American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Oct 2017
Observational StudyObjectively measured short sleep duration and later sleep midpoint in pregnancy are associated with a higher risk of gestational diabetes.
Experimental and epidemiologic data suggest that among nonpregnant adults, sleep duration may be an important risk factor for chronic disease. Although pregnant women commonly report poor sleep, few studies objectively evaluated the quality of sleep in pregnancy or explored the relationship between sleep disturbances and maternal and perinatal outcomes. ⋯ Our results demonstrate a relationship between short sleep duration and later sleep midpoint with gestational diabetes. Our data suggest independent contributions of these 2 sleep characteristics to the risk for gestational diabetes in nulliparous women.
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Am. J. Obstet. Gynecol. · Oct 2017
Multicenter StudyAssessing the potential impact of extending antenatal steroids to the late preterm period.
In 2016, guidance statements were issued by the Society for Maternal-Fetal Medicine and the American Congress of Obstetricians and Gynecologists about extending antenatal steroid use to selected late preterm singleton pregnancies. ⋯ Careful consideration of which pregnancies should receive late preterm antenatal steroids and how to identify these pregnancies is important to optimize benefits and mitigate potential risks of this intervention.
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Am. J. Obstet. Gynecol. · Oct 2017
Neonatal outcomes in fetuses with cardiac anomalies and the impact of delivery route.
Congenital fetal cardiac anomalies compromise the most common group of fetal structural anomalies. Several previous reports analyzed all types of fetal cardiac anomalies together without individualized neonatal morbidity outcomes based on cardiac defect. Mode of delivery in cases of fetal cardiac anomalies varies greatly as optimal mode of delivery in these complex cases is unknown. ⋯ Most fetal cardiac anomalies were diagnosed postnatally and associated with increased rates of neonatal morbidity. Planned cesarean delivery for prenatally diagnosed cardiac anomalies was not associated with less neonatal morbidity.
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Am. J. Obstet. Gynecol. · Oct 2017
Observational StudyTrends in end-of-life care and health care spending in women with uterine cancer.
High-intensity care including hospitalizations, chemotherapy, and other interventions at the end of life is costly and often of little value for cancer patients. Little is known about patterns of end-of-life care and resource utilization for women with uterine cancer. ⋯ Among women with uterine cancer, high-intensity care is common in the last month of life, associated with substantial monetary expenditures, and does not appear to be decreasing.