Search Results (208)

Background: Artificial intelligence (AI) and machine learning (ML) have been reshaping maternal, fetal, neonatal, and reproductive healthcare by enhancing risk prediction, diagnostic accuracy, and operational efficiency across the perinatal continuum. However, no comprehensive synthesis has yet been published. Objective: To conduct a scoping review of reviews of AI/ML applications spanning reproductive, prenatal, postpartum, neonatal, and early child-development care. Methods: We searched PubMed, Embase, the Cochrane Library, Web of Science, and Scopus through April 2025. Two reviewers independently screened records, extracted data, and assessed methodological quality using AMSTAR 2 for systematic reviews, ROBIS for bias assessment, SANRA for narrative reviews, and JBI guidance for scoping reviews. Results: Thirty-nine reviews met our inclusion criteria. In preconception and fertility treatment, convolutional neural network-based platforms can identify viable embryos and key sperm parameters with over 90 percent accuracy, and machine-learning models can personalize follicle-stimulating hormone regimens to boost mature oocyte yield while reducing overall medication use. Digital sexual-health chatbots have enhanced patient education, pre-exposure prophylaxis adherence, and safer sexual behaviors, although data-privacy safeguards and bias mitigation remain priorities. During pregnancy, advanced deep-learning models can segment fetal anatomy on ultrasound images with more than 90 percent overlap compared to expert annotations and can detect anomalies with sensitivity exceeding 93 percent. Predictive biometric tools can estimate gestational age within one week with accuracy and fetal weight within approximately 190 g. In the postpartum period, AI-driven decision-support systems and conversational agents can facilitate early screening for depression and can guide follow-up care. Wearable sensors enable remote monitoring of maternal blood pressure and heart rate to support timely clinical intervention. Within neonatal care, the Heart Rate Observation (HeRO) system has reduced mortality among very low-birth-weight infants by roughly 20 percent, and additional AI models can predict neonatal sepsis, retinopathy of prematurity, and necrotizing enterocolitis with area-under-the-curve values above 0.80. From an operational standpoint, automated ultrasound workflows deliver biometric measurements at about 14 milliseconds per frame, and dynamic scheduling in IVF laboratories lowers staff workload and per-cycle costs. Home-monitoring platforms for pregnant women are associated with 7–11 percent reductions in maternal mortality and preeclampsia incidence. Despite these advances, most evidence derives from retrospective, single-center studies with limited external validation. Low-resource settings, especially in Sub-Saharan Africa, remain under-represented, and few AI solutions are fully embedded in electronic health records. Conclusions: AI holds transformative promise for perinatal care but will require prospective multicenter validation, equity-centered design, robust governance, transparent fairness audits, and seamless electronic health record integration to translate these innovations into routine practice and improve maternal and neonatal outcomes. Full article

Background/Objectives: Cesarean delivery often leads to delayed breastfeeding initiation, potentially affecting infant health compared with vaginal delivery. This prospective observational study (conducted between August 2022 and January 2024) comparatively evaluates the impact of delivery method—vaginal, planned cesarean, and emergency cesarean—on breastfeeding initiation and continuation and examines the maternal factors influencing these outcomes. Materials and Methods: We enrolled 338 mother–infant pairs at a tertiary university hospital. Breastfeeding effectiveness was assessed using the Bristol Breastfeeding Assessment Tool (BBAT) at birth and at one, three, and six months postpartum. Rates of breastfeeding continuation and formula supplementation were documented through structured interviews. Results: The mothers who delivered vaginally had a significantly higher rate of breastfeeding within one hour after birth (85.5%) compared with planned (57.9%) and emergency cesarean sections (64.9%) (p < 0.001). Baseline BBAT scores were higher for vaginal births but converged across the groups by one month postpartum (p > 0.05). At six months, breastfeeding continuation rates remained high (94.4–95.2%) irrespective of delivery method. Conclusions: Delivery method exerts a transient effect on breastfeeding initiation. With lactation support, the mothers delivering by cesarean section achieved comparable breastfeeding outcomes within the first month postpartum. These findings reinforce the importance of Baby-Friendly Hospital Initiative (BFHI) practices, including immediate skin-to-skin contact, effective pain management, and lactation counseling, in ensuring equitable breastfeeding outcomes. Full article

Ketosis and fatty liver syndrome are metabolic disorders apparent in dairy cows during the transition period. The study focused on examining how varying levels of milk production in dairy cows might reflect or influence specific blood biochemical markers and liver health as assessed through ultrasonography. A total of 65 Holstein-Friesian cows from six farms were evaluated at three time points as follows: 7 days before expected calving and at 7 and 21 ± 3 days postpartum. Each evaluation included the body condition score (BCS), blood sampling for biochemical analysis, and liver ultrasonography. Based on average farm milk yield, cows were divided into three production groups as follows: GR1 (38.4 ± 6.45 L/day, n = 23), GR2 (42.9 ± 2.77 L/day, n = 24), and GR3 (45.69 ± 7.49 L/day, n = 18). Parameters assessed included liver lipid content and ultrasonographic measurements such as portal vein diameter and depth, liver depth, and liver angle. Significant time-dependent changes were observed in liver size, fat metabolism, and electrolyte balance, especially postpartum. However, no significant differences emerged among the production groups, indicating that these changes likely represent physiological adaptations to lactation. These findings support the use of blood analysis and ultrasonography as practical, minimally invasive tools for routine metabolic health monitoring in dairy cows during the transition period. Full article

Background: Hypertensive disorders of pregnancy (HDPs) are a major cause of maternal morbidity and mortality worldwide. Very little progress has been made in reducing HDP-related maternal deaths in low- and middle-income countries (LMICs), including South Africa, over the past decade. Aim: The aim of this study was to describe maternal deaths arising from HDPs at tertiary/quaternary hospital in Johannesburg, South Africa, with specific focus on maternal characteristics, management, timing of death, causes, and avoidable factors and to use the information to inform clinical practice. Methods: We conducted a retrospective review of patient clinical records covering the period 1 January 2015 to 31 December 2018. Data on maternal demographic and pregnancy characteristics, management, causes, and timing of death were extracted from the clinical records and transferred into a Microsoft Excel^® Spreadsheet and analysed using descriptive statistics. Results: During the study period, 70 maternal deaths were recorded, of which 23 (32.8%) were due to HDP-related complications. The majority of the maternal deaths, 20 (86.9%), occurred during the postpartum period, predominantly affecting Black African women, 23 (100%), with a median age of 27 years. Notably, 18 (78.2%) of the deceased had booked early and attended antenatal care (ANC). Eclampsia emerged as the most common final cause of death. Key avoidable factors included non-adherence to established protocols, particularly failure to initiate aspirin prophylaxis in at-risk women, as well as incorrect or inadequate administration of antihypertensive therapy and magnesium sulphate (MgSO₄) prophylaxis. Conclusions: HDP-related maternal deaths are largely preventable. They primarily result from poor quality of care due to a lack of adherence to evidence-based protocol. Full article

Background/Objectives: Postnatal immunisation is critical for maternal and child health, particularly in low-income countries. Despite international efforts, maternal awareness and access to care remain limited. Understanding the drivers behind postnatal immunisation services is critical for improving neonatal and maternal healthcare interventions. Methods: A tertiary healthcare facility’s postpartum mothers who were seeking immunisation services participated in a prospective cross-sectional electronic survey. Convenience sampling was used to select respondents, who then answered a structured electronic questionnaire intended to obtain information on immunisation practices. To evaluate important trends and correlations, data was analysed using both descriptive and inferential statistics. A factor analysis was performed using the principal component analysis method, eigenvalue criteria, communalities, and confirmatory factor analysis. The study adhered to the STROBE guidelines. Results: We found that postnatal mothers’ good immunisation practices were influenced by their adherence to immunisation schedules (% variance: 56.407; Eigenvalue: 7.33), and significant satisfaction with communication (% variance: 8.338; Eigenvalue: 1.084); giving a cumulative variance explained of 64.745% of the total variance of variables under study. However, suboptimal practices include limited resource availability, poor record maintenance, insufficient support for side effects, a lack of support from healthcare providers, and a decline in immunisation recommendations, all of which had Eigenvalue <1 and insignificant percentage of variance contribution to the total variance explained. We developed a two-factor model of postnatal immunisation practices, focusing on adherence and effective communication. The model showed high loadings and adequate fit indices (χ²(34) = 91.333, p < 0.001; CFI = 0.945; TLI = 0.927; RMSEA = 0.071; SRMR = 0.042), good evidence of internal consistency (α = 0.823–0.877), and composite reliability (ω = 0.832–0.877). Conclusions: The study recommends a comprehensive approach to increasing newborn vaccine coverage, which includes health education, improved service delivery, and culturally sensitive communication strategies. Future research should focus on digital health interventions, community-based initiatives, and policy-driven postnatal care. Full article

Weight stigma remains a pervasive issue in contemporary society, impacting individuals’ psychological well-being, social inclusion, and access to opportunities. This study explored the lived experiences of overweight women, focusing on body image, stigma, and engagement with dominant health and beauty norms. Using a qualitative, phenomenological approach, online in-depth interviews were conducted with 14 women aged 25 to 51, primarily residing in southern and eastern Europe (Greece, Cyprus, Albania, Romania, and Bulgaria), with three participants from the United Kingdom. Thematic analysis revealed four key themes: workplace discrimination, pressures during pregnancy and the postpartum period, ambivalence toward body positivity movements, and the emotional toll of stigma, including extreme coping strategies. Participants described being marginalized professionally, scrutinized publicly and within families, and caught between ideals of inclusivity and persistent societal rejection. The findings emphasize the psychological burden of weight-based discrimination and the superficial nature of many body acceptance campaigns. This study calls for structural changes in healthcare, media, and employment practices to support body diversity and dismantle entrenched biases. By centering the voices of overweight women, the research contributes to broader discussions on embodiment, social justice, and intersectionality within the field of body image scholarship. Full article

Introduction. Scientific societies emphasize the benefits of breastfeeding. The effectiveness of education, information, and support during pregnancy has been demonstrated. However, further research is needed on the prevention and treatment of nipple damage, which is a major cause of breastfeeding cessation. Objective. To determine whether the use in clinical practice of beeswax breast pads in combination with the WHO (World Health Organization) health education program improves continuation of breastfeeding among first-time mothers over a 6-month follow-up period compared with the use of the WHO health education program alone. Material and methods. A prospective randomized control study was conducted in 122 first-time mothers who were seen in the midwifery office between 2017 and 2021 in several health centers in Alicante and Valencia. Data were collected through a prepartum health questionnaire, in the first weeks postpartum, and at 3 and 6 months postpartum. Results. A higher percentage of mothers in the intervention group continued breastfeeding at 6 months compared to the control group (76.3% versus 57.1%). The continuity of breastfeeding is only significant in relation to the use of the breast areolas, with values, respectively, at 3 and 6 months OR (odds ratio) = 3.129 (95% CI; 1.249–7.839; p = 0.015) and OR = 2.282 (95% CI, 1.038–5.016; p = 0.040). The NNT (number needed to treat) at 3 months = 5 (95% CI 3–13; p = 0.004) and at 6 months = 5 (95% CI 3–26; p = 0.025) Conclusions. The use of organic beeswax breast pads in combination with the WHO health education program improves initiation and maintenance of exclusive breastfeeding among first-time mothers and the perception of their health status compared to the health education program alone. Full article

Background/Objectives: In the context of maternal mental health, this cross-sectional study investigates a moderated mediation model to explore how prenatal planning is associated with postpartum depression. Specifically, we examined whether planned pregnancy (X) is associated with fewer postpartum depression symptoms (Y) through greater positive affect (M), and whether the indirect association is moderated by breastfeeding duration (W). Methods: Data were collected from 117 postpartum mothers via self-report questionnaires that measured the degree of pregnancy planning, positive affect, postpartum depression symptoms, and breastfeeding duration. Bootstrap analyses were performed to assess the conditional indirect effects across two levels of breastfeeding duration. Results: The findings suggest an indirect association between pregnancy planning and postpartum depressive symptoms through positive affect, moderated by breastfeeding duration. This association was statistically significant only among mothers who breastfed for less than six months, indicating that the protective emotional effect of pregnancy planning may be more evident in this group. No significant indirect effects were observed in mothers who breastfed beyond this duration. Conclusions: These exploratory findings suggest that positive affect may be a pathway through which prenatal planning relates to maternal well-being, particularly in the context of breastfeeding practices. Given the cross-sectional design, causal inferences cannot be drawn. Future longitudinal research is needed to confirm these associations. Full article

Perineal injuries are a common complication of vaginal delivery, affecting 75–85% of women. This review examines current knowledge on risk factors, classification, treatment, and quality of life impacts. Risk factors are divided into maternal, foetal, and labour-related categories. Treatment depends on injury severity. First-degree tears can be managed conservatively, with skin glue or suturing—preferably with synthetic absorbable sutures to reduce pain and infection risk. Second-degree tears and episiotomies respond best to continuous non-locking sutures, improving healing, and minimizing postpartum pain. Severe third- and fourth-degree tears require specialised surgical techniques, such as the overlay method for anal sphincter repair, which improves faecal continence. Proper preoperative care, including antibiotics and anaesthesia, enhances outcomes. Episiotomy is controversial; selective use based on clinical indications is recommended over routine practice. Research shows no significant long-term benefits compared to spontaneous tears, and links episiotomy to psychological distress and negative body image. Preventative strategies, like perineal massage and warm compresses during labour, may reduce the risk of severe trauma, particularly in first-time mothers. Perineal trauma can have lasting physical and psychological effects, impacting sexual function, continence, and mental health. Proper diagnosis, treatment, and postpartum care are essential. Future studies should aim to standardise care protocols and explore long-term outcomes to enhance patient quality of life. Full article

Background: Anemia is a chronic condition that disproportionately affects women and children. Anemia shows detrimental long-term impacts on maternal and child health and development, with the highest burden observed in low- and middle-income countries. In the Lao People’s Democratic Republic (PDR), anemia is prevalent in 39% of women of reproductive age, 47% of pregnant women, and 43% of children under five. Objective: Our study evaluates associations between maternal anemia at pregnancy and postpartum and infant hemoglobin (Hb) levels in early infancy. We further investigate the influence of breastfeeding practices on this association. Methods: Data from the Social Transfers for Exclusive Breastfeeding ongoing randomized control trial (RCT) (n = 298) in Vientiane, Lao PDR, was used. Maternal and infant Hb levels were assessed during pregnancy and at one, six, and twelve months postpartum. We used generalized estimating equations (GEE) for repeated measures analysis. Results: Anemic mothers at pregnancy and postpartum saw a 1.89 g/L (adjusted 95% CI: −4.48 to 0.70, p = 0.15) and 3.25 g/L (adjusted 95% CI: −7.86 to 1.36, p = 0.17) decrease in infant Hb levels compared to non-anemic mothers. Among postpartum anemic mothers who followed the World Health Organization (WHO) breastfeeding recommendations, an increase of 7.87 g/L in infant Hb levels (adjusted 95% CI: −2.21 to 17.94, p = 0.13) was observed. Conclusions: A weak negative association was found between maternal anemia during pregnancy and the first year postpartum and infant Hb levels. However, among anemic mothers at postpartum, adhering to WHO breastfeeding recommendations may help to mitigate this impact. Full article

Background/Objectives: Breastfeeding multiple birth infants (MBIs) poses unique challenges that require tailored support; however, research on these mothers’ experiences is limited. This study explored the breastfeeding journeys of Australian mothers of MBIs, highlighting barriers, facilitators, and support needs. Methods: Data were collected via an online survey (May–August 2024) and included quantitative data on breastfeeding initiation, duration, and challenges, as well as qualitative insights into mothers’ experiences. Thematic analysis was used to identify key themes, and statistical analyses were used to compare breastfeeding outcomes by parity. Results: While most mothers (87%) had an antenatal intention to breastfeed, they faced barriers such as latching difficulties (56%), inadequate milk supply (49%), and sore nipples (47%). Preterm births (58%) and neonatal unit admissions delayed the breastfeeding initiation. Most mothers (99%) used electric breast pumps to boost milk supply (68%) and enable expressed breast milk feeding by other caregivers (65% of mothers). While 72% were satisfied with hospital breastfeeding support and some mothers received excellent hands-on support, others felt neglected due to busy staff or conflicting advice. Mothers frequently reported that breastfeeding guidance was geared toward singletons, leaving them unprepared for the challenges of feeding multiples. Mothers’ suggestions for improving care included specialised guidance, better access to lactation support, and in-home practical support to alleviate the burden of feeding and expressing. Additionally, mothers reported that healthcare professionals should be trained to offer practical, non-judgemental support to help mothers navigate the elaborate challenges of breastfeeding MBIs. Conclusions: This study underscores the need for early postpartum support and tailored guidelines to enhance MBI breastfeeding outcomes and maternal-infant well-being. Full article

This study evaluates the health of a captive colony of Hamadryas baboons at Ravenna Zoo Safari (Italy), focusing on oxidative stress markers and biometric data. Forty-eight individuals were assessed during routine veterinary procedures: males underwent vasectomy, and females were checked for pregnancy. Biometric data collected included body weight, body length, and genital measurements in males, while females were evaluated for reproductive status. Oxidative stress was measured using two tests that assess both harmful pro-oxidant levels and the body’s antioxidant defenses. Results showed no significant differences in oxidative stress levels between sexes, although males and females differed in body weight. Pregnant and postpartum females exhibited higher oxidative stress, likely due to the metabolic and hormonal demands of reproduction. This supports the idea that reproductive activity increases the production of reactive oxygen species, requiring stronger antioxidant responses. In males, correlations between body weight and genital measurements suggest these could help estimate age in the absence of birth records. No link was found between oxidative stress and body weight, indicating limited age-related effects on these markers. Overall, the study highlights the importance of monitoring oxidative stress in captive primates to better understand the effects of reproduction and aging, and to improve welfare and management practices. Full article

Background/Objectives: Breastfeeding is a cornerstone of infant nutrition, promoting optimal development and health benefits for both mother and child. Despite high initiation rates in Poland (97%), exclusive breastfeeding (EBF) drops sharply, reaching only 4% by six months postpartum. The aim of this study is to identify factors associated with breastfeeding practices and barriers to exclusive breastfeeding (EBF) among Polish women during the postpartum period, with particular emphasis on the role of medical personnel support and maternal stress levels. Methods: A cross-sectional observational study, adhering to STROBE guidelines, was conducted from January to May 2023. The study included 1092 Polish women, surveyed using the Computer-Assisted Web Interview (CAWI) methodology. The women exclusively breastfeeding accounted for 79% (n = 863) of the study group. The remaining women supplemented their child with modified milk (n = 229; 21%). Statistical analyses were performed using IBM SPSS Statistics (Version 26.0), and logistic regression to assess associations between variables and breastfeeding outcomes. Results: Logistic regression analysis indicated that in the women experiencing low or medium stress, none of the analysed support factors significantly influenced the likelihood of exclusive breastfeeding discontinuation. However, women experiencing high stress, receiving counselling for effective breastfeeding (OR = 0.467; 95% CI: 0.232–0.941; p = 0.033) and assistance with proper breastfeeding (OR = 0.424; 95% CI: 0.220–0.819; p = 0.011) were associated with a lower likelihood of introducing formula feeding. The main reported reasons for early breastfeeding cessation included breast health issues, mental exhaustion, lack of medical support and infant-related difficulties. Conclusions: The findings allow us to underscore the urgent need for targeted interventions to improve breastfeeding rates in Poland. New evidence indicates that women experiencing higher levels of stress require increased support from medical personnel in order to breastfeed exclusively. Full article

Gestational diabetes mellitus (GDM) leads to increased lifelong cardiometabolic risk in both mothers and their offspring. The identification of effective strategies to contain the future risk of type 2 diabetes (T2D) and cardiovascular disease (CVD) is of utmost importance to reduce the burden of the disease. Breastfeeding (BF) is effective in reducing short- and long-term child morbidity. In recent years, BF has emerged as a candidate low-cost intervention to prevent future cardiometabolic complications both in mothers and infants exposed to GDM. The aim of this review is to provide an overview of the evidence about the possible metabolic benefits of BF for both mothers with a history of GDM and their offspring. Increasing evidence supports the positive effects of exclusive BF over formula feeding (FF) or mixed feeding on glucose homeostasis and the lipid profile in women with previous GDM in the early postpartum period. Studies with a longer observation suggest clear benefits of intensive and longer BF on the risk of diabetes and prediabetes in mothers after adjustment for confounders. In regards to infants, in most studies, the intensity and duration of BF are positively associated with slower infant growth curves compared with FF, indicating that the positive effect of BF on growth trends might contrast the increased risk of obesity and metabolic diseases observed in infants exposed to GDM. Considering these findings, a global effort should be made to support BF practice to possibly reduce cardiometabolic morbidity after GDM. Full article

The Perinatal Multisite Databank (PMD) aims at facilitating research on perinatal mental health by collecting clinical information of patients referred for evaluations at perinatal mental health clinics across the province of Quebec, Canada with the potential to improve patient care and support evidence-based practice. This study provides a detailed description of the first 693 participants concerning psychosocial risk characteristics, the prevalence of psychiatric disorders and comorbidity during the perinatal period, the evolution of perinatal depression and anxiety symptoms over time, and the treatments received. Data were collected using clinical reports and well-validated questionnaires at multiple timepoints (from pregnancy to 6 months postpartum). Results are discussed within the context of improving patient care and disease prevention strategies in the perinatal period. Full article