Delivery Hospitalization Cardiac and Respiratory Complications during SARS-CoV-2 Delta Variant Dominance.

In 2021, the severe acute respiratory syndrome coronavirus 2 Delta variant rapidly proliferated and became dominant. Some but not all research evidence supports that Delta was associated with increased maternal risk. The purpose of this study was to determine whether Delta was associated with risk for cardiac and respiratory complications in a national sample.

Antenatal pyelonephritis hospitalisation trends, risk factors and associated adverse outcomes: A retrospective cohort study.

Objective: To analyse trends, risk factors and adverse outcomes associated with antenatal pyelonephritis hospitalisations.

Design: Retrospective cohort.

Setting: A national sample of US delivery hospitalisations with associated antenatal hospitalisations.

Postpartum Hemorrhage after Vaginal Delivery Is Associated with a Decrease in Immediate Breastfeeding Success.

Objective:  This study aimed to identify the impact of postpartum hemorrhage (PPH) after vaginal delivery on immediate breastfeeding success.

Study Design:  This is a retrospective cohort study examining the impact of PPH on breastfeeding for nulliparous patients after term, singleton, vaginal deliveries at a large academic institution from 2017 to 2018. Indicators of successful breastfeeding in the immediate postpartum period were measured by the presence of breastfeeding, the need for formula supplementation, the average number of breastfeeding sessions per day, the average amount of time spent at each breastfeeding session, the average number of newborn stools and wet diapers produced daily, and the neonatal percentage in weight loss over the first 2 to 3 days of life.

Infection and Sepsis Trends during United States' Delivery Hospitalizations from 2000 to 2020.

Objective:  This study aimed to evaluate trends, risk factors, and outcomes associated with infections and sepsis during delivery hospitalizations in the United States.

Study Design:  The 2000-2020 National Inpatient Sample was used for this repeated cross-sectional analysis. Delivery hospitalizations of patients aged 15 to 54 with and without infection and sepsis were identified.

Risk Factors, Trends, and Outcomes Associated With Postpartum Sepsis Readmissions.

Objective: To evaluate the prevalence, timing, clinical risk factors, and adverse outcomes associated with postpartum readmissions for maternal sepsis.

Methods: We conducted a retrospective cohort study of delivery hospitalizations and 60-day postpartum readmissions for females aged 15-54 years with and without sepsis using the 2016-2020 Nationwide Readmissions Database. Temporal trends in sepsis diagnoses during delivery hospitalizations and 60-day postpartum readmissions were analyzed with the National Cancer Institute's Joinpoint Regression Program to estimate the average annual percent change with 95% CIs.

Association between Maternal Neuraxial Analgesia and Neonatal Outcomes in Very Preterm Infants.

 Although the use of neuraxial analgesia has been shown to improve uteroplacental blood flow and maternal and fetal hemodynamics related to labor pain, possibly improving immediate outcomes in term neonates, the association between neuraxial analgesia use and outcomes in preterm neonates remains unclear.  The aim of this article was to evaluate the association between maternal use of neuraxial analgesia and neonatal outcomes in very preterm infants.  This is a retrospective cohort study of women delivering singleton neonates between 23 and 32 weeks' gestation at a large academic center between 2012 and 2016.

Review of Current Insights and Therapeutic Approaches for the Treatment of Refractory Postpartum Hemorrhage.

Refractory postpartum hemorrhage (PPH) affects 10-20% of patients with PPH when they do not respond adequately to first-line treatments. These patients require second-line interventions, including three or more uterotonics, additional medications, transfusions, non-surgical treatments, and/or surgical intervention. Multiple studies have suggested that patients with refractory PPH have different clinical characteristics and causes of PPH when compared to patients who respond to first-line agents.

Comparison of Breastfeeding Success by Mode of Delivery.

Objective: This article identifies how mode of delivery and the presence of labor affect the initiation and effectiveness of breastfeeding.

Study Design: This is a retrospective cohort study of breastfeeding success after vaginal delivery, cesarean section after labor, and scheduled cesarean section in term, singleton deliveries in nulliparous patients at a large academic institution from 2017 to 2018. Exclusion criteria included major postpartum complications requiring admission to the surgical intensive care unit or neonatal intensive care unit, general anesthesia, and major fetal anomalies.

The Association between Gestational Weight Gain in Each Trimester and Pregnancy Outcomes in Twin Pregnancies.

Objective: Adequate maternal weight gain in twin pregnancies is associated with improved outcomes such as increased fetal growth and decreased incidence of preterm birth. However, it remains unclear when gestational weight gain has the greatest influence on pregnancy outcomes. Our objective was to identify at which time in a twin pregnancy does inadequate maternal weight gain have the greatest association with adverse pregnancy outcomes.

Weight gain and pregnancy outcomes in overweight or obese women with twin gestations.

Background: While adequate weight gain in twin pregnancies with normal prepregnancy BMI has been associated with improved pregnancy outcomes, it remains unclear whether adequate weight gain in patients with overweight or obese prepregnancy BMI is associated with similarly improved pregnancy outcomes, and whether this comes at the expense of maternal health risks such as increased risk for gestational diabetes or hypertension.

Objective: To estimate the association between adherence to weight gain recommendations and pregnancy outcomes in overweight and obese women with twin pregnancies.

Methods: This is a retrospective cohort study of women with overweight (BMI 25.

Predictors of early-onset neonatal sepsis or death among newborns born at <32 weeks of gestation.

Objective: To develop a predictive model for early-onset neonatal sepsis or death among infants born at less than 32 weeks of gestation.

Study Design: This was a case-control study of all deliveries <32 weeks between 2011 and 2015 in a single tertiary care center. Cases were defined as neonates diagnosed with early-onset sepsis based on a blood or cerebrospinal fluid culture or neonates who expired during the first week of life.

The association between 17-hydroxyprogesterone caproate use and postpartum hemorrhage.

Objective: To evaluate whether receipt of 17α-hydroxyprogesterone caproate within seven days of delivery is associated with increased risk of postpartum hemorrhage.

Study Design: This was a retrospective cohort study of women who were receiving 17α-hydroxyprogesterone caproate for preterm birth prevention and delivered between 2010 and 2014. Women were dichotomized by whether a dose of 17α-hydroxyprogesterone caproate was administered within seven days of delivery.

Association between time of day and performance, indications, and outcomes of obstetric interventions among nulliparous women delivering at term.

Objective: The objective of this study is to determine whether there is an association between delivery time and obstetric interventions, as well as maternal and perinatal outcomes.

Study Design: Retrospective cohort study of nulliparous women delivering singleton, vertex, live births at ≥37 weeks gestation at a single center from 2014 to 2015. Nighttime deliveries were designated as those occurring between 18:00 and 05:59 h.

Delayed cord clamping in preterm dichorionic twin gestations.

To examine the practice of delayed cord clamping and associated neonatal outcomes in preterm dichorionic twin gestations. This is a retrospective cohort study of women delivering dichorionic-diamniotic twin gestations between 23 and 32 weeks of gestation at a single large academic center between 2013 and 2015. Neonatal outcomes of twins receiving delayed cord clamping were compared to those who did not.

Weight gain and pregnancy outcomes in underweight women with twin gestations.

Adherence to minimum weight gain recommendations in twin pregnancies as defined by the Institute of Medicine (IOM) guidelines is associated with improved pregnancy outcomes; however, these recommendations have yet to be made for underweight women (BMI < 18.5 kg/m). To determine if existing pregnancy weight gain recommendations in twin gestations apply to women with underweight prepregnancy body mass index (BMI), and if these women have similar pregnancy outcomes to women with normal prepregnancy BMI.

Disparities in Postpartum Contraceptive Counseling and Provision Among Mothers of Preterm Infants.

Objective: Use of effective contraception could be one method to decrease recurrent preterm birth by increasing intervals between pregnancies. We assessed correlates of contraceptive counseling and uptake among women who delivered preterm.

Materials And Methods: This is a retrospective cohort study of women who delivered live-born singletons or twins before 32 weeks' gestation.

Evaluation of Introduction of a Delayed Cord Clamping Protocol for Premature Neonates in a High-Volume Maternity Center.

Objective: To evaluate adherence to a delayed cord clamping protocol for preterm births in the first 2 years after its introduction, perform a quality improvement assessment, and determine neonatal outcomes associated with protocol implementation and adherence.

Methods: This is a retrospective cohort study of women delivering singleton neonates at 23-32 weeks of gestation in the 2 years before (preprotocol) and 2 years after (postprotocol) introduction of a 30-second delayed cord clamping protocol at a large-volume academic center. This policy was communicated to obstetric and pediatric health care providers and nurses and reinforced with intermittent educational reviews.

Obstetrician call schedule and obstetric outcomes among women eligible for a trial of labor after cesarean.

Background: Reducing cesarean deliveries is a major public health goal. The low rate of vaginal birth after cesarean has been attributed largely to a decrease in the likelihood of choosing a trial of labor after cesarean, despite evidence suggesting a majority of women with 1 prior low transverse cesarean are trial of labor after cesarean candidates. Although a number of reasons for this decrease have been explored, it remains unclear how systems issues such as physician call schedules influence delivery approach and mode in this context.

Racial and ethnic disparities in use of 17-alpha hydroxyprogesterone caproate for prevention of preterm birth.

Background: Racial/ethnic disparities in preterm birth remain a major public health challenge in the United States. While 17-alpha hydroxyprogesterone caproate (17OHP-C) is recommended for preterm birth prevention in women with a prior preterm birth, non-Hispanic black women continue to experience higher rates of recurrent preterm birth than white women receiving the same treatment. Further investigation of disparities in 17OHP-C use and adherence is warranted.

Relationship between obstetricians' cognitive and affective traits and delivery outcomes among women with a prior cesarean.

Objective: We sought to investigate the relationship between obstetricians' cognitive traits and delivery outcomes among women with a prior cesarean delivery.

Study Design: A total of 94 obstetricians completed 5 standardized psychometric scales: Reflective Coping, Proactive Coping, Multiple Stimulus Types Ambiguity Tolerance (MSTAT), Need for Cognition, and State-Trait Anxiety Inventory. Scores were analyzed by quartile.

The relationship between obstetricians' cognitive and affective traits and their patients' delivery outcomes.

Objective: The objective of the study was to investigate the relationship between physician coping skills, need for cognition, tolerance of ambiguity, and anxiety and their patients' mode of delivery.

Study Design: Ninety-four obstetricians were surveyed using 5 standardized psychometric scales: Reflective Coping, Proactive Coping, Multiple Stimulus Types Ambiguity Tolerance-II, Need for Cognition (measures learner motivation and engagement in cognitive efforts), and State-Trait Anxiety Inventory. Psychometric test scores were analyzed by quartile.