The annual meeting of the American College of Obstetricians and Gynecologists was held from May 19 to 21 in Baltimore and attracted more than 4,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in obstetrics and gynecology. The conference highlighted recent advances in the prevention, detection, and treatment of conditions impacting women, with presentations focusing on the advancement of health care services for women worldwide.
In one study, Katherine Panushka, M.D., of the Montefiore Medical Center and Albert Einstein College of Medicine in New York City, and colleagues found that women with hypertension who do not desire future fertility are not receiving adequate amounts of counseling.
The researchers evaluated U.S. Centers for Disease Control and Prevention data from the National Survey of Family Growth, which is nationally representative of all women in the United States, and found that two-thirds of women with high blood pressure with no desire for future fertility did not receive counseling about contraception. In addition, Black women with high blood pressure received decreased rates of counseling. This finding is particularly concerning as the most commonly used birth control is the oral contraceptive pill, which should be avoided in the setting of high blood pressure, the authors said.
"Our study highlights an unmet need for safe and accessible contraceptive options among hypertensive individuals, particularly Black individuals, at risk for unintended pregnancy," Panushka said. "Addressing this gap through targeted interventions, provider education, and improved access to a variety of contraceptive methods will not only enhance the quality of care for this population but also contribute to reducing the rates of unintended pregnancies and their associated adverse health outcomes."
In another study, Yosra Elsayed, of the Central Michigan University College of Medicine in Mount Pleasant, and colleagues found that COVID-19 infection during pregnancy increases the risk for poor birth outcomes.
The authors performed a retrospective chart review using medical records from a single university-affiliated obstetric practice. Patients were categorized into subgroups, including those who were positive for COVID-19 infection during pregnancy (69 patients) or negative for COVID-19 infection and delivering before the pandemic (59 patients).
The researchers found that COVID-19 infection during pregnancy decreased birth weight by almost half a pound and increased the risk for an extended delivery hospitalization almost threefold. These effects were largely driven by earlier delivery, as those who had a COVID-19 infection during pregnancy had a fourfold increased risk for preterm delivery. The investigators also found that severity of infection was important. Compared with those who had milder infections, those with more severe COVID-19 infections had newborns with significantly lower birth weights and substantially higher rates of preterm birth, need for oxygen at birth, and neonatal intensive care unit admission.
"Severe infection, based on the need for an emergency department visit, hospitalization, oxygen treatment, steroids, antibodies, or ventilation, was a strong predictor of poor outcomes, with the worst outcomes in our study among those with the most severe infections during pregnancy," Elsayed said. "A larger more diverse sample is needed to confirm findings, and to examine potential impact of vaccination in reducing the impact of COVID-19 infection during pregnancy."
Runzhi Wang, M.D., of the Johns Hopkins University School of Medicine in Baltimore, and colleagues found that just under 25 percent of pregnant women responding to an electronic survey trusted health care practitioners less after the COVID-19 pandemic, especially Black/African American pregnant women with a history of illicit drug use.
The authors evaluated the impact of the COVID-19 pandemic on medical mistrust by distributing an electronic survey among pregnant women between 15 and 45 years of age, who were undergoing prenatal care at a single medical institution. The authors found that 24.4 percent of respondents said they trusted health care practitioners less following the COVID-19 pandemic, and 13.6 percent grew more mistrustful of provided information.
"Nearly a quarter of participants trusted health care providers less after the COVID-19 pandemic," the authors write. "Black/African American pregnant women and those with a history of drug use have greater medical mistrust than White/Caucasian women."