Samantha Swartz | The University of Iowa (2024)

Proceedings in obstetrics and gynecology, Mar 29, 2023

Journal of medical-clinical research & reviews, May 30, 2021

Journal of Maternal-fetal & Neonatal Medicine, Oct 12, 2021

INTRODUCTION Maternal obesity has been linked to adverse outcomes for mothers and their offspring... more INTRODUCTION Maternal obesity has been linked to adverse outcomes for mothers and their offspring, including, but not limited to gestational hypertension (gHTN), gestational diabetes (GDM), pre-eclampsia, fetal macrosomia, and emergency cesarean section. Recent investigations have also shown that obesity, as defined by a body mass index (BMI) ≥ 30, especially severe obesity (BMI ≥ 40), is a risk factor for both hospitalization and death from COVID-19. OBJECTIVES The objective of this study is to determine the prevalence and association of maternal obesity at delivery with adverse antenatal, intrapartum, and neonatal outcomes in a cohort of consecutive delivering patients at a tertiary care center in Iowa from May to September 2020. A secondary objective is to determine if maternal obesity has any relationship to past or current COVID-19 infection status at the time of delivery. This is a secondary analysis of a prospective cohort study to analyze obstetric outcomes among COVID-19 infected and uninfected patients. METHODS We conducted a prospective cohort study using demographic and clinical data obtained from the electronic medical record. Excess plasma was collected from routine blood samples obtained at delivery admission to determine the seroprevalence of COVID-19 antibody using the DiaSorin and Roche antibody assays. Frequency variables were each calculated separately, and a comparison of maternal and neonatal outcomes was conducted using the generalized linear mixed modeling (GLMM) framework to account for varying distributions (normal and binary). RESULTS 1001 women delivered during the study period and 89.7% met criteria for being overweight or obese; 17.9% met criteria for severe obesity. Women with obesity had 49.8% lower odds of possessing private insurance, and women with severe obesity were less than half as likely to plan to breastfeed at the time of discharge. Women with obesity of any kind had a significantly increased odds of GDM and gHTN, and an increased risk of an infant with macrosomia, hypoglycemia, and NICU admission. No significant association was found between BMI and COVID-19 infection or disease severity. CONCLUSION This study provides insight into obstetric complications facing women with obesity, especially those with severe obesity. This report serves to highlight potential challenges, such as insurance status and labor complications, that impact women of high BMI to a greater degree when compared to their normal-weight counterparts.

American Journal of Perinatology, Feb 21, 2021

Proceedings in Obstetrics and Gynecology

Introduction: The University of Iowa Hospitals and Clinics (UIHC) serves as the main referral cen... more Introduction: The University of Iowa Hospitals and Clinics (UIHC) serves as the main referral center for Iowa and has seen increased delivery volumes following many hospital closures across the state. Maternal characteristics are also shifting as pre-pregnancy obesity of reproductive-age women is increasing nationally and in Iowa; average maternal age at first delivery has also increased over time. The aim of the current study was to characterize the outcomes of the delivering population at UIHC over a one-year period to better understand the population we serve, as well as compare our population to state and national delivering populations. Methods: This study is a secondary analysis of a pre-existing prospectively gathered database related to COVID-19 in pregnancy. The current study included all pregnant patients who delivered or underwent procedures for a spontaneous or induced second-trimester abortion on the labor and delivery unit at UIHC between May 1, 2020, and April 30, 202...

Gynecology & Reproductive Health

Objective: To determine if ABO blood group, age, body mass index (BMI), or symptomatic COVID-19 i... more Objective: To determine if ABO blood group, age, body mass index (BMI), or symptomatic COVID-19 infection are associated with COVID-19 antibody response in unvaccinated COVID-19 antibody positive pregnant women at time of delivery. Methods: At the time of delivery, 2,499 consecutive pregnant women were tested for ABO blood group and antibodies to both the spike protein and nucleocapsid protein of the COVID-19 virus. The DiaSorin assay was used for antibody to spike protein analysis and the Roche assay for antibody to nucleocapsid protein. Gamma regression models with a log link were used to compare antibody signals, with blood group, age, and BMI as the predictors. Results: 260 (10.4%) of 2,499 women who had not been vaccinated for COVID-19, were positive for both spike and nucleocapsid protein antibodies to COVID-19. The mean signal for COVID-19 nucleocapsid antibody was significantly lower for blood group AB (p=0.028) compared with blood group O. A relationship between blood group...

Evolution and ecology can be used to gain a better understanding of cancer. Here, my focus is on ... more Evolution and ecology can be used to gain a better understanding of cancer. Here, my focus is on applying concepts and tools from evolution and ecology to generate new insights into the importance of the tumor microenvironment and tumor heterogeneity for cancer progression. I used a model prostate cancer cell line called PC-3, which contains both an epithelial cell type (PC-3E) and a mesenchymal cell type (TEM4-18) that are maintained at about a 75:25 PC3E:TEM4-18 ratio in the parental population. Mesenchymal cells are particularly interesting because they have the ability to metastasize. Data of the growth rates of each cell type in isolation suggested that PC-3E cells have a higher growth rate than the TEM4-18 cells. Because of this, it unclear what mechanisms maintain the TEM4-18 cells in the parental population. To begin to understand how the dangerous mesenchymal cells are maintained, I combined the PC3E and TEM4-18 cells at equal proportions in one flask and monitored the popu...

INTRODUCTION Maternal obesity has been linked to adverse outcomes for mothers and their offspring... more INTRODUCTION Maternal obesity has been linked to adverse outcomes for mothers and their offspring, including, but not limited to gestational hypertension (gHTN), gestational diabetes (GDM), pre-eclampsia, fetal macrosomia, and emergency cesarean section. Recent investigations have also shown that obesity, as defined by a body mass index (BMI) ≥ 30, especially severe obesity (BMI ≥ 40), is a risk factor for both hospitalization and death from COVID-19. OBJECTIVES The objective of this study is to determine the prevalence and association of maternal obesity at delivery with adverse antenatal, intrapartum, and neonatal outcomes in a cohort of consecutive delivering patients at a tertiary care center in Iowa from May to September 2020. A secondary objective is to determine if maternal obesity has any relationship to past or current COVID-19 infection status at the time of delivery. This is a secondary analysis of a prospective cohort study to analyze obstetric outcomes among COVID-19 in...

Aim: To compare prevalence and disease severity of Severe Acute Respiratory Syndrome Coronavirus ... more Aim: To compare prevalence and disease severity of Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19) among multiparous and nulliparous pregnant patients at a rural Midwest tertiary care hospital; parity used as a surrogate for having additional children, assessing if exposure to other coronaviruses is protective for COVID-19. Methods: Retrospective cohort study included all patients who delivered at the University of Iowa between May 1, 2020 and September 22, 2020. Reverse transcriptase polymerase chain reaction and plasma antibody testing for COVID-19 were performed on women at the time of delivery. Demographics and outcome information were obtained from the electronic medical record. Adjusted odds ratio estimates for COVID-19 risk factors were obtained through the generalized linear modeling framework. Results: In 1,001 delivering patients, 6.2% tested positive for COVID-19 by either viral or antibody tests. Comparing infection rates by parity strata revealed no significa...

American Journal of Perinatology

Objective This study aimed to estimate the prevalence of severe acute respiratory syndrome-corona... more Objective This study aimed to estimate the prevalence of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) among pregnant patients at the time of delivery in a rural Midwest tertiary care hospital and to examine demographics, clinical factors, and maternal and neonatal outcomes associated with SARS-CoV-2 infection during pregnancy. Study Design This prospective cohort study included all delivering patients between May 1 and September 22, 2020 at the University of Iowa Hospitals and Clinics. Plasma SARS-CoV-2 antibody testing was performed. SARS-CoV-2 viral reverse-transcription polymerase chain reaction (RT-PCR) results and maternal and neonatal outcomes were collected from the electronic medical record. Data were analyzed using univariate statistical methods with clustering for multiple births. Results In total, 1,000 patients delivered between May 1 and September 22, 2020. Fifty-eight (5.8%) were SARS-CoV-2 antibody positive. Twenty-three also tested viral positive duri...

Proceedings in obstetrics and gynecology, Mar 29, 2023

Journal of medical-clinical research & reviews, May 30, 2021

Journal of Maternal-fetal & Neonatal Medicine, Oct 12, 2021

INTRODUCTION Maternal obesity has been linked to adverse outcomes for mothers and their offspring... more INTRODUCTION Maternal obesity has been linked to adverse outcomes for mothers and their offspring, including, but not limited to gestational hypertension (gHTN), gestational diabetes (GDM), pre-eclampsia, fetal macrosomia, and emergency cesarean section. Recent investigations have also shown that obesity, as defined by a body mass index (BMI) ≥ 30, especially severe obesity (BMI ≥ 40), is a risk factor for both hospitalization and death from COVID-19. OBJECTIVES The objective of this study is to determine the prevalence and association of maternal obesity at delivery with adverse antenatal, intrapartum, and neonatal outcomes in a cohort of consecutive delivering patients at a tertiary care center in Iowa from May to September 2020. A secondary objective is to determine if maternal obesity has any relationship to past or current COVID-19 infection status at the time of delivery. This is a secondary analysis of a prospective cohort study to analyze obstetric outcomes among COVID-19 infected and uninfected patients. METHODS We conducted a prospective cohort study using demographic and clinical data obtained from the electronic medical record. Excess plasma was collected from routine blood samples obtained at delivery admission to determine the seroprevalence of COVID-19 antibody using the DiaSorin and Roche antibody assays. Frequency variables were each calculated separately, and a comparison of maternal and neonatal outcomes was conducted using the generalized linear mixed modeling (GLMM) framework to account for varying distributions (normal and binary). RESULTS 1001 women delivered during the study period and 89.7% met criteria for being overweight or obese; 17.9% met criteria for severe obesity. Women with obesity had 49.8% lower odds of possessing private insurance, and women with severe obesity were less than half as likely to plan to breastfeed at the time of discharge. Women with obesity of any kind had a significantly increased odds of GDM and gHTN, and an increased risk of an infant with macrosomia, hypoglycemia, and NICU admission. No significant association was found between BMI and COVID-19 infection or disease severity. CONCLUSION This study provides insight into obstetric complications facing women with obesity, especially those with severe obesity. This report serves to highlight potential challenges, such as insurance status and labor complications, that impact women of high BMI to a greater degree when compared to their normal-weight counterparts.

American Journal of Perinatology, Feb 21, 2021

Proceedings in Obstetrics and Gynecology

Introduction: The University of Iowa Hospitals and Clinics (UIHC) serves as the main referral cen... more Introduction: The University of Iowa Hospitals and Clinics (UIHC) serves as the main referral center for Iowa and has seen increased delivery volumes following many hospital closures across the state. Maternal characteristics are also shifting as pre-pregnancy obesity of reproductive-age women is increasing nationally and in Iowa; average maternal age at first delivery has also increased over time. The aim of the current study was to characterize the outcomes of the delivering population at UIHC over a one-year period to better understand the population we serve, as well as compare our population to state and national delivering populations. Methods: This study is a secondary analysis of a pre-existing prospectively gathered database related to COVID-19 in pregnancy. The current study included all pregnant patients who delivered or underwent procedures for a spontaneous or induced second-trimester abortion on the labor and delivery unit at UIHC between May 1, 2020, and April 30, 202...

Gynecology & Reproductive Health

Objective: To determine if ABO blood group, age, body mass index (BMI), or symptomatic COVID-19 i... more Objective: To determine if ABO blood group, age, body mass index (BMI), or symptomatic COVID-19 infection are associated with COVID-19 antibody response in unvaccinated COVID-19 antibody positive pregnant women at time of delivery. Methods: At the time of delivery, 2,499 consecutive pregnant women were tested for ABO blood group and antibodies to both the spike protein and nucleocapsid protein of the COVID-19 virus. The DiaSorin assay was used for antibody to spike protein analysis and the Roche assay for antibody to nucleocapsid protein. Gamma regression models with a log link were used to compare antibody signals, with blood group, age, and BMI as the predictors. Results: 260 (10.4%) of 2,499 women who had not been vaccinated for COVID-19, were positive for both spike and nucleocapsid protein antibodies to COVID-19. The mean signal for COVID-19 nucleocapsid antibody was significantly lower for blood group AB (p=0.028) compared with blood group O. A relationship between blood group...

Evolution and ecology can be used to gain a better understanding of cancer. Here, my focus is on ... more Evolution and ecology can be used to gain a better understanding of cancer. Here, my focus is on applying concepts and tools from evolution and ecology to generate new insights into the importance of the tumor microenvironment and tumor heterogeneity for cancer progression. I used a model prostate cancer cell line called PC-3, which contains both an epithelial cell type (PC-3E) and a mesenchymal cell type (TEM4-18) that are maintained at about a 75:25 PC3E:TEM4-18 ratio in the parental population. Mesenchymal cells are particularly interesting because they have the ability to metastasize. Data of the growth rates of each cell type in isolation suggested that PC-3E cells have a higher growth rate than the TEM4-18 cells. Because of this, it unclear what mechanisms maintain the TEM4-18 cells in the parental population. To begin to understand how the dangerous mesenchymal cells are maintained, I combined the PC3E and TEM4-18 cells at equal proportions in one flask and monitored the popu...

INTRODUCTION Maternal obesity has been linked to adverse outcomes for mothers and their offspring... more INTRODUCTION Maternal obesity has been linked to adverse outcomes for mothers and their offspring, including, but not limited to gestational hypertension (gHTN), gestational diabetes (GDM), pre-eclampsia, fetal macrosomia, and emergency cesarean section. Recent investigations have also shown that obesity, as defined by a body mass index (BMI) ≥ 30, especially severe obesity (BMI ≥ 40), is a risk factor for both hospitalization and death from COVID-19. OBJECTIVES The objective of this study is to determine the prevalence and association of maternal obesity at delivery with adverse antenatal, intrapartum, and neonatal outcomes in a cohort of consecutive delivering patients at a tertiary care center in Iowa from May to September 2020. A secondary objective is to determine if maternal obesity has any relationship to past or current COVID-19 infection status at the time of delivery. This is a secondary analysis of a prospective cohort study to analyze obstetric outcomes among COVID-19 in...

Aim: To compare prevalence and disease severity of Severe Acute Respiratory Syndrome Coronavirus ... more Aim: To compare prevalence and disease severity of Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19) among multiparous and nulliparous pregnant patients at a rural Midwest tertiary care hospital; parity used as a surrogate for having additional children, assessing if exposure to other coronaviruses is protective for COVID-19. Methods: Retrospective cohort study included all patients who delivered at the University of Iowa between May 1, 2020 and September 22, 2020. Reverse transcriptase polymerase chain reaction and plasma antibody testing for COVID-19 were performed on women at the time of delivery. Demographics and outcome information were obtained from the electronic medical record. Adjusted odds ratio estimates for COVID-19 risk factors were obtained through the generalized linear modeling framework. Results: In 1,001 delivering patients, 6.2% tested positive for COVID-19 by either viral or antibody tests. Comparing infection rates by parity strata revealed no significa...

American Journal of Perinatology

Objective This study aimed to estimate the prevalence of severe acute respiratory syndrome-corona... more Objective This study aimed to estimate the prevalence of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) among pregnant patients at the time of delivery in a rural Midwest tertiary care hospital and to examine demographics, clinical factors, and maternal and neonatal outcomes associated with SARS-CoV-2 infection during pregnancy. Study Design This prospective cohort study included all delivering patients between May 1 and September 22, 2020 at the University of Iowa Hospitals and Clinics. Plasma SARS-CoV-2 antibody testing was performed. SARS-CoV-2 viral reverse-transcription polymerase chain reaction (RT-PCR) results and maternal and neonatal outcomes were collected from the electronic medical record. Data were analyzed using univariate statistical methods with clustering for multiple births. Results In total, 1,000 patients delivered between May 1 and September 22, 2020. Fifty-eight (5.8%) were SARS-CoV-2 antibody positive. Twenty-three also tested viral positive duri...