BMC Pregnancy and Childbirth最新文献

{"title":"Effect of treating mild hyperglycemia in early pregnancy on maternal and neonatal clinical outcomes.","authors":"Yue Zhang, Lei Qu, Yan Jin, Wenguang Sun","doi":"10.1186/s12884-025-07408-3","DOIUrl":"10.1186/s12884-025-07408-3","url":null,"abstract":"<p><strong>Background: </strong>Maternal hyperglycemia during pregnancy can lead to adverse maternal and neonatal outcomes. Although early treatment is recommended, several randomized controlled trials did not show significant benefits from early intensified treatment, meaning that the benefits of treatment for early abnormal glucose remain unclear. Therefore, in this study, we aimed to evaluate the effect of medical nutritional treatment during early pregnancy of women with mild hyperglycemia on maternal and neonatal clinical outcomes.</p><p><strong>Methods: </strong>Women in this retrospective cohort study who had mild hyperglycemia (6.1 mmol/L > fasting plasma glucose ≥ 5.1 mmol/L and hemoglobin A1c < 5.9%) in the first trimester and a diagnosis of gestational diabetes mellitus after an oral glucose tolerance test at 24-28 weeks were divided into control and treatment groups depending on whether they receive medical nutritional treatment during early pregnancy. We compared the maternal and neonatal outcomes.</p><p><strong>Results: </strong>A total of 344 women were enrolled, and 309 participants were available for analysis (170 in the treatment group and 139 in the control group). Compared with the control group, fewer women in the treatment group had cesarean deliveries (44.7% vs. 61.2%; relative risk [RR], 0.70; 95% confidence interval [CI], 0.54-0.90, P = 0.004) and required insulin therapy (2.9% vs. 8.6%; RR, 0.94; 95% CI, 0.88-0.99, P = 0.004). Women in the treatment group exhibited lower glucose levels and weight gain. Newborns in the treatment group had a higher gestational age at birth than those in the control group (39.1 [39.5, 40.0] vs. 38.8 [38.1, 39.5], P = 0.005). No significant differences were observed in other maternal and neonatal outcomes.</p><p><strong>Conclusions: </strong>Immediate medical nutritional treatment for pregnant women with mild hyperglycemia during early pregnancy seems to lower the incidence of cesarean delivery and insulin therapy during pregnancy than no treatment. However, no significant differences were observed in neonatal outcomes, except for a higher gestational age at birth of the newborns in the treatment group.</p><p><strong>Clinical trial number: </strong>Not applicable. This is an observational study.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"305"},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646923","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 maternal prenatal phthalate exposure and genetic polymorphisms of metabolic enzyme genes with spontaneous preterm birth: a nested case-control study in China.","authors":"Nana Li, Lu Li, Zhen Liu, Ying Deng, Meixian Wang, Yuting Li, Hong Kang, Yanping Wang, Ping Yu, Jun Zhu","doi":"10.1186/s12884-025-07420-7","DOIUrl":"10.1186/s12884-025-07420-7","url":null,"abstract":"<p><strong>Background: </strong>The relationship between prenatal phthalate exposure and preterm birth from previous studies has been inconsistent. Meanwhile, few studies have explored the relationship between spontaneous preterm birth (SPTB) and genetic polymorphisms of metabolic enzyme genes or gene-phthalate interactions. The aim of this study is to evaluate the association of maternal phthalate exposure, genetic polymorphisms, and their interactions with SPTB.</p><p><strong>Methods: </strong>A total of 182 cases with SPTB and 321 controls with full-term delivery were enrolled. Nine phthalate metabolites in maternal second trimester urine samples were measured by ultra-high performance liquid chromatography coupled with tandem mass spectrometry. Genotyping was performed on twenty-six single nucleotide polymorphisms (SNPs) of metabolic enzyme genes, including CYP2C9, CYP2C19, UGT1A7, UGT2B7 and UGT2B15 genes. The associations between maternal phthalate exposure or genetic polymorphisms and SPTB were estimated by multivariable logistic regression analysis. The impact of interactions between gene-gene and gene-phthalate exposure on SPTB were analyzed via generalized multifactor dimensionality reduction.</p><p><strong>Results: </strong>There were no significant differences in the concentrations of phthalate metabolites between the two groups. No statistically significant associations were observed between maternal phthalate exposure and SPTB. The rs4244285 polymorphism of CYP2C19 gene was associated with decreased odds of SPTB under the log-additive (aOR = 0.73, 95% CI: 0.55-0.98) and recessive model (aOR = 0.37, 95% CI: 0.18-0.74). Two SNP loci of UGT2B15 were associated with increased odds of SPTB under the recessive genetic model (aOR = 3.85, 95% CI: 1.31-11.35 for rs3100, and aOR = 3.85, 95% CI: 1.31-11.35 for rs4148269). However, these associations were not significant after the false discovery rate correction. No significant gene-gene or gene-phthalate metabolites interactions for SPTB were observed.</p><p><strong>Conclusions: </strong>Maternal phthalate exposure in the present subjects and genetic polymorphisms of metabolic enzyme genes were not associated with SPTB. Moreover, there were no significant gene-gene or gene-phthalates interactions for SPTB.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"301"},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647206","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":"Birth plans: Developing a shared medical decision aid tool.","authors":"M Goetz-Fu, L Gaucher, C Huissoud, B De la Fourniere, C Dupont, M Cortet","doi":"10.1186/s12884-025-07355-z","DOIUrl":"10.1186/s12884-025-07355-z","url":null,"abstract":"<p><strong>Objective(s): </strong>Birth plans appeared at the end of the twentieth century, enabling women to express their expectations towards childbirth. This reflects a rising demand for patients to take a proactive role in their medical care. This study aimed to collaboratively develop a medical decision aid with expectant mothers to prepare them better for the events surrounding their child's birth.</p><p><strong>Study design: </strong>Five topics frequently addressed in birth plans were identified by both patients' associations, using semi-structured interview with representatives of women's associations, and professionals, using an online poll. Initially, work groups with perinatal care professionals drafted items designed to guide expectant mothers in developing their birth plans and actively participating in childbirth decisions. Subsequently, we used a modified Delphi-consensus in three rounds to retain the most relevant items. The first two rounds engaged a multidisciplinary team of professionals, while the third involved expectant mothers from two maternity wards in Lyon, France. Items that received a rating between 3 (good value) and 4 (excellent value) on a 4-point scale by more than 75% of participants were deemed consensual. The study assessed inter-rater agreement using the Fleiss kappa score.</p><p><strong>Results: </strong>The professional work groups proposed a total of 124 items distributed across five themes: analgesia during labour, drug administration before and during labour, events in the delivery room, initial neonatal care, and perineal protection. Ultimately, 65.3% of the initial 124 items were deemed relevant by both the experts and the expectant mothers. Notably, the most significant differences in consensus centered around analgesia and the complexity of information. Non-medicinal analgesic methods were favored by mothers-to-be but not by professionals. Conversely, detailed information on delayed cord clamping were favored by experts.</p><p><strong>Conclusions: </strong>A modified Delphi consensus was used to create with expectant mothers a decision aid tool to help them write their birth projects, addressing five main topics that are frequently reported in the literature. We now need to test this tool in clinical practice to assess its relevance in routine obstetrics consultation.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"306"},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647251","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 impact of maternal HBeAg carries status and elevated ALT values on adverse outcomes: a population-based cohort study in 198,049 pregnancies.","authors":"Kang Zou, Shiyao Huang, Chunrong Liu, Peng Zhao, Jin Guo, Wanqiang Wei, Jingwen Chen, Guanhua Yao, Yongyao Qian, Biao Rong, Moliang Chen, Yiquan Xiong, Xin Sun, Jing Tan","doi":"10.1186/s12884-025-07410-9","DOIUrl":"10.1186/s12884-025-07410-9","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B virus (HBV) infection is a common public health problem, and maternal HBV infection can cause adverse outcomes in both mothers and fetuses. However, the influence of hepatitis B e antigen (HBeAg) serostatus on obstetric outcomes is not well established. This study aims to investigate the prevalence trend of maternal HBV infection in China, and its impact on obstetric outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study used data from an established population-based pregnancy registry (REPRESENT) in Xiamen, China. Maternal hepatitis B surface antigen (HBsAg) and HBeAg serostatus were regularly tested at the first antenatal visits. Multivariable regression was conducted to evaluate the impact of maternal HBV infection on maternal and neonatal outcomes.</p><p><strong>Results: </strong>From January 2015 to March 2019, 198,049 pregnancies were included. The overall prevalence of HBsAg + HBeAg + was 2.26% and has decreased during these years (relative risk 0.59, 95% CI 0.54-0.65). Compared to HBsAg-HBeAg- pregnancies, maternal HBsAg + HBeAg- was associated with a higher risk of intrahepatic cholestasis of pregnancy (ICP) (adjusted odds ratio 3.43, 95% CI 2.94-4.00) and cesarean section (1.04, 1.01-1.08). HBsAg + HBeAg + was further associated with a higher risk of ICP (3.44, 2.64-4.48), fetal distress (1.33, 1.05-1.67), and preterm birth (1.37, 1.04-1.81). In addition, subgroup analysis indicated that abnormal alanine aminotransferase status at the first antenatal visit may exacerbate the impact of maternal HBV infection on maternal and neonatal outcomes.</p><p><strong>Conclusion: </strong>The prevalence of maternal HBsAg + HBeAg + serostatus is still high, but has decreased over time. Given its significant adverse effects, prenatal screening for HBsAg and HBeAg should be performed.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"302"},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647072","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":"Maternal plasma cell-free DNA nucleosome footprints can reveal changes in gene expression profiles during pregnancy and pre-eclampsia.","authors":"Kun Li, Zhiwei Guo, Fenxia Li, Shijing Lu, Min Zhang, Xingyu Wei, Chao Sheng, Wenbo Hao, Xuexi Yang","doi":"10.1186/s12884-025-07453-y","DOIUrl":"10.1186/s12884-025-07453-y","url":null,"abstract":"<p><strong>Background: </strong>Differential gene expression analysis is important to understand pregnancy processes and disease development. However, no non-invasive and comprehensive methods exist to identify differentially expressed genes (DEGs) in the fetus and placenta during pregnancy or pregnancy complications. Nucleosome footprints in maternal peripheral blood plasma cell-free DNA (cfDNA) reflect the gene expression profile of the cell of origin, mainly immune cells in the maternal blood and placenta. This study aimed to validate the feasibility of detecting changes in gene expression profiles as differentially depth gene (DDGs) based on plasma nucleosome footprints as a potential biomarker for pregnancy and pre-eclampsia.</p><p><strong>Methods: </strong>Deep sequencing was performed on separated plasma cfDNA collected from 34 women, including eight non-pregnant women, 14 healthy pregnant women, and 12 pre-eclamptic pregnant women. The number of reads in the promoter region of each gene was extracted and normalized. Normalized depths of genes were compared between healthy pregnant vs. non-pregnant women, all pregnant women vs. non-pregnant women, and healthy pregnant women vs. pre-eclamptic pregnant women using the Wilcoxon rank-sum test to identify statistically significant DDGs. The roles of these genes were identified by functional enrichment analysis using gene ontology.</p><p><strong>Results: </strong>Plasma cfDNA revealed different nucleosome footprints in preeclampsia pregnant, healthy pregnant, and non-pregnant women. Gene annotation revealed that the functions of 629 DDGs in pregnant and non-pregnant women mainly involved immune regulation, regardless of pre-eclampsia. 1978 DDGs between healthy pregnant and pre-eclamptic pregnant women displayed differences in immune regulation, cell cycle regulation, and sensory perception. These results are consistent with prior microarray and RNA-sequencing data.</p><p><strong>Conclusions: </strong>The depth of the cfDNA nucleosome footprint in maternal plasma can be used to reflect changes in the gene expression profile during pregnancy and pre-eclampsia. The plasma cfDNA nucleosome footprint is a potential non-invasive biomarker for pregnancy and placental-origin pregnancy complications.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"304"},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647008","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":"Emergency department use during pregnancy by medicaid type.","authors":"Alyssa R Hersh, Ann Martinez Acevedo, Ava Mandelbaum, Esther Choo, Maria I Rodriguez","doi":"10.1186/s12884-025-07390-w","DOIUrl":"10.1186/s12884-025-07390-w","url":null,"abstract":"<p><strong>Background: </strong>Emergency department (ED) use is common among patients with Medicaid insurance during pregnancy. However, it is unknown how ED utilization differs among those with different types of Medicaid such as Emergency Medicaid, with which access to outpatient care is more restricted.</p><p><strong>Objective: </strong>We sought to compare differences in ED use during between pregnant persons with Emergency Medicaid and Traditional Medicaid and pregnancy outcomes by ED utilization.</p><p><strong>Study design: </strong>This was a retrospective cohort study of all births among Medicaid enrollees in South Carolina from 2010 to 2019. The main comparator was type of Medicaid. Our primary outcome was an ED visit during pregnancy. Secondary outcomes included average number of visits, perinatal outcomes, and prenatal and hospital charges.</p><p><strong>Results: </strong>There were 240,597 births that met inclusion criteria for this analysis. Over the study period, the proportion of patients with at least one ED visit increased for all groups. A higher proportion of patients with Traditional Medicaid had at least one ED visit compared with Emergency Medicaid (58.2% versus 22.7%). Patients who had at least one ED visit were more likely to be younger, of Black race, live rurally, nulliparous, have lower or higher body mass index, and have a higher prevalence of pre-existing medical co-morbidities.</p><p><strong>Conclusion: </strong>We found that individuals with Traditional Medicaid were more likely to have an antenatal ED visit than individuals with Emergency Medicaid.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"303"},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646934","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":"Evaluating predelivery platelet and coagulation indices as predictors of immediate postpartum haemorrhage in low-risk women undergoing vaginal delivery.","authors":"Yaru Peng, Jinyi Liu, Peng Liu, Ying Wu, Guohua Zhang, Yanwei Guo","doi":"10.1186/s12884-025-07427-0","DOIUrl":"10.1186/s12884-025-07427-0","url":null,"abstract":"<p><strong>Background: </strong>Although monitoring systems for high-risk postpartum haemorrhage (PPH) are well-established, predicting immediate PPH-defined as blood loss ≥ 500 mL within 2 h postpartum, distinct from general PPH (≥ 500 mL within 24 h)-remains challenging in low-risk vaginal deliveries. This case-control study aimed to explore the association between predelivery coagulation profiles and the occurrence of immediate PPH in low-risk parturients, specifically those without severe pregnancy complications and with singleton vertex presentations.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 409 vaginal deliveries at a tertiary hospital from 2014 to 2019. Of these, 179 cases met the WHO criteria for immediate PPH, while 230 served as controls (blood loss < 500 mL). Thirty clinical and laboratory variables were extracted, including predelivery coagulation parameters-platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), and thrombin time (TT)-as well as delivery characteristics such as forceps-assisted delivery and placental retention. Logistic regression was used to identify independent risk factors, and a multivariable prediction model was subsequently developed.</p><p><strong>Results: </strong>Multivariate analysis identified several independent predictors of immediate PPH: Rural residence, Forceps deliveries, Retained placenta and membrane, Newborn birth weight ≥ 3500 g, PLT ≤ 212 × 10⁹/L, PT > 11 s, APTT > 28.8 s, and TT > 13.8 s. (all P < 0.05). The combined prediction model demonstrated excellent predictive performance, with an area under the receiver operating characteristic curve (AUC) of 0.854, achieving 82.58% sensitivity and 74.78% specificity.</p><p><strong>Conclusions: </strong>This multidimensional predictive model effectively identifies parturients at elevated risk for immediate PPH in low-risk deliveries, enabling more targeted preventive interventions. Prospective studies are warranted to validate and refine this model in broader clinical settings.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"298"},"PeriodicalIF":2.8,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of India's flagship conditional maternity benefit scheme on utilization of maternal and child health services: evidence from a statewide evaluation study.","authors":"Rupsa Banerjee, Bhanu Shanker Singh, Neha Sahrawat, Amit Mehrotra, Sumant Swain, Ram Manohar Mishra, Piush Antony, U Aparna, B K Jain, Sutapa Bandyopadhyay Neogi","doi":"10.1186/s12884-025-07416-3","DOIUrl":"10.1186/s12884-025-07416-3","url":null,"abstract":"<p><strong>Background: </strong>The Pradhan Mantri Matru Vandana Yojana (PMMVY) is India's flagship Maternity Benefit Programme to improve maternal nutrition and child health. This study evaluates the functional status of the scheme, knowledge regarding the scheme and its effect on pattern of service utilization in a north Indian state.</p><p><strong>Methods: </strong>A three-pronged mixed-methods evaluation including household survey of beneficiary and non-beneficiary women, in-depth interviews of key stakeholders (district and state level program managers, program implementers and frontline workers) and review of secondary data from the PMMVY Common Application Software and state PMMVY dashboard was done. Household survey covered 1290 women, and 70 in-depth interviews were held with eligible women, and PMMVY managerial and implementation staff. Quantitative data was analysed using SPSS version 22.0, qualitative data was analysed thematically and triangulated with quantitative results for effective analysis and conclusion. The study received ethical approval from the Institutional Review Board of IIHMR Delhi.</p><p><strong>Results: </strong>A strong political commitment with requisite systems and resources across all levels was observed. Coverage of PMMVY was less in urban areas (53.1% as compared to overall coverage of 95.9%). Knowledge of the scheme was high among both beneficiary and non-beneficiary women (97.8% beneficiary women and 94.2% non-beneficiary women). Utilization of Maternal and Child Health (MCH) services were significantly poorer among non-beneficiary women for four antenatal check-ups (OR 0.74, 95% CI 0.55-0.99, p = 0.04), childbirth registration (OR 0.28, 95% CI 0.18-0.45, p < 0.001) and child immunization (OR 0.43, 95% CI 0.33-0.55, p < 0001). However, certain operational challenges were found related to beneficiary enrolment and use of PMMVY software, and a gap in intended and actual use of PMMVY incentive was observed (26.2% beneficiary women had spent the cash incentive on needs not related to nutrition or health).</p><p><strong>Conclusion: </strong>Despite operational challenges, PMMVY has been effective in improving the utilization of health services like antenatal check-ups, childbirth registration and child immunization. The benefits of the scheme may be maximized by addressing those limitations in its delivery.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"294"},"PeriodicalIF":2.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633474","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":"Circulating miR-486-3p as a potential biomarker for the diagnosis of gestational diabetes mellitus and the prediction of adverse pregnancy outcomes.","authors":"Yaqin Hu, Yukai Zeng, Xiaoshuang Du, Qi Li, Yumei Cao, Huihui Song, Zhenlan Wu, Yingxuan Huang","doi":"10.1186/s12884-025-07405-6","DOIUrl":"10.1186/s12884-025-07405-6","url":null,"abstract":"<p><strong>Objective: </strong>Gestational diabetes mellitus (GDM) seriously endangers the health of pregnant women and their offspring. Early prediction and diagnosis allow timely treatment of GDM, preventing adverse pregnancy outcomes and related diseases. This research aims to explore the predictive significance of miR-486-3p expression levels in diagnosing GDM in early pregnancy.</p><p><strong>Methods: </strong>A retrospective study was conducted by enrolling 103 subjects with GDM and 98 healthy subjects. qRT-PCR was used to analyze the expression level of miR-486-3p. The chi-square test and t-test were used to evaluate the differences in miR-486-3p expression levels between the GDM and control groups. The predictive value of miR-486-3p in early diagnosis of GDM was analyzed by receiver operating characteristic (ROC). Potential indicators that may lead to adverse pregnancy outcomes in patients with GDM were predicted by multivariate logistic regression analysis.</p><p><strong>Results: </strong>Downregulation of miR-486-3p expression level was observed in the GDM group compared with healthy individuals. The predictive value of miR-486-3p for early diagnosis of GDM was indicated by the ROC curve. The expression level of miR-486-3p in the GDM group was negatively correlated with glycated hemoglobin (HbA1c), fasting blood glucose (FBG), homeostasis model-insulin resistance index (HOMA-IR), and leptin (LEP). Multivariate logistic regression analysis suggested that miR-486-3p, HbA1c, HOMA-IR, and FBG could be regarded as adverse pregnancy outcome risk factors in GDM subjects.</p><p><strong>Conclusion: </strong>miR-486-3p showed a clinical predictive value for GDM in early pregnancy. miR-486-3p, HbA1c, HOMA-IR, and FBG indicators can be considered adverse pregnancy outcome risk factors in GDM patients.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"291"},"PeriodicalIF":2.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633471","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":"Clinical comparison of vaginal misoprostol combined with a foley balloon versus vaginal misoprostol alone for inducing labor: a prospective cohort study.","authors":"Rui Zheng, Lijia Du, Xiaoxiong Zhu, Xiaoying Zhang, Weihua Han, Zhifen Yang","doi":"10.1186/s12884-025-07375-9","DOIUrl":"10.1186/s12884-025-07375-9","url":null,"abstract":"<p><strong>Objective: </strong>To compare the induction-to-delivery time and maternal satisfaction associated with vaginal misoprostol combined with a Foley balloon to those associated with vaginal misoprostol alone for labor induction.</p><p><strong>Methods: </strong>This was a prospective cohort study involving singleton full-term pregnant women with fetuses who were observed in the cephalic position; these patients were divided into a combination group (25 µg vaginal misoprostol combined with a Foley balloon, n = 94) and a misoprostol group (25 µg vaginal misoprostol, n = 105). The primary outcome was the induction-to-delivery time, and the secondary outcomes included maternal satisfaction, mode of delivery and neonatal conditions.</p><p><strong>Results: </strong>The induction-to-delivery time was significantly lower in the combination group than in the misoprostol group (13.91 [10.85-21.48] hours vs. 17.8 [12.63-26.63] hours, respectively; P = 0.016), and this difference was still observed in analyses including only those women with vaginal births (13.40 [10.65-20.47] hours vs. 18.49 [12.91-27.00] hours, respectively; P = 0.001). Stratified analysis revealed that this benefit was particularly significant among nulliparous women. The questionnaire survey revealed similar levels of maternal satisfaction with birth experience between the combination group and the misoprostol group (69.9% vs. 66.7%, P = 0.627) but a higher rate of pain during labor induction in the combination group (16% vs. 5.8%, P = 0.02). No significant differences were observed in neonatal conditions, satisfaction rates regarding the duration of labor induction and the frequency and intensity of contractions between the groups.</p><p><strong>Conclusion: </strong>Vaginal misoprostol combined with a Foley balloon effectively shortens the induction-to-delivery time but induces more severe pain during labor induction, thus providing overall satisfaction comparable to that of vaginal misoprostol for labor induction. An optimal scheme for labor induction should be determined according to expectations regarding the induction-to-delivery time, and the personal feelings of the pregnant women.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"295"},"PeriodicalIF":2.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633472","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}