J. Matern. Fetal. Neonatal. Med. [JOURNAL]
Sun
200 papers
The effect of Helicobacter pylori infection on pregnancy and fetal complications: a systematic review and meta-analysis.
Ahmadi S, Ardalani P, Ahmadi S … +2 more , Moradi Y, Ghadirzadeh B
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41748262 · Publisher ↗
BACKGROUND: The association between Helicobacter pylori infection and adverse pregnancy outcomes has remained uncertain due to heterogeneous diagnostic approaches. A systematic review and meta-analysis was therefore cond...
BACKGROUND: The association between Helicobacter pylori infection and adverse pregnancy outcomes has remained uncertain due to heterogeneous diagnostic approaches. A systematic review and meta-analysis was therefore conducted to quantify associations between maternal H. pylori and pregnancy outcomes such as preeclampsia, gestational diabetes mellitus (GDM), hyperemesis gravidarum (HG), preterm birth, and small for gestational age (SGA), alongside appraising consistency across key methodological strata. METHODS: Observational cohort and case-control studies were identified in various online databases to September 2025 following PRISMA 2020. Exposure was determined by serology, urea breath test, stool antigen testing, molecular assays, or mixed strategies. Study quality was evaluated using the Newcastle-Ottawa Scale. Effect estimates were pooled as risk ratios (RRs) using fixed-effect models upon low heterogeneity and random-effects (REML) models otherwise. Small-study effects and robustness were explored using funnel plots, Egger's test, and leave-one-out analyses, with predefined subgroup analyses by diagnostic method, region, design, and quality. RESULTS: From 1,998 records, 25 studies were included. H. pylori infection was associated with higher risks of preeclampsia (RR 2.06, 95% CI 1.42-3.01), GDM (RR 1.42, 95% CI 1.00-2.03), Hyperemesis gravidarum (RR 5.57, 95% CI 3.43-9.04), preterm birth (RR 1.30, 95% CI 1.14-1.49), and Small for gestational age (RR 1.18, 95% CI 1.03-1.36). Evidence of small-study effects was observed for several outcomes. Subgroup analyses suggested stronger associations with serologic and stool antigen assessments, but effect directionality remained consistent across strata. The evidence base consisted entirely of observational studies, and substantial between-study heterogeneity and small-study effects were observed for several outcomes. CONCLUSIONS: Maternal H. pylori infection was found to be associated with increased risks of HG, preeclampsia, GDM, preterm birth, and SGA; however, given the observational evidence base, heterogeneity, and small-study effects, these findings should be interpreted as exploratory and hypothesis-generating. The current evidence does not support routine screening or eradication during pregnancy, and any potential clinical implications remain speculative pending large, methodologically robust prospective studies and randomized trials with standardized exposure ascertainment and rigorous control of confounding. REGISTRATION: PROSPERO CRD420251152286.
Low-level laser therapy for breastfeeding women with nipple pain in the early postpartum period: a randomized controlled trial.
Gaitero MV, Mira TA, Gondim EJ … +3 more , Gonçalves AV, Nascimento SL, Surita FG
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41740971 · Publisher ↗
BACKGROUND: During the immediate postpartum period, breastfeeding could be challenge for many women due nipple pain and trauma. Non-pharmacological therapeutic strategies that reduce pain and accelerate healing are essen...
BACKGROUND: During the immediate postpartum period, breastfeeding could be challenge for many women due nipple pain and trauma. Non-pharmacological therapeutic strategies that reduce pain and accelerate healing are essential to prevent early weaning and support successful lactation. OBJECTIVE: This study aimed to evaluate the effectiveness of low-level laser therapy (LLLT) in reducing pain and promoting healing of nipple trauma in postpartum women, as well as to assess participants satisfaction with the intervention. METHODS: This multicentric, controlled, randomized, double-blind clinical trial included 60 women equally divided into an experimental group (2 J of red light at the nipple's central point and 4 J of infrared light in a cross pattern over the areolar region) and a sham group. Pain intensity was measured using the Numeric Rating Scale before, during, and up to 7 days after the intervention, and healing was assessed using a validated instrument. Intention-to-treat analysis was conducted. RESULTS: We found a significant reduction in pain in the experimental group, with relief observed 30 min ( = 0.0439) after the LLLT application. Pain diary analyses indicated that, compared to the sham group, the experimental group reported lower pain intensity at 1h ( = 0.0485), 6h ( = 0.0194), 12h ( = 0.0033), and 7 days after the intervention ( = 0.0085). There was no significant difference in the level of satisfaction between groups ( = 0.652), and no adverse effects were identified. CONCLUSION: LLLT proved to be a safe, effective, and feasible approach for managing pain associated with nipple trauma in the early postpartum, providing maternal comfort and supporting the continuation of exclusive breastfeeding.
Vaginal delivery in pregnancies with active COVID-19 infection: a retrospective analysis.
Yi J, Tang Z, Chen X … +1 more , Zhang B
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41740969 · Publisher ↗
BACKGROUND: To investigate safety, risk and perinatal outcomes of vaginal delivery in women with active coronavirus disease 2019 (COVID-19) infection. MATERIALS AND METHODS: Three hundred and fifty-one women who gave bir...
BACKGROUND: To investigate safety, risk and perinatal outcomes of vaginal delivery in women with active coronavirus disease 2019 (COVID-19) infection. MATERIALS AND METHODS: Three hundred and fifty-one women who gave birth between 7 December 2022 and 31 December 2022 were recruited. Women with a COVID-19 infection were considered to be cases (COVID-19 group), and those without COVID-19 infection were controls (non-COVID-19). The maternal demographic characteristics, intrapartum parameters, and perinatal outcomes were compared between both groups. RESULTS: There was no significant difference regarding maternal demographic characteristics within two groups ( > 0.05). The rate of multiparity was significantly higher in non-COVID-19 group compared with COVID-19 group ( < 0.05); a prolonged first stage and total labor duration were more frequently seen in COVID-19 group ( < 0.05). Higher rate of fever during delivery was noted in the COVID-19 group as compared with non-COVID-19 group ( < 0.05). Generalized linear model analysis demonstrated that COVID-19 infection status was not correlated to the risk of a prolonged first stage and total labor duration; Multivariate logistic regression analysis found that COVID-19 infection was associated with an 8-fold increased risk of fever during delivery. CONCLUSIONS: Vaginal delivery is an appropriate delivery option and associated with favorable outcomes among COVID-19-infected asymptomatic or mild individuals in late pregnancy who underwent vaginal birth; COVID-19 status alone is associated with increased risk of fever during delivery for COVID-19-infected women, and pregnant women would benefit from increased monitoring during delivery management.
Lauromacrogol pericystic injection combined with curettage vs. uterine artery embolization with curettage for cesarean scar pregnancy.
Sun Y, Liu L, Sun G … +1 more , Ying L
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41735003 · Publisher ↗
OBJECTIVE: With the policy of allowing all couples to have three children unveiled in China, the cesarean section rate has increased, leading to a corresponding rise in the number of cesarean scar pregnancy (CSP) cases....
OBJECTIVE: With the policy of allowing all couples to have three children unveiled in China, the cesarean section rate has increased, leading to a corresponding rise in the number of cesarean scar pregnancy (CSP) cases. Therefore, improving the treatment quality is very important. This article is to compare the efficacy of two different methods treating CSP: Lauromacrogol pericystic injection combined with curettage and uterine artery embolization with curettage. METHODS: We performed a retrospective study at Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine (Hangzhou, China) of 55 patients diagnosed with CSP between January 2016 and December 2021. Patients were consecutively assigned to treatment groups: the lauromacrogol treatment group ( = 23) and the uterine artery embolization treatment group ( = 22). The amount of bleeding during and after uterine curettage, the recovery time of human chorionic gonadotropin (β-HCG), hospitalization time, hospitalization expenses, menstrual recovery time, ovulation recovery time, postoperative ovarian function, postoperative pain scores, and adverse reactions were compared between the two groups. RESULTS: All patients were successfully treated without major intraoperative complications. The amount of bleeding during and after uterine curettage, the recovery time of β-HCG, and menstrual recovery time showed no significant differences between the two groups ( > 0.05). However, the lauromacrogol group demonstrated significantly shorter ovulation recovery time (96.45 ± 11.64 days vs. 113.76 ± 14.33 days, < 0.001) and better postoperative ovarian function profiles with lower FSH and LH levels and higher E2 and AMH levels (all < 0.05). The hospitalization cost in the lauromacrogol group was significantly lower than that in the uterine artery embolization group (¥6863.27 ± 908.22 vs. ¥20747.02 ± 4963.43, < 0.001), and the incidence of adverse reactions was significantly less than that in the uterine artery embolization group (17.39% vs. 45.45%, < 0.05). Postoperative pain scores at 2 and 4 weeks were also significantly lower in the lauromacrogol group ( < 0.05). CONCLUSION: Lauromacrogol injection around the pregnancy sac combined with curettage and uterine artery embolization combined with curettage demonstrated comparable efficacy in terms of bleeding control, β-HCG recovery, and menstrual resumption for the treatment of cesarean scar pregnancy. However, the lauromacrogol approach offered significant advantages including lower cost, better preservation of ovarian function, faster ovulation recovery, reduced postoperative pain, and fewer adverse reactions, making it suitable for broader adoption in hospitals, particularly those without interventional radiology facilities.
Assessing the institutional provision of maternal nutrition services in antenatal clinics in Beijing.
Li Y, Wang X, Wang D … +5 more , Zhang S, Li Y, Hu M, Sun Y, Ma L
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41724577 · Publisher ↗
OBJECTIVE: To evaluate the availability, quality, and delivery of maternal nutrition services in antenatal clinics across Beijing, focusing on service types, provider qualifications, resource adequacy, and barriers to ef...
OBJECTIVE: To evaluate the availability, quality, and delivery of maternal nutrition services in antenatal clinics across Beijing, focusing on service types, provider qualifications, resource adequacy, and barriers to effective service delivery. The study also aims to identify factors influencing service availability and institutional variation and propose a framework for improving maternal nutrition care in urban China. METHODS: A cross-sectional study was conducted across 110 antenatal clinics in Beijing, using structured surveys targeting institutional characteristics, service coverage, personnel qualifications, and service delivery methods, supplemented by qualitative insights from open-ended responses. RESULTS: Among 104 valid responses, 56% of institutions offered prenatal nutrition education classes. Provision varied descriptively by facility type (e.g. 12.5% in private hospitals vs ∼55-57% in other facility types), but the facility-type comparison was not statistically significant (chi-square = 5.72, df = 3, = 0.13). While 76% of institutions reported having personnel with formal nutrition qualifications, gaps in training and reliance on non-specialized staff were common. Resource constraints (e.g. space, equipment, and limited digital support) were frequently reported as barriers. Institutional respondents reported high perceived patient satisfaction and the presence of feedback systems, but no patient-level outcomes were measured. CONCLUSION: This city-wide institutional survey suggests that maternal nutrition services in Beijing antenatal clinics are broadly available but heterogeneous in delivery, staffing, and resources. Observed contrasts across facility types should be interpreted as descriptive patters rather than confirmed group differences. Future work should evaluate whether standardization, workforce development, infrastructure strengthening, and digital support improve service quality and equity, using patient-level and implementation indicators.
Pre-pregnancy BMI, gestational weight gain trajectories, and new-onset hypertensive disorders in ART singleton pregnancies: a retrospective cohort study.
Ye W, Li Y, Li B … +6 more , Zhu H, Wu Y, Guo D, Yu M, Xu J, Ji L
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41724573 · Publisher ↗
OBJECTIVE: To investigate non-linear associations between pre-pregnancy BMI and new-onset hypertensive disorders of pregnancy (HDP), and the relationship between gestational weight gain (GWG) trajectories and HDP. METHOD...
OBJECTIVE: To investigate non-linear associations between pre-pregnancy BMI and new-onset hypertensive disorders of pregnancy (HDP), and the relationship between gestational weight gain (GWG) trajectories and HDP. METHODS: Using data from the Ningbo Birth Cohort of Population Undergoing ART (NBart) cohort (June 2018-June 2024), we included women with singleton ART pregnancies. Restricted cubic splines, latent class mixed models, and logistic regression were applied. RESULTS: Of 4219 eligible pregnancies, 255 (6.0%) developed HDP. Risk increased when pre-pregnancy BMI exceeded 21.5 kg/m (∼6% higher per 0.5 kg/m gain). In stratified analyses, risk also increased below 16.6 kg/m; the J-shaped relationship was evident in normal-weight women; a significant non-linear association was not detected within the overweight and obese subgroups alone. Advanced maternal age, nulliparity, primary infertility, and frozen embryo cycle amplified BMI-related risk. Exceeding recommended GWG guidelines at various pregnancy stages increased HDP risk; refined GWG thresholds were proposed for ART pregnancies. Two GWG patterns-concave negative (0-20 ± 1 weeks; aOR = 0.540, 95% CI: 0.290-0.944) and delayed acceleration (entire gestation period; aOR = 0.627, 95% CI: 0.380-0.996)-were inversely associated with HDP. Both featured minimal or negative early-pregnancy weight change followed by steady gain, occurred predominantly in overweight and obese women, and total GWG was lower compared with other patterns. CONCLUSIONS: Maintaining optimal pre-pregnancy BMI and adhering to the proposed, more conservative GWG thresholds for ART pregnancies may reduce HDP risk. Distinct GWG trajectories may further modulate this risk.
Mendelian randomization analysis of labor anesthesia and adverse neonatal outcomes.
Qu D, Zhang Y, Wang S … +5 more , Dou H, Xiu Y, Dong Y, Wang Y, Yang L
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41702668 · Publisher ↗
BACKGROUND: Despite the lack of data from randomized controlled trials, studies have indicated that labor anesthesia may be associated with neonatal asphyxia, neonatal respiratory distress and adverse neonatal neurologic...
BACKGROUND: Despite the lack of data from randomized controlled trials, studies have indicated that labor anesthesia may be associated with neonatal asphyxia, neonatal respiratory distress and adverse neonatal neurological outcomes. Therefore, we performed a two-sample Mendelian randomization analysis to explore the potential causal relationships between labor anesthesia methods and adverse neonatal outcomes. METHOD: We collected genome-wide association study (GWAS) data, including on spinal ( = 3,780), epidural ( = 3,970), and other labor anesthesia methods ( = 4,094), as well as neonatal asphyxia ( = 499,936), neonatal respiratory distress (NRDS) ( = 499,974) and cerebral palsy ( = 496,311), attention-deficit hyperactivity disorder (ADHD) ( = 495,160), and intellectual disability ( = 363,663). Data on different delivery analgesia methods that were sourced from the Integrative Epidemiology Unit (IEU) OpenGWAS project were used as exposure data. Neonatal asphyxia, neonatal respiratory distress and neurological adverse outcomes sourced from the FinnGen consortium R12 were used as the outcome data. A two-sample MR was used to evaluate the effects of different delivery analgesia methods on neonatal asphyxia, neonatal respiratory distress and three adverse neurological outcomes in newborns to determine the existence of a causal relationship between them. The inverse-variance weighted (IVW) method was used for MR analysis and a series of sensitivity analyses were conducted. The MR-Egger intercept test was used to assess directional horizontal pleiotropy. Heterogeneity was evaluated using the Cochran's Q statistic. Instrument strength was assessed using F-statistics, with values greater than 10 indicating a low risk of weak instrument bias. RESULTS: Spinal, epidural, and other methods of labor anesthesia were not found to be strongly associated with neonatal asphyxia (OR = 0.707, 95% CI = 0.176-2.832, = 0.624; OR = 3.222, 95% CI = 0.973-10.664, = 0.055; OR = 0.732, 95% CI = 0.166-3.230, = 0.681, respectively), NRDS (OR = 0.941, 95% CI = 0.381-2.321, = 0.894; OR = 1.116, 95% CI = 0.505-2.465, = 0.786; OR = 0.801, 95% CI = 0.329-1.950, = 0.624), cerebral palsy (OR = 0.930, 95% CI = 0.442-1.959, = 0.849; OR = 0.636, 95% CI = 0.318-1.271, = 0.200; OR = 1.112, 95% CI = 0.544-2.271, = 0.771, respectively), intellectual disability (OR = 1.586, 95% CI = 0.917-2.743, = 0.099; OR = 0.809, 95% CI = 0.454-1.440, = 0.471; OR = 0.774, 95% CI = 0.380-1.575, = 0.479, respectively), or attention deficit hyperactivity disorder (OR = 0.827, 95% CI = 0.621-1.102, = 0.195; OR = 0.998, 95% CI = 0.739-1.346, = 0.988; OR = 1.136, 95% CI = 0.771-1.673, = 0.519, respectively). The sensitivity analyses, performed with Cochran's Q test and the MR-Egger intercept, showed little evidence of substantial heterogeneity or directional horizontal pleiotropy. CONCLUSION: Our MR study based on genetic data does not support the existence of a causal relationship between different labor anesthesia methods and neonatal asphyxia, neonatal respiratory distress or adverse neonatal neurological outcomes. Thus, labor pain relief methods can be selected based on the mother's needs and condition without increasing associated risks.
Long-term indomethacin therapy and cervical stabilization in dichorionic twin pregnancies.
Bucak M, Seif K, Goetzinger K … +3 more , Turan S, Harman C, Turan O
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41702667 · Publisher ↗
OBJECTIVE: To evaluate the effect of long-term indomethacin therapy (LIT) in stabilizing cervical length in dichorionic-diamniotic (DCDA) twin pregnancies with a short cervix. METHODS: This retrospective cohort study inc...
OBJECTIVE: To evaluate the effect of long-term indomethacin therapy (LIT) in stabilizing cervical length in dichorionic-diamniotic (DCDA) twin pregnancies with a short cervix. METHODS: This retrospective cohort study included 54 dichorionic-diamniotic twin pregnancies with a short cervix (≤25 mm), managed with LIT between 18 and 26 weeks of gestation age (GA) at a single quaternary medical center from 2014 to 2024. LIT was initiated with a 100 mg oral loading dose, followed by 50 mg every 6 h for 48 h, and continued at 25 mg every 6 h until 32 weeks or delivery. Weekly monitoring included transvaginal ultrasound, amniotic fluid assessment, and fetal Doppler studies. The expected cervical length (E_LCL) was modeled by applying an assumed physiologic cervical shortening rate of 0.9 mm per week to the observed first cervical length (O_FCL) in twin pregnancies without intervention. E_CL = O_FCL - [(GA at O_LCL - GA at O_FCL (weeks)) × 0.9 (mm/week)]. Cervical stabilization was defined as the observed last cervical length (O_LCL) exceeding the expected last cervical length (E_LCL) at the last examination. The primary outcome was cervical stabilization, while the secondary outcome was gestational age at delivery. RESULTS: LIT was successful in stabilizing the cervix in 81.5% ( = 44/54) of cases. The mean GA at LIT onset was 22.9 ± 1.9 weeks, with a median O_FCL of 14.5 mm (IQR: 10.0-18.0). The mean duration of LIT was 48 days (IQR: 25-61). Final O_LCL was significantly longer than E_LCL (15.9 ± 6.1 mm vs. 9.3 ± 5.9 mm, < .001). Median gestational age at delivery was higher in stabilized vs. non-stabilized patients (34.6 weeks [IQR: 31.7-36.6] vs. 30.8 weeks [IQR: 26.1-32.3], = .004). No difference was observed in initial cervical length between groups ( = .282). LIT was discontinued in 11.2% due to ductus arteriosus constriction or oligohydramnios; no adverse neonatal outcomes were reported. CONCLUSION: These findings suggest an association between LIT and cervical stabilization in DCDA twin pregnancies with a short cervix; this exploratory, hypothesis-generating analysis warrants confirmation in prospective studies.
Causal relationship between 91 inflammatory factors and fetal growth restriction: a bidirectional Mendelian randomization study.
Shen J, Chen X, Fang R … +3 more , Cai R, Wang Y, Zheng J
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41702666 · Publisher ↗
PURPOSE: Current studies have indicated a potential association between inflammatory cytokines and Fetal Growth Restriction (FGR), but the causal relationship between specific inflammatory cytokines and FGR remains uncer...
PURPOSE: Current studies have indicated a potential association between inflammatory cytokines and Fetal Growth Restriction (FGR), but the causal relationship between specific inflammatory cytokines and FGR remains uncertain. In this study, we used Mendelian randomization (MR) to further investigate the causal link between 91 inflammatory cytokines and FGR. METHODS: We included data from a sample of 14,824 Europeans and FinnGen consortium fetal growth restriction data (4054 cases vs. 226,256 controls) encompassing 91 inflammatory cytokines. The primary analysis method used was inverse-variance weighted (IVW). Additionally, MR Egger, Weighted median, Simple mode, and Weighted mode were utilized as auxiliary analyses to reinforce the final results. Furthermore, sensitivity analysis was conducted to assess the robustness of the data. RESULTS: Our study revealed that C-C motif chemokine 4 (CCL4), C-X-C motif chemokine 1 (CXCL1), Fibroblast growth factor 19 (FGF-19), IL-10, IL-20, IL-24, and Monocyte chemoattractant protein-4 (CCL13) exhibited associations with FGR risk; however, due to horizontal pleiotropy concerns regarding CCL13 it was excluded from further investigation. Conversely, reverse MR results demonstrated no significant association between inflammatory factors and FGR. CONCLUSION: This MR study provides evidence for an association between CCL4,CXCL1,FGF-19,IL-10, IL-20, IL-24, and FGR risk.More research is needed to evaluate the potential role of these cytokines in preventing and treating FGR.
Impact of fetal and maternal genetically predicted birth weight on cardiometabolic risk: a Mendelian randomization study of cytokine mediation in Europeans.
Hou N, Jiao Y, Zhang R … +4 more , Liu A, Lou H, Zhu Y, Huang H
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41702656 · Publisher ↗
BACKGROUND: Birth weight (BW) is influenced by both fetal and maternal genetic factors and is correlated with cardiometabolic outcomes later in life. Investigating these factors can clarify whether the association betwee...
BACKGROUND: Birth weight (BW) is influenced by both fetal and maternal genetic factors and is correlated with cardiometabolic outcomes later in life. Investigating these factors can clarify whether the association between BW and health risk arises from fetal, maternal, or shared genetic factors. Inflammation likely plays a key role in cardiometabolic risk related to BW. This study examined the causal effects of fetal and maternal genetically predicted BW on cardiometabolic outcomes, focusing specifically on the mediating role of inflammatory cytokines. METHODS: We used a two-sample Mendelian randomization (MR) framework to estimate the causal effects of fetal-specific and maternal-specific BW on ten cardiometabolic and autoimmune outcomes. Additionally, we conducted a two-step MR mediation analysis to assess the role of 41 core inflammatory cytokines in these effects. Exposure data for fetal-specific BW ( = 298,142) and maternal-specific BW ( = 210,267) were sourced from the EGG Consortium and UK Biobank. Outcome data were mainly obtained from GWAS consortia including FinnGen, Pan-UKBB, and DIAGRAM. Cytokine data were collected from Finnish cohorts. Genetic instruments (Single nucleotide polymorphisms, SNPs) were selected at < 5 × 10, with F-statistics > 10 ensuring robustness. Primary analyses used inverse-variance weighted MR and conducted sensitivity analyses to evaluate pleiotropy. RESULTS: Fetal-specific BW was inversely associated with type 2 diabetes (T2D, OR = 0.585, 95% CI: 0.491-0.697), fasting glucose (FG, 0.918, 0.886-0.951), fasting insulin (FI, 0.907, 0.878-0.937), coronary artery disease (CAD, 0.782, 0.701-0.873), myocardial infarction (MI, 0.746, 0.650-0.855), and systemic lupus erythematosus (SLE, 0.432, 0.228-0.818), but positively associated with venous thromboembolism (VTE, 1.252, 1.108-1.416). Maternal-specific BW was inversely associated with FI (0.927, 0.889-0.966), hypertension (0.697, 0.564-0.861), CAD (0.775, 0.652-0.921), and MI (0.730, 0.593-0.897). Cytokines such as PDGF-BB, MIP-1β, SDF-1α, and IL-4 partially mediated the associations between fetal-specific BW, maternal-specific BW, and cardiometabolic outcomes, but their mediation proportions were limited. CONCLUSIONS: This study provides evidence that both fetal and maternal genetically predicted BW independently influence cardiometabolic outcomes, with fetal genetic effects having a broader impact. Although inflammatory cytokines (PDGF-BB, MIP-1β, SDF-1α, IL-4) partially explain these effects, their contributions are limited, suggesting additional biological pathways underlie these lifelong associations.
Clinical value of magnetic resonance imaging in the early diagnosis of cervical insufficiency in pregnancy.
Zheng Z, Wang N, Huang Y … +6 more , Mao G, Zhao S, Tu G, Weng L, Zhang Z, Wei F
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41692586 · Publisher ↗
BACKGROUND: Cervical insufficiency (CI) is a leading cause of mid-to-late trimester pregnancy loss, making early and accurate diagnosis critical. While clinical diagnosis primarily relies on transvaginal ultrasound (TVUS...
BACKGROUND: Cervical insufficiency (CI) is a leading cause of mid-to-late trimester pregnancy loss, making early and accurate diagnosis critical. While clinical diagnosis primarily relies on transvaginal ultrasound (TVUS), its limitations in visualizing cervical microstructure are recognized. High-resolution magnetic resonance imaging (MRI) offers exceptional soft-tissue contrast, potentially enabling a detailed assessment. This study aimed to explore the descriptive imaging features of MRI in suspected CI. MATERIALS AND METHODS: This retrospective study enrolled 77 pregnant women with clinically suspected CI between June 2021 and October 2023. All patients underwent TVUS, and a subset ( = 43) also received MRI. Imaging features, including anatomical visualization quality, endocervical dimensions, and specific MRI findings, were evaluated and described. RESULTS: MRI demonstrated significantly superior anatomical visualization compared to TVUS, with satisfaction rates of 100% vs. 67.53% for internal os depiction, 100% vs. 83.11% for external os, and 65.12% vs. 54.55% for amniotic sac protrusion (all < 0.05). Quantitative measurements revealed a greater endocervical width on MRI (23.47 ± 14.83 mm) compared to ultrasound (12.78 ± 8.41 mm; = 0.001). Furthermore, MRI detected specific features not visualized by ultrasound, including pericervical defects (88.4%), stromal changes (83.7%), and the "dirty sign" (53.5%). Due to inherent incorporation bias in the reference standard, comparative diagnostic accuracy metrics between modalities were not calculated or reported. CONCLUSION: MRI demonstrates particular promise as a complementary diagnostic tool for cervical insufficiency when ultrasound findings are inconclusive, providing superior anatomical visualization and detecting unique imaging features. The observed association between cervical canal width and CI requires validation in prospective studies designed to mitigate verification and incorporation biases.
Can transvaginal and transabdominal cervical length measurements at 37 weeks predict the risk of prolonged pregnancy?
Bezirganoglu Altuntas N, Baki Yıldırım S
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41692585 · Publisher ↗
OBJECTIVE: To evaluate the role of transvaginal and transabdominal cervical length (CL) measurements at 37 weeks of gestation in predicting the risk of prolonged pregnancy among nulliparous women. METHODS: A retrospectiv...
OBJECTIVE: To evaluate the role of transvaginal and transabdominal cervical length (CL) measurements at 37 weeks of gestation in predicting the risk of prolonged pregnancy among nulliparous women. METHODS: A retrospective cohort study was conducted between February 2022 and June 2024 at a regional tertiary maternity hospital. Transvaginal (TVS) and transabdominal sonography (TAS) were performed in low-risk nulliparous patients at 37 weeks of gestation. Patients were categorized into two groups based on delivery time: <41 weeks (term) and ≥41 weeks (late-term). Demographic, obstetric, and ultrasonographic parameters were compared between groups. Logistic regression was used to identify independent predictors of late-term delivery. Agreement between TVS and TAS measurements was assessed using Bland-Altman analysis. Statistical analyses were performed using SPSS software (version 27.0; IBM SPSS Inc., Chicago, IL, USA) and a value < 0.05 was considered statistically significant. RESULTS: A total of 179 patients were included in the study. Of these, 19 (10.6%) were classified as late-term group, while 160 (89.4%) were classified as term group. Maternal age and BMI were similar between groups. The median CL was higher in the late-term group by both TVS and TAS; however, only TVS-CL remained statistically significant ( = 0.032) in the late-term group. Bland-Altman analysis showed acceptable agreement between TAS and TVS measurements with a mean difference of 1.47 mm and 95% limits of agreement ranging from -6.8 to 9.8 mm. After adjusting for potential confounders, a longer TVS-CL was independently associated with an increased risk of late-term delivery (adjusted OR = 1.26; 95% CI 1.01-1.58). A positive correlation was observed between measured transvaginal CL at 37 weeks and gestational age at delivery. CONCLUSION: A longer cervical length measured by transvaginal sonography at 37 weeks was independently associated with an increased risk of late-term delivery. Our findings demonstrate the potential value of standardized ultrasonographic assessment in identifying women at risk of prolonged pregnancy, which could help optimize perinatal outcomes.
Introduction of central fetal monitoring and impact on neonatal outcome - a retrospective observational cohort study.
Söröd M, Gyllencreutz E
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41692581 · Publisher ↗
INTRODUCTION: Cardiotocography (CTG) is used for fetal surveillance to prevent asphyxia related neonatal outcomes during pregnancy and delivery. In Sweden, all delivery wards have transitioned from CTG registered and pri...
INTRODUCTION: Cardiotocography (CTG) is used for fetal surveillance to prevent asphyxia related neonatal outcomes during pregnancy and delivery. In Sweden, all delivery wards have transitioned from CTG registered and printed on paper inside the delivery room, to digital central fetal monitoring where CTG is visible both in the delivery room and on distance for multiple observers. We aimed to evaluate whether the transition from CTG on paper to central fetal monitoring has affected neonatal morbidity. MATERIAL AND METHODS: The study was conducted as a retrospective cohort study. Data from 8577 deliveries in Östersund, Sweden were extracted from medical records. The study population was divided into two cohorts, one where the CTG registration during delivery had been printed on paper (Cohort I, January 2012-December 2015), and one where digital central fetal monitoring was used (Cohort II, July 2016-December 2019). The cohorts were compared regarding the incidence of neonatal metabolic acidosis (umbilical artery pH <7.05 and base deficit >12 mmol/L) as the main outcome, and secondary outcomes such as Apgar score at 5 min of age, the incidence of neonatal resuscitation, and the incidence of emergency cesarean and instrumental vaginal birth due to suspected fetal hypoxia. RESULTS: The incidence of metabolic acidosis was 0.5% in Cohort I and 0.6% in Cohort II, odds ratio (OR) 1.27, 95% confidence interval (CI) 0.67-2.40, = 0.46. There were no statistically significant differences in any of the secondary neonatal outcomes. Adjustment for potential confounders did not alter the estimates. The cohorts differed in the incidence of inductions of labor; 18.8% in Cohort I vs 23.2% in Cohort II, < 0.0001, and the use of oxytocin; 50.2% vs 60.0%, < 0.0001, both of which were more frequent in Cohort II. The incidence of instrumental vaginal births due to suspected fetal hypoxia was lower in the cohort with digital CTG; 3.6% vs 2.6%, = 0.01. CONCLUSION: We observed no difference regarding the incidence of neonatal metabolic acidosis or other neonatal outcomes between the cohort that had CTG registered and printed on paper, and the cohort with digital central fetal monitoring.
Case series and literature review on functional pulmonary atresia in neonates functional PA in neonates: case & review.
Qu Y, Yang S, Wu Y … +1 more , Wang Q
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41692580 · Publisher ↗
BACKGROUND: Functional pulmonary atresia (FPA) is a rare neonatal condition charac-terized by the failure of a structurally normal pulmonary valve to open. METHODS: This case series analyzed five neonates diagnosed with...
BACKGROUND: Functional pulmonary atresia (FPA) is a rare neonatal condition charac-terized by the failure of a structurally normal pulmonary valve to open. METHODS: This case series analyzed five neonates diagnosed with FPA and reviewed relevant literature. The diagnostic criteria for FPA included: (1) retrograde flow through the pulmonary valve during diastole; (2) significant tricuspid regurgitation with estimation of right ventricular pressure by tricuspid regurgitation peak velocity; (3) marked right heart enlargement; and (4) resolution of pulmonary valve obstruction with restoration of antegrade flow on follow-up echocardiography. RESULTS: All five patients demonstrated recovery of forward flow across the pulmonary valve following individualized medical management. One neonate required surgical intervention due to progressive closure of the ductus arteriosus and foramen ovale. Ultimately, all five neonates were successfully discharged. CONCLUSION: Prompt and accurate recognition of FPA is critical to prevent unnecessary surgical procedures, and tailored therapeutic strategies can promote reopening of the pulmonary valve, resulting in favorable clinical outcomes.
Application of Shengxuening tablets for the prevention of anemia in pregnancy: stratified efficacy analysis based on serum ferritin levels and thalassemia subgroups.
Rui Y, Hongmei X, Xiaoli W … +3 more , Lexia Z, Yamin Z, Jing X
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41672571 · Publisher ↗
OBJECTIVE: To investigate the effects of Shengxuening (SXN) tablets on gestational anemia and iron metabolism, focusing on efficacy differences among pregnant women with the thalassemia trait and those stratified by base...
OBJECTIVE: To investigate the effects of Shengxuening (SXN) tablets on gestational anemia and iron metabolism, focusing on efficacy differences among pregnant women with the thalassemia trait and those stratified by baseline serum ferritin (SF) levels. METHODS: A retrospective single-center cohort (2016-2022) reviewed prenatal records of 843 pregnant women. Participants were allocated to either an SXN prophylaxis group ( = 620) or a non-prophylaxis group ( = 223) based on whether hemoglobin (Hb) was ≥110 g/L when iron supplementation was initiated. Within the SXN group, women were further stratified by baseline SF levels (<30, 30-70, 71-100, and >100 µg/L) to evaluate efficacy across SF subgroups. Primary endpoints were the incidence of gestational anemia and iron deficiency (ID). Secondary outcomes included changes in Hb, red blood cell (RBC) count, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and SF. RESULTS: Among the 843 pregnant women, the incidence of ID ranged from 59.52% to 73.58% in the second and third trimesters, while iron deficiency anemia (IDA) was observed in 22.51% to 32.84% of cases. Comparative analysis within the SXN prophylaxis group, stratified by baseline SF levels, revealed that participants with SF ≥ 30 μg/L had significantly higher rates of adequate Hb levels before delivery ( = 0.003) and higher mean SF concentrations at 30-34 weeks of gestation ( = 0.025) compared to those with SF < 30 μg/L. Among 57 pregnant women with the thalassemia trait, the SXN prophylaxis group demonstrated significantly better Hb adequacy rates across gestational weeks and superior iron-related parameters compared to the non-prophylaxis group ( < 0.05). CONCLUSION: SXN tablets effectively ameliorate ID and anemia in both the general obstetric population and pregnant women with the thalassemia trait. The greatest benefit occurs when prophylaxis is initiated at baseline SF ≥30 μg/L. Baseline SF levels positively correlate with therapeutic response, indicating that adequate iron reserves enhance treatment efficacy. Routine, guideline-based iron supplementation should remain a cornerstone of antenatal care; however, individualized regimens tailored to initial iron status warrant further investigation.
A retrospective comparison of hysteroscopic resection and curettage in the treatment of retained products of conception: surgical and reproductive outcomes.
Coban G, Biber Ak AY, Ozdemir AZ … +1 more , Coban EF
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41663249 · Publisher ↗
OBJECTIVE: To compare the efficacy, safety, and reproductive outcomes of hysteroscopic resection versus conventional dilation and curettage (D&C) in the management of retained products of conception (RPOC) following deli...
OBJECTIVE: To compare the efficacy, safety, and reproductive outcomes of hysteroscopic resection versus conventional dilation and curettage (D&C) in the management of retained products of conception (RPOC) following delivery or abortion. MATERIALS AND METHODS: This retrospective cross-sectional study included 55 patients diagnosed with RPOC at a tertiary care center between January 2015 and December 2025. The surgical intervention selected for each patient was determined by clinical indications, with either hysteroscopic resection or dilation and curettage (D&C) being the preferred option. The diagnosis was confirmed by transvaginal ultrasonography and histopathological examination. A comprehensive analysis encompassing demographic characteristics, clinical manifestations, surgical outcomes, and fertility outcomes was conducted between the two groups. RESULTS: Hysteroscopy was performed in 28 patients (50.9%). D&C was performed in 27 patients (49.1%). The median time from pregnancy termination to intervention was significantly longer in the hysteroscopy group (28 vs. 7.5 days; = 0.036). Residual tissue size and operative time were also significantly greater in the hysteroscopy group ( = 0.017 and < 0.001, respectively). Although not statistically significant, time to conception was shorter in the hysteroscopy group (5 vs. 9.4 months), and the rate of pregnancy desire was significantly higher (82.1% vs. 66.7%; = 0.021). Pregnancy was observed to be more prevalent in the D&C group during the follow-up period. However, this difference did not attain statistical significance. CONCLUSION: Hysteroscopy and dilation and curettage (D&C) have been demonstrated to be both effective and safe options for RPOC. The use of hysteroscopy, with its capacity for direct visualization and targeted removal, is supported by its efficacy in precise intrauterine assessment. The fertility outcomes observed in this cohort were comparable between the study groups.
Quantitative evaluation of placental vascularization using MV-Flow imaging for predicting small-for-gestational-age neonates.
He B, Wang B, Yao B … +1 more , Bao L
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41663248 · Publisher ↗
OBJECTIVE: To evaluate the association between third-trimester placental vascularization measured by microvascular flow (MV-Flow) imaging and the risk of small-for-gestational-age (SGA) neonates. METHODS: In this prospec...
OBJECTIVE: To evaluate the association between third-trimester placental vascularization measured by microvascular flow (MV-Flow) imaging and the risk of small-for-gestational-age (SGA) neonates. METHODS: In this prospective cohort study, women with singleton pregnancies at 30-32 weeks' gestation underwent MV-Flow ultrasound for quantification of placental vascular indices (VI). Maternal characteristics, fetoplacental Doppler parameters, and MV-Flow-derived VI were analyzed, and pregnancy outcomes were recorded. RESULTS: Of 207 pregnancies, 20 (9.7%) resulted in SGA neonates and 187 in appropriate-for-gestational-age (AGA) neonates. Compared with the AGA pregnancies, placental VI in the SGA group were significantly lower across the upper, middle, and lower regions of the placenta (upper: 32.0 ± 13.4 vs 43.1 ± 13.8, middle: 36.0 ± 15.3 vs 49.6 ± 15.0, lower: 30.3 ± 10.0 vs 42.5 ± 13.5; all < 0.001). The SGA group also exhibited higher uterine artery pulsatility index (UtA-PI) and lower middle cerebral artery PI (MCA-PI) and cerebroplacental ratio (CPR) (all < 0.05). In multivariable logistic regression, UtA-PI, CPR, and mid-placental VI were independently associated with SGA. The middle placental VI demonstrated moderate discriminative for SGA (AUC 0.756) compared with UtA-PI (AUC 0.626) and CPR (AUC 0.695). A combined model incorporating UtA-PI, CPR, and placental VI achieved an AUC of 0.866 with 55% sensitivity and a 10% false-positive rate. CONCLUSIONS: Reduced placental vascularization index measured by MV-Flow ultrasonography is significantly associated with SGA. Integration of MV-Flow-derived VI with conventional Doppler parameters may improve risk stratification for SGA and provides supportive evidence for the potential clinical value of MV-Flow in assessing placental microcirculation and fetal growth.
Use of uterine activity to predict preterm birth by artificial intelligence assisted models: a narrative systematic review.
Chopra J, Maden C, Howlett I … +7 more , Perry H, Kermack AJ, Ozbey Arabaci M, Chapman A, Yang K, Altamirano D, Cheong Y
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41663244 · Publisher ↗
OBJECTIVE: The benefit of interventions to improve neonatal outcomes of preterm birth (PTB) must be balanced with the associated fetal and maternal risks. Artificial intelligence (AI) could be used to assess uterine cont...
OBJECTIVE: The benefit of interventions to improve neonatal outcomes of preterm birth (PTB) must be balanced with the associated fetal and maternal risks. Artificial intelligence (AI) could be used to assess uterine contractions and consequently help to predict PTB. This paper aims to assess the predictive accuracy and applicability of AI models currently using uterine contractions in PTB prediction. METHODS: A systematic Embase, Medline, Pubmed and Web of Science review was conducted using PRISMA guidelines. Eligible studies assessed EHG or time-series data using AI methods, including deep learning/machine learning/neural networks to predict PTB. Data on AI model performance measures, validity, and applicability were collected. Results are reported as a narrative review due to study heterogeneity. Bias was assessed using the PROBAST framework. RESULTS: The studies used various Electrohysterography (EHG) contractility features and/or classifiers for AI analysis and varying performance measures to assess predictive accuracy for PTB. A wide range of EHG features were assessed included temporal, spectral, entropy and topological features. A total of 53 records were identified for inclusion. Of these, 18 examined EHG features, 22 assessed AI classifiers, and 3 tested both. Excellent classification performance (ACC and/or AUC ≥0.9) were reported by 38.8% (7/18) of studies examining EHG features and 86.3% (19/22) of studies assessing AI classifiers. Non-linear features outperformed linear features, and deep-learning models such as neural networks were the highest-performing classifiers. Bias assessment showed 86.7% (46/53) had an unclear or high risk of bias. Key concerns include unbalanced data, small sample size and lack of validity outside of sampled datasets. CONCLUSION: Non-linear features and DL models offer superior results. However, we did not find evidence of external validation, thus the applicability of models in uterine contraction assessment for the prediction of PTB remains limited. Future research requires an emphasis on clinical data integration within high-quality studies, as well as more more studies focusing on early PTB detection.
The impact of basal metabolic rate on preeclampsia etiology: a Mendelian randomization study.
Xu Q, Liu G
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41663240 · Publisher ↗
OBJECTIVE: Preeclampsia complicates 3-8% of pregnancies worldwide, an obstetric condition contributed to the short- and long-term morbidity and mortality of mothers and newborns. For its treatment and prevention, it is e...
OBJECTIVE: Preeclampsia complicates 3-8% of pregnancies worldwide, an obstetric condition contributed to the short- and long-term morbidity and mortality of mothers and newborns. For its treatment and prevention, it is essential to comprehend the risk factors. This study aimed to investigate the potential causal influence of basal metabolic rate (BMR) on preeclampsia risk. METHODS: We utilized data from publicly available genome-wide association studies (GWAS) of European populations, focusing on BMR and preeclampsia. We selected single-nucleotide polymorphisms (SNPs) as instrumental variables for basal metabolic rate (BMR). Causal estimates were derived using multiple Mendelian Randomization (MR) methods: inverse-variance weighted (IVW), MR-Egger, weighted median, simple mode, and weighted mode. To ensure result robustness, we conducted comprehensive sensitivity analyses assessing potential pleiotropy and heterogeneity. RESULTS: We found evidence of a causal relationship between specific BMR indicators () and preeclampsia risk. The IVW model indicated that genetically predicted higher BMR was associated with increased odds of preeclampsia. Cochran's Q test and I statistics indicated no significant heterogeneity between and preeclampsia, however, slight heterogeneity was observed for the other indicators. According to the MR-Egger regression, our findings were barely impacted by horizontal pleiotropy. CONCLUSION: This MR study supports a causal role of BMR in preeclampsia risk. This highlights the potential of targeting metabolic pathways in preeclampsia prevention. Future research should be performed to explore the underlying mechanisms and evaluate the potential interventions modulating BMR to reduce preeclampsia incidence.
RAMA: implementing Machine Learning to develop mortality risk prediction models for NICU patients with Acute Kidney Injury.
Vyas A, Pandya A, Dawson M … +5 more , Shaikh T, Agrawal G, Sethi S, Wazir S, Raina R
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41663237 · Publisher ↗
BACKGROUND: Acute Kidney Injury (AKI) is common in neonates admitted to the Neonatal Intensive Care Unit (NICU). Neonatal AKI is associated with multiple comorbid conditions of greater clinical severity, which also incre...
BACKGROUND: Acute Kidney Injury (AKI) is common in neonates admitted to the Neonatal Intensive Care Unit (NICU). Neonatal AKI is associated with multiple comorbid conditions of greater clinical severity, which also increase the neonate's risk of mortality. Understanding the risk of mortality, in addition to the severity of AKI, may be useful in determining alternative treatment options for neonates with AKI. METHODS: Two independent datasets containing neonatal patient data from eleven healthcare centers were filtered, cleaned, and combined to produce a dataset fit for training and testing with seven Machine Learning algorithms. After initial modeling with 34 training features, feature elimination was utilized to isolate the most contributing features and create streamlined models. The models were fine-tuned using Bayesian search before being compared to select the most accurate and interpretable architecture. RESULTS: A patient cohort of 245 patients included 189 alive and 56 deceased neonates with incidence of AKI. Of the 245 patients included in this study, 73.5% were male and 26.5% were female, alongside a median age at entry of 12 h and interquartile range of 35 h. Three tree-based models, Random Forest, XGBoost, and LightGBM, were found to be the most accurate and interpretable of the seven models tested. Support Vector Machine produced similar results, albeit with less interpretability. The RAMA (Raina, Arnav, Max, Aadi) model followed results of the XGBoost algorithm, with Area under the Receiver Operating Characteristic Curve (AUC-ROC) of 0.882 ± 0.132, Accuracy of 0.878 ± 0.052, and F1 Score of 0.923 ± 0.029. CONCLUSION: RAMA utilizes a tree-based decision-making algorithm, allowing it to determine the risk of mortality in neonates susceptible to AKI.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe