American journal of perinatology最新文献

{"title":"Optimizing RhD Immune Globulin Use in Pregnancy.","authors":"Elizabeth Miller, Lana El-Kassis, George Saade, Rebecca Horgan","doi":"10.1055/a-2550-5130","DOIUrl":"10.1055/a-2550-5130","url":null,"abstract":"<p><p>The global shortage of RhD immune globulin, formally acknowledged by the Food and Drug Administration in 2023, is ongoing but has improved in recent months. In response, the American College of Obstetricians and Gynecologists (ACOG) issued guidance in March 2024 on alternative strategies to conserve RhD immune globulin supplies. Our objective is to evaluate strategies for optimizing RhD immune globulin use in pregnancy amidst a global shortage.This clinical opinion reviews guidance on strategies to conserve RhD immune globulin. These include targeted administration based on non-invasive fetal RhD genotyping using cell-free DNA (cfDNA), the use of alternative RhD immune globulin products, and selective withholding of prophylaxis in early pregnancy loss under 12 weeks' gestation. ACOG guidance on the administration of RhD immune globulin in pregnancy differs from many countries worldwide, as well as the World Health Organization and the American Society of Family Planning.Targeted administration and the use of non-invasive cell-free DNA (cfDNA) testing for fetal RhD status have shown promising accuracy and reliability in studies across multiple countries, leading to reduced unnecessary prophylaxis and potential cost savings. Additionally, withholding RhD immune globulin in select early pregnancy losses could further conserve resources without increasing alloimmunization risk.This review underscores the need for evidence-based approaches to manage limited RhD immune globulin supplies effectively and suggests that targeted prophylaxis could benefit both patient outcomes and healthcare resource allocation in the face of global shortages. · Alternative RhD immune globulin strategies are vital amid ongoing global shortages.. · Targeted administration using cfDNA testing reduces unnecessary RhD immune globulin use.. · Consider withholding RhD immune globulin in <12-week pregnancy loss without instrumentation..</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":"143555481","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":"Adverse Perinatal Outcomes Associated with True Knot of the Umbilical Cord: A Multicenter Retrospective Study.","authors":"Maayan Bas Lando, Hen Y Sela, Sarit Helman, Eliel Shapira, Sorina Grisaru-Granovsky, Misgav Rottenstreich","doi":"10.1055/a-2553-9200","DOIUrl":"10.1055/a-2553-9200","url":null,"abstract":"<p><p>This study aimed to estimate the prevalence of true knot of the umbilical cord (TKUC) and identify associated adverse maternal and neonatal outcomes.A multicenter retrospective cohort study was conducted, including all women with singleton pregnancies who delivered between 24 and 42 weeks of gestation from 2005 to 2021 at two large obstetrical centers. Gross pathological examinations of the placenta and umbilical cord were routinely performed immediately after delivery. Women with TKUC detected postpartum were compared with those without TKUC. Maternal and neonatal characteristics, along with adverse outcomes, were compared between the two groups.During the study period, 283,055 deliveries met inclusion and exclusion criteria. The incidence of TKUC was 1.3%, intrauterine fetal death (IUFD) rate was significantly higher in the TKUC group (1.8% vs. 0.3%), with 91% of these deaths occurring after 34 weeks of gestation, and 72% occurring after 37 weeks. Women with TKUC experienced higher rates of preterm premature rupture of membranes, premature rupture of membranes, induction of labor, meconium-stained amniotic fluid, vacuum-assisted vaginal delivery, and postpartum hemorrhage. The rate of intrapartum cesarean deliveries was similar between the groups. Neonatal outcomes revealed similar birth weights, but higher rates of small-for-gestational-age neonates, low Apgar scores, jaundice, hypoglycemia, and intracranial hemorrhage in the TKUC group. Multivariate analysis demonstrated that TKUC was independently associated with IUFD (adjusted odds ratios [aOR]: 6.07; 95% confidence intervals [CI]: 4.68-7.86, <i>p</i> < 0.01).TKUC is not uncommon and is associated with an increased risk of IUFD, particularly in the late third trimester, as well as adverse neonatal outcomes. Early diagnosis in the third trimester followed by delivery in the late preterm or early term period may reduce IUFD rates. · TKUC occurred in 1.3% of approximately 300,000 deliveries.. · It is associated with a sixfold higher risk of IUFD.. · Most IUFDs (91%) occurred > 34 weeks, with 72% occurring > 37.. · Third-trimester ultrasound and delivery at approximately 37 weeks may reduce IUFD..</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":"143596118","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":"Letter to the Editor in Response to \"Fetal Growth Restriction: A Pragmatic Approach\".","authors":"Allan Nadel","doi":"10.1055/a-2547-4322","DOIUrl":"10.1055/a-2547-4322","url":null,"abstract":"","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":"143522410","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":"Comparison of Outpatient Mechanical Cervical Ripening Methods to Standard Inpatient Ripening.","authors":"Mary P Goering, Whitney L Wunderlich, Marc C Vacquier, David A Watson, Kelly A Drake, Sandra I Hoffman, Anna Schulte, Laura C Colicchia, Abbey C Sidebottom","doi":"10.1055/a-2553-9258","DOIUrl":"https://doi.org/10.1055/a-2553-9258","url":null,"abstract":"<p><p>This study aimed to assess clinical efficiency and maternal and neonatal outcomes for patients who underwent outpatient cervical ripening using mechanical methods (osmotic dilators and Foley balloon) compared with patients who underwent inpatient ripening.A retrospective cohort study from March 2020 to March 2022 compared patients with low-risk, term, singleton pregnancies who underwent outpatient cervical ripening to clinically similar patients who had inpatient ripening. Inverse probability of treatment weighting for analysis of outcomes to account for differences in groups and comparisons of outcomes are reported as mean differences with 95% confidence intervals (CIs).The cohort included 391 patients (116 outpatient, 275 inpatient). Among the outpatient group, half used only mechanical devices, and all others received additional pharmacological methods after admission for labor induction. Among the inpatient group, the most common cervical ripening method was pharmacological only (66.2%), followed by both pharmacological and mechanical (25.8%), and 8% used only mechanical. After outpatient cervical ripening, patients had significantly higher cervical dilation (mean difference 1.9 cm, 95% CI: 1.6, 2.3) and simplified bishop scores (mean difference 1.6, 95% CI: 1.2, 2.1) on admission compared with the inpatient group. The average time from admission to delivery was 5.8 hours shorter (95% CI: -8.6, -2.9) for the outpatient group compared with the inpatient group, and the average total length of stay was 7.1 hours shorter (95% CI: -12.1, -2.1) for the outpatients among patients with vaginal deliveries. Both groups had similar hours of oxytocin use, and mode of delivery, and did not differ for maternal complications or neonatal outcomes.Outpatient cervical ripening using multiple mechanical methods was associated with significantly higher cervical dilation, shorter average time from patient admission to delivery, and shorter total length of stay for vaginal deliveries. Outpatient cervical ripening may be an important option for easing resource utilization for induced labor. · Outpatient cervical ripening resulted in superior cervical dilation and Bishop scores.. · Hospital length of stay was shorter for those receiving outpatient cervical ripening.. · Maternal complications and neonatal outcomes did not differ by setting..</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":"143741823","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":"Head Ultrasound Findings in Infants with Birth Weight >1,500 g and Gestational Age >32 Weeks Exposed to Prenatal Opioids.","authors":"Rishika P Sakaria, Divya Rana, Mimily Harsono, Harris L Cohen, Massroor Pourcyrous","doi":"10.1055/a-2552-0715","DOIUrl":"https://doi.org/10.1055/a-2552-0715","url":null,"abstract":"<p><p>This study aimed to evaluate the effects of prenatal exposure to opioids on head ultrasound (HUS) and to determine the need for routine HUS evaluation in infants exposed to prenatal opioids.This is a retrospective cohort study performed at a level III NICU. Infants >32 weeks gestational age and >1,500 g birth weight with prenatal opioid exposure (<i>n</i> = 127) were included in this study. Data including demographic information and HUS results were recorded.Twenty (16%) infants were exposed to opioids only whereas the rest of the infants (84%) were exposed to opioids plus other drugs (polysubstance) in utero. Sixteen of 127 infants (13%) had abnormal initial HUS. Sub-ependymal hemorrhage or grade 1 intraventricular hemorrhage was the most common abnormal finding. Absent septum pellucidum was seen in three infants.A relatively large proportion (13%) of infants in this study had abnormal HUS findings; however, further studies are required to correlate HUS findings with a specific drug of exposure, duration of exposure, polysubstance use, umbilical cord drug concentration levels, and neurodevelopmental outcomes. · Limited data exists regarding HUS findings in infants with prenatal opioid exposure.. · A relatively large proportion of infants exposed to opioids in utero had abnormal HUS.. · Subependymal hemorrhages or grade I intraventricular hemorrhage was the most common abnormal finding..</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":"143741902","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":"Psychosocial, Behavioral, and Medical Drivers of Gestational Diabetes among Racial-Ethnic Groups.","authors":"Austin B Gardner, Macie L Champion, Teresa Janevic, Lynn M Yee, Ashley N Battarbee","doi":"10.1055/a-2554-0925","DOIUrl":"https://doi.org/10.1055/a-2554-0925","url":null,"abstract":"<p><p>Certain racial and ethnic groups have historically been labeled \"high-risk\" for the development of gestational diabetes mellitus (GDM). Our objective was to identify the psychosocial, behavioral, and medical factors associated with GDM and determine if they differ by race/ethnicity.Secondary analysis of a multicenter, prospective cohort study of pregnant nulliparous individuals with singleton gestations (2010-2013). The primary outcome was GDM. Psychosocial, behavioral, and medical characteristics were compared by self-reported race/ethnicity. Multivariable logistic regression with backward selection identified factors associated with GDM. Interaction terms between race/ethnicity and risk factors were tested.Of 8,672 pregnant individuals, 61% were non-Hispanic White, 13% non-Hispanic Black, 17% Hispanic, 4% Asian, and 5% other. The incidence of GDM differed by race/ethnicity with 4% non-Hispanic White, 3% non-Hispanic Black, 5% Hispanic, 11% Asian, and 5% other (<i>p</i> < 0.001). Of 34 psychosocial, behavioral, and medical factors, those associated with GDM were parent with history of diabetes (adjusted odds ratio [aOR]: 1.72; 95% confidence interval [CI]: 1.33-2.23), non-English language (aOR: 2.57; 95% CI: 1.14-5.79), daily calorie intake (aOR: 1.18; 95% CI: 1.08-1.29), daily fiber intake (aOR: 0.84; 95% CI: 0.75-0.94), maternal age (aOR: 1.53; 95% CI: 1.37-1.70), prepregnancy BMI (aOR: 1.21; 95% CI: 1.02-1.44), and waist circumference (aOR: 1.21; 95% CI: 1.03-1.43). These associations did not differ based on race/ethnicity (interaction <i>p</i>-values > 0.1).Replacing race/ethnicity as a risk factor for GDM with significant upstream psychosocial, behavioral, and medical factors should be considered. · GDM varies in incidence based on race.. · GDM was linked to a parent with various factors.. · These factors are the history of diabetes, non-English language, and daily calorie intake.. · These factors also include lower daily fiber intake, maternal age, prepregnancy BMI, and waist circumference.. · The psychosocial, behavioral, and medical factors associated with GDM did not differ based on race/ethnicity..</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":"143742005","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":"Leadership Challenges in Neonatal Services during the COVID-19 Pandemic.","authors":"Kanekal Suresh Gautham, Lakshmi Katakam, Jens Eickhoff, Ryan McAdams","doi":"10.1055/a-2551-5143","DOIUrl":"10.1055/a-2551-5143","url":null,"abstract":"<p><p>This study aimed to identify key challenges, barriers, personal experiences, coping mechanisms, and lessons learned by neonatal health care leaders during the COVID-19 pandemic, because they are not well documented.Voluntary, anonymous, online survey of leaders in perinatal care systems.A total of 154 leaders responded. The exact number of survey recipients could not be enumerated because the survey was sent via email distribution lists (listservs). The key challenges reported included managing patient and family-centered care, staffing shortages, education and training, resource allocation, communication, support systems, and maintaining trust in a time of uncertainty. Common self-care techniques included exercise, sleep, meditation, social support, and taking time off. Respondents highlighted lessons such as the critical importance of effective communication, flexibility, teamwork, resilience, and the prioritization of self-care for sustainable leadership.These findings underscore the need for structured crisis management strategies and proactive support systems to strengthen resilience in neonatal health care leaders, enhancing preparedness for future systemic crises. · Leaders in perinatal care faced significant challenges during the COVID-19 pandemic.. · Key challenges were managing patient/family-centered care, staffing shortages, communication, and trust.. · Structured crisis management strategies and proactive support systems for resilience are required..</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":"143571839","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":"Early Effective Antibiotic Therapy and Meningitis Following a Bloodstream Infection in Hospitalized Infants: A Cohort Study.","authors":"Jessica E Ericson, Rachel Greenberg, P Brian Smith, Reese Clark, Daniel K Benjamin, Ryan Kilpatrick","doi":"10.1055/a-2568-7085","DOIUrl":"https://doi.org/10.1055/a-2568-7085","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the role of early effective antibiotic therapy in preventing secondary meningitis as a sequelae of bacterial bloodstream infections (BSI).</p><p><strong>Study design: </strong>In this multicenter cohort study, we identified blood cultures that were positive for Group B Streptococcus (GBS), Staphylococcus aureus, Escherichia coli, and other non-E. coli gram-negative bacteria that had a corresponding cerebrospinal fluid sample collected ≤7 days after the positive blood culture among infants discharged from a neonatal intensive care unit managed by the Pediatrix Medical Group 2002 - 2020. The odds of secondary meningitis for early effective antibiotic therapy vs delayed antibiotic therapy were compared using an adjusted logistic regression model. The odds of secondary meningitis following GBS BSI were compared for infections treated with empirical vancomycin vs beta-lactam antibiotic.</p><p><strong>Results: </strong>Secondary meningitis was identified in 11% of 5967 BSI. Early effective antibiotic therapy was not associated with a reduced odds of secondary meningitis for GBS (aOR 1.17; 95% CI, 0.82-1.66) or E. coli (aOR 1.06; 95% CI, 0.82-1.38); however, was associated with decreased odds for non-E. coli gram-negative bacteria (aOR 0.69; 95% CI, 0.49-0.98) and S. aureus (aOR 0.51; 95% CI, 0.34-0.74). GBS BSI were more often complicated by meningitis when vancomycin was used empirically compared to beta-lactam antibiotic (aOR 2.01; 95% CI, 1.28- 3.14).</p><p><strong>Conclusion: </strong>Early effective antibiotic therapy for BSI in infants did not reduce the odds of secondary meningitis caused by GBS or E. coli; however, early effective antibiotic therapy did reduce episodes due to non-E. coli gram-negative bacteria and S. aureus.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741897","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":"RSV vaccination in pregnancy and social determinants of health .","authors":"Meralis Lantigua-Martinez, Cody Goldberger, Rosanne Vertichio, Julia Kim, Hye Heo, Ashley S Roman","doi":"10.1055/a-2568-8489","DOIUrl":"https://doi.org/10.1055/a-2568-8489","url":null,"abstract":"<p><strong>Objective: </strong>Social determinants of health (SDOH) may impact the incidence of Respiratory Syncytial Virus (RSV) infection and the uptake of vaccinations in pregnancy. The objective of this study is to identify contributors to disparities in RSV vaccination in pregnancy.</p><p><strong>Design: </strong>This is a retrospective cohort study of patients delivering at term within three hospitals during February and March 2024, comparing pregnant patients identified as receiving vs not receiving RSV vaccinations. This period and gestational age were chosen to include patients who would have qualified for RSV vaccination administration. Vaccination status was extracted from standardized admission templates where these variables were recorded as discrete fields. Patients without RSV vaccination information were excluded. Sociodemographic factors, COVID vaccination status, and delivery campus were evaluated. Outcomes were analyzed using chi-squared, t-test, and McNemar test.</p><p><strong>Result: </strong>2181 patients met inclusion criteria and RSV vaccination information was available for 1548 patients (71%) with a 14% vaccination rate. Compared to those not vaccinated (n=1332), RSV vaccinated patients (n=216) were more likely to be older (30.7 vs 34.8, p<0.001), have private insurance (42% vs 85%, p<0.001), speak English (82% vs 95%, p<0.001), and deliver at our regional perinatal center (26% vs 77%, p<0.001). 50% of RSV vaccinated patients had a history of COVID vaccination compared to 33% of those not vaccinated against RSV (p<0.001).</p><p><strong>Conclusions: </strong>SDOH were associated with differences in RSV vaccination status. In addition, patients without RSV vaccination were less likely to have had COVID vaccination. These findings highlight the need to address SDOH to increase vaccination rates for vulnerable populations.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741944","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 pre-pregnancy obesity versus excessive gestational weight gain with adverse maternal outcomes in the United States.","authors":"Rodney McLaren, Deepa Rastogi, Shantanu Rastogi","doi":"10.1055/a-2568-9060","DOIUrl":"https://doi.org/10.1055/a-2568-9060","url":null,"abstract":"<p><strong>Objective: </strong>Pre-pregnancy BMI >30 kg/m2 or obesity (PPO) and excessive gestational weight gain (eGWG) are associated with increased risks for adverse maternal outcomes. There is little is known regarding the individual effects of PPO and eGWG. The objective of this study was to compare the effects of PPO and eGWG with adverse maternal outcomes.</p><p><strong>Methods: </strong>This was a retrospective cohort study of singleton, live births in the United States in 2018 using data from the National Vital Statistics System. Pregnancies complicated by pregestational diabetes, chronic hypertension, and with unknown maternal body mass index (BMI) were excluded. IOM recommendations was used to define GWG. These births were divided into four groups: 1) normal pre-pregnancy BMI and normal GWG, 2) normal pre-pregnancy BMI and eGWG, 3) PPO and normal GWG and 4) PPO and eGWG. Outcomes such as Gestational diabetes, hypertensive disorders of pregnancy, cesarean delivery, maternal transfusion, and medical intensive care unit (MICU) admissions were compared among groups using ANOVA, and multivariable.</p><p><strong>Results: </strong>Of the 1,432,602 births included in the study, 22.2%, 42.3%, 10.1%, and 25.4% were in Groups 1-4 respectively. Compared with pregnancies in Group 1 (adjusted OR (95%CI)), Groups 3 and 4 had higher risk for gestational diabetes (2.80 (2.72-2.88) and 2.28 (2.22-2.34)) respectively, while Groups 2-4 had higher risk of hypertensive disease of pregnancy (1.58 (1.53-1.64), 3.88 (3.74-4.03) and 5.07 (4.90-5.23)); eclampsia (1.61 (1.33-1.95), 2.99 (2.42-3.69) and 3.57, (2.97-4.29)), and cesarean delivery (1.21 (1.19-1.23), 1.97 (1.92-2.02), and 2.45 (2.40-2.50)) respectively.</p><p><strong>Conclusion: </strong>Both PPO and eGWG are independently associated with higher odds of gestational diabetes, gestational hypertension, preeclampsia and cesarean sections, with the highest risk among pregnancies with both PPO and eGWG. This data supports the importance of pre-pregnancy weight management in preventing adverse pregnancy outcomes.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741873","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}