Preterm delivery is an important risk factor for child mortality and psychiatric, metabolic and cardiovascular disease later in life. In most of the cases, the cause of prematurity remains unidentified. There is still ongoing debate about whether abnormal maternal thyroid function during pregnancy contributes to a higher risk of preterm birth. This study aimed to examine the relationship between hypothyroidism, the presence of anti-thyroid antibodies and preterm delivery. This cross-sectional analytic study was conducted in the Department of Obstetrics and Gynaecology at Dhaka Medical College Hospital (DMCH), Bangladesh from June 2022 to May 2023. Two hundred patients were enrolled in this study obeying exclusion and inclusion criteria. Purposive sampling method was used for the selection of respondent. Both preterm and term labor was diagnosed clinically. Gestational age was established based on LMP and early dated ultrasonography. Estimation of maternal thyroid stimulating hormone (Serum TSH) was done by Immuno-radiometric assay and anti-thyroperoxidase antibody (Anti-TPO) by Siemens ADVIA Centaur XPT Chemiluminescence Immunoassay methods. Relevant data was collected in a predesigned questionnaire. Among women who experienced preterm delivery, 27.0% were found to have hypothyroidism, whereas only 12.0% of those who delivered at term had this condition. Anti-TPO antibody positivity was observed in 16.0% of the preterm group compared with 7.0% of the term delivery group. Both the prevalence of hypothyroidism and anti-TPO antibody positivity were significantly higher in the preterm delivery group, with the differences reaching statistical significance (p<0.05). But this significant association was with very early preterm group not with moderate preterm delivery. Hypothyroidism had effect on preterm delivery rates, but had significant association with very early preterm delivery. The existence of anti-TPO antibodies in the serum had a significant increasing effect on preterm deliveries and could be regarded as risk factor.

The third stage of labour happens after the baby or babies are born and when the placenta (afterbirth) is delivered. This Scientific Impact Paper reviews new evidence related to clamping of the umbilical cord, and other interventions that impact the birthing woman and newborn during this part of labour. The paper summarises recent additional information on anatomy (structure of the circulation system) and physiology (how the system functions) of the newborn baby's circulation before the umbilical cord blood vessels close, whether naturally or after a clamp is placed on the umbilical cord. The minutes after birth are now recognised as a time of remarkable change within the baby and we have learned that interfering with this natural process can cause potential harm. Up until birth, the fetus's oxygen supply comes from the mother via blood flow through the umbilical cord. The baby's first breath promotes rapid and profound changes to the circulation, allowing the baby to transition to a new oxygen supply from its own lungs. Fetal blood handles oxygen in a different manner to adult blood, which may be more important immediately after birth when the baby takes its first breaths. Since the last Scientific Impact Paper, more evidence confirms there is very little justification for immediate cord clamping at all gestations. Neonatal harm and death can be reduced when blood from the placenta is allowed to transfuse spontaneously to the baby in the minutes following birth. Those attending the birth should avoid intervening too early or too much while providing initial care (e.g., thermal care, stimulation). The benefits of waiting a few minutes before clamping are especially significant for premature babies. Early cord clamping will result in the baby having a lower blood volume as it is estimated that a baby at full term will receive around 30% of its total blood volume from placental transfer via the umbilical cord. The decision on timing to clamp the umbilical cord should be based on observations of the baby, its heart rate and breathing rather than a predefined interval after birth. Also, the palpable pulsation of the cord is unrelated to the blood flowing back and forth therefore it should not be used to guide the time when clamping occurs. Clamping at the placental end allows some blood in the cord to transfer to the newborn. There are other benefits to the baby from the placental transfer of blood such as transfer of stem cells.

Iron deficiency anaemia (IDA) affects up to 30% of all pregnant women often causing symptoms including malaise and lethargy which can significantly impact daily life and well-being. Additionally, IDA is associated with serious complications, including an increased risk of bleeding, preterm birth, small for gestational age babies and rarely, but significantly, stillbirth. The most common current management approach reactively treats IDA once it is diagnosed, usually with an oral iron preparation such as ferrous sulphate or another ferrous salt. There have been calls to investigate a policy of prevention, to discover if outcomes can be improved. We therefore designed the primary prevention of maternal anaemia to prevent preterm delivery and other adverse outcomes trial, to assess whether the prevention of IDA during pregnancy, through routine iron supplementation from early pregnancy, will reduce the risks of significant adverse clinical outcomes for women and their babies.

Objective: To investigate the management of pregnant women with positive anti-Ro/Sjögren's syndrome antigen A (SSA) antibody and (or) anti-La/Sjögren's syndrome antigen B (SSB) antibody complicated with fetal arrhythmia. Methods: Clinical data of pregnant women with positive anti-Ro/SSA and (or) anti-La/SSB antibodies complicated with fetal arrhythmia who delivered in Beijing Anzhen Hospital, Capital Medical University from January 2020 to June 2026 were retrospectively collected. Maternal autoantibody profiles, types of fetal arrhythmia and pregnancy outcomes were analyzed. Results: A total of 9 cases of pregnant women with positive anti-Ro/SSA and (or) anti-La/SSB antibodies complicated with fetal arrhythmia were included. All 9 cases were positive for anti-Ro/SSA antibody, including 6 strongly positive, 2 moderately positive and 1 weakly positive; among them, 6 cases were concomitantly positive for anti-La/SSB antibody. Among the 9 fetuses, 4 presented with third-degree atrioventricular block (AVB), 1 with first-degree AVB, 1 with transient bradycardia, 2 with supraventricular tachycardia, and 1 with atrial premature beats. Two cases of fetal third-degree AVB and one case of atrial premature beats failed to restore sinus rhythm after in utero pharmacological treatment, while one fetus with transient bradycardia and one fetus with supraventricular tachycardia achieved rhythm conversion after treatment. Among all 9 cases, 5 resulted in live births, including 4 cesarean deliveries and 1 vaginal delivery. Of these live-born infants, 2 were delivered at term and 3 were preterm. The other 4 pregnancies were terminated by induction of labor. Conclusions: AVB is the most common type of fetal arrhythmia induced by maternal positive anti-Ro/SSA and (or) anti-La/SSB antibodies. The utero pharmacological treatment is unlikely to reverse third-degree AVB in the fetus.

Background and Objectives: Twin pregnancies carry a high risk of preterm birth, and cerclage for a short or dilated cervix is typically placed before 24 weeks. Its use at or after 24 weeks is less well characterized in twins. Materials and Methods: We describe the perinatal course of twin pregnancies that underwent cervical cerclage at 24-32+0 weeks at three university hospitals in South Korea between 2015 and 2024, with pregnancies treated before 24 weeks as a descriptive reference. Entry into the late group required remaining undelivered at 24 weeks without prior cerclage, so the groups do not share a common baseline and were not compared. Results: Eighteen pregnancies received cerclage at 24-32+0 weeks (median 26.3 weeks), and 25 received it before 24 weeks. In the late group, delivery occurred at a median of 34.1 weeks (IQR 31.7-35.4) after a mean cerclage-to-delivery interval of 45.8 days (95% CI 34.7-56.9). No fetal, neonatal, or perinatal death occurred (0 of 36 fetuses in 18 pregnancies; 95% CI 0.0-17.6%, calculated on the 18 pregnancies). NICU admission was 83.3% (95% CI 62.3-93.8), and adverse neonatal morbidity was 55.6% (95% CI 34.2-75.0). Conclusions: No perinatal death was recorded in this descriptive series. Because no untreated control group was available, these findings do not establish efficacy but provide a real-world basis for future prospective controlled trials.