Dynamic analysis of critical maternal complications in tertiary hospitals in Wuxi: A study based on four years of monitoring data

by Ye Xu, Peimin Hua, Ye Shen

Background

Severe maternal morbidity (SMM) is a significant public health concern. This study analyzed the incidence, trends, causes, and pregnancy outcomes of SMM in Wuxi to inform future clinical and public health strategies.

Methods

A retrospective analysis was conducted on 315 critical maternal cases identified from 156,435 deliveries in Wuxi between October 1, 2020, and September 30, 2024. Data were extracted from a citywide near-miss maternal surveillance system. Statistical analyses were performed using SPSS 25.0, employing chi-square tests and Cochran-Armitage trend tests to evaluate trends, and chi-square tests for comparisons between groups.

Results

The overall incidence of SMM was 0.20%. Initially, this rate remained stable at 0.19% across the first three cycles (P > 0.05); however, it significantly increased to 0.24% during the cycle from October 2023 to September 2024 (χ² = 5.24, P = 0.02). This increase was closely associated with a rise in the proportion of women of advanced maternal age (≥35 years), which reached 26.03% (χ² = 11.76, P = 0.001). Over time, the distribution of risk levels shifted. Initially, the high-risk group was dominant (63.29%), but in recent cycles, the moderate-risk group became more prominent (64.44%). The moderate-risk group was associated with a higher rate of adverse outcomes (25.00–25.71%) compared to the high-risk group (17.11–20.69%; χ² = 10.83, P = 0.01). Direct obstetric factors were the primary causes, accounting for 79.05% of cases, with obstetric hemorrhage being the most prevalent (53.97%). In contrast, the proportion of cases attributable to indirect obstetric factors increased from 17.81% to 26.67%, primarily due to heart disease and infectious diseases.

Conclusion

Improving maternal safety involves dynamic risk assessments, tiered referrals for moderate-risk pregnancies, better multidisciplinary management of complications, optimized emergency responses in primary care, and refined regional referral systems to reduce preventable SMM and mortality.

Comparative Efficacy of Non‐Pharmacological Interventions on Fatigue, Depression, and Quality of Life in Patients With Lung Cancer: A Network Meta‐Analysis of Randomized Controlled Trials

ABSTRACT

Background

Non-pharmacological interventions (NPIs) have been shown to be effective in reducing fatigue, depression, and improving quality of life (QoL) in patients with lung cancer. However, given the diversity of NPIs, the most effective intervention remains to be confirmed.

Objectives

To compare the efficacy of different NPIs in reducing fatigue, depression, and improving QoL in patients with lung cancer.

Methods

Six databases were searched from inception to May 10, 2025. Two reviewers independently screened studies and extracted data. A pairwise meta-analysis and a network meta-analysis were performed sequentially to determine the efficacy of different NPIs in improving fatigue, depression, and QoL in patients with lung cancer.

Results

A total of 58 studies involving 13 NPIs were included. The top three NPIs for reducing fatigue were acupuncture, acceptance and commitment therapy (ACT), and nutritional intervention. Meanwhile, ACT, cognitive behavioral therapy, and body–mind-spirit intervention ranked among the top three in improving depression. ACT emerged as the most effective intervention in improving QoL, followed by nutritional intervention and mind–body exercise.

Linking Evidence to Action

This study revealed the efficacy ranking of different NPIs in reducing fatigue, depression, and improving QoL in patients with lung cancer. Clinical healthcare professionals should be encouraged to utilize these potentially effective NPIs to improve health outcomes in patients with lung cancer.

Trial Registration

Registration Number: PROSPERO (CRD420251087360)