The latest medical research on Pregnancy

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about pregnancy gathered by our medical AI research bot.

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Paternal protein provisioning to embryos during male seahorse pregnancy.

Reproduction

Syngnathid embryos (seahorses, pipefishes, and seadragons) develop on or in the male in a specialised brooding structure (brood pouch). Seahorse br...

Decision To Delivery Time and Its Predictors Among Mothers Who Underwent Emergency Cesarean Delivery At Selected Hospitals of Northwest Ethiopia, 2023: Prospective Cohort Study.

International Journal of Epidemiology

The decision to delivery time is the interval between the decision and the childbirth by emergency caesarean delivery. The Royal College of Obstetricians and Gynecologists and the American College of Obstetricians and Gynecologists recommend that the decision to delivery time interval is less than 30 min. Additionally, the decision to delivery time varies across institutions and countries.

The aim of this study was to determine the decision to delivery time and its predictors among women who underwent emergency cesarean delivery at selected hospitals of Northwest Ethiopia, 2023.

An institutional-based prospective cohort study was conducted at selected hospitals of Northwest Ethiopia, among women who underwent emergency cesarean delivery from November 1 to January 30, 2023. A total of 285 participants were enrolled, and data collected using structured and pre-tested questionnaires. A systematic sampling technique was used. Data were entered into Epi-Data version 4.6 and then exported to STATA 15 for further analysis. The log rank test was utilized to compare group differences. The time is estimated by using the Kaplan-Meier curve and Cox proportional-hazard regression analysis was carried out to determine the predictors.

From 285 participants, 56 (21.8%) women delivered within the recommended 30 min. The overall median survival time was undetermined and the restricted mean survival time was 48.9 min (95% CI: 47.4-50.5). The average decision to delivery time is affected among women who hesitate to accept consent (AHR: 0.17, 95% CI: 0.02-1.25), cord prolapses (AHR: 1.36, 95% CI: 0.46-3.94), rank of surgeon (AHR: 0.42. 95% CI: 0.42-1.08), no free operation room table (AHR: 0.27, 95% CI: 0.28-0.94), regional anesthesia (AHR: 0.56, 95% CI: 0.25-1.28), and use of a bladder flap (AHR: 0.33, 95% CI: 0.16-0.85).

Overall decision to delivery times among women who underwent emergency cesarean section at selected hospitals were longer than the recommended time.

Association of antenatal evaluations with postmortem and genetic findings in the series of fetal osteogenesis imperfecta.

Fetal Diagnosis Therapy

Counseling Osteogenesis Imperfecta (OI) pregnancies is challenging due to the wide range of onsets and clinical severities, from perinatal lethality to milder forms detected later in life.

Thirty-eight individuals from 36 families were diagnosed with OI through prenatal ultrasonography and/or postmortem clinical and radiographic findings. Genetic analysis was conducted on 26 genes associated with OI in these subjects that emerged over the past 20 years, while some genes were examined progressively, all 26 genes were examined in the group where no pathogenic variations were detected.

Prenatal and postnatal observations both consistently showed short limbs in 97%, followed by bowing of the long bones in 89%. Among 32 evaluated cases, all exhibited cranial hypomineralization. Fractures were found in 29 (76%) cases, with multiple bones involved in 18 of them. Genetic associations were disclosed in 27 families with 22 (81%) autosomal dominant and five (19%) autosomal recessive forms, revealing 25 variants in six genes (COL1A1, COL1A2, CREB3L1, P3H1, FKBP10, and IFITM5), including nine novels. Postmortem radiological examination showed variability in intra-family expression of CREBL3 and P3H1-related OI.

Prenatal diagnosis for distinguishing OI and its subtypes relies on factors such as family history, timing, ultrasound, genetic and postmortem evaluation.

Enhanced Recovery after Surgery (ERAS) in open fetal spina bifida repair.

Fetal Diagnosis Therapy

For open fetal spina bifida (fSB) repair, a maternal laparotomy is required. Hence, enhanced maternal recovery after surgery (ERAS) is paramount. A revision of our ERAS protocol was made, including changes in operative techniques and postoperative pain management. This study investigates eventual benefits.

Our study included 111 women with open fSB repair at our center. The old protocol group (group 1) either received a transverse incision of the fascia with transection of the rectus abdominis muscle (RAM) or a longitudinal incision of the fascia without RAM transection, depending on placental location. The new protocol required longitudinal incisions in all patients (group 2). Postoperative pain management was changed from tramadol to oxycodone/naloxone. Outcomes of the two different protocol groups were analyzed and compared regarding the primary endpoint, the length of hospital stay after fetal surgery (LOS), as well as regarding the following secondary endpoints: postoperative pain scores, day of first mobilization, removal of urinary catheter, bowel movement, and the occurrence of maternal and fetal complications.

Out of 111 women, 82 (73.9%) were in group 1 and 29 (26.1%) were in group 2. Women in group 2 showed a significantly shorter LOS (18 [14-23] days vs. 27 [18-39] days, p = 0.002), duration until mobilization (3 [2-3] days vs. 3 [3-4] days, p = 0.03), and removal of urinary catheter (day 3 [3-3] vs. day 4 [3-4], p = 0.004). Group 2 less often received morphine subcutaneously (0% vs. 35.4%, p < 0.001) or intravenously (0% vs. 17.1%, p = 0.02), but more often oxycodone (69.0% vs. 18.3%, p < 0.001). No significant differences were seen regarding pain scores, bowel movement, and maternal and/or fetal complications.

The new ERAS protocol that combined changes in surgical technique and pain medication led to better outcomes while reducing LOS. Continuous revisions of current ERAS protocols are essential to improve patient care continuously.

Prevalence and Factors Associated with Anxiety Disorders Among Pregnant Women at Mulago National Referral Hospital, Uganda.

International Journal of Epidemiology

Anxiety disorders in pregnancy are common and represent a global concern. However, data regarding the magnitude of anxiety among pregnant women in Uganda are limited, and yet, these data could pave way for implementing effective mitigation measures. We determined the prevalence of anxiety disorders and associated factors among pregnant women at Mulago Hospital Uganda.

A cross-sectional study was conducted among pregnant women attending antenatal care clinic at Mulago Hospital between September and November 2015. Systematic sampling was used to enroll eligible women. An interviewer-administered demographic questionnaire and the Hamilton Anxiety Rating Scale for Antenatal Anxiety (HAMA-A) scale were used to assess demographic features and anxiety, respectively. Women with HAMA-A score ≥17 were considered to have anxiety disorder. Factors associated with anxiety disorders were determined using multivariate logistic regression.

A total of 501 pregnant women were enrolled into the study; the prevalence of anxiety disorders was 13% (n=65; 95% CI: 9.8-15.7%). Factors that were significantly associated with anxiety disorders were low income of the participants (adjusted odds ratio [AOR]=2.65, 95% CI: 1.16-6.06), bad relationship with spouse (AOR = 2.50, 95% CI: 1.01-5.82) and history of hypertension in previous pregnancy (AOR = 4.17, 95% CI: 1.68-10.37).

Approximately one in ten women surveyed exhibited anxiety disorders. Anxiety disorders were associated with low-income levels, bad spousal relationships, and a history of hypertension during previous pregnancies. Multidisciplinary approaches that integrate mental health support, social services, and partner involvement may help address anxiety disorders in pregnancy and contribute to improved maternal and child outcomes.

Prevalence and Factors Contributing to Fear of Recurrence in Breast Cancer Patients and Their Partners: A Cross-Sectional Study.

International Journal of Epidemiology

The fear of cancer recurrence (FCR) is a generalized psychological problem among cancer patients and their spouses. The purpose of this study is to investigate the current status of cancer recurrence fear among breast cancer patients and their spouses, as well as its predictive factors.

A total of 155 breast cancer patients and their partners between March 2022 to Feb 2023 were selected from Affiliated Hospital of Jiangnan University. The survey was investigated by fear of progression questionnaire-short form (FoP‑Q‑SF), fear of progression questionnaire-short form for partners (FoP-Q-SF/P), family resilience questionnaire (FaRE), and health literacy management scale (HeLMS). Predictors were assessed using univariate and multivariable regression analyses.

52.9% (n=82) of breast cancer patients and 51.6% (n=80) of their spouses experienced high levels of fear of cancer recurrence (FCR). There was a positive correlation between the FCR of the patients and their spouses, while family resilience and health literacy were statistically significant negative predictive factors for breast cancer patients' fear of cancer recurrence.

In summary, the study found that the partner's FCR, health literacy and family resilience were closely related to the FCR in breast cancer patients. Therefore, healthcare workers can reduce the patient's FCR by reducing the FCR in spouses, improving patients' health literacy and family resilience in the future. In practical application, these findings hold significant implications for developing comprehensive care plans and interventions targeting FCR in breast cancer patients. By focusing on patients' partners and providing appropriate support and resources, healthcare professionals can promote patients' psychological well-being and overall health, leading to improved quality of life.

The Association Between Exercise During Pregnancy and the Risk of Preterm Birth.

International Journal of Epidemiology

We aimed to examine the association between exercise during pregnancy and preterm birth (PTB).

This study was a baseline survey of the Jinan birth cohort. The study subjects were the mothers one month after giving birth, which were investigated by questionnaires retrospectively containing physical exercise (frequency, time, and primary exercise patterns) during pregnancy and each trimester. Individual time spent on exercise and energy expenditure were assessed based on the questionnaires. PTB was clinically defined as a newborn born on or before the last day of the 37th week. Adjusted odds ratios (OR) were estimated using logistic regression to assess the relationship between exercise during pregnancy and the risk of PTB. Variable selection for the multivariate models was guided by the directed acyclic graph. The median effect was analyzed by the sequential test.

The prevalence of PTB in this study was 4.38% (285/6501). The adjusted OR (95% CI) for the risk of PTB related to exercise during pregnancy was 0.74 (0.58-0.95). During the 1st and 2nd trimesters, the ORs (95% CI) for 2.5 to 7 hours of exercise per week were 0.77 (0.59-0.99) and 0.74 (0.57-0.96). During the 3rd trimester, the ORs (95% CI) for 2.5 to 7 hours and more than 7 hours of exercise per week were 0.74 (0.56-0.96) and 0.65 (0.44-0.94). After stratifying the subjects, the association was only found among subjects without pregnancy complications. Pregnancy complications partially mediated (52.40%) the relationship between exercise during pregnancy and PTB.

Exercise during pregnancy can reduce the risk of PTB for women without pregnancy complications. 2.5 to 7 hours of exercise (like walking) per week may be appropriate in three trimesters of pregnancy, and the time could be extended in the 3rd trimester.

A Common Trajectory Toward a Professional Identity as a Faculty Developer.

Fam Med

Professional identity formation is a complex construct that continually evolves in relation to an individual's experiences. The literature on educators identifying as faculty developers is limited and incompletely addresses how that identify affects other identities, careers, and influences on teaching. Twenty-six health professionals were trained to serve as faculty developers within our educational system. We sought to examine the factors that influence the professional identity of these faculty developers and to determine whether a common trajectory existed.

We employed a constructivist thematic analysis methodology using an inductive approach to understand the experiences of faculty developers. We conducted semistructured recorded interviews. Coding and thematic analysis were completed iteratively.

We identified eight primary themes: (1) initial invitation, (2) discovery of faculty development as a professional activity, (3) discovery of educational theory, skills, and need for more education, (4) process of time and experience, (5) fostering relationships and community, (6) transfer of skills to professional and personal roles, (7) experiences that lead to credibility, and (8) sense of greater impact.

An individual's journey to a faculty developer identity is variable, with several shared pivotal experiences that help foster the emergence of this identity. Consideration of specific programmatic elements to support the themes identified might allow for a strategic approach to faculty development efforts in health professions education.

Using the Skill of Noticing to Support Empathy for Third-Year Medical Students in Family Medicine.

Fam Med

Previous research has described a waning interest among third-year students to employ empathetic practice along with decreased opportunity to develop empathic communication skills. In this study we sought to address this decline using the skill of noticing (ie, the capacity to attune to specific aspects of practice and interactions) as an intervention for third-year medical students.

We designed a qualitative study to address the following research question: How can a focused noticing tool encourage empathetic moments during the patient interview for third-year medical students? Eight third-year medical students used the Social Emotional Noticing Tool (SENT) during their 4-week family medicine rotation, then joined a focus group to share their experiences with SENT and articulate barriers and opportunities toward practicing empathy during clerkship.

Student participants (a) described using the tool, including barriers and opportunities; (b) made connections between the practice of noticing using SENT and enacting empathy; and (c) emphasized how enacting empathy in their third year is largely influenced by interactions with clinical faculty.

The use of SENT helped students notice empathy or lack thereof. However, making connections between individual capacity for empathic interactions and the impact of positive or negative role models is necessary. Based on our findings, we encourage the need for shared responsibility among students, faculty and preceptors, and organizations.

Significant Prognostic Factor at Age Cut-off of 73 Years for Advanced Ovarian Serous Cystadenocarcinoma Patients: Insights from Real-World Study.

International Journal of Epidemiology

The objective of this research was to determine the age cut-off for worse prognosis and investigate age-related differentially expressed genes (DEGs) in patients with advanced ovarian serous cystadenocarcinoma (AOSC).

In this research, we included a cohort of 20,846 patients diagnosed with AOSC, along with RNA-seq data from 374 patients in publicly available databases. Then we used the X-tile software to determine the age cut-off and stratified the patients into young and old groups. We utilized propensity score matching (PSM) to balance baseline between the young and old groups. Furthermore, we conducted an enrichment analysis of DEGs between the two age groups using Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways and gene ontology (GO) to identify dysregulated pathways. To evaluate the potential prognostic value of the DEGs, we performed survival analysis, such as Kaplan-Meier analysis and Log rank test.

We stratified the patients into young group (n=16,336) and old group (n=4510) based on the cut-off age of 73 years by X-tile software. Age over 73 years was identified as an independent risk factor for overall survival (OS) and cancer-specific survival (CSS). Next, we identified 436 DEGs and found that the neurotrophin signaling pathway and translation factor activity were associated with prognosis outcomes. Among the top 10 hub genes (RELA, NFKBIA, TRAF6, IRAK2, TAB3, AKT1, TBP, EIF2S2, MAPK10, and SUPT3H), RELA, TAB3, AKT1, TBP, and SUPT3H were found to be significantly associated with poor prognosis in old patients with AOSC.

Our study determined 73 years as the cutoff value for age in patients with AOSC. RELA, TAB3, AKT1, TBP, and SUPT3H were identified as age-related DEGs that could contribute to the poor prognosis of older patients with AOSC.

Current Situation and Mental Health of Pregnant Women During the Prevention and Control of Novel Coronavirus Infection: A Cross-Sectional Study on the Investigation of Influencing Factors.

International Journal of Epidemiology

COVID-19 is a highly contagious respiratory infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which became a global public health crisis. In the past 3 years, the COVID-19 pandemic has resulted in a dramatic increase in the occurrence of psychological symptoms such as depression, anxiety, and stress in global populations. Therefore, it is important to help pregnant women cope with major public emergencies and improve their physical and mental health.

To investigate the status and influencing factors of anxiety, insomnia, and psychological stress disorder in pregnant women with COVID-19 to provide a theoretical basis for psychological intervention in pregnant women in the case of public health emergency events.

A cross-sectional survey was conducted with 435 pregnant women from multiple tertiary hospitals in Zhengzhou from November 6 to December 6, 2022. The questionnaire contents included the general information of pregnant women, insomnia scale, generalized anxiety scale, and the revised version of the Accident Impact Scale.

There are 251 pregnant women with anxiety (57.7%, 95% CI: (53.0%-62.4%).There are 166 pregnant women with insomnia.(38.2%, 95% CI: 33.6%-42.7%), There are 314 pregnant women with stress disorder.(72.2%, 95% CI: 68.0%-76.4%). During the epidemic prevention and control period, whether pregnant women had a history of adverse pregnancy had a statistically significant difference in anxiety, insomnia and stress disorders.

During the COVID-19 pandemic, pregnant women appeared to generally have anxiety, insomnia, and stress disorders. Poor pregnancy history is a protective factor for pregnant women with anxiety, insomnia, and post-traumatic stress disorder. In the case of similar public health emergencies, attention bias modification (ABM) may be a potential intervention measure to provide potentially new ideas for alleviating the psychological disorders of pregnant women during this special period.

Prenatal Diagnosis of Fetal Aqueductal Stenosis: A Multicenter Prospective Observational Study through the North American Fetal Therapy Network (NAFTNet).

Fetal Diagnosis Therapy

A critical component of an evidence-based reassessment of in-utero intervention for fetal aqueductal stenosis (fetal AS) is determining if the prenatal diagnosis can be accurately made at a gestational age amenable to in-utero intervention.

A multicenter, prospective, observational study was conducted through the North American Fetal Therapy Network (NAFTNet). Pregnancies complicated by severe CNS ventriculomegaly (lateral ventricle diameter >15 mm) not secondary to a primary diagnosis (myelomeningocele, encephalocele, etc.) were recruited at diagnosis. Imaging and laboratory findings were recorded in an online REDCap database. After evaluation, investigators were asked to render their degree of confidence in the diagnosis of fetal AS. The prenatal diagnosis was compared to the postnatal diagnosis obtained through neonatal neuroimaging. Performance characteristics of ultrasound and MRI were calculated, as was the mean gestational age at diagnosis.

Between April 2015 and October 2022, eleven NAFTNet centers contributed 64 subjects with severe fetal CNS ventriculomegaly. Of these, 56 had both prenatal and postnatal diagnoses recorded. Ultrasound revealed 32 fetal AS true positives, 4 false positives, 7 false negatives, and 13 true negatives rendering a sensitivity of 0.82, a specificity of 0.76, a positive predictive value of 0.89, and a negative predictive value of 0.65. The mean gestational age at diagnosis by ultrasound was 25.5 weeks (std +/- 4.7w). The proportion of agreement (true positive + true negative/n) was highest at 24 weeks gestation. For fetal MRI (n=35), the sensitivity for fetal AS was 0.95, specificity was 0.69, positive predictive value was 0.84, and negative predictive value was 0.90. MRI was performed at 25 weeks on average.

The prenatal diagnosis of fetal aqueductal stenosis can be made with accuracy at a gestational age potentially amenable to in-utero intervention. Only 7% of subjects were incorrectly diagnosed prenatally with fetal AS by ultrasound and 11% by MRI. Diagnostic accuracy of fetal AS will likely improve with increased experience.