BMC Pregnancy and Childbirth最新文献

{"title":"The association of Helicobacter pylori with adverse pregnancy outcomes in three European birth cohorts.","authors":"Raquel Galan, Lucy Pembrey, Mariona Bustamante, Ruth Aguilar, Dan Mason, Marta Vidal, Marc Bañuls, Theano Roumeliotaki, Juana Mari Delgado-Saborit, Natalia Marin, Martine Vrijheid, Vicky Bempi, Gemma Moncunill, Carlota Dobaño, Manolis Kogevinas, Marianna Karachaliou","doi":"10.1186/s12884-024-06901-5","DOIUrl":"10.1186/s12884-024-06901-5","url":null,"abstract":"<p><strong>Background: </strong>Helicobacter pylori is a prevalent infection that may complicate pregnancy, but evidence remains limited, controversial and may not apply to all pregnant women.</p><p><strong>Objective: </strong>This study aims to evaluate whether Helicobacter pylori is a risk factor for adverse pregnancy outcomes and to identify vulnerable subpopulations.</p><p><strong>Study design: </strong>Multiplex serology was utilized to measure blood levels of immunoglobulin G against eight Helicobacter pylori antigens in 1372 pregnant women from three European birth cohorts: BiB (United Kingdom), Rhea (Greece) and INMA (Spain). Outcomes of interest included gestational diabetes mellitus, gestational hypertension, preeclampsia, preterm birth and small for gestational age neonates, as well as prenatal anxiety and depression. Adjusted logistic regression models were used to evaluate the association between Helicobacter pylori seropositivity (overall and by antigen) and antigen specific antibody levels with the outcomes. We examined effect modification of the associations by ethnicity.</p><p><strong>Results: </strong>Helicobacter pylori seropositivity was detected in 18.8% (258/1372) of pregnant women. Preeclampsia was the least common outcome (26/830). Helicobacter pylori seropositivity was associated with the development of two or more adverse pregnancy outcomes (gestational hypertension, gestational diabetes, preterm birth, small gestational age and preeclampsia) [OR:1.32 (95% CI: 1.06-1.65), p-value: 0.01], especially in women with high antibody levels to OMP antigen [OR: 2.12 (95% CI: 1.62-2.76), p-value: 0.001]. Women with high antibody levels to Helicobacter pylori antigens GroEL and NapA were more likely to develop preeclampsia [OR: 2.34 (95% CI: 1.10-8.82), p-value: 0.03; OR: 4.09 (95% CI: 1.4-11.93), p-value 0.01)]. Helicobacter pylori seropositivity increased the odds of developing any hypertensive disorder during pregnancy among women of western ethnicity (948/1372) [OR:3.35 (95% CI: 1.29-8.74), p-value 0.03].</p><p><strong>Conclusion: </strong>Our study suggests that Helicobacter pylori seropositivity is a risk factor for multiple adverse pregnancy outcomes and particularly in women of western origin for hypertensive disorders during pregnancy. Moreover, pathogen specific characteristics reflected in the antibody responses against OMP, GroEL and NapA seem to determine disease associations.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"745"},"PeriodicalIF":2.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614078","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":"Are rates of clinical interventions during pregnancy and childbirth different for refugees and asylum seekers in high-income countries? A scoping review.","authors":"Alix Bukkfalvi-Cadotte, Gargi Naha, Ashra Khanom, Amy Brown, Helen Snooks","doi":"10.1186/s12884-024-06893-2","DOIUrl":"10.1186/s12884-024-06893-2","url":null,"abstract":"<p><strong>Background: </strong>Adequate maternity care and appropriate clinical interventions during labour and delivery can reduce adverse perinatal outcomes, but unnecessary interventions may cause harm. While studies have shown that refugees and asylum seekers face important barriers when accessing maternity care, there is a lack of high-quality quantitative data on perinatal health interventions, such as induction of labour or caesarean sections, among refugees and asylum seekers and the findings reported in the literature tend to be inconsistent. Our goal was to examine and synthesise the evidence regarding the rates of intrapartum clinical interventions in women who are refugees and asylum seekers in high-income countries compared to other population groups.</p><p><strong>Methods: </strong>We conducted a scoping review of peer-reviewed studies published in English since 2011 that report original quantitative findings regarding intrapartum clinical interventions among refugees and asylum seekers in high-income countries compared to those in non refugee, non asylum seeker populations. We examined reported rates of clinical pain relief, labour induction and augmentation, episiotomies, instrumental deliveries, and caesarean sections.</p><p><strong>Results: </strong>Twenty-five papers were included in the review. Findings indicate that refugees and asylum seekers were less likely to receive pain relief, with 16 out of 20 data points showing unadjusted ORs ranging from 0.20 (CI: 0.10-0.60) to 0.96 (CI: 0.70-1.32). Similarly, findings indicate lower odds of instrumental delivery among refugees and asylum seekers with 14 of 21 data points showing unadjusted ORs between 0.25 (CI: 0.15-0.39) and 0.78 (CI: 0.47-1.30); the remaining papers report no statistically significant difference between groups. There was no discernable trend in rates of labour induction and episiotomies across studies.</p><p><strong>Conclusions: </strong>The studies included in this review suggest that asylum seekers and refugees are less likely to receive clinical pain relief and experience instrumental delivery than non-refugee groups in high-income countries. This review strengthens our understanding of the links between immigration status and maternity care, ultimately informing policy and practice to improve perinatal health and the provision of care for all.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"742"},"PeriodicalIF":2.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614067","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":"Modelling the temporal trajectories of human milk components.","authors":"József Baranyi, Tünde Pacza, Mayara L Martins, Sagar K Thakkar, Tinu M Samuel","doi":"10.1186/s12884-024-06896-z","DOIUrl":"10.1186/s12884-024-06896-z","url":null,"abstract":"<p><strong>Background: </strong>This paper demonstrates how available data can be explored and utilized to conclude generic patterns in the temporal changes in Human Milk (HM) composition.</p><p><strong>Methods: </strong>The temporal trajectories of selected human milk components (HMC-s) were described, in the first four months postpartum, by a primary model consisting of two phases: a short linear phase in the colostrum, triggered by the parturition; and a longer second phase, where the concentration of the component converges to a steady state. The model was fitted to data available in a recently published database of temporal HMC trajectories both at the levels of individual molecules (such as specific fatty acid, oligosaccharide, and mineral molecules) and molecule-groups (such as total protein, total fat).</p><p><strong>Results: </strong>The properties of the trajectories suggest that experimental designs should follow non-equidistant sampling times, with increasingly longer time intervals after the first week postpartum. A selected parameter, the final stationary level, of the primary model was then studied as a function of geographical location (secondary modelling).</p><p><strong>Conclusions: </strong>We found that the total variation of the concentration of specific HMC-s is dominantly due to the inherent biological differences between individual mothers and to less extent to the geographical location.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"739"},"PeriodicalIF":2.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614133","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":"Building a machine learning-based risk prediction model for second-trimester miscarriage.","authors":"Sangsang Qi, Shi Zheng, Mengdan Lu, Aner Chen, Yanbo Chen, Xianhu Fu","doi":"10.1186/s12884-024-06942-w","DOIUrl":"10.1186/s12884-024-06942-w","url":null,"abstract":"<p><strong>Background: </strong>Second-trimester miscarriage is a common adverse pregnancy outcome that imposes substantial economic and psychological pressures on both the physical and mental well-being of patients and their families. Currently, there is a scarcity of research on predictive models for the risk of second-trimester miscarriage.</p><p><strong>Methods: </strong>Clinical data were retrospectively collected from patients who were in the second trimester of pregnancy (between 14+0 and 27+6 weeks gestation), whose main diagnosis was \"threatened abortion\" and who were hospitalized at the Women and Children's Hospital of Ningbo University from January 2020 to October 2023. Following preliminary data processing, the patient cohort was randomly stratified into a training cohort and a validation cohort at proportions of 70% and 30%, respectively. The Boruta algorithm and multifactor analysis were used to refine feature factors and determine the optimal features linked to second-trimester miscarriages. The imbalanced dataset from the training cohort was rectified by applying the SMOTE oversampling approach. Seven machine-learning models were built and subjected to a comprehensive analysis to validate and evaluate their predictive capabilities. Through this rigorous assessment, the optimal model was selected. Shapley additive explanations (SHAP) were generated to provide insights into the model's predictions, and a visual representation of the predictive model was built.</p><p><strong>Results: </strong>A total of 2006 patients were included in the study; 395 (19.69%) of them had second-trimester miscarriages. XGBoost was shown to be the optimal model after a comparison of seven different models utilizing metrics such as accuracy, precision, recall, the F1 score, precision-recall average precision, the receiver operating characteristic-area under the curve, decision curve analysis, and the calibration curve. The most significant feature was cervical length, and the top ten features of second-trimester miscarriage were found using the SHAP technique based on relevance rankings.</p><p><strong>Conclusion: </strong>The risk of a second-trimester miscarriage can be accurately predicted by the visual risk prediction model, which is based on the machine learning mentioned above.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"738"},"PeriodicalIF":2.8,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11550545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614090","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":"Weight-based disparities in perinatal care: quantitative findings of respect, autonomy, mistreatment, and body mass index in a national Canadian survey.","authors":"Nisha Malhotra, Cecilia M Jevitt, Kathrin Stoll, Wanda Phillips-Beck, Saraswathi Vedam","doi":"10.1186/s12884-024-06928-8","DOIUrl":"10.1186/s12884-024-06928-8","url":null,"abstract":"<p><strong>Background: </strong>Qualitative studies document episodes of weight-related disrespectful care, particularly for people with high body mass index (BMI ≥ 30) and reveal implicit and explicit biases in health care providers. No large quantitative studies document the pervasiveness of weight stigma or if experiences change with increasing BMI.</p><p><strong>Methods: </strong>The multi-stakeholder RESPCCT study team designed and distributed a cross-sectional survey on the experiences of perinatal services in all provinces and territories in Canada. From July 2020 to August 2021, participants who had a pregnancy within ten years responded to closed and open-ended questions. Chi square analysis assessed differences in mean scores derived from three patient-reported experience measures of autonomy (MADM), respect (MOR), and mistreatment (MIST). Controlling for socio-demographic factors, multivariate logistic regression analysis explored relationships between different BMI categories and respectful care.</p><p><strong>Results: </strong>Of 4,815 Canadians who participated, 3,280 with a BMI of ≥ 18.5 completed all the questions. Pre-pregnancy BMI was significantly associated with race/ethnicity, income sufficiency, and education but not with age. Individuals with higher BMIs were more likely to experience income insufficiency, have lower levels of education, and more frequently self-identified as Indigenous or White. Those with BMI ≥ 35 exhibited notably higher odds of reduced autonomy (MADM) scores, with an unadjusted odds ratio of 1.62 and an adjusted odds ratio of 1.45 compared to individuals with a normal weight. Individuals with BMIs of 25-25.9, 30-34.9, and ≥ 35 exhibited odds of falling into the lower tercile of respect (MOR) scores of 1.34, 1.51, and 2.04, respectively (p < .01). The odds of reporting higher rates of mistreatment (top 33% MIST scores) increased as BMI increased.</p><p><strong>Conclusions: </strong>While socio-demographic factors like race and income play significant roles in influencing perinatal care experiences, BMI remains a critical determinant even after accounting for these variables. This study reveals pronounced disparities in the provision of respectful perinatal care to pregnant individuals with higher BMIs in Canada. Data suggest that those with higher BMIs face disrespect, discrimination, and mistreatment. Identification of implicit and explicit weight bias may give providers insight enabling them to provide more respectful care.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"737"},"PeriodicalIF":2.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614119","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 of joint exposure to organophosphorus flame retardants and phthalate acid esters with gestational diabetes mellitus: a nested case-control study.","authors":"Qi Lang, Xianfeng Qin, Xiangyuan Yu, Shudan Wei, Jinyan Wei, Min Zhang, Chaochao Zhao, Jun Zhang, Dingyuan Zeng, Xiaoying Zhang, Bo Huang","doi":"10.1186/s12884-024-06925-x","DOIUrl":"10.1186/s12884-024-06925-x","url":null,"abstract":"<p><strong>Background: </strong>Organic phosphate flame retardants (OPFRs) and phthalate acid esters (PAEs) are common endocrine-disrupting chemicals that cause metabolic disorders. This study aimed to assess the association between joint exposure to OPFRs and PAEs during early pregnancy in women with gestational diabetes mellitus (GDM).</p><p><strong>Methods: </strong>Seven OPFRs and five PAEs were detected in the urine of 65 GDM patients and 100 controls using gas chromatography-tandem triple quadrupole mass spectrometry (GC-MS). The association of OPFRs and PAEs with GDM was assessed using logistic regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models.</p><p><strong>Results: </strong>Levels of dibutyl phthalate (DBP), di-2-ethylhexyl phthalate (DEHP), diethyl phthalate (DEP), dimethyl phthalate (DMP), tris (2-butoxyethyl) phosphate (TBEP), tributyl phosphate (TBP), tris (2-chloroethyl) phosphate (TCEP), tris (1,3-dichloro-2-propyl) phosphate (TDCPP), tri-ortho-cresyl phosphate (TOCP), and triphenyl phosphate (TPHP) increased in the GDM group, and the OPFRs and PAEs, except for BBP and TMCP, were associated with GDM in the logistic regression analysis. In the WQS model, the mixture of OPFRs and PAEs was significantly positively associated with GDM (OR = 3.29, 95%CI = 1.27-8.51, P = 0.014), with TDCPP having the highest WQS index weight. BKMR analysis reinforced these results, showing that the overall association of joint exposure to the OPFRs and PAEs with GDM increased at exposure levels of the 55th to 75th percentiles. Independent exposure to TDCPP (OR = 1.42, 95%CI = 1.09-1.86, P = 0.011) and TBEP (OR = 1.29, 95%CI = 1.04-1.60, P = 0.023) were associated with an increased risk of GDM.</p><p><strong>Conclusions: </strong>Environmental exposure to OPFRs and PAEs is significantly associated with GDM. These findings provide evidence for the adverse effects of exposure to OPFRs and PAEs on the health of pregnant women.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"736"},"PeriodicalIF":2.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614073","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":"Completion of maternal and child health continuum of care and associated factors in West Gondar Zone, North West Ethiopia, 2023: a community based cross sectional study.","authors":"Asrat Mekonnen Tegegne, Yohannes Ayanaw Habitu, Yeshiwas Ayale Ferede, Elsa Awoke Fentie","doi":"10.1186/s12884-024-06949-3","DOIUrl":"10.1186/s12884-024-06949-3","url":null,"abstract":"<p><strong>Background: </strong>The maternal and child health continuum of care integrates services from pre-pregnancy through childhood to enhance maternal and child outcomes. It is crucial for reducing maternal and child mortality by focusing on comprehensive health interventions. Despite its significance, comprehensive studies on the continuum remain limited. This study aimed to assess the completion of the maternal and child health continuum of care and associated factors among mothers with index children aged 12-23 months in the West Gondar Zone, Northwest Ethiopia, in 2023.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted from May 1-30, 2023, by interviewing mothers of 12-23-month-old children in West Gondar zone. A simple random sampling method was used to select 1,019 mothers. Data were collected via KoboCollect and analyzed in Stata version 14.0. Binary logistic regression was used to examine associations between independent variables and the continuum of care. Variables with a p value < 0.2 in bi-variable analysis were included in the multivariable model. Finally, adjusted odds ratios (AOR) with 95% confidence intervals (CI) and p values < 0.05 were used to determine statistical significance. The Hosmer and Lemeshow goodness-of-fit test was computed.</p><p><strong>Results: </strong>The overall rate of completion of the maternal and child health continuum of care was 6.19% (95% CI: 4.69-7.68). The factors associated were having the first ANC visit before 16 weeks of pregnancy [AOR: 4.25 (CI: 2.14-8.47)], birth preparedness and complication readiness [AOR: 3.02 (CI: 1.41-6.46)], history of modern contraceptive use [AOR: 2.34 (CI: 1.16-4.73)], intended pregnancy [AOR: 3.25 (CI: 1.63-6.48)], receiving maternal services during ANC visits [AOR: 2.69 (CI: 1.07-6.80)], and the health facility being less than an hour away from home [AOR: 2.53 (CI: 1.06-6.03)].</p><p><strong>Conclusions: </strong>The maternal and child health (MCH) continuum of care in West Gondar was low. Key factors affecting completion included birth preparedness and complication readiness, early ANC initiation, planned pregnancy, family planning use, proximity to health facilities, and maternal health services provided during ANC. Efforts should target these factors and ensure services at each stage of the continuum to stay mothers along the path of the MCH continuum of care.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"734"},"PeriodicalIF":2.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614092","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":"Neighborhood socioeconomic status and postpartum depression among commercial health insurance enrollees: a retrospective cohort study.","authors":"Onur Baser, Lauren Isenman, Erdem Baser, Wenjing Li, Burhan Cigdem","doi":"10.1186/s12884-024-06882-5","DOIUrl":"10.1186/s12884-024-06882-5","url":null,"abstract":"<p><strong>Background: </strong>Postpartum depression (PPD) is a prevalent psychological condition. Although the effect of obstetrical and maternal complications on PPD are well described, the impact of neighborhood socioeconomic status (SES) on PPD is relatively unexplored.</p><p><strong>Objectives: </strong>This study examined the relationship between neighborhood SES score and PPD.</p><p><strong>Methods: </strong>A summary SES measure for each U.S. zip code was constructed using income, education, and occupational 2021 Census data and linked to national commercial claims for 2017-2023. PPD status using diagnosis codes at outpatient and inpatient visits, and prescription drug use 3, 6, 9, and 12 months postpartum, were determined. Multivariate analysis controlled for potential confounders.</p><p><strong>Results: </strong>PPD prevalence in commercial claims was 11.48%. Patients with PPD had higher rates of obstetrical (OR: 1.555, p < .0001) and maternal complications (OR: 1.145, p < .0001), and more lifestyle risk factors (OR: 1.113, p < .0001). Comorbidity scores were higher for patients with PPD. Controlling for age and clinical factors, living in a disadvantaged neighborhood was associated with an increased incidence of PPD (OR: 1.137, p < .0001).</p><p><strong>Limitations: </strong>Claims data may include potential inaccurate coding of diagnoses/procedures. Clinical information is limited to conditions and treatments defined by ICD-10-CM codes. Area-based SES measures inevitably misclassify people on both ends of the socioeconomic spectrum (this misclassification is random; direction of bias is known).</p><p><strong>Conclusions: </strong>The inverse and significant effect of area-based high SES on PPD rates demonstrates that preventive efforts may require interventions focusing on both the patient and the lived environment.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"732"},"PeriodicalIF":2.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614134","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":"Predictive modeling of gestational weight gain: a machine learning multiclass classification study.","authors":"Audêncio Victor, Hellen Geremias Dos Santos, Gabriel Ferreira Santos Silva, Fabiano Barcellos Filho, Alexandre de Fátima Cobre, Liania A Luzia, Patrícia H C Rondó, Alexandre Dias Porto Chiavegatto Filho","doi":"10.1186/s12884-024-06952-8","DOIUrl":"10.1186/s12884-024-06952-8","url":null,"abstract":"<p><strong>Background: </strong>Gestational weight gain (GWG) is a critical factor influencing maternal and fetal health. Excessive or insufficient GWG can lead to various complications, including gestational diabetes, hypertension, cesarean delivery, low birth weight, and preterm birth. This study aims to develop and evaluate machine learning models to predict GWG categories: below, within, or above recommended guidelines.</p><p><strong>Methods: </strong>We analyzed data from the Araraquara Cohort, Brazil, which comprised 1557 pregnant women with a gestational age of 19 weeks or less. Predictors included socioeconomic, demographic, lifestyle, morbidity, and anthropometric factors. Five machine learning algorithms (Random Forest, LightGBM, AdaBoost, CatBoost, and XGBoost) were employed for model development. The models were trained and evaluated using a multiclass classification approach. Model performance was assessed using metrics such as area under the ROC curve (AUC-ROC), F1 score and Matthew's correlation coefficient (MCC).</p><p><strong>Results: </strong>The outcomes were categorized as follows: GWG within recommendations (28.7%), GWG below (32.5%), and GWG above recommendations (38.7%). The XGBoost presented the best overall model, achieving an AUC-ROC of 0.79 for GWG within, 0.76 for GWG below, and 0.65 for GWG above. The LightGBM also performed well with an AUC-ROC of 0.79 for predicting GWG within recommendations, 0.76 for GWG below, and 0.624 for GWG above. The most important predictors of GWG were pre-gestational BMI, maternal age, glycemic profile, hemoglobin levels, and arm circumference.</p><p><strong>Conclusion: </strong>Machine learning models can effectively predict GWG categories, offering a valuable tool for early identification of at-risk pregnancies. This approach can enhance personalized prenatal care and interventions to promote optimal pregnancy outcomes.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"733"},"PeriodicalIF":2.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614137","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":"Time trends in maternal hypertensive disorder incidence in Brazil, Russian Federation, India, China, and South Africa (BRICS): an age-period-cohort analysis for the GBD 2021.","authors":"Xiaochan Wang, Fangqun Cheng, Qiupeng Fu, Peiyu Cheng, Jianzhong Zuo, Yuhang Wu","doi":"10.1186/s12884-024-06931-z","DOIUrl":"10.1186/s12884-024-06931-z","url":null,"abstract":"<p><strong>Objectives: </strong>Maternal hypertensive disorder (MHD) is a leading cause of significant maternal and fetal mortality and morbidity. The BRICS nations are crucial in the global MHD landscape, given their large populations and varied healthcare infrastructures. This investigation evaluates the incidence trends of MHD in BRICS countries from 1992 to 2021.</p><p><strong>Study design and methods: </strong>Data on the number, all-age rate, age-standardized rate (ASR), and the relative change of MHD incidence from this study were sourced from the Global Burden of Disease (GBD) 2021 public dataset to investigate temporal trends in MHD incidence over three decades globally and in BRICS countries. The age-period-cohort (APC) model was used to estimate net drift, local drift, age-specific curves, and period (cohort) relative risks.</p><p><strong>Results: </strong>A 15.87% increase in global MHD cases, alongside a 13.40% decrease in age-standardized incidence rates from 1992 to 2021. MHD incidence rates are declining across various BRICS age groups, except in China and Russian Federation, where most groups exhibit increasing trends. Annual net drift in MHD incidence ranges from - 4.25% in India to 2.38% in China. A shift in the age distribution of MHD cases from younger to older within the childbearing age range is observed in all BRICS nations. Countries exhibit similar age-effect patterns, with decreasing risk with increasing age, and varying period and cohort effects, indicative of differential control measures and temporal incidence trends.</p><p><strong>Conclusions: </strong>Global and BRICS-specific reductions in MHD incidence vary in magnitude. Customized preventive strategies, leveraging existing resources, are advisable for BRICS nations to address pregnancy complications. Enhancing primary healthcare and maternal care quality, particularly for older mothers, is imperative.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"731"},"PeriodicalIF":2.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11545085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614106","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}