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Fryar C, Mouro S, Whiteside JL, Tumin D. Effect of COVID-19 pandemic on same-day discharge for elective benign hysterectomy. Am J Obstet Gynecol 2024; 230:e92-e98. [PMID: 38181829 DOI: 10.1016/j.ajog.2023.12.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/05/2023] [Accepted: 12/26/2023] [Indexed: 01/07/2024]
Affiliation(s)
- Caroline Fryar
- Department of Obstetrics and Gynecology, Brody School of Medicine, East Carolina University, 600 Moye Blvd., Greenville, NC 27834.
| | - Steven Mouro
- Department of Obstetrics and Gynecology, Brody School of Medicine, East Carolina University, 600 Moye Blvd., Greenville, NC 27834
| | - James L Whiteside
- Department of Obstetrics and Gynecology, Brody School of Medicine, East Carolina University, 600 Moye Blvd., Greenville, NC 27834
| | - Dmitry Tumin
- Department of Pediatrics and Department of Academic Affairs, Brody School of Medicine, East Carolina University, Greenville, NC
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Claiborne A, Wisseman B, Kern K, Steen D, Jevtovic F, McDonald S, Strom C, Newton E, Isler C, Devente J, Mouro S, Collier D, Kuehn D, Kelley GA, May LE. Exercise FITT-V during pregnancy: Association with birth outcomes. Birth Defects Res 2024; 116:e2340. [PMID: 38659157 DOI: 10.1002/bdr2.2340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 03/07/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Prenatal exercise improves birth outcomes, but research into exercise dose-response effects is limited. METHODS This study is a retrospective, secondary analysis of pooled data from three blinded, prospective, randomized controlled trials. Prenatal exercise frequency, intensity, type, time, and volume (FITT-V) were assessed in supervised sessions throughout pregnancy. Gestational age (GA), neonatal resting heart rate (rHR), morphometrics (body circumferences, weight-to-length and ponderal index) Apgar and reflex scores, and placental measures were obtained at birth. Stepwise regressions and Pearson correlations determined associations between FITT-V and birth outcomes. RESULTS Prenatal exercise frequency reduces ponderal index (R2 = 0.15, F = 2.76, p = .05) and increased total number of reflexes present at birth (R2 = 0.24, F = 7.89, p < .001), while exercise intensity was related to greater gestational age and birth length (R2 = 0.08, F = 3.14; R2 = 0.12, F = 3.86, respectively; both p = .04); exercise weekly volume was associated with shorter hospital stay (R2 = 0.24, F = 4.73, p = .01). Furthermore, exercise type was associated with placenta size (R2 = 0.47, F = 3.51, p = .01). CONCLUSIONS Prenatal exercise is positively related to birth and placental outcomes in a dose-dependent manner.
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Affiliation(s)
- Alex Claiborne
- Department of Kinesiology, East Carolina University (ECU), North Carolina, USA
- Human Performance Laboratory, ECU, Greenville, North Carolina, USA
- East Carolina Diabetes and Obesity Institute, ECU, Greenville, North Carolina, USA
| | - Breanna Wisseman
- Department of Kinesiology, East Carolina University (ECU), North Carolina, USA
- Human Performance Laboratory, ECU, Greenville, North Carolina, USA
- East Carolina Diabetes and Obesity Institute, ECU, Greenville, North Carolina, USA
| | - Kara Kern
- Department of Kinesiology, East Carolina University (ECU), North Carolina, USA
- Human Performance Laboratory, ECU, Greenville, North Carolina, USA
- East Carolina Diabetes and Obesity Institute, ECU, Greenville, North Carolina, USA
| | - Dylan Steen
- Department of Kinesiology, East Carolina University (ECU), North Carolina, USA
- Human Performance Laboratory, ECU, Greenville, North Carolina, USA
- East Carolina Diabetes and Obesity Institute, ECU, Greenville, North Carolina, USA
| | - Filip Jevtovic
- Department of Kinesiology, East Carolina University (ECU), North Carolina, USA
- Human Performance Laboratory, ECU, Greenville, North Carolina, USA
- East Carolina Diabetes and Obesity Institute, ECU, Greenville, North Carolina, USA
| | - Samantha McDonald
- School of Kinesiology and Recreation, Illinois State University, Normal, Illinois, USA
| | - Cody Strom
- Department of Kinesiology and Sport, University of Southern Indiana, Evansville, Indiana, USA
| | - Edward Newton
- Department of Obstetrics and Gynecology, East Carolina University, Greenville, North Carolina, USA
| | - Christy Isler
- Department of Obstetrics and Gynecology, East Carolina University, Greenville, North Carolina, USA
| | - James Devente
- Department of Obstetrics and Gynecology, East Carolina University, Greenville, North Carolina, USA
| | - Steven Mouro
- Department of Obstetrics and Gynecology, East Carolina University, Greenville, North Carolina, USA
| | - David Collier
- Department of Pediatrics, East Carolina University, Greenville, North Carolina, USA
| | - Devon Kuehn
- Department of Pediatrics, East Carolina University, Greenville, North Carolina, USA
| | - George A Kelley
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, West Virginia, USA
- School of Public and Population Health, Boise State University, Boise, Idaho, USA
| | - Linda E May
- Department of Kinesiology, East Carolina University (ECU), North Carolina, USA
- Human Performance Laboratory, ECU, Greenville, North Carolina, USA
- East Carolina Diabetes and Obesity Institute, ECU, Greenville, North Carolina, USA
- Department of Obstetrics and Gynecology, East Carolina University, Greenville, North Carolina, USA
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Mouro S, Hamed JLC, Whiteside JL, Tumin D. Relevance of Uterine Weight for Predicting Surgical Complications in Minimally Invasive Benign Hysterectomy. J Minim Invasive Gynecol 2023; 30:976-982. [PMID: 37611741 DOI: 10.1016/j.jmig.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/25/2023]
Abstract
STUDY OBJECTIVES To describe the uterine weight threshold for increasing risk of complications after a laparoscopic hysterectomy using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. DESIGN Cross-sectional analysis using the American College of Surgeons NSQIP database from 2016 to 2021. SETTING American College of Surgeons NSQIP database. PATIENTS Patients undergoing minimally invasive hysterectomy for benign indications (N = 64 289). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Uterine weight was entered in grams and 30-day complications were abstracted from patient charts. In the analytic sample, median uterine weight was 135 grams (interquartile range, 90-215) and 6% of patients (n = 4085) experienced complications. Uterine weight performed very poorly in predicting complications on bivariate analysis (area under the receiver operating characteristics curve, 0.53; 95% confidence interval, 0.53-0.54). On multivariable analysis, a uterine weight cutoff of 163 grams was associated with higher odds of complications (odds ratio, 1.11; 95% confidence interval, 1.03-1.19; p = .003), but this threshold achieved only a 43% sensitivity and 62% specificity for predicting complications. CONCLUSIONS Uterine weight alone possessed negligible utility for predicting the risk of perioperative complications in minimally invasive hysterectomy.
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Affiliation(s)
- Steven Mouro
- Department of Obstetrics and Gynecology (Drs. Mouro and Whiteside), East Carolina University, Greenville, North Carolina.
| | - Jenna L Carter Hamed
- Brody School of Medicine (Ms. Carter Hamed), East Carolina University, Greenville, North Carolina
| | - James L Whiteside
- Department of Obstetrics and Gynecology (Drs. Mouro and Whiteside), East Carolina University, Greenville, North Carolina
| | - Dmitry Tumin
- Department of Pediatrics and Department of Academic Affairs (Dr. Tumin), East Carolina University, Greenville, North Carolina
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McDonald SM, Mouro S, Wisseman B, Isler C, DeVente J, Newton E, Hildebrand J, Kuehn D, Kelley G, Chasan-Taber L, Broskey NT, May LE. Influence of prenatal exercise on the relationship between maternal overweight and obesity and select delivery outcomes. Sci Rep 2022; 12:17343. [PMID: 36243785 PMCID: PMC9569361 DOI: 10.1038/s41598-022-22283-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 10/12/2022] [Indexed: 01/10/2023] Open
Abstract
Women with overweight or obesity (OWOB) have an increased risk of cesarean birth, preterm birth (PTB), and high birth weight infants. Although regular exercise decreases this risk in healthy weight women, these associations have not been explored in OWOB. Women were randomized at 13-16 weeks' gestation to 150-min of moderate-intensity exercise (n = 131) or non-exercising control (n = 61). Delivery mode, gestational age (GA), and birth weight (BW) were obtained via electronic health records. Pregnant exercisers had no differences in risk of cesarean birth, PTB, or BW compared to control participants. OWOB exercisers had higher rates of cesarean birth (27.1% vs. 11.1%), trends of higher PTB (15.3% vs. 5.6%), but normal weight babies relative to normal weight exercisers. Controlling for race and body mass index (BMI), maternal exercise reduced the relative risk (RR) for cesarean birth from 1.63 to 1.43. Cesarean births predicted by pre-pregnancy BMI and fitness level, whereas BW was predicted by race, gestational weight gain (GWG), pre-pregnancy fitness level, and exercise level. Cesarean birth was predicted by pre-pregnancy BMI and fitness level, while maternal exercise reduced the magnitudes of the relative risks of cesarean birth. Maternal exercise, pre-pregnancy fitness level, and GWG predict neonatal BW.Trial Registration: Influence of Maternal Exercise on Infant Skeletal Muscle and Metabolomics-#NCT03838146, 12/02/2019, https://register.clinicaltrials.gov/prs/app/template/EditRecord.vm?epmode=Edit&listmode=Edit&uid=U0003Z0X&ts=8&sid=S0008FWJ&cx=77ud1i .
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Affiliation(s)
- Samantha M. McDonald
- grid.257310.20000 0004 1936 8825School of Kinesiology and Recreation, Illinois State University, Normal, IL USA
| | - Steven Mouro
- grid.253606.40000000097011136Campbell University School of Osteopathic Medicine, Lillington, NC USA ,grid.255364.30000 0001 2191 0423Department of Obstetrics and Gynecology, ECU, 1851 MacGregor Downs Rd, MS#701, Greenville, NC 27834 USA
| | - Breanna Wisseman
- grid.255364.30000 0001 2191 0423Human Performance Laboratory, East Carolina University (ECU), Greenville, NC USA
| | - Christy Isler
- grid.255364.30000 0001 2191 0423Department of Obstetrics and Gynecology, ECU, 1851 MacGregor Downs Rd, MS#701, Greenville, NC 27834 USA
| | - James DeVente
- grid.255364.30000 0001 2191 0423Department of Obstetrics and Gynecology, ECU, 1851 MacGregor Downs Rd, MS#701, Greenville, NC 27834 USA
| | - Edward Newton
- grid.255364.30000 0001 2191 0423Department of Obstetrics and Gynecology, ECU, 1851 MacGregor Downs Rd, MS#701, Greenville, NC 27834 USA
| | - Jason Hildebrand
- grid.255364.30000 0001 2191 0423Department of Obstetrics and Gynecology, ECU, 1851 MacGregor Downs Rd, MS#701, Greenville, NC 27834 USA
| | - Devon Kuehn
- grid.255364.30000 0001 2191 0423Department of Pediatrics, ECU, Greenville, NC USA
| | - George Kelley
- grid.268154.c0000 0001 2156 6140Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, WV USA
| | - Lisa Chasan-Taber
- grid.266683.f0000 0001 2166 5835Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst, MA USA
| | - Nicholas T. Broskey
- grid.255364.30000 0001 2191 0423Human Performance Laboratory, East Carolina University (ECU), Greenville, NC USA ,grid.255364.30000 0001 2191 0423East Carolina Diabetes and Obesity Institute, ECU, Greenville, NC USA
| | - Linda E. May
- grid.255364.30000 0001 2191 0423Department of Obstetrics and Gynecology, ECU, 1851 MacGregor Downs Rd, MS#701, Greenville, NC 27834 USA ,grid.255364.30000 0001 2191 0423Human Performance Laboratory, East Carolina University (ECU), Greenville, NC USA ,grid.255364.30000 0001 2191 0423East Carolina Diabetes and Obesity Institute, ECU, Greenville, NC USA ,grid.255364.30000 0001 2191 0423Department of Foundational Sciences and Research, ECU, Greenville, NC USA
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