About

Dwight Rouse is a Professor of Epidemiology and Obstetrics and Gynecology at Brown University. His research focuses on maternal-fetal medicine, including preeclampsia prevention, labor induction methods, neonatal outcomes, and gestational diabetes management. He has contributed to understanding the association between labor features and birth outcomes, as well as the cost-effectiveness of interventions in obstetrics. His work involves analyzing maternal and neonatal health outcomes, with an emphasis on improving clinical practices and maternal-fetal health through evidence-based research.

Research topics

• Medicine
• Internal medicine
• Virology
• Pathology
• Pediatrics

Selected publications

• Validation of an Extended Maternal Comorbidity Index for Prediction of Severe Maternal Morbidity

  Obstetrics and Gynecology · 2025-06-12 · 1 citations

  article

  The expanded maternal comorbidity index developed by Leonard et al uses pre-existing maternal health conditions (eg, hypertension, asthma) to produce a risk score that predicts severe maternal morbidity (SMM). This tool has been adopted into clinical and research use without external validation in a data source not reliant on administrative codes. We assessed the validity of the maternal comorbidity index to predict SMM in a modern obstetric cohort using data derived from detailed medical record abstraction. In this secondary analysis of a multicenter cohort of patients delivering at 17 U.S. hospitals (2019-2020), the maternal comorbidity index risk score was applied to all individuals and the performance of the score to predict SMM was assessed using the area under the receiver operating curve (AUC). Of 20,898 individuals in this cohort, 668 (3.2%) experienced SMM. The AUC for the maternal comorbidity index was 0.72 (95% CI, 0.70-0.74) to predict SMM and 0.83 (95% CI, 0.79-0.86) to predict SMM without transfusion. The expanded maternal comorbidity index for prediction of SMM was externally valid, and findings support the ongoing use of this tool.

  PublisherDOI

• Association between Induction Start Time and Labor Duration in Nulliparous Women Undergoing Elective Induction of Labor

  American Journal of Perinatology · 2025-02-27 · 1 citations

  articleOpen access

  Abstract This study aimed to examine the association between elective induction of labor (EIOL) start time and labor duration among nulliparous women. The ARRIVE trial was a multicenter randomized controlled trial of induction of labor at 390/7 to 394/7 weeks versus expectant management in low-risk nulliparous women. In this secondary analysis, we included participants randomized to the induction group who had an EIOL without spontaneous labor or rupture of membranes prior to the induction start. The start time of EIOL was categorized as: early a.m. (midnight to 5:59 a.m.), late AM (6 AM–11:59 a.m.), early p.m. (noon–5:59 p.m.), or late p.m. (6 p.m.–11:59 p.m.). The primary outcome was labor duration. Cesarean delivery rates by induction start time were also examined. Multivariable analysis was conducted controlling for age, body mass index, insurance status, and modified Bishop score on admission (<5 or ≥5). Of 3,062 women randomized to EIOL, 2,197 were included in this analysis. EIOL occurred in the early a.m. in 13%, in late a.m. in 28%, in early p.m. in 13%, and in late p.m. in 45%. Participants induced in the late a.m. had the shortest mean labor durations (21.5 ± 11.3 hours) and the highest frequency of delivery at < 24 hours (68%). In adjusted analyses, induction in the late a.m. (vs. grouped other time periods) remained significantly associated with shorter labor duration (−1.5 hours; confidence interval: −2.5 and −0.4; p = 0.006), and there was no interaction between Bishop score and time of EIOL. Cesarean delivery rates did not differ by start time. Induction of labor starting between 6 a.m. and 11:59 a.m. was associated with shorter labor durations, independent of baseline maternal characteristics including cervical status on admission.

  PublisherOA PDFDOI

• Long COVID After Acquisition of the Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) During Pregnancy Compared With Outside of Pregnancy

  Obstetrics and Gynecology · 2025-10-02

  articleOpen access

  OBJECTIVE: To evaluate whether the risk of long COVID among individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy differs from that of individuals who were not pregnant at time of virus acquisition. METHODS: We conducted a multicenter observational cohort study at 79 NIH RECOVER (Researching COVID to Enhance Recovery) sites. Individuals assigned female at birth aged 18-45 years with an index (first) SARS-CoV-2 infection on or after December 1, 2021, were included. The exposure was pregnancy (any gestational age) at the time of index SARS-CoV-2 infection. The primary outcome was long COVID 6 months after index infection , defined as RECOVER-Adult Long COVID Research Index score 11 or higher based on a detailed symptom survey. To account for confounding and differential selection between participants who were pregnant and not pregnant at infection, propensity score-matching methods were used to balance the groups on variables potentially associated with both pregnancy status and long COVID. RESULTS: Overall 2,423 participants were included; 580 (23.9%) were pregnant at index SARS-CoV-2 infection. The median age at infection was 33 years (interquartile range 28-38 years), and 2,131 of participants (90.0%) with known vaccination status were vaccinated. After propensity score matching, the adjusted long COVID prevalence estimates 6 months after index infection were 10.2% (95% CI, 6.2-14.3%) among those pregnant at infection and 10.6% (95% CI, 8.8-12.4%) among those not pregnant at infection. Pregnancy was not associated with a difference in adjusted risk of long COVID (adjusted risk ratio 0.96, 95% CI, 0.63-1.48). CONCLUSION: Acquisition of SARS-CoV-2 during pregnancy was not associated with a differential risk of long COVID at 6 months compared with similar-aged individuals who acquired SARS-CoV-2 outside of pregnancy.

  PublisherOA PDFDOI

• Continuing the discussion regarding “Nonsevere hypertensive disorders of pregnancy and oral antihypertensive medications: an argument against use”

  American Journal of Obstetrics & Gynecology MFM · 2025-05-14

  letterOpen accessSenior author
  PublisherOA PDFDOI

• Improving perinatal outcomes: A review of landmark trials that have changed obstetric practice

  Seminars in Perinatology · 2025-12-13

  reviewSenior author
  PublisherDOI

• The association of cytomegalovirus hyperimmune globulin with adverse pregnancy outcomes

  American Journal of Obstetrics and Gynecology · 2025-04-11 · 2 citations

  articleOpen access1st authorCorresponding

  Because a prior randomized trial suggested that cytomegalovirus (CMV) hyperimmune globulin (HIG) might increase the frequency of adverse pregnancy outcomes,1 we assessed whether there was such an association in our more recent and larger trial.

  PublisherDOI

• Development of a Risk-Scoring System for Prediction of Blood Transfusion During Hospitalization for Delivery

  O&G Open · 2025-04-01 · 1 citations

  articleOpen access

  OBJECTIVE: To develop and internally validate a practical and data-driven risk-scoring system to predict blood transfusion during hospitalization for delivery in a contemporary U.S. cohort. METHODS: This was a secondary analysis of a multicenter cohort of patients who delivered on randomly selected days at 17 U.S. hospitals (2019-2020). Patients with placenta accreta spectrum were excluded. The primary outcome was any blood transfusion during hospitalization for delivery. Candidate risk factors for transfusion were selected based on relevant literature. A multivariable logistic regression model was developed and internally validated using stratified k-fold (k=5) cross validation with stepwise backward elimination that used significance level of 0.05. Each risk factor included in the final model was assigned a point value by dividing the log of the odds ratio (OR) by the log of the OR of the factor with the lowest value. The summed points for an individual generate a numeric risk score predictive of transfusion. Performance of the risk score to predict transfusion was assessed using the area under the receiver operating curve (AUC). RESULTS: Of 21,780 included individuals, 2.5% (n=545) received a blood transfusion. Factors associated with the highest risk for transfusion in the final model included thrombocytopenia, and placental abruption or significant antepartum bleeding. Risk score outputs among patients in the cohort ranged from 0 to 17 (maximum possible 26) with a corresponding predicted risk for transfusion from 1.0% to 84.4%. The AUC for prediction of transfusion in the validation subsample was 0.81 (95% CI, 0.76-0.85). CONCLUSION: We developed a clinically applicable numeric risk score to predict blood transfusion during hospitalization for delivery. Future work should externally validate this risk-scoring system.

  PublisherDOI

• Childhood sexual abuse and post‐cesarean pain

  Pregnancy · 2025-11-01

  articleOpen access

  Abstract Background Sexual abuse before the age of 10 is reported by 2.7% of US women. Chronic pain has been linked to sexual abuse, but little is known about acute postoperative pain in those with a sexual abuse history and no history of chronic pain. We hypothesized that those who report prepubertal sexual abuse experience more pain at 7 days after hospital discharge from a cesarean delivery. Objective To evaluate whether patients who report prepubertal sexual abuse experience more pain 7 days after hospital discharge from a cesarean delivery. Study Design Secondary analysis of a multicenter randomized trial of individuals who underwent cesarean at 31 US hospitals (2020–2022). Participants were excluded if they had chronic pain or were missing sexual abuse data. The primary outcome was moderate‐to‐severe worst pain (≥4 on a scale from 0 to 10), as assessed by the Brief Pain Inventory (BPI), 7 days after discharge. Secondary outcomes included BPI at 2 weeks post‐discharge and 6 weeks and 90 days postpartum, Pain Catastrophizing Scale (PCS) and Physical Function (PF) scores at 6 weeks, Milligram Morphine Equivalents (MME) use in 24 h before discharge, and opioid use measured at 90 days (number of prescriptions beyond discharge and total number of tablets taken after discharge). Maternal characteristics were compared between those with and without prepubertal sexual abuse. Multivariable modeling was performed adjusting for prepregnancy body mass index (BMI), family history of substance use disorders, and Edinburgh depression score ≥13 at randomization. Results Of the 4881 participants included in the analysis, 5.3% reported prepubertal sexual abuse. They were significantly more likely to have a BMI ≥30 (54% vs. 44%), a family history of substance use disorders (58% vs. 24%), and an Edinburgh depression score ≥ 13 (9% vs. 4%) (all p < 0.05). Multivariable models showed that a BPI score ≥ 4 was significantly higher 7 days post‐discharge (75% vs. 57%; adjusted relative risk [aRR], 1.3 [1.2, 1.4]) in those reporting prepubertal sexual abuse. BPI scores remained significantly higher through 6 weeks (2 weeks: 42% vs. 30%; aRR, 1.3 [1.1, 1.6]; 6 weeks: 14% vs. 10%; aRR, 1.5 [1.01, 2.1]; 90 days: 5% vs. 5%; aRR, 0.9 [0.4, 1.8]). PCS score ≥ 12 (15% vs. 12%) and PF score below average (64% vs. 56%) were not significantly different at 6 weeks. Opioid use in the 24 h before discharge (median MME 22.5% vs. 15, p < 0.01), additional opioid prescriptions after discharge (10% vs. 6%; aRR, 1.7 [1.1, 2.5]), and median total opioid tabs used after discharge (9% vs. 4 tabs, p < 0.01) were all significantly higher among individuals reporting prepubertal sexual abuse. Conclusion In postpartum individuals who reported prepubertal sexual abuse, post‐cesarean pain through 6 weeks and prescription opioid use were significantly higher. These associations warrant further study.

  PublisherOA PDFDOI

• Characteristics and outcomes associated with multiple triage visits among patients with suspected preterm labor or preterm premature rupture of membranes

  UNC Libraries · 2025-12-18

  articleOpen access
  PublisherDOI

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

  American Journal of Perinatology · 2024-05-10

  articleOpen access

  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, or critical COVID-19. STUDY DESIGN: This was a secondary analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients who delivered from March through December 2020 at hospitals across the United States. Those eligible for this analysis presented for delivery with a current or previous asymptomatic or mild SARS-CoV-2 infection. The primary outcome was moderate, severe, or critical COVID-19 during the delivery admission through 42 days postpartum. The prediction model was developed and internally validated using stratified cross-validation with stepwise backward elimination, incorporating only variables that were known on the day of hospital admission. RESULTS: Of the 2,818 patients included, 26 (0.9%; 95% confidence interval [CI], 0.6-1.3%) developed moderate-severe-critical COVID-19 during the study period. Variables in the prediction model were gestational age at delivery admission (adjusted odds ratio [aOR], 1.15; 95% CI, 1.08-1.22 per 1-week decrease), a hypertensive disorder in a prior pregnancy (aOR 3.05; 95% CI, 1.25-7.46), and systolic blood pressure at admission (aOR, 1.04; 95% CI, 1.02-1.05 per mm Hg increase). This model yielded an area under the receiver operating characteristic curve of 0.82 (95% CI, 0.72-0.91). CONCLUSION: Among individuals presenting for delivery who had asymptomatic-mild COVID-19, gestational age at delivery admission, a hypertensive disorder in a prior pregnancy, and systolic blood pressure at admission were predictive of delivering with moderate, severe, or critical COVID-19. This prediction model may be a useful tool to optimize resources for SARS-CoV-2-infected pregnant individuals admitted for delivery. KEY POINTS: · Three factors were associated with delivery with more severe COVID-19.. · The developed model yielded an area under the receiver operating characteristic curve of 0.82 and model fit was good.. · The model may be useful tool for SARS-CoV-2 infected pregnancies admitted for delivery..

  PublisherOA PDFDOI

Recent grants

• Brown University/Women & Infants Hospital of Rhode Island (WIH) Center Application for the Eunice Kennedy Shriver NICHD Maternal Fetal Medicine Units Network

  NIH · $3.1M · 2001–2030

• NIH Grant U10HD040500

  NIH · $7.5M · 2016

• NIH Grant K24HD001375

  NIH · $553k · 2006

• NIH Grant U10HD027869

  NIH · $18.9M · 2016

Frequent coauthors

• George R. Saade

  1982 shared

• Alan T. Tita

  Office of the Director

  1899 shared

• Michael W. Varner

  Eunice Kennedy Shriver National Institute of Child Health and Human Development

  1654 shared

• John M. Thorp

  1481 shared

• Brian M. Casey

  The University of Texas Southwestern Medical Center

  1470 shared

• Yoram Sorokin

  Wayne State University

  1322 shared

• Jay D. Iams

  Eunice Kennedy Shriver National Institute of Child Health and Human Development

  1320 shared

• Ronald J. Wapner

  New York Genome Center

  1277 shared

Education

• Ph.D., Epidemiology

  Brown University

  1990

• M.D., Obstetrics and Gynecology

  Brown University

  1984

• B.A., Biology

  Brown University

  1980