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Reticulocyte Hemoglobin Trend in Pregnancy [Letter]

Griffin, Myah M; Avtushka, Valeryia; Venkatesh, Pooja; Aquino, Jennifer; Roman, Ashley S
PMID: 37419168
ISSN: 1097-6868
CID: 5539482

Patient Experience with Telehealth Medicine During the Ongoing COVID-19 Pandemic in New York City

Aquino, Jennifer; Cyr, Micaela E; Hoskins, Iffath A; Conroy, Erin M; Gossett, Dana R
PMID: 36607815
ISSN: 1556-3669
CID: 5433522

Risk Factors for First Trimester Iron Deficiency [Meeting Abstract]

Griffin, M; Avtushka, V; Venkatesh, P; Aquino, J; Roman, A S
Objective: Iron deficiency is the most common cause of anemia in pregnancy, which is associated with maternal and neonatal complications. The objective of this study was to identify the frequency and risk factors for isolated iron deficiency (iID) in the 1st trimester.
Study Design: This was a secondary analysis of a prospective cohort study to identify risk factors for iID of non-anemic pregnant individuals presenting for prenatal care in the 1st trimester from February 2022 to June 2022 at NYU Langone Health. iID was defined as serum ferritin level of <= 29 ng/mL. Inclusion criteria included pregnant individuals ages 18-60 years with a singleton gestation enrolled in the 1st trimester (prior to 14 weeks 0 days gestation) and were non-anemic (hemoglobin >=11.0 g/dl). Patients were excluded if they had 1st trimester anemia or history of blood transfusion 3 months prior to pregnancy. Univariate analyses were followed by multiple logistic regression (OR [95% CI]) with statistical significance defined at p< 0.05.
Result(s): Of 600 patients enrolled in the study, 89 (14.8%) had 1st trimester iID. Black/African American patients (19.1% vs. 8.2%, p=0.003), those with uterine fibroids (20.2% vs. 9.4%, p=0.003), and those with higher median BMI (25.2 kg/m2 (IQR 22.7-29.6) vs. 23.6 kg/m2 (IQR 21.4-27.3), p=0.01) were more likely have to 1st trimester iID. White patients (41.6% vs. 56.6%, p=0.01) and those with a normal BMI (44.9% vs. 57.3%, p=0.04) were less likely to have 1st trimester iID. After adjusting for confounders in regression models, Black/African American patients had the strongest association with 1st trimester iID (aOR 2.18 [1.12-4.11], p=0.02), followed by uterine fibroids (aOR 2.02 [1.05-3.72], p=0.03). Overweight or obese BMIs were not identified as risk factors for 1st trimester iID.
Conclusion(s): Based on our findings, Black/African American pregnant individuals and those with uterine fibroids are at highest risk for 1st trimester iID. Future studies should investigate perinatal outcomes for pregnant individuals with 1st trimester iID. [Formula presented]
Copyright
EMBASE:2022102109
ISSN: 1097-6868
CID: 5512842

Reticulocyte Hemoglobin Trend in Pregnancy [Meeting Abstract]

Griffin, M; Avtushka, V; Venkatesh, P; Aquino, J; Roman, A S
Objective: Reticulocyte hemoglobin (RetHb) is used for early detection of iron deficiency (ID) in the nonpregnant patient population. It provides an indication of iron availability in the bone marrow and is an early marker of iron deficiency (ID) erythropoiesis before anemia is present. Due to the paucity of data regarding RetHb use in pregnancy, the study objective was to establish normal values and trend for RetHb during the 1st and 2nd trimester of pregnancy by correlating it with ferritin and Hb.
Study Design: This is a secondary analysis of an observational, prospective cohort study evaluating ID parameters in singleton gestations presenting for prenatal care in the first trimester from 2/2022 to 6/2022. ID was defined as serum ferritin level of <= 29 ng/mL. For this analysis, patients were excluded if they had 1st trimester anemia (Hb< 11.0 g/dL) or history of blood transfusion 3 months prior to pregnancy. Data were analyzed using student's t-test and linear regression modeling with statistical significance defined at p< 0.05.
Result(s): 209 patients met inclusion criteria. In table 1, demographics of the study cohort are shown. There was a prevalence of 16.3% of ID in the 1st trimester and 69.9% in the 2nd trimester. Distribution of RetHb values throughout the first 2 trimesters are demonstrated in figure 1. In the 1st trimester, the mean RetHb in women with ID was 34.01 pg +/- SD 1.64 compared to 34.68 pg +/- 1.65 in women without iron deficiency (p=0.03). In the second trimester, the mean RetHb in women with ID was 33.02 pg +/- 2.34 compared to 34.20 pg +/- SD 1.94 in women without ID (p< 0.001).
Conclusion(s): A statistically significant physiologic decrease was observed among pregnant individuals both with and without iron deficiency in the first and second trimester of pregnancy. Future studies should evaluate the utility of RetHb use in pregnancy to predict ID and iron deficiency anemia throughout pregnancy. [Formula presented] [Formula presented]
Copyright
EMBASE:2022101946
ISSN: 1097-6868
CID: 5512862

Ectopic production of human chorionic gonadotropin by synovial sarcoma of the hip [Case Report]

Stevens, Erin E; Aquino, Jennifer; Barrow, Nekia; Lee, Yi-Chun
BACKGROUND: Human chorionic gonadotropin (hCG) is a marker of pregnancy and a tumor marker for some gynecologic malignancies, including germ cell tumors and gestational trophoblastic neoplasia. Rarely, hCG is secreted by nongynecologic tumors, confounding the diagnosis. CASE: A 45-year-old woman was evaluated for a persistently elevated beta-hCG. Diagnosis of her primary malignancy, synovial sarcoma of the hip, was delayed as more common etiologies were considered, including ectopic pregnancy and gestational trophoblastic neoplasm. The workup eventually led to the diagnosis using imaging studies but ultimately resulted in a 3-month delay and unnecessary medical and surgical treatments. CONCLUSION: This case highlights the importance of nongynecologic malignancies when evaluating patients with a persistent beta-hCG.
PMID: 23344411
ISSN: 1873-233x
CID: 2061822

Multiplexed Kinase Substrate And Signal Transduction Profiling Of Human Ovarian Cancer: Towards Patient Tailored Therapeutics [Meeting Abstract]

Aquino JA; Fishman DA; Coukos G; Liotta LA; Petricoin EF; Wulfkuhle JD
ORIGINAL:0005451
ISSN: 1071-5576
CID: 60217