BMC Pregnancy and Childbirth最新文献

{"title":"Independent risk factors for placental abruption: a systematic review and meta-analysis.","authors":"Dexin Chen, Xuelin Gao, Tingyue Yang, Xing Xin, Guohua Wang, Hong Wang, Rongxia He, Min Liu","doi":"10.1186/s12884-025-07482-7","DOIUrl":"10.1186/s12884-025-07482-7","url":null,"abstract":"<p><strong>Background: </strong>Placental abruption is one of the most severe complications during pregnancy, and its associated risk factors remain incompletely understood and somewhat controversial.</p><p><strong>Methods: </strong>This study conducted a systematic search of the PubMed, Embase, Cochrane, Web of Science, and Scopus databases to collect literature related to placental abruption, with a cutoff date of July 30, 2024.</p><p><strong>Results: </strong>A total of 54 observational studies were included, covering 7,267,241 pregnant women, with 47,702 cases diagnosed with placental abruption. The study identified three categories of independent risk factors: The first category includes baseline maternal characteristics (18 items), such as maternal age ≥ 35 years, black race, low prepregnancy BMI (< 18.5 kg/m²), unmarried status, smoking during pregnancy, alcohol consumption, inadequate prenatal care (< 4 visits), marijuana use, multiple pregnancy, parity ≥ 3, anemia (hemoglobin < 11 g/dL), previous placental abruption, previous cesarean section, previous miscarriage, previous stillbirth, cervical incompetence, habitual abortions, and assisted reproductive technology. Among these, previous placental abruption (AOR = 2.72, 95% CI [2.16, 3.42]) was found to be the most significant risk factor. The second category includes pregnancy-related complications (7 items), such as preterm premature rupture of membranes, preeclampsia, small for gestational age, polyhydramnios, antepartum hemorrhage, gestational hypertension, and placenta previa. Of these, placenta previa (AOR = 7.31, 95% CI [4.78, 11.19]) was identified as the most significant risk factor. The third category consists of other independent risk factors (33 items) and protective factors (3 items). However, methodological inconsistencies and publication bias in the current studies may affect the reliability of the meta-analysis results.</p><p><strong>Conclusion: </strong>This study summarizes 58 independent risk factors for placental abruption, covering various aspects such as maternal baseline characteristics and pregnancy complications. For these high-risk populations, it is essential to strengthen the frequency of prenatal check-ups, establish early warning systems, and provide targeted health guidance. Future research should further refine risk factor models and develop more targeted preventive strategies to reduce the incidence of placental abruption and improve maternal and neonatal outcomes.</p><p><strong>Prospero: </strong>CRD42024546514.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"351"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717580","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 pregnancy outcomes of women with SARS-CoV-2 infection in the first trimester ---a longitudinal cohort study.","authors":"Jiangtao Hu, Ju Li, Li Lin, Zhi Li, Jing Wang","doi":"10.1186/s12884-025-07486-3","DOIUrl":"10.1186/s12884-025-07486-3","url":null,"abstract":"<p><strong>Background: </strong>In recent years, severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection has been prevalent worldwide. Pregnant women belong to a special group, and it is very important for clinicians to pay attention to the impact of SARS-CoV-2 infection on pregnancy outcomes. However, there are limited studies on the impact of SARS-CoV-2 infection on pregnancy outcomes during the first trimester.</p><p><strong>Objective: </strong>To investigate the effect of SARS-CoV-2 infection in the first trimester on pregnancy outcomes.</p><p><strong>Methods: </strong>Clinical information of pregnant women whose last menstrual period was between October 1, 2022, and April 1, 2023, and who were registered in the Obstetrics and Gynecology department of Peking University International Hospital, was analyzed. Among them, 498 pregnant women with SARS-CoV-2 infection in the first trimester were included in the study group; while a total of 654 pregnant women with no SARS-CoV-2 infection in the first trimester were included in the control group. Mann Whitney U test, χ2 test, Fisher's exact probability method, and multivariate logistic regression were used to analyze the impact of SARS-CoV-2 infection on pregnancy outcomes during the first trimester.</p><p><strong>Results: </strong>A total of 30 cases in the study group experienced pregnancy loss before 28 weeks of gestation, and 468 cases delivered. In the control group, 41 cases experienced pregnancy loss before 28 weeks of gestation, and 613 cases delivered. The rates of pregnancy loss in the two groups were 6.02% and 6.27%, respectively, with no statistically significant difference between the two groups (P > 0.05). There was no statistically significant difference (P > 0.05) in the baseline data (delivery age, pre-pregnancy body mass index, gestational age, and parity) between the two groups. The rates of neonatal malformation, premature birth, premature rupture of membranes, postpartum hemorrhage, cesarean section, small for gestational age infants, low birth weight infants, macrosomia, and neonatal asphyxia were compared, with no statistically significant difference between the two groups (P > 0.05). However, the incidence of gestational hypertension in the study group was significantly higher than that in the control group (P = 0.012).</p><p><strong>Conclusions: </strong>In this single center study, we found that SARS-CoV-2 infection in the first trimester may increase the risk of gestational hypertension, while the incidences of other adverse pregnant outcomes such as premature birth, premature rupture of membranes, cesarean section, postpartum hemorrhage, small for gestational age infants, low birth weight infants, and neonatal asphyxia did not significantly increase compared with women without SARS-CoV-2 infection in the first trimester.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"352"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717605","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":"Trends in induction of labour and associated co-morbidities and demographics in Queensland, Australia from 2001 to 2020: a population-based study.","authors":"Nigel Lee, Emma Ballard, Tracy Humphrey","doi":"10.1186/s12884-025-07379-5","DOIUrl":"10.1186/s12884-025-07379-5","url":null,"abstract":"<p><strong>Background: </strong>Amongst women who plan a vaginal birth at term, previous studies have reported that rates of induction of labour are increasing potentially impacting other labour and birth outcomes. Indications for induction of labour (IOL) have changed over time though the influences of parity and demographic factors such as age, ethnicity and regionality are not often considered. The aim of this study was to describe the changes in demographic, co-morbidity, IOL indication and clinical outcomes in women undertaking a planned cephalic vaginal birth at term over a 20 year period.</p><p><strong>Methods: </strong>A retrospective population-based study was undertaken using routinely collected anonymised perinatal data from Queensland, Australia from January 2001 to December 2020. We included all singleton term (≥ 37 weeks) planned vaginal births. A total of 836,065 births met the study criteria. Data for pregnancy complications and IOL indications were grouped by ICD-10 codes. Analysis was stratified by parity and presented as frequency and percentages over time and the difference in percentages between two defined years.</p><p><strong>Results: </strong>Rates of IOL increased by 15.5% (31.6 to 47.1%) in nulliparous and 14.6% (26.2 to 40.8% in multiparous women, most notable from 2015 onwards. Over the same period infants born between 37 and 38 weeks gestation increased by 13.9%. (18.1-32%). Amongst co-morbidities gestational diabetes increased from 3.8 to 12.8% and anaemia from 1.7 to 8.1%. As an indication for IOL prolonged pregnancy decreased from 41.0 to 11.2%. In nulliparous women the percentage of intact perineum decreased from 21.3 to 6.7% while episiotomy increased from 20.2 to 38.8%.</p><p><strong>Conclusions: </strong>We conclude that for women planning a vaginal birth not only has the rate of IOL increased substantially over the last two decades there also appears to be considerable interaction between demographic, co-morbidity, IOL indications and clinical outcomes that warrants further large population-based research.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"354"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717606","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":"Translation, cultural adaptation, and validation of the maternal health promotion behavior scale.","authors":"Huiyuan Wang, Yinting Zou, Yulan Guan, Zhirong Li, Xuerong Ran, Tingting Hu, Jinguo Zhai","doi":"10.1186/s12884-025-07463-w","DOIUrl":"10.1186/s12884-025-07463-w","url":null,"abstract":"<p><strong>Background: </strong>United Nations reports show that maternal health is currently deteriorating in most parts of the world, which is far from achieving the 2030 goal of ensuring good maternal health. Adopting health-promoting behaviors during pregnancy is a safe strategy for maintaining and improving maternal and child health. Owing to the high-dimensional, multivariate, and non-directly measurable characteristics of health-promoting behaviors, a comprehensive assessment of these behaviors will help improve population health. The purpose of this study was to translate and cross-culturally adapt Maternal Health Promotion Behavior Scale, which was specifically developed for the maternal population, and to assess the psychometric properties of its Chinese version.</p><p><strong>Method: </strong>This cross-sectional study was conducted between May 2023 and August 2024; convenience sampling was used to select pregnant women in late pregnancy who underwent antenatal checkups. First, the original Maternal Health Promotion Behavior Scale was translated into Chinese and culturally adapted. The psychometric properties of the Chinese version of the Scale were subsequently assessed, including item analysis, content validity, construct validity, internal consistency reliability, and test-retest reliability.</p><p><strong>Results: </strong>A total of 296 pregnant women were included. The Chinese version of the Maternal Health Promotion Behavior Scale consists of 36 scored items in 6 dimensions, with item-level Content Validity Index ranging from 0.83 to 1, and the mean scale-level Content Validity Index of all the items is 0.95. Exploratory factor analysis identified 6 potential factors, and confirmatory factor analysis demonstrated a good fit of the data for this structural equation model. The total Cronbach's α coefficient for the scale was 0.837, McDonald's ω coefficient was 0.848, and test-retest reliability was 0.990.</p><p><strong>Conclusion: </strong>The Chinese version of the Maternal Health Promotion Behavior Scale is a valid and reliable instrument for measuring maternal health-promoting behaviors.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"343"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708475","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":"Association between clinical subtypes and pregnancy outcome of cervical incompetence: a retrospective cohort study.","authors":"Huiqin Xiao, Xiaofang Xing, Can Zhang, Yong Shao","doi":"10.1186/s12884-025-07465-8","DOIUrl":"10.1186/s12884-025-07465-8","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between clinical subtypes and pregnancy outcomes of cervical incompetence.</p><p><strong>Methods: </strong>The clinical data of emergency cerclage group (96 cases) were analyzed retrospectively. According to the different degree of cervical dilatation and amniotic sac protrusion during operation, the emergence cerclage group was divided into 4 subtypes: Type I(43 cases), Type II(27 cases), Type III(14 cases), and the Type IV(12 cases).</p><p><strong>Results: </strong>①Patients with type IV in the emergency cervical cerclage group had a higher frequency of late miscarriage and preterm birth when compared to the other three subtypes (type I, type II and type III) (P < 0.05);②Patients with type IV in the emergency cervical cerclage group had a lower gestational age at surgery than type I and II patients, while type III patients had a longer duration of surgery than type I and II patients, and longer length of hospital stay than type I (P < 0.05);③Patients with type IV in the emergency cervical cerclage group had a lower gestational age at termination than type I and type II patients, lower birth weight of newborns than type I and type III patients, lower term delivery rate than type I patients, and higher neonatal admission to NICU rate than type I patients (P < 0.05).</p><p><strong>Conclusion: </strong>Cervical incompetence can be classified into four subtypes based on the degree of cervical dilation and amniotic sac protrusion; Transvaginal amniotic fluid reduction provides a possible surgical solution for patients with cervical incompetence type IV.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"348"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708409","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":"Placental rupture after fetoscopic SOLOMON technique for twin-twin transfusion syndrome: 2 cases report.","authors":"Xiaochuan Xu, Feng Qin, Lulu Li, Xingbo Tian, Gongli Chen","doi":"10.1186/s12884-025-07487-2","DOIUrl":"10.1186/s12884-025-07487-2","url":null,"abstract":"<p><strong>Objective: </strong>To present 2 cases of placental rupture at delivery after fetoscopic SOLOMON technique for twin-twin transfusion syndrome.</p><p><strong>Methods: </strong>2 cases diagnosed with TTTS in the second trimester. Fetoscopic SOLOMON procedure was performed successfully subsequently.</p><p><strong>Results: </strong>Placental rupture was confirmed by cesarean section in the third trimester. All fetuses were survived. No severe maternal complications but postpartum haemorrhage (PPH) was detected in one of the 2 cases.</p><p><strong>Conclusion: </strong>The SOLOMON technique may further result in placental rupture which may lead to the risk of fetal demise and postpartum haemorrhage, should pay close attention.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"345"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708461","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":"Prevalence and factors associated with low 5th minute APGAR score among mothers who birth through emergency cesarean section: prospective cross-sectional study in Ethiopia.","authors":"Temesgen Tantu, Tayech Tantu, Yohanna Hailu, Dereje Gashaw, Biruk Melkamu","doi":"10.1186/s12884-025-07456-9","DOIUrl":"10.1186/s12884-025-07456-9","url":null,"abstract":"<p><strong>Background: </strong>Apgar score is a method to assess the status of the baby immediately after delivery. It also used to assess the response to and overall the prognosis of the resuscitations. In Ethiopia Birth asphyxia is the one leading cause of neonatal mortality and morbidity. The APGAR score especially the 5th minute one has strong prediction of the neonatal outcome than the 1st minute APGAR score so this study focuses on identifying the prevalence and factors associated with of 5th minute APGAR score among mothers who gave birth through cesarean section in Wolkite University specialized hospital in January to June 2023 G.C.</p><p><strong>Methods: </strong>Institution based prospective cross-sectional study was conducted by using convenience sampling on 270 Mothers, who gave birth through cesarean section in Wolkite University specialized hospital from January 1- June 30 2023 GC. The data collection was conducted through meticulous chart review and interviews. Data were entered using Epi data 7 and analyzed with SPSS 26. The association between independent variables and the 5th minute APGAR was estimated using an odds ratio with 95% confidence intervals. The statistical significance of the association was declared at P-value < 0.05.</p><p><strong>Results: </strong>Total of 270 mothers were included and the prevalence of low fifth minute APGAR score 27.4%. multivariate logistic regression analysis showed that the predictors of low 5th minute APGAR score are fetal heart beat before intervention( bradycardia ( AOR = 9.1; 95% CI: 3.8,21.9),tachycardia ( AOR = 3.7; 95% CI: 1.5,9.8)), meconium stained Amniotic fluid (AOR = 3.0; 95% CI: 1.5,6.2), labor duration greater than 24 h ( AOR = 11.2; 95% CI: 3.9, 31.9), low birth weight( AOR = 4.3; 95% CI: 1.7,10.3).</p><p><strong>Conclusion: </strong>A low APGAR score is highly prevalent. Fetal heart beat before intervention, meconium stained Amniotic fluid, labor duration greater than 24 h, low birth weight are statistically significant predictors of poor APGAR. Enhancing the early obstetric interventions like electronic fetal monitoring, use of partograph, and timely cesarean sections as well as early neonatal resuscitation techniques might mitigate the risk of complications linked with low APGAR scores.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"342"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708467","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":"Does induction of labor without a medical indication explain the overall increase in the induction rate: an observational study before and after the ARRIVE trial.","authors":"Isabelle Attali, Julie Cormier, François Goffinet, Camille Le Ray","doi":"10.1186/s12884-025-07403-8","DOIUrl":"10.1186/s12884-025-07403-8","url":null,"abstract":"<p><strong>Background: </strong>The rate of induction of labor increased particularly after the publication of ARRIVE trial conducted in low-risk primiparous patients without medical indication. However, this increase of induction rate does not seem to concern this population alone. Our aim was to understand how induction rate have evolved according to its indications and the impact on cesarean rate.</p><p><strong>Methods: </strong>This was a retrospective observational study in a tertiary university maternity unit, including all women who gave birth between January 1st 2014 and December 31th 2021, at more than 24 weeks of gestation with a liveborn infant weighing ≥ 500 g (N = 9,523). We described the frequency of induction and caesarean section per year within the maternity unit. We differentiated two study periods: 2014-2017 and 2018-2021. We used the Grenoble classification to analyse the contribution of each of group to the overall induction rate and calculated the absolute and relative difference in induction rate for each group between the two periods. We analysed changes in the risk of caesarean section in each of the groups.</p><p><strong>Results: </strong>The overall induction rate increased from 19.3 to 27.4% between 2014 and 2021 (p < 0.01). The cesarean section rate for women who underwent induction decreased significantly from 29.5% in 2014 to 25.2% in 2021 (p < 0.01). The induction rate moderately increased in the group corresponding to induction of labor \"without medical indication\" (relative difference of 14.9%; 95%CI [6.0;21.0]). The groups with the greatest increase in their induction rate between the two study periods were the breech group (relative difference of 66.7% 95%CI [49.0;83.0]) and the fetal pathology induction group (relative difference of 75.5% 95%CI [61.2;90.1]). The rate of cesarean among inducted women reduced significantly in the group of \"multiple pregnancies\" (aOR = 0.6; 95%CI [0.4;0.9]) and in the group of \"maternal pathologies\" (aOR = 0.8; 95%CI [0.6;0.9]). For the group 8 \"induction without medical induction\" the reduction was not significant (aOR = 0.8; 95%CI [0.8;1.2]).</p><p><strong>Conclusion: </strong>From 2014 to 2021, we observed a marked increase in the induction rate in our maternity unit. This increase was not associated with a change of the cesarean rate. Induction of labor without medical indication represent only a small part of the induction rate.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"349"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708452","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":"Evaluating maternal serum sortilin levels: a potential biomarker for predicting preeclampsia.","authors":"Gulsan Karabay, Burak Bayraktar, Zeynep Seyhanli, Betul Tokgoz Cakir, Gizem Aktemur, Serap Topkara Sucu, Nazan Vanli Tonyali, Umut Karabay, Dilara Kurt, Ali Turhan Caglar","doi":"10.1186/s12884-025-07452-z","DOIUrl":"10.1186/s12884-025-07452-z","url":null,"abstract":"<p><strong>Objective: </strong>To determine the role of sortilin in the pathogenesis of preeclampsia by examining serum sortilin levels in maternal blood.</p><p><strong>Methods: </strong>This prospective case-control study was conducted from May to November 2023 at the Perinatology Clinic of Ankara Etlik City Hospital. The study cohort was divided into two groups: Group 1 consisted of 44 pregnant women diagnosed with preeclampsia, and Group 2 served as the control group, comprising 44 healthy pregnant women. The groups were matched individually, with controls selected based on similar maternal age and gestational age at the time of sample collection.</p><p><strong>Results: </strong>Maternal sortilin levels were significantly elevated in preeclampsia patients compared to controls. Using a cut-off value of > 3.57 ng/mL, sortilin levels could distinguish preeclampsia cases with a sensitivity of 90.9%, a specificity of 45.5%, and an area under the curve (AUC) of 0.679 (p = 0.002). At a cut-off of > 3.57 ng/mL, it was significantly associated with composite adverse neonatal outcomes, with a sensitivity of 89.6%, a specificity of 36.1%, and an AUC of 0.620 (p = 0.045). In addition, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and protein in 24-hour urine, which are important components in the diagnosis and severity of preeclampsia, were significantly correlated maternal blood sortilin levels.</p><p><strong>Conclusion: </strong>Our findings indicate that maternal sortilin levels are elevated in patients with preeclampsia compared to those in a healthy pregnant control group. Furthermore, maternal sortilin levels may predict adverse neonatal outcomes. In addition, sortilin levels are correlated key clinical markers of preeclampsia severity.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"338"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708456","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":"Pregnancy outcomes and risk factors for thrombocytopenia in pregnant patients with systemic lupus erythematosus.","authors":"Qing-Ying Fang, De-Hai Gan, Jia Huang, Fan Lian","doi":"10.1186/s12884-025-07451-0","DOIUrl":"10.1186/s12884-025-07451-0","url":null,"abstract":"<p><strong>Background: </strong>To compare pregnancy outcomes between systemic lupus erythematosus (SLE) patients with thrombocytopenia and those without, and to develop a nomogram for assessing the risk of developing SLE-related thrombocytopenia during pregnancy.</p><p><strong>Methods: </strong>Clinical data from 178 pregnant patients with SLE were analyzed. Patients were classified into thrombocytopenia and normal platelet groups using a platelet count cutoff of < 100 × 10^9/L. Pregnancy outcomes were compared between these groups. A nomogram was developed to identify factors associated with thrombocytopenia based on univariate and multivariable logistic regression analyses. The performance of the nomogram was assessed through receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Among the 178 patients, 34 were in the thrombocytopenia group and 144 in the normal platelet group. SLE patients with thrombocytopenia had a significantly higher rate of active disease (55.9% vs. 5.6%, P < 0.001) and a higher SLE-Pregnancy Disease Activity Index (SLEPDAI) (4.71 ± 3.04 vs. 2.29 ± 1.88, P < 0.001). When comparing patients with thrombocytopenia (categorized by platelet counts < 50 × 10^9/L and > 50 × 10^9/L) to the control group, the incidence of severe preeclampsia (20.00% vs. 15.79% vs. 4.86%, P = 0.027) and postpartum hemorrhage (26.32% vs. 6.67% vs. 3.47%, P = 0.007) was also significantly higher in the thrombocytopenia group. This group exhibited elevated rates of pregnancy loss (73.33% vs. 31.58% vs. 4.17%, P < 0.001) and stillbirth (20.00% vs. 15.79% vs. 0.69%, P < 0.001). Active disease, previous abortion, and anti-β2GPI antibodies positivity were identified as independent factors of developing SLE-related thrombocytopenia during pregnancy. The area under the curve for the nomogram was 0.833 (95% CI: 0.753-0.913). Both the calibration curve and DCA indicated that the model performed well.</p><p><strong>Conclusion: </strong>Thrombocytopenia in pregnant patients with SLE is associated with increased disease activity and a higher incidence of adverse outcomes, including pregnancy loss and stillbirth. The nomogram for developing thrombocytopenia during pregnancy may help clinicians improve the management of this group of patients.</p><p><strong>Clinical trial number: </strong>not applicable.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"344"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708465","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}