Browsing by Author "Rone, Victoria"

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    Impact of the Dobbs Decision on Obstetrics and Gynecology Residency Applications – an Exploratory Survey
    (The European Society of Medicine, 2025-04-30) Conklin, Alissa M.; Rone, Victoria; Arrocha, Diana; Scott, Nicole P.; Peipert, Jeffrey F.; Shanks, Anthony L.
    Objective: To evaluate the early impact of the Dobbs v. Jackson Women’s Health Organization decision on Obstetrics and Gynecology (OBGYN) residency applications by analyzing changes in applicant behavior, including application numbers and signal allocation, based on abortion law categories, program prestige, geographic region, and the availability of family planning fellowships. Study Design: This cross-sectional survey assessed 61 medium-to-large OBGYN residency programs to examine application trends before and after the Dobbs decision. Data were collected on residency applications for the 2021–2022 and 2022–2023 application cycles, the number of gold and silver signals received in the 2022 Electronic Residency Application Service (ERAS) cycle, program prestige (US News & World Report and Doximity rankings), geographic region (Center for Disease Control and Prevention (CDC)-defined), and the presence of a family planning fellowship or Ryan Program affiliation. Descriptive statistics, paired t-tests, and analysis of variance (ANOVA) were used to analyze differences in application numbers and signal allocation. Results: Across all abortion law categories, applications declined from the 2021–2022 to the 2022–2023 cycle (mean: 895.9 vs. 856.7, p = 0.02), with the largest decrease in states with abortion restrictions (-7.58%). Programs in states with abortion protections received significantly more gold (p = 0.04) and silver signals (p < 0.001) than those in restrictive states. Programs offering family planning fellowships and those affiliated with the Ryan Program also received more signals (p < 0.05). Conclusion: Programs in abortion-restrictive states received fewer applications and signals, suggesting applicants prioritize abortion training access. These trends may impact the geographic distribution of OBGYNs and reproductive healthcare availability. Implications: Declining applications to restrictive states may exacerbate maternity care shortages. Further research is needed to assess long-term effects on workforce retention and training.
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    Risk of Neonatal Sepsis With Rescue Steroids in Preterm Premature Rupture of Membranes
    (Springer Nature, 2023-04-06) Tenbrink, Emily; Quain, Angela; Rone, Victoria; Harris, Kate; Hadley, Emily; Haas, David; Shanks, Anthony L.; Obstetrics and Gynecology, School of Medicine
    Objective: To evaluate whether a rescue course of corticosteroids, when given at least 14 days after the initial course, is associated with an increased risk of neonatal sepsis after preterm premature rupture of membranes (PPROM). Methods: We performed a retrospective, descriptive cohort study of women with singleton gestations from 23+0 to 34+0 weeks of gestation who received a rescue course of corticosteroids within the Indiana University Health Network from January 2009 through October 2016. Patients were separated into three groups based on amniotic membrane status at the time of each corticosteroid administration: Group 1 (intact membranes at initial/intact membranes at rescue), Group 2 (intact membranes at initial/PPROM at rescue), and Group 3 (PPROM at initial/PPROM at rescue). The primary outcome (neonatal sepsis) was compared between the groups. Patient characteristics and neonatal outcomes were analyzed with Fisher’s exact test for categorical variables and ANOVA for continuous variables. Relative risk (RR) was calculated by comparing those with ruptured membranes to those with intact membranes at the time of rescue course administration. Results: A total of 143 patients were eligible. Neonatal sepsis occurred in 6.8% of patients in Group 1, 21.1% of patients in Group 2, and 23.8% of patients in Group 3. Groups 2 and 3 had a statistically significant higher rate of neonatal sepsis than Group 1 (p = 0.021). The RR of neonatal sepsis after a rescue course in patients with PPROM (Groups 2 and 3) was 3.31 (95% CI = 1.32, 8.29) compared to those with intact membranes at the time of rescue course administration (Group 1). Conclusion: A rescue course of corticosteroids in women with PPROM at the time of rescue administration was associated with an increased risk of neonatal sepsis. This increased risk was seen in women with intact membranes as well as ruptured membranes during their initial course of steroids. Larger studies are needed to further investigate this association.