Explore the vast range of titles available.

Purpose compare incidences of maternal–fetal complications during pregnancy, labor, and early puerperium according to baseline BMI in a consecutive cohort of pregnant women. Methods This retrospective cohort study compares pregnancy outcome indicators by body mass index (BMI) in 1236 pregnant women managed over the period January 2017 to May 2018. Data were collected regarding the personal history (smoking, diabetes and hypertension), obstetrics and BMI (kg/m 2 ) (normoweight 18.5–24.9, overweight 25–29.9, obese ≥ 30). Results Of the 1236 women, 354 (28.6%) were overweight and 206 (16.7%) were obese at the start of pregnancy follow-up. Mean age at this time was 33 years (SD 6). Risk factors for a cesarean-section delivery assessed through logistic regression were maternal age (OR 1.05 95% CI 2.06–6.15; p  < 0.001) and previous C-section (OR 4.21 95% CI 2.89–6.14; p  < 0.001) regardless of BMI. In a propensity score analysis, pregnancy weight gain was found lower in obese vs normoweight (− 2.73 kg 95% CI − 3.74 to − 1.72 p  < 0.001), and newborn weight higher in obese vs normoweight women (161.21 g 95% CI 57.94–264.48 p  = 0.002). Labor duration and weight gain were reduced in overweight vs normoweight subjects (− 0.72 h 95% CI − 1.27 to − 0.17 p  = 0.010 and 0.81 kg 95% CI − 1.50 to − 0.12 p  = 0.021, respectively). Conclusions In this cohort, obese women showed higher rates of prenatal complications yet obesity and overweight were not related to worse puerperium outcomes.

Background Periprosthetic femoral fractures following hip arthroplasty (FH-PPF) represent a severe complication, especially in elderly patients with compromised health. Traditionally, revision arthroplasty is recommended for B2–B3 FH-PPF, yet internal fixation has emerged as a debated alternative in select patients. The hypothesis was that fixation, in selected patients with B2–B3 FH-PPF, decreases mortality and surgical complication rates with the same functional outcomes as revision arthroplasty. Materials and methods PIPPAS is a multicenter prospective observational study. This cohort substudy includes 485 patients across 57 hospitals with B2–B3 FH-PPF between January 2021 and May 2023. Management strategy, revision or fixation, was at the attending surgeon’s discretion. Propensity score matching, controlled for age, age-adjusted Charlson Comorbidity Index (a-CCI), prefracture mobility, Pfeiffer scale, and ASA score, was done. Mortality risk factors were assessed using univariate and multivariate analysis. Results Out of 485 patients, 164 received fixation, and 321 underwent revision. Fixation patients were older (88 versus 82 years, p  < 0.001) and frailer. Fixation was associated with shorter hospital stay (13 versus 15 days, p  = 0.003) but higher 1-year mortality (25% versus 14.3%, p  = 0.04). There were no differences in medical or surgical complications ( p  = 0.83 and p  = 0.36) at any time, but dislocation rate was higher in the revision group ( p  = 0.001). The 1-year mortality rate in patients with no weight-bearing restrictions was higher for the revision group ( p  = 0.01). The propensity score matching showed higher 1-year mortality rate in the fixation group but no differences in functional outcomes, complications, or up to 6-months mortality. In the multivariate analysis a-CCI, cognitive impairment, B3 fractures, and prefracture independent walking impairment were independent mortality risk factors. Conclusions Revision arthroplasty showed less 1-year mortality rate and weight-bearing restrictions than fixation. However, frail patients with B2–B3 FH-PPF managed with fixation allowing full weight-bearing showed a lower 1-year mortality rate. Fixation in B2–B3 FH-PPF is a treatment option in frail patients, while aiming for stable constructions allowing full weight-bearing. Level of Evidence II: prospective cohort study. Trial registration: ClinicalTrials.gov (NCT04663893) Graphical Abstract