BMC Pregnancy and Childbirth最新文献

{"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}

{"title":"Experience of pregnant women living in temporary shelters post-earthquake: a phenomenological study.","authors":"Mine Gökduman Keleş, Eylem Toker","doi":"10.1186/s12884-025-07994-2","DOIUrl":"10.1186/s12884-025-07994-2","url":null,"abstract":"","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"908"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941932","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":"Strengthening the first antenatal visit to improve maternal health: results from a cross-sectional study in Bantul, Indonesia.","authors":"Soraya Isfandiary Iskandar, Samsu Aryanto, Shinta Prawitasari, Bayu Satria Wiratama","doi":"10.1186/s12884-025-08038-5","DOIUrl":"10.1186/s12884-025-08038-5","url":null,"abstract":"","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"911"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942145","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":"Machine learning for preventing stillbirths: is it possible to transform data into life-saving insights?","authors":"Maria Eduarda Ferro de Mello, Élisson da Silva Rocha, Patricia Takako Endo","doi":"10.1186/s12884-025-08028-7","DOIUrl":"10.1186/s12884-025-08028-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the performance of machine learning models using different data imputation techniques in different balancing scenarios, employing sociodemographic attributes and maternal health history, using data of a population from the state of Pernambuco, Brazil, to predict fetal death during pregnancy.</p><p><strong>Methods: </strong>We used a dataset from a social program in Pernambuco, Brazil, covering the period from 2008 to 2022, that includes sociodemographic, prenatal, maternal and family health history data. We separated two scenarios with two balancing techniques to train the models, Random Undersampling (RU scenario) and Hybrid Undersampling 2x (H2X scenario) and we explored using four tree-based machine learning models, each of which was evaluated based on their performance and feature importance.</p><p><strong>Results: </strong>The models were evaluated under different metrics. The XGBoost model stood out with 81.06% specificity and the Random Forest model stood out with 67.73% sensitivity, in different scenarios. The attributes that most impacted the learning process were first prenatal care, age, education and interpregnancy interval.</p><p><strong>Conclusion: </strong>This application is particularly valuable in the context of social projects, such as those in Brazil, where innovative solutions can contribute to achieving the SDGs offering a unique perspective on the intersection of technology, healthcare, and social impact.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"906"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942087","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":"Adverse events during pregnancy, circulating metabolites, and congenital malformations: a Mendelian randomization study.","authors":"Jian Cheng, Xiao Dong, Yang Yang, Xiaohan Qin, Xing Zhou, Yongcheng Fu, Jingyue Wang, Yuanyuan Wang, Da Zhang","doi":"10.1186/s12884-025-07860-1","DOIUrl":"10.1186/s12884-025-07860-1","url":null,"abstract":"<p><strong>Background: </strong>Adverse events during pregnancy are implicated in increasing the risk of congenital malformations in offspring. Current research does not fully encompass the spectrum of adverse events nor the mechanisms by which they affect fetal development.</p><p><strong>Methods: </strong>A two-sample and two-step Mendelian randomization (MR) study was conducted to assess the association between adverse events during pregnancy and congenital malformations in offspring, and to investigate the mediating role of circulating metabolites in linking these adverse events to congenital malformations.</p><p><strong>Results: </strong>Maternal bleeding during pregnancy was associated with an increased risk of congenital ichthyosis and a decreased risk of congenital hydrocephalus. Anemia during pregnancy showed a significant correlation with an increased risk of atrioventricular septal defects. Placenta previa and placental abruption were associated with a decreased risk of congenital hydrocephalus and an increased risk of congenital malformation of the breast. Premature birth was associated with an increased risk of complex heart defects. Fetal malposition correlated with a decreased risk of cleft lip. Urogenital infection during pregnancy was linked to an increased risk of congenital malformation of cardiac chambers and connection. Glycine may mediate approximately 1.1% of the effect of premature birth on the risk of complex heart defects.</p><p><strong>Conclusion: </strong>MR was employed to elucidate the mediating role of circulating metabolites in the impact of these adverse events on congenital malformations, providing new insights into their causal relationships. However, the underlying mechanisms remain unclear, necessitating further research and clinical trials to elucidate these relationships.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"915"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941967","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":"Risk factors and prediction model for massive transfusion during cesarean section in singleton pregnancies with anterior placenta previa, prior caesarean and prenatal suspicion of placenta accreta spectrum: a retrospective case-control study.","authors":"Pin Cao, Lu Ji, Shuo Zhang, Chong Qiao","doi":"10.1186/s12884-025-08041-w","DOIUrl":"10.1186/s12884-025-08041-w","url":null,"abstract":"<p><strong>Background: </strong>Severe postpartum hemorrhage is frequently encountered during cesarean sections (CSs) in individuals with placenta accreta spectrum (PAS). The prompt and adequate administration of blood transfusions has emerged as a critical intervention in managing severe postpartum hemorrhage. Considering that anterior placenta previa (APP) and a prior CS constitute key risk factors for PAS, this investigation aims to investigate these risk factors and develop a prediction model for massive transfusion (MT) during CS in cases of singleton pregnancies with APP, a prior CS, and prenatal suspicion of PAS, utilizing the placenta accreta spectrum ultrasound scoring system (PASUSS).</p><p><strong>Methods: </strong>A cohort of 430 individuals with APP, having undergone prior CS, and with prenatal suspicion of PAS, as determined by PASUSS, were retrospectively examined at Shengjing Hospital, affiliated with China Medical University, between January 2018 and December 2021. These patients were divided into cohorts of MT (168 cases) and non-MT (262 cases) according to the volume of packed red blood cells transfused intraoperatively. The cohort was arbitrarily subdivided into training and validation cohorts in a 7:3 proportion. LASSO and multivariate logistic regression analyses were employed to ascertain independent risk factors for MT. A prediction model was developed, and its predictive efficacy was evaluated through the use of receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Out of the 430 patients, 168 underwent MT during CS, reflecting an incidence rate of 39.07%. Independent risk factors for MT in cases of singleton pregnancies with APP, prior CS, and prenatal suspicion of PAS included emergency surgery, PASUSS score, preoperative hemoglobin level, clinical staging of PAS, and one-step conservative surgery. A nomogram was subsequently developed utilizing these identified factors. The areas under the ROC curves for the training and validation cohorts were 0.908 (0.875-0.940) and 0.925 (0.882-0.968), respectively. Both calibration curves and DCA demonstrated that this nomogram possessed a strong predictive value.</p><p><strong>Conclusions: </strong>Independent risk factors for MT included emergency surgery, PASUSS score, preoperative hemoglobin level, clinical staging of PAS, and one-step conservative surgery. The nomogram constructed from these variables serves as an effective prediction model for identifying MT in singleton pregnancies characterized by APP, prior CS, and prenatal suspicion of PAS.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"910"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942104","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":"Retrospective evaluation of cerebral fissure depths by magnetic resonance imaging in fetuses with isolated ventriculomegaly.","authors":"Nizamettin Bozbay, Ayşe Ceren Duymuş, Rabia Nur Sağlam, Fatih Ateş, Mehmet Sedat Durmaz, Mustafa Koplay, Gökçen Örgül, Aybike Tazegül Pekin","doi":"10.1186/s12884-025-07961-x","DOIUrl":"10.1186/s12884-025-07961-x","url":null,"abstract":"<p><strong>Background: </strong>We aimed to compare the cerebral fissure depths in isolated mild-moderate ventriculomegaly fetuses and healthy fetuses according to gestational weeks using magnetic resonance imaging.</p><p><strong>Method: </strong>A total of 203 fetuses were included in our study. While 77 fetuses had normal fetal MRI reports and were included in the control group, 126 fetuses had isolated mild-moderate ventriculomegaly and were included in the patient group. All measurements were performed by two clinicians, a radiologist and a perinatologist.</p><p><strong>Results: </strong>In the study, parieto-occipital fissure and calcarine fissure depths of the isolated mild-moderate ventriculomegaly group were significantly lower than the control group (p < 0.001, p < 0.001, respectively). Significant negative correlation was observed between ventricular width and parieto-occipital fissure and calcarine fissure depth. In our study, the intraclass correlation coefficient values of the agreement between the two experts were found to be 0.995 for calcarine fissure, 0.996 for parieto-occipital fissure, 0.990 for lateral ventricle width, and it was found to be perfect agreement.</p><p><strong>Conclusion: </strong>Although the potential of cerebral fissure depths as a predictive marker for postnatal developmental problems has not yet been established, we believe that underdevelopment of these fissures in isolated mild-moderate ventriculomegaly fetuses may be an additional indicator of developmental abnormalities.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"914"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942165","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 characteristics, pregnancy outcomes, and neonatal effects of cytomegalovirus infection in pregnant women in Liuzhou city, North central Guangxi of Southern China: a retrospective study from 2018 to 2024.","authors":"Ling Zhang, Weiyou Lv, Jiaolian Ya, Yuanxiu Li, Dejian Yuan, Pengfei Cai, Lizhu Chen, Ning Tang, Hui Chen, Bailing Liu, Xiangrong Tang, Qiurong Lai, Guang Cheng, Lifang Zhang, Xiaoni Wei, Qingyan Zhong","doi":"10.1186/s12884-025-08083-0","DOIUrl":"10.1186/s12884-025-08083-0","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical characteristics, pregnancy and neonatal outcomes of cytomegalovirus (CMV) infection in pregnant women.</p><p><strong>Methods: </strong>This retrospective study included 22,673 pregnant women from Liuzhou, Guangxi, China, between 2018 and 2024. Amniotic fluid samples collected during mid-to-late pregnancy were tested for CMV DNA. Clinical data among CMV-infected pregnant women were collected, including prenatal diagnosis indicators, early-pregnancy CMV antibodies, pregnancy and neonatal outcomes, and offspring follow-up outcomes.</p><p><strong>Results: </strong>Among 22,673 pregnant women, 36 (1.59‰) were tested positive for CMV DNA in amniotic fluid, among which 14 (38.9%) with adverse pregnancy outcomes, including 7(19.4%) termination of pregnancy, 3(8.3%) stillbirth and 4 (11.1%) preterm delivery. Prenatal imaging modalities detected fetal abnormalities 21 (58.3%) in the CMV-infected pregnant women, mainly were ventriculomegaly, fetal growth restriction (FGR), pericardial effusion, ascites, cardiomegaly, placentomegaly, enlarged cisterna magna and hyperechogenic bowel. Notably, Fetuses of 2 pregnant women with primary CMV infection developed severe edema. Four newborns failed with initial hearing screening during postnatal evaluation. Among them, two (50%) were diagnosed with severe sensorineural hearing loss (SNHL) and one child was diagnosed with cerebral palsy in subsequent clinical assessments.</p><p><strong>Conclusion: </strong>Diagnosis of primary CMV infection during pregnancy is of critical importance. Current guidelines recommend implementing CMV serological screening during the first trimester, with subsequent CMV IgG avidity testing when CMV IgG antibodies are detected. Maternal CMV infection during the second and third trimesters may lead to fetal complications, including ventriculomegaly, FGR and fetal hydrops. Congenital CMV (cCMV) infection predominantly manifests with sensorineural hearing loss (SNHL) and cerebral palsy. It is essential to screen all neonates from CMV-infected pregnant women for CMV DNA and provide mandatory 5-year follow-up for symptomatic cCMV children.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"909"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144941631","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}