This study identified modifiable factors, especially antibiotic dosing and drain use, associated with surgical site infection in patients with neuromuscular scoliosis.

CI 2.14-2.48) reported suicidal ideation, and 9.3% (N=416; AOR 3.24, 95% CI 2.91-3.60) reported at least one suicide attempt within the last 12 months. Developmental assets decreased the odds of these outcomes for all youth, but were less protective for homeless youth than non-homeless youth. Conclusion:Youth who have been homeless with their families during the past year are at significantly higher risk of suicidality than their non-homeless peers. Internal and external factors that protect against suicidality are somewhat less impactful among youth who have experienced family homelessness, implicating family homelessness as a marker of extreme risk during adolescence. Future research among this group should take broader ecological factors into account, ideally in a longitudinal manner. Preventive interventions among homeless youth may need to not only promote developmental assets but also address the need for stable housing and the mitigation of extreme psychosocial risk.

INTRODUCTION: Between 1999 and 2013, the prevalence of neonatal abstinence syndrome (NAS) in the United States increased almost 300%. Regional differences in the NAS prevalence highlight the need for comprehensive prevention strategies for opioid use disorder (OUD) in pregnancy. Our objective was to assess the presence of legislation requiring reporting of OUD in pregnancy, as well as available treatment resources. METHODS: We surveyed each state for existing laws or pending legislation requiring reporting of OUD in pregnancy by searching state government websites for keywords/phrases and contacted state officials directly to confirm the presence or absence of pertinent legislation. Information treatment resources offered and priority access to pregnant women was also collected. RESULTS: Fifteen states have active legislation for reporting OUD in pregnancy. Eighteen states treat OUD in pregnancy as child abuse. Twenty-five states provide priority access to pregnant women with OUD. The states not requiring reporting of OUD in pregnancy had a higher prevalence of NAS. CONCLUSION: Less than half of states have active legislation requiring OUD in pregnancy reporting. The rising prevalence and healthcare costs associated with NAS continue to confirm the need for legislation and comprehensive guidelines for opioid prescribing in each state, as well as the establishment of treatment resources for our pregnant patient population.

Placenta Accreta Spectrum (PAS) represents 1:250 cases in the United States. PAS is associated with significant maternal morbidity and mortality. Numerous centers for the care of PAS patients have been established and data suggested optimal outcomes with referral to a PAS center. Current referral guidelines rely on historic and ultrasonographical findings although less than 50% of cases are successfully referred to centers using these criteria. Thus, our goal was to explore the utility of Placental Growth Factor (PlGF) as a biomarker for high risk patients with Placenta previa and PAS. STUDY DESIGN: Urine specimens were collected from patients with suspected PAS, placenta previa, and scheduled repeat cesarean sections. Quantitative analysis of PlGF was performed by ELISA. Expression profiles were correlated and analyzed for diagnostic accuracy and reproducibility. RESULTS: Specimens were collected from a total of 24 subjects (12 PAS, 6 previa, 6 control). PlGF urine quantities were assessed by ELISA. Average urine PlGF quantities were 6.1, 18.2, and 17.6 pg/mL for control, previa and PAS subjects respectively (p¼0.24). In addition the PAS cohort was subdivided by traditional pathology (accreta, increta, percreta), there was no statistically significant difference in final pathology (p¼0.67). CONCLUSION: Placental growth factor expression may be detected in the urine of patients with placenta previa and PAS. PlGF quantities may distinguish between control subjects but cannot distinguish between placenta previa and PAS. PlGF did not discriminate among the PAS pathologies (accreta, increta, percreta). PlGF may serve as part of a developing biologic hierarchy for the detection and referral of high risk patients to tertiary centers of care.

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