Publications by authors named "Yasser El-Sayed"

Article Synopsis
  • - The study aimed to see if treating mild chronic hypertension (CHTN) during pregnancy would lead to fewer unplanned healthcare visits after childbirth.
  • - An analysis of 2,293 pregnant patients showed that overall unplanned healthcare utilization rates were similar between the treatment and control groups, though emergency visits were notably lower in the treated group.
  • - Factors like higher BMI and cesarean deliveries were found to increase the likelihood of needing unplanned postpartum care, even though treating mild CHTN showed some specific benefits.
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  • A recent study analyzed the effect of oxytocin dosage on cesarean delivery rates and adverse outcomes in low-risk nulliparous patients undergoing labor induction at 39 weeks or more.
  • The research compared mid- to high-dose oxytocin regimens with low-dose regimens, finding that higher doses were associated with fewer cesarean deliveries, without increasing negative perinatal outcomes.
  • The study was a secondary analysis of a larger randomized trial and utilized various statistical methods to evaluate the impact of the different oxytocin dosages on the primary outcomes.
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Quercetin (QRT), a potent flavonoid, holds immense mechanistic potential in enhancing various aspects of broiler chicken physiological status. This comprehensive study explores the profound еffеcts of QRT on behavior, productive performance, and immune functions, unraveling the underlying mechanisms behind its efficacy. Four hundred, one-day-old Cobb 500 chicks were placed randomly into 4 supplementation groups (100 birds /group and five replicates) and provided diets enriched with varying concentrations of QRT (0, 200, 400, and 600 ppm) for six weeks.

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Background: The Chronic Hypertension and Pregnancy Study demonstrated that a target blood pressure of <140/90 mm Hg during pregnancy is associated with improved perinatal outcomes. Outside of pregnancy, pharmacologic therapy for patients with diabetes and hypertension is adjusted to a target blood pressure of <130/80 mm Hg. During pregnancy, patients with both diabetes and chronic hypertension may also benefit from tighter control with a target blood pressure <130/80 mm Hg.

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Objective: To compare differences in postpartum blood pressure (BP) control (BP below 140/90 mm Hg) for participants with hypertension randomized to receive antihypertensive treatment compared with no treatment during pregnancy.

Methods: This study was a planned secondary analysis of a multicenter, open-label, randomized controlled trial (The CHAP [Chronic Hypertension and Pregnancy] trial). Pregnant participants with mild chronic hypertension (BP below 160/105 mm Hg) were randomized into two groups: active (antihypertensive treatment) or control (no treatment unless severe hypertension, BP 160/105 mm Hg or higher).

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Objective: To evaluate the risks of adverse maternal and neonatal outcomes associated with pregnancies complicated by hepatitis C virus (HCV) infection.

Methods: This is a secondary analysis of a multicenter prospective cohort study of HCV infection in pregnancy. Participants were screened for HCV infection with serum antibody tests, and each participant with a positive HCV result (case group) was matched with up to two individuals with negative HCV results (control group) prospectively by gestational age (±2 weeks) at enrollment.

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Objective: To investigate the optimal gestational age to deliver pregnant people with chronic hypertension to improve perinatal outcomes.

Methods: We conducted a planned secondary analysis of a randomized controlled trial of chronic hypertension treatment to different blood pressure goals. Participants with term, singleton gestations were included.

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Objective: To evaluate maternal and neonatal outcomes by type of antihypertensive used in participants of the CHAP (Chronic Hypertension in Pregnancy) trial.

Methods: We conducted a planned secondary analysis of CHAP, an open-label, multicenter, randomized trial of antihypertensive treatment compared with standard care (no treatment unless severe hypertension developed) in pregnant patients with mild chronic hypertension (blood pressure 140-159/90-104 mm Hg before 20 weeks of gestation) and singleton pregnancies. We performed three comparisons based on medications prescribed at enrollment: labetalol compared with standard care, nifedipine compared with standard care, and labetalol compared with nifedipine.

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Article Synopsis
  • The study analyzed the prevalence and treatment of chronic hypertension during pregnancy in the U.S. from 2008 to 2021, highlighting its rising prevalence from 1.8% to 3.7% among pregnancies.
  • The use of oral antihypertensive medications remained steady, with a shift from methyldopa and hydrochlorothiazide to labetalol and nifedipine for treatment.
  • Despite recent hypertension guidelines released in 2017, there were no significant changes in prevalence or treatment practices for chronic hypertension during pregnancy during the study period.
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Introduction: Fetal magnetic resonance imaging (MRI) lung volume nomograms are increasingly used to prognosticate neonatal outcomes in fetuses with suspected pulmonary hypoplasia. However, pregnancies complicated by fetal anomalies associated with pulmonary hypoplasia may also be complicated by fetal growth restriction (FGR). If a small lung volume is suspected in such cases, it is often unclear whether the lungs are "small" because of underlying lung pathology, or small fetal size.

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Objective: To estimate the association between mean arterial pressure during pregnancy and neonatal outcomes in participants with chronic hypertension using data from the CHAP (Chronic Hypertension and Pregnancy) trial.

Methods: A secondary analysis of the CHAP trial, an open-label, multicenter randomized trial of antihypertensive treatment in pregnancy, was conducted. The CHAP trial enrolled participants with mild chronic hypertension (blood pressure [BP] 140-159/90-104 mm Hg) and singleton pregnancies less than 23 weeks of gestation, randomizing them to active treatment (maintained on antihypertensive therapy with a goal BP below 140/90 mm Hg) or standard treatment (control; antihypertensives withheld unless BP reached 160 mm Hg systolic BP or higher or 105 mm Hg diastolic BP or higher).

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Importance: The Antenatal Late Preterm Steroids (ALPS) trial changed clinical practice in the United States by finding that antenatal betamethasone at 34 to 36 weeks decreased short-term neonatal respiratory morbidity. However, the trial also found increased risk of neonatal hypoglycemia after betamethasone. This follow-up study focused on long-term neurodevelopmental outcomes after late preterm steroids.

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Background: Hypoxic-ischemic encephalopathy contributes to morbidity and mortality among neonates ≥36 weeks of gestation. Evidence of preventative antenatal treatment is limited. Magnesium sulfate has neuroprotective properties among preterm fetuses.

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 The four initial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pregnant women presenting at term gestation to our institution presented with transaminitis. Three of the four were diagnosed with intrahepatic cholestasis of pregnancy (IHCP). Growing evidence exists of an associated transaminitis in nonpregnant SARS-CoV-2 patients.

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Objective: To characterize breastfeeding behaviors and identify factors associated with breastfeeding initiation among people with hepatitis C virus (HCV) infection.

Methods: We conducted a secondary analysis of a multicenter observational cohort of pregnant people with singleton gestations and HCV seropositivity. This analysis includes individuals with data on breastfeeding initiation and excludes those with human immunodeficiency virus (HIV) co-infection.

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Objective: To evaluate the association between maternal blood pressure (BP) below 130/80 mm Hg compared with 130-139/80-89 mm Hg and pregnancy outcomes.

Methods: We conducted a planned secondary analysis of CHAP (Chronic Hypertension and Pregnancy), an open label, multicenter, randomized controlled trial. Participants with mean BP below 140/90 mm Hg were grouped as below 130/80 mm Hg compared with 130-139/80-89 mm Hg by averaging postrandomization clinic BP throughout pregnancy.

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Article Synopsis
  • The study aimed to estimate the rate of perinatal transmission of hepatitis C virus (HCV) and identify associated risk factors among pregnant individuals.
  • Conducted from 2012 to 2018, the research included screening for HCV in over 109,000 participants, with the main outcome measured being evidence of transmission in infants up to 2 years old.
  • Results showed a 6.0% perinatal transmission rate, predominantly in viremic individuals, with higher viral loads and antepartum bleeding identified as significant risk factors.
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  • This study investigates how potential national abortion bans could affect the rates of neonatal single-ventricle cardiac defects in the U.S. by using a decision tree model to analyze different ban scenarios.
  • It found that under a complete abortion ban, there could be a significant increase (53.7%) in single-ventricle cardiac defects, leading to more neonatal surgeries and higher mortality rates.
  • The conclusion suggests that states looking to impose abortion restrictions should consider the potential strain on healthcare resources and the increased health risks for neonates.
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Background: Increased duration of breastfeeding improves maternal cardiovascular health and may be especially beneficial in high-risk populations, such as those with chronic hypertension. Others have shown that individuals with hypertension are less likely to breastfeed, and there has been limited research aimed at supporting breastfeeding goals in this population. The impact of perinatal blood pressure control on breastfeeding outcomes among people with chronic hypertension is unknown.

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  • The study aimed to assess how maternal characteristics and delivery methods affect women's perceived control during childbirth, using a self-reported questionnaire called the Labor Agentry Scale.
  • Researchers conducted a secondary analysis on data from a large randomized trial involving low-risk first-time mothers, focusing on various factors such as age, race, BMI, and labor pain.
  • Results showed that certain groups, such as those identifying as Asian or Hispanic, smokers, and women with higher BMIs or cesarean deliveries, reported significantly lower levels of perceived control during labor compared to White women and those who had spontaneous deliveries.
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Importance: Existing reports of pregnant patients with COVID-19 disease who require extracorporeal membrane oxygenation (ECMO) are limited, with variable outcomes noted for the maternal-fetal dyad.

Objective: To examine maternal and perinatal outcomes associated with ECMO used for COVID-19 with respiratory failure during pregnancy.

Design, Setting, And Participants: This retrospective multicenter cohort study examined pregnant and postpartum patients who required ECMO for COVID-19 respiratory failure at 25 hospitals across the US.

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