BMC Pregnancy and Childbirth最新文献

{"title":"Birth and Regulation of head Extension to Guide Manual perineal Assistance (BREGMA) study: a prospective cohort study.","authors":"Abdelrahman Abouelhassan, Vladimir Kalis, Marc Schüssler, Hassan Awwad, Rania H M Ahmed, Khaled M Ismail","doi":"10.1186/s12884-025-07428-z","DOIUrl":"10.1186/s12884-025-07428-z","url":null,"abstract":"<p><strong>Background: </strong>The exact positioning of the dominant hand at the time of manual perineal protection (MPP) is not clearly specified. The main aim of this work was to identify the place on the perineum where pressure needs to be applied to achieve optimal forward fetal head displacement away from the anal sphincters using the bregma to posterior fourchette distance (BFD) and the perineal body length (PBL).</p><p><strong>Methods: </strong>This was a two-center prospective cohort study. Term cephalic singleton nulliparous women having spontaneous vaginal delivery were considered eligible for recruitment into the study. Once crowning was diagnosed and just prior the initiation of manual perineal protection (MPP) or cutting an episiotomy, the BFD and PBL were measured using a standardized measurement protocol.</p><p><strong>Results and discussion: </strong>A total of 100 women (50 women in each center) were recruited into the study. The overall mean BFD was 2.8 ± 0.5 cm. The overall mean PBL was 4.4 ± 0.8 cm. There were no statistically significant differences between the measurements taken in both units regarding BFD or PBL (p = 0.81 and 0.10 respectively). There was a weak correlation between both measurements. Based on our measured parameters, it seems that the most effective point to apply perineal pressure to displace the head away from the anus is approximately 1 - 1.5 cm anterior to the anal margin.</p><p><strong>Conclusion: </strong>Measurements generated by this study will form the bases of future biomechanical studies to confirm their validity.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"334"},"PeriodicalIF":2.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676692","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":"Measuring responsiveness and respectful treatment in maternity care in sub-Saharan Africa: a questionnaire validation and development of a score.","authors":"Zoë Morris, Soha El Halabi, Claudia Hanson, Bianca Kandeya, Elizabeth Ayebare, Gisele Houngbo, Anastasia Månsson, Fadhlun Alwy Al-Beity, Kristi Sidney Annerstedt","doi":"10.1186/s12884-025-07319-3","DOIUrl":"10.1186/s12884-025-07319-3","url":null,"abstract":"<p><strong>Introduction: </strong>The importance of respectful maternity care on optimal maternal outcomes is increasingly acknowledged globally. However, mistreatment and abuse are still experienced by women during hospital childbirth in many parts of the world, with sub-Saharan Africa being one of the places where it is most common. Interventions aiming to improve respectful maternity care must be able to assess the prevalence of responsiveness and mistreatment women experience. This is usually done with questionnaires, though these are not always validated. Scores to represent the level of responsiveness and mistreatment experienced can be created from questionnaire results and have many uses, though no score is consistently used in this field. A new questionnaire measuring responsiveness and respectful treatment was developed for use in the ALERT project, as a questionnaire covering both of these concepts did not exist. This study aimed to validate this questionnaire and to create a scoring method.</p><p><strong>Methods: </strong>Psychometric analyses, including exploratory and confirmatory factor analysis, were performed on cross-sectional data collected from the ALERT study to identify and confirm underlying factors. Using these factors, simple summation and factor-weighted methods were used to create scores and their results compared.</p><p><strong>Results: </strong>Six factors were identified: \"Communication & supportive care\", \"Hospital environment\", \"Maintained respect & dignity\", \"Social support\", \"Maintained privacy & confidentiality\" and \"Lack of physical & verbal abuse\". The results of the two scoring methods developed were similar.</p><p><strong>Conclusions: </strong>The responsiveness and respectful treatment questionnaire has high validity in the ALERT study population for the six factors identified. The two scoring methods developed are useful for different aspects of the ALERT intervention and can be used to facilitate comparisons or measure progress towards improving respectful maternity care in these settings.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"329"},"PeriodicalIF":2.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676705","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 and its effect on fetal thymus size: a case-control study.","authors":"Nasrin Mansouri, Erfan Khezripour, Niko Rashtiani, Marzieh Bagherinia, Ali Azizi","doi":"10.1186/s12884-025-07468-5","DOIUrl":"10.1186/s12884-025-07468-5","url":null,"abstract":"<p><strong>Introduction: </strong>Fetal thymus size has recently been recognized as a sensitive parameter linked to pregnancy complications. This study investigates whether maternal diabetes affects fetal thymus size, potentially offering a means to identify at-risk fetuses before birth.</p><p><strong>Methods: </strong>This study was designed as a case-control study conducted from September 2023 to November 2024 in Iran. The study samples included 112 diabetic women (gestational diabetes or pre-pregnancy diabetes) as the case group and 112 healthy pregnant women attending the same hospital as the control group. Data were collected using a researcher-designed demographic questionnaire, and fetal thymus size was measured via abdominal ultrasound. Fetal thymus size is calculated using the thymic-thoracic ratio (TTR) and the thymus circumference.</p><p><strong>Results: </strong>A statistically significant difference was observed between the two groups regarding body mass index (BMI), an obstetric and demographic variable. The thymic-thoracic ratio (TTR) and the thymus circumference in diabetic pregnancies were statistically significantly lower than in the control group (p = 0.000). Odds ratios (95% CI) for the TTR index were 0.61 (CI 95%: 0.48 to 0.78), and thymus circumference was 0.95 (CI 95%: 0.93 to 0.97).</p><p><strong>Conclusion: </strong>The present study indicated that a reduction in fetal thymus size may be associated with diabetes in pregnant women. However, it remains to be determined whether ultrasound evaluation of fetal thymus size can help predict perinatal outcomes in diabetic women.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"330"},"PeriodicalIF":2.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676703","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":"Determination of the relationships between hyperemesis gravidarum and systemic inflammation markers: a case‒control study.","authors":"Fikriye Işıl Adıgüzel, Serhat Altınkaya, Sadık Kükrer, Ahmet Zeki Nessar, Gülsüm Uysal, Cevdet Adıgüzel","doi":"10.1186/s12884-025-07399-1","DOIUrl":"10.1186/s12884-025-07399-1","url":null,"abstract":"<p><strong>Background: </strong>We conducted our study to investigate the relationships between hyperemesis gravidarum (HEG) and inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR).</p><p><strong>Materials and methods: </strong>A total of 150 pregnant women diagnosed with HEG and 150 controls were included in our study. The data analysed included demographic variables, complete blood count results, and urinary ketonuria levels.</p><p><strong>Results: </strong>We found that the NLR, PLR and MLR were significantly greater in HEG patients than in controls (p < 0.05), indicating a potential role of systemic inflammation in the pathophysiology of HEG. Receiver operating characteristic (ROC) analysis revealed that these markers had moderate discriminative power, suggesting their utility as adjunctive diagnostic tools in clinical settings. However, no correlation was found between inflammatory markers and the severity of ketonuria.</p><p><strong>Conclusions: </strong>The NLR, PLR and MLR can be used as indicators of HEG as a result of the inflammatory process in pregnant women with HEG.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"331"},"PeriodicalIF":2.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676695","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":"Racial/ethnic disparities in the association of maternal diabetes and obesity with risk of preterm birth among 17 million mother-infant pairs in the United States: a population-based cohort study.","authors":"Juan Xie, Yuxiang Yan, Ziyi Ye, Yuxiao Wu, Yongfu Yu, Yangbo Sun, Shuang Rong, Donna A Santillan, Kelli Ryckman, Linda G Snetselaar, Buyun Liu, Wei Bao","doi":"10.1186/s12884-025-07352-2","DOIUrl":"10.1186/s12884-025-07352-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The racial/ethnic disparities in the prevalence of obesity, diabetes, and adverse birth outcomes such as preterm delivery indicate that it is essential to account for the varying risks associated with pregnant women of different races and ethnics during clinical prenatal examinations. However, the racial and ethnic disparities in how pre-pregnancy diabetes in mothers relates to preterm birth as well as the combined association of maternal diabetes and pre-pregnancy obesity with preterm birth remain unclear. In this study, we aimed to 1) examine the racial/ethnic disparities in the association of maternal diabetes including gestational diabetes mellitus (GDM) and pre-pregnancy diabetes with preterm birth 2) and the racial/ethnic disparities in the joint associations of maternal diabetes and pre-pregnancy obesity with preterm birth.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this population-based cohort study, we included 17,027,792 mothers documented in the National Vital Statistic System in the U.S. from 2016 to 2020. All these data were analyzed in 2021. Maternal pre-pregnancy diabetes was defined as having diabetes diagnosed prior to this pregnancy, and GDM was defined as having newly diagnosed diabetes in this pregnancy. Pre-pregnancy BMI (kg/m&lt;sup&gt;2&lt;/sup&gt;) was classified as underweight (&lt; 18.5 kg/ m&lt;sup&gt;2&lt;/sup&gt;), normal weight (18.5-24.9 kg/m&lt;sup&gt;2&lt;/sup&gt;), overweight (25.0-29.9 kg/m&lt;sup&gt;2&lt;/sup&gt;), obesity class I (30.0-34.9 kg/m&lt;sup&gt;2&lt;/sup&gt;), obesity class II (35.0-39.9 kg/m&lt;sup&gt;2&lt;/sup&gt;), and obesity class III (≥ 40 kg/m&lt;sup&gt;2&lt;/sup&gt;). Preterm birth, defined as delivery occurring at less than 37 weeks of gestation, was the main outcome of interest. We further categorized preterm birth into three subtypes: extremely (&lt; 28 weeks), very (28-31 weeks), and moderately (32-36 weeks) preterm birth. Logistic regression models were used for association analyses in this study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 17,027,792 mothers (mean age: 29.4 ± 5.4 years), 1,374,286 (8.07%) mothers delivered a preterm infant. Women with pre-pregnancy diabetes had the highest risk of preterm birth followed by women with GDM overall and across all racial/ ethnic groups. However, from pre-pregnancy underweight to obesity III, the magnitude of the association between pre-pregnancy diabetes and preterm birth decreased for non-Hispanic Black women (underweight, 4.47 [3.34-5.99], normal weight 4.28 [3.98-4.60], overweight 3.29 [3.11-3.49], obesity I 3.09 [2.93-3.26], obesity II 2.98 [2.82-3.16], obesity III 3.19 [3.04-3.35]), while it showed an increasing trend for non-Hispanic Asians ( underweight 1.45 [0.91-2.30], normal weight 2.16 [1.90-2.47], overweight 2.71 [2.47-2.97], obesity I 3.10 [2.82-3.41], obesity II 3.58 [3.13-4.09], obesity III 3.99 [3.34-4.77]). The corresponding OR was (underweight 4.33 [3.21-5.83], normal weight 3.69 [3.47-3.93], overweight 3.26 [3.10-3.42], obesity I 3.33 [3.19-3.49], obesity II 3.47 [3.29-3.65], obesity III 3.8","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"333"},"PeriodicalIF":2.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676667","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":"Lethal acantholytic epidermolysis bullosa- a report on the prenatal phenotype of two cases and a review of antenatal sonographic signs of congenital denuding skin diseases.","authors":"Maya Lehavi, Hagit Daum, Nuphar Hacohen, Michal Gur, Jonathan Rips, Somaya Salah, Noa Ofek-Shlomai, Shay Porat","doi":"10.1186/s12884-025-07380-y","DOIUrl":"10.1186/s12884-025-07380-y","url":null,"abstract":"<p><strong>Background: </strong>The DSP gene encodes the desmosomal protein desmoplakin and is located on chromosome 6. Pathogenic variants in this gene have been linked to different phenotypes that may include the skin, hair, nails, teeth, and the heart. Lethal acantholytic epidermolysis bullosa (LAEB, OMIM # 609638) is a severe and lethal form of epidermolysis bullosa, caused by biallelic pathogenic variants in the DSP gene.</p><p><strong>Case presentation: </strong>This report describes two fetuses from the same family, both affected by LAEB. The parents were second degree cousins. Both fetuses showed multiple sonographic abnormalities antenatally. The first fetus had a lemon shaped skull, an abnormal profile with frontal bossing, flat nasal bridge, nasal hypoplasia and micrognathia. There was increased pericardial fluid, situs ambiguous (left stomach with dextrocardia) and hypoplastic aortic arch. The kidneys were suspected as dysplastic and indeed there was also oligohydramnios. Echogenic sediment was noted in the fetal stomach. The fetus was small for gestational age (SGA) with an estimated fetal weight (EFW) under the 3rd percentile. The second fetus exhibited a novel sonographic sign - constantly open eyelids. Additional notable sonographic signs were echogenic amniotic fluid, and an abnormal profile comprising of flat nasal bridge, hypoplastic nose and micrognathia. Furthermore, hypospadias was suspected as well as abnormal scrotum. The scan revealed echogenic sediment in stomach and SGA fetus with EFW under 3rd percentile similarly to the previous pregnancy. After delivery severe extensive skin and mucosal erosion and sloughing were evident and the neonate succumbed at day 2 of life. Extensive genetic workup diagnosed LAEB in both children.</p><p><strong>Discussion and conclusions: </strong>This is the first report to describe the antenatal sonographic phenotype of LAEB. We discuss the diverse phenotypes of DSP gene pathogenic variants and review the specific biochemical and sonographic findings in the context of congenital skin denudation diseases.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"327"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668918","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":"Iodine nutritional status in different trimesters of pregnancy and its association with dietary habits: a prospective observational study in Taiwan.","authors":"Li-Hsin Pan, Chang-Ching Yeh, Shun-Jie Yang, Chen-Chang Yang, Chii-Min Hwu, Harn-Shen Chen, Fan-Fen Wang, Chun-Jui Huang","doi":"10.1186/s12884-025-07445-y","DOIUrl":"10.1186/s12884-025-07445-y","url":null,"abstract":"<p><strong>Background: </strong>Pregnant women are susceptible to iodine deficiency. Most iodine nutritional studies in pregnant women have involved cross-sectional evaluations of iodine status. This prospective observational study was designed to longitudinally follow the iodine status of pregnant women in different trimesters of pregnancy and to assess the demographic characteristics and dietary influences on iodine status.</p><p><strong>Methods: </strong>A prospective cohort study was conducted at Taipei Veterans General Hospital from March 2019 to July 2022. A total of 211 women were enrolled and each subject was asked to provide a spot urine sample at each trimester. Urinary iodine concentration (UIC) was measured using inductively coupled plasma-mass spectrometry. Dietary habit was assessed via food frequency questionnaires (FFQs) at each trimester.</p><p><strong>Results: </strong>The median UICs for the first, second and third trimesters were 156.3 µg/L (interquartile range [IQR]: 100.7-241.1), 146.2 µg/L (84.6-224.4), and 169.9 µg/L (94.4-283.5), respectively. Compared to the first trimester, participants consumed seaweed (p = 0.004 and p < 0.001, respectively), fish (p < 0.001 for both), and prenatal multivitamins (p < 0.001 for both) more frequently during the second and third trimesters. Additionally, an increasing number of women raised their intake of dairy products as their pregnancies progressed. Multivariate analysis indicated a positive association between nulliparity and UIC < 150 µg/L (adjusted odds ratio [OR]: 2.258, 95% confidence interval [CI]: 1.167-4.367, p = 0.02). Additionally, less prenatal iodine-containing multivitamin intake increased the odds of UIC < 150 µg/L across all trimesters (adjusted OR: 2.562, 95% CI: 1.234-5.319; p = 0.01 for the first trimester; adjusted OR: 2.264, 95% CI: 1.167-4.395; p = 0.02 for the second trimester; and adjusted OR: 2.022, 95% CI: 1.031-3.967; p = 0.04 for the third trimester).</p><p><strong>Conclusions: </strong>Mild iodine deficiency was observed in the second trimester despite adequate iodine status in the first and third trimesters. Nulliparous women and those not ingesting iodine-containing multivitamins are at greater risk of iodine deficiency, highlighting the need for targeted dietary education and interventions.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"323"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668977","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":"Anemia in pregnant women: findings from Kuwait birth cohort study.","authors":"Abdullah Al-Taiar, Ali H Ziyab, Majeda S Hammoud, Reem Al-Sabah, Saeed Akhtar","doi":"10.1186/s12884-025-07439-w","DOIUrl":"10.1186/s12884-025-07439-w","url":null,"abstract":"<p><strong>Background: </strong>Anemia is the most common hematologic disorder in pregnancy, affecting over one-third of pregnant women globally. This study aimed to assess the prevalence of anemia in pregnant women and its associated factors in the Kuwait Birth Cohort study.</p><p><strong>Methods: </strong>The Kuwait birth cohort (n = 1,108) was a prospective study in which pregnant women were recruited during their second or third trimester. Data were collected through personal interviews during antenatal care visits, including data on sociodemographic and lifestyle factors. Blood samples were analyzed under strict quality control to measure various laboratory indicators. Anemia was defined as hemoglobin (Hb) < 110 g/L. Predictors of anemia were categorized as underlying or direct factors, and logistic regression models were used to investigate their association with anemia.</p><p><strong>Results: </strong>The prevalence of anemia was 28.16% (95% CI:25.53-30.91%), with 8.75% of women experiencing moderate anemia and 19.40% mild anemia. No cases of severe anemia were observed. Multivariable analysis identified current iron supplement use, (Adjusted Odds Ratio [AOR] 0.52, 95%CI:0.28-0.99; p = 0.049), vitamin D status (sufficient vs. insufficient/deficient), (AOR 0.63, 95%CI:0.43-0.92; p = 0.018), iron levels (p < 0.001), and ferritin levels (p < 0.001) as factors significantly associated with anemia.</p><p><strong>Conclusion: </strong>Anemia in pregnant women in Kuwait represents a mild to moderate public health concern, primarily driven by iron deficiency. The estimated prevalence of anemia is influenced by the Hb threshold used to define anemia, a topic currently subject to vigorous debate. Our findings suggest that improved screening for iron deficiency during pregnancy may further reduce anemia in pregnant women in Kuwait.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"326"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668947","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":"A machine learning model based on placental magnetic resonance imaging and clinical factors to predict fetal growth restriction.","authors":"Jida Wang, Zhuying Chen, Hongxi Zhang, Weikang Li, Kui Li, Meixiang Deng, Yu Zou","doi":"10.1186/s12884-025-07450-1","DOIUrl":"10.1186/s12884-025-07450-1","url":null,"abstract":"<p><strong>Objectives: </strong>To create a placental radiomics-clinical machine learning model to predict FGR.</p><p><strong>Materials and methods: </strong>Retrospectively analyzed placental MRI and clinical data of 110 FGR cases and 158 healthy controls at 28-37 weeks of gestation from two campuses of ZWH. 227 cases from Hubin campus were randomly divided into training (n = 182) and internal testing set (n = 45). 41 cases from Xiaoshan campus were included in external testing set. Placental MRI features were extracted from sagittal T2WI. Mann-Whitney U test, redundancy analysis, and LASSO were used to identify the radiomics signature, and the best-performing radiomics model was constructed by comparing eight machine learning algorithms. Clinical factors determined by univariate and multivariate analyses. A united model and nomogram combining the radiomics Rad-score and clinical factors were established. The performance of the models was assessed by DeLong test, calibration curve and decision curve analysis.</p><p><strong>Results: </strong>Of 1561 radiomics features, 10 strongly correlated with FGR were selected. The radiomics model using logistic regression performed best compared eight algorithms. 5 important clinical features identified by analysis. The united model demonstrated a good predictive performance in the training, internal testing and external testing sets, with AUC 0.941 (95% CI, 0.0.904-0.977), 0.899 (95% CI, 0.789-1) and 0.861 (95% CI 0.725-0.998), prediction accuracies 0.885, 0.844 and 0.805, precisions 0.871, 0.789 and 0.867, recalls 0.836, 0.833 and 0.684, and F1 scores 0.853, 0.811 and 0.765, respectively. The calibration and decision curves of the united model also showed good performance. Nomogram confirmed clinical applicability of the model.</p><p><strong>Conclusions: </strong>The proposed placental radiomics-clinical machine learning model is simple yet effective to predict FGR.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"325"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668932","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 correlation between serum fructose levels and pregnancy outcomes in IVF patients with and without PCOS: a case-control study.","authors":"Bowen Zhang, Yunfei Li, Yuxuan Li, Jiahui Song, Yuanyuan Fang, Zhijing Na, Da Li","doi":"10.1186/s12884-025-07415-4","DOIUrl":"10.1186/s12884-025-07415-4","url":null,"abstract":"<p><strong>Background: </strong>Excessive fructose intake can impact pregnancy health. Additionally, Polycystic ovary syndrome (PCOS) is associated with both elevated fructose levels and adverse pregnancy outcomes. Therefore, it is significant to investigate whether serum fructose levels influence pregnancy outcomes in patients with or without PCOS.</p><p><strong>Methods: </strong>This case-control study included 270 participants (PCOS, n = 135; non-PCOS, n = 135). The serum fructose levels of consecutively treated women undergoing in vitro fertilization - embryo transfer treatment at the Center of reproductive medicine in Shengjing hospital of China Medical University, from June 2020 to June 2021, were measured. Pregnancies were monitored until the ultimate outcome was determined. The antenatal, delivery, and neonatal outcomes were extracted from hospital records.</p><p><strong>Results: </strong>In patients with PCOS, those who experienced miscarriage had significantly higher serum fructose levels (P = 0.011). The incidence of miscarriage increased as the serum fructose quartiles increased in patients with PCOS (P = 0.010). There was a significant correlation between serum fructose levels and miscarriage (r = 0.258, P = 0.002). The results of multivariate logistic regression analysis remain consistent (odd ratio [OR] = 10.138, P = 0.005). Conversely, in women without PCOS, those who prematurely delivered had significantly higher serum fructose levels (P = 0.001). The incidence of preterm delivery increased as the serum fructose quartiles increased in patients without PCOS (P < 0.001). There was a significant correlation between serum fructose levels and preterm delivery (r = 0.311, P < 0.001) in non-PCOS group. The multivariate logistic regression analysis indicated the identical results (OR = 18.359, P = 0.008). The area under the curve for fructose-mediated prediction of miscarriage in PCOS was 0.686, while for prediction of preterm birth in non-PCOS individuals, the area under the curve was 0.731.</p><p><strong>Conclusions: </strong>Serum fructose levels are positively associated with miscarriage risk in patients with PCOS. Within the non-PCOS cohort, fructose levels are linked to preterm birth. Further investigation is warranted to comprehensively elucidate the underlying mechanisms, thus enhancing our profound understanding.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"324"},"PeriodicalIF":2.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668992","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}