Publications by authors named "Madeline Rice"
Oxytocin regimen used for induction of labor and pregnancy outcomes.
Am J Obstet Gynecol MFM
December 2024
Article Synopsis
- A recent study analyzed the effect of oxytocin dosage on cesarean delivery rates and adverse outcomes in low-risk nulliparous patients undergoing labor induction at 39 weeks or more.
- The research compared mid- to high-dose oxytocin regimens with low-dose regimens, finding that higher doses were associated with fewer cesarean deliveries, without increasing negative perinatal outcomes.
- The study was a secondary analysis of a larger randomized trial and utilized various statistical methods to evaluate the impact of the different oxytocin dosages on the primary outcomes.
Importance: Compared with early cord clamping (ECC), umbilical cord milking (UCM) reduces delivery room cardiorespiratory support, hypoxic-ischemic encephalopathy, and therapeutic hypothermia in nonvigorous near-term and full-term infants. However, UCM postdischarge outcomes are not known.
Objective: To determine the 2-year outcomes of children randomized to UCM or ECC at birth in the Milking in Nonvigorous Infants (MINVI) trial.
Background: Current postpartum hemorrhage (PPH) risk stratification is based on traditional statistical models or expert opinion. Machine learning could optimize PPH prediction by allowing for more complex modeling.
Objective: We sought to improve PPH prediction and compare machine learning and traditional statistical methods.
Community-based healthcare delivery systems frequently lack cancer-specific survivorship support services. This leads to a burden of unmet needs that is magnified in rural areas. Using sequential mixed methods we assessed unmet needs among rural cancer survivors diagnosed between 2015 and 2021.
View Article and Find Full Text PDFObjectives: Neonatal trials have traditionally used binary composite short-term (such as death or bronchopulmonary dysplasia) or longer-term (such as death or severe neurodevelopmental impairment) outcomes. We applied the Desirability Of Outcome Ranking (DOOR) method to rank the overall patient outcome by best (no morbidities) to worst (death).
Study Design: Using a completed large multicenter trial (Milking In Non-Vigorous Infants [MINVI]) of umbilical cord milking (UCM) vs.
Advances in vaccinology have resulted in various new vaccines being introduced into recommended immunization schedules. Armenia introduced the rotavirus vaccine (RV) and the pneumococcal conjugate vaccine (PCV) into its national schedule in 2012 and 2014, respectively. Using data from the Armenia Demographic and Health Survey, the uptake of the RV and the PCV among children aged younger than three years was estimated.
View Article and Find Full Text PDFBackground: In randomized trials, 1 primary outcome is typically chosen to evaluate the consequences of an intervention, whereas other important outcomes are relegated to secondary outcomes. This issue is amplified for many obstetrical trials in which an intervention may have consequences for both the pregnant person and the child. In contrast, desirability of outcome ranking, a paradigm shift for the design and analysis of clinical trials based on patient-centric evaluation, allows multiple outcomes-including from >1 individual-to be considered concurrently.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to assess how maternal characteristics and delivery methods affect women's perceived control during childbirth, using a self-reported questionnaire called the Labor Agentry Scale.
- Researchers conducted a secondary analysis on data from a large randomized trial involving low-risk first-time mothers, focusing on various factors such as age, race, BMI, and labor pain.
- Results showed that certain groups, such as those identifying as Asian or Hispanic, smokers, and women with higher BMIs or cesarean deliveries, reported significantly lower levels of perceived control during labor compared to White women and those who had spontaneous deliveries.
Background: Delayed cord clamping and umbilical cord milking provide placental transfusion to vigorous newborns. Delayed cord clamping in nonvigorous newborns may not be provided owing to a perceived need for immediate resuscitation. Umbilical cord milking is an alternative, as it can be performed more quickly than delayed cord clamping and may confer similar benefits.
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- The study investigates whether the glucose response during the oral glucose tolerance test (OGTT) in pregnancy can predict the risk of developing hypertension later in life.
- It analyzes data from participants who had abnormal glucose tests during pregnancy, assessing their blood pressure years later and looking for correlations with OGTT values and trends.
- Results indicate a significant relationship between certain OGTT outcomes—specifically, a 2-hour glucose level and a monophasic response pattern—with higher risks of elevated blood pressure and hypertension in the long term.
Objective: This study aimed to evaluate maternal and neonatal outcomes by method of cervical ripening for labor induction among low-risk nulliparous individuals.
Study Design: This is a secondary analysis of a multicenter randomized trial of labor induction at 39 weeks versus expectant management in low-risk nulliparous participants. Participants undergoing cervical ripening for labor induction in either group were included.
Article Synopsis
- The study evaluated racial and ethnic disparities in adverse perinatal outcomes among pregnant patients, focusing on those who delivered between 37 to 41 weeks.
- The analysis included data from over 115,000 patients and categorized them by race and ethnicity, revealing that Black neonates had the highest unadjusted risk of adverse outcomes compared to others.
- After adjusting for factors like age, BMI, and health history, the disparities in risk were minimized, suggesting that sociodemographic factors significantly contribute to the observed differences.
Background: Investigators have attempted to derive tools that could provide clinicians with an easily obtainable estimate of the chance of vaginal birth after cesarean delivery for those who undertake trial of labor after cesarean delivery. One tool that has been validated externally was derived from data from the Maternal-Fetal Medicine Units Cesarean Registry. However, concern has been raised that this tool includes the socially constructed variables of race and ethnicity.
View Article and Find Full Text PDFObjective: To compare risks of maternal and perinatal outcomes by completed week of gestation from 39 weeks in low-risk nulliparous patients undergoing expectant management.
Methods: We conducted a secondary analysis of a multicenter randomized trial of elective induction of labor at 39 weeks of gestation compared with expectant management in low-risk nulliparous patients. Participants with nonanomalous neonates, who were randomized to and underwent expectant management and attained 39 0/7 weeks of gestation, were included.
Objective: To develop models to predict vaginal delivery in low-risk, nulliparous women contemplating elective induction of labor or expectant management at 39 weeks of gestation.
Methods: We conducted a secondary analysis of a randomized controlled trial of planned elective induction of labor at 39 weeks of gestation compared with expectant management for low-risk nulliparous women. Two groups were included for this analysis: 1) women who were randomized to the induction of labor group and underwent elective induction at 39 0/7-39 4/7 weeks of gestation and 2) women who were randomized to the expectant management group who experienced spontaneous labor or medically indicated delivery (including postterm).
Objective: To evaluate characteristics associated with adverse outcomes in low-risk nulliparous women randomized to elective labor induction at 39 weeks of gestation or expectant management.
Methods: We conducted a secondary analysis of women randomized during the 38th week to induction at 39 weeks of gestation or expectant management. Deliveries before 39 weeks of gestation and those not adherent to study protocol or with fetal anomalies were excluded.
Objective: To estimate whether the frequency of adverse maternal and neonatal outcomes differs between low-risk nulliparous and multiparous women at 39-41 weeks of gestation.
Methods: This is a secondary analysis of an observational obstetrics cohort of maternal-neonatal dyads at 25 hospitals. Low-risk women with nonanomalous singletons who delivered between 39 0/7 and 41 6/7 weeks of gestation were included.
Background: Successful control of vaccine preventable diseases not only requires high coverage but also requires that vaccines are administered in a timely manner. Prior studies have examined the timing of vaccinations in Armenia and found that although vaccination coverage is high, children are not receiving the vaccinations in a timely manner. This study aims to further elucidate the timing and associated factors of childhood vaccinations among children in Armenia in 2015-2016.
View Article and Find Full Text PDFBackground: Although induction of labor of low-risk nulliparous women at 39 weeks reduces the risk of cesarean delivery compared with expectant management, concern regarding more frequent use of labor induction remains, given that this intervention historically has been thought to incur greater resource utilization.
Objective: The objective of the study was to determine whether planned elective labor induction at 39 weeks among low-risk nulliparous women, compared with expectant management, was associated with differences in health care resource utilization from the time of randomization through 8 weeks postpartum.
Study Design: This is a planned secondary analysis of a multicenter randomized trial in which low-risk nulliparous women were assigned to induction of labor at 39 weeks or expectant management.
Objective: The main purpose of this article is to evaluate whether identification and treatment of women with mild gestational diabetes mellitus (GDM) during pregnancy affects subsequent maternal body mass index (BMI), anthropometry, metabolic syndrome, and risk of diabetes.
Study Design: This is a follow-up study of women who participated in a randomized controlled treatment trial for mild GDM. Women were enrolled between 5 and 10 years after their index pregnancy.
Studies have demonstrated the adverse effects of smoking on the risk of microvascular complications; however, few have also examined the potential mediating effects of glycemic control. Using data from the Diabetes Control and Complications Trial (DCCT 1983-1993), we describe the acute and long-term risks of smoking on glycemic control and microvascular complications in a well-characterized cohort of participants with type 1 diabetes. The DCCT recorded self-reported smoking behaviors, glycemic exposure based on HbA1c, and complications status.
View Article and Find Full Text PDFObjective: There has been an appreciable rise in postpartum hemorrhage requiring blood transfusions in the United States. Our objective is to better define patients at greatest risk for peripartum transfusion at the time of cesarean in order to identify cases for early intervention and monitoring.
Methods: Our study is a secondary analysis of a retrospective cohort study.