Edited by Jake Remaly

TOPLINE:

A new analysis showed that preeclampsia is associated with an increased risk for young-onset dementia.

METHODOLOGY:

• Researchers analyzed data from the French Conception study, a nationwide prospective cohort study of more than 1.9 million pregnancies.
• Mothers were followed for an average of 9 years.

TAKEAWAY:

• Nearly 3% of the mothers had preeclampsia, and 128 developed young-onset dementia.
• Preeclampsia was associated with a 2.65-fold increased risk for young-onset dementia after adjusting for obesity, diabetes, smoking, drug or alcohol addiction, and social deprivation.
• The risk was greater when preeclampsia occurred before 34 weeks of gestation (hazard ratio [HR], 4.15) or was superimposed on chronic hypertension (HR, 4.76).
• Prior research has found an association between preeclampsia and vascular dementia, but this analysis “is the first to show an increase in early-onset dementia risk,” the authors of the study wrote.

IN PRACTICE:

“Individuals who have had preeclampsia should be reassured that young-onset dementia remains a very rare condition. Their absolute risk increases only imperceptibly,” Stephen Tong, PhD, and Roxanne Hastie, PhD, both with the University of Melbourne, Melbourne, Australia, wrote in a related commentary about the findings.

“Individuals who have been affected by preeclampsia in a prior pregnancy might instead focus on reducing their risk of developing the many chronic health ailments that are far more common,” they added. “Although it is yet to be proven in clinical trials, it is plausible that after an episode of preeclampsia, adopting a healthy lifestyle may improve vascular health and reduce the risk of many serious cardiovascular conditions.”

SOURCE:

Valérie Olié, PhD, of the Santé Publique France in Saint-Maurice, France, was the corresponding author on the paper. The research letter was published online in JAMA Network Open.

LIMITATIONS:

The investigators relied on hospital records to identify cases of dementia, which may have led to underestimation of incidence of the disease.

DISCLOSURES:

The study was funded by the French Hypertension Society, the French Hypertension Research Foundation, and the French Cardiology Federation. A co-author disclosed personal fees from pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

A new analysis showed that preeclampsia is associated with an increased risk for young-onset dementia.

METHODOLOGY:

• Researchers analyzed data from the French Conception study, a nationwide prospective cohort study of more than 1.9 million pregnancies.
• Mothers were followed for an average of 9 years.

TAKEAWAY:

• Nearly 3% of the mothers had preeclampsia, and 128 developed young-onset dementia.
• Preeclampsia was associated with a 2.65-fold increased risk for young-onset dementia after adjusting for obesity, diabetes, smoking, drug or alcohol addiction, and social deprivation.
• The risk was greater when preeclampsia occurred before 34 weeks of gestation (hazard ratio [HR], 4.15) or was superimposed on chronic hypertension (HR, 4.76).
• Prior research has found an association between preeclampsia and vascular dementia, but this analysis “is the first to show an increase in early-onset dementia risk,” the authors of the study wrote.

IN PRACTICE:

“Individuals who have had preeclampsia should be reassured that young-onset dementia remains a very rare condition. Their absolute risk increases only imperceptibly,” Stephen Tong, PhD, and Roxanne Hastie, PhD, both with the University of Melbourne, Melbourne, Australia, wrote in a related commentary about the findings.

“Individuals who have been affected by preeclampsia in a prior pregnancy might instead focus on reducing their risk of developing the many chronic health ailments that are far more common,” they added. “Although it is yet to be proven in clinical trials, it is plausible that after an episode of preeclampsia, adopting a healthy lifestyle may improve vascular health and reduce the risk of many serious cardiovascular conditions.”

SOURCE:

Valérie Olié, PhD, of the Santé Publique France in Saint-Maurice, France, was the corresponding author on the paper. The research letter was published online in JAMA Network Open.

LIMITATIONS:

The investigators relied on hospital records to identify cases of dementia, which may have led to underestimation of incidence of the disease.

DISCLOSURES:

The study was funded by the French Hypertension Society, the French Hypertension Research Foundation, and the French Cardiology Federation. A co-author disclosed personal fees from pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

A new analysis showed that preeclampsia is associated with an increased risk for young-onset dementia.

METHODOLOGY:

• Researchers analyzed data from the French Conception study, a nationwide prospective cohort study of more than 1.9 million pregnancies.
• Mothers were followed for an average of 9 years.

TAKEAWAY:

• Nearly 3% of the mothers had preeclampsia, and 128 developed young-onset dementia.
• Preeclampsia was associated with a 2.65-fold increased risk for young-onset dementia after adjusting for obesity, diabetes, smoking, drug or alcohol addiction, and social deprivation.
• The risk was greater when preeclampsia occurred before 34 weeks of gestation (hazard ratio [HR], 4.15) or was superimposed on chronic hypertension (HR, 4.76).
• Prior research has found an association between preeclampsia and vascular dementia, but this analysis “is the first to show an increase in early-onset dementia risk,” the authors of the study wrote.

IN PRACTICE:

“Individuals who have had preeclampsia should be reassured that young-onset dementia remains a very rare condition. Their absolute risk increases only imperceptibly,” Stephen Tong, PhD, and Roxanne Hastie, PhD, both with the University of Melbourne, Melbourne, Australia, wrote in a related commentary about the findings.

“Individuals who have been affected by preeclampsia in a prior pregnancy might instead focus on reducing their risk of developing the many chronic health ailments that are far more common,” they added. “Although it is yet to be proven in clinical trials, it is plausible that after an episode of preeclampsia, adopting a healthy lifestyle may improve vascular health and reduce the risk of many serious cardiovascular conditions.”

SOURCE:

Valérie Olié, PhD, of the Santé Publique France in Saint-Maurice, France, was the corresponding author on the paper. The research letter was published online in JAMA Network Open.

LIMITATIONS:

The investigators relied on hospital records to identify cases of dementia, which may have led to underestimation of incidence of the disease.

DISCLOSURES:

The study was funded by the French Hypertension Society, the French Hypertension Research Foundation, and the French Cardiology Federation. A co-author disclosed personal fees from pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

Over 80% of women with new-onset hypertensive disorders during pregnancy experienced persistent hypertension in the 6 weeks after delivery.

METHODOLOGY:

• Researchers analyzed data from 2705 women in the University of Pittsburgh Medical Center system who developed new-onset hypertensive disorders during pregnancy and participated in a remote blood pressure (BP) monitoring program after discharge from the hospital.
• Nurses showed patients how to monitor their pressure at home, and patients had access to a call center that focused on BP management.

TAKEAWAY:

• Persistent hypertension postpartum — defined as an at-home BP measurement of 140/90 mmHg or greater or treatment with an antihypertensive medication — occurred in 81.8% of the participants.
• A total of 14.1% developed severe hypertension (BP of 160/110 mmHg or greater); 22.6% started an antihypertensive medication after discharge.
• Hospital readmission occurred for 13.4% of the women with severe hypertension, 4% of the women with less serious hypertension, and 2.7% of those who did not have persistent high BP.

IN PRACTICE:

Many of the patients had met criteria to initiate antihypertensive treatment during the delivery admission based on guidance from the American College of Cardiology/American Heart Association (67.9%) and the American College of Obstetricians and Gynecologists (38.7%), “yet only 23.5% were discharged with antihypertensive medications,” Sadiya S. Khan, MD, MSc, of Northwestern University Feinberg School of Medicine, in Chicago, wrote in an editor’s note accompanying the study. “These data highlight several critical gaps in evidence-based recommendations for the monitoring and management of BP following a pregnancy complicated by” hypertensive disorders of pregnancy.

SOURCE:

The study was led by Alisse Hauspurg, MD, MS, of Magee-Womens Research Institute in Pittsburgh, and appeared online in JAMA Cardiology.

LIMITATIONS:

The study was limited to data from one center, and the researchers relied on self-reported BP measurements.

DISCLOSURES:

The study was supported by the National Institutes of Health and the American Heart Association. A coauthor disclosed consulting for Organon and being a cofounder of Naima Health.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

Over 80% of women with new-onset hypertensive disorders during pregnancy experienced persistent hypertension in the 6 weeks after delivery.

METHODOLOGY:

• Researchers analyzed data from 2705 women in the University of Pittsburgh Medical Center system who developed new-onset hypertensive disorders during pregnancy and participated in a remote blood pressure (BP) monitoring program after discharge from the hospital.
• Nurses showed patients how to monitor their pressure at home, and patients had access to a call center that focused on BP management.

TAKEAWAY:

• Persistent hypertension postpartum — defined as an at-home BP measurement of 140/90 mmHg or greater or treatment with an antihypertensive medication — occurred in 81.8% of the participants.
• A total of 14.1% developed severe hypertension (BP of 160/110 mmHg or greater); 22.6% started an antihypertensive medication after discharge.
• Hospital readmission occurred for 13.4% of the women with severe hypertension, 4% of the women with less serious hypertension, and 2.7% of those who did not have persistent high BP.

IN PRACTICE:

Many of the patients had met criteria to initiate antihypertensive treatment during the delivery admission based on guidance from the American College of Cardiology/American Heart Association (67.9%) and the American College of Obstetricians and Gynecologists (38.7%), “yet only 23.5% were discharged with antihypertensive medications,” Sadiya S. Khan, MD, MSc, of Northwestern University Feinberg School of Medicine, in Chicago, wrote in an editor’s note accompanying the study. “These data highlight several critical gaps in evidence-based recommendations for the monitoring and management of BP following a pregnancy complicated by” hypertensive disorders of pregnancy.

SOURCE:

The study was led by Alisse Hauspurg, MD, MS, of Magee-Womens Research Institute in Pittsburgh, and appeared online in JAMA Cardiology.

LIMITATIONS:

The study was limited to data from one center, and the researchers relied on self-reported BP measurements.

DISCLOSURES:

The study was supported by the National Institutes of Health and the American Heart Association. A coauthor disclosed consulting for Organon and being a cofounder of Naima Health.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

Over 80% of women with new-onset hypertensive disorders during pregnancy experienced persistent hypertension in the 6 weeks after delivery.

METHODOLOGY:

• Researchers analyzed data from 2705 women in the University of Pittsburgh Medical Center system who developed new-onset hypertensive disorders during pregnancy and participated in a remote blood pressure (BP) monitoring program after discharge from the hospital.
• Nurses showed patients how to monitor their pressure at home, and patients had access to a call center that focused on BP management.

TAKEAWAY:

• Persistent hypertension postpartum — defined as an at-home BP measurement of 140/90 mmHg or greater or treatment with an antihypertensive medication — occurred in 81.8% of the participants.
• A total of 14.1% developed severe hypertension (BP of 160/110 mmHg or greater); 22.6% started an antihypertensive medication after discharge.
• Hospital readmission occurred for 13.4% of the women with severe hypertension, 4% of the women with less serious hypertension, and 2.7% of those who did not have persistent high BP.

IN PRACTICE:

Many of the patients had met criteria to initiate antihypertensive treatment during the delivery admission based on guidance from the American College of Cardiology/American Heart Association (67.9%) and the American College of Obstetricians and Gynecologists (38.7%), “yet only 23.5% were discharged with antihypertensive medications,” Sadiya S. Khan, MD, MSc, of Northwestern University Feinberg School of Medicine, in Chicago, wrote in an editor’s note accompanying the study. “These data highlight several critical gaps in evidence-based recommendations for the monitoring and management of BP following a pregnancy complicated by” hypertensive disorders of pregnancy.

SOURCE:

The study was led by Alisse Hauspurg, MD, MS, of Magee-Womens Research Institute in Pittsburgh, and appeared online in JAMA Cardiology.

LIMITATIONS:

The study was limited to data from one center, and the researchers relied on self-reported BP measurements.

DISCLOSURES:

The study was supported by the National Institutes of Health and the American Heart Association. A coauthor disclosed consulting for Organon and being a cofounder of Naima Health.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

Various surgical approaches to treat vaginal vault prolapse may be similarly safe and effective and can produce high rates of patient satisfaction.

METHODOLOGY:

• A randomized clinical trial at nine sites in the United States included 360 women with vaginal vault prolapse after hysterectomy (average age, 66 years).
• The women were randomly assigned to undergo native tissue repair (transvaginal repair using the sacrospinous or uterosacral ligament), sacrocolpopexy (mesh repair placed abdominally via open or minimally invasive surgery), or transvaginal mesh repair.

TAKEAWAY:

• At 36 months, a composite measure of treatment failure — based on the need for retreatment, the presence of symptoms, or prolapse beyond the hymen — had occurred in 28% of the women who received sacrocolpopexy, 29% who received transvaginal mesh, and 43% who underwent native tissue repair.
• Sacrocolpopexy was superior to native tissue repair for treatment success (adjusted hazard ratio, 0.57; P = .01), and transvaginal mesh was noninferior to sacrocolpopexy, the researchers found.
• All of the surgical approaches were associated with high rates of treatment satisfaction and improved quality of life and sexual function.
• Adverse events and mesh complications were uncommon.

IN PRACTICE:

“All approaches were associated with high treatment satisfaction; improved symptoms, quality of life, and sexual function; and low rates of regret,” the authors of the study wrote. “As such, clinicians counseling patients with prolapse can discuss the ramifications of each approach and engage in shared, individualized decision-making.”

SOURCE:

The study was led by Shawn A. Menefee, MD, Kaiser Permanente San Diego in San Diego, California. It was published online in JAMA Surgery.

LIMITATIONS:

The US Food and Drug Administration in April 2019 banned transvaginal mesh for pelvic organ prolapse because of concerns about complications such as exposure and erosion. Five trial participants who had been assigned to receive transvaginal mesh but had not yet received it at that time were rerandomized to one of the other surgical approaches.

DISCLOSURES:

The study was supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institutes of Health Office of Research on Women’s Health. Researchers disclosed consulting for companies that market medical devices.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

Various surgical approaches to treat vaginal vault prolapse may be similarly safe and effective and can produce high rates of patient satisfaction.

METHODOLOGY:

• A randomized clinical trial at nine sites in the United States included 360 women with vaginal vault prolapse after hysterectomy (average age, 66 years).
• The women were randomly assigned to undergo native tissue repair (transvaginal repair using the sacrospinous or uterosacral ligament), sacrocolpopexy (mesh repair placed abdominally via open or minimally invasive surgery), or transvaginal mesh repair.

TAKEAWAY:

• At 36 months, a composite measure of treatment failure — based on the need for retreatment, the presence of symptoms, or prolapse beyond the hymen — had occurred in 28% of the women who received sacrocolpopexy, 29% who received transvaginal mesh, and 43% who underwent native tissue repair.
• Sacrocolpopexy was superior to native tissue repair for treatment success (adjusted hazard ratio, 0.57; P = .01), and transvaginal mesh was noninferior to sacrocolpopexy, the researchers found.
• All of the surgical approaches were associated with high rates of treatment satisfaction and improved quality of life and sexual function.
• Adverse events and mesh complications were uncommon.

IN PRACTICE:

“All approaches were associated with high treatment satisfaction; improved symptoms, quality of life, and sexual function; and low rates of regret,” the authors of the study wrote. “As such, clinicians counseling patients with prolapse can discuss the ramifications of each approach and engage in shared, individualized decision-making.”

SOURCE:

The study was led by Shawn A. Menefee, MD, Kaiser Permanente San Diego in San Diego, California. It was published online in JAMA Surgery.

LIMITATIONS:

The US Food and Drug Administration in April 2019 banned transvaginal mesh for pelvic organ prolapse because of concerns about complications such as exposure and erosion. Five trial participants who had been assigned to receive transvaginal mesh but had not yet received it at that time were rerandomized to one of the other surgical approaches.

DISCLOSURES:

The study was supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institutes of Health Office of Research on Women’s Health. Researchers disclosed consulting for companies that market medical devices.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

Various surgical approaches to treat vaginal vault prolapse may be similarly safe and effective and can produce high rates of patient satisfaction.

METHODOLOGY:

• A randomized clinical trial at nine sites in the United States included 360 women with vaginal vault prolapse after hysterectomy (average age, 66 years).
• The women were randomly assigned to undergo native tissue repair (transvaginal repair using the sacrospinous or uterosacral ligament), sacrocolpopexy (mesh repair placed abdominally via open or minimally invasive surgery), or transvaginal mesh repair.

TAKEAWAY:

• At 36 months, a composite measure of treatment failure — based on the need for retreatment, the presence of symptoms, or prolapse beyond the hymen — had occurred in 28% of the women who received sacrocolpopexy, 29% who received transvaginal mesh, and 43% who underwent native tissue repair.
• Sacrocolpopexy was superior to native tissue repair for treatment success (adjusted hazard ratio, 0.57; P = .01), and transvaginal mesh was noninferior to sacrocolpopexy, the researchers found.
• All of the surgical approaches were associated with high rates of treatment satisfaction and improved quality of life and sexual function.
• Adverse events and mesh complications were uncommon.

IN PRACTICE:

“All approaches were associated with high treatment satisfaction; improved symptoms, quality of life, and sexual function; and low rates of regret,” the authors of the study wrote. “As such, clinicians counseling patients with prolapse can discuss the ramifications of each approach and engage in shared, individualized decision-making.”

SOURCE:

The study was led by Shawn A. Menefee, MD, Kaiser Permanente San Diego in San Diego, California. It was published online in JAMA Surgery.

LIMITATIONS:

The US Food and Drug Administration in April 2019 banned transvaginal mesh for pelvic organ prolapse because of concerns about complications such as exposure and erosion. Five trial participants who had been assigned to receive transvaginal mesh but had not yet received it at that time were rerandomized to one of the other surgical approaches.

DISCLOSURES:

The study was supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institutes of Health Office of Research on Women’s Health. Researchers disclosed consulting for companies that market medical devices.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

Physical performance significantly correlates with increased survival rates in individuals aged over 80 years.

METHODOLOGY:

• Researchers analyzed data from 195 participants in the ilSIRENTE study, a prospective cohort study in L’Aquila, Italy, that included men and women born before 1924. The analysis focused on participants aged < 85 years at the time of enrollment (mean age, 82 years).
• Physical performance was assessed via the Short Physical Performance Battery (SPPB), which tests balance, gait speed, and leg strength based on the ability to stand from a seated position in a chair.
• Based on SPPB scores, participants were classified as having severe, moderate, mild, or no functional impairment.

TAKEAWAY:

• About 21% of the participants lived to 95 years of age.
• Higher scores on the SPPB and faster gait speed were linked to a lower risk for mortality before that age.
• The average gait speed was 0.88 m/s among participants who lived to 95 years of age and 0.78 m/s for those who died at younger ages.

IN PRACTICE:

“Physical performance is ... a reliable metric for assessing mortality risk in octogenarians,” the authors of the study wrote. “Our findings, together with available evidence, support the view that physical performance is a primary target for interventions to enhance longevity and extend health span.”

SOURCE:

Stefano Cacciatore, MD, with Universita Cattolica del Sacro Cuore, in Rome, was the corresponding author on the paper. The study was published online on May 2, 2024, in Journal of the American Geriatrics Society.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.

TOPLINE:

Physical performance significantly correlates with increased survival rates in individuals aged over 80 years.

METHODOLOGY:

• Researchers analyzed data from 195 participants in the ilSIRENTE study, a prospective cohort study in L’Aquila, Italy, that included men and women born before 1924. The analysis focused on participants aged < 85 years at the time of enrollment (mean age, 82 years).
• Physical performance was assessed via the Short Physical Performance Battery (SPPB), which tests balance, gait speed, and leg strength based on the ability to stand from a seated position in a chair.
• Based on SPPB scores, participants were classified as having severe, moderate, mild, or no functional impairment.

TAKEAWAY:

• About 21% of the participants lived to 95 years of age.
• Higher scores on the SPPB and faster gait speed were linked to a lower risk for mortality before that age.
• The average gait speed was 0.88 m/s among participants who lived to 95 years of age and 0.78 m/s for those who died at younger ages.

IN PRACTICE:

“Physical performance is ... a reliable metric for assessing mortality risk in octogenarians,” the authors of the study wrote. “Our findings, together with available evidence, support the view that physical performance is a primary target for interventions to enhance longevity and extend health span.”

SOURCE:

Stefano Cacciatore, MD, with Universita Cattolica del Sacro Cuore, in Rome, was the corresponding author on the paper. The study was published online on May 2, 2024, in Journal of the American Geriatrics Society.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.

TOPLINE:

Physical performance significantly correlates with increased survival rates in individuals aged over 80 years.

METHODOLOGY:

• Researchers analyzed data from 195 participants in the ilSIRENTE study, a prospective cohort study in L’Aquila, Italy, that included men and women born before 1924. The analysis focused on participants aged < 85 years at the time of enrollment (mean age, 82 years).
• Physical performance was assessed via the Short Physical Performance Battery (SPPB), which tests balance, gait speed, and leg strength based on the ability to stand from a seated position in a chair.
• Based on SPPB scores, participants were classified as having severe, moderate, mild, or no functional impairment.

TAKEAWAY:

• About 21% of the participants lived to 95 years of age.
• Higher scores on the SPPB and faster gait speed were linked to a lower risk for mortality before that age.
• The average gait speed was 0.88 m/s among participants who lived to 95 years of age and 0.78 m/s for those who died at younger ages.

IN PRACTICE:

“Physical performance is ... a reliable metric for assessing mortality risk in octogenarians,” the authors of the study wrote. “Our findings, together with available evidence, support the view that physical performance is a primary target for interventions to enhance longevity and extend health span.”

SOURCE:

Stefano Cacciatore, MD, with Universita Cattolica del Sacro Cuore, in Rome, was the corresponding author on the paper. The study was published online on May 2, 2024, in Journal of the American Geriatrics Society.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.

TOPLINE:

A study comparing cervical pessary and vaginal progesterone for the prevention of preterm birth in women with a short cervix of ≤ 35 mm found no significant difference between the interventions for perinatal complications. Among women with a cervical length of ≤ 25 mm, however, pessaries appeared to be less effective at preventing spontaneous preterm birth and adverse outcomes, according to the researchers.

METHODOLOGY:

• Researchers conducted an open-label, randomized controlled trial at 20 hospitals and five obstetric ultrasound practices in the Netherlands.
• The study included 635 women with healthy singleton pregnancies between 18 and 22 weeks’ gestation and an asymptomatic short cervix of ≤ 35 mm. Participants had no history of spontaneous preterm birth.
• Women were randomly assigned to receive either an Arabin cervical pessary or 200 mg/d vaginal progesterone for ≤ 36 weeks of gestation.
• The investigators examined a composite measure of adverse perinatal outcomes, including  (grade, > 1), chronic lung disease,  (grade, III or IV),  (stage, > 1), , stillbirth, and death of the baby.

TAKEAWAY:

• Adverse perinatal outcomes occurred in 6% of each treatment group, and the rate of spontaneous preterm birth did not differ significantly between the groups.
• In a subgroup analysis of 131 patients with a cervical length of ≤ 25 mm, spontaneous preterm birth at < 28 weeks occurred more often in the pessary group (16% vs 4%).
• Adverse perinatal outcomes also seemed to occur more frequently in the pessary group (24% vs 12%; relative risk, 2.1 [95% CI, 0.95-4.60]), in the subgroup analysis, according to the researchers.

IN PRACTICE:

“Even though the study was not powered for the subgroup with a short cervix of ≤ 25 mm, results suggest that a cervical pessary should not be used as preventive treatment in this group,” the researchers wrote.

SOURCE:

The study was led by Charlotte E. van Dijk, MD, with Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. It was published online in The BMJ.

LIMITATIONS:

The researchers were unable to mask the treatment groups, which could introduce bias. The study’s reliance on self-reported medication adherence in the progesterone group and a lack of extra training for pessary placement might have influenced the outcomes, the researchers noted.

DISCLOSURES:

The study was supported by Stichting Stoptevroegbevallen, a nonprofit research foundation. An author disclosed financial ties with Merck.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

A study comparing cervical pessary and vaginal progesterone for the prevention of preterm birth in women with a short cervix of ≤ 35 mm found no significant difference between the interventions for perinatal complications. Among women with a cervical length of ≤ 25 mm, however, pessaries appeared to be less effective at preventing spontaneous preterm birth and adverse outcomes, according to the researchers.

METHODOLOGY:

• Researchers conducted an open-label, randomized controlled trial at 20 hospitals and five obstetric ultrasound practices in the Netherlands.
• The study included 635 women with healthy singleton pregnancies between 18 and 22 weeks’ gestation and an asymptomatic short cervix of ≤ 35 mm. Participants had no history of spontaneous preterm birth.
• Women were randomly assigned to receive either an Arabin cervical pessary or 200 mg/d vaginal progesterone for ≤ 36 weeks of gestation.
• The investigators examined a composite measure of adverse perinatal outcomes, including  (grade, > 1), chronic lung disease,  (grade, III or IV),  (stage, > 1), , stillbirth, and death of the baby.

TAKEAWAY:

• Adverse perinatal outcomes occurred in 6% of each treatment group, and the rate of spontaneous preterm birth did not differ significantly between the groups.
• In a subgroup analysis of 131 patients with a cervical length of ≤ 25 mm, spontaneous preterm birth at < 28 weeks occurred more often in the pessary group (16% vs 4%).
• Adverse perinatal outcomes also seemed to occur more frequently in the pessary group (24% vs 12%; relative risk, 2.1 [95% CI, 0.95-4.60]), in the subgroup analysis, according to the researchers.

IN PRACTICE:

“Even though the study was not powered for the subgroup with a short cervix of ≤ 25 mm, results suggest that a cervical pessary should not be used as preventive treatment in this group,” the researchers wrote.

SOURCE:

The study was led by Charlotte E. van Dijk, MD, with Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. It was published online in The BMJ.

LIMITATIONS:

The researchers were unable to mask the treatment groups, which could introduce bias. The study’s reliance on self-reported medication adherence in the progesterone group and a lack of extra training for pessary placement might have influenced the outcomes, the researchers noted.

DISCLOSURES:

The study was supported by Stichting Stoptevroegbevallen, a nonprofit research foundation. An author disclosed financial ties with Merck.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

TOPLINE:

A study comparing cervical pessary and vaginal progesterone for the prevention of preterm birth in women with a short cervix of ≤ 35 mm found no significant difference between the interventions for perinatal complications. Among women with a cervical length of ≤ 25 mm, however, pessaries appeared to be less effective at preventing spontaneous preterm birth and adverse outcomes, according to the researchers.

METHODOLOGY:

• Researchers conducted an open-label, randomized controlled trial at 20 hospitals and five obstetric ultrasound practices in the Netherlands.
• The study included 635 women with healthy singleton pregnancies between 18 and 22 weeks’ gestation and an asymptomatic short cervix of ≤ 35 mm. Participants had no history of spontaneous preterm birth.
• Women were randomly assigned to receive either an Arabin cervical pessary or 200 mg/d vaginal progesterone for ≤ 36 weeks of gestation.
• The investigators examined a composite measure of adverse perinatal outcomes, including  (grade, > 1), chronic lung disease,  (grade, III or IV),  (stage, > 1), , stillbirth, and death of the baby.

TAKEAWAY:

• Adverse perinatal outcomes occurred in 6% of each treatment group, and the rate of spontaneous preterm birth did not differ significantly between the groups.
• In a subgroup analysis of 131 patients with a cervical length of ≤ 25 mm, spontaneous preterm birth at < 28 weeks occurred more often in the pessary group (16% vs 4%).
• Adverse perinatal outcomes also seemed to occur more frequently in the pessary group (24% vs 12%; relative risk, 2.1 [95% CI, 0.95-4.60]), in the subgroup analysis, according to the researchers.

IN PRACTICE:

“Even though the study was not powered for the subgroup with a short cervix of ≤ 25 mm, results suggest that a cervical pessary should not be used as preventive treatment in this group,” the researchers wrote.

SOURCE:

The study was led by Charlotte E. van Dijk, MD, with Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. It was published online in The BMJ.

LIMITATIONS:

The researchers were unable to mask the treatment groups, which could introduce bias. The study’s reliance on self-reported medication adherence in the progesterone group and a lack of extra training for pessary placement might have influenced the outcomes, the researchers noted.

DISCLOSURES:

The study was supported by Stichting Stoptevroegbevallen, a nonprofit research foundation. An author disclosed financial ties with Merck.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.