J. Matern. Fetal. Neonatal. Med. [JOURNAL]
Sun
200 papers
Incidence and outcome of major perinatal comorbidities of all hospitalized neonates requiring intensive and critical care: a livebirth population-based survey.
Zhang X, Zhai S, Zhao Z … +45 more , Li L, Qiao B, Wen Z, Li J, Wang M, Wei P, Xu Y, Guo X, Sun B, Handan Neonatal Collaborative Study Group, Ma L, Wang H, Zhao X, Wang Z, Li X, Du S, Wang X, Shi S, Dong Y, Zhang H, Fang P, Yue M, Guo Y, Zhang S, Zhang J, Han H, Li Q, Wang B, Feng S, Yang Y, Ning H, Dong L, Liu T, Wen Z, He X, Zhao Z, Guo J, Wang Y, Ma Y, Li J, He X, Yin Y, Gao J, Jia X, Miao X
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41656072 · Publisher ↗
OBJECTIVES: Prevalence, outcome and causal implication of neonatal survival-associated major morbidities remain the central focus of quality improvement of maternal-fetal and neonatal medicine. We aimed to estimate basel...
OBJECTIVES: Prevalence, outcome and causal implication of neonatal survival-associated major morbidities remain the central focus of quality improvement of maternal-fetal and neonatal medicine. We aimed to estimate baseline information of neonatal intensive and critical care by analyzing surviving data of all hospitalized neonates from livebirth population. SUBJECTS AND METHODS: We prospectively collected a datafile consisting of 10,840 (13.72%) cases as all hospitalized neonates from 79,012 livebirths in Handan in 2020, a sub-provincial region with 9.41 million population and intermediate-to-high level of socioeconomic development in north China. The diagnoses of diseases requiring intensive and/or critical care, and causes of deaths, were categorized, and perinatal and disease-specific risks of death were estimated by multivariable logistic regression models. RESULTS: Livebirth-based incidence of major perinatal comorbidities were 19.7‰ for congenital pneumonia/early onset sepsis, 12.1‰ intraventricular hemorrhage, 8.7‰ birth asphyxia, 8.7‰ respiratory distress syndrome (RDS), 7.7‰ sepsis and 6.8‰ congenital anomalies (CA). Case-fatality rate (cause-specific mortality rate referring to livebirths) of major diseases were 47.1% (0.2‰) pulmonary hemorrhage, 26.9% (0.1‰) necrotizing enterocolitis, 15.6% (0.2‰) late onset sepsis, 14.1% (1.2‰) RDS, 11.3% (0.8‰) CA, and 11% (1.0‰) asphyxia. There were 242 (2.2%) died in hospital (3.1‰ of all livebirths), 52.1% being in the preterm, 49.2% in low birthweight, and <40% in those <28 weeks of gestation, or <1000 g birthweight, respectively. Death risks associated with the perinatal and neonatal morbidities were markedly declined with variable magnitudes as estimated by multivariable logistic regression models. CONCLUSIONS: The incidence rates of major perinatal comorbidities, neonatal mortality rates, and major risks to the overall and specific outcome of all the hospitalized neonates in Handan, denote baseline characteristics and efficiency of the regional perinatal-neonatal care system.
Exploring the needs of women with normal vaginal deliveries during the postpartum period in China: a longitudinal qualitative study.
Binxia L, Lina Y, Xingxing L … +1 more , Yufan Y
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41656071 · Publisher ↗
OBJECTIVES: To explore the changes in needs among postpartum women and provide a reference for the development of scientific and effective targeted nursing interventions. METHODS: We conducted a longitudinal qualitative...
OBJECTIVES: To explore the changes in needs among postpartum women and provide a reference for the development of scientific and effective targeted nursing interventions. METHODS: We conducted a longitudinal qualitative study of 18 postpartum women who initially experienced normal vaginal deliveries in China. Participants were selected using a purposive sampling method, and semi-structured interviews were conducted at twenty-four hours, three days, two weeks, and forty-two days during the postpartum period. The study was designed using a phenomenological approach and the data were analyzed using a social-ecological framework. RESULTS: The study extracted three main themes and eleven subthemes: the micro system (including needs for scientific newborn care guidance, needs for nursing of maternal physiological discomfort, needs for breastfeeding guidance, and Needs for dynamic psychological care of Postpartum), the meso system (including needs for single - room of the ward environment, needs for online consultation after discharge, needs for health education for family members), and the macro system (including needs for birth certificate policy optimization, needs for comprehensive guidance on vaccination, needs for home visit to optimize, and needs for standardized education implementation and personalized, dynamic learning). CONCLUSION: This study indicates that the needs of women who have undergone normal vaginal delivery undergo a dynamic change process. Consequently, clinical medical staff should develop health education programs and provide personalized and precise interventions based on varying needs at different stages of the postpartum period.
Statement of Retraction: The effect of prophylactic oral tranexamic acid plus buccal misoprostol on blood loss after vaginal delivery: a randomized controlled trial.
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41656005 · Publisher ↗
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Risk factors and perinatal outcomes of gestational diabetes mellitus in dichorionic twin pregnancies: a retrospective cohort study.
Fang X, Shen Z, Zhang Z … +1 more , Zheng L
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41644284 · Publisher ↗
OBJECTIVE: To identify maternal risk factors for gestational diabetes mellitus (GDM) and to evaluate its perinatal implications in dichorionic (DC) twin pregnancies, a population in which metabolic demands and placental...
OBJECTIVE: To identify maternal risk factors for gestational diabetes mellitus (GDM) and to evaluate its perinatal implications in dichorionic (DC) twin pregnancies, a population in which metabolic demands and placental physiology differ substantially from singleton gestations. METHODS: A retrospective cohort study was conducted among 378 women with confirmed DC twin pregnancies, including 122 women with GDM and 256 without GDM, delivered at a tertiary maternal-fetal medicine center between 2018 and 2023. GDM was diagnosed using IADPSG criteria following a 75-g oral glucose tolerance test. Maternal demographic factors, conception mode, early ultrasound parameters, obstetric outcomes, and neonatal outcomes were compared between women with and without GDM using univariate analyses and multivariate logistic regression. RESULTS: Pre-pregnancy BMI ≥25 kg/m (adjusted OR 1.857, 95% CI 1.050-3.284) and conception assisted reproductive technology (adjusted OR 1.608, 95% CI 1.029-2.514) independently increased the likelihood of developing GDM. Most maternal and neonatal outcomes-including preterm birth, birth weight patterns, neonatal hypoglycemia, and NICU admission-did not differ significantly between the two groups. However, GDM was associated with a higher incidence of single intrauterine fetal demise (7.4% vs. 2.7%, = 0.036). CONCLUSION: In DC twin pregnancies, maternal overweight and ART conception constitute significant risk factors for GDM. While many perinatal outcomes appear unaffected, the elevated risk of single fetal demise underscores the need for intensified fetal surveillance and individualized management in this high-risk population.
Variation in neonatal antibiotic management for patients undergoing fetal myelomeningocele repair across Children's Hospitals Neonatal Consortium (CHNC) centers.
Welke NL, Eyerly-Webb SA, Linabery AM … +4 more , Downey AG, Halvorson KG, Lampland AL, Children’s Hospitals Neonatal Consortium (CHNC) Fetal Therapy Focus Group
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41633758 · Publisher ↗
OBJECTIVE: Limited data informing evidence-based regimens for antibiotic use in neonates undergoing fetal myelomeningocele (fMMC) repair have been published to date, and no standard of care has been established across ce...
OBJECTIVE: Limited data informing evidence-based regimens for antibiotic use in neonates undergoing fetal myelomeningocele (fMMC) repair have been published to date, and no standard of care has been established across centers. The goal of this study was to describe current neonatal antibiotic use practices following fMMC repair within the Children's Hospitals Neonatal Consortium (CHNC), a collaborative network of North American institutions with Level IV neonatal intensive care units. METHODS: We conducted a cross-sectional survey of site sponsors at all 48 CHNC centers from April 2024 to January 2025, and invited CHNC Fetal Therapy Focus Group members in May 2024, with one response requested per center. RESULTS: A neonatologist at 34 centers (center response rate = 71%) completed the survey, of which 30 (88%) reported performing fMMC repair surgery (15/34, 44%) or delivering/receiving fMMC neonates (15/34, 44%) at their center. One-quarter of responding centers (7/30, 23%) reported having an existing clinical protocol for antibiotic management for fMMC neonates after birth. Notably, there was heterogeneity across existing protocols with respect to criteria for antibiotic use, the specific antibiotics used, and the duration of use. Responding centers reported administering antibiotics with guidance from infectious disease, neurosurgery, and fetal specialists. Two responding centers (6%) reported performing beta-2 transferrin testing on dehisced wounds when there is a suspected cerebrospinal fluid (CSF) leak, while the majority did not do so (20/30, 67%), and the remainder did not know their institutional practice (7/30, 23%). CONCLUSIONS: Current antibiotic use in fMMC neonates after birth varies widely between centers in North America, highlighting the need for evidence-based data to inform the development of best practice guidelines.
Association between maternal stress hormone levels during labor induction and the occurrence of neonatal hyperbilirubinemia.
Liu S, Xiao H, Wang Y … +4 more , Liu H, Qi X, Fang Y, Zhang L
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41629054 · Publisher ↗
OBJECTIVE: To investigate the relationship between changes in maternal stress hormone levels during labor induction and the occurrence of neonatal hyperbilirubinemia (NNH), and to identify potential independent risk fact...
OBJECTIVE: To investigate the relationship between changes in maternal stress hormone levels during labor induction and the occurrence of neonatal hyperbilirubinemia (NNH), and to identify potential independent risk factors. METHODS: A prospective cohort study was conducted involving 1,000 pregnant women who underwent labor induction at our hospital between June 2022 and May 2025. Maternal plasma levels of cortisol, epinephrine (EPI), and norepinephrine (NE) were measured before induction (T), during induction (T), and 30 min after delivery (T). Neonatal total bilirubin concentrations were measured at 24, 48, and 72 h after birth. According to the occurrence of NNH, subjects were divided into the NNH group ( = 95) and the non-NNH group ( = 905). Hormonal and bilirubin changes were compared between the two groups. Point-biserial correlation and multivariate logistic regression analyses were performed to explore associations and identify independent predictors. RESULTS: Maternal plasma levels of cortisol, EPI, and NE at T and T were significantly higher in the NNH group. All three hormones at T showed moderate positive correlations with the occurrence of NNH ( = 0.28-0.31, < 0.001). Cortisol, EPI, and NE at T were independently associated with the occurrence of NNH, while gestational age served as a protective factor. Male sex, cephalohematoma, direct antiglobulin test (DAT) positivity, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and exclusive breastfeeding were all associated with a higher risk of NNH. The regression model showed strong discriminatory power and predictive performance. CONCLUSION: Elevated maternal stress hormone levels during labor induction may serve as potential predictive indicators for assessing the risk of NNH.
Do maternal and neonatal outcomes differ with single or twin pregnancies affected by hypertensive disorders? A systematic review and meta-analysis.
Shen Q, Huang Q
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41622029 · Publisher ↗
OBJECTIVE: To compare maternal and neonatal outcomes of singleton and twin gestations complicated by hypertensive disorders of pregnancy (HDP). METHODS: PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Googl...
OBJECTIVE: To compare maternal and neonatal outcomes of singleton and twin gestations complicated by hypertensive disorders of pregnancy (HDP). METHODS: PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Google Scholar were searched for comparative studies till 15th May 2025. RESULTS: Thirteen studies were included. The analysis of crude data found a significantly elevated risk of preterm birth and cesarean section with twins compared to singleton gestations complicated by HDP. A significantly higher risk of small-for-gestational-age (SGA) was noted in twin pregnancies, but the effect was lost on subgroup analysis for preeclampsia. The analysis did not show any differences in 5-min Apgar score <7, respiratory distress, or neonatal intensive care unit (NICU) admission. Twin pregnancies were linked with significantly greater risk of neonatal death. CONCLUSION: Twin pregnancies with HDP may be associated with significantly higher risk of preterm birth, cesarean section, SGA, and neonatal death, but without any difference in 5-min Apgar score <7, respiratory distress, and NICU admission as compared to singleton pregnancies complicated by HDP. Limited research indicates that twin pregnancies with preeclampsia may confer protection against SGA, but the findings should be interpreted with caution. Lack of adjustment of confounders is a major limitation of present evidence.
Effects of depression and relative fat mass on gestational diabetes mellitus history: evidence from NHANES 2007-2020.
Yang X, Jiang R, Wang G … +3 more , Zhao N, Yin X, Li C
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41622028 · Publisher ↗
BACKGROUND: The growing prevalence of gestational diabetes mellitus (GDM) presents a significant clinical concern. In parallel, obesity has escalated to epidemic levels, and the mental health-GDM connection has been incr...
BACKGROUND: The growing prevalence of gestational diabetes mellitus (GDM) presents a significant clinical concern. In parallel, obesity has escalated to epidemic levels, and the mental health-GDM connection has been increasingly documented. Against this backdrop, the present study primarily investigates the independent and joint contributions of relative fat mass (RFM) and depression to GDM risk. METHODS: Data were collected from the National Health and Nutrition Examination Survey (NHANES) covering the years 2007-2020. The separate associations of RFM and depression with GDM history were analyzed using a weighted logistic regression model, while interaction analysis was conducted to explore their combined effect. Subgroup analyses were conducted for further validation. RESULTS: Among 8622 eligible participants, 775 (9.00%) had a history of GDM. The median age at first live birth was 22.00 years (19.00, 26.00). After adjusting for confounding variables, both increased RFM (OR = 1.07; 95% CI: 1.05-1.09) and depression scores (OR = 1.04; 95% CI: 1.02-1.06) were linked to an elevated risk of GDM. The coexistence of obesity (RFM ≥ 40%) and depression yielded a synergistic effect greater than their individual impacts (RERI = 0.87; ROR = 1.33). These findings were consistent across subgroup and sensitivity analyses. CONCLUSIONS: Concurrent elevation in RFM and depressive symptoms significantly heightens the likelihood of GDM history. These results support the integration of metabolic and psychological factors into preventive frameworks targeting GDM history.
Risk factors and clinical features of feeding intolerance in preterm infants and the effect of multimodal oral-sucking-oromotor training: a single-center retrospective analysis.
Zhao H, Qi H, Xu R … +1 more , Xie G
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41622027 · Publisher ↗
BACKGROUND: Feeding intolerance (FI) is a common gastrointestinal problem among hospitalized preterm infants that can delay establishment of enteral nutrition and increase the risk of complications. OBJECTIVE: To identif...
BACKGROUND: Feeding intolerance (FI) is a common gastrointestinal problem among hospitalized preterm infants that can delay establishment of enteral nutrition and increase the risk of complications. OBJECTIVE: To identify factors associated with FI and characterize its clinical manifestations in preterm infants, and to evaluate the association between addition of multimodal oral-sucking-oromotor training to routine care and FI incidence and short-term outcomes, including subgroup analyses by weight for gestational age. METHODS: We performed a single-center retrospective cohort study that included 649 preterm infants admitted between January 2020 and December 2022. Based on nursing and medical records, infants were classified into an intervention group ( = 320; routine care plus multimodal oral-sucking-oromotor training) and a control group ( = 329; routine care only). The primary outcomes were FI-related endpoints (FI incidence, severity, duration, and days to attainment of full enteral feeding). Secondary outcomes included in-hospital complications, nutritional and growth indices, and neurobehavioral scores. Subgroup analyses were conducted for infants who were appropriate for gestational age (AGA) and small for gestational age (SGA). Multivariable logistic regression was used to identify independent factors associated with FI. RESULTS: The incidence of FI was significantly lower in the intervention group than in the control group (28.1% vs. 40.7%, < 0.001), with a notably smaller proportion of severe FI. The intervention group also exhibited shorter FI duration, earlier attainment of full enteral nutrition, and superior weight-gain velocity, nutritional biochemical markers and NBNA scores compared with controls (all < 0.001). In stratified analyses by weight-for-gestational-age, multimodal oral-sucking-oromotor training was likewise associated with more favorable short-term outcomes in both AGA and SGA preterm infants. Multivariable logistic regression identified 1-minute Apgar ≤7, SGA status, delayed first feeding >72 h, mechanical ventilation/respiratory support and early-onset sepsis (EOS) as independent correlates of FI. After adjustment for covariates, higher gestational age, greater birth weight, breastfeeding (adjusted OR = 0.60) and multimodal oral-sucking-oromotor training (adjusted OR = 0.59, 95% CI 0.42-0.82) remained independently associated with a reduced risk of FI. CONCLUSIONS: Addition of multimodal oral-sucking-oromotor training to routine care was independently associated with a lower incidence of FI and with improvements in short-term nutritional and growth outcomes in preterm infants; benefits were observed in both AGA and SGA subgroups. SGA status, delayed initiation of first feeding (>72 h), requirement for respiratory support/mechanical ventilation and EOS were independent risk factors for FI.
Development and validation of a risk prediction model for early-onset hypoglycemia in preterm infants.
Li R, He C, Luo M … +3 more , Situ M, Li Z, Xie Q
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41611524 · Publisher ↗
BACKGROUND: Early-onset hypoglycemia is a frequent metabolic complication in preterm infants and may lead to adverse neurodevelopmental outcomes. Accurate risk prediction is essential for timely clinical intervention. ME...
BACKGROUND: Early-onset hypoglycemia is a frequent metabolic complication in preterm infants and may lead to adverse neurodevelopmental outcomes. Accurate risk prediction is essential for timely clinical intervention. METHODS: A retrospective study was conducted on 436 preterm infants admitted to a tertiary hospital in Guangzhou from January 2022 to November 2023. The dataset was randomly divided into a training set ( = 305) and a validation set ( = 131). Univariate analysis and LASSO logistic regression were used to screen predictive variables. A multivariate logistic regression model was developed and visualized as a nomogram. Internal validation was performed using calibration plots, ROC curves, and decision curve analysis (DCA). RESULTS: A retrospective cohort of 436 preterm infants was analyzed, among whom 124 cases (28.44%) experienced hypoglycemia within 48 h after birth. Multivariate logistic regression identified six independent risk factors: reduced gestational age, multiple births, cesarean delivery, maternal gestational diabetes, gestational hypertension, and abdominal distension observed on the second postnatal day. The predictive model exhibited solid discriminative power, with an AUC of 0.802 in the training group and 0.829 in the validation group. Model calibration was satisfactory across datasets. DCA further supported the model's clinical utility, indicating consistent net benefit over a wide spectrum of risk thresholds. CONCLUSION: The model demonstrated promising predictive ability for early-onset hypoglycemia in preterm infants and could potentially serve as a preliminary tool to inform risk stratification strategies. However, its clinical translation requires confirmation through external validation in prospective, multicenter studies before any consideration of widespread implementation.
Vaginal birth after cesarean: maternal and fetal outcomes in a multicenter study.
Duran MN, Ilgin SK, Demir SS … +2 more , Sengi A, Demir B
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41605508 · Publisher ↗
OBJECTIVE: Trial of labor after cesarean (TOLAC) has reemerged as an important strategy to lower rising cesarean rates and provide women with a safe alternative to repeat surgery. Successful vaginal birth after cesarean...
OBJECTIVE: Trial of labor after cesarean (TOLAC) has reemerged as an important strategy to lower rising cesarean rates and provide women with a safe alternative to repeat surgery. Successful vaginal birth after cesarean (VBAC) may also reduce long-term complications associated with multiple cesarean deliveries. Despite this growing interest, data from high-fertility regions remain limited. This study evaluated outcomes of TOLAC in secondary-level hospitals in Türkiye and compared them with elective repeat cesarean section (ERCS). METHODS: This retrospective multicenter cohort included women with ≥1 prior low-transverse cesarean delivery between January 2020 and January 2026. Eligible patients underwent either ERCS or attempted TOLAC, which resulted in VBAC or emergency cesarean. Maternal characteristics, peripartum variables, and neonatal outcomes were assessed. Crude risk ratios (RRs) with 95% confidence intervals (CIs) were calculated. RESULTS: Of 19,768 women with a previous cesarean, 2,185 (11.1%) attempted TOLAC and 17,583 (89.0%) selected ERCS. VBAC was achieved in 1,464 women (67.0%), while 721 (33.0%) required emergency cesarean. Compared with ERCS, VBAC was associated with lower risks of gestational diabetes (RR 0.68; 95% CI 0.52-0.89) and pregnancy-related hypertension (RR 0.62; 95% CI 0.44-0.89). Emergency cesarean was linked to higher transfusion requirements (RR 1.36; 95% CI 1.02-1.82). Uterine rupture was rare across groups. Neonatal outcomes were broadly similar, although fetal acidosis appeared more frequent after failed TOLAC. CONCLUSIONS: VBAC success rates in this cohort aligned with contemporary international benchmarks and demonstrated favorable maternal outcomes in appropriately selected patients. Emergency cesarean following failed TOLAC represented the highest-risk pathway, emphasizing the need for meticulous intrapartum monitoring and timely surgical readiness. Expanding safe TOLAC programs may reduce unnecessary repeat cesarean deliveries in high-fertility settings.
Clinical management of late-stage infection with complete placenta previa: a case report of conception in a natural cycle following stillbirth.
Wu T, Ren L, Bian L … +3 more , Liu C, Tao H, Cui R
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41592870 · Publisher ↗
OBJECTIVE: is a pathogenic Gram-positive bacterium that poses a serious threat to pregnant women and their fetuses. This case report aims to highlight the management and outcomes of such an infection in a pregnancy with...
OBJECTIVE: is a pathogenic Gram-positive bacterium that poses a serious threat to pregnant women and their fetuses. This case report aims to highlight the management and outcomes of such an infection in a pregnancy with multiple complications. METHODS: We describe the clinical management of a 33-year-old woman who conceived via in vitro fertilization (IVF) and presented in the third trimester with infection, complicated by complete placenta previa, a succenturiate placenta, and breech presentation. RESULTS: Despite prompt medical intervention, intrauterine fetal demise occurred. Following prophylactic uterine artery embolization (UAE), successful vaginal delivery was achieved. Three months postpartum, her menstrual cycle returned to normal. After monitoring her follicles during natural cycles, she successfully conceived again within one cycle, experienced a smooth pregnancy, and ultimately delivered a healthy baby boy at term. CONCLUSIONS: This case underscores the importance of increased awareness regarding the risk of infection during pregnancy. It discusses the potential of applying next-generation sequencing (NGS) to amniotic fluid samples obtained via amniocentesis for early diagnosis and highlights that performing uterine artery embolization when necessary can help maximize the preservation of fertility.
Physical activity and quality of life after childbirth: a cross-sectional study.
Siani S, Faria PCS, Scanavachi Oliveira A … +4 more , Carvalho ED, Vay LF, Guida JPS, Surita FG
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41582070 · Publisher ↗
BACKGROUND: The period of life after childbirth represents a particularly demanding phase in a woman's life and may significantly compromise both mental and physical health. Adhering to the World Health Organization's (W...
BACKGROUND: The period of life after childbirth represents a particularly demanding phase in a woman's life and may significantly compromise both mental and physical health. Adhering to the World Health Organization's (WHO) recommendation of 150 min of physical activity per week, in addition to maintaining adequate sleep quality, may pose considerable challenges during this time. METHOD: Prospective cross-sectional study including women between three months and two years after childbirth. Physical activity was self-reported and measured by the International Physical Activity Questionnaire (IPAQ, Version 6, long form); quality of life was assessed by the World Health Organization Quality of Life questionnaire (WHOQOL-BREF); and sleep quality was evaluated through the Pittsburgh Sleep Quality Index (PSQI-BR). Sociodemographic data were collected using a personal characterization questionnaire. RESULTS: 187 women were included. Of the total sample, 86.1% reported engaging in physical activity prior to pregnancy, 71.1% during pregnancy, and 43.3% in the postpartum period. The majority was primiparous (62.6%), white (73.8%), in a stable relationship (95.2%), engaged in paid employment (82.4%), and had completed high school education (96.3%). According to IPAQ classification, 42.2% of participants exhibited a moderate level of physical activity. Based on PSQI, 59.9% of the women presented with poor sleep quality. The most physically active women during pregnancy were those over 30 years of age, primiparous, and with a well-established support network. Those with lower activity levels also reported worse sleep and lacked support. Women who engaged in physical activity during pregnancy were approximated seven times more likely to maintain physical activity in the postpartum period (OR 7.25 95% CI 2.85-18.45). CONCLUSION: A reduction in physical activity levels was observed after childbirth. The most active women were primiparous, over 30 years of age, and had a structured support network. Engaging in physical activity during pregnancy was associated with a greater likelihood of maintaining such a habit after childbirth.
Intrauterine interventions for severe fetal anemia due to parvovirus B19 national outbreak.
Tenenbaum-Gavish K, Alter R, Duvdevani NR … +7 more , Yahalom V, Barzilai M, Idelson A, Shapira Rootman M, Almog A, Danon D, Gielchinsky Y
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41582067 · Publisher ↗
OBJECTIVE: Parvovirus B19 infection during pregnancy can cause severe fetal anemia, hydrops fetalis, and fetal death. This study describes our experience managing ten cases of severe fetal anemia due to parvovirus B19 in...
OBJECTIVE: Parvovirus B19 infection during pregnancy can cause severe fetal anemia, hydrops fetalis, and fetal death. This study describes our experience managing ten cases of severe fetal anemia due to parvovirus B19 infection during the 2023-2024 national outbreak in Israel. METHODS: This single-center descriptive cohort study included ten singleton pregnancies with fetal anemia (MCA-PSV >1.5 MoM) requiring intrauterine transfusion. Parvovirus B19 infection was confirmed by maternal IgM serology and/or amniotic fluid PCR. For pregnancies <20 weeks of gestation, we implemented a modified intraperitoneal transfusion technique incorporating pre-transfusion ascites drainage. Intravascular transfusions were used for later gestations. Platelet transfusions were administered when thrombocytopenia was present. Serial fetal sonography and neuroimaging were performed throughout the follow-up period. RESULTS: Seventy percent of fetuses presented with anemia and hydrops before 20 weeks of gestation. The modified intraperitoneal transfusion technique doubled the mean transfused packed red blood cell volumes compared to the standard technique (40 mL vs. 20 mL; = 0.009). We performed 15 intraperitoneal transfusions (mean 2.14 per fetus) and 11 intravascular transfusion procedures. One fetal death occurred following intraperitoneal transfusion. Complications included one iatrogenic abdominal wall defect post-intraperitoneal transfusion (successfully repaired postnatally) and one case of transient ascites with hemosiderin deposits (resolved after birth). Two fetuses required platelet transfusions. All surviving infants demonstrated normal neuroimaging. Mean gestational age at delivery was 37 weeks 5 days, with 88% delivered at term. One preterm delivery occurred at 27 weeks due to cervical shortening and contractions, resulting in neonatal complications of prematurity. CONCLUSION: Intensive intrauterine intervention, including ascites drainage and repeated red blood cell and platelet transfusions, may improve fetal outcomes in severe parvovirus B19 anemia. The modified intraperitoneal transfusion technique with pre-transfusion ascites drainage enabled larger transfusion volumes. Early, aggressive intervention appears crucial for optimal outcomes in these challenging cases.
Transient conductive hearing loss as a notable and rare manifestation of preeclampsia: a case report.
Chen X, Jin L, Zhao B
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41582066 · Publisher ↗
OBJECTIVE: To report a case of transient conductive hearing loss secondary to secretory otitis media (SOM) in a patient with preeclampsia, highlight its unique pathophysiological link, and emphasize the importance of rec...
OBJECTIVE: To report a case of transient conductive hearing loss secondary to secretory otitis media (SOM) in a patient with preeclampsia, highlight its unique pathophysiological link, and emphasize the importance of recognizing this potential complication. CASE PRESENTATION: Preeclampsia is a severe, pregnancy-specific multisystem disorder characterized by new-onset hypertension and proteinuria after 20 weeks of gestation. While endothelial dysfunction and vasospasm are central to its pathophysiology, its clinical manifestations are diverse. Auditory dysfunction, particularly conductive hearing loss, is infrequently reported. We present a case of a 25-year-old gravida 2, para 0 woman diagnosed with preeclampsia at 33 weeks of gestation. She had persistent proteinuria (24-hour urinary protein 1244.7 mg), unstable hypertension (148-165/95-107mmHg) managed with labetalol (100 mg every 8 h, suboptimal adherence), and gestational diabetes. She had no prior history of ear disease, trauma, or ototoxic medication use.At 35w5d gestation, the patient developed sudden bilateral hearing loss, accompanied by mild chest tightness and an elevated brain natriuretic peptide (BNP) level (346.1 pg/ml). Otolaryngology consultation was performed, and otoendoscopic examination revealed bilateral intratympanic fluid. Pure tone audiometry confirmed bilateral conductive hearing loss with significant air-bone gaps (left 30 dB, right 13 dB). Bone conduction thresholds were within normal limits (left 15 dB, right 16 dB), ruling out sensorineural hearing loss. Acoustic immittance audiometry showed bilateral B-type tympanograms, indicative of middle ear effusion. Alternative causes of conductive hearing loss (e.g. upper respiratory infection-related eustachian tube dysfunction, barotrauma, tympanic membrane pathology, middle ear mass) were excluded through clinical evaluation, negative inflammatory markers (C-reactive protein: <0.5 mg/l, white blood cell count: 12.9 × 10^9), and absence of relevant symptoms. Given her deteriorating condition, an emergent Cesarean section was performed at 36 weeks of gestation, delivering a healthy male infant. Postoperatively, supportive management with combined diuretics (furosemide and spironolactone) led to rapid and complete resolution of her hearing deficits within three days. She was discharged on continued antihypertensive therapy and was well at one-month follow-up. CONCLUSION: Transient conductive hearing loss due to SOM is a rare manifestation of preeclampsia, likely driven by hypertension-induced increased vascular permeability and altered fluid dynamics. Severe proteinuria may exacerbate systemic fluid imbalance, contributing to middle ear effusion. Early recognition audiometric and tympanometric evaluation, exclusion of alternative etiologies, and targeted management (e.g. fluid overload reduction) can ensure prompt recovery and improve maternal outcomes. Early recognition and management can improve maternal outcomes by addressing fluid dysregulation and potentially preventing further complications.
Baseline serum AMH‑to‑FSH ratio, menstrual pattern, and risk of intra‑uterine adhesion recurrence: a prospective multi‑state Markov model study.
Li J, Yan J, Hu H … +5 more , Li Y, Yang X, Dong C, Guo Z, Shen H
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41582008 · Publisher ↗
BACKGROUND: Intra-uterine adhesion (IUA) frequently recurs after hysteroscopic adhesiolysis, undermining menstruation and fertility. We aimed to determine whether baseline serum anti‑Müllerian hormone (AMH)‑to-follicle‑s...
BACKGROUND: Intra-uterine adhesion (IUA) frequently recurs after hysteroscopic adhesiolysis, undermining menstruation and fertility. We aimed to determine whether baseline serum anti‑Müllerian hormone (AMH)‑to-follicle‑stimulating hormone (FSH) ratio and menstrual pattern independently and jointly predict IUA severity transitions after adhesiolysis using a multi‑state Markov model. METHODS: We conducted a single-center prospective study of 210 women (18-45 years) undergoing first adhesiolysis for moderate-to-severe IUA. Baseline serum AMH and FSH were measured and menstrual pattern was classified as normal, hypomenorrhea, or amenorrhea. Hysteroscopy at 3, 6, 12, and 24 months defined four severity states (none, mild, moderate, severe) and two absorbing outcomes (pregnancy ≥ 12 weeks, repeat surgery). Continuous-time multi-state Markov models estimated transition-specific adjusted hazard ratios (HRs) with 95% confidence intervals (CIs), controlling for age, body-mass index (BMI), baseline adhesion severity, and adjuvant therapy. Internal validation used 200-bootstrap c-index and calibration. RESULTS: Of 210 participants, 83 women (39.5%) had any recurrence and 28 (13.3%) progressed to severe adhesions. Pregnancy ≥ 12 weeks occurred in 54 (25.7%) and repeat surgery in 36 (17.1%). Each one-standard-deviation decrease in AMH/FSH increased hazards from mild to moderate (adjusted HR 1.81, 95% CI 1.29-2.54) and from moderate to severe (HR 2.15, 95% CI 1.41-3.28), with a non-significant trend from none to mild (HR 1.20, 95% CI 0.95-1.52). Amenorrhea versus normal was associated with higher hazards for none to mild (HR 1.88, 95% CI 1.23-2.99) and mild to moderate (HR 1.55, 95% CI 1.10-2.18). An interaction suggested that amenorrhea amplified the adverse effect of a low AMH/FSH ratio on progression to severe disease (HR 1.39, 95% CI 1.03-1.88). The model showed good performance, with bootstrap‑corrected C‑index 0.78 (95% CI 0.74-0.82), optimism‑corrected C‑index 0.76, and optimism‑corrected calibration slope 0.94. CONCLUSIONS: Baseline endocrine status summarized by the AMH/FSH ratio and menstrual pattern independently and jointly predict IUA dynamics after adhesiolysis. A biomarker-based, multi-state risk tool may help personalize severity-anchored surveillance and re-intervention after adhesiolysis.
Statement of Retraction: Urinary tract injuries during cesarean section in patients with morbid placental adherence: retrospective cohort study.
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41571288 · Publisher ↗
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Statement of Retraction: Low-dose vaginal misoprostol in the management of intrauterine fetal death.
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41565365 · Publisher ↗
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Statement of Retraction: Transvaginal cervical length measurement at 22- to 26-week pregnancy in prediction of preterm births in twin pregnancies.
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41565360 · Publisher ↗
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Ultrasound and SNP-based cell-free DNA zygosity testing in twin pregnancies.
Quintero R, Hurt KJ, Vora NL … +19 more , Seligman NS, Reilly GP, Wick MJ, Wolf SB, Hopkins M, Westover T, Ahmadzia HK, Kanaan C, Rebarber A, Kontopoulos EV, Zhang J, Egbert M, Vourthis S, Cantu-Weinstein A, Saben JL, Jelsema R, Souter V, Johnson CT, Benn P
J Matern Fetal Neonatal Med · 2026 Dec · PMID 41555214 · Publisher ↗
INTRODUCTION: The importance of prenatal determination of chorionicity for the management of twin pregnancies is well recognized. However, research on the contribution of prenatal evaluation of zygosity to the management...
INTRODUCTION: The importance of prenatal determination of chorionicity for the management of twin pregnancies is well recognized. However, research on the contribution of prenatal evaluation of zygosity to the management of twins is limited. We assessed the utility of adding SNP-based cell-free DNA (cfDNA) zygosity testing to ultrasound chorionicity assessment for the clinical management of twin pregnancies. METHODS: Prospective observational study involving 13 United States practices with proficiency in prenatal ultrasound. Patients diagnosed by ultrasound with twins in the first trimester were assessed with cfDNA screening for zygosity. Ultrasound assessment of chorionicity was performed prior to cfDNA results. Placental pathology was used as the gold standard for chorionicity assessment. Gestational age at delivery and standardized birthweights were compared, based on chorionicity and zygosity. RESULTS: 110 twin pregnancies were included. Among 79 dichorionic (DC) cases confirmed by placental pathology, one (1.3%) was misclassified as monochorionic (MC) by ultrasound, but was dizygous (DZ) by cfDNA, consistent with DC. Of 31 monozygotic (MZ) twins by cfDNA, confirmed as MC by pathology, ultrasound misclassified one (3.6%) as DC. Median gestational age at delivery was earlier for MZ twin pregnancies (35.0 weeks) compared to DZ (36.9 weeks, = 0.02). After adjusting for fetal sex and gestational age at birth, MZDC twins had significantly lower birthweights ( = 0.006) and birthweight percentiles ( = 0.004) than DZDC twins. CONCLUSIONS: Based on postpartum placental pathology as the reference standard for determining MC versus DC, cfDNA zygosity testing appears to aid in the prenatal assignment of chorionicity. Larger studies are needed to confirm the value of zygosity testing in the management of twin pregnancies.
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