The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians最新文献

{"title":"Maternal cardiovascular dysfunction in women with early onset preeclampsia: a cross-sectional study.","authors":"Ajith Ananthakrishna Pillai,&nbsp;Monica Thiyagarajan,&nbsp;Devendra Kishanlal Sharma,&nbsp;Bhagwati Prasad Pant,&nbsp;S B Keerti Priya,&nbsp;Anish Keepanasseril","doi":"10.1080/14767058.2021.1974834","DOIUrl":"https://doi.org/10.1080/14767058.2021.1974834","url":null,"abstract":"Abstract Background Cardiac remodeling and diastolic dysfunction may occur, in women with early-onset preeclampsia, following raised total vascular resistance in response to the impaired placentation. These changes can increase the risk of premature cardiac morbidity and mortality later in life. According to updated guidelines by the American and European Societies of Echocardiography (ASE/ESE) to diagnose diastolic dysfunction, using a simpler criterion is not yet used in pregnant women. Objective To compare the maternal cardiovascular changes and the variation in the diastolic dysfunction using the 2009 and 2016 criteria by ASE/ESE among women with early onset preeclampsia and gestational age-matched normotensive controls. Methods A prospective matched cross-sectional study conducted in a tertiary hospital in South India, involving 40 women with early and 40 women with gestational age-matched normotensive controls. Cardiac function and remodeling were assessed by conventional 2D, M-mode, and Doppler echocardiography. Results Compared to the controls, women with early-onset preeclampsia had significantly higher. Total vascular resistance index (2867.6 vs. 2277.2 dynes/s/cm5/m2, p = .035) and median end-systolic stress index (5.2 vs. 9.2 dyne/cm2/m2), suggesting a higher afterload. Cases had a significant rate of left ventricular diastolic dysfunction using the 2009 criteria (grade II/III: 21 (52%) vs. 0 (0%), p<.001) whereas the rates were much lower when the updated 2016 guidelines were used (grade II/III: 9 (22.5%) vs. 1 (2.5%), p<.001). Conclusions In women with early-onset preeclampsia, cardiovascular adaption occurs to minimize wall stress and myocardial oxygenation. The prevalence of diastolic dysfunction was observed to be lower with the 2016 criteria. Further studies involving pregnant women are required to assess the impact of newer guidelines on association with short- and long-term cardiovascular outcomes in high-risk women.","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8394-8399"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39390078","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":"Risk of uterine niche following single-layer locked versus unlocked uterine closure: a randomized study.","authors":"Recep Bayraktar,&nbsp;Baris Mulayim,&nbsp;Esra Tamburaci,&nbsp;Ceyda Karadag,&nbsp;Burak Karadag","doi":"10.1080/14767058.2021.1966763","DOIUrl":"https://doi.org/10.1080/14767058.2021.1966763","url":null,"abstract":"<p><strong>Introduction: </strong>The primary objective of the present study is to evaluate the effect of single-layer locked versus single-layer unlocked uterine closure techniques on the development of uterine niche. The secondary objective is to evaluate the effect of the ratio of lower uterine segment (LUS) to upper uterine segment (UUS) on the development of uterine niche, which was not previously investigated in literature but which the authors consider to be a major risk factor for the development of uterine niche.</p><p><strong>Methods: </strong>Included in this randomized study were 194 patients who were admitted to the Department of Obstetrics and Gynecology at Health Sciences University Antalya Training and Research Hospital and who underwent cesarean section (CS) due to any reason between October 2017 and May 2018. Two different techniques were used in the closure of hysterotomy: Single-layer locked continuous suturing (Group 1) and single-layer unlocked continuous suturing (Group 2). During surgery, the thicknesses of the LUS and UUS were measured using a sterile scale prior to hysterotomy closure. The patients were evaluated for the development of uterine niche at postoperative six months by transvaginal ultrasound.</p><p><strong>Results: </strong>Control transvaginal ultrasound performed at six months after surgery revealed uterine niches in 58 out of 194 patients (29.29%; 34 patients in Group 1 [34.3%] and 24 patients in Group 2 [25.3%]). No significant difference was noted in terms of the development of uterine niche between the two groups (<i>p</i> = .167). The mean LUS and UUS in patients without uterine niche development were 6.81 ± 1.26 mm and 9.38 ± 1.26 mm, whereas the mean LUS and UUS in patients with uterine niche development were 4.24 ± 1.15 mm and 9.21 ± 2.15, respectively (<i>p</i> = .001 and <i>p</i> = .236). The mean UUS/LUS ratio is 1.4 ± 0.16 among patients without uterine niche and 2.21 ± 0.31 in patients with uterine niche (<i>p</i> < .001).</p><p><strong>Conclusions: </strong>The present study found no statistically significant difference in niche size between the two groups. However, the study reports that the ratio of upper to lower uterine segment that was not previously investigated in literature is a major risk factor for the development of uterine niche.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8210-8216"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39391374","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":"The risk of small and large for gestational age newborns in women with gestational diabetes according to pre-gestational body mass index and weight gain.","authors":"Ronit Koren,&nbsp;Chen Idan,&nbsp;Matan Elkan,&nbsp;Shlomit Koren,&nbsp;Yifat Wiener","doi":"10.1080/14767058.2021.1974390","DOIUrl":"https://doi.org/10.1080/14767058.2021.1974390","url":null,"abstract":"<p><strong>Aim: </strong>To explore the effects of pregestational body mass index (BMI) and gestational weight gain (GWG) on maternal and neonatal outcomes of women with gestational diabetes mellitus (GDM).</p><p><strong>Methods: </strong>We conducted retrospective cohort analyses of outcomes among women with GDM who delivered at Shamir Medical Center, Israel (2017-2018).</p><p><strong>Results: </strong>We included 673 women with GDM in our analysis, 217 (32.24%) with appropriate GWG (aGWG), 247 (36.7%) with excessive GWG (eGWG), and 209 (31%) with insufficient GWG (iGWG). Cesarean section (CS) was less prevalent among women with iGWG (19.6%), compared with women with eGWG (31.2%) and aGWG (31.1%) (<i>p</i> = .008). Small for gestational weight (SGA) newborns were more prevalent in women with iGWG 9.1%, compared with 2% and 0.9% for women with eGWG and aGWG, respectively (<i>p</i><.001). Large for gestational age (LGA) newborns were significantly more prevalent in women with eGWG 17.4% compared with 4.8% and 9.7% in patients with iGWG and aGWG women, respectively (<i>p</i><.001). SGA and LGA newborns were more prevalent in women with iGWG and e-GWG across all pre-gestational BMI groups >18.5 kg/m².</p><p><strong>Conclusions: </strong>A complex interplay exists between pregestational weight, GWG, and GDM and pregnancy outcomes, specifically SGA and LGA newborns. A strict follow-up considering the pregestational BMI, GWG, blood glucose levels, treatment modality, and fetal abdominal circumference could assist in managing the complex interplay of patients with GDM for better neonatal outcomes.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8382-8387"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39433484","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":"Effects of pregnancy on cardiac structure and function in women with sickle cell anemia: a longitudinal comparative study.","authors":"Zubaida Aliyu,&nbsp;Oyewole A Kushimo,&nbsp;Ayodeji A Oluwole,&nbsp;Casmir Amadi,&nbsp;Nuvie Oyeyemi,&nbsp;Amam Mbakwem,&nbsp;Bosede B Afolabi","doi":"10.1080/14767058.2022.2089549","DOIUrl":"https://doi.org/10.1080/14767058.2022.2089549","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell anemia is the commonest hemoglobinopathy in pregnant Nigerian women, and cardiac manifestations are a significant feature of the disease especially in pregnancy. Pregnant women with sickle cell anemia are at high risk of morbidity and mortality and cardiac dysfunction in them increases this risk and may compromise their post-partum health.</p><p><strong>Objective: </strong>To evaluate the cardiac size and function in women with sickle cell anemia (HbSS) during late pregnancy and postpartum.</p><p><strong>Methodology: </strong>This was a longitudinal comparative study in which 40 women, consisting of 20 pregnant HBSS and 20 pregnant HBAA women controls, were recruited. Echocardiography was performed in the third trimester of pregnancy and 6 weeks postpartum.</p><p><strong>Results: </strong>There was a decrease in the mean left atrial diameter (<i>p</i> < .001), left ventricular diameter in diastole (<i>p</i> = .041), and left ventricular mass (<i>p</i> = .004) of HBSS women in the postpartum period compared to their antepartum state. In contrast, there was no significant difference in most cardiac dimensions of pregnant vs postpartum HBAA women. There was no significant change in cardiac function in the pregnant vs postpartum states in both study groups. There were significant differences in cardiac size but not function when comparing HBSS and HBAA women in pregnancy and postpartum.</p><p><strong>Conclusion: </strong>Changes in cardiac size of sickle cell women in pregnancy does not appear to affect cardiac function during pregnancy and in the puerperium, suggesting that the increased size may purely be a response to their chronic anemic state. Studies following women up for longer periods including those with co-morbidities are recommended.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"10049-10054"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40072535","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":"Interpregnancy interval and subsequent perinatal risk of congenital heart disease in Guangzhou, Southern China: a retrospective cohort study, 2014-2019.","authors":"Weidong Li,&nbsp;Liandong Zuo,&nbsp;Yanyan Ni,&nbsp;Di Xiao,&nbsp;Weijian Mo,&nbsp;Zihao Wen,&nbsp;Jing Zhao,&nbsp;Jinxin Zhang,&nbsp;Li Yang","doi":"10.1080/14767058.2021.2008898","DOIUrl":"https://doi.org/10.1080/14767058.2021.2008898","url":null,"abstract":"<p><strong>Background: </strong>The association between maternal interpregnancy interval (IPI) and congenital heart disease (CHD) in neonates remains inconclusive. This study aimed to examine the effect of maternal IPI on birth risk of CHD.</p><p><strong>Methods: </strong>Chinese women with two consecutive singleton deliveries in Guangzhou between January 2014 and December 2019 were selected as participants. Information on IPI and CHD was extracted from the Guangzhou Perinatal Health Care and Delivery Registry and the Guangzhou Birth Defects Surveillance Program. We stratified IPI into four categories: <24 months, 24-35 months, 36-59 months, and ≥60 months. A multivariate logistic regression model was used to examine the association between IPI and CHD. Subgroup analysis was also performed to assess whether the associations differed across top three CHD subtypes.</p><p><strong>Results: </strong>For 119,510 women enrolled in this study, the mean ages at two consecutive deliveries were 26.2 ± 3.8 and 28.8 ± 4.0 years, which yielded a median IPI of 51.2 (interquartile range, 32.1-77.2) months. Among them, 828 delivered infants with CHD during their second pregnancy. There was a J-shaped curve relationship between IPI and CHD with the lowest birth prevalence (5.33‰) at 24-35-month interval. Compared to women with an IPI of 24-35 months, those with an IPI ≥60 had an increased risk of delivering infants with CHD (adjusted odds ratio (OR), 1.41; 95% confidence interval (CI), 1.19-1.64). However, for those with an IPI <24 months (adjusted OR, 1.24; 95% CI, 0.97-1.51), IPI was statistically insignificant associated with the risk of delivering infants with CHD (<i>p</i> = .12). There were different patterns of associations for different CHD subtypes.</p><p><strong>Conclusions: </strong>Longer maternal IPI (≥60 months) was associated with an increased risk of delivering infants with CHD in the Chinese population.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8989-8997"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39679196","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":"Association between maternal single-nucleotide polymorphisms in HLA-G gene and risk of preeclampsia.","authors":"Cui Ma,&nbsp;Yuanyuan Zheng,&nbsp;Xiaowei Liu,&nbsp;Weiyuan Zhang","doi":"10.1080/14767058.2021.2020240","DOIUrl":"https://doi.org/10.1080/14767058.2021.2020240","url":null,"abstract":"<p><strong>Aim: </strong>To determine the relationship between the maternal single-nucleotide polymorphisms (SNPs) in human leukocyte antigen G (HLA-G) gene and preeclampsia (PE), so as to provide guidance for the early risk prediction of PE.</p><p><strong>Methods: </strong>From October 2017 to October 2019, a total of 99 pregnant women were enrolled in this cross-sectional study. The PE group included 51 pregnant women with severe PE, and the control group included 48 pregnant women with normal delivery during the same period. DNA was extracted and the SNPs in HLA-G gene of the two groups were sequenced. Maternal SNPs in HLA-G gene affecting the occurrence of the PE were determined.</p><p><strong>Results: </strong>In this study, patients with PE had increased gravidity (<i>p</i> = .002), increased BMI before delivery (<i>p</i> = .004), reduced neonatal weight (<i>p</i> < .001), reduced gestational weeks (<i>p</i> < .001), reduced placental weight (<i>p</i> < .001), and increased proportion of cesarean section (<i>p</i> < .001). There were significant differences in SNPs at locus 29794467, 29796376, and 29799440 between the two groups (<i>p</i> < .05). In locus 29799440, patients with genotype CC had a lower risk of PE than patients with genotype TT (<i>p</i> = .047), with an odds ratio (OR) of 0.347(95%CI: 0.031, 3.881). And there was no significant difference in the risk of PE between patients with genotype CT, and those with genotype TT (<i>p</i> = .090) (OR = 2.344 95%CI: 0.187, 29.344).</p><p><strong>Conclusion: </strong>There is an association between a SNP in locus 29799440 of the HLA-G gene and susceptibility of PE in Han Chinese pregnant women, and the risk of PE increases with genotype CT/TT in pregnant women.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"9195-9200"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39768652","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":"Glycemic variability and indices of glycemic control among pregnant women with type 1 diabetes (T1D) based on the use of continuous glucose monitoring share technology.","authors":"Julie Sklar,&nbsp;Laura Pyle,&nbsp;Janet K Snell-Bergeon,&nbsp;Rachel Garcetti,&nbsp;Prakriti Joshee,&nbsp;Jamie K Demmitt,&nbsp;Sarit Polsky","doi":"10.1080/14767058.2021.2008895","DOIUrl":"https://doi.org/10.1080/14767058.2021.2008895","url":null,"abstract":"Abstract Background Pregnancies complicated by type 1 diabetes (T1D) experience high levels of glycemic variability, which may be associated with adverse maternal and neonatal outcomes. Therefore, strategies that help pregnant women with T1D manage their glycemic control are of great interest. Methods We examined associations with or without remote monitoring of Continuous Glucose Monitor (CGM) data by friends and family with indices of glycemic control and glycemic variability during pregnancies complicated by T1D in a pilot non-randomized trial (n = 28). During preconception or the first trimester, participants were placed in one of two groups based on device compatibility: (1) CGM Alone (n = 13): women without iPhone, iPad or iPod Touch; or (2) CGM Share (n = 15): women with iPhone, iPad, or iPod Touch and followers with devices compatible for data viewing. Linear mixed models were used to compare indices of glycemic control and glycemic variability over time between groups. Results Participants using CGM Share had lower estimated HbA1c levels over time (p = .028), glucose management index (p = .041), and fewer glucose excursions >200 mg/dL in each trimester (p = .022) compared to those using CGM Alone. Participants using CGM Alone had higher high blood glucose index (p = .020), mean area under the curve (p = .026), and standard deviation (p = .046) compared to those using CGM Share. Other measures of glycemic variability did not differ between groups. Conclusion In this non-randomized pilot study, use of CGM Share was associated with improvements in several indices of glycemic control and glycemic variability.","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"8968-8974"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39789987","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":"Use of gestation adjusted projection method for predicting fetal head circumference.","authors":"Michelle N Lende,&nbsp;Ariana G Munger,&nbsp;Craig M Zelig","doi":"10.1080/14767058.2021.1926450","DOIUrl":"https://doi.org/10.1080/14767058.2021.1926450","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to determine if the gestation adjusted projection (GAP) method applied to a fetal head circumference (FHC) measured on ultrasound between 32 and 36 weeks and 6 days gestation can predict birth head circumference, specifically ≥ 35 cm, which is a known risk factor for Cesarean.</p><p><strong>Methods: </strong>This is a retrospective chart review of 60 pregnancies from January to December 2019. Eligible patients delivered a singleton term neonate and received two ultrasounds, one at 32-36 weeks and 6 days gestation (period 1) and a second within 7 days of a term birth (period 2). Fetal head circumference was predicted two ways, by applying (1) the GAP method to the period 1 ultrasound and (2) by direct measurement with a period 2 ultrasound. These estimates were compared to the birth head circumference (HC_BIRTH) by measures of error and with paired <i>t</i>-tests. McNemar's test compared the ability to predict head circumference (HC) ≥ 35 cm.</p><p><strong>Results: </strong>None of the measures of error were significantly different between the GAP and the period 2 ultrasound, including the ability to predict HC ≥ 35 cm. In patients who delivered at ≥ 39 weeks, the period 2 ultrasound performed poorly while the GAP's performance remained good.</p><p><strong>Conclusion: </strong>The GAP method applied to an early third trimester ultrasound predicts HC_BIRTH with accuracy similar to an ultrasound performed seven days from delivery and may be superior for deliveries ≥ 39 weeks. The ability to predict HC_BIRTH could improve clinical management of affected pregnancies.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"6836-6840"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1926450","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38990492","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":"COVID-19: changing the care process for women's health-the patient's perspective.","authors":"Reem S Abu-Rustum,&nbsp;Melissa Bright,&nbsp;Nash Moawad,&nbsp;Emily Weber LeBrun,&nbsp;Kay Roussos-Ross,&nbsp;Gregory Christman,&nbsp;Alice Rhoton-Vlasak,&nbsp;John C Smulian","doi":"10.1080/14767058.2021.1909560","DOIUrl":"https://doi.org/10.1080/14767058.2021.1909560","url":null,"abstract":"<p><strong>Objective: </strong>Assess women's perceptions of the impact of COVID-19 on their health care and well-being, access to and satisfaction with medical care due to the changes in delivery of care triggered by the pandemic.</p><p><strong>Methods: </strong>An online survey of women having health care appointments in the outpatient facilities across all divisions of a Department of Obstetrics and Gynecology at a tertiary care referral center in North Central Florida. Patients had outpatient appointments that were scheduled, canceled or rescheduled, in person or by telemedicine, between 11 March 2020 and 11 May 2020, a time during which a COVID-19 stay-at-home order was enacted across our state. A total of 6,697 visits were planned. Patients with multiple visits were unified, leaving 6,044 unique patients to whom the survey was emailed between 20 July 2020 and 31 July 2020. The survey was closed on 21 August 2020. Analyses were focused on simple descriptive statistics to assess frequency of responses. Analyses of variance and chi-square analyses were conducted to compare outcomes when all cells were ≥ 10, based on sub-specialty and insurance status; otherwise, frequencies were examined for the entire sample only. Missing data were excluded listwise.</p><p><strong>Results: </strong>A total of 6044 patients were contacted. Completed surveys numbered 1,083 yielding a response rate of 17.9%. The most common sub-specialty visit was gynecology (56.7%) followed by obstetrics (31.5%,), pelvic floor disorders (4.8%), gynecological oncology (2.9%,), and reproductive endocrinology (0.5%). A substantial percentage of women had visits canceled (19.2%), rescheduled (32.8%) or changed (42.1%) to telemedicine. In our patient population, 32.6% were worried about visiting the clinic and 48.1% were worried about visiting the hospital. COVID-19 triggered changes were perceived to have a negative impact by 26.1% of respondents. Refusal of future telemedicine visits was by 17.2%, however, 75.2% would prefer to use both in-person and telemedicine visits.</p><p><strong>Conclusion: </strong>During the initial COVID-19 surge with lockdown, the majority of survey respondents were following public health precautions. However, there were significant concerns amongst women related to obstetric and gynecologic medical appointments scheduled during that period. During pandemics, natural disasters and similar extreme circumstances, digital communication and telemedicine have the potential to play a critical role in providing reassurance and care. Nevertheless, given the concerns expressed by survey respondents, communication and messaging tools are needed to increase comfort and ensure equity with the rapidly changing methods of care delivery.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"6180-6184"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1909560","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39025722","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":"Association of maternal lead exposure with the risk of preterm: a meta-analysis.","authors":"Ahmad Habibian,&nbsp;Morteza Abyadeh,&nbsp;Mostafa Abyareh,&nbsp;Nader Rahimi Kakavandi,&nbsp;Atefeh Habibian,&nbsp;Maliheh Khakpash,&nbsp;Mahmoud Ghazi-Khansari","doi":"10.1080/14767058.2021.1946780","DOIUrl":"https://doi.org/10.1080/14767058.2021.1946780","url":null,"abstract":"<p><strong>Background: </strong>The relationship between maternal lead level and risk of preterm birth (PTB) remained controversial. Therefore, herein we performed this meta-analysis to investigate the association of maternal blood, urine and cord blood lead level with the risk of PTB using observational studies.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, EMBASE and Ovid Medline databases from inception to August 2019, and sixteen studies with 65600 participants investigating the association between maternal lead level and PTB were included in our meta-analysis. Odds ratios (ORs) and 95% confidence intervals (95% CI) were calculated for the highest versus lowest lead level by random-effects model.</p><p><strong>Results: </strong>Overall, the pooled OR of all included articles for the highest versus lowest PTB score was 1.29 (95% CI = 1.14-1.46; I2 = 80.4%, <i>p</i> < .001), and the results revealed a direct and significant relationship between second and third trimester blood lead level (BLL) and PTB (OR 2nd trimester= 1.61, 95% CI = 1.08-2.40, OR 3rd trimester= 1.57, 95% CI = 1.11-2.23).</p><p><strong>Conclusion: </strong>Results of this meta-analysis showed that maternal BLL is directly associated with the risk of PTB.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"7222-7230"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1946780","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39059845","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}