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Objective This study aimed to determine the effect of the Omicron variant on pregnancy-related and neonatal outcomes among the Black-dominant population. Study Design We performed a single-center, retrospective cohort study during the prepandemic period from December 1, 2019, to February 29, 2020, and the Omicron surging period from December 1, 2021, to February 28, 2022. A total of 518 pregnant women were admitted for delivery during the study period. Multiple gestations (n = 21) and deliveries at less than 20 weeks of gestation (n = 5) were excluded. We analyzed and compared the sociodemographic and clinical data from mothers and their neonates between the two cohorts as well as between severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) positive and negative mothers during the Omicron surge. Subgroup analyses were also conducted specifically among the Black-only population. Results The cohorts were predominantly Black (88.6%), with smaller proportions of Hispanic (8.9%), Asian (0.8%), White (0.8%), and other ethnicities (0.8%). Of 492 singleton deliveries, 275 live births, 8 (2.8%) stillbirths, and 31 (11.3%) preterm births (PTBs) occurred during the prepandemic period, and 207 live births, 2 (1%) stillbirths, and 33 (15.9%) PTBs occurred during the Omicron wave. There was no statistically significant difference in the rates of PTBs, stillbirths, medically indicated PTBs, and cesarean delivery between the two cohorts. SARS-CoV-2-positive mothers were not at an increased risk of adverse outcomes. However, neonatal intensive care unit (NICU) admission rate significantly increased among neonates born to SARS-CoV-2 positive mothers compared with negative mothers (32.3 vs. 16.5%, p = 0.038). In subgroup analyses among Black individuals, this difference was not observed. Conclusion There was no significant difference in pregnancy-related or neonatal outcomes in the Black-dominant population between the two cohorts. SARS-CoV-2 infection did not alter these findings except for an increased NICU admission rate among neonates born to SARS-CoV-2-positive mothers. Key Points Most pregnant women infected with SARS-CoV-2 during the Omicron wave were asymptomatic. The Omicron wave did not increase the risk of pregnancy-related or neonatal adverse outcomes when compared with the prepandemic period. Maternal SARS-CoV-2 infection increased NICU admission rate. Among Black individuals, no significant increase in adverse outcomes was observed during the Omicron pandemic. [ABSTRACT FROM AUTHOR]

Objectives: NPFFR2 is a biomarker produced by the placenta during pregnancy and is thought to be associated with in various physiological processes, including pain modulation, opioid receptor regulation, and cardiovascular function. Pre-eclampsia (PE) is a major public health concern due to its links with cardiovascular disease (CVD), stroke and neonatal morbidity and mortality. Consequently, timely diagnosis and efficient management of PE are essential for both maternal and neonatal health. This study aimed to conduct a comparative analysis of neuropeptide FFR2 (NPFFR2), echocardiographic evaluation results, and pregnancy outcomes in pregnant women with and without PE. Methods: This is a prospective case-control study. It included 94 pregnant participants who applied to Manisa City Hospital between October 2021 to January 2023 and were grouped into women with PE (n = 47) and those without PE (n = 47). Biochemical and NPFFR2 analyses were performed using the blood samples collected from all participants, along with echocardiography and 24 hours. Ambulatory blood pressure monitoring (ABPM). A p-value <0.05 was considered statistically significant. Results: The study group comprised 94 pregnant women with a mean age of 29.2 years and mean gestational age of 27.6 weeks. The preeclampsia group had a significantly higher NPFFR2 levels, lower gestational age at birth and higher all 24-hours ABPM findings. The left atrial-to-aortic ratio and right ventricle myocardial performance index were significantly higher and EA ratio was significantly lower in the preeclampsia group than in the control group. NPFFR2, gestational age at birth, LDL cholesterol, and body mass index were found to be independently associated with neonatal intensive care unit admission. Conclusions: The women with PE presented with increased serum NPFFR2 levels and the prognosis of pregnancy was associated with NPFFR2 levels. [ABSTRACT FROM AUTHOR]

Background: Up to now, a number of studies have explored the influence of blastocyst biopsy on maternal and neonatal outcomes, and the results have been somewhat inconsistent. Therefore, the aim of this study was to investigate whether blastocyst biopsy is associated with an elevated risk of hypertensive disorders of pregnancy (HDP) and other adverse perinatal outcomes during frozen embryo transfer (FET) cycles in singleton live births resulting from intracytoplasmic sperm injection (ICSI) in women aged ≤ 35 years. Methods: A total of 1,008 women were involved in this study from January 2020 to June 2022, who underwent ICSI cycles and received single FET, leading to the birth of a live singleton newborn. The study population were categorized into two groups: the preimplantation genetic testing (PGT) group, comprising 269 women whose blastocysts underwent trophectoderm biopsy, and the control group, consisting of 739 women whose blastocysts did not undergo biopsy. The primary outcome assessed in this study was HDP. Additionally, various relevant perinatal outcomes related to both maternal and neonatal health were also evaluated. Results: In comparison to the control group, notable disparities were observed between the groups in relation to infertility duration, EMT, infertility type, infertility cause and endometrial preparation protocol (P < 0.05, for all). The percentage of female gender significantly increased in the PGT group in comparison with the control group (P < 0.05). However, the risk of HDP, other maternal and neonatal outcomes exhibited comparable results between the two groups (P > 0.05, for all). Moreover, univariate regression analyses further revealed that PGT had no influence on maternal and neonatal outcomes, except for gender (aOR 1.44; 95% CI, 1.03–2.01; P = 0.031). Conclusions: In the short-term perspective, it could be inferred that blastocyst biopsy may not increase the risks associated with HDP or other unfavorable maternal and neonatal outcomes. However, despite the limited sample size, our findings may not be applicable to those aged 35 or over; therefore, larger cohort studies are imperative for the validation of our results. [ABSTRACT FROM AUTHOR]

Simple Summary: Pregnancy-associated cancer (PAC) refers to cancers diagnosed during pregnancy or within a year postpartum. Although rare, the rising trend of delayed childbearing has increased its prevalence. Managing PAC is complex due to the need to balance maternal cancer treatment with fetal well-being. This systematic review examines neonatal outcomes associated with PAC, focusing on risks such as preterm birth and low birthweight. The findings highlight the critical need for multidisciplinary care to optimize outcomes for mothers and their newborns. Background/Objectives: Pregnancy-associated cancer (PAC) presents significant challenges for maternal and neonatal health, and yet its impact on neonatal outcomes remains poorly understood. This systematic review aims to evaluate the neonatal risks associated with PAC. Methods: A systematic search of PubMed, Embase, Scopus, and other databases was conducted up to 1 November 2024, identifying observational studies and randomized controlled trials assessing neonatal outcomes in pregnancies affected by PAC. Outcomes included preterm birth, low birthweight, macrosomia, small and large for gestational age, low Apgar score, congenital anomalies, and neonatal mortality. Results: Eleven high-quality studies encompassing over 46 million births, including 9953 PAC-affected pregnancies, were reviewed. PAC significantly increased the risks of preterm birth (adjusted ORs ranging from 1.48 to 6.34) and low birthweight (adjusted ORs up to 5.5). Other adverse outcomes included low Apgar scores and neonatal mortality, primarily linked to prematurity. Cancer type and treatment timing influenced these outcomes, with gynecological and breast cancers posing higher risks. Conclusions: Neonates of mothers with PAC face increased risks of adverse outcomes, underscoring the importance of tailored, multidisciplinary management. Further prospective studies are needed to clarify the impacts of specific cancer treatments during pregnancy. [ABSTRACT FROM AUTHOR]

Background: Overweight and obesity are global issues, especially among women of childbearing age, linked to adverse maternal and neonatal outcomes. These risks vary by age, race, and ethnicity, with increasing rates among immigrant and minority women. This study compares overweight and obesity rates, pregnancy weight gain, and neonatal outcomes in Turkish and Syrian immigrant/refugee women. Methods: In this retrospective study, at Buca Seyfi Demirsoy Hospital in Izmir, Turkey a total of 1353 mother-infant pairs were checked for eligibility. Of the entire cohort of 1353 mother-infant pairs, 323 pairs with complete medical records were included. The primary outcome was rate of pregestational obesity or overweight as secondary outcomes were weight gain during pregnancy and adherence to guidelines, neonatal outcomes according to different BMI categories and possible impact of maternal weight gain on neonatal morbidities in two different ethic populations. Results: Of the 323 mother-infant pairs, overweight/obese mothers had higher birth weights and cesarean-section rates. Syrian mothers were more likely to gain less weight than recommended. Neonatal outcomes, such as hospitalization and SGA/LGA birth rates, were similar across groups, with varying compliance to weight gain guidelines. Conclusions: Pre-pregnancy BMI and gestational weight gain significantly affect some of the neonatal outcomes. High obesity rates and ethnic disparities highlight the need for culturally tailored prenatal care to improve maternal and neonatal health, especially in immigrant populations. Further research with larger, diverse cohorts is needed. [ABSTRACT FROM AUTHOR]

Introduction: Preterm Labour (PTL) remains a significant challenge in obstetrics, contributing to neonatal morbidity and mortality. The management of PTL involves the use of tocolytic agents to delay delivery, thereby allowing for further foetal development. Aim: To compare the tocolytic efficacy of Nifedipine and Atosiban in the management of PTL. Materials and Methods: This prospective interventional study was conducted at Dr. DY Patil Medical College, Hospital, and Research Centre, Pune, Maharashtra, India from October 2022 to August 2024. Ninety pregnant women between 24 to 34 weeks of gestation, diagnosed with PTL, were assigned to receive either Atosiban (n=45) or Nifedipine (n=45) according to the inclusion criteria. The primary outcomes measured were the duration of pregnancy prolongation, neonatal outcomes and Neonatal Intensive Care Unit (NICU) admissions. Chi-square tests or t-tests were used to compare these categorical variables. Results: Nifedipine was associated with a slightly higher percentage (36 cases, or 80%) achieving pregnancy prolongation for more than seven days compared to Atosiban (34 cases, or 75.56%). Nifedipine also demonstrated better neonatal outcomes and reduced NICU admissions (Nifedipine: 14 cases, or 31.11% vs. Atosiban: 20 cases, or 44.44%). However, Nifedipine was linked to a higher incidence of maternal side-effects, such as headache, hypotension and tachycardia, whereas Atosiban was better tolerated, with fewer reported side-effects. Atosiban was more frequently used in cases with earlier gestational ages, reflecting its utility in more acute clinical scenarios. Conclusion: Both Atosiban and Nifedipine were effective in managing PTL, with each drug offering distinct advantages depending on the clinical scenario. Nifedipine was more effective in prolonging pregnancy and improving neonatal outcomes, while Atosiban was associated with fewer maternal side-effects and is preferred in acute cases. [ABSTRACT FROM AUTHOR]

Abstract Background Overweight and obesity are global issues, especially among women of childbearing age, linked to adverse maternal and neonatal outcomes. These risks vary by age, race, and ethnicity, with increasing rates among immigrant and minority women. This study compares overweight and obesity rates, pregnancy weight gain, and neonatal outcomes in Turkish and Syrian immigrant/refugee women. Methods In this retrospective study, at Buca Seyfi Demirsoy Hospital in Izmir, Turkey a total of 1353 mother-infant pairs were checked for eligibility. Of the entire cohort of 1353 mother-infant pairs, 323 pairs with complete medical records were included. The primary outcome was rate of pregestational obesity or overweight as secondary outcomes were weight gain during pregnancy and adherence to guidelines, neonatal outcomes according to different BMI categories and possible impact of maternal weight gain on neonatal morbidities in two different ethic populations. Results Of the 323 mother-infant pairs, overweight/obese mothers had higher birth weights and cesarean-section rates. Syrian mothers were more likely to gain less weight than recommended. Neonatal outcomes, such as hospitalization and SGA/LGA birth rates, were similar across groups, with varying compliance to weight gain guidelines. Conclusions Pre-pregnancy BMI and gestational weight gain significantly affect some of the neonatal outcomes. High obesity rates and ethnic disparities highlight the need for culturally tailored prenatal care to improve maternal and neonatal health, especially in immigrant populations. Further research with larger, diverse cohorts is needed.

Abstract Background The World Health Organization recommends a cesarean delivery rate of 5–15%, which is thought to be within the range that can reduce infant morbidity and mortality. Various investigations have shown that those poor newborn outcomes are influenced by a variety of maternal and fetal factors and are more prevalent in emergencies than planned cesarean deliveries. Ethiopia is one of the five nations that account for 50% of all neonatal fatalities worldwide. Sub-Saharan African countries account for 38% of all infant deaths worldwide. Aim To know the determinants of adverse early neonatal outcomes after emergency cesarean delivery. Method and material A multicenter case-control study design would be carried out between November 2022 and January 2023. Using the consecutive method, a sample of 318 mother-newborn pairs was studied. Direct observation and face-to-face interviews were undertaken to gather the data using a semi-structured questionnaire. For both data input and analysis, Epi Data version 4.6 and Stata version 14 software were used. Both the crude and adjusted odds ratios were computed. The measure of significance was based on the adjusted odds ratio with a 95% confidence interval and a p-value of less than 0.05. Results Maternal age over 35, the presence of danger signs during pregnancy, and non-reassuring fetal heart rate were significantly associated with increased risk of adverse fetal outcomes following emergency cesarean section. Women aged over 35 were 3.6 times more likely to experience adverse fetal outcomes compared to younger women (AOR: 3.6, 95% CI: 1.1, 9.7). Women with danger signs during pregnancy were 3.5 times more likely to have adverse fetal outcomes compared to those without (AOR = 3.5, 95% CI: 2.4, 36). Similarly, cases with non-reassuring fetal heart rate were associated with a 5.2 times higher risk of adverse newborn outcomes (AOR = 5.2, 95% CI: 1.1, 26). Conclusion This study identified advanced maternal age (over 35 years old), pregnancy complications, and non-reassuring fetal heart rate as significant risk factors for adverse neonatal outcomes following emergency cesarean section.

Introduction: The placenta helps in supporting the developing fetus by providing essential metabolic, immunological, endocrine, respiratory and nutritional functions. During pregnancy, the placenta grows in size to adequately support the needs of the developing fetus. Abnormalities in placental thickness (PT) can serve as an indicator of potential complications during pregnancy. Utilizing ultrasound technology to assess the thickness of the placenta throughout pregnancy, aiming to identify potential connections with fetal well-being, as well as other relevant factors. In addition, the objective is to establish reference charts for PT during 32 and 36 weeks of gestation. Materials and Methods: An bservational study at a Medical College and Hospital in India, from February 2023–2024, that included 400 patients. The thickness of the placenta was measured at 32 and 36 weeks in women who were referred for antenatal scans. Out of the 400 participants, 25 gave birth before reaching 36 weeks, while the remaining 375 were monitored until they reached 36 weeks. The thickness was categorized into three groups: Normal (10th–90th percentile), thin (90th percentile). The outcomes of the newborns were evaluated after delivery and statistical analysis was conducted using ANOVA to calculate descriptive measures such as the mean and standard deviation. Results: Among the 400 patients at 32 weeks, PT measurements had varied from 25 to 40 mm, with a PT (mean) of approximately 31 mm ± 3.13 mm. At 36 weeks, among the 375 patients, PT ranged from 27 to 44 mm and a mean PT of approximately 35.2 mm ± 3.27 mm. The correlation of PT and the fetal birth weight was noticeable, with a stronger correlation observed at 36 weeks (r = 0.432) compared to 32 weeks (r = 0.316). Conclusion: The overall thickness of the placenta at 32 and 36 weeks is closely related to the stage of pregnancy and can provide valuable insights into the overall wellness of the newborn. It is important to measure PT along with biometric parameters during ultrasound examinations for pregnant women. In addition, we observed the interaction of different factors, including body mass index and parity.

Abstract Background The literature has been evolving to standardize gestational diabetes mellitus (GDM) diagnosis and terminology. The significance of timing in diagnosing hyperglycemia during pregnancy is underlined by evidence that women diagnosed at 24 weeks of gestation or earlier are at a higher risk of developing postpartum prediabetes, but its association with adverse outcomes for the newborn is controversial. We aimed to investigate the association between early-onset GDM and adverse outcomes in newborns and neonates, comparing it with the late-onset GDM model. Methods It was a retrospective cohort study conducted at the Perinatal Diabetes Research Center in Assis/SP, affiliated with the Botucatu Medical School-UNESP in Brazil. The group composition was as follows: early-onset participants had fasting glucose levels ≥ 92 mg/dL and

Abstract Background The aim of this retrospective cohort study was to assess the impact of day 3(D3) embryo cell number on the clinical pregnancy and neonatal outcomes of day 4(D4) single embryo transfer in fresh cycles. Methods The study included 431 day 4 single embryo transfer in fresh cycles conducted between December 2018 and June 2023. These cycles were divided into three groups according to the day 3 embryo cell number: 248 cycles in the 7 ~ 9-cell group, 149 cycles in the 10 ~ 13-cell group and 34 cycles in the >13-cell group, and clinical pregnancy outcomes and neonatal outcomes were compared among the three groups. Results The clinical outcomes with 10 ~ 13-cell were significantly higher than those of the 7 ~ 9-cell group, regardless of whether the female age was

Abstract Background Limited data on the impact of the coronavirus disease 2019 (COVID-19) during pregnancy on newborn outcomes are available. This study aimed to characterize and compare the clinical outcomes of newborns from women with and without the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection during late pregnancy. Method This was a retrospective cohort study of women who were either infected or not infected with the SARS-CoV-2 virus during late pregnancy. The neonatal complications associated with COVID-19-positive pregnant women were investigated and analyzed. Results Among 2063 pregnant women over 28 weeks of gestation, 1.2%, 3.3%, and 18.7% of patients with multiple pregnancies, abnormal fetal positions, and lack of maternal or neonatal follow-up data, respectively, were excluded. Patients who were COVID-19-negative (60.6%) and -positive (16.2%) remained for further analysis. SARS-CoV-2 infection was significantly associated with higher SARS-CoV-2 infection rates in newborns (0% vs. 1.49%, P

Background: The World Health Organization recommends a cesarean delivery rate of 5–15%, which is thought to be within the range that can reduce infant morbidity and mortality. Various investigations have shown that those poor newborn outcomes are influenced by a variety of maternal and fetal factors and are more prevalent in emergencies than planned cesarean deliveries. Ethiopia is one of the five nations that account for 50% of all neonatal fatalities worldwide. Sub-Saharan African countries account for 38% of all infant deaths worldwide. Aim: To know the determinants of adverse early neonatal outcomes after emergency cesarean delivery. Method and material: A multicenter case-control study design would be carried out between November 2022 and January 2023. Using the consecutive method, a sample of 318 mother-newborn pairs was studied. Direct observation and face-to-face interviews were undertaken to gather the data using a semi-structured questionnaire. For both data input and analysis, Epi Data version 4.6 and Stata version 14 software were used. Both the crude and adjusted odds ratios were computed. The measure of significance was based on the adjusted odds ratio with a 95% confidence interval and a p-value of less than 0.05. Results: Maternal age over 35, the presence of danger signs during pregnancy, and non-reassuring fetal heart rate were significantly associated with increased risk of adverse fetal outcomes following emergency cesarean section. Women aged over 35 were 3.6 times more likely to experience adverse fetal outcomes compared to younger women (AOR: 3.6, 95% CI: 1.1, 9.7). Women with danger signs during pregnancy were 3.5 times more likely to have adverse fetal outcomes compared to those without (AOR = 3.5, 95% CI: 2.4, 36). Similarly, cases with non-reassuring fetal heart rate were associated with a 5.2 times higher risk of adverse newborn outcomes (AOR = 5.2, 95% CI: 1.1, 26). Conclusion: This study identified advanced maternal age (over 35 years old), pregnancy complications, and non-reassuring fetal heart rate as significant risk factors for adverse neonatal outcomes following emergency cesarean section. [ABSTRACT FROM AUTHOR]

Background: Foetal reduction, which involves selectively terminating one or more foetuses in a multiple gestation pregnancy, has become more common. This systematic review and meta-analysis aims to assess and compare pregnancy outcomes of foetal reduction from twin to singleton gestation to ongoing twin gestations. Methods: A comprehensive search of electronic databases (MEDLINE, EMbase, Cochrane Library, CINAHL and PsycINFO) was done for studies published until 15 April 2023. The outcomes analysed included gestational diabetes mellitus (DM), hypertension, caesarean delivery, foetal loss, perinatal death, preterm birth (PTB), intrauterine growth restriction (IUGR), preterm prelabour rupture of membranes (PPROM) and birth weight. Results: A total of 13 studies comprising 1241 cases of twin to singleton foetal reduction gestation were compared to 20,693 ongoing twin gestations. Our findings indicate that foetal reduction was associated with a significantly lower risk of developing maternal gestational DM (odds ratio [OR] = 0.40, 95% confidence interval [CI] 0.27–0.59) and hypertension (OR = 0.36, 95% CI 0.23–0.57) compared to the control group. Incidence rate of caesarean delivery (OR = 0.65, 95% CI 0.53–0.81) after foetal reduction was significantly lower compared to ongoing twin gestations. There was a 63% lower chance of PTB before 37 weeks of pregnancy. However, there was no significant association between foetal reduction and outcomes such as foetal loss, perinatal death, IUGR and PPROM. Conclusions: Our findings suggest that foetal twin to singleton reduction entails potential benefits as compared to ongoing twin gestations. Further well planned studies are needed to explore underlying mechanisms to understanding of the outcomes associated with foetal reduction procedures and inform clinical decision-making for pregnant individuals and healthcare providers alike. PLAIN LANGUAGE SUMMARY: Foetal reduction, a procedure where one or more foetuses in a twin pregnancy are selectively terminated, has become more common. This study reviewed existing research to compare the outcomes of foetal reduction to singleton pregnancies with those of ongoing twin pregnancies. The study found that mothers who underwent foetal reduction had a lower risk of developing gestational diabetes and hypertension, and they were less likely to have a caesarean delivery. There was also a reduced chance of preterm birth before 37 weeks. However, foetal reduction did not appear to significantly impact outcomes like foetal loss, perinatal death, intrauterine growth restriction or preterm pre-labour rupture of membranes. It is important to note that there is some variation in the results among different studies, and more research is needed to fully understand these findings. [ABSTRACT FROM AUTHOR]

Purpose: Distinct clinical phenotypes of pathological fetal heart rate (FHR) tracings may affect neonatal outcomes differently. This study aimed to determine and differentiate neonatal outcomes amongst the clinical phenotypes of pathological FHR tracing. Methods: This prospective observational study included women in labour with pathological fetal heart rate tracing during delivery. Pathological fetal heart rate tracings were characterized into 11 clinical phenotypes and corresponding neonatal and maternal outcomes were recorded. Neonates and mothers were followed till discharge from the hospital. The primary outcome was a 5-min Apgar score. The secondary outcomes were NICU admission, mode of delivery, mode of anesthesia, neonatal morbidity and mortality. Result: 271 women with pathological fetal heart rate tracing at the time of delivery were included in the study. Most of the women (64%) underwent cesarean delivery. The most common pathological fetal heart rate tracing was repetitive late decelerations (24.7%), followed by reduced variability with repetitive variable decelerations (24.4%). The 5-min Apgar score was comparable across all clinical phenotypes of pathological fetal heart rate tracing. Tachycardia with reduced variability was associated with a significantly higher likelihood of NICU admission (aOR 5.03, 95% CI 1.32–19.27, p = 0.018). Reduced variability, repetitive late decelerations and the combination of repetitive late decelerations with prolonged decelerations and reduced variability showed moderately increased odds of NICU admission. Conclusions: The 5-min Apgar score remained comparable in all clinical phenotypes of pathological fetal heart rate tracing. Nonetheless, the odds of NICU admission were significantly higher in women with tachycardia and reduced variability. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the maternal and newborn outcomes of pregnant women with placenta previa who gave birth at 36, 37, or 38 weeks. Material and Methods: We retrospectively examined the Gynecology and Obstetrics Clinic of Necmettin Erbakan University Faculty of Medicine Hospital between January 2015 and June 2024. We assessed the patients' demographic, and clinical data, and compared perinatal outcomes. Results: The study included 431 women with placenta previa, divided into three delivery timing groups: 36 weeks (n=127), 37 weeks (n=201), and 38 weeks (n=103). The median age was 36 years, median number of pregnancies was 3, and parity was 1. Preoperative and postoperative hemoglobin levels were 11.7±1.44 g/dL and 11.03±1.56 g/dL, respectively. Emergency hemorrhage necessitated cesarean delivery in 11.8% of cases. Spinal anesthesia was used in 52% of patients, and general anesthesia in 48%. The mean surgery duration was 59.6 minutes, and 16.9% received blood transfusions. The mean maternal hospital stay was 2 days, and 17.9% of neonates were admitted to the neonatal intensive care unit (NICU). No significant differences in maternal outcomes were found between groups. However, birth weights (p<0.001) and NICU admissions differed significantly (p<0.001). When patients requiring blood transfusion were evaluated according to gestational weeks, no statistically significant difference was found between the groups regarding preoperative hemoglobin, postoperative hemoglobin, and red blood cell transfusion requirements (p>0.05). Conclusion: This study has shown that delivery can be safely delayed until the 38th week of pregnancy in placenta previa patients, except in significant vaginal bleeding. [ABSTRACT FROM AUTHOR]

Objective: With the increasing number of cesarean sections worldwide, the need to determine the gestational age for scheduled cesarean sections has increased. The literature needs clear information, especially about cesarean sections four or more times. Our study aims to determine the ideal gestational week for mothers and babies in patients who are not in labor and who will have four or more cesarean sections. Methods: In our retrospective study, the records of 2318 pregnant women were accessed, and those with singleton pregnancies, without medication use during pregnancy, and without any complicated pregnancies, such as newly defined preeclampsia, diabetes, and thyroid disease, and those over 18 years of age were included. All of the cesarean sections were under scheduled conditions (no beginning of labor and no pain/contraction). The exclusion criteria were patients with vaginal dilatation and effacement, a history of uterine rupture, and a diagnosis of placental adhesion spectrum disorder. Maternal and neonatal outcomes were evaluated. Results: Although there was no significant difference in neonatal outcomes according to gestational week, regardless of the number of cesarean sections, transient tachypnea of the newborn increased significantly in scheduled cesareans performed at the 37th week compared with other weeks (p < 0.01). The results can be expected at 39 weeks and above. Conclusion: As a result, patients should not undergo cesarean section before 39 weeks unless they are in labor, and it seems safe to wait until 39 weeks. [ABSTRACT FROM AUTHOR]

Background: Twin pregnancy is associated with higher risks of adverse perinatal outcomes for both the mother and the babies. Among the many challenges in the follow-up of twin pregnancies, the mode of delivery is the last but not the least decision to be made, with the main influencing factors being amnionicity and fetal presentation. The aim of the study was to compare perinatal outcomes in two European centers using different protocols for twin birth in case of non-cephalic second twin; the Italian patients being delivered mainly by cesarean section with those in Belgium being routinely offered the choice of vaginal delivery (VD). Methods: This was a dual center international retrospective observational study. The population included 843 women with a twin pregnancy ≥ 32 weeks (dichorionic or monochorionic diamniotic pregnancies) and a known pregnancy outcome. The population was stratified according to chorionicity. Demographic and pregnancy data were reported per pregnancy, whereas neonatal outcomes were reported per fetus. We used multiple logistic regression models to adjust for possible confounding variables and to compute the adjusted odds ratio (adjOR) for each maternal or neonatal outcome. Results: The observed rate of cesarean delivery was significantly higher in the Italian cohort: 85% for dichorionic pregnancies and 94.4% for the monochorionic vs 45.2% and 54.4% respectively in the Belgian center (p-value < 0.001). We found that Belgian cohort showed significantly higher rates of NICU admission, respiratory distress at birth and Apgar score of < 7 after 5 min. Despite these differences, the composite severe adverse outcome was similar between the two groups. Conclusion: In this study, neither the presentation of the second twin nor the chorionicity affected maternal and severe neonatal outcomes, regardless of the mode of delivery in two tertiary care centers, but VD was associated to a poorer short-term neonatal outcome. [ABSTRACT FROM AUTHOR]

Background: The aim of this retrospective cohort study was to assess the impact of day 3(D3) embryo cell number on the clinical pregnancy and neonatal outcomes of day 4(D4) single embryo transfer in fresh cycles. Methods: The study included 431 day 4 single embryo transfer in fresh cycles conducted between December 2018 and June 2023. These cycles were divided into three groups according to the day 3 embryo cell number: 248 cycles in the 7 ~ 9-cell group, 149 cycles in the 10 ~ 13-cell group and 34 cycles in the >13-cell group, and clinical pregnancy outcomes and neonatal outcomes were compared among the three groups. Results: The clinical outcomes with 10 ~ 13-cell were significantly higher than those of the 7 ~ 9-cell group, regardless of whether the female age was < 30 or ≥ 30 years. The same result could be found when the insemination pattern was IVF, and when the transferred embryos were the grade of complete fusion. There were no differences in neonatal outcomes between different groups.After adjusting for confounding factors, the 7 ~ 9-cell group was associated with lower clinical pregnancy rates(CBR) and live birth rates(LBR) compared with the 10 ~ 13-cell group (CPR: aOR 0.527, 95% CI 0.317 ~ 0.874, P = 0.013; LBR: aOR 0.499, 95% CI 0.308 ~ 0.807, P = 0.005). Conclusion: The cell number of D3 embryos can be an important reference indicator for D4 embryo selection. When performing day 4 single embryo transfer in fresh cycles, embryos with 10 ~ 13-cell on D3 can be preferentially selected for transplantation to enhance clinical outcomes, especially when the insemination pattern is IVF, and when the transferred embryos are the grade of compaction stage. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions The study aimed to describe the incidence of pregnancy‐associated colorectal cancer (PACRC) in New South Wales (NSW), Australia, and to examine the perinatal outcomes of women with PACRC and their babies.A population‐based cohort study was conducted using linked data from NSW. The study group comprised all women diagnosed with colorectal cancer during pregnancy (gestational CRC) or postpartum (postpartum CRC). Women who gave birth without cancer during pregnancy or postpartum formed the comparison group (no‐cancer group).A total of 123 women were diagnosed with PACRC (22 gestational, 101 postpartum), and 1 786 078 women were in the no‐cancer group. The incidence of PACRC was 6.9/100 000 women giving birth. From 1994 to 2013, the incidence significantly increased even when adjusting for maternal age (adjusted increase of 5.8% per year). Women with gestational CRC had significantly higher odds of severe maternal complications (AOR 29.27, 95% CI: 11.18–76.63) and were more likely to give birth by labor induction or no‐labor caesarean section (AOR 4.39, 95% CI: 1.50–12.84) than women in the no‐cancer group. Although babies born to women with gestational CRC did not experience congenital anomalies, they had higher odds of planned preterm birth (AOR 9.91, 95% CI: 1.99–49.21) and severe neonatal adverse outcomes (AOR 8.65, CI: 3.65–20.5) than babies of women without cancer.The study found a significant increase in PACRC incidence in NSW over the study period, independent of maternal age. Increased interventions during gestational CRC births reflect management challenges with higher maternal and neonatal morbidities. [ABSTRACT FROM AUTHOR]

Objectives: The limited data regarding obstetrical outcomes in multiple pregnancies following both fresh embryo transfer and frozen-thawed embryo transfer (FET), along with the association between multiple pregnancies and increased pregnancy complications compared to singleton pregnancies, highlight the need for research on this topic. Therefore, this study aimed to compare obstetrical and neonatal outcomes of twin pregnancies after fresh embryo transfer versus FET. Design: This was a retrospective single-center study. Participants: There were in vitro fertilization (IVF) dichorionic twin pregnancies ≥23 weeks of gestation during 2010–2022. Setting: This retrospective study was based on data recorded at Galilee Medical Center, a tertiary-care university-affiliated hospital, Israel. Methods: We conducted a comparative analysis of obstetrical and neonatal outcomes between IVF dichorionic twin pregnancies after fresh embryo transfer and those after FET. This analysis included variables such as gestational age at delivery, birthweight, preterm birth rates, low birthweight rates, neonatal intensive care unit admissions, and complications related to prematurity. Results: The study included 389 IVF twin pregnancies: 253 after fresh embryo transfer and 136 after FET. Following fresh embryo transfer compared to FET, the mean gestational age at delivery was earlier (34 + 6 vs. 35 + 5 weeks, p = 0.001) and the rate of preterm birth (<37 weeks) was higher (70.4% vs. 53.7%, p = 0.001). This difference in gestational age at delivery remained significant after adjustment for maternal age, parity, and BMI (OR = 2.11, 95% CI: 2.11–3.27, p = 0.001). Similarly, the difference in preterm birth rates remained significant after adjustment of the same variables (p = 0.001). For the fresh embryo transfer compared to the FET group, the mean birthweight was lower (2,179.72 vs. 2,353.35 g, p = 0.003); and low birthweight and very low birthweight rates were higher (71.2% vs. 56.3%, p < 0.001 and 13.5% vs. 6.7%, p = 0.004, respectively). For the fresh embryo transfer compared to the FET group, the proportions were higher of neonates admitted to the neonatal intensive care unit (23.3% vs. 16.0%, p = 0.019), of neonates with respiratory distress syndrome (10.5% vs. 5.9%, p = 0.045) and those needing phototherapy (23.3% vs. 16.0%, p = 0.019). Limitations: Limitations of the study include its retrospective nature. Furthermore, we were unable to adjust for some confounders, such as the number of eggs retrieved, the number of embryos transferred, and methods for ovarian stimulation or preparation of the endometrium for embryo transfer. Conclusions: Obstetrical and neonatal outcomes of twin pregnancies were worse after fresh embryo transfer than after FET. The findings support favorable fetal outcomes after FET and support the current trend of shifting from fresh embryo transfer to FET. Prospective studies are needed to support our results. [ABSTRACT FROM AUTHOR]

The article focuses on the effect of esomeprazole in the treatment of preeclampsia in pregnant women. Topics include the comparison of esomeprazole and placebo in maternal and fetal outcomes, the lack of statistically significant differences between the groups, and the conclusion that esomeprazole's effectiveness in preventing or controlling preeclampsia remains uncertain.

Objective: This study aimed to investigate the fetal modified (mod)‐myocardial performance index (MPI) for fetal cardiac function in placenta percreta (PPC) pregnancies with placenta previa (PP) and assess neonatal outcomes. Materials and Methods: This study included 104 pregnant women: 52 with PPC and 52 as the control group. Mod‐MPI measurements and neonatal outcomes were evaluated in all cases. Results: The PPC group had a significantly lower left ejection time (p = 0.044) and significantly higher mod‐MPI (p = 0.001) than the control group. The optimal mod‐MPI predictive cut‐off value at the neonatal intensive care unit (NICU) admission in the PPC group was 0.53 with 53.8% specificity and 88.5% sensitivity (p = 0.019). The optimal mod‐MPI predictive cut‐off value at the 5th APGAR score below 7 in the PPC group was 0.55 with a specificity of 67.7% and a sensitivity of 76.2% (p = 0.016). Conclusion: Fetal MPI was higher in pregnant women with PPC compared to the control group. Among the PPC cases, those with MPI above a certain predictive level showed more frequent NICU admissions and lower APGAR scores. [ABSTRACT FROM AUTHOR]

Background/Objectives: In regions of Africa with a high prevalence of malaria, pregnant women in their first or second trimester should be administered intermittent preventive treatment in pregnancy (IPTp). However, infants may contract malaria despite the IPTp therapy that their mothers have received. The objective of the present investigation was to assess the symptoms and various treatments for neonatal malaria. Methods: Entropy weight and TOPSIS were used to achieve the study goal. The TOPSIS multi-attribute decision-making system was used to assess newborn malaria symptoms and select the optimal treatment, even for mothers receiving IPTp medication during pregnancy. The entropy weight approach calculated TOPSIS attribute weights. The present research used UNICEF data for 14 African nations in 2023. Results: The results indicated that neonates whose mothers received IPTp therapy ultimately contracted malaria, with diarrhea being the primary symptom. It is important to note that health providers administer a combination of zinc and oral rehydration solution (ORS) to infants as the most effective treatment for malaria symptoms, thereby abandoning the first-line treatment for malaria, artemisinin-based combination therapy (ACT). Conclusions: The most effective treatment for neonatal malaria is a combination of zinc and ORS, although less than half of children in Africa have access to ORS. Therefore, the findings of this study may encourage African countries to prioritize co-pack therapy in their procurement and supply, healthcare provider training, and expenditures. This therapy will also help alleviate the symptoms of malaria in neonates. [ABSTRACT FROM AUTHOR]

Antenatal corticosteroid therapy is a crucial intervention to improve neonatal outcomes in pregnancies at risk of preterm birth. Corticosteroids such as betamethasone and dexamethasone enhance fetal lung maturation and reduce morbidity and mortality. To assess the effects of these drugs, we conducted a systematic review adhering to PRISMA guidelines. Data were located through extensive searches of PubMed, MEDLINE, Cochrane Library, Scopus, and Web of Science, using keywords such as "antenatal corticosteroids," "fetal Doppler," and "neonatal outcomes," and applying filters for human studies published between 2013 and 2024. Studies were selected based on inclusion criteria that prioritized original research articles, systematic reviews, and meta-analyses in English. Screening and eligibility assessments were performed by independent reviewers, with full-text articles. Data extraction involved recording study designs, sample sizes, corticosteroid regimens, Doppler metrics assessed, and neonatal outcomes observed. The extracted data were synthesized qualitatively through narrative methods and quantitatively using meta-analysis where applicable. The review found that corticosteroid administration leads to transient reductions in the resistance and pulsatility indices of key fetal vessels, reflecting improved placental and cerebral perfusion. These Doppler changes correlate with better neonatal outcomes, including reduced respiratory distress syndrome and enhanced neurodevelopmental results. Despite these promising findings, limitations such as small sample sizes and short follow-up periods were noted. Future research should focus on larger, multicenter trials and long-term outcome assessments. Clinicians are advised to incorporate serial Doppler monitoring in high-risk pregnancies to optimize maternal-fetal management and neonatal outcomes. [ABSTRACT FROM AUTHOR]

The impacts of maternal depression during mid-to-late pregnancy on fetal growth have been extensively investigated. However, the association between maternal depression during early pregnancy and fetal intrauterine growth are less clear. A prospective study comprised 23,465 eligible pregnant women and their offspring was conducted at a hospital-based center in Shanghai. Prenatal depression was assessed used using Patient Health Questionnaire (PHQ-9) before 14 gestational weeks. Differences in fetal growth trajectory of different maternal depressive statuses during three periods (16–23, 24–31, and 32–41 gestational weeks) were compared using a multilevel model with fractional polynomials. Women with depressive symptoms during early pregnancy had higher longitudinal fetal trajectories, with an estimated increase in fetal weight (β = 0.33; 95 % CI, 0.06–0.61), compared to those without depressive symptoms. Increases in fetal abdominal circumference among women with depressive symptoms were observed before 23 gestational weeks. Offspring born to mothers with early pregnancy depression had a significantly higher birth weight of 14.13 g (95 % CI, 1.33–27.81 g) and an increased risk of severe large size for gestational age (adjusted odds ratio [aOR], 1.64; 95 % CI, 1.32–2.04) and macrosomia (aOR, 1.21; 95 % CI, 1.02–1.43). Self-rated scale was used to assess depressive symptoms rather than clinical diagnosis. And Long-term effects of early pregnancy depression on offspring were not explored. The study revealed an association between maternal depression during early pregnancy and increased fetal biometrics, higher birth weight, and an elevated risk of severe large size for gestational age and macrosomia. • Maternal depression during early pregnancy is associated with excessive fetal growth and increased birth weight. • The effect of early pregnancy depression on fetal growth is strongest in late pregnancy. • Prenatal depression screening should be taken in early stages of pregnancy. [ABSTRACT FROM AUTHOR]

Introduction: There is a growing body of evidence supporting the role of customized growth charts in improving detection of fetal growth restriction (FGR) and decreasing false positive diagnoses. The aim of the study is to produce a customised birthweight standard for Poland. Material and methods: Maternal height and weight, ethnicity, gestational age, weight and sex at birth as well as pre-existing and gestational complications were collected. Coefficients were derived using a backwards stepwise multiple regression technique. Smallness for gestational age by the customised standard was compared with the in-use Fenton standard in assessing risk of adverse outcomes using relative risk with 95% confidence intervals. Results: Data from 4,270 pregnancies were used as the study cohort. Fenton and customised SGA rates were 6.6% and 11.9%, respectively. The customised standard identified more cases that were at significantly increased risk of stillbirth, admission to neonatal intensive care or other neonatal complications, many of which were missed by the Fenton standard. Conclusions: The analysis confirmed the physiological variables that affect birthweight in studies from other countries and was able to quantify additional pathological factors of high maternal age and pregnancy-induced hypertension. Comparison with the Fenton standard showed that adverse outcomes associated with SGA birthweight are better identified by the customised standard in a Polish population. [ABSTRACT FROM AUTHOR]

Background: Limited data on the impact of the coronavirus disease 2019 (COVID-19) during pregnancy on newborn outcomes are available. This study aimed to characterize and compare the clinical outcomes of newborns from women with and without the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection during late pregnancy. Method: This was a retrospective cohort study of women who were either infected or not infected with the SARS-CoV-2 virus during late pregnancy. The neonatal complications associated with COVID-19-positive pregnant women were investigated and analyzed. Results: Among 2063 pregnant women over 28 weeks of gestation, 1.2%, 3.3%, and 18.7% of patients with multiple pregnancies, abnormal fetal positions, and lack of maternal or neonatal follow-up data, respectively, were excluded. Patients who were COVID-19-negative (60.6%) and -positive (16.2%) remained for further analysis. SARS-CoV-2 infection was significantly associated with higher SARS-CoV-2 infection rates in newborns (0% vs. 1.49%, P < 0.01) and longer duration of hospital stay (6.39 ± 2.2 vs. 4.92 ± 1.6, P < 0.01). However, comparing neonatal complications, including Apgar score, preterm birth, low birth weight, cesarean section rate, newborn hearing, neonatal congenital heart defects, and height and weight compliance rate of 6-month-old children, between non-infected and infected participants did not reach statistical significance. Conclusion: SARS-CoV-2 infection in late pregnancy has no significant impact on neonatal outcomes. After six months of follow-up of the neonates, we observed that SARS-CoV-2 infection in the third trimester of pregnancy did not affect their growth and development. Hopefully, these findings will guide management strategies and clinical practice. [ABSTRACT FROM AUTHOR]

Objectives: Whereas some women may perceive pregnancy as a welcome challenge and a source of satisfaction, self-development, and maturity, others may experience perinatal-specific stress (PSS). Emerging evidence has demonstrated the efficacy of mindfulness-based interventions (MBIs) for perinatal women. Given the debate about the effects of MBIs on PSS reduction, as well as the limitations of existing studies, such as practical concerns and small sample sizes, the current study aimed to contribute further evidence by utilizing a randomized controlled trial (RCT) to investigate the effects of mobile-delivered MBIs on women's PSS and neonatal outcomes, compared with outcomes from a mobile-delivered psychoeducation intervention. Method: One hundred and seventy-eight adult pregnant women were randomized into two groups––one to receive a mobile-delivered eight-session MBI (n = 93) and the other to receive a web-based perinatal education program (n = 85). Outcomes included perinatal distress, mindfulness, and neonatal outcomes. Results: Women in the MBI group showed a significantly greater reduction in their PSS levels from baseline to the follow-up-timepoint (T2) compared with the control group. The MBI group had a significant enhancement of mindfulness, and their newborns had higher Apgar scores compared with the control group. Mindfulness improvement levels after the intervention significantly mediated the intervention effect in reducing the participating women's PSS levels. Conclusions: With a reasonably high participation rate (approximately 75%), the MBI delivered by mobile phone can be a feasible, desirable, and efficacious intervention for reducing perinatal-specific stress throughout pregnancy and enhancing neonatal outcomes. [ABSTRACT FROM AUTHOR]

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Background: Prenatal arsenic exposure can harm both the mother and foetus by changing gene expression and impacting foetal growth. The study aimed to assess the impact of arsenic exposure on GLI3 expression in feto-placental tissue via maternal blood and record neonatal outcomes. Material and Methods: The study used 54 mother-infant pairs. Atomic absorption spectrophotometer used for measuring arsenic in maternal blood. Based on the median value of arsenic content in maternal blood, samples were split into two groups: the arsenic-low and the arsenic-high group. Maternal age, gestational age, arsenic exposure history, neonatal data were compared between two groups. Using qRT-PCR fold change in GLI3 expression was determined. Results: Many participants resided in arsenic-contaminated regions and consumed underground water. The arsenic high group had a considerably higher mean arsenic content. The arsenic high group had a considerably lower gestational age than the low group. Neonatal birth weight significantly reduced in arsenic high group. Neonatal birth length increased in arsenic high group in comparison to arsenic-low group. Exposure to arsenic significantly decreased the relative expression of GLI3. Conclusion: Prenatal arsenic exposure via maternal blood reduces GLI3 expression and affects neonatal anthropometry.

Abstract Objectives This study aimed to compare plasma concentrations of anesthetic drugs administered during Cesarean section with low Apgar score in neonates deliveried under general anesthesia and analyze associated risk factors. Methods Data from 76 neonates undergoing Cesarean section under general anesthesia with blood concentrations of anesthetic drugs were analyzed. A low Apgar score was defined as ≤ 7. Perioperative maternal and neonatal data were collected and analyzed. Neonates were divided into a control group (Group CON, n = 65) and a low Apgar score group (Group LAS, n = 11) based on Apgar score. Results There were no significant differences in the plasma concentrations of anesthetic drugs in maternal artery, umbilical vein or umbilical artery blood between the two groups. Risk factors for neonatal low Apgar scores during Cesarean section under general anesthesia were premature delivery (aOR 10.2, 95% CI = 1.8–56.9) and preoperative fetal distress (aOR 9.6, 95% CI = 1.3–69.0). The prediction model was: probability = 1/(e‑Y), Y= -4.607 + 2.318× (premature delivery) + 2.261× (fetal distress) (yes = 1, no = 0). The Hosmer–Lemeshow test showed χ²= 9.587, P = 0.213, and the area under the curve (AUC) was 0.850 (0.670 ~ 1.000). With a cutoff value of 0.695, sensitivity and specificity were 81.8% and 87.7%, respectively. Conclusions There was no correlation between blood concentration of general anesthetic drugs and Apgar score or occurrence of neonatal low Apgar scores. Premature delivery and preoperative fetal distress were identified as independent risk factors for neonatal low Apgar scores after Cesarean section under general anesthesia.

Abstract Background With the increasing incidence of obesity and the childbearing-age delay among women, a debate over obesity’s impacts on pregnancy and neonatal outcomes becomes hot. The potential negative effects of obesity and aging on fertility lead to an idea, whether an obese female pursuing IVF treatment can benefit from an ideal BMI achieved over a long-time weight loss process at the cost of aging? We aimed to assess the association between body mass index (BMI) and clinical or neonatal outcomes in patients undergoing in vitro fertilization (IVF) treatment, for answering whether it is necessary to lose weight first for obese patients, particularly those at advanced age. Methods A retrospective cohort study was performed using multicentered data from China. The women were stratified into 5 groups in terms of pre-gravid BMI (kg/m2) with the WHO obesity standard (group 1: BMI

Objectives: This study aimed to compare plasma concentrations of anesthetic drugs administered during Cesarean section with low Apgar score in neonates deliveried under general anesthesia and analyze associated risk factors. Methods: Data from 76 neonates undergoing Cesarean section under general anesthesia with blood concentrations of anesthetic drugs were analyzed. A low Apgar score was defined as ≤ 7. Perioperative maternal and neonatal data were collected and analyzed. Neonates were divided into a control group (Group CON, n = 65) and a low Apgar score group (Group LAS, n = 11) based on Apgar score. Results: There were no significant differences in the plasma concentrations of anesthetic drugs in maternal artery, umbilical vein or umbilical artery blood between the two groups. Risk factors for neonatal low Apgar scores during Cesarean section under general anesthesia were premature delivery (aOR 10.2, 95% CI = 1.8–56.9) and preoperative fetal distress (aOR 9.6, 95% CI = 1.3–69.0). The prediction model was: probability = 1/(e‑Y), Y= -4.607 + 2.318× (premature delivery) + 2.261× (fetal distress) (yes = 1, no = 0). The Hosmer–Lemeshow test showed χ²= 9.587, P = 0.213, and the area under the curve (AUC) was 0.850 (0.670 ~ 1.000). With a cutoff value of 0.695, sensitivity and specificity were 81.8% and 87.7%, respectively. Conclusions: There was no correlation between blood concentration of general anesthetic drugs and Apgar score or occurrence of neonatal low Apgar scores. Premature delivery and preoperative fetal distress were identified as independent risk factors for neonatal low Apgar scores after Cesarean section under general anesthesia. [ABSTRACT FROM AUTHOR]

Background/Aim: The aim of the present retrospective study was to examine the efficiency and safety of the induction of labor with Misoprostol, administered either vaginally or orally. Patients and Methods: This retrospective cohort study included pregnant women with a gestational age of ≥36 +0 weeks and a singleton pregnancy who underwent induction of labor with Misoprostol as vaginal insert or as tablet (oral) between January 2014 and January 2019 at the Department of Obstetrics and Gynecology of the University Hospital of Cologne. The objective of this study was to analyze the time until delivery and the maternal and neonatal outcomes. Results: A total of 1,511 patients were included in this retrospective analysis, of whom 1,035 patients (68.5%) underwent induction of labor with a misoprostol vaginal insert (MVI) and 476 (31.5%) with tablets (oral misoprostol: OM). MVI significantly shortened the time from application to delivery (p<0.001) in comparison to OM, reduced the need for epidural anesthesia (EA) (p=0.018) without an increase in caesarean sections (CS) (p=1), ventouse deliveries (VD) (p=0.715), maternal birth injuries or a reduced neonatal outcome (APGAR-Score, umbilical cord pH). Conclusion: MVI is superior to OM in terms of efficiency (primary outcome: time from application to delivery) and is equally safe (primary outcome: CS rate). Our study, along with existing literature, highlights the need for further research, particularly regarding neonatal outcomes. Additionally, it underscores the importance of careful consideration when inducing labor and ensuring informed consent. [ABSTRACT FROM AUTHOR]

Objective: To determine the incidence, risk factors and outcomes of babies with neonatal jaundice in a network of referral‐level hospitals in Nigeria. Design: A cross‐sectional analysis of perinatal data collected over a 1‐year period. Setting: Fifty‐four referral‐level hospitals (48 public and 6 private) across the six geopolitical zones of Nigeria. Population: A total of 77 026 babies born at or admitted to the participating facilities (67 697 hospital live births; plus 9329 out‐born babies), with information on jaundice between 1 September 2019 and 31 August 2020. Methods: Data were extracted and analysed to calculate incidence and sociodemographic and clinical risk factors for neonatal jaundice. Main outcome measures: Incidence and risk factors of neonatal jaundice in the 54‐referral hospitals in Nigeria. Results: Of 77 026 babies born in or admitted to the participating facilities, 3228 had jaundice (41.92 per 1000 live births). Of the 67 697 hospital live births, 845 babies had jaundice (12.48 per 1000 live births). The risk factors associated with neonatal jaundice were no formal education (adjusted odds ratio [aOR] 1.68, 95% CI 1.11–2.52) or post‐secondary education (aOR 1.17, 95% CI 0.99–1.38), previous caesarean section (aOR 1.68, 95% CI 1.40–2.03), booked antenatal care at <13 weeks or 13–26 weeks of gestation (aOR 1.58, 95% CI 1.20–2.08; aOR 1.15, 95% CI 0.93–1.42, respectively), preterm birth (aOR 1.43, 95% CI 1.14–1.78) and labour more than 18 hours (aOR 2.14, 95% CI 1.74–2.63). Conclusions: Hospital‐level and regional‐level strategies are needed to address newborn jaundice, which include a focus on management and discharge counselling on signs of jaundice. [ABSTRACT FROM AUTHOR]

Purpose: Fetal sex is independently associated with pregnancy complications and impacts neonatal outcomes. Evidence suggests that females have an advantage over males, with a better outcome in the perinatal period. In addition, fetal outcome in twin gestations is also related to the intrauterine position of the fetus, such as the first, the presenting or second twin. It has been demonstrated that the neonatal outcome of the second fetus is worse than that of the first fetus. This study aimed to examine the influence of fetal sex on obstetric outcomes in twin pregnancies based on the location of the fetus in the uterus. Methods: Retrospective study. Maternal and obstetric outcomes were compared among three groups: male‒male, female‒female, and male‒female groups. Comparisons of neonatal outcomes were performed among the four groups: male A-male B, male A-female B, female A-male B, and female A-female B. Results: A total of 1073 twin gestations were included, comprising 288 male‒male, 288 female‒female, and 497 male‒female gestations. A greater percentage of neonates admitted to the NICU was observed for male fetuses than for female fetuses. Adverse composite neonatal outcome was more common in the male‒male group than in the female‒male group and in the female‒female group. Conclusion: Twin gestation with a first twin male tends to have worse neonatal outcomes than does twin gestation with a first twin female. The presence of a male co-twin increases the risk of adverse outcomes. [ABSTRACT FROM AUTHOR]

Objective: To assess the prevalence of adenomyosis at pathologic examination, and its association with obstetric complications, peripartum maternal clinical characteristics and neonatal birth weight in patients undergoing postpartum hysterectomy due to postpartum hemorrhage (PPH). Methods: A multicenter, observational, retrospective, cohort study was carried out including all women who underwent postpartum hysterectomy due to PPH at gestational week 23+0 or later, between January 2010 and May 2023. Patients were categorized into two groups based on the presence of adenomyosis at pathologic examination, and were compared for obstetric complications, peripartum maternal clinical characteristics, and neonatal birth weight. Results: The histologically‐based prevalence of adenomyosis in patients undergoing postpartum hysterectomy due to PPH was 39.4%. Adenomyosis was associated with a longer hospitalization time (regression coefficient: 4.43 days, 95% CI: 0.34–8.52, P = 0.034) and a higher risk of hypertensive disorders (OR: 5.82, 95% CI: 1.38–24.46, P = 0.016), threatened preterm labor (OR: 3.34, 95% CI: 1.08–10.31, P = 0.036), urgent/emergency C‐section (OR: 24.15, 95% CI: 2.60–223.96, P = 0.005), postpartum maternal complications (OR: 4.96, 95% CI: 1.48–16.67, P = 0.012), maternal intensive care unit admission (OR: 3.56, 95% CI: 1.05–12.05, P = 0.041), and low birth weight neonates (OR: 3.8, 95% CI: 1.32–11.02, P = 0.013). Conclusion: In patients undergoing postpartum hysterectomy due to PPH, adenomyosis is a highly prevalent condition among, and is associated with adverse obstetric, maternal, and neonatal outcomes. Synopsis: In patients undergoing postpartum hysterectomy due to postpartum hemorrhage, adenomyosis shows a histologically‐based prevalence of almost 40% and is associated to several adverse obstetric, maternal, and neonatal outcomes. [ABSTRACT FROM AUTHOR]

It is necessary to quantify the relationship between pregnancy outcomes and epilepsy and antiepileptic medication exposure. To look into the relationship between epilepsy and reproductive outcomes, and whether or not antiepileptic medication exposure was involved, this systematic review was conducted. This review was conducted following PRISMA guidelines. Hence, studies that discussed the newborn and maternal outcomes of mothers with epilepsy, were published between the years 2011 and 2024 and were searched using electronic databases including MEDLINE, Cochrane, AMED, and Embase, without regard to language limitations. Fourteen articles totaling 3,177,752 participants (16,647 with epilepsy and 3,161,105 without epilepsy) were included in the systematic review; twelve of the included studies discussed both maternal and neonatal out-comes, one study focused solely on neonatal outcomes, and one study solely on maternal outcomes. It was found that there is a correlation between epilepsy, antiepileptic medication exposure, and unfavorable out-comes for the mother, newborn, and infants during pregnancy. [ABSTRACT FROM AUTHOR]

Intrauterine growth restriction leads to an altered lipid and amino acid profile in the cord blood at the end of pregnancy. Pre-pregnancy underweight is an early risk factor for impaired fetal growth. The aim of this study was to investigate whether a pre-pregnancy body mass index (ppBMI) of <18.5 kg/m2, as early as at the beginning of pregnancy, is associated with changes in the umbilical cord metabolome. In a sample of the Survey of Neonates in Pomerania (SNIP) birth cohort, the cord blood metabolome of n = 240 newborns of mothers with a ppBMI of <18.5 kg/m2 with n = 208 controls (ppBMI of 18.5–24.9 kg/m2) was measured by NMR spectrometry. A maternal ppBMI of <18.5 kg/m2 was associated with increased concentrations of HDL4 cholesterol, HDL4 phospholipids, VLDL5 cholesterol, HDL 2, and HDL4 Apo-A1, as well as decreased VLDL triglycerides and HDL2 free cholesterol. A ppBMI of <18.5 kg/m2 combined with poor intrauterine growth (a gestational weight gain (GWG) < 25th percentile) was associated with decreased concentrations of total cholesterol; cholesterol transporting lipoproteins (LDL4, LDL6, LDL free cholesterol, and HDL2 free cholesterol); LDL4 Apo-B; total Apo-A2; and HDL3 Apo-A2. In conclusion, maternal underweight at the beginning of pregnancy already results in metabolic changes in the lipid profile in the cord blood, but the pattern changes when poor GWG is followed by pre-pregnancy underweight. [ABSTRACT FROM AUTHOR]

Background: With the increasing incidence of obesity and the childbearing-age delay among women, a debate over obesity's impacts on pregnancy and neonatal outcomes becomes hot. The potential negative effects of obesity and aging on fertility lead to an idea, whether an obese female pursuing IVF treatment can benefit from an ideal BMI achieved over a long-time weight loss process at the cost of aging? We aimed to assess the association between body mass index (BMI) and clinical or neonatal outcomes in patients undergoing in vitro fertilization (IVF) treatment, for answering whether it is necessary to lose weight first for obese patients, particularly those at advanced age. Methods: A retrospective cohort study was performed using multicentered data from China. The women were stratified into 5 groups in terms of pre-gravid BMI (kg/m2) with the WHO obesity standard (group 1: BMI < 18.5; group 2: 18.5 ≤ BMI < 23.0; group 3: 23.0 ≤ BMI < 25.0; group 4: 25.0 ≤ BMI < 30.0; group 5: BMI ≥ 30.0). The primary outcome was cumulative live birth rate (CLBR), and other clinical and neonatal outcomes were weighed as secondary outcomes. Multivariate logistic regression analyses were carried to evaluate the association between BMI and the CLBR, or between BMI and some neonatal outcomes. Furthermore, we implemented a machine-learning algorithm to predict the CLBR based on age and BMI. Results: A total of 115,287 women who underwent first IVF cycles with autologous oocytes from January 2013 to December 2017 were included in our study. The difference in the CLBR among the five groups was statistically significant (P < 0.001). The multivariate logistic regression analysis showed that BMI had no significant impact on the CLBR, while women's age associated with the CLBR negatively. Further, the calculation of the CLBR in different age stratifications among the five groups revealed that the CLBR lowered with age increasing, quantitatively, it decreased by approximately 2% for each one-year increment after 35 years old, while little difference observed in the CLBR corresponding to the five groups at the same age stratification. The machine-learning algorithm derived model showed that BMI's effect on the CLBR in each age stratification was negligible, but age's impact on the CLBR was overwhelming. The multivariate logistic regression analysis showed that BMI did not affect preterm birth, low birth weight infant, small for gestational age (SGA) and large for gestational age (LGA), while BMI was an independent risk factor for fetal macrosomia, which was positively associated with BMI. Conclusions: Maternal pre-gravid BMI had no association with the CLBR and neonatal outcomes, except for fetal macrosomia. While the CLBR was lowered with age increasing. For the IVF-pursuing women with obesity plus advanced age, rather than losing weight first, the sooner the treatment starts, the better. A multicentered prospective study with a large size of samples is needed to confirm this conclusion in the future. [ABSTRACT FROM AUTHOR]

Obesity is an important risk factor for the development of pregnancy complications. We investigated the effects of pregestational overweight and obesity on maternal lipidome during pregnancy and on newborns' characteristics. The study encompassed 131 pregnant women, 99 with pre-pregnancy body mass index (BMI) < 25 kg/m2 and 32 with BMI ≥ 25 kg/m2. Maternal lipid status parameters, plasma markers of cholesterol synthesis and absorption and sphingolipids were determined in each trimester. Data on neonatal height, weight and APGAR scores were assessed. The results showed a higher prevalence (p < 0.05) of pregnancy and childbirth complications among the participants with elevated pregestational BMI. Levels of total cholesterol, HDL-cholesterol (p < 0.05) and LDL-cholesterol (p < 0.01) were significantly lower, and concentrations of triglycerides were higher (p < 0.05) in women with increased pre-gestational BMI. Lower concentrations of the cholesterol synthesis marker, desmosterol, in the 2nd trimester (p < 0.01) and the cholesterol absorption marker, campesterol, in each trimester (p < 0.01, p < 0.05, p < 0.01, respectively) were also found in this group. Markers of maternal cholesterol synthesis were in positive correlation with neonatal APGAR scores in the group of mothers with healthy pre-pregnancy weight but in negative correlation in the overweight/obese group. Our results indicate that gestational adaptations of maternal lipidome depend on her pregestational nutritional status and that such changes may affect neonatal outcomes. [ABSTRACT FROM AUTHOR]

This sub-study within the JAKIDS longitudinal cohort study compares medical and psychosocial outcomes of pregnancy in younger adolescent mothers (<16 years), older adolescent mothers (16–19 years) and adult mothers (>19 years) in Jamaica. Participants were recruited from July to September 2011 and included 9521 mother–infant dyads; mean maternal age 26.0 years (SD 6.8). Adolescent mothers represented 19.1% (n = 1822) of the sample – 1704 older adolescent mothers (17.9%) and 118 younger adolescent mothers (1.2%). Participants completed interviewer-administered questionnaires regarding their sexual and reproductive health history, feelings about the current pregnancy, and presence of anxious and depressive symptoms. Data on delivery and perinatal and neonatal outcomes were extracted from hospital charts. Younger adolescent mothers were more likely to deliver preterm (p < 0.001) and low birth weight infants (p < 0.001) than older adolescent and adult mothers. Younger adolescent mothers had lower levels of antenatal anxiety regarding the pregnancy and its outcome (p < 0.001) while prevalence of elevated depressive symptoms antenatally (EPDS ≥11) was similar across age groups. Older adolescent mothers with significant depressive symptoms had increased odds of preterm delivery. These findings call for close antenatal monitoring of younger adolescent mothers and highlight the need for psychological services for all mothers. [ABSTRACT FROM AUTHOR]

This study aimed to determine the mortality in a Jamaican birth cohort over a 3-month period. Data on the outcome of 87.5% of all births in Jamaica between July and September 2011 were used to determine trends in and determinants of neonatal mortality. There were 9650 live births and 144 neonatal deaths yielding a Neonatal Mortality Rate of 14.9/1000 (95% CI: 12.6–17.52/1000) livebirths. One hundred and twenty-one (84%) deaths occurred within the first seven days of life giving an Early Neonatal Mortality Rate of 12.5/1000 (95%CI: 10.4–15.0/1000) livebirths and a Late Neonatal Mortality Rate of 2.38/1000 (95%CI: 1.51–3.57/1000) live births. Sixty-nine (48%) deaths occurred within the first 24 hours. Thirty-eight neonates (26%) died prior to being admitted to a neonatal unit, approximately within 2 hours of life. Maternal age <15 years, decreasing birthweight, prematurity, male gender, multiple gestation and birth by caesarean section were associated with an increased risk of mortality p < 0.05. In order for Jamaica to experience further decline in its Neonatal Mortality Rate to meet the Sustainable Developmental Goal of at least as low as 12 per 1,000 live births by 2030 the focus must be on decreasing mortality in the very low birth weight infants who disproportionally contribute to mortality as well as continuing to implement measures to further decrease mortality in the larger infants. [ABSTRACT FROM AUTHOR]

Purpose: Pregnancies complicated by placenta accreta spectrum (PAS) are associated with severe maternal morbidities. The aim of this study is to describe the neonatal outcomes in pregnancies complicated with PAS compared with pregnancies not complicated by PAS. Methods: A retrospective cohort study conducted at a single tertiary center between 03/2011 and 01/2022, comparing women with PAS who underwent cesarean delivery (CD) to a matched control group of women without PAS who underwent CD. We evaluated the following adverse neonatal outcomes: umbilical artery pH < 7.0, umbilical artery base excess ≤ − 12, APGAR score < 7 at 5 min, neonatal intensive care unit (NICU) admission, mechanical ventilation, hypoxic ischemic encephalopathy, seizures and neonatal death. We also evaluated a composite adverse neonatal outcome, defined as the occurrence of at least one of the adverse neonatal outcomes described above. Multivariable regression analysis was used to determine which adverse neonatal outcome were independently associated with the presence of PAS. Results: 265 women with PAS were included in the study group and were matched to 1382 controls. In the PAS group compared with controls, the rate of composite adverse neonatal outcomes was significantly higher (33.6% vs. 18.7%, respectively, p < 0.001). In a multivariable logistic regression analysis, Apgar score < 7 at 5 min, NICU admission and composite adverse neonatal outcome were independently associated with PAS. Conclusion: Neonates in PAS pregnancies had higher rates of adverse outcomes. Apgar score < 7 at 5 min, NICU admission and composite adverse neonatal outcome were independently associated with PAS. [ABSTRACT FROM AUTHOR]

Objective Fetal growth restriction (FGR) is defined as an estimated fetal weight (EFW) or abdominal circumference (AC) <10th percentile (%ile) for gestational age (GA). An EFW <3rd %ile for GA is considered severe FGR (sFGR). It remains unknown if fetuses with isolated AC <3rd %ile should be considered sFGR. Our primary objective was to assess composite neonatal outcomes in fetuses with an AC <3 rd %ile and overall EFW 3rd to 9th %ile compared with those with an EFW <3rd %ile. Study Design This retrospective cohort study was undertaken at a tertiary academic center from January 2016 to December 2021. Inclusion criteria were singleton fetuses with an EFW <3rd %ile (Group 1) or AC <3rd %ile with EFW 3rd to 9th %ile (Group 2) at 28 weeks' gestation or greater. Exclusion criteria were multiple gestations, presence of a major fetal anomaly, resolution of FGR, genetic syndrome, or infection. Composite neonatal outcome was defined by any of the following: neonatal intensive care unit admission >48 hours, necrotizing enterocolitis, sepsis, respiratory distress syndrome, mechanical ventilation, retinopathy of prematurity, seizures, intraventricular hemorrhage, stillbirth, or death before discharge. Small for gestational age (SGA) was defined as birth weight <10th %ile for GA. Results A total of 743 patients fulfilled our study criteria, with 489 in Group 1 and 254 in Group 2. The composite neonatal outcome occurred in 281 (57.5%) neonates in Group 1 and 53 (20.9%) in Group 2 (p < 0.01). The rates of SGA at birth were 94.9 and 75.6% for Group 1 and Group 2, respectively (OR 5.99, 95% confidence interval 3.65–9.82). Conclusion Although AC <3rd %ile with EFW 3rd to 9th %ile is associated with a lower frequency of SGA and neonatal morbidity than EFW <3 %ile, fetuses with AC <3 %ile still exhibited moderate rates of these adverse perinatal outcomes. Consideration should be given to inclusion of an AC <3rd %ile with EFW 3rd to 9th %ile as a criterion for sFGR. However, prospective studies comparing delivery at 37 versus 38 to 39 weeks' gestation are needed to ensure improved outcomes before widespread adaptation in clinical practice. Key Points The composite neonatal outcome occurred in 57.5% of fetuses with an overall EFW <3rd %ile and 20.9% of fetuses with an AC <3rd %ile but EFW 3rd to 9th %ile. Both groups demonstrated a high positive predictive value for SGA birth weight. Consideration should be given to inclusion of an AC <3rd %ile as a criterion for sFGR. [ABSTRACT FROM AUTHOR]