Birth Rate Research Articles

Obstetrical and neonatal outcomesafter vitrified-warmed blastocyst transfer in day 1 rescue intracytoplasmic sperm injection cycles: a retrospective cohort study.

Fertilization failure often occurs in conventional IVF cycles, and day 1 rescue ICSI is frequently recommended. In this study, the effect of rescue ICSI on obstetrical and neonatal outcomes after a single blastocyst transfer in vitrified-warmed cyclesis evaluated. This cohort study was a retrospective analysis of 703 vitrified-warmed single blastocyst transfers and 219 singletons in the r-ICSI group compared with 11,611 vitrified-warmed single blastocyst transfers in the IVF/ICSI and 4472 singletons in the IVF/ICSI group, respectively, and patients just undergoing their first IVF treatments were included in this study. Pregnancy rate (PR), live birth rate (LBR), and singleton birthweight were the primary outcome measures. Multiple linear regression analysis and logistic regression analysis were performed to evaluate the possible relationship between obstetrical and neonatal outcomes and fertilization method (including IVF, ICSI, and r-ICSI) after adjusting for other potential confounding factors. PR and the LBR were lower in the r-ICSI group compared with the IVF/ ICSI group. Singletons from the r-ICSI group had a higher Z-score and the proportion of large for gestational age (LGA) newborns was greater compared with singletons from the IVF/ICSI group. The results of the study indicated that a 31% LBR after r-ICSI is acceptable for vitrified-warmed blastocyst transfer, but the safety of transfer is a concern because of the lower PR and LBR compared with IVF/ICSI. The safety of r-ICSI newborns is also a concern because of the significantly higher birthweight and the proportion of LGA in r-ICSI group newborns compared with the IVF/ICSI group.

Effects of Fluoride Toxicity on Female Reproductive System of Mammals: A Meta-Analysis.

Considerable integrative efforts have been made to investigate the effects of fluoride on female reproductive organs since the last years. The ingestion of fluoride causes adverse effects on human health like causing skeletal fluorosis, dental fluorosis, bone fractures, kidney problems, decrease birth rates, weakening of thyroid functionality, and impair intelligence, particularly in children. In this review, we discuss the adverse effects of fluoride on female reproductive organs and presented certain remedies. A total of 53 papers on the effect of fluoride on female reproductive organs, including 6 population surveys were examined. Google Scholar, Google, Research Gate, PubMed, and the International Journal of Fluoride have all been searched for fluoride research papers. Various doses and pathological effects have been described in this review article.

Maternal and obstetric outcomes following the transfer of embryos warmed with fatty acid-supplemented solutions

BackgroundVitrification procedures decrease intracytoplasmic lipid content and impair developmental competence. Adding fatty acids (FAs) to the warming solution has been shown to recover the lipid content of the cytoplasm and improve developmental competence and pregnancy outcomes. However, the influence of the FA supplementation on live birth rates after embryo transfers and perinatal outcomes remains unknown. In the present study, we examined the influence of FA-supplemented warming solutions on live birth rates, pregnancy complications, and neonatal outcomes after single vitrified-warmed cleavage-stage embryo transfers (SVCTs).MethodsThe clinical records of 701 treatment cycles in 701 women who underwent SVCTs were retrospectively analyzed. Vitrified embryos were warmed using solutions (from April 2022 to June 2022, control group) or FA-supplemented solutions (from July 2022 to September 2022, FA group). The live birth rate, pregnancy complications, and perinatal outcomes were compared between the control and FA groups.ResultsThe live birth rate per transfer was significantly higher in the FA group than in the control group. Multivariate logistic regression analysis further demonstrated a higher probability of live births in the FA group than in the control group. Miscarriage rates, the incidence and types of pregnancy complications, the cesarean section rate, gestational age, incidence of preterm delivery, birth length and weight, incidence of low birth weight, infant sex, and incidence of birth defects were all comparable between the control and FA groups. Multivariate logistic regression analysis further demonstrated no adverse effects of FA-supplemented warming solutions.ConclusionsFA-supplemented warming solutions improved live birth rates after SVCTs without exerting any adverse effects on maternal and obstetric outcomes. Therefore, FA-supplemented solutions can be considered safe and effective for improving clinical outcomes and reducing patient burden.

Female smoking does not affect live birth rate after frozen thawed blastocyst transfer cycle

PurposeThe development of vitrification and blastocyst culture have recently led to a rapidly growing number of single frozen thawed blastocyst transfer (FBT) cycles worldwide. Although the impact of female smoking on spontaneous fertility is well established, its effect on assisted reproductive technologies (ART) outcome is still controversial, and no study has specifically evaluated its effect on FBT cycles’ outcome. MethodsThis retrospective study was conducted in all consecutive FBT cycles conducted between 2012 and 2021 in a single University-based ART centre. Endometrial preparation was standard and based on hormonal replacement therapy. One or two blastocysts were transferred according to couple's history and embryo quality. Female smoking status was recorded for each cycle, and the association between female smoking status and Live Birth Rate (LBR) after FBT cycle was evaluated with univariate and multivariate analysis. ResultsA total of 1537 FBT cycles performed in non-smoking women and 397 FBT cycles performed in smoking women were included in the analysis. No independent association between female smoking status and LBR in FBT cycles was found after logistic regression (OR=1.07 [0.79–1.45], p = 0.649). ConclusionOur study suggests that female smoking might not impair endometrial receptiveness in non-stimulated FBT cycles. Further studies should nevertheless consider assessing more precisely the current smoking exposure.

Trade-off between double cleavage-stage embryos transfer and single blastocyst-stage embryo transfer in patients with few good quality embryos in antagonist cycles: a retrospective study using a propensity score matching analysis

ObjectiveThis study aimed to compare the per OPU clinical outcomes for transfer of Day 3 double cleavage-stage embryos (DET) and Day 5 single blastocyst-stage (SBT) in patients with five or fewer good quality embryos on day 3 per occyte pick-up cycle (OPU) in antagonist cycles with consideration of blastocyst formation failure.MethodsThis was a retrospective, observational cohort study of 2,116 cases of OPU treated with antagonist protocol in the affiliated Chenggong Hospital of Xiamen University between January 2013 and December 2020. DET was performed in 1,811cycles and SBT was performed in 305 cycles. The DET group was matched to the SBT group by propensity score (PS) matching according to multiple maternal baseline covariates. After PS matching, there were 303 ET cycles in each group. The primary outcomes were the cumulative live birth rate (CLBR), cumulative multiple pregnancy rate(CMPR)per OPU and the number of ET to achieve live birth per OPU. Secondary outcomes were the percentage of clinical pregnancy(CPR), live birth rate(LBR), multiple pregnancy rate(MPR).ResultsFollowing PS mating, the CLBR was slightly higher (48.8% versus 40.3% ; P = 0.041) and the CMPR was significantly higher in the DET group compared to SBT group(44.2% versus 7.9%, P < 0.001). The CPR, LBR and MPR per fresh transfer were higher in DET group compared to SBT group(50.2% versus 28.7%; 41.3% versus 21.5%;29.6% versus 0%, P < 0.001). The number of ET to achieve live birth per OPU in SBT group was obiviously more than in DET group(1.48 ± 0.578 versus 1.22 ± 0.557 ,P < 0.001).ConclusionWith a marginal difference cumulative live birth rate, the lower live birth rate per fresh transfer and higher number of ET per OPU in the SBT group suggested that it might take longer time to achieve a live birth with single blastocyst strategy. A trade-off decision should be made between efficiency and safety.

Complete rupture of the pregnant uterus: A 12-year retrospective study.

To assess the frequency of uterine ruptures, clinical characteristics, and maternal and neonatal outcomes in a tertiary referral center. Information on complete uterine rupture between July 2010 and June 2022 was investigated retrospectively at a tertiary center. There were 42 cases of complete uterine rupture in 144 474 deliveries, with an incidence rate of 0.029%. Twenty-seven cases had a scarred uterus and 15 had an unscarred uterus; Rupture of the lower uterine segment was predominant in the scarred uterus, whereas rupture of the body of the uterus was predominant in the non-scarred uterus (P ≤ 0.001). Newborns with Apgar score of 7 or less at 1 min in the non-scarred uterus group was more than that in the scarred uterus group (P = 0.001). There were no significant differences in the history of gynecologic surgery, induction of labor, mode of delivery, clinical features, maternal outcomes, neonatal weight, preterm birth rate, 5-min Apgar score, or neonatal mortality between the two groups (P > 0.05). The clinical manifestations of uterine rupture are mainly abdominal pain, abnormal fetal heartbeat, or vaginal bleeding. Attention should also be paid to the history of previous uterine surgery. Strict prenatal management, early identification, and aggressive management can help improve maternal and child outcomes. Hysterectomy is not imperative.

In cases with raised sperm DNA fragmentation, can sperm selection by magnetic-activated cell sorting or testicular sperm aspiration help improve reproductive outcomes?

To evaluate the efficacy of magnetic-activated cell sorting (MACS) or testicular sperm aspiration (TESA) to improve reproductive outcomes in cases with elevated sperm DNA fragmentation undergoing assisted reproduction. This randomized controlled trial included couples with failed IVF cycles and sperm DNA fragmentation > 30%. Sperm DNA fragmentation was assessed using the sperm chromatin structure assay (SCSA) method. Participants were randomly assigned to either the MACS or TESA group. Testicular sperm retrieval was performed for the TESA group, while MACS involved sperm selection using magnetic beads. Extended blastocyst culture, freeze all policy of blastocysts by vitrification, and frozen embryo transfer were undertaken as per clinic's standard operating protocols. Blastocyst formation rate, implantation rate, miscarriage rate, multiple pregnancy rate, and live birth rate were analyzed and compared between MACS and TESA groups. There were no significant differences in female age, male age, or sperm DNA fragmentation index (DFI) between the MACS and TESA groups. The blastocyst conversion rate was slightly higher in the TESA group (39%) compared to the MACS group (32%). However, the MACS group had a higher implantation rate (50%) than the TESA group (35%). Miscarriage rates, multiple pregnancy rates, and live birth rates did not show statistically significant differences between the groups. A chi-squared test was conducted to compare categorical variables, and t-tests were done to compare continuous variables. In cases with raised sperm DNA fragmentation, sperm selection by MACS or TESA seems to offer comparable reproductive outcomes. There seems no superiority of one intervention over the other in cases with raised sperm DNA fragmentation undergoing assisted reproduction. Both interventions seem to be beneficial for couples seeking assisted reproduction with raised sperm DNA fragmentation.

Pregnancy outcomes of monochorionic diamniotic and dichorionic diamniotic twin pregnancies conceived by assisted reproductive technology and conceived naturally: a study based on chorionic comparison

ObjectiveTo evaluate monochorionic diamniotic (MCDA) and dichorionic diamniotic (DCDA) twin pregnancies conceived by assisted reproductive technology (ART) and conceived naturally.MethodsWe retrospectively analyzed the data on twin pregnancies conceived by ART from January 2015 to January 2022,and compared pregnancy outcomes of MCDA and DCDA twins conceived by ART with those of MCDA and DCDA twins conceived naturally, pregnancy outcomes between MCDA and DCDA twins conceived by ART, and pregnancy outcomes of DCT and TCT pregnancies reduced to DCDA pregnancies with those of DCDA pregnancies conceived naturally.ResultMCDA pregnancies conceived by ART accounted for 4.21% of the total pregnancies conceived by ART and 43.81% of the total MCDA pregnancies. DCDA pregnancies conceived by ART accounted for 95.79% of the total pregnancies conceived by ART and 93.26% of the total DCDA pregnancies. Women with MCDA pregnancies conceived by ART had a higher premature delivery rate, lower neonatal weights, a higher placenta previa rate, and a lower twin survival rate than those with MCDA pregnancies conceived naturally (all p < 0.05). Women with DCDA pregnancies conceived naturally had lower rates of preterm birth, higher neonatal weights, and higher twin survival rates than women with DCDA pregnancies conceived by ART and those with DCT and TCT pregnancies reduced to DCDA pregnancies (all p < 0.05).ConclusionOur study confirms that the pregnancy outcomes of MCDA pregnancies conceived by ART are worse than those of MCDA pregnancies conceived naturally. Similarly, the pregnancy outcomes of naturally-conceived DCDA pregnancies are better than those of DCDA pregnancies conceived by ART and DCT and TCT pregnancies reduced to DCDA pregnancies.

Is the Early Screening of Lower Genital Tract Infections Useful in Preventing Adverse Obstetrical Outcomes in Twin Pregnancy?

Objectives: Twin pregnancy implies a higher risk of preterm birth and, consequently, higher neonatal morbidity and mortality. In singleton pregnancies, infections of the lower genital tract (LGTIs) and bacterial vaginosis are associated with preterm labor, and their early detection has been proven effective in reducing complications like the preterm premature rupture of membranes (pPROM) and preterm delivery. The same evidence, however, is lacking for twin pregnancies. This study aimed to evaluate whether the early identification and treatment of LGTIs or bacterial vaginosis in asymptomatic women with twin pregnancy could reduce the rate of miscarriages, pPROM, and preterm birth. Methods: This study performed a retrospective comparison of 285 women with a multiple pregnancy submitted for a cervico-vaginal swab only at 20-22 weeks (Single Test Group, STG), and 199 women who underwent the swab at 12-14 and again at 20-22 weeks (Double Test Group, DTG). All women included in the study had a twin pregnancy and were followed up at Sant'Anna Hospital, Turin (Italy), between September 2012 and February 2021. Results: In STG, 21.7% of patients had a positive swab; in DTG, 19.9% had an early positive swab that was immediately treated by targeted antibiotics; and 16.7% had a mid-pregnancy positive swab. The DTG showed a significantly lower incidence of pPROM in univariate analysis (14.4% vs. 23.1%, p = 0.021), which was confirmed by multivariate analysis (OR 0.55, CI 0.33-0.93, p = 0.025). Conclusions: Our study suggests that, in asymptomatic women with twin pregnancy, the early screening of LGTIs and bacterial vaginosis by a cervico-vaginal swab at 12-14 weeks of gestational age is effective in reducing the risk of pPROM.

Iron deficiency therapy in pregnant women: advantages and new possibilities of iron carboxymaltose

Introduction. Impact of iron deficiency on pregnancy outcomes appears an urgent issue despite generally accepted standards of therapy. Iron needs increase during pregnancy and manifestations of its deficiency reduce QoL in pregnant women and worsen newborn health. Ferric carboxymaltose helps overcome iron deficiency in a quick and efficient manner from the 2nd trimester.Aim. To analyse the results of ferric carboxymaltose therapy of iron deficiency conditions in pregnant women.Materials and methods. In this article we presented our own experience in providing ferric carboxymaltose therapy to treat iron deficiency in 152 pregnant women from the 2nd trimester.Results and discussion. Correction of anaemic syndrome was observed in more than 73.3% (up to 93.3% depending on the severity of primary anaemia) as early as the first week after administration of ferric carboxymaltose. Haemoglobin and ferritin levels at 3 week post-infusion were significantly higher than pre-infusion levels (p &lt; 0.001). Improvement of haemoglobin levels at 6 weeks after initiation of therapy was achieved in all women with mild anaemia and in 98.5% of women with severe anaemia. No definite severe hypersensitivity reactions were detected. The overall incidence of side effects was 10.5%, with headache being the most frequently reported type (7.9%). All pregnancies resulted in a live birth without malformations; the rate of preterm birth was 9.5%.Conclusion. Ferric carboxymaltose is an effective drug to quickly correct iron deficiency in pregnant women with a minimum number of adverse reactions and without negative impact on newborn health.

Intracytoplasmic Sperm Injection Versus In vitro Fertilization in Infertile Women with Thyroid Autoimmunity.

Background: It has been reported that intracytoplasmic sperm injection (ICSI) may be the preferred fertilization method for women with thyroid autoimmunity (TAI) seeking assisted reproduction. We compared the reproductive outcomes of women with TAI who were treated with ICSI compared with in vitro fertilization (IVF). Methods: In this retrospective cohort study, we included women with infertility who were referred to the Reproductive Centre of Peking University Third Hospital for their first IVF/ICSI and embryo transfer (ET) treatment cycle from January 2019 to February 2021. In total, 2171 and 743 women with TAI underwent IVF and ICSI, respectively, while 8702 and 2668women without TAI underwent IVF and ICSI, respectively. We examined the cumulative live birth rate (primary outcome) from the initiated stimulative cycle as well as the secondary outcomes of fertilization rate, rates of clinical pregnancy, and live birth after the first ET cycle. We compared the reproductive outcomes of women treated with IVF and ICSI according to TAI status. Multivariable logistic regression analyses were performed to adjust for relevant confounders. Results: Women who underwent ICSI had significantly higher fertilization rates than those who underwent IVF (median [interquartile range]: 0.6 [0.5-0.8] in the TAI-positive and IVF group vs. 0.7 [0.5-0.8] in the TAI-positive and ICSI group vs. 0.6 [0.5-0.8] theTAI-negative and IVF group vs. 0.7 [0.5-0.8] in the TAI-negativeand ICSI group, p < 0.001). However, the rates of cumulative live births, clinical pregnancies, and live births were significantly lower among women with TAI who underwent ICSI than those who underwent IVF (cumulative live birth: 51.8% vs. 47%, adjusted odds ratio [aOR]: 0.80 [confidence interval, CI: 0.67-0.97]; clinical pregnancy: 43.0% vs. 38.8%, aOR: 0.81 [CI: 0.67-0.97]; live birth: 36.2% vs. 32.4%, aOR: 0.81 [CI: 0.66-0.98]). Conclusion: We observed that the use of ICSI in women with TAI was not associated with better assisted reproductive outcomes compared with IVF. Further prospective clinical trials are needed to confirm our findings.

Mortality from the 1944–1945 famine in Java, Indonesia

AbstractThis article examines the human toll of the 1944–1945 famine in Java, Indonesia's main island. It estimates birth and death rates for the Indonesian population in Java during 1941–1951. Using the net population loss method, the article approximates a net loss of 3.3 million people during the 1942–1945 Japanese occupation period. This includes 1.8 million excess deaths; 0.7 million during 1944 and 1.1 million during 1945. The remainder are 1.4 million missing births in 1944 and 1945, associated with the malnutrition of women of childbearing ages and physical separation of wives from husbands recruited by Japanese authorities for forced labour.

Abstract PS13-03: Safety of taxane chemotherapy for the treatment of breast cancer during pregnancy: an international cohort study

Abstract Introduction: The addition of taxanes to anthracycline-based chemotherapy regimens offers increased odds of survival in breast cancer (BC) patients. However, some clinicians defer their use in pregnant patients due to limited evidence supporting safety during gestation. The aim of this study is to describe the prevalence of maternal and neonatal adverse events in BC patients exposed to taxane-containing regimens during pregnancy. Methods: This is an international cohort study of BC patients treated with taxane chemotherapy during pregnancy. Inclusion criteria were age ≥18 years, treatment in a participating center (n=10), and completion of pregnancy. Results: A total of 103 women with a median age of 34 years (range 21-44) were included, of whom the majority (91/101; 90.1%) were also exposed to anthracyclines. The median gestational age at initiation of any chemotherapy agent was 16 weeks (range 4-34), while that of taxanes was 28 weeks (range 12-37). Paclitaxel was the most frequently used taxane (100/103; 97.1%), most prescribed as an 80 mg/m2 weekly infusion. All cases were singleton pregnancies except for one twin gestation. The overall live birth rate was 98.0% (100/102). Median gestational age at delivery was 37 weeks (range 32 to 40), with 36/83 live births being preterm (gestational age of &amp;lt; 37 weeks; 43.4%). Median birth weight was 2700 grams (range 1440-4000). The prevalence of grade 3 to 4 adverse events, obstetric complications, and neonatal outcomes are shown in the Table. A total of 56/58 (96.6%) of neonates had a 5-minute Apgar score ≥7 and 14/88 (15.9%) were admitted to a neonatal intensive care unit. Follow-up beyond the neonatal period was available for 28 neonates (median 42 months, range 1-228), of which reported adverse events were: cardiac abnormality (n=1), speech disorder (n=1), renal disfunction (n=1), and femoral anteversion (n=1). Conclusion: The use of taxane-containing chemotherapy during pregnancy does not seem to increase the risk of obstetric and neonatal complications. Our findings support the use of taxanes during gestation when clinically indicated. Table 1. Reported adverse events with gestational use of taxane-containing chemotherapy regimens. Citation Format: Ana Ferrigno Guajardo, Bryan Vaca-Cartagena, Erica Mayer, Chayma Bousrih, Oluchi Oke, Cristina Saura, Fedro Alessandro Peccatori, Wendy Muñoz-Montaño, Alvaro Cabrera-Garcia, Matteo Lambertini, Luis Corrales, Andrea Becerril-Gaitan, Tal Sella, Alexandra Newman, Barbara Pistilli, Ashley Martinez, Carolina Ortiz, Laia Joval-Ramentol, Giovanna Scarfone, Barbara Buonomo, Fernando Lara-Medina, Jacqueline Sanchez, Luca Arecco, Allan Ramos-Esquivel, Snezana Susnjar, Gilberto Morgan, Cynthia Villarreal-Garza, Hatem Azim. Safety of taxane chemotherapy for the treatment of breast cancer during pregnancy: an international cohort study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS13-03.

Socio-Cultural Factors and Components of the Digital Economy in Ethnic Minority Regions

We define the digital economy as all economic activities conducted through the use of information technologies, including activities to create new markets, expand old ones, and produce digital goods and services. The digital economy has become a major driver of sustainable development and the transition towards a greener economy. However, studies show an unequal level of progress among cities, regions, and countries. Consequently, this paper explores the associations between socio-cultural factors (such as attitudes towards marriage/raising a family) and components of the digital economy (such as expenses/investment in ICT and the proportion of personal computers and the Internet in households). This study specifically examines twenty-two ethnic minority regions in Russia with data covering a five-year period. Using the Pearson correlation coefficient, the results show that socio-cultural factors including a large urban population and high divorce rates were positively associated with the digital economy, whereas a large rural population, higher birth rates, and higher natural population growth were negatively correlated with the digital economy.

Cervical Septum Incision Adversely Impacts Clinical Outcomes in Women with Complete Uterine Septum and Duplicated Cervix

To investigate the reproductive outcomes of women with complete septate uterus and duplicated cervix who either did or did not receive cervical septum incision during hysteroscopic transcervical incision of the uterine septum. Retrospective study approved by the Hospital Ethics Committee. Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. Women with complete septate uterus and duplicated cervix who underwent hysteroscopic transcervical incision of the uterine septum in Obstetrics and Gynecology Hospital of Fudan University between January 2008 and December 2020 (n=105). Hysteroscopic incision of the septum. Included patients were grouped according to whether or not cervical septum incision was performed. Reproductive outcomes including gravidity, abortion rate, preterm birth rate, full-term birth rate, premature rupture of membranes (PROM), and cervical incompetence were assessed. In no incision group, the abortion rate (7.4%) was significantly lower than that of incision group (27.6%, p=0.01); the preterm birth rate (4.6%) was significantly lower than that of incision group (36.8%); and the full-term birth rate (95.5%) exceeded that of incision group (63.2%, p<0.01). Incidence of PROM and cervical incompetence during pregnancy was higher in incision group (15.8% and 10.5%, p<0.01 and p=0.03). Significantly improved reproductive outcomes were observed among patients with complete septate uterus and duplicated cervix whose cervical septum was preserved during the hysteroscopic transcervical incision of the uterine septum procedure.

Epidemiologic Look at Teen Birth [ID 2683394

INTRODUCTION: To take an epidemiologic look at the most up-to-date geographical variation in the average teenage birth rates by county in the United States. METHODS: Data from the National Center for Health Statistics were used in this retrospective cohort to count the total number of live births to females aged 15–19 years by county between 2003 and 2020. Software for disease surveillance and spatial cluster analysis was used to identify clusters of high or low birth rates in counties or areas of greater than 100,000 teenage females. The data were then further analyzed by unemployment rate, no high school diploma rate, Hispanic rate, African American rate, and poverty rate per county as influence on the prediction of teenage birth rate. RESULTS: Spatial analysis identified 94 significant spatial clusters of teenage births. When adjusted for time and space, there were three significant clusters within Texas, all within 2013–2020, showing a steep increase in teenage birth rates. The top cluster with a 60% higher chance of teenage birth than the remainder of the country. Individual covariates examined showed the best predicter of teenage birth is unemployment followed by low education. CONCLUSION: Nationally, teenage births have declined over the last 30 years; however, clusters of elevated teenage birth rates remain predominantly in the southeastern United States and Texas. When adjusting for covariates of social determinants of health, some of these clusters remained, indicating other factors with influence on teenage birth rate.

Induction Method Combination in Patients With Hypertensive Disorders of Pregnancy [ID 2683632

INTRODUCTION: We aim to evaluate cesarean birth (CB) rates according to induction method combinations in patients with hypertensive disorders of pregnancy (HDP). METHODS: We conducted a retrospective study including singleton pregnancies with HDP admitted to labor and delivery at a tertiary center from January 2018 to December 2019. Clinical and sociodemographic data were extracted from electronic medical records. Pregnancies with incomplete data and those who declined a trial of labor were excluded. Hypertensive disorder of pregnancy was defined according to the American College of Obstetricians and Gynecologists classification. Cesarean birth rates were compared among induction agent combinations using binary logistic regression. A value of P&lt;.05 was considered significant. RESULTS: A total of 552 pregnancies met inclusion criteria. Of these, 113 were induced with oxytocin, 112 with mechanical agents and oxytocin, 58 with a mechanical method and prostaglandins, 31 received prostaglandins alone, 54 received oxytocin and prostaglandins, 80 received oxytocin, prostaglandins, and a mechanical agent, 35 were induced with mechanical methods, and 69 were in spontaneous labor. Demographic and baseline characteristics were not different by induction agent combination. After logistic regression, the combination of prostaglandins and mechanical agents was associated with a decreased CB rate; odds ratio, 0.4 (95% CI: 0.1–0.9), using those in spontaneous labor as reference. No other agent combination was associated with an increased or decreased in CB rate. CONCLUSION: Induction of labor with a combination of prostaglandins and mechanical agents may decrease CB rates compared with other combination methods for induction in pregnancies with HDP.

Locationally activated PRP via an injectable dual-network hydrogel for endometrial regeneration

Enhancing the effectiveness of platelet-rich plasma (PRP) for endometrial regeneration is challenging, due to its limited mechanical properties and burst release of growth factors. Here, we proposed an injectable interpenetrating dual-network hydrogel that can locationally activate PRP within the uterine cavity, sustained release growth factors and further address the insufficient therapeutic efficacy. Locational activation of PRP is achieved using the dual-network hydrogel. The phenylboronic acid (PBA) modified methacrylated hyaluronic acid (HAMA) dispersion chelates Ca2+ by carboxy groups and polyphenol groups, and in situ crosslinked with PRP-loaded polyvinyl alcohol (PVA) dispersion by dynamic borate ester bonds thus establishing the soft hydrogel. Subsequently, in situ photo-crosslinking technology is employed to enhance the mechanical performance of hydrogels by initiating free radical polymerization of carbon-carbon double bonds to form a dense network. The PRP-hydrogel significantly promoted the endometrial cell proliferation, exhibited strong pro-angiogenic effects, and down-regulated the expression of collagen deposition genes by inhibiting the TGF-β1-SMAD2/3 pathway in vitro. In vivo experiments using a rat intrauterine adhesion (IUA) model showed that the PRP-hydrogel significantly promoted endometrial regeneration and restored uterine functionality. Furthermore, rats treated with the PRP-hydrogel displayed an increase in the number of embryos, litter size, and birth rate, which was similar to normal rats. Overall, this injectable interpenetrating dual-network hydrogel, capable of locational activation of PRP, suggests a new therapeutic approach for endometrial repair.

The Impact of Immigration Policy Changes on Preterm Birth Rates in Texas: An Examination of Border and Nonborder Regions

BackgroundOur study examined the acute and sustained impact of immigration policy changes announced in January 2017 on preterm birth (PTB) rates among Hispanic and non-Hispanic white women in Texas's border and nonborder regions. MethodsUsing Texas birth certificate data for years 2008 through 2020, we used a multiple group interrupted time series approach to explore changes in PTB rates. ResultsIn the nonborder region, the PTB rate among Hispanic women of any race was 8.64% in 2008 and was stable each year before 2017 but increased by .29% (95% CI [.12, .46]) annually between 2017 and 2020. This effect remained statistically significant even when compared with that of non-Hispanic white women (p = .014). In the border areas, the PTB rate among Hispanic women of any race was 11.67% in 2008 and remained stable each year before and after 2017. No significant changes were observed when compared with that of non-Hispanic white women (p = .897). In Texas as a whole, the PTB rate among Hispanic women of any race was 10.16% in 2008 and declined by .07% (95% CI [−.16, −.03]) per year before 2017, but increased by .16% (95% CI [.05, .27]) annually between 2017 and 2020. The observed increase was not statistically significant when compared with that of non-Hispanic white women (p = .326). ConclusionsThe January 2017 immigration policies were associated with a sustained increase in PTB among Hispanic women in Texas's nonborder region, suggesting that geography plays an important role in perceptions of immigration enforcement. Future research should examine the impact of immigration policies on maternal and child health, considering geography and sociodemographic factors.

Evaluating Contraception Counseling and Desire for Immediate Postpartum Long-Acting Contraception in Publicly Insured Adolescents [ID 2683512

INTRODUCTION: Adolescent pregnancy is associated with a high prevalence of short interval birth and unplanned pregnancy, along with other risks. Immediate postpartum long-acting reversible contraception (IPP LARC) has the potential to improve these outcomes. This study aimed to examine the presence of counseling, desire, and obtainment of IPP LARC during hospitalization. METHODS: This retrospective cohort analysis used electronic health records to capture demographics, pregnancy details, and contraceptive discussions and plans for pregnant patients admitted for delivery in one East Tennessee hospital. Exclusion criteria included those with private insurance or received permanent sterilization during hospitalization. Adolescence was defined as age less than 20 years at the time of delivery. Data were extracted from March 2018 to June 2023. Chi-squared tests were conducted in SPSS. RESULTS: 10,492 patients that met inclusion criteria delivered between March 2018 and June 2023. Of these, 10.8% (n=1,128) were adolescents. Desire for IPP LARC upon admission was higher among adolescents (31.6% versus 25.1%; P&lt;.001). IPP LARC placement was significantly higher among adolescents (overall, 24.0% [n=2,523]; adolescents, 27.5%, versus age 20 and older, 23.6%; P=.005). Adolescents who self-reported receiving contraceptive counseling during prenatal care were more likely to receive IPP LARC (66.5% versus 42.4%; P&lt;.001). CONCLUSION: In this study, prenatal contraception counseling increased patient obtainment of desired postpartum contraceptive plan, including IPP LARC. Adolescents both desired and obtained IPP LARC more frequently than their older counterparts. Improved contraceptive counseling and access to all contraceptive options, including IPP LARC, may improve teen pregnancy and birth rates.