BMC Pregnancy and Childbirth最新文献

Background: Maternal serum biomarkers, primarily introduced for aneuploidy screening, have also been investigated as predictors of adverse pregnancy outcomes. However, their value in late-preterm and term pregnancies remains unclear.

Methods: In this retrospective cohort study, 592 singleton pregnancies screened at a tertiary perinatology center between 2020 and 2025 were analyzed. Participants underwent either the first-trimester combined test (n = 461) or the second-trimester triple test (n = 131). Serum biomarker multiples of the median (MoM) were categorized as low (< 0.5), normal (0.5-2.0), or high (> 2.0). Perinatal outcomes-including Apgar scores, umbilical artery pH, neonatal intensive care unit (NICU) admission, and preterm premature rupture of membranes (PPROM)-were assessed using predefined group comparisons, multivariate adjustment, and ROC curve analysis.

Results: Low first-trimester free β-hCG was significantly associated with reduced Apgar scores at 1 and 5 min in term neonates (p = 0.025 and p = 0.005, respectively). In the second trimester, infants with normal AFP levels demonstrated lower umbilical artery pH compared to those with elevated AFP (p = 0.013), and low AFP was associated with an increased risk of NICU admission (p = 0.041). ROC analysis identified an AFP threshold ≥ 1.075 MoM as predictive of PPROM with 75.0% sensitivity and 69.3% specificity (AUC = 0.723, p = 0.035). No significant associations were observed for PAPP-A.

Conclusions: First-trimester low free β-hCG and second-trimester AFP abnormalities showed modest associations with neonatal outcomes and PPROM in late-preterm and term pregnancies, whereas PAPP-A did not. These findings suggest limited standalone predictive capacity of serum biomarkers, underscoring the need for integrated multiparametric models in risk stratification.

Background: The aim of this study was to compare recombinant and urinary follicle stimulating hormone (FSH) with each other in terms of endometrial receptivity for the purpose of controlled ovarian stimulation.

Methods: Twenty-four female albino mice (Mus musculus, C/C; 6-8 weeks, 18-22 g) and six males (8-10 weeks) were divided into four groups: control (no mating), spontaneous mating, urinary FSH (uFSH), and recombinant FSH (rFSH). Females in estrus received 5 IU of uFSH or rFSH, followed by mating after 48 h. Implantation sites were evaluated using histopathology and immunohistochemistry with anti-LIF, anti-Laminin, and integrin αVβ3 antibodies. LIF levels in serum collected from the tail vein were measured using ELISA.

Results: The Tukey multiple comparison test showed significant group differences in Laminin and Integrin αVβ3 staining intensity (p < 0.001). rFSH treatment significantly increased Laminin and Integrin αVβ3 expression compared with both uFSH and spontaneous conception groups (p < 0.001), while uFSH also showed higher levels than the spontaneous group (p < 0.001). For LIF, no difference was found between the control and spontaneous groups (p > 0.05), but both rFSH and uFSH groups exhibited higher expression than the spontaneous group, with the highest levels in the rFSH group (p < 0.001).

Conclusion: rFSH treatment was associated with the greatest enhancement of endometrial receptivity markers, both immunohistochemically and biochemically, suggesting that rFSH may exert a more favorable effect on implantation potential compared with uFSH.

Background: Effective disaster preparedness protects pregnant women, a disadvantaged group, and reduces potential harm.

Aim: This study was planned to determine the effects of training provided to pregnant women regarding disasters on their knowledge and disaster preparedness levels.

Methods: A total of 140 participants (70 in the experimental group and 70 in the control group) who attended the obstetrics and gynecology outpatient clinics of a state hospital in western Turkey between November 2023 and December 2024 and met the inclusion criteria were included in the study. Data were collected through face-to-face interviews using pre-test and post-test forms and standardized questionnaires.

Results: It was determined that 34.3% of the pregnant women in both the experimental and control groups were aged between 26 and 30 years. In the experimental group, 34.3% of the participants were high school graduates, whereas 34.3% of those in the control group were undergraduate graduates. The mean gestational week was 33.41 ± 7.25 in the experimental group and 20.79 ± 11.68 in the control group. Following the training intervention, disaster knowledge levels of pregnant women in the experimental group increased markedly, with no incorrect responses observed in the post-test assessment. A statistically significant difference was found between the post-test total scores of the Disaster Preparedness Scale in the experimental and control groups (t = 23.23, p < 0.001, Cohen's d = 3.93), indicating a very large effect size of the training intervention. In contrast, no statistically significant difference was found between the pre-test scores of the two groups (t = - 1.04, p = 0.30).

Conclusions: The training provided to pregnant women, a vulnerable group, emphasized the importance of pre-disaster preparedness and increased their knowledge and awareness. These findings highlight the need to integrate disaster preparedness education into routine prenatal care programs and broader clinical practice.

Trial registration: Registration was made to the Iran Randomized Clinical Research Center on June 29, 2024, with the ID IRCT20240531061964N1.

Introduction: Lifestyle interventions are critical for optimizing maternal and child health outcomes during pregnancy. As a mind-body exercise rooted in the principles of traditional Chinese Medicine (TCM), qigong shows promise as adaptable prenatal interventions, but the evidence is limited.

Objective: This multicenter randomized controlled trial (RCT) protocol aims to evaluate the additive effect of a qigong intervention program, compared to routine lifestyle intervention alone, on reducing the rate of caesarean section (primary outcome) and improving a range of secondary maternal and child health outcomes.

Methods: This multicenter RCT will be conducted across 11 institutions in China. A total of 1062 participants aged 18-45 years, with singleton pregnancies at 11-13^+ 6 weeks of gestation, will be enrolled and randomly allocated to two groups using a central stratified block randomization method. Participants will be randomized to either a control group receiving standard prenatal care plus evidence-based lifestyle education (encompassing nutrition, physical activity, sleep hygiene, stress management, and environmental avoidance), or an intervention group receiving all control components supplemented with supervised pregnancy-adapted qigong intervention (a modified seated Baduanjin exercise program). The primary outcome is caesarean section rate. Secondary outcomes include obstetric complications (abortion, preterm birth, gestational diabetes mellitus, gestational hypertension, postpartum hemorrhage, fetal growth restriction), neonatal indicators (birth weight, Apgar scores), maternal gestational weight gain, and mental health and sleep-related outcomes assessed through validated instruments such as Perceived Stress Scale-4 (PSS-4) for stress levels, Fear of Birth Scale (FOBS) for fear of childbirth, and Brief Pittsburgh Sleep Quality Index (B-PSQI) for sleep quality.

Conclusion: This rigorously designed multicenter RCT protocol addresses a significant gap by investigating whether integrating the traditional mind-body practice of qigong into standard prenatal lifestyle education confers additional benefits for reducing cesarean sections and enhancing broader maternal-child health metrics. The findings will provide robust evidence on the clinical value of this TCM intervention in integrative prenatal care to improve pregnancy outcomes and maternal and child well-being.

Trial registration: This trial was registered at International Traditional Medicine Clinical Trial Registry, ITMCTR2025002612.