BMC Pregnancy and Childbirth最新文献

{"title":"Development of a prognostic scoring system for predicting hospitalization duration in postpartum endometritis.","authors":"Yael Yagur, Lisa Barcilon-Tiosano, Dana Segal, Tally Pinchas-Cohen, Nagam Gnaiem, Yair Daykan, Ron Schonman, Michal Kovo, Omer Weitzner","doi":"10.1186/s12884-024-07090-x","DOIUrl":"10.1186/s12884-024-07090-x","url":null,"abstract":"<p><strong>Background: </strong>We aim to identify risk factors contributing to extended rehospitalizations in patients diagnosed with postpartum endometritis requiring intravenous antibiotics.</p><p><strong>Methods: </strong>This retrospective cohort study examined postpartum endometritis patients readmitted for treatment from 2014 to 2022, comparing short (≤ 48 h) and prolonged hospitalization (> 48 h). Data included patient demographics, medical history, presentation parameters, vaginal examination findings, sonographic data, laboratory results, and details of the current labor to create a scoring system predicting prolonged hospitalization risk.</p><p><strong>Results: </strong>During the study, 270 women with postpartum endometritis were hospitalized. Among them, 61 (22.6%) had hospital stays ≤ 48 h, while 209 (77.4%) experienced hospitalization > 48 h. Upon readmission, compared to the group with short stays, patients in the > 48 h group exhibited significantly elevated heart rates (97.9 ± 18.3 vs. 89.7 ± 12.9 bpm; p < 0.002) and CRP levels (13.8 ± 9.8 mg/dL vs. 8.1 ± 7 mg/dL; p < 0.001), respectively. Ultrasound revealed higher rates of pelvic hematoma or abscess in the > 48 h group (35.4% vs. 13.1%, respectively; p = 0.02). Multivariable logistic regression identified independent associations between hospitalization > 48 h and rupture of membranes > 14.5 h adjusted odds ratio (aOR 1.29, 95% CI 0.16-0.6, p = 0.016), temperature > 37.25 °C at readmission (aOR 1.31, 95% CI 0.013-0.42, p < 0.001), and CRP > 6.5 mg/dL at readmission (aOR 1.27, 95% CI 0.09-0.4, p = 0.002). A predictive scoring system was developed, indicating risks for prolonged hospitalization from 0.5 to 0.8.</p><p><strong>Conclusion: </strong>The scoring system developed to predict prolonged hospitalization in postpartum endometritis can provide clinicians with valuable insights for improved diagnosis and prognosis.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"877"},"PeriodicalIF":2.8,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11682643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891931","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":"Mobile-based peer-led theoretically-designed intervention on continued breastfeeding among Iranian mothers.","authors":"Afsoon Tizvir, Sakineh Rakhshanderou, Yadollah Mehrabi, Leili Mazar, Samira Daneshvar, Mohtasham Ghaffari","doi":"10.1186/s12884-024-07094-7","DOIUrl":"10.1186/s12884-024-07094-7","url":null,"abstract":"<p><strong>Background: </strong>This study addresses the determination of educational intervention-based on the Theory of Planned Behavior (TPB)-effectiveness on continued breastfeeding among Iranian mothers attending health centers, considering low researchers' attention to the continued breastfeeding index despite its important impact on children's health.</p><p><strong>Methods: </strong>The present study was conducted among 230 mothers with exclusively breastfed infant (115 in the intervention group and 115 in the control group). Sampling starts with randomly selecting 12 health centers among all health centers in Karaj, Alborz province, and allocating them randomly into two equal groups of intervention and control. A study-specific questionnaire, designed in alignment with TPB, was the primary data collection tool. The intervention group received peer education, and optional additional education through a social network. Data were collected in 4 stages, including before the intervention, immediately, 3 months, and 6 months after the intervention. Data were analyzed using SPSS-16 and Independent t-test, Chi-square RMANOVA, ANCOVA, Cochran and McNemar tests.</p><p><strong>Results: </strong>There was a significant increase in the mean scores of attitude, subjective norms and perceived behavioral control constructs in the intervention group and a significant decrease of those constructs was observed in the control group (p < 0.05). There was an improvement in the mean score of breastfeeding continuation behavior among intervention group mothers after intervention exposure but it was not significant (p > 0.05). There was also a significant decrease in breastfeeding and an increase in the usage of powdered milk in mothers of the control group (p < 0.05).</p><p><strong>Conclusion: </strong>It was concluded that educational interventions based on TPB by using peer group and social network can promote the behavior of continued breastfeeding. This theoretical framework can act as a road map for future development of educational interventions targeting breastfeeding continuation.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"871"},"PeriodicalIF":2.8,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891939","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":"Exploring key embryonic developmental morphokinetic parameters that affect clinical outcomes during the PGT cycle using time-lapse monitoring systems.","authors":"Ran Jiang, Guang Yang, Huihui Wang, Junnan Fang, Jingyi Hu, Tongwei Zhang, Yue Kong, Zhaoting Wu, Xianju Huang, Lin Qi, Ning Song, Wenyan Song, Haixia Jin, Guidong Yao","doi":"10.1186/s12884-024-07080-z","DOIUrl":"10.1186/s12884-024-07080-z","url":null,"abstract":"<p><strong>Research question: </strong>Is it possible to predict blastocyst quality, embryo chromosomal ploidy, and clinical pregnancy outcome after single embryo transfer from embryo developmental morphokinetic parameters?</p><p><strong>Design: </strong>The morphokinetic parameters of 1011 blastocysts from 227 patients undergoing preimplantation genetic testing were examined. Correlations between the morphokinetic parameters and the quality of blastocysts, chromosomal ploidy, and clinical pregnancy outcomes following the transfer of single blastocysts were retrospectively analyzed.</p><p><strong>Results: </strong>The morphokinetic parameters of embryos in the high-quality blastocyst group were significantly shorter than those in the low-quality blastocyst group (p < 0.05). In contrast, the CC2 time was significantly prolonged (p < 0.05). On chromosomal analysis of biopsy blastocysts nourished by trophectoderm cells, in comparison to euploid embryos, aneuploid embryos exhibited significant extensions in tPNa, S3, tSC, tM, tSB, and tB (p < 0.05), with a simultaneous significant reduction in CC2 time (p < 0.05). After adjusting for age and body mass index through logistic regression analysis, late morphokinetic parameters, namely tM (OR 0.96; 95% CI 0.93-0.99), tSB (OR 0.94; 95% CI 0.90-0.97), and tB (OR 0.93; 95% CI 0.90-0.97), emerged as independent risk factors influencing the development of embryos into high-quality blastocysts. S3 (< 12.01 h), t8 (< 62.48 h), and tPB2 (< 3.36 h) were potential predictors of a successful clinical pregnancy after blastocyst transfer.</p><p><strong>Conclusion: </strong>Morphokinetic parameters showed correlations with blastocyst quality, chromosomal status, and clinical pregnancy outcomes post-transfer, making them effective predictors for clinical results. Embryos with relatively rapid development tended to exhibit better blastocyst quality, chromosomal ploidy, and improved clinical pregnancy outcomes. The late morphokinetic parameter, S3, demonstrated a strong predictive effect on blastocyst quality, chromosomal ploidy, and clinical pregnancy outcomes.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"870"},"PeriodicalIF":2.8,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891870","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":"Conceiving during the first postoperative year after bariatric surgery: a retrospective study of pregnancy outcomes.","authors":"Sesilia Kaukonen, Susanna Pajula, Mika Gissler, Anne Juuti, Veli-Matti Ulander, Marja Kaijomaa","doi":"10.1186/s12884-024-07047-0","DOIUrl":"10.1186/s12884-024-07047-0","url":null,"abstract":"<p><strong>Background: </strong>An increasing number of childbearing-aged women have undergone bariatric surgery (BS). Although pregnancy outcomes generally improve after BS, concern remains over the impact of rapid weight loss and the catabolic state that occurs soon after BS. At least a 12-month surgery-to-conception time (SCT) is recommended, though the reasoning behind this has been questioned. This retrospective study was conducted to compare post-BS pregnancies with SCTs of less (Group 1) or more (Group 2) than 12 months.</p><p><strong>Methods: </strong>The Hospital Register and Finnish Medical Birth Register were queried for data on BS and subsequent pregnancies. The characteristics of women at surgery and maternal and newborn outcomes in post-BS pregnancies were collected.</p><p><strong>Results: </strong>Between 2010 and 2022, 113 women gave birth after BS. This included 17 and 96 patients in Groups 1 and 2. The mean SCTs were 8.0 ± 2.7 and 39.0 ± 24.3 months (p < 0.001), respectively. At BS, the characteristics of age (p = 0.316), weight (p = 0.718), body mass index (BMI) (p = 0.114) and surgical technique used (p = 0.648) were similar. During pregnancy, the mean age of Group 1 women was significantly lower (p = 0.005). With no difference in weight (p = 0.961) or BMI (p = 0.567), the incidence of gestational diabetes mellitus (GDM, p = 0.039) was higher in Group 2. The mean gestational age at delivery (p = 0.206) and incidence rates of preterm (p = 0.645), post-term (p = 1.00) and caesarean deliveries (p = 1.00) in the groups were similar. A significantly higher incidence of delivery induction (p < 0.001 was detected in Group 2. The mean newborn weight in Group 1 was lower (p = 0.038), but the mean birth weight standard deviation (p = 0.883) and incidences of low birth weight (< 2500 g, p = 0.345) and small-for-gestational-age newborns (p = 0.469) were similar. The 1- (p = 0.191) and 5-min (p = 0.174) Apgar points in the groups were similar, and no associations between pregnancy outcomes and surgery technique were detected.</p><p><strong>Conclusions: </strong>The outcome in pregnancies with an SCT 12 months, postponing pregnancy may not always improve pregnancy outcomes. Therefore, all risks should be weighed when counselling women regarding the optimal time of pregnancy after BS.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"862"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891926","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":"Correction: Impact of varied feeding protocols on gastrointestinal function recovery in the early postoperative period following repeat cesarean section: a randomized controlled trial.","authors":"Xiao-Li Hu, Yu-Peng Wang, Lu-Ping Wu, Xiao-Feng Shi, Li-Hua Yu, Ai-Hua Zhang, Xiao-Xiao Zhu, Xiao-Feng Weng","doi":"10.1186/s12884-024-07100-y","DOIUrl":"10.1186/s12884-024-07100-y","url":null,"abstract":"","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"867"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891928","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":"Uncertain significance and molecular insights of CPLANE1 variants in prenatal diagnosis of Joubert syndrome: a case report.","authors":"Si-Xiu Li, Leiting Chen, Chen Deng, Dongmei Tang, Jing Zhang, Wen-Guang Hu, Yu Hu, Hua Lai, Xiao Yang","doi":"10.1186/s12884-024-07052-3","DOIUrl":"10.1186/s12884-024-07052-3","url":null,"abstract":"<p><strong>Background: </strong>Prenatal whole exome sequencing (WES) is becoming an increasingly used diagnostic tool for fetuses with structural anomalies. However, the identification of variants of uncertain significance (VUS) in clinically relevant genes can significantly complicate prenatal diagnosis and genetic counseling.</p><p><strong>Case presentation: </strong>A fetus conceived through in vitro fertilization at the third attempt presented with polydactyly and molar tooth sign at 24 + 6 weeks of gestation. Trio-based WES was performed on both parents and the affected fetus, revealing a pair of compound heterozygous CPLANE1 variants (c.4646 A > T/p.Glu1549Val and c.1233 C > A/p.Tyr411*) potentially associated with Joubert syndrome. According to the ACMG guidelines, one of the biallelic variants was classified as VUS, and the other as pathogenic. However, these variants had no allele frequencies in the general population. The p.Tyr411* variant was classified as deleterious, while the p.Glu1549Val variant was located in highly conserved residues, was predicted to be damaging by in silico tools, and altered hydrogen bonding. Furthermore, CPLANE1 expression was highest in the brain during the embryonic and fetal stages. These findings provide additional support for the association between CPLANE1 variants in this fetus and Joubert syndrome. Thus, the most likely diagnosis was Joubert syndrome, and after careful consideration, the couple decided to terminate the pregnancy.</p><p><strong>Conclusion: </strong>The expression patterns of CPLANE1 and the molecular effects of the variants may provide further evidence supporting the potential for prenatal diagnosis of Joubert syndrome in the case of biallelic VUS and pathogenic variant. This study suggests that molecular insights may play a role in interpreting VUS in clinically relevant prenatal genes for prenatal diagnosis.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"865"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of schistosomiasis infection on maternal and neonatal outcomes in pregnancy: a prospective cohort study in Nigeria.","authors":"Chigozie F Okoroafor, Osita S Umeononihu, Chidebe C Anikwe, Adeniyi J Adebayo, Chijioke O Ezeigwe, Ayodele A Olaleye, Bartholomew C Okorochukwu, Onyechrelam M Ogelle, George U Eleje","doi":"10.1186/s12884-024-07064-z","DOIUrl":"10.1186/s12884-024-07064-z","url":null,"abstract":"<p><strong>Background: </strong>Schistosomiasis, a neglected tropical disease, affects approximately 40 million women of reproductive age contributing to preventable anaemia during pregnancy, intrauterine growth retardation and low birth weight. In spite of the high prevalence rate of this disease among school aged children in Abakaliki, no study in Abakaliki has looked at the burden of Schistosomal infection in pregnancy with a view to determining maternal and neonatal outcomes.</p><p><strong>Objective: </strong>To determine the association between schistosomal infection and maternal anemia, low birth weight, and other neonatal outcomes in Abakaliki.</p><p><strong>Materials and methods: </strong>This was a prospective cohort study involving 94 randomly selected pregnant women with schistosomal infection and 94 matched controls without schistosomal infection. Pregnant women included were at 34 to 36 weeks of gestation. The Kato-Katz technique was used for identification and quantification of the S. mansoni, and S. japonicum, parasites in the stool, while the Ziel-Neilson stain was used for detection of the S. haematobium parasites in the urine. The patients were followed up until delivery to determine maternal and neonatal outcomes. The data were analysed using IBM SPSS version 20. The level of significance is at P - value < 0.05.</p><p><strong>Results: </strong>The prevalence of schistosomiasis in the study area was (94/968) 9.71%. The predominant species identified was Schistosoma haematobium (61/94; 64.9%). Nulliparous women were more likely to have heavy schistosomiasis infections than multiparous women (OR 6.09, 95% CI 2.3 - 15.68; P =0.0001). Neonates of women infected with schistosomiasis had low birth weight compared with the control group (2.91 ±0.70kg vs. 3.20±0.60kg, P = 0.002). Placental mass was lower in cohort of women with the disease compared with the control (0.49±0.08kg vs. 0.52±0.09kg, P = 0.02). All the cohort of women with schistosomiasis were anaemic (28±1.9 vs. 30 ±2.1, P = < 0.0001). Burden of maternal anaemia was very high among cohort with heavy infection compared with those that had light infection (OR = 2.4 95%CI1.02-5.9, P = 0.04). Schistosoama haematobium infection was more likely to cause lower maternal haematocrit levels than Schistosoama mansoni infection was (OR 4.72 95% CI 1.87-11.95, P < 0.001).</p><p><strong>Conclusion: </strong>Schistosomiasis in pregnancy is associated with adverse maternal and neonatal outcomes. S. haematobium was more likely to cause maternal anaemia than S. mansoni. We recommend routine antenatal screening of Schistosomiasis infection in the study area and the need to consider routine administration of praziquantel to antenatal attendee in the study area.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"864"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891873","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 of malaria and associated factors among pregnant women in East Dembia District Northwest Ethiopia.","authors":"Mekonnen Sisay, Meseret Kebede, Atalay Goshu","doi":"10.1186/s12884-024-07083-w","DOIUrl":"10.1186/s12884-024-07083-w","url":null,"abstract":"<p><strong>Background: </strong>Even though several measures have been taken to eliminate malaria, its burden remains persistently high in Sub-Saharan Africa. More than 125 million pregnant women are at risk of getting malaria per year. There is a scarcity of community based evidence on malaria prevalence among pregnant women and associated factors in Northwest Ethiopia. This study aimed to generate evidence on the prevalence and associated factors of malaria among pregnant women in East Dembia district, North West Ethiopia.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted from March to June 2022 in East Dembia district, Northwest Ethiopia. A multi-stage sampling technique was used to select 821 pregnant women. A structured questionnaire was used for data collection. Malaria was diagnosed using rapid diagnostic testing. The data was entered using EPI info version 7 and transferred to SPSS version 20 for analysis. Descriptive statistics were presented using frequency and percentages. Bivariable and multivariable binary logistic regression models were fitted to identify factors associated with malaria infection among pregnant women. Variables having p-value < 0.2 were considered in the multivariable analysis. And a p value of < 0.05 was used as the cut-off value for statistical significance in the multivariable models. Adjusted odds ratio with its 95% confidence interval was used to measure the strength of the association.</p><p><strong>Results: </strong>In this study, 111 (14%, 95% Confidence Interval (CI): 10.20-19.40%) of the participants were found to have malaria. Among these, 82 (73.80%) of the parasite-positive pregnant women were infected with Plasmodium falciparum, and the remaining 23 (20.72%) and 6 (5.41%) were infected with Plasmodium vivax and mixed species respectively. In the multivariate analysis; unprotected source of water (Adjusted Odds Ratio (AOR): 14.99; 95% CI: 1.08-207.50), utilization insecticide-treated bed net (ITN) (AOR: 0.13; 95% CI: 0.03-0.49) stagnant water less than 1Killo meter (KM) distance from home (AOR: 3.52; 95% CI: 1.16-10.74), ownership bed net (AOR: 0.10; 95% CI: 0.04-0.70) were significantly associated with malaria among pregnant women.</p><p><strong>Conclusion: </strong>Malaria is still a public health problem among pregnant women in East Dembia district. The present study indicated that adequate distribution of bed net, its community ownership, and eradication of stagnant water in regular basis might be helpful to prevent and control malaria. In addition, screening pregnant women for asymptomatic malaria infection and distribution of proper utilization of bed nets shall be provided.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"866"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891946","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":"Integrated proteomics and metabolomics network analysis across different delivery modes in human pregnancy: a pilot study.","authors":"Yun Huang, Yanyan Ni, Yu Meng, Xiaojing Zeng, Xiaoqing He, Lin Zhang, Jun Zhang","doi":"10.1186/s12884-024-07097-4","DOIUrl":"10.1186/s12884-024-07097-4","url":null,"abstract":"<p><strong>Background: </strong>Delivery mode has been linked to child health, e.g., allergic disease. However, it remains unclear whether protein and metabolite differences across different delivery modes may underlie child development.</p><p><strong>Methods: </strong>A cohort comprising 16 spontaneous onset vaginal delivery (VD), 16 prelabor cesarean delivery on maternal request (CS), and 8 intrapartum cesarean section (Intra_CS) women were analyzed using label-free proteomic and untargeted metabolomics assays on amniotic fluid and cord blood samples, respectively. We used weighted gene co-expression network analyses (WGCNA) to identify modules of highly correlated proteins or metabolites that associated with delivery modes and related clinical traits. KEGG enrichment analyses were performed to investigate the biological function of the identified modules. Integrative multiomics analysis was employed to examine the biological interplay between proteomic and metabolic interactions.</p><p><strong>Results: </strong>Compared to the CS group, the proteomic and metabolomic profiles were similar between the Intra_CS and VD groups in our study. We did not identify any enriched protein or metabolite pathways related to immune development that could influence the risk of allergic diseases in offspring across different delivery modes. However, we identified seven protein modules correlated with the duration from the rupture of the membranes to full dilation of the cervix, with the actin cytoskeleton module significantly enriched. A metabolic module in cord blood that correlated with VD was enriched in subclasses including C21 steroids, steroid sulfates, and oxysterols. Integrative analysis of proteomic and metabolomic data suggested pathways related to mode of delivery and duration of labor, encompassing the actin cytoskeleton, NADP metabolic process, nicotinate, and nicotinamide metabolism in amniotic fluid, and the steroid hormone biosynthesis pathway in cord blood.</p><p><strong>Conclusions: </strong>Differences in steroid hormones and the actin cytoskeleton pathway according to proteomics and metabolomics in amniotic fluid and cord blood were more indicative of the labor process. These findings could guide future studies on delivery-associated biochemical pathways.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"868"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891876","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":"Differences between neonatal units with high and low rates of breast milk feeding for very preterm babies at discharge: a qualitative study of staff experiences.","authors":"Jenny McLeish, Annie Aloysius, Chris Gale, Maria Quigley, Jennifer J Kurinczuk, Fiona Alderdice","doi":"10.1186/s12884-024-07039-0","DOIUrl":"10.1186/s12884-024-07039-0","url":null,"abstract":"<p><strong>Background: </strong>Breast milk has significant benefits for preterm babies, but 'very preterm' babies are unable to feed directly from the breast at birth. Their mothers have to initiate and sustain lactation through expressing milk for tube feeding until their babies are developmentally ready to feed orally. There are wide disparities between neonatal units in England in rates of breast milk feeding at discharge. This study explored health professionals' experiences of barriers and facilitators to their role in supporting breast milk feeding and breastfeeding for very preterm babies.</p><p><strong>Methods: </strong>12 health professionals were interviewed, from four neonatal units in England with high or low rates of breast milk feeding at discharge. Interviews were analysed using comparative thematic analysis.</p><p><strong>Results: </strong>Five themes were developed: 'The role of the infant feeding specialist', 'Achieving a whole team approach to breast milk feeding', 'Supporting initiation of breastfeeding' 'Supporting long-term expressing', 'Supporting the transition to breastfeeding'. There were notable differences between neonatal units in the time allocated to specialist feeding support, the team's sense of collective responsibility for supporting feeding, leadership, the use of external standards as levers for change, and training for the multi-disciplinary team. The feeding challenges faced by mothers of very preterm babies could be made worse where there was no joined-up working between neonatal and postnatal staff; inadequate facilities for mothers to stay with their babies; and when opportunities were missed to give information about the importance of early initiation of expressing and to support mothers' confidence during the transition to direct breastfeeding.</p><p><strong>Conclusions: </strong>Effective support can be influenced by having a supernumerary post dedicated to infant feeding; strong leadership that champions breast milk feeding and breastfeeding within Family Integrated Care; maintaining accountability by using existing quality improvement tools and accredited standards for neonatal units; and training for the whole multi-disciplinary team that encourages and enables every member of staff to take an appropriate share of responsibility for consistently informing and assisting mothers with expressing and breastfeeding. Joined-up working between staff on antenatal and postnatal wards and neonatal units is important to enable integrated feeding support for the mother-baby dyad.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"863"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891934","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}