Hyperemesis gravidarum affects up to 10.8% of pregnant women, causing severe nausea, vomiting and dehydration, but is often misunderstood and inadequately treated, writes emergency physician Dr. Robyn Glessner. Glessner suggests early referral to specialized clinics that provide proactive interventions such as infusions and antiemetics, and she also recommends using tools such as the Hyperemesis Level Prediction Score for more accurate diagnosis.

Moderate-to-vigorous physical activity during pregnancy is linked to a lower risk of preterm birth in women with gestational diabetes, according to research published in JAMA Network Open. The study, involving 1,427 women in China, found that both regular and concentrated exercise provided similar benefits, with preterm birth risks decreasing significantly with increased activity.

A study published in JAMA Network Open found that breastmilk from mothers taking antidepressants and anti-inflammatory drugs had lower levels of protein, fat and energy. While these macronutrient levels remained within the normal range, the study suggested potential health risks, especially for vulnerable infants such as those born preterm.

A study published in the Journal of the American Medical Association found that insulin was better for gestational diabetes than oral medications like metformin and glyburide. Researchers said infants born to mothers treated with insulin were less likely to be large for gestational age compared with those treated with oral agents. Insulin also was associated with lower rates of maternal hypoglycemia.

Prenatal exposure to glucocorticoids is linked to increased risks of mental disorders in offspring, including autism spectrum disorder and ADHD, according to a study in JAMA Network Open. The study highlights the need to weigh treatment risks during pregnancy.

A study published in JAMA Pediatrics suggested a connection between gestational exposure to nonsteroidal anti-inflammatory drugs and a higher risk of pediatric chronic kidney disease. The study, which included more than 1 million children, found significant risks associated with maternal NSAID use in the second and third trimesters of pregnancy.

A study in the Journal of Clinical Investigation found that more than 15 million people in the US were diagnosed with autoimmune diseases from 2011 to 2022, with women nearly twice as likely to be affected as men. The research, using electronic health records from six health care systems, highlights rheumatoid arthritis as the most prevalent condition.

Researchers reported in BMC Pregnancy and Childbirth that women using the Continuous Precision Medicine mobile app after cesarean deliveries had a 92% reduction in the odds of prescription opioid misuse compared to nonusers. The study involved 58 women and showed that those not using the app had a seven times higher risk of misuse. The app, CPMRx, aids clinicians in optimizing medication use while minimizing opioid dependency.

Digital screening tools and virtual patient education may increase genetic testing rates and hereditary cancer risk assessments, researchers reported in Obstetrics & Gynecology. "In a recent study, integration of refined, protocol-driven, clinic-specific hereditary cancer risk assessment processes resulted in a fourfold increase in genetic testing among patients in two U.S. community obstetrics and gynecology practices, which enabled detection of pathogenic variants that would not otherwise have been identified and helped clinicians better meet standard of care," researchers wrote.

Research published in JAMA Network Open found that hospitals with low volumes of operative vaginal deliveries experience higher rates of adverse perinatal outcomes, such as newborns with shoulder dystocia, subgaleal hemorrhage and NICU admission. Hospitals with low operative vaginal delivery volume also had an increased proportion of obstetric anal sphincter injury compared with hospitals with medium and high volumes. The study, which analyzed over 306,000 deliveries in California, suggests that increased simulation training or setting a minimum number of such deliveries could improve outcomes.