Urinary microbiome community types associated with urinary incontinence severity in women

Microbiology Spectrum

Technical bias is a pressing issue in microbiome research, and variability can be introduced at any stage from sample collection to figure generation. In this study, we aim to reduce biases in studying the human vaginal microbiome by examining the impact of sample storage buffer and multiple swabbing events using 16S rRNA gene amplicon sequencing data generated from vaginal swabs. We show that AssayAssure Genelock, a clinically relevant preservative for urine samples, is effective in preserving vaginal samples for microbiome studies. When comparing Genelock to 95% (vol/vol) ethanol and no preservative (air only), host variability explained more variance in both weighted and unweighted UniFrac measurements than the preservation method. We further examined the impact of three successive self-swabbing events, as the relatively low biomass nature of vaginal samples can inherently introduce bias. It …

BJOG: An International Journal of Obstetrics & Gynaecology

Objective To identify vaginal morphology and position factors associated with prolapse recurrence following vaginal surgery. Design Secondary analysis of magnetic resonance images (MRI) of the Defining Mechanisms of Anterior Vaginal Wall Descent cross‐sectional study. Setting Eight clinical sites in the US Pelvic Floor Disorders Network. Population or Sample Women who underwent vaginal mesh hysteropexy (hysteropexy) with sacrospinous fixation or vaginal hysterectomy with uterosacral ligament suspension (hysterectomy) for uterovaginal prolapse between April 2013 and February 2015. Methods The MRI (rest, strain) obtained 30–42 months after surgery, or earlier for participants with recurrence who desired reoperation before 30 months, were analysed. MRI‐based prolapse recurrence was defined as prolapse beyond the hymen at strain on MRI. Vaginal segmentations (at rest) were used to …

bioRxiv

Metabolomics reflects the molecular communications within a biological system. Urine can be obtained non-invasively and is rich in metabolites that are potential biomarkers for human health and disease. The optimal urine storage conditions for metabolomic analysis are unknown. We measured the impact of common storage conditions and the presence of a DNA-stabilizer, AssayAssure® (Thermo Scientific), on metabolite content of voided human urine. Urinary metabolite composition was not altered across storage conditions. Although addition of AssayAssure® significantly alters metabolic profile by adduct addition, this does not preclude the identification of parent metabolites or overshadow biological differences. These data suggest biobanked urine stored in any of the tested conditions for metabolomic studies may be considered for metabolomic analysis.

Accountability in Research

Authorship and dissemination policies vary across NIH research consortia. We aimed to describe elements of real-life policies in use by eligible U01 clinical research consortia. Principal investigators of eligible, active U01 clinical research projects identified in the NIH Research Portfolio Online Reporting Tools database shared relevant policies. The characteristics of key policy elements, determined a priori, were reviewed and quantified, when appropriate. Twenty one of 81 research projects met search criteria and provided policies. K elements (e.g., in quotations): “manuscript proposals reviewed and approved by committee” (90%); “guidelines for acknowledgements” (86%); “writing team formation” (71%); “process for final manuscript review and approval” (71%), “responsibilities for lead author” (67%), “guidelines for other types of publications” (67%); “draft manuscript review and approval” (62 …

npj Viruses

Orthohantaviruses infect distinct eulipotyphlan and rodent reservoirs throughout the world; some rodent orthohantaviruses can cause disease in humans. In the United States, a primary rodent reservoir for the human-pathogenic Sin Nombre virus (SNV) is the western deermouse (Peromyscus sonoriensis; formerly included in Peromyscus maniculatus). Deermice (rodents of genus Peromyscus) carry presumably distinct orthohantaviruses but, although deermice of ten species have been recorded in New Mexico, only SNV has been reported in rodents from that state. Using a set of pan-orthohantavirus primers, we discovered a non-SNV orthohantavirus in a brush deermouse (P. boylii), trapped in central New Mexico in 2019. Sequencing enabled the generation of a consensus coding-complete genome sequence, revealing similarity to the known partial sequences of the unclassified “Limestone Canyon virus (LSCV …

This new journal feature is intended to stimulate a thoughtful preparation for surgeons preparing their hands to treat patients. Preparing both mind and body is an age-old ritual–one very familiar to all surgeons. The Urogynecology Assistant Editors have developed a (pretty large!) list of potential topics for this feature. We welcome additional suggestions for this new feature! If you have a suggestion for the Assistant Editors, please send it to us at Editor@ urogynjournal. org.

Journal of Urology

Purpose:Patients with suspected urinary tract infections (UTIs) are categorized into three clinical phenotypes based on current guidelines: no UTI, asymptomatic bacteriuria (ASB), or UTI. However, all patients may not fit neatly into these groups. Our objective was to characterize clinical presentations of patients who receive urine tests using the “continuum of UTI” approach.Materials and Methods:This was a retrospective cohort study of a random sample of adult non-catheterized inpatient and ED encounters with paired urinalysis and urine cultures from 5 hospitals in three states between January 01, 2017 and December 31, 2019. Trained abstractors collected clinical (eg, symptom) and demographic data. A focus group discussion with multidisciplinary experts was conducted to define the “continuum of UTI,” a 5-level classification scheme that includes two new categories: lower urinary tract symptoms/other urologic …

Although numerous studies have demonstrated the impact of microbiome manipulation on human health, research on the microbiome’s influence on female health remains relatively limited despite substantial disease burden. In light of this, we present a selected review of clinical trials and preclinical studies targeting both the vaginal and gut microbiomes for the prevention or treatment of various gynecologic conditions. Specifically, we explore studies that leverage microbiota transplants, probiotics, prebiotics, diet modifications, and engineered microbial strains. A healthy vaginal microbiome for females of reproductive age consists of lactic acid-producing bacteria predominantly of the Lactobacillus genus, which serves as a protective barrier against pathogens and maintains a balanced ecosystem. The gut microbiota’s production of short-chain fatty acids, metabolism of primary bile acids, and modulation of sex …

Journal of Wound Ostomy & Continence Nursing

PURPOSE:Although maternal depression is associated with adverse outcomes in women and children, its relationship with lower urinary tract symptoms (LUTS) in offspring is less well-characterized. We examined the association between prenatal and postpartum maternal depression and LUTS in primary school-age daughters.DESIGN:Observational cohort study.SUBJECTS AND SETTING:The sample comprised 7148 mother-daughter dyads from the Avon Longitudinal Study of Parents and Children.METHOD:Mothers completed questionnaires about depressive symptoms at 18 and 32 weeks' gestation and 21 months postpartum and their children's LUTS (urinary urgency, nocturia, and daytime and nighttime wetting) at 6, 7, and 9 years of age. Multivariable logistic regression models were used to estimate the association between maternal depression and LUTS in daughters.RESULTS:Compared to daughters of …

bioRxiv

There is growing appreciation that commensal bacteria impact the outcome of viral infections, though the specific bacteria and their underlying mechanisms remain poorly understood. Studying a simian-human immunodeficiency virus (SHIV)-challenged cohort of pediatric nonhuman primates, we bioinformatically associated Lactobacillus gasseri and the bacterial family Lachnospiraceae with enhanced resistance to infection. We experimentally validated these findings by demonstrating two different Lachnospiraceae isolates, Clostridium immunis and Ruminococcus gnavus, inhibited HIV replication in vitro and ex vivo. Given the link between tryptophan catabolism and HIV disease severity, we found that an isogenic mutant of C. immunis that lacks the aromatic amino acid aminotransferase (ArAT) gene, which is key to metabolizing tryptophan into 3-indolelactic acid (ILA), no longer inhibits HIV infection. Intriguingly, we confirmed that a second commensal bacterium also inhibited HIV in an ArAT-dependent manner, thus establishing the generalizability of this finding. In addition, we found that purified ILA inhibited HIV infection by agonizing the aryl hydrocarbon receptor (AhR). Given that the AhR has been implicated in the control of multiple viral infections, we demonstrated that C. immunis also inhibited human cytomegalovirus (HCMV) infection in an ArAT-dependent manner. Importantly, metagenomic analysis of individuals at-risk for HIV revealed that those who ultimately acquired HIV had a lower fecal abundance of the bacterial ArAT gene compared to individuals who did not, which indicates our findings translate to humans. Taken together, our …

PLOS Neglected Tropical Diseases

Background Hantaviruses are negative-stranded RNA viruses that can sometimes cause severe disease in humans; however, they are maintained in mammalian host populations without causing harm. In Panama, sigmodontine rodents serve as hosts to transmissible hantaviruses. Due to natural and anthropogenic forces, these rodent populations are having increased contact with humans. Methods We extracted RNA and performed Illumina deep metatranscriptomic sequencing on Orthohantavirus seropositive museum tissues from rodents. We acquired sequence reads mapping to Choclo virus (CHOV, Orthohantavirus chocloense) from heart and kidney tissue of a two-decade old frozen museum sample from a Costa Rican pygmy rice rat (Oligoryzomys costaricensis) collected in Panama. Reads mapped to the CHOV reference were assembled and then validated by visualization of the mapped reads against the assembly. Results We recovered a 91% complete consensus sequence from a reference-guided assembly to CHOV with an average of 16X coverage. The S and M segments used in our phylogenetic analyses were nearly complete (98% and 99%, respectively). There were 1,199 ambiguous base calls of which 93% were present in the L segment. Our assembled genome varied 1.1% from the CHOV reference sequence resulting in eight nonsynonymous mutations. Further analysis of all publicly available partial S segment sequences support a clear relationship between CHOV clinical cases and O. costaricensis acquired strains. Conclusions Viruses occurring at extremely low abundances can be recovered from deep …

Antimicrobial Stewardship & Healthcare Epidemiology

Background Historically, diagnosis of urinary tract infections (UTIs) has been divided into 3 categories based on symptoms and urine culture results: not UTI, asymptomatic bacteriuria (ASB), or UTI. However, some populations (eg, older adults, catheterized patients) may not present with signs or symptoms referrable to the urinary tract or have chronic lower urinary tract symptoms (LUTS), making the diagnosis of UTI challenging. We sought to understand the clinical presentation of patients who receive urine tests in a cohort of diverse hospitals. Methods This retrospective descriptive cohort study included all adult noncatheterized inpatient and ED encounters with paired urinalysis and urine cultures (24 hours apart) from 5 community and academic hospitals in 3 states (NC, VA, GA) between January 1, 2017, and December 31, 2019. Trained abstractors collected clinical and demographic data using a 60-question …

Neurourology and Urodynamics

Objective A small, but growing literature links stressors and mental health disorders (MHDs) across the life course to overactive bladder (OAB) and urinary incontinence symptoms. Mechanisms by which stressors and MHDs may impact bladder health are not fully understood, limiting novel prevention and treatment efforts. Moreover, potential biopsychosocial mechanisms involving the brain and gut have not been considered in an integrated, comprehensive fashion. Methods Members of the prevention of lower urinary tract symptoms Research Consortium developed conceptual models to inform research on biopsychosocial mechanisms through which stress and MDHs may impact bladder health among girls and women, focusing on brain and gut physiology. Results Two conceptual models were developed—one to explain central (brain‐based) and peripheral (gut‐based) mechanisms linking stressors and …

Neurourology and Urodynamics

Objectives To describe the methods for the in‐person assessment of the RISE FOR HEALTH (RISE) study, a population‐based multicenter prospective cohort study designed to identify factors that promote bladder health and/or prevent lower urinary tract symptoms in adult women, conducted by the Prevention of Lower Urinary Tract Symptoms Research Consortium (PLUS). Methods and results A subset of RISE participants who express interest in the in‐person assessment will be screened to ensure eligibility (planned n = 525). Eligible consenting participants are asked to complete 15 physical assessments in addition to height and weight, to assess pelvic floor muscle function, musculoskeletal (MSK) status, and pain, and to provide urogenital microbiome samples. Pelvic floor muscle assessments include presence of prolapse, strength, levator attachment integrity (tear) and myofascial pain. MSK tests evaluate …

International Urogynecology Journal

In this first episode of the Microbiologist in the Clinic series, clinicians and laboratory scientists share their perspectives about a 30 y/o woman, who is seeking specialty consultation for frequent episodes of urinary urgency, frequency, and dysuria, which respond to short courses of antibiotics. Although her home dipsticks suggest that she has a UTI, and her urinalysis typically has a moderate number of white blood cells, her urine cultures are always negative. The challenges of this clinical presentation are discussed with evidence for evaluation and treatment.

Microbiology Resource Announcements

Here, we present the draft genome sequences of Lactobacillus delbrueckii and Klebsiella pneumoniae, both isolated from the urinary bladder of an asymptomatic post-menopausal female patient with a diagnosis of recurrent urinary tract infections. These genomes will facilitate analyses of interbacterial interactions in the urinary microbiome.

Human metapneumovirus (HMPV) is a common cause of respiratory infections in children, accounting for 5-15% of all acute respiratory infections in this population. Although HMPV is closely related to respiratory syncytial virus (RSV) its incidence, epidemiology, and genetic diversity are poorly understood. In the United States, HMPV infections typically occur annually in the winter and early spring months. Similar to other common respiratory viruses, during the first two years of the COVID-19 pandemic, cases of HMPV were nearly absent. However, in the summer and early fall of 2022 an atypical and dramatic increase of HMPV cases across the United States was detected. In addition to the infections being out of the typical winter respiratory infection season, the incidence and clinical severity appeared to be increased. To investigate if the atypical infections were due to a new and more virulent strain of HMPV, we conducted genomic sequencing of 96 pediatric cases from Arkansas Children’s Research Institute. Genetic analysis revealed the co-circulation of multiple genetic lineages, including two recently described lineages with large duplications in the surface glycoprotein, G; however, no novel mutations or lineages were detected. Our data indicates that the atypical outbreak of HMPV in 2022 was not caused by a new strain of HMPV. It is possible that the increase in cases may have been in response to a decrease in the use of preventive measures such as wearing masks, and social distancing and/or exposure in a population with reduced and waning natural immunity.

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 …