BMC Pregnancy And Childbirth[JOURNAL]
Sun
200 papers
Risk of suicidal behaviors among adolescent pregnant women with early married: a systematic review and meta-analysis.
Davtalab Esmaeili E, Derakhshi Ghazi Jahan F, Azizi H … +4 more , Nadi A, Khodamoradi F, Bastani P, Ranjbari F
BMC Pregnancy Childbirth · 2026 Jun · PMID 42332611 · Full text
BACKGROUND: Adolescent pregnancy and early marriage are major public health issues with potential adverse mental health consequences, including suicidal behaviors (SBs). This systematic review and meta-analysis aimed to...
BACKGROUND: Adolescent pregnancy and early marriage are major public health issues with potential adverse mental health consequences, including suicidal behaviors (SBs). This systematic review and meta-analysis aimed to estimate the pooled prevalence of, and the association between, adolescent pregnancy and SBs among girls aged < 19 years. METHODS: The review systematically searched databases including PubMed, Scopus, Web of Science, Google Scholar, and Embase, beginning from the date of 13 June 2025. The study included any observational studies reporting the association between SBs including suicide, suicidal ideation (SI), suicide attempts (SA) and adolescent pregnancy. Meta-analysis and subgroup analyses using a random-effects model were conducted to estimate pooled prevalence and odds ratios (ORs), with I2 used to assess heterogeneity for the association between adolescent pregnancy and SI, SA, and suicide. RESULTS: A total of 12 studies involving 125,551 pregnant adolescent women were included. The pooled estimate and 95% CIs for the prevalence of SI and SA were 14% (9% - 19%) and 6% (5% - 8%), respectively. Furthermore, subgroup meta-analysis by region indicated that the pooled estimate for the prevalence of SA is 10% (5% - 16%) for Asia, 3% (2% - 3%) for India and Africa, and 6% (1% - 10%) for developed countries. The pooled OR and 95% CI for the risk of SI was OR = 1.63 (1.21-2.05), for SA it was OR = 1.99 (1.16-2.83), and for suicide, it was OR = 1.43 (1.40-2.24) in pregnant adolescents compared to pregnant women aged over 19 years. CONCLUSION: Findings indicated that adolescent pregnancy was associated to an increased risk of SBs. Additionally, the pooled estimate for the prevalence of SI and SA among adolescent pregnant mothers is higher than that in the general population, as well as among unmarried teenage girls and young women.
Self-assessment risk scoring system for early screening of preterm birth in low resource settings.
Novianti L, Irwinda R, Saroyo YB … +1 more , Hiksas R
BMC Pregnancy Childbirth · 2026 Jun · PMID 42332600 · Full text
INTRODUCTION: Preterm birth is a leading cause of neonatal mortality and morbidity globally. According to the World Health Organization (WHO), 15 million babies were born prematurely in 2010. Indonesia has the fifth-high...
INTRODUCTION: Preterm birth is a leading cause of neonatal mortality and morbidity globally. According to the World Health Organization (WHO), 15 million babies were born prematurely in 2010. Indonesia has the fifth-highest number of preterm births in the world, with 675,700 occurring every year. Early screening for preterm birth is crucial, but many health centers in low-resource settings lack the equipment required to do so. This study aims to develop a scoring system that can predict preterm birth based on socio-demographics, nutrition, lifestyle, previous pregnancy history, and maternal condition. The goal is to create a simple, fast, and inexpensive method that can be easily accessed for early screening in low-resource settings. METHODS: This case-control study was conducted between June 2021 and June 2022 at Cipto Mangunkusumo General Hospital, Jakarta. Subjects were categorized into preterm and control groups. Clinical data were obtained through history taking and medical records and analyzed using IBM SPSS 23. Significant variables in bivariate analysis underwent multivariable analysis through logistic regression. The receiver operating characteristics (ROC) indicate how accurately the risk-scoring system performs. The validity of the scoring formula was analyzed using the Hosmer-Lemeshow test. The performance of the score was assessed using the area under the curve parameter. RESULTS: Multivariate analysis showed that socioeconomic level, antenatal visits, history of preterm, hypertension, and weight gain during pregnancy were independent predictors of preterm birth, with an area under the curve of 0.844 (95% CI 0.802-0.885) and p < 0.001, indicating a good predictive ability. Hosmer-Lemeshow test showed a well-fitted model (p = 0.26). Based on the scoring system in this study, the cut-off ≥ 4 had a sensitivity and specificity of 81.3% and 82.2%, respectively, in predicting preterm birth. CONCLUSION: Socioeconomic level, history of preterm delivery, antenatal visits, weight gain during pregnancy, and history of hypertension were independent predictors associated with preterm birth.
When it could have been prevented: A maternal death from postpartum hemorrhage due to genital tract lesions complicated by urinary fistula in an Ebola treatment unit in DR Congo.
Imani-Musimwa P, Grant E, Mukadi-Bamuleka D … +13 more , Tsongo-Kibendelwa Z, Fraterne-Muhayangabo R, Mbala-Kingebeni P, Kitenge-Omasumbu R, Barhwamire-Kabesha T, Nyakio-Ngeleza O, Sihali-Kyolov J, Feza-Malira M, Manwa-Budwaga B, Alumeti-Munyali D, Bitwe-Mihanda R, Sengey-Mushengezi-Amani D, Ververs M
BMC Pregnancy Childbirth · 2026 Jun · PMID 42332598 · Full text
BACKGROUND: Ebola Virus Disease (EVD) increases the risk for complications to a healthy pregnancy and delivery, notably post-partum hemorrhage. Additionally, successful management of post-partum hemorrhage and resource-i...
BACKGROUND: Ebola Virus Disease (EVD) increases the risk for complications to a healthy pregnancy and delivery, notably post-partum hemorrhage. Additionally, successful management of post-partum hemorrhage and resource-intensive clinical interventions are difficult in the low-resourced setting of an Ebola Treatment Unit (ETU). CASE PRESENTATION: This report describes the clinical course of a pregnant adolescent, gravida 2 para 1, with a history of delivery by cesarean section only 12 months before her second pregnancy. She was vaccinated with rVSV-ZEBOV following the death of a family member with confirmed EVD. She was admitted to the ETU 8 days after her vaccination, where a diagnosis of EVD in pregnancy was made, and her RT-PCR results on the blood sample showed a high viral load. At admission, she was 32 weeks pregnant. She was treated with mAb114, a neutralizing monoclonal antibody. In the first two days of her treatment, viral loads were measured, and they progressively declined after the third day of treatment. On day 3 of admission, following the failure of tocolysis, she delivered a preterm live infant. Her delivery was complicated by post-partum hemorrhage, two lateral cervical and vaginal mucosa lesions, with leakage of urine through the vagina, suggesting a genito-urinary fistula due to the extension of these lesions. A manual uterine exploration was required to remove placental debris with the administration of uterotonic drugs. Methylene blue instillation confirmed the vesicovaginal fistula. Due to a lack of obstetrical equipment in the ETU, the full extent of the cervical lesions could not be assessed nor repaired. Despite our resuscitation measures and mechanical cervical compression, she died 14 h after delivery of hemorrhagic shock complicated by coagulopathy with severe acute respiratory distress in the setting of acute EVD infection despite decreasing viral load. CONCLUSION: In cases of Ebola in pregnancy, not all maternal deaths due to post-partum hemorrhage are necessarily due to EVD and, therefore, could be averted with resources to provide specialized obstetric and post-partum care.
Investigating the effect of familiarization with wound care after cesarean section through multimedia in reducing wound complications.
Yadavi S, Sharifi F, Gholipour Morad Dashtaki D … +2 more , Moezzi M, Shabanian S
BMC Pregnancy Childbirth · 2026 Jun · PMID 42332596 · Full text
BACKGROUND: Wound infection and dehiscence are common complications following childbirth. This study aimed to investigate the effect of multimedia-based education on cesarean section wound care in reducing postoperative...
BACKGROUND: Wound infection and dehiscence are common complications following childbirth. This study aimed to investigate the effect of multimedia-based education on cesarean section wound care in reducing postoperative wound complications among women undergoing cesarean delivery. METHODS: A semi-experimental clinical trial was conducted on 360 post-cesarean women divided into three groups: Group A1 received face-to-face training with educational content, Group A2 received only educational content, and a control group received routine care. Data were collected using a two-part questionnaire assessing demographic characteristics and awareness across knowledge, attitude, and performance domains. A wound complication checklist was completed one week after discharge. Data analysis was performed using SPSS software. FINDINGS: Pre-intervention knowledge scores did not differ significantly among groups. Post-intervention, the control group scored lower than both A1 and A2 groups (P < 0.001). One week after discharge, wound site pain was significantly higher in the control group compared to A1 and A2 (P < 0.05). Clinically, wound site infection occurred in 35% of the control group, compared to 23% in A1 and 25% in A2; however, these differences were not statistically significant. No significant difference in satisfaction was observed between the experimental groups (P > 0.05), and participants in both A1 and A2 reported high satisfaction with the educational content. CONCLUSION: Multimedia-based education on cesarean wound care effectively improves knowledge and reduces postoperative pain, supporting its use as a complementary intervention to standard care. Both face-to-face and content-only educational strategies were well-received by participants. TRIAL REGISTRATION: Study was registered with the Iranian Trial Center (IRCT Number: 20160709028844N4) in date of 12.24.2024.
The effect of motivational interviewing on self-efficacy in managing health and quality of life in pregnant women with gestational diabetes mellitus: a randomized controlled trial.
Fındık FY, Akbas M
BMC Pregnancy Childbirth · 2026 Jun · PMID 42332592 · Full text
BACKGROUND: Gestational diabetes mellitus is a multidimensional health problem that may negatively affect lifestyle behaviors and quality of life during pregnancy. Effective management of gestational diabetes mellitus re...
BACKGROUND: Gestational diabetes mellitus is a multidimensional health problem that may negatively affect lifestyle behaviors and quality of life during pregnancy. Effective management of gestational diabetes mellitus requires self-efficacy in areas such as glycemic monitoring, healthy nutrition, physical activity, and weight control. Motivational interviewing is a patient-centered counseling approach that may support behavior change and health management. This study aimed to determine the effect of motivational interviewing on self-efficacy for health practices and quality of life in pregnant women diagnosed with gestational diabetes mellitus. METHODS: The study was conducted as a randomized controlled experimental trial. The study data were collected between June 1, 2024, and June 30, 2025, at two hospitals providing services in a city center in southern Türkiye. Participants were randomized into the intervention (n = 30) and control (n = 30) groups. While the pregnant women in the intervention group received four sessions of motivational interviewing, the control group received routine care. A Personal Information Form, the Self-Rated Abilities for Health Practices Scale, and the Short Form-36 Health Survey were used for data collection. To evaluate the effect of motivational interviewing, the changes in the groups over time were compared. The statistical significance level was accepted as p < 0.05. RESULTS: Before the intervention, no significant difference was found between the groups in terms of descriptive characteristics or the mean scores of the Self-Rated Abilities for Health Practices Scale and the Short Form-36 Health Survey (p > 0.05). Following motivational interviewing, the intervention group demonstrated significantly higher total Self-Rated Abilities for Health Practices Scale scores than the control group at post-test (92.30 ± 5.33 vs. 72.46 ± 17.95, p < 0.001) and follow-up (93.13 ± 6.21 vs. 71.06 ± 17.21, p < 0.001). The intervention group also had significantly higher scores in the physical functioning (60.16 ± 9.51 vs. 45.33 ± 15.47), vitality (60.50 ± 8.23 vs. 46.33 ± 15.13), mental health (70.53 ± 7.08 vs. 60.66 ± 10.40), social functioning (68.33 ± 15.99 vs. 56.48 ± 19.67), and general health perception (64.66 ± 7.87 vs. 47.32 ± 11.65) domains of the Short Form-36 Health Survey at post-test, with the differences between groups reaching statistical significance (p < 0.05). CONCLUSION: This study demonstrates that motivational interviewing is effective in increasing self-efficacy and quality of life in pregnant women diagnosed with gestational diabetes mellitus. Integrating motivational interviewing into care processes is recommended as an effective approach that can contribute to supporting self-efficacy and quality of life in these pregnant women. TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov (ID: NCT06243939). First Submitted Date: 15.11.2023.
Isolation, prevalence, and antimicrobial resistance profiles of Ureaplasma spp. and Mycoplasma hominis in cervical secretions from pregnant and postpartum women in Hangzhou, China.
Ye J, Xuan X, Xu K … +1 more , Ye M
BMC Pregnancy Childbirth · 2026 Jun · PMID 42332573 · Full text
OBJECTIVE: To evaluate the prevalence and antimicrobial resistance profiles of Ureaplasma spp. and Mycoplasma hominis in cervical secretions samples from pregnant and postpartum women in Hangzhou, China. METHODS: We perf...
OBJECTIVE: To evaluate the prevalence and antimicrobial resistance profiles of Ureaplasma spp. and Mycoplasma hominis in cervical secretions samples from pregnant and postpartum women in Hangzhou, China. METHODS: We performed a retrospective analysis of Ureaplasma spp. and Mycoplasma hominis culture positive rates and antimicrobial susceptibility patterns using 1,177 cervical secretion specimens, including 616 from pregnant women, 150 from postpartum women, and 411 from asymptomatic non-pregnant women attending routine gynecological check-ups. All secretion specimens were collected at Zhejiang Provincial People's Hospital clinical microbiology laboratory between January 2017 and July 2023. RESULTS: Among 1,177 participants, the overall genital mycoplasma (Ureaplasma spp. and Mycoplasma hominis) colonization rate was 51.60% (607/1,177), with significantly higher prevalence in pregnant women (57.10%, 352/616) compared to other groups. The highest colonization rate occurred in pregnant adolescents < 20 years (66.70%, 4/6). Ureaplasma spp. was the predominant detected species (51.50%, 317/616 in pregnant women), while M. hominis colonization was rare (≤ 0.80% overall). Co-colonization (Ureaplasma spp. + M. hominis) was detected in 4.90% (30/616) of pregnant women. The highest in vitro resistance rates among all genital mycoplasma-positive isolates (Ureaplasma spp. and Mycoplasma hominis) were observed for gatifloxacin (80.26%, 122/152), ciprofloxacin (69.17%, 184/266), and roxithromycin (37.70%, 92/244). CONCLUSION: Ureaplasma spp. was the predominant genital mycoplasma colonizing pregnant and postpartum women in Hangzhou, with the highest rate observed among those under 20 years of age. There was high in vitro resistance to commonly used antibiotics such as ciprofloxacin and roxithromycin among the isolates. These findings provide local epidemiologic and antimicrobial susceptibility data for pregnant and postpartum women and highlight the need for further multi-center studies to confirm regional resistance patterns and clarify their clinical implications, including when genital mycoplasma colonization may warrant intervention.
Norepinephrine versus colloid for preventing spinal anesthesia-induced hypotension and its impact on intracranial pressure in preeclamptic parturients: a randomized double-blind controlled trial.
Chen W, Du C, Wang Y … +5 more , Yao W, Wang R, Wang B, Zhu F, Chen Y
BMC Pregnancy Childbirth · 2026 Jun · PMID 42324510 · Full text
OBJECTIVE: This study aims to evaluate the effects of two strategies for preventing hypotension after spinal anesthesia (prophylactic fluid loading and norepinephrine infusion) on intracranial pressure (ICP) in preeclamp...
OBJECTIVE: This study aims to evaluate the effects of two strategies for preventing hypotension after spinal anesthesia (prophylactic fluid loading and norepinephrine infusion) on intracranial pressure (ICP) in preeclamptic women by measuring the optic nerve sheath diameter (ONSD) using ultrasound. METHODS: In this prospective, randomized, controlled trial, 60 healthy parturients and 60 preeclamptic parturients undergoing cesarean delivery under spinal anesthesia were enrolled. Normal parturients were randomly assigned to the infusion group (NA group, n = 30) and NE (norepinephrine) group (NB group, n = 30), while preeclamptic parturients were randomly assigned to the infusion group (PA group, n = 30) and NE group (PB group, n = 30). The primary outcome was bilateral ONSD values at baseline, pretreatment, 5 min after spinal anesthesia (Post-SA), and 5 min after fetal delivery (Post-birth). The secondary outcomes included maternal general characteristics, renal function indices, postoperative headache, fetal umbilical cord arterial blood gas indices, and Apgar scores. RESULTS: Pretreatment ONSD was significantly higher than baseline in both infusion groups, and baseline ONSD was higher in preeclamptic versus normal parturients (all P < 0.01). Among preeclamptic parturients, pretreatment ONSD was higher in the PA group than in the PB group (P < 0.01), with a similar difference (PA > PB) confirmed in normal parturients (P < 0.01). In addition, compared to the PA group, the PB group showed no significant differences in systolic blood pressure (SBP), diastolic blood pressure (DBP), or mean arterial pressure (MAP) at any time point in preeclamptic parturients (P > 0.05). Conversely, in normal parturients, post-birth SBP, DBP, and MAP were significantly higher in the NB than in the NA group (P < 0.01). Baseline hemodynamic values were higher in preeclamptic versus normal parturients (P < 0.01), and post-birth values decreased significantly from baseline in the PA and PB groups (P < 0.001). No significant intergroup differences were observed in maternal heart rate (HR), renal function indices, umbilical artery blood gas indices, Apgar scores, or the incidence of postpartum headache (all P > 0.05). CONCLUSION: For preeclamptic parturients, the risks induced by ICP increase should be noted. Compared to colloids, prophylactic infusion of NE was more effective and safer and did not increase ICP. TRIAL REGISTRATION: This randomized controlled trial was registered on Chinese Clinical Trial Registry (ChiCTR2400092317; http://www.chictr.org.cn/) with the Clinical Trial Registry ({1}).
Association of diagnostic oral glucose tolerance test values with neonatal hypoglycemia in diet-controlled gestational diabetes mellitus: a retrospective cohort study.
Zhang G, Qiu Y, Su J … +7 more , Du J, Li S, Fan Y, Sun W, Wang D, Li L, Shi H
BMC Pregnancy Childbirth · 2026 Jun · PMID 42324462 · Full text
BACKGROUND: Whether diagnostic oral glucose tolerance test (OGTT) values are associated with neonatal hypoglycemia (NH) in women with diet-controlled gestational diabetes mellitus (GDM) remains uncertain. We aimed to eva...
BACKGROUND: Whether diagnostic oral glucose tolerance test (OGTT) values are associated with neonatal hypoglycemia (NH) in women with diet-controlled gestational diabetes mellitus (GDM) remains uncertain. We aimed to evaluate the associations of diagnostic OGTT values with neonatal glycemic outcomes and to identify other determinants of NH in this population. METHODS: In this retrospective cohort study, 2,051 singleton pregnancies with diet-controlled GDM were included from a maternal and child health center in Liaocheng, China, between January 2019 and August 2023. Diagnostic fasting blood glucose (FBG), 1-hour post-glucose (1hPG), and 2-hour post-glucose (2hPG) values from the 75-g OGTT were analyzed. Restricted cubic spline (RCS)-based linear and logistic regression models were used to assess possible non-linear associations with neonatal 1-h postnatal blood glucose and NH after adjustments. RESULTS: NH occurred in 12.0% of neonates (247/2,051). After multivariable adjustment, neither standard regression nor RCS analyses showed significant overall or non-linear associations between diagnostic OGTT values and NH or neonatal 1-h postnatal blood glucose (all P > 0.05). Gestational age at delivery was independently protective, with each additional week associated with a lower risk of NH (aOR = 0.62, 95% CI 0.48-0.80). Cesarean delivery was associated with higher odds of NH than vaginal delivery (aOR = 2.24, 95% CI 1.62-3.10). CONCLUSIONS: In diet-controlled GDM pregnancies, diagnostic OGTT values were not independently associated with NH or neonatal 1-h postnatal blood glucose. These findings suggest that subsequent clinical management and obstetric factors, particularly gestational age at delivery and delivery mode, may be more important than the diagnostic OGTT value itself for neonatal glycemic outcomes.
Development of antenatal risk prediction model for preeclampsia with severe features in Lagos, Nigeria (PreSev study): protocol of a prospective cohort study.
Babasola O, Kehinde O, Ayokunle O … +6 more , Fatimah AJ, Muisi A, Oluwole O, Gbolahan A, Temitope O, Olalekan U
BMC Pregnancy Childbirth · 2026 Jun · PMID 42323576 · Full text
BACKGROUND: Preeclampsia with severe features is a major contributor to maternal and perinatal morbidity and mortality, particularly in low- and middle-income countries (LMICs). Despite improvements in obstetric care, ea...
BACKGROUND: Preeclampsia with severe features is a major contributor to maternal and perinatal morbidity and mortality, particularly in low- and middle-income countries (LMICs). Despite improvements in obstetric care, early identification of women at highest risk remains limited, and existing prediction tools lack contextual specificity for African populations. OBJECTIVE: This study describes the protocol for the PreSev Study, which aims to develop and validate a machine-learning risk prediction model for preeclampsia with severe features among pregnant women in Lagos, Nigeria. METHODS: This multicentre prospective cohort study will recruit at-risk pregnant women aged ≥ 18 years between 14 and 24 weeks' gestation from four major hospitals in Lagos State between September 2025 and December 2026. A total of 938 women will be enrolled for model development (training set n = 750) and independent validation (n = 486). Data on epidemiologic and clinical predictors of preeclampsia will be collected using REDCap. Five machine-learning models, random forest, extreme gradient boosting (XGBoost), multilayer perceptron (MLP), LightGBM, and glmnet, will be trained using 10-fold cross-validation and hyperparameter optimisation. Model performance will be assessed using area under the curve (AUC), calibration, decision curves, and clinical performance metrics. SHAP values will be used to evaluate feature importance. The best-performing model will be converted into an accessible online risk-prediction tool. CONCLUSION: The PreSev Study will generate a context-specific, clinically applicable machine-learning model to support early risk stratification for preeclampsia with severe features, with potential to enhance maternal outcomes in Nigeria and similar low-resource settings.
Persistence of antenatal anti-D immunoglobulin G at delivery in twin versus singleton pregnancies: a retrospective cohort study.
Ünlü C, Aksoy H
BMC Pregnancy Childbirth · 2026 Jun · PMID 42323563 · Full text
BACKGROUND: Anti-D immunoglobulin administered in the early third trimester to Rhesus D negative women with Rhesus D incompatibility is widely assumed to provide protection against silent fetomaternal haemorrhage until d...
BACKGROUND: Anti-D immunoglobulin administered in the early third trimester to Rhesus D negative women with Rhesus D incompatibility is widely assumed to provide protection against silent fetomaternal haemorrhage until delivery. However, previous studies in singleton pregnancies demonstrated that passively acquired anti-D is frequently no longer detectable by the time of delivery. The aim of this study was to assess whether the proportion of women with detectable passively administered anti-D antibodies in maternal serum at delivery differs between twin and singleton pregnancies. MATERIALS AND METHODS: In this retrospective cohort study, twin and singleton pregnancies with Rhesus incompatibility that delivered at Kayseri City Hospital, Obstetrics and Gynecology Clinic between January 2020 and July 2025, in women who had not previously undergone alloimmunization and received anti-D immunoglobulin prophylaxis at 28 weeks of gestation, were compared in terms of antibody persistence determined by the indirect Coombs test of maternal serum at delivery. RESULTS: The indirect Coombs test performed at delivery was found to be negative in 50 (70.4%) of 71 twin pregnancies and in 100 (56.5%) of 177 singleton pregnancies. This difference was found to be statistically significant. CONCLUSIONS: Twin gestations showed a lower frequency of detectable passive anti-D at delivery compared with singletons. This represents a pharmacokinetic/surrogate laboratory finding and should not be interpreted as evidence of reduced clinical effectiveness of prophylaxis. Prospective studies with serial measurements and clinical outcomes are warranted.
Perceived partner support during pregnancy and its associations with anxiety, antenatal care utilization, and fear of childbirth: a cross-sectional mediation analysis.
Özbek H, Dilmen S
BMC Pregnancy Childbirth · 2026 Jun · PMID 42323562 · Full text
BACKGROUND: Perceived partner support during pregnancy influences maternal mental health and antenatal care utilization. However, limited evidence exists regarding how different dimensions of partner support relate to pr...
BACKGROUND: Perceived partner support during pregnancy influences maternal mental health and antenatal care utilization. However, limited evidence exists regarding how different dimensions of partner support relate to pregnancy-related anxiety and fear of childbirth, and the mechanisms underlying these associations. This study examined the associations between perceived partner support, pregnancy-related anxiety, antenatal care utilization, and fear of childbirth, and explored the mediating role of pregnancy-related anxiety. METHODS: A total of 331 pregnant women were included in this cross-sectional study. Data were collected using the Personal Information Form, the Perceived Partner Support Scale, the Pregnancy-Related Anxiety Scale, and the Wijma Delivery Expectancy/Experience Questionnaire. Binary logistic regression analysis was conducted to identify the determinants of regular antenatal care utilization. Hierarchical linear regression analysis was conducted to examine the determinants of pregnancy-related anxiety. After controlling for sociodemographic and relational variables, a mediation analysis was conducted using Hayes' PROCESS macro (Model 4) with 5,000 bootstrap samples. RESULTS: Financial support was a significant negative predictor of pregnancy-related anxiety (B = - 2.19, p < 0.001), while pregnancy-related anxiety was positively associated with fear of childbirth (B = 0.88, p < 0.001). Financial support also had a significant direct effect on fear of childbirth (B = - 1.47, p = 0.002). The mediation analysis showed that pregnancy-related anxiety partially mediated the relationship between financial support and fear of childbirth (indirect effect = - 1.93, 95%CI [- 2.73, - 1.27]). Additionally, the logistic regression analysis indicated that financial support significantly increased the likelihood of regular antenatal care utilization (OR = 1.66, p = 0.024), while higher pregnancy-related anxiety was associated with a decreased likelihood of regular antenatal care utilization (OR = 0.91, p = 0.014). All models were statistically significant (p < 0.001). CONCLUSION: Partner support during pregnancy plays a multifaceted role in maternal psychological well-being and health-related behaviors. Partners' financial support emerged as a key protective factor associated with lower pregnancy-related anxiety, reduced fear of childbirth, and greater utilization of antenatal care. Pregnancy-related anxiety serves as an important mediating mechanism. These findings underscore the importance of family-centered antenatal care approaches that actively involve partners and address both psychosocial and structural support needs.
Management of threatened preterm labor based on cervical length: a randomized controlled trial.
Chaiyakarn S, Warintaksa P, Nuntnarumit P … +2 more , Swatesutipun B, Chaemsaithong P
BMC Pregnancy Childbirth · 2026 Jun · PMID 42323545 · Full text
BACKGROUND: A substantial proportion of women with threatened preterm labor do not deliver imminently, frequently receiving unnecessary tocolytic agents and antenatal corticosteroids. The objective of this study is to ev...
BACKGROUND: A substantial proportion of women with threatened preterm labor do not deliver imminently, frequently receiving unnecessary tocolytic agents and antenatal corticosteroids. The objective of this study is to evaluate whether the use of cervical length measurement in managing threatened preterm labor can reduce inappropriate treatment. METHODS: A randomized controlled trial was conducted involving patients presenting with threatened preterm labor between 24 and 33 weeks of gestation. Patients exhibiting a transvaginal cervical length between 15 and 30 mm were randomized into two groups: (1) the expectant group; and (2) the treatment group. The expectant group received no treatment, while the treatment group received standard corticosteroids and tocolytic agents. The measurements of cervical length in the expectant management group were performed every 2 h if there were regular uterine contractions with intervals of less than 10 min or every 4 h if the contractions occurred at intervals > 10 min or were irregular until there was no uterine contraction. Corticosteroids and tocolytics were administered only if cervical shortening > 20% from the baseline value or cervical length measured below 15 mm. The primary outcome was inappropriate treatment, defined as undelivered for more than a week after a complete course of corticosteroid treatment or spontaneous preterm delivery within 7 days of recruitment without corticosteroid administration. RESULTS: One hundred fifteen patients were identified, and 65 cases were excluded. Among the 50 recruited cases, 26 were randomized to the expectant group and 24 to the treatment group. Expectant management leads to a significant 92% reduction in inappropriate treatment [7.7% vs. 98.5%; RR 0.08; 95% CI: 0.02-0.31]. There were significantly lower rates of maternal tachycardia, hypotension, and hypokalemia, as well as a shorter median maternal stay (p < 0.05 for all) in the expectant group. CONCLUSION: Patients with threatened preterm labor whose cervical length is within 15-30 mm without additional cervical shortening can be safely managed expectantly. This approach reduces maternal side effects and shortens maternal hospital stays. TRIAL REGISTRATION: This study was retrospectively registered at the Thai Clinical Trials Registry (Registration Number: TCTR20250218004) on February 18, 2025 (Date of registration) was conducted and reported in accordance with the Consolidated Standards of Reporting Trials (CONSORT) 2010 Statement.
Evaluation of an e-health integrated intervention for pregnant women with co-occurring mental health and substance use symptoms: an exploratory randomized clinical trial.
Carmona Camacho R, López Carpintero N, Barrigón ML … +13 more , Albarracín García L, Barahona I, Baca-García E, Ruiz Nogales C, Menéndez I, Sánchez Alonso M, Vidal Mariño C, Rodríguez Blanco L, Campos Soler SM, Díaz Rosell M, Le Cook B, Alegría M, Caro Cañizares I
BMC Pregnancy Childbirth · 2026 Jun · PMID 42321702 · Full text
BACKGROUND: The co-occurrence of substance use and mental health problems in pregnant women implies higher maternal-foetal morbidity, and treatments often do not meet care needs. This study aims to generate preliminary e...
BACKGROUND: The co-occurrence of substance use and mental health problems in pregnant women implies higher maternal-foetal morbidity, and treatments often do not meet care needs. This study aims to generate preliminary evidence and hypothesis by exploring the potential effect of an integrated intervention based on third-generation therapies by comparing a telephone intervention with a digital intervention and treatment as usual. METHODS: In an exploratory randomised trial, 111 pregnant women (out of 2014 screened) with co-occurring mental health and substance use symptoms were assigned to either telephone-delivered intervention, digitally-delivered intervention, or treatment as usual groups. Interventions, based on third-generation therapy, lasted eight weeks. Outcomes (alcohol, tobacco use, depression, anxiety, and trauma) were measured at baseline and after two, four, eight, and twelve months. RESULTS: The telephone intervention group performed significantly better with regard to alcohol, depression, and trauma symptoms after two and four months compared to the digital intervention and treatment as usual groups. The digital intervention group showed limited benefit and higher attrition. All groups had returned to baseline by the 12 month point. CONCLUSIONS: Standardised clinical interventions delivered by telephone can improve the treatment outcomes of pregnant women with co-occurring mental health and substance use problems. New approaches are needed to effectively implement these interventions via digital support. TRIAL REGISTRATION: ClinicalTrials.gov ID NCT06965270 (retrospectively registered in May 11, 2025).
Benefits of doula care for labor duration and maternal health during vaginal delivery.
Lin Y, Lu L, Hu S … +5 more , Hu L, Pan Y, Wang J, Tan C, Weng T
BMC Pregnancy Childbirth · 2026 Jun · PMID 42321683 · Full text
BACKGROUND: Doulas are trained professionals that provide comprehensive emotional, physical, and informational support to women during the perinatal period. The aim of this study was to evaluate the utility and benefits...
BACKGROUND: Doulas are trained professionals that provide comprehensive emotional, physical, and informational support to women during the perinatal period. The aim of this study was to evaluate the utility and benefits of doula care on the labor duration and maternal health during vaginal delivery. METHODS: This retrospective cohort study involved 2095 women with vaginal deliveries. In the control group, women received essential perinatal and intrapartum cares. In the doula group, the women received additional doula cares during labor, including music, labor ball, birth dance, positioning cushion, massage and breathing exercises. The primary outcomes of interest were labor duration and perineal status. Secondary outcome measures included delivery mode, the occurrence of prenatal fever, the characteristic of amniotic fluid and the amount of postpartum bleeding within 24 h. RESULTS: Compared to the control group, women who received doula cares experienced significantly shorter labor durations across all stages (first-stage, second-stage, and total) (all p < 0.001). Additionally, the doula group had a lower incidence of episiotomy and second-degree lacerations (21.98% vs. 33.69%, p < 0.001; 7.42% vs. 8.98%, p = 0.002). Furthermore, forceps delivery was more prevalent in the control group (10%) than in the doula group (7%) (p = 0.033), while postpartum bleeding was significantly reduced in the doula care group compared to the control group (227.38 ± 3.21 vs. 247.15 ± 3.69, p < 0.001). However, there were no significant differences in the characteristics of amniotic fluid or the occurrence of prenatal fever between the two groups. CONCLUSION: Doula care during vaginal delivery could shorten labor durations, reduce the need for episiotomy and the incidence of severe perineal lacerations, and decrease the incidence of forceps delivery and postpartum bleeding. These findings supported the promotion of doula care to enhance natural deliveries and ensure maternal and child safety.
Progesterone-induced endometrial thickness changes do not affect singleton neonatal outcomes in frozen embryo transfer: a retrospective analysis of 6,331 newborns.
Ye J, Zhang J, Du T … +6 more , Yu S, Zhu Y, Gao H, Liu Y, Chen Q, Kuang Y
BMC Pregnancy Childbirth · 2026 Jun · PMID 42321682 · Full text
BACKGROUND: To evaluate whether progesterone-induced changes in endometrial thickness (EMT) affect singleton infant outcomes during frozen-thawed embryo transfer (FET) cycles. METHODS: This retrospective study analyzed 6...
BACKGROUND: To evaluate whether progesterone-induced changes in endometrial thickness (EMT) affect singleton infant outcomes during frozen-thawed embryo transfer (FET) cycles. METHODS: This retrospective study analyzed 6,331 singleton live births following frozen-thawed Day 3 embryo transfers. EMT was measured via transvaginal ultrasound one day before progesterone initiation and on the day of FET. Participants were grouped by EMT change: increase, decrease, or stable. Primary outcomes included mean birthweight, low birthweight (LBW), and small-for-gestational-age (SGA) status. Associations between EMT changes and neonatal outcomes were evaluated using multivariable linear and logistic regression. RESULTS: No significant differences in mean birthweight were observed among the three groups (3,355.30 ± 502.69 g vs. 3,351.30 ± 474.79 g vs. 3,344.26 ± 514.54 g; p = 0.753). Compared with the EMT stable group, the EMT decreased group showed no significant increase in LBW (1.1%; aOR 1.645, 95% CI 0.818-3.307) or SGA (2.7%; aOR 1.141, 95% CI 0.783-1.662). Similarly, the EMT increased group showed no significant association with LBW (aOR 1.310, 95% CI 0.723-2.375) or SGA (aOR 0.912, 95% CI 0.660-1.261). Multiple linear regression confirmed that gestational age and infant gender significantly influenced birthweight, while EMT change did not. CONCLUSIONS: EMT may increase, decrease, or remain stable after progesterone administration in FET cycles. However, these changes do not demonstrate an independent association with adverse perinatal outcomes in term singleton infants.
Mothers' experiences during prenatal and childbirth journey in Bali: a qualitative study.
Kurniasari NMD, Tanaka K, Widyanthini DN … +5 more , Suariyani NLP, Listyowati R, Urayama A, Wirawan IMA, Yoshimura K
BMC Pregnancy Childbirth · 2026 Jun · PMID 42321681 · Full text
BACKGROUND: Indonesia has made substantial progress in reducing maternal mortality, with the Maternal Mortality Ratio (MMR) declining from 446 per 100,000 live births in 1990 to 305 per 100,000 live births in 2015 [1]. N...
BACKGROUND: Indonesia has made substantial progress in reducing maternal mortality, with the Maternal Mortality Ratio (MMR) declining from 446 per 100,000 live births in 1990 to 305 per 100,000 live births in 2015 [1]. Nevertheless, further improvements in the quality of maternal healthcare are needed. This study sought to investigate the experiences of Balinese mothers and their perceptions regarding care during pregnancy and childbirth. METHODS: We used a qualitative descriptive study design with in-depth semi-structured interviews to explore experiences of Balinese mothers and their perceptions of the perinatal care they received during pregnancy and childbirth. Nineteen Balinese women who had given birth in Bali were recruited for the study. Data were collected from August 2017 to January 2018 in Badung Regency, Gianyar Regency, Karangasem Regency and Denpasar City in Bali Province and were analysed using the qualitative content analysis method. RESULTS: The analysis revealed one core category, "Mothers' preferences and aspirations for childbirth," and four major categories that characterize Balinese mothers' experiences. The core category highlighted the importance of acknowledging women's wishes in shaping positive birth experiences; mothers felt supported and confident when respected. The four major categories were: desire for a convenient and comfortable birth environment, support from community midwives, dissatisfaction with hospital care, and the stages leading to childbirth. Balinese women typically choose hospitals for delivery due to the availability of superior facilities, yet they frequently reported dissatisfaction with the attitudes and communication of health professionals. Furthermore, a significant lack of maternal knowledge and empowerment was observed, with many women tending to passively accept medical recommendations. CONCLUSIONS: Although mothers preferred hospitals for safety, many reported dissatisfaction with poor communication and negative attitudes from health professionals. Strengthening respectful communication, supporting shared decision-making, and expanding midwife-led, culturally sensitive care may enhance maternal satisfaction and birth experiences.
Exploring community kangaroo mother care practices among NICU graduates: a prospective cohort study in South India.
Jeganathan S, Schwinger C, Strand TA … +2 more , Veerasamy R, Kvestad I
BMC Pregnancy Childbirth · 2026 Jun · PMID 42321677 · Full text
AIM: To describe Kangaroo Mother Care (KMC) practice in the community (cKMC) two months after discharge from the Neonatal Intensive Care Unit (NICU). in South Indian mother-LBW infants. METHOD: A prospective study enroll...
AIM: To describe Kangaroo Mother Care (KMC) practice in the community (cKMC) two months after discharge from the Neonatal Intensive Care Unit (NICU). in South Indian mother-LBW infants. METHOD: A prospective study enrolling 420 dyads at discharge from the NICU with follow-up on cKMC practice two months after discharge. Factors associated with cKMC were explored using logistic regression. RESULT: Among the 420 enrolled, 2 (0.5%) infants died, and 12 (2.9%) were lost to follow-up. Of the remaining families, 25% (101) never practiced cKMC, effective practice was done by 19% (77). Infant birth weight ≥ 1.5 kg (OR: 3.1, 95% CI 1.8, 5.3) was associated with higher odds of practicing cKMC, while being born at term (OR: 0.5, 95% CI 0.3, 0.8) and mothers' weight > 45 kg (OR: 0.3, 95% CI 0.1-0.7) was associated with lower odds of practicing cKMC. Continued KMC practice 48 h before discharge was associated with higher odds (OR: 3.4, 95% CI 1.8-6.2), while absence of father's support was associated with lower odds (OR: 0.6, 95% CI 0.3, 1.0) of effective cKMC. CONCLUSION: The continuum of cKMC after discharge from the NICU was inadequate. Factors associated with cKMC practice should be considered when planning interventions to improve cKMC practices.
Women's perceptions of midwifery continuity of care provided by bachelor of midwifery students from a public university in Northern Uganda: a descriptive qualitative study.
Apili F, Isoke R, Mann J … +6 more , Matte RF, Abeja CJ, Auma AG, Atuhairwe I, Agaba B, Ukoha WC
BMC Pregnancy Childbirth · 2026 Jun · PMID 42321671 · Full text
BACKGROUND: Domiciliary care is a midwifery continuity of care given to a mother by midwives in the hospital, clinic, or home during pregnancy, labor, and puerperium. While evidence exists on the benefits of continuity o...
BACKGROUND: Domiciliary care is a midwifery continuity of care given to a mother by midwives in the hospital, clinic, or home during pregnancy, labor, and puerperium. While evidence exists on the benefits of continuity of midwifery care models to women and neonates, little is known about the perceptions of women who received domiciliary midwifery from midwifery students in Uganda. AIM: This study explores women's perceptions of midwifery continuity of care provided by Bachelor of Midwifery students. METHODS: An exploratory, descriptive qualitative study was conducted in Lira city, Uganda, from April to August 2024. Individual in-depth interviews were conducted using semi-structured interviews among eighteen purposively selected postnatal women who received domiciliary care from Bachelor of Midwifery students. Data was transcribed verbatim and analysed using the thematic technique and NVivo version 20. FINDINGS: The analysed data revealed that women appreciated the continuity of care received. Thematic analysis identified four themes: experience of care, empowerment through knowledge and skills, access to the health care system, and innovation approach to care, as well as 12 sub-themes from the study. CONCLUSION: The study's findings show that women had positive experiences with the rendered care as it provided an opportunity for continuity of information and care. They felt empowered with knowledge, skills and information that they had not received in their previous deliveries and wished for the continuation of this care. There is also a need for stakeholder involvement and support to ensure continuation, maximize the impact of the care, and ensure the sustainability of the program.
Comparison of obstetric, maternal, and neonatal outcomes between preterm prelabor rupture of membranes at 34 + 0-36 + 6 weeks and term prelabor rupture of membranes at ≥ 37 weeks.
Ay O, Bahçeci P, Taşkıran D … +1 more , Gezginç K
BMC Pregnancy Childbirth · 2026 Jun · PMID 42321655 · Full text
BACKGROUND: To compare preterm prelabor rupture of membranes (PPROM) at 34 + 0-36 + 6 weeks with term prelabor rupture of membranes at ≥ 37 weeks in terms of obstetric outcomes, maternal morbidity, and short-term neonata...
BACKGROUND: To compare preterm prelabor rupture of membranes (PPROM) at 34 + 0-36 + 6 weeks with term prelabor rupture of membranes at ≥ 37 weeks in terms of obstetric outcomes, maternal morbidity, and short-term neonatal outcomes. METHODS: This retrospective cohort study included 646 singleton pregnancies diagnosed with PROM at 34 + 0 weeks or later in a tertiary care center between January 1, 2018 and July 30, 2025. Cases were grouped as PPROM at 34 + 0-36 + 6 weeks (n = 334) and term PROM at ≥ 37 weeks (n = 312). Maternal, obstetric, and neonatal outcomes were compared. Logistic regression was used to identify factors associated with NICU admission and the respiratory neonatal morbidity composite. RESULTS: Compared with term PROM, the 34 + 0-36 + 6 weeks PPROM group had longer antibiotic use, higher rates of tocolysis and antenatal corticosteroid administration and longer latency. Infectious maternal morbidity did not differ significantly between groups. However, PPROM at 34 + 0-36 + 6 weeks was associated with lower birth weight, a higher rate of NICU admission (25.7% vs. 6.7%, p < 0.001), and a higher rate of the respiratory neonatal morbidity composite (14.5% vs. 3.5%, p < 0.001). In multivariable analysis, PPROM at 34 + 0-36 + 6 weeks remained independently associated with NICU admission (aOR 5.05, 95% CI 2.90-8.76) and respiratory neonatal morbidity composite (aOR 5.91, 95% CI 2.82-12.37). CONCLUSIONS: PPROM at 34 + 0-36 + 6 weeks appears to be a distinct clinical entity rather than simply an earlier form of term PROM. Despite similar maternal infectious morbidity, its substantially higher neonatal morbidity burden supports individualized management and consideration of expectant management in carefully selected cases.
Predictors of exclusive breastfeeding cessation among employed mothers in Mogadishu, Somalia: A cross-sectional study.
Mudei NM, Hassan Orey FA, Garba B … +3 more , Mohamed Hussein A, Abdullahi Omar A, Mohamud KH
BMC Pregnancy Childbirth · 2026 Jun · PMID 42321654 · Full text
BACKGROUND: Exclusive breastfeeding (EBF) is critical for infant health and development during the first six months of life. However, employed mothers often face workplace-related challenges that contribute to EBF cessat...
BACKGROUND: Exclusive breastfeeding (EBF) is critical for infant health and development during the first six months of life. However, employed mothers often face workplace-related challenges that contribute to EBF cessation before the recommended six months. Evidence specifically examining predictors of EBF cessation among employed mothers in Somalia remains limited. This study aimed to assess the prevalence and predictors of EBF cessation among employed mothers in Mogadishu, Somalia. METHODS: A quantitative, descriptive cross-sectional study was conducted in Mogadishu, Somalia, from August 20, 2024, to October 20, 2024, among 303 employed mothers with children aged 6-24 months. Participants were selected using stratified random sampling across four occupational categories. Data were collected through face-to-face interviews using a structured questionnaire adapted from World Health Organization infant and young child feeding tools and the Somalia Health and Demographic Survey. Bivariable and multivariable logistic regression analyses were performed, and crude odds ratios (CORs) and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. RESULTS: The prevalence of EBF cessation was 76.2% (231/303; 95% CI: 70.3%-81.2%). Among mothers with available cessation timing data, the largest proportion stopped EBF in the third month (109/229; 47.6%). In multivariable analysis, flexible working time was associated with lower odds of EBF cessation (AOR = 0.47; 95% CI: 0.23-0.96), and family support was strongly protective (AOR = 0.07; 95% CI: 0.03-0.16). Receiving paid maternity leave showed higher odds of EBF cessation but did not reach statistical significance after adjustment (AOR = 2.52; 95% CI: 0.97-6.54). Lactation breaks showed a non-significant protective trend (AOR = 0.53; 95% CI: 0.24-1.19). CONCLUSION: EBF cessation was highly prevalent among employed mothers in Mogadishu. Flexible working time and family support were protective, while paid maternity leave showed a positive but non-significant association with cessation after adjustment, possibly reflecting short leave duration and early return to full-time work. Workplace policies that extend practical maternity protection, improve work flexibility, provide breastfeeding spaces, and strengthen family and employer support are needed.
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