BMC Pregnancy and Childbirth最新文献

{"title":"Awareness of cardiovascular disease risk and care received among Australian women with a history of hypertensive disorders of pregnancy: a cross-sectional survey.","authors":"Kaylee Slater, Rachael Taylor, Clare E Collins, Melinda Hutchesson","doi":"10.1186/s12884-024-07018-5","DOIUrl":"https://doi.org/10.1186/s12884-024-07018-5","url":null,"abstract":"<p><strong>Background: </strong>Women with a history of hypertensive disorders of pregnancy (HDP), including chronic hypertension, gestational hypertension, and preeclampsia have an increased risk of cardiovascular disease (CVD). Current research suggests that general practitioners are unaware of women's HDP history, and although ideally placed to follow-up with these women, there is limited understanding of current CVD prevention practices in women after HDP. Additionally, preeclampsia confers a higher CVD risk compared to other types of HDP, and Australian research suggests that lower socioeconomic status (SES) is associated with a higher incidence of both HDP and CVD. Therefore, the aim of the analysis was to investigate awareness of CVD risk and care received from health professionals among women with a history of HDP and examine differences between type of HDP and SES.</p><p><strong>Methods: </strong>Analysis of a cross-sectional survey of 293 Australian women with a history of HDP (from 2017 onwards). Data were analysed using basic descriptive statistics. To assess differences in HDP type and SES, one-way ANOVA was used to assess continuous variables and χ2 tests for categorical variables, with P < 0.05 considered statistically significant.</p><p><strong>Results: </strong>Most women with a history of HDP were unaware of their increased CVD risk (68%). Women with a history of preeclampsia, gestational hypertension or preeclampsia were more aware of CVD risk compared to those with chronic hypertension (p = 0.02). Regardless of HDP type or SES, women post-HDP were less likely to receive assessment and management of lifestyle CVD risk factors compared to blood pressure. Most women felt supported in managing stress and mental health, but not for managing body weight, smoking and sleep.</p><p><strong>Conclusions: </strong>Women with a history of HDP are unaware of their increased CVD risk and are not receiving recommended CVD preventative care, irrespective of HDP type and/or SES. Findings should be used to inform development of tailored CVD prevention interventions in the primary care setting for women following HDP.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"15"},"PeriodicalIF":2.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the experiences of women and people with diabetes in pregnancy in metropolitan and rural Australia: a national survey.","authors":"Ellen Payne, Susan Heaney, Clare Collins, Megan Rollo, Leanne J Brown","doi":"10.1186/s12884-024-07093-8","DOIUrl":"https://doi.org/10.1186/s12884-024-07093-8","url":null,"abstract":"<p><strong>Background: </strong>Women and people diagnosed with diabetes in pregnancy, are recommended to have frequent monitoring and careful management for optimal pregnancy outcomes. This health care management should be supported by a multidisciplinary healthcare team. For individuals living in rural areas, there are increased barriers to healthcare access, with subsequent worse health outcomes compared to those in metropolitan regions. Despite this, there remains a lack of research into the experiences of healthcare delivery for rural women and people with diabetes in pregnancy.</p><p><strong>Methods: </strong>Survey invitations were sent via the National Diabetes Services Scheme email list. The survey included multiple choice and open-ended questions. Responses from the open-ended question asking participants the changes they would want made to their care delivery were interpreted using qualitative content analysis. Responses were separated into metropolitan and rural categories using the Modified Monash Model criteria.</p><p><strong>Results: </strong>There were 668 survey responses, with 409 responding to the open-ended qualitative survey question/s. 71.6% of respondents were metropolitan and 27.6% lived rurally. A total of 31 codes were established from the open-ended responses, with the five overarching themes of 'quality of care', 'practice & communication', 'individual's experience', 'access' and 'burden of care' identified. The most frequently occurring codes irrespective of location included education or information (n = 45), frequency and timeliness of care (n = 42), no changes (n = 42) and improved health professional communication (n = 40). Local care options was the only code with more rural quotes compared to metropolitan.</p><p><strong>Conclusions: </strong>The most frequently occurring codes had strong representation from metropolitan and rural respondents, indicating that those with previous diabetes in pregnancy had similar priorities for changes in their healthcare delivery regardless of location. Rural respondents identifying local care options as a priority for change is likely indicative of the rural healthcare landscape with limited access to care options. Recommendations from this study supported by previous research include focusing on improving health professional communication both with women and people with diabetes in pregnancy and with other relevant professionals. Recommendations for rural locations should focus on improving local care options whilst considering resource limitation, such as telehealth clinics.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"16"},"PeriodicalIF":2.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical length of preoperative cervical cerclage prognostic impacted the effect of cervical insufficiency.","authors":"Yayun Zhang, Zihan Zhao, Jiaqi Xu, Fei Wu, Ting Chen, Shunyu Hou, Aifen Wang","doi":"10.1186/s12884-025-07142-w","DOIUrl":"https://doi.org/10.1186/s12884-025-07142-w","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to analyze the impact of preoperative cervical length before cervical cerclage on the extension of gestational days in patients with various diagnostic types of cervical insufficiency, including obstetric history-based diagnosis, ultrasound-based diagnosis, and physical examination-based diagnosis.</p><p><strong>Methods: </strong>168 patients were segregated into four categories based on cervical length: 0-0.4 cm, 0.5-1.4 cm, 1.5-2.4 cm, and ≥ 2.5 cm. Kaplan-Meier, linear regression curve and Cox regression analyses were used, with a focus on clinical variables, particularly cervical length and the duration of extension after cervical cerclage.</p><p><strong>Results: </strong>The length of the cervix prior to cervical cerclage correlated with the prognosis of 168 postoperative patients by linear regression analysis. When delivery beyond 28 or 34 weeks was set as the primary prognostic indicator, univariate Cox analysis showed that postoperative C-reactive protein (CRP) level was identified as a risk factor for gestational age extension in cervical cerclage patients. Longer cervical length was identified as a protective factor for overall gestational age extension in cervical cerclage patients. In addition, the obstetrical-history diagnosis group had a better prognosis compared to the emergency cerclage group, which had a worse prognosis compared to the ultrasound-based diagnosis group. Kaplan-Meier curve analysis of all patients revealed a statistically significant impact of different cervical lengths on the gestational age of delivery (P < 0.001). However, in the physical examination-based diagnosis group, Kaplan-Meier curve analysis demonstrated a statistically significant impact of different cervical lengths on gestational age at delivery (P = 0.006).</p><p><strong>Conclusion: </strong>Longer preoperative cervical length was associated with better outcomes in terms of gestational prolongation and newborn survival after cervical cerclage.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"12"},"PeriodicalIF":2.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CLP-Net: an advanced artificial intelligence technique for localizing standard planes of cleft lip and palate by three-dimensional ultrasound in the first trimester.","authors":"Guangzhi He, Zhou Li, Zhiyuan Zhu, Tong Han, Yan Cao, Chaoyu Chen, Yuhao Huang, Haoran Dou, Lianying Liang, Fangmei Zhang, Jin Peng, Tao Tan, Hongmei Liu, Xin Yang, Dong Ni","doi":"10.1186/s12884-024-07108-4","DOIUrl":"https://doi.org/10.1186/s12884-024-07108-4","url":null,"abstract":"<p><strong>Background: </strong>Early diagnosis of cleft lip and palate (CLP) requires a multiplane examination, demanding high technical proficiency from radiologists. Therefore, this study aims to develop and validate the first artificial intelligence (AI)-based model (CLP-Net) for fully automated multi-plane localization in three-dimensional(3D) ultrasound during the first trimester.</p><p><strong>Methods: </strong>This retrospective study included 418 (394 normal, 24 CLP) 3D ultrasound from 288 pregnant woman between July 2022 to October 2024 from Shenzhen Guangming District People's Hospital during the 11-13^+ 6 weeks of pregnancy. 320 normal volumes were used for training and validation, while 74 normal and 24 CLP volumes were used for testing. Two experienced radiologists reviewed three standard lip and palate planes (mid sagittal, retronasal triangle, and maxillary axial planes) as ground truth (GT) and the CLP-Net was developed to locate these planes.</p><p><strong>Results: </strong>In normal test set, mean angle(± SD)° and distance(± SD)mm differences were 6.24 ± 4.83, 9.81 ± 5.48, 15.36 ± 18.14 and 0.86 ± 0.72, 1.36 ± 1.15, 1.96 ± 2.35 for MSP ± SD, RTP ± SD and MAP ± SD, NCC and SSIM were 0.931 ± 0.079, 0.819 ± 0.122, 0.781 ± 0.157 and 0.896 ± 0.058, 0.785 ± 0.076, 0.726 ± 0.088 respectively. In the CLP cases, there were 8.61 ± 5.52, 10.67 ± 5.08, 16.91 ± 17.42 and 1.03 ± 1.20, 1.17 ± 1.08, 1.34 ± 0.95 for mean angle and distance in MSP, RTP, and MAP, respectively. NCC and SSIM were 0.876 ± 0.104, 0.803 ± 0.084, 0.793 ± 0.089 and 0.841 ± 0.105, 0.812 ± 0.085, 0.764 ± 0.100, respectively. CLP-Net predictions had a highly visual acceptance rate among radiologists (MSP: 95%, RTP: 70%, MAP: 70%), with improved localization speed 15s(31.3%) for senior radiologists and 63s(38.9%) for junior radiologists.</p><p><strong>Conclusions: </strong>CLP-Net accurately locates three planes for CLP screening, aiding radiologists and enhancing the efficiency of ultrasound examinations.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"10"},"PeriodicalIF":2.8,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944140","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":"Gestational - age - specific reference intervals for blood pressure in normal pregnancy in a Southern Chinese population.","authors":"Yuguo Deng, Lanfang Liang, Ying Gao, Guilian Liao, Qiaozhu Chen, Zijian Huang, Jinying Yang","doi":"10.1186/s12884-024-07117-3","DOIUrl":"https://doi.org/10.1186/s12884-024-07117-3","url":null,"abstract":"<p><strong>Objective: </strong>Physiological blood pressure changes in pregnancy are insufficiently defined. This paper describes the blood pressure changes across healthy pregnancies in a Southern Chinese population to present gestational - age - specific blood pressure ranges with smoothed centiles (3rd, 10th, 50th, 90th, and 97th).</p><p><strong>Methods: </strong>Antenatal blood pressure measurements [median (interquartile range) 9 (8 - 10) per woman] were repeated in 17, 776 women from a Southern China population. Multilevel cubic splines models were used to derive longitudinal reference ranges for systolic blood pressure (SBP) and diastolic blood pressure (DBP) from 6 to 42 weeks of gestation for the normal pregnancies (excluding chronic hypertension, preeclampsia, diabetic ones, and preterm birth et al.).</p><p><strong>Results: </strong>Systolic and diastolic BP increased from 6 weeks of gestation: 50th centile (3rd - 97th centile) 106 (87 - 125); 61 (47 - 77) mm Hg to 12 weeks of gestation: 50th centile (3rd - 97th centile) 108 (88 - 129); 64 (49 - 81) mm Hg. Then, the lowest value of 107 (87 - 129); 62 (47 - 78) mm Hg was reached at 16 weeks and 20 weeks of gestation, respectively. Systolic and diastolic BP then rose to a maximum median (3rd - 97th centile) of 115 (96 - 135); 68 (53 - 85) mm Hg at 42 weeks of gestation. Additionally, the ascending tendency of SBP after 16 weeks of gestation was interrupted by two fluctuations that occurred at 24 weeks and 30 weeks of gestation.</p><p><strong>Conclusions: </strong>In summary, our study provides blood pressure reference values for Southern Chinese women with normal pregnancies. To identify gestational hypertension and hypotension, centiles for gestational - age - specific BP should be defined in healthy pregnancies. Understanding these changes in low risk pregnancies is essential to optimize maternal blood pressure management.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"8"},"PeriodicalIF":2.8,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944122","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":"Everything feels just a little heavier, more wrought with implications, you know? - a mixed-methods study examining lifestyle behaviors, health, and well-being of pregnant and postpartum women during the early months of the COVID-19 pandemic.","authors":"Sara Dube, Muhammad Asim, Jennifer Gonzalez, Gracia Dala, Michelle L Wright, Megan J Gray, Linda G Kahn, Deborah Jacobvitz, Elizabeth M Widen","doi":"10.1186/s12884-024-07011-y","DOIUrl":"https://doi.org/10.1186/s12884-024-07011-y","url":null,"abstract":"<p><strong>Background: </strong>While the striking impact of the COVID-19 pandemic on mental health, heath care access and lifestyle behaviors, including perceived health, diet, physical activity, and sleep has been reported, few studies have examined these domains jointly among pregnant and postpartum people in the early stages of the COVID-19 pandemic.</p><p><strong>Methods: </strong>This mixed methods study was conducted among a subset of participants (n = 22) in a cohort study in Austin, Texas, who were pregnant or had recently delivered when the outbreak occurred. Measures were from the early second trimester up to 6 months postpartum. Findings from questionnaires were complemented by qualitative interviews during Spring/Summer 2020 regarding experiences during the early pandemic.</p><p><strong>Results: </strong>From our quantitative data (n = 22), most participants reported that the pandemic generally had a negative impact on their lives (81%), that they shifted to eating more at home (71%), and that they were less physically active (62%). Five major themes emerged in our qualitative interviews (n = 22): (1) adaptation to pandemic restrictions; (2) psychosocial experiences, such as feelings of anxiety, guilt, sadness, isolation, and frustration; (3) health behavior changes; (4) health care experiences; and (5) where they obtained general and perinatal related pandemic information. Of those who completed both pregnancy and postpartum interviews (n = 8), all reported anxiety during both periods; however, those who delivered in Spring 2020 experienced more anxiety surrounding delivery and less social support than those who delivered in Summer 2020, who reported less anxiety surrounding hospital birth and greater social support, particularly after delivery.</p><p><strong>Conclusions: </strong>Overall, our findings confirm prior evidence that the COVID-19 pandemic had a marked impact on stress, anxiety, and worries, as well as lifestyle behaviors among pregnant and postpartum people. Our work provides lessons for health care practitioners about support need for pregnant and postpartum persons amid societal disruption.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"9"},"PeriodicalIF":2.8,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944111","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":"Exploring postpartum women's experiences, perspectives, and expectations in maternal health care at a Chinese maternity care center: a qualitative study.","authors":"Xiaoqian Zhang, Yang Liu, Tang Li, Frank Buntinx, Mieke Vermandere","doi":"10.1186/s12884-024-07087-6","DOIUrl":"https://doi.org/10.1186/s12884-024-07087-6","url":null,"abstract":"<p><strong>Background: </strong>The postpartum period presents critical challenges for new mothers, involving significant physical and emotional adjustments. Traditionally, Chinese culture has addressed this phase through \"doing the month,\" emphasizing rest and specific cultural practices. Modernization in urban China has led to a rise in professional maternal care centers, yet research on women's experiences and expectations in these settings remains limited. This study aims to explore the experiences, perspectives, and expectations of postpartum women who utilize hospital-based maternity care centers, focusing on the integration of traditional practices with modern healthcare standards.</p><p><strong>Methods: </strong>In this study, 16 participants who had utilized the hospital's maternal care center within the previous year were chosen via purposive sampling in Qingdao, China. Data were collected through semi-structured interviews and analyzed employing The Qualitative Analysis Guide of Leuven (QUAGOL), a framework ensuring transparency and depth in identifying and interpreting themes.</p><p><strong>Results: </strong>Analysis revealed three main themes: co-created health management, shared knowledge and growth, and interpersonal connections and support. The study highlighted the benefits of a collaborative approach to healthcare, where personalized care and maternal autonomy were prioritized. It also pointed out the educational aspect of motherhood, emphasizing the role of community support and shared experiences. Furthermore, the study highlighted the positive impact of social dynamics, such as family, peer, and professional support, emphasizing their crucial contribution to the postpartum recovery process.</p><p><strong>Conclusion: </strong>This study underscores the importance of integrating traditional postpartum practices with modern healthcare, focusing on co-created health management, shared knowledge and growth, and interpersonal connections and support. These elements significantly enhance maternal well-being, addressing both physical and psychosocial needs. These results highlight the importance of culturally sensitive care tailored to the societal and cultural contexts of postpartum women in China. Practical recommendations include enhancing personalized care models and strengthening support networks within healthcare systems to better meet mothers' needs. These findings provide a foundation for improving postpartum care policies and practices, with implications for creating more supportive environments for new mothers. Future studies are encouraged to expand the participant diversity, explore diverse cultural settings, and apply quantitative methods to validate these outcomes.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"7"},"PeriodicalIF":2.8,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944114","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":"Validation of the uncertainty stress scale-high-risk pregnancy - Chinese brief version: Rasch analysis.","authors":"Yi Jing Tsai, Chi Chen Chen, Yu Yun Hsu, Chuan Chuan Chen","doi":"10.1186/s12884-024-07078-7","DOIUrl":"https://doi.org/10.1186/s12884-024-07078-7","url":null,"abstract":"<p><strong>Background: </strong>High-risk pregnancy leads to uncertainty and stress in pregnant women due to the threatened of mother and fetus health. The Uncertainty Stress Scale High-Risk Pregnancy Version, a 54-item Chinese version (USS-HRPV-C), has been widely used to assess the uncertainty and stress that women experience during pregnancy. However, the length of the scale may result in a burden for respondents. Thus, a brief version of the USS-HRPV-C is needed for a concise and vigorous assessment. The aim of this study was to shorten the USS-HRPV-C and validate the brief version.</p><p><strong>Methods: </strong>This study used a cross-sectional design. A convenience sample of 200 women with high-risk pregnancies completed the 54-item USS-HRPV- C. Confirmatory factor analysis (CFA) and Rasch model to examine the construct validity of the short version of the USS-HRPV-C. Rasch analysis was used with a stepwise approach to select items with better goodness-of-fit and no differential item functioning (DIF). Additionally, Cronbachs' α and Pearson correlations to evaluate the internal consistency of the original and brief versions. Test analysis modules (TAM) and Lavaan packages in R were used for data analyses.</p><p><strong>Results: </strong>The results of CFA supported a two-factor structure of the HRPV-C. Using the Rasch analysis, we reduced the USS-HRPV-C scale from 54 to 17 items. The selected 17 items were robust without displaying differential item functioning. Further, the 17-item short version exhibited satisfactory fit statistics that infit and outfit mean square ranged between 0.71 and 1.35, respectively. Internal consistency of Cronbach's α for the short version of the USS-HRPV-C scale ranged was 0.90 and 0.92 for the subscales of uncertainty and stress respectively. Both subscales of the brief version were significantly related to the original version of USS-HRPV-C.</p><p><strong>Conclusions: </strong>This study developed a 17-item brief version of the USS-HRPV-C scale, which has demonstrated its satisfactory psychometric properties. Healthcare providers can use the validated brief version of the USS-HRPV-C to proficiently assess women's psychosocial stress and uncertainty during pregnancy.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"6"},"PeriodicalIF":2.8,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11702129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944248","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":"A systematic review and meta-analysis of exercise-based intervention to prevent gestational diabetes in women with overweight or obesity.","authors":"Teresa E Santa Cruz, Cristina Sarasqueta, Juan Carlos Muruzábal, Eukene Ansuategui, Olga Sanz","doi":"10.1186/s12884-024-07021-w","DOIUrl":"https://doi.org/10.1186/s12884-024-07021-w","url":null,"abstract":"<p><strong>Background: </strong>There is evidence that exercise may reduce the risk of gestational diabetes mellitus (GDM) and improve other obstetric outcomes in overweight or obese pregnant women. However, the available evidence is of low quality and inconclusive. The purpose of this study is to assess the effects of exercise, compared with usual care, in reducing GDM and other obstetric risks, in overweight and obese pregnant women.</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, and the Cochrane Library from their inception dates up to August 2022. Randomised studies comparing physical exercise versus routine obstetric care in pregnant women with overweight or obesity (BMI ≥ 25.0). Each abstract and full-text article was independently reviewed by the same two authors. The primary outcome was the incidence of GDM, and the secondary outcomes were excessive weight gain, preterm delivery, and foetal macrosomia. Summary risk ratios (RRs) and 95% confidence intervals (CIs) were calculated.</p><p><strong>Main results: </strong>Seven studies covering 1162 patients were identified. Exercise did not reduce the risk of GDM: RR, 0.82 [95% CI, (0.58-1.17)] but subgroup analysis shows a significant benefit among patients adhering to the programs: RR, 0.56 [95% CI, (0.40-0.78)] and no effect among non-adherents: RR, 1.11 [95% CI, (0.82-1.50)]. We did not find a significant effect on excessive weight gain: RR, 0.92 [95% CI, (0.76-1.11)] but there was a reduction in the risk of foetal macrosomia: RR, 0.5 [95% CI, (0.32-0.79)]. Exercise has not been associated with an increased risk of preterm birth: RR, 0.79 [95% CI, (0.44-1.39)].</p><p><strong>Conclusions: </strong>The present study does not allow us to conclude that structured exercise programs for pregnant women with overweight or obesity leads to a reduction in the risk of gestational diabetes. When exercise program adherence is high, a significant reduction of GDM is observed. These findings will need to be confirmed with large primary trials. A reduction in the incidence of foetal macrosomia has also been observed. TRIAL REGISTRATION: This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO; identifier: CRD42023399004).</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"5"},"PeriodicalIF":2.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is it possible for parents to endure a stillbirth? Initial experiences, perceptions and strategies: individual in-depth interviews in Sweden 2021-2023.","authors":"Berit Höglund, Ingegerd Hildingsson","doi":"10.1186/s12884-024-07055-0","DOIUrl":"10.1186/s12884-024-07055-0","url":null,"abstract":"<p><strong>Background: </strong>Stillbirth occurs at a rate of 3.0 per thousand in Sweden. However, few studies have focused on the initial experiences of parents facing a stillbirth. The aim of this qualitative study is to deepen and broadly explore parents' initial experiences, perceptions, internal processes and strategies from the moment of suspicion or awareness of stillbirth until one month after the event.</p><p><strong>Methods: </strong>Ten individual in-depth interviews were conducted between 2021 and 2023, and data were evaluated using thematic network analysis.</p><p><strong>Results: </strong>Two key themes emerged: 'Following the journey - from suspicion to acceptance' and 'Support, structured activities and processes after stillbirth'. These themes captured the significant consequences of a sudden, unexpected and devastating end to pregnancy. The suspicion and eventual diagnosis of stillbirth were initially associated with sudden discomfort, fear, overwhelming grief, and intense pain. Nevertheless, a vaginal birth was regarded as the optimal mode of delivery for both physical and emotional wellbeing. Caring for the stillborn baby through physical proximity for an extended period of time helped parents comprehend and cope with their grief, while also affirming their sense of parenthood.</p><p><strong>Conclusions: </strong>This study sheds light on the profound and devastating impact of stillbirth on parents who are confronted with the loss of their long-awaited and cherished baby. The intense grief and pain experienced by parents during the first month after stillbirth were described as an ongoing heavy burden, persisting day and night, and reflected in poor/very poor mental health. Despite the immense challenges faced by parents, the study highlights the importance of developing individual coping strategies to deal with this tragic and irreversible life-changing event.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"4"},"PeriodicalIF":2.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926416","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}