Tracy Manuck - Academia.edu (original) (raw)

Papers by Tracy Manuck

Research paper thumbnail of 397: Mapping genetic susceptibility to preterm birth: Analysis of Utah pedigrees using shared genomic segment analysis

American Journal of Obstetrics and Gynecology, 2016

Research paper thumbnail of Progesterone Receptor Genotype, Family History, and Spontaneous Preterm Birth

Obstetrics and Gynecology, Apr 1, 2010

OBJECTIVE: To examine whether women with a personal or family history of preterm birth are more l... more OBJECTIVE: To examine whether women with a personal or family history of preterm birth are more likely to have genetic variation in the human progesterone receptor (hPR).

Research paper thumbnail of COMPOSITIONS AND METHODS FOR DIAGNOSING AND PREVENTING SPONTANEOUS PRETERM BIRTH

Research paper thumbnail of Tocolysis for Women With Early Spontaneous Preterm Labor and Advanced Cervical Dilation

Obstetrics and gynecology, 2015

To characterize tocolytic use and examine perinatal outcomes among women presenting very preterm ... more To characterize tocolytic use and examine perinatal outcomes among women presenting very preterm with spontaneous labor and cervical dilation 4 cm or greater. This was a retrospective cohort study. Data from January 2000 to June 2011 in a single health care system were reviewed. Women with singleton, nonanomalous fetuses and preterm labor with intact membranes between 23 and 32 weeks of gestation who had cervical dilation 4 cm or greater and less than 8 cm at admission were included. Women receiving one or more tocolytics (magnesium sulfate, indomethacin, or nifedipine) were compared with those who did not receive tocolysis. The primary outcome was composite major neonatal morbidity. Two hundred ninety-seven women were included; 233 (78.5%) received at least one tocolytic. Women receiving tocolysis were slightly less dilated (median 5 compared with 6 cm, P<.001) at presentation and were more likely to receive at least a partial course of corticosteroids (88.4% compared with 56.3%...

Research paper thumbnail of Outcomes of Expectantly Managed Pregnancies with Multiple Gestations and Mid-Trimester Preterm Premature Rupture of Membranes (PPROM)

Reproductive Sciences

The objective of the study was to determine the obstetric and neonatal outcomes of expectantly ma... more The objective of the study was to determine the obstetric and neonatal outcomes of expectantly managed multifetal pregnancies complicated by early preterm premature rupture of membranes (PPROM) prior to 26 weeks. This was a retrospective cohort of all multifetal pregnancies complicated by documented PPROM occurring before 26 0/7 weeks and managed expectantly by a single maternal-fetal medicine practice between July 4, 2002, and Sept. 1, 2013. Neonatal and maternal outcomes were assessed and comparisons made between the fetus with ruptured membranes and the first fetus to deliver with intact membranes. Twenty-three pregnancies (46 fetuses) were analyzed with a median gestational age at PPROM of 22.9 weeks; 74% experienced PPROM at less than 24 weeks&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; gestation. A median latency of 11 days was achieved with expectant management. Of the 46 neonates, 20 (43%) survived to hospital discharge. Of these, 12 (60%) experienced severe neonatal morbidity defined as defined as grade III or IV intraventricular hemorrhage, bronchopulmonary dysplasia, pulmonary hypoplasia, necrotizing enterocolitis requiring surgical intervention, and/or grade 3 or 4 retinopathy of prematurity. Eight neonates survived to hospital discharge without severe neonatal morbidity. The multiple with ruptured membranes was more likely to experience intrauterine demise but otherwise had similar outcomes as the multiple with intact membranes. Maternal morbidity was considerable, with 7 of 23 pregnancies (30%) complicated by clinical chorioamnionitis, 12 of 23 (52%) delivering by cesarean, of which 3 of 12 (25%) were classical cesarean deliveries. Overall, neonatal survival to hospital discharge was 43%, but only 17% survived without significant neonatal morbidity. These data provide a basis for counseling and management of women with multifetal gestation complicated by very early PPROM.

Research paper thumbnail of 399: Conversion of society for maternal fetal medicine (SMFM) abstract presentations to manuscript publications

American Journal of Obstetrics and Gynecology, 2015

Research paper thumbnail of Conversion of Society for Maternal-Fetal Medicine abstract presentations to manuscript publications

American Journal of Obstetrics and Gynecology, 2015

We sought to evaluate the rate of conversion of Society for Maternal-Fetal Medicine (SMFM) annual... more We sought to evaluate the rate of conversion of Society for Maternal-Fetal Medicine (SMFM) annual meeting abstract presentations to full manuscript publications over time. Full manuscript publications corresponding to all SMFM oral abstracts 2003 through 2010 inclusive, and SMFM poster abstracts in 2003, 2005, 2007, and 2009 were manually searched in PubMed. An abstract was considered to &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;match&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; a full publication if the abstract and publication titles as well as main methods and results were similar and the abstract first author was a publication author. In cases of uncertainty, the abstract-publication match was reviewed by a second physician researcher. Time to publication, publication rates over time, and publication rates among US vs non-US authors were examined. PubMed identification numbers were also collected to determine if &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;1 abstract contributed to a manuscript. Data were analyzed using Wilcoxon rank sum, analysis of variance, t test, and logistic regression. In all, 3281 abstracts presented at SMFM over the study period, including 629 orals (63 main plenary, 64 fellows plenary, 502 concurrent), were reviewed. Of 3281, 1780 (54.3%) were published, generating 1582 unique publications. Oral abstracts had a consistently higher rate of conversion to publications vs posters (77.1% vs 48.8%, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). The median time to publication was 19 (interquartile range, 9-36) months, and was significantly shorter for orals vs posters (11 vs 21 months, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). Over the study period, rates of publication of orals remained constant, but rates of publication of posters were lower in 2007 and 2009 compared to 2003 and 2005. Publications related to SMFM abstracts were published in 194 different journals, most commonly American Journal of Obstetrics and Gynecology (39.8%), Obstetrics and Gynecology (9.7%), and Journal of Maternal-Fetal and Neonatal Medicine (6.5%). Publication rates were higher if the abstract&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s first author was affiliated with a non-US institution (64.8% vs 51.1%, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001) and if the abstract received an award (82.7% vs 53.3%, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). In regression models, oral presentation at SMFM, first author affiliation with a non-US institution, submission for American Journal of Obstetrics and Gynecology SMFM special issue, and year of abstract presentation at SMFM were associated with full manuscript publication. From 2003 through 2010, full manuscript publication rates of SMFM abstracts were high and consistent, and time to publication decreased/improved across the study period for oral presentations.

Research paper thumbnail of Maternal and fetal morbidity associated with uterine rupture of the unscarred uterus

American Journal of Obstetrics and Gynecology, 2015

We sought to report obstetric and neonatal characteristics and outcomes following primary uterine... more We sought to report obstetric and neonatal characteristics and outcomes following primary uterine rupture in a large contemporary obstetric cohort and to compare outcomes between those with primary uterine rupture vs those with uterine rupture of a scarred uterus. This was a retrospective case-control study. Cases were defined as women with uterine rupture of an unscarred uterus. Controls were women with uterine rupture of a scarred uterus. Demographics, labor characteristics, and obstetric, maternal, and neonatal outcomes were compared. Primary rupture case outcomes were also compared by mode of delivery. There were 126 controls and 20 primary uterine rupture cases. Primary uterine rupture cases had more previous live births than controls (3.6 vs 1.9, P &amp;amp;amp;amp;amp;amp;lt; .001). Cases were more likely to have received oxytocin augmentation (80% vs 37%, P &amp;amp;amp;amp;amp;amp;lt; .001). Vaginal delivery was more common among cases (45% vs 9%, P &amp;amp;amp;amp;amp;amp;lt; .001). Composite maternal morbidity was higher among primary uterine rupture mothers (65% vs 20%, P &amp;amp;amp;amp;amp;amp;lt; .001). Cases had a higher mean estimated blood loss (2644 vs 981 mL, P &amp;amp;amp;amp;amp;amp;lt; .001) and higher rate of blood transfusion (68% vs 17%, P &amp;amp;amp;amp;amp;amp;lt; .001). Women with primary uterine rupture were more likely to undergo hysterectomy (35% vs 2.4%, P &amp;amp;amp;amp;amp;amp;lt; .001). Rates of major composite adverse neonatal neurologic outcomes including intraventricular hemorrhage, periventricular leukomalacia, seizures, and death were higher in cases (40% vs 12%, P = .001). Primary uterine rupture cases delivering vaginally were more likely to ultimately undergo hysterectomy than those delivering by cesarean (63% vs 9%, P = .017). Although rare, primary uterine rupture is particularly morbid. Clinicians must remain vigilant, particularly in the setting of heavy vaginal bleeding and severe pain.

Research paper thumbnail of 576: Clinical vs pathologic chorioamnionitis and risk of adverse neonatal & childhood outcomes

American Journal of Obstetrics and Gynecology, 2015

Research paper thumbnail of Correlation between initial neonatal and early childhood outcomes following preterm birth

American journal of obstetrics and gynecology, 2014

Neonatal diagnoses are often used as surrogate endpoints for longer-term outcomes. We sought to c... more Neonatal diagnoses are often used as surrogate endpoints for longer-term outcomes. We sought to characterize the correlation between neonatal diagnoses and early childhood neurodevelopment. We conducted secondary analysis of a multicenter randomized controlled trial of antenatal magnesium sulfate vs placebo administered to women at imminent risk for delivery <32.0 weeks to prevent death and cerebral palsy in their offspring. Singletons and twins delivering 23.0-33.9 weeks who survived to hospital discharge and had 2-year-old outcome data were included. Those surviving to age 2 years were assessed by trained physicians and the Bayley II Scales of Infant Development Mental Development and Psychomotor Development Indices. Neonatal diagnoses at the time of each baby's initial hospital discharge were examined singly and in combination to determine those most predictive of childhood neurodevelopmental impairment, defined as a childhood diagnosis of moderate/severe cerebral palsy an...

Research paper thumbnail of PRELIM II(EDI BOARD)

Research paper thumbnail of 188: Non-anomalous stillbirth by gestational age: Trends differ based on method of epidemiologic calculation

OBJECTIVE: Evidence suggests increased risk of fetal cerebral hypoxemia in CHD. Hypoxic brain inj... more OBJECTIVE: Evidence suggests increased risk of fetal cerebral hypoxemia in CHD. Hypoxic brain injury could lead to poor brain growth and development. The risk of poor fetal brain growth as determined by newborn microcephaly was ascertained in isolated CHD.

Research paper thumbnail of A Genome-Wide Association Study of spontaneous preterm birth in a European population

Research paper thumbnail of 14: The phenotype of spontaneous preterm birth: application of a clinical phenotyping tool

American Journal of Obstetrics and Gynecology, 2015

Research paper thumbnail of 187: Cluster analysis of spontaneous preterm birth phenotypes identifies potential associations between preterm birth mechanisms

American Journal of Obstetrics and Gynecology, 2015

ABSTRACT We sought to employ an innovative tool based on common biological pathways to identify s... more ABSTRACT We sought to employ an innovative tool based on common biological pathways to identify specific phenotypes among women with spontaneous preterm birth (SPTB), in order to enhance investigators&#39; ability to identify to highlight common mechanisms and underlying genetic factors responsible for SPTB. A secondary analysis of a prospective case-control multicenter study of SPTB. All cases delivered a preterm singleton at SPTB ≤34.0 weeks gestation. Each woman was assessed for the presence of underlying SPTB etiologies. A hierarchical cluster analysis was used to identify groups of women with homogeneous phenotypic profiles. One of the phenotypic clusters was selected for candidate gene association analysis using VEGAS software. 1028 women with SPTB were assigned phenotypes. Hierarchical clustering of the phenotypes revealed five major clusters. Cluster 1 (N=445) was characterized by maternal stress, cluster 2 (N=294) by premature membrane rupture, cluster 3 (N=120) by familial factors, and cluster 4 (N=63) by maternal comorbidities. Cluster 5 (N=106) was multifactorial, characterized by infection (INF), decidual hemorrhage (DH) and placental dysfunction (PD). These three phenotypes were highly correlated by Chi-square analysis [PD and DH (p&lt;2.2e-6); PD and INF (p=6.2e-10); INF and DH (p=0.0036)]. Gene-based testing identified the INS (insulin) gene as significantly associated with cluster 3 of SPTB. We identified 5 major clusters of SPTB based on a phenotype tool and hierarchal clustering. There was significant correlation between several of the phenotypes. The INS gene was associated with familial factors underlying SPTB. Copyright © 2015 Elsevier Inc. All rights reserved.

Research paper thumbnail of 560: Predictors of response to 17-alpha hydroxyprogesterone caproate (17P) for prevention of recurrent spontaneous preterm birth (SPTB)

American Journal of Obstetrics and Gynecology, 2015

Research paper thumbnail of Progesterone receptor genotype, family history, and spontaneous preterm birth

Obstetrics and gynecology, 2010

To examine whether women with a personal or family history of preterm birth are more likely to ha... more To examine whether women with a personal or family history of preterm birth are more likely to have genetic variation in the human progesterone receptor (hPR). Women with a singleton preterm birth at less than 37 weeks of gestation between 2002 and 2006 were identified from a prospectively collected clinical and biologic obstetric database (cases). Women in the control group were those with only term deliveries at or above 38 weeks of gestation. The Utah Population Database was queried for family history (first- or second-degree relative) of preterm birth. DNA was extracted from stored buffy coats and genotyped for six single nucleotide polymorphisms in the hPR. One hundred fifty-four patients (92 women in the preterm case group, 62 women in the term control group) were included. All were white or Hispanic. There were no statistical differences between white and Hispanic allele frequencies. Women in the preterm case group were more likely to carry the minor allele, G (minor allele f...

Research paper thumbnail of Outcomes of expectantly managed pregnancies with multiple gestations and preterm premature rupture of membranes prior to 26 weeks

American Journal of Obstetrics and Gynecology, 2015

The objective of the study was to determine the obstetric and neonatal outcomes of expectantly ma... more The objective of the study was to determine the obstetric and neonatal outcomes of expectantly managed multifetal pregnancies complicated by early preterm premature rupture of membranes (PPROM) prior to 26 weeks. This was a retrospective cohort of all multifetal pregnancies complicated by documented PPROM occurring before 26 0/7 weeks and managed expectantly by a single maternal-fetal medicine practice between July 4, 2002, and Sept. 1, 2013. Neonatal and maternal outcomes were assessed and comparisons made between the fetus with ruptured membranes and the first fetus to deliver with intact membranes. Twenty-three pregnancies (46 fetuses) were analyzed with a median gestational age at PPROM of 22.9 weeks; 74% experienced PPROM at less than 24 weeks&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; gestation. A median latency of 11 days was achieved with expectant management. Of the 46 neonates, 20 (43%) survived to hospital discharge. Of these, 12 (60%) experienced severe neonatal morbidity defined as defined as grade III or IV intraventricular hemorrhage, bronchopulmonary dysplasia, pulmonary hypoplasia, necrotizing enterocolitis requiring surgical intervention, and/or grade 3 or 4 retinopathy of prematurity. Eight neonates survived to hospital discharge without severe neonatal morbidity. The multiple with ruptured membranes was more likely to experience intrauterine demise but otherwise had similar outcomes as the multiple with intact membranes. Maternal morbidity was considerable, with 7 of 23 pregnancies (30%) complicated by clinical chorioamnionitis, 12 of 23 (52%) delivering by cesarean, of which 3 of 12 (25%) were classical cesarean deliveries. Overall, neonatal survival to hospital discharge was 43%, but only 17% survived without significant neonatal morbidity. These data provide a basis for counseling and management of women with multifetal gestation complicated by very early PPROM.

Research paper thumbnail of 403: Maternal cardiac complications in women with structural congenital heart disease: results from the national perinatal research consortium registry for adverse rare events (RARE)

American Journal of Obstetrics and Gynecology, 2015

Research paper thumbnail of Non-anomalous stillbirth by gestational age: Trends differ based on method of epidemiologic calculation

Journal of Maternal-Fetal and Neonatal Medicine, 2010

The objective of the study is to compare gestational age specific rates, risks and prospective ri... more The objective of the study is to compare gestational age specific rates, risks and prospective risks of stillbirth. A retrospective cohort study of women with a singleton non-anomalous pregnancy was conducted. Definitions were chosen to maintain consistency with previous literature. Rate was highest at 20 weeks, nadired at 41 weeks and rose thereafter. Risk was low earlier in gestation, nadired at 29 weeks and rose with increasing gestational age. Prospective risk was highest at 20 weeks, nadired at 40 weeks and rose at 42 weeks. Differences in trends of stillbirth are noted depending on the calculation. All of these calculations are useful in clinical practice.

Research paper thumbnail of 397: Mapping genetic susceptibility to preterm birth: Analysis of Utah pedigrees using shared genomic segment analysis

American Journal of Obstetrics and Gynecology, 2016

Research paper thumbnail of Progesterone Receptor Genotype, Family History, and Spontaneous Preterm Birth

Obstetrics and Gynecology, Apr 1, 2010

OBJECTIVE: To examine whether women with a personal or family history of preterm birth are more l... more OBJECTIVE: To examine whether women with a personal or family history of preterm birth are more likely to have genetic variation in the human progesterone receptor (hPR).

Research paper thumbnail of COMPOSITIONS AND METHODS FOR DIAGNOSING AND PREVENTING SPONTANEOUS PRETERM BIRTH

Research paper thumbnail of Tocolysis for Women With Early Spontaneous Preterm Labor and Advanced Cervical Dilation

Obstetrics and gynecology, 2015

To characterize tocolytic use and examine perinatal outcomes among women presenting very preterm ... more To characterize tocolytic use and examine perinatal outcomes among women presenting very preterm with spontaneous labor and cervical dilation 4 cm or greater. This was a retrospective cohort study. Data from January 2000 to June 2011 in a single health care system were reviewed. Women with singleton, nonanomalous fetuses and preterm labor with intact membranes between 23 and 32 weeks of gestation who had cervical dilation 4 cm or greater and less than 8 cm at admission were included. Women receiving one or more tocolytics (magnesium sulfate, indomethacin, or nifedipine) were compared with those who did not receive tocolysis. The primary outcome was composite major neonatal morbidity. Two hundred ninety-seven women were included; 233 (78.5%) received at least one tocolytic. Women receiving tocolysis were slightly less dilated (median 5 compared with 6 cm, P<.001) at presentation and were more likely to receive at least a partial course of corticosteroids (88.4% compared with 56.3%...

Research paper thumbnail of Outcomes of Expectantly Managed Pregnancies with Multiple Gestations and Mid-Trimester Preterm Premature Rupture of Membranes (PPROM)

Reproductive Sciences

The objective of the study was to determine the obstetric and neonatal outcomes of expectantly ma... more The objective of the study was to determine the obstetric and neonatal outcomes of expectantly managed multifetal pregnancies complicated by early preterm premature rupture of membranes (PPROM) prior to 26 weeks. This was a retrospective cohort of all multifetal pregnancies complicated by documented PPROM occurring before 26 0/7 weeks and managed expectantly by a single maternal-fetal medicine practice between July 4, 2002, and Sept. 1, 2013. Neonatal and maternal outcomes were assessed and comparisons made between the fetus with ruptured membranes and the first fetus to deliver with intact membranes. Twenty-three pregnancies (46 fetuses) were analyzed with a median gestational age at PPROM of 22.9 weeks; 74% experienced PPROM at less than 24 weeks&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; gestation. A median latency of 11 days was achieved with expectant management. Of the 46 neonates, 20 (43%) survived to hospital discharge. Of these, 12 (60%) experienced severe neonatal morbidity defined as defined as grade III or IV intraventricular hemorrhage, bronchopulmonary dysplasia, pulmonary hypoplasia, necrotizing enterocolitis requiring surgical intervention, and/or grade 3 or 4 retinopathy of prematurity. Eight neonates survived to hospital discharge without severe neonatal morbidity. The multiple with ruptured membranes was more likely to experience intrauterine demise but otherwise had similar outcomes as the multiple with intact membranes. Maternal morbidity was considerable, with 7 of 23 pregnancies (30%) complicated by clinical chorioamnionitis, 12 of 23 (52%) delivering by cesarean, of which 3 of 12 (25%) were classical cesarean deliveries. Overall, neonatal survival to hospital discharge was 43%, but only 17% survived without significant neonatal morbidity. These data provide a basis for counseling and management of women with multifetal gestation complicated by very early PPROM.

Research paper thumbnail of 399: Conversion of society for maternal fetal medicine (SMFM) abstract presentations to manuscript publications

American Journal of Obstetrics and Gynecology, 2015

Research paper thumbnail of Conversion of Society for Maternal-Fetal Medicine abstract presentations to manuscript publications

American Journal of Obstetrics and Gynecology, 2015

We sought to evaluate the rate of conversion of Society for Maternal-Fetal Medicine (SMFM) annual... more We sought to evaluate the rate of conversion of Society for Maternal-Fetal Medicine (SMFM) annual meeting abstract presentations to full manuscript publications over time. Full manuscript publications corresponding to all SMFM oral abstracts 2003 through 2010 inclusive, and SMFM poster abstracts in 2003, 2005, 2007, and 2009 were manually searched in PubMed. An abstract was considered to &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;match&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; a full publication if the abstract and publication titles as well as main methods and results were similar and the abstract first author was a publication author. In cases of uncertainty, the abstract-publication match was reviewed by a second physician researcher. Time to publication, publication rates over time, and publication rates among US vs non-US authors were examined. PubMed identification numbers were also collected to determine if &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;1 abstract contributed to a manuscript. Data were analyzed using Wilcoxon rank sum, analysis of variance, t test, and logistic regression. In all, 3281 abstracts presented at SMFM over the study period, including 629 orals (63 main plenary, 64 fellows plenary, 502 concurrent), were reviewed. Of 3281, 1780 (54.3%) were published, generating 1582 unique publications. Oral abstracts had a consistently higher rate of conversion to publications vs posters (77.1% vs 48.8%, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). The median time to publication was 19 (interquartile range, 9-36) months, and was significantly shorter for orals vs posters (11 vs 21 months, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). Over the study period, rates of publication of orals remained constant, but rates of publication of posters were lower in 2007 and 2009 compared to 2003 and 2005. Publications related to SMFM abstracts were published in 194 different journals, most commonly American Journal of Obstetrics and Gynecology (39.8%), Obstetrics and Gynecology (9.7%), and Journal of Maternal-Fetal and Neonatal Medicine (6.5%). Publication rates were higher if the abstract&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s first author was affiliated with a non-US institution (64.8% vs 51.1%, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001) and if the abstract received an award (82.7% vs 53.3%, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). In regression models, oral presentation at SMFM, first author affiliation with a non-US institution, submission for American Journal of Obstetrics and Gynecology SMFM special issue, and year of abstract presentation at SMFM were associated with full manuscript publication. From 2003 through 2010, full manuscript publication rates of SMFM abstracts were high and consistent, and time to publication decreased/improved across the study period for oral presentations.

Research paper thumbnail of Maternal and fetal morbidity associated with uterine rupture of the unscarred uterus

American Journal of Obstetrics and Gynecology, 2015

We sought to report obstetric and neonatal characteristics and outcomes following primary uterine... more We sought to report obstetric and neonatal characteristics and outcomes following primary uterine rupture in a large contemporary obstetric cohort and to compare outcomes between those with primary uterine rupture vs those with uterine rupture of a scarred uterus. This was a retrospective case-control study. Cases were defined as women with uterine rupture of an unscarred uterus. Controls were women with uterine rupture of a scarred uterus. Demographics, labor characteristics, and obstetric, maternal, and neonatal outcomes were compared. Primary rupture case outcomes were also compared by mode of delivery. There were 126 controls and 20 primary uterine rupture cases. Primary uterine rupture cases had more previous live births than controls (3.6 vs 1.9, P &amp;amp;amp;amp;amp;amp;lt; .001). Cases were more likely to have received oxytocin augmentation (80% vs 37%, P &amp;amp;amp;amp;amp;amp;lt; .001). Vaginal delivery was more common among cases (45% vs 9%, P &amp;amp;amp;amp;amp;amp;lt; .001). Composite maternal morbidity was higher among primary uterine rupture mothers (65% vs 20%, P &amp;amp;amp;amp;amp;amp;lt; .001). Cases had a higher mean estimated blood loss (2644 vs 981 mL, P &amp;amp;amp;amp;amp;amp;lt; .001) and higher rate of blood transfusion (68% vs 17%, P &amp;amp;amp;amp;amp;amp;lt; .001). Women with primary uterine rupture were more likely to undergo hysterectomy (35% vs 2.4%, P &amp;amp;amp;amp;amp;amp;lt; .001). Rates of major composite adverse neonatal neurologic outcomes including intraventricular hemorrhage, periventricular leukomalacia, seizures, and death were higher in cases (40% vs 12%, P = .001). Primary uterine rupture cases delivering vaginally were more likely to ultimately undergo hysterectomy than those delivering by cesarean (63% vs 9%, P = .017). Although rare, primary uterine rupture is particularly morbid. Clinicians must remain vigilant, particularly in the setting of heavy vaginal bleeding and severe pain.

Research paper thumbnail of 576: Clinical vs pathologic chorioamnionitis and risk of adverse neonatal & childhood outcomes

American Journal of Obstetrics and Gynecology, 2015

Research paper thumbnail of Correlation between initial neonatal and early childhood outcomes following preterm birth

American journal of obstetrics and gynecology, 2014

Neonatal diagnoses are often used as surrogate endpoints for longer-term outcomes. We sought to c... more Neonatal diagnoses are often used as surrogate endpoints for longer-term outcomes. We sought to characterize the correlation between neonatal diagnoses and early childhood neurodevelopment. We conducted secondary analysis of a multicenter randomized controlled trial of antenatal magnesium sulfate vs placebo administered to women at imminent risk for delivery <32.0 weeks to prevent death and cerebral palsy in their offspring. Singletons and twins delivering 23.0-33.9 weeks who survived to hospital discharge and had 2-year-old outcome data were included. Those surviving to age 2 years were assessed by trained physicians and the Bayley II Scales of Infant Development Mental Development and Psychomotor Development Indices. Neonatal diagnoses at the time of each baby's initial hospital discharge were examined singly and in combination to determine those most predictive of childhood neurodevelopmental impairment, defined as a childhood diagnosis of moderate/severe cerebral palsy an...

Research paper thumbnail of PRELIM II(EDI BOARD)

Research paper thumbnail of 188: Non-anomalous stillbirth by gestational age: Trends differ based on method of epidemiologic calculation

OBJECTIVE: Evidence suggests increased risk of fetal cerebral hypoxemia in CHD. Hypoxic brain inj... more OBJECTIVE: Evidence suggests increased risk of fetal cerebral hypoxemia in CHD. Hypoxic brain injury could lead to poor brain growth and development. The risk of poor fetal brain growth as determined by newborn microcephaly was ascertained in isolated CHD.

Research paper thumbnail of A Genome-Wide Association Study of spontaneous preterm birth in a European population

Research paper thumbnail of 14: The phenotype of spontaneous preterm birth: application of a clinical phenotyping tool

American Journal of Obstetrics and Gynecology, 2015

Research paper thumbnail of 187: Cluster analysis of spontaneous preterm birth phenotypes identifies potential associations between preterm birth mechanisms

American Journal of Obstetrics and Gynecology, 2015

ABSTRACT We sought to employ an innovative tool based on common biological pathways to identify s... more ABSTRACT We sought to employ an innovative tool based on common biological pathways to identify specific phenotypes among women with spontaneous preterm birth (SPTB), in order to enhance investigators&#39; ability to identify to highlight common mechanisms and underlying genetic factors responsible for SPTB. A secondary analysis of a prospective case-control multicenter study of SPTB. All cases delivered a preterm singleton at SPTB ≤34.0 weeks gestation. Each woman was assessed for the presence of underlying SPTB etiologies. A hierarchical cluster analysis was used to identify groups of women with homogeneous phenotypic profiles. One of the phenotypic clusters was selected for candidate gene association analysis using VEGAS software. 1028 women with SPTB were assigned phenotypes. Hierarchical clustering of the phenotypes revealed five major clusters. Cluster 1 (N=445) was characterized by maternal stress, cluster 2 (N=294) by premature membrane rupture, cluster 3 (N=120) by familial factors, and cluster 4 (N=63) by maternal comorbidities. Cluster 5 (N=106) was multifactorial, characterized by infection (INF), decidual hemorrhage (DH) and placental dysfunction (PD). These three phenotypes were highly correlated by Chi-square analysis [PD and DH (p&lt;2.2e-6); PD and INF (p=6.2e-10); INF and DH (p=0.0036)]. Gene-based testing identified the INS (insulin) gene as significantly associated with cluster 3 of SPTB. We identified 5 major clusters of SPTB based on a phenotype tool and hierarchal clustering. There was significant correlation between several of the phenotypes. The INS gene was associated with familial factors underlying SPTB. Copyright © 2015 Elsevier Inc. All rights reserved.

Research paper thumbnail of 560: Predictors of response to 17-alpha hydroxyprogesterone caproate (17P) for prevention of recurrent spontaneous preterm birth (SPTB)

American Journal of Obstetrics and Gynecology, 2015

Research paper thumbnail of Progesterone receptor genotype, family history, and spontaneous preterm birth

Obstetrics and gynecology, 2010

To examine whether women with a personal or family history of preterm birth are more likely to ha... more To examine whether women with a personal or family history of preterm birth are more likely to have genetic variation in the human progesterone receptor (hPR). Women with a singleton preterm birth at less than 37 weeks of gestation between 2002 and 2006 were identified from a prospectively collected clinical and biologic obstetric database (cases). Women in the control group were those with only term deliveries at or above 38 weeks of gestation. The Utah Population Database was queried for family history (first- or second-degree relative) of preterm birth. DNA was extracted from stored buffy coats and genotyped for six single nucleotide polymorphisms in the hPR. One hundred fifty-four patients (92 women in the preterm case group, 62 women in the term control group) were included. All were white or Hispanic. There were no statistical differences between white and Hispanic allele frequencies. Women in the preterm case group were more likely to carry the minor allele, G (minor allele f...

Research paper thumbnail of Outcomes of expectantly managed pregnancies with multiple gestations and preterm premature rupture of membranes prior to 26 weeks

American Journal of Obstetrics and Gynecology, 2015

The objective of the study was to determine the obstetric and neonatal outcomes of expectantly ma... more The objective of the study was to determine the obstetric and neonatal outcomes of expectantly managed multifetal pregnancies complicated by early preterm premature rupture of membranes (PPROM) prior to 26 weeks. This was a retrospective cohort of all multifetal pregnancies complicated by documented PPROM occurring before 26 0/7 weeks and managed expectantly by a single maternal-fetal medicine practice between July 4, 2002, and Sept. 1, 2013. Neonatal and maternal outcomes were assessed and comparisons made between the fetus with ruptured membranes and the first fetus to deliver with intact membranes. Twenty-three pregnancies (46 fetuses) were analyzed with a median gestational age at PPROM of 22.9 weeks; 74% experienced PPROM at less than 24 weeks&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; gestation. A median latency of 11 days was achieved with expectant management. Of the 46 neonates, 20 (43%) survived to hospital discharge. Of these, 12 (60%) experienced severe neonatal morbidity defined as defined as grade III or IV intraventricular hemorrhage, bronchopulmonary dysplasia, pulmonary hypoplasia, necrotizing enterocolitis requiring surgical intervention, and/or grade 3 or 4 retinopathy of prematurity. Eight neonates survived to hospital discharge without severe neonatal morbidity. The multiple with ruptured membranes was more likely to experience intrauterine demise but otherwise had similar outcomes as the multiple with intact membranes. Maternal morbidity was considerable, with 7 of 23 pregnancies (30%) complicated by clinical chorioamnionitis, 12 of 23 (52%) delivering by cesarean, of which 3 of 12 (25%) were classical cesarean deliveries. Overall, neonatal survival to hospital discharge was 43%, but only 17% survived without significant neonatal morbidity. These data provide a basis for counseling and management of women with multifetal gestation complicated by very early PPROM.

Research paper thumbnail of 403: Maternal cardiac complications in women with structural congenital heart disease: results from the national perinatal research consortium registry for adverse rare events (RARE)

American Journal of Obstetrics and Gynecology, 2015

Research paper thumbnail of Non-anomalous stillbirth by gestational age: Trends differ based on method of epidemiologic calculation

Journal of Maternal-Fetal and Neonatal Medicine, 2010

The objective of the study is to compare gestational age specific rates, risks and prospective ri... more The objective of the study is to compare gestational age specific rates, risks and prospective risks of stillbirth. A retrospective cohort study of women with a singleton non-anomalous pregnancy was conducted. Definitions were chosen to maintain consistency with previous literature. Rate was highest at 20 weeks, nadired at 41 weeks and rose thereafter. Risk was low earlier in gestation, nadired at 29 weeks and rose with increasing gestational age. Prospective risk was highest at 20 weeks, nadired at 40 weeks and rose at 42 weeks. Differences in trends of stillbirth are noted depending on the calculation. All of these calculations are useful in clinical practice.