Article

Key clinical point: Compared with hepatic arterial infusion chemotherapy (HAIC)+lenvatinib, the triple therapeutic regimen HAIC+lenvatinib+sequential ablation significantly improved the survival of patients with advanced hepatocellular carcinoma (HCC) without compromising safety.

Major finding: Patients who received HAIC+lenvatinib+sequential ablation vs HAIC+lenvatinib had a significantly longer median overall survival (>30 vs 13.6 months; P = .010), progression-free survival (PFS; 12.8 vs 5.6 months; P = .001), and intrahepatic PFS (14.6 vs 6.4 months; P = .002) and similar incidence of grade 1-2 (P = .404) and 3-4 (P = .333) adverse events.

Study details: This multicenter retrospective study included 150 patients with advanced HCC who received HAIC+lenvatinib (n = 97) or HAIC+lenvatinib+sequential ablation (n = 53).

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Liu Y et al. Efficacy and safety of hepatic arterial infusion chemotherapy combined with lenvatinib and sequential ablation in the treatment of advanced hepatocellular carcinoma. Cancer Med. 2022 (Oct 17). Doi: 10.1002/cam4.5366

Key clinical point: Compared with hepatic arterial infusion chemotherapy (HAIC)+lenvatinib, the triple therapeutic regimen HAIC+lenvatinib+sequential ablation significantly improved the survival of patients with advanced hepatocellular carcinoma (HCC) without compromising safety.

Major finding: Patients who received HAIC+lenvatinib+sequential ablation vs HAIC+lenvatinib had a significantly longer median overall survival (>30 vs 13.6 months; P = .010), progression-free survival (PFS; 12.8 vs 5.6 months; P = .001), and intrahepatic PFS (14.6 vs 6.4 months; P = .002) and similar incidence of grade 1-2 (P = .404) and 3-4 (P = .333) adverse events.

Study details: This multicenter retrospective study included 150 patients with advanced HCC who received HAIC+lenvatinib (n = 97) or HAIC+lenvatinib+sequential ablation (n = 53).

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Liu Y et al. Efficacy and safety of hepatic arterial infusion chemotherapy combined with lenvatinib and sequential ablation in the treatment of advanced hepatocellular carcinoma. Cancer Med. 2022 (Oct 17). Doi: 10.1002/cam4.5366

Key clinical point: Compared with hepatic arterial infusion chemotherapy (HAIC)+lenvatinib, the triple therapeutic regimen HAIC+lenvatinib+sequential ablation significantly improved the survival of patients with advanced hepatocellular carcinoma (HCC) without compromising safety.

Major finding: Patients who received HAIC+lenvatinib+sequential ablation vs HAIC+lenvatinib had a significantly longer median overall survival (>30 vs 13.6 months; P = .010), progression-free survival (PFS; 12.8 vs 5.6 months; P = .001), and intrahepatic PFS (14.6 vs 6.4 months; P = .002) and similar incidence of grade 1-2 (P = .404) and 3-4 (P = .333) adverse events.

Study details: This multicenter retrospective study included 150 patients with advanced HCC who received HAIC+lenvatinib (n = 97) or HAIC+lenvatinib+sequential ablation (n = 53).

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Liu Y et al. Efficacy and safety of hepatic arterial infusion chemotherapy combined with lenvatinib and sequential ablation in the treatment of advanced hepatocellular carcinoma. Cancer Med. 2022 (Oct 17). Doi: 10.1002/cam4.5366

Key clinical point: Atezolizumab plus bevacizumab (Atez/Bev) is effective and safe against both virus-related and non-viral hepatocellular carcinoma (HCC).

Major finding: The objective response rate (20.6% and 24.6%, respectively; P = .55), median progression-free survival (7.0 and 6.2 months, respectively; hazard ratio 0.96; P = .33), and incidence and severity of adverse events, including diarrhea and liver injury, were comparable between patients with virus-related and non-viral HCC.

Study details: Findings are from a retrospective cohort study including 126 propensity score-matched pairs of patients with virus-related and non-viral HCC who had Child-Pugh class A, Barcelona Clinic Liver Cancer stage B or C, and performance status ≤1 and received Atez/Bev.

Disclosures: No source of funding was reported. Some authors declared receiving honoraria and research grants from various sources.

Source: Hatanaka T et al. Comparative efficacy and safety of atezolizumab and bevacizumab between hepatocellular carcinoma patients with viral and non-viral infection: A Japanese multicenter observational study. Cancer Med. 2022 (Oct 13). Doi: 10.1002/cam4.5337

Key clinical point: Atezolizumab plus bevacizumab (Atez/Bev) is effective and safe against both virus-related and non-viral hepatocellular carcinoma (HCC).

Major finding: The objective response rate (20.6% and 24.6%, respectively; P = .55), median progression-free survival (7.0 and 6.2 months, respectively; hazard ratio 0.96; P = .33), and incidence and severity of adverse events, including diarrhea and liver injury, were comparable between patients with virus-related and non-viral HCC.

Study details: Findings are from a retrospective cohort study including 126 propensity score-matched pairs of patients with virus-related and non-viral HCC who had Child-Pugh class A, Barcelona Clinic Liver Cancer stage B or C, and performance status ≤1 and received Atez/Bev.

Disclosures: No source of funding was reported. Some authors declared receiving honoraria and research grants from various sources.

Source: Hatanaka T et al. Comparative efficacy and safety of atezolizumab and bevacizumab between hepatocellular carcinoma patients with viral and non-viral infection: A Japanese multicenter observational study. Cancer Med. 2022 (Oct 13). Doi: 10.1002/cam4.5337

Key clinical point: Atezolizumab plus bevacizumab (Atez/Bev) is effective and safe against both virus-related and non-viral hepatocellular carcinoma (HCC).

Major finding: The objective response rate (20.6% and 24.6%, respectively; P = .55), median progression-free survival (7.0 and 6.2 months, respectively; hazard ratio 0.96; P = .33), and incidence and severity of adverse events, including diarrhea and liver injury, were comparable between patients with virus-related and non-viral HCC.

Study details: Findings are from a retrospective cohort study including 126 propensity score-matched pairs of patients with virus-related and non-viral HCC who had Child-Pugh class A, Barcelona Clinic Liver Cancer stage B or C, and performance status ≤1 and received Atez/Bev.

Disclosures: No source of funding was reported. Some authors declared receiving honoraria and research grants from various sources.

Source: Hatanaka T et al. Comparative efficacy and safety of atezolizumab and bevacizumab between hepatocellular carcinoma patients with viral and non-viral infection: A Japanese multicenter observational study. Cancer Med. 2022 (Oct 13). Doi: 10.1002/cam4.5337

Key clinical point: The use of immune checkpoint inhibitor (ICI)-based regimens after prior immunotherapy is safe and confers a treatment benefit in a clinically meaningful proportion of patients with hepatocellular carcinoma (HCC).

Major finding: The objective response and disease control rates were 22% and 59% with first-line ICI therapy (ICI-1) and 26% and 55% with second-line ICI therapy (ICI-2), respectively. The median times to progression with ICI-1 and ICI-2 were 5.4 (95% CI 3.0-7.7) months and 5.2 (95% CI 3.3-7.0) months, respectively. Grade 3-4 treatment-related adverse events with ICI-1 and ICI-2 occurred in 16% and 17% of patients, respectively.

Study details: This multicenter retrospective included 58 patients with HCC who received ≥2 lines of ICI-based therapies.

Disclosures: This study did not receive any specific funding. Some authors declared serving as investigators for or receiving advisory, consulting, or speaker fees or travel support from various sources.

Source: Scheiner B et al. Efficacy and safety of immune checkpoint inhibitor rechallenge in individuals with hepatocellular carcinoma. JHEP Rep. 2022;100620 (Oct 26). Doi: 10.1016/j.jhepr.2022.100620

Key clinical point: The use of immune checkpoint inhibitor (ICI)-based regimens after prior immunotherapy is safe and confers a treatment benefit in a clinically meaningful proportion of patients with hepatocellular carcinoma (HCC).

Major finding: The objective response and disease control rates were 22% and 59% with first-line ICI therapy (ICI-1) and 26% and 55% with second-line ICI therapy (ICI-2), respectively. The median times to progression with ICI-1 and ICI-2 were 5.4 (95% CI 3.0-7.7) months and 5.2 (95% CI 3.3-7.0) months, respectively. Grade 3-4 treatment-related adverse events with ICI-1 and ICI-2 occurred in 16% and 17% of patients, respectively.

Study details: This multicenter retrospective included 58 patients with HCC who received ≥2 lines of ICI-based therapies.

Disclosures: This study did not receive any specific funding. Some authors declared serving as investigators for or receiving advisory, consulting, or speaker fees or travel support from various sources.

Source: Scheiner B et al. Efficacy and safety of immune checkpoint inhibitor rechallenge in individuals with hepatocellular carcinoma. JHEP Rep. 2022;100620 (Oct 26). Doi: 10.1016/j.jhepr.2022.100620

Key clinical point: The use of immune checkpoint inhibitor (ICI)-based regimens after prior immunotherapy is safe and confers a treatment benefit in a clinically meaningful proportion of patients with hepatocellular carcinoma (HCC).

Major finding: The objective response and disease control rates were 22% and 59% with first-line ICI therapy (ICI-1) and 26% and 55% with second-line ICI therapy (ICI-2), respectively. The median times to progression with ICI-1 and ICI-2 were 5.4 (95% CI 3.0-7.7) months and 5.2 (95% CI 3.3-7.0) months, respectively. Grade 3-4 treatment-related adverse events with ICI-1 and ICI-2 occurred in 16% and 17% of patients, respectively.

Study details: This multicenter retrospective included 58 patients with HCC who received ≥2 lines of ICI-based therapies.

Disclosures: This study did not receive any specific funding. Some authors declared serving as investigators for or receiving advisory, consulting, or speaker fees or travel support from various sources.

Source: Scheiner B et al. Efficacy and safety of immune checkpoint inhibitor rechallenge in individuals with hepatocellular carcinoma. JHEP Rep. 2022;100620 (Oct 26). Doi: 10.1016/j.jhepr.2022.100620

Key clinical point: Compared with sorafenib, atezolizumab-bevacizumab led to more frequent acute variceal bleeding (AVB) in patients with locally advanced hepatocellular carcinoma (HCC) and cirrhosis, with a history of AVB being associated with AVB during follow-up.

Major finding: At 1 year, patients who received atezolizumab-bevacizumab vs sorafenib had significantly higher AVB occurrence (21% vs 5%; P = .02). A previous history of AVB was independently associated with AVB during therapy (adjusted hazard ratio 10.58; P = .03).

Study details: This single-center prospective study included 43 patients with locally advanced HCC and cirrhosis who received atezolizumab-bevacizumab and a retrospective series of 122 control patients who received sorafenib.

Disclosures: This study did not receive any funding. No information on conflicts of interest was provided.

Source: Larrey E et al. A history of variceal bleeding is associated with further bleeding under atezolizumab-bevacizumab in patients with HCC. Liver Int. 2022 (Oct 18). Doi: 10.1111/liv.15458

Key clinical point: Compared with sorafenib, atezolizumab-bevacizumab led to more frequent acute variceal bleeding (AVB) in patients with locally advanced hepatocellular carcinoma (HCC) and cirrhosis, with a history of AVB being associated with AVB during follow-up.

Major finding: At 1 year, patients who received atezolizumab-bevacizumab vs sorafenib had significantly higher AVB occurrence (21% vs 5%; P = .02). A previous history of AVB was independently associated with AVB during therapy (adjusted hazard ratio 10.58; P = .03).

Study details: This single-center prospective study included 43 patients with locally advanced HCC and cirrhosis who received atezolizumab-bevacizumab and a retrospective series of 122 control patients who received sorafenib.

Disclosures: This study did not receive any funding. No information on conflicts of interest was provided.

Source: Larrey E et al. A history of variceal bleeding is associated with further bleeding under atezolizumab-bevacizumab in patients with HCC. Liver Int. 2022 (Oct 18). Doi: 10.1111/liv.15458

Key clinical point: Compared with sorafenib, atezolizumab-bevacizumab led to more frequent acute variceal bleeding (AVB) in patients with locally advanced hepatocellular carcinoma (HCC) and cirrhosis, with a history of AVB being associated with AVB during follow-up.

Major finding: At 1 year, patients who received atezolizumab-bevacizumab vs sorafenib had significantly higher AVB occurrence (21% vs 5%; P = .02). A previous history of AVB was independently associated with AVB during therapy (adjusted hazard ratio 10.58; P = .03).

Study details: This single-center prospective study included 43 patients with locally advanced HCC and cirrhosis who received atezolizumab-bevacizumab and a retrospective series of 122 control patients who received sorafenib.

Disclosures: This study did not receive any funding. No information on conflicts of interest was provided.

Source: Larrey E et al. A history of variceal bleeding is associated with further bleeding under atezolizumab-bevacizumab in patients with HCC. Liver Int. 2022 (Oct 18). Doi: 10.1111/liv.15458

Key clinical point: Highly elevated antidrug antibody (ADA) levels (≥1,000 ng/mL) at 3 weeks (cycle 2 day 1 [C2D1]) may be associated with poor clinical outcomes after atezolizumab/bevacizumab (Atezo/Bev) treatment in patients with advanced hepatocellular carcinoma (HCC).

Major finding: In both discovery cohort (DC) and validation cohort (VC), patients with high vs low ADA levels at C2D1 had worse progression-free survival (DC: hazard ratio [HR] 2.84; P = .005; VC: HR 2.52; P = .006) and overall survival (DC: HR 3.30; P = .003; VC: HR 5.81; P = .001).

Study details: This prospective cohort study included 132 patients with advanced HCC treated with first-line Atezo/Bev (DC n = 50; VC n = 82).

Disclosures: This study was sponsored by a National Research Foundation of Korea grant funded by the Korean government and others. Some authors reported serving as advisors for or receiving personal fees or grants from various sources. Two authors declared having a pending method patent for predicting therapeutic response to biologic drugs by quantifying blood ADA.

Source: Kim C et al. Association of high levels of antidrug antibodies against atezolizumab with clinical outcomes and T-cell responses in patients with hepatocellular carcinoma. JAMA Oncol. 2022 (Oct 20). Doi: 10.1001/jamaoncol.2022.4733

Key clinical point: Highly elevated antidrug antibody (ADA) levels (≥1,000 ng/mL) at 3 weeks (cycle 2 day 1 [C2D1]) may be associated with poor clinical outcomes after atezolizumab/bevacizumab (Atezo/Bev) treatment in patients with advanced hepatocellular carcinoma (HCC).

Major finding: In both discovery cohort (DC) and validation cohort (VC), patients with high vs low ADA levels at C2D1 had worse progression-free survival (DC: hazard ratio [HR] 2.84; P = .005; VC: HR 2.52; P = .006) and overall survival (DC: HR 3.30; P = .003; VC: HR 5.81; P = .001).

Study details: This prospective cohort study included 132 patients with advanced HCC treated with first-line Atezo/Bev (DC n = 50; VC n = 82).

Disclosures: This study was sponsored by a National Research Foundation of Korea grant funded by the Korean government and others. Some authors reported serving as advisors for or receiving personal fees or grants from various sources. Two authors declared having a pending method patent for predicting therapeutic response to biologic drugs by quantifying blood ADA.

Source: Kim C et al. Association of high levels of antidrug antibodies against atezolizumab with clinical outcomes and T-cell responses in patients with hepatocellular carcinoma. JAMA Oncol. 2022 (Oct 20). Doi: 10.1001/jamaoncol.2022.4733

Key clinical point: Highly elevated antidrug antibody (ADA) levels (≥1,000 ng/mL) at 3 weeks (cycle 2 day 1 [C2D1]) may be associated with poor clinical outcomes after atezolizumab/bevacizumab (Atezo/Bev) treatment in patients with advanced hepatocellular carcinoma (HCC).

Major finding: In both discovery cohort (DC) and validation cohort (VC), patients with high vs low ADA levels at C2D1 had worse progression-free survival (DC: hazard ratio [HR] 2.84; P = .005; VC: HR 2.52; P = .006) and overall survival (DC: HR 3.30; P = .003; VC: HR 5.81; P = .001).

Study details: This prospective cohort study included 132 patients with advanced HCC treated with first-line Atezo/Bev (DC n = 50; VC n = 82).

Disclosures: This study was sponsored by a National Research Foundation of Korea grant funded by the Korean government and others. Some authors reported serving as advisors for or receiving personal fees or grants from various sources. Two authors declared having a pending method patent for predicting therapeutic response to biologic drugs by quantifying blood ADA.

Source: Kim C et al. Association of high levels of antidrug antibodies against atezolizumab with clinical outcomes and T-cell responses in patients with hepatocellular carcinoma. JAMA Oncol. 2022 (Oct 20). Doi: 10.1001/jamaoncol.2022.4733

Key clinical point: Prenatal exposure to hypertensive disorders during pregnancy (HDP), particularly preeclampsia and eclampsia, increased the risk for all-cause mortality in offspring from birth to young adulthood, with early-onset and severe preeclampsia exposure notably increasing the risk.

Major finding: Offspring exposed vs not exposed to maternal HDP were at a 26% higher risk for all-cause mortality (adjusted hazard ratio [aHR] 1.26; 95% CI 1.18-1.34), with the risk being 29% (aHR 1.29; 95% CI 1.20-1.38) and 188% (aHR 2.88; 95% CI 1.79-4.63) higher on exposure to preeclampsia and eclampsia, respectively. The all-cause mortality risk was much higher in offspring prenatally exposed to early-onset and severe preeclampsia (aHR 6.06; 95% CI 5.35-6.86).

Study details: This population-based cohort study included 2,437,718 offspring born between 1978 and 2018, of which 102,095 were prenatally exposed to maternal HDP.

Disclosures: This study was supported by the National Natural Science Foundation of China, Shanghai Rising-Star Program, Shanghai Municipal Natural Science Foundation, Shanghai Municipal Science and Technology Major Project, Independent Research Fund Denmark, Nordic Cancer Union, Karen Elise Jensens Fond, and Novo Nordisk Fonden. The authors declared receiving support from the sources funding the study.

Source: Huang C et al. Maternal hypertensive disorder of pregnancy and mortality in offspring from birth to young adulthood: National population based cohort study. BMJ. 2022;379:e072157 (Oct 19) Erratum: 2022;379:o2726. Doi: 10.1136/bmj-2022-072157

Key clinical point: Prenatal exposure to hypertensive disorders during pregnancy (HDP), particularly preeclampsia and eclampsia, increased the risk for all-cause mortality in offspring from birth to young adulthood, with early-onset and severe preeclampsia exposure notably increasing the risk.

Major finding: Offspring exposed vs not exposed to maternal HDP were at a 26% higher risk for all-cause mortality (adjusted hazard ratio [aHR] 1.26; 95% CI 1.18-1.34), with the risk being 29% (aHR 1.29; 95% CI 1.20-1.38) and 188% (aHR 2.88; 95% CI 1.79-4.63) higher on exposure to preeclampsia and eclampsia, respectively. The all-cause mortality risk was much higher in offspring prenatally exposed to early-onset and severe preeclampsia (aHR 6.06; 95% CI 5.35-6.86).

Study details: This population-based cohort study included 2,437,718 offspring born between 1978 and 2018, of which 102,095 were prenatally exposed to maternal HDP.

Disclosures: This study was supported by the National Natural Science Foundation of China, Shanghai Rising-Star Program, Shanghai Municipal Natural Science Foundation, Shanghai Municipal Science and Technology Major Project, Independent Research Fund Denmark, Nordic Cancer Union, Karen Elise Jensens Fond, and Novo Nordisk Fonden. The authors declared receiving support from the sources funding the study.

Source: Huang C et al. Maternal hypertensive disorder of pregnancy and mortality in offspring from birth to young adulthood: National population based cohort study. BMJ. 2022;379:e072157 (Oct 19) Erratum: 2022;379:o2726. Doi: 10.1136/bmj-2022-072157

Key clinical point: Prenatal exposure to hypertensive disorders during pregnancy (HDP), particularly preeclampsia and eclampsia, increased the risk for all-cause mortality in offspring from birth to young adulthood, with early-onset and severe preeclampsia exposure notably increasing the risk.

Major finding: Offspring exposed vs not exposed to maternal HDP were at a 26% higher risk for all-cause mortality (adjusted hazard ratio [aHR] 1.26; 95% CI 1.18-1.34), with the risk being 29% (aHR 1.29; 95% CI 1.20-1.38) and 188% (aHR 2.88; 95% CI 1.79-4.63) higher on exposure to preeclampsia and eclampsia, respectively. The all-cause mortality risk was much higher in offspring prenatally exposed to early-onset and severe preeclampsia (aHR 6.06; 95% CI 5.35-6.86).

Study details: This population-based cohort study included 2,437,718 offspring born between 1978 and 2018, of which 102,095 were prenatally exposed to maternal HDP.

Disclosures: This study was supported by the National Natural Science Foundation of China, Shanghai Rising-Star Program, Shanghai Municipal Natural Science Foundation, Shanghai Municipal Science and Technology Major Project, Independent Research Fund Denmark, Nordic Cancer Union, Karen Elise Jensens Fond, and Novo Nordisk Fonden. The authors declared receiving support from the sources funding the study.

Source: Huang C et al. Maternal hypertensive disorder of pregnancy and mortality in offspring from birth to young adulthood: National population based cohort study. BMJ. 2022;379:e072157 (Oct 19) Erratum: 2022;379:o2726. Doi: 10.1136/bmj-2022-072157

Key clinical point: Prenatal exposure to hypertensive disorders during pregnancy (HDP), particularly preeclampsia and eclampsia, increased the risk for all-cause mortality in offspring from birth to young adulthood, with early-onset and severe preeclampsia exposure notably increasing the risk.

Major finding: Offspring exposed vs not exposed to maternal HDP were at a 26% higher risk for all-cause mortality (adjusted hazard ratio [aHR] 1.26; 95% CI 1.18-1.34), with the risk being 29% (aHR 1.29; 95% CI 1.20-1.38) and 188% (aHR 2.88; 95% CI 1.79-4.63) higher on exposure to preeclampsia and eclampsia, respectively. The all-cause mortality risk was much higher in offspring prenatally exposed to early-onset and severe preeclampsia (aHR 6.06; 95% CI 5.35-6.86).

Study details: This population-based cohort study included 2,437,718 offspring born between 1978 and 2018, of which 102,095 were prenatally exposed to maternal HDP.

Disclosures: This study was supported by the National Natural Science Foundation of China, Shanghai Rising-Star Program, Shanghai Municipal Natural Science Foundation, Shanghai Municipal Science and Technology Major Project, Independent Research Fund Denmark, Nordic Cancer Union, Karen Elise Jensens Fond, and Novo Nordisk Fonden. The authors declared receiving support from the sources funding the study.

Source: Huang C et al. Maternal hypertensive disorder of pregnancy and mortality in offspring from birth to young adulthood: National population based cohort study. BMJ. 2022;379:e072157 (Oct 19) Erratum: 2022;379:o2726. Doi: 10.1136/bmj-2022-072157

Key clinical point: Prenatal exposure to hypertensive disorders during pregnancy (HDP), particularly preeclampsia and eclampsia, increased the risk for all-cause mortality in offspring from birth to young adulthood, with early-onset and severe preeclampsia exposure notably increasing the risk.

Major finding: Offspring exposed vs not exposed to maternal HDP were at a 26% higher risk for all-cause mortality (adjusted hazard ratio [aHR] 1.26; 95% CI 1.18-1.34), with the risk being 29% (aHR 1.29; 95% CI 1.20-1.38) and 188% (aHR 2.88; 95% CI 1.79-4.63) higher on exposure to preeclampsia and eclampsia, respectively. The all-cause mortality risk was much higher in offspring prenatally exposed to early-onset and severe preeclampsia (aHR 6.06; 95% CI 5.35-6.86).

Study details: This population-based cohort study included 2,437,718 offspring born between 1978 and 2018, of which 102,095 were prenatally exposed to maternal HDP.

Disclosures: This study was supported by the National Natural Science Foundation of China, Shanghai Rising-Star Program, Shanghai Municipal Natural Science Foundation, Shanghai Municipal Science and Technology Major Project, Independent Research Fund Denmark, Nordic Cancer Union, Karen Elise Jensens Fond, and Novo Nordisk Fonden. The authors declared receiving support from the sources funding the study.

Source: Huang C et al. Maternal hypertensive disorder of pregnancy and mortality in offspring from birth to young adulthood: National population based cohort study. BMJ. 2022;379:e072157 (Oct 19) Erratum: 2022;379:o2726. Doi: 10.1136/bmj-2022-072157

Key clinical point: Prenatal exposure to hypertensive disorders during pregnancy (HDP), particularly preeclampsia and eclampsia, increased the risk for all-cause mortality in offspring from birth to young adulthood, with early-onset and severe preeclampsia exposure notably increasing the risk.

Major finding: Offspring exposed vs not exposed to maternal HDP were at a 26% higher risk for all-cause mortality (adjusted hazard ratio [aHR] 1.26; 95% CI 1.18-1.34), with the risk being 29% (aHR 1.29; 95% CI 1.20-1.38) and 188% (aHR 2.88; 95% CI 1.79-4.63) higher on exposure to preeclampsia and eclampsia, respectively. The all-cause mortality risk was much higher in offspring prenatally exposed to early-onset and severe preeclampsia (aHR 6.06; 95% CI 5.35-6.86).

Study details: This population-based cohort study included 2,437,718 offspring born between 1978 and 2018, of which 102,095 were prenatally exposed to maternal HDP.

Disclosures: This study was supported by the National Natural Science Foundation of China, Shanghai Rising-Star Program, Shanghai Municipal Natural Science Foundation, Shanghai Municipal Science and Technology Major Project, Independent Research Fund Denmark, Nordic Cancer Union, Karen Elise Jensens Fond, and Novo Nordisk Fonden. The authors declared receiving support from the sources funding the study.

Source: Huang C et al. Maternal hypertensive disorder of pregnancy and mortality in offspring from birth to young adulthood: National population based cohort study. BMJ. 2022;379:e072157 (Oct 19) Erratum: 2022;379:o2726. Doi: 10.1136/bmj-2022-072157

Key clinical point: The maternal blood and umbilical cord serum leptin, visfatin, and spexin levels were significantly altered in nondiabetic pregnant women with vs without preeclampsia, with leptin and visfatin levels showing a significant and positive correlation with maternal body mass index (BMI) in women with and without preeclampsia.

Major finding: Pregnant women with vs without severe preeclampsia had significantly higher levels of serum leptin and visfatin (P < .001) and lower levels of spexin (P < .001) in both maternal blood and umbilical cord, with maternal BMI and leptin and visfatin levels in maternal blood and umbilical cord being positively correlated in women with (P < .001) and without (P < .01) severe preeclampsia.

Study details: This was a case-control observational study including 45 pregnant women with severe preeclampsia and 45 gestational age-matched women with normal pregnancies without known medical conditions, who underwent a cesarean section at 34-35 weeks of gestation.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Gök S et al. Evaluation of the adipokine levels of pregnant women with preeclampsia. J Obstet Gynaecol Res. 2022 (Oct 13). Doi: 10.1111/jog.15463

Key clinical point: The maternal blood and umbilical cord serum leptin, visfatin, and spexin levels were significantly altered in nondiabetic pregnant women with vs without preeclampsia, with leptin and visfatin levels showing a significant and positive correlation with maternal body mass index (BMI) in women with and without preeclampsia.

Major finding: Pregnant women with vs without severe preeclampsia had significantly higher levels of serum leptin and visfatin (P < .001) and lower levels of spexin (P < .001) in both maternal blood and umbilical cord, with maternal BMI and leptin and visfatin levels in maternal blood and umbilical cord being positively correlated in women with (P < .001) and without (P < .01) severe preeclampsia.

Study details: This was a case-control observational study including 45 pregnant women with severe preeclampsia and 45 gestational age-matched women with normal pregnancies without known medical conditions, who underwent a cesarean section at 34-35 weeks of gestation.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Gök S et al. Evaluation of the adipokine levels of pregnant women with preeclampsia. J Obstet Gynaecol Res. 2022 (Oct 13). Doi: 10.1111/jog.15463

Key clinical point: The maternal blood and umbilical cord serum leptin, visfatin, and spexin levels were significantly altered in nondiabetic pregnant women with vs without preeclampsia, with leptin and visfatin levels showing a significant and positive correlation with maternal body mass index (BMI) in women with and without preeclampsia.

Major finding: Pregnant women with vs without severe preeclampsia had significantly higher levels of serum leptin and visfatin (P < .001) and lower levels of spexin (P < .001) in both maternal blood and umbilical cord, with maternal BMI and leptin and visfatin levels in maternal blood and umbilical cord being positively correlated in women with (P < .001) and without (P < .01) severe preeclampsia.

Study details: This was a case-control observational study including 45 pregnant women with severe preeclampsia and 45 gestational age-matched women with normal pregnancies without known medical conditions, who underwent a cesarean section at 34-35 weeks of gestation.

Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.

Source: Gök S et al. Evaluation of the adipokine levels of pregnant women with preeclampsia. J Obstet Gynaecol Res. 2022 (Oct 13). Doi: 10.1111/jog.15463

Key clinical point: Shoulder dystocia was identified as the highest contributing risk factor for intrapartum fetal deaths in addition to other independent risk factors, such as uterine rupture and preterm delivery.

Major finding: Overall, 0.1% of deliveries resulted in intrapartum fetal deaths. Independent risk factors for intrapartum fetal deaths included uterine rupture (adjusted odds ratio [aOR] 19.0; 95% CI 7.0-51.4), preterm delivery (aOR 11.9; 95% CI 8.6-16.5), with shoulder dystocia being the highest contributing risk factor (aOR 23.8; 95% CI 9.9-57.3).

Study details: This population-based retrospective cohort study analyzed the data of 344,781 singleton deliveries.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Davidesko S et al. Critical analysis of risk factors for intrapartum fetal death. Arch Gynecol Obstet. 2022 (Oct 12). Doi: 10.1007/s00404-022-06811-x

Key clinical point: Shoulder dystocia was identified as the highest contributing risk factor for intrapartum fetal deaths in addition to other independent risk factors, such as uterine rupture and preterm delivery.

Major finding: Overall, 0.1% of deliveries resulted in intrapartum fetal deaths. Independent risk factors for intrapartum fetal deaths included uterine rupture (adjusted odds ratio [aOR] 19.0; 95% CI 7.0-51.4), preterm delivery (aOR 11.9; 95% CI 8.6-16.5), with shoulder dystocia being the highest contributing risk factor (aOR 23.8; 95% CI 9.9-57.3).

Study details: This population-based retrospective cohort study analyzed the data of 344,781 singleton deliveries.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Davidesko S et al. Critical analysis of risk factors for intrapartum fetal death. Arch Gynecol Obstet. 2022 (Oct 12). Doi: 10.1007/s00404-022-06811-x

Key clinical point: Shoulder dystocia was identified as the highest contributing risk factor for intrapartum fetal deaths in addition to other independent risk factors, such as uterine rupture and preterm delivery.

Major finding: Overall, 0.1% of deliveries resulted in intrapartum fetal deaths. Independent risk factors for intrapartum fetal deaths included uterine rupture (adjusted odds ratio [aOR] 19.0; 95% CI 7.0-51.4), preterm delivery (aOR 11.9; 95% CI 8.6-16.5), with shoulder dystocia being the highest contributing risk factor (aOR 23.8; 95% CI 9.9-57.3).

Study details: This population-based retrospective cohort study analyzed the data of 344,781 singleton deliveries.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Davidesko S et al. Critical analysis of risk factors for intrapartum fetal death. Arch Gynecol Obstet. 2022 (Oct 12). Doi: 10.1007/s00404-022-06811-x

Key clinical point: Recurrence risk was highest for postpartum hemorrhage (PPH) due to dystocia, with maternal age, birth weight, and previous cesarean section being significant risk factors for PPH due to dystocia.

Major finding: The recurrence risk was highest for PPH due to dystocia (adjusted odds ratio [aOR] 6.8; 95% CI 6.3-7.4), with a prior history of cesarean section (aOR 6.08; 95% CI 5.82-6.35), older maternal age (30-34 vs 25-29 years: aOR 1.42; 95% CI 1.38-1.46), and higher birth weight (4000-4499 vs 3500-3999 g: aOR 1.98; 95% CI 1.92-2.03) being significant risk factors for PPH due to dystocia.

Study details: This population-based cohort study included 3,003,025 singleton deliveries with spontaneous onset or induction of labor (gestational age at delivery ≥22 weeks), of which 277,746 were complicated by postpartum hemorrhage.

Disclosures: LE Linde declared being employed at the University of Bergen. The research file was financed by a research grant from the Western Norway Regional Health Authority. The authors declared no conflicts of interest.

Source: Linde LE et al. Risk factors and recurrence of cause-specific postpartum hemorrhage: A population-based study. PLoS One. 2022;17(10):e0275879 (Oct 14). Doi: 10.1371/journal.pone.0275879

Key clinical point: Recurrence risk was highest for postpartum hemorrhage (PPH) due to dystocia, with maternal age, birth weight, and previous cesarean section being significant risk factors for PPH due to dystocia.

Major finding: The recurrence risk was highest for PPH due to dystocia (adjusted odds ratio [aOR] 6.8; 95% CI 6.3-7.4), with a prior history of cesarean section (aOR 6.08; 95% CI 5.82-6.35), older maternal age (30-34 vs 25-29 years: aOR 1.42; 95% CI 1.38-1.46), and higher birth weight (4000-4499 vs 3500-3999 g: aOR 1.98; 95% CI 1.92-2.03) being significant risk factors for PPH due to dystocia.

Study details: This population-based cohort study included 3,003,025 singleton deliveries with spontaneous onset or induction of labor (gestational age at delivery ≥22 weeks), of which 277,746 were complicated by postpartum hemorrhage.

Disclosures: LE Linde declared being employed at the University of Bergen. The research file was financed by a research grant from the Western Norway Regional Health Authority. The authors declared no conflicts of interest.

Source: Linde LE et al. Risk factors and recurrence of cause-specific postpartum hemorrhage: A population-based study. PLoS One. 2022;17(10):e0275879 (Oct 14). Doi: 10.1371/journal.pone.0275879

Key clinical point: Recurrence risk was highest for postpartum hemorrhage (PPH) due to dystocia, with maternal age, birth weight, and previous cesarean section being significant risk factors for PPH due to dystocia.

Major finding: The recurrence risk was highest for PPH due to dystocia (adjusted odds ratio [aOR] 6.8; 95% CI 6.3-7.4), with a prior history of cesarean section (aOR 6.08; 95% CI 5.82-6.35), older maternal age (30-34 vs 25-29 years: aOR 1.42; 95% CI 1.38-1.46), and higher birth weight (4000-4499 vs 3500-3999 g: aOR 1.98; 95% CI 1.92-2.03) being significant risk factors for PPH due to dystocia.

Study details: This population-based cohort study included 3,003,025 singleton deliveries with spontaneous onset or induction of labor (gestational age at delivery ≥22 weeks), of which 277,746 were complicated by postpartum hemorrhage.

Disclosures: LE Linde declared being employed at the University of Bergen. The research file was financed by a research grant from the Western Norway Regional Health Authority. The authors declared no conflicts of interest.

Source: Linde LE et al. Risk factors and recurrence of cause-specific postpartum hemorrhage: A population-based study. PLoS One. 2022;17(10):e0275879 (Oct 14). Doi: 10.1371/journal.pone.0275879