American journal of perinatology最新文献

{"title":"Evaluation of Cesarean Delivery Risk by Physician Sex.","authors":"Yuki Joyama, Misa Hayasaka, Lindsay Robbins, George Saade, Tetsuya Kawakita","doi":"10.1055/a-2615-5055","DOIUrl":"10.1055/a-2615-5055","url":null,"abstract":"<p><p>This study aimed to examine the association between physician sex, cesarean delivery, and neonatal complications.We analyzed the Consortium on Safe Labor database including 228,437 deliveries from 2002 to 2008. The study focused on singleton pregnancies with cephalic presentations, excluding cases with contraindications to vaginal delivery, elective cesarean deliveries, and nonobstetricians and gynecologists or maternal-fetal medicine physician management. The primary outcome of this study was cesarean delivery; secondary outcomes were cesarean delivery due to arrest of dilation or descent, cesarean delivery for nonreassuring fetal heart tracings (NRFHT), cesarean delivery for other indications, and a composite of neonatal complications. To estimate average marginal effects (AMEs) in percentage points (pp) with 95% confidence intervals (95% CI) of cesarean delivery between male and female physicians, we performed generalized estimating equations with Poisson distribution and exchange-correlation structure, adjusting for maternal, physician-level characteristics, and hospital-fixed effects.Of 108,004 individuals, 46,779 (43.3%) were attended by 183 female physicians, and 61,225 (56.7%) were attended by 250 male physicians. Female physicians were associated with a lower overall adjusted cesarean delivery proportion (11.93 vs. 13.47%; AME -1.54 pp [95% CI: -2.35, -0.73]), cesarean delivery for failure to progress (5.72 vs. 6.48%; AME -0.76 pp [95% CI: -1.24, -0.27]), and cesarean delivery for indications except for failure to progress or NRFHT (1.68 vs. 2.01%; AME -0.33 pp [95% CI: -0.56, -0.10]). There were no significant differences in cesarean outcomes for NRFHT or composite neonatal complications between male and female physicians.Compared with male physicians, female physicians had a lower rate of cesarean delivery. Further research is needed to understand the underlying mechanisms and develop targeted interventions. · Compared with male physicians, female physicians had a lower rate of cesarean delivery.. · This reduction was particularly evident for cesarean deliveries due to failure to progress.. · The reduction was not associated with an increased risk of neonatal complications..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101179","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":"Outcomes of Total Abdominal Hysterectomy Compared to Supracervical Hysterectomy for Management of Placenta Accreta Spectrum.","authors":"Alexandra D Forrest, Debra Eluobaju, Amanda Finney, Laura Prichett, Nicole R Gavin, Christopher Novak, Kristin Martin, Arthur Jason Vaught","doi":"10.1055/a-2615-5098","DOIUrl":"10.1055/a-2615-5098","url":null,"abstract":"<p><p>Although cesarean hysterectomy (C-HYST) is standard management for placenta accreta spectrum (PAS), the type of hysterectomy performed, total abdominal (TAH), or supracervical (SCH), is left to surgeon discretion. TAH has been previously associated with higher estimated blood loss (EBL), transfusion requirements, and complications compared to SCH.This was a single-site retrospective cohort study examining outcomes of TAH compared to SCH for PAS performed from 2008 to 2023. PAS was confirmed by clinical and pathologic diagnoses. Cervical removal was confirmed by operative report, postoperative exam, and pathology. Associations were assessed using chi-square tests, Fisher's exact tests, Mann-Whitney U tests, or individual <i>t</i>-tests.During the study period, 90 TAH and 54 SCH were performed. There were no significant differences in patient demographics, except that planned C-HYST was more likely to be TAH. TAH was associated with significantly lower transfusion requirements. When unexpected hysterectomies were excluded, there was not a significant difference in blood products transfused between the TAH and SCH groups.In PAS, maternal outcomes after TAH are at least equivalent to SCH. The surgical approach for the management of PAS should be further explored. · In PAS, outcomes are at least equivalent between TAH and SCH.. · C-HYST is optimally performed in a planned manner with all multidisciplinary team members present.. · Vertical skin incision was significantly associated with TAH in this retrospective cohort study..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101181","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":"Diabetes technology use in pregnancies with type 1 diabetes in the United States from 2009 to 2020.","authors":"Nasim Camillia Sobhani, Yongmei Huang, Kartik Kailas Venkatesh, Jason D Wright, A M Friedman, Timothy Wen","doi":"10.1055/a-2625-6437","DOIUrl":"https://doi.org/10.1055/a-2625-6437","url":null,"abstract":"<p><strong>Objective: </strong>The use of continuous glucose monitors (CGM) and insulin pumps as revolutionized the care of patients with type 1 diabetes (T1D). Few data are available regarding use of diabetes technology use in the pregnant T1D population. This study was conducted to evaluate temporal trends of diabetes technology use and predictors of use among pregnant individuals with TID in the United States from 2009 to 2020.</p><p><strong>Methods: </strong>MarketScan® Research Databases from 2009 to 2020 were used to identify pregnant individuals with T1D who were and were not using CGM and/or insulin pumps. Joinpoint regression analysis was used to estimate average annual percent change (AAPC) in diabetes technology use over time. Unadjusted and adjusted log-linear Poisson regression models were developed to assess the associations between the outcomes of CGM and insulin pump use and demographic and clinical predictors. Associations were reported as adjusted risk ratios (ARR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>Among 9,201 pregnancies with T1D, CGM use increased from 2.3% in 2009 to 13.7% in 2020 (AAPC 13.9%, 95% CI 11.7-17.1%), while insulin pump use remained unchanged from 10.9% in 2009 to 11.8% in 2020 (AAPC -2.4%, 95% CI -4.4-0.4%). Medicaid insurance and obesity were associated with lower likelihood of CGM use and insulin pump use, while high obstetric comorbidity index score was associated with higher likelihood of insulin pump use (ARR 1.26, 95% CI 1.05-1.51).</p><p><strong>Conclusion: </strong>From 2009 to 2020, CGM use among pregnant individuals with T1D increased, while insulin pump use remained unchanged. Use varied by patient demographic and clinical factors, most notable for lower likelihood of CGM use and insulin pump use with Medicaid insurance. Although CGM use increased over time, overall CGM use remained lower than expected despite the known benefits of CGM use in improving neonatal outcomes in pregnancies complicated by T1D.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214650","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":"When Is Intensive Care Warranted for the Most Immature Infants?","authors":"Joseph W Kaempf, Luca Brunelli, Alex Vidaeff, Susan Albersheim","doi":"10.1055/a-2605-7881","DOIUrl":"https://doi.org/10.1055/a-2605-7881","url":null,"abstract":"<p><p>Withholding or starting, withdrawing or continuing, high-technology interventions available to extremely premature newborns is a fundamental challenge in obstetrics and neonatology. Attempting to save an infant's life is a judgment fraught with uncertainty and risk because suffering can be prolonged, long-term outcomes are frequently unfavorable, and socio-economic inequities are burdensome to families. Survival rates of 22-23-24-week infants are increasing in hospitals that promote \"active care,\" yet morbidity rates and long-term neurodevelopmental impairments remain substantial and not improving. Outcomes acceptable to some pregnant women and families are not to others. Delivery of premature infants, particularly by cesarean section, is associated with maternal health risks. Intensive care of extremely premature infants is expensive, and lost opportunity costs are under-appreciated. Autonomy of pregnant women contrasted with the rights of the fetus and infant are culture and religion-affected, technology-influenced, and powerfully persuaded by physicians and institutions who possess a conflict of interest related to career goals, research, and income, all factors not necessarily shared by pregnant women.Physicians should resist dogmatic positions tethered to unproven technologies and nonrigorous evidence. Some hospitals promote near-universal intensive care of 22-23-24-week infants while others recommend palliative care, differences curiously seen between and within countries, even cities. The legitimate zone of parental discretion is characterized by the value pluralistic shared decision-making of informed consent and is endorsed by the American Academy of Pediatrics, the Canadian Paediatric Society, and the American College of Obstetricians and Gynecologists. Physicians should objectively provide clinical outcomes, compassionately listen to pregnant women's concerns and preferences, and resist presenting care options as a restrictive protocol, or a wide-open menu. Because there is no unifying cultural or bioethical ethos, we should embrace shared decision-making recognizing inherent contingencies and tensions, with humble circumspection of possible nihilism (which might influence palliative care), and therapeutic fury (which might promote unreasonable zeal for interventional care). · Extreme prematurity requires knowing outcomes.. · Parental discretion may broaden with uncertainty.. · Shared decision-making assumes informed consent.. · Parental values differ from the values of physicians.. · Asymmetry of responsibility supports parental values..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214651","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":"Progesterone Supplementation After Cerclage Does Not Improve the Preterm Birth Rate.","authors":"Lauren C Sayres, Natalie T Simon, Virginia A Lijewski, Jeanelle Sheeder, Shane A Reeves","doi":"10.1055/a-2605-7721","DOIUrl":"10.1055/a-2605-7721","url":null,"abstract":"<p><p>The goal of this study is to evaluate whether adjuvant progesterone following cerclage affords a reduction in the rate of preterm delivery.This is a retrospective cohort review of all individuals who underwent transvaginal cerclage placement at a tertiary care academic medical center between 2005 and 2021. The rate of delivery prior to 37 weeks and several secondary maternal and neonatal outcomes were compared between patients with and without progesterone supplementation after cerclage. Multivariable regression, subgroup, and matched pairs analyses were performed in order to account for the formulation of progesterone, indication for cerclage, and other potential confounding variables. The study was powered a priori to detect a difference in our primary outcome.Among 451 patients, there were 163 history-, 135 ultrasound-, and 153 examination-indicated cerclages. Overall, 284 (63%) received adjuvant progesterone. Adjuvant progesterone was associated with an increased rate of preterm delivery before 37 weeks (45 vs. 34%, <i>p</i> = 0.03) with an adjusted odds ratio of 1.78 (95% confidence interval: 1.14 and 2.80) in our multivariable model. The median latency from cerclage placement to delivery was shorter when progesterone was used (119 vs. 139 days, <i>p</i> < 0.001). There was no benefit of adjuvant progesterone when analyzed by formulation of progesterone or indication for cerclage or when analyzing pairs matched based on propensity score matching. There were no differences in secondary outcomes for pregnant patients or their offspring.Adjuvant progesterone does not decrease the preterm delivery rate and may in fact cause harm by decreasing latency from cerclage to delivery. Maternal and neonatal outcomes do not vary with supplemental progesterone after cerclage. Our data do not support a synergistic benefit of cerclage and postcerclage progesterone. · There are currently no guidelines for the use of progesterone after cerclage.. · Adjuvant progesterone does not decrease the preterm birth rate.. · Secondary maternal and neonatal outcomes do not improve with adjuvant progesterone..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960941","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 Anti-inflammatory Peptide RLS-0071 Reduces Immune Cell Recruitment and Oxidative Damage in a Neonatal Rat Model of Hypoxic-Ischemic Encephalopathy.","authors":"Kaitlyn G Jackson, Alana C Sampson, Kenji M Cunnion, Zachary A Vesoulis, Neel K Krishna","doi":"10.1055/a-2607-2619","DOIUrl":"10.1055/a-2607-2619","url":null,"abstract":"<p><p>Perinatal hypoxic-ischemic encephalopathy (HIE) is a major contributor to infant death and neurological injury worldwide. Both neuroglia and infiltrating peripheral immune cells contribute to inflammation and oxidative stress, which leads to neuronal loss and cerebral tissue necrosis in neonates with HIE. To date, there are no approved pharmacological interventions to treat inflammatory responses in infants affected by HIE. Therapeutic hypothermia (TH) remains the only effective treatment option. Therefore, novel pharmacotherapeutics that interrupt immune-mediated brain inflammation in HIE represent a promising target for intervention. To meet this unmet need, this study tested the hypothesis that a novel anti-inflammatory peptide, RLS-0071 (pegtarazimod), could modulate neuroinflammation in a neonatal rat model of HIE.RLS-0071 was evaluated in the acute stages of hypoxic-ischemic injury utilizing the well-established Vannucci rat pup model of HIE. Rat pups subject to hypoxia-ischemic brain insult received three interventions: normothermia, hypothermia, and RLS-0071. Histopathological effects were assessed via fluorescence microscopy of the hypoxic-ischemic induced cerebral infarct in the cortex at 24 and 48 hours after controlled oxygen deprivation.Increased surviving neurons were seen at 48 hours for RLS-0071 treatment compared with hypothermia treatment as assessed by neuronal nuclear protein (NeuN) staining. Ionized calcium-binding adaptor molecule 1 (Iba1)-positive microglial recruitment was reduced by fourfold in RLS-0071 treatment or hypothermia-treated rats between 24 and 48 hours, compared to normothermia controls. Likewise, myeloperoxidase (MPO) staining showed a twofold decrease in RLS-0071 or hypothermia-treated rats between 24 and 48 hours compared to normothermia controls.Our findings suggest that RLS-0071 decreases immune cell recruitment and oxidative damage to levels comparable to TH in an animal model of HIE. · No pharmacologic interventions for HIE currently exist.. · TH is the current standard of care.. · RLS-0071 increases neuron survival and lowers microglial cell influx in a HIE rat model.. · RLS-0071 limits oxidative damage in a HIE rat model.. · RLS-0071 may provide an orthogonal treatment for HIE..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075371","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":"Late Preterm Antenatal Corticosteroids in Pregestational and Gestational Diabetic Pregnancies.","authors":"Lylach Haizler-Cohen, Maria C Alzamora, Nicole Legro, Leila Eter, Tasha Freed, Suditi Rahematpura, Ayah Arafat, Victoria R Greenberg, Sara N Iqbal","doi":"10.1055/a-2624-8405","DOIUrl":"https://doi.org/10.1055/a-2624-8405","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the association between late preterm ACS administration and the incidence of hypoglycemia and respiratory complications in neonates born to individuals with PGDM and GDM.</p><p><strong>Study design: </strong>Multi-center retrospective cohort study between 2016-2022. Pregnant people with PGDM or GDM who presented in the late preterm period with concern for preterm delivery were included. The indication for preterm delivery was classified as preterm labor, preterm pre-labor rupture of membranes, or maternal/fetal indication. Exclusion criteria included multifetal gestations, fetal anomalies, stillbirths, prior course of ACS, or no anticipation for delivery in the next seven days. The primary outcome was neonatal hypoglycemia. Secondary outcomes included composite respiratory morbidity, composite non-respiratory morbidity, neonatal intensive care unit (NICU) admission, length of NICU stay and neonatal death. Multivariable regression models were used to calculate the odds ratio and 95% confidence intervals for the outcomes after adjusting for gestational age at delivery and neonatal birth weight. Outcome data were then stratified by diabetes type (PGDM versus GDM) and number of ACS doses administered. For PGDM pregnancies, outcome data were additionally stratified by glycemic control.</p><p><strong>Results: </strong>In the study period, 453 patients (126 with PGDM and 327 with GDM) were included. Of those, 265 (58.5%) received ACS and 188 (41.5%) did not. There were no significant differences in neonatal hypoglycemia and composite respiratory morbidity between the ACS and non-ACS groups, including in subgroup analysis of PGDM and GDM pregnancies. However, late preterm ACS were associated with reductions in supplemental oxygen use, mechanical ventilation and respiratory distress syndrome when two doses of ACS were administered. In PGDM pregnancies, neonatal outcomes did not differ between the ACS and non-ACS groups, regardless of glycemic control.</p><p><strong>Conclusion: </strong>Late preterm ACS administration in diabetic pregnancies was not associated with increased neonatal hypoglycemia or improvements in composite respiratory morbidity.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207372","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 Impact of Opt-in versus Opt-out Consent Process for the Use of Donor Human Milk on Feeding Practice and Growth Pattern in Preterm Neonates.","authors":"Christhian Alejandro Cano-Guerra, Meghan I Short, Elizabeth Yen","doi":"10.1055/a-2624-7278","DOIUrl":"https://doi.org/10.1055/a-2624-7278","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of an opt-out consent process compared to the opt-in consent process for using pasteurized donor human milk (PDHM) on feeding practices and growth in preterm neonates.</p><p><strong>Study design: </strong>A retrospective study of 200 neonates ≤ 28 weeks' gestation compared the effects of opt-in vs. opt-out consent processes on time to first enteral feed, feeding types, growth trajectories, and prematurity-related morbidities. Descriptive statistics were used to compare the two groups.</p><p><strong>Results: </strong>The opt-out process did not significantly alter the time to first enteral feed (range opt-in: 0 to 12 days vs. opt-out 0 to 5 days, Mann-Whitney U p=0.295). Compared to the opt-in process, the opt-out process was associated with less formula use, less mother's milk use, and more PDHM/mixed mom's milk-PDHM use in the first 4 weeks of life (p<0.01). Unadjusted analyses showed a greater weight gain in the opt-out group on days of life/DOLs 14 and 28 (2.49 [0.20, 4.78] and 3.94 [0.07, 7.80]%, p<0.05), and following adjustment, it remained significant for DOL 14 (1.87 [0.02, 3.71]). Prematurity-related morbidities were similar between the two groups.</p><p><strong>Conclusion: </strong>The opt-out consent process may impart short-term growth benefits in preterm infants. However, long-term outcomes require further study.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207373","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 Borderline Fetal Growth with Progression with Fetal Growth Restriction.","authors":"Baillie A Bronner, Monique Holod, Margaret Schermerhorn, Juliana Sung, Anna C Mccormick, Samantha De Los Reyes","doi":"10.1055/a-2451-9118","DOIUrl":"10.1055/a-2451-9118","url":null,"abstract":"<p><p>This study aimed to evaluate if an estimated fetal weight (EFW) between 10 and 15th percentiles at the time of anatomy ultrasound, referred to as borderline fetal growth, is associated with progression to fetal growth restriction (FGR) on subsequent ultrasound, delivery of a small for gestational age (SGA) neonate, or neonatal intensive care (NICU) admission.We performed a secondary analysis using the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMom2b) data. The exposures were normotensive pregnancies with non-anomalous singleton gestations with normal growth, defined as EFW >15th percentile at the anatomy scan compared to borderline fetal growth fetuses defined as those with an EFW in the 10 to 15th percentiles. The primary outcome was FGR at subsequent ultrasound, defined as EFW or AC <10%. The secondary outcomes were NICU admission and SGA neonate. Univariable analyses were performed comparing maternal baseline demographic and clinical characteristics. Multivariable analysis was performed for the primary outcome with variables adjusted a priori for body mass index, smoking status, race/ethnicity, insurance status, and drug use.In total, 4,883 patients met inclusion criteria with 114 in the borderline fetal growth group and 4,769 in the normal growth group. There were no significant differences in maternal demographic or medical characteristics. In adjusted multivariable analysis, patients with borderline growth had significantly higher odds of being diagnosed with FGR at their subsequent scan (adjusted odds ratio [aOR] = 6.68, confidence interval [CI]: 3.98-11.20) compared to those with normal growth. For secondary outcomes, patients with borderline fetal growth were significantly more likely to have SGA neonates (6.14 vs. 2.67%, <i>p</i> = 0.025). There was no difference in admissions to the NICU between groups.Diagnosis of borderline fetal growth at the time of the anatomy scan was associated with significantly increased odds of progression to FGR at subsequent scans and delivery of an SGA neonate. · Patients with EFWs between the 10th and 15th percentiles, referred to as borderline fetal growth, are at an increased risk of progression to FGR compared to those with EFWs >15th percentile.. · Patients with borderline fetal growth are more likely to deliver SGA neonates compared to those with EFWs >15th percentile.. · Providers should consider follow-up antenatal growth assessment in patients with borderline fetal growth..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1012-1016"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492902","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":"Trends in Gabapentin Use in Neonatal Intensive Care Units from 2005 to 2020.","authors":"Annette G Roberts, Ryan Kilpatrick, Lindsey D Diaz, Scott Benjamin, Athziry J Espinoza Santiago, Bubacarr Jallow, Madison F Monteith, Sarah Rumsey, Reese H Clark, Kanecia Zimmerman, Daniel K Benjamin, Rachel G Greenberg","doi":"10.1055/a-2451-9925","DOIUrl":"10.1055/a-2451-9925","url":null,"abstract":"<p><p>This study aimed to analyze trends in gabapentin use in neonatal intensive care units (NICUs) and examine demographic characteristics, diagnoses, and concomitant medications associated with its use.Cohort study of 987,181 infants hospitalized in the NICU from 2005 to 2020.Eighty-five infants (<0.01%) received gabapentin. From 2009 to 2020, there was a 1,055% relative increase in gabapentin use (<i>p</i> < 0.01). The median birth weight was 2,160 g (25th, 75th percentiles: 875, 3,080 g) in gabapentin-exposed infants compared with 2,498 g (1,890, 3,210 g) in unexposed infants (<i>p</i> < 0.001). Over half (55%) of infants receiving gabapentin were born prematurely, 54% (<i>n</i> = 45) had chronic lung disease, 46% (<i>n</i> = 39) had gastrostomy tubes, and 34% (<i>n</i> = 29) had drug withdrawal syndrome; 49% (<i>n</i> = 42) and 27% (<i>n</i> = 23) received opioids and benzodiazepines, respectively.Use of gabapentin was rare but increased over time despite limited research on its safety and efficacy in infants, illuminating the need for further studies. · Gabapentin safety in infants is not well understood.. · Gabapentin use increased despite limited safety research.. · Further studies on gabapentin use in infants are needed..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1017-1023"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715071","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}