Introduction: Kansas is a predominantly rural state that had 9853 rural births in 2018. The Kansas Rural Obstetrical Access Task Force was formed to study and address factors affecting these births. One of these factors is the distance between mothers and the location of maternity services. Poor access leading to increased travel times between mothers and maternity care providers has been associated with a greater rate of pregnancy complications, premature birth, and higher cost of care. In Kansas, the current state of access is not clearly described. Adding to the concern were reports of rural hospital closures and provider cessation of maternity care services. This was likely leading to 'maternity deserts': entire counties that have no maternity care providers. The goal of this project was to identify who currently delivers babies in Kansas, map their location, and determine future plans for maternity care service provision.
Methods: The study began by dividing the state of Kansas into counties by population density and by identifying current practitioners in the state. Once identified, providers were sent a 72-item mixed methods survey with content including demographics, practice location, provision of maternity care, and intents on future practice changes.
Results: Analysis of the survey responses led to a clearer picture of the current state of maternity care provider distribution in Kansas. This revealed multiple existing maternity deserts and a projected expansion of these deserts over the next 10 years.
Conclusion: The current distribution of maternity care services in Kansas reveals numerous maternity deserts, and provider survey projections as far forward as 2030 show expansion of these deserts. This poor access to care may be contributing to unnecessary pregnancy complications. With the extent of this issue identified, targeted efforts toward narrowing the current and expanding maternity deserts are being implemented.
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http://dx.doi.org/10.22605/RRH6137 | DOI Listing |
JAMA Netw Open
January 2025
Department of Obstetrics and Gynecology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York.
Importance: Understanding environmental risk factors for gestational diabetes (GD) is crucial for developing preventive strategies and improving pregnancy outcomes.
Objective: To examine the association of county-level radon exposure with GD risk in pregnant individuals.
Design, Setting, And Participants: This multicenter, population-based cohort study used data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b) cohort, which recruited nulliparous pregnant participants from 8 US clinical centers between October 2010 and September 2013.
JAMA Netw Open
January 2025
Division of Neonatology, Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands.
Importance: Preventive efforts in pregnancy-related alloimmunization have considerably decreased the prevalence of hemolytic disease of the fetus and newborn (HDFN). International studies are therefore essential to obtain a deeper understanding of the postnatal management and outcomes of HDFN. Taken together with numerous treatment options, large practice variations among centers may exist.
View Article and Find Full Text PDFDiabetes
January 2025
Institute for Developmental and Regenerative Cardiovascular Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
Diabetes is a major risk factor for cardiovascular disease, but the molecular mechanisms underlying diabetic vasculopathy have been elusive. Here we report that inositol hexakisphosphate kinase 1 (IP6K1) mediates hyperglycemia-induced endothelial senescence by rewiring the liver kinase B1 (LKB1) signaling from activating the adenosine monophosphate-activated protein kinase (AMPK) pathway to the p53 pathway. We found that hyperglycemia upregulated IP6K1, which disrupts the Hsp/Hsc70 and carboxyl terminus of Hsc70-interacting protein (CHIP)-mediated LKB1 degradation, leading to increased expression levels of LKB1.
View Article and Find Full Text PDFJ Assist Reprod Genet
January 2025
Department of Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Pregnancy complications pose challenges for both pregnant women and obstetricians globally, with the pathogenesis of many remaining poorly understood. Recently coined as a mode of cell death, cuproptosis has been proposed but remains largely unexplored. This process involves copper overload, resulting in the accumulation of fatty acylated proteins and subsequent loss of iron-sulfur cluster proteins.
View Article and Find Full Text PDFSci China Life Sci
December 2024
New Cornerstone Science Laboratory, Key Laboratory of Epigenetic Regulation and Intervention, Shanghai Key Laboratory of Molecular Andrology, CAS Center for Excellence in Molecular Cell Science, Shanghai Institute of Biochemistry and Cell Biology, Chinese Academy of Sciences-University of Chinese Academy of Sciences, Shanghai, 200031, China.
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