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  1. Article ; Online: De Novo Postpartum Hypertension: Is Pregnancy a Stress Test or Risk Factor?

    Sanusi, Ayodeji A / Sinkey, Rachel G

    Hypertension (Dallas, Tex. : 1979)

    2023  Volume 80, Issue 2, Page(s) 288–290

    MeSH term(s) Pregnancy ; Female ; Humans ; Exercise Test ; Hypertension/diagnosis ; Hypertension/epidemiology ; Risk Factors ; Postpartum Period ; Hypertension, Pregnancy-Induced/diagnosis ; Hypertension, Pregnancy-Induced/epidemiology ; Pre-Eclampsia/diagnosis ; Pre-Eclampsia/epidemiology
    Language English
    Publishing date 2023-01-18
    Publishing country United States
    Document type Editorial ; Research Support, N.I.H., Extramural ; Comment
    ZDB-ID 423736-5
    ISSN 1524-4563 ; 0194-911X ; 0362-4323
    ISSN (online) 1524-4563
    ISSN 0194-911X ; 0362-4323
    DOI 10.1161/HYPERTENSIONAHA.122.20155
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Clinical Trials That Have Changed Obstetric Practice: The Chronic Hypertension and Pregnancy (CHAP) Trial.

    Sanusi, Ayodeji A / Sinkey, Rachel G / Tita, Alan T N

    Clinical obstetrics and gynecology

    2024  

    Abstract: We describe the evolution of treatment recommendations for chronic hypertension (CHTN) in pregnancy, the CHTN and pregnancy (CHAP) trial, and its impact on obstetric practice. The US multicenter CHAP trial showed that antihypertensive treatment for mild ... ...

    Abstract We describe the evolution of treatment recommendations for chronic hypertension (CHTN) in pregnancy, the CHTN and pregnancy (CHAP) trial, and its impact on obstetric practice. The US multicenter CHAP trial showed that antihypertensive treatment for mild CHTN in pregnancy [blood pressures (BP)<160/105 mm Hg] to goal<140/90 mm Hg, primarily with labetalol or nifedipine compared with no treatment unless BP were severe reduced the composite risk of superimposed severe preeclampsia, indicated preterm birth <35 weeks, placental abruption, and fetal/neonatal death. As a result of this trial, professional societies in the United States recommended treatment of patients with CHTN in pregnancy to BP goal<140/90 mm Hg.
    Language English
    Publishing date 2024-03-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 391207-3
    ISSN 1532-5520 ; 0009-9201
    ISSN (online) 1532-5520
    ISSN 0009-9201
    DOI 10.1097/GRF.0000000000000857
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Electronic Cigarette Use during Pregnancy: Is It Harmful?

    Vilcassim, M J Ruzmyn / Stowe, Samuel / Majumder, Rachel / Subramaniam, Akila / Sinkey, Rachel G

    Toxics

    2023  Volume 11, Issue 3

    Abstract: Although combustible cigarette smoking rates have declined in recent years, alternative tobacco product use, particularly electronic cigarette use ("vaping"), has increased among young adults. Recent studies indicate that vaping during pregnancy is on ... ...

    Abstract Although combustible cigarette smoking rates have declined in recent years, alternative tobacco product use, particularly electronic cigarette use ("vaping"), has increased among young adults. Recent studies indicate that vaping during pregnancy is on the rise, possibly due to the perception that it is a safer alternative to combustible cigarette smoking. However, e-cigarette aerosols may contain several newer, potentially toxic compounds, including some known developmental toxicants that may adversely impact both the mother and the fetus. However, there is paucity of studies that have examined the effects of vaping during pregnancy. While the adverse perinatal outcomes of cigarette smoking during pregnancy are well established, the specific risks associated with inhaling vaping aerosols during pregnancy requires more research. In this article, we discuss the existing evidence and knowledge gaps on the risks of vaping during pregnancy. Studies that investigate vaping-associated systemic exposure and its effects (i.e., biomarker analyses) and maternal and neonatal clinical health outcomes are needed to reach more robust conclusions. We particularly emphasize the need to go beyond comparative studies with cigarettes, and advocate for research that objectively evaluates the safety of e-cigarettes and other alternative tobacco products.
    Language English
    Publishing date 2023-03-18
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2733883-6
    ISSN 2305-6304 ; 2305-6304
    ISSN (online) 2305-6304
    ISSN 2305-6304
    DOI 10.3390/toxics11030278
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Lower Blood Pressure Thresholds Raise the Bar in Pregnancy.

    Sinkey, Rachel G / Oparil, Suzanne

    Circulation research

    2019  Volume 125, Issue 2, Page(s) 195–197

    MeSH term(s) Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Female ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Hypotension ; Infant, Newborn ; Mothers ; Pregnancy
    Language English
    Publishing date 2019-07-03
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 80100-8
    ISSN 1524-4571 ; 0009-7330 ; 0931-6876
    ISSN (online) 1524-4571
    ISSN 0009-7330 ; 0931-6876
    DOI 10.1161/CIRCRESAHA.119.315384
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Society for Maternal-Fetal Medicine Consult Series #68: Sickle cell disease in pregnancy.

    Sinkey, Rachel G / Ogunsile, Foluso J / Kanter, Julie / Bean, Cynthia / Greenberg, Mara

    American journal of obstetrics and gynecology

    2023  Volume 230, Issue 2, Page(s) B17–B40

    Abstract: Pregnant individuals with sickle cell disease have an increased risk of maternal and perinatal morbidity and mortality. However, prepregnancy counseling and multidisciplinary care can lead to favorable maternal and neonatal outcomes. In this consult ... ...

    Abstract Pregnant individuals with sickle cell disease have an increased risk of maternal and perinatal morbidity and mortality. However, prepregnancy counseling and multidisciplinary care can lead to favorable maternal and neonatal outcomes. In this consult series, we summarize what is known about sickle cell disease and provide guidance for sickle cell disease management during pregnancy. The following are Society for Maternal-Fetal Medicine recommendations.
    MeSH term(s) Pregnancy ; Infant, Newborn ; Female ; Humans ; Perinatology ; Pregnancy Complications, Hematologic/diagnosis ; Pregnancy Complications, Hematologic/therapy ; Anemia, Sickle Cell/therapy
    Language English
    Publishing date 2023-10-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80016-8
    ISSN 1097-6868 ; 0002-9378
    ISSN (online) 1097-6868
    ISSN 0002-9378
    DOI 10.1016/j.ajog.2023.10.031
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Physiologic blood pressure patterns in pregnancies with mild chronic hypertension.

    Sinkey, Rachel G / Blanchard, Christina T / Sanusi, Ayodeji / Elkins, Cooper / Szychowski, Jeff M / Harper, Lorie M / Tita, Alan T

    Pregnancy hypertension

    2024  Volume 36, Page(s) 101118

    Abstract: Objectives: To assess physiologic blood pressure (BP) changes throughout pregnancy in patients with mild chronic hypertension (CHTN) who do and do not develop preeclampsia (PEC), compared to patients with normal BP.: Study design: Retrospective ... ...

    Abstract Objectives: To assess physiologic blood pressure (BP) changes throughout pregnancy in patients with mild chronic hypertension (CHTN) who do and do not develop preeclampsia (PEC), compared to patients with normal BP.
    Study design: Retrospective cohort of singleton gestations with CHTN at a single tertiary center from 2000 to 2014 and a randomly selected cohort of patients without CHTN and normal pregnancy outcomes (NML) in the same time period with BP measurements available <12 weeks gestational age.
    Main outcome measures: The primary outcome was gestational age (GA) at nadir of systolic and diastolic BP. Secondary outcomes included perinatal death, umbilical cord pH, maternal and neonatal length of stay, GA at delivery, and mode of delivery. Quadratic mixed models were used to estimate SBP and DBP throughout gestation.
    Results: Of 367 pregnancies with CHTN, 268 (73%) had CHTN without PEC and 99 (27%) had CHTN with PEC; 198 NML pregnancies were used as a comparison group. The median GA nadir for patients in the NML, CHTN without PEC, and CHTN with PEC for SBP were 20, 24, and 21, respectively. For DBP, the median GA nadir were 22, 24, and 21 for patients in the NML, CHTN without PEC, and CHTN with PEC cohorts, respectively. Adverse secondary outcomes were more frequent in patients with CHTN who developed PEC.
    Conclusions: BP trajectories in pregnancy are different between patients with CHTN with PEC, CHTN without PEC, and patients with normal BP. These findings may be useful in assessing patients' risks for developing preeclampsia during pregnancy.
    Language English
    Publishing date 2024-03-08
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2584464-7
    ISSN 2210-7797 ; 2210-7789
    ISSN (online) 2210-7797
    ISSN 2210-7789
    DOI 10.1016/j.preghy.2024.101118
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Racial Disparities in Breastfeeding Rates in Patients with Heart Disease.

    Oben, Ayamo G / Blanchard, Christina T / Robinson, Ashton / Girling, Isabel / Joly, Joanna M / Cribbs, Marc / Tita, Alan / Casey, Brian / Sinkey, Rachel

    Journal of racial and ethnic health disparities

    2024  

    Abstract: Objective: To evaluate racial disparities in breastfeeding rates in patients with heart disease.: Study design: Retrospective cohort of pregnant patients with maternal cardiac disease managed by a Cardio-Obstetrics program. Patients self-identifying ... ...

    Abstract Objective: To evaluate racial disparities in breastfeeding rates in patients with heart disease.
    Study design: Retrospective cohort of pregnant patients with maternal cardiac disease managed by a Cardio-Obstetrics program. Patients self-identifying as Non-Hispanic Black (NHB) and Non-Hispanic White (NHW), who attended ≥ 1 prenatal visit at the Cardio-Obstetrics Program and delivered at the same hospital between March 2015 and June 2019 were included. The primary outcome was breastfeeding rate at discharge from the delivery-associated hospitalization. Secondary outcomes included breastfeeding intent on admission and breastfeeding rates at the postpartum visit among patients who initiated breastfeeding.
    Results: 138 pregnant patients with cardiac disease were included: 58 (42%) NHB and 80 (58%) NHW patients. Parity, marital status and insurance were statistically different between groups. NHB patients were more likely to have government insurance compared to NHW patients (77.6% vs. 40%; p < 0.001). There was a significant difference in the intent to breastfeed upon admission for the delivery-associated hospitalization (74.2% NHB vs. NHW 91.3%; p = 0.01), but not at hospital discharge (84.5% NHB vs. 93.8% NHW; p = 0.08). However, breastfeeding rates were significantly lower among NHB patients at the postpartum visit among the entire cohort (38.2% in NHB vs. 61.1% in NHW women; p = 0.036) and among those who initiated breastfeeding (35.3% NHB vs. 61.1% NHW, p = 0.018).
    Conclusions: Despite similar breastfeeding rates at hospital discharge, NHB patients with maternal cardiac disease were less likely to intend to breastfeed at admission and/or continue breastfeeding by the postpartum visits. Qualitative studies understanding these differences are crucial to improve breastfeeding rates, especially for NHB patients with maternal cardiac disease.
    Language English
    Publishing date 2024-03-20
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2760524-3
    ISSN 2196-8837 ; 2197-3792
    ISSN (online) 2196-8837
    ISSN 2197-3792
    DOI 10.1007/s40615-024-01933-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Breastfeeding Practices in Patients with Heart Disease Stratified by Area Deprivation Index.

    Collins, Isabel C / Blanchard, Christina T / Tipre, Meghan / Oben, Ayamo / Robinson, Ashton / Kako, Tavonna / Joly, Joanna M / Cribbs, Marc G / Casey, Brian / Tita, Alan / Sinkey, Rachel

    Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine

    2024  Volume 19, Issue 4, Page(s) 256–261

    Abstract: Objective: ...

    Abstract Objective:
    MeSH term(s) Humans ; Female ; Breast Feeding/statistics & numerical data ; Retrospective Studies ; Adult ; Pregnancy ; Heart Diseases/epidemiology ; Alabama/epidemiology ; Socioeconomic Factors ; Infant, Newborn ; Pregnancy Complications, Cardiovascular/epidemiology ; Mothers/psychology
    Language English
    Publishing date 2024-03-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2234680-6
    ISSN 1556-8342 ; 1556-8253
    ISSN (online) 1556-8342
    ISSN 1556-8253
    DOI 10.1089/bfm.2023.0295
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Systematic Review of Lymphangioleiomyomatosis Outcomes in Pregnancy and a Proposed Management Guideline.

    Champion, Macie L / Maier, Julia G / Bushman, Elisa T / Barney, Joseph B / Casey, Brian M / Sinkey, Rachel G

    American journal of perinatology

    2023  

    Abstract: Objective:  Lymphangioleiomyomatosis (LAM) is a rare, multisystem disease that primarily affects women of reproductive age. Disease progression has been linked to estrogen exposure, and as such many patients are advised to avoid pregnancy. Data are ... ...

    Abstract Objective:  Lymphangioleiomyomatosis (LAM) is a rare, multisystem disease that primarily affects women of reproductive age. Disease progression has been linked to estrogen exposure, and as such many patients are advised to avoid pregnancy. Data are limited regarding the interaction between LAM and pregnancy, and as such we performed a systematic review to summarize available literature reporting outcomes of pregnancies complicated by maternal LAM.
    Study design:  This was a systematic review including randomized controlled trials, observational studies, systematic reviews, case reports, clinical practice guidelines, and quality improvement studies with full-text manuscripts or abstracts in the English language with primary data on pregnant or postpartum patients with LAM. The primary outcome was maternal outcomes during pregnancy as well as pregnancy outcomes. Secondary outcomes were neonatal outcomes and long-term maternal outcomes. This search occurred in July 2020 and included MEDLINE, Scopus, clinicaltrials.gov, Embase, and Cochrane Central. Risk of bias was ascertained using the Newcastle-Ottawa Scale. Our systematic review was registered with PROSPERO as protocol number CRD 42020191402.
    Results:  A total of 175 publications were identified in our initial search; ultimately 31 studies were included. Six (19%) studies were retrospective cohort studies and 25 (81%) studies were case reports. Patients diagnosed during pregnancy had worse pregnancy outcomes compared to those diagnosed with LAM prior to pregnancy. Multiple studies reported a significant risk of pneumothoraces during pregnancy. Other significant risks included preterm delivery, chylothoraces, and pulmonary function deterioration. A proposed strategy for preconception counseling and antenatal management is provided.
    Conclusion:  Patients diagnosed with LAM during pregnancy generally experience worse outcomes including recurrent pneumothoraces and preterm delivery as compared to patients with a LAM diagnosis prior to pregnancy. Given that there are limited studies available, and that the majority are low-quality evidence and subject to bias, further investigation of the interaction between LAM and pregnancy is warranted to guide patient care and counseling.
    Key points: · Data are limited on the effects of lymphangioleiomyomatosis on pregnancy outcomes.. · We performed a systematic review to summarize pregnancy outcomes complicated by LAM.. · Patients diagnosed with LAM during pregnancy experience worse outcomes..
    Language English
    Publishing date 2023-04-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605671-4
    ISSN 1098-8785 ; 0735-1631
    ISSN (online) 1098-8785
    ISSN 0735-1631
    DOI 10.1055/a-2051-8395
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Physiologic Treatment of Severe Hypertension in Pregnancy and Postpartum.

    Davis, Allison M / Blanchard, Christina T / Subramaniam, Akila / Sinkey, Rachel G / Tita, Alan T / Battarbee, Ashley N

    Obstetrics and gynecology

    2023  Volume 143, Issue 2, Page(s) 277–280

    Abstract: We aimed to evaluate physiologic treatment of severe hypertension. This was a retrospective cohort study of pregnant and postpartum patients with severe hypertension (systolic blood pressure [BP] 160 mm Hg or higher or diastolic BP 110 mm Hg or higher) ... ...

    Abstract We aimed to evaluate physiologic treatment of severe hypertension. This was a retrospective cohort study of pregnant and postpartum patients with severe hypertension (systolic blood pressure [BP] 160 mm Hg or higher or diastolic BP 110 mm Hg or higher) treated with intravenous labetalol or hydralazine at a single tertiary care center between 2013 and 2018. Patients were classified as having physiologic treatment if they had hyperdynamic physiology (pulse pressure 65 mm Hg or higher) and received labetalol or had vasoconstrictive physiology (diastolic BP 100 mm Hg or higher) and received hydralazine. The primary outcome was number of antihypertensive doses to achieve nonsevere BP. Of 1,120 patients included in the analysis, 653 had physiologic treatment and 467 had nonphysiologic treatment, with 16 (1.4%) excluded for inability to classify physiology. Physiologic treatment was associated with fewer antihypertensive doses (1.4±0.9 doses vs 1.6±1.4 doses; adjusted β -0.28, 95% CI, -0.42 to -0.14) and lower odds of medication conversion (2.5% vs 4.7%; adjusted odds ratio 0.48, 95% CI, 0.24-0.93) but no difference in time to nonsevere BP (31 minutes [interquartile range 16-66 minutes] vs 34 minutes [interquartile range 15-76 minutes]; adjusted hazard ratio 1.0, 95% CI, 0.9-1.2). Physiologic treatment of severe hypertension warrants further evaluation.
    MeSH term(s) Female ; Humans ; Pregnancy ; Antihypertensive Agents ; Blood Pressure ; Hydralazine/adverse effects ; Hypertension/drug therapy ; Labetalol ; Nifedipine/therapeutic use ; Postpartum Period ; Retrospective Studies ; Hypertension, Pregnancy-Induced
    Chemical Substances Antihypertensive Agents ; Hydralazine (26NAK24LS8) ; Labetalol (R5H8897N95) ; Nifedipine (I9ZF7L6G2L)
    Language English
    Publishing date 2023-11-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 207330-4
    ISSN 1873-233X ; 0029-7844
    ISSN (online) 1873-233X
    ISSN 0029-7844
    DOI 10.1097/AOG.0000000000005472
    Database MEDical Literature Analysis and Retrieval System OnLINE

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