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 MPH Associate Professor Healthy Mothers, Babies and Children South Australian Health and Medical Research Institute Adelaide, Australia  MedicalResearch.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 27709  MedicalResearch.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 Hospital  MedicalResearch.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 Fellow Clinical Genetics Branch Division of Cancer Epidemiology & Genetics National Cancer Institute Rockville, MD 20892  MedicalResearch.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.
(more…)
Author Interviews, Endocrinology, Fertility, OBGYNE / 05.10.2018

MedicalResearch.com Interview with: Dr. Ernest Loumaye, MD, PhD Co-Founder and CEO ObsEva SA   MedicalResearch.com: What is the background for this announcement? How does Nolasiban work to decrease contractions and improve uterine blood flow? Response: The WHO has recognized infertility as a global health issue, and many couples undergo IVF treatment: there are more than 700,000 annual IVF treatment cycles in Europe and more than 200,000 in the U.S. However, more than 50% of IVF procedures do not result in pregnancy, and failure has tremendous emotional and financial costs to patients.  ObsEva is dedicated to improving fertility outcomes in IVF while also supporting the use of single embryo transfer to minimize multiple births that are associated with significant health risks to mother and baby, as well as significant health costs from premature delivery. Nolasiban works by blocking the hormone oxytocin, which is known to induce uterine contractions.  Nolasiban reduces uterine contractions and could improve uterine blood flow, both effects being favourable for the embryo to properly implant. (more…)
Author Interviews, Heart Disease, JAMA, OBGYNE, Pediatrics / 22.09.2018

MedicalResearch.com Interview with: Eyal Cohen, MD, MSc, FRCP(C) Associate Scientist and Program Head (interim), Child Health Evaluative Sciences Research Institute, The Hospital for Sick Children Staff Physician, Division of Paediatric Medicine, The Hospital for Sick Children Professor, Paediatrics and Health Policy Management & Evaluation The University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings? Response: Having a child with a major birth defect can be a life-changing and stressful event for the child's mother.  This stress may be associated with higher risk of premature cardiovascular disease. We found that mothers of infants born with a major birth defect had a 15% higher risk of premature cardiovascular disease that a comparison group of mothers.  The risk was more pronounced, rising to 37% among mothers who gave birth to a more severely affected infant (and infant born with major birth defects affecting more than one organ system). The risk was apparent even within the first 10 years after the birth of the child. (more…)
Author Interviews, Diabetes, Gluten, Lancet, OBGYNE, Pediatrics / 21.09.2018

MedicalResearch.com Interview with: Knud Josefsen, senior researcher Bartholin Institute, Rigshospitalet, Copenhagen K, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: In a large population of pregnant women, we found that the risk of the offspring being diagnosed with type 1 diabetes before the age of 15.6 years (the follow up period) was doubled in the group of women ingesting the highest amounts of gluten (20-66 g/day) versus the group of women ingesting the lowest amounts of gluten (0-7 g/day). For every additional 10 grams of gluten ingested, the risk for type 1 diabetes in the child increased by a factor of 1.31. It the sense that it was a hypothesis that we specifically tested, we were not surprised. We had seen in animal experiments that a gluten-free diet during pregnancy protected the offspring from diabetes, and we wanted to see if we could prove the same pattern in humans. There could be many reasons why we would not be able to show the association, even if it was there (sample size, low quality data, covariates we could not correct for and so on), but we were off course pleasantly surprised that we found the association that we were looking for, in particular because it is quite robust (more…)
Author Interviews, OBGYNE, Pediatrics / 20.09.2018

MedicalResearch.com Interview with: Vida Maralani PhD Associate Professor Department of Sociology Cornell University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Breastfeeding is a time-intensive and culturally and emotionally charged topic in the U.S. with many different stakeholders. Women hear the strong message that they should breastfeed their infants for the first year of life, yet it is unambiguously clear that they find these guidelines hard to follow in practice. We were interested in exploring how breastfeeding duration is associated with how many children women go on to have. Our results show that women who breastfeed their first child for five months or longer are more likely to have three or more children, and less likely to have only one child, than women who breastfeed for shorter durations or not at all. Women who initiate breastfeeding did not differ in how many children they expected to have before they started their families. Rather, the number of children women actually bear differs by how long they breastfeed their first child. Women who breastfeed for shorter durations are more likely to have fewer children than they expected than to have more children than expected. In contrast, women who breastfeed longer are as likely to achieve their expectations as to exceed them, and they are nearly as likely to have more children than they expected as they are to have fewer. (more…)
Allergies, Author Interviews, OBGYNE / 20.09.2018

MedicalResearch.com Interview with: “Pollen” by John S. Quarterman is licensed under CC BY 2.0Bircan Erbas, Associate Professor Reader/Associate Professor, Department of Public Health School of Psychology & Public Health La Trobe University  MedicalResearch.com: What is the background for this study? Response: Around the world allergic respiratory diseases especially in children is a major problem. Studies have already shown that cord blood IgE can be used to identify children at risk for allergic diseases. Our previous research showed that exposure to high levels of outdoor pollen, especially grass, in the first couple of months after birth increased risk of allergic respiratory diseases. Based on this, we suspected that exposure to high grass pollen during pregnancy could be also important. (more…)
Author Interviews, Diabetes, JAMA, OBGYNE / 12.09.2018

MedicalResearch.com Interview with: Boyd E Metzger, MD Professor Emeritus of Medicine (Endocrinology) Feinberg School of Medicine Northwestern University MedicalResearch.com: What is the background for this study? Response: The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study showed that higher levels of a mother’s blood sugar during pregnancy are associated with higher risks of increased birthweight, fatter babies, delivery by Cesarean Section, low blood sugar in newborn babies and high levels of insulin in the cord blood at birth. It is not clear whether levels of a mother’s blood sugar during pregnancy are associated with risk obesity later in life as is known to occur in offspring or pre-existing maternal diabetes mellitus. With funding from the National Institutes of Health, the HAPO Follow Up Study addressed this in a subset of nearly 5,000 mothers and their children from the original HAPO Study 10-14 years later (average 11.4 years). (more…)
Author Interviews, JAMA, OBGYNE, STD, USPSTF / 09.09.2018

MedicalResearch.com Interview with: Melissa A. Simon, M.D., M.P.H. Member, U.S. Preventive Services Task Force George H. Gardner professor of clinical gynecology, Vice chair of clinical research Department of Obstetrics and Gynecology Professor of preventive medicine and medical social sciences Northwestern University Feinberg School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: The number of babies born with syphilis is increasing, mirroring the recent increase of syphilis among women. Syphilis infection passed from a pregnant woman to her baby, also known as congenital syphilis, can lead to serious health complications for the baby including premature birth, low birthweight, birth defects, and even death. The Task Force recommends that all pregnant women be screened for syphilis as early in pregnancy as possible to prevent congenital syphilis.  (more…)
Author Interviews, CDC, Cost of Health Care, JAMA, OBGYNE / 07.09.2018

MedicalResearch.com Interview with: Michelle H. Moniz, MD, MSc Assistant Professor Department of Obstetrics and Gynecology Ann Arbor, MI 48109-2800 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We wanted to examine whether Medicaid expansion in Michigan was associated with improved access to birth control/family planning services in our state.  We conducted a survey of enrollees in the Michigan Medicaid expansion program (called "Healthy Michigan Plan"). We found that 1 in 3 women of reproductive age reported improved access to birth control/family planning services after joining HMP.  Women who were younger, who were uninsured prior to joining HMP, and those who had recently seen a primary care clinician were most likely to report improved access.  (more…)
Author Interviews, Endocrinology, Kaiser Permanente, Menopause, OBGYNE, Pediatrics, Pediatrics, Vaccine Studies / 30.08.2018

MedicalResearch.com Interview with: Allison L. Naleway, PhD Senior Investigator Associate Director, Science Programs Center for Health Research Kaiser Permanente MedicalResearch.com: What is the background for this study? Response: Reports of premature menopause after human papillomavirus (HPV) vaccination have received a lot of media attention, including on social media, but these reports were based on a small number of isolated cases. Large studies have demonstrated the safety of HPV vaccination, but parental safety concerns—including potential impact on future fertility—are often cited as one reason for lower HPV coverage. Rates of HPV vaccination have lagged behind coverage rates for other recommended adolescent vaccinations, such as tetanus-diphtheria-acellular pertussis and meningococcal conjugate. (Based on national coverage estimates from 2016, 65% of 13–17 year-old females received at least one HPV vaccination and only 49.5% were up to date with the series, compared to about 88% of adolescents who received Tdap.) We conducted a study of nearly 200,000 young women to determine whether there was any elevated risk of primary ovarian insufficiency (POI) after HPV or other recommended vaccinations.  (more…)
Author Interviews, Cancer Research, JAMA, OBGYNE, UCLA / 29.08.2018

MedicalResearch.com Interview with: Dr. Carol Mangione, M.D., M.S.P.H., F.A.C.P. Division Chief of General Internal Medicine and Health Services Research Professor of Medicine Barbara A. Levey, MD, and Gerald S. Levey, MD, endowed chair in Medicine David Geffen School of Medicine University of California, Los Angeles (UCLA) professor of public health at the UCLA Fielding School of Public Health. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Screening for cervical cancer saves lives by identifying cervical cancer early when it is treatable. Most cases of cervical cancer occur in women who have not been regularly screened or treated, which is why it’s important for women to get screened regularly throughout their lifetime with one of several effective options. Women ages 21 to 29 should get a Pap test every three years. Women ages 30-65 can choose between three approaches, depending on their preferences: a Pap test every three years, an HPV test every five years, or a combination of a Pap test and an HPV test every five years. There are some women who don’t need to be screened for cervical cancer including women younger than 21, women older than 65 who have been adequately screened in the past and are not at high risk, and women who have had a hysterectomy.  (more…)
Author Interviews, JAMA, NEJM, OBGYNE, University Texas / 09.08.2018

MedicalResearch.com Interview with: George R. Saade, MD Professor Jennie Sealy Smith Distinguished Chair Professor, Obstetrics & Gynecology, and Cell Biology Chief of Obstetrics and Maternal Fetal Medicine Director, Perinatal Research Division Department of Obstetrics and Gynecology Division of Maternal Fetal Medicine UTMB at Galveston MedicalResearch.com: What is the background for this study? Response: Several analyses show that the lowest risk to the baby is if delivered at 39 weeks. As pregnancy goes beyond 39 weeks, the risk to the baby increases. On the other hand, the general belief was that induction of labor at 39 increases the risk of cesarean and may not be good for the baby. The guideline were that induction without medical indication, or what we call elective induction of labor, should not be done. However, the studies on which this belief was based were not appropriately designed or analyzed. These studies compared women who were induced at 39 weeks to those who had spontaneous labor at 39 weeks. This comparison is not appropriate. While induction is a choice, having spontaneous labor at 39 weeks is not by choice.  So the correct comparison should be between women who were induced at 39 weeks to those who were not induced and continued their pregnancy beyond 39 weeks. In other words, they continued until they had spontaneous labor or developed an indication to be delivered (expectantly managed). That is how the study was done. First time pregnant women were randomized between these 2 options. The reason the study was done in first time mothers is that they have the highest risk of cesarean compared with women who had delivered vaginally before. (more…)