J. Matern. Fetal. Neonatal. Med. [JOURNAL]
Sun
200 papers
Patients' perceptions of postpartum hemorrhage management: a qualitative study.
Kraus AC, Cureton B, Bullington BW … +1 more , Quist-Nelson J
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42120339 · Publisher ↗
INTRODUCTION: Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide. While efforts to prevent and improve the management of PPH, including the use of emergency checklists during a hemorrhage ev...
INTRODUCTION: Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide. While efforts to prevent and improve the management of PPH, including the use of emergency checklists during a hemorrhage event, have increased, there has been limited attention to the lived experiences of pregnant people. OBJECTIVE: To describe patients' perceptions of their experiences with an inpatient multidisciplinary team response to PPH management when an emergency checklist was utilized. METHODS: Individuals who experienced PPH, defined as a cumulative blood loss of 1,000 mL or more, were approached to participate in the study. Purposeful sampling was employed to ensure diversity by both self-reported racial and ethnic identity and severity of PPH. Participants completed remotely conducted semi-structured interviews between February and November 2024. A qualitative phenomenological approach was employed to establish a shared understanding of participants' perceptions and lived experiences. RESULTS: Twenty participants completed interviews. PPH imposed a substantial physical and emotional burden on patients. While patients often felt exposed and reported a loss of agency during their PPH, these concerns were eased when the care team maintained a steady presence and clearly articulated their management and interventions. Perception of the emergency checklist, when recalled, provided additional reassurance by reinforcing trust in systematic care and adherence to protocols. Participants emphasized the importance of ongoing education and guidance on PPH treatment and its implications after hospital discharge. CONCLUSIONS: Patients who experienced PPH described feelings of vulnerability; however, the care team's composed presence and clear communication were perceived by participants as sources of reassurance during these experiences. Awareness of emergency checklist use, when present, was described by some participants as fostering confidence in team management. Patient support should extend beyond medical management throughout the postpartum period.
Progress and challenges in modernizing delivery rooms.
Zhang Y, Yang X
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42120334 · Publisher ↗
OBJECTIVE: Childbirth is a profound life event that can be both challenging and empowering. The delivery room environment significantly influences a woman's experience, affecting physiological processes, emotional well-b...
OBJECTIVE: Childbirth is a profound life event that can be both challenging and empowering. The delivery room environment significantly influences a woman's experience, affecting physiological processes, emotional well-being, and clinical outcomes. This review synthesizes evidence on how modernized delivery rooms can mitigate stress and actively promote a positive, safe, and empowering birth experience. METHODS: Despite the known importance of the physical setting, many delivery rooms remain highly clinical, and research on optimizing their design is evolving. We discuss the transition from traditional, medically-focused spaces to modern, homelike environments that support physiological labor. Key topics include the discreet integration of advanced medical equipment, the role of family presence, and the application of emerging technologies for maternal and neonatal monitoring. The involvement of the full multidisciplinary team-including obstetricians, midwives, obstetric nurses, anesthesiologists, and neonatologists-is essential for successful modernization. RESULTS: We also identify major challenges, such as balancing safety with comfort, managing costs, and the need for more robust evidence to guide design decisions. CONCLUSION: The findings underscore that effective delivery room modernization requires a patient-centered, multidisciplinary approach, integrating evidence-based design principles to improve outcomes for mothers, infants, and healthcare providers.
Oxidative stress and antioxidative defense in fetuses and newborn children with spina bifida in cerebrospinal fluid.
Pastuszka A, Zalejska-Fiolka J, Kasperczyk S … +3 more , Zamłyński M, Pawlicki K, Dolibog P
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42120332 · Publisher ↗
BACKGROUND: Spina bifida remains the most prevalent defect of the central nervous system and second most common congenital birth anomaly. Oxidative stress is one of the key factors affecting the extent of tissue damage d...
BACKGROUND: Spina bifida remains the most prevalent defect of the central nervous system and second most common congenital birth anomaly. Oxidative stress is one of the key factors affecting the extent of tissue damage during fetal life. Harmful effects of Reactive Oxygen Species (ROS) are exacerbated by rapid growth and development of tissues, coupled with weak antioxidant defenses, and lead to protein, lipid and DNA damage, ultimately resulting in cell death through apoptosis or necrosis. METHODS: A total of 62 samples of the cerebrospinal fluid from children with spina bifida were collected: 31 fetuses-prenatal repair (Group 1) and 31 newborns-postnatal repair on day 1, within the first 24 h of life (Group 2). The activity of glutathione reductase (GR), catalase (KAT), superoxide dismutase (SOD) and its mitochondrial isoenzyme (MnSOD), as well as Total Antioxidant Capacity (TAC) and Total Oxidative Status (TOC) levels, were compared. RESULTS: Both the activity of the antioxidant enzymes (SOD, MnSOD, GR, KAT) and TAC and TOS levels were statistically significantly higher in the fetuses as compared to the newborns. CONCLUSIONS: Significantly higher antioxidant enzyme activity and TAC and TOS levels were found in the cerebrospinal fluid samples in the prenatal as compared to the postnatal repair groups. These results suggest insufficient antioxidant protection in the postnatal repair group, which may increase the risk of oxidative damage, potentially affecting the neurological system more severely than in the fetuses. Extinguishment of the enzymatic activity of the antioxidant system during fetal life may lead to irreversible damage to the exposed structures of the central and peripheral nervous system in fetuses with spina bifida.
Retraction statement: carbetocin versus oxytocin for prevention of postpartum hemorrhage in obese nulliparous women undergoing emergency cesarean delivery.
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42120321 · Publisher ↗
Abstract loading — click title to view on PubMed.
Postpartum care utilization among high-risk pregnancies in an urban safety-net health system.
Vani K, Nordlicht R, Atrio J … +2 more , Fiori K, Lounsbury D
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42108383 · Publisher ↗
INTRODUCTION: The postpartum period carries substantial risk for preventable morbidity, particularly among individuals with high-risk pregnancies complicated by chronic or pregnancy-associated conditions. Despite recomme...
INTRODUCTION: The postpartum period carries substantial risk for preventable morbidity, particularly among individuals with high-risk pregnancies complicated by chronic or pregnancy-associated conditions. Despite recommendations for early and ongoing postpartum follow-up, patterns of postpartum and acute care utilization across high-risk conditions remain poorly characterized. We evaluated postpartum and acute care utilization among individuals with high-risk pregnancies versus low-risk pregnancies in an urban safety-net health system. METHODS: We conducted a retrospective cohort study of individuals who delivered at two campuses of a tertiary academic medical center between 1 June 2018 and 31 May 2022. High-risk pregnancy status was defined using ICD-9/10 codes corresponding to chronic medical or pregnancy-associated conditions; low-risk was defined by the absence of these codes. The primary outcome was attendance of ≥1 postpartum visit (PPV) within 12 weeks of delivery. Secondary outcomes included emergency department (ED) visits and hospital readmissions within 12 weeks postpartum. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs). RESULTS: Of 13,874 included individuals, 9435 (68.0%) had ≥1 high-risk diagnosis, and nearly half had multiple coexisting conditions. High-risk individuals were more likely than low-risk individuals to attend any PPV (59.2% vs. 45.4%) and an early PPV within 21 days (40.5% vs. 24.2%, both < 0.001). ED visits (16.9% vs. 13.9%) and readmissions (5.4% vs. 2.7%) were also more frequent among high-risk individuals ( < 0.001). In adjusted analyses, hypertensive disorders of pregnancy (aOR 1.67), mental health conditions (aOR 1.49), cesarean delivery, and greater prenatal care utilization were associated with higher odds of PPV attendance, while gestational diabetes was associated with lower odds (aOR 0.79). High-risk conditions, particularly hypertensive disorders and pregestational diabetes, were associated with increased acute care utilization. CONCLUSIONS: Although high-risk individuals were more likely to attend PPVs, overall engagement remained suboptimal and acute care utilization was high. These findings highlight the need for risk-tailored postpartum care and improved care coordination to reduce preventable morbidity.
Clinical significance of soluble E-selectin and soluble vascular cell adhesion molecule-1 levels in umbilical cord blood for neonatal respiratory distress syndrome: a retrospective study.
Huang Q, Qin Y
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42108382 · Publisher ↗
OBJECTIVE: This study evaluates the clinical significance of soluble E-selectin (sE-selectin) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in umbilical cord blood for neonatal respiratory distress syndrome (NR...
OBJECTIVE: This study evaluates the clinical significance of soluble E-selectin (sE-selectin) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in umbilical cord blood for neonatal respiratory distress syndrome (NRDS). METHODS: This retrospective single-center study collected 558 preterm infants, categorized into NRDS ( = 162) and non-NRDS ( = 396) groups. sE-selectin and sVCAM-1 levels in umbilical cord blood were measured. Their correlations with the 5-minute Apgar score and PaO/FiO ratio were assessed using Spearman/Pearson analysis. ROC curves were generated to assess their predictive value for NRDS diagnosis and discriminatory value for 28-day prognosis. Logistic and Poisson regression models were used to identify risk factors for poor prognosis. RESULTS: sE-selectin and sVCAM-1 were elevated in NRDS infants and positively correlated with disease severity. They showed negative correlations with 5-minute Apgar score and PaO/FiO ratio. For NRDS prediction, the AUC was 0.894 for sE-selectin and 0.878 for sVCAM-1. sE-selectin combined with sVCAM-1 achieved an AUC of 0.935. For discriminating poor 28-day prognosis, the AUC was 0.867 for sE-selectin and 0.878 for sVCAM-1. The combined AUC of 0.913 was higher than that of any biomarker alone. sE-selectin (: 1.163, 95%CI: 1.057 ∼ 1.279), sVCAM-1 (: 1.097, 95%CI: 1.035 ∼ 1.163), and 5-minute Apgar score (: 0.408, 95%CI: 0.269 ∼ 0.620) were independently associated with poor prognosis. Poisson regression analysis results in the generalized linear model were consistent with the conclusions of the logistic regression analysis. CONCLUSION: sE-selectin and sVCAM-1 are elevated in umbilical cord blood in NRDS infants and closely correlated with disease severity and 28-day prognosis.
Association between glycemic variability and composite adverse neonatal outcomes in patients with gestational diabetes mellitus: a retrospective study.
Chen Y, Song H, Yang M
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42108378 · Publisher ↗
OBJECTIVE: Glycemic variability (GV) has emerged as a potential contributor to adverse pregnancy outcomes beyond mean glucose levels. This study aimed to investigate the association between GV indices derived from self-m...
OBJECTIVE: Glycemic variability (GV) has emerged as a potential contributor to adverse pregnancy outcomes beyond mean glucose levels. This study aimed to investigate the association between GV indices derived from self-monitoring of blood glucose (SMBG) and composite adverse neonatal outcomes (CANO) in patients with gestational diabetes mellitus (GDM). METHODS: This retrospective study included 160 women with GDM who delivered at Guiyang Maternal and Child Health Hospital between January 2022 and December 2024. GV indices, including standard deviation (SD), coefficient of variation (CV), and mean amplitude of glycemic excursions (MAGE), were calculated from SMBG data. CANO was defined as the occurrence of at least one of: macrosomia, large for gestational age, small for gestational age, neonatal hypoglycemia, jaundice requiring phototherapy, respiratory distress syndrome, NICU admission >24 h, or preterm birth. Multivariable logistic regression was used to evaluate the association between GV indices and CANO, adjusting for maternal characteristics and glycemic control parameters. RESULTS: CANO occurred in 67 patients (41.88%). The CANO group had higher glucose SD (1.38 ± 0.32 vs. 1.18 ± 0.31 mmol/L [24.8 ± 5.8 vs. 21.2 ± 5.6 mg/dL]), CV (21.63 ± 5.32% vs. 19.19 ± 5.25%), and MAGE (2.86 ± 0.72 vs. 2.52 ± 0.65 mmol/L [51.5 ± 13.0 vs. 45.4 ± 11.7 mg/dL]) compared with those without CANO. After adjustment for confounders, glucose SD (OR = 1.85 per 0.5 mmol/L [9.0 mg/dL], 95% CI: 1.18-2.90, = 0.007) and CV (OR = 1.48 per 5%, 95% CI: 1.12-1.96, = 0.006) remained independently associated with CANO, whereas MAGE did not retain significance (OR = 1.42, 95% CI: 0.92-2.19, = 0.112). These associations remained robust after excluding SGA from the composite endpoint and across all other sensitivity analyses. Receiver operating characteristic analysis showed modest predictive performance, with glucose SD having the highest AUC of 0.652. CONCLUSION: Glycemic variability, measured by glucose SD and CV from SMBG data, was independently associated with CANO in women with GDM, though with limited discriminative ability as a standalone predictor. Future prospective studies with larger sample sizes and CGM-derived metrics are needed to validate these findings.
Acceptability of the knee-to-chest flexion maneuver to reduce neonatal respiratory distress after elective cesarean section: a qualitative study among healthcare providers.
Shirima FL, Manteiga KR, Mchome B … +4 more , Keus A, Mmbaga BT, Te Pas AB, van den Akker T
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42091518 · Publisher ↗
BACKGROUND: The risk of neonatal respiratory distress increases in planned cesarean section (CS), due to elevated lung liquid resulting from the absence of labor. The knee-to-chest flexion (KCF) maneuver is a novel, low-...
BACKGROUND: The risk of neonatal respiratory distress increases in planned cesarean section (CS), due to elevated lung liquid resulting from the absence of labor. The knee-to-chest flexion (KCF) maneuver is a novel, low-resource technique intended to mimic the uterine contraction by flexing the newborn's legs against the chest to aid lung fluid expulsion. Although the maneuver has shown to be feasible and safe, its acceptability among healthcare providers is unknown. The study aimed to understand how healthcare providers perceive and accept the KCF intervention for preventing neonatal respiratory distress following planned CS. METHODS: The study used an exploratory qualitative approach, with semi-structured interviews at a tertiary referral hospital in Moshi, Tanzania. Fifteen interviews were conducted with obstetricians and resident doctors who had observed and/or performed the maneuver as part of an ongoing clinical trial which aims to test effectiveness of KCF maneuver in reducing newborn respiratory distress (ClinicalTrials.gov: NCT06270823). The data was first analyzed thematically using the Theoretical Framework of Acceptability as guidance, and later by inductive coding. RESULTS: The KCF maneuver was generally viewed as acceptable, supported by its simplicity, compatibility with routine workflows, and observed clinical benefits, such as visible lung fluid expulsion. Its physiological rationale further contributed to clinicians' confidence in the procedure. However, acceptability remains closely tied to perceptions of effectiveness, with several providers awaiting trial results before they would endorse its use. CONCLUSION: This study suggests that the KCF maneuver could be an acceptable intervention for improving newborn outcomes following planned CS, provided that efficacy is confirmed.
Prenatal cigarette smoke exposure increases vulnerability to chronic retinal hypoperfusion in adult rats.
Mammel B, Kvarik T, Werling D … +7 more , Szabo Z, Gyarmati J, Ertl T, Helyes Z, Kiss P, Atlasz T, Reglodi D
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42091501 · Publisher ↗
BACKGROUND: Numerous studies indicate that smoking during pregnancy has harmful effects on the offspring. Prenatal smoke exposure (PSE) may lead to fetal hypoxia and ischemia, which negatively affect brain development an...
BACKGROUND: Numerous studies indicate that smoking during pregnancy has harmful effects on the offspring. Prenatal smoke exposure (PSE) may lead to fetal hypoxia and ischemia, which negatively affect brain development and increase the risk of neurological deficits. However, its long‑term impact on retinal vulnerability in adulthood is less well understood. OBJECTIVE: To investigate the effects of prenatal smoke exposure on retinal structure and vulnerability in a chronic retinal hypoperfusion model in adult rats. METHODS: Wistar rats were mated and exposed to whole‑body tobacco smoke for 2 hours daily from mating until delivery, using a closed‑chamber manual smoking system with four research cigarettes per occasion, modelling passive smoking. Neurobehavioral development was assessed in newborn rats during the first weeks of life. At 5 months of age, permanent bilateral common carotid artery occlusion (BCCAO) was performed under isoflurane anaesthesia via midline neck incision. Two weeks after BCCAO, all animals were sacrificed with an overdose of anaesthetic, and eyes were processed for histological analysis. Retinal layer thickness (outer and inner nuclear and plexiform layers) and cell counts per 100 µm in the ganglion cell layer (GCL) were measured. RESULTS: BCCAO resulted in markedly reduced retinal layer thickness and morphological signs of degeneration with individual variation in all layers compared to sham‑operated controls. The number of cells in the GCL decreased by approximately 50%. Prenatal smoke exposure alone also led to a significant reduction in GCL cell number. While our previous work had shown only minor retardation of neurobehavioral development in prenatally smoke‑exposed neonatal rats, the present study demonstrated pronounced histological damage in the retina of adult rats subjected to PSE, with further exacerbation after chronic hypoperfusion. CONCLUSIONS: Prenatal exposure to tobacco smoke induces long‑lasting structural alterations in the retina and increases susceptibility to later hypoperfusion‑induced retinal injury in adult rats. These findings support the concept that adverse intrauterine exposures have persistent consequences for neural tissues and underscore the importance of avoiding smoking during pregnancy.
Radiologic examinations in pregnancy: a critical appraisal of radiation and contrast risks.
Forrest AD, Mahesh M, Fishman EK … +1 more , Blakemore KJ
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42091463 · Publisher ↗
BACKGROUND: Radiologic examinations (medical imaging studies involving ionizing radiation) are sometimes avoided in pregnancy due to concerns about maternal and fetal radiation exposure. However, diagnostic imaging can b...
BACKGROUND: Radiologic examinations (medical imaging studies involving ionizing radiation) are sometimes avoided in pregnancy due to concerns about maternal and fetal radiation exposure. However, diagnostic imaging can be critical for maternal and fetal care, and the actual risks are frequently overestimated. OBJECTIVE: To provide a critical appraisal of radiation and contrast exposure during pregnancy, focusing on fetal dosage from commonly used imaging modalities, associated risks, and clinical contexts in which radiologic studies may be appropriate. METHODS: A narrative review of the literature was performed, emphasizing guideline statements from professional societies, large cohort and case-control studies, and updated dosimetric data. RESULTS: Across X-ray, computed tomography, nuclear medicine, and fluoroscopic examinations, fetal radiation exposure is typically far below the 50-100 mGy threshold associated with teratogenicity. Most diagnostic studies deliver fetal doses under 25 mGy, a level at which adverse outcomes have not been demonstrated. Deterministic effects such as structural anomalies are not observed at diagnostic dose ranges. Stochastic risks such as childhood cancer appear negligible or, at most, minimally increased. Guidelines consistently advise that medically indicated imaging should not be withheld in pregnancy. CONCLUSIONS: The available evidence supports the safety of diagnostic radiologic studies in pregnancy when clinically indicated. Perceptions of risk often exceed measured fetal exposures by an order of magnitude, leading to underutilization of important diagnostic tools. Improved awareness of true dose thresholds and integration of shared decision-making are essential to ensure that pregnant patients receive appropriate, timely imaging.
Association of weekend delivery with adverse neonatal outcomes: a systematic review and meta-analysis.
Pandey P, Shabil M, Sulthana H … +2 more , Verma A, Sah R
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42086493 · Publisher ↗
BACKGROUND: Maternal and neonatal outcomes are key indicators of healthcare quality. However, disparities in outcomes related to hospital staffing patterns and resource availability during weekends, commonly referred to...
BACKGROUND: Maternal and neonatal outcomes are key indicators of healthcare quality. However, disparities in outcomes related to hospital staffing patterns and resource availability during weekends, commonly referred to as the "weekend effect," remain a global concern. This systematic review and meta-analysis aimed to evaluate the association between weekend delivery and adverse neonatal outcomes using adjusted estimates from diverse healthcare settings worldwide. METHODS: A systematic search of major databases was conducted to identify observational studies published up to January 2026. Studies were eligible if they reported adjusted effect estimates for neonatal outcomes comparing weekend and weekday deliveries. Nine high-quality studies, with Newcastle-Ottawa Scale scores ranging from 7 to 9, were included. A random-effects meta-analysis was performed to calculate pooled adjusted odds ratios (aORs) with 95% confidence intervals (CIs). All analyses were conducted using R software version 4.4. RESULTS: Nine studies were included. For neonatal mortality, weekend delivery was associated with a 4.5% increase in adjusted odds; however, this association was not statistically significant (aOR 1.045, 95% CI 0.994-1.099; I = 0.0%). In contrast, weekend delivery was significantly associated with higher odds of neonatal intensive care unit (NICU) admission (aOR 1.199, 95% CI 1.027-1.399; I = 94.3%), maternal obstetric infection (aOR 1.078, 95% CI 1.045-1.112; I = 0.0%), and preterm birth among high-risk populations, including women with pregestational diabetes or advanced maternal age (aOR 1.632, 95% CI 1.518-1.756; I = 0.0%). CONCLUSION: Although contemporary obstetric care systems appear effective in preventing excess neonatal mortality after adjustment for case mix, significant disparities remain in important morbidity outcomes. These findings suggest that modifiable health system factors during off-hours care continue to influence perinatal outcomes and underscore the need for standardized seven-day clinical coverage to improve maternal and neonatal safety.
Vaginal trial outcomes and emergency cesarean section factors among women with different classifications of hypertensive disorders of pregnancy.
Zhang Y, Sun J, Shen J
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42086488 · Publisher ↗
BACKGROUND: Hypertensive disorders of pregnancy (HDP) are a prevalent complication and a leading cause of maternal and perinatal mortality. While vaginal delivery is generally possible for most women with HDP, there is n...
BACKGROUND: Hypertensive disorders of pregnancy (HDP) are a prevalent complication and a leading cause of maternal and perinatal mortality. While vaginal delivery is generally possible for most women with HDP, there is no standardized framework detailing variations in vaginal delivery outcomes across different HDP classifications or identifying the factors influencing emergency cesarean section (EmCS). OBJECTIVE: To explore the vaginal trial outcomes and risk factors associated with emergency cesarean section among women with different classifications of HDP. METHODS: This was a single-center retrospective cohort study of 894 pregnant women with HDP who underwent a vaginal trial. Of these, 584 were diagnosed with gestational hypertension, 216 with pre-eclampsia, and 94 with chronic hypertension. The study collected and compared detailed maternal and perinatal outcomes. RESULTS: (1) The success rate of vaginal delivery ranged from 85.1% to 90.8% across various classifications of HDP without significant differences. (2) Chronic hypertension was four times more likely to lead to intrapartum poorly controlled blood pressure than gestational hypertension. (3) Factors influencing EmCS in HDP included parity, antepartum BMI, labor induction, intrapartum fever, intrapartum antihypertensive use, and oxytocin during stages of labor. Parity served as an independent protective factor across all HDP classifications. Stratified analysis revealed that for gestational hypertension, risk factors included antepartum BMI ≥ 30 kg/m, labor induction, and intrapartum antihypertensive use. For pre-eclampsia, oxytocin and intrapartum fever were risk factors. In chronic hypertension, antepartum BMI ≥ 30 kg/m and intrapartum fever were identified as risk factors, although the former was not significant. CONCLUSION: The success rate of vaginal trials across various classifications of HDP is high. Vaginal trial can impact intrapartum blood pressure, particularly for women with chronic hypertension. Tailored management strategies should include encouraging vaginal trial for multiparous women, control of antepartum BMI, judicious use of labor induction, and vigilant monitoring of hypertension and fever, with individualized evaluation and treatment based on HDP classification.
Assisted reproductive technology and birth defects: analysis of the mediating pathways in twin pregnancies.
Hu F, Zhu H, Fang J … +2 more , Li B, Xie D
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42086487 · Publisher ↗
OBJECTIVE: To systematically evaluate the epidemiological association between ART and the risk of birth defects. METHODS: Based on the latest provincial monitoring data from a large sample in Hunan Province, China for th...
OBJECTIVE: To systematically evaluate the epidemiological association between ART and the risk of birth defects. METHODS: Based on the latest provincial monitoring data from a large sample in Hunan Province, China for the period 2023-2024, we conducted a retrospective study comparing baseline characteristics between ART-conceived and naturally-conceived pregnancies. Through multivariable logistic regression, we estimated ART-birth defect associations, with interaction analyses across key subgroups. Besides, we performed mediation analysis to quantify twin pregnancy's role in the ART-birth defect relationship. RESULTS: A total of 745,671 fetuses were included in this study. Regression analysis showed that assisted reproduction is a risk factor for birth defects, with an adjusted odds ratio(aOR) of 1.84 (1.68-2.01). Compared with infants born through natural conception, infants conceived through ART had a significantly increased risk of birth defects (single fetus: aOR = 1.59, 95% confidence interval [CI]: 1.42-1.77; twin fetus: aOR = 1.83, 95%CI: 1.51-2.21). The risk of specific birth defect subtypes in infants conceived through ART was significantly increased, including: circulatory system defects, musculoskeletal abnormalities, and cleft lip and palate. Subgroup analysis showed that gestational age ( < 0.001) and place of residence ( = 0.007) had significant interaction effects on the association between ART and birth defects. In addition, in the mediation analysis, twin pregnancies could explain 14.33% of the relative impact of ART on birth defects. CONCLUSIONS: This study has found that the use of ART increases the risk of birth defects. In the association between ART and birth defects, twin pregnancies accounted for 14.33%.
The effect of maternal scent-infused blanket on the stress level, crying duration and physiological parameters of premature newborns.
Shafaati Laleh S, Inal S, Mirghafourvand M
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42070973 · Publisher ↗
BACKGROUND: Olfactory cues from the mother may soothe distress in premature infants in the Neonatal Intensive Care Unit (NICU). This study evaluated the effect of a maternal scent-infused blanket on stress, crying durati...
BACKGROUND: Olfactory cues from the mother may soothe distress in premature infants in the Neonatal Intensive Care Unit (NICU). This study evaluated the effect of a maternal scent-infused blanket on stress, crying duration, and physiological parameters in premature newborns. METHODS: This double-blind randomized clinical trial included 69 premature infants who were randomly assigned to one of three groups: maternal scent-infused blanket, unscented blanket, or control (no blanket) group. Infants were covered with the assigned blanket for 60 min daily for 3 consecutive days. The maternal scent was obtained by placing a clean blanket in contact with the mother's bare chest overnight prior to each day's exposure, with fragrance-free cleansing products used and a new blanket for each session. Primary outcomes were stress level (Newborn Stress Scale, NSS), crying duration (chronometer), and Secondary outcomes were physiological parameters (heart rate, respiratory rate, oxygen saturation, and body temperature). Measurements were collected at 5 min before intervention, immediately after, and at 15, 30, 45, and 60 min during intervention, plus 5 min after intervention, each day for three consecutive days. Data were analyzed using one-way ANOVA and ANCOVA adjusting for baseline values; < 0.05 denoted significance. RESULTS: Stress scores and crying duration differed significantly among groups during the intervention, with the maternal scent-infused blanket group showing lower NSS scores and shorter crying times than the unscented and no-blanket groups ( < 0.001). During exposure, heart rate, oxygen saturation, and body temperature differed among groups (significant at multiple time points, < 0.001); by contrast, respiratory rate did not differ significantly ( > 0.05). Differences were not observed at baseline or immediately after the intervention for these physiological measures. CONCLUSION: The maternal scent-infused blanket may reduce stress and crying duration, with transient improvements in some physiological parameters during exposure. Maternal olfactory cues could serve as a feasible non-pharmacological adjunct to support comfort and well-being in vulnerable newborns, emphasizing parental involvement in neonatal care.
Association of interpregnancy interval with hypertensive disorders of pregnancy: a retrospective cohort study.
Luo M, Wang Y, Wang Y … +2 more , Zhao J, Gao J
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42055952 · Publisher ↗
OBJECTIVE: The optimal interpregnancy interval (IPI) for preventing hypertensive disorders of pregnancy (HDP) remains unclear, and whether this association is modified by maternal baseline characteristics has not been we...
OBJECTIVE: The optimal interpregnancy interval (IPI) for preventing hypertensive disorders of pregnancy (HDP) remains unclear, and whether this association is modified by maternal baseline characteristics has not been well established. This study aimed to evaluate the association between IPI and the risk of HDP and to examine potential effect modification by maternal characteristics. METHODS: This retrospective cohort study included 1,633 women with at least two consecutive singleton deliveries between 2014 and 2023. IPI was modeled as a continuous variable in regression analyses. Modified Poisson regression with robust variance was applied to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for HDP and preeclampsia. Subgroup and sensitivity analyses were performed to assess effect modification and the robustness of the findings. RESULTS: After full adjustment, longer IPI was weakly but statistically significantly associated with an increased risk of HDP (adjusted RR [aRR] = 1.009 per month, 95% CI: 1.001-1.017, = 0.024). No significant association was observed between IPI and preeclampsia (all > 0.05). A significant interaction with prior HDP status was observed ( for interaction = 0.023); 10.3% of participants had a history of HDP, and the positive association between longer IPI and HDP was confined to women without prior HDP (aRR = 1.017, = 0.005). No statistically significant interaction was observed for maternal age or pre-pregnancy BMI. Sensitivity analyses demonstrated consistent results across multiple scenarios, including additional adjustment for aspirin use. CONCLUSION: Longer IPI was independently associated with a modest increase in the risk of HDP, particularly among women without prior HDP. No significant association was observed for preeclampsia, suggesting that IPI may primarily influence the broader HDP phenotype rather than specific subtypes. These findings support the consideration of IPI in preconception counseling, with an emphasis on individualized risk assessment.
Methodological reflections on early postpartum severe maternal morbidity among mothers of low birthweight infants.
Antar AS, Roghani F, Nisa NU … +1 more , Riaz L
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42045105 · Publisher ↗
Abstract loading — click title to view on PubMed.
Risk factor analysis and nomogram predictive model construction for neonatal hypospadias: a large-scale multicenter study in East China.
Hu W, Zhao J, Chen C … +6 more , Zhong Z, Zheng P, Wei J, Liang P, Zhu Q, Luo Q
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42045102 · Publisher ↗
OBJECTIVE: To conduct a retrospective multicenter study using objective data from a large sample size, which in order to identify reliable risk factors for hypospadias and establish a practical predictive model. METHODS:...
OBJECTIVE: To conduct a retrospective multicenter study using objective data from a large sample size, which in order to identify reliable risk factors for hypospadias and establish a practical predictive model. METHODS: We retrospectively studied the medical records of the mothers who gave birth at Women's Hospital of Zhejiang University, School of Medicine, which was the obstetric treatment center in East China, and Xinchang Maternal and Child Health Hospital, and Quzhou Maternal and Child Health Hospital, from January 2019 to December 2021. RESULTS: 42809 male babies were born in the three hospitals, including 139 of which were diagnosed with hypospadias. The incidence of hypospadias was 0.325%. 33591 mothers and 35517 newborns were finally included to the statistical analysis. Among them, there were 121 newborns diagnosed with hypospadias and 121 mothers who gave birth to the hypospadias newborns. Premature birth, multiple pregnancies, gestational hypertension, fetal distress and abnormal placental morphology were set as the predictor to construct the nomogram model. The internal verification results displayed the area under the curve (AUC) was 0.834 (95% CI = 0.769-0.900), with a specificity of 85.6% and a sensitivity of 68.9%. The temporal verification results displayed the AUC was 0.857 (95% CI = 0.795-0.919), with a specificity of 74.2% and a sensitivity of 85.0%. The slope of the calibration curves were both close to 1, indicating high fitting degree of the model. CONCLUSION: Our findings suggested that premature birth, multiple pregnancies, gestational hypertension, fetal distress and abnormal placental morphology were independent risk factors for hypospadias in newborns. We successfully established a nomogram predictive model for hypospadias, which can effectively, conveniently, clearly and visually predict the risk of hypospadias occurrence.
Response of reticulocyte and red blood cell indices to single-dose intravenous iron in pregnant women with moderate iron deficiency anemia: secondary analysis of the RAPIDIRON trial.
Somannavar MS, Mehta S, Sharma DK … +14 more , Mehta S, S Y, Charantimath U, Leiby BE, Georgieff MK, Aghai ZH, Mallapur A, Ramadurg U, Sangavi R, Patil P, Akshaykirthan JP, Boelig RC, Bellad MB, Derman RJ
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42045095 · Publisher ↗
BACKGROUND: Iron deficiency anemia in pregnancy is a significant health concern. Reticulocyte hemoglobin equivalent (Ret-He) and immature reticulocyte fraction (IRF) are emerging as early markers, yet their response to d...
BACKGROUND: Iron deficiency anemia in pregnancy is a significant health concern. Reticulocyte hemoglobin equivalent (Ret-He) and immature reticulocyte fraction (IRF) are emerging as early markers, yet their response to different iron therapies in pregnancy is underexplored. OBJECTIVE: To determine whether intravenous single-dose iron administration produces a more favorable effect on reticulocyte indices than oral iron therapy in anemic pregnant women. METHODS: This is a secondary analysis of the RAPIDIRON Trial, a multicenter, three-arm randomized controlled trial comparing ferric carboxymaltose (FCM), ferric derisomaltose (FDM) and standard oral ferrous sulfate. Reticulocyte hemoglobin equivalent (Ret-He), Immature Reticulocyte Fraction (IRF) and other red blood cell indices including Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Hemoglobin Concentration (MCHC) were measured at baseline (12-16 weeks), mid-gestation (26-30 weeks) and 42 days postpartum. Cord blood indices were assessed at delivery. RESULTS: By 26-30 weeks of gestation, iron deficient anemic women receiving IV iron demonstrated significant improvements in all red cell indices when compared to those receiving oral iron. Specifically, MCV increased by 2.87 fL (95% CI, 2.41-3.33) in the IV FDM group and 3.02 fL (95% CI, 2.54-3.49) in the IV FCM group compared to oral iron. Similarly Ret-He levels were also significantly increased in IV FDM and FCM compared to oral iron (1.32 (1.02, 1.63) and 1.31 (1.01, 1.62) respectively. By 42 days postpartum, intergroup differences in Ret-He, IRF and other parameters were no longer statistically significant, indicating that hematologic parameters had converged across treatment arms, reflecting restoration of iron homeostasis and stabilization of erythropoiesis in all groups. CONCLUSION: Intravenous iron therapy produces a more rapid and pronounced improvement in maternal red cell and reticulocyte indices than oral iron in moderately anemic pregnant women. Ret-He and IRF are emerging as early and sensitive biomarkers of iron availability and erythropoietic activity, with potential clinical utility for early detection of treatment response and optimization of iron therapy in pregnancy.
Evaluation of rapid intrapartum PCR screening for Group B Streptococcus in mothers of full-term newborns at a level 3 maternity center.
Dentaud L, Gascoin G, Paret L … +5 more , Brehin C, Marechal O, Vayssiere C, Bettiol C, Assouline C
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42036407 · Publisher ↗
BACKGROUND: Rapid intrapartum PCR testing for Group B Streptococcus (GBS) has been implemented in our Maternity Hospital since March 2020 to better identify women at highest risk of transmitting GBS during labor. MATERIA...
BACKGROUND: Rapid intrapartum PCR testing for Group B Streptococcus (GBS) has been implemented in our Maternity Hospital since March 2020 to better identify women at highest risk of transmitting GBS during labor. MATERIALS AND METHODS: We conducted a single-center, observational, descriptive study comparing two populations of full-term newborns delivered by women who underwent either vaginal GBS culture in 2019 or rapid intrapartum GBS PCR in 2022. Newborns with congenital anomalies, surgical conditions, or severe hypoxic-ischemic encephalopathy were excluded. RESULTS: A total of 8,634 mother-newborn dyads were included and analyzed. The incidence of early onset GBS sepsis was 0,46 per 1,000 live births. We observed a significant reduction in the proportion of neonates receiving antibiotic therapy more than 72 h (OR 0.60 [0.40;0.88]), as well as a significant overall decrease in neonatal antibiotic use (OR 0.64 [0.47;0,89]). In 2022, only 0,76% of pregnant women had an unknown GBS status at delivery. The administration of intrapartum antibiotic prophylaxis remained appropriate, with no increase in the proportion of women receiving antibiotics (12,3% in 2019 vs. 12,2% in 2022). CONCLUSION: Rapid intrapartum GBS PCR testing appears to be a valuable screening tool for preventing neonatal GBS infections.
Letter to the editor regarding the article: ultrasonographic characteristics and outcome of fetal intrahepatic umbilical-porto-systemic venous shunts: a single-center study.
Noor M, Sufiyan R
J Matern Fetal Neonatal Med · 2026 Dec · PMID 42036406 · Publisher ↗
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