535 results on '"Thom, Elizabeth A."'
Search Results
2. Prenatal Repair of Myelomeningocele and School-age Functional Outcomes.
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Houtrow, Amy, Thom, Elizabeth, Fletcher, Jack, Burrows, Pamela, Adzick, N, Thomas, Nina, Brock, John, Cooper, Timothy, Bilaniuk, Larissa, Pruthi, Sumit, MacPherson, Cora, Walker, William, Johnson, Mark, Howell, Lori, Glenn, Orit, Gupta, Nalin, Lee, Hanmin, and Farmer, Diana
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Adaptation ,Psychological ,Cerebrospinal Fluid Shunts ,Child ,Child ,Preschool ,Encephalocele ,Family ,Female ,Follow-Up Studies ,Humans ,Hydrocephalus ,Male ,Meningomyelocele ,Postnatal Care ,Pregnancy ,Prenatal Care ,Quality of Life ,Rhombencephalon ,Treatment Outcome - Abstract
BACKGROUND AND OBJECTIVES: The Management of Myelomeningocele Study (MOMS), a randomized trial of prenatal versus postnatal repair for myelomeningocele, found that prenatal surgery resulted in reduced hindbrain herniation and need for shunt diversion at 12 months of age and better motor function at 30 months. In this study, we compared adaptive behavior and other outcomes at school age (5.9-10.3 years) between prenatal versus postnatal surgery groups. METHODS: Follow-up cohort study of 161 children enrolled in MOMS. Assessments included neuropsychological and physical evaluations. Children were evaluated at a MOMS center or at a home visit by trained blinded examiners. RESULTS: The Vineland composite score was not different between surgery groups (89.0 ± 9.6 in the prenatal group versus 87.5 ± 12.0 in the postnatal group; P = .35). Children in the prenatal group walked without orthotics or assistive devices more often (29% vs 11%; P = .06), had higher mean percentage scores on the Functional Rehabilitation Evaluation of Sensori-Neurologic Outcomes (92 ± 9 vs 85 ± 18; P < .001), lower rates of hindbrain herniation (60% vs 87%; P < .001), had fewer shunts placed for hydrocephalus (49% vs 85%; P < .001) and, among those with shunts, fewer shunt revisions (47% vs 70%; P = .02) than those in the postnatal group. Parents of children repaired prenatally reported higher mean quality of life z scores (0.15 ± 0.67 vs 0.11 ± 0.73; P = .008) and lower mean family impact scores (32.5 ± 7.8 vs 37.0 ± 8.9; P = .002). CONCLUSIONS: There was no significant difference between surgery groups in overall adaptive behavior. Long-term benefits of prenatal surgery included improved mobility and independent functioning and fewer surgeries for shunt placement and revision, with no strong evidence of improved cognitive functioning.
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- 2020
3. Subsequent pregnancy outcomes after open maternal-fetal surgery for myelomeningocele
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Goodnight, William H, Bahtiyar, Ozan, Bennett, Kelly A, Emery, Stephen P, Lillegard, JB, Fisher, Allan, Goldstein, Ruth, Jatres, Jillian, Lim, Foong-Yen, McCullough, Laurence, Moehrlen, Ueli, Moldenhauer, Julie S, Moon-Grady, Anita J, Ruano, Rodrigo, Skupski, Daniel W, Thom, Elizabeth, Treadwell, Marjorie C, Tsao, KuoJen, Wagner, Amy J, Waqar, Lindsay N, Zaretsky, Michael, and NAFTNet, fMMC Consortium sponsored by
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Congenital Structural Anomalies ,Preterm ,Low Birth Weight and Health of the Newborn ,Spina Bifida ,Contraception/Reproduction ,Clinical Research ,Perinatal Period - Conditions Originating in Perinatal Period ,Conditions Affecting the Embryonic and Fetal Periods ,Pediatric ,Rare Diseases ,Infant Mortality ,Reproductive health and childbirth ,Good Health and Well Being ,Abortion ,Spontaneous ,Adult ,Blood Transfusion ,Cesarean Section ,Female ,Fetal Death ,Fetus ,Gestational Age ,Humans ,Live Birth ,Meningomyelocele ,Pregnancy ,Pregnancy Outcome ,Prospective Studies ,Registries ,Uterine Rupture ,cesarean delivery ,fetal myelomeningocele ,fetal myelomeningocele repair ,fetal surgery ,fMMC ,myelomeningocele ,open maternal fetal surgery ,spina bifida ,uterine rupture ,fMMC Consortium sponsored by NAFTNet ,Paediatrics and Reproductive Medicine ,Obstetrics & Reproductive Medicine - Abstract
BACKGROUND:Open maternal-fetal surgery for fetal myelomeningocele results in reduction in neonatal morbidity related to spina bifida but may be associated with fetal, neonatal, and maternal complications in subsequent pregnancies. OBJECTIVE:The objective of this study was to ascertain obstetric risk in subsequent pregnancies after open maternal-fetal surgery for fetal myelomeningocele closure. STUDY DESIGN:An international multicenter prospective observational registry created to track and report maternal, obstetric, fetal/neonatal, and subsequent pregnancy outcomes following open maternal-fetal surgery for fetal myelomeningocele was evaluated for subsequent pregnancy outcome variables. Institutional Review Board approval was obtained for the registry. RESULTS:From 693 cases of open maternal-fetal surgery for fetal myelomeningocele closure entered into the registry, 77 subsequent pregnancies in 60 women were identified. The overall live birth rate was 96.2%, with 52 pregnancies delivering beyond 20 weeks gestational age and median gestational age at delivery of 37 (36.3-37.1) weeks. The uterine rupture rate was 9.6% (n = 5), resulting in 2 fetal deaths. Maternal transfusion was required in 4 patients (7.7%). CONCLUSION:The risk of uterine rupture or dehiscence in subsequent pregnancies with associated fetal morbidity after open maternal-fetal surgery is significant, but is similar to that reported for subsequent pregnancies after classical cesarean deliveries. Future pregnancy considerations should be included in initial counseling for women contemplating open maternal-fetal surgery.
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- 2019
4. Effects of repeat prenatal corticosteroids given to women at risk of preterm birth: An individual participant data meta-analysis.
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Guinn, Debra, Hallman, Mikko, Hardy, Pollyanna, Lee, Men-Jean, Maurel, Kimberley, Mazumder, Premasish, McEvoy, Cindy, Murphy, Kellie, Peltoniemi, Outi, Thom, Elizabeth, Wapner, Ronald, Doyle, Lex, Crowther, Caroline, Middleton, Philippa, Voysey, Merryn, Askie, Lisa, Zhang, Sasha, Martlow, Tanya, Aghajafari, Fariba, Asztalos, Elizabeth, Brocklehurst, Peter, Dutta, Sourabh, and Garite, Thomas
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Adrenal Cortex Hormones ,Adult ,Clinical Trials as Topic ,Drug Administration Schedule ,Female ,Humans ,Infant ,Newborn ,Obstetric Labor ,Premature ,Parturition ,Pregnancy ,Pregnancy Outcome ,Premature Birth ,Prenatal Exposure Delayed Effects ,Recurrence ,Risk Assessment ,Risk Factors ,Young Adult - Abstract
BACKGROUND: Infants born preterm compared with infants born at term are at an increased risk of dying and of serious morbidities in early life, and those who survive have higher rates of neurological impairments. It remains unclear whether exposure to repeat courses of prenatal corticosteroids can reduce these risks. This individual participant data (IPD) meta-analysis (MA) assessed whether repeat prenatal corticosteroid treatment given to women at ongoing risk of preterm birth in order to benefit their infants is modified by participant or treatment factors. METHODS AND FINDINGS: Trials were eligible for inclusion if they randomised women considered at risk of preterm birth who had already received an initial, single course of prenatal corticosteroid seven or more days previously and in which corticosteroids were compared with either placebo or no placebo. The primary outcomes for the infants were serious outcome, use of respiratory support, and birth weight z-scores; for the children, they were death or any neurosensory disability; and for the women, maternal sepsis. Studies were identified using the Cochrane Pregnancy and Childbirth search strategy. Date of last search was 20 January 2015. IPD were sought from investigators with eligible trials. Risk of bias was assessed using criteria from the Cochrane Collaboration. IPD were analysed using a one-stage approach. Eleven trials, conducted between 2002 and 2010, were identified as eligible, with five trials being from the United States, two from Canada, and one each from Australia and New Zealand, Finland, India, and the United Kingdom. All 11 trials were included, with 4,857 women and 5,915 infants contributing data. The mean gestational age at trial entry for the trials was between 27.4 weeks and 30.2 weeks. There was no significant difference in the proportion of infants with a serious outcome (relative risk [RR] 0.92, 95% confidence interval [CI] 0.82 to 1.04, 5,893 infants, 11 trials, p = 0.33 for heterogeneity). There was a reduction in the use of respiratory support in infants exposed to repeat prenatal corticosteroids compared with infants not exposed (RR 0.91, 95% CI 0.85 to 0.97, 5,791 infants, 10 trials, p = 0.64 for heterogeneity). The number needed to treat (NNT) to benefit was 21 (95% CI 14 to 41) women/fetus to prevent one infant from needing respiratory support. Birth weight z-scores were lower in the repeat corticosteroid group (mean difference -0.12, 95%CI -0.18 to -0.06, 5,902 infants, 11 trials, p = 0.80 for heterogeneity). No statistically significant differences were seen for any of the primary outcomes for the child (death or any neurosensory disability) or for the woman (maternal sepsis). The treatment effect varied little by reason the woman was considered to be at risk of preterm birth, the number of fetuses in utero, the gestational age when first trial treatment course was given, or the time prior to birth that the last dose was given. Infants exposed to between 2-5 courses of repeat corticosteroids showed a reduction in both serious outcome and the use of respiratory support compared with infants exposed to only a single repeat course. However, increasing numbers of repeat courses of corticosteroids were associated with larger reductions in birth z-scores for weight, length, and head circumference. Not all trials could provide data for all of the prespecified subgroups, so this limited the power to detect differences because event rates are low for some important maternal, infant, and childhood outcomes. CONCLUSIONS: In this study, we found that repeat prenatal corticosteroids given to women at ongoing risk of preterm birth after an initial course reduced the likelihood of their infant needing respiratory support after birth and led to neonatal benefits. Body size measures at birth were lower in infants exposed to repeat prenatal corticosteroids. Our findings suggest that to provide clinical benefit with the least effect on growth, the number of repeat treatment courses should be limited to a maximum of three and the total dose to between 24 mg and 48 mg.
- Published
- 2019
5. Effects of repeat prenatal corticosteroids given to women at risk of preterm birth: An individual participant data meta-analysis
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Crowther, Caroline A, Middleton, Philippa F, Voysey, Merryn, Askie, Lisa, Zhang, Sasha, Martlow, Tanya K, Aghajafari, Fariba, Asztalos, Elizabeth V, Brocklehurst, Peter, Dutta, Sourabh, Garite, Thomas J, Guinn, Debra A, Hallman, Mikko, Hardy, Pollyanna, Lee, Men-Jean, Maurel, Kimberley, Mazumder, Premasish, McEvoy, Cindy, Murphy, Kellie E, Peltoniemi, Outi M, Thom, Elizabeth A, Wapner, Ronald J, Doyle, Lex W, and Group, the PRECISE
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Paediatrics ,Reproductive Medicine ,Biomedical and Clinical Sciences ,Lung ,Clinical Research ,Clinical Trials and Supportive Activities ,Infant Mortality ,Conditions Affecting the Embryonic and Fetal Periods ,Perinatal Period - Conditions Originating in Perinatal Period ,Preterm ,Low Birth Weight and Health of the Newborn ,Pediatric ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Reproductive health and childbirth ,Adrenal Cortex Hormones ,Adult ,Clinical Trials as Topic ,Drug Administration Schedule ,Female ,Humans ,Infant ,Newborn ,Obstetric Labor ,Premature ,Parturition ,Pregnancy ,Pregnancy Outcome ,Premature Birth ,Prenatal Exposure Delayed Effects ,Recurrence ,Risk Assessment ,Risk Factors ,Young Adult ,PRECISE Group ,Medical and Health Sciences ,General & Internal Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundInfants born preterm compared with infants born at term are at an increased risk of dying and of serious morbidities in early life, and those who survive have higher rates of neurological impairments. It remains unclear whether exposure to repeat courses of prenatal corticosteroids can reduce these risks. This individual participant data (IPD) meta-analysis (MA) assessed whether repeat prenatal corticosteroid treatment given to women at ongoing risk of preterm birth in order to benefit their infants is modified by participant or treatment factors.Methods and findingsTrials were eligible for inclusion if they randomised women considered at risk of preterm birth who had already received an initial, single course of prenatal corticosteroid seven or more days previously and in which corticosteroids were compared with either placebo or no placebo. The primary outcomes for the infants were serious outcome, use of respiratory support, and birth weight z-scores; for the children, they were death or any neurosensory disability; and for the women, maternal sepsis. Studies were identified using the Cochrane Pregnancy and Childbirth search strategy. Date of last search was 20 January 2015. IPD were sought from investigators with eligible trials. Risk of bias was assessed using criteria from the Cochrane Collaboration. IPD were analysed using a one-stage approach. Eleven trials, conducted between 2002 and 2010, were identified as eligible, with five trials being from the United States, two from Canada, and one each from Australia and New Zealand, Finland, India, and the United Kingdom. All 11 trials were included, with 4,857 women and 5,915 infants contributing data. The mean gestational age at trial entry for the trials was between 27.4 weeks and 30.2 weeks. There was no significant difference in the proportion of infants with a serious outcome (relative risk [RR] 0.92, 95% confidence interval [CI] 0.82 to 1.04, 5,893 infants, 11 trials, p = 0.33 for heterogeneity). There was a reduction in the use of respiratory support in infants exposed to repeat prenatal corticosteroids compared with infants not exposed (RR 0.91, 95% CI 0.85 to 0.97, 5,791 infants, 10 trials, p = 0.64 for heterogeneity). The number needed to treat (NNT) to benefit was 21 (95% CI 14 to 41) women/fetus to prevent one infant from needing respiratory support. Birth weight z-scores were lower in the repeat corticosteroid group (mean difference -0.12, 95%CI -0.18 to -0.06, 5,902 infants, 11 trials, p = 0.80 for heterogeneity). No statistically significant differences were seen for any of the primary outcomes for the child (death or any neurosensory disability) or for the woman (maternal sepsis). The treatment effect varied little by reason the woman was considered to be at risk of preterm birth, the number of fetuses in utero, the gestational age when first trial treatment course was given, or the time prior to birth that the last dose was given. Infants exposed to between 2-5 courses of repeat corticosteroids showed a reduction in both serious outcome and the use of respiratory support compared with infants exposed to only a single repeat course. However, increasing numbers of repeat courses of corticosteroids were associated with larger reductions in birth z-scores for weight, length, and head circumference. Not all trials could provide data for all of the prespecified subgroups, so this limited the power to detect differences because event rates are low for some important maternal, infant, and childhood outcomes.ConclusionsIn this study, we found that repeat prenatal corticosteroids given to women at ongoing risk of preterm birth after an initial course reduced the likelihood of their infant needing respiratory support after birth and led to neonatal benefits. Body size measures at birth were lower in infants exposed to repeat prenatal corticosteroids. Our findings suggest that to provide clinical benefit with the least effect on growth, the number of repeat treatment courses should be limited to a maximum of three and the total dose to between 24 mg and 48 mg.
- Published
- 2019
6. Amniocentesis to diagnose congenital cytomegalovirus infection following maternal primary infection
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Dinsmoor, Mara J., Fette, Lida M., Hughes, Brenna L., Rouse, Dwight J., Saade, George R., Reddy, Uma M., Allard, Donna, Mallett, Gail, Thom, Elizabeth A., Gyamfi-Bannerman, Cynthia, Varner, Michael W., Goodnight, William H., Tita, Alan T.N., Costantine, Maged M., Swamy, Geeta K., Heyborne, Kent D., Chien, Edward K., Chauhan, Suneet P., El-Sayed, Yasser Y., Casey, Brian M., Parry, Samuel, Simhan, Hyagriv N., Napolitano, Peter G., and Macones, George A.
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- 2022
- Full Text
- View/download PDF
7. The Management of Myelomeningocele Study: full cohort 30-month pediatric outcomes.
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Farmer, Diana L, Thom, Elizabeth A, Brock, John W, Burrows, Pamela K, Johnson, Mark P, Howell, Lori J, Farrell, Jody A, Gupta, Nalin, Adzick, N Scott, and Management of Myelomeningocele Study Investigators
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Management of Myelomeningocele Study Investigators ,Humans ,Meningomyelocele ,Treatment Outcome ,Fetal Therapies ,Follow-Up Studies ,Prospective Studies ,Single-Blind Method ,Child Development ,Pregnancy ,Adult ,Child ,Preschool ,Infant ,Infant ,Newborn ,Female ,Male ,Neurodevelopmental Disorders ,Management of Myelomeningocele Study ,and hip movement ,ankle ,fetal surgery ,knee ,long-term follow-up ,motor outcomes ,myelomeningocele ,postnatal motor function ,shunt ,ventricular size ,ventriculomegaly ,Pediatric ,Perinatal Period - Conditions Originating in Perinatal Period ,Clinical Trials and Supportive Activities ,Conditions Affecting the Embryonic and Fetal Periods ,Brain Disorders ,Clinical Research ,Rehabilitation ,Neurosciences ,Reproductive health and childbirth ,Good Health and Well Being ,Paediatrics and Reproductive Medicine ,Obstetrics & Reproductive Medicine - Abstract
BackgroundPrevious reports from the Management of Myelomeningocele Study demonstrated that prenatal repair of myelomeningocele reduces hindbrain herniation and the need for cerebrospinal fluid shunting, and improves motor function in children with myelomeningocele. The trial was stopped for efficacy after 183 patients were randomized, but 30-month outcomes were only available at the time of initial publication in 134 mother-child dyads. Data from the complete cohort for the 30-month outcomes are presented here. Maternal and 12-month neurodevelopmental outcomes for the full cohort were reported previously.ObjectiveThe purpose of this study is to report the 30-month outcomes for the full cohort of patients randomized to either prenatal or postnatal repair of myelomeningocele in the original Management of Myelomeningocele Study.Study designEligible women were randomly assigned to undergo standard postnatal repair or prenatal repair
- Published
- 2018
8. Attenuated early pregnancy weight gain by prenatal lifestyle interventions does not prevent gestational diabetes in the LIFE-Moms consortium
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Redman, Leanne M., Drews, Kimberly L., Klein, Samuel, Horn, Linda Van, Wing, Rena R., Pi-Sunyer, Xavier, Evans, Mary, Joshipura, Kaumudi, Arteaga, S. Sonia, Cahill, Alison G., Clifton, Rebecca G., Couch, Kimberly A., Franks, Paul W., Gallagher, Dympna, Haire-Joshu, Debra, Martin, Corby K., Peaceman, Alan M., Phelan, Suzanne, Thom, Elizabeth A., Yanovski, Susan Z., and Knowler, William C.
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- 2021
- Full Text
- View/download PDF
9. The Management of Myelomeningocele Study: obstetrical outcomes and risk factors for obstetrical complications following prenatal surgery
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Johnson, Mark P, Bennett, Kelly A, Rand, Larry, Burrows, Pamela K, Thom, Elizabeth A, Howell, Lori J, Farrell, Jody A, Dabrowiak, Mary E, Brock, John W, Farmer, Diana L, Adzick, N Scott, and Investigators, Management of Myelomeningocele Study
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Conditions Affecting the Embryonic and Fetal Periods ,Infant Mortality ,Pediatric ,Preterm ,Low Birth Weight and Health of the Newborn ,Prevention ,Clinical Research ,Perinatal Period - Conditions Originating in Perinatal Period ,Contraception/Reproduction ,Brain Disorders ,Clinical Trials and Supportive Activities ,Reproductive health and childbirth ,Good Health and Well Being ,Adult ,Female ,Fetal Diseases ,Fetal Membranes ,Premature Rupture ,Fetal Therapies ,Gestational Age ,Humans ,Hysterotomy ,Infant ,Newborn ,Logistic Models ,Male ,Meningomyelocele ,Multivariate Analysis ,Obstetric Labor ,Premature ,Odds Ratio ,Oligohydramnios ,Parity ,Placenta Diseases ,Postoperative Complications ,Pregnancy ,Premature Birth ,Risk Factors ,Surgical Wound Dehiscence ,Time Factors ,Young Adult ,fetal myelomeningocele ,fetal spina bifida ,fetal therapy ,prenatal surgery ,Management of Myelomeningocele Study Investigators ,Paediatrics and Reproductive Medicine ,Obstetrics & Reproductive Medicine - Abstract
BackgroundThe Management of Myelomeningocele Study was a multicenter randomized trial to compare prenatal and standard postnatal closure of myelomeningocele. The trial was stopped early at recommendation of the data and safety monitoring committee and outcome data for 158 of the 183 randomized women published.ObjectiveIn this report, pregnancy outcomes for the complete trial cohort are presented. We also sought to analyze risk factors for adverse pregnancy outcome among those women who underwent prenatal myelomeningocele repair.Study designPregnancy outcomes were compared between the 2 surgery groups. For women who underwent prenatal surgery, antecedent demographic, surgical, and pregnancy complication risk factors were evaluated for the following outcomes: premature spontaneous membrane rupture ≤34 weeks 0 days (preterm premature rupture of membranes), spontaneous membrane rupture at any gestational age, preterm delivery at ≤34 weeks 0 days, nonintact hysterotomy (minimal uterine wall tissue between fetal membranes and uterine serosa, or partial or complete dehiscence at delivery), and chorioamniotic membrane separation. Risk factors were evaluated using χ2 and Wilcoxon tests and multivariable logistic regression.ResultsA total of 183 women were randomized: 91 to prenatal and 92 to postnatal surgery groups. Analysis of the complete cohort confirmed initial findings: that prenatal surgery was associated with an increased risk for membrane separation, oligohydramnios, spontaneous membrane rupture, spontaneous onset of labor, and earlier gestational age at birth. In multivariable logistic regression of the prenatal surgery group adjusting for clinical center, earlier gestational age at surgery and chorioamniotic membrane separation were associated with increased risk of spontaneous membrane rupture (odds ratio, 1.49; 95% confidence interval, 1.01-2.22; and odds ratio, 2.96, 95% confidence interval, 1.05-8.35, respectively). Oligohydramnios was associated with an increased risk of subsequent preterm delivery (odds ratio, 9.21; 95% confidence interval, 2.19-38.78). Nulliparity was a risk factor for nonintact hysterotomy (odds ratio, 3.68; 95% confidence interval, 1.35-10.05).ConclusionDespite the confirmed benefits of prenatal surgery, considerable maternal and fetal risk exists compared with postnatal repair. Early gestational age at surgery and development of chorioamniotic membrane separation are risk factors for ruptured membranes. Oligohydramnios is a risk factor for preterm delivery and nulliparity is a risk factor for nonintact hysterotomy at delivery.
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- 2016
10. Impact on family and parental stress of prenatal vs postnatal repair of myelomeningocele
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Antiel, Ryan M, Adzick, N Scott, Thom, Elizabeth A, Burrows, Pamela K, Farmer, Diana L, Brock, John W, Howell, Lori J, Farrell, Jody A, Houtrow, Amy J, and Investigators, Management of Myelomeningocele Study
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Reproductive Medicine ,Biomedical and Clinical Sciences ,Behavioral and Social Science ,Clinical Trials and Supportive Activities ,Pediatric ,Clinical Research ,Reproductive health and childbirth ,Good Health and Well Being ,Adult ,Caregivers ,Child ,Preschool ,Female ,Fetus ,Gestational Age ,Humans ,Infant ,Meningomyelocele ,Parents ,Postnatal Care ,Risk Factors ,Stress ,Psychological ,family impact ,maternal-fetal surgery ,myelomeningocele parental stress ,spina bifida ,Management of Myelomeningocele Study Investigators ,myelomeningocele ,parental stress ,Paediatrics and Reproductive Medicine ,Obstetrics & Reproductive Medicine ,Reproductive medicine - Abstract
BackgroundThe Management of Myelomeningocele Study was a multicenter, randomized controlled trial that compared prenatal repair with standard postnatal repair for fetal myelomeningocele.ObjectiveWe sought to describe the long-term impact on the families of the women who participated and to evaluate how the timing of repair influenced the impact on families and parental stress.Study designRandomized women completed the 24-item Impact on Family Scale and the 36-item Parenting Stress Index Short Form at 12 and 30 months after delivery. A revised 15-item Impact on Family Scale describing overall impact was also computed. Higher scores reflected more negative impacts or greater stress. In addition, we examined Family Support Scale and Family Resource Scale scores along with various neonatal outcomes. Repeated measures analysis was conducted for each scale and subscale.ResultsOf 183 women randomized, 171 women completed the Impact on Family Scale and 172 completed the Parenting Stress Index at both 12 and 30 months. The prenatal surgery group had significantly lower revised 15-item Impact on Family Scale scores as well as familial-social impact subscale scores compared to the postnatal surgery group (P = .02 and .004, respectively). There was no difference in total parental stress between the 2 groups (P = .89) or in any of the Parenting Stress Index Short Form subscales. In addition, walking independently at 30 months and family resources at 12 months were associated with both family impact and parental stress.ConclusionThe overall negative family impact of caring for a child with spina bifida, up to 30 months of age, was significantly lower in the prenatal surgery group compared to the postnatal surgery group. Ambulation status and family resources were predictive of impact on family and parental stress.
- Published
- 2016
11. Prenatal surgery for myelomeningocele and the need for cerebrospinal fluid shunt placement.
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Tulipan, Noel, Wellons, John C, Thom, Elizabeth A, Gupta, Nalin, Sutton, Leslie N, Burrows, Pamela K, Farmer, Diana, Walsh, William, Johnson, Mark P, Rand, Larry, Tolivaisa, Susan, D'alton, Mary E, Adzick, N Scott, and MOMS Investigators
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MOMS Investigators ,Choroid Plexus ,Third Ventricle ,Humans ,Hydrocephalus ,Meningomyelocele ,Fetal Death ,Neuroendoscopy ,Treatment Outcome ,Cautery ,Prenatal Care ,Cerebrospinal Fluid Shunts ,Ventriculostomy ,Reoperation ,Logistic Models ,Risk Factors ,Gestational Age ,Pregnancy ,Adult ,Infant ,Infant ,Newborn ,Female ,Infant Death ,ETV-CPC = endoscopic third ventriculostomy and choroid plexus coagulation ,MOMS = The Management of Myelomeningocele Study ,cerebrospinal fluid shunt ,congenital ,fetal surgery ,hindbrain herniation ,hydrocephalus ,myelomeningocele ,spina bifida ,Clinical Research ,Neurosciences ,Perinatal Period - Conditions Originating in Perinatal Period ,Pediatric ,Brain Disorders ,Clinical Trials and Supportive Activities ,6.4 Surgery ,Evaluation of treatments and therapeutic interventions ,Reproductive health and childbirth ,Paediatrics and Reproductive Medicine ,Neurology & Neurosurgery - Abstract
ObjectThe Management of Myelomeningocele Study (MOMS) was a multicenter randomized trial comparing the safety and efficacy of prenatal and postnatal closure of myelomeningocele. The trial was stopped early because of the demonstrated efficacy of prenatal surgery, and outcomes on 158 of 183 pregnancies were reported. Here, the authors update the 1-year outcomes for the complete trial, analyze the primary and related outcomes, and evaluate whether specific prerandomization risk factors are associated with prenatal surgery benefit.MethodsThe primary outcome was a composite of fetal loss or any of the following: infant death, CSF shunt placement, or meeting the prespecified criteria for shunt placement. Primary outcome, actual shunt placement, and shunt revision rates for prenatal versus postnatal repair were compared. The shunt criteria were reassessed to determine which were most concordant with practice, and a new composite outcome was created from the primary outcome by replacing the original criteria for CSF shunt placement with the revised criteria. The authors used logistic regression to estimate whether there were interactions between the type of surgery and known prenatal risk factors (lesion level, gestational age, degree of hindbrain herniation, and ventricle size) for shunt placement, and to determine which factors were associated with shunting among those infants who underwent prenatal surgery.ResultsNinety-one women were randomized to prenatal surgery and 92 to postnatal repair. The primary outcome occurred in 73% of infants in the prenatal surgery group and in 98% in the postnatal group (p < 0.0001). Actual rates of shunt placement were only 44% and 84% in the 2 groups, respectively (p < 0.0001). The authors revised the most commonly met criterion to require overt clinical signs of increased intracranial pressure, defined as split sutures, bulging fontanelle, or sunsetting eyes, in addition to increasing head circumference or hydrocephalus. Using these modified criteria, only 3 patients in each group met criteria but did not receive a shunt. For the revised composite outcome, there was a difference between the prenatal and postnatal surgery groups: 49.5% versus 87.0% (p < 0.0001). There was also a significant reduction in the number of children who had a shunt placed and then required a revision by 1 year of age in the prenatal group (15.4% vs 40.2%, relative risk 0.38 [95% CI 0.22-0.66]). In the prenatal surgery group, 20% of those with ventricle size < 10 mm at initial screening, 45.2% with ventricle size of 10 up to 15 mm, and 79.0% with ventricle size ≥ 15 mm received a shunt, whereas in the postnatal group, 79.4%, 86.0%, and 87.5%, respectively, received a shunt (p = 0.02). Lesion level and degree of hindbrain herniation appeared to have no effect on the eventual need for shunting (p = 0.19 and p = 0.13, respectively). Similar results were obtained for the revised outcome.ConclusionsLarger ventricles at initial screening are associated with an increased need for shunting among those undergoing fetal surgery for myelomeningocele. During prenatal counseling, care should be exercised in recommending prenatal surgery when the ventricles are 15 mm or larger because prenatal surgery does not appear to improve outcome in this group. The revised criteria may be useful as guidelines for treating hydrocephalus in this group.
- Published
- 2015
12. Bladder Function After Fetal Surgery for Myelomeningocele
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Brock, John W, Carr, Michael C, Adzick, N Scott, Burrows, Pamela K, Thomas, John C, Thom, Elizabeth A, Howell, Lori J, Farrell, Jody A, Dabrowiak, Mary E, Farmer, Diana L, Cheng, Earl Y, Kropp, Bradley P, Caldamone, Anthony A, Bulas, Dorothy I, Tolivaisa, Susan, and Baskin, Laurence S
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Reproductive Medicine ,Biomedical and Clinical Sciences ,Clinical Sciences ,Urologic Diseases ,Conditions Affecting the Embryonic and Fetal Periods ,Clinical Research ,Biomedical Imaging ,Pediatric ,Evaluation of treatments and therapeutic interventions ,6.4 Surgery ,Renal and urogenital ,Reproductive health and childbirth ,Adult ,Female ,Fetus ,Humans ,Kidney ,Male ,Meningomyelocele ,Neurosurgical Procedures ,Postoperative Complications ,Pregnancy ,Time Factors ,Treatment Outcome ,Ultrasonography ,Urinary Bladder ,Urinary Catheterization ,Urodynamics ,MOMS Investigators ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Pediatrics ,Biomedical and clinical sciences ,Health sciences ,Psychology - Abstract
BackgroundA substudy of the Management of Myelomeningocele Study evaluating urological outcomes was conducted.MethodsPregnant women diagnosed with fetal myelomeningocele were randomly assigned to either prenatal or standard postnatal surgical repair. The substudy included patients randomly assigned after April 18, 2005. The primary outcome was defined in their children as death or the need for clean intermittent catheterization (CIC) by 30 months of age characterized by prespecified criteria. Secondary outcomes included bladder and kidney abnormalities observed by urodynamics and renal/bladder ultrasound at 12 and 30 months, which were analyzed as repeated measures.ResultsOf the 115 women enrolled in the substudy, the primary outcome occurred in 52% of children in the prenatal surgery group and 66% in the postnatal surgery group (relative risk [RR]: 0.78; 95% confidence interval [CI]: 0.57-1.07). Actual rates of CIC use were 38% and 51% in the prenatal and postnatal surgery groups, respectively (RR: 0.74; 95% CI: 0.48-1.12). Prenatal surgery resulted in less trabeculation (RR: 0.39; 95% CI: 0.19-0.79) and fewer cases of open bladder neck on urodynamics (RR: 0.61; 95% CI: 0.40-0.92) after adjustment by child's gender and lesion level. The difference in trabeculation was confirmed by ultrasound.ConclusionsPrenatal surgery did not significantly reduce the need for CIC by 30 months of age but was associated with less bladder trabeculation and open bladder neck. The implications of these findings are unclear now, but support the need for long-term urologic follow-up of patients with myelomeningocele regardless of type of surgical repair.
- Published
- 2015
13. One-year postpartum anthropometric outcomes in mothers and children in the LIFE-Moms lifestyle intervention clinical trials
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Phelan, Suzanne, Clifton, Rebecca G., Haire-Joshu, Debra, Redman, Leanne M., Van Horn, Linda, Evans, Mary, Joshipura, Kaumudi, Couch, Kimberly A., Arteaga, S. Sonia, Cahill, Alison G., Drews, Kimberly L., Franks, Paul W., Gallagher, Dympna, Josefson, Jami L., Klein, Samuel, Knowler, William C., Martin, Corby K., Peaceman, Alan M., Thom, Elizabeth A., Wing, Rena R., Yanovski, Susan Z., and Pi-Sunyer, Xavier
- Published
- 2020
- Full Text
- View/download PDF
14. Trump’s Trump: Lou Barletta and the Limits of Anti-Immigrant Politics in Pennsylvania
- Author
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Thom, Elizabeth, primary and Skocpol, Theda, additional
- Published
- 2020
- Full Text
- View/download PDF
15. Effect of Thyroxine Therapy on Depressive Symptoms Among Women With Subclinical Hypothyroidism
- Author
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Costantine, Maged M., Smith, Karen, Thom, Elizabeth A., Casey, Brian M., Peaceman, Alan M., Varner, Michael W., Sorokin, Yoram, Reddy, Uma M., Wapner, Ronald J., Boggess, Kim, Tita, Alan T.N., Rouse, Dwight J., Sibai, Baha, Iams, Jay D., Mercer, Brian M., Tolosa, Jorge E., Caritis, Steve N., and VanDorsten, J. Peter
- Published
- 2020
- Full Text
- View/download PDF
16. In Reply
- Author
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Silver, Robert M., Rice, Madeline Murguia, Grobman, William A., Thom, Elizabeth A., and Saade, George R.
- Published
- 2021
- Full Text
- View/download PDF
17. Customized Probability of Vaginal Delivery With Induction of Labor and Expectant Management in Nulliparous Women at 39 Weeks of Gestation
- Author
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Silver, Robert M., Rice, Madeline Murguia, Grobman, William A., Reddy, Uma M., Tita, Alan T. N., Mallett, Gail, Hill, Kim, Thom, Elizabeth A., El-Sayed, Yasser Y., Wapner, Ronald J., Rouse, Dwight J., Saade, George R., Thorp, John M., Jr, Chauhan, Suneet P., Chien, Edward K., Casey, Brian M., Gibbs, Ronald S., Srinivas, Sindhu K., Swamy, Geeta K., Simhan, Hyagriv N., and Macones, George A.
- Published
- 2020
- Full Text
- View/download PDF
18. Elective Labor Induction at 39 Weeks of Gestation Compared With Expectant Management: Factors Associated With Adverse Outcomes in Low-Risk Nulliparous Women
- Author
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El-Sayed, Yasser Y., Rice, Madeline Murguia, Grobman, William A., Reddy, Uma M., Tita, Alan T.N., Silver, Robert M., Mallett, Gail, Hill, Kim, Thom, Elizabeth A., Wapner, Ronald J., Rouse, Dwight J., Saade, George R., Thorp, John M., Jr, Chauhan, Suneet P., Chien, Edward K., Casey, Brian M., Gibbs, Ronald S., Srinivas, Sindhu K., Swamy, Geeta K., Simhan, Hyagriv N., and Macones, George A.
- Published
- 2020
- Full Text
- View/download PDF
19. Fetoscopic Tracheal Occlusion for Severe Congenital Diaphragmatic Hernia: The State of the Evidence
- Author
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Thom, Elizabeth A.
- Published
- 2020
- Full Text
- View/download PDF
20. Hydrocephalus and school-age neurodevelopmental outcomes in the management of myelomeningocele prenatal surgery trial: a secondary analysis
- Author
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Fletcher, Jack M., primary, Houtrow, Amy J., additional, MacPherson, Cora, additional, Thomas, Nina H., additional, Gupta, Nalin, additional, Adzick, N. Scott, additional, and Thom, Elizabeth A., additional
- Published
- 2023
- Full Text
- View/download PDF
21. Alcohol treatment policy 1950-1990 : from alcohol treatment to alcohol problems management
- Author
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Thom, Elizabeth Whyte and Berridge, Virginia
- Subjects
362.1 ,Public health model ,Alcoholism - Abstract
The thesis draws on historical and social policy perspectives to examine the factors influencing development and change in alcohol treatment policy between 1950 and 1990. The study uses data from primary and secondary documentation and from taped interviews. Three themes are highlighted as particularly relevant to an examination of policy trends. The first of these is the emergence and evolution of a `policy community'. Spearheaded by psychiatrists in the 1960s, the `policy community' broadened to include other professional groups and the voluntary sector by the 1990s. The second theme concerns the role of research in influencing the nature and direction of treatment policy. The study indicates increasing use of research as the rationale for policy and illustrates the move towards a `contractor' relationship between research workers and policy makers. The final theme deals with the influence on policy of ideological frames and changing conceptualisations of the alcohol problem. Two major shifts were important for treatment, the re-discovery of the disease concept of alcoholism in the 1950s and the emergence of a new public health model of alcohol problems in the 1970s. Within these broad themes, the study includes an examination of tensions - between different professional perspectives, between government departments with differing responsibilities, between different ideologies - and of moves to secure consensus in the formulation and implementation of treatment policy. The final chapter addresses shifts in thinking from the re-emergence of a `disease' model of alcoholism in the 1950s, to a `consumptionist' (population-based) model in the 1970s, towards a `harm reduction' approach to alcohol problems management in the 1990s. The thesis concludes that over the past forty years competing paradigms of the alcohol problem have emerged and gained policy salience within particular historical-social contexts in the search for policy consensus to manage the problematic aspects of alcohol consumption.
- Published
- 1997
- Full Text
- View/download PDF
22. Antenatal Magnesium and Cerebral Palsy in Preterm Infants
- Author
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Hauth, John C., Todd, Allison, Hill, Tawanda, Harris, Stacy, Nelson, Kathleen G., Biasini, Fred J., Anderson, Kristine, Jensen, Marla K., Williams, Lori A., Fullmer, Lisa H., Guzman, Anna M., Collin, Marc, VanBuren, George, Milluzzi, Cynthia, Fundzak, Monica, Santori, Cathy, Johnson, Francee, Landon, Mark B., Latimer, Cheryl, Curry, Valerie, Meadows, Sandra, Sciscione, Anthony, DiVito, Michelle, Talucci, Mary, Desai, Shobhana A., Paul, David A., Sibai, Baha M., Ramsey, Risa D., Mabie, William C., Kao, Lu, Cassie, Melanie, Norman, Gwendolyn S., Driscoll, Debra, Steffy, Barbara, Dombrowski, Mitchell P., Meis, Paul J., Swain, Melissa, Klinepeter, Kurt, O'Shea, T. Michael, Steele, Linda, Moise, Kenneth J., Jr., Brody, Seth, Bernhardt, Janice, Dorman, Karen, Gilstrap, Larry C., III, Day, Mary-Clare, Flinn-Gildersleeve, Erin, Ortiz, Felecia, Kerr, Marcia, Pemberton, Victoria, Paley, Lisa, Paley, Charles, Bousleiman, Sabine, Carmona, Vilmarie, Tillinghast, JoAnn, Allard, Donna, Vohr, Betty, Noel, Lucy, McCarten, Kathleen, Miodovnik, Menachem, Elder, Nancy, Girdler, Wendy, Gratton, Teresa L., Moawad, Atef, Lindheimer, Marshall, Jones, Phyllis L., Doyle, Faith, Alfonso, Carmen, Scott, May, Washington, Ramona, Mallett, Gail, Ramos-Brinson, Mercedes, Simon, Paula, Wen, Tony, Goodrum, Linda A., Saade, George R., Olson, Gayle L., Harirah, Hassan M., Martin, Elizabeth, Xenakis, Elly M.-J., Conway, Deborah L., Berkus, Michael, Kamon, Theresa M., Cotroneo, Margaret, Milford, Cheryl A., Sherman, M. Lynne, Dax, Jody S., Fay-Randall, Lisa, Melton, Carla F., Flores, Ester, Thom, Elizabeth, Jones-Binns, Barbara, Cooney, Maureen, Fischer, Molly L., McLaughlin, Sarah, Brunette, Kimberly, Fricks, Elizabeth, Spong, Catherine Y., Tolivaisa, Susan, McNellis, Donald, Catz, Charlotte, Howell, Kimberly, Nelson, Karin B., Roberts, James M., Hirtz, Deborah G., Weiner, Steven J., Bulas, Dorothy, DiPietro, Michael, Seibert, Joanna, Rouse, Dwight J., Mercer, Brian M., Varner, Michael W., Reddy, Uma M., Iams, Jay D., Wapner, Ronald J., Sorokin, Yoram, Thorp, John M., Jr., Ramin, Susan M., Malone, Fergal D., Carpenter, Marshall W., O'Sullivan, Mary J., Peaceman, Alan M., Hankins, Gary D.V., Dudley, Donald, and Caritis, Steve N.
- Published
- 2015
- Full Text
- View/download PDF
23. Labor Induction Versus Expectant Management in Low-Risk Nulliparous Women
- Author
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Grobman, William A., Rice, Madeline M., Reddy, Uma M., Tita, Alan T. N., Silver, Robert M., Mallett, Gail, Hill, Kim, Thom, Elizabeth A., El-Sayed, Yasser Y., Perez-Delboy, Annette, Rouse, Dwight J., Saade, George R., Boggess, Kim A., Chauhan, Suneet P., Iams, Jay D., Chien, Edward K., Casey, Brian M., Gibbs, Ronald S., Srinivas, Sindhu K., Swamy, Geeta K., Simhan, Hyagriv N., and Macones, George A.
- Published
- 2019
- Full Text
- View/download PDF
24. Overview of the obesity intervention taxonomy and pooled analysis working group
- Author
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Belle, Steven H., Stevens, June, Cella, David, Foltz, Jennifer L., Loria, Catherine M., Murray, David M., Czajkowski, Susan M., Arteaga, S. Sonia, Thom, Elizabeth, and Pratt, Charlotte A.
- Published
- 2016
- Full Text
- View/download PDF
25. Treatment of Subclinical Hypothyroidism or Hypothyroxinemia in Pregnancy
- Author
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Casey, Brian M., Thom, Elizabeth A., Peaceman, Alan M., Varner, Michael W., Sorokin, Yoram, Hirtz, Deborah G., Reddy, Uma M., Wapner, Ronald J., Thorp, John M., Jr., Saade, George, Tita, Alan T.N., Rouse, Dwight J., Sibai, Baha, Iams, Jay D., Mercer, Brian M., Tolosa, Jorge, Caritis, Steve N., and VanDorsten, Peter J.
- Published
- 2017
- Full Text
- View/download PDF
26. Prospective Risk of Stillbirth and Neonatal Complications in Twin Pregnancies: Systematic Review and Meta-analysis
- Author
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Cheong-See, Fiona, Schuit, Ewoud, Arroyo-Manzano, David, Khalil, Asma, Barrett, Jon, Joseph, K. S., Asztalos, Elizabeth, Hack, Karien, Lewi, Liesbeth, Lim, Arianne, Liem, Sophie, Norman, Jane E., Morrison, John, Combs, C. Andrew, Garite, Thomas J., Maurel, Kimberly, Serra, Vicente, Perales, Alfredo, Rode, Line, Worda, Katharina, Nassar, Anwar, Aboulghar, Mona, Rouse, Dwight, Thom, Elizabeth, Breathnach, Fionnuala, Nakayama, Soichiro, Russo, Francesca Maria, Robinson, Julian N., Dodd, Jodie M., Newman, Roger B., Bhattacharya, Sohinee, Tang, Selphee, Mol, Ben Willem J., Zamora, Javier, Thilaganathan, Basky, and Thangaratinam, Shakila
- Published
- 2017
- Full Text
- View/download PDF
27. Antenatal Betamethasone for Women at Risk for Late Preterm Delivery
- Author
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Gyamfi-Bannerman, Cynthia, Thom, Elizabeth A., Blackwell, Sean C., Tita, Alan T.N., Reddy, Uma M., Saade, George R., Rouse, Dwight J., McKenna, David S., Clark, Erin A.S., Thorp, John M., Jr., Chien, Edward K., Peaceman, Alan M., Gibbs, Ronald S., Swamy, Geeta K., Norton, Mary E., Casey, Brian M., Caritis, Steve N., Tolosa, Jorge E., Sorokin, Yoram, VanDorsten, Peter J., and Jain, Lucky
- Published
- 2016
- Full Text
- View/download PDF
28. A Core Outcome Set for Evaluation of Interventions to Prevent Preterm Birth
- Author
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van ʼt Hooft, Janneke, Duffy, James M. N., Daly, Mandy, Williamson, Paula R., Meher, Shireen, Thom, Elizabeth, Saade, George R., Alfirevic, Zarko, Mol, Ben Willem J., and Khan, Khalid S.
- Published
- 2016
- Full Text
- View/download PDF
29. Maternal reproductive outcomes after in-utero repair of myelomeningocele: 50
- Author
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Thom, Elizabeth A.
- Published
- 2016
- Full Text
- View/download PDF
30. Intrapartum Fetal ECG ST-Segment Analysis
- Author
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Belfort, Michael A., Saade, George R., and Thom, Elizabeth A.
- Published
- 2015
31. Relationship between 17-alpha hydroxyprogesterone caproate concentration and spontaneous preterm birth
- Author
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Caritis, Steve N., Venkataramanan, Raman, Thom, Elizabeth, Harper, Margaret, Klebanoff, Mark A., Sorokin, Yoram, Thorp, John M., Jr., Varner, Michael W., Wapner, Ronald J., Iams, Jay D., Carpenter, Marshall W., Grobman, William A., Mercer, Brian M., Sciscione, Anthony, Rouse, Dwight J., and Ramin, Susan
- Published
- 2014
- Full Text
- View/download PDF
32. A Randomized Trial of Intrapartum Fetal ECG ST-Segment Analysis
- Author
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Belfort, Michael A., Saade, George R., Thom, Elizabeth, Blackwell, Sean C., Reddy, Uma M., Thorp, John M., Jr., Tita, Alan T.N., Miller, Russell S., Peaceman, Alan M., McKenna, David S., Chien, Edward K.S., Rouse, Dwight J., Gibbs, Ronald S., El-Sayed, Yasser Y., Sorokin, Yoram, Caritis, Steve N., and VanDorsten, Peter J.
- Published
- 2015
- Full Text
- View/download PDF
33. Prenatal Repair and Physical Functioning Among Children With Myelomeningocele
- Author
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Houtrow, Amy J., primary, MacPherson, Cora, additional, Jackson-Coty, Janet, additional, Rivera, Monica, additional, Flynn, Laura, additional, Burrows, Pamela K., additional, Adzick, N. Scott, additional, Fletcher, Jack, additional, Gupta, Nalin, additional, Howell, Lori J., additional, Brock, John W., additional, Lee, Hanmin, additional, Walker, William O., additional, and Thom, Elizabeth A., additional
- Published
- 2021
- Full Text
- View/download PDF
34. 17 alpha-hydroxyprogesterone caproate to prevent prematurity in nulliparas with cervical length less than 30 mm
- Author
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Grobman, William A., Thom, Elizabeth A., Spong, Catherine Y., Iams, Jay D., Saade, George R., Mercer, Brian M., Tita, Alan T.N., Rouse, Dwight J., Sorokin, Yoram, Wapner, Ronald J., Leveno, Kenneth J., Blackwell, Sean, Esplin, Sean M., Tolosa, Jorge E., Thorp, John M., Jr, Caritis, Steve N., and Van Dorsten, Peter J.
- Published
- 2012
- Full Text
- View/download PDF
35. Antenatal Magnesium and Cerebral Palsy in Preterm Infants
- Author
-
Hirtz, Deborah G., Weiner, Steven J., Bulas, Dorothy, DiPietro, Michael, Seibert, Joanna, Rouse, Dwight J., Mercer, Brian M., Varner, Michael W., Reddy, Uma M., Iams, Jay D., Wapner, Ronald J., Sorokin, Yoram, Thorp, John M., Jr., Ramin, Susan M., Malone, Fergal D., Carpenter, Marshall W., OʼSullivan, Mary J., Peaceman, Alan M., Hankins, Gary D.V., Dudley, Donald, Caritis, Steve N., Hauth, John C., Todd, Allison, Hill, Tawanda, Harris, Stacy, Nelson, Kathleen G., Biasini, Fred J., Anderson, Kristine, Jensen, Marla K., Williams, Lori A., Fullmer, Lisa H., Guzman, Anna M., Collin, Marc, VanBuren, George, Milluzzi, Cynthia, Fundzak, Monica, Santori, Cathy, Johnson, Francee, Landon, Mark B., Latimer, Cheryl, Curry, Valerie, Meadows, Sandra, Sciscione, Anthony, DiVito, Michelle, Talucci, Mary, Desai, Shobhana A., Paul, David A., Sibai, Baha M., Ramsey, Risa D., Mabie, William C., Kao, Lu, Cassie, Melanie, Norman, Gwendolyn S., Driscoll, Debra, Steffy, Barbara, Dombrowski, Mitchell P., Meis, Paul J., Swain, Melissa, Klinepeter, Kurt, OʼShea, Michael T., Steele, Linda, Moise, Kenneth J., Jr., Brody, Seth, Bernhardt, Janice, Dorman, Karen, Gilstrap, Larry C., III, Day, Mary-Clare, Flinn-Gildersleeve, Erin, Ortiz, Felecia, Kerr, Marcia, Pemberton, Victoria, Paley, Lisa, Paley, Charles, Bousleiman, Sabine, Carmona, Vilmarie, Tillinghast, JoAnn, Allard, Donna, Vohr, Betty, Noel, Lucy, McCarten, Kathleen, Miodovnik, Menachem, Elder, Nancy, Girdler, Wendy, Gratton, Teresa L., Moawad, Atef, Lindheimer, Marshall, Jones, Phyllis L., Doyle, Faith, Alfonso, Carmen, Scott, May, Washington, Ramona, Mallett, Gail, Ramos-Brinson, Mercedes, Simon, Paula, Wen, Tony, Goodrum, Linda A., Saade, George R., Olson, Gayle L., Harirah, Hassan M., Martin, Elizabeth, Xenakis, Elly M.-J., Conway, Deborah L., Berkus, Michael, Kamon, Theresa M., Cotroneo, Margaret, Milford, Cheryl A., Sherman, Lynne M., Dax, Jody S., Fay-Randall, Lisa, Melton, Carla F., Flores, Ester, Thom, Elizabeth, Jones-Binns, Barbara, Cooney, Maureen, Fischer, Molly L., McLaughlin, Sarah, Brunette, Kimberly, Fricks, Elizabeth, Spong, Catherine Y., Tolivaisa, Susan, McNellis, Donald, Catz, Charlotte, Howell, Kimberly, Nelson, Karin B., and Roberts, James M.
- Published
- 2015
- Full Text
- View/download PDF
36. Vitamins C and E to prevent complications of pregnancy-associated hypertension
- Author
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Roberts, James M., Myatt, Leslie, Spong, Catherine Y., Thom, Elizabeth A., Hauth, John C., Leveno, Kenneth J., Pearson, Gail D., Wapner, Ronald J., Varner, Michael W., Thorp, John M. Jr., Mercer, Brian M., Peaceman, Alan M., Ramin, Susan M., Carpenter, Marshall W., Samuels, Philip, Sciscione, Anthony, Harper, Margaret, Smith, Wendy J., Saade, George, Sorokin, Yoram, and Anderson, Garland B.
- Subjects
Hypertension in pregnancy -- Diet therapy ,Vitamin C -- Health aspects ,Vitamin E -- Health aspects ,Drugs -- Adverse and side effects ,Drugs -- Prevention - Abstract
A study was conducted to evaluate the benefits of antioxidation supplementation with vitamins C and E in helping prevent adverse events during pregnancy due to hypertension. Results indicated that the intake of the vitamins did not reduce the incidence of complications during pregnancy.
- Published
- 2010
37. A multicenter, randomized trial of treatment for mild gestation diabetes
- Author
-
Landon, Mark B., Spong, Catherine Y., Thom, Elizabeth, Carpenter, Marshall W., Ramin, Susan M., Casey, Brian, Wapner, Ronald J., Varner, Michael W., Rouse, Dwight J., Thorp, John M., Jr., Sciscione, Anthony, Catalano, Patrick, Harper, Margaret, Saade, George, Lain, Kristine Y., Sorokin, Yoram, Peaceman, Alan M., Tolosa, Jorge E., and Anderson, Garland B.
- Subjects
Diabetes in pregnancy -- Care and treatment ,Hypertension -- Prevention ,Infants (Newborn) -- Diseases ,Infants (Newborn) -- Care and treatment - Abstract
The study aims to evaluate whether treatment for mild, gestational diabetes helps improve the outcomes during pregnancy. The results indicate that treatment of gestational diabetes did not significantly improve stillbirth or perinatal death or several neonatal complications, it did reduce risks of fetal overgrowth, cesarean delivery and hypertensive disorders.
- Published
- 2009
38. Evaluating Progestogens for Preventing Preterm birth International Collaborative (EPPPIC): meta-analysis of individual participant data from randomised controlled trials
- Author
-
Stewart, Lesley A, primary, Simmonds, Mark, additional, Duley, Lelia, additional, Llewellyn, Alexis, additional, Sharif, Sahar, additional, Walker, Ruth AE, additional, Beresford, Lucy, additional, Wright, Kath, additional, Aboulghar, Mona M, additional, Alfirevic, Zarko, additional, Azargoon, Azam, additional, Bagga, Rashmi, additional, Bahrami, Elham, additional, Blackwell, Sean C, additional, Caritis, Steve N, additional, Combs, C Andrew, additional, Croswell, Jennifer M, additional, Crowther, Caroline A, additional, Das, Anita F, additional, Dickersin, Kay, additional, Dietz, Kristina C, additional, Elimian, Andrew, additional, Grobman, William A, additional, Hodkinson, Alexander, additional, Maurel, Kimberley A, additional, McKenna, David S, additional, Mol, Ben W, additional, Moley, Kelle, additional, Mueller, Jamie, additional, Nassar, Anwar, additional, Norman, Jane E, additional, Norrie, John, additional, O'Brien, John M, additional, Porcher, Raphael, additional, Rajaram, Shalini, additional, Rode, Line, additional, Rouse, Dwight J, additional, Sakala, Carol, additional, Schuit, Ewoud, additional, Senat, Marie-Victoire, additional, Simpson, Joe L, additional, Smith, Katherine, additional, Tabor, Anne, additional, Thom, Elizabeth A, additional, van Os, Melanie A, additional, Whitlock, Evelyn P, additional, Wood, Stephen, additional, and Walley, Tom, additional
- Published
- 2021
- Full Text
- View/download PDF
39. 85 Prevention of preterm delivery after fetoscopy for twin-twin transfusion: a multicenter prospective cohort study
- Author
-
Buskmiller, Cara, primary, Bergh, Eric P., additional, Miller, Jena L., additional, Baschat, Ahmet A., additional, Galan, Henry L., additional, Behrendt, Nicholas J., additional, Habli, Mounira, additional, Piero, Jose L., additional, Snowise, Saul, additional, Fisher, James, additional, MacPherson, Cora, additional, Thom, Elizabeth, additional, Johnson, Anthony, additional, Blackwell, Sean C., additional, and Papanna, Ramesha, additional
- Published
- 2021
- Full Text
- View/download PDF
40. Maternal Depressive Risk in Prenatal versus Postnatal Surgical Closure of Myelomeningocele: Associations with Parenting Stress and Child Outcomes
- Author
-
Schreiber, Jane E., primary, Cole, Joanna C.M., additional, Houtrow, Amy J., additional, Kallan, Michael J., additional, Thom, Elizabeth A., additional, Howell, Lori J., additional, and Adzick, N. Scott, additional
- Published
- 2021
- Full Text
- View/download PDF
41. Prenatal Repair of Myelomeningocele and School-age Functional Outcomes.
- Author
-
Houtrow, Amy J, Houtrow, Amy J, Thom, Elizabeth A, Fletcher, Jack M, Burrows, Pamela K, Adzick, N Scott, Thomas, Nina H, Brock, John W, Cooper, Timothy, Lee, Hanmin, Bilaniuk, Larissa, Glenn, Orit A, Pruthi, Sumit, MacPherson, Cora, Farmer, Diana L, Johnson, Mark P, Howell, Lori J, Gupta, Nalin, Walker, William O, Houtrow, Amy J, Houtrow, Amy J, Thom, Elizabeth A, Fletcher, Jack M, Burrows, Pamela K, Adzick, N Scott, Thomas, Nina H, Brock, John W, Cooper, Timothy, Lee, Hanmin, Bilaniuk, Larissa, Glenn, Orit A, Pruthi, Sumit, MacPherson, Cora, Farmer, Diana L, Johnson, Mark P, Howell, Lori J, Gupta, Nalin, and Walker, William O
- Abstract
Background and objectivesThe Management of Myelomeningocele Study (MOMS), a randomized trial of prenatal versus postnatal repair for myelomeningocele, found that prenatal surgery resulted in reduced hindbrain herniation and need for shunt diversion at 12 months of age and better motor function at 30 months. In this study, we compared adaptive behavior and other outcomes at school age (5.9-10.3 years) between prenatal versus postnatal surgery groups.MethodsFollow-up cohort study of 161 children enrolled in MOMS. Assessments included neuropsychological and physical evaluations. Children were evaluated at a MOMS center or at a home visit by trained blinded examiners.ResultsThe Vineland composite score was not different between surgery groups (89.0 ± 9.6 in the prenatal group versus 87.5 ± 12.0 in the postnatal group; P = .35). Children in the prenatal group walked without orthotics or assistive devices more often (29% vs 11%; P = .06), had higher mean percentage scores on the Functional Rehabilitation Evaluation of Sensori-Neurologic Outcomes (92 ± 9 vs 85 ± 18; P < .001), lower rates of hindbrain herniation (60% vs 87%; P < .001), had fewer shunts placed for hydrocephalus (49% vs 85%; P < .001) and, among those with shunts, fewer shunt revisions (47% vs 70%; P = .02) than those in the postnatal group. Parents of children repaired prenatally reported higher mean quality of life z scores (0.15 ± 0.67 vs 0.11 ± 0.73; P = .008) and lower mean family impact scores (32.5 ± 7.8 vs 37.0 ± 8.9; P = .002).ConclusionsThere was no significant difference between surgery groups in overall adaptive behavior. Long-term benefits of prenatal surgery included improved mobility and independent functioning and fewer surgeries for shunt placement and revision, with no strong evidence of improved cognitive functioning.
- Published
- 2020
42. First-trimester screening for trisomies 21 and 18
- Author
-
Wapner, Ronald, Thom, Elizabeth, Simpson, Joe Leigh, Pergament, Eugene, Silver, Richard, Filkins, Karen, Platt, Lawrence, Mahoney, Maurice, Johnson, Anthony, Hogge, W. Allen, Wilson, R. Douglas, Mohide, Patrick, Hershey, Douglas, Krantz, David, Zachary, Julia, Snijders, Rosalinde, Greene, Naomi, Sabbagha, Rudy, MacGregor, Scott, Hill, Lyndon, Gagnon, Alain, Hallahan, Terrence, and Jackson, Laird
- Subjects
Prenatal diagnosis -- Innovations ,Trisomy -- Diagnosis ,Edwards' syndrome -- Diagnosis ,Down syndrome -- Diagnosis - Abstract
A blood test and an ultrasound scan of the fetal neck can identify babies who have Down syndrome and other chromosomal abnormalities during the first trimester, according to a study of 8,514 pregnant women. Most other tests for chromosomal abnormalities are done during the second trimester. But many women may object to having an abortion in the second trimester.
- Published
- 2003
43. Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproate
- Author
-
Meis, Paul J., Klebanoff, Mark, Thom, Elizabeth, Dombrowski, Mitchell P., Sibai, Baha, Moawad, Atef H., Spong, Catherine Y., Hauth, John C., Miodovnik, Menachem, Varner, Michael W., Levano, Kenneth J., Caritis, Steve N., Iams, Jay D., Wapner, Ronald J., Conway, Deborah, O'Sullivan, Mary J., Carpenter, Marshall, Mercer, Brian, Ramin, Susan M., Thorp, John M., and Peaceman, Alan M.
- Subjects
Premature birth -- Prevention ,Hydroxyprogesterone -- Evaluation - Abstract
Weekly injections of a hormone called 17 alpha-hydroxyprogesterone caproate can lower the risk of premature birth in pregnant women with a previous premature birth. This was the conclusion of a study of 463 pregnant women. The newborn babies of women who received the injections were also less likely to have necrotizing enterocolitis, brain hemorrhage, or the need for oxygen at birth.
- Published
- 2003
44. Chromosomal Microarray versus Karyotyping for Prenatal Diagnosis
- Author
-
Wapner, Ronald J., Martin, Christa Lese, Levy, Brynn, Ballif, Blake C., Eng, Christine M., Zachary, Julia M., Savage, Melissa, Platt, Lawrence D., Saltzman, Daniel, Grobman, William A., Klugman, Susan, Scholl, Thomas, Simpson, Joe Leigh, McCall, Kimberly, Aggarwal, Vimla S., Bunke, Brian, Nahum, Odelia, Patel, Ankita, Lamb, Allen N., Thom, Elizabeth A., Beaudet, Arthur L., Ledbetter, David H., Shaffer, Lisa G., and Jackson, Laird
- Published
- 2012
- Full Text
- View/download PDF
45. Frequency of uterine contractions and the risk of spontaneous preterm delivery
- Author
-
Iams, Jay D., Newman, Roger B., Thom, Elizabeth A., Goldenberg, Robert L., Mueller-Heubach, Eberhard, Moawad, Atef, Sibai, Baha M., Caritis, Steve N., Miodovnik, Menachem, Paul, Richard H., Dombrowski, Mitchell P., and McNellis, Donald
- Subjects
Uterus -- Contraction ,Premature birth -- Research - Abstract
Measuring the frequency of uterine contractions between 22 and 24 weeks of pregnancy does not appear to be useful in predicting which pregnant women will deliver prematurely. Although a study of 306 women showed that women who delivered prematurely had more contractions, there was no clear cutoff point to distinguish them from women who delivered at term.
- Published
- 2002
46. Failure of metronidazole to prevent preterm delivery among pregnant women with asymptomatic Trichomonas vaginalis infection
- Author
-
Klebanoff, Mark A., Carey, J. Christopher, Hauth, John C., Hillier, Sharon L., Nugent, Robert P., Thom, Elizabeth A., Ernest, J.M., Heine, R. Phillip, Wapner, Ronald J., Trout, Wayne, Moawad, Atef, and Leveno, Kenneth J.
- Subjects
Trichomoniasis -- Drug therapy ,Premature birth -- Prevention ,Pregnant women -- Diseases ,Metronidazole -- Evaluation - Abstract
Treating Trichomonas vaginalis infection in pregnant women will not necessarily prevent premature birth. In fact, in a study of 320 women who took an antibiotic for Trichomonas infection and 297 women who took a placebo, the premature birth rate was higher in the women who took the antibiotic.
- Published
- 2001
47. A Randomized Trial of Prenatal versus Postnatal Repair of Myelomeningocele
- Author
-
Adzick, Scott N., Thom, Elizabeth A., Spong, Catherine Y., Brock, John W., III, Burrows, Pamela K., Johnson, Mark P., Howell, Lori J., Farrell, Jody A., Dabrowiak, Mary E., Sutton, Leslie N., Gupta, Nalin, Tulipan, Noel B., DʼAlton, Mary E., and Farmer, Diana L.
- Published
- 2011
48. 497: Does parity impact outcomes with open maternal-fetal surgery for myelomeningocele closure?
- Author
-
Moldenhauer, Julie, primary, Soni, Shelly, additional, Bennett, Kelly, additional, Crombleholme, Timothy, additional, Fisher, Allan, additional, Goldstein, Ruth, additional, Goodnight, William, additional, Hirose, Shinjiro, additional, Jatres, Jillian, additional, Lillegard, Joseph, additional, McCullough, Laurence, additional, Lim, Foong Yen, additional, Moehrlen, Ueli, additional, Moon-Grady, Anita, additional, Skupski, Daniel, additional, Thom, Elizabeth, additional, Treadwell, Marjorie, additional, Tsao, Kuojen, additional, Wagner, Amy, additional, and Zaretsky, Michael V., additional
- Published
- 2020
- Full Text
- View/download PDF
49. 817: Perinatal outcomes after fetal resuscitation during fetal MMC closure
- Author
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Peterson, Erika, primary, Bennett, Kelly, additional, Crombleholme, Timothy, additional, Fisher, Allan, additional, Goldstein, Ruth, additional, Goodnight, William, additional, Hirose, Shinjiro, additional, Jatres, Jillian, additional, Lillegard, Joseph, additional, Lim, Foong Yen, additional, Laurence, McCullough, additional, Moehrlen, Ueli, additional, Moldenhauer, Julie, additional, Moon-Grady, Anita, additional, Skupski, Daniel, additional, Thom, Elizabeth, additional, Treadwell, Marjorie, additional, Tsao, Kuojen, additional, Wagner, Amy, additional, and Zaretsky, Michael V., additional
- Published
- 2020
- Full Text
- View/download PDF
50. 585: Fetal MMC Closure Stratified by Maternal BMI: a sub-analysis of the MOMS trial cohort
- Author
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Moldenhauer, Julie, primary, Kallan, Michael, additional, Thom, Elizabeth, additional, and Adzick, N. Scott, additional
- Published
- 2020
- Full Text
- View/download PDF
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