Postpartum depression (PPD) is a significant maternal mental health concern with implications for both mothers and infants. Evidence from Jordan is growing but remains variable across different settings. This study aimed to determine the prevalence of probable PPD and its associated factors among women attending postnatal care in Jordan. A cross-sectional study was conducted among 471 postpartum women consecutively recruited from four purposively selected primary health care centers in Mafraq and Irbid governorates, Jordan. Women aged ≥ 18 years assessed at 4–6 weeks after delivery were interviewed using a structured, self-reported questionnaire. Probable (screen-positive) PPD was assessed using the Arabic Edinburgh Postnatal Depression Scale (EPDS). Multivariable logistic regression was used to identify factors associated with probable PPD. Using the EPDS cutoff ≥ 13, the prevalence of probable PPD was 13.4
Hypertensive disorders of pregnancy (HDP) are a major cause of maternal and perinatal morbidity. Serum uric acid (SUA) has been implicated in the pathophysiology of HDP, particularly preeclampsia, but the shape and clinical interpretation of this association remain uncertain. We investigated the cross-sectional association between gestational SUA levels and hypertensive status during pregnancy in a nationally representative sample and examined whether similar patterns were present in an independent clinical cohort. We conducted a cross-sectional analysis of pregnant women aged 18 to 49 years from the National Health and Nutrition Examination Survey (NHANES) 1999–2018. Survey-weighted logistic regression, restricted cubic splines, and generalized additive models were used to evaluate potential non-linear associations between SUA and hypertensive status during pregnancy. To reduce small-event bias, parsimonious adjustment models and penalized regression were applied. The fixed quadratic model derived from NHANES was subsequently evaluated in a cohort from the First Affiliated Hospital of Harbin Medical University. In the external cohort, additional exploratory analyses were performed separately for preeclampsia and gestational hypertension. Among 1,220 pregnant women in NHANES, 30 cases of concurrent pregnancy-onset hypertension were identified after exclusion of self-reported pre-pregnancy hypertension. Survey-weighted spline analyses suggested a possible non-linear (U-shaped) association between SUA and hypertensive status. The estimated nadir of predicted probability ranged from approximately 3.8 to 4.1 mg/dL across modeling approaches, although confidence intervals were wide because of the limited number of events. In the external cohort (n = 291; HDP n = 53; mean gestational age at sampling, 35 weeks), SUA was associated with concurrent hypertensive status during pregnancy. Discriminative performance differed by subtype: the area under the receiver operating characteristic curve was 0.83 for preeclampsia versus controls and 0.64 for gestational hypertension versus controls. In this cross-sectional analysis, gestational SUA levels showed a U-shaped association with hypertensive status during pregnancy in NHANES, and a similar directional pattern was observed in an external clinical cohort. However, because SUA and blood pressure were measured concurrently in both datasets, especially late in pregnancy in the validation cohort, temporal relationships cannot be established and reverse causality cannot be excluded. These findings should therefore be interpreted as associative rather than predictive. Prospective longitudinal studies with early-pregnancy sampling are needed to clarify causality and clinical utility.
Maternal serum alpha-fetoprotein (AFP) is related to placental dysfunction, whereas aminotransferases are routinely available biochemical measures. We evaluated an empirically constructed AFP/(AST×ALT) index measured during second-trimester screening as an exploratory marker associated with subsequent preeclampsia. We specifically examined whether the index showed a consistent severity gradient and whether it provided clinically meaningful discrimination. This retrospective cohort study included 164 singleton pregnancies followed at a tertiary referral center between January 2022 and June 2024: 81 pregnancies without preeclampsia, 42 with preeclampsia without severe features, and 41 with preeclampsia with severe features. AFP, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) measured at 16–18 weeks were retrieved. The AFP/(AST×ALT) index was calculated. Group comparisons were performed using variance-robust methods with post-hoc pairwise testing. Candidate diagnostic performance was explored using receiver-operating-characteristic analysis, and logistic regression was scaled per 0.1-unit increase in the index. Multivariable models included maternal age, body mass index, parity, and gestational age at sampling. The index showed a non-monotonic pattern across groups: 0.200 ± 0.188 in pregnancies without preeclampsia, 0.801 ± 0.422 in preeclampsia without severe features, and 0.229 ± 0.239 in preeclampsia with severe features. The comparison between pregnancies without preeclampsia and preeclampsia with severe features was not significant, whereas both comparisons involving preeclampsia without severe features were significant. This pattern was driven largely by lower second-trimester AST and ALT values in the group without severe features. For preeclampsia presence, ROC analysis yielded an AUC of 0.738 (95
Alcohol use during pregnancy remains a major public health concern in South Africa, particularly in communities with entrenched historical, social, and structural drivers of harmful drinking. Saldanha Bay, a peri-urban fishing community in the Western Cape, has among the highest reported rates of fetal alcohol spectrum disorder globally. Understanding the multilevel social and structural dynamics that sustain alcohol use in pregnancy is essential to inform contextually appropriate interventions. Formative qualitative research to inform the adaptation of a peer-led intervention to reduce alcohol use during pregnancy was conducted between January and June 2025. We held two focus group discussions, one with healthcare providers (n = 6) and one with community leaders (n = 7) and conducted in-depth interviews with male partners of women who drank during pregnancy (n = 15) and drinking peers (friends or family members; n = 16). We purposively recruited participants with support of a long-standing community partner and through snowball sampling. Data were collected in Afrikaans and English using semi-structured guides, audio-recorded, transcribed, translated, and analyzed thematically using NVivo. Analysis followed an iterative coding and memoing process, and reporting adhered to COREQ guidelines. Six interrelated themes emerged. First, couple-level dynamics, particularly male partner drinking, were perceived as the primary driver of continued alcohol use during pregnancy, with partner drinking heavily influencing maternal drinking behaviors. Trajectories ranged from mutual continuation to solidarity-driven reduction. Second, participants described that the need for social belonging and fear of isolation often outweighed pregnancy-related health motivations, especially in contexts where alcohol use is central to social life and pregnancies are unplanned. Third, intergenerational misinformation normalized and actively undermined medical advice during pregnancy and breastfeeding. Fourth, alcohol use functioned as a coping mechanism for stressors like poverty, violence, unplanned pregnancy, and partner absence; some participants described loss of control consistent with addiction. Fifth, there was strong expressed support for mentor-based interventions delivered by credible, relatable women with lived experience, ideally engaging partners and broader social networks. Sixth, participants emphasized that support should be community-based rather than clinic-based, combine group and individual support, and provide sustained engagement throughout pregnancy. Family, peers and partners closest to women who use alcohol in pregnancy describe how addressing these issues in this context will require moving beyond individual behavior change to address intersecting relational and structural factors. Effective interventions must engage male partners, debunk family level myths and misinformation, and utilize trusted peers in non-stigmatized spaces and community-centered delivery models with sustained community support.
Substantial evidence has associated maternal hypocalcemia with high blood pressure, pregnancy-induced hypertension, and pre-eclampsia. Women from low- and middle-income countries (LMICs) like Nigeria are more likely to have micronutrient deficiencies such as hypocalcemia resulting from suboptimal calcium intake. This study evaluated the mean serum calcium levels difference between non-pregnant women of reproductive age and normotensive pregnant women within the first twenty weeks of gestation at the Lagos University Teaching Hospital. This was a hospital-based cross-sectional study. Seventy-five (75) healthy non-pregnant women and an equal number of pregnant women within the first twenty weeks of gestation were recruited. The serum calcium levels of the two groups were determined and compared. Chi-square and Fisher’s exact tests were used to test the associations between categorical variables. Students’ t-test and Mann-Whitney U test were used to compare means or medians of continuous variables, depending on their distribution. P-values less than 0.05 were considered statistically significant. The mean serum calcium level was significantly higher in non-pregnant (2.5 ± 0.14mmol/L) than in pregnant (2.20 ± 0.17mmol/L) women (p = 0.048), and the prevalence of hypocalcemia was lower among the non-pregnant women when compared with the pregnant women (44.0
