Contemporary OB/GYN week in review: Avian influenza, US health rankings, and more

Thank you for visiting the Contemporary OB/GYN® website. Take a look at some of our top stories from last week (Monday, December 16 - Friday, December 20, 2024), and click each link to read and watch anything you may have missed.

Avian influenza during pregnancy linked to high mortality rates

Avian influenza virus infection during pregnancy is associated with high rates of maternal and infant mortality, according to a recent report from the Centers for Disease Control and Prevention.

Investigators conducted a systematic review to evaluate the impact of avian influenza virus infection in pregnant women. Articles were obtained through searches of the MEDLINE and EMBASE databases from inception until June 2024. Studies including pregnant women with avian influenza virus infections and reporting pregnancy outcomes were included.

Poor maternal and infant outcomes were reported in infected women, including a maternal death rate of 90% and an infant death rate of 86%. Only 5 infants survived, with 4 being born preterm. Of these births, 3 occurred during maternal infection through spontaneous labor or emergency cesarean section.

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Study reports US health rankings to plummet by 2050

Health progress in the United States is steadily declining, causing the nation to fall behind the pace of many other countries worldwide, according to a recent study published in The Lancet.

Forecasts indicate the United States will rank significantly lower than other nations in health-adjusted life expectancy (HALE), defined as the average number of years an individual is expected to live in good health. By 2050, the United States’ rank for HALE is expected to drop to 108, compared to 80 in 2022.

The declines are sharper in women’s health than men’s compared to other countries. Estimates have predicted a decrease in female HALE within 20 states by 2050. Additionally, the female LE in the United States is forecasted to be rank 74 in 2050. In comparison, ranks were 19 in 1990 and 51 in 2022.

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FDA adds boxed warning to fezolinetant for rare serious liver injury

The US Food and Drug Administration (FDA) has issued a boxed warning regarding the risk of fezolinetant (Veozah) causing rare, serious liver injuries to patients.

“We also added new recommendations for patients and health care professionals about increasing the frequency of liver blood testing, adding monthly testing for the next 2 months after starting Veozah, and then at months 3, 6, and 9 of treatment as already recommended,” the FDA wrote. “The updated prescribing information also instructs patients to stop the medicine immediately and contact the health care professional who prescribed the medicine if signs and symptoms of liver injury occur.”

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Preoperative anemia linked to higher health care costs in gynecologic surgery

Health care resource utilization and cost is significantly increased among patients with preoperative anemia when receiving elective gynecologic surgery, according to a recent study published in the Journal of Minimally Invasive Gynecology.

Anemic patients had a mean health care cost of $6134.88 ± $2782.38. In comparison, nonanemic patients had a reduced cost at $6009.97 ± $2423.27. A significant increase in total health care cost of $124.91 per person was reported in the anemic group vs the nonanemic group.

Significantly increased costs were also reported in the anemia group when utilizing a generalized linear model. Anemia was associated with a 2.08% increase in cost.

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Improving pediatric HPV vaccination rates: Early initiation and addressing disparities

In this discussion, Jonathan Miller, MD, and Caitlin Miller, a medical student, discussed methods of improving the human papillomavirus (HPV) vaccination rates in pediatric patients, focusing on a quality improvement project aimed at addressing low vaccination uptake.

Historically, HPV vaccination rates in children have been lower compared to other vaccines, such as Tdap and meningococcal, with national rates hovering around the mid-60s. This is significantly lower than the high 80s or 90% uptake seen for other childhood vaccines.

This gap in HPV vaccination led to the development of a quality improvement project aiming to increase vaccination rates, particularly by initiating the vaccine at an earlier age. The standard practice had been to begin HPV vaccination at age 11 or 12 years, but the project sought to start at age 9 years. By doing so, the goal was to ensure children were fully vaccinated by age 13 years, before potential exposure to the virus.

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