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2. Machine learning-enabled maternal risk assessment for women with pre-eclampsia (the PIERS-ML model): a modelling study

Author

Brown, Mark A., Davis, Gregory K., Parker, Claire, Walters, Barry N., Sass, Nelson, Ansermino, J. Mark, Cao, Vivien, Cundiff, Geoffrey W., von Dadelszen, Emma C.M., Douglas, M. Joanne, Dumont, Guy A., Dunsmuir, Dustin T., Hutcheon, Jennifer A., Joseph, K.S., Lalji, Sayrin, Lee, Tang, Li, Jing, Lim, Kenneth I., Lisonkova, Sarka, Lott, Paula, Menzies, Jennifer M., Millman, Alexandra L., Palmer, Lynne, Payne, Beth A., Qu, Ziguang, Russell, James A., Sawchuck, Diane, Shaw, Dorothy, Still, D. Keith, Ukah, U. Vivian, Wagner, Brenda, Walley, Keith R., Hugo, Dany, Gruslin, The late Andrée, Tawagi, George, Smith, Graeme N., Côté, Anne-Marie, Moutquin, Jean-Marie, Ouellet, Annie B., Lee, Shoo K., Duan, Tao, Zhou, Jian, Haniff, The late Farizah, Mahajan, Swati, Noovao, Amanda, Karjalainend, Hanna, Kortelainen, Alja, Laivuori, Hannele, Ganzevoort, J. Wessel, Groen, Henk, Kyle, Phillipa M., Moore, M. Peter, Pullar, Barbra, Bhutta, Zulfiqar A., Qureshi, Rahat N., Sikandar, Rozina, Bhutta, The late Shereen Z., Cloete, Garth, Hall, David R., van Papendorp, The late Erika, Steyn, D. Wilhelm, Biryabarema, Christine, Mirembe, Florence, Nakimuli, Annettee, Allotey, John, Thangaratinam, Shakila, Nicolaides, Kypros H., Ionescu, Olivia, Syngelaki, Argyro, de Swiet, Michael, Magee, Laura A., von Dadelszen, Peter, Akolekar, Ranjit, Walker, James J., Robson, Stephen C., Broughton-Pipkin, Fiona, Loughna, Pamela, Vatish, Manu, Redman, Christopher W.G., Barry, Sarah J.E., Kavanagh, Kimberley, Montgomery-Csobán, Tunde, Murray, Paul, Robertson, Chris, Tsigas, Eleni Z., Woelkers, Douglas A., Lindheimer, Marshall D., Grobman, William A., Sibai, Baha M., Merialdi, Mario, Widmer, Mariana, Montgomery-Csobán, Tünde, Barry, Sarah J E, Vivian Ukah, U, Payne, Beth A, Nicolaides, Kypros H, Hutcheon, Jennifer A, and Magee, Laura A

Published
2024
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5. The Impact of Excluding Adverse Neonatal Outcomes on the Creation of Gestational Weight Gain Charts Among Women from Low- and Middle-income Countries with Normal and Overweight BMI

Author

Accrombessi, Manfred, Adu-Afarwuah, Seth, Alves, João Guilherme, Leal de Araújo, Carla Adriane, Arifeen, Shams, Artes, Rinaldo, Ashorn, Per, Ashorn, Ulla, Assefa, Nega, Ayoola, Omolola Olukemi, Azizi, Fereidoun, Bawah, Ahmed Tijani, Behboudi-Gandevani, Samira, Berhane, Yemane, Bernstein, Robin, Bhutta, Zulfiqar, Briand, Valérie, Calvo, Elvira Beatriz, Cardoso, Marly Augusto, Cheng, Yue, Chico-Barba, Gabriela, Clayton, Peter Ellis, Collins, Shalean M, Costello, Anthony M, Cruickshank, John Kennedy, Devakumar, Delanjathan, Dewey, Kathryn G, Dwarkanath, Pratibha, Estrada-Gutierrez, Guadalupe, Fair, Frankie J, Farias, Dayana Rodrigues, Friis, Henrik, Ghosh, Shibani, Girard, Amy Webb, Gomo, Exnevia, Gondwe, Austrida, Hallamaa, Lotta, Hambidge, K Michael, Hussein, Hawawu, Huybregts, Lieven, Iqbal, Romaina, Katz, Joanne, Khatry, Subarna K, Kolsteren, Patrick, Krebs, Nancy F, Kulmala, Teija, Kumar, Pratap, Kurpad, Anura V, Lachat, Carl, Lartey, Anna, Lauer, Jacqueline M, Li, Qian, Lipoeto, Nur Indrawaty, López, Laura Beatriz, Loy, See Ling, Maiya, G Arun, Maleta, Kenneth, Malta, Maíra Barreto, Manandhar, Dharma S, Mangani, Charles, Martínez-Rojano, Hugo, Martin-Prevel, Yves, Martorell, Reynaldo, Matias, Susana L, McClure, Elizabeth M, Melse-Boonstra, Alida, Miller, Joshua D, Mohamad, Marhazlina, Jan Mohamed, Hamid Jan, Moore, Sophie, Mosquera, Paola Soledad, Mridha, Malay Kanti, Munim, Shama, Muñoz-Manrique, Cinthya, Natamba, Barnabas K, Ome-Kaius, Maria, Osrin, David, Perichart-Perera, Otilia, Prentice, Andrew M, Ramachandra, Preetha, Ramakrishnan, Usha, Rivera, Juan, Roberfroid, Dominique, Rodrigues, Patricia Lima, Rodríguez-Cano, Ameyalli, Rogerson, Stephen J, Rondó, Patricia HC, Sámano, Reyna, Saville, Naomi M, Shivalli, Siddharudha, Shrestha, Bhim P, Shrestha, Robin, Roberto da Silva Júnior, José, Soltani, Hora, Soofi, Sajid, Tehrani, Fahimeh Ramezani, Thomas, Tinku, Tielsch, James M, Unger, Holger W, Vaz, Juliana dos Santos, Worku, Alemayehu, Yang, Nianhong, Young, Sera L, Yussif, Adam Bawa, Zeng, Lingxia, Zhong, Chunrong, Zhu, Zhonghai, Rangel Bousquet Carrilho, Thais, Wang, Dongqing, Hutcheon, Jennifer A, Wang, Molin, Fawzi, Wafaie W, and Kac, Gilberto

Published
2024
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10. The effect of changing screening practices and demographics on the incidence of gestational diabetes in British Columbia, 2005-2019

Author

Nethery, Elizabeth, Law, Michael R., Kotaska, Andrew, Janssen, Patricia A., and Hutcheon, Jennifer A.

Subjects
Diabetes in pregnancy -- Diagnosis -- Care and treatment, Medical screening -- Methods -- Evaluation, Health
Abstract

Background: Rates of gestational diabetes are reported to be increasing in many jurisdictions, but the reasons for this are poorly understood. We sought to evaluate the relative contribution of screening practices for gestational diabetes (including completion and methods of screening) and population characteristics to risk of gestational diabetes in British Columbia, Canada, from 2005 to 2019. Methods: We used a population-based cohort from a provincial registry of perinatal data, linked to laboratory billing records. We used data on screening completion, screening method (1-step 75-g glucose test or 2-step approach of 50-g glucose screening test, followed by a diagnostic test for patients who screen positive) and demographic risk factors. We modelled predicted annual risk for gestational diabetes, sequentially adjusted for screening completion, screening method and risk factors. Results: We included 551 457 pregnancies in the study cohort. The incidence of gestational diabetes more than doubled over the study period, from 7.2% in 2005 to 14.7% in 2019. Screening completion increased from 87.2% in 2005 to 95.5% in 2019. Use of 1-step screening methods increased from 0.0% in 2005 to 39.5% in 2019 among those who were screened. Unadjusted models estimated a 2.04 (95% confidence interval [CI] 1.94-2.13) increased risk of gestational diabetes in 2019 (v. 2005). This increase was 1.89 (95% CI 1.81-1.98) after accounting for the rise in screening completion and 1.34 (95% CI 1.28-1.40) after accounting for changes in screening methods. Further accounting for demographic risk factors (e.g., age, body mass index, prenatal care) had a small impact (increase of 1.25, 95% CI 1.19-1.31). Interpretation: Most of the observed increase in the incidence of gestational diabetes was attributable to changes in screening practices (primarily changes in screening methods) rather than changing population factors. Our findings highlight the importance of understanding variation in screening practices when monitoring incidence rates for gestational diabetes., Rates of gestational diabetes are reported to be increasing worldwide. (1) In Canada, the rate of gestational diabetes increased from 4.0% of deliveries in 2004 to 7.0% in 2014. (2) [...]

Published
2023
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15. Gestational weight gain according to the Brazilian charts and its association with maternal and infant adverse outcomes

Author

Oliveira, Adauto Emmerich, Esteves-Pereira, Ana Paula, Sato, Ana Paula Sayuri, da Silva, Antônio Augusto Moura, Gomes, Caroline de Barros, de Moraes, Claudia Leite, Saunders, Claudia, da Silva Rocha, Daniela, Farias, Dayana Rodrigues, Barros, Denise C., Gigante, Denise Petrucci, dos Santos Neto, Edson Theodoro, Lacerda, Elisa Maria de Aquino, Fujimori, Elizabeth, Surita, Fernanda Garanhani, Kac, Gilberto, Bierhals, Isabel Oliveira, Capelli, Jane de Carlos Santana, Cecatti, José Guilherme, Vaz, Juliana dos Santos, Cesar, Juraci Almeida, Mastroeni, Marco Fabio, Carvalhaes, Maria Antonieta de Barros Leite, Leal, Maria do Carmo, Domingues, Marlos Rodrigues, Fernandes, Mayra Pacheco, Reichenheim, Michael Eduardo, Drehmer, Michele, Batalha, Mônica de Araújo, de Freitas-Costa, Nathalia Cristina, Padilha, Patrícia de Carvalho, Souza, Renato Teixeira, Mastroeni, Silmara Salete de Barros Silva, Saldiva, Silvia Regina Dias Medici, da Cruz, Simone Seixas, Morais, Sirlei Siani, Carrilho, Thais Rangel Bousquet, Hutcheon, Jennifer A., Rasmussen, Kathleen M., Reichenheim, Michael E., and Freitas-Costa, Nathalia Cristina

Published
2023
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19. Machine learning-enabled maternal risk assessment for women with pre-eclampsia (the PIERS-ML model): a modelling study

Author

Montgomery-Csobán, Tünde, primary, Kavanagh, Kimberley, additional, Murray, Paul, additional, Robertson, Chris, additional, Barry, Sarah J E, additional, Vivian Ukah, U, additional, Payne, Beth A, additional, Nicolaides, Kypros H, additional, Syngelaki, Argyro, additional, Ionescu, Olivia, additional, Akolekar, Ranjit, additional, Hutcheon, Jennifer A, additional, Magee, Laura A, additional, von Dadelszen, Peter, additional, Brown, Mark A., additional, Davis, Gregory K., additional, Parker, Claire, additional, Walters, Barry N., additional, Sass, Nelson, additional, Ansermino, J. Mark, additional, Cao, Vivien, additional, Cundiff, Geoffrey W., additional, von Dadelszen, Emma C.M., additional, Douglas, M. Joanne, additional, Dumont, Guy A., additional, Dunsmuir, Dustin T., additional, Hutcheon, Jennifer A., additional, Joseph, K.S., additional, Lalji, Sayrin, additional, Lee, Tang, additional, Li, Jing, additional, Lim, Kenneth I., additional, Lisonkova, Sarka, additional, Lott, Paula, additional, Menzies, Jennifer M., additional, Millman, Alexandra L., additional, Palmer, Lynne, additional, Payne, Beth A., additional, Qu, Ziguang, additional, Russell, James A., additional, Sawchuck, Diane, additional, Shaw, Dorothy, additional, Still, D. Keith, additional, Ukah, U. Vivian, additional, Wagner, Brenda, additional, Walley, Keith R., additional, Hugo, Dany, additional, Gruslin, The late Andrée, additional, Tawagi, George, additional, Smith, Graeme N., additional, Côté, Anne-Marie, additional, Moutquin, Jean-Marie, additional, Ouellet, Annie B., additional, Lee, Shoo K., additional, Duan, Tao, additional, Zhou, Jian, additional, Haniff, The late Farizah, additional, Mahajan, Swati, additional, Noovao, Amanda, additional, Karjalainend, Hanna, additional, Kortelainen, Alja, additional, Laivuori, Hannele, additional, Ganzevoort, J. Wessel, additional, Groen, Henk, additional, Kyle, Phillipa M., additional, Moore, M. Peter, additional, Pullar, Barbra, additional, Bhutta, Zulfiqar A., additional, Qureshi, Rahat N., additional, Sikandar, Rozina, additional, Bhutta, The late Shereen Z., additional, Cloete, Garth, additional, Hall, David R., additional, van Papendorp, The late Erika, additional, Steyn, D. Wilhelm, additional, Biryabarema, Christine, additional, Mirembe, Florence, additional, Nakimuli, Annettee, additional, Allotey, John, additional, Thangaratinam, Shakila, additional, Nicolaides, Kypros H., additional, de Swiet, Michael, additional, Magee, Laura A., additional, Walker, James J., additional, Robson, Stephen C., additional, Broughton-Pipkin, Fiona, additional, Loughna, Pamela, additional, Vatish, Manu, additional, Redman, Christopher W.G., additional, Barry, Sarah J.E., additional, Montgomery-Csobán, Tunde, additional, Tsigas, Eleni Z., additional, Woelkers, Douglas A., additional, Lindheimer, Marshall D., additional, Grobman, William A., additional, Sibai, Baha M., additional, Merialdi, Mario, additional, and Widmer, Mariana, additional

Published
2024
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24. Supplementation practices among pregnant women and those trying to conceive: a population-representative survey in Vancouver, Canada.

Author

Cochrane, Kelsey M., Hutcheon, Jennifer A., and Karakochuk, Crystal D.

Subjects
*FERTILITY, *PHARMACEUTICAL arithmetic, *MAGNESIUM, *CONSUMER attitudes, *QUESTIONNAIRES, *STATISTICAL sampling, *FOLIC acid, *PREGNANT women, *PSYCHOLOGY of women, *MICRONUTRIENTS, *PRENATAL care, *CHOLINE, *CALCIUM, *VITAMINS, *DOSAGE forms of drugs, *GENETIC techniques, *DIETARY supplements, *DRUG utilization, *PREGNANCY
Abstract

Dietary supplements including vitamins, minerals, and natural health products are commonly consumed by those aiming to optimize fertility and pregnancy outcomes. The aim of this survey was to describe supplementation practices among individuals who were pregnant or trying to conceive in Vancouver, Canada. An online survey was conducted among 500 individuals who were pregnant (n = 250) or trying to conceive (n = 250). Participants met a substantial proportion of vitamin and mineral recommendations through supplements alone. Exceptions included calcium, magnesium, and choline, with median (interquartile range (IQR)) supplementation doses reported by those who were pregnant and trying to conceive, respectively, of: 250 (200 and 250 mg) and 250 (200 and 250 mg), 50 (50 and 75 mg) and 50 (50 and 90 mg), and 53 (10 and 150 mg) and 55 (10 and 100 mg), as compared to perinatal recommendations of 1000 mg/day (calcium), 350 mg/day (magnesium), and 450 mg/day (choline). Conversely, median (IQR) doses of folate reported by those who were pregnant and trying to conceive, respectively, were: 1000 (780 and 1000 µg) and 1000 (800 and 1000 µg), with ∼70% overall (337/471) reporting doses ≥1000 µg (the tolerable upper intake level). Most participants (451/500; 90%) reported supplementation with a prenatal multivitamin; of these, 83% reported that supplementation occurred daily. Overall, as diet was not considered, we cannot ascertain whether recommendations for calcium, magnesium, and choline were met through the combination of supplements and foods; however, we believe that additional supplementation with choline may be required to meet recommendations in pregnancy. Excessive folate supplementation has been previously identified as a concern throughout North America; here, we provide further evidence for excessively high doses consumed via supplements. [ABSTRACT FROM AUTHOR]

Published
2024
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26. The impact of cohort inclusion/exclusion criteria on pregnancy weight gain chart percentiles.

Author

Rangel Bousquet Carrilho, Thais, Bodnar, Lisa M., Johansson, Kari, Kac, Gilberto, and Hutcheon, Jennifer A.

Abstract

Pregnancy weight gain standards are charts describing percentiles of weight gain among participants with no risk factors that could adversely affect weight gain. This detailed information is burdensome to collect. We investigated the extent to which exclusion of various pre-pregnancy, pregnancy and postpartum factors impacted the values of pregnancy weight gain percentiles. We examined pregnancy weight gain (kg) among 3178 participants of the US nuMoM2b-Heart Health Study (HHS). We identified five groups of potential exclusion criteria for pregnancy weight gain standards: socio-economic characteristics (group 1), maternal morbidities (group 2), lifestyle/behaviour factors (group 3), adverse neonatal outcomes (group 4) and longer-term adverse outcomes (group 5). We established the impact of different exclusion criteria by comparing the median, 25th and 75th percentiles of weight gain in the full cohort with the values after applying each of the five exclusion criteria groups. Differences > 0·75 kg were considered meaningful. Excluding participants with group 1, 2, 3 or 4 exclusion criteria had no impact on the 25th, median or 75th percentiles of pregnancy weight gain. Percentiles were only meaningfully different after excluding participants in group 5 (longer-term adverse outcomes), which shifted the upper end of the weight gain distribution to lower values (e.g. 75th percentile decreased from 19·6 kg to 17·8 kg). This shift was due to exclusion of participants with excess postpartum weight retention > 5 kg or > 10 kg. Except for excess postpartum weight retention, most potential exclusion criteria for pregnancy weight gain standards did not meaningfully impact chart percentiles. [ABSTRACT FROM AUTHOR]

Published
2024
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27. Navigating the Grey Zone: Counselling for Late Preterm Antenatal Corticosteroids and the Impact of the 2023 SOGC Technical Update

Author

Liauw, Jessica, primary, Bansback, Nick, additional, Burrows, Jason, additional, Cohen, Matthew, additional, Coll-Black, Mary, additional, Ennis, Madeleine, additional, Guyatt, Gordon, additional, Hutcheon, Jennifer A., additional, Jain, Venu, additional, Metcalfe, Rebecca, additional, Pulsifer, Jodie, additional, Shivananda, Sandesh, additional, Skoll, Amanda, additional, and Soliman, Nancy, additional

Published
2024
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29. The impact of excluding adverse neonatal outcomes on the creation of gestational weight gain charts among women from low- and middle-income countries with normal and overweight BMI

Author

Bousquet Carrilho, Thais Rangel, primary, Wang, Dongqing, additional, Hutcheon, Jennifer A., additional, Wang, Molin, additional, Fawzi, Wafaie W., additional, Kac, Gilberto, additional, Accrombessi, Manfred, additional, Adu-Afarwuah, Seth, additional, Alves, João Guilherme, additional, Leal de Araújo, Carla Adriane, additional, Arifeen, Shams, additional, Artes, Rinaldo, additional, Ashorn, Per, additional, Ashorn, Ulla, additional, Assefa, Nega, additional, Ayoola, Omolola Olukemi, additional, Azizi, Fereidoun, additional, Bawah, Ahmed Tijani, additional, Behboudi-Gandevani, Samira, additional, Berhane, Yemane, additional, Bernstein, Robin, additional, Bhutta, Zulfiqar, additional, Briand, Valérie, additional, Calvo, Elvira Beatriz, additional, Cardoso, Marly Augusto, additional, Cheng, Yue, additional, Chico-Barba, Gabriela, additional, Clayton, Peter Ellis, additional, Collins, Shalean M., additional, Costello, Anthony M., additional, Cruickshank, John Kennedy, additional, Devakumar, Delanjathan, additional, Dewey, Kathryn G., additional, Dwarkanath, Pratibha, additional, Estrada-Gutierrez, Guadalupe, additional, Fair, Frankie J., additional, Farias, Dayana Rodrigues, additional, Friis, Henrik, additional, Ghosh, Shibani, additional, Girard, Amy Webb, additional, Gomo, Exnevia, additional, Gondwe, Austrida, additional, Hallamaa, Lotta, additional, Hambidge, K. Michael, additional, Hussein, Hawawu, additional, Huybregts, Lieven, additional, Iqbal, Romaina, additional, Katz, Joanne, additional, Khatry, Subarna K., additional, Kolsteren, Patrick, additional, Krebs, Nancy F., additional, Kulmala, Teija, additional, Kumar, Pratap, additional, Kurpad, Anura V., additional, Lachat, Carl, additional, Lartey, Anna, additional, Lauer, Jacqueline M., additional, Li, Qian, additional, Yang, Nianhong, additional, Lipoeto, Nur Indrawaty, additional, López, Laura Beatriz, additional, Loy, See Ling, additional, Maiya, G. Arun, additional, Maleta, Kenneth, additional, Malta, Maíra Barreto, additional, Manandhar, Dharma S., additional, Mangani, Charles, additional, Martínez-Rojano, Hugo, additional, Martin-Prevel, Yves, additional, Martorell, Reynaldo, additional, Matias, Susana L., additional, McClure, Elizabeth M., additional, Melse-Boonstra, Alida, additional, Miller, Joshua D., additional, Mohamad, Marhazlina, additional, Jan Mohamed, Hamid Jan, additional, Moore, Sophie, additional, Mosquera, Paola Soledad, additional, Mridha, Malay Kanti, additional, Munim, Shama, additional, Muñoz-Manrique, Cinthya, additional, Natamba, Barnabas K., additional, Ome-Kaius, Maria, additional, Osrin, David, additional, Perichart-Perera, Otilia, additional, Prentice, Andrew M., additional, Ramachandra, Preetha, additional, Ramakrishnan, Usha, additional, Rivera, Juan, additional, Roberfroid, Dominique, additional, Rodrigues, Patricia Lima, additional, Rodríguez-Cano, Ameyalli, additional, Rogerson, Stephen J., additional, Rondó, Patricia H.C., additional, Sámano, Reyna, additional, Saville, Naomi M., additional, Shivalli, Siddharudha, additional, Shrestha, Bhim P., additional, Shrestha, Robin, additional, Roberto da Silva Júnior, José, additional, Soltani, Hora, additional, Soofi, Sajid, additional, Tehrani, Fahimeh Ramezani, additional, Thomas, Tinku, additional, Tielsch, James M., additional, Unger, Holger W., additional, Vaz, Juliana dos Santos, additional, Worku, Alemayehu, additional, Young, Sera L., additional, Yussif, Adam Bawa, additional, Zeng, Lingxia, additional, Zhong, Chunrong, additional, and Zhu, Zhonghai, additional

Published
2024
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33. Antenatal corticosteroid administration and attention-deficit/ hyperactivity disorder in childhood: a regression discontinuity study

Author

Hutcheon, Jennifer A., Strumpf, Erin C., Liauw, Jessica, Skoll, M. Amanda, Socha, Peter, Srour, Myriam, Ting, Joseph Y., and Harper, Sam

Subjects
Corticosteroids -- Complications and side effects, Prenatal drug exposure -- Research, Attention-deficit hyperactivity disorder -- Drug therapy -- Risk factors, Pediatric research, Health
Abstract

Background: Antenatal corticosteroids reduce respiratory morbidity in preterm infants, but their use during late preterm gestation (34-36 weeks) is limited because their safety for longer-term child neurodevelopment is unclear. We sought to determine if fetuses with higher probability of exposure to antenatal corticosteroids had increased rates of prescriptions for attention-deficit/hyperactivity disorder (ADHD) medication in childhood, using a quasiexperimental design that better controls for confounding than existing observational studies. Methods: We identified 16 358 children whose birthing parents were admitted for delivery between 31 + 0 (31 weeks, 0 days) and 36 + 6 weeks' gestation in 2000-2013, using a perinatal data registry from British Columbia, Canada, and linked their records with population-based child ADHD medication data (2000-2018). We used a regression discontinuity design to capitalize on the fact that pregnancies presenting for delivery immediately before and immediately after the clinical cut-off for antenatal corticosteroid administration of 34 + 0 weeks' gestation have very different levels of exposure to corticosteroids, but are otherwise similar with respect to confounders. Results: Over a median follow-up period of 9 years, 892 (5.5%) children had 1 or more dispensations of ADHD medication. Children whose birthing parents were admitted for delivery just before the corticosteroid clinical cut-off of 34 + 0 weeks' gestation did not appear to be more likely to be prescribed ADHD medication than those admitted just after the cut-off (rate ratio 1.1, 95% confidence interval [CI] 0.8 to 1.6; 1.3 excess cases per 100 children, 95% CI -2.5 to 5.7). Interpretation: We found little evidence that children with higher probability of exposure to antenatal corticosteroids have higher rates of ADHD prescriptions in childhood, supporting the safety of antenatal corticosteroids for this neurodevelopmental outcome., Antenatal corticosteroid administration to prevent neonatal respiratory morbidity and death has long been recommended for pregnancies with threatened preterm delivery before 34 weeks' gestation. (1,2) Although evidence has shown that [...]

Published
2022
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34. Antenatal corticosteroids and newborn respiratory outcomes in twins: A regression discontinuity study.

Author

Socha, Peter M., Harper, Sam, Strumpf, Erin, Murphy, Kellie E., and Hutcheon, Jennifer A.

Subjects
REGRESSION discontinuity design, NEWBORN infants, MULTIPLE pregnancy, PREGNANCY outcomes, CORTICOSTEROIDS, FETOFETAL transfusion
Abstract

Objective: To estimate the effect of antenatal corticosteroids on newborn respiratory morbidity in twins. Design: Regression discontinuity applied to population‐based birth registry data. Setting: British Columbia, Canada, 2008–2018. Population: Twin pregnancies admitted for birth between 31+0 and 36+6 weeks of gestation. Methods: During our study period, Canadian clinical practice guidelines recommended antenatal corticosteroid administration for imminent preterm birth up to 33+6 weeks. We used a logistic model to compare the predicted risks of our outcomes among pregnancies admitted for birth immediately before this clinical cut‐point (higher probability of exposure to antenatal corticosteroids) versus immediately after it (lower probability). Main outcome measures: Our primary outcome was a composite of newborn respiratory distress or in‐hospital death. Our secondary outcome was a composite of newborn respiratory intervention or in‐hospital death. Results: Among 2524 pregnancies (5035 liveborn twins), 47% of admissions before 34+0 weeks of gestation were exposed to antenatal corticosteroids but only 4.2% of admissions after this cut‐point were exposed. The risk of newborn respiratory distress or in‐hospital mortality increased abruptly at 34+0 weeks, corresponding to a protective effect of treatment (risk ratio [RR] 0.69, 95% CI 0.53–0.90; risk difference [RD] −12 cases per 100 births, 95% CI −20 to −4.1). There was no clear evidence for or against an effect on newborn respiratory intervention or in‐hospital death (RR 0.89, 95% CI 0.70–1.13; RD −4.2 per 100, 95% CI −13 to +4.2). Conclusions: Our findings provide evidence for the effectiveness of antenatal corticosteroids in preventing adverse newborn respiratory outcomes in twins. [ABSTRACT FROM AUTHOR]

Published
2024
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48. Characteristics, determinants, and frequency of persistent use among prescription opioid episodes initiated postpartum: a population-based cohort study from British Columbia, Canada

Author

Schummers, L., primary, Wilton, James, additional, Yu, Amanda, additional, Hutcheon, Jennifer A., additional, Liauw, Jessica, additional, Pearce, Margo, additional, Chong, Mei, additional, Wong, Stanley, additional, Abdia, Younathan, additional, Purssell, Roy, additional, Z, Naveed Janjua, additional, and A, Jane Buxton, additional

Published
2023
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