Author Interviews, Environmental Risks, JAMA, OBGYNE, Pediatrics / 04.02.2022
Number of Extremely Preterm Births Varies with Season
MedicalResearch.com Interview with:
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Dr. Hviid[/caption]
Anders Hviid M.Sc.,Dr.Med.Sci.
Head of Department (acting),
Professor of Pharmacoepidemiology,
Department of Epidemiology Research
Statens Serum Institut
MedicalResearch.com: What is the background for this study?
Response: An unusually low number of extremely preterm births have been observed in some countries during the initial covid-19 lockdowns. We speculated that this could be because of fewer infections, reduced activity levels, less stress etc. These are also factors that change with the seasons, and we hypothesized that extremely preterm birth might be associated with seasonality.
Dr. Hviid[/caption]
Anders Hviid M.Sc.,Dr.Med.Sci.
Head of Department (acting),
Professor of Pharmacoepidemiology,
Department of Epidemiology Research
Statens Serum Institut
MedicalResearch.com: What is the background for this study?
Response: An unusually low number of extremely preterm births have been observed in some countries during the initial covid-19 lockdowns. We speculated that this could be because of fewer infections, reduced activity levels, less stress etc. These are also factors that change with the seasons, and we hypothesized that extremely preterm birth might be associated with seasonality.
Dr. Howard[/caption]
Jeffrey Howard, PhD
Associate Professor
Department of Public Health
College for Health, Community and Policy
University of Texas at San Antonio
MedicalResearch.com: What is the background for this study?
Response: Drug and alcohol related mortality has been on the rise in the US for the past decade, which has drawn a lot of focus from researchers. At the same time maternal mortality, deaths caused by pregnancy complications, is recognized to be higher in the US than in other developed nations.
Very little has been reported about deaths among pregnant and recently pregnant women that are not caused by pregnancy complications, so my collaborators and I wanted to explore this. We did not anticipate that drug and alcohol deaths and homicides would account for so many deaths among pregnant and recently pregnant women.
Dr. Caughey[/caption]
Aaron B. Caughey, M.D., M.P.P., M.P.H., Ph.D.
Professor and ChairDepartment of Obstetrics and Gynecology
Associate dean for Women’s Health Research and Policy
Oregon Health & Science University in Portland, OR.
Founder and Chair, Centers for Disease Control and Prevention–funded
Oregon Perinatal Collaborative
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Preeclampsia is one of the most serious health problems that can occur during pregnancy. It can lead to preterm birth, and in some cases even death of the pregnant person and their baby.
The Task Force looked at the latest available evidence and found that low-dose aspirin can help prevent preeclampsia in pregnant people who are at highest risk, and it can also protect their babies. This new final recommendation is consistent with the Task Force’s 2014 recommendation statement and has the potential to save many lives.
Helen Trottier Ph.D
Assistant Professor, Department of Social and Preventive Medicine,
Researcher, CHU Sainte-Justine Research Center
Université de Montréal
Montréal, Québec, Canada
MedicalResearch.com: What is the background for this study?
Response: We know that HPV infection can have serious consequences such as the development of cancerous lesions in the cervix. HPV infection is also very prevalent in young women of childbearing age but the possible consequences of HPV in pregnancy have been poorly studied. Some population registers around the world have shown a reduction in the risk of preterm birth with HPV mass vaccination, but we must be careful with this kind of ecological correlation.
We have set up a large cohort study in pregnant women to study the association between HPV in pregnancy and preterm birth by targeting certain HPV genotypes and the duration of the infection.
Dr. Chien-Wen Tseng[/caption]
Chien-Wen Tseng, M.D., M.P.H., M.S.E.E.
The Hawaii Medical Service Association Endowed Chair
Health Services and Quality Research
Professor, and Associate Research Director
Department of Family Medicine and Community Health
University of Hawaii John A. Burns School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Gaining weight during pregnancy is natural but gaining too little or too much weight can be harmful for pregnant people and their babies. For the first time, the Task Force reviewed the evidence and found that counseling pregnant people on healthy weight gain during pregnancy can lower their risk for diabetes during pregnancy, emergency cesarean deliveries, and babies born with a birth weight that is too high. Pregnant people may not know what amount of weight gain is healthy during pregnancy, or how weight gain can affect their pregnancy and baby.
We recommend that clinicians offer all pregnant people counseling on healthy weight gain throughout their pregnancy for healthier, safer pregnancies.
Dr. Carlson[/caption]
Susan E. Carlson Ph.D.
Associate Dean for Research
Program Director,, AJ Rice Professor
Department of Dietetics and Nutrition
University of Kansas Medical Center
Kansas City, KS
MedicalResearch.com: What is the background for this study? What are its benefits?
Response: DHA is an omega-3 fatty acid. Good food sources include some types of seafood (e.g., salmon, tuna, trout) and chicken eggs. Persons in the USA and in much of the developing world consume little dietary DHA. DHA supplements in pregnancy have been linked to lower risk of preterm birth for 20 years, especially early preterm births (<34 weeks gestation). For about 10 years, prenatal supplements with about 200 mg DHA have been readily available in the USA, however, no study has asked if this amount of DHA is optimal to reduce early preterm birth. Participants were given a supplement of 1000 mg or 200 mg DHA beginning before 20 weeks gestation using an adaptive randomization that periodically assigned more participants to the group with the fewest early preterm births.
Dr. Andersson[/caption]
Niklas Worm Andersson, MD
Department of Epidemiology Research
Statens Serum Institut,
Copenhagen Denmark
MedicalResearch.com: What is the background for this study?
Response: "Findings from some previous fetal safety studies on topical corticosteroid use in pregnancy have raised concerns for an increased risk of newborns being small for gestational age or having low birth weight, in particular among pregnancies where larger amounts of potent to very potent agents have been used."
Prof. Papageorghiou[/caption]
Aris Papageorghiou MBChB, MRCOG
Professor of Fetal Medicine and the Clinical Research Director
Oxford Maternal and Perinatal Health Institute
University of Oxford
MedicalResearch.com: What is the background for this study?
Response: Our study was really guided by a key question: does Covid-19 in pregnancy increase the risk of adverse maternal and neonatal outcomes as compared with pregnant women who do not have the infection?
The question is highly relevant because of the known deleterious effects of other coronavirus infections in pregnancy, e.g. SARS (severe acute respiratory syndrome) and MERS-CoV (Middle East respiratory syndrome coronavirus).
In order to answer this question we undertook this multinational cohort study.
Prof.Auger[/caption]
Nathalie Auger
Professeure agrégée de clinique
École de santé publique - Département de médecine sociale et preventive
University of Montreal
MedicalResearch.com: What is the background for this study?
Response: COVID-19, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been a major public health concern. The number of infected pregnant women continues to increase. Pregnant women and infants are particularly susceptible to COVID-19 because the physiologic changes of pregnancy involve cardiovascular, respiratory, and immune changes that may alter the response to SARS-CoV-2 infection. Fetuses may be exposed to SARS-CoV-2 during critical periods of development. The nature of the association between COVID-19 and pregnancy outcomes remains unclear and meta-analyses of pregnant women with COVID-19 are lacking.
Dr. Bunik[/caption]
Maya Bunik, MD, MPH | Professor, Pediatrics
Medical Director, Child Health Clinic, Primary Care | Breastfeeding Management Clinic
Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS)
School of Medicine| University of Colorado Anschutz Medical Campus
Children's Hospital Colorado
MedicalResearch.com: What is the background for this study?
Response: Marijuana legalization has been increasing in the United States, with increasing consumption of marijuana products. Currently, the American Academy of Pediatrics (AAP), American College of Obstetricians and Gynecologists (ACOG) and Academy of Breastfeeding Medicine (ABM) do not recommend marijuana use during pregnancy or lactation due to concerning though limited data on the effects of perinatal marijuana exposure.
As there has been increasing prevalence of women using marijuana during pregnancy due to legalization and perceptions of safety, we sought to determine the duration of THC excretion in breast milk among women who had evidence of marijuana use at delivery and abstained post-partum.
Dr. Maru[/caption]
Sheela Maru, MD, MPH
Department of Health System Design and Global Health and
Arnhold Institute for Global Health and
Department of Obstetrics, Gynecology and Reproductive Science
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study?
Response: Universal screening for SARS-CoV-2 infection on Labor and Delivery (L&D) units is a critical strategy to manage patient and health worker safety, especially in a vulnerable high-prevalence community. We describe the results of a SARS-CoV-2 universal screening program at the L&D Unit at Elmhurst Hospital in Queens, NY, a 545-bed public hospital serving a diverse, largely immigrant and low-income patient population and an epicenter of the global pandemic.
Dr. Spann[/caption]
Marisa N. Spann, PhD, MPH
Columbia University Irving Medical Center
New York, New York
MedicalResearch.com: What is the background for this study?
Response: Prior research has demonstrated that higher maternal pre-pregnancy body mass index is associated with adverse long-term outcomes for offspring including obesity, poorer cognitive and social abilities, and increased risk of psychiatric disorders.
MedicalResearch.com: What are the main findings?
Response: In this study, we investigated the association of maternal pre-pregnancy body mass index with fetal growth and neonatal functional connectivity and found that maternal pre-pregnancy BMI has a significant positive correlation with fetal weight and with greater thalamic connectivity of the brain.
