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":"https://doi.org/10.1055/a-2486-7642","url":null,"abstract":"<p><strong>Objective: </strong> 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.</p><p><strong>Study design: </strong> 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.</p><p><strong>Results: </strong> 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.</p><p><strong>Conclusion: </strong> 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.</p><p><strong>Key points: </strong>· 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":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-21","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":"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><strong>Objective: </strong> 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).</p><p><strong>Study design: </strong> 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.</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, <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.</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><p><strong>Key points: </strong>· 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":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-21","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":"Pneumonia Vaccines: Indications for Use and Current Safety Data in Pregnancy.","authors":"Karley Dutra, Hayley Berry, Gwen Lazenby","doi":"10.1055/a-2505-5434","DOIUrl":"https://doi.org/10.1055/a-2505-5434","url":null,"abstract":"<p><p>Streptococcus pneumoniae is a leading cause of pneumonia, meningitis, and invasive pneumococcal disease among adults in the United States, with higher rates of disease occurring among individuals with chronic medical and immunocompromising conditions. Pregnant individuals, especially those with co-morbid conditions, are also at increased risk of infection due to S. pneumoniae due to physiologic and immunologic changes in pregnancy. Vaccination against pneumococcus is recommended for adults living with HIV aged 19-49, congenital or acquired immunodeficiency, asplenia, chronic renal failure, sickle cell disease, alcohol abuse, cerebrospinal fluid leaks, congestive heart failure and cardiomyopathies, chronic lung disease, chronic liver disease, and diabetes mellitus. During pregnancy, the American College of Obstetricians and Gynecologists (ACOG) recommends vaccination against S. pneumoniae for individuals meeting criteria for immunization outside of pregnancy. Pneumococcal vaccine uptake has been low. There are no data available for vaccine uptake in pregnancy, but we suspect it is lower than non-pregnant populations. Low uptake of immunization rates in pregnancy is likely multifactorial and includes general vaccine hesitancy among pregnant individuals, cost, access to care, and supply shortages. While data in support of pneumococcal vaccines during pregnancy are limited, sufficient evidence exists to support the safety and efficacy of vaccination in the antepartum period. Pregnancy provides an opportunity to continuously engage individuals in care, allowing obstetricians and gynecologists to establish rapport, work to reduce vaccine hesitancy, and to provide pneumococcal immunization to those who are eligible. Medical indications for pneumococcal vaccination will increasingly apply to pregnant persons as the population acquires co-morbidities and there is a need for improved education among obstetricians on the topic of antenatal pneumococcal vaccination.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862944","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":"Integrating Payor Segregated Outpatient OBGYN Care Models: The Patient Perspective.","authors":"Arina Chesnokova, Annie Apple, Karampreet Kaur, Allison Schachter, Elizabeth G Clement, Marilyn M Schapira, Sarita Sonalkar, Florencia Polite, Kavita Vinekar, Abike James, Rebecca F Hamm","doi":"10.1055/a-2505-5508","DOIUrl":"https://doi.org/10.1055/a-2505-5508","url":null,"abstract":"<p><strong>Objective: </strong>Significant racial and ethnic disparities in maternal morbidity and mortality as well as gynecologic outcomes persist in the U.S. The role of ambulatory care in OBGYN, particularly in facilities that separate resident and attending care along payor (and de facto racial) lines, remains unclear. This study examines patient perspectives on payor-segregated healthcare delivery in an academic medical center (AMC) and opinions on possible integration.</p><p><strong>Study design: </strong>This is a qualitative study conducted at a single AMC with payor-segregated resident and attending outpatient sites. Interviews focused on patient perception of experience and value in outpatient OBGYN care, perspectives on the segregated care model, and attitudes about integration. Patients participated in a 30-minute semi-structured interview with recruitment continuing until thematic saturation was reached (10/2022-8/2023). Interviews were coded using an integrated approach with grounded theory; 12% of transcripts were double-coded (k=0.86).</p><p><strong>Results: </strong>We interviewed 26 patients (16 from resident, 10 from attending site). Patients prioritized practical aspects such as clinic proximity and quality of clinician interaction. Most were unaware of the payor-segregated clinic system and disapproved upon learning about it. Opinions varied on topics of telehealth and continuity, indicating diverse patient needs. Notably, minoritized patients valued race and class concordance in clinical spaces. Patients generally supported care integration, conditional upon preservation of aspects of care they valued.</p><p><strong>Conclusion: </strong>Successful OBGYN care integration requires meeting individual needs while ensuring diversity, safety, and community-oriented care, alongside access and convenience. Incorporating patient voices is crucial for aligning services with expectations and improving patient experiences.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862941","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":"Intratracheal administration of budesonide with surfactant for prevention of death or bronchopulmonary dysplasia in extremely low birth weight infants - a before-after study.","authors":"Anish Pillai, Nandkishor Kabra, Sharayu Kothavade, Anita Chevle, Sachin Sakharkar, Deepika Tiwari, Richa Choubey, Haribalakrishna Balasubramanian","doi":"10.1055/a-2506-2893","DOIUrl":"https://doi.org/10.1055/a-2506-2893","url":null,"abstract":"<p><strong>Objectives: </strong>Previous studies have suggested a potential role for inhaled corticosteroids, such as budesonide, in reducing bronchopulmonary dysplasia (BPD) among preterm infants. The objective of our study was to investigate the effectiveness of intratracheal administration of corticosteroid with surfactant on the composite outcome of death or BPD at 36 weeks in extremely low birth weight (ELBW) infants.</p><p><strong>Study design: </strong>This before-after cohort study compared outcomes in ELBW infants with respiratory distress syndrome (RDS) who received intratracheal surfactant with budesonide to a historical cohort who received surfactant alone. Data was collected retrospectively for neonates in the surfactant group and prospectively for those receiving surfactant plus budesonide.</p><p><strong>Results: </strong>A total of 385 ELBW infants were included. Death or BPD occurred in 123/203 (60.5%) in the surfactant with budesonide group versus 105/182 (57.6%) in the surfactant group; adjusted odds ratio 1.10 (95% CI 0.69 to 1.75; p=0.69). Statistical analysis revealed no significant difference in the incidence of the composite primary outcome (death or BPD at 36 weeks of post menstrual gestational age), and its components, between the two study groups.</p><p><strong>Conclusion: </strong>In our study, co-administration of budesonide and surfactant was deemed safe and feasible among ELBW infants with RDS. However, we did not observe a significant reduction in the rates of composite or individual outcomes of death or BPD. Larger, randomized controlled trials are necessary to explore the potential advantages of this intervention.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862942","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":"Incidence of New, Nonphysiologic Maternal Findings on Fetal Magnetic Resonance Imaging.","authors":"Shirley J Shao, Andrew Grimes, Marley Rashad, Liina Poder, Dorothy Shum, Nasim C Sobhani","doi":"10.1055/a-2466-1319","DOIUrl":"10.1055/a-2466-1319","url":null,"abstract":"<p><strong>Objective: </strong> Fetal magnetic resonance imaging (MRI) is increasingly used for evaluation of fetal anomalies, and rates of incidental maternal findings are not well characterized. Our objective was to evaluate the rate of incidental maternal findings at the time of antenatal MRI performed for fetal indications.</p><p><strong>Study design: </strong> This was a retrospective cohort study that included all fetal MRIs performed between 2018 and 2023 at a single tertiary care institution with a multidisciplinary fetal diagnosis and treatment center. The electronic medical record was reviewed to identify all documented maternal findings and any new, nonphysiologic maternal findings. The latter was defined as previously unknown abnormalities of maternal structures unrelated to normal physiology.</p><p><strong>Results: </strong> Our study included 834 imaging events, performed at an average gestational age of 23 weeks. The most common indication for imaging was fetal anomaly (81.1%). The most common imaging type was fetal brain MRI (81.4%). Overall, 16.2% reported a maternal finding and 7% reported a new, nonphysiologic finding. The most common new, nonphysiologic findings were renal cysts (<i>n</i> = 11), liver cysts (<i>n</i> = 6), and gallstones or gallbladder sludge (<i>n</i> = 5). Compared with imaging events that included a fetal brain MRI, imaging events that included a fetal body MRI had a significantly higher rate of any maternal findings (53.0 vs. 10.4%, <i>p</i> < 0.001) and new, nonphysiologic maternal findings (26.9 vs. 3.7%, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong> Our results suggest that the risk of identifying new, nonphysiologic maternal findings on fetal MRI is low. The rate of any maternal and new, nonphysiologic maternal findings may differ by fetal MRI type due to differences in imaging depth and extent of radiology subspecialist review. These data should be incorporated into pretest counseling for patients planning to have fetal MRI.</p><p><strong>Key points: </strong>· The rate of incidental maternal findings on fetal MRI was 7%-lower than previously reported.. · Incidental maternal findings were more common on fetal body versus brain MRI.. · Maternal BMI did not impact incidence of new, nonphysiologic maternal findings.. · Our results could inform pretest counseling and consent discussions around fetal MRI..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612353","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":"Congenital Colorectal Conditions: Caregiver Perspectives of Their Experience in the Neonatal Intensive Care Unit.","authors":"Vatche Melkonian, Andrea Bischoff, Luis De La Torre, Jill Ketzer, Kristina Matkins, Laura Judd-Glossy","doi":"10.1055/a-2463-4207","DOIUrl":"10.1055/a-2463-4207","url":null,"abstract":"<p><strong>Objective: </strong> This study aimed to examine the experiences of children with colorectal conditions who spent time in the neonatal intensive care unit (NICU) and their caregivers.</p><p><strong>Study design: </strong> In March 2024, a 36-question survey was sent to the Colorectal Support Network Facebook community, to gather information from caregivers of children who have a congenital colorectal diagnosis and spent time in the NICU.</p><p><strong>Results: </strong> Fifty-two families completed the survey. Most patients were diagnosed after birth (89.47%). Approximately half of respondents stayed in the NICU for 1 to 2 weeks (50.88%), lived less than 60 minutes away from the hospital (54.91%), and felt somewhat uncomfortable (28.07%) or very uncomfortable (21.05%) caring for their child's medical needs after discharge. Also, 49.12% of caregivers were informed of their child's future bowel control prognosis. When asked for suggestions to improve care in the NICU, common themes included the importance of having colorectal congenital anomalies addressed by colorectal surgeons and the need for families to be informed about support groups.</p><p><strong>Conclusion: </strong> Counseling families in the NICU with congenital colorectal conditions can be improved by providing additional information and support for families prior to discharge, informing them about their child's prognosis for bowel control and connecting them with other families.</p><p><strong>Key points: </strong>· Patients with colorectal conditions should be informed of pediatric colorectal surgeon specialists.. · Families benefit from the knowledge of available support groups regarding their children's condition.. · There are many areas in the care of NICU patients with colorectal diseases, which can be improved..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602580","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":"Indomethacin and Cefazolin for physical exam-indicated cerclage to improve latency - a protocol validation study.","authors":"Nicola Young, Luke A Gatta, Sarahn Wheeler, Jerome J Federspiel, Sarah Dotters-Katz","doi":"10.1055/a-2502-7225","DOIUrl":"https://doi.org/10.1055/a-2502-7225","url":null,"abstract":"<p><strong>Objective: </strong>A single center randomized trial showed improved latency with use of indomethacin and cefazolin (I/C) during and following exam-indicated cerclage (EIC). The same center recently published a pre/post comparison demonstrating similar results. This research aimed to validate the protocol in a different setting.</p><p><strong>Study design: </strong>Retrospective cohort study of singleton pregnancies undergoing EIC at a single center between 2013 and 2022. EIC was performed for painless cervical dilation between 16-23 weeks gestation with dilation ≥1cm. Exposure was defined as receipt of I/C during and following EIC. The primary outcome was latency ≥28 days after cerclage placement. Secondary outcomes included latency; gestational age at delivery; delivery ≤28 weeks; preterm prelabor rupture of membranes (PPROM); intraamniotic infection (IAI); and median birth weight. Bivariate statistics were used to analyze data; multivariable regression analyses were used to control for confounders (progesterone use, cervical dilation at time of cerclage placement, history of PTB, and prolapsing membranes).</p><p><strong>Results: </strong>EIC was placed in 81 pregnancies, and 48 (59%) received I/C. Baseline characteristics did not differ between groups, except that prolapsing membranes were significantly less likely in patients receiving I/C (6.2% vs. 21.2%; p=0.04). Latency ≥28 days occurred in 90% of I/C recipients and 82% of the controls (p=0.32); this difference remained non-significant after controlling for confounders (adjusted relative risk: 1.02 [95% confidence interval: 0.85, 1.21]). I/C recipients had lower rates of IAI (4.2 vs. 24.2%, p=0.007), even after adjustment (adjusted relative risk: 0.18 [95% confidence interval: 0.04, 0.74]). Other secondary outcomes did not differ.</p><p><strong>Conclusion: </strong>Use of indomethacin/cefazolin at the time of exam-indicated cerclage at this center was not associated with increased latency to delivery (albeit in a small cohort) but was associated with lower rates of intraamniotic infection. Larger-scale validation studies would be helpful to confirm the value of this intervention.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833366","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":"Prevalence of hypovitaminosis D in pregnancy and potential benefits of oral supplementation.","authors":"Gabriele Saccone, Giorgia Buonomo, Serena Guerra, Doriana Gentile, Attilio Di Spiezio Sardo","doi":"10.1055/a-2502-7295","DOIUrl":"https://doi.org/10.1055/a-2502-7295","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate prevalence of hypovitaminosis D in a cohort of Italian pregnant women, and to evaluate potential benefits of oral supplementation Methods: Observational cohort of women with singleton gestations who were referred to our institution for first trimester prenatal visit. Screening for hypovitaminosis D was performed at the time of first trimester routine scan between 11 and 13 weeks of gestations. Women were offered measurement of serum 25-hydroxyvitamin D (25[OH]D). Levels of 25(OH)D are interpreted as follows: 12-< 20 ng/mL: Vitamin D insufficiency; < 12 ng/mL: Vitamin D deficiency. Women with Vitamin D insufficiency or deficiency were offered daily oral supplementation at the dose of 2.000 UI, along with folic acid. The primary outcome was the prevalence of hypovitaminosis D in our cohort.</p><p><strong>Results: </strong>During the study period, between January 2023 to January 2024, 250 pregnant women were included in the study and screened for 25(OH)D. More than half of the screened women had 25(OH)D<20 ng/mL, with a prevalence of <12 ng/mL of 14%. Out of the 140 (140/250 = 56%) women with 25(OH)D<20 ng/mL, 127/140 (90%) accepted supplementation with Vitamin D, while 13 refused the therapy for fear of teratogenic effects of the fetus. The overall rate of preterm delivery before 37 weeks was 8.4%, while the incidence of preeclampsia was 2.8%. Rate of preterm delivery was higher in women who did not received supplementation (9.5% vs 30.8%), but the study was not powered for such comparison.</p><p><strong>Conclusion: </strong>Hypovitaminosis D has high prevalence in pregnant women. Universal screening in the first trimester with measurement of serum 25-hydroxyvitamin D (25[OH]D) can identify women at risk that may benefit of oral supplementation.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association between Perinatal Complications and Adverse Childhood Experiences: Findings from a Nationwide Online Survey.","authors":"Yousuke Imanishi, Ichiro Wada, Takahiro Tabuchi","doi":"10.1055/a-2464-3665","DOIUrl":"https://doi.org/10.1055/a-2464-3665","url":null,"abstract":"<p><strong>Objective: </strong> This study aimed to evaluate the association between maternal adverse childhood experiences (ACEs) levels and the risk of perinatal complications.</p><p><strong>Study design: </strong> This is a retrospective cohort study of 5,693 mother-child pairs born between 2019 and 2021, who completed questionnaires on maternal ACE scores and perinatal complications such as preterm birth, low birth weight infants, pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), and premature rupture of membrane (PROM). Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression according to the three ACE score groups after adjusting for confounding factors such as maternal age, child's sex, household income, and maternal education.</p><p><strong>Results: </strong> Maternal ACEs have a significant positive correlation with preterm birth (OR: 1.42, 95% CI: 1.09-1.86, <i>p</i> for trend = 0.009), PIH (OR: 1.55, 95% CI: 1.17-2.07, <i>p</i> for trend = 0.002), and PROM (OR: 1.42, 95% CI: 1.09-1.84, <i>p</i> for trend = 0.01). These associations remained unchanged when stratified according to smoking, alcohol consumption, and obesity.</p><p><strong>Conclusion: </strong> Maternal ACEs were associated with the risk of perinatal complications such as preterm birth, PIH, and PROM.</p><p><strong>Key points: </strong>· Maternal ACEs are linked to higher risks of preterm birth, PIH, and PROM.. · Parental divorce, emotional abuse, and neglect were the most common ACEs among Japanese mothers.. · Mothers with ACEs score ≥ 2 had a higher risk of perinatal complications..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821822","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}