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The number of pregnant women with opioid use disorder (OUD) has quadrupled from 1999 to 2014. Current first line treatment for OUD in pregnancy is methadone with increasing support for buprenorphine. Limited data exist on use of buprenorphine/naloxone for OUD in pregnancy despite it being standard therapy in the non-pregnant individuals. The aim of this study was to compare neonatal opioid withdrawal syndrome (NOWS) prevalence and characteristics among neonates born to women prescribed methadone and buprenorphine/naloxone.This is a retrospective cohort analysis of mother-neonate dyads treated with either methadone or buprenorphine/naloxone for OUD in pregnancy who received prenatal care in the substance abuse, treatment, education, and prevention program (STEPP) clinic and delivered at OSU. Primary neonatal outcomes included: neonates diagnosed and treated for NOWS, peak scores on Modified Finnegan Neonatal Abstinence Score (FNAS), number of scores ≥9 on FNAS, and duration of treatment for NOWS. Secondary outcomes included: fetal growth restriction, preterm birth (37 weeks), neonatal head circumference, birth weight, NICU admission, five-minute Apgar score, and length of hospitalization.From 2013 to 2017, we identified 588 mother-neonate dyads: 149 treated with methadone and 439 treated with buprenorphine/naloxone. Ninety-eight neonates (65.8%) in the methadone group were diagnosed with NOWS requiring pharmacological interventions compared with 170 (38.7%) in the buprenorphine/naloxone group (aOR 3.46, 95% confidence interval (CI) 2.31-5.20,Buprenorphine/naloxone treatment for OUD in pregnancy appears safe and has decreased NOWS and pharmacologic intervention for the neonate.

BackgroundPreeclampsia (PE) is a pregnancy-specific vascular endothelial disorder characterized by multi-organ system involvement. This includes the maternal kidneys, with changes such as continuous vasospasm of renal arteries and reduced renal blood flow. However, it is unclear whether similar renal vascular changes are seen in the fetus. This study sought to compare renal artery impedance in fetuses of women with and without PE.MethodsThis was a prospective Doppler assessment study of the fetal renal artery impedance in 48 singleton fetuses. The group with PE consisted of 24 appropriately grown fetuses in pregnancy complicated by both mild and severe PE and a control group of 24 uncomplicated pregnancies. Doppler studies included renal artery systolic/diastolic (S/D) ratio, pulsatility index (PI), resistance index (RI), and identification of end-diastolic blood flow.ResultsFetuses of mothers with PE were more likely to have a lower renal artery Doppler S/D ratio (7.85 [6.4–10.2] vs. 10.8 [7.75–22.5], P = 0.03) and lower RI (0.875 [0.842–0.898] vs. 0.905 [0.872–0.957], P = 0.03). However, there was no statistically significant difference in PI. There was also no difference in the incidence of absent end-diastolic flow.ConclusionThis study suggests that PE results in changes in blood flow to the renal arteries of the fetus. This may be associated with long-term adverse health effects later in adulthood.

Problem Limited data exists on the temporal trend of the Sars‐CoV‐2 immunologic response and duration of protection following natural infection. We sought to investigate the presence and duration of Sars‐CoV‐2 serum antibodies in obstetrical healthcare workers (HCW) on serial assessments over a 6‐month period, and to assess rates of vaccine acceptance and reported vaccine side effects among this cohort. Method of study A prospective cohort study of a convenience sample of obstetrical HCWs at a tertiary hospital. Serum Sars‐CoV‐2 antibodies for Immunoglobulin G (IgG) and Immunoglobulin M (IgM) were measured longitudinally at four intervals: baseline, 4 weeks, 12 weeks, and 6 months. Participants completed voluntary surveys on COVID19 testing, high‐risk exposures, vaccine acceptance, and vaccine side effects. Results One hundred twenty‐six of 150 (84%) HCWs who volunteered for participation completed all four blood draws. Prevalence of seropositive HCWs based on positive Sars‐CoV‐2 IgG antibodies increased from 2% at baseline to 31% at 12 weeks but declined to 21% by 6 months. Forty‐two percent (19/43) of the participants considered seropositive for Sars‐CoV‐2 IgG antibodies at any of the initial three blood draws converted to seronegative status at the 6‐month follow‐up. Eighty‐seven percent (72/83) of participants who responded to a follow‐up survey were willing to accept the COVID19 vaccine. Rates of acceptance did not differ by participant antibody status. Those that experienced symptoms with the first injection were more likely to have positive Sars‐CoV‐2 IgG antibodies (36.8% vs. 9.6%, p = .01). Conclusion Sars‐CoV‐2 IgG antibodies wane over time and may not provide prolonged and robust immune protection. This underscores the importance of vaccination and continued research in this area while the COVID19 pandemic continues.

Cervical cancer is the 2nd most common female cancer worldwide. However, in the developed world, cervical screening has reduced this cancer burden. Most smear referrals are low-grade, requiring continuous monitoring until they regress. Others need monitoring for static disease, while a few require treatment due to persistent low-grade or progressive disease. The ‘Holy Grail’ in cervical screening is predicting which patient is likely to have progressive disease. Fourier-transform infrared (FTIR) spectroscopy exploits the fact that an infrared (IR) spectrum represents a “biochemical-cell fingerprint”, which can be obtained from a cellular specimen based on a wavenumber-dependent absorption band pattern of constituents' vibrating chemical bonds. Low-grade (CIN1) specimens (n = 67) diagnosed on cytology were analysed using IR spectroscopy. The n = 67 study participants were rescreened by conventional cytology after a year whereupon three showed progressive disease and 31 had persistent low-grade atypia; 33 had regressed. Spectra from the initial cytology samples were then analysed using principal component analysis (PCA) with output (10 principal components) being inputted into linear discriminant analysis (LDA) to predict which samples would progress, remain static or regress; this approach was compared with variable selection techniques, namely the successive projection algorithm (SPA) and genetic algorithm (GA). Significant wavenumbers distinguishing regressive vs. static disease were 1736 cm−1, 1680 cm−1, 1512 cm−1, 1234 cm−1, 1099 cm−1 and 968 cm−1; separating the two categories is difficult due to a significant degree of ‘overlap’. Progressive disease can be significantly differentiated from static disease based on wavenumbers 1662 cm−1, 1648 cm−1, 1628 cm−1, 1512 cm−1, 1474 cm−1 and 965 cm−1; it can be segregated from regressive disease with 1686 cm−1, 1674 cm−1, 1625 cm−1, 1561 cm−1, 1525 cm−1 and 1310 cm−1. The GA–LDA model shows good separation for all categories (i.e., regressive vs. static vs. progressive disease) using 35 wavenumbers. An ability to predict progressive disease will reduce the need for repeat smears every six months whilst allowing early identification of patients who require treatment.