjustment for multiple testing, and these findings can only be used to generate hypotheses. As an observational study, this analysis cannot confirm clinical benefits of probiotics. All observed findings represent exploratory associations, which require further verification in randomized controlled trials.</p><p><strong>Trial registration: </strong>This observational study was retrospectively registered with the Chinese Clinical Trial Registry (ChiCTR2500100649) on April 11, 2025. Registration was delayed because the research team was initially unaware that registration is mandatory for observational clinical studies.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179267","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":"Neonatal outcome in macrosomia and gestational diabetes mellitus depending on the definition of macrosomia: a retrospective cohort study.","authors":"Luisa Laura Meurer, Sabine Körber, Johannes Stubert","doi":"10.1186/s12884-026-09840-5","DOIUrl":"10.1186/s12884-026-09840-5","url":null,"abstract":"<p><strong>Introduction: </strong>Gestational diabetes increases the risk of neonatal macrosomia, which is associated with maternal and neonatal morbidity. However, the definition of macrosomia is inconsistent and includes both a fixed weight limit and a gestational age-dependent percentile. This study aimed to evaluate the association between different definitions of macrosomia and short-term neonatal outcome in pregnancies complicated by gestational diabetes.</p><p><strong>Material and methods: </strong>In this retrospective single-center cohort study, 882 women with gestational diabetes and a singleton pregnancy were included. Adverse neonatal outcome was defined as 5-min Apgar score below eight and/or admission to the neonatal intensive care unit. We compared three different definitions of macrosomia: 1.) birthweight ≥ 4000 g, 2.) birthweight > 90th percentile, and 3.) length-related birthweight > 90th percentile. Eutrophic newborns served as controls and small-for-gestational-age infants were excluded. Additionally, umbilical artery Doppler parameters were explored.</p><p><strong>Results: </strong>Overall, 220 out of 882 newborns (24.9%) met at least one definition of macrosomia: 129 (14.6%) with birthweight ≥ 4000 g, 126 (14.3%) with birthweight > 90th percentile, and 205 (23.2%) with length-related birthweight > 90th percentile. Short-term adverse neonatal outcome occurred in 6.2% (n = 55). In the total cohort, macrosomia was not associated with adverse outcome. Newborns with a birthweight > 90th percentile showed a higher, but not statistically significant, rate of adverse outcome (odds ratio (OR) 1.5 [0.8-3.1], p = 0.231). In analyses restricted to macrosomic infants, those with birthweight > 90th percentile had higher rates of adverse outcome compared with those ≤ 90th percentile (8.7% vs. 1.1%; OR 8.9, 95% CI 1.1-70.2). This remained associated after adjustment for preterm birth (adjusted OR 8.8, 95% CI 1.1-71.4), although preterm birth was the strongest overall predictor. The effect was mainly observed in infants weighing < 4000 g. Umbilical artery Doppler showed limited predictive value.</p><p><strong>Conclusions: </strong>Macrosomia represents a heterogeneous group not uniformly associated with adverse short-term neonatal outcome. Within this cohort, birthweight > 90th percentile, particularly in infants < 4000 g, was associated with higher rates of adverse outcome, whereas fixed weight thresholds were not. Gestational age-adjusted definitions may better identify at-risk neonates.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817314","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":"Plasma exchange-based artificial liver support for acute liver failure associated with early-onset intrahepatic cholestasis of pregnancy: a case report.","authors":"Yannan Zhu, Zuoxin Qin, Haiyan Tang, Bangmin Li","doi":"10.1186/s12884-026-09844-1","DOIUrl":"https://doi.org/10.1186/s12884-026-09844-1","url":null,"abstract":"<p><strong>Background: </strong>Intrahepatic cholestasis of pregnancy (ICP) is typically benign, but progression to acute liver failure (ALF) is a rare, life-threatening complication. We report a case of ALF associated with early-onset ICP managed successfully with plasma exchange-based artificial liver support system (ALSS).</p><p><strong>Case presentation: </strong>A 29-year-old Chinese woman (G2P1) presented with abnormal liver function at 20 weeks of gestation, characterized by markedly elevated aminotransferases but only mildly increased total bile acid (TBA, 12.4 µmol/L). Despite supportive care, she developed progressive cholestasis, hyperbilirubinemia, coagulopathy, and mild encephalopathy. Pregnancy was terminated at 23 weeks due to disease progression. Post-termination, TBA surged to 360.9 µmol/L, indicating persistent severe cholestasis. Given the poor response to conventional therapy, sequential ALSS combining Double Plasma Molecular Adsorption System (DPMAS) and plasma exchange was initiated. The patient exhibited rapid biochemical improvement and recovered fully without liver transplantation.</p><p><strong>Conclusions: </strong>This case illustrates a rare clinical presentation of acute liver failure associated with early-onset intrahepatic cholestasis of pregnancy in the setting of multiple potential contributing factors. Plasma exchange-based artificial liver support may provide temporary extracorporeal support for selected patients with progressive pregnancy-associated hepatic dysfunction. Further studies are required to clarify the optimal timing, indications, and clinical benefits of this therapy.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103544","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":"Evaluation of fetal frontal lobe development and Evans index in pregnancies complicated by gestational diabetes mellitus: prospective comparative observational study.","authors":"Kubilay Çanga, Recep Taha Ağaoğlu, Özgür Volkan Akbulut, Dinçer Sümer, Seyit Ahmet Erol, Şevki Çelen","doi":"10.1186/s12884-026-09827-2","DOIUrl":"10.1186/s12884-026-09827-2","url":null,"abstract":"<p><strong>Objective: </strong>To assess whether third-trimester fetal frontal lobe biometry and ventricular-cranial proportionality differ between pregnancies with gestational diabetes mellitus (GDM) and normoglycemic controls, and whether these markers vary by treatment (diet vs. insulin) or composite adverse perinatal outcome (CAPO).</p><p><strong>Methods: </strong>In this single-center prospective observational study, 73 singleton GDM pregnancies and 73 low-risk controls underwent ultrasound at comparable gestational ages (30-38 weeks). On the transventricular plane we measured frontal anteroposterior diameter (FAPD) and occipitofrontal diameter (OFD), and derived two indices (100×FAPD/OFD; 100×FAPD/head circumference [HC]). Maximal width of the frontal horns (MWFH) and maximal inner cranial diameter (MID) were recorded and the fetal Evans index (EI, MWFH/MID) calculated. Obstetric and neonatal outcomes were compared, with subgroup analyses within the GDM cohort. Multiple linear regression adjusted the main neurosonographic outcomes for estimated fetal weight, gestational age at ultrasound, maternal age, BMI, and parity.</p><p><strong>Results: </strong>Gestational age at scan was similar (33.8 ± 1.9 vs. 33.6 ± 2.0 weeks), while estimated fetal weight was higher in GDM (2504 ± 514 vs. 2320 ± 531 g; p = 0.035). FAPD was modestly higher in GDM (median 39.4 vs. 38.9 mm; p = 0.040) with comparable OFD, and both frontal indices were higher (FAPD/OFD 37.61 vs. 36.59, p < 0.001; FAPD/HC 12.74 vs. 12.55, p < 0.001). MWFH and MID were slightly larger (p = 0.025 and 0.006), yet EI was unchanged (0.263 ± 0.011 vs. 0.262 ± 0.014; p = 0.574). After adjustment, GDM remained linked to a lower OFD (- 2.516 mm; 95% CI - 3.730 to - 1.303; p < 0.001), a higher FAPD/OFD ratio (adjusted mean difference 1.088; 95% CI 0.633-1.542; p < 0.001) and FAPD/HC ratio (0.150; 95% CI 0.033-0.268; p = 0.012), but not to FAPD, MWFH, MID, or EI. Major neonatal morbidity, NICU admission, and CAPO rates were comparable. Within the GDM group, neurosonographic measures did not differ by diet vs. insulin, and CAPO tracked with lower birth weight, not EI or frontal indices.</p><p><strong>Conclusion: </strong>GDM showed small but significant shifts in proportional fetal frontal indices that held after adjustment for fetal size and maternal covariates, whereas absolute FAPD, ventricular measurements, and EI showed no independent association. Because OFD was lower after adjustment while FAPD was not, the higher ratios partly reflect their denominator and cannot be read as greater absolute frontal growth. Frontal proportions appear altered while ventricular-cranial proportionality is preserved, though the clinical and neurodevelopmental meaning is still unclear. Longitudinal work using objective glycemic metrics and standardized postnatal neurodevelopmental follow-up is needed.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13492028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787830","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":"Comparison of four unidimensional pain scales and women's preferences during the first stage of labor: a cross-sectional study.","authors":"Zehra Çerçer, Ferhat Aslan","doi":"10.1186/s12884-026-09811-w","DOIUrl":"10.1186/s12884-026-09811-w","url":null,"abstract":"<p><strong>Background: </strong>To compare four unidimensional pain assessment scales during the first stage of labor by evaluating agreement among the scales and women's preferences for pain assessment tools in a clinical setting.</p><p><strong>Methods: </strong>A cross-sectional comparative study was conducted between August 2023 and June 2024 with 135 women who experienced spontaneous vaginal births at a state hospital in Türkiye. Four commonly used unidimensional pain scales-the Visual Analog Scale (VAS), Facial Pain Scale (FPS), Numerical Rating Scale (NRS), and Verbal Descriptive Scale (VDS)-were compared in terms of inter-scale agreement during the latent and active phases of labor. Participants were also asked to indicate their preferred pain scale.</p><p><strong>Results: </strong>The FPS was the most preferred scale, chosen by 41.5% of the women. All four pain scales showed strong, positive, and statistically significant correlations during both the latent and active phases of labor (p < 0.001). The intraclass correlation coefficient (ICC) for pain scores among the scales was 0.941 (F = 17.063, p < 0.001) during the latent phase and 0.932 (F = 14.679, p < 0.001) during the active phase.</p><p><strong>Conclusions: </strong>The Facial Pain Scale demonstrated the highest preference and reliability among women during labor, whereas the Visual Analog Scale was rated lower in both preference and consistency. These findings highlight the importance of using appropriate and patient-centered tools in labor pain management.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891038","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 characteristics and clinical outcomes in 82 cases with agenesis of corpus callosum: single tertiary center experience.","authors":"Verda Alpay, Fırat Ersan, Barış Boza, Melike Makul","doi":"10.1186/s12884-026-09799-3","DOIUrl":"10.1186/s12884-026-09799-3","url":null,"abstract":"<p><strong>Background: </strong>Agenesis of the corpus callosum (ACC) is one of the most common structural brain malformations, with a highly variable prognosis. The aim of this study was to investigate all cases of ACC managed at our clinic and to provide a comprehensive assessment of its prenatal features, associated conditions, and postnatal outcomes.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study including all prenatally diagnosed cases of ACC in our maternal-fetal medicine unit between October 2020 and November 2024. Maternal characteristics, gestational age at diagnosis, associated anomalies, genetic testing results, and perinatal outcomes were recorded. Postnatal neurodevelopmental outcomes were assessed using the Denver II test, with a follow-up duration ranging from 6 to 40 months.</p><p><strong>Results: </strong>A total of 82 fetuses with ACC were collected. Of these, 59.8% (n = 49) had complete and 40.2% (n = 33) had partial ACC. 43.9% (n = 36) of cases were isolated and associated anomalies were detected in 56.1% (n = 46). 37.8% (n = 31) of cases opted for termination of pregnancy, whereas 19.5% (n = 16) resulted in postnatal death, and 42.7% (n = 35) survived. No significant difference was observed between partial and complete isolated ACC cases in terms of postnatal neurodevelopmental outcomes. Genetic abnormalities were identified in 31.1% (19/61) of patients who underwent genetic testing.</p><p><strong>Conclusions: </strong>In cases of ACC, the most important prognostic factors are the presence of additional anomalies and genetic conditions. Genetic testing, including whole exome sequencing when karyotype and chromosomal microarray results are negative, is strongly recommended, even in isolated cases, to support counseling. In isolated ACC, neurodevelopmental outcomes were favorable in 85.2% (23/27) of patients, regardless of whether ACC was partial or complete.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872818","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":"Predictive value of serum β-hCG and blastocyst transfer for clinical pregnancy after frozen-thawed embryo transfer: a retrospective cohort study.","authors":"Yun Le, Sheng Yang, Mengyi Zhu, Tengfei Wang, Guosong Shen, Yuanping Zhou, Lijun Peng","doi":"10.1186/s12884-026-09773-z","DOIUrl":"10.1186/s12884-026-09773-z","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the predictive value of serum beta-human chorionic gonadotropin (β-hCG) measured at 11-14 days after frozen-thawed embryo transfer (FET) for clinical pregnancy, and to explore the potential associations of blastocyst transfer and other serum markers (total protein, albumin, red blood cell distribution width) with pregnancy outcomes.</p><p><strong>Methods: </strong>A retrospective cohort study was performed on 268 infertile patients who underwent FET at our hospital from January 2025 to December 2025. Patients were divided into clinical pregnancy (n = 132) and non-pregnancy (n = 136) groups. Baseline characteristics and serum markers (TP, Alb, RDW) measured on day 7 post-transfer were compared between groups. The predictive performance of β-hCG was evaluated using receiver operating characteristic (ROC) curve analysis. Univariate and multivariable logistic regression analyses were performed to identify factors independently associated with clinical pregnancy.</p><p><strong>Results: </strong>Serum β-hCG levels were significantly higher in the clinical pregnancy group (P < 0.001). ROC analysis showed that β-hCG predicted clinical pregnancy with an area under the curve (AUC) of 0.994 (95% CI: 0.989-0.999). The optimal cut-off value was 112.0 mIU/mL, yielding a sensitivity of 96.2% and a specificity of 98.5%. Multivariable logistic regression identified ln(hCG + 1) (OR = 12.55, 95% CI: 5.13-30.69, P < 0.001). Blastocyst transfer showed a trend towards an association in univariate analysis (OR = 1.59, 95% CI: 0.92-2.75, P = 0.10) but was not statistically significant in multivariable analysis (OR = 1.39, 95% CI: 0.30-6.32, P = 0.67). TP showed a trend towards an association in univariate analysis (OR = 0.95, 95% CI: 0.89-1.01, P = 0.10) but was not statistically significant, and was not an independent factor for clinical pregnancy (OR = 0.84, 95% CI: 0.68-1.03, P = 0.10). Alb and RDW showed no significant differences between groups.</p><p><strong>Conclusion: </strong>In this retrospective cohort study, serum β-hCG measured 11-14 days after FET demonstrated excellent predictive performance for clinical pregnancy (AUC 0.994). While both blastocyst transfer and total protein showed trends toward association in univariate analysis, neither remained an independent predictor in multivariable analysis. Other serum markers (Alb, RDW) provided no incremental predictive value beyond β-hCG. These findings support the clinical utility of early post-FET β-hCG measurement; however, the potential roles of blastocyst transfer and total protein require further investigation in larger, prospective cohorts.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890892","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":"Predicting of early miscarriage based on machine learning: a retrospective cohort study in China.","authors":"Jia Cai, Jialin Qu, Tingjia Chai, Hua Zou, Dachuan Zeng, Shu Li, Fanghong Liao, Chunli Li, Qian Li","doi":"10.1186/s12884-026-09765-z","DOIUrl":"https://doi.org/10.1186/s12884-026-09765-z","url":null,"abstract":"<p><strong>Background: </strong>Early miscarriage (EM) remains a significant reproductive health challenge, with current serum hormone biomarkers (β-hCG, progesterone, estradiol) showing inconsistent predictive value across studies. To address these limitations, artificial intelligence (AI) and machine learning (ML) techniques are increasingly applied to integrate complex biomarker data and improve the early prediction of EM.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 17,926 singleton pregnancies (1,918 EM vs. 16,008 live births) from Chongqing (2017-2023), China, to establish optimal hormonal predictors and timing for EM risk assessment. Serum hormone concentrations were longitudinally analyzed across distinct gestational weeks to characterize temporal variations. To assess the predictive efficacy of individual biomarkers and composite models, we conducted receiver operating characteristic (ROC) curve analyses. The optimal predictive biomarker and the earliest gestational time point for EM detection were determined through comparative evaluation of area under the ROC curve (AUC) values derived from univariate and multivariate logistic regression models. Finally, a systematic machine learning approach employing ten distinct algorithms was implemented to screen and validate the most robust prediction model.</p><p><strong>Results: </strong>Longitudinal analysis revealed distinct gestational patterns: β-hCG and estradiol showed weekly increases through 9 weeks before stabilizing, while progesterone demonstrated a biphasic pattern (decline until 7 weeks, subsequent rise). EM cases exhibited significantly lower hormone levels across all gestational weeks. Receiver operating characteristic (ROC) analysis was conducted to assess the predictive performance of both univariate and multivariate models, which revealed a progressive increase in accuracy with advancing gestational age (AUC range: 0.67-0.99). Notably, week 4 progesterone alone showed predictive capacity (AUC = 0.67, cut-off = 17.75 pg/ml). Machine learning evaluation of 10 algorithms identified an artificial neural network (ANN) incorporating β-hCG, progesterone, estradiol, and maternal age as optimal, achieving superior prediction accuracy at week 4 (training AUC = 0.82; validation AUC = 0.81). This multivariate model enables EM risk stratification earlier than conventional hormonal assessments.</p><p><strong>Conclusions: </strong>Our findings resolve key controversies regarding predictive thresholds and timing while demonstrating the clinical potential of machine learning integration for early pregnancy risk assessment. The established week 4 prediction window offers critical opportunities for timely intervention and patient counseling.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103612","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":"Mothers' perceptions and decision-making regarding tandem breastfeeding in Türkiye: a child health-focused qualitative study.","authors":"Meltem Aslan, Cemile Say, Hilal Ezgi Navruz, Şimal Niğiz, Zeliha Özge Kuroğlu","doi":"10.1186/s12884-026-09764-0","DOIUrl":"https://doi.org/10.1186/s12884-026-09764-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Tandem breastfeeding, defined as breastfeeding two non-twin children during the same period, remains an underexplored practice in maternal and child health. Although it may be perceived as a way of maintaining breastfeeding continuity and emotional closeness with the older child, mothers may also encounter physical, emotional, practical, social and professional challenges. This study aimed to explore mothers' perceptions of tandem breastfeeding in Türkiye and to examine how these perceptions are shaped by emotional, socio-cultural, practical and healthcare-related factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A qualitative study design based on reflexive thematic analysis was used. Semi-structured, in-depth interviews were conducted with 21 mothers who had at least one child aged 0-2 years and were familiar with the concept of tandem breastfeeding. Mothers were recruited using purposive and snowball sampling. Current or previous direct tandem breastfeeding experience was not systematically recorded as a mother characteristic. Interviews were audio-recorded, transcribed verbatim and analysed inductively using MAXQDA 24. The study was reported in accordance with the COREQ checklist.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Four main themes were identified: the perceived meaning of tandem breastfeeding, the perceived burden of tandem breastfeeding, social perceptions, and limited professional support. Mothers associated tandem breastfeeding with maintaining the mother-child bond, preventing abrupt weaning of the older child, and supporting a sense of fairness between siblings. They also perceived it as potentially involving physical fatigue, sleep deprivation, emotional ambivalence, increased care demands, and uncertainty regarding practical feasibility. Social norms, family attitudes, misconceptions, and limited access to evidence-based professional guidance influenced mothers' decision-making. Because direct tandem breastfeeding experience was not systematically recorded, the findings represent a combination of perceptions, beliefs, observed examples, anticipated concerns, and decision-making considerations rather than the confirmed lived experiences of a clearly defined group of tandem breastfeeding mothers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Tandem breastfeeding was perceived as a complex maternal and child health practice shaped by emotional, practical, socio-cultural, and healthcare-related factors. The findings provide insight into how mothers understand and evaluate tandem breastfeeding and how they approach decisions about whether to initiate or continue the practice. However, because mothers with confirmed direct tandem breastfeeding experience could not be distinguished from those expressing perceptions, expectations, or observed experiences, the findings should not be interpreted as evidence of the lived experience, feasibility, safety, or clinical outcomes of tandem breastfeeding. Further research involving clearly id","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103947","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}