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9 results on '"Kuppermann M"'

1. Sociodemographic and attitudinal predictors of simultaneous and redundant multiple marker and cell-free DNA screening among women aged ⩾35 years

Author

Lewkowitz, A K, Kaimal, A J, Thao, K, O'Leary, A, Nseyo, O, and Kuppermann, M

Abstract

Objective:To identify characteristics associated with undergoing cell-free DNA (cfDNA) and multiple marker screening (MMS) simultaneously or redundantly (after receiving negative results from the first screening test) among women aged ⩾35 years.Study design:Participants presenting for prenatal testing completed a questionnaire that included measures of pregnancy worry and attitudes toward potential testing outcomes; data on prenatal test use was obtained via medical record review. We used multivariable logistic regression to identify factors associated with redundant or simultaneous screening.Results:Among 164 participants, 69 (42.1%) had cfDNA redundantly (n=51) to, or simultaneously (n=18) with, MMS. Compared with the 46 MMS-negative women who did not undergo further testing, those who underwent redundant or simultaneous cfDNA/MMS screening were more likely to have annual family incomes >$150 000, to feel having a miscarriage would be worse than having an intellectually disabled child, to desire comprehensive testing for intellectual disability and to have more pregnancy worry.Conclusion:Providers who counsel patients on prenatal aneuploidy screening tests should explain the appropriate utilization of these screening tests to avoid unnecessary or minimally informative use of multiple tests.

Published
2017
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2. Dynamic outcome prediction in a socio-demographically diverse population-based cohort of extremely preterm neonates

Author

Steurer, M A, Anderson, J, Baer, R J, Oltman, S, Franck, L S, Kuppermann, M, Rand, L, Ryckman, K K, Partridge, J C, Jelliffe-Pawlowski, L L, and Rogers, E E

Abstract

Objective:Accurate outcome prediction is crucial for counseling parents and providing individualized treatment to extremely premature infants. We sought to improve upon existing prediction model by using a diverse population-based cohort of extremely premature live births (⩽28 weeks’ gestation) for survival and survival without severe neonatal morbidity at different times throughout the first week of life and to evaluate potential differences by race/ethnicity and maternal education.Study design:Retrospective cohort study of all California live births from 2007 through 2011 with linked birth, death and hospital discharge records.Results:A total of 6009 infants were included. In the validation data set at time of delivery, the area under the receiver-operating characteristic curve for the model containing all predictors was 0.863 for survival and 0.789 for survival without severe morbidity. The marginal probability of survival without severe neonatal morbidity of an Asian infant born to a mother with <12 years of education compared with the reference (Caucasian infant, mother with ⩾12 years of education) was −0.23 (95% confidence interval (CI) −0.31 to −0.15) for all infants at time of birth and −0.28 (95% CI −0.39 to −0.18) for infants with attempted resuscitation. Notably, no other differences by racial/ethnic category and maternal education emerged.Conclusions:Probabilities of survival and survival without major morbidity change rapidly throughout the first week of life. Extremely premature infants born to Asian mothers with less than a high school education appear to have a lower probability to survive without significant morbidity compared with their Caucasian peers.

Published
2017
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3. Population-based risks of mortality and preterm morbidity by gestational age and birth weight

Author

Baer, R J, Rogers, E E, Partridge, J C, Anderson, J G, Morris, M, Kuppermann, M, Franck, L S, Rand, L, and Jelliffe-Pawlowski, L L

Abstract

Objective:: The objective of this study is to examine the effect of small or large for gestational age (SGA/LGA) status on mortality and morbidity by gestational age. Study Design:: Logistic binomial regression was used to calculate relative risks (RRs) and 95% confidence intervals for infant mortality and preterm morbidities for SGA or LGA compared with appropriately grown (AGA) deliveries stratified by gestational age group. Results:: Compared with AGA infants of similar gestational age, SGA infants were at increased risk for infant mortality. Mortality risk was decreased for LGA infants born between 25 and 27 weeks (RR: 0.6) but increased for LGA infants born between 28 and 31 weeks (RR: 1.9). Risk of preterm morbidity was increased for SGA infants born between 28 and 38 weeks, but decreased for LGA infants born before 37 weeks. Conclusion:: This study demonstrates the importance of considering birth weight for gestational age when evaluating morbidity and mortality risks.

Published
2016
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6. Success of uterus-preserving treatments for abnormal uterine bleeding, chronic pelvic pain, and symptomatic fibroids: age and bridges to menopause.

Author

Learman LA, Nakagawa S, Gregorich SE, Jackson RA, Jacoby A, and Kuppermann M

Subjects
UTERINE surgery, AGE distribution, CHRONIC diseases, GYNECOLOGIC surgery, HYSTERECTOMY, MENOPAUSE, PELVIC pain, UTERINE fibroids, UTERINE hemorrhage, UTERINE tumors, TREATMENT effectiveness
Abstract

OBJECTIVE: The purpose of this study was to determine whether age at first uterus-preserving treatment (UPT) predicts symptom resolution among women with common pelvic problems. STUDY DESIGN: We conducted an analysis of 557 participants in the Study of Pelvic Problems, Hysterectomy and Intervention Alternatives cohort who reported having undergone a UPT. We performed multivariable regression modeling age at first UPT, hysterectomy, menopause, and other covariates to predict symptom resolution. RESULTS: Mean ± SD age at enrollment was 42.7 ± 4.7 years; mean follow-up time was 4.4 ± 2.7 years. Sixteen percent of the women underwent hysterectomy; 37% of the women entered menopause. Hysterectomy was a strong predictor of symptom resolution (P < .001). Compared with women who were younger (first UPT at age <40 years), older women reported greater symptom resolution, even after the data were controlled for hysterectomy use and menopausal status (P = .028). CONCLUSION: Women who are >=40 years old when they undergo their first uterus-preserving treatment experience greater symptom resolution than younger women. Framing UPTs as hysterectomy alternatives may be accurate only for a subset of women who are >40 years old. [ABSTRACT FROM AUTHOR]

Published
2011

7. Symptom resolution after hysterectomy and alternative treatments for chronic pelvic pain: does depression make a difference?

Author

Learman LA, Gregorich SE, Schembri M, Jacoby A, Jackson RA, and Kuppermann M

Subjects
PELVIC pain treatment, CHRONIC diseases, MENTAL depression, HYSTERECTOMY, PELVIC pain, PHYSICAL therapy, QUESTIONNAIRES, TREATMENT effectiveness, DISEASE complications
Abstract

OBJECTIVE: The purpose of this study was to determine whether depression influences treatment outcomes and to identify predictors of symptom resolution among women with chronic pelvic pain (CPP). STUDY DESIGN: Analysis of 701 women with CPP in the Study of Pelvic Problems, Hysterectomy and Intervention Alternatives prospective cohort study, which included 153 women (22%) with depression. We conducted multivariable analyses to evaluate the influence of depression on pre-/posttreatment differences in symptoms and health-related quality of life and to identify other predictors of symptom improvement. RESULTS: CPP treatments included hysterectomy (9%), other surgical treatments (9%), hormonal medications (50%), narcotic analgesics (47%), physical therapy (12%), and nonprescription medications (93%). Depression predicted lower gains in health perception (P < .05) but not in symptom resolution, sexual functioning, or other aspects of health-related quality of life. Symptom resolution was predicted by hysterectomy (P < .001), entering menopause (P < .001), and pretreatment satisfaction with sex (P = .039). CONCLUSION: Depression does not influence substantially treatment-related gains in CPP symptom resolution and health-related quality of life. Coexisting depression should not delay treatment for CPP. [ABSTRACT FROM AUTHOR]

Published
2011

9. Perceived risk of prenatal diagnostic procedure-related miscarriage and Down syndrome among pregnant women.

Author

Caughey AB, Washington AE, and Kuppermann M

Abstract

OBJECTIVE: The objective of the study was to identify correlates of perceived risk of carrying a Down syndrome-affected fetus or experiencing a procedure-related miscarriage among a diverse group of pregnant women. STUDY DESIGN: We conducted a cross-sectional survey of 1081 English-, Spanish-, or Chinese-speaking women receiving prenatal care in the San Francisco Bay area. Perceived risk of procedure-related miscarriage or carrying a Down syndrome-affected fetus was assessed using a linear rating scale from 0 (no risk) to 1 (high risk). Bivariate and multivariable analyses were used to explore associations between maternal characteristics including age, race/ethnicity, and socioeconomic status and perceived risks of carrying a Down syndrome-affected fetus or experiencing a procedure-related miscarriage. RESULTS: Women aged 35 years old or older had a higher perceived risk of Down syndrome than younger women (0.28 vs 0.22 on a scale from 0 to 1, P < .001) but a lower perceived risk of a procedure-related miscarriage (0.31 vs 0.36, P = .004). In multivariable linear regression analysis among women younger than age 35 years, the perceived risk of carrying a Down syndrome-affected fetus was higher in women who had not attended college (+0.06, P = .019) or had poor self-perceived health status (+0.08, P = .045). Latinas (+0.11, P = .008), women with an annual income less than $35,000 (+0.09, P = .003), and those who had difficulty conceiving (+0.09, P = .026) had higher perceived procedure-related miscarriage risk. Among women aged 35 years or older, perceived risk of carrying a Down syndrome-affected fetus was associated with the inclination to undergo prenatal diagnosis. CONCLUSION: Women's perceived risks of carrying a Down syndrome-affected fetus or having a procedure-related miscarriage are associated with numerous characteristics that have not been shown to be associated with the actual risks of these events. These perceived risks are associated with prenatal diagnostic test inclination. Understanding patients' risk perceptions and effectively communicating risk is critical to helping patients make informed decisions regarding use of invasive prenatal testing. [ABSTRACT FROM AUTHOR]

Published
2008
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