Journal of Pregnancy
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Acceptance rate9%
Submission to final decision132 days
Acceptance to publication15 days
CiteScore5.900
Journal Citation Indicator1.050
Impact Factor3.2

Incidence of Adverse Perinatal Outcomes among Women Exposed to Maternal Near-Misses in Arsi Zone in Ethiopia: Prospective Cohort Study in 2022

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 Journal profile

Journal of Pregnancy publishes original research articles, review articles, and clinical studies related to all aspects of pregnancy and childbirth. Topics include biomedical aspects of pregnancy labour, maternal health and breastfeeding.

 Editor spotlight

Chief Editor, Dr. Ozgu-Erdinc, has been an active practitioner for over 30 years. Her research is focused on gestational diabetes mellitus screening, diagnosis and management including being actively involved in clinical research for new and novel ways to improve outcomes for mothers and babies.

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Research Article

Higher Circulating Lymphocytes and the Incidence of Pre-eclampsia and Eclampsia

Excessive immune activation contributes to the onset of early dysfunction of the maternal-fetal interface, and it is closely linked to the development of pre-eclampsia. However, the effect of specific immune cells on the risk of pre-eclampsia and eclampsia remains controversial. We investigated the causal relationship between immune cells and pre-eclampsia and eclampsia. For exposure, we extracted genetic variants associated with immune cell-related traits, and for outcomes, we used summary genetic data of pre-eclampsia/eclampsia. A two-sample Mendelian randomization (MR) analysis was then performed to assess the causal relationship. Robustness of the MR results was then evaluated through colocalization analysis. We found that genetically proxied circulating lymphocyte absolute count was causally associated with total eclampsia (, 95% confidence interval (CI) (1.31-1.79), ) and pre-eclampsia (, 95% CI (1.28-1.77), ); T cell absolute count was causally associated with total eclampsia (, 95% CI (1.28-1.73), ) and pre-eclampsia (, 95% CI (1.25-1.72), ). And CD28- CD25+ CD8+ T cell absolute count was causally associated with total eclampsia (, 95% CI (1.44-2.32), ) and pre-eclampsia (, 95% CI (1.38-2.26), ). Colocalization analysis revealed that immune cell-related traits shared the same variant with pre-eclampsia/eclampsia. Our study suggested causal effects of genetic predisposition to high lymphocyte absolute count levels, T cell absolute count, and CD28- CD25+ CD8+ T cell absolute count on eclampsia, particularly pre-eclampsia risk, providing crucial new insights into the potential prevention target for eclampsia and pre-eclampsia.

Research Article

Validation of a Model for Predicting Magnesium Concentration in Women with Preeclampsia: A Retrospective Cohort Study

Objective. To validate a model for predicting magnesium concentration in magnesium sulfate treatment in preeclampsia. Design. Retrospective cohort study. Setting. Three secondary care hospitals, one accepting neonates from gestational week . Population. Women with preeclampsia undergoing magnesium sulfate treatment. Subjects initially received Zuspan treatment (4 g bolus and 1 g/h maintenance dose), commonly increased by individual titration. Main Outcome Measures. Difference in mean between measured and predicted magnesium concentration. Proportion of women reaching target concentration (>2 mM) in 25 h. Results. 56 women were included, with 356 magnesium measurements available. Mean magnesium concentration was 1.82 mM. The prediction model overestimated magnesium concentration by 0.10 mM (CI 0.04–0.16) but exhibited no bias for weight, creatinine, or treatment duration. Weighted mean infusion rate was 1.22 g/h during 30 hours. Overall success rate in reaching target concentration was 54%, decreasing to 40% in  kg. Overall success rate at 8 hours was 11%. No toxic concentrations were found. Conclusions. Zuspan regimen is very safe, but slow to reach therapeutic concentrations—despite efforts of individual titration. Success rate is lower in heavy women, which is of particular importance considering their predisposition to develop preeclampsia. The validated pharmacokinetic model performs well and may be used to individually tailor treatment from the outset.

Research Article

Childbirth Self-Efficacy and Its Associated Factors among Pregnant Women in Arba Minch Town, Southern Ethiopia, 2023: A Cross-Sectional Study

Background. Childbirth self-efficacy is a pregnant women’s perception of their ability to cope with labor stress. Low childbirth self-efficacy is linked to pain intolerance and poor labor progression, which increase the possibility of operative delivery. However, Ethiopia has limited data. So, the aim of this study was to assess childbirth self-efficacy and its factors among pregnant women attending antenatal care in public health facilities in Arba Minch town, Southern Ethiopia, in 2023. Objective. To assess childbirth self-efficacy and associated factors among pregnant women attending antenatal care in public health facilities in Arba Minch town, Southern Ethiopia, in 2023. Methods. An institution-based cross-sectional study was carried out among 416 women from January 1 to January 30, 2023. A systematic random sampling technique was employed. Data were collected by KoboToolbox through face-to-face interviews using a structured and pretested questionnaire. Modified short-form childbirth self-efficacy inventory was used to score self-efficacy. The Statistical Package for Social Sciences, version 27, was used for data management and analysis. Descriptive statistics were calculated for each variable, and a logistic model was used. Statistical significance was determined at a value of less than 0.05 and 95% confidence level. Results. A total of 416 pregnant women participated in the study. Two hundred twenty-eight (54.8%) of the pregnant women had low childbirth self-efficacy. Age group in ≤24 years (, 95% CI: 1.82-8), primigravida (, 95% CI: 1.10-2.86), unplanned pregnancy (, 95% CI: 1.02-2.70), poor social support (, 95% CI: 1.09-4.30), having anxiety (, 95% CI: 1.10-3.64), having poor knowledge of childbirth (, 95% CI: 2.09-5.39), and severe fear of childbirth (, 95% CI: 2.60-9.80) were statistically significant with low childbirth self-efficacy. Conclusions. The magnitude of low childbirth self-efficacy was high in the study area. Being primigravida, unplanned pregnancy, years, severe fear of childbirth, anxiety, poor social support, and poor knowledge were significantly associated with low childbirth self-efficacy. Therefore, giving special attention to these factors during antenatal care would be important.

Review Article

Multiple Gestation after Elective Single-Embryo Transfer: A State-of-the-Art Review of Literature and Suggested Mechanisms

Background. Elective single-embryo transfers are being increasingly used to curb the increase in multiple gestation rates. However, it has been documented that single-embryo transfers could still result in twins and on rarer occasions in triplet pregnancies. Main Body. A literature review was done to highlight the possible mechanisms leading to embryonic splitting. In this review, the incidence of zygotic splitting was addressed and the notion of chorionicity was explained. Risk factors for zygotic splitting and suggested mechanisms for both twin and higher order pregnancies were suggested and discussed. Conclusion. The hypotheses that we have so far remain unproven due to the rarity of zygotic splitting as well as the ethicolegal considerations of human embryo research. The presence of such incidents necessitates extensive counselling of the couple.

Review Article

Drug Utilization Studies in Pregnant Women for Newly Licensed Medicinal Products: A Contribution from IMI ConcePTION

Purpose. Studies focusing on safety outcomes typically require large populations to comprehensively characterise the patient groups exposed to the medicines under investigation. However, there is often less information for subpopulations, such as pregnant or breastfeeding women, particularly when new medicines are considered. It is important to understand what information can be obtained from drug utilization studies (DUS) involving pregnant women in the early years postmarketing to provide supportive information for safety studies. The aims of this literature review are to (1) identify and review DUS for new medicines in pregnancy and breastfeeding and (2) list and summarise key information items to be reported in a DUS for new medicines in pregnancy. Methods. To identify postmarketing DUS of new prescription medicines or enantiomers in pregnancy, a systematic literature review was undertaken in PubMed and Embase between January 2015 and June 2022. In addition, the complete database of the ENCePP EU PAS Register was systematically searched to June 2022. Results. We identified 11 published DUS on new medicines in pregnancy from the ENCePP EU PAS Register and none from other sources. No studies on breastfeeding were identified. The 11 identified publications reported the medicine’s use for the first 3 to 5 years after marketing approval. No reports assessed utilization in the first 3 years of approval. It was usual to issue interim reports annually (7 studies). All studies concerned conditions managed in ambulatory care (primary care and outpatient facilities) and included some primary care prescribing. Most () only had prescribing/dispensing data available at individual level for ambulatory care; outpatient prescribing was included in three of these studies Three studies held a limited amount of in-hospital prescribing data. A DUS can confirm at an early stage whether there are sufficient exposed pregnancies in available data sources to ensure a safety study is powered to detect a difference in the prevalence of adverse pregnancy or infant outcomes or if additional data from other databases are needed. A DUS may also help address methodological considerations such as selection of comparators. DUS can be performed embedded in a DUS in the general population, in a cohort of women of childbearing age, or in a cohort of pregnant women. Conclusion. This review summarises key aspects of a DUS for new medicines in pregnancy. DUS for new medicines in pregnancy should be planned before marketing, scheduled for the first 3 to 5 years after release, with annual interim/progress reports, and reported in peer-reviewed journals. By offering detailed information on data sources, exposure timing, prevalence and location, coprescribing, comorbidities, coexposures, and demographics, a DUS will offer a firm foundation for safety studies and will help to contextualize spontaneous reporting of serious adverse events.

Research Article

Obesity Cut-Off Points Using Prepregnancy Body Mass Index according to Cardiometabolic Conditions in Pregnancy

Aim. To suggest cut-off points for body mass index (BMI) using gestational hypertension, preeclampsia, and gestational diabetes mellitus (GDM) as cardiometabolic conditions in pregnancy. Methods. In this prospective study, singleton pregnant women from the fetal medicine service of the Brazilian Unified Health System were included. The pregnancy, perinatal, and newborn data were obtained from the clinical medical records. Maternal anthropometry included an assessment of weight and height and the prepregnancy BMI evaluation categorized according to the World Health Organization cut-off points. The area under the curve and confidence interval values from receiver operator curves were generated to identify the optimal cut-off points using prepregnancy BMI with better sensitivity and specificity. Results. Data on 218 pregnancies were analyzed, with 57.9% () being classified as overweight/obese, 11% () with GDM, 6.9% () with preeclampsia, and 11.0% () with gestational hypertension. The BMI cut-off points for predicting cardiometabolic conditions were 27.52 kg/m2 (S: 66.7%; E: 63.8%) for women with GDM; 27.40 kg/m2 (S: 73.3%; E: 62.4%; S: 79.2%; E: 64.9%; S: 70.3%; E: 66.3%) for women with preeclampsia, gestational hypertension, and gestational hypertension plus preeclampsia, respectively; and 27.96 kg/m2 (S: 69.6%; E: 65.6%) for women with preeclampsia plus GDM. Conclusion. The findings suggest that the optimal prepregnancy BMI cut-off point is around 27 kg/m2 for pregnant women with maternal cardiometabolic conditions.

Journal of Pregnancy
 Journal metrics
See full report
Acceptance rate9%
Submission to final decision132 days
Acceptance to publication15 days
CiteScore5.900
Journal Citation Indicator1.050
Impact Factor3.2
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