American journal of obstetrics & gynecology MFM
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Am J Obstet Gynecol MFM · Nov 2020
Race, ethnicity, and gender in academic obstetrics and gynecology: 12-year trends.
Diversity among healthcare teams enhances team function and improves the quality of patient care and outcomes. Women and racial minorities are historically underrepresented in medicine. However, the representation of gender and racial or ethnic groups in academic obstetrics and gynecology in the United States has not been described in recent years. ⋯ Across the 12-year period, the representation of women and racial minorities has increased in academic obstetrics and gynecology in the United States. There is now a predominance of women, but there remains a trend for a predominance of white and male physicians in higher academic ranks, leadership positions, and tenure. It will be important to assess how these groups are represented in the coming years as the changing demographics of incoming cohorts progress through their careers to more senior positions. Promoting diversity in medical schools, leadership positions, and higher academic ranks may be an important area of focus.
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Preeclampsia complicates 5% to 8% of all pregnancies. Previous studies have examined the maternal morbidity and mortality associated with preeclampsia and the expectant management of severe preterm preeclampsia. However, these studies either did not comment on outcomes by race or were primarily made up of nonblack participants. ⋯ Within our population, there were no differences in maternal outcomes between black and nonblack women who were undergoing expectant management of severe preterm preeclampsia. More research is needed to determine if the known disparities in maternal morbidity among races are due to factors beyond the antepartum management of severe preterm preeclampsia.
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Am J Obstet Gynecol MFM · Nov 2020
Universal testing for severe acute respiratory syndrome coronavirus 2 in 2 Philadelphia hospitals: carrier prevalence and symptom development over 2 weeks.
The coronavirus disease 2019 pandemic caused by the severe acute respiratory syndrome coronavirus 2 has challenged obstetrical care providers. Universal testing on labor and delivery units has been implemented by many hospitals to ensure patient and staff safety. Asymptomatic carrier rates are expected to vary based on geographic differences in disease prevalence, although differences within the same city have not been reported previously. In addition, clinical follow-up of women who had a negative result for severe acute respiratory syndrome coronavirus 2 during obstetrical hospitalization has not been included in any previous reports. ⋯ The asymptomatic positive severe acute respiratory syndrome coronavirus 2 test rate among an obstetrical population in Philadelphia differed between 2 hospitals and was lower than that described in other geographic regions. This supports the importance of institution-specific testing protocols. The development of symptomatic severe acute respiratory syndrome coronavirus 2 infection after hospitalization among women with initial negative test results is uncommon.
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Am J Obstet Gynecol MFM · Nov 2020
Low-dose aspirin for preeclampsia prevention: efficacy by ethnicity and race.
Low-dose aspirin is recommended for the prevention of preeclampsia among women at a high risk of developing the disease. Aspirin undergoes polymorphic metabolism, and it is well known that common genetic polymorphisms are related to aspirin intolerance. We hypothesized that the efficacy of aspirin prophylaxis may differ by ethnicity and race. ⋯ The incidence of preeclampsia was significantly reduced among low-risk non-Hispanic white women who received aspirin compared with placebo (P=.007), but not overall or among Hispanic or non-Hispanic black women. The analysis of high-risk women did not indicate a difference in the efficacy of aspirin by ethnicity and race.
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Am J Obstet Gynecol MFM · Nov 2020
Risk factors for severe acute respiratory syndrome coronavirus 2 infection in pregnant women.
Risk factors for severe acute respiratory syndrome coronavirus 2 infection in pregnancy remain poorly understood. Identifying and understanding populations at a heightened risk of acquisition is essential to more effectively target outreach and prevention efforts. ⋯ Many risk factors for severe acute respiratory syndrome coronavirus 2 infection in pregnancy are similar to the social and structural determinants of health that have been reported in the general population. The observed association between severe acute respiratory syndrome coronavirus 2 infection and having children raises the possibility of children themselves being vectors of viral spread or behavior patterns of parents being mediators of acquisition.