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Objective A ventricle-to-brain index (VBI) >0.35 is associated with low scores on the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) in preterm infants with birth weight <1,250 g. However, VBI obtained at the third ventricle has only moderate interobserver reliability. The objective of this study was to test (1) reliability of VBI measured at the foramen of Monro on the latest ultrasonogram (US) before discharge using the intraclass correlation coefficient (ICC) and (2) the relationship between VBI and BSID-III scores at ≥18 months corrected age. Study Design The present study is a single-center retrospective cohort study. Results The study included 270 preterm infants born at 23 0/7 to 28 6/7 weeks of gestational age. The ICC of VBI between independent measurements by two study radiologists on the first 50 patients was 0.934. Factors associated with the value of VBI included severe intraventricular hemorrhage, bronchopulmonary dysplasia, and systemic steroid administration for BPD but not postmenstrual age. In multivariate analysis, VBI was negatively and independently associated with cognitive (p = 0.002), language (p = 0.004), and motor (p < 0.001) BSID-III scores. The association between VBI and BSID-III scores was observed even in infants in whom the latest US was obtained before term equivalent age. The association between VBI and BSID-III scores was also observed after excluding those with severe intraventricular hemorrhage. Conclusion In this very preterm cohort the measurement of VBI had excellent reliability. Moreover, VBI measurements were negatively associated with motor, language, and cognitive BSID-III scores. Key Points Mean values of VBI are stable with postmenstrual age. Values at the foramen of Monro are reliable and reproducible. VBI is negatively associated with Bayley scores. The association is observed even before term age. [ABSTRACT FROM AUTHOR]

Objective: As in many realms of academia and medicine, in obstetrics and gynecology, women experience gender bias in residency evaluations and academic promotions. More specifically, women in Maternal-Fetal Medicine (MFM) are underrepresented within departmental leadership positions. As a means of identifying spaces where bias may exist, multiple investigators have previously reported on gender bias in letters of recommendation (LORs) for residency and subspecialty training programs. We aimed to determine if linguistic differences exist in LORs for self-identified male and female applicants to MFM fellowship at an academic institution., Study Design: This was a retrospective single-site cohort study from 2019 to 2021. Data collected included applicant's age, self-reported race/ethnicity and gender, geographic region of residency, step 1 and 2 scores, scholarly and volunteer activities, and number of LORs. The Linguistic Inquiry and Word Count (LIWC) software, a validated text analysis program, was used to characterize LOR linguistic content. Multivariable analysis was used to compare letter characteristics to applicant demographics., Results: A total of 212 applications were reviewed, including 808 LORs. Women comprised 76.9% of applicants, and men 23.1%. Most applicants identified as non-Hispanic White (52.8%). Men were more likely to be international medical graduates (20 vs. 6%, p ≤ 0.01), and women reported more volunteer activities (7.1 ± 5.1 vs. 5.5 ± 4.3, p  = 0.04). There were no differences in step scores, number of research projects, or number of LORs. Multivariable analysis controlling for applicant race, step 1 score, and gender of letter writer revealed that letters written for males contained significantly more references to the word category cognitive processes (7.4 ± 0.2 vs. 7.1 ± 0.1, p  = 0.046), specifically in reference to the subcategories of certainty and differentiation., Conclusion: We identified linguistic differences in LORs written for MFM applicants, suggesting potential bias in the style of writing for male and female physicians applying to this field., Key Points: · Gender bias exists in the evaluation and promotion of women in medicine.. · We sought to determine whether it also exists in letters of recommendation for MFM fellowship.. · Previous studies have examined gender bias in letters of recommendation for other specialties.. · Linguistic bias was detected in letters of recommendation for MFM fellowship from 2019 through 2021.. · We found evidence of linguistic differences based on gender of applicant and letter writers.., Competing Interests: M.F-.R. is a consultant for Boston Scientific and a researcher for AbbVie., (Thieme. All rights reserved.)