Uma M Reddy

Uma M Reddy
U.S. Department of Health and Human Services | HHS · National Institutes of Health (NIH)

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414
Publications
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Introduction
Skills and Expertise

Publications

Publications (414)
Article
Full-text available
Objective Stillbirth can result in numerous adverse psychosocial sequelae. Recommendations vary with regard to holding the baby after a stillbirth. Few studies have addressed the impact of fetal abnormalities on these outcomes. Study design Analyses of singleton stillbirths within the Stillbirth Collaborative Research Network were conducted. Patie...
Article
Full-text available
Objective: To examine the association of fetal/placental DNA copy number variants (CNVs) with pathologic placental lesions (PPLs) in pregnancies complicated by stillbirth. Design: A secondary analysis of stillbirth cases in the Stillbirth Collaborative Research Network case-control study. Setting: Multicenter, 59 hospitals in 5 geographic regi...
Article
(Abstracted from N Engl J Med 2022;386:1781–1792) Chronic hypertension develops in 2% of pregnancies in the United States. As this condition disproportionately affects Black women and is associated with 3 to 5 times the risk of placental abruption, preeclampsia, preterm birth (PTB), small-for-gestational-age (SGA) birthweight, and perinatal death,...
Article
Background Despite growing evidence suggesting racial or ethnic disparities in the risk of severe maternal morbidity (SMM) among live births, there is little research investigating potential differences in SMM risk among stillbirths across race and ethnicity. Objectives This study aimed to compare the risk of SMM by race and ethnicity among patien...
Article
Objective This study was aimed to investigate delivery management of patients with antepartum stillbirth. Study Design Using data from fetal death certificates and linked maternal hospital discharge records, we identified a population-based sample of patients with singleton antepartum stillbirth at 20 to 42 weeks of gestation in California in 2007...
Article
Objective: To compare maternal outcomes in subsequent pregnancies of patients who had a prior classical cesarean delivery with those with a prior low transverse cesarean delivery. Methods: We conducted a cross-sectional analysis of patients with live singleton births at or after 24 weeks of gestation who had a prior classical cesarean delivery o...
Article
Full-text available
Objective: To evaluate whether hypertensive disorders of pregnancy (HDP) among low-risk nulliparous people expectantly managed (EM) at or after 39 weeks of gestation are associated with adverse outcomes. Design: Secondary analysis of a randomized trial. Setting: Multicenter United States. Population: Individuals in the EM group who delivered...
Article
Background: Penicillin allergy is the most commonly reported drug allergy in the United States, however less than 10% of individuals labeled with a penicillin allergy are truly allergic. A reported penicillin allergy in pregnancy is associated with adverse maternal and perinatal outcomes. Despite recommendations for penicillin allergy testing in pr...
Article
Objective Delta-like homolog 1 (DLK1) is a growth factor that is reduced in maternal sera in pregnancies with small for gestational age neonates. We sought to determine if DLK1 is associated with stillbirth (SB), with and without placental insufficiency. Study Design A nested case-control study was performed using maternal sera from a multicenter c...
Article
Objective: To assess the association of maternal BMI with a composite of severe maternal outcomes. Study Design: Secondary analysis of a cohort of deliveries on randomly selected days at 25 hospitals from 2008-2011. Data on comorbid conditions, intrapartum events, and postpartum course were collected. The reference group (REF, BMI 18.5-29.9), obese...
Article
Objective We sought to (1) use the Robson 10-Group Classification System (TGCS), which classifies deliveries into 10 mutually exclusive groups, to characterize the groups that are primary contributors to cesarean delivery frequencies, (2) describe inter-hospital variations in cesarean delivery frequencies, and (3) evaluate the contribution of patie...
Article
Purpose: To derive a prescriptive sex-specific fetal growth standard and assess clinical management and outcomes according to sex-specific growth status. Materials and methods: This was a secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b), a prospective observational study of 10,038 nulliparas from...
Article
Background Congenital cytomegalovirus infection following maternal primary cytomegalovirus infection affects approximately 0.4% of newborns in the United States but may be hard to diagnose prenatally. Objective To evaluate the current sensitivity and specificity of amniocentesis in detecting congenital CMV infection. Study Design Secondary analysis...
Article
Objective: To compare health care medical resource utilization in low-risk nulliparous pregnancies according to body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) categories. Methods: This is a secondary analysis of a multicenter randomized controlled trial of induction of labor between 39 0/7 39 and 4/7...
Article
Background Our objective was to assess new chronic hypertension 6 to 12 months postpartum for those with hypertensive disorder of pregnancy (HDP) compared with normotensive participants. Methods and Results We performed a prospective cohort study of participants with singleton gestations and no known preexisting medical conditions who were diagnos...
Article
Full-text available
Background: The benefits and safety of the treatment of mild chronic hypertension (blood pressure, <160/100 mm Hg) during pregnancy are uncertain. Data are needed on whether a strategy of targeting a blood pressure of less than 140/90 mm Hg reduces the incidence of adverse pregnancy outcomes without compromising fetal growth. Methods: In this op...
Article
Fetal exposure to testosterone may contribute to vulnerability for autism spectrum disorder (ASD). It is hypothesized that placental aromatase prevents fetal exposure to maternal testosterone, however, this pathway and the implications for child neurodevelopment have not been fully explored. We examined the relationships between prenatal maternal t...
Article
Background The NICHD Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b) was established to investigate the underlying causes and pathophysiologic pathways associated with adverse pregnancy outcomes in nulliparous gravidas. Objective Our objectives were to study placental physiology and identify novel biomarkers in relation to...
Preprint
Importance Polygenic risk scores (PRS) for Type II Diabetes Mellitus (T2DM) can improve risk prediction for Gestational Diabetes Mellitus (GDM), yet the strength of the relationship between genetic and lifestyle risk factors has not been quantified. Objective To assess the effects of PRS and physical activity on existing GDM risk models and identi...
Article
Objective: To assess whether neonatal morbidities evident by the time of hospital discharge are associated with subsequent CP or death. Study design: This is a secondary analysis of data from a multi-center placebo-controlled trial of magnesium sulfate for the prevention of CP. The association between pre-specified intermediate neonatal outcomes...
Article
Full-text available
Objective: To evaluate the association between maternal fructosamine levels at the time of delivery and stillbirth. Design: Secondary analysis of a case-control study. Settings: Multicenter study of five geographic catchment areas in the United States (U.S). Population or sample: All singleton stillbirths with known diabetes status and fruct...
Preprint
Background Adverse pregnancy outcomes (APOs) affect a large proportion of pregnancies and represent an important cause of morbidity and mortality worldwide. Yet, the pathophysiology of APOs is poorly understood, limiting our ability to prevent and treat these conditions. Objective To search for genetic risk markers for four APOs, we performed geno...
Article
Background: Obesity is associated with a variety of placenta-mediated adverse pregnancy outcomes including preeclampsia, preterm birth, and stillbirth. Mechanisms linking obesity with placental dysfunction are incompletely understood. Objective: To examine the relationship between early pregnancy body mass index (BMI) and placental angiogenic bioma...
Article
Introduction: Adverse pregnancy outcomes (APOs) are associated with an increased risk of developing cardiovascular disease (CVD). While the Mediterranean diet pattern has been inversely related to CVD outcomes, its association with APOs in US women has not been previously evaluated. Hypothesis: Adherence to a Mediterranean diet pattern during the p...
Preprint
Objective To examine the association of DNA copy number variants (CNVs) with pathologic placental lesions (PPLs) in stillborn fetuses. Design A secondary analysis of stillbirth cases in the Stillbirth Collaborative Research Network case-control study. Setting Multicenter, 59 hospitals in 5 geographic regions in the USA. Population 387 stillbirth ca...
Article
Rationale: Knowledge gaps exist regarding health implications of sleep disordered breathing (SDB) identified in pregnancy and/or post-delivery. Objective: To determine whether SDB in pregnancy and/or post-delivery is associated with hypertension (HTN) and metabolic syndrome (MS). Methods: The nuMoM2b Heart Health Study (n=4,508) followed parti...
Article
Objective: To develop and internally validate a noninvasive method for the prediction of congenital cytomegalovirus (CMV) infection after primary maternal CMV infection. Methods: We conducted a secondary analysis of a multicenter randomized placebo-controlled trial of CMV hyperimmune globulin to prevent congenital infection. Women were eligible...
Article
Importance: Hypertensive disorders of pregnancy are associated with future cardiovascular disease, perhaps because of subclinical cardiac dysfunction before pregnancy leading to impaired adaptation to pregnancy. Natriuretic peptides are promising biomarkers for detecting subclinical cardiac dysfunction outside of pregnancy. Objective: To investi...
Article
Full-text available
Background Preeclampsia is characterized by decreased trophoblastic angiogenesis leading to abnormal invasion of spiral arteries, shallow implantation and resulting in compromised placentation with poor uteroplacental perfusion. Vitamin D plays an important role in pregnancy influencing implantation, angiogenesis and placental development. The obje...
Article
(Abstracted from N Engl J Med 2021;385:436–444) Congenital cytomegalovirus (CMV) infections are associated with stillbirth, neonatal death, deafness, and cognitive and motor delay. Small observational studies have evaluated CMV hyperimmune globulin to prevent congenital infection in women with primary CMV infection during pregnancy; however, the re...
Article
Objective This study aimed to determine if one abnormal value of four on the diagnostic 3-hour oral glucose tolerance test (OGTT) is associated with adverse perinatal outcomes in obese women. Study Design This is a secondary analysis of a prospective study of nulliparous women in eight geographic regions. Women with body mass index <30 kg/m2 and pr...
Article
Objective Antenatal and early neonatal nutritional environment may influence later metabolic health. Infants of mothers with gestational diabetes mellitus (GDM) have higher risk for childhood obesity and metabolic syndrome (MetS). Leptin and adiponectin are known biomarkers for MetS and may guide interventions to reduce later obesity. We sought to...
Article
Objective: To study the association between nicotine or cannabis metabolite presence in maternal urine and child neurodevelopmental outcomes. Methods: We conducted a secondary analysis of two parallel multicenter randomized controlled trials of treatment for hypothyroxinemia or subclinical hypothyroidism among pregnant individuals enrolled at 8-...
Article
Objective: To evaluate race and ethnicity differences in cesarean birth and maternal morbidity in low-risk nulliparous people at term. Methods: We conducted a secondary analysis of a randomized trial of expectant management compared with induction of labor in low-risk nulliparous people at term. The primary outcome was cesarean birth. Secondary...
Article
Introduction Because most data on placental abruption are derived from retrospective studies, multiple sources of bias may have affected the results. Thus, we aimed to characterize risk factors and outcomes for placental abruption in a large prospective cohort of nulliparous women. Methods This was a secondary analysis of women enrolled in the Nul...
Article
Objective The aim of the study is to evaluate whether values and the shape of the glucose curve during the oral glucose tolerance test (OGTT) in pregnancy identify women at risk of developing hypertension (HTN) later in life. Methods This category includes the secondary analysis of a follow-up from a mild gestational diabetes mellitus (GDM) study t...
Article
Objective: The long-term impact of hypertensive disorders of pregnancy (HDP) exposure on offspring health is an emerging research area. The objective of this study was to evaluate the association between a maternal diagnosis of HDP (gestational hypertension and preeclampsia) and adverse neurodevelopmental outcomes in the offspring. Study design:...
Article
Objective: To compare maternal and neonatal outcomes after preterm prelabor rupture of membranes (PROM) from 23 to 34 weeks of gestation in twin compared with singleton gestations. Methods: We conducted a secondary analysis of an obstetric cohort of 115,502 individuals and their singleton or twin neonates born in 25 hospitals nationwide (2008-20...
Article
Objective Marijuana (MJ) use is associated with adverse effects on fetal growth. We aimed to investigate the timing of suboptimal fetal growth onset in MJ-exposed pregnancies. In addition, we aimed to explore the relationship between MJ-exposure and both abnormal uterine artery (UtA) Doppler parameters and small for gestational age (SGA). Study de...
Article
Full-text available
Importance Health literacy is considered an important social determinant of health that may underlie many health disparities, but it is unclear whether inadequate health literacy among pregnant individuals is associated with adverse maternal and neonatal outcomes. Objective To assess the association between maternal health literacy and maternal an...
Article
Objective This study aimed to evaluate whether intrapartum fetal electrocardiogram (ECG) tracings with ST-elevation or depression occur more frequently in each stage of labor in small-for-gestational age (SGA) or large-for-gestational age (LGA), as compared with appropriate-for-gestational age (AGA) fetuses. Study Design We conducted a secondary an...
Article
Objective This study aimed to evaluate maternal and neonatal outcomes by method of cervical ripening for labor induction among low-risk nulliparous individuals. Study Design This is a secondary analysis of a multicenter randomized trial of labor induction at 39 weeks versus expectant management in low-risk nulliparous participants. Participants und...
Article
Objective: To evaluate intrapartum resuscitation interventions and improvement in category II fetal heart rate (FHR) tracings. Methods: This secondary analysis of a randomized trial of intrapartum fetal electrocardiographic ST-segment analysis included all participants with category II FHR tracings undergoing intrauterine resuscitation: maternal...
Article
Administration of antenatal corticosteroids has been widely adopted as the standard of care in the management of pregnancies at risk for preterm delivery prior to 37 weeks of gestation, with the primary goal of reducing neonatal morbidity. However, the long-term risks associated with antenatal corticosteroid use remain uncertain. The purpose of thi...
Article
Background Primary cytomegalovirus (CMV) infection during pregnancy carries a risk of congenital infection and possible severe sequelae. There is no established intervention for preventing congenital CMV infection. Methods In this multicenter, double-blind trial, pregnant women with primary CMV infection diagnosed before 24 weeks’ gestation were r...
Article
Background: Antenatal depression affects approximately one in seven pregnancies, with an increasing prevalence across gestation. Data regarding the associations between antenatal depression and adverse pregnancy outcomes yield conflicting results. However, previous studies evaluated the cross-sectional prevalence of depression at various time poin...
Article
Objective This study aimed to determine whether specific factors of the built environment related to physical activity and diet are associated with inadequate and excessive gestational weight gain (GWG). Study Design This analysis is based on data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be, a prospective cohort of nulli...
Article
Background Previous studies show that obesity predisposes patients to higher risks of adverse pregnancy outcomes. Data on the relationship between increasing degrees of obesity and risks of severe maternal morbidity (SMM), including mortality, are limited. Objective We examined the association of increasing classes of obesity, especially super obe...
Article
Objective In the antenatal late preterm steroids (ALPS) trial betamethasone significantly decreased short-term neonatal respiratory morbidity but increased the risk of neonatal hypoglycemia, diagnosed only categorically (<40 mg/dL). We sought to better characterize the nature, duration, and treatment for hypoglycemia. Study Design Secondary analysi...
Article
Background The American College of Obstetricians and Gynecologists (ACOG) recommends pregnant patients receive expeditious treatment with first-line antihypertensive agents within one hour of confirmed severe hypertension to reduce the risk of maternal stroke. However, it is unknown how often this guideline is followed and what factors influence a...
Article
Background: Several features of the neighborhood built environment have been shown to promote leisure-time physical activity (PA) in the general population, but few studies have examined its impact on PA during pregnancy. Methods: Data were extracted from 8362 Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be cohort participants (20...
Article
Introduction To determine the impact of prior vaginal birth on neonatal and maternal outcomes among individuals undergoing a trial of labor after two cesarean births. Materials and methods This was a cross-sectional study using the U.S. National Vital Statistics 2014–2018 period linked birth and infant death data. Inclusion criteria were term, cep...
Article
Objective: To evaluate whether breastfeeding and its duration are associated with a reduced risk of low IQ scores or other neurodevelopmental problems. Methods: We conducted a secondary analysis of two parallel multicenter, double-blinded randomized controlled trials in which participants with a singleton pregnancy and either subclinical hypothy...
Article
(Am J Obstet Gynecol. 2020;222:369.e1–369.e11) The A Randomized Trial of Induction Versus Expectant Management (ARRIVE) trial was conducted to analyze the effects of planned elective induction of labor on 6000 low-risk nulliparous women in comparison with expectant management. The ARRIVE trial found that planned elective labor induction at 39 weeks...
Article
(N Engl J Med. 2020;383:1107–1116) Between 25% and 60% of stillbirth cases are unexplained. Exome sequencing has been used to determine the cause of disease, especially in childhood disorders and fetal structural anomalies. There is an opportunity to further apply clinical exome sequencing to investigating the cause of stillbirth. Previous studies...
Article
Background While the neonatal morbidity associated with shoulder dystocia are well known, the maternal morbidity occurring with this obsetetric emergency is infrequently reported. Objective To assess the composite maternal and neonatal adverse outcomes among vaginal deliveries (at 34 weeks or later) with and without shoulder dystocia. Material an...
Article
Background Cardiovascular risk in young adulthood is an important determinant of lifetime cardiovascular disease risk. Women with adverse pregnancy outcomes (APOs) have increased cardiovascular risk, but the relationship of other factors is unknown. Methods and Results Among 4471 primiparous women, we related first‐trimester atherogenic markers to...