Background/Aims Robust research is needed to improve tailored support for perinatal mental health. However, recruitment can be challenging. This study explored why a feasibility randomised controlled trial failed to recruit participants (pregnant women aged 16–19 years with depressive symptoms). Methods Semi-structured interviews (n=18) were carried out with a purposive sample of peer support workers and professionals involved in development and delivery. The data were analysed thematically. Results The themes explored the potential of the intervention and the role of peer support workers, including in further research with pregnant teenagers, and the importance of ongoing engagement and collaboration to design tailored interventions, including practical considerations for working with clinicians. Conclusions Peer support interventions are highly valued in perinatal care by midwives, researchers and peer support workers. There are challenges to overcome in recruiting to and delivering randomised controlled trials on peer support interventions specific to teenagers in an NHS setting, which must be considered carefully. Implications for practice Researchers should co-design health-related interventions and training with midwives and stakeholders, ensuring the role of peer support workers is suitably defined. Openness and honesty in research collaborations is vital to understand and address challenges in recruiting vulnerable groups and how to mitigate against these.

Prevalence, trends in, and factors associated with neurodevelopmental disorders (NDDs) in low- and low-middle income countries (LLMICs): A systematic review and meta-analysis.

Blood Pressure, Urinalysis, and Edema Assessment in Perinatal Care: From Historical Foundations to Evidence-Based Practice

A scoping review on palliative care communication in the South African setting.

Seizure control, delivery, and neonatal outcomes in pregnant women with focal epilepsies: a prospective cohort study.

Background: As awareness of the possibilities for trans people to attain parenthood grows, trans, non-binary and other people with diverse genders are increasingly accessing perinatal care as part of their family-building journeys. International literature confirms that midwives can feel clinically challenged by, and poorly prepared for, working with pregnant trans people, but also that they are motivated to provide high quality care and desire professional support to do so. This two-phase study included interviews with trans people who were or had been pregnant, and/or whose partners were or had been pregnant, which informed the development of a nationwide perinatal care workforce survey. Aim: Phase Two aimed to identify current practice relating to inclusion, and the knowledge, beliefs and education needs of the perinatal care workforce in relation to working with pregnant trans people. Method: An online nationwide survey of perinatal care providers was undertaken in 2022. Data were collected through single- and multi-response questions, Likert scales and open-ended text boxes. Analyses included descriptive statistics and content analysis of open-text responses. Results: Of 476 respondents, this paper reports only the midwives’ responses (67%; n = 317). Fewer than 25% of midwives recalled receiving any specific education about providing culturally safe care for trans people, but most (78%) identified interest in accessing education if it were made available. Midwives are knowledgeable regarding some clinical aspects of gender affirming care, e.g., the effects of hormone therapy on fertility, but we identified some knowledge gaps. Most articulated positive attitudes towards caring for pregnant trans, takatāpui and intersex people but a minority raised concerns about what they perceived as the ‘erasure of women’ within wider efforts to be inclusive. Many noted workforce pressure as a barrier to progressing change. Conclusion: Some midwives are already implementing inclusive practices, primarily led by Lead Maternity Carers (LMCs) who champion affirming and inclusive community-based care. Ensuring that trans people and whānau can anticipate consistently affirming care when they engage in services beyond their LMC, particularly during hospital-based care, needs prioritisation as a workforce development strategy. To date, midwives have not been well prepared to provide inclusive care to this community, but they are willing to engage in education to support affirming and inclusive practice.

Introduction Ερευνητικό ερώτημα: Σκοπός της παρούσας συμβολής είναι να συνεισφέρει στην κατανόηση της επίδρασης του βιοϊατρικού λόγου και βλέμματος στη στάση/συμπεριφορά της εγκύου/επιτόκου, μέσω της ανάλυσης/ερμηνείας της ιατρο-τεχνολογικής παρέμβασης. Methods Μεθοδολογία: Έχει επιλεγεί μέρος της παλαιότερης και επικαιροποιημένης βιβλιογραφίας, και γίνεται «ανάλυση περιεχομένου και ερμηνευτικές προσεγγίσεις του λόγου» σχετικά με την επίδραση της ιατρο-τεχνολογικής παρέμβασης στην έγκυο/επίτοκο αλλά και το/τη γιατρό εντός του ιατρο-τεχνολογικού περιβάλλοντος. Θεωρητικό πλαίσιο – πρωτοτυπία: Χρησιμοποιούνται οι έννοιες της «θέασης» και «αυτοθέασης», και ο συλλογισμός διευρύνεται, περιλαμβάνοντας την επίδραση των μηχανισμών πολιτισμικού ελέγχου, μεταφερόμενοι στο σύγχρονο ιατρο–τεχνολογικό περιβάλλον. Οι παραπάνω ερμηνείες συναρθρώνονται με έννοιες της μεταδομιστικής θεωρίας. Results Ευρήματα: Η ιατρο-τεχνολογική παρέμβαση σταδιακά συμβάλλει στη (συν)δόμηση ενός αδιόρατου πλέγματος εξουσιαστικών σχέσεων που έχει την τάση να εδραιώνει την παθητικότητα του γυναικείου σώματος που κυοφορεί/γεννά. Conclusions Συμπεράσματα: Τα ευρήματα φωτίζουν αδιόρατες πτυχές του φαινομένου και μπορούν να λειτουργήσουν συνδυαστικά με την ιατρική/μαιευτική διερεύνηση που συνήθως έχει ποσοτικό χαρακτήρα. Προτείνεται διεξαγωγή διεπιστημονικής έρευνας πεδίου (ποιοτικής και ποσοτικής) για την επίδραση της ιατρικής τεχνολογίας στον ενεργητικό/παθητικό ρόλο των εγκύων/επιτόκων –ειδικά στην Ελλάδα.

Background This study aimed to determine how obstetricians’ knowledge of T18 influences their attitudes toward the antepartum, intrapartum, and postpartum management of T18 cases and to compare these attitudes with their approaches to trisomy 21 (T21) cases. These attitudes were analysed within the framework of the medical ethics principles of beneficence and autonomy. Methods This cross-sectional descriptive survey study was conducted between 1 February and 31 July 2021. Data from 194 of 388 participants who completed all questionnaire items were analysed. Results The study included specialists in obstetrics and gynecology (mean age: 47.8 ± 8.9 years; 56.2% female). 40.2% defined “lethal congenital malformation” as anomalies inevitably causing intrauterine death; 91.2% considered T18 “lethal” and 77.6% “incompatible with life.” For T18, 82.8% always recommended termination. When pregnancy continued, most acted in line with maternal wishes; 56.8% would prefer cesarean in fetal distress and 60.5% supported perinatal palliative care. For T21, 89.0% did not define it as lethal, 94.8% did not consider it incompatible with life, and only 57.1% always recommended termination. Multivariate analysis showed older age and religious beliefs predicted lower termination recommendation for T21; only religious beliefs predicted this for T18. Female obstetricians more often provided palliative care and fetal monitoring for T21. Conclusions This study reveals significant gaps and variability in knowledge, attitudes, and management strategies for prenatally diagnosed T18 among obstetricians in Turkey. Such variability may result in some women not being offered appropriate care options during pregnancy or delivery. More practical training and ethical guidance are needed for consistent, patient-centred care in fetal anomaly management.

The acronym TORCH designates a group of pathogens that can lead to serious pregnancy complications, such as miscarriage, fetal growth restriction, and congenital infections. This review summarizes current insights into these infections, offering practical guidance primarily for obstetricians, infectious disease specialists, and general practitioners involved in prenatal care. The TORCH complex includes Toxoplasma gondii, Rubella virus, Cytomegalovirus (CMV), and Herpes simplex virus (HSV). The definition may be extended to encompass additional (other) pathogens such as Hepatitis B and C viruses (HBV, HCV), Human immunodeficiency virus (HIV), Varicella-zoster virus (VZV), Treponema pallidum (syphilis), Parvovirus B19, and Zika virus. Screening practices for TORCH infections during pregnancy vary significantly across countries. Despite widespread access to medical care and increasing awareness among women planning pregnancy, routine screening for TORCH pathogens is not universally implemented. In Poland, diagnostic procedures during pregnancy are defined by the Standard of Perinatal Care established by the Ministry of Health. This regulation- which replaced earlier recommendations of the Polish Society of Gynecologists and Obstetricians- does not distinguish between ,,mandatory” and ,,recommended” tests but specifies a unified set of investigations to be performed at defined stages of pregnancy. Screening conducted during pregnancy plays a crucial role in detecting previously unrecognized infections. In Poland , a substantial proportion of new diagnoses of HIV, HBV and HCV among young women are made during routine antenatal testing, underscoring the importance of standardized serological screening in prenatal care rather than relying on diagnosis before conception. However, due to their distinct epidemiological and clinical profiles, HIV, HBV, and HCV infections are not discussed in detail in this review.

Background: Perinatal palliative care (PC) provides comprehensive, interdisciplinary, and planned care for infants with life-limiting or chronic critical conditions. Poor utilization of PC services was seen at our Level IV neonatal intensive care unit (NICU), limiting the care quality that was provided to these infants and their families. Purpose: This quality improvement project aimed to increase the use of early PC consults for eligible infants from 33% to 100% from August to December 2022. Methods: The Promoting Action on Research Implementation in Health Services framework guided this quality improvement project. Standardized diagnostics, prenatal referrals, and chronicity trigger eligibility criteria were implemented in 1 NICU. The outcome measure was PC consult ordering compliance. De-identified patient data were collected by chart auditing, and consult compliance was analyzed with a control chart. The process measure was provider education, which was evaluated by descriptive and nonparametric analysis. Results: Median PC consult ordering compliance for eligible patients improved from 33% to 100% within 2 weeks of the first intervention and was maintained at 100% compliance for 10 weeks until project cycle completion. The median time from NICU admission to PC consult order entry was reduced from 40 to 15.5 days. Ninety-eight percent of the site healthcare providers received educational training. Clinician comfort in identifying PC-eligible infants significantly improved after the educational training ( Z = 3.02, P = .003). Implications for Practice and Research: Standardization of eligibility criteria and personnel education successfully improved early PC consult ordering within 1 NICU.

Insomnia symptoms during the perinatal period are prevalent and may contribute to negative mental health and birthing outcomes. Cognitive Behavioural Therapy for Insomnia (CBT-I) is a non-pharmacological therapy efficacious in the treatment of insomnia. Previous studies have shown the effectiveness of digital CBT-I during the perinatal period. However, to date, our understanding of whether this treatment can be effectively implemented in community perinatal care is limited. In this two-arm hybrid effectiveness-implementation type 1 randomised controlled trial (RCT), eligible pregnant individuals with self-reported insomnia symptoms (Insomnia Severity Index > 7) will be randomised to either the CBT-I intervention (Healthy Sleep Program) or active control (sleep hygiene education). The primary outcome is maternal insomnia symptom severity at (i) one pregnancy endpoint and (ii) averaged across three times post birth for the postpartum endpoint. An economic evaluation will assess cost-effectiveness. Barriers and enablers to sustained implementation will be explored using the Theoretical Domains Framework and the Practical Robust Implementation and Sustainability Model. This study will offer an understanding of the effectiveness, cost-effectiveness, and sustained implementation potential of a digital sleep health program in perinatal care. These outcomes will provide empirical evidence to inform broader implementation of a scalable sleep program to improve insomnia symptoms in perinatal populations. Australian New Zealand Clinical Trials Registry ACTRN12622000940774. Registered on 01/07/2022.

Aim of the study. The aim of this study was to evaluate the impact of Vojta therapy on the quality of life, level of independence and pain symptoms in adult patients with cerebral palsy (CP). Basic assumptions. Cerebral palsy is a group of disorders caused by damage to the developing brain during the prenatal and neonatal periods, affecting motor development, muscle tone, and posture. Motor disorders in CP are often accompanied by sensory, perceptual, cognitive, communication, and behavioral disorders, as well as epilepsy. Despite advances in prenatal and perinatal care, the overall prevalence of CP has remained stable over the past 40 years. The functional abilities of adults with CP in daily life depend on the severity of symptoms and the presence of any comorbid conditions. These individuals can function with full independence in daily activities, partial dependence, or require round-the-clock care. Pain is one of the most frequently reported problems by adults with CP and negatively impacts their functioning. One of the leading therapeutic approaches used in the treatment of CP is the Vojta method. This therapy has been successfully used for many years in children with CP, as well as in healthy adults and adults with multiple sclerosis. However, no one has yet evaluated the possibility of its application in adults with CP. Therefore, the authors of this article attempted to apply elements of the Vojta therapy in adult patients with CP and assess its potential impact on their quality of life, level of independence, and pain symptoms.

Objective: The objective of this study was to study the outcomes of newborns referred to the special newborn care unit (SNCU) of a tertiary care hospital. Methods: A retrospective observational study was conducted on 893 neonates referred from community health centers and district hospitals from April 2024 to March 2025. Data regarding demographic details, birth weight, gestational age, primary diagnosis, and outcomes were analyzed. Results: Of the 893 admissions, 64% were male. Term neonates constituted 73.8% while 26.2% were preterm. Low birth weight (<2500 g) accounted for 50.7% of cases. The leading causes of admission were birth asphyxia (20%), sepsis (18.4%), jaundice (16.5%), and respiratory disorders (12.8%). The overall discharge rate was 69%, mortality was 26.7%, and 4.3% left against medical advice. Duration of stay analysis revealed that 4.6% stayed <1 day, 22.2% for 1–3 days, 30.9% for 4–7 days, and 42.3% >7 days, with prolonged admissions generally associated with improved outcomes. Conclusion: Birth asphyxia, sepsis, and jaundice were the leading causes of referral and mortality. Strengthening perinatal care, timely stabilization before referral, and effective neonatal transport can improve survival outcomes in SNCUs.

This study explores midwives' perceptions of bereavement care for women experiencing perinatal loss through metaphor analysis. Perinatal loss is a traumatic event that also affects midwives emotionally and professionally, yet their experiences remain underexplored. Data were collected via an online semi-structured form from Turkish midwives who had previously cared for bereaved women. Using metaphorical expressions, participants conveyed emotional, cognitive, and professional reflections on bereavement care. Metaphors were identified, coded, and grouped into overarching themes. Three themes emerged: Supportive and Positive Role, Emotional Approach, and Challenges and Negatives. Midwives often saw themselves as emotional guides and caregivers, while also reporting burnout, helplessness, and fatigue. These findings highlight the emotional demands placed on midwives and the need for institutional support, training, and standardized guidelines. The study contributes to the limited literature on bereavement midwifery in Turkey and calls for cross-cultural research to advance global understanding of perinatal grief care.

Cerebral palsy (CP) remains a leading cause of childhood disability, with varying clinical presentations and comorbidity patterns. This study explored the clinical spectrum, functional severity, and perinatal risk factors of CP among children aged 4–14 years in eastern India to identify priority areas for early intervention and support. A cross-sectional study was conducted over one year at a tertiary care centre. Data were collected through structured caregiver interviews and clinical assessments using standardized tools—the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS). Associations between demographic, perinatal, and clinical variables and CP severity were analysed using likelihood ratio tests and partial correlation analyses. Among 127 children with CP (median age: 5.9 years; 74.0% male), spastic CP was the predominant subtype (75.6%), followed by dyskinetic (9.4%), ataxic (7.9%), and mixed (7.1%) forms. Severe motor impairments (GMFCS IV–V) were present in 63.8% of participants, and manual ability severity increased proportionally with GMFCS levels (ρ = 0.702; p < 0.001). Significant correlates of severe impairment included younger age, parental age (20–29 years), high birth weight (> 4000 g), home delivery, absence of crying at birth, neonatal seizures, hypoxic–ischemic encephalopathy, and jaundice. Comorbidities were common—language (78.7%), cognitive (62.2%), and personal–social (58.3%) impairments were most frequent. Only 12.6% of children attended school; attendance was positively associated with older age, male gender, lower GMFCS and MACS levels, and absence of cognitive, language, fine-motor, personal–social impairments, and seizure history. Spastic CP was the most frequent subtype, commonly associated with severe motor limitations and multiple comorbidities that significantly restricted educational participation. Strengthening perinatal care, early screening, and multidisciplinary rehabilitation are essential to improve functional outcomes and inclusion for children with CP in resource-limited settings.

Practices of maternity nurses regarding perinatal bereavement care: a cross-sectional study.

Occupational disruption (OD) is common during the perinatal period. Occupational therapy (OT) intervention may improve knowledge of perinatal occupational balance (OB) strategies. The aim of this exploratory study was to evaluate the effectiveness of an OT intervention in increasing knowledge of perinatal OB strategies among working first-time mothers (WFTMs). A total of 30 perinatal WFTMs attended a virtual OT educational workshop that addressed the OB constructs of stress management, energy conservation, sleep hygiene, and routine management. Pre- and post-intervention surveys measured OD and self-reported knowledge of OB strategies. Data were analyzed using descriptive statistics and paired samples t-tests. Participants reported moderate OD across all OB constructs. Statistically significant improvements were noted in knowledge of OB strategies to improve energy conservation (p = .003) and overall OB (p = .001). OT intervention can improve knowledge of OB strategies in perinatal WFTMs. Including OB education in routine perinatal care shows promise.

Perinatal Depression and Anxiety Among Adolescents: A Comprehensive Review of Knowledge Gaps, Perinatal Mental Health Needs, Care Preferences, Access, and Pathways to Care [Formula: see text

To evaluate the implementation of a publicly funded statewide perinatal exome sequencing (ES) program in Victoria, Australia, focusing on eligibility, diagnostic yield, clinical utility, and equity. We conducted a retrospective cohort study of ES referrals for fetal anomalies from 2018 to 2022. Eligibility was assessed by multidisciplinary teams at four tertiary fetal medicine units. We examined approval rates, referral indications, diagnostic yield, turnaround time, timing (prenatal or postmortem), and pregnancy outcomes. Subgroup analysis was conducted for prenatal and postmortem cases. Differences in proportions were assessed using z-tests (p<0.05 significant). Of 195 referrals, 179 (93%) were approved for publicly funded ES. Diagnostic yield was 38%, similar in prenatal (37.5%) and postmortem (38%) cases. In prenatal cases, termination was significantly more frequent when a causative variant was identified (67% vs. 17%, p<0.0001). Most ES recipients lived in metropolitan areas (77% vs. 68%, p=0.01), with no significant disparities in socioeconomic status or migrant background. This study demonstrates the feasibility and clinical utility of a state-funded MDT-led perinatal ES program in Australia. It highlights equitable access across population groups, supports the value of structured implementation, and underscores the need for ongoing evaluation to ensure equitable genomic care delivery.

ABSTRACT Objective This study investigated the association between childbirth experience and maternal parenting style during early infancy, using attachment theory and the caregiving system as guiding frameworks. Method Participants were 285 Israeli mothers who gave birth in the previous year. They completed validated self-report questionnaires assessing their childbirth experience (physiological versus medicalised birth), adult attachment (ECR-RS), and parenting style towards their infants (IPSQ). Results Mothers who experienced physiological childbirth reported lower levels of discipline, involvement, routine, and anxiety in their parenting style compared to those who underwent medicalised childbirth. Due to extremely low variance in attachment measures, moderation effects could not be meaningfully assessed. Conclusions The findings suggest that the childbirth experience is associated with variations in early maternal caregiving. Mothers who experienced physiological birth tended to report a less controlling parenting style, possibly due to enhanced maternal empowerment and hormonal processes that facilitate bonding and emotion regulation. Conversely, medicalised births may disrupt these processes, increasing anxiety and control-oriented parenting behaviours. Perinatal care should prioritise not only physical safety of the mother and baby but also their psychological and emotional well-being, offering supportive and respectful birthing options.