Maternal-fetal Medicine
Review | Pre-eclampsia
27 Feb, 2023 | 12:47h | UTCPre-eclampsia – Nature Reviews Disease Primers (if the link is paywalled, try this one)
RCT | Aspirin discontinuation at 24 to 28 weeks’ gestation in pregnancies at high risk of preterm preeclampsia
24 Feb, 2023 | 13:56h | UTCArticle: Aspirin Discontinuation at 24 to 28 Weeks’ Gestation in Pregnancies at High Risk of Preterm Preeclampsia: A Randomized Clinical Trial – JAMA (free for a limited period)
Editorial: Biomarkers and the Risk of Preeclampsia – JAMA (free for a limited period)
Commentary on Twitter
Aspirin discontinuation at 24 to 28 weeks of gestation was noninferior to aspirin continuation for preventing preterm preeclampsia in pregnant individuals at high risk of preeclampsia and a normal sFlt-1:PlGF ratio. https://t.co/6yIBsfxwU5 pic.twitter.com/RGqQLvb20l
— JAMA (@JAMA_current) February 21, 2023
SR | Antenatal dietary supplementation with myo‐inositol for preventing gestational diabetes
24 Feb, 2023 | 13:45h | UTCSummary: The article discusses the effectiveness of myo-inositol, a naturally occurring sugar, as a dietary supplement for preventing gestational diabetes in pregnant women. The review included seven randomized controlled trials, with a total of 1319 women who were 10 to 24 weeks pregnant at the start of the studies. The results showed that myo-inositol may reduce the incidence of gestational diabetes, hypertensive disorders of pregnancy, and preterm birth, but there was limited data on other outcomes, such as perinatal mortality and serious infant morbidity. The certainty of the evidence was low to very low due to small sample sizes, inconsistency in doses and timing of administration, and lack of data from diverse populations. The authors suggest that further well-designed studies are needed to assess the effectiveness of myo-inositol in preventing gestational diabetes and improving other health outcomes for mothers and their babies.
Cohort Study | Association of large-for-gestational age birth and prediabetes/diabetes 10-14 years’ postpartum
24 Feb, 2023 | 13:43h | UTCSummary: Several studies show that women who develop diabetes during pregnancy are at increased risk of developing diabetes later in life. This study investigated whether giving birth to a larger-than-normal baby is associated with an increased risk of prediabetes or diabetes 10-14 years after pregnancy in individuals without gestational diabetes. The study used data from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Follow-up Study, including pregnant individuals without gestational diabetes. After adjusting for various baseline maternal characteristics, the researchers found that individuals who gave birth to a large-for-gestational age (LGA) infant had a 21% higher risk of being diagnosed with prediabetes or diabetes 10-14 years after delivery compared to those who had an appropriate-for-gestational age (AGA) infant. The study concluded that having a previous LGA infant is a marker of increased risk of developing prediabetes or diabetes in individuals without gestational diabetes.
Abstract: Association of large-for-gestational age birth and prediabetes/diabetes 10-14 years’ postpartum in the HAPO follow-up study – American Journal of Obstetrics & Gynecology (link to abstract, presented at the Society for Maternal-Fetal Medicine’s annual meeting)
Commentaries:
Delivering a Plus-Sized Baby Could Be Sign of Diabetes Risk – HealthDay
Large for Gestational Age Births Could Increase Diabetes Risk in Women – HCP Live
M-A | Pregnancy outcomes in Takayasu arteritis patients
24 Feb, 2023 | 13:40h | UTCSummary: The systematic review and meta-analysis examined the data from 27 studies with 825 pregnancies and found that pregnant women with Takayasu arteritis (TA) are at higher risk for adverse pregnancy outcomes; 37% developed hypertension, 14% developed pre-eclampsia, and the occurrence of miscarriage was 16%. High disease activity during pregnancy, renal artery involvement, and history of hypertension were identified as risk factors, while maternal age or prolonged disease duration did not pose a risk. The most common treatments were corticosteroids, anti-hypertensive agents, low-dose aspirin, and azathioprine. The study was limited by the heterogeneity of the included studies and the lack of large-scale prospective case-control studies, indicating the need for further research.
ISUOG Practice Guidelines | Performance of 11–14-week ultrasound scan
23 Feb, 2023 | 13:35h | UTC
Cohort Study | Pre-pregnancy migraine linked to a higher risk of adverse pregnancy outcomes
23 Feb, 2023 | 13:31h | UTCSummary: This study investigated the relationship between migraine and adverse pregnancy outcomes. Researchers examined data from the Nurses’ Health Study II, which included 30,555 pregnancies from 19,694 women. Pre-pregnancy migraine was associated with a higher risk of preterm delivery, gestational hypertension, and preeclampsia. Migraine with aura was associated with a higher preeclampsia risk than migraine without aura. However, migraine was not associated with low birth weight or gestational diabetes mellitus. The study suggests that migraine history, and to a lesser extent, migraine phenotype, could be useful in identifying women at risk of pregnancy complications. Regular aspirin use prior to pregnancy was associated with a lower risk of preterm delivery for women with migraine, but randomized trials are needed to evaluate this hypothesis.
Article: Prepregnancy Migraine, Migraine Phenotype, and Risk of Adverse Pregnancy Outcomes – Neurology (link to abstract – $ for full-text)
News Release: Migraine associated with increased risk for pregnancy complications – Brigham and Women’s Hospital
Commentary: Prepregnancy Migraine Tied to Adverse Pregnancy Outcomes – HealthDay
AHA Scientific Statement | Anesthetic care of the pregnant patient with cardiovascular disease
20 Feb, 2023 | 12:29h | UTCSummary: The AHA emphasizes the need for specialized cardio-obstetric anesthesiology care for pregnant patients with cardiovascular disease, involving a multidisciplinary team of obstetricians, cardiologists, anesthesiologists, and other specialists as needed. The approach includes preoperative evaluation, intraoperative management, and postoperative care to maintain maternal hemodynamic stability, optimize oxygen delivery to the fetus, and avoid factors that exacerbate cardiovascular disease. Vaginal delivery with effective neuraxial analgesia is the preferred mode of delivery, with cesarean delivery used for obstetrical indications or high-risk patients. Specific recommendations are also provided for the management of patients with different types of cardiovascular disease, including congenital heart disease, valvular heart disease, pulmonary hypertension, and hypertrophic cardiomyopathy.
Top Things to Know: Statement on the anesthetic care of the pregnant patient with cardiovascular disease – American Heart Association
10-year follow-up on preterm prelabor rupture of membranes: induced labor vs. expectant management childhood outcomes
16 Feb, 2023 | 15:05h | UTCSummary: This study aimed to compare the long-term outcomes of children born after singleton pregnancies complicated by preterm prelabor rupture of membranes and managed by induction of labor vs. expectant management in RCTs undergone between 2007 and 2011. The study assessed the children’s cognition, motor function, and behavior as the primary outcomes. It found that expectant management did not improve long-term outcomes compared to induction of labor for children born after pregnancies with preterm prelabor (between 34 0/7 and 36 6/7 weeks of pregnancy) rupture of membranes. The confidence in the results of this follow-up study is diminished because only 35% of the children who participated in the original trials participated in the follow-up study.
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
AHA Statement | Optimizing prepregnancy cardiovascular health improves outcomes for pregnant women, offspring
15 Feb, 2023 | 16:14h | UTCSummary: This statement highlights the need to optimize cardiovascular health before pregnancy to reduce the risk for adverse pregnancy outcomes and cardiovascular disease in mothers and children. It emphasizes the role of clinicians in promoting early cardiovascular health, clinical trials to investigate interventions, and the use of a life course framework to monitor health. By targeting cardiovascular health before pregnancy, interventions can improve health outcomes across generations.*
News Release: Does risk for heart disease start before birth? – American Heart Association
*Note: This summary was created through the collaboration of a medical editor and ChatGPT.
SR | The effect of parental leave on parents’ mental health
15 Feb, 2023 | 15:44h | UTCInvited Commentary: Paid parental leave and mental health: the importance of equitable policy design – The Lancet Public Health
News Release: Generous parental leave schemes protect against poorer mental health – Stockholm University / News Medical
Cohort Study | In utero exposure to ADHD medication does not seem to result in worse offspring neurodevelopmental outcomes
14 Feb, 2023 | 10:54h | UTCSummary: The authors conducted a study to investigate the long-term effects of in utero exposure to ADHD medication (methylphenidate, amphetamine, dexamphetamine, lisdexamphetamine, modafinil, atomoxetine, clonidine) on offspring. The study followed 1,068,073 liveborn singletons from 1998 to 2018 and compared the outcomes of children whose mothers continued or discontinued ADHD medication during pregnancy. The main outcomes were neurodevelopmental psychiatric disorders, impairments in vision or hearing, epilepsy, seizures, or growth impairment during childhood or adolescence. After adjustment for demographic and psychiatric characteristics of the mother, no increased risk of any developmental disorders was found in offspring exposed to ADHD medication compared to those not exposed. The results provide reassurance for women with ADHD who depend on medication and consider continuing it during pregnancy.
(By ChatGPT, reviewed and edited)
Article: In utero exposure to ADHD medication and long-term offspring outcomes – Molecular Psychiatry (link to abstract – $ for full-text)
Commentary from the author on Twitter (thread – click for more)
In-utero exposure to ADHD medication is not associated with long-term adverse neurodevelopmental disorders and growth restriction in the offspring.
Read the thread below 🧵on our new paper just published in @molpsychiatry
👉 https://t.co/MKZ0aeFnhU#ADHD— Kathrine Bang Madsen (@Kathrine_BaMa) February 9, 2023
Stillbirth after adolescent and young adult cancer: a population-based study
14 Feb, 2023 | 10:33h | UTCCommentary: Previous Cancer Treatment Not Tied to Higher Stillbirth Rate – HealthDay
RCT | Testing equivalence of two doses of intravenous iron to treat iron deficiency in pregnancy
14 Feb, 2023 | 10:31h | UTC
Development of a machine learning model for sonographic assessment of gestational age
14 Feb, 2023 | 10:30h | UTCCommentary: AI Models Have Higher Accuracy for Estimating Gestational Age – HealthDay
RCT | Azithromycin reduces the risk of maternal sepsis or death in women planning a vaginal birth
13 Feb, 2023 | 13:02h | UTCAzithromycin 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
The Lancet Series | Breastfeeding 2023
13 Feb, 2023 | 12:52h | UTCHomepage: Breastfeeding 2023 – The Lancet
Editorial: Unveiling the predatory tactics of the formula milk industry
Breastfeeding: crucially important, but increasingly challenged in a market-driven world
Marketing of commercial milk formula: a system to capture parents, communities, science, and policy
Commentaries:
Expert reaction to review of formula baby milk – Science Media Centre
US infant pertussis incidence trends before and after implementation of the maternal Tdap vaccine
13 Feb, 2023 | 12:38h | UTCUS Infant Pertussis Incidence Trends Before and After Implementation of the Maternal Tetanus, Diphtheria, and Pertussis Vaccine – JAMA Pediatrics (free for a limited period)
Commentary: Maternal Tdap Vaccination Protects Youngest Infants From Pertussis – HealthDay
Commentary on Twitter
Study findings suggest that maternal #Tdap vaccination is associated with a reduction in #pertussis among infants younger than 2 months, the strategy’s target age group. https://t.co/a5h3z2zXY2
— JAMA Pediatrics (@JAMAPediatrics) February 7, 2023
POTS and Pregnancy: a review of literature and recommendations for evaluation and treatment
10 Feb, 2023 | 13:37h | UTC
Cohort Study | Adverse pregnancy outcomes and long-term risk of ischemic heart disease in mothers
9 Feb, 2023 | 14:02h | UTCNews Release: Five major adverse pregnancy outcomes associated with long term risks of ischemic heart disease – News Medical/BMJ
Commentary: Complications during pregnancy linked to a higher risk of heart disease, study finds – CNN
Related:
AHA Scientific Statement | Adverse Pregnancy Outcomes and Cardiovascular Disease Risk
Cohort Study: Preeclampsia and Cardiovascular Disease
All Hypertensive Disorders of Pregnancy Increase the Risk of Future Cardiovascular Disease
Gestational Hypertension and Future Risk of Cardiovascular Disease
RCT | Pregnancy and neonatal safety of PrEP for HIV prevention initiated during pregnancy vs. afterwards
9 Feb, 2023 | 13:55h | UTCPregnancy and neonatal safety outcomes of timing of initiation of daily oral tenofovir disoproxil fumarate and emtricitabine pre-exposure prophylaxis for HIV prevention (CAP016): an open-label, randomised, non-inferiority trial – The Lancet HIV (link to abstract – $ for full-text)
Guideline | Fetal monitoring in labor
9 Feb, 2023 | 13:48h | UTCFetal monitoring in labour – National Institute for Health and Care Excellence
Guideline | Intrapartum care for healthy women and babies
9 Feb, 2023 | 13:49h | UTCIntrapartum care for healthy women and babies – National Institute for Health and Care Excellence
Review | The role of MRI in the diagnosis and prognostic evaluation of fetuses with congenital diaphragmatic hernia
9 Feb, 2023 | 13:40h | UTC
RCT | Outcomes in children of women with type 2 diabetes exposed to metformin vs. placebo during pregnancy
8 Feb, 2023 | 12:32h | UTCOutcomes in children of women with type 2 diabetes exposed to metformin versus placebo during pregnancy (MiTy Kids): a 24-month follow-up of the MiTy randomised controlled trial – The Lancet Diabetes & Endocrinology (link to abstract – $ for full-text)