BMC Pregnancy and Childbirth最新文献

{"title":"Mediating effect of osteocalcin underlying the link between insulin-like growth factor-I and gestational diabetes mellitus.","authors":"Lingling Cui, Yuting Gao, Ruijie Sun, Zhiqian Li, Zhengya Zhang, Linpu Ji, Yibo Wang, Hua Ye, Luying Qin","doi":"10.1186/s12884-025-07689-8","DOIUrl":"10.1186/s12884-025-07689-8","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the associations of serum insulin like growth factor I (IGF-I) and Osteocalcin (OC) concentrations with gestational diabetes mellitus (GDM) risk among Chinese women.</p><p><strong>Methods: </strong>A case-control study was conducted in China, involving 125 GDM and 153 healthy pregnant women at 24-28 gestational weeks from 2019 to 2022. The study was approved by the Clinical Trial Ethics Committee of the Third Afliated Hospital of Zhengzhou University in January 04, 2020, and the study had been registered with the Chinese Clinical Trial Registry (ChiCTR2000028811). Maternal serum IGF-I and OC levels were measured in the second trimester. Logistic regression models and restricted cubic spline (RCS) were employed to calculate the association of IGF-I and OC levels with the risk of GDM, and and receiver operating characteristic (ROC) curves were generated to evaluate the predictive capacity of IGF-I and OC for GDM. Mediation analyses were used to investigate the mediation effect of OC on the association between IGF-I and the risk of GDM.</p><p><strong>Results: </strong>Both serum IGF-I and undercarboxylated Osteocalcin (ucOC) concentration were positively associated with the risk of GDM. The relationship between serum IGF-I and the risk of GDM is not linear (P-value < 0.001, P-Nonlinear < 0.001). Mediation analyses suggested that 48.61% of the associations between IGF-I and GDM might be mediated by ucOC. The areas under the ROC curves for IGF-I and integrated model were 74.5% and 76.2%.</p><p><strong>Conclusions: </strong>Serum IGF-I might provide a new dimension in the diagnosis of GDM for clinical application, and ucOC might serve as a mediator between IGF-I and GDM.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"579"},"PeriodicalIF":2.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085588","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 prognostic nutritional index is associated with preeclampsia in twin pregnancies.","authors":"Qing Han, Shuisen Zheng, Xiaoling Chen, Yuting Gao, Huale Zhang, Na Lin","doi":"10.1186/s12884-025-07669-y","DOIUrl":"https://doi.org/10.1186/s12884-025-07669-y","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate the relationship between the prognostic nutritional index (PNI) during the third trimester and the risk of preeclampsia (PE) in twin pregnancies.</p><p><strong>Method: </strong>A total of 2998 twin pregnancies were enrolled in Fujian Maternal and Child Health Hospital from January 2015 to December 2021, including preeclampsia group (n = 421) and control group (n = 2577). The significance of the characteristic variables in predicting PE in twin pregnancies were calculated using the random forest algorithm (Boruta package) and the correlation between PNI and PE in twin pregnancies was examined in three distinct models using multivariable logistic regression corrected for confounders. Receiver operating characteristics (ROC) curves were used to evaluate the ability for PNI to predict PE in twin pregnancies.</p><p><strong>Results: </strong>PNI (37.92 ± 3.86 vs. 40.57 ± 3.63, P < 0.001) was significantly lower in the PE group than in the control group. After adjusting for all covariates, the PNI was negatively associated with PE in twin pregnancies (OR = 0.780; 95% CI: 0.753, 0.808). Meanwhile, the higher PNI remained an independent protective factor for PE in twin pregnancies compared to lower PNI (OR, 95% CI: 0.410, 0.438-0.530; 0.144, 0.103-0.201) in sensitivity analysis. ROC curve analysis revealed an area under curve (AUC) of 0.691 for PNI and the cut-off value of PNI was 40.162.</p><p><strong>Conclusion: </strong>PNI was negatively correlated with the risk of PE in twin pregnancies, which may help in risk assessment for twin pregnancies.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"568"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075794","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 body mass index on maternal and neonatal health in term pregnancies: a cross-sectional study in Turkey.","authors":"Ayşe Daştan Yilmaz, Kıymet Yeşilçiçek Çalik, Mehtap Budak","doi":"10.1186/s12884-025-07690-1","DOIUrl":"https://doi.org/10.1186/s12884-025-07690-1","url":null,"abstract":"<p><strong>Backgroud and objective: </strong>Maternal obesity and gestational weight gain (GWG) are important determinants of maternal and neonatal health outcomes. This study aimed to investigate the effects of prepregnancy body mass index (PPBMI) and GWG on maternal and neonatal outcomes in Türkiye.</p><p><strong>Methods: </strong>This prospective cross-sectional study was conducted in a public hospital in Turkey between December 2021 and December 2022. A total of 1137 women between the ages of 19 and 45 who had singleton and live births and had complete medical records were included in the study using simple random sampling. Data were collected using medical records and a structured interview form. PPBMI and GWG were calculated from self-reported weight and height data. Kruskal-Wallis, Mann-Whitney U, and binary logistic regression tests were used to analyze the data.</p><p><strong>Results: </strong>Among the participants, 4.7% were underweight, 61% had a normal weight, 27.6% were overweight, and 9.9% were obese on the basis of PPBMI. According to the Institute of Medicine (IOM) GWG guidelines, 17.2% had insufficient GWG, 55.1% had adequate GWG, and 27.8% had excessive GWG. Overweight women had significantly increased odds of gestational diabetes mellitus (OR = 0.479, p = 0.024), genital tract infections (OR = 2.15, p = 0.000), urinary tract infections (OR = 2.42; p = 0.011), elective cesarean delivery (OR = 8.62, p = 0.035), macrosomia (OR = 9.15, p = 0.031), and low APGAR (Appearance, Pulse, Grimace, Activity, Respiration) scores (< 7 at 5 min) (OR = 0.20, p = 0.000). Obese women also showed higher odds of elective cesarean (OR = 9.56; p = 0.030) and macrosomia (OR = 8.27, p = 0.044). Underweight women had higher odds of neonatal hospital stay > 5 days. Insufficient GWG was associated with increased risks of low birth weight (OR = 0.46, p = 0.013), third-trimester bleeding (OR = 0.45, p = 0.016), and neonatal hospitalization > 5 days (OR = 0.44, p = 0.003), while macrosomia risk was lower (OR = 2.06, p = 0.001).</p><p><strong>Conclusion: </strong>PPBMI and GWG are significant predictors of maternal and neonatal health outcomes. Elevated PPBMI and inappropriate GWG are associated with increased risks of gestational diabetes, macrosomia, cesarean delivery, low APGAR scores, low birth weight, and prolonged neonatal hospitalization. These findings highlight the critical role of routine assessment and management of maternal weight status and weight gain during prenatal care in reducing preventable complications for both mothers and their newborns.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"572"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075779","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 influence of dietary choices: investigation of the relationship dietary inflammatory index and fetal growth restriction.","authors":"Ayşe Gülçin Baştemur, İclal Sena Gezer, Burcu Kesikli, Atakan Tanaçan, Özgür Kara, Nuray Yazıhan, Dilek Şahin","doi":"10.1186/s12884-025-07674-1","DOIUrl":"https://doi.org/10.1186/s12884-025-07674-1","url":null,"abstract":"<p><strong>Background: </strong>Fetal growth restriction (FGR) is characterized by the fetus's inability to reach its growth potential and affecting approximately 10% of the population. The etiology of late-onset FGR, which occurs after 32 weeks, is unclear but may be influenced by maternal weight. A proinflammatory diet can cause chronic inflammation and, Dietary Inflammatory Index (DII) was developed to evaluate of the diet's impact on inflammation. A high DII indicates a pro-inflammatory diet, known to increase serum inflammatory markers, with oxidative stress playing a key role in inflammatory diseases. The study aimed to investigate the correlation between maternal DII, total oxidant status (TOS), total antioxidant status (TAS), interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-α) levels in FGR-diagnosed pregnant women.</p><p><strong>Methods: </strong>This prospective-observational study included FGR-diagnosed pregnant women and healthy pregnant women with gestational ages of 32-38 weeks (n = 23 per group). Chronic diseases, hypertension, fetal anomalies, membrane ruptures, and multiple pregnancies were excluded. The DII was calculated using the BeBiS-9 program based on 3-day dietary records kept by an expert dietician. Blood samples were collected, centrifuged, and analyzed for IL-6, TNF-α, IL-10, TAS, and TOS.</p><p><strong>Results: </strong>The study group had significantly higher DII scores (p < 0.001), lower energy (p = 0.004), carbohydrate (p = 0.002), protein (p = 0.011), fiber (p < 0.001) intake than the control group. TNF-α levels were elevated in the FGR group (p < 0.001), while IL-6 levels were higher but not statistically significant (p = 0.06). IL-10 levels were lower in the study group (p = 0.05). TAS, TOS, and TAS/TOS levels showed no significant differences between groups. Logistic regression indicated a 62% increase in FGR probability with higher DII levels (p = 0.001, CI 1.209-2.195). Correlation analysis revealed a strong positive correlation between DII and maternal serum TNF-α (r = 0.375, p = 0.01) and a strong negative correlation between birth weight and TNF-α (r=-0.478, p < 0.001) and DII (r=-0.446, p = 0.002).</p><p><strong>Conclusion: </strong>This study showed that a pro-inflammatory maternal diet increased dietary inflammatory index and increased maternal inflammatory markers, and this was more significant in fetuses with FGR than in normal weight fetuses.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"569"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075781","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":"Comparison of long-term clinical effect and re-pregnant outcomes between hysteroscopic resection and laparoscopic defect repair in patients with non-severe cesarean scar defect: a retrospective study.","authors":"Shiyu Cheng, Han Gao, Yanli Li, Xin Li, Tingzhu Meng, Dan Teng, Mei Du, Dongqin Deng, Jing Liu, Xiyan Ouyang, Lingna Chai, Jie Shi","doi":"10.1186/s12884-025-07667-0","DOIUrl":"https://doi.org/10.1186/s12884-025-07667-0","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate and compare the long-term therapeutic effect and the re-pregnant outcomes of hysteroscopic resection and laparoscopic defect repair in the treatment of non-severe cesarean scar defect (CSD).</p><p><strong>Methods: </strong>The clinical data of 154 CSD patients whose residual myometrium thickness (RMT) ≥ 3 mm that treated at Maternal and Child Health Hospital of Hubei Province from January 2019 to May 2022 were retrospectively analyzed (74 accepted hysteroscopic resection and 80 received laparoscopic defect repair). We compared the general clinical data, laboratory tests, surgical related indicators and perioperative complications of two groups of patients, followed up and recorded the menstrual days at the 3rd, 6th, and 12th months after surgery, as well as the obstetric outcomes of re-pregnant patients.</p><p><strong>Results: </strong>The surgical duration, intraoperative bleeding, postoperative vaginal bleeding days, hospital stay, and total treatment cost in hysteroscopic group were all obviously lower than those in laparoscopic group. More importantly, the incidence of postoperative complications such as fever and pelvic pain was also significantly lower in patients undergoing hysteroscopic surgery than those undergoing laparoscopic surgery. In terms of menstrual improvement, at the postoperative 3rd,6th and 12th month, the patients of hysteroscopic group had shorter menstrual days than laparoscopic group. Additionally, the postoperative re-pregnancy rate of hysteroscopic group (61.29%) was higher than that of laparoscopic group (55%). No serious obstetric complications such as placenta implantation and uterine rupture occurred in the re-pregnant patients of both groups.</p><p><strong>Conclusions: </strong>Although both hysteroscopic resection and laparoscopic defect repair have good clinical effects on improving the symptoms of non-severe CSD patients. But in contrast, the hysteroscopic resection displays the advantages of minimal trauma, shorter surgical time, less intraoperative bleeding, shorter hospital stay, lower treatment costs, faster postoperative recovery, lower incidence of postoperative complications, and higher re-pregnancy rate. Hence, hysteroscopic resection is safe and effective, and could be the first choice for the treatment of no-severe CSD patients.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"573"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075735","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":"Effect of a multifaceted intervention with audit and feedback on low-risk childbirth practice: a multicentre prospective study.","authors":"Kayo Ueda, Mai Takeshita, Yoshimitsu Takahashi, Hatoko Sasaki, Naoki Ozu, Takeo Nakayama","doi":"10.1186/s12884-025-07681-2","DOIUrl":"https://doi.org/10.1186/s12884-025-07681-2","url":null,"abstract":"<p><strong>Background: </strong>Care for low-risk childbirths constitutes a large proportion of deliveries and is highly influenced by factors such as region, birthing facilities, and health care providers. Audit and feedback as a quality indicator (QI) intervention alone have limited effectiveness. Multidisciplinary approaches, including QI and organizational development, are reportedly effective; however, the impact on low-risk childbirth care remains unclear. We aimed to assess the impact of multifaceted intervention, including audit and feedback, on improving care for low-risk childbirths using QIs.</p><p><strong>Methods: </strong>We conducted a 1-year pre-post comparison targeting healthy pregnant women in four obstetric wards in Japan. The intervention included audit and feedback combined with multifaceted approaches, improvement efforts by a multidisciplinary team, and educational training on health care quality and organizational culture. The outcomes were 12 QIs. The main analysis used interrupted time-series analysis over 6 months pre- and post-intervention. We compared the 9 months pre-intervention with 3 months post-intervention in secondary analysis to assess delayed effects.</p><p><strong>Results: </strong>We included 288 women pre-intervention and 167 women post-intervention. \"The spontaneous vaginal delivery indicator showed a significant increase in slope (risk ratio [RR] 1∙08, 95% confidence interval [CI]: 1∙00-1∙16, p < 0∙05), indicating a trend-based improvement rather than an immediate change per month in the main analysis. Secondary analysis showed a significant increase in the administration of uterotonic agents during the third stage of labour (RR 1∙19, 95% CI: 1∙01-1∙41, p < 0∙05).</p><p><strong>Conclusion: </strong>The improvement effects of multifaceted interventions, including audit and feedback, using QIs for low-risk childbirths were limited. However, some indicators may improve over time, suggesting a potential delayed effect.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"571"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring healthcare providers' perspectives of childbirth education classes for quality of care and positive childbirth experience: an interpretative phenomenological analysis study.","authors":"Anwar Nader AlKhunaizi, Sami Abdulrahman Alhamidi, Areej Ghalib Al-Otaibi, Amany Anwar AlAbdullah, Kawther Saleh Alosaif, Meral Jehad Al Zayer","doi":"10.1186/s12884-025-07698-7","DOIUrl":"https://doi.org/10.1186/s12884-025-07698-7","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy is a significant transitional life experience that can be one of the most stressful experiences in life. Childbirth education is designed to improve health behaviors and offers information on psychological and physical changes that occur in pregnancy, signs that labor has begun, hospital routines and what to expect, how to manage pain through non-pharmacological strategies, the first hours of a newborn's life, and the benefits of breastfeeding. Healthcare providers play an essential role in this education. To discover how healthcare providers view childbirth education classes, we explored their perceptions in relation to the quality of care and positive childbirth experiences.</p><p><strong>Methods: </strong>An interpretative phenomenological qualitative approach was conducted in three government hospitals in the Eastern Province of Saudi Arabia. Data collection involved conducting semi-structured interviews with 15 participants. The sample consisted of physicians, nurses, and educators, ensuring a diverse range of perspectives.</p><p><strong>Results: </strong>An interpretative phenomenological analysis was conducted for data analysis. One core category (Road to a Pleasant and Safe Journey) with three themes (Mother's Experience, Obstacles, and Struggles of Healthcare Providers, and Solutions & Suggestions) emerged from the data analysis. The study findings indicate that childbirth education programs boost maternal health and facilitate a more positive delivery experience.</p><p><strong>Conclusions: </strong>Receiving childbirth education about natural and instinctive childbirth was necessary for low-risk mothers to experience a positive childbirth experience. The education also enabled mothers to feel in control during pregnancy, birth, and postpartum. From the results of this research the following recommendations can be made: childbirth education should be mandatory for all hospitals and primary healthcare institutions in the Kingdom and its curriculum should be standardized by the ministry of health and all healthcare providers employed in maternity care should be required to attend the standardized childbirth education programs.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"570"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075807","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":"Overreliance on cultural doulas: the paradox of entrusting the communication and care of high-risk migrant women to cultural doulas.","authors":"Birgitta Essén, Ayanthi Wickramasinghe, Lise Eriksson","doi":"10.1186/s12884-025-07700-2","DOIUrl":"https://doi.org/10.1186/s12884-025-07700-2","url":null,"abstract":"<p><strong>Background: </strong>It is widely recognized that migrant women from low-income countries are considered to be a group with increased obstetric challenges. To address these challenges, cultural doulas were introduced to provide continuous emotional and practical support during childbirth in Sweden. Leveraging their shared cultural background, language skills, and understanding, the idea behind these doulas was supposed to facilitate effective communication between the woman, her partner, and healthcare staff, with the assumption that this would lead to better maternity care for migrants. The aim of this study was to explore healthcare providers reflections on the role of cultural doulas and to explore their perceptions of cultural doulas' impact on childbirth.</p><p><strong>Methods: </strong>A qualitative study was conducted in 2022, involving semi-structured interviews with 18 healthcare providers; obstetricians and midwives from two Swedish counties. The data was analyzed using reflexive thematic analysis and discourse analysis, guided by Bacchi's 'What Is the Problem Represented to Be?'</p><p><strong>Approach: </strong></p><p><strong>Results: </strong>Using Bacchi's 'What Is the Problem Represented to Be?' approach, the analysis highlights how healthcare providers interpreted cultural doulas as an asset in relation to problems in migrants' maternity care. Three key discourses that emerged were: underlying social and cultural factors, assumptions of improved outcomes and integration, and cultural doulas as informal interpreters. Instead of emphasizing medical risks, healthcare providers focused on social risks and overlooked the importance of professional training.</p><p><strong>Conclusions: </strong>Cultural doulas are recognized as valuable in addressing gaps in migrant maternity care, yet their role presents a paradox. Entrusting the care of high-risk migrant women to minimally trained non-medical professionals paradoxically risks miscommunication and compromised care quality. Insufficient training, unclear roles, and the overextension of cultural doulas further exacerbate this issue, underscoring the need for systemic reforms. To resolve this paradox and improve maternal outcomes, the maternity care system must redefine the role of cultural doulas, prioritize professional interpretation services, and implement integrated care models tailored to the evidence based medical needs of migrant women.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"574"},"PeriodicalIF":2.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075812","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":"Association between late pregnancy A/G ratio and the risk of neonatal admission for neonatal hyperbilirubinemia.","authors":"Hongjuan Wei, Xin Chang, Rufeng Ji, Yinyan Tang","doi":"10.1186/s12884-025-07706-w","DOIUrl":"10.1186/s12884-025-07706-w","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between late pregnancy A/G (Albumin to globulin) ratio and the risk of admission for neonatal hyperbilirubinemia (NHB).</p><p><strong>Methods: </strong>This cross-sectional study selected mothers in labor and their newborns delivered at Nanjing Lishui People's Hospital, from January to December 2022. Multivariate logistic regression was utilized to analyze the relationship between late pregnancy A/G ratio and the risk of admission for NHB.</p><p><strong>Results: </strong>Out of 1432 pregnant women, 15.7% of newborns were admitted for NHB. Outcome 1: Dichotomizing the A/G ratio at 1.29, the risk of NHB admission decreased by 33% (95% CI: 0.46-0.97) for every 0.1 increase in A/G ratio < 1.29. Conversely, when the A/G ratio ≥ 1.29, the risk of NHB admission increased by 16% (95% CI: 1.01-1.32) for each 0.1 increase in A/G ratio. Outcome 2: When A/G ratio was categorized into three groups using thresholds of 1.15 and 1.40, the risk of NHB admission increased by 107% (95% CI: 1.17-3.66) for G1 and 60% (95% CI: 1.16-2.19) for G3, compared to G2.</p><p><strong>Conclusion: </strong>Late pregnancy A/G ratio is closely associated with the risk of admission for NHB. A/G ratio within different ranges affects the risk of NHB in varying directions and to different extents. Monitoring the A/G ratio may help identify pregnancies at higher risk of NHB.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"563"},"PeriodicalIF":2.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring uterine niche: a systemic review on secondary infertility rates, pathophysiological correlations, impact on assisted reproduction technology (ART), and the efficacy of surgical interventions.","authors":"D M C S Jayasundara, I A Jayawardane, T D K M Jayasingha, S D S Weliange","doi":"10.1186/s12884-025-07638-5","DOIUrl":"10.1186/s12884-025-07638-5","url":null,"abstract":"<p><strong>Background: </strong>The rising trend of cesarean sections worldwide has resulted in an increased incidence of uterine niches, a cavity formed at the cesarean scar site due to impaired tissue healing. Secondary infertility in women with uterine niches is a hot topic in obstetrics and gynecology. Therefore, the current study aims to untwist the link between secondary infertility and uterine niche, exploring the pathophysiological correlations, effects on assisted reproduction technology, and role of surgical interventions in resuming fertility.</p><p><strong>Methodology: </strong>PubMed, Cochrane Library, Embase, and Science Direct were searched systematically. Rayyan was employed as a semi-automated tool for study selection. Full-text articles in the English language were included. Systematic reviews, meta-analyses, or book chapters were excluded. Newcastle-Ottawa Scale assessed the quality of cohort and case-control studies, while the Cochrane Risk-of-bias tool evaluated randomized controlled trials. Data synthesis followed a thematic analysis.</p><p><strong>Results: </strong>35 articles from 3301 studies met the inclusion criteria. Among those, 25 were cohort studies, only one was a randomized controlled trial, and the rest had different study designs. The study quality assessment revealed average to good quality. The incidence of secondary infertility in women with uterine niches ranged from 27.37% (n = 95) to 75% (n = 16). Decreased residual myometrial thickness, chronic inflammatory changes at the niche site, and fluid accumulation within the niche cavity were identified as leading causes of secondary infertility. The uterine niche adversely affected assisted reproductive outcomes through multiple mechanisms. Various surgical interventions, including hysteroscopy, laparoscopy, or combined surgery, showed differing efficacies in restoring fertility.</p><p><strong>Conclusion: </strong>The study provides valuable insights regarding the association between secondary infertility and uterine niche. However, smaller sample sizes, retrospective nature of study designs, reliance on observational data, and heterogeneity of study reporting have limited the ability to arrive at solid conclusions. Therefore, we encourage well-designed prospective studies, including randomized controlled trials, to further explore this trending area.</p><p><strong>Register: </strong>The study protocol was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD4204526319).</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"566"},"PeriodicalIF":2.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969915","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}