ArticleBMC pregnancy and childbirth2025
Mediating role of preterm birth in the relationship between maternal disease and infant development.
Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPreterm birth is a major adverse perinatal outcome and may act as a mediator linking maternal disease to impaired infant growth and neurodevelopment. However, the mediating role of preterm birth has not been well explored in relation to maternal diseases. This study aimed to investigate whether preterm birth mediates the association between maternal diseases and infant outcomes including Body Mass Index, the Neonatal Behavioral Neurological Assessment, and the Gesell Development Schedule.
methodsThis study recruited a total of 2000 mother-child pairs from the Pediatric Healthcare Centre at the Third Xiangya Hospital. Maternal diseases, including gestational diabetes mellitus, pregnancy-induced hypertension, anaemia, hypothyroidism, hyperthyroidism, and thrombocytopenia, were assessed through hospital records and parental questionnaires verified against medical records. Infant outcomes were evaluated by trained pediatric nurses blinded to maternal conditions, using anthropometric measurements (Body Mass Index) and standardized neurodevelopmental tools (Neonatal Behavioral Neurological Assessment and Gesell Development Schedule). Mediation analysis with 1,000-sample bootstrapping was applied to quantify the indirect effects of preterm birth.
resultsPreterm birth significantly mediated the association between Pregnancy-Induced Hypertension and Neonatal Behavioral Neurological Assessment (Indirect effect = -0.653, 95% CI: -0.98 - -0.36, p < 0.001). Preterm birth also significantly mediated the relationship between Gestational Diabetes Mellitus and Body Mass Index (Indirect effect = - 0.046, 95% CI: -0.08 - -0.01, p = 0.01).
conclusionsPreterm birth may act as a mediator between maternal diseases and infant growth and neurodevelopmental outcomes. The results support the feasibility and value of using mediation analysis in maternal-infant research. Findings highlight the importance of early prenatal screening, prevention, and management of preterm birth in pregnancies complicated by maternal disease. Future research is warranted to employ longitudinal neurodevelopmental monitoring in affected infants.
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