This issue of the Journal includes this summary and selected papers presented at the 2013 meeting of the American Gynecological and Obstetrical Society (AGOS). Society membership is open to applicants who have demonstrated leadership in advancing the reproductive health of women through significant contributions to education, research, and/or service. This year’s scientific presentations were made by Dr Sara Morelli,* the American Association of Obstetricians and Gynecologists Foundation (AAOGF)/American Board of Obstetrics and Gynecology (ABOG) Endowment Scholar on Cellular Origins of Endometrial Cells ; Dr Jacob Larkin, the AAOGF/Society for Maternal-Fetal Medicine Endowment Scholar on The Role of NDRG1 in Placental Injury ; and Dr R. Ann Word, the AAOGF Career Speaker who described her work on Pro-gestational Factors that Regulate Cervical Function During Pregnancy and Parturition . Dr Errol Norwitz refereed a panel including Drs Helen Feltovich, Michael House, Sonia Hassan, and Michal Elovitz, who discussed their basic and clinical studies of the role of the cervix in parturition.
The program of the 2013 meeting was intended to charge the Society and its individual members with accepting responsibility to address social determinants of reproductive health locally and nationally. Opening presentations by Drs Firdaus Dhabhar ( Good Stress, Bad Stress, and Immunity ); Anil Sood and Susan Lutgendorf ( Mechanisms of Stress Effects on Cancer Metastasis ); and Lisa Christian* ( Effects of Stress and Depression on Immune Measures in Pregnancy ) established the neuroendocrine and immunological basis for the mechanisms by which chronic stress affects reproductive health, including gynecological cancers, conception, the course of pregnancy, and fetal well-being. Evidence documenting the connections between adverse reproductive health outcomes and stressors were presented by Drs William Callaghan* ( Geographic Variation of Reproductive Health Indicators and Outcomes in the United States: Place Matters ); Jeffrey Peipert ( Social Barriers to Optimal Pregnancy Planning ); Christos Coutifaris and Samantha Butts ( Social Influences on Human Fertility ); and Zsakeba Henderson ( Teen Pregnancy in America ). Dr Arthur James delivered the Charles Hunter Prize presentation entitled, The Life Course Perspective and Racial Disparities in Adverse Pregnancy Outcomes , describing the adverse effects on reproductive health in African Americans initiated and maintained by the 400-year history of slavery, Jim Crow practices, and current social conditions. Dr James reminded AGOS members of the presentation by Dr James Collins at the 2009 Society meeting that described evidence of adverse reproductive health outcomes in the granddaughters of recent African immigrants after just 2 generations in North America. The Joseph Price Oration on Social Determinants of Health was given by Sir Michael Marmot, MBBS, MPH, PhD, FRCP, FFPHM, FMEDSCI, of the International Institute for Society and Health, University College London, England. He is the author of numerous reports and publications including The Status Syndrome , a book that describes his work on the Whitehall Studies of British civil servants, investigating explanations for the striking inverse social gradient in morbidity and mortality. Sir Michael chairs the World Health Organization’s Commission on the Social Determinants of Health and was knighted for his work. His presentation challenged the Society collectively and individually to use their credibility and authority as physician leaders and academics to influence public policies to reduce social barriers to optimal health for women and infants.
Having established the magnitude and breadth of social determinants as the root causes of reproductive disorders across the spectrum of obstetrics and gynecology, the remainder of the meeting highlighted successful efforts to overcome social barriers to optimal fertility and conception, pregnancy outcomes, and care for gynecological cancer. Dr William Grobman presented a succinct primer on Quality Improvements and Systems in Health Care , demonstrating the techniques and effectiveness of systemic pathways to address adverse outcomes such as surgical site and blood stream infection, nonmedically indicated scheduled births before 39 weeks, and perinatal transmission of human immunodeficiency virus. Drs Maureen Phipps, Robert Rebar, and Edward Partridge described systems-based work that they and their colleagues have led locally, regionally, and/or nationally to reduce the origins and consequences of social disparities in teen pregnancy in Rhode Island (Dr Phipps), to curb national rates of higher-order multifetal gestation (Dr Rebar), and to reduce the incidence and improve care of reproductive tract cancers in the Deep South Network for Cancer Control in Alabama and Mississippi (Dr Partridge).
The meeting closed with the inaugural presentation of the ABOG and the ABOG Education Foundation Endowed Lecture entitled Ob-Gyns and the American Dream by Dr Michael C. Lu, Associate Administrator of the Maternal Child Health Bureau in Health Resources and Services Administration. Dr Lu applied the American dream, “…of a land in which life should be better and richer and fuller for everyone, with opportunity for each according to ability or achievement…regardless of the fortuitous circumstances of birth or position,” to his work at the Maternal Child Health Bureau, and in his own life as the son of immigrant parents who built the foundations for lives of achievement and good health from meager beginnings. He inspired listeners to work toward assuring a full chance of fulfilling the American dream for all of our patients, every day.
Dr Lu’s presentation fit well with the President’s Address in which AGOS members were asked in their work as clinicians, teachers, and health leaders of their communities to accept personal responsibility for the health, not only of their patients, but for their communities at large, and especially for women whose health was or could be compromised by adverse social conditions. AGOS was challenged as a society of leaders to take a first step toward that goal by including a review of national reproductive health metrics as part of every annual AGOS meeting. The rates of maternal mortality, infant mortality, triplet gestation, and human papillomavirus vaccination were suggested as appropriate metrics, including black/white disparity ratios for each of these. These rates in September 2013 are shown in Figures 1-4 .
