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23 results on '"Ledyard, Rachel"'

9. 599 Differing clinical management for postpartum hemorrhage and associated risk for intensive care unit admission

Author

Son, Moeun, primary, Lundsberg, Lisbet S., additional, Dysart, Kevin, additional, Partridge, Caitlin, additional, Burris, Heather, additional, Handley, Sara, additional, Ledyard, Rachel, additional, Baisden, Kristie, additional, Berhane, Leah, additional, Doamekpor, Lauren, additional, Bersoff-Matcha, Susan, additional, and Culhane, Jennifer F., additional

Published
2024
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13. Changes in prenatal testing during the COVID-19 pandemic

Author

Handley, Sara C., primary, Ledyard, Rachel, additional, Lundsberg, Lisbet S., additional, Passarella, Molly, additional, Yang, Nancy, additional, Son, Moeun, additional, McKenney, Kathryn, additional, Greenspan, Jay, additional, Dysart, Kevin, additional, Culhane, Jennifer F., additional, and Burris, Heather H., additional

Published
2022
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15. Changes in Prenatal Testing During the COVID-19 Pandemic

Author

Handley, Sara C, Ledyard, Rachel, Lundsberg, Lisbet S, Passarella, Molly, Yang, Nancy, Son, Moeun, McKenney, Kathryn, Greenspan, Jay S., Dysart, Kevin, Culhane, Jennifer F, Burris, Heather H, Handley, Sara C, Ledyard, Rachel, Lundsberg, Lisbet S, Passarella, Molly, Yang, Nancy, Son, Moeun, McKenney, Kathryn, Greenspan, Jay S., Dysart, Kevin, Culhane, Jennifer F, and Burris, Heather H

Abstract

Objective: The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare delivery, including prenatal care. The study objective was to assess if timing of routine prenatal testing changed during the COVID-19 pandemic. Methods: Retrospective observational cohort study using claims data from a regional insurer (Highmark) and electronic health record data from two academic health systems (Penn Medicine and Yale New Haven) to compare prenatal testing timing in the pre-pandemic (03/10/2018-12/31/2018 and 03/10/2019-12/31/2019) and early COVID-19 pandemic (03/10/2020-12/31/2020) periods. Primary outcomes were second trimester fetal anatomy ultrasounds and gestational diabetes (GDM) testing. A secondary analysis examined first trimester ultrasounds. Results: The three datasets included 31,474 pregnant patients. Mean gestational age for second trimester anatomy ultrasounds increased from the pre-pandemic to COVID-19 period (Highmark 19.4 vs. 19.6 weeks; Penn: 20.1 vs. 20.4 weeks; Yale: 18.8 vs. 19.2 weeks, all p < 0.001). There was a detectable decrease in the proportion of patients who completed the anatomy survey <20 weeks' gestation across datasets, which did not persist at <23 weeks' gestation. There were no consistent changes in timing of GDM screening. There were significant reductions in the proportion of patients with first trimester ultrasounds in the academic institutions (Penn: 57.7% vs. 40.6% and Yale: 78.7% vs. 65.5%, both p < 0.001) but not Highmark. Findings were similar with multivariable adjustment. Conclusion: While some prenatal testing happened later in pregnancy during the pandemic, pregnant patients continued to receive appropriately timed testing. Despite disruptions in care delivery, prenatal screening remained a priority for patients and providers during the COVID-19 pandemic.

Published
2022

23. Spatially and Temporally Resolved Ambient PM 2.5 in Relation to Preterm Birth.

Author

Cowell, Whitney, Colicino, Elena, Zhang, Xueying, Ledyard, Rachel, Burris, Heather H., Hacker, Michele R., Kloog, Itai, Just, Allan, Wright, Robert O., and Wright, Rosalind J.

Subjects
PREMATURE labor, ELECTRONIC health records, PARTICULATE matter, MATERNAL exposure, GESTATIONAL age
Abstract

Growing evidence suggests that maternal exposure to ambient fine particulate matter (PM2.5) during pregnancy is associated with preterm birth; however, few studies have examined critical windows of exposure, which can help elucidate underlying biologic mechanisms and inform public health messaging for limiting exposure. Participants included 891 mother–newborn pairs enrolled in a U.S.-based pregnancy cohort study. Daily residential PM2.5 concentrations at a 1 × 1 km2 resolution were estimated using a satellite-based hybrid model. Gestational age at birth was abstracted from electronic medical records and preterm birth (PTB) was defined as <37 completed weeks of gestation. We used Critical Window Variable Selection to examine weekly PM2.5 exposure in relation to the odds of PTB and examined sex-specific associations using stratified models. The mean ± standard deviation PM2.5 level averaged across pregnancy was 8.13 ± 1.10 µg/m3. PM2.5 exposure was not associated with an increased odds of PTB during any gestational week. In sex-stratified models, we observed a marginal increase in the odds of PTB with exposure occurring during gestational week 16 among female infants only. This study does not provide strong evidence supporting an association between weekly exposure to PM2.5 and preterm birth. [ABSTRACT FROM AUTHOR]

Published
2021
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