BMC Pregnancy and Childbirth最新文献

{"title":"Timing of diagnostic workups in Chinese population with recurrent pregnancy loss: a cross-sectional study.","authors":"Liyang Zhang, Yushu Du, Jingshuang Zhou, Chuanyang Liu, Jiapo Li, Chong Qiao","doi":"10.1186/s12884-025-07330-8","DOIUrl":"10.1186/s12884-025-07330-8","url":null,"abstract":"<p><strong>Background: </strong>There are no specific guidelines regarding the definition, diagnostic workup and treatment of recurrent pregnancy loss (RPL) in China at present. Whether the diagnostic workup should occur after two or three or more pregnancy losses in the Chinese population is not clear.</p><p><strong>Methods: </strong>This cross-sectional study collected data from January 2017 to December 2022 from the RPL Clinic at Shengjing Hospital, affiliated with China Medical University. The results of diagnostic tests for evidence-based and possible risk factors of RPL,which is defined as two or more failed clinical pregnancies, were collected. The data collected include parental chromosomal karyotypes, immune factors (anticardiolipin antibody, anti-β2-glycoprotein I antibody, lupus anticoagulants, and antinuclear antibodies), endocrine factors (polycystic ovary syndrome, thyroid dysfunction, hyperprolactinemia, obesity, and glucose abnormalities), anatomical factors (uterine malformations, endometrial polyps, intrauterine adhesions, uterine fibroids or adenomyosis), coagulation factors (thrombelastogram, antithrombin III, and homocysteine levels) and other factors (vitamin D levels, MTHFR polymorphisms and ultrasound indices of endometrial receptivity). All these data were compared between patients with two or three or more pregnancy losses.</p><p><strong>Results: </strong>Among all 785 patients with RPL, the rates of abnormal anatomical factors (40.96% versus 32.94%, P = 0.021, OR 1.41, (95% Cl 1.05-1.89)), endometrial polyps (6.21% versus 3.06%, P = 0.034, OR 2.10, (95% Cl 1.04-4.23)) and obesity (13.76% versus 5.59%, P < 0.0001, OR 2.69, (95% Cl 1.62-4.49)) were significantly higher in people with three or more pregnancy losses than in people with two pregnancy losses. The rates of other diagnostic tests were not statistically significant between the two groups.</p><p><strong>Conclusion: </strong>Based on the high rate of abnormal test results in the Chinese RPL population, our findings may provide evidence for patients in our area begin routine etiological screening after two pregnancy losses.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03561766, 18/5/2018.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"373"},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742257","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":"Barriers to postpartum health and opinions on a postpartum peer navigator program amongst refugee women resettled in California.","authors":"Sarah Alsamman, Ruth Teseyem Tadesse, Khatira Sarferaz, Amina Sheik Mohamed, Sheila K Mody","doi":"10.1186/s12884-025-07479-2","DOIUrl":"10.1186/s12884-025-07479-2","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study is to identify postpartum challenges and assess for interest in a postpartum peer navigator program amongst refugee women resettled in California.</p><p><strong>Methods: </strong>Participants were recruited through ethnic community-based organizations in California using convenience and snowball sampling. Arabic, Dari, or Pashto speaking women who have given birth in the United States within the last five years and entered the country as refugees, special immigrant visa holders, or asylum seekers were eligible to participate. Semi-structured interviews were analyzed using Braun and Clarke's thematic analysis.</p><p><strong>Results: </strong>We interviewed 26 participants. The mean age was 30 years (SD = 6.3) and mean length of time in the United States was 4.5 years (SD = 3.0). All participants are state insurance recipients. Most participants (89%, n = 23) utilize an interpreter. We identified seven themes: (1) lack of comprehensible postpartum information; (2) displacement and isolation worsen postpartum mental health; (3) stigma and fear discourage seeking postpartum mental health care; (4) barriers in interpretation undermine postpartum care recommendations; (5) interest in a language concordant postpartum navigator.</p><p><strong>Conclusion: </strong>Refugee women encounter challenges with contraception and mental health care postpartum exacerbated by language barriers and difficulties with interpreter use. There is interest in language concordant postpartum peer navigation as tool to mitigating these challenges.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"372"},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742238","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":"Accurate prediction of mediolateral episiotomy risk during labor: development and verification of an artificial intelligence model.","authors":"Tingting Hu, Liheng Zhao, Xueling Zhao, Lin He, Xiaoli Zhong, Zhe Yin, Junjie Chen, Yanting Han, Ka Li","doi":"10.1186/s12884-025-07441-2","DOIUrl":"10.1186/s12884-025-07441-2","url":null,"abstract":"<p><strong>Objective: </strong>The study developed an intelligent online evaluation system for mediolateral episiotomy, which incorporated machine learning algorithms and integrated maternal physiological data collected during delivery.</p><p><strong>Methods: </strong>In this study, a predictive model for mediolateral episiotomy was constructed first, and based on this, an early warning system using open-source R software was established. The physiological data of 1191 parturients who delivered at Deyang People's Hospital in western China from January 2022 to December 2022 were collected and divided into training set and test set according to a ratio of 8:2. The factors affecting mediolateral episiotomy were determined based on the expert consultation method. Six machine learning models, namely Logistic regression(LR), Support Vector Machine(SVM), K-Nearest Neighb(KNN), Random Forest (RF), Light Gradient Boosting Machine(LightGBM), and eXtreme Gradient Boosting‌(XGBoost) were constructed on this basis. The models' performance was evaluated using accuracy, precision, recall, F1 value, and area under the receiver operating characteristic curve (AUC) measures. Additionally, a confusion matrix was employed to assess their performance across different categories. SHapley Additive exPlanation (SHAP) provided interpretability. The clinical external verification process focused on data collected from January to March 2023, and an intelligent online evaluation system for mediolateral episiotomy was developed.</p><p><strong>Results: </strong>Twenty eight factors influencing mediolateral episiotomy were screened. The model evaluation results showed that the SVM model has the best prediction ability among the six models, with an accuracy of 0.793, a recall rate of 0.981, a precision rate of 0.790, and a F1 value of 0.875. The area under ROC curve of SVM was 0.882, The verification results showed that the prediction accuracy was 74% for undergoing mediolateral episiotomy and 93% for not undergoing it. SHAP analysis identified perineal elasticity, number of pregnancies, BMI, perineum edema, and age as top predictors. An early warning system for mediolateral episiotomy was successfully constructed, which can assist the clinical medical staff in decision-making by inputting the maternal data.</p><p><strong>Conclusion: </strong>The early warning system for the risk of mediolateral episiotomy constructed in this study can accurately and rapidly utilize the physiological data of parturients during labor to predict the risk of mediolateral episiotomy in the third stage of labor.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"370"},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742236","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":"Fetal umbilical vein thrombosis associated with fetal bartter syndrome: an unusual case report and literature review.","authors":"Jinglin Zhao, Aiyun Xing, Jin Jia","doi":"10.1186/s12884-025-07496-1","DOIUrl":"10.1186/s12884-025-07496-1","url":null,"abstract":"<p><strong>Background: </strong>Bartter syndrome (BS) is a rare autosomal recessive renal disease. There are relatively few reports on fetal Bartter syndrome, but it has been documented that the condition can increase the incidence of prematurity and hypovolemia. Umbilical vein thrombosis (UVT) is a rare obstetric complication that poses a serious threat to fetal safety, potentially leading to acute fetal distress and even intrauterine fetal death. Consequently, early identification and intervention of UVT are crucial.</p><p><strong>Case presentation: </strong>We present a case of an emergency cesarean section prompted by ultrasound findings of intrahepatic segment of umbilical vein thrombosis and polyhydramnios. After birth, the newborn was admitted to the Department of Neonatology for observation and further treatment due to persistent, uncorrected hypokalemia. Genetic testing diagnosed the infant with Bartter syndrome type 4b. We hypothesize that the umbilical vein thrombosis and polyhydramnios in this case may be associated with fetal Bartter syndrome.</p><p><strong>Conclusion: </strong>This case highlights a suspected instance of umbilical vein thrombosis and polyhydramnios potentially linked to fetal Bartter syndrome. Currently, the causes of umbilical vein thrombosis primarily focus on abnormalities in umbilical cord structure or mechanical injury to the cord, with few cases involving fetal genetic conditions. The purpose of this report is to enhance medical professionals' understanding of Bartter syndrome and to consider it as a possible cause of fetal umbilical vein thrombosis and polyhydramnios. Further research should explore the link between fetal Bartter syndrome, umbilical vein thrombosis, and polyhydramnios. Additionally, strengthening case collection and analysis will help accumulate experience, optimize management strategies, and improve maternal and fetal outcomes.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"371"},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742251","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":"Endometrial preparation methods prior to frozen embryo transfer: a retrospective cohort study comparing true natural cycle, ovulation induction, hormone replacement treatment and GnRHa pretreatment.","authors":"Jiaoqi Mei, Nana Liu, Yuxiang Liu, Min Li","doi":"10.1186/s12884-025-07211-0","DOIUrl":"https://doi.org/10.1186/s12884-025-07211-0","url":null,"abstract":"<p><strong>Purpose: </strong>To compare pregnancy outcomes of four endometrial preparation methods prior to frozen embryo transfer (FET).</p><p><strong>Methods: </strong>A total of 3,030 programmed cycles were analyzed: 302 with natural cycle (NC), 131 with ovulation induction (OI), 1,078 with hormone replacement treatment (HRT), and 1,519 with GnRHa pretreatment (GnRHa + HRT). Primary outcomes investigated were positive human chorionic gonadotropin (hCG), chemical pregnancy, clinical pregnancy, abortion, and live birth. Additionally, the impact of age, body mass index (BMI), embryo number, high-quality embryo, and endometrial thickness on pregnancy outcomes were analyzed.</p><p><strong>Results: </strong>The positive hCG rates for NC, OI, HRT, and GnRHa + HRT groups were 63.4%, 62.6%, 68.3%, and 71.7%, respectively (P = 0.004). Clinical pregnancy rates were 50.4%, 54%, 57.5%, and 61.8%, respectively (P = 0.004). Live birth rates were 38.2%, 45%, 46.5%, and 50.9%, respectively (P = 0.007). No significant differences were found in abortion and chemical pregnancy rates among the four protocols. NC showed significantly higher positive hCG (p = 0.044), live birth (p = 0.005), and clinical pregnancy rates (p = 0.010) compared to other methods. Compared to HRT, GnRHa + HRT displayed significantly higher live birth (p = 0.027) and clinical pregnancy rates (p = 0.027). Multiple logistic regression showed that the number of embryos and high-quality embryos increased HCG positivity, clinical pregnancy, and live birth rates, while age reduced these rates. BMI increased the abortion rate, and endometrial thickness increased the live birth rate. Chemical pregnancy was unaffected by these factors.</p><p><strong>Conclusion: </strong>NC offers improved outcomes compared to other methods. Additionally, specific factors such as embryo quality and embryo number significantly influence pregnancy outcomes.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"366"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742213","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":"Critical signs and symptoms for self-assessment in the immediate postnatal period: an international Systematic Scoping Review and Delphi consensus study.","authors":"Teesta Dey, Nada Bassiony, Angela Hancock, Lenka Benova, Matthews Mathai, Etienne Vincent Langlois, Sam Ononge, Tina Lavender, Andrew Weeks","doi":"10.1186/s12884-025-07472-9","DOIUrl":"https://doi.org/10.1186/s12884-025-07472-9","url":null,"abstract":"<p><strong>Background: </strong>Every two minutes a woman dies from complications of pregnancy and childbirth. Most maternal deaths occur within the first 24 hours following birth, highlighting the importance of immediate postnatal care (iPNC). Self-care strategies are increasingly being employed to promote women-centred, continuous care provision. Despite international calls for development of strategies promoting self-care, none have been developed for self-monitoring in the immediate postnatal period. Fundamental to the development of a self-monitoring strategy, is an understanding of which signs and symptoms are predictive of maternal morbidity and mortality and can be easily assessed by mothers and birth companions, in health facilities, without the need for equipment. The objective of this study was to develop and achieve international consensus on the key signs and symptoms.</p><p><strong>Methods: </strong>A multi-step approach involving a systematic scoping review, two- round Delphi Survey, and expert consensus was employed to identify key signs and symptoms that can be self- assessed and predict morbidity and mortality in the immediate postnatal period.</p><p><strong>Results: </strong>A comprehensive list of 351 key signs and symptoms was identified from 44 clinical practice guidelines. Subsequently, 134 signs and symptoms were reviewed by Delphi respondents and international expert consensus was achieved for 19 key signs and symptoms across seven condition categories. The signs that were considered both important and able to be self-assessed by mothers and birth companions in the first 24 hours following birth included change in consciousness, seizure, severe headache, persistent visual impairment, urinary incontinence, chest pain, shortness of breath, severe pallor, fast heartbeat, rejection of baby, suicidal/infanticidal, fever, heavy blood loss, soft flabby uterus, unable to urinate easily, foul smelling discharge, rigors, syncope/dizziness, abnormal coloured urine.</p><p><strong>Conclusion: </strong>This study identified key signs and symptoms which can be easily assessed by mothers and birth companions in the immediate postnatal period to identify those most at risk of morbidity and mortality. Further work is needed to validate this screening tool, and adapt it regionally and nationally.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"364"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742207","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":"Establishing a predictive model for ectopic pregnancy risk following assisted reproductive technology.","authors":"Jie Li, Tiantian Dai, Yang Liu, Yuanyi Li, Tailin Chen, Xiaojun Chen, Li Jin","doi":"10.1186/s12884-025-07455-w","DOIUrl":"https://doi.org/10.1186/s12884-025-07455-w","url":null,"abstract":"<p><strong>Background: </strong>The risk of ectopic pregnancy (EP) is known to increase with assisted reproductive technology (ART), but the specific risk factors are unclear.</p><p><strong>Methods: </strong>We screened 6872 cycles for clinical data that met our study's inclusion criteria and conducted univariate and multivariate analyses to identify factors associated with EP and develop a nomogram prediction model for its incidence.</p><p><strong>Results: </strong>The multivariate analysis demonstrated that women with polycystic ovary syndrome (PCOS) have an over two-fold increased risk of EP (aOR = 2.07, 95% CI: 1.27-3.36, P = 0.004). Frozen embryo transfer can significantly reduce the risk of EP compared to fresh embryo transfer (aOR = 2.17, 95% CI: 1.62-2.91, P < 0.001). Male infertility factor was associated with a 1.4-fold increased risk of EP (aOR = 1.39, 95% CI: 1.05-1.85,P = 0.021). Each 1 mm increase in endometrial thickness (EMT) is associated with a 15% reduction in the odds of EP(aOR = 0.86, 95% CI: 0.77-0.93, P < 0.001). Women with EP history was associated with 1.4-fold increased risk of EP (aOR = 1.41, 95% CI: 1.01-1.97, P = 0.046). A nomographic prediction model was established based on the results above. The area under the curve (AUC) for the model predicting EP following ART is 0.624, whereas in the external validation set, it is 0.618.</p><p><strong>Conclusions: </strong>Our findings indicate that PCOS increases the risk of EP after ART, and fresh embryo transfer is also linked to higher EP rates. We developed a nomogram to predict and mitigate the incidence of EP.</p><p><strong>Trial registration: </strong>Retrospectively registered.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"365"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742215","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":"Comparing the maternal and neonatal outcomes in vaccinated and unvaccinated pregnant women against COVID-19: a retrospective cohort study.","authors":"Zahra Gholami, Maryam Mohseni, Pouran Allahbakhshi Nasab","doi":"10.1186/s12884-025-07462-x","DOIUrl":"https://doi.org/10.1186/s12884-025-07462-x","url":null,"abstract":"<p><strong>Background: </strong>Following the emergence of COVID-19 disease, and considering the limited number of studies regarding vaccination among pregnant women, as well as the differences between the vaccine administered in Iran and those used in other countries, this study aimed to compare maternal and neonatal outcomes in vaccinated and unvaccinated women against COVID-19 disease.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at the comprehensive healthcare centers of Rafsanjan city. Initially, the contact information of expectant mothers who were pregnant between June 22, 2021, and December 22, 2021, was obtained through Iran's integrated healthcare system (Sib). Subsequently, the required information was collected via a checklist during phone interviews. Out of 969 pregnant women, after applying the inclusion and exclusion criteria, 610 subjects were included in the study. Among these, 330 were unvaccinated, while the remaining participants had received the inactivated COVID-19 vaccine prior to or during pregnancy. Maternal and neonatal outcomes were compared between vaccinated and unvaccinated women. Data analysis was performed using SPSS version 26, employing one-way analysis of variance (ANOVA), Tukey's multiple comparison test, Fisher's exact test, Chi-square test, and multiple logistic regression.</p><p><strong>Results: </strong>The findings indicated that vaccination against COVID-19 in pregnant women significantly increased the risk of neonatal jaundice (P < 0.05). Conversely, the miscarriage rate among these women was significantly lower (P < 0.05). No adverse outcomes were observed including hypertensive disorders, gestational diabetes, maternal hospitalization, maternal COVID-19 infection, preterm labor, premature rupture of membranes, perinatal mortality, admission to the neonatal intensive care unit, and low birth weight.</p><p><strong>Conclusions: </strong>COVID-19 Vaccination is recommended for pregnant women to mitigate adverse neonatal and maternal outcomes.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"367"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742240","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":"Perinatal healthcare experiences of pregnant and parenting people with a history of substance use disorder: a qualitative study.","authors":"Carol Y Franco-Rowe, Angela E Lee-Winn, Venice Ng Williams, Connie Lopez, Gregory J Tung, Mandy A Allison","doi":"10.1186/s12884-025-07473-8","DOIUrl":"https://doi.org/10.1186/s12884-025-07473-8","url":null,"abstract":"<p><strong>Background: </strong>Clinical guidelines in the United States (U.S.) recommend a patient-centered approach to healthcare for pregnant people with substance use disorders (SUD); however, pregnant people with SUD often describe experiencing stigmatization and shame when seeking prenatal care. We explored the perspectives of pregnant and parenting people engaged with SUD treatment regarding their experiences with healthcare providers during the perinatal period to improve guidance for patient-centered care.</p><p><strong>Materials and methods: </strong>Using an adapted phenomenological approach, we conducted in-depth interviews with 22 pregnant and parenting people recruited from inpatient or outpatient substance use treatment centers in the U.S. state of Colorado. We developed an interview guide to explore participants' experiences during pregnancy, childbirth, and postpartum. We audio recorded, transcribed, and validated interviews for analyses. A codebook was developed using an iterative process. Three coders analyzed the data and synthesized data into thematic memos.</p><p><strong>Results: </strong>Participants reported challenges within the healthcare system, including barriers to receiving services, connection to or education on resources, challenges in and reasons for sharing their history of substance use with healthcare providers, provider reactions to this information, and the impact of providers' response to knowing about their substance use history. Participants described shame regarding their substance use but also a strong desire to ensure the health of their infants. This desire motivated them to share their history of substance use with healthcare providers. When participants perceived nonjudgmental and empathetic responses, they reported feeling pride and empowerment. Participants who reported judgmental responses from providers stated that it made them less likely to share and engage with other healthcare providers in the future.</p><p><strong>Conclusion: </strong>The perspectives and experiences of people engaged in SUD treatment can inform the implementation of clinical guidelines for patient-centered care for pregnant and parenting people in perinatal healthcare settings. Learnings from this study addresses ongoing challenges to compassionate care during this critical window, leading to disengagement of patients. Support through connection of resources can be helpful for ongoing recovery. Recommendations are made to establish trust through transparency and non-judgmental care and to reinforce receipt of appropriate healthcare services.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"369"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742255","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":"Hormonal and metabolic influences on outcomes in PCOS undergoing assisted reproduction: the role of BMI in fresh embryo transfers.","authors":"Li Wang, Xiaoyu Yu, Dongsheng Xiong, Mei Leng, Meiyu Liang, Rong Li, Libing He, Heqiu Yan, Xiaoju Zhou, Erniu Jike, Weixin Liu, Jiuzhi Zeng","doi":"10.1186/s12884-025-07480-9","DOIUrl":"https://doi.org/10.1186/s12884-025-07480-9","url":null,"abstract":"<p><strong>Background: </strong>This retrospective study aimed to examine the influence of hormonal and metabolic parameters across varying body mass index (BMI) levels on embryo quality and pregnancy outcomes in fresh embryo transfer cycles using assisted reproductive technology (ART) in patients diagnosed with polycystic ovary syndrome (PCOS).</p><p><strong>Methods: </strong>A total of 167 women diagnosed with PCOS and 266 women without PCOS (control group) were included. Metabolic and hormonal parameters was compared between the two groups to evaluate their relationship with embryo quality and pregnancy outcomes. Subgroup analyses were performed to assess these effects in patients with normal and high BMI.</p><p><strong>Results: </strong>In the PCOS group, hormonal and metabolic parameters such as insulin, blood lipids, luteinizing hormone (LH), anti-Müllerian hormone (AMH) and antral follicle counting (AFC) were significantly higher than in the control group. The PCOS group also produced more blastocysts and a higher proportion of high-quality blastocysts. However, pregnancy rate and clinical pregnancy rates were similar between the two groups, regardless of BMI. Among the high-BMI PCOS patients, the miscarriage rate was significantly higher compared to the control group, and its rate showed a positive correlation with BMI, LH, and total testosterone (TSTO) levels.</p><p><strong>Conclusion: </strong>Hormonal imbalances and glucose-lipid metabolism have minimal influence on embryo development in PCOS patients. However, hormonal factors-particularly in PCOS patients with high BMI-significantly influence pregnancy outcomes, with elevated BMI and androgen levels increasing the risk of miscarriage. These findings underscore the importance of addressing metabolic and hormonal factors in the management of PCOS patients undergoing ART.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"368"},"PeriodicalIF":2.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742253","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}