Sexual orientation disparities in adverse pregnancy outcomes

Preventive Medicine Reports

ObjectivesTo examine the association between parents’ influenza vaccination and their children’s coronavirus disease 2019 (COVID-19) vaccination status.MethodsParticipants included father-mother dyads from Fathers & Families, a cohort of fathers and their co-parents living in the United States. Parents’ influenza vaccination status and children’s COVID-19 vaccination status were reported from June 2022-July 2023. Logistic regression was used to examine the association between parental influenza vaccination (both parents vs. neither parent vs. mother only vs. father only vaccinated) and child COVID-19 vaccination (received at least 1 vs. 0 doses). Models were adjusted for recruitment site, income, parent education, child race/ethnicity, child age, and childcare enrollment. Inverse probability weighting was used to account for selection bias into the father-mother dyad sample.ResultsChildren were …

SSM-Mental Health

Sexually minoritized women (SMW) may be at an increased risk of adverse perinatal mental health, though prior research is limited. We examined sexual orientation-related differences in perinatal mental health (i.e., stress and depression), and antidepressant utilization among those at different severities of clinically significant perinatal depressive symptoms.Nurses’ Health Study 3 participants with prospectively assessed pregnancies (N = 6,364) received pregnancy and postpartum questionnaires. Using weighted log-binomial generalized estimating equations, we examined differences in stress (Perceived Stress Scale 4 [PSS-4]), depression (the Edinburgh Postnatal Depression Scale [EDPS] at four cut-off scores [≥7, ≥9, ≥11, ≥13]), and patterns of antidepressant utilization across five groups: completely heterosexual with no same-sex sexual partners (reference group; n = 5,178); heterosexual with same …

American Journal of Preventive Medicine

IntroductionThis study evaluated effects of exposure to culturally tailored anti-smoking ads versus control ads on quitting intentions, cigarette purchase intentions, and tobacco industry perceptions among young adult, cisgender and transgender, sexual minority women (SMW).Study DesignAn online randomized controlled experiment with 1-month longitudinal follow-up was conducted.Setting and ParticipantsAbout 2,214 U.S. SMW ages 18–30 were recruited via online survey panels (The PRIDE Study and Prolific), social media ads and posts, and HER dating app ads. Data were collected in 2021–2022.InterventionParticipants were randomly assigned to receive up to 20 tailored ads containing LGBTQ+ branding versus 20 control ads without LGBTQ+ branding over 4 weeks. Both conditions used identical anti-smoking statements and photographs (including several photographs of individuals who self-identified as …

Health disparities related to sexual orientation and gender identity exist across multiple outcomes. Scholarship has begun to evaluate whether structural stigma—ie, societal-level conditions, cultural norms, and institutional policies that constrain opportunities, resources, and wellbeing—contributes to health burdens among LGBTQ+ individuals. We conducted a comprehensive review of quantitative studies examining this hypothesis. We found 98 articles that linked objective (ie, non-self-reported) measures of structural stigma to mental (n=57), behavioural (ie, substance use; n=27; HIV/AIDS or sexually transmitted infection; n=20), and physical (n=20) health outcomes. There was generally consistent evidence that structural stigma increases risk of poor health among LGBTQ+ individuals. Several methodological strengths were identified, including the use of multiple measures (eg, laws or policies [59%, 58 of 98 …

Human Reproduction

STUDY QUESTION Does medically assisted reproduction (MAR) use among cisgender women differ among those with same-sex partners or lesbian/bisexual identities compared to peers with different-sex partners or heterosexual identities? SUMMARY ANSWER Women with same-sex partners or lesbian/bisexual identities are more likely to utilize any MAR but are no more likely to use ART (i.e. IVF, reciprocal IVF, embryo transfer, unspecified ART, ICSI, and gamete or zygote intrafallopian transfer) compared to non-ART MAR (i.e. IUI, ovulation induction, and intravaginal or intracervical insemination) than their different-sex partnered and completely heterosexual peers. WHAT IS KNOWN ALREADY Sexual minority women (SMW) form families in myriad ways, including through fostering, adoption, genetic, and/or biological routes. Emerging evidence …

Journal of Advanced Nursing

Aim Quantify disparities and identify correlates and predictors of ‘wellness’ supplement use among nurses during the first year of the pandemic. Design Longitudinal secondary analysis of Nurses' Health Studies 2 and 3 and Growing Up Today Study data. Methods Sample included 36,518 total participants, 12,044 of which were nurses, who completed surveys during the first year of the COVID‐19 pandemic (April 2020 to April 2021). Analyses were conducted in March 2023. Modified Poisson models were used to estimate disparities in ‘wellness’ supplement use between nurses and non‐healthcare workers and, among nurses only, to quantify associations with workplace‐related predictors (occupational discrimination, PPE access, workplace setting) and psychosocial predictors (depression/anxiety, county‐level COVID‐19 mortality). Models included race/ethnicity, gender identity, age and cohort as covariates …

arXiv preprint arXiv:2401.04832

An important task in health research is to characterize time-to-event outcomes such as disease onset or mortality in terms of a potentially high-dimensional set of risk factors. For example, prospective cohort studies of Alzheimer's disease typically enroll older adults for observation over several decades to assess the long-term impact of genetic and other factors on cognitive decline and mortality. The accelerated failure time model is particularly well-suited to such studies, structuring covariate effects as `horizontal' changes to the survival quantiles that conceptually reflect shifts in the outcome distribution due to lifelong exposures. However, this modeling task is complicated by the enrollment of adults at differing ages, and intermittent followup visits leading to interval censored outcome information. Moreover, genetic and clinical risk factors are not only high-dimensional, but characterized by underlying grouping structure, such as by function or gene location. Such grouped high-dimensional covariates require shrinkage methods that directly acknowledge this structure to facilitate variable selection and estimation. In this paper, we address these considerations directly by proposing a Bayesian accelerated failure time model with a group-structured lasso penalty, designed for left-truncated and interval-censored time-to-event data. We develop a custom Markov chain Monte Carlo sampler for efficient estimation, and investigate the impact of various methods of penalty tuning and thresholding for variable selection. We present a simulation study examining the performance of this method relative to models with an ordinary lasso penalty, and apply the …

American Journal of Public Health

Objectives. To describe longitudinal trends in the prevalence of mental distress across the first year of the COVID-19 pandemic (April 2020‒April 2021) among US women at the intersection of sexual orientation and racialized group. Methods. Participants included 49 805 cisgender women and female-identified people from the COVID-19 Sub-Study, a cohort of US adults embedded within the Nurses’ Health Studies 2 and 3 and the Growing Up Today Study. We fit generalized estimating equation Poisson models to estimate trends in depressive and anxiety symptoms by sexual orientation (gay or lesbian, bisexual, mostly heterosexual, completely heterosexual); subsequent models explored further differences by racialized group (Asian, Black, Latine, White, other or unlisted). Results. Relative to completely heterosexual peers, gay or lesbian, bisexual, and mostly heterosexual women had a higher prevalence of …

Alcohol: Clinical and Experimental Research

Background People who identify as lesbian, gay, bisexual, transgender, or queer/questioning (LGBTQ+) have higher rates of risky drinking than their cisgender, heterosexual peers. It is unknown to what extent recent age and gender trends in binge drinking vary by LGBTQ+ identity. Methods We used nationally representative, serial, cross‐sectional surveys from men and women in the 2014–2022 Behavioral Risk Factor Surveillance System (N = 2,099,959) to examine trends in past‐month binge drinking by LGBTQ+ identity, gender, and age (18–29, 30–44, 45 and older). We estimated stratum‐specific prevalence ratios for an average 1‐year increase in prevalence of past‐month binge drinking using survey‐weighted log‐binomial models, controlling for education, race/ethnicity, marriage, and parenthood status. Results In the beginning of the study period, LGBTQ+ women endorsed binge drinking at higher …

medRxiv

Background Benzodiazepine use in older adults following acute ischemic stroke (AIS) is common, yet short-term safety concerning falls or fall-related injuries remains unexplored. Methods We emulated a hypothetical randomized trial of benzodiazepine use during the acute post stroke recovery period to assess incidence of falls or fall related injuries in older adults. Using linked data from the Get With the Guidelines Registry and Mass General Brigham's electronic health records, we selected patients aged 65 and older admitted for Acute Ischemic Stroke (AIS) between 2014 and 2021 with no documented prior stroke and no benzodiazepine prescriptions in the previous 3 months. Potential for immortal-time and confounding biases was addressed via separate inverse-probability weighting strategies. Results The study included 495 patients who initiated inpatient benzodiazepines within three days of admission and 2,564 who did not. After standardization, the estimated 10-day risk of falls or fall-related injuries was 694 events per 1000 (95% confidence interval CI: 676-709) for the benzodiazepine initiation strategy and 584 events per 1000 (95% CI: 575-595) for the non-initiation strategy. Subgroup analyses showed risk differences of 142 events per 1000 (95% CI: 111-165) and 85 events per 1000 (95% CI: 64-107) for patients aged 65 to 74 years and for those aged 75 years or older, respectively. Risk differences were 187 events per 1000 (95% CI: 159-206) for patients with minor (NIHSS <= 4) AIS and 32 events per 1000 (95% CI: 10-58) for those with moderate-to-severe AIS. Conclusions Initiating inpatient benzodiazepines within three days of …

ImportanceUse of nonprescribed weight-loss products in adolescents is a public health concern that is associated with negative physical and psychological consequences. However, the prevalence of nonprescribed weight-loss product use in adolescents is unknown.ObjectiveTo determine the global prevalence of nonprescription weight-loss product use in children and adolescents.Data SourcesFour databases, including MEDLINE, PsycINFO, CINAHL (Cumulative Index of Nursing and Allied Health), and EMBASE, were searched for quantitative studies that reported prevalence data on use of nonprescription weight-loss products with no restrictions on publication date. The search was performed December 1, 2020, and updated March 6, 2023.Study SelectionStudies were included in the meta-analysis if they reported the prevalence of weight-loss product use, were published in English, and included individuals …

JAMA Network Open

The need to classify disease and predict outcomes is as old as medicine itself. Nearly 50 years ago, the advantage of applying multivariable statistics to these problems became evident. 1 Since then, the increasing availability of databases containing often-complex clinical information from tens or even hundreds of millions of patients, combined with powerful statistical techniques and computing environments, has spawned exponential growth in efforts to create more useful, focused, and accurate prediction models. JAMA Network Open receives dozens of manuscripts weekly that present new or purportedly improved instruments intended to predict a vast array of clinical outcomes. Although we are able to accept only a small fraction of those submitted, we have, nonetheless, published nearly 2000 articles dealing with predictive models over the past 6 years. The profusion of predictive models has been accompanied …

Journal of Gay & Lesbian Mental Health

IntroductionWhile trauma experiences and treatment-seeking are common among sexual and gender minority (SGM) individuals, little is known about their specific experiences in psychotherapy, including treatment types, characteristics (e.g., length, episodes), barriers, satisfaction, and microaggressions.MethodSGM individuals (N = 2,685) from a national cohort study completed a survey.ResultsThe majority (87%) of participants endorsed past therapy, including for trauma (56%). Ratings of therapy barriers and microaggressions were low and satisfaction with therapy was high. However, therapy experiences differed based on sexual orientation, gender, and if the therapy was focused on trauma.ConclusionEffective treatments for trauma should be informed by the needs of the diverse groups that comprise the SGM community.

Cancer Causes & Control

PurposeAlthough national medical organizations often neglect to include trans and gender diverse (TGD) people in their breast and cervical cancer screening recommendations, the World Profession Association of Transgender Health recommends that TGD people who are at risk for these cancers follow existing guidelines for cisgender women. Despite WPATH’s recommendations, TGD people are less likely to get screened in large part due to discrimination. The COVID-19 pandemic has limited access to cancer screenings among cisgender people, but it is unknown how this has impacted TGD people.MethodsUsing national survey data from the Behavioral Risk Factors Surveillance System (BRFSS), we examined differences in cervical and breast cancer screening noncompliance across gender identity at two time points: before and during the COVID-19 pandemic.ResultsScreening noncompliance increased …

Social Psychiatry and Psychiatric Epidemiology

PurposeTransgender adults face increasingly discriminatory laws/policies and prejudicial attitudes in many regions of the United States (US), yet research has neither quantified state-level transphobia using indicators of both, nor considered their collective association with transgender adults’ psychological wellbeing, hindering the identification of this potential social determinant of transgender mental health inequity. MethodsWe therefore used factor analysis to develop a more comprehensive structural transphobia measure encompassing 29 indicators of transphobic laws/policies and attitudes at the state level, which we linked to individual-level mental health data from a large national sample of 27,279 transgender adults (ages 18–100) residing in 45 US states and the District of Columbia (DC).ResultsControlling for individual- (i.e., demographics), interpersonal- (i.e., perceived discrimination), and state- (i.e …

Lesbian, gay, bisexual, transgender, queer, intersex, asexual, aromantic, and other sexual and/or gender minority (LGBTQIA+) communities are underrepresented in health research and subject to documented health disparities. In addition, LGBTQIA+ communities have experienced mistreatment, discrimination, and stigma in health care and health research settings. Effectively engaging LGBTQIA+ communities and individuals in health research is critical to developing representative data sets, improving health care provision and policy, and reducing disparities. However, little is known about what engagement approaches work well with LGBTQIA+ people. This paper describes the development of PRIDEnet (pridenet. org), a national network dedicated to catalyzing LGBTQIA+ community involvement in health research and built upon well-established community-engaged research (CEnR) principles. PRIDEnet’s …

JAMA

ImportanceExtensive evidence documents health disparities for lesbian, gay, and bisexual (LGB) women, including worse physical, mental, and behavioral health than heterosexual women. These factors have been linked to premature mortality, yet few studies have investigated premature mortality disparities among LGB women and whether they differ by lesbian or bisexual identity.ObjectiveTo examine differences in mortality by sexual orientation.Design, Setting, and ParticipantsThis prospective cohort study examined differences in time to mortality across sexual orientation, adjusting for birth cohort. Participants were female nurses born between 1945 and 1964, initially recruited in the US in 1989 for the Nurses’ Health Study II, and followed up through April 2022.ExposuresSexual orientation (lesbian, bisexual, or heterosexual) assessed in 1995.Main Outcome and MeasureTime to all-cause mortality from …

American Journal of Obstetrics and Gynecology

BackgroundThere are significant racial disparities in in vitro fertilization outcomes, which are poorly explained by individual-level characteristics. Environmental factors such as neighborhood-level socioeconomic factors may contribute to these disparities. However, few studies have directly addressed this research question in a large, racially diverse cohort.ObjectiveThis study aimed to investigate whether neighborhood deprivation is associated with differences in in vitro fertilization outcomes.Study DesignOur retrospective cohort study included 1110 patients who underwent 2254 autologous in vitro fertilization cycles between 2014 and 2019 at an academic fertility center in the Southeastern United States. Neighborhood deprivation was estimated using the Neighborhood Deprivation Index, a composite variable measuring community levels of material capital based on poverty, occupation, housing, and education …

American Journal of Obstetrics and Gynecology

ObjectiveAccurate individualized assessment of preeclampsia risk enables the identification of patients most likely to benefit from initiation of low-dose aspirin at 12-16 weeks’ gestation when there is evidence for its effectiveness, as well as guiding appropriate pregnancy care pathways and surveillance. The primary objective of this study was to evaluate the performance of artificial neural network models for the prediction of preterm preeclampsia (<37 weeks’ gestation) using patient characteristics available at the first antenatal visit and data from prenatal cell-free DNA (cfDNA) screening. Secondary outcomes were prediction of early onset preeclampsia (<34 weeks’ gestation) and term preeclampsia (≥37 weeks’ gestation).MethodsThis secondary analysis of a prospective, multicenter, observational prenatal cfDNA screening study (SMART) included singleton pregnancies with known pregnancy outcomes. Thirteen …

American Journal of Obstetrics and Gynecology

ObjectiveThis study aims to investigate whether CT-derived biomarkers, such as pre-sacral thickness and volume, are correlated with specific factors like body mass index (BMI), age, or certain medical conditions.MethodsWe examined CT images from 143 female patients with suspected or clinically diagnosed pelvic floor dysfunction. Presacral thickness (PT) was measured on axial CT images at the sacral promontory level by drawing a transverse line tangent to the anterior borders of the external or common iliac arteries, followed by measuring a perpendicular line drawn to the anterior sacral promontory at L5-S1. The presacral volume (PV) was manually measured using advanced volumetric visualization software (Vitrea, Canon Medical Systems, USA) from the sacral promontory to S3. From the medical record we extracted demographic information including age, race, and BMI and pertinent medical history (lipid …

American Journal of Obstetrics and Gynecology

BackgroundThe US Food and Drug Administration supports innovations to facilitate new indications for high-risk human papillomavirus testing. This report describes the retrospective testing of stored specimens and analysis of existing data to efficiently and cost-effectively support a new indication for the Onclarity human papillomavirus assay (Becton, Dickinson and Company, BD Life Sciences - Integrated Diagnostic Solutions, Sparks, MD). The performance of this index test was compared with that of a predicate test, the cobas human papillomavirus assay (Roche Diagnostics, Indianapolis, IN). Both human papillomavirus assays are based on real-time polymerase chain reaction platforms that detect the presence of 14 high-risk human papillomavirus genotypes. The predicate assay reports human papillomavirus types 16 and 18 as individual results and the other 12 human papillomavirus genotypes as 1 pooled …

American Journal of Obstetrics and Gynecology

BackgroundCytomegalovirus is responsible for the most common congenital infection, affecting 0.5% to 1.0% of live births in Europe. Congenital cytomegalovirus infection can be diagnosed during pregnancy by viral DNA amplification in the amniotic fluid, but the prognosis of fetuses without severe brain abnormalities remains difficult to establish on the basis of prenatal imaging alone.ObjectiveTo identify predictors of moderate to severe symptomatic cytomegalovirus infection among fetal blood parameters and to propose an algorithm on the basis of these parameters and on prenatal imaging that would provide the best positive and negative predictive values.Study DesignFetal blood sampling at 21–28 weeks gestation was performed in fetuses with congenital cytomegalovirus infection confirmed by amniocentesis after maternal infection in the first-trimester or periconceptional period. We compared the levels of …

American Journal of Obstetrics and Gynecology

BackgroundZika virus congenital infection evades double-stranded RNA detection and may persist in the placenta for the duration of pregnancy without accompanying overt histopathologic inflammation. Understanding how viruses can persist and replicate in the placenta without causing overt cellular or tissue damage is fundamental to deciphering mechanisms of maternal-fetal vertical transmission.ObjectivePlacenta-specific microRNAs are believed to be a tenet of viral resistance at the maternal-fetal interface. We aimed to test the hypothesis that the Zika virus functionally disrupts placental microRNAs, enabling viral persistence and fetal pathogenesis.Study DesignTo test this hypothesis, we used orthogonal approaches in human and murine experimental models. In primary human trophoblast cultures (n=5 donor placentae), we performed Argonaute high-throughput sequencing ultraviolet-crosslinking and …

American journal of obstetrics and gynecology

Sexual orientation disparities in adverse pregnancy outcomes Sexual orientation disparities in adverse pregnancy outcomes Am J Obstet Gynecol. 2024 Mar 6:S0002-9378(24)00429-0. doi: 10.1016/j.ajog.2024.02.315. Online ahead of print. Authors Payal Chakraborty 1 , Ellis Schroeder 2 , Colleen A Reynolds 3 , Sarah McKetta 3 , Juno Obedin-Maliver 4 , S Bryn Austin 5 , Bethany Everett 6 , Sebastien Haneuse 7 , Brittany M Charlton 8 Affiliations 1 Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, 401 Park Dr, Suite 401 E, Boston, MA 02215; Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA. Electronic address: pchakraborty@hsph.harvard.edu. 2 Druid Hills High School, Atlanta, GA. 3 Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA; Department of …

American Journal of Obstetrics and Gynecology

BackgroundThere are limited data to guide the diagnosis and management of vasa previa. Currently, what is known is largely based on case reports or series and cohort studies.ObjectiveThis study aimed to systematically collect and classify expert opinions and achieve consensus on the diagnosis and clinical management of vasa previa using focus group discussions and a Delphi technique.Study DesignA 4-round focus group discussion and a 3-round Delphi survey of an international panel of experts on vasa previa were conducted. Experts were selected on the basis of their publication record on vasa previa. First, we convened a focus group discussion panel of 20 experts and agreed on which issues were unresolved in the diagnosis and management of vasa previa. A 3-round anonymous electronic survey was then sent to the full expert panel. Survey questions were presented on the diagnosis and …

American Journal of Obstetrics and Gynecology

BackgroundPlant-based diets have been associated with a lower risk of cardiovascular disease in nonpregnant adults, but specific evidence for their effects on risk of hypertensive disorders of pregnancy is scarce.ObjectiveThis study aimed to evaluate the prospective association between adherence to plant-based diets before pregnancy and the risk for hypertensive disorders of pregnancy. We hypothesized that women with higher adherence to plant-based diets would have a lower risk for hypertensive disorders of pregnancy.Study DesignWe followed 11,459 parous women (16,780 singleton pregnancies) without chronic diseases, a history of preeclampsia, and cancers who participated in the Nurses’ Health Study II (1991–2009), which was a prospective cohort study. Diet was assessed every 4 years using a validated food frequency questionnaire from which we calculated the plant-based diet index (higher …

American journal of obstetrics and gynecology

Prospective first-trimester transvaginal 3-dimensional power Doppler and hysterectomy association in placenta accreta spectrum Prospective first-trimester transvaginal 3-dimensional power Doppler and hysterectomy association in placenta accreta spectrum Am J Obstet Gynecol. 2024 Mar 2:S0002-9378(24)00423-X. doi: 10.1016/j.ajog.2024.02.310. Online ahead of print. Authors Christina L Herrera 1 , Quyen N Do 2 , Yin Xi 2 , Catherine Y Spong 3 , Diane M Twickler 4 Affiliations 1 Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9032; Parkland Health, Dallas, TX. Electronic address: christina.herrera@utsouthwestern.edu. 2 Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX. 3 Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, …

American Journal of Obstetrics and Gynecology

BackgroundIn the LIBERTY Long-Term Extension study, once-daily relugolix combination therapy (40 mg relugolix, estradiol 1 mg, norethindrone acetate 0.5 mg) substantially improved uterine fibroid-associated heavy menstrual bleeding throughout the 52-week treatment period in the overall study population.ObjectiveBlack or African American women typically experience a greater extent of disease and symptom burden of uterine fibroids vs other racial groups and have traditionally been underrepresented in clinical trials. This secondary analysis aimed to assess the efficacy and safety of relugolix combination therapy in the subgroup population of Black or African American women with uterine fibroids in the LIBERTY Long-Term Extension study.Study DesignBlack or African American premenopausal women (aged 18–50 years) with uterine fibroids and heavy menstrual bleeding who completed the 24-week …

American Journal of Obstetrics and Gynecology

BackgroundIn July 2017, the State of Victoria’s largest maternity service implemented a new clinical guideline to reduce the rates of stillbirth at term for South Asian women.ObjectiveThis study aimed to evaluate the impact of offering fetal surveillance from 39 weeks to South Asian-born women on rates of stillbirth and neonatal and obstetrical interventions.Study DesignThis was a cohort study of all women receiving antenatal care at 3 large metropolitan university-affiliated teaching hospitals in Victoria, who gave birth in the term period between January 2016 and December 2020. Differences in rates of stillbirth, neonatal deaths, perinatal morbidities, and interventions after July 2017 were determined. Multigroup interrupted time-series analysis was used to assess changes in rates of stillbirth and induction of labor.ResultsA total of 3506 South Asian-born women gave birth before, and 8532 after the change in practice …

American journal of obstetrics and gynecology

Prospective first-trimester transvaginal 3-dimensional power Doppler and hysterectomy association in placenta accreta spectrum Prospective first-trimester transvaginal 3-dimensional power Doppler and hysterectomy association in placenta accreta spectrum Am J Obstet Gynecol. 2024 Mar 2:S0002-9378(24)00423-X. doi: 10.1016/j.ajog.2024.02.310. Online ahead of print. Authors Christina L Herrera 1 , Quyen N Do 2 , Yin Xi 2 , Catherine Y Spong 3 , Diane M Twickler 4 Affiliations 1 Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9032; Parkland Health, Dallas, TX. Electronic address: christina.herrera@utsouthwestern.edu. 2 Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX. 3 Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, …

American journal of obstetrics and gynecology

Corrigendum to Research biopsies in patients with gynecologic cancers: patient-reported outcomes, perceptions, and preferences: Am J Obstet Gynecol 225 (2021) 658.e1-658.e9/Article 658 Corrigendum to Research biopsies in patients with gynecologic cancers: patient-reported outcomes, perceptions, and preferences: Am J Obstet Gynecol 225 (2021) 658.e1-658.e9/Article 658 Am J Obstet Gynecol. 2024 Apr 27:S0002-9378(24)00475-7. doi: 10.1016/j.ajog.2024.03.039. Online ahead of print. Authors Ainhoa Madariaga 1 , Gita Bhat 2 , Michelle K Wilson 2 , Xuan Li 3 , Sunu Cyriac 2 , Valerie Bowering 4 , Wendy Hunt 4 , David Gutierrez 4 , Luisa Bonilla 2 , Lawrence Kasherman 2 , Michelle McMullen 2 , Lisa Wang 5 , Sangeet Ghai 6 , Neesha C Dhani 2 , Amit M Oza 2 , Stephanie Lheureux 7 Affiliations 1 Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, …

American Journal of Obstetrics and Gynecology

BackgroundUrinary microbiome (urobiome) studies have previously reported on specific taxa and community differences in women with mixed urinary incontinence compared with controls. Therefore, a hypothesis was made that higher urinary and vaginal microbiome diversity would be associated with increased urinary incontinence severity.ObjectiveThis study aimed to test whether specific urinary or vaginal microbiome community types are associated with urinary incontinence severity in a population of women with mixed urinary incontinence.Study DesignThis planned secondary, cross-sectional analysis evaluated associations between the urinary and vaginal microbiomes and urinary incontinence severity in a subset of Effects of Surgical Treatment Enhanced With Exercise for Mixed Urinary Incontinence trial participants with urinary incontinence. Incontinence severity was measured using bladder diaries and …

American journal of obstetrics and gynecology

BackgroundClerkship grades in obstetrics and gynecology play an increasingly important role in the competitive application process to residency programs. An analysis of clerkship grading practices has not been queried in the past 2 decades in our specialty.ObjectiveThis study aimed to investigate obstetrics and gynecology clerkship directors’ practices and perspectives in grading.Study DesignA 12-item electronic survey was developed and distributed to clerkship directors with active memberships in the Association of Professors of Gynecology and Obstetrics.ResultsA total of 174 of 236 clerkship directors responded to the survey (a response rate of 73.7%). Respondents reported various grading systems with the fewest (20/173 [11.6%]) using a 2-tiered or pass or fail system and the most (72/173 [41.6%]) using a 4-tiered system. Nearly one-third of clerkship directors (57/163 [35.0%]) used a National Board of …

American Journal of Obstetrics and Gynecology

Respiratory syncytial virus is a leading cause of lower respiratory tract illness globally in children aged <5 years. Each year, approximately 58,000 hospitalizations in the United States are attributed to respiratory syncytial virus. Infants aged ≤6 months experience the most severe morbidity and mortality. Until recently, prevention with the monoclonal antibody, palivizumab, was only offered to infants with high-risk conditions, and treatment primarily consisted of supportive care. Currently, 2 products are approved for the prevention of respiratory syncytial virus in infants. These include the Pfizer bivalent recombinant respiratory syncytial virus prefusion F protein subunit vaccine, administered seasonally to the pregnant person between 32 0/7 and 36 6/7 weeks of gestation, and the monoclonal antibody, nirsevimab, administered to infants aged up to 8 months entering their first respiratory syncytial virus season. With few …

American Journal of Obstetrics and Gynecology

BackgroundGestational diabetes (GDM) is associated with an increased risk of hypertensive disorders of pregnancy (HDP), but there are limited data on fetal growth and neonatal outcomes when both conditions are present.ObjectivesWe evaluated the risk of abnormal fetal growth and neonatal morbidity in pregnancies with co-occurrence of GDM and HDP.Study DesignIn a retrospective study of 47,093 singleton pregnancies, we compared the incidence of appropriate for gestational age birthweight (AGA) in pregnancies affected by GDM alone, HDP alone, or both GDM and HDP (GDM/HDP) to that in pregnancies affected by neither disorder using generalized estimating equations (covariates: maternal age, nulliparity, BMI, insurance type, race, marital status and prenatal care site). Secondary outcomes were large for gestational age birthweight (LGA), small for gestational age birthweight (SGA), and a neonatal …

American journal of obstetrics and gynecology

BackgroundIdentifying risk factors for Alzheimer disease in women is important as women compose two-thirds of individuals with Alzheimer disease. Previous work links vasomotor symptoms, the cardinal menopausal symptom, with poor memory performance and alterations in brain structure, function, and connectivity. These associations are evident when vasomotor symptoms are monitored objectively with ambulatory skin conductance monitors.ObjectiveThis study aimed to determine whether vasomotor symptoms are associated with Alzheimer disease biomarkers.Study DesignBetween 2017 and 2020, the MsBrain study enrolled 274 community-dwelling women aged 45 to 67 years who had a uterus and at least 1 ovary and were late perimenopausal or postmenopausal status. The key exclusion criteria included neurologic disorder, surgical menopause, and recent use of hormonal or nonhormonal vasomotor …

American Journal of Obstetrics and Gynecology

BackgroundContemporary guidance for preoperative feeding allows solids up to 6 hours and clear fluids up to 2 hours before anesthesia. Clinical trial evidence to support this approach for cesarean delivery is lacking. Many medical practitioners continue to follow conservative policies of no intake from midnight to the time of surgery, especially in pregnant women.ObjectiveThis study aimed to evaluate the pragmatic approach of permitting free access to water up to the call to dispatch to the operating theater vs fasting from midnight in preoperative oral intake restriction for planned cesarean delivery under spinal anesthesia on perioperative vomiting and maternal satisfaction.Study DesignA randomized controlled trial was conducted in the obstetrical unit of the University of Malaya Medical Centre from October 2020 to May 2022. A total of 504 participants scheduled for planned cesarean delivery were randomized …