A description of the methods of the Nulliparous Pregnancy Outcomes Study: monitoring mothers-to-be (nuMoM2b)

Haas, David M.; Parker, Corette B.; Wing, Deborah A.; Parry, Samuel; Grobman, William A.; Mercer, Brian M.; Simhan, Hyagriv N.; Hoffman, Matthew; Silver, Robert M.; Wadhwa, Pathik D.; Iams, Jay D.; Koch, Matthew; Caritis, Steve N.; Wapner, Ronald J.; Esplin, M. Sean; Elovitz, Michal A.; Foroud, Tatiana; Peaceman, Alan M.; Saade, George R.; Willinger, Marian; Reddy, Uma M.

doi:10.1016/j.ajog.2015.01.019

Cited by 182 publications

(193 citation statements)

References 52 publications

Supporting

Mentioning

191

Contrasting

Unclassified

Order By: Relevance

“…NuMoM2b was an observational cohort study, conducted at 8 clinical sites and managed by a central data coordinating and analysis center. [26] The parent study protocol included nulliparous women of at least 13 years of age, although for this sub-study, those under the age of 18 were excluded given significant differences in adolescent versus adult sleep. In addition, while the parent study included women with chronic hypertension, these women were excluded from this sub-study given the difficulty in accurately diagnosing a new-onset hypertensive disorder in women with pre-existing hypertension.…”

Section: Methodsmentioning

confidence: 99%

Objectively measured short sleep duration and later sleep midpoint in pregnancy are associated with a higher risk of gestational diabetes

Facco

Grobman²,

Reid³

et al. 2017

American Journal of Obstetrics and Gynecology

Self Cite

136

View full text Add to dashboard Cite

Background Experimental and epidemiologic data suggest that among non-pregnant adults, sleep duration may be an important risk factor for chronic disease. Although pregnant women commonly complain of poor sleep, few studies have objectively evaluated the quality of sleep in pregnancy or have explored the relationship between sleep disturbances and maternal and perinatal outcomes. Objectives Our objective was to examine the relationship between objectively assessed sleep duration, timing and continuity (measured via wrist actigraphy) and maternal cardiovascular and metabolic morbidity specific to pregnancy. Study Design This was a prospective cohort study of nulliparous women. Women were recruited between 16 0/7 and 21 6/7 weeks’ gestation. They were asked to wear a wrist actigraphy monitor and to complete a daily sleep log for a seven consecutive-day period. The primary sleep exposure variables were the averages of the following over the total valid nights (minimum 5, maximum 7 nights): short sleep duration during the primary sleep period (< 7 hours/night), late sleep midpoint (midpoint between sleep onset and sleep offset > 5 AM), and top quartile of minutes of wake time after sleep onset (WASO) and sleep fragmentation index. The primary outcomes of interest were a composite of hypertensive disorders of pregnancy (mild, severe, or superimposed preeclampsia; eclampsia; or antepartum gestational hypertension) and gestational diabetes (GDM). Chi-square tests were used to assess associations between sleep variables and categorical baseline characteristics. Crude odds ratios and 95% confidence intervals were estimated from univariate logistic regression models to characterize the magnitude of the relationship between sleep characteristics and hypertensive disorders of pregnancy and GDM. For associations that were significant in univariate analysis, multiple logistic regression was used to explore further the association of sleep characteristics with pregnancy outcomes. Results Nine-hundred and one eligible women consented to participate. Of these women 782 submitted valid actigraphy studies. Short sleep duration and a later sleep midpoint were associated with an increased risk of GDM (OR 2.24, 95% CI 1.11, 4.53; OR 2.58, 95% CI 1.24, 5.36, respectively) but not of hypertensive disorders. A model with both sleep duration and sleep midpoint as well as their interaction term revealed that while there was no significant interaction between these exposures, the main effects of both short sleep duration and later sleep midpoint with GDM remained significant (aOR 2.06, 95% CI 1.01, 4.19; aOR 2.37, 95% CI 1.13, 4.97, respectively). Additionally, after adjusting separately for age, BMI and race/ethnicity, both short sleep duration and later sleep midpoint remained associated with GDM. No associations were demonstrated between the sleep quality measures (WASO, sleep fragmentation) and hypertensive disorders or GDM. Conclusions Our results demonstrate a relationship between short sleep duration and later sleep midpoin...

show abstract

Section: Methodsmentioning

confidence: 99%

Objectively measured short sleep duration and later sleep midpoint in pregnancy are associated with a higher risk of gestational diabetes

Facco

Grobman²,

Reid³

et al. 2017

American Journal of Obstetrics and Gynecology

Self Cite

136

View full text Add to dashboard Cite

show abstract

“…Each site’s local governing Institutional Review Board approved the nuMoM2b protocol and procedures. 18 …”

Section: Methodsmentioning

confidence: 99%

“…17,18 More than 10,000 women with singleton pregnancies were enrolled in the nuMoM2b study, which combined detailed demographic and medical information, clinical parameters, ultrasound measurements, genetics, biomarker measurements in biologic fluids, and psychosocial and behavioral measures in both pre-specified and exploratory analyses to identify pregnant women at risk for adverse pregnancy outcomes. 17,18 Uterine artery Doppler studies were performed for all nuMoM2b subjects during the second trimester of pregnancy in order to study the relationship between uterine artery compliance and adverse pregnancy outcomes attributed to placental dysfunction, including SGA birth weights and preeclampsia. The objective of the current analysis was to determine the utility of early second trimester maternal uterine artery Doppler study measures as predictors of SGA babies.…”

Section: Introductionmentioning

confidence: 99%

Role of early second-trimester uterine artery Doppler screening to predict small-for-gestational-age babies in nulliparous women

Parry

Sciscione

Haas

et al. 2017

American Journal of Obstetrics and Gynecology

Self Cite

View full text Add to dashboard Cite

Background Trophoblastic invasion of the uterine spiral arteries substantially increases compliance to accommodate increased blood flow to the placenta. Failure of this process impedes uterine artery blood flow, and this may be detected by uterine artery Doppler flow studies. However, the clinical utility of uterine artery Doppler flow studies in the prediction of adverse pregnancy outcomes in a general population remains largely unknown. Objective To determine the utility of early second trimester uterine artery Doppler studies as a predictor of small for gestational age (SGA) neonates. Study Design Nulliparous women with a viable singleton pregnancy were recruited during their first trimester into an observational prospective cohort study at eight institutions across the United States. Participants were seen at three study visits during pregnancy and again at delivery. Three indices of uterine artery Doppler flow (resistance index, pulsatility index, and diastolic notching) were measured in the right and left uterine arteries between 16 weeks 0 days and 22 weeks 6 days gestation. Test characteristics for varying thresholds in the prediction of SGA (defined as birth weight <5th percentile for gestational age [Alexander growth curve]) were evaluated. Results Uterine artery Doppler indices, birth weight, and gestational age at birth were available for 8,024 women. Birth weight <5th percentile for gestational age occurred in 358 (4.5 percent) of the births. Typical thresholds for the uterine artery Doppler indices were all associated with birth weight <5th percentile for gestational age (P<0.0001 for each), but the positive predictive values for these cutoffs were all <15 percent and areas under receiver operating characteristic curves (AUCs) ranged from 0.50 to 0.60. Across the continuous scales for these measures, the AUCs ranged from 0.56 to 0.62. Incorporating maternal age, early pregnancy BMI, race/ethnicity, smoking status prior to pregnancy, chronic hypertension, and pre-gestational diabetes in the prediction model resulted in only modest improvements in the AUCs ranging from 0.63 to 0.66. Conclusion In this large prospective cohort, early second trimester uterine artery Doppler studies were not a clinically useful test for predicting SGA babies.

show abstract

“…11 Several studies demonstrate the importance of quality assurance, showing that 10% to 30% of the submitted images were classified as ''unacceptable,'' meaning that a review of the images identified incorrect technique, despite training beforehand. 11,[13][14][15][16][17] Such errors could potentially alter clinical management, leading to unnecessary pharmacologic therapy or even unwarranted surgeries.…”

Section: The Techniquementioning

confidence: 99%

Measuring the Cervical Length

Markham

Iams²

2016

Clinical Obstetrics &Amp; Gynecology

Self Cite

View full text Add to dashboard Cite

An important step toward the goal of eradicating spontaneous preterm birth was achieved with the advent of cervical sonography, a tool that advanced our knowledge of the entity of preterm parturition, improved our ability to detect women at risk for early delivery, and allowed us to prevent some of these premature births. We will describe here the correct technique for obtaining such measurements and will review the literature regarding the use of this tool in specific pregnant populations.

show abstract

A description of the methods of the Nulliparous Pregnancy Outcomes Study: monitoring mothers-to-be (nuMoM2b)

Cited by 182 publications

References 52 publications

Objectively measured short sleep duration and later sleep midpoint in pregnancy are associated with a higher risk of gestational diabetes

Objectively measured short sleep duration and later sleep midpoint in pregnancy are associated with a higher risk of gestational diabetes

Role of early second-trimester uterine artery Doppler screening to predict small-for-gestational-age babies in nulliparous women

Measuring the Cervical Length

Contact Info

Product

Resources

About