An external exposome-wide association study of opioid use disorder diagnosed during pregnancy in Florida.

The prevalence of opioid use disorder (OUD) during pregnancy has quadrupled in recent years and widely varies geographically in the US. However, few studies have examined which environmental factors are associated with OUD during pregnancy. We conducted an external exposome-wide association study (ExWAS) to investigate the associations between external environmental factors and OUD diagnosed during pregnancy.

Streamlining Universal Prenatal Screening for Risk for Adverse Birth Outcomes.

Objective: Many of the medical risk factors for adverse birth outcomes (e.g., preeclampsia) are regularly monitored in prenatal care.

A survey assessment of clinician perceptions of opioid supply and monitoring requirement policy changes.

Objective: Florida-mandated Prescription Drug Monitoring Program (PDMP) use and restricted Schedule II opioid dispensing for acute pain to 3-day supply in 2018. This study assessed physician perception of these policies.

Design: A cross-sectional study design.

Preventing Traumatic Causes of Maternal Death.

Despite medical advances, maternal deaths in the U.S. are more common than in nearly all other developed nations.

Obstetrician-gynecologist perceptions and utilization of prescription drug monitoring programs: A survey study.

Query of Prescription Drug Monitoring Programs (PDMPs) is recommended before prescribing opioids by the US Centers for Disease Control and Prevention, to inform clinical practice and aid diversion prevention. Many states mandate prescriber PDMP use; however, little is known about PDMP perception of utility and use among Obstetricians-Gynecologists (OB/GYN), who are the primary provider for most women during pregnancy.This study examined OB/GYN perceptions and utilization of their state PDMP.

Factors associated with opioid prescriptions among women proximal to pregnancy in the United States.

Background: Pregnant women are a vulnerable population exposed to opioids in the United States.

Objective: To examine trends and factors associated with opioid prescribing to women proximal to pregnancy.

Methods: The 2011 to 2015 Medical Expenditure Panel Survey (MEPS) was used to identify participants (n = 3020) with self-reported pregnancy or pregnancy-relevant events aged between 18 and 44 years old.

Validation of algorithms to estimate gestational age at birth in the Medicaid Analytic eXtract-Quantifying the misclassification of maternal drug exposure during pregnancy.

Purpose: Accurate ascertainment of gestational age (GA) has been a challenge in perinatal epidemiologic research. To date, no study has validated GA algorithms in Medicaid Analytic eXtract (MAX).

Methods: We linked livebirths of mothers enrolled in Medicaid ≥30 days after delivery in 1999-2010 MAX to state birth certificates.

Increased Tdap and Influenza Vaccination Acquisition Among Patients Participating in Group Prenatal Care.

CenteringPregnancy, an alternative to traditional prenatal care, offers additional time between clinicians and patients with the goal of increasing knowledge, understanding, and autonomy in pregnant participants. We investigated whether these women would be more likely to receive recommended Tdap and influenza vaccinations relative to others who received one-on-one traditional prenatal care. Our study employed a retrospective chart review of all women who participated in CenteringPregnancy group care compared to a group of matched women who received only traditional prenatal care at a large, quaternary care referral academic center.

Impact of an on-site perinatal mood disorders clinic in the diagnosis and management of perinatal mood disorders.

Objectives To assess change in Edinburgh Postnatal Depression Scale (EPDS) scores in women treated at the Perinatal Mood Disorders Clinic (PMDC) as a measure of improvement in perinatal mood disorders (primary outcome), and treatment disposition at final visit. Methods Chart review was performed for all PMDC patients between March 1, 2017 and June 1, 2018 (n=120), as a self-controlled case series design. Two-tailed t-tests compared initial and final EPDS scores for all patients with >1 visit (n=64), where EPDS score of ≥13 indicated a positive screen for depression.

Assessing the utility of the Healthy Start Screen to predict an elevated Edinburgh Postnatal Depression Scale score.

Objective To examine the utility of the Healthy Start Screen (HSS), which is an assessment of health, environment, and behavioral risk factors offered to all pregnant women in the state of Florida, in identifying women at risk for developing postpartum depression (PPD). Methods The sample for this Institutional Review Board (IRB)-approved, retrospective study consisted of patients who presented to a women's clinic for a new prenatal visit. Those patients who completed both the HSS at their prenatal visit and the Edinburgh Postnatal Depression Scale (EPDS) at their postpartum visit were included.

OB/GYN perceptions of prescription drug monitoring programs as a primary prevention tool for neonatal abstinence syndrome.

Background: The U.S. Centers for Disease Control and Prevention recommend clinicians use Prescription Drug Monitoring Program (PDMPs) as a risk assessment tool for opioid-related harms.

Variation in Tdap and Influenza Vaccination Coverage Among Pregnant Women by Insurance Type - Florida, 2016-2018.

Infants are at increased risk for pertussis-associated morbidity and mortality, and pregnant women and their infants are more likely than other patient populations to experience severe influenza-related illness (1,2). The Advisory Committee on Immunization Practices (ACIP) recommends that all women receive the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine during each pregnancy, preferably during the early part of gestational weeks 27-36 (3). ACIP also recommends that women who are or might be pregnant during the influenza season receive the inactivated influenza vaccine at any time during pregnancy (4).

Usability of encounter data for Medicaid comprehensive managed care vs traditional Medicaid fee-for-service claims among pregnant women.

Background: The completeness of medical encounters capture among Medicaid enrollees in comprehensive managed care (CMC) has been shown to vary across states and years. CMC penetration has grown, and CMC encounter capture specific to pregnancy care is understudied.

Objectives: To compare the completeness of encounter data for pregnant beneficiaries in CMC versus traditional fee-for-service (FFS) in Texas and Florida between 2007 and 2010.

Perception of prescription drug monitoring programs as a prevention tool in primary medical care.

Background: Prescription drug monitoring programs (PDMPs) are primary prevention tools to reduce substance use disorders (SUD) and sequelae. Evidence regarding perceptions of PDMPs from different primary care providers, which may impact PDMP utilization for women, is unavailable.

Objective: To examine perceived PDMP effectiveness among obstetrician-gynecologists (OB/GYNs) compared to primary care physicians (PCPs).

Case-based care for pre-existing or new-onset mood disorders in patients undergoing infertility therapy.

The inability to conceive is an immensely stressful event in a woman's life. Thus, it is no surprise that women with infertility have twice the rates of depressive symptoms as women without infertility. Incidence of depression in the general female population is approximately 20% compared to almost 40% in infertile females.

The Power and Pitfalls of Big Data Research in Obstetrics and Gynecology: A Consumer's Guide.

Importance: Research in obstetrics and gynecology (OB/GYN) increasingly relies on "big data" and observational study designs. There is a gap in practitioner-relevant guides to interpret and critique such research.

Objective: This guide is an introduction to interpreting research using observational data and provides explanations and context for related terminology.

Potential selection bias associated with using geocoded birth records for epidemiologic research.

Purpose: There is an increasing use of geocoded birth registry data in environmental epidemiology research. Ungeocoded records are routinely excluded.

Methods: We used classification and regression tree analysis and logistic regression to investigate potential selection bias associated with this exclusion among all singleton Florida births in 2009 (n = 210,285).

It's not your mother's marijuana: effects on maternal-fetal health and the developing child.

Pro-marijuana advocacy efforts exemplified by the "medical" marijuana movement, coupled with the absence of conspicuous public health messages about the potential dangers of marijuana use during pregnancy, could lead to greater use of today's more potent marijuana, which could have significant short- and long-term consequences. This article reviews the current literature regarding the effects of prenatal marijuana use on the pregnant woman and her offspring.

The effects of air pollution on adverse birth outcomes.

Background: Air pollution has been shown to have adverse effects on many health outcomes including cardiorespiratory diseases and cancer. However, evidence on the effects of prenatal exposure is still limited. The purpose of this retrospective cohort study is to evaluate the effects of prenatal exposure to air pollutants including particulate matter with aerodynamic diameter less than 2.