BMC Pregnancy and Childbirth最新文献

{"title":"Partner presence in labor: does it influence maternal anxiety and childbirth experience beyond pain?","authors":"Arif Onur Atay, Samican Ozmen, Mucahit Furkan Balci, Ozgen Nahya Ozdogar","doi":"10.1186/s12884-026-09701-1","DOIUrl":"10.1186/s12884-026-09701-1","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between partner presence during labor and maternal state anxiety, birth satisfaction, and pain perception in women undergoing spontaneous labor.</p><p><strong>Methods: </strong>This prospective comparative observational study included women with singleton term pregnancies, spontaneous active labor, and vaginal delivery. Women with labor induction, epidural analgesia, additional obstetric pathology, systemic disease, or known psychiatric illness were excluded. Maternal anxiety was assessed using the State-Trait Anxiety Inventory Form TX-1 (STAI TX-1) during active labor, pain intensity using a visual analog scale (VAS) during the active phase, and birth satisfaction using the Birth Satisfaction Scale-Revised (BSS-R) within the first 24 h postpartum.</p><p><strong>Results: </strong>Of the 168 women, 68 labored with partner presence and 100 without. Women accompanied by their partner had significantly lower STAI TX-1 scores and higher BSS-R scores than those without partner accompaniment (both p < 0.001), whereas VAS pain scores did not differ significantly between groups (p = 0.428). Birth satisfaction was inversely correlated with anxiety (Spearman's rho=-0.373, p < 0.001) and weakly positively correlated with pain (Spearman's rho = 0.198, p = 0.010). In multivariable analyses, partner presence remained independently associated with lower anxiety (unstandardized regression coefficient [B]=-5.24, 95% CI -7.14 to -3.34, p < 0.001) and higher birth satisfaction (B = 2.57, 95% CI 1.24 to 3.90, p < 0.001).</p><p><strong>Conclusion: </strong>Partner presence during labor was associated with lower maternal anxiety and higher birth satisfaction, without a significant difference in pain intensity. These findings suggest that the beneficial contribution of partner accompaniment may be more closely related to psychological and experiential factors than to pain reduction alone during the childbirth process.</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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219944","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":"Subclinical thiamine deficiency in third-trimester pregnancy despite routine antenatal supplementation: a cross-sectional study in an urban setting, Bangkok, Thailand.","authors":"Ajjima Thussachan, Itsara Jangjaroenphorn, Monnapa Chantrangkul, Apanchanid Thepouypon, Chattraya Ngamlerst, Natnicha Promyos, Kamparnart Kaewyai, Dennopporn Sudjai, Kriengsak Limkittikul, Thitiya Yakasaem, Salin Sirinam, Weerawan Hattasingh","doi":"10.1186/s12884-026-09653-6","DOIUrl":"10.1186/s12884-026-09653-6","url":null,"abstract":"<p><strong>Background: </strong>Thiamine deficiency disorders (TDD) remain a preventable yet underrecognized contributor to maternal and infant morbidity, particularly in low- and middle-income countries. During pregnancy, thiamine deficiency may go undetected despite routine antenatal care and can lead to serious neurological and cardiac complications in breastfed infants. However, data on thiamine status in urban populations receiving standard antenatal supplementation are limited. This study aimed to determine the prevalence of thiamine deficiency in third-trimester pregnant women and to identify associated factors and clinical manifestations in an urban setting of Thailand.</p><p><strong>Methods: </strong>This cross-sectional study enrolled pregnant women in the third-trimester (≥ 28 weeks of gestation) attending antenatal care in Bangkok, Thailand. Demographic characteristics, obstetric history, dietary habits, medication and supplement use, and TDD-related symptoms were collected using a structured questionnaire. Functional thiamine status was assessed using the erythrocyte transketolase activity coefficient (ETKAC), with abnormal thiamine status defined as ETKAC > 1.25. Penalized logistic regression with Firth's correction was used to identify factors associated with abnormal ETKAC.</p><p><strong>Results: </strong>A total of 328 participants (mean age 28.9 years; mean gestational age 31.1 weeks) were included. Although 97.9% reported receiving at least one antenatal supplement, only 53.1% received formulations containing thiamine. Based on ETKAC, 17.7% demonstrated biochemical thiamine deficiency (ETKAC > 1.25). Consumption of refined carbohydrates without thiamine containing supplement was independently associated with deficiency (aOR 4.20, 95% CI 1.30-17.87). Clinical symptoms were nonspecific and largely similar between groups, except for reduced concentration or memory problems, which was more common among participants with thiamine deficiency (p = 0.007).</p><p><strong>Conclusion: </strong>These findings suggest that despite high antenatal supplementation coverage, nearly one-fifth of third-trimester pregnant women demonstrated biochemical evidence of subclinical thiamine deficiency. Routine clinical assessment was insufficient to identify affected individuals. These findings suggest that current antenatal supplementation strategies may be inadequate to ensure optimal thiamine status during late pregnancy and highlight the need to re-evaluate micronutrient policies in similar urban settings.</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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219987","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":"Maternal age and perinatal morbidity: a comparative cohort study including advanced maternal age and adolescent pregnancy.","authors":"Samaneh Movahedinia, Najmeh Soltaninejad, Neda Nikpour, Maryam Mirzaei, Samaneh Omidi Kermanshahaninezhad","doi":"10.1186/s12884-026-09586-0","DOIUrl":"10.1186/s12884-026-09586-0","url":null,"abstract":"<p><strong>Background: </strong>Maternal age at childbirth shows a bimodal risk distribution worldwide. While adolescent pregnancy remains common in many areas, the rate of advanced maternal age is rising in high-income countries. Both extremes are associated with adverse outcomes through different pathways. This study tests the hypothesis that adolescent (< 19 years) and older (> 35 years) mothers face higher obstetric and neonatal risks than young adults (19-35 years), regardless of key confounders.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted from 2019 to 2023 at a tertiary-care center. A total of 19,728 mother-neonate dyads were included and stratified by maternal age: adolescents (n = 1,570), young adults (n = 14,707), and older adults (n = 3,451). We analyzed maternal demographics, antenatal care, and maternal-neonatal outcomes. Multivariable logistic regression was adjusted for confounders, including socioeconomic status, parity, prenatal care, and comorbidities. Primary outcomes included mode of delivery, preterm birth, low birth weight, preeclampsia, and neonatal intensive care unit (NICU) admission.</p><p><strong>Results: </strong>Older adult mothers showed the highest adjusted risks: preeclampsia (aOR = 3.15, 95% CI: 2.82-3.52), cesarean delivery (aOR = 1.89, 1.72-2.08), and preterm birth (aOR = 2.94, 2.68-3.22). Adolescent mothers had lower cesarean rates but significantly higher adjusted odds of low birth weight (aOR = 1.72, 1.45-2.04) and preterm birth (aOR = 1.48, 1.25-1.75). The likelihood of NICU admission increased for both groups. Socioeconomic disadvantage was most apparent among adolescents, while medical comorbidities characterized the older group.</p><p><strong>Conclusion: </strong>This study confirms a U-shaped risk curve, with both adolescent and advanced maternal ages remaining associated with increased risk after adjustment for measured confounders for adverse pregnancy outcomes. The findings highlight the need for specific, age-tailored clinical and public health strategies: targeted social support and early prenatal care for adolescents, and careful monitoring and management of medical comorbidities for older mothers.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547700","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":"Investigation of the impact of social, behavioral, and pre-existing clinical risk factors on preeclampsia.","authors":"Uma Sarder, Todd Gary, Allysceaeioun Britt, Leah Alexander, Bishnu Sarker, Aize Cao","doi":"10.1186/s12884-026-09612-1","DOIUrl":"10.1186/s12884-026-09612-1","url":null,"abstract":"<p><strong>Background: </strong>Preeclampsia is one of the leading causes of maternal morbidity and mortality, disproportionately impacting women from diverse backgrounds. Early identification of risk factors is critical for timely preventive interventions. This study examined the impact of socioeconomic factors, prior substance use, and pre-existing health conditions on the development of preeclampsia using the data from the NIH All of Us Research Program.</p><p><strong>Methods: </strong>Participants aged 18 to 55 with at least one pregnancy in the NIH All of Us research program between 2018 and 2023 were included. Relative factors considered include socioeconomic status (education, income, health insurance), substance use disorders (alcohol, cannabis, cocaine, nicotine, opioid, stimulant), and pre-existing health conditions (blood clotting, depression, diabetes, hypertension, liver failure, renal failure, thyroid-stimulating hormone). Electronic health records and surveys were used to identify the study cohort and risk factors. We conducted multivariate analysis using a generalized linear model, along with subgroup analysis.</p><p><strong>Results: </strong>A total of 12,098 individuals were identified with 14,354 pregnancy episodes after applying the inclusion and exclusion criteria, and 8.7% of the participants developed preeclampsia. They were predominantly Hispanic (43.5%), Non-Hispanic White (33.9%), and Non-Hispanic Black (14.5%), with an average age of 30.4 years (SD = 6.2). Among these individuals, 35% had a college or advanced degree, 38% reported income less than $50k, and 7% lacked health insurance. The commonly used substance use disorders were nicotine (8.5%), cannabis (3.7%), and opioids (2.2%). The leading pre-existing clinical conditions included depression (17%), followed by hypertension (8%), and diabetes (5%). Adjusted odds ratio from multivariate generalized linear model indicated that participants who had income less than $50k (OR:1.35, 95% CI: 1.05-1.74) are more likely to develop preeclampsia compared with those who had income higher than $100k. Other significant factors included stimulant use disorder (OR:2.04, 95% CI: 1.32-3.14), diabetes (OR:1.36, 95% CI: 1.07-1.70), and hypertension (OR:2.54, 95% CI: 2.12-3.05).</p><p><strong>Conclusions: </strong>Low income, stimulant use disorder, diabetes, and hypertension were strongly associated with preeclampsia.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535206","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 effect of a pregnancy pillow used in the last trimester on fatigue and comfort in pregnant women: a randomized controlled trial.","authors":"Serap Öztürk Altınayak, Betül Uzun Özer, Özlem Arı, Hava Özkan","doi":"10.1186/s12884-026-09533-z","DOIUrl":"10.1186/s12884-026-09533-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to examine the effect of a pregnancy pillow used in the last trimester on fatigue and comfort in pregnant women.</p><p><strong>Method: </strong>This study used an RCT design. The study was conducted with 77 primiparous pregnant women (39 intervention, 38 control) who met the inclusion criteria and were admitted to the obstetrics outpatient clinic of a university hospital in the Black Sea region. The pregnant women were randomly assigned to groups using \"Random Allocation Software\". Data were collected through a Personal Information Form, the Chalder Fatigue Scale (CFS), and the Prenatal Comfort Scale (PCS). The Pearson chi-square test, Yates corrected chi-square test, Fisher's Exact test, Fisher-Freeman-Halton test, Robust Mixed ANOVA, and partial eta-squared (η²) values were employed for effect size calculations and reported with 95% confidence intervals. The Phi coefficient (φ) and Cramer's V were computed to measure the effect size for categorical analysis. The correlation coefficient (r) and Cohen's d were employed to measure the effect size of both the Mann-Whitney U and Wilcoxon tests. In all analyses, the statistical significance level was considered to be p < 0.05.</p><p><strong>Findings: </strong>In the intervention group, CFS scores significantly decreased from 19.38 ± 6.89 to 7.18 ± 5.21 and (p < 0.05), while PCS scores significantly increased from 53.21 ± 10.25 to 69.18 ± 6.19 a significant difference was found in the within-group comparison (p < 0.05). Conversely, in the control group, CFS scores significantly increased from 14.84 ± 6.25 to 28.84 ± 5.59 (p < 0.05), whereas PCS scores significantly decreased from 60.47 ± 12.28 to 40.58 ± 8.45 in the within-group comparison (p < 0.05). Robust regression analysis revealed that the post-test comfort score in the intervention group was 29.695 points higher than in the control group (p < 0.001). The post-test total fatigue score of the intervention group was 23.687 points less than that of the control group (p < 0.001).</p><p><strong>Conclusion: </strong>The study findings indicated that using a pregnancy pillow during gestation enhanced comfort and decreased fatigue. Consequently, it can be stated that a pregnancy pillow may aid in preventing or alleviating fatigue during gestation.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535298","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":"Derived inflammatory indicators for identifying preeclampsia in pregnant patients with systemic lupus erythematosus: a case-control study.","authors":"Jiaxin Huo, Minyi Zhang, Haoyue Hu, Yinghua Xu, Shujie Liu, Jun Chen, Jiayi Zhou, Sishi Song, Manna Sun, Guifang Hu, Mei Zhong","doi":"10.1186/s12884-026-09681-2","DOIUrl":"10.1186/s12884-026-09681-2","url":null,"abstract":"<p><strong>Background: </strong>Pregnant women with systemic lupus erythematosus (SLE) are at high risk of preeclampsia (PE). However, overlapping clinical features between the two conditions make it challenging to detect superimposed PE. Failure to promptly recognize PE significantly increases the risk of adverse pregnancy outcomes. In recent years, complete blood count-derived inflammatory indicators (e.g., platelet-to-lymphocyte ratio) have emerged as readily available, low-cost biomarkers with clinical utility. This study aimed to assess the discriminative capacity of these derived inflammatory indicators, measured within one week before delivery, for identifying superimposed PE in pregnant patients with SLE.</p><p><strong>Methods: </strong>This retrospective single-center study included 157 pregnant women with SLE treated at Nanfang Hospital of Southern Medical University from April 2010 to October 2024. Clinical and laboratory data, including complete blood count, liver function tests, and coagulation parameters, were collected. Univariate and multivariate logistic regression were performed to identify risk factors for PE and construct combined models. Model performance was assessed using receiver operating characteristic (ROC) curves, Hosmer-Lemeshow test, calibration plots, and the integrated discrimination improvement (IDI) and net reclassification improvement (NRI) indices. Internal validation used the bootstrap method, and sensitivity analysis used E-values.</p><p><strong>Results: </strong>Among the study patients, 35 developed PE. Univariate logistic regression analysis showed significant differences in monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR) between groups (P < 0.05). Multivariable logistic regression identified that lower MLR (OR = 0.223, 95% CI: 0.071-0.699) and PLR (OR = 0.344, 95% CI: 0.175-0.675) levels may be associated with an increased risk of superimposed PE in SLE pregnancies. The models based on MLR (AUC = 0.859, 95% CI: 0.782-0.936) and PLR (AUC = 0.860, 95% CI: 0.786-0.934) each showed discriminative capacity for identifying PE in pregnant patients with SLE.</p><p><strong>Conclusion: </strong>MLR and PLR may serve as cost-effective and readily available markers for identifying superimposed preeclampsia in pregnant patients with SLE. These preliminary findings warrant validation in larger prospective cohorts, given the small sample size.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547767","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":"Midwives' perspective on participation of pregnant individuals planning an elective caesarean section delivery in antenatal classes in Germany: a qualitative interview study.","authors":"Sandra Jaax, Jessica Breuing, Barbara Prediger, Nadja Könsgen","doi":"10.1186/s12884-026-09676-z","DOIUrl":"10.1186/s12884-026-09676-z","url":null,"abstract":"<p><strong>Background: </strong>Studies indicate that pregnant individuals sometimes feel inadequately prepared for caesarean section (CS) in antenatal classes. This suggests that the antenatal classes may not sufficiently address the information needs of those planning an elective CS. As antenatal classes provide valuable information beyond preparation for vaginal birth, they may nevertheless be relevant for this group. This study aims to examine how antenatal classes in Germany address elective CS and what factors influence the participation of pregnant individuals planning to have an elective CS according to midwives.</p><p><strong>Methods: </strong>We conducted a qualitative study using semi-structured interviews with midwives, who were sampled via a convenience sampling technique. The eligibility criteria required midwives currently offering antenatal classes who had conducted at least one antenatal class in Germany that included a pregnant individual planning an elective CS. Recruitment was carried out via telephone or email and through midwifery associations. The 15 interviews took place between October and December 2023. We performed data analysis using a content-structured approach (Mayring), employing MAXQDA 2022 (VERBI Software, Berlin, Germany).</p><p><strong>Results: </strong>Midwives reported, as a barrier to participation, that pregnant individuals preparing for an elective CS often assume that antenatal classes are not relevant for them. This is partly due to a lack of information regarding the importance of their participation as well as insufficient awareness about the content of antenatal classes. Moreover, midwives noted that, as another barrier of participation, other participants and midwives in antenatal classes sometimes respond negatively to the decision of having a CS. All midwives generally take CS as a topic into account and most generally discuss the content of elective CS. The majority of midwives in the study considered addressing the informational needs of pregnant individuals preparing for an elective CS to be important. The idea of offering a separate course was subject to extensive discussion during the interviews. Some participants raised concerns regarding its practical feasibility.</p><p><strong>Conclusions: </strong>A more comprehensive education of all pregnant individuals regarding the content of antenatal classes is necessary. Tailored course formats could improve access to and relevance of antenatal classes for pregnant individuals planning an elective CS.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"26 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535234","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":"Midwives' experiences of maternal death surveillance and response: insights from Mwanza District Hospital, Malawi.","authors":"Wakhonderachi Temweka Likha, Gaily Lungu, Fikile Singano, Martha Kamanga","doi":"10.1186/s12884-026-09697-8","DOIUrl":"10.1186/s12884-026-09697-8","url":null,"abstract":"<p><strong>Background: </strong>Despite the introduction of the Maternal Death Surveillance and Response (MDSR) program in Malawi in 2002, preventable maternal deaths remain a significant concern. Malawi's maternal mortality ratio (MMR) declined from 439 deaths per 100,000 live births in 2015 to 224 in 2024 (MDHS 2024) but remains well above the Sustainable Development Goal target of fewer than 70 deaths per 100,000 live births by 2030. In 2023/2024, Mwanza District Hospital recorded nine alarming maternal deaths. This study explored midwives' experiences in maternal death identification, notification, and reporting within the MDSR cycle.</p><p><strong>Methods: </strong>An exploratory descriptive qualitative design was employed. Nineteen purposively selected midwives participated in semi-structured audio-recorded interviews. Data were analyzed thematically following Braun and Clarke's six steps, supported by NVivo 12 software. Ethical approval was obtained from the College of Medicine Research Ethics Committee (P.10/23-0358).</p><p><strong>Results: </strong>Midwives identified challenges across all stages of the MDSR cycle. During identification and notification, psychological distress and cross-border care complexities hampered accurate reporting. In the review and analysis stage, inconsistent documentation, weak coordination, and a prevailing culture of blame limited open discussion and learning. In the response and action stage, follow-up was fragmented, and fear of punishment discouraged active participation. In the monitoring and evaluation stage, feedback loops were weak, and lessons from reviews were not consistently shared with frontline providers, undermining system-wide improvement.</p><p><strong>Conclusion: </strong>Midwives at Mwanza District Hospital experience significant emotional strain and systemic barriers in executing MDSR responsibilities. Strengthening support for timely identification and notification, promoting a blame-free culture in reviews, ensuring structured follow-up actions, and reinforcing feedback mechanisms are critical to improving maternal death surveillance and response.</p><p><strong>Significance: </strong>Organizing midwives' experiences through the MDSR cycle highlights key intervention points. Addressing gaps in identification, review, response, and monitoring can enhance both provider well-being and system accountability, ultimately contributing to the reduction of preventable maternal mortality in resource-limited settings.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547817","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":"Pregnant women's perceived unhappiness with current pregnancy: an analysis of prevalence, reasons, and associated factors in Quelimane district, Mozambique.","authors":"Ariel Nhacolo, Felizarda Amosse, Hélio Amaro, Tonecas Armando, Daniel Massanduzi, Neil Adolfo, Elísio Xerinda, Milton Kincardett, Rosauro Varo, Laura Garcia-Otero, Quique Bassat, Inacio Mandomando, Orvalho Augusto, Carlos Arnaldo, Pedro L Alonso","doi":"10.1186/s12884-026-09682-1","DOIUrl":"10.1186/s12884-026-09682-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pregnant women's emotional well-being is a major determinant of maternal and pregnancy outcomes. This study aimed to estimate the prevalence of pregnant women's perceived unhappiness with their current pregnancy, and to examine the reasons and factors associated with such feelings in Quelimane district, Central Mozambique.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A population-based pregnancy surveillance study was conducted during 2023-2024. Data included pregnant women's perceived status of unhappiness with their current pregnancy at realization, reasons for such feelings, and perceived reactions of their sexual partners. Variables associated with women's unhappiness were investigated within a couple-centered conceptual framework that views pregnancy-related unhappiness as the result of interacting socio-demographic, reproductive, and partner-level factors; using descriptive statistics and multivariate logistic regression (three sequentially adjusted models).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 1546 participating women, 24.5% referred being unhappy with their pregnancy, and this was higher among adolescents (42.2%), in daughters/grand-daughters/daughters-sisters-in-law (33.5%), residing in larger households (29.7%), un-married women (36.6%), first trimester of gestation (37.7%), without couple's communication about childbirth (48.9%), and with unhappy partner (74.5%). The leading reasons for unhappiness were unplanned pregnancy (30.2%), unwanted/undesired pregnancy (26.5%), and fear of consequences (17.7%). In the multivariate logistic regression analysis, the associations of socio-demographic (first model) and reproductive (second model) variables with unhappiness were progressively attenuated as the models were being fitted. In the fully adjusted model (third model), women's age and gestational age maintained strong association with unhappiness, with adolescents and older women showing higher odds of unhappiness compared to middle-aged adults (OR = 2.18, 95% CI:1.43-3.32) and (OR = 2.21, 95% CI:1.25-3.93), respectively; and women interviewed in the first and third trimester being more likely to be unhappy than those in the second trimester (OR = 2.19, 95% CI:1.10-4.37) and (OR = 1.51, 95% CI:1.08-2.11), respectively. However, partner-related variables emerged as strongly associated with maternal unhappiness, with partner's unhappiness with pregnancy showing ORs of 8.23 (95% CI:5.04-13.43), lack of couple's communication (OR = 2.23, 95% CI:1.34-3.74), and partner's pregnancy intendedness showing ORs of 1.73 (95% CI:1.12-2.65).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Nearly one in four women in Quelimane reported being unhappy with their pregnancy, and unhappiness was particularly frequent among adolescents, non-married, women in first gestational age, those without couple's communication, and with unhappy partners. While women's socio-demographic and reproductive factors contributed to unhappiness, partner's emotional r","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535197","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":"Non-adherence to iron and folic acid consumption among Indian pregnant women: evidences from national family health survey-5 data (2019-21).","authors":"Angan Sengupta, Meghna Prakash, Tina Dutta","doi":"10.1186/s12884-026-09639-4","DOIUrl":"10.1186/s12884-026-09639-4","url":null,"abstract":"<p><strong>Background: </strong>Iron and Folic Acid (IFA) supplementation is one of the highly recommended strategies to tackle anemia. Under the backdrop of high anemia prevalence among pregnant women, this study examines the level of non-adherence with IFA supplementation, separately for 100 + days and 180 + days, among pregnant women in India.</p><p><strong>Methods: </strong>The analysis is conducted on a sample of 174,947 women, who bought or received IFA tablets/syrup during their last pregnancy, and was surveyed during the National Family Health Survey-5 (2019-21). The NFHS is a cross-sectional survey that claims to represent 95% of the Indian population. The survey adopted stratified random sampling specific to rural and urban population. Descriptive statistics and conditional probabilities are calculated to examine the initiation and attainment of different levels of IFA consumption across selected background variables. Binary logistic regressions are employed to understand the influence of socio-economic factors on non-adherence of IFA supplementation for minimum 100 days and 180 days, and the results are presented as adjusted odds ratios at 95% confidence intervals.</p><p><strong>Results: </strong>While the probability of initiation of IFA tablets is fairly high among pregnant women in India, the probability of consuming at least 100 tablets declines drastically for pregnant women irrespective of their socio-economic profile. The chances of not taking IFA for at least 100 days and 180 days are lesser by 21% and 15% respectively for urban with respect to rural women. When compared to the richest, the poorest face 1.6 times higher odds for not consuming IFA for at least 100 days, and 1.96 times higher in case of non-adherence for minimum 180 days. Women with no education shows 1.73 and 1.46 times higher likelihood to be non-adherent with both criteria as compared to those with higher education. Minimum four antenatal care (ANC) visits and husband's presence during any of these visits demonstrated significant associations. Risk of non-compliance is lesser among women with lower birth order as compared to pregnancies of third and higher birth order.</p><p><strong>Conclusion: </strong>It is mandatory to involve community health workers in awareness generation and close monitoring of IFA consumption behaviour first ensuring access to IFA supplements, and then adherence for 100 + days, which in turn will improve the possibility of meeting 180 days' recommendation.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519787","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}