BMC Pregnancy and Childbirth最新文献

{"title":"\"Is she pregnant with Jesus?\" exploring sociocultural obstacles to following medical advice in the context of stillbirth prevention in Nigeria.","authors":"Uchenna Gwacham-Anisiobi, Adetola Oladimeji, Victoria Yesufu, Jennifer J Kurinczuk, Manisha Nair, Jenny McLeish","doi":"10.1186/s12884-025-07646-5","DOIUrl":"10.1186/s12884-025-07646-5","url":null,"abstract":"<p><strong>Background: </strong>Each year 182,000 babies are stillborn in Nigeria, representing nearly 10% of the annual global stillbirth burden. Imo state in south-eastern Nigeria has one of the highest levels of maternal health service access in Nigeria, yet this has not translated into good pregnancy outcomes. Many stillbirth prevention initiatives in Nigeria focus on maternal health education but empirical evidence suggests that sociocultural factors impact healthcare choices and outcomes. This study aims to explore women's and health workers' perspectives of the sociocultural barriers to following medical advice during pregnancy and childbirth, and specifically how these barriers may contribute to an increased risk of stillbirth. This study is part of a broader community-based stillbirth prevention mixed-methods research in Imo State, Nigeria.</p><p><strong>Methods: </strong>A qualitative descriptive study was conducted using in-depth interviews and focus group discussions. 38 participants were purposively recruited; 20 women and 18 health workers. Audio recordings were transcribed, translated and analysed using inductive thematic analysis.</p><p><strong>Results: </strong>Four themes were identified: (1) trust, where scepticism about health worker motives or competence and trust in community informal networks were highlighted (2) power dynamics within families, with husbands and older female relatives influencing health decisions; (3) personal and community beliefs that undermine confidence in medical interventions, including a pervasive stigma associated with caesarean section; and (4) grassroots proposals for solutions, emphasising the importance of a whole-community approach to maternal health education, mobilising peer voices, engaging traditional leaders and training of traditional birth attendants.</p><p><strong>Conclusion: </strong>This study provides insights into the sociocultural barriers to following medical advice during pregnancy in Nigeria, which include a lack of trust in health professionals, power dynamics within a woman's family, and entrenched cultural and religious beliefs that oppose medical intervention. Women's decisions about pregnancy and childbirth are heavily influenced by family and cultural norms. Culturally sensitive, community-wide interventions which aim to rebuild trust in the health system, involve women as decision-makers in antenatal care, and engage religious and traditional leaders would be beneficial for improving outcomes.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"593"},"PeriodicalIF":2.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric properties of the questionnaire for assessing the childbirth experience in a Chinese sample of postpartum women.","authors":"Xiaoying Zhong, Linqian He, Xinru Liu, Bangjun Wang, Xixi Li, Changqing Pan, Lin Peng","doi":"10.1186/s12884-025-07659-0","DOIUrl":"10.1186/s12884-025-07659-0","url":null,"abstract":"<p><strong>Background: </strong>The objective of this paper was to test the psychometric properties of the questionnaire for assessing the childbirth experience (QACE) among Chinese postpartum women.</p><p><strong>Methods: </strong>Research instruments included the demographic characteristics form, the QACE, the Edinburgh Postnatal Depression Scale (EPDS), and the Generalized Anxiety Disorder-7 (GAD-7). The item analysis, confirmatory factor analysis (CFA), known-groups discriminant validity, divergent validity, and internal consistency reliability were assessed for the psychometric properties of QACE.</p><p><strong>Results: </strong>A total of 235 postpartum women were recruited in this study. Item analysis showed that the critical ratios of all items were greater than 3, and all item-total correlation coefficients were greater than 0.4. The fit indices showed that the original correlated four-factor model of QACE was adequate. In terms of the divergent validity, the QACE subscale and total score were in a significant positive correlation with the EPDS and GAD-7. Regarding reliability, the Cronbach's alpha of the QACE was 0.812, ranging from 0.611 to 0.844 for total scale and sub-scales, respectively.</p><p><strong>Conclusions: </strong>The QACE is a valid and reliable tool for measuring childbirth experience among Chinese women sample of postpartum women.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"592"},"PeriodicalIF":2.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109609","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 maternal hypothyroidism on fetal thyroid gland: a prospective observational study.","authors":"Xinyuan Feng, Huijie Sun, Tianci Liu, Liang Li","doi":"10.1186/s12884-025-07714-w","DOIUrl":"10.1186/s12884-025-07714-w","url":null,"abstract":"<p><strong>Background: </strong>Maternal hypothyroidism has been associated with impaired offspring neurodevelopment but the underlying mechanisms are unclear now. We hypothesize that maternal hypothyroidism influences the development of fetal hypothalamic-pituitary-thyroid (HPT) axis, and thereby indirectly affects postnatal cognitive development.</p><p><strong>Methods: </strong>This prospective observational study included singleton pregnancies with hypothyroidism before 14 weeks of gestation. Ultrasound measurements of fetal thyroid size were performed at 20-24 and 28-32 weeks. The primary outcome was fetal thyroid volumes at two time points; and the secondary outcomes were pregnancy and neonatal outcomes, including birthweight, delivery weeks, preterm birth, stillbirth or miscarriage, and neonatal thyroid functions on the third postnatal day.</p><p><strong>Results: </strong>A total of 136 women participated in this study, comprising 68 with hypothyroidism and 68 with uncomplicated pregnancies. There was no significant difference between the hypothyroidism and control group of fetal thyroid volumes measured at gestation of 20-24 weeks (230.58 ± 63.75mm3 vs. 230.15 ± 75.69mm3, P = 0.98) and 28-32 weeks (491.55 ± 154.88mm3 vs. 450.16 ± 136.13mm3, P = 0.059). Additionally, the incidence of adverse events was also similar between groups. These findings remained unchanged after adjusting for confounding factors.</p><p><strong>Conclusions: </strong>The results of this study suggest that maternal hypothyroidism may not significantly influence the fetal HPT axis. However, it is important to emphasize that this conclusion is based solely on data from mothers with well-controlled hypothyroidism. Moreover, the small prevalence of overt clinical hypothyroidism should be considered when interpreting this finding.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"594"},"PeriodicalIF":2.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109583","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":"Prevalence and risk factors of intestinal parasitic infections in pregnancy: a cross-sectional study in a rural district in Ghana.","authors":"John Gameli Deku, Faustina Adu Ofosua, Godsway Edem Kpene, Israel Bedzina, Kenneth Ablordey, Florence Shine Edziah, Arnold Togiwe Luuse, Enoch Aninagyei","doi":"10.1186/s12884-025-07720-y","DOIUrl":"10.1186/s12884-025-07720-y","url":null,"abstract":"<p><strong>Background: </strong>Intestinal parasitic infection is a common public health problem in developing countries. The disease caused by these infections affects millions of pregnant women worldwide, and may lead to adverse maternal and foetal outcomes. This study aimed to determine the burden of intestinal parasitic infections and the associated risk factors among pregnant women attending Pentecost Hospital in the Upper Denkyira West District of Ghana.</p><p><strong>Methods: </strong>A hospital-based cross-sectional study was conducted at Pentecost Hospital in the Upper Denkyira West district in the Central region of Ghana. Pregnant women were recruited from June to October 2021. Questionnaires were administered to the participants to obtain socio-demographic, behavioural, and obstetrics characteristics. Non-repetitive fresh stool samples were produced by the participants and processed for parasite detection by direct wet mount, formol-ether concentration, and Ziehl-Neelsen staining technique.</p><p><strong>Results: </strong>Two hundred and seven pregnant women were enrolled. Most (61.8%) of them were between 20 and 29 years. The overall prevalence of intestinal parasitosis was 19.3% (95% CI: 14.2-25.3). Eight different parasitic species were identified, among which hookworm (4.8%) was the majority, and identified by both direct wet mount (4.8%) and formol-ether concentration (3.4%) methods. Pregnant women who have experienced a pregnancy loss had 2.912 times increased odds of parasitic infection compared to those with no record of pregnancy loss [aOR = 2.912, 95% CI: 1.210-7.011; p-value = 0.017].</p><p><strong>Conclusion: </strong>Intestinal parasitic infection was prevalent among pregnant women, with hookworm being the most common parasite. Risk factors included a history of pregnancy loss and handwashing practices. Unexpectedly, women who washed their hands with soap and water had higher infection rates. Public health interventions are essential to mitigate the impact of these infections on maternal and foetal health.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"587"},"PeriodicalIF":2.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101209","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":"Lifestyle interventions addressing cardiometabolic health among Black American women of reproductive age in the U.S. : an integrative review.","authors":"Eyitayo O Owolabi, Kougang Anne Mbe, Stephen L Clancy, Renaisa Anthony, Yuqing Guo","doi":"10.1186/s12884-025-07490-7","DOIUrl":"10.1186/s12884-025-07490-7","url":null,"abstract":"<p><strong>Background: </strong>Cardiometabolic disorders among childbearing women, particularly Black American women, contribute to adverse perinatal outcomes and long-term health consequences. Lifestyle interventions are critical approaches to improve cardiometabolic health.</p><p><strong>Objective: </strong>This integrative review synthesized evidence on lifestyle interventions promoting cardiometabolic health among Black women of childbearing age in the U.S.</p><p><strong>Methods: </strong>A comprehensive search strategy was developed and applied across PubMed, CINAHL, the Web of Science Core Collection, and Scopus from the databases' inception through August 2023. Key inclusion criteria were Black American women of childbearing age, lifestyle interventions using an experimental/quasi-experimental design conducted in the U.S., and cardiometabolic, health behavior, or psychosocial outcomes.</p><p><strong>Results: </strong>Thirty-three studies were included, with 29 (87%) using randomized controlled trials. Lifestyle interventions were primarily implemented during pregnancy and/or postpartum periods, only two in pre-pregnancy stage. Health education (i.e. structured/unstructured teaching on various lifestyle content) was the main intervention component. While many studies incorporated digital health technologies, only six leveraged mhealth tools (e.g., mobile health applications, internet-based platforms, social media) as the primary delivery method. Weight change was the most common cardiometabolic outcome, with five out of 13 studies showing significant reductions in gestational weight gain or postpartum weight retention. Of seven studies measuring other cardiometabolic outcomes (e.g., blood glucose), only one showed a significantly decreased incidence of hypertension. Three of 11 studies reported a significant increase in physical activity, and four out of ten showed significant improvement in dietary behaviors. Nine of the 15 studies measuring psychosocial outcomes found significant improvement, with five noting decreased depression. Common weaknesses included recruitment challenges, convenience sampling, small sample sizes, high attrition rates, and short post-intervention follow-up. Some studies adopting digital health technologies reported better retention rates and higher engagement.</p><p><strong>Conclusions: </strong>The results suggest the potential impact of lifestyle interventions on weight reduction, increased physical activity, healthier dietary behaviors, and decreased depression. Future high-quality and powered studies are needed to investigate the efficacy of lifestyle interventions on cardiometabolic outcomes in this population by considering the use of digital health technologies to improve intervention recruitment, engagement and retention, including Black American women of childbearing age representing all socioeconomic levels, and targeting the pre-pregnancy stage.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"590"},"PeriodicalIF":2.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101128","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":"Epidemiological profile of perinatal health among indigenous pregnant people in the Wayamu territory, Brazil.","authors":"Christiano Adson Barbosa Lima, Ragner Borgia Junott, Anisio Pereira da Silva Neto, Maysa Carla Paiva Terasawa, Márcia Jeane do Rego Dias, Lívia de Aguiar Valentim, Adjanny Estela Santos de Souza","doi":"10.1186/s12884-025-07699-6","DOIUrl":"10.1186/s12884-025-07699-6","url":null,"abstract":"<p><strong>Objective: </strong>To describe the epidemiological profile of prenatal care, childbirth, and live births among Indigenous women in the Wayamu Territory, located in the municipality of Oriximiná, Pará, Brazil, from 2013 to 2022.</p><p><strong>Methods: </strong>This is a descriptive, retrospective, and quantitative study based on secondary data from the Live Birth Information System (SINASC), accessed via DATASUS. A total of 713 live births were analyzed. The study included the following variables: maternal age, type of delivery, number of prenatal consultations, place of birth, birth weight, Apgar score at 1 and 5 min, and newborn sex. Low birth weight was defined as < 2,500 g. Statistical analyses included descriptive statistics, Chi-square tests, Pearson correlation, and t-tests, with a significance level of p < 0.05.</p><p><strong>Results: </strong>Most births were vaginal (81.35%), and the majority of mothers were aged 20-29 years (46.84%), followed by adolescents aged 10-19 years (24.96%). A total of 96.77% of Indigenous women attended at least one prenatal consultation, and 39.55% completed seven or more. Low birth weight was observed in 8.84% of newborns. A significant positive correlation was found between the number of prenatal consultations and birth weight (r = 0.789, p = 0.006). A Chi-square test showed that adolescent mothers were proportionally more represented than adult women aged 20-29 years (p < 0.001).</p><p><strong>Conclusion: </strong>The maternal and neonatal outcomes observed among Indigenous women in the Wayamu Territory are similar to national patterns but reveal persistent challenges, including adolescent pregnancy, low prenatal consultation rates, and increasing medicalization of childbirth. These findings highlight the need for expanded public policies focused on culturally sensitive and equitable maternal and child healthcare for Indigenous populations in Brazil.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"589"},"PeriodicalIF":2.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101100","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":"Preterm birth and stillbirth: total bile acid levels in intrahepatic cholestasis of pregnancy and outcomes of twin pregnancies: a retrospective cohort study from 2014 to 2022.","authors":"Yongzhao Zhao, Qianwen Zhang, Yuting Sheng, Man Zhang, Guolin He, Xinghui Liu","doi":"10.1186/s12884-025-07644-7","DOIUrl":"10.1186/s12884-025-07644-7","url":null,"abstract":"<p><strong>Background: </strong>Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disorder characterized by maternal pruritus and elevated serum bile acids. Twin pregnancies, as a type of high-risk pregnancy, present additional complexities when complicated by ICP compared to singleton pregnancies. Our study aims to investigate the relationship between bile acid levels in intrahepatic cholestasis of pregnancy and adverse pregnancy outcomes such as preterm birth and stillbirth in twin pregnancies.</p><p><strong>Methods: </strong>This retrospective single-center cohort study was conducted at the Second Hospital of Sichuan University from January 2014 to July 2022, focusing on twin pregnancies complicated by ICP. Patients were grouped based on peak levels of total bile acids during pregnancy. Differences among these groups in gestational weeks at delivery, preterm birth, fetal growth restriction, fetal distress, stillbirth, premature rupture of membranes, meconium-stained amniotic fluid, and newborn birth weight were observed as pregnancy outcome indicators.</p><p><strong>Results: </strong>In 1156 twin pregnancies complicated by ICP, were 430 cases classified as mild, 392 as moderate-low, 292 as moderate-high, and 42 as severe. Regarding pregnancy outcomes, significant differences were observed among the four groups of pregnant women in terms of gestational weeks at delivery (P < 0.001), rate of preterm birth (P < 0.001), newborn birth weight (P < 0.001), incidence of meconium-stained amniotic fluid (P < 0.001), and proportion of low birth weight infants (P < 0.001).</p><p><strong>Conclusion: </strong>The study results indicate that the severity of intrahepatic cholestasis of pregnancy (ICP) is associated with adverse pregnancy outcomes such as preterm birth, newborn birth weight, and meconium-stained amniotic fluid contamination. Additionally, among different bile acid level groups, gestational weeks at delivery showed varying trends in stillbirth occurrence.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"588"},"PeriodicalIF":2.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101141","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":"Perinatal outcomes and predictors of neonatal mortality in preterm premature rupture of membranes: a tertiary center experience.","authors":"Recep Taha Ağaoğlu, Özge Öztürk, Can Ozan Ulusoy, Figen Günday, Dilara Sarikaya Kurt, Meltem Aksu, Burak Hizli, Kadriye Yakut Yücel","doi":"10.1186/s12884-025-07688-9","DOIUrl":"10.1186/s12884-025-07688-9","url":null,"abstract":"<p><strong>Background: </strong>Preterm premature rupture of membranes (PPROM) is a serious obstetric condition associated with increased maternal, fetal, and neonatal morbidity and mortality. It accounts for approximately one-third of all spontaneous preterm births and is associated with complications such as respiratory distress syndrome (RDS), sepsis, pulmonary hypoplasia, and neonatal mortality. Despite significant advances in prenatal care, proper management, particularly in early gestational age, remains unclear. Identifying factors associated with neonatal mortality in PPROM is important to develop therapeutic interventions and improve perinatal outcomes.</p><p><strong>Methods: </strong>This retrospective study examined clinical data and neonatal outcomes in 183 pregnant women with PPROM between the gestational ages of 23 and 36 + 6 weeks who were admitted to a tertiary referral hospital. The study population was categorized into four gestational age cohorts: Group I (23-27 + 6 weeks), Group II (28-31 + 6 weeks), Group III (32-33 + 6 weeks), and Group IV (34-36 + 6 weeks). Neonatal outcomes, including admission to the neonatal intensive care unit (NICU), the incidence of respiratory distress syndrome, the requirement for oxygen and mechanical ventilation, the necessity for surfactant and inotropic support, sepsis, suspected pulmonary hypoplasia, and early and late neonatal mortality were compared between the groups.</p><p><strong>Results: </strong>Group I had the highest CRP values (18.68 ± 21.34), while Group III had the lowest (6.81 ± 5.16). Significant differences were found between the groups in terms of death at discharge, gestational age at delivery, birth weight, and presence of oligohydramnios. The intubated group had higher CRP levels and lower gestational age and birth weight. Of the 14 neonatal deaths, eight occurred in the early neonatal period, corresponding to a mortality rate of 7.6%. The neonatal mortality rate was 63.2% in Group I. No deaths were recorded in Groups II and III. In Group IV, the mortality rate was 2.2%.</p><p><strong>Conclusion: </strong>Neonatal mortality was associated with low gestational age, low birth weight, and oligohydramnios. The predominant cause of early infant deaths was RDS, whereas late neonatal mortality was primarily attributed to sepsis. Specifically, active management options after 34 weeks of gestational age have demonstrated enhancements in neonatal outcomes, underscoring the significance of tailored clinical approaches in cases of PPROM.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"585"},"PeriodicalIF":2.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092757","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":"Comparison of pregnancy outcomes between induction of labor at 40 weeks and 41 weeks in low-risk women with Singleton pregnancies: a retrospective cohort study.","authors":"Hua He, Wei Ren, Shiyu Li, Chaoli Chen, Wenpei Zheng","doi":"10.1186/s12884-025-07691-0","DOIUrl":"10.1186/s12884-025-07691-0","url":null,"abstract":"<p><strong>Background: </strong>The best timing of delivery for term pregnancies has not been determined. This retrospective cohort study compared pregnancy outcomes between induction of labor (IOL) at 40 weeks and 41 weeks in low-risk women with singleton pregnancies and investigated maternal motivations regarding elective IOL.</p><p><strong>Methods: </strong>A total of 603 pregnant women were included in this study, with 342 (56.7%) undergoing IOL at 40-40^+ 6 weeks and 261 (43.3%) at 41-41^+ 6 weeks. The primary pregnancy outcome was the rate of cesarean section (CS), and the secondary pregnancy outcomes included the rates of neonatal asphyxia and neonatal intensive care unit (NICU) admission. Maternal motivations regarding elective IOL were investigated.</p><p><strong>Results: </strong>The rate of CS was 25.1% in the IOL at 40-40^+ 6 weeks group and 33.7% in the IOL at 41-41^+ 6 weeks group (p = 0.021). The three most prevalent indications for CS in both groups were: (1) non-reassuring fetal heart rate patterns (NRFHRP); (2) meconium-stained amniotic fluid; and (3) failed induction of labor. Compared with the 41-week IOL group, women who underwent IOL at 40 weeks' gestation exhibited higher educational attainment (93.6% vs. 82.0%, P < 0.001), a higher proportion of high-income families (91.5% vs. 68.2%, P < 0.001), a higher proportion of multiparae (24.0% vs. 16.5%, P < 0.05), a lower proportion of ripeness of the cervix (27.5% vs. 37.2%, P < 0.05), shorter hospitalization durations (5.84 ± 1.79 vs. 6.17 ± 1.95, P < 0.05), and higher hospitalization costs (13627.39 ± 3227.56 vs. 10837.77 ± 3276.73, P < 0.001). No significant intergroup differences were observed in the rates of neonatal asphyxia and NICU admission. The most common motivation for elective IOL was concern regarding fetal distress or stillbirth. Parity ≥ 1 and a Bishop score ≥ 6 were protective factors against CS following IOL.</p><p><strong>Conclusions: </strong>IOL at 40 weeks did not result in increased adverse outcomes compared to IOL at 41 weeks. Parturients with higher education and income were more likely to choose elective IOL. Parity ≥ 1 and a Bishop score ≥ 6 were protective factors against CS following IOL. These may provide a new option for clinical decision-making.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"586"},"PeriodicalIF":2.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092749","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 natural history and management of vasa previa: a single institution's 15-year experience managing patients remote from labor and delivery.","authors":"Monica Rincon, Heather Rhodes, Emily Boniface, Leonardo Pereira, Rahul J D'Mello, Sarena Hayer, Amy Hermesch, Raphael C Sun, Roya Sohaey, Andrew H Chon","doi":"10.1186/s12884-025-07708-8","DOIUrl":"10.1186/s12884-025-07708-8","url":null,"abstract":"<p><strong>Introduction: </strong>Vasa previa (VP) is a diagnosis with potential catastrophic obstetric outcomes. We describe the outcomes of VP managed at our institution, which uniquely provides inpatient monitoring on an antepartum unit located remotely from labor and delivery (L&D).</p><p><strong>Methods: </strong>Retrospective study of singleton pregnancies diagnosed with VP at a single institution. VP was diagnosed prenatally by ultrasound if one or more fetal vessels unsupported by underlying placenta were coursing within 2 cm of the internal os. Most cases were admitted for inpatient monitoring; however, patients were counseled that high-quality data were lacking demonstrating superiority of inpatient admission compared to outpatient management. Descriptive analyses were performed to compare outcomes in patients with resolved vs. persistent VP as well outpatient versus inpatient management among those with persistent VP. Results are reported as median (range).</p><p><strong>Results: </strong>Fifty patients were diagnosed with VP at a gestational age of 22.9 weeks (18.0-34.3) with 38 (76.0%) VP persisting until delivery. There was an outpatient group (8, 21.0%) who declined hospital monitoring, and an inpatient group (30, 79.0%). The admission GA for the inpatient group was 31.2 weeks (25.6-34.3) for a duration of 19.5 days (2-52). The majority (70%) of patients required at least one transfer from the antepartum unit to L&D. There was no difference in urgent or emergent cesarean deliveries among patients managed outpatient vs. inpatient [3 (37.5%) vs 13 (43.3%), p = 0.547]. There were no cases of neonatal anemia related to VP or perinatal deaths.</p><p><strong>Conclusion: </strong>Admitting patients with VP to a location separate from the L&D operating rooms was not associated with adverse pregnancy or neonatal outcomes. Monitoring of patients with vasa previa in a location remote from L&D was not associated with worse pregnancy outcomes.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"581"},"PeriodicalIF":2.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092760","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}