MedicalResearch.com Interview with:
Jason D. Wright, M.D.
Levine Family Assistant Professor of Women's Health
Florence Irving Assistant Professor of Obstetrics and Gynecology
Division of Gynecologic Oncology
Columbia University College of Physicians and Surgeons
161 Fort Washington Ave, New York, New York 10032
Medical Research: What are the main findings of the study?
Dr. Wright: This study is one of the first large scale studies to examine the risk of cancer specifically in women who underwent hysterectomy with electric power morcellation. Among 32,000 women treated at over 500 hospitals across the US we noted cancer in 27 per 10,000 women.
MedicalResearch.com Interview with:
Dr. Dong-Xin Wang, MD, PhD
Department of Anesthesiology and Surgical Intensive Care
Peking University First Hospital
Beijing 100034, China
Medical Research: What are the main findings of the study?
Answer: We found that use of epidural analgesia during labor is associated with decreased risk of postpartum depression.
MedicalResearch.com Interview with:
Jared Baeten, MD PhD
Professor, Departments of Global Health and Medicine
Adjunct Professor, Department of Epidemiology
University of Washington
Seattle, WA 98104
Medical Research: What are the main findings of the study?
Dr. Baeten: Among heterosexual African couples in which the male was HIV positive and the female was not, receipt of antiretroviral pre-exposure preventive (PrEP) therapy did not result in significant differences in pregnancy incidence, birth outcomes, and infant growth compared to females who received placebo.
MedicalResearch.com Interview with:
David Olds, Ph.D.
Professor of Pediatrics and Director
Prevention Research Center for Family and Child Health
University of Colorado Department of Pediatrics
Aurora, Colorado 80045
Medical Research: What are the main findings of the study?
Dr. Olds: We’ve conducted a randomized controlled trial of a program of nurse home visiting for low-income women with no previous live firths during pregnancy and the first two years of the child’s life, with randomization of participants beginning in 1990. In our most recent follow-up of mothers and children in Memphis, those who received nurse-visitation were less likely to have died over a 2-decade period following the child’s birth than those in the control group. Death among mothers and children in these age ranges in the US is rare and extraordinarily important for what it tells us about the health of the population studied in this trial.
For children, the reduction in death was present for preventable causes, that is, sudden infant death syndrome, injuries, and homicide. All of the child deaths for preventable causes were in the control group, for whom the rate was 1.6%. None of the nurse-visited children died of preventable causes.
The reductions in maternal mortality were found for two nurse-visited groups combined for this report: one received prenatal and newborn visitation and a second received visitation during pregnancy and through child age two. Overall, mothers assigned to the control group were nearly 3 times more likely to die than those assigned to the two nurse-visited conditions. The relative reduction in maternal mortality was particularly pronounced for deaths linked to maternal behaviors -- suicide, drug overdose, injuries, and homicide; for these external causes of death, 1.7% of the mothers in the control group had died, compared to 0.2% of those visited by nurses.
MedicalResearch.com Interview Invitation
Dr. Krista Huybrechts MD PhD
Brigham & Women’s Hospital
Department of Medicine
Division of Pharmacoepidemiology & Pharmacoeconomics
Boston, MA 02120
MedicalResearch: What are the main findings of the study?
Dr. Huybrechts: In this cohort study including 949,504 pregnant women enrolled in Medicaid, we examined whether the use of selective serotonin reuptake inhibitors (SSRIs) and other antidepressants during the first trimester of pregnancy is associated with increased risks for congenital cardiac defects. In order to control for potential confounding by depression and associated factors, we restricted the cohort to women with a depression diagnosis and used propensity score adjustment to control for depression severity and other potential confounders. We found no substantial increased risk of cardiac malformations attributable to SSRIs. Relative risks for any cardiac defect were 1.25 (95%CI, 1.13-1.38) unadjusted, 1.12 (1.00-1.26) depression-restricted, and 1.06 (0.93-1.22) depression-restricted and fully-adjusted. We found no significant associations between the use of paroxetine and right ventricular outflow tract obstruction (1.07, 0.59-1.93), or the use of sertraline and ventricular septal defects (1.04, 0.76-1.41); two potential associations that had been of particular concern based on previous research findings.
MedicalResearch.com Interview with:
Sergio R. Ojeda, D.V.M.
Division Head and Senior Scientist Division of Neuroscience
Division of Neuroscience, OR National Primate Research Center/Oregon Health and Science University,
Beaverton OR 97006
MedicalResearch: What are the main findings of the study?
Dr. Ojeda: The study shows that a receptor for two growth factors (brain-derived neurotrophic factor [BDNF] and neurotrophin 4/5 [NT4/5]) that are known to be important for development of the nervous system is also essential for maintaining oocyte integrity and survival in the mammalian ovary. Intriguingly, the full-length form of this receptor (known as NTRK2-FL) is not expressed in oocytes until the time of the first ovulation. At this time, the pre-ovulatory gonadotropin discharge stimulates granulosa cells of ovarian follicles to produce not only more BDNF, but also more of a peptide known as kisspeptin, to induce the formation of NTRK2-FL in oocytes. To date, kisspeptin was known to be only critical for the hypothalamic control of reproduction. To induce NTRK2-FL, BDNF binds to truncated NTRK2 receptors (NTRK2-T1), which are abundant in oocytes throughout prepubertal development. Kisspeptin, on the other hand, does so by activating its receptor KISS1R, also expressed in oocytes. Once present after the first ovulation, NTRK2-FL is able to activate a survival pathway in oocytes following gonadotropin stimulation, presumably at every cycle. In the absence of NTRK2-FL, oocytes die, follicular structure disintegrates and a condition of premature ovarian failure ensues.
MedicalResearch.com: Interview with
Rachel Thompson PhD
Postdoctoral Research Fellow
The Dartmouth Center for Health Care Delivery Science
Dartmouth College
MedicalResearch: What are the main findings of the study?
Dr. Thompson: This study, which surveyed 417 women aged 15-45 years and 188 contraceptive care providers in 2013, found important differences in what matters most to these two groups when it comes to discussing and deciding on a contraceptive method. Women’s most important question when choosing a contraceptive was “Is it safe?” – this was in the top three questions for 42% of women but only 21% of providers. Alternatively, providers’ most important question was “How is it used?”. Information on side effects and how a method actually works to prevent pregnancy was also a higher priority for women than for providers.
MedicalResearch.com Interview with:
Antonio E. Frias, MD
Associate Professor | Division of Maternal Fetal Medicine
Oregon Health & Science University
Director, Diabetes and Pregnancy Program
Assistant Scientist | Oregon National Primate Research Center
Portland, Oregon 97239
MedicalResearch: What are the main findings of the study?
Dr. Frias: Resveratrol supplementation in pregnant nonhuman primates fed a Western-style diet improved maternal metabolism, restored placental blood flow, reduced placental inflammation and improved lipid deposition in the fetal liver. However, there was an unexpected disruption of fetal pancreatic development that is very concerning.
MedicalResearch.com Interview with :
Dr. Francesco Fiorentino
CEO and Lab Director
ROME - ITALY
MedicalResearch: What are the main findings of the study?
Dr. Fiorentino: This study describes findings from first and second of a three-phase strategy to validate the use of next-generation sequencing (NGS) for comprehensive aneuploidy screening, as a preclinical step toward its routine use in the diagnosis of chromosomal aneuploidy on embryos. The first phase involved a large preclinical validation study on single cells, and demonstrated that the NGS-based 24-aneuploidy screening protocol was accurate and reliable. The results provided 100% consistency for aneuploid embryo call with array-CGH, the highly validated method of aneuploidy screening.
The second phase of the study, instead, focused on the clinical application of the NGS-based protocol for the detection of all chromosomes in embryos. A prospective trial involving analysis of human embryos at the blastocyst stage of development was designed for this purpose, in order to establish similar levels of chromosome-specific NGS copy number assignment concordance compared with 24sure array as those observed in the first phase of the study. Consistency of NGS-based aneuploidy detection was assessed matching the results obtained with array-CGH–based diagnoses,
Embryos obtained from 55 consecutive clinical PGS cycles, blindly assessed in parallel with both NGS and array-CGH techniques, displayed 100% concordance for aneuploid embryo call. Consistency obtained during this investigation was similar to those obtained in the first phase of the study that used NGS to examine single cell samples, demonstrating the reliability of the NGS-based method in detection of chromosome aneuploidy also in embryos at blastocyst stage derived from clinical preimplantation genetic screening (PGS) cycles. The clinical outcomes obtained in this study from preimplantation genetic screening cycles performed with the NGS approach were very encouraging, resulting in a clinical pregnancy rate per embryo transfer of 63.8% (mean age 38.5+2.1 years) and an ongoing implantation rate of 64.0%, values that are comparable with recent results from other comprehensive chromosome screening approaches.
In conclusion, the results achieved in this study demonstrate the reliability of the NGS-based protocol for detection of whole chromosome aneuploidies, mosaicism occurrences and segmental changes in embryos.
MedicalResearch.com Interview with:
Ai Kubo, MPH PhD
Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612
MedicalResearch: What are the main findings of the study?
Dr. Kubo: The main findings of the study are three folds:
1) The CDC guideline works for the majority of infants in preventing vertical transmission, if the immunizations are done according to the recommended schedule.
2) It takes an organized effort to case-manage each mother-infant pairs in order to achieve almost complete immunization rates and very low transmission rates.
3) Highest risk group was mothers with extremely high viral load and e-antigen positivity. This group of women may benefit from additional therapy to prevent the vertical transmission. However, for others, the risk of transmission is extremely low as long as the infants are immunized according to the guideline.
MedicalResearch.com Interview with:
Wei Bao MD, PhD
Postdoc fellow, Epidemiology Branch
Division of Intramural Population Health Research
NICHD/National Institutes of Health
Rockville, MD 20852
MedicalResearch: What are the main findings of the study?
Dr. Wei Bao: This study, to our knowledge, is the first attempt to examine the associations of physical activity and sedentary behaviors with risk of type 2 diabetes mellitus (T2DM) among women with a history of gestational diabetes mellitus (GDM), which is a high-risk population of T2DM. The main findings are:
(1) Physical activity is inversely associated with risk of progression from GDM to T2DM. Each 5-metabolic equivalent hours per week increment of total physical activity, which is equivalent to 100 minutes per week of moderate-intensity physical activity or 50 minutes per week of vigorous physical activity, was related to a 9% lower risk of T2DM; this inverse association remained significant after additional adjustment for body mass index (BMI).
(2) An increase in physical activity is associated with a lower risk of progression from gestational diabetes mellitus to T2DM. Compared with women who maintained their total physical activity levels, women who increased their total physical activity levels by 7.5 MET-h/wk or more (equivalent to 150 minutes per week of moderate-intensity physical activityor 75 minutes per week of vigorous physical activity) had a 47% lower risk of T2DM; the association remained significant after additional adjustment for BMI.
(3) Prolonged time spent watching TV, as a common sedentary behavior, is associated with an increased risk of progression from gestational diabetes mellitus to T2DM. Compared with women who watched TV 0 to 5 hours per week, those watched TV 6 to 10, 11 to 20, and 20 or more hours per week had 28%, 41%, and 77%, respectively, higher risk of T2DM. The association was no longer significant after additional adjustment for BMI.
MedicalResearch.com Interview with:
Flor M. Munoz, MD
Department of Pediatrics
Department of Molecular Virology and Microbiology
Baylor College of Medicine, Houston, Texas
MedicalResearch.com: What are the main findings of the study?
Dr. Munoz:
1. Tdap vaccine was safe and well tolerated during pregnancy
2. Women who are pregnant have adequate responses to the Tdap vaccine, similar to those of women who are not pregnant.
3. Antibodies to pertussis are efficiently transferred to the fetus through the placenta so that babies of mothers who were vaccinated during pregnancy had significantly higher concentrations of antibody at birth and up to 2 months of age, when compared to infants of mothers who were vaccinated post-partum.
4. Higher antibody concentrations in the first two months of life are likely to provide protection against pertussis during this period of high vulnerability
5. Infants of mothers who were vaccinated during pregnancy had adequate responses to their routine pertussis vaccines at 2, 4, and 6 months of age, and had expected and adequate responses to their 4th dose of vaccine at 1 year of age. The absolute concentration of antibodies to some of the pertussis antigens might be modestly lower after the primary series of vaccines in some infants of mothers who were vaccinated during pregnancy, but this difference does not persist after the 4th dose.
Dr. Donald Redelmeier, MD
Professor, Full SGS Member
Director, Clinical Epidemiology Unit
Sunnybrook Health Sciences Centre
Toronto, ON
MedicalResearch: What are the main findings of the study?
Dr. Redelmeier: We identified every woman in Ontario, Canada, who gave birth to a newborn baby between 2006 and 2011 and then evaluated each driver for the months before, during, and after pregnancy. This amounted to about half a million women who accounted for almost 8000 serious crashes that sent the driver to hospital. We found that the second trimester of pregnancy led to a 42% increase in the risk of a serious motor vehicle crash. The increased risk included diverse populations, distinct obstetrical cases, different crash characteristics. The risk equated to about twice the population norm but was still below male drivers at this age.
MedicalResearch.com Interview with:
Jessica A. Grieger (BSc(hons), R Nutr, PhD)
Post-doctoral research fellow
Robinson Research Institute, University of Adelaide
MedicalResearch: What are the main findings of the study?
Dr. Grieger: The study aimed to identify associations between maternal dietary patterns in the 12 months before conception on fetal growth and preterm delivery. We report that a one standard deviation increase in the scores on the high-protein/fruit pattern was associated with decreased likelihood for preterm birth, whereas a one standard deviation increase on the high-fat/sugar/takeaway pattern was associated with increased likelihood for preterm birth as well as shorter gestation and birth length.
MedicalResearch.com Interview with:
Professor Khalid Khan
MMEd, MRCOG, MSc, FCPS, MBBS
Women's Health Research Unit | Multi-disciplinary Evidence Synthesis Hub
The Blizard Institute | 58 Turner Street | London | E1 2AB
MedicalResearch.com: What are the main findings of the study?
Prof. Khan: The risk of cesarean section was 12% lower among women undergoing induction of labor in comparison to the one that were managed expectantly. The subgroup comparison showed that the effect was significant in term and post-term however not in preterm gestations. Furthermore, induction of labor was associated with 50% and 14% reduction in risk of fetal death and admission to a neonatal intensive care unit, respectively.
MedicalResearch.com Interview with:
Barbara A. Cohn, Ph.D.
Director, Child Health and Development Studies
A Project of the Public Health Institute
Berkeley, CA 94709
MedicalResearch.com: What are the main findings of the study?
MedicalResearch.com Interview with:
Enrique F. Schisterman, Ph.D.
Chief and Senior Investigator
Epidemiology Branch, DIPHR
Eunice Kennedy Shriver National Institute of Child Health and Human Development Rockville, MD 20854
MedicalResearch.com: What are the main findings of the study?
Dr. Schisterman: Our results indicate that aspirin is not effective for reducing the chances of pregnancy loss in most cases. For the total number of women in the study, 13 percent of women who took aspirin and became pregnant subsequently experienced another loss, compared with 12 percent who took the placebo. Ultimately, 58 percent of women taking aspirin and 53 percent of the placebo group got pregnant and later gave birth.
However, additional research is needed to investigate the finding that women who had experienced a single, recent pregnancy loss (before 4 1/2 months of pregnancy and within the past year) had an increased rate of pregnancy and live birth while on aspirin therapy. Among this group, 78 percent of those who took aspirin became pregnant, compared with 66 percent of those who took the placebo. For this subset of women, 62 percent of the aspirin group and 53 percent of the placebo group gave birth.
MedicalResearch.com Interview with:
Dr. Hong-Mei Xiao M.D.,Ph.D.
Cognition Section
Professor of Gynecology,Reproductive Medicine
The Institute of Reproduction and Stem Cell Engineering
Xiangya School of Medicine, Central South University
Vice director, Reproduction and Genetics Hospital of CITIC-Xiangya
China, Changsha
MedicalResearch.com Interview with:
Dr. Kristy Ward
Department of Reproductive Medicine
UCSD School of Medicine
MedicalResearch.com: What are the main findings of this study?
Dr. Ward: As the second leading cause of preventable death, obesity is one of the nation’s most serious public health problems. Over two-thirds of the US population is currently overweight or obese and the prevalence continues to increase. A number of studies have linked obesity with an overall elevated risk of cancer and with many individual cancer types. Among obesity related cancers in women, endometrial cancer is most strongly associated with increasing body mass, with 39% of cases in the US attributable to obesity.
In patients with clinically severe obesity (BMI ≥ 40 kg/m2), bariatric surgery results in rapid weight loss and has greater long-term success when compared to non-surgical weight loss methods. Surgical weight loss procedures have been found to reduce obesity-related comorbidites and improve outcomes in clinically severe obese populations. In addition to improved cardiovascular risk factors and mitigation of physical symptoms, there is increasing evidence that cancer risk is reduced after bariatric surgery.
Michael Kimlin
Professor of Cancer Prevention Research
Institute of Health and Biomedical Innovation
Queensland University of Technology
Australia
MedicalResearch.com: What are the main findings of the study?
Answer: The main findings of this study were that women who where classified as having the highest level of sun exposure in our sample had a significantly larger drop in blood folate levels compared to women with lower sun exposures. This was quite a powerful finding, as all women were supplemented with folate and tested so that so that we knew that each sun exposure group had similar average levels of blood folate at the start of the study. We then measured their sun exposure over a week and took a sample of blood at the end of this week to see how the degree of sun exposure affected folate levels.
MedicalResearch.com Interview with:
Shamez Ladhani, MRCPCH PhD
Health Protection Services, Immunisation, Hepatitis, and Blood Safety Department, Public Health England, London
MedicalResearch.com: What are the main findings of the study?
Dr. Ladhani: Pregnancy was associated with an increased of serious infection by a bacterium called Haemophilus influenzae which is usually associated with respiratory tract infections. Nearly all the H. influenzae were unencapsulated; that is, they did not have an outer sugar capsule which is often required to make the bacterium more virulent. The encapsulated H. influenzae type b (Hib), for example, was the most common cause of bacterial meningitis in your children prior to routine immunisation. We also found that infection with unencapsulated H. influenzae was associated with poor pregnancy outcomes, including miscarriages, stillbirth and premature birth.