Background/Objectives: Screening for food insecurity, while common practice in pediatric populations, remains novel in pregnancy. Food insecurity during pregnancy is associated with medical comorbidities that in turn confer additional obstetric risks to the maternal–fetal dyad. Few studies have evaluated the impact of interventions for patients with food insecurity in the prenatal period. This study first demonstrates the ease of FI screening in pregnancy using the Hunger Vital Sign™ and next assesses if providing patients with a referral to a registered dietician decreases the incidence of inappropriate weight gain in pregnant patients with food insecurity. Methods: A retrospective chart review was conducted from November 2019 to March of 2021 at a United States Northeast inner-city hospital-based clinic to identify patients with food insecurity in the prenatal period. All pregnant patients who screened positive for food insecurity were given an educational pamphlet with resources and offered a referral to a registered dietician. We compared the incidence of appropriate weight gain among these patients depending on whether they attended an appointment with a registered dietician. We defined appropriate weight gain following the recommendations of the Institute of Medicine (IOM) based on pre-pregnancy body mass index. Inferential statistics were performed to compare differences using univariate statistics, and multivariate regression was conducted to control for confounders, with an alpha of 0.05. Results: In total, 139 patients screened positive for food insecurity (FI); 52 (37.4%) attended an appointment with a registered dietician. Overall, 88 (61.9%) patients had inappropriate weight gain during pregnancy. Fewer patients who attended a visit with a registered dietician had inappropriate weight gain than those who did not attend a visit (27 [30.7%] vs. 61 [69.3%], p = 0.031, respectively). Both study groups’ demographics, comorbidities, and postpartum outcomes were comparable. Conclusions: We found that for pregnant individuals with food insecurity, consultation with a registered dietician was associated with a decrease in the incidence of inappropriate weight gain during pregnancy.

Background: Treprostinil has demonstrated effectiveness in treating Pulmonary Arterial Hypertension (PAH) and Pulmonary Hypertension associated with Interstitial Lung Disease (PH-ILD). However, tolerability remains a clinical challenge. Identifying factors influencing tolerability is important, given the adverse outcomes of PAH and PH-ILD and the potential of treprostinil to slow disease progression. Objective: This study was undertaken to identify tolerance factors and develop a predictive scoring system. Methods: A retrospective analysis of 65 patients (37 PAH, 28 PH-ILD) was conducted using patient history, pulmonary function tests (PFTs), transthoracic echocardiograms (TTEs), and right heart catheterizations (RHCs). Of these, 67.7% (n = 44) tolerated treprostinil, while 32.3% (n = 21) were intolerant. Results: Patients who tolerated treprostinil had better pulmonary function, with a higher forced expiratory volume in one second/forced vital capacity (FEV₁/FVC) ratio (82.27 ± 16.06 vs. 72.86 ± 17.76, p = 0.037) and superior right ventricular function, as indicated by higher tricuspid annular plane systolic excursion (TAPSE: 2.05 ± 0.37 vs. 1.64 ± 0.42, p < 0.001), higher cardiac index (CI: 2.51 ± 0.67 vs. 2.03 ± 0.53, p = 0.003), and improved functional status (p < 0.001). The Inhaled Treprostinil Intolerance Score (ITIS), incorporating TAPSE < 1.6, CI < 2, FEV₁/FVC < 70%, and WHO functional class (FC) 3 or 4, demonstrated strong predictive accuracy (cutoff ≥ 2, AUC = 0.884 ± 0.048, p < 0.001). Predictive performance was stronger in PAH patients (AUC = 0.921 ± 0.053) than PH-ILD (AUC = 0.833 ± 0.093, p < 0.001). Conclusions: These findings demonstrate the importance of clinical parameters in predicting treprostinil tolerance. Further investigation is warranted to refine the scoring system, particularly for PH-ILD patients.