BMC Pregnancy and Childbirth最新文献

{"title":"Association between sleep quality and weight gain in pregnancy: a cross-sectional study.","authors":"Ana Paula Santos Costa Roberto, Ana Beatriz Henrique Parenti, Caroline de Barros Gomes, Maria Antonieta de Barros Leite Carvalhaes, Cristina Maria Garcia de Lima Parada","doi":"10.1186/s12884-024-06965-3","DOIUrl":"10.1186/s12884-024-06965-3","url":null,"abstract":"<p><strong>Introduction: </strong>There are grounds for the hypothesis that poor sleep quality, regardless of the pre-gestational nutritional status, is a risk factor for inadequate gestational weight gain.</p><p><strong>Objective: </strong>To investigate the association between sleep quality and insufficient or excessive gestational weight gain in Brazilian pregnant women without gestational complications and monitored in public prenatal care units.</p><p><strong>Methods: </strong>This is a cross-sectional study nested within a cohort study that reviewed pregnant women's mental health, sleep, and nutritional outcome. Data collection was carried out from May 2018 to June 2019 through face-to-face and telephone interviews and consultation of pregnant women's medical records. Sleep quality was assessed using the Mini-sleep Questionnaire. The pregnancy weight gain was measured based on the Institute of Medicine's recommendations. Univariate and multivariate Poisson regression analysis was used for the two outcomes: insufficient or excessive weight gain, using pregnant women with adequate weight gain as the reference category. Associations were considered significant when p < 0.05.</p><p><strong>Results: </strong>The prevalence of severe sleep disorders was high: 63.4% of pregnant women experienced this condition. Severe sleep disorders enhanced independently the risk of insufficient gestational weight gain (PR = 2.40; 95% CI = 1.06-5.42, p = 0.035). There was no association between sleep disorders and excessive gestational weight gain.</p><p><strong>Conclusion: </strong>The hypothesis that poor sleep quality influences gestational weight gain was confirmed. Severe sleep disorders, a highly prevalent condition, significantly increased the prevalence of insufficient gestational weight gain, yet it was not associated with excessive weight gain. Thus, educational actions should be included in the preconception and prenatal periods, in order to encourage the adoption of habits that favor sleep quality, an intervention that may have positive effects in reducing insufficient gestational weight gain.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"779"},"PeriodicalIF":2.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715251","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":"Deep learning model using continuous skin temperature data predicts labor onset.","authors":"Chinmai Basavaraj, Azure D Grant, Shravan G Aras, Elise N Erickson","doi":"10.1186/s12884-024-06862-9","DOIUrl":"10.1186/s12884-024-06862-9","url":null,"abstract":"<p><strong>Background: </strong>Changes in body temperature anticipate labor onset in numerous mammals, yet this concept has not been explored in humans. We investigated if continuous body temperature exhibits similar changes in women and whether these changes may be linked to hormonal status. Finally, we developed a deep learning model using temperature patterning to provide a daily forecast of time to labor onset.</p><p><strong>Methods: </strong>We evaluated patterns in continuous skin temperature data in 91 (n = 54 spontaneous labors) pregnant women using a wearable smart ring. In a subset of 28 pregnancies, we examined daily steroid hormone samples leading up to labor to analyze relationships among hormones and body temperature trajectory. Finally, we applied an autoencoder long short-term memory (AE-LSTM) deep learning model to provide a novel daily estimation of days until labor onset.</p><p><strong>Results: </strong>Features of temperature change leading up to labor were associated with urinary hormones and labor type. Spontaneous labors exhibited greater estriol to α-pregnanediol ratio, as well as lower body temperature and more stable circadian rhythms compared to pregnancies that did not undergo spontaneous labor. Skin temperature data from 54 pregnancies that underwent spontaneous labor between 34 and 42 weeks of gestation were included in training the AE-LSTM model, and an additional 37 pregnancies that underwent artificial induction of labor or Cesarean without labor were used for further testing. The input to the pipeline was 5-min skin temperature data from a gestational age of 240 days until the day of labor onset. During cross-validation AE-LSTM average error (true - predicted) dropped below 2 days at 8 days before labor, independent of gestational age. Labor onset windows were calculated from the AE-LSTM output using a probabilistic distribution of model error. For these windows AE-LSTM correctly predicted labor start for 79% of the spontaneous labors within a 4.6-day window at 7 days before true labor, and 7.4-day window at 10 days before true labor.</p><p><strong>Conclusion: </strong>Continuous skin temperature reflects progression toward labor and hormonal change during pregnancy. Deep learning using continuous temperature may provide clinically valuable tools for pregnancy care.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"777"},"PeriodicalIF":2.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715175","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":"How power and knowledge hierarchies affect communication in intrapartum care: findings from public health facilities in two southern Indian districts.","authors":"Abha Rao, V Srinidhi, Baneen Karachiwala, Sanjana Santosh, Shreelata Rao Seshadri, Sophia Thomas, Sreeparna Chattopadhyay, Anuradha Sreevathsa, Gita Sen","doi":"10.1186/s12884-024-06973-3","DOIUrl":"10.1186/s12884-024-06973-3","url":null,"abstract":"<p><strong>Background: </strong>Effective communication is a key element of medical care; it can foster a warm interpersonal relationship, facilitate the exchange of information, and enable shared decision-making. In the context of obstetric care, it is associated with a range of positive clinical and social outcomes for mother and baby. Extant communication frameworks and respectful maternity care (RMC) guidelines emphasize the importance of effective communication during intrapartum care. Yet, studies conducted in Indian public health settings suggest that there are gaps in the implementation of RMC guidelines.</p><p><strong>Methods: </strong>As part of a larger study on disrespect and abuse in Indian public hospitals, we studied the nature of communication in the intrapartum context and the extent to which it is respectful. The study is based on interviews with 29 providers across different levels of public health facilities. Interviews were translated, transcribed, and thematically coded. We examined codes related to communication to understand what kinds of communication occur during intrapartum care and the role played by knowledge and power hierarchies. We then considered their implications for RMC.</p><p><strong>Results: </strong>We identified four types of communication that occurred in the context of intrapartum care: (a) compassionate, to comfort and support the laboring woman, (b) factual, to obtain or provide information or updates, (c) prescriptive, to obtain consent and cooperation from the woman and her family members, and (d) defensive, to protect against accusations of poor care. Knowledge and power hierarchies operated differently in each type of communication, with prescriptive and defensive communication more likely to be disrespectful than others.</p><p><strong>Conclusions: </strong>Our findings suggest that successful implementation of RMC guidelines requires greater attention to knowledge and power hierarchies, and an understanding of the ways in which they operate in a clinical setting. Integrating this understanding into guidelines, medical education, training programmes, and interventions will facilitate effective and respectful communication during maternity care.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"781"},"PeriodicalIF":2.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715178","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":"Socio-cultural practices and experience of mothers' post stillbirth and newborn death: a population-based perspective from India.","authors":"Moutushi Majumder, G Anil Kumar, Sarah Binte Ali, Sibin George, Siva Prasad Dora, Md Akbar, Shuchi Sree Akhouri, Sweta Kumari, Tanmay Mahapatra, Rakhi Dandona","doi":"10.1186/s12884-024-06906-0","DOIUrl":"10.1186/s12884-024-06906-0","url":null,"abstract":"<p><strong>Introduction: </strong>We report on post stillbirth and newborn death socio-cultural experience of women from a population-based representative sample in the Indian state of Bihar.</p><p><strong>Methods: </strong>A state-representative sample of 7,270 births between July 2020 and June 2021 was sampled, including 582 stillbirths and 831 newborn deaths. Detailed confidential interviews were conducted with the consenting women with stillbirth and newborn death to understand their post-birth experience.</p><p><strong>Results: </strong>A total of 501 (86.1% participation) women with stillbirth and 717 (86.3% participation) with neonatal death provided interview. Able to talk to someone about their baby and receiving support to cope with their loss were reported by 369 (74.2%) and 398 (80.2%) women with stillbirth; these proportions were 76.7% and 77.3% for women with newborn deaths, respectively. More than 80% of these women reported spouses as their main source of support. At least one negative experience was reported by 150 (30.9%) and 233 (32.5%) women with stillbirth and newborn death, respectively. The most commonly reported negative experience was receiving insensitive/hurtful comments about the baby (18.6% for stillbirth and 20.4% for newborn deaths), followed by being blamed for the baby's death (14.3% for stillbirths and 15.0% for newborn deaths). The majority of women reported being verbally abused by the mother-in-law for both stillbirth (24, 63.2%) and newborn death (49, 64.5%); while 48 (67.6%) and 66 (61.7%) women were blamed by the mother-in-law for stillbirth and neonatal death, respectively. Most women with stillbirth (72.7%) and with neonatal death (77.1%) were asked to forget about their babies as a means to cope with their loss. Naming, seeing, and holding the stillborn were reported by 56 (11.2%), 229 (45.9%), and 64 (12.8%) women with a stillborn.</p><p><strong>Conclusion: </strong>With one-third women with adverse birth outcome reporting negative experience, this translates into a significant number of women in India as it accounts for high numbers of stillbirths and newborn deaths globally. These population-based data can facilitate in designing interventions to improve post-partum experience for women with adverse birth outcomes in India.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"778"},"PeriodicalIF":2.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715284","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":"Smartphone pregnancy apps: systematic analysis of features, scientific guidance, commercialization, and user perception.","authors":"Michael Nissen, Shih-Yuan Huang, Katharina M Jäger, Madeleine Flaucher, Adriana Titzmann, Hannah Bleher, Constanza A Pontones, Hanna Huebner, Nina Danzberger, Peter A Fasching, Bjoern M Eskofier, Heike Leutheuser","doi":"10.1186/s12884-024-06959-1","DOIUrl":"10.1186/s12884-024-06959-1","url":null,"abstract":"<p><strong>Background: </strong>Over 50% of pregnant women use pregnancy applications (apps). Some app s lack credibility, information accuracy, and evidence-based clinical advice, containing potentially harmful functionality. Previous studies have only conducted a limited analysis of pregnancy app functionalities, expert involvement/evidence-based content, used commercialization techniques, and user perception.</p><p><strong>Methods: </strong>We used the keyword \"pregnancy\" to scrape (automatically extract) apps and app information from Apple App Store and Google Play. Unique functionalities were derived from app descriptions and user reviews. App descriptions were screened for evidence-based content and expert involvement, and apps were subsequently analyzed in detail. Apps were opened and searched for used commercialization techniques, such as advertisements or affiliate marketing. Automated text analysis (natural language processing) was used on app reviews to assess users' perception of evidence-based content/expert involvement and commercialization techniques.</p><p><strong>Results: </strong>In total, 495 apps were scraped. 226 remained after applying exclusion criteria. Out of these, 36 represented 97%/88% of the total market share (Apple App Store/Google Play), and were thus considered for review. Overall, 49 distinct functionalities were identified, out of which 6 were previously unreported. Functionalities for fetal kick movement counting were found. All apps are commercial. Only 15 apps mention the involvement of medical experts. 10.3% of two-stars user reviews include commercial topics, and 0.6% of one-/two-/three-/five stars user reviews include references to scientific content accuracy.</p><p><strong>Conclusion: </strong>Problematic features and inadequate advice continue to be present in pregnancy apps. App developers should adopt an evidence-based development approach and avoid implementing as many features as possible, potentially at the expense of their quality or over-complication (\"feature creep\"). Financial incentives, such as grant programs, could support adequate content quality. Caregivers play a key role in pregnant individuals' decision-making, should be aware of potential dangers, and could guide them to trustworthy apps.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"782"},"PeriodicalIF":2.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of risk for early or very early preterm births using high-resolution urinary metabolomic profiling.","authors":"Yaqi Zhang, Karl G Sylvester, Ronald J Wong, Yair J Blumenfeld, Kuo Yuan Hwa, C James Chou, Sheeno Thyparambil, Weili Liao, Zhi Han, James Schilling, Bo Jin, Ivana Marić, Nima Aghaeepour, Martin S Angst, Brice Gaudilliere, Virginia D Winn, Gary M Shaw, Lu Tian, Ruben Y Luo, Gary L Darmstadt, Harvey J Cohen, David K Stevenson, Doff B McElhinney, Xuefeng B Ling","doi":"10.1186/s12884-024-06974-2","DOIUrl":"10.1186/s12884-024-06974-2","url":null,"abstract":"<p><strong>Background: </strong>Preterm birth (PTB) is a serious health problem. PTB complications is the main cause of death in infants under five years of age worldwide. The ability to accurately predict risk for PTB during early pregnancy would allow early monitoring and interventions to provide personalized care, and hence improve outcomes for the mother and infant.</p><p><strong>Objective: </strong>This study aims to predict the risks of early preterm (< 35 weeks of gestation) or very early preterm (≤ 26 weeks of gestation) deliveries by using high-resolution maternal urinary metabolomic profiling in early pregnancy.</p><p><strong>Design: </strong>A retrospective cohort study was conducted by two independent preterm and term cohorts using high-density weekly urine sampling. Maternal urine was collected serially at gestational weeks 8 to 24. Global metabolomics approaches were used to profile urine samples with high-resolution mass spectrometry. The significant features associated with preterm outcomes were selected by Gini Importance. Metabolite biomarker identification was performed by liquid chromatography tandem mass spectrometry (LCMS-MS). XGBoost models were developed to predict early or very early preterm delivery risk.</p><p><strong>Setting and participants: </strong>The urine samples included 329 samples from 30 subjects at Stanford University, CA for model development, and 156 samples from 24 subjects at the University of Alabama, Birmingham, AL for validation.</p><p><strong>Results: </strong>12 metabolites associated with PTB were selected and identified for modelling among 7,913 metabolic features in serial-collected urine samples of pregnant women. The model to predict early PTB was developed using a set of 12 metabolites that resulted in the area under the receiver operating characteristic (AUROCs) of 0.995 (95% CI: [0.992, 0.995]) and 0.964 (95% CI: [0.937, 0.964]), and sensitivities of 100% and 97.4% during development and validation testing, respectively. Using the same metabolites, the very early PTB prediction model achieved AUROCs of 0.950 (95% CI: [0.878, 0.950]) and 0.830 (95% CI: [0.687, 0.826]), and sensitivities of 95.0% and 60.0% during development and validation, respectively.</p><p><strong>Conclusion: </strong>Models for predicting risk of early or very early preterm deliveries were developed and tested using metabolic profiling during the 1st and 2nd trimesters of pregnancy. With patient validation studies, risk prediction models may be used to identify at-risk pregnancies prompting alterations in clinical care, and to gain biological insights of preterm birth.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"783"},"PeriodicalIF":2.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715182","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":"Provider advice, pregnant persons' expectations, and actual gestational weight gain among United States military health care beneficiaries: a secondary analysis of a randomized controlled trial.","authors":"Erin Solomon, Abby McPhail, Zoran Bursac, Melissa A Little, G Wayne Talcott, Rebecca A Krukowski","doi":"10.1186/s12884-024-06987-x","DOIUrl":"10.1186/s12884-024-06987-x","url":null,"abstract":"<p><strong>Introduction: </strong>Healthy gestational weight gain (GWG) is associated with improved pregnancy and delivery outcomes. Previous literature shows provider advice and expectations regarding GWG significantly associated with GWG outcomes. In this study, we explore the influence of these factors on GWG in a military population in this secondary analysis of data from a randomized controlled trial.</p><p><strong>Materials and methods: </strong>Participants (N = 377) came from a completed randomized controlled trial focused on behavioral interventions for healthy GWG and/or postpartum weight loss among TRICARE beneficiaries. At baseline, participants filled out a 5-item questionnaire assessing provider advice and self-expectations for GWG. For the actual GWG primary outcome variable, we calculated the difference between the weight obtained in the first trimester and the weight obtained at 36 weeks of gestation. We used regression models to assess the predictive ability of expectations about GWG on actual GWG.</p><p><strong>Results: </strong>Participants with higher baseline BMIs were more likely to expect excessive GWG as defined by the National Academy of Medicine (NAM; Overweight: 46.3%, Obesity: 65.4%). Participants' expectations showed a significant association with actual GWG (OR 2.1, 95% CI 1.29-3.41, p = 0.003). Most participants (64.7%) reported no provider advice about how much weight to gain during their pregnancy. Of those who did receive advice, 55.4% reported that it was within the NAM guidelines.</p><p><strong>Conclusions: </strong>The study documented infrequent provider advice about GWG in a large sample of TRICARE beneficiaries (i.e., both active duty and non-active duty individuals) and supported an association between self-expectations and later actual GWG. Future studies might test strategies to increase/improve provider advice regarding GWG and to aid pregnant individuals in shaping and achieving their GWG expectations.</p><p><strong>Clinical trial registration: </strong>The trial was prospectively registered on clinicaltrials.gov (NCT03057808) on February 20, 2017.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"785"},"PeriodicalIF":2.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715198","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":"Impact of healthy pregnancy and lifestyle in mothers on developmental delay in their offspring: a strength-based analysis of a longitudinal study among indigenous children in Australia.","authors":"Md Irteja Islam, Thomas Stubbs, Tuguy Esgin, Alexandra Martiniuk","doi":"10.1186/s12884-024-06990-2","DOIUrl":"10.1186/s12884-024-06990-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Extensive literature has investigated the prenatal risk factors of developmental delay in children, with evidence highlighting the impact of prenatal health, mental health, and behavioural factors. While a deficit discourse has underscored Indigenous health research and policies, strengths-based approaches provide an opportunity to reframe this discourse, to illustrate and celebrate the strength and resilience of Australian Indigenous families. As such, this study aimed to identify the protective impact of healthy pregnancy and lifestyle in mothers on developmental delay in Indigenous Australian children; and whether it varies by child birthweight adjusted for gestational age. Further, we also tested whether child birthweight for adjusted gestational age mediates the association between a healthy pregnancy and lifestyle in mothers and developmental delay in their Indigenous offspring.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Strength-based analysis was conducted using data from 8 longitudinal waves of LSIC study in Australia. Random-effect models were used to longitudinally measure the impact of maternal healthy pregnancy and lifestyle on developmental delays in their children between 2008 and 2018. A composite score (ranging from 0 to 3, score = 3 refers to most healthy pregnancy) was created for a healthy pregnancy and lifestyle variable using three criteria - (1) a lack of medical conditions, (2) no substance use including smoking/alcohol/illicit drugs, and (3) intake of iron/folic acid during pregnancy. All models were adjusted for potential covariates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 780 mother-child dyads analysed, 65.4% of mothers reported healthy pregnancy and lifestyle; while 73.5% of children born with a recommended appropriate birthweight adjusted for gestational age, and 91.4% reported no developmental delays. In children born in the recommended range of appropriate birthweight adjusted for gestational age, healthy pregnancy in mothers (most healthy, aOR: 4.76, 95% CI: 1.12-20.18; and 2nd most healthy, aOR: 4.02, 95% CI: 1.09-14.83) was protective against development delay compared to maternal unhealthy pregnancy. Living in remote areas (vs. major city, and regional) was also found to be protective against developmental delay in those who were born within the recommended range of birthweight adjusted for gestational age. Further, the current study found that child birthweight for adjusted gestational age does not have any mediating effect on the association between healthy pregnancy in mothers and developmental delay in their children.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This strengths-based study suggests healthy pregnancy in mothers should be advocated to prevent developmental delay in their offspring in the Australian Indigenous population. The findings also found living in remote areas has a protective effect against developmental delay in Indigenous children who born within the recommended range of ","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"776"},"PeriodicalIF":2.8,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695254","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":"Glycated albumin levels in the third trimester of women with gestational diabetes mellitus are associated with adverse pregnancy-related outcomes.","authors":"Yueshuai Pan, Ruting Gu, Qianqian Li, Jingyuan Wang, Yan Zhang, Lin Zhao, Yue Wu, Lili Wei","doi":"10.1186/s12884-024-06994-y","DOIUrl":"10.1186/s12884-024-06994-y","url":null,"abstract":"<p><strong>Background: </strong>Glycated albumin (GA) levels have been considered as a promising biomarker for estimating glycemic control during pregnancy, but the relationship between GA levels and the incidence of adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM) remains unclear. Our study aimed to investigate the relationship between GA levels during the third trimester and 13 different adverse pregnancy-related outcomes among women with GDM in China.</p><p><strong>Methods: </strong>We retrospectively extracted clinical data from the medical records of 819 pregnant women with GDM who underwent prenatal examinations and child delivery at the Affiliated Hospital of Qingdao University between January 2022 and October 2022. The cohort was divided into GA-high (GA-H) and GA-low (GA-L) groups based on the median GA level of 10.6%. Then, the incidence rates of 13 specific adverse pregnancy outcomes were compared between the two groups. Furthermore, we estimated the mean GA levels in pregnant GDM women with or without specific adverse outcomes. Multivariate logistic regression analysis was performed to assess whether the GA levels (high or low) were independent risk factors for specific adverse outcomes in pregnant women with GDM. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive value of GA levels for the adverse pregnant outcomes in women with GDM. E-value for sensitivity analysis was performed to assess the robustness of the findings to unmeasured confoundings.</p><p><strong>Results: </strong>We included 819 pregnant women with GDM, whose average age was 33.09 ± 4.47 years, average pre-pregnancy BMI was 23.51 ± 3.67 kg/m², and the average gestational week in which GDM diagnosed was 24.80 ± 1.79 weeks. The analysis showed that 80.71% (661/819) pregnant women with GDM were associated with adverse pregnancy-related outcomes. Pregnant women in the GA-L group showed higher incidence of the premature rupture of membranes (PROM), whereas those in the GA-H group showed higher incidence of neonatal hypoglycemia. The GA levels showed acceptable clinical performance for predicting neonatal hypoglycemia with an area under the ROC curve (AUC) value of 0.700 (P = 0.010), sensitivity of 71.4%, and specificity of 70.2%. The optimal cut off value for GA was 11.55%.</p><p><strong>Conclusions: </strong>This study demonstrated that GA levels were significantly associated with specific adverse pregnancy outcomes, especially PROM and neonatal hypoglycemia. Furthermore, GA levels in the third trimester showed acceptable clinical performance for predicting neonatal hypoglycemia among pregnant women with GDM. In the future, the potential role of GA as a predictor of adverse pregnancy outcomes need to be further confirmed and explored in GDM women.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"774"},"PeriodicalIF":2.8,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695249","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":"Effect of day 3 embryo cell number on the pregnancy and neonatal outcomes of day 4 single embryo transfer from fresh cycles.","authors":"Lin-Lin Tao, Bo Zheng, Guo-Zhen Li, Ya-Song Geng, Yu-Ying Guo, Hao-Yang Dai, Shu-Song Wang, Fang-Fang Dai","doi":"10.1186/s12884-024-06976-0","DOIUrl":"10.1186/s12884-024-06976-0","url":null,"abstract":"<p><strong>Background: </strong>The aim of this retrospective cohort study was to assess the impact of day 3(D3) embryo cell number on the clinical pregnancy and neonatal outcomes of day 4(D4) single embryo transfer in fresh cycles.</p><p><strong>Methods: </strong>The study included 431 day 4 single embryo transfer in fresh cycles conducted between December 2018 and June 2023. These cycles were divided into three groups according to the day 3 embryo cell number: 248 cycles in the 7 ~ 9-cell group, 149 cycles in the 10 ~ 13-cell group and 34 cycles in the >13-cell group, and clinical pregnancy outcomes and neonatal outcomes were compared among the three groups.</p><p><strong>Results: </strong>The clinical outcomes with 10 ~ 13-cell were significantly higher than those of the 7 ~ 9-cell group, regardless of whether the female age was < 30 or ≥ 30 years. The same result could be found when the insemination pattern was IVF, and when the transferred embryos were the grade of complete fusion. There were no differences in neonatal outcomes between different groups.After adjusting for confounding factors, the 7 ~ 9-cell group was associated with lower clinical pregnancy rates(CBR) and live birth rates(LBR) compared with the 10 ~ 13-cell group (CPR: aOR 0.527, 95% CI 0.317 ~ 0.874, P = 0.013; LBR: aOR 0.499, 95% CI 0.308 ~ 0.807, P = 0.005).</p><p><strong>Conclusion: </strong>The cell number of D3 embryos can be an important reference indicator for D4 embryo selection. When performing day 4 single embryo transfer in fresh cycles, embryos with 10 ~ 13-cell on D3 can be preferentially selected for transplantation to enhance clinical outcomes, especially when the insemination pattern is IVF, and when the transferred embryos are the grade of compaction stage.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"775"},"PeriodicalIF":2.8,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695247","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}