BMC Pregnancy And Childbirth[JOURNAL]
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200 papers
Case report on resistant postpartum hemorrhage during cesarean section treated with a modified quadruple uterine belt suture technique for uterus preservation.
Bai Y, Guo L, Wang F … +1 more , Zhu K
BMC Pregnancy Childbirth · 2026 Jun · PMID 42288755 · Full text
BACKGROUND: Severe postpartum hemorrhage during cesarean section is a critical obstetric emergency; delayed hemostasis may lead to hemorrhagic shock, hysterectomy, and even maternal mortality. Individualized uterine-pres...
BACKGROUND: Severe postpartum hemorrhage during cesarean section is a critical obstetric emergency; delayed hemostasis may lead to hemorrhagic shock, hysterectomy, and even maternal mortality. Individualized uterine-preserving hemostatic strategies represent the central focus and greatest challenge in current clinical management. CASE PRESENTATION: This article reports a case of a patient at 40 + 2 weeks of gestation with concurrent gestational diabetes mellitus and prenatal fever. During cesarean section, the patient developed severe postpartum hemorrhage (with blood loss reaching 2,500 mL) due to complete dense adhesion between placenta and membranes, partial placental implantation on the posterior uterine wall, extensive intrauterine adhesions with pseudocyst formation, and uterine atony. Despite multiple hemostatic measures-including manual placental detachment, forceps removal of implanted tissue, suture closure with braided sutures, administration of uterotonic agents, ligation of bilateral ascending uterine arteries, local figure-of-eight sutures, and intrauterine gauze packing-all proved ineffective. Emergency quadruple modified uterine belt suturing was subsequently performed, successfully preserving the uterus. Postoperatively, multidisciplinary comprehensive management was implemented, encompassing anti-infection therapy, antithrombotic treatment, prevention of uterine necrosis, and correction of anemia and hypoalbuminemia, effectively preventing complications such as infection, uterine necrosis, and venous thrombosis. Follow-up imaging at 3 months showed no abnormalities, with favorable outcomes for both mother and fetus. This study delineates key procedural principles for this technique, providing a reproducible emergency management protocol for clinical practice. CONCLUSIONS: The quadruple modified uterine dorsal suture technique represents a variant of traditional compression suturing, enabling uniform compression of the entire uterine segment and rapid hemostasis. Combined with multimodal interventions, it effectively addresses refractory postpartum hemorrhage of complex etiology. Strict control of suture tension and postoperative dynamic monitoring can balance the benefits of uterine preservation with surgical risks.
Associations between arginine metabolism and gestational diabetes mellitus: an exploratory longitudinal study using widely targeted metabolomics.
Li Y, Li Y, Wang J … +4 more , Ma L, Zhang S, Zhao W, Sun Y
BMC Pregnancy Childbirth · 2026 Jun · PMID 42286545 · Full text
OBJECTIVE: To characterize longitudinal metabolic alterations associated with gestational diabetes mellitus (GDM) and to identify candidate metabolite signals for earlier risk assessment using a widely targeted metabolom...
OBJECTIVE: To characterize longitudinal metabolic alterations associated with gestational diabetes mellitus (GDM) and to identify candidate metabolite signals for earlier risk assessment using a widely targeted metabolomics platform. METHODS: In this prospective cohort, 35 women who developed GDM and 35 matched healthy controls underwent fasting blood sampling in early pregnancy (6-13 weeks) and mid-pregnancy (24-28 weeks). Widely targeted metabolomics and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed. Multivariate analyses, logistic regression, receiver operating characteristic (ROC) analysis, internal cross-validation, and restricted cubic spline modeling were applied within an exploratory framework. RESULTS: In early pregnancy, 11 differential metabolites were identified, including 6 amino acid-related metabolites, but no robust signal remained after false discovery rate (FDR) correction. By mid-pregnancy, 35 differential metabolites were identified, including 13 amino acid-related metabolites. Among 19 amino acid-related metabolites examined in focused analyses, L-arginine was the only amino acid-related metabolite that remained significant after FDR correction (FDR = 0.043). Higher mid-pregnancy L-arginine was associated with increased odds of GDM (aOR = 2.840, 95% CI 1.481-5.446), was positively correlated with 1-h (r = 0.28) and 2-h (r = 0.26) glucose levels during OGTT, and showed modest discrimination (AUC = 0.754; mean cross-validated AUC = 0.754). Quartile analyses showed a more pronounced risk increase in the highest exposure group, and restricted cubic spline analysis suggested an overall positive association with a possible nonlinear trend at higher levels. KEGG analyses highlighted arginine- and amino acid-related pathways, including arginine and proline metabolism and arginine biosynthesis, while network analysis suggested a potential link to mTOR signaling. CONCLUSION: In this exploratory longitudinal analysis, pregnancies complicated by GDM showed progressively increasing amino acid-related metabolic disturbances from early to mid-pregnancy. Mid-pregnancy L-arginine emerged as a candidate metabolic signal associated with GDM risk, post-load glycemia, and greater risk elevation at higher levels. These findings support further investigation of amino acid-focused metabolic profiling as a research-stage approach for earlier GDM risk identification.
Evidence-based behaviour change techniques to aid smoking cessation for pregnant women with mental illness: a systematic review.
Jones E, Casey A, MacArthur C … +2 more , Taylor B, Coleman T
BMC Pregnancy Childbirth · 2026 Jun · PMID 42286542 · Full text
BACKGROUND: Smoking during pregnancy is the leading preventable cause of maternal and infant morbidity and mortality in high income countries, disproportionately affecting women with mental illness. While behavioural smo...
BACKGROUND: Smoking during pregnancy is the leading preventable cause of maternal and infant morbidity and mortality in high income countries, disproportionately affecting women with mental illness. While behavioural smoking cessation interventions are effective for pregnant women and non-pregnant people with mental illness separately, evidence for specific smoking cessation interventions for pregnant women with mental illness is lacking. This review aimed to identify and map BCTs from effective general mental health smoking cessation trials to determine which may be helpful for pregnant women experiencing mental illness. METHODS: A systematic review identified effective smoking cessation RCTs among people with mental illness. MEDLINE, EMBASE, PsycINFO, CINAHL, HMIC and CENTRAL databases were searched through April 2026. BCTs were coded using BCT Taxonomy; those in at least two effective interventions classified as 'promising' and compared against BCTs identified within National Centre for Smoking Cessation Training Standard Treatment Programme for pregnant women. RESULTS: Of 12,403 records, 195 full texts were screened and 16 RCTs met the inclusion criteria. Most interventions combined psychosocial and pharmacological components; motivational interviewing was the most common. Of 39 distinct BCTs identified, 26 were 'promising'. Frequent BCTs included goal setting (1.1), problem solving (1.2), action planning (1.4), social support (unspecified) (3.1), instruction on how to perform the behaviour (4.1) and pharmacological support (11.1). High overlap exists; most promising BCTs for mental health populations are already embedded within the standard UK pregnancy care pathway. CONCLUSIONS: This study shows that behavioural components of effective smoking cessation interventions for people experiencing mental illness align with what is available women accessing NHS smoking in pregnancy cessation services. However, persistently high smoking rates in pregnant women with mental illness suggest that the presence of these techniques alone is insufficient. These findings imply that service improvements should prioritise adapting the delivery of existing BCTs, such as goal setting and problem-solving, to address specific psychological barriers and social contexts of this group to improve engagement and clinical outcomes.
Inequities in maternal healthcare access in the Marrakech-Safi region, Morocco: a cross-sectional study.
Ouahid H, Mansoury O, Sebbani M … +2 more , Amine M, Adarmouch L
BMC Pregnancy Childbirth · 2026 Jun · PMID 42286538 · Full text
INTRODUCTION: Gender norms may shape maternal healthcare utilization, yet evidence from Morocco remains limited. This study examined the association between gender norms, measured using the Moroccan Arabic Gender Equitab...
INTRODUCTION: Gender norms may shape maternal healthcare utilization, yet evidence from Morocco remains limited. This study examined the association between gender norms, measured using the Moroccan Arabic Gender Equitable Men scale (MA-GEM), and maternal healthcare utilization (antenatal care, facility-based delivery, and postnatal care) in the Marrakech-Safi region. METHODS: We conducted a cross-sectional survey among 632 adults aged ≥ 18 years using mixed online and in-person convenience recruitment. MA-GEM was administered to both women and men to assess general gender-norm attitudes and household power relations, while maternal healthcare outcomes were assessed separately using direct service-utilization questions. Analyses of maternal healthcare outcomes were restricted to pregnancy-exposed respondents (n = 207). Chi-square tests and multivariable logistic regression were used to examine associations between MA-GEM categories, sociodemographic factors, and maternal healthcare utilization. Sex-stratified models were conducted as sensitivity analyses. RESULTS: Our findings reveal that participants adhering to inequitable gender norms were significantly less likely to use antenatal care (AOR = 0.169, 95% CI [0.061-0.469], p = 0.001) and facility-based delivery (AOR = 0.034, 95% CI [0.007-0.169], p < 0.001). Rural residence (AOR = 0.071, 95% CI [0.014-0.367], p = 0.002) and lack of paid employment (AOR = 0.101, 95% CI [0.027-0.380], p = 0.001) were also associated with lower facility-based delivery. No statistically significant adjusted associations were observed for postnatal care. CONCLUSION: MA-GEM-measured gender norms were associated with antenatal care utilization and facility-based delivery in Marrakech-Safi. Findings support integrated interventions addressing both sociocultural norms and structural barriers to improve maternal healthcare utilization.
LIFT: Lifting the Impacted fetal head; the Fetal Pillow and Tydeman Tube trial: protocol for a prospective observational study to evaluate two disimpaction devices.
van der Krogt L, Rosen O'Sullivan H, Hall M … +4 more , Seed PT, Briley A, Tydeman G, Shennan A
BMC Pregnancy Childbirth · 2026 Jun · PMID 42286533 · Full text
BACKGROUND: Impacted fetal head (IFH) at full dilatation caesarean section (CS) is an increasingly recognised obstetric emergency associated with significant maternal and neonatal morbidity. Despite its importance, there...
BACKGROUND: Impacted fetal head (IFH) at full dilatation caesarean section (CS) is an increasingly recognised obstetric emergency associated with significant maternal and neonatal morbidity. Despite its importance, there is limited evidence to guide management, particularly the use of disimpaction devices. METHODS: LIFT is a prospective observational trial comparing the use of two commercially available disimpaction devices-the Fetal Pillow and the Tydeman Tube -for the management of IFH at full dilatation caesarean section. DISCUSSION: The LIFT study will compare the performance of the Fetal Pillow and Tydeman Tube in the management of IFH and contribute to the development of an evidence base to support best practice. As awareness of the clinical significance and implications of IFH continues to grow, generating robust data on available management options is essential. This study represents an important step toward optimising the safe and effective management of this challenging obstetric emergency. TRIAL REGISTRATION: NCT07372768, registered 28/01/2026, https://clinicaltrials.gov/study/NCT07372768.
Clinical analysis of prenatal diagnosis, ultrasound findings, and follow-up in 92 Turner mosaic fetuses: a retrospective analysis of 12-year experience.
Luo X, Niu H, Tang Y … +8 more , Xu J, Zhou F, Cong X, Li S, Pei Y, Chang L, Liu W, Wei F
BMC Pregnancy Childbirth · 2026 Jun · PMID 42286522 · Full text
OBJECTIVE: This study conducted a retrospective analysis on ultrasound findings, karyotype characteristics, pregnancy outcomes, and follow-up data for 92 fetuses diagnosed with Turner mosaicism. It provides essential cli...
OBJECTIVE: This study conducted a retrospective analysis on ultrasound findings, karyotype characteristics, pregnancy outcomes, and follow-up data for 92 fetuses diagnosed with Turner mosaicism. It provides essential clinical data on the prenatal and postnatal outcomes of these cases. METHODS: A comprehensive review and analysis were conducted on 92 cases of Turner mosaic fetuses diagnosed by karyotyping, SNP-array, or FISH at the Prenatal Diagnosis Center of Shenzhen Longgang Maternal and Child Health Hospital, a tertiary medical center, between January 2013 and September 2025. The analysis focused on maternal demographic data, types and proportions of mosaic karyotypes, ultrasound findings, pregnancy outcomes, and postnatal follow-up data. RESULTS: Of 12,855 high-risk pregnancies undergoing amniocentesis, 92 Turner mosaic fetuses ( 0.72%, 92/12855) were identified. The majority (65/92, 70.7%) exhibited X-chromosome aneuploidy mosaicism, most commonly 45,X/46,XX (52 cases). Mosaicism involving structural abnormalities of the X chromosome was observed in 27 cases (29.3%), including eight cases of 45,X/46,X, i(X)(q10). Ultrasonography detected abnormalities in 10 fetuses - three with cardiovascular malformations, two with growth restriction, and one with cystic hygroma - while the remaining 82 cases had no abnormal ultrasound findings. Two cases were notable for complex multi-system anomalies: one with 45,X[24]/46,XX[76] presented with coarctation of the aorta, a horseshoe kidney, and increased nuchal translucency (3.2 mm); another with 46,X, i(X)(q10)[66]/46,XX[24] had a ventricular septal defect, left clubfoot, and bilateral ventricular widening. Of the 92 fetuses with Turner mosaicism, 69 pregnancies were terminated and 23 were continued. Among the 23 continuing pregnancies, one resulted in embryonic arrest, one was subsequently terminated, and one delivered preterm at 34 weeks. Twenty infants were live-born and followed up: three showed delayed language and motor development, one had epilepsy, one had hearing loss, and one exhibited short stature with dry skin. Notably, the abnormal mosaic ratio in all cases with postnatal findings ranged from 20% to 30%. CONCLUSION: The prenatal phenotype of Turner mosaicism is largely determined by the proportion of abnormal cells and the tissues involved. Clinical decisions should caution against termination for mosaic ratio below 30%, as cases under 10% typically have favorable outcomes. Although prenatal ultrasound findings for Turner mosaicism lack specificity, they may be closely associated with cardiovascular abnormalities and intrauterine growth restriction. After birth, it is crucial to conduct close postnatal monitoring of neurodevelopment for these children.
Prevalence and determinants of low-birth-weight deliveries at four district hospitals in Kigali, Rwanda: a cross-sectional study.
Absolomon G, Kalisa R, Condo J … +7 more , Rubuga FK, Mwiseneza MJ, Girimpundu CM, Ishimwe J, Nikwigize S, Moreland P, Nsereko E
BMC Pregnancy Childbirth · 2026 Jun · PMID 42286494 · Full text
BACKGROUND: Low birth weight (LBW) is a significant public health concern, particularly in developing countries, because it is associated with increased neonatal and infant morbidity and mortality. In Rwanda, LBW remains...
BACKGROUND: Low birth weight (LBW) is a significant public health concern, particularly in developing countries, because it is associated with increased neonatal and infant morbidity and mortality. In Rwanda, LBW remains a critical issue affecting the overall health and development of children. Understanding the factors contributing to LBW is essential for designing effective interventions to reduce its prevalence and improve maternal and child health outcomes. We aimed to determine the prevalence and determinants of LBW among neonates delivered at four district hospitals in the City of Kigali Province, Rwanda. METHODS: A hospital-based retrospective cross-sectional study was conducted among neonates delivered at three public and one private district hospital located in the City of Kigali from November 2023 to February 2024. All available neonatal medical records that met the inclusion criteria were reviewed using retrospective chart review approach. Data analysis was performed via STATA version 17 to conduct descriptive, bivariate, and multivariate logistic regression to determine the adjusted odds ratios (AORs) with 95% confidence intervals (CIs) and corresponding P-values for the determinants of LBW. RESULTS: The prevalence of LBW was 8.2% (95% CI: 7.6-8.8; n = 453/5520). Significant determinants included HIV-positive status (AOR = 2.07, 95% CI [1.01-4.22], p = 0.046), indicating more than twice the odds of delivering an LBW infant compared to HIV-negative mothers; female neonates (AOR = 1.52, 95% CI [1.21-1.89], p < 0.001); preeclampsia/eclampsia (AOR = 4.46, 95% CI [2.32-8.58], p < 0.001); and hospitalization during pregnancy (AOR = 4.34, 95% CI [2.20-8.56], p < 0.001). Preterm birth (< 38 weeks gestation) was the strongest determinant (AOR = 16.85, 95% CI [13.19-21.52], p < 0.001). CONCLUSION: The prevalence of LBW among neonates in Kigali was 8.2%. Maternal HIV-positive status, female child sex, preeclampsia/eclampsia, and prior admission during current pregnancy were key determinants of LBW. Strengthening antenatal care and targeted maternal health programs, especially for teenage mothers, HIV-positive pregnant women, and women with hypertensive disorders of pregnancy, can help address these factors and reduce LBW rates in Rwanda.
Protocol for the external validation of machine learning models for risk prediction in early-onset preeclampsia: a multicenter prospective cohort study.
Domínguez-Del Olmo P, Melchor I, Cánovas E … +10 more , García-Manau P, Cahuana MJ, Pérez-Marqués M, Satorres E, Bugatto F, Villalaín C, Robisco E, L Ayala J, Galindo A, Herraiz I
BMC Pregnancy Childbirth · 2026 Jun · PMID 42277749 · Full text
BACKGROUND: Early-onset preeclampsia (eoPE), defined as preeclampsia occurring before 34 weeks of gestation, remains one of the leading causes of severe maternal morbidity, iatrogenic prematurity, and maternal mortality...
BACKGROUND: Early-onset preeclampsia (eoPE), defined as preeclampsia occurring before 34 weeks of gestation, remains one of the leading causes of severe maternal morbidity, iatrogenic prematurity, and maternal mortality worldwide. Its heterogeneous and rapidly evolving clinical course makes the prediction of adverse outcomes particularly challenging. Although machine learning (ML)-based models have shown promise in stratifying eoPE risk and supporting clinical decision-making, robust prospective external validation is still lacking. The present study aims to address this gap through a multicenter validation of three ML models previously developed by our group to: (1) predict maternal complications, (2) estimate the likelihood of delivery within ≤ 7 days of diagnosis, and (3) identify the risk of hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome or placental abruption. METHODS: This prospective multicenter cohort study (2024-2027) recruits pregnant women diagnosed with eoPE after informed consent. Clinical, analytical, and ultrasound data, including all variables used in the models, are recorded from early pregnancy to delivery. The first 100 cases will undergo quantitative external validation of three ML models and a semi-quantitative evaluation by clinicians, after which these cases will be used to retrain the models. The updated models will then be prospectively applied to the next 100 participants. Model predictions and physician´s assessment of the clinical utility of such predictions are generated through a secure web application accessible only after delivery. DISCUSSION: This study addresses a critical gap in the prospective validation of ML-based tools for eoPE, emphasizing methodological rigor, data quality, and external validation in a multicenter setting. By integrating quantitative performance assessment with clinician-centered evaluation, the project seeks to ensure both statistical robustness and real-world clinical relevance. If successfully validated, these models could support more individualized and timely decision-making in eoPE management.
Pregnancy outcome and relationship with hypertensive retinopathy in hypertensive disorders of pregnancy among antenatal patients of a tertiary hospital in Nigeria.
Emeonye A, Emeonye R, Gobo D … +4 more , Ezenwankwo F, Ogborogu E, Obi I, Onyia O
BMC Pregnancy Childbirth · 2026 Jun · PMID 42277748 · Full text
INTRODUCTION: Hypertensive retinopathy can occur among women with hypertensive disorders of pregnancy (HDP). The aim of this study was to determine the proportion of hypertensive retinopathy in HDP, and its relationship...
INTRODUCTION: Hypertensive retinopathy can occur among women with hypertensive disorders of pregnancy (HDP). The aim of this study was to determine the proportion of hypertensive retinopathy in HDP, and its relationship with pregnancy outcome measures among antenatal patients at Federal Teaching Hospital (FTH), Owerri, Imo State, Nigeria. METHOD: This was a tertiary hospital-based observational prospective study carried out between March and December 2023. One hundred and fifty participants who met the recruitment eligibility criteria were enrolled in the study. All patients had physical and ocular examinations. The findings were recorded and analyzed using SPSS v24.0. Categorical variables were summarized as proportions and percentages. Comparison of variables was done using the Chi-square test; a p-value < 0.05 was considered statistically significant. RESULTS: The proportion of retinopathy in the study population was 58.7%. Pregnancy outcome measures observed to have a significant correlation with hypertensive retinopathy were maternal outcome [seizures] (p = 0.004), preterm delivery (p = 0.013) and low birth weight (p = 0.033). Pregnancy outcome measures without a significant correlation with hypertensive retinopathy included mode of delivery (p = 0.114), neonatal outcome (p = 0.231), and APGAR score (p = 0.483). CONCLUSION: Retinopathy in hypertensive disorder of pregnancy was significantly associated with maternal outcome (seizure), preterm delivery and low birth weight. It is recommended from these results that advocacy for strengthening maternal & child health (MCH) and education, to prevent complications of hypertensive disorder of pregnancy, is important.
AI-guided meta-analysis of non-invasive prenatal testing platforms for trisomy 21 screening: comparative evaluation of cffDNA and fetal cell-based approaches.
Elmetwalli A, Ameen F, Magrashi N … +4 more , Alamri ES, Albalawi AN, Alzahrani OR, El-Far AH
BMC Pregnancy Childbirth · 2026 Jun · PMID 42277722 · Full text
BACKGROUND: Trisomy 21 (Down syndrome) remains the most prevalent autosomal aneuploidy, necessitating accurate prenatal diagnosis. While cell-free fetal DNA (cffDNA)-based non-invasive prenatal testing (NIPT) has transfo...
BACKGROUND: Trisomy 21 (Down syndrome) remains the most prevalent autosomal aneuploidy, necessitating accurate prenatal diagnosis. While cell-free fetal DNA (cffDNA)-based non-invasive prenatal testing (NIPT) has transformed screening, challenges persist in low fetal fraction cases and confined placental mosaicism. Integrating artificial intelligence (AI), multi-omics, and fetal cell-based approaches represents a paradigm shift toward comprehensive prenatal diagnostics. OBJECTIVE: This AI-assisted meta-analysis evaluates NIPT platforms for Trisomy 21 detection, comparing cffDNA-based, SNP-based, digital PCR, and emerging fetal cell-based approaches. METHODS: Following PRISMA guidelines, we systematically searched PubMed, Web of Science, and Scopus (2010-2023). Ten high-quality studies were analyzed for diagnostic accuracy metrics across multiple NIPT platforms. RESULTS: MPS-based cffDNA NIPT demonstrated pooled sensitivity of 99.3% (95% CI: 98.7-99.7%) and specificity of 99.9% (95% CI: 99.8-100%). Alternative platforms, including fetal cell-based NIPT, showed promising but moderately lower accuracy. AI-driven risk stratification models demonstrated enhanced diagnostic precision in complex cases. CONCLUSION: MPS-based NIPT remains the gold standard for Trisomy 21 screening. Future integration of AI-enhanced fetal cell isolation and multi-omics profiling may expand diagnostic capabilities beyond aneuploidy detection.
Platelet-rich plasma for wound healing and scar formation after cesarean section: a systematic review and meta-analysis of randomized controlled trials.
Şen S, Şen FG
BMC Pregnancy Childbirth · 2026 Jun · PMID 42277717 · Full text
BACKGROUND: Surgical wound complications follow 3-15% of cesarean deliveries globally. Platelet-rich plasma (PRP), an autologous concentrate of growth factors, has documented regenerative activity across several surgical...
BACKGROUND: Surgical wound complications follow 3-15% of cesarean deliveries globally. Platelet-rich plasma (PRP), an autologous concentrate of growth factors, has documented regenerative activity across several surgical disciplines, yet no quantitative synthesis of randomized trial evidence has been published for its intraoperative use during cesarean section. METHODS: PubMed/MEDLINE, Embase, CENTRAL, Scopus, and Web of Science were systematically searched from inception through March 2026 to identify randomized controlled trials comparing intraoperative PRP with standard care during cesarean section. Primary outcomes were skin scar quality measured with the Patient and Observer Scar Assessment Scale (POSAS), the Vancouver Scar Scale (VSS), or the Manchester Scar Scale; early wound inflammation measured with the Redness, Edema, Ecchymosis, Discharge, and Approximation (REEDA) scale; and uterine scar integrity defined by niche formation rate and residual myometrial thickness. Secondary outcomes were postoperative pain on visual analogue or numeric rating scales and analgesic consumption. Standardized mean differences (Hedges' g) were pooled using a DerSimonian-Laird random-effects model. Ambiguity regarding dispersion measures in one study was resolved through p-value back-calculation, and sensitivity analyses were pre-specified. The protocol was registered prospectively (INPLASY202640041; doi: https://doi.org/10.37766/inplasy2026.4.0041). RESULTS: Five randomized trials enrolling 366 women across five countries were included, with four trials (n = 336) contributing to skin-scar synthesis. PRP improved patient-reported scar quality (POSAS-patient SMD - 0.50, 95% CI - 0.83 to - 0.17; p = 0.003; I² = 0%) and clinician-assessed scar quality (POSAS-observer SMD - 0.42, 95% CI - 0.75 to - 0.10; p = 0.012; I² = 32%), and reduced early wound inflammation (REEDA SMD - 0.52, 95% CI - 0.84 to - 0.20; p = 0.002; I² = 0%; sensitivity analysis under the naive SD assumption produced I² = 98% and was uninterpretable). In a single small trial that targeted the uterine scar, PRP reduced niche formation from 46.7% to 13.3% (RR 0.29, 95% CI 0.07-1.16; Fisher's exact p = 0.109 on the binary 2 × 2 table). Vancouver Scar Scale heterogeneity precluded pooling (I² = 94%). Visual analogue pain at early time points was not significantly reduced (pooled SMD - 0.22, 95% CI - 0.50 to + 0.06; p = 0.12). No safety event attributable to PRP was reported in any trial. CONCLUSIONS: Across a small and clinically heterogeneous evidence base of five randomized trials, intraoperative PRP improves cesarean skin scar quality and reduces early wound inflammation, while early pain intensity does not appear to be affected. The single trial that addressed the uterine scar suggests a substantial reduction in niche formation, but with only thirty patients, an unreproducible study-reported p-value, and a Fisher's exact p of 0.109 on the binary outcome, this signal is hypothesis-generating and requires confirmation in adequately powered trials before any change in practice can be considered. PROTOCOL REGISTRATION: INPLASY202640041 (doi: https://doi.org/10.37766/inplasy2026.4.0041).
Resilience paths: maternal experiences in coping with syphilis exposure or congenital infection and the role of support networks.
de Souza Fernandes Poggianella T, Machado-Kayzuka GC, de Lima Guedes AL … +7 more , Caldeira NMVP, Mendes LMC, da Fonseca LCMM, Ávila FMVP, Nascimento LC, Gomes-Sponholz FA, Barbosa NG
BMC Pregnancy Childbirth · 2026 Jun · PMID 42277715 · Full text
BACKGROUND: Congenital syphilis is a significant public health problem and can lead to several unfavorable perinatal outcomes and severe sequelae in children. In Brazil, the number of cases of congenital and gestational...
BACKGROUND: Congenital syphilis is a significant public health problem and can lead to several unfavorable perinatal outcomes and severe sequelae in children. In Brazil, the number of cases of congenital and gestational syphilis continues to increase, highlighting the need for timely diagnosis, treatment, and prevention. A lack of adequate follow-up during prenatal care may result in unwanted outcomes for the neonate, such as prolonged hospitalization and impacts on neurodevelopment. Although many studies have focused on the clinical aspects of congenital syphilis, there is a gap in understanding maternal experiences, especially regarding affective and psychological elements and the importance of support networks. OBJECTIVES: To explore the experiences of mothers of children exposed to syphilis during pregnancy or with congenital infection regarding the diagnosis and hospitalization of the child and the influence of their support networks. METHODS: This is a descriptive study with a qualitative approach based on the concept of social support networks. After ethical approval, individual and semi-structured interviews were conducted and submitted for content analysis. The study enrolled 11 mothers of children with congenital infection and two mothers of children exposed to gestational syphilis at an outpatient clinic in Juiz de Fora, Minas Gerais, Brazil. RESULTS: The guilt of the mother and her responsibility for the vertical transmission were identified. The women experienced feelings of sadness, doubts about the child, mistaken conception of the disease, and fear of the child's death. The experience was permeated by stigma and prejudice. The hospitalization of the child and the consequent need for invasive procedures was a moment of shock for the mother. The perspective of the child's well-being and the recognition of the benefits of the treatment, as well as faith and the presence of a support network, were fundamental in the process. CONCLUSION: The presence of a support network in the process of coping with congenital syphilis or exposure to infection can modulate maternal health. This highlights the need for health education and more inclusive actions in the context of maternal and child health from the time of prenatal care.
Taking folic acid supplementation on postpartum depression in women: a clinical trial.
Mohammadizadeh M, Rahmani R, Jalili J … +1 more , Mayvan MR
BMC Pregnancy Childbirth · 2026 Jun · PMID 42277704 · Full text
INTRODUCTION AND OBJECTIVE: Postpartum depression is a common complication in mothers that leads to adverse outcomes for mothers, children, and families. Some studies have investigated the role of supplement use in reduc...
INTRODUCTION AND OBJECTIVE: Postpartum depression is a common complication in mothers that leads to adverse outcomes for mothers, children, and families. Some studies have investigated the role of supplement use in reducing and preventing depression; therefore, the present study aimed to determine the effect of folic acid supplement use on the rate of postpartum depression. METHODS: This study was conducted as a single-blind clinical trial on 60 postpartum mothers who had referred to service centers in Mashhad and Gonabad for 3-5 days of postpartum care in 2023. Sampling was carried out using a convenient method and using block random allocation of participants in two groups. Data collection tools included a demographic and obstetric characteristics checklist and the Edinburgh Standard Questionnaire. In this study, the control group used one placebo tablet daily and the intervention group used half a 1 mg folic acid vitamin tablet daily for two months. The depression score was measured at the beginning and one month and two months after the intervention. After completing the sampling, the three-day food intake record was examined at the beginning and end of the study in both groups. The collected data were analyzed using SPSS version 21 software and the level of significance was set at p < 0.05. FINDINGS: The mean postpartum depression score in the intervention group was 5.07(2.77) lower than the control group 5.70(3.63), but there was no significant difference. CONCLUSION: The present study showed that although folic acid consumption in the postpartum period had reduced the mean depression score, there was no statistically significant relationship between folic acid supplement consumption and reducing the score on maternal depression. It is recommended to recommend further studies with larger sample sizes and longer folic acid consumption.
Antenatal intervention for childbirth trauma: the clinical profile of Australian women at a tertiary hospital.
MacMillan KK, Greenhalgh CF, Cleary DB … +7 more , Cahill J, Dedman K, Weir C, Bright C, White SW, Bradfield Z, Watson SJ
BMC Pregnancy Childbirth · 2026 Jun · PMID 42271335 · Full text
BACKGROUND: Despite global recognition of childbirth trauma, as well as identifiable factors in pregnancy that may increase its occurrence, there is an absence of accessible and cost-effective primary (i.e., before child...
BACKGROUND: Despite global recognition of childbirth trauma, as well as identifiable factors in pregnancy that may increase its occurrence, there is an absence of accessible and cost-effective primary (i.e., before childbirth) antenatal intervention. This study describes an antenatal intervention, Sensitive Care Birth Plans (SCBP), currently implemented at the Women and Newborn Health Service (WNHS) in Western Australia and aims to analyse the maternal and infant characteristics of women accessing it for childbirth trauma. METHODS: Data were drawn from 126 patient files, which was the total number of women identified with SCBPs from January to December 2022 at WNHS in a retrospective file review. Where possible, outcomes of the SCBP cohort are compared to all other women who birthed during the same period at the service. RESULTS: Data were analysed using descriptive and inferential statistics. The SCBP cohort was 14.1-44.4 years of age (M = 30.34 years). Most women were diagnosed with the diagnostic category of a neurotic, stress-related and somatoform disorder (85.3%). There were high prevalences of childhood and adulthood trauma (63.5% and 63.2%, respectively), childbirth trauma (64.3%) and perinatal loss (54.1%). There was also high use of mental health services (84.8%), elevated antenatal admission days (M = 3.72), and caesarean section birth (44.3%) observed in the SCBP cohort. Infants born to women in the SCBP cohort, compared to the full birthing cohort, had a 79% (p<.001) increased likelihood of admission to the Special Care Nursery. CONCLUSIONS: By understanding the profile of women receiving SCBPs, this study provides an insight into the complex interaction of factors for women receiving antenatal intervention for childbirth trauma. Key additional risk factors for childbirth trauma such as perinatal loss are highlighted, with the high rates of childhood and adulthood trauma demonstrating the potential role of screening to ensure that women with known vulnerabilities are identified for comprehensive assessment.
High exposure of pregnant women to SARS-CoV-2 during COVID-19 waves in Senegal.
Diouara AAM, Thiam F, Coundoul S … +16 more , Manga NM, Ndiaye HD, Senghor A, Tene SD, Sané S, Kane B, Sarr H, Dieye Y, Lo S, Danfakha F, Dieme MEF, Biaye B, Nguer CM, Peeters M, Kane CT, Ayouba A
BMC Pregnancy Childbirth · 2026 Jun · PMID 42271320 · Full text
BACKGROUND: The COVID-19 pandemic raised concerns about SARS-CoV-2 infection in pregnant women, especially regarding pregnancy outcomes and maternal-child health. Despite the limited seroprevalence data in this populatio...
BACKGROUND: The COVID-19 pandemic raised concerns about SARS-CoV-2 infection in pregnant women, especially regarding pregnancy outcomes and maternal-child health. Despite the limited seroprevalence data in this population category, it is crucial for public health strategies in Africa. Therefore, this study aims to determine the seroprevalence of SARS-CoV-2 in pregnant women attending antenatal consultations (ANC) in Senegal. METHODS: This is a retrospective serological study using archived plasma samples collected prospectively, ensuring no redundancies, among pregnant women attending ANC, between March and July 2021 during the Delta wave of COVID-19. Plasma samples were stored at -80 °C until analysis for the presence of IgG and IgM antibodies against SARS-CoV-2 using the WANTAI SARS-CoV-2 Ab ELISA (Wantai Biological Pharmacy Enterprise, Beijing), according to the manufacturer's protocol. Bivariate analysis was conducted to evaluate characteristics associated with seropositivity using JMP Pro Version 15.0.0 software (SAS Institute Inc., Cary, NC, 1989-2021). For categorical variables with frequencies below 5%, either chi-squared or Fisher tests were applied as appropriate. Significance was defined as p < 0.05 for all tests. RESULT: A total of 1,227 pregnant women were recruited from five health facilities, including two in Dakar (n = 166) and one in each of the following regional capitals: Saint-Louis (n = 400), Ziguinchor (n = 264), and Kédougou (n = 397). The median age was 25 years [range:18-50]. The overall seroprevalence observed was 64.9% [95% CI: 62.24-67.57], with higher exposure rates in Dakar 71.6% [95% CI: 64.40-77.99], and Ziguinchor 68.1% [95% CI: 62.34-73.51]. Kédougou and Saint-Louis reported 62.9% [95% CI: 58.12-67.58] and 62% [95% CI: 57.15-66.62], respectively. According to age group, the seroprevalence was 62.6% [95% CI: 58.49-66.71], 66.6% [95% CI: 61.62-71.36], 66.3% [95% CI: 59.94-72.24], and 67.2% [95% CI: 58.37-75.01], respectively, for [18-23], [24-29], [30-35], and ≥ 36 years old. Despite these observed variations in the seroprevalence of SARS-CoV-2 across localities, differences are not statistically significant (p = 0.7024). CONCLUSION: In summary, this study highlights a high seroprevalence of SARS-CoV-2 among pregnant women, with higher exposure rates in Dakar and Ziguinchor. These findings demonstrated that SARS-CoV-2 has spread massively in Senegal, despite few reported cases, similar to trends observed in other African countries. Ultimately, this study reveals seroepidemiological data for SARS-CoV-2 in pregnant women, previously unknown at the national level.
Prevalence and associated factors of EPDS-defined depressive symptoms in fathers of preterm infants admitted to the NICU: a cross-sectional study.
Li S, Ma Y, Wu T … +4 more , Chen J, Zhu Z, Huang J, Ding X
BMC Pregnancy Childbirth · 2026 Jun · PMID 42271304 · Full text
BACKGROUND: The admission of a preterm infant to the neonatal intensive care unit (NICU) represents a stressful event for parents and families, often precipitating negative emotions such as anxiety and sadness, and in so...
BACKGROUND: The admission of a preterm infant to the neonatal intensive care unit (NICU) represents a stressful event for parents and families, often precipitating negative emotions such as anxiety and sadness, and in some cases, depressive symptoms. The impact of preterm infants' admission to the NICU within 2-3 days after birth on maternal EPDS-defined depressive symptoms has been extensively studied, but research on EPDS-defined depressive symptoms arising from this context remains scarce. This study aimed to investigate the prevalence and associated factors of EPDS-defined depressive symptoms among fathers of preterm infants shortly after the infants' admission to the NICU. METHODS: A cross-sectional study was conducted between November 2024 and October 2025 using a convenience sampling method in a tertiary maternal and child health hospital's neonatal intensive care unit (NICU) in Gansu Province, China. A total of 379 fathers of preterm infants were recruited as study participants. The survey was conducted at 2-3 days after NICU admission. Data were collected using baseline demographic questionnaires, the Edinburgh Postnatal Depression Scale (EPDS), the Eysenck Personality Questionnaire-Revised Short Form (EPQ-RSC), and the Family Assessment Device (FAD). RESULTS: In this study, we used the Edinburgh Postnatal Depression Scale (EPDS) with a cutoff score of ≥ 10 to define screen-positive depressive symptoms. The prevalence of screen-positive depressive symptoms among fathers of preterm infants at 2-3 days after NICU admission was 29.55%. The associated factors included monthly income 5,000-10,000 CNY (OR = 0.557, 95%CI:0.312-0.995), paternity leave availability (OR = 0.532, 95%CI:0.291-0.974), infant birth weight 1,500-2,499 g (OR = 0.327, 95%CI:0.117-0.916), Psychoticism (OR = 1.913, 95%CI:1.592-2.299), Extraversion(OR = 0.846, 95%CI:0.739-0.968), Neuroticism (OR = 1.507, 95%CI:1.331-1.706), moderate family functioning (OR = 2.634, 95%CI: 1.356-5.117), poor family functioning (OR = 8.939, 95%CI:4.351-18.365). CONCLUSION: Among fathers of preterm infants shortly after the infants' admission to the NICU, EPDS-defined depressive symptoms were relatively common and were associated with several paternal, infant, and family-related variables. These findings warrant further exploration in multicenter longitudinal studies.
Characterization of pro-inflammatory, regulatory, and anti-inflammatory interleukins in placentas affected by acute fetal distress across gestational ages: a pilot study.
Brikune E, Junga A, Brikune J … +1 more , Pilmane M
BMC Pregnancy Childbirth · 2026 Jun · PMID 42271295 · Full text
BACKGROUND: Pregnancy requires finely regulated immunological adaptation, in which interleukins play central roles in mediating maternal-fetal communication and maintaining immune equilibrium. Acute fetal distress (distr...
BACKGROUND: Pregnancy requires finely regulated immunological adaptation, in which interleukins play central roles in mediating maternal-fetal communication and maintaining immune equilibrium. Acute fetal distress (distress acuta) is associated with inflammatory processes that may compromise placental function and pregnancy outcomes. The present study aimed to investigate the expression patterns and distribution of selected interleukins-IL-1α, IL-2, IL-4, IL-6, IL-7, IL-8, and IL-10-in placental tissues across three gestational stages (28, 31, and 40 weeks). METHODS: A retrospective exploratory study was conducted on placental tissues obtained from 15 participants with acute fetal distress (n = 5 per group) and 5 control samples at 40 weeks of gestation. Immunohistochemical analysis with semi-quantitative assessment and nonparametric statistical methods was applied. RESULTS: Distressed placentas demonstrated increased expression of pro-inflammatory interleukins, particularly IL-1α, IL-2, and IL-8, compared to controls. IL-2 expression appeared to decrease toward term, while IL-7 and IL-8 showed relatively consistent activity across gestational stages. Anti-inflammatory interleukins IL-4 and IL-10 demonstrated reduced expression in distressed placentas, whereas control samples showed comparatively higher levels. In contrast, IL-6 expression remained relatively stable across gestational stages in both groups. Correlation analysis indicated coordinated interleukin expression patterns across placental compartments. CONCLUSIONS: These findings may suggest an altered interleukin profile in placental distress acuta, characterized by a shift toward a pro-inflammatory environment. However, given the exploratory design and limited sample size, the results should be interpreted with caution, and further studies are required to confirm these observations.
Patterns and risk factors of birth defects in Bangladesh: evidence from a neonatal intensive care unit.
Hasan SH, Akter H, Ferdous J … +4 more , Zahur T, Nahar K, Das JC, Banu T
BMC Pregnancy Childbirth · 2026 Jun · PMID 42271281 · Full text
INTRODUCTION: Birth defects constitute substantial contributor to neonatal mortality and morbidity particularly in low and middle income countries. In Bangladesh, limited screening and low awareness contribute to delayed...
INTRODUCTION: Birth defects constitute substantial contributor to neonatal mortality and morbidity particularly in low and middle income countries. In Bangladesh, limited screening and low awareness contribute to delayed diagnoses and inadequate care. This study aimed to delineate the patterns of birth defects and identify associated risk factors to provide baseline data in a tertiary care neonatal intensive care unit in Bangladesh to support future surveillance, inform policy development, and guide preventive strategies. METHODS: This hospital based prospective observational study was conducted in the Department of Neonatology at Chittagong Medical College Hospital, Bangladesh, from August to December 2020. Neonates with birth defects were identified through detailed clinical examination and classified according to the International Classification of Diseases, 10th Revision, Clinical Modification. Relevant data were collected using a predesigned questionnaire. Data were analyzed in SPSS version 28. Logistic regression was done to identify perinatal risk factors. A p-value < 0.05 was considered statistically significant. RESULTS: Among 5,223 admitted neonates, 183 (3.5%) had birth defects. Musculoskeletal anomalies were most common (67 cases), followed by cleft lip/palate (30), circulatory (29), chromosomal (24), eye, ear, face and neck (23) anomalies. Among these neonates, 56 (30.6%) died, with a 1.59 fold higher mortality risk compared to those without defects (95% CI: 1.15-2.18; p = 0.005). Maternal hypertension (AOR: 3.92; 95% CI: 2.56-5.99; p < 0.001), diabetes mellitus (AOR: 4.15; 95% CI: 2.37-7.27; p < 0.001), polyhydramnios (AOR: 7.33; 95% CI: 2.63-20.41; p < 0.001), and oligohydramnios (AOR: 10.19; 95% CI: 3.68-28.23; p < 0.001) were strongly associated with birth defects. CONCLUSIONS: The study highlights the significant burden of birth defects and associated neonatal mortality. Musculoskeletal anomalies were the most frequently observed defects. Maternal hypertension and diabetes mellitus were identified as strong predictors, warranting targeted antenatal screening and timely intervention. Routine neonatal examination at community level as well as in hospital is recommended to facilitate early detection and proper referral of birth defects.
A newly discovered PAX7 variant associated with craniofacial duplication: a case report.
Li CX, Huang DS, Gong ZC
BMC Pregnancy Childbirth · 2026 Jun · PMID 42271274 · Full text
BACKGROUND: Diprosopus (craniofacial duplication) is an exceedingly rare craniomaxillofacial dysmorphosis, considered a subgroup of conjoined twins, with phenotypes ranging from partial structural duplication to complete...
BACKGROUND: Diprosopus (craniofacial duplication) is an exceedingly rare craniomaxillofacial dysmorphosis, considered a subgroup of conjoined twins, with phenotypes ranging from partial structural duplication to complete dicephalus. Its embryogenesis and molecular mechanisms remain poorly understood. This study describes a case of partial dentofacial duplication and reports novel genetic findings to explore potential etiology. CASE PRESENTATION: A newborn Kazak male was referred for a prenatal-detected maxillary mass. Physical examination revealed left complete unilateral cleft lip and a 2.5 × 3.0 cm soft tissue mass (accessory upper lip with a central sinus tract) originating from the ipsilateral upper lip. CT confirmed duplicated, translocated maxillary arches and widened nasal bone. The patient underwent two surgeries (at 11 months and 4 years of age) for cleft lip repair, duplicated maxilla excision, and bony contouring. Long-term follow-up showed unimpaired feeding and speech. Whole-exome sequencing (WES) of the patient and mother identified a shared heterozygous missense variant: PAX7 c.1033G > C (p.Ala345Pro, NM_001135254.1), classified as a variant of uncertain significance (VUS) per ACMG/AMP guidelines. CONCLUSIONS: This is the first report of a PAX7 VUS associated with craniofacial duplication. PAX7 plays critical roles in craniofacial development, and the conserved Ala345 residue suggests potential functional impact. While causality is not established, this finding links PAX7 to a rare duplication phenotype, providing a preliminary molecular basis for future prenatal screening and mechanistic studies. Additional functional validation and larger cohort studies are needed to confirm pathogenicity.
Pregnancy-related transverse arch deformation: a subject-specific finite element analysis of the contributions of body weight and tissue stiffness.
Li X, Lu Z, Fang Y … +3 more , Fekete G, Sun D, Gu Y
BMC Pregnancy Childbirth · 2026 Jun · PMID 42271272 · Full text
BACKGROUND: Pregnancy is accompanied by physiological changes that alter foot structure and loading conditions, which may contribute to foot pain, instability, and an increased risk of falls. Gestational weight gain and...
BACKGROUND: Pregnancy is accompanied by physiological changes that alter foot structure and loading conditions, which may contribute to foot pain, instability, and an increased risk of falls. Gestational weight gain and pregnancy-related changes in passive soft-tissue compliance occur simultaneously, making it difficult for clinical studies to distinguish their individual contributions to transverse arch deformation. The purpose of this study was to independently quantify the effects of increased body weight and reduced soft tissue stiffness on transverse foot arch geometry during pregnancy and to clarify their potential mechanical relevance. METHODS: A computed tomography (CT) -based subject-specific finite element (FE) model and a full factorial design were used to independently quantify the effects of body weight (W) and tissue stiffness (K) on the transverse arch. The reference-condition FE prediction was benchmarked against in-shoe plantar pressure measurements from the same participant, showing close agreement for forefoot and heel peak pressures (< 3% difference). A 4 × 4 factorial analysis was then performed across sixteen conditions, including the reference condition and the 1st, 2nd, and 3rd trimester pregnancy states. RESULTS: Under the prescribed W-K schedule, the greatest model-predicted flattening occurred in the second trimester, corresponding to the stage with the largest prescribed reduction in tissue stiffness. Regression analysis showed that increased load was the primary driver of transverse widening of the midfoot, whereas modelled reductions in passive tissue stiffness predominantly governed loss of arch height and curvature. Interaction effects between load and tissue stiffness were minimal, indicating largely independent mechanical pathways. Model-predicted stresses in the medial cuneiform, intermediate cuneiform, and cuboid were highest in the second trimester. CONCLUSIONS: Within this single-subject static FE framework, gestational weight gain (W) and modelled reductions in passive tissue stiffness (K) influenced the tarsal transverse arch through distinct mechanical pathways. Increased W was more strongly associated with transverse widening, whereas lower modelled K was more closely related to vertical flattening and loss of arch curvature. Among the simulated conditions, the most pronounced model-predicted flattening occurred in the second trimester, consistent with the prescribed second-trimester minimum in K. These findings provide a mechanical interpretation of pregnancy-related transverse arch deformation and may help guide future studies of supportive exercise and footwear strategies. TRIAL REGISTRATION: Not applicable.
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