bluuebunny/crossref_metadata_2025_split huggingface dataset:
Planned Mode of Delivery of Preterm Twins and Neonatal and 2-Year Outcomes
Authors: Sentilhes Loïc , Lorthe Elsa , Marchand-Martin Laetitia , Marret Stéphane , Ancel Pierre-Yves , Delorme Pierre , Goffinet François , Quere Mathilde , Kayem Gilles ,   for the Etude Epidémiologique sur les Petits Ages Gestationnels (EPIPAGE) 2 Obstetric Writing Group
Published: December 2018

OBJECTIVE:
To assess neonatal and 2-year outcomes for preterm twins born after planned vaginal delivery compared with planned cesarean delivery.

METHODS:
Women with preterm cephalic first twins delivered after preterm labor or preterm prelabor rupture of membranes from 24 0/7 to 34 6/7 weeks of gestation, with both fetuses alive at the beginning of labor, were identified from the national prospective population-based Etude Epidémiologique sur les Petits Ages Gestationnels 2 cohort study. Planned vaginal delivery was defined as vaginal delivery or cesarean delivery performed during labor. Planned cesarean delivery was considered if performed during labor for the indication of preterm twins or before labor whatever the indication. A propensity score analysis was used to compare planned vaginal delivery and planned cesarean delivery. Outcomes analyzed separately for the first and second twins were survival at discharge, survival at discharge without severe morbidity, and survival at 2 years of corrected age without neurosensory impairment.

RESULTS:
Among the 932 women with a twin pregnancy, 549 were excluded mainly as a result of the first twin in noncephalic presentation, cause of delivery other than preterm labor or preterm prelabor rupture of membranes, at least one twin died before labor, and gestational age at delivery less than 24 weeks of gestation. The planned vaginal delivery group included 276 women and the planned cesarean delivery group 107. For first and second twins, survival at discharge (97.7% vs 98.3% and 95.6% vs 97.1%, respectively), survival at discharge without severe morbidity (91.6% vs 88.8% and 90.3% vs 84.5%, respectively), and survival at 2 years of corrected age without neurosensory impairment (96.0% vs 95.4% and 92.9% vs 90.8%, respectively) did not differ significantly between the planned vaginal delivery and planned cesarean delivery groups. Propensity score analysis showed that planned cesarean delivery was not associated with improved outcomes with the caveat that the infrequency of death and disability limited the statistical power of the study to detect potentially clinically meaningful differences between planned modes of delivery.

CONCLUSION:
Planned cesarean delivery for women in preterm labor or with preterm prelabor rupture of membranes was not associated with improved neonatal outcomes or 2-year outcomes.
Obstetrician–Gynecologists' Strategies to Address Vaccine Refusal Among Pregnant Women
Authors: O'Leary Sean T. , Riley Laura E. , Lindley Megan C. , Allison Mandy A. , Albert Alison P. , Fisher Allison , Jiles Angela J. , Crane Lori A. , Hurley Laura P. , Beaty Brenda , Brtnikova Michaela , Kempe Allison 
Published: December 2018

OBJECTIVE:
To describe 1) obstetrician–gynecologists' (ob-gyns’) perceptions of the frequency of vaccine refusal among pregnant patients and perceived reasons for refusal and 2) ob-gyns’ strategies used when encountering vaccine refusal and perceived effectiveness of those strategies.

METHODS:
We conducted an email and mail survey among a nationally representative network of ob-gyns from March 2016 to June 2016.

RESULTS:
The response rate was 69% (331/477). Health care providers perceived that pregnant women more commonly refused influenza vaccine than tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine: 62% of respondents reported 10% or greater of pregnant women they care for in a typical month refused influenza vaccine compared with 32% reporting this for Tdap vaccine. The most commonly reported reasons for vaccine refusal were patients' belief that influenza vaccine makes them sick (48%), belief they are unlikely to get a vaccine-preventable disease (38%), general worries about vaccines (32%), desire to maintain a natural pregnancy (31%), and concern that their child could develop autism as a result of maternal vaccination (25%). The most commonly reported strategies ob-gyns used to address refusal were stating that it is safe to receive vaccines in pregnancy (96%), explaining that not getting the vaccine puts the fetus or newborn at risk (90%), or that not getting the vaccine puts the pregnant woman's health at risk (84%). The strategy perceived as most effective was stating that not getting vaccinated puts the fetus or newborn at risk.

CONCLUSION:
Ob-gyns perceive vaccine refusal among pregnant women as common and refusal of influenza vaccine as more common than refusal of Tdap vaccine. Emphasizing the risk of disease to the fetus or newborn may be an effective strategy to increase vaccine uptake.
Effects of Two Educational Posters on Contraceptive Knowledge and Intentions
Authors: Anderson Seri , Frerichs Leah , Kaysin Alexander , Wheeler Stephanie B. , Halpern Carolyn Tucker , Lich Kristen Hassmiller 
Published: December 2018

OBJECTIVE:
To compare the Centers for Disease Control and Prevention's (CDC) contraceptive effectiveness poster with a more patient-centered poster on factors affecting the likelihood of using effective contraceptives.

METHODS:
The posters were tested in a randomized controlled trial. Women were eligible if they were aged 18–44 years, could speak and read English, were not pregnant or trying to conceive, and had engaged in vaginal intercourse in the past 3 months. An online survey administered through Amazon Mechanical Turk was used to collect baseline and immediate follow-up data on three primary outcomes: contraceptive knowledge (measured using the Contraceptive Knowledge Assessment), perceived pregnancy risk, and the effectiveness of the contraceptive the woman intended to use in the next year. Subgroup analyses were conducted in women with prior pregnancy scares, low numeracy, and no current contraceptive. Within- and between-group differences were compared for the two randomized groups.

RESULTS:
From January 26 to February 13, 2018, 2,930 people were screened and 990 randomized. For the primary outcomes, the only significant result was that the patient-centered poster produced a greater improvement in contraceptive knowledge than the CDC poster (P<.001). Relative to baseline, both posters significantly improved contraceptive knowledge (CDC +3.6, patient-centered +6.4 percentage points, P<.001) and a constructed score measuring the effectiveness of the contraceptive that women intended to use in the next year (CDC and patient-centered +3 percentage points, P<.01). This is equivalent to 1–17 of every 100 women who viewed a poster changing their intentions in favor of a more effective contraceptive.

CONCLUSION:
This study suggests that both posters educate women about contraception and may reduce unplanned pregnancy risk by improving contraceptive intentions. Of the three primary outcomes, the patient-centered poster performs significantly better than the CDC poster at increasing contraceptive knowledge.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT03372369.
Cohort Analysis of Immigrant Rhetoric on Timely and Regular Access of Prenatal Care
Authors: Chu Derrick M. , Aagaard Joshua , Levitt Ryan , Whitham Megan , Mastrobattista Joan , Rac Martha , Eppes Catherine , Gandhi Manisha , Belfort Michael A. , Aagaard Kjersti M. 
Published: December 2018

OBJECTIVE:
To assess whether recent anti-immigration rhetoric is significantly associated with inadequate prenatal care.

METHODS:
This was a population-based cohort study (2011–2017). In their native language, patients were consented and queried regarding country of origin and time in the United States. Additional variables were collected or abstracted from the medical record, including documentation and timing of prenatal visits. Based on relevance and prevalence during the study period, publicly available Google search trends were mined for the terms “Make America Great Again,” “Mexico Wall,” and “Deportation” by geographic region. The time of first deviation from the mode Google search popularity value for each term was ascertained (mode inflection date). Perinatal data was averaged over 15 days moving windows, and the Adequacy of Prenatal Care Utilization Index was used to categorically define inadequate prenatal care by validated standards.

RESULTS:
Twenty-four thousand nine hundred thirty-three deliveries occurred during the study period. A mode inflection date was extrapolated from Google trend analytics and used to define the period before change in trends use pre (before rhetoric) and post (after rhetoric). Coincident to the rhetoric change, there was a significant increase in days until the first prenatal visit, fewer prenatal visits, and a decreased trend of mean hemoglobin nadir among U.S. non-native Hispanic women (P<.001). Immigrant status was an independent predictor of inadequate prenatal care as defined by the Adequacy of Prenatal Care Utilization Index standard, with increased adjusted odds among Hispanic women (adjusted odds ratio 1.581, 95% CI 1.407–1.777 [1.4–1.8]) coincident with anti-immigration rhetoric.

CONCLUSION:
Our findings are of likely significant public health importance and suggest that recent anti-immigrant rhetoric is associated with adequate, timely, and regular access to prenatal care among nearly 25,000 deliveries in Houston, Texas.
Prenatal Marijuana Use by Self-Report and Umbilical Cord Sampling in a State With Marijuana Legalization
Authors: Metz Torri D. , Silver Robert M. , McMillin Gwendolyn A. , Allshouse Amanda A. , Jensen Triniti L. , Mansfield Chanel , Heard Kennon , Kinney Gregory L. , Wymore Erica , Binswanger Ingrid A. 
Published: December 2018

OBJECTIVE:
To compare self-reported maternal marijuana use with quantitative biological sampling for a marijuana metabolite, 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid, in umbilical cord homogenate in a state with legalized marijuana.

METHODS:
We conducted a cross-sectional study of women approached at the time of admission for delivery with live, singleton pregnancies at 24 weeks of gestation or greater at two urban medical centers in Colorado. Maternal marijuana use was estimated by 1) report to a health care provider on admission history and physical, 2) survey of self-reported use, and 3) liquid chromatography–tandem mass spectrometry analysis of umbilical cord homogenate for 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid. Women were categorized by survey-reported last use (30 days ago or less, 30 days to 1 year, more than 1 year, never) and proportion of women with cord results above the limit of detection and limit of quantification for 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid was reported for each group. Comparisons between groups were made using contingency tables. Correlation between survey-reported frequency of use and quantitative 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid cord homogenate results was evaluated.

RESULTS:
We included 116 women with self-report surveys linked to cord assay results. Six percent (95% CI 2.5–12.0%) of participants reported use in the past 30 days on survey and 2.6% (95% CI 0.5–7.4%) of participants reported marijuana use to health care providers. On umbilical cord assay, 22.4% (95% CI 15.2–31.1%) had detectable 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid. The proportion of women with detectable 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid increased with more recent self-reported use. Survey-reported frequency of use in the past 30 days had moderate correlation with quantified umbilical cord 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid (correlation coefficient 0.44, 95% CI 0.28–0.58, P<.001).

CONCLUSION:
Umbilical cord sampling results in higher estimates of prenatal marijuana use than self-report even in the setting of legalization. Umbilical cord assays for 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid demonstrate promise for quantifying use. Future studies should examine how the use of biological sampling informs the association between marijuana use and perinatal outcomes.
Reproductive Health Care in Catholic Facilities
Authors: Thorne Nichole B. , Soderborg Taylor K. , Glover Jacqueline J. , Hoffecker Lilian , Guiahi Maryam 
Published: December 2018

OBJECTIVE:
Given the rise in Catholic ownership of U.S. health care facilities, we aimed to examine reproductive health care provision and patient outcomes. We performed a scoping review, which maps the literature and considers inclusion of studies that are not specifically quantitative.

DATA SOURCES:
We searched five databases (MEDLINE, EMBASE, Web of Science and Cochrane Library, ClinialTrials.gov) from inception through August 2018 using terms related to reproductive health care and religion.

METHODS OF STUDY SELECTION:
We screened 2,906 studies. Articles were included if in English, included primary research data, and referenced U.S.-based Catholic facilities. We reviewed the reference lists of included articles. We excluded articles that addressed the relationship of patient or health care provider religion to provision of reproductive services, described reproductive health care services in non-Catholic facilities, or reported legal cases or concerns. Two independent reviewers screened all citations, a third reviewer resolved differences, and all three reviewers categorized included citations.

TABULATION, INTEGRATION, AND RESULTS:
We included 27 studies. Investigators most commonly focused on the provision of emergency contraception (n=9) or other contraceptive and sterilization methods (n=7); few focused on a range of family planning methods (n=3), natural family planning (n=2), ectopic pregnancy management (n=2), abortion care (n=2), miscarriage management (n=1), and infertility care (n=1). The most common study designs were cross-sectional (18/27 [67%]) and qualitative investigations (6/27 [22%]). Common data collection approaches included surveys, interviews, and mystery caller designs. Two studies involved authors with Catholic hospital affiliations and one of these reported patient outcomes; no other patient outcome reports were found. Studies cited restrictions to care in comparison with non-Catholic settings and multisite studies demonstrated variable rates of provision of reproductive health services across Catholic sites.

CONCLUSIONS:
Despite the significant proportion and recent growth of Catholic health care within the U.S. health care sector, little is known about reproductive health outcomes in these settings and in comparison with other settings.
Ultrasound-Guided Transcervical Ablation of Uterine Leiomyomas
Authors: Chudnoff Scott , Guido Richard , Roy Kelly , Levine David , Mihalov Linda , Garza-Leal José Gerardo 
Published: December 2018

OBJECTIVE:
To evaluate the 12-month safety and effectiveness of transcervical ablation for the treatment of symptomatic uterine leiomyomas.

METHODS:
In this prospective, multicenter, single-arm interventional trial, transcervical ablation was performed on 1–10 leiomyomas per patient with leiomyoma diameters ranging from 1 to 5 cm. Treated leiomyomas included all nonpedunculated types. Coprimary endpoints assessed at 12 months were reduction in menstrual blood loss and absence of surgical reintervention. Additional assessments included symptom severity, quality of life, patient satisfaction, reductions in uterine and leiomyoma volumes, and safety.

RESULTS:
One hundred forty-seven patients were enrolled and treated in the United States and Mexico. The study met its coprimary endpoints at 12 months (N=143; full analysis set), because 64.8% of patients (95% CI 56.3–72.6%) experienced 50% or greater reduction in menstrual bleeding and 99.3% of patients (95% CI 95.1–99.9%) were free from surgical reintervention. The mean pictorial blood loss assessment chart score decreased by 38.9%, 48.4%, and 51.1% at 3, 6, and 12 months, respectively (P<.001), and 95.1% of patients experienced a reduction in menstrual bleeding at 12 months. There were significant mean improvements in symptom severity and health-related quality of life of 32.1 points and 43.7 points, respectively, at 12 months (all P<.001). Mean maximal leiomyoma volume reduction per patient was 62.4% (P<.001). More than half of patients returned to normal activity within 1 day, 96.3% of patients reported symptom improvement at 12 months, and 97% expressed satisfaction with the treatment at 12 months. There were no device-related adverse events.

CONCLUSION:
Transcervical ablation was associated with a significant reduction in leiomyoma symptoms with no device-related adverse events and a low surgical reintervention rate through 12 months, demonstrating its potential to safely and effectively treat all nonpedunculated leiomyoma types through a uterus-conserving, incisionless approach.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT02228174.
Funding Source: Supported by Gynesonics, Inc.
Five-Year Contraceptive Efficacy and Safety of a Levonorgestrel 52-mg Intrauterine System
Authors: Teal Stephanie B. , Turok David K. , Chen Beatrice A. , Kimble Thomas , Olariu Andrea I. , Creinin Mitchell D. 
Published: December 2018

OBJECTIVE:
To assess the 5-year contraceptive efficacy and safety of a levonorgestrel (LNG) 52-mg intrauterine system (IUS) from an ongoing 10-year phase 3 contraceptive trial.

METHODS:
Study investigators enrolled 1,751 nulliparous and parous females aged 16–45 years and desiring contraception to receive a novel LNG 52-mg IUS at 29 centers in the United States, including reproductive health clinics, private offices, and university centers. Participants had scheduled follow-up visits four times during the first year. After year 1, study visits occurred every 6 months, with phone contact at the 3-month point between visits. We assessed the primary outcome of pregnancy rate (Pearl Index) in females aged 16–35 years at enrollment through 60 months. The safety evaluation included all females for their entire duration of participation.

RESULTS:
The 1,751 enrollees included 1,600 females aged 16–35 years and 151 aged 36–45 years. Successful IUS placement occurred in 1,714 (97.9%) participants. At the time of the data evaluation, 495 participants finished 5 years and 176 had entered the seventh year of IUS use. Nine pregnancies occurred, six of which were ectopic. The Pearl Indices for years 1 and 5 were 0.15 (95% CI 0.02–0.55) and 0.20 (95% CI 0.01–1.13) pregnancies per 100 women-years, respectively. The cumulative life-table pregnancy rate was 0.92% (0.46–1.82%) through 5 years. Participants aged 16–35 years at enrollment were significantly more likely to report new or worsening acne, dyspareunia, pelvic pain, and dysmenorrhea; participants aged 36–45 years at enrollment were more likely to report new or worsening weight increase. Discontinuation for adverse events occurred in 322 (18.8%) participants, most commonly related to expulsion (n=65 [3.8%]). Only 39 (2.2%) IUS users discontinued as a result of bleeding symptoms. Pelvic infection was diagnosed in 14 (0.8%) participants.

CONCLUSION:
This LNG 52-mg IUS is highly effective and safe over 5 years of use in U.S. females.

CLINICAL TRIAL REGISTRATION:

Clinicaltrials.gov, NCT00995150.

FUNDING SOURCE:
Medicines360.
Comparison of Corneal Epithelial Remodeling Over 2 Years in LASIK Versus SMILE: A Contralateral Eye Study
Authors: Kanellopoulos Anastasios J. 
Published: December 2018

Purpose:
To evaluate 3-dimensional epithelial remodeling in patients undergoing myopic laser in situ keratomileusis (LASIK) versus small incision lenticule extraction (SMILE).

Methods:
In a prospective randomized contralateral eye study of LASIK versus SMILE procedures, 21 consecutive patients (42 eyes) were evaluated with corneal epithelial mapping by anterior segment optical coherence tomography for up to 2 years.

Results:
In the LASIK group, central epithelial thickness increased from 52.38 ± 2.57 μm to 57.00 ± 4.23 μm and remained almost stable at this level for up to 24 months. In the SMILE eyes, it increased from 52.52 ± 3.01 μm to 57.15 ± 4.57 μm and also remained stable for up to 24 months. Both techniques created the same level of epithelial thickness increase and variation, with a significantly higher mid-peripheral epithelial thickness increase. The differences between the preoperative and postoperative changes were found statistically significant, but not different between the 2 techniques at any given time studied.

Conclusions:
Both LASIK and SMILE resulted in significant epithelial thickening. This response seemed to be surprisingly quite similar between the 2 different techniques. This study suggests that epithelial remodeling may correlate with relative curvature changes resulting after both techniques, rather than the obvious difference of subepithelial corneal denervation changes.
Brief Report: Durability of the Effect of Financial Incentives on HIV Viral Load Suppression and Continuity in Care: HPTN 065 Study
Authors: El-Sadr Wafaa M. , Beauchamp Geetha , Hall H. Irene , Torian Lucia V. , Zingman Barry S. , Lum Garret , Elion Richard A. , Buchacz Kate , Burns David , Zerbe Allison , Gamble Theresa , Donnell Deborah J. ,   for the HPTN 065 Study
Published: December 2018

Background:
Results from the HPTN 065 study showed that financial incentives (FI) were associated with significantly higher viral load suppression and higher levels of engagement in care among patients at HIV care sites randomized to FI versus sites randomized to standard of care (SOC). We assessed HIV viral suppression and continuity in care after intervention withdrawal to determine the durability of FI on these outcomes.

Setting:
A total of 37 HIV test and 39 HIV care sites in the Bronx, New York, and Washington, DC, participated in the study.

Methods:
Laboratory data reported to the US National HIV Surveillance System were used to determine site-level viral suppression and continuity in care outcomes. Postintervention effects were assessed for the 3 quarters after discontinuation of FI. Generalized estimation equations were used to compare FI and SOC site-level outcomes after intervention withdrawal.

Results:
After FI withdrawal, a trend remained for an increase in viral suppression by 2.7% (−0.3%, 5.6%, P = 0.076) at FI versus SOC sites, decreasing from the 3.8% increase noted during implementation of the intervention. The significant increase in continuity in care during the FI intervention was sustained after intervention with 7.5% (P = 0.007) higher continuity in care at FI versus SOC sites.

Conclusions:
After the withdrawal of FI, findings at the 9-months postintervention withdrawal from this large study showed evidence of durable effects of FI on continuity in care, with trend for continued higher viral suppression. These findings are promising for adoption of such interventions to enhance key HIV-related care outcomes.