A novel approach for inferring effects on pregnancy loss.

Identifying the determinants of pregnancy loss is a critical public health concern. However, pregnancy loss is often not noticed, and even when it is, it is inconsistently recorded. Thus, past studies have been limited to medically-identified losses or small, highly selected cohorts, which can lead to biased or non-generalizable results.

Anemia Near Delivery is Prevalent, Pernicious, and Associated with Lower Neighbourhood Income: An Analysis of Over 50 000 Pregnancies.

Objectives: Anemia in pregnancy has negative impacts on maternal and neonatal morbidity and mortality and has been described as an issue of health equity. The primary aim of our study was to describe rates of anemia near delivery and assess whether this correlates with neighbourhood-level income status.

Methods: We conducted a retrospective cohort study of pregnant individuals delivering from January 2012 through December 2022 at two large academic centres.

Determinants of utilization of infertility services by race and ethnicity in a state with a comprehensive infertility mandate.

Objective: To examine the association between sociodemographic factors and utilization of infertility services by race and ethnicity in a state with a comprehensive infertility mandate.

Design: Retrospective cohort.

Setting: Academic-affiliated fertility center.

Neighborhood Food Access in Early Life and Trajectories of Child Body Mass Index and Obesity.

Importance: Limited access to healthy foods, resulting from residence in neighborhoods with low food access, is a public health concern. The contribution of this exposure in early life to child obesity remains uncertain.

Objective: To examine associations of neighborhood food access during pregnancy or early childhood with child body mass index (BMI) and obesity risk.

Prenatal Care Clinician Preferences Among Patients With Spanish-Preferred Language.

Objective: To measure what patients with Spanish language preference and limited English proficiency value most when selecting a prenatal care clinician.

Methods: A discrete choice experiment was administered at two large academic medical centers in Boston, Massachusetts. Participants were identified by electronic medical record, had preferred Spanish language and self-identified limited English proficiency, and either were pregnant with a completed fetal anatomy scan or had given birth within the past 12 months at the time of the study.

Implementation of a financial navigation program in gynecologic oncology.

Background: "Financial Toxicity" (FT) is the financial burden imposed on patients due to disease and its treatment. Approximately 50% of gynecologic oncology patients experience FT. This study describes the implementation and outcomes of a novel financial navigation program (FNP) in gynecologic oncology.

Using Parametric g-Computation for Time-to-Event Data and Distributed Lag Models to Identify Critical Exposure Windows for Preterm Birth: An Illustrative Example Using in a Retrospective Birth Cohort Based in Eastern Massachusetts (2011-2016).

Background: Parametric g-computation is an attractive analytic framework to study the health effects of air pollution. Yet, the ability to explore biologically relevant exposure windows within this framework is underdeveloped.

Objectives: We outline a novel framework for how to incorporate complex lag-responses using distributed lag models (DLMs) into parametric g-computation analyses for survival data.

A Randomized Controlled Trial of Consent for Patients Undergoing Transobturator Slings.

Importance: Improving patients' recall and understanding of their planned surgery is essential for fully informed consent.

Objective: The objective of this study was to assess if the addition of an information handout to the standard preoperative consent process for the transobturator midurethral sling procedure improved patient understanding, recall, and satisfaction.

Study Design: This is a randomized controlled trial of adult women undergoing a transobturator midurethral sling procedure for the treatment of stress urinary incontinence.

Polybrominated diphenyl ethers and gestational weight gain: a multi-center prospective cohort study.

Objective: To evaluate the associations of plasma polybrominated diphenyl ether (PBDE) concentrations in early pregnancy with gestational weight gain (GWG).

Design: Prospective cohort study.

Setting: US-based, multicentre cohort of pregnant women.

Cohort profile: the Environmental Reproductive and Glucose Outcomes (ERGO) Study (Boston, Massachusetts, USA) - a prospective pregnancy cohort study of the impacts of environmental exposures on parental cardiometabolic health.

Purpose: Pregnancy and the postpartum period are increasingly recognised as sensitive windows for cardiometabolic disease risk. Growing evidence suggests environmental exposures, including endocrine-disrupting chemicals (EDCs), are associated with an increased risk of pregnancy complications that are associated with long-term cardiometabolic risk. However, the impact of perinatal EDC exposure on subsequent cardiometabolic risk post-pregnancy is less understood.

Cerclage Plus Adjuvant Vaginal Progesterone for Preterm Birth Prevention in Patients with a Short or Dilated Cervix without Prior Preterm Birth.

Objective:  The primary objective was to determine if vaginal progesterone following cerclage for cervical length <10 mm or cervical dilation in patients without a history of spontaneous preterm birth (sPTB) decreased the risk of preterm birth at <34 weeks' gestation compared with cerclage alone. Secondary objectives were to determine if vaginal progesterone following cerclage (1) decreased the risk of preterm birth at <24, <28, and <37 weeks' gestation and (2) increased the latency period from cerclage placement to delivery compared with treatment with cerclage alone.

Study Design:  Multicenter retrospective cohort study from 2015 to 2020 of singleton pregnancies, without prior sPTB, who had cerclage placement <24 weeks' gestation for cervical length <10 mm or cervical dilation.

Supplementation with antioxidant micronutrients in pregnant women with obesity: a randomized controlled trial.

Background/objective: Obesity increases maternal morbidity and adversely affects child health. Maternal inflammation may play a role in adverse outcomes. The objective of this study was to determine whether providing a higher dose of antioxidant micronutrients to pregnant women with obesity would raise concentrations of key antioxidant vitamins and impact inflammation and oxidative stress during pregnancy.

Education in Female Sexual Function and Dysfunction among American Urogynecologic Society Members: An Unmet Need.

Objectives: Sexual function is an important component of women's health that has not been traditionally emphasized during medical training, suggesting that further education is needed to provide comprehensive patient care. The purpose of this study was to describe education and interest in female sexual function among urogynecology providers.

Methods: Conducted in 2020, this was a cross-sectional survey of American Urogynecologic Society members assessing educational and clinical experience with female sexual function.

Association between gestational exposure to solar activity and pregnancy loss using live births from a Massachusetts-based medical center.

Background: Solar activity has been linked to biological mechanisms important to pregnancy, including folate and melatonin levels and inflammatory markers. Thus, we aimed to investigate the association between gestational solar activity and pregnancy loss.

Methods: Our study included 71,963 singleton births conceived in 2002-2016 and delivered at an academic medical center in Eastern Massachusetts.

Triage of HPV positivity in a high HIV prevalence setting: A prospective cohort study comparing visual triage methods and HPV genotype restriction in Botswana.

Objective: Guidelines for effective triage following positive primary high-risk human papillomavirus (HPV) screening in low- and middle-income countries with high human immunodeficiency virus (HIV)-prevalence have not previously been established. In the present study, we evaluated the performance of three triage methods for positive HPV results in women living with HIV (WLHIV) and without HIV in Botswana.

Methods: We conducted baseline enrollment of a prospective cohort study from February 2021 to August 2022 in South-East District, Botswana.

Experiences and Communication Preferences in Pregnancy Care Among Patients With a Spanish Language Preference: A Qualitative Study.

Objective: To explore Spanish-speaking patients' experiences and preferences regarding communication during pregnancy care with specific attention to language barriers.

Methods: Patients with a Spanish language preference who gave birth between July 2022 and February 2023 at an academic medical center were invited to participate in focus groups. Focus groups were held over Zoom, audio-recorded, transcribed in Spanish, translated into English, and reviewed for translation accuracy.

Factors associated with increased financial toxicity after the completion of radiation treatment for gynecologic cancer.

Purpose: We evaluated financial toxicity (FT) in patients with gynecologic cancer treated with radiation and assessed the impact of the COVID-19 pandemic on patients' financial wellbeing.

Methods: Patients completed a survey 1 month after completing radiation from August 2019-March 2020 and November 2020-June 2021. The survey included the COmprehensive Score for Financial Toxicity (COST) tool, EQ-5D to measure quality of life (QOL) and pandemic-related questions for the second survey period.

Association of body mass index with early age at diagnosis of endometrial intraepithelial neoplasia.

Objective: Elevated body mass index (BMI) is a risk factor for endometrioid endometrial cancer and its precursor, endometrial intraepithelial neoplasia (EIN). Our objective was to describe the association between BMI and age at EIN diagnosis.

Methods: We conducted a retrospective study of patients diagnosed with EIN from 2010 to 2020 at a large academic medical center.

Characteristics of providers who prescribed only anticholinergic medications for overactive bladder in 2020.

Background: Pharmacologic therapy for overactive bladder typically includes either an anticholinergic or a beta-3 agonist. Based on research that has demonstrated increased risks of cognitive impairment and dementia associated with anticholinergic use, current guidelines support the use of beta-3 agonists rather than anticholinergics in older patients.

Objective: This study aimed to describe the characteristics of providers prescribing only anticholinergics to treat overactive bladder in patients aged ≥65 years.

Antepartum depressive symptoms are associated with significant postpartum opioid use.

Background: Antepartum depression is common, and outside of childbirth preoperative anxiety and depression have been associated with heightened postoperative pain. In light of the national opioid epidemic, the relationship between antepartum depressive symptoms and postpartum opioid use is particularly relevant.

Objective: This study evaluated the association between antepartum depressive symptoms and significant postpartum opioid use during birth hospitalization.

Associations of solar activity and related exposures with fetal growth.

Background: Solar and geomagnetic activity have been shown to suppress melatonin and to degrade folate levels, important hormones for fetal development. We examined whether solar and geomagnetic activity were associated with fetal growth.

Methods: We included 9573 singleton births with 26,879 routine ultrasounds at an academic medical center in Eastern Massachusetts from 2011 through 2016.

Acceptance of genetic editing and of whole genome sequencing of human embryos by patients with infertility before and after the onset of the COVID-19 pandemic.

Research Question: Has acceptance of heritable genome editing (HGE) and whole genome sequencing for preimplantation genetic testing (PGT-WGS) of human embryos changed after the onset of COVID-19 among infertility patients?

Design: A written survey conducted between April and June 2018 and July and December 2021 among patients at a university-affiliated infertility practice. The questionnaire ascertained the acceptance of HGE for specific therapeutic or genetic 'enhancement' indications and of PGT-WGS to prevent adult disease.

Results: In 2021 and 2018, 172 patients and 469 patients (response rates: 90% and 91%, respectively) completed the questionnaire.