OBGYNE
21 Jul Large Proportion of Pregnant Women Use Alcohol and Tobacco in First Trimester
MedicalResearch.com Interview with: [caption id="attachment_26340" align="alignleft" width="131"]
Dr. Qiana Brown[/caption]
Dr. Qiana L. Brown, PhD, MPH, LCSW
Postdoctoral Research Fellow
Columbia University
Mailman School of Public Health
Department of Epidemiology
Substance Abuse Epidemiology Training Program
MedicalResearch.com: What is the background for this study?
Dr. Brown: Prenatal substance use is a major public health concern, and poses significant threats to maternal and child health. Tobacco and alcohol are the most commonly used substances among pregnant women and non-pregnant women of reproductive age, and are leading causes of preventable adverse health outcomes for both mother and baby. Women with health insurance have more prenatal visits, and present for prenatal care earlier than uninsured women, which may increase their exposure to health messaging around substance abuse prevention at prenatal visits. Additionally, treatment for substance use disorders and maternal and child health care are part of the Essential Health Benefits covered by the Affordable Care Act, which may encourage patients and providers to engage in discussions around alcohol and tobacco use prevention during pregnancy.
Given these factors, we examined the relationship between health insurance coverage and both past month tobacco use and past month alcohol use among a nationally representative sample of reproductive age women in the United States. We sampled 97,788 women ages 12 to 44 years old who participated in the U.S. National Survey of Drug Use and Health in 2010 to 2014. Among these women, 3.28% (n=3,267) were pregnant. We specifically investigated whether the relationship between health insurance and alcohol or tobacco use differed between pregnant and non-pregnant women.
20 Jul Is There an Increased Risk of Breast Cancer in Women Who Have IVF?
MedicalResearch.com Interview with: [caption id="attachment_26343" align="alignleft" width="174"]
Dr. Alexandra van den Belt-Dusebout[/caption]
Alexandra W. van den Belt-Dusebout, PhD
Department of Epidemiology
The Netherlands Cancer Institute
The Netherlands
MedicalResearch.com: What is the background for this study?
Response: In vitro fertilization (IVF) is commonly used, but because of the relatively recent use of IVF, long-term breast cancer risk is not yet known. Female sex hormones have been shown to affect breast cancer risk. Because sex hormone levels during hormonal stimulation of the ovaries for IVF are up to 10 times higher than in natural cycles, IVF was expected to increase breast cancer risk.
12 Jul Co-infection with HPV and Chlamydia Can Be Asymptomatic and Lead to Infertility
MedicalResearch.com Interview with: [caption id="attachment_26136" align="alignleft" width="149"]
Dr. Dejan Nonato[/caption]
Dejan R. Nonato, MD, PhD
Institute of Tropical Pathology and Public Health
School of Medicine
Federal University of Goiás
Goiânia, GO, Brazil
MedicalResearch.com: What is the background for this study?
Response: Human papillomavirus (HPV) and Chlamydia trachomatis (CT) share the same route of sexual transmission and possess similar risk factors, indicating that co-infection may act synergistically in the induction of epithelial cell abnormalities.
09 Jul Uterine Artery Embolization vs Hysterectomy For Symptomatic Fibroids
MedicalResearch.com Interview with: [caption id="attachment_25946" align="alignleft" width="200"]
Dr. Annefleur de Bruijn[/caption]
Annefleur de Bruijn MD
VU Medical Centre
Department of Gynecology
Amsterdam, The Netherlands
MedicalResearch.com: What is the background for this study?
Response: Since 1995 uterine artery embolization has been described in patients with symptomatic fibroids. Uterine artery embolization is a less invasive treatment option compared to hysterectomy. Studies including several randomized controlled trials established uterine artery embolization as a valuable treatment. Earlier these trials reported outcomes in terms of health related quality of life, clinical outcomes, efficacy and cost effectiveness after 1, 2 and 5 years of follow-up. In the randomized EMMY trial, we analyzed these results again, currently 10 years after treatment.
04 Jul Statin Users Have Lower Incidence of Uterine Fibroids
MedicalResearch.com Interview with: [caption id="attachment_25811" align="alignleft" width="200"] Dr. Mostafa Borahay[/caption] Mostafa Borahay, MD, PhD, FACOG Assistant Professor Department of Obstetrics and Gynecology Galveston, TX MedicalResearch.com: What is the background for this study? What are the main findings? Response: Uterine fibroids are the commonest tumors of the female reproductive system. More than 50% of women are estimated to...
04 Jul Prenatal Acetaminophen May Increase Autism Symptoms in Boys
MedicalResearch.com Interview with:
Claudia Avella-García MD, MPH, PhD
ISGlobal - Institut de Salut Global Barcelona
Unitat Docent de Medicina Preventiva i Salut Publica H.Mar-UPF-ASPB
MedicalResearch.com: What is the background for this study?
Response: Acetaminophen (paracetamol) is used by around half of all pregnant women in developed countries and is currently the recommended treatment for fever and pain during gestation. However, evidence linking exposure to this medication with negative changes in neurodevelopment has been coming to light, warranting further study. Therefore, our objective was to evaluate whether prenatal exposure to acetaminophen was adversely associated with child neurodevelopment at 1 and 5 years of age. For this reason, we evaluated 2644 mother-child pairs recruited during pregnancy as part of the INfancia y Medio Ambiente – Childhood and Environment (INMA) project, a Spanish general population-based cohort. We collected information on acetaminophen use prospectively up until week 32 of gestation. We evaluated neurodevelopment at 1 year of age using the Bayley Scales of Infant Development. At 5 years of age we applied a battery of tests evaluating different aspects of neurodevelopment including both cognitive and behavioural aspects.
29 Jun Genital Grooming a Cultural Phenomenon Among Younger, White and Educated Women
Posted at 21:22h
in Author Interviews, Dermatology, JAMA, OBGYNE, Sexual Health, Social Issues, UCSF
MedicalResearch.com Interview with:
[caption id="attachment_25598" align="alignleft" width="126"]
Dr. Tami Rowen[/caption]
Tami Rowen MD MS
Obstetrics, Gynecology and Reproductive Sciences
UCSF
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study sought to answer the question of which women are engaging in genital grooming and understand their motivations. Prior studies have been limited by geography and age thus our goal was to provide a nationally representative sample of women.
28 Jun Prehypertension in Pregnancy Linked to Postpartum Metabolic Syndrome
Posted at 16:07h
in Annals Internal Medicine, Author Interviews, Blood Pressure - Hypertension, Metabolic Syndrome, OBGYNE
MedicalResearch.com Interview with:
[caption id="attachment_25658" align="alignleft" width="153"]
Dr. Jian Min Niu[/caption]
Dr. Jian-Min Niu
Department of Obstetrics
Guangdong Women and Children Hospita
Guangzhou , China
MedicalResearch.com: What is the background for this study?
Response: Physiological alteration leads to the question of whether the criteria for the diagnosis of gestational hypertension are suitable because the current criteria (systolic BP [SBP] ≥140 mm Hg and diastolic BP [DBP] ≥90 mm Hg) are derived from the non-pregnant population. The optimal blood pressure levels in pregnant women remain an open question. Recent studies have demonstrated associations between prehypertension before pregnancy and hypertensive disorders during pregnancy and gestational diabetes mellitus. To our knowledge, the association between prehypertension during pregnancy and postpartum cardiovascular risk has not been addressed.
27 Jun Researchers Find Link Between Low Birth Weight and Adult Type 2 Diabetes
MedicalResearch.com Interview with: [caption id="attachment_25432" align="alignleft" width="200"]
Dr. Lu Qi[/caption]
Lu Qi, MD, PhD, FAHA
HCA Regents Distinguished Chair and Professor
Director, Tulane University Obesity Research Center
Department of Epidemiology
Tulane University
School of Public Health and Tropical Medicine
New Orleans, LA 70112
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Prenatal malnutrition and other stresses may cause small newborn babies, who are more likely develop type 2 diabetes and other chronic diseases during adulthood. However, whether such relation is causal remains to be determined. Genetic associations provide a new approach to provide evidence for such causality.
26 Jun Requests for Abortions in South American Rise Dramatically Since Zika, Especially in Brazil
MedicalResearch.com Interview with: [caption id="attachment_25543" align="alignleft" width="129"]
Dr. Abigail Aiken[/caption]
Abigail R.A. Aiken, MD, MPH, PhD
Assistant Professor
LBJ School of Public Affairs
University of Texas at Austin
Austin, TX, 78713
MedicalResearch.com: What is the background for this study?
Response: As Zika began to emerge as an epidemic in Latin America and its links with microcephaly began to be realized, we were aware that women in the region who were already pregnant or who would become pregnant would have a very limited set of reproductive options. Research and media attention about the possible biological effects of Zika in pregnancy began to appear rapidly. But much less attention was been paid to the impacts of Zika on women. We followed the responses of governments and health organizations and when they began to issue advisories warning women to avoid pregnancy, we knew it would be important to investigate the impacts of those advisories. A country-wide policy that is impossible to follow if you are pregnant or cannot avoid pregnancy is an unusual and important public issue. Accurate data on abortion are very difficult to obtain in Latin America because in most countries, abortion is highly restricted. We wanted to provide a window on the issue of how women were responding to the risks of Zika and its associated advisories, so we worked with Women on Web (WoW), an online non-profit telemedicine initiative that provides safe medical abortion to women in countries where safe, legal abortion is not universally available.
22 Jun Intravaginal Device Can Detect Fetal Deafness
MedicalResearch.com Interview with: [caption id="attachment_25408" align="alignleft" width="200"]
Dr-Álex-García-Faura[/caption]
Dr. Álex García-Faura
Scientific Director of the Institut Marquès
Spain
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our clinical research during the last three years has been focused on the effects of music during the early stages of life; in our preliminary studies, applying music to pregnant patients using abdominal speakers, we discovered that there was no fetal reaction to music and that the fetus would only be able to hear it as a distorted whisper because of the effects of the abdominal wall. We thought that it would be necessary to get the music closer to the fetus, and we decided to try to apply the music vaginally. It was a great decision.
21 Jun Cannabis Exposure During Pregnancy Linked To Changes in Brain Development in Childhood
MedicalResearch.com Interview with: Dr. Hanan El Marroun, PhD Assistant Professor Department of Child and Adolescent Psychiatry, Department of Epidemiology The Generation R Study Erasmus, The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for the study is that little is known about the potential long-term effects of cannabis exposure during pregnancy on child development. The main findings are the prenatal cannabis exposure was associated with differences in cortical thickness in childhood. MedicalResearch.com: What should readers take away from your report? Response: That our findings suggest an association between prenatal cannabis exposure and cortical thickness in children. However, the results must be carefully interpreted, as there may be other factors involved that we did not take into account. Therefore, further research is needed to explore the causal nature of this association.17 Jun Parental Race/Ethnicity Discordance Linked to Adverse Pregnancy Outcomes
MedicalResearch.com Interview with: [caption id="attachment_25230" align="alignleft" width="124"]
Dr. Luisa Borrell[/caption]
Luisa N. Borrell, DDS, PhD
Professor
Department of Epidemiology & Biostatistics
Graduate School of Public Health & Health Policy
City University of New York
MedicalResearch.com: What is the background for this study?
Dr. Borrell: Racial/ethnic disparities in birth outcomes in the United States are well documented, with non-Hispanic Black women exhibiting the worst outcomes. Several hypotheses have been proposed as explanation to this finding such as the weathering hypothesis and cumulative or chronic experiences of social inequality and racism. However, these hypotheses have only accounted for the stress burden associated with the mother’s race/ethnicity, as her race/ethnicity has been the sole information used to determine the child’s race/ethnicity, ignoring the possible stress associated with the father’s race/ethnicity. We used NYC birth- and death-linked data from 2000 to 2010 to examine the added effect of paternal race/ethnicity on adverse birth outcomes (low birth weight [LBW], small for gestational age [SGA], preterm births, and infant mortality [IM]) among NYC women.
17 Jun Maternal Antidepressants Have Subtle Effects on Newborn Brain Activity
MedicalResearch.com Interview with: [caption id="attachment_25312" align="alignleft" width="166"]
Dr. Mari Videman[/caption]
Mari Videman
Senior Consultant in Child Neurology
BABA Center
Children’s Hospital, Helsinki University Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Depression and anxiety are common during pregnancy, and up to 5% of all pregnant women are treated with serotonin uptake inhibitors (SRI). It is now known that SRIs do not cause major malformations in humans, however recent animal studies have suggested that fetal early SRI exposure may cause changes in brain microstructure and neuronal signaling. Prior human studies have shown that fetal SRI exposure leads to transient postnatal adaptation syndrome, as well as to an increased risk of developing childhood depression.
We used electroencephalography (EEG) and advanced computational methods to assess both the local and global cortical function of the newborn brain. We found that several aspects of newborn brain activity are affected by exposuse to SRI during pregnancy. Most importantly, the communication between brain hemispheres, and the synchronization between cortical rhythms were weaker in the SRI-exposed newborns. These changes were most likely related to SRI exposure, because they did not correlate with the psychiatric symptoms of the mothers.
17 Jun Higher Minimum Wage Associated With Fewer Small Babies and Neonatal Deaths
MedicalResearch.com Interview with: [caption id="attachment_25155" align="alignleft" width="142"]
Dr. Kelli Komro[/caption]
Kelli A. Komro, MPH, PhD, Professor
Director of Graduate Studies
Behavioral Sciences and Health Education
Jointly Appointed, Epidemiology
Rollins School of Public Health
Emory University
Atlanta, GA 30322
MedicalResearch.com: What is the background for this study?
Dr. Komro: Epidemiologists have done a thorough job describing the income-health gradient, which shows a clear association between income and health. That is, as income increases, exposure to health risks and premature mortality decreases. Each step down on the income ladder decreases one’s health for many reasons related to material resources, physical environment exposures and social circumstances.
The income to health association begins at birth, and more than one in four women giving birth in the U.S. are below the poverty level, putting nearly 1 million babies at risk each year. Low-income mothers are more likely to give birth prematurely, to have low birth weight babies, and to suffer the death of their infant during the post-neonatal period (28 to 364 days old).
Given the importance of the income-health gradient, we set out to test the health effects of policies that are designed to increase economic security among low-income families. Our main question is: Do policies designed to reduce poverty and improve family economic security also improve health?
One relevant policy is minimum wage laws. A federal minimum wage was first enacted in 1938. The real value (in 2015 dollars) of the federal minimum wage reached a high of $10.85 in 1968. The current federal rate is $7.25. Many cities and states have passed minimum wage laws that are higher than the federal rate, and currently there is a range of minimum wage increases under active public and policymaker discussion.
Given that some states pass minimum wage standards and others do not, and that laws within states change over time, we took advantage of all the changes that have occurred to design a natural experiment. Our natural experiment examined the effects of state minimum wage laws on infant health.
05 Jun Premature Infants May Have Some Infection Protection from Vaccinated Mothers
MedicalResearch.com Interview with:
Dr Paul T Heath MB BS, FRACP, FRCPCH
Reader / Honorary Consultant
Paediatric Infectious Diseases
St George’s, University of London and Vaccine Institute
London, United Kingdom
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Heath: Vaccinating pregnant women is an important and proven strategy for protecting young infants against tetanus, influenza and pertussis. Among the infants at highest risk for complications of these infections are infants born prematurely but it is generally believed that because antibody transfer from mother to baby is maximal in the 3rd trimester, babies born prematurely may miss out on the benefits of maternal vaccination.
27 May Majority of Women with Endometriosis Do Not Experience Infertility
MedicalResearch.com Interview with: [caption id="attachment_24730" align="alignleft" width="92"] Dr. Stacey Missmer[/caption] Stacey A. Missmer, ScD Associate Professor of Obstetrics, Gynecology, and Reproductive Biology Director of Epidemiologic Research, Division of Reproductive Medicine Scientific Director, Boston Center for Endometriosis Brigham and Women’s Hospital and Harvard Medical School Associate Professor in Epidemiology Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the...
25 May Smoking During Pregnancy Raises Risk of Schizophrenia in Offspring
MedicalResearch.com Interview with: [caption id="attachment_24645" 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?
Dr. Brown: Smoking during pregnancy is a risk factor for several pregnancy-related outcomes including low birthweight and preterm birth. Evidence for a link with schizophrenia is scant. We analyzed a maternal biomarker of smoking called cotinine, a nicotine metabolite, in mothers of nearly 1,000 schizophrenia cases and 1,000 controls in a national birth cohort in Finland. We found that heavy smoking in pregnancy was related to a 38% increase in schizophrenia risk in offspring and that as cotinine levels increased even in the more moderate smokers risk of schizophrenia also increased.
25 May Early Prenatal Events and Infancy Tied To Cardiovascular Events in Adulthood
Posted at 02:14h
in Author Interviews, Heart Disease, Nutrition, OBGYNE, Pediatrics, Weight Research
MedicalResearch.com Interview with:
[caption id="attachment_24661" align="alignleft" width="200"]
Dr. Brian Stansfield[/caption]
Dr. Brian Stansfield MD
Neonatologist
Children's Hospital of Georgia and the Medical College of Georgia
Augusta University
MedicalResearch.com: What is the background for this study?
Dr. Stansfield: Since the mid-20th century, we have experimental evidence in animal models and human data demonstrating the influence of maternal nutrition on the offspring - both in the short term and long term. Low birth weight has been connected with higher incidence of cardiometabolic diseases including insulin resistance, coronary artery disease, and hypertension. Interestingly, low birth weight infants grow up to be relatively thin adults compared to their normal or high birth weight counterparts. Conversely, high birth weight infants tend to become heavier adults and obesity is directly linked with the same adult outcomes. So the association of cardiac and metabolic diseases with low birth weight is not linked to adult obesity in general. Thus, speculation as to why extremes of birth weight lead to adult onset cardiometabolic disease suggests different mechanisms and modifying factors.
MedicalResearch.com: What are the main findings?
Dr. Stansfield: The findings of our study shed considerable light on the relationship between birth weight and risk factors for insulin resistance and visceral adiposity. Using magnetic resonance imaging (MRI) to achieve precise measurements of visceral adipose content and biomarkers for insulin resistance, we show that both low and high birth weight are associated with increased visceral adiposity and insulin resistance in a healthy population of adolescents aged 13-17 years. This association persists when we account for several recognized confounders including age, sex, race, activity level, and socioeconomic status. The most interesting finding of our study is that when you account for each adolescent’s current body mass index, a measure of obesity, the relationship between increased visceral fat and insulin resistance and low birth weight is strengthened suggesting that these adolescents had relatively high visceral adipose content despite obesity rates that were similar to their normal birth weight counterparts. On the other hand, correction for adolescent BMI (obesity) reduced the relationship between these metabolic markers and high birth weight infants. Thus, low birth weight infants may develop insulin resistance and increased visceral fat, both significant risk factors for cardiovascular disease and metabolic disease, despite having a relatively normal body shape in adolescents.
18 May Continued Use of Marijuana in Pregnancy is Risk for Both Mother and Baby
MedicalResearch.com Interview with: [caption id="attachment_24476" align="alignleft" width="150"]
Prof. Claire Roberts[/caption]
Professor Claire Roberts PhD
Robinson Research Institute
Adelaide University
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Roberts: Our research aimed to identify novel risk factors for the four main complications of pregnancy;
- preeclampsia where the mother gets high blood pressure and her kidneys don’t work properly,
- preterm birth which is delivery before 37 weeks of gestation,
- small for gestational age and
- gestational diabetes. We have studied over 5500 pregnant women in 6 centres in 4 countries, Australia, New Zealand, the UK and Ireland. We have identified a number of factors that contribute to these major pregnancy complications. However, in this paper we have focused on well known risk factors for pregnancy complications including maternal cigarette smoking, BMI and socioeconomic status. To these we added maternal use of marijuana before pregnancy, in first trimester, at 15 weeks and at 20 weeks gestation. After adjusting the data for the other factors, we found that continued maternal marijuana use at 20 weeks gestation is strongly associated with spontaneous pre-term birth independent of maternal cigarette smoking. Women who continued to use marijuana at 20 weeks’ gestation were over 5 times more likely to deliver preterm than women who did not use marijuana. Previous studies have shown conflicting evidence but none have accounted for maternal cigarette smoking.
12 May Maternal obesity, gestational diabetes, breastfeeding and childhood overweight at age 2 years
MedicalResearch.com Interview with: [caption id="attachment_24286" align="alignleft" width="156"]
Dr. Anny Xiang[/caption]
Anny H. Xiang, PhD
Kaiser Permanente Southern California Department of Research & Evaluation
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Xiang: Previous studies have identified a link between maternal obesity, diabetes and/or excessive gestational weight gain and long-term obesity risk in children. Our study examined the interplay among all four factors associated with childhood obesity: pre-pregnancy obesity, gestational weight gain, gestational diabetes and breastfeeding. To our knowledge, the interplay among these factors and their independent contributions to childhood obesity with data from a large and multi-ethnic cohort under current standard clinical care had not been previously studied.
The study included 15,710 women who delivered babies at Kaiser Permanente medical facilities in Southern California in 2011. The key findings were:
- A woman being obese (BMI of 30.0 or higher) prior to getting pregnant increased the odds of her child being overweight at age 2 by more than two-fold compared to women who had a normal pre-pregnancy weight (BMI between 18.5 and 25), after adjusting for weight gain during pregnancy, gestational diabetes and breastfeeding.
- A woman being overweight (BMI between 25.0 and 29.9) prior to pregnancy was associated with 50 percent increased odds of her child being overweight at age 2.
- Excessive weight gain during pregnancy was associated with 23 percent increased odds of a child being overweight at age 2 compared to women who had healthy weight gain during pregnancy after adjusting for pre-pregnancy weight, gestational diabetes and breastfeeding.
- Breastfeeding for at least six months was associated with a 24 percent reduction for the odds of a child being overweight at age 2 regardless of a mother’s pre-pregnancy weight, gestational diabetes or excessive weight gain during pregnancy.
- Gestational diabetes was not associated with the risk of a child being overweight at age 2. Women with gestational diabetes in this cohort were treated following standard clinical practice and had 40-49 percent lower rate of excessive weight gain during pregnancy and similar breastfeeding rates compared to women without gestational diabetes.
11 May Using Tumor-homing Peptides To Target Drug Delivery to Placenta
MedicalResearch.com Interview with: [caption id="attachment_24222" align="alignleft" width="125"]
Dr. Lynda Harris[/caption]
Lynda Harris PhD
Lecturer in Pharmaceutics
University of Manchester
Manchester Pharmacy School
Maternal and Fetal Health Research Centre
Manchester
MedicalResearch.com: What is the background for this study?
Dr. Harris: Pregnancy complications such as pre-eclampsia and fetal growth restriction remain a problem despite advances in antenatal care, and impact heavily on future health: small size at birth is associated with an increased risk of cardiovascular disease and diabetes in later life. Drugs to improve pregnancy outcome are severely lacking, as pregnant women are considered a high risk cohort by drug companies, who fear expensive lawsuits associated with side effects and teratogenicity. The majority of pregnancy complications are caused by a poorly growing or poorly functioning placenta. A number of potential drugs have been identified that enhance placental function in vitro, and improve fetal growth in animal models; however, there is currently no means of restricting their actions to the placenta, and systemic administration of these drugs to pregnant women is not feasible due to the risk of adverse effects in other tissues. To address this issue, we have identified a series of placental “homing peptides” which we have used to create nanocarriers for targeted delivery of drugs to the placenta.
09 May Women of Color Discuss Unique Issues Surrounding PostPartum Depression
MedicalResearch.com Interview with: [caption id="attachment_24187" align="alignleft" width="155"]
Dr. Robert Keefe[/caption]
Professor Robert H. Keefe PhD, LMSW, ACSW
School of Social Work, University at Buffalo
State University of New York, Buffalo, New York
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Keefe: The study focuses on recommendations mothers of color, who have histories of postpartum depression, would make to service providers that they believe would improve service effectiveness. The study is timely inasmuch as the Patient Protection and Affordable Care Act mandates ongoing research to better understand and address differences in treatment needs among mothers from racial and ethnic groups and to develop culturally competent, evidence-based treatment approaches.
We were concerned that the research on postpartum depression relies heavily on White mothers, who have access to care, ongoing relationships with service providers, are married or otherwise coupled, and from middle-class backgrounds. While the limited research on mothers of color notes their rates of postpartum depression are markedly higher than White mothers, it does little to address how their treatment needs differ from White mothers.
We undertook this study to get recommendations from the mothers and discovered that many of the issues that inhibit the mothers from accessing services are the very issues that lead mothers to have postpartum depression. For example, many of the mothers report because they have poor-paying jobs, no health benefits, and limited transportation, they are unable to keep appointments despite wanting to do what is best for their newborn babies. Furthermore, because they missed appointments, the service provider would terminate the mother from a service the mother needs, or worse contact Child Protective Services to report the mother for neglect. The mothers were not at all neglectful. They were all invested in their child’s wellbeing; but various life problems kept mounting up so that they and their babies were not receiving ongoing care.
Consequently, the recommendations these mothers make have little to do with psychotherapy. In fact, most of the mothers reported they had no time to be depressed and that psychotherapy was a luxury they could not afford. Instead, the mothers wanted service systems in place that would allow them to receive the care they need so that they and their new-born babies could live happy and health lives.
09 May IVF: More Embryos Transferred Means More Costs and Worse Outcomes
MedicalResearch.com Interview with: [caption id="attachment_24169" align="alignleft" width="200"]
Dr. E. Scott Sills[/caption]
Dr. Scott Sills MD, PhD
Medical Director at the Center for Advanced Genetics
an IVF program based in Carlsbad, California
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Sills: Often regarded as a miracle procedure by many infertile couples, in vitro fertilization (IVF) can be financially difficult for those without insurance coverage for the treatment. This prohibitive cost leads many would-be parents who pursue IVF to transfer multiple embryos at once, to increase their chances of getting a baby and minimize the need for additional attempts.
This new study now reports that the economic impact of IVF deserves a closer look. As corresponding author E. Scott Sills, MD PhD noted, rates of cesarean-section deliveries, premature births, and low birth weight of babies are all greater with two or more embryos transferred to the mother at once, compared to a lower risk, single-embryo pregnancy.
The data derived from a comprehensive analysis of all IVF cases in Vermont (UVM) and was recently published in the journal Applied Health Economics & Health Policy. It is believed to be the first effort to calculate the difference in infant hospital costs based on the number of embryos transferred. Sills and his team had access to UVM Medical Center records of patients who conceived through IVF and delivered at least 20 weeks into their pregnancies between 2007 and 2011.
09 May Flu Vaccination During Pregnancy Protects Both Mother and Baby
MedicalResearch.com Interview with: [caption id="attachment_24161" align="alignleft" width="142"]
Dr. Julie Shakib[/caption]
Julie H. Shakib, DO, MS, MPH
Assistant Professor of Pediatrics | University of Utah
Medical Director | Well Baby and Intermediate Nursery
Salt Lake City
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Shakib: Immunization against influenza in the first six months of life is ineffective due to an immature immune response. Passive protection via maternal immunization offers an alternative but only a few studies have evaluated the efficacy of this immunization strategy. We found that in infants born to women immunized against influenza during pregnancy, the risk of laboratory-confirmed influenza and influenza-related hospitalization were reduced by 70% and 81% in their first 6 months of life, respectively.This large study provides more evidence that when women are immunized against influenza during pregnancy, their infants are much less likely to be diagnosed with influenza in their first 6 months.
02 May Exposure to SSRI’s During Pregnancy May Raise Risk of Adolescent Depression
Posted at 13:44h
in Author Interviews, Depression, Mental Health Research, OBGYNE, Pediatrics, Pharmacology
MedicalResearch.com Interview with:
[caption id="attachment_23955" align="alignleft" width="200"]
Dr. Heli Malm[/caption]
Heli Malm, MD, PhD
Specialist in Obstetrics and Gynecology
Teratology Information Service
Helsinki University and Helsinki University Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Malm: Animal studies have demonstrated that exposure to SSRIs during early brain development can result in depression-like behavior in adolescence. Today 6% of pregnant women in the US and 4% in Finland are on selective serotonin reuptake inhibitors (SSRIs) at some stage of pregnancy. SSRIs pass the placenta but no prior studies have followed children beyond childhood to monitor the development of depressive disorders, which typically emerge after puberty onset. Results on autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorders (ADHD) have been conflicting.
The study material is based on national register data from Finland. We investigated offspring psychiatric diagnoses, including depression, anxiety, ASD, and ADHD, of nearly 16,000 mothers who had used SSRIs during pregnancy between 1996 and 2010. Children in this cohort ranged in age from 0 to 15 years old. Because maternal psychiatric illness can affect offspring neurodevelopment in the absence of SSRIs, primary comparisons were made between offspring of the SSRI group and offspring of mothers with a psychiatric disorder diagnosis but no antidepressant use.
Children exposed to SSRIs during gestation were diagnosed with depression at an increasing rate after age 12, reaching a cumulative incidence of 8.2% by age 15, compared to 1.9% in the group of children exposed to maternal psychiatric illness but no antidepressants. Rates of anxiety, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) diagnoses did not differ significantly between the two groups.
29 Apr Racial Disparities in Teen Birth Rate Narrows
MedicalResearch.com Interview with: [caption id="attachment_23922" align="alignleft" width="180"]
Dr. Lisa Romero[/caption]
Lisa Romero DrPH, MPH
Division of Reproductive Health
National Center for Chronic Disease Prevention and Health Promotion
CDC
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Romero: Since 2006, teen birth rates have fallen almost half among Hispanic and black teens; dropping the national teen birth rate to an all-time low. While dramatic declines among Hispanic and black teens have helped reduce gaps, birth rates remain twice as high for these teens nationally compared to white teens, and more than three times as high in some states. Data also highlight the role socioeconomic conditions play, finding that higher unemployment and lower income and education are more common in communities with the highest teen birth rates, regardless of race.
This research highlights the importance of teen pregnancy prevention interventions that address socioeconomic conditions like unemployment and lower education levels, for reducing disparities in teen births rates. State and community leaders can use local data to better understand teen pregnancy in their communities and to direct programs and resources to areas with the greatest need.
To generate these findings, we analyzed national- and state-level data from the National Vital Statistics System (NVSS) to examine trends in births to American teens aged 15 to 19 years between 2006 and 2014. County-level NVSS data for 2013 and 2014 offer a point-in-time picture of local birth rates. To better understand the relationship between key social and economic factors and teen birth rates, researchers examined data from the American Community Survey between 2010 and 2014.
21 Apr Early Pregnancy Risk Factors for Pre-Eclampsia Identified
MedicalResearch.com Interview with: [caption id="attachment_23665" align="alignleft" width="142"]
Dr. Joel Ray[/caption]
Joel Ray, MD MSc FRCPC
Clinician-Scientist
St. Michael’s Hospital
Toronto, ON
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Ray:
- Clinical practice guidelines strongly recommend that physicians and midwives start aspirin before 20 weeks gestation in a woman at high risk of preeclampsia (PE).
- However, these guidelines do not provide a systematic approach for identifying a woman at high risk of pre-eclampsia (PE), using readily available clinical risk factors (RFs) known before 20 weeks gestation.
- Thus, there is a need for a clear, concise and evidence-based list of risk factors that clinicians can use, before 20 weeks gestation, to estimate a woman’s risk of pre-eclampsia.
- We systemically analyzed large cohort studies and estimates of the absolute pooled risk of developing pre-eclampsia in the presence vs. absence of one of 14 common risk factors.
21 Apr High Fructose Diet During Pregnancy Predisposes Children to Obesity
Posted at 10:12h
in Author Interviews, Diabetes, Metabolic Syndrome, OBGYNE, Pediatrics, University Texas, Weight Research
MedicalResearch.com Interview with:
[caption id="attachment_23639" align="alignleft" width="150"]
Dr. Antonio Saad[/caption]
Antonio Saad, MD
Fellow in Maternal Fetal Medicine & Critical Care Medicine
University of Texas Medical Branch at Galveston
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Saad: Recently the WHO announced an alarming news, the prevalence of diabetes has increased four fold in the past quarter-century. The major factors attributed for this increase included excessive weight, and obesity. In the US alone, two thirds of people are either overweight or obese. There are shocking numbers that should alert physicians, patients and government officials for awareness and interventions that we can alter the path away from this drastic epidemic.
In light of recent events, our group strongly believes that poor diet during pregnancy predisposes offspring in adult life to develop obesity and diabetes through fetal programming. High fructose introduction into our food chain has coincided with the obesity and diabetes epidemics. Hence, we designed an animal study where we fed pregnant mice with either regular diet or high fructose diet until delivery. Then we looked at the offspring, at 12 months of age. We looked at their blood pressure, glucose tolerance tests, insulin resistance, and weights. We also tested for serum marker of metabolic dysfunction and used computed tomography imaging to assess for liver fat infiltration and percent visceral adipose tissue. To our surprise, these offspring (mothers were fed high fructose diet) developed several features of metabolic syndrome. Female offspring’s cardiovascular and metabolic function at one year of age (adulthood) had increased weight, blood pressure, visceral adiposity, liver fat infiltrates and insulin resistance with impaired glucose tolerance). The male counterparts were limited to high blood pressure and glucose intolerance. Keeping in mind that the amount of fructose given to these animals were equivalent to daily soda cans consumption in humans.