Association of Periconceptional Dietary Inflammatory Index and Hypertensive Disorders of Pregnancy and Its Subtype.

Background: The association between diet and hypertensive disorders of pregnancy (HDP) is inconclusive due incomplete assessment of dietary measures and HDP subtypes.

Objective: We determined the association between the energy-adjusted Dietary Inflammatory Index (E-DII) and the risk of HDP subtypes in a large, diverse cohort of pregnant individuals.

Methods: We completed a secondary analysis of data from the nuMoM2b study.

Diabetes Technology Use in Pregnancies with Type 1 Diabetes in the United States from 2009 to 2020.

The use of continuous glucose monitors (CGM) and insulin pumps has revolutionized the care of patients with type 1 diabetes (T1D). Few data are available regarding the use of diabetes technology use in the pregnant T1D population. This study was conducted to evaluate temporal trends of diabetes technology use and predictors of use among pregnant individuals with TID in the United States from 2009 to 2020.

Association Between Breastfeeding and Long-Term Risk of Cardiovascular Disease.

Objective: To estimate whether breastfeeding is associated with the estimated risk of long-term atherosclerotic cardiovascular disease (ASCVD) and whether this association varies with prior gestational diabetes mellitus (GDM).

Methods: We conducted a secondary analysis from the prospective HAPO (Hyperglycemia and Adverse Pregnancy Outcome) Follow-Up Study. The exposure was any breastfeeding (yes or no).

Variation in Inpatient Admission for Management and Cost Drivers in Placenta Accreta Spectrum Disorder.

Objective: To assess variation in inpatient antepartum management strategies for placenta accreta spectrum (PAS) disorder and their association with hospitalization costs in a national sample.

Methods: This retrospective cohort study used the 2016-2021 Nationwide Readmissions Database to identify individuals aged 15-54 years who underwent cesarean hysterectomy for PAS between 23 and 35 weeks of gestation. Patients were categorized into four management groups based on whether they had a separate antepartum hospitalization and their predelivery length of stay (LOS) during the delivery hospitalization.

Risk of Adverse Pregnancy Outcomes Among Asian Individuals With Gestational Diabetes Mellitus in the U.S., 2016-2021.

Objective: The risk of adverse pregnancy outcomes (APOs) differs among race and ethnic groups with gestational diabetes mellitus (GDM). Heterogeneity in APOs may be masked by aggregating these groups. We assessed whether the frequency and risk of APOs differed among Asian groups with GDM.

Review of Patient Perspectives and Psychosocial Experiences With Automated Insulin Delivery in Pregnancy With Type 1 Diabetes.

Pregnancy adds unique medical and psychosocial complexity to the management of type 1 diabetes (TID). Automated insulin delivery (AID) use in pregnancy increasingly shows promise both in improving clinical outcomes and the patient experience for individuals living with T1D. Survey and qualitative data on psychosocial correlates of AID use in pregnancy demonstrate patient benefits compared with other glucose management strategies (such as multiple daily injections, continuous subcutaneous insulin infusion, or sensor-augmented pump therapy).

Pregnancy tTG-IgA seropositivity and maternal and infant health in the Child Health and Development Studies.

Background: We examined associations between pregnancy anti-tissue transglutaminase immunoglobulin A (tTG-IgA) seropositivity, a screening test for celiac disease, and celiac-related conditions in pregnancy and offspring health outcomes. We hypothesized that seropositivity would identify pregnant women and infants at risk of poor health.

Methods: The Child Health and Development Studies enrolled pregnant woman from 1959-1967 and prospectively followed their pregnancies and offspring.

Breastfeeding and Maternal and Child Cardiometabolic Outcomes 10-14 Years after Delivery.

Breastfeeding can improve long-term maternal and child cardiometabolic outcomes, but many of the cardiometabolic outcomes remain understudied. To examine the association between breastfeeding and maternal and child cardiometabolic outcomes 10-14 years after delivery. A secondary analysis of the prospective Hyperglycemia and Adverse Pregnancy Outcome Follow-Up Study (2013-2016).

Rural maternal health interventions: A scoping review and implications for best practices.

Purpose: Maternal health outcomes in rural areas of the United States are persistently poor, with pregnant individuals in rural areas facing complex health care obstacles. Interventions adapted to the needs of rural patients are critical to mitigate worsening health disparities. To inform future efforts in this field, we conducted a scoping review, given the complex and diverse nature of existing interventions, to synthesize the literature on rural maternal health interventions, analyze mechanisms to improve care, and identify barriers and facilitators to intervention implementation.

Association of neighborhood-level socioeconomic disadvantage and Life's Essential 8 in early pregnancy.

We examined whether neighborhood-level socioeconomic disadvantage per the Area Deprivation Index (ADI) was associated with maternal cardiovascular health (CVH) in early pregnancy per the American Heart Association Life's Essential 8 (LE8). This is a cross-sectional analysis from the prospective Nulliparous Pregnancy Outcomes Study-Monitoring Mothers-to-Be Heart Health Study (nuMoM2b-HHS) cohort. The exposure was the ADI in tertiles (T) from least (T1) to most (T3) socioeconomic disadvantage.

Hypertensive disorders of pregnancy and gestational diabetes mellitus and predicted risk of maternal cardiovascular disease 10-14 years after delivery: A prospective cohort.

Aims: Studies evaluating the relationship between adverse pregnancy outcomes (APOs), namely hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM), with the estimated risk of atherosclerotic cardiovascular disease (ASCVD) remains limited and could inform patient-centred decision-making in the postpartum period. We examined whether HDP or GDM were associated with a higher 10- and 30-year predicted risk of ASCVD measured 10-14 years after delivery.

Methods: A secondary analysis from the international prospective Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (2013-2016) cohort.

Blood Pressure in Pregnancy and Hypertension 10-14 Years After Delivery.

We examined the association between blood pressure (BP) in the early third trimester and hypertension 10-14 years after delivery per American College of Cardiology and American Heart Association recommendations. We conducted a secondary analysis using the prospective HAPO FUS (Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study) in patients without a chronic hypertension diagnosis. The exposure and outcome were systolic and diastolic BP measured in the early third trimester and 10-14 years after delivery, respectively.

Using machine learning to predict the risk of developing hypertensive disorders of pregnancy using a contemporary nulliparous cohort.

Background: Hypertensive disorders of pregnancy (HDP) are significant drivers of maternal and neonatal morbidity and mortality. Current management strategies include early identification and initiation of risk mitigating interventions facilitated by a rules-based checklist. Advanced analytic techniques, such as machine learning, can potentially offer improved and refined predictive capabilities.

Birthing Parent Experiences of Postpartum at-Home Blood Pressure Monitoring Versus Office-Based Follow up After Diagnosis of Hypertensive Disorders of Pregnancy.

Hypertensive disorders of pregnancy are a leading cause of pregnancy-related morbidity and mortality. The primary objective of this study was to compare the frequency of documentation of postpartum blood pressure through remote blood pressure monitoring with text-message delivered reminders versus office-based follow-up 7-10 days postpartum. The secondary objective was to examine barriers and facilitators of both care strategies from the perspectives of individuals who experienced a hypertensive disorder of pregnancy.

Clinical Presentation and Outcomes of Diabetic Ketoacidosis in Pregnancy.

Objective: To examine the presentation, management, and outcomes of pregnancies complicated by diabetic ketoacidosis (DKA) in a contemporary obstetric population.

Methods: This is a case series of all admissions for DKA during pregnancy at a single Midwestern academic medical center over a 10-year period. Diabetic ketoacidosis was defined per the following diagnostic criteria: anion gap more than 12 mEq/L, pH less than 7.

Diabetic Ketoacidosis and Adverse Outcomes Among Pregnant Individuals With Pregestational Diabetes in the United States, 2010-2020.

Objective: To assess the frequency of, risk factors for, and adverse outcomes associated with diabetic ketoacidosis (DKA) at delivery hospitalization among individuals with pregestational diabetes (type 1 and 2 diabetes mellitus) and secondarily to evaluate the frequency of and risk factors for antepartum and postpartum hospitalizations for DKA.

Methods: We conducted a serial, cross-sectional study using the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project Nationwide Readmissions Database from 2010 to 2020 of pregnant individuals with pregestational diabetes hospitalized for delivery. The exposures were 1) sociodemographic and clinical risk factors for DKA and 2) DKA.