BMC Pregnancy and Childbirth最新文献

{"title":"Global prevalence of constipation during pregnancy: a systematic review and meta-analysis.","authors":"Nader Salari, Sakine Mohamadi, Mahvan Hemmati, Amirreza Fallahi, Shabnam Rasoulpoor, Hosna Zarei, Shamarina Shohaimi, Masoud Mohammadi","doi":"10.1186/s12884-024-07057-y","DOIUrl":"10.1186/s12884-024-07057-y","url":null,"abstract":"<p><strong>Background: </strong>Constipation is a common complication and an unpleasant experience during pregnancy. Due to hormonal factors, intestinal movements decrease during this time, causing the digestive system to malfunction. This study aims to explore the worldwide prevalence of constipation during pregnancy to prevent and minimize its complications.</p><p><strong>Method: </strong>Researchers conducted a meta-analysis of published data on the prevalence of constipation in pregnancy. The articles, which covered the period 1966 to 2024, were collected by searching Embase, PubMed, Scopus, Science Direct, Wos, and the Google Scholar search engine. The initial search was conducted on July 21, 2024, and the final update was made on August 10, 2024.</p><p><strong>Results: </strong>Thirteen studies were identified to determine the prevalence of constipation during pregnancy. The results show that the global prevalence of constipation throughout pregnancy is 32.4%, with the first trimester at 21.1%, the second trimester at 34%, and the third trimester at 30.3%.</p><p><strong>Conclusion: </strong>According to a study, constipation is most common during the second trimester of pregnancy and the least common during the first trimester. Further research on the causes of constipation and prevention methods can help decrease its prevalence during pregnancy. Therefore, it is important to provide educational interventions on nutrition and encourage moderate physical activity during pregnancy to reduce the occurrence of constipation.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"836"},"PeriodicalIF":2.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871066","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":"Challenges and opportunities in perinatal public health: the utility of perinatal health inequality dashboards in addressing disparities in maternal and neonatal outcomes.","authors":"Olufisayo Olakotan, Jennifer N W Lim, Thillagavathie Pillay","doi":"10.1186/s12884-024-07056-z","DOIUrl":"10.1186/s12884-024-07056-z","url":null,"abstract":"<p><strong>Introduction: </strong>In clinical settings, digital dashboards display medical data, with the aim of identifying trends and signals. In so doing these contribute towards improving service delivery and care within hospitals. It is not clear whether the utility of perinatal health equity dashboards could be used to identify health inequality trends that could potentially impact on health service delivery, care and public health interventions. This study aims to evaluate the implementation of health inequality dashboards that address disparities in maternal and neonatal outcomes, with a specific focus on identifying key challenges encountered during their deployment and use in healthcare settings.</p><p><strong>Methods: </strong>Three databases, namely Embase, CINAHL, and Medline were searched to identify relevant studies in English Language published between 2010 and 2022. All findings were reported according to PRISMA guidelines for scoping reviews.</p><p><strong>Results: </strong>Of 670 identified articles, only 13 met the inclusion criteria. The study identified three key themes: dashboard functionality, data accuracy, and challenges in collecting health inequality data. Dashboards were used to visualize disparities, with functionalities focusing on specific audiences, contents, and utility. Issues with data completeness, standardization, and challenges in collecting consistent health inequality data, especially from diverse ethnic groups, hindered the accurate tracking of maternal and neonatal disparities.</p><p><strong>Conclusion: </strong>The use of perinatal health inequality dashboards is a critical step forward in optimizing maternal and neonatal care by providing targeted interventions. However, further research is needed to assess their long-term impact on reducing health inequalities, while addressing challenges related to data accuracy, completeness, and standardization to improve their effectiveness.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"837"},"PeriodicalIF":2.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871336","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":"Ectopic pregnancy is associated with increased risk of displaced implantation window: a retrospective study.","authors":"Hong Zeng, Yahan Chang, Nenghui Liu, Shuyi Li","doi":"10.1186/s12884-024-07072-z","DOIUrl":"10.1186/s12884-024-07072-z","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the risk factors associated with WOI (window of implantation) displacement based on ERT (endometrial receptivity test), and to confirm the association of ectopic pregnancy with WOI displacement.</p><p><strong>Methods: </strong>This is a retrospective study at the Reproductive Medicine Center of Xiangya Hospital from January 2020 to April 2024, consisting of 934 patients who performed ERT. The patients underwent 3771 assisted reproductive technology (ART) cycles and 2629 embryo transfer (ET) cycles, with each patient experiencing at least one implantation failure. The study utilized generalized estimation equation (GEE) models to examine factors associated with WOI displacement, adjusting for confounding factors like age, body mass index (BMI), and infertility type. Non-linear relationships between age or BMI with WOI displacement were explored using generalized additive models (GAM) with thresholds detected by segmented regression.</p><p><strong>Results: </strong>Among the patients, 60.17% were in the receptive phase, 39.40% in the pre-receptive phase, and 0.43% in the post-receptive phase. Ectopic pregnancy history increased the risk of WOI displacement by 62% (aOR 1.62, 95%CI 1.03-2.53, P = 0.035), patients over 35 years old had a 50% higher risk of WOI displacement compared to patients under 34 (aOR 1.50, 95% CI 1.12-2.00, P = 0.007). Secondary infertility showed a 26% lower risk of WOI displacement than primary infertility without statistical significance (aOR 0.74 95% CI 0.54-1.02, P = 0.062). BMI ≥ 22 kg/m2 was associated with a 25% increased risk of WOI displacement without statistical significance (aOR 1.25, 95% CI 0.94-1.67, P = 0.12).</p><p><strong>Conclusion: </strong>Ectopic pregnancy and advanced age (≥ 35) are significantly associated with increased risk of WOI displacement. Primary infertility and higher BMI (≥ 22 kg/m²) tend to increase the risk of WOI displacement though without statistical significance.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"839"},"PeriodicalIF":2.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871058","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":"Sexual health after childbirth in Dutch women: prevalence, associated factors and perceived need for information: a cross-sectional study.","authors":"E L Wassenaar, F Lont, C J Verhoeven, J Henrichs, Lml Titulaer, J C Warmelink, C C Geerts","doi":"10.1186/s12884-024-06918-w","DOIUrl":"10.1186/s12884-024-06918-w","url":null,"abstract":"<p><strong>Background: </strong>After childbirth, women often experience changes in sexual health. Little is known about the associated factors for the development of sexual health problems. Therefore, in this study we aim to investigate (1) how many women report changes in sexual health; (2) the prevalence and associated factors of women's postpartum sexual health problems and (3) whether women want to be better informed about postpartum sexual health after childbirth.</p><p><strong>Methods: </strong>From March to May 2021, 641 postpartum Dutch women participated in a cross-sectional study through an online survey, distributed via social media. At a mean time of 11.6 months (SD = 6.23) after birth, women reported information on maternal, pregnancy and childbirth characteristics and childbirth experience, sexual dysfunction (Female Sexual Function Index), sexual distress (Female Sexual Distress Scale), relationship satisfaction (Relationship Assessment Scale) and \"perceived need for information\" to discuss sexual health with their maternity care provider.</p><p><strong>Results: </strong>Postpartum changes in sexual health were found in 88% of women. Of the women who participated, 43.7% reported sexual dysfunction and 52.3% reported sexual distress. Overall, 46% of women perceived more need for information. Multivariable logistic regression analyses showed that negative sexual experiences were associated with increased odds of sexual dysfunction (odds ratio (OR) 1.58, 95% CI 1.04-2.40) and sexual distress (OR 1.70, 1.17-2.46). Perineal damage (OR 1.54, 1.03-2.29) was associated with increased odds of sexual dysfunction, and a BMI ≥ 30 kg/m² (OR 0.46, 0.28-0.70) was associated with decreased odds of sexual dysfunction. A higher level of relationship satisfaction was associated with decreased odds of sexual dysfunction (OR 0.36, 0.25-0.51) and sexual distress (OR 0.47, 0.35-0.63). A positive childbirth experience was associated with decreased odds of sexual distress (OR 0.88, 0.81-0.96) and decreased odds of \"perceived need for information\" (OR 0.86, 0.79 to 0.94).</p><p><strong>Conclusion: </strong>Sexual health problems are experienced by half of postpartum women. Midwives should inform women and their partners about these possible problems, taking into account birth-related factors, e.g. birth experience and perineal damage. Care providers should pay special attention to women with negative sexual experiences.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"838"},"PeriodicalIF":2.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871188","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":"Does caesarean section have an impact on exclusive breastfeeding? Evidence from four Southeast Asian countries.","authors":"Kyaw Lwin Show, Nampet Jampathong, Pyae Linn Aung, Kyawt Mon Win, Chetta Ngamjarus, Porjai Pattanittum, Thae Maung Maung, Khaing Nwe Tin, Su Mon Myat, Meghan A Bohren, Nogati Chairunnisa, Pisake Lumbiganon","doi":"10.1186/s12884-024-07024-7","DOIUrl":"10.1186/s12884-024-07024-7","url":null,"abstract":"<p><strong>Background: </strong>The effect of caesarean section (CS) on breastfeeding initiation has been extensively studied, but its influence on exclusive breastfeeding practices remains inconclusive. Therefore, this study aims to investigate the impact of CS on exclusive breastfeeding using evidence from four countries in the Southeast Asian region.</p><p><strong>Methods: </strong>This cross-sectional study used secondary data obtained from the Demographic and Health Surveys (DHS) conducted between 2016 and 2022 in four countries within the Southeast Asian Region. We included information on the youngest children aged 0-5 months living with their mothers within the DHS datasets. The association between CS and exclusive breastfeeding was determined using a simple and multiple logistic regression models. Weight factors were taken into account in all analyses for the two-stage stratified cluster sampling design.</p><p><strong>Results: </strong>Among 3420 children, nearly half (49.1%, 95%CI: 47.0, 51.2) were exclusively breastfed. Children born by CS had lower odds of being exclusively breastfed, compared to children born vaginally (aOR = 0.68, 95%CI: 0.53, 0.88). Women who were married or living with a partner (aOR = 2.19, 95%CI: 1.33, 3.60), children born at a health facility (aOR = 1.31, 95%CI: 1.00, 1.71), and girl babies (aOR = 1.24, 95%CI: 1.05, 1.48) had higher odds of exclusive breastfeeding. Furthermore, residing in rural areas was associated with an increased likelihood of exclusive breastfeeding (aOR = 1.47, 95%CI: 1.20, 1.80). Maternal age, mother's education, parity, antenatal and postnatal care taken, and mass media exposure were not associated with exclusive breastfeeding.</p><p><strong>Conclusion: </strong>This study highlights a significant association between CS and reduced exclusive breastfeeding practices. The findings underscore the importance of providing adequate support and interventions to mothers who deliver by CS and their family members to ensure they can successfully achieve exclusive breastfeeding, particularly in a global context where CS rates are rising.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"822"},"PeriodicalIF":2.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862985","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 receiving care and folic acid supplementation prior to pregnancy: a large cross-sectional study in Shiraz, Iran.","authors":"Niloufar Izaddoost, Leila Amiri-Farahani, Fatemeh Sajjadian, Sally Pezaro","doi":"10.1186/s12884-024-07041-6","DOIUrl":"10.1186/s12884-024-07041-6","url":null,"abstract":"<p><strong>Background and aim: </strong>Preconceptional care aims to improve health and is influenced by various factors including health literacy. Considering the importance and necessity of high quality preconceptional care, this study aimed to determine the predictors of receiving care and folic acid supplementation prior to pregnancy.</p><p><strong>Methods: </strong>This cross-sectional study included 693 participants with pregnancies of less than 14 weeks gestation referred to health centers and gynecologists in Shiraz city, Iran. Multi-stage sampling occurred from May 2021 to February 2022 in 18 comprehensive urban health centers and 20 gynecology offices via the proportional allocation method. Data was collected using a questionnaire consisting of 3 parts: 1) individual and fertility characteristics, 2) information related to the components of preconceptional care and 3) health literacy. This was completed by individual participants who self-reported their responses.</p><p><strong>Results: </strong>Examining the frequency of the variables related to individual characteristics revealed that the mean age of participants in the study was 30.32 with a standard deviation of 5.29 years and more than half (59.3%) had a university level education. The receipt of pre-conceptual care was found to have a statistically significant relationship with the following: level of education, employment status, length of marriage, number of pregnancies, week of pregnancy and whether it was planned or not, along with health literacy (P < 0.05). Folic acid supplementation was found to have a statistically significant relationship with the following: level of education, financial status of the family, length of marriage, number of pregnancies and current pregnancy status (P < 0.05). In examining the predictive effect of individual variables and health literacy in the logistic regression model with the outcome of receiving preconceptional care and folic acid supplementation, length of marriage, health literacy, occupational status, and pregnancy planning status variables remained in the model following analysis.</p><p><strong>Conclusion: </strong>Several factors had a statistically significant relationship with receiving pre-conceptual care and folic acid supplementation. In order to improve pre-conceptual care and increase folic acid supplementation, special attention must be paid to improving health literacy, increasing levels of education and reducing unplanned pregnancies.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"824"},"PeriodicalIF":2.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862889","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":"Gestational diabetes mellitus and peripartum depression: a longitudinal study of a bidirectional relationship.","authors":"Maja Žutić, Marijana Matijaš, Jasminka Štefulj, Maja Brekalo, Sandra Nakić Radoš","doi":"10.1186/s12884-024-07046-1","DOIUrl":"10.1186/s12884-024-07046-1","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) and peripartum depression (PPD) are increasing global health issues with potentially long-lasting adverse outcomes. While limited studies suggest a bidirectional relationship between GDM and PPD, most research has been cross-sectional and focused on one direction of the relationship, primarily if GDM predicts postpartum depression. The interplay between antenatal depression and GDM is less explored, with a critical lack of prospective bidirectional studies. This longitudinal study aimed to investigate the bidirectional relationship between GDM and PPD in a total sample and according to different pre-pregnancy body mass index (BMI) categories. Specifically, we examined whether antenatal depression symptoms predict a subsequent GDM diagnosis and whether GDM predicts subsequent postpartum depression symptoms.</p><p><strong>Methods: </strong>A three-wave online longitudinal study included 360 women who were followed from the second trimester (20-28 weeks, T1) through the third trimester (32-42 weeks, T2), and into the postpartum period (6-20 weeks after birth, T3). Participants completed the General Data Questionnaire, one item about the diagnosis of GDM, and the Edinburgh Postnatal Depression Scale (EPDS). The sample was stratified according to pre-pregnancy BMI into normal-weight (N = 247) and overweight/obese (N = 113) subgroups. Women with type I and II diabetes, GDM at T1, and underweight BMI were excluded.</p><p><strong>Results: </strong>In the total sample, antenatal depression symptoms predicted GDM, whereas GDM did not predict postpartum depression symptoms. A bidirectional relationship was observed in normal-weight women, where antenatal depression symptoms predicted subsequent GDM diagnosis, and GDM diagnosis predicted postpartum depression symptoms. In contrast, no associations were found in either direction in the overweight/obese subgroup.</p><p><strong>Conclusions: </strong>This study provides evidence of a bidirectional relationship between GDM and PPD only in women with normal body weight before pregnancy. The results highlight the complexity of the relationship between peripartum mental and metabolic health, that is dependent on pre-pregnancy BMI. Clinicians should be aware that normal-weight women may have a unique sensitivity to the bidirectional interplay between GDM and PPD. Pregnant women should be closely monitored for both mental and metabolic health issues and targeted for prevention programs to reduce the risks and burdens associated with both conditions.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"821"},"PeriodicalIF":2.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862887","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":"Late antenatal care booking and associated factors among pregnant women in Ethiopia: evidence from 2019 performance monitoring for action data analysis.","authors":"Getachew Teshale, Melak Jejaw, Kaleb Assegid Demissie, Mihret Getnet, Endalkachew Dellie, Demiss Mulatu Geberu, Tesfahun Zemene Tafere, Banchlay Addis, Lake Yazachew, Nigusu Worku, Misganaw Guadie Tiruneh, Tadele Biresaw Belachew","doi":"10.1186/s12884-024-07038-1","DOIUrl":"10.1186/s12884-024-07038-1","url":null,"abstract":"<p><strong>Introduction: </strong>Pregnancy is a crucial period for a woman, her family, and society. Early initiation of antenatal care (ANC) follow-up helps to identify pre-existing health conditions and complications arising during pregnancy. It also allows the mother to receive health promotion and disease prevention services. On the other hand, late initiation or missing of ANC follow-up may lead to transmission of the infections to their fetus, stillbirth, anemia, congenital malformation, and congenital syphilis. This study aims to determine the magnitude and determinant factors of late ANC booking in Ethiopia.</p><p><strong>Methods: </strong>The 2019 Ethiopia Performance Monitoring for Action (PMA) cross-sectional survey data was used for this study. It is a multistage cluster, nationally representative household survey. A total of 709 pregnant women were eligible for our study. The results of this study were presented as narrations, frequency tables, and graphs. Variables with p-value < 0.2 in univariable logistic regression were taken to a multi-variable logistic regression analysis and in the final model variables with Adjusted Odds Ratio (AOR) at 95% confidence interval and p-value of ≤ 0.05 were identified as predictor variables of late antenatal care booking.</p><p><strong>Results: </strong>The overall prevalence of late ANC booking was 54.28% (95% CI: 48.85, 59.49). Women who never attend formal education (AOR = 0.16 95% CI: 0.13, 0 0.67), women whose parity was 1 or 2 (AOR = 2.30, 95% CI: 1.05, 4.53) and women with wanted pregnancies (AOR = 1.80, 95% CI: 1.73, 4.32) were significant variables associated with late antenatal care booking.</p><p><strong>Conclusion: </strong>In Ethiopia, over half of the pregnant mothers initiated their ANC follow-up late and it is high as compared to the WHO recommendation. Unwanted pregnancy, being uneducated, and parity I or II were the factors for late ANC booking. Hence, it is important to provide health education on the timing of ANC among women within reproductive ages. Priority should be given to women with low levels of education, women who have one or more parity, and women with unplanned pregnancies. Family planning or birth spacing programs should be enhanced to prevent unwanted pregnancies.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"826"},"PeriodicalIF":2.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862888","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":"Risk factors associated with pregnancy outcomes in patients with recurrent pregnancy loss after treatment.","authors":"Tingfeng Fang, Xiaohui Ji, Ziyang Su, Ao Zhang, Liqiong Zhu, Jing Tang, Zhuoyao Mai, Haiyan Lin, Nengyong Ouyang, Hui Chen","doi":"10.1186/s12884-024-07048-z","DOIUrl":"10.1186/s12884-024-07048-z","url":null,"abstract":"<p><strong>Background: </strong>The treatment for recurrent pregnancy loss (RPL) has been addressed in international guidelines. However, limited studies have investigated the risk factors associated with pregnancy and live birth outcomes in patients with RPL after treatment. The objective of this study was to offer a comprehensive assessment of the risk factors for pregnancy loss in patients with a history of RPL following therapeutic interventions.</p><p><strong>Methods: </strong>This retrospective cohort study involved 431 women in early pregnancy with a history of RPL who experienced treatment at the Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, between June 2018 and June 2020. The main outcome measures were the ongoing pregnancy ≥ 12 weeks and the live birth outcomes. Univariate and multivariate logistic regression analyses were conducted to identify the risk factors for pregnancy loss < 12 weeks and live birth outcomes.</p><p><strong>Results: </strong>Patient's age and the prevalence of uterine malformations were significantly different between the patients with and without ongoing pregnancy ≥ 12 weeks (32.64 ± 5.08 vs. 31.54 ± 4.34, P = 0.026; 34.70% vs. 24.60%, P = 0.035). The risk of pregnancy loss < 12 weeks was significantly increased with age and those with uterine abnormalities (adjusted OR: 1.48 [95% CI: 1.05 to 2.07], P = 0.025; adjusted OR:1.78 [95% CI 1.11 to 2.79], P = 0.016). The risk of non-live birth was significantly increased in couples with parental karyotype abnormalities (adjusted OR: 0.08 [95% CI 0.01 to 0.76], P = 0.029). No statistically significant differences were found between the patients with and without ongoing pregnancy ≥ 12 weeks and live birth regarding number of miscarriages, BMI, thyroid stimulating hormone, thyroid peroxidase antibody, thyroglobulin antibody, homa insulin-resistance, parental karyotype abnormality, B lymphocyte, NK cells, antinuclear antibody, antithrombin III activity, platelet aggregation function, anticardiolipin antibody, lupus anticoagulant, homocysteine, protein C, protein S, anti-β2 glycoprotein antibody, anti-phosphatidylserine and thromboelastograms.</p><p><strong>Conclusions: </strong>In patients with RPL after treatment, age and uterine anomalies were identified as risk factors linked to pregnancy loss < 12 weeks, while parental karyotype abnormalities were recognized as an independent risk factor affecting live birth outcomes.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"827"},"PeriodicalIF":2.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862890","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":"Unveiling socioeconomic disparities in maternal smoking during pregnancy: a comprehensive analysis of rural and Appalachian areas in Virginia utilizing the multi-dimensional YOST index.","authors":"Asal Pilehvari, Ashley Chipoletti, Rebecca Krukowski, Melissa Little","doi":"10.1186/s12884-024-07032-7","DOIUrl":"10.1186/s12884-024-07032-7","url":null,"abstract":"<p><strong>Background: </strong>Maternal smoking during pregnancy carries significant health risks for both mothers and infants, especially in vulnerable regions like rural and Appalachian areas with high smoking rates. Understanding the causes of high smoking rates in vulnerable areas is crucial for designing effective interventions to promote smoking cessation and reduce preventable health disparities.</p><p><strong>Methods: </strong>Data from the Virginia Pregnancy Risk Assessment Monitoring System (PRAMS; years 2009-2020) comprised of 7,861 women aged over 18 were used in this cross-sectional observational study. Pregnant individuals were categorized as smoking if they reported smoking during the last trimester. A multi-level logistic regression was employed to examine the association of individual sociodemographic factors, rurality, Appalachian status, and county socioeconomic status (SES) proxied by Yost Index quintiles with smoking behaviors during pregnancy. The county of residence was considered as a random factor in the analysis. Trend analysis were also conducted.</p><p><strong>Results: </strong>Out of the overall sample, 92.8% (n = 7,292) were non-smokers, while 7.2% (n = 569) were smokers. The multi-level logistic regression analysis showed pregnant individuals aged 18-24 had 1.06 times higher odds of smoking compared to those over 35 (95% CI [1.02-1.10]). Those with a college education or higher had significantly reduced odds (OR: 0.10, 95% CI [0.10, 0.10]), as did racially minoritized individuals (OR: 0.59, 95% CI [0.51-0.68]) and Hispanic individuals (OR: 0.14, 95% CI [0.09-0.21]). Living in rural areas was associated with a 26% higher likelihood of smoking during pregnancy compared to urban areas (OR: 1.26, 95% CI [1.21-1.31]), while residing in Appalachian regions led to a 25% higher probability of smoking. Additionally, lower SES quintiles were linked to higher odds of smoking, with the lowest quintile at OR: 2.10 (95% CI [1.67-2.65]) and the second quintile at OR: 1.64 (95% CI [1.53-1.76]) as compared with the most affluent quintile. Trend analsysis shows smoking has declined across all quintiles, but a substantial gap persists between lowest and highest SES regions.</p><p><strong>Conclusions: </strong>Smoking rates during pregnancy have dropped overall but remain alarmingly high in specific rural and Appalachian areas. As smoking during pregnancy poses significant health risks, targeted interventions and resources for tobacco cessation programs are needed in these highly vulnerable regions.</p><p><strong>Trial registration: </strong>Not Applicable.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"828"},"PeriodicalIF":2.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862891","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}