High blood pressure during pregnancy can lead to preterm birth and preeclampsia, among other issues for both the mother and the fetus, particularly in low- and middle-income countries including Ethiopia. Thus, the purpose of this study was to identify the contributing factors and their marginal effects on high blood pressure among pregnant women attending antenatal care (ANC) visits at Dilla University Referral Hospital. A hospital-based cross-sectional design was applied to study the blood pressure of 204 sampled pregnant women from November 2023 to October 2024. Pregnant women with chronic hypertension and had fewer than four blood pressure readings were excluded. According to the 2017 AHA/ACC guidelines, blood pressure was categorized as normal, elevated, stage I hypertension, and stage II hypertension. Descriptive statistics (frequency and percentage) and ordinal logistic regression model were used for analysis. The association between each explanatory variable and a single blood pressure level category was presented using the marginal effect. The Brant test was used to verify the parallel line assumption under the ordinal logistic regression model. The proportional odds assumption was satisfied, and then significant factors for high blood pressure were identified by using the proportional odds model. Of the 204 pregnant women, 116 (56.86
Pregnancy-related pain may occur across multiple anatomical regions and may be influenced by biomechanical, psychological, and central pain-processing mechanisms. However, the relationships between overall pain severity, pain distribution, pelvic-girdle-specific symptoms, central sensitization, sleep quality, physical activity, and kinesiophobia during pregnancy remain incompletely understood. This study investigated the associations of these factors with overall pain severity and pelvic-girdle-specific symptom burden during pregnancy. In this cross-sectional analytical study, 128 pregnant women were assessed. Overall pain intensity and anatomical distribution were evaluated using the Visual Analog Scale (VAS) and a 26-region body diagram. Pelvic-girdle-specific symptoms and functional limitations, central sensitization, physical activity, sleep quality, and kinesiophobia were assessed using the Pelvic Girdle Questionnaire (PGQ), Central Sensitization Inventory (CSI), Pregnancy Physical Activity Questionnaire (PPAQ), Pittsburgh Sleep Quality Index (PSQI), and Tampa Scale for Kinesiophobia (TSK-17), respectively. Mean VAS pain intensity was 4.5 ± 2.1. The lower back was the most frequently reported pain site (60.9
This study aimed to evaluate the effects of peanut ball use during labor on labor pain, labor duration, anxiety levels, and maternal satisfaction in primiparous women. This randomized controlled trial was conducted between January 30, 2025, and May 1, 2025, in the maternity unit of a tertiary referral hospital in southeastern Türkiye. A total of 114 primiparous women were randomized (57 per group); four discontinued participation after randomization, and 110 women were included in the final per-protocol analysis (55 per group). The intervention group received peanut-ball application during the first stage of labor, whereas the control group received standard care. Data were collected using the Personal Information Form, Visual Analog Scale (VAS), State Anxiety Inventory (SAI), and Maternal Satisfaction Assessment Scale for Normal Birth (MSASNB). Repeated VAS and SAI measurements were analyzed using generalized estimating equations, while labor duration and maternal satisfaction were analyzed using covariate-adjusted analysis of covariance. Bonferroni adjustment was applied to time-specific pairwise comparisons of repeated VAS and SAI measurements; no global multiplicity adjustment was applied across the four outcome domains. Statistical significance was set at p < 0.05. Significant group-by-time interactions were observed for labor pain and state anxiety. After covariate adjustment and Bonferroni correction, VAS scores were lower in the intervention group at T1, T3, and T5, whereas the between-group differences at T2 and T4 were not statistically significant. Adjusted SAI scores were lower in the intervention group at both post-intervention and postpartum follow-up assessments (all p < 0.001). The adjusted durations of the active and transition phases were shorter, and the adjusted mean maternal satisfaction score was higher, in the intervention group (all p < 0.001). Peanut-ball use as an adjunct to routine intrapartum care was associated with lower labor pain and anxiety, shorter labor duration, and greater maternal satisfaction. Given the baseline imbalances and methodological limitations, these findings should be confirmed in adequately powered multicenter randomized controlled trials. NCT06804577, (registration date 20250127)
Outpatient balloon cervical ripening has been implemented in several countries for selected low-risk pregnancies. In France, little is known about women’s willingness to consider such a pathway. We therefore conducted a prospective bicentric pilot study to assess women’s acceptability of a hypothetical outpatient balloon induction of labor (IOL) pathway among women undergoing standard inpatient balloon cervical ripening. This prospective bicentric non-comparative study was conducted from May 2023 to January 2024 in the maternity units of Nantes University Hospital and Vendée Departmental Hospital. Pregnant women with a singleton pregnancy and an indication for IOL from 37+ 0 weeks of gestation who underwent balloon catheter cervical ripening under standard inpatient care were eligible. Before balloon insertion, women were asked whether they would have been interested in outpatient management (primary outcome) and completed the EQ-5D-5 L quality-of-life questionnaire; their experience of induction was assessed after delivery with the French version of the EXIT questionnaire. Maternal and neonatal outcomes were recorded as contextual descriptive data only; the study was not designed to evaluate the safety, efficacy, or feasibility of outpatient IOL. Of the 150 eligible women to whom the questionnaire was distributed, 75 (50.0
Preeclampsia (PE) involves complex placental microenvironment alterations, with immune dysregulation playing a central role. While M2 macrophages have been implicated, specific co-expression modules to M2 enrichment and their differential expression in PE remain poorly defined. We conducted a computational study to identify genes transcriptionally correlated with inferred M2 macrophage enrichment in PE. Using the xCell algorithm, we inferred relative immune cell enrichment scores from bulk placental transcriptomes. Weighted gene co-expression network analysis was applied to identify M2-correlated modules; module genes were intersected with PE-associated differentially expressed genes. The overlap underwent feature selection via three machine learning approaches in a discovery cohort. A logistic regression model based on the consensus genes was evaluated in an independent validation cohort. PE placentas showed significant differences in inferred immune cell enrichment. From the intersection of M2-correlated module genes and differentially expressed genes, we identified a robust three-gene placental signature (FLT1, LEP, HTRA4). The signature achieved area under the curve of 0.869 (discovery) and 0.865 (validation). Functional annotation associated each gene to core pathologies: FLT1 (VEGF signaling antagonism and impaired angiogenesis), LEP (metabolic-inflammatory dysregulation), and HTRA4 (extravillous trophoblast function and remodeling). Literature suggests these genes operate within an M2-enriched microenvironment and may participate in immune–trophoblast crosstalk, collectively reflecting multi-pathway dysregulation. We identify and validate a three-gene placental expression signature for PE within an M2-correlated transcriptional context, linking angiogenic, metabolic, and trophoblast-immune axes. This integrative placental expression framework advances understanding of microenvironment-level immune dysregulation and serves as a foundation for future mechanistic studies, though single-cell or spatial resolution is required to confirm cellular origins and causal relationships.
