BMC Pregnancy and Childbirth最新文献

{"title":"Reproductive outcomes following hysteroscopic uterine septum resection in infertile women: a retrospective cohort study.","authors":"Zahra Kaveh, Fatemeh Davari Tanha, Hamideh Pakniyat, Sara Saeedi, Shohreh Salimi Sotoodeh, Elham Feizabad, Mohadese Dashtkoohi, Marjan Ghaemi","doi":"10.1186/s12884-025-07460-z","DOIUrl":"10.1186/s12884-025-07460-z","url":null,"abstract":"<p><strong>Objective: </strong>A septate uterus is a common congenital anomaly often identified during infertility evaluations and is associated with adverse reproductive outcomes. Hysteroscopic septum resection is widely recognized as a standard, safe, and effective treatment. This study aimed to evaluate reproductive and pregnancy outcomes in infertile women who underwent hysteroscopic septum resection.</p><p><strong>Method: </strong>This retrospective cohort study included infertile women aged 18 to 45 years who were diagnosed with a uterine septum and were candidates for assisted reproductive technology (ART) between 2011 and 2021. Participants had either primary or secondary infertility and underwent hysteroscopic septoplasty. Data were collected from medical records and telephone interviews, which included demographic information and postoperative outcomes, such as chemical and clinical pregnancy rates, live birth rates, and adverse pregnancy outcomes. Statistical analyses employed descriptive methods, including frequencies and means.</p><p><strong>Results: </strong>Among 735 women, 84.6% had primary infertility, and 51.5% had infertility for 1-5 years. The chemical pregnancy rate was 44.6%, clinical pregnancy 42.8%, and live birth 36.7%. No significant differences were found between primary and secondary infertility groups in pregnancy or live birth rates. Adverse outcomes included preterm labor (6.7%) and preeclampsia (4.8%). Vaginal delivery was the most common mode (81.8%).</p><p><strong>Conclusion: </strong>Hysteroscopic septum resection appears to improve pregnancy outcomes and live birth rates in individuals undergoing ART. Nevertheless, prospective studies with control groups are needed to confirm these findings and establish stronger evidence.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"350"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708470","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":"Conservative management of giant retroperitoneal hematoma after cesarean section in severe preeclampsia: a rare case report.","authors":"Jingwen Yu, Mengge Ke, Guangming Wang","doi":"10.1186/s12884-025-07467-6","DOIUrl":"10.1186/s12884-025-07467-6","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous retroperitoneal hematoma (RPH) after cesarean section is an extremely rare disease with various causes, which can lead to unexplained maternal shock and death. Because cases of RPH are extremely rare in obstetric settings, there is also a paucity of literature.</p><p><strong>Case presentation: </strong>This study reports a rare case of giant RPH after cesarean section. The patient underwent cesarean section due to severe preeclampsia at 38 weeks of gestation. The procedure was uneventful with little intraoperative bleeding, but a huge retroperitoneal hematoma developed 18 h after the operation and was successfully managed conservatively.</p><p><strong>Conclusions: </strong>The treatment taste of retroperitoneal hematoma depends on the size of the hematoma, the etiology, and the hemodynamic status of the patient. For patients in stable condition, conservative treatment can be adopted, such as fluid infusion, blood transfusion, vascular embolization and hematoma drainage.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"346"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708419","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 effectiveness of real-time telelactation intervention on breastfeeding outcomes among employed mothers: a systematic review and meta-analysis.","authors":"Tippawan Iamchareon, Wantana Maneesriwongul","doi":"10.1186/s12884-025-07440-3","DOIUrl":"10.1186/s12884-025-07440-3","url":null,"abstract":"<p><strong>Background: </strong>The global exclusive breastfeeding (EBF) rate during the first six months is < 50%. This rate is particularly low among employed mothers, who may face obstacles in accessing in-person lactation services. Given that telelactation services can increase EBF rates, we conducted this study to assess the effects of real-time telelactation services (vs. usual lactation services) on breastfeeding outcomes among employed mothers.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic Reviews Meta-Analyses guidelines were followed. Studies published between 2012 and 2023 were identified from the Academic Search Ultimate, Cochrane, CINAHL Complete, Embase, ProQuest, SAGE journals, ScienceDirect, Scopus, Springer Link, Google Scholar, and Thai Journal Online databases. Randomized controlled trials and quasi-experimental studies that met the inclusion criteria were included. The JBI critical appraisal tool was used to assess the studies selected for the systematic review. Categorical data were analyzed using relative risk (RR) with 95% confidence intervals (CIs) and a random-effects model.</p><p><strong>Results: </strong>Of the 18 studies selected for the review, 13 were included in the meta-analysis with a total of 4,564 participants. Of these, 3,582 were employed mothers. We identified three types of real-time telelactation services based on the activities of the provider and client: proactive, reactive, and mixed services. The results showed that real-time telelactation services had a statistically significant positive effect on the EBF rate during the first six months compared to usual care (Relative risk (RR): 1.31, 95% Confidence interval (CI) [1.10, 1.54]; p = 0.002). Proactive and mixed services significantly enhanced the rate of EBF (RR: 1.59, 95% CI [1.23, 2.05]; p = 0.0004 and RR: 1.38, 95% CI [1.01, 1.87]; p = 0.04, respectively). Reactive services did not significantly affect the EBF rate during the first six months compared to usual care (RR: 0.98, 95% CI [0.93, 1.04]; p = 0.54).</p><p><strong>Conclusions: </strong>Real-time telelactation services delivered by lactation/trained professionals in a proactive or combined proactive/reactive manner (i.e., via scheduled appointments and on demand) were the most effective. These service models should be considered by lactation service providers and healthcare policymakers seeking to increase EBF among the majority of participants who were employed mothers.</p><p><strong>Review registration: </strong>This review has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42023429900).</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"341"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708472","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":"Associations of maternal cyclin-dependent kinase 5 regulatory subunit-associated protein 1-like 1(CDKAL1) gene variants with adverse pregnancy outcome in Chinese women.","authors":"Shuoying Yue, Meng Su, Zihao Zhang, Jing Li, Junhong Leng, Weiqin Li, Jin Liu, Tao Zhang, Yijuan Qiao, Zhijie Yu, Gang Hu, Jun Ma, Xilin Yang, Hui Wang","doi":"10.1186/s12884-025-07418-1","DOIUrl":"10.1186/s12884-025-07418-1","url":null,"abstract":"<p><strong>Objective: </strong>To test associations of cyclin-dependent kinase 5 regulatory subunit-associated protein 1-like 1 (CDKAL1) gene variants with the risk of adverse pregnancy outcome in Chinese women and whether the association was mediated by occurrence of gestational diabetes mellitus.</p><p><strong>Methods: </strong>We organized a 1:1 age-matched study nested within a prospective cohort of pregnant women (207 pairs) established in urban Tianjin. Adverse pregnancy outcome was defined as a composite outcome of preterm birth, low birth weight or macrosomia. Logistic regression analyses were used to estimate associations of CDKAL1 gene variants with adverse pregnancy outcome and its components. The CDKAL1 genetic marker was defined as encompassing any of the identified susceptibility variants for adverse pregnancy outcome.</p><p><strong>Results: </strong>The CDKAL1 genetic marker was associated with the risk of adverse pregnancy outcome (OR: 2.51, 95%CI: 1.47, 4.28), low birth weight (OR: 19.80, 95%CI: 2.15, 182) and macrosomia (OR: 2.40, 95%CI: 1.17, 4.93), but not with preterm birth (P = 0.105) after adjusting for traditional risk factors. Further adjusting for gestational diabetes mellitus, the CDKAL1 genetic marker remained significantly associated with adverse pregnancy outcome, and the OR (95%CI) was 2.52 (1.48, 4.30).</p><p><strong>Conclusion: </strong>The maternal CDKAL1 gene variants were associated with increased risk of adverse pregnancy outcome, low birth weight and macrosomia, independent of gestational diabetes mellitus. CDKAL1 gene might be a useful marker for identification of individuals at a particularly high risk of adverse pregnancy outcome in early pregnancy.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"347"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708415","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":"\"I went to the primary health centre close to my workplace, but their capacity cannot deliver the baby\": exploring why women choose different providers for maternal health services in Nigeria.","authors":"Kofoworola O Akinsola, Olabisi Olasupo, Julius Salako, Jennifer Z Sanaka, Rose N Samuel, Oluwabunmi Bakare, Risikat Quadri, Oluwapelumi Emmanuel, Carina King, Adegoke Falade, Ayobami Adebayo Bakare","doi":"10.1186/s12884-025-07382-w","DOIUrl":"10.1186/s12884-025-07382-w","url":null,"abstract":"<p><strong>Background: </strong>Maternal health remains a significant public health concern globally, including Nigeria. Despite concerted efforts to improve maternal health services, maternal mortality rates in Nigeria remain unacceptably high. Understanding the factors that shape women's choices in selecting the place of birth could help tailor services and improve quality of care for mothers and infants. Therefore, our study explores the experiences, barriers and facilitators that influence where women choose to access maternal health services in three diverse Nigerian states of Lagos, Oyo and Jigawa.</p><p><strong>Methods: </strong>We conducted qualitative in-depth interviews with nursing mothers and healthcareworkers (HCWs) in Lagos, Oyo and Jigawa states, and community birth attendants (CBAs) in Lagos and Oyo. We used maximum variation sampling to purposefully recruit nursing mothers in their puerperium who gave birth in different places. HCWs and CBAs were purposively selected from health facilities and birth homes. All interviews were conducted between September - December 2023. We used reflexive thematic analysis to generate themes across participant types and states.</p><p><strong>Results: </strong>We recruited 44 participants for this study, 25 nursing mothers and 19 HCWs. We identified five major themes: (1) Preference for safe, comfortable and quality health services; (2) Social diffusion and cultural/religious influences; (3) Physical, geographical and financial inaccessibility; (4) Symbolic perception of health facilities and (5) Misunderstanding of health promoting and preventive care in pregnancy. The main reasons for choosing a particular place of birth were the preference for safe, comfortable, and high-quality healthcare, as well as the perceived convenience and accessibility of birth homes within close proximity to the women's homes.</p><p><strong>Conclusions: </strong>We found women's choice of place of birth is influenced by a complex interplay of factors. Among these are health system inadequacies, socio-economic factors, and the desire for comfortable and quality maternal healthcare. HCWs, CBAs, and nursing mothers emphasised these determinants as critical in shaping women's decisions regarding where to give birth. This highlights the need for comprehensive interventions across policy, healthcare delivery, community engagement, and individual levels to overcome barriers, improve maternal health outcomes, and support women in making informed childbirth decisions.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"339"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708404","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 pre-pregnancy body mass index and gestational weight gain with continued breastfeeding until 6 months postpartum in Japanese women: the Japan Environment and Children's Study.","authors":"Hidekuni Inadera, Kenta Matsumura, Takashi Yoda, Takashi Nakano, Haruka Kasamatsu, Kanako Shimada, Akiko Tsuchida","doi":"10.1186/s12884-025-07429-y","DOIUrl":"10.1186/s12884-025-07429-y","url":null,"abstract":"<p><strong>Background: </strong>The relationship of pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with continued breastfeeding (BF) in Japanese women remains unclear. To evaluate different maternal pre-pregnancy BMI and GWG categories according to the initial BMI, we conducted an analysis of continued BF until 6 months postpartum in a large Japanese cohort.</p><p><strong>Methods: </strong>This study used data from the Japan Environment and Children's Study, which included approximately 100,000 pregnant women. Pre-pregnancy BMI (kg/m²) was categorized as underweight (BMI < 18.5), normal weight (BMI 18.5-24.9), and overweight (BMI 25.0-29.9). GWG was categorized as insufficient, optimal, and excessive based on the 2021 criteria from the Japanese Society of Obstetrics and Gynecology. Continued BF for the first 6 months postpartum was categorized into 3 patterns: exclusive BF (EBF), non-EBF type-I (6 months of BF with formula), and non-EBF type-II (< 6 months of BF). Logistic regression analysis was conducted to evaluate the association of pre-pregnancy BMI and GWG with continued BF. Normal BMI and optimal GWG and EBF were used as reference values while controlling for covariates.</p><p><strong>Results: </strong>Of 82,129 women with singleton pregnancies, BMI was categorized as underweight in 16.6%, normal weight in 75.3%, and overweight in 8.1%. The rate of EBF in these groups was 37.1% for underweight, 37.2% for normal weight, and 26.8% for overweight. In underweight women, both insufficient and excessive GWG were associated with higher rates of non-EBF type-II. In normal-weight women, insufficient and excessive GWG were associated with higher rates of non-EBF type-II. Overweight women showed higher rates of non-EBF type-I and type-II, irrespective of GWG.</p><p><strong>Conclusions: </strong>Our results indicate that the effects of GWG on continued BF were associated with pre-pregnancy BMI. Adequate GWG should be recommended to underweight and normal-weight women to promote BF. Efforts toward the prevention of overweight prior to pregnancy should be encouraged to enhance BF.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"340"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708412","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":"Antiphospholipid syndrome in pregnancy: a comprehensive literature review.","authors":"Viorela Romina Murvai, Radu Galiș, Anca Panaitescu, Casandra Maria Radu, Timea Claudia Ghitea, Paula Trif, Miruna Onița-Avram, Alexandra Alina Vesa, Anca Huniadi","doi":"10.1186/s12884-025-07471-w","DOIUrl":"10.1186/s12884-025-07471-w","url":null,"abstract":"<p><strong>Background: </strong>Antiphospholipid syndrome (APS) is an autoimmune disorder associated with thrombotic events and adverse obstetric outcomes, particularly in its obstetric form (OAPS). Affecting approximately 0.5% of the population, APS is a leading contributor to recurrent pregnancy loss (RPL), preeclampsia (PE), and fetal growth restriction ((FGR). Despite advancements in understanding its pathophysiology and management, optimal treatment strategies for APS in pregnancy remain challenging and require systematic evaluation. This review synthesizes current evidence on APS mechanisms, diagnostic criteria, and therapeutic interventions, with a focus on maternal and fetal outcomes in OAPS.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, was conducted to identify studies exploring APS pathogenesis, diagnostic standards, and treatment efficacy in obstetric settings. Inclusion criteria prioritized randomized controlled trials, cohort studies, and systematic reviews with a clear focus on APS and pregnancy.</p><p><strong>Results: </strong>The review confirmed that APS current accepted pathogenesis is governed by a \"two-hit\" model, where antiphospholipid antibodies (aPLs) initiate endothelial damage, culminating in thrombosis and placental insufficiency. Epidemiological analysis underscores the prevalence and severity of APS in obstetric contexts, with lupus anticoagulant (LA) emerging as a significant predictor of adverse outcomes. Evidence supports the use of low-dose aspirin (LDA) and heparin to reduce miscarriage rates, while adjunctive treatments, such as hydroxychloroquine (HCQ), have shown promise in improving live birth rates and reducing preterm delivery in high-risk cases. Emerging therapies, including tumoral necrosis factor (TNF-alpha) inhibitors and nitric oxide modulators, may offer additional benefits in refractory cases.</p><p><strong>Conclusion: </strong>APS remains a critical determinant of adverse pregnancy outcomes, necessitating precise diagnostic criteria and tailored management approaches. This systematic review emphasizes the importance of individualized therapeutic regimens to optimize maternal and fetal health in OAPS and highlights areas for future research, particularly regarding novel pharmacological approaches. Further studies are essential to refine treatment protocols and improve clinical guidelines for managing APS in pregnancy.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"337"},"PeriodicalIF":2.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699490","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":"Psychometric properties of the Chinese version of the Get Active Questionnaire for Pregnancy and its companion form to assess physical activity readiness.","authors":"Fangping Xu, Hua Tao, Zachary J Weston, Liping Sun, Lingyan Lu, Xiaojiao Wang, Chunyi Gu","doi":"10.1186/s12884-025-07381-x","DOIUrl":"10.1186/s12884-025-07381-x","url":null,"abstract":"<p><strong>Introduction: </strong>Engaging in physical activity is essential for a healthy pregnancy. A reliable tool is necessary to enhance the assessment and counseling of safe physical activity. This study aimed to translate the original English Get Active Questionnaire for Pregnancy (GAQ-P) and its companion Health Care Provider Consultation Form for Prenatal Physical Activity (cHCP-CF-PPA) into simplified Chinese language and evaluate the psychometric properties in Chinese pregnant women.</p><p><strong>Methods: </strong>The Brislin's model of translation was employed to translate the GAQ-P/cHCP-CF-PPA tool. We conducted a cross-sectional study at a tertiary women's hospital in Shanghai, China, enrolling a convenience sample of 325 pregnant women across all trimesters to evaluate the psychometric properties of the GAQ-P/cHCP-CF-PPA. Reliability was assessed through test-retest reliability and inter-rater reliability, while validity was examined using content validity, known-groups validity, and criterion validity. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated using PARmed-X for Pregnancy as the gold standard.</p><p><strong>Results: </strong>Regarding content validity, the GAQ-P had an average S-CVI/UA of 0.81 (I-CVIs: 0.83-1.0), while the cHCP-CF-PPA exhibited an average S-CVI/UA of 0.87 (I-CVIs: 0.83-1.0). The GAQ-P/cHCP-CF-PPA scores effectively distinguished women recommended for physical activity from those with contraindications. The Spearman's correlations between the GAQ-P/cHCP-CF-PPA and the PARmed-X for Pregnancy were 0.851 for absolute contraindications and 0.847 for relative contraindications. The test-retest reliability score was 0.759 for physical activity contraindications, and 0.953 for inter-rater reliability. The sensitivity of the GAQ-P/cHCP-CF-PPA was determined to be 90.00%, with a specificity of 98.31%. The positive predictive value was 78.26%, while the negative predictive value reached 99.32%.</p><p><strong>Conclusion: </strong>The Chinese version of the GAQ-P/cHCP-CF-PPA is a reliable and valid tool for assessing physical activity readiness in pregnant women.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"335"},"PeriodicalIF":2.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699513","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":"Domestic violence in pregnancy: a systematic review of clinical guidelines.","authors":"Raheleh Babazadeh, Farangis Sharifi, Malikeh Amel Barez","doi":"10.1186/s12884-025-07459-6","DOIUrl":"10.1186/s12884-025-07459-6","url":null,"abstract":"<p><strong>Background: </strong>Domestic violence is a public health concern and human rights violation affecting more than one-third of all pregnant women globally. Abused pregnant women need several interventions to reduce domestic violence and its negative consequences on mother and child. The purpose of this study was to determine the quality, scope, and consistency of clinical guidelines for managing domestic violence during pregnancy.</p><p><strong>Methods: </strong>This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Electronic databases of Scopus, PubMed, Embase, Web of Science, Up-to-date, Cochrane Library database, Google Scholar, and Guideline repositories, including NICE, SIGN, GAC, NHMRC, NGC, New Zealand Guidelines Group, TRIP, AHRQ, G-I-N, and MD Consult, using appropriate keywords were searched. Included studies were clinical guidelines containing recommendations about domestic violence in pregnancy and postpartum. Two reviewers used the AGREE II (Appraisal of Guidelines, Research, and Evaluation version 2) instrument to evaluate the quality of guidelines, and textual syntheses were used to appraise and compare the relevant recommendations. Out of 381 relevant published guidelines, 14 clinical guidelines were ultimately reviewed systematically.</p><p><strong>Results: </strong>Seven countries had a clinical guideline for domestic violence during pregnancy. None of the reviewed guidelines was rated > 75% across all domains of AGREE II while the highest-rated domains were scope, purpose, and clarity. Four related categories were recognized from the synthesis of recommendations within the appropriate guidelines. These consisted of an introduction, domestic violence in pregnancy, the role of health care professionals, and the resources. Recommendations for privacy and confidentiality, screening, identification, support, and documentation were the most commonly reported, which all of the guidelines advised them, suggesting the importance of identification of violence in pregnancy and support for abused pregnant women. 93% of the reviewed guidelines had recommendations on communication, support and building trust, child protection, and professional education and training.</p><p><strong>Conclusion: </strong>The study findings suggest that there are currently gaps in clinical guidelines in various areas, including patterns of violence, the cycle of violence, identifying risk factors for violence during pregnancy, providing medical care, implementing home visitation programs, promoting self-care and empowerment, preventing violence, offering follow-up support, and conducting community education programs. Therefore, it is crucial to develop or adapt clinical guidelines for abused pregnant women, emphasizing their needs to ensure their safety and well-being.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"336"},"PeriodicalIF":2.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699507","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 of institutional delivery service utilization in Ethiopia: an umbrella review.","authors":"Kasiye Shiferaw, Getahun Tiruye, Habtamu Bekele","doi":"10.1186/s12884-025-07464-9","DOIUrl":"10.1186/s12884-025-07464-9","url":null,"abstract":"<p><strong>Introduction: </strong>One of the global health's top priorities is improving maternal health. There is a high maternal mortality ratio, despite its major progress in the past two decades. Many countries in Sub-Saharan Africa, including Ethiopia, have not yet reached the sustainable development goal target. The majority of women die of labor and delivery-related complications, which are preventable if they had access to maternal health service utilization, particularly institutional delivery services. The low institutional delivery services utilization in Ethiopia was related to several factors. There are literature disagreements on these predictors and systematic review and meta-analysis (SRMA) studies reported different contributing factors. Therefore, this umbrella review aimed to identify pooled predictors of institutional delivery service utilization in Ethiopia.</p><p><strong>Method: </strong>PubMed, Web of Science, Embase, CINAHL, Scopus, Google Scholar and Cochrane were searched for SRMA studies on the predictors of institutional delivery service utilization in Ethiopia. All SRMA studies selected for potential inclusion in the umbrella review were subjected to a rigorous, independent appraisal by two critical reviewers using the Assessment of Multiple Systematic Reviews tool. Authors selected SRMA studies and abstracted data independently, and discrepancies were resolved through discussion or a third author intervened. A random-effects meta-analysis model was used to pool estimates of the included SRMA studies. Studies' heterogeneity and risk of bias were assessed using I² and Egger tests, respectively.</p><p><strong>Result: </strong>The umbrella review revealed that institutional delivery services utilization in Ethiopia was 24% (95% confidence interval, CI: 14 to 34). Further, women education (odds ratio, OR = 3.54, 95% CI: 3.04, 4.12), attitude of the women toward maternal and child health (MCH) service (OR = 2.20, 95% CI: 1.30, 3.74), place of residence (OR = 3.29, 95% CI: 2.02, 5.34), live less than 5 km away from the nearest health facilities (OR = 3.48, 95% CI: 2.58, 4.71) and having at least one antenatal care follow-up (OR = 3.62, 95% CI: 3.03, 4.33) were significantly associated with institutional delivery service utilization.</p><p><strong>Conclusion: </strong>The proportion of pregnant women using institutional delivery services is low in Ethiopia. The findings highlight women's education, tailored intervention in the attitude of women toward maternal and child health services, supporting rural communities, improving access and availability of health facilities and promoting antenatal care (ANC) follow-up play a crucial role in enhancing facility childbirth, thereby reducing maternal and neonatal mortality and achieving sustainable development goal 3.1 and 3.2.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"332"},"PeriodicalIF":2.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676708","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}