The Utility of Performing Cervical Length Follow-Up in Lower Risk Singleton

Introduction: Short cervical length (\u3c25 mm) during pregnancy is known to be an increased risk factor for preterm birth (\u3c37 weeks). While interventions exist for women who have had prior preterm births, it is important to investigate the cost effectiveness of screening low risk women with an intermediate cervical length (26-29 mm). Objective: To quantify the association between change in cervical length on follow up and the incidence of preterm birth in otherwise low risk women with an initial intermediate cervical length. Methods: A retrospective cohort study was conducted, reviewing 108 charts of women who had an initial screening between 26 and 29 mm. Charts were reviewed for whether or not a follow-up ultrasound was recommended, whether or not the follow-up was performed, and the outcome of their deliveries. Results: 93.5% (N=101) of women were recommended to get a follow-up ultrasound and 84% (N=85) completed their follow-up. 9.3% (N=10) had a CL of \u3c25mm on followup. 9.3% (N=10) had preterm deliveries. A significant difference was found between cervical length on followup and the incidence of early preterm birth (\u3c34 weeks) (p-value = .015). On univariate analysis, a significant difference was found between cervical length difference (initial cervical length-followup) and the incidence of preterm birth (p-value=.021). Conclusion: Cervical Length Followup for low risk women is a worthwhile investment to decrease the incidence of preterm birth and allows for the implementation of timely interventions for women whose cervixes spontaneously shorten to less than 25 mm

Effects of Intravenous Iron Versus Oral Iron for Treatment of Anemia in Pregnancy on Maternal and Fetal Outcomes: A Systematic Review and Meta-analysis

Introduction: Anemia during pregnancy can lead to preterm birth, low fetal birthweight, and poorer neonatal neurological outcomes. The purpose of this study was to compare maternal and fetal outcomes following intravenous (IV) versus oral iron supplementation for iron-deficiency anemia during pregnancy. Methods: We searched MEDLINE, OVID, Scopus, ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials (RCTs) comparing IV versus oral iron supplementation for iron-deficiency anemia during pregnancy. Studies were included in this meta-analysis if they reported maternal and fetal hematologic outcomes. The relative risk (RR) or standard mean difference (SMD) of IV iron supplementation was calculated for notable outcomes. Results: Eleven studies, with a total of 1621 women in the IV group and 1640 women in the oral group, were included in this meta-analysis. Fetal birthweight, was higher in the IV iron group (SMD 58.60g, 95% confidence interval (CI) 2.63,114.58). There was no significant difference in the rate of preterm birth or gestational age at birth between the two groups. Maternal hemoglobin at delivery was significantly higher in the IV group compared to the oral group (SMD 0.85 g/dL (95% CI (0.15, 1.55)). The IV group experienced 40 (2.5%) cases of gastrointestinal distress, compared to 69 (4.2%) cases in the oral group (RR 0.60 (95% CI (0.40,0.89)). Discussion: Intravenous iron supplementation for iron-deficiency anemia during pregnancy results in higher neonatal birthweight, higher maternal hemoglobin levels, and minimal adverse effects. Future studies are needed to investigate the cost-effectiveness of IV iron

Health disparities among pregnant women diagnosed with COVID-19 in Philadelphia

Introduction: The CDC has cited language barriers and racial discrimination as some of the social determinants of health during the COVID-19 pandemic. This study aims to investigate the socioeconomic factors that affect COVID-19 diagnosis and outcomes in pregnant women. We hypothesize that women whose primary language is not English will have higher rates of COVID-19 compared to women whose primary language is English. Methods: This is a retrospective cohort study of women who delivered at TJUH between 04/13/2020 and 06/31/2020. Data on demographics, SARS-CoV-2 PCR, maternal, fetal, neonatal outcomes were collected. The primary outcome was the proportion of English vs Non-English-speaking patients with and without SARS-CoV-2 positive PCR. Data were analyzed using a Chi-squared test. Multivariable logistic regression will be used to control for the effect of factors including comorbidities and income level. The study was approved by TJUH Institutional Review Board. Results: Preliminary data are herein reported. 473 women have been included thus far (of 713 eligible), 106 tested positive and 367 tested negative. Overall, the preferred language was English in 78.4%, Spanish in 12.9%, Other in 8.7%. There were significantly more Non-English-speaking patients in the COVID-19 positive group than in the COVID-19 negative group (36.8% vs 17.2%, p\u3c0.001). Discussion: Non-English-speaking pregnant women are disproportionally represented in the COVID positive patient population, which supports our hypothesis. This suggest that language is significant barrier to SARS-CoV-2 care, this may be related to other sociodemographic factors. Further analysis will provide data on the impact of this disparity. Data collection will be completed in January 2021

Improving Utilization of Aspirin for Prevention of Preeclampsia in a High Risk Urban Cohort

High risk women without a history of preeclampsia were less likely to be recommended aspirin for preeclampsia prevention. A simple screening tool at 1st trimester ultrasound can significantly improve aspirin utilization for preeclampsia preventionhttps://jdc.jefferson.edu/obgynposters/1009/thumbnail.jp