Could Breast Milk from Overweight Moms Play a Role in Childhood Obesity?

MedicalResearch.com Interview with:

Henry J. Nuss, Ph.D. Assistant Professor Louisiana State University Health Sciences Center School of Public Health New Orleans, LA

Dr. Nuss

Henry J. Nuss, Ph.D.
Assistant Professor
Louisiana State University Health Sciences Center
School of Public Health
New Orleans, LA 

MedicalResearch.com: What is the background for this study?

Response: Childhood obesity rates in the U.S. have been increasing within the past 30 years. We can point to things like sedentary lifestyle, energy-dense, nutrient-poor foods and savvy marketing techniques of large food corporations that target kids and their parents to buy food items that aren’t healthy. That said, we do know that women who have an unhealthy weight status (as measured by BMI ≥ 25) tend to have offspring that eventually attain an unhealthy weight status themselves. Aside from environmental factors, could this be due to maternal programming or perhaps something in the breastmilk? Or both? We saw some interesting research that showed breastfed infants/toddlers born to asthmatic moms were more likely to develop asthma. Furthermore, this association became stronger the longer the infants/toddlers were breastfed. The conclusion here is that it must be something in the breastmilk.

We knew that asthma and obesity are both inflammatory in nature and that there are specific pro- and anti-inflammatory and obesogenic bioactive compounds in human breastmilk. Some have been studied before but there were no studies at the time that tied all of the pieces together. If we could target specific compounds in the milk that were associated with unhealthy growth patterns in infants then we could perhaps be more specific in how we fight this problem.

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Cesarean Section: Multimodal Program Using Non-Opioid EXPAREL Reduced Pain and Need for Opioids After Surgery

MedicalResearch.com Interview with:
Ashraf Habib, MDChief of the Division of Women’s Anesthesia and Professor of AnesthesiologyDuke University Ashraf Habib, MD
Chief of the Division of Women’s Anesthesia
Professor of Anesthesiology
Duke University 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This was a multicenter study conducted in 13 clinical sites in the United States enrolling patients undergoing elective Cesarean-section and receiving spinal anesthesia. 186 patients were enrolled and randomized to receive EXPAREL, a long-acting, non-opioid option to manage postsurgical pain, administered via transversus abdominis plane (TAP) field block, mixed with plain bupivacaine or TAP block with plain bupivacaine alone. A TAP block numbs the nerves that supply the abdominal wall. We presented the data at the 51st Annual Meeting of the Society of Obstetric Anesthesia and Perinatology (SOAP) in Phoenix, AZ.

We aimed to collect clinical evidence that a multimodal postsurgical pain regimen using a TAP block with EXPAREL (bupivacaine liposome injectable suspension) together with regularly scheduled acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) could reduce opioid consumption more so than a standard multimodal pain control approach that combines TAP block with standard bupivacaine, regularly scheduled acetaminophen, and NSAIDs.

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Prenatal Exposure to Nicotine May Increase Risk of Nicotine Susceptibility Later in Life

MedicalResearch.com Interview with:

Davide Dulcis, PhDAssociate ProfessorDepartment of Psychiatry, UCSD School of MedicineUniversity of California, San DiegoLa Jolla, CA 92093-0603

Dr. Dulcis

Davide Dulcis, PhD
Associate Professor
Department of Psychiatry, UCSD School of Medicine
University of California, San Diego
La Jolla, CA 92093-0603

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Previous studies in humans have shown that pre-natal and early life exposure to nicotine can lead to altered children behavior and propensity for drug abuse, but the precise mechanisms involved are still unclear.

In this pre-clinical study we showed how nicotine “primes” neurons of the mouse brain’s reward center for a fate they normally would not have taken, making them more susceptible to the effects of nicotine when the animals are again exposed to nicotine later in life, said Dr. Benedetto Romoli, first author of the research article.   Continue reading

Few Teen Moms Protect Themselves with Condoms and Long Acting Contraceptives

MedicalResearch.com Interview with:
Lee Warner, PhD

Chief of the Women’s Health and Fertility Branch
Division of Reproductive Health
CDC

MedicalResearch.com: What is the background for this study?

Response: Previous research has found lower prevalence of condom use combined with the most effective reversible contraceptive methods among teens, but this is the first study to our knowledge to confirm the finding among sexually active teen mothers in the postpartum period.

Our new paper finds that only 3 in 10 postpartum teen mothers report using condoms combined with a more effective contraceptive method (either long-acting reversible contraception or LARC or a non-LARC hormonal method). Dual use was 50 percent lower among LARC users compared with users of non-LARC hormonal methods.

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Why Do 700 US Women Die of Pregnancy-Related Causes Each Year?

MedicalResearch.com Interview with:

Emily Petersen, MD.Lead for the Pregnancy Mortality Surveillance SystemDivision of Reproductive Health

Dr. Peterson

Emily Petersen, MD.
Lead for the Pregnancy Mortality Surveillance System
Division of Reproductive Health  

MedicalResearch.com: What is the background for this study?

Response: About 700 women die of pregnancy-related causes each year in the United States. The new analysis provides much-needed perspective on the circumstances surrounding pregnancy-related deaths and summarizes potential strategies to prevent future deaths.

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Father’s Age Linked To Pregnancy Problems and Childhood Disorders

MedicalResearch.com Interview with:

Nancy Phillips, MDClinical Assistant ProfessorRutgers Robert Wood Johnson Medical SchoolWomen's Health InstituteNew Brunswick, NJ

Dr. Phillips

Nancy Phillips, MD
Clinical Assistant Professor
Rutgers Robert Wood Johnson Medical School
Women’s Health Institute
New Brunswick, NJ

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The background of this article was as an interest piece prompting a literature review. We both felt it represented an underserved clinical need.

The main findings are that the paternal age at conception does impact pregnancy outcomes,  including pregnancy complications, fetal chromosomal anomalies and childhood cancers and psychological disorders. Continue reading

Which Matters More? Pre-Pregnancy Obesity vs Pregnancy Weight Gain?

MedicalResearch.com Interview with:

Dr-Romy GaillardRomy Gaillard MD PhD
LifeCycle Project-Maternal Obesity and Childhood Outcomes Study Group
Erasmus MC

MedicalResearch.com: What is the background for this study?  

Response: Obesity among women of reproductive age is a major problem for society. Scientists have long known that maternal weight before and during pregnancy are associated with pregnancy outcomes. Gestational weight gain is necessary to ensure healthy development of the fetus, but too much weight gain is associated with a higher risk of pregnancy complications.

The magnitude of the associations of maternal weight before and during pregnancy with the risks of pregnancy complications, as well as the optimal amount of weight that especially obese women should gain during pregnancy were not well-known. Continue reading

Vaginal Progesterone May Reduce Miscarriages in Women with Bleeding in Early Pregnancy

MedicalResearch.com Interview with:

Prof. Arri Coomarasamy MBChB, MD, FRCOGInstitute of Metabolism and Systems ResearchProfessor of GynaecologyDirector of Tommy's National Centre for Miscarriage ResearchUniversity of Birmingham

Prof. Coomarasamy

Prof. Arri Coomarasamy MBChB, MD, FRCOG
Institute of Metabolism and Systems Research
Professor of Gynaecology
Director of Tommy’s National Centre for Miscarriage Research
University of Birmingham

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Progesterone hormone is known to be essential to maintain a pregnancy. Researchers and clinicians have debated for over 50 years whether progesterone supplementation in women with early pregnancy bleeding could rescue a pregnancy from miscarrying. There were some clinical studies suggesting progesterone could be useful, but the studies were of poor quality and small, so we could not be certain.

So the current study, called the PRISM trial, was conducted using very sound methods and on a large population of women, in fact over 4000 women in the UK, to produce a definitive answer to this question. Overall, there were more babies in the group of women given progesterone compared with the group of women given the dummy placebo tablets, but there was statistical uncertainty in this finding.

However, when we looked at the sub-population of women who were at high risk of miscarriage because of not only bleeding in early pregnancy but also having a history of previous miscarriage, we found progesterone was shown to have clear benefit. This is a hugely important finding as there is now a treatment option to women with early pregnancy bleeding and a history of previous miscarriages.

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How Did Medicaid Expansion Affect Low Birth Weights and Preterm Births?

MedicalResearch.com Interview with:

Clare Brown, PhDHealth Systems and Services ResearchUniversity of Arkansas for Medical Sciences

Dr. Brown

Clare Brown, PhD
Health Systems and Services Research
University of Arkansas for Medical Sciences

J. Mick Tilford, PhD, Professor and ChairDepartment of Health Policy and ManagementFay W. Boozman College of Public HealthUniversity of Arkansas for Medical Science

Dr. Tilford

J. Mick Tilford, PhD,
Professor and Chair

Department of Health Policy and Management
Fay W. Boozman College of Public Health
University of Arkansas for Medical Science

 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Prematurity and low birthweight are associated with increased risk of infant mortality as well as increased risk of chronic conditions throughout infancy and into adulthood. Non-Hispanic black infants are twice as likely to be born low birthweight (13.9% vs 7.0%) and 1.5 times as likely to be born prematurely (13.9% vs 9.1%) compared to non-Hispanic white infants.

Under the Affordable Care Act (ACA), states may expand Medicaid to adults with household income levels at or below 138% of the federal poverty level, thus extending coverage to childless adults and improving continuity. Insurance gain may ultimately improve maternal health, increased use and earlier initiation of prenatal care services, and improved access to pregnancy planning resources.

Our study aimed to evaluate whether there were changes in rates of low birthweight and preterm birth outcomes among states that expanded Medicaid versus states that did not expand Medicaid. Continue reading

Is There a Link Between Benzodiazepines During Pregnancy and Childhood ADHD?

MedicalResearch.com Interview with:

Dr. Angela Lupattelli, PhDSchool of PharmacyUniversity of Oslo

Dr. Lupattelli

Dr. Angela Lupattelli, PhD
School of Pharmacy
University of Oslo

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Between 1-4% of pregnant women take at least once a benzodiazepine and/or a z-hypnotic medication during the course of gestation. These medications are generally used intermittently in pregnancy, mainly for treatment of anxiety disorders and sleeping problems, which are not uncommon conditions among pregnant women.

However, data regarding the safety of benzodiazepine and/or a z-hypnotic in pregnancy on child longer-term development are sparse. For instance, studies on child motor skills are only available up to toddler age, and little is known in relation to other child developmental domains. So, there is an urgent need to better understand whether prenatal use of benzodiazepine and/or a z-hypnotic medication may pose detrimental longer-term child risks. Continue reading

Medication Abortion Rebounded in Texas After FDA Approved Label Change for Mifeprex®

Sarah Baum, MPHinvestigator at the Texas Policy Evaluation ProjectAssociate at Ibis Reproductive Health

Sarah Baum

MedicalResearch.com Interview with:
Sarah Baum, MPH

investigator at the Texas Policy Evaluation Project
Associate at Ibis Reproductive Health

MedicalResearch.com: What is the background for this study?  

Response: Before 2013, use of medication abortion in Texas mirrored national trends, which have steadily increased since the approval of mifepristone–one of the two medications used for medication abortion–in 2000. However, House Bill 2 (HB 2), which was implemented on November 1, 2013, imposed restrictions on medication abortion and required providers to follow the outdated mifepristone label. HB 2 reduced the gestational age limit to 49 days and generally required four visits.

On March 29, 2016, the US Food and Drug Administration (FDA) approved a revised label for Mifeprex® (mifepristone 200 mg) that reflected evidence-based practice, which essentially nullified the medication abortion restrictions in HB 2. The label change brought medication abortion prescribing guidelines in line with evidence-based practice, reducing the number of required in-person visits from four to two and extending the period when patients can take the pill from seven weeks of pregnancy to 10 weeks. Continue reading

Massive Reduction in Cervical Cancer Among Vaccinated Young Women

MedicalResearch.com Interview with:

Dr. Tim PalmerHonorary Senior LecturerDepartment of PathologyUniversity of EdinburghEdinburgh, UK

Dr. Palmer

Dr. Tim Palmer
Honorary Senior Lecturer
Department of Pathology
University of Edinburgh
Edinburgh, UK 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: High risk HPV infection is the obligate cause of between 70 and 90% of cervical cancers, depending upon the country. The development of vaccines against the commonest hr-HPV types has the potential to reduce the burden of cervical cancer, especially in low and middle income countries that cannot afford screening programmes. Cervical cancer affects predominantly women in their 30s and is a major public health issue even in countries with well-established screening programmes. Scotland has had a successful immunisation programme since 2008, and women immunised at age 12 to13 have been screened since 2015. We can therefore demonstrate the effect of hr-HPV immunisation on the pre-invasive stages of cervical cancer.

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Gout Medication Colchicine May Mitigate Inflammatory Effects of Obesity

MedicalResearch.com Interview with:

Jack A. Yanovski, MD, PhDSenior InvestigatorSection on Growth and Obesity, DIR, NICHDNational Institutes of HealthHatfield Clinical Research CenterBethesda, MD 20892‐1103

Dr. Yanovski

Jack A. Yanovski, MD, PhD
Senior Investigator
Section on Growth and Obesity, DIR, NICHD
National Institutes of Health
Hatfield Clinical Research Center
Bethesda, MD 20892‐1103

MedicalResearch.com: What is the background for this study?

Response: Studies of both mouse models and people suggest that obesity induced inflammation may promote insulin resistance and progression to diabetes. Others have proposed that suppressing this chronic, low level inflammation may slow the onset of diabetes. Nod-like Receptor Family Pyrin Domain Containing 3 (NLRP3) has recently been shown to play a strong role in promoting the inflammatory state in obesity. Colchicine, traditionally used to suppress or prevent inflammation in gout and other disorders is believed to inhibit formation of the NLRP3 inflammasome. Our group hypothesized that colchicine would improve obesity associated inflammation in adults with metabolic syndrome who had not yet developed type 2 diabetes.

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Fetal Haptoglobin as Potential Biomaker for Increased Risk of Cerebral Palsy

MedicalResearch.com Interview with:

MedicalResearch.com Interview with:Catalin S. Buhimschi MD, MMS, MBAProfessor of Obstetrics and GynecologyDivision of Maternal Fetal MedicineDirector of ObstetricsDepartment of Obstetrics and GynecologyChicago, IL, 60612

Dr. Buhimschi

Catalin S. Buhimschi MD, MMS, MBA
Professor of Obstetrics and Gynecology
Division of Maternal Fetal Medicine
Director of Obstetrics
Department of Obstetrics and Gynecology
Chicago, IL, 60612

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In 2008, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal–Fetal Medicine Units Network published the results of a randomized controlled trial of magnesium sulfate for the prevention of cerebral palsy (CP). The results of this trial suggested that fetal exposure to magnesium sulfate before anticipated early preterm delivery did not reduce the combined risk of moderate to severe cerebral palsy or death, although the rate of cerebral palsy was reduced among survivors. As such, the search for a biomarker or a therapeutic solution to prevent CP had to continue.

We are grateful to the NICHD for giving us access to the umbilical cord blood samples retrieved at the time of birth for the infants enrolled, who were also followed for 2 years postnatally. We discovered that fetus’s ability to switch-on haptoglobin (Hp) expression in response to inflammation was associated with reduction of intra-ventricular hemorrhage (IVH) and/or death, and cerebral palsy and/or death. Fetuses unable to mount such a response in-utero had an increased risk of adverse outcomes.

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Extremely Low Gestational Age Neonates May Benefit From Delayed Cord Clamping

MedicalResearch.com Interview with:

Abhay K Lodha Department of PediatricsAlberta Health Services 

Dr. Lodha

Abhay K Lodha MD, DM, MSc
Department of Pediatrics
Alberta Health Services  

MedicalResearch.com: What is the background for this study?

Response: There is no physiological rationale for clamping the umbilical cord immediately after birth. In moderate (32+0 weeks-33+6 weeks) and late preterm infants (34+0 to 36+6), delayed cord clamping reduces the need for blood transfusions, leads to circulatory stability and improves blood pressure.

However, the information on the association of delayed cord clamping with outcomes for extremely low gestational age neonates (22-28 weeks of gestation) is limited.

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Women Choose Invasive vs Non-Invasive Prenatal Testing Based on Tradeoff Between Risk Taking and Information Seeking

MedicalResearch.com Interview with:

Valerie Seror, PhD French Institute of Health and Medical Research Inserm 

Dr. Seror

Valerie Seror, PhD
French Institute of Health and Medical Research
Inserm

MedicalResearch.com: What is the background for this study?

Response: In the highly sensitive context of prenatal diagnosis where autonomous and informed decision-making is of crucial issue, the present study is a companion study to a prospective clinical trial [ClinicalTrials.gov Identifier: NCT02127515] aiming at comparing clinical benefits involved by invasive vs. non-invasive testing in women at high risk of Down syndrome following routine combined screening.

Our study (involving 2,436 consecutive high-risk pregnant women following combined screening for Down syndrome) confirmed that attitudes towards invasive testing are notably guided by risk aversion to invasive testing-related fetal loss whereas it showed that attitudes towards non-invasive testing are notably guided by aversion to the ambiguity generated by results restricted to the only targeted abnormalities.

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Metformin in Pregnancy Associated With Increased Obesity in Children

MedicalResearch.com Interview with:

Liv Guro Engen Hanem, PhD CandidateDepartment of Clinical and Molecular MedicineNorwegian University of Science and Technology

Liv Guro Engen Hanem

Liv Guro Engen Hanem, PhD Candidate
Department of Clinical and Molecular Medicine
Norwegian University of Science and Technology

MedicalResearch.com: What is the background for this study?  

Response: The antidiabetic drug metformin is increasingly used in pregnancy: to treat gestational diabetes and type 2 diabetes, and to prevent pregnancy complications related to polycystic ovary syndrome (PCOS) and obesity. Metformin passes the placenta, and the fetus is thus exposed to the drug. Although no teratogenicity has been reported, metformin might have long-term effects on offspring health.

This study is a follow-up of cardiometabolic risk factors of 141 5- to 10-year-old children born in the PregMet study. This study was a double-blind, randomized controlled trial (RCT) designed to test the hypothesis that metformin given throughout pregnancy reduces the prevalence of pregnancy complications that are associated with the common endocrine disorder PCOS. Pregnant women with PCOS were randomized to receive metformin or placebo throughout pregnancy.  Continue reading

Marijuana Use During Pregnancy May Increase Risk of Psychosis in Offspring

MedicalResearch.com Interview with:

Jeremy FineB.A. in Philosophy, Neuroscience, and PsychologyWashington University in St. Louis, Class of 2019

Jeremy Fine

Jeremy Fine
B.A. in Philosophy, Neuroscience, and Psychology
Washington University in St. Louis, Class of 201

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Alongside increasingly permissive marijuana use attitudes and laws, the prevalence of marijuana use among pregnant mothers has increased substantially (by 75% between 2002 and 2016), with some evidence that pregnant women may be using cannabis to combat pregnancy-related nausea.

Our data came from the Adolescent Brain Cognitive Development (ABCD) Study, which included over 4,000 subjects with data on maternal marijuana use during pregnancy.

Our main finding was that the children of mothers who used marijuana after learning they were pregnant had a small but significant increase in risk for psychosis in their future.

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Link Between Night Shift Work and Miscarriage

MedicalResearch.com Interview with:

Luise Mølenberg BegtrupInstitute of Public HealthUniversity of Southern Denmark | SDU

Luise Mølenberg Begtrup

Luise Mølenberg Begtrup
Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There are indications that working fixed night shifts is associated with a higher risk of miscarriage.

Since many women work rotating shifts including night shifts, we were interested in examining the association between the amount of night work and miscarriage. We were able to do this by use of detailed exposure data based on payroll data.

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Minimally Invasive Uterine Fibroid Embolization Reduces Bleeding Risk and Preserves Uterus

MedicalResearch.com Interview with:
Dr. Jemianne Bautista-Jia,  MD
Radiology resident
Kaiser Permanente

MedicalResearch.com: What is the background for this study?

Response: There were a few patient experiences that took me by surprise. I had a patient come to clinic for an initial consultation for uterine fibroid embolization (UFE) and I asked her how she knew about the procedure. She told me that she heard about it on the radio. Another patient who came in told me she heard about it from a close friend. Why did these patients not hear about UFE from their primary physicians?

Being a woman, I know that if I had this condition I would prefer a minimally invasive option over surgery. Surgery comes with complications, and I definitely would not want an organ removed from my body if I could avoid it. Therefore I wanted to study UAE to hopefully provide additional objective data to the scientific community to support its use for the treatment of women with fibroids. Continue reading

How Do Men Express Grief After Pregnancy Loss?

MedicalResearch.com Interview with

Haley Kranstuber Horstman, Ph.D.Department of CommunicationUniversity of Missouri

Dr. Kranstuber Horstman

Haley Kranstuber Horstman, Ph.D.
Department of Communication
University of Missouri

MedicalResearch.com: What is the background for this study?

Response: Miscarriage is a prevalent health concern, with one in five pregnancies ending in miscarriage, which is a pregnancy loss before 20 weeks’ gestation. Past research has shown that women who have miscarried often suffer mental health effects such as heightened grief, depression, loneliness, and suicidality.

Although much of the research on coping with miscarriage has focused on women’s health, many miscarriages occur within romantic relationships and affect the non-miscarrying partner as well. Women in heterosexual marriages report that their husband is often their top support-provider. Past research has shown that husbands suffer with mental health effects after a miscarriage, sometimes for even longer than their wives, but are not often supported in their grief because miscarriage is a “woman’s issue” and they feel uncomfortable talking about it.

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Simple Urine Test May Allow Pregnant Women to Detect Preeclampsia at Home

MedicalResearch.com Interview with:

Dr. Kara Rood MDMaternal-fetal Medicine PhysicianThe Ohio State University Wexner Medical Center

Dr. Rood

Dr. Kara Rood MD
Maternal-fetal Medicine Physician
The Ohio State University Wexner Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: This is a simple, rapid, non-invasive test for early recognition of preeclampsia. 

MedicalResearch.com: What should readers take away from your report?

Response: Aid in timely diagnosis to help provide closer observations to pregnancies with complicated by preeclampsia, to prevent the devastating adverse pregnancies outcomes for mom’s and babies that can occur when pregnancies become complicated by preeclampsia.

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IVF Birth Weights Show Steady Increase Over Three Decades

MedicalResearch.com Interview with:
Prof. Daniel R Brison PhD, FRCPath
Scientific Director
Department of Reproductive Medicine
Manchester University NHS Foundation Trust
Old St. Mary’s Hospital
Manchester U.K and

Catherine M Castillo PhD
Maternal & Fetal Health Research Centre
Division of Developmental Biology and Medicine
School of Medical Sciences, Faculty of Biology, Medicine and Health
The University of Manchester 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: IVF conceived children have been known to have poorer birth outcomes when compared to spontaneously conceived children. Even when excluding twins and triplets, which result from more complicated pregnancies, IVF singletons have an increased risk of low birth weight and being born small for “dates” (length of gestation).  This is important as studies carried out in non-IVF children show that low birth weight is associated with slightly higher risk of disease in later life.

We knew from the literature that birth outcomes differed within the IVF population depending on the type of treatment used; for example, singletons conceived from frozen/thawed embryos are born with higher average birth weights when compared to their fresh embryo conceived counterparts. Our research team wanted to investigate whether IVF practices and technologies per se (which have advanced quite rapidly over the years since 1978 when the first IVF baby was conceived) were associated with differences in singleton birth weight.

In attempting to quantify historical changes in laboratory practice going back as far as we could, we discovered that our outcome of interest – birth weight – had indeed increased notably throughout the time period covered by the available data. Besides observing an increase in birth weight of almost 180g over the study period (when accounting for child gender, gestational age and maternal parity), we also observed that frozen embryo transfer was associated with higher birth weight, and spontaneous fetal reduction and longer duration of infertility were associated with lower average birth weight.

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High-Dose Vitamin D During Pregnancy Did Not Reduce Risk of Childhood Asthma

MedicalResearch.com Interview with:

Bo Chawes, MD, PhD, DMScAssociate ProfessorC‌openhagen Prospective Studies on Asthma in ChildhoodH‌erlev and G‌entofte H‌ospitalU‌niversity of C‌openhagen

Dr. Chawes

Bo Chawes, MD, PhD, DMSc
Associate Professor
C‌openhagen Prospective Studies on Asthma in Childhood
H‌erlev and G‌entofte H‌ospital
U‌niversity of C‌openhagen

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There has been a global surge in vitamin D deficiency happening in parallel with an increase in prevalence of childhood asthma, which suggests that low maternal vitamin D levels during pregnancy may increase asthma risk in the child.

Due to that we conducted a randomized double-blinded controlled trial within the Danish COPSAC2010 cohort (www.copsac.com) of 7-fold (2,800 IU/d) vs. standard dose (400 IU/d) of vitamin D supplementation from pregnancy week 24 aiming to reduce offspring asthma risk. At age 3, we observed a non-significant 24% reduced risk of recurrent asthma-like symptoms, ie. recurrent wheeze, in the high-dose vitamin D group. In the current study, we followed 545 of the 581 children in the study till age 6, where an asthma diagnosis can be established and observed no effect of the high-dose vitamin D supplement on the child’s risk of asthma. 

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Steroids for Risk of Late Preterm Delivery Help Babies and Reduce Costs

MedicalResearch.com Interview with:

Cynthia Gyamfi-Bannerman, MD, MScEllen Jacobson Levine and Eugene JacobsonProfessor of Women's Health in Obstetrics and GynecologyDirector, Maternal-Fetal Medicine Fellowship ProgramCo-Director, CUMC Preterm Birth Prevention Center Columbia University

Dr. Gyamfi-Bannerman

Cynthia Gyamfi-Bannerman, MD, MSc
Ellen Jacobson Levine and Eugene Jacobson
Professor of Women’s Health in Obstetrics and Gynecology
Director, Maternal-Fetal Medicine Fellowship Program
Co-Director, CUMC Preterm Birth Prevention Center
Columbia University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In 2016 our group published the findings of the Antenatal Late Preterm Steroids (ALPS) trial in the NEJM.  We found that administration of antenatal corticosteroids to women at high risk for delivery from 34-36 weeks decreased breathing problems in their neonates.  This treatment had been traditionally only given at less than 34 weeks.

The current paper is a cost analysis of that trial.  We found that the treatment was also cost effective.  From a cost perspective treatment was both low cost and highly effective (the options are low cost, low effect/low cost/high effect, high cost/low effect, high cost/high effect).  Continue reading

Obesity and Depression Can Be Treated With Collaborative Care

MedicalResearch.com Interview with:

Jun Ma, MD, PhD, FAHA, FABMRProfessor and Associate Head of Research, Department of MedicineDirector, Center for Health Behavior ResearchThe University of Illinois at Chicago

Dr. Jun Ma

Jun Ma, MD, PhD, FAHA, FABMR
Professor and Associate Head of Research
Department of Medicine
Director, Center for Health Behavior Research
The University of Illinois at Chicago

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Obesity and depression are major public health problems. Obesity affects 40% of United States (US) adults. About 20% in US women and 13% in men experience major depressive disorder at some point in their lifetime and, additionally, many adults have elevated depressive symptoms that do not meet clinical diagnostic criteria but can nevertheless negatively affect their health and quality of life. Obesity and depression share common risk factors, such as poor diet and lack of exercise, and cause other health problems, such as diabetes and cardiovascular disease. People with obesity are at increased risk of being depressed and, likewise, people with depression are at increased risk of being obese. Consequently, obesity and depression often co-occur. To date, there has been no integrated therapy to effectively treat patients affected by both conditions at the same time.

The RAINBOW randomized clinical trial addressed this gap.

The main finding from the trial is that, among adult patients with obesity and depression, a collaborative care intervention integrating behavioral weight loss treatment, problem-solving therapy, and as-needed antidepressant medications significantly improve weight loss and depressive symptoms over one year compared with usual care, which patients received through their primary care physicians. 

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USPSTF Recommends Interventions to Prevent Perinatal Depression

MedicalResearch.com Interview with:

Dr. Karina Davidson, PhD Professor of Behavioral Medicine (in Medicine and Psychiatry) Executive Director, Center for Behavioral Cardiovascular Health Columbia University Medical Center

Dr. Davidson

Dr. Karina Davidson, PhD
Professor of Behavioral Medicine (in Medicine and Psychiatry)
Executive Director, Center for Behavioral Cardiovascular Health
Columbia University Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Perinatal depression, which includes depression that develops during pregnancy or after childbirth, is one of the most common complications of pregnancy and the postpartum period, affecting as many as 1 in 7 pregnant women. The Task Force found that counseling can help those who are at increased risk of developing perinatal depression, and clinicians should provide or refer pregnant and postpartum individuals who are at increased risk to counseling. Clinicians can determine who might be at increased risk of perinatal depression by looking at someone’s history of depression, current depressive symptoms, socioeconomic risk factors, recent intimate partner violence, and other mental-health related factors.

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Risk of Spontaneous Abortion & Birth Defects with Oral Yeast Drug During Pregnancy

MedicalResearch.com Interview with:

Anick Bérard PhD FISPE Research chair FRQS on Medications and Pregnancy Director, Réseau Québécois de recherche sur le médicament (RQRM) Professor, Research Chair on Medications, Pregnancy and Lactation Faculty of Pharmacy, University of Montrealand Director, Research Unit on Medications and Pregnancy Research Center CHU Ste-Justine

Dr. Bérard

Anick Bérard PhD FISPE
Research chair FRQS on Medications and Pregnancy
Director, Réseau Québécois de recherche sur le médicament
Professor, Research Chair on Medications, Pregnancy and Lactation
Faculty of Pharmacy, University of Montrealand
Director, Research Unit on Medications and Pregnancy
Research Center
CHU Ste-Justin

 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Yeast infections are common during pregnancy (10%). Although topical treatments are first-line therapies, yeast infections during gestation are often more severe and are resistant to topical options. Hence, low dose oral fluconazole is often the treatment of choice for pregnant women (1 dose for 1 day).

Human and animal studies have shown that high dose of fluconazole is teratogenic.Few studies are available for the risk associated with low dose of fluconazole (the most used during pregnancy). Also, no one has studied the combined effect of low- and high-dose fluconazole use during pregnancy on overall adverse pregnancy outcomes (spontaneous abortions, stillbirths and major malformations).  Continue reading

Ultrasensitive DNA Screening for Down Syndrome Offers Potential for Early Detection

MedicalResearch.com Interview with:

Zhiyong Zhang PhD Key Laboratory for the Physics and Chemistry of Nanodevices and  Department of Electronics Peking University Beijing China

Prof. Zhang

Zhiyong Zhang PhD
Key Laboratory for the Physics and Chemistry of Nanodevices
Department of Electronics
Peking University
Beijing China

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Down syndrome is caused by the presence of an extra 21st chromosome within the genome and is the most common birth defect (occurring in approximately 1 in 800 births). In the absence of a multiplexed quantitative diagnostic device, pregnant women have been examined with the ultrasound and the indirect biochemical markers (Alpha-fetoprotein, chorionic gonadotropin and free estriol) which are accompanied with a high misdiagnosis rate. And the diagnostic test (such as amniocentesis) following the wrong screening test results will bring harm to both the pregnant women and the fetuses.

Through PCR (polymerization chain reaction) amplification of the fetal DNA in the pregnant mother’s peripheral blood and fluorescence read-out, whole-genome sequencing (WGS)-based non-invasive prenatal testing (NIPT) sequences all the genomic DNA segments in parallel and quantitatively compares the percentage of different chromosomes, which increases the sensitivity for prenatal detection of Down syndrome. However, the complex instrumental setups and the resulted high processing cost present challenges for the large-scale application of WGS-based diagnosis at the point of care in the urban and rural areas of developing countries. Hence, beside the costly WGS method, there is an urgent need to develop a cost-effective NIPT biochip with simple instrumental setting, fast detection speed, high sensitivity, and programmable to multiple disease markers.

Taking advantages of we have developed a novel field effect transistor (FET) based biosensor that reveals a fast, ultra-sensitive, highly specific and cost-effective methods and someday can be used to detect fetal Down syndrome in NIPT.  Continue reading

HPV Testing for Primary Cervical Cancer Screening

MedicalResearch.com Interview with:

Matejka Rebolj, PhD King’s College London, London, UK

Dr. Rebolj

Matejka Rebolj, PhD
King’s College London, London, UK

Henry Kitchener, MD FRCOG FRCS University of Manchester, Manchester, UK

Dr. Kitchener

 

Professor Henry Kitchener, MD FRCOG FRCS
University of Manchester, Manchester, UK

 

MedicalResearch.com: What is the background for this study?

Response: We now have reliable and affordable technologies to detect human papillomavirus (HPV), a virus which is universally accepted as the cause of cervical cancer. Various large trials confirmed that cervical screening could be improved by replacing the smear (cytology) test that has been in use for decades, with HPV testing. Many countries are now making the switch. In England, this is planned for the end of 2019. To test how to run HPV testing within the English National Health Service, a pilot was initiated in 2013 in six screening laboratories. We also wanted to determine whether the encouraging findings from the trials could be translated to everyday practice. This is important not only because we will be using different HPV tests, but also because women undergoing screening in trials are much more selected than those who are invited to population-based screening.  Continue reading