Maternal Morbidity and Medically Assisted Reproduction Treatment Types.

Objective: To compare odds of maternal morbidity by mode of becoming pregnant and type of medically assisted reproduction treatments: fertility-enhancing drugs, intrauterine insemination (IUI), and assisted reproductive technology (ART) with autologous or donor oocytes.

Methods: Birth certificates were used to study maternal morbidity among the birthing population in Utah between 2009 and 2017 (N=469,919 deliveries); 22,543 pregnancies occurred through medically assisted reproduction (4.8%).

Racial and Ethnic Disparities in Regulatory Air Quality Monitor Locations in the US.

Importance: Understanding exposure to air pollution is important to public health, and disparities in the spatial distribution of regulatory air quality monitors could lead to exposure misclassification bias.

Objective: To determine whether racial and ethnic disparities exist in Environmental Protection Agency (EPA) regulatory air quality monitor locations in the US.

Design, Setting, And Participants: This national cross-sectional study included air quality monitors in the EPA Air Quality System regulatory monitoring repository, as well as 2022 American Community Survey Census block group estimates for racial and ethnic composition and population size.

The Relationship Between Perceived Discrimination and Reported Nutrient Intake Among Pregnant Individuals of Minoritized Racial and Ethnic Groups.

Background: Implications of lifelong, perceived discrimination on nutrient intake during the preconception period are unclear.

Objective: The objective was to identify associations between perceived discrimination and consumption of specific nutrients associated with risk of adverse pregnancy outcomes.

Design: This is a secondary data analysis of the prospective Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be cohort.

Racial and ethnic inequities in stillbirth in the US: Looking upstream to close the gap: Seminars in Perinatology.

Though stillbirth rates in the United States improved over the previous decades, inequities in stillbirth by race and ethnicity have persisted nearly unchanged since data collection began. Black and Indigenous pregnant people face a two-fold greater risk of experiencing the devastating consequences of stillbirth compared to their White counterparts. Because race is a social rather than biological construct, inequities in stillbirth rates are a downstream consequence of structural, institutional, and interpersonal racism which shape a landscape of differential access to opportunities for health.

Diabetes Group Prenatal Care: A Systematic Review and Meta-analysis.

Objective: To estimate the effect of diabetes group prenatal care on rates of preterm birth and large for gestational age (LGA) among patients with diabetes in pregnancy compared with individual diabetes prenatal care.

Data Sources: We searched Ovid Medline (1946-), Embase.com (1947-), Scopus (1823-), Cochrane Central Register of Controlled Trials, and ClinicalTrials.

Inequalities in cesarean births between American Indian & Alaska Native people and White people.

Objective: To explore population-level American Indian & Alaska Native-White inequalities in cesarean birth incidence after accounting for differences in cesarean indication, age, and other individual-level risk factors.

Data Sources And Study Setting: We used birth certificate data inclusive of all live births within the United States between January 1 and December 31, 2017.

Study Design: We calculated propensity score weights that simultaneously incorporate age, cesarean indication, and clinical and obstetric risk factors to estimate the American Indian and Alaska Native-White inequality.

Association between short interpregnancy interval and placenta accreta spectrum.

Background: The incidence of placenta accreta spectrum is increasing in parallel with the growing number of cesarean deliveries performed. A shorter interpregnancy interval following cesarean delivery may prevent adequate scar healing, which could impact the risk of placenta accreta spectrum.

Objective: We aimed to investigate the association between short interpregnancy intervals and placenta accreta spectrum.

Prophylactic Ureteral Stent Placement and Urinary Injury During Hysterectomy for Placenta Accreta Spectrum.

Objective: To evaluate the association between prophylactic ureteral stent placement at the time of hysterectomy for placenta accreta spectrum and genitourinary injury.

Methods: We conducted a retrospective cohort study of patients with placenta accreta spectrum who underwent hysterectomy at two referral centers from 2001 to 2021. The exposure was prophylactic ureteral stent placement.

Racism and perinatal health inequities research: where we have been and where we should go.

For more than a century, substantial racial and ethnic inequities in perinatal health outcomes have persisted despite technical clinical advances and changes in public health practice that lowered the overall incidence of morbidity. Race is a social construct and not an inherent biologic or genetic reality; therefore, racial differences in health outcomes represent the consequences of structural racism or the inequitable distribution of opportunities for health along racialized lines. Clinicians and scientists in obstetrics and gynecology have a responsibility to work to eliminate health inequities for Black, Brown, and Indigenous birthing people, and fulfilling this responsibility requires actionable evidence from high-quality research.

Trends in Unplanned Peripartum Hysterectomy in the United States, 2009-2020.

The incidence of unplanned peripartum hysterectomy is increasing nationwide, which may reflect an increase in placenta accreta spectrum disorders.

Directly Measured Costs of Severe Maternal Morbidity Events during Delivery Admission Compared with Uncomplicated Deliveries.

Objective: To estimate the actual excess costs of care for delivery admissions complicated by severe maternal morbidity (SMM) compared with uncomplicated deliveries.

Study Design: This is a retrospective cohort study of all deliveries between October 2015 and September 2018 at a single tertiary academic center. Pregnant individuals ≥ 20 weeks' gestation who delivered during a hospital admission (i.

Racial and Ethnic Inequities in Cesarean Birth and Maternal Morbidity in a Low-Risk, Nulliparous Cohort.

Objective: To evaluate race and ethnicity differences in cesarean birth and maternal morbidity in low-risk nulliparous people at term.

Methods: We conducted a secondary analysis of a randomized trial of expectant management compared with induction of labor in low-risk nulliparous people at term. The primary outcome was cesarean birth.

Society for Maternal-Fetal Medicine Special Statement: COVID-19 research in pregnancy: progress and potential.

The COVID-19 global pandemic has broad implications for obstetrical care and perinatal outcomes. As we approach the 2-year mark into an unprecedented international pandemic, this review presents the progress and opportunities for research related to COVID-19 and pregnancy. Research is the basis for evidence-based clinical guidelines, and we aim to provide the structure and guidance for framing COVID-19-related obstetrical research.

Racial and Ethnic Disparities in Adverse Perinatal Outcomes at Term.

Objective: This study aimed to evaluate whether racial and ethnic disparities in adverse perinatal outcomes exist at term.

Study Design: We performed a secondary analysis of a multicenter observational study of 115,502 pregnant patients and their neonates (2008-2011). Singleton, nonanomalous pregnancies delivered from 37 to 41 weeks were included.

Associations of the Neighborhood Built Environment With Physical Activity Across Pregnancy.

Background: Several features of the neighborhood built environment have been shown to promote leisure-time physical activity (PA) in the general population, but few studies have examined its impact on PA during pregnancy.

Methods: Data were extracted from 8362 Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be cohort participants (2010-2013). Residential address information was linked to 3 built environment characteristics: number of gyms and recreation areas within a 3-km radius of residence and census block level walkability.

Sonographic Assessment of Fetal Growth Abnormalities.

Fetal growth abnormalities have significant consequences for pregnancy management and maternal and fetal well-being. The accurate diagnosis of fetal growth abnormalities contributes to optimal antenatal management, which may minimize the sequelae of inadequate or excessive fetal growth. An accurate diagnosis of abnormal fetal growth depends on accurate pregnancy dating and serial growth measurements.

Association of Acculturation With Adverse Pregnancy Outcomes.

Objective: To evaluate the relationship between acculturation and adverse pregnancy outcomes, and whether these relationships differ across racial or ethnic groups.

Methods: This is a planned secondary analysis of the nuMoM2b study (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be), a prospective observational cohort study of 10,038 pregnant women at eight academic health care centers in the United States. Nulliparous pregnant women with singleton gestations were recruited between 6 0/7 and 13 6/7 weeks of gestation from October 2010-September 2013.

Stillbirth Associated With Infection in a Diverse U.S. Cohort.

Objective: To better characterize infection-related stillbirth in terms of pathogenesis and microbiology.

Methods: We conducted a secondary analysis of 512 stillbirths in a prospective, multisite, geographically, racially and ethnically diverse, population-based study of stillbirth in the United States. Cases underwent evaluation that included maternal interview, chart abstraction, biospecimen collection, fetal autopsy, and placental pathology.

Pregnancy-Associated Death in Utah: Contribution of Drug-Induced Deaths.

Objective: Drug-induced deaths, defined as intentional or unintentional consumption of illicit substances or diverted medications leading to death, are the leading cause of death for reproductive-age women in the United States. Our objective was to describe pregnancy-associated deaths attributed to drug-induced causes to identify opportunities for intervention.

Methods: Using the Utah Perinatal Morality Review Committee database, we performed a retrospective cohort study of all pregnancy-associated deaths-death of a woman during pregnancy or within 1 year from the end of pregnancy-from 2005 to 2014.

Why women are dying from unsafe abortion: narratives of Ghanaian abortion providers.

In Ghana, despite the availability of safe, legally permissible abortion services, high rates of morbidity and mortality from unsafe abortion persist. Through interviews with Ghanaian physicians on the front lines of abortion provision, we begin to describe major barriers to widespread safe abortion. Their stories illustrate the life-threatening impact that stigma, financial restraints, and confusion regarding abortion law have on the women of Ghana who seek abortion.

Racial residential segregation and low birth weight in Michigan's metropolitan areas.

Objectives: We examined the influence of racial residential segregation, independent of neighborhood economic factors, on the overall and specific etiological risks of low birth weight.

Methods: We geocoded all singleton births in Michigan metropolitan areas during 2000 to census tracts. We used hierarchical generalized linear models to investigate the association between low birth weight (< 2500 g) and neighborhood-level economic and racial segregation, controlling for individual and neighborhood characteristics.