BMC Pregnancy and Childbirth最新文献

{"title":"Mental health risks in pregnancy and early parenthood among male and female parents following unintended pregnancy or fertility treatment: a cross-sectional observational study.","authors":"Naoki Mizunuma, Keiko Yamada, Takashi Kimura, Yutaka Ueda, Takashi Takeda, Takahiro Tabuchi, Kunihiko Kurosaki","doi":"10.1186/s12884-024-07082-x","DOIUrl":"10.1186/s12884-024-07082-x","url":null,"abstract":"<p><strong>Background: </strong>Unintended pregnancy at higher risk of perinatal mood disorders; however, concurrent factors such as socioeconomic conditions may be more critical to mental health than pregnancy intention. Mental health risks among individuals undergoing fertility treatment are inconsistent. We investigated mental health risks during pregnancy and parenthood in parents who conceived unintentionally or through fertility treatment compared to those who conceived naturally and intentionally.</p><p><strong>Methods: </strong>We conducted a web-based study with 10,000 adults ≥ 18 years old, either pregnant or with a child aged < 2 years. Male and female respondents weren't couples. We analyzed 1711 men and 7265 women, after filtering out invalid responses. We used a questionnaire including conception methods (e.g., naturally conceived intended/unintended pregnancies, fertility treatment such as scheduled intercourse or ovulation inducers [SI/OI], intrauterine insemination [IUI], and in-vitro fertilization or intracytoplasmic sperm injection [IVF/ICSI]) and mental health risks (e.g., psychological distress, chronic pain, death fantasies). Using a modified Poisson regression, we estimated relative risks (RR [CI]) for mental health risks compared to those with intended pregnancies.</p><p><strong>Results: </strong>Unintended pregnancy showed higher mental health risks during pregnancy in both genders, with women having significantly higher psychological distress, chronic pain, and death fantasies (RR 1.63 [1.05-2.54], RR 1.63 [1.14-2.33], and RR 2.18 [1.50-3.18], respectively). Women's death fantasies risk remained high in parenthood: RR 1.40 (1.17-1.67). In relation to fertility treatments, men using SI/OI during their partner's pregnancy showed higher mental health risks, especially for chronic pain (RR 1.75 [1.01-3.05]). Men who underwent IUI showed higher mental health risks during parenthood, notably death fantasies (RR 2.41 [1.13-5.17]). Pregnant women using SI/OI experienced higher mental health risks, with a significant risk of chronic pain (RR 1.63 [1.14-2.33]). Pregnant women using IVF/ICSI had a significantly lower risk of chronic pain (RR 0.44 [0.22-0.87]), but women who used IVF/ICSI had a significantly higher risk of death fantasies during parenthood (RR 1.40 [1.04-1.88]).</p><p><strong>Conclusions: </strong>Mental health risks vary by parenting stage (pregnancy or early parenthood) and gender, especially for those who conceived unintentionally or through fertility treatment. Both stages require adaptable mental health support for all parents.</p><p><strong>Trial registration: </strong>N/A (non-interventional study).</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"860"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891894","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":"Integrative development of a concise screening questionnaire for early detection of pregnant women at risk for dystrophy.","authors":"Yadi Zhang, Xiaoge Gao, Haiyan Zhu, Qi Zhou, Xiaxia Cai, Pamela Ann Koch, Shengzhi Sun, Huanling Yu","doi":"10.1186/s12884-024-07051-4","DOIUrl":"10.1186/s12884-024-07051-4","url":null,"abstract":"<p><strong>Background: </strong>Maintaining a healthy diet during pregnancy is vital for reducing the risk of adverse birth outcomes. However, conventional methods of assessing the dietary behavior of pregnant women, such as the FFQ, are often time-consuming. This study aims to develop a concise nutritional screening questionnaire tailored for pregnant women, empowering prenatal healthcare providers to quickly identify key adverse dietary behaviors and provide targeted guidance.</p><p><strong>Methods: </strong>To validate the Pregnancy Nutrition Checklist, we enrolled 208 women in early pregnancy and 200 women were included to analysis (with an average age of 31.54 ± 4.24 years). Spearman rank correlation analysis was used to assess the relative reliability of the Pregnancy Nutrition Checklist compared with the FFQ scale. Exploratory factor analysis was used to test the structural validity of the scale. A generalized linear model was used to analyze the correlation between dietary behavior and birth weight.</p><p><strong>Results: </strong>The pregnancy nutrition checklist includes 15 dietary items and 3 other lifestyle habit items. Compared with traditional FFQ questionnaires, the correlation analysis of corresponding items in the pregnancy nutrition checklist revealed statistical significance (p < 0.05), except for fat intake. EFA identified three underlying factors, namely, \"high-fat foods,\" \"moderate-fat foods,\" and \"low-fat foods,\" indicating that the questionnaire has good construct validity. Insufficient consumption of vegetables by pregnant women(OR = 2.64, 95% CI: 1.08-6.46, p = 0.033) was associated with a significantly greater risk of developing LGA fetuses. Pregnant women whose sugar, coffee, or tea intake did not exceed the classification criteria had significantly greater fetal birth weights than those whose intake exceeded the classification criteria (OR = 3.38, 95% CI: 1.18-9.68, p = 0.023). In contrast, consuming fewer highly palatable snacks can reduce the incidence of LGA babies (OR = 0.29, 95% CI: 0.11-0.74, p = 0.010).</p><p><strong>Conclusions: </strong>This tool has great potential for identifying unhealthy dietary behaviors, potentially leading to improved pregnancy outcomes.</p><p><strong>Trial registration: </strong>This study was preregistered on May 5, 2023, at the Chinese Clinical Trial Registry (ChiCTR2300071126).</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"861"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891891","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":"Models for predicting vaginal birth after cesarean section: scoping review.","authors":"Hong Cui, Wenhui Shan, Quan Na, Tong Liu","doi":"10.1186/s12884-024-07101-x","DOIUrl":"10.1186/s12884-024-07101-x","url":null,"abstract":"<p><strong>Background: </strong>Women who are pregnant again after a prior cesarean section are faced with the choice between a vaginal trial and another cesarean section. Vaginal delivery is safer for mothers and babies, but face the risk of trial labor failure. Predictive models can evaluate the success rate of vaginal trial labor after cesarean section, which will help obstetricians and pregnant women choose the appropriate delivery method.</p><p><strong>Objective: </strong>To review the existing prediction models of vaginal delivery after cesaean.</p><p><strong>Methods: </strong>Seven databases, including CNKI, Wanfang Data, Chinese Science and Technology Periodical Database, China Biomedical Literature Database, PubMed, Embase, and Web of Science, were searched for studies on the predictive model of VBAC from inception to July 20, 2022. Two researchers independently screened the literature and extracted the data. The risk of bias and applicability of the included researches was evaluated using the Prediction model Risk of Bias Assessment Tool.</p><p><strong>Results: </strong>Twenty-six studies that covered 26 models were included. The overall property of the included models was good, but validation of the included models was insufficient. The methodological quality of the included studies was generally low, with 3 studies rated as having a low risk of bias and 23 studies rated as having a high risk of bias. The main predictors in the models were the Bishop score, history of vaginal delivery, neonatal weight, maternal age, and BMI.</p><p><strong>Conclusions: </strong>Although a variety of prediction models have been developed globally, the methodology of these studies has limitations and the models have not been adequately validated. In the future, more prospective and high-quality research is needed to develop visual models to serve clinical work more effectively and conveniently. Obstetricians or midwives could use predictive models to help a woman choose the right delivery method.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"869"},"PeriodicalIF":2.8,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891942","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":"Integrative multi-omic analysis reveals potential biomarkers in the cervicovaginal fluid of patients with placenta accrete spectrum.","authors":"Hai Jiang, Jiangxue Qu, Nana Huang, Zeli Li, Xiaoming Shi, Lian Chen, Yangyu Zhao","doi":"10.1186/s12884-024-07065-y","DOIUrl":"10.1186/s12884-024-07065-y","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to detect the proteins and metabolites in the cervicovaginal fluid to observe their relationship with the occurrence of placenta accreta spectrum and the potential biomarkers with predictive value.</p><p><strong>Methods: </strong>Cervicovaginal fluid samples were collected before delivery from 6 participants of PAS and 6 controls subjects with similar gestational ages. The severity of PAS was evaluated by ultrasound and MRI scoring system and confirmed by the intraoperative findings or pathological examination. We used 4D label-free quantitative proteomics and untargeted metabolomics to identify the proteins and metabolites in cervicovaginal fluid, and analyzed the functions of differential expressed proteins or metabolites in PAS by multi-omics combined with bioinformatics analysis.</p><p><strong>Results: </strong>Proteomics and metabolomics screened 127 and 12 differential expressed proteins and metabolites in CVF of PAS, respectively. Proteins and metabolites that significantly dysregulated in participants with placenta accreta spectrum were factors that regulate angiogenesis, and extracellular matrix proteins that regulate trophoblast invasion. Among them, the important difference expressed proteins/metabolites with representative significance are arginine, GAL7, uPA, MMP9 and ITGAM, that may be useful as potential biomarkers for the prediction and early diagnosis of PAS.</p><p><strong>Conclusion: </strong>Cervicovaginal fluid in patients with PAS presents a protein-metabolic microenvironment that promotes trophoblast invasion, endothelial activation and vascular proliferation.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"856"},"PeriodicalIF":2.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881172","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":"Empowering women with fetal malpositions: enhancing childbirth experience and empowerment through educational interventions: a randomized controlled clinical trial.","authors":"Xiuhong Wang, Xueyan Wang, Xiaofeng Wan, Xueheng Wen, Cailing Lv, Jinguo Zhai","doi":"10.1186/s12884-024-07092-9","DOIUrl":"10.1186/s12884-024-07092-9","url":null,"abstract":"<p><strong>Background: </strong>This study aims to determine the impact of a childbirth educational intervention, based on empowerment theory, on childbirth experience and empowerment in women with fetal occiput posterior and occiput transverse malpositions.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted from February 2022 to December 2022 involving pregnant women with fetal occiput posterior and occiput transverse malpositions. Eligible women were randomly assigned to either the control or study group. The control group received routine care during childbirth, while the study group received routine care and a childbirth-empowering educational intervention delivered by midwives. Primary outcomes assessed were childbirth experience and patient perceptions of patient-empowering nurse behaviors in pregnant women. Secondary outcomes included pregnancy outcomes, delivery support and control, maternal coping behavior during delivery, maternal participation in delivery decisions, and perception of empowerment.</p><p><strong>Results: </strong>A total of 137 pregnant women were enrolled, with 69 and 68 in the control and study groups, respectively. The study group showed significantly higher levels of childbirth experience and reported better patient perceptions of patient-empowering nurse behaviors than the control group. Additionally, the study group demonstrated higher levels of delivery support and control, maternal coping behavior, and specific aspects of perceived participation and patient perception of empowerment compared to the control group. There were no statistically significant differences in pregnancy outcomes between the two groups.</p><p><strong>Conclusion: </strong>The childbirth empowering educational intervention effectively improved the childbirth experience and empowerment of women with fetal occiput posterior and occiput transverse malpositions. However, further studies are required to investigate its impact on pregnancy outcomes.</p><p><strong>Trial registration: </strong>The study protocol was approved by the hospital ethics committee (approval number:2020140A01) and registered at the Chinese Clinical Trial Registry (registration number: ChiCTR2300070915; date of first registration: 26/04/2023).</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"859"},"PeriodicalIF":2.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885174","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":"Multicultural doula support and obstetric and neonatal outcomes: a multi-centre comparative study in Norway.","authors":"Hanna Oommen, Linda Reme Sagedal, Jennifer J Infanti, Ulrika Byrskog, Marit Stene Severinsen, Mirjam Lukasse","doi":"10.1186/s12884-024-07073-y","DOIUrl":"10.1186/s12884-024-07073-y","url":null,"abstract":"<p><strong>Background: </strong>Migrant women face an increased risk of poor obstetric and neonatal outcomes. Norway implemented a multicultural doula (MCD) program in 2018, which was designed to improve pregnancy care for this group in vulnerable circumstances. This study aimed to assess the impact of MCD support, provided in addition to standard care, on obstetric and neonatal outcomes for selected newly arrived migrants.</p><p><strong>Methods: </strong>This was a multi-centre case-control study involving all nine hospitals actively running the MCD program, which covers four of Norway's five regions. Women who received MCD support at the time of childbirth (n = 339), from 2018-2023, were compared to similar newly arrived immigrant women who did not receive MCD support (n = 339) and gave birth within the same timeframe. Hospital records were reviewed, and outcomes were analysed using binary logistic regression. The results are expressed as crude and adjusted associations with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Women receiving MCD support exhibited a 41% lower likelihood of undergoing emergency caesarean sections (adjusted odds ratio [aOR] 0.59, 95% Cl 0.34-0.98) and those giving birth vaginally had a 75% lower risk of estimated blood loss ≥1000 ml (aOR 0.25, 95% Cl 0.12-0.52) compared with women without MCD support. Additionally, MCD support was associated with more use of pain-relief (aOR 2.88, 95% Cl 1.93-4.30) in labour and increased rates of exclusive breastfeeding at discharge (aOR 2.26, 95% Cl 1.53-3.36).</p><p><strong>Conclusions: </strong>Our study suggests that MCD support may contribute to improved outcomes for migrants in vulnerable circumstances, potentially impacting their future reproductive health and children's well-being.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"854"},"PeriodicalIF":2.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880675","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":"Intergenerational risk of preterm birth in First Nations Australians: a population-based cohort study from the Northern Territory, Australia.","authors":"Holger W Unger, Abel Dadi, Kiarna Brown, David Simon, Steven Guthridge","doi":"10.1186/s12884-024-07053-2","DOIUrl":"10.1186/s12884-024-07053-2","url":null,"abstract":"<p><strong>Background: </strong>PTB increases the risk of health problems such as chronic renal disease and diabetes in later life and adverse impacts are inversely correlated with gestational age at birth. Rates of PTB in the Northern Territory (NT) of Australia are amongst the highest nationally and globally, with First Nations babies most affected. This study assessed the magnitude and potential drivers of intergenerational PTB recurrence in the NT.</p><p><strong>Methods: </strong>A retrospective intergenerational cohort study (1986-2017) was conducted amongst 5,366 mothers born singleton who had 9,571 singleton live births (7,673 First Nations, and 1,898 non-First Nations babies). Maternal and offspring PTB was categorised as early (< 34 weeks) and late (34-36 gestational weeks). Modified Poisson regression was used to estimate the relative risk (RR) of PTB associated with maternal PTB, adjusting for moderators such as receipt of antenatal care prior to the offspring PTB. Secondary analyses assessed the impact of additional adjustment for conditions with a familial component, or that PTB predisposes to, on the risk estimate. Mediation analysis assessed the degree of mediation of maternal-offspring PTB relationships by these conditions.</p><p><strong>Results: </strong>Overall, First Nations women born preterm (< 37 weeks) had an increased risk of delivering before 37 gestational weeks (aRR 1.28; 95%CI 1.08, 1.51). Women born preterm had a higher risk of delivering early (< 34 gestational weeks) but not late preterm (34-36 weeks): the risk of early offspring PTB was increased amongst women themselves born early preterm (aRR 1.95, 95%CI 1.17, 3.24) or late preterm (aRR 1.41, 95%CI 1.01, 1.97). Adjustment for pre-eclampsia, intrauterine growth restriction, and hypertensive renal disease attenuated the observed intergenerational PTB associations. Mediation analysis suggested these conditions may mediate up to 26% of the observed intergenerational PTB recurrence. Similar trends were observed when first-time mothers were considered only. Maternal PTB status was not associated with PTB amongst non-First Nations women.</p><p><strong>Conclusions: </strong>First Nations women born preterm have an increased risk of early PTB. This association is in part driven by pre-eclampsia and hypertensive renal disease. Routine inquiry of maternal birth status may be a useful tool to identify NT First Nations women who may benefit from preventative measures.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"855"},"PeriodicalIF":2.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880662","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":"A comprehensive and bias-free machine learning approach for risk prediction of preeclampsia with severe features in a nulliparous study cohort.","authors":"Yun C Lin, Daniel Mallia, Andrea O Clark-Sevilla, Adam Catto, Alisa Leshchenko, Qi Yan, David M Haas, Ronald Wapner, Itsik Pe'er, Anita Raja, Ansaf Salleb-Aouissi","doi":"10.1186/s12884-024-06988-w","DOIUrl":"10.1186/s12884-024-06988-w","url":null,"abstract":"<p><p>Preeclampsia is one of the leading causes of maternal morbidity, with consequences during and after pregnancy. Because of its diverse clinical presentation, preeclampsia is an adverse pregnancy outcome that is uniquely challenging to predict and manage. In this paper, we developed racial bias-free machine learning models that predict the onset of preeclampsia with severe features or eclampsia at discrete time points in a nulliparous pregnant study cohort. To focus on those most at risk, we selected probands with severe PE (sPE). Those with mild preeclampsia, superimposed preeclampsia, and new onset hypertension were excluded.The prospective study cohort to which we applied machine learning is the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b) study, which contains information from eight clinical sites across the US. Maternal serum samples were collected for 1,857 individuals between the first and second trimesters. These patients with serum samples collected are selected as the final cohort.Our prediction models achieved an AUROC of 0.72 (95% CI, 0.69-0.76), 0.75 (95% CI, 0.71-0.79), and 0.77 (95% CI, 0.74-0.80), respectively, for the three visits. Our initial models were biased toward non-Hispanic black participants with a high predictive equality ratio of 1.31. We corrected this bias and reduced this ratio to 1.14. This lowers the rate of false positives in our predictive model for the non-Hispanic black participants. The exact cause of the bias is still under investigation, but previous studies have recognized PLGF as a potential bias-inducing factor. However, since our model includes various factors that exhibit a positive correlation with PLGF, such as blood pressure measurements and BMI, we have employed an algorithmic approach to disentangle this bias from the model.The top features of our built model stress the importance of using several tests, particularly for biomarkers (BMI and blood pressure measurements) and ultrasound measurements. Placental analytes (PLGF and Endoglin) were strong predictors for screening for the early onset of preeclampsia with severe features in the first two trimesters.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"853"},"PeriodicalIF":2.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881165","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":"Evaluation of the mediating role of physical activity self-efficacy in the relationship between knowledge, social support, and physical activity in pregnant women with a high risk for gestational diabetes.","authors":"Lu Chen, Rong-Rong Han, Xin Chen, Bai-Ling Fu, Bernice O C Lam Nogueira, Ling-Ling Gao","doi":"10.1186/s12884-024-07068-9","DOIUrl":"10.1186/s12884-024-07068-9","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the associations between knowledge, social support, and physical activity and explore the mediating role of physical activity self-efficacy in pregnant women with a high risk for gestational diabetes mellitus (GDM).</p><p><strong>Methods: </strong>A cross-sectional study was conducted in Guangzhou, China, from July 2022 to May 2023. Five hundred thirty-seven pregnant women with a high risk for GDM completed the Pregnancy Physical Activity Questionnaire, Pregnancy Physical Activity Self-Efficacy Scale, Pregnancy Physical Activity Knowledge Scale, Physical Activity Social Support Scale, and a socio-demographic data sheet. The mediation effect was tested using structural equation modeling (SEM) and the bootstrap method.</p><p><strong>Results: </strong>42.5% of pregnant women did not meet the current physical activity guidelines. Physical activity self-efficacy (β, 0.16; P<0.001), knowledge (β, 0.15; P = 0.001), social support (β, 0.10; P = 0.019), education, and type of conception were predictors of physical activity. The SEM results found that physical activity self-efficacy mediated the association between physical activity and knowledge (β, 0.24; 95% CI, 0.17 to 0.32) and social support (β, 0.30; 95% CI, 0.20 to 0.39). The data fit of the model (RMSEA = 0.067, CFI = 0.851, TLI = 0.828, χ²/df = 3.440) was acceptable.</p><p><strong>Conclusion: </strong>This study found that the prevalence of being physically inactive was high in pregnant women with a high risk for GDM. The present study's findings suggested that healthcare providers should try to enhance physical activity self-efficacy, knowledge, and social support of pregnant women with a high risk for GDM to improve their physical activity with a focus on physical activity self-efficacy.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"857"},"PeriodicalIF":2.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881170","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":"Trajectory of breastfeeding among Chinese women and risk prediction models based on machine learning: a cohort study.","authors":"Yi Liu, Jie Xiang, Ping Yan, Yuanqiong Liu, Peng Chen, Yujia Song, Jianhua Ren","doi":"10.1186/s12884-024-07010-z","DOIUrl":"10.1186/s12884-024-07010-z","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding is the optimal source of nutrition for infants and young children, essential for their healthy growth and development. However, a gap in cohort studies tracking breastfeeding up to six months postpartum may lead caregivers to miss critical intervention opportunities.</p><p><strong>Methods: </strong>This study conducted a three-wave prospective cohort analysis to examine maternal breastfeeding trajectories within the first six months postpartum and to develop risk prediction models for each period using advanced machine learning algorithms. Conducted at a leading Maternal and Children's hospital in China from October 2021 to June 2022, data were gathered via self-administered surveys and electronic health records.</p><p><strong>Results: </strong>Of the 3307 women recruited, 3175 completed the surveys, yielding a 96% effective response rate. Breastfeeding(BF) rates were observed at 100%, 96%,93% and 83% at discharge, 42 day, 3 month and 6 month postpartum, respectively. Exclusively breastfeeding(EBF) rates were recorded at 91%, 64%,72% and 58% for the same intervals. Among the five machine learning methods employed, Random Forest (RF) demonstrated superior accuracy in predicting breastfeeding patterns, with classification accuracies of 0.629 and an area under the receiver operating characteristic curve (AUC) of 0.8122 at 42 days, 0.925 and an AUC of 0.9800 at 3 months, and 0.836 and an AUC of 0.9463 at 6 months postpartum, respectively. Key predictive factors for breastfeeding at 42 days postpartum included the newborn's birth weight and the mother's pre-delivery and prenatal weights. Predictors for feeding type at 3 months and 6 months postpartum included early feeding types and the scores from the Breastfeeding Self-Efficacy Scale-short Form (BSES-SF) at 6 months. The predictive model based on follow-up data showed strong performance.</p><p><strong>Conclusion: </strong>Breastfeeding rates slightly declined from discharge to 6 months postpartum. The breastfeeding context in this region is comparatively optimistic both within China and internationally. Factors such as newborn's birth weight, gestational age, maternal weight management before and during pregnancy, early support and breastfeeding success, breastfeeding knowledge and self-efficacy are intricately linked to long-term breastfeeding outcomes. This study highlights critical, modifiable risk factors for early breastfeeding stages, providing valuable insights for enhancing breastfeeding intervention programs and informed decision-making.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"858"},"PeriodicalIF":2.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885177","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}