BMC Pregnancy And Childbirth[JOURNAL]
Sun
200 papers
Validation of chichewa version of the city birth trauma scale at postnatal clinics in Lilongwe, Malawi.
Kanjedza HM, Nyirongo D, Chorwe-Sungani G
BMC Pregnancy Childbirth · 2026 Jun · PMID 42321651 · Full text
BACKGROUND: Postpartum Post-Traumatic Stress Disorder (PTSD) is a significant mental health concern for postpartum women. In Malawi, there were no data showing the prevalence of Postpartum Post-Traumatic Stress Disorder...
BACKGROUND: Postpartum Post-Traumatic Stress Disorder (PTSD) is a significant mental health concern for postpartum women. In Malawi, there were no data showing the prevalence of Postpartum Post-Traumatic Stress Disorder and no validated Chichewa tool for assessing Postpartum PTSD. City Birth Trauma Scale (CityBiTS) is a tool that is used to assess Postpartum PTSD. CityBiTS is the best choice because it was developed specifically to measure trauma related to childbirth, tailors to the unique psychological, physical and emotional experiences of postpartum women. The tool also adheres to DSM-5 Criteria and has been validated across cultures which has shown high reliability and credibility to be used in clinical practice and research. The study aimed at assessing the diagnostic accuracy of the Chichewa Version City Birth Trauma Scale at Postnatal clinics in Lilongwe District, Malawi. The study's objectives were; to determine the prevalence of postpartum PTSD and establish the psychometric properties of Chichewa Version of the City Birth Trauma Scale in Malawi. METHODS: It was a cross-sectional study conducted at two hospital facilities and these were Bwaila Hospital and Area 25 Health Centre postnatal clinics in Lilongwe District, Malawi. English City Birth Trauma Scale was translated into Chichewa version and adapted. A total of 384 postnatal mothers were selected by systematic random sampling technique. Data was analysed by SPSS version 23 and Sensitivity Analysis was done to examine the psychometric properties. RESULTS: The prevalence of Postpartum PTSD was 22.6% [95% CI 18.8% - 27.1%] on Structured Clinical Interview for Diagnostic Statistical for Mental Disorders Version 5 and 10.9% [95% CI 7.9% - 14.5% on City Birth Trauma Scale. The following psychometrics were established: Cronbach's alpha 0.780, ROC 0.872, sensitivity 81.6% [95% CI 71.8%-89.1%], specificity 78.9% [95% CI 73.8%-83.4%], Positive Predictive Value 53.0% [95% CI 47%-58.9%], Negative Predictive Value 93.6%, [95% CI 90.4%-95.8%] optimum cut-off score > 23, Youden Index 0.605, Exploratory Factor Analysis for variance 65.6%.Factor 1 which are birth-related symptoms and factor 2 which are general symptoms emerged and all items loaded except items 10 and 17 and Convergent Validity at 0.65. The prevalence rate of Postpartum PTSD and Psychometric properties were consistent with other studies affirming its utility. CONCLUSION: The study determined the information on prevalence of Postpartum PTSD. It further demonstrated that Chichewa Version City Birth Trauma Scale is a reliable, accurate and valid tool for screening Postpartum PTSD with good psychometric properties for clinical practice and research.
Histopathological placental inflammation and umbilical cord blood inflammatory biomarkers in preterm infants: a prospective cohort study.
Šantić K, Bogojević I, Šahinović I … +4 more , Kralik K, Rajc J, Pušeljić S, Kardum D
BMC Pregnancy Childbirth · 2026 Jun · PMID 42316349 · Full text
BACKGROUND: Histopathological placental inflammation provides objective evidence of intrauterine inflammatory exposure in preterm birth, but placental histopathology is not immediately available after delivery. We aimed...
BACKGROUND: Histopathological placental inflammation provides objective evidence of intrauterine inflammatory exposure in preterm birth, but placental histopathology is not immediately available after delivery. We aimed to determine whether placental inflammatory pathology is associated with cord blood and postnatal inflammatory biomarkers in preterm infants. METHODS: In this prospective cohort study, 87 preterm infants with birth weight < 2500 g were enrolled. Cord blood collected at birth was analyzed for procalcitonin (PCT), presepsin (P-SEP), and high-sensitivity C-reactive protein (hs-CRP). Placentas were categorized as no pathological findings, inflammatory placental pathology, or other placental pathology. Exploratory lesion-specific analyses further classified inflammatory lesions as maternal inflammatory response only (MIR-only) or fetal inflammatory response present (FIR-present). Multiple linear regression models with log-transformed outcomes were used to examine associations between inflammatory placental pathology and cord blood PCT and postnatal CRP after adjustment for perinatal covariates. RESULTS: Fifteen infants (17%) had inflammatory placental pathology. Cord blood PCT differed significantly between the primary placental pathology groups and was highest in infants with inflammatory placental pathology (P = 0.001), whereas cord blood P-SEP and hs-CRP did not differ significantly. Postnatal CRP was also higher in infants with inflammatory placental pathology (P = 0.004). In adjusted binary models, inflammatory placental pathology remained associated with higher cord blood PCT (adjusted fold change 2.31, 95% CI 1.50-3.55; P < 0.001) and higher postnatal CRP (adjusted fold change 4.66, 95% CI 2.23-9.76; P < 0.001). Exploratory lesion-specific analyses showed stepwise increases in cord blood PCT and postnatal CRP from no inflammatory lesion to MIR-only and the highest values in FIR-present cases (overall P = 0.003 and P = 0.002, respectively). Culture-confirmed or clinically diagnosed EOS and microbiological positivity were more frequent in infants with inflammatory placental pathology. CONCLUSIONS: Histopathological placental inflammation in preterm infants was associated with higher umbilical cord PCT and higher postnatal CRP. Cord blood PCT showed the most consistent association with inflammatory placental pathology, including in exploratory analyses of fetal inflammatory response lesions. These findings support the potential clinical relevance of clinically available inflammatory biomarkers in relation to placental inflammatory pathology, but larger studies are needed to confirm lesion-specific associations and clarify their clinical utility.
Is there an effect of the start day of luteal phase support on pregnancy outcomes in natural vitrified-warmed blastocyst transfer?
Turgay B, Özmen B, Atabekoğlu CS … +4 more , Şükür YE, Sönmezer M, Berker B, Aytaç R
BMC Pregnancy Childbirth · 2026 Jun · PMID 42316342 · Full text
OBJECTIVE: To evaluate whether the timing of luteal phase support (LPS) initiation affects pregnancy outcomes in natural cycle vitrified-warmed blastocyst transfer (NC-FET) cycles. METHODS: This retrospective cohort stud...
OBJECTIVE: To evaluate whether the timing of luteal phase support (LPS) initiation affects pregnancy outcomes in natural cycle vitrified-warmed blastocyst transfer (NC-FET) cycles. METHODS: This retrospective cohort study included NC-FET cycles performed between January 2022 and December 2024 at a tertiary university fertility center. Only true natural cycles with blastocyst transfer were analyzed. Patients were divided into two groups according to the initiation of LPS: two days before embryo transfer (Group 1) or on the day of embryo transfer (Group 2). All patients received vaginal and subcutaneous progesterone for LPS. Baseline characteristics, embryo features, serum progesterone levels on transfer day, and reproductive outcomes were compared. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were performed to identify factors associated with clinical pregnancy. RESULTS: A total of 246 NC-FET cycles were analyzed (Group 1: n = 172; Group 2: n = 74). Baseline characteristics, embryo quality, and transfer parameters were comparable between groups. Serum progesterone levels on the day of transfer were significantly higher in Group 1 (32.1 ± 13.0 ng/mL) compared with Group 2 (10.3 ± 3.8 ng/mL; p = 0.001). However, total pregnancy rate (66.2% vs. 47.1%, p = 0.006), clinical pregnancy rate (56.8% vs. 40.7%, p = 0.020), and live birth rate (52.7% vs. 37.2%, p = 0.024) were significantly higher in Group 2. Logistic regression analysis showed that initiation of LPS on the day of transfer was independently associated with increased clinical pregnancy (OR 2.37, 95% CI 1.17-4.81). Serum progesterone level did not predict pregnancy outcomes. CONCLUSION: In NC-FET cycles, initiating luteal phase support on the day of embryo transfer is associated with improved pregnancy and live birth rates compared with earlier initiation, despite lower serum progesterone levels.
Examining the joint contribution of maternal health, behavioral factors, psychosocial adversities, and environmental conditions during pregnancy for disparities in birth outcomes.
Lee S, Appleton AA
BMC Pregnancy Childbirth · 2026 Jun · PMID 42316075 · Full text
BACKGROUND: Many pre-pregnancy and gestational exposures, such as maternal physical health, behavioral factors, psychosocial adversities, and environmental conditions during pregnancy, influence birth outcomes. These ris...
BACKGROUND: Many pre-pregnancy and gestational exposures, such as maternal physical health, behavioral factors, psychosocial adversities, and environmental conditions during pregnancy, influence birth outcomes. These risk factors can co-occur, particularly among populations that experience health disparities, yet much of past researchers tend to examine them in isolation, which may lead inadvertently to some underestimation or mis-specification of risk. Therefore, this study examined the joint contribution of several maternal physical health, behaviors, psychosocial adversities, and environmental conditions during pregnancy on birth outcomes, and whether disparities were evident according to infant sex, maternal race/ethnicity, and education attainment. METHODS: Participants were from the Albany Infant and Mother Study, a prospective observational cohort of socioeconomic and racial/ethnic diverse pregnant women and their infants (n = 291). Latent Class Analysis was employed to identify discrete groups with different levels and combinations of the following prenatal exposures: maternal health (pre-pregnancy body mass index, pregnancy conditions), behaviors (smoking, recreational drug use, western diet), psychosocial (depression, adverse childhood experiences, social support), and physical environment (lead exposure, indoor environmental contaminants). Linear regression analysis tested associations between exposure classes and birth outcomes. RESULTS: Three latent classes were identified: Class 1 (47.7%; low-risk in all domains), Class 2 (42.9%; high-risk across all domains), and Class 3 (9.4%; high-risk in behavioral and environmental domains, but lower health and psychosocial risks). Compared to the low-risk referent Class 1, Class 2 was associated with lower birth weight, length, head circumference, more restricted fetal growth, and earlier gestational age at delivery (all p < 0.05). Class 3 infants also had marginally lower birth weight and increased intrauterine growth restriction (all p < 0.10). Associations were strongest among male infants, and participants from racial/ethnic and lower education backgrounds. CONCLUSIONS: This comprehensive examination of the combined effects of multiple exposures-encompassing physical health, behavioral, psychosocial and environmental domains- indicated that different patterns of multiple perinatal risks work in combination to influence birth outcomes and disparities at the earliest time in the life course. Research and practice focused on inequalities in maternal and perinatal health should consider the coordinated impacts of multiple risks simultaneously.
Establishment of biological reference intervals for coagulation indicators in pregnancy using a non-parametric approach.
Li X, Mo B, Xie C
BMC Pregnancy Childbirth · 2026 Jun · PMID 42316067 · Full text
BACKGROUND: This study aimed to evaluate changes in activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), and fibrinogen (FIB), and D-dimer (DD) levels during different trimesters of pr...
BACKGROUND: This study aimed to evaluate changes in activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), and fibrinogen (FIB), and D-dimer (DD) levels during different trimesters of pregnancy in healthy pregnant women. The objective was to establish trimester-specific reference intervals for these coagulation parameters using the non-parametric percentile method as recommended by the Clinical and Laboratory Standards Institute (CLSI) C28-A3 guideline, thereby providing a basis for accurate clinical assessment of coagulation status during pregnancy. METHODS: A total of 2,657 healthy pregnant women were selected from Sichuan JinxinXinan Women and Children Hospital from January 2024 to December 2024. Of these women, 646 were included in the first-trimester group; 1,128 were included in the second-trimester group; and 883 were included in the third-trimester group. In addition,198 healthy non-pregnant women were included in the control group. The coagulation indicators of each group were detected and analyzed, and differences in these indicators across different age groups were assessed. Following the CLSI C28-A3 guidelines, reference intervals were established using the non-parametric percentile method (P-P for APTT, PT, TT, and FIB; P for DD). The established reference intervals were validated using an independent sample of 20 healthy pregnant women per trimester. RESULTS: No significant differences were observed in any coagulation indicators between pregnant women aged < 30 years and those aged ≥ 30 years in the first-, second-, and third-trimester groups(P > 0.01).APTT, PT, and TT decreased with the advancement of gestational age, and the differences between the periods of each gestation were statistically significant (P < 0.01).FIB and DD levels increased with the advancement of gestational age, and the differences were statistically significant between each trimester(P < 0.01).The established reference intervals for the first trimester were: APTT 25.20-36.48 s, PT 11.10-13.00 s, TT 15.00-17.70 s, FIB 2.58-5.04 g/L, and DD ≤ 1.11 µg/mL. For the second trimester: APTT 24.40-34.56 s, PT 10.90-12.60 s, TT 14.70-17.20 s, FIB 2.95-5.27 g/L, and DD ≤ 2.94 µg/mL. For the third trimester: APTT 24.70-33.40 s, PT 10.60-12.40 s, TT 14.60-16.80 s, FIB 3.39-5.90 g/L, and DD ≤ 4.62 µg/mL. Compared with previously published reference intervals from other populations, our findings show similar trends but with notable differences in absolute values, particularly for FIB and DD, which may be attributed to geographical and ethnic variations. The biological reference intervals of all five coagulation indicators were successfully validated. CONCLUSION: Trimester-specific reference intervals were successfully established for five coagulation indicators using the non-parametric approach recommended by CLSI C28-A3. These intervals provide a crucial tool for accurate clinical diagnosis and prevention of coagulation disorders during pregnancy, potentially reducing misdiagnosis and unnecessary interventions associated with using non-pregnancy reference intervals. However, multicenter validation studies are needed to confirm the generalizability of these findings to other populations.
Prevalence of fetal macrosomia and associated factors among delivered neonates in Ethiopia: a systematic review and meta-analysis.
Gebreegziabher BG, Geneti SA
BMC Pregnancy Childbirth · 2026 Jun · PMID 42316065 · Full text
BACKGROUND: Globally, macrosomia affects 3 to 15% of all pregnancies; there is a global variation in the magnitude of macrosomia among countries. It is one of the public health problems in most developing countries and c...
BACKGROUND: Globally, macrosomia affects 3 to 15% of all pregnancies; there is a global variation in the magnitude of macrosomia among countries. It is one of the public health problems in most developing countries and contributes to maternal and newborn complications. There are some inconsistent individual studies done in Ethiopia, but there is no current pooled national data on its prevalence and factors associated with it. So the study will be used to design and implement a well-comprehensive intervention targeting maternal and child health services. OBJECTIVE: To estimate the pooled prevalence and associated factors of fetal macrosomia in Ethiopia. METHODS: A systematic review and Meta-analysis of published and grey literature was conducted. A Web of Science, EMBASE, PubMed, Scopus, African Journals Online and Elsevier Science direct were searched as electronic databases, while Google Scholar was utilized as a supplementary search engine. Joanna Briggs Institute (JBI) quality appraisal tools were used for quality assessment and the study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to maintain scientific robustness. Statistical analyses were performed using STATA software (version 14). For each identified associated factor, pooled effect sizes, 95% confidence intervals and measures of statistical heterogeneity were calculated. Heterogeneity among the included studies was quantified using I statistic where a value greater than 50% indicated substantial heterogeneity. Potential sources of heterogeneity were explored using meta-regression, sensitivity analysis, and subgroup analysis. Either random-effects or fixed-effect models were employed based on the observed level of heterogeneity. Potential publication bias was assessed using funnel plots and Egger's regression test. Statistical significance was declared at a p-value less than 0.05 with a 95% CI. RESULT: A total of 4309 neonates were delivered in Ethiopian Health institutions, from which 3670 singleton births were included to estimate the pooled effect of fetal macrosomia. The pooled prevalence of fetal macrosomia among delivered neonates in Ethiopia was 10.84% (95% CI: 6.38%-15.31%). Regionally, the highest and lowest pooled estimates were reported from Tigray (13.24%) and Amhara region (7.41%) respectively. Significant heterogeneity was observed across the pooled effect (I= 71.6%, P-value = 0.004) 95% CI. Subgroup analysis by year revealed that the pooled estimate of macrosomia before and after 2019 was 12.31% and 7.42%, respectively. Meta-regression indicated that this heterogeneity was not significantly driven by sample size (p = 0.08), geographic region (SNNP: p = 0.558, Tigray: p = 0.30, Amhara: p = 0.150), or publication year (p = 0.20). Sensitivity analysis was conducted to evaluate individual study effects; the pooled estimate fluctuated between 9.1% and 12.35%, indicating no single study disproportionately influenced the overall result. In the random-effects meta-analysis, five potential determinants were evaluated; however, none demonstrated a statistically significant pooled association due to marked statistical imprecision. The pooled adjusted odds ratios were as follows: Previous history of macrosomia.(AOR = 4.23, 95%CI, 0.334-53.668), being male(AOR = 2.32, 95%CI, 0.40-13.33), physical inactivity (AOR = 3.014, 95%CI, 0.229-39.614), weight gain during pregnancy((AOR = 4.88, 95%CI, 0.169-140.97), and higher gestational age (AOR = 4.71, 95%CI, 0.47-46.28). CONCLUSION: Fetal macrosomia represents a notable public health concern in Ethiopia, with a pooled prevalence exceeding multiple Sub-Saharan regional reports. Because pooled exposure analyses were highly underpowered and statistically non-significant, routine clinical screening during antenatal care should be strengthened, and larger prospective cohort studies are required to establish precise national risk pathways.
A systematic review and meta-analysis on labour pain management methods utilization and its associated factors among obstetric caregivers in Ethiopia.
Bishaw KA, Aynalem BY, Kefale D
BMC Pregnancy Childbirth · 2026 Jun · PMID 42316058 · Full text
BACKGROUND: Despite growing attention to maternal health, labour pain management remains a neglected aspect of obstetric care in Ethiopia. Existing studies in Ethiopia on labour pain management among obstetric caregivers...
BACKGROUND: Despite growing attention to maternal health, labour pain management remains a neglected aspect of obstetric care in Ethiopia. Existing studies in Ethiopia on labour pain management among obstetric caregivers (OCGs) provide some insights; their findings are often inconsistent, geographically limited, and lack national representativeness. We therefore conducted a systematic review and meta-analysis to examine the utilization of labour pain management methods and associated factors among obstetric caregivers in Ethiopia. METHODS: This review included all observational, full-text, English-language, published, and gray studies that reported on labour pain management practices or associated factors among obstetric caregivers in Ethiopia, searched from July 1-September 12/2025. Studies were identified via a comprehensive search of MEDLINE, PUBMED, Cochrane Library, EMBASE, Google Scholar, CINAHL, SCOPUS, and a direct Google search of international databases. Methodological quality and heterogeneity among the included studies was assessed using the Hoy D et al. risk of bias tool & I² statistic, respectively. Publication bias was checked using Egger's and funnel plots. All statistical analyses were conducted using STATA version 17.0. RESULTS: Half of the included studies were rated as high quality. About 45.18% of OCGs utilized labour pain management methods (95% CI: 39.87-50.48). Utilization was higher among female OCGs (Adjusted Odd Ratio [AOR] = 1.90; 95% CI: 1.24-2.93), midwives (AOR = 1.50; 95% CI: 1.15-1.94), having adequate knowledge of labour pain (AOR = 2.61; 95% CI: 1.51-4.53), having received training on labour pain management (AOR = 3.05; 95% CI: 2.17-4.30), working in facilities with adequate supplies (AOR = 5.43; 95% CI: 2.90-10.14), the presence of labour pain management protocol (AOR = 2.06; 95% CI: 1.46-2.90), and perceiving of labour pain as moderate to severe (AOR = 2.21; 95% CI: 1.40-3.49). CONCLUSION: Fewer than one in two OCGs utilized labour pain management methods. Individual caregiver characteristics (sex, profession, knowledge) and institutional factors (protocols, supplies, training) were associated with labour pain relief utilization among obstetric caregivers.
Pre-hospital healthcare for hyperemesis gravidarum: a cross-sectional analysis of baseline data from the SUKK-P study.
Erdal H, Trovik J, Heitmann K … +5 more , Negård A, Holstad AD, Tønnesen K, Krakeli I, Holst L
BMC Pregnancy Childbirth · 2026 Jun · PMID 42316057 · Full text
BACKGROUND: Women suffering fromhyperemesis gravidarum need timely and appropriate treatment to alleviate symptoms and prevent complications to the mother and fetus. AIM: The aim of this study was to identify and analyze...
BACKGROUND: Women suffering fromhyperemesis gravidarum need timely and appropriate treatment to alleviate symptoms and prevent complications to the mother and fetus. AIM: The aim of this study was to identify and analyze treatment given prior to hospitalization to women included in the SUKK-P study. METHODS: This study presents cross-sectional analyses at enrollment in the prospective SUKK-P cohort study of hyperemesis gravidarum (HG) treatment. Women hospitalized for HG were included from 11 departments within Norway between February 2021 and December 2023. Self-reported symptom severity and its impact on daily life at inclusion, treatment and health care received prior to hospitalization were collected by survey and chart review. RESULTS: The majority (89%) of the 214 women included in SUKK-P had sought health care for nausea and vomiting during pregnancy (NVP)/HG prior to hospitalization. Although 88% had used one or more antiemetics prior to hospitalization, 42% were on sick leave for nausea prior to being offered antiemetic treatment. The median PUQE-score at hospitalization was 14 (interquartile range (IQR) 12-15) with a median wellbeing score of 2 (IQR 1-3). The participants reported severe impact on daily life in terms of reduced ability to perform household chores, care for children, and socialize. Nearly all (99%) were feeling low or depressed to some degree, and nine of ten reported that the nausea impacted the relationship with their partners. Half of the women reported having thoughts about terminating the pregnancy. One or more additional symptoms were reported by 97% with headache and hopelessness or feeling low as the most frequent, closely followed by difficulty sleeping, acid reflux, and constipation. CONCLUSIONS: Women with hyperemesis gravidarum describe high level of distress, still there is a delay in being provided antiemetics as 42% reported provision of sick leave as first healthcare measure.
Assessment of fetal cardiac function using the modified myocardial performance index in fetuses with growth restriction: a prospective observational study.
Ates C, Karaaslan O
BMC Pregnancy Childbirth · 2026 Jun · PMID 42316046 · Full text
BACKGROUND: Accurate differentiation between constitutionally small fetuses and those affected by true fetal growth restriction (FGR) remains a major clinical challenge, particularly in fetuses with estimated fetal weigh...
BACKGROUND: Accurate differentiation between constitutionally small fetuses and those affected by true fetal growth restriction (FGR) remains a major clinical challenge, particularly in fetuses with estimated fetal weight between the 3rd and 10th percentiles. Conventional Doppler parameters may remain normal until late stages of placental insufficiency. The modified myocardial performance index (M-MPI) has been proposed as a sensitive marker of early fetal cardiac dysfunction. METHODS: This prospective observational study included 157 singleton pregnancies at ≥ 32 weeks of gestation. Fetuses were classified into three groups according to abdominal circumference (AC) percentiles (< 3rd percentile, 3rd-10th percentile, and > 10th percentile), using a classification framework informed by the Delphi consensus definition of fetal growth restriction. Fetal biometry, amniotic fluid index, umbilical artery and middle cerebral artery Doppler measurements were obtained. Fetal cardiac function was assessed using the modified myocardial performance index. Delivery outcomes were recorded. Comparisons among groups were performed using appropriate statistical tests. RESULTS: Maternal demographic and obstetric characteristics were similar among groups. Umbilical artery Doppler, middle cerebral artery Doppler, cerebroplacental ratio, and amniotic fluid index did not differ significantly between groups (all p > 0.05). In contrast, both fetuses below the 3rd percentile and those between the 3rd and 10th percentiles exhibited significantly prolonged isovolumetric contraction and relaxation times, shortened ejection time, and increased M-MPI values compared with fetuses above the 10th percentile (p < 0.05). No significant differences in M-MPI parameters were observed between the <3rd percentile and 3rd-10th percentile groups. CONCLUSIONS: Fetuses with abdominal circumference below the 10th percentile, including those within the borderline 3rd-10th percentile range, demonstrate subclinical cardiac dysfunction despite normal conventional Doppler findings. Assessment of the modified myocardial performance index may provide valuable additional information in the evaluation of suspected fetal growth restriction.
Machine learning to improve the prediction of Large for Gestational Age (LGA) neonates: a cohort study.
Cubillos G, Monckeberg M, Plaza A … +7 more , Morgan M, Estevez PA, Choolani M, Kemp MW, Li SWL, Illanes SE, Perez CA
BMC Pregnancy Childbirth · 2026 Jun · PMID 42316044 · Full text
BACKGROUND: Prediction of Large for Gestational Age (LGA) risk is important as it can enable earlier, more effective interventions, and avoid or mitigate cumulative injury to both mother and baby at the time of delivery....
BACKGROUND: Prediction of Large for Gestational Age (LGA) risk is important as it can enable earlier, more effective interventions, and avoid or mitigate cumulative injury to both mother and baby at the time of delivery. The goal of this research is to improve the prediction of LGA using machine learning (ML) models and variables that are widely available as that allow for broad intervention in late pregnancy and during delivery. METHODS: An improved prediction of LGA was achieved using twelve ML models with hyperparameter optimization. Also, to improve the LGA prediction a data augmentation method was employed in the training set. Additionally, improvement in LGA prediction was obtained with four variable selection methods employed to identify the most significant variables. To rank the best models on the validation set after training, the Area under the Receiver Operating Characteristic Curve (AUROC) was used. Finally, to assess the generalization performance, the best models were evaluated on the test set. RESULTS: Our method enabled us to identify several models with high sensitivity and specificity. The best models included those that achieved a sensitivity of 0.84, a specificity of 0.84, an accuracy of 0.84, and AUCROC 0.83, requiring 14 variables. Another model reached an accuracy of 0.87, a sensitivity of 0.71, and a specificity of 0.90 with an AUCROC of 0.83 (14 variables). Additionally, a model with a sensitivity of 0.58, the same as that described by Hadlock et al. [1] for ultrasound, required 10 variables, and reached an accuracy of 0.91, a specificity of 0.97, and an AUCROC of 0.86. Both models included maternal BMI (body mass index), First Control, Maternal Weight, BMI Last Control, and EFW (estimated fetal weight) as the most important variables. CONCLUSIONS: The main contributions of our study include the prediction of LGA using data obtained from standard clinical evaluations during prenatal care, as well as the development ML models, tuning the hyperparameters to improve prediction results, thus achieving high levels of sensitivity and specificity. To achieve optimal LGA prediction outcomes across different models, a data augmentation approach is introduced, an important improvement in LGA prediction over using only Hadlock's ultrasound formula.
Placenta-derived small extracellular vesicles transfer miR-520d-5p to mediate pancreatic β-cell injury in gestational diabetes mellitus by targeting SIRT1.
Ma Q, Dai L, Chen F … +4 more , Li S, Zhang Z, Ai L, Dong J
BMC Pregnancy Childbirth · 2026 Jun · PMID 42310610 · Full text
BACKGROUND: Small extracellular vesicles (sEV) mediate intercellular communication in gestational diabetes mellitus (GDM). However, the mechanisms by which GDM-derived placental sEV induce pancreatic islet cell injury re...
BACKGROUND: Small extracellular vesicles (sEV) mediate intercellular communication in gestational diabetes mellitus (GDM). However, the mechanisms by which GDM-derived placental sEV induce pancreatic islet cell injury remain unclear. Here, we investigated the functions and underlying mechanisms of placenta-derived sEV (Pd-sEV)-associated miRNAs in GDM. METHODS: Pregnant women with normal glucose tolerance (NGT) or GDM were recruited, and clinical characteristics and inflammatory indices were assessed. Pd-sEVs were isolated and characterized. The effects of GDM-derived Pd-sEVs on insulin secretion and apoptosis in β-cells were evaluated. Following miRNA sequencing and diagnostic assessment, bioinformatic analysis identified downstream targets. Finally, miRNA mimics, specific inhibitors, and Sirtuin 1 (SIRT1) overexpression, and enzymatic activity assays were used to validate the regulatory mechanisms. RESULTS: GDM patients exhibited a sustained inflammatory state and significantly elevated levels of Pd-sEVs. These GDM-derived Pd-sEVs were efficiently internalized by β-cells, impairing glucose-stimulated insulin secretion (GSIS) and inducing apoptosis. Sequencing revealed selective alterations in the miRNA profile in GDM-sEV, with 4 significantly upregulated and 11 downregulated miRNAs. Among these, miR-520d-5p showed the most robust alteration in vivo and demonstrated the highest diagnostic sensitivity and specificity. Notably, circulating miR-520d-5p levels positively correlated with 75-g oral glucose tolerance test (OGTT) glucose levels. Bioinformatics analysis identified 707 high-confidence target genes, with SIRT1 identified as a core gene. Additionally, miR-520d-5p mimics or GDM-derived Pd-sEVs significantly reduced SIRT1 levels and impaired its enzymatic deacetylation activity. Mechanistically, miR-520d-5p directly targeted the SIRT1 3'-UTR, while miR-520d-5p inhibition or SIRT1 overexpression significantly attenuated the Pd-sEV-induced functional defects. CONCLUSIONS: This study supports that miR-520d-5p shuttled by Pd-sEVs mediates pancreatic β-cell injury in GDM via targeting SIRT1. These findings suggest that Pd-sEV-associated miR-520d-5p serves as a promising diagnostic biomarker, and targeting the miR-520d-5p/SIRT1 axis offers a potential therapeutic strategy for preserving β-cell function in GDM.
Mendelian randomization study on the effects of women's reproductive traits and socioeconomic traits on pregnancy complications.
Zhang L, Xia Y, Wang W
BMC Pregnancy Childbirth · 2026 Jun · PMID 42310608 · Full text
BACKGROUND: Pregnancy complications are influenced by a complex interplay of socioeconomic and reproductive factors. Observational studies have suggested associations with socioeconomic traits-such as educational attainm...
BACKGROUND: Pregnancy complications are influenced by a complex interplay of socioeconomic and reproductive factors. Observational studies have suggested associations with socioeconomic traits-such as educational attainment (EDU), household income (INC), and physically demanding work (PDW)-as well as reproductive traits including age at first sexual intercourse (AFS) and age at first birth (AFB). However, observational findings are prone to confounding and reverse causation, making it difficult to establish causality. Therefore, this study applies Mendelian randomization (MR) to investigate the causal relationships between reproductive and socioeconomic traits and the risk of pregnancy complications. METHODS: We conducted univariable and multivariable MR analyses to assess the causal effects of reproductive traits and socioeconomic traits on pregnancy complications. Genetic instruments reaching genome-wide significance (P < 5 × 10⁻) were selected from large-scale genome-wide association studies (GWAS) involving 263,615 to 766,345 participants for socioeconomic traits (EDU, INC, PDW) and 214,547 to 418,758 participants for reproductive traits (AFS, AFB). Outcome data were derived from GWAS based on biobank datasets for eight pregnancy complications: spontaneous abortion (SA), postpartum depression (PD), gestational diabetes (GD), Pre-eclampsia or eclampsia (PE), premature rupture of membranes (PRM), premature separation of placenta (PSP), intrahepatic cholestasis of pregnancy (ICP), and hyperemesis gravidarum (HG). Sample sizes ranged from 294 to 9,113 cases and 59,610 to 117,892 controls. RESULTS: Univariable MR analysis identified significant associations, including AFB-PD(OR = 0.90, 95% CI: 0.81-0.98, P = 0.024 ), AFS-SA(OR = 0.77, 95% CI: 0.62-0.96, P = 0.020 ), AFS-PD(OR = 0.46, 95% CI: 0.36-0.59, P < 0.001 ), AFS-GD(OR = 0.62, 95% CI: 0.48-0.82, P < 0.001 ), AFS-PRM (OR = 0.68, 95% CI: 0.48-0.94, P = 0.020 ), EDU-SA (OR = 0.83, 95% CI: 0.71-0.97, P = 0.020 ), EDU-PD (OR = 0.55, 95% CI: 0.46-0.67, P < 0.001 ), EDU-GD (OR = 0.68, 95% CI: 0.56-0.83, P < 0.001 ), EDU-PRM (OR = 0.72, 95% CI: 0.56-0.94, P = 0.010 ), INC-PD (OR = 0.58, 95% CI: 0.48-0.70, P < 0.001 ), INC-GD (OR = 0.65, 95% CI: 0.43-0.97, P = 0.030 ), PDW-PD (OR = 2.00, 95% CI: 1.06-3.77, P = 0.030 ), and PDW-PE (OR = 2.80, 95% CI:1.09-7.18, P = 0.030 ). Multivariable MR analysis confirmed independent protective effects of higher EDU on PD (OR = 0.58, 95% CI: 0.37-0.91, P = 0.020 ), GD (OR = 0.58, 95% CI: 0.35-0.96, P = 0.030 ), and PRM (OR = 0.44, 95% CI: 0.24-0.81, P = 0.010 ). AFS was independently associated with an increased risk of PSP(OR = 1.86, 95% CI: 1.03-3.36, P = 0.040).Two-step MR mediation indicated that AFS partially mediates the EDU-outcome relationship for SA, PD, GD, and PSP (proportions mediated ~ 55-65% ), while the reverse pathway (EDU as mediator of AFS) showed smaller but directionally consistent mediation (~ 24-29% ). CONCLUSION: Lower EDU is causally associated with increased risks of PD, PE, and PRM. Educational level may influence reproductive timing, such as AFS, which in turn affects the likelihood of pregnancy complications. These findings highlight the potential benefits of targeted educational and social interventions in mitigating adverse pregnancy outcomes.
Oral health skills framework for pregnant women: a professional consensus.
Tenenbaum A, Yazdanbakhsh M, Cerdan I … +9 more , Omiya J, de Andrade V, Maurice A, Marquillier T, Margat A, Lombrail P, Gagnayre R, Riquet S, Azogui-Levy S
BMC Pregnancy Childbirth · 2026 Jun · PMID 42310585 · Full text
BACKGROUND: Oral health during the perinatal period is essential for maternal and child oral health. Pregnancy increases vulnerability to oral conditions (periodontal disease and dental caries) associated with adverse pr...
BACKGROUND: Oral health during the perinatal period is essential for maternal and child oral health. Pregnancy increases vulnerability to oral conditions (periodontal disease and dental caries) associated with adverse pregnancy outcomes, while children's oral health is strongly influenced by parental-particularly maternal-knowledge, attitudes, practices, and oral health status. Although oral health education interventions may be offered during pregnancy follow-up, their effectiveness is difficult to evaluate, due to a lack of validated framework. This study aimed to develop a competency framework for oral health education during the perinatal period. METHODS: A Delphi study assessed expert opinion on the competencies pregnant women should acquire to ensure good oral health for themselves and their children through oral health education interventions. The questionnaire comprises two sections (pregnant woman and child) and covered core skill domains-preventing oral diseases, monitoring oral health conditions, and seeking dental care- subdivided into 97 contributory learning objectives across knowledge, practices and attitudes. Objective were rated on a 4-point Likert scale, with consensus defined as ≥ 70%. The expert panel included 21 perinatal healthcare professionals (midwives, pediatricians, gynecologists, general practitioners, dentists, and pharmacists). RESULTS: In the first round, 59% of objectives were rated as very useful, and 40 were revised the second round due to lack of consensus. After three rounds, consensus was reached for all objectives except four: the links between periodontal disease and preeclampsia, impact of breastfeeding on oral health, the protective role of saliva and women's active search for oral health information. The discussion of the unresolved areas highlighted gaps in healthcare professionals' understanding of oral-general health links in the perinatal period, and in perceptions of individuals' autonomy in health information seeking. CONCLUSIONS: This study resulted in a consensus-based competency framework for oral health education during pregnancy, structured around three key competencies: preventing oral diseases, participating in care plans, and asserting health-related rights. Establishing consensus on women's oral health competencies supports a cross-disciplinary approach to prevention and health education during the perinatal period. Future research should focus on translating this framework into practical, implementable strategies across diverse healthcare settings.
Exploring working conditions and job stability of midwives in Spain: results from a cross-sectional national survey.
Rodríguez-Blanco N, Sánchez-Más J, Ayuso-Murillo D … +4 more , Fontán-Vinagre MG, Angulo-Perea M, Díaz-Gautier A, Guerrero-Menéndez R
BMC Pregnancy Childbirth · 2026 Jun · PMID 42310573 · Full text
BACKGROUND: Midwives are essential to perinatal care in Spain's healthcare system, with roles expanding due to demographic changes to encompass technology integration, multidisciplinary collaboration, and pharmacotherape...
BACKGROUND: Midwives are essential to perinatal care in Spain's healthcare system, with roles expanding due to demographic changes to encompass technology integration, multidisciplinary collaboration, and pharmacotherapeutic management. Challenges persist, including suboptimal remuneration, competency misalignment, and employment precarity (92.7% temporary contracts in 2024), aggravating professional dissatisfaction, reduced job satisfaction, and well-being deficits. Influential factors include workload, contractual stability, and work-life balance, emphasizing the imperative for empirical analysis of labour conditions. This study describes midwives' perceptions of Spanish work environments and assesses contract-type variations. METHODS: We conducted a cross-sectional, quantitative survey of registered midwives in Spain using a self-administered, 23-item, web questionnaire (five domains) on EUSurvey to assess working conditions, capturing demographics, job characteristics, training/competence, and entitlements, and evaluating differences in professional perceptions by contract type. Bivariate analyses and multivariable logistic regression models (adjusted for age group and years of professional experience) were performed to evaluate differences in professional perceptions by contract type. RESULTS: Of the 2,499 responses, 2,310 met the requirements (27.8% of practicing midwives in Spain). The majority worked in public hospitals (66.1%); 43.4% had permanent contracts, a figure that increased with age and experience. Temporary shiftcts, more common in the private sector, were associated with lower salaries and less salary satisfaction (mean scores 4.0-4.1 vs. 4.6 on a 10-point scale; p < 0.001) and greater exposure unfavourable working conditions due to staff shortages (requests for off-hours shifts: 90.2%, denied leave: 55.4%, approved leave cancelled: 22.8%; p < 0.001). Role intrusion was frequent (77.1%). Despite widespread participation in continuous training, only 15.8% felt fully competent in all core competencies. CONCLUSIONS: Employment temporariness and staffing shortages are associated with poorer working conditions, greater role intrusion, and low pay satisfaction among midwives. Despite access to training, key competencies remain under-implemented, highlighting the need for greater job stability, adequate staffing, and equitable professional development.
Maternal and neonatal systemic inflammatory indices and perinatal outcomes in methamphetamine-exposed pregnancies.
Bekmezci M, Demirtas MS
BMC Pregnancy Childbirth · 2026 Jun · PMID 42310571 · Full text
OBJECTIVE: The aim of this study is to evaluate maternal hematological inflammatory indices such as (neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), and syste...
OBJECTIVE: The aim of this study is to evaluate maternal hematological inflammatory indices such as (neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), and systemic inflammatory response index (SIRI)) in pregnant women using methamphetamine and to examine the relationship between these indices and neonatal inflammatory parameters. METHODS: This retrospective case-control study included 52 pregnant individuals with methamphetamine use and 93 matched controls delivering at a university training hospital. Maternal inflammatory indices were calculated from admission blood counts, and neonatal indices were assessed in 28 exposed neonates and compared with maternal indices using the Wilcoxon signed rank test. Among the 52 methamphetamine-exposed pregnancies, neonatal complete blood count data were available for only 28 neonates. Neonatal blood sampling was performed solely when clinically indicated according to routine neonatal practice. Therefore, neonates without available hematological data were not included in the paired maternal-neonatal analysis. Neonatal outcomes were compared between groups, and multivariate logistic regression was used to identify factors associated with adverse perinatal outcomes. RESULTS: The case group demonstrated higher median NLR and PLR ratios. Furthermore, neutrophil, platelet, monocyte counts along with the systemic immune-inflammation index (SII (case vs. control, 1419.2 [1086.9-2231.3] vs. 883.7 [634.2-1076]); p<0.001), and systemic inflammatory response index (SIRI (case vs. control, 3.28 [2.2-5.55] vs. 2.12 [1.51-2.98]); p<0.001) levels were significantly higher than controls (all p<0.001). Furthermore, statistically significant differences were found between maternal and neonatal paired inflammatory indices (NLR, PLR, SII, and SIRI) (all p<0.001). In logistic regression analysis, prenatal methamphetamine exposure was identified as the strongest independent risk factor for adverse perinatal outcomes (odds ratio 2.742, 95% CI: 1.182-8.330; p=0.045). CONCLUSION: Methamphetamine use during pregnancy can lead to changes in maternal inflammatory indices, and these changes may be correlated with neonatal inflammatory parameters.
Perceived satisfaction in fetal therapy: proposal and pilot of a novel assessment tool (FETAL Surgery Global Satisfaction).
Domínguez-Moreno M, Chimenea Á, De-Martín-Hernández J … +2 more , García-Díaz L, Antiñolo G
BMC Pregnancy Childbirth · 2026 Jun · PMID 42310570 · Full text
BACKGROUND: The quality of healthcare services has drawn significant attention within the medical field, with patient-perceived satisfaction emerging as a crucial indicator. Analyzing patient satisfaction could uncover a...
BACKGROUND: The quality of healthcare services has drawn significant attention within the medical field, with patient-perceived satisfaction emerging as a crucial indicator. Analyzing patient satisfaction could uncover areas of weakness, suggesting the need for improvements in care. However, in the specialized field of Fetal Medicine and Therapy, there lacks a validated tool for assessing care quality from the patient´s perspective. This study aims to design and pilot an instrument for measuring patient-perceived satisfaction as a barometer of the quality of services provided. METHODS: We developed a survey instrument to assess six key areas of healthcare (Follow-up care, environment, transparency, accessibility of care, link between physician and patient, and global satisfaction), through 20 multiple-choice questions. Every key area was rated from 1 to 5 and the overall score was calculated by dividing the total score by the number of areas, resulting in rates from 1 to 5, higher scoring represented a greater patient-perceived satisfaction. It was initially piloted on a sample of 34 pregnant women undergoing a specific fetal therapy (Ex Utero Intrapartum Treatment, EXIT) at our center between June 2007 and January 2024. RESULTS: A total of 29 out of 34 patients agreed to participate. According to the proposed tool and the suggested scoring scale, we achieved an overall score of 4.67, indicating a very satisfactory rating. The highest mean score was for the "Global satisfaction" domain (4.76), revealing that participants where highly likely to recommend our department. It was followed by "Follow-up care" and "Environment" domains (4.69, each). Notably, "Transparency" and "Link between physician-patient" were the lowest rated domains (4.58 and 4.62, respectively), suggesting the timely provision of enhancement. CONCLUSIONS: We propose "FETAL Surgery Global Satisfaction Tool" as a potential valuable instrument to assess patient-perceived satisfaction. It could provide insights into the quality of services offered by Fetal Medicine and Therapy Units. By identifying key areas for improvement, this tool could support continuous quality enhancement across Fetal Therapy programs globally. Further studies are warranted to evaluate its validity and potential future reliability.
Exploring infant safe sleeping practice in a multicultural setting: findings from the maternal and infant health monitoring system in Abu Dhabi.
Kaddoura R, Elsiwi B, Chen W … +9 more , Mousa M, Hassan Z, MIHMS Consortium, Al Suwaidi H, Gietel-Basten S, Everett DB, Al Hammadi Y, Al Hajeri O, Habbal KA
BMC Pregnancy Childbirth · 2026 Jun · PMID 42304324 · Full text
BACKGROUND: Safe infant sleep recommendations are well established in many high-income countries, several of which are multicultural countries. However, less is known about infant sleep practices in non-Western, highly m...
BACKGROUND: Safe infant sleep recommendations are well established in many high-income countries, several of which are multicultural countries. However, less is known about infant sleep practices in non-Western, highly multicultural settings, where, the majority of residents are expatriates from diverse world regions. The United Arab Emirates (UAE) represents a unique pediatric context, with more than 80% of residents being expatriates from over 200 nationalities, and limited national guidance on infant sleep. METHODS: Using cross-sectional data collected between 2023 and 2024 data from the Abu Dhabi Maternal and Infant Health Monitoring System, we determined the prevalence of five infant sleep practices: (1) back sleep position, (2) separate approved sleep surface, (3) room sharing with an adult without bed sharing, (4) room sharing with bed sharing and (5) no soft objects or loose bedding. We used multivariable logistic regression to estimate the associations between sociodemographic and behavioral factors and each of the infant sleep practices. RESULTS: The least prevalent safe sleep practices were using a separate approved sleep surface (8.4%) and avoiding soft bedding (11.5%). Region of origin was associated with all sleep practices. Reported receipt of healthcare-provider advice was infrequent and was not associated with adherence to any sleep practice. CONCLUSION: In a multicultural, high-income setting in the Middle East, adherence to infant safe sleep recommendations is selective and is associated with cultural background. These findings highlight the need for culturally responsive pediatric guidance and suggest that US-derived safe sleep recommendations may require contextual adaptation to improve effectiveness in diverse populations.
Maternal age differences among women with histologically diagnosed molar pregnancy.
Yagur Y, Schreiber H, Heresco L … +6 more , Markovitch O, Weitzner O, Schonman R, Klein Z, Daykan Y, Arbib N
BMC Pregnancy Childbirth · 2026 Jun · PMID 42304304 · Full text
OBJECTIVE: To determine the occurrence of molar pregnancies across maternal age groups and to examine βhCG levels at admission and follow-up. METHODS: A retrospective cohort study conducted between the years 2014-2021. I...
OBJECTIVE: To determine the occurrence of molar pregnancies across maternal age groups and to examine βhCG levels at admission and follow-up. METHODS: A retrospective cohort study conducted between the years 2014-2021. Included women with a pathology-diagnosed partial or complete mole. Demographic, clinical and laboratory data of women with a molar pregnancy, ≤ 40 or > 40 years were compared. Long-term follow-up data after surgical evacuation and βhCG levels were collected. RESULTS: A total of 115 cases of complete (n = 15) or partial moles (n = 100) during the study period were included. Women's ages ranged from 16 to 55 years (mean 33.3 ± 8.2). Most participants, 73 (63.5%) were 20-35 years. Compared to women > 40 years (n = 23), women ≤ 40 (n = 92) partial moles were more common in the ≤ 40 group (85 [92.4%] vs. 15 [65.2%], p = 0.001), while complete moles were more frequent in the > 40 group (8 [34.8%] vs. 7 [7.6%], p = 0.001), even after controlling for age, gravidity, and parity (p = 0.005, OR 6.5). βhCG levels over time were followed with follow-up ranged from 30 to 203 days. βhCG levels normalized within 3 months in 90% of cases, with the largest decrease occurred after the first month. Gestational trophoblastic neoplasia (GTN) occurred in 7 (6.1%) cases, with no age group differences. CONCLUSIONS: This study emphasis that molar pregnancies affect a wide age range. Furthermore, it confirms a positive long-term prognosis.
A cross-sectional study on the prevalence and determinants of antenatal anxiety among pregnant women in the second and third trimesters.
Choudhary N, Sangwan RK, Kumar M … +6 more , Khetan M, Dahiya N, Yadav B, Dhikav V, Choudhary R, Babu BV
BMC Pregnancy Childbirth · 2026 Jun · PMID 42304291 · Full text
BACKGROUND: Globally, anxiety is prevalent during pregnancy and is associated with poor outcomes, yet it is often under-documented, underdiagnosed, and untreated during antenatal care in low- and middle-income countries,...
BACKGROUND: Globally, anxiety is prevalent during pregnancy and is associated with poor outcomes, yet it is often under-documented, underdiagnosed, and untreated during antenatal care in low- and middle-income countries, and its associated factors remain poorly understood. This study aimed to estimate the prevalence of anxiety among pregnant women in their second and third trimesters and identify associated factors. METHODS: A community-based cross-sectional study was conducted at four primary health centres in a rural western Indian district. Pregnant women in their second or third trimester without prior mental illness were included. Anxiety was assessed using the PRAQ-R2 tool. Data on sociodemographic characteristics, obstetric history, and various psychosocial factors were collected using the Epicollect5 application and analysed with SPSS v25. RESULTS: Among 213 participants, 84% had pregnancy-related anxiety (60.1% mild, 22.5% moderate, and 1.4% severe). The most common PRAQ-R2 item contributing to anxiety was fear of giving birth, followed by worries about bearing an ill child, and concerns about self-appearance. Univariate analysis showed significant association with parity (crude odds ratio [COR] = 4.98, 95% confidence interval [95% CI] = 2.42-10.22), gravida (1.96, 1.04-3.71), history of abortion/intrauterine death (3.47, 1.67-7.20), negative comments or behaviour from family regarding increased appetite (1.99, 1.045-3.79), worried about specific concerns (9.42, 2.20-40.38), difficulty in reaching a healthcare facility (2.17, 1.09-4.31) and past traumatic events (1.92, 1.01-3.64), were significant. In multivariate logistic regression, parity (adjusted odds ratio, AOR = 7.83, 95% CI = 1.68-36.63), history of abortion/intrauterine death (5.08, 1.30-19.83) and worried about specific concerns during pregnancy (9.09, 1.93-42.88) remained independently associated with antenatal anxiety. CONCLUSION: Anxiety was highly prevalent and influenced by a complex interplay of clinical, sociodemographic, and psychosocial factors. The high prevalence in rural settings raises serious public health concerns, suggesting the need for improved screening, early identification, and timely intervention during routine antenatal care to prevent adverse pregnancy outcomes.
Cytomegalovirus congenital infection awareness, knowledge, and attitude towards prenatal screening among Jordanian women: a cross-sectional study.
Thekrallah F, Bushnaq M, Alshamali O … +5 more , Almansi M, Nihad M, Asfan B, Alsalameen O, Tutunji L
BMC Pregnancy Childbirth · 2026 Jun · PMID 42304248 · Full text
OBJECTIVES: Cytomegalovirus (CMV) can be transmitted from the mother to the fetus during pregnancy, leading to a congenital CMV (cCMV), the most common congenital infection worldwide and may lead to severe neurological s...
OBJECTIVES: Cytomegalovirus (CMV) can be transmitted from the mother to the fetus during pregnancy, leading to a congenital CMV (cCMV), the most common congenital infection worldwide and may lead to severe neurological sequelae. Therefore, it is essential to evaluate the awareness of CMV infection and cCMV in childbearing women in high CMV prevalence countries, such as Jordan. METHODS: A cross-sectional study was conducted to assess Jordanian women's knowledge and awareness of CMV and cCMV infection, attitudes toward prenatal and neonatal screening for CMV, and the frequency of behaviors that may increase the risk of CMV transmission. Data were collected over two months using a structured questionnaire administered face-to-face in private settings at public community centers and the University of Jordan Hospital clinics. The questionnaire included demographic variables, CMV-related knowledge, attitudes toward screening, and behaviors potentially associated with CMV transmission risk. Data were recorded electronically by interviewers. RESULTS: Out of 589 eligible women, only 16.3% of women had heard of CMV, and among those, 67% were aware of cCMV. Never-pregnant women were more likely to report awareness of cCMV than recently-pregnant women. After receiving educational information about CMV, 91.7% and 94.9% of women believed that CMV screening for pregnant women and newborns, respectively, should be offered. Additionally, 71.3% indicated they would choose prenatal screening in a future pregnancy. Childcare‑related behaviors that may increase CMV transmission-such as kissing children on the lips or sharing cups and food-were commonly reported, highlighting important knowledge gaps. CONCLUSIONS: This study demonstrates a substantial lack of awareness of CMV and cCMV among Jordanian women of childbearing age, regardless of pregnancy history. However, brief education markedly improved support for both prenatal and newborn CMV screening. These findings underscore the urgent need for comprehensive CMV education, increased public health messaging on CMV transmission, and consideration of policy measures to reduce cCMV risk in high‑prevalence populations.
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