bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Epidural Analgesia During L&D With Autism Spectrum Disorder in Offspring
Authors: Hanley G.E. , Bickford C. , Ip A. , Lanphear N. , Lanphear B. , Weikum W. , Zwaigenbaum L. , Oberlander T.F. 
Published: June 2022

(JAMA. 2021;326:1178–1185)
Although epidural analgesia is a common and safe modality for pain relief during labor and delivery, few studies have examined long-term outcomes. Since 2000 the diagnosis of Autism Spectrum Disorder (ASD) in children has increased from 1 in 150 to 1 in 54 in 2016 in the United States. Inconsistent and conflicting studies have suggested there may be a relationship between epidural analgesia and a later diagnosis of ASD. Considering epidural analgesia use is reported at 57% in Canada and higher than 70% in the United States, millions of newborns in both countries could be impacted. The aim of this population-based study of British Columbia, Canada evaluated the association between ASD in offspring and maternal epidural analgesia use during delivery.
Labor Epidural Analgesia and Autism Spectrum Disorder: Is There an Association?
Authors: Wong C. , Stevens H. 
Published: June 2022

(JAMA. 2021;326:1155–1157)
Autism spectrum disorder (ASD) is a disorder with known genetic and environmental factors. These factors include birth complications, maternal preeclampsia, obesity, diabetes, prenatal exposure to anticonvulsants, prenatal exposure to asthma medications, and prematurity. Most researchers conclude that an increase in the diagnosis of ASD throughout the years can be attributed to the increased awareness of ASD, but some question whether factors causing or contributing to ASD are going undetected.
Intravenous Oxytocin Dosing Regimens for Postpartum Hemorrhage Prevention Following Cesarean Delivery: A Systematic Review and Meta-Analysis
Authors: Phung L.C. , Farrington E.K. , Connolly M. , Wilson A.N. , Carvalho B. , Homer C.S.E. , Vogel J.P. 
Published: June 2022

(Am J Obstet Gynecol. 2021;225:250.e1–250.e38. [Epub May 4, 2021])
Postpartum hemorrhage (PPH) is a leading cause of maternal mortality. A common cause of PPH is uterine atony. To decrease the nearly 20% of 295,000 worldwide maternal deaths from PPH, there has been an increase in the use of uterotonics for all women during delivery. In 2018 the World Health Organization (WHO) recommended 10 IU of oxytocin to be administered to all women for both vaginal and cesarean deliveries (CD) to improve uterine atony and prevent PPH. There is insufficient evidence that 10 IU was an optimal amount for both types of delivery and the dose was based on insufficient evidence from an outdated Cochrane systematic review. The purpose of this review was to analyze the dosing regimens of IV oxytocin used for CD and to determine if any regimens are superior to others.
Preeclampsia and Long-term Health Outcomes for Mother and Infant: An Umbrella Review
Authors: Pittara T. , Vyrides A. , Lamnisos D. , Giannakou K. 
Published: June 2022

(BJOG. 2021;128:1421–1430. [Epub March 23, 2021])
Preeclampsia during pregnancy is a risk factor for multiple long-term health outcomes in both mother and infant. As the most prevalent hypertensive condition in pregnancy, it affects 2% to 8% of all pregnancies and is a leading cause of maternal and neonatal morbidity and mortality. Occurring after the 20th week of gestation, preeclampsia involves multisystem organ dysfunction, and can lead to many short-term acute maternal complications and adverse neonatal outcomes including death, usually secondary to preterm delivery. In addition to the close-range impacts, mounting evidence suggests increased risk of future cardiovascular, metabolic, and renal disease in the mother. Long-range reports in neonates indicate risk for altered cognitive abilities, psychiatric disorders, and mood and anxiety disturbances. Most research studies are observational and are summarized by outcome through systematic review and meta-analysis, and thus are subject to the bias of inflated estimates of association. This umbrella review is offered to contextualize quality and strength of evidence across all long-term outcomes in mother and infant and identify the associations with the strongest epidemiological evidence.
Black-White Disparities in Maternal In-Hospital Mortality According to Teaching and Black-serving Hospital Status
Authors: Burris H.H. , Passarella M. , Handley S.C. , Srinivas S.K. , Lorch S.A. 
Published: June 2022

(Am J Obstet Gynecol. 2021;225:83.e1–9)
From 1987 to 2018, the maternal mortality rate (MMR) in the United States rose from 7.2 per 100,000 live births to 17.4. Compared with white patients, Black patients have significantly higher maternal mortality rate (14.9 vs. 37.3 per 100,000 live births). There are multiple factors contributing to this disparity. Approximately 90% of preventable maternal mortality may be due to provider factors, and therefore it is important to identify provider factors that contribute to the higher MMR among Black patients. The authors hypothesized that racial disparities in in-hospital MMR would differ between teaching and nonteaching hospitals. Further they hypothesized that the disparity would be larger in hospitals that care for a lower proportion of Black patients.
Population Risk Factors for Nulliparous, Term, Singleton, Vertex Cesarean Birth: A National Cross-sectional Study
Authors: Andrikopoulou M. , Wen T. , Sheen J.J. , Krenitsky N. , Baptiste C.D. , Goffman D. , Staniczenko A.P. , D'Alton M.E. , Friedman A.M. 
Published: June 2022

(BJOG. 2021;128:1456–1463. [Epub April 6, 2021])
Analysis of nulliparous, term, singleton, vertex (NTSV) cesarean births remains an important measure for quality of care. Hospital-level NTSV-cesarean statistics are endorsed by many quality leadership organizations as a metric of interest. Relevant to interpreting NTSV hospital-level cesarean rate is the degree to which patient factors modify risk, including obesity, maternal age, and pregestational diabetes. The case mix at hospitals may contribute to differentially distributed risk factors that increase the likelihood of NTSV cesarean delivery (CD). This cross-sectional study investigated whether medical, obstetric, and demographic factors were associated with risk for NTSV CD.
Association Between Iatrogenic Delivery for Suspected Fetal Growth Restriction and Childhood School Outcomes
Authors: Selvaratnam R.J. , Wallace E.M. , Wolfe R. , Anderson P.J. , Davey M.-A. 
Published: June 2022

(JAMA. 2021;326:145–153)
Undetected fetal growth restriction (FGR) is associated with a late pregnancy stillbirth rate of 16.4 per 1000, but when detected and managed, the rate of stillbirth drops to 0.8 per 1000. Clinicians face difficult decisions in managing pregnancies affected by FGR, as prematurity is associated with a host of poor neonatal and childhood outcomes. In addition, fetuses are commonly falsely suspected of having FGR. This study investigated the childhood school outcomes for children born via iatrogenic delivery for suspected FGR.
Trends in Gestational Diabetes at First Live Birth by Race and Ethnicity in the US, 2011-2019
Authors: Shah N.S. , Wang M.C. , Freaney P.M. , Perak A.M. , Carnethon M.R. , Kandula N.R. , Gunderson E.P. , Bullard K.M. , Grobman W.A. , O'Brien M.J. , Khan S.S. 
Published: June 2022

(JAMA. 2021;326:660–669)
Gestational diabetes mellitus (GDM) is a common condition during pregnancy associated with adverse maternal and child outcomes, including increased risk for future diabetes postpregnancy and cardiovascular disease. For infants, maternal GDM is shown to be associated with macrosomia and increased adiposity, and increased risk for cardiometabolic disease into the full lifespan. Differentiated rates of GDM in the United States has been estimated for major ethnic groups but is undefined for disaggregated subgroups within these larger populations. Large-scale data were mined to quantify annual rates of GDM in mothers at first live birth stratified across race and ethnicity subgroups in the United States. This analysis informs equitable approaches for management and prevention of gestational diabetes at the clinical and population levels.
Incidence of Subdural Catheter Placement During Epidural Procedure Based on Fluoroscopic Imaging
Authors: Sidash S. , Zhang X. , Herrick M. , McIntyre J.J. , Sites B.D. 
Published: June 2022

(Reg Anesth Pain Med. 2021;46:538–539)
The percentage of failed epidural anesthesia placement due to subdural catheter placement is unknown. Subdural catheter placement is difficult to identify because it can occur despite having a negative test dose and negative aspiration of cerebrospinal fluid. This poses a problem to the patient because subdural placement may not penetrate anterior nerve roots, resulting in continued pain. This study utilized real-time fluoroscopic imaging in an effort to determine the incidence of subdural catheter placement during epidural anesthesia.
Evaluation of Therapies for Peripheral and Neuraxial Opioid-induced Pruritus based on Molecular and Cellular Discoveries
Authors: Nguyen E. , Lim G. , Ross S.E. 
Published: June 2022

(Anesthesiology. 2021;135:350–365)
The clinical burden of opioid-induced pruritus is observed in many patient populations. Opioids are used to control numerous types of pain including acute, chronic, preoperative, intraoperative and postoperative, and cancer pain. Pruritus is an extremely common side effect of neuraxial opioids (30% to 85%) and also occurs with parenteral administration particularly after extended dosing. Pruritis secondary to neuraxial opioids in the childbirth setting is also extremely common (up to 85%) and is primarily dose dependent. Pruritus following neuraxial opioid administration is more common in women in all settings (60% to 85%), mirroring the elevated incidence of chronic pain that also affects female patients, perhaps implicating sensitivities of the μ-opioid receptor susceptible to the estrous cycle. Polymorphisms of the human μ-opioid receptor (OPRM1) may be associated with protection against the effects of pruritus.
Maternal Vitamin D, Oxidative Stress, and Preeclampsia
Authors: Wei S.Q. , Bilodeau J.-F. , Julien P. , Luo Z.-C. , Abenhaim H.A. , Bi W.G. , Nuyt A.M. , Leduc L. , Audibert F. , Fraser W.D. 
Published: June 2022

(Int J Gynecol Obstet. 2021;154:444–450)
Preeclampsia (PE) is a serious and complex pregnancy-related disorder with negative effects on both the mother and fetus. Prevention is vital to reduce 18% of maternal mortality that results from PE in the United States each year. After years of study, its causes and mechanisms have not yet been fully unraveled. A recent review and analysis have shown an association between maternal vitamin D levels during pregnancy and an increased risk of PE.
COVID-19 Vaccine Acceptance in Pregnant Women
Authors: Ayhan S.G. , Oluklu D. , Atalay A. , Beser D.M. , Tanacan A. , Tekin O.M. , Sahin D. 
Published: June 2022

(Int J Gynecol Obstet. 2021;154:291–296)
In the time since the SARS-CoV-2 pandemic began in 2020, over 5 million deaths worldwide have been attributed to the disease, COVID-19, which the SARS-COV-2 virus causes. Pregnant women who contract COVID-19 have been shown in studies to be 20 times more likely to die of complications from the disease than their pregnant peers who do not contract COVID-19. Infected pregnant women are much more likely to develop preeclampsia, experience preterm birth, require intubation, and stay in an ICU setting. They are at higher risk for severe disease than both their noninfected pregnant peers and their nonpregnant infected peers. Although new treatments for COVID-19 are emerging, the best way for pregnant women to protect themselves and their unborn baby from the effects of COVID-19 is through vaccination. Vaccination for COVID-19 has been shown to strengthen an individual’s immune response and decrease the severity of the disease in infected individuals.
The FAST-M Complex Intervention for the Detection and Management of Maternal Sepsis in Low-resource Settings: A Multi-site Evaluation
Authors: Cheshire J. , Jones L. , Munthali L. , Kamphinga C. , Liyaya H. , Phiri T. , Parry-Smith W. , Dunlop C. , Makwenda C. , Devall A.J. , Tobias A. , Nambiar B. , Merriel A. , Williams H.M. , Gallos I. , Wilson A. , Coomarasamy A. , Lissauer D. 
Published: June 2022

(BJOG. 2021;128:1324–1333)
Maternal sepsis is the third most common direct cause of maternal mortality worldwide. Low-resource settings are disproportionately affected by maternal sepsis. While sepsis screening and care bundles can reduce the time to initiation of treatment and improve outcomes, the current bundles are not specific to maternal care nor are they suitable for low-resource settings. The FAST-M maternal sepsis care bundle was developed using a modified Delphi process with input from care providers from low- to middle-income countries. This study aimed to gauge the feasibility of implementing the FAST-M complex intervention in low-resource settings.
Magnetic Resonance Imaging of Cerebrospinal Fluid Spread in the Epidural Space and Postdural Puncture Headache in Obstetrics: A Proof-of-Concept Study
Authors: Ahmed I. , Majeed A. , Fernando R. , Hyare H. , Columb M. , Setty T. 
Published: June 2022

(Eur J Anaesthesiol. 2021;38:777–784)
Labor analgesia that includes epidural catheter placement can be complicated by accidental dural puncture (ADP). In parturients, ADP is followed by postdural puncture headache (PDPH) in up to 70% to 80% of cases. Prompt diagnosis and treatment of PDPH are important as delay can exacerbate sequelae, leading to serious debilitating and chronic complications. The current most effective treatment, epidural blood patch (EBP), is performed based on subjective clinical judgment of the parturient’s progression and severity of symptoms. An evidence-based protocol may benefit parturients with atypical PDPH presentation by allowing an earlier EBP, rather than forestalling until PDPH becomes severe. Egress of cerebrospinal fluid (CSF) into the epidural space following ADP can be readily recognized in T1-weighted and T2-weighted magnetic resonance imaging (MRI) of the brain and spine. The correlations between neuroradiological findings and the severity of PDPH in obstetric patients is presented.
Optimal Use of Intravenous Tranexamic Acid for Hemorrhage Prevention in Pregnant Women
Authors: Ahmadzia H.K. , Luban N.L.C. , Li S. , Guo D. , Miszta A. , Gobburu J.V.S. , Berger J.S. , James A.H. , Wolberg A.S. , van den Anker J. 
Published: June 2022

(Am J Obstet Gynecol. 2021;225:85.e1–11)
Postpartum hemorrhage (PPH) is a major cause of pregnancy-related death worldwide. Tranexamic acid (TXA) reduced death from bleeding by 31% when administered to women with PPH in the World Maternal Antifibrinolytic (WOMAN) trial. While some data suggests a low dose of TXA may achieve a therapeutic effect while minimizing exposure to the neonate, there is a lack of data on the use of TXA in pregnant women, including pharmacokinetic (PK) and pharmacodynamic (PD) data. This study aimed to evaluate the safety of using TXA in women undergoing cesarean delivery, including PK and PD outcomes, and to provide data on breast milk TXA concentration.
Pregnancy-related Venous Thromboembolism and HIV Infection
Authors: Schapkaitz E. , Libhaber E. , Rhemtula H. , Gerber A. , Jacobson B.F. , Chauke L. , Buller H.R. 
Published: June 2022

(Int J Gynecol Obstet. 2021;155:110–118)
Pregnant women and recently pregnant women are at an increased risk for venous blood clots due to pregnancy being an acquired hyper-coagulable state. This state is caused by increased platelet activation, a reduction in free and total proteins, and decreased fibrinolysis. The increase in thrombin predisposes pregnant women to venous thromboembolism (VTE) which can lead to deep vein thrombosis and pulmonary embolism. Conditions which can increase a mother’s likelihood for VTE include a personal history of thrombosis, inherited thrombophilia, medical comorbidities, age above 35, significant pregnancy complications, and especially cesarean delivery.
Surgical, Obstetric, and Anesthetic Mortality Measurement at a Ugandan Secondary Referral Hospital
Authors: Firth P.G. , Mushagara R. , Musinguzi N. , Liu C. , Boatin A.A. , Mugabi W. , Kayaga D. , Naturinda P. , Twesigye D. , Sanyu F. , Mugyenyi G. , Ngonzi J. , Ttendo S.S. 
Published: June 2022

(Anesth Analg. 2021;133:1608–1616)
In low- and middle-income countries, health care systems may have limited ability to safely treat surgical disorders. An appropriate standardized metric is needed to assess hospital and patient outcomes in terms of safe surgical care in low-income countries. The perioperative mortality rate (POMR) is one metric used to compare the quality and safety of hospitals in high- and low-income countries. In Uganda, the Mbarara Regional Referral Hospital (MRRH) is a government-funded hospital located in a rural area. This study examined surgical deaths over one year at this hospital with the aim of determining a suitable mortality metric to measure outcomes and assess care delivery in this limited-resource health system. The hypothesis was that the majority of admission deaths did not involve an operation.
The Extension of Epidural Blockade for Emergency Cesarean Delivery: A Survey of UK Practice
Authors: Richardson A.L. , Bhuptani S. , Lucas D.N. 
Published: June 2022

(Int J Obstet Anesth. 2021;46:102977)
One-fifth of emergency cesarean deliveries (CD) in the United Kingdom are performed under extension of labor epidural analgesia to surgical anesthesia. In 2014, a survey was sent to lead obstetric anesthetists in the United Kingdom regarding practices for extending labor analgesia to achieve surgical anesthesia. These results were compared with a similar survey published in 2008.
Technical Trick: T-Bar External Fixator for Definitive Management of Periarticular and Metadiaphyseal Tibial Fractures
Authors: Mease Samuel J. , Bradley Hallie R. , Thota Dharani R. , Starr Adam J. , Sanders Drew T. 
Published: June 2022

Purpose:
Tibia fractures with soft tissue compromise present are challenging to manage. For fractures with significant swelling or open injury not amenable to internal stabilization, external fixators provide sufficient stability for bony healing. Ring fixators and hybrid constructs provide adequate stability for healing but are costly, and challenging to apply and maintain. We present the “T-bar” external fixator, a novel construct that can be maintained until bony union and allows for range of motion of adjacent joints. We also report the demographics, clinical, and radiographic outcomes of 34 patients treated definitively with this construct.

Materials and Methods:
The T-bar external fixator uses standard pins and bars in a novel arrangement. It can be applied for Arbeitsgemeinshaft fur Osteosynthesefragen/Orthopaedic Trauma Association-type 41/42/43 type injuries, with or without supplemental fixation for intra-articular patterns.

Results:
Between 2008 and 2015, 34 patients were treated for tibia fracture with T-bar external fixation, with intention to treat in a definitive manner. Twenty-nine were male, and average age was 44.3 years. Thirty-one sustained high energy mechanisms of injury. Twenty were Gustilo-type 2 or 3 fractures. Of 14 closed fractures, 12 were Tscherne-type 2 or 3.

Conclusions:
The T-bar external fixator offers an alternative to ring and hybrid external fixator constructs in treatment of tibia fractures with significant soft tissue compromise. Of 28 patients with complete follow up, only 1 case of osteomyelitis was reported. All patients were managed without amputation. Three required revision for nonunion, all Arbeitsgemeinshaft fur Osteosynthesefragen/Orthopaedic Trauma Association-type 43.
Using Administrative Data to Examine Telemedicine Usage Among Medicaid Beneficiaries During the Coronavirus Disease 2019 Pandemic
Authors: Hossain Mallick , Dean Emma B. , Kaliski Daniel 
Published: June 2022

Background:
The coronavirus disease 2019 (COVID-19) pandemic necessitated the replacement of in-person physician consultations with telemedicine. During the pandemic, Medicaid covered the cost of telemedicine visits.

Objectives:
The aim was to measure the adoption of telemedicine during the pandemic. We focus on key patient subgroups including those with chronic conditions, those living in urban versus rural areas, and different age groups.

Methods:
This study examined the universe of claims made by Florida Medicaid beneficiaries (n=2.4 million) between January 2019 and July 2020. Outpatient visits were identified as in-person or telemedicine. Telemedicine visits were classified into audio-visual or audio-only visits.

Results:
We find that telemedicine offsets much of the decline in in-person outpatient visits among Florida’s Medicaid enrollees, however, uptake differs by enrollee type. High utilizers of care and beneficiaries with chronic conditions were significantly more likely to use telemedicine, while enrollees living in rural areas and health professional shortage areas were moderately less likely to use telemedicine. Elderly Medicaid recipients (dual-eligibles) used audio-only telemedicine visits at higher rates than other age groups, and the demand for these consultations is more persistent.

Conclusions:
Telemedicine offset the decline in health care utilization among Florida’s Medicaid-enrolled population during the novel coronavirus pandemic, with particularly high uptake among those with prior histories of high utilization. Audio-only visits are a potentially important method of delivery for the oldest Medicaid beneficiaries.
Accommodation Is Decreased in Eyes with Acute Central Serous Chorioretinopathy
Authors: Maltsev Dmitrii S. , Kulikov Alexei N. , Vasiliev Alexander S. , Chhablani Jay 
Published: June 2022

SIGNIFICANCE
This is a case-control study showing changes in accommodation in eyes with acute central serous chorioretinopathy. We found that decreased accommodative amplitude in the affected eyes may indicate suppression of parasympathetic activity in those eyes as one of the pathophysiological mechanisms controlling choroidal thickness and perfusion.

PURPOSE
This study aimed to evaluate the changes of accommodation in patients with acute central serous chorioretinopathy.

METHODS
Patients with unilateral central serous chorioretinopathy, with and without foveal involvement, as well as patients after resolution of subretinal fluid and healthy age-matched controls were included. Accommodative amplitude was measured and compared between eyes with active or resolved central serous chorioretinopathy, fellow eyes of active central serous chorioretinopathy individuals, and eyes of controls. Correlation between accommodative amplitude and ocular and demographic parameters was calculated.

RESULTS
Nineteen acute central serous chorioretinopathy patients (16 males and 3 females, 38.1 ± 5.1 years) and 17 age-matched controls (13 males and 4 females, 37.2 ± 5.4 years) were included. Accommodative amplitude in the study eyes of central serous chorioretinopathy patients was lower than that in the fellow unaffected eyes (1.25 ± 1.0 and 2.54 ± 0.94 D, respectively; P = .002) or in the eyes of healthy controls (2.41 ± 1.38 D, P = .002). In central serous chorioretinopathy eyes, after resolution of subretinal fluid or without foveal involvement, the median accommodative amplitude was lower than that in fellow eyes (1.6 [95% confidence interval, 0.83 to 1.75] and 2.7 D [95% confidence interval, 1.23 to 3.61], respectively; P = .004). No correlation was found between accommodative amplitude in affected central serous chorioretinopathy eyes and different parameters, except for age (r = −0.47, P = .04).

CONCLUSIONS
Acute central serous chorioretinopathy is associated with a substantial reduction of accommodative amplitude.