American journal of perinatology最新文献

{"title":"Maternal Characteristics and Pregnancy Outcomes Associated with Delivery versus Expectant Management following Decreased Fetal Movement at Term.","authors":"Jia Jennifer Ding, Olivia Paoletti, Jennifer Culhane, Lisbet Lundsberg, Caitlin Partridge, Sarah N Cross","doi":"10.1055/a-2486-7642","DOIUrl":"10.1055/a-2486-7642","url":null,"abstract":"<p><p>This study aimed to compare maternal characteristics and pregnancy outcomes between term patients evaluated for decreased fetal movement (DFM) who were delivered versus expectantly managed.Retrospective cohort study of term patients delivering within a large hospital system from 2015 to 2023 who were evaluated for DFM. Patients were classified into three groups based on the time between evaluation for DFM and delivery admission: (1) <24 hours, (2) 24-48 hours, (3) >48 hours. Bivariate comparisons and multinomial logistic regression were performed to evaluate which maternal characteristics were associated with immediate delivery (<24 and 24-48 hours latency) as compared with expectant management (>48 hours latency) as well as to compare delivery and neonatal outcomes.Of 2,015 patients, significant sociodemographic and clinical variations were noted between groups. Following adjustment, noncommercial insurance, hypertension in pregnancy, and body mass index (BMI) ≥30 kg/m² at delivery were associated with reduced odds of admission <24 and 24-48 hours as compared with >48 hours. There were no cases of stillbirth or neonatal demise and there were no differences in delivery or neonatal outcomes.Among patients with DFM at term, there are significant sociodemographic and clinical variations between those admitted for <24, 24-48, and >48 hours, though delivery and neonatal outcomes were similar. · Having noncommercial insurance, hypertension in pregnancy, and BMI ≥30 kg/m2 at delivery were associated with reduced odds of admission within <24 and 24-48 hours as compared with >48 hours after presenting with DFM at term.. · There were no cases of stillbirth or neonatal demise among this cohort of patients presenting with DFM at term.. · There were no differences in delivery or neonatal outcomes among this cohort of patients presenting with DFM at term as stratified by timing from presentation to admission for delivery..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1243-1248"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871004","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 Heart Rate and Amniotic Fluid Volume Measurements with a Home Ultrasound Device.","authors":"Anat Pardo, Shir Nahum Fridland, Or Lee Rak, Emilie Klochendler Frishman, Hadar Zafrir Danieli, Anat Shmueli, Shiri Barbash-Hazan, Arnon Wiznitzer, Asnat Walfisch, Tomer Sela, Leor Wolff, Eran Hadar","doi":"10.1055/a-2469-0887","DOIUrl":"10.1055/a-2469-0887","url":null,"abstract":"<p><p>Pulsenmore ES is a self-scanning ultrasound (US) system for remote fetal assessment. It comprises a handheld transducer that serves as a smartphone cradle coupled with an application and clinician's web-viewer dashboard. Recently, a novel capability was added to the system allowing offline fetal heart rate (FHR) and maximal vertical pocket (MVP) measurements. The aim of this study was to evaluate these tools for usability and accuracy.A prospective, non-randomized, non-blinded clinical study design was used. Pulsenmore ES scans were obtained by non-professional laypersons in app-guided (AG) mode (user follows video tutorials in the application) or clinician-guided (CG) mode (user is guided by a health care professional in a real-time telemedicine visit). The scans were stored on a cloud for later interpretation by a health care professional. Each self-scan was immediately followed by a standard US scan performed by a clinician. The asynchronous FHR and MVP measurements made on the AG and CG scans through the designated dashboard were analyzed and compared with the real-time, in-clinic (INC) measurements.The cohort included 28 women. Rates of successful utilization of the Pulsenmore tool for measurement of FHR were 84.7 ± 11.24% of scans made in AG mode and 96.3 ± 6.35% of scans made in CG mode. Corresponding values for MVP were 91.7 ± 2.31% and 95.0 ± 1.73%. FHR accuracy (difference from INC values) was 10.8 ± 7.5 beats per minute (bpm; 7.2%) in AG mode and 5.8 ± 5.1 bpm (4%) in CG mode. MVP accuracy was 1.3 ± 1.4 cm (22%) and 0.9 ± 0.8 cm (14%), respectively. Sensitivity (87.5% and 100% in AG and CG modes, respectively) and specificity (95% and 95.5% in AG and CG modes, respectively) were established for MVP.FHR and MVP measurements obtained from scans captured by the self-operated Pulsenmore ES ultrasound platform are highly accurate and reliable for clinical use relative to standard INC measurements. · Pulsenmore ES is a self-scanning US system for remote fetal assessment.. · FHR and MVP can be accurately and remotely measured from home.. · Home US can play a critical role in remote antenatal surveillance..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1192-1199"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674822","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":"Simplifying Management of Cholestasis: A Proposal for a Classification System.","authors":"Minhazur Sarker, Gladys A Ramos, Lauren Ferrara, Cynthia Gyamfi-Bannerman","doi":"10.1055/a-2495-3553","DOIUrl":"10.1055/a-2495-3553","url":null,"abstract":"<p><p>Given the stillbirth risk associated with intrahepatic cholestasis of pregnancy, management to reduce this adverse outcome has primarily involved planned delivery as early as 36 weeks gestation. While earlier planned delivery has decreased the incidence of stillbirth in this population, recently, there have been multiple published retrospective studies to better correlate the association of adverse outcomes with cholestasis severity. Despite these new data, the uptake of individualized management for cholestasis has been varied from provider to provider. In this opinion, we briefly review the current literature and evidence regarding cholestasis and adverse outcomes and propose a cholestasis classification system with subsequent algorithms for management. · Recently, multiple studies have further characterized adverse outcomes with cholestasis.. · Incorporation of severity-associated management into clinical practice is variable.. · A cholestasis classification system will simplify and streamline management..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1229-1234"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779248","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":"Retroverted Uterus in the First Trimester and Associated Pregnancy Outcomes.","authors":"Emily R Schneider, Agata Kantorowska, Joanna M Clough, Erin L Miller, Emmanuella Kobara, Jasmine Brite, Meredith L Akerman, Wendy L Kinzler, Anju Suhag, Martin R Chavez, Patricia Rekawek","doi":"10.1055/a-2466-1155","DOIUrl":"10.1055/a-2466-1155","url":null,"abstract":"<p><p>This study aimed to investigate if retroverted (RV) uterus noted on nuchal translucency (NT) ultrasound is associated with second-trimester pregnancy loss and other adverse pregnancy outcomes.This was a retrospective cohort study of patients with RV uterus documented on NT ultrasound at a single academic medical center from October 2019 to March 2023. Subjects were identified using a query for \"retroverted\" uterine position within an obstetric ultrasound imaging program. For each RV case, two anteverted (AV) subjects were selected for comparison. Patients with multiple gestation, Mullerian anomalies, or fetal aneuploidy were excluded. Maternal demographics, obstetric, and neonatal outcomes were obtained by chart review. Fisher's exact test and Mann-Whitney test were used for categorical and continuous variables, respectively, with <i>p</i>-value <0.05 denoting significance. Multivariable logistic regression was used to adjust for possible confounding variables.Analysis included 249 patients-83 RV and 166 AV. RV patients were more likely to identify as Caucasian (71.1 vs. 49.4%, <i>p</i> = 0.001), have private insurance (80.7 vs. 59.4%, <i>p</i> = 0.001), lower body mass index (25.4 ± 5.1 vs 29.1 ± 7.2, <i>p</i> < 0.001), and conceive by in vitro fertilization (IVF, 11 vs. 3%, <i>p</i> = 0.018). Most RV subjects (98%) had a resolution of retroversion by the second trimester. There was no difference in second-trimester pregnancy loss (0 vs. 1.2%, <i>p</i> = 0.55). After adjusting for race and IVF, RV subjects were four times more likely to have first-trimester vaginal bleeding (16.9 vs. 4.2%, odds ratio = 4.1, <i>p</i> = 0.0056). No other differences in adverse outcomes were observed.Persistent RV uterus in the first trimester is associated with increased risk of first-trimester vaginal bleeding. However, rates of pregnancy loss were similar between groups, providing valuable information for patient counseling. Significantly more RV subjects conceived by IVF, highlighting the need for further study in this population. · Pregnancy outcomes of patients with retroverted uterus have not been widely studied.. · Significantly more patients with a retroverted uterus conceived by in vitro fertilization.. · Patients with retroverted uterus were four times more likely to have first-trimester bleeding.. · Despite increased rates of vaginal bleeding, there was no increased rate of pregnancy loss..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1179-1185"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779242","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 C Leung","doi":"10.1055/a-2483-5788","DOIUrl":"10.1055/a-2483-5788","url":null,"abstract":"<p><p>This study aimed 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).We conducted a retrospective study of infants <33 weeks 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.Of 425 eligible infants with documented hearing screen results, 353 (83%) passed and 72 (17%) failed the hearing screen (unilateral, <i>N</i> = 44 [61%]; bilateral, <i>N</i> = 28 [39%]). Compared to infants who passed the hearing screen, infants with hearing screen failure were lower gestational age and birth weight, male sex, were screened at later postnatal and postmenstrual ages (PMAs), had lower 1- and 5-minute Apgar scores, longer duration of furosemide therapy, early hypotension, intraventricular hemorrhage (IVH) ≥Grade 3, and bronchopulmonary dysplasia (BPD) at 36 weeks PMA. Infants with hearing screen failure experienced longer exposures to invasive and noninvasive respiratory support. Heated, humidified, high flow nasal cannula >2 liters per minute 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 ± standard deviation [SD], <i>p</i> < 0.001). In the final logistic model, IVH ≥Grade 3 (odds ratio [OR] = 3.22, 95% confidence interval [CI]: 1.15-8.98, <i>p</i> = 0.026) and BPD (OR = 2.27, 95% CI: 1.25-4.11, <i>p</i> = 0.007) were the factors with the greatest risk for hearing screen failure.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. · NICU noise often exceeds recommended sound levels.. · Seventeen percent of infants with <33 weeks GA in SFR NICU failed hearing screenings.. · BPD and IVH are risk factors for hearing screen failure.. · Respiratory devices contribute to increased NICU noise.. · hearing protection should be considered during respiratory support..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":"1272-1280"},"PeriodicalIF":1.5,"publicationDate":"2025-07-01","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":"Placenta Accreta Spectrum Outcomes with a Multidisciplinary Team and Standardized Ultrasound Approach.","authors":"Elise A Rosenthal, Ashlyn K Lafferty, Jessica E Pruszynski, Naseem Uddin, Catherine Y Spong, Christina L Herrera","doi":"10.1055/a-2626-3120","DOIUrl":"https://doi.org/10.1055/a-2626-3120","url":null,"abstract":"<p><p>This study aimed to compare outcomes before and after starting a multidisciplinary PAS team with a standardized ultrasound approach.Retrospective cohort study of deliveries ≥ 24 weeks complicated by PAS from August 2009 to April 2022 at a large tertiary care hospital. The multidisciplinary team started in October 2020, and a standardized ultrasound approach was consistently practiced. We compared demographics and pregnancy characteristics before and after the formation of the PAS team. Statistical analysis included Fisher's exact test and <i>χ</i> ² for categorical variables student's <i>t</i>-test and Kruskal-Wallis test for continuous variables.Of 244 patients, 32 delivered with and 212 delivered before the PAS team. Median gestational age at delivery did not change (37 [36-38] vs. 37 [36-37] weeks before the team, <i>p</i> = 0.680). With the team, 31/32 cases of PAS were prenatally diagnosed (97%) compared with 177/212 (83%) before the team (<i>p</i> = 0.058). There were more cases of false positive prenatal suspicion present with the team (11% vs. 31%). Fewer hysterectomies occurred with the team at 21 (66%) versus 197 (93%) before the team, (<i>p</i> < 0.001). Pathologic severity in hysterectomy specimens significantly differed (<i>p</i> = 0.032), with 10 cases with negative pathology before and none with the team. Due to the lower rate of hysterectomy, the overall median EBL was lower with the team (<i>p</i> = 0.018), but other outcomes were similar. This difference in EBL did not persist when limiting to hysterectomy cases. Maternal LOS overall (6 [5-9] vs. 8 [5-15] days, <i>p</i> = 0.031) and within hysterectomies (6 [5-8] vs. 9 [6-16] days, <i>p</i> = 0.042) was significantly shorter with the team.A multidisciplinary PAS team with a standardized ultrasound approach decreased unnecessary hysterectomies and reduced the length of stay at a large tertiary hospital. A higher rate of false positive prenatal suspicion was observed. This finding supports a need for improved prenatal diagnosis to enable better preoperative risk stratification and planning. · A multidisciplinary PAS team with standardized ultrasound reduces unnecessary hysterectomy.. · Heightened assessment increased identification prenatally resulting in more false positive cases.. · Our findings highlight the need for improved preoperative risk stratification and planning..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511425","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":"Yoga in the NICU for Parents: A Pilot Study on Reducing Stress in the NICU.","authors":"Sara K Neches, Alanna Feltner, Mihai Puia-Dumitrescu, Krystle Perez, Leanne Matullo, Dennis E Mayock, Sandra E Juul","doi":"10.1055/a-2629-0956","DOIUrl":"10.1055/a-2629-0956","url":null,"abstract":"<p><p>Explore the effect of a 6-week online program of yogic breathing, meditation, and gentle postures for parents of infants hospitalized in the neonatal intensive care unit (NICU).From October 2021 to October 2023, we conducted a two-center pilot study of yoga for NICU parents. We assigned consented parents of NICU inpatients to receive yoga classes (YG) and/or usual care (UC) for parent support within 14 days of admission to the NICU. Self-directed yoga sessions were completed using an online platform. UC included parental support as practiced in each NICU and served as a control group. Primary outcomes were assessed at the study entrance, midpoint, and conclusion using the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS: NICU) and the Postpartum Bonding Questionnaire (PBQ) in English and Spanish.A total of <i>n</i> = 51 parents (71%) mothers, were allocated using parallel assignment to UC (<i>n</i> = 28, 55%) or YG (<i>n</i> = 23, 45%). A total of <i>n</i> = 39 (76%) parents completed the classes to the midpoint of the study and <i>n</i> = 33 (65%) completed all 6 weeks of the study. There were no differences in baseline characteristics for parents or infants between groups. Average participation in the online yoga materials was 3 hours and 45 minutes per parent. A significant decrease in NICU-related parent stress emerged for all PSS: NICU subscales and total PSS: NICU scores for parents assigned to YG between enrollment and the midpoint of the study. Neither parents in UC nor YG approached thresholds indicating disorders of the parent-infant relationship as assessed by the PBQ.When initiated early, an online, asynchronous yoga intervention designed for parents may reduce NICU parent stress. · Yoga may reduce stress and enhance emotional health for parents of critically ill newborns.. · Virtual and self-directed mindfulness interventions for parents are feasible in the NICU environment.. · Sustaining parental wellness over an extended NICU hospitalization is challenging..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245780","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 R Legro, Leila Eter, Tasha Freed, Suditi Rahematpura, Ayah Arafat, Victoria Greenberg, Sara N Iqbal","doi":"10.1055/a-2624-8405","DOIUrl":"10.1055/a-2624-8405","url":null,"abstract":"<p><p>This study aims to evaluate the association between late preterm antenatal corticosteroids (ACS) administration and the incidence of hypoglycemia and respiratory complications in neonates born to individuals with pregestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM).Multi-center retrospective cohort study between 2016 and 2022. Pregnant people with PGDM or GDM who presented in the late preterm period with concern for preterm delivery were included. The indication for admission was classified as preterm labor, preterm prelabor rupture of membranes, poorly controlled diabetes, or other maternal/fetal indications. Exclusion criteria included multifetal gestations, fetal anomalies, stillbirths, prior course of ACS, or no anticipation for delivery in the next 7 days. The primary outcome was neonatal hypoglycemia. Secondary outcomes included composite respiratory morbidity, composite nonrespiratory 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 an indication for admission, gestational age at delivery, and neonatal birth weight. Outcome data were then stratified by diabetes type (PGDM vs. GDM) and completion status of the ACS course (partial vs. complete). For PGDM pregnancies, outcome data were additionally stratified by glycemic control.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 the subgroup analysis of PGDM and GDM pregnancies. However, late preterm ACS was associated with reductions in supplemental oxygen use, mechanical ventilation, and respiratory distress syndrome when a complete course of ACS was administered. In PGDM pregnancies, neonatal outcomes did not differ between the ACS and non-ACS groups, regardless of glycemic control.Late preterm ACS administration in diabetic pregnancies was not associated with increased neonatal hypoglycemia or improvements in composite respiratory morbidity. · Late preterm steroids in diabetic pregnancies are not associated with neonatal hypoglycemia.. · Composite respiratory morbidity is not improved in this setting.. · Glycemic control does not impact neonatal outcomes with late preterm steroid use..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-25","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":"Diabetes Technology Use in Pregnancies with Type 1 Diabetes in the United States from 2009 to 2020.","authors":"Nasim C Sobhani, Yongmei Huang, Kartik K Venkatesh, Jason D Wright, Alexander M Friedman, Timothy Wen","doi":"10.1055/a-2625-6437","DOIUrl":"10.1055/a-2625-6437","url":null,"abstract":"<p><p>The use of continuous glucose monitors (CGM) and insulin pumps has revolutionized the care of patients with type 1 diabetes (T1D). Few data are available regarding the 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.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 the 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).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 to 0.4). Medicaid insurance and obesity were associated with a lower likelihood of CGM use and insulin pump use, while a high obstetric comorbidity index score was associated with a higher likelihood of insulin pump use (ARR: 1.26; 95% CI: 1.05-1.51).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. · CGM use in pregnant individuals with T1D increased from 2.3 to 13.7%, but pump use was stable.. · Medicaid and obesity were associated with lower CGM and pump use in pregnant individuals with T1D.. · Low CGM use in pregnant T1D individuals highlights barriers and the need for equitable access..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-24","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":"Association of Food Insecurity and Short-Term Kidney Outcomes in Neonates.","authors":"Michelle C Starr, Abigail C Hardy, Paulomi Chaudhry, Cara L Slagle, Stephanie P Gilley, Danielle E Soranno","doi":"10.1055/a-2628-3904","DOIUrl":"https://doi.org/10.1055/a-2628-3904","url":null,"abstract":"<p><p>This study aimed to determine the association between food insecurity (FI) and short-term kidney outcomes in neonates.Single-site prospective cohort study of sequentially admitted neonates to two neonatal intensive care units (NICUs). We collected demographic characteristics and FI status on maternal-neonatal dyads using the Hunger Vital Signs tool. Kidney outcomes (acute kidney injury [AKI]) within the first 14 days, recovery from AKI, and serum creatinine (SCr) at day 14 of age) were compared by FI status.Of the 70 neonates in this study, 39% lived in FI households. Infants from FI households were more likely to have early AKI (56 vs. 14%, <i>p</i> = 0.002) and were more likely to have a slower recovery from AKI (66 vs. 17%, <i>p</i> = 0.035) than those from food-secure households. Neonates from FI households were also more likely to have an abnormally elevated SCr at 2 weeks of age (66 vs. 17%, <i>p</i> = 0.007).FI is common in families with neonates admitted to the NICU. Neonates born into FI households were more likely to have early AKI, slower AKI recovery, and elevated SCr at 2 weeks of age. Our findings emphasize the importance of FI screening and recognition as part of prenatal care and as an essential social determinant of health in studies investigating kidney outcomes. · FI is common in families with neonates admitted to the NICU.. · Neonates born into households with FI were more likely to have early AKI.. · They also had slower AKI recovery and elevated SCr at 2 weeks of age.. · Our findings emphasize the importance of FI screening and recognition as part of prenatal care.. · FI is an essential social determinant of health in studies investigating kidney outcomes..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482791","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}