Search Results (780)

Background: Despite well-established racial/ethnic disparities in cancer outcomes, little is known about the extent to which race/ethnicity influences adverse pregnancy outcomes (APOs) among women with early onset cancer. We evaluated racial/ethnic disparity in the occurrence of cancer during pregnancy and APOs among women with cancer in the United States. Methods: Data consisted of 17.6 million singleton deliveries among females aged 18–49 years from the National Inpatient Sample. Logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). Results: From 2000 to 2022, the prevalence of births among women with cancer increased more than 225%, from 120.4 to 391.8 per 100,000. After accounting for sociodemographic and behavioral/lifestyle factors and comorbidity index among women with cancer (n = 49,824, mean age = 33.4 years), non-Hispanic Black women had the highest odds for hypertensive disorders of pregnancy (OR = 1.67, CI: 1.54–1.82), preterm birth (OR = 1.44, CI: 1.26–1.64) and fetal death (OR = 3.04, CI: 1.99–4.63). Asian or Pacific Islander and Native American women had the highest odds for gestational diabetes (OR = 2.48, CI: 2.17–2.85) and fetal growth restriction (OR = 1.92, CI: 1.00–3.69), respectively. Among racial/ethnic minority women, the odds for maternal mortality and several APOs were significantly higher among those with cancer than those without cancer, with the odds for APOs being highest for breast cancer (OR = 1.39, CI: 1.23–1.56). Conclusions: This large population-based study showed significant racial and ethnic disparities in APOs among women with a concurrent cancer diagnosis at delivery. Targeted management of APO risk factors during pregnancy among racial/ethnic minority populations with cancer may help reduce adverse maternal and neonatal outcomes. Full article

Introduction: Interpregnancy interval (IPI) plays a critical role in neonatal health, yet optimal spacing remains controversial. This study assessed neonatal outcomes across short and long IPI using three complementary classification approaches to identify consistent patterns of risk. Materials and Methods: In this retrospective cohort study, medical records of 1194 women with a prior live birth who delivered singleton pregnancies in 2024 at a tertiary referral center were analyzed. IPI was calculated as the delivery-to-conception interval (LMP + 14 days). Three IPI classification systems were applied: (1) classical cut-offs (<6, 6–11, 12–23, 24–59, and ≥60 months), (2) quartiles, and (3) tertiles. Primary outcomes included preterm birth, low birth weight (LBW), and NICU admission. Multivariable logistic regression models adjusted for maternal age, gravidity, and previous cesarean delivery. Results: Short IPI (6–11 months) demonstrated the highest NICU admission rates (29.4%). Very long IPI (≥60 months) showed the highest prevalence of LBW (16.6%). Multivariable regression analysis revealed that intervals ≥ 24 months were independently protective against preterm birth (24–59 months: aOR 0.48, p = 0.002; ≥60 months: aOR 0.58, p = 0.042), while maternal age increased preterm birth risk by 7% per year. Short IPI (6–11 months) and very long IPI (≥60 months) independently increased NICU admission risk (aOR 2.29, p = 0.002 and aOR 1.61, p = 0.036, respectively). Previous cesarean delivery was an independent predictor of NICU admission (aOR 1.35; p = 0.048). Conclusions: Short and very long IPIs are associated with increased neonatal morbidity, particularly NICU admission, while the apparent preterm risk in long intervals is largely mediated by maternal age. Once adjusted, IPIs exceeding 24 months demonstrate protective effects against preterm birth. However, the rising trend toward LBW and NICU admission in intervals beyond 5 years suggests that birth-spacing counseling targeting an optimal window of 18–24 months provides the best balance in minimizing competing neonatal risks. Full article

Background: Hypothyroidism is one of the most common endocrine conditions during pregnancy and has been associated with poor obstetric and perinatal outcomes. There is still a lack of data from Middle Eastern populations, despite its clinical significance. This study aimed to evaluate thyroid management patterns during pregnancy and examine the association between thyroid function control and maternal and perinatal outcomes in women with hypothyroidism at a tertiary care center in Qatar. Methods: A retrospective cohort study including 379 pregnant women with hypothyroidism diagnosed between January 2019 and November 2022 was conducted at Sidra Medicine in Doha, Qatar. Based on trimester-specific Thyroid-stimulating hormone (TSH )reference values, participants were categorized as having adequately or inadequately controlled thyroid function. Data on obstetrics, biochemistry, and demographics were taken from electronic medical records (EMR). Statistical analyses were performed using chi-square tests for categorical variables and t-tests for continuous variables, with a significance threshold of p < 0.05. Results: Participants had a mean Body Mass Index (BMI) of 30.33 ± 6.14 kg/m² and an average age of 32.65 ± 4.99 years; 54% of them were Qataris. Of the patients, 58.5% had positive thyroid antibodies and 55.7% had pre-gestational hypothyroidism. Women with pre-gestational hypothyroidism required significantly higher levothyroxine doses compared with those with gestational hypothyroidism (93.2 ± 47.5 mcg/day vs. 67.6 ± 30.1 mcg/day; p < 0.001). Treatment adjustment was demonstrated by the improvement in TSH normalization from 51.3% in the first trimester to 64.2% in the third trimester (p = 0.041). No significant associations were observed with pre-eclampsia, preterm delivery, hypertension, or placental abruption. However, women with normal third-trimester TSH had a higher prevalence of gestational diabetes mellitus (GDM) compared with those with elevated TSH (51.6% vs. 36.8%; p = 0.013). Conclusions: Appropriate trimester-specific monitoring and timely levothyroxine titration was associated with improved biochemical control without adverse maternal outcomes. Greater levothyroxine requirements in women with pre-gestational hypothyroidism emphasize the importance of early intervention. These findings highlight the potential benefit of structured thyroid monitoring and multidisciplinary care approaches in pregnancy and may help inform future regional clinical practice guidelines. Full article

Background and Objectives: To evaluate the impact of liver cirrhosis on pregnancy outcomes using a large-scale, propensity score-matched cohort, with adjustment for numerous confounding variables. Materials and Methods: From a total of 3,701,876 pregnancies (women aged 18–49) from 1 January 2010, to 31 December 2024, after propensity score matching, 2498 pregnancies with cirrhosis and 2498 pregnancies without cirrhosis in TrinetX database were included in our analysis. To adjust for potential confounding, pregnancies in the cirrhosis group were matched 1:1 to those without cirrhosis using propensity scores derived from demographic, lifestyle, comorbidity, and laboratory characteristics. Relative risks (RRs), risk differences (RDs), and corresponding 95% confidence intervals (CIs) were calculated for pregnancy-related outcomes. Subgroup analyses stratified by maternal age were further performed to assess potential effect modification. Main outcomes included Gestational diabetes mellitus, preeclampsia, premature rupture membranes, preterm birth, miscarriage, stillbirth, placental abruption, dystocia, postpartum hemorrhagia, and cesarean delivery. Results: After matching, 2485 women were included in each group, with well-balanced baseline characteristics. Compared with women without cirrhosis, those with cirrhosis had a higher risk of pregnancy-related outcomes, including gestational diabetes mellitus (15.5% vs. 11.9%; RR = 1.30; 95% CI, 1.13–1.50, p < 0.001), preeclampsia (8.6% vs. 5.7%; RR = 1.52; 95% CI, 1.24–1.87, p < 0.001), and preterm birth (9.0% vs. 4.9%; RR = 1.85; 95% CI, 1.49–2.29, p < 0.001). Cirrhosis during pregnancy was also associated with a higher risk of miscarriage (6.6% vs. 4.8%), stillbirth (1.3% vs. 0.5%), placental abruption (1.8% vs. 0.8%), postpartum hemorrhage (6.9% vs. 4.3%), and cesarean delivery (20% vs. 17.2%). The limitations include the lack of detailed data on cirrhosis severity. Conclusions: Pregnancy with liver cirrhosis is associated with increased risks of diverse maternal and neonatal complications. Our findings highlight the importance of multidisciplinary management and individualized care planning in order to reduce adverse outcomes. Full article

Background: Closing/closed gastroschisis (CGS) accounts for approximately 6% of gastroschisis cases globally. Currently, no consensus exists regarding: antenatal predictors of CGS types, optimal antenatal management (ultrasound screening frequency, indications for early delivery), or standardized surgical strategies tailored to CGS type (staging/timing of procedures, enterostomy necessity/level). Methods: Five neonates with CGS were enrolled and classified according to Perrone’s classification: two patients with type B (40%), one with type C (20%), one with type D (20%), one patient was classified as unclear (20%). Gender distribution—80% female (n = 4), 20% male (n = 1); gestational age—median 35 weeks (IQR 35–38); preterm birth rate—80% (n = 4); birth weight—median 2620 g (IQR 2310–3850). Results: Three patients (60%) developed antenatal intestinal obstruction signs at the third trimester, including two who postnatally demonstrated viable intestinal loops. Two patients (40%) with necrosis of eviscerated intestine demonstrated onset of antenatal intestinal obstruction signs at the second trimester. Patients with CGS type B were managed using a staged surgical approach; patients with types C and D received single-stage repair. Patient with CGS type B achieved complete clinical recovery. Three patients (60%) with CGS types C and D developed short bowel syndrome. Conclusions: The appearance of sonographic signs of intestinal obstruction in the second trimester may be a predictor for a high risk of subsequent significant vascular compromise of the eviscerated bowel, leading to more severe types of CGS (C and D). For patients with CGS type B, a staged surgical approach is advisable to maximize bowel length preservation. Full article

Background/Objectives: To compare the maternal, fetal, and neonatal outcomes of pregnancies undergoing amniocentesis with those undergoing non-invasive prenatal testing (NIPT), within a cohort of women with comparable clinical indications, aiming to evaluate differences in adverse outcomes in a risk-indicated population. Methods: In this retrospective cohort study, pregnancy outcomes of 2044 pregnant women who underwent amniocentesis and 7668 pregnant women who underwent NIPT were evaluated using single-center data. The analysis was restricted to pregnancies with normal/reportable test results and without structural or genetic anomalies. Pregnancy loss outcomes were evaluated in the full cohort, while perinatal outcomes were analyzed among cases with available delivery data (377 amniocentesis and 2063 NIPT cases). Pregnancy and perinatal outcomes, including miscarriage, intrauterine fetal demise (IUD), preterm birth (PTB), pregnancy-induced hypertensive diseases (PIHDs), gestational diabetes mellitus (GDM), intrahepatic cholestasis of pregnancy (ICP), low birth weight (LBW), small for gestational age (SGA), and low APGAR scores (<7), were evaluated. Multivariate logistic regression analysis was performed to adjust for potential confounding factors, and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were reported. Results: Amniocentesis was associated with a significantly higher risk of an adverse outcome compared to NIPT in this risk-indicated cohort. The likelihood of miscarriage was significantly higher in the amniocentesis group (aOR: 1.91, 95% CI: 1.17–3.14, p = 0.025), as was the risk of IUD (aOR: 4.10, 95% CI: 2.05–8.20, p < 0.001). PTB risk was also increased (aOR: 1.96, 95% CI: 1.53–2.51, p < 0.001). LBW was significantly more prevalent in the amniocentesis group (aOR: 7.73, 95% CI: 5.40–11.05, p < 0.001), and the likelihood of delivering a SGA neonate was also increased (aOR: 1.45, 95% CI: 1.02–2.06, p = 0.040). A 1st-minute APGAR score < 7 was also more frequent in the amniocentesis group (aOR: 1.51, 95% CI: 1.06–2.16, p = 0.022), although the association with 5th-minute APGAR scores < 7 did not reach statistical significance (aOR: 1.45, 95% CI: 0.83–2.52, p = 0.193). Overall, the risk of composite maternal and perinatal adverse outcomes (aOR: 1.77, 95% CI: 1.41–2.22, p < 0.001) as well as composite fetal and neonatal adverse outcomes (aOR: 1.97, 95% CI: 1.50–2.58, p < 0.001) was significantly higher in the amniocentesis group compared to the NIPT group. No significant association was observed for PIHD, GDM, or ICP. Conclusions: Our findings showed that, apart from fetal loss, amniocentesis may be associated with adverse perinatal outcomes such as PTB, LBW, SGA and low APGAR scores. Full article

Background: Does maternal body mass index (BMI) influence embryo morphokinetics in fresh embryo transfer cycles, and how does this relate to clinical outcomes and obstetric complications? Methods: A retrospective cohort study was conducted on 2238 fresh embryo transfer (ET) cycles, categorized into four BMI groups: underweight, normal weight, overweight, and obese. Baseline characteristics, stimulation parameters, hormonal profiles, morphokinetic data, and pregnancy and delivery outcomes were analyzed. Results: Higher BMI was associated with more anovulatory infertility and greater endometrial thickness. Peak estradiol and estradiol-to-oocyte ratios declined progressively with increasing BMI, despite preserved oocyte yield and embryo quality scores. Interestingly, the underweight group exhibited a significantly distinct biphasic morphokinetics developmental pattern compared with the overweight and obese groups. Pregnancy rates, including clinical and live birth, did not differ significantly across BMI groups. However, obese women had markedly higher cesarean section rates (51.9% vs. ~25–28% in other groups) and a non-significant trend toward more gestational diabetes. Other perinatal outcomes, such as preeclampsia and preterm birth, were not significantly different. Conclusions: In fresh IVF cycles, a higher BMI does not impair pregnancy achievement but is linked to altered hormonal response and increased obstetric risk, particularly cesarean delivery. These findings highlight the importance of preconception counseling and targeted obstetric management for women with elevated BMI undergoing fresh ET. Full article

Background: Preterm birth is a leading cause of neonatal mortality and long-term disability worldwide. Injury in premature infants is demonstrated by disrupted organ development from inflammation, oxidative stress, hypoxia, and impaired vascular maturation. Current therapies largely provide supportive care and do not directly promote tissue regeneration. Mesenchymal stem cell (MSC)-based therapies have emerged as a potential strategy to enhance endogenous repair across organ systems commonly affected by prematurity. Results: Evidence indicates that MSCs exert therapeutic effects primarily through transient paracrine signaling rather than long-term engraftment. Following administration, MSCs release cytokines, growth factors, and extracellular vesicles that reduce inflammation, promote angiogenesis, and support tissue repair. In preclinical models of neonatal brain injury, MSC therapy has been associated with improved oligodendrocyte maturation and reduced white matter injury. Early clinical trials in neonatal encephalopathy demonstrate feasibility and short-term safety of both autologous and allogeneic cell products. However, studies remain limited by small sample sizes and short follow-up. Cell-free approaches using MSC-derived extracellular vesicles may offer similar biological benefits with potentially lower safety and regulatory concerns. Conclusions: MSC-based therapies represent a promising regenerative approach for complications of prematurity. Rigorous, large-scale trials with standardized protocols and long-term follow-up are necessary to clarify efficacy, optimize delivery strategies, and define safety in this vulnerable population. Full article

Background: Neonatal hyperglycemia is a common metabolic complication in extremely preterm (EP) infants; however, early risk factors and associated outcomes remain incompletely defined. Objective: To evaluate the association between neonatal hyperglycemia in the first postnatal week and key neonatal morbidities including early neurodevelopmental risk in EP infants. Methods: We conducted a retrospective cohort study of EP infants born in 2018–2019 at the Women’s Wellness and Research Center. Neonatal hyperglycemia was defined as a blood glucose level > 8.3 mmol/L. Maternal factors, delivery room interventions, early physiological markers, neonatal morbidities, and follow-up outcomes were compared. Propensity score matching was applied to balance the baseline demographic and perinatal differences. Results: Among 225 EP infants, 131 (58.2%) developed neonatal hyperglycemia in the first week (mild, 21.4%; moderate, 42%; severe, 36.6%). Before matching, infants with neonatal hyperglycemia had lower gestational age and birth weight and required more delivery-room surfactant, and their mothers had lower rates of premature rupture of membranes. After matching, neonatal hyperglycemia was associated with higher rates of ventilator-associated pneumonia (1.45 vs. 0.37; IRR 6.2, 95% CI 1.4–27.6), longer duration of invasive ventilation (19.8 ± 25.3 vs. 8.9 ± 24.8 days; mean difference −10.9 days; p = 0.042), higher postnatal steroid exposure (18.2% vs. 5.5%; OR 4.6, 95% CI 1.6–14.4; p = 0.040), and severe retinopathy of prematurity (ROP) (21.6% vs. 6.4%; OR 4.0, 95% CI 1.0–15.5; p = 0.032). A trend toward moderate-to-severe bronchopulmonary dysplasia was observed (33.3% vs. 15.9%; p = 0.054). Mortality did not differ significantly between groups; however, among non-survivors, age at death was higher in the neonatal hyperglycemia group. Conclusions: In EP infants, early neonatal hyperglycemia is associated with higher respiratory morbidity and severe ROP even after propensity score matching. These findings support neonatal hyperglycemia as a clinically relevant early risk marker and justify further prospective and interventional studies. Full article

Background/Objectives: Human milk composition is shaped by gestational age at delivery and stage of lactation; however, proteomic differences between milk from mothers of preterm and term infants and their temporal patterns remain incompletely characterised. Methods: This prospective study enrolled 40 lactating mothers: 20 who delivered preterm infants (<32 weeks’ gestation) and 20 who delivered at term (37–42 weeks). Each provided milk samples during early lactation (first 10 days postpartum) and during later lactation (week five postpartum). Milk serum was analysed using quantitative data-independent acquisition mass spectrometry. Differential protein abundance was assessed separately at each time point; functional annotation was performed using Gene Ontology biological process analysis. Results: Eighty samples were analysed. On average, a total of 662 proteins were identified per sample, of which 169 were consistently quantified across all samples (1% FDR). During early lactation, 10 proteins differed significantly, with bidirectional changes and moderate effect sizes. At week five, 19 proteins were differentially abundant, predominantly higher in preterm samples. Immune-related proteins constituted the largest functional category at both stages. Immunoglobulin heavy constant gamma 4 remained consistently downregulated in preterm milk (1.6-fold lower abundance). Ferritin heavy chain (1.5) and HLA class II histocompatibility antigen gamma chain (1.8) were elevated only early, whereas calprotectin subunits S100A8 (5.6) and S100A9 (5.2) were markedly upregulated later. Conclusions: Proteomic differences vary across lactation stages, highlighting lactation stage as an essential contextual variable in comparative milk proteomics. Full article

Background/Objectives: Dichorionic triamniotic (DCTA) triplet pregnancies are associated with increased rates of placenta-specific complications primarily attributed to vascular anastomoses in the monochorionic (MC) pair. Selective fetal reduction to twins (of one of the MC pair) is a complex and not a widely available procedure. Multifetal reduction (MFR) to singleton pregnancy can reduce adverse pregnancy outcomes but is controversial due to medico-legal and socio-ethical issues. The aim of this study is to identify the rate of miscarriage < 24 weeks or preterm birth < 34 weeks following MFR to singleton pregnancy in DCTA triplets and compare the results with expectant management. Methods: This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered in the Prospective Register of Systematic Reviews System (ID: CRD42023422585). Results: Overall, from 21 citations of relevance, 6 studies with a total of 548 DCTA triplet pregnancies fulfilled the inclusion/exclusion criteria. In comparison with expectant management (n = 336), meta-analysis demonstrated that MFR to singleton pregnancy (n = 212) was associated with a lower rate (9.4% vs. 48.5%) of preterm birth (RR = 0.19, 95%CI 0.07–0.51), whereas the rate of miscarriage (14.6% vs. 9.2%) did not significantly increase (RR = 1.53, 95%CI 0.91–2.55). Conclusions: In DCTA triplet pregnancies, MFR to singleton pregnancy was associated with a reduced preterm birth rate and not associated with an increased miscarriage rate. Given the fact that the MC pair is reduced only to lower the rate of preterm birth, appropriate counselling and justification are important. In the absence of randomized controlled trials, data from systematic reviews are the best available evidence for counseling on the different management options. Full article

Background/Objectives: The rates of adverse maternal and neonatal outcomes—including preterm birth < 37 weeks’ gestation (PTB), hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), small for gestational age (SGA), and large for gestational age (LGA)—remain elevated in the United States. Preventive strategies beyond the current standard of care (SOC) may be needed, particularly in diverse and socioeconomically vulnerable populations. The study evaluated a targeted diet and lifestyle intervention incorporating selected nutrient and gene variant analysis with personalized trimester-based counseling and supplementation (Standard of Care Plus, PLUS). Methods: The prospective observational study compared outcomes among participants receiving PLUS in addition to SOC with regional SOC data. A Nevada PLUS cohort (n = 15), consisting of high-risk participants with 100% Medicaid coverage, received the intervention virtually. An Oregon PLUS cohort (n = 387), consisting of moderate-risk participants with approximately 50% Medicaid coverage, received PLUS through in-person group sessions. Outcomes were compared with regional SOC rates and between PLUS cohorts. Cochran–Mantel–Haenszel (CMH) analyses were performed to account for site-level differences in pooled analyses. Primary outcome was PTB < 37 weeks’ gestation; secondary outcomes included HDP, GDM, SGA, and LGA. Results: The Nevada PLUS application was associated with lower adverse outcome rates compared with regional SOC; however, statistical significance was not observed, likely reflecting limited sample size. The Oregon PLUS cohort experienced statistically significant association with reductions across all five outcomes (all p < 0.001) compared to regional SOC. No statistically significant differences were observed between the Nevada (virtual) and Oregon (in-person) PLUS cohorts. In pooled analyses (n = 402), significant reductions compared with SOC were observed for PTB (RR = 0.23), HDP (RR = 0.11), GDM (RR = 0.06), SGA (RR = 0.25), and LGA (RR = 0.35) (all p < 0.001). Conclusions: The implementation of selected nutrient and gene variant analysis combined with targeted nutritional and lifestyle interventions, delivered in collaboration with standard obstetric care, was associated with reduced adverse maternal and neonatal outcomes. Interpretation of virtual delivery remains limited by small sample size. Full article

Background/Objectives: Preterm birth (PTB) is a major global cause of neonatal morbidity and mortality, and its heterogeneous mechanisms limit the development of reliable prediction tools. Recent genomic and proteomic studies have highlighted molecular pathways involving inflammation, extracellular matrix dysfunction, and uterine activation, yet their clinical integration remains limited. Defining distinct clinical phenotypes may facilitate more targeted biomarker research. Methods: We performed a retrospective cohort study of singleton spontaneous preterm births (24–36 + 6 weeks) at Filantropia Clinical Hospital, Bucharest (2022–2024). Maternal and neonatal data were extracted from electronic records. Four phenotypes were defined by presentation (preterm premature rupture of membranes—PPROM vs. contractions) and maternal inflammatory status. Statistical comparisons used ANOVA or Kruskal–Wallis tests, Chi-square tests, and logistic regression adjusted for gestational age and birth weight to assess neonatal outcomes. Results: Of 585 preterm births, 318 spontaneous singleton cases met inclusion criteria. The cohort was predominantly late preterm, with 85.5% of deliveries occurring between 34 and 36 + 6 weeks’ gestation. Four phenotypes were identified: phenotype 1 inflammatory PPROM (22.3%), phenotype 2 structural PPROM (38.1%), phenotype 3 mixed inflammatory + uterine activation (11.9%), and phenotype 4 uterotonic/endocrine phenotype (19.2%). Conclusions: These clinical phenotypes exhibited distinct maternal and neonatal patterns and correspond to mechanisms increasingly supported by genomic and proteomic studies. They may provide a practical framework for integrating clinical and molecular approaches in future PTB research. Full article

Background/Objectives: Neonatal hypothermia remains a significant contributor to neonatal mortality and morbidity mainly in low and middle-income countries, such as those in sub-Saharan Africa. The objective of this systematic review and meta-analysis is to assess the prevalence of neonatal hypothermia and its risk factors in sub-Saharan Africa. Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis statement (PRISMA) guideline was used to search databases (PubMed, Scopus, Cocrane library and Google Scholar) for studies reporting both the prevalence and factors associated with neonatal hypothermia in sub-Saharan Africa. We have included cross-sectional, cohort and descriptive studies published between 1 June 2014 and 31 May 2024. The Joanna Briggs Institute (JBI) quality appraisal checklist was used for the appraisal of studies. Subgroup analysis was conducted by country, study design and population. A total of 21 articles with 12,803 participants from 9 countries were included in the analysis. Results: The pooled prevalence of neonatal hypothermia was 55.39% (95% CI: 48.52, 62.25). Preterm birth (odds ratio (OR): 3.49; 95% CI: 1.98–6.16), low birth weight (OR: 3.56; 95% CI: 2.36–5.39), no skin-to-skin contact (OR: 1.31; 95% CI: 0.55–3.13), lack of resuscitation (OR: 2.56; 95% CI: 1.75–3.76), delayed initiation of breast feeding (OR: 2.38; 95% CI: 1.57–3.61), admission during cold season (OR: 1.80; 95% CI: 1.33–2.44), home delivery (OR: 1.94; 95% CI: 1.51–2.50) and early bathing (OR: 3.03; 95% CI: 0.98–9.38) were the factors significantly associated with neonatal hypothermia. Conclusions: The observed high prevalence of hypothermia was associated with physiological, behavioral and environmental factors. Full article

Background and Objectives: To evaluate pregnancy outcomes and transthoracic echocardiographic (TTE) findings during the antenatal and postpartum periods in women with repaired Tetralogy of Fallot (ToF) who delivered at Çukurova University Faculty of Medicine, Balcalı Hospital, between 2011 and 2025 and to interpret these findings in the context of the 2025 European Society of Cardiology (ESC) recommendations. Materials and Methods: This single-center retrospective cohort study undertaken between 2011 and 2025 included 11 pregnant women with surgically repaired ToF. Maternal demographic characteristics, obstetric outcomes, mode of delivery, neonatal outcomes, and antenatal TTE parameters were recorded. Cardiac measurements obtained during pregnancy were compared with postpartum TTE findings performed 3–6 months after delivery to assess pregnancy-related cardiac adaptation and recovery. Results: A total of 11 pregnancies in women with repaired ToF were analyzed. Nine pregnancies resulted in live births, while one ended in missed abortion at 9 + 2 weeks and one in intrauterine fetal demise at 34 + 2 weeks. Among live births, the mean gestational age was 36 + 2 weeks and the mean birthweight was 2865 g, with a preterm delivery rate of 55.6%. Cesarean section was performed in 70% of cases, while 30% delivered vaginally. During pregnancy, the mean left ventricular ejection fraction was 62.6%, and residual tricuspid regurgitation was the most frequently observed echocardiographic finding. Postpartum TTE evaluations indicated that echocardiographic parameters were largely stable over the observation period, with no numerical change and no clear evidence of deterioration in ventricular function or progression of valvular regurgitation. Conclusions: Despite successful surgical repair, pregnancy may still pose potential risks for women with ToF, underscoring the importance of individualized, multidisciplinary management. In this cohort, pregnancy appeared to be generally well-tolerated when care was provided in accordance with contemporary ESC recommendations. The observation of preserved ejection fraction and overall stable right ventricular function in the early postpartum period suggests that favorable maternal cardiac adaptation may be achievable in carefully selected patients. Early postpartum echocardiographic assessment may be useful for identifying functional changes and informing structured long-term follow-up strategies. Full article