Background: Various techniques have been proposed to predict and evaluate the timing and conditions of childbirth in pregnant women at different stages of pregnancy. Providing precise methods for forecasting childbirth status can reduce the burden on the healthcare system. This study aimed to evaluate the predictive value of transvaginal sonography of cervical length (CL) and cervical angle (CA) on full-term delivery outcomes.
Methods: This cohort study analyzed 151 pregnant women between 37 and 42 weeks of gestational age who were treated at Rasoul Akram Hospital affiliated with Iran University of Medical Sciences from June 2023 to January 2024. All Participants received transvaginal examinations. This study evaluated the accuracy of CL and CA by transvaginal sonography in predicting outcomes like vaginal delivery, cesarean section, necessity for labor induction, and the rate of Premature Rupture of Membranes (PROM). The study used the Receiver Operating Characteristic (ROC) curve to determine the optimal cutoff for predicting birth outcomes.
Results: The mean age of the pregnant women was 28.9 ± 4.22 years, while the average duration of pregnancy was 39.8 ± 2.11 weeks. Cesarean delivery was performed on 45 individuals (29.8%) and 106 (70.1%) underwent vaginal delivery. The mean CL overall stood at 21.2 ± 6.4 mm. PROM was observed in 41 cases (27.1%) among full-term pregnancies. A significant difference was noted in mean CL between the cesarean and vaginal delivery groups (24.2 ± 2.4 vs. 20.1 ± 2.1 mm, p = 0.001). The predictive value of a CL measuring 21 mm for cesarean delivery was 72.2% sensitive and 79.1% specific. Similarly, a CL of 22 mm showed 66.6% sensitivity and 80.2% specificity for labor induction. Regarding PROM in full-term pregnancies, a CL assessment demonstrated 59.8% sensitivity and 69.1% specificity. Finally, a CA of 115.2° exhibited 70.3% sensitivity and 78.4% specificity in predicting vaginal delivery.
Conclusion: The present study showed that evaluating CL and CA via transvaginal sonography demonstrated adequate diagnostic accuracy in predicting spontaneous birth, need for labor induction, cesarean delivery, and incidence of PROM in full-term pregnant women. This method is suggested to be an accurate and appropriate way to predict delivery results.
{"title":"The predictive value of transvaginal cervical length and cervical angle ultrasonography in term delivery outcomes: a cohort study.","authors":"Ghazal Tajeran, Roya Derakhshan, Fatemeh Jayervand, Maryam Rahimi, Parisa Hajari, Neda Hashemi","doi":"10.1080/14767058.2024.2406344","DOIUrl":"https://doi.org/10.1080/14767058.2024.2406344","url":null,"abstract":"<p><strong>Background: </strong>Various techniques have been proposed to predict and evaluate the timing and conditions of childbirth in pregnant women at different stages of pregnancy. Providing precise methods for forecasting childbirth status can reduce the burden on the healthcare system. This study aimed to evaluate the predictive value of transvaginal sonography of cervical length (CL) and cervical angle (CA) on full-term delivery outcomes.</p><p><strong>Methods: </strong>This cohort study analyzed 151 pregnant women between 37 and 42 weeks of gestational age who were treated at Rasoul Akram Hospital affiliated with Iran University of Medical Sciences from June 2023 to January 2024. All Participants received transvaginal examinations. This study evaluated the accuracy of CL and CA by transvaginal sonography in predicting outcomes like vaginal delivery, cesarean section, necessity for labor induction, and the rate of Premature Rupture of Membranes (PROM). The study used the Receiver Operating Characteristic (ROC) curve to determine the optimal cutoff for predicting birth outcomes.</p><p><strong>Results: </strong>The mean age of the pregnant women was 28.9 ± 4.22 years, while the average duration of pregnancy was 39.8 ± 2.11 weeks. Cesarean delivery was performed on 45 individuals (29.8%) and 106 (70.1%) underwent vaginal delivery. The mean CL overall stood at 21.2 ± 6.4 mm. PROM was observed in 41 cases (27.1%) among full-term pregnancies. A significant difference was noted in mean CL between the cesarean and vaginal delivery groups (24.2 ± 2.4 vs. 20.1 ± 2.1 mm, <i>p</i> = 0.001). The predictive value of a CL measuring 21 mm for cesarean delivery was 72.2% sensitive and 79.1% specific. Similarly, a CL of 22 mm showed 66.6% sensitivity and 80.2% specificity for labor induction. Regarding PROM in full-term pregnancies, a CL assessment demonstrated 59.8% sensitivity and 69.1% specificity. Finally, a CA of 115.2° exhibited 70.3% sensitivity and 78.4% specificity in predicting vaginal delivery.</p><p><strong>Conclusion: </strong>The present study showed that evaluating CL and CA via transvaginal sonography demonstrated adequate diagnostic accuracy in predicting spontaneous birth, need for labor induction, cesarean delivery, and incidence of PROM in full-term pregnant women. This method is suggested to be an accurate and appropriate way to predict delivery results.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-08-29DOI: 10.1080/14767058.2024.2395490
Qian Chen, Huihao Zhou, Yiqin Hu, Jingui Xue
Objective: To compare the efficacy of simultaneous and sequential administration of oxytocin and intrauterine balloons in labor induction.
Methods: The databases of Cochrane Library, Web of Science, PubMed, ClinicalTrials.gov, and Embase were thoroughly searched from their inception to November 2023. Randomized controlled trials (RCTs) investigating the simultaneous and sequential use of oxytocin and intrauterine balloons for labor induction in pregnancy were included. The meta-analysis was performed using RevMan 5.3 statistical software. Heterogeneity among the selected studies was evaluated using the I2 statistic. Dichotomous outcomes were estimated using relative risk (RR) with corresponding 95% confidence intervals (CI), while continuous outcomes were measured as the mean difference (MD).
Results: A total of eight studies, involving a total of 1,315 nulliparous and multiparous women with an unfavorable cervix, were included in the systematic review. Moreover, a subgroup analysis was conducted, separately evaluating nulliparous and multiparous women. Compared with the sequential groups, simultaneous use of oxytocin and intrauterine balloons resulted in a significantly higher rate of delivery within 24h in nulliparas (RR = 1.30, 95%CI:1.04, 1.63, p = 0.02), a higher rate of vaginal delivery within 24h in multiparas (RR = 1.32, 95%CI:1.15,1.51, p < 0.00001), a superior rate of delivery within 12h and a shorter time to delivery in both nulliparas and multiparas. No statistically significant differences were observed in cesarean delivery and maternal and neonatal adverse outcomes between the sequential and simultaneous groups.
Conclusions: These findings provide support for the simultaneous use of intrauterine balloons and oxytocin during labor induction in nulliparous women. Additionally, this approach may also prove beneficial for multiparas.
{"title":"Which approach is better for labor induction: simultaneous or sequential administration of oxytocin and intrauterine balloon-a systematic review and a meta-analysis.","authors":"Qian Chen, Huihao Zhou, Yiqin Hu, Jingui Xue","doi":"10.1080/14767058.2024.2395490","DOIUrl":"10.1080/14767058.2024.2395490","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy of simultaneous and sequential administration of oxytocin and intrauterine balloons in labor induction.</p><p><strong>Methods: </strong>The databases of Cochrane Library, Web of Science, PubMed, ClinicalTrials.gov, and Embase were thoroughly searched from their inception to November 2023. Randomized controlled trials (RCTs) investigating the simultaneous and sequential use of oxytocin and intrauterine balloons for labor induction in pregnancy were included. The meta-analysis was performed using RevMan 5.3 statistical software. Heterogeneity among the selected studies was evaluated using the <i>I<sup>2</sup></i> statistic. Dichotomous outcomes were estimated using relative risk (RR) with corresponding 95% confidence intervals (CI), while continuous outcomes were measured as the mean difference (MD).</p><p><strong>Results: </strong>A total of eight studies, involving a total of 1,315 nulliparous and multiparous women with an unfavorable cervix, were included in the systematic review. Moreover, a subgroup analysis was conducted, separately evaluating nulliparous and multiparous women. Compared with the sequential groups, simultaneous use of oxytocin and intrauterine balloons resulted in a significantly higher rate of delivery within 24h in nulliparas (RR = 1.30, 95%CI:1.04, 1.63, <i>p</i> = 0.02), a higher rate of vaginal delivery within 24h in multiparas (RR = 1.32, 95%CI:1.15,1.51, <i>p</i> < 0.00001), a superior rate of delivery within 12h and a shorter time to delivery in both nulliparas and multiparas. No statistically significant differences were observed in cesarean delivery and maternal and neonatal adverse outcomes between the sequential and simultaneous groups.</p><p><strong>Conclusions: </strong>These findings provide support for the simultaneous use of intrauterine balloons and oxytocin during labor induction in nulliparous women. Additionally, this approach may also prove beneficial for multiparas.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-06-16DOI: 10.1080/14767058.2024.2355495
Jee Yoon Park, Kyong-No Lee, Hyeon Ji Kim, Kiroong Choe, Aeri Cho, Bohyoung Kim, Jinwook Seo, Hayan Kwon, Jong Woon Kim, Jin-Gon Bae, Ji-Hee Sung, Se Jin Lee, Young Mi Jung, You Jung Han, Subeen Hong, Jin-Hoon Chung, Hye-Sung Won, Jong Kwan Jun
Objectives: To determine the effects of cerclage on twin pregnancies.
Methods: A multicenter, retrospective, cohort study was conducted at 10 tertiary centers using a web-based data collection platform. The study population included twin pregnancies delivered after 20 weeks of gestation. Patients with one or two fetal deaths before 20 weeks of gestation were excluded. Maternal characteristics, including prenatal cervical length (CL) and obstetric outcomes, were retrieved from the electronic medical records.
Results: A total of 1,473 patients had available data regarding the CL measured before 24 weeks of gestation. Seven patients without CL data obtained prior to cerclage were excluded from the analysis. The study population was divided into two groups according to the CL measured during the mid-trimester: the CL ≤2.5 cm group (n = 127) and the CL >2.5 cm group (n = 1,339). A total of 127 patients (8.7%) were included in the CL ≤2.5 cm group, including 41.7% (53/127) who received cerclage. Patients in the CL >2.5 cm group who received cerclage had significantly lower gestational age at delivery than the control group (hazard ratio (HR): 1.8; 95% confidence interval (CI): 1.11-2.87; p = .016). Patients in the CL ≤2.5 cm group who received cerclage had a significantly higher gestational age at delivery than the control group (HR: 0.5; 95% CI: 0.30-0.82; p value = .006).
Conclusions: In twin pregnancies with a CL ≤2.5 cm, cerclage significantly prolongs gestation. However, unnecessary cerclage in women with a CL >2.5 cm may result in a higher risk of preterm labor and histologic chorioamnionitis although this study has a limitation originated from retrospective design.
{"title":"Pregnancy outcomes of cerclage in twin gestations: a multicenter retrospective cohort study.","authors":"Jee Yoon Park, Kyong-No Lee, Hyeon Ji Kim, Kiroong Choe, Aeri Cho, Bohyoung Kim, Jinwook Seo, Hayan Kwon, Jong Woon Kim, Jin-Gon Bae, Ji-Hee Sung, Se Jin Lee, Young Mi Jung, You Jung Han, Subeen Hong, Jin-Hoon Chung, Hye-Sung Won, Jong Kwan Jun","doi":"10.1080/14767058.2024.2355495","DOIUrl":"10.1080/14767058.2024.2355495","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the effects of cerclage on twin pregnancies.</p><p><strong>Methods: </strong>A multicenter, retrospective, cohort study was conducted at 10 tertiary centers using a web-based data collection platform. The study population included twin pregnancies delivered after 20 weeks of gestation. Patients with one or two fetal deaths before 20 weeks of gestation were excluded. Maternal characteristics, including prenatal cervical length (CL) and obstetric outcomes, were retrieved from the electronic medical records.</p><p><strong>Results: </strong>A total of 1,473 patients had available data regarding the CL measured before 24 weeks of gestation. Seven patients without CL data obtained prior to cerclage were excluded from the analysis. The study population was divided into two groups according to the CL measured during the mid-trimester: the CL ≤2.5 cm group (<i>n</i> = 127) and the CL >2.5 cm group (<i>n</i> = 1,339). A total of 127 patients (8.7%) were included in the CL ≤2.5 cm group, including 41.7% (53/127) who received cerclage. Patients in the CL >2.5 cm group who received cerclage had significantly lower gestational age at delivery than the control group (hazard ratio (HR): 1.8; 95% confidence interval (CI): 1.11-2.87; <i>p</i> = .016). Patients in the CL ≤2.5 cm group who received cerclage had a significantly higher gestational age at delivery than the control group (HR: 0.5; 95% CI: 0.30-0.82; <i>p</i> value = .006).</p><p><strong>Conclusions: </strong>In twin pregnancies with a CL ≤2.5 cm, cerclage significantly prolongs gestation. However, unnecessary cerclage in women with a CL >2.5 cm may result in a higher risk of preterm labor and histologic chorioamnionitis although this study has a limitation originated from retrospective design.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2023-12-25DOI: 10.1080/14767058.2023.2295808
Charissa Joy, Taya A Collyer, Kathryn McMahon
Objective: To test the accuracy of transcutaneous bilirubinometry (TcB) in neonates 12 h after discontinuing phototherapy.
Study design: In a prospective study of 91 neonates at ≥35 weeks of gestation, paired measurements of total serum bilirubin (TSB) and TcB were obtained 12 h after discontinuation of phototherapy. TcB measurements were obtained on the uncovered skin of the sternum and the covered skin of the lower abdomen. Bland-Altman plots were used to evaluate agreement between TSB and TcB.
Results: TcB was found to systematically underestimate TSB on both covered and uncovered skin. The smallest but statistically significant difference between TSB and TcB was found on the covered lower abdomen (-1.03, p < .0001) compared with the uncovered skin of the sternum (-1.44, p < .0001). The correlation between TSB and TcB was excellent on both covered (r = 0.86, p < .001) and uncovered skin (r = 0.90, p < .001). Bland and Altman plots showed poor agreement between TcB and TSB.
Conclusions: This study demonstrated excellent correlation between TcB and TSB 12 h after phototherapy but poor TcB-TSB agreement. TcB cannot be reliably used in neonates exposed to phototherapy.
{"title":"Accuracy of transcutaneous bilirubinometry in term infants after phototherapy: a prospective observational study.","authors":"Charissa Joy, Taya A Collyer, Kathryn McMahon","doi":"10.1080/14767058.2023.2295808","DOIUrl":"10.1080/14767058.2023.2295808","url":null,"abstract":"<p><strong>Objective: </strong>To test the accuracy of transcutaneous bilirubinometry (TcB) in neonates 12 h after discontinuing phototherapy.</p><p><strong>Study design: </strong>In a prospective study of 91 neonates at ≥35 weeks of gestation, paired measurements of total serum bilirubin (TSB) and TcB were obtained 12 h after discontinuation of phototherapy. TcB measurements were obtained on the uncovered skin of the sternum and the covered skin of the lower abdomen. Bland-Altman plots were used to evaluate agreement between TSB and TcB.</p><p><strong>Results: </strong>TcB was found to systematically underestimate TSB on both covered and uncovered skin. The smallest but statistically significant difference between TSB and TcB was found on the covered lower abdomen (-1.03, <i>p</i> < .0001) compared with the uncovered skin of the sternum (-1.44, <i>p</i> < .0001). The correlation between TSB and TcB was excellent on both covered (<i>r</i> = 0.86, <i>p</i> < .001) and uncovered skin (<i>r</i> = 0.90, <i>p</i> < .001). Bland and Altman plots showed poor agreement between TcB and TSB.</p><p><strong>Conclusions: </strong>This study demonstrated excellent correlation between TcB and TSB 12 h after phototherapy but poor TcB-TSB agreement. TcB cannot be reliably used in neonates exposed to phototherapy.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139038147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-01-10DOI: 10.1080/14767058.2023.2299111
Hua Jiang, Zhang Bo
Objective: This study aimed to investigate changes in the cervical strain rate (SR), cervical length (CL), and uterine artery blood flow parameters during early pregnancy in women with cervical insufficiency and evaluate the clinical efficacy of these markers for screening of cervical insufficiency in early pregnancy.
Methods: This retrospective study in 60 pregnant women with cervical insufficiency and 100 normal pregnant women was conducted between September 2021 and January 2023 and measured ultrasound parameters of the cervix during early pregnancy. The cervical SR, CL, and uterine artery resistance index (RI) were measured in both groups at 11-14 weeks of gestation. Strain elastography represented by the SR was used to assess the hardness of the internal and external cervical openings.
Results: During early pregnancy, the SR at the internal and external cervical openings were significantly higher in the cervical insufficiency group than those in the normal pregnancy group (SR I: 0.19 ± 0.018% vs. 0.16 ± 0.014%; SR E: 0.26 ± 0.028% vs. 0.24 ± 0.025%; p < .001). The CL was significantly shorter in the cervical insufficiency group than that measured in the normal pregnancy group (34.3 ± 2.9 mm vs. 35.2 ± 1.99 mm; p = .036), while cervical blood perfusion was also poorer in the cervical insufficiency group than that in the normal pregnancy group (uterine artery RI: 0.76 ± 0.07 vs. 0.74 ± 0.05; p = .048). Receiver operating characteristic (ROC) curve analysis showed that the optimal critical values for diagnosing cervical insufficiency were 0.17% for SR I, 0.25% for SR E, 33.8 mm for CL, and 0.78 for uterine artery RI. Of these parameters, the ROC curve for SR I had the largest area under the curve [AUC = 0.89 (p < .001)], with the highest sensitivity (78%) and specificity (82%). Multivariate logistic regression analysis demonstrated that the SR at the internal cervical opening (OR 17.47, 95% confidence interval (CI) 5.08-60.08; p < .001) and CL (OR 5.05, 95% CI 1.66-15.32; p = .004) still showed significant differences between the two groups.
Conclusion: Cervical elastography is an effective tool for screening early pregnancy cervical insufficiency. The SR at the internal cervical opening is a valuable indicator for screening cervical insufficiency and has superior clinical efficacy for screening for this condition compared to that of CL and the uterine artery blood flow index.
研究目的本研究旨在探讨宫颈机能不全妇女在孕早期宫颈应变率(SR)、宫颈长度(CL)和子宫动脉血流参数的变化,并评估这些指标对筛查孕早期宫颈机能不全的临床疗效:这项回顾性研究在2021年9月至2023年1月期间对60名宫颈机能不全孕妇和100名正常孕妇进行了研究,测量了早孕期宫颈的超声参数。两组孕妇均在妊娠 11-14 周时测量了宫颈 SR、CL 和子宫动脉阻力指数(RI)。以 SR 为代表的应变弹性成像用于评估宫颈内外口的硬度:结果:在妊娠早期,宫颈机能不全组宫颈内外口的 SR 明显高于正常妊娠组(SR I:0.19 ± 0.018% vs. 0.16 ± 0.014%;SR E:0.26 ± 0.028% vs. 0.24 ± 0.025%; p p = .036),而宫颈机能不全组的宫颈血液灌注也比正常妊娠组差(子宫动脉 RI: 0.76 ± 0.07 vs. 0.74 ± 0.05; p = .048)。接收者操作特征(ROC)曲线分析显示,诊断宫颈机能不全的最佳临界值为:SR I 为 0.17%,SR E 为 0.25%,CL 为 33.8 mm,子宫动脉 RI 为 0.78。在这些参数中,SR I 的 ROC 曲线下面积最大[AUC = 0.89(p p = .004),两组之间仍有显著差异:宫颈弹性成像是筛查孕早期宫颈机能不全的有效工具。结论:宫颈弹性成像是筛查孕早期宫颈机能不全的有效工具,宫颈内口处的SR是筛查宫颈机能不全的重要指标,与CL和子宫动脉血流指数相比,宫颈弹性成像在筛查宫颈机能不全方面具有更好的临床疗效。
{"title":"Application value of ultrasound elastography for screening of early pregnancy cervical insufficiency: a retrospective case-control study.","authors":"Hua Jiang, Zhang Bo","doi":"10.1080/14767058.2023.2299111","DOIUrl":"10.1080/14767058.2023.2299111","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate changes in the cervical strain rate (SR), cervical length (CL), and uterine artery blood flow parameters during early pregnancy in women with cervical insufficiency and evaluate the clinical efficacy of these markers for screening of cervical insufficiency in early pregnancy.</p><p><strong>Methods: </strong>This retrospective study in 60 pregnant women with cervical insufficiency and 100 normal pregnant women was conducted between September 2021 and January 2023 and measured ultrasound parameters of the cervix during early pregnancy. The cervical SR, CL, and uterine artery resistance index (RI) were measured in both groups at 11-14 weeks of gestation. Strain elastography represented by the SR was used to assess the hardness of the internal and external cervical openings.</p><p><strong>Results: </strong>During early pregnancy, the SR at the internal and external cervical openings were significantly higher in the cervical insufficiency group than those in the normal pregnancy group (SR <sub>I</sub>: 0.19 ± 0.018% vs. 0.16 ± 0.014%; SR <sub>E</sub>: 0.26 ± 0.028% vs. 0.24 ± 0.025%; <i>p</i> < .001). The CL was significantly shorter in the cervical insufficiency group than that measured in the normal pregnancy group (34.3 ± 2.9 mm vs. 35.2 ± 1.99 mm; <i>p</i> = .036), while cervical blood perfusion was also poorer in the cervical insufficiency group than that in the normal pregnancy group (uterine artery RI: 0.76 ± 0.07 vs. 0.74 ± 0.05; <i>p</i> = .048). Receiver operating characteristic (ROC) curve analysis showed that the optimal critical values for diagnosing cervical insufficiency were 0.17% for SR <sub>I</sub>, 0.25% for SR <sub>E</sub>, 33.8 mm for CL, and 0.78 for uterine artery RI. Of these parameters, the ROC curve for SR <sub>I</sub> had the largest area under the curve [AUC = 0.89 (<i>p</i> < .001)], with the highest sensitivity (78%) and specificity (82%). Multivariate logistic regression analysis demonstrated that the SR at the internal cervical opening (OR 17.47, 95% confidence interval (CI) 5.08-60.08; <i>p</i> < .001) and CL (OR 5.05, 95% CI 1.66-15.32; <i>p</i> = .004) still showed significant differences between the two groups.</p><p><strong>Conclusion: </strong>Cervical elastography is an effective tool for screening early pregnancy cervical insufficiency. The SR at the internal cervical opening is a valuable indicator for screening cervical insufficiency and has superior clinical efficacy for screening for this condition compared to that of CL and the uterine artery blood flow index.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To evaluate the clinical value of ultrasound findings in the screening of fetal chromosomal abnormalities and the analysis of risk factors for chromosome microarray analysis (CMA) abnormalities.
Methods: We retrospectively analyzed the datasets of 15,899 pregnant women who underwent prenatal evaluations at Affiliated Maternity and Child Health Care Hospital of Nantong University between August 2018 and December 2022. Everyone underwent ultrasound screening, and those with abnormal findings underwent CMA to identify chromosomal abnormalities.
Results: The detection rates for isolated ultrasound anomalies and combined ultrasound and CMA anomalies were 11.81% (1877/15,899) and 2.40% (381/15,899), respectively. Among all ultrasound abnormalities, detection rates for isolated ultrasound soft marker anomalies, isolated structural abnormalities, and both ultrasound soft marker anomalies with structural abnormalities were 82.91% (1872/2258), 15.99% (361/2258), and 1.11% (25/2258), respectively. The detection rate of abnormal chromosomes in pregnant women with abnormal ultrasound results was 16.87% (381/2258). The detection rates were 13.33% in cases with two or more ultrasound soft markers anomalies, 47.37% for two or more structural anomalies, and 48.00% for concomitant ultrasound soft marker and structural anomalies.
Conclusions: Enhanced detection rates of chromosomal anomalies in fetal malformations are achieved with specific ultrasound findings (NT thickening, cardiovascular abnormalities, and multiple soft markers) or when combined with high-risk factors (advanced maternal age, familial history, parental chromosomal anomalies, etc.). When the maternal age is over 35 and with ≥2 ultrasound soft marker anomalies accompanied with any high-risk factors, CMA testing can aid in the diagnosis of prenatal chromosomal abnormalities.
{"title":"Clinical value of screening prenatal ultrasound combined with chromosomal microarrays in prenatal diagnosis of chromosomal abnormalities.","authors":"Hongru Jiang, Xiangtian Kong, Wenjun Bian, Jiangyue Liu, Yuanyuan Xu, Aimin Cui, Xian Cao","doi":"10.1080/14767058.2024.2324348","DOIUrl":"10.1080/14767058.2024.2324348","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical value of ultrasound findings in the screening of fetal chromosomal abnormalities and the analysis of risk factors for chromosome microarray analysis (CMA) abnormalities.</p><p><strong>Methods: </strong>We retrospectively analyzed the datasets of 15,899 pregnant women who underwent prenatal evaluations at Affiliated Maternity and Child Health Care Hospital of Nantong University between August 2018 and December 2022. Everyone underwent ultrasound screening, and those with abnormal findings underwent CMA to identify chromosomal abnormalities.</p><p><strong>Results: </strong>The detection rates for isolated ultrasound anomalies and combined ultrasound and CMA anomalies were 11.81% (1877/15,899) and 2.40% (381/15,899), respectively. Among all ultrasound abnormalities, detection rates for isolated ultrasound soft marker anomalies, isolated structural abnormalities, and both ultrasound soft marker anomalies with structural abnormalities were 82.91% (1872/2258), 15.99% (361/2258), and 1.11% (25/2258), respectively. The detection rate of abnormal chromosomes in pregnant women with abnormal ultrasound results was 16.87% (381/2258). The detection rates were 13.33% in cases with two or more ultrasound soft markers anomalies, 47.37% for two or more structural anomalies, and 48.00% for concomitant ultrasound soft marker and structural anomalies.</p><p><strong>Conclusions: </strong>Enhanced detection rates of chromosomal anomalies in fetal malformations are achieved with specific ultrasound findings (NT thickening, cardiovascular abnormalities, and multiple soft markers) or when combined with high-risk factors (advanced maternal age, familial history, parental chromosomal anomalies, etc.). When the maternal age is over 35 and with ≥2 ultrasound soft marker anomalies accompanied with any high-risk factors, CMA testing can aid in the diagnosis of prenatal chromosomal abnormalities.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-06-14DOI: 10.1080/14767058.2024.2367082
Jane K Martin, Sherri A Longo, Victoria R Jauk, Erin A S Clark, George R Saade, Kim A Boggess, Sean Esplin, Ronald J Wapner, Michelle Y Owens, Sean C Blackwell, William W Andrews, Jeff M Szychowski, Alan T Tita
Objective: It is currently unknown whether adjunctive azithromycin prophylaxis at the time of non-elective cesarean has differential effects on neonatal outcomes in the context of prematurity. The objective of this study was to compare whether neonatal outcomes differ in term and preterm infants exposed to adjunctive azithromycin prophylaxis before non-elective cesarean delivery.
Study design: A planned secondary analysis of a multi-center randomized controlled trial that enrolled women with singleton pregnancies ≥24 weeks gestation undergoing non-elective cesarean delivery (during labor or ≥4 h after membrane rupture). Women received standard antibiotic prophylaxis and were randomized to either adjunctive azithromycin (500 mg) or placebo. The primary composite outcome was neonatal death, suspected or confirmed neonatal sepsis, and serious neonatal morbidities (NEC, PVL, IVH, BPD). Secondary outcomes included NICU admission, neonatal readmission, culture positive infections and prevalence of resistant organisms. Odds ratios (OR) for the effect of azithromycin versus placebo were compared between gestational age strata (preterm [less than 37 weeks] versus term [37 weeks or greater]). Tests of interaction examined homogeneity of treatment effect with gestational age.
Results: The analysis includes 2,013 infants, 226 preterm (11.2%) and 1,787 term. Mean gestational ages were 34 and 39.5 weeks, respectively. Within term and preterm strata, maternal and delivery characteristics were similar between the azithromycin and placebo groups. There was no difference in the odds of composite neonatal outcome between those exposed to azithromycin versus placebo in preterm neonates (OR 0.82, 95% CI 0.48-1.41) and in term neonates (OR 1.06, 95% CI 0.77-1.46), with no difference between gestational age strata (p = 0.42). Analysis of secondary outcomes also revealed no differences in treatment effects within or between gestational age strata.
Conclusion: Exposure to adjunctive azithromycin antibiotic prophylaxis for non-elective cesarean delivery does not increase neonatal morbidity or mortality in term or preterm infants.
{"title":"Neonatal outcomes in term and preterm infants following adjunctive azithromycin antibiotic prophylaxis for non-elective cesarean delivery.","authors":"Jane K Martin, Sherri A Longo, Victoria R Jauk, Erin A S Clark, George R Saade, Kim A Boggess, Sean Esplin, Ronald J Wapner, Michelle Y Owens, Sean C Blackwell, William W Andrews, Jeff M Szychowski, Alan T Tita","doi":"10.1080/14767058.2024.2367082","DOIUrl":"10.1080/14767058.2024.2367082","url":null,"abstract":"<p><strong>Objective: </strong>It is currently unknown whether adjunctive azithromycin prophylaxis at the time of non-elective cesarean has differential effects on neonatal outcomes in the context of prematurity. The objective of this study was to compare whether neonatal outcomes differ in term and preterm infants exposed to adjunctive azithromycin prophylaxis before non-elective cesarean delivery.</p><p><strong>Study design: </strong>A planned secondary analysis of a multi-center randomized controlled trial that enrolled women with singleton pregnancies ≥24 weeks gestation undergoing non-elective cesarean delivery (during labor or ≥4 h after membrane rupture). Women received standard antibiotic prophylaxis and were randomized to either adjunctive azithromycin (500 mg) or placebo. The primary composite outcome was neonatal death, suspected or confirmed neonatal sepsis, and serious neonatal morbidities (NEC, PVL, IVH, BPD). Secondary outcomes included NICU admission, neonatal readmission, culture positive infections and prevalence of resistant organisms. Odds ratios (OR) for the effect of azithromycin versus placebo were compared between gestational age strata (preterm [less than 37 weeks] versus term [37 weeks or greater]). Tests of interaction examined homogeneity of treatment effect with gestational age.</p><p><strong>Results: </strong>The analysis includes 2,013 infants, 226 preterm (11.2%) and 1,787 term. Mean gestational ages were 34 and 39.5 weeks, respectively. Within term and preterm strata, maternal and delivery characteristics were similar between the azithromycin and placebo groups. There was no difference in the odds of composite neonatal outcome between those exposed to azithromycin versus placebo in preterm neonates (OR 0.82, 95% CI 0.48-1.41) and in term neonates (OR 1.06, 95% CI 0.77-1.46), with no difference between gestational age strata (<i>p</i> = 0.42). Analysis of secondary outcomes also revealed no differences in treatment effects within or between gestational age strata.</p><p><strong>Conclusion: </strong>Exposure to adjunctive azithromycin antibiotic prophylaxis for non-elective cesarean delivery does not increase neonatal morbidity or mortality in term or preterm infants.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov, NCT01235546.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-06-23DOI: 10.1080/14767058.2024.2367090
Retu Saxena, Gretchen Benson, Abbey C Sidebottom, Brynn Okeson, Joy Hayes, Kirsten Shaw, Courtney Jordan-Baechler, William Wagner
Background: Current guidelines recommend multidisciplinary cardiovascular obstetric programs (CVOB) to manage complex pregnant patients with cardiovascular disease. Minimal evaluation of these programs exists, with most of these programs offered at university-based centers.
Methods: A cohort of 113 patients managed by a CVOB team at a non-university health system (2018-2019) were compared to 338 patients seen by cardiology prior to the program (2016-2017). CVOB patients were matched with comparison patients (controls) on modified World Health Organization (mWHO) category classification, yielding a cohort of 102 CVOB and 102 controls.
Results: CVOB patients were more ethnically diverse and cardiovascular risk was higher compared to controls based on mWHO ≥ II-III (57% vs 17%) and. After matching, CVOB patients had more cardiology tests during pregnancy (median of 8 tests vs 5, p < .001) and were more likely to receive telemetry care (32% vs 19%, p = .025). The median number of perinatology visits was significantly higher in the CVOB group (8 vs 2, p < .001). Length of stay was a half day longer for vaginal delivery patients in the CVOB group (median 2.66 vs 2.13, p = .006).
Conclusion: Implementation of a CVOB program resulted in a more diverse patient population than previously referred to cardiology. The CVOB program participants also experienced a higher level of care in terms of increased cardiovascular testing, monitoring, care from specialists, and appropriate use of medications during pregnancy.
{"title":"Reach and effectiveness of a non-university cardio-obstetrics program.","authors":"Retu Saxena, Gretchen Benson, Abbey C Sidebottom, Brynn Okeson, Joy Hayes, Kirsten Shaw, Courtney Jordan-Baechler, William Wagner","doi":"10.1080/14767058.2024.2367090","DOIUrl":"https://doi.org/10.1080/14767058.2024.2367090","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines recommend multidisciplinary cardiovascular obstetric programs (CVOB) to manage complex pregnant patients with cardiovascular disease. Minimal evaluation of these programs exists, with most of these programs offered at university-based centers.</p><p><strong>Methods: </strong>A cohort of 113 patients managed by a CVOB team at a non-university health system (2018-2019) were compared to 338 patients seen by cardiology prior to the program (2016-2017). CVOB patients were matched with comparison patients (controls) on modified World Health Organization (mWHO) category classification, yielding a cohort of 102 CVOB and 102 controls.</p><p><strong>Results: </strong>CVOB patients were more ethnically diverse and cardiovascular risk was higher compared to controls based on mWHO ≥ II-III (57% vs 17%) and. After matching, CVOB patients had more cardiology tests during pregnancy (median of 8 tests vs 5, <i>p</i> < .001) and were more likely to receive telemetry care (32% vs 19%, <i>p</i> = .025). The median number of perinatology visits was significantly higher in the CVOB group (8 vs 2, <i>p</i> < .001). Length of stay was a half day longer for vaginal delivery patients in the CVOB group (median 2.66 vs 2.13, <i>p</i> = .006).</p><p><strong>Conclusion: </strong>Implementation of a CVOB program resulted in a more diverse patient population than previously referred to cardiology. The CVOB program participants also experienced a higher level of care in terms of increased cardiovascular testing, monitoring, care from specialists, and appropriate use of medications during pregnancy.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-07-23DOI: 10.1080/14767058.2024.2379910
Dianyi Lyu, Shufang Fu
Objective: A decrease in platelet count has been reported to be associated with several neonatal inflammatory diseases, including sepsis and necrotizing enterocolitis; while its association with neonatal acute kidney injury (AKI) has not been reported. This study aims to explore the association between platelet count and neonatal AKI.
Methods: This was a retrospective cohort study based on the Medical Information Mart for Intensive Care III (MIMIC-III) database. Data were extracted based on baseline characteristics, comorbidities, vital signs, laboratory parameters, and intervention measures. Logistic regression analysis was used to assess the association between platelet count and AKI, and results were shown as odds ratios (OR) with 95% confidence intervals (CI).
Results: A total of 1,576 neonates were finally included in the analysis. After adjusting birth weight, sepsis, patent ductus arteriosus, hematocrit, percentage of neutrophils, and vasopressor use, we found that platelet count in the lowest quartile (Q1) was significantly associated with the higher odds of AKI than platelet count in the highest quartile (Q4) (OR = 1.70, 95% CI: 1.01-2.87).
Conclusions: Low platelet count was associated with the high odds of AKI in the neonatal intensive care unit (NICU), indicating that platelet count might be a biomarker for neonatal AKI. Large-scale multicenter studies should be performed to verify the results.
目的:有报道称,血小板计数下降与多种新生儿炎症性疾病(包括败血症和坏死性小肠结肠炎)有关,但其与新生儿急性肾损伤(AKI)的关系尚未见报道。本研究旨在探讨血小板计数与新生儿急性肾损伤之间的关系:这是一项基于重症监护医学信息市场 III(MIMIC-III)数据库的回顾性队列研究。根据基线特征、合并症、生命体征、实验室参数和干预措施提取数据。采用逻辑回归分析评估血小板计数与AKI之间的关系,结果以几率比(OR)和95%置信区间(CI)表示:最终共有 1,576 名新生儿被纳入分析。在对出生体重、败血症、动脉导管未闭、血细胞比容、中性粒细胞百分比和血管加压器使用情况进行调整后,我们发现血小板计数最低四分位数(Q1)与发生 AKI 的几率显著高于血小板计数最高四分位数(Q4)(OR = 1.70,95% CI:1.01-2.87):血小板计数低与新生儿重症监护室(NICU)发生AKI的几率高有关,这表明血小板计数可能是新生儿AKI的生物标志物。应开展大规模多中心研究来验证这一结果。
{"title":"Association between platelet count and neonatal acute kidney injury: a cohort study using the medical information mart for intensive care III database.","authors":"Dianyi Lyu, Shufang Fu","doi":"10.1080/14767058.2024.2379910","DOIUrl":"https://doi.org/10.1080/14767058.2024.2379910","url":null,"abstract":"<p><strong>Objective: </strong>A decrease in platelet count has been reported to be associated with several neonatal inflammatory diseases, including sepsis and necrotizing enterocolitis; while its association with neonatal acute kidney injury (AKI) has not been reported. This study aims to explore the association between platelet count and neonatal AKI.</p><p><strong>Methods: </strong>This was a retrospective cohort study based on the Medical Information Mart for Intensive Care III (MIMIC-III) database. Data were extracted based on baseline characteristics, comorbidities, vital signs, laboratory parameters, and intervention measures. Logistic regression analysis was used to assess the association between platelet count and AKI, and results were shown as odds ratios (OR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>A total of 1,576 neonates were finally included in the analysis. After adjusting birth weight, sepsis, patent ductus arteriosus, hematocrit, percentage of neutrophils, and vasopressor use, we found that platelet count in the lowest quartile (Q1) was significantly associated with the higher odds of AKI than platelet count in the highest quartile (Q4) (OR = 1.70, 95% CI: 1.01-2.87).</p><p><strong>Conclusions: </strong>Low platelet count was associated with the high odds of AKI in the neonatal intensive care unit (NICU), indicating that platelet count might be a biomarker for neonatal AKI. Large-scale multicenter studies should be performed to verify the results.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01Epub Date: 2024-05-05DOI: 10.1080/14767058.2024.2345305
Mahsa Piri, Azam Maleki, Omid Saed
Objective: The present study aimed to determine the influence of educational interventions on improving the quality of life (QOL) of women suffering from pregnancy-related nausea and vomiting (NVP) as a systematic review.
Methods: The current systematic review followed the standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist guideline. The English electronic databases were used to identify relevant studies published 2000 until 14 August 2023. The search strategies employed were based on Mesh browser keywords and free-text words. The study risk of bias was evaluated using the Cochrane Collaboration's tool for assessing the risk of bias tools and publication bias was evaluated using a funnel plot and Begg and Egger tests. The heterogeneity of the studies was evaluated using I2 and tau-squared tests. Data were analyzed using the RevMan 5 software. Results of the random-effects meta-analysis were presented using the standard mean difference, along with a 95% confidence interval (CI).
Results: Out of the seven randomized clinical/control trial (RCT) studies with a total of 946 subjects included in the review, five studies reported a significant result, indicating that the interventions had a statistically significant effect on the QOL of women suffering NVP and in two studies did not have a significant result. A subgroup analysis was done based on the type of quality-of-life measurements. The pooled standardized mean difference (SMD) of four articles (Nausea and Vomiting Pregnancy Quality of Life, NVPQOL) with a total of 335 subjects was -2.91, and CI of -4.72 to -1.11, p value = .002, I2 = 97.2%. The pooled SMD of three articles (SF36) with a total of 611 subjects was -0.05, and CI of -0.23 to -0.12, p value = .550, I2 = 10%.
Conclusions: The overall results of the analysis indicated that educational intervention had a small positive impact on the QOL of women experiencing NVP. However, to draw a better conclusion, it is recommended to conduct further studies with larger sample sizes and longer follow-up periods.
{"title":"The effect of educational intervention on the quality of life of women suffering from pregnancy-related nausea and vomiting: a systematic review.","authors":"Mahsa Piri, Azam Maleki, Omid Saed","doi":"10.1080/14767058.2024.2345305","DOIUrl":"10.1080/14767058.2024.2345305","url":null,"abstract":"<p><strong>Objective: </strong>The present study aimed to determine the influence of educational interventions on improving the quality of life (QOL) of women suffering from pregnancy-related nausea and vomiting (NVP) as a systematic review.</p><p><strong>Methods: </strong>The current systematic review followed the standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist guideline. The English electronic databases were used to identify relevant studies published 2000 until 14 August 2023. The search strategies employed were based on Mesh browser keywords and free-text words. The study risk of bias was evaluated using the Cochrane Collaboration's tool for assessing the risk of bias tools and publication bias was evaluated using a funnel plot and Begg and Egger tests. The heterogeneity of the studies was evaluated using <i>I</i><sup>2</sup> and tau-squared tests. Data were analyzed using the RevMan 5 software. Results of the random-effects meta-analysis were presented using the standard mean difference, along with a 95% confidence interval (CI).</p><p><strong>Results: </strong>Out of the seven randomized clinical/control trial (RCT) studies with a total of 946 subjects included in the review, five studies reported a significant result, indicating that the interventions had a statistically significant effect on the QOL of women suffering NVP and in two studies did not have a significant result. A subgroup analysis was done based on the type of quality-of-life measurements. The pooled standardized mean difference (SMD) of four articles (Nausea and Vomiting Pregnancy Quality of Life, NVPQOL) with a total of 335 subjects was -2.91, and CI of -4.72 to -1.11, <i>p</i> value = .002, <i>I</i><sup>2</sup> = 97.2%. The pooled SMD of three articles (SF36) with a total of 611 subjects was -0.05, and CI of -0.23 to -0.12, <i>p</i> value = .550, <i>I</i><sup>2</sup> = 10%.</p><p><strong>Conclusions: </strong>The overall results of the analysis indicated that educational intervention had a small positive impact on the QOL of women experiencing NVP. However, to draw a better conclusion, it is recommended to conduct further studies with larger sample sizes and longer follow-up periods.</p>","PeriodicalId":50146,"journal":{"name":"Journal of Maternal-Fetal & Neonatal Medicine","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}