Denise J Jamieson

Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States

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Publications (393)2250.6 Total impact

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    ABSTRACT: Little is known about the extent to which HIV-infected street youth (living part or full time on the streets) exhibit behaviors associated with HIV transmission in their interactions with youth not living on the streets ("non-street youth"). We aimed to determine prevalences and predictors of such "bridging behaviors": inconsistent condom use and needle sharing between HIV-positive street youth and non-street youth. A total of 171 street youth in 3 Ukrainian cites were identified as HIV infected after testing of eligible participants aged 15 to 24 years after random selection of venues. Using data from these youth, we calculated prevalence estimates of bridging behaviors and assessed predictors using logistic regression. Overall, two-thirds of HIV-infected street youth exhibited bridging behaviors; subgroups with high prevalences of bridging included females (78.3%) and those involved in transactional sex (84.2%). In multivariable analysis, inconsistent condom use with non-street youth was associated with being female (adjusted prevalence ratio [aPR], 1.2; 95% confidence interval [CI], 1.1-1.4), working (aPR, 1.2; 95% CI, 1.03-1.4), multiple partners (aPR, 1.4; 95% CI, 1.2-1.6), and "never" (aPR, 1.4; 95% CI, 1.1-1.6) or "sometimes" (aPR, 1.3; 95% CI, 1.02-1.8) versus "always" sleeping on the street. Needle sharing with non-street youth was associated with being male (aPR, 1.4; 95% CI, 1.02-2.0), orphaned (aPR, 2.3; 95% CI, 1.8-3.0), and 2 years or less living on the streets (aPR, 1.8; 95% CI, 1.5-2.1). Bridging behaviors between HIV-infected street youth and non-street youth are common. Addressing the comprehensive needs of street and other at-risk youth is a critical prevention strategy.
    Sexually transmitted diseases 09/2015; 42(9):513-20. DOI:10.1097/OLQ.0000000000000326 · 2.75 Impact Factor
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    ABSTRACT: To examine characteristics and causes of legal induced abortion-related deaths in the United States between 1998 and 2010. Abortion-related deaths were identified through the national Pregnancy Mortality Surveillance System with enhanced case-finding. We calculated the abortion mortality rate by race, maternal age, and gestational age and the distribution of causes of death by gestational age and procedure. During the period from 1998-2010, of approximately 16.1 million abortion procedures, 108 women died, for a mortality rate of 0.7 deaths per 100,000 procedures overall, 0.4 deaths for non-Hispanic white women, 0.5 deaths for Hispanic women, and 1.1 deaths for black women. The mortality rate increased with gestational age, from 0.3 to 6.7 deaths for procedures performed at 8 weeks or less and at 18 weeks or greater, respectively. A majority of abortion-related deaths at 13 weeks of gestation or less were associated with anesthesia complications and infection, whereas a majority of abortion-related deaths at more than 13 weeks of gestation were associated with infection and hemorrhage. In 20 of the 108 cases, the abortion was performed as a result of a severe medical condition where continuation of the pregnancy threatened the woman's life. Deaths associated with legal induced abortion continue to be rare events-less than 1 per 100,000 procedures. Primary prevention of unintended pregnancy, including those in women with serious pre-existing medical conditions, and increased access to abortion services at early gestational ages may help to further decrease abortion-related mortality in the United States. III.
    Obstetrics and Gynecology 08/2015; 126(2):258-265. DOI:10.1097/AOG.0000000000000945 · 4.37 Impact Factor
  • William M Callaghan · Andreea A Creanga · Denise J Jamieson
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    ABSTRACT: To estimate the burden of pregnancy-related mortality resulting from influenza A (H1N1)pdm09 virus infection during the 2009-2010 pandemic influenza season. Data from the Centers for Disease Control and Prevention's Pregnancy Mortality Surveillance System were used to identify women whose death during or shortly after pregnancy was attributed or likely attributed to the influenza A (H1N1)pdm09 virus from April 15, 2009, through June 30, 2010. We report the characteristics of these women and enumerate cases resulting in death as the pandemic began, peaked, and resolved. During the pandemic season, we identified 915 pregnancy-related deaths and 4,911,297 live births. Seventy-five (8.2%) women died as a result of confirmed influenza A (H1N1)pdm09 infection deaths and 34 (3.7%) women as a result of possible influenza A (H1N1)pdm09 infection deaths. The pregnancy-related mortality ratio for confirmed and possible (combined) influenza A (H1N1)pdm09 infection deaths was 2.2 per 100,000 live births. Most deaths occurred during the 2009 calendar year with the peak of the distribution of deaths over time occurring in October 2009. Twelve percent of pregnancy-related deaths were attributed to confirmed or possible influenza A (H1N1)pdm09 infection during the 2009-2010 pandemic season. Because prediction of pandemics is difficult, planning for prevention of influenza and care for those women affected are critical for preventing associated severe maternal morbidity and mortality. III.
    Obstetrics and Gynecology 07/2015; DOI:10.1097/AOG.0000000000000996 · 4.37 Impact Factor
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    ABSTRACT: Infants born to HIV-1 infected mothers in resource-limited areas where replacement feeding is unsafe and impractical are repeatedly exposed to HIV-1 throughout breastfeeding. Despite this, the majority of infants do not contract HIV-1 postnatally, even in absence of maternal antiretroviral therapy. This suggests that immune factors in breast milk of HIV-1-infected mothers help to limit vertical transmission. We compared the HIV-1 envelope-specific breast milk and plasma antibody responses of clade C HIV-1-infected postnatally transmitting and nontransmitting mothers in the control arm of the Malawi-based Breastfeeding Antiretrovirals and Nutrition study using multivariable logistic regression modeling. We found no association between milk or plasma neutralization activity, antibody-dependent cell-mediated cytotoxicity, or HIV-1 envelope-specific IgG responses and postnatal transmission risk. While the envelope-specific breast milk and plasma IgA responses also did not reach significance in predicting postnatal transmission risk in the primary model after correction for multiple comparisons, subsequent exploratory analysis using two distinct assay methodologies demonstrated that the magnitudes of breast milk total and secretory IgA responses against a consensus HIV-1 envelope gp140 (B.con env03) were associated with reduced postnatal transmission risk. These results suggest a protective role for mucosal HIV-1 envelope-specific IgA responses in the context of postnatal virus transmission. This finding supports further investigations into the mechanisms by which mucosal IgA reduces risk of HIV-1 transmission via breast milk, and into immune interventions aimed at enhancing this response. Infants born to HIV-1 infected mothers are repeatedly exposed to virus in breast milk. Remarkably, the transmission rate is low, suggesting that immune factors in breast milk of HIV-1-infected mothers help to limit transmission. We compared the antibody responses in plasma and breast milk of HIV-1 transmitting and nontransmitting mothers to identify responses that correlated with reduced risk of postnatal HIV-1 transmission. We found that neither plasma nor breast milk IgG antibody responses were associated with risk of HIV-1 transmission. In contrast, the magnitude of the breast milk IgA and secretory IgA response against HIV-1 envelope proteins was associated with reduced risk of postnatal HIV-1 transmission. The results of this study support further investigations of the mechanisms by which mucosal IgA may reduce the risk of HIV-1 transmission via breastfeeding, and development of strategies to enhance milk envelope-specific IgA responses to reduce mother-to-child HIV transmission and promote an HIV-free generation. Copyright © 2015, American Society for Microbiology. All Rights Reserved.
    Journal of Virology 07/2015; DOI:10.1128/JVI.01560-15 · 4.65 Impact Factor
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    ABSTRACT: To examine the associations between hormonal contraceptive use and measures of HIV disease progression and antiretroviral treatment (ART) effectiveness. A prospective cohort study of women with prevalent HIV infection in St Petersburg, Russia was conducted. After contraceptive counseling, participants chose to use combined oral contraceptives (COCs), depot-medroxyprogesterone acetate (DMPA), a copper intrauterine device (IUD), or male condoms for pregnancy prevention. Among participants not using ART at enrollment, we used multivariate Cox regression to assess the association between current (time-varying) contraceptive use and disease progression, measured by the primary composite outcome of CD4 decline to <350 cells/mm(3), ART initiation, or death. Among participants using ART at enrollment, we used linear mixed models to estimate the predicted mean CD4 change at select time points by contraceptive method. During a total of 5,233 months follow-up among participants not using ART with enrollment CD4 ≥350 cells/mm(3) (n=315), 97 experienced disease progression. Neither current use of COCs (adjusted hazard ratio [aHR] 0.91, 95% confidence interval [CI] 0.56-1.48) nor DMPA (aHR 1.28, 95% CI 0.71-2.31) was associated with a statistically significant increased risk for disease progression compared with use of non-hormonal methods (IUD or condoms). Among participants using ART at enrollment (n=77), we found no statistically significant differences in the predicted mean changes in CD4 cell count comparing current use of COCs (P=0.1) or DMPA (P=0.3) with non-hormonal methods. Hormonal contraceptive use was not significantly associated with measures of HIV disease progression or ART effectiveness among women with prevalent HIV infection. Hormonal contraceptive use was not significantly associated with measures of HIV disease progression or ART effectiveness among women with prevalent HIV infection. Copyright © 2015. Published by Elsevier Inc.
    Contraception 07/2015; DOI:10.1016/j.contraception.2015.07.003 · 2.93 Impact Factor
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    ABSTRACT: The objective of this study is to assess nevirapine (NVP) resistance in infants who became infected in the three arms of the Breastfeeding, Antiretrovirals and Nutrition (BAN) study: daily infant NVP prophylaxis, triple maternal antiretrovirals or no extra intervention for 28 weeks of breastfeeding. A prospective cohort study. The latest available plasma or dried blood spot specimen was tested from infants who became HIV-positive between 3 and 48 weeks of age. Population sequencing was used to detect mutations associated with reverse transcriptase inhibitor resistance. Sequences were obtained from 22 out of 25 transmissions in the infant-NVP arm, 23 out of 30 transmissions in the maternal-antiretroviral arm and 33 out of 38 transmissions in the control arm. HIV-infected infants in the infant-NVP arm were significantly more likely to have NVP resistance than infected infants in the other two arms of the trial, especially during breastfeeding through 28 weeks of age (56% in infant-NVP arm vs. 6% in maternal-antiretroviral arm and 11% in control arm, P = 0.004). There was a nonsignificant trend, suggesting that infants with NVP resistance tended to be infected earlier and exposed to NVP while infected for a greater duration than infants without resistance. Infants on NVP prophylaxis during breastfeeding are at a reduced risk of acquiring HIV, but are at an increased risk of NVP resistance if they do become infected. These findings point to the need for frequent HIV testing of infants while on NVP prophylaxis, and for the availability of antiretroviral regimens excluding NVP for treating infants who become infected while on such a prophylactic regimen.
    AIDS (London, England) 07/2015; DOI:10.1097/QAD.0000000000000814 · 6.56 Impact Factor
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    ABSTRACT: We explored how changes in insurance coverage contributed to recent nationwide decreases in newborn circumcision. Hospital discharge data from the 2000-2010 Nationwide Inpatient Sample were analyzed to assess trends in circumcision incidence among male newborn birth hospitalizations covered by private insurance or Medicaid. We examined the impact of insurance coverage on circumcision incidence. Overall, circumcision incidence decreased significantly from 61.3% in 2000 to 56.9% in 2010 in unadjusted analyses (P for trend = .008), but not in analyses adjusted for insurance status (P for trend = .46) and other predictors (P for trend = .55). Significant decreases were observed only in the South, where adjusted analyses revealed decreases in circumcision overall (P for trend = .007) and among hospitalizations with Medicaid (P for trend = .005) but not those with private insurance (P for trend = .13). Newborn male birth hospitalizations covered by Medicaid increased from 36.0% (2000) to 50.1% (2010; P for trend < .001), suggesting 390 000 additional circumcisions might have occurred nationwide had insurance coverage remained constant. Shifts in insurance coverage, particularly toward Medicaid, likely contributed to decreases in newborn circumcision nationwide and in the South. Barriers to the availability of circumcision should be revisited, particularly for families who desire but have less financial access to the procedure. (Am J Public Health. Published online ahead of print July 16, 2015: e1-e7. doi:10.2105/AJPH.2015.302629).
    American Journal of Public Health 07/2015; DOI:10.2105/AJPH.2015.302629 · 4.23 Impact Factor
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    ABSTRACT: Of 28 infants diagnosed with HIV infections after breastfeeding cessation in a large clinical trial (the Breastfeeding, Antiretrovirals and Nutrition Study), 19 (68%) were first detected more than 6 weeks (and up to 168 days) post reported weaning. The current recommendation for HIV testing of infants is at 6 weeks after weaning; these data argue for repeat HIV testing of infants up to 6 months after breastfeeding cessation, so that no infant HIV infections are missed.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.
    AIDS (London, England) 07/2015; DOI:10.1097/QAD.0000000000000796 · 6.56 Impact Factor
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    ABSTRACT: The objective of this study is to determine whether detection of HIV infection was delayed in infants exposed to antiretroviral prophylaxis to prevent HIV transmission during breastfeeding. The Breastfeeding, Antiretrovirals and Nutrition (BAN) study was a randomized trial of 2369 mother-infant pairs conducted from 2004 to 2010. In addition to an intrapartum regimen, all mother-infant pairs were randomly assigned to three antiretroviral intervention arms during 28 weeks of breastfeeding: no further antiretroviral prophylaxis (control arm); infant-daily nevirapine (nevirapine arm); and maternal zidovudine, lamivudine and either nevirapine, nelfinavir or lopinavir-ritonavir (maternal arm). After breastfeeding cessation counselling and stopping the antiretroviral interventions by 28 weeks, 28 infant HIV infections occurred. To determine whether these infections occurred during the breastfeeding and antiretroviral intervention phase but had delayed detection on the antiretroviral arms, we performed ultrasensitive (droplet digital PCR) HIV testing on infants with stored peripheral blood mononuclear cell (PBMC) specimens at 24 weeks (n = 9). Of the nine infants, all three on the infant nevirapine arm had detectable HIV DNA at 24 weeks, compared with two of four on the maternal antiretroviral arm and one of two on the control arm. For infants with detectable HIV at 24 weeks, the median delay in detection between the ultrasensitive and standard assays was 18.3 weeks for the nevirapine arm, 15.4 weeks for the maternal arm and 9.4 weeks for the control arm. The prolonged inability to detect HIV with standard assays in the context of postnatal antiretroviral prophylaxis suggests that early antiretrovirals may restrict HIV replication sufficiently to lead to missed diagnosis among infected infants. Therefore, repeat virologic testing is warranted beyond the WHO-recommended point of testing at 6 weeks after breastfeeding cessation.
    AIDS (London, England) 07/2015; DOI:10.1097/QAD.0000000000000794 · 6.56 Impact Factor
  • Lee Warner · Denise J Jamieson · Wanda D Barfield
    Journal of Women's Health 07/2015; 24(7). DOI:10.1089/jwh.2015.5355 · 1.90 Impact Factor
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    ABSTRACT: Background: Little is known about the influence of antiretroviral therapy with or without micronutrient supplementation on the micronutrient concentrations of HIV-infected lactating women in resource-constrained settings. Objective: We examined associations of highly active antiretroviral therapy (HAART) and lipid-based nutrient supplements (LNS) with concentrations of selected micronutrients in HIV-infected Malawian women at 24 wk postpartum. Methods: Plasma micronutrient concentrations were measured in a subsample (n = 690) of Breastfeeding, Antiretrovirals, and Nutrition (BAN) study participants who were randomly assigned at delivery to receive HAART, LNS, HAART+LNS, or no HAART/no LNS (control). HAART consisted of protease inhibitor–based triple therapy. LNS (140 g/d) met energy and micronutrient requirements of lactation. Multivariable linear regression tested the association of HAART and LNS, plus their interaction, with micronutrient concentrations, controlling for season, baseline viral load, and baseline CD4 count. Results: We found significant HAART by LNS interactions for folate (P = 0.051), vitamin B-12 (P < 0.001), and transferrin receptors (TfRs) (P = 0.085). HAART was associated with lower folate (with LNS: 227%, P < 0.001; without LNS: 212%, P = 0.040) and higher TfR concentrations (with LNS: +14%, P = 0.004; without LNS: +28%, P < 0.001), indicating iron deficiency. LNS increased folate (with HAART: +17%, P = 0.037; without HAART: +39%, P < 0.001) and decreased TfR concentrations (with HAART only: 212%, P = 0.023). HAART was associated with lower vitamin B-12 concentrations only when LNS was present (218%, P = 0.001), whereas LNS increased vitamin B-12 only when no HAART was present (+27%, P < 0.001). HAART, but not LNS, was associated with higher retinol-binding protein (RBP; +10%, P = 0.007). We detected no association of HAART or LNS with selenium, ferritin, or hemoglobin. Conclusion: The association of HAART with lower folate, iron deficiency, and higher RBP plus the attenuation of LNS effects on folate and vitamin B-12 when combined with HAART has implications for the health of lactating HIV-infected women taking HAART in prevention of mother-to-child transmission programs. This trial was registered at as NCT00164736.
    Journal of Nutrition 07/2015; 145:1950. DOI:10.3945/jn.115.212290 · 4.23 Impact Factor
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    ABSTRACT: To evaluate whether initiation of a contraceptive implant, a method of long-acting reversible contraception (LARC), reduces condom use, as measured by a biomarker of recent semen exposure (prostate-specific antigen (PSA)). We conducted a randomized controlled clinical trial in which 414 Jamaican women at high risk for sexually transmitted infections (STIs) attending family planning clinics received the contraceptive implant at baseline ("immediate" insertion arm, N=208) or at the end ("delayed" insertion arm, N=206) of a three-month study period. Participants were tested for PSA at baseline and two follow-up study visits, and asked about their sexual activity and condom use. At baseline, 24.9% of women tested positive for PSA. At both follow-up visits, the prevalence of PSA detection did not significantly differ between the immediate versus delayed insertion arm (1-month: 26.1% vs. 20.2%; prevalence ratio (PR) = 1.3; (95% confidence interval (CI) = 0.9-1.9); 3-month: 25.6% vs. 23.1%; PR= 1.1; (95% CI = 0.8-1.6)). The change in PSA positivity over the 3 study visits was not significantly larger in the immediate arm compared to the delayed arm (1-sided p-value=0.15). Contraceptive implants can be successfully introduced into a population at high risk of unintended pregnancy and STIs without a biologically detectable difference in unprotected sex in the short-term. This information strengthens the evidence to support promotion of implants in such populations and can help refine counseling for promoting and maintaining use of condoms among women who choose to use implants. Sex unprotected by a condom was not higher over 3 months in women receiving a contraceptive implant, compared with those not receiving the implant. Copyright © 2015. Published by Elsevier Inc.
    Contraception 06/2015; DOI:10.1016/j.contraception.2015.06.009 · 2.93 Impact Factor
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    ABSTRACT: To use linked assisted reproductive technology (ART) surveillance and birth certificate data to compare ET practices and perinatal outcomes for a state with a comprehensive mandate requiring coverage of IVF services versus states without a mandate. Retrospective cohort study. Not applicable. Live-birth deliveries ascertained from linked 2007-2009 National ART Surveillance System and birth certificate data for a state with an insurance mandate (Massachusetts) and two states without a mandate (Florida and Michigan). None. Number of embryos transferred, multiple births, low birth weight, preterm delivery. Of the 230,038 deliveries in the mandate state and 1,026,804 deliveries in the nonmandate states, 6,651 (2.9%) and 8,417 (0.8%), respectively, were conceived by ART. Transfer of three or more embryos was more common in nonmandate states, although the effect was attenuated for women 35 years or older (33.6% vs. 39.7%; adjusted relative risk [RR], 1.46; 95% confidence interval [CI], 1.17-1.81) versus women younger than 35 (7.0% vs. 26.9%; adjusted RR, 4.18; 95% CI, 2.74-6.36). Lack of an insurance mandate was positively associated with triplet/higher order deliveries (1.0% vs. 2.3%; adjusted RR, 2.44; 95% CI, 1.81-3.28), preterm delivery (22.6% vs. 30.7%; adjusted RR, 1.31; 95% CI, 1.20-1.42), and low birth weight (22.3% vs. 29.5%; adjusted RR, 1.28; 95% CI, 1.17-1.40). Compared with nonmandate states, the mandate state had higher overall rates of ART use. Among ART births, lack of an infertility insurance mandate was associated with increased risk for adverse perinatal outcomes. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
    Fertility and sterility 06/2015; DOI:10.1016/j.fertnstert.2015.05.015 · 4.59 Impact Factor
  • A.P. Kourtis · J.S. Read · D.J. Jamieson
    Obstetric Anesthesia Digest 06/2015; 35(2):67-68. DOI:10.1097/01.aoa.0000463812.15481.00
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    ABSTRACT: Knowledge of state-specific infertility is limited. The objectives of this study were to explore state-specific estimates of lifetime prevalence of having ever experienced infertility, sought treatment for infertility, types of treatments sought, and treatment outcomes. Male and female adult residents aged 18-50 years from three states involved in the States Monitoring Assisted Reproductive Technology Collaborative (Florida, Massachusetts, and Michigan) were asked state-added infertility questions as part of the 2012 Behavioral Risk Factor Surveillance System, a state-based, health-related telephone survey. Analysis involved estimation of lifetime prevalence of infertility. The estimated lifetime prevalence of infertility among 1,285 adults in Florida, 1,302 in Massachusetts, and 3,360 in Michigan was 9.7%, 6.0%, and 4.2%, respectively. Among 736 adults in Florida, 1,246 in Massachusetts, and 2,742 in Michigan that have ever tried to get pregnant, the lifetime infertility prevalence was 25.3% in Florida, 9.9% in Massachusetts, and 5.8% in Michigan. Among those with a history of infertility, over half sought treatment (60.7% in Florida, 70.6% in Massachusetts, and 51.6% in Michigan), the most common being non-assisted reproductive technology fertility treatments (61.3% in Florida, 66.0% in Massachusetts, and 75.9% in Michigan). State-specific estimates of lifetime infertility prevalence in Florida, Massachusetts, and Michigan varied. Variations across states are difficult to interpret, as they likely reflect both true differences in prevalence and differences in data collection questionnaires. State-specific estimates are needed for the prevention, detection, and management of infertility, but estimates should be based on a common set of questions appropriate for these goals.
    Journal of Women's Health 05/2015; 24(7):150529124050006. DOI:10.1089/jwh.2014.5102 · 1.90 Impact Factor
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    ABSTRACT: Previous studies report associations between conception with assisted reproductive technology (ART) and autism. Whether these associations reflect an ascertainment or biologic effect is undetermined. We assessed diagnosis age and initial autism symptom severity among >30,000 children with autism from a linkage study of California Department of Developmental Services records, birth records, and the National ART Surveillance System. Median diagnosis age and symptom severity levels were significantly lower for ART-conceived than non-ART-conceived children. After adjustment for differences in the socio-demographic profiles of the two groups, the diagnosis age differentials were greatly attenuated and there were no differences in autism symptomatology. Thus, ascertainment issues related to SES, not ART per se, are likely the driving influence of the differences we initially observed.
    Journal of Autism and Developmental Disorders 05/2015; DOI:10.1007/s10803-015-2462-1 · 3.06 Impact Factor
  • Human Reproduction 05/2015; 30(7). DOI:10.1093/humrep/dev107 · 4.59 Impact Factor
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    ABSTRACT: Approximately half of in vitro fertilization (IVF) cycles are double embryo transfers, often resulting in multiple gestations, which increases maternal and neonatal morbidity. We assessed trends and predictors of "perfect implantation" in double embryo transfer (both embryos implant) to further identify candidates for elective single embryo transfer. We analyzed 1,793,067 fresh, autologous cycles reported to the National Assisted Reproductive Technology Surveillance System from 2000 to 2012. We calculated trends of perfect implantation in double embryo transfer, identified as cycles with number of hearts on 6-week ultrasonography equal to or greater than number of embryos transferred. Adjusted risk ratios (RRs) for perfect implantation were estimated using log binomial models, adjusted for demographic and clinical characteristics, after stratifying by prognosis. Favorable prognosis was defined as first-time IVF with supernumerary embryo(s). Average prognosis was defined as first-time IVF without supernumerary embryos, prior unsuccessful IVF with supernumerary embryo(s), prior IVF with previous birth(s) resulting from IVF, or natural conception. During 2000-2012, rates of perfect implantation with double embryo transfer increased from 13.4% to 18.1% (P for trend <.001). Perfect implantation was positively associated with blastocyst (compared with cleavage) transfer in favorable (adjusted RR 1.58 [1.51-1.65]) and average (adjusted RR 1.67 [1.60-1.75]) prognosis groups and negatively associated with age older than 35 years in both prognosis groups. For average prognosis patients, perfect implantation was associated with retrieving more than 10 oocytes (adjusted RR 1.22 [1.18-1.24]). Regardless of prognosis, patients who are younger than 35 years with blastocyst-stage embryos, and average prognosis patients from whom more than 10 oocytes are retrieved, may be good candidates for elective single embryo transfer, which would reduce multiple gestations and associated complications.
    Obstetrics and Gynecology 05/2015; 125 Suppl 1:54S. DOI:10.1097/01.AOG.0000463697.33456.a3 · 4.37 Impact Factor
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    ABSTRACT: To estimate the maternal and fetal risks of smallpox vaccination during pregnancy. MEDLINE, Web of Science, EMBASE, Global Health,, and CINHAL from inception to September 2014. We included published articles containing primary data regarding smallpox vaccination during pregnancy that reported maternal or fetal outcomes (spontaneous abortion, congenital defect, stillbirth, preterm birth, or fetal vaccinia). The primary search yielded 887 articles. After hand-searching, 37 articles were included: 18 articles with fetal outcome data and 19 case reports of fetal vaccinia. Outcomes of smallpox vaccination in 12,201 pregnant women were included. Smallpox vaccination was not associated with an increased risk of spontaneous abortion (pooled relative risk [RR] 1.03, confidence interval [CI] 0.76-1.41), stillbirth (pooled RR 1.03, CI 0.75-1.40), or preterm birth (pooled RR 0.84, CI 0.62-1.15). When vaccination in any trimester was considered, smallpox vaccination was not associated with an increased risk of congenital defects (pooled RR 1.25, CI 0.99-1.56); however, first-trimester exposure was associated with an increased risk of congenital defects (2.4% compared with 1.5%, pooled RR 1.34, CI 1.02-1.77). No cases of fetal vaccinia were reported in the studies examining fetal outcomes; 21 cases of fetal vaccinia were identified in the literature, of which three neonates survived. The overall risk associated with maternal smallpox vaccination appears low. No association between smallpox vaccination and spontaneous abortion, preterm birth, or stillbirth was identified. First-trimester vaccination was associated with a small increase in congenital defects, but the effect size was small and based on limited data. Fetal vaccinia appears to be a rare consequence of maternal smallpox vaccination but is associated with a high rate of fetal loss.
    Obstetrics and Gynecology 05/2015; 125(6):1. DOI:10.1097/AOG.0000000000000857 · 4.37 Impact Factor
  • Tara C Jatlaoui · Sarah Cordes · Carrie Cwiak · Peggy Goedken · Denise J Jamieson
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    ABSTRACT: More than 100,000 bariatric procedures are performed yearly in the United States. Women account for the majority of cases. Guidelines cosponsored by the American Association of Clinical Endocrinologists, The Obesity Society, and the American Society of Metabolic and Bariatric Surgery recommend women avoid pregnancy preoperatively and 12-18 months after surgery. This survey aims to identify the family planning knowledge, attitudes, and practices of bariatric providers in the perioperative period. We developed a quantitative survey from qualitative data of semistructured health care provider interviews and mailed it to American Society of Metabolic and Bariatric Surgery members. We collected data from a convenience sample of the first 275 responders to perform a descriptive analysis. A total of 272 participants consented to the study. More than 70% of respondents recommend women avoid pregnancy for 12-24 months after bariatric procedures. The majority considers the most effective contraceptive methods to be safe for women after gastric bypass; however, the minority (35.3%) provides contraceptive services or referrals. Although most (73.0%) consider female reproductive health discussions very important, the majority (70.4%) never or almost never feels comfortable with these discussions. Respondents most frequently prefer the patient's own gynecologist (80.9%) and the bariatric surgeon (71.0%) discuss contraception. Bariatric providers consider reproductive health very important; however, most are not comfortable having these conversations and would prefer patients see their gynecologists to discuss contraception. This is an opportunity for gynecologists to educate themselves and colleagues about contraception recommendations after bariatric surgery and collaborate with bariatric centers in their area to meet the needs of these patients.
    Obstetrics and Gynecology 05/2015; 125 Suppl 1:67S-68S. DOI:10.1097/01.AOG.0000463109.32807.7b · 4.37 Impact Factor

Publication Stats

7k Citations
2,250.60 Total Impact Points


  • 2015
    • Johns Hopkins Bloomberg School of Public Health
      Baltimore, Maryland, United States
  • 2001–2015
    • Emory University
      • • Department of Gynecology and Obstetrics
      • • Department of Pediatrics
      Atlanta, Georgia, United States
  • 2000–2015
    • Centers for Disease Control and Prevention
      • • Division of Reproductive Health
      • • National Center for Emerging and Zoonotic Infectious Diseases
      • • Epidemiology and Analysis Program Office
      Атланта, Michigan, United States
  • 2005–2013
    • University of North Carolina at Chapel Hill
      • • Department of Medicine
      • • Department of Epidemiology
      North Carolina, United States
  • 2012
    • University of Texas Southwestern Medical Center
      Dallas, Texas, United States
  • 2011
    • California Department of Public Health
      Richmond, California, United States
  • 2010
    • University of Texas Medical Branch at Galveston
      • Department of Obstetrics and Gynecology
      Galveston, TX, United States
    • New York City Department of Health and Mental Hygiene
      לאנג איילענד סיטי, New York, United States
    • Kenya Medical Research Institute
      • Centre for Microbiology Research (CMR)
      Nairobi, Nairobi Province, Kenya
  • 2009
    • Ibis Reproductive Health
      Cambridge, Massachusetts, United States
  • 2008
    • Fred Hutchinson Cancer Research Center
      Seattle, Washington, United States
    • Kenya Centers for Disease Control and Prevention
      Winam, Kisumu, Kenya
  • 2006
    • Eastern Virginia Medical School
      • Division of Obstetrics and Gynecology
      Norfolk, Virginia, United States
    • Brown University
      Providence, Rhode Island, United States
    • Johns Hopkins Medicine
      • Department of Gynecology & Obstetrics
      Baltimore, MD, United States
  • 2004
    • University of Alabama at Birmingham
      • School of Public Health
      Birmingham, AL, United States
    • Princeton University
      • Office of Population Research
      Princeton, New Jersey, United States
  • 2002
    • Johns Hopkins University
      Baltimore, Maryland, United States