Identifying pregnancies in insurance claims data: Methods and application to retinoid teratogenic surveillance.

Purpose: The purpose of the study is to develop an algorithm to identify pregnancies in administrative databases and apply it to assess pregnancy rates and outcomes in women prescribed isotretinoin or tretinoin.

Methods: Using the 2011 to 2015 Truven Health MarketScan Database, we identified pregnancies, including losses and terminations. In a cohort design, nonpregnant women filling a prescription for isotretinoin or tretinoin were matched to five women without either prescription.

Use and safety of disease-modifying therapy in pregnant women with multiple sclerosis.

Purpose: The purpose of this study is to describe dispensing patterns and comparative safety of disease-modifying therapies (DMTs) during pregnancy in women with multiple sclerosis (MS).

Methods: We identified pregnancies from the Truven Health Marketscan® Commercial Claims and Encounters Database (2011-2015) and ascertained MS before delivery from inpatient and outpatient claims. We computed the proportion of women with DMT dispensing claims around pregnancy and estimated risk ratios of spontaneous abortion, infections, cesarean section, preterm delivery, poor fetal growth, preeclampsia, and major structural malformations by DMT exposure.

Pregnancy Outcomes in Women With Multiple Sclerosis.

Few studies have assessed the risk of adverse pregnancy outcomes in women with multiple sclerosis (MS). We used 2 large US administrative databases, the Truven Health MarketScan Database (2011-2015; Truven Health Analytics Inc., Ann Arbor, Michigan) and the Nationwide Inpatient Sample (2007-2011), to identify delivery cohorts.

Frequency of Opioid Dispensing After Vaginal Delivery.

Objective: To describe nationwide patterns in outpatient opioid dispensing after vaginal delivery.

Methods: Using the Truven Health Analytics MarketScan database, we performed a large, nationwide retrospective cohort study of commercially insured beneficiaries who underwent vaginal delivery between 2003 and 2015 and who were opioid-naive for 12 weeks before the delivery admission. We assessed the proportion of women dispensed an oral opioid within 1 week of discharge, the associated median oral morphine milligram equivalent dose dispensed, and the frequency of opioid refills during the 6 weeks after discharge.

Assessment of recording bias in pregnancy studies using health care databases: An application to neurologic conditions.

Background: Pre-existing conditions are imperfectly recorded in health care databases. We assessed whether pre-existing neurologic conditions (epilepsy, multiple sclerosis [MS]) were differentially recorded in the presence of major obstetric outcomes (Caesarean delivery, preterm delivery, preeclampsia) in delivery records. We also evaluated the impact of differential recording on measures of frequency and association between the conditions and outcomes.

Use of atypical antipsychotics in pregnancy and maternal gestational diabetes.

Background: Second generation antipsychotic medications (SGAs) are widely used by reproductive-age women to treat a number of psychiatric illnesses. Some SGAs have been associated with an increased risk of developing diabetes, although information regarding their diabetogenic effect in pregnant women is scarce.

Objective: To evaluate the risk of gestational diabetes (GDM) among women treated with SGA.

Pregabalin use early in pregnancy and the risk of major congenital malformations.

Objective: To assess whether first-trimester exposure to pregabalin is associated with an increased risk of major congenital malformations, as recently suggested in a pregnancy registry study.

Methods: We performed a cohort study nested in the US Medicaid Analytic eXtract (MAX). The study population included 1,323,432 pregnancies resulting in a live-born infant between 2000 and 2010.

Patterns of Gestational Weight Gain in Early Pregnancy and Risk of Gestational Diabetes Mellitus.

Background: Despite a call to study the effect of weight gain pattern on development of gestational diabetes mellitus, few studies have correctly adjusted for independent effects of gain after the first trimester. We used a conditional percentile approach to model the independent association between first and second trimester weight gain trajectories and development of gestational diabetes.

Methods: We sampled women delivering singleton infants from 1998 to 2010 at Magee-Womens Hospital in Pittsburgh, PA, (n = 124,590) using a case-cohort design.

Mortality and Morbidity During Delivery Hospitalization Among Pregnant Women With Epilepsy in the United States.

Importance: Between 0.3% and 0.5% of all pregnancies occur among women with epilepsy.

Delivery planning for pregnancies with gastroschisis: findings from a prospective national registry.

Objective: The purpose of this study was to determine the influence of planned mode and planned timing of delivery on neonatal outcomes in infants with gastroschisis.

Study Design: Data from the Canadian Pediatric Surgery Network cohort were used to identify 519 fetuses with isolated gastroschisis who were delivered at all tertiary-level perinatal centers in Canada from 2005-2013 (n = 16). Neonatal outcomes (including length of stay, duration of total parenteral nutrition, and a composite of perinatal death or prolonged exclusive total parenteral nutrition) were compared according to the 32-week gestation planned mode and timing of delivery with the use of the multivariable quantile and logistic regression.

The role of clarity and blur in guiding visual attention in photographs.

Visual artists and photographers believe that a viewer's gaze can be guided by selective use of image clarity and blur, but there is little systematic research. In this study, participants performed several eye-tracking tasks with the same naturalistic photographs, including recognition memory for the entire photo, as well as recognition memory and personality ratings for individual people in the photos (Experiments 1-3). The results showed that fixations occurred more rapidly and frequently to a local region of clarity than to a comparable blurred region in all tasks, independent of the content of the photo in the local region, and even under instructions to look equally at both regions.