Pregnancy (Hoboken, N.J.)最新文献

{"title":"Prenatal remote blood pressure monitoring: Impacts on blood pressure measurement and health outcomes.","authors":"Mary Reed, Jie Huang, Dayakar Beeravolu, Monique Hedderson, Andrea Millman, Mara Greenberg","doi":"10.1002/pmf2.70340","DOIUrl":"10.1002/pmf2.70340","url":null,"abstract":"<p><strong>Introduction: </strong>Remote monitoring technology can help patients and healthcare providers to track blood pressure measurements during pregnancy to manage hypertension, but limited evidence from widespread community use is available.</p><p><strong>Methods: </strong>Among pregnant patients in 2022-2023 with hypertensive disorders of pregnancy, in a setting offering home blood pressure monitoring with blood pressure data collected either via weekly nurse telephone calls or digital remote upload of blood pressures with nurse calls only as-needed, we compared participant characteristics, monitoring process, and clinical outcomes between remote monitoring participants and non-remote monitoring participants using propensity weighting to account for differences between participant groups.</p><p><strong>Results: </strong>Among all 2750 pregnant patients with hypertensive disorders of pregnancy, 2366 (86.0%) participated in remote monitoring. After adjustment, compared with patients with telephonic nurse monitoring of home-recorded measures, patients with remote monitoring had statistically significantly (all <i>p</i> < 0.05) fewer synchronous nurse phone calls (6.4 with remote monitoring vs. 12.6 without remote monitoring), more weeks with blood pressure readings shared with clinicians (measures on 12.7 weeks with remote monitoring vs. 8.3 weeks without remote monitoring,) and more weeks with severe hypertension captured (events on 1.08 weeks with remote monitoring vs. 0.22 weeks without remote monitoring). While the number of medication adjustments was not significantly different between monitoring types, the gestational age at first adjustment was 1.96 weeks earlier (95% confidence interval [CI] 0.22-3.69) in patients with remote monitoring. Emergency department visits and hospitalizations did not differ statistically significantly between monitoring groups, nor did severe maternal morbidity or cesarean or stillbirth outcomes.</p><p><strong>Conclusions: </strong>Remote blood pressure monitoring uptake and feasibility was high and was associated with higher capture of clinically actionable values, earlier medication adjustment, improved resource utilization, and similar perinatal outcomes compared with a telephone-based care model for hypertensive disorders of pregnancy.</p>","PeriodicalId":520540,"journal":{"name":"Pregnancy (Hoboken, N.J.)","volume":"2 4","pages":"e70340"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of implementing a multidisciplinary team approach in the management of placenta accreta spectrum.","authors":"Binh T Luu, Megha Arora, Ava D Mandelbaum, Andrew H Chon, Tania F Esakoff, Deirdre J Lyell, Aaron B Caughey","doi":"10.1002/pmf2.70323","DOIUrl":"https://doi.org/10.1002/pmf2.70323","url":null,"abstract":"<p><strong>Objective: </strong>Placenta accreta spectrum (PAS) is associated with high maternal morbidity. Recent studies have shown that a multidisciplinary team (MDT) approach to managing PAS can improve outcomes. This study aimed to evaluate the cost-effectiveness of implementing an MDT for the management of PAS.</p><p><strong>Methods: </strong>A decision-analytic model was built using TreeAge software to compare the outcomes and cost-effectiveness of the MDT approach versus the standard of care. The theoretical cohort included 5000 individuals in the United States with PAS annually. Maternal outcomes included severe postpartum hemorrhage (>2000 mL estimated blood loss), adjacent organ injury, intensive care unit (ICU) admission, maternal death, and hospital readmission. The cost of the MDT was estimated by assuming that there would be specific maternal-fetal medicine (MFM) physician and nursing leadership assigned for administrative coordination and estimates of the cost of the multidisciplinary clinicians during the PAS cases. Model inputs were derived from the literature. The cost-effectiveness threshold was $100,000/quality-adjusted life-year (QALY). Sensitivity analyses were performed to assess the robustness of the results.</p><p><strong>Results: </strong>An MDT approach for the management of PAS resulted in 3724 fewer severe postpartum hemorrhages, 139 fewer adjacent organ injuries, 506 fewer ICU admissions, 87 fewer hospital readmissions within 6 months, and one less maternal death compared to standard of care. When assuming a minimum baseline of 15 PAS cases per year, the MDT approach was a dominant strategy resulting in a $12.1 million cost reduction and an increase of 26 QALYs relative to standard care. One-way sensitivity analyses on the cost of the MDT per PAS case and the number of PAS cases per medical center demonstrated that the MDT strategy remains cost effective when the cost per case was less than $9290 and when centers treat at least seven PAS cases annually.</p><p><strong>Conclusion: </strong>Implementing an MDT was cost effective and improved maternal outcomes. These findings may inform interventions that promote MDT in the management of this high-risk condition.</p>","PeriodicalId":520540,"journal":{"name":"Pregnancy (Hoboken, N.J.)","volume":"2 4","pages":"e70323"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Society for Maternal-Fetal Medicine Statement: Evaluation and management of cell-free DNA screening for fetal red cell antigen genotype in alloimmunized and non-alloimmunized pregnancies.","authors":"Britton D Rink, Jeffrey A Kuller, Teresa N Sparks, Malavika Prabhu, Anne H Mardy, Lorraine Dugoff, Joseph R Biggio","doi":"10.1002/pmf2.70339","DOIUrl":"https://doi.org/10.1002/pmf2.70339","url":null,"abstract":"<p><p>A substantial portion of RhD-negative pregnant patients carry an RhD-negative fetus and are not at risk of RhD alloimmunization. Knowing the fetal RhD genotype allows such patients to avoid unnecessary monitoring or treatment. The use of cell-free DNA (cfDNA) to detect the fetal RhD genotype from maternal blood has been proposed to identify pregnancies in alloimmunized patients at risk for hemolytic disease of the fetus and newborn and to decrease the antenatal use of Rho(D) immune globulin (RhIg) in patients not at risk. However, a number of factors limit the utility of cfDNA for RhD genotyping, including a lack of data that adequately reflect US populations or US laboratory testing approaches and a lack of data or research from independent sources. This document describes considerations and offers guidance on cfDNA screening for red blood cell antigen genotypes in three scenarios: RhD in a non-alloimmunized patient, RhD in a non-alloimmunized patient in the setting of an RhIg shortage, and any fetal red cell antigen genotype in an alloimmunized obstetrical patient.</p>","PeriodicalId":520540,"journal":{"name":"Pregnancy (Hoboken, N.J.)","volume":"2 4","pages":"e70339"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized controlled trial of traxi panniculus retractor use during non-emergent cesarean delivery.","authors":"Tooba Anwer, Tina Yi Jin Hsieh, Emily Stonestreet, Audrey Mutoni, Phillip Hess, Yunping Li, Tyler Lueck, Michael Furdyna, John Kowalczyk, Anna Modest, Ai-Ris Y Collier","doi":"10.1002/pmf2.70345","DOIUrl":"https://doi.org/10.1002/pmf2.70345","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The objective of our study is to determine whether the use of a self-retaining panniculus retraction device (traxi) in patients with obesity will improve operative time, pulmonary function, or patient and provider experience for non-emergent cesarean delivery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Pregnant patients with body mass index (BMI) ≥40 kg/m&lt;sup&gt;2&lt;/sup&gt; undergoing non-emergent cesarean delivery were recruited from two academic hospitals and randomized to traxi panniculus retraction or to no traxi. Computer-generated block randomization, stratified by prior abdominal surgery, was used to randomize participants in a 1:1 ratio to the traxi or standard care. Demographic information was collected by self-report. Surgical time from skin incision to closure and clinical data was collected by review of the electronic health record. Pulmonary function testing via spirometer was performed before and after application of retraction. Participant and provider experience was collected postoperatively. Intention-to-treat analysis was performed using a Wilcoxon rank-sum test and a chi-squared test for continuous and dichotomous variables, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We enrolled 135 participants from 2018 to 2024 at two academic hospitals; 67 were randomized to traxi and 68 were randomized to no traxi. Of these, 43 (31.9%) reported no prior abdominal surgery (including prior cesarean or other laparotomy) and the median BMI was 48.9 (interquartile range [IQR] 45.0, 52.5). The trial was terminated before the target sample size of 220 participants was achieved due to slow accrual and waning clinical equipoise. Baseline characteristics of each group were similar. Median surgical time was 65.0 min (IQR 55.0, 81.0) in the traxi group and 70.0 min (IQR 57.0, 86.0) in the no traxi group, but this difference was not statistically significant (&lt;i&gt;p&lt;/i&gt; = 0.31). There was less restrictive pulmonary physiology associated with application of traxi compared to no traxi; the forced expiratory volume in 1 second (FEV1) difference was -0.03 L (-0.20, 0.10) and -0.11 L (-0.45, -0.02) (&lt;i&gt;p&lt;/i&gt; = 0.048), respectively. Providers were significantly more likely to report that the traxi was very effective, not really difficult to use, not really physically uncomfortable to use, very satisfying to use, and a form of retraction that they would very likely recommend to another colleague. All patients in the traxi arm reported they would choose this retraction method in a future cesarean delivery compared to 91% of patients in the no traxi arm; however, this finding was not statistically significant (&lt;i&gt;p&lt;/i&gt; = 0.05). \"A little bit\" of rash where the method of taping was used within 2 days of surgery was reported by 0% of patients in the traxi arm, compared to the no traxi arm (20%, &lt;i&gt;p&lt;/i&gt; = 0.0048).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Traxi panniculus retraction did not significantly improve surgical time but was associated with less r","PeriodicalId":520540,"journal":{"name":"Pregnancy (Hoboken, N.J.)","volume":"2 4","pages":"e70345"},"PeriodicalIF":0.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic administration after previable preterm prelabor rupture of membranes is associated with prolonged latency.","authors":"Alexandra L Hammerquist, Alexander M Saucedo, Selina L Bowler, Mohan Pammi, Catherine Eppes, Ignatia Van den Veyver, Michael D Jochum, Enrico R Barrozo","doi":"10.1002/pmf2.70342","DOIUrl":"https://doi.org/10.1002/pmf2.70342","url":null,"abstract":"<p><strong>Introduction: </strong>While antibiotics have been shown to increase the interval to delivery between rupture of membranes and delivery (latency) and improve neonatal outcomes after viable preterm prelabor rupture of membranes (PPROM), this has not been well investigated in the previable PPROM population. We aimed to investigate the association between antenatal antibiotics and latency following previable PPROM. Secondarily, we examined various maternal and neonatal outcomes. We hypothesized that the administration of antibiotics would prolong latency in pregnancies with previable PPROM.</p><p><strong>Methods: </strong>Single-center retrospective cohort study that included pregnancies diagnosed with previable PPROM between 14^0/7 and 21^6/7 and delivered between 2012 and 2024. Administration of antibiotics at any time after membrane rupture to prolong latency was the exposure of interest. Chi-squared tests were performed for categorical variables and the Wilcoxon rank-sum test for numerical variables. Statistical significance was defined as <i>p <</i> 0.05. Multivariable linear regression was performed for the primary outcome, including gestational age at rupture of membranes as a covariate.</p><p><strong>Results: </strong>After controlling for estimated gestational age at rupture of membranes, receipt of antibiotics after previable PPROM was associated with a 14.7-day increase in latency (SE = 6.86, <i>p = </i>0.034). Antibiotics were associated with a later gestational age at delivery (25.07 vs. 20.31 weeks' gestation) and delivery at or beyond 22^0/7 (80.95% vs. 15.62%). Administration of antibiotics was associated with lower rates of intrauterine fetal demise (IUFD; 20.63% vs. 65.62%, <i>p <</i> 0.001) and higher rates of neonatal survival to discharge (49.21% vs. 6.25%, <i>p <</i> 0.031).</p><p><strong>Conclusion: </strong>Receipt of latency antibiotics after previable PPROM was associated with prolonged latency in both singleton and multiple gestation pregnancies. Those exposed to antibiotics had more deliveries at or beyond 22 0/7 weeks, higher neonatal survival-to-discharge rates, and fewer IUFDs. These findings highlight the potential benefit of latency antibiotics in extending pregnancy duration and improving neonatal outcomes following previable PPROM, supporting their consideration in expectant management and the necessity for larger prospective studies.</p>","PeriodicalId":520540,"journal":{"name":"Pregnancy (Hoboken, N.J.)","volume":"2 4","pages":"e70342"},"PeriodicalIF":0.0,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal point-of-care ultrasound training during Maternal Fetal Medicine fellowship: A national survey.","authors":"Elsa Parra, Sheree Carter, Anna Joy Rogers, Kerri Brackney","doi":"10.1002/pmf2.70348","DOIUrl":"https://doi.org/10.1002/pmf2.70348","url":null,"abstract":"<p><strong>Introduction: </strong>Point-of-care ultrasound (POCUS) is widely used to facilitate management of critical patients. Literature about maternal POCUS (M-POCUS) is limited, but there is interest in its potential to optimize care for high-risk obstetric patients. Currently, there is no data on the frequency of M-POCUS use among Maternal Fetal Medicine (MFM) fellows in training. We aimed to determine what proportion of MFM fellows perform M-POCUS, and whether exposure to an obstetric intensive care unit (OBICU) impacts M-POCUS utilization.</p><p><strong>Methods: </strong>This was a cross-sectional survey of fellows in the United States. An anonymous 20-item web-based survey was designed to ascertain fellow exposure and interest in M-POCUS training. We defined M-POCUS as maternal cardiac, lung, and/or abdominal ultrasound, and excluded feto-placental assessment. We directly contacted 382 fellows and 112 program coordinators and directors via email. Surveys were distributed by email twice weekly and by text message weekly in March, 2025. The analysis was descriptive, with proportions and medians used when appropriate. Comparisons of participant demographics and responses were performed with a chi-square or Fisher's exact test when appropriate, and <i>p</i> < 0.05 was considered significant. Univariate regression was used to perform odds ratios (ORs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>The response rate was 56.3% (<i>n</i> = 215/382). MFM fellows with OBICU exposure did not report a significant difference in M-POCUS use (<i>p</i> = 0.18). Overall, 60.0% of respondents performed M-POCUS at least once during fellowship. The highest predictors of performing an M-POCUS exam were self-reported adequate M-POCUS training (OR, 19.29; 95% CI, 5.79-64.32) and observing an M-POCUS exam during MFM fellowship (OR, 9.44; 95% CI, 4.70-18.98). Almost all respondents (96.7%, <i>n</i> = 208/215) are interested in pursuing further M-POCUS training.</p><p><strong>Conclusion: </strong>Although OBICU exposure during MFM fellowship did not alter M-POCUS use among respondents, they generally perceive value in this skill and have interest in further training opportunities.</p>","PeriodicalId":520540,"journal":{"name":"Pregnancy (Hoboken, N.J.)","volume":"2 4","pages":"e70348"},"PeriodicalIF":0.0,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a patient-centered planning intervention on postpartum visit attendance.","authors":"Sheree L Boulet, Kaitlyn K Stanhope, Taé Stallworth, Gabriela Juarez, Marisela Lozada, Franklyn Geary, Victoria L Green, Taylore King, Lauren Furst, Danielle Vuncannon, Anna Newton-Levinson, Denise J Jamieson, Anne L Dunlop","doi":"10.1002/pmf2.70346","DOIUrl":"https://doi.org/10.1002/pmf2.70346","url":null,"abstract":"<p><strong>Introduction: </strong>Pregnant individuals with cardiometabolic conditions-including diabetes, hypertensive disorders, and obesity-are at elevated risk for postpartum complications. Timely postpartum care is critical for mitigating postpartum risks, yet postpartum visit attendance remains suboptimal, and few evidence-based interventions exist, especially among those receiving care in safety-net health systems. We aimed to evaluate whether a patient-centered postpartum care planning intervention increases comprehensive postpartum visit attendance among obstetric patients with at least one cardiometabolic risk factor.</p><p><strong>Methods: </strong>We conducted a single-center, parallel group randomized control trial at a metropolitan safety-net health system, enrolling pregnant individuals who were 20-34 weeks gestation, English or Spanish-speaking, and had a diagnosis of diabetes mellitus, chronic hypertension, gestational diabetes, gestational hypertension or preeclampsia, and/or pre-pregnancy obesity. Participants were randomized 1:1 to receive standard obstetric care (control) or standard obstetric care plus prenatal education and co-creation of a postpartum care plan (intervention). The primary outcome was attendance at a comprehensive postpartum visit between 4 and 12 weeks postpartum. We used generalized linear models to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for the intervention using an intent-to-treat approach, stratified by parity.</p><p><strong>Results: </strong>We randomized 159 participants to the intervention and 161 to the control arms (<i>N</i> = 320). Overall, 52.8% and 55.3% of participants in the intervention and control arms, respectively, attended a comprehensive postpartum visit (<i>p </i>= 0.66). When stratified by parity, no differences were seen among primiparous participants (61.5% vs. 50.0%; RR, 1.23; 95% CI, 0.82-1.85) or multiparous participants (48.6% vs. 56.6%; RR, 0.86; 95% CI, 0.67-1.10). For multiparous participants, among those receiving one or no prenatal study visits with a research coordinator, only 29.6% attended a comprehensive postpartum visit, whereas 72.4% of those with ≥3 visits did so (<i>p </i>= 0.001).</p><p><strong>Conclusion: </strong>The patient-centered postpartum care planning intervention did not significantly improve postpartum visit attendance. However, attendance rates were higher among those with greater prenatal intervention exposure, suggesting that intensity and continuity of patient engagement may improve postpartum care utilization.</p><p><p><b>Trial registration</b>: Date of registration: June 20, 2022; date of initial participant enrollment: August 8, 2022; clinical trial identification number: NCT05430815; URL of the registration site: https://clinicaltrials.gov/study/NCT05430815.</p>","PeriodicalId":520540,"journal":{"name":"Pregnancy (Hoboken, N.J.)","volume":"2 4","pages":"e70346"},"PeriodicalIF":0.0,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of body mass index with adverse pregnancy outcomes when stratified by cardiovascular health.","authors":"Karen J Gibbins, Amy M Valent, Nicole E Marshall","doi":"10.1002/pmf2.70341","DOIUrl":"https://doi.org/10.1002/pmf2.70341","url":null,"abstract":"<p><strong>Introduction: </strong>High body mass index (BMI) is associated with adverse pregnancy outcomes, but it is not a direct measure of cardiovascular health (CVH) and misclassifies many. As CVH is a lead determinant of lifelong morbidity and mortality, we aimed to evaluate the association between BMI ≥30 and adverse pregnancy outcomes stratified by CVH.</p><p><strong>Methods: </strong>Secondary analysis of the nuMoM2b multicenter cohort of nulliparas, excluding people with pregestational diabetes (GDM) and chronic hypertension. We used American Heart Association's Life's Simple 7 to assess CVH. Metrics included smoking, physical activity, healthy diet pattern, total cholesterol, and blood pressure. We omitted BMI given our objective, and we added triglycerides as these are a marker of CVH in pregnancy. We assigned 0 points for Poor category, 1 for Intermediate, and 2 for Ideal for each metric, with a maximum total score of 14. Total score was categorized as Poor (1-7), Intermediate (8-11), or Ideal (12-14). Outcomes included adverse perinatal outcomes previously linked to BMI. Association between exposures and outcomes was calculated via logistic regression.</p><p><strong>Results: </strong>A total of 2381 participants were included, of which 445 (20.0%) had BMI ≥30, 134 (5.4%) had Poor CVH, 1733 (72.8%) had Intermediate CVH, and 514 (21.6%) had Ideal CVH. Overall, BMI ≥30 was associated with increased hypertensive disease of pregnancy (HDP, 38.7% vs. 19.6%; odds ratio [OR], 2.6; 95% confidence interval [CI], 2.1-3.2), severe preeclampsia (8.3 vs. 3.1%; OR, 2.8; 95% CI, 1.9-4.3), large for gestational age (LGA, 10.6% vs. 4.3%; OR, 2.6; 95% CI, 1.8-3.8), GDM (7.4% vs. 2.6%; OR, 3.0; 95% CI, 1.9-4.6), and cesarean birth (37.0% vs. 22.4%; OR, 2.0; 95% CI, 1.6-2.5). However, when stratified by CVH category, these associations were attenuated. In the Ideal CVH category, BMI ≥30 was only associated with LGA and GDM. Poor CVH was associated with an elevated risk of HDP regardless of BMI.</p><p><strong>Conclusion: </strong>Relying on BMI alone to assess pregnancy risk appears to overestimate the risk of BMI ≥30 in those with otherwise Ideal CVH and underestimate in those with BMI 18.5-29.9 but Poor CVH. A more comprehensive assessment of CVH could result in a more accurate risk stratification.</p>","PeriodicalId":520540,"journal":{"name":"Pregnancy (Hoboken, N.J.)","volume":"2 4","pages":"e70341"},"PeriodicalIF":0.0,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reframing maternal and newborn health after the Sustainable Development Goals 2030 agenda: The role of The Lancet Commission on Maternal and Newborn Health.","authors":"Mehreen Zaigham, Ines Nunes, Bo Jacobsson","doi":"10.1002/pmf2.70349","DOIUrl":"https://doi.org/10.1002/pmf2.70349","url":null,"abstract":"","PeriodicalId":520540,"journal":{"name":"Pregnancy (Hoboken, N.J.)","volume":"2 4","pages":"e70349"},"PeriodicalIF":0.0,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of treatment for prenatal depression with cardiovascular disease within 24 months after delivery.","authors":"Christina M Ackerman-Banks, Kristin Palmsten, Heather S Lipkind, Katherine A Ahrens","doi":"10.1002/pmf2.70344","DOIUrl":"https://doi.org/10.1002/pmf2.70344","url":null,"abstract":"<p><strong>Introduction: </strong>While the strong association of prenatal depression with an increased risk of new cardiovascular disease (CVD) within 24 months postpartum has been demonstrated in two distinct cohorts, it is unclear if treatment of prenatal depression may mitigate this risk. We aimed to estimate the cumulative risk of new CVD and new chronic hypertension in the first 24 months postpartum among pregnant individuals with prenatal depression treated with antidepressant medications or psychotherapy compared with those with untreated prenatal depression. We hypothesized that treatment for prenatal depression may be associated with a lower risk of CVD postpartum among those with prenatal depression.</p><p><strong>Methods: </strong>Our longitudinal population-based study included pregnant individuals with deliveries in the Maine Health Data Organization's All Payer Claims Data during 2007-2020. We excluded those individuals with any diagnosis before pregnancy of the cardiovascular conditions being examined postpartum, multifetal gestations, or no continuous health insurance during pregnancy. Prenatal depression, psychotherapy, and antidepressant medications were identified with ICD9/10 diagnosis codes, CPT codes, and pharmacy dispensing data, respectively. Primary outcomes were a dichotomous CVD composite (heart failure, ischemic heart disease, cerebrovascular disease, arrhythmia/cardiac arrest, cardiomyopathy) and chronic hypertension within 24 months postpartum. Adjusted Cox models were used to estimate hazard ratios.</p><p><strong>Results: </strong>Among the 17,100 pregnant individuals with depression included in our analysis (13.5% of 126,333 total eligible pregnancies), 50.0% (<i>n</i> = 8556) had treatment with antidepressants and/or psychotherapy visits. Among the 16,953 pregnant individuals with depression included in the composite CVD outcome analysis, treatment with antidepressant medication use and/or psychotherapy was associated with a 25% lower risk of CVD (adjusted hazard ratio [aHR],, 0.75; 95% confidence interval [CI], 0.57-0.98). However, among the 15,240 pregnant individuals with depression included in the new chronic hypertension outcome analysis, no association was observed (aHR, 1.05; 95% CI, 0.84-1.32).</p><p><strong>Conclusion: </strong>The cumulative risk of new CVD within 24 months postpartum was significantly lower in patients with antidepressant and/or psychotherapy use during pregnancy compared to those with untreated prenatal depression. This suggests that treatment of prenatal depression may mitigate CVD risk; however, given the limitations of observational research, further study is warranted to elucidate the pathophysiologic mechanisms that underlie this association.</p>","PeriodicalId":520540,"journal":{"name":"Pregnancy (Hoboken, N.J.)","volume":"2 4","pages":"e70344"},"PeriodicalIF":0.0,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}