Midwifery LibGuide

J Pharm Bioallied Sci. 2025 May;17(Suppl 1):S346-S349. doi: 10.4103/jpbs.jpbs_1635_24. Epub 2025 Mar 6.

ABSTRACT

BACKGROUND: Maternal body mass index (BMI) significantly influences both maternal and fetal outcomes. Changing socioeconomic factors in India have led to a rise in both obesity due to lifestyle factors and malnutrition due to poverty. Each extreme of BMI-underweight and overweight-has distinct risks. Overweight and obese women face complications, such as gestational diabetes, gestational hypertension, and macrosomia, while underweight women are at higher risk of conditions, like intrauterine growth restriction (IUGR), low birth weight, and anemia.

MATERIALS AND METHODS: This observational study was conducted over nine months from September 2019 to June 2020, involving 850 pregnant women attending the gynecology outpatient department (OPD) at a tertiary hospital. First-trimester BMI was calculated to classify patients as underweight (<18.5), normal weight (18.5-22.9), overweight (23-24.9), pre-obese (25-29.9), or obese (≥30). Data collection included personal and medical history, physical and obstetric examinations, and monitoring of maternal and fetal outcomes.

RESULTS: The study found that women at the extremes of BMI experienced higher rates of adverse outcomes. Obese and overweight women showed increased risks of gestational diabetes, hypertension, preeclampsia, cesarean deliveries, and postpartum hemorrhage. Conversely, underweight women had a higher incidence of IUGR, anemia, preterm birth, and increased perinatal mortality.

CONCLUSION: Both high and low maternal BMI are associated with distinct risks for adverse pregnancy outcomes. Preconception counseling and lifestyle guidance for women of reproductive age may reduce the incidence of these complications, emphasizing the importance of optimal weight management for improved maternal and fetal health outcomes.

PMID:40511216 | PMC:PMC12156600 | DOI:10.4103/jpbs.jpbs_1635_24

J Clin Med. 2025 May 30;14(11):3860. doi: 10.3390/jcm14113860.

ABSTRACT

Background/Objectives: Adverse pregnancy outcomes (APOs), which include hypertensive disorders of pregnancy (gestational hypertension, preeclampsia, and related disorders), gestational diabetes, preterm birth, fetal growth restriction, low birth weight, small-for-gestational-age newborn, placental abruption, and stillbirth, are health risks for pregnant women that can have fatal outcomes. This study's aim is to investigate the usefulness of artificial intelligence (AI) in improving these outcomes and includes changes in the utilization of ultrasound, continuous monitoring, and an earlier prediction of complications, as well as being able to individualize processes and support clinical decision-making. This study evaluates the use of AI in improving at least one APO. Methods: PubMed, Web of Science, and Scopus databases were searched and limited to the English language, humans, and between 2020 and 2024. This scoping review included peer-reviewed articles across any study design. However, systematic reviews, meta-analyses, unpublished studies, and grey literature sources (e.g., reports and conference abstracts) were excluded. Studies were eligible for inclusion if they described the use of AI in improving APOs and the associated ethical issues. Results: Five studies met the inclusion criteria and were included in this scoping review. Although this review initially aimed to evaluate AI's role across a wide range of APOs, including placental abruption and stillbirth, the five selected studies focused primarily on preterm birth, hypertensive disorders of pregnancy, and gestational diabetes. None of the included studies addressed placental abruption or stillbirth directly. The studies primarily utilized machine-learning models, including extreme gradient boosting (XGBoost) and random forest (RF), showing promising results in enhancing prenatal care and supporting clinical decision-making. Ethical considerations, including algorithmic bias, transparency, and the need for regulatory oversight, were highlighted as critical challenges. Conclusions: The application of these tools can improve prenatal care by predicting obstetric complications, but ethics and transparency are pivotal. Empathy and humanization in healthcare must remain fundamental, and flexible training mechanisms are needed to keep up with rapid innovation. AI offers an opportunity to support, not replace, the doctor-patient relationship and must be subject to strict legislation if it is to be used safely and fairly.

PMID:40507618 | DOI:10.3390/jcm14113860

J Clin Med. 2025 May 23;14(11):3671. doi: 10.3390/jcm14113671.

ABSTRACT

A total of 30 hydropic fetuses, including 25 cases from published reports and 5 from our own series, were reviewed, validated, and analyzed. This review yielded the following key findings: (1) Unlike most cases of nonimmune hydrops fetalis (NIHF), hydrops caused by syphilis is not only preventable but also treatable, with complete resolution possible when appropriately managed. (2) Syphilis-associated hydrops carries a poor prognosis if timely and appropriate treatment is not administered. (3) Based on limited data, intravenous penicillin G is probably more effective than intramuscular benzathine penicillin in treating hydropic fetuses. (4) Middle cerebral artery peak systolic velocity (MCA-PSV) measurements are increasingly used as a reliable and noninvasive tool for assessing fetal anemia, determining the need for intrauterine transfusion (IUT), and monitoring treatment response. (5) A significant number of cases did not receive prenatal treatment due to false-negative serologic results caused by the prozone effect, as well as the omission of syphilis from the differential diagnosis of NIHF, leading to missed prenatal diagnoses. (6) IUT may help mitigate cellular damage in developing vital organs caused by anemic hypoxia, particularly while awaiting the effects of medical treatment. In conclusion, the modern approach to managing this ancient disease includes: (1) prioritizing intensive intravenous penicillin G therapy over conventional intramuscular benzathine penicillin G; (2) utilizing MCA-PSV in conjunction with other indicators of anemia to monitor its severity; and (3) implementing IUT to prevent anemic hypoxic injury in cases where the hematocrit falls below 30%.

PMID:40507432 | DOI:10.3390/jcm14113671