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Research Interests: Obstetrics, Ultrasound, Medicine, Pregnancy, Humans, and 14 moreFemale, Risk factors, Clinical Sciences, Retrospective Studies, Chi Square Distribution, Risk Factors, Ultrasound In Medicine, Gestational Age, Gestation, Umbilical Cord, Predictive value of tests, Pregnancy Outcome, Paediatrics and reproductive medicine, and Obstetric Labor Premature
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1989-91 VS 1999-01. BARBARA LUKE, VICTOR HUGO GONZALEZ-QUINTERO, University of Miami School of Nursing and Health Studies, Coral Gables, Florida, University of Miami School of Medicne, Obstetrics and Gynecology, Miami, Florida OBJECTIVE:... more
1989-91 VS 1999-01. BARBARA LUKE, VICTOR HUGO GONZALEZ-QUINTERO, University of Miami School of Nursing and Health Studies, Coral Gables, Florida, University of Miami School of Medicne, Obstetrics and Gynecology, Miami, Florida OBJECTIVE: Our objective was to evaluate the characteristics of late preterm twin births during 1989-91 and 1999-01 to determine if risk factors and pregnancy outcomes had changed using national vital statistics data. STUDY DESIGN: The study population included all liveborn twins of 34-36 weeks gestation from the 1989-91 and 1999-01 Birth Cohort Linked Birth/Infant Death Data Set: 99,127 twins in 1989-91 and 156,984 twins in 1999-01. Maternal and newborn characteristics were compared using 2 or t tests. Adjusted odds ratios (AORs) and 95% confidence intervals calculated the infant mortality risk, controlling for maternal age, race, parity, education, smoking, adequacy of prenatal care, and infant gender. RESULTS: Between the two time periods, there was a significant shift to older maternal ages (35, 11.5% to 20.3%), more education (college graduates, from 19.8% to 33.2%), and earlier prenatal care (first trimester, from 78.7% to 85.6%), but also increases in smoking (from 6.7% to 8.9%), diabetes (from 2.9% to 4.3%), pregnancy-associated hypertension (from 7.5% to 10.6%), and cesarean delivery (from 53% to 58.7%). The risk of infant mortality fell significantly by 38% between the two time periods (AOR 0.62, 95% CI 0.57-0.68), with reductions in both neonatal and postneonatal deaths. CONCLUSION: The contemporary risk profile of women delivering late preterm twins has changed since the early 1990s, with decreases in many risk factors, but increases in others. Advances in medical care have resulted in significant reductions in neonatal and infant mortality during this period.
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Research Interests: Obstetrics, Fertility, Medicine, Birth Weight, Pregnancy, and 15 moreHumans, Low Birth Weight, Fertility and Sterility, Female, High risk pregnancy, Clinical Sciences, Adult, Maternal Age, Public health systems and services research, Fetus, Perinatal Outcome, Pregnancy Outcome, Cohort Studies, Pregnancy complications, and Paediatrics and reproductive medicine
Research Interests: Obstetrics, Medicine, Twins, Pregnancy, Humans, and 15 moreFertility and Sterility, Female, High risk pregnancy, Risk factors, Clinical Sciences, Adult, Maternal Age, Public health systems and services research, Retrospective Studies, Risk Factors, Reference Values, Pregnancy Outcome, Cohort Studies, Pregnancy complications, and Paediatrics and reproductive medicine
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Research Interests: Medicine, Humans, Escherichia coli, Sepsis, American, and 15 moreIncidence, Length of Stay, Newborn Infant, Infant Mortality, Retrospective Studies, Streptococcus, Neonatal Sepsis, Neonatal Intensive Care Unit, Elsevier, Group B Streptococcus, Escherichia Coli Infections, Apgar Score, Paediatrics and reproductive medicine, Streptococcal infections, and Respiration Artificial
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Research Interests: Obstetrics, Medicine, Birth Weight, Gestational diabetes, Pregnancy, and 14 moreComplication, Obstetrics Gynecology, Urinary tract infection, Hiv Infection, Body Mass Index, Human immunodeficiency virus, Maternal Age, Study design, Gestational Age, Gestation, Sexually Transmitted Disease, Preterm Labor, Paediatrics and reproductive medicine, and preterm premature rupture of membranes
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Objective: To evaluate the outcome of pregnancies among Hispanics in a tertiary care hospital in Miami, Florida. Study design: Retrospective study of all women who delivered in our institution over an 11-year period. Outcome variables... more
Objective: To evaluate the outcome of pregnancies among Hispanics in a tertiary care hospital in Miami, Florida. Study design: Retrospective study of all women who delivered in our institution over an 11-year period. Outcome variables were stratified by race/ethnicity groups: Hispanics, non-Hispanic blacks and non-Hispanic whites. Variables included rates of low birth weight (LBW), preterm delivery (PTD) and other selected pregnancy outcomes. Results: Thirty-five percent were of Hispanic origin, mainly of Caribbean, Central American and South American origin. Hispanics had the lowest rate of LBW (9%) when compared to blacks, non-Hispanics (18%) and white non-Hispanics (11%) (p < 0.0001). Hispanic women were less likely to deliver prematurely, at < 37 weeks (adjusted odds ratio [AOR] 0.68, 95% CI 0.65-0.91, p < 0.0001), < 32 weeks (AOR 0.57, 95% CI 0.52-0.63, p < 0.0001) and < 28 weeks (AOR 0.66, 95% CI 0.51-0.65, p < 0.0001). Hispanic women were less likely to have preterm premature rupture of membranes (AOR 0.66, 95% CI 0.58-0.75, p < 0.0001). Conclusion: Hispanics have the lowest PTD and LBW rates when compared to non-Hispanic whites and blacks.
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Research Interests: Obstetrics, Obesity, Medicine, Birth Weight, Gestational diabetes, and 15 moreHumans, Female, Confidence intervals, American, Body Mass Index, Clinical Sciences, Adult, Analysis of Variance, Odds ratio, Cesarean Section, Gestational Age, Obesity in Pregnancy, Logistic Models, Cohort Studies, and Paediatrics and reproductive medicine
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Research Interests: Obstetrics, Medicine, Comorbidity, Pregnancy, Humans, and 15 moreFemale, American, Newborn Infant, Adult, Maternal Age, Odds ratio, Retrospective Studies, Age Factors, Fetus, Gestational Age, Fetal death, Pregnancy Outcome, Premature Birth, Confidence Interval, and Paediatrics and reproductive medicine
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Research Interests: Obstetrics, Surgery, Medicine, Pregnancy, Complication, and 15 moreHumans, Female, Headache, Male, Obstetrics Gynecology, Medline, Adult, Thoracic epidural analgesia, Gestational Age, X ray Computed Tomography, Pregnancy Outcome, Oligohydramnios, Pneumocephalus, Acute Disease, and Paediatrics and reproductive medicine
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Research Interests: Obstetrics, Ultrasound, Medicine, Logistic Regression, Pregnancy, and 15 moreHumans, Ultrasonography, Female, ROC Curve, Clinical Sciences, Perinatology, Study design, Gestational Age, Logistic Regression Model, Gestation, Receiver Operating Characteristic, Predictive value of tests, Singleton, Cervical Ripening, and Paediatrics and reproductive medicine
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Research Interests: Obstetrics, Surgery, Magnetic Resonance Imaging, Medicine, Pregnancy, and 15 moreHumans, Female, Spinal Cord, Obstetrics Gynecology, Cesarean Section, Giant Cell Tumor of Bone, Laminectomy, Decompression, Spinal Fusion, Fecal Incontinence, Thoracotomy, Corpectomy, Spinal cord compression, Paediatrics and reproductive medicine, and Paresis
Aims: To estimate the complication rate of 2nd-trimester amniocentesis and to determine the associated risk factors. Methods: A retrospective chart review of genetic amniocenteses performed at a single tertiary care institution, from 1996... more
Aims: To estimate the complication rate of 2nd-trimester amniocentesis and to determine the associated risk factors. Methods: A retrospective chart review of genetic amniocenteses performed at a single tertiary care institution, from 1996 to 1998, was done. The variables studied included gestational age, indication for amniocentesis, number and site of needle punctures, and amniotic fluid color. Complications included fetal loss, rupture of membranes, and bleeding. Results: Out of the 1,347 procedures analyzed, the most common indications were advanced maternal age (72.3%) and abnormal triple screen (20.3%). Transplacental genetic amniocenteses totaled 234 (17.4%). Clear fluid was observed in 98.2% of the patients. Twenty-two complications (1.6%) were observed: fetal loss (0.22%), bleeding (0.59%), and rupture of membranes (0.82%). An abnormal karyotype was detected in 34 (2.5%) fetuses. In separate univariate logistic regression analyses, complications were significantly associated...
Research Interests: Genetics, Obstetrics, Medicine, Logistic Regression, Multivariate Analysis, and 15 moreHumans, Genetic Testing, Female, Amniotic Fluid, Incidence, Amniocentesis, Logistic Regression Analysis, Adult, Maternal Age, Gestational Age, Fetal death, Logistic Models, Gynecologic, Confidence Interval, and Obstetric Labor Premature
Research Interests: Medicine, Humans, Vasopressin, Female, Anesthesia, and 13 moreYoung Adult, Hemoglobin, Middle Aged, Adult, Public health systems and services research, Retrospective Studies, Blood Transfusion, Blood Loss, Hematocrit, Tourniquets, Leiomyoma, Blood volume pulse, and Paediatrics and reproductive medicine
We sought to determine if outcomes of nulliparous twin pregnancies differ based on maternal age. Nulliparous women with current twin pregnancies were identified from a database of women enrolled for outpatient nursing surveillance. Data... more
We sought to determine if outcomes of nulliparous twin pregnancies differ based on maternal age. Nulliparous women with current twin pregnancies were identified from a database of women enrolled for outpatient nursing surveillance. Data were stratified into four groups by maternal age: less than 20, 20 to 34, 35 to 39, and greater than or equal to 40 years. Maternal and neonatal outcomes for women less than 20, 35 to 39, and 40 or more were compared with 20- to 34-year-old controls using Kruskal-Wallis, Mann-Whitney, and Pearson chi-square analyses. We analyzed 2144 nulliparous twin pregnancies. Patients ≥35 years (34 to 39, 78.5% or ≥40, 85.9%) were more likely to have cesarean deliveries compared with controls 20 to 34 years old (71.2%). Women aged 35 to 39 were less likely to deliver at &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;37 weeks, and women in the ≥40 group were less likely to deliver at &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;35 weeks due to spontaneous preterm labor compared with the controls. Neonates born to women aged 35 to 39 had a greater gestational age at delivery and larger average birth weight than controls. Maternal and neonatal outcomes were not adversely influenced by advanced maternal age in nulliparous women carrying twin gestations.
Research Interests: Obstetrics, Medicine, Twins, Birth Weight, Pregnancy, and 15 moreHumans, Female, Young Adult, Clinical Sciences, Adult, Maternal Age, Cesarean Section, Chi Square Distribution, Parity, Gestational Age, Gestation, Twin Pregnancy, Pregnancy Outcome, Paediatrics and reproductive medicine, and Obstetric Labor Premature
We evaluated the impact of adherence to the new Institute of Medicine weight gain guidelines within each prepregnancy body mass index (PPBMI) category on the development of pregnancy-related hypertension (PRH). Patients with singleton... more
We evaluated the impact of adherence to the new Institute of Medicine weight gain guidelines within each prepregnancy body mass index (PPBMI) category on the development of pregnancy-related hypertension (PRH). Patients with singleton term deliveries (≥37 weeks) with documented PPBMI and pregnancy weight gain information were identified from a database of women enrolled for outpatient nursing services. Included were women without history of cardiovascular disease, PRH, or diabetes at initiation of services (N = 7676). Data were stratified by PPBMI (underweight = &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 18.5 kg/m(2); normal weight = 18.5 to 24.9 kg/m(2); overweight = 25.0 to 29.9 kg/m(2); obese = ≥ 30.0 kg/m(2)). PRH rates were compared overall and within each PPBMI group for those women gaining less than recommendations, within recommendations, and above recommendations using Pearson&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s chi-square and Kruskal-Wallis H test statistics. Overall, PRH rates were 5.0%, 5.4%, and 10.8% for less than, within, and above recommendation groups, respectively (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Above recommendation weight gain resulted in higher PRH incidence in each PPBMI category (underweight 7.6%, normal weight 6.2%, overweight 12.4%, and obese 17.0%), reaching statistical significance in all but the underweight PPBMI group. Excessive weight gain above established guidelines was associated with increased rates of PRH. Regardless of PPBMI, women should be counseled to avoid excessive weight gain during pregnancy.