BMC Pregnancy and Childbirth最新文献

{"title":"A novel digital hybrid care model for maternal mental health: preliminary findings from a matched retrospective cohort study.","authors":"Elombe Calvert, Kelly Chen, Khatiya Chelidze Moon, Margaret R Emerson, Natalie Feldman, Catherine Lager, John Torous","doi":"10.1186/s12884-026-09370-0","DOIUrl":"https://doi.org/10.1186/s12884-026-09370-0","url":null,"abstract":"<p><strong>Background: </strong>Perinatal mood and anxiety disorders are among the most common complications of pregnancy and the postpartum period, while access to timely, evidence-based mental health care remains limited. Although smartphone applications may help extend access to care, recent research highlights notable limitations, including variable quality and unclear effectiveness. Hybrid care models, which integrate asynchronous app use with synchronous clinician-delivered care, have therefore emerged as a promising alternative. This study examined one such model, the Digital Clinic, to assess its potential to help bridge this treatment gap by analyzing clinical outcomes among peripartum women receiving care for anxiety and depressive symptoms.</p><p><strong>Methods: </strong>Pregnant and postpartum women referred for anxiety and depression of peripartum onset received 8 weeks of synchronous, virtual, evidence-based CBT from a trained clinician. This treatment was complemented by the asynchronous use of the mindLAMP app, providing digital phenotyping, psychoeducation, and CBT skills, with the support of a Digital Health Navigator. Preliminary clinical outcomes were assessed by comparing GAD-7 and PHQ-9 scores from intake to the completion of the treatment course.</p><p><strong>Results: </strong>This preliminary matched retrospective cohort study included 13 peripartum and 39 matched non-peripartum patients receiving care through the Digital Clinic. Among the peripartum cohort, GAD-7 scores decreased from 14.4 (SD = 5.0) at intake to 5.5 (SD = 4.3) at treatment completion, corresponding to a significant mean reduction of 8.9 points (SD = 4.8; p < 0.01; d = -1.91, 95% CI: -2.89 to -0.93). PHQ-9 scores decreased from 9.3 (SD = 5.9) to 5.6 (SD = 4.8), corresponding to a mean reduction of 3.7 points (SD = 6.3); however, this change did not reach statistical significance (p = 0.055; d = -0.68, 95% CI: -1.41 to 0.05).</p><p><strong>Conclusion: </strong>The Digital Clinic, a hybrid care model, was associated with reductions in anxiety symptoms and less conclusive reductions in depressive symptoms among pregnant and postpartum women. This approach to maternal mental health holds promise for delivering accessible, evidence-based care to peripartum patients in real-world settings. Future research efforts should further evaluate its effectiveness in larger, more diverse patient populations, including those with more moderate to severe symptoms.</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":"149223370","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":"Breastfeeding after early-onset breast cancer: a scoping review.","authors":"Jennifer G Taylor, Tisha Felder, Karen Wickersham, Michael D Wirth, Linda Hazlett","doi":"10.1186/s12884-026-09351-3","DOIUrl":"https://doi.org/10.1186/s12884-026-09351-3","url":null,"abstract":"<p><strong>Objective: </strong>To synthesize the current evidence examining the breastfeeding experiences of women with a history of early-onset breast cancer.</p><p><strong>Data sources: </strong>A scoping review of the literature was conducted using the following databases: CINAHL, PubMed, Psych Info and Web of Science. Citations of relevant articles were also reviewed.</p><p><strong>Study selection: </strong>We included articles published in English from 2000 to 2023 that were primary empirical full-text articles with objectives examining breastfeeding in women with a history of breast cancer under the age of 45. Thirty-seven full-text articles were assessed for eligibility, and 11 articles met criteria.</p><p><strong>Data extraction: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used to organize the search results. Information extracted from the articles included: country of origin, objectives of the study, demographics of participants, types of support and breastfeeding challenges.</p><p><strong>Data synthesis: </strong>All articles reported cases of successful breastfeeding after breast cancer. Common challenges of breastfeeding after breast cancer included insufficient milk supply, nipple pain, and little knowledge on the topic from the clinical team.</p><p><strong>Conclusion: </strong>Potential challenges women may experience with breastfeeding after breast cancer are insufficient milk supply, engorgement, and lack of support from their family and their healthcare team. Discussion of infant-feeding goals during the antepartum period with continued support immediately and well into the postpartum period is crucial to assist with breastfeeding issues and prolong success.</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":"149227129","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":"Deviations from the standard of care in the treatment of pregnant people with opioid use disorder in jails; a mixed methods study.","authors":"Sonia Hamilton, Erin Sommers, Camille Kramer, Carolyn Sufrin","doi":"10.1186/s12884-026-09667-0","DOIUrl":"10.1186/s12884-026-09667-0","url":null,"abstract":"<p><strong>Background: </strong>Medications for opioid use disorder (MOUD) with methadone or buprenorphine are the standard of care for opioid use disorder (OUD) during pregnancy and postpartum. MOUD is not routinely available in US jails. Little is known about OUD management practices and patient experiences when MOUD is unavailable in jails. This study aims to assess deviations from standard pregnancy OUD care in jail and demonstrate patients' experiences of such deviations.</p><p><strong>Methods: </strong>Mixed-methods, secondary analysis from two prior studies: (1) a survey of US jails (n = 836) regarding availability MOUD in pregnancy and (2) interviews with pregnant and postpartum people with OUD (n = 32) who were in jail while pregnant. We analyzed survey results using descriptive statistics and interview transcripts using directed content analysis. We triangulated practices across both studies and grouped them thematically.</p><p><strong>Results: </strong>Practices deviating from the standard of care included: use of naltrexone in pregnancy (n = 111), MOUD discontinuation postpartum (n = 489), and use of acetaminophen/codeine as maintenance therapy (n = 5). Interviewees described a lack of counseling and choice in MOUD, frequent opioid withdrawal, and inadequate withdrawal management.</p><p><strong>Conclusions: </strong>Deviations from standard pregnancy OUD care are common in jail. Since the lack of MOUD and opioid withdrawal increases overdose risk and other adverse perinatal outcomes, we must address substandard care in jail for this population.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219913","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":"A risk assessment model for gestational diabetes mellitus integrating maternal demographics and hematological indices in Thai women.","authors":"Thaveesak Sai-Ong, Donrawee Waeyeng, Tanaporn Khamphaya, Yanisa Rattanapan, Chutima Jansakun, Atsuko Ikeda, Supabhorn Yimthiang","doi":"10.1186/s12884-026-09608-x","DOIUrl":"https://doi.org/10.1186/s12884-026-09608-x","url":null,"abstract":"<p><strong>Background: </strong>Universal screening for Gestational Diabetes Mellitus (GDM) is the gold standard, but it can be difficult and expensive in resource-limited settings. Many current prediction models rely on specialized tests that are not available in primary care. This study aimed to create a cost-effective risk assessment model using common maternal demographic and blood test data to help identify GDM risk in Thai pregnant women.</p><p><strong>Methods: </strong>We conducted a cross-sectional study with 200 pregnant women (24-28 weeks of gestation) at a secondary care hospital in Southern Thailand. We analyzed routine antenatal data, including complete blood count and other lab results. A risk-scoring system was built using multivariate logistic regression. We then tested the model's performance using Receiver Operating Characteristic (ROC) curve analysis to determine the optimal cut-off point.</p><p><strong>Results: </strong>Six independent predictors were found maternal age over 35 years, systolic blood pressure above 130 mmHg, glycosuria, hemoglobin at least 11 g/dL, platelets at least 260.50 × 10³/µL, and neutrophil-to-lymphocyte ratio (NLR) of 2.89 or higher. The combined risk model performed better (AUC = 0.804; 95% CI: 0.74-0.87) than single-marker models. With a risk score cut-off of 2.5 (indicating three or more risk factors), the model had a sensitivity of 71.4% and a specificity of 78.1%.</p><p><strong>Conclusion: </strong>The new risk assessment model, which uses basic demographic and routine blood test data, offers a reliable and affordable way to screen for GDM. This method enables early risk identification and helps healthcare providers use resources more efficiently, potentially reducing unnecessary tests in resource-limited settings.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223421","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":"Impact of lipid-based nutritional supplementation on cardio metabolic risk factors in underweight pre-eclamptic primigravidas: A randomized controlled trial.","authors":"Hafsa Zafar, Murad A Mubaraki, Mashal Zafar, Nabila Sher, Rubina Nazli, Kalsoom Tariq, Hashim Khan, Ijaz Ahmad, Fozia Fozia","doi":"10.1186/s12884-026-09646-5","DOIUrl":"10.1186/s12884-026-09646-5","url":null,"abstract":"<p><strong>Background: </strong>Pre-eclampsia is a major cause of maternal and fetal complications in Pakistan, particularly among primigravidas, where poor nutritional status further increases risk. Emerging evidence suggests that underweight pre-eclamptic women may have distinct cardio metabolic adaptations, higher susceptibility to adverse pregnancy outcomes, and increased long-term cardiovascular risk. Lipid-based nutritional supplementation provides essential energy and micronutrients and may help improve maternal metabolic status and pregnancy outcomes in pre-eclamptic women.</p><p><strong>Objective: </strong>To determine the effect of lipid-based micronutrient supplementation on lipid profile, Insulin resistance and blood pressure in underweight pre-eclamptic primigravidas at delivery, six months and twelve months postnatal.</p><p><strong>Methods: </strong>An open label randomized controlled trial was undertaken to explore the effects of supplementation on the cardio metabolic risk factors in the tertiary care hospitals of KPK, Pakistan. A total of sixty primigravidas were randomized equally into two groups; Group A: control group and Group B; supplement group. At delivery, 26 and 28 participants in Groups A and B, respectively and at 6 and 12 months, 23 and 25 participants were analyzed. In addition to their prescribed antenatal treatment of preeclampsia and IFA (60 mg iron and 400ug FA) daily, the Group B also received one 75gm of lipid-based nutrition supplement (LNS) sachet (MAAMTA) daily from their first antenatal visit after enrollment till one year postnatally. The IFA was stopped 6 weeks after delivery.</p><p><strong>Results: </strong>There was no discernable difference among the baseline cardio-metabolic parameters like insulin, glucose & HOMA-IR of two groups at delivery. Also, the difference in BP (systolic) was non-significant while BP (diastolic) was decreased in group B (p = 0.025). Similarly, at delivery the significant declined were observed in triglyceride (TGs) levels with LNS supplementation (p = 0.007), Total cholesterol (p = 0.01), LDL (p = 0.02) and VLDL (p = 0.005). At 6 months follow-up systolic (p = 0.002) and diastolic blood pressure (p = 0.013) were decreased significantly in group B & also a significant decline in TGs (p = 0.05), cholesterol (p < 0.001), LDL (p < 0.001) and VLDL levels (p = 0.04) observed in group B. A significant decrease was seen in cholesterol levels (p < 0.001) and LDL levels (p < 0.001) in group B at 12 months postnatal.</p><p><strong>Conclusion: </strong>This study concludes that long term LNS supplementation can cause a decrease in cholesterol, TGs, LDL and VLDL in underweight pre-eclamptic primigravidas and thus may contribute to a more favorable cardio metabolic risk profile.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: ISRCTN 15485068. Registered on April 21, 2018: https://doi.org/10.1186/ISRCTN15485068 .</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839238","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 relationship between pregnancy risk perception and attitudes toward sexuality during pregnancy among pregnant women in Türkiye: a cross-sectional study.","authors":"Sabriye Uçan Yamaç, Nazife Bakır","doi":"10.1186/s12884-026-09602-3","DOIUrl":"10.1186/s12884-026-09602-3","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy is a period marked by anatomical, physiological, and psychological changes that may be associated with women's perceptions of risk and their attitudes toward sexuality during pregnancy. Risk perception during pregnancy is a subjective experience shaped by personal, medical, psychological, and cultural factors. Sexuality during pregnancy may also be associated with myths, misconceptions, physiological changes, and concerns about maternal or fetal safety. Although previous studies have examined sexual function, sexual beliefs, and body image during pregnancy, limited evidence is available on the relationship between pregnancy-related risk perception and attitudes toward sexuality during pregnancy. This study aimed to examine this relationship among pregnant women in Türkiye.</p><p><strong>Methods: </strong>A descriptive, cross-sectional study was conducted with 306 pregnant women who applied to family health centers in a district in Türkiye. The sample size was determined using statistical power analysis, and data were collected through structured face-to-face interviews. Data collection tools included a Personal Information Form, the Perception of Pregnancy Risk Questionnaire (PPRQ), and the Attitude Scale toward Sexuality during Pregnancy (ASSP). Descriptive statistics, independent samples t-tests, one-way analysis of variance with Bonferroni post-hoc tests, and Pearson correlation analysis were performed using IBM SPSS Statistics version 25. Statistical significance was accepted at p < 0.05.</p><p><strong>Results: </strong>The mean total PPRQ score was 41.75 +/- 13.97. The mean score for risk perception toward oneself was 42.37 +/- 17.13, and the mean score for risk perception toward the baby was 40.98 +/- 16.58. The mean total ASSP score was 104.99 +/- 23.23, and 23.9% of participants had a positive attitude toward sexuality during pregnancy according to the ASSP cut-off point. A weak positive correlation was found between risk perception toward the baby and approval of sexuality during pregnancy (r = 0.195, p = 0.001), and between risk perception toward the baby and total ASSP score (r = 0.143, p = 0.012). A weak negative correlation was found between risk perception toward oneself and total ASSP score (r = -0.215, p < 0.001). Significant differences in PPRQ and ASSP scores were observed according to several sociodemographic and pregnancy-related characteristics.</p><p><strong>Conclusions: </strong>This cross-sectional study found weak correlations between pregnancy risk perception sub-dimensions and attitudes toward sexuality during pregnancy. The findings should be interpreted cautiously because of the weak magnitude of the correlations, the cross-sectional design, the single-district sample, and the use of self-reported data.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148696934","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":"Serum biomarkers and their association with disease severity and perinatal outcomes in preeclampsia: a retrospective study.","authors":"Chong Feng, Meng Hou","doi":"10.1186/s12884-026-09691-0","DOIUrl":"10.1186/s12884-026-09691-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;To investigate the associations of pre-delivery serum blood urea nitrogen (BUN), uric acid (UA), cystatin C (CysC), and serum calcium levels with the occurrence of preeclampsia (PE), disease severity, and birth weight, and to evaluate their discriminatory performance in distinguishing severe preeclampsia (sPE) from PE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 328 women with singleton pregnancies who delivered at our hospital between January 2020 and December 2022 and met the inclusion and exclusion criteria were retrospectively enrolled, including 113 women in the normal pregnancy group, 125 in the PE group, and 90 in the sPE group. Maternal demographic characteristics, gestational age at blood sampling, gestational age at delivery, birth weight and related perinatal outcomes, blood pressure measurements, and laboratory parameters were collected. Multivariable binary logistic regression analyses were performed to evaluate the associations between the major laboratory biomarkers and the occurrence of PE and sPE after adjustment for maternal age, body mass index (BMI), nulliparity, assisted reproductive technology (ART) conception, and gestational age at blood sampling. Spearman correlation analysis and multiple linear regression analysis were used to assess the associations between the major laboratory biomarkers and birth weight after further adjustment for gestational age at delivery. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminatory performance of the major laboratory biomarkers and the combined model consisting of BUN, UA, and CysC in distinguishing sPE from PE. The calibration and clinical utility of the combined model were further evaluated using the Hosmer-Lemeshow goodness-of-fit test, calibration plots, and decision curve analysis (DCA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Significant differences in BUN, UA, CysC, and serum calcium levels were observed among the three groups. After adjustment for maternal age, BMI, nulliparity, ART conception, and gestational age at blood sampling, elevated BUN, UA, and CysC levels were independently associated with the occurrence of PE, with odds ratios (ORs) of 3.057, 4.432, and 6.738, respectively (all P &lt; 0.001). Higher serum calcium levels were associated with a lower risk of PE (OR = 0.733, P = 0.019). Among women with PE, only UA remained significantly associated with sPE after adjustment for the above confounding factors (OR = 1.444, 95% confidence interval [CI]: 1.056-1.975, P = 0.021). Correlation analyses showed that BUN, UA, and CysC were negatively correlated with birth weight, whereas serum calcium was not significantly associated with birth weight. After further adjustment for gestational age at delivery, only BUN and UA remained significantly associated with reduced birth weight. ROC analysis showed that the area under the curve (AUC) values for BUN, UA, CysC, and serum calcium (evaluated in the lower-value dir","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223408","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":"Implementation of Robson's ten-group classification system for cesarean section rates at a tertiary university hospital in Egypt: a prospective study.","authors":"Ahmed Gamal Ahmed Alamrawy, Tarek Abdel-Zaher Karkour, Tamer Mamdouh Abdel-Dayem, Hesham Adel El Fazary","doi":"10.1186/s12884-026-09693-y","DOIUrl":"10.1186/s12884-026-09693-y","url":null,"abstract":"<p><strong>Background: </strong>Egypt has one of the highest reported cesarean section (CS) rates globally. Aggregate CS rates alone, however, do not identify which obstetric populations contribute most to CS use or whether interventions are clinically appropriate. The Robson Ten-Group Classification System (TGCS) provides a standardized method for institutional audit and benchmarking.</p><p><strong>Methods: </strong>We conducted a prospective observational study at El-Shatby Maternity University Hospital, Alexandria, Egypt, from September 1, 2021, to March 1, 2022. All women admitted for delivery at ≥ 28 weeks' gestation and/or fetal weight > 500 g were included. Women were categorized into Robson groups using the six core obstetric variables. Proportions and 95% confidence intervals (CIs) were calculated for the main estimates.</p><p><strong>Results: </strong>Among 5682 deliveries, 3405 were by CS (59.9%, 95% CI 58.6-61.2). Group 5 was the largest group (1742/5682, 30.7%) and contributed 47.6% of all CSs, with a group-specific CS rate of 93.1% (95% CI 91.8-94.2). Group 10 comprised 16.7% of the obstetric population and contributed 20.6% of all CSs; its group-specific CS rate was 73.9% (95% CI 71.1-76.6). Groups 2 and 4 had CS rates of 47.1% and 50.4%, respectively. Group 1 and Group 3 had lower group-specific CS rates of 14.5% and 11.9%, respectively. Vaginal birth after cesarean (VBAC) occurred in 126 cases (2.2% of all deliveries).</p><p><strong>Conclusions: </strong>This prospective audit established a standardized Robson baseline for a high-volume Egyptian tertiary maternity unit. The high overall CS rate reflected a large Group 5, high CS rates in modifiable Groups 2 and 4, and a substantial contribution from Group 10. The findings identify priorities for future audit, including prevention of unnecessary primary CS, assessment of trial of labor after cesarean (TOLAC) eligibility and counseling, and review of preterm CS decision-making. They should not be interpreted as proving that all observed CSs were unnecessary.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560795","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":"Derivation of a risk model to predict urinary incontinence during pregnancy: a research article.","authors":"Alícia Carrera-Boix, Jordi Cassadó Garriga, Jordi Blanch, Lia Alves-Cabratosa, Anna Ponjoan, Ruth Martí-Lluch, Rafel Ramos Blanes","doi":"10.1186/s12884-026-09654-5","DOIUrl":"https://doi.org/10.1186/s12884-026-09654-5","url":null,"abstract":"<p><strong>Background: </strong>The onset of urinary incontinence (UI) during pregnancy is related to urinary incontinence persistence in the postpartum and later years. We aimed to design a prediction model of urinary incontinence that could be used at the beginning of pregnancy and included clinical and ultrasound variables.</p><p><strong>Materials and methods: </strong>Design: Prospective cohort study.</p><p><strong>Settings: </strong>Obstetrics and Gynecology Service of Santa Caterina's Hospital (Girona, Spain) between 2018 and 2020.</p><p><strong>Population: </strong>Women at 12-14 weeks' gestation were invited to participate by consecutive sampling and a follow-up visit was carried out at 32-35 pregnancy weeks.</p><p><strong>Methods: </strong>During the visits, we collected clinical data, measured 2D ultrasound variables, and administered the International Consultation on Incontinence Questionnaire (ICIQ-SF). We built a multivariable model to predict urinary incontinence, assessed its calibration and discrimination (with the area under the ROC curve), and performed an internal validation. All the analyses were carried out using the R software (version 4.1).</p><p><strong>Results: </strong>We recruited 174 nulliparous pregnant women during the study period and designed two models to predict urinary incontinence based on the significant variables in the univariate analysis: the urethral mobility and body mass index (BMI). The OR (95% CI) for the BMI category > 30 kg/m2 was 4.24 (1.48-12.30) in the first model (introital urethral mobility and BMI) and 3.31 (1.13-9.62) in the second model (transperineal urethral mobility and BMI). The area under the ROC curve was 0.725 for the first model and 0.687 for the second model. These models were used to create an online urinary incontinence prediction calculator.</p><p><strong>Conclusion: </strong>We built two multivariable models to predict, at the beginning of pregnancy, the individual risk of each pregnant woman to develop moderate/severe urinary incontinence in the third trimester. These models may provide a foundation for the future development of tailored primary prevention strategies.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227114","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":"Development and validation of a risk prediction model for preterm birth in women concurrent with Hepatitis B virus carrier status and gestational diabetes mellitus.","authors":"Zaidi Gui, Xiaoxiao Fan, Tianzi Zang, Hongyan Xu, Qi Wu, Lijun Chen, Jinbing Bai, Yanqun Liu","doi":"10.1186/s12884-026-09689-8","DOIUrl":"10.1186/s12884-026-09689-8","url":null,"abstract":"<p><strong>Background: </strong>Preterm birth is a major adverse neonatal outcome that has been associated with maternal hepatitis B virus carrier status. Co-occurrence of hepatitis B virus carrier status carrier status and gestational diabetes mellitus is associated with an increased risk of preterm birth compared with hepatitis B virus carrier status alone. This study aimed to develop and externally validate a clinically applicable multivariable prediction model incorporating both clinical risk factors and maternal blood biomarkers to estimate preterm birth risk among women with concurrent hepatitis B virus carrier status and gestational diabetes mellitus.</p><p><strong>Methods: </strong>A retrospective analysis was performed using clinical data and maternal blood biomarkers from 882 pregnant women with hepatitis B virus carrier status and gestational diabetes mellitus who delivered at Women's Hospital, in Zhejiang Province, China, from January 2015 to December 2024. Following data preprocessing, participants were randomly allocated to training and validation sets at a 7:3 ratio. Variable selection was performed using the least absolute shrinkage and selection operator (LASSO), and univariate and multivariable logistic regression analyses were subsequently conducted to assess the associations of clinical variables and maternal blood biomarkers with preterm birth in women with concurrent hepatitis B virus carrier status and gestational diabetes mellitus. A nomogram was developed to facilitate clinical application. Model discrimination and calibration were evaluated using receiver operating characteristic curve analysis and calibration plots, respectively, while clinical utility was assessed through decision curve analysis.</p><p><strong>Results: </strong>A total of 847 women with hepatitis B virus carrier status and gestational diabetes mellitus were included in this study, of whom 187 (22%) experienced preterm birth. Multivariable logistic regression analysis identified pre-pregnancy body mass index, diastolic blood pressure, systolic blood pressure, alanine aminotransferase, placenta previa, white blood cell count, and maternal blood biomarkers-including total protein, total bile acid, total thyroxine, mode of membrane rupture, and prothrombin time-as independent predictors of preterm birth. These variables were incorporated into a nomogram, which demonstrated good calibration and discrimination. The area under the curve was 0.854 (95% CI: 0.823-0.881) in the training set and 0.754 (95% CI: 0.697-0.806) in the validation set. Decision curve analysis indicated that the nomogram provided favorable clinical utility for predicting preterm birth.</p><p><strong>Conclusion: </strong>The model demonstrated good discriminative ability and calibration, enabling accurate prediction of preterm birth risk in women with concurrent hepatitis B virus carrier status and gestational diabetes mellitus.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219935","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}