BMC Pregnancy And Childbirth[JOURNAL]
Sun
200 papers
The association between adverse perinatal outcomes, obstructive sleep apnoea and the role of depressive symptoms.
Redhead K, Walsh J, Newnham JP … +3 more , Hince D, Eastwood P, Galbally M
BMC Pregnancy Childbirth · 2026 Jun · PMID 42271270 · Full text
BACKGROUND: Both obstructive sleep apnoea (OSA) and depressive symptoms have been independently associated with adverse perinatal outcomes. However, defining the individual contribution of each condition to adverse perin...
BACKGROUND: Both obstructive sleep apnoea (OSA) and depressive symptoms have been independently associated with adverse perinatal outcomes. However, defining the individual contribution of each condition to adverse perinatal outcomes is difficult because many pregnant women with OSA also have depressive symptoms. This observational study aimed to investigate the relationship between OSA in pregnancy and perinatal outcomes, accounting for the confounding effects of depressive symptoms. METHODS: One hundred twenty two pregnant women (≥ 26 weeks' gestation) from a tertiary maternity hospital completed overnight monitoring of oxygen saturation and airflow and reported depressive symptoms. Medical records were reviewed, and maternal and newborn outcomes recorded. Binary logistic regression assessed the association of maternal and newborn outcomes with OSA, accounting for depressive symptoms. RESULTS: Newborns of mothers with OSA had 18 times the odds of having an Apgar score of < 7 at 5 min after birth after accounting for depressive symptoms and body mass index (aOR 18.41, 95% CI 1.17-289.29). Mothers with more frequent dips in oxygenation > 3% had higher birthweight infants after accounting for BMI and depressive symptoms (β = 0.75, 95% CI 0.20-1.29; p = 0.008). Women with depressive symptoms were almost 7 times more likely to have a preterm infant (aOR 6.85, 95% CI 1.57-29.95). Maternal OSA was not associated with gestational hypertensive disorders, gestational diabetes or caesarean delivery. CONCLUSIONS: This study shows OSA relates to newborns with low Apgar scores after birth, while depressive symptoms relate to preterm birth. Considering this both psychological interventions and OSA treatment may be valuable in improving perinatal mental health and infant wellbeing.
Determinants of uterine rupture among pregnant mothers who gave birth at University of Gondar comprehensive specialized Hospital, Northwest Ethiopia: unmatched case control study.
Abate YM, Woretaw AW, Zeleke EG … +1 more , Geremew BM
BMC Pregnancy Childbirth · 2026 Jun · PMID 42271266 · Full text
BACKGROUND: Uterine rupture is a tear in the wall of the uterus that commonly occurs in its lower segment. Despite it being the most preventable obstetric complication and different interventions being done by stakeholde...
BACKGROUND: Uterine rupture is a tear in the wall of the uterus that commonly occurs in its lower segment. Despite it being the most preventable obstetric complication and different interventions being done by stakeholders, the prevalence of uterine rupture is high, and it remains one of the leading public health problems in developing countries, including Ethiopia. It is also a leading cause of severe maternal morbidity and mortality. Although risk factors for uterine rupture are context-specific, there is a lack of clarity in our context regarding the contributing factors and untoward outcomes of uterine rupture. Therefore, this study aimed to identify determinants of uterine rupture among pregnant mothers who gave birth at the University of Gondar Specialized and Comprehensive Hospital, Northwest Ethiopia. METHODS AND MATERIALS: An institutional-based unmatched case-control study was conducted on 450 women (150 cases and 300 controls) from 2018 to 2022. A data collection tool containing variables was designed to extract data from log books and client cards. Data were entered into EpiData 6.7 and exported to Stata-16 software for cleaning and analysis. In bivariate analysis, p-values < 0.2 were entered into multivariable analysis, and statistical significance was declared at p-value < 0.05 with AOR reported. RESULTS: In this study, being in a rural residence (AOR = 4.8, 95% CI: (1.15,11)), distance from the hospital (AOR = 11.2, 95% CI: (2.6,47.3)), self-referral case (AOR = 0.17, 95% CI: (0.04,0.7)), had not Antenatal Care follow-up (AOR = 3.7, 95% CI: (1.2,16)), no Cephalopelvic Disproportion (AOR = 0.01, 95% CI: (0.02,0.1)), and had not used partograph (AOR = 3.9, 95% CI: 1.2,12)) were significantly associated with uterine rupture. CONCLUSION: In this study, being a rural resident, distance from the hospital, referral from a health center, ANC follow-up, CPD, and use of a partograph were independent determinants of uterine rupture. Therefore, we provide client-centered counseling on birth preparedness and complication readiness plan and encourage women to use maternal waiting areas to avoid uterine rupture.
Application of next-generation sequencing in nonimmune hydrops fetalis and its impact on pregnancy decisions.
Qin Y, Li W, Zhu S … +12 more , Zhang S, Fang R, Kang Q, Fan L, Liu J, Li S, Wu J, Wu Y, Shi X, Feng L, Chen S, Xiao J
BMC Pregnancy Childbirth · 2026 Jun · PMID 42265713 · Full text
BACKGROUND: Nonimmune hydrops fetalis (NIHF) has a highly heterogeneous etiology, with genetic factors contributing substantially to its pathogenesis. This study aimed to investigate the chromosomal and monogenic etiolog...
BACKGROUND: Nonimmune hydrops fetalis (NIHF) has a highly heterogeneous etiology, with genetic factors contributing substantially to its pathogenesis. This study aimed to investigate the chromosomal and monogenic etiologies of NIHF. METHODS: This single-center retrospective cohort study included 121 pregnancies complicated by NIHF evaluated at a tertiary referral center between August 2020 and August 2023. All cases underwent copy number variation sequencing (CNV-seq), and 95 additionally underwent whole-exome sequencing (WES), both assays were based on next-generation sequencing (NGS) technology. Cases were stratified according to gestational age at diagnosis, maternal age, conception method, and whether NIHF was isolated or non-isolated. Genetic findings and pregnancy outcomes were analyzed and compared across subgroups, with longitudinal follow-up of pregnancy outcomes. RESULTS: Among the 121 NIHF cases, pathogenic or likely pathogenic genetic findings were identified in 62 cases, yielding an overall positivity rate of 51.2% (62/121). CNV-seq detected pathogenic abnormalities in 49 cases (40.5%, 49/121), including 38 numerical chromosomal abnormalities and 11 structural chromosomal abnormalities. Among the 95 fetuses that underwent WES, 14 had pathogenic or likely pathogenic variants, corresponding to a positivity rate of 14.7% (14/95). RASopathies (RIT1, RAF1, and BRAF) and skeletal disorders (FGFR2, COL1A1, and HSPG2) were the most frequently identified monogenic conditions. The overall genetic positivity rate was significantly higher in cases diagnosed at ≤ 13 weeks than in those diagnosed at ≥ 14 weeks (61.4% vs. 28.9%, P = 0.001), and in non-isolated NIHF compared with isolated NIHF (58.8% vs. 10.5%, P < 0.001). However, after excluding aneuploidies, no statistically significant differences were observed across clinical subgroups in the detection rates of pathogenic structural chromosomal abnormalities or WES-detected pathogenic/likely pathogenic variants. Cases with positive genetic findings had significantly more adverse pregnancy outcomes than genetically negative cases. CONCLUSION: NIHF is associated with a broad spectrum of genetic abnormalities, including aneuploidies, pathogenic structural chromosomal abnormalities, and single-gene disorders. After excluding aneuploidy, the diagnostic yields of pathogenic CNVs and WES were comparable across clinical subgroups. These findings suggest that expanded genomic testing may be valuable across the spectrum of NIHF and may help inform genetic counseling and future pregnancy planning.
Associations of physical activity during pregnancy with antenatal and postpartum depression: a systematic review and dose-response meta-analysis.
Zhang W, Yang Y, Fu Y … +7 more , Li S, Chen J, Chen Y, Wang J, Li E, Chen X, Zou Z
BMC Pregnancy Childbirth · 2026 Jun · PMID 42265669 · Full text
OBJECTIVE: To explore the dose-response associations of physical activity (PA) during pregnancy with antenatal depression (AD) and postpartum depression (PPD). METHOD: Thirteen electronic databases were searched from inc...
OBJECTIVE: To explore the dose-response associations of physical activity (PA) during pregnancy with antenatal depression (AD) and postpartum depression (PPD). METHOD: Thirteen electronic databases were searched from inception to April 8, 2026 and additionally screened references manually. Interventional and longitudinal observational studies in pregnant populations were eligible if they reported dose-response associations for PA during pregnancy in relation to AD or PPD; cross-sectional studies were excluded. Linear and nonlinear dose-response meta-analyses were conducted. RESULTS: Twenty-three studies from 10 countries involving 122,847 participants were included, comprising 5 randomized clinical trials and 18 cohort studies. In the linear dose-response meta-analysis, each 300 MET-min/wk increase in PA was associated with a 6% lower risk of AD (RR, 0.94; 95% CI, 0.90-0.97), with substantial heterogeneity (I2 = 70.6%, P < 0.001). AD also showed a significant nonlinear dose-response relationship, with the lowest risk observed at approximately 1000-2000 MET-min/wk and no evident protective association above approximately 4000 MET-min/wk. PA during pregnancy was associated with a lower risk of depression in late pregnancy, whereas the overall associations with mid-pregnancy depression and PPD were not statistically significant. CONCLUSIONS: PA during pregnancy was associated with a lower risk of AD and showed a significant nonlinear dose-response relationship, with the lowest risk observed at approximately 1000 to 2000 MET-min/wk, whereas no significant overall association was observed with PPD.
Factors influencing obstetricians' intentions to facilitate normal physiological birth: a qualitative study.
Meyer H, Lee N, George K … +1 more , Kearney L
BMC Pregnancy Childbirth · 2026 Jun · PMID 42265648 · Full text
INTRODUCTION: Spontaneous vaginal birth is the preferred mode of birth for most women, however, increasing intervention has decreased rates, especially for nulliparous women. Obstetricians are identified as key stakehold...
INTRODUCTION: Spontaneous vaginal birth is the preferred mode of birth for most women, however, increasing intervention has decreased rates, especially for nulliparous women. Obstetricians are identified as key stakeholders in intrapartum care, however very few studies have focused on the role obstetricians' intentions, attitudes and behaviours may have on mode of physiological birth. The purpose of this study was to explore factors influencing the intentions of obstetricians to facilitate normal physiological birth. METHODS: This qualitative study was underpinned by the Theory of Planned Behaviour. All participants were obstetricians, registered and practising within Australia, and had experience providing care to birthing women who met the 'selected primipara' criteria. Semi structured interviews were conducted with eight obstetricians representing various models of care across most States and Territories of Australia. Interviews were analysed using thematic analysis. RESULTS: Two key themes were identified from the data, with three sub-themes nested within each. Theme 1 identified the 'Knowledge and beliefs' influencing participants intentions to facilitate normal physiological birth, including 'Definitions and nomenclature', 'Knowledge acquisition', and 'Communication and litigation'. Theme 2 identified 'External influences' impacting participants intentions to facilitate normal physiological birth and included 'Colleagues', 'Structures - policy, resources and models of care', and 'Women and the Community'. CONCLUSIONS: While obstetricians aimed to support the enabling of normal physiological birth, their intentions were influenced by many factors. Facilitating interdisciplinary interactions and education, embedding woman-centred care and promoting midwives' autonomy and full scope of practice would further alleviate known barriers.
Early neonatal death due to prenatally undiagnosed congenital subglottic stenosis in Noonan syndrome.
Bhuwapathanapun M, Chaiyakarn S, Pongtippan A … +6 more , Arunotai S, Chaemsaithong P, Warintaksa P, Promsonthi P, Noojarern S, Wattanasirichaigoon D
BMC Pregnancy Childbirth · 2026 Jun · PMID 42265646 · Full text
INTRODUCTION: Congenital subglottic stenosis is a rare malformation of the laryngeal airway. In its severe forms, it can result in immediate neonatal respiratory failure and death if not managed emergently at birth. CASE...
INTRODUCTION: Congenital subglottic stenosis is a rare malformation of the laryngeal airway. In its severe forms, it can result in immediate neonatal respiratory failure and death if not managed emergently at birth. CASE PRESENTATION: A pregnant woman, whose fetus was suspected of having Noonan syndrome, underwent a cesarean delivery. Notably, subglottic stenosis was not detected on prenatal imaging. The neonate exhibited immediate and severe respiratory distress, and upper airway obstruction was diagnosed during neonatal resuscitation, leading to failed intubation and subsequent neonatal demise. The post-mortem examination revealed cartilaginous subglottic stenosis and type C tracheoesophageal (TE) fistula. Exome sequencing identified a de novo, c.923 A>G, PTPN11 pathogenic variant. CONCLUSION: The pitfalls in prenatal diagnosis and genetic counseling could raise awareness of possible lethal upper airway obstruction in Noonan syndrome patients. Comprehensive prenatal evaluation and diagnosis are critical to ensuring appropriate neonatal resuscitation.
Primary mediastinal large B cell lymphoma in pregnancy: a case report and review of the literature.
Wei P, Tang S, Zhang W
BMC Pregnancy Childbirth · 2026 Jun · PMID 42265636 · Full text
BACKGROUND: Primary mediastinal B-cell lymphoma (PMBCL) is a subtype of diffuse large B-cell lymphoma (DLBCL) that typically presents as a large mass originating in the mediastinum and infiltrating the surrounding organs...
BACKGROUND: Primary mediastinal B-cell lymphoma (PMBCL) is a subtype of diffuse large B-cell lymphoma (DLBCL) that typically presents as a large mass originating in the mediastinum and infiltrating the surrounding organs, resulting in pleural and pericardial effusions. The occurrence of PMBCL during pregnancy presents a significant challenge to clinical management, necessitating a comprehensive consideration of the unique risks posed to both the pregnant woman and the foetus when selecting the optimal treatment. This report presents cases of PMBCL diagnosed during late pregnancy and reviews the pertinent literature, emphasising the necessity of prompt diagnosis and the implementation of tailored management strategies for different stages of pregnancy to enhance pregnancy outcomes. CASE PRESENTATION: A 29-year-old woman with four documented pregnancies, yet no documented deliveries. At 15 weeks' gestation, the patient presented at the local hospital with a cough, which was diagnosed as an upper respiratory tract infection. She was treated with oral antibiotics; however, there was no significant improvement in her condition. During the 28th week of gestation, the patient's respiratory distress and dysphagia worsened, and she was unable to assume a recumbent position. The patient was admitted to our hospital with a computed tomography scan indicating the presence of a sizable mediastinal mass. Given the potential risks, benefits, and recent status, a decision was made to perform an emergency caesarean section. The procedure resulted in the successful delivery of the foetus, with Apgar scores of 6, 7, and 7 at 1, 5, and 10 minutes, respectively. A comprehensive examination of the neonate revealed no additional abnormalities and demonstrated normal developmental progress after a period of over four months. Following delivery, the diagnosis of PMBCL was confirmed by puncture biopsy of the mediastinal mass and PET-CT. The pregnant woman then received five doses of DA-EPOCH-R chemotherapy, resulting in a significant reduction of the mediastinal mass and remission of her symptoms. CONCLUSION: This case study illustrates the significant challenges associated with diagnosing and treating Primary mediastinal B-cell lymphoma during pregnancy. In this rare and complex case, the timing of termination of pregnancy and the choice of treatment regimen are of critical importance in order to improve maternal and infant outcomes.
Intrapartum cardiac telemetry monitoring in patients with cardiovascular disease.
Duncan ME, Valente AM, Ensing G … +7 more , Easter SR, Gauvreau K, Carabuena JM, Barker N, Economy KE, Wu FM, STORCC Investigators
BMC Pregnancy Childbirth · 2026 Jun · PMID 42265629 · Full text
BACKGROUND: There are no guidelines for cardiac telemetry monitoring during labor and delivery in patients with cardiovascular disease (CVD). We sought to identify factors influencing provider recommendations for intrapa...
BACKGROUND: There are no guidelines for cardiac telemetry monitoring during labor and delivery in patients with cardiovascular disease (CVD). We sought to identify factors influencing provider recommendations for intrapartum telemetry monitoring and associated outcomes. METHODS: This is a single-center, cohort study comparing cardiovascular outcomes during the antepartum, intrapartum, and postpartum periods between those who received telemetry and those who did not. Clinically significant arrhythmic events (CSAEs) were assessed in all patients. RESULTS: Among 717 pregnancies in patients with CVD, 94 (13.1%) had antepartum recommendations for telemetry. Type of CVD differed between those with and without telemetry recommendations (P < 0.001), with a higher proportion of individuals with arrhythmias in the recommended telemetry group. These pregnancies were also more likely to present with New York Heart Association (NYHA) Class ≥ 2 at enrollment (12.8 vs. 5.3%, P = 0.008), new antepartum arrhythmia (26.6 vs. 2.1%, P < 0.001), and greater use of beta blockers (55.3 vs. 27.9%, P < 0.001), anti-arrhythmic medications (16.0 vs. 2.1%, P < 0.001), or calcium channel blockers (8.5 vs. 2.1%, P = 0.002). Telemetry was used in 77 vaginal deliveries (10.7%) and all 261 cesarean deliveries. Only one patient monitored with telemetry experienced an intrapartum CSAE (0.3%). There were no CSAEs in patients not monitored on telemetry. CONCLUSIONS: Cardiac telemetry monitoring has a limited impact on the intrapartum management of patients with CVD. Further studies are needed to identify which patients may benefit most from intrapartum telemetry.
Maternal knowledge of neonatal danger signs and associated factors among postpartum mothers attending public health facilities in Adama town, Ethiopia.
Feyissa GD, Begashaw A, Workneh T … +2 more , Mohammed E, Endebu T
BMC Pregnancy Childbirth · 2026 Jun · PMID 42260439 · Full text
BACKGROUND: The neonatal period, defined as the first 28 days of life, remains a critical phase for child survival. According to the 2019 Ethiopian Demographic and Health Survey, the neonatal mortality rate was 33 deaths...
BACKGROUND: The neonatal period, defined as the first 28 days of life, remains a critical phase for child survival. According to the 2019 Ethiopian Demographic and Health Survey, the neonatal mortality rate was 33 deaths per 1,000 live births. Despite various interventions, neonatal mortality and morbidities related to neonatal danger signs persist. Previous studies on maternal knowledge of neonatal danger signs have reported inconsistent findings. OBJECTIVE: This study replicates established associations between maternal characteristics and neonatal danger sign knowledge in a previously unstudied urban site within Oromia, Ethiopia, and also examines how prompted recognition affects the measured prevalence of knowledge compared with spontaneous-recall approaches. METHODS: A facility-based cross-sectional study was conducted from April 1-30, 2022. A total of 426 postpartum women were selected using systematic random sampling. Data were collected through face-to-face exit interviews using a structured questionnaire. Data entry was done with EPI Info, and analysis was performed using SPSS version 26. Knowledge assessed via 9 World Health Organization (WHO) neonatal danger signs (NDS) items (prompted yes/no, mean cutoff ≥ 5 = good). Multivariable logistic regression identified factors (p < 0.05). RESULTS: 75.5% (95% CI 71.6-79.7%) had good knowledge. Factors significantly associated with good maternal knowledge include educational level of college or above [AOR: 4.83; 95% CI: 1.49, 15.64], secondary educational level [AOR: 3.10; 95% CI: 1.09, 8.78], delivery by caesarean section [AOR: 2.47; 95% CI: 1.28, 4.80], multigravida [AOR: 2.11; 95% CI: 1.26, 3.52], and grand multigravida [AOR: 3.68; 95% CI: 1.08, 12.62]. CONCLUSION: Maternal knowledge of neonatal danger signs was relatively high in this urban postnatal sample, but the estimate is influenced by the recognition-based measurement approach. The findings reinforce previously reported associations and provide context-specific evidence from Adama town to inform newborn health education.
Multilevel analysis of women's empowerment and maternal high-risk fertility behavior in Sub-Saharan Africa, 2011-2022.
Tan J, Yu ST
BMC Pregnancy Childbirth · 2026 Jun · PMID 42260438 · Full text
BACKGROUND: High-risk fertility behaviors remain a persistent public health challenge in sub-Saharan Africa, where maternal mortality and fertility rates are high. Women's empowerment is an essential factor in understand...
BACKGROUND: High-risk fertility behaviors remain a persistent public health challenge in sub-Saharan Africa, where maternal mortality and fertility rates are high. Women's empowerment is an essential factor in understanding and addressing high-risk fertility behaviors. However, previous studies have often focused on singular aspects of empowerment, such as education or decision-making authority. This study adopts a multidimensional approach to examine the association between women's empowerment and high-risk fertility behaviors across sub-Saharan Africa. METHODS: We used Demographic and Health Survey data from 29 sub-Saharan African countries collected between 2011 and 2022 (n = 179,430). Women's empowerment was measured using principal component analysis to derive three dimensions of empowerment (decision-making, attitudes toward violence, and social independence). High-risk fertility behaviors were assessed based on childbirth before age 18, short birth intervals (< 24 months), and high birth parity (≥ 4 births). We used multilevel regressions to examine the association between empowerment dimensions and high-risk fertility behaviors while accounting for country-specific effects and controlling for potential determinants and risk factors. RESULTS: Across the study population, substantial variation in women's empowerment dimensions was observed across countries and population subgroups. Multilevel analyses showed significant associations between each empowerment dimension and reduced probabilities of engaging in high-risk fertility behaviors. For example, a one standard deviation increase in social independence was associated with lower odds of early childbirth (OR = 0.534; CI = 0.502-0.567), short birth intervals (OR = 0.796; CI = 0.761-0.832), and high birth parity (OR = 0.560; CI = 0.532-0.590). Similar negative associations were observed for the decision-making and attitudinal dimensions. These associations appeared strongest for high-risk behaviors occurring earlier in women's reproductive lives. CONCLUSIONS: The findings highlight the importance of women's empowerment in reducing high-risk fertility behaviors across multiple dimensions and life stages, providing insights for potential policy interventions targeted at gender-based factors contributing to high-risk fertility behaviors to improve the region's maternal and child health outcomes.
Barriers to compliance with hepatitis B vaccination: sociocultural and socioeconomic perspectives of pregnant women in the Bono East Region of Ghana.
Bardoe D, Bio RB, Hayford D … +2 more , Yar DD, Bardoe SA
BMC Pregnancy Childbirth · 2026 Jun · PMID 42260434 · Full text
BACKGROUND: Non-compliance with hepatitis B virus (HBV) vaccination among pregnant women poses a significant challenge to maternal health, particularly due to the risk of vertical transmission. Understanding the factors...
BACKGROUND: Non-compliance with hepatitis B virus (HBV) vaccination among pregnant women poses a significant challenge to maternal health, particularly due to the risk of vertical transmission. Understanding the factors influencing non-compliance is essential for contextualising patterns of HBV vaccination uptake and the risk of infection. This study, therefore, investigated the sociocultural and socioeconomic barriers to compliance with HBV vaccination among pregnant women in the Bono East Region of Ghana. METHODS: This was a hospital-based cross-sectional study that employed the mixed method approach. A serological screening, a closed-ended questionnaire, in-depth interviews (IDIs), and focus group discussions (FGDs) were used to collect data from 1430 pregnant women. Quantitative data were analysed with the Software Package for Social Sciences (SPSS) version 25 (IBM, USA). Logistic regression was performed to compute the odds ratios and identify the barriers that were significantly associated with HBV. Thematic analysis was used to analyse qualitative data, with a focus on four steps: transcription, profiling, coding, and thematic framework. RESULTS: The prevalence of HBV infection among pregnant women was 1.8% (95% CI: 1.24-2.65). The majority of participants (74.34%) reported not taking the HBV vaccine or not completing the full vaccination regimen. Several sociocultural and socioeconomic factors were qualitatively reported as reasons for non-compliance. These included spiritual beliefs, fear of divine punishment, concerns about becoming a burden to family members, perceived cost of interventions, and time constraints. In the multivariate analysis, pregnant women who cited belief in spiritual poisoning as a reason for non-compliance had significantly higher odds of HBV infection (aOR = 8.79; 95% CI: 3.57-13.63; p < 0.001). Concern about being a burden to family members (aOR = 2.73; 95% CI: 1.03-7.21; p = 0.042) and perceived cost of intervention (aOR = 5.86; 95% CI: 1.13-9.26; p = 0.034) were also associated with increased odds of HBV infection. CONCLUSION: This study sheds light on the various sociocultural and socioeconomic barriers to compliance with HBV vaccination. This highlights the complexity involved in promoting essential interventions among pregnant women. Addressing these challenges requires collaborative efforts to promote responsiveness, improve healthcare accessibility, enhance health education, and strengthen community support systems.
Identification of risk factors for postpartum pelvic floor dysfunction in a Chinese population: a retrospective study.
Yan Y, Pan X, Lv W … +2 more , Shuai X, Cao Y
BMC Pregnancy Childbirth · 2026 Jun · PMID 42260431 · Full text
OBJECTIVE: To identify risk factors for postpartum pelvic floor dysfunction (PFD) diagnosed at 6 weeks after delivery in a Chinese population. METHODS: This retrospective study examined data from 828 postpartum women in...
OBJECTIVE: To identify risk factors for postpartum pelvic floor dysfunction (PFD) diagnosed at 6 weeks after delivery in a Chinese population. METHODS: This retrospective study examined data from 828 postpartum women in China, collected from January 2020 to August 2021. Multivariate analyses were employed to identify factors associated with six outcomes of PFD, including anterior vaginal wall prolapse, posterior vaginal wall prolapse, uterine prolapse, stress urinary incontinence (SUI), and impaired type I and type II muscle fiber strength. RESULTS: A series of factors are considered to be associated with PFD. Cesarean delivery significantly reduced severe anterior vaginal wall prolapse risk (OR=0.426, P＜0.001). Age, overweight (BMI ≥24.9 kg/m²), macrosomia (birth weight ≥4000g), forceps-assisted delivery, and constipation significantly increased risks of anterior and posterior vaginal wall prolapse, uterine prolapse, and SUI (all OR>1, P<0.05). Twin pregnancy reduced type I (OR=0.430, P=0.013) and type II (OR=0.385, P=0.009) muscle fiber strength but increased risks of anterior vaginal wall prolapse, uterine prolapse, and SUI. Higher parity (two or more) was correlated with higher risks of anterior (OR=2.402, P<0.001) and posterior vaginal wall prolapse (OR=2.977, P=0.0003) and SUI (OR=1.726, P=0.001). Heavy physical labor was strongly associated with posterior vaginal wall prolapse (OR=6.285, P=0.008), uterine prolapse (OR=5.264, P=0.009), and SUI (OR=3.987, P=0.024). Underweight status (BMI<18.5 kg/m²) significantly increased risks of impaired type I (OR=0.173, P<0.001) and type II muscle fiber strength (OR=0.197, P=0.0003). CONCLUSION: This study identified significant PFD risk factors in a Chinese population, highlighting the importance of targeted prenatal, perinatal, and postpartum care to mitigate these risks. In addition to uncontrollable factors like mode of delivery, age, and parity, interventions targeting weight gain and fetal macrosomia during pregnancy and appropriate assisted delivery could mitigate the risks of PFD. Educational programs for pregnant women should emphasize a proper diet and lifestyle. For women with chronic constipation, clinical treatment should be carried out as soon as possible to avoid further aggravating the damage to the pelvic floor muscles.
Translation and evaluation of the Perinatal Grief Intensity Scale in Kenya and Uganda.
Nabisere A, Wakasiaka S, Dodd J … +5 more , Byrne-Davis L, Lesosky M, Lavender T, Mills TA, Ayebare E
BMC Pregnancy Childbirth · 2026 Jun · PMID 42260428 · Full text
BACKGROUND AND AIM: Stillbirth or neonatal death are distressing life experiences for parents. In many sub-Saharan African countries, bereavement care and support are inadequate. Context-appropriate interventions are nee...
BACKGROUND AND AIM: Stillbirth or neonatal death are distressing life experiences for parents. In many sub-Saharan African countries, bereavement care and support are inadequate. Context-appropriate interventions are needed to improve perinatal bereavement care. To assess whether these interventions work, reliable assessment tools are required. This study aimed to translate and evaluate the Perinatal Grief Intensity Scale [PGIS] for use among bereaved women in Kenya and Uganda. METHODS: A mixed-methods study, involving cross cultural translation, adaptation and psychometric evaluation in Kenya and Uganda. The PGIS was translated into Kiswahili and Luganda with input from community engagement groups and stakeholders. Pilot-testing was conducted in 2 stages; 'Think aloud' interviews (n = 16) and test-retest (n = 20). The finalised tools were tested with 160 women who had experienced stillbirth or neonatal death, 20 in the test-retest phase and 140 in wider testing. Analyses included test-retest reliability, internal consistency and exploratory associations with participant characteristics using single variable linear regression. RESULTS: Agreed translations of the PGIS in Kiswahili and Luganda were produced. In pilot testing, test-retest consistency was high with an intraclass correlation coefficient of 0.840 (95% CI, 0.590-0.937). Wider testing demonstrated acceptable internal consistency, Cronbach's alpha of the total PGIS score was 0.737, confirming overall reliability, with similar results in the pilot testing and wider testing subgroups. Single variable linear regression showed that PGIS scores were higher for women in Uganda (coefficient 0.123, 95% Confidence Interval (CI) 0.042 to 0.205, p value = 0.003) compared to Kenya, and higher for caesarean births (coefficient 0.113, 95% CI 0.014 to 0.211, p value = 0.025) compared to vaginal births. CONCLUSION: Preliminary evaluation of the Kiswahili and Luganda versions of the PGIS demonstrated good reliability for use in Kenya and Uganda. The tools have potential for future use in research to assess the impact of bereavement care interventions and in clinical practice to identify women who would benefit from increased bereavement support. Further assessments, including factor analyses and predictive performance are required to establish validity in this context.
Antenatal care utilisation among pregnant adolescents in urban Ghana: a qualitative study of individual, family and health system influences.
Opoku-Mensah K, Blankson NA, Ayimbila EA … +1 more , Glozah F
BMC Pregnancy Childbirth · 2026 Jun · PMID 42260423 · Full text
BACKGROUND: Adolescent pregnancy remains an important public health concern in Ghana and other low- and middle-income settings. Pregnant adolescents often initiate antenatal care later than recommended or attend irregula...
BACKGROUND: Adolescent pregnancy remains an important public health concern in Ghana and other low- and middle-income settings. Pregnant adolescents often initiate antenatal care later than recommended or attend irregularly, increasing the risk of adverse maternal and newborn outcomes. While determinants of antenatal care use have been widely studied, less is known about how individual, family, and health system factors interact to shape adolescents' care seeking experiences. This study explored influences on antenatal care utilisation among pregnant adolescents in an urban municipality in southern Ghana. METHODS: A qualitative descriptive study was conducted in the La Nkwantanang Madina Municipality in the Greater Accra Region of Ghana. Data were collected through in-depth interviews, focus group discussions, and key informant interviews with pregnant adolescents, caregivers, midwives, and community members. Interviews were conducted in English or Twi, audio recorded, transcribed verbatim, and analysed thematically. RESULTS: Forty-two participants were included: 15 pregnant adolescents, 6 caregivers, 5 midwives, and 16 community members. Three interrelated themes shaped antenatal care utilisation: individual influences, family influences, and health system influences. Delayed pregnancy recognition, stigma, and financial constraints contributed to late initiation of care. Family responses, including support or disapproval, influenced attendance patterns. Health system factors such as provider attitudes, waiting time, privacy concerns, and out of pocket costs also shaped utilisation, although supportive care experiences encouraged continued attendance. CONCLUSION: Antenatal care utilisation among pregnant adolescents is shaped by interacting individual, family, and health system influences. Strengthening adolescent responsive services, supportive family engagement, and reducing structural barriers may improve timely and consistent antenatal attendance.
Exploring the prevalence of gestational diabetes mellitus and associated factors among pregnant women attending tertiary antenatal hospitals in Bangladesh: a cross-sectional survey-based approach.
Tasnim M, Tasnim NT, Sultana A … +2 more , Deen NS, Haque FKM
BMC Pregnancy Childbirth · 2026 Jun · PMID 42260421 · Full text
BACKGROUND: Gestational diabetes mellitus (GDM) is a form of hyperglycemia which is first diagnosed during pregnancy. South Asian women show a higher prevalence of GDM, which has been associated with both genetic and lif...
BACKGROUND: Gestational diabetes mellitus (GDM) is a form of hyperglycemia which is first diagnosed during pregnancy. South Asian women show a higher prevalence of GDM, which has been associated with both genetic and lifestyle factors. OBJECTIVES: This survey-based cross-sectional study aimed to estimate the prevalence of GDM among pregnant women attending tertiary healthcare facilities for antenatal care and to identify factors independently associated with GDM. METHODS: A total of 250 pregnant women at 18-40 weeks of gestation attending tertiary healthcare facilities in the Dhaka, Chattogram, and Mymensingh divisions were selected using a non-probability consecutive sampling approach. Data were collected using a structured questionnaire covering demographic, obstetric, clinical, and lifestyle factors after obtaining informed consent from all participants. GDM status was determined based on a one-step 75 g OGTT test in accordance with national and WHO criteria. RESULTS: The prevalence of GDM was 14% in this study. Fisher's exact test and Chi-square test were used for initial comparisons. Univariate and multivariate logistic regression were performed to estimate crude odds ratios (cOR) and adjusted odds ratios (aOR) with 95% confidence intervals (95% CI) for factors associated with GDM. In the adjusted analysis, obesity class II (aOR: 9.929, 95% CI: 1.174-83.983, p = 0.035) and obesity class III (aOR: 26.945, 95% CI: 1.101-659.624, p = 0.044) were significantly associated with increased odds of GDM. However, the wide confidence intervals suggest limited precision of these estimates. Parental history of diabetes (aOR: 3.079, 95% CI: 1.275-7.432, p = 0.012), betel quid chewing (aOR: 2.689, 95% CI: 1.010-7.160, p = 0.048), and sugar-sweetened beverage intake (aOR: 3.827, 95% CI: 1.649-8.880, p = 0.002) were also significantly associated with increased odds of GDM. In contrast, maternal age (aOR: 0.996, 95% CI: 0.911-1.088, p = 0.922), pre-obesity (aOR: 2.238, 95% CI: 0.461-10.864, p = 0.317), obesity class I (aOR: 4.515, 95% CI: 0.921-22.139, p = 0.063) and oral contraceptive use (aOR: 2.136, 95% CI: 0.871-5.240, p = 0.097) were not significantly associated with GDM after adjustment. The first pregnancy was associated with lower odds of GDM in the crude analysis; however, this association was no longer statistically significant after adjustment (aOR: 0.382, 95% CI: 0.118-1.241, p = 0.110). CONCLUSION: These findings highlight the multifactorial nature of GDM, with both genetic susceptibility and modifiable lifestyle behaviours contributing to its development. Targeted awareness initiatives focusing on dietary behaviours, particularly reducing the consumption of sugar-sweetened beverages, may be beneficial in similar populations, alongside early screening of women with a family history of diabetes.
Navigating complexity: understanding the experiences, motivations and challenges of conducting research with perinatal individuals who use opioids and other substances.
Edwards RC, Shah SK, Sinche BK … +8 more , Ahrenholtz R, Cao Q, Davis TJ, Blum AL, Premkumar A, Norton ES, Massey SH, Wakschlag LS
BMC Pregnancy Childbirth · 2026 Jun · PMID 42260419 · Full text
BACKGROUND: Despite increased opioid use (OU) among individuals of child-bearing age, pregnant and postpartum individuals with OU, and the experiences of these individuals and scientists with related expertise, are notab...
BACKGROUND: Despite increased opioid use (OU) among individuals of child-bearing age, pregnant and postpartum individuals with OU, and the experiences of these individuals and scientists with related expertise, are notably absent in scientific literature and discourse. The HEALthy Brain and Child Development (HBCD) Study, a large, longitudinal, U.S.-based consortium project, aims to understand how brain and child development is shaped by various adversities and protective factors, including prenatal exposure to opioids and other substances. Given the persistent challenges of engaging pregnant and postpartum individuals with OU in longitudinal research, this qualitative study, conducted during the pilot phase of HBCD, aimed to better understand barriers, motivators, and best practices to recruitment and retention of this underrepresented population. METHODS: Participants included perinatal individuals with opioid use disorder (OUD) (n = 6) and researchers with expertise in perinatal substance use (n = 22). Semi-structured interviews were conducted and thematically analyzed to identify effective strategies for recruitment, engagement, and retention in longitudinal research. Knowledge and comfort with neurodevelopmental research procedures was also explored. RESULTS: Key themes emerging from both participant groups included the centrality of trust and nonjudgmental relationships between research teams and participants, transparency about research aims and procedures, and meaningful connections to emotional, educational, and logistical supports. Respondents emphasized the value of research staff continuity, flexible study designs, and opportunities for participants to share their stories and receive feedback. Although participants generally expressed comfort with infant neuroimaging and biospecimen collection, misunderstandings about these methods underscored the need for thorough, accessible education. CONCLUSIONS: Findings highlight the importance of responsive, ethically grounded research practices to strengthen research on opioid use in a manner responsive to the needs of affected populations. Successful engagement requires creative and adaptable study designs, ancillary supports, and research staff who foster trusting relationships and help participants feel heard and valued.
Predictors of male partners' behavioral intentions and cognitive readiness toward maternal health service utilization in rural Tanzania: an application of the theory of planned behavior.
Moshi FV, Millanzi WC
BMC Pregnancy Childbirth · 2026 Jun · PMID 42260413 · Full text
BACKGROUND: Men are not only heads and decision-makers in most families, but they also heavily influence the healthcare access of their female partners and/or children. However, low male spousal accompaniment at health f...
BACKGROUND: Men are not only heads and decision-makers in most families, but they also heavily influence the healthcare access of their female partners and/or children. However, low male spousal accompaniment at health facilities remains a persistent public health challenge in rural Tanzania. While structural barriers are well documented, there is a lack of evidence regarding the behavioral intention factors that drive this men's physical disengagement from clinical spaces. Understanding these internal drivers is critical for designing effective targeted interventions to improve maternal service utilization in rural settings. Applying the Theory of Planned Behavior (TPB), this study assessed the predictors of male partners' behavioral intentions and cognitive readiness toward spousal accompaniment in maternal health service utilization in rural Tanzania. METHODS: A baseline community-based assessment from a longitudinal interventional study was adopted to evaluate 546 randomly selected male partners from June to October 2017 was conducted using a quantitative research approach. A multi-stage sampling technique was employed to select participants. While male accompaniment broadly encompasses emotional and domestic support, this study specifically operationalized male spousal accompaniment as men's physical accompaniment of their expectant mothers to the health facility for clinical maternal health services. Data were analyzed using IBM SPSS version 25. Bivariate and multivariable logistic regression analyses were performed to identify independent predictors (α = 0.05). RESULTS: Participants' mean age was 31 ± 7.726 years, and 71.8% were married. Findings revealed that 61.7% of male partners had never physically accompanied their spouses to health facilities for maternal services. High rates of negative behavioral constructs were observed, with 59.0%, 57.0%, and 57.0% of male partners reporting negative attitudes, demonstrating negative perceived subjective norms, and negative perceived behavior control, respectively. Multivariable analysis showed that positive attitude (AOR = 3.616; p < 0.05; 95%CI: 1.333, 6.138), positive perceived subjective norms (AOR = 2.374; p < 0.05; 95%CI: 1.669, 5.984), and positive perceived behavioral control (AOR = 1.759; p < 0.05; 95%CI: 1.004, 4.373) were significantly associated with increased prospective intention to accompany partners to care. CONCLUSION: A significant proportion of male partners in rural Tanzania remain physically disengaged from clinical maternal spaces, driven primarily by negative cognitive constructs and traditional social norms that designate pregnancy care as an exclusively female domain. Policy and programmatic actions should prioritize community-based social and behavior change communications (SBCC) that challenge restrictive subjective norms, foster joint family decision-making, and reshape male attitudes toward spousal accompaniment.
Association of pre-pregnancy abnormal glucose metabolism and insulin resistance with assisted reproductive technology outcomes and pregnancy complications in women with PCOS: a retrospective propensity score matching study.
Shen X, Zou J, Song J … +1 more , Gui J
BMC Pregnancy Childbirth · 2026 Jun · PMID 42260412 · Full text
BACKGROUND: Polycystic ovary syndrome (PCOS) is frequently accompanied by insulin resistance (IR) and abnormal glucose metabolism, impairing fertility and pregnancy outcomes. This retrospective study aimed to investigate...
BACKGROUND: Polycystic ovary syndrome (PCOS) is frequently accompanied by insulin resistance (IR) and abnormal glucose metabolism, impairing fertility and pregnancy outcomes. This retrospective study aimed to investigate their associations with assisted reproductive technology (ART) outcomes and pregnancy complications in women with PCOS. METHODS: This retrospective study enrolled 1815 women with PCOS who underwent ART at Renmin Hospital of Wuhan University from January 2019 to January 2025. Patients were stratified into two groups according to pre-pregnancy glucose and insulin status: a study group with abnormal glucose metabolism or IR, and a control group with neither condition. Propensity score matching (PSM) was performed to balance baseline characteristics. Multivariate logistic regression was used to screen factors associated with live birth, preterm birth, gestational diabetes mellitus (GDM), and pregnancy-induced hypertension (PIH). A multivariate exploratory prediction model and receiver operating characteristic (ROC) curve were constructed to preliminarily evaluate the predictive efficacy and discriminative performance for GDM and PIH. RESULTS: After PSM, the study group had a significantly lower live birth rate and a higher miscarriage rate than the control group (both P < 0.001). Pre-pregnancy abnormal glucose metabolism/IR emerged as an independent associated factor of reduced live birth (OR = 0.551). For preterm birth, female age (OR = 0.843), GDM (OR = 2.789), and the number of embryos transferred (OR = 2.174) were identified as independent associated factors. Female age (OR = 1.305) and fasting plasma glucose (FPG) (OR = 1.865) were significant associated indicators of GDM, while body mass index (BMI) (OR = 1.506), embryo transfer type (OR = 6.406), and FPG (OR = 2.224) were associated with PIH. Two preliminary exploratory multivariate prediction models for GDM (AUC = 0.746 pre-PSM, 0.712 post-PSM) and PIH (AUC = 0.741 pre-PSM, 0.711 post-PSM) showed moderate cohort-specific predictive efficacy for the respective complications. CONCLUSION: Pre-pregnancy abnormal glucose metabolism or IR is independently associated with adverse ART and pregnancy outcomes in women with PCOS, including increased miscarriage risk, reduced live birth rate, and elevated odds of GDM. We identified distinct independent associated factors for live birth, preterm birth, GDM, and PIH. Furthermore, we developed preliminary exploratory multivariate prediction models for GDM and PIH. These models demonstrated moderate discriminative ability in our cohort but require external validation before any clinical application can be considered.
Impact of COVID-19 infection on gamete quality and embryo development and in subsequent pregnancy of patients undergoing ART.
Zhang XJ, Meng XQ, Huang JH … +9 more , Wan Q, Zhang B, Wen ZN, Sun Q, Huang J, Zhou JM, Lei P, Wang Q, Han TT
BMC Pregnancy Childbirth · 2026 Jun · PMID 42260410 · Full text
BACKGROUND: Coronavirus Disease 2019 (COVID-19 ) was a public health concern from 2019 through to 2022. It was assumed that Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)-the virus responsible for COVID-19-...
BACKGROUND: Coronavirus Disease 2019 (COVID-19 ) was a public health concern from 2019 through to 2022. It was assumed that Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)-the virus responsible for COVID-19-could infect human ovaries and cross the blood-testis barrier. Nonetheless, the impact of COVID-19 infection on gamete quality, embryonic development, and pregnancy is yet to be reported, forming the basis of this study. METHOD: This case-control study, conducted at Sichuan Jinxin Xi'nan Women's and Children's Hospital from December, 2020 to July, 2023, aimed to explore the impact of SARS-CoV-2 on gamete quality, embryo development and subsequent pregnancy in patients undergoing artificial reproductive technology (ART). The participants included ten female (average age 30.7 ± 4.11years ) and eight male (average age 32.13 ± 4.45 years) COVID-19 patients, along with their COVID-19 negative spouses. All female patients underwent ovarian stimulation for In Vitro Fertilization (IVF) and frozen-thawed embryo transfer (FET). The control group comprised 16 healthy couples who underwent ART procedures matched on the criteria: age, body mass index (BMI), infertility etiology, infertility and treatment duration, serum follicle-stimulating hormone (FSH) and anti-Mullerian hormone (AMH) levels, antral follicle count (AFC), initial gonadotropin (Gn) dosage, duration of Gn administration and total Gn dose. Semen and follicular fluid samples were analyzed for SARS-CoV-2 RNA using Real-time Fluorescent Quantitative Polymerase Chain Reaction (RT-qPCR) assay. The sperm parameters, fertilization, cleavage and blastulation rates were compared between the groups, and follow-up data collected during was statistically analyzed. RESULTS: The COVID-19-positive patients and controls were comparable in average age. Furthermore, no SARS-CoV-2 RNA was detected in semen or follicular fluid samples from affected patients. There were also no statistically significant differences between the control and test groups in sperm parameters, as well as fertilization, cleavage, and blastulation rates (P>0.05). Nonetheless, COVID-19 patients still exhibited a declining trend. Moreover, although the clinical pregnancy rate between male COVID-19 patients and controls was statistically significant (P=0.034), no statistical significance was observed in the difference between female COVID-19 patients and controls (P>0.05), albeit with a declining tendency. CONCLUSION: We found that COVID-19 infections could negatively influence gamete quality, embryonic development, and clinical pregnancy. We hope that our findings will greatly inform future studies on the impact of COVID-19 infections on fertility in SARS-CoV-2-infected patients.
Postpartum ovarian vein thrombosis: plain CT with clinical indicators-diagnostic performance and clinical application.
Zeng W, Qian Y, Peng J … +2 more , Song T, Zhang J
BMC Pregnancy Childbirth · 2026 Jun · PMID 42260408 · Full text
BACKGROUND: Postpartum ovarian vein thrombosis (POVT) is a rare but serious condition, often presenting with nonspecific symptoms and potentially leading to life-threatening complications such as pulmonary embolism. The...
BACKGROUND: Postpartum ovarian vein thrombosis (POVT) is a rare but serious condition, often presenting with nonspecific symptoms and potentially leading to life-threatening complications such as pulmonary embolism. The utility of plain computed tomography (CT) in POVT remains unexplored. METHODS: We retrospectively analyzed 25 POVT patients and 27 postpartum controls with fever or abdominal pain. CT parameters, including plain and enhanced thrombus CT values and their ratios to the inferior vena cava (IVC), along with clinical markers, were measured and compared. Random forest models were constructed for discrimination and identifying concurrent thrombosis. RESULTS: Compared to controls, POVT patients showed significantly higher plain thrombus CT value (P-CT) and P-CT ratio, and lower enhanced thrombus CT value (E-CT) and E-CT ratio (all P < 0.001). ROC analysis demonstrated good discrimination performance for plain CT parameters (AUC: 0.773 for P-CT). For identifying concurrent thrombosis in other organs, D-dimer (AUC: 0.813) and P-CT (AUC: 0.807) were effective predictors. In repeated cross‑validation, the random forest models achieved mean AUCs of 0.94 (95% CI: 0.54-1.00) for classifying POVT and 0.82 (95% CI: 0.00-1.00) for identifying concurrent thrombosis. CONCLUSIONS: Plain CT can serve as a valuable initial screening tool for POVT. The integration of imaging and clinical parameters through machine learning models showed encouraging but preliminary discriminative ability (mean AUC 0.94 and 0.82, respectively), though with notable instability reflecting the modest sample size. These models may aid in early identification but require external validation.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe