281 results match your criteria: "George Washington University Biostatistics Center[Affiliation]"

Article Synopsis
  • 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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Background: Perinatal depression has been suggested to adversely impact child neurodevelopment. However, the complexity of the early childhood environment challenges conclusive findings.

Objective: To evaluate whether there is an association between perinatal depressive symptoms and child intelligence quotient (IQ) at 5 years of age.

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Pregnancy Outcomes in Patients With Hepatitis C Virus Infection.

Obstet Gynecol

October 2024

Departments of Obstetrics and Gynecology, Brown University, Providence, Rhode Island, University of Texas Medical Branch, Galveston, Texas, The Ohio State University, Columbus, Ohio, Case Western Reserve University, Cleveland, Ohio, University of Alabama at Birmingham, Birmingham, Alabama, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, University of Utah Health Sciences Center, Salt Lake City, Utah, Columbia University, New York, New York, Boston Medical Center, Boston, Massachusetts, University of Pittsburgh, Pittsburgh, Pennsylvania, Duke University, Durham, North Carolina, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, Texas, Northwestern University, Chicago, Illinois, Stanford University, Stanford, California, University of Texas Southwestern Medical Center, Dallas, Texas, University of Pennsylvania, Philadelphia, Pennsylvania, and University of Texas at Austin, Austin, Texas; the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.

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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To examine the incidence of overt hypothyroidism 1 and 5 years after pregnancies where screening before 21 weeks identified subclinical hypothyroidism (SH) or hypothyroxinemia (HT). Secondary analysis of two multicenter treatment trials for either SH or HT diagnosed between 8 and 20 weeks gestation. Current analyses focus only on individuals randomized to the placebo groups in the two parallel studies.

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Background: Recent data in nonpregnant individuals suggest a protective effect of influenza vaccination against SARS-CoV-2 infection and its severity.

Objectives: Our primary objective was to evaluate whether influenza vaccination was associated with COVID-19 severity and pregnancy and neonatal outcomes among those infected with SARS-CoV-2. The secondary objective was to examine the association between influenza vaccination and SARS-CoV-2 infection.

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Importance: Compared with early cord clamping (ECC), umbilical cord milking (UCM) reduces delivery room cardiorespiratory support, hypoxic-ischemic encephalopathy, and therapeutic hypothermia in nonvigorous near-term and full-term infants. However, UCM postdischarge outcomes are not known.

Objective: To determine the 2-year outcomes of children randomized to UCM or ECC at birth in the Milking in Nonvigorous Infants (MINVI) trial.

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Background: Current postpartum hemorrhage (PPH) risk stratification is based on traditional statistical models or expert opinion. Machine learning could optimize PPH prediction by allowing for more complex modeling.

Objective: We sought to improve PPH prediction and compare machine learning and traditional statistical methods.

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Optimizing Opioid Prescription Quantity After Cesarean Delivery: A Randomized Controlled Trial.

Obstet Gynecol

August 2024

Departments of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah, The Ohio State University, Columbus, Ohio, University of Pennsylvania, Philadelphia, Pennsylvania, University of Pittsburgh, Pittsburgh, Pennsylvania, University of Alabama at Birmingham, Birmingham, Alabama, Brown University, Providence, Rhode Island, Columbia University, New York, New York, University of Texas Medical Branch, Galveston, Texas, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, Northwestern University, Chicago, Illinois, and University of Texas at Austin, Austin, Texas; the Department of Anesthesiology, Columbia University, New York, New York; the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.

Objective: To test whether an individualized opioid-prescription protocol (IOPP) with a shared decision-making component can be used without compromising postcesarean pain management.

Methods: In this multicenter randomized controlled noninferiority trial, we compared IOPP with shared decision making with a fixed quantity of opioid tablets at hospital discharge. We recruited at 31 centers participating in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network.

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Article Synopsis
  • The study investigated whether pregnancy and delivery during the COVID-19 pandemic affected gestational weight gain (GWG) and birth outcomes compared to pre-pandemic pregnancies.
  • A total of 10,717 pregnant individuals were analyzed, with 4,225 experiencing the pandemic, revealing that those during the pandemic had slightly higher excessive GWG but lower inadequate GWG rates.
  • The frequency of small-for-gestational-age (SGA) neonates decreased slightly during the pandemic, while the rate of large-for-gestational-age (LGA) neonates showed a small increase, suggesting some variations in birth outcomes linked to pandemic conditions.
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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: Venous thromboembolism accounts for approximately 9% of pregnancy-related deaths in the United States. National guidelines recommend postpartum risk stratification and pharmacologic prophylaxis in at-risk individuals. Knowledge on modern rates of postpartum pharmacologic thromboprophylaxis and its associated risks is limited.

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Objective: Our objective was to evaluate whether iodine status in pregnant patients with either subclinical hypothyroidism or hypothyroxinemia in the first half of pregnancy is associated with measures of behavior and neurodevelopment in children through the age of 5 years.

Study Design: This is a secondary analysis of a multicenter study consisting of two randomized, double-masked, placebo-controlled treatment trials conducted in parallel. Patients with a singleton gestation before 20 weeks' gestation underwent thyroid screening using serum thyrotropin and free thyroxine.

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Objectives: Neonatal trials have traditionally used binary composite short-term (such as death or bronchopulmonary dysplasia) or longer-term (such as death or severe neurodevelopmental impairment) outcomes. We applied the Desirability Of Outcome Ranking (DOOR) method to rank the overall patient outcome by best (no morbidities) to worst (death).

Study Design: Using a completed large multicenter trial (Milking In Non-Vigorous Infants [MINVI]) of umbilical cord milking (UCM) vs.

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Breastfeeding Initiation, Duration, and Associated Factors Among People With Hepatitis C Virus Infection.

Obstet Gynecol

March 2024

Departments of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, University of Texas Medical Branch, Galveston, Texas, Brown University, Providence, Rhode Island, MetroHealth Medical Center-Case Western Reserve University, Cleveland, Ohio, University of Alabama at Birmingham, Birmingham, Alabama, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, University of Utah Health Sciences Center, Salt Lake City, Utah, Columbia University, New York, New York, Boston Medical Center, Boston, Massachusetts, University of Pittsburgh, Pittsburgh, Pennsylvania, Duke University, Durham, North Carolina, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, Texas, Northwestern University, Chicago, Illinois, Stanford University, Stanford, California, University of Texas Southwestern Medical Center, Dallas, Texas, and University of Pennsylvania, Philadelphia, Pennsylvania; the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.

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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Validation of Three Models for Prediction of Blood Transfusion during Cesarean Delivery Admission.

Am J Perinatol

May 2024

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania.

Objective: Prediction of blood transfusion during delivery admission allows for clinical preparedness and risk mitigation. Although prediction models have been developed and adopted into practice, their external validation is limited. We aimed to evaluate the performance of three blood transfusion prediction models in a U.

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Background Our aim was to investigate the association of coronary artery calcium (CAC) with cognitive function in adults with impaired glucose tolerance or type 2 diabetes. Methods and Results The Diabetes Prevention Program was a randomized controlled trial comparing an intensive lifestyle intervention, metformin, or placebo for prevention of type 2 diabetes among patients with prediabetes. After 3 years, intensive lifestyle intervention and placebo were stopped, the metformin arm was unmasked, and participants continued in the DPPOS (Diabetes Prevention Program Outcomes Study).

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Article Synopsis
  • - Clinical research networks, like the Antibacterial Resistance Leadership Group (ARLG), conduct essential studies on antibiotic resistance, including diagnostic research and treatment strategies, that might not be explored by other organizations.
  • - The value of these networks goes beyond just their findings; they foster collaboration to create new research methodologies and tools that improve how studies are designed and conducted.
  • - The ARLG specifically focuses on innovating methods in diagnostic and clinical trials to address antibiotic-resistant infections, which can significantly enhance the effectiveness and efficiency of future research in this field.
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Priorities and Progress in Diagnostic Research by the Antibacterial Resistance Leadership Group.

Clin Infect Dis

October 2023

Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.

The advancement of infectious disease diagnostics, along with studies devoted to infections caused by gram-negative and gram-positive bacteria, is a top scientific priority of the Antibacterial Resistance Leadership Group (ARLG). Diagnostic tests for infectious diseases are rapidly evolving and improving. However, the availability of rapid tests designed to determine antibacterial resistance or susceptibility directly in clinical specimens remains limited, especially for gram-negative organisms.

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Addressing the treatment and prevention of antibacterial-resistant gram-negative bacterial infections is a priority area of the Antibacterial Resistance Leadership Group (ARLG). The ARLG has conducted a series of observational studies to define the clinical and molecular global epidemiology of carbapenem-resistant and ceftriaxone-resistant Enterobacterales, carbapenem-resistant Pseudomonas aeruginosa, and carbapenem-resistant Acinetobacter baumannii, with the goal of optimizing the design and execution of interventional studies. One ongoing ARLG study aims to better understand the impact of fluoroquinolone-resistant gram-negative gut bacteria in neutropenic patients, which threatens to undermine the effectiveness of fluoroquinolone prophylaxis in these vulnerable patients.

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Risk Factors for Perinatal Transmission of Hepatitis C Virus.

Obstet Gynecol

September 2023

Departments of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, University of Texas Medical Branch, Galveston, Texas, Brown University, Providence, Rhode Island, MetroHealth Medical Center-Case Western Reserve University, Cleveland, Ohio, University of Alabama at Birmingham, Birmingham, Alabama, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, University of Utah Health Sciences Center, Salt Lake City, Utah, Columbia University, New York, New York, Boston Medical Center, Boston, Massachusetts, University of Pittsburgh, Pittsburgh, Pennsylvania, Duke University, Durham, North Carolina, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, Texas, Northwestern University, Chicago, Illinois, Stanford University, Stanford, California, University of Texas Southwestern Medical Center, Dallas, Texas, University of Pennsylvania, Philadelphia, Pennsylvania, University of Florida Center for HIV/AIDS Research, Education and Service, Jacksonville, Florida, San Juan Hospital, San Juan, Puerto Rico, Children's Diagnostic and Treatment Center, Fort Lauderdale, Florida, Jacobi Medical Center, Bronx, New York, University of Southern California, Los Angeles, California, SUNY Stony Brook, Stony Brook, New York, and Washington University in St. Louis, St Louis, Missouri; and the George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.

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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Objective: We examined factors associated with telehealth utilization during COVID-19 among adult Medicaid beneficiaries with behavioral health conditions.

Data Sources And Study Setting: NC Medicaid 2019-2021 beneficiary and claims data.

Study Design: This retrospective cohort study examined and compared behavioral health service use pre-COVID-19 (03/01/2019 to 02/28/2020) and during COVID-19 (04/01/2020 to 03/31/2021).

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Importance: A short cervix as assessed by transvaginal ultrasound is an established risk factor for preterm birth. Study findings for a cervical pessary to prevent preterm delivery in singleton pregnancies with transvaginal ultrasound evidence of a short cervix have been conflicting.

Objective: To determine if cervical pessary placement decreases the risk of preterm birth or fetal death prior to 37 weeks among individuals with a short cervix.

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Longitudinal assessment of spiral and uterine arteries in normal pregnancy using novel ultrasound tool.

Ultrasound Obstet Gynecol

December 2023

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA, USA.

Objectives: To use superb microvascular imaging (SMI) to evaluate longitudinally spiral artery (SA) and uterine artery (UtA) vascular adaptation in normal human pregnancy, and to develop reference ranges for use at various gestational ages throughout pregnancy.

Methods: The data for this study were obtained from the National Institutes of Health (NIH)-funded Human Placenta Project. Women aged 18-35 years, with a body mass index < 30 kg/m , without comorbidities, with a singleton gestation conceived spontaneously, and gestational age at or less than 13 + 6 weeks were eligible for inclusion.

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