Author Interviews, CMAJ, OBGYNE / 19.02.2019

MedicalResearch.com Interview with: Anick Bérard PhD FISPE Research chair FRQS on Medications and Pregnancy Director, Réseau Québécois de recherche sur le médicament Professor, Research Chair on Medications, Pregnancy and Lactation Faculty of Pharmacy, University of Montrealand Director, Research Unit on Medications and Pregnancy Research Center CHU Ste-Justin MedicalResearch.com: What is the background for this study? What are the main findings?Response: Yeast infections are common during pregnancy (10%). Although topical treatments are first-line therapies, yeast infections during gestation are often more severe and are resistant to topical options. Hence, low dose oral fluconazole is often the treatment of choice for pregnant women (1 dose for 1 day). Human and animal studies have shown that high dose of fluconazole is teratogenic.Few studies are available for the risk associated with low dose of fluconazole (the most used during pregnancy). Also, no one has studied the combined effect of low- and high-dose fluconazole use during pregnancy on overall adverse pregnancy outcomes (spontaneous abortions, stillbirths and major malformations).(more…)
Author Interviews, Genetic Research, OBGYNE / 18.02.2019

MedicalResearch.com Interview with: Zhiyong Zhang PhD Key Laboratory for the Physics and Chemistry of Nanodevices Department of Electronics Peking University Beijing China MedicalResearch.com: What is the background for this study? What are the main findings?Response: Down syndrome is caused by the presence of an extra 21st chromosome within the genome and is the most common birth defect (occurring in approximately 1 in 800 births). In the absence of a multiplexed quantitative diagnostic device, pregnant women have been examined with the ultrasound and the indirect biochemical markers (Alpha-fetoprotein, chorionic gonadotropin and free estriol) which are accompanied with a high misdiagnosis rate. And the diagnostic test (such as amniocentesis) following the wrong screening test results will bring harm to both the pregnant women and the fetuses. Through PCR (polymerization chain reaction) amplification of the fetal DNA in the pregnant mother’s peripheral blood and fluorescence read-out, whole-genome sequencing (WGS)-based non-invasive prenatal testing (NIPT) sequences all the genomic DNA segments in parallel and quantitatively compares the percentage of different chromosomes, which increases the sensitivity for prenatal detection of Down syndrome. However, the complex instrumental setups and the resulted high processing cost present challenges for the large-scale application of WGS-based diagnosis at the point of care in the urban and rural areas of developing countries. Hence, beside the costly WGS method, there is an urgent need to develop a cost-effective NIPT biochip with simple instrumental setting, fast detection speed, high sensitivity, and programmable to multiple disease markers. Taking advantages of we have developed a novel field effect transistor (FET) based biosensor that reveals a fast, ultra-sensitive, highly specific and cost-effective methods and someday can be used to detect fetal Down syndrome in NIPT.(more…)
Author Interviews, BMJ, Cancer Research, HPV, OBGYNE / 13.02.2019

MedicalResearch.com Interview with: Matejka Rebolj, PhD King’s College London, London, UK   Professor Henry Kitchener, MD FRCOG FRCS University of Manchester, Manchester, UK   MedicalResearch.com: What is the background for this study?Response: We now have reliable and affordable technologies to detect human papillomavirus (HPV), a virus which is universally accepted as the cause of cervical cancer. Various large trials confirmed that cervical screening could be improved by replacing the smear (cytology) test that has been in use for decades, with HPV testing. Many countries are now making the switch. In England, this is planned for the end of 2019. To test how to run HPV testing within the English National Health Service, a pilot was initiated in 2013 in six screening laboratories. We also wanted to determine whether the encouraging findings from the trials could be translated to everyday practice. This is important not only because we will be using different HPV tests, but also because women undergoing screening in trials are much more selected than those who are invited to population-based screening.(more…)
Author Interviews, Gender Differences, OBGYNE, Psychological Science, Sexual Health / 11.02.2019

MedicalResearch.com Interview with:Dr. Alexander Lischke, Dipl.-Psych. Universität Greifswald Institut für Psychologie Physiologische und Klinische Psychologie/Psychotherapie University of Greifswald, Germany MedicalResearch.com: What is the background for this study? Response: We know for a long time that cyclic variations in womens' estrogen and progesterone levels affect their emotion recognition abilities by modulating neural activity in brain regions implicated in emotion processing. We also know that oral contraceptives suppress cyclic variations in womens' estrogen and progesterone levels. We, thus, assumed that oral contraceptives would affect womens' emotion recognition abilities due to the aforementioned suppression of cylic variations in estrogen and progesterone levels that modulate neural activity in brain regions during emotion processing. To test this assumption, at least with respect to the behavioral effects of oral contraceptive use on emotion recognition, we performed the current study. We recruited regular cylcling women with and without oral contraceptive use for our study. None of the women were in psychotherapeutical or psychopharmacological treatment at the time of the study. During the study, women performed a emotion recognition task that required the recognition of complex emotional expressions like, for example, pride or contempt. (more…)
Author Interviews, CDC, Flu - Influenza, OBGYNE, Pediatrics / 07.02.2019

MedicalResearch.com Interview with: Kim Newsome, MPH National Center on Birth Defects and Developmental Disabilities CDCMedicalResearch.com: What is the background for this study? Response: This study supports data from previous studies that have shown increased risks for infants born to pregnant women who are severely ill with flu. MedicalResearch.com: What are the main findings?Response: Our study found that severely ill women with 2009 H1N1 influenza during pregnancy were more likely to have adverse birth outcomes (such as their baby being born preterm or of low birth weight) than women without influenza.(more…)
Author Interviews, Heart Disease, OBGYNE / 07.02.2019

MedicalResearch.com Interview with: Professor Dino A. Giussani PhD ScD FRCOG Professor of Developmental Cardiovascular Physiology & Medicine Department of Physiology Development & Neuroscience University of Cambridge Director of Studies in Medicine College Lectureship in Medicine '1958' Gonville & Caius College UK MedicalResearch.com: What is the background for this study? What are the main findings?Response: Heart disease kills 1 in 3 people worldwide. When we hear about heart disease, the first thing we think of is a gene-environent interaction. That is to say, how our genes interact with traditional lifestyle factors, such as smoking, obesity and/or a sedentary lifestyle to promote an increased risk of cardiovascular disease. However, it has also become established that the gene-environment interaction early in life may be just as, if not more, important in ‘programming’ future heart health and heart disease. That is to say, how the quality of the intrauterine environment in which we develop may also shape our future heart risk. Evidence from human sibling-pair studies suggests that these relationships are causal, that they occur independently of genotype and that they are significantly influenced by the quality of the intrauterine environment during pregnancy. For instance, bariatric surgery to decrease the weight of obese women reduced the risk of obesity, insulin resistance and raised blood pressure in children born after surgery compared to those born before. Therefore, these studies highlight a disproportionate risk of disease in offspring born from the same mother but under different in utero conditions, providing strong evidence in humans that the environment experienced during this critical period of development directly influences long-term cardiovascular health. One of the most common outcomes of complicated pregnancy in humans is chronic fetal hypoxia, as can occur during placental insufficiency or preeclampsia. The main findings of our study show that prenatal hypoxia can programme future heart disease in the offspring and that maternal treatment with the antioxidant vitamin C can be protective (see paper attached). (more…)
Author Interviews, CMAJ, Fertility, McGill, OBGYNE / 04.02.2019

MedicalResearch.com Interview with: Natalie Dayan MD MSc FRCPC General Internal Medicine and Obstetric Medicine, Clinician-Scientist, Research Institute Centre for Outcomes Research and Evaluation (CORE) McGill University Health Centre Montréal QC MedicalResearch.com: What is the background for this study? What are the main findings?Response: Infertility treatment is rising in use and has been linked with maternal and perinatal complications in pregnancy, but the extent to which it is associated with severe maternal morbidity (SMM), a composite outcome of public health importance, has been less well studied. In addition, whether the effect is due to treatment or to maternal factors is unclear. We conducted a propensity matched cohort study in Ontario between 2006 and 2012. We included 11 546 women who had an infertility-treated pregnancy and a singleton live or stillborn delivery beyond 20 weeks. Each woman exposed to infertility treatment was then matched using a propensity score to approximately 5 untreated pregnancies (n=47 553) in order to address confounding by indication. Poisson regression revealed on overall 40% increase in the risk of a composite of SMM (one of 44 previously validated indicators using ICD-10CA codes and CCI procedure codes) (30.3 per 1000 births vs. 22.8 per 1000 births, adjusted relative risk 1.39, 95% CI 1.23-1.56). When stratified according to invasive (eg., IVF) and non-invasive treatments (eg. IUI or pharmacological ovulation induction), women who were treated with IVF had an elevated risk of having any severe maternal morbidity, and of having 3 or more SMM indicators (adjusted odds ratio 2.28, 95% CI 1.56 – 3.33), when compared with untreated women, whereas women who were treated with non-invasive treatments had no increase in these risks. (more…)
Author Interviews, Eating Disorders, OBGYNE / 04.02.2019

MedicalResearch.com Interview with: Valentina Tonei, PhD British Academy Research Associate Department of Economics and Related Studies University of York, UK MedicalResearch.com: What is the background for this study? What are the main findings?Response: There has been a growing utilisation of Caesarean sections in the past decades. To put it in a perspective, in the United Kingdom, the caesarean section rate was about 26% in 2015, while in 1990s it was about 12-15%. A similar increase has been observed in other countries, for example in the USA. So, while this study focuses on the United Kingdom, I believe that the evidence from this research can apply also to other countries. I study the health consequences for mothers who give birth through an emergency caesarean. Thanks to previous studies, we are well-aware of the implications for mothers’ physical health; instead, this research sheds light on the impact on new mothers’ mental health. I find that new mothers who have an emergency caesarean delivery are at higher risk of developing postnatal depression in the first 9 months after the delivery.(more…)
Author Interviews, JACC, Karolinski Institute, OBGYNE, Pediatrics, Weight Research / 12.01.2019

MedicalResearch.com Interview with: Martina Persson, M.D, PhD Karolinska Institute MedicalResearch.com: What is the background for this study? What are the main findings?Response: It is well known that maternal obesity increases risks of adverse fetal outcomes, including congenital malformations of the heart. However, it is unclear if maternal overweight and obesity associate with risks of specific and more complex congenital heart defects. We conducted a population-based cohort study in Sweden using data from several health registries. The study included more than 2 million live, singletons born between 1992-2012. Risks (prevalence rate ratios) of complex heart defects (Tetralogy of Fallot, transposition of the great arteries (TGA), atrial septal defects (ASD), aortic arch defects, and single ventricle heart) and several specific heart defects were estimated in infants to mothers with overweight and increasing degree of obesity. We found that risks of aortic arch defects, ASD and patent ductus arteriosus (in term infants) increased with maternal obesity severity. On the other hand, we found no clear associations between maternal BMI and risks of several other complex and specific heart defects.(more…)
Author Interviews, OBGYNE, Weight Research / 04.01.2019

MedicalResearch.com Interview with: "Breast feeding... Like its her job." by Jason Lander is licensed under CC BY 2.0 <a href="https://creativecommons.org/licenses/by/2.0"> CC BY 2.0</a>Gabrielle G. Snyder, MPH Department of Epidemiology Graduate School of Public Health University of Pittsburgh MedicalResearch.com: What is the background for this study? What are the main findings?Response: Although previous studies have investigated the association between breastfeeding duration and maternal weight change, we still do not know if there is an optimal duration of breastfeeding for mothers in order to realize potential health benefits. Furthermore, these studies were unable to determine whether health outcomes were due to breastfeeding or other health-promoting behaviors, like better diet and more physical activity. Our study aims to address both points. To test the association between breastfeeding duration and maternal waist circumference, we used traditional regression models as well as two additional statistical methods that allowed us to control for factors that may influence if a woman would breastfeed and for how long. We found that women who breastfed more than 6 months had smaller waist circumference, as well as lower body mass index, one decade after delivery compared to women who breastfed 6 months or less. These results were consistent across all statistical methods.(more…)
Author Interviews, Breast Cancer, NIH, OBGYNE / 27.12.2018

MedicalResearch.com Interview with: Dale P. Sandler, Ph.D. Chief, Epidemiology Branch National Institute of Environmental Health Sciences NIH MedicalResearch.com: What is the background for this study? Response: Not having children is a well-established risk factor for breast cancer, but most of this evidence comes from studies of postmenopausal women since breast cancer before menopause is relatively uncommon. There is growing evidence that some risk factors differ for premenopausal and postmenopausal breast cancer – for example obesity which increases risk for breast cancer after menopause but appears to be protective before menopause. There was some evidence that breast cancer risk increased shortly after pregnancy. It was thought that this risk lasted for 5 to ten years. Studies were unable to fully characterize the duration of this increase in risk or evaluate factors such as breast feeding, age at birth, or family history of breast cancer that could modify the relationship between recent pregnancy and breast cancer risk. Breast cancer before menopause or age 55 is relatively rare, and few individual studies are large enough to answer these questions. To answer these questions, we formed the Breast Cancer Collaborative Group, a pooling project involving 20 prospective cohort studies. We included 890,000 women from 15 of these long-term studies across three continents, including over 18,000 incident breast cancer cases.(more…)
Author Interviews, Education, JAMA, OBGYNE, Pediatrics, Social Issues / 21.12.2018

MedicalResearch.com Interview with "Pregnancy 1" by operalynn is licensed under CC BY 2.0Josephine Funck Bilsteen, MSc Department of Pediatrics, Hvidovre University Hospital, Hvidovre, Section of Epidemiology, Department of Public Health University of Copenhagen Copenhagen, Denmark MedicalResearch.com: What is the background for this study? What are the main findings?Response: The background of this study is that there is increasing recognition of the longer-term health and social outcomes associated with preterm birth such as independent living, quality of life, self-perception and socioeconomic achievements. However, much less is known about differences in education and income among adults born at different gestational weeks in the term period. In this study shorter gestational duration, even within the term range, was associated with lower chances of having a high personal income and having completed a secondary or tertiary education at age 28 years. This is the first study to show that adults born at 37 and 38 completed weeks of gestation had slightly lower chances of having a high income and educational level than adults born at 40 completed weeks of gestation.(more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, OBGYNE, Pediatrics / 19.12.2018

MedicalResearch.com Interview with: Krista F. Huybrechts, MS PhD Associate Professor of Medicine Brigham and Women’s Hospital Harvard Medical School Boston, MA 02120MedicalResearch.com: What is the background for this study? What are the main findings?Response: Pregnant women often experience nausea and vomiting, particularly during the first trimester. Early treatment is recommended to relieve symptoms and prevent progression to hyperemesis gravidarum. Although not formally approved for this indication, ondansetron is the most frequently prescribed treatment for nausea and vomiting in pregnancy in the US: 22% of pregnant women reportedly used ondansetron in the US in 2014. Despite this common use, the available evidence on the fetal safety of ondansetron is limited and conflicting, and the possibility of a doubling in risk of cleft palate and cardiac malformations has been raised. We therefore evaluated the association between ondansetron exposure during the first trimester of pregnancy, the period of organogenesis, and the risk of congenital malformations in a cohort of 1,816,414,publicly insured pregnancies using the nationwide Medicaid Analytic eXtract data for 2000-2013. A total of 88,467 women (4.9%) were exposed to ondansetron during the first trimester. After adjusting for a broad range of potential confounding variables, we found no association with cardiac malformations (RR = 0.99; 95% CI, 0.93 – 1.06) and congenital malformations overall (RR = 1.01; 95% CI, 0.98 – 1.05). For oral clefts, we found a 24% increase in risk (RR=1.24; 95% CI, 1.03 – 1.48), which corresponds to an absolute risk of 2.7 per 10,000 births (95% CI, 0.2 – 5.2 per 10,000 births). These findings were consistent across sensitivity analyses, conducted to address potential misclassification and confounding bias.(more…)
Allergies, Author Interviews, OBGYNE, Pediatrics / 18.12.2018

MedicalResearch.com Interview with: Karen Robbins, M.D. Allergist at Children’s National Health SystemMedicalResearch.com: What is the background for this study? What are the main findings?Response: The background is that mothers are often concerned that something they did contributed to their children developing food allergies. Many will relate that they ate a lot of one specific food allergen while pregnant, and question how this could have impacted their unborn child. We realized that we hear a lot of anecdotal stories in clinic, but were not sure how frequently mothers try to alter their diet in the hopes of preventing food allergy in their children. We also were not sure where families get information or guidance on this topic. (more…)
Author Interviews, Memory, OBGYNE / 06.12.2018

MedicalResearch.com Interview with: Heather A. Bimonte-Nelson, Ph.D. Professor, Barrett Honors Faculty Department of Psychology Arizona State University MedicalResearch.com: What is the background for this study? What are the main findings?Response: The dogma in the field is that the nonpregnant uterus is dormant, and therefore it has not necessarily been of interest to study. Textbooks have described the nonpregnant uterus as “quiescent,” “dormant,” and “useless.” When I was in graduate school studying endocrinology, I read statements in books saying that the sole purpose of the uterus is for gestation. However, all women aging into midlife will experience some type of menopause, and some of these women will undergo surgical menopause via removal of all, or a part of, their reproductive tracts. Research evaluating reproductive tract-brain connections has grown quite a bit in the last few decades. For example, the ovary-brain connection has been focused on quite a bit, and we now know that hormones coming from the ovaries (such as estrogens and progesterone) can affect more than reproduction, and can impact brain functioning. While the uterus-brain connection is not well understood, there is research indicating that the uterus and autonomic nervous system communicate directly. We also know that hormones released from the ovaries impact the uterus. Therefore, there is a uterus-ovary-brain triad system. This uterus-ovary-brain triad has undergone little scientific investigation for functions outside of reproduction. Given that by age 60 one in three women experience hysterectomy, thereby interrupting this uterus-ovary-brain triad system, we believe it is important to understand the effects of variants of surgical menopause including hysterectomy. This led to our current evaluation testing multiple variations in surgical menopause using a rat model, where we tested the effects of uterus removal alone (hysterectomy), ovarian removal alone, or uterus plus ovarian removal. (more…)
Author Interviews, OBGYNE, Science / 05.12.2018

MedicalResearch.com Interview with: "38 week fetus" by Zappys Technology Solutions is licensed under CC BY 2.0Kimberley Whitehead Neuroscience, Physiology & Pharmacology University College London MedicalResearch.com: What is the background for this study? Response: Fetuses move a lot! Very similar movement patterns are seen in both pre-term and full-term newborn infants, but their function is unclear. In animals such as rats, spontaneous movement and consequent feedback from the environment during the early developmental period trigger specific patterns of electrical activity in the brain that are necessary for proper brain mapping. (more…)
Author Interviews, Cancer Research, JAMA, OBGYNE / 02.12.2018

MedicalResearch.com Interview with: Dr. Weimin Ye, MD MSC, PhD Department of Medical Epidemiology and Biostatistics Karolinska Institue MedicalResearch.com: What is the background for this study? What are the main findings?Response: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting 5-10% of women of reproductive age. Characterized by hyperandrogenism and metabolic abnormalities, PCOS is known to be related to various long-term health consequences, including diabetes, cardiovascular disease and endometrial cancer. Besides, inconsistent results have been reported for the associations between PCOS and the risk of ovarian and breast cancer. Studies addressing the risks of other cancers are scarce. Thus, we conducted a large, population-based cohort study with a long follow-up and rather sufficient confounding adjustment to explore the full picture of associations between PCOS and the risks of various cancer types. We found that PCOS is a risk factor for certain types of cancer, including cancers of the endometrium, ovary, endocrine gland, pancreas, kidney and skeletal & hematopoietic system. (more…)
Addiction, Author Interviews, Methamphetamine, OBGYNE, Opiods / 02.12.2018

MedicalResearch.com Interview with: Lindsay Admon, MD MSc Assistant Professor, Department of Obstetrics & Gynecology Institute for Healthcare Policy and Innovation University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? In our previous work (https://journals.lww.com/greenjournal/Fulltext/2017/12000/Disparities_in_Chronic_Conditions_Among_Women.19.aspx), we identified higher rates of deliveries complicated by substance use among rural women. We knew that some of this difference would be accounted for by opioids.What we didn’t expect was that when we took a closer look, amphetamine use disorder accounted for a significant portion of this disparity as well. The main findings of this study are that, between 2008-09 and 2014-15, amphetamine and opioid use among delivering women increased disproportionately across rural compared to urban counties in three of four census regions. By 2014-15, amphetamine use disorder was identified among approximately 1% of all deliveries in the rural western United States, which was higher than the incidence of opioid use in most regions. Compared to opioid-related deliveries, amphetamine-related deliveries were associated with higher incidence of the majority of adverse gestational outcomes that we examined including pre-eclampsia, preterm delivery, and severe maternal morbidity and mortality. (more…)
Author Interviews, Baylor College of Medicine Houston, Infections, Microbiome, OBGYNE, Vaccine Studies / 30.11.2018

MedicalResearch.com Interview with: Sasirekha Ramani, PhD Assistant Professor Molecular Virology and Microbiology Baylor College of Medicine Houston, TX MedicalResearch.com: What is the background for this study? Response: This work pertains to Rotavirus, a leading cause of diarrhea and vomiting in children under the age of 5 years. In this paper, we described our work with a rotavirus strain that almost exclusively causes neonatal infections. For many years, we have been trying to understand why this strain primarily infects newborns and why infection in some babies is associated with gastrointestinal symptoms while others are asymptomatic. A few years ago, we showed that this particular virus binds to developmentally-regulated glycans (sugars) in the gut as receptors. As the baby grows, these sugars get modified, and that potentially explains why infection with this virus is primarily restricted to neonates. However, we didn’t really have to answer to why there are differences in association with clinical presentations. (more…)
Author Interviews, OBGYNE, Omega-3 Fatty Acids / 18.11.2018

MedicalResearch.com Interview with: “omega 3” by Khaldaa Photographer is licensed under CC BY 2.0Philippa Middelton MPHAssociate Professor Healthy Mothers, Babies and Children South Australian Health and Medical Research Institute Adelaide, AustraliaMedicalResearch.com: What is the background for this study? What are the main findings?Response: For several decades, it has been known that fish or fish oils can lengthen gestation. In our Cochrane review of 70 studies and nearly 20,000 women we show that fish oil (mainly as omega-3 fatty acid supplements), prevents premature birth, specifically
  • An 11% reduction in premature birth < 37 weeks gestation;
  • And a 42% reduction in premature birth < 34 weeks gestation.
(more…)
Author Interviews, Environmental Risks, NIH, Nutrition, OBGYNE, Pediatrics / 14.11.2018

MedicalResearch.com Interview with: "Baby Bottle" by brokinhrt2 is licensed under CC BY 2.0Kristen Upson, PhD, MPH and Donna D. Baird, PhD Epidemiology Branch National Institute of Environmental Health Sciences Research Triangle Park, NC 27709MedicalResearch.com: What is the background for this study? What are the main findings?Response: Menstrual pain is the most common menstrual complaint and can substantially affect the quality of women’s lives. A prior study in young adults who participated in feeding studies as infants reported an increased risk of greater menstrual pain severity in adulthood with soy formula feeding. Since that study, evidence from laboratory animal studies support the disruptive effects of a phytoestrogen present in soy formula, genistein, on reproductive system development, including aspects involved in menstrual pain. The laboratory animal studies also demonstrate that the developmental changes with genistein can persist into adulthood. Given these results, we were interested in further evaluating the association between infant soy formula feeding and menstrual pain in a cohort of young women. In our study of women ages 23-35 years old, we observed that soy formula feeding during infancy was associated with several indicators of severe menstrual pain in reproductive-age women. This included a 40% increased risk of ever using hormonal contraception for menstrual pain and 50% increased risk of moderate/severe menstrual discomfort with most periods during early adulthood.(more…)
Author Interviews, JAMA, OBGYNE / 13.11.2018

MedicalResearch.com Interview with: Joel Ray MD, MSc, FRCPC Institute of Health Policy, Management and Evaluation Faculty of Medicine University of Toronto, Toronto MedicalResearch.com: What is the background for this study? What are the main findings?Response: Many women who die within childbirth or soon thereafter experience rapid onset of morbidity/illness before succumbing. Thus, severe maternal morbidity (SMM) offers a detectable (or set of detectable) conditions that might be dealt with before they progress to a fatality. Even so, severe maternal morbidity alone can be non-fatal, but create disability for a new mother (e.g., a stroke), or prolong separation of mother and newborn. So, we showed that, as the number of severe maternal morbidity indicators rises, so does the probability of maternal death. This relation was exponential in nature. (more…)
Author Interviews, Depression, Gender Differences, OBGYNE / 07.11.2018

MedicalResearch.com Interview with: Dr Sarah Myers PhDDr Sarah Myers PhD Honorary Research Associate UCL Department of Anthropology MedicalResearch.com: What is the background for this study? Response: Postnatal or postpartum depression is unfortunately common after giving birth; a figure often quoted is 15%, but some studies have found much higher numbers. Postnatal depression is associated with a range of poorer outcomes for mothers and their infants, and the financial costs of treating maternal mental ill health put health services under considerable strain. Studies have found that providing additional emotional support to at risk mothers, for instance via peer support programmes or regular phone calls with health visitors, can reduce the likelihood of them developing the condition. Therefore, it is really important that we understand the full range of risk factors that put women at greater risk of becoming depressed after giving birth. There is increasing evidence for a link between inflammation and depression, with factors that trigger an inflammatory immune response also increasing the likelihood of depressive symptoms. The opens up the possibility of finding new risk factors for postnatal depression based on known associations with inflammation. (more…)
Author Interviews, Cannabis, Cognitive Issues, OBGYNE / 05.11.2018

MedicalResearch.com Interview with: Ryan J. McLaughlin, PhD Assistant Professor Department of Integrative Physiology & Neuroscience College of Veterinary Medicine Washington State University Pullman, WA 99164-7620 MedicalResearch.com: What is the background for this study? What are the main findings?Response: The use of cannabis during pregnancy is a growing health concern, yet the long-term cognitive ramifications for developing offspring remain largely unknown. Human studies exploring the long-term effects of maternal cannabis use have been sparse for several reasons, including the length and cost of such studies, as well as the fact that experimentally assigning mothers to smoke cannabis during pregnancy is obviously ethically impractical. Animal models of maternal cannabis use have been advantageous in this respect, but they have been limited by the drugs used (synthetic cannabinoids vs. THC vs. cannabis plant) and the way that they are administered. In our study, we used a more translationally relevant animal model of maternal cannabis use that exposes pregnant rat dams to whole plant cannabis extracts using the intra-pulmonary route of administration that is most common to human users. Our preliminary data indicate that twice-daily exposure to a high-dose cannabis extract during pregnancy may produce deficits in cognitive flexibility in adult rat offspring. Importantly, these rats did not experience general learning deficits, as they performed comparably to non-exposed offspring when required to follow a cue in their environment that dictate reinforcer delivery. Instead, deficits were observed only when rats were required to disregard this previous cue-based strategy and adopt a new egocentric spatial strategy in order to continue receiving the sugar reinforcers. (more…)
Author Interviews, Autism, JAMA, OBGYNE / 01.11.2018

MedicalResearch.com Interview with: Magdalena Janecka PhD Department of Psychiatry Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: Our paper explored the association between maternal use of medication during pregnancy and the rates of autism in a large cohort from Israel. This followed on from a number of earlier studies reporting that the use of certain medications - for example antidepressants - during pregnancy is associated with higher rates of autism in children. However, rather than test the effects of any particular drug, or a set of drugs aggregated based on maternal condition, our large dataset allowed us to group all medications prescribed to pregnant women based on their drug target, and in the subsequent analyses focus on over 50 groups that included drugs with neurotransmitter-relevant targets - for example agonists and antagonists of their receptors. (more…)
Author Interviews, OBGYNE, Pediatrics, Vaccine Studies / 27.10.2018

MedicalResearch.com Interview with: Anna Beavis, MD, MPH Assistant Professor The Kelly Gynecologic Oncology Service Department of Gynecology and Obstetrics Johns Hopkins Medicine Baltimore, MD 21287-128 MedicalResearch.com: What is the background for this study? What are the main findings?Response: We wanted to look at reasons parents don’t vaccinate their children against HPV, including how those reasons have changed over time from 2010-2016 and how those reasons are different between boys and girls in the most recent data from 2016. We used a nationwide dataset which is publically available from the CDC (Centers for Disease Control) – the National Immunization Survey-Teen, or NIS-Teen - which surveys parents of teens ages 13-17 years old every year to determine rates of all recommended vaccinations. In parents who report that they don’t intend to vaccinate their child against HPV , the survey asks parents why. We found that from 2010 to 2016, the percentage of parents reporting concerns about their child not being sexually active yet went down significantly for both boys and girls. Also, in boys specifically, parents reported male gender as a less common reason for not vaccinating. For both boys and girls, we found that concerns about safety and side effects, necessity, and lack of knowledge about the vaccine were common reasons for not planning to vaccinate. Also, 10% of parents of girls vs. 20% of parents of boys reporting never having a provider recommendation for the vaccine as their primary reason for not vaccinating. These results may reflect the growing public understanding of the HPV vaccine as a vaccine which is best given before exposure, so before initiation of sexual activity between the ages of 11 and 12, and that it is recommended for both boys and girls. Also, over 80% of people will have an HPV infection in their lifetime, so everyone should get vaccinated regardless of anticipated sexual activity. Additionally, providers should focus their counseling and recommendation on improving knowledge about the HPV vaccine, including its decade-long track record of safety and necessity. (more…)
Author Interviews, Biomarkers, Endocrinology, JCEM, OBGYNE, Yale / 25.10.2018

MedicalResearch.com Interview with: Valerie A. Flores, MD Clinical Instructor Division of Reproductive Endocrinology & Infertility Department of Obstetrics, Gynecology & Reproductive Sciences Yale School of Medicine - Yale New Haven Hospital MedicalResearch.com: What is the background for this study? What are the main findings?Response: Endometriosis is a debilitating gynecologic disease that affects 1 in 10 reproductive-aged women, causing pain and infertility. It is a hormonally dependent disorder— estrogens promote growth of endometriosis, while progesterone inhibits estrogen-dependent proliferation. Although progestin-based therapies (including combined oral contraceptives) are first-line therapy in the management of endometriosis-associated pain, response to progestins is variable and currently unpredictable. (more…)
Author Interviews, Endocrinology, OBGYNE, Smoking / 24.10.2018

MedicalResearch.com Interview with: Nis Brix M.D., PhD Student Department of Public Health Department of Epidemiology Aarhus University Hospital Nis Brix M.D., PhD Student Department of Public Health Department of Epidemiology Aarhus University HospitalMedicalResearch.com: What is the background for this study? What are the main findings?Response: Several studies have indicated a secular trend towards earlier puberty. This is a potential concern as early puberty has been linked to an increased risk of a number of diseases, such as obesity, diabetes, cardiovascular diseases and certain types of cancer. For this reason, our research team are interested in identifying potential modifiable causes of early puberty. Smoking during pregnancy may be such a modifiable cause of early puberty in the children. Former studies have already linked smoking during pregnancy to earlier age at the daughters’ first menstrual period, a relatively late marker of pubertal development, but other markers of puberty are less studied, especially in the sons. We studied 15,819 sons and daughters. The mothers gave detailed information on smoking during their pregnancies, and the children gave information on a number of pubertal milestones half-yearly from the age of 11 years. The milestones for the sons were age at voice break, first ejaculation of semen, pubic hair and testicular growth, armpit hair growth and onset of acne. For the daughters the milestones were age at their first menstrual period, pubic hair growth, breast development, armpit hair growth and onset of acne. Our results suggested that the more cigarettes the mother smoked during her pregnancy the earlier her children, both sons and daughters, went through puberty. If the mother smoked more than ten cigarettes a day during pregnancy, the children appeared to go through puberty, on average, three to six months earlier than the children of non-smoking mothers. (more…)
Author Interviews, Nutrition, OBGYNE, Pediatrics, Race/Ethnic Diversity / 19.10.2018

MedicalResearch.com Interview with: "Tortillas di una miscela di mais azzurro tostato" by fugzu is licensed under CC BY 2.0Vijaya Kancherla, PhD Research Assistant Professor, Department of Epidemiology Epidemiologist, Center for Spina Bifida Prevention Rollins School of Public Health Emory University Atlanta GA 30322 MedicalResearch.com: What is the background for this study? Response: The scientific evidence since 1991 has shown that folic acid prevents from 35%-95% of neural tube birth defects that are caused due to low folic acid (also known as vitamin B9) in the mother’s diet prior to conception and during early pregnancy. Neural tube defects form in the embryo at 4th week of gestation when most women are unaware they are pregnant. Taking any amount of folic acid after the 4th week of pregnancy will not prevent neural tube defects. There is no cure for these birth defects. So, it matters for women to have enough folic acid prior to conception and in the first four weeks of pregnancy. If a woman is not taking prenatal vitamins that early, folic acid fortified foods come to rescue. Foods fortified with folic acid will prevent folate deficiency for everyone, and offer the benefit to mothers who were not planning their pregnancies or were not taking folic acid pills. If corn masa flour and tortillas were fortified with folic acid, that would help millions of reproductive aged women have healthy stores of folic acid in their bodies, to prepare them for their pregnancy, irrespective of their pregnancy plans. Prior to April 2016, folic acid (also known as vitamin B9) was not allowed to be added to corn masa flour (or products made from masa such as tortillas and tortilla chips) in the US. So, there was no expectation of having folic acid in these products. The March of Dimes, Spina Bifida Foundation, the American Academy of Pediatricians, Gruma Corporation and others filed a petition with the US FDA and succeeded in allowing millers to voluntarily add folic acid to corn masa flour and tortillas as a food additive. This regulation was implemented by the US FDA in April 2016.(more…)
Author Interviews, Cancer Research, HPV, JAMA, OBGYNE / 13.10.2018

MedicalResearch.com Interview with: Megan Clarke, PhD, MHS Cancer Prevention FellowClinical Genetics BranchDivision of Cancer Epidemiology & GeneticsNational Cancer InstituteRockville, MD 20892MedicalResearch.com: What is the background for this study?
  • Infection with high-risk human papillomavirus (hrHPV) is the primary cause of cervical cancer. While hrHPV infection is common, most infections are benign and clear on their own without causing cervical cancer. However, some women develop persistent hrHPV infections and are at risk for cervical cancer and its precursors (i.e., precancer).
  • The United States Preventative Services Task Force recommends screening every 3 years with cervical cytology (i.e. Pap) alone, every 5 years with hrHPV testing alone, or with a combination of hrHPV testing and cytology (co-testing) for women aged 30 to 65 years.
  • Screening with hrHPV testing is highly sensitive for detecting cervical precancer but requires additional triage tests to identify HPV-positive women at high-risk of developing cancer who should undergo colposcopy (visualization of the cervix) and biopsy from those at low-risk who can be safely monitored.
  • Currently, Pap cytology is recommended as a triage test for women testing HPV-positive, but this approach requires frequent re-testing at short intervals because the risk of cervical precancer is not low enough in HPV-positive women who test cytology negative to provide long-term reassurance against future risk. In most settings, women who test HPV-positive, cytology-negative are referred to repeat screening within one year.
  • The p16/Ki-67 dual stain assay is a molecular test that measures two specific proteins, p16 that is strongly linked with hrHPV infection, and Ki-67, a marker of cell proliferation that is common in precancers and cancers.
  • Studies have shown that the dual stain test has greater accuracy for detecting cervical precancers in HPV-positive women compared with cytology.
  • In order to determine the optimal screening intervals for the dual stain test, long-term prospective studies are needed to determine how long HPV-positive women who test dual stain negative can be safely reassured of a low precancer risk.
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