J. Matern. Fetal. Neonatal. Med. [JOURNAL]
Sun
200 papers
Perceptual distortions during simultaneous continuous monitoring of fetal and maternal heart rate in laboring patients.
Ploran EJ, Comfort L, Rausch A … +2 more , Snellings JT, Rochelson B
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41549988 · Publisher ↗
OBJECTIVE: Our previous work examined the effect on assessment of fetal well-being when presenting twin fetal heart rate tracings (FHRT) simultaneously on screen. To further examine the potential impact of subconscious p...
OBJECTIVE: Our previous work examined the effect on assessment of fetal well-being when presenting twin fetal heart rate tracings (FHRT) simultaneously on screen. To further examine the potential impact of subconscious perceptual influences on fetal well-being, the current study presented singleton FHRT with and without simultaneous presentation of maternal heart rate in a within-subjects design. Tracings were taken from archival cases with either normal or abnormal Apgar scores to identify differential impact depending on final outcome. All tracings were evaluated for variability, accelerations, decelerations, and overall concern. STUDY DESIGN: Obstetrical medical professionals (nurses, physician assistants, and physicians; = 32) assessed FHRTs from 20 singleton gestations that resulted in live births (half with normal Apgar scores (control group), half with a 5-minute Apgar < 7 (at-risk group)) presented either alone or with maternal heart rate on the same tracing. Nurses were naïve to the fact that the fetal heart rate tracings presented in the unpaired condition were the same as those presented in the paired condition. Within-subjects assessments were then compared between the two conditions. RESULTS: Each nurse participant completed ratings on four metrics for each of 20 singleton gestations across two conditions, plus rated three tracings per condition again to determine test-retest reliability within each condition (52 FHRT assessments, 208 metrics total per participant). The intraobserver impact of visual context was calculated as the frequency of changed opinions regarding an individual metric (e.g. variability) between the paired and unpaired contexts for control versus at-risk FHRT. Participants demonstrated substantial self-agreement when assessing variability, accelerations, and decelerations for control FHRT, but only moderate agreement for the same metrics when assessing at-risk FHRT. In addition, assessment of level of concern demonstrated moderate intraobserver agreement for control FHRT but lowered to only slight agreement for at-risk FHRT. CONCLUSIONS: The simultaneous presentation of fetal heart rate tracings with maternal heart rate tracings introduces both intraobserver and interobserver variances in interpretation of decelerations and overall level of concern, particularly for at-risk FHRT. These changes in interpretation are likely due to the influence of subconscious perceptual decision-making and additional cognitive load in separating multiple streams of information. This may theoretically affect outcomes in cases in which visual information is nuanced. Medical professionals may want to exercise caution when adding more than one tracing to the visual array, as it may affect decision-making.
Elective cesarean preserves maternal-fetal redox homeostasis, whereas emergency cesarean disrupts it: a prospective observational study.
Karakelleoğlu G, Arslan G, Kırımlı Yanık ECN
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41549977 · Publisher ↗
INTRODUCTION: Oxidative stress is a key component of maternal-fetal physiology and varies with the mode of delivery. Labor induces hypoxia-reoxygenation cycles that elevate reactive oxygen species, whereas elective cesar...
INTRODUCTION: Oxidative stress is a key component of maternal-fetal physiology and varies with the mode of delivery. Labor induces hypoxia-reoxygenation cycles that elevate reactive oxygen species, whereas elective cesarean section (CS) occurs in a controlled metabolic environment. Emergency CS combines labor-related hypoxia with acute surgical stress. Comprehensive comparisons of maternal and cord oxidative profiles across all delivery modes remain limited. METHODS: This prospective observational study included 126 term singleton pregnancies categorized as elective CS ( = 46), emergency CS ( = 39), or vaginal delivery ( = 41). Maternal blood was collected immediately before delivery and cord blood after birth. Total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), and paraoxonase-1 (PON-1) activity were measured using automated RelAssay methods; OSI was calculated as (TOS/TAS)×100. Neonatal outcomes included Apgar scores and NICU admission. Group comparisons used ANOVA, Kruskal-Wallis, and chi-square tests, with ANCOVA adjusting for gestational age, maternal weight, diabetes, hypothyroidism, preeclampsia, and ASA use. RESULTS: Baseline characteristics were comparable. Emergency CS had lower Apgar-1 scores and higher NICU admission. Maternal OSI ( = 0.002) and PON-1 ( = 0.004) differed significantly, with elective CS showing the most favorable profile. Cord TOS ( < 0.001), OSI ( < 0.001), and PON-1 ( = 0.001) were also highest in emergency CS. Delivery mode independently predicted maternal OSI and PON-1, and cord TOS, OSI, and PON-1 (all < 0.01). DISCUSSION: The pronounced oxidative shifts observed in emergency CS likely reflect the cumulative impact of prolonged labor, fetal distress, and abrupt surgical intervention. Elective CS, by avoiding labor-induced hypoxia and metabolic exhaustion, preserves a more balanced maternal-fetal redox environment. The parallel maternal and cord responses underscore the sensitivity of the fetoplacental unit to intrapartum oxidative changes. These findings clarify mechanistic differences between delivery modes and highlight redox status as a potential peripartum biomarker. CONCLUSION: Elective CS preserves maternal-fetal redox homeostasis, whereas emergency CS results in significant oxidative disruption and poorer neonatal adaptation. These findings support the potential use of oxidative stress markers as adjunct indicators of acute intrapartum stress when interpreted alongside established clinical parameters.
Vaccine acceptance in gravid patients in the COVID-19 era.
Schreiber-Gonzalez S, Snead K, Phelps AJ … +3 more , Hakimian D, Harrison R, Holmgren C
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41549971 · Publisher ↗
OBJECTIVE: To describe risk factors for declining antepartum vaccination, including the novel COVID-19 vaccine during the COVID-19 pandemic. METHODS: Retrospective cohort study including women delivering at a single cent...
OBJECTIVE: To describe risk factors for declining antepartum vaccination, including the novel COVID-19 vaccine during the COVID-19 pandemic. METHODS: Retrospective cohort study including women delivering at a single center in the fall and winter of 2021. Patients without vaccine data were excluded. Baseline characteristics collected from the electronic medical record included maternal age, nulliparity, body mass index, insurance, and self-identified race/ethnicity. Those who accepted the COVID-19 vaccine were compared to those who declined. Separate comparisons were done to assess those who accepted and those who declined influenza and tetanus, diphtheria, pertussis (Tdap) vaccines as well. Statistical analysis was performed using Student's t-test, Fisher's exact test, chi square, and logistic regression. The regression model assessed the impact of patient characteristics on vaccine acceptance and was adjusted for age, nulliparity, body mass index, insurance, and race/ethnicity. RESULTS: Vaccine data was available for 772 patients. The rate of acceptance was 46.1% for COVID-19 vaccine, 58.0% for influenza vaccine, and 80.8% for Tdap vaccine. Those who accepted the COVID-19 vaccine were older (34.3 ± 3.8 years vs 33.0 ± 4.8 years, < 0.001) and more frequently nulliparous (8.7% vs 2.9%, < 0.001) than those declining it. Those accepting Tdap were also older (33.8 ± 4.3 vs 32.7 ± 4.9 years, = 0.006). Insurance type differed across groups for all three vaccines ( < 0.001). Race differed between acceptance and refusal of the influenza and Tdap vaccines, but not the COVID-19 group. In the adjusted analysis, public insurance remained independently associated with reduced acceptance for COVID-19 (aOR 0.28, 95% CI 0.14-0.55) and influenza (aOR 0.38, 95% CI 0.20-0.73), but not for Tdap. Older age and nulliparity were independently associated with increased acceptance of COVID-19. CONCLUSION: Public insurance in pregnancy is associated with a decreased likelihood of vaccine acceptance for the COVID-19 and influenza vaccines. Specific efforts for understanding the motivations for declining vaccination are needed to develop strategies to improve uptake in this population.
Fetal hemoglobin fraction is correlated to the risk of prematurity complications.
Dani C, Remaschi G, Ulivi M … +2 more , Monti N, Pratesi S
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41549966 · Publisher ↗
BACKGROUND: Fetal hemoglobin (HbF) plays a critical role in the progressive adaptation to the postnatal oxygen-rich environment in preterm infants due to its peculiar properties and its postnatal decrease has been associ...
BACKGROUND: Fetal hemoglobin (HbF) plays a critical role in the progressive adaptation to the postnatal oxygen-rich environment in preterm infants due to its peculiar properties and its postnatal decrease has been associated to the combined adverse effects of increasing tissue hyperoxia and decreasing antioxidant defenses in preterm infants. PURPOSE: We aimed to assess the association between HbF fractions and the risk of bronchopulmonary dysplasia (BPD) intraventricular hemorrhage (IVH), and retinopathy of prematurity (ROP). METHODS: We studied 166 preterm infants with a gestational age of 27.1 ± 1.6 weeks. One hundred and twenty-six infants (74%) had no or mild BPD, and 40 (24%) moderate to severe BPD. One hundred and forty-three infants (86%) had no or grade 1 IVH, and 23 (14%) grade 2-4 IVH. One hundred and thirty (80%) had no ROP, and 32 (20%) had any grade ROP. HbF fractions were recorded during the first seven days of life, at 14, 21, and 28 days of life, and 31, 34, and 36 weeks of postmenstrual age. Mean values during the first week of life (HbF) and at 31, 34, and 36 weeks (HbF) were calculated. RESULTS: Logistic regression analysis showed that: HbF decreased the risk of moderate to severe BPD (OR 0.944, 95% CI 0.911-0.977; = 0.001); female sex (OR 0.278, 95% CI 0.093-0.832; = 0.022) and HbF (OR 0.949, 95% CI 0.901-0.999; = 0.048) decreased the risk of grade 2-4 IVH; and HbF (OR 0.958, 95% Cl 0.919-0.998; = 0.042) and HbF (OR 0.956, 95% CI 0.927-0.986; = 0.004) decreased the risk of any grade ROP. CONCLUSION: Low HbF fractions were associated with increased risk of moderate-to severe BPD, grade 2-4 IVH, and any grade ROP. These results confirm previous findings and support the importance of minimizing blood sampling from these fragile patients.
Predictive value of serum IGFBP-3 and transvaginal cervical length measurement for spontaneous preterm birth in singleton pregnancies: a prospective study.
Mhernchan S, Phupong V
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41543242 · Publisher ↗
OBJECTIVE: To determine the predictive value of serum IGFBP-3 in combination with transvaginal ultrasonography cervical length in singleton pregnancies during the 18-23 weeks' gestational period for the prediction of pre...
OBJECTIVE: To determine the predictive value of serum IGFBP-3 in combination with transvaginal ultrasonography cervical length in singleton pregnancies during the 18-23 weeks' gestational period for the prediction of preterm birth. METHODS: This prospective observational study included singleton pregnant women who received antenatal care at King Chulalongkorn Memorial Hospital at 18-23 weeks' gestation between December 2022 and April 2024. Cervical length was determined by transvaginal ultrasound and serum was collected to measure IGFBP-3 levels. Demographic data and pregnancy outcomes were recorded. RESULTS: A total of 176 pregnant women were analyzed. Twelve cases (6.8%) of preterm births were identified. Preterm birth prediction, when using serum IGFBP-3 values greater than 6.9 ng/ml, had a sensitivity of 75%, a specificity of 61.5%, a positive predictive value (PPV) of 12.3% and a negative predictive value (NPV) of 97.1%. When cervical length values less than 37 mm were used, the prediction had a sensitivity of 66.7%, a specificity of 44.6%, a PPV of 8%, and a NPV of 94.9%. When serum IGFBP-3 or cervical length was used to predict preterm birth, sensitivity, specificity, PPV and NPV were 83.3%, 27.1%, 7.6% and 95.7%, respectively. CONCLUSIONS: The use of serum IGFBP-3 levels in combination with cervical length had a good sensitivity to predict preterm birth. While NPV is high, the low PPV limits its standalone use to predict preterm birth.
A prospective study on maternal and neonatal outcomes and influencing factors in pregnant women with borderline hypertension.
Chen W, Tang X, Sun L … +2 more , Wu D, Zhang Y
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41543223 · Publisher ↗
OBJECTIVE: To investigate maternal and neonatal outcomes and influencing factors in pregnant women with borderline hypertension. METHODS: This prospective cohort study consecutively enrolled 600 pregnant women receiving...
OBJECTIVE: To investigate maternal and neonatal outcomes and influencing factors in pregnant women with borderline hypertension. METHODS: This prospective cohort study consecutively enrolled 600 pregnant women receiving prenatal care at two hospitals between January 1 and December 31, 2024. Participants were divided into a normotensive control group ( = 300) and a borderline hypertension group (systolic 130-139 mmHg and/or diastolic 80-89 mmHg, = 300). The primary outcome was progression to hypertensive disorders of pregnancy (HDP). Maternal and neonatal outcomes were compared, and influencing factors were analyzed. RESULTS: Women with borderline hypertension exhibited significantly higher rates of cesarean delivery (63.0% vs. 42.0%; < 0.001), HDP progression (27.0% vs. 0.0%; < 0.001), fetal growth restriction (15.7% vs. 2.7%; < 0.001), and NICU admission (13.7% vs. 4.0%; < 0.001) compared to normotensive controls. Notably, later gestational age at onset of borderline hypertension was identified as a protective factor against HDP progression (OR = 0.785 per week; 95% CI: 0.724-0.851; < 0.001), corresponding to a 21.5% risk reduction for each delayed week of onset. CONCLUSION: Borderline hypertension is associated with markedly increased adverse perinatal outcomes. Early detection and intervention-especially for women developing borderline elevation before 20 weeks-may help mitigate HDP progression. Integrating blood pressure trajectory monitoring into routine prenatal care is recommended.
Methodological considerations in evaluating intrapartum hyoscine butyl bromide for delayed labor progress.
Sharma A, Katkuri SN, Vadhithala V … +3 more , Kumar A, Verma S, Dedeepya D
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41535066 · Publisher ↗
Abstract loading — click title to view on PubMed.
Implementation of physiological interpretation of fetal heart rate changes: from scientific principles to frontline practice.
Chandraharan E, Mappa I, Gracia Perez-Bonfils A … +1 more , Pereira S
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41535023 · Publisher ↗
Onset of uterine contractions which become progressively more frequent, intense and last for longer durations as the labor progresses is expected to cause a gradually evolving hypoxic stress to human fetuses. This is bec...
Onset of uterine contractions which become progressively more frequent, intense and last for longer durations as the labor progresses is expected to cause a gradually evolving hypoxic stress to human fetuses. This is because of the repeated constriction of maternal spiral arterioles supplying the placental bed and compression of the umbilical cord as the labor advances. The majority of fetuses are able to mount physiological compensatory responses to protect their high priority central organs by maintaining aerobic metabolism. However, fetuses who are exposed to preexisting compromise such as chronic utero-placental insufficiency, chorioamnionitis or chronic fetal anemia and acidosis may not have sufficient reserves to withstand further hypoxic stress, leading to rapid decompensation and neurological injury or death. Physiological interpretation of fetal heart rate changes involves recognition of specific features of both hypoxic and non-hypoxic stresses on the cardiotocograph (CTG) and determining the fetal compensatory responses to ongoing stress. This approach which is based on the cardinal principle of individualization of care will enable frontline clinicians to differentiate features of compensation from decompensation. Timely interventions to improve intrauterine environment and/or to accomplish urgent birth will help avoid hypoxic ischemic encephalopathy (HIE) and its long term sequalae (cerebral palsy or learning difficulties) and perinatal deaths. Conversely, continuation of labor with careful observation in fetuses with compensated gradually evolving hypoxic stress will help avoid unnecessary intrapartum operative interventions. Emerging evidence suggests reduction in the rates of both HIE and emergency cesarean sections following the implementation of principles of physiological interpretation of CTG.
Association between maternal age and low birth weight and small for gestational age in Japanese women with gestational diabetes mellitus: Hamamatsu GRACE Study 2.
Takeshita K, Hashimoto T, Toyama Y … +4 more , Kanamoto A, Miyake T, Furukawa S, Tsuriya D
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41535021 · Publisher ↗
AIM: The association between maternal age and low birth weight (LBW) or small for gestational age (SGA) has been variably reported in previous epidemiological studies. In gestational diabetes mellitus (GDM), evidence on...
AIM: The association between maternal age and low birth weight (LBW) or small for gestational age (SGA) has been variably reported in previous epidemiological studies. In gestational diabetes mellitus (GDM), evidence on this issue remains limited and mixed. To date, no study has investigated these associations in Japanese women with GDM. The aim of this study was to address this gap by examining the association between maternal age and LBW/SGA in Japanese women with GDM. MATERIALS AND METHODS: We enrolled 641 women with GDM in this study. Following exclusion of 94 cases with incomplete data, the final analytic sample comprised 547 women. Logistic regression analysis was performed to calculate crude odds ratios (ORs) and 95% confidence intervals (CIs) for the association between maternal age and LBW and SGA. Maternal age was categorized into tertiles (younger: <32 years, middle-aged: 32-35 years, and older: ≥36 years), and further evaluated in 5-year intervals (<30 years, 30-34 years, 35-39 years, and ≥40 years) for a more detailed analysis. RESULTS: The mean maternal age was 33.3 years. The prevalence of LBW and SGA was 12.8% and 9.0%, respectively. The younger group was independently and positively associated with LBW (adjusted OR, 2.43 [95% CI, 1.08-5.68]) and SGA (adjusted OR, 2.30 [95% CI, 1.19-4.65]). Compared with women aged 30-34 years old, those under 30 years old had significantly higher risks of both LBW (adjusted OR 3.63 [95% CI, 1.49-9.07], for trend = 0.001) and SGA (adjusted OR 3.15 [95% CI, 1.50-6.77], for trend = 0.001). CONCLUSIONS: In Japanese patients with GDM, younger maternal age was independently associated with LBW and SGA.
Letter to the editor regarding the article: the effect of preterm premature rupture of membranes on neonatal outcomes in low-birth-weight infants: a retrospective study.
Noor M, Abid A, Shah FA … +1 more , Saeed MH
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41530922 · Publisher ↗
Abstract loading — click title to view on PubMed.
A clinical study on the construction of a prenatal ultrasound-based predictive model for fetal lung maturity in late pregnancy using propensity score matching.
Wang P, Li Y, Peng Y … +5 more , Zheng X, Chen G, Ma J, Wang S, Liu L
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41530918 · Publisher ↗
BACKGROUND: Fetal lung maturity (FLM) is closely associated with neonatal mortality, morbidity, and respiratory diseases such as neonatal respiratory distress syndrome (NRDS). At present, the assessment of FLM largely re...
BACKGROUND: Fetal lung maturity (FLM) is closely associated with neonatal mortality, morbidity, and respiratory diseases such as neonatal respiratory distress syndrome (NRDS). At present, the assessment of FLM largely relies on invasive procedures, while the establishment of a noninvasive ultrasound-based method has important clinical significance. OBJECTIVE: To construct and validate a predictive model of FLM based on ultrasound parameters in late pregnancy, exploring a noninvasive approach for risk assessment in fetal lung development. METHODS: A total of 195 pregnant women (gestational age ≥34 weeks) who underwent ultrasound examinations at the Department of Ultrasound, The Fourth Hospital of Shijiazhuang, China, from January to December 2023 were enrolled. Maternal baseline information, ultrasound parameters, and neonatal outcomes were collected. Fetal lung maturity was assessed based on the occurrence of neonatal respiratory distress syndrome (NRDS), diagnosed using standard clinical criteria including symptoms, blood gas analysis, and chest X-ray findings. Propensity score matching (PSM) was performed with gestational age and corticosteroid use as matching conditions. Least absolute shrinkage and selection operator (LASSO) regression and multivariate logistic regression were used to identify key predictors of FLM, and a nomogram prediction model was constructed. The model's discrimination and clinical utility were evaluated using 1,000 bootstrap resamples and 10-fold cross-validation. RESULTS: Among the 195 participants, the incidence of NRDS was 23.07%. Placental maturity, fetal breathing movement scores, and biparietal diameter were significantly higher in the lung-mature group compared with the NRDS group, while the proportion of gestational diabetes mellitus (GDM) was significantly higher in the NRDS group (all < 0.005). Multivariate logistic regression after LASSO selection showed that GDM, placental maturity ( < 0.05), and biparietal diameter (OR = 0.027, 95% CI: 0.006-0.101, < 0.001) were independent predictors of FLM. A nomogram incorporating these three predictors achieved an AUC of 0.871, and both bootstrap validation and 10-fold cross-validation showed promising discriminative ability in this sample; however, this performance is preliminary and requires validation in independent cohorts. CONCLUSION: The nomogram developed in this study represents a preliminary model for evaluating fetal lung maturity using ultrasound measurements. However, these findings are from a small, single-center, cross-sectional study and require external validation in larger, diverse populations. BPD, gestational diabetes, and placental maturity play critical roles in FLM and warrant enhanced monitoring and management in clinical practice.
Early essential newborn care for late preterm and term infants delivered by cesarean section: a randomized controlled trial on neonatal hypoglycemia and breastfeeding.
Liu J, Ji WJ, Qu ZT … +1 more , Qiao J
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41526173 · Publisher ↗
OBJECTIVE: To evaluate the effects of Early Essential Newborn Care (EENC) on neonatal hypoglycemia and breastfeeding in late preterm and term cesarean-born infants. METHODS: In this RCT, infants were randomly assigned to...
OBJECTIVE: To evaluate the effects of Early Essential Newborn Care (EENC) on neonatal hypoglycemia and breastfeeding in late preterm and term cesarean-born infants. METHODS: In this RCT, infants were randomly assigned to the EENC group (immediate skin-to-skin contact and early breastfeeding) or the control group (standard care). Blood glucose was measured at 1, 3, and 6 h post-birth. Breastfeeding outcomes included the onset of lactogenesis II and exclusive breastfeeding at discharge. Time to first breastfeeding was recorded solely as a process fidelity check to confirm intervention adherence. We used multiple imputation as the primary analysis for missing data and conducted pre-specified sensitivity analyses, including a complete-case analysis. RESULTS: Infants in the EENC group had significantly higher blood glucose levels at 1 h (aMD = 11.56 mg/dL [95%CI: 8.85, 14.27]), 3 h (aMD = 9.06 mg/dL [95%CI: 7.08, 11.04]), and 6 h (aMD = 6.83 mg/dL [95%CI: 5.31, 8.36]) post-birth, compared to the control group (all < 0.001). The RR for hypoglycemia was significantly lower in the EENC group (RR = 0.88, [95%CI: 0.80, 0.96], = 0.006). Additionally, mothers in the EENC group experienced earlier onset of lactogenesis II (aMD=-8.82 h [95%CI: -10.23, -7.41], < 0.001), and had a higher rate of exclusive breastfeeding (RR = 1.31 [95% CI: 1.02, 1.26], = 0.022). Sensitivity analyses yielded consistent directions for primary glycemic and breastfeeding outcomes. CONCLUSION: The EENC improves neonatal glucose regulation and breastfeeding in cesarean-born late preterm and term infants, potentially enhancing neonatal health, maternal-infant bonding, and postpartum transition.
Does magnesium sulfate affect duration of labor for nulliparous patients undergoing induction of labor for hypertensive disorders of pregnancy at term?
Mei JY, Lee D, Negi M
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41521063 · Publisher ↗
OBJECTIVE: Magnesium sulfate is administered intrapartum for seizure prophylaxis in patients with preeclampsia with severe features. We aimed to quantify the effect of magnesium sulfate on duration of labor induction in...
OBJECTIVE: Magnesium sulfate is administered intrapartum for seizure prophylaxis in patients with preeclampsia with severe features. We aimed to quantify the effect of magnesium sulfate on duration of labor induction in nulliparous patients undergoing induction of labor for hypertensive disorders of pregnancy at term gestation. METHODS: This retrospective cohort study was a secondary analysis from the Consortium on Safe Labor, a multicenter cohort study of 228,438 deliveries in 19 U.S. hospitals. The analysis included nulliparous patients ≥ 18 years old with singleton gestation undergoing induction of labor for hypertensive disorders of pregnancy with delivery at ≥37 weeks gestation. Primary outcome was duration of labor induction, defined as time in hours (h) from initiation of induction to delivery, between patients who received magnesium sulfate and those who did not. Secondary outcomes were rate of cesarean delivery and perinatal outcomes. RESULTS: Total 5,886 patients met inclusion criteria, of whom 2102 (35.7%) received magnesium sulfate intrapartum. Median duration of labor induction was significantly longer in the magnesium cohort (16.8h, IQR 10.3h-25.3h vs 15.0h, IQR 9.0h-22,9h; < 0.001). Multivariate logistic regression controlling for baseline characteristics different between groups found that magnesium use was significantly associated with labor length over 12 h (adjusted odds ratio [aOR] 1.36; 95% confidence interval [CI] 1.21-1.54; < 0.001) as well as over 24 h (aOR, 1.44; 95% CI, 1.26-1.64; < 0.001). The overall rate of CD was 39.2% in the cohort. Magnesium use was not associated with higher rate of CD ( = 0.58) but was associated with longer maternal length of stay ( < 0.001) and higher rate of endometritis ( < 0.001). Magnesium use was associated with higher rates of neonatal intensive care unit admission ( < 0.001), 5-minute APGAR ≤ 7 ( < 0.001), respiratory distress syndrome ( < 0.001), and composite neonatal morbidity ( < 0.001). CONCLUSION: Magnesium sulfate administration is significantly associated with longer induction of labor length amongst patients undergoing induction for hypertension, though it did not impact mode of delivery. Appropriate care should be taken in expeditiously managing labor for this high-risk patient cohort.
Risk of recurrent preterm premature rupture of membrane in subsequent pregnancy: a systematic review and meta-analysis.
Min Y, Yao Q
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41521062 · Publisher ↗
OBJECTIVE: Preterm prelabor rupture of membranes (PPROMs) is associated with high rates of neonatal mortality and morbidity. We aimed to review evidence on the risk of recurrent PPROM and preterm birth (PTB) in women wit...
OBJECTIVE: Preterm prelabor rupture of membranes (PPROMs) is associated with high rates of neonatal mortality and morbidity. We aimed to review evidence on the risk of recurrent PPROM and preterm birth (PTB) in women with a history of PPROM in prior pregnancy. METHODS: PubMed, Embase, Scopus, and Web of Science databases were searched up to 26 August 2025, for studies reporting the recurrent risk of PPROM and/or PTB in the subsequent pregnancy. Pooled estimates with 95% confidence intervals (CIs) were calculated in the DerSimonian-Laird random-effects meta-analysis model. RESULTS: Nine studies were included. Pooled analysis showed that the overall risk of recurrent PPROM in women was 18% (95% CI: 12-25%). Inter-study heterogeneity was high ( = 93%). On leave-one-out meta-analysis, the recurrence rate varied from 16% (95% CI: 11-22%) to 20% (95% CI: 14-27%). The risk of PTB when defined as <37 weeks was 34% (95% CI: 22-59%), while the risk was 23% (95% CI: 12-39%) and 20% (95% CI: 9-38%) when PTB was defined as <34 and <28 weeks, respectively. Subgroup analysis based on the definition of PPROM and location resulted in varied estimates. CONCLUSIONS: Women with PPROM in the prior pregnancy have a high risk of recurrence of PPROM as well as PTB.
Understanding stillbirth causes in Brazil using the CODAC classification system.
Metelus S, Vieira MC, Brasileiro M … +14 more , Griggio TB, Dias MAB, Leite DF, Cunha Filho EVD, Schreiner L, Ramos JGL, Haddad SM, Osanan G, Mayrink J, de Jesús GR, Fernandes KG, Pasupathy D, Cecatti JG, Souza RT
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41521060 · Publisher ↗
OBJECTIVE: To evaluate the contribution of the Causes of Death and Associated Condition (CODAC) classification system in reducing the proportion of nonspecific and unspecified causes of stillbirths compared to the ICD-10...
OBJECTIVE: To evaluate the contribution of the Causes of Death and Associated Condition (CODAC) classification system in reducing the proportion of nonspecific and unspecified causes of stillbirths compared to the ICD-10 system and to assess maternal and pregnancy-related factors associated with stillbirth in Brazil. METHODS: A retrospective cross-sectional study was conducted in ten tertiary obstetric care facilities in Brazil, including cases of stillbirths 2009 to 2018. Data were obtained from medical records, death certificates, and postmortem investigations. The CODAC system was applied to identify specific causes of death, and maternal and pregnancy characteristics were evaluated to find associations with stillbirth. Agreement between the two systems was assessed using the kappa coefficient, and McNemar's test was used to evaluate differences in the prevalence of unspecified causes. RESULTS: Of the 3390 initially assessed cases, 2545 were included in the final analysis. The CODAC system reduced the proportion of unspecified stillbirths from 40.79% (ICD-10) to 22.00%. Regional disparities were evident. Cases with unspecified causes (ICD-10 P20/P95) were more prevalent in the northeast (56.4%), whereas other specific ICD-10 causes were predominant in the southeast (47.9%). Maternal conditions such as preeclampsia (24.0% vs. 18.6%, = 0.004) and placental abruption (20.6% vs. 10.0%, < 0.001) were significantly associated with cases in which a specific cause of stillbirth was assigned. The agreement between the classification systems was low (kappa = 0.376), and McNemar's test showed a significant difference ( < 0.001). CONCLUSION: The CODAC improves the understanding of causes of death over the ICD-10 classification system currently used in Brazil. The CODAC was able to decrease the proportion of unexplained cases, which could potentially contribute to better informing maternal and perinatal health policies.
Lung ultrasound features during the evolution of BPD: a study from an animal model.
Zong H, Li C, Ye N … +6 more , Song J, Yang L, Fang S, Shi J, Chen X, Yang C
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41506781 · Publisher ↗
OBJECTIVE: To explore lung ultrasound (LUS) in the evolution of bronchopulmonary dysplasia (BPD) and the diagnostic value of LUS in BPD. METHODS: Newborn rats were randomly assigned to the room air (RA) group or the oxyg...
OBJECTIVE: To explore lung ultrasound (LUS) in the evolution of bronchopulmonary dysplasia (BPD) and the diagnostic value of LUS in BPD. METHODS: Newborn rats were randomly assigned to the room air (RA) group or the oxygen (O) group. LUS were performed at 12 h and on the 3rd, 7th, and 10th days to explore the LUS in BPD rats. Hematoxylin-eosin staining and immunohistochemical were analyzed to evaluate pathological characteristics. RESULTS: LUS score (LUSs) in the O group was significantly increased on the 7th and 10th days. In the early stage, LUS revealed multiple B-lines and air bronchograms. In the late stage, LUS revealed anechoic echoic areas on the pleural surface and scattered dot-like hyperechoic patterns in the lung field. The LUS findings were consistent with the pathological results. CONCLUSION: There was a strong positive correlation between LUS and pathological findings. LUS can be used to monitor the evolution of BPD.
The association between the uric acid to high-density lipoprotein cholesterol ratio with gestational diabetes mellitus: a cross-sectional study based on NHANES 1999-2020.
Feng Y, Song Q, Qin Y
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41506780 · Publisher ↗
BACKGROUND: Gestational diabetes mellitus (GDM) affects approximately one in six pregnant women worldwide, imposing a significant health and economic burden. The uric acid to high-density lipoprotein cholesterol ratio (U...
BACKGROUND: Gestational diabetes mellitus (GDM) affects approximately one in six pregnant women worldwide, imposing a significant health and economic burden. The uric acid to high-density lipoprotein cholesterol ratio (UHR), as a biomarker reflecting metabolic dysfunction, may be utilized to assess the prevalence of developing GDM. METHODS: We calculated the UHR index using data from pregnant women who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2020. Subsequently, we conducted in-depth validation through analytical methods including multivariate logistic regression, smooth curve fitting, and subgroup analysis. RESULTS: The logistic regression model demonstrated a positive correlation between the UHR index and GDM, which remained significant even after adjusting for all confounding variables (Odds Ratio [OR] = 1.16, 95% Confidence Interval [CI]: 1.07-1.26, < 0.001). A linear dose-response relationship was observed in the restricted cubic spline (RCS) regression (p for overall < 0.001, p for nonlinear = 0.293). This association remained consistent in sensitivity analyses and subgroup analyses. The diagnostic utility of the UHR index for GDM was limited (Area Under the Curve [AUC] = 0.611, 95% CI: 0.554-0.667). CONCLUSIONS: Although UHR demonstrated limited independent diagnostic accuracy (AUC = 0.611), its dual role in correlating inflammation and lipid metabolism may confer complementary value within multiparametric models, a hypothesis that warrants future research validation.
Early versus late combined amniotomy and oxytocin after mechanical cervical ripening-a secondary analysis of a randomized controlled trial.
Dakwar Shaheen J, Einav S, Sammour R … +2 more , Sagi S, Bleicher I
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41503628 · Publisher ↗
PURPOSE: The aim of this study was to compare the time to delivery between early (within 2 h) and late (after 2 h) amniotomy and oxytocin initiation in patients undergoing cervical ripening with a cervical ripening ballo...
PURPOSE: The aim of this study was to compare the time to delivery between early (within 2 h) and late (after 2 h) amniotomy and oxytocin initiation in patients undergoing cervical ripening with a cervical ripening balloon (CRB). METHODS: Secondary analysis of data collected from a previous parallel randomized controlled trial comparing CRB removal after 6 versus 12 h. For our study, the full cohort from the original trial was divided into patients who had amniotomy and oxytocin infusion within 2 h of CRB removal (study group) and patients who hadamniotomy and oxytocin more than 2 h after CRB removal (control group). Inclusion criteria were age > 18 years, ≥ 37 gestational weeks, Bishop score < 5, singleton vertex presentation, intact membranes, and no contraindication for vaginal delivery. Primary outcome for the current study was the time from CRB removal to delivery. Secondary outcomes included the rate of cesarean delivery and adverse maternal and neonatal outcomes. RESULTS: A total of 197 patients were analyzed, 34 in the study group and 163 in the control group. The study and control groups did not differ in baseline characteristics but differences were observed in the treatment characteristics stemming from the division into the two groups for the analysis. Time from CRB removal to delivery was significantly shorter in the study group vs control (9 ± 6.7 vs.17 ± 11.9 h, < 0.001) respectively. The rate of cesarean deliveries and other maternal and neonatal outcomes were similar in the two groups. CONCLUSION: Our findings suggest that early amniotomy and oxytocin infusion combination in patients undergoing labor induction with a CRB is associated with a shorter duration of labor and similar cesarean deliveries rate. Latent confounding remains possible.
Retraction Statement: Ultrasound markers for prediction of gestational diabetes mellitus in early pregnancy in Egyptian women: observational study.
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41503627 · Publisher ↗
Abstract loading — click title to view on PubMed.
Impact of hysteroscopic tubal occlusion on the uterine microenvironment and pregnancy outcomes in tubal factor infertility.
Cai Y, Wu C, Song Y … +3 more , Wang S, Sun L, Cai H
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41485983 · Publisher ↗
BACKGROUND: Hysteroscopic tubal occlusion serves as an effective minimally invasive treatment, aiming to improve the efficacy of assisted reproductive technologies by preventing hydrosalpinx fluid from entering the uteri...
BACKGROUND: Hysteroscopic tubal occlusion serves as an effective minimally invasive treatment, aiming to improve the efficacy of assisted reproductive technologies by preventing hydrosalpinx fluid from entering the uterine cavity. This study aims to investigate the specific alterations in the intrauterine microenvironment associated with this surgery and its positive impact on the success rate of fertilization and embryo transfer (IVF-ET). METHODS: This retrospective study included 158 patients with hydrosalpinx who underwent hysteroscopic tubal occlusion between January 2019 and December 2021. Pre- and postoperative evaluations included endometrial total protein levels, cytokines (TNF-α, bFGF, IL-10), immune markers (CD138, CD38, CD68), hormone receptors (ER, PR), uterine microbial composition, postoperative recovery, and IVF-ET pregnancy outcomes. RESULTS: Postoperative total protein levels in endometrial tissues significantly increased ( < 0.05). Protein levels of CD138, CD38, CD68, ER, and PR were all significantly reduced postoperatively ( < 0.05). The abundance of increased significantly from 81.56% to 91.71% (χ=4.153, = 0.042), while other microbial species showed no significant differences. Pain scores decreased significantly from 3.24 ± 0.68 to 1.36 ± 0.31, and the mean time to return to daily activities was 1.08 ± 0.26 days. IVF-ET outcomes showed a clinical pregnancy rate of 39.87%, ongoing pregnancy rate of 32.91%, live birth rate of 29.75%, and a miscarriage rate of 6.96%, with no ectopic pregnancies reported. CONCLUSIONS: Hysteroscopic tubal occlusion effectively alters the uterine microenviron-ment by modulating immune, hormonal, and microbial profiles, while improving patient recovery and supporting favorable pregnancy outcomes in IVF-ET.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe