Obstetrics and Gynecology

Adam C. Urato, MD Research Laboratory

Adam Urato, MD is a maternal-fetal medicine physician at Tufts Medical Center.The research laboratory of Adam C. Urato, MD at Tufts Medical Center in downtown Boston, MA is focused on investigating the subtypes of preeclampsia, cesarean section delivery factors and the effect of SSRI usage on preterm birth in OB/GYN patients. 

Prenatal screening and Preeclampsia subtype

There is increasing recognition that there are different subtypes of preeclampsia, a hypertensive disorder during pregnancy.  What those subtypes are and how they should be classified is an area of increasing investigation.  Possibly the serum analytes that are assessed on the Quad screen at 16-18 weeks could be used to differentiate the different subtypes of preeclampsia.  These analytes are alpha feto-protein (AFP), human Chorionic Gonadatropin (hCG), estriol, and Inhibin A levels.  Associations between Quad screen components and incidence of pre-term birth, and low birth weight as well as maternal lab values were studied.  Results of this study indicated that the serum analytes (particularly AFP and Inhibin A) can be used to differentiate different subtypes of preeclampsia and will be reported in the Journal of Perinatology.  Drs. Adam Urato and Agatha Critchfield were the lead investigators of this study.

Cesarean Section Delivery Factors

Cesarean delivery rates were about 5% in 1970 and they have been rising to their current risk of approximately 33%.  There is general agreement that obstetrical providers should make every effort to lower rates.  One of the community hospitals in the Tufts residency system has had historically high rates, but these rates have been falling over the past few years.  An investigation is currently underway to determine what factors may be contributing to this decrease.  Drs. Urato and Jeannie Kelly are the lead investigators of this study.

Selective Serotonin Reuptake Inhibitor (SSRI) usage and Preterm Birth

Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants have been used since the release of Prozac in 1987.  Use during pregnancy is not uncommon, with reported rates as high as 13%.  Preterm birth is the major cause of newborn morbidity and mortality and costs of care from preterm birth are high.  Dr. Urato and his collaborators at Brigham and Women’s Hospital and Vanderbilt University are currently conducting a meta-analysis to study the association between SSRI antidepressants and preterm birth.