Introduction Racial and socioeconomic disparities exist in cervical cancer screening, incidence, and mortality. The purpose of this study was to investigate how cervical cancer stage at diagnosis is associated with rurality and race/ethnicity. Methods We analyzed 2010 through 2014 data from the Centers for Disease Control and Prevention’s National Program of Cancer Registries and the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program. We compared cervical cancer frequency and age-adjusted incidence for each stage by county-level rurality and race/ethnicity. Results There were 59,432 incident cases of cervical cancer reported from 2010 through 2014. The most common stage at diagnosis was localized (urban, 43.3%; rural 41.3%). Rural counties had higher incidence than urban counties for localized (rate ratio [RR] = 1.11; 95% confidence interval [CI], 1.07–1.15), regional (RR = 1.14; 95% CI, 1.10–1.19), and distant (RR = 1.12; 95% CI, 1.05–1.19) stage cervical cancer. Hispanic and non-Hispanic black women had higher incidence of regional and distant cervical cancer than non-Hispanic white women. Non-Hispanic white women in rural counties had higher incidence than those in urban counties at every stage. However, incidence for non-Hispanic white women was lower than for non-Hispanic black or Hispanic women. Conclusion Rural counties had higher incidence of cervical cancer than urban counties at every stage. However, the association of rural residence with incidence varied by race/ethnicity.

Studies on the effectiveness of prophylactic negative-pressure wound therapy at cesarean delivery are heterogeneous but suggest a reduction in surgical site infection and overall wound complications. Larger definitive trials are needed to clarify the clinical utility of prophylactic negative-pressure wound therapy after cesarean delivery.

No abstract

Objective: To determine whether inter-pregnancy weight loss is associated with improved perinatal outcomes among pregnancies complicated by recurrent diabetes. Methods: We performed a retrospective cohort study of all women with at least 2 singleton pregnancies complicated by gestational (GDM) or type 2 (T2DM) and cared for by the Resident Diabetes in Pregnancy Clinic at a large tertiary referral center from 2007-2017. Women whose initial pregnancy weight decreased between pregnancies were compared to those whose weight stayed the same or increased. Demographic characteristics were compared between groups and logistic regression was used to control for potential confounding variables including maternal age, race, and depression. Results: There were 62 pregnancies complicated by recurrent diabetes during the study period. Weight loss between pregnancies occurred in 24 women. Women with pregnancies with inter-pregnancy weight loss were older (31.6 vs. 27.6, p=0.01) and had higher early pregnancy Edinburgh Postnatal Depression Scale scores (median 7; IQR 5,8 vs. median 2; IQR 1, 3, =0.01). Adjusted analyses using logistic regression demonstrated no significant association between inter-pregnancy weight loss and adverse maternal/neonatal outcomes including large for gestational age, small for gestational age, cesarean section, shoulder dystocia, birth injury, NICU admission>24 hours, and preterm birth. Conclusions: Inter-pregnancy weight loss was not associated with improved maternal or neonatal outcomes among pregnancies complicated by GDM or T2DM. Future studies are needed to identify the impact of depression on gestational weight gain/loss and subsequent pregnancy outcomes. Disclosure L. Yu: None. C.J. Herrick: None. H.E. Duckham: None. E.B. Carter: None. Funding American Diabetes Association/Pathway to Stop Diabetes (1-19-ACE-02 to E.B.C.); Robert Wood Johnson Foundation (74250); Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD095075)

No abstract