In utero flu vaccine exposure not tied to adverse outcomes | Guidance covers infants born to mothers with COVID-19 | Trial of labor after cesarean can be safe option
August 3, 2020
OBGYN SmartBrief
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Lead Story
A study in Pediatrics found no statistically significant association between in utero exposure to influenza vaccine and adverse health outcomes in children older than 6 months. The findings were based on data involving more than 750,000 children.
Full Story: 2 Minute Medicine (7/27) 
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Pregnancy Care & Childbirth
The American Academy of Pediatrics issued updated guidance saying that it no longer recommends separating newborn infants from mothers infected with COVID-19 and that they may room-in according to usual center practice. The AAP also said a mother should maintain appropriate distance from her infant when possible during birth hospitalization and perform proper hand hygiene and wear a mask when providing hands-on care to her infant.
Full Story: Healio (free registration)/Infectious Diseases in Children (7/28) 
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Dr. Chavi Eve Karkowsky is an expert in high-risk pregnancies, and she writes that sometimes a cesarean delivery is medically necessary for both the health of the mother and the baby. However, letting a woman choose vaginal birth for a subsequent pregnancy, or "trial of labor after cesarean," when appropriate can help bring down the rising number of cesarean deliveries that occur in the US, Karkowsky writes.
Full Story: Slate (7/30) 
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Primary Care, Gynecologic Care & Women's Health
Research published in JAMA Internal Medicine linked improvements in lifestyle factors, including reduced smoking and less heavy alcohol consumption, to a lower risk of hip fracture in adults. Hip fracture incidence decreased by 4.4% annually from 1970 to 2010, the study found.
Full Story: Healio (free registration) (7/28) 
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Women with prepregnancy creatinine levels above the 95th percentile had an increased risk for induced preterm birth before 37 weeks of gestation, compared with those with prepregnancy creatinine at or below the 95th percentile, researchers reported in CMAJ. The findings, based on data involving 55,946 pregnancies, also showed that women with abnormally elevated levels of serum creatinine had a greater risk of stillbirth.
Full Story: Physician's Briefing/HealthDay News (7/27),  MedPage Today (free registration) (7/27) 
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    Health Policy & Legislation
    Medicaid enrollment increased from 71.5 million in March to 72.3 million in April due to the economic impact of the COVID-19 pandemic, but it did not increase as much as some analysts predicted. The results suggest people worried about COVID-19 may have decided to avoid seeking care and not sign up for health coverage, but Joan Alker, executive director of the Center for Children and Families at Georgetown University, said she expects Medicaid enrollment to continue to increase through the summer.
    Full Story: Kaiser Health News (7/28) 
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    The novel coronavirus pandemic relief package offered by Senate Republicans includes $25 billion for health care providers, in addition to $175 billion already approved, and liability protection for hospitals, physicians and nurses. Senate Majority Leader Mitch McConnell, R-Ky., said the legislation also focuses on incentives for domestic manufacturing of health care supplies.
    Full Story: FierceHealthcare (7/27) 
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    Practice Management & Professional News
    Physician recruitment searches conducted by Merritt Hawkins decreased 30% since March 31, and while family medicine continues to be the most sought-after specialty, demand for primary care physicians is leveling off, the company said. The report predicted a drop in primary care salaries overall and noted telehealth will generate a bigger percentage of revenue.
    Full Story: Medscape (free registration) (7/27) 
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    The key to life is resilience. ... We will always be knocked down. It's the getting up that counts.
    Dominique Browning,
    writer, editor
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