American journal of perinatology最新文献

{"title":"Continuous versus Intermittent Blood Pressure Monitoring in Postpartum Preeclampsia with Severe Features.","authors":"Helen Woolcock Martinez, Noora Haghighi, Anne-Sophie van Wingerden, Michael Kirschner, Whitney A Booker, Natalie A Bello, Nils Petersen, Eliza C Miller","doi":"10.1055/a-2457-2781","DOIUrl":"10.1055/a-2457-2781","url":null,"abstract":"<p><strong>Objective: </strong> In this study, we piloted the use of continuous 24-hour blood pressure (BP) monitoring in postpartum patients with preeclampsia with severe features.</p><p><strong>Study design: </strong> We measured continuous BP for up to 24 hours using finger plethysmography. We also used an oscillometric device to measure brachial BP per usual clinical protocol (intermittent BP) during the same monitoring period. Using a paired <i>t</i>-test, we compared mean BP values assessed using intermittent and continuous methods, and using McNemar's test, we compared the proportion of patients with sustained severe-range BP using each BP measurement method.</p><p><strong>Results: </strong> A total of 25 patients were included in this study. There was no difference in mean systolic BP (SBP) and mean arterial pressure between intermittent and continuous BP measurements. Intermittently recorded mean diastolic BP (DBP) was significantly higher than continuously recorded DBP. Eleven participants (44%) had sustained SBP ≥160 mm Hg using continuous monitoring compared with two using intermittent monitoring (<i>p</i> = 0.003). Of these 11 participants, 3 (37%) also recorded sustained DBP ≥110 mm Hg using continuous monitoring compared with none using intermittent monitoring.</p><p><strong>Conclusion: </strong> Continuous BP monitoring is a feasible and reliable method for detecting sustained severe-range BP in postpartum patients receiving treatment for preeclampsia with severe features.</p><p><strong>Key points: </strong>· Postpartum continuous BP monitoring is feasible.. · Continuous BP detects more sustained severe BP.. · Continuous BP may be a reliable BP method..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563755","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":"Fetal Growth Ultrasound in Obese Patients for the Detection of Growth Abnormalities.","authors":"Juliana G Martins, Elizabeth Miller, Rebecca Horgan, Tetsuya Kawakita","doi":"10.1055/a-2460-5846","DOIUrl":"10.1055/a-2460-5846","url":null,"abstract":"<p><strong>Objective: </strong> This study aimed to examine the impact of maternal obesity on fetal growth abnormalities including fetal growth restriction (FGR) and large for gestational age (LGA) fetuses.</p><p><strong>Study design: </strong> Secondary analysis from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b). The study excluded individuals with pregestational or gestational diabetes, chronic hypertension, and other major maternal medical conditions. First-trimester ultrasound was performed to establish accurate dating criteria. Ultrasound assessments were performed at 16 to 21 and 22 to 29 weeks of gestation. Our exposure was the presence of pre-pregnancy obesity. Our primary outcome was rates of fetal growth abnormalities identified by ultrasound, defined as FGR (estimated fetal weight [EFW] or abdominal circumference <10th percentile) or LGA (EFW >90th percentile) among obese compared with nonobese women. A secondary analysis was performed after limiting ultrasound performed from 28 to 29 weeks. To estimate adjusted relative risks (aRRs) with 95% confidence intervals (95% CIs), we used generalized linear models with Poisson distribution and log link using robust error variance, adjusting for the predefined covariates.</p><p><strong>Results: </strong> Of 7,354 participants, 1,443 (19.6%) had pre-pregnancy obesity while 5,911 (80.4%) did not. Pre-pregnancy obesity compared with normal weight was associated with an increased risk of fetal growth abnormalities both at 16 to 21 weeks (16.0% vs. 13.2%; aRR 1.23; 95% CI 1.06-1.42) and 22 to 29 weeks (16.0% vs. 12.1%; aRR 1.33; 95% CI 1.14-1.54). Furthermore, pre-pregnancy obesity compared with normal weight was associated with an increased risk of LGA both at 16 to 21 weeks (12.5% vs. 10.3%; aRR 1.24; 95% CI 1.05-1.47) and 22 to 29 weeks (10.6% vs. 6.9%; aRR 1.66; 95% CI 1.38-2.01). In a secondary analysis limited to the ultrasound at 28 to 29 weeks, both fetal growth abnormalities and LGA were associated with the presence of obesity. In any of the analyses, pre-pregnancy obesity was not associated with FGR compared with normal weight.</p><p><strong>Conclusion: </strong> Maternal obesity is associated with an increased risk of fetal growth abnormalities and LGA fetuses.</p><p><strong>Key points: </strong>· Obesity is associated with increased LGA risk.. · Association between obesity and FGR remains unclear.. · Ultrasound is effective in obese women to detect fetal growth abnormalities.. · Future research is needed to assess the association between obesity and FGR..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575124","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":"Bedside Utilization of Intestinal Pathology in Preterm Infants with Surgical Necrotizing Enterocolitis.","authors":"Padma Parvesh Garg, Victoria G Weis, Jeffrey Shenberger, Jared Weiss, Anna Mcdonald, Parvesh Mohan Garg","doi":"10.1055/a-2483-5736","DOIUrl":"https://doi.org/10.1055/a-2483-5736","url":null,"abstract":"<p><p>Necrotizing enterocolitis (NEC) is one of the most common conditions requiring emergency surgery in the neonatal intensive care unit and is associated with multi-organ dysfunction, multiple systemic morbidities and mortality. The resected bowel commonly shows evidence of coagulative necrosis, inflammation, interstitial hemorrhages, and reparative changes on the pathology examination. The severity of these pathological abnormalities may correlate with the disease's severity and pace of progression and may assist in the prediction of clinical outcomes. This review presents current evidence about the clinical utility of the intestinal pathology in bedside decision making, accurate diagnosing, prediction of outcomes, and in the prognostication of preterm infants with surgical NEC. Developing refined and validated noninvasive methods to diagnose the extent of bowel injury and monitoring of tissue repair throughout disease progression is paramount to mitigating the long-term morbidities in preterm infants with surgical NEC. Improved imaging methods such as targeted bowel ultrasound capable of assessing the inflammation and necrosis in real time will greatly advance care and provide focus for the temporal framework of surgical interventions.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715037","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":"Fetal Growth Restriction: A Pragmatic Approach.","authors":"Allan Nadel, Malavika Prabhu, Anjali Kaimal","doi":"10.1055/a-2483-5684","DOIUrl":"https://doi.org/10.1055/a-2483-5684","url":null,"abstract":"<p><p>An accurate diagnosis of fetal growth restriction relies on a precise estimation of gestational age based on a carefully obtained history as well as early ultrasound, since a difference of just a few days can lead to a significant error. There is a continuum of risk for adverse outcome that depends on the certainty of dates and presence or absence of comorbidities, in addition to the estimated fetal weight percentile and the umbilical artery waveform. The results of several studies, most notably the TRUFFLE trial, demonstrate that optimal management of fetal growth restriction with an abnormal umbilical artery waveform requires daily electronic fetal heart rate monitoring, and this monitoring does not require computerized interpretation. The role of ductus venosus waveform, biophysical profile, and middle cerebral artery waveform is less clear, and the results of these three modalities should be interpreted with caution.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715050","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":"Posttraumatic Stress Symptoms among Obstetricians with Personal Experience of Birth Trauma.","authors":"Anna R Whelan, Laurie B Griffin, Melissa L Russo, Nina K Ayala, Emily S Miller, Melissa A Clark","doi":"10.1055/a-2452-7862","DOIUrl":"10.1055/a-2452-7862","url":null,"abstract":"<p><strong>Objective: </strong> Psychological birth trauma (BT), defined as an event that occurs during labor and delivery involving actual or threatened harm or death to the pregnant person and/or their baby, has been reported in up to one-third of births. Obstetrician-Gynecologists (OBGYNs) who personally experience BT are at a unique risk of re-traumatization upon return to work. We aimed to investigate the prevalence of personal BT among obstetricians and their perceptions of how personal BT impacts their experience of caring for obstetric patients.</p><p><strong>Study design: </strong> We performed a web-based survey of OBGYNs who had given birth. Participants were recruited from the \"OMG (OBGYN Mom Group)\" on Facebook. The questionnaire assessed individuals' personal experience of childbirth using items adapted from the \"City Birth Trauma Scale\" to assess posttraumatic symptoms related to their childbirth and patient interactions following the personal experience of BT. Responses were categorized by whether or not the participant considered one or more of their own births to be traumatic. Posttraumatic stress symptoms (PTSSs) and symptoms of occupational re-traumatization were compared by reported BT. Bivariable analyses were used.</p><p><strong>Results: </strong> Of the 591 OBGYNs who completed the survey, 180 (30.5%) reported experiencing BT. Ninety-two percent of OBs cared for birthing patients after giving birth. There were no differences in demographic or clinical practice characteristics between those with and without BT. OBGYNs with BT experienced PTSSs including flashbacks (60.6% vs. 14.4%), amnesia (36.7% vs. 20.9%), and insomnia (24.4% vs. 1.2%) at higher rates than those without BT (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong> Almost one-third of OBGYNs in this sample reported personally experiencing BT, mirroring data from reported BT rates in the general population. Given that OBGYNs are at high risk for occupational re-traumatization, initiatives focused on improving support for birthing OBGYNs upon returning to work should be studied to assess the impact on emotional wellness among practicing OBGYNs.</p><p><strong>Key points: </strong>· Birthing OBGYNs experience psychological BT at similar rates to the general population.. · OBGYNs who experience personal BT may experience PTSSs at work.. · Further research on the prevalence of personal BT among OBGYNs is needed..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520716","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":"Impact of Attempted Mode of Delivery on Neonatal Outcomes in Nulliparous Individuals According to Body Mass Index.","authors":"Rula Atwani, George Saade, Tetsuya Kawakita","doi":"10.1055/a-2451-9197","DOIUrl":"10.1055/a-2451-9197","url":null,"abstract":"<p><strong>Objective: </strong> This study aimed to compare neonatal and maternal outcomes based on the attempted mode of delivery, stratified by prepregnancy body mass index (BMI; kg/m²) in nulliparous individuals.</p><p><strong>Study design: </strong> This was a repeated cross-sectional analysis of U.S. vital statistics Live Birth and Infant Death-linked data from 2011 to 2020. The analysis was restricted to nulliparas with singleton pregnancies and cephalic presentation who delivered at term. Our primary outcome was a composite neonatal outcome. We also examined a composite maternal outcome. We compared outcomes between individuals who attempted labor and those who opted for nonlabor cesarean delivery, categorized by BMI (<18.5, 18.5-24.9, 25-29.9, 30-39.9, ≥40). To account for significant differences in baseline characteristics between groups, Coarsened Exact Matching was applied using a k-to-k solution. We employed modified Poisson regression and calculated a difference-in-difference (DID) to compare differences in predicted proportions across BMI categories.</p><p><strong>Results: </strong> Out of 9,709,958 individuals, 1,083,332 were included in the matched analysis. Compared with attempted vaginal delivery, nonlabor cesarean delivery was associated with an increased risk of the composite neonatal outcome across all BMI categories. However, the increase in risk was less pronounced in higher BMI categories compared with the reference group (BMI 18.5-24.9). For maternal outcomes, nonlabor cesarean delivery was associated with an increased risk of the composite maternal outcome in the BMI 18.5-24.9 and 25-29.9 categories. In contrast, the risk of adverse maternal outcomes associated with nonlabor cesarean delivery was lower in higher BMI groups compared with the reference group, with DID values ranging from -0.12 in the BMI 30-39.9 group to -0.16 in the BMI ≥40 group.</p><p><strong>Conclusion: </strong> Nonlabor cesarean delivery, as compared with attempted vaginal delivery, was associated with adverse neonatal outcomes across all BMI categories, though the relative increase in risk was diminished in higher BMI groups.</p><p><strong>Key points: </strong>· Compared with attempting vaginal delivery, nonlabor cesarean was associated with an increased risk of the composite neonatal outcome in all BMI classes (range of absolute risk difference 1.27-2.35%).. · The increased risk of the composite neonatal outcome was less pronounced in nulliparous individuals with a BMI of 40 kg/m2 or greater.. · Even for individuals with high BMI, attempting vaginal delivery is reasonable..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492904","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":"A Survey of Minimally Invasive Surfactant Use in the United States.","authors":"Natasha Ahn, Matthew Derrick, Walid Hussain","doi":"10.1055/a-2453-6883","DOIUrl":"https://doi.org/10.1055/a-2453-6883","url":null,"abstract":"<p><strong>Objective: </strong> Minimally invasive surfactant therapy (MIST) has become the standard of care in delivering surfactant noninvasively in many parts of the world, particularly throughout Europe; however, centers in the United States have been slower to adopt it. The most recent assessment of the use of MIST in the United States was in 2018 by Kurepa et al. Considering the increasing evidence favoring MIST, this paper reassessed the current rate of utilization and aims to examine barriers to MIST implementation.</p><p><strong>Study design: </strong> A web-based survey was distributed to approximately 4,500 individuals in the American Academy of Pediatrics Section of Neonatal-Perinatal Medicine (AAP SoNPM) mailing list. The questions were aimed at addressing MIST usage in the United States, examining barriers for neonatology providers to implement MIST into their practice, and determining the use of sedation during the MIST procedure.</p><p><strong>Results: </strong> Of the 381 respondents, 39% used MIST as part of their practice, which was an increase from 15% in 2018. The most prevalent barrier to implementation was the lack of procedural training. There was a large increase in the use of sedation for the procedure compared with 2018.</p><p><strong>Conclusion: </strong> MIST use among AAP SoNPM respondents has more than doubled since 2018; InSurE (INtubation-SURfactant delivery Extubation) remains the most prevalent method of surfactant delivery in non-intubated patients. The list of different types of barriers and comments provided by respondents can be a resource for units planning to implement MIST.</p><p><strong>Key points: </strong>· The usage of MIST in the United States.. · What are the barriers to MIST implementation?. · The usage of sedation during MIST procedure..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715034","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":"Risk Factors for Hearing Screen Failure in a Single Family Room Neonatal Intensive Care Unit.","authors":"Rebecca Suflas, Rebecca Cox, Rose M Viscardi, Jocelyn Leung","doi":"10.1055/a-2483-5788","DOIUrl":"https://doi.org/10.1055/a-2483-5788","url":null,"abstract":"<p><strong>Objective: </strong>To determine hearing screen outcomes and identify clinical and environmental risk factors for hearing screen failure in very preterm infants at a level IV single family room (SFR) neonatal intensive care unit (NICU).</p><p><strong>Study design: </strong>We conducted a retrospective study of infants <33wks gestational age admitted to a level IV SFR NICU who survived to discharge and had automated auditory brainstem response results available. Demographics, antenatal and postnatal factors, and respiratory support modes and their duration were collected from the electronic medical record.</p><p><strong>Results: </strong>Of 425 eligible infants with documented hearing screen results, 353 (83%) passed and 72 (17%) failed the hearing screen [unilateral, N= 44 (61%); bilateral, N= 28 (39%)]. Compared to infants who passed the hearing screen, infants with hearing screen failure were lower gestational age and birthweight, male sex, were screened at later postnatal and postmenstrual ages, had lower 1 and 5 min Apgar scores, longer duration of furosemide therapy, early hypotension, IVH≥ Grade 3, and BPD at 36 weeks PMA. Infants with hearing screen failure experienced longer exposures to invasive and non-invasive respiratory support. Heated, humidified, high flow nasal cannula >2LPM exposure was significantly longer in infants with bilateral hearing screen failure (18.4±18.4 d) compared to duration in infants who passed (7.4±12.8 d) and those with unilateral failure (9±13 d), (mean ± SD, p<0.001). In the final logistic model, IVH ≥Grade 3 (OR 3.22, 95% CI 1.15-8.98, p=0.026) and BPD (OR 2.27, 95% CI 1.25-4.11, p=0.007) were the factors with greatest risk for hearing screen failure.</p><p><strong>Conclusion: </strong>We speculate that the association of BPD with hearing screen failure may be mediated, in part, by chronic noise exposure, including from respiratory support devices. Attention to hearing protection in at-risk infants during respiratory support may mitigate the risk of hearing loss.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715068","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":"Impact of Cannabis Legalization on Umbilical Cord Tetrahydrocannabinol (THC) Levels.","authors":"Kimberly Spence, Sarah Milota, Paula Buchanan, Nirja Acharya, Amit Mathur","doi":"10.1055/a-2480-3163","DOIUrl":"https://doi.org/10.1055/a-2480-3163","url":null,"abstract":"<p><strong>Title: </strong>Impact of Cannabis Legalization on Umbilical Cord Tissue Tetrahydrocannabinol (THC) levels Objective: To assess the impact of cannabis legalization on both qualitative and quantitative umbilical cord tissue tetrahydrocannabinol (THC) rates and concentrations as a proxy for fetal exposure.</p><p><strong>Study design: </strong>This is a retrospective, observational study of umbilical cord tissue THC levels in a single center, comparing THC exposure rates and concentration levels before and after cannabis legalization in the state of Illinois, Epoch 1 (October 1,2018-June 30, 2019, pre-legalization) and Epoch 2 (July 1, 2019-August 31, 2021, post-legalization).</p><p><strong>Results: </strong>811 umbilical cords were analyzed during epoch 1 and 2170 during epoch 2. A higher percent of umbilical cord tissue tested positive for THC in Epoch 2 compared to Epoch 1 (46.2% vs. 40.6%; p<0.01). Mean THC levels were 51% higher in umbilical cord tissue in Epoch 2 vs. Epoch 1 (6.2ng/gm vs 4.1 ng/gm; p<0.001).</p><p><strong>Conclusions: </strong>Legalization of recreational cannabis was associated with more fetuses exposed to THC and in higher concentrations.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685849","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":"Longer inter-pregnancy interval is associated with gestational diabetes mellitus recurrence.","authors":"Tzuria Peled, Daniella Federmesser, Eyal Mazaki, Hen Sela, Sorina Grisaru-Granovsky, Misgav Rottenstreich","doi":"10.1055/a-2480-5407","DOIUrl":"https://doi.org/10.1055/a-2480-5407","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the effect of inter-pregnancy interval (IPI) on the gestational diabetes (GDM) recurrence rate in subsequent pregnancies following an initial pregnancy complicated by GDM.</p><p><strong>Study design: </strong>A multicenter retrospective cohort study was conducted. The study included women diagnosed with GDM during their index pregnancy who subsequently delivered between 26 and 42 weeks of gestation from 2005 to 2021. The study population was categorized into 8 groups according to their IPIs: up to 3 months, 3-5 months, 6-11 months, 12-17 months, 18-23 months, 24-35 months, 36-47 months, and over 48 months. We examined the recurrence rate of GDM in the different groups compared to the 18-23 months group that was defined as the reference. Statistical analyses included univariate analyses and multiple logistic regression.</p><p><strong>Results: </strong>Out of 3,532 women that were included in the study, 1776 (50.3%) experienced GDM recurrence in subsequent pregnancy. The recurrence rate was 44.6% for women IPI <6 months, 42.6% for women IPI of 6-11 months, 48.0% for women IPI of 12-17 months, 49.7% for women IPI of 18-23 months, 58.0% for women IPI of 24-47 months and 62.6% for women IPI above 48 months. Multivariable logistic regression revealed that IPIs of 24-47 months and over 48 months were significantly associated with higher recurrence rates as compared to the 18-23 months reference group (adjusted odds ratio [aOR], 95% confidence interval [CI] 1.66 [1.04-2.64] and 3.15 [1.07-9.29], respectively). This analysis also revealed other independent risk factors for GDM recurrence including medication-controlled GDM in the index pregnancy, obesity, maternal age, parity, and gravidity.</p><p><strong>Conclusion: </strong>Longer IPIs (over 24 months) are associated with an increased risk of GDM recurrence in subsequent pregnancies. Clinicians should consider IPI when managing postpartum care and planning future pregnancies for women with a history of GDM.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685973","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}