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  1. 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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  2. Article ; Online: Outcomes in low-risk patients before and after an institutional policy offering 39-week elective induction of labor.

    Cozzi-Glaser, Gabriella D / Blanchard, Christina T / Stanford, Jenna N / Oben, Ayamo G / Jauk, Victoria C / Szychowski, Jeff M / Subramaniam, Akila / Battarbee, Ashley N / Casey, Brian M / Tita, Alan T / Sinkey, Rachel G

    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

    2023  Volume 37, Issue 1, Page(s) 2295223

    Abstract: Objective: Elective induction of labor versus expectant management at 39 weeks gestation in low-risk nulliparous patients was shown in the ARRIVE randomized trial of over 6000 patients to decrease risks of cesarean delivery without significant change in ...

    Abstract Objective: Elective induction of labor versus expectant management at 39 weeks gestation in low-risk nulliparous patients was shown in the ARRIVE randomized trial of over 6000 patients to decrease risks of cesarean delivery without significant change in the composite perinatal outcome. We aimed to pragmatically analyze the effect of offering elective induction of labor (eIOL) to all low-risk patients.
    Methods: Retrospective cohort study of low-risk nulliparous and multiparous patients delivering live, non-anomalous singletons at a single center at greater than or equal to 39 0/7 weeks gestational age. Those with prior or planned cesarean delivery, ruptured membranes, medical comorbidities, or contraindications to vaginal delivery were excluded. Patients were categorized as before (pre-eIOL; 1/2012-3/2014) or after (post-eIOL; 3/2019-12/2021) an institution-wide policy offering eIOL at 39 0/7 weeks. Births occurring April 2014 to December 2018 were allocated to a separate cohort (during-eIOL) given increased exposure to eIOL as our center recruited participants for the ARRIVE trial. The primary outcome was cesarean birth. Secondary outcomes included select maternal (e.g. chorioamnionitis, operative delivery, postpartum hemorrhage) and neonatal morbidities (e.g. birthweight, small- and large-for gestational age, hypoglycemia). Characteristics and outcomes were compared between the pre and during-eIOL, and pre and post-eIOL groups; adjusted OR (95% CI) were calculated using multivariable regression. Subgroup analysis by parity was planned.
    Results: Of 10,758 patients analyzed, 2521 (23.4%) were pre-eIOL, 5410 (50.3%) during-eIOL, and 2827 (26.3%) post-eIOL. Groups differed with respect to labor type, age, race/ethnicity, marital and payor status, and gestational age at care entry. Post-eIOL was associated with lower odds of cesarean compared to pre-eIOL (aOR 0.83 [95% CI 0.72-0.96]), which was even lower among those specifically undergoing labor induction (aOR 0.58 [0.48-0.70]. During-eIOL was also associated with lower odds of cesarean compared to pre-eIOL (aOR 0.79 [0.69-0.90]). Both during and post-eIOL groups were associated with higher odds of chorioamnionitis, operative delivery, and hemorrhage compared to pre-eIOL. However, only among post-eIOL were there fewer neonates weighing ≥4000 g, large-for-gestational age infants, and neonatal hypoglycemia compared to pre-IOL.
    Conclusion: An institutional policy offering eIOL at 39 0/7 to low-risk patients was associated with a lower cesarean birth rate, lower birthweights and lower neonatal hypoglycemia, and an increased risk of chorioamnionitis and hemorrhage.
    MeSH term(s) Female ; Humans ; Infant, Newborn ; Pregnancy ; Chorioamnionitis/etiology ; Gestational Age ; Hypoglycemia/etiology ; Infant, Newborn, Diseases/etiology ; Labor, Induced/methods ; Organizational Policy ; Postpartum Hemorrhage/etiology ; Retrospective Studies ; Randomized Controlled Trials as Topic
    Language English
    Publishing date 2023-12-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 2077261-0
    ISSN 1476-4954 ; 1057-0802 ; 1476-7058
    ISSN (online) 1476-4954
    ISSN 1057-0802 ; 1476-7058
    DOI 10.1080/14767058.2023.2295223
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3510: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: A systematic review of biomarkers associated with maternal infection in pregnant and postpartum women.

    Oben, Ayamo G / Johnson, Brittany M / Tita, Alan T N / Andrews, William W / Hibberd, Patricia L / Subramaniam, Akila / Sinkey, Rachel G

    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

    2021  Volume 157, Issue 1, Page(s) 42–50

    Abstract: Background: Serum biomarkers are commonly used to support the diagnosis of infection in non-pregnant patients whose clinical presentation suggests infection. The utility of serum biomarkers for infection in pregnant and postpartum women is uncertain.: ...

    Abstract Background: Serum biomarkers are commonly used to support the diagnosis of infection in non-pregnant patients whose clinical presentation suggests infection. The utility of serum biomarkers for infection in pregnant and postpartum women is uncertain.
    Search strategy: PubMed, CINAHL, EMBASE, ClinicalTrials.gov, Cochrane Library, CINAHL, and SCOPUS were searched from inception to February 2020.
    Selection criteria: Full-text manuscripts in English were included if they reported the measurement of maternal serum biomarkers-and included a control group-to identify infection in pregnant and postpartum women.
    Data collection and analysis: two authors independently screened manuscripts, extracted data, and assessed methodologic quality.
    Main results: Interleukin-6 (IL-6), C-reactive protein, procalcitonin, insulin-like growth factor binding protein 1, tumor necrosis factor-α, calgranulin B, neopterin, and interferon-γ inducible protein 10 reliably indicated infection. Intercellular adhesion molecule 1, monocyte chemotactic and activating factor, soluble IL-6 receptor, and IL-8 were not useful markers in pregnant and postpartum women.
    Conclusions: Findings suggest that certain biomarkers have diagnostic value when maternal infection is suspected, but also confirms limitations in this population.
    MeSH term(s) Biomarkers ; Female ; Humans ; Postpartum Period ; Pregnancy
    Chemical Substances Biomarkers
    Language English
    Publishing date 2021-06-21
    Publishing country United States
    Document type Journal Article ; Review ; Systematic Review
    ZDB-ID 80149-5
    ISSN 1879-3479 ; 0020-7292
    ISSN (online) 1879-3479
    ISSN 0020-7292
    DOI 10.1002/ijgo.13747
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 355: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 183: Show issues

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  4. Article ; Online: Identifying Risk Factors for Cesarean Delivery in a Predominantly Hispanic Teenage Population: A 5-Year Retrospective Study.

    Oben, Ayamo G / Batiste, Oliver / Fokong, Kunuwo / Davidson, Sasha / Acosta, Ometeotl M

    Journal of pediatric and adolescent gynecology

    2018  Volume 31, Issue 5, Page(s) 485–489

    Abstract: Study objective: To identify risk factors for primary nonelective cesarean delivery, in a predominantly Hispanic teen population of an urban tertiary care center.: Design: Retrospective descriptive study.: Setting: A tertiary academic center with ... ...

    Abstract Study objective: To identify risk factors for primary nonelective cesarean delivery, in a predominantly Hispanic teen population of an urban tertiary care center.
    Design: Retrospective descriptive study.
    Setting: A tertiary academic center with approximately 3000 deliveries per year.
    Participants: Our study population comprised all women (ages 13-19 years at time of delivery) who gave birth at our tertiary university hospital between July 2011 and July 2016.
    Interventions: None.
    Main outcome measures: Our main outcome of interest was primary nonelective cesarean delivery.
    Results: Of the 958 included deliveries, 9.6% (92/958) were delivered via nonelective cesarean section. The population was 89% Hispanic with a mean age of 17.7 years. Age, body mass index at delivery, and neonatal birth weight were significantly associated with delivery via cesarean section. Mothers of neonates with extremes of birth weights (<2500 g, >4000 g) had higher odds of having a cesarean delivery, compared with neonates with normal birth weight (odds ratio, 3.27; 95% confidence interval, 1.90-5.63 and odds ratio, 4.43; 95% confidence interval, 1.33-14.72).
    Conclusion: Among adolescent patients, age, body mass index at delivery, and birth weight of the neonate were found to be risk factors that place the gravid teen at increased risk for cesarean delivery.
    MeSH term(s) Adolescent ; Adult ; Cesarean Section/statistics & numerical data ; Female ; Hispanic Americans/statistics & numerical data ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy in Adolescence/ethnology ; Pregnancy in Adolescence/statistics & numerical data ; Retrospective Studies ; Risk Factors ; Tertiary Care Centers ; Young Adult
    Language English
    Publishing date 2018-05-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1325079-6
    ISSN 1873-4332 ; 1083-3188
    ISSN (online) 1873-4332
    ISSN 1083-3188
    DOI 10.1016/j.jpag.2018.05.001
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2337: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Racial disparities in reliable contraceptive use in women with heart disease.

    Oben, Ayamo G / Walker, Zachary W / Blanchard, Christina T / Szychowski, Jeff M / Maier, Julia G / Rajapreyar, Indranee / Cribbs, Marc G / Tita, Alan / Sinkey, Rachel G

    The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception

    2021  Volume 27, Issue 3, Page(s) 174–179

    Abstract: Objective: The aim of the study was to investigate the differences in reliable contraceptive use between black women and white women with maternal cardiac disease.: Methods: The study comprised a retrospective cohort of women with maternal cardiac ... ...

    Abstract Objective: The aim of the study was to investigate the differences in reliable contraceptive use between black women and white women with maternal cardiac disease.
    Methods: The study comprised a retrospective cohort of women with maternal cardiac disease managed by the University of Alabama at Birmingham (UAB) Comprehensive Pregnancy and Heart Program (CPHP). Women were included if they had attended one or more prenatal visits at the UAB CPHP and delivered at the UAB hospital between March 2015 and June 2019. The primary outcome was reliable contraceptive use within 2 months postpartum, defined by receipt of long-acting reversible contraception (i.e., an intrauterine contraceptive device or an etonogestrel implant) or female sterilisation. All outcomes were compared based on self-reported race.
    Results: One hundred and forty-nine women met the inclusion criteria. Black women (
    Conclusion: Black women with maternal cardiac disease were more likely than white women to receive reliable contraception. Interventions to prevent unintended pregnancy in women with maternal cardiac disease should focus on improving reliable contraceptive use, especially for women with modified WHO class III/IV lesions.
    MeSH term(s) Contraception ; Contraceptive Agents, Female/therapeutic use ; Female ; Heart Diseases ; Humans ; Pregnancy ; Pregnancy, Unplanned ; Retrospective Studies
    Chemical Substances Contraceptive Agents, Female
    Language English
    Publishing date 2021-12-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 1397560-2
    ISSN 1473-0782 ; 1362-5187
    ISSN (online) 1473-0782
    ISSN 1362-5187
    DOI 10.1080/13625187.2021.2010042
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4819: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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