cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.14073586.v1
title: Amnioreduction with rescue cerclage at advanced cervical dilation or gestational age

description: To determine the feasibility of rescue cerclage and amnioreduction at advanced cervical dilation or gestational age. We present a retrospective case series of women who underwent rescue cerclage at either an advanced gestational age (24 + 0 to 24 + 6 weeks) or cervical dilation (≥4 cm), with a subset undergoing amnioreduction prior to cerclage placement. Nine women were included and amnioreduction was performed in 7 (78%). A bi-modal distribution of obstetric outcomes was observed, with 5 (56%) women delivering ≥34 weeks gestation, 3 (33%) of which delivered at term. Two (22%) women experienced intra-operative rupture of membranes and subsequent perinatal deaths. Two (22%) women delivered extremely premature, with one resulting in infant death. Our data show that rescue cerclage with amnioreduction may be successful at advanced gestational ages or cervical dilations, suggesting that these women should be included in prospective studies to better establish the efficacy and safety of this procedure.
DOI: 10.6084/m9.figshare.17704467
title: Impact of labor induction at 39 weeks gestation compared with expectant management on maternal and perinatal morbidity among a cohort of low-risk women

description: To determine maternal and perinatal outcomes after induction of labor (IOL) at 39 weeks compared with expectant management. This is a retrospective national cohort study from the National Center for Health Statistics birth database. The study included singleton, low-risk pregnancies with a non-anomalous fetus delivered at 39–42 weeks gestation between 2015 and 2018. Maternal outcomes available included chorioamnionitis (Triple I), blood transfusion, intensive care unit (ICU) admission, uterine rupture, cesarean delivery (CD), and cesarean hysterectomy. Fetal and infant outcomes included stillbirth, 5-min Apgar ≤3, prolonged ventilation, seizures, ICU admission, and death within 28 days. We compared women undergoing IOL at 39 weeks to those managed expectantly. Non-adjusted and adjusted relative risks (aRRs) were estimated using multivariate log-binomial regression analysis. There were 15,900,956 births available for review of which 5,017,524 met inclusion and exclusion criteria. For the maternal outcomes, the IOL group was less likely to require a CD (aRR 0.880; 95% CI [0.874–0.886]; <i>p</i> value &lt; .01) or develop Triple I (aRR 0.714; 95% CI [0.698–0.730]; <i>p</i> value &lt; .01) but demonstrated a small increase in the cesarean hysterectomy rate (aRR 1.231; 95% CI [1.029–1.472]; <i>p</i> value &lt; .01). Among perinatal outcomes, the stillbirth rate (aRR 0.195; 95% CI [0.153–0.249]; <i>p</i> value &lt; .01), 5-min Apgar ≤3 (aRR 0.684; 95% CI [0.647–0.723]; <i>p</i> value &lt; .01), prolonged ventilation (aRR 0.840; 95% CI [0.800–0.883]; <i>p</i> value &lt; .01), neonatal intensive care (NICU) admission (aRR 0.862; 95% CI [0.849–0.875]; <i>p</i> value &lt; .01) were lower after 39 week IOL compared with expectant management. There were no differences in risk for neonatal seizures (aRR 0.848; 95% CI [0.718–1.003]; <i>p</i> value 0.011) or death (aRR 1.070; 95% CI [0.722–1.586]; <i>p</i> value 0.660). IOL at 39 weeks of gestation in a low-risk cohort is associated with a lower risk of CD and maternal infection, stillbirth, and lower neonatal morbidity. There was no effect on the risk for neonatal seizures or death.
DOI: 10.6084/m9.figshare.17704467.v1
title: Impact of labor induction at 39 weeks gestation compared with expectant management on maternal and perinatal morbidity among a cohort of low-risk women

description: To determine maternal and perinatal outcomes after induction of labor (IOL) at 39 weeks compared with expectant management. This is a retrospective national cohort study from the National Center for Health Statistics birth database. The study included singleton, low-risk pregnancies with a non-anomalous fetus delivered at 39–42 weeks gestation between 2015 and 2018. Maternal outcomes available included chorioamnionitis (Triple I), blood transfusion, intensive care unit (ICU) admission, uterine rupture, cesarean delivery (CD), and cesarean hysterectomy. Fetal and infant outcomes included stillbirth, 5-min Apgar ≤3, prolonged ventilation, seizures, ICU admission, and death within 28 days. We compared women undergoing IOL at 39 weeks to those managed expectantly. Non-adjusted and adjusted relative risks (aRRs) were estimated using multivariate log-binomial regression analysis. There were 15,900,956 births available for review of which 5,017,524 met inclusion and exclusion criteria. For the maternal outcomes, the IOL group was less likely to require a CD (aRR 0.880; 95% CI [0.874–0.886]; <i>p</i> value &lt; .01) or develop Triple I (aRR 0.714; 95% CI [0.698–0.730]; <i>p</i> value &lt; .01) but demonstrated a small increase in the cesarean hysterectomy rate (aRR 1.231; 95% CI [1.029–1.472]; <i>p</i> value &lt; .01). Among perinatal outcomes, the stillbirth rate (aRR 0.195; 95% CI [0.153–0.249]; <i>p</i> value &lt; .01), 5-min Apgar ≤3 (aRR 0.684; 95% CI [0.647–0.723]; <i>p</i> value &lt; .01), prolonged ventilation (aRR 0.840; 95% CI [0.800–0.883]; <i>p</i> value &lt; .01), neonatal intensive care (NICU) admission (aRR 0.862; 95% CI [0.849–0.875]; <i>p</i> value &lt; .01) were lower after 39 week IOL compared with expectant management. There were no differences in risk for neonatal seizures (aRR 0.848; 95% CI [0.718–1.003]; <i>p</i> value 0.011) or death (aRR 1.070; 95% CI [0.722–1.586]; <i>p</i> value 0.660). IOL at 39 weeks of gestation in a low-risk cohort is associated with a lower risk of CD and maternal infection, stillbirth, and lower neonatal morbidity. There was no effect on the risk for neonatal seizures or death.
DOI: 10.6084/m9.figshare.19353347
title: Pregnancy and delivery after traumatic brain injury: a nationwide population-based cohort study in Finland

description: Few studies have assessed pregnancies and deliveries after traumatic brain injury (TBI). We report the incidence of TBIs and TBI-related surgeries in fertile-aged females and investigate subsequent pregnancy outcomes. All fertile-aged (15–49) women with TBI diagnosis during our study period (1998–2018) were retrieved from the Care Register for Health Care and combined with data from the National Medical Birth Register. TBIs were categorized into three subgroups based on the length of the hospitalization period and the need for neurosurgery. Logistic regression was used to analyze preterm deliveries, cesarean sections (CS) and neonatal health. Results are reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI). The incidence of TBIs increased from 103 per 100 000 person-years in 1998 to 257 per 100 000 (149.5%) in 2018. The incidence of TBI-related surgeries remained stable during our study period. The rate of preterm deliveries was 5.6% in the TBI group and 3.0% in the control group (AOR 1.23, CI 1.17–1.28). The CS rate in the TBI group was 19.2% and 15.9% in the control group (AOR 1.23, CI 1.18–1.29). The use of labor analgesia was higher among women with previous TBI. The rate of neonates requiring intensive care in the TBI group was 13.1% and 9.9% in the control group (AOR 1.30, CI 1.24–1.37). The incidence of TBI hospitalizations increased during our study period, whereas the number of surgically treated TBI remained stable. Preterm deliveries, CS, instrumental vaginal deliveries and labor analgesia were more prevalent in women with previous TBI. Furthermore, more neonates required intensive care in this group. Therefore, a history of TBI should be acknowledged as a possible factor affecting the delivery and health of the neonate.
DOI: 10.6084/m9.figshare.19353347.v1
title: Pregnancy and delivery after traumatic brain injury: a nationwide population-based cohort study in Finland

description: Few studies have assessed pregnancies and deliveries after traumatic brain injury (TBI). We report the incidence of TBIs and TBI-related surgeries in fertile-aged females and investigate subsequent pregnancy outcomes. All fertile-aged (15–49) women with TBI diagnosis during our study period (1998–2018) were retrieved from the Care Register for Health Care and combined with data from the National Medical Birth Register. TBIs were categorized into three subgroups based on the length of the hospitalization period and the need for neurosurgery. Logistic regression was used to analyze preterm deliveries, cesarean sections (CS) and neonatal health. Results are reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI). The incidence of TBIs increased from 103 per 100 000 person-years in 1998 to 257 per 100 000 (149.5%) in 2018. The incidence of TBI-related surgeries remained stable during our study period. The rate of preterm deliveries was 5.6% in the TBI group and 3.0% in the control group (AOR 1.23, CI 1.17–1.28). The CS rate in the TBI group was 19.2% and 15.9% in the control group (AOR 1.23, CI 1.18–1.29). The use of labor analgesia was higher among women with previous TBI. The rate of neonates requiring intensive care in the TBI group was 13.1% and 9.9% in the control group (AOR 1.30, CI 1.24–1.37). The incidence of TBI hospitalizations increased during our study period, whereas the number of surgically treated TBI remained stable. Preterm deliveries, CS, instrumental vaginal deliveries and labor analgesia were more prevalent in women with previous TBI. Furthermore, more neonates required intensive care in this group. Therefore, a history of TBI should be acknowledged as a possible factor affecting the delivery and health of the neonate.
DOI: 10.6084/m9.figshare.20109107
title: Depression, anxiety, and post-traumatic stress disorder symptoms after hyperemesis gravidarum: a prospective cohort study

description: To determine the prevalence of depression, anxiety, and posttraumatic stress disorder (PTSD) years after hyperemesis gravidarum (HG) and its association with HG severity. This prospective cohort study consisted of a follow-up of 215 women admitted for HG, who were eligible to participate in a randomized controlled trial and either declined or agreed to be randomized between 2013 and 2016 in 19 hospitals in the Netherlands. Participants completed the Hospital Anxiety and Depression Scale (HADS) six weeks postpartum and during follow-up and the PTSD checklist for DSM-5 (PCL-5) during follow-up. An anxiety or depression score ≥8 is indicative of an anxiety or depression disorder and a PCL-5 ≥ 31 indicative of PTSD. Measures of HG severity were symptom severity (PUQE-24: Pregnancy Unique Quantification of Emesis), weight change, duration of admissions, readmissions, and admissions after the first trimester. About 54/215 participants completed the HADS six weeks postpartum and 73/215 participants completed the follow-up questionnaire, on average 4.5 years later. Six weeks postpartum, 13 participants (24.1%) had an anxiety score ≥8 and 11 participants (20.4%) a depression score ≥8. During follow-up, 29 participants (39.7%) had an anxiety score ≥8, 20 participants (27.4%) a depression score ≥8, and 16 participants (21.9%) a PCL-5 ≥ 31. Multivariable logistic regression analysis showed that for every additional point of the mean PUQE-24 three weeks after inclusion, the likelihood of having an anxiety score ≥8 and PCL-5 ≥ 31 at follow-up increased with OR 1.41 (95% CI: 1.10;1.79) and OR 1.49 (95% CI: 1.06;2.10) respectively. Depression, anxiety, and PTSD symptoms are common years after HG occurred.
DOI: 10.6084/m9.figshare.20109107.v1
title: Depression, anxiety, and post-traumatic stress disorder symptoms after hyperemesis gravidarum: a prospective cohort study

description: To determine the prevalence of depression, anxiety, and posttraumatic stress disorder (PTSD) years after hyperemesis gravidarum (HG) and its association with HG severity. This prospective cohort study consisted of a follow-up of 215 women admitted for HG, who were eligible to participate in a randomized controlled trial and either declined or agreed to be randomized between 2013 and 2016 in 19 hospitals in the Netherlands. Participants completed the Hospital Anxiety and Depression Scale (HADS) six weeks postpartum and during follow-up and the PTSD checklist for DSM-5 (PCL-5) during follow-up. An anxiety or depression score ≥8 is indicative of an anxiety or depression disorder and a PCL-5 ≥ 31 indicative of PTSD. Measures of HG severity were symptom severity (PUQE-24: Pregnancy Unique Quantification of Emesis), weight change, duration of admissions, readmissions, and admissions after the first trimester. About 54/215 participants completed the HADS six weeks postpartum and 73/215 participants completed the follow-up questionnaire, on average 4.5 years later. Six weeks postpartum, 13 participants (24.1%) had an anxiety score ≥8 and 11 participants (20.4%) a depression score ≥8. During follow-up, 29 participants (39.7%) had an anxiety score ≥8, 20 participants (27.4%) a depression score ≥8, and 16 participants (21.9%) a PCL-5 ≥ 31. Multivariable logistic regression analysis showed that for every additional point of the mean PUQE-24 three weeks after inclusion, the likelihood of having an anxiety score ≥8 and PCL-5 ≥ 31 at follow-up increased with OR 1.41 (95% CI: 1.10;1.79) and OR 1.49 (95% CI: 1.06;2.10) respectively. Depression, anxiety, and PTSD symptoms are common years after HG occurred.
DOI: 10.6084/m9.figshare.14206184
title: Trends and predictors of preterm birth among Asian Americans by ethnicity, 1992–2018

description: In an increasingly diverse United States (US) population, racial disparities in preterm birth outcomes continue to widen. In this study, we examined temporal trends and risk of preterm birth among Asian American women over a quarter century (1992–2018). This is a retrospective cohort study using the 1992–2018 Natality data files. We conducted joinpoint regression analyses to examine trends in preterm birth among Asian Americans and non-Hispanic (NH) Whites. Bivariate and multivariable analyses were used to identify risk factors associated with preterm birth among Asian Americans and their ethnic sub-groups as compared to NH-Whites. There were a total of 251,278 preterm births among Asian American women, corresponding to a rate of 10.0%, which was relatively stable over time. The incidence of extremely, very and moderate-to-late preterm birth among Asian Americans was 0.4%, 0.9% and 8.7% respectively. Overall, Asian American women exhibited lower adjusted odds (OR = 0.92; 95% CI: 0.88–0.97) of preterm birth than their NH-White counterparts. Comparing Asian American subgroups to NH-Whites, Filipinas and Vietnamese mothers had increased adjusted odds, whereas Chinese, Korean, Japanese and Asian Indian women showed decreased adjusted odds for preterm birth. The risk of preterm birth varied among the ethnic subgroups of Asian Americans in the United States. Future studies should explore the socio-cultural and environmental nuances that might explain these differences.
DOI: 10.6084/m9.figshare.14206184.v1
title: Trends and predictors of preterm birth among Asian Americans by ethnicity, 1992–2018

description: In an increasingly diverse United States (US) population, racial disparities in preterm birth outcomes continue to widen. In this study, we examined temporal trends and risk of preterm birth among Asian American women over a quarter century (1992–2018). This is a retrospective cohort study using the 1992–2018 Natality data files. We conducted joinpoint regression analyses to examine trends in preterm birth among Asian Americans and non-Hispanic (NH) Whites. Bivariate and multivariable analyses were used to identify risk factors associated with preterm birth among Asian Americans and their ethnic sub-groups as compared to NH-Whites. There were a total of 251,278 preterm births among Asian American women, corresponding to a rate of 10.0%, which was relatively stable over time. The incidence of extremely, very and moderate-to-late preterm birth among Asian Americans was 0.4%, 0.9% and 8.7% respectively. Overall, Asian American women exhibited lower adjusted odds (OR = 0.92; 95% CI: 0.88–0.97) of preterm birth than their NH-White counterparts. Comparing Asian American subgroups to NH-Whites, Filipinas and Vietnamese mothers had increased adjusted odds, whereas Chinese, Korean, Japanese and Asian Indian women showed decreased adjusted odds for preterm birth. The risk of preterm birth varied among the ethnic subgroups of Asian Americans in the United States. Future studies should explore the socio-cultural and environmental nuances that might explain these differences.
DOI: 10.6084/m9.figshare.17156400
title: Pregnancy and posttraumatic stress disorder: associations with infant outcomes and prenatal care utilization

description: Posttraumatic stress disorder (PTSD) affects 3.6–9.7% of women, and has been associated with adverse outcomes in pregnancy; however, associations with prenatal care (PNC) utilization are not clear. To evaluate associations of PTSD in pregnancy with PNC utilization and adverse infant outcomes in an active-duty military population (a population with universal health insurance). This was a retrospective cohort study of pregnant active-duty service members in Department of Defense Birth and Infant Health Research program data from 2007 to 2014. Administrative medical encounter data were used to define PTSD cases and outcomes of interest. Descriptive statistics and multivariable log-binomial regression compared PNC utilization and adverse infant outcomes (preterm birth, small for gestational age [SGA], major birth defects) among service members with current PTSD (defined as PTSD in the year prior to pregnancy or during pregnancy) to those without current PTSD. Of the 103,221 singleton live births identified, 1657 (1.6%) were born to active-duty service members diagnosed with current PTSD. Service members with PTSD were more likely to initiate PNC in the first trimester (93.5% vs. 90.2%) and score adequate plus on the Adequacy of Prenatal Care Utilization Index (63.2% vs. 40.0%) compared to service members without PTSD. PTSD case status was not associated with preterm birth, SGA, or major birth defects, regardless of the adjustment set used (fully adjusted RR 0.96, 95% CI 0.82–1.13; RR 1.08, 95% CI 0.79–1.48; and RR 1.03, 95% CI 0.79–1.34, respectively). For pregnant service members with current PTSD, no associations with adverse infant outcomes were noted, and these patients initiated care earlier and had higher PNC utilization scores compared to pregnant service members without current PTSD. Universal health care coverage and utilization of PNC in this population may mitigate adverse pregnancy outcomes observed in civilian populations of patients with PTSD.
DOI: 10.6084/m9.figshare.17156400.v2
title: Pregnancy and posttraumatic stress disorder: associations with infant outcomes and prenatal care utilization

description: Posttraumatic stress disorder (PTSD) affects 3.6–9.7% of women, and has been associated with adverse outcomes in pregnancy; however, associations with prenatal care (PNC) utilization are not clear. To evaluate associations of PTSD in pregnancy with PNC utilization and adverse infant outcomes in an active-duty military population (a population with universal health insurance). This was a retrospective cohort study of pregnant active-duty service members in Department of Defense Birth and Infant Health Research program data from 2007 to 2014. Administrative medical encounter data were used to define PTSD cases and outcomes of interest. Descriptive statistics and multivariable log-binomial regression compared PNC utilization and adverse infant outcomes (preterm birth, small for gestational age [SGA], major birth defects) among service members with current PTSD (defined as PTSD in the year prior to pregnancy or during pregnancy) to those without current PTSD. Of the 103,221 singleton live births identified, 1657 (1.6%) were born to active-duty service members diagnosed with current PTSD. Service members with PTSD were more likely to initiate PNC in the first trimester (93.5% vs. 90.2%) and score adequate plus on the Adequacy of Prenatal Care Utilization Index (63.2% vs. 40.0%) compared to service members without PTSD. PTSD case status was not associated with preterm birth, SGA, or major birth defects, regardless of the adjustment set used (fully adjusted RR 0.96, 95% CI 0.82–1.13; RR 1.08, 95% CI 0.79–1.48; and RR 1.03, 95% CI 0.79–1.34, respectively). For pregnant service members with current PTSD, no associations with adverse infant outcomes were noted, and these patients initiated care earlier and had higher PNC utilization scores compared to pregnant service members without current PTSD. Universal health care coverage and utilization of PNC in this population may mitigate adverse pregnancy outcomes observed in civilian populations of patients with PTSD.
DOI: 10.6084/m9.figshare.19352630
title: Health disparities, COVID-19, and maternal and childbirth outcomes: a meta-epidemiological study of equity reporting in systematic reviews

description: Pregnant women with COVID-19 are at increased risk for adverse maternal and pregnancy outcomes, and birth complications. Given the health outcome disparities among pregnant women of racial and ethnic minorities and the reliance of medical practice on systematic reviews and meta-analyses (SRMAs)—as they are the apical component in the hierarchy of evidence in medical research—the primary objective of the study is to examine the inclusion of the equity reporting in SRMAs focused on pregnancy outcomes and COVID-19 using PROGRESS-Plus equity framework. PROGRESS represents equity measures of Place, Race, Occupation, Gender, Religion, Education, Social capital, and Socio-economic status. We conducted a systematic search of three databases to identify SRMAs related to maternal and pregnancy outcomes related to COVID-19. We extracted whether SRMAs reported or analyzed PROGRESS-Plus components among other study characteristics. Nearly 85% of SRMAs did not include any equity items to account for racial or geographic disparities. Reporting of race was absent from 95% of the studies. Place was the most common PROGRESS item and maternal age was the most common PROGRESS-<i>Plus</i> item reported overall. When research is performed and reported in a way that fails to address disparities, the downstream repercussions may include medical care in the form of new protocol-driven hospital management, pharmacologic interventions, and other treatment options that mirror this absence in reporting. The absence of adequate reporting widens gaps in health outcomes among at-risk groups, such as pregnant women of racial and ethnic minorities.