BMC Pregnancy and Childbirth

ObjectiveTo evaluate modifiable antepartum and intrapartum factors associated with nulliparous, term, singleton, vertex (NTSV) cesarean delivery and to model risk stratified induction timing strategies that minimize cesarean risk across maternal risk profiles. Study DesignThis retrospective cohort study included all NTSV deliveries at a tertiary care center from January 2015 through August 2025 (overall cohort n=10,525; limited risk cohort n=5,663). Machine learning identified key predictors o...

BackgroundAdvanced maternal age (AMA, [≥]35 years) has become increasingly common, with corresponding rises in obstetric complications. Abnormal placental cord insertion (PCI), including marginal (MCI) and velamentous cord insertion (VCI), has been linked to adverse perinatal outcomes, yet its relationship with AMA remains poorly defined. This study examined whether AMA is associated with abnormal PCI morphology in singleton pregnancies. MethodsA secondary analysis was conducted using 564 pr...

ObjectiveTo analyse clinical factors associated with urinary albumin-to-creatinine ratio among women with preeclampsia. Design & MethodsA prospective cohort analysis was conceived at Amana referral regional hospital. Women with preeclampsia (exposed group) were compared with women without evidence of preeclampsia (control group) from any time after 20th week of pregnancy to at most 24-hours post-delivery. A simple random sampling with 1:1 matching was used to get study participants. Each partic...

ObjectivesTo determine temporal trends in the rates of preterm birth and its sub-types in Sweden and assess the contribution of known-risk factors. DesignA population-based register study. SettingSweden. Participants (Instead of patients or subjects)3,264,146 pregnancies registered in the Swedish Medical Birth Registry with information on pregnancy duration and onset of labour (1991 - 2021). Main outcome measuresThe primary outcomes were the overall, spontaneous and iatrogenic preterm birth ...

BackgroundIn Belgium, maternal and newborn health indicators indicate high quality of care compared to other countries of Europe. However, some challenges still persist in the quality of maternal and newborn care (QMNC) and little is known regarding womens experience with care and their mental health (MH). MethodsWe conducted a cross-sectional survey among 621 women who gave birth between March 2022 and January 2025 in Belgium, using the WHO-based IMAgiNE EURO questionnaire, updated with MH ite...

BackgroundEstimating the contribution of preeclampsia (PE) to perinatal mortality in low-resource settings remains difficult due to limited diagnostic capacity. Lack of specific histopathologic changes in stillbirth, foetuses and/or placenta often hampers assignment of PE as cause of death. While PE angiogenic biomarkers (sFlt-1, PlGF) predict adverse pregnancy outcomes, their post-mortem diagnostic utility is unclear. We evaluated the potential role of these biomarkers in identifying PE-related...

Preterm premature rupture of membranes (PPROM) is a major obstetric complication, particularly at early gestational ages. This retrospective, bicentric study (2019-2023) analyzed the short-term outcomes of pregnancies complicated by PPROM between 22 and 32 weeks of gestation under expectant management. Patients were divided into two groups: G1 (22-26 weeks) and G2 (26-32 weeks). The mean maternal age was 32 years, with a history of PPROM and preterm birth in 26% and 29% of cases, respectively. ...

BackgroundUterine atony ([~]70%), lacerations ([~]20%) and placenta-related problems ([~]10%) are assumed main reasons for postpartum hemorrhage genesis. Coagulation components predictive for postpartum blood loss can be identified prepartum and before traditionally assumed main reasons are observed. ObjectivesTo better understand postpartum hemorrhage genesis, we prospectively researched prepartum clinical information, presence of assumed main reasons and peripartum coagulation changes in part...

BackgroundPlacenta accreta spectrum (PAS) is characterized by abnormal trophoblastic invasion into the uterine myometrium and is a cause of postpartum hemorrhage and maternal death. Protease-activated receptor-1 (PAR-1) promotes various cellular actions, including invasion. Here, we analyzed the expression of PAR-1, platelet antigen, and fibrin in PAS. MethodsWe analyzed 49 PAS cases (placenta accreta vera [accreta vera], 31 cases; placenta increta [increta], 8 cases; placenta percreta [percret...

ObjectiveTo retrospectively validate an electronic health record (EHR) implementation of the patient-initiated PreMA screener and compare its association with severe maternal morbidity (SMM) outcomes against established obstetric comorbidity indices. MethodsWe conducted a retrospective observational study using UCSF (single center) and UC-wide (multi-center) de-identified EHR data, identifying live-birth deliveries with documented preconception data. PreMA and established comorbidity index (Bat...

ObjectiveTo evaluate experiences of labor and delivery (L&D) staff with a Values Clarification and Attitude Transformation (VCAT) workshop on abortion perspectives and professional responsibilities prior to expanding abortion services to L&D. MethodsWe conducted VCAT workshops about abortion with 192 perinatal healthcare personnel at a single urban, community-based, tertiary care center in California. The workshops used a virtual adaptation of the Four Corners exercise, a previously published V...

BackgroundPreterm premature rupture of membranes (PPROM) is a leading contributor of adverse perinatal outcomes, particularly in low-resource and conflict-affected settings. Despite its clinical importance, prospective evidence on its impact on composite adverse perinatal outcomes in northern Ethiopia remains limited. This study examined the impact of Preterm premature rupture of membranes on composite adverse perinatal outcomes and identified associated predictors among pregnant women in public...

To characterize sleeping posture, behaviour, and environment in healthy pregnant participants and their bed partners across multiple nights in the home setting during late pregnancy, we completed a manual review of overnight video recordings from a four-night, in-home, level 3 sleep apnea study. Sleeping postures were scored according to a thirteen-posture classification system to determine the cumulative time per night spent in each sleeping posture. Additional aspects of sleeping posture, beha...

IntroductionThere is a lack of evidence to support clinical recommendations to delay cervical screening to 12-weeks postnatal. In previous studies, half of women were out of date for screening by the end of pregnancy and the majority would be more likely to take up cervical screening, if onered at the 6-week postnatal check-up. We explored views about postnatal cervical screening the acceptability of onering cervical screening, using conventional and urine self-sampling, earlier within the postn...

ABSTRACT/SUMMARYO_ST_ABSObjectiveC_ST_ABSCannabis use during pregnancy is increasing; associations with neonatal growth may be confounded by nicotine. We evaluated prenatal cannabis exposure (PreCE) and neonatal outcomes in a prospective cohort with biochemical control for nicotine exposure. MethodsIn the Cannabis Use During Early Life and Development (CUDDEL) study, pregnant women with a lifetime history of cannabis use were classified as PreCE if they self-reported use or had urine THC-COOH p...

Medical management of pregnancy loss and termination has evolved considerably over the past decade, with misoprostol-based protocols emerging as a cornerstone of care in many settings. Standardized regimens, such as the FIGO 2017 recommendations, aim to improve outcomes by ensuring effectiveness, safety, and reproducibility across diverse clinical contexts. Evaluating their real-world performance is essential, particularly in resource-constrained environments where protocol adherence can directl...

BackgroundRisk screening for pre-eclampsia relies on accurate gestational age assessment, but routine access to ultrasound-based gestational dating remains challenging in many low- and middle-income countries (LMICs). As part of the formative work for the "Preventing pre-eclampsia: Evaluating AspiRin Low-dose regimens following risk Screening" (PEARLS) trial, we aim to validate and implement an Artificial Intelligence (AI)-based algorithm for estimation of gestational age, using blind sweeps don...

BackgroundPrescribing pharmaceutical agents during pregnancy requires a balance between maternal therapeutic needs and foetal risks. Quetiapine, an atypical antipsychotic, is prescribed in psychiatric disorders and increasingly used off-label in low-dosages (<200mg daily) for insomnia during pregnancy. This study aimed to investigate the possible relationship between using quetiapine in a low dosage during pregnancy and the neonatal outcome within the first three days after birth. MethodsA retr...

BackgroundPostpartum weight retention (PPWR) is a key contributor to long-term obesity risk and an important determinant of maternal health. Mobile health (mHealth) interventions may support postpartum change to a healthier lifestyle, but their effectiveness may depends on usability. This study examined whether perceived usability of the INTER-ACT app was associated with weight loss at 6 months postpartum and whether this association was mediated by app use frequency, motivational power, and imp...

BackgroundUndernutrition during pregnancy is a major public health issue and may lead to negative pregnancy outcomes. The body mass index (BMI), considered widely used as the reference method for assessing nutritional status due to its established population-based cut-off points; however, it can be misleading in pregnancy. This study aimed to validate the mid-upper arm circumference (MUAC) as a screening tool for identifying undernourished pregnant women (PW) in an urban slum, compared to BMI. ...