2021
The Society for Obstetric Anesthesia and Perinatology Interdisciplinary Consensus Statement on Neuraxial Procedures in Obstetric Patients With Thrombocytopenia
Bauer ME, Arendt K, Beilin Y, Gernsheimer T, Perez Botero J, James AH, Yaghmour E, Toledano RD, Turrentine M, Houle T, MacEachern M, Madden H, Rajasekhar A, Segal S, Wu C, Cooper JP, Landau R, Leffert L. The Society for Obstetric Anesthesia and Perinatology Interdisciplinary Consensus Statement on Neuraxial Procedures in Obstetric Patients With Thrombocytopenia. Anesthesia & Analgesia 2021, 132: 1531-1544. PMID: 33861047, DOI: 10.1213/ane.0000000000005355.Peer-Reviewed Original ResearchConceptsSpinal epidural hematomaObstetric patientsNeuraxial proceduresImmune thrombocytopeniaEpidural hematomaGeneral anesthesiaRisk factorsObstetric risk factorsRisk-benefit discussionsDiagnosis of thrombocytopeniaRelevant professional societiesInterdisciplinary consensus statementGestational thrombocytopeniaThrombocytopenia etiologyHypertensive disordersPatient comorbiditiesCesarean deliveryProfessional societiesAirway examinationPotential morbidityPlatelet countPatient preferencesObstetric anesthesiaAirway equipmentAffected patients
2020
Maternal Stroke
Miller E, Leffert L. Maternal Stroke. 2020, 343-361. DOI: 10.1007/978-3-030-43477-9_25.Peer-Reviewed Original ResearchPregnancy-related strokeCerebral venous sinus thrombosisPosterior reversible encephalopathy syndromeReversible cerebral vasoconstriction syndromeArterial ischemic strokeCerebral vasoconstriction syndromeReversible encephalopathy syndromeVenous sinus thrombosisSetting of pregnancyCNS morbidityEncephalopathy syndromeHyperacute managementMaternal strokeHypertensive disordersSinus thrombosisIschemic strokePoststroke careHemorrhagic strokeSubarachnoid hemorrhageMaternal mortalityPostpartum womenHeart diseaseRisk factorsLeading causeStroke mechanismRisk Factors, Etiologies, and Screening Tools for Sepsis in Pregnant Women: A Multicenter Case-Control Study
Bauer M, Housey M, Bauer S, Behrmann S, Chau A, Clancy C, Clark E, Einav S, Langen E, Leffert L, Lin S, Madapu M, Maile M, McQuaid-Hanson E, Priessnitz K, Sela H, Shah A, Sobolewski P, Toledo P, Tsen L, Bateman B. Risk Factors, Etiologies, and Screening Tools for Sepsis in Pregnant Women: A Multicenter Case-Control Study. Obstetric Anesthesia Digest 2020, 40: 65-66. DOI: 10.1097/01.aoa.0000661332.57510.93.Peer-Reviewed Original ResearchMulticenter case-control studyCase-control studyMaternal sepsisQuick Sequential Organ Failure Assessment criteriaSequential Organ Failure Assessment criteriaSystemic inflammatory response syndrome criteriaPregnancy-related deathsSigns of sepsisMaternal morbidityMaternal outcomesSyndrome criteriaPrompt treatmentPregnant womenEarly sepsisRisk factorsSepsisEarly identificationDifferent screening methodsPregnancyScreening toolScreening criteriaPhysiological changesPrimary objectiveScreening methodHospitalization
2019
Risk Factors, Etiologies, and Screening Tools for Sepsis in Pregnant Women
Bauer ME, Housey M, Bauer ST, Behrmann S, Chau A, Clancy C, Clark EAS, Einav S, Langen E, Leffert L, Lin S, Madapu M, Maile MD, McQuaid-Hanson E, Priessnitz K, Sela HY, Shah A, Sobolewski P, Toledo P, Tsen LC, Bateman BT. Risk Factors, Etiologies, and Screening Tools for Sepsis in Pregnant Women. Anesthesia & Analgesia 2019, Publish Ahead of Print: &na;. PMID: 31743182, PMCID: PMC7543988, DOI: 10.1213/ane.0000000000003709.Peer-Reviewed Original ResearchConceptsSystemic inflammatory response syndromeQuick Sequential Organ Failure AssessmentRisk factorsDelivery hospitalizationsMaternal sepsisSepsis casesCommon causeMortality rateMaternal Early Warning CriteriaSequential Organ Failure AssessmentScreening toolHours of diagnosisTiming of antibioticsOrgan Failure AssessmentCohort of patientsInflammatory response syndromePotential risk factorsHalf of casesAcademic medical centerDate of deliveryQSOFA criteriaControl patientsAntibiotic therapyResponse syndromeSignificant morbidity
2018
Timing and Risk Factors of Postpartum Stroke
Too G, Wen T, Boehme AK, Miller EC, Leffert LR, Attenello FJ, Mack WJ, D'Alton M, Friedman AM. Timing and Risk Factors of Postpartum Stroke. Obstetrics And Gynecology 2018, 131: 70-78. PMID: 29215510, PMCID: PMC6402829, DOI: 10.1097/aog.0000000000002372.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultCohort StudiesConfidence IntervalsCost-Benefit AnalysisDatabases, FactualFemaleHumansHypertension, Pregnancy-InducedMaternal AgeOdds RatioPatient DischargePatient ReadmissionPostpartum PeriodPre-EclampsiaPregnancyPregnancy, High-RiskPrognosisRetrospective StudiesRisk AssessmentStrokeTime FactorsYoung AdultConceptsChronic hypertensionDays of dischargeNationwide Readmissions DatabaseHypertensive diseasePostpartum strokeStroke readmissionDelivery hospitalizationsIndex hospitalizationOdds ratioUtilization Project Nationwide Readmissions DatabaseOptimal blood pressure managementDelivery hospitalization dischargeRetrospective cohort studyBlood pressure managementRisk of readmissionCases of strokeMajority of readmissionsCases of readmissionCalendar year 2013Hospitalization dischargeCohort studyHospital dischargeMedian timeReadmission riskRisk factors
2017
Risk Factors for Pregnancy-Associated Stroke in Women With Preeclampsia
Miller EC, Gatollari HJ, Too G, Boehme AK, Leffert L, Marshall RS, Elkind MSV, Willey JZ. Risk Factors for Pregnancy-Associated Stroke in Women With Preeclampsia. Stroke 2017, 48: 1752-1759. PMID: 28546324, PMCID: PMC5539968, DOI: 10.1161/strokeaha.117.017374.Peer-Reviewed Original ResearchConceptsPregnancy-associated strokeRisk factorsChronic hypertensionProthrombotic stateOdds ratioMultivariable conditional logistic regression modelsConditional logistic regression modelsNew York State hospitalsIndependent risk factorVascular risk factorsSeverity of preeclampsiaLogistic regression modelsRace/ethnicityPregnancy complicationsSevere preeclampsiaMultivariable analysisInpatient DatabaseProthrombotic conditionsPreeclampsiaHigh riskClose monitoringNew York State DepartmentState HospitalCoagulopathyBilling data
2016
Risk of Pregnancy-Associated Stroke Across Age Groups in New York State
Miller EC, Gatollari HJ, Too G, Boehme AK, Leffert L, Elkind MS, Willey JZ. Risk of Pregnancy-Associated Stroke Across Age Groups in New York State. JAMA Neurology 2016, 73: 1461-1467. PMID: 27775757, DOI: 10.1001/jamaneurol.2016.3774.Peer-Reviewed Original ResearchConceptsPregnancy-associated strokePregnant/postpartum womenRisk of strokeIncidence risk ratioRisk factorsPostpartum womenAge groupsNonpregnant womenStroke riskOlder womenCumulative riskAge-specific incidence ratiosPost partumCalendar year 2003Cerebral venous thrombosisStroke risk factorsTransient ischemic attackVascular risk factorsOverall median ageLogistic regression modelsActive smokingChronic hypertensionIschemic attackNPAS groupCerebrovascular events
2015
Patient Characteristics and Outcomes After Hemorrhagic Stroke in Pregnancy
Leffert LR, Clancy CR, Bateman BT, Cox M, Schulte PJ, Smith EE, Fonarow GC, Schwamm LH, Kuklina EV, George MG. Patient Characteristics and Outcomes After Hemorrhagic Stroke in Pregnancy. Circulation Cardiovascular Quality And Outcomes 2015, 8: s170-s178. PMID: 26515206, DOI: 10.1161/circoutcomes.115.002242.Peer-Reviewed Original ResearchConceptsStroke risk factorsSubarachnoid hemorrhage patientsHemorrhagic strokeRisk factorsHS patientsHospital mortalityHemorrhage patientsDiseases-Ninth Revision codesBlood pressure criteriaGuidelines-Stroke registryPregnancy-related strokeAssociation of pregnancyNonpregnant female patientsConditional logistic regressionFisher's exact testWilcoxon rank sum testRank sum testGuidelines-StrokeSevere preeclampsiaHome dischargeIschemic strokeNonpregnant womenPatient characteristicsRisk patientsIndependent ambulationHypertensive Disorders and Pregnancy-Related Stroke
Leffert LR, Clancy CR, Bateman BT, Bryant AS, Kuklina EV. Hypertensive Disorders and Pregnancy-Related Stroke. Obstetrics And Gynecology 2015, 125: 124-131. PMID: 25560114, PMCID: PMC4445352, DOI: 10.1097/aog.0000000000000590.Peer-Reviewed Original ResearchConceptsTraditional stroke risk factorsPregnancy-associated strokeHypertensive disordersPregnancy hospitalizationsStroke risk factorsStroke-related complicationsStroke riskRisk factorsOdds ratioNationwide Inpatient SampleCongenital heart diseaseCross-sectional studyComplication rateStroke hospitalizationsInpatient SampleHeart diseaseNationwide rateHospitalizationPregnancyStrokeLogistic regressionCongenital coagulationDisordersConfidence intervalsComplications
2014
Cardiac Arrest during Hospitalization for Delivery in the United States, 1998–2011
Mhyre JM, Tsen LC, Einav S, Kuklina EV, Leffert LR, Bateman BT. Cardiac Arrest during Hospitalization for Delivery in the United States, 1998–2011. Anesthesiology 2014, 120: 810-818. PMID: 24694844, PMCID: PMC4445354, DOI: 10.1097/aln.0000000000000159.Peer-Reviewed Original ResearchConceptsAmniotic fluid embolismCardiac arrestPotential etiologiesHeart failureCommon potential etiologyMaternal cardiac arrestNationwide Inpatient SampleDemographic risk factorsMaternal cardiopulmonary arrestHospital dischargeCardiopulmonary arrestU.S. hospitalizationsUnderlying etiologyInpatient SampleMaternal arrestRisk factorsHospitalizationSurvival rateEtiologySepsisEmbolismHemorrhageArrestPatientsSurvival
2012
Peripartum Subarachnoid Hemorrhage
Bateman B, Olbrecht V, Berman M, Minehart R, Schwamm L, Leffert L. Peripartum Subarachnoid Hemorrhage. Anesthesiology 2012, 116: 324-333. PMID: 22166951, DOI: 10.1097/aln.0b013e3182410b22.Peer-Reviewed Original ResearchConceptsSubarachnoid hemorrhageHypertensive disordersRisk factorsPregnancy-related admissionsIndependent risk factorIntracranial venous thrombosisNationwide Inpatient SampleAfrican American raceVariety of etiologiesRange of etiologiesSickle cell diseaseIdentified admissionsHospital deathMaternal morbidityNonpregnant patientsNonpregnant womenIndependent predictorsMalignant etiologySevere headacheVenous thrombosisNonpregnant controlsPregnancy resultsVenous bleedingInstitution experienceInpatient Sample
2010
The Epidemiology of Postpartum Hemorrhage in a Large, Nationwide Sample of Deliveries
Bateman BT, Berman MF, Riley LE, Leffert LR. The Epidemiology of Postpartum Hemorrhage in a Large, Nationwide Sample of Deliveries. Anesthesia & Analgesia 2010, 110: 1368-1373. PMID: 20237047, DOI: 10.1213/ane.0b013e3181d74898.Peer-Reviewed Original ResearchConceptsPostpartum hemorrhageUterine atonyRisk factorsCesarean deliveryRate of PPHCases of PPHIncidence of PPHSubstantial maternal morbidityIndependent risk factorClinical Modification codesNationwide Inpatient SampleLogistic regression modelingAntepartum haemorrhageDelivery complicationsHospital deathMaternal morbidityMaternal outcomesMultiple gestationsCommon complicationHospital admissionHypertensive diseaseCommon etiologyMaternal ageInpatient SampleContemporary epidemiology