BMC Pregnancy and Childbirth最新文献

{"title":"Effectiveness of the support program of providing food baskets for needy undernourished pregnant and lactating mothers in Iran: a case study of population level intervention.","authors":"Sepideh Dolati, Ali Barzegar, Fatemeh Mohammadi-Nasrabadi, Morteza Abdollahi, Rahim Khodayari-Zarnaq","doi":"10.1186/s12884-025-07764-0","DOIUrl":"https://doi.org/10.1186/s12884-025-07764-0","url":null,"abstract":"<p><strong>Background: </strong>Inadequate maternal nutrition has adverse consequences for both mother and fetus. This study was conducted with the aim of investigating the effectiveness of the food basket support program for undernourished pregnant and lactating mothers on maternal and infant weight gain and maternal anemia.</p><p><strong>Methods: </strong>The present study was conducted retrospectively and semi-experimentally in 2023. Pregnant women (n = 652) were divided into Three groups: food basket (intervention), eligible non-supported (control), and non-needy control group. If a pregnant mother met one of the following criteria and was in financial need, she entered the program: body mass index (BMI) < 18.5 kg/m², body weight < 45 kg, hemoglobin < 11 g/dL, multiple birth, unfavorable weight gain (WG) during pregnancy. The collected information includes the mothers' socio-economic characteristics, BMI, WG and hemoglobin in the fourth and eighth months of pregnancy, the weight and head circumference of the infants at the time of birth, and the trend of the infants' weight and type of nutrition at 2, 4 and 6 months. Repeated measurement ANOVA was used to compare data in several times.</p><p><strong>Results: </strong>There was a significant difference between the three groups in terms of educational and occupational level. The prevalence of anemia was remained unchanged in the food basket group (from 23 to 25%); however, it increased in the eligible non-supported group (from 22 to 37%) and non-needy control (from 0.5 to 8.6%) groups. The difference in mother's WG in the fourth and eighth months of pregnancy was evident between the intervention group and others. The birth weight of infants in the eligible non-supported group (3036.6 ± 457.6) was significantly lower than the non-needy control group (3161.0 ± 440.4). Repeated measurement ANOVA showed the time*group interaction was significant in weight of infants in 2, 4, and 6 months that means groups were significantly different in terms of infant weight during 6 months of age (p < 0.05).</p><p><strong>Conclusion: </strong>The present study showed that participation in the food basket support program could lead to an increase in the appropriate weight of mothers, an improvement in birth weight and an increase in the weight of infants compared to the non-needy control group.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"687"},"PeriodicalIF":2.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551880","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":"Prediction of caesarean section birth using machine learning algorithms among pregnant women in a district hospital in Ghana.","authors":"Frederick Osei Owusu, Helena Addai-Manu, Esther Serwah Agbedinu, Emmanuel Konadu, Lydia Asenso, Mercy Addae, Joseph Osarfo, Brenda Abena Ampah, Douglas Aninng Opoku","doi":"10.1186/s12884-025-07716-8","DOIUrl":"https://doi.org/10.1186/s12884-025-07716-8","url":null,"abstract":"<p><strong>Background: </strong>Machine learning algorithms may contribute to improving maternal and child health, including determining the suitability of caesarean section (CS) births in low-resource countries. Despite machine learning algorithms offering a more robust approach to predicting/diagnosing a health-related problem, research on their use in determining CS birth is scarce in sub-Saharan Africa. This study therefore aimed to compare the performance of five machine learning techniques in predicting CS birth among pregnant women in a district hospital in Ghana.</p><p><strong>Methods: </strong>This was a cross-sectional study that used retrospective data from medical records of pregnant women who delivered at a district hospital in Ghana. A clinical decision support system for predicting CS birth was developed using five machine learning techniques including logistic regression, Support Vector Machines, Naïve Bayes, Random Forest and Extreme Gradient Boosting. Measures such as accuracy, sensitivity, specificity, negative and positive predictive values and area under the receiver operating characteristics curve (AUC-ROC) were used for the model performance.</p><p><strong>Results: </strong>Of a total of 2310 deliveries, the prevalence of CS birth was 37.7% with previous CS being the most prevalent indication. The Random Forest model showed the best performance for predicting CS birth with an accuracy of 0.981, recall of 0.994, F1 score of 0.985 and an AUC-ROC of 0.988. The Naïve Bayes model followed with an accuracy of 0.965, recall of 0.967, F1 score of 0.972 and AUC-ROC of 0.986. The top five most important predictors proved to be diastolic (0.0906) and systolic (0.0848) blood pressures, maternal age (0.0756), previous CS (0.0641) and marital status (0.0400).</p><p><strong>Conclusion: </strong>This study demonstrated that although all five machine learning techniques had good performance in determining CS births, the Random Forest model was superior to all the others in predicting them. This finding suggests that machine learning could help identify at-risk pregnant women for CS births, potentially supporting early interventions and informing policies in maternal healthcare.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"690"},"PeriodicalIF":2.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551893","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":"The silent threat: effects of PM2.5 exposure on perinatal complications and neonatal outcomes.","authors":"Fei Li, Xiaolei Liu, Shuo Gong, Peng Li, Yumei Gao, Xueyan Guo, Wenjun Zheng, Ying Chen","doi":"10.1186/s12884-025-07767-x","DOIUrl":"https://doi.org/10.1186/s12884-025-07767-x","url":null,"abstract":"<p><strong>Background: </strong>Fine particulate matter (PM2.5) is recognized as a significant risk factor for adverse health effects, however, its association with perinatal complications and neonatal outcomes remains incompletely understood. Elucidation of this relationship is critical for enhancing perinatal healthcare strategies.</p><p><strong>Methods: </strong>This research employed a retrospective analysis of patient data from the First People's Hospital of Shangqiu and Henan Children's Hospital, covering the period from February 1, 2018, to December 30, 2022. The study cohort consisted of 13,828 patients who underwent either vaginal or cesarean delivery, patients were categorized based on their delivery method (vaginal or cesarean) and PM2.5 exposure levels (< 50 µg/m3, 50-100 µg/m3, > 100 µg/m3). The study compared perinatal complications and neonatal outcomes among these groups.</p><p><strong>Results: </strong>PM2.5 exposure was associated with a significant rise in gestational hypertension across both delivery modes. In the cesarean delivery group, higher PM2.5 exposure was associated with an increased incidence of oligohydramnios (p = 0.006). Furthermore, lower birth weights were consistently observed within groups subject to higher PM2.5 exposure, irrespective of the mode of delivery. Multivariate logistic regression analysis revealed a significant correlation between elevated PM2.5 exposure levels and an increased risk of gestational hypertension (p < 0.001). Linear analysis demonstrated a negative correlation between elevated PM2.5 exposure levels and neonatal birth weight (p < 0.001). The adjusted Generalized Additive Model (GAM) suggested a non-linear pattern, indicating potential thresholds between PM2.5 exposure and the measured outcomes.</p><p><strong>Conclusions: </strong>The exposure level of PM2.5 is significantly correlated with an increased incidence of gestational hypertension and a decrease in birth weight, it is essential for obstetricians to incorporate air quality considerations into the framework of prenatal care.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"686"},"PeriodicalIF":2.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551897","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":"Validation of the arabic version of the edinburgh postnatal depression scale for screening antenatal depression in Oman.","authors":"Khalood Al-Abri, Hana Al Sumri, Mohammed Al-Azri, Divya Kuzhivilayil Yesodharan, Rahma Al Kindi","doi":"10.1186/s12884-025-07793-9","DOIUrl":"https://doi.org/10.1186/s12884-025-07793-9","url":null,"abstract":"<p><strong>Background: </strong>Antenatal depression is a common mental health problem that women experience during their pregnancies. If left untreated, it can increase a woman's risk of developing postnatal depression and have adverse effects on both mothers and children. Therefore, early identification of depression requires a valid screening tool. The Edinburgh Postnatal Depression Scale (EPDS) is still the most widely recognised screening instrument used to identify symptoms of postnatal depression. Despite the existence of a general Arabic version, it may not accurately reflect the unique cultural characteristics and healthcare practices of Oman. Therefore, the validity of the EPDS for antenatal depression remains uncertain, as no studies have yet addressed its validation in this population.</p><p><strong>Aims: </strong>To establish the validity of the Omani Arabic version of EPDS with an optimal cut-off value as a screening instrument to identify symptoms of depression among women attending antenatal care.</p><p><strong>Methods: </strong>A thoroughly translated and modified Arabic Omani version of the EPDS was designed and validated, with the Arabic PHQ-9 being used as the gold standard. Self-questionnaires were distributed to a sample of 352 women receiving antenatal care at University Medical City Oman and five primary healthcare centres in Muscat governorate, the capital city of Oman. Receiver Operator Characteristic curve was plotted, the area under the curve was calculated, and the optimal cut-off value was identified using Youden's index.</p><p><strong>Results: </strong>The Omani version validation of the EPDS yielded an optimal cut-off score of 11/12 for antenatal depression, with sensitivity, specificity, positive and negative predictive values of 86.30%, 71.37%, 45.65%, and 94.92%, and an area under the curve of 0.85. Youden's index reached a maximum at 0.58 with a cut-off point of 11. The optimal cut-off value is 10 in the first trimester (Youden's index 0.63) with sensitivity of 100.00% and specificity of 63.16%, 11 in the second trimester (Youden's index 0.56) with sensitivity of 86.21% and specificity of 69.90%, and 12 in the third trimester (Youden's index 0.60) with sensitivity of 78.57% and specificity of 80.99%. The internal consistency using Cronbach's alpha was 0.70, indicating acceptable reliability.</p><p><strong>Conclusion: </strong>The study's findings indicate that the Omani version of the EPDS as a valid instrument to screen symptoms of antenatal depression among Omani women.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"677"},"PeriodicalIF":2.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551915","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":"Maternal and gestational factors associated with congenital anomalies among live births: a nationwide population-based study in Brazil from 2012 to 2020.","authors":"Qeren Hapuk Rodrigues Ferreira Fernandes, Enny S Paixão, Maria da Conceição Nascimento Costa, Maria Glória Teixeira, Mauricio Lima Barreto, Angelina Xavier Acosta","doi":"10.1186/s12884-025-07675-0","DOIUrl":"https://doi.org/10.1186/s12884-025-07675-0","url":null,"abstract":"<p><strong>Background: </strong>Congenital anomalies are structural and/or functional alterations that contribute significantly to an increase in morbidity and mortality risk observed in children around the world. These disorders are complex, and their occurrence is influenced by a variety of factors, including socioeconomic conditions that play a significant. Understanding these factors is essential to informing targeted preventive strategies for children with congenital anomalies. Thus, this study investigated the socioeconomic and biological factors associated with congenital anomalies in Brazil.</p><p><strong>Methods: </strong>We conducted a population-based study using linked data (the birth information system (SINASC) and mortality information system (SIM)), in Brazil from 2012 to 2020. We estimated the odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression based on a hierarchical model. Initially, a bivariate analysis was carried out to estimate the crude effect of factors associated with congenital anomalies in live births. It was followed by a multilevel framework with three models, in which Model 1 included distal variables, Model 2 added an intermediate variable, and Model 3 incorporated all variables.</p><p><strong>Results: </strong>Of the 26,107,682 live births included in this study, 144,291 (0.6%) had congenital abnormalities. Black mothers had higher odds of having children with congenital anomalies (OR 1.16; CI 95% 1.14-1.19) than white mothers, and those without prenatal appointments had an increased chance of having children with congenital anomalies (OR 1.47; CI 95% 1.39-1.56) compared to those who started prenatal care in the first months of pregnancy. Maternal age, more than 40 years (OR 2.26; CI 95% 2.20-2.33), and multifetal gestation (OR 1.49; CI 95% 1.45-1.54) were factors associated with a greater chance of live births with congenital anomalies.</p><p><strong>Conclusions: </strong>Our findings indicate that the likelihood of congenital anomalies is highest among live births from the most socially and economically disadvantaged women in Brazil, mainly those who did not have access to adequate prenatal care. In addition, biological characteristics such as advanced maternal age and multifetal pregnancy have also been shown to increase the chances of an affected birth. Understanding the risk factors for the occurrence of births affected by congenital anomalies allows the implementation of actions to reduce exposure to modifiable risk factors, before and during pregnancy.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"678"},"PeriodicalIF":2.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551810","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":"The impact of unexplained spontaneous miscarriage history on cycle outcomes in patients undergoing in vitro fertilization: an analysis of 6535 patients.","authors":"Shutian Jiang, Xueyi Jiang, Yanping Kuang, Wenzhi Li","doi":"10.1186/s12884-025-07812-9","DOIUrl":"https://doi.org/10.1186/s12884-025-07812-9","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether the previous spontaneous miscarriages affect the cycle outcomes in in vitro fertilization and embryo transfer (IVF-ET).</p><p><strong>Methods: </strong>Comparisons were made on the cycle characteristics and outcomes between patients (underwent their first IVF-ET cycles between January 2018 and June 2022) without (Group A) and with (Group B) spontaneous miscarriage histories. Multiple regression analysis was performed to adjust for other possible confounders of cycle outcomes.</p><p><strong>Results: </strong>In controlled ovarian stimulation cycles, the rate of viable embryos per oocyte in group A was higher than that in group B (0.40 ± 0.26 vs. 0.38 ± 0.27, p = 0.006). Multiple linear regression analysis confirmed that the previous miscarriage history was negatively associated with the oocyte utilization rate (p = 0.002). Moreover, in ET cycles, no statistical difference was observed regarding the miscarriage rate between the two groups (p = 0.497), while Group B presented with lower clinical pregnancy rate (46.1% vs. 42.3%, p = 0.006), lower ongoing pregnancy rate (40.5% vs. 37.0%, p = 0.009) and lower live birth rate (38.5% vs. 35.0%, p = 0.009). Further binary logistic regression analysis demonstrated that the previous miscarriage history had no significant effect on these pregnancy outcomes.</p><p><strong>Conclusions: </strong>For patients receiving IVF-ET treatment, a miscarriage history is related to a lower oocyte utilization rate. However, there was no association between previous history of miscarriage and the pregnancy outcomes (e.g. miscarriage rate, pregnancy rate, live birth rate), once the patients had acceptable embryos for later transfer.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"684"},"PeriodicalIF":2.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551896","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":"Mandatory second opinion to reduce caesarean section rate among low-risk pregnant women at a private tertiary hospital, a pre and post intervention study: an analysis using WHO Robson classification.","authors":"Gregory Ntiyakunze, Amri Kyaruzi, Lynn Moshi, Munawar Kaguta, Jaiswal Shweta, Willbroad Kyejo, Tumbwene Mwansisya, Harrison Chuwa, Muzdalifat Abeid","doi":"10.1186/s12884-025-07814-7","DOIUrl":"10.1186/s12884-025-07814-7","url":null,"abstract":"<p><strong>Background: </strong>Caesarean section rate has increased globally even among low-risk obstetric deliveries. Therefore, more mothers and babies are subjected to potential complications associated with caesarean section. Hence, World Health Organization introduced measures to reduce unnecessary caesarean section, including worldwide accepted means of classifying all deliveries by the Robson's classification system and recommended safe non-medical interventions, such as mandatory second opinion prior caesarean section. Thus, this study aimed at comparing caesarean section rate pre and post introduction of mandatory second opinion prior caesarean section among low-risk pregnant women at a private hospital using Robson classification.</p><p><strong>Methodology: </strong>This was a pre and post intervention study design, conducted at tertiary private hospital. Data were collected from all deliveries before intervention period from May 2022 to December 2022 and after intervention from May 2023 to December 2023. The intervention was mandatory second opinion prior caesarean section for deliveries in group one and two. The relative risk was calculated to compare caesarean section rate before and after mandatory second opinion at the 95% confidence interval. T-test and Chi-square were used to compare the pregnancy outcome in pre and post intervention periods. Statistical significance was determined at p-value of < 0.05.</p><p><strong>Results: </strong>Total deliveries were 941 and 1107 before and post intervention period respectively. Caesarean section rate was 45.5% and 41.3% among low-risk groups (group one and two) in pre intervention and post intervention periods, relative risk of 0.921(95% CI: 0.75-1.11). There was no statistical significance regarding pregnancy outcome.</p><p><strong>Conclusion: </strong>This study illustrated high caesarean section rate in all Robson's groups. Mandatory second opinion alone had no statistical significance in reducing the Caesarean Section rate and impact on the pregnancy outcomes. Therefore, to reduce the rate of caesarean section interventions targeting patients, health care workers and health system may effectively tackle the drivers of elevated caesarean section rates, leading to substantial reductions at both the facility and national levels.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"698"},"PeriodicalIF":2.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551809","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":"Retrospective cohort of prenatal home ultrasound utilization and maternal-neonatal outcomes.","authors":"Anat Pardo, Erkan Kalafat, Shira Hazon, Monica Pailis, Emilie Klochendler-Frishman, Or Lee Rak, Ofri Samueloff, Rachel Gomez-Tolub, Anat Shmueli, Noam Pardo, Tomer Sela, Leor Wolff, Asnat Walfisch, Arnon Wiznitzer, Eran Hadar","doi":"10.1186/s12884-025-07664-3","DOIUrl":"https://doi.org/10.1186/s12884-025-07664-3","url":null,"abstract":"<p><strong>Background: </strong>Telehealth solutions, including ultrasound technology, are sought as a modality to enhance prenatal. We aimed to evaluate the utilization of a self-operated home ultrasound service in a real-world large cohort, comparing users vs. non-users. This service provides a handheld, app-connected ultrasound device for remote basic fetal monitoring, with its use determined at the discretion of the patient as a supplement - rather than a replacement - to standard prenatal care.</p><p><strong>Methods: </strong>Retrospective analysis comparing maternal and neonatal outcomes among users versus non-users of the home ultrasound service, between January 2020 and December 2022. Primary outcome measures were preterm delivery and a composite adverse neonatal outcome. Confounders were balanced between the groups using nearest neighbour matching with propensity scores. Multivariable analyses including the confounders were conducted in matched cohorts to obtain doubly robust estimates. A sensitivity analysis included those who began using the device before 22 gestational weeks and continued for more than 10 weeks. Safety was assessed by identifying any maternal, obstetrical, or neonatal complications plausibly linked to device use.</p><p><strong>Results: </strong>The study compared two cohorts; the exposed cohort of 4,460 pregnant women using Clalit's home ultrasound service (users), and the control (non-users) cohort of 102,707 pregnant women with an equal HMO insurance status. Users had higher socioeconomic scores, were more primiparous and had a higher incidence of chronic disease and pregnancy complications. Preterm birth rates and adverse neonatal outcomes did not differ between groups. Device utilization, both overall and stratified by actual utilization degree, was safe and not associated with any maternal, obstetrical or neonatal adverse pregnancy outcomes.</p><p><strong>Conclusions: </strong>A self-operated home ultrasound device, during the second and third trimester, is safe and not significantly associated with any pregnancy adverse event or neonatal complications.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"691"},"PeriodicalIF":2.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551894","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":"Early pregnancy triglycerides and blood pressure: a combined predictor for preeclampsia.","authors":"Ying Zhu, Hui Wang, Si-Yi Wei, Xue-Yuan Liu, Jian-Xia Fan, Chen-Ming Xu, Xian-Hua Lin, Dan-Dan Wu","doi":"10.1186/s12884-025-07761-3","DOIUrl":"10.1186/s12884-025-07761-3","url":null,"abstract":"<p><strong>Background: </strong>Increased blood pressure and triglyceride (TG) levels are linked to adverse pregnancy outcomes. Although the widespread acknowledgment that stage 2 hypertension serves as a significant predictor of preeclampsia, the prognostic significance of elevations in other blood pressure categories remains a subject of debate. Consequently, we intended to evaluate the joint influence of increased blood pressure and TG levels in the initial stages of pregnancy on preeclampsia risk and to identify a high-risk subgroup of individuals who require clinical attention.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including 78,016 individuals with singleton births at the Shanghai International Peace Maternity and Child Health Hospital (IPMCH) between January 2014 and December 2019. The study was approved by the IPMCH Institutional Review Board. Patients were classified into four groups on the basis of blood pressure readings taken during early stages of pregnancy: normotensive, elevated, stage 1 hypertension and stage 2 hypertension, stratified by TG levels (below or above the 90th percentile). Analysis using generalized additive models and logistic regression models was conducted to investigate the relationships among blood pressure, TG levels, and preeclampsia risk.</p><p><strong>Results: </strong>Among the 78,016 patients, 2,204 (2.83%) developed preeclampsia. Multivariate logistic regression revealed that both stage 1 and stage 2 hypertension in early stages of pregnancy markedly increased preeclampsia risk (adjusted odds ratio (AOR), 3.40 [95% CI, 3.05-3.80]; AOR, 6.96 [95% CI, 6.15-7.88]). Generalized additive models revealed that high TG levels significantly increased the probability of preeclampsia as blood pressure increased. Stratification by blood pressure and TG levels revealed that patients with high TG levels and stage 1 or 2 hypertension exhibited a significantly greater risk of preeclampsia when compared to those with normotensive and reference TG levels, with AORs of 5.52 (95% CI, 4.61-6.62) and 10.13 (95% CI, 8.23-12.46), respectively. Interaction analysis showed stage 1 hypertension and high TG demonstrated a 1.5-fold synergistic risk of preeclampsia (OR = 1.50, P = 0.021).</p><p><strong>Conclusion: </strong>The combination of increased blood pressure and high TG levels, especially high TG levels, which coincide with stage 1 or stage 2 hypertension, markedly heightened preeclampsia risk. Our findings indicate that the co-occurrence of stage 1 hypertension with high TG levels should be regarded as a notable risk factor for preeclampsia, approaching the risk level associated with stage 2 hypertension alone.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"704"},"PeriodicalIF":2.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551879","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":"Maternal health education and social support needs across the perinatal continuum of care: a thematic analysis of interviews with postpartum women in Punjab, India.","authors":"Preetika Sharma, Rashmi Bagga, Maliha Khan, Mona Duggal, Darshan Hosapatna Basavarajappa, Alka Ahuja, Ankita Kankaria, Nadia Diamond-Smith, Vijay Kumar, Manju Kashyap, Pushpendra Singh, Jasmeet Kaur, Alison M El Ayadi","doi":"10.1186/s12884-025-07813-8","DOIUrl":"https://doi.org/10.1186/s12884-025-07813-8","url":null,"abstract":"<p><strong>Background: </strong>Perinatal social support and maternal education throughout the antenatal, childbirth, and postpartum phases contribute to the optimization of health and well-being of mothers and infants. Understanding deficits among support and educational resources can contribute to improved public health decision-making and maternal and child healthcare and wellbeing. This study aimed to explore health and social experiences and resources to characterize and unmet needs across the perinatal period.</p><p><strong>Methods: </strong>We conducted a qualitative study among 20 primiparous postpartum women from Punjab state, North India. Potential participants were identified from antenatal care registers maintained at healthcare sub-centers and were interviewed at their homes. Data were analyzed thematically, examining social support resources and needs across perinatal phases by social support domain: emotional, tangible, and informational.</p><p><strong>Results: </strong>Study participants received the most social and educational support antenatally. We identified considerably low knowledge surrounding childbirth and low maternal knowledge and social support around postpartum care and practices. Notable issues reported involved lack of consent, and satisfaction and comfort with childbirth care. Participant narratives highlighted the crucial role of both formal and informal support structures, with a heavy reliance on advice from community health workers (ASHAs), midwives, and doctors. Unmet needs were identified in areas such as post-cesarean section diet and care, institutional childbirth, and ASHA support, along with discrepancies between the advice given and evidence-based practices. While many participants' support needs were met by their networks, these gaps highlight critical areas for systems improvement.</p><p><strong>Conclusion: </strong>This study-identified gaps in maternal knowledge and support, particularly in the post-cesarean and institutional childbirth contexts, are underexplored in existing research. Findings suggest critical areas for improvement in maternal healthcare support, particularly regarding the alignment of advice with evidence-based practices. Programs should focus on educating women about the institutional childbirth process and providing better postpartum care education, especially regarding post-cesarean care and infant care. Strengthening the role of community health workers (ASHAs) with evidence-based training can improve support. Additionally, programs should enhance the integration of both formal (doctors, midwives) and informal support networks to create a more comprehensive care system.</p><p><strong>Trial registration: </strong>This research is part of the formative phase of a larger intervention trial. Trial was prospectively registered with Clinical trial registry of India. (CTRI/2020/12/029800 [Registered on: 15/12/2020].</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"681"},"PeriodicalIF":2.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551811","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}