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Maureen George,1 Carlos A Camargo Jr,2 Autumn Burnette,3 Yuning Chen,4 Ajinkya Pawar,4 Cliona Molony,4 Melissa Auclair,4 Michael A Wells,4 Thomas J Ferro4 1Office of Research and Scholarship, Columbia University School of Nursing, New York, NY, USA; 2Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 3Division of Allergy and Immunology, Howard University Hospital, Howard University College of Medicine, Washington, DC, USA; 4Sanofi, Cambridge, MA, USACorrespondence: Maureen George, Office of Research and Scholarship, Columbia University School of Nursing, New York, NY, 10032, USA, Tel +1 212-305-1175, Email mg3656@cumc.columbia.eduPurpose: The identification of risk factors associated with uncontrolled moderate-to-severe asthma is important to improve asthma outcomes. Aim of this study was to identify risk factors for uncontrolled asthma in United States cohort using electronic health record (EHR)-derived data.Patients and Methods: In this retrospective real-world study, de-identified data of adolescent and adult patients (≥ 12 years old) with moderate-to-severe asthma, based on asthma medications within 12 months prior to asthma-related visit (index date), were extracted from the Optum® Humedica EHR. The baseline period was 12 months prior to the index date. Uncontrolled asthma was defined as ≥ 2 outpatient oral corticosteroid bursts for asthma or ≥ 2 emergency department visits or ≥ 1 inpatient visit for asthma. A Cox proportional hazard model was applied.Results: There were 402,403 patients in the EHR between January 1, 2012, and December 31, 2018, who met the inclusion criteria and were analyzed. African American (AA) race (hazard ratio [HR]: 2.08), Medicaid insurance (HR: 1.71), Hispanic ethnicity (HR: 1.34), age of 12 to < 18 years (HR 1.20), body mass index of ≥ 35 kg/m2 (HR: 1.20), and female sex (HR 1.19) were identified as risk factors associated with uncontrolled asthma (P < 0.001). Comorbidities characterized by type 2 inflammation, including a blood eosinophil count of ≥ 300 cells/μL (as compared with eosinophil < 150 cells/μL; HR: 1.40, P < 0.001) and food allergy (HR: 1.31), were associated with a significantly higher risk of uncontrolled asthma; pneumonia was also a comorbidity associated with an increased risk (HR: 1.35) of uncontrolled asthma. Conversely, allergic rhinitis (HR: 0.84) was associated with a significantly lower risk of uncontrolled asthma.Conclusion: This large study demonstrates multiple risk factors for uncontrolled asthma. Of note, AA and Hispanic individuals with Medicaid insurance are at a significantly higher risk of uncontrolled asthma versus their White, non-Hispanic counterparts with commercial insurance.Keywords: asthma, underserved, uncontrolled, Medicaid

The motor function of the gastrointestinal tract relies on the enteric nervous system, which includes neurons spanning from the esophagus to the internal anal sphincter. Disorders of gastrointestinal motility arise as a result of disease within the affected portion of the enteric nervous system and may be caused by a wide array of underlying diseases. The etiology of motility disorders may be primary or due to secondary causes related to infection or inflammation, congenital abnormalities, metabolic disturbances, systemic illness, or medication-related side effects. The symptoms of gastrointestinal dysmotility tend to be nonspecific and may cause diagnostic difficulty. Therefore, evaluation of motility disorders requires a combination of clinical, radiologic, and endoscopic or manometric testing. Radiologic studies including fluoroscopy, CT, MRI, and nuclear scintigraphy allow exclusion of alternative pathologic conditions and serve as adjuncts to endoscopy and manometry to determine the appropriate diagnosis. Additionally, radiologist understanding of clinical evaluation of motility disorders is necessary for guiding referring clinicians and appropriately imaging patients. New developments and advances in imaging techniques have allowed improved assessment and diagnosis of motility disorders, which will continue to improve patient treatment options.

Background Previous studies suggest a protective effect of parenthood on suicide, but little is known about how the association may change across the lifespan, or in relation to sex, marital status or occurrence of psychiatric disorders. Methods We followed a cohort of over 5 million Swedish women and men, from 1991 to 2011, up to max. age 75, for death by suicide using national registers. Information on childbirths/adoptions, potential confounders and modifying factors were obtained from national registers. We assessed the associations between parenthood and suicide across adulthood using within time-stratified Cox regression models, with parenthood as a time-dependent exposure. Results Parents had a lower risk of suicide than non-parents across the lifespan, after adjusting for sociodemographic factors. The association was most pronounced in young adults, especially young women, but attenuated with increasing age and converged between sexes in older age groups. The lower risk of suicide over the life course was similar whether parents were married, unmarried or divorced, apart from married men; among them, parents only had a lower risk above age 55. The lower risk in parents was also evident in people with a history of psychiatric hospitalizations, but disappeared from age 55 in this population. Conclusion The lower risk of suicide was present in both parents, was most pronounced in young adulthood and weakened with increasing age. Our results are consistent with a plausible mechanism where feelings of responsibility and connectedness are protective against suicide in parents.

Background Subjective online physician evaluation is an important component of patient decision-making. Understanding reviews may improve satisfaction and build positive online reputation. Objectives The aim of this study was to analyze and compare the top predictive factors driving patient satisfaction across the most popular plastic surgery procedures. Methods Online reviews were analyzed from RealSelf, Yelp, and Google for the 5 highest-rated plastic surgeons in 6 US metropolitan areas. Blank, non-English, consultation, duplicate, and unrelated reviews were excluded. Data from free-text reviews included physician rating, patient-reported reasons for rating, procedure, and complications. Univariate analysis was performed to compare predictive factors of online ratings. Results In total, 11,078 reviews were included. RealSelf had the highest average rating (4.77), and Yelp had the lowest (4.66). Reviews in Miami, Philadelphia, New York City, and Chicago were mostly published on RealSelf, whereas Houston and Los Angeles mostly used Google and Yelp, respectively. Reconstructive procedures were rated significantly higher than cosmetic procedures (P = 0.035). Aesthetic appearance was the strongest predictor of rating across all procedures. Buccal fat removal (98.8%) and abdominoplasty (98.1%) had the highest satisfaction, and Brazilian butt lift had the lowest (88.2%) (P < 0.001). Additional significant contributors included staff interaction, bedside manner, health outcomes, complications, and postoperative care (P < 0.001). Conclusions Although aesthetic outcome is an important predictor of satisfaction, other aspects of care, such as bedside manner and staff interaction, provide an important foundation of support. Excellent patient-surgeon communication and postoperative care may mitigate patient dissatisfaction and elicit high-satisfaction online patient reviews.

Background Patients often utilize the Internet to seek information related to their care. This study assesses the readability of online patient educational materials for submental fat reduction. Methods Patient educational materials from the 12 most popular websites related to submental fat reduction were downloaded and assessed for readability grade level using 10 unique scales. Results Analysis of the 12 most popular websites (and corresponding 47 articles) revealed that patient educational materials were written, on average, at an 11th grade reading level. The Flesch Reading Ease score was 48.9 (range 39.8–59.2), representing a “difficult” level of reading. Mean readability grade levels (range 9–13th grade for individual websites) were as follows: Coleman-Liau, 11.1; Flesch-Kincaid, 10.8; FORCAST, 10.8; Fry Graph, 10.1; Gunning Fog, 12.7; New Dale-Chall, 10.1; New Fog Count, 11.8; Simple Measure of Gobbledygook, 11.7; Raygor, 6.7. No website was at the 6th grade reading level for patient educational materials recommended by the American Medical Association and National Institutes of Health. Conclusions Online patient educational materials for submental fat reduction are written well above the recommended reading level. Recognition of disparities in health literacy is necessary to enable patients to make informed decisions and become active participants in their own care. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

BACKGROUND Political contributions from healthcare providers are essential to shaping healthcare policy and allow physicians to expand their influence on a national level. Political Action Committees in particular provide a useful avenue for unifying contributions for the interest of a specific community. This study examined the geographical distribution, temporal pattern, and overall nature of the political contributions made by plastic surgeons. METHODS The Federal Election Commission was analyzed for political contributions made by plastic surgeons from 2003 to 2021 using the search terms "plastic surgeon," "microsurgeon," and "craniofacial" as well as physician contributions to PlastyPAC. Contributions were categorized based on political parties (Democratic, Republican, and independent parties), and further analyzed based on state distribution and year of contribution. Spatial distribution data were then visualized using heatmaps for each state. RESULTS The total sum of contributions between 2003 and 2021 from plastic surgeons was $5,306,605, with $1,737,178.51 for the Republican party, $962,773.26 for the Democratic party, and $2,604,149.86 for independent parties. Political funding of PlastyPAC consisted of 47.3% of the overall political contributions. There was no significant trend through the years in the overall contribution amount. The states with the most political contributions were California, New York, Florida, and Texas. CONCLUSIONS The temporal stagnation of total political contributions and decline in recent PlastyPAC funding from plastic surgeons support an increased political awareness for new plastic surgeons. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Purpose Conventional model observers (MO) in CT are often limited to a uniform background or varying background that is random and can be modelled in an analytical form. It is unclear if these conventional MOs can be readily generalized to predict human observer performance in clinical CT tasks that involve realistic anatomical background. Deep-learning-based model observers (DL-MO) have recently been developed, but have not been validated for challenging low contrast diagnostic tasks in abdominal CT. We consequently sought to validate a DL-MO for a low-contrast hepatic metastases localization task. Methods We adapted our recently-developed DL-MO framework for the liver metastases localization task. Our previously-validated projection-domain lesion- / noise-insertion techniques were used to synthesize realistic positive and low-dose abdominal CT exams, using the archived patient projection data. Ten experimental conditions were generated, which involved different lesion sizes / contrasts, radiation dose levels, and image reconstruction types. Each condition included 100 trials generated from a patient cohort of 7 cases. Each trial was presented as liver image patches (160×160×5 voxels). The DL-MO performance was calculated for each condition and was compared with human observer performance, which was obtained by 3 sub-specialized radiologists in an observer study. The performance of DL-MO and radiologists was gauged by the area under localization receiver-operating-characteristic curves. The generalization performance of the DL-MO was estimated with the repeated 2-fold cross-validation method over the same set of trials used in human observer study. A multi-slice Channelized Hoteling Observers (CHO) was compared with the DL-MO across the same experimental conditions. Results The performance of DL-MO was highly correlated to that of radiologists (Pearson's correlation coefficient: 0.987; 95% C.I.: 0.942, 0.997). The performance level of DL-MO was comparable to that of the grouped radiologists, i.e. the mean performance difference was -3.3%. The CHO performance was poorer than the grouped radiologist performance, before internal noise could be added. The correlation between CHO and radiologists was weaker (Pearson's correlation coefficient: 0.812, and 95% C.I.: [0.378, 0.955]), and the corresponding performance bias (-29.5%) was statistically significant. Conclusion The presented study demonstrated the potential of using the DL-MO for image quality assessment in patient abdominal CT tasks. This article is protected by copyright. All rights reserved.

INTRODUCTION: Childbirth is a life-changing event where fathers desire being involved. As fathers take a more active role, fear of childbirth can arise. The aim of this study was to explore fathers' experiences of childbirth fear during pregnancy and after the birth of their baby. METHODS: This was a qualitative longitudinal prospective study that included 14 interviews with seven fathers, one during the prenatal period, and one follow-up interview after childbirth. Data were analyzed using thematic analysis according to Braun and Clark. RESULTS: The main theme 'Being vulnerable during the transition to fatherhood' was based on the perception of childbirth as risky with threats toward the woman's and baby's health, not being able to give and receive enough support, unable to handle the unknown process of birth, and not being a good father. Helpful strategies for coping with fear were to talk about fear, to learn more about childbirth and techniques on how to handle fear, and to avoid dealing with fear. Fathers' fear of childbirth changed after the birth of their baby. Their thoughts of another childbirth did not evoke the same strong feelings of fear. Issues important for the reduction of childbirth fear were: receiving professional support, actively taking part in the childbirth process, and the partner having an uncomplicated birth. CONCLUSIONS: Fathers with childbirth fear regarded childbirth as risky, but they expressed helpful coping strategies. After the birth of their baby, they became less fearful. Quality of fear-reducing support to expectant fathers may influence how they cope with their transition into fatherhood.

Gastrointestinal (GI) bleeding is a common potentially life-threatening medical condition frequently requiring multidisciplinary collaboration to reach the proper diagnosis and guide management. GI bleeding can be

Despite guidelines developed to standardize the diagnosis and management of gastrointestinal (GI) bleeding, significant variability remains in recommendations and practice. The purpose of this survey was to obtain information on practice patterns for the evaluation of overt lower GI bleeding (LGIB) and suspected small bowel bleeding. A 34-question electronic survey was sent to all Society of Abdominal Radiology (SAR) members. Responses were received from 52 unique institutions (40 from the United States). Only 26 (50%) utilize LGIB management guidelines. 32 (62%) use CT angiography (CTA) for initial evaluation in unstable patients. In stable patients with suspected LGIB, CTA is the preferred initial exam at 21 (40%) versus colonoscopy at 24 (46%) institutions. CTA use increases after hours for both unstable (n = 32 vs. 35, 62% vs. 67%) and stable patients (n = 21 vs. 27, 40% vs 52%). CTA is required before conventional angiography for stable (n = 36, 69%) and unstable (n = 15, 29%) patients. 38 (73%) institutions obtain two post-contrast phases for CTA. 49 (94%) institutions perform CT enterography (CTE) for occult small bowel bleeding with capsule endoscopy (n = 26, 50%) and CTE (n = 21, 40%) being the initial test performed. 35 (67%) institutions perform multiphase CTE for occult small bowel bleeding. In summary, stable and unstable patients with overt lower GI are frequently imaged with CTA, while CTE is frequently performed for suspected occult small bowel bleeding.

Liver magnetic resonance imaging (MRI) is a commonly performed imaging technique with multiple indications and applications. There are two general groups of contrast agents used when imaging the liver, extracellular contrast agents (ECA) and hepatobiliary agents (HBA), each of which has its own advantages and limitations. Liver MRI with ECA provides excellent information on abdominal vasculature and better quality multi-phasic studies for characterization of focal liver lesions. HBA improves lesion detection, provides information regarding liver function and can be helpful for evaluating biliary tree anatomy, excretion, anastomotic stenoses, or leaks. Most liver MRI studies are usually performed with one agent, however in some cases, a second study is performed with another agent to obtain additional information or confirm the findings in the first study. Administering both agents in a single exam can potentially eliminate the need for additional imaging in certain situations. In this pictorial review, the techniques and indications for dual contrast MRI will be detailed with multiple demonstrative examples.

Swedish child health centres (CHCs) have created a series of visits for fathers/non-birthing parents. The primary aim was to assess child health nurses’ implementation fidelity of the father/non-birthing parent visits, with a secondary aim of exploring predictor variables for fidelity. In 2017, nurses voluntarily implemented a series of father/non-birthing parent visits in Region Stockholm. Nurses (n = 122) completed baseline and 8—12 month follow-up surveys. Multiple imputation was used for missing data. Register data on the number of fathers attending the three-to-five month visit was used. Frequencies of nurses reporting good overall adherence to the home visit, three-to-five week visit, and three-to-five month visit were 86%, 76%, and 68%, respectively. A total of 3,609 fathers attended the three-to-five month visit in 2018, where over half of the visits were at 14 of the 134 CHCs. Multiple linear regression showed that working for a private CHC, seeing more fathers, and nurses’ perceptions of receiving enough support predicted higher three-to-five month visit adherence. After nurses saw eight fathers, they were more likely to adhere to the guidelines.

Acute mesenteric ischemia is a life-threatening condition that results from abrupt reduction in or cessation of blood flow to the bowel. Characterized by nonspecific abdominal symptoms, mesenteric ischemia is infrequently encountered and commonly misdiagnosed, with potentially catastrophic consequences. Prompt clinical diagnosis and early implementation of therapeutic interventions are critical to improving patient outcomes. Because cross-sectional imaging plays a key role in the diagnosis of mesenteric ischemia, radiologists must be familiar with the varied imaging manifestations of intestinal ischemia. Thus, the objectives of this article are to review the various types and common causes of mesenteric ischemia and to describe its spectrum of multimodality imaging findings, with special attention to novel imaging techniques and emerging diagnoses.

Eosinophilic gastrointestinal disorders (EGIDs) are inflammatory conditions of the gastrointestinal tract that are characterized by tissue eosinophilia and end-organ dysfunction or damage. Primary EGIDs are associated with atopy and other allergic conditions, whereas secondary EGIDs are associated with underlying systemic diseases or hypereosinophilic syndrome. Within the spectrum of EGIDs, eosinophilic esophagitis is the most prevalent. Eosinophilic gastroenteritis and eosinophilic colitis are relatively uncommon. Eosinophilic infiltration of the liver, biliary tree, and/or pancreas also can occur and mimic other inflammatory and malignant conditions. Although endoscopic evaluation is the method of choice for eosinophilic esophagitis, radiologic evaluation of the esophagus plays an important role in the assessment of disease severity. CT and MR enterography are the modalities of choice for demonstrating specific forms of eosinophilic gastroenteritis. CT and MRI are important in the detection of abdominal visceral involvement in EGIDs. Diagnosis is often challenging and relies on symptoms, imaging findings, histologic confirmation of tissue eosinophilia, and correlation with peripheral eosinophilia. Imaging is crucial for identifying characteristic organ-specific findings, although imaging findings are not specific. When promptly treated, EGIDs usually have a benign clinical course. However, a delayed diagnosis and associated surgical interventions have been associated with morbidity. Therefore, a radiologist's knowledge of the imaging findings of EGIDs in the appropriate clinical settings may aid in early diagnosis and thereby improve patient care. An overview of the clinical features and imaging findings of EGIDs and the eosinophilic disorders of associated abdominal viscera is provided.

Mosquitoes are the greatest animal threat to human health, causing hundreds of millions of infections and around one million deaths each year. All mosquito-borne pathogens must traverse the salivary glands (SGs) to be transmitted to the next host, making this organ an ideal target for interventions. The adult SG develops from precursor cells located in the larval SG duct bud. Characterization of the larval SG has been limited. We sought to better understand larval SG architecture, secretion, and gene expression. We developed an optimized method for larval SG staining and surveyed hundreds of larval stage 4 (L4) SGs using fluorescence confocal microscopy. Remarkable variation in SG cell and chromatin organization differed among individuals and across the L4 stage. Lumen formation occurred during L4 stage through secretion likely involving a coincident cellular apical lipid enrichment and extracellular vesicle-like structures. Meta-analysis of microarray data showed that larval SG gene expression is divergent from adult SGs, more similar to larval gastric cecae, but different from other larval gut compartments. This work highlights the variable cell architecture of larval Anopheles gambiae SGs and provides candidate targets for genetic strategies aiming to disrupt SGs and transmission of mosquito-borne pathogens.

In mammals, the serine protease plasmin degrades extracellular proteins during blood clot removal, tissue remodeling, and cell migration. The zymogen plasminogen is activated into plasmin by two serine proteases: tissue-type plasminogen activator (tPA) and urokinase-type plasminogen activator (uPA), a process regulated by plasminogen activator inhibitor 1 (PAI-1), a serine protease inhibitor that specifically inhibits tPA and uPA. Plasmodium gametes and sporozoites use tPA and uPA to activate plasminogen and parasite-bound plasmin degrades extracellular matrices, facilitating parasite motility in the mosquito and the mammalian host. Furthermore, inhibition of plasminogen activation by PAI-1 strongly blocks infection in both hosts. To block parasite utilization of plasmin, we engineered Anopheles stephensi transgenic mosquitoes constitutively secreting human PAI-1 (huPAI-1) in the midgut lumen, in the saliva, or both. Mosquitoes expressing huPAI-1 strongly reduced rodent and human Plasmodium parasite transmission to mosquitoes, showing that co-opting plasmin for mosquito infection is a conserved mechanism among Plasmodium species. huPAI-1 expression in saliva induced salivary gland deformation which affects sporozoite invasion and P. berghei transmission to mice, resulting in significant levels of protection from malaria. Targeting the interaction of malaria parasites with the fibrinolytic system using genetically engineered mosquitoes could be developed as an intervention to control malaria transmission.

In this study, we determined the timing of burial and subsequent exhumation of Barrovian metamorphic rocks from the Chloride Cliff area of the Funeral Mountains in southeastern California by constraining the ages of different portions of a pressure-temperature (P-T) path. Using a split-stream laser-ablation inductively coupled plasma–mass spectrometry (ICP-MS) system, we analyzed 192 domains from 35 grains of monazite within five samples with a spot size of 8 µm to determine U-Pb ages and trace-element abundances from the same samples (same polished sections) that were analyzed to produce the P-T paths. Changes that took place within individual monazite grains reflect localized equilibrium and captured the changes in heavy rare earth element (HREE) abundances in the matrix reservoir that occurred as garnet grew, resorbed, and then regrew, thus constraining ages on different portions of the P-T path. The results show that garnet began growing ca. 168 Ma, began resorbing ca. 160 Ma, began retrograde regrowth ca. 157 Ma, and continued to regrow at least through ca. 143 Ma. The early garnet growth corresponds to a period of pressure increase along the P-T path. The subsequent partial resorption corresponds to the prograde crossing of a garnet-consuming reaction during decompression, and the retrograde garnet regrowth occurred when this same reaction was recrossed in the retrograde sense during further decompression. These results are consistent with previously determined ages, which include a Lu-Hf garnet age of 167.3 ± 0.72 Ma for the early pressure-increase portion of the P-T path, and 40Ar/39Ar muscovite cooling ages of 153 and 146 Ma in the lower-grade Indian Pass area 10 km southeast of Chloride Cliff. The 40Ar/39Ar muscovite ages document cooling at the same time as retrograde garnet regrowth was taking place at Chloride Cliff. The oldest monazite age obtained in this study, 176 ± 5 Ma, suggests that southeast-directed thrusting within the Jurassic retroarc was ongoing by this time along the California portion of the western North American plate margin, as a consequence of east-dipping subduction and/or arc collision. The Funeral Mountains were likely located on the east side of the northern Sierra Nevada range in the Jurassic, taking into account dextral strike-slip displacement along the Cretaceous Mojave–Snow Lake fault. The Late Jurassic timing of burial in the Funeral Mountains and its Jurassic location suggest burial was associated with the East Sierran thrust system. The timing of prograde garnet resorption during exhumation (160–157 Ma) corresponds to a change from regional dextral transpression to sinistral transtension along the Jurassic plate margin inferred to have occurred ca. 157 Ma. The recorded exhumation was concurrent with intrusion of the 148 Ma Independence dike swarm in the eastern Sierra Nevada and Mojave regions, which developed within a regime of northeast-southwest extension.

To examine if the professional support that fathers received from midwives and child health nurses was associated with improvements in fathers' coparenting. A secondary aim was to investigate if there were any support differences between fathers based on parity.Stronger coparenting is associated with improved maternal, paternal and child health. It is unclear if routine prenatal and postnatal professional support is associated with improved coparenting in fathers of infants.Cross-sectional online survey.In total, 612 fathers of infants (aged 0-24 months) completed baseline data between November 2018 and March 2020. Socio-demographics, pregnancy control variables, social support, professional support, being invited to attend and attending three specific visits for fathers, respectively, and the fathers' coparenting relationship, using the Brief Coparenting Relationship Scale, were assessed. The STROBE checklist was used as the reporting guideline for this study.Fathers' attendance at child health visits, support from the prenatal and postnatal midwife, respectively, and total support from the child health nurse, are associated with more positive coparenting. Primiparous fathers reported more received social and professional support, as well as a more positive coparenting relationship than multiparous fathers.Receiving clinical support from both midwives and child health nurses is associated with fathers' positive coparenting. All fathers should be invited and encouraged to attend prenatal, postnatal and child health visits to further support their coparenting relationship. Relative to primiparous fathers, multiparous fathers may require targeted and additional clinical support regarding their coparenting relationship.With fathers becoming more involved in childrearing, having stronger coparenting skills can help them better adapt to their parental roles. Our findings help understand how routine professional support from midwives and child health nurses are experienced among new fathers and that multiparous fathers are in further need of coparenting support.

Background Labiaplasty is an increasingly popular procedure performed for both cosmetic and pathologic etiologies. Questions have been raised regarding the efficacy of the procedure, especially for cosmetic etiologies. Objectives The aim of this study was to examine the complication profiles of labiaplasties for both cosmetic and pathologic etiologies. Methods The 2005 to 2017 National Surgical Quality Improvement Program database was analyzed for patients who, according to the relevant Current Procedural Terminology code, had undergone labiaplasties. Our cohort was further separated into cosmetic and pathologic groups based on International Classification of Diseases codes. Information was collected on patient demographic characteristics, patient comorbidities, and operative variables. Outcomes of interest included surgical complications and delayed length of stay (DLOS). A univariate analysis and multivariate logistic regression were applied to determine statistically significant predictors of our outcomes of interest for both etiologies. Results There were 640 patients in the cosmetic cohort and 1919 patients in the pathologic cohort. There were no significant differences in rates of surgical complications between the 2 groups, but there was a statistically significant increase in length of stay for the pathologic group. Univariate analysis revealed operative time and plastic surgeon specialty to be predictive of DLOS in the cosmetic cohort. No covariates were implicated with multivariate analysis for either surgical complications or for DLOS in the cosmetic cohort. Conclusions Our findings suggest that cosmetic labiaplasty is a safe and efficacious procedure with low complication rates and no predictors of adverse outcomes. Level of Evidence: 4