Publications by authors named "Amelie Boutin"
Article Synopsis
- * Results showed that GDM diagnoses were more common (17%) with the one-step test compared to the two-step method (6%), and that adverse outcomes were generally low regardless of the testing approach.
- * The findings suggested that stricter testing (one-step) could lead to more GDM diagnoses but also indicated a potential increased risk for larger babies and preterm births linked to abnormal glucose levels just below diagnostic thresholds.
Article Synopsis
- Maternal mortality ratios (MMR) in the U.S. increased significantly from 1999-2021, rising from 9.60 to 23.5 per 100,000 live births, with higher increases noted in states with already high MMRs.
- The study found that decreases in MMRs due to clear obstetric causes were similar across low and high MMR states, but the rise in deaths from less specific causes was much more pronounced in high-MMR states like Texas than in lower-MMR ones like California.
- Overall, increases in MMRs from less-specific/potentially incidental causes were observed across all racial and ethnic groups, indicating a troubling trend in maternal health disparities.
Background: Unintentional injuries are a leading cause of death among children aged 1-19 years worldwide. Systematic reviews assessing various risk factors for different childhood injuries have been published previously. However, most of the related literature does not distinguish minor from severe or fatal injuries.
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- Maternal mortality rates in the U.S. have nearly doubled from 2018 to 2021, rising from 17.4 to 32.9 deaths per 100,000 live births, potentially influenced by factors beyond obstetrical issues.
- This study examines whether these rising rates are due to changes in obstetrical factors, maternal health conditions, or shifts in how maternal mortality is tracked and reported.
- Results show a 144% increase in maternal deaths from 1999-2002 to 2018-2021 across all racial and ethnic groups, with notable rises in both direct and indirect obstetrical deaths.
Article Synopsis
- A study investigated whether a daily aspirin dose of 75 to 81 mg, started during the first trimester of pregnancy, could prevent preterm pre-eclampsia, building on previous findings that 150 mg daily is effective.
- Researchers conducted a systematic review of 11 randomized controlled trials involving nearly 14,000 participants, assessing the effectiveness of lower aspirin doses compared to placebo.
- The analysis found no significant reduction in preterm pre-eclampsia with the lower doses, but the variability among the studies was high, making it unclear if those doses could effectively influence pregnancy outcomes.
Effect of the COVID-19 Pandemic on Stillbirths in Canada and the United States.
J Obstet Gynaecol Can
April 2024
Objective: There is uncertainty regarding the effect of the COVID-19 pandemic on population rates of stillbirth. We quantified pandemic-associated changes in stillbirth rates in Canada and the United States.
Methods: We carried out a retrospective study that included all live births and stillbirths in Canada and the United States from 2015 to 2020.
Background: Physiological changes during pregnancy invalidate use of general population reference intervals (RIs) for pregnant people. The complete blood count (CBC) is commonly ordered during pregnancy, but few studies have established pregnancy RIs suitable for contemporary Canadian mothers. Prospective RI studies are challenging to perform during pregnancy while retrospective techniques fall short as pregnancy and health status are not readily available in the laboratory information system (LIS).
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- The study aimed to analyze how the COVID-19 pandemic affected obstetric interventions and perinatal outcomes in the U.S. from 2015 to 2021.
- It found significant changes during the pandemic, including decreases in preterm birth and labor induction rates, while rates of macrosomia (larger than average babies), postterm births, and perinatal deaths increased.
- High-risk groups, such as those with prepregnancy diabetes, experienced even more pronounced effects, with substantial decreases in preterm birth and labor interventions related to the pandemic onset.
Objectives: Endometriosis is a common gynaecologic disease for which surgery is often required. Our objective was to evaluate the potential determinants of perioperative complications in day-surgeries for endometriosis.
Methods: We conducted a retrospective cohort study of patients undergoing day-surgeries for endometriosis using Canadian administrative data from between 2015 and 2019.
Article Synopsis
- This study investigates the impact of high-dose docosahexaenoic acid (DHA) supplementation on the risk of severe bronchopulmonary dysplasia (BPD) in very preterm infants born at less than 29 weeks of gestation.
- It will employ an individual participant data (IPD) meta-analysis of randomized controlled trials, assessing severe BPD outcomes at 36 weeks' postmenstrual age while considering various neonatal morbidities.
- Ethical approval was secured for each trial, and informed consent was obtained from parents, ensuring proper collaboration and data sharing among participating institutions.
Background: A significant proportion of patients with endometriosis require surgery for management of the disease.
Aims: We aimed to assess the trend and regional variation in day surgeries for endometriosis across Canada and to identify perioperative complications associated with types of surgeries and their temporal trend and regional variation.
Materials And Methods: We conducted a retrospective cohort study of women undergoing day surgeries for endometriosis between 2015 and 2019 using Canadian administrative data from the National Ambulatory Care Reporting System, which includes data from four provinces (Ontario (ON), Alberta (AB), Nova Scotia (NS) and Prince Edward Island (PEI)).
Article Synopsis
- The study explored whether the benefits of antenatal corticosteroids in late preterm pregnancies outweigh the risks, focusing on the decision-making support needed by patients and physicians.
- Interviews were conducted with pregnant individuals, obstetricians, and pediatricians in Vancouver to gather insights on informational needs and decision-making preferences.
- The findings indicated a desire for a decision-support tool that clearly outlines risks and benefits, as pregnant participants wanted to be actively involved in treatment decisions.
Background: Endometriosis is a common gynecological condition with a wide range of symptoms, including infertility, dyspareunia, intestinal disorders, and pelvic pain. Laparoscopy and laparotomy are used widely for diagnosing and managing endometriosis. We will conduct a systematic review and meta-analysis with the aims of reporting complications rates following each type of surgeries for endometriosis and determinants of complications.
View Article and Find Full Text PDFImportance: High-dose docosahexaenoic acid (DHA), a long-chain polyunsaturated fatty acid, may affect the risk of bronchopulmonary dysplasia (BPD). However, high-level summative evidence supporting such clinical association in very preterm infants is lacking.
Objective: To examine the association between enteral supplementation with high-dose DHA during the neonatal period and the risk of BPD in preterm infants born at less than 29 weeks' gestation.
Background: Recommendations for deliveries of pregnant patients with a previous cesarean delivery and the type of hospitals deemed safe for these deliveries have evolved in recent years, although no studies have examined hospital factors and associated safety. We sought to evaluate maternal and neonatal outcomes among patients with a previous cesarean delivery by hospital tier and volume.
Methods: We carried out an ecological study of singleton live births delivered at term gestation to patients with a previous cesarean delivery in all Canadian hospitals (excluding Quebec), 2013-2019.
Technical Update No. 439: Antenatal Corticosteroids at Late Preterm Gestation.
J Obstet Gynaecol Can
June 2023
Objective: To update recommendations for administration of antenatal corticosteroids in the late preterm period.
Target Population: Pregnant individuals at risk of preterm birth from 34 to 36 weeks gestation.
Options: Administration or non-administration of a single course of antenatal corticosteroids at 34 to 36 weeks gestation.
Article Synopsis
- The study aims to evaluate the effects of high-dose docosahexaenoic acid (DHA) supplementation in very preterm infants (born before 29 weeks gestation) on the risk of bronchopulmonary dysplasia (BPD) by comparing it to a control group at 36 weeks' postmenstrual age.
- Researchers will conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) published up to November 2021, with specific criteria for inclusion focusing on the infant population and DHA supplementation effects.
- The findings will help guide clinical decisions regarding DHA supplementation to prevent BPD and will be shared through various dissemination methods, including conferences and publications, as ethical approval is not needed since no new
Background: The initial COVID-19 pandemic response-related effects on conceptions following the use of assisted reproductive technologies (ART), and on changes in the maternal characteristics of women who conceived during the early vs. pre-pandemic period, have been understudied.
Objectives: To examine the effects of ART clinic closures in the United States (US) in March 2020 on the frequency of ART-conceived live births, multiple births and stillbirths; and to describe changes in the characteristics of women who conceived in the early pandemic period.
Article Synopsis
- This study analyzes the impact of gestational age at delivery on long-term outcomes like stillbirth, infant mortality, cerebral palsy, and epilepsy in low-risk pregnancies in Sweden.
- The research included 1,773,269 singleton infants born between 1998 and 2019, using statistical models to compare risks associated with different gestational ages.
- Findings suggest that births at 37 or 38 weeks pose higher risks for adverse outcomes, while delivering at 39-40 weeks is linked to reduced risks, highlighting the importance of timing in obstetric management.