SMFM 2023: what we learned

Isabel Fulcher
VP of Data Science
at Delfina
min read

This past week, the Delfina team had the opportunity to attend the Society for Maternal-Fetal Medicine’s 43rd Annual Pregnancy Meeting (SMFM23). It was an incredible opportunity to learn about some of the latest developments in pregnancy research and to meet others who are passionate about maternal and fetal health. It also gave us the chance to reunite in person with Delfinians from around the world! 

The Delfina team in front of an SMFM23 sign
Ali, Adesh, Anna, Isabel (that's me!), Tim, Senan

As the VP of Data Science at Delfina, here are some of my main takeaways from the panels, talks, and conversations that I attended. 

First, we observed significant interest in incorporating machine learning in obstetric care. Delfina Care utilizes machine learning to help clinicians identify which patients can potentially benefit from early interventions, and we are continuously working to adapt and improve our underlying models. At SMFM23, our research team presented our abstracts on predicting gestational diabetes and trends of hypertension in preterm births. Our CEO Senan Ebrahim also spoke on the Innovation in Obstetrics panel to share our model of collaboration with academic and community obstetric practices. 

Senan on the Obstetric Innovation panel

The Delfina Care platform is multifaceted, and one of our priorities is to facilitate better care between patients and providers by helping our patients collect data that reflects their pregnancy journey. Studies like this one, presented by Lorie M. Harper, MD, MSCI, propose and debate targets for blood pressure control in patients with chronic hypertension and diabetes. This demonstrates the importance of collecting more granular blood pressure data to define personalized targets. We send patients tools like blood pressure cuffs, glucometers, and weight scales so they can track their pregnancy journey, with an emphasis on patients with hypertensive disorders of pregnancy or gestational diabetes. New associations between hypertensive disorders of pregnancy and increased risks of cardiovascular diseases postpartum, presented by Christina M. Ackerman-Banks, MD, imply that postpartum care should involve continuous monitoring of blood pressure, symptoms, and care-seeking among individuals who develop HDP. We agree that it is crucial to support patients after delivery and continue patient monitoring through Delfina Care during the postpartum period. 

Me and Adesh with our research on machine learning prediction and diabetes

We also attended many talks about gestational diabetes management during pregnancy, another focus of Delfina Care. Crucially, Agata Kantorowska, MD, found that remote patient monitoring for diabetes management in pregnancy was associated with improved maternal and neonatal outcomes compared to paper logs. This provides evidence that Delfina Care’s use of connected glucometers can result in better outcomes: glycemic control, lower rates of preeclampsia, and lower rates of neonatal hyperglycemia. Additionally, we were excited about the presentation from Kristina M. Feldman, DO, demonstrating that in patients with GDM, testing blood glucose values every other day was as effective as testing every day in the management of GDM. If adopted in practice, this would reduce the burden of daily glucose monitoring among pregnant folks diagnosed with GDM. On a national level, community walkability has been associated with better glycemic control among pregnant individuals with pre-gestational diabetes. This study by Kartik Venkatesh, MD, PhD, a member of our Medical Advisory Board, highlights the potential impact of community-level factors on pregnancy-related health outcomes – an important consideration when tailoring interventions to individuals.  

Postpartum care plays a critical role in alleviating the maternal health crisis: 53% of pregnancy-related deaths happen between 7-365 days postpartum, so finding interventions for postpartum challenges is of great concern. We learned partner status is associated with increased risk of postpartum depression, and will continue to treat partner status and perceived support as an important data point for future research. However, we did not see a lot of research on mood disorders in general. As mental health conditions account for 22.7% of pregnancy-related deaths, we need better data on perinatal depression diagnoses in order to push the field further. 

We also learned from several members of our Medical Advisory Board who shared their work at SMFM23: In addition to his study on community walkability, Kartik Ventakesh, MD, PhD presented multiple times on research related to diabetes in pregnancy and health disparities. Alexis Gimovsky, MD appeared on the Obstetric Innovation panel alongside our CEO Senan Ebrahim, MD, PhD, and led a forum on techniques to improve morbidity during second stage cesarean delivery. Mark Clapp, MD, MPH presented a study showing that natural language processing of admission notes can predict postpartum hemorrhage. Finally, our Associate CMO, Tim Wen, MD, MPH authored and co-authored studies that appeared on 16 posters, including this one on the risk factors for postpartum psychosis readmission

Overall, SMFM23 was a reinvigorating, energizing experience for our whole team. We are grateful to be in a field that is full of passionate clinicians, researchers, and innovators! Delfina is committed to incorporating research on the cutting-edge of pregnancy care and constantly adapting to best support our pregnant patients and best equip their providers to deliver care. We cannot wait to learn and share more at SMFM24!

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