Development and Usability of the OHiFamily Mobile App to Enhance Accessibility to Maternal and Infant Information for Expectant Families in Ohio: Qualitative Study.

Background: The Infant Mortality Research Partnership in Ohio is working to help pregnant individuals and families on Medicaid who are at risk for infant mortality and preterm birth. As part of this initiative, researchers at The Ohio State University worked to develop a patient-facing mobile app, OHiFamily, targeted toward, and created for, this population. To address the social determinants of health that can affect maternal and infant health, the app provides curated information on community resources, health care services, and educational materials in a format that is easily accessible and intended to facilitate contact between families and resources.

Clinical Presentation and Outcomes of Diabetic Ketoacidosis in Pregnancy.

Objective: To examine the presentation, management, and outcomes of pregnancies complicated by diabetic ketoacidosis (DKA) in a contemporary obstetric population.

Methods: This is a case series of all admissions for DKA during pregnancy at a single Midwestern academic medical center over a 10-year period. Diabetic ketoacidosis was defined per the following diagnostic criteria: anion gap more than 12 mEq/L, pH less than 7.

Diabetic Ketoacidosis and Adverse Outcomes Among Pregnant Individuals With Pregestational Diabetes in the United States, 2010-2020.

Objective: To assess the frequency of, risk factors for, and adverse outcomes associated with diabetic ketoacidosis (DKA) at delivery hospitalization among individuals with pregestational diabetes (type 1 and 2 diabetes mellitus) and secondarily to evaluate the frequency of and risk factors for antepartum and postpartum hospitalizations for DKA.

Methods: We conducted a serial, cross-sectional study using the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project Nationwide Readmissions Database from 2010 to 2020 of pregnant individuals with pregestational diabetes hospitalized for delivery. The exposures were 1) sociodemographic and clinical risk factors for DKA and 2) DKA.

Tandem T:Slim X2 Insulin Pump Use in Clinical Practice Among Pregnant Individuals With Type 1 Diabetes: A Retrospective Observational Cohort Study.

Background: Insulin pump use is increasing in frequency among pregnant individuals with type 1 diabetes (T1D). Automated insulin delivery (AID) technologies have not been studied extensively in pregnancy.

Method: We present a retrospective case series of eight individuals with T1D who used the Tandem t:slim X2 insulin pump (Tandem Diabetes Care, Inc.

Association between glycemic control and group B streptococcus colonization among pregnant individuals with pregestational diabetes.

Problem: Pregestational diabetes increases the risk of group B streptococcus (GBS) colonization in pregnancy. Whether glycemic control is associated with differences in this risk is unknown. We examined the association between glycemic control and GBS colonization among pregnant individuals with pregestational diabetes.

Association of community walkability and glycemic control among pregnant individuals with pregestational diabetes mellitus.

Background: Neighborhood walkability is a community-level social determinant of health that measures whether people who live in a neighborhood walk as a mode of transportation. Whether neighborhood walkability is associated with glycemic control among pregnant individuals with pregestational diabetes remains to be defined.

Objective: This study aimed to evaluate the association between community-level neighborhood walkability and glycemic control as measured by hemoglobin A1c (A1C) among pregnant individuals with pregestational diabetes.

Disparities in Continuous Glucose Monitoring Use Among Women of Reproductive Age with Type 1 Diabetes in the T1D Exchange.

We identified characteristics associated with continuous glucose monitoring (CGM) use in women of reproductive age with type 1 diabetes (T1D) in the T1D Exchange clinic registry from 2015 to 2018. Among 6643 assessed women, the frequency of CGM increased from 2015 to 2018 (20.6% vs.

Association of community-level food insecurity and glycemic control among pregnant individuals with pregestational diabetes.

Aim: To evaluate whether pregnant individuals with pregestational diabetes who live in a food-insecure community have worse glycemic control compared to those who do not live in a food-insecure community.

Methods: A retrospective analysis of pregnant individuals with pregestational diabetes enrolled in a multidisciplinary prenatal and diabetes care program. The exposure was community-level food insecurity per the Food Access Research Atlas.

Association Between Social Vulnerability and Achieving Glycemic Control Among Pregnant Individuals With Pregestational Diabetes.

Objective: To evaluate the association between community-level social vulnerability and achieving glycemic control (defined as hemoglobin A1c [Hb A1c] less than 6.0% or less than 6.5%) among individuals with pregestational diabetes.

Risk of Adverse Pregnancy Outcomes Among Pregnant Individuals With Gestational Diabetes by Race and Ethnicity in the United States, 2014-2020.

Importance: Gestational diabetes, which increases the risk of adverse pregnancy outcomes, has been increasing in frequency across all racial and ethnic subgroups in the US.

Objective: To assess whether the frequency of adverse pregnancy outcomes among those in the US with gestational diabetes changed over time and whether the risk of these outcomes differed by maternal race and ethnicity.

Design, Setting, And Participants: Exploratory serial, cross-sectional, descriptive study using US National Center for Health Statistics natality data for 1 560 822 individuals with gestational diabetes aged 15 to 44 years with singleton nonanomalous live births from 2014 to 2020 in the US.

Association of change in haemoglobin A1c with adverse perinatal outcomes in women with pregestational diabetes.

Aims: To determine whether a net decline in glycosylated haemoglobin (HbA ) from early to late pregnancy is associated with lower risk of adverse perinatal outcomes at delivery among women with pregestational diabetes.

Methods: A retrospective analysis from 2012 to 2016 at a tertiary care centre. The exposure was the net change in HbA from early (<20 weeks gestation) to late pregnancy (≥20 weeks gestation).

Differences in Hemoglobin A1c during Pregnancy between Non-Hispanic Black versus White Women with Prepregnancy Diabetes.

Objective: The objective of this was to determine whether the change in hemoglobin A1c (HbA1c) from early to late pregnancy differs between non-Hispanic Black and White women with prepregnancy diabetes.

Study Design: A retrospective analysis was performed from an integrated prenatal and diabetes care program from 2012 to 2016. We compared HbA1c as a continuous measure and secondarily, HbA1c <6.

Glycemic Control and Aspirin Resistance in Patients Taking Low-Dose Aspirin for Pre-eclampsia Prevention.

Objectives: To assess the association between aspirin and glycemic control in diabetic, pregnant patients, and the risk for aspirin resistance in those with poor glycemic control across gestation taking low-dose aspirin (LDA) for pre-eclampsia (PEC) prevention.

Study Design: We performed a secondary analysis of samples collected during the Maternal-Fetal Medicine Units trial of LDA for PEC prevention. A subset of insulin-controlled diabetic patient samples on placebo or 60 mg aspirin daily were evaluated.

Gestational Weight Gain and Adverse Maternal and Neonatal Outcomes for Pregnancies Complicated by Pregestational and Gestational Diabetes.

Objective: This study aimed to investigate the association between excess and less than recommended gestational weight gain (GWG) and adverse maternal and neonatal outcomes in women with pregestational and gestational diabetes.

Study Design: We conducted a secondary analysis of the National Institute of Child Health and Human Development (NICHD) Consortium on Safe Labor (CSL) study. We included deliveries >23 weeks of nonanomalous singletons with either pregestational or gestational diabetes.

The Association of Moms2B, a Community-Based Interdisciplinary Intervention Program, and Pregnancy and Infant Outcomes among Women Residing in Neighborhoods with a High Rate of Infant Mortality.

Objectives: We evaluated the effectiveness of Moms2B, a community-based group pregnancy and parenting program, in an effort to assess whether the program improved pregnancy and infant outcomes.

Methods: We conducted a retrospective matched exposure cohort study comparing women exposed to the Moms2B program during pregnancy (two or more prenatal visits) who delivered a singleton live birth or stillbirth (≥ 20 weeks gestation) from 2011-2017 to a closely matched group of women not exposed to the program. Primary outcomes were preterm birth and low birth weight.

The use of longitudinal hemoglobin A1c values to predict adverse obstetric and neonatal outcomes in pregnancies complicated by pregestational diabetes.

Background: Although an elevated early pregnancy hemoglobin A1c has been associated with both spontaneous abortion and congenital anomalies, it is unclear whether A1c assessment is of value beyond the first trimester in pregnancies complicated by pregestational diabetes.

Objective: We sought to investigate the prognostic ability of longitudinal A1c assessment to predict obstetric and neonatal adverse outcomes based on degree of glycemic control in early and late pregnancy.

Materials And Methods: This was a retrospective cohort study of all pregnancies complicated by pregestational diabetes from January 2012 to December 2016 at The Ohio State University Wexner Medical Center with both an early A1c (<20 weeks' gestation) and late A1c (>26 weeks' gestation) available for analysis.

Practical considerations for pregnant women with diabetes and severe acute respiratory syndrome coronavirus 2 infection.

Epidemiologic data available so far suggest that individuals with diabetes, especially when not well controlled, are at a greater risk than the general population for severe acute respiratory syndrome coronavirus 2 morbidity such as acute respiratory distress syndrome, multiorgan failure, and mortality. Given the significant correlation between severity of coronavirus disease 2019 and diabetes mellitus and the lack of pregnancy-specific recommendations, we aim to provide some guidance and practical recommendations for the management of diabetes in pregnant women during the pandemic, especially for general obstetricians-gynecologists and nonobstetricians taking care of these patients.

Predictive Models for Very Preterm Birth: Developing a Point-of-Care Tool.

Objective: The objective of this study was to create three point-of-care predictive models for very preterm birth using variables available at three different time points: prior to pregnancy, at the end of the first trimester, and mid-pregnancy.

Study Design: This is a retrospective cohort study of 359,396 Ohio Medicaid mothers from 2008 to 2015. The last baby for each mother was included in the final dataset.

The Accuracy and Cost-Effectiveness of Selective Fetal Echocardiography for the Diagnosis of Congenital Heart Disease in Patients with Pregestational Diabetes Stratified by Hemoglobin A1c.

Objective: To evaluate the accuracy of antenatal diagnosis of congenital heart disease (CHD) using screening methods including a combination of elevated hemoglobin A1c, detailed anatomy ultrasound, and fetal echocardiography.

Study Design: This is a retrospective cohort study of all pregnancies complicated by pregestational diabetes from January 2012 to December 2016. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each screening regimen.

Changes in the burnout profile of chairs of academic departments of obstetrics and gynecology over the past 15 years.

Background: While many studies have documented the high prevalence of burnout in practicing physicians and medical trainees, fewer reports describe burnout in academic leaders. In 2002, we observed a moderate-high to high level of burnout in 41.4% of chairs of academic departments of obstetrics and gynecology.