Author Interviews, OBGYNE, Social Issues / 20.10.2017

MedicalResearch.com Interview with: Jennifer Buher Kane PhD Assistant Professor, Department of Sociology University of California, Irvine 92697-510  MedicalResearch.com: What is the background for this study? What are the main findings? Response: It’s not uncommon for new parents to relocate in search of neighborhoods with better schools, safer streets and healthier, more kid-friendly activities. But our new study found that living in such neighborhoods before a baby is born protects against the risks of poor birth outcomes. Published online this month in SSM – Population Health, the research shows that having highly educated, wealthy neighbors reduces an expectant mother’s risk of delivering a low-weight or preterm baby – health markers that can be associated with neurodevelopmental problems, language disorders, learning disabilities and poor health later in life. Our study is the first to look at how both the level of affluence and disadvantage — two sociologically distinct attributes of neighborhoods — affect newborn health; past studies have only explored the impact of neighborhood disadvantage. Neighborhood disadvantage signals factors such as poverty, unemployment, or underemployment. On the other hand, neighborhood affluence is thought to signal the presence of locally-based community organizations that can meet the needs of all residents – health-related and otherwise – regardless of one’s own socioeconomic resources. (more…)
Author Interviews, Diabetes, Heart Disease, JAMA, OBGYNE / 17.10.2017

MedicalResearch.com Interview with: Cuilin Zhang MD, PhD Senior Investigator Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health. Bethesda, MD 20817 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Gestational diabetes (GDM) is a common pregnancy complication. The American Heart Association identifies gestational diabetes as a risk factor for cardiovascular disease (CVD) in women, based on consistent evidence for the relationships between gestational diabetes and subsequent hypertension, dyslipidemia, type 2 diabetes, vascular dysfunction and atherosclerosis. Also, previous studies identify GDM as a risk factor for intermediate markers of CVD risk; however, few are prospective, evaluate hard cardiovascular disease end points, or account for shared risk factors including body weight and lifestyle. (more…)
Author Interviews, Lancet, OBGYNE / 06.10.2017

MedicalResearch.com Interview with: Jonathan Marc Bearak, PhD Senior Research Scientist Guttmacher Institute New York MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although U.S. women who live farther from abortion clinics are less likely to obtain one, no national study has examined inequality in women’s access to abortion and whether inequality in abortion access has increased as the number of abortion clinics have declined. We found that half of women live within 11 miles of an abortion provider. However, 1 in 5 women would need to travel at least 43 miles. We found substantially greater variation within than across states, because even in relatively rural states, women and clinics were concentrated in urban areas. These disparities have persisted since at least 2000. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, JAMA, OBGYNE / 03.10.2017

MedicalResearch.com Interview with: Andrew L. Beam, PhD Instructor in Biomedical Informatics Department of Biomedical Informatics Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study is one piece of a larger story regarding the use of 17-alpha-hydroxyprogesterone caproate (17P) to treat recurrent preterm birth. This drug was originally only available in a compounded form, but since receiving an orphan drug designation in 2011, a branded and manufactured form was marketed under the name "Makena". This branded form was then sold for a much higher price than the compounded version, but a study that provided concrete data on pricing and outcomes had not been done. (more…)
Author Interviews, Infections, OBGYNE, Pediatrics, Vaccine Studies / 03.10.2017

MedicalResearch.com Interview with: Tami H Skoff Centers for Disease Control and Prevention Atlanta, GeorgiaTami H Skoff Centers for Disease Control and Prevention Atlanta, Georgia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Infants are at greatest risk for severe pertussis (whooping cough) morbidity and mortality, especially during the first months of life before infant immunizations begin.  CDC and the Advisory Committee on Immunization Practices (ACIP) currently recommend that women receive a dose of Tdap during the third trimester of each pregnancy.  This recommendation has been in place since 2012.  By getting Tdap, pregnant women pass critical short-term protection to their unborn babies. This helps protect babies until they are old enough to start getting their own whooping cough vaccines at 2 months of age. The purpose of our study was to evaluate the effectiveness of maternal Tdap during pregnancy at preventing whooping cough in infants <2 months of age. In our evaluation, Tdap administration during the third trimester of pregnancy prevented more than 3 in 4 (78%) infant cases.  Additionally, Tdap vaccination during pregnancy was even more effective (90%) at preventing whooping cough serious enough that the baby had to get treatment in a hospital. (more…)
Author Interviews, Blood Pressure - Hypertension, JCEM, OBGYNE, Pediatrics, Weight Research / 28.09.2017

MedicalResearch.com Interview with: Duo Li, PhD Chief professor of Nutrition Institute of Nutrition and Health Qingdao University, China.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Childhood obesity is becoming an emerging public health issue worldwide, owing to its association with a variety of health problems at younger ages in adulthood, including obesity, type 2 diabetes and cardiovascular diseases. Identification of prenatal and early life risk factors is key for curbing the epidemic of the childhood obesity. Main finding of the present study is that among pregnant women, elevated blood pressure is associated with a greater risk of overweight and obesity for their children. (more…)
Author Interviews, Infections, JAMA, OBGYNE, Surgical Research, Weight Research / 20.09.2017

MedicalResearch.com Interview with: Dr. Carri R. Warshak, MD Associate Professor of Obstetrics & Gynecology University of  Cincinnati MedicalResearch.com: What is the background for this study? Response: Cesarean deliveries are the most common major surgical procedure performed in the United States.  A common complication of cesarean section is wound infections that can include infections in the skin and incision site, or infections in the uterus itself after delivery.  These complications can lead to prolonged hospitalization after delivery for antibiotics and even further surgery in severe infections.  Often these wound complications lead to delayed healing, wound opening which can sometimes take several weeks to heal. Studies have demonstrated as many as 12% of women experience a surgical site infection after delivery. Obesity is a strong risk factor for increased surgical site infections.  Increasing maternal weight increases the risk of wound complications, with a two to five fold increase in risk, making surgical site infections and common and concerning complication of cesarean delivery in obese women. (more…)
Author Interviews, JAMA, OBGYNE, Pediatrics, Smoking / 19.09.2017

MedicalResearch.com Interview with: Filippos Filippidis MD MPH PhD Lecturer in Public Health School of Public Health Imperial College London London MedicalResearch.com: What is the background for this study? What are the main findings? Response: Smoking kills millions of people every year. It is well established that increasing tobacco prices is the most effective way to reduce tobacco consumption and hence mitigate the devastating effects of tobacco on health. Taxation on tobacco products is high in the European Union, which makes cigarettes less affordable. However, transnational tobacco companies are known to manipulate prices, ensuring that cheap or ‘budget’ cigarettes are still available. This is particularly important for younger smokers and those of low socioeconomic status who are more sensitive in price increases. Smoking during pregnancy, as well as exposure of pregnant women and babies to cigarette smoke increase infant mortality. There is also evidence that increasing tobacco prices is associated with lower infant mortality. However, researchers typically use average or premium cigarette prices. We analysed 54 million births from 23 European Union countries to see if the differential between average priced and budget cigarettes (i.e. the availability of cigarettes much cheaper than average priced ones) is associated with infant mortality. We found that increasing average cigarette prices by 1 Euro per pack was associated with 0.23 fewer deaths per 1,000 live births in the same year and an additional 0.16 fewer deaths per 1,000 live births in the following year. A 10% increase in the price differential between budget and average priced cigarettes was associated with 0.07 more deaths per 1,000 live births the following year. This means that 3,195 infant deaths could potentially have been avoided in these 23 countries if there was no price difference between cigarette products over the 10-year study period. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, OBGYNE / 13.09.2017

MedicalResearch.com Interview with: Leslie V. Farland, ScD Assistant Director of Epidemiologic Research Center for Infertility and Reproductive Surgery Brigham and Women's Hospital | Harvard Medical School Instructor | Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: Endometriosis is chronic gynecologic condition that affects approximately ten percent of women. Women with endometriosis can experience painful menstrual periods, general chronic pelvic pain, and pain associated with intercourse. Currently we know very few modifiable risk factors for endometriosis. (more…)
Author Interviews, Autism, Environmental Risks, OBGYNE, Toxin Research, UC Davis / 12.09.2017

MedicalResearch.com Interview with: Rebecca J. Schmidt, M.S., Ph.D.  Assistant Professor, Public Health Sciences UC Davis California MedicalResearch.com: What is the background for this study? Response: Maternal folic acid taken near conception has been linked to reduced risk for autism in the child in previous studies. Separate studies show that exposure to pesticides during pregnancy is associated with increased risk for autism. Animal studies demonstrate that folic acid and other B-vitamins can attenuate effects of certain environmental contaminants, including pesticides. This case-control study examined combined maternal folic acid and pesticide exposures in relation to autism in the child. (more…)
Author Interviews, BMJ, Mental Health Research, OBGYNE, Pharmacology / 10.09.2017

MedicalResearch.com Interview with: Xiaoqin Liu, PhD Department of Economics and Business Economics Aarhus University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research on the long-term neurodevelopmental outcomes of serotonin-reuptake inhibitor (SSRI) use during pregnancy has primarily focused on offspring risk of autism spectrum disorder. Given SSRIs cross the placental barrier and affect the fetal brain, in-utero SSRI exposure may increase risks of other psychiatric disorders as well as autism spectrum disorder. We conducted a population-based study to look at a range of diagnostic groups of psychiatric disorders in children whose mothers used antidepressants during pregnancy. This was possible because of the nature of information available in Danish population registers, allowing us to follow children for many years. We found increased risks of various diagnostic groups of psychiatric disorders in children whose mothers continued antidepressant treatment during pregnancy, in comparison to children whose mothers stopped antidepressant treatment before pregnancy. (more…)
Author Interviews, Nature, OBGYNE, Pediatrics, Toxin Research / 05.09.2017

MedicalResearch.com Interview with: Ashley Larsen, PhD Assistant professor Bren School of Environmental Science & Management University of California, Santa Barbara MedicalResearch.com: What is the background for this study? What are the main findings? Response: The relationship between pesticides and adverse birth outcomes has been recognized as an important question for quite some time, and there have been many good studies on the topic. Since randomly exposing people to different levels of pesticides is clearly unethical, researchers focused on the health consequences of non-occupational pesticide exposure often have to choose between detailed studies that follow a couple hundred or couple thousand individuals through pregnancy or larger scale studies that use easier to observe, but less accurate metrics of pesticide exposure (e.g. nearby crops or crop types). Here we tried to provide complementary insight by bridging the gap between detail and scale using detailed pesticide use data and individual birth certificate records for hundreds of thousands of births in an agriculturally dominated region of California. While we found negative effects of pesticide use on birth outcomes including low birth weight, preterm birth and birth abnormalities, these effects were generally in the magnitude of a 5-9% increase in probability of an adverse outcome, and only observed for individuals exposed to very high levels of pesticides. (more…)
Author Interviews, BMC, OBGYNE, Pediatrics / 05.09.2017

MedicalResearch.com Interview with: Jan Alexander, MD,PhD Norwegian Institute of Public Health Oslo Norway  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for this study was the widespread uncertainty and general concern among the public about increasing exposure to weak radio frequency electromagnetic fields (EMF-RF). The concern on whether using your cell phone while pregnant can harm your foetus are mainly due to the extensive use of cell phones, that emit EMF-RF. Even though the RF-EMF exposure that may reach the foetus is very low, evidence from previous epidemiological studies with mothers and children are inconsistent as to whether EMF-RF emission from cell phone might harm the developing brain of the foetus. This includes also animal experiments where the exposure may be very different from that in humans. We therefore studied the association between maternal cell phone use during pregnancy and child’s neurodevelopment at 3 and 5 years. We included around 45,000 mother and their children from all over Norway from the Norwegian Mother and Child Study (MoBa study) and used language development as the outcome because we in previous studies found this parameter to be sensitive to exposure to neurotoxicants. T here was no evidence of a harmful effect of the mother using her cell phone during pregnancy on her child’s neurodevelopment at 3 and 5 years. Surprisingly, we even found that the more the mother was using her cell phone during pregnancy the better language and motor skills her child had at 3 years of age. We observed no associations when the child was 5 years old. (more…)
OBGYNE, Pediatrics, Weight Research / 30.08.2017

MedicalResearch.com Interview with: Leanne M. Redman MS, PhD LPFA Endowed Fellowship Associate Professor Pennington Biomedical Research Center Baton Rouge, Louisiana  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Two well-documented risk factors for aberrant weight gain and obesity is whether your mother was obese when she was pregnant and the amount of weight she gained. Up until now few studies have asked questions about whether the pattern of weight gain in pregnancy affect outcomes in offspring, such as birth weight. In a cohort of over 16,000 pregnant women and infants, we found that regardless of the obesity status (BMI) of the mother at the time of pregnancy, weight gain that occurs up until week 24, had the strongest effect on infant birth weight. Infants born to mothers who had weight gain in excess of the 2009 IOM guidelines from conception until week 24, had a 2.5 times higher likelihood of being born large for gestational age. The weight gain that occurred after 24 weeks until delivery, did not attenuate this risk. (more…)
Author Interviews, OBGYNE, PLoS, Weight Research / 23.08.2017

MedicalResearch.com Interview with: Prof. Deborah A Lawlor MSc(Lond), MBChB, PhD(Bristol), MPH(Leeds), MRCGP, MFPHM Professor of Epidemiology MRC Integrative Epidemiology Unit at the University of Bristol NIHR Bristol Biomedical Research Centre Population Health Sciences, Bristol Medical School Oakfield House, Oakfield Grove, Bristol MedicalResearch.com: What is the background for this study? What are the main findings? Response: As the obesity epidemic has occurred there has been increasing concern about pregnant women being more adipose (having higher levels of fat) during their pregnancy. One particular concern is that women who are on average fatter will have more extreme changes in pregnancy on their lipid, fatty acid, amino acid and glucose levels. In normal ‘healthy’ pregnancy these metabolites increase during pregnancy as part of the physiological response to pregnancy which ensures that the developing fetus has sufficient fuel (nutrients – fats, proteins, sugars) for healthy growth and development. Women who are more adipose tend to have a more extreme change in these fuels and as a consequence the developing fetus is ‘overfed’. There is a linear relationship between a pregnant woman’s body mass index and her infants birth weight, such that each increment greater adiposity (body mass index) of the mother there is on average and increment greater infant birth weight. Recently, using a method that uses genetic variants (Mendelian randomization) we have shown that this association is likely to be causal (JAMA 2016). But whether there is a lasting effect on offspring health of being overfed in the uterus is unknown. There are concerns that there will be a lasting effect and that for daughters of more adipose women, this would mean that they go into their pregnancies on average fatter and with higher levels of the metabolites that could then overfeed their developing fetus. If this were the case it would mean the obesity epidemic could be accelerated across generations. There are associations of mothers body mass index with later offspring body mass index, BUT this might not be anything to do with developmental overfeeding of the feeding in the uterus – it could simply reflect shared lifestyles that offspring adopt from their mother (and father) or shared genetic effects. In this study we tried to separate out whether there was evidence for a long-term offspring effect on their lipids, fatty acids, amino acids, glucose, and an inflammatory marker, of having a mother who was on average fatter during her pregnancy that was due to overfeeding in the uterus, as opposed to shared family lifestyle and genetics. We did this by comparing associations of mothers pre-pregnancy BMI with offspring outcomes to the same associations of fathers pre-pregnancy BMI with the same outcomes. Our assumption here was that fathers BMI could not directly result in overfeeding of the fetus and so if the associations were similar this would suggest that they were largely driven by family factors. (more…)
Author Interviews, Cancer Research, OBGYNE, PLoS / 11.08.2017

MedicalResearch.com Interview with: Jane McElroy, Ph.D. Associate professor Department of Family and Community Medicine MU School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: More than 31,000 new cases of endometrial cancer are expected to be diagnosed in 2017. Through a five-year observational study, we found that women with increased levels of cadmium had an increased risk of endometrial cancer. Cadmium is a metal commonly found in foods such as kidneys, liver and shellfish as well as tobacco It’s a finding we hope could lead to new treatments or interventions to prevent the fourth most common cancer in women. (more…)
Author Interviews, OBGYNE, Pediatrics / 21.07.2017

MedicalResearch.com Interview with: Parvati Singh B. Tech, MBA, MPA PhD student, Department of Public Health, University of California, Irvine and Dr. Tim Bruckner, first author MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study builds upon earlier research by our group which showed that male fetal deaths rose and the number of liveborn males fell after the 9/11 attacks. Here we show that, in California, the number of live born males with birth defects fell after 9/11. This finding appears consistent with the notion that frail male gestations, such as those with defects, may have been lost in utero as a result of the stress induced by the 9/11 attacks. (more…)
Author Interviews, BMJ, Exercise - Fitness, OBGYNE, Weight Research / 20.07.2017

MedicalResearch.com Interview with: Shakila Thangaratinam Professor of Maternal and Perinatal Health Joint Director of BARC (Barts Research Centre for Women's Health) Women's Health Research Unit | Multidisciplinary Evidence Synthesis Hub (MESH) Barts and the London School of Medicine and Dentistry R & D Director for Women's Health Queen Mary University of London  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pregnant women who are overweight or obese, or who gain excess weight gain in pregnancy are at high risk of complications. We wanted to find
  1. If healthy diet and physical activity in pregnancy reduced weight gain, and improved outcomes for the mother and baby
  2. If the effects of the interventions differed according to the characteristics of the mother such as body mass index, parity, ethnicity, and underlying medical condition
We established a network (International Weight Management in Pregnancy i-WIP) of researchers from 16 countries, and 41 institutions to answer the above. We found that women who followed a healthy diet and moderate physical activity gained less weight in pregnancy than other women; this beneficial effect was observed irrespective of mother's body mass index, parity, ethnicity, and underlying medical condition. Diet and physical activity in pregnancy has a beneficial effect on weight gain in pregnancy, and lowers the odds of caesarean section, and gestational diabetes. (more…)
Author Interviews, OBGYNE, Pediatrics / 19.07.2017

MedicalResearch.com Interview with: Francesca Volpe Psy.D and Prof. Vincenzo Zanardo Division of Perinatal Medicine, Policlinico Abano Terme Abano Terme, ItalyFrancesca Volpe Psy.D and Prof. Vincenzo Zanardo Division of Perinatal Medicine, Policlinico Abano Terme Abano Terme, Italy MedicalResearch.com: What is the background for this study? What are the main findings? Response: Newborn infants, placed skin-to-skin on their mother’s chest instinctively have the ability to crawl to their mother’s breast, exploring with their hands and massaging the breast to support the first feed.  Left undisturbed, the infant will make several attempts until it finds and latches onto the nipple and begins to nurse. What leads mammalian infants who are placed on their mothers’ chests to seek out, without any assistance, the nipple and to attach themselves to it to nurse is not fully understood. When we turned our attention to the thermal properties of the female’s nipple-areolar complex (NAC) in lactating mothers soon after birth, we found that it had a higher temperature and pH value and lower elasticity with respect to the surrounding breast skin. We hypothesised that the higher temperature could help the newborn infant to locate the nipple and to latch onto it, leading to the first sucking experience.  In addition, the diffusion of odorous molecules is presumably enhanced by the relatively high surface temperature of the areola in view of the rich supply of blood capillaries that irrigate the region. There is, in fact, some scientific evidence that show that infants respond to the odours released by the breasts of lactating women; breast odours, which are enhanced by the skin’s greater warmth, are another factor that facilitates breastfeeding by helping the infant to recognize its mother participating in the mother-to-infant bonding. (more…)
Author Interviews, CDC, OBGYNE, Pediatrics, Race/Ethnic Diversity / 17.07.2017

MedicalResearch.com Interview with: Dr. Erica H. Anstey PhD Division of Nutrition, Physical Activity and Obesity National Center for Chronic Disease Prevention and Health Promotion Immunization Services Division National Center for Immunization and Respiratory Diseases CDC MedicalResearch.com: What is the background for this study? Response: The American Academy of Pediatrics (AAP) recommends that infants are breastfed exclusively for about the first 6 months and that breastfeeding continue for at least 12 months, and thereafter for as long as mother and baby desire. Although breastfeeding initiation and duration rates have increased overall in the United States, breastfeeding rates vary by geographic location, socioeconomic, and race/ethnic groups. Breastfeeding initiation and duration have been historically and consistently lower among black infants compared with white and Hispanic infants. There are many factors that influence a woman’s decision to start and continue breastfeeding. These include knowledge about breastfeeding, cultural and social norms, family and social support, and work and childcare environments. Some barriers to breastfeeding are disproportionately experienced by black women, including earlier return to work, inadequate receipt of breastfeeding information from providers, and lack of access to professional breastfeeding support. (more…)
Author Interviews, OBGYNE, Testosterone / 23.06.2017

MedicalResearch.com Interview with: David M. Kristensen, PhD Assistant Professor                                                                                                         Novo Nordisk Foundation Center for Protein Research Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3A, DK-2200 Copenhagen, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have demonstrated that a reduced level of testosterone during fetal life by paracetamol means that male characteristics do not develop as they should. This also affects sex drive. In the trial, mice exposed to paracetamol at the foetal stage were simply unable to copulate in the same way as our control animals. Male programming had not been properly established during their foetal development and this could be seen long afterwards in their adult life. Moreover, the area of the brain that controls sex drive - the sexual dimorphic nucleus - had half as many neurons in the mice that had received paracetamol as the control mice. The inhibition of testosterone seem to have led to less activity in an area of the brain that is significant for male characteristics. (more…)
Author Interviews, Nutrition, OBGYNE, Pediatrics, Weight Research / 19.06.2017

MedicalResearch.com Interview with: Cuilin Zhang MD, PhD Senior Investigator, Epidemiology Branch Division of Intramural Population Health Research NICHD/National Institutes of Health Bethesda, MD 20817  MedicalResearch.com: What is the background for this study? Response: Refined grains with a high glycemic index and reduced fiber and nutrient content have been linked to increased adiposity and higher risk of metabolic syndrome among adults. Despite these differences and the growing body of literature on the link between maternal diet/nutrition during pregnancy and subsequent offspring health consequences throughout the lifespan, little is known about the intergenerational impact of refined-grain intake during pregnancy on long-term cardio-metabolic outcomes in the offspring. (more…)
Author Interviews, Depression, OBGYNE, Pharmacology / 19.06.2017

MedicalResearch.com Interview with: Samantha Meltzer-Brody, MD, MPH Associate Professor and Associate Chair for Faculty Development Director, Perinatal Psychiatry Program Director, Taking Care of Our Own Program Department of Psychiatry Chapel Hill, NC 2759  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Lancet published results from a randomized, placebo-controlled, phase 2 clinical trial with the investigational medication, brexanolone, for women with severe postpartum depression (PPD). During the study, which was conducted at multiple sites across the country, physician researchers administered brexanolone in 21 women, 10 of whom were administered a 60-hour infusion of brexanolone. The other 11 women were given a placebo. Results from the trial showed that 70 percent of participants who received the drug saw remission of their PPD symptoms within 60 hours of treatment, an effect that was maintained until the 30-day follow up. (more…)
Author Interviews, Fertility, OBGYNE / 15.06.2017

MedicalResearch.com Interview with: Prof. Dr. João Martins Pisco MD PhD Radiologia de Intervenção Hospital Saint Louis - Rua Luz Soriano PortugalProf. Dr. João Martins Pisco MD PhD Radiologia de Intervenção Hospital Saint Louis - Rua Luz Soriano Portugal MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for the study is the good results I started to check in patients with uterine fibroids who could conceive a successful pregnancy with live birth following embolization. MedicalResearch.com: What should readers take away from your report? Response: The readers should know that fertility can be restored following embolization of uterine fibroids, particularly if the embolization is partial. The wish of conception in patients with uterine fibroids is not a contraindication for fibroids embolization. (more…)
Author Interviews, JAMA, Lifestyle & Health, OBGYNE, Weight Research / 07.06.2017

MedicalResearch.com Interview with:   Professor Helena Teede MBBS, FRACP, PhD Executive Director Monash Partners Academic Health Research Translation Centre Director Monash Centre for Health Research and Implementation Monash University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Reproductive aged women are gaining weight rapidly both before and during pregnancy. Here in 1.3 million pregnancies internationally we show that almost 3 in 4 have unhealthy weight gain (half with excess weight gain and one quarter with inadequate gain) MedicalResearch.com: What should readers take away from your report? Response: For women establish your healthy weight for your height and try to stay within this for better fertility, pregnancy and for your and your child's health. Regardless of your starting weigh,  aim to gain within targets in pregnancy. Seek help to do so. For health professionals: unhealthy weight gain in pregnancy is now the norm, we must monitor women in pregnancy wand support them to gain healthy weight for better health outcomes. Weighing is not enough with health professionals needing skills in healthy conversations and support strategies for women. For governments and policy makers this life stage around pregnancy is an optimal time to tackle obesity prevention and is targeted by WHO. (more…)
Author Interviews, CMAJ, OBGYNE / 05.06.2017

MedicalResearch.com Interview with: Giulia Muraca, MPH, PhD(c) Vanier Canada Graduate Scholar School of Population and Public Health Child & Family Research Institute Faculty of Medicine University of British Columbia  MedicalResearch.com: What is the background for this study? Response: The rate of cesarean delivery has increased dramatically over the last 30 years. And in an effort to curb the rising trend in caesarean delivery, The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine have recently advocated for increased use of operative vaginal delivery (forceps/vacuum delivery) as a strategy to reduce the cesarean delivery rate. The evaluation of approaches to achieve this end are underway and the current discourse surrounding operative vaginal delivery centers on methods to promote these important skills. But, the truth is, we don’t yet fully understand the balance of risks and benefits to mothers and their babies following operative vaginal delivery compared with caesarean delivery. The preferred choice given these two options relies heavily on how far the baby’s head has descended in the birth canal. If the baby’s head has descended far enough that it is visible and on the perineum, then the use of an instrument has clear advantage. However, when the fetal head is engaged in the maternal pelvis, but has not descended so far down the birth canal, the decision between these modes of delivery becomes much less clear. These deliveries are called midpelvic deliveries. And it’s an increase in these midpelvic deliveries that would have the most potential as a strategy to reduce the cesarean delivery rate, and as a result, it is these deliveries that we were interested in studying. Operative vaginal deliveries are carried out in approximately 14% of all term births in Canada and those that occur when the baby is at midpelvic station account for over 20% of all operative vaginal deliveries. This translates to about 2-3% of all term, singleton deliveries in Canada or about 10,000 deliveries per year overall. The literature on perinatal and maternal outcomes contrasting midpelvic operative vaginal delivery and caesarean delivery is based on studies undertaken 25 to 30 years ago that are no longer reflective of the current obstetric practice.  This was the impetus for our study. We reasoned that before we decide to encourage increased OVD we should first get a sense of the safety of such procedures compared to cesarean delivery as provided by contemporary maternity care providers. (more…)
Author Interviews, CDC, Flu - Influenza, OBGYNE, Vaccine Studies / 31.05.2017

MedicalResearch.com Interview with: Dr. Elyse Olshen Kharbanda, MD MPH HealthPartners Institute Minneapolis, MN MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pregnant women who get the flu are at an increased risk for severe illness. To protect pregnant women, the Advisory Committee on Immunization Practices recommends women receive inactivated influenza vaccine (IIV) during any trimester of their pregnancy. This study used data from the Vaccine Safety Datalink to evaluate if there was an increased risk for selected major structural birth defects for infants whose mothers received IIV in the first trimester of pregnancy versus infants who were unexposed to IIV. Among over 425,000 live births, including 52,856 whose mothers received IIV during first trimester, we evaluated risks for major structural birth defects.  In this large observational study, we did not observe increased risks for major structural birth defects in offspring following first trimester maternal inactivated influenza vaccine exposure. (more…)
Author Interviews, OBGYNE, PLoS / 31.05.2017

MedicalResearch.com Interview with: Sarka Lisonkova, MD, PhD Assistant Professor, Department of Obstetrics and Gynaecology, University of British Columbia. Children’s and Women’s Health Centre MedicalResearch.com: What is the background for this study? What are the main findings? Response: Adverse fetal and infant outcomes associated with maternal age were known and our study confirms that the risk of fetal and neonatal death and severe neonatal morbidity increases among mothers over 30 years. We also knew that older mothers are more likely to have hypertension, diabetes, and other chronic diseases, and they are more likely to develop gestational diabetes, hypertension during pregnancy, and preeclampsia. These complications may put the fetus or newborn at risk, but are generally not considered to be potentially life threatening to the mother. Our study adds new information on the rates of severe maternal morbidities that have a high case-fatality rate, lead to organ damage, or have serious health implications such as hysterectomy. Our study also adds the information on the rates of any severe adverse birth outcome - for baby or mom - in the association with maternal age, which is important for counseling. Women usually want to know ‘what are the chances that anything bad happens’. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, OBGYNE, Stroke / 27.05.2017

MedicalResearch.com Interview with: Eliza Miller, M.D. Vascular neurology fellow New York-Presbyterian Hospital/Columbia University Medical Center New York City  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Preeclampsia is a common disorder that causes high blood pressure during pregnancy. It affects about 1 in 20 pregnant women. Women with preeclampsia are at higher risk for stroke during pregnancy and post-partum, but it’s very difficult to predict who is going to have a stroke. Our study looked at a large dataset of billing data from New York State, and compared women who had preeclampsia and strokes to women who had preeclampsia but did not have a stroke. We found that preeclamptic women with urinary tract infections, bleeding or clotting disorders, or preexisting high blood pressure were at higher risk of having strokes during pregnancy or postpartum. (more…)