Against the backdrop of rapid global progress in perinatal medicine, the past year has witnessed multiple internationally influential research achievements that provide important evidence-based guidance for obstetric clinical practice. Meanwhile, in response to changes in China’s childbearing population structure and the upgrading of reproductive health needs, perinatal medicine is undergoing a profound transformation from “reducing mortality” to “improving life-cycle quality.” At year-end, Obstetrics & Gynecology Networkinvited Professor Qi Hongbo from the First Affiliated Hospital of Chongqing Medical University to review domestic and international frontier advances and directions for discipline development, with the aim of offering insights for the high-quality development of perinatal medicine.
Three Major Breakthroughs in Obstetric Clinical Research
Over the past year, several landmark studies in international obstetrics have provided key guidance for clinical practice, mainly covering three major areas: prevention of preeclampsia, preterm birth intervention, and postpartum hemorrhage management.
1. Preeclampsia Prevention: High-Dose Aspirin Shows Superior Efficacy
Two pivotal studies have driven updates to preeclampsia prevention strategies:
One randomized controlled trial (RCT) compared the preventive effects of 162 mg versus 81 mg aspirin, showing that the 162 mg dose could further reduce the risk of preeclampsia by 14%, confirming its advantage over traditional low-dose regimens.
A second study targeting high-risk populations (e.g., obese pregnant women) indicated that such groups require larger doses of aspirin—162 mg was significantly more effective than low-dose regimens, providing a basis for precision prevention in high-risk pregnancies.
2. Preterm Birth Prevention: Cervical Cerclage No Better Than Progesterone — Avoid Overintervention
Research on preterm birth prevention suggests that cervical cerclage does not outperform progesterone medication in preventing preterm birth. This conclusion warns clinicians against overuse of mechanical interventions in pregnant women with cervical insufficiency; drug-based regimens with evidence support should be prioritized to reduce unnecessary procedural risks.
3. Postpartum Hemorrhage Management: Tranexamic Acid Gains Prominent Attention
In recent years, research on tranexamic acid in preventing and treating postpartum hemorrhage has continued to deepen. Whether used as prophylaxis in high-risk populations (e.g., twin pregnancy, women with uterine scars) or as treatment after hemorrhage occurs, tranexamic acid has shown good efficacy. Its clinical potential warrants further exploration and promotion by obstetric professionals, offering a new tool to reduce adverse outcomes related to postpartum hemorrhage.
Clinical Frontier Exploration: Focus on FGR and Cesarean Scar Management
Professor Qi noted that although his team had no breakthrough translational results in the past year, it achieved two important advances in basic research and clinical frontier exploration, laying the foundation for future intervention strategies.
1. FGR Intervention: Mechanism Study of Targeting PPARγ to Promote Fetal Fat Formation
Addressing fetal growth restriction (FGR), a challenging clinical issue, Professor Qi’s team used rosiglitazone to target placental peroxisome proliferator-activated receptor γ (PPARγ). They found this intervention could promote fetal fat formation, thereby improving FGR status. The study remains at the preclinical stage; subsequent translational research is needed to verify safety and efficacy in humans.
2. Cesarean Scar Repair: Inhibiting Fibrosis to Improve Healing Quality
Focusing on uterine scar healing after cesarean section, Professor Qi’s team published research in Nature Communications, revealing that interfering with the expression of secreted frizzled-related protein 2 (SFRP2) gene can inhibit uterine fibrosis and promote more uniform and firm scar tissue healing. Based on this, the team proposed the hypothesis that “improving scar quality may lower the incidence of placenta accreta spectrum (PAS) disorders,” pointing the way for future clinical translation.
Responding to Changes in Fertility Patterns: Building a Full-Cycle Multidisciplinary Collaborative Prevention System
China’s current childbearing population shows the characteristic of “declining births but increasing numbers of advanced maternal age pregnancies,” alongside challenges such as the widespread use of assisted reproductive technology and compounded environmental teratogenic risks. These require perinatal medicine to shift from “single-disease management” to “full-life-cycle health management.”
1. Establish an Interdisciplinary Integrated System Covering the Entire Reproductive Chain
It is necessary to break down barriers among reproductive medicine, genetics, maternal-fetal medicine, perinatal medicine, neonatology, and pediatrics, building a “big fertility” interdisciplinary collaborative system. Its core is multi-dimensional cooperation to identify risk prevention and control nodes across the entire journey from pre-pregnancy, pregnancy, to offspring health.
2. Data-Driven Approach: Build a Full-Cycle Database
Data are the foundation of precise prevention and control. A full-chain database covering women’s reproductive cycles must be established, integrating multi-dimensional information from preconception, pregnancy, delivery, postpartum, to offspring growth. By analyzing individual data characteristics, precise intervention targets can be identified to realize individualized health management tailored to each person. Construction of this database requires deep participation from all disciplines, pooling data and expertise to ultimately form a new paradigm of data-driven prevention and control.
Three Key Directions for Perinatal Medicine Development: Technology Empowerment, Global Collaboration, and System Building
Looking ahead, Professor Qi pointed out that high-quality development of perinatal medicine must focus on three core directions:
1. Technology-Driven: Deep Empowerment by Data and Artificial Intelligence
Data-driven approaches and AI technologies will reshape perinatal healthcare models. By integrating multi-source data and applying AI analysis, early risk screening, warning, and intelligent recommendation of intervention plans can be achieved, significantly improving service efficiency and precision.
2. Global Collaboration: Unite the Perinatal Medicine Community
Perinatal medicine professionals worldwide need to strengthen cooperation, share research findings and clinical experience, jointly address cross-regional and cross-cultural reproductive health challenges, and promote synchronized updates of guidelines and practices globally.
3. Domestic System Building: Full Coverage from Urban to Rural Areas
Leveraging the institutional advantages of China’s maternal and child health care system, it is essential to accelerate the construction of an integrated “urban–primary care–rural” perinatal medicine service system. Currently, the responsibility of perinatal medicine in China has shifted from “reducing maternal and perinatal mortality” to “improving perinatal life quality.” This transition demands moving from “quantitative accumulation” to “qualitative leap,” consolidating health foundations through systematic construction, and providing more solid health protection for every family planning childbirth.
Conclusion
Over the past year, breakthroughs in international research and explorations by domestic teams have jointly propelled the advancement of perinatal medicine. Meanwhile, shifts in fertility patterns and waves of technological revolution call for us to take innovation as our wings and collaboration as our foundation, building a full-life-cycle, multidisciplinary life-health management system. This is both the mission of the era for perinatal medicine and the inevitable path to safeguarding maternal and infant health.
Expert Profile
Qi Hongbo, Professor
Vice President, First Affiliated Hospital of Chongqing Medical University
Second-Level Professor / MD / PhD Supervisor
Professional Appointments:
Chair-Elect, Perinatal Medicine Branch, Chinese Medical Association
Vice President, China Maternal and Child Health Research Association
National Outstanding Physician (First Medical High-Level Talent Program)
National Candidate of the New Century Hundred-Thousand-Ten Thousand Talents Project
National Outstanding Contribution Young and Middle-Aged Expert
National Health Commission Outstanding Contribution Young and Middle-Aged Expert
Recipient of State Council Special Allowance
Chongqing Talent Plan · Outstanding Scientist
Chair, Obstetrics and Gynecology Branch, Chongqing Medical Association
Deputy Chief Editor, National Standardized 5-Year Obstetrics and Gynecology(9th–10th Editions)
Deputy Chief Editor, National Standardized 8-Year Obstetrics and Gynecology(4th Edition)
Principal Investigator of more than 30 projects including National Key R&D Programs and National Natural Science Foundation Key Projects
Published over 260 SCI papers, including in Cell(impact factor up to 64.5); ranked among the world’s top 2% scientists by Stanford University & Elsevier for four consecutive years
Editor: Ma Ye