Impact of COVID-19 on Perinatal Outcomes and Birth Locations in a Large US Metropolitan Area.

This was a population-based study to determine the impact of COVID-19 on birth outcomes in the Chicago metropolitan area, comparing pre-pandemic (April-September 2019) versus pandemic (April-September 2020) births. Multivariable regression models that adjusted for demographic and neighborhood characteristics were used to estimate the marginal effects of COVID-19 on intrauterine fetal demise (IUFD)/stillbirth, preterm birth, birth hospital designation, and maternal and infant hospital length of stay (LOS). There were no differences in IUFD/stillbirths or preterm births between eras.

First trimester "clean catch" urine and vaginal swab sample distinct microbiological niches.

Untreated asymptomatic bacteriuria (ASB) has been associated with adverse pregnancy outcomes, including pyelonephritis, preterm labor, and low birth weight infants. Thus, routine screening by standard urine culture (SUC) and treatment of ASB are currently recommended for all pregnant women. For this purpose, some researchers claim that vaginal swabs and urine samples can be used as proxies for each other.

Determinants of Physical Activity Among Black Women During Pregnancy.

Objective: To describe associations among background determinants of physical activity, modifiable theoretical determinants of physical activity, and measures of physical activity during the second and third trimesters of pregnancy among Black women.

Design: Longitudinal cohort.

Setting: Medical center obstetric clinic.

Effectiveness of extended postpartum inpatient monitoring for hypertensive disorders of pregnancy to reduce the risk of readmission for preeclampsia with severe features.

Background: Preeclampsia is an obstetrical disorder, which complicates 3% to 6% of pregnancies and contributes to 21.6% of readmissions in the postpartum period. The optimal strategy for inpatient monitoring of blood pressures to minimize readmissions for postpartum patients with hypertensive disorders is not known.

MRSA screening: incidence and maternal postpartum outcomes in an obstetric population at a tertiary care center.

Purpose: To assess the incidence of MRSA positive patients in pregnancy, as well as the postpartum outcomes in MRSA positive patients.

Methods: This is a retrospective cohort study of women who underwent universal MRSA universal at a tertiary medical center. A MRSA swab was routinely collected as part of the patient's prenatal care at 35-37 weeks gestation or on admission to labor and delivery.

Conscious prone positioning in a pregnant patient with COVID-19 respiratory distress: A case report and review.

Prone positioning has been used for decades to improve oxygenation in patients with acute respiratory distress syndrome. With the COVID-19 pandemic there has been a growing emphasis on the utilization of prone positioning for non-intubated patients as a means of preventing invasive ventilation and improving outcomes. In this case report, a patient is presented with acute hypoxemic respiratory failure in late pregnancy who experienced significant improvements in oxygenation with prone positioning.

Cytokine profiling: variation in immune modulation with preterm birth vs. uncomplicated term birth identifies pivotal signals in pathogenesis of preterm birth.

Objectives: To assess deviations in longitudinally measured cytokines with preterm birth (PTB).

Methods: Prospective longitudinal study targeting 80 subjects. Phlebotomy specimens for broad panel of cytokine analysis were obtained at three time (T) intervals: first trimester (T1: 8-14 weeks' gestation), second trimester (T2: 18-22 weeks' gestation), and third trimester (T3: 28-32 weeks' gestation).

Society for Maternal-Fetal Medicine Special Statement: Society for Maternal-Fetal Medicine's conflict of interest policy.

A vital mission of the Society for Maternal-Fetal Medicine is to provide independent, objective, scientifically based information and recommendations for providers, patients, and payors of high-risk pregnancy care. To ensure that these recommendations are free from bias, special interest, or the perception of either, a publicly transparent process for disclosing relevant financial and nonfinancial interests (disclosures of interest) and management of potential conflicts of interest are essential. Educational and research presentations also require proper disclosure to allow attendees to properly assess information presented at the Society for Maternal-Fetal Medicine events.

Longitudinal changes in glucose metabolism in women with gestational diabetes, from late pregnancy to the postpartum period.

Aims/hypothesis: This study aimed to determine, in women with gestational diabetes (GDM), the changes in insulin sensitivity (Matsuda Insulin Sensitivity Index; IS), insulin response and disposition index (DI) from late pregnancy (34-37 weeks gestation, T1), to early postpartum (1-5 days, T2) and late postpartum (6-12 weeks, T3). A secondary aim was to correlate the longitudinal changes in maternal lipids, adipokines, cytokines and weight in relation to the changes in IS, insulin response and DI.

Methods: IS, insulin response and DI were calculated at the three time points (T1, T2 and T3) using the results of a 75 g OGTT.

Variation in C-reactive protein at 1 month post-partum by etiology of preterm birth: selective identification of those at risk for both poor pregnancy outcome and future health complications.

Objective To assess post-partum inflammation for patients delivering prior to 34 6/7 weeks by birth etiology. Methods This was an observational study of early preterm birth (PTB) occurring between 20 0/7 and 34 6/7 weeks of gestation. Serum C-reactive protein (CRP) levels were measured 1 month post-partum.

Should women with gestational diabetes be screened at delivery hospitalization for type 2 diabetes?

Background: Less than one-half of women with gestational diabetes mellitus are screened for type 2 diabetes postpartum. Other approaches to postpartum screening need to be evaluated, including the role of screening during the delivery hospitalization.

Objective: To assess the performance of an oral glucose tolerance test administered during the delivery hospitalization compared with the oral glucose tolerance test administered at a 4- to 12-week postpartum visit.

Aortic Dissection in a Pregnant Patient without Other Risk Factors.

An aortic dissection is a life-threatening condition in which the intima of the artery tears causing separation of the intima and media. Pregnancy places women at a significantly increased risk of common vascular events including venous thromboembolism, myocardial infarction, and stroke, while also increasing the risk of rarer vascular events such as aortic dissection and aortic rupture. A 30-year-old previously healthy multiparous woman presenting at 36 weeks of pregnancy with a Type A aortic dissection.

Microorganisms Identified in the Maternal Bladder: Discovery of the Maternal Bladder Microbiota.

 The objective of this study was to characterize the bladder microbiota in pregnancy.  A prospective observational study of 51 pregnant women, admitted to a tertiary care hospital, who underwent straight catheterization urine collection or transurethral Foley catheter placement. 16S rRNA gene sequencing and enhanced quantitative urine culture assessed the maternal bladder microbiota with comparisons made to standard urine culture results.

Maternal and Neonatal Morbidity for Women Who Would Be Added to the Diagnosis of GDM Using IADPSG Criteria: A Secondary Analysis of the Hyperglycemia and Adverse Pregnancy Outcome Study.

Objective: To assess the frequency of adverse outcomes for women who are diagnosed with gestational diabetes mellitus (GDM) by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria using data from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study.

Research Design And Methods: This is a secondary analysis from the North American HAPO study centers. Glucose measurements from a 75-g oral glucose tolerance test were used to group participants into three nonoverlapping categories: GDM based on Carpenter-Coustan (CC) criteria (also GDM based on IADPSG criteria), GDM diagnosed based on IADPSG criteria but not CC criteria, and no GDM.

A retrospective cohort study of factors relating to the longitudinal change in birth weight.

Background: Recent reports have shown a decrease in birth weight, a change from prior steady increases. Therefore we sought to describe the demographic and anthropometric changes in singleton term fetal growth.

Methods: This was a retrospective cohort analysis of term singleton deliveries (37-42 weeks) from January 1, 1995 to January 1, 2010 at a single tertiary obstetric unit.

A risk of waiting: the weekly incidence of hypertensive disorders and associated maternal and neonatal morbidity in low-risk term pregnancies.

Background: Elective induction of labor (eIOL) prior to 39 weeks' gestation is discouraged because of presumed fetal benefits. However, few data exist on the maternal risks of expectant management. To date, no study has evaluated the maternal risk of developing a hypertensive disorder of pregnancy with expectant management of a low-risk gravid at term.

Measures of success: Prediction of successful labor induction.

Ideally, all pregnant women would enter labor spontaneously at the safest time to yield the best health outcomes for both themselves and their newborns. Unfortunately, this does not always happen and leaves obstetric providers weighing the maternal and fetal risks of continued expectant management versus labor induction. Several elements have been reported to affect the success rate of an induction, including the Bishop score, maternal parity, body mass index (BMI), age, medical comorbidities, fetal gestational age, and estimated weight, as well as the hospital site and provider practice.

Perinatal outcomes associated with the diagnosis of gestational diabetes made by the international association of the diabetes and pregnancy study groups criteria.

Objective: To assess perinatal outcomes with Carpenter-Coustan criteria for gestational diabetes mellitus (GDM), those with normal glucose testing, and those who would be added to GDM by The International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria.

Methods: This was a retrospective cohort study of women who underwent screening and diagnostic testing for GDM. Patients were divided into nonoverlapping groups: GDM by Carpenter-Coustan (Carpenter-Coustan), IADPSG GDM criteria but not Carpenter-Coustan (IADPSG), and normal GDM screening or testing (control).

Maternal and neonatal outcomes in electively induced low-risk term pregnancies.

Objective: Elective induction of labor has been discouraged over concerns regarding increased complications. We evaluated the mode of delivery and maternal and neonatal morbidities in low-risk patients whose labor was electively induced or expectantly managed at term.

Study Design: This was a retrospective cross-sectional study from 12 US institutions (19 hospitals), 2002 through 2008 (Safe Labor Consortium).

The risk of fetal death: current concepts of best gestational age for delivery.

Objective: To compare the risk of fetal death (FD) between 34 and 41 weeks' gestational age (GA) with the neonatal mortality rate to examine the best GA for delivery.

Study Design: Linked birth and infant death data for the US from the National Center for Health Statistics analyzed nonanomalous singleton pregnancies between 2003 and 2005. Pregnancies were classified as high risk or low risk based on preexisting maternal complications.

Neonatal body composition according to the revised institute of medicine recommendations for maternal weight gain.

Background: In 2009, the Institute of Medicine (IOM) released revised pregnancy weight gain guidelines. There are limited data regarding the effect of maternal weight gain on newborn adiposity.

Objective: The aim of this study was to estimate neonatal fat mass, lean body mass, and percentage body fat according to current Institute of Medicine (IOM) pregnancy weight gain guidelines.

Maternal weight gain in women who develop gestational diabetes mellitus.

Objective: To assess maternal weight gain before 24 weeks in women developing gestational diabetes mellitus (GDM) compared with controls with normal glucose tolerance.

Methods: This was a retrospective cohort study of maternal weight gain. Women developing GDM were matched to three controls by self-reported prepregnancy body mass index (BMI), maternal age, race, and parity.

Women's reported weight: is there a discrepancy?

Objective: To compare self-reported pre-pregnancy weight & delivery weight with documented pre-pregnancy & delivery weight and determine whether there are differences compared with the Institute of Medicine's (IOM) guidelines.

Methods: This is a retrospective analysis of 234 women. Inclusion criteria included documented height, self-reported pre-pregnancy weight, self-reported delivery weight, documented pre-pregnancy weight ± 12 weeks from last menstrual period, and documented delivery weight ± 2 weeks from delivery.