J. Matern. Fetal. Neonatal. Med. [JOURNAL]
Sun
200 papers
Key protein identification in endometrium of recurrent pregnancy loss patients through integrated proteomic and transcriptomic analysis.
Huang S, Mu F, Wang K … +1 more , Wang F
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41942343 · Publisher ↗
BACKGROUND: Multiple omics studies on patients with recurrent pregnancy loss (RPL) have deepened the understanding of its pathogenesis. However, few studies have combined multi-omics techniques to provide a more accurate...
BACKGROUND: Multiple omics studies on patients with recurrent pregnancy loss (RPL) have deepened the understanding of its pathogenesis. However, few studies have combined multi-omics techniques to provide a more accurate characterization of RPL. This study aims to identify biomarkers with RPL through proteomic and transcriptomic analyses, providing new insights for its diagnosis and treatment. METHODS: Endometrial tissue samples were collected from RPL patients ( = 34) and normal controls ( = 22) for proteomic analysis to identify differentially expressed proteins (DEPs). Protein-protein interaction network analysis and functional enrichment analysis were performed to explore the biological functions of the DEPs. LASSO regression was used to screen for hub proteins, which were further validated using transcriptomic data from the GSE165004 dataset (24 RPL patients and 24 controls). An artificial neural network (ANN) model was constructed to assess the classification performance of the key DEPs. RESULTS: A total of 275 DEPs were identified between the RPL group and the normal groups. Function enrichment analyses revealed significant involvement of these DEPs in immune and inflammatory responses. LASSO analysis identified 23 hub proteins. By combining transcriptomic data, five proteins, FOSB, HPS4, MRPL34, LCAT, and TMSB10 were ultimately identified as key DEPs. The ANN model demonstrated high accuracy in distinguishing between RPL patients and normal controls, with an accuracy rate of 81.25%. CONCLUSION: Our study identified five key DEPs closely associated with RPL and revealed their promising diagnostic potential. Future validation in independent cohorts and functional studies is warranted to confirm their value as diagnostic biomarkers. CLINICAL TRIALS REGISTRY: Not applicable.
Prokineticin 2 is upregulated in preeclampsia and impairs trophoblast function.
Li Y, Qin T, Long XG … +2 more , Wei HT, Chi Y
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41936573 · Publisher ↗
OBJECTIVE: To investigate the role of prokineticin 2 (PK2) in the pathogenesis of preeclampsia (PE), a severe hypertensive disorder of pregnancy with incompletely understood placental mechanisms. METHODS: The placental e...
OBJECTIVE: To investigate the role of prokineticin 2 (PK2) in the pathogenesis of preeclampsia (PE), a severe hypertensive disorder of pregnancy with incompletely understood placental mechanisms. METHODS: The placental expression of PK2 and prokineticin receptor 2 (PKR2) was assessed by immunohistochemistry, and PK2 levels were quantified by enzyme-linked immunosorbent assay in samples from patients with PE and a PE mouse model, compared with normal controls. The functional impact of recombinant PK2 protein on proliferation and migration was assessed in the trophoblast cell line HTR-8/SVneo. Transcriptomic analysis was performed on PK2-treated cells to identify differentially expressed genes and enriched pathways. RESULTS: PK2 and PKR2 were significantly upregulated in PE placentas. PK2 expression was significantly higher in the culture medium of primary trophoblast cells derived from PE patients and a PE mouse model than in that from normal controls. Recombinant PK2 markedly inhibited trophoblast proliferation and migration. Transcriptomic analysis revealed PK2-induced upregulation of a gene set (including , , , , and ) with significant enrichment in stress-response and inflammatory pathways. CONCLUSIONS: This study identifies PK2 as a key pathogenic factor in PE that impairs trophoblast function. The findings suggest that its mechanism may involve the induction of AP-1 components. Our work provides the first evidence positioning the PK2/PKR2 axis as a novel contributor to PE pathogenesis and a potential therapeutic target.
Response to letter regarding "role of the cerebroplacental ratio and non-stress test in predicting adverse perinatal outcomes in high-risk pregnancies.
Nguyen Thi HT, Nguyen Thi NH, Van TV … +1 more , Nguyen Vu QH
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41916877 · Publisher ↗
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The association between mode of delivery and severe intraventricular hemorrhage in very preterm infants.
Keel E, Kalimeris S, Adams M … +1 more , Grass B
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41905948 · Publisher ↗
BACKGROUND: Infants born before 32 weeks of gestation are at high risk of developing intraventricular hemorrhage (IVH), which is associated with significant mortality and morbidity as well as long-term neurodevelopmental...
BACKGROUND: Infants born before 32 weeks of gestation are at high risk of developing intraventricular hemorrhage (IVH), which is associated with significant mortality and morbidity as well as long-term neurodevelopmental impairment. There is currently a lack of consensus regarding the impact of delivery mode on these infants. Therefore, the aim of this study was to determine the association between mode of delivery and the incidence of severe intraventricular hemorrhage (sIVH) in very to extremely preterm infants born before 32 weeks of gestation. METHODS: This retrospective cohort study was conducted at the University Hospital Zurich, Switzerland, using integrated obstetric and neonatal databases. Live births born between 23 + 0 and 31 + 6 weeks from 2015 to 2023 were included. Confounders were selected a priori based on a direct acyclic graph, and severe IVH incidence was compared between vaginal and cesarean delivery using univariable and multivariable logistic regression models. RESULTS: A total of 683 infants were eligible for analysis. The proportion of children born by cesarean section was 77.5%. The incidence of sIVH in preterm infants delivered by cesarean section was 4.7% compared to 3.9% in vaginal deliveries. The univariable logistic regression analysis demonstrated no significant association between cesarean section and sIVH (OR 1.32, 95% CI 0.53-3.28, = 0.529). CONCLUSION: In this cohort of very and extremely preterm infants, there was no significant association between the incidence of severe IVH and mode of delivery. These findings do not support cesarean sections as a preventive measure for sIVH and highlight the importance of optimizing pre-, peri-, and postnatal factors that impact haemodynamic stability.
Prevalence and related factors for low birth weight among singleton neonates: a retrospective cross-sectional study.
Nie F, Chen S, Wang Z … +1 more , Wei G
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41905931 · Publisher ↗
BACKGROUND: Low birth weight (LBW) is one of the major causes of neonatal mortality and an important factor influencing the growth and development of newborns. This study aimed to investigate the prevalence of LBW and it...
BACKGROUND: Low birth weight (LBW) is one of the major causes of neonatal mortality and an important factor influencing the growth and development of newborns. This study aimed to investigate the prevalence of LBW and its related maternal and neonatal factors. METHODS: This was a retrospective cross-sectional study. The research subjects were 89,214 pregnant women who gave birth at Maternity & Child Healthcare Hospital of Longgang District, Shenzhen City from 2015 to 2021. Factors associated with LBW encompassed demographic characteristics, antenatal and obstetric factors, and neonatal states. R software was used for statistical analyses, and multivariable logistic regression was performed to identify the significantly related factors of LBW. RESULTS: The prevalence of LBW in this study was 3.88%. Education level (Junior college and below vs. College and above, OR: 1.18, 95%CI 1.09-1.29), parity (Nulliparous vs. Parous, OR: 1.37, 95%CI 1.20-1.56), pre-pregnancy BMI (Underweight vs. Normal, OR: 1.62, 95%CI 1.47-1.78), mode of delivery (Cesarean section vs. Vaginal delivery, OR: 1.70, 95%CI 1.56-1.86), congenital malformation (Yes vs. No, OR: 2.79, 95%CI 2.40-3.25), sex of neonate (Female vs. Male, OR: 1.70, 95%CI 1.56-1.85), Apgar 1 min score (<7 vs. ≥7, OR: 4.57, 95%CI 2.73-7.58), number of antenatal care visits (<8 vs. ≥8, OR: 1.97, 95%CI 1.80-2.15), gestational age (<37 weeks vs. ≥37 weeks, OR: 48.80, 95%CI 44.65-53.36), pregnancy complications (Yes vs. No, OR: 1.69, 95%CI 1.52-1.88) were identified as risk factors for LBW. Number of pregnancies (2 vs. 1, OR: 0.82, 95%CI 0.72-0.94; ≥3 vs. 1, OR: 0.75, 95%CI 0.64-0.87) was considered as a protective factor. Premature birth, pregnancy complications, and insufficient antenatal care visits had synergistic effects on LBW. CONCLUSIONS: LBW was correlated with specific maternal and neonatal factors, and there were interactions between the influencing factors. Compared with a single intervention, comprehensively assessing pregnancy risks to develop personalized antenatal care may be more effective.
Research progress on the complications related to cervical cerclage failure.
Wu Y, Shen K, Hu C … +3 more , Wei J, Huang J, Pei C
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41905902 · Publisher ↗
To systematically clarify the severe complications, clinical risk factors, and predictive biomarkers associated with cervical cerclage (CC) failure to guide individualized clinical decisions. A narrative review was condu...
To systematically clarify the severe complications, clinical risk factors, and predictive biomarkers associated with cervical cerclage (CC) failure to guide individualized clinical decisions. A narrative review was conducted by searching electronic databases (PubMed and Web of Science) for English-language studies. The review synthesizes evidence-based data on surgical complications, clinical risk factors, and novel inflammatory biomarkers. Severe post-operative adverse events, such as preterm premature rupture of membranes (PPROM) and chorioamnionitis (CAM), are most prevalent in physical examination-indicated cerclage (PEIC). Key risk factors for surgical failure include advanced cervical dilatation, fetal membrane protrusion, and vaginal microbial dysbiosis. Emerging evidence suggests that inflammatory markers in maternal blood (e.g., SII, SIRI) and amniotic fluid, alongside vaginal abundance, serve as potential novel biomarkers for predicting cervical cerclage failure. Cervical insufficiency is increasingly recognized as an inflammation-related syndrome. While novel biomarkers show promise for predicting outcomes, their clinical value must be further validated through large-scale, prospective, multicenter studies.
Association between second-trimester sFlt-1/PlGF ratio and composite adverse neonatal outcome in patients with preeclampsia.
Liu J, Yang N, Zhang M … +1 more , Zhang S
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41883315 · Publisher ↗
OBJECTIVES: To investigate the predictive performance of the second-trimester soluble fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PlGF) ratio for composite adverse neonatal outcome (CANO) in preeclampsia (...
OBJECTIVES: To investigate the predictive performance of the second-trimester soluble fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PlGF) ratio for composite adverse neonatal outcome (CANO) in preeclampsia (PE). METHODS: This retrospective cohort study enrolled 253 PE women during June 2022-June 2024. Maternal serum levels of sFlt-1 and PlGF were assessed, and their ratio was determined at 13-27 gestational weeks. Subjects were stratified into CANO ( = 80) and non-CANO ( = 173) groups. Baseline characteristics and the sFlt-1/PlGF ratio were compared. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors for CANO. Predictive value was assessed using ROC curve analysis, and a nomogram prediction model was constructed. RESULTS: The sFlt-1/PlGF ratio was markedly higher in the CANO group than the non-CANO group ( < 0.001). Multivariate analysis identified the sFlt-1/PlGF ratio ( = 1.040, 95% : 1.020-1.060, < 0.001), serum uric acid level ( = 1.007, 95% : 1.000-1.013, = 0.043), and history of pre-pregnancy hypertension ( = 13.51, 95% : 2.065-88.36, = 0.007) as independent risk factors for CANO. Conversely, gestational age at delivery ( = 0.727, 95% : 0.621-0.852, < 0.001) was a protective factor. The sFlt-1/PlGF ratio predicted CANO with an AUC of 0.799 (95% : 0.743-0.855). The integrated nomogram model achieved a C-index of 0.880 (95% : 0.836-0.923), indicating excellent discrimination. CONCLUSION: The second-trimester sFlt-1/PlGF ratio is an independent predictor for CANO in PE. A model incorporating this biomarker facilitates the early identification of high-risk neonates, informing personalized perinatal management.
Retraction Statement: 'Efficacy of ferrous bis-glycinate versus ferrous glycine sulfate in the treatment of iron deficiency anemia with pregnancy: a randomized double-blind clinical trial'.
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41883305 · Publisher ↗
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Association between diabetes mellitus type 2 and cervical insufficiency: a retrospective case-control study.
Tersigni C, Beneduce G, Onori M … +4 more , Sannino F, Petrecca A, Di Simone N, Ghi T
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41883297 · Publisher ↗
AIMS: Cervical insufficiency (CI) is the inability of the cervix to retain the pregnancy leading to a high risk of second-trimester fetal loss or extremely preterm birth. There is no current evidence of any association b...
AIMS: Cervical insufficiency (CI) is the inability of the cervix to retain the pregnancy leading to a high risk of second-trimester fetal loss or extremely preterm birth. There is no current evidence of any association between CI and maternal abnormal glucose tolerance (AGT). The aim of this study was to investigate a potential association between CI and maternal AGT. MATERIAL AND METHODS: This retrospective case-control study was conducted by recruiting all women referred to the Department of Women and Child Health of the Research Hospital Gemelli IRCCS of Rome, from 2016 to 2023 for CI. Cases were chosen among patients with an ultrasound finding of short cervical length (<25 mm) before 24 weeks of gestation, with at least one second trimester fetal loss for CI. Healthy women admitted for delivery at term with at least one previous normal pregnancy and no previous fetal losses or preterm deliveries were enrolled as controls. All women enrolled in this study, both cases and controls, were monthly evaluated for fasting glucose levels in pregnancy and underwent oral glucose tolerance test (OGTT) for gestational diabetes mellitus (GDM) screening at 24-28 weeks of gestation. Prevalence of AGT was compared among cases and controls and the finding of AGT was associated with maternal-neonatal outcomes among the study population. Cases and controls were compared using parametric or non-parametric tests, as appropriate. Multivariable logistic regression analyses were performed to account for potential confounders, such as maternal age and BMI. RESULTS: Women with CI showed a significantly higher prevalence of diabetes mellitus type 2 (DM2) (11/96 vs. 1/96, < 0.01), vaginal/cervical infections (45/96 vs. 22/96, < 0.001), and chorioamnionitis (28/96 vs. 0/96, < 0.0001) compared to controls. CONCLUSIONS: Pregnant women with DM2 were eightfold more likely to have CI compared to pregnant women with normal glucose tolerance.
Present status of sFLT1 and PlGF as diagnostic and therapeutic targets for preeclampsia.
Irby MN, Hsu CD, Winget V … +2 more , Srinivasan SA, Goyal R
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41881780 · Publisher ↗
OBJECTIVE: To review the current role of soluble fms-like tyrosine kinase-1 (sFLT1) and placental growth factor (PlGF) in the pathophysiology, diagnosis, prediction, and treatment of preeclampsia. BACKGROUND: Preeclampsi...
OBJECTIVE: To review the current role of soluble fms-like tyrosine kinase-1 (sFLT1) and placental growth factor (PlGF) in the pathophysiology, diagnosis, prediction, and treatment of preeclampsia. BACKGROUND: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality worldwide and has increased in prevalence in the United States. It is characterized by new-onset hypertension, proteinuria, and/or end-organ dysfunction, with early-onset disease often associated with placental ischemia, placental insufficiency, and fetal growth restriction. A central mechanism in preeclampsia is angiogenic imbalance, characterized by increased antiangiogenic factors, particularly sFLT1, and reduced proangiogenic signaling mediated by VEGF and PlGF. METHODS: This review summarizes current evidence regarding sFLT1 biology, the clinical utility of the sFLT1/PlGF ratio, and emerging therapeutic strategies targeting sFLT1 in preeclampsia. RESULTS: sFLT1 is a soluble splice variant of VEGF receptor-1 that binds circulating VEGF and PlGF, thereby promoting endothelial dysfunction, vasoconstriction, and systemic manifestations of preeclampsia. The sFLT1/PlGF ratio has emerged as a clinically useful biomarker, particularly for short-term risk stratification in women with suspected preeclampsia, with strong negative predictive value for ruling out progression to severe disease within 1 to 2 weeks in appropriately selected patients. The ratio has been incorporated into clinical practice in multiple countries and was approved by the US Food and Drug Administration in 2023 for inpatient risk assessment in singleton pregnancies between 23 and 34 weeks and 6 days of gestation with hypertensive disorders of pregnancy. In parallel, therapeutic approaches targeting sFLT1, including small interfering RNA, antibodies, VEGF or PlGF-based molecular strategies, and apheresis, have shown promise in preclinical and early translational studies. CONCLUSION: sFLT1 is central to the pathophysiology of preeclampsia and has substantial clinical relevance as both a biomarker and a potential therapeutic target. The sFLT1/PlGF ratio is reshaping risk assessment and management of preeclampsia, while sFLT1-directed therapies may offer future disease-modifying treatment options. Further refinement of biomarker-guided use and therapeutic development is needed before broader implementation.
The association of gestational age discrepancy in the growth restricted fetus at anatomy ultrasound with small for gestational age neonates: a retrospective cohort study.
Epsten M, Premkumar A, Farooqui A … +5 more , Manthena V, Guernsey E, Sung J, McCormick A, de Los Reyes S
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41871491 · Publisher ↗
OBJECTIVE: To evaluate the association between gestational age (GA) discrepancy in FGR fetuses at time of anatomy US with small for gestational age neonates, as well as evaluate the risk of persistent FGR and adverse per...
OBJECTIVE: To evaluate the association between gestational age (GA) discrepancy in FGR fetuses at time of anatomy US with small for gestational age neonates, as well as evaluate the risk of persistent FGR and adverse perinatal outcomes. DESIGN: Retrospective cohort study of pregnant patients with singleton, non-anomalous gestations diagnosed with FGR at anatomy US performed between 18w0d-21w6d from January 2021 to December 2023. Patients were grouped by GA discrepancy: >10 days vs ≤10 days from EDD. Our primary outcome was SGA neonate at delivery and secondary outcomes included persistent FGR at subsequent ultrasound and adverse perinatal outcomes. Univariable analysis evaluated baseline maternal demographic and clinical differences. Multivariable regression adjusted for a priori maternal age and race/ethnicity. RESULTS: 68 patients met inclusion criteria with 13 (19%) with measured GA > 10 days and 55 (81%) with FGR with measured GA ≤ 10 days. GA > 10 days had a lower weight percentile at anatomy US compared to GA ≤ 10 days (1% vs 7%, < .001) and lower birthweight (2400 g vs. 2680 g, = .030). GA > 10 days had more SGA neonates (53.9% vs 45.5%) but these findings were not significant (RR 1.40, 95% CI 0.416, 4.708) and persisted in multivariable analysis, (aRR 1.48, 95% CI 0.428, 5.091). GA > 10 days were more likely to have persistent FGR and 5-min Apgar score <3. There were no differences in other maternal and perinatal outcomes. CONCLUSIONS: A GA discrepancy >10 days in FGR at anatomy scan was not associated with an increased risk of SGA but was associated with an increased risk of persistent FGR and 5-min Apgar scores <3.
Relationship between infertility and body mass-related indices in women of childbearing age: a cross-sectional study of the NHANES 2013-2016.
Wang Y, Tong L, Yan T … +3 more , Deng Y, Wu K, Yi Y
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41869736 · Publisher ↗
BACKGROUND: To further assess the relationship between obesity and infertility, we employed a novel anthropometric index, specifically designed to assess the relationship between a body shape index (ABSI) and infertility...
BACKGROUND: To further assess the relationship between obesity and infertility, we employed a novel anthropometric index, specifically designed to assess the relationship between a body shape index (ABSI) and infertility in women of childbearing age. Furthermore, we examined the correlation between ABSI and visceral obesity index (VAI) in relation to infertility. METHODS: A total of 1989 female participants of childbearing age were included, based on National Health and Nutrition Examination Survey (NHANES) data from 2013 to 2016. The ABSI is calculated by dividing waist circumference by body mass index (BMI) * height. VAI was calculated using the following formula: waist circumference/(36.58 + (1.89*BMI)) x (triglycerides/0.81) × (1.52/HDL cholesterol). Infertility or fertility status was defined by interviewing female participants of childbearing age through a reproductive health questionnaire. Weighted multifactorial logistic regression analysis was used to explore the independent relationship between ABSI and infertility. Smoothed curve fitting, subgroup analyses and interaction tests were also performed. RESULTS: Among the 1989 participants, 183 (9.2%) women were categorized as infertile. Logistic regression modeling showed that ABSI was positively associated with infertility and remained significant even after adjusting for all confounders(OR = 1.31, 95% CI: 1.07-1.60, = 0.0098). This association was consistent across all subgroups (age, race, smoking, alcohol consumption, hypertension, diabetes mellitus, and the regularity of menstruation over the previous 12 months), ( > 0.05 for all interactions). The results of the smooth curve fitting demonstrated a linear, positive association between ABSI and infertility. CONCLUSION: There is a statistically significant positive correlation between body mass index and infertility. As a body shape index rises, women of childbearing age are at greater risk of infertility.
Prediction models for spontaneous preterm birth in asymptomatic low-risk singleton pregnancies: a systematic review.
Hanumaiah G, Srinivas T, Chaudhuri S … +4 more , Nagendra D, Vasudeva A, Udupa AA, Rao S
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41866245 · Publisher ↗
OBJECTIVE: To systematically review prediction models developed for spontaneous preterm birth (sPTB) in asymptomatic low-risk singleton pregnancies and to evaluate their methodological quality and clinical applicability....
OBJECTIVE: To systematically review prediction models developed for spontaneous preterm birth (sPTB) in asymptomatic low-risk singleton pregnancies and to evaluate their methodological quality and clinical applicability. MATERIALS AND METHODS: A systematic search of PubMed, Scopus, Embase and Cochrane Library was conducted until 20 August 2025, following PRISMA guidelines (PROSPERO: CRD420251129960). Studies reporting development or validation of prediction models for sPTB in asymptomatic low-risk singleton pregnancies were included. Data extraction was performed using the CHARMS checklist, and methodological quality was assessed using the PROBAST tool. Due to substantial heterogeneity in predictors, modeling approaches, and outcome definitions, findings were summarized narratively. RESULTS: Among 16,475 screened records, three prospective cohort studies met the inclusion criteria. Sample sizes ranged from 135 to 1,107, with sPTB rates of 4.4-11.5%. All models were developed using logistic regression, demonstrating moderate to strong apparent discrimination (AUC 0.781-0.94). One model combined uterocervical angle (UCA) ≥99° and cervical length (CL) ≤33.8 mm with odds ratio of 24.3 (95% CI:13.9-42.4), another used the UCA/CL ratio (cutoff 3.09°/mm) with AUC of 0.78, and a third integrated CL with quantitative fetal fibronectin, and glutamate-acetate-D-lactate with AUC of 0.94. CL was a consistent predictor across studies. Marked heterogeneity in predictors, modeling strategies and reporting was observed across studies, limiting comparability. All studies were assessed as having a high risk of bias, primarily within the analysis domain, and none performed internal or external validation. CONCLUSION: Evidence on prediction models for sPTB in asymptomatic low-risk singleton pregnancies remains limited and heterogeneous. None of the existing models demonstrated sufficient methodological rigor or validation for clinical application. Current evidence is insufficient, and robust multicenter studies with standardized predictors, transparent reporting and proper validation are needed to develop reliable prediction models.
Aortic dissection during the perinatal period in women with Marfan-related disorders: a retrospective cohort study using the Japanese Diagnosis Procedure Combination database.
Nariai M, Wada-Hiraike O, Sasabuchi Y … +6 more , Matsuo Y, Yasunaga H, Sayama S, Iriyama T, Harada M, Hirota Y
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41866242 · Publisher ↗
OBJECTIVE: Women with Marfan-related disorders face an elevated risk of aortic dissection during pregnancy and the postpartum period. This study aimed to investigate the incidence of aortic dissection during the perinata...
OBJECTIVE: Women with Marfan-related disorders face an elevated risk of aortic dissection during pregnancy and the postpartum period. This study aimed to investigate the incidence of aortic dissection during the perinatal period in women with Marfan-related disorders. METHODS: This retrospective cohort study analyzed data extracted from the Japanese Diagnosis Procedure Combination, a nationwide administrative claims database. We included women diagnosed with Marfan-related disorders (Marfan syndrome, Loeys-Dietz syndrome, or Ehlers-Danlos syndrome) who delivered between 2010 and 2023. We assessed the incidence of aortic dissection during pregnancy or postpartum hospitalization, and the incidence of re-hospitalization for aortic dissection. Moreover, we described the use of cabergoline and the incidence of aortic dissection. RESULTS: During the study period, we identified a total of 226 deliveries by 175 women with Marfan-related disorders. Cesarean section accounted for 69.0% of deliveries. During pregnancy, 1.8% of cases (4/226) experienced aortic dissection and required aortic surgery. In the postpartum period, 2.7% of cases (6/226) experienced aortic dissection during postpartum hospitalization. Within 1 year after delivery, 2.7% of cases (6/226) underwent re-hospitalization for aortic dissection. Cabergoline was administered for elective avoidance of breastfeeding within 2 days postpartum in 15 (6.6%) cases. The incidence of postpartum aortic dissection did not differ significantly between cabergoline users and non-users. CONCLUSIONS: Women with Marfan-related disorders may remain at risk of developing aortic dissection for up to 1 year postpartum.
Maternal hypertension and survival without bronchopulmonary dysplasia in preterm infants: a meta-analysis of cohort studies.
Wang S, Yu H, Li C … +4 more , Luo L, Dong W, Zhou J, Lei X
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41866235 · Publisher ↗
BACKGROUND: The association between hypertensive disorders of pregnancy (HDP) and bronchopulmonary dysplasia (BPD) in preterm infants remains controversial due to inconsistent findings in previous studies. However, syste...
BACKGROUND: The association between hypertensive disorders of pregnancy (HDP) and bronchopulmonary dysplasia (BPD) in preterm infants remains controversial due to inconsistent findings in previous studies. However, systematic studies and meta-analyses evaluating the association remain limited. METHODS: The study followed the Meta-analysis of Observational Studies in Epidemiology (PRISMA) reporting guideline. The PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and the Chinese Science and Technology Periodical Database (VPCS) databases were searched from January 1997 to October 2024. Search terms included gestational hypertension, preeclampsia, eclampsia, or superimposed preeclampsia on chronic hypertension; bronchopulmonary dysplasia; Premature Birth; and Stillbirth, Fetal Death or Perinatal Mortality. A random-effects meta-analysis model was used to clarify the relationships between HDP and 1) survival without BPD, 2) BPD, and 3) perinatal mortality. RESULTS: A total of 29538 publications were found, of which 21 were included in the meta-analysis. HDP was associated with reduced survival without BPD (RR 0.875, 95% CI 0.818, 0.935) and increased BPD risk (RR 1.211, 95% CI 1.101, 1.332), while no significant link with perinatal mortality (RR 1.005, 95% CI 0.781, 1.291). Stratified analyses suggested that gestational age, publication year, and geographic region may partly explain the heterogeneity among previous findings. CONCLUSIONS: HDP negatively correlates with survival without BPD and positively correlates with BPD in preterm infants, underscoring the need for targeted postnatal pulmonary monitoring.
Prenatal radiofrequency ablation for bronchopulmonary sequestration: a case report of successful fetal intervention and longitudinal outcomes.
Xi H, Su H, Jiang Z … +5 more , Li G, Luo Y, Tang Y, Zhang H, Ling D
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41850878 · Publisher ↗
INTRODUCTION: Bronchopulmonary sequestration (BPS), a rare congenital pulmonary malformation, is characterized by nonfunctional pulmonary parenchyma with aberrant systemic arterial supply (typically from the aorta or its...
INTRODUCTION: Bronchopulmonary sequestration (BPS), a rare congenital pulmonary malformation, is characterized by nonfunctional pulmonary parenchyma with aberrant systemic arterial supply (typically from the aorta or its major branches) and absence of communication with the tracheobronchial tree. Large BPS lesions pose significant fetal risks, including hydrops fetalis, mediastinal shift, and polyhydramnios, necessitating timely prenatal intervention to prevent fetal demise. CASE PRESENTATION: We present a case of successful ultrasound-guided radiofrequency ablation (RFA) of the feeding artery in a fetus diagnosed with BPS at 22 weeks of gestation. Under ultrasound guidance, a 17-gauge RFA needle was percutaneously inserted into the aberrant feeding artery, achieving complete vascular occlusion without procedural complications. Serial prenatal ultrasounds demonstrated progressive lesion involution. The pregnancy was complicated by cephalopelvic disproportion (CPD), prompting cesarean delivery at 38 weeks. Neonatal computed tomography (CT) confirmed shrinkage of the residual sequestration tissue. Six-month postnatal follow-up revealed normal respiratory function, age-appropriate growth, and developmental milestones. CONCLUSION: RFA represents a safe and effective minimally invasive prenatal therapy for BPS. Candidate selection requires comprehensive evaluation of fetal hydrops, lesion size, gestational age, and parental preferences. Amniotic fluid sampling during the procedure is advisable for genetic/ancillary testing. This case highlights the utility of RFA in optimizing fetal outcomes while avoiding open neonatal period surgery. Long-term neonatal follow-up supports the durability of vascular occlusion and functional recovery.
Early predictive value of maternal peripheral blood circulating immune cell counts for spontaneous preterm birth.
Zhou C, Xu Y, Yang S … +1 more , Huang J
J Matern Fetal Neonatal Med · 2026 Mar · PMID 41850874 · Publisher ↗
OBJECTIVE: To investigate the profiles of circulating immune cells in maternal peripheral blood in spontaneous preterm birth (SPB) and evaluate their potential for the early prediction of SPB, thereby providing a basis f...
OBJECTIVE: To investigate the profiles of circulating immune cells in maternal peripheral blood in spontaneous preterm birth (SPB) and evaluate their potential for the early prediction of SPB, thereby providing a basis for clinical screening of preterm birth risk. METHODS: This study included 43 women with SPB (SPB group) and 129 women who delivered at term (term delivery group). Baseline characteristics (e.g. age, pre-pregnancy body mass index, obstetric history) were compared between the two groups. Peripheral blood samples were collected at 26 ± 1 weeks of gestation during routine antenatal examination. The proportions of T cells, B cells, natural killer (NK) cells, CD4 T cells, and CD8 T cells in peripheral blood were measured by flow cytometry, and the CD4/CD8 ratio was calculated. Variables with significant intergroup differences in baseline data were entered into multivariate regression analysis to identify independent associations between immune cell parameters and SPB. Three predictive models were constructed using backward stepwise logistic regression: an immune cell model, a clinical characteristics model, and a combined model (clinical characteristics + immune cells). The predictive performance of each model was evaluated using the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. RESULTS: Significant between‑group differences were observed in the proportion of multiparous women and history of preterm birth, with a trend toward significance for history of abortion. Cervical length was significantly shorter in the SPB group. Compared with the term delivery group, the SPB group exhibited significantly higher percentages of NK cells and CD8 T cells, and a significantly lower CD4/CD8 ratio. Multivariate regression analysis indicated that a lower CD4/CD8 ratio and a higher NK cell percentage were independently associated with SPB. Among the three predictive models, Model 1 (immune cells) and Model 2 (clinical characteristics) showed comparable AUC values of 0.777 and 0.775, respectively. Model 3 (combined) demonstrated significantly superior predictive performance, with an AUC of 0.857, a sensitivity of 74.42%, and a markedly improved specificity of 82.95%. CONCLUSION: Women with SPB exhibit features of immune imbalance characterized by elevated NK cells, elevated CD8 T cells, and a decreased CD4/CD8 ratio. The CD4/CD8 ratio and NK cell percentage were independently associated with SPB.
Commentary: Translating the PRIME Trial into European obstetric care.
Di Renzo GC, Simeoni U, Anumba DOC
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41833452 · Publisher ↗
Abstract loading — click title to view on PubMed.
A novel c.2429dup mutation causing kabuki syndrome type 2 identified in a fetus with increased nuchal translucency.
Liang Y, Liu T, Zhang C … +5 more , Gao J, Dai M, Xu Z, Qiao F, Wang Y
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41833451 · Publisher ↗
BACKGROUND: Kabuki syndrome (KS) is a rare, multiple congenital anomaly syndrome, characterized by dysmorphic facial features, skeletal anomalies, dermatoglyphic abnormalities, developmental delay, mild-to-moderate intel...
BACKGROUND: Kabuki syndrome (KS) is a rare, multiple congenital anomaly syndrome, characterized by dysmorphic facial features, skeletal anomalies, dermatoglyphic abnormalities, developmental delay, mild-to-moderate intellectual disability, and postnatal growth restriction. KS type 1 (KS1, OMIM 147920) is caused by autosomal dominant pathogenic mutations in , and KS type 2 (KS2, OMIM 300867) is caused by X-linked dominant pathogenic mutations in . OBJECTIVES: To identify the genetic etiologies in a fetus with increased nuchal translucency (NT) observed by ultrasound at 11weeks of gestation. METHODS: Chromosomal microarray analysis (CMA) and trio-exome sequencing (trio-ES) were performed on amniotic fluid sample to investigate the potential genetic causes. Sanger sequencing was utilized for validation of the candidate variant. RESULTS: A 28-year-old Chinese pregnant woman was referred for prenatal evaluation due to fetal increased NT (NT = 6.7 mm). CMA yielded a normal result, with no pathogenic or likely pathogenic copy number variants, or mosaicism detected. However, trio-ES identified a novel frameshift mutation (NM_021140.4: c.2429dup (p.Thr811Aspfs*2)) in the gene. This variant was classified as pathogenic (PVS1 + PS2_Supporting + PM2_Supporting) based on the American College of Medical Genetics and Genomics guidelines. CONCLUSIONS: The fetus was diagnosed with X-linked dominant KS2. The identification of this novel frameshift variant, together with the first report of increased NT as a prenatal feature, enriched both the mutation spectrum and prenatal phenotypic spectrum of KS2. These findings underscore the diagnostic utility of ES for fetuses with increased NT, especially when CMA yields normal results.
Cesarean scar pregnancy as a precursor lesion for placenta accreta spectrum: evidence and implications.
Bucak M, Akkus F, Turan S … +1 more , Turan O
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41819987 · Publisher ↗
BACKGROUND: Cesarean scar pregnancy (CSP) is a form of abnormal implantation in which the gestational sac embeds within the myometrial defect of a previous cesarean incision. Its incidence is rising in parallel with incr...
BACKGROUND: Cesarean scar pregnancy (CSP) is a form of abnormal implantation in which the gestational sac embeds within the myometrial defect of a previous cesarean incision. Its incidence is rising in parallel with increasing cesarean delivery rates. Emerging evidence indicates that CSP and placenta accreta spectrum (PAS) share common histopathological and sonographic characteristics, supporting the concept that CSP represents an early phenotype within the PAS. OBJECTIVE: To synthesize current evidence on the diagnosis, classification and management of CSP and to clarify the biological and clinical continuum linking CSP with PAS, with emphasis on early prediction and reproductive implications. RESULTS: Early first-trimester targeted transvaginal ultrasonography, including assessment of residual myometrial thickness, implantation site, vascularity and standardized classification systems, remains central to diagnosis and risk stratification. Surgical approaches that incorporate scar resection laparoscopy, laparotomy or transvaginal techniques demonstrate the highest success and lowest recurrence rates, as excision of scar tissue restores myometrial integrity. Other modalities such as suction curettage, hysteroscopy, local methotrexate, uterine artery embolization, balloon tamponade and high-intensity focused ultrasound show variable effectiveness depending on gestational age and CSP subtype. Expectant management may result in live birth, but it carries substantial risk because PAS develops in up to 80% of ongoing pregnancies and severe hemorrhage and hysterectomy are common. Shared pathological findings such as deficient decidualization, myometrial disruption and abnormal uteroplacental vascular remodeling support the concept that CSP and PAS represent a unified pathological spectrum rather than distinct entities. CONCLUSION: CSP may represent an early phenotype within the PAS. Standardized terminology, early first-trimester screening and risk-based management strategies are essential to reduce maternal morbidity and optimize reproductive outcomes. Multicenter prospective studies are needed to guide evidence-based prevention and treatment strategies.
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