American Journal of Obstetrics & Gynecology Mfm最新文献

{"title":"Patterns of opioid prescription fills in birthing people undergoing vaginal and cesarean birth in the United States","authors":"","doi":"10.1016/j.ajogmf.2024.101472","DOIUrl":"10.1016/j.ajogmf.2024.101472","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074127","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}

{"title":"Cochrane Update: news and reviews from the Cochrane US Network.","authors":"Chris E Philip, Ethan Litman, Barbara O'Brien, Jeanne-Marie Guise, David M Haas","doi":"10.1016/j.ajogmf.2024.101473","DOIUrl":"10.1016/j.ajogmf.2024.101473","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074126","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}

{"title":"External validation and comparison of four prediction scores for severe maternal morbidity","authors":"","doi":"10.1016/j.ajogmf.2024.101471","DOIUrl":"10.1016/j.ajogmf.2024.101471","url":null,"abstract":"<div><h3>Background</h3><p>Severe maternal morbidity (SMM) is increasing in the United States. Several tools and scores exist to stratify an individual's risk of SMM.</p></div><div><h3>Objective</h3><p>We sought to examine and compare the validity of four scoring systems for predicting SMM.</p></div><div><h3>Study Design</h3><p>This was a retrospective cohort study of all individuals in the Consortium on Safe Labor dataset, which was conducted from 2002 to 2008. Individuals were excluded if they had missing information on risk factors. SMM was defined based on the Centers for Disease Control and Prevention excluding blood transfusion. Blood transfusion was excluded due to concerns regarding the specificity of International Classification of Diseases codes for this indicator and its variable clinical significance. Risk scores were calculated for each participant using the Assessment of Perinatal Excellence (APEX), California Maternal Quality Care Collaborative (CMQCC), Obstetric Comorbidity Index (OB-CMI), and modified OB-CMI. We calculated the probability of SMM according to the risk scores. The discriminative performance of the prediction score was examined by the areas under receiver operating characteristic curves and their 95% confidence intervals (95% CI). The area under the curve for each score was compared using the bootstrap resampling. Calibration plots were developed for each score to examine the goodness-of-fit. The concordance probability method was used to define an optimal cutoff point for the best-performing score.</p></div><div><h3>Results</h3><p>Of 153, 463 individuals, 1115 (0.7%) had SMM. The CMQCC scoring system had a significantly higher area under the curve (95% CI) (0.78 [0.77–0.80]) compared to the APEX scoring system, OB-CMI, and modified OB-CMI scoring systems (0.75 [0.73–0.76], 0.67 [0.65–0.68], 0.66 [0.70–0.73]; <em>P</em>&lt;.001). Calibration plots showed excellent concordance between the predicted and actual SMM for the APEX scoring system and OB-CMI (both Hosmer–Lemeshow test <em>P</em> values=1.00, suggesting goodness-of-fit).</p></div><div><h3>Conclusion</h3><p>This study validated four risk-scoring systems to predict SMM. Both CMQCC and APEX scoring systems had good discrimination to predict SMM. The APEX score and the OB-CMI had goodness-of-fit. At ideal calculated cut-off points, the APEX score had the highest sensitivity of the four scores at 71%, indicating that better scoring systems are still needed for predicting SMM.</p></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047296","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}

{"title":"Genomic abnormalities in apparently isolated polyhydramnios and the role of confirmed fetal phenotype: a systematic review and meta-analysis.","authors":"Evangelia Tsakmaki, Athina Ververi, Christos Chatzakis, Paolo Cavoretto, Alexandros Sotiriadis","doi":"10.1016/j.ajogmf.2024.101469","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2024.101469","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this systematic review and meta-analysis was to assess the rate of genomic abnormalities detected in pregnancies with apparently isolated hydramnios and explore the role of confirmed fetal phenotype.</p><p><strong>Data sources: </strong>PubMed, Cochrane Library, Google Scholar and Scopus databases were searched up to May 4, 2024.</p><p><strong>Study eligibility criteria: </strong>Observational studies, published after the year 2000 and written in a European language, reporting on the genomic outcome of pregnancies complicated with prenatally diagnosed isolated polyhydramnios were included in this meta-analysis.</p><p><strong>Study appraisal and synthesis methods: </strong>The main outcome was the incidence of genomic abnormalities, defined as chromosomal numerical or structural anomalies or monogenic syndromes, diagnosed prenatally or postnatally in neonates from pregnancies complicated with isolated polyhydramnios. Additional outcomes included the incidence of chromosomal abnormalities including both numerical and structural aberrations of the chromosomes (detected by karyotype/chromosomal microarray [CMA]), monogenic abnormalities (detected by next-generation sequencing [NGS] or clinical genetic examination after the result of a normal karyotype/CMA), genetic syndromes in general (diagnosed clinically with or without genetic confirmation), and structural abnormalities detected postnatally. Pooled proportions were calculated for each outcome.</p><p><strong>Results: </strong>Twelve studies (2561 pregnancies complicated with isolated hydramnios) were included in the meta-analysis. The pooled prevalence of genomic anomalies in fetuses with apparently isolated polyhydramnios (12 studies, 2634 fetuses) was 4.5% (95%CI 2.6-7.6). The pooled prevalence of chromosomal abnormalities (11 studies, 2427 fetuses) was 2.1% (95%CI 1.1-3.7). The proportion of major structural defects detected postnatally (9 studies, 1731 fetuses) was 2.9% (95%CI 1.5-5.4); in this particular subgroup (4 studies, 14 fetuses), the pooled prevalence of genomic anomalies was 29.8% (95%CI 11.3-58.6). A meta-regression analysis indicated that the rate of genomic anomalies was positively associated with the severity of hydramnios. Also, the pooled rate of monogenic anomalies was 5.6% (95%CI 2-5; I² =58%) in the two studies using NGS for genomic diagnosis.</p><p><strong>Conclusions: </strong>This meta-analysis showed that the rate of genomic anomalies in apparently isolated polyhydramnios is 4.5%; approximately half of them are chromosomal abnormalities and the other half are non-chromosomal genomic anomalies. From a clinical standpoint, CMA and possibly NGS could be considered even in cases of apparently isolated polyhydramnios; this may be even more important in cases of incomplete fetal phenotype. Further studies using NGS and addressing cost-effectiveness issues would fine-tune such recommendations.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047297","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}

{"title":"Association of uterine fibroids with perinatal outcomes: a multicenter cohort study","authors":"","doi":"10.1016/j.ajogmf.2024.101452","DOIUrl":"10.1016/j.ajogmf.2024.101452","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000879","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}

{"title":"Reply to “Contractions of the lower uterine segment during transvaginal ultrasound cervical length: incidence, significance, proper measurement, and management”","authors":"","doi":"10.1016/j.ajogmf.2024.101468","DOIUrl":"10.1016/j.ajogmf.2024.101468","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005450","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}

{"title":"Evaluation of fecal incontinence after obstetric anal sphincter injury: a 12-year follow-up cohort study","authors":"","doi":"10.1016/j.ajogmf.2024.101461","DOIUrl":"10.1016/j.ajogmf.2024.101461","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996613","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}

{"title":"Association between timing of labor induction and neonatal and maternal outcomes: an observational study from China","authors":"","doi":"10.1016/j.ajogmf.2024.101456","DOIUrl":"10.1016/j.ajogmf.2024.101456","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND&lt;/h3&gt;&lt;p&gt;Growing evidence suggests that elective induction of labor at 39 weeks’ gestation may lead to more favorable perinatal outcomes than expectant management, however, how to weigh the pros and cons of elective labor induction at 39 weeks, the expectation of spontaneous delivery at 40 or 41 weeks, or delayed labor induction at 40 or 41 weeks on neonatal and maternal outcomes remains a practical challenge in clinical decision-making.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;p&gt;We compared the neonatal and maternal outcomes between elective induction of labor at 39 weeks’ gestation and expectant management in a real-world setting. We also divided the expectantly managed group and compared outcomes of the spontaneous delivery at 40 or 41 weeks’ gestation group and the induced group at 40 or 41 weeks’ gestation with those of the elective induction at 39 weeks’ gestation group.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN&lt;/h3&gt;&lt;p&gt;This retrospective cohort study included 21,282 participants who delivered between January 1, 2019, and June 30, 2022. Participants were initially categorized into 3 groups at 39 weeks’ gestation, namely elective induction of labor, spontaneous delivery, and expectant management, for the primary analysis in which elective induction was compared with expectant management. Subsequently, the expectant management group at 39 weeks’ gestation was divided into 3 groups at 40 weeks, and participants who underwent expectant management at 40 weeks were then divided into 2 groups at 41 weeks’ gestation, namely elective induction and spontaneous delivery. In total, 6 groups were compared in the secondary analysis with the elective induction at 39 weeks’ gestation group serving as the reference group.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;p&gt;At 39 weeks’ gestational age, participants who underwent elective induction of labor had a significantly lower risk for the primary composite outcomes than participants who were managed expectantly (adjusted odds ratio, 0.72; 95% confidence interval, 0.55–0.95), and there was no significant difference in the risk for cesarean delivery between the 2 groups. After further dividing the expectantly managed group and comparing them with participants who underwent elective induction of labor at 39 weeks’ gestation, those who underwent spontaneous delivery at 40 weeks’ gestation had significantly lower risks for cesarean delivery (0.61; 0.52–0.71) and chorioamnionitis (0.78; 0.61–1.00) but a higher risk for fetal distress (1.39; 1.22–1.57); those with spontaneous delivery at 41 weeks’ gestation had a significantly higher risk for fetal distress (1.44; 1.16–1.79), postpartum hemorrhage (1.83; 1.26–2.66), and prolonged or arrested labor (1.61; 1.02–2.54). Moreover, when compared with participants who underwent elective induction of labor at 39 weeks’ gestation, participants who were induced later in gestation had significantly higher risks for adverse neonatal and maternal outcomes, especially at 40 weeks’ gestation.&lt;","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589933324001824/pdfft?md5=29537b27d3b78110d82e0f9bdb84dd71&pid=1-s2.0-S2589933324001824-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996612","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}

{"title":"Interventions to mitigate pregnancy-related mortality and morbidity in Black birthing people: a systematic review","authors":"","doi":"10.1016/j.ajogmf.2024.101464","DOIUrl":"10.1016/j.ajogmf.2024.101464","url":null,"abstract":"<div><h3>Objective</h3><p>To conduct a systematic review of interventions to improve perinatal outcomes to mitigate pregnancy-related mortality and morbidity in Black birthing people.</p></div><div><h3>Data Sources</h3><p>We searched 5 databases from 2000 through the final search date of April 5, 2023: Cumulative Index of Nursing and Allied Health Literature Plus with Full Text (EBSCOhost), Embase (Elsevier), PubMed, and Scopus (Elsevier) and ClinicalTrials.gov.</p></div><div><h3>Study Eligibility Criteria</h3><p>Only quantitative studies were eligible including observational and randomized controlled trials. All participants in selected studies must identify as Black or study results must be stratified by race that includes Black birthing people. The study must (1) measure a perinatal outcome of interest (2) occur in the United States and (3) be written in the English language. Studies were excluded if they were published prior to 2000, not published in the English language, or did not meet the criteria above.</p></div><div><h3>Study Appraisal and Synthesis Methods</h3><p>A data extraction template identified intervention type and perinatal outcome. Perinatal outcomes included but were not limited to: cardiovascular disorders, mortality, or preterm delivery. Interventions included: community programs, educational enhancement, individual counseling, medical intervention, or policy. Risk of bias was assessed using the Mixed Method Appraisal Tool. Three investigators assessed studies individually and group consensus was used for a final decision.</p></div><div><h3>Results</h3><p>From 4,302 unique studies, 41 studies met inclusion criteria. Community programs such as the Supplemental Program for Women, Infants, and Children (WIC) and Healthy Start (n=17, 41.5%) were the most common interventions studied. Individual counseling closely followed (n=15, 36.6%). Medical interventions were not among the more commonly used intervention types (n=9, 21.9%). Most articles focused on preterm delivery (n=28, 68.3%). Few articles studied cardiovascular disorders (n=4, 9.8%) or hemorrhage (n=3, 7.3%). No articles studied pregnancy-related morbidity.</p></div><div><h3>Conclusions</h3><p>Despite current conversations on Black maternal mortality, there is currently limited literature examining interventions addressing perinatal morbidity and mortality in Black birthing people in the United States. These interventions do not address how to mitigate perinatal outcomes of interest. Patient-centered outcomes research is warranted to better understand as well as to resolve inequities related to Black maternal health.</p></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989100","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}

{"title":"Antepartum yoga and pregnancy outcomes in nulliparous individuals: a retrospective cohort study","authors":"","doi":"10.1016/j.ajogmf.2024.101465","DOIUrl":"10.1016/j.ajogmf.2024.101465","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983443","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}