Fetal Health Research Articles

The End-to-end Fetal Head Circumference Detection and Estimation in Ultrasound Images.

In prenatal examinations, the fetal head circumference (HC) measurement is essential for assessing fetal weight and health conditions. The sonographers obtain the fetal HC manually by fitting peripheral skull ellipse in clinical practice, which is highly subjective, time-consuming, and experience-dependent. Recently, many fetal HC automatic measurement algorithms have been proposed to improve workflow efficiency in prenatal examination. But most automatic measurement algorithms focus on using fetal head segmentation as an intermediate processing step, and HC estimation relies heavily on segmentation results, which causes the accumulation of errors in the above two stages. Independent of the segmentation method, we design a regression network to generate the oriented bounding box to detect the head contour, and directly obtain the fetal head parameters with a pixel-based ellipse regression (PER) loss. Moreover, an effective 3D attention mechanism is integrated into the network to estimate HC more precisely without adding parameters in complex ultrasound images. The extensive experimental results on the public HC18 and our clinical dataset show that the proposed network provides a feasible scheme for end-to-end estimating fetal HC, and avoids the mistake brought by the intermediary processes.

Assessment of Pregnancy Intention and Its Related Factors among Females Attending the Antenatal Clinic

Background and Objective: The intention of pregnancy is considered one of the major factors contributing to the foetal or maternal outcome. An exploration of the magnitude of this problem and its related factors can lead to improved foetal or maternal health. Thus, the objective of this study was to assess pregnancy intention and its related factors among females attending antenatal clinics of tertiary care hospitals. Methods: It is a Cross-sectional (analytical) study conducted at the Antenatal clinic, Jinnah Hospital Lahore, within the duration of January-April 2022. Two hundred and fifty(250) pregnant women aged 20 to 39 years were enrolled using non-probability convenience sampling. All the information was noted in a structured questionnaire based on study variables. The collected data was analysed using SPSS version 27.0 and frequency tables were generated. Appropriate test of significance was applied and p-value < 0.05 was taken as statistically significant. Results: Among 250 pregnant females, about 195(78%) of the females reported the current pregnancy to be intentional while 55(22%) were unintentional. It was also seen that age and parity were significantly related to the intention of pregnancy p-value<0.05. The main reasons behind unintentional pregnancies were; 28(51%) unaware about contraception, and 20(36.4%) contraception methods had failed. Conclusions: Approximately one-fourth of all pregnancies were unintentional which raises a concern regarding contraceptive usage and its effectiveness. The prevalence is high compared to reported by the Pakistan demographic health survey. Health education, advocacy, and health protection measures taken on all levels of health care to increase the use and access to contraceptive services are need of hour to address this unwanted situation of unwanted pregnancies.

Uniform Distribution Tuna Swarm Optimization (UDTSO) and Deep Neural Network (DNN) for Fetal Health Classification

Uniform Distribution Tuna Swarm Optimization (UDTSO) and Deep Neural Network (DNN) for Fetal Health Classification

Impact of dental imaging on pregnant women and recommendations for fetal radiation safety: A systematic review.

This study was conducted to investigate the safety of dental imaging in pregnant women with respect to fetal health. Searches were conducted of the PubMed, Scopus, and Web of Science databases in May 2023. The inclusion criteria encompassed cross-sectional and longitudinal studies that focused on the analysis of diagnostic dental imaging in pregnant women, as well as studies utilizing phantoms to simulate imaging examinations. The exclusion criteria consisted of reviews, letters to the editor, book chapters, and abstracts from scientific conferences and seminars. A total of 3,913 articles were identified. Based on a review of the titles and abstracts, 3,892 articles were excluded, leaving 21 articles remaining for full-text review. Of these, 18 were excluded, and 4 additional articles were included as cross-references. Ultimately, 7 articles underwent quantitative-qualitative analysis. Three retrospective studies were focused on pregnant women who underwent dental imaging procedures. The remaining 4 studies utilized female phantoms to simulate imaging examinations and represent the radiation doses absorbed by the uterus or thyroid. Few dental radiology studies have been conducted to determine the safe radiation threshold for pregnant women. Additionally, the reviewed articles did not provide numbers of dental examinations, by type, corresponding to this dose. Dental imaging examinations of pregnant women should not be restricted if clinically indicated. Ultimately, practitioners must be able to justify the examination and should adhere to the "as low as diagnostically acceptable, being indication-oriented and patient-specific" (ALADAIP) principle of radioprotection.

Federated Machine Learning Based Fetal Health Prediction Empowered with Bio-Signal Cardiotocography

Federated Machine Learning Based Fetal Health Prediction Empowered with Bio-Signal Cardiotocography

Current Screening and Management Practices for Gestational Diabetes Mellitus in Public Hospitals of South India

Background Gestational Diabetes Mellitus GDM leads to adverse maternal and foetal health outcomes. There are several benefits of screening pregnant women for GDM including reducing the impact and timing of GDM-associated complications. However there is limited evidence regarding GDM screening and management in public hospitals in low- and middle-income countries. Therefore we aimed to understand the current GDM screening and management practice in public hospitals in South India through the study of pregnant women in Bangalore.Methods We conducted a cross-sectional study in all the six tertiary-level public hospitals of Bengaluru which were providing antenatal services during September 2017. We compared the results of GDM screening in five of these hospitals with a tertiary public hospital wherein a cohort of women were studied during the same time wherein voluntarily consented women were subjected to GDM screening and were followed up through their pregnancy and post-partum.Results Among the 186 pregnant women included in the cross-sectional study 41.4 n77186 had undergone random blood sugar test and 22 n39186 underwent a confirmatory test in the form of either a Glucose Challenge Test GCT or Oral Glucose Tolerance Test OGTT for diagnosis. Similarly pregnant women underwent capillary blood glucose testing 5.1 n9186 fasting blood sugar 1.7 n3186 urine glucose and albumin level 1.7 n3186 testing. The prevalence of GDM in this cross-sectional study obtained via routine screening in public hospitals was 4.3 n8186 while in comparison the prevalence of GDM was 15.4 n1571019 in the ongoing cohort. Furthermore only 22.9 of cohort women diagnosed with GDM received any follow-up treatment in public hospitals. We also found that 12.1 and 7 of women achieved glucose control in the antenatal and postnatal period respectively.Conclusion Our results suggest that most women with GDM attending public hospitals may be ldquomissedrdquo from GDM diagnosis and treatment even in the major public hospitals in Bangalore. Therefore strengthening the GDM screening and management in public hospitals is imperative to avert the adverse risks of GDM among women and their children in urban areas.

Hair Cortisol Concentrations in Opioid-Exposed versus Nonexposed Mother-Infant Dyads.

To pilot measurement of hair cortisol concentration (HCC) in pregnant women with opioid use disorder and their infants over time and study the potential utility of hair cortisol as a biomarker of chronic stress in this population. In this pilot prospective cohort study of mother-infant dyads with and without prenatal opioid exposure, we obtained mother-infant HCCs at delivery and again within 1 to 3 months' postpartum. HCCs were compared between the opioid and control groups and between the two time points. There were no significant differences between opioid and control group maternal or infant HCCs at either time point. However, within the opioid-exposed group, there was a significant increase in infant HCCs across the two time points. This pilot study describes our experience with the measurement of HCCs in opioid-exposed mother-infant dyads. · Maternal stress impacts fetal and child health.. · Many stressors in pregnant women with opioid use disorder.. · Hair cortisol may be a useful stress biomarker..

Exploring the Complex Interplay of Trace Elements and Their Association with the Risk of Development of Pre-eclampsia in Pregnancy: a Case-Control.

Pre-eclampsia, a hypertensive disorder occurring during pregnancy, poses significant risks to maternal and fetal health worldwide. Despite extensive research, the precise cause of pre-eclampsia remains unknown. Recent studies have indicated that trace elements, essential minerals crucial for various biological processes, might be significant factors in the development of pre-eclampsia. This study examines the intricate relationship between trace elements (magnesium, copper, zinc, calcium, phosphorus, and iron) and the severity of pre-eclampsia. The study involves a total of 150 participants, categorized into three distinct groups: 50 individuals with mild pre-eclampsia, 50 with severe pre-eclampsia, and 50 healthy pregnant controls. Specifically, out of the 100 pre-eclampsia cases, 5 were identified as early-onset and 95 as late-onset. Participants were recruited from a tertiary care hospital based on stringent inclusion and exclusion criteria. All the trace elements were quantitatively measured by direct colorimetric method using the Beckman Coulter AU480 analyzer system (Beckman Coulter, USA). Pre-eclampsia cases exhibited a significantly lowered level of magnesium (2.02 mg/dL), zinc (57.62 mg/dL), calcium (8.02 mg/dL), and phosphorus (3.93 mg/dL). These levels were approximately 14.4%, 20.2%, 21.1%, and 22.6% lower when compared to healthy pregnant women. Conversely, copper (151.67 mg/dL) and iron (53 μg/dL) levels were significantly elevated in pre-eclampsia cases. Age emerged as a significant risk factor, correlating with heightened pre-eclampsia susceptibility. Magnesium showed a protective effect, correlating negatively with age and positively with gestational age. The complex relationships between trace elements, age, and pre-eclampsia underline the need for personalized interventions, potentially including magnesium supplementation, in high-risk pregnancies.

Fetal growth analysis from ultrasound videos based on different biometrics using optimal segmentation and hybrid classifier.

Birth defects and their associated deaths, high health and financial costs of maternal care and associated morbidity are major contributors to infant mortality. If permitted by law, prenatal diagnosis allows for intrauterine care, more complicated hospital deliveries, and termination of pregnancy. During pregnancy, a set of measurements is commonly used to monitor the fetal health, including fetal head circumference, crown-rump length, abdominal circumference, and femur length. Because of the intricate interactions between the biological tissues and the US waves mother and fetus, analyzing fetal US images from a specialized perspective is difficult. Artifacts include acoustic shadows, speckle noise, motion blur, and missing borders. The fetus moves quickly, body structures close, and the weeks of pregnancy vary greatly. In this work, we propose a fetal growth analysis through US image of head circumference biometry using optimal segmentation and hybrid classifier. First, we introduce a hybrid whale with oppositional fruit fly optimization (WOFF) algorithm for optimal segmentation of segment fetal head which improves the detection accuracy. Next, an improved U-Net design is utilized for the hidden feature (head circumference biometry) extraction which extracts features from the segmented extraction. Then, we design a modified Boosting arithmetic optimization (MBAO) algorithm for feature optimization to selects optimal best features among multiple features for the reduction of data dimensionality issues. Furthermore, a hybrid deep learning technique called bi-directional LSTM with convolutional neural network (B-LSTM-CNN) for fetal growth analysis to compute the fetus growth and health. Finally, we validate our proposed method through the open benchmark datasets are HC18 (Ultrasound image) and oxford university research archive (ORA-data) (Ultrasound video frames). We compared the simulation results of our proposed algorithm with the existing state-of-art techniques in terms of various metrics.

Gender-Based Violence and its Effect on Mother, Fetus and Newborn Baby: A Systematic Review

Abstract: Gender-based violence (GBV) is a major public health concern resulting in physical, psychological, sexual, and social issues. GBV during pregnancy may results in complicated and grave consequences for mother and unborn child. The prevalence of GBV was reportedly higher in developing countries, indicating higher maternal and child mortalities. Effect of GBV on pregnancy has been reported to enhance the chances of prolonged labor, obstructed labor and in severe injuries higher incidents of miscarriages and abortions are also been reported. Moreover, fetal respiratory distress, diarrhea, small for gestaional age and Intra Uterine Growth Retardation (IUGR) have also been reported. This review aims to present a systematic view of genderbased violence and its association with adverse pregnancy outcomes and to contribute by filling the existing information gap. Review assessed the effect of GBV during pregnancy on fetal health, reporting infant diarrhea more frequently, along with fever, vomiting, and respiratory distress. The significant association between adverse maternal and fetal outcomes and gender-based violence has been evaluated extensively.

Indications and results of prenatal invasive diagnosis (amniocentesis, chorionic villus sampling, cordocentesis): A tertiary center experience

Objective: To evaluate the indications for prenatal invasive procedures and karyotype results in pregnant women Materials and Methods: We conducted a retrospective analysis of the indications and karyotype results of pregnant women who opted for invasive diagnostic testing in a tertiary center between September 2022 and May 2023. Results: Of the 331 patients who underwent prenatal genetic diagnosis, 267 underwent amniocentesis (80.7%), 62 underwent chorionic villus sampling (18.7%), and 2 underwent cordocentesis (0.6%). The most common indication for amniocentesis was an elevated risk in first-trimester screening tests (29.6%). Chorionic villus sampling was most frequently performed due to an increased risk in the first-trimester screening test (37.1%) and because of an increased nuchal translucency (37.1%). Cordocentesis was exclusively performed in cases of abnormal second-trimester ultrasound examinations. Trisomy 21 was most frequently detected in cases with increased nuchal translucency (13.3%). Conclusions: The importance of invasive prenatal diagnostic procedures for the early detection and diagnosis of genetic disorders and the assessment of fetal health is evident. However, the decision to undergo these procedures should be made thoughtfully, with careful consideration of patient counselling and informed consent.

Impact of Gestational Diabetes and Pre-existing Diabetes in Fetal Outcome among Pregnancy Cases of Rangpur

Introduction: Diabetes in pregnancy, including gestational and pre-gestational diabetes, presents significant risks to both maternal and fetal health. Understanding the impact of these conditions on pregnancy outcomes is crucial for developing effective management strategies.
 Methods: This observational comparative study involved 300 pregnant women at Rangpur Medical College Hospital, divided into three groups: pre-gestational diabetic (Group A), gestational diabetic (Group B), and non-diabetic control (Group C). Data on socio-demographic characteristics, obstetric profiles, mode of delivery, maternal complications, and fetal outcomes were collected and analyzed.
 Result: The study meticulously analyzed socio-demographic characteristics, revealing no significant differences across the groups. In obstetric profiles, Group A (Pre-Gestational Diabetic) had a notably lower mean gestational age at delivery (36.06 ± 2.71 weeks) compared to Group B (Gestational Diabetic) and Group C (Control), with mean ages of 37.34± 1.12 and 38.46±1.13 weeks, respectively. Maternal complications were significantly higher in Group A at 47%, compared to 25% in Group B and 12% in Group C. Fetal outcomes showed marked variations: Group A had 95% stable births, 5% stillbirths, and 60% of neonates with Apgar scores ≤7 at 5 minutes. In contrast, Group B had 96% stable births, 4% stillbirths, and 27% of neonates with Apgar scores ≤7, while Group C reported 100% stable births and 11% with Apgar scores ≤7. Birth weight distribution indicated 24% of neonates in Group A weighed <2 kg, compared to 5% in Group B and 4% in Group C. NICU admissions were highest in Group A (44%), followed by Group B (29%) and Group C (11%). Perinatal complications like birth asphyxia (38% in Group A, 16% in Group B, 6% in Group C), hypoglycemia (22% in Group A, 10% in Group B, 4% in Group C), and hyperbilirubinemia (16% in Group A, 12% in Group B, 0% in Group C) were also significantly higher in diabetic groups.
 Conclusion: The presence of gestational or pre-gestational diabetes in mothers significantly impacts fetal outcomes and increases the risk of maternal complications. This study highlights the need for specialized care and vigilant monitoring in pregnancies complicated by diabetes to improve health outcomes for mothers and babies.
  

METHODS OF RADIATION DIAGNOSTICS IN EXAMINATION OF PREGNANT WOMEN AT DIFFERENT GESTATIONAL AGE

Currently, due to a variety of radiation examination methods, the question arises about the safety of fetal health when choosing a method of examination for pregnant women. The purpose of the review is to analyze and evaluate current data concerning the opportunities of using X–ray and magnetic resonance examinations in pregnant women at different gestational age, taking into account minimization of possible adverse effects. Materials and methods. Domestic and foreign sources of literature from 1987 to 2022 were used, they were taken from electronic libraries of scientific publications and medical databases, in particular "CyberLeninka", "Google Academy", "ScienceResearch", Elibrary.ru and PubMed. The review included the sources relevant to the topic of this review, which were searched using keywords such as pregnancy, radiography, magnetic resonance imaging, ionizing radiation, fetus, scintigraphy, radiation diagnostics, dose absorbed by the fetus, ultrasound diagnostics and positron emission tomography, with the exception of sources that did not mention the influence of certain diagnostic methods directly on the pregnant woman and the fetus. Study results. Ionizing radiation represents the greatest danger during embryo implantation (the first 2-3 weeks of pregnancy), as well as during organogenesis (from the 5th to the 8th week of pregnancy), when the anlage and development of the main organs and systems occur. MRI throughout the gestation period is preferable to any other study using ionizing radiation, but during the first trimester of pregnancy, a careful, reasonable and balanced approach to the use of MRI is necessary if there are indications and there are no alternative diagnostic methods. Conclusions. If there is a threat to life, there are no absolute contraindications to examination by radiation methods of pregnant women at any gestation period; however, it is always necessary to adhere to the principle when the potential benefit of the study will exceed its possible risk.

Unveiling the unborn: Advancing fetal health classification through machine learning

Fetal health classification is a critical task in obstetrics, which enables early identification and management of potential health problems. However, it remains a challenging task due to data complexity and limited labeled samples. This research paper presents a novel machine-learning approach for fetal health classification, leveraging a LightGBM classifier trained on a comprehensive dataset. The proposed model achieves an impressive accuracy of 98.31% on a test set. The findings demonstrate machine learning can potentially enhance fetal health classification, offering a more objective and accurate assessment. Notably, the presented approach combines various features, such as fetal heart rate, uterine contractions, and maternal blood pressure, to provide a comprehensive evaluation. This methodology holds promise for improving early detection and treatment of fetal health issues, ensuring better outcomes for both mothers and babies. In addition to the high accuracy, the novelty of this approach lies in its comprehensive feature selection and assessment methodology. By incorporating multiple data points, this model offers a more holistic and reliable evaluation compared to traditional methods. This research has significant implications in the field of obstetrics, paving the way for advancements in early detection and intervention of fetal health concerns. Future work involves validating the model on a larger dataset and developing a clinical application. Ultimately, we anticipate that our research will revolutionize the assessment and management of fetal health, contributing to improved healthcare outcomes for expectant mothers and their fetuses.

Ethical considerations in prenatal diagnosis and genetic counseling

Introduction: Prenatal diagnosis, as the world widest spread reproductive option, refers to fetus health research methods. Fetal life congenital malformation detection and allowing termination of pregnancy are among its main objectives. An ethical approach, based on respect for people and for confidentiality, avoiding hurt and respecting autonomy, is the key towards optimum genetic counseling. Objective: to set out some ethical considerations in medical genetics health care practice starting from bioethics fundamental principles, which are linked to prenatal diagnosis and to the genetic counseling process. Results: Since dealing with issues related to these ethical aspects in medical genetics practice is a relatively new subject that has been influenced by the development of bioethics and the solution to ethical and social dilemmas in medical practice. Conclusions: In the field of prenatal diagnosis some ethical, social and juridical conflicts could be presented, for that reason doctors should apply on their professional exercise the bioethical principles of autonomy, justice, beneficence and not maleficence, which constitute the main rules that regulate their conduct and give then the basis for the reasoning and orientation for their actions during the genetic counseling process.

Influence of Physical Activity during Pregnancy on Maternal Hypertensive Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Gestational hypertension is a notable concern with ramifications for maternal and fetal health. Preemptive measures, including physical activity (PA), are crucial. There is a pressing need for comprehensive investigations into the impact of various forms of PA on hypertensive disorders. A systematic review and meta-analysis (CRD42022372468) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed. Our review exclusively considered randomized clinical trials (RCTs) between 2010 and 2023, using the following databases: EBSCO, including Academic Search Premier, Education Resources Information Center, PubMed/MEDLINE, SPORTDiscus, and OpenDissertations; Clinicaltrials.gov; Web of Science; Scopus; the Cochrane Database of Systematic Reviews; and the Physiotherapy Evidence Database (PEDro). The primary outcome was hypertensive disorders occurring during pregnancy (14 studies). Diagnosed preeclampsia (15 studies) and blood pressure levels were also examined (17 studies). PA during pregnancy was significantly associated with a reduced risk of hypertensive disorders (RR = 0.44, 95% CI = 0.30, 0.66). The data also indicate a positive correlation between PA during pregnancy and both systolic (MD = -2.64, 95% CI = -4.79, -0.49) and diastolic (MD = -1.99, 95% CI = -3.68, -0.29) blood pressure levels. The relationship between PA and the incidence of diagnosed preeclampsia did not demonstrate a statistically significant association (RR = 0.81, 95% CI = 0.59, 1.11; p = 0.20). Random effects were used for all analyses. PA during pregnancy promises to improve maternal health by reducing the risk of gestational hypertension and positively affecting systolic and diastolic blood pressure.

Improved fetal heartbeat detection using pitch shifting and psychoacoustics

ObjectiveFetal phonocardiography is a cost-effective and non-invasive method for monitoring of fetal health. However, the captured signal is often too noisy and unstable for reliable analysis. Detection of fetal heartbeats therefore requires a robust set of features to differentiate relevant sounds from background noise. We propose a novel set of features based on pitch shifting and psychoacoustics which lead to significant improvements of automatic fetal heartbeat detection. MethodsWe collected, annotated, cleaned, processed and segmented microphone recordings taken from pregnant women. In addition, we employed a well-known simulated dataset to validate the methodology further. A total of 212 features were extracted, including classical audio features, psychoacoustic features, and features based on Empirical Mode Decomposition. Methods from statistical analysis and machine learning were applied to demonstrate the relevance of specific features. Afterwards, we trained a set of machine learning algorithms with different subsets of features. ResultsPsychoacoustic features extracted from pitch-shifted signals are generally shown to be relevant and useful features for fetal heartbeat detection. When psychoacoustic features were added to the baseline features, classification accuracy of a robust classifier significantly increased from 69.24% to 76.16% for the real-world signals, and from 92.69% to 97.42% for one of the simulated datasets. ConclusionThe results demonstrate considerable gains in detection accuracy once pitch shifting and psychoacoustic modeling are applied to the input signal. SignificanceImprovements achieved from applying psychoacoustics on fetal phonocardiographic signals might be an important finding in the effort of making remote monitoring of fetal wellbeing inexpensive and accessible.

Understanding Transfusion Therapy in Obstetrics: Ensuring Maternal and Fetal Health

Transfusion therapy plays a pivotal role in obstetrics, serving as a critical intervention to address various maternal and fetal health challenges. The review encompasses the indications, types, and implications of transfusion therapy, aiming to provide a thorough understanding of its role in ensuring optimal outcomes for both mother and fetus. Obstetric hemorrhage remains a leading cause of maternal morbidity and mortality globally. Transfusion therapy, involving the administration of blood and blood products, emerges as a cornerstone in the management of obstetric hemorrhage, offering a lifeline in critical situations. This abstract delves into the specific scenarios, such as postpartum hemorrhage and placental abruption, where timely transfusions are essential to prevent severe complications. Anemia, a prevalent concern in pregnancy, necessitates a nuanced approach to transfusion therapy. Understanding the thresholds for transfusion in the context of pregnancy-related anemia is crucial for balancing the benefits against potential risks. This review discusses the challenges in managing anemia, exploring the role of transfusion in alleviating symptoms and optimizing maternal and fetal health. In conclusion, this paper synthesizes the current knowledge on transfusion therapy in obstetrics, emphasizing its pivotal role in managing obstetric hemorrhage, anemia, and blood disorders. By elucidating the intricacies of transfusion therapy and its implications for maternal and fetal health, this review aims to guide healthcare professionals in making informed decisions, ultimately contributing to enhanced obstetric care and improved outcomes for pregnant individuals and their infants.

Mobile Prenatal Education and Its Impact on Reducing Adverse Pregnancy Outcomes: Retrospective Real-World Study.

Pregnancy is a pivotal phase in a woman's life, demanding special attention to ensure maternal and fetal health. Prenatal education plays a vital role in promoting healthy pregnancies and reducing adverse outcomes for pregnant women. Mobile prenatal education programs have gained traction due to their accessibility and timeliness, especially in light of finite health care resources and the constraints imposed by the COVID-19 pandemic. This study aims to develop and evaluate the effectiveness of a mobile-based prenatal education program in improving pregnancy outcomes. We developed a mobile-based prenatal education curriculum in collaboration with a multidisciplinary maternal care team from Peking Union Medical College Hospital (PUMCH) in Beijing, China. Data were retrospectively collected from 1941 pregnant women who had registered for the PUMCH mobile prenatal education program and subsequently delivered at PUMCH between May 2021 and August 2022. The study compared pregnancy outcomes between the completing group, which were pregnant women who had completed at least 1 course, and the noncompleting group. We also analyzed differences among course topics within the completing group and assessed course topic popularity among pregnant women. The PUMCH mobile prenatal education curriculum consists of 436 courses across 9 topics. Out of the participants, a total of 1521 did not complete any courses, while 420 completed at least 1 course. Compared with the noncompleting group, pregnant women who completed courses exhibited a significant reduction in the risk of gestational diabetes mellitus, induced abortion, postpartum infection, fetal intrauterine distress, and neonatal malformation. Among those in the completing group, a total of 86% (361/420) started course completion during the first and second trimesters. Furthermore, completing courses related to topics of pregnancy psychology and pregnancy nutrition was associated with reduced risks of premature rupture of membranes and small for gestational age infants, respectively. Pregnancy psychology and postpartum recovery were the preferred topics among pregnant women. The study demonstrates the potential of mobile-based prenatal education programs in improving pregnancy outcomes and supporting health care providers in delivering effective prenatal education. The rise of mobile prenatal education presents an opportunity to improve maternal and child health outcomes. Further research and broader implementation of such programs are warranted to continually improve maternal and child health.

An overview of periodontal disease in pregnancy

Periodontal disease (PD), an inflammatory and infectious condition affecting the tissues supporting teeth, is prevalent among pregnant women due to hormonal changes. Studies indicate a link between PD and adverse pregnancy outcomes, including preterm labor and low birthweight newborns, likely due to increased inflammatory mediators. Oral pathogens like Tannerella forsythia and Porphyromonas gingivalis have been associated with these complications. The most prevalent oral conditions affecting pregnant women that may influence the course of their pregnancy are periodontitis, gingivitis, and dental caries. From supragingival plaques to subgingival infections and PD, these conditions are linked to one another. Elevated maternal serum antibodies to these pathogens and inflammatory markers correlate with poor pregnancy outcomes. Animal models further support the connection between PD and fetal health issues. While research suggests that periodontal treatment may reduce the risk, the exact mechanisms remain complex and multifactorial. Integrating dental care into prenatal care is vital for prevention and management.