BMC Pregnancy and Childbirth最新文献

{"title":"Hybrid concept analysis of fear of childbirth based on pregnant women's experiences: a qualitative protocol study.","authors":"Elham Shirdel, Sakine Nazari, Soheila Mohamadirizi","doi":"10.1186/s12884-026-08712-2","DOIUrl":"10.1186/s12884-026-08712-2","url":null,"abstract":"<p><strong>Background: </strong>Clarifying the concept of fear of childbirth in pregnant women is crucial, especially for medical professionals like midwives and nurses. This research aims to analyze the concept of fear of childbirth based on the experiences and perspectives of Iranian pregnant women, as no previous study has focused on clarifying this phenomenon.</p><p><strong>Method: </strong>In this study, the hybrid concept analysis model will be used to analyze the concept of fear of childbirth in pregnant women. This model consists of three theoretical stages: literature review, field work, and final analysis. A literature review will be conducted to retrieve any definition and measurement, behaviors, antecedents, and consequences about concept of fear of childbirth in pregnant women. In the second phase the qualitative study will be conducted for extracting experiences and perspectives of pregnant women of fear of childbirth, using semi-structural interviews. In the third phase will involve a comprehensive analysis that combines the results from the previous two phases. We will compare the concept of fear of childbirth in the articles with the findings from the fieldwork phase, highlighting any differences between the data obtained from the fieldwork and the theoretical phase. We will then extract and report these differences.</p><p><strong>Discussion: </strong>The present study aims to provide an overview of the concept of fear of childbirth by reviewing texts, articles, tools, and the perceptions of pregnant women based on their lived experiences. The concept of \"fear of childbirth\" encompasses various types of anxiety and fear that women experience in relation to pregnancy and childbirth. Understanding the characteristics of this concept can help develop it in health systems and improve care before and during pregnancy.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629430","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":"Comment on: Managing sickle cell disease and related complications in pregnancy: results of an international Delphi panel.","authors":"Deva Sharma, Ilknur Pamuk, Kenneth I Ataga, Alexandra Benachi, Selim Büyükkurt, Sophie Lanzkron, Hakan Ozdogu, Shivan Pancham, Lydia H Pecker, Susan E Robinson, Safak Yilmaz Baran","doi":"10.1186/s12884-026-09721-x","DOIUrl":"10.1186/s12884-026-09721-x","url":null,"abstract":"<p><p>Consensus-based recommendations on managing sickle cell disease in pregnancy were recently published in a hematology journal. As this topic is also of great interest to obstetricians and gynecologists, we summarize some of these recommendations, while highlighting the challenges of providing evidence-based medical care to pregnant individuals with sickle cell disease.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618015","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 ultrasound findings associated with intrauterine CMV infection: a multicenter retrospective analysis of clinical and sonographic features.","authors":"Shilin Zhong, Yan Feng, Ruona Zheng, Taige Wu, Ting Lei, Lin Chen, Huanjun Wang, Mengzhi Hong, Xiaomei Zhang, Hongning Xie, Hao Huang, Xuan Huang","doi":"10.1186/s12884-026-09579-z","DOIUrl":"10.1186/s12884-026-09579-z","url":null,"abstract":"<p><strong>Background: </strong>To assess the association between prenatal ultrasonography and intrauterine Cytomegalovirus (CMV) infection and to elucidate its clinical characteristics.</p><p><strong>Methods: </strong>Cases were selected from three medical centers (2015-2024) in which amniotic fluid CMV-DNA testing was performed following prenatal ultrasound findings suggestive of CMV infection. CMV infection rates were analyzed in relation to distinct sonographic abnormalities. Associations between amniotic fluid viral load, imaging characteristics, and pregnancy outcomes were subsequently evaluated.</p><p><strong>Results: </strong>Among 1,174 pregnant women, 45 (3.83%) tested positive for CMV‑DNA in amniotic fluid. Sonographic findings with CMV infection rates exceeding 50% included fetal intracranial hyperechogenicity, intraventricular adhesions, hepatosplenomegaly, and placental thickening. The infection rate was significantly higher in fetuses with multiple abnormalities (10.42%) than with isolated findings (2.14%) (P<0.001). Combined intracranial and extracranial abnormalities carried a higher infection rate (13.41%) than purely intracranial (3.28%) or purely extracranial (2.76%) abnormalities (P<0.001). In CMV‑positive cases, amniotic fluid VL ranged from 1.1 × 10² to 7.71 × 10⁷ copies/mL (median 3.86 × 10⁵ copies/mL). VL was significantly elevated in cases with intracranial, severe, or non‑isolated abnormalities (P<0.05). Of 14 cases tested for cord blood CMV‑IgM, 10 (71.43%) were positive; intracranial abnormalities were present in 8 of these, but in none of the IgM‑negative cases. Maternal CMV‑IgM was positive in only 2/19 (10.53%) infected cases. Pregnancy was terminated in 25 cases; among 13 live‑born infants with follow‑up, 9 had normal outcomes, 3 had hearing impairment, and 1 had severe neurological sequelae.</p><p><strong>Conclusions: </strong>Specific prenatal ultrasound findings show a high rate of association with intrauterine CMV infection, especially when there are multiple abnormalities or when abnormalities involve both the intracranial and extracranial compartments. Amniotic fluid CMV-DNA load correlates positively with the presence of intracranial abnormalities and overall severity of ultrasound findings.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058269","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":"The role of climate change education on awareness, anxiety, and hope among pregnant women: a randomized controlled study.","authors":"Sevilay Aydın Çeli̇k, Beyzanur İşbay Aydemi̇r, Melike Di̇şsi̇z, Mine Akkuş Kala","doi":"10.1186/s12884-026-09698-7","DOIUrl":"10.1186/s12884-026-09698-7","url":null,"abstract":"<p><strong>Background: </strong>Climate change poses significant risks to physical and psychological health, particularly among vulnerable groups such as pregnant women. Awareness of climate-related threats can influence anxiety levels as well as coping mechanisms such as hope. This study aims to evaluate the effects of climate change education on pregnant women's awareness, anxiety, and hope.</p><p><strong>Methods: </strong>This randomized controlled pretest-posttest experimental study was conducted with 154 pregnant women who attended a public hospital in Istanbul between September 2025 and January 2026. Participants were randomly assigned to either the intervention group (n = 77) or the control group (n = 77). The intervention group received a 60-minute face-to-face training session focusing on climate change and pregnancy, whereas no intervention was applied to the control group. Data were collected before the intervention and four weeks afterward using the Climate Change Worry Scale, the Climate Change Awareness Scale, and the Climate Change Hope Scale. The data were analyzed using descriptive statistics (such as frequency, percentage, and mean), parametric tests (independent samples t-test and ANOVA).</p><p><strong>Results: </strong>The mean age of participants in the intervention group was 28.49 ± 6.55 years, while it was 27.99 ± 6.85 years in the control group. No significant differences were found between the groups in terms of individual and obstetric characteristics (p > 0.05). Following the intervention, significant increases were observed in climate change anxiety, awareness, and hope levels in the intervention group (p < 0.001). In contrast, the control group showed decreases in anxiety and hope levels, while awareness demonstrated only a limited increase (p < 0.05). Between-group comparisons revealed that posttest scores were significantly higher in the intervention group (p < 0.05). Repeated measures ANOVA indicated a significant interaction between group and time for all variables (p < 0.001). Effect sizes were found to be large (d = 1.30-2.20), indicating a strong impact of the intervention.</p><p><strong>Conclusion: </strong>The findings of this study demonstrate that climate change education is an effective intervention that significantly influences awareness, anxiety, and hope levels among pregnant women. These results suggest that structured educational programs for pregnant women may serve as a valuable tool in enhancing environmental awareness and supporting psychological well-being.</p><p><strong>Trial registration number: </strong>NCT07403513, www.</p><p><strong>Clinicaltrials: </strong>gov . Registered on January 29, 2026.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029682","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 weight gain status and body satisfaction among Kurdish women: a cohort study.","authors":"Rushna Ghazy Abdulwahid, Hamdia Mirkhan Ahmed","doi":"10.1186/s12884-026-09645-6","DOIUrl":"https://doi.org/10.1186/s12884-026-09645-6","url":null,"abstract":"<p><strong>Background: </strong>Appropriate gestational weight gain (GWG) is crucial for predicting maternal and infant morbidity and mortality, and is considered a key indicator of maternal and child health status worldwide. While excessive GWG is a concern in high- income countries, the prevalence of obesity and inadequate GWG remains unclear among Kurdish women. This study aimed to assess the status of gestational weight gain and body satisfaction among Kurdish pregnant women.</p><p><strong>Methods: </strong>A prospective cohort study was conducted among pregnant women attending antenatal care in two randomly selected primary health care centers in Erbil City. A purposive sample of 152 pregnant women was enrolled. Data were collected at four time points: on pregnancy diagnosis, 13 weeks, 26 weeks, and 37 weeks of gestation. Data were collected on sociodemographic, obstetrical history, physical measurements, and the Body Understanding Measure for pregnancy scale (BUMPs). Statistical analysis, including descriptive statistics, Fisher-Freeman-Halton Exact Test, and simple linear regression, was performed using SPSS version 27.</p><p><strong>Results: </strong>Obesity increased dramatically from 23.7% by 1st visit on pregnancy diagnosis to 74.3% by the 4th visit (37 weeks) among the total sample. A highly significant association was found between pre- pregnancy body mass index (BMI) and total weight gain in the third trimester (p < 0.001). The majority of women who started pregnancy as overweight (79.7%) or obese (88.9%) experienced excessive weight gain compared to those who had a normal BMI. A highly significant association was found between overall body understanding at the 4th visit and total GWG (p < 0.001). A significant association was found between socioeconomic status and weight gain (p = 0.027), with women in the middle socioeconomic group showing the highest proportion of high weight gain (64.9%).</p><p><strong>Conclusions: </strong>Pre-pregnancy BMI is a strong predictor of total GWG, with overweight and obese women being highly prone to excessive gain. Furthermore, lower levels of body understanding satisfaction are significantly associated with high total weight gain.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227099","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":"Human chorionic gonadotropin levels of cesarean scar pregnancy compared with those of other ectopic pregnancies: a retrospective cohort study.","authors":"Nobuyuki Kidera, Tomonori Ishikawa, Toshihiro Kawamura, Naoyuki Miyasaka","doi":"10.1186/s12884-026-09706-w","DOIUrl":"https://doi.org/10.1186/s12884-026-09706-w","url":null,"abstract":"<p><strong>Background: </strong>A cesarean scar pregnancy (CSP) is an abnormal implantation of an embryo within a previous cesarean section scar and considered a relatively rare form of ectopic pregnancy. We aimed to clarify the factors associated with CSP and evaluate whether differences in serum human chorionic gonadotropin (hCG) levels according to implantation site could contribute to early detection of CSP.</p><p><strong>Methods: </strong>We investigated 27,528 freeze-thawed embryo transfer cycles performed at our hospital between January 2016 and March 2025.</p><p><strong>Results: </strong>Forty-four patients were diagnosed with ectopic pregnancy: 26 had tubal pregnancies, 10 had cervical pregnancies, 5 had CSP, 2 had peritoneal pregnancy, and 1 had an ovarian pregnancy. History of myomectomy and ≥ 2 cesarean sections showed significant differences in the logistic regression analysis (history of myomectomy: P = 0.003, history of > 2 cesarean sections: P = 0.006). The hCG levels (median [interquartile range {IQR}]) for ectopic pregnancy were 58.15 mIU/mL (33.0-100.3) for cervix, 179.0 mIU/mL (150.8-294.1) for CSP, 24.3 mIU/mL (8.8-49.7) for fallopian tube, and 9.1 mIU/mL for others (ovary and peritoneal pregnancy). There was a significant difference between CSP and all non-CSP ectopic pregnancies combined (P = 0.001). The hCG level for clinical intrauterine pregnancy was 235.6 mIU/mL (136.6-382.4). There was a significant difference in hCG levels between clinical pregnancy and ectopic pregnancy (P < 0.001), but this significant difference disappeared when clinical pregnancy was compared with CSP (P = 0.607).</p><p><strong>Conclusions: </strong>Serum hCG levels in early pregnancy were higher in CSP than in other ectopic pregnancies. Even in the presence of high serum hCG levels during early pregnancy, CSP should be considered if there is a history of cesarean section, especially > 2 cesarean deliveries. The study included only five CSP cases, one of which was a duplicate case from a different treatment cycle. Consequently, the findings should be considered exploratory. Given the limited sample size, additional cases should be included and the statistical analysis repeated to ensure the robustness of the results.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227083","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":"Umbilical cord ulceration complicating fetal upper gastrointestinal obstruction: a case report.","authors":"Yuanyuan Zhu, Tangyi Geng, Miao Qian, Yun Gu, Li Zhang, Rui Zhang","doi":"10.1186/s12884-026-09666-1","DOIUrl":"https://doi.org/10.1186/s12884-026-09666-1","url":null,"abstract":"<p><p>Umbilical cord ulceration (UCU) is an uncommon but devastating cause of acute fetal hemorrhage, often associated with fetal upper gastrointestinal obstruction. We report a woman aged 30-35 years (gravida 4, para 1) referred at 23 weeks of gestation for suspected fetal gastrointestinal abnormality. Prenatal ultrasonography showed an enlarged fetal stomach with a double-bubble sign, and subsequent examinations demonstrated progressive polyhydramnios with increasing bowel dilatation. At 32 weeks and 4 days of gestation, after previously reassuring fetal assessment, the fetal heart rate suddenly fell and remained at 90-97 beats per minute, prompting emergency caesarean delivery. A large volume of blood stained amniotic fluid was noted and a longitudinal vessel rupture at the fetal end of the umbilical cord was identified with active bleeding. The neonate had profound anemia and died after withdrawal of care. Histopathology confirmed umbilical cord ulceration with vessel rupture and erythrocyte extravasation. This case highlights the abrupt onset of UCU and supports heightened surveillance when fetal upper gastrointestinal obstruction is suspected.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227139","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":"Acceptability and uptake of COVID-19 vaccines among pregnant and lactating women seeking services at a tertiary public hospital in Kampala, Uganda.","authors":"Elizabeth B Katana, Eva Agnes Laker Odongpiny, Brenda N Simbwa, Edirisa J Nsubuga, Josephine Namayanja, Richard Muhindo, Daniel Kiiza, Barbara Castelnuovo, Alex R Ario, Catriona Waitt","doi":"10.1186/s12884-026-09708-8","DOIUrl":"https://doi.org/10.1186/s12884-026-09708-8","url":null,"abstract":"<p><strong>Background: </strong>Globally, several vaccines, including COVID-19 vaccines, have been routinely recommended during pregnancy and lactation. However, data on COVID-19 vaccine acceptability and uptake among pregnant and lactating women are limited in Sub-Saharan Africa. While COVID-19 is no longer a public health emergency it is important to take stock of lessons learnt to prepare for future health threats including those that disproportionately affect pregnant/lactating women. We aimed to assess acceptability and uptake of COVID-19 vaccines among pregnant and lactating women in Uganda.</p><p><strong>Methods: </strong>This was a cross-sectional study conducted among 424 pregnant and lactating women, who were seeking maternal and child health care at Kawempe National Referral Hospital in Kampala conducted between May and July 2023. We obtained data on vaccine acceptability defined as willingness to accept vaccines using interviewer-administered questionnaires. In addition, we assessed vaccination status. Factors associated with COVID-19 vaccine acceptability and uptake were evaluated using modified Poisson regression.</p><p><strong>Results: </strong>The mean age of the respondents was 26.9 years (SD = 5.7), ranging from 14 to 45 years. Among 424 respondents, 51.6% had received at least one dose of COVID-19 vaccine, 94.1% had received tetanus toxoid vaccine, and 48.4% regardless of their vaccination status, were willing to receive COVID-19 vaccines. Only 5/212(2.4%) had received COVID-19 vaccines while lactating with none having been received during pregnancy. Factors associated with COVID-19 vaccine uptake included history of testing for COVID-19 (aPR = 1.92, CI:1.46-2.54) and having a vaccinated household member (aPR = 1.34, CI:1.03-1.84). COVID-19 vaccine willingness was significantly associated with being a household head (aPR = 2.2, CI:1.12-4.27) and having a vaccinated household member (aPR = 1.33, CI:1.04-1.76).</p><p><strong>Conclusion: </strong>COVID-19 vaccine acceptance among pregnant and lactating women remains suboptimal despite high acceptance of other maternal vaccines. These findings highlight the need for targeted interventions to improve the acceptance and uptake of COVID-19 vaccines, during pregnancy and lactation. Strengthening risk communication, addressing safety concerns, and leveraging trusted sources of information may enhance vaccine confidence and improve uptake during pregnancy and lactation.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227090","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":"Combined albumin-adjusted ischemia-modified albumin ratio and uterine artery Doppler for differentiating early-onset preeclampsia from gestational hypertension: a prospective exploratory pilot study.","authors":"Serkan Özbey, Handan Turhan Karakuş, Alper Gümüş, Pakizer Banu Kılıçoğlu Dane","doi":"10.1186/s12884-026-09700-2","DOIUrl":"https://doi.org/10.1186/s12884-026-09700-2","url":null,"abstract":"<p><strong>Background: </strong>Distinguishing early-onset preeclampsia (EO-PE) from gestational hypertension (GHT) at initial presentation remains challenging, particularly when classical diagnostic features are absent or evolving. We evaluated whether combining the albumin-adjusted ischemia-modified albumin ratio (IMAR) with uterine artery pulsatility index expressed as multiples of the median (UtA-PI MoM) provides complementary information in this setting.</p><p><strong>Methods: </strong>In this prospective single-center exploratory study, 90 singleton pregnancies (30 EO-PE, 30 GHT, 30 controls) were included. IMAR and UtA-PI MoM were assessed individually and in combination using receiver operating characteristic analysis and logistic regression with bootstrap internal validation.</p><p><strong>Results: </strong>IMAR and UtA-PI MoM were higher in EO-PE than in GHT (p = 0.003 and p < 0.001, respectively), whereas raw IMA did not distinguish the groups. IMAR demonstrated moderate discrimination (AUC 0.727, 95% CI 0.600-0.854), and UtA-PI MoM demonstrated higher performance (AUC 0.844, 95% CI 0.743-0.946). The combined model showed the highest apparent discrimination (AUC 0.898, 95% CI 0.818-0.977; optimism-corrected AUC 0.889), with 83.3% sensitivity and 86.7% specificity at the exploratory operating point.</p><p><strong>Conclusions: </strong>Combining IMAR with UtA-PI MoM may provide complementary information for distinguishing EO-PE from GHT at initial presentation. This exploratory model is not intended to replace established angiogenic biomarkers and requires validation in larger, multicenter studies before clinical application.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223437","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":"Fetal cardiac interventions versus expectant management in congenital heart disease: a systematic review and meta-analysis.","authors":"Peng Ning, Junhui Liu, Shuting Lin, Chenyue Zhao, Zhixian Ji, Silin Pan","doi":"10.1186/s12884-026-09703-z","DOIUrl":"https://doi.org/10.1186/s12884-026-09703-z","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate biventricular circulation (BVC), live birth, and postnatal mortality after fetal cardiac intervention (FCI) compared with expectant management, and to examine outcomes according to technical success of FAV.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Embase, Web of Science, and Cochrane Library were searched from database inception through 31 December 2025 for observational FCI studiehis systematic review and meta-analysis followed PRISs. The primary analysis was limited to studies with an internal expectant-management comparator; eligible non-comparative FAV studies were considered only for the secondary technical-success analysis. Random-effects meta-analyses were performed in Stata, and heterogeneity was assessed using I².</p><p><strong>Results: </strong>Eleven comparative reports representing 11 independent study populations were included in the primary FCI-versus-expectant-management synthesis, comprising 775 fetuses (418 interventions and 357 controls). Overall FCI estimates included both technically successful and unsuccessful procedures. Among cohorts with available live-birth data, live birth occurred in 271/315 (86.0%) FCI cases and 287/319 (90.0%) controls, with no significant difference between groups (OR 0.680, 95% CI 0.350-1.320; p = 0.256). Postnatal death among live-born infants with available postnatal outcome data occurred in 53/271 (19.6%) in the FCI group and 94/287 (32.8%) in the expectant-management group and was lower after FCI (OR 0.457, 95% CI 0.280-0.746; p = 0.002). For FAV, postnatal death among live-born infants was lower (OR 0.419, 95% CI 0.216-0.813; p = 0.010), whereas BVC showed a non-significant trend (OR 2.260, 95% CI 0.970-5.290; p = 0.060). Fetal pulmonary valvuloplasty (FPV) showed no significant association with BVC (OR 2.430, 95% CI 0.880-6.760; p = 0.088) or postnatal death among live-born infants (OR 0.432, 95% CI 0.098-1.909; p = 0.268). Technically successful FAV was associated with higher odds of BVC and live birth compared with unsuccessful FAV. Fetal atrial septal intervention (FASI) analyses included live birth and postnatal death among live-born infants only. No statistically significant difference was found for live birth (OR 0.480, 95% CI 0.110-2.060; p = 0.325) or postnatal death among live-born infants (OR 0.433, 95% CI 0.127-1.482; p = 0.183).</p><p><strong>Conclusions: </strong>FAV was associated with lower odds of postnatal death among live-born infants and showed a non-significant trend toward improved BVC, while technically successful FAV was associated with higher odds of BVC and live birth than unsuccessful FAV. In contrast, comparative evidence for FPV and FASI remains sparse, and these findings should be interpreted as exploratory.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227156","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}