BMC Pregnancy and Childbirth最新文献

{"title":"Factors associated with institutional delivery in remote areas: a cross-sectional survey in Papua Region, Indonesia.","authors":"Nuzulul Kusuma Putri, Agung Dwi Laksono, Ernawaty, Ina Kusrini, Yuly Astuti, Ratu Matahari","doi":"10.1186/s12884-025-08231-6","DOIUrl":"10.1186/s12884-025-08231-6","url":null,"abstract":"<p><strong>Background: </strong>Indonesia is the third country in Southeast Asia with the highest maternal mortality ratio. In its remotest area, Papua, pregnant women still face limited access to safe delivery in health facilities, despite being covered by national health insurance.</p><p><strong>Objective: </strong>This study examined the factors associated with institutional delivery in the Papua Region, Indonesia.</p><p><strong>Methods: </strong>This cross-sectional study analysed 2,275 women aged 15 or older who had given birth in the last five years. The outcome variable was institutional delivery, while nine independent variables were assessed: province, residence, age, marital status, education, employment, wealth, parity, and completeness of antenatal care (ANC). Binary logistic regression was used to identify associated factors. Additionally, a Geographic Information System (GIS) was employed to map disparities in institutional delivery across the region.</p><p><strong>Results: </strong>The overall coverage of institutional delivery in the Papua Region was 50.1%. Coastal areas showed higher prevalence, while the Central Mountains region had the lowest coverage. Institutional delivery was significantly associated with all nine independent variables. Women with lower education and without partners were less likely to deliver in health facilities, even when financially covered by health insurance.</p><p><strong>Conclusions: </strong>The findings suggest that a combination of demographic, socioeconomic, and healthcare access factors influences the use of institutional delivery in Papua. Improving access requires multisectoral strategies, including infrastructure development, health education, and equitable healthcare delivery, particularly for women in remote and underserved areas.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1124"},"PeriodicalIF":2.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12542200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343114","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":"Prediction of ectopic pregnancy using interpretable machine learning algorithms.","authors":"Arkan Aghayari, Amir Sorayaie Azar, Mortaza Taheri-Anganeh, Sonia Sadeghpour, Yousef Mohammadpour, Jamshid Bagherzadeh Mohasefi, Hojat Ghasemnejad-Berenji","doi":"10.1186/s12884-025-08179-7","DOIUrl":"10.1186/s12884-025-08179-7","url":null,"abstract":"<p><strong>Background: </strong>Ectopic Pregnancy (EP) is a type of pregnancy where the developing blastocyst implants in a location other than the endometrial cavity. The aim of study was developing predictive models that could improve the accuracy of identifying individuals at risk and uncover relationships between known risk factors and ectopic pregnancy occurrence.</p><p><strong>Methods: </strong>Five-fold cross-validation were employed to prevent overfitting and the Grid Search method was utilized to determine the optimal hyper-parameters for the models. The performance of the models was evaluated using metrics such as accuracy, Area Under the Curve (AUC), and Negative Predictive Value (NPV). The SHapley Additive exPlanations (SHAP) method was used to interpret the model's decision-making process and identify the most significant features.</p><p><strong>Results: </strong>RF demonstrated the best performance (87.13% accuracy, 90.65% AUC). Key predictors identified via logistic regression (LR) and SHAP analysis included mid-cycle pain, genital surgery history and dysmenorrhea.</p><p><strong>Conclusion: </strong>This investigation illustrates the potential for machine learning models to improve clinical decision-making and optimize patient outcomes in cases of ectopic pregnancy. Further validation in diverse populations is required due to the constraints of single-center data and the absence of critical risk factors, such as the use of PIDs and IUDs.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1119"},"PeriodicalIF":2.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12538930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343054","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":"Barriers and enablers of community-based Kangaroo Mother Care (cKMC) practice: a mixed methods systematic review.","authors":"Hagos T Atalay, Victoria J Kain, Amanda G Carter","doi":"10.1186/s12884-025-08115-9","DOIUrl":"10.1186/s12884-025-08115-9","url":null,"abstract":"","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1114"},"PeriodicalIF":2.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342968","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":"Validity and reliability study of the Turkish version of the postpartum sexual life quality scale.","authors":"Funda Tosun Güleroğlu, Taylan Onat, Yurdagül Günaydın","doi":"10.1186/s12884-025-07906-4","DOIUrl":"10.1186/s12884-025-07906-4","url":null,"abstract":"","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1122"},"PeriodicalIF":2.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12542052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343110","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":"Retraction Note: Uterine salvage management for atonic postpartum hemorrhage using \"modified Lynch suture\".","authors":"M El-Sokkary, K Wahba, Y El-Shahawy","doi":"10.1186/s12884-025-08371-9","DOIUrl":"10.1186/s12884-025-08371-9","url":null,"abstract":"","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1113"},"PeriodicalIF":2.7,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12538719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336366","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":"Disparities in Access to the Northwest Ambulance Service during pregnancy, birth and postpartum period and its association with neonatal and maternal outcomes [DiAAS]: a retrospective cohort study and qualitative framework analysis.","authors":"Stephanie Heys, Daisy Pegler, Anam Elahi, Alexander E P Heazell, Kylie Watson, Holly Hope, Cathrine Fullwood, Hora Soltani","doi":"10.1186/s12884-025-08108-8","DOIUrl":"10.1186/s12884-025-08108-8","url":null,"abstract":"<p><strong>Background: </strong>This study will be the first UK-based study to investigate access to ambulance services for women and families from diverse backgrounds during pregnancy, birth and early postpartum period. The study will explore relevant maternal and infant outcomes for families who seek help from the ambulance service to explore health disparities in accessing urgent and emergency care. Findings from this study will inform local and national policy aimed at reducing maternal and perinatal mortality and morbidity. This will contribute to the identification of access challenges experienced by seldom-heard women in a crucially important, but under investigated area of unscheduled urgent and emergency maternity care.</p><p><strong>Methods: </strong>A mixed methods approach including two workpackages (WP). WP1 includes a retrospective comparative cohort study (WP1) to describe the characteristics of and outcomes for pregnant women and their neonates who are transferred via ambulance to Manchester University NHS Foundation Trust (MFT) and those that are not. Descriptive statistics with comparative analyses will be presented. WP2 includes a qualitative framework analysis of a purposive sub-sample of routinely collected free-text digital records documented by paramedics for women who arrived at the unit via ambulance. Purposive sampling will be undertaken for women who are identified at an increased risk of poor maternal and/or neonatal outcomes following WP1 analyses. The patient journey will be mapped, and patient profiles constructed. An explanatory mixed methods approach will be undertaken for triangulation of data for insight.</p><p><strong>Discussion: </strong>The study aims to provide an in-depth understanding of access to emergency maternity care to allow investigation of opportunities for alternative clinical decision making and review of current service provision. This also helps to identify women with increased risk factors for accessing urgent and emergency care as a gateway to maternity services. This will help to address timely access to the most appropriate services, reducing risk factors for adverse maternity and neonatal outcomes and associated impact upon the emergency services. Findings will be used to inform local and national interventions for at risk populations who access ambulance services during pregnancy, birth, and early postpartum. Findings will also support system conversations around the reasons for seeking help from the ambulance service in the perinatal period and ways to improve access and care provisions for underserved communities.</p><p><strong>Study registration number: </strong>This study/project is funded by the National Institute for Health and Care Research (NIHR) [Research for Patient Benefit NIHR206378]. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1109"},"PeriodicalIF":2.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312236","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":"Transforming care by integrating maternity and psychological support: a mixed-methods evaluation of a Maternal Mental Health Service.","authors":"Jasmine Reed, Hadiss Khossravi, Sanne van Rhijn","doi":"10.1186/s12884-025-08096-9","DOIUrl":"10.1186/s12884-025-08096-9","url":null,"abstract":"","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1111"},"PeriodicalIF":2.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312356","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":"Prevalence of prenatal alcohol use among Aboriginal and non-Aboriginal women in the Northern Territory, Australia: estimate from perinatal, emergency, and admission datasets.","authors":"Behailu Derseh, Abel Dadi, Hoang Phan, Holger W Unger, Kiarna Brown, Demeke Mesfin Belay, Steven Guthridge","doi":"10.1186/s12884-025-08216-5","DOIUrl":"10.1186/s12884-025-08216-5","url":null,"abstract":"<p><strong>Background: </strong>Prenatal Alcohol Use (PAU) has detrimental effects on mothers and their children. Robust estimates of the prevalence of PAU and associated risk factors are critical for informing interventions to reduce adverse health impacts. This study aimed to estimate the prevalence and risk factors of PAU among Aboriginal and non-Aboriginal mothers in the Northern Territory of Australia.</p><p><strong>Methods: </strong>We used linked individual-level records from the NT perinatal register, hospital admissions, and emergency department presentations to estimate the prevalence of PAU for all 19,588 births to NT-resident women from 2013 to 2017. Permutation analysis was used to create four PAU categories: no PAU, early PAU (alcohol use in early pregnancy only), continued PAU (alcohol use in early and late pregnancy), and extreme PAU (hospital admissions/ presentations for alcohol-related diagnosis during pregnancy). Multinomial logit models explored the associations between sociodemographic and clinical factors and degrees of PAU. A relative risk ratio (RRR) with a 95% confidence interval (CI) was used to measure associations.</p><p><strong>Results: </strong>There were 19,588 births to 16,199 women during the study period (6,310 births to 5,207 Aboriginal women). The mean gestational age at birth for Aboriginal women was 37.8 (95% CI: 37.7, 37.9) weeks and 38.7 (38.6, 38.8) weeks for non-Aboriginal women. The overall PAU prevalence for births to Aboriginal women was 13.1% (95% CI: 12.2, 14.0), including 5.9% (95% CI: 5.2, 6.5) early PAU, 4.3% (95% CI: 3.8, 4.8) continued PAU, and 2.8% (95% CI: 2.4, 3.3) \"extreme\" PAU. The overall prevalence for non-Aboriginal women was 2.3% (95% CI: 2.1, 2.6), including 1.7% (95% CI: 1.5, 1.9), 0.53% (95% CI: 0.4, 0.7) and 0.1% (95% CI: 0.02, 0.1) for each category, respectively. Age, smoking, and substance misuse-related hospitalisation were associated with an increased risk of PAU among both populations. Being a victim of violence was an additional risk among Aboriginal women. More than five antenatal care (ANC) visits were associated with less PAU. However, 17.9% (n = 3520) of births had missing records related to PAU.</p><p><strong>Conclusion: </strong>The study provides refined prevalence estimates for PAU across groups with increasing risk of harm. Early identification and effective engagement with women at risk of PAU are critical for improving outcomes for mothers and their children. Targeted interventions like enhanced services that support cessation of alcohol and other drugs (AOD), strengthening families, and sustained engagement with culturally safe, trauma-informed maternity care may aid in reducing PAU. The study also highlights the critical need to enhance both the quality and completeness of the routine recording of alcohol use during pregnancy.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1110"},"PeriodicalIF":2.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312227","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":"Breastfeeding difficulties and maternal mental health: role of social support in rural northwestern China.","authors":"Jie Yang, Yunjie Liu, Xu Zhang, Yihan Zhang, Yuchen Meng, Junhao Wu, Yongchang Duan, Hongyu Guan","doi":"10.1186/s12884-025-08186-8","DOIUrl":"10.1186/s12884-025-08186-8","url":null,"abstract":"<p><strong>Background: </strong>Globally, escalating mental health issues among postpartum women underscore their significant impact on individuals, children, and society. This study investigates the associations between breastfeeding difficulties and maternal mental health in rural areas of northwestern China. Additionally, we examine how mothers' perceived family support and home visits by community health workers (CHWs) are associated with variations in maternal mental health outcomes.</p><p><strong>Methods: </strong>Data for this study were collected in March and December 2021. Descriptive statistics and multivariate linear regression analyses were conducted to examine the prevalence of maternal mental health problems and the association between breastfeeding difficulties and maternal mental health. Maternal mental health was assessed using Depression, Anxiety, and Stress Scale (DASS-21), while breastfeeding difficulties were measured based on mothers' self-reported experiences with common breastfeeding challenges. Perceived family support for breastfeeding and a community-based home visit intervention were analyzed to explore differences in associations across subgroups.</p><p><strong>Results: </strong>Greater overall breastfeeding difficulty was significantly associated with higher maternal stress (β = 2.391, P = 0.001), and showed marginally positive associations with depression (β = 1.186, P = 0.102) and anxiety (β = 0.953, P = 0.082). Among specific categories, feeding process difficulties were significantly associated with increased anxiety (β = 1.173, P = 0.031) and stress (β = 2.031, P = 0.008). Among mothers with lower practical support, breastfeeding difficulties were significantly associated with higher depression (β = 1.782, P = 0.009), anxiety (β = 1.577, P = 0.002), and stress (β = 2.722, P < 0.001), whereas associations in the higher support group were not significant. For emotional support, a stronger association with stress was observed in the lower support group (β = 2.748, P = 0.008) but not in the higher support group. Stratification by community health worker home visits showed minimal subgroup differences.</p><p><strong>Conclusions: </strong>In essence, this study underscores the impact of breastfeeding challenges on maternal mental health and highlights family support's pivotal role, calling for targeted intervention to support rural mothers.</p><p><strong>Trial registration: </strong>The study was approved by the Medical Ethics Committee of Shaanxi Normal University and Xi'an Jiaotong University of China (No: 2020 - 1240) on 08/03/2019. Meantime, the study obtained the registration numbers ISRCTN98898991 from the ISRCTN registry, which is recognized by WHO and ICMJE, on 26/03/2019.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1112"},"PeriodicalIF":2.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312292","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":"Comparative metabolomic profiling reveals distinct metabolic signatures in amniotic fluid and umbilical cord blood between advanced and young maternal age pregnancies.","authors":"Dianjie Li, Shilei Pan, Wei Cai, Mei Zhong, Yuxin Huang","doi":"10.1186/s12884-025-08118-6","DOIUrl":"10.1186/s12884-025-08118-6","url":null,"abstract":"<p><strong>Background: </strong>Given the heightened risk of complications during pregnancy in women of advanced maternal age (AMA), it is crucial to understand the metabolites in amniotic fluid and umbilical cord blood in this demographic.  METHODS: We analyzed the metabolites in amniotic fluid from 60 women, divided into two groups: the AMA group (aged 35 or above, n = 29), and the control group (aged below 35, n = 31). We then conducted a follow-up analysis on the metabolites of umbilical cord blood from a sample of 19 women (9 from the AMA group, and 10 from the control group).</p><p><strong>Results: </strong>In total, we identified 96 differential metabolites in the amniotic fluid and 146 in the cord blood between the two groups. The significant changes in the metabolites of the amniotic fluid mainly involved sphingolipid metabolism, steroid hormone biosynthesis, and cholesterol metabolism. Conversely, the preliminary significant changes in cord blood metabolites were mainly linked to metabolism of arginine and proline, degradation of valine, leucine, and isoleucine, fatty acid metabolism, alanine, aspartate and glutamate metabolism, and the biosynthesis of unsaturated fatty acids. Further analysis revealed a significant upregulation of lysophosphatidylcholine (LPC), phosphatidylcholine (PC), and taurodeoxycholic acid in the amniotic fluid. In the cord blood, various forms of lysophosphatidic acid (LPA), sphingomyelin (SM), phosphatidylglycerol (PG), LPC, and PC were found preliminarily to be either upregulated or downregulated.</p><p><strong>Conclusion: </strong>Our results preliminarily showed that the metabolites of amniotic fluid and cord blood in AMA women differed significantly from the control group. These findings provide crucial insights for future research to explore the role of metabolomics in adverse pregnancy outcomes in AMA women.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"1106"},"PeriodicalIF":2.7,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12532403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306879","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}