Journal of Osteopathic Medicine最新文献

{"title":"The utility of the implantable loop recorder in patients with Ehlers-Danlos syndrome and hypermobility spectrum disorder.","authors":"Ermin Tale, Grace Robinson, Justin Edward, Riya Kaushal, Bernadette Riley, Todd J Cohen","doi":"10.1515/jom-2025-0036","DOIUrl":"https://doi.org/10.1515/jom-2025-0036","url":null,"abstract":"<p><strong>Context: </strong>Patients with Ehlers-Danlos Syndrome (EDS) and hypermobility spectrum disorder (HSD) often complain of palpitations, presyncope/syncope, attributable to postural orthostatic tachycardia syndrome (POTS). Occasionally, the etiology of these complaints is not positional, unclear, and may require further cardiac evaluation, including cardiac monitoring. To our knowledge, the utility of implantable loop recorders (ILRs) has yet to be explored in this population.</p><p><strong>Objectives: </strong>This study aimed to evaluate the utility of the ILRs in diagnosing and/or excluding arrhythmias not attributable to POTS in symptomatic patients with EDS and HSD.</p><p><strong>Methods: </strong>Patients with EDS and HSD were referred from the New York Institute of Technology (NYIT) Ehlers-Danlos Syndrome/Hypermobility Treatment Center to the Long Island Heart Rhythm Center (LIHRC) for cardiac evaluation between January 2019 and November 2023. A retrospective analysis of observational de-identified data from the LIHRC was permitted by the NYIT College of Osteopathic Medicine Institutional Review Board (BHS-1465). Patients were monitored monthly, and the utility of the ILRs was assessed based on a correlation of symptoms to an arrhythmia, the ability of the device to monitor therapy efficacy, and/or to rule out an arrhythmia as the explanation of symptoms. Data is reported as percentages and mean ± standard deviation (SD).</p><p><strong>Results: </strong>A total of 116 hypermobile patients (81 EDS/35 HSD) were evaluated. Among these patients, 31 (26.7 %) received an ILR (length of follow-up, 27.3 months ± 14.0 months), 29 females/2 males, 28 patients had EDS, 3 patients had HSD, age 34.1 ± 11.4 years. Symptomatic sinus tachycardia (ST) occurred in 16 patients (51.6 %), and ST helped diagnose POTS and/or monitor therapy in 15 (48.4 %). Symptomatic premature ventricular complexes (PVCs) occurred in 8 patients (25.8 %), supraventricular tachycardia (SVT) in 6 (19.4 %), and ventricular tachycardia (VT) in 1 (3.2 %). In 2 patients, ILR findings led to further interventions, including PVC ablation and an implantable cardioverter-defibrillator (ICD) for symptomatic VT. The ILR demonstrated utility in all patients.</p><p><strong>Conclusions: </strong>This study demonstrated the utility of the ILR in identifying symptomatic arrhythmias in patients with EDS and HSD. ILR monitoring also aided in solidifying a POTS diagnosis and guiding patient management/treatment efficacy. Further evaluation in a larger cohort is needed to further understand the impact of ILR monitoring in hypermobile patients.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteopathic manipulation to increase lactation quantity: a prospective case series.","authors":"Eileen M Conaway, Arlene E O'Donnell","doi":"10.1515/jom-2024-0250","DOIUrl":"https://doi.org/10.1515/jom-2024-0250","url":null,"abstract":"<p><strong>Context: </strong>There is currently no clinical research investigating the effect of osteopathic manipulation on the milk supply of lactating patients. Herbal and prescription galactagogues are limited and have the potential for serious side effects.</p><p><strong>Objectives: </strong>The objective of this study was to determine whether osteopathic manipulative treatment (OMT) can increase milk supply in lactating people with low milk supply (hypogalactia).</p><p><strong>Methods: </strong>The patients presented in this series participated in an Institutional Review Board (IRB)-approved prospective pilot study. All participants were aged 18-40 years old and 2-28 weeks postpartum with the desire to exclusively breastfeed with infants who weighed at least 2,500 g at birth. At 1 h, the measured milk production was <1 oz expressed through a hospital-grade pump. Participants were ineligible if they were utilizing prescription galactagogues or had a contraindication to OMT. They were treated with an OMT protocol plus ad lib OMT once a week for 4 weeks. The study was suspended and ultimately closed due to the SARS-CoV-2 pandemic.</p><p><strong>Results: </strong>All three participants demonstrated an increase in milk production from baseline at each visit. Given the small number of participants, these results are not statistically significant. Power analysis calculated a need for 10 subjects. Therefore, these patients are presented as a case series.</p><p><strong>Conclusions: </strong>These results show promise for the use of osteopathic manipulation to increase human milk production. A study with a larger number of participants is needed.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interactive module's effectiveness on empathy and attitudes of healthcare students.","authors":"Jacob Linomaz, Desmond Chee, Jana Wardian, Elizabeth Beverly, Shelene Thomas","doi":"10.1515/jom-2023-0281","DOIUrl":"https://doi.org/10.1515/jom-2023-0281","url":null,"abstract":"<p><strong>Context: </strong>As the prevalence of social determinants of health (SDH) continues to have an impact on the management of chronic conditions, it is imperative to expose health professional students to these encounters.</p><p><strong>Objectives: </strong>This study investigates the role that virtual interactive modules play on osteopathic medical students and physician assistant (PA) students' empathy and attitudes toward individuals with diabetes mellitus who are also affected by an array of SDHs.</p><p><strong>Methods: </strong>Students from both health professional programs were asked to complete a pre-survey and post-survey that encompassed the Diabetes Attitude Scale, the Jefferson Empathy Scale, and the Assessing Student Competence and Knowledge of Social Determinants of Health (ASCK-SDH) Instrument. Students engaged with virtual interactive modules to follow the life of a patient, Lula Mae, who lives in the Appalachian area with Type 2 diabetes.</p><p><strong>Results: </strong>Results from 151 osteopathic medical students concluded significant findings for the Diabetes Attitudes Scale (p<0.001), Jefferson Empathy Scale (p<0.02), and ASCK-SDH (p=0.02). While the matched data pairs for the PA students were too small in number to be significant, the data showed a positive trend pre-module to post-module.</p><p><strong>Conclusions: </strong>This interactive module improved health professionals' awareness, empathy, and attitudes toward SDH affecting those with chronic conditions. This implementation can be a valuable and insightful medical educational tool that can be adapted for other scenarios like various clinical rotations and sensitive healthcare topics to enhance the development of health professional students' cultural competency and health equity awareness by exposure to various cultural, socioeconomic, and social identities in their future medical decision-making.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research gaps in the correlation of anxiety and depression prevalence in former college athletes: a systematic review.","authors":"Madison L Reese, Blakelee A Eggleston, Alexandra M Smith, Austin J Young, Anna Mazur, Micah Hartwell","doi":"10.1515/jom-2025-0008","DOIUrl":"https://doi.org/10.1515/jom-2025-0008","url":null,"abstract":"<p><strong>Context: </strong>There is not much current literature looking at anxiety and depression in athletes transitioning out of college sports into the real world. This study identified gaps in the current mental health literature for former college athletes and what interventions are currently being offered to help them. By utilizing the gaps identified in the current literature, we provided recommendations for educational programs that are modeled on the programs that professional sports leagues offer while utilizing the existing college infrastructure. We also encourage future research to perform longitudinal studies following these athletes as they transition from sports.</p><p><strong>Objectives: </strong>Collegiate sports participation is integral to culture and identity. Transitioning from athletics to regular life often leads to significant mental health concerns. Abrupt lifestyle and identity changes can result in dietary, career, and health consequences that impact athletes' mental well-being. While some data addresses this transition, research focused on developing best practices to support athletes during this period remains limited. This study aims to conduct a systematic review to identify the existing research and gaps concerning the described supports in mental health, particularly depression and anxiety, in retired athletes.</p><p><strong>Methods: </strong>A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review (PRISMA-ScR) guidelines. We analyzed original research, literature reviews, systematic reviews, meta-analyses, clinical trials, and case studies. Articles were sourced from PubMed (MEDLINE), Embase, Scopus, Cochrane, and Web of Science.</p><p><strong>Results: </strong>A total of 169 articles were identified, with 61 selected for full-text screening and nine included in the study. These nine articles comprised four cross-sectional studies analyzing survey data, four systematic or scoping reviews, and one qualitative analysis. While all articles addressed depression or anxiety, most focused on individuals returning to exercise post-injury and quality of life.</p><p><strong>Conclusions: </strong>Current research highlights the needs of collegiate, professional, and retired athletes. Limited literature exists on former collegiate athletes, with available studies emphasizing university programs to ease transitions and help athletes apply their skills in retirement. Research gaps include examining programs across divisions and sports, minimizing self-reporting surveys, and conducting longitudinal studies. Future efforts should focus on addressing these gaps to better support athletes transitioning to life beyond sports.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scholar 12 longitudinal outcomes: osteopathic research development application to facilitate scholarly activity during the pandemic and beyond.","authors":"Marija J Rowane, Kevin A Thomas, Travis M Smith, Mark A Terrel, Michael P Rowane, Robert W Hostoffer","doi":"10.1515/jom-2025-0041","DOIUrl":"https://doi.org/10.1515/jom-2025-0041","url":null,"abstract":"<p><strong>Context: </strong>The coronavirus disease 2019 (COVID-19) pandemic necessitated a rapid transformation in medical education and research. Online learning became the standard to supplement in-person training and maintain accreditation requirements. Scholar 12 was constructed from the Scholar Series foundational lectures and a Master of Science in Medical Education thesis into a comprehensive research development platform accessible to all learners and institutions (https://scholar12.org).</p><p><strong>Objectives: </strong>The objectives of this study were to involve students and faculty in a free, interactive virtual platform to address osteopathic literature deficits and scholarly activity criteria, promote new generational learning of research skills, build scholarly culture, and to employ Scholar 12 in a group-mentor research poster project to encourage osteopathic medical student participation in osteopathic-focused research.</p><p><strong>Methods: </strong>A blinded, multi-campus, optional presurvey was digitally administered to third-year osteopathic medical students, prior to completing the Scholar 12 program, in collaboration with junior faculty mentors, during their Geriatrics/Osteopathic Principles and Practices (OPP) core rotation. Students self-reported their research skill competency relevant to each learning unit, on a 5-point Likert scale, before and after completing Scholar 12. Additional survey questions assessed the efficacy of the group mentor model and the quantity of further research presentations.</p><p><strong>Results: </strong>Students' self-reported research skill competency scores significantly improved (p=4.53 × 10e^-8) after completion of Scholar 12, in comparison of the composite presurvey (n=1,800, 75.0 % response rate) vs. postsurvey responses (n=1,200, 50.0 % response rate), over four academic years (2020-24). Poster presentations for institutional research day grew an average of 166 % per academic year, after the introduction of Scholar 12, from 40 posters in 2019-2020 to 278 posters in 2023-2024.</p><p><strong>Conclusions: </strong>The successful Scholar 12 implementation into a medical school curriculum demonstrated sustainable institutional scholarly activity growth through four consecutive academic years. Scholar 12 offers an accessible research learning platform relevant to undergraduate and graduate medical education objectives.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A swell case.","authors":"Lauren Fill, Robert W Hostoffer","doi":"10.1515/jom-2023-0055","DOIUrl":"https://doi.org/10.1515/jom-2023-0055","url":null,"abstract":"","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to: Comprehensive review of the heart failure management guidelines presented by the American College of Cardiology and the current supporting evidence.","authors":"Lia Lazareva, Jay H Shubrook, Milind Dhond","doi":"10.1515/jom-2025-3003","DOIUrl":"https://doi.org/10.1515/jom-2025-3003","url":null,"abstract":"","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic pain outcomes among patients treated by osteopathic vs. allopathic physicians: a 36-month follow-up study.","authors":"John C Licciardone, Hanna Lewis, Kaylee Dahl, Branden Adams, Subhash Aryal","doi":"10.1515/jom-2025-0037","DOIUrl":"https://doi.org/10.1515/jom-2025-0037","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Context: &lt;/strong&gt;Osteopathic physicians take a whole-person approach to medical care that may be seen in their relationships with patients and may involve utilizing osteopathic manipulative treatment (OMT) as an alternative to opioid therapy in patients with chronic pain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aimed to compare the outcomes of patients with chronic low back pain (CLBP) treated by osteopathic and allopathic physicians in the United States utilizing a pragmatic design reflecting medical care in real-world settings, including an assessment of potential mediators of osteopathic medical care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective cohort study was conducted utilizing patients with CLBP selected from the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation (PRECISION) from September 2016 through September 2024. Patients were followed at quarterly encounters for up to 36 months after PRECISION enrollment to determine if they were receiving their CLBP medical care from either osteopathic or allopathic physicians. Outcomes pertaining to pain, function, pain impact, health-related quality of life (HRQOL), and the frequency of chronic widespread pain (CWP) and CLBP recovery were also measured at these encounters utilizing generalized estimating equations. Results were adjusted for sociodemographic and clinical characteristics in multivariable analyses. Regression-based analyses were utilized to determine if OMT, opioid prescribing, or physician empathy mediate the outcomes of osteopathic medical care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were 1,491 patients in the study, including 278 (18.6 %) and 1,213 (81.4 %) treated by osteopathic and allopathic physicians, respectively. A total of 8,854 encounters were completed over 36 months, including 2,107 (23.8 %) and 6,747 (76.2 %) in the osteopathic and allopathic medical care groups, respectively. The adjusted means (95 % confidence intervals [CIs]) for patients treated by osteopathic vs. allopathic physicians were 6.3 (6.0-6.6) vs. 6.5 (6.3-6.7) for low back pain intensity (p=0.05); 14.8 (13.8-15.8) vs. 15.6 (14.8-16.4) for back-related disability (p=0.008); 31.9 (30.6-33.2) vs. 32.7 (31.7-33.7) for pain impact (p=0.07); and 57.8 (56.7-58.8) vs. 58.4 (57.6-59.3) for HRQOL deficits (p=0.04). The frequency of CWP occurrence (risk ratio [RR], 1.00; 95 % CI, 0.87-1.15; p=0.98) and CLBP recovery (RR, 0.65; 95 % CI, 0.38-1.11; p=0.12) did not differ between the osteopathic and allopathic medical care groups after adjusting for potential confounders. The significant results pertaining to pain, function, and HRQOL were consistently and most strongly mediated by physician empathy and, to a lesser extent, by OMT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study found that patients with CLBP treated by osteopathic physicians reported better outcomes for pain, function, and HRQOL than patients treated by allopathic physicians over 36 months of fo","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incorporating the Certified Professional in Patient Safety credential into undergraduate medical curriculum: assessment and lessons learned.","authors":"Lillee Gelinas, Amany K Hassan, Janet Lieto, Albert H Yurvati","doi":"10.1515/jom-2023-0248","DOIUrl":"https://doi.org/10.1515/jom-2023-0248","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Context: &lt;/strong&gt;Medical error is cited as a leading cause of preventable harm and death. Medical education in the United States must be restructured to enhance the development of skills, behaviors, and attitudes that medical students will need upon graduation, including the crucial ability to manage clinical and scientific information, understanding the basic concepts of human dynamics, patient safety, systems theory, and the development of basic management, communication, and teamwork skills. To accomplish this goal, it will be necessary for medical schools to balance their current, intensive focus on basic and clinical services with patient safety science. Although many examples exist of incorporating patient safety awareness into medical school courses, there are no recognized and accepted models related to incorporating mandatory patient safety education into medical school curricula that provide comprehensive measures of competence. This study evaluates the quantitative and qualitative outcomes of an intensive, mandatory patient safety course implemented during the third year of undergraduate medical education.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The objective of this study was to determine if the implementation of an advanced mandatory 2-week patient safety course, leading to the attainment of the Certified Professional in Patient Safety (CPPS™) credential, can yield a measurable impact on medical students' patient safety knowledge entering into residency.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were gathered from 12 cohorts of students in each of two consecutive third-year classes. Utilizing mixed-methods analyses, this study followed a total of 430 students to measure the change in their knowledge and perceptions before and after taking the course. The study also assessed what factors were associated with first-time passing of the CPPS™ Certification Examination. These factors included grade point average (GPA), positive perceptions about the course, and class year.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There was significant improvement in the knowledge scores of all five patient safety domains. Similarly, there was a significant improvement in the perceived importance of receiving patient safety education in undergraduate medical education, attaining certification, and the value for students when applying for residency positions. Students' GPA was the only reliable predictor of passing the CPPS™ Certification Examination. Themes from qualitative data analysis reveal student perceptions of the course and certification to be extremely important to understanding the magnitude of the preventable harm problem and highlighting tools to address patient safety issues in the future. Most students reported that the course was essential to preparing for the comprehensive CPPS™ Certification Examination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Patient safety science subject matter can be successfully integrated into a formal course for third-year med","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations in fetal outcomes from cesarean sections with maternal comorbidities: a cross-sectional study of the Pregnancy Risk Assessment Monitoring System.","authors":"Mackenzie Enmeier, Elise Stephenson, Jordyn Prince, Caroline Markey, Binh Phung, Micah Hartwell","doi":"10.1515/jom-2024-0060","DOIUrl":"https://doi.org/10.1515/jom-2024-0060","url":null,"abstract":"<p><strong>Context: </strong>Cesarean sections (CSs) can reduce maternal and fetal risk in medically necessary cases. However, studies show that CSs are associated with negative fetal outcomes, including birth defects, low birth weight, delayed fetal resuscitation, neonatal acidosis, and even infant mortality. Maternal comorbidities play a role in determining if a CS is necessary and may contribute to negative fetal outcomes following a CS.</p><p><strong>Objectives: </strong>The primary objective of this study was to determine the prevalence of negative fetal outcomes such as low birth weight, birth defects, prolonged hospital stay, and infant mortality in CS deliveries and their increased risk of occurrence among mothers with comorbidities.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of the Phase 8 (2016-2019) Pregnancy Risk Assessment Monitoring System (PRAMS) to assess the associations of the aforementioned birth outcomes with pre-existing conditions such as high blood pressure (HBP), depression, and type II diabetes mellitus, as well as demographic factors in the United States (US).</p><p><strong>Results: </strong>Our findings showed that mothers who delivered via CS with pre-existing or gestational HBP, or gestational diabetes, were less likely to experience infant mortality (adjusted odds ratio [AOR]: 0.4; confidence interval [CI]: 0.17-0.92, AOR: 0.2; CI: 0.09-0.44, and AOR: 0.09; CI: 0.03-0.33, respectively). However, mothers who delivered via CS with pre-existing or gestational diabetes, pre-existing or gestational HBP, or pre-existing or gestational depression had higher rates of prolonged infant hospital stay (AOR: 1.73; CI: 1.41-2.11, AOR: 1.21; CI: 1.05-1.39, AOR: 1.77; CI: 1.5-2.09, AOR: 2.58; CI: 2.31-2.88, AOR: 1.25; CI: 1.09-1.43 and AOR: 1.33; CI: 1.16-1.52, respectively). Likewise, mothers who delivered via CS with pre-existing or gestational HBP, or pre-existing or gestational depression, were more likely to deliver an infant with low birth weight (AOR: 1.88; CI: 1.62-2.19, AOR: 2.7; CI: 2.45-2.98, AOR: 1.24; CI: 1.09-1.41, and OR: 1.28; CI: 1.14-1.42, respectively).</p><p><strong>Conclusions: </strong>Our study revealed a lower incidence of infant mortality following CS deliveries among mothers with pre-existing or gestational HBP, or gestational diabetes. This suggests a potential benefit in antenatal testing in mothers experiencing depression or those with no comorbidities. Additionally, infants born to mothers with these comorbidities experienced longer hospital stays, and infants of mothers with pre-existing or gestational HBP and depression had a higher incidence of low birth weight. Given the increasing rates of diabetes, HBP, and depression in the US, it is crucial to provide healthcare professionals with the necessary guidance to prevent and manage these comorbidities and improve fetal outcomes following CS deliveries.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}