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 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: Vijaya 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.
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, Autism, OBGYNE / 22.09.2018
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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: Bircan 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…)
Abbvie, Author Interviews, OBGYNE, Pain Research / 26.07.2018
MedicalResearch.com Interview with: Dr. Dawn Carlson MD MPH Vice President, General Medicine Development AbbVie MedicalResearch.com: Please provide some background on this announcement. Would you briefly explain what endometriosis is? Whom does it affect and how does it interfere with quality of life? Response: Endometriosis is one of the most common gynecologic disorders in the U.S that affects an estimated one in 10 women of reproductive age. It occurs when tissue similar to the lining of the uterus starts growing outside of the uterus, where it doesn’t belong. The symptoms of endometriosis, including pain with menstrual periods and between periods, and with sexual intercourse, can be debilitating and significantly impact day-to-day activities of women’s lives, personally and professionally. Unfortunately, women with endometriosis can suffer for up to 10 years and visit multiple physicians before receiving a proper diagnosis. Unresolved endometriosis pain results in higher healthcare costs from emergency department visits and repeat surgeries. (more…)
Author Interviews, HIV, OBGYNE, Pediatrics, Pediatrics, STD / 24.07.2018
MedicalResearch.com Interview with: Monika K. Goyal, M.D., M.S.C.E., senior study author Assistant professor of Pediatrics and Emergency Medicine Children’s National Health System Washington, DC MedicalResearch.com: What is the background for this study? Response: Patients with pelvic inflammatory disease (PID) are at an increased risk for syphilis and HIV. We know that adolescents account for 20 percent of the 1 million cases of PID that are diagnosed each year. We also know that an estimated one in four sexually active adolescent females has a sexually transmitted infection (STI). While screening for syphilis and HIV is recommended when diagnosing PID, actual screening rates among adolescents have been understudied. This multi-center study aimed to quantify rates of HIV and syphilis screening in young women diagnosed with . pelvic inflammatory disease in pediatric emergency departments and to explore patient- and hospital-specific characteristics associated with screening for these two sexually transmitted infections. (more…)
Author Interviews, Depression, JAMA, OBGYNE / 15.07.2018
MedicalResearch.com Interview with: Rebecca Pearson, PhD Lecturer in Psychiatric Epidemiology Centre for Academic Mental Health School of Social & Community Medicine University of Bristol MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know depression and anxiety are common in young women and during pregnancy when there are also implications for the developing child. It is therefore important to investigate whether symptoms are rising given the pressures of modern life. We found that compared to their mothers generation in the 1990s young pregnancy women today are more likely to be depressed. This was driven largely by symptoms of anxiety and feeling overwhelmed rather than feeling down. (more…)
MedicalResearch.com Interview with: Dr Elizabeth R Cluett PhD MSc RM RGN PGCEA PFHEA Senior Lecturer, Faculty of Health Sciences University of Southampton Southampton UK MedicalResearch.com:What is the background for this study? Response: Water immersion during labor and birth is increasingly popular and is becoming widely accepted across many countries, and particularly in midwifery-led care settings. Immersion in water during labor and birth facilitates physiological labor and birth, offers women a non-pharmacological pain relief option and facilitates a sense of choice, control and comfort; qualities strongly associated with women’s satisfaction with their birth experience. (more…)
Author Interviews, JAMA, Mental Health Research, Nutrition, OBGYNE / 05.07.2018
MedicalResearch.com Interview with: Joshua L. Roffman, MD Department of Psychiatry Mass General Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Autism, schizophrenia, and other serious mental illness affecting young people are chronic, debilitating, and incurable at present. Recent public health studies have associated prenatal exposure to folic acid, a B-vitamin, with reduced subsequent risk of these illnesses. However, until this point, biological evidence supporting a causal relationship between prenatal folic acid exposure and reduced psychiatric risk has remained elusive. We leveraged the rollout of government-mandated folic acid fortification of grain products in the U.S. from 1996-98 as a "natural experiment" to determine whether increased prenatal folic acid exposure influenced subsequent brain development. This intervention, implemented to reduce risk of spina bifida and other disabling neural tube defects in infants, rapidly doubled blood folate levels among women of childbearing age in surveillance studies. Across two large, independent cohorts of youths age 8 to 18 who received MRI scans, we observed increased cortical thickness, and a delay in age-related cortical thinning, in brain regions associated with schizophrenia risk among individuals who were born during or after the fortification rollout, compared to those born just before it. Further, delayed cortical thinning also predicted reduced risk of psychosis spectrum symptoms, a finding that suggests biological plausibility in light of previous work demonstrating early and accelerated cortical thinning among school-aged individuals with autism or psychosis. (more…)
Author Interviews, Cancer Research, JAMA, OBGYNE / 04.07.2018
MedicalResearch.com Interview with: Dr. Gina Ogilvie | MD MSc FCFP DrPH Professor | Faculty of Medicine | University of British Columbia Canada Research Chair | Global control of HPV related disease and cancer Senior Public Health Scientist | BC Centre for Disease Control Senior Research Advisor | BC Women's Hospital and Health Centre BC Women's Hospital and Health Centre Vancouver, BC MedicalResearch.com: What is the background for this study? What are the main findings? Response: HPV is known to be the cause of 99% of cervcial cancers. In this study, we compared the routine screening test for cervical cancer, Pap test, to HPV testing. We found that by using HPV testing, women were significantly more likely to have cervical pre-cancers detected earlier. In addition, women with negative HPV tests were significantly less likely to have pre-cancers 48 months later. (more…)
Annals Internal Medicine, Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, Heart Disease, OBGYNE / 03.07.2018
MedicalResearch.com Interview with: Jennifer J. Stuart, ScD Postdoctoral Research Fellow in Reproductive & Cardiovascular Epidemiology Department of Epidemiology Harvard T.H. Chan School of Public Health Division of Women's Health Brigham and Women's Hospital and Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Preeclampsia and gestational hypertension are common pregnancy complications involving high blood pressure that develops for the first time during pregnancy and returns to normal after delivery. Approximately 10 to 15% of all women who have given birth have a history of either preeclampsia or gestational hypertension. Previous studies have shown that women with a history of high blood pressure in pregnancy are more likely to develop cardiovascular disease events like heart attack and stroke later in life when compared to women with normal blood pressure in pregnancy. However, what is less clear is to what extent these women are more likely to develop chronic hypertension, diabetes, and high cholesterol and when these risk factors begin to emerge after pregnancy. We examined this question in a cohort of nearly 60,000 American women who we were able to follow for up to 50 years after their first pregnancy. Previous studies have been limited by small numbers, short follow-up, or a lack of information on shared risk factors, such as pre-pregnancy body mass index, smoking, and family history. This research was conducted within the Nurses’ Health Study II, which collected data on these pre-pregnancy factors in tens of thousands of women over several decades. (more…)
Author Interviews, JAMA, OBGYNE, Surgical Research / 29.06.2018
MedicalResearch.com Interview with: Sarah CM Roberts, DrPH Associate Professor ObGyn&RS Zuckerberg San Francisco General UCSF MedicalResearch.com: What is the background for this study? What are the main findings? Response: Thirteen states have laws that require abortions to be provided in Ambulatory Surgery Centers (ASCs); many of these laws apply only in the second trimester. We examined outcomes from more than 50,000 abortions provided in two facility types: Ambulatory Surgery Centers and office-based settings. We found that there was no significant difference in abortion-related complications across facility type; in both settings, about 3.3% had any complication and about 0.3% had a major complication. There also was no significant difference in complications across facility types for second trimester and later abortions. (more…)
Author Interviews, OBGYNE, Pediatrics / 23.06.2018
MedicalResearch.com Interview with: Melissa Lorenzo MD Pediatric medical resident Dr. Lorenzo is currently training at the University of Toronto, however the research was conducted while a medical student at Queens University MedicalResearch.com: What is the background for this study? Response: Preterm infants are born before 37 weeks gestation, with late preterm neonates defined as infants born between 34 weeks to 37 weeks gestation. Of all preterm births, over 70% of babies are born in the late preterm period. Late preterm births are common, affecting 12.5% of all births in the United States. Compared to infants born at term, late preterm neonates are at increased risk for many common complications following birth such as jaundice, low blood sugar, and respiratory distress, prolong hospital stay, admission to the neonatal intensive care unit, and increase readmission rate after hospital discharge. There are many causes for preterm delivery- two important ones are early onset of labour either spontaneous or after premature rupture of membranes, and medically indicated delivery prior to full term gestation due to chronic diseases in mother affecting her health in pregnancy, fetal medical reasons, or placental insufficiency. There is a debate that the risk of neonatal complications is affected by the causes of preterm delivery with immaturity acting as a contributing factor. The relative contribution of immaturity versus the reason for delivery and the resulting neonatal complications is unclear. (more…)
Author Interviews, CMAJ, OBGYNE / 19.06.2018
MedicalResearch.com Interview with: Giulia Muraca, PhD, MPH Postdoctoral Fellow School of Population and Public Health BC Children’s Hospital Research Institute Faculty of Medicine University of British Columbia MedicalResearch.com: What is the background for this study? What are the main findings? Response: While cesarean delivery rates have increased in Canada over the last few decades, as in most industrialized settings, the rate of forceps and vacuum deliveries have declined. These opposing trends have led to recommendations to increase forceps and vacuum delivery rates as a strategy to reduce cesarean delivery rates. We found that the rate of obstetric trauma in Canada increased significantly in recent years, especially among forceps deliveries. In first-time mothers, the rate of obstetric trauma increased by 7% among forceps deliveries (from 19.4% in 2004 to 26.5% in 2014) and in women who had a previous cesarean delivery, the rate of obstetric trauma among forceps deliveries increased by 9% (from 16.6% to 25.6%). We found that a 1% increase in the forceps and vacuum delivery rate in Canada was associated with approximately 700 additional cases of obstetric trauma and 18 additional cases of severe birth trauma annually among first-time mothers alone. (more…)
Author Interviews, Infections, OBGYNE, Pediatrics, Vaccine Studies / 17.06.2018
MedicalResearch.com Interview with: Sylvia Becker-Dreps, MD MPH Associate Professor, Department of Family Medicine Associate Director, Office of International Activities (Latin America Focus) Director, UNC Program in Nicaragua University of North Carolina at Chapel Hill Chapel Hill, NC 27599-7595 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pertussis (or whooping cough) is a respiratory infection caused by bacteria. It has been becoming more common in the US over the past two decades. Infants are more likely to be hospitalized and die of the disease. They are especially vulnerable in the first months of life because they have not yet had time to complete the DTaP vaccine series themselves. (Currently, infants receive 3 doses of DTaP at 2,4, and 6 months of age.) Immunizing mothers allows the mothers to pass antibodies against pertussis through the placenta and provide passive immunity to infants early in life. In early 2013, the CDC recommended that pregnant women receive a Tdap vaccine in every pregnancy. That recommendation was based on studies of the immune response to the vaccine, not real cases of pertussis. Our study examined clinical cases of pertussis in over 675,000 infants throughout the US. We found that in the first six months of life, infants of vaccinated mothers (those that received Tdap during pregnancy) had 75% less pertussis hospitalizations and 50% less pertussis cases overall. (more…)