Integrating Reproductive and Clinical Variables to Predict Postpartum Disability Outcomes in Multiple Sclerosis Using Machine Learning.

Association between early pregnancy thyroid function and placental-to-fetal weight ratio (PWR): A large-scale retrospective cohort study.

To develop a practical risk-stratification framework for unplanned cesarean delivery (CD) among term nulliparous individuals with hypertensive disorders of pregnancy (HDP) undergoing induction of labor (IOL). This was a retrospective cohort study at a single tertiary care center (January 2010-March 2025) of nulliparous individuals with singleton gestations diagnosed with HDP undergoing IOL at ≥ 37 + 0 weeks. We excluded multiple gestations, major fetal anomalies, planned CD, or intrauterine fetal death. We included demographic and pregnancy characteristics available prior to induction and evaluated association with unplanned CD. Stepwise backward logistic regression was used to build a model for identifying independent predictors of unplanned CD. Sensitivity, specificity, and likelihood ratios (LR) were calculated. Among 1,326 eligible individuals, 347 (26.2%) underwent unplanned CD. Independent predictors of CD were age > 35 years (adjusted odds ratio [aOR] 1.97, 95% CI 1.45-2.66), body mass index ≥ 30 kg/m2 (aOR 2.07, 95% CI 1.58-2.70), HDP with severe features (aOR 1.71, 95% CI 1.17-2.49), thrombocytopenia (aOR 2.66, 95% CI 1.17-6.06), and need for cervical ripening (aOR 1.63, 95% CI 1.23-2.16). Cesarean risk increased stepwise with accumulation of risk factors: 28.4% with ≥ 1 factor, 36.7% with ≥ 2, 44.7% with ≥ 3, and 64.7% with ≥ 4. The presence of ≥ 4 factors yielded a positive LR of 5.17 (95% CI 1.92-13.99). In term nulliparous individuals with HDP undergoing induction, approximately one in four require CD. A simple model based on five routinely available pre-induction factors enables individualized counseling and shared decision-making at the bedside.

BackgroundInitiation of non-invasive ventilation (NIV) rather than delivery-room (DR) intubation reduces lung injury and bronchopulmonary dysplasia (BPD) in premature babies.MethodsWe performed a retrospective cohort study of infants born at 23 + 0 to <32 + 0 weeks' gestation at a single tertiary centre (St George's Hospital) from 2017 to 2024, excluding major congenital anomalies. Clinical data were extracted from BadgerNet and Cerner. Temporal trends in DR intubation and associations with neonatal outcomes were examined using univariable and multivariable analyses.ResultsA total of 717 infants were included. DR intubation rates declined from 66.3% in 2017 to 27.5% in 2024 (p < 0.001), with the large changes in infants >26 + 0 weeks' gestation and >500g birthweight. Compared with non-intubated infants, those intubated in the DR were of lower gestational age, lower birthweight, and were less likely to be from multiple pregnancies. DR intubation was associated with higher rates of intubation at 24 h and 7 days, oxygen dependency at 28 days and at discharge, as well as BPD, IVH, death, and longer durations of invasive and non-invasive ventilation. After adjustment, DR intubation remained independently associated with intubation at 24 h and 7 days, oxygen dependency at 28 days and at discharge, BPD, IVH, death, and longer invasive (+6.56 days) and non-invasive ventilation (+7.42 days), but not with severe BPD, ROP, or length of stay.ConclusionPreterm infants offered NIV from birth had improved respiratory outcomes. DR intubation rates fell substantially over the study period, particularly in infants 26 + 0 to <32 + 0 weeks' gestation and birthweight ≥500g. Although DR intubation likely reflects baseline immaturity and vulnerability, it remained independently associated with several adverse neonatal outcomes, supporting ongoing efforts to avoid unnecessary early invasive ventilation where feasible.

Background Obturator hernia is an extremely rare subtype of abdominal wall hernia, typically occurring in elderly female with a history of chronic increased intra-abdominal pressure or multiple pregnancies. However, it is rarely encountered in young individuals, which may lead to diagnostic oversight. Here, we report a case of a young female with Marfan syndrome who developed a left obturator hernia Patient presentation A young female with Marfan syndrome and pectus excavatum presented with 6 h of persistent severe left inguinal pain. Diagnostic process Physical examination revealed a 2 cm × 2 cm localized swelling in the upper medial aspect of the left thigh, medial to the inguinal ligament. Left Howship-Romberg sign (+). Computed tomography (CT) examination indicated pectus excavatum, cardiomegaly, and a left obturator hernia. Intervention Based on these findings, laparoscopic preperitoneal inguinal hernia mesh repair was performed. Outcome The patient was discharged on postoperative day 3 and followed up for 14 months. Recovery was uneventful with no complications. Conclusion This case highlights the importance of differential diagnostic thinking for hernias in patients with connective tissue diseases.

The objective of this study is to evaluate the effects of delayed cord clamping (DCC) on hematocrit at 6 hours and 6 weeks of age, hospital stay, and other clinical outcomes at discharge. This randomized controlled trial was conducted in a tertiary care center in Western India. Preterm multiple gestations were randomized to DCC at 60 seconds of birth or early cord clamping (ECC) within 30 seconds of birth. The primary outcome was hematocrit at 6 hours of age. A total of 76 mothers and 155 preterm infants of multiple gestation (73 twins and 3 triplets) were randomized. The mean hematocrit at 6 hours was significantly higher in the DCC group (61.9 ± 5.5 vs. 55.8 ± 5.3, N = 155, p < 0.001). Hematocrit at 6 weeks was also significantly higher in the DCC group (55.5 ± 3.8 vs. 49.6 ± 4.5, N = 142, p < 0.001). DCC adherence rate was 88% (n = 70) in the intervention group. Mortality was observed in six infants in the DCC group (7.5%) and eight infants (11%) in the ECC group. Infants in the DCC group had a higher peak bilirubin level, although not statistically significant (13.1 ± 2.3 vs. 11.1 ± 2.5 mg/dL, p = 0.09) and significantly prolonged duration of phototherapy (93.6 ± 32.8 vs. 61.4 ± 38.6 hours, p < 0.001). Other secondary outcomes were similar between the two groups. DCC was feasible in preterm multiple gestation and resulted in improved hematocrit at 6 hours and 6 weeks of life. There was a nonsignificant trend toward higher peak bilirubin levels in infants who received DCC. This trial is registered with the Clinical Trials Registry of India (identifier: CTRI/2023/10/058944). · DCC increased hematocrit at 6 hours and 6 weeks in preterm multiple gestation.. · DCC increased peak bilirubin levels and prolonged the duration of phototherapy.. · DCC is feasible in preterm multiple gestation..

Vanishing twin syndrome (VTS) is a common condition in assisted reproductive procedures, where a multi-fetus pregnancy is spontaneously reduced to a singleton pregnancy. However, the effects of VTS on the development of the remaining fetus is relatively unknown. The purpose of this study was to estimate the effect of VTS on the dynamic measurement of growth and development of the singletons (0-3years) born from frozen embryo transfer (FET). This study was a retrospective cohort design and was carried out from January 2017 to December 2023. To optimize statistical efficiency and reduce confounding variables, singletons conceived using VTS were matched at a 4:1 ratio based on the couples' ages, body mass index, occupation, women's anti-Müllerian hormone (AMH) levels, and embryo status. Ultimately, 66 children in the VTS group and 264 children in the non-VTS group were included in the final analysis. After propensity matching, there was no significant difference in growth and development of children between the VTS group and the non-VTS group. The number of embryos transferred in the VTS group were higher than the non-VTS group (P<0.0001). The height and the head circumference (at 3months) in the VTS group were lower than the non-VTS group (P<0.05). The occurrence of VTS did not detrimentally affect the growth and development of offspring (0-3years) from FET. More comprehensive and long-term follow-up results are needed for further verification. More than one embryo transfer not only increases the rate of multiple births, but also increases the occurrence of VTS in assisted reproductive technologies (ART).

Multiple births are common in randomised trials targeting preterm populations. Clustering due to multiple births is often overlooked in individual trials and may impact the results of meta-analyses that pool their results. We aimed to assess how multiple births have been handled in the reporting and meta-analyses of recent systematic reviews. We conducted a methodological systematic review of Cochrane and non-Cochrane systematic reviews. The search was conducted on 10 September 2024 in the Cochrane Database of Systematic Reviews and PubMed for articles published in the previous 12 months. Reviews were eligible if they involved randomised trials of interventions delivered in pregnancy or infancy, included multiple births and reported results of at least one aggregate data meta-analysis for an infant outcome. After screening 222 articles, 39 had unclear eligibility due to making no mention of multiple births and nine met the eligibility criteria (five Cochrane and four non-Cochrane reviews). Multiple births were inconsistently handled across included reviews. The degree of clustering due to multiple births was poorly described and meta-analyses accounting for clustering were rarely reported (2/9 reviews; 22%). CIs around pooled treatment effect estimates were wider after accounting for clustering. Clustering due to multiple births is a poorly recognised issue in systematic reviews and meta-analyses. Given the potential for this clustering to alter conclusions about the effectiveness of interventions, we recommend accounting for clustering due to multiple births in future meta-analyses.

This study aims to investigate the effects of different transfer strategies (blastocyst vs cleavage-stage embryo) on the cumulative live birth rate (CLBR) and perinatal outcomes. In this propensity score matching (PSM) study, we evaluated the clinical data of 683 oocyte retrieval cycles performed using in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) from June 2017 to December 2022. The primary outcome was CLBR. Secondary outcomes were clinical pregnancy, implantation, live birth, multiple pregnancy, abortion (<28 weeks), ectopic pregnancy, preterm birth (<37 weeks), stillbirth, pregnancy complications, gestational age, birth weight, sex ratio, and birth defects in newborns. After PSM, compared to the cleavage-stage embryo transfer group in fresh embryo transfer cycles, the number of embryos transferred was lower, implantation rate was higher, and multiple pregnancy rate was lower in the blastocyst transfer group. In frozen-thawed embryo transfer cycles, the number of embryos transferred was lower, and clinical pregnancy rate, implantation rate and live birth rate were higher in the blastocyst transfer group. The CLBR was higher, and the multiple pregnancy rate was lower in the blastocyst transfer group. There was no statistically significant difference in perinatal outcomes between the 2 groups. Logistic regression analysis showed that CLBR was positively affected by the number of frozen embryos, and blastocyst transfer increased the CLBR. We conclude that blastocyst transfer is beneficial for improving CLBR and reducing multiple pregnancy rate.

The placenta plays a crucial role in fetal development, yet normal placental volumetric growth trajectories remain poorly characterized, as most studies focus on pathological pregnancies or limited gestational-age (GA) ranges. We aimed to establish magnetic reference imaging (MRI)-based normative reference curves for placental volume (PV) and the placental-to-fetal-volume ratio (PFR) between 16 and 36 weeks' gestation. This single-center, prospective study conducted as part of the 'LUMIERE on the Fetus' project included healthy pregnant women with a low-risk, singleton, 16-36-week fetus evaluated between December 2021 and June 2022. Additional participants with MRI data available at 16 weeks were recruited between January 2023 and October 2025. MRI was performed using a standardized protocol, and placental and fetal volumes were segmented using three-dimensional imaging software. Mean fetal body volume across 16-36 weeks was derived from our previously published normative MRI-based dataset obtained from the same cohort. Mean PV and PFR were calculated for each week of gestation. PV growth across gestation was modeled using logarithmic regression, while PFR growth was modeled using a quadratic term, and percentile curves were generated. The study cohort comprised 265 MRI datasets from 247 healthy pregnant women with a singleton fetus. Mean PV increased from 149 cm3 at 16 weeks to 890 cm3 at 36 weeks, following the function: PV(GA) = (911.3 × ln(GA)) - 2375.7, where GA is in weeks. Over the same period, fetal body volume increased 22-fold, leading to a progressive decline in PFR. Specifically, mean PFR decreased from 1.22 at 16 weeks to 0.31 at 36 weeks, confirming its downward trajectory as fetal growth progresses. The relationship between PFR and GA was modeled using the quadratic function: PFR(GA) = 4.03 - (0.215 × GA) + (0.00313 × GA2), where GA is in weeks. This study establishes MRI-based normative percentile curves for PV and PFR, from 16 to 36 weeks' gestation, confirming the physiological decline in PFR with advancing gestation. These benchmarks may aid in detecting placental dysfunction and characterizing fetal growth restriction. Further validation is needed in pathological and multiple pregnancies. © 2026 International Society of Ultrasound in Obstetrics and Gynecology.

Introduction: Preterm birth (PTB), defined as delivery before 37 completed weeks of gestation, remains a leading cause of neonatal morbidity and mortality worldwide. In India, PTB contributes significantly to neonatal complications and under-five mortality. Identifying determinants in highburden settings such as tertiary hospitals is essential for guiding preventive strategies. Methodology: A retrospective observational study was conducted over six months in the Department of Obstetrics and Gynaecology at a tertiary care hospital in South India. A total of 200 women who delivered during the study period were included based on eligibility criteria. Data were extracted from hospital records regarding maternal demographics, obstetric history, medical comorbidities, delivery characteristics, and neonatal outcomes. Descriptive statistics were applied, and associations were analysed using chi-square and logistic regression, with p &lt;0.05 considered significant. Results: The prevalence of PTB was 29%. Key determinants significantly associated with PTB included previous preterm birth (20.7% vs. 5.6%, p=0.002), multiple pregnancy (17.2% vs. 4.2%, p=0.004), hypertensive disorders (24.1% vs. 8.5%, p=0.003), antepartum haemorrhage (10.3% vs. 2.8%, p=0.045), and maternal anaemia (34.5% vs. 21.1%, p=0.048). Preterm neonates had higher rates of low birth weight (35%), NICU admission (27%), and complications such as respiratory distress (9%), jaundice (11%), and sepsis (7%) compared with term neonates. Conclusion: This study highlights a high burden of PTB in a tertiary hospital, with maternal and obstetric complications as key determinants. Strengthened antenatal surveillance, timely management of high-risk pregnancies, and larger multicentric studies are warranted to reduce PTB and improve neonatal outcomes.

Background Vitamin D inadequacy is globally prevalent among pregnant women, but its impact on offspring cardiometabolic risks remains inconclusive. This study aimed to evaluate associations between in utero vitamin D status and childhood cardiometabolic risk factors. Methods In the original Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) Study, all pregnant women booked for antenatal care, except teenage pregnancy, plan to delivery at another hospital, uncertain last menstrual period and no ultrasonographic estimated gestational age, inability to complete the oral glucose tolerance test (OGTT), multiple pregnancy, conception by assisted reproduction, glucose testing before recruitment, or diagnosis of diabetes during or before the current pregnancy and required medication. Archived maternal serum samples from 24 to 32 gestational weeks and umbilical cord serum samples at birth in the original HAPO Study at the Hong Kong Centre were assayed for total 25-hydroxyvitamin D [25(OH)D] levels by using liquid chromatography-tandem mass spectroscopy. Children’s clinical and biochemistry parameters were collected at the HAPO Follow-Up Study at around age 7, including anthropometry, blood pressure (BP), carotid-femoral pulse wave velocity (cfPWV), fasting lipid profile, plasma glucose (PG), and insulin levels at OGTT. Linear regression analyses were used to evaluate the associations of in-utero 25(OH)D levels with children’s cardiometabolic risk factors. Findings There was no association between maternal serum total 25(OH)D level in 24–32 weeks of gestation and childhood cardiometabolic risk factors. In contrast, umbilical cord serum total 25(OH)D level at birth was negatively associated with offspring diastolic BP, cfPWV, and fasting PG at around age 7, whereas no significant results were observed in other cardiometabolic risk factors. Every 1-SD (18.0 nmol/L) increase in the umbilical cord serum total 25(OH)D level was independently associated with a reduction in diastolic BP, cfPWV, and fasting PG by 0.73 mmHg (95% CI [−1.44, −0.02], p = 0.044), 0.08 m/s ([−0.14, −0.03], p = 0.004), and 0.04 mmol/L ([−0.07, −0.01], p = 0.017), respectively. However, only associations with cfPWV and fasting PG remained significant after correction for multiple testing. Interpretation A low umbilical cord serum 25(OH)D level at birth, but not maternal serum 25(OH)D in 24–32 weeks of gestation, was associated with higher childhood diastolic BP, arterial stiffness, and fasting PG levels. Although maternal total 25(OH)D levels between 24 and 32 gestational weeks were not associated with childhood cardiometabolic risks, our findings indicated that neonatal vitamin D status at birth may be relevant to childhood vascular and glucose metabolic health. Given the observational study design and modest effect size, these findings should be interpreted cautiously and warrant further investigations.

Among women in the UK, over 186,000 new cancer diagnoses and around 78,000 cancer deaths occurred annually from 2017 to 2019. Evidence suggests that pregnancy complications are linked to mortality and morbidity risks in later life. This umbrella review aims to assess the association between pregnancy complications and cancer risk. It forms part of a series of studies exploring associations between pregnancy complications and long-term health conditions. MEDLINE, Embase, and Cochrane databases were searched from inception to April 2024. Key search terms encompassed 'cancer' and 'pregnancy complications' or 'pregnancy risk factors'. Screening data extraction and quality appraisal (AMSTAR 2) were completed by two independent reviewers. Data were synthesised narratively and quantitatively. Relative risks (RR)/odds ratio (OR)/hazard ratios (HR) with 95% confidence intervals were reported. Of the 25 reviews assessed for methodological quality, 2 were rated high, 12 moderate, 9 low, and 2 critically low. After excluding 10 overlapping reviews and 2 critically low reviews, 13 reviews included reviews consisted of 170 primary studies. Associations between 7 pregnancy complications and 17 cancers are reported. Women with molar pregnancy had four-fold higher risk of developing gestational trophoblastic neoplasia [OR 4.72 (1.81-12.32)]. Miscarriage was associated with thyroid cancer [OR 1.29 (95% CI 1.15-1.44)], but not with breast or ovarian cancer. Pre-eclampsia was associated with a reduced risk of breast cancer [RR 0.89 (0.83-0.95)] and an almost twofold higher risk of ovarian cancer [RR 1.82 (1.16-2.85)]. Gestational diabetes mellitus was associated with a higher risk of thyroid cancer [RR 1.28 (1.16-1.42)], stomach cancer [RR 1.43 (1.02-2.00)], liver cancer [RR 1.27 (1.03-1.55)], and blood cancer [RR 1.48 (1.04-2.09)] but was not associated with other cancers studied. Preterm birth showed a very small association with breast cancer risk (OR 1.03, 95% CI 1.00-1.07). There was no significant association between caesarean section and cervical cancer or multiple births and breast cancer. Some pregnancy complications were associated with selected cancer outcomes, although the evidence was heterogeneous and limited by potential bias, confounding, and inconsistent review quality.

Abstract Monozygotic (MZ) twins sharing a placenta are known as monochorionic (MC) and account for approximately two-thirds of MZ twin pregnancies. MC twins discordant for a congenital anomaly are of particular interest as they challenge the common idea of “identical” monozygotic twins. We have performed a retrospective study including 51 monochorionic multiple pregnancies with discordant anomalies that received care at the University Hospital of Graz between 2013 and 2023, aiming to assess the accordance of the observed cases with the existing explanatory models in the literature. This study primarily identified structural discordance, while genetic insights were limited due to the rare decision of parents to undergo further genetic testing. The most frequent anomalies were hydrocephalus, neural tube defects, body-stalk anomaly and congenital heart defects. Acknowledging the limitations related to the sample size and incomplete cohort data, this study supports a growing awareness of the complexity underlying MC twin development, emphasizing the need for more longitudinal genetically and epigenetically focused studies to uncover the subtle and cumulative effects of early contributing factors that ultimately also determine phenotypic expression.

Background In vitro fertilization (IVF) pregnancies are associated with an increased risk of maternal and perinatal complications. Advanced maternal age and multiple gestations are more common in IVF and may contribute to adverse outcomes. Evaluating the interaction between mode of conception and maternal age may help clarify risk profiles in IVF pregnancies. Methods This single-center, retrospective observational study included nulliparous women who delivered from 26 weeks’ gestation onward. A total of 144 IVF and 106 spontaneously conceived pregnancies were analyzed. IVF pregnancies included cycles with fresh or frozen embryo transfer and homologous or heterologous fertilization. Maternal characteristics, pregnancy complications, fetal and neonatal outcomes were compared between groups. Results IVF pregnancies were associated with a significantly higher incidence of hypertensive disorders (17.9% vs 7.3%), and multiple pregnancies (25.9% vs 4.6%). Fetal complications, including fetal growth restriction (20% vs 7.3%), oligohydramnios (10.6% vs 2.8%), polyhydramnios (7.3% vs 0%), preterm premature rupture of membranes (6.4% vs 3%), and non-reassuring fetal heart rate patterns (17.1% vs 8%), were more frequent in IVF pregnancies. IVF pregnancies delivered at a lower gestational age (35.98 vs 37.99 weeks, p < .001), with lower birth weight (2244 vs 3074 g, p < .001), lower Apgar scores at 1 and 5 min, higher cesarean section rate (70.7% vs 52.8%), and higher NICU admission (38.8% vs 5.1%). Conclusion IVF pregnancies were associated with increased maternal morbidity and adverse fetal and neonatal outcomes compared to spontaneous pregnancies, including hypertensive disorders, fetal growth restriction, preterm birth, cesarean delivery, and NICU admission.

Understanding urban-rural disparities in infant mortality in Bangladesh: A decomposition analysis.

To establish the due date in a singleton gestation in the second trimester, U.S. societal guidelines recommend using a composite of the fetal biparietal diameter, head circumference, abdominal circumference, and femur length. In twin pregnancies, evidence supports using either the head circumference or composite biometry of the larger twin. Our objective was to compare the accuracy of these two approaches in determining the true gestational age of twin gestations.We conducted a retrospective cohort study of dichorionic, diamniotic gestations conceived with assisted reproductive technologies between 2006 and 2016, excluding fetuses with major anomalies that could impact accurate dating, pregnancies complicated by loss of one or both twins, or higher-order multiple gestations reduced to twins. The earliest second-trimester ultrasound study for each subject was reviewed and the gestational age was calculated using head circumference alone and composite biometry based on Hadlock's formulas. Paired sample statistics were used to calculate the mean difference in days from the observed versus true gestational age to assess the accuracy of each strategy and represented graphically using Bland-Altman plots.A total of 179 subjects with a second-trimester ultrasound were identified that met criteria over the 10-year period. Ultrasounds were performed at a mean gestational age of 19.9 days (range: 14.43-26.14). Use of head circumference alone resulted in a mean absolute difference of 3.11 days from the true gestational age (standard deviation [SD]: 4.51, standard error mean [SEM]: 0.34). Composite biometry resulted in a mean absolute difference of 1.74 days (SD: 3.60; SEM: 0.27). The difference of approximately 1 to 2 days was significant (p < 0.001).In our twin population, the use of composite biometry of the larger twin more accurately approximates gestational age compared with head circumference alone, though the difference between the two approaches is modest. · Head circumference or composite biometry is used to date twins.. · In our study, composite biometry improved accuracy.. · The difference between the two was modest (1-2 days)..

Plain Language Summary Multiple pregnancy is a preventable complication of in vitro fertilisation (IVF). Multiple pregnancies are often the result of a treatment approach that means more than one embryo is placed into the womb during each IVF treatment cycle in the belief that this may increase the chance of a successful pregnancy resulting in a live birth. In reality, this approach has led to a higher rate of IVF multiple pregnancies, ranging between one in three and one in seven pregnancies across many parts of the world, including the UK. Multiple pregnancy carries higher risks for both the mother and babies, most notably the risk of premature birth leading to an increased chance of early death or long‐term physical or learning disability. At present, there is no available treatment that can prevent premature birth in multiple pregnancies. The number of multiple pregnancies resulting from IVF treatment can be reduced by placing one embryo per IVF treatment cycle (single embryo transfer, SET) into the womb and freezing other embryos so that they can be used at a later date. Explaining this approach to women and their partners and families is essential in agreeing to this approach. Over the past 15 years, many of those involved in providing fertility treatment, including the independent regulator, medical professional societies, all fertility treatment clinics and patient advocates, have worked together to encourage the practice of placing a single embryo per IVF treatment cycle into the womb to reduce the chance of multiple pregnancy. Those efforts have been hugely successful in reducing multiple pregnancy rates following IVF—from one in four pregnancies in 2009 to one in 16 pregnancies in 2019—without reducing the overall chance of achieving a pregnancy per IVF treatment cycle. The multiple pregnancy rate can be lowered even further to below one in 20 pregnancies with additional improvements to the IVF treatment process. This is likely to lead to more clinics and more women, their partners and families choosing single embryo transfer, particularly if the NHS is prepared to fund three full IVF treatment cycles across the whole of the UK.

BackgroundEmerging evidence suggests that elevated serum uric acid levels may be associated with adverse pregnancy outcomes.ObjectivesTo investigate the association between serum uric acid levels and adverse pregnancy outcomes among pregnant women.Materials and methodsA prospective cohort study was conducted among 200 pregnant women attending Vinh Long General Hospital, including 100 women with hyperuricemia and 100 without hyperuricemia. Hyperuricemia was defined as a serum uric acid level >360 µmol/L. Pregnancy-, delivery-, and postpartum-related complications were recorded and compared between the two groups.ResultsThe mean maternal age was 25.06 ± 5.79 years. In the hyperuricemia group, 45.0% were primigravida, whereas 22.0% had multiple pregnancies. Adverse pregnancy outcomes were more frequent in women with hyperuricemia than in those without hyperuricemia (28.0% vs. 15.0%; odds ratio = 2.20; 95% confidence interval: 1.09-4.44). Within the hyperuricemia group, smoking was more common among women who developed complications than among those without complications (42.9% vs. 18.1%), along with lower platelet counts and higher creatinine levels (p < 0.05). Multivariable logistic regression analysis identified alcohol consumption (odds ratio = 3.85), serum creatinine (odds ratio = 1.19), and hyperuricemia (odds ratio = 1.65) as independent predictors of adverse pregnancy outcomes (p < 0.05).ConclusionHyperuricemia was independently associated with an increased risk of adverse pregnancy outcomes.

Determinants of small vulnerable newborn births in two rural community-based cohorts in India: a prospective study.