BMC Pregnancy and Childbirth最新文献

{"title":"Prediction of gestational diabetes mellitus using early-pregnancy data: a secondary analysis from a prospective cohort study in Iran.","authors":"Mohammadamin Parsaei, Mohadese Dashtkoohi, Mohammadamin Noorafrooz, Mohammad Haddadi, Mahdi Sepidarkish, Azar Mardi-Mamaghani, Mahnaz Esmaeili, Mehrnoosh Shafaatdoost, Arshia Shizarpour, Ashraf Moini, Reihaneh Pirjani, Sedigheh Hantoushzadeh","doi":"10.1186/s12884-024-07079-6","DOIUrl":"10.1186/s12884-024-07079-6","url":null,"abstract":"<p><strong>Background: </strong>Early identification of gestational diabetes mellitus is essential for improving maternal and neonatal outcomes. While risk factors such as advanced maternal age, elevated pre-pregnancy body mass index, multiparity, and a history of gestational diabetes have been recognized, the role of serum biomarkers remains uncertain. This study explores the predictive value of early-pregnancy laboratory findings in conjunction with maternal demographic and clinical characteristics for gestational diabetes mellitus.</p><p><strong>Methods: </strong>Early-pregnancy data from the first pregnancy visits at 6-12 weeks of gestation from women in the Mothers and Children's Health cohort were collected. Comprehensive maternal demographic data (e.g., age and body mass index) and obstetrics history (e.g., gravidity, parity, miscarriage, intrauterine growth retardation, gestational diabetes mellitus, and preeclampsia) were recorded. Maternal blood samples were analyzed for complete blood count and biochemistry parameters. Gestational diabetes mellitus was diagnosed based on 75-g oral glucose tolerance test results between 24 and 28 weeks of gestation, following the International Association of Diabetes and Pregnancy Study Groups criteria. Multivariate logistic regression analysis assessed the predictive capacity of various variables. Receiver operating curve analysis was conducted to identify optimal predictive cut-offs for continuous variables.</p><p><strong>Results: </strong>1,565 pregnant women with a mean age of 32.6 ± 5.7 years, mean body mass index of 25.5 ± 4.9 kg/m², mean gravidity of 1.1 ± 1.1, and mean parity of 0.8 ± 0.8 were included. 297 pregnancies (19.0%) were complicated by gestational diabetes mellitus. In the multivariate analysis, higher maternal age (p < 0.001, odds ratio = 1.076 [1.035-1.118]), a history of gestational diabetes mellitus (p < 0.001, odds ratio = 3.007 [1.787-5.060]) and preeclampsia (p = 0.007, odds ratio = 2.710 [1.310-5.604]), and elevated early-pregnancy fasting blood sugar (p < 0.001, odds ratio = 1.062 [1.042-1.083]) emerged as independent predictors of gestational diabetes mellitus. Moreover, the receiver operating curve yielded an optimal cut-off of 89.5 mg/dL for early-pregnancy fasting blood sugar in predicting gestational diabetes mellitus.</p><p><strong>Conclusions: </strong>Our findings demonstrated that, in addition to established risk factors, a history of preeclampsia and elevated early-pregnancy fasting blood glucose are independent predictors of gestational diabetes mellitus. Therefore, close monitoring of pregnant women with these risk factors in early pregnancy is warranted to facilitate timely diagnostic and therapeutic interventions, reducing the burden of gestational diabetes.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"849"},"PeriodicalIF":2.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880967","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":"Efficacy of vitamin D supplementation on the incidence of preeclampsia: a systematic review and meta-analysis.","authors":"Khaled Moghib, Thoria I Ghanm, Abdallah Abunamoos, Munia Rajabi, Shehab M Moawad, Ahmed Mohsen, Said Kasem, Khalid Elsayed, Moaaz Sayed, Ali I Dawoud, Izere Salomon, Alaaeldin Elmaghreby, Mohamed Ismail, Ahmed Amer","doi":"10.1186/s12884-024-07081-y","DOIUrl":"10.1186/s12884-024-07081-y","url":null,"abstract":"<p><strong>Background: </strong>Preeclampsia is a severe pregnancy complication affecting 2-8% of pregnancies globally, contributing to substantial maternal and fetal morbidity and mortality. Vitamin D deficiency has been associated with an increased risk of preeclampsia, yet the efficacy of its supplementation during pregnancy in reducing preeclampsia incidence remains uncertain.</p><p><strong>Objectives: </strong>This systematic review and meta-analysis aimed to evaluate the impact of vitamin D supplementation on the incidence of preeclampsia and related maternal and neonatal outcomes.</p><p><strong>Method: </strong>We systematically searched PubMed, Scopus, Cochrane Library, and Web of Science until August 2024 for randomized controlled trials (RCTs) examining the effects of vitamin D supplementation on preeclampsia. Eligible studies included pregnant women with varying doses of vitamin D supplementation compared to placebo or standard care. Primary outcomes were the incidence of pre-eclampsia and preterm labor; secondary outcomes included serum 25-hydroxyvitamin D levels, low birth weight, and APGAR scores. Data were synthesized using R statistical software, with effect measures reported as relative risk (RR) and mean difference (MD) with a 95% confidence interval (CI).</p><p><strong>Results: </strong>A total of 33 RCTs involving 10,613 participants were included. Vitamin D supplementation significantly reduced the risk of preeclampsia by 44.8% (RR = 0.55, 95% CI [0.43, 0.71], P < 0.0001) and preterm labor by 30% (RR = 0.70, 95% CI [0.51, 0.96], P = 0.0286). Subgroup analyses indicated that the benefits were more pronounced when the control group received a placebo rather than low-dose vitamin D. Serum 25-hydroxyvitamin D levels significantly increased in the supplementation group (MD = 32.42 nmol/L, 95% CI [20.33, 44.50], P < 0.0001). However, no significant differences were observed in the incidence of low birth weight (RR = 0.65, 95% CI [0.42, 1.02], P = 0.057) or Apgar scores at 5 min (MD = 0.20, 95% CI [-0.01, 0.40], P = 0.057).</p><p><strong>Conclusion: </strong>Vitamin D supplementation during pregnancy significantly reduces the risk of preeclampsia and preterm labor, though its impact on neonatal outcomes remains unclear. These findings underscore the potential value of vitamin D supplementation in prenatal care for improving maternal outcomes. Further research is needed to clarify its effects on neonatal health.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"852"},"PeriodicalIF":2.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881168","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":"Use of chlorhexidine digluconate 7.1% gel for umbilical cord care in selected regions in Northern Ghana: qualitative perspectives of key stakeholders.","authors":"Demi Priscilla Letsa Duah, Andrews Adjekwei Adjieteh, Selase Adjei, Kamil Fuseini, Akua Danquah Obeng-Dwamena, Joseph Addo-Yobo, Augustine Ankomah","doi":"10.1186/s12884-024-07060-3","DOIUrl":"10.1186/s12884-024-07060-3","url":null,"abstract":"<p><strong>Background: </strong>The Government of Ghana in 2017 included chlorhexidine (CHX) digluconate 7.1% gel in the essential medicines list to replace methylated spirit for umbilical cord care. However, there are limited studies around the use of the CHX gel. This paper explores the perspectives of stakeholders in childcare regarding the use of the gel for umbilical cord care in selected regions in Northern Ghana.</p><p><strong>Methods: </strong>Data for the study were from 42 in-depth interviews and 12 focus group discussions conducted among mothers, caregivers, fathers, traditional birth attendants, and health care providers (including pharmacists and over the counter medicine sellers). The transcribed data was analysed and organized into themes and sub-themes using thematic analysis approach. The data analysis was conducted using NVIVO version 12 analytical software.</p><p><strong>Results: </strong>CHX gel was used side-by-side with methylated spirit for umbilical cord care in the study areas. Use of methylated spirit for umbilical cord care was found to be common, and in the home setting there was evidence of use of traditional substances such as shea butter, toothpaste, cow dung, herbs and chalk. However, shea butter was regarded as the \"golden standard\" for cord care among non-health professionals. Co-use of traditional and orthodox cord care substances was also rife. The limited use of the CHX gel was attributable to the fact that some participants, especially health providers were convinced that the gel and methylated spirit were both effective; hence they continued prescribing methylated spirit over the gel for cord care. Evidence on the efficacy of the gel was mixed perhaps a reflection of the limited awareness and knowledge about the CHX gel, and the limited use behaviour / use skills. Additionally, awareness of the inclusion of the CHX gel in the national health insurance was also mixed.</p><p><strong>Conclusions: </strong>The CHX gel is yet to replace other cord care substances as the use of methylated spirit and traditional substances were still prevalent. Hence, a comprehensive strategy is needed to create awareness and educate providers, significant others, and the community about the gel and its efficacy if it is to replace methylated spirit as the cord care substance.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"851"},"PeriodicalIF":2.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881174","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":"Predictors and outcomes of premature rupture of membranes among pregnant women admitted to a teaching Hospital in Saudi Arabia: a cohort study.","authors":"Hayfaa Wahabi, Hala Elmorshedy, Hanadi Bakhsh, Samia Ahmed, Raghad E AlSubki, Amsha S Aburasyin, Amel Fayed, Amal Mahmoud Ibrahim Goda","doi":"10.1186/s12884-024-07020-x","DOIUrl":"10.1186/s12884-024-07020-x","url":null,"abstract":"<p><strong>Background: </strong>Premature rupture of the membrane (PROM), refers to rupture of the fetal membranes prior to the onset of regular uterine contractions. When this occurs at term (≥ 37 weeks of gestation), it is classified as PROM, whereas if it occurs before 37 weeks, it is termed preterm premature rupture of membranes (PPROM). PROM and PPROM are linked to adverse outcomes for both mother and newborn.</p><p><strong>Objectives: </strong>To investigate the factors associated with PROM and the outcomes of pregnancies complicated with PROM.</p><p><strong>Methods: </strong>This was a retrospective cohort study. The participants were divided into three groups; those with PROM, those with PPROM and a control group who had normal onset of membranes rupture. The groups were compared with respect to predictors of PROM (maternal demographic profile, obstetrical history, and comorbidities), in addition to outcomes (postpartum hemorrhage, hospital stay, low APGAR scores, sepsis, low birthweight, preterm rate, and admission to neonatal Intensive care Unit (NICU)). Multivariable logistic regression model was used for predicting risk factors associated with PROM and PPROM.</p><p><strong>Results: </strong>A total of 1,894 pregnant women were enrolled in the study, 77.6% had normal onset of ruptured membranes, while 382 (20.1%) were diagnosed with a PROM and 43 (2.3%) diagnosed with PPROM. Primiparous mothers were more likely to develop PROM (AOR = 1.56, 95% CI (1.10-2.22)) as compared to multiparous, while obese and overweight mothers were less likely to develop PPROM (AOR = 0.86, 95% CI (0.94 - 0.49)). Significantly more mothers with PPROM were delivered by emergency cesarean Sect. (30.2% vs. 22.9%, P < 0.01), develop chorioamnionitis (4.7% vs. 0.1%, P < 0.01), and stayed in the hospital more than three days (16.3% vs. 2.5%, P < 0.01) compared to the control group. Neonates of mothers who had PPROM were more likely to have low birth weight (35.7% vs. 10.4%, P < 0.01), and NICU admission (67.4% vs. 20.4%, P < 0.01) as compared to the control group. Perinatal death rate was not significantly different between the groups.</p><p><strong>Conclusion: </strong>In this study, nulliparity is a predictor of PROM, while overweight/ obese mothers are less likely to develop PPROM. Despite the relatively low occurrence of PPROM among Saudi women, the condition is associate with increase risk of cesarean section delivery, chorioamnionitis, prolonged hospitalization, and an increase need for neonatal intensive care compare to those with a normal onset of membrane rupture.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"850"},"PeriodicalIF":2.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881092","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":"Systematic druggable genome-wide Mendelian randomization identifies therapeutic targets for hyperemesis gravidarum.","authors":"Fengyang Wang, Wenpeng Ruan, Qiuyuan Yin, Lei Zhu","doi":"10.1186/s12884-024-07077-8","DOIUrl":"10.1186/s12884-024-07077-8","url":null,"abstract":"<p><strong>Background: </strong>Hyperemesis gravidarum (HG), excessive vomiting in pregnancy, occurs in 0.3-10.8% of pregnancies and is associated with maternal and fetal morbidity. Despite the existence of several off-label treatment options that have shown clinical effectiveness in managing HG symptoms, the variability in treatment response highlights the need for more effective therapies. Our study aims to identify novel therapeutic targets that could lead to the development of additional, more effective treatment options.</p><p><strong>Methods: </strong>A two-sample Mendelian randomization (MR) analysis was performed to estimate the causal effects of blood-druggable genes on HG. Summary statistics for HG were obtained from the FinnGen study and UK Biobank. Cis-expression quantitative trait loci (cis-eQTL) for blood druggable genes were obtained from the eQTLGen Consortium and used as genetic instrumental variables. Another MR method, summary level mendelian randomization (SMR), was used to further confirm our results. We also used eQTL data of other vomiting-related tissues, brain regions, and esophagus, to validate our MR results. Finally, the potential side effects of the druggable genes for HG treatment were assessed using a phenome-wide MR.</p><p><strong>Results: </strong>Overall, 2499 unique druggable genes were gathered. Two blood drug targets (OVGP1 and LGALS1) showed significant MR results in two independent datasets. No significant heterogeneity of instrumental variables or pleiotropy was detected. In addition, SMR analysis further confirmed the significance of these two prior druggable genes in the brain and esophagus tissues. Further phenome-wide MR analysis revealed no association between genetic proxies of OVGP1, and LGALS1 has been detected in increasing the risk of adverse pregnancy outcomes and other common diseases.</p><p><strong>Conclusions: </strong>This study provides genetic evidence that targeting two druggable genes for HG has potential therapeutic advantages. This information is of considerable value in guiding and prioritizing the development of more effective therapies for HG.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"848"},"PeriodicalIF":2.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881167","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":"Prenatal ultrasound scoring in diagnosis and postpartum outcomes prediction for Placenta Accreta Spectrum (PAS): a systematic review.","authors":"Xue Peng, Xi Tan, Zhao Wu","doi":"10.1186/s12884-024-07076-9","DOIUrl":"10.1186/s12884-024-07076-9","url":null,"abstract":"<p><strong>Background: </strong>Placenta accreta spectrum (PAS) is one of the most dangerous pregnancy-related conditions. This study aims to conduct a systematic review of current research on the ultrasound scoring systems used in PAS patients with a comprehensive summarization of researches and comparison of prenatal ultrasound scoring in evaluating postpartum outcomes.</p><p><strong>Methods: </strong>This systematic review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were retrieved from four databases (PubMed, Cochrane Library, Embase and Web of Science) up to December 2023. Original studies involving women diagnosed with PAS using ultrasound scoring for diagnosis or outcome evaluation were screened based on predefined inclusion and exclusion criteria. The primary outcome was the diagnostic performance of ultrasound scoring systems and their effectiveness in predicting labor outcomes. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was utilized to assess the study quality. The study has been registered on the PROSPERO website with the registration number CRD42024507311.</p><p><strong>Results: </strong>Sixteen studies met the inclusion criteria. 3930 patients were included in the review, with 1693 participants in the control group. Included studies had a high risk of bias in patient selection, with a low risk in flow and timing and reference standards. Existing studies have reported several indicators that can be included in ultrasound scoring systems and tested their effectiveness in diagnosis and severity evaluation. The pool sensitivity, specificity, and area under the curve (AUC) of ultrasound scoring system in diagnosing PAS were 0.89 (95% confidence interval [CI]: 0.82-0.94), 0.85(95%CI: 0.80-0.90) and 0.93 (95%CI:0.91-0.95). Ultrasound scores are associated with PAS outcomes including intraoperative haemorrhage, postpartum haemorrhage, hysterectomy, length of hospital stay, and neonatal prognosis. Limitation is that the existing studies are wide-ranging but have low replication and association.</p><p><strong>Conclusion: </strong>Ultrasound scoring systems play a role in the prenatal diagnosis, management, and prediction of postnatal complications in PAS. Nevertheless, additional research is required to further evaluate the performance between different scoring systems to develop a unified consensus.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"846"},"PeriodicalIF":2.8,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871149","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":"Adverse birth outcome research case definitions associated with maternal HIV and antiretroviral drug use in pregnancy: a scoping review.","authors":"Kopano R Dube, Shani T de Beer, Kathleen M Powis, Michael McCaul, Amy L Slogrove","doi":"10.1186/s12884-024-06939-5","DOIUrl":"10.1186/s12884-024-06939-5","url":null,"abstract":"<p><strong>Background: </strong>Adverse birth outcomes (preterm birth, low birth weight, small for gestational age, and stillbirth) seem to persist in infants born to people with HIV, even in the context of maternal antiretroviral therapy. However, findings have been disparate, inconclusive, and difficult to compare directly across settings, partly owing to variable outcome definitions. We aimed to collate, compare, and map existing adverse birth outcome definitions to inform a harmonized approach to universally measure these outcomes in studies including pregnant people with HIV.</p><p><strong>Methods: </strong>We conducted a scoping review of studies that reported adverse birth outcomes associated with maternal HIV and antiretroviral use in pregnancy, specifically those that included definitions of 'preterm birth', 'low birth weight', 'small for gestational age', and 'stillbirth'. Five databases were searched from 01 January 2011 to 15 August 2022. Title, abstract and full-text screening was conducted independently in duplicate. A comparative quantitative analysis was conducted to compare study characteristics by period of study (< 2013; 2013-2015; > 2016) and country income group. A qualitative content analysis was conducted to compare and map deviations from the WHO definitions as a reference.</p><p><strong>Results: </strong>Of the 294 articles that included at least one adverse birth outcome, 214 (73%) studies started before 2013, 268 (91%) were published as primary research articles, and 137 (47%) were conducted in Eastern and Southern Africa. Among the 283 studies included in the country income group analysis, 178 (63%) were conducted in low- and middle-income countries. Studies reporting low birth weight, preterm birth, small for gestational age and stillbirth deviated from the WHO definitions in n = 11/169 (7%), n = 93/246 (39%), n = 40/112 (36%) and n = 85/108 (79%) instances, respectively. The variations included the use of different thresholds and the addition of new terminology.</p><p><strong>Conclusion: </strong>The current WHO definitions are valuable tools for population-level monitoring; however, through consensus, these definitions need to be optimized for research data collection, analysis, and presentation. In conjunction with good reporting, variation in adverse birth outcome definitions can be decreased to facilitate comparability of studies as well as pooling of data for enhanced evidence synthesis.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"844"},"PeriodicalIF":2.8,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871304","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":"Predicting preterm birth using electronic medical records from multiple prenatal visits.","authors":"Chenyan Huang, Xi Long, Myrthe van der Ven, Maurits Kaptein, S Guid Oei, Edwin van den Heuvel","doi":"10.1186/s12884-024-07049-y","DOIUrl":"10.1186/s12884-024-07049-y","url":null,"abstract":"<p><p>This study aimed to predict preterm birth in nulliparous women using machine learning and easily accessible variables from prenatal visits. Elastic net regularized logistic regression models were developed and evaluated using 5-fold cross-validation on data from 8,830 women in the Nulliparous Pregnancy Outcomes Study: New Mothers-to-Be (nuMoM2b) dataset at three prenatal visits: <math><msup><mn>6</mn> <mn>0</mn></msup> </math> - <math><msup><mn>13</mn> <mn>6</mn></msup> </math> , <math><msup><mn>16</mn> <mn>0</mn></msup> </math> - <math><msup><mn>21</mn> <mn>6</mn></msup> </math> , and <math><msup><mn>22</mn> <mn>0</mn></msup> </math> - <math><msup><mn>29</mn> <mn>6</mn></msup> </math> weeks of gestational age (GA). The models' performance, assessed using Area Under the Curve (AUC), sensitivity, specificity, and accuracy, consistently improved with the incorporation of data from later prenatal visits. AUC scores increased from 0.6161 in the first visit to 0.7087 in the third visit, while sensitivity and specificity also showed notable improvements. The addition of ultrasound measurements, such as cervical length and Pulsatility Index, substantially enhanced the models' predictive ability. Notably, the model achieved a sensitivity of 0.8254 and 0.9295 for predicting very preterm and extreme preterm births, respectively, at the third prenatal visit. These findings highlight the importance of ultrasound measurements and suggest that incorporating machine learning-based risk assessment and routine late-pregnancy ultrasounds into prenatal care could improve maternal and neonatal outcomes by enabling timely interventions for high-risk women.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"843"},"PeriodicalIF":2.8,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871148","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":"Identification of hub genes, diagnostic model, and immune infiltration in preeclampsia by integrated bioinformatics analysis and machine learning.","authors":"Yihan Zheng, Zhuanji Fang, Xizhu Wu, Huale Zhang, Pengming Sun","doi":"10.1186/s12884-024-07028-3","DOIUrl":"10.1186/s12884-024-07028-3","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify novel biomarkers for preeclampsia (PE) diagnosis by integrating Weighted Gene Co-expression Network Analysis (WGCNA) with machine learning techniques.</p><p><strong>Patients and methods: </strong>We obtained the PE dataset GSE25906 from the gene expression omnibus (GEO) database. Analysis of differentially expressed genes (DEGs) and module genes with Limma and Weighted Gene Co-expression Network analysis (WGCNA). Candidate hub genes for PE were identified using machine learning. Subsequently, we used western-blotting (WB) and real-time fluorescence quantitative (qPCR) to verify the expression of F13A1 and SCCPDH in preeclampsia patients. Finally, we estimated the extent of immune cell infiltration in PE samples by employing the CIBERSORT algorithms.</p><p><strong>Results: </strong>Our findings revealed that F13A1 and SCCPDH were the hub genes of PE. The nomogram and two candidate hub genes had high diagnostic values (AUC: 0.90 and 0.88, respectively). The expression levels of F13A1 and SCCPDH were verified by WB and qPCR. CIBERSORT analysis confirmed that the PE group had a significantly larger proportion of plasma cells and activated dendritic cells and a lower portion of resting memory CD4 + T cells.</p><p><strong>Conclusion: </strong>The study proposes F13A1 and SCCPDH as potential biomarkers for diagnosing PE and points to an improvement in early detection. Integration of WGCNA with machine learning could enhance biomarker discovery in complex conditions like PE and offer a path toward more precise and reliable diagnostic tools.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"847"},"PeriodicalIF":2.8,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871127","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":"Oral dydrogesterone along with vaginal micronized progesterone supplementation for luteal phase support in IVF patients, and its impact on pregnancy and live birth rates: a prospective randomized trial.","authors":"Leonardo Rinaldi, Francesco Crescenzi, Helmy Selman","doi":"10.1186/s12884-024-07069-8","DOIUrl":"10.1186/s12884-024-07069-8","url":null,"abstract":"<p><strong>Background: </strong>A normal luteal function is an essential factor for maintaining pregnancy; luteal phase deficiency decreases embryo implantation and pregnancy rate and increases the early miscarriage rate. In stimulated in vitro fertilization-embryo transfer (IVF-ET) patients, luteal phase support (LPS) is achieved by the exogenous supplementation with progesterone to increase endometrial receptivity and pregnancy. While several protocols exist, no commonly accepted protocol has been established for optimal luteal support after IVF-ET to date, the purpose of this study was to investigate the effect of two different luteal phase support protocols in patients undergoing assisted reproductive technologies.</p><p><strong>Methods: </strong>In a prospective open, randomized study conducted in a private IVF Unit a total of 700 infertile patients, undergoing in vitro fertilization treatment, were recruited for this study. All patients had a mild ovarian stimulation protocol with GnRH antagonist. The patients were randomized into two groups based on the type of luteal phase support route: Group A, control group (n = 310) patients received our routine LPS protocol which consists of the administration of 800 mg of micronized vaginal progesterone and Group B, study group, (n = 310) patients received a combination of oral dydrogesterone 20 mg and 90 mg of a gel of vaginal micronized progesterone Pregnancy rate, live birth rate, implantation rate and miscarriage rate were evaluated as primary endpoints. Statistical analysis was performed using JMP software (version 17; SAS, Inc., Cary, NC, USA). A P ≤ 0.05 was considered statistically significant.</p><p><strong>Results: </strong>No differences were observed between the two groups in terms of pregnancy rate (Group A 34,9% vs. Group B 35,7%), live birth rate (Group A 30,6% vs. Group B 29,2%), miscarriage rate (Group A 12% vs. Group B 18%) and implantation rate (Group A 18,6% vs. Group B 17,1%).</p><p><strong>Conclusions: </strong>The combination of two different formulations of progesterone (vaginal and oral) for luteal phase support does not improve IVF outcomes when compared to the vaginal route of progesterone administration alone.</p><p><strong>Trial registration: </strong>The study has been retrospectively registered with the Clinical Trials registry reference number ISRCTN52148405 ( http://isrctn.org/ ).</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"845"},"PeriodicalIF":2.8,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871138","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}