2025年 · 第07卷第02期

Maternal and newborn mortality continues to represent a critical global public health challenge, particularly in low- and middle-income countries (LMICs). According to the World Health Organization (WHO) 2020 report, approximately 800 women die daily from complications related to pregnancy or childbirth, equating to one maternal death every two minutes. The majority of these deaths are preventable or treatable with timely and adequate healthcare interventions.¹Additionally, an estimated 6400 neonatal deaths occurred each day in 2020, culminating in 2.3 million newborn fatalities within the first month of life.²Despite significant global efforts, improving maternal and neonatal health outcomes remains a formidable challenge, particularly in LMICs, which account for nearly 95% of global maternal deaths.¹The coronavirus disease 2019 pandemic has further exacerbated these challenges, placing additional strain on already overburdened healthcare systems and highlighting the urgent need for targeted interventions.

The concept of leadership emerged relatively late in China, especially in the academic medical field, and has not been widely emphasized. Currently, only a few medical schools in China offer leadership education programs for medical students.^1,2For practicing doctors, there is a lack of systematic leadership discussions and training for potential future leaders.³Preparing and Advancing Women Leadership in Health Science (PAWLHS), jointly initiated by the University of Michigan and Peking University Health Science Center, and funded by the China Medical Board, is the first female leadership development program specifically for women in the academic medicine field in China.

To compare the analgesic effects of ibuprofen administered orally via two modes combined with a conventional, patient-controlled intravenous analgesia pump on maternal pain after cesarean section (CS).

This prospective, randomized, controlled study enrolled females who underwent CS from August 2022 to August 2023 at Peking University First Hospital, Beijing, China. Participants were randomly assigned to either an as-needed ibuprofen group (300 mg orally upon request) or a scheduled ibuprofen group (300 mg every 12 hours for 48 hours). The primary outcomes assessed were postoperative pain levels using the Wong-Baker Faces Pain Scale-Revised and cumulative oxycodone consumption at multiple time points up to 48 hours post-delivery. Secondary outcomes included recovery parameters (time to first flatus, ambulation, and lactation initiation), patient satisfaction with pain control, and postpartum depression scores evaluated by the Edinburgh Postnatal Depression Scale on postoperative day 3. Normally distributed data analyzed with t-tests; non-normal data with Mann-Whitney U tests; categorical variables with chi-square or Fisher’s exact tests (SPSS 26.0, P < 0.05).

After excluding 61 non-eligible cases, 339 patients were included (171 as-needed vs. 168 scheduled). The scheduled group showed significantly better pain control at 12 hours (4.00 (2.00-5.50) vs. 4.00 (4.00-6.00), P < 0.001), 24 hours (4.00 (2.00-4.00) vs. 4.00 (2.00-6.00), P < 0.001), and 36 hours (2.00 (2.00-4.00) vs. 4.00 (2.00-4.00), P < 0.001), and 48 hours (2.00 (2.00-4.00) vs. 2.00 (2.00-4.00), P = 0.004) post-delivery and lower levels of oxycodone consumption at 36 hours (10.20 (8.20-13.35) vs. 11.00 (8.80-14.40), P = 0.042) and 48 hours (12.40 (10.40-15.95) vs. 13.80 (11.00-16.00), P = 0.020) postpartum compared with those in the as-needed group. Additionally, the time to the return of bowel movements was shorter in the scheduled group than in the as-needed group (23.50 (16.94, 31.47) vs. 27.00 (19.88, 35.97), P = 0.004). Differences in post-delivery ambulation, lactation initiation, satisfaction levels, and depression scores were not significantly different between the two groups.

The results of this study promote the use of ibuprofen (scheduled oral administration) combined with a conventional, patient-controlled intravenous analgesia pump for achieving better post-CS pain control than an as-needed dosage regimen.

Chinese Clinical Trial Registry, ChiCTR2400082474.

To assess the adverse maternal and neonatal outcomes of anemia among pregnant women in primary hospitals in Southern Ethiopia.

This institution-based prospective cohort study was conducted from March 1 to October 30, 2022, in three primary hospitals in the Hadiya zone of Southern Ethiopia. Participants were categorized into exposed (Hb < 11 g/dL) and non-exposed (Hb ≥ 11 g/dL) groups based on hemoglobin levels measured before delivery. Baseline characteristics were comparable between groups. Maternal and neonatal complications were considered as outcomes. Data were analyzed using STATA version 15. Descriptive statistics summarized baseline characteristics, and Chi-square tests assessed associations. Generalized linear models with a log link calculated adjusted relative risks (aRRs) with 95% CIs. Statistical significance was set at P < 0.05. Multivariable models adjusted for confounders, and sensitivity analyses evaluated robustness using multiple imputations for missing data.

A total of 490 participants were enrolled in the study, with 245 in each of the exposed and non-exposed groups. Due to loss to follow-up, 220 participants in the exposed group and 239 in the non-exposed group were assessed for outcomes. Prolonged labor (adjusted RR (aRR)= 3.235; 95% CI: 1.658, 6.312; P = 0.003) and postpartum hemorrhage (aRR = 2.901; 95% CI: 1.202, 7.910; P = 0.045) were identified as adverse maternal pregnancy outcomes of anemia. We observed low birth weight (aRR = 3.020; 95% CI: 1.233, 6.010; P = 0.002) and respiratory distress syndrome (aRR = 4.820; 95% CI: 2.901, 9.012; P = 0.001) as neonatal complications. Furthermore, having no previous history of anemia reduced the risk of prolonged labor (aRR = 0.078; 95% CI: 0.033, 0.188; P = 0.015) and low birth weight (aRR = 0.480; 95% CI: 0.370, 0.592; P = 0.001).

Mothers who have experienced maternal anemia in the past or present face serious consequences for both themselves and their children. Preventing anemia should thus start before conception and continue through pregnancy.

Alternative splicing (AS) is a crucial process that produces functionally distinct proteins from a single gene, depending on the developmental or physiological state of cells in multicellular organisms. It plays a significant role in cellular proliferation, survival, and differentiation, including embryonic development, spermatogenesis, and a broad spectrum of diseases. However, the precise involvement of AS in embryo implantation is still unclear. In this review, we summarize the potential roles of AS in regulating mesenchymal-epithelial transitions during embryo implantation, specifically in epithelium regeneration and decidualization initiation via the mesenchymal-epithelial transformation process. Overall, this review emphasizes the impact of AS and splicing variants on embryo implantation and offers novel insights into the potential application of alternative splicing in the treatment of female infertility.

A 34-year-old Han Chinese woman, 22⁺⁴weeks pregnant, presented to the hospital on September 21, 2022, with a fever lasting over 10 hours. Her body temperature was 38.4°C, and blood tests indicated elevated markers of infection. However, there were no symptoms of other systemic infections. She was admitted with the diagnosis of "unexplained fever during mid-pregnancy." Patient’s consent to publish the clinical information in the article was obtained.

The Kidd (JK) blood group system comprises the Jka, Jkb and Jk3 antigens. The Kidd antigens commonly cause typical acute hemolytic transfusion reactions but also cause delayed hemolytic transfusion reactions due to the strong anamnestic response. Jkb antibodies can result in hemolytic disease of the newborn (HDN) but rarely lead to severe fetal anemia.¹We report a successful case of severe early intrauterine anemia (23 g/L, 22 weeks gestation) caused by Jkb antibodies with a good pregnancy outcome after three intrauterine transfusions (IUTs).

Hemolytic disease of the fetus and newborn (HDFN) is a life-threatening condition caused by maternal alloimmunization to red blood cell (RBC) antigens. Over the years, the introduction of preventive and therapeutic measures has significantly reduced the frequency of anti-D and non-D immunizations in pregnant women, leading to a decline in HDFN cases. The postnatal and antenatal administration of anti-D immunoglobulins has reduced the prevalence of anti-D antibodies in pregnant women to less than 0.5%.¹However, the relative importance of non-D antibodies has increased following the widespread adoption of immunoprophylaxis. Among non-D antibodies, those from the Rh system and anti-K antibodies are the most common causes of HDFN. Approximately 50% of pregnant women with non-D antibodies have a history of blood transfusions.²Therefore, transfusing women of reproductive age with RBCs compatible with Kell, Rhc, RhE, and RhC antigens could further reduce the incidence of non-D antibodies and HDFN.

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In 2020, an estimated 287,000 women globally died during pregnancy and childbirth, with a significant proportion occurring in low- and middle-income countries. India accounted for 8% of these deaths, with a maternal mortality ratio of 103 per 100,000 live births, highlighting the urgent need for accessible healthcare and effective interventions.¹Despite the availability of various contraceptives, India faces a 19% unmet need for family planning, contributing to women having more children than desired and often with insufficient spacing between births. India’s family planning program has shifted from population control to prioritizing maternal and newborn health. Ensuring healthy timing and spacing of pregnancies is critical for improving reproductive, maternal, neonatal, child, and adolescent health outcomes.²

Maternal health services (MHSs) are a cornerstone of public health, playing a pivotal role in ensuring the well-being of mothers and newborns. This is particularly critical in rural areas of South Africa, where the demand for such services far exceeds the available supply. The provision of effective maternal health care in these regions is hindered by a complex interplay of factors, including infrastructure deficits, staffing shortages, suboptimal quality of care, and socio-cultural barriers. This correspondence synthesizes findings from a systematic literature review conducted to assess these challenges, underscoring the urgent need for targeted interventions to enhance service delivery in underserved communities.