Bruce Morris
University of Connecticut
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Featured researches published by Bruce Morris.
Journal of Maternal-fetal & Neonatal Medicine | 2007
Bruce Morris; James Egan; Yu Ming Victor Fang; Winston A. Campbell
Objective. This study evaluated whether utilization of prenatal care, as measured by the Kessner index, affects the number of Down syndrome live births. Methods. A retrospective analysis of birth certificate data of Down syndrome live births comparing 1989 to 2001 by year, maternal age, gestational age at first prenatal visit, and adequacy of prenatal care according to Kessner categories of adequacy of prenatal care. Results. Down syndrome live births were inversely correlated with adequacy of prenatal care. Reductions in Down syndrome live births were seen in all categories of prenatal care in all age groups. In 2001 a minimum 30% reduction was seen in any category rising to a 58% reduction in women ≥35 years with adequate prenatal care. The largest reductions were seen in women ≥35 years of age. Conclusions. Reductions in Down syndrome live births occurred in all age groups between 1989 and 2001. Utilization of prenatal care as measured by the Kessner index was associated with reductions in Down syndrome live births, with a greater reduction in women ≥35 years of age.
American Journal of Obstetrics and Gynecology | 2017
Thomas J. Garite; C. Andrew Combs; Kimberly Maurel; Anita Das; Kevin Huls; Richard P. Porreco; Dale P. Reisner; George Lu; Melissa Bush; Bruce Morris; April T. Bleich; Kimberly Mallory; Jasmin Bono; Dawn Artis; Guadalupe Weis; Julie Rael; Jeri Lech; Kathleen Swearingen; Ana Bodea Braescu; Michelle Games; Gloria Mullen; Charlotte Engelke; Julia Yeoman; Jillian Rigdon; Willa Tyler; Fonda Garza
BACKGROUND: Counseling for patients with impending premature delivery traditionally has been based primarily on the projected gestational age at delivery. There are limited data regarding how the indications for the preterm birth affect the neonatal outcome and whether this issue should be taken into account in decisions regarding management and patient counseling. OBJECTIVE: We performed a prospective study of pregnancies resulting in premature delivery at less than 32 weeks to determine the influence of both the indications for admission and their associated indications for delivery on neonatal mortality and complications of prematurity. STUDY DESIGN: This is a multicenter, prospective study in 10 hospitals where all data from the neonatal intensive care unit routinely was imported to a deidentified data warehouse. Maternal data were collected prospectively at or near the time of delivery. Eligible subjects included singleton deliveries in these hospitals between 23 0/7 and 31 6/7 weeks. The primary hypothesis of the study was to determine whether there was a difference in the primary outcome, which was defined as neonatal composite morbidity, between those neonates delivered after admission for premature labor vs premature rupture of membranes, because these were expected to be the 2 most frequent diagnoses leading to premature birth. The sample size was calculated based on a 10% difference in outcomes for these 2 entities. We based this hypothesis on the knowledge that premature rupture of membranes has a greater incidence of intra‐amniotic infection and inflammation than premature labor and that outcomes for premature neonates are worse when delivery is associated with intra‐amniotic infection. Additional outcomes were analyzed for all other indications for admission and delivery. Composite morbidity was defined as ≥1 of the following: respiratory distress syndrome (oxygen requirement, clinical diagnosis, and consistent chest radiograph), bronchopulmonary dysplasia (requirement for oxygen support at 28 days of life), severe intraventricular hemorrhage (grades 3 or 4), periventricular leukomalacia, blood culture‐proven sepsis present within 72 hours of birth, necrotizing enterocolitis, or neonatal death before discharge from the hospital. A secondary composite of serious neonatal morbidity also was defined prospectively. RESULTS: The study included 1089 mother/baby pairs. Composite morbidity between those with premature labor (77.2%) and premature rupture of membranes (73.2%) was not significantly different (P = .29). A few neonatal complications were associated with indications for admission and delivery, but on logistic regression adjusting for gestational age and other confounders, suspected intrauterine growth restriction was the only indication for admission or delivery associated with an increase in serious morbidity (odds ratio 4.5, [2.1 to 9.8], P < .003). Other factors not related to the indications for admission including cesarean delivery, and low 5‐minute Apgar were associated with an increase in morbidity. CONCLUSION: Studies of many single factors related to the indications for preterm delivery have been shown to be associated with adverse neonatal outcome. In this study evaluating all of the most frequent indications, however, we found only suspected intrauterine growth restriction as an indication for admission and delivery was found to be so. Thus, it seems that in almost all situations counseling patients can be based primarily on gestational age along with other factors including estimated fetal weight, sex, race, plurality, and completion of a course of antenatal corticosteroids.
Connecticut medicine | 2009
Yu Ming Victor Fang; James Egan; Tali Rombro; Bruce Morris; Carolyn Zelop
American Journal of Obstetrics and Gynecology | 2006
Cheryl Oncken; Bruce Morris; Ellen A. Dornelas; Henry R. Kranzler; Stephen J. Walsh; Jack Greene
American Journal of Obstetrics and Gynecology | 2007
Bruce Morris; Darcy Moschenross; Henry Furneaux; Roxanne Stepnowski; John C. Greene; Melinda Sanders; Cheryl Oncken
American Journal of Obstetrics and Gynecology | 2006
Mary Beth Janicki; James Egan; Henry Roque; Bruce Morris; Anne-Marie Prabulos; Winston A. Campbell
American Journal of Obstetrics and Gynecology | 2006
Jay Bolnick; James Egan; Mary Beth Janicki; Bruce Morris; Winston A. Campbell; Carolyn Zelop
American Journal of Obstetrics and Gynecology | 2005
Bruce Morris; James Egan; Henry Roque; Mary Beth Janicki; Victor Fang; Winston A. Campbell
American Journal of Obstetrics and Gynecology | 2005
Henry Roque; Bruce Morris; Mary Beth Janicki; James Egan
American Journal of Obstetrics and Gynecology | 2005
Henry Roque; Mary Beth Janicki; Bruce Morris; James Egan