Obstetrics and gynecology
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Obstetrics and gynecology · Feb 2017
Severe Maternal Morbidity Among Hispanic Women in New York City: Investigation of Health Disparities.
To investigate differences in severe maternal morbidity between Hispanic mothers and three major Hispanic subgroups compared with non-Hispanic white mothers and the extent to which differences in delivery hospitals may contribute to excess morbidity among Hispanic mothers. ⋯ Hispanic compared with non-Hispanic white mothers are more likely to deliver at hospitals with higher risk-adjusted severe maternal morbidity rates and these differences in site of delivery may contribute to excess morbidity among Hispanic mothers. Our results suggest improving quality at the lowest performing hospitals could benefit both non-Hispanic white and Hispanic women and reduce ethnic disparities in severe maternal morbidity rates.
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Obstetrics and gynecology · Feb 2017
Association of Intended Route of Delivery and Maternal Morbidity in Twin Pregnancy.
To evaluate maternal morbidity in twin pregnancies according to intended mode of delivery. ⋯ When adjustment is made for potential confounders, women undergoing a trial of labor with twins experience a higher odds of maternal morbidity than those electing cesarean delivery, primarily as a result of hemorrhage. In pragmatic terms, the tradeoff for a 74% chance of vaginal delivery is a 4% absolute increase in the rate of serious postpartum hemorrhage.
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Obstetrics and gynecology · Feb 2017
It's All How You "Spin" It: Interpretive Bias in Research Findings in the Obstetrics and Gynecology Literature.
Scientific publications can be subject to varying degrees of interpretive bias, also known as spin. The rate of spin in randomized controlled trials (RCTs) with nonsignificant primary outcomes in the general obstetrics and gynecology literature is unknown. A decade (January 2006 through December 2015) of the tables of contents of Obstetrics & Gynecology and the American Journal of Obstetrics & Gynecology were screened, with 503 RCTs identified. ⋯ In articles that contained spin in the abstract, the more common types were: emphasizing statistically significant secondary results despite a nonsignificant primary outcome (40%); interpreting statistically nonsignificant primary results as showing treatment equivalence or comparable effectiveness (37%); and emphasizing the beneficial effect of the treatment despite statistically nonsignificant results (15%). Half of parallel-group RCTs with nonsignificant primary outcomes published in the two leading journals in general obstetrics and gynecology contains some level of spin. As readers of the medical literature, we should be aware of the concept of spin, the diversity and heterogeneity of spin in the reporting of conclusions, and its effects, particularly when discussing articles that may change clinical practice.
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Obstetrics and gynecology · Jan 2017
Comparative Study Observational StudyFeasibility and Outcomes of Fetoscopic Tracheal Occlusion for Severe Left Diaphragmatic Hernia.
To evaluate feasibility and initial outcomes of fetoscopic tracheal occlusion for severe diaphragmatic hernia compared with a historical cohort who had not received fetal tracheal occlusion. ⋯ ClinicalTrials.gov, https://clinicaltrials.gov, NCT00881660.
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Since the police-involved deaths of Michael Brown and Freddie Gray, activists have argued for connecting police violence with reproductive justice. We argue that systematic violence, including police violence, should be evaluated in relation to reproductive health outcomes of individual patients and communities. Beyond emphasizing the relationship between violence and health outcomes, both qualitative and epidemiologic data can be used by activists and caregivers to effectively care for individuals from socially marginalized communities.