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High risk pregnancy coding

Marissa Raymond-Flesch, Colette Auerswald, Linda McGlone, Megan Comfort, Alexandra Minnis
BACKGROUND: Latino youth, particularly in rural settings, experience significant disparities in rates of teen pregnancy and violence. Few data are available regarding social and structural influences on Latino youth's developmental trajectories, specifically on factors that promote wellbeing and protect them from engagement in high-risk sexual and violence-related behaviors. METHODS: Forty-two youth aged 13 to 19 years old were recruited from middle schools and youth leadership programs to participate in one of eight community-based focus groups in Salinas, a predominantly Latino, urban center in California's rural central coast...
February 8, 2017: BMC Public Health
Teresa N Harrison, David A Sacks, Carly Parry, Mayra Macias, Deborah S Ling Grant, Jean M Lawrence
INTRODUCTION: Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. Current approaches to GDM management and education are labor intensive and costly. Telemedicine offers a potential solution to reduce the time and cost burden of prenatal care for women with GDM. METHODS: We assessed the acceptability of a telemedicine intervention to transmit patients' weight, blood pressure, and blood glucose measurements from wireless devices to health care providers, and to alternate "virtual office visits" with office-based prenatal visits...
January 30, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Chelsea Jordan Messinger, Ilias Mahmud, Sushama Kanan, Yamin Tauseef Jahangir, Malabika Sarker, Sabina Faiz Rashid
BACKGROUND: As many as one-third of all pregnancies in Bangladesh are unplanned, with nearly one-half of these pregnancies ending in either menstrual regulation (MR) or illegal clandestine abortion. Although MR is provided free of charge, or at a nominal cost, through the public sector and various non-profits organizations, many women face barriers in accessing safe, affordable MR and post-MR care. Mobile health (mHealth) services present a promising platform for increasing access to MR among low-income women at risk for clandestine abortion...
January 14, 2017: Reproductive Health
Jessica Galin, Barbara Abrams, Stephanie A Leonard, Ellicott C Matthay, Dana E Goin, Jennifer Ahern
BACKGROUND: During pregnancy, most women do not meet gestational weight gain (GWG) guidelines, potentially resulting in adverse maternal and infant health consequences. Social environment determinants of GWG have been identified, but evidence on the relationship between neighbourhood violence and GWG is scant. Our study aims to examine the relationship between neighbourhood violence and GWG outside the recommended range. METHODS: We used statewide vital statistics and health care utilization data from California for 2006-12 (n = 2 364 793) to examine the relationship of neighbourhood violence (quarters of zip-code rates of homicide and assault) in the first 37 weeks of pregnancy with GWG (categorized using the Institute of Medicine's pregnancy weight gain guidelines)...
January 2017: Paediatric and Perinatal Epidemiology
Sarah H O'Brien, Terah Koch, Sara K Vesely, Eleanor Bimla Schwarz
OBJECTIVE: To investigate safety of hormonal contraception with regard to thromboembolic events in women with type 1 or 2 diabetes. RESEARCH DESIGN AND METHODS: We used data from 2002-2011 in Clinformatics Data Mart to identify women in the U.S., 14-44 years of age, with an ICD-9-CM code for diabetes and a prescription for a diabetic medication or device. We examined contraceptive claims and compared time to thromboembolism (venous thrombosis, stroke, or myocardial infarction) among women with diabetes dispensed hormonal contraception using a modification of Cox regression to control for age, smoking, obesity, hypertension, hyperlipidemia, diabetic complications, and history of cancer; we excluded data for 3 months after women gave birth...
November 29, 2016: Diabetes Care
Emily F Gregory, Matthew A Goldshore, Nakiya N Showell, Marquita C Genies, Mariel E Harding, Janice L Henderson
BACKGROUND: Infants of obese women are at a high risk for development of obesity. Prenatal interventions targeting gestational weight gain among obese women have not demonstrated consistent benefits for infant growth trajectories. METHODS: To better understand why such programs may not influence infant growth, qualitative semi-structured interviews were conducted with 19 mothers who participated in a prenatal nutrition intervention for women with BMI 30 kg/m(2) or greater, and with 19 clinicians (13 pediatric, 6 obstetrical)...
November 17, 2016: Childhood Obesity
Martha A Monson, Karen J Gibbons, M Sean Esplin, Michael W Varner, Tracy A Manuck
OBJECTIVE: To characterize subsequent pregnancy outcomes among women with a history of previable, preterm prelabor rupture of membranes (PROM) and assess factors associated with recurrent preterm birth. METHODS: This was a retrospective cohort study of women cared for with a history of one or more singleton pregnancy complicated by preterm PROM at less than 24 weeks of gestation between 2002 and 2013 who were cared for in two tertiary care health systems by a single group of maternal-fetal medicine specialists...
November 2016: Obstetrics and Gynecology
Lauren Stephanie Chernick, Rebecca Schnall, Melissa S Stockwell, Paula M Castaño, Tracy Higgins, Carolyn Westhoff, John Santelli, Peter S Dayan
BACKGROUND: Over 15 million adolescents use the emergency department (ED) each year in the United States. Adolescent females who use the ED for medical care have been found to be at high risk for unintended pregnancy. Given that adolescents represent the largest users of text messaging and are receptive to receiving text messages related to their sexual health, the ED visit represents an opportunity for intervention. OBJECTIVE: The aim of this qualitative study was to explore interest in and preferences for the content, frequency, and timing of an ED-based text message intervention to prevent pregnancy for adolescent females...
September 29, 2016: Journal of Medical Internet Research
Katarzyna Kosicka, Anna Siemiątkowska, Agnieszka Pękal, Aleksandra Majchrzak-Celińska, Grzegorz Bręborowicz, Mariola Krzyścin, Franciszek Główka
INTRODUCTION: One of the hypotheses concerning the etiology of gestational hypertension (GH) and pre-eclampsia (PE) assumes that they develop as a result of placenta malfunctioning at the early stage of pregnancy. Placental dysfunction is also associated with the decreased activity of 11β-hydroxysteroid dehydrogenase 2 (11β-HSD2), which in normal pregnancy protects the fetus from the excess of maternal cortisol. OBJECTIVE: The aim of the study was to analyze the sequence of HSD11B2, a gene that encodes 11β-HSD2, searching for mutations and haplotypes associated with the increased risk of GH or PE...
August 10, 2016: Journal of Maternal-fetal & Neonatal Medicine
R M D Smyth, W Taylor, A E Heazell, C Furber, M Whitworth, T Lavender
BACKGROUND: Worldwide maternal perception of fetal movements has been used for many years to evaluate fetal wellbeing. It is intuitively regarded as an expression of fetal well-being as pregnancies in which women consistently report regular fetal movements have very low morbidity and mortality. Conversely, maternal perception of reduced fetal movements is associated with adverse pregnancy outcomes. We sought to gain insight into pregnant women's and clinicians views and experiences of reduced movements...
September 26, 2016: BMC Pregnancy and Childbirth
Elise D Berlan, Nicole M Pritt, Alison H Norris
STUDY OBJECTIVE: Adolescents are at high risk for unintended pregnancy. Because of pediatricians' potential role in contraceptive counseling, understanding their attitudes and beliefs and counseling practices about use of long-acting reversible contraceptives (LARC; ie, etonogestrel implant and intrauterine devices [IUDs]) is vital. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We interviewed primary care pediatricians (N = 23) in a Midwestern city in June-August 2014...
February 2017: Journal of Pediatric and Adolescent Gynecology
Karen M Clements, Monika Mitra, Jianying Zhang, Lisa I Iezzoni
BACKGROUND: Women with disabilities are at risk for poor birth outcomes. Little is known about specific potentially disabling health conditions and their effects on pregnancies. Using hospital claims, we identified women at risk for disability and evaluated the relationship between disability risk and demographic characteristics, pregnancy risks, and infant and maternal outcomes. METHODS: The 2006 through 2009 Massachusetts Pregnancy to Early Life Longitudinal data system linked birth certificate and hospital claims one year pre-pregnancy through delivery...
September 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
David Henry, Colin Dormuth, Brandace Winquist, Greg Carney, Shawn Bugden, Gary Teare, Linda E Lévesque, Anick Bérard, J Michael Paterson, Robert W Platt
BACKGROUND: Isotretinoin, a teratogen, is widely used to treat cystic acne. Although the risks of pregnancy during isotretinoin therapy are well recognized, there are doubts about the level of adherence with the pregnancy prevention program in Canada. Our objective was to evaluate the effectiveness of the Canadian pregnancy prevention program in 4 provinces: British Columbia, Saskatchewan, Manitoba and Ontario. METHODS: Using administrative data, we identified 4 historical cohorts of female users of isotretinoin (aged 12-48 yr) for the period 1996 to 2011...
July 12, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
M Toftager, J Bogstad, T Bryndorf, K Løssl, J Roskær, T Holland, L Prætorius, A Zedeler, L Nilas, A Pinborg
STUDY QUESTION: Is the risk of severe ovarian hyperstimulation syndrome (OHSS) similar in a short GnRH antagonist and long GnRH agonist protocol in first cycle IVF/ICSI patients less than 40 years of age?. SUMMARY ANSWER: There is an increased risk of severe OHSS in the long GnRH agonist group compared with the short GnRH antagonist protocol. WHAT IS KNOWN ALREADY?: In the most recent Cochrane review, the GnRH antagonist protocol was associated with a similar live birth rate (LBR), a similar on-going pregnancy rate (OPR), and a lower incidence of OHSS (odds ratio (OR) = 0...
June 2016: Human Reproduction
Armando D'Angelo, Luca Valsecchi
INTRODUCTION: Antithrombin levels are often reduced in preeclampsia and infusion of antithrombin concentrates has been reported to prolong gestation in severe preeclampsia. We aimed to evaluate efficacy and safety of high-dose antithrombin (ATIII) supplementation in patients with single pregnancies and preeclampsia occurring before 30 weeks of gestation. MATERIALS AND METHODS: In November 2004 a double-blind, placebo-controlled trial (code KB033) was started in 13 Italian centers...
April 2016: Thrombosis Research
Corrie M Whisner, Meg Bruening, Kimberly O O'Brien
STUDY OBJECTIVE: To provide a brief assessment of dietary beliefs and behaviors in an understudied high-risk population of pregnant adolescents. DESIGN, SETTING, AND PARTICIPANTS: Diverse pregnant adolescents (n = 66) recruited from the Rochester Adolescent Maternity Program at the University of Rochester Medical Center in Rochester, New York completed a nutrition knowledge and beliefs survey once during pregnancy. INTERVENTIONS AND MAIN OUTCOME MEASURES: Responses were recorded by a health project coordinator who had good rapport with the teens...
October 2016: Journal of Pediatric and Adolescent Gynecology
Clare L Whitehead, Helen McNamara, Susan P Walker, Maria Alexiadis, Peter J Fuller, Daniel K Vickers, Natalie J Hannan, Roxanne Hastie, Laura Tuohey, Tu'uhevaha J Kaitu'u-Lino, Stephen Tong
BACKGROUND: Late-onset fetal growth restriction (FGR) is often undetected prior to birth, which puts the fetus at increased risk of adverse perinatal outcomes including stillbirth. OBJECTIVE: Measuring RNA circulating in the maternal blood may provide a noninvasive insight into placental function. We examined whether measuring RNA in the maternal blood at 26-30 weeks' gestation can identify pregnancies at risk of late-onset FGR. We focused on RNA highly expressed in placenta, which we termed "placental-specific genes...
April 2016: American Journal of Obstetrics and Gynecology
Sarah J Kilpatrick, Anisha Abreo, Naomi Greene, Kathryn Melsop, Nancy Peterson, Larry E Shields, Elliot K Main
BACKGROUND: Hypertensive diseases of pregnancy are associated with severe maternal morbidity and remain common causes of maternal death. Recently, national guidelines have become available to aid in recognition and management of hypertension in pregnancy to reduce morbidity and mortality. The increased morbidity related to hypertensive disorders of pregnancy is presumed to be associated with the development of severe hypertension. However, there are few data on specific treatment or severe maternal morbidity in women with acute severe intrapartum hypertension as opposed to severe preeclampsia...
July 2016: American Journal of Obstetrics and Gynecology
Maike K Kahr, Melissa A Suter, Jerasimos Ballas, Ryan Ramphul, Graciela Lubertino, Winifred J Hamilton, Kjersti M Aagaard
BACKGROUND: Preterm birth (PTB) is a multifactorial disorder, and air pollution has been suggested to increase the risk of occurrence. However, large population studies controlling for multiple exposure measures in high-density settings with established commuter patterns are lacking. OBJECTIVE: We performed a geospatial analysis with the use of a publicly available database to identify whether residence during pregnancy, specifically with regard to exposure to traffic density and mobility in urban and suburban neighborhoods, may be a contributing risk factor for premature delivery...
July 2016: American Journal of Obstetrics and Gynecology
Henry Nsubuga, Juliet N Sekandi, Hassard Sempeera, Fredrick E Makumbi
BACKGROUND: In Uganda, the risk of unintended pregnancies and unsafe abortions remains high due to relatively low contraceptive use. There is paucity of data on knowledge, attitudes, perceptions and practices towards modern contraceptives and, sexual and reproductive health especially among the young female university students. METHODS: A survey was conducted at Makerere University main campus in Kampala, Uganda during April 2014. A team of well-trained and experienced research assistants interviewed female undergraduate students who provided data on socio-demographic characteristics, knowledge, perceptions and attitudes and use of contraceptives, as well as other sexual and reproductive health practices...
2016: BMC Women's Health
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