OBGYNE
09 Dec Uterine Microbiome Plays Key Role in IVF Success
MedicalResearch.com Interview with: [caption id="attachment_30400" align="alignleft" width="155"]
Dr. Carlos Simón[/caption]
Carlos Simón, M.D., Ph. D.
Professor of Obstetrics & Gynecology. Valencia University, Spain
Scientific Director, Igenomix SL.
Adjunct Clinical Professor, Department of Ob/Gyn, Stanford University, CA
Adjunct Professor, Department of Ob/Gyn, Baylor College of Medicine, TX
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The main findings of this study reside in the concept that the uterine cavity, which has been classically considered as a sterile organ, possess its own microbiome and that the composition of this uterine microbiome have a functional impact on the reproductive outcome of IVF patients.
09 Dec Which Religious Group Breastfeeds More? Protestants or Catholics?
MedicalResearch.com Interview with: Jonathan Y. Bernard, PhD Inserm UMRS 1153 – Centre for research in Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS) Team ORCHAD: early Origin of the Child Health And Development Hôpital Paul Brousse MedicalResearch.com: What is the background for this study? What are the main findings? Response: Despite the World Health Organization’s recommendations promoting breast feeding, wide variations in breast feeding initiation rates are observed among Western countries: some reach >95%, while others remain <80%. Many individual-level determinants of breast feeding are known, including maternal age, education, ethnicity, smoking and employment status. Less is known regarding cultural determinants, such as religion, which could be underlying and explain rate differences between and within countries. We aimed at comparing countries’ breast feeding rates with the proportions of Catholics and Protestants. We thus carried out an ecological study by collating publicly available online data for 135 countries. We additionally gathered within-country data for 5 Western nations: France, Ireland, the UK, Canada and the USA. We found that, in Western countries, the proportion of Catholics was negatively correlated with the rate of breast feeding. This was also observed within countries in France, Ireland, the UK and Canada. In the USA, where breast feeding rates vary hugely between states, race was an important confounder. Interestingly, we also found the correlation in non-Hispanic whites. All our findings hold even when we account for wealth indicators, such as gross domestic product per capita.01 Dec Prediction of Congenital CMV Infection in High-Risk Pregnant Women
MedicalResearch.com Interview with: [caption id="attachment_30252" align="alignleft" width="133"]
Dr. Kenji Tanimura[/caption]
Dr. Kenji Tanimura M.D., Ph.D.
Assistant professor
Division of Obstetrics and Gynecology
Graduate School of Medicine and
Hideto Yamada M.D., Ph.D.
Professor and Chairman Department of Obstetrics and Gynecology
Kobe University Graduate School of Medicine
MedicalResearch.com: What is the background for this study?
Response: Congenital cytomegalovirus (CMV) infection can cause long-term neurological sequelae, such as hearing difficulties and mental retardations, in affected children. Some investigators reported that early diagnosis and antiviral therapy can improve neurological outcomes in symptomatic congenital infected infants. However, universal screening of newborns for congenital CMV infection is not yet available. Therefore, the development of non-invasive methods for prenatal detection of mothers and newborns at high risk for congenital CMV infection has been desired.
We aimed to determine maternal clinical, laboratory, and ultrasound findings that effectively predict the occurrence of congenital CMV infection in high-risk pregnant women, who were positive for CMV IgM.
We performed maternal blood screening for CMV IgG and IgM, and 300 IgM-positive pregnant women, including 22 with congenital CMV infection, received series of examinations. We evaluated maternal clinical and laboratory findings, including serum CMV IgM and IgG, IgG avidity index, antigenemia testing, and CMV-DNA PCR for the maternal serum, urine, and uterine cervical secretion, and prenatal ultrasound findings.
01 Dec National Trends and Outcomes of Embryo Donation
[caption id="attachment_30068" align="alignleft" width="200"]
Dr. Jennifer F. Kawwass[/caption]
MedicalResearch.com Interview with:
Jennifer F. Kawwass, MD, FACOG
Assistant Professor, Emory Reproductive Center
Director of Third Party Reproduction, Emory Reproductive Center
MedicalResearch.com: What is the background for this study?
Response: With the increasing use of assisted reproductive technology (ART), the number of cryopreserved embryos in storage has increased, as residual viable embryos from an in vitro fertilization (IVF) cycle may be frozen for future use. Each embryo maintains attributes reflective of the age of the female at time of the original oocyte retrieval. Embryo donation, a form of third-party reproduction, involves donation without compensation of previously formed embryos to another couple for implantation.
Limited published data exist detailing outcomes of donor embryo cycles. Patients and clinicians would benefit from information specific to donor embryo cycles to inform fertility treatment options, counselling, and clinical decision-making. We sought to quantify trends in donor embryo cycles in the United States, to characterize donor embryo recipients, and to report transfer, pregnancy, and birth outcomes of donor embryo transfers.
21 Nov New Online Fertility Calculators Predict Chance of IVF Success
MedicalResearch.com Interview with: [caption id="attachment_29707" align="alignleft" width="144"]
Dr. David McLernon[/caption]
David McLernon PhD MPhil BSc
Research Fellow in Medical Statistics
Medical Statistics Team
Institute of Applied Health Sciences
University of Aberdeen
Foresterhill Aberdeen
MedicalResearch.com: What is the background for this study?
Response: Normally when a couple attend a fertility clinic to begin IVF treatment they are only informed about their chances of having a baby for the first attempt of IVF. In actual fact the first treatment is often unsuccessful and many couples will go on to have several complete cycles of the treatment– each involving the transfer of one or two fresh embryos potentially followed by one or more frozen embryo transfers. We felt that a prediction model that could calculate the chances of having a baby over the complete package of treatment would provide better information for couples.
20 Nov Cesarean Section Rates Vary Across US Hospitals
MedicalResearch.com Interview with: Kamila Mistry, PhD MPH AHRQ MedicalResearch.com: What is the background for this study? Response: Although the overall cesarean section (C-section) rate in the United States has declined slightly in recent years, nearly a third of all births continue to be delivered by C-section—higher than in many other industrialized countries. A number of medical as well as nonmedical factors may contribute to high C-section rates. C-section is the most common surgical procedure performed in the United States. This operation carries additional risks compared with vaginal delivery, such as infection and postoperative pain. A C-section also may make it more difficult for the mother to establish breastfeeding and may complicate subsequent pregnancies. Consensus guidelines from the American Congress of Obstetricians and Gynecologists and other national efforts to improve perinatal care have shown promise in reducing nonmedically indicated C-sections. However, recent research has found wide variation in hospital C-section rates even for low-risk deliveries.18 Nov Breastfeeding Important For Mothers’ Health As Well As Babies
MedicalResearch.com Interview with: [caption id="attachment_29763" align="alignleft" width="180"]
Dr. Melissa Bartick[/caption]
Melissa C. Bartick, MD, MSc
Department of Medicine
Cambridge Health Alliance
Harvard Medical School
Cambridge, MA
MedicalResearch.com: What is the background for this study?
Response: This is the first study ever to combine maternal and pediatric health outcomes from breastfeeding into a single model.
We had published a cost analysis of suboptimal breastfeeding for pediatric disease in 2010, which found that suboptimal breastfeeding cost the US $13 billion in costs of premature death costs and medical expenses, and 911 excess deaths. We followed that up with a maternal cost analysis which found about $18 billion in premature death costs and medical expenses.
In both these studies, most of the costs were from premature death. We were unable to combine the results of these two studies because their methodologies were different, and both of them, especially the pediatric portion needed to be updated.
15 Nov Bariatric Surgery in Women of Childbearing Age and Perinatal Complications
MedicalResearch.com Interview with: Brodie Parent, MD MS General Surgery R4 University of Washington MedicalResearch.com: What is the background for this study? What are the main findings? Response: We already knew that women with a history of bariatric surgery are a high risk group when it comes to childbirth. Our study has confirmed prior data which show that infants from these women are at a higher risk for being premature, low birth-weight, or requiring ICU admission. However, this is some of the first data which looks at their risk over time after recovery from the operation. Data from this study show that risks to the infant are highest in the first 3 years after an operation, and diminish over time. This suggests that women should wait a minimum of three years after an operation before attempting conception.10 Nov Early Planned Birth Linked To Developmental Delays
MedicalResearch.com Interview with: [caption id="attachment_29559" align="alignleft" width="184"]
Jason Bentley[/caption]
Jason Bentley, MBiostat
Doctoral Fellow
Menzies Centre for Health Policy
University of Sydney
MedicalResearch.com: What is the background for this study?
Response: Planned birth (labor induction or pre-labor caesarean section) is a decision to intervene and so determines a gestational age at birth that would have otherwise been later if pregnancy had progressed through to spontaneous labor. Significant changes in clinical practice have seen an increase in planned births before 39-40 completed week’s gestation from an increased use of primary and repeat cesarean section and a greater use of labor induction. At a population level this has resulted in a decrease in modal gestational age with planned birth accounting for almost half of births before 39-40 weeks.
Clinical research has indicated that the threshold for planned birth and the gestational age for intervening has reduced. Numerous reasons have been given as justification for this including litigation, patient and provider perception of safety versus risk, reduced perinatal mortality, increased fetal monitoring, maternal age, obesity and convenience. There has also been the clinical perception that birth just before the optimal date carries little significant morbidity, with a focus on short-term risks to mother or baby only rather than longer-term outcomes. It is of paramount importance to ensure there are no unintended harms from such a significant shift in clinical practice.
This study investigated whether the timing of planned birth was associated with poorer developmental outcomes at school age.
09 Nov Comparing Benefits of Donor Breast Milk to Formula For Very Low Birth Weight Babies
MedicalResearch.com Interview with: Dr. Sharon Unger BSc, MD, FRCP Staff Neonatologist at Mount Sinai Hospital Associate Staff Neonatologist at The Hospital for Sick Children (SickKids) Associate Professor in the Department of Paediatrics at the University of Toronto. Medical Director of the Rogers Hixon Ontario Human Milk Bank and Dr. Deborah L. O’Connor PhD, RD Senior Associate Scientist in Physiology & Experimental Medicine SickKids and Professor Department of Nutritional Sciences at the University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings? Response: Babies who are born very early (before 32 weeks’ gestation) and/or at very low weights (less than 1,500 grams) are among the most fragile of all paediatric patients, typically facing serious medical issues and requiring care in a Neonatal Intensive Care Unit (NICU). In addition to underdeveloped organs and risk of neurodevelopmental issues, preterm and very low birth weight babies are at risk of a severe bowel emergency called necrotizing enterocolitis, which involves the damage and potential destruction of the intestinal tissue. This disease affects approximately six per cent of very low birth weight infants each year, making it one of the most common causes of death and long-term complications in this population. As a neonatologist and a PhD-trained dietitian, we have spent our careers working to improve outcomes for babies and supporting breastfeeding. While there is already strong evidence to suggest that breastfeeding is associated with a variety of benefits including reduced risk of childhood infections and may play a role in the prevention of overweight and diabetes, in healthy, full-term infants, we launched a research program a decade ago to figure out how to ensure the same advantage could be provided to vulnerable hospitalized infants, specifically very low birth weight infants. Breastfeeding initiation rates in Canada are now at all-time high for healthy newborns, but for many reasons related to preterm birth, up to two thirds of mothers of very low birth weight infants are unable to provide a sufficient volume of breast milk to their infant. A variety of factors may limit breast milk production in these cases, including immaturity of the breast cells that make milk, maternal illness, breast pump dependency, and stress. In addition to the health benefits attributed to mother’s milk for full-term, healthy infants, previous studies have shown that use of mother’s milk in very low birth weight infants is associated with a reduction in necrotizing enterocolitis. It is also associated with a reduction in severe infection, improved feeding tolerance and more rapid hospital discharge. Ten years ago, along with our inter-professional colleagues at 21 NICUs in the Greater Toronto and Hamilton areas, we began to examine whether using donor breast milk as a supplement to mother’s milk would improve health outcomes of very low birth weight infants when mother’s milk was not available.07 Nov No Iron Benefit To Mother From Eating Placenta
MedicalResearch.com Interview with: [caption id="attachment_29438" align="alignleft" width="110"]
Dr. Daniel C Benyshek[/caption]
Daniel C Benyshek, PhD
Professor, Department of Anthropology
Adjunct Professor, UNLV School of Medicine
Co-Director, Metabolism, Anthropometry and Nutrition Lab
University of Nevada, Las Vegas
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Maternal placentophagy is ubiquitous among nearly all terrestrial mammals, but is rare to non-existent among humans in the historic and cross-cultural records. Recently, however, human maternal placentophagy has emerged as a popular trend among a small but growing number of women in many industrialized countries. Most women engaging in the practice today consume their processed placenta in capsule form, taken daily, over several weeks postpartum. While human maternal placentophagy advocates claim many maternal health benefits from the practice, including improved postpartum mood, increased breast-milk production, and improved energy, among others, no carefully designed, placebo-controlled studies have evaluated these claims.
Our randomized, double-blind, placebo-controlled pilot study (N=23) investigated some of these claims. Our study found that the postpartum iron status of participants who consumed their own encapsulated placenta (based on the three week daily intake recommendation of one prominent placenta encapsulation service), was no different from those women who consumed the same amount of beef placebo.
04 Nov Fewer Births To Preteen Mothers Means Lower Preterm Birth Rates
MedicalResearch.com Interview with: Cynthia Ferre MA PhD Division of Reproductive Health National Center for Chronic Disease Prevention and Health Promotion CDC MedicalResearch.com: What is the background for this study? Response: Reductions in births to teens and preterm birth rates are two recent public health successes in the United States. To date, however, we haven’t had data to indicate whether these two declines are associated. So, we used age-specific data on trends in births overall and in preterm births to determine the effects of changes in maternal age on preterm birth.03 Nov Fetal Structural Defects Detected Later in Pregnancy Than Chromosomal Abnormalities
MedicalResearch.com Interview with: Sarah Horvath, MD Paula M. Castaño, MD, MPH Anne R. Davis, MD, MPH Columbia University Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Approximately 3% of pregnant women in the United States will receive a prenatal diagnosis of fetal aneuploidy (such as trisomy 21) or fetal structural abnormality (such as cardiac or CNS malformations). Many of these women will undergo abortion. Advances in screening over the past few decades have allowed earlier diagnosis of aneuploidy, but most structural abnormalities cannot be diagnosed until the anatomy ultrasound at 18-20 weeks gestational age because of fixed patterns of fetal development. Our analysis examines gestational age at time of abortion for these two types of fetal diagnosis from 2004-2014. Our main finding was that median gestational age at time of abortion for fetal aneuploidy decreased from 19 weeks to 14 weeks. However, over the same 11 year period, median gestational age at time of abortion for fetal structural abnormalities remained unchanged and at or above 20 weeks gestation.02 Nov No Congenital Defects Found With TDAP Vaccine During Pregnancy
MedicalResearch.com Interview with: [caption id="attachment_29371" align="alignleft" width="130"]
Dr. Malini B. DeSilva[/caption]
Malini B. DeSilva, MD, MPH
Clinician Investigator
HealthPartners Institute
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This is a retrospective study of more than 324,000 live births at seven Vaccine Safety Datalink sites between 2007 and 2013 which showed that the Tdap vaccine in pregnant mothers was not associated with increased risk for microcephaly or other major birth defects in their offspring.
26 Oct US Task Force Recommends Primary Care Interventions to Support Breastfeeding
MedicalResearch.com Interview with: [caption id="attachment_29144" align="alignleft" width="169"]
Dr. Ann Kurth[/caption]
Ann Kurth, Ph.D., C.N.M., R.N.
USPSTF Task Force member
Dean of the Yale School of Nursing
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Breastfeeding is beneficial for both mothers and their babies, with the evidence showing that babies who are breastfed are less likely to get infections such as ear infections, or to develop chronic conditions such as asthma, obesity, and diabetes. For mothers, breastfeeding is associated with a lower risk for breast and ovarian cancer and type 2 diabetes. While breastfeeding rates have been rising in recent decades—with 80 percent of women starting to breastfeed and just over half still doing so at six months—they are still lower than the Healthy People 2020 targets and the Task Force wanted to review the latest evidence around how clinicians can best support breastfeeding.”
After balancing the potential benefits and harms, the Task Force found sufficient evidence to continue to recommend interventions during pregnancy and after birth to support breastfeeding. This recommendation includes the same types of interventions the Task Force recommended in 2008, such as education about the benefits of breastfeeding, guidance and encouragement, and practical help for how to breastfeed.
24 Oct Risk of Pregnancy-Associated Stroke Across Age Groups
MedicalResearch.com Interview with: Eliza Miller, M.D. Vascular Neurology Fellow New York-Presbyterian Hospital/Columbia University Medical Center We collaborated with researchers at the Massachusetts General Hospital and with the New York State Department of Health. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior research has found that older women of childbearing age are at higher risk of stroke during pregnancy and postpartum than younger women. We hypothesized that their increased stroke risk might not be due to pregnancy-related factors, but just due to the fact that stroke risk increases with age for all people. We used billing data from New York State hospitals to calculate incidence risk ratios for four age groups: 12-24, 25-34, 35-44 and 45-55. In each age group, we compared the incidence of stroke in women who were pregnant or postpartum to the incidence of stroke in women of the same age who were not pregnant. As in prior studies, we found that the incidence of pregnancy-associated stroke was higher in older women compared to younger women (about 47/100,000 deliveries in the oldest group, versus 14/100,000 deliveries in the youngest group). However, the incidence ratios showed that pregnancy increased stroke risk significantly in women under 35, but did not appear to increase stroke risk in women over 35. In the youngest group (age 12-24), pregnancy more than doubled the risk of stroke, and in the 25-34 age group, pregnancy increased stroke risk by 60%. In women aged 35 and older, pregnancy did not increase stroke risk. Women who had pregnancy-related strokes tended to have fewer traditional vascular risk factors like hypertension and diabetes, compared to same-aged women with non-pregnancy related strokes.21 Oct High Cortisol Levels in Hair May Be Linked To Lower IVF Success
MedicalResearch.com Interview with: [caption id="attachment_29039" align="alignleft" width="120"]
Prof. Kavita Vedhara[/caption]
Kavita Vedhara FAcSS
Professor of Health Psychology
Division of Primary Care
School of Medicine
University Park,Nottingham
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There has been a longstanding interest in the role of the hormone cortisol in fertility, because of its potential to affect the functioning of the biological systems that influence both conception and pregnancy.
This interest has extended to IVF, with researchers exploring the relationship between levels of the hormone and pregnancy since the advent of the treatment in the late 1970s.
However, a recent review showed that the relationship between cortisol and pregnancy in IVF was unclear. A number of reasons were highlighted for this, including that all of the studies to date had relied on short-term measures of the hormone measured in blood, saliva, urine and sometimes follicular fluid. Such measures can only capture hormone levels over a matter of minutes and hours. Such ‘snapshots’ are unable to give us an accurate picture of the levels of hormone over longer periods of time. This is important because any clinically relevant effects of cortisol on fertility are only likely to occur in the context of long-term changes in the hormone.
In recent years it has become possible to measure long-term levels of cortisol in hair. Cortisol is deposited in the hair shaft and because human hair grows, on average, 1cm per month, a 3cm sample of hair closest to the scalp can tell us about levels of cortisol in the previous 3 months.
We used the development of this technique to examine whether long term levels of cortisol (as measured in hair), or short term levels of cortisol (as measured in saliva) could predict whether or not women going through IVF would become pregnant. If you are trying to obtain a perfect cortisol balance, I use this product that helps to do just that.
19 Oct GnRH Receptor Antagonist Elagolix Offers Hope for Patients With Endometriosis
MedicalResearch.com Interview with: [caption id="attachment_28997" align="alignleft" width="142"]
Dr. Hugh S. Taylor[/caption]
Hugh S. Taylor, MD
Anita O'Keeffe Young Professor of Obstetrics, Gynecology, and Reproductive Sciences and Professor of Molecular, Cellular, and Developmental Biology; Chair of Obstetrics
Gynecology, and Reproductive Sciences, Yale School of Medicine
Chief of Obstetrics and Gynecology
Yale-New Haven Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The abstract presented at ASRM featured results from two replicate pivotal Phase 3 clinical trials evaluating the efficacy and safety of Elagolix in premenopausal women who suffer from endometriosis. Elagolix is an investigational, orally administered, gonadotropin-releasing hormone (GnRH) receptor antagonist that blocks endogenous GnRH signaling by binding competitively to GnRH receptors in the pituitary gland. Administration results in rapid, reversible, dose-dependent inhibition of luteinizing hormone and follicle-stimulating hormone secretion, leading to reduced ovarian production of the sex hormones, estradiol and progesterone, while on therapy.
The data demonstrated dose-dependent superiority in reducing daily menstrual and non-menstrual pelvic pain associated with endometriosis compared to placebo. At month three and month six, patients treated with Elagolix reported statistically significant reductions in scores for menstrual pain (dysmenorrhea) and non-menstrual pelvic pain associated with endometriosis as measured by the Daily Assessment of Endometriosis Pain scale. The safety profile of Elagolix was consistent across both Phase 3 trials and also consistent with prior Elagolix studies.
14 Oct Maternal Chronic Disease Linked to Increased Risk of Cardiac Birth Defects in Offspring
MedicalResearch.com Interview with: Prof. Chung-Yi Li Department of Public Health College of Medicine National Cheng Kung University Tainan Taiwan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Congenital heart disease is the leading congenital malformation that causes perinatal and infant deaths. However, little information is available about the risk factors, especially modifiable environmental and behavioral factors that may have posed adverse effects on fetal cardiac development. We conducted a nationwide population-based study in Taiwan to further evaluate the potential role of maternal chronic diseases in the risk of developing congenital heart disease in offspring. We found that children of women with several kinds of chronic disease were at elevated risk for congenital heart disease; these diseases included type 1 and type 2 diabetes, hypertension, congenital heart defects, anemia, connective tissue disorders, epilepsy, and mood disorders.13 Oct Maternal Use of SSRIs May Be Related to Speech and Language Disorders in Offspring
MedicalResearch.com Interview with: [caption id="attachment_28737" align="alignleft" width="133"]
Dr. Alan Brown[/caption]
Alan S. Brown, M.D., M.P.H.
Professor of Psychiatry and Epidemiology
Columbia University Medical Center
Director, Program in Birth Cohort Studies, Division of Epidemiology
New York State Psychiatric Institute
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Maternal use of antidepressants during pregnancy has been increasing. A previous study from a team that I led in a national birth cohort in Finland showed that mother’s use of a serotonin reuptake inhibitor antidepressant is related to an increased risk of depression in offspring. We sought to evaluate whether these medications also increased risk of speech/language, scholastic, and motor outcomes in offspring. We found an increased risk (37% higher risk) of speech/language disorders in offspring of mothers exposed to SSRIs in pregnancy compared to mothers who were depressed during pregnancy but did not take an SSRI during pregnancy.
12 Oct Exercise and Pregnancy in Recreational and Elite Athletes Reviewed
MedicalResearch.com Interview with: [caption id="attachment_28794" align="alignleft" width="180"]
Prof. Kari Bø[/caption]
Prof. Kari Bø PhD
Norwegian School of Sport Sciences
Oslo, Norway
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The background is that more and more female elite athletes continue to exercise into their 30s and beyond and more want to become pregnant and some to continue to compete at the same level after giving birth.
MedicalResearch.com: What should readers take away from your report?
Response: To date there is little scientific knowledge on elite athletes and others who perform strenuous exercise (eg women in the military) during pregnancy and after childbirth and we therefore have to be cautious when recommending intensity levels of both endurance and strength training exercise. However, given the knowledge we have now.
- Elite athletes planning pregnancy may consider reducing high impact training routines in the week after ovulation and refraining from repetitive heavy lifting regimens during the first trimester as some evidence suggests increased miscarriage risk.
- There is little risk of abnormal fetal heart rate response when elite athletes exercise at <90% of their maximal heart rates in the second and third trimesters.
- Baby birthweights of exercising women are less likely to be excessively large (>4000g) and not at increased risk of being excessively small (<2500g).
- Exercise does not increase the risk of preterm birth.
- Exercise during pregnancy does not increase the risk of induction of labour, epidural anesthesia, episiotomy or perineal tears, forceps or vacuum deliveries.
- There is some encouraging evidence that the first stage of labour (before full dilatation) is shorter in exercising women.
- There is also some encouraging evidence that exercise throughout pregnancy may reduce the need for caesarean section.
09 Oct Breast Feeding Educates Baby’s Immune System
MedicalResearch.com Interview with: Ameae M. Walker Vice Provost for Academic Personnel Distinguished Teaching Professor Biomedical Sciences School of Medicine University of California, Riverside MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has previously been some evidence that immune cells in breast milk could pass through the wall of the immature gut, but if active they, like antibodies in milk, were considered likely a form of passive immunity. We now show that in addition to some maternal cells being active in the newborn (i.e. that they do contribute to passive cellular immunity), there are, more importantly, others that go to the thymus where they participate in selection of the neonate’s T cells. In this fashion, the neonate develops cells that recognize antigens against which the mother has been vaccinated – a process we have dubbed maternal educational immunity.30 Sep Breastfeeding Is a Women’s Health Issue
MedicalResearch.com Interview with: [caption id="attachment_28454" align="alignleft" width="125"]
Dr. Melissa Bartick[/caption]
Melissa C. Bartick, M.D.
Assistant Professor of Medicine
Department of Medicine, Cambridge Health Alliance, Cambridge
Harvard Medical School, Boston
Massachusetts
MedicalResearch.com: What is the background for this study?
Response: There has never been a study that combined maternal and pediatric health outcomes and costs into a single model. My colleague Arnold Reinhold and I had published a pediatric study in 2010, which was widely publicized but needed to be updated. My colleagues and I published a maternal study in 2013. But the two studies had different methodologies, and so the total costs could not be simply added together.
Here, we wanted to get a picture of the impact of breastfeeding in the US public health as whole, by creating a single model that combined maternal and pediatric outcomes. That had never been done before.
28 Sep Vitamin B3 in Pregnancy and Atopic Dermatitis in Childhood
MedicalResearch.com Interview with: Dr Sarah El-Heis MBBS, MRCP (London) Clinical Research Fellow MRC Lifecourse Epidemiology Unit University of Southampton Southampton General Hospital Southampton MedicalResearch.com: What is the background for this study? What are the main findings? Response: Atopic eczema is a common, multifactorial and potentially distressing skin condition. Evidence that it partly originates in utero is increasing with some studies suggesting links with aspects of maternal diet during pregnancy. Nicotinamide is a naturally occurring nutrient that is maintained through the dietary intakes of vitamin B3 and tryptophan. As a topical treatment it has been used in the management of some skin conditions including atopic eczema, and has been shown to have anti-inflammatory effects, to stabilise mast cells and to alter lipids in the outer layers of the skin. The objective of our study was to examine the link between maternal serum concentrations of nicotinamide and related tryptophan metabolites to the risk of atopic eczema in the offspring. We found that maternal late pregnancy concentrations of nicotinamide and related metabolite concentrations were not associated with offspring atopic eczema at age 6 months. Higher maternal serum concentrations of nicotinamide and anthranilic acid were, however, associated with a 30% lower risk of eczema at age 12 months.27 Sep C-section carries a 4-fold increased risk of blood clots, compared with vaginal deliveries
Posted at 11:23h
in Author Interviews, Blood Clots, CHEST, OBGYNE, Surgical Research, Thromboembolism
MedicalResearch.com Interview with:
Marc Blondon, MD
Division of Angiology and Hemostasis, Department of Specialties of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Office of Research and Development, Seattle, WA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Venous thromboembolism, a condition including deep vein thrombosis (blood clots) and pulmonary embolism, is more common in older than younger patients. However, pregnancy and particularly the postpartum period are times at greater risk of blood clots in women. It is important to understand the risk and the risk factors for thrombosis in the postpartum period to guide the use of preventive measures such as heparin, an anticoagulant treatment, or leg compression devices.
Our study summarizes the evidence on the link between C-sections and blood clots from the past 35 years.
Our meta-analysis demonstrates that:
- C-section carries a 4-fold increased risk of blood clots in the postpartum period, compared with vaginal deliveries ;
- that this risk is most prominent but not restricted to emergency C-section ;
- and that women who undergo elective C-section are also at higher risk than women who have a vaginal delivery.
- Importantly, we estimated an absolute risk of blood clots after a C-section of 2-4 per 1000 pregnancies: on average, 3 out of 1000 women after C-section will develop a blood clot.
26 Sep Nausea and Vomiting During Pregnancy May Signal Less Risk of Pregnancy Loss
MedicalResearch.com Interview with: Stefanie N. Hinkle, Ph.D. Staff Scientist | Epidemiology Branch Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Thank you for the interest in our research. Nausea and vomiting are very common early in pregnancy and these symptoms can be difficult for women. Before we began this study there was very limited high-quality data on the implications of these difficult symptoms in pregnancy. Our study is unique because we asked women to report their symptoms continuously throughout their pregnancy before they may or may not have gone on to have a loss. We found that among women with 1 or 2 prior pregnancy losses, women who have nausea, and particularly nausea with vomiting, were less likely to have a pregnancy loss.21 Sep Bidirectional Link Between Depression and Risk of Gestational Diabetes
MedicalResearch.com Interview with: [caption id="attachment_28228" align="alignleft" width="158"]
Dr. Cuilin Zhang[/caption]
Cuilin Zhang MD, PhD
Senior Investigator
NICHD, National Institutes of Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Pregnant women are at high risk of developing depressive symptoms; at least 10% US women suffering from depression during pregnancy. Gestational diabetes is a common pregnancy complication, affecting 4-7% of pregnancies in the U.S.. Gestational diabetes has adverse health implications on both women and their children. Depression and glucose intolerance commonly co-occur among non-pregnant individuals; however, the temporal relationship between gestational diabetes and depression during pregnancy and the postpartum period is less understood.
19 Sep Pregnancy May Be a Time of Heightened Homicide Risk, Particularly For Young Black Women
[caption id="attachment_28111" align="alignleft" width="133"]
Dr. Pauline Mendola[/caption]
MedicalResearch.com Interview with:
Pauline Mendola, PhD
Investigator, Epidemiology Branch
Division of Intramural Population Health Research
Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH
Bethesda, MD 20892
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Efforts to monitor and reduce maternal mortality during and around the time of pregnancy largely focus on causes physiologically related to the pregnancy, despite the fact that increasing evidence suggests violent death – including homicide and suicide – are leading causes.
In this study, we analyzed US death certificates from 2005-2010 from states that include pregnancy information on the death record in order to estimate rates of pregnancy-associated homicide and suicide, and to determine if risk of violent death was increased for women during pregnancy and postpartum. Given the large proportion of death records with unknown pregnancy status, we adjusted for a range of possible misclassification and found that pregnancy-associated homicide risk ranged from 2.2-6.2 per 100,000 live births, while pregnancy-associated suicide risk ranged from 1.6-4.5 per 100,000 live births. Overall, homicide risk was 1.8 times higher among pregnant/postpartum women compared to non-pregnant women in the population. The risk of suicide was 38% lower among pregnant/postpartum women than the general population.