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A systematic review was performed to compare adverse maternal and neonatal outcomes among pregnant patients with gunshot wounds (GSW) to the abdominopelvic vs other region(s) at ≥ 20 weeks gestation. A search of Medline Ovid, Elsevier Embase, EBSCO CINAHL, and Cochrane Library in July 2022 and reference searches resulted in 1742 studies, which were screened. The 41 included studies reported outcomes for 59 pregnant patients with GSW, of which 31 (52.5%) had an isolated abdominopelvic GSW and 28 (47.5%) had an extremity, thorax, head/neck, back/spine, poly-site, or other/unknown GSW. Stillbirth occurred in 26.7% of abdominopelvic GSW and 26% of non-abdominopelvic GSW. Maternal death occurred in 3.7% of abdominopelvic GSW and 10.7% of non-abdominopelvic GSW. Neonatal death occurred in 9.1% of abdominopelvic GSW and 5.3% of non-abdominopelvic GSW. Further research is needed to standardize the approach for the evaluation and management of patients with GSW in pregnancy. [ABSTRACT FROM AUTHOR]

Background: Better understanding of the factors associated with formula feeding during the hospital stay can help in identifying potential lactation problems and promote early intervention. Our aim was to ascertain factors associated with exclusive formula feeding in newborns of low‐risk pregnancies. Methods: A population‐based, retrospective study using the United States vital statistics datasets (2014‐2018) evaluating low‐risk pregnancies with a nonanomalous singleton delivery from 37 to 41 weeks. People with hypertensive disorders, or diabetes, were excluded. Primary outcome was newborn feeding (breast vs exclusive formula feeding) during hospital stay. Adjusted relative risks (aRRs) with 95% confidence intervals (CI) were calculated. Results: Of the 19 623 195 live births during the study period, 11 605 242 (59.1%) met inclusion criteria and among them, 1 929 526 (16.6%) were formula fed. Factors associated with formula feeding included: age < 20 years (aRR 1.31 [95% CI 1.31‐1.32]), non‐Hispanic Black (1.42, 1.41‐1.42), high school education (1.69, 1.69‐1.70) or less than high school education (1.94, 1.93, 1.95), Medicaid insurance (1.52, 1.51, 1.52), body mass index (BMI) < 18.5 (1.10, 1.09‐1.10), BMI 25‐29.9 (1.09, 1.09‐1.09), BMI 30‐34.9 (1.19, 1.19‐1.20), BMI 35‐39.9 (1.31, 1.30‐1.31), BMI ≥ 40 (1.43, 1.42‐1.44), multiparity (1.29, 1.29‐1.30), lack of prenatal care (1.49, 1.48‐1.50), smoking (1.75, 1.74‐1.75), and gestational age (ranged from 37 weeks [1.44, 1.43‐1.45] to 40 weeks [1.11, 1.11‐1.12]). Conclusions: Using a large cohort of low‐risk pregnancies, we identified several modifiable factors associated with newborn feeding (eg, prepregnancy BMI, access to prenatal care, and smoking cessation). Improving the breast feeding initiation rate should be a priority in our current practice to ensure equitable care for all neonates. [ABSTRACT FROM AUTHOR]

To evaluate associations between maternal characteristics and a short cervix in patients without history of preterm delivery, and to determine if these characteristics can predict the presence of a short cervix. This is a retrospective cohort study that included 18,592 women with singleton pregnancies without history of previous preterm deliveries who underwent universal transvaginal cervical length (TVCL) screening between 18 + 0 and 23 + 6 weeks/days of gestation. A short cervix was defined as a cervical length (CL) ≤25 mm, ≤20 mm, and ≤15 mm. Associations between maternal age, weight, height, body mass index (BMI), previous term deliveries, and history of previous miscarriages, with a short cervix were evaluated using logistic regression models. The prevalence of a short cervix in our population was: CL ≤25 mm, 2.2% (n = 403); CL ≤20 mm, 1.2% (n = 224); and CL ≤15 mm, 0.9% (n = 161). Women with BMI >30 and/or previous abortions constituted 45.5% of the total population (8463/18,582). Significant associations with short cervix were observed for women with BMI ≥30, and for women with at least one previous abortion (p <.001). Parous women had a significantly lower association with a short cervix than nulliparous women (p <.001). Maternal age or height were not associated with a short cervix. Prediction of short cervix based on presence of any of the following: BMI ≥ 30 or previous abortions showed sensitivities of 55.8% (≤25 mm), 61.6% (≤20 mm), and 63.4% (≤15 mm) with similar specificity (50.1–54.6%) and likelihood ratio positive (1.2–1.5); and prediction based on BMI ≥ 30 and previous abortions showed sensitivities of 11.1% (≤25 mm), 14.7% (≤20 mm), and 16.7% (≤15 mm) with specificity 93%. Among low risk women for spontaneous preterm delivery, those with a BMI ≥30 and/or previous miscarriages had a significantly increased risk for a short cervix at 18 + 0 and 23 + 6 weeks/days of gestation. Despite these significant associations, screening by maternal risk factors in a low risk population of pregnant women should not be an alternative to mid-trimester universal CL measurement. In pregnant women evaluated at 18/0 and 23/6 weeks + days of gestation without history of preterm delivery, a 16.7% detection rate for short cervix ≤15 mm can be achieved by risk factors BMI ≥30, and at least one previous miscarriage. Nevertheless, screening for short cervix by risk factors among low risk women might not be an effective alternative to universal cervical length screening. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to estimate weekly differences in the prevalence of a short cervix during the period of 18+0 to 23+6 weeks of gestation in pregnant women with and without a history of previous preterm delivery (PTD). Design: An observational study was conducted. Methods:Setting and participants: 20,002 pregnant women, 18,591 without a history of previous PTD (low risk) and 1,411 with at least one previous PTD (high risk), were evaluated at 18+0 to 23+6 weeks + days of gestation. Weekly differences in the prevalence of a short cervix (≤25 mm, ≤20 mm, and ≤15 mm) between women with and without previous PTD were estimated. Results: High-risk women had a significantly higher prevalence of a short cervix, defined as either ≤25 mm (4.4% vs. 2.2%; p < 0.0001) or ≤20 mm (2.4% vs. 1.2%; p < 0.0001) but not for ≤15 mm (1.2% vs. 0.9%; p < 0.2) as compared to low-risk pregnant women. The odds ratio for a short cervix ≤25 mm in high-risk as compared to low-risk women was 2.0 (95% CI 1.54–2.61; p < 0.0001). Among low-risk women, those evaluated at 22 or 23 weeks of gestation had a significantly higher prevalence of a short cervix ≤25 mm (3.8% vs. 1.9%; p < 0.0001), ≤20 mm (2.4% vs. 0.98%; p < 0.0001), and ≤15 mm (1.6% vs. 0.7%; p < 0.0001) than low-risk women scanned between 18 and 21 weeks of gestation. Similar results were observed for high-risk women. Limitations: No gestational age at delivery was evaluated. Conclusion: There is higher prevalence of short cervix when pregnant women are evaluated at 22+0 to 23+6 than at 18+0 to 21+6 weeks of gestation. [ABSTRACT FROM AUTHOR]