Pub Date : 2026-02-01DOI: 10.1097/aog.0000000000006168
Robert M Silver
{"title":"Social Determinants of Health and Stillbirth: Time for the Next-Generation.","authors":"Robert M Silver","doi":"10.1097/aog.0000000000006168","DOIUrl":"https://doi.org/10.1097/aog.0000000000006168","url":null,"abstract":"","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"15 1","pages":"137-138"},"PeriodicalIF":7.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2025-11-07DOI: 10.1097/AOG.0000000000006115
Tetsuya Kawakita, Misa Hayasaka, Ann M Harper, John Brush, George Saade
Objective: To examine the association between neighborhood-level social determinants of health and stillbirth.
Methods: We performed a retrospective cohort study of deliveries that occurred at a gestational age of at least 20 weeks within a five-hospital system (2012-2022). Electronic health record data mapped to the Observational Medical Outcomes Partnership Common Data Model were geocoded using addresses at the time of delivery and linked to neighborhood health indices, which included the Area Deprivation Index (ADI), Maternal Vulnerability Index (MVI), and Social Vulnerability Index (SVI) at the Census tract level. Stillbirths were adjudicated by medical record review. Modified Poisson regression generated relative risks (RRs) and 95% CIs, controlling for maternal age, body mass index (BMI), parity, marital status, chronic hypertension, and pregestational diabetes.
Results: Among 61,008 pregnancies, 288 (0.5%, 95% CI, 0.4-0.5%) resulted in stillbirths. The ADI quartiles (relative to Census tracts within the United States as a whole) 2, 3, and 4 were associated with an increased risk of stillbirth (RR [95% CI] 2.32 [1.34-4.03], 3.08 [1.74-5.44], and 2.07 [1.03-4.14], respectively) compared with quartile 1. The ADI relative to Census tracts within the states showed comparable gradients. MVI quartiles 2 and 3 were associated with an increased risk of stillbirth (RR [95% CI] 1.44 [1.01-2.05] and 1.49 [1.02-2.19], respectively) compared with quartile 1. Similarly, SVI quartiles 2 and 3 were associated with an increased risk of stillbirth (RR [95% CI] 1.46 [1.03-2.07] and 1.86 [1.32-2.63], respectively) compared with quartile 1. Neither MVI nor SVI quartile 4 showed a statistically significant association with stillbirth. Among MVI subthemes, the mental health domain demonstrated a strong association with stillbirth (quartiles 2-4 RR range 1.64-2.07).
Conclusion: Neighborhood deprivation, quantified by ADI score, was a robust independent predictor of stillbirth, whereas the associations between the MVI or SVI and stillbirth were modest. Integrating the ADI into obstetric risk assessment and directing resources, especially perinatal mental health services, to highly deprived areas may help reduce persistent stillbirth disparities.
{"title":"Association Between Neighborhood Social Determinants of Health and Stillbirth.","authors":"Tetsuya Kawakita, Misa Hayasaka, Ann M Harper, John Brush, George Saade","doi":"10.1097/AOG.0000000000006115","DOIUrl":"10.1097/AOG.0000000000006115","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association between neighborhood-level social determinants of health and stillbirth.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of deliveries that occurred at a gestational age of at least 20 weeks within a five-hospital system (2012-2022). Electronic health record data mapped to the Observational Medical Outcomes Partnership Common Data Model were geocoded using addresses at the time of delivery and linked to neighborhood health indices, which included the Area Deprivation Index (ADI), Maternal Vulnerability Index (MVI), and Social Vulnerability Index (SVI) at the Census tract level. Stillbirths were adjudicated by medical record review. Modified Poisson regression generated relative risks (RRs) and 95% CIs, controlling for maternal age, body mass index (BMI), parity, marital status, chronic hypertension, and pregestational diabetes.</p><p><strong>Results: </strong>Among 61,008 pregnancies, 288 (0.5%, 95% CI, 0.4-0.5%) resulted in stillbirths. The ADI quartiles (relative to Census tracts within the United States as a whole) 2, 3, and 4 were associated with an increased risk of stillbirth (RR [95% CI] 2.32 [1.34-4.03], 3.08 [1.74-5.44], and 2.07 [1.03-4.14], respectively) compared with quartile 1. The ADI relative to Census tracts within the states showed comparable gradients. MVI quartiles 2 and 3 were associated with an increased risk of stillbirth (RR [95% CI] 1.44 [1.01-2.05] and 1.49 [1.02-2.19], respectively) compared with quartile 1. Similarly, SVI quartiles 2 and 3 were associated with an increased risk of stillbirth (RR [95% CI] 1.46 [1.03-2.07] and 1.86 [1.32-2.63], respectively) compared with quartile 1. Neither MVI nor SVI quartile 4 showed a statistically significant association with stillbirth. Among MVI subthemes, the mental health domain demonstrated a strong association with stillbirth (quartiles 2-4 RR range 1.64-2.07).</p><p><strong>Conclusion: </strong>Neighborhood deprivation, quantified by ADI score, was a robust independent predictor of stillbirth, whereas the associations between the MVI or SVI and stillbirth were modest. Integrating the ADI into obstetric risk assessment and directing resources, especially perinatal mental health services, to highly deprived areas may help reduce persistent stillbirth disparities.</p>","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":" ","pages":"139-147"},"PeriodicalIF":4.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12794715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1097/aog.0000000000006144
Teresa K L Boitano,Charles A Leath
{"title":"Evolving Paradigms in Human Papillomavirus-Associated Vulvar Intraepithelial Neoplasia Management: Surgery, Immunotherapy, and the Pursuit of Functional Outcomes.","authors":"Teresa K L Boitano,Charles A Leath","doi":"10.1097/aog.0000000000006144","DOIUrl":"https://doi.org/10.1097/aog.0000000000006144","url":null,"abstract":"","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"20 1","pages":"148-150"},"PeriodicalIF":7.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-29DOI: 10.1097/aog.0000000000006190
Rebecca B Perkins,Jessica B DiSilvestro
{"title":"Human Papillomavirus Self-Collection: It's Time to Support Patient Choice.","authors":"Rebecca B Perkins,Jessica B DiSilvestro","doi":"10.1097/aog.0000000000006190","DOIUrl":"https://doi.org/10.1097/aog.0000000000006190","url":null,"abstract":"","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"24 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1097/aog.0000000000006162
Cynthia Gyamfi-Bannerman,Rebecca G Clifton,Robert A Wise,Alan T N Tita,Jessica A de Voest,Sharon A McGrath-Morrow,Elizabeth C Matsui,Sean C Blackwell,Monica Longo,Sabine Z Bousleiman,Felecia Ortiz,Sankaran Krishnan,Dwight J Rouse,Torri D Metz,George R Saade,Maged M Costantine,Kent D Heyborne,John M Thorp,Kelly S Gibson,Geeta K Swamy,William A Grobman,Yasser Y El-Sayed,George A Macones,
OBJECTIVETo evaluate whether antenatal betamethasone affects childhood respiratory impairment.METHODSThis was a prospective follow-up study of children aged 6 years and older from parents in the ALPS (Antenatal Late Preterm Steroids) trial randomized to betamethasone or placebo from 34 0/7 to 36 6/7 weeks of gestation. Primary outcome composite included the following: 1) abnormal spirometry, forced expiratory volume in 1 second (FEV1) below the lower limit of normal, FEV1/forced vital capacity (FVC) below the lower limit of normal, or FVC below the lower limit of normal, defined as below the 5th percentile by the Global Lung Initiative; 2) physician-diagnosed asthma and daily asthma medication; or 3) daily asthma medication use in the past year. Children whose parents were enrolled in a concurrent trial were recruited to provide a term reference cohort for lung function. Adjusted analyses were performed controlling for confounders.RESULTSOf 2,831 ALPS children, 1,218 enrolled, and 1,194 (98.0%) completed spirometry. There were no differences in the primary outcome (35.3% betamethasone, 35.8% placebo; adjusted relative risk [RR] 1.02, 95% CI, 0.87-1.18) or its individual components, although ever-noting wheezing or whistling in the chest was less common (40.7% betamethasone, 45.5% placebo, adjusted RR 0.88, 95% CI, 0.77-0.996). Compared with 432 children from the term reference cohort, ALPS children had more wheezing with exercise in the past year (7.2% betamethasone vs 4.4% term control group, adjusted RR 1.77, 95% CI, 1.03-3.06; 8.8% placebo vs term control group, adjusted RR 2.09, 95% CI, 1.25-3.48).CONCLUSIONAmong children aged 6 years or older, late preterm antenatal exposure to betamethasone was associated with lower rates of wheezing or whistling in the chest but no differences in other respiratory outcomes.
{"title":"Childhood Pulmonary Outcomes After Late Preterm Antenatal Corticosteroids.","authors":"Cynthia Gyamfi-Bannerman,Rebecca G Clifton,Robert A Wise,Alan T N Tita,Jessica A de Voest,Sharon A McGrath-Morrow,Elizabeth C Matsui,Sean C Blackwell,Monica Longo,Sabine Z Bousleiman,Felecia Ortiz,Sankaran Krishnan,Dwight J Rouse,Torri D Metz,George R Saade,Maged M Costantine,Kent D Heyborne,John M Thorp,Kelly S Gibson,Geeta K Swamy,William A Grobman,Yasser Y El-Sayed,George A Macones, ","doi":"10.1097/aog.0000000000006162","DOIUrl":"https://doi.org/10.1097/aog.0000000000006162","url":null,"abstract":"OBJECTIVETo evaluate whether antenatal betamethasone affects childhood respiratory impairment.METHODSThis was a prospective follow-up study of children aged 6 years and older from parents in the ALPS (Antenatal Late Preterm Steroids) trial randomized to betamethasone or placebo from 34 0/7 to 36 6/7 weeks of gestation. Primary outcome composite included the following: 1) abnormal spirometry, forced expiratory volume in 1 second (FEV1) below the lower limit of normal, FEV1/forced vital capacity (FVC) below the lower limit of normal, or FVC below the lower limit of normal, defined as below the 5th percentile by the Global Lung Initiative; 2) physician-diagnosed asthma and daily asthma medication; or 3) daily asthma medication use in the past year. Children whose parents were enrolled in a concurrent trial were recruited to provide a term reference cohort for lung function. Adjusted analyses were performed controlling for confounders.RESULTSOf 2,831 ALPS children, 1,218 enrolled, and 1,194 (98.0%) completed spirometry. There were no differences in the primary outcome (35.3% betamethasone, 35.8% placebo; adjusted relative risk [RR] 1.02, 95% CI, 0.87-1.18) or its individual components, although ever-noting wheezing or whistling in the chest was less common (40.7% betamethasone, 45.5% placebo, adjusted RR 0.88, 95% CI, 0.77-0.996). Compared with 432 children from the term reference cohort, ALPS children had more wheezing with exercise in the past year (7.2% betamethasone vs 4.4% term control group, adjusted RR 1.77, 95% CI, 1.03-3.06; 8.8% placebo vs term control group, adjusted RR 2.09, 95% CI, 1.25-3.48).CONCLUSIONAmong children aged 6 years or older, late preterm antenatal exposure to betamethasone was associated with lower rates of wheezing or whistling in the chest but no differences in other respiratory outcomes.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"920 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1097/aog.0000000000006175
Fanny Njie,Ashley A Busacker,Crystal Gibson,Carla Syverson,Kristi Seed,David A Goodman,Lisa M Hollier
Pregnancy Mortality Surveillance System (PMSS) data from 2012-2022 were analyzed for this descriptive study. Specific subclassifications of deaths within the PMSS category of "other noncardiovascular medical conditions" (OMC) were analyzed by sociodemographic characteristics, and pregnancy-related mortality ratios (PRMRs; pregnancy-related deaths/100,000 live births) were calculated within each subclassification. Prepandemic (2012-2019) and coronavirus disease 2019 (COVID-19) pandemic (2020-2022) time periods are reported separately. The overall OMC-specific PRMR was 2.20 (95% CI, 2.06-2.35). Epilepsy was the most frequent specific subclassification of pregnancy-related OMC deaths before (15.7%) and during (16.1%) the COVID-19 pandemic. Diabetes (10.7%) and asthma (10.1%) followed epilepsy prepandemic, and asthma (13.1%) and diabetes (10.2%) followed during the pandemic. Reporting subclassifications of pregnancy-related deaths improves the ability to focus attention and interventions on these less frequently occurring consistent causes of pregnancy-related death.
{"title":"Noncardiovascular Medical Conditions in the Pregnancy Mortality Surveillance System, 2012-2022.","authors":"Fanny Njie,Ashley A Busacker,Crystal Gibson,Carla Syverson,Kristi Seed,David A Goodman,Lisa M Hollier","doi":"10.1097/aog.0000000000006175","DOIUrl":"https://doi.org/10.1097/aog.0000000000006175","url":null,"abstract":"Pregnancy Mortality Surveillance System (PMSS) data from 2012-2022 were analyzed for this descriptive study. Specific subclassifications of deaths within the PMSS category of \"other noncardiovascular medical conditions\" (OMC) were analyzed by sociodemographic characteristics, and pregnancy-related mortality ratios (PRMRs; pregnancy-related deaths/100,000 live births) were calculated within each subclassification. Prepandemic (2012-2019) and coronavirus disease 2019 (COVID-19) pandemic (2020-2022) time periods are reported separately. The overall OMC-specific PRMR was 2.20 (95% CI, 2.06-2.35). Epilepsy was the most frequent specific subclassification of pregnancy-related OMC deaths before (15.7%) and during (16.1%) the COVID-19 pandemic. Diabetes (10.7%) and asthma (10.1%) followed epilepsy prepandemic, and asthma (13.1%) and diabetes (10.2%) followed during the pandemic. Reporting subclassifications of pregnancy-related deaths improves the ability to focus attention and interventions on these less frequently occurring consistent causes of pregnancy-related death.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"42 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1097/aog.0000000000006174
Rajita Patil,Rebecca Woofter,May Sudhinaraset,Jessica D Gipson
OBJECTIVETo compare the efficacy and safety of telemedicine medication abortion and clinic-based medication abortion among patients at one academic health system in California.METHODSWe conducted a retrospective cohort study of electronic medical records for all patients who had either telemedicine medication abortion or clinic-based medication abortion up to 77 days of gestation between April 1, 2020, and December 31, 2022. All patients who met eligibility requirements were offered telemedicine medication abortion. Patients who were not eligible for or did not prefer telemedicine medication abortion completed clinic-based medication abortion. We examined attendance at follow-up visits, successful medication abortion without requiring surgical intervention, and occurrence of serious adverse events. Among patients who had telemedicine medication abortion, we also examined attendance at 4-week follow-up visits and results of home urine pregnancy tests.RESULTSOverall, 165 patients who had telemedicine medication abortion and 411 patients who had clinic-based medication abortion were included in the study. A total of 91.6% of patients who had telemedicine medication abortion and 84.5% of patients who had clinic-based medication abortion completed at least one follow-up visit, with no significant difference detected by modality after controlling for covariates (adjusted odds ratio [aOR] 1.90, 95% CI, 0.96-3.77). Ninety percent of patients who had telemedicine medication abortion and 88.4% of patients who had clinic-based medication abortion had successful abortions without requiring surgical intervention. Odds of successful abortions did not statistically significantly differ by medication abortion modality (aOR 0.78, 95% CI, 0.38-1.59). Because of the rarity of serious adverse events (less than 1% in both groups, all requiring either intravenous antibiotics or blood transfusions), we could not complete multivariable models for this outcome.CONCLUSIONOur findings from one academic health system in California support prior studies showing that telemedicine medication abortion and clinic-based medication abortion are equally effective. When possible, the provision of telemedicine medication abortion should be expanded to meet the growing demand for abortion access.
目的比较加州某学术卫生系统远程医疗药物流产与临床药物流产的疗效和安全性。方法对2020年4月1日至2022年12月31日期间妊娠77天以内的所有远程医疗药物流产或临床药物流产患者的电子病历进行回顾性队列研究。所有符合资格要求的患者均被提供远程医疗药物流产。不符合或不喜欢远程医疗药物流产的患者完成了基于临床的药物流产。我们检查了随访的出席率，不需要手术干预的药物流产的成功，以及严重不良事件的发生。在远程医疗药物流产的患者中，我们还检查了4周随访的出勤率和家庭尿妊娠试验的结果。结果共纳入165例远程医疗药物流产患者和411例临床药物流产患者。91.6%的远程医疗药物流产患者和84.5%的临床药物流产患者完成了至少一次随访，在控制协变量后，两组间的模态差异无统计学意义（校正优势比[aOR] 1.90, 95% CI, 0.96-3.77）。90%的远程医疗药物流产患者和88.4%的临床药物流产患者在不需要手术干预的情况下成功流产。不同药物流产方式流产成功率差异无统计学意义（aOR 0.78, 95% CI 0.38-1.59）。由于严重不良事件的罕见性（两组均小于1%，均需要静脉注射抗生素或输血），我们无法完成该结果的多变量模型。结论：我们在加州一个学术卫生系统的研究结果支持了先前的研究，即远程医疗药物流产和临床药物流产同样有效。在可能的情况下，应扩大提供远程医疗药物堕胎，以满足日益增长的堕胎服务需求。
{"title":"Comparing Efficacy of Medication Abortion by Health Care Modality at a California Health System.","authors":"Rajita Patil,Rebecca Woofter,May Sudhinaraset,Jessica D Gipson","doi":"10.1097/aog.0000000000006174","DOIUrl":"https://doi.org/10.1097/aog.0000000000006174","url":null,"abstract":"OBJECTIVETo compare the efficacy and safety of telemedicine medication abortion and clinic-based medication abortion among patients at one academic health system in California.METHODSWe conducted a retrospective cohort study of electronic medical records for all patients who had either telemedicine medication abortion or clinic-based medication abortion up to 77 days of gestation between April 1, 2020, and December 31, 2022. All patients who met eligibility requirements were offered telemedicine medication abortion. Patients who were not eligible for or did not prefer telemedicine medication abortion completed clinic-based medication abortion. We examined attendance at follow-up visits, successful medication abortion without requiring surgical intervention, and occurrence of serious adverse events. Among patients who had telemedicine medication abortion, we also examined attendance at 4-week follow-up visits and results of home urine pregnancy tests.RESULTSOverall, 165 patients who had telemedicine medication abortion and 411 patients who had clinic-based medication abortion were included in the study. A total of 91.6% of patients who had telemedicine medication abortion and 84.5% of patients who had clinic-based medication abortion completed at least one follow-up visit, with no significant difference detected by modality after controlling for covariates (adjusted odds ratio [aOR] 1.90, 95% CI, 0.96-3.77). Ninety percent of patients who had telemedicine medication abortion and 88.4% of patients who had clinic-based medication abortion had successful abortions without requiring surgical intervention. Odds of successful abortions did not statistically significantly differ by medication abortion modality (aOR 0.78, 95% CI, 0.38-1.59). Because of the rarity of serious adverse events (less than 1% in both groups, all requiring either intravenous antibiotics or blood transfusions), we could not complete multivariable models for this outcome.CONCLUSIONOur findings from one academic health system in California support prior studies showing that telemedicine medication abortion and clinic-based medication abortion are equally effective. When possible, the provision of telemedicine medication abortion should be expanded to meet the growing demand for abortion access.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"263 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1097/aog.0000000000006170
Sarah M Lindley,Kimberly B Glazer,Teresa Janevic,Molly Passarella,Angelina Malenda,Natalia N Egorova,Jennifer Zeitlin,Scott A Lorch,Elizabeth A Howell
Individuals with Medicaid insurance are more likely to have pregnancy-related complications than individuals with private insurance, but previous research has not described postpartum hospital use in the population of patients with Medicaid. Using Medicaid claims data, we analyzed time to the first instance of postpartum hospital use during the postpartum year using Kaplan-Meier curves and described causes of postpartum hospital use at different postpartum windows. Among 1,626,056 birthing individuals, 20.7% had postpartum hospital use at 1 year postpartum. We found a higher proportion of postpartum hospital use after the typical 30-day postpartum analysis window than within the initial 30 days postpartum, with causes of postpartum hospital use shifting away from delivery-related causes over time. This highlights the need to better understand postpartum hospital use in the population of patients with Medicaid insurance, because 40% of births in the United States occur in this population.
{"title":"Understanding Postpartum Hospital Use Among Birthing People With Medicaid Insurance.","authors":"Sarah M Lindley,Kimberly B Glazer,Teresa Janevic,Molly Passarella,Angelina Malenda,Natalia N Egorova,Jennifer Zeitlin,Scott A Lorch,Elizabeth A Howell","doi":"10.1097/aog.0000000000006170","DOIUrl":"https://doi.org/10.1097/aog.0000000000006170","url":null,"abstract":"Individuals with Medicaid insurance are more likely to have pregnancy-related complications than individuals with private insurance, but previous research has not described postpartum hospital use in the population of patients with Medicaid. Using Medicaid claims data, we analyzed time to the first instance of postpartum hospital use during the postpartum year using Kaplan-Meier curves and described causes of postpartum hospital use at different postpartum windows. Among 1,626,056 birthing individuals, 20.7% had postpartum hospital use at 1 year postpartum. We found a higher proportion of postpartum hospital use after the typical 30-day postpartum analysis window than within the initial 30 days postpartum, with causes of postpartum hospital use shifting away from delivery-related causes over time. This highlights the need to better understand postpartum hospital use in the population of patients with Medicaid insurance, because 40% of births in the United States occur in this population.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"39 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-16DOI: 10.1097/aog.0000000000006180
{"title":"Expression of Concern: Fezolinetant and Elinzanetant Therapy for Menopausal Women Experiencing Vasomotor Symptoms: A Systematic Review and Meta-Analysis.","authors":"","doi":"10.1097/aog.0000000000006180","DOIUrl":"https://doi.org/10.1097/aog.0000000000006180","url":null,"abstract":"","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"18 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-15DOI: 10.1097/aog.0000000000006167
Erica A Heilman,Hannah E Sweeney,Ella Stern,Matthew K Hoffman
BACKGROUNDShoulder dystocia is an obstetric emergency with the potential to cause maternal and neonatal injuries.TECHNIQUEThe hook & roll maneuver is a modification of other posterior axilla maneuvers that involves hooking the posterior axilla with one finger and providing gentle traction, elevating the posterior shoulder toward the vaginal opening while simultaneously rolling the anterior shoulder toward the fetal face and rotating approximately 30-90°.EXPERIENCEAt the time of this submission, the hook & roll maneuver has been used 54 times in our institution, successfully resolving shoulder dystocia in 53 of the 54 cases (98.1%). In 16 cases in which the hook & roll maneuver was used as the primary internal maneuver, no neonatal injuries occurred.CONCLUSIONHook & roll is a posterior axilla maneuver combined with rotation of the anterior shoulder ventrally that is highly successful and easy to perform. The hook & roll maneuver is a promising alternative maneuver to consider in cases of shoulder dystocia, and early data suggest low rates of neonatal complications.
{"title":"The Hook & Roll Maneuver for Resolution of Shoulder Dystocia.","authors":"Erica A Heilman,Hannah E Sweeney,Ella Stern,Matthew K Hoffman","doi":"10.1097/aog.0000000000006167","DOIUrl":"https://doi.org/10.1097/aog.0000000000006167","url":null,"abstract":"BACKGROUNDShoulder dystocia is an obstetric emergency with the potential to cause maternal and neonatal injuries.TECHNIQUEThe hook & roll maneuver is a modification of other posterior axilla maneuvers that involves hooking the posterior axilla with one finger and providing gentle traction, elevating the posterior shoulder toward the vaginal opening while simultaneously rolling the anterior shoulder toward the fetal face and rotating approximately 30-90°.EXPERIENCEAt the time of this submission, the hook & roll maneuver has been used 54 times in our institution, successfully resolving shoulder dystocia in 53 of the 54 cases (98.1%). In 16 cases in which the hook & roll maneuver was used as the primary internal maneuver, no neonatal injuries occurred.CONCLUSIONHook & roll is a posterior axilla maneuver combined with rotation of the anterior shoulder ventrally that is highly successful and easy to perform. The hook & roll maneuver is a promising alternative maneuver to consider in cases of shoulder dystocia, and early data suggest low rates of neonatal complications.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"8 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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