American journal of perinatology最新文献

{"title":"Unintended Upper Uterine Wall Extensions at the Time of Cesarean Delivery: Risk Factors and Associated Adverse Maternal and Neonatal Outcomes.","authors":"Tzuria Peled, Noa Saar, Giulia M Muraca, Hen Y Sela, Sorina Grisaru-Granovsky, Misgav Rottenstreich","doi":"10.1055/a-2408-7813","DOIUrl":"10.1055/a-2408-7813","url":null,"abstract":"<p><p>This study aims to estimate the frequency of unintended upper uterine wall extensions during cesarean delivery (CD) and identify associated risk factors and adverse outcomes.A multicenter retrospective cohort study was conducted, including patients who underwent CD between 2005 and 2021. Demographic factors, obstetric history, CD indications, delivery and surgical characteristics, adverse maternal and neonatal outcomes were compared between those with unintended upper uterine wall extensions during CD and those without extensions. Crude and adjusted estimates (odds ratios [ORs] and 95% confidence intervals [CIs]) were used.Among 30,517 patients meeting inclusion criteria, 117 (0.4%) had an unintended upper uterine wall extension. In univariate analysis, upper uterine wall extensions were associated with higher rates of intrapartum CD, second-stage CD, unplanned or emergency CD, CD following failed vacuum delivery or trial of labor after CD, chorioamnionitis, prolonged labor, increased vaginal exams, lower fetal head station, and higher birth weight. During surgery, higher rates of general anesthesia, significant intraperitoneal adhesion, fetal malpresentation, and fetal extraction by the leg were observed. Multivariable analysis identified fetal extraction not by head (adjusted OR [aOR]: 9.17, 95% CI: 5.35-15.73), vertex fetal presentation (aOR: 3.65, 95% CI: 1.81-7.35), second-stage CD (aOR: 3.07, 95% CI: 1.24-7.59), and trial of labor after cesarean (aOR: 2.04, 95% CI: 1.08-3.84) as significant risk factors for unintended upper uterine wall extensions. Additionally, upper uterine wall extensions were associated with higher rates of maternal and neonatal complications, including longer operating times, excessive bleeding, postpartum hemorrhage, intraperitoneal drainage, blood product transfusion, puerperal fever, paralytic ileus, Apgar score < 7 at 1 and 5 minutes, and fetal intracranial hemorrhage.Our study identifies risk factors for unintended upper uterine wall extensions during CD. While these extensions are infrequent, their occurrence is associated with increased maternal and neonatal morbidity. · Unintended upper uterine wall extensions occur in 0.4% of cesarean deliveries.. · Significant risk factors include fetal extraction not by head and second-stage CD.. · Extensions are associated with increased maternal complications like excessive bleeding and prolonged surgery.. · Neonatal complications include lower Apgar scores and intracranial hemorrhage.. · Awareness of these risks is critical for improving cesarean delivery outcomes..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"572-579"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Umbilical Cord Vascular Rupture during Labor: A Retrospective Analysis of 12 Cases.","authors":"Ruiyun Chen, Lin Lin","doi":"10.1055/a-2412-3169","DOIUrl":"10.1055/a-2412-3169","url":null,"abstract":"<p><p>Umbilical cord vascular rupture is a rare and severe condition that can occur during labor, leading to adverse outcomes for the fetus before as well as after delivery. Prompt diagnosis and intervention are crucial for improving the chances of a successful outcome. We aimed to analyze cases of umbilical cord vascular rupture during labor to provide insights into this challenging condition.This retrospective study evaluated the medical records of patients diagnosed with umbilical cord vessel rupture or umbilical cord hematoma at Fujian Maternity and Child Health Hospital from January 1, 2015, to May 31, 2023. The inclusion criteria included gestational age of ≥28 weeks, occurrence during labor, and availability of complete delivery data. Data on fetal heart rate (FHR) changes, delivery intervals, intraoperative findings, placental pathology, and neonatal outcomes were collected and analyzed.A total of 12 cases were analyzed. The incidence of umbilical cord vascular rupture during childbirth was 0.08%. The FHR patterns in umbilical cord rupture during delivery included baseline tachycardia, minimal or absent variability, variable or late deceleration, prolonged deceleration, and undetectable heart rate. The bradycardia-to-delivery interval (BDI) ranged from 6 to 26 minutes. Among the 12 neonates, 9 were discharged well, 2 were stillbirths, and there was 1 neonatal death. Hemorrhagic shock was common in live births.Our study highlights the significance of continuous FHR monitoring during labor and the urgent need for medical teams to respond quickly in cases of umbilical cord vascular rupture. Despite advancements in neonatal resuscitation techniques, managing cases with undetectable fetal heart activity remains clinically challenging, and even with immediate pregnancy termination, poor neonatal outcomes may still occur. · Umbilical cord vascular rupture during labor is a rare event.. · Its clinical management presents significant challenges.. · Advances in neonatal resuscitation have improved rescue success rates.. · In such cases, hemorrhagic shock is common in live births..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"586-592"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142363978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Routine Transvaginal Ultrasound at the Time of the Anatomy Scan: To Do or Not To Do?","authors":"Olivia Grubman, Mackenzie Mitchell, Thomas Owens, Mia Heiligenstein, Elianna Kaplowitz, Guillaume Stoffels, Zainab Al-Ibraheemi, Lois Brustman, Graham Ashmead, Farrah N Hussain","doi":"10.1055/a-2414-0857","DOIUrl":"10.1055/a-2414-0857","url":null,"abstract":"<p><p>There are no universal guidelines for transvaginal ultrasound (TVUS) at the time of the anatomy scan. TVUS can provide information on placental location and cervical length (CL) but may lead to more interventions. As a quality assurance initiative, a universal TVUS (UTVUS) protocol at the time of the anatomy scan was started at our institution. This study was conducted to assess whether there was a decrease in preterm birth (PTB), postpartum hemorrhage (PPH), and neonatal intensive care unit (NICU) admission once UTVUS was implemented.This was a retrospective cohort study performed on singleton gestations from February 2021 to January 2022. In the first 6 months of the study period, patients only had TVUS based on risk factors (pre group). In the second half of the study period, UTVUS was implemented at the time of the anatomy scan (post group).A total of 2,118 patients were included in the study. There were 1,037 patients in the pre group, of which 161 underwent TVUS based on high-risk factors (history of the cervical procedure, history of prior PTB, and placenta appearing low lying or cervix appearing short on abdominal ultrasound). The post group/UTVUS included 1,081 patients. Patients in the pre group had statistically significantly earlier gestational age at first TVUS (<i>p</i> < 0.0001), were less likely to have had a prior PTB <36 weeks (<i>p</i> = 0.03), and were more likely to have a history of cervical procedure (<i>p</i> = 0.0006) than patients in the post group. There was an increased use of vaginal progesterone in the UTVUS with 33 patients (as opposed to 10 patients in the pre group; <i>p</i> = 0.0007). The proportion of patients with PTB, PPH, or NICU admission did not significantly differ between the two groups even after adjusting for cofounders (<i>p</i> > 0.05).Our data show that UTVUS did not decrease the adverse pregnancy outcomes. In addition, the implementation of UTVUS adds more discomfort for a patient, more time to the patient's scan, and is an additional cost. Therefore, surveillance by abdominal ultrasound and adding TVUS based on risk factors may be a reasonable alternative. · UTVUS showed no difference between CLs.. · There is not sufficient evidence to conclude a difference between PTB or PPH in the two groups.. · There was significantly more placenta previa diagnosed in the post group, yet most resolved..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"643-648"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost Comparison of a Traditional Didactic versus National Flipped Classroom Curriculum.","authors":"Melissa M Carbajal, Heidi Karpen, AnnaMarie Arias-Shah, Carly Gisondo, Heather M French, Megan M Gray, Susan Izatt, Maria Gillam-Krakauer, Lindsay C Johnston, Allison Payne, Margarita M Vasquez, Elizabeth M Bonachea, Alison J Falck, Patricia R Chess, Rita Dadiz","doi":"10.1055/a-2410-9126","DOIUrl":"10.1055/a-2410-9126","url":null,"abstract":"<p><p>We compared the cost of faculty time preparing educational materials for traditional didactic (TD) education provided at local institutions with that of faculty time preparing National Neonatology Curriculum (NNC) flipped classroom (FC) educational materials shared among institutions for fellow education across the United States.Using survey data and the national average for faculty educators' salaries, we calculated the cost of developing TD versus FC materials. Wilcoxon rank-sum test and comparison of two Poisson rates were utilized to evaluate the time to create versus update TD materials and the cost to create new TD versus FC materials, respectively.FC materials required more time to develop than TD materials (FC, median 17 h, interquartile range [IQR]: 17; TD, median, 5 h, IQR: 5; <i>p</i> < 0.001). However, when the size of individual fellowship programs was factored into the cost analysis, FC materials shared nationally among programs resulted in a 19- to 72-fold cost savings when compared to the creation of new locally used TD materials (FC, $2.49 per fellow; TD $32.05-576.90 per fellow at very large-to-small fellowship programs; <i>p</i> < 0.001).Educational materials developed and disseminated to fellowship programs across the country confer significant savings in faculty educator time and cost per learner. Standardized programs such as the NNC may serve as a model to develop shared peer-reviewed educational resources for other specialties. · Educational materials developed for national use confer time and cost savings.. · Small fellowships benefit greatly from having access to shared resources.. · Shared, peer-reviewed resources promote equity in education.. · Shared resources can free faculty time to focus on other academic interests..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"580-585"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and neonatal outcomes in gestational hypertension for delivery at 37 weeks versus 38-40 weeks.","authors":"Lauren Thompson, Joseph Werthammer, Grace Montgomery, Matthew Nudelman, Jesse Cottrell, David Gozal, Rebekah Fabela, Kennedy Snavely","doi":"10.1055/a-2568-9104","DOIUrl":"https://doi.org/10.1055/a-2568-9104","url":null,"abstract":"<p><strong>Objective: </strong>To compare neonatal and maternal outcomes for mothers with gestational hypertension delivered at 37 weeks' gestation compared with 38-40 weeks.</p><p><strong>Study design: </strong>Single center, retrospective chart review of women with gestational hypertension delivered between 37+0-40+6 weeks' gestation over a 29-month period.</p><p><strong>Results: </strong>337 mother-infant dyads with gestational hypertension were included: 194 delivered at 37 weeks' gestation (cohort 1) and 143 delivered at 38-40 weeks' gestation (cohort 2). Preeclampsia developed in 12% of cohort 1 and 8% of cohort 2 (p=0.242). No significant differences in severe hypertensive-related complications were found between the cohorts. Neonatal outcomes including NICU admission, respiratory support, phototherapy, and length of stay were all more frequent in cohort 1.</p><p><strong>Conclusion: </strong>For women with gestational hypertension, delivery at 38-40 weeks was not associated with increased maternal complications but was associated with fewer neonatal complications when compared to delivery at 37 weeks.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Adverse Perinatal Outcomes in Pregnancies with gestational diabetes and excessive gestational weight gain according to obesity status.","authors":"Henry Lesser, Vani Movva, Amanda Young, Celia Gray, Dhanya Mackeen","doi":"10.1055/a-2568-6317","DOIUrl":"https://doi.org/10.1055/a-2568-6317","url":null,"abstract":"<p><strong>Objective: </strong>Obesity, gestational diabetes mellitus (GDM), and excessive gestational weight gain (EGWG) are associated with adverse outcomes. It is unclear which carries the greatest risk. In this study, the relationship of obesity, GDM, and EGWG independently and concomitantly was analyzed to determine if one is a greater risk factor than the other.</p><p><strong>Study design: </strong>A retrospective cohort study of singleton gestations at Geisinger from 10/2007-3/2023 was performed. Exclusion criteria were pregravid BMI <18 kg/m2, gestational age (GA)<34 weeks, pregestational diabetes or chronic hypertension, prior cesarean delivery (CD) or contraindication to vaginal delivery. Patients were grouped by BMI class and the order of groups within each BMI for the test for trend were no GDM/no EGWG, GDM/no EGWG, no GDM/EGWG, and GDM/EGWG. The rates of HDP (hypertensive disorders of pregnancy), severe HDP, CD, large for gestational age (LGA), shoulder dystocia, and neonatal intensive care unit (NICU) admission >35 weeks were evaluated. A test for trend and odds ratios with 95% CIs were reported. P-values were reported across the GDM/EGWG groups per BMI category.</p><p><strong>Results: </strong>42,627 pregnancies were included. At each BMI category, HDP, severe HDP, CD, LGA, and shoulder dystocia generally increased from patients with no GDM/no EGWG to those with GDM/no EGWG to those with no GDM/EGWG to those with GDM/EGWG. NICU admission ≥35 weeks did not follow this progression.</p><p><strong>Conclusions: </strong>EGWG poses a greater risk than GDM regardless of pregravid BMI for HDP, severe HDP, CD, LGA, and shoulder dystocia. Attention should be given to determine the optimal strategy to manage pregnancies experiencing EGWG.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Clinical Outcomes of Severe Bronchopulmonary Dysplasia through New Definitions and Phenotypes.","authors":"Susan McAnany, Gangaram Akangire, Ashley Sherman, Venkatesh Sampath, Winston Manimtim","doi":"10.1055/a-2550-5306","DOIUrl":"10.1055/a-2550-5306","url":null,"abstract":"<p><p>This study aimed to compare the accuracy of three newly proposed definitions of bronchopulmonary dysplasia (BPD) in predicting outcomes, and to investigate the impact of large airway versus parenchymal versus vascular BPD phenotypes on BPD outcomes.Retrospective chart review of 100 infants with severe BPD discharged from a Children's hospital between 2020 and 2021. Multivariable models evaluated the associations between BPD definitions and phenotypes with tracheostomy and death at 6 months and 1 year after NICU discharge. Secondary outcomes included the need for respiratory support, the use of pulmonary medications, and the need for long-term gastrostomy feeding.Neonatal research network (NRN) and BPD collaborative criteria best-predicted outcomes associated with tracheostomy and/or death (<i>p</i> < 0.001). Among the three BPD phenotypes, large airway disease was independently associated with death or tracheostomy (odds ratios [OR]: 10.5; 95% confidence interval [CI]: 1.6, 68.1). The combination of all three phenotypes was also associated with death or tracheostomy (OR: 9.8; 95% CI: 1.0, 93.5). Both NRN and BPD collaborative definitions showed an association with the need for respiratory support, medication use, and need for long-term gastrostomy tube feeding. Among the 29 infants for whom complete information was available, 18 (62%), 20 (69%), and 18 (62%) had parenchymal, central airway and pulmonary vascular phenotype, respectively.Our results indicate that newer definitions of BPD may better predict the severity of BPD and the need for long-term invasive ventilation support compared with the 2001 National Institute of Health definition of BPD phenotypes impacting mortality and short-term outcomes. These data may be useful for counseling families and developing phenotype-based individualized treatment plans. · The current definition of BPD has limitations.. · New definitions of BPD better predict outcomes.. · BPD phenotypes can better predict outcomes..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Needs of Parents and Neonates in the Intensive Care Unit: A Literature Review.","authors":"Brandon W Qualls","doi":"10.1055/a-2552-9008","DOIUrl":"10.1055/a-2552-9008","url":null,"abstract":"<p><p>The admission of a neonate to the neonatal intensive care unit (NICU) presents unique and complex needs for both the infant and their parents. This literature review aims to synthesize existing research to comprehensively understand these needs, focusing on parental psychosocial well-being, practical requirements, and the neonate's developmental necessities. Understanding these needs is crucial for optimizing clinical outcomes and fostering healthy parent-infant relationships. A nonsystematic literature review was conducted using PubMed, Google Scholar, and PsycINFO databases. Search criteria focused on \"neonatal intensive care\" and \"parental needs.\" Articles published in English between 2011 and 2022 were included. The review analyzed 123 articles, primarily focusing on research conducted in Western countries. Parental needs were categorized into seven areas: mental health/psychosocial well-being, practical needs (physical, safety, monetary), parental involvement, relationships (infant, staff, peers), information, spiritual needs, and help with other responsibilities. Neonatal needs included parental involvement, skin-to-skin contact, breastfeeding, and reduced length of stay. Key findings highlighted the prevalence of parental anxiety and depression, the importance of practical support, and the critical role of parental involvement in both parent and infant well-being. This review underscores the interconnectedness of parental and neonatal needs within the NICU environment. Parental involvement is essential for both groups, and factors such as hospital policies, community resources, and socioeconomic status significantly influence fulfilling these needs. The limitation of the review indicates the need for more diverse global research. Future studies should address these limitations and explore effective interventions to meet the identified needs, improving outcomes for NICU families. · The review identifies seven key parental needs in the NICU and four neonatal needs.. · It is important to provide support for the well-being of both parents and infants.. · Hospital policies, community resources, and socioeconomic status impact the ability to meet these..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Disparities in the Adherence to an Enhanced Recovery After Cesarean Protocol (ERAC): A Retrospective Observational Study at Two NYC Hospitals, 2016-2020.","authors":"Abbey T Gilman, Jessica Kim, Silis Y Jiang, Sharon E Abramovitz, Robert S White","doi":"10.1055/a-2548-0737","DOIUrl":"https://doi.org/10.1055/a-2548-0737","url":null,"abstract":"<p><p>Enhanced recovery after surgery programs for cesarean deliveries (ERAC) aim to optimize the quality of care for all patients. Race is not routinely monitored in ERAC programs. Given the extensive reports of racial disparities in obstetrical care, the goal of this study was to investigate racial differences in adherence rates to individual ERAC protocol elements.A cohort study was performed among cesarean delivery patients enrolled in an ERAC program at two hospitals from October 2016 to September 2020. Compliance with anesthesia-specific ERAC metrics, including ketorolac, ondansetron, and active warming methods, were compared by race. Race was self-reported by all patients. Logistic regression models stratified by pre- and post-ERAC status were used to assess relationships.The sample consisted of 7,812 cesarean delivery patients, of which 4,640 were pre-ERAC (59.4%) and 3,172 were post-ERAC (40.6%). There were no racial differences found in overall ERAC protocol adherence, active warming methods, or ondansetron administration in the pre- and post-ERAC groups. The odds of ketorolac administration in Black patients (adjusted odds ratio [aOR]: 0.72; 95% confidence interval [CI]: 0.55-0.95; <i>p</i> = 0.020) and Asian patients (aOR: 0.81; 95% CI: 0.68-0.98; <i>p</i> = 0.027) pre-ERAC were significantly lower compared with white patients. In the post-ERAC group, this disparity persisted in Black (aOR: 0.80; 95% CI: 0.65-0.99; <i>p</i> = 0.042) and Asian patients (aOR: 0.85; 95% CI: 0.73-0.98; <i>p</i> = 0.023).Appropriate implementation and adherence to all elements of the ERAC program may provide a practical approach to reducing disparities in outcomes and ensuring equitable treatment for all patients. · No racial differences were found in ondansetron administration pre- and post-ERAC.. · No racial differences were found in active warming methods pre- and post-ERAC.. · Black patients had significantly lower odds of ketorolac administration pre- and post-ERAC.. · Asian patients had significantly lower odds of ketorolac administration pre- and post-ERAC.. · ERAC metrics must be routinely monitored by race to resolve any observed inequities..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Maternal Serum Retinol-Binding Protein Levels with Adverse Pregnancy Outcomes: A Retrospective Cohort Study.","authors":"Wenjing Dong, Xuelian Chu, Yanan Wang, Linyuan Gu, Yiming Chen","doi":"10.1055/a-2544-9158","DOIUrl":"10.1055/a-2544-9158","url":null,"abstract":"<p><p>This study aimed to determine the correlation between decreased or increased retinol-binding protein (RBP) levels during pregnancy and adverse pregnancy outcomes.A retrospective cohort study was conducted to analyze the data of 16,094 pregnant women who participated in serum RBP level detection during pregnancy. The chi-square test or Mann-Whitney U test was used for the univariate analysis of qualitative or quantitative data. Multiple logistic regression analysis, odds ratio (OR), and 95% confidence interval were used to evaluate the effect of RBP levels on adverse pregnancy outcomes.The groups showed a significant difference in RBP levels (<i>p</i> < 0.001). The results of multiple logistic regression analysis revealed that twins (OR = 2.631), upper respiratory tract infection (URTI, OR = 2.596), premature delivery (OR = 1.833), and macrosomia (OR = 1.524) were correlated with low retinol-binding protein (L-RBP), while preeclampsia (PE, OR = 0.147), intrahepatic cholestasis of pregnancy (OR = 1.654), gestational hypertension (GH, OR = 1.646), oligohydramnios (OR = 1.487), and advanced maternal age (OR = 1.470) were correlated with high retinol-binding protein (H-RBP). Decreased or increased RBP levels were correlated with hyperlipidemia (OR = 1.738, 2.857), Antenatal anemia (OR = 1.378, 0.791), gestational diabetes mellitus (GDM, OR = 1.272, 0.796), and small infant size (OR = 0.664, 1.444). L-RBP may indicate an increased risk of antenatal anemia and GDM, whereas H-RBP may indicate a decreased risk of antenatal anemia and GDM. Pregnant women with H-RBP were more likely to give birth to smaller infants, whereas those with L-RBP had a lower risk of this outcome. Additionally, mothers with H-RBP were not likely to give birth to male infants.Hyperlipidemia, URTI, GH, PE, and GDM affect serum RBP levels, and these exposure factors can lead to different degrees of adverse pregnancy outcomes. · To study the effect of adverse exposure factors on pregnancy outcome and the relationship with RBP.. · RBP may be a new biomarker that can be used to help stratify pregnancy risk.. · This study included 16,094 participants and a high number of variables in the analysis..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}