BMC Pregnancy and Childbirth最新文献

{"title":"The impact of adenomyosis on intrauterine insemination success in unexplained infertile women: a retrospective cross-sectional study.","authors":"Sefa Arlıer, Sadık Kükrer, Fikriye Işıl Adıgüzel, Ahmet Zeki Nessar, Gülsüm Uysal, Cevdet Adıgüzel, Dilek Kaya Kaplanoğlu","doi":"10.1186/s12884-025-07769-9","DOIUrl":"10.1186/s12884-025-07769-9","url":null,"abstract":"<p><strong>Background: </strong>Adenomyosis is increasingly recognized as a significant factor affecting fertility, particularly in the context of assisted reproductive technologies (ART). This study aimed to assess the independent impact of adenomyosis on intrauterine insemination (IUI) success rates in women with unexplained infertility.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 533 IUI cycles in 374 infertile women treated at the University of Health Science, assisted reproductive technologies center, Adana City Hospital. The study identified adenomyosis in 95 patients via 2D transvaginal Doppler ultrasonography and 3D transabdominal ultrasonography, whereas direct and indirect adenomyosis features were not detected in 279 patients. Both groups started ovulation induction on cycle day 2-3 using recombinant follicle stimulating hormone (rFSH) or letrozole combined with rFSH or rFSH combined with recombinant luteinizing hormone (rLH). Clinical and ultrasound findings were recorded systematically. IUI was performed 36 h post-human chorionic ggonadotropin (hCG) administration, with pregnancy defined as a positive β-hCG 12-14 days after IUI. Logistic regression models were used to analyze the independent effects of adenomyosis on clinical pregnancy rates, adjusting for potential confounders.</p><p><strong>Results: </strong>The cumulative pregnancy rate per cycle was significantly lower in women with adenomyosis (12.23%) compared to those without adenomyosis (20.81%). Adenomyosis was identified as a significant negative predictor of IUI success (OR 0.575, 95% CI: 0.335-0.998, p = 0.049).</p><p><strong>Conclusion: </strong>Adenomyosis negatively affects IUI outcomes, suggesting the need for tailored fertility treatment strategies in this population. Routine assessment of adenomyosis should be considered in infertility evaluations to optimize clinical management and treatment success.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"650"},"PeriodicalIF":2.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214817","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":"Impact of health literacy and primary language on the decision to pursue trial of labor after prior cesarean delivery.","authors":"Daisy Leon-Martinez, Christine Dehlendorf, Molly Zeme, W John Boscardin, Anjali J Kaimal, William A Grobman, Miriam Kuppermann","doi":"10.1186/s12884-025-07788-6","DOIUrl":"10.1186/s12884-025-07788-6","url":null,"abstract":"<p><strong>Background: </strong>Both a trial of labor after cesarean (TOLAC) and elective repeat cesarean delivery (ERCD) are reasonable choices after a cesarean delivery, with differing risks and benefits. This study explores the impact of patient health literacy and primary language on the decision to pursue a TOLAC and on decision quality.</p><p><strong>Methods: </strong>This is a secondary analysis of the Prior Cesarean Decision (PROCEED) trial, which examined the effect of a patient-centered decision support tool on rates of TOLAC and decision quality. Logistic regression was performed to estimate the association of limited health literacy (Newest Vital Sign score ≤4/6) and non-English primary language (NEPL) with TOLAC. Decision quality was assessed by calculating mean scores for decision-quality scales and using linear regression to estimate adjusted mean differences (aMD) by health literacy and NEPL.</p><p><strong>Results: </strong>Among 1455 participants, 44.6% underwent TOLAC, and 71.0% of those with a TOLAC had a vaginal birth after cesarean (VBAC). Limited health literacy was associated with lower odds of TOLAC (aOR 0.60, 95% CI [0.38, 0.93]). For decision quality, limited health literacy was associated with similar scores for decisional conflict, shared decision-making, decision self-efficacy and decision satisfaction, but lower knowledge scores (3.9 vs. 5.4; aMD -0.7, 95% CI [-1.0, -0.5]). Compared to participants whose primary language was English (n=1043), those with NEPL (n=255) had similar odds of TOLAC (aOR 1.08, 95% CI [0.69, 1.68]), but greater decisional conflict (20.9 vs. 16.7; aMD 3.9, 95% CI [1.4, 6.3]) and lower decision self-efficacy (88.6 vs. 90.9; aMD -3.3, 95% CI [-5.6, -1.1]) and decision satisfaction (4.6 vs. 4.7; aMD -0.1, 95% CI [-0.2, 0.0]).</p><p><strong>Conclusions: </strong>In this study of pregnant people with a prior cesarean and no prior VBAC, those with limited health literacy had lower odds of TOLAC and lower knowledge scores about risks and benefits of TOLAC vs. ERCD. While those with NEPL had similar odds of TOLAC, they had lower decision quality scores compared to those with those with English as a primary language. These findings indicate factors that may result in less effective counseling related to delivery options after prior cesarean and may contribute to differences in approach to delivery and decision quality.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"648"},"PeriodicalIF":2.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214816","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":"Spatial distribution and predictors of early childbearing among Ethiopian women: evidence from the 2016 Ethiopian Demographic and Health Survey.","authors":"Amare Teshome Tefera, Fanuel Gashaw, Martha Solomon, Nebiyu Bekele, Shegaye Shumet, Tigist Mulugeta, Araya Mesfin Nigatu, Solomon Gedlu Nigatu","doi":"10.1186/s12884-025-07758-y","DOIUrl":"10.1186/s12884-025-07758-y","url":null,"abstract":"<p><strong>Background: </strong>Age at first birth is a crucial factor in understanding fertility patterns within a population. Ethiopia reports high rates of maternal and child mortality alongside elevated fertility levels. Early childbearing is associated with increased health risks for both mothers and infants. However, there is limited information on the spatial distribution and predictors of early childbearing among Ethiopian women. Therefore, this study sought to assess the spatial distribution and determinants of early childbearing for women in Ethiopia using data from the 2016 Ethiopian Demographic Health Survey.</p><p><strong>Methods: </strong>The study utilized data from the 2016 Ethiopia Demographic and Health Survey, incorporating 10,587 women in the analysis. Initially, spatial autocorrelation was employed to examine the geographic variation in early childbearing. To identify factors contributing to this spatial variation, both ordinary least squares and geographically weighted regression techniques were applied. The analysis for both regression methods was conducted using ArcGIS software.</p><p><strong>Results: </strong>The mean age and age at first birth among the study participants were 27.93 (9.15 SD), and 18.98(3.81 SD) years respectively. About 40% (95%CI: 35, 44%) of the study participants had their first birth before the age of 18 years, with 86.15% of early childbearing found in rural residents. The study identified statistically significant hot spots of early childbearing in specific regions of Ethiopia, including parts of Amhara, Afar, southern Tigray, East Shewa, and southwest of Benishangul. The geographic weighted regression analysis found that religion (being Muslim), age at first cohabitation (before the age of 15 years, and between 15 and 17 years of age), and marital status (divorced) were the potential predictors that had a significant impact on geographic variation of early childbearing in Ethiopia. The geographically weighted regression model explained 65% of the geographic variation of early childbearing in Ethiopia.</p><p><strong>Conclusion: </strong>Early childbearing was high in Ethiopia, and variation existed across its regions. The main hotspot for early childbearing was in the Amhara and Benishangul regions. Religion, age at first cohabitation, and marital status were the important predictors of early childbearing. Therefore, regional-specific strategies that target these variables should be considered while designing strategies aimed at reducing the level of early childbearing in Ethiopia.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"644"},"PeriodicalIF":2.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207563","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 perinatal outcomes and associated factors among mothers of advanced age at a tertiary hospital, Southwestern Uganda: a cross-sectional study.","authors":"Sezalio Masembe, Richard Migisha, Hillary Aheisibwe, John Crysistom Lule","doi":"10.1186/s12884-025-07776-w","DOIUrl":"10.1186/s12884-025-07776-w","url":null,"abstract":"<p><strong>Background: </strong>Pregnancies among mothers of advanced age (≥ 35 years) are inherently associated with poor perinatal outcomes. In this study, we determined the proportion of adverse perinatal outcomes and identified associated factors among pregnant mothers of advanced age who delivered at Kabale Regional Referral Hospital (KRRH) in Southwestern Uganda.</p><p><strong>Methods: </strong>We conducted a cross-sectional study at KRRH's Maternity Ward from March to August 2023. We enrolled post-delivery mothers aged ≥ 35 years. We collected data on socio-demographic, obstetric, and medical characteristics, as well as fetal outcomes, using interviewer-administered structured questionnaires. We defined an adverse perinatal outcome as the occurrence of any of the following complications: early neonatal death, preterm birth, congenital anomalies, macrosomia, low APGAR score, or low birth weight, sustained by the fetus or neonate during pregnancy, delivery, or the immediate post-delivery period before discharge from the hospital. We performed multivariable logistic regression to identify factors associated with adverse perinatal outcomes.</p><p><strong>Results: </strong>We enrolled 417 participants, of whom 206 (49.4%) were aged 35-37 years. The majority (n = 273; 65.5%) were multiparous (parity ≥ 5). Adverse perinatal outcomes occurred in 8.4% (n = 36; 95% CI: 6.1-11.5%) of participants, with early neonatal death being the most common (3.6%), followed by low birth weight (2.4%), congenital anomalies (2.6%), macrosomia (1.4%), low APGAR score (1.4%), and preterm birth (1.2%). Prolonged labor (adjusted odds ratio [aOR] = 3.71, 95% CI: 1.40-9.85) and a history of abortion (aOR = 2.56, 95% CI: 1.17-5.60) were significantly associated with adverse fetal outcomes.</p><p><strong>Conclusion: </strong>Approximately 1 out of every 10 advanced-aged mothers surveyed experienced a poor perinatal outcome, with mothers who had prolonged labor or history of abortions having increased odds of the poor perinatal outcomes. We recommend strengthening close monitoring of labour and timely interventions to reduce adverse perinatal outcomes including early neonatal deaths.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"645"},"PeriodicalIF":2.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207557","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":"Characteristics of neonatal necrotizing enterocolitis in relation to the presence or absence of patent ductus arteriosus.","authors":"Xin Lin, Lingling Liu, Huiping Zeng, Wenhong Cai","doi":"10.1186/s12884-025-07721-x","DOIUrl":"10.1186/s12884-025-07721-x","url":null,"abstract":"<p><strong>Objective: </strong>The presence of a patent ductus arteriosus (PDA) increases the morbidity and mortality rates in neonates with necrotizing enterocolitis (NEC), attributable to the \"diastolic steal\" phenomenon. Consequently, it is vital to assess the characteristics of NEC in relation to the presence or absence of PDA.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted from 2015 to 2022, encompassing 135 neonates who were categorized into mild and severe NEC groups, with each group further divided into NO-PDA and PDA subgroups. Demographic characteristics of both mothers and neonates, as well as neonatal respiratory mechanics, hematologic parameters, and echocardiographic data were meticulously collected. Logistic regression analyses were conducted, and the results were statistically processed using the R programming language.</p><p><strong>Results: </strong>In the mild NEC group, 46.9% (38/81) of neonates had the presence of PDA, compared to 53.7% (29/54) in the severe NEC group. Additionally, a lower left ventricular systolic function and a higher incidence of moderate to severe tricuspid regurgitation were observed in the PDA subgroup of the severe NEC group (P < 0.05). The occurrence of increased blood urea nitrogen, positive blood culture results in cases of sepsis, heart failure, and intraventricular hemorrhage was 1.27, 1.60, 1.91, and 3.86 times higher, respectively, in the PDA subgroup than in the NO-PDA subgroup. Within the PDA subgroup, for every one gram per liter decrease in fibrinogen, the incidence risk of NEC increased by 65%, and for each one mmol/L decrease in calcium levels, the incidence risk of NEC increased by 89% after adjustment.</p><p><strong>Conclusions: </strong>HsPDA in neonates not only affects the severity and progression of NEC but also exerts an impact on multi-system functions. This includes exacerbating respiratory issues (due to high pulmonary blood flow and increased need for ventilatory support), increasing the load on the left ventricular blood flow, promoting hypercoagulability, disrupting calcium metabolism, and raising the risk of sepsis and IVH.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"642"},"PeriodicalIF":2.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207559","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":"Intersectional dynamics and care disparities in intrapartum electronic fetal monitoring: a socio-technical systems perspective.","authors":"Verónica Blanco Gutiérrez, Lyuba V Bozhilova, Natalie Darko, Antoniya Georgieva, Kenton O'Hara","doi":"10.1186/s12884-025-07765-z","DOIUrl":"10.1186/s12884-025-07765-z","url":null,"abstract":"<p><strong>Background: </strong>Intrapartum Electronic Fetal Monitoring interpretation is subjective, variable and dependent on clinical expertise. Electronic Fetal Monitoring is also influenced by human factors, such as the labour ward context, staffing pressures, situational awareness, local protocols, workflow variations, team dynamics, and reporting cultures. This paper explored whether, and how, socio-technical factors may have the potential to contribute to disparities in intrapartum Electronic Fetal Monitoring care and their implications for maternal and neonatal health.</p><p><strong>Methods: </strong>This study employed an exploratory qualitative design to investigate clinicians' experiences of Electronic Fetal Monitoring. Eighteen semi-structured interviews were undertaken online with midwives, student midwives and obstetricians involved in labour ward care in the UK. Critical Race Feminism and Intersectionality theories shaped the study design and analysis. Interviews were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Seven themes were identified under the overarching theme intersectional dynamics in intrapartum Electronic Fetal Monitoring: 1) Social determinants in Electronic Fetal Monitoring interpretation, (2) Disparities in care expectations and decision agency, (3) Cultural influence on decision choices, (4) Disparities in communication, (5) Rationalising Electronic Fetal Monitoring outcomes towards preferred course of action, (6) Stereotypes and bias, and (7) Wider influences of Electronic Fetal Monitoring and labour care.</p><p><strong>Conclusions: </strong>Electronic Fetal Monitoring is a socially and contextually interpreted tool used to support particular interventions or inactions. Electronic Fetal Monitoring management is subject to systematic contextual influences, maternal Social Determinants of Health and biases that may further contribute to disparities in labour care and outcomes. Addressing maternal Social Determinants of Health while providing Electronic Fetal Monitoring care is vital to promoting equitable care, facilitating a positive experience and improving health outcomes.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"647"},"PeriodicalIF":2.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207561","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":"KCNK2-mediated regulation of MMP-2/9 by PlGF influences uterine artery function in pregnancy-induced hypertension.","authors":"Yinzhen Chen, Mingfu Chen, Ridong Zhou, Jichang Zheng, Gongxin Yang, Meiyu Chen, Jing Tu, Hongming Lin, Hu Zhao, Chen Lin, Xiaobin Chen","doi":"10.1186/s12884-025-07743-5","DOIUrl":"10.1186/s12884-025-07743-5","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy induced hypertension (PIH) is characterized by aberrant uterine arterial remodeling, a process tightly associated with an imbalance between placental growth factor (PlGF) and soluble fms like tyrosine kinase 1 (sFlt 1) as well as the down regulation of matrix metalloproteinases 2/9 (MMP 2/9). This study investigated the regulatory effect of PlGF on the two pore domain potassium channel KCNK2 and its downstream targets MMP 2/9, and explored the role of the PlGF KCNK2 MMP 2/9 axis in PIH related uterine arterial dysfunction.</p><p><strong>Methods: </strong>In vitro, human aortic endothelial cells (HAECs) were assessed for proliferation and migration using CCK 8 and Transwell assays. Nitric oxide (NO) and endothelin 1 (ET 1) levels were quantified by ELISA, while KCNK2 and MMP 2/9 expression was analyzed by Western blotting. In vivo, a Sprague Dawley rat PIH model was established to monitor blood pressure and 24 h urinary protein. Hematoxylin-eosin staining was used to measure uterine arterial intimal thickness; endothelial nitric oxide synthase (eNOS) and ET 1 localization was determined by immunohistochemistry, and KCNK2 as well as MMP 2/9 expression was quantified by immunohistochemistry and Western blotting.</p><p><strong>Results: </strong>2,2,2 Trichloroethanol and PlGF significantly enhanced endothelial cell proliferation and migration, increased NO, decreased ET 1, and up regulated KCNK2 and MMP 2/9 expression (P < 0.05); ropivacaine produced opposite effects. PIH rats exhibited markedly elevated blood pressure and urinary protein, intimal thickening, reduced eNOS and elevated ET 1, together with diminished MMP 2/9 expression. Combined treatment with PlGF and 2,2,2 trichloroethanol lowered blood pressure and urinary protein, attenuated intimal thickness, increased eNOS and decreased ET 1, and up regulated KCNK2 and MMP 2/9 (P < 0.05).</p><p><strong>Conclusion: </strong>2,2,2 Trichloroethanol activates KCNK2, elevates MMP 2/9, and improves uterine arterial endothelial function, while PlGF synergizes with KCNK2 signaling to potentiate these effects. The PlGF KCNK2 MMP 2/9 axis plays a pivotal regulatory role in the vascular pathology of PIH, highlighting its potential as a therapeutic target for PIH related vascular dysfunction.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"646"},"PeriodicalIF":2.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207562","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":"Accuracy of second and third trimester ultrasound in the determination of chorionicity in twin pregnancies: a cross-sectional observational study.","authors":"Chantal Stewart, Zoe Momberg, Henriette van Zyl, Stephen Lindow","doi":"10.1186/s12884-025-07404-7","DOIUrl":"10.1186/s12884-025-07404-7","url":null,"abstract":"<p><strong>Background: </strong>Determination of chorionicity in twin pregnancies is essential for optimizing management. In South Africa, many women first access antenatal care at late gestations. The accuracy of ultrasound in the determination of chorionicity up to 14 weeks' gestation is well documented. However, there is little data on determination of chorionicity in late pregnancy. We thus aimed to determine the accuracy of five ultrasound parameters performed after 14 weeks' gestation in determining chorionicity.</p><p><strong>Method: </strong>This was a cross-sectional diagnostic validity study where postpartum placental histology was accepted as the standard test for chorionicity. All twin pregnancies > 14 weeks' gestation in whom chorionicity had not been determined and without any complications were included. Data collected included demographic data, ultrasound-determined number of placentae, fetal sexes, membrane 'take-off' (lambda or T-Sign), thickness, and number of layers in the dividing membrane. Placentae and membranes were examined by the Anatomical Pathology department. Each of the 5 ultrasound parameters for chorionicity was analyzed separately in relation to the corresponding histology result.</p><p><strong>Results: </strong>A total of 85 patients were included, for whom histology was available in 58. Of these, 12 were monochorionic diamniotic and 44 dichorionic diamniotic. The diagnostic accuracies of discordant gender, number of placentas, lambda sign, membrane thickness and number of layers in the membranes were 44.1, 49.1, 76.7, 76.1 and 82.9, respectively. We developed a step-wise algorhithm for the determination of chorionicity.</p><p><strong>Conclusion: </strong>Determination of chorionicity late in twin pregnancies remains inaccurate. However, a step-wise algorithm for the application of 5 parameters is helpful.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"643"},"PeriodicalIF":2.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207556","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":"Global burden of maternal hypertensive disorders (1990-2045): trends, regional disparities, and causal links to occupational exposures.","authors":"Junpeng Xiong, Shuwen Chen, Han Wang, Xiaonan Yang, Xinyi Chen, Binquan You, Ronghui Yu","doi":"10.1186/s12884-025-07766-y","DOIUrl":"10.1186/s12884-025-07766-y","url":null,"abstract":"<p><strong>Background: </strong>Maternal Hypertensive Disorders (MHD), encompassing gestational hypertension, chronic hypertension, preeclampsia, and eclampsia, which was a significant contributor to maternal morbidity and mortality, particularly in regions with lower socioeconomic status.</p><p><strong>Methods: </strong>Using data from the 2021 Global Burden of Disease (GBD) study, we analyzed the burden of MHD globally. We used the slope index and concentration index to measure cross-country inequality in MHD burden, and employed a Bayesian age-period-cohort (BAPC) model to project the burden from 2022 to 2045. Additionally, we conducted a two-sample Mendelian randomization (MR) analysis based on genome-wide association study (GWAS) to investigate potential causal relationships between occupational exposures and MHD.</p><p><strong>Results: </strong>Overall, the global incidence, prevalence, mortality, and DALYs for MHD have declined. However, incidence and prevalence rose in Central Asia, Eastern Europe, and Western Europe, while the Caribbean increasing in mortality and DALYs. Iron deficiency emerged as the leading risk factor. Significant SDI-related inequalities in MHD burden were observed, especially in lower SDI countries. Projections suggest ongoing reductions in MHD burden through 2045. MR results revealed a significant causal link between frequent exposure to chemical or other fumes in the workplace and MHD, while no clear causal relationships were identified for particulate matter or other assessed exposures.</p><p><strong>Conclusions: </strong>Although the global MHD burden is decreasing, marked regional disparities persist. Efforts focusing on addressing iron deficiency, improving nutritional support, and mitigating occupational exposures may further reduce the burden. Strengthening maternal healthcare services-especially in low-SDI will be crucial for achieving sustainable declines in MHD worldwide.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"641"},"PeriodicalIF":2.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207560","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":"Assessing the antenatal care-seeking determinants associated with the penetration of the WHO eight-visit antenatal care policy across states in Nigeria.","authors":"Christiana Ikemeh, Adedayo O Adeyemi, Kazeem Arogundade, Leah M Frerichs, Christopher M Shea, Justin G Trogdon","doi":"10.1186/s12884-025-07713-x","DOIUrl":"10.1186/s12884-025-07713-x","url":null,"abstract":"<p><strong>Background: </strong>Following the adoption and implementation of the 2016 WHO eight-visit antenatal care (8vANC) policy in Nigeria, a national cross-sectional survey conducted in 2021 indicated significant state-level differences in the utilization rates of 8vANC.</p><p><strong>Methods: </strong>We used a post-implementation sample, n = 9,416, obtained from the Nigeria Multiple Indicator Cluster Survey 2021 data to perform secondary analyses using the theory, model, and framework (TMF) implementation research approach. The outcome was defined as the penetration of the WHO 8vANC policy and measured as the proportion of women who used a minimum of 8vANC out of the total number of women who had live births within two years before the survey in 2021. We used multilevel modeling mixed effects logistic regression for the statistical analyses because of its ability to examine contextual effects in cross-sectional data.</p><p><strong>Results: </strong>The results revealed that the residual variation in state-level 8vANC utilization--after accounting for the explanatory variables-attributable to between-state differences went from 46% in the unadjusted model to11% in the final adjusted model. The findings indicated that women in Southern states had the highest odds of 8vANC utilization. We also found that women who self-reported their perception of life satisfaction as 'very happy' (OR: 1.81, 95% C.I: 1.25-2.63, p = 0.002), and 'somewhat happy' (OR: 1.63, 95% C.I: 1.14-2.40, p = 0.012) had the highest odds of 8vANC utilization across states. Conversely, the perception of wife beating justified 'if she goes out without telling husband' had low odds (OR: 0.77, 95% C.I: 0.61-0.97, p = 0.032) on the penetration of the WHO 8vANC policy across states.</p><p><strong>Conclusion: </strong>A greater proportion of the observed differences in 8vANC penetration occurred among women nested within states than between states. Our findings support the need for a revised policy that promotes the integration of routine prenatal mental health screening into the current ANC model.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"640"},"PeriodicalIF":2.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207558","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}