The 39th Annual Meeting of the Society for Maternal Fetal Medicine (SMFM) was held in Las Vegas, NV and was the largest assembly in the history of its membership. This meeting is primarily “about the science” and puts together the best information from America’s researchers but also draws well from international scientists.
The SMFM has worked diligently to focus on issues of maternal care and outcomes and the research this year seemed to mirror this focus. Within the first oral plenary session, two abstracts displayed work on the topic of health outcome disparities. Dr. Aleha Aziz and co-workers at Columbia University presented their retrospective cohort study of a nationwide database of over 2.4 million births and showed higher readmission rates and increased rates of severe maternal morbidity in black women and highlighted the need for possible short-term postpartum follow up. Moments later, Dr. Adi Hirshberg and her colleagues at University of Pennsylvania displayed their study on how a novel program of text message remote blood pressure monitoring eliminated racial disparities in the care of African-American women in postpartum hypertension care. This program almost tripled the ascertainment of early blood pressure measurement in black women in the study allowing for treatment of worsening blood pressure and elimination of hypertensive readmission. This latter study won the award for the best abstract of the meeting’s opening session.
Immediately thereafter, in the first poster session of the meeting, several studies concentrated on the opioid epidemic which has become a growing problem not only throughout the country but also in pregnant populations. Dr. Kern-Goldberger presented data from over 15 million pregnancy-related hospital admissions and this information highlighted the continually increasing concern that opioid use disorder (OUD) has become since approximately 2004. OUD also appears to be involved with other complications as well and this study showed that OUD was a diagnosis in almost three percent of antepartum admissions while only present as a diagnosis in a much smaller percentage (0.7%) of delivery admissions. Dr. Craig Towers and colleagues from the University of Tennessee, Knoxville displayed their two studies on opiate detoxification during pregnancy and novel treatment strategies. The first study showed his prospective data on utilization of a bridge device as part of a comprehensive OUD clinic with collaborative behavioral health intervention. The second study presented information after transition of patients weaned off medication-assisted treatment (MAT) during their gestation and thereafter placed on naltrexone. The naltrexone study showed the safety profile of the immediate outcomes of patients on naltrexone with no fetal complications noted prior to delivery. The initial study on the detoxification of patients, prior to delivery as part of a comprehensive program of behavioral health and obstetric care, fully eliminated neonatal abstinence syndrome (NAS) in patients undergoing successful detoxification in comparison to a 77 percent NAS rate of those patients on a traditional MAT therapy. Interestingly, the arm of the study which weaned MAT during pregnancy had a lower rate of NAS at 55 percent.
The SMFM also maintained its unique commitment to community outreach in its conference cities. Ten SMFM members volunteered with a half-day program at a local public high school, Rancho High School in downtown Las Vegas. Rancho High School, via data from "U.S. News and World Report", has a minority enrollment 90 percent and 73 percent of students are considered economically disadvantaged. This half-day program for approximately 200 students in divided sessions provided simulations in delivery and invasive ultrasound procedures as well as a lecture on the blood clotting cascade and a panel on a life in healthcare and physician thoughts for students during an open panel of question and answer. A second half-day was provided where 46 students were paired with 23 SMFM physician mentors on a half-day of research at the annual meeting. Each student was provided with three abstracts of research from the Thursday poster session and provided the student with explanations of research from YouTube or other friendly web sources. Students were asked to formulate questions on the research to prompted to ask researchers direct questions at the poster session. This exercise was intended to introduce students to the scientific method and process of questioning research design and method. The commitment of the SMFM to local communities and has become a key element of the annual meeting and conforms with the society’s members desire to provide not only care but caring with unique public outreach and efforts for community improvement.
Brian Iriye, MD is the President of the Society for Maternal Fetal Medicine and was a Local Arrangements Chair for the 39th Annual Meeting.
