Brenna L Hughes

Professor of Obstetrics and Gynecology

Obstetrics and Gynecology, Maternal Fetal Medicine

brenna.hughes@duke.edu

AT A GLANCE

Credentials
1. Education
2. Medical Licensure

Academic Experience

Expertise

Research
1. Selected Grants
2. External Relationships

Publications
1. Selected Publications

Artistic Works / Events

Teaching

Advising & Mentoring

Recognition
1. Awards & Honors
2. In the News

Professional Activities
1. Selected Presentations & Appearances

Manage Profile

Embed Profile Data

Selected Publications

Optimal Timing of Delivery for Pregnant Individuals With Mild Chronic Hypertension.

Journal Article Obstet Gynecol · September 1, 2024 OBJECTIVE: To investigate the optimal gestational age to deliver pregnant people with chronic hypertension to improve perinatal outcomes. METHODS: We conducted a planned secondary analysis of a randomized controlled trial of chronic hypertension treatment ... Full text Link to item Cite

Post-Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) After Infection During Pregnancy.

Journal Article Obstet Gynecol · September 1, 2024 OBJECTIVE: To estimate the prevalence of post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) after infection with SARS-CoV-2 during pregnancy and to characterize associated risk factors. METHODS: In a multic ... Full text Link to item Cite

Pregnancy Outcomes in Patients With Hepatitis C Virus Infection.

Journal Article Obstet Gynecol · August 22, 2024 OBJECTIVE: To evaluate the risks of adverse maternal and neonatal outcomes associated with pregnancies complicated by hepatitis C virus (HCV) infection. METHODS: This is a secondary analysis of a multicenter prospective cohort study of HCV infection in pre ... Full text Link to item Cite

Near-miss and maternal sepsis mortality: A qualitative study of survivors and support persons.

Journal Article Eur J Obstet Gynecol Reprod Biol · August 2024 BACKGROUND: Prior studies have shown that maternal deaths due to sepsis occur due to delays in recognition, treatment, and escalation of care through medical chart reviews. This study was conducted to obtain the patient perspective for near-miss and matern ... Full text Link to item Cite

Mean Arterial Pressure and Neonatal Outcomes in Pregnancies Complicated by Mild Chronic Hypertension.

Journal Article Obstet Gynecol · July 1, 2024 OBJECTIVE: To estimate the association between mean arterial pressure during pregnancy and neonatal outcomes in participants with chronic hypertension using data from the CHAP (Chronic Hypertension and Pregnancy) trial. METHODS: A secondary analysis of the ... Full text Link to item Cite

Postpartum pharmacologic thromboprophylaxis and complications in a US cohort.

Journal Article Am J Obstet Gynecol · July 2024 BACKGROUND: Venous thromboembolism accounts for approximately 9% of pregnancy-related deaths in the United States. National guidelines recommend postpartum risk stratification and pharmacologic prophylaxis in at-risk individuals. Knowledge on modern rates ... Full text Link to item Cite

Pregnancy Outcomes of Nifedipine Compared With Labetalol for Oral Treatment of Mild Chronic Hypertension.

Journal Article Obstet Gynecol · July 1, 2024 OBJECTIVE: To evaluate maternal and neonatal outcomes by type of antihypertensive used in participants of the CHAP (Chronic Hypertension in Pregnancy) trial. METHODS: We conducted a planned secondary analysis of CHAP, an open-label, multicenter, randomized ... Full text Link to item Cite

Association Between Influenza Vaccination and SARS-CoV-2 Infection.

Journal Article Am J Reprod Immunol · July 2024 BACKGROUND: Recent data in nonpregnant individuals suggest a protective effect of influenza vaccination against SARS-CoV-2 infection and its severity. OBJECTIVES: Our primary objective was to evaluate whether influenza vaccination was associated with COVID ... Full text Link to item Cite

Gestational Weight Gain and Neonatal Biometry during the COVID-19 Pandemic: A Multicenter Observational Cohort.

Journal Article Am J Perinatol · June 24, 2024 OBJECTIVE: This study aimed to test the hypothesis that being pregnant and delivering during the coronavirus disease 2019 (COVID-19) pandemic was associated with changes in gestational weight gain (GWG) or frequency of small- (SGA) or large-for-gestationa ... Full text Link to item Cite

Ensuring safe and equitable discharge: a quality improvement initiative for individuals with hypertensive disorders of pregnancy.

Journal Article BMJ Qual Saf · May 17, 2024 OBJECTIVE: To improve timely and equitable access to postpartum blood pressure (BP) monitoring in individuals with hypertensive disorders of pregnancy (HDP). METHODS: A quality improvement initiative was implemented at a large academic medical centre in th ... Full text Open Access Link to item Cite

Prediction of COVID-19 Severity at Delivery after Asymptomatic or Mild COVID-19 during Pregnancy.

Journal Article Am J Perinatol · May 10, 2024 OBJECTIVE: This study aimed to develop a prediction model that estimates the probability that a pregnant person who has had asymptomatic or mild coronavirus disease 2019 (COVID-19) prior to delivery admission will progress in severity to moderate, severe, ... Full text Link to item Cite

The Association between Prenatal Nicotine Exposure and Offspring's Hearing Impairment.

Journal Article Am J Perinatol · May 2024 OBJECTIVES: The objective of this study is to evaluate whether there is an association between in-utero exposure to nicotine and subsequent hearing dysfunction. MATERIALS AND METHODS: Secondary analysis of a multicenter randomized trial to prevent congenit ... Full text Link to item Cite

Pregnancy-Associated Extracorporeal Membrane Oxygenation in the United States.

Journal Article Am J Perinatol · May 2024 OBJECTIVE: The use of extracorporeal membrane oxygenation (ECMO) therapy has increased in the adult population. Studies from the H1N1 influenza pandemic suggest that ECMO deployment in pregnancy is associated with favorable outcomes. With increasing number ... Full text Link to item Cite

Preterm Birth Rates and Racial Disparities during the COVID-19 Pandemic at a Single Institution in the Southeastern United States.

Journal Article Am J Perinatol · May 2024 OBJECTIVE: The COVID pandemic has been associated with varied effects on preterm birth (PTB). We sought to compare rates of PTB during the pre- and post vaccination COVID periods with pre-pandemic PTB rates, stratified by race and ethnicity. STUDY DESIGN: ... Full text Link to item Cite

Understanding New Recommendations for Respiratory Syncytial Virus Prevention in Pregnancy.

Journal Article Obstet Gynecol · April 1, 2024 Respiratory syncytial virus (RSV) is a significant cause of infant morbidity and mortality worldwide with peak hospitalization rates for RSV-mediated illnesses between 2 and 3 months of life. Until very recently, prevention strategies for RSV involved prim ... Full text Link to item Cite

Performance Characteristics of Sepsis Screening Tools During Delivery Admissions.

Journal Article Obstet Gynecol · March 1, 2024 OBJECTIVE: To evaluate the screening performance characteristics of existing tools for the diagnosis of sepsis during delivery admissions. METHODS: This was a case-control study using electronic health record data, including vital signs and laboratory resu ... Full text Link to item Cite

Performance Characteristics of Sepsis Screening Tools During Antepartum and Postpartum Admissions.

Journal Article Obstet Gynecol · March 1, 2024 OBJECTIVE: To evaluate the performance characteristics of existing screening tools for the prediction of sepsis during antepartum and postpartum readmissions. METHODS: This was a case-control study using electronic health record data obtained between 2016 ... Full text Link to item Cite

Breastfeeding Initiation, Duration, and Associated Factors Among People With Hepatitis C Virus Infection.

Journal Article Obstet Gynecol · March 1, 2024 OBJECTIVE: To characterize breastfeeding behaviors and identify factors associated with breastfeeding initiation among people with hepatitis C virus (HCV) infection. METHODS: We conducted a secondary analysis of a multicenter observational cohort of pregna ... Full text Link to item Cite

Postpartum Pyelonephritis and Risk of Severe Maternal Morbidity.

Journal Article Am J Perinatol · February 2024 OBJECTIVE: Pyelonephritis is the most common nonobstetric cause for hospitalization during pregnancy. The maternal and obstetric complications associated with antepartum pyelonephritis are well described. However, it is not clear whether these risks extend ... Full text Link to item Cite

Delta variant neutralizing antibody response following maternal COVID-19 vaccination.

Conference Am J Infect Control · February 2024 The Delta pandemic wave saw increased maternal morbidity and mortality compared to prior viral strains. COVID-19 vaccination in pregnancy elicits detectable levels of neutralizing antibodies to SARS-CoV-2 wild type and SARS-CoV-2 Delta variants in both mat ... Full text Link to item Cite

Optimal Timing of Delivery for Pregnant Individuals With Mild Chronic Hypertension.

Post-Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) After Infection During Pregnancy.

Pregnancy Outcomes in Patients With Hepatitis C Virus Infection.

Near-miss and maternal sepsis mortality: A qualitative study of survivors and support persons.

Mean Arterial Pressure and Neonatal Outcomes in Pregnancies Complicated by Mild Chronic Hypertension.

Postpartum pharmacologic thromboprophylaxis and complications in a US cohort.

Pregnancy Outcomes of Nifedipine Compared With Labetalol for Oral Treatment of Mild Chronic Hypertension.

Association Between Influenza Vaccination and SARS-CoV-2 Infection.

Gestational Weight Gain and Neonatal Biometry during the COVID-19 Pandemic: A Multicenter Observational Cohort.

Ensuring safe and equitable discharge: a quality improvement initiative for individuals with hypertensive disorders of pregnancy.

Prediction of COVID-19 Severity at Delivery after Asymptomatic or Mild COVID-19 during Pregnancy.

The Association between Prenatal Nicotine Exposure and Offspring's Hearing Impairment.

Pregnancy-Associated Extracorporeal Membrane Oxygenation in the United States.

Preterm Birth Rates and Racial Disparities during the COVID-19 Pandemic at a Single Institution in the Southeastern United States.

Understanding New Recommendations for Respiratory Syncytial Virus Prevention in Pregnancy.

Performance Characteristics of Sepsis Screening Tools During Delivery Admissions.

Performance Characteristics of Sepsis Screening Tools During Antepartum and Postpartum Admissions.

Breastfeeding Initiation, Duration, and Associated Factors Among People With Hepatitis C Virus Infection.

Postpartum Pyelonephritis and Risk of Severe Maternal Morbidity.

Delta variant neutralizing antibody response following maternal COVID-19 vaccination.

Society for Maternal-Fetal Medicine Statement: Clinical considerations for the prevention of respiratory syncytial virus disease in infants.

Journal Article Am J Obstet Gynecol · February 2024 Respiratory syncytial virus is a leading cause of lower respiratory tract illness globally in children aged <5 years. Each year, approximately 58,000 hospitalizations in the United States are attributed to respiratory syncytial virus. Infants aged ≤6 month ... Full text Link to item Cite

Perinatal Outcomes Associated With Management of Stage 1 Hypertension.

Journal Article Obstet Gynecol · December 1, 2023 OBJECTIVE: To evaluate the association between maternal blood pressure (BP) below 130/80 mm Hg compared with 130-139/80-89 mm Hg and pregnancy outcomes. METHODS: We conducted a planned secondary analysis of CHAP (Chronic Hypertension and Pregnancy), an ope ... Full text Link to item Cite

Randomized Trial of Hyperimmune Globulin for Congenital CMV Infection - 2-Year Outcomes.

Journal Article N Engl J Med · November 9, 2023 Full text Link to item Cite

Breastfeeding initiation and duration among people with mild chronic hypertension: a secondary analysis of the Chronic Hypertension and Pregnancy trial.

Journal Article Am J Obstet Gynecol MFM · September 2023 BACKGROUND: Increased duration of breastfeeding improves maternal cardiovascular health and may be especially beneficial in high-risk populations, such as those with chronic hypertension. Others have shown that individuals with hypertension are less likely ... Full text Link to item Cite

Risk Factors for Perinatal Transmission of Hepatitis C Virus.

Journal Article Obstet Gynecol · September 1, 2023 OBJECTIVE: To estimate the rate of perinatal transmission of hepatitis C virus (HCV) infection, to identify risk factors for perinatal transmission of HCV infection, and to determine the viremic threshold for perinatal transmission. METHODS: This was a pro ... Full text Link to item Cite

Alliance for Innovation on Maternal Health: Consensus Bundle on Sepsis in Obstetric Care.

Journal Article Obstet Gynecol · September 1, 2023 Sepsis in obstetric care is one of the leading causes of maternal death in the United States, with Black, Asian/Pacific Islander, and American Indian/Alaska Native obstetric patients experiencing sepsis at disproportionately higher rates. State maternal mo ... Full text Link to item Cite

Racial and Rural-Urban Disparities in Maternal Cardiac Disease Care in North Carolina: A Call to Action

Journal Article North Carolina Medical Journal · July 5, 2023 BackgroundCardiac disease is a leading cause of severe maternal morbidity (SMM). We sought to estimate the effects of race and rural-urban status on cardiac-specific severe maternal morbidity (“c ... Full text Cite

Pregnancy inclusion in US statewide scarce resource allocation guidelines during COVID-19 pandemic.

Journal Article Am J Obstet Gynecol MFM · July 2023 Full text Link to item Cite

Antibiotic Recommendations After Postpartum Uterine Exploration or Instrumentation.

Journal Article Obstet Gynecol Surv · July 2023 IMPORTANCE: Multiple postpartum scenarios require uterine exploration or instrumentation. These may introduce bacteria into the uterus, increasing the risk of endometritis. Data on the use of antibiotics in these scenarios is limited, resulting in few guid ... Full text Link to item Cite

Development of a Definition of Postacute Sequelae of SARS-CoV-2 Infection.

Journal Article JAMA · June 13, 2023 IMPORTANCE: SARS-CoV-2 infection is associated with persistent, relapsing, or new symptoms or other health effects occurring after acute infection, termed postacute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID. Characterizing PASC requ ... Full text Link to item Cite

The Temporal Relationship Between the Coronavirus Disease 2019 (COVID-19) Pandemic and Preterm Birth.

Journal Article Obstet Gynecol · June 1, 2023 OBJECTIVE: To evaluate whether preterm birth rates changed in relation to the onset of the coronavirus disease 2019 (COVID-19) pandemic and whether any change depended on socioeconomic status. METHODS: This is an observational cohort study of pregnant indi ... Full text Link to item Cite

Researching COVID to enhance recovery (RECOVER) pregnancy study: Rationale, objectives and design.

Journal Article medRxiv · April 24, 2023 IMPORTANCE: Pregnancy induces unique physiologic changes to the immune response and hormonal changes leading to plausible differences in the risk of developing post-acute sequelae of SARS-CoV-2 (PASC), or Long COVID. Exposure to SARS-CoV-2 during pregnancy ... Full text Link to item Cite

The gestational membrane microbiome in the presence or absence of intraamniotic infection.

Journal Article Am J Obstet Gynecol MFM · March 2023 BACKGROUND: Data regarding the microbiome of the gestational membranes are emerging and conflicting. Shifts in the microbial communities in the setting of labor, rupture of membranes, and intraamniotic infection are yet to be understood. OBJECTIVE: This st ... Full text Link to item Cite

First- or second-trimester SARS-CoV-2 infection and subsequent pregnancy outcomes.

Journal Article Am J Obstet Gynecol · February 2023 BACKGROUND: SARS-CoV-2 infection during pregnancy is associated with adverse pregnancy outcomes, including fetal death and preterm birth. It is not known whether that risk occurs only during the time of acute infection or whether the risk persists later in ... Full text Link to item Cite

For better care we need better data: towards a national obstetrics registry.

Journal Article Am J Obstet Gynecol MFM · January 2023 Unacceptably high rates of severe maternal morbidity and mortality in the United States and stark racial disparities in outcomes are generating efforts to improve both research capacity and quality improvement in obstetrical care. Comprehensive, high-quali ... Full text Link to item Cite

Delaying the Start Date for Obstetrics and Gynecology Subspecialty Training and Inequity.

Journal Article Obstet Gynecol · January 1, 2023 Full text Link to item Cite

Adverse pregnancy outcomes in a contemporary cohort of pregnant people with hepatitis c infection

Conference AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY · 2023 Cite

Differences in severe maternal morbidity and comorbidity indices in two North Carolina health systems

Conference AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY · 2023 Cite

Racial and ethnic disparities in severe maternal morbidity in two health systems in North Carolina

Conference AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY · 2023 Cite

Association Between Giving Birth During the Early Coronavirus Disease 2019 (COVID-19) Pandemic and Serious Maternal Morbidity.

Journal Article Obstet Gynecol · January 1, 2023 OBJECTIVE: To evaluate whether delivering during the early the coronavirus disease 2019 (COVID-19) pandemic was associated with increased risk of maternal death or serious morbidity from common obstetric complications compared with a historical control per ... Full text Link to item Cite

Pregnancy outcomes by pandemic wave among pregnant individuals with COVID-19 infection

Conference AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY · 2023 Cite

Researching COVID to Enhance Recovery (RECOVER) adult study protocol: Rationale, objectives, and design.

Journal Article PLoS One · 2023 IMPORTANCE: SARS-CoV-2 infection can result in ongoing, relapsing, or new symptoms or other health effects after the acute phase of infection; termed post-acute sequelae of SARS-CoV-2 infection (PASC), or long COVID. The characteristics, prevalence, trajec ... Full text Link to item Cite

Maternal and neonatal outcomes in patients with hepatitis C and intrahepatic cholestasis of pregnancy: The sum of the parts.

Journal Article PLoS One · 2023 OBJECTIVE: Hepatitis C virus and intrahepatic cholestasis of pregnancy (ICP) are well-known independent risk factors for adverse outcomes in pregnancy. In addition, it is well-established that there is an association between Hepatitis C and ICP. This study ... Full text Link to item Cite

Researching COVID to enhance recovery (RECOVER) pregnancy study: Rationale, objectives and design.

Journal Article PLoS One · 2023 IMPORTANCE: Pregnancy induces unique physiologic changes to the immune response and hormonal changes leading to plausible differences in the risk of developing post-acute sequelae of SARS-CoV-2 (PASC), or Long COVID. Exposure to SARS-CoV-2 during pregnancy ... Full text Link to item Cite

Symptomatic versus asymptomatic COVID-19: does it impact placental vasculopathy?

Journal Article J Matern Fetal Neonatal Med · December 2022 This study sought to assess the impact of COVID-19 on placental vasculature in the context of maternal symptomatology - comparing asymptomatic to symptomatic pregnant patients - and disease severity - comparing pregnant patients with mild, moderate, severe ... Full text Link to item Cite

Improving treatment of severe hypertension in pregnancy and postpartum using a hypertensive pathway.

Journal Article Pregnancy Hypertens · December 2022 OBJECTIVE: To assess the implementation of an antihypertensive pathway order set to improve treatment of severe hypertension in pregnancy and the postpartum period in the inpatient setting. STUDY DESIGN: A multi-disciplinary task force created a hypertensi ... Full text Link to item Cite

Universal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Testing for Obstetric Inpatient Units Across the United States.

Journal Article Clin Infect Dis · August 24, 2022 BACKGROUND: The purpose of this study was to estimate prevalence of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among patients admitted to obstetric inpatient units throughout the United States as detected by univers ... Full text Link to item Cite

Association of SARS-CoV-2 Infection with Serious Maternal Morbidity and Mortality from Obstetric Complications

Journal Article Obstetrical and Gynecological Survey · August 1, 2022 Full text Cite

Amniocentesis to diagnose congenital cytomegalovirus infection following maternal primary infection.

Journal Article Am J Obstet Gynecol MFM · July 2022 BACKGROUND: Congenital cytomegalovirus infection following maternal primary cytomegalovirus infection affects approximately 0.4% of newborns in the United States but may be hard to diagnose prenatally. OBJECTIVE: To evaluate the current sensitivity and spe ... Full text Link to item Cite

Treatment for Mild Chronic Hypertension during Pregnancy.

Journal Article N Engl J Med · May 12, 2022 BACKGROUND: The benefits and safety of the treatment of mild chronic hypertension (blood pressure, <160/100 mm Hg) during pregnancy are uncertain. Data are needed on whether a strategy of targeting a blood pressure of less than 140/90 mm Hg reduces the inc ... Full text Link to item Cite

Development of a Generic Physiologically-Based Pharmacokinetic Model for Lactation and Prediction of Maternal and Infant Exposure to Ondansetron via Breast Milk.

Journal Article Clin Pharmacol Ther · May 2022 Ondansetron is commonly used in breastfeeding mothers to treat nausea and vomiting. There is limited information in humans regarding safety of ondansetron exposure to nursing infants and no adequate study looking at ondansetron pharmacokinetics during lact ... Full text Link to item Cite

Hyperimmune Globulin for Congenital Cytomegalovirus Infection. Reply.

Journal Article N Engl J Med · March 10, 2022 Full text Link to item Cite

Health Outcomes Associated With Clinician-initiated Delivery for Hypertensive Disorders at 34-38 Weeks' Gestation.

Journal Article Epidemiology · March 1, 2022 BACKGROUND: Clinicians caring for the nearly 10% of patients in the United States with nonsevere hypertensive disorders in late pregnancy need better evidence to balance risks and benefits of clinician-initiated delivery. METHODS: We conducted a record-bas ... Full text Link to item Cite

Clinical factors associated with cytomegalovirus shedding among seropositive pregnant women.

Journal Article Am J Obstet Gynecol MFM · March 2022 BACKGROUND: Both neighborhood disadvantage and close contact with children have been associated with seroprevalence of cytomegalovirus in pregnancy. However, it is unknown which individual factors influence whether seropositive women are likely to have ong ... Full text Link to item Cite

Noninvasive Prediction of Congenital Cytomegalovirus Infection After Maternal Primary Infection.

Journal Article Obstet Gynecol · March 1, 2022 OBJECTIVE: To develop and internally validate a noninvasive method for the prediction of congenital cytomegalovirus (CMV) infection after primary maternal CMV infection. METHODS: We conducted a secondary analysis of a multicenter randomized placebo-control ... Full text Link to item Cite

Association of SARS-CoV-2 Infection With Serious Maternal Morbidity and Mortality From Obstetric Complications.

Journal Article JAMA · February 22, 2022 IMPORTANCE: It remains unknown whether SARS-CoV-2 infection specifically increases the risk of serious obstetric morbidity. OBJECTIVE: To evaluate the association of SARS-CoV-2 infection with serious maternal morbidity or mortality from common obstetric co ... Full text Link to item Cite