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Biomedicines
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Maternal-Fetal and Neonatal Medicine
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Maternal-Fetal and Neonatal Medicine

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (31 October 2025) | Viewed by 16092

Special Issue Editor

Dr. Dimitrios Papageorgiou

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Guest Editor
Department of Gynecology, Athens Naval and Veterans Hospital, 11521 Athens, Greece
Interests: minimal invasive gynecological surgery; gynecologic oncology; endoscopic surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Maternal–fetal and neonatal health is determined by biological, environmental, and socioeconomic factors, influencing pregnancy outcomes and newborn survival. This Special Issue, ‘Maternal–Fetal and Neonatal Medicine’, addresses the key determinants, novel diagnostics, and evolving treatment strategies.

Maternal health is affected by prenatal nutrition, infections, chronic diseases, and access to healthcare, while neonatal health is affected by conditions such as prematurity, birth asphyxia, infection, and congenital abnormalities.

Early diagnosis is the key in neonatal care. Prenatal imaging (ultrasound, MRI), genetic testing, APGAR scoring, blood gas analysis, and metabolic studies with advances in these fields enable the early detection of complications. Emerging technologies, including point-of-care testing and AI-powered analysis, also enhance accuracy and speed.

Therapeutic interventions, including neonatal intensive care, respiratory therapy (CPAP, surfactant therapy), phototherapy for jaundice, and targeted antimicrobial therapies keep evolving. Emerging therapies, such as stem cell therapy, neuroprotective therapy, and precision medicine, have the potential to treat previously untreatable diseases.

This Special Issue provides a comprehensive examination of maternal and neonatal health challenges with an emphasis on early diagnosis and innovative therapies. By fostering clinical advancements and research insights, it aims to enhance survival rates and long-term health outcomes for mothers and newborns worldwide.

We are pleased to invite authors to submit original studies, meta-analyses, and reviews investigating new advances in the field of diagnosis and treatment of maternal and fetal health issues and neonatal care.

Dr. Dimitrios Papageorgiou
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • maternal–fetal health
  • neonatal health
  • prenatal care
  • prenatal diagnosis
  • fetal growth
  • diabetes mellitus
  • hypertension
  • pre-eclampsia
  • congenital infections
  • gene therapies

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Published Papers (5 papers)

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Research

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12 pages, 243 KB  
Article
Maternal Vitamin D Status, Gestational Hypertension, and Preeclampsia: A Cross-Sectional Study in Urban Greece
by Artemisia Kokkinari, Kleanthi Gourounti, Maria Dagla, Nikoleta Tsinisizeli and Georgios Iatrakis
Biomedicines 2025, 13(11), 2624; https://doi.org/10.3390/biomedicines13112624 - 27 Oct 2025
Viewed by 770
Abstract
Background: Evidence linking maternal vitamin D status with gestational hypertensive disorders and neonatal outcomes in Southern Europe remains limited. We evaluated maternal and cord 25-hydroxyvitamin D [25(OH)D] at birth in an urban Greek cohort and examined associations with gestational hypertension and preeclampsia. [...] Read more.
Background: Evidence linking maternal vitamin D status with gestational hypertensive disorders and neonatal outcomes in Southern Europe remains limited. We evaluated maternal and cord 25-hydroxyvitamin D [25(OH)D] at birth in an urban Greek cohort and examined associations with gestational hypertension and preeclampsia. Methods: We conducted a cross-sectional study of 248 mother–infant dyads delivering at Tzaneio General Hospital of Piraeus, Greece. Eligible participants were of Greek origin or long-term residents (>10 years). Maternal venous and umbilical cord blood were obtained at birth and analyzed for serum 25(OH)D. Postpartum questionnaires captured sun exposure, supplement use, and selected lifestyle factors; clinical and obstetric data, including diagnoses of gestational hypertension and preeclampsia, were abstracted from medical records. We classified 25(OH)D as deficient (<20 ng/mL), insufficient (20–29 ng/mL), and, for risk-stratified analyses, treated values < 30 ng/mL as low. Results: Maternal 25(OH)D concentrations varied seasonally (winter 16.96 ± 9.60 ng/mL; summer 24.22 ± 12.57 ng/mL) and correlated with cord concentrations (r = 0.80). Most mothers (75–89%) had <30 ng/mL across seasons, and 73% of neonates were <20 ng/mL despite supplementation. Gestational hypertension occurred in 29/248 (11.7%) and preeclampsia in 15/248 (6.0%), with low maternal 25(OH)D common among affected women. Conclusions: In this cross-sectional study of an urban Mediterranean population, hypovitaminosis D was highly prevalent among mothers and neonates, with seasonal variation and clustering among hypertensive pregnancies. These findings support prenatal care strategies beyond fixed supplementation, incorporating season- and environment-sensitive dosing with screening and dietary counseling. Prospective studies are needed to clarify causality and refine supplementation targets. Full article
(This article belongs to the Special Issue Maternal-Fetal and Neonatal Medicine)
13 pages, 849 KB  
Article
The Role of Perinatal Complications in Neurodevelopmental Outcomes of ART-Conceived Children: Prognostic Model for Brain Immaturity
by Sevara Ilmuratova, Vyacheslav Lokshin, Zhanar Nurgaliyeva, Kаnatzhan Kеmelbekov, Gulshat Kulniyazova, Bibigul Abdykalykova, Roza Seisebayeva, Karlygash Zhubanysheva, Gulmira Altynbayeva, Gulnar Mukhambetova, Ainur Sadykova, Damir Marapov, Valeriya Nekhorosheva and Lyazat Manzhuova
Biomedicines 2025, 13(10), 2551; https://doi.org/10.3390/biomedicines13102551 - 20 Oct 2025
Viewed by 767
Abstract
Background/Objectives: Since the first successful birth following assisted reproductive technologies (ART) several decades ago, the global population of ART-conceived children has surpassed 13 million, with over 40,000 born in Kazakhstan. Despite this growth, questions remain about their long-term neurological outcomes, with existing [...] Read more.
Background/Objectives: Since the first successful birth following assisted reproductive technologies (ART) several decades ago, the global population of ART-conceived children has surpassed 13 million, with over 40,000 born in Kazakhstan. Despite this growth, questions remain about their long-term neurological outcomes, with existing studies reporting inconsistent findings. This study aimed to assess psychomotor development and the prevalence of nervous system pathologies among ART-conceived children in Kazakhstan and to develop a prognostic model for identifying pathological neurodevelopmental conditions. Methods: We studied 252 children (120 conceived via ART and 132 controls) using clinical examination and medical history data. Brain immaturity predictors were identified by univariate and multivariate logistic regression. Results: ART-conceived children exhibited a higher incidence of neurosonographic signs of brain structure immaturity. However, multivariate analysis indicated that ART itself was not an independent risk factor. Instead, perinatal complications—including prematurity, multiple pregnancy, low birth weight, asphyxia, and intrauterine infections—explained the observed differences. The prognostic model highlighted prematurity and preconceptional progesterone therapy as significant predictors. Overall neurological development did not differ significantly between the groups. Conclusions: These findings underscore the importance of early identification of perinatal risk factors and targeted preventive interventions to mitigate adverse neurodevelopmental outcomes in ART-conceived children. Full article
(This article belongs to the Special Issue Maternal-Fetal and Neonatal Medicine)
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Review

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18 pages, 1793 KB  
Review
Letrozole at the Crossroads of Efficacy and Fetal Safety in Ovulation Induction: A Narrative Review
by Aris Kaltsas, Anna Efthimiou, Christos Roidos, Vasileios Tzikoulis, Ioannis Georgiou, Alexandros Sotiriadis, Athanasios Zachariou, Michael Chrisofos, Nikolaos Sofikitis and Fotios Dimitriadis
Biomedicines 2025, 13(9), 2051; https://doi.org/10.3390/biomedicines13092051 - 22 Aug 2025
Viewed by 4822
Abstract
Letrozole, a third-generation aromatase inhibitor initially developed for breast cancer, has become the preferred first-line agent for ovulation induction (OI), particularly in women with polycystic ovary syndrome (PCOS). This narrative review critically evaluates the efficacy, safety, and clinical applications of letrozole across diverse [...] Read more.
Letrozole, a third-generation aromatase inhibitor initially developed for breast cancer, has become the preferred first-line agent for ovulation induction (OI), particularly in women with polycystic ovary syndrome (PCOS). This narrative review critically evaluates the efficacy, safety, and clinical applications of letrozole across diverse infertility contexts. Compared to clomiphene citrate, letrozole is associated with higher ovulation and live birth rates, a lower risk of multiple gestation, and a more favorable endometrial environment. Its pharmacokinetics—marked by transient estrogen suppression and a short half-life—limit embryonic exposure, supporting its favorable safety profile. Emerging data from large, randomized trials and meta-analyses demonstrate no increase in congenital anomalies, miscarriage, or adverse perinatal outcomes in letrozole-conceived pregnancies. Moreover, maternal side effects are generally mild, and the risk of ovarian hyperstimulation syndrome is low. Letrozole has also shown utility in mild stimulation protocols, fertility preservation for estrogen-sensitive malignancies, and clomiphene-resistant PCOS. Key clinical strategies—such as early-cycle initiation, lowest effective dosing, and individualized monitoring—optimize therapeutic outcomes while minimizing potential risks. While long-term offspring data remain limited and mechanistic concerns persist, current evidence robustly supports letrozole as a safe and effective option for OI, balancing reproductive success with maternal–fetal safety across a range of infertility indications. Full article
(This article belongs to the Special Issue Maternal-Fetal and Neonatal Medicine)
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18 pages, 785 KB  
Review
Tubal Ectopic Pregnancy: From Diagnosis to Treatment
by Dimitrios Papageorgiou, Ioakeim Sapantzoglou, Ioannis Prokopakis and Eleftherios Zachariou
Biomedicines 2025, 13(6), 1465; https://doi.org/10.3390/biomedicines13061465 - 13 Jun 2025
Cited by 3 | Viewed by 5795
Abstract
The most frequent form of ectopic pregnancy, known as tubal pregnancy, leads to a dangerous situation where the fertilized ovum implants inside a fallopian tube, which can result in tubal rupture and severe bleeding. The purpose of this narrative review is to evaluate [...] Read more.
The most frequent form of ectopic pregnancy, known as tubal pregnancy, leads to a dangerous situation where the fertilized ovum implants inside a fallopian tube, which can result in tubal rupture and severe bleeding. The purpose of this narrative review is to evaluate all existing data regarding epidemiology, risk factors, pathophysiology, clinical presentation, diagnosis, and management of tubal ectopic pregnancy in order to provide a comprehensive understanding of this common yet difficult clinical condition. Prior ectopic pregnancy, together with tubal pathology and assisted reproduction, represent the main risk factors for this condition. The diagnosis relies on serial β-hCG tests combined with transvaginal ultrasonography, but laparoscopy serves as the diagnostic tool for cases with uncertain results. The treatment plan depends on the fallopian tube integrity, along with the patient’s hemodynamic condition. Patients with unruptured pregnancies who are hemodynamically stable receive methotrexate treatment as the preferred option, but surgical intervention with salpingectomy or salpingostomy becomes necessary in case of tubal rupture or when medical treatment fails. The development of laparoscopic procedures has led to better results and improved possibilities for fertility preservation. The psychological effects on patients require both counseling and follow-up care. Early detection, along with personalized management, helps decrease maternal complications and optimize reproductive outcomes. Full article
(This article belongs to the Special Issue Maternal-Fetal and Neonatal Medicine)
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Other

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20 pages, 2139 KB  
Systematic Review
Does Phototherapy Affect Ductus Arteriosus Closure in Preterm Infants ≤32 Weeks of Gestation, and Can We Influence This Through Chest Shielding? Review of the Literature and a Meta-Analysis
by Marta Simon, Zsuzsanna Gall, Monika Rusneac, Amalia Fagarasan, Raluca Marian, Madalina Anciuc-Crauciuc, Andreea Racean, Andrea Noemi Toth and Manuela Cucerea
Biomedicines 2025, 13(10), 2567; https://doi.org/10.3390/biomedicines13102567 - 21 Oct 2025
Viewed by 333
Abstract
Background: Persistency of patent ductus arteriosus is the main cardiac condition in the preterm population born before 32 completed weeks of gestation with possible short- and long-term hemodynamic disturbances leading to vast morbidity. Jaundice is present in the majority of very preterms [...] Read more.
Background: Persistency of patent ductus arteriosus is the main cardiac condition in the preterm population born before 32 completed weeks of gestation with possible short- and long-term hemodynamic disturbances leading to vast morbidity. Jaundice is present in the majority of very preterms needing phototherapy, that also may have an influence on immature hemodynamics. The objectives of this review and meta-analysis were to find relevant evidence of whether chest shielding during phototherapy does or does not have an impact on the ductus arteriosus patency and hemodynamics. Methods: we reviewed the literature and performed a meta-analysis of five randomized controlled trials regarding chest shielding effect on the ductus arteriosus closure. Results: A total of 452 infants, with a mean gestational age of 28.04 weeks and mean birth weight of 1004.8 g were included in our meta-analysis, where we found an RR of 0.6 for developing PDA during phototherapy and chest shielding (95% CI: 0.37; 0.96. prediction interval: 0.18; 1.99) while development of hemodynamically significant PDA had RR = 0.57, within 95% CI: 0.3; 1.06, and a predictive interval between: 0.11; 2.93. Conclusions: Although the estimated RR may suggest a possible moderate protective role of the chest shield regarding development of PDA during phototherapy, the wideness of the predictive intervals, that include no effect, as well as the small number of eligible trials with heterogeneity between them, make the available data insufficient to evaluate the effectiveness of chest shielding during phototherapy. For more conclusive evidence there is a need for well-designed, blinded, multicenter randomized controlled trials with standardized assessment addressing to a more compact target population, knowing the large physiological differences among preterm infants of different gestational ages. Full article
(This article belongs to the Special Issue Maternal-Fetal and Neonatal Medicine)
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