Pub Date : 2025-12-11DOI: 10.1016/j.ajogmf.2025.101873
Michael R. Foley MD
{"title":"Tasting the strawberry: a reflection for the maternal-fetal medicine physician","authors":"Michael R. Foley MD","doi":"10.1016/j.ajogmf.2025.101873","DOIUrl":"10.1016/j.ajogmf.2025.101873","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 2","pages":"Article 101873"},"PeriodicalIF":3.1,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752235","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 : 2025-12-07DOI: 10.1016/j.ajogmf.2025.101865
Karley Dutra MD , Jonathan M. Fenkel MD, FACP, FAASLD
Hepatitis C virus (HCV) infection has become a public health crisis in the last few decades, with a significant impact on individuals of reproductive age. Direct-acting antivirals (DAAs) were introduced in 2011 and are highly effective at eradicating HCV infection through 8- to 12-week treatment courses, making them the mainstay of treatment for nonpregnant adults. Obstetric guidelines have not recommended treatment of HCV infection during pregnancy due to more limited data on DAA use during pregnancy. The risk of perinatal transmission of HCV is up to 9%, with at least one-third of transmissions occurring antenatally. Infant follow-up after perinatal exposure to HCV infection has been poor due to loss to care and a long latency to recommended testing. In recent years, there has been a growing body of evidence that DAAs are safe and effective in pregnancy, with similar cure rates as nonpregnant adults. Pregnancy represents a time when individuals are continuously engaged in care, providing an optimal window for treatment of HCV infection. Obstetrician/gynecologists should employ shared decision-making surrounding treatment of HCV infection during pregnancy, acknowledging the benefits and efficacy of treatment versus the available data on DAA exposure in pregnancy. Therapy should be initiated during the second or third trimesters, with limited but reassuring data on DAA exposure through breastmilk. Ledipasvir/sofosbuvir and sofosbuvir/velpatasvir currently have the most data available in pregnancy and should be included in conversations regarding HCV treatment in pregnancy. Multidisciplinary care between maternal-fetal medicine, infectious disease, and hepatology can help promote access to HCV treatment in pregnancy.
{"title":"Hepatitis C treatment during pregnancy: time for a practice change","authors":"Karley Dutra MD , Jonathan M. Fenkel MD, FACP, FAASLD","doi":"10.1016/j.ajogmf.2025.101865","DOIUrl":"10.1016/j.ajogmf.2025.101865","url":null,"abstract":"<div><div>Hepatitis C virus (HCV) infection has become a public health crisis in the last few decades, with a significant impact on individuals of reproductive age. Direct-acting antivirals (DAAs) were introduced in 2011 and are highly effective at eradicating HCV infection through 8- to 12-week treatment courses, making them the mainstay of treatment for nonpregnant adults. Obstetric guidelines have not recommended treatment of HCV infection during pregnancy due to more limited data on DAA use during pregnancy. The risk of perinatal transmission of HCV is up to 9%, with at least one-third of transmissions occurring antenatally. Infant follow-up after perinatal exposure to HCV infection has been poor due to loss to care and a long latency to recommended testing. In recent years, there has been a growing body of evidence that DAAs are safe and effective in pregnancy, with similar cure rates as nonpregnant adults. Pregnancy represents a time when individuals are continuously engaged in care, providing an optimal window for treatment of HCV infection. Obstetrician/gynecologists should employ shared decision-making surrounding treatment of HCV infection during pregnancy, acknowledging the benefits and efficacy of treatment versus the available data on DAA exposure in pregnancy. Therapy should be initiated during the second or third trimesters, with limited but reassuring data on DAA exposure through breastmilk. Ledipasvir/sofosbuvir and sofosbuvir/velpatasvir currently have the most data available in pregnancy and should be included in conversations regarding HCV treatment in pregnancy. Multidisciplinary care between maternal-fetal medicine, infectious disease, and hepatology can help promote access to HCV treatment in pregnancy.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 2","pages":"Article 101865"},"PeriodicalIF":3.1,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716014","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 : 2025-12-06DOI: 10.1016/j.ajogmf.2025.101871
Brian A Burnett, Christian M Parobek, Ahmed A Nassr
{"title":"Cardiogenic hydrops and placental thickening are independent predictors of maternal mirror syndrome.","authors":"Brian A Burnett, Christian M Parobek, Ahmed A Nassr","doi":"10.1016/j.ajogmf.2025.101871","DOIUrl":"10.1016/j.ajogmf.2025.101871","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101871"},"PeriodicalIF":3.1,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709988","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 : 2025-12-06DOI: 10.1016/j.ajogmf.2025.101868
Arielle J. Higgs MD , Karl E. Seif MD
{"title":"Beyond 23+6: rethinking cerclage eligibility in the age of early viability","authors":"Arielle J. Higgs MD , Karl E. Seif MD","doi":"10.1016/j.ajogmf.2025.101868","DOIUrl":"10.1016/j.ajogmf.2025.101868","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 2","pages":"Article 101868"},"PeriodicalIF":3.1,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709976","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 : 2025-12-03DOI: 10.1016/j.ajogmf.2025.101869
Johanna Quist-Nelson MD , Marie-Louise Meng MD , Janet Rich-Edwards ScD , Matthew Fuller MS , Chuan Hong PhD , Michael Pencina PhD , Kim Boggess MD , Ricardo Henao PhD , Jennifer Stuart ScD
BACKGROUND
There are limited data defining the rate of progression of the development of adverse pregnancy outcomes and short-term cardiovascular risk factors in a contemporary cohort.
OBJECTIVE
This study aimed to examine the association between adverse pregnancy outcomes and short-term cardiovascular disease risk factors in a contemporary population.
STUDY DESIGN
This was a hospital-based electronic health record retrospective cohort study from 2 healthcare systems in North Carolina. Patients who gave birth between 2016 and 2020, were free of cardiovascular disease risk factors or events at delivery, and had >1 prenatal care appointment during pregnancy and 1 postnatal care appointment ≤3 months after delivery were included in the study. However, only the first pregnancy in the study period was included. Adverse pregnancy outcomes were defined using the International Classification of Diseases, 10th Revision, codes for preeclampsia, gestational hypertension, gestational diabetes mellitus, preterm birth, and small-for-gestational-age infant. The development of a short-term cardiovascular disease risk factor was defined as a new diagnosis of chronic hypertension, hyperlipidemia, diabetes mellitus, or prediabetes mellitus by December 31, 2021. Cox proportional hazards regression was used to model associations between adverse pregnancy outcomes and cardiovascular disease risk factors.
RESULTS
A total of 32,623 patients were included in this study. More than a quarter of the patients (8965 [27.5%]) experienced at least 1 adverse pregnancy outcome, with more patients with an adverse pregnancy outcome developing a cardiovascular disease risk factor during follow-up than those without an adverse pregnancy outcome (9.5% vs 3.2%, respectively). Patients with any adverse pregnancy outcomes were 3 times more likely to be diagnosed with a cardiovascular disease risk factor (hazard ratio, 3.11 [95% confidence interval, 2.87–3.38]) and had a median time to event of 1.98 years (interquartile range, 0.82–3.34). The highest risks were observed in patients with gestational diabetes mellitus developing type 2 diabetes mellitus (hazard ratio, 21.29 [95% confidence interval, 16.49–27.47]) and in those with preeclampsia developing chronic hypertension (hazard ratio, 6.35 [95% confidence interval, 5.51–7.32]).
CONCLUSION
A pregnancy complicated by an adverse pregnancy outcome is associated with a 3-fold increased risk of developing cardiovascular disease risk factors as early as 2 years after delivery. These findings highlight the importance of screening for cardiovascular disease risk factors in the early years after delivery for patients who experienced an adverse pregnancy outcome.
{"title":"Adverse pregnancy outcomes and development of short-term cardiovascular disease risk factors","authors":"Johanna Quist-Nelson MD , Marie-Louise Meng MD , Janet Rich-Edwards ScD , Matthew Fuller MS , Chuan Hong PhD , Michael Pencina PhD , Kim Boggess MD , Ricardo Henao PhD , Jennifer Stuart ScD","doi":"10.1016/j.ajogmf.2025.101869","DOIUrl":"10.1016/j.ajogmf.2025.101869","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>There are limited data defining the rate of progression of the development of adverse pregnancy outcomes and short-term cardiovascular risk factors in a contemporary cohort.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to examine the association between adverse pregnancy outcomes and short-term cardiovascular disease risk factors in a contemporary population.</div></div><div><h3>STUDY DESIGN</h3><div>This was a hospital-based electronic health record retrospective cohort study from 2 healthcare systems in North Carolina. Patients who gave birth between 2016 and 2020, were free of cardiovascular disease risk factors or events at delivery, and had >1 prenatal care appointment during pregnancy and 1 postnatal care appointment ≤3 months after delivery were included in the study. However, only the first pregnancy in the study period was included. Adverse pregnancy outcomes were defined using the International Classification of Diseases, 10th Revision, codes for preeclampsia, gestational hypertension, gestational diabetes mellitus, preterm birth, and small-for-gestational-age infant. The development of a short-term cardiovascular disease risk factor was defined as a new diagnosis of chronic hypertension, hyperlipidemia, diabetes mellitus, or prediabetes mellitus by December 31, 2021. Cox proportional hazards regression was used to model associations between adverse pregnancy outcomes and cardiovascular disease risk factors.</div></div><div><h3>RESULTS</h3><div>A total of 32,623 patients were included in this study. More than a quarter of the patients (8965 [27.5%]) experienced at least 1 adverse pregnancy outcome, with more patients with an adverse pregnancy outcome developing a cardiovascular disease risk factor during follow-up than those without an adverse pregnancy outcome (9.5% vs 3.2%, respectively). Patients with any adverse pregnancy outcomes were 3 times more likely to be diagnosed with a cardiovascular disease risk factor (hazard ratio, 3.11 [95% confidence interval, 2.87–3.38]) and had a median time to event of 1.98 years (interquartile range, 0.82–3.34). The highest risks were observed in patients with gestational diabetes mellitus developing type 2 diabetes mellitus (hazard ratio, 21.29 [95% confidence interval, 16.49–27.47]) and in those with preeclampsia developing chronic hypertension (hazard ratio, 6.35 [95% confidence interval, 5.51–7.32]).</div></div><div><h3>CONCLUSION</h3><div>A pregnancy complicated by an adverse pregnancy outcome is associated with a 3-fold increased risk of developing cardiovascular disease risk factors as early as 2 years after delivery. These findings highlight the importance of screening for cardiovascular disease risk factors in the early years after delivery for patients who experienced an adverse pregnancy outcome.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 2","pages":"Article 101869"},"PeriodicalIF":3.1,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688301","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 : 2025-12-01DOI: 10.1016/j.ajogmf.2025.101792
Jesrine Hong MObGyn, Mukhri Hamdan PhD, Peng Chiong Tan PhD
{"title":"Reply to: Regarding “Antenatal dexamethasone versus betamethasone on glycemic control in mild gestational diabetes: A randomized clinical trial”","authors":"Jesrine Hong MObGyn, Mukhri Hamdan PhD, Peng Chiong Tan PhD","doi":"10.1016/j.ajogmf.2025.101792","DOIUrl":"10.1016/j.ajogmf.2025.101792","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 12","pages":"Article 101792"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145680765","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 : 2025-12-01DOI: 10.1016/j.ajogmf.2025.101810
Alisse Hauspurg MD, MS, Rodolfo Fernandez Criado MD, Tracy L. Jackson PhD, Scott Machado, Nicole Konecki, Samantha E. Parker PhD, Kerrie P. Nelson PhD, Danielle Simmons NP, Maria Mejia Castillo BA, William Hunt, Nina K. Ayala MD, ScM, Methodius G. Tuuli MD, MPH, MBA, Adam K. Lewkowitz MD, MPHS
{"title":"Outcomes and engagement among Spanish- versus English-speaking participants in a remote postpartum blood pressure monitoring program","authors":"Alisse Hauspurg MD, MS, Rodolfo Fernandez Criado MD, Tracy L. Jackson PhD, Scott Machado, Nicole Konecki, Samantha E. Parker PhD, Kerrie P. Nelson PhD, Danielle Simmons NP, Maria Mejia Castillo BA, William Hunt, Nina K. Ayala MD, ScM, Methodius G. Tuuli MD, MPH, MBA, Adam K. Lewkowitz MD, MPHS","doi":"10.1016/j.ajogmf.2025.101810","DOIUrl":"10.1016/j.ajogmf.2025.101810","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 12","pages":"Article 101810"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681294","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 : 2025-12-01DOI: 10.1016/j.ajogmf.2025.101764
Grace E. Fuller BA, Timothy Wen MD, MPH, Fiamma van Biema MA, Suneet P. Chauhan MD, Hon DSc, Alexander M. Friedman MD, MPH, Teresa C. Logue MD, MPH
{"title":"Severe maternal morbidity among births to American Indians and Alaska Natives, 2000–2021","authors":"Grace E. Fuller BA, Timothy Wen MD, MPH, Fiamma van Biema MA, Suneet P. Chauhan MD, Hon DSc, Alexander M. Friedman MD, MPH, Teresa C. Logue MD, MPH","doi":"10.1016/j.ajogmf.2025.101764","DOIUrl":"10.1016/j.ajogmf.2025.101764","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 12","pages":"Article 101764"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681295","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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