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Maternal-fetal Medicine

M-A | Prevalence of perinatal depression in low- and middle-income countries

17 Mar, 2023 | 12:49h | UTC

Prevalence of Perinatal Depression in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis – JAMA Psychiatry

 

Commentary on Twitter

 


Cohort Study | Timing of antidepressant discontinuation during pregnancy and postpartum psychiatric outcomes

17 Mar, 2023 | 12:48h | UTC

Timing of Antidepressant Discontinuation During Pregnancy and Postpartum Psychiatric Outcomes in Denmark and Norway – JAMA Psychiatry

 

Commentary on Twitter

 


Study shows increased nuchal translucency can be ascertained using transverse planes

17 Mar, 2023 | 12:45h | UTC

Increased nuchal translucency can be ascertained using transverse planes – American Journal of Obstetrics & Gynecology

Commentary: Transverse Views In Ultrasound Advantageous To Identify Increased Nuchal Translucency: AJOG – Medical Dialogues

 

Commentary on Twitter

 


M-A | Maternal and infant outcomes of pregnancy associated with anti-SSA/RO antibodies

16 Mar, 2023 | 13:15h | UTC

Maternal and infant outcomes of pregnancy associated with anti-SSA/RO antibodies: a systematic review and meta-analysis – Pediatric Rheumatology

 


Circulating microparticle proteins predict pregnancies complicated by placenta accreta spectrum

16 Mar, 2023 | 13:05h | UTC

Circulating microparticle proteins predict pregnancies complicated by placenta accreta spectrum – Scientific Reports

News Release: Researchers Identify blood panel to predict placenta accreta – Brigham and Women’s Hospital

 


RCT | Insulin degludec is noninferior to insulin detemir for the treatment of pregnant women with type 1 diabetes

16 Mar, 2023 | 12:59h | UTC

Insulin degludec versus insulin detemir, both in combination with insulin aspart, in the treatment of pregnant women with type 1 diabetes (EXPECT): an open‑label, multinational, randomised, controlled, non-inferiority trial – The Lancet Diabetes & Endocrinology (link to abstract – $ for full-text)

 


Cohort Study | Risk of interpersonal violence during and after pregnancy among people with schizophrenia

16 Mar, 2023 | 12:56h | UTC

Risk of interpersonal violence during and after pregnancy among people with schizophrenia: a population-based cohort study – Canadian Medical Association Journal

News Release: Pregnant people with schizophrenia have threefold risk of interpersonal violence – Canadian Medical Association Journal

 


Updated recommendations for the use of antiretroviral drugs during pregnancy and interventions to reduce perinatal HIV transmission

15 Mar, 2023 | 15:22h | UTC

Recommendations for the Use of Antiretroviral Drugs During Pregnancy and Interventions to Reduce Perinatal HIV Transmission in the United States – Department of Health and Human Services

Commentary: Antiretroviral Therapy During Pregnancy and Interventions to Reduce Perinatal Transmission: 2023 Recommendations – Journal Watch

 


20 million pregnant women with group B streptococcus carriage: consequences, challenges, and opportunities for prevention

15 Mar, 2023 | 14:53h | UTC

20 million pregnant women with group B streptococcus carriage: consequences, challenges, and opportunities for prevention – Current Opinion in Pediatrics

 


M-A | Pretest probability assessment and D-Dimer are preferred for the initial evaluation of suspected PE in pregnant women

15 Mar, 2023 | 14:50h | UTC

Noninvasive diagnostic work-up for suspected acute pulmonary embolism during pregnancy: a systematic review and meta-analysis of individual patient data – Journal of Thrombosis and Haemostasis

 


RCT | Intrapartum azithromycin fails to reduce neonatal sepsis and death

14 Mar, 2023 | 14:00h | UTC

Summary: This randomized controlled trial aimed to evaluate the effectiveness of administering azithromycin during labor to reduce neonatal sepsis and mortality. The randomized trial involved 11,983 birthing parents and their infants in West Africa.

The study found no significant difference in the incidence of neonatal sepsis or mortality between the azithromycin and placebo groups. On the other hand, the rate of non-invasive infections, including skin infections in newborns, and mastitis and puerperal fever in parents, was lower in the azithromycin group in the following four weeks.

The authors concluded that these results do not support the routine introduction of oral intrapartum azithromycin to reduce neonatal sepsis or mortality. However, it is important to notice that a recent large study published in the New England Journal of Medicine showed conflicting results.

Article: Effect of Intrapartum Azithromycin vs Placebo on Neonatal Sepsis and Death: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)

Commentaries:

Azithromycin during labor doesn’t reduce sepsis, mortality in newborns – CIDRAP

Effect of antibiotics during pregnancy on neonatal sepsis and mortality – MedicalResearch.com

Related study with conflicting results: Azithromycin to Prevent Sepsis or Death in Women Planning a Vaginal Birth – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: Single-dose antibiotic prevents maternal sepsis and death – NIH News

Commentaries:

In large study, a single antibiotic dose slashed rate of sepsis in childbirth – STAT

Dose of azithromycin found to cut risk of maternal death, sepsis in childbirth – CIDRAP

 

Commentary on Twitter

 


Review | Pathogenesis, epidemiology and control of Group A Streptococcus infection

14 Mar, 2023 | 13:38h | UTC

Pathogenesis, epidemiology and control of Group A Streptococcus infection – Nature Reviews Microbiology

 

Commentary on Twitter

 


RCT | Sulfadoxine-pyrimethamine vs. dihydroartemisinin-piperaquine for preventive treatment of malaria in pregnant women in Africa

13 Mar, 2023 | 14:43h | UTC

Effect of monthly intermittent preventive treatment with dihydroartemisinin–piperaquine with and without azithromycin versus monthly sulfadoxine–pyrimethamine on adverse pregnancy outcomes in Africa: a double-blind randomised, partly placebo-controlled trial – The Lancet

Commentary: New antimalarial prevents malaria more effectively than current treatments but does not improve birth outcomes – News Medical / Liverpool School of Tropical Medicine

 


RCT | Vaginal cleansing before unscheduled cesarean delivery did not reduce postoperative infections

10 Mar, 2023 | 14:23h | UTC

Vaginal cleansing before unscheduled cesarean delivery to reduce infection: a randomized clinical trial – American Journal of Gynecology & Obstetrics (link to abstract – $ for full-text)

Related studies with conflicting results:

Systematic Review: Vaginal Preparation with Antiseptics Before Cesarean Section for Preventing Postoperative Infections

Vaginal Cleansing Before Cesarean Delivery: A Systematic Review and Meta-analysis – Obstetrics & Gynecology (link to abstract – $ for full-text)

 

Commentary on Twitter

 


Pregnancy complications linked to long-term mortality in a racially diverse cohort

10 Mar, 2023 | 14:01h | UTC

Pregnancy Complications and Long-Term Mortality in a Diverse Cohort – Circulation

Related:

Adverse Pregnancy Outcomes and Cardiovascular Disease Risk: Unique Opportunities for Cardiovascular Disease Prevention in Women: A Scientific Statement From the American Heart Association – Circulation

Cardiovascular health after menopause transition, pregnancy disorders, and other gynaecologic conditions: a consensus document from European cardiologists, gynaecologists, and endocrinologists – European Heart Journal

Optimizing Prepregnancy Cardiovascular Health to Improve Outcomes in Pregnant and Postpartum Individuals and Offspring: A Scientific Statement From the American Heart Association – Circulation

Adverse pregnancy outcomes and long term risk of ischemic heart disease in mothers: national cohort and co-sibling study – The BMJ

Primary Care–Based Cardiovascular Disease Risk Management After Adverse Pregnancy Outcomes: a Narrative Review – Journal of General Internal Medicine

Pregnancy Complications and Risk of Cardiovascular Disease Later in Life: A Nationwide Cohort Study – Journal of the American Heart Association

Risk and trajectory of premature ischaemic cardiovascular disease in women with a history of pre-eclampsia: a nationwide register-based study – European Journal of Preventive Cardiology

Severity of obstructive coronary artery stenosis after pre-eclampsia – Heart

Preeclampsia and Cardiovascular Disease in a Large UK Pregnancy Cohort of Linked Electronic Health Records: A CALIBER Study – Circulation

Association of Conventional Cardiovascular Risk Factors With Cardiovascular Disease After Hypertensive Disorders of Pregnancy: Analysis of the Nord-Trøndelag Health Study – JAMA Cardiology

All Hypertensive Disorders of Pregnancy Increase the Risk of Future Cardiovascular Disease – Hypertension

Association Between Gestational Hypertension and Risk of Cardiovascular Disease Among 617 589 Norwegian Women – Journal of the American Heart Association

Conjoint Associations of Gestational Diabetes and Hypertension With Diabetes, Hypertension, and Cardiovascular Disease in Parents: A Retrospective Cohort Study – American Journal of Epidemiology

 


Consensus bundle on cardiac conditions in obstetric care

9 Mar, 2023 | 14:14h | UTC

Alliance for Innovation on Maternal Health: Consensus Bundle on Cardiac Conditions in Obstetric Care – Obstetrics & Gynecology

 


RCT | Home telemonitoring vs. hospital care in complicated pregnancies in the Netherlands

9 Mar, 2023 | 13:58h | UTC

Home telemonitoring versus hospital care in complicated pregnancies in the Netherlands: a randomised, controlled non-inferiority trial (HoTeL) – The Lancet Digital Health

 

Commentary on Twitter

 


Position Statement | Telemedicine in obstetrics — quality and safety considerations

8 Mar, 2023 | 14:23h | UTC

Society for Maternal-Fetal Medicine Special Statement: Telemedicine in obstetrics—quality and safety considerations -American Journal of Obstetrics & Gynecology

 

Commentary on Twitter

 


Cohort Study | Early pregnancy exposure to NSAIDs is associated with slightly higher risks of neonatal and maternal adverse outcomes

7 Mar, 2023 | 12:56h | UTC

Summary:

A nationwide cohort study in South Korea, including 1.8 million pregnancies, investigated the association between the use of nonsteroidal anti-inflammatory drugs (NSAIDs) during early pregnancy and neonatal and maternal adverse outcomes.

The study revealed that pregnant women exposed to NSAIDs during early pregnancy were at increased risk of oligohydramnios and had a slightly higher likelihood of having an infant with major congenital malformations and low birth weight. These risks remained elevated when comparing NSAIDs against acetaminophen or past users.

The study suggests that clinicians should weigh the need to prescribe NSAIDs in early pregnancy against the modest but possible risk of neonatal and maternal outcomes and consider prescribing nonselective NSAIDs for <10 days, with continued careful monitoring for any safety signals.

Article: Neonatal and maternal adverse outcomes and exposure to nonsteroidal anti-inflammatory drugs during early pregnancy in South Korea: A nationwide cohort study – PLOS Medicine

 


Severity and impact of accidental bowel leakage two decades after no, one, or two obstetrical sphincter injuries

3 Mar, 2023 | 13:56h | UTC

Summary: This study investigated the long-term severity and subjective impact of anal incontinence among women who had experienced 1 or 2 consecutive obstetrical anal sphincter injuries compared with those without injuries. The study used prospectively registered data and a questionnaire to analyze outcomes, including the frequency of fecal and gas incontinence, the impact on daily life, and the effect on other pelvic floor disorders. The results showed that the severity and impact of anal incontinence doubled and quadrupled in women with 1 or 2 consecutive sphincter injuries, respectively, compared with those without injury. The second sphincter injury had an equally large additive effect compared to the first injury. However, the study found that 1 or 2 sphincter injuries did not affect other pelvic floor disorders or lower urinary tract symptoms compared to women without injury.

Article: Severity and impact of accidental bowel leakage two decades after no, one, or two sphincter injuries – American Journal of Obstetrics & Gynecology

News Release: Decades-long suffering from obstetric injuries – University of Gothenburg

 


Maternal diabetes and overweight as risk factors for congenital heart defects in offspring – A nationwide register study from Finland

3 Mar, 2023 | 13:51h | UTC

Summary: The study aimed to determine the association between maternal diabetes and overweight/obesity and the risk of congenital heart defects (CHDs) in offspring. The study analyzed data from all children born in Finland between 2006 and 2016 and their mothers. Maternal type 1 diabetes (T1DM) was found to be associated with a significantly increased risk for any CHD, with an odds ratio of 3.71, whereas maternal overweight and obesity were associated with only a slightly increased risk for complex defects and left ventricular outflow tract obstruction. Maternal diabetes was responsible for 3.0% of offspring’s CHD, while maternal overweight and obesity were responsible for 0.7%, indicating weaker associations between maternal overweight and obesity and CHD in the offspring than previously reported.

[Preprint] Maternal diabetes and overweight as risk factors for congenital heart defects in offspring – A nationwide register study from Finland – medRxiv

 

Commentary from the author on Twitter

 


M-A | Incidence, indications, risk factors, and outcomes of emergency peripartum hysterectomy worldwide

2 Mar, 2023 | 12:54h | UTC

Incidence, Indications, Risk Factors, and Outcomes of Emergency Peripartum Hysterectomy Worldwide: A Systematic Review and Meta-analysis – Obstetrics & Gynecology

 


Cohort Study | Association between marked fetal heart rate variability and neonatal acidosis

2 Mar, 2023 | 12:44h | UTC

Association between marked fetal heart rate variability and neonatal acidosis: A prospective cohort study – BJOG

Commentary: Marked variability associated with twofold increased risk of neonatal acidosis: BJOG

 


WHO Report | A woman dies every two minutes due to pregnancy or childbirth

28 Feb, 2023 | 14:04h | UTC

Summary: This new report by United Nations agencies shows that a woman dies every two minutes due to pregnancy or childbirth. The report covers maternal deaths from 2000 to 2020 and reveals that maternal deaths either increased or stagnated in nearly all regions of the world, with some regions experiencing major setbacks. The poorest parts of the world and countries affected by conflict continue to have the highest rates of maternal deaths. Severe bleeding, high blood pressure, pregnancy-related infections, complications from unsafe abortion, and underlying conditions aggravated by pregnancy are the leading causes of maternal deaths, which are largely preventable and treatable with access to high-quality healthcare. The COVID-19 pandemic may have further held back progress on maternal health. The report calls for urgent action to ensure every woman and girl has access to critical health services before, during, and after childbirth, so they can fully exercise their reproductive rights.

News Release: A woman dies every two minutes due to pregnancy or childbirth: UN agencies – World Health Organization

Report: Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division – World Health Organization

Commentaries:

Ambitious goal to slash maternal deaths in jeopardy – Nature

U.N.: Progress on reducing global maternal mortality has stalled since 2015 – STAT

Eight Hundred Women Die Every Day During Pregnancy or Childbirth – Health Policy Watch

 


M-A | Adverse perinatal outcomes associated with antiretroviral therapy in women living with HIV

27 Feb, 2023 | 12:48h | UTC

Adverse perinatal outcomes associated with antiretroviral therapy in women living with HIV: A systematic review and meta-analysis – Frontiers in Medicine

 


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