SARS-CoV-2 Prevalence in a Delivering Refugee Population: Refugee Status, Payor Type, Race, and Vaccination Status.

Underserved communities were disproportionately affected during the coronavirus (COVID-19) pandemic. Limited data exist on the impact of COVID-19 among refugee populations because refugee status is not often classified in electronic medical record (EMR) systems, unlike race or primary language. The study aim was to evaluate the PCR-based prevalence of SARS-CoV-2 in a delivering population over the first 2 years of the pandemic by refugee status, ethnicity, insurance, and vaccination status.

Identification of Endometrial Cancer-Specific microRNA Biomarkers in Endometrial Fluid.

Abnormal uterine bleeding is a common benign gynecological complaint and is also the most common symptom of endometrial cancer (EC). Although many microRNAs have been reported in endometrial carcinoma, most of them were identified from tumor tissues obtained at surgery or from cell lines cultured in laboratories. The objective of this study was to develop a method to detect EC-specific microRNA biomarkers from liquid biopsy samples to improve the early diagnosis of EC in women.

Clinical and economic evaluation of a proteomic biomarker preterm birth risk predictor: cost-effectiveness modeling of prenatal interventions applied to predicted higher-risk pregnancies within a large and diverse cohort.

Objectives: Preterm birth occurs in more than 10% of U.S. births and is the leading cause of U.

Sentinel surveillance of SARS-CoV-2 rates and equity impacts using labor and delivery patients in Phoenix, Arizona.

Proactive management of SARS-CoV-2 requires timely and complete population data to track the evolution of the virus and identify at risk populations. However, many cases are asymptomatic and are not easily discovered through traditional testing efforts. Sentinel surveillance can be used to estimate the prevalence of infections for geographical areas but requires identification of sentinels who are representative of the larger population.

Better Estimation of Spontaneous Preterm Birth Prediction Performance through Improved Gestational Age Dating.

The clinical management of pregnancy and spontaneous preterm birth (sPTB) relies on estimates of gestational age (GA). Our objective was to evaluate the effect of GA dating uncertainty on the observed performance of a validated proteomic biomarker risk predictor, and then to test the generalizability of that effect in a broader range of GA at blood draw. In a secondary analysis of a prospective clinical trial (PAPR; NCT01371019), we compared two GA dating categories: both ultrasound and dating by last menstrual period (LMP) (all subjects) and excluding dating by LMP (excluding LMP).

Protocol of the Snuggle Bug/Acurrucadito Study: a longitudinal study investigating the influences of sleep-wake patterns and gut microbiome development in infancy on rapid weight gain, an early risk factor for obesity.

Background: Overweight, obesity, and associated comorbidities are a pressing global issue among children of all ages, particularly among low-income populations. Rapid weight gain (RWG) in the first 6 months of infancy contributes to childhood obesity. Suboptimal sleep-wake patterns and gut microbiota (GM) have also been associated with childhood obesity, but little is known about their influences on early infant RWG.

Severe acute respiratory syndrome coronavirus 2: a canary in the coal mine for public safety net hospitals.

Background: The coronavirus disease 2019 pandemic has exposed disproportionate health inequities among underserved populations, including refugees. Public safety net healthcare systems play a critical role in facilitating access to care for refugees and informing coordinated public health prevention and mitigation efforts during a pandemic.

Objective: This study aimed to evaluate the prevalence ratios of severe acute respiratory syndrome coronavirus 2 infection between refugee women and nonrefugee parturient patients admitted to the hospital for delivery.

Performance of a proteomic preterm delivery predictor in a large independent prospective cohort.

Background: Preterm birth remains a common and devastating complication of pregnancy. There remains a need for effective and accurate screening methods for preterm birth. Using a proteomic approach, we previously discovered and validated (Proteomic Assessment of Preterm Risk study, NCT01371019) a preterm birth predictor comprising a ratio of insulin-like growth factor-binding protein 4 to sex hormone-binding globulin.

Racism, COVID-19, and Health Inequity in the USA: a Call to Action.

The current national COVID-19 mortality rate for Black Americans is 2.1 times higher than that of Whites. In this commentary, we provide historical context on how structural racism undergirds multi-sector policies which contribute to racial health inequities such as those highlighted by the COVID-19 pandemic.

Motivational Interviewing to Promote Long-Acting Reversible Contraception in Postpartum Teenagers.

Study Objective: To determine if teenage patients receiving prenatal care in an adolescent-focused clinic, emphasizing long-acting reversible contraception (LARC) using motivational interviewing techniques, had higher rates of uptake of postpartum LARC than a control group.

Design And Setting: Retrospective cohort study comparing young women who received prenatal care in an adolescent-focused setting with those enrolled in standard prenatal care.

Participants: Adolescents between the ages of 13 and 17 years receiving prenatal care within the Maricopa Integrated Health safety-net system between 2007 and 2014.

Development and validation of a spontaneous preterm delivery predictor in asymptomatic women.

Background: Preterm delivery remains the leading cause of perinatal mortality. Risk factors and biomarkers have traditionally failed to identify the majority of preterm deliveries.

Objective: To develop and validate a mass spectrometry-based serum test to predict spontaneous preterm delivery in asymptomatic pregnant women.

Ethical Issues in Maternal-Fetal Care Emergencies.

Ethical issues that arise in the care of pregnant women are challenging to physicians, especially in critical care situations. By familiarizing themselves with the concepts of medical ethics in obstetrics, physicians will become more capable of approaching complex ethical situations with a clear and structured framework. This review discusses ethical approaches regarding 3 specific scenarios: (1) the life of the fetus versus the life of the mother and situations of questionable maternal decision making; (2) withdrawal of care in a brain-dead pregnant patient; and (3) domestic violence and the pregnant patient.

Intimate partner violence before and during pregnancy: related demographic and psychosocial factors and postpartum depressive symptoms among Mexican American women.

Although research examining intimate partner violence (IPV) has expanded in recent years, there has been relatively little examination of the related demographic and psychosocial factors, as well as mental health outcomes, for IPV before and during pregnancy, especially in a Mexican American population. The current study provides a snapshot of the occurrence of IPV in a community sample of low-income, perinatal Mexican American women (n = 320). Results indicated that 13.

Birth Outcomes of Patients Enrolled in "Familias Sanas" Research project.

Purpose: This chapter examines birth outcomes of patients enrolled in Familias Sanas (Healthy Families), an educational intervention designed to reduce health disadvantages of low-income, immigrant Latvia mothers by providing social support during and after pregnancy.

Methodology/approach: Using a randomized control-group design, the project recruited 440 pregnant Latina women, 88% of whom were first generation. Birth outcomes were collected through medical charts and analyzed using regression analysis to evaluate if there were any differences between patients enrolled in Familias Sanas compared to those patients who followed a typical prenatal course.

Physical activity and sedentary behaviors in postpartum Latinas: Madres para la Salud.

Purpose: To describe the physical activity (PA) and sedentary behaviors of postpartum Latinas who are overweight or obese before initiating Madres para la Salud, a social support-mediated walking intervention to promote postpartum weight loss.

Methods: One hundred thirty-nine postpartum women (13.6 ± 7.

Influenza Vaccine Coverage among Pregnant Women in a Public Hospital System during the 2009-2010 Pandemic Influenza Season.

The purpose of this study was to compare influenza vaccination rates of pregnant women in a public safety-net health system to national coverage rates during the 2009-2010 pandemic influenza season. A chart review of a random sample of deliveries was undertaken to determine rates of coverage and predictors of vaccine coverage of women who obtained prenatal care and delivered in our health system. Rates were calculated from deliveries from when the vaccine was first available through April 30, 2010.

Reentry into clinical practice in obstetrics and gynecology.

The American College of Obstetricians and Gynecologists selected "Reentry Into Practice" as the subject for the 2012 Issue of the Year. Physician reentry programs in obstetrics and gynecology are driven by the fact that there is a projected physician shortage, and there are physicians who voluntarily leave clinical practice for a period of time. In planning formal reentry programs, evidence-based practice and highest regard for patient safety must be considered.

Interpregnancy intervals and the risk for infant mortality: a case control study of Arizona infants 2003-2007.

There is well-documented evidence on how interpregnancy interval (IPI) is associated with adverse perinatal outcomes and how short and long IPIs are associated with increased risk for preterm birth, low birth weight, and intra-uterine growth restriction. However, the extremes of IPI on infant mortality are less well documented. The current study builds on the existing evidence on IPI to examine if extremes of IPI are associated with infant mortality, and also examines if IPI is associated with both neonatal and post-neonatal mortality after adjusting for several known confounders.

Inhibition of uterine contractility with various tocolytics with and without progesterone: in vitro studies.

Objective: Various tocolytics are used to suppress uterine contractility in patients in preterm labor. Progesterone (P4) is used in patients at high risk for preterm delivery. In this study, we evaluated the effects of various tocolytics with and without P4 to examine effects on uterine contractility.

Acculturation and health care utilization among Mexican heritage women in the United States.

With the increasing Latino population in the United States, it is critical to examine the influence of the process of acculturation on health care practices and utilization. The purpose of this study was to evaluate the relationship between acculturation level and post-partum visit (PPV) compliance among Latinas participating in a larger psycho-educational intervention aimed at encouraging women to engage in positive healthcare practices. Acculturation was measured with the Bicultural Involvement Questionnaire which assigned participants to five categories: Assimilated, Separated, Moderate, Bicultural and Alienation.

Additive inhibitory effects of progesterone and sodium nitroprusside on uterine contractility during pregnancy.

Progesterone (P4) and nitric oxide (NO) suppress uterine contractility (CTX). This study compares the effects of P4 to sodium nitroprusside (SNP, an NO donor) and their combination on human CTX of term/preterm and labor/nonlabor tissues. Uterine tissues (n = 128) from women (n = 28) undergoing Cesarean were suspended in organ baths.

Transient tachypnea of the newborn: is labor prior to cesarean delivery protective?

Transient tachypnea of the newborn (TTN) is a common respiratory problem in newborns. This study aims to determine if cesarean delivery (CD) is a risk factor for TTN, and if labor prior to CD decreases this risk. A linked data set consisting of Arizona birth certificates (1994 to 1998) and infants enrolled in a high-risk perinatal program provided 800 TTN cases and 800 controls, stratified by year.

Knowledge and attitudes regarding preconception care in a predominantly low-income Mexican American population.

Objective: The objective of the study was to determine knowledge and attitudes regarding preconception care in a low-income Mexican American population.

Study Design: This was a cross-sectional survey of 305 reproductive-age women at an urban public hospital.

Results: The sample was mostly Hispanic (88%) and pregnant (68%); 35% had not completed high school.

The clinical content of preconception care: reproductive history.

A history of previous birth of a low birthweight infant, previous cesarean sections, multiple previous spontaneous abortions, prior stillbirth, or uterine anomaly identifies women at increased risk for recurrent abortion, preterm birth, or stillbirth. We review the evidence for the potential benefit of reproductive history in identifying strategies for evaluation and treatment to prevent recurrent adverse pregnancy outcome. We offer evidence-based recommendations for management of women with these histories.