BMC Pregnancy and Childbirth最新文献

{"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}

{"title":"Reproductive outcomes following hysteroscopic uterine septum resection in infertile women: a retrospective cohort study.","authors":"Zahra Kaveh, Fatemeh Davari Tanha, Hamideh Pakniyat, Sara Saeedi, Shohreh Salimi Sotoodeh, Elham Feizabad, Mohadese Dashtkoohi, Marjan Ghaemi","doi":"10.1186/s12884-025-07460-z","DOIUrl":"10.1186/s12884-025-07460-z","url":null,"abstract":"<p><strong>Objective: </strong>A septate uterus is a common congenital anomaly often identified during infertility evaluations and is associated with adverse reproductive outcomes. Hysteroscopic septum resection is widely recognized as a standard, safe, and effective treatment. This study aimed to evaluate reproductive and pregnancy outcomes in infertile women who underwent hysteroscopic septum resection.</p><p><strong>Method: </strong>This retrospective cohort study included infertile women aged 18 to 45 years who were diagnosed with a uterine septum and were candidates for assisted reproductive technology (ART) between 2011 and 2021. Participants had either primary or secondary infertility and underwent hysteroscopic septoplasty. Data were collected from medical records and telephone interviews, which included demographic information and postoperative outcomes, such as chemical and clinical pregnancy rates, live birth rates, and adverse pregnancy outcomes. Statistical analyses employed descriptive methods, including frequencies and means.</p><p><strong>Results: </strong>Among 735 women, 84.6% had primary infertility, and 51.5% had infertility for 1-5 years. The chemical pregnancy rate was 44.6%, clinical pregnancy 42.8%, and live birth 36.7%. No significant differences were found between primary and secondary infertility groups in pregnancy or live birth rates. Adverse outcomes included preterm labor (6.7%) and preeclampsia (4.8%). Vaginal delivery was the most common mode (81.8%).</p><p><strong>Conclusion: </strong>Hysteroscopic septum resection appears to improve pregnancy outcomes and live birth rates in individuals undergoing ART. Nevertheless, prospective studies with control groups are needed to confirm these findings and establish stronger evidence.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"350"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708470","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":"Conservative management of giant retroperitoneal hematoma after cesarean section in severe preeclampsia: a rare case report.","authors":"Jingwen Yu, Mengge Ke, Guangming Wang","doi":"10.1186/s12884-025-07467-6","DOIUrl":"10.1186/s12884-025-07467-6","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous retroperitoneal hematoma (RPH) after cesarean section is an extremely rare disease with various causes, which can lead to unexplained maternal shock and death. Because cases of RPH are extremely rare in obstetric settings, there is also a paucity of literature.</p><p><strong>Case presentation: </strong>This study reports a rare case of giant RPH after cesarean section. The patient underwent cesarean section due to severe preeclampsia at 38 weeks of gestation. The procedure was uneventful with little intraoperative bleeding, but a huge retroperitoneal hematoma developed 18 h after the operation and was successfully managed conservatively.</p><p><strong>Conclusions: </strong>The treatment taste of retroperitoneal hematoma depends on the size of the hematoma, the etiology, and the hemodynamic status of the patient. For patients in stable condition, conservative treatment can be adopted, such as fluid infusion, blood transfusion, vascular embolization and hematoma drainage.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"346"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708419","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 effectiveness of real-time telelactation intervention on breastfeeding outcomes among employed mothers: a systematic review and meta-analysis.","authors":"Tippawan Iamchareon, Wantana Maneesriwongul","doi":"10.1186/s12884-025-07440-3","DOIUrl":"10.1186/s12884-025-07440-3","url":null,"abstract":"<p><strong>Background: </strong>The global exclusive breastfeeding (EBF) rate during the first six months is < 50%. This rate is particularly low among employed mothers, who may face obstacles in accessing in-person lactation services. Given that telelactation services can increase EBF rates, we conducted this study to assess the effects of real-time telelactation services (vs. usual lactation services) on breastfeeding outcomes among employed mothers.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic Reviews Meta-Analyses guidelines were followed. Studies published between 2012 and 2023 were identified from the Academic Search Ultimate, Cochrane, CINAHL Complete, Embase, ProQuest, SAGE journals, ScienceDirect, Scopus, Springer Link, Google Scholar, and Thai Journal Online databases. Randomized controlled trials and quasi-experimental studies that met the inclusion criteria were included. The JBI critical appraisal tool was used to assess the studies selected for the systematic review. Categorical data were analyzed using relative risk (RR) with 95% confidence intervals (CIs) and a random-effects model.</p><p><strong>Results: </strong>Of the 18 studies selected for the review, 13 were included in the meta-analysis with a total of 4,564 participants. Of these, 3,582 were employed mothers. We identified three types of real-time telelactation services based on the activities of the provider and client: proactive, reactive, and mixed services. The results showed that real-time telelactation services had a statistically significant positive effect on the EBF rate during the first six months compared to usual care (Relative risk (RR): 1.31, 95% Confidence interval (CI) [1.10, 1.54]; p = 0.002). Proactive and mixed services significantly enhanced the rate of EBF (RR: 1.59, 95% CI [1.23, 2.05]; p = 0.0004 and RR: 1.38, 95% CI [1.01, 1.87]; p = 0.04, respectively). Reactive services did not significantly affect the EBF rate during the first six months compared to usual care (RR: 0.98, 95% CI [0.93, 1.04]; p = 0.54).</p><p><strong>Conclusions: </strong>Real-time telelactation services delivered by lactation/trained professionals in a proactive or combined proactive/reactive manner (i.e., via scheduled appointments and on demand) were the most effective. These service models should be considered by lactation service providers and healthcare policymakers seeking to increase EBF among the majority of participants who were employed mothers.</p><p><strong>Review registration: </strong>This review has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42023429900).</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"341"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708472","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":"Associations of maternal cyclin-dependent kinase 5 regulatory subunit-associated protein 1-like 1(CDKAL1) gene variants with adverse pregnancy outcome in Chinese women.","authors":"Shuoying Yue, Meng Su, Zihao Zhang, Jing Li, Junhong Leng, Weiqin Li, Jin Liu, Tao Zhang, Yijuan Qiao, Zhijie Yu, Gang Hu, Jun Ma, Xilin Yang, Hui Wang","doi":"10.1186/s12884-025-07418-1","DOIUrl":"10.1186/s12884-025-07418-1","url":null,"abstract":"<p><strong>Objective: </strong>To test associations of cyclin-dependent kinase 5 regulatory subunit-associated protein 1-like 1 (CDKAL1) gene variants with the risk of adverse pregnancy outcome in Chinese women and whether the association was mediated by occurrence of gestational diabetes mellitus.</p><p><strong>Methods: </strong>We organized a 1:1 age-matched study nested within a prospective cohort of pregnant women (207 pairs) established in urban Tianjin. Adverse pregnancy outcome was defined as a composite outcome of preterm birth, low birth weight or macrosomia. Logistic regression analyses were used to estimate associations of CDKAL1 gene variants with adverse pregnancy outcome and its components. The CDKAL1 genetic marker was defined as encompassing any of the identified susceptibility variants for adverse pregnancy outcome.</p><p><strong>Results: </strong>The CDKAL1 genetic marker was associated with the risk of adverse pregnancy outcome (OR: 2.51, 95%CI: 1.47, 4.28), low birth weight (OR: 19.80, 95%CI: 2.15, 182) and macrosomia (OR: 2.40, 95%CI: 1.17, 4.93), but not with preterm birth (P = 0.105) after adjusting for traditional risk factors. Further adjusting for gestational diabetes mellitus, the CDKAL1 genetic marker remained significantly associated with adverse pregnancy outcome, and the OR (95%CI) was 2.52 (1.48, 4.30).</p><p><strong>Conclusion: </strong>The maternal CDKAL1 gene variants were associated with increased risk of adverse pregnancy outcome, low birth weight and macrosomia, independent of gestational diabetes mellitus. CDKAL1 gene might be a useful marker for identification of individuals at a particularly high risk of adverse pregnancy outcome in early pregnancy.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"347"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708415","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":"\"I went to the primary health centre close to my workplace, but their capacity cannot deliver the baby\": exploring why women choose different providers for maternal health services in Nigeria.","authors":"Kofoworola O Akinsola, Olabisi Olasupo, Julius Salako, Jennifer Z Sanaka, Rose N Samuel, Oluwabunmi Bakare, Risikat Quadri, Oluwapelumi Emmanuel, Carina King, Adegoke Falade, Ayobami Adebayo Bakare","doi":"10.1186/s12884-025-07382-w","DOIUrl":"10.1186/s12884-025-07382-w","url":null,"abstract":"<p><strong>Background: </strong>Maternal health remains a significant public health concern globally, including Nigeria. Despite concerted efforts to improve maternal health services, maternal mortality rates in Nigeria remain unacceptably high. Understanding the factors that shape women's choices in selecting the place of birth could help tailor services and improve quality of care for mothers and infants. Therefore, our study explores the experiences, barriers and facilitators that influence where women choose to access maternal health services in three diverse Nigerian states of Lagos, Oyo and Jigawa.</p><p><strong>Methods: </strong>We conducted qualitative in-depth interviews with nursing mothers and healthcareworkers (HCWs) in Lagos, Oyo and Jigawa states, and community birth attendants (CBAs) in Lagos and Oyo. We used maximum variation sampling to purposefully recruit nursing mothers in their puerperium who gave birth in different places. HCWs and CBAs were purposively selected from health facilities and birth homes. All interviews were conducted between September - December 2023. We used reflexive thematic analysis to generate themes across participant types and states.</p><p><strong>Results: </strong>We recruited 44 participants for this study, 25 nursing mothers and 19 HCWs. We identified five major themes: (1) Preference for safe, comfortable and quality health services; (2) Social diffusion and cultural/religious influences; (3) Physical, geographical and financial inaccessibility; (4) Symbolic perception of health facilities and (5) Misunderstanding of health promoting and preventive care in pregnancy. The main reasons for choosing a particular place of birth were the preference for safe, comfortable, and high-quality healthcare, as well as the perceived convenience and accessibility of birth homes within close proximity to the women's homes.</p><p><strong>Conclusions: </strong>We found women's choice of place of birth is influenced by a complex interplay of factors. Among these are health system inadequacies, socio-economic factors, and the desire for comfortable and quality maternal healthcare. HCWs, CBAs, and nursing mothers emphasised these determinants as critical in shaping women's decisions regarding where to give birth. This highlights the need for comprehensive interventions across policy, healthcare delivery, community engagement, and individual levels to overcome barriers, improve maternal health outcomes, and support women in making informed childbirth decisions.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"339"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708404","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}