American Journal of Perinatology (AM J PERINAT)

Publisher: Georg Thieme Verlag

Journal description

The American Journal of Perinatology is the definitive forum for today's specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine. Each issue maintains a critical balance of original, peer-reviewed articles on all aspects of perinatal and critical care management, including maternal risk factors, antenatal diagnosis and intervention, abnormalities and complications of pregnancy, labor and delivery, and congenital and acquired diseases and disorders in newborns.

Current impact factor: 1.91

Impact Factor Rankings

2016 Impact Factor Available summer 2017
2014 / 2015 Impact Factor 1.905
2013 Impact Factor 1.597
2012 Impact Factor 1.574
2011 Impact Factor 1.316
2010 Impact Factor 1.118
2009 Impact Factor 1.126
2008 Impact Factor 1.158
2007 Impact Factor 0.829
2006 Impact Factor 0.72
2005 Impact Factor 0.685
2004 Impact Factor 0.664
2003 Impact Factor 0.859
2002 Impact Factor 0.603
2001 Impact Factor 0.497
2000 Impact Factor 0.616
1999 Impact Factor 0.71
1998 Impact Factor 0.725
1997 Impact Factor 0.457
1996 Impact Factor 0.45
1995 Impact Factor 0.458
1994 Impact Factor 0.449
1993 Impact Factor 0.424
1992 Impact Factor 0.442

Impact factor over time

Impact factor
Year

Additional details

5-year impact 1.59
Cited half-life 6.40
Immediacy index 0.35
Eigenfactor 0.01
Article influence 0.60
Website American Journal of Perinatology website
Other titles American journal of perinatology
ISSN 0735-1631
OCLC 8875325
Material type Periodical, Internet resource
Document type Journal / Magazine / Newspaper, Internet Resource

Publisher details

Georg Thieme Verlag

  • Pre-print
    • Author cannot archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Author's post-print or Publisher's version/PDF on author's personal website immediately
    • Author's post-print in Institutional Repository and PubMed Central after 12 months embargo
    • Publisher's version/PDF can be used on author's personal website only
    • Publisher copyright and source must be acknowledged
    • Link to Publisher version (www.thieme-connect.com) must be included if article has been published online
    • Publisher last contacted on 31/03/2015
    • 'Georg Thieme Verlag' is an imprint of 'Thieme Publishing'
  • Classification
    blue

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective Central catheters (CCs) are routinely used in the neonatal intensive care unit (NICU). Ultrasonography (US) has been advocated as a procedural adjunct for CC placement to better localize catheter tip position (CTP), minimize radiation exposure, and decrease procedural burden. This review evaluates the clinical benefit, practical considerations for implementation, and limitations of US for CC placement in the NICU. Study Design A literature search was conducted using the Pubmed and Ovid databases with search terms regarding the ultrasound modality relating to CCs in infants and neonates. Results Five studies regarding US-guided CC insertions and seven studies describing postinsertion US were determined pertinent to this review's objective and discussed. Conclusions At this time, the literature seems insufficient to recommend US as a replacement for radiography for CTP confirmation; however, US-guidance during insertion followed by radiographic verification can decrease line manipulations and repeat radiographs. Postinsertion assessments by US can better determine the CTP and guide repositioning decisions, reducing the likelihood of malposition and potential complications, and may be more practical for many NICUs. However, it is unclear how much training and experience is necessary to deem an individual competent for reliable and clinically beneficial bedside US evaluations.
    No preview · Article · Dec 2015 · American Journal of Perinatology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective Elevated homocysteine (HC) levels and/or shortened telomere length (TL) are associated with adverse medical conditions. Our objective is to investigate the relationship between HC and TL in cord blood leukocytes of newborns. Study Design This is a nested study from a prospective cohort from 2011 to 2012 in pregnant women admitted for delivery at a university-affiliated hospital. Cord blood was collected at delivery and genomic DNA was analyzed using quantitative PCR. The telomere-to-single copy gene ratio method was employed to quantify TL. Newborn HC levels were measured. generalized linear regression modeling (GLM) and bootstrap statistical analyses were performed. Results Seventy-seven maternal-fetal dyads with a mean gestational age of 39 weeks were included. The distribution of the coefficient of homocysteine showed most values greater than zero demonstrating that homocysteine had a positive relationship with TL. In 915 of 10,000 (9.15%) iterations, the p-value was < 0.05 demonstrating a positive effect. Conclusion Increasing newborn concentrations of HC are not associated with decreasing TL. Larger, prospective studies are needed to confirm these findings and long-term implications.
    No preview · Article · Dec 2015 · American Journal of Perinatology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective The objective of this study was to quantify the influence of various patient characteristics on early smoking cessation to better identify target populations for focused counseling and interventions. Study Design This study was a population-based retrospective cohort study of 1,003,532 Ohio live births more than 7 years (2006-2012). Women who quit smoking in the first trimester were compared with those who smoked throughout pregnancy. Logistic regression estimated the strength of association between patient factors and smoking cessation. Results The factors most strongly associated with early smoking cessation were non-white race and Hispanic ethnicity, at least some college education, early prenatal care, marriage, and breastfeeding. Numerous factors commonly associated with adverse perinatal outcomes were found to have a negative association with smoking cessation: low educational attainment, limited or late prenatal care, prior preterm birth, age < 20 years, age ≥ 35 years, and indicators of low SES. In addition, the heaviest smokers (≥ 20 cigarette/day) were least likely to quit (adjusted relative risk [RR], 0.35; 95% confidence interval 0.34, 0.36). Conclusion Early prenatal care and initiation of breastfeeding before discharge from the hospital are associated with increased RR of quitting early in pregnancy by 52 and 99%, respectively. Public health initiatives and interventions should focus on the importance of early access to prenatal care and education regarding smoking cessation for these particularly vulnerable groups of women who are at inherently high risk of pregnancy complications.
    No preview · Article · Dec 2015 · American Journal of Perinatology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective The objective of this study was to evaluate cesarean outcomes, stratified by abdominal incision type, in women with class III obesity. Study Design We performed a retrospective cohort study of patients with class III obesity undergoing cesarean at our institution from 2010 to 2013 with singletons ≥ 34 weeks. Outcomes were compared between patients with transverse subpannicular and vertical abdominal incisions. The primary outcome was a wound composite (cellulitis, abscess, hematoma, seroma, or dehiscence). Other outcomes included transfusion, vertical hysterotomy, 5-minute Apgar < 7, and umbilical artery pH < 7.10. Results Of 423 patients, 364 had subpannicular transverse, 57 had vertical, and 2 had periumbilical transverse incisions (not analyzed). Although vertical incisions were associated with more wound complications (26.3 vs. 14.8%; p = 0.03), the difference became null after adjustment (adjusted odds ratios [aOR], 1.7; 95% confidence interval [CI], 0.7, 4.1). Vertical incisions were associated with increased risk of vertical hysterotomy (aOR 4.8; 95% CI, 2.2, 10.4), decreased risk of 5-minute Apgar < 7 (aOR, 0.06; 95% CI, 0.004, 0.9), and not statistically significantly associated with transfusion (aOR, 4.2; 95% CI, 0.9, 19.0) or umbilical artery pH < 7.1 (aOR, 0.42; 95% CI, 0.11, 1.7). Conclusions In women with class III obesity cesarean delivery via vertical abdominal incisions is associated with more maternal but less immediate neonatal complications.
    No preview · Article · Dec 2015 · American Journal of Perinatology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To examine whether time of delivery influences the risk of neonatal morbidity among women with singleton pregnancies. Study Design Secondary analysis of data from the Maternal Fetal Medicine Units Network Factor V Leiden Mutation study. We categorized time of delivery as day (07:00-16:59), evening (17:00-23:59), and overnight (midnight-06:59). Severe neonatal morbidity was defined by at least one of the following: respiratory distress syndrome, transient tachypnea of the newborn, sepsis, seizures, neonatal intensive care admission, or a 5-minute APGAR ≤3. We calculated frequencies of severe neonatal morbidity by time of delivery. Multivariate analysis was performed to determine whether time of delivery was independently associated with severe neonatal morbidity. Results Among 4,087 women, 1,917 (46.9%) delivered during the day, 1,140 (27.9%) delivered in the evening, and 1,030 (25.2%) delivered overnight. We observed no significant differences in the rates of neonatal morbidity between delivery time periods (day: 12.3%; evening: 12.8%; overnight: 12.6%; p = 0.9). No significant association was observed between time of delivery and neonatal morbidity after adjustment for maternal, obstetric, and peripartum factors. Conclusion Our findings suggest that time of delivery is not associated with severe neonatal morbidity.
    No preview · Article · Nov 2015 · American Journal of Perinatology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective This study aims to compare how national guidelines approach the management of obesity in reproductive age women. Study Design We conducted a search for national guidelines in the English language on the topic of obesity surrounding the time of a pregnancy. We identified six primary source documents and several secondary source documents from five countries. Each document was then reviewed to identify: (1) statements acknowledging increased health risks related to obesity and reproductive outcomes, (2) recommendations for the management of obesity before, during, or after pregnancy. Results All guidelines cited an increased risk for miscarriage, birth defects, gestational diabetes, hypertension, fetal growth abnormalities, cesarean sections, difficulty with anesthesia, postpartum hemorrhage, and obesity in offspring. Counseling on the risks of obesity and weight loss before pregnancy were universal recommendations. There were substantial differences in the recommendations pertaining to gestational weight gain goals, nutrient and vitamin supplements, screening for gestational diabetes, and thromboprophylaxis among the guidelines. Conclusion Stronger evidence from randomized trials is needed to devise consistent recommendations for obese reproductive age women. This research may also assist clinicians in overcoming one of the many obstacles they encounter when providing care to obese women.
    No preview · Article · Nov 2015 · American Journal of Perinatology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To examine the impact of a rooming-in program for infants at risk of neonatal abstinence syndrome (NAS) on the need for pharmacologic treatment and length of hospitalization. Study Design Our hospital implemented a rooming-in program for newborns at risk of NAS in June 2013. Previously, standard care was to admit these infants to the neonatal intensive care unit. Charts were reviewed to abstract data on at-risk infants born in the 13-month periods prior and subsequent to implementation of rooming-in (n = 24 and n = 20, respectively) and the groups were compared with the outcomes of interest. Result Rooming-in was associated with a reduced need for pharmacologic treatment and shorter length of stay. Conclusion These findings add to an emerging body of evidence on the health care resource utilization benefits associated with rooming-in for infants at risk of NAS. Future studies should evaluate a broader range of outcomes for this model of care.
    No preview · Article · Nov 2015 · American Journal of Perinatology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To understand the variation in Labor and Delivery triage and delivery volumes in an urban tertiary care center and the types of visits associated with this variability. Study Design Retrospective descriptive study from the electronic medical record of 7,678 women presenting to Labor and Delivery Triage. Results Overall, there was a sixfold variation in Labor and Delivery triage visits (mean: 21, SD: 5.7, range: 6-36), with the least and most busy days having 28.6% and 171.4% of mean volume. Volumes varied 3.8- to 17-fold on weekdays and 4- to 11-fold on weekends. Significant variation in volume and triage evaluation type also occurred through the day, with admission for delivery as the predominate reason between 2 to 10 am, and outpatient assessments predominating thereafter (p < 0.001). Conclusion There is substantial variation in daily and hourly Labor and Delivery triage activity. If not planned for, this variability could strain available resources and negatively impact care. Further study of the effect of surges in Labor and Delivery triage and delivery volumes on pregnancy outcomes and of optimal methods to improve surge capacity in the Labor and Delivery setting are needed.
    No preview · Article · Nov 2015 · American Journal of Perinatology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective The aim of the study is to examine the impact of exposure to maternal cigarette smoking on neonatal outcomes of very preterm infants. Study Design A retrospective cohort study examined preterm infants (< 33 weeks gestational age) admitted to the Canadian Neonatal Network centers between 2003 and 2011. Mortality and major morbidities (bronchopulmonary dysplasia, severe intraventricular hemorrhage, necrotizing enterocolitis, and retinopathy) were compared between infants exposed and unexposed to maternal smoking during pregnancy after adjusting for confounders. Results Among 29,051 study infants, 4,053 (14%) were exposed to maternal smoking during pregnancy. Multivariable analysis revealed higher odds of grade 3 or 4 intraventricular hemorrhage or periventricular leukomalacia (adjusted odds ratio [OR]: 1.21, 95% confidence interval [CI]: 1.04-1.41) and bronchopulmonary dysplasia (adjusted OR: 1.16, 95% CI: 1.02-1.33) in the smoking group, while mortality, severe retinopathy, and necrotizing enterocolitis were not significantly different. Conclusion Maternal smoking during pregnancy is associated with severe neurological injury and bronchopulmonary dysplasia in preterm infants.
    No preview · Article · Mar 2015 · American Journal of Perinatology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The aim of this article is to determine the risk of maternal chorioamnionitis and neonatal morbidity in women with preterm premature rupture of membranes (PPROM) exposed to one corticosteroid course versus a single repeat corticosteroid steroid course. Study design: Secondary analysis of a cohort of women with singleton pregnancies and PPROM. The primary outcome was a clinical diagnosis of maternal chorioamnionitis. Using multivariate logistic regression, we controlled for maternal age, race, body mass index, diabetes, gestational age at membrane rupture, preterm labor, and antibiotic administration. Neonatal morbidities were compared between groups controlling for gestational age at delivery. Results: Of 1,652 women with PPROM, 1,507 women received one corticosteroid course and 145 women received a repeat corticosteroid course. The incidence of chorioamnionitis was similar between groups (single course = 12.3% vs. repeat course = 11.0%; p = 0.8). Women receiving a repeat corticosteroid course were not at increased risk of chorioamnionitis (adjusted odds ratio, 1.28; 95% confidence interval, 0.69-2.14). A repeat course of steroids was not associated with an increased risk of any neonatal morbidity. Conclusion: Compared with a single steroid course, our findings suggest that the risk of maternal chorioamnionitis or neonatal morbidity may not be increased for women with PPROM receiving a repeat corticosteroid course.
    No preview · Article · Dec 2014 · American Journal of Perinatology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The aim of the article is to determine whether maternal body mass index (BMI) influences the beneficial effects of diabetes treatment in women with gestational diabetes mellitus (GDM). Study design: Secondary analysis of a multicenter randomized treatment trial of women with GDM. Outcomes of interest were elevated umbilical cord c-peptide levels (> 90th percentile 1.77 ng/mL), large for gestational age (LGA) birth weight (> 90th percentile), and neonatal fat mass (g). Women were grouped into five BMI categories adapted from the World Health Organization International Classification of normal, overweight, and obese adults. Outcomes were analyzed according to treatment group assignment. Results: A total of 958 women were enrolled (485 treated and 473 controls). Maternal BMI at enrollment was not related to umbilical cord c-peptide levels. However, treatment of women in the overweight, Class I, and Class II obese categories was associated with a reduction in both LGA birth weight and neonatal fat mass. Neither measure of excess fetal growth was reduced with treatment in normal weight (BMI < 25 kg/m(2)) or Class III (BMI ≥ 40 kg/m(2)) obese women. Conclusion: There was a beneficial effect of treatment on fetal growth in women with mild GDM who were overweight or Class I and Class II obese. These effects were not apparent for normal weight and very obese women.
    No preview · Article · Dec 2014 · American Journal of Perinatology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The aim of this study is to compare fecal calprotectin (FC) levels as measured by a rapid FC assay with those measured by enzyme-linked immunosorbent assay (ELISA) from concurrent stool samples. We also attempted to demonstrate a correlation between elevated rapid assay FC levels and the presence of necrotizing enterocolitis (NEC) and to define a cutoff FC value which could serve as a basis for diagnosing NEC in the future. Study design: Stool samples were collected for FC analysis at 1 and 3 weeks postnatally and whenever there was clinical suspicion of NEC. Results: Rapid assay FC levels were elevated with NEC (3,000 µg/g stool [2075,7875] vs. without (195 µg/g stool [110,440] p < 0.001); and were well correlated with ELISA FC levels (r(2) = 0.89). Conclusion: We present the first data showing that rapid assay FC levels are potentially useful in the bedside diagnosis of NEC.
    No preview · Article · Aug 2014 · American Journal of Perinatology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Over 70% of women with gestational diabetes mellitus (GDM) will develop diabetes mellitus (DM), but only 30% follow through with the recommended postpartum oral glucose tolerance testing (OGTT). HbA1c is approved to diagnose DM, and combined with a fasting plasma glucose it can identify 93% of patients with dysglycemia. We tested the hypothesis that a single blood draw to assess for dysglycemia at the postpartum visit could improve testing rates compared with those required to obtain an OGTT at an outside laboratory. Study design: Prospective cohort study of all women with GDM who delivered between July 2010 and December 2011. When insurance status required testing at an outside laboratory an OGTT was ordered, when insurance allowed testing at our center a random sugar and HbA1c were drawn at the postpartum visit (SUGAR Protocol). Results: Of the 40 women, 36 attended a postpartum visit. In the SUGAR arm, 19 of 19 (100%) were tested versus 9 of 17 (53%) in the OGTT arm; relative risk of testing was 1.9 (95% confidence interval, 1.2-3.0). 36% were glucose intolerant. Conclusion: This pilot study found that an in-office testing model doubled the rate of postpartum testing in this clinic population, and was reasonably sensitive at detecting dysglycemia.
    No preview · Article · Aug 2014 · American Journal of Perinatology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The aim of this study is to examine the hypothesis that prolonged rupture of membranes (PROM) is associated with increased cord blood erythropoietin (EPO) concentrations, proportional to the duration of ruptured membranes. Study design: This study is a prospective, cross-sectional, observational (noninterventional) cohort study of mother-infant pairs. Criteria for inclusion were as follows: active labor with or without ruptured membranes and vaginally delivered neonates. Excluded were infants with major factors known to be associated with a potential increase in fetal erythropoiesis. Results: A total of 40 mother-infant pairs were recruited. EPO was not influenced by duration of ruptured membranes and significantly correlated only with maternal body mass index. Conclusion: Cord blood concentrations of EPO do not appear to be significantly affected by the duration of ruptured membranes. We speculate that erythropoiesis is upregulated in PROM by mechanisms that involve the production of cytokines and are not EPO driven.
    No preview · Article · Jul 2014 · American Journal of Perinatology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Until recently, all twin pregnancies were treated in a similar fashion. Ultrasounds were undertaken every 3 to 4 weeks to assess serial fetal growth. Monochorionic (MC) twins comprise only 20% of all twin pregnancies yet unique complications such as twin-twin transfusion syndrome (TTTS), twin reversed arterial perfusion sequence, twin anemia-polycythemia sequence, and selective intrauterine growth restriction can occur. In addition, the in utero death of one twin of a MC pair poses significant risks for death or severe neurologic morbidity in the cotwin. With the exception of discordant growth, these complications are not seen in dichorionic twinning due to the lack of placental anastomoses. In the last two decades, new technologies such as laser photocoagulation for the treatment of severe TTTS and radiofrequency ablation and bipolar cautery for selective reduction have markedly improved outcomes for many of the complications of MC twins. Thus, stratification of "low-risk" twinning (dichorionic twins) versus "high-risk" twinning (MC twins) is paramount to improved outcomes. This can be easily and accurately accomplished with first trimester ultrasound by evaluating the interface of the intertwin membrane with the placenta. This should now be the standard of care for all multiple gestations.
    No preview · Article · Jul 2014 · American Journal of Perinatology
  • [Show abstract] [Hide abstract]
    ABSTRACT: The underlying etiology of twin-twin transfusion syndrome (TTTS) is unknown, but our growing understanding of the cardiovascular features of TTTS suggests this may be a disease that could respond to transplacental medical therapy. Adjunctive medical therapy in TTTS with the calcium channel blocker nifedipine has been shown to improve recipient survival while having no effect on the donor. There is no significant difference in recipient survival from postoperative day 5 to birth suggesting that the survival benefit is confined to the effects of nifedipine in the perioperative period. Also, there is no significant effect of nifedipine on gestational age at delivery suggesting the survival benefit was unrelated to the tocolytic effects of nifedipine and more likely a result of hemodynamic effects in the recipient twins' cardiovascular system during the perioperative period. TTTS remains poorly understood but there appears to be good evidence suggesting twin-twin hypertensive cardiomyopathy is a large component of the pathophysiology in recipient twins. The initial findings of nifedipine's effectiveness as a targeted medical therapy to address TTTS cardiomyopathy and improve survival of recipient twins opens the door for further research for adjunctive medical therapies in TTTS.
    No preview · Article · Jul 2014 · American Journal of Perinatology