Teresa JanevicIcahn School of Medicine at Mount Sinai | MSSM
Teresa Janevic
MPH, PhD
About
153
Publications
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Introduction
Dr. Janevic's research focuses on investigating the structural and social determinants of maternal and child health.
Publications
Publications (153)
Background
Placenta accreta spectrum (PAS) disorder is a source of severe obstetric morbidity and mortality worldwide. The objective of this paper was to evaluate the potential relationship between social vulnerability and severe maternal morbidity in a cohort of patients delivering a pregnancy complicated by PAS.
Methods
A retrospective review of...
Importance
Subclinical hyperglycemia before pregnancy may be associated with the likelihood of maternal morbidity but is understudied among young people.
Objective
To explore the association of preconception hemoglobin A 1c (HbA 1c ) levels among adolescents and young adults with risk of gestational diabetes at first live birth.
Design, Setting,...
Importance
Acute respiratory tract infections are the leading cause of emergency department visits and hospitalizations in US children, with highest risks in the first 2 months after birth. Out-of-home childcare settings increase the spread of respiratory tract infections. The study team hypothesized that access to state-paid family leave could red...
OBJECTIVE
To explore the contribution of psychosocial factors, perceived barriers to care, structural racism, and experiences of care to disparities in postpartum outcomes for Black patients, as measured by emergency department (ED) visits and postpartum readmissions.
METHODS
We conducted semi-structured interviews with women of color who were rea...
Objective
We characterized the state-to-state transitions in postpartum A1c levels after gestational diabetes, including remaining in a state of normoglycemia or transitions between prediabetes or diabetes states of varying severity.
Methods
We used data from the APPLE Cohort, a postpartum population-based cohort of individuals with gestational di...
In the United States, maternal health inequities disproportionately affect Global Majority (e.g., Asian, Black, and Hispanic) populations. Despite a substantial body of research underscoring the influence of racism on these inequities, little research has examined how experiences of gendered racial microaggressions during pregnancy and birth impact...
Importance
The Joint Commission Unexpected Complications in Term Newborns measure characterizes newborn morbidity potentially associated with quality of labor and delivery care. Infant exclusions isolate relatively low-risk births, but unexpected newborn complications (UNCs) are not adjusted for maternal factors that may be associated with outcomes...
Disturbances in T-cells, specifically the Th17/Treg balance, have been implicated in adverse pregnancy outcomes. We investigated these two T-cell populations following pre-pregnancy and pregnancy SARS-CoV-2 infection and COVID-19 vaccination in 351 participants from a pregnancy cohort in New York City (Generation C; 2020-2022). SARS-CoV-2 infection...
Associations between antenatal SARS-CoV-2 infection and pregnancy outcomes have been conflicting and the role of the immune system is currently unclear. This prospective cohort study investigated the interaction of antenatal SARS-CoV-2 infection, changes in cytokine and HS-CRP levels, birthweight and gestational age at birth. 2352 pregnant particip...
Introduction: Postpartum hypertension is a leading cause of racial inequities in maternal morbidity and mortality.
Research Question: Is racial-economic segregation, a proxy for structural racism, associated with differences in postpartum blood pressure (BP) in Black, Hispanic and Asian (“Global Majority”) birthing people?
Methods: We used data (n=...
OBJECTIVE
To estimate racial and ethnic disparities in type 2 diabetes mellitus after gestational diabetes mellitus (GDM) and to investigate baseline pregnancy clinical and social or structural characteristics as mediators.
METHODS
We conducted a retrospective cohort of individuals with GDM using linked 2009–2011 New York City birth and hospital d...
Glycated hemoglobin is an adjunct tool in early pregnancy to assess glycemic control. We examined trends and maternal predictors for those who had A1c screening in early pregnancy using hospital discharge and vital registry data between 2009 and 2017 linked with the New York City A1C Registry (N = 798,312). First-trimester A1c screening increased f...
Objective:
Racial/ethnic-specific estimates of the influence of gestational diabetes mellitus (GDM) on type 2 diabetes remain underexplored in large population-based cohorts. We estimated racial/ethnic differences in the influence of GDM on diabetes risk and glycemic control in a multiethnic, population-based cohort of postpartum women.
Research...
Noncitizen immigrants are often excluded from accessing critical safety-net programs, such as Medicaid. Access to health care plays a central role in current policy debates on maternal health. Yet, immigrant exclusions are rarely considered in maternal health policy research. Through open-ended interviews with 31 policymakers, researchers, and prog...
We examined differences in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody responses in pregnant individuals with natural, vaccine-induced, or combined immunity. Participants had live or nonlive births between 2020 and 2022, were seropositive (SARS-CoV-2 spike protein, anti-S), and had available mRNA vaccination and infection...
INTRODUCTION
Antenatal SARS-CoV-2 infection causes significant maternal morbidity and mortality. Preeclampsia and SARS-CoV-2 infection share common pathophysiology that may worsen pregnancy outcomes when both coexist. The purpose of this study was to investigate the effect of gestational SARS-CoV-2 infection on the risk of developing hypertensive d...
Importance:
Postpartum emergency department (ED) visits may indicate poor access to care and risk for maternal morbidity.
Objectives:
To identify patient and hospital characteristics associated with postpartum ED visit rates.
Design, setting, and participants:
This retrospective cohort study used data from the 2014 to 2016 New York State Inpat...
Research suggest prenatal vaccination against coronavirus disease-19 (COVID-19) is safe. However, previous studies utilized retrospectively collected data or examined late pregnancy vaccinations. We investigated the associations of COVID-19 vaccination throughout pregnancy with delivery and neonatal outcomes. We included 1,794 mother-neonate dyads...
Background:
Perfluoroalkylated substances (PFAS) are man-made, persistent organic compounds with immune-modulating potentials. Given that pregnancy itself represents an altered state of immunity, PFAS exposure-related immunotoxicity is an important variable to consider in SARS-CoV-2 infection during pregnancy as it may further affect humoral immun...
Importance:
Disparities exist in access to timely prenatal care between immigrant women and US-born women. Exclusions from Medicaid eligibility based on immigration status may exacerbate disparities.
Objective:
To examine changes in timely prenatal care by nativity after Medicaid expansion.
Design, setting, and participants:
A cross-sectional...
Objectives
This study aimed to summarize evidence on the economic outcomes of prenatal and postpartum interventions for the management of gestational diabetes mellitus and hypertensive disorders of pregnancy (HDP), assess the quality of each study, and identify research gaps that may inform future research.
Methods
Electronic databases including P...
Introduction:
Maternal SARS-CoV-2 infection during pregnancy is associated with adverse pregnancy outcomes and can have effects on the placenta, even in the absence of severe disease or vertical transmission to the fetus. This study aimed to evaluate histopathologic and molecular effects in the placenta after SARS-CoV-2 infection during pregnancy....
The Maternal Fetal Medicine Units Network (MFMU) vaginal birth after cesarean (VBAC) calculator is a clinical tool designed to predict trial of labor after cesarean delivery (TOLAC) success. The calculator has come under scrutiny for its inclusion of race and ethnicity, which systematically predicts a lower likelihood of success for patients who id...
Youths who are negatively affected by social determinants of health suffer adverse effects like increased risks of chronic health conditions and mental health issues. Part 2 of this series describes the adverse effects social determinants of health can have on vulnerable children around the world. Available for purchase at https://shop.aap.org/pedi...
Background/Objectives
The purpose of this study was to explore the postpartum experiences of publicly-insured women of color, and identify how postpartum care can be improved to reduce hospital emergency department usage after delivery.
Methods
We conducted four focus groups with 18 publicly-insured women who primarily self-identified as Black and...
Background: Structural racism and pandemic-related stress from the COVID-19 pandemic may increase risk of adverse birth outcomes.
Objective: Our objective was to examine associations between neighborhood measures of structural racism and pandemic stress with three outcomes: SARS-CoV-2 infection, preterm birth (PTB) and delivering a newborn small-fo...
Background
In the U.S, a wide body of evidence has documented significant racial-ethnic disparities in women's health, and growing attention has focused on discrimination in health care as an underlying cause. Yet, there are knowledge gaps on how experiences of racial-ethnic health care discrimination across the life course influence the health of...
Abstract Objective Exclusive breastmilk feeding during the delivery hospitalization, a Joint Commission indicator of perinatal care quality, is associated with longer-term breastfeeding success. Marked racial and ethnic disparities in breastfeeding exclusivity and duration existed prior to COVID-19. The pandemic, accompanied by uncertainty regardin...
Background:
Rapid and reliable health data on SARS-CoV-2 infection among pregnant individuals are needed to understand the influence of the virus on maternal health and child development, yet the validity of self-reported COVID-19 testing and diagnosis remains unknown.
Objectives:
We assessed the validity of self-reported COVID-19 polymerase cha...
Background: Latinos have a nearly two-fold increased risk of diabetes and diabetes-specific mortality compared to non-Latino whites. Until recently, foreign-born individuals have shown a lower prevalence of diabetes. However, limited research has examined the social and demographic factors contributing to prediabetes among Latinos. Directing preven...
Introduction
Maternal SARS-CoV-2 infection during pregnancy is associated with adverse pregnancy outcomes and can have effects on the placenta, even in the absence of severe disease or vertical transmission to the fetus. This study aimed to evaluate histopathologic and molecular effects in the placenta after SARS-CoV-2 infection during pregnancy....
Objectives. To determine if the introduction of New York State’s 8-week paid family leave policy on January 1, 2018, reduced rates of hospitalizations with respiratory syncytial virus (RSV) bronchiolitis or any acute lower respiratory tract infection among young infants.
Methods. We conducted an interrupted time series analysis using New York State...
Objective: Dysregulation of the immune system during pregnancy is associated with adverse pregnancy outcomes. Recent studies report cytokine changes during the acute phase of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We examine whether there is a lasting association between SARS-CoV-2 infection during pregnancy and per...
Immigrant women represent half of New York City (NYC) births, and some immigrant groups have elevated risk for poor maternal health outcomes. Disparities in health care utilization across the maternity care spectrum may contribute to differential maternal health outcomes. Data on immigrant maternal health utilization are under-explored in the liter...
Background
The COVID-19 pandemic is an ongoing global health threat, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Questions remain about how SARS-CoV-2 impacts pregnant individuals and their children.
Objective
To expand our understanding of the effects of SARS-CoV-2 infection during pregnancy on pregnancy outcomes,...
Objectives:
To investigate racial and ethnic differences in unexpected, term newborn morbidity and the influence of hospital quality on disparities.
Methods:
We used 2010-2014 birth certificate and discharge abstract data from 40 New York City hospitals in a retrospective cohort study of 483 834 low-risk (term, singleton, birth weight ≥2500 g, w...
Objective
To examine the impact of the COVID-19 pandemic on birth satisfaction and perceived health care discrimination during childbirth, and in turn, the influence of these birth experiences on postpartum health.Study DesignWe conducted a cross-sectional, bilingual web survey of 237 women who gave birth at two hospitals in New York City and asses...
Importance
The coronavirus disease 2019 (COVID-19) pandemic may exacerbate existing racial/ethnic inequities in preterm birth.
Objective
To assess whether racial/ethnic disparities in very preterm birth (VPTB) and preterm birth (PTB) increased during the first wave of the COVID-19 pandemic in New York City.
Design, Setting, and Participants
This...
Objective
To assess the influence of racial and economic residential segregation of home or hospital neighborhood on very preterm birth morbidity and mortality.
Study design
We constructed a retrospective cohort of n=6461 infants born <32 weeks using 2010-2014 New York City vital statistics-hospital data. We calculated racial and economic Index of...
Background: In May-July 2020 in the New York City area, up to 16% of pregnant women had reportedly been infected with SARS-CoV-2. Prior studies found associations between SARS-CoV-2 infection during pregnancy and certain adverse outcomes (e.g., preterm birth, cesarean delivery). These studies relied on reverse transcription polymerase chain reactio...
Purpose of Review
The goal of this review is to assess current evidence on diabetes risk and control among adult immigrants in the USA.
Recent Findings
Patterns of diabetes risk in US immigrants may reflect global diabetes trends. Asian, Black, and Latinx immigrants all see a diabetes disadvantage relative to US-born Whites. Diabetes risk in Asian...
Background:
Black and Latina women in New York City are twice as likely to experience a potentially life-threatening morbidity during childbirth than White women. Health care quality is thought to play a role in this stark disparity, and patient-provider communication is one aspect of health care quality targeted for improvement. Perceived health...
Objective
To explore whether racial/ethnic differences in telehealth use existed during the peak pandemic period among NYC patients seeking care for COVID-19 related symptoms.
Materials and Methods
This study used data from a large health system in NYC – the epicenter of the US crisis – to describe characteristics of patients seeking COVID-related...
Objective
To determine whether delivery hospitals that perform poorly for women also perform poorly for high-risk infants and to what extent Black and Hispanic women receive care at hospitals that perform poorly for both women and infants.Methods
We examined the correlation between hospital rankings for severe maternal morbidity and very preterm mo...
Recent national and state legislation has called attention to stark racial/ethnic disparities in maternal mortality and severe maternal morbidity (SMM), the latter of which is defined as having a life-threatening condition or life-saving procedure during childbirth. Using linked New York City birth and hospitalization data for 2012-14, we examined...
(Abstracted from J Pediatr 2019;215:56–63)
Severe maternal morbidity is defined as a life-threatening diagnosis or lifesaving procedure during delivery. It occurs more often in very preterm deliveries, as opposed to term deliveries.
Objective:
To synthesize the literature on associations between social determinants of health and pregnancy-related mortality and morbidity in the United States and to highlight opportunities for intervention and future research.
Data sources:
We performed a systematic search using Ovid MEDLINE, CINAHL, Popline, Scopus, and ClinicalTrials.gov (1...
Objectives
The Arabic-speaking population is increasing in Europe and North America. Evidence suggests that Arab migrants have a greater risk of adverse birth outcomes than nonmigrants, but the risk of stillbirth is largely understudied. We examined inequality in stillbirth rates between Arab women and the French and English majority of women in Qu...
Objective:
To examine within-hospital racial and ethnic disparities in severe maternal morbidity rates and determine whether they are associated with differences in types of medical insurance.
Methods:
We conducted a population-based, cross-sectional study using linked 2010-2014 New York City discharge and birth certificate data sets (N=591,455...
Background:
Studies of body mass index and semen quality have reported mixed results, but almost all were cross-sectional and many were conducted in selected populations. Longitudinal studies in population-based cohorts are necessary to identify how timing and duration of excess adiposity may affect semen quality.
Methods:
In 193 members of the...
Little is known about pregnancy outcomes of black immigrant women to the US. We surveyed 447 black women post-partum in two hospitals in Newark, NJ. Length of gestation was obtained from medical records. Covariates and information on immigration were collected by in-person interview. Risks ratios for preterm birth (< 37 weeks) comparing immigrant t...
To examine the influence of socioeconomic, clinical, and hospital characteristics on the risk of severe maternal morbidity among postpartum readmissions.
A cross-sectional analysis was conducted using the National Inpatient Sample 2006–2012 to estimate the risk of severe maternal morbidity and identify potential risk factors. Odds ratios were calcu...
Objective:
To estimate the prevalence of severe maternal morbidity among very preterm births and determine its association with very preterm infant mortality and morbidity.
Study design:
This study used New York City Vital Statistics birth and death records linked with maternal and newborn discharge abstract data for live births between 2010 and...
(Abstracted from JAMA Pediatr 2018;172(11):1061–1069)
Racial/ethnic disparity in neonatal mortality associated with the increased risk of very preterm birth among black infants is well documented. However, racial/ethnic disparities in severe neonatal morbidities among very preterm infants are less studied, despite the association of these morbiditi...
Objectives
We investigated differences in prevalence of major birth defects by maternal nativity within racial/ethnic groups for 27 major birth defects.
Methods
Data from 11 population‐based birth defects surveillance systems in the United States including almost 13 million live births (approximately a third of U.S. births) during 1999–2007 were p...
In Reply Our team is pleased that Basso and Gagliardi agree that racial/ethnic disparities in neonatal morbidities in preterm birth subcohorts are likely underestimated.¹ They favor estimates across gestational age presented in our article, which conclude disparities are larger than previously reported. However, they note limitations of our analysi...
Objective To evaluate the effectiveness of a multilevel intervention, Healthy Babies are Worth the Wait (HBWW), in reducing preterm birth (PTB) and very preterm birth (VPTB) among black women in Newark, NJ. Methods HBWW is a program linking the local March of Dimes office, providers, community-based organizations, and public health institutions to...
Background
The objective was to estimate the frequency of visits to a dentist and to assess the impact of determinants on dental care utilisation among adults in the Republic of Srpska (RS), Bosnia and Herzegovina.
Methods
We conducted a cross‐sectional study using data from the 2010 National Health Survey performed in the RS. A total of 4,128 adu...
Gestational diabetes mellitus (GDM) currently affects 7% of all pregnancies (Setji
et al, 2005). In particular, gestational impaired glucose tolerance is associated with
increased rates of prematurity, large for gestational age infants, macrosomic infants
and admission to the neonatal intensive care unit for 2 days or longer (Ostlund et
al, 2003)....
Importance
Severe morbidity in very preterm infants is associated with profound clinical implications on development and life-course health. However, studies of racial/ethnic disparities in severe neonatal morbidities are scant and suggest that these disparities are modest or null, which may be an underestimation resulting from the analytic approac...
(Abstracted from JAMA Pediatr 2018;172:269–277)
Currently, 98% of neonatal intensive care units (NICUs) have a risk-adjusted rate of mortality equal to the best 10% of units in 2005, a statistic showcasing the significant improvements in neonatal care over the past decade. Despite improvements, research shows significant racial disparities in neona...
Background:
Elective delivery (ED) before 39 weeks, low-risk cesarean delivery, and episiotomy are routinely reported obstetric quality measures and have been the focus of quality improvement initiatives over the past decade.
Objective:
To estimate trends and differences in obstetric quality measures by race/ethnicity.
Research design:
We used...
Purpose
To examine if the role of obesity in the risk of gestational diabetes differs between immigrant and U.S.-born women.
Methods
We used New York City–linked 2010–2014 birth certificate and hospital data. We created four racial/ethnic groups (non-Hispanic black, Hispanic, non-Hispanic white, and Asian) and three subgroups (Mexican, Indian, and...
Importance
Substantial quality improvements in neonatal care have occurred over the past decade yet racial and ethnic disparities in morbidity and mortality remain. It is uncertain whether disparate patterns of care by race and ethnicity contribute to disparities in neonatal outcomes.
Objectives
To examine differences in neonatal morbidity and mor...
The conflict in Kosovo created mass displacement and a fractured health system. Roma, Ashkali, and Balkan Egyptian communities are particularly vulnerable to discrimination and exclusion from institutions. We aimed to examine Roma, Ashkali, and Balkan Egyptian disparities in quantity and quality of antenatal care received. We conducted a cross-sect...
Background Roma are Europe’s largest minority population. Serbia and Macedonia have the greatest proportion of Roma outside of the European Union. Our objective was to examine women’s agency and how it related to desired timing of pregnancy among Romani women in Macedonia and Serbia. Methods We surveyed 410 Romani women who had given birth in the l...
Introduction:
The current study examined the relationship between acute (past 30 day) and recent (past year but not past 30 day) serious psychological distress (SPD) and smoking during pregnancy among women in the United States overall, stratified by demographic characteristics, and described the change in the prevalence of prenatal smoking among...
Objective:
To investigate differences in severe maternal morbidity between Hispanic mothers and three major Hispanic subgroups compared with non-Hispanic white mothers and the extent to which differences in delivery hospitals may contribute to excess morbidity among Hispanic mothers.
Methods:
We conducted a population-based cross-sectional study...
Background:
Racial discrimination may increase the risk of low birthweight (LBW), but has not been studied among Roma, the largest minority population in Europe. Moreover, few studies test both institutional and interpersonal forms of racial discrimination on health. Our objective was to examine associations between institutional and interpersonal...