Virtual navigation in healthy aging: Activation during learning and deactivation during retrieval predicts successful memory for spatial locations
(2022) Neuropsychologia, 173, art. no. 108298, .
Richmond, L.L.a b , Sargent, J.Q.c , Zacks, J.M.a
a Department of Psychological and Brain Sciences, Washington University in St Louis, United States
b Department of Psychology, Stony Brook University, United States
c Department of Psychology, Francis Marion University, United States
Abstract
Spatial navigation and spatial memory are two important skills for independent living, and are known to be compromised with age. Here, we investigate the neural correlates of successful spatial memory in healthy older adults in order to learn more about the neural underpinnings of maintenance of navigation skill into old age. Healthy older adults watched a video shot by a person navigating a route and were asked to remember objects along the route and then attempted to remember object locations by virtually pointing to the location of hidden objects from several locations along the route. Brain activity during watching and pointing was recorded with functional MRI. Larger activations in temporal and frontal regions during watching, and larger deactivations in superior parietal cortex and intraparietal sulcus during pointing, were associated with smaller location errors. These findings suggest that larger evoked responses during learning of spatial information coupled with larger deactivation of canonical spatial memory regions at retrieval are important for effective spatial memory in late life. © 2022 Elsevier Ltd
Author Keywords
aging; fMRI; Intraparietal sulcus; spatial memory; virtual pointing task
Funding details
National Institute on AgingNIAF32 AG050400, R21 AG041419
Document Type: Article
Publication Stage: Final
Source: Scopus
Circulating Immune Cell and Outcome Analysis from the Phase II Study of PD-L1 Blockade with Durvalumab for Newly Diagnosed and Recurrent Glioblastoma
(2022) Clinical Cancer Research, 28 (12), pp. 2567-2578.
Nayak, L.a , Standifer, N.b , Dietrich, J.c , Clarke, J.L.d , Dunn, G.P.e , Lim, M.f , Cloughesy, T.g , Gan, H.K.h , Flagg, E.i , George, E.j , Gaffey, S.a , Hayden, J.a , Holcroft, C.k , Wen, P.Y.a , MacRi, M.l , Park, A.J.l , Ricciardi, T.l , Ryan, A.l , Schwarzenberger, P.l , Venhaus, R.l , De Los Reyes, M.m , Durham, N.M.m , Creasy, T.m , Huang, R.Y.i , Kaley, T.n , Reardon, D.A.a
a Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
b Integrated Bioanalysis, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, South San Francisco, CA, United States
c Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
d Departments of Neurology and Neurosurgery, University of California,San Francisco, San Francisco, CA, United States
e Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, United States
f Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
g Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States
h Department of Medical Oncology, Austin Health, Melbourne, Australia
i Department of Radiology, Brigham and Women’s Hospital, Boston, MA, United States
j Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
k PROMETRIKA, LLC, New York, NY, United States
l Ludwig Cancer Research, New York, NY, United States
m Translational Medicine Oncology, Early and Early Oncology, R&D, Gaithersburg, MD, United States
n Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
Abstract
Purpose: PD-L1 is upregulated in glioblastoma and supports immunosuppression. We evaluated PD-L1 blockade with durvalumab among glioblastoma cohorts and investigated potential biomarkers. Patients and Methods: MGMT unmethylated newly diagnosed patients received radiotherapy plus durvalumab (cohort A; n = 40). Bevacizumab-naïve, recurrent patients received durvalumab alone (cohort B; n = 31) or in combination with standard bevacizumab (cohort B2; n = 33) or low-dose bevacizumab (cohort B3; n = 33). Bevacizumab-refractory patients received durvalumab plus bevacizumab (cohort C; n = 22). Primary endpoints were: OS-12 (A), PFS-6 (B, B2, B3), and OS-6 (C). Exploratory biomarkers included: a systematic, quantitative, and phenotypic evaluation of circulating immune cells; tumor mutational burden (TMB); and tumor immune activation signature (IAS). Results: No cohort achieved the primary efficacy endpoint. Outcome was comparable among recurrent, bevacizumab-naïve cohorts. No unexpected toxicities were observed. A widespread reduction of effector immune cell subsets was noted among recurrent patients compared with newly diagnosed patients that was partially due to dexamethasone use. A trend of increased CD8+Ki67+T cells at day 15 was noted among patients who achieved the primary endpoint and were not on dexamethasone. Neither TMB nor IAS predicted outcome. Conclusions: Patients with recurrent glioblastoma have markedly lower baseline levels of multiple circulating immune cell subsets compared with newly diagnosed patients. An early increase in systemic Ki67+CD8+cells may warrant further evaluation as a potential biomarker of therapeutic benefit among patients with glioblastoma undergoing checkpoint therapy. Dexamethasone decreased immune cell subsets. PD-L1 blockade and combination with standard or reduced dose bevacizumab was ineffective. © 2022 American Association for Cancer Research Inc.. All rights reserved.
Funding details
National Institutes of HealthNIH
National Cancer InstituteNCIP30 CA008748
Cancer Research InstituteCRI
Bristol-Myers SquibbBMS
AstraZeneca
Merck
Novartis
Leukemia and Lymphoma SocietyLLS
Ludwig Institute for Cancer ResearchLICR
AcelRx Pharmaceuticals
Merck KGaA
Bayer FundBF
MedImmune
Cure Brain Cancer FoundationCBCF
Document Type: Article
Publication Stage: Final
Source: Scopus
Adverse driving behaviors are associated with sleep apnea severity and age in cognitively normal older adults at risk for Alzheimer’s disease
(2022) Sleep, 45 (6), .
Doherty, J.M.a , Roe, C.M.a , Murphy, S.A.a , Johnson, A.M.b , Fleischer, E.c , Toedebusch, C.D.a , Redrick, T.a , Freund, D.a , Morris, J.C.a d e , Schindler, S.E.a e , Fagan, A.M.a d e , Holtzman, D.M.a d e f , Lucey, B.P.a d f , Babulal, G.M.a g h i
a Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
b Center for Clinical Studies, Washington University in St. Louis, St. Louis, MO, USA
c Byram Hills High School, NY, NY, United States
d Hope Center for Neurological Disorders, Washington University in St Louis, St. Louis, MO, USA
e Knight Alzheimer’s Disease Research Center, Washington University in St Louis, St. Louis, MO, USA
f Center on Biological Rhythms and Sleep, Washington University in St Louis, St. Louis, MO, USA
g Institute of Public Health, Washington University in St. Louis, St. Louis, United States
h Department of Psychology, Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
i Department of Clinical Research and Leadership, George Washington University School of Medicine and Health Sciences, DCWA, United States
Abstract
Alzheimer’s disease (AD) pathology accumulates for decades before the onset of cognitive decline. Cognitively normal individuals with biomarker evidence of AD brain pathology (i.e. biomarker + or preclinical AD) can be differentiated from individuals without AD brain pathology based on naturalistic driving data, such as hard acceleration or braking and speeding, measured using in-vehicle dataloggers. Older adults are at increased risk of injury and death from motor vehicle crashes and driving cessation is also linked to negative health outcomes. Identifying potentially modifiable risk factors that increase driving risk may prolong safe driving in old age. Sleep apnea is associated with adverse driving behaviors across the age span. In this study, we hypothesized that high-risk driving behaviors would be associated with increased sleep apnea severity and AD pathology. We found that higher sleep apnea severity measured by a home sleep apnea test was associated with a higher incidence of adverse driving behaviors even after controlling for multiple confounders (β = 0.24 ± 0.09, p < 0.01). This association was independent of AD biomarker positivity (i.e. increased t-tau/Aβ 42 ratio). Increasing age was associated with a higher likelihood of high-risk driving behaviors in individuals with AD brain pathology (β = 0.12 ± 0.04, p < 0.01), but a lower likelihood in individuals without AD brain pathology (β = -0.06 ± 0.03, p < 0.05). These findings suggest that adverse driving behaviors linked to a higher rate of traffic crashes in older adults are associated with sleep apnea severity and AD pathology even in cognitively unimpaired individuals. Further studies are needed to determine if treatment of sleep apnea decreases high-risk driving behaviors and therefore motor vehicle crashes. © The Author(s) 2022. Published by Oxford University Press on behalf of Sleep Research Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Author Keywords
Alzheimer’s disease; driving; obstructive sleep apnea; older adults
Document Type: Article
Publication Stage: Final
Source: Scopus
The Hydrocephalus Clinical Research Network quality improvement initiative: the role of antibiotic-impregnated catheters and vancomycin wound irrigation
(2022) Journal of Neurosurgery: Pediatrics, 29 (6), pp. 711-718.
Chu, J.a , Jensen, H.b , Holubkov, R.b , Krieger, M.D.a , Kulkarni, A.V.c , Riva-Cambrin, J.d , Rozzelle, C.J.e , Limbrick, D.D., Jr.f , Wellons, J.C., IIIg , Browd, S.R.h , Whitehead, W.E.i , Pollack, I.F.j , Simon, T.D.k , Tamber, M.S.l , Hauptman, J.S.h , Pindrik, J.m , Naftel, R.P.g , McDonald, P.J.n , Hankinson, T.C.o , Jackson, E.M.p , Rocque, B.G.e , Reeder, R.b , Drake, J.M.c , Kestle, J.R.W.q , for the Hydrocephalus Clinical Research Networkr
a Division of Neurosurgery, Children’s Hospital Los Angeles, Department of Neurosurgery, University of Southern California, Los Angeles, CA, United States
b Department of Pediatrics, University of Utah, Salt Lake City, UT, United States
c Division of Neurosurgery, Hospital for Sick Children, University of TorontoON, Canada
d Department of Clinical Neurosciences, University of Calgary, Alberta, Canada
e Section of Pediatric Neurosurgery, Division of Neurosurgery, Children’s Hospital of Alabama, University of Alabama–BirminghamAL, United States
f Department of Neurosurgery, St. Louis Children’s Hospital, Washington University in St. LouisMO, United States
g Division of Pediatric Neurosurgery, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, United States
h Department of Neurosurgery, University of Washington, Seattle Children’s Hospital, Seattle, WA, United States
i Division of Pediatric Neurosurgery, Department of Neurosurgery, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, United States
j Division of Neurosurgery, Children’s Hospital of PittsburghPA, United States
k Department of Pediatrics, Children’s Hospital Los Angeles, University of Southern California, Los Angeles, CA, United States
l Department of Surgery, Division of Neurosurgery, British Columbia Children’s Hospital, University of British Columbia, Vancouver, BC, Canada
m Department of Neurosurgery, Nationwide Children’s Hospital, Columbus, OH, United States
n Section of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada
o Division of Pediatric Neurosurgery, Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, United States
p Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States
q Department of Neurosurgery, University of Utah, Salt Lake City, UT, United States
Abstract
OBJECTIVE Two previous Hydrocephalus Clinical Research Network (HCRN) studies have demonstrated that compliance with a standardized CSF shunt infection protocol reduces shunt infections. In this third iteration, a simplified protocol consisting of 5 steps was implemented. This analysis provides an updated evaluation of protocol compliance and evaluates modifiable shunt infection risk factors. METHODS The new simplified protocol was implemented at HCRN centers on November 1, 2016, for all shunt procedures, excluding external ventricular drains, ventricular reservoirs, and subgaleal shunts. Procedures performed through December 31, 2019, were included (38 months). Compliance with the protocol, use of antibiotic-impregnated catheters (AICs), and other variables of interest were collected at the index operation. Outcome events for a minimum of 6 months postoperatively were recorded. The definition of infection was unchanged from the authors’ previous report. RESULTS A total of 4913 procedures were performed at 13 HCRN centers. The overall infection rate was 5.1%. Surgeons were compliant with all 5 steps of the protocol in 79.4% of procedures. The infection rate for the protocol alone was 8.1% and dropped to 4.9% when AICs were added. Multivariate analysis identified having ≥ 2 complex chronic conditions (odds ratio [OR] 1.76, 95% confidence interval [CI] 1.26–2.44, p = 0.01) and a history of prior shunt surgery within 12 weeks (OR 1.84, 95% CI 1.37–2.47, p < 0.01) as independent risk factors for shunt infection. The use of AICs (OR 0.70, 95% CI 0.50–0.97, p = 0.05) and vancomycin irrigation (OR 0.36, 95% CI 0.21–0.62, p < 0.01) were identified as independent factors protective against shunt infection. CONCLUSIONS The authors report the third iteration of their quality improvement protocol to reduce the risk of shunt infection. Compliance with the protocol was high. These updated data suggest that the incorporation of AICs is an important, modifiable infection prevention measure. Vancomycin irrigation was also identified as a protective factor but requires further study to better understand its role in preventing shunt infection. ©AANS 2022
Author Keywords
cerebrospinal fluid; hydrocephalus; protocol; quality improvement; shunt infection
Funding details
Hydrocephalus AssociationHA
National Institute of Neurological Disorders and StrokeNINDS1RC1NS068943-01
Document Type: Article
Publication Stage: Final
Source: Scopus
Neurobehavior in low-risk very preterm infants with low medical risk and full-term infants
(2022) Journal of Perinatology, .
Pineda, R.a b c d e , Liszka, L.a f , Tran, P.a , Kwon, J.a b , Inder, T.g
a Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, United States
b Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
c Department of Pediatrics, Keck School of Medicine, Los Angeles, CA, United States
d Gehr Family Center for Health Systems Science and Innovation, University of Southern California, Los Angeles, CA, United States
e Center for the Changing Family, University of Southern California, Los Angeles, CA, United States
f Department of Physical and Occupational Therapy, Duke University Health System, Durham, NC, United States
g Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
Abstract
Objective: To describe differences in neurobehavior among very preterm infants with low medical risk at term equivalent age and full-term infants. Study design: One-hundred eighty-six (136 infants born ≤32 weeks gestation with low medical risk at term equivalent age and 50 full-term infants within 4 days of birth) had standardized neurobehavioral assessments. Low medical risk was defined by ventilation <10 days and absence of significant brain injury, necrotizing enterocolitis, patent ductus arteriosus, and retinopathy of prematurity. Results: Very preterm infants with low medical risk at term equivalent age demonstrated more sub-optimal reflexes (p < 0.001; ß = 1.53) and more stress (p < 0.001; ß = 0.08) on the NICU Network Neurobehavioral Scale compared to their full-term counterparts. Very preterm infants with low medical risk also performed worse on the Hammersmith Neonatal Neurological Examination (p = 0.005; ß = −3.4). Conclusion: Very preterm infants at term equivalent age continue to demonstrate less optimal neurobehavior compared to full-term infants. © 2022, The Author(s), under exclusive licence to Springer Nature America, Inc.
Funding details
Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentNICHDU54 HD087011
National Institutes of HealthNIH
Institute of Clinical and Translational SciencesICTS
Gordon and Betty Moore FoundationGBMF
National Institutes of HealthNIH
National Institutes of HealthNIHROI HD 057098, K12 HD055931
Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentNICHDP30 HD062171
National Center for Advancing Translational SciencesNCATSUL1 TR000448, 5R24HD065688‐05
Document Type: Article
Publication Stage: Article in Press
Source: Scopus
Assessment of Instrumental Activities of Daily Living in Preclinical Alzheimer Disease
(2022) OTJR Occupation, Participation and Health, .
Keleman, A.A., Bollinger, R.M., Wisch, J.K., Grant, E.A., Benzinger, T.L., Ances, B.M., Stark, S.L.
Washington University in St. LouisMO, United States
Abstract
Questionnaires are used to assess instrumental activities of daily living (IADL) among individuals with preclinical Alzheimer disease (AD). They have indicated no functional impairment among this population. We aim to determine among cognitively normal (CN) older adults with and without preclinical AD whether: (a) performance-based IADL assessment measures a wider range of function than an IADL questionnaire and (b) biomarkers of AD are associated with IADL performance. In this cross-sectional analysis of 161 older adults, participants in studies of AD completed an IADL questionnaire, performance-based IADL assessment, cognitive assessments, and had biomarkers of AD (amyloid, hippocampal volume, brain network strength) assessed within 2 to 3 years. Performance-based IADL scores were more widely distributed compared with the IADL questionnaire. Smaller hippocampal volumes and reduced brain network connections were associated with worse IADL performance. A performance-based IADL assessment demonstrates functional impairment associated with neurodegeneration among CN older adults. © The Author(s) 2022.
Author Keywords
cognitive impairment; dementia; instrumental activities of daily living; neuroscience; older adults
Document Type: Article
Publication Stage: Article in Press
Source: Scopus
Integrative Approach to Predict Severity in Nonketotic Hyperglycinemia
(2022) Annals of Neurology, .
Hübschmann, O.K.a , Juliá-Palacios, N.A.b , Olivella, M.c , Guder, P.d , Zafeiriou, D.I.e , Horvath, G.f , Kulhánek, J.g , Pearson, T.S.h , Kuster, A.i , Cortès-Saladelafont, E.b j , Ibáñez, S.k , García-Jiménez, M.C.l , Honzík, T.g , Santer, R.d , Jeltsch, K.a , Garbade, S.F.m , Hoffmann, G.F.a , Opladen, T.a , García-Cazorla, Á.b
a University Children’s Hospital Heidelberg, Division of Child Neurology and Metabolic Disorders, Heidelberg, Germany
b Inborn Errors of Metabolism Unit, Department of Neurology, Recerca Sant Joan de Déu Institute, CIBERER-ISCIII and MetabERN, Barcelona, Spain
c Bioinformatics and Medical Statistics Group, Faculty of Science and Technology, Vic University–University of Central Catalonia, Barcelona, Spain
d Children’s Hospital, University Medical Center Hamburg–Eppendorf, Hamburg, Germany
e First Department of Pediatrics, Aristotle University of Thessaloniki, Thessaloniki, Greece
f Division of Biochemical Genetics, Department of Pediatrics, University of British Columbia, BC Children’s Hospital, Vancouver, BC, Canada
g Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
h Department of Neurology, Washington University School of Medicine, St Louis, MO, United States
i Department of Neurometabolism and Metabolic Disorders, University Hospital of Nantes, Nantes, France
j Inborn Errors of Metabolism and Child Neurology Unit, Department of Pediatrics, Germans Trias i Pujol Hospital, Badalona and Faculty of Medicine, Autonomous University of Barcelona, Barcelona, Spain
k Department of Pediatric Neurology, Virgen de la Arrixaca Hospital, Murcia, Spain
l Metabolic Diseases Unit, Miguel Servet University Hospital, Zaragoza, Spain
m Dietmar-Hopp Metabolic Center, University Children’s Hospital Heidelberg, Heidelberg, Germany
Abstract
Objective: Glycine encephalopathy, also known as nonketotic hyperglycinemia (NKH), is an inherited neurometabolic disorder with variable clinical course and severity, ranging from infantile epileptic encephalopathy to psychiatric disorders. A precise phenotypic characterization and an evaluation of predictive approaches are needed. Methods: Longitudinal clinical and biochemical data of 25 individuals with NKH from the patient registry of the International Working Group on Neurotransmitter Related Disorders were studied with in silico analyses, pathogenicity scores, and molecular modeling of GLDC and AMT variants. Results: Symptom onset (p < 0.01) and diagnosis occur earlier in life in severe NKH (p < 0.01). Presenting symptoms affect the age at diagnosis. Psychiatric problems occur predominantly in attenuated NKH. Onset age ≥ 3 months (66% specificity, 100% sensitivity, area under the curve [AUC] = 0.87) and cerebrospinal fluid (CSF)/plasma glycine ratio ≤ 0.09 (57% specificity, 100% sensitivity, AUC = 0.88) are sensitive indicators for attenuated NKH, whereas CSF glycine concentration ≥ 116.5μmol/l (100% specificity, 93% sensitivity, AUC = 0.97) and CSF/plasma glycine ratio ≥ 0.15 (100% specificity, 64% sensitivity, AUC = 0.88) are specific for severe forms. A ratio threshold of 0.128 discriminates the overlapping range. We present 10 new GLDC variants. Two mild variants resulted in attenuated, whereas 2 severe variants or 1 mild and 1 severe variant led to severe phenotype. Based on clinical, biochemical, and genetic parameters, we propose a severity prediction model. Interpretation: This study widens the phenotypic spectrum of attenuated NKH and expands the number of pathogenic variants. The multiparametric approach provides a promising tool to predict disease severity, helping to improve clinical management strategies. ANN NEUROL 2022. © 2022 American Neurological Association.
Funding details
European Regional Development FundERDFPI19/00348
Ministerstvo Zdravotnictví Ceské RepublikyMZCRProgresQ26/LF1, RVO‐VFN 64165 GJIH‐0599‐00‐7‐846
Instituto de Salud Carlos IIIISCIIIFIS P118/00111, FI21/00073
Document Type: Article
Publication Stage: Article in Press
Source: Scopus
The Impact of a Multidisciplinary Opioid Use Disorder Prenatal Clinic on Breastfeeding Rates and Postpartum Care
(2022) American Journal of Perinatology, .
Hensel, D.a , Helou, N.E.a , Zhang, F.a , Stout, M.J.b , Raghuraman, N.a , Friedman, H.c , Carter, E.a , Odibo, A.O.a , Kelly, J.C.a
a Division of Maternal Fetal Medicine and Ultrasound, Department of Obstetrics and Gynecology, Washington University, School of Medicine in St. Louis, 660 S. Euclid Avenue Mail Stop: 8064-37-1005, St. Louis, MO 63110, United States
b Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, United States
c Department of Pediatrics, Washington University, School of Medicine in St. Louis, St. Louis, MO, United States
Abstract
Objective To evaluate the hypothesis that patients with opioid use disorder (OUD), who receive prenatal care in a multidisciplinary, prenatal OUD clinic, have comparable postpartum breastfeeding rates, prenatal and postpartum visit compliance, and postpartum contraceptive use when compared with matched controls without a diagnosis of OUD. Study Design This was a retrospective, matched, cohort study that included all patients who received prenatal care in a multidisciplinary, prenatal OUD clinic-Clinic for Acceptance Recovery and Empowerment (CARE)-between September 2018 and August 2020. These patients were maintained on opioid agonist therapy (OAT) throughout their pregnancy. CARE patients were matched to controls without OUD in a 1:4 ratio for mode of delivery, race, gestational age ± 1 week, and delivery date ± 6 months. The primary outcome was rate of exclusive breastfeeding at maternal discharge. Secondary outcomes included adherence with prenatal care (≥4 prenatal visits), adherence with postpartum care (≥1 postpartum visit), postpartum contraception plan prior to delivery, and type of postpartum contraceptive use. Conditional multivariate logistic regression was used to account for possible confounders in adjusted calculations. Results A total of 210 patients were included (42 CARE and 168 matched controls). Despite having lower rates of adequate prenatal care, 40 CARE patients (95%) were exclusively breastfeeding at discharge resulting in CARE patients being significantly more likely to be breastfeeding at discharge (adjusted relative risk (aRR): 1.28, 95% confidence interval [CI]: 1.05-1.55). CARE patients and controls demonstrated no difference in postpartum visit compliance (86 vs. 81%, aRR: 1.03, 95% CI: 0.76-1.40) or effective, long-term contraception use (48 vs. 48%; aRR: 0.81, 95% CI: 0.36-1.84). Conclusion In the setting of multidisciplinary OUD prenatal care during pregnancy, patients with OUD were more likely to be breastfeeding at the time of discharge than matched controls, with no difference in postpartum visit compliance or effective, long-term contraception. Key Points Women with OUD are more likely to breastfeed when engaged in a multidisciplinary prenatal clinic. Women with OUD had no difference in LARC use when engaged in a multidisciplinary prenatal clinic. Women with OUD had no difference in postpartum visit rate in a multidisciplinary prenatal clinic. © 2022 Georg Thieme Verlag. All rights reserved.
Author Keywords
breastfeeding; contraception; multidisciplinary prenatal clinic; opioid use disorder; postpartum
Document Type: Article
Publication Stage: Article in Press
Source: Scopus