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Seminars in Perinatology

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https://www.readbyqxmd.com/read/28889958/maternity-care-access-quality-and-outcomes-a-systems-level-perspective-on-research-clinical-and-policy-needs
#1
REVIEW
Katy B Kozhimannil, Rachel R Hardeman, Carrie Henning-Smith
The quality of maternity care in the United States is variable, and access to care is tenuous for rural residents, low-income individuals, and people of color. Without accessible, timely, and high-quality care, certain clinical and sociodemographic characteristics of individuals may render them more vulnerable to poor birth outcomes. However, risk factors for poor birth outcomes do not occur in a vaccum; rather, health care financing, delivery, and organization as well as the policy environment shape the context in which patients seek and receive maternity care...
September 7, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28889957/pathophysiology-of-preterm-labor-with-intact-membranes
#2
REVIEW
Asha N Talati, David N Hackney, Sam Mesiano
Preterm labor with intact membranes is a major cause of spontaneous preterm birth (sPTB). To prevent sPTB a clear understanding is needed of the hormonal interactions that initiate labor. The steroid hormone progesterone acting via its nuclear progesterone receptors (PRs) in uterine cells is essential for the establishment and maintenance of pregnancy and disruption of PR signaling (i.e., functional progesterone/PR withdrawal) is key trigger for labor. The process of parturition is also associated with inflammation within the uterine tissues and it is now generally accepted that inflammatory stimuli from multiple extrinsic and intrinsic sources induce labor...
September 7, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28886866/genetics-hormonal-influences-and-pretertm-birth
#3
REVIEW
Kara M Rood, Catalin S Buhimschi
Prematurity is a devastating disease with high neonatal morbidity and mortality based on gestational age at birth. Genetic and hormonal signals impact directly on the maternal predisposition to preterm birth or sudden onset of myometrial contractility. Candidate gene or genome-wide approaches are beginning to identify potential variants for women at risk for premature delivery or increased responsiveness to hormonal signals including progesterone. However, a majority of these studies have not yielded definitive results to allow for at this stage for development of personalized therapy...
September 5, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28865982/epidemiology-of-preterm-birth
#4
REVIEW
Stephanie E Purisch, Cynthia Gyamfi-Bannerman
Preterm birth is a worldwide epidemic with a global incidence of 15 million per year. Though rates of preterm birth in the United States have declined over the last decade, nearly 1 in 10 babies is still born preterm. The incidence, gestational age, and underlying etiology of preterm birth is highly variable across different racial and ethnic groups and geographic boundaries. In this article, we review the epidemiology of preterm birth in the United States and globally, with a focus on temporal trends and racial, ethnic, and geographic disparities...
August 30, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28864275/racial-disparity-in-infant-mortality
#5
Nana Matoba, James W Collins
In the United States, African-American infants have significantly higher mortality than white infants. Previous work has identified associations between individual socioeconomic factors and select community-level factors. In this review, the authors look beyond traditional risk factors for infant mortality and examine the social context of race in this country, in an effort to understand African-American women's long-standing birth outcome disadvantage. In the process, recent insights are highlighted concerning neighborhood-level factors such as crime, segregation, built environment, and institutional racism, other likely causes for the poor outcomes of African-American infants in this country compared with infants in most other industrialized nations...
August 29, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28860024/perinatal-legislative-policies-and-health-outcomes
#6
REVIEW
Scott A Lorch
Perinatal epidemiology examines the variation and determinants of pregnancy outcomes from a maternal and neonatal perspective. However, improving public and population health also requires the translation of this evidence base into substantive public policies. Assessing the impact of such public policies requires sufficient data to include potential confounding factors in the analysis, such as coexisting medical conditions and socioeconomic status, and appropriate statistical and epidemiological techniques...
August 28, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28860023/understanding-pregnancy-outcomes-using-epidemiology-and-health-services-research
#7
EDITORIAL
Scott A Lorch
No abstract text is available yet for this article.
August 28, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28826790/the-pathophysiology-of-human-premature-cervical-remodeling-resulting-in-spontaneous-preterm-birth-where-are-we-now
#8
REVIEW
Joy Vink, Mirella Mourad
Approximately one in ten (approximately 500,000) pregnancies results in preterm birth (PTB) annually in the United States. Although we have seen a slight decrease in the U.S. PTB rate between 2007 and 2014, data from 2014 to 2015 shows the preterm birth rate has slightly increased. It is even more intriguing to note that the rate of PTB has not significantly decreased since the 1980s. In order to decrease the rate of spontaneous preterm birth (sPTB), it is imperative that we improve our understanding of normal and abnormal reproductive tissue structure and function and how these tissues interact with each other at a cellular and biochemical level...
August 18, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28823579/epidemiology-of-maternal-morbidity-and-mortality
#9
REVIEW
Adi Hirshberg, Sindhu K Srinivas
Maternal morbidity and mortality remains a significant health care concern in the United States, as the rates continue to rise despite efforts to improve maternal health. In 2013, the United States ranked 60th in maternal mortality worldwide. We review the definitions, rates, trends, and top causes of severe maternal morbidity and mortality, as well as risk factors for adverse maternal outcomes. We describe current local and national initiatives in place to reduce maternal morbidity and mortality and offer suggestions for future research...
August 17, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28823578/maternal-microbiomes-in-preterm-birth-recent-progress-and-analytical-pipelines
#10
REVIEW
Lindsay A Parnell, Catherine M Briggs, Indira U Mysorekar
Worldwide, 10% of babies are born preterm, defined as birth before 37 weeks' gestation. We have had little success in developing strategies to prevent preterm births, the majority of which are due to infection or are idiopathic. An emerging hypothesis is that the maternal microbiome-the bacteria that inhabit the mother's body and play vital functions in normal health-contributes to the etiology of preterm birth. Here, we highlight the latest data revealing correlations between preterm birth and maternal intestinal, vaginal, cervical, and placental microbiomes...
August 17, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28818301/in-vitro-fertilization-and-adverse-obstetric-and-perinatal-outcomes
#11
Chantae S Sullivan-Pyke, Suneeta Senapati, Monica A Mainigi, Kurt T Barnhart
Most IVF-conceived children are healthy, but IVF has also been associated with adverse obstetric and perinatal outcomes as well as congenital anomalies. There is also literature suggesting an association between IVF and neurodevelopmental disorders as well as potentially long-term metabolic outcomes. The main driver for adverse outcomes is the higher risk of multiple gestations in IVF, but as the field moves toward single embryo transfer, the rate of multiple gestations is decreasing. Studies have shown that singleton IVF pregnancies still have a higher incidence of adverse outcomes compared to unassisted singleton pregnancies...
August 14, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28818300/birth-outcome-racial-disparities-a-result-of-intersecting-social-and-environmental-factors
#12
Heather H Burris, Michele R Hacker
Adverse birth outcomes such as preterm birth, low-birth weight, and infant mortality continue to disproportionately affect black and poor infants in the United States. Improvements in healthcare quality and access have not eliminated these disparities. The objective of this review was to consider societal factors, including suboptimal education, income inequality, and residential segregation, that together lead to toxic environmental exposures and psychosocial stress. Many toxic chemicals, as well as psychosocial stress, contribute to the risk of adverse birth outcomes and black women often are more highly exposed than white women...
August 14, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28818299/current-preterm-birth-prevention-strategies
#13
EDITORIAL
Joy Vink, Cynthia Gyamfi-Bannerman
No abstract text is available yet for this article.
August 14, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28807394/preterm-prelabor-rupture-of-the-membranes-a-disease-of-the-fetal-membranes
#14
Ramkumar Menon, Lauren S Richardson
Preterm prelabor rupture of the membranes (pPROM) remains a significant obstetric problem that affects 3-4% of all pregnancies and precedes 40-50% of all preterm births. pPROM arises from complex, multifaceted pathways. In this review, we summarize some old concepts and introduce some novel theories related to pPROM pathophysiology. Specifically, we introduce the concept that pPROM is a disease of the fetal membranes where inflammation-oxidative stress axis plays a major role in producing pathways that can lead to membrane weakening through a variety of processes...
August 11, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28888263/epidemiology-of-racial-ethnic-disparities-in-severe-maternal-morbidity-and-mortality
#15
Sarah J Holdt Somer, Rachel G Sinkey, Allison S Bryant
The literature abounds with examples of racial/ethnic disparities in both obstetric outcomes and care. Disparities in maternal mortality are well documented with non-Hispanic blacks carrying the burden of the highest maternal mortality rates. Maternal deaths likely represent only the "tip of the iceberg" with respect to pregnancy complications, leading many to explore risk factors and disparities in severe maternal morbidity, a more common precursor to maternal mortality. This review article explores commonly cited indicators of severe maternal morbidity and includes a review of the epidemiological literature supporting or refuting disparities among each indicator...
August 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28888262/introduction
#16
EDITORIAL
Judette Louis, Sindhu Srinivas
No abstract text is available yet for this article.
August 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28735811/improving-hospital-quality-to-reduce-disparities-in-severe-maternal-morbidity-and-mortality
#17
Elizabeth A Howell, Jennifer Zeitlin
Significant racial/ethnic disparities in maternal morbidity and mortality exist in the United States. Black women are 3-4 times more likely to die a pregnancy-related death as compared with white women. Growing research suggests that hospital quality may be a critical lever for improving outcomes and narrowing disparities. This overview reviews the evidence demonstrating that hospital quality is related to maternal mortality and morbidity, discusses the pathways through which these associations between quality and severe maternal morbidity generate disparities, and concludes with a discussion of possible levers for action to reduce disparities by improving hospital quality...
August 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28709520/strategies-to-reduce-disparities-in-maternal-morbidity-and-mortality-the-role-of-obesity-and-metabolic-disease
#18
Christina Paidas Teefey, Celeste P Durnwald
Maternal obesity, excessive gestational weight gain, and preexisting diabetes are known risk factors for increased maternal and neonatal morbidity. These conditions are more prevalent in certain racial and ethnic minorities. Identification and acknowledgement of racial and ethnic inequalities related to maternal metabolic disease is crucial for clinicians to provide the most comprehensive care in pregnancy. Research and clinical efforts should focus on implementation of healthy lifestyle interventions preconceptually and risk reduction efforts in disease complications during pregnancy...
August 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28669415/global-disparities-in-maternal-morbidity-and-mortality
#19
Maria J Small, Terrence K Allen, Haywood L Brown
The disparity in maternal mortality for African American women remains one of the greatest public health inequities in the United States (US). To better understand approaches toward amelioration of these differences, we examine settings with similar disparities in maternal mortality and "near misses" based on race/ethnicity. This global analysis of disparities in maternal mortality/morbidity will focus on middle- and high-income countries (based on World Bank definitions) with multiethnic populations. Many countries with similar histories of slavery and forced migration demonstrate disparities in health outcomes based on social determinants such as race/ethnicity...
August 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28651792/racial-and-ethnic-differences-in-contraception-use-and-obstetric-outcomes-a-review
#20
REVIEW
Andrea V Jackson, Lin-Fan Wang, Jessica Morse
In the United States, racial and ethnic minority women experience higher rates of contraceptive non-use, failure, unintended pregnancy, and lower use of long-acting reversible contraception (LARC), compared to whites. Simultaneously researchers have found that unintended pregnancy is associated with poor pregnancy outcomes and pregnancy behaviors, including pre-term birth and late initiation of prenatal care, respectively. Due to the association of pregnancy intention and obstetrical outcomes, public health efforts have focused on the increase in contraception use among these populations as a way to decrease poor pregnancy outcomes...
August 2017: Seminars in Perinatology
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