Author Interviews, OBGYNE / 05.04.2017

MedicalResearch.com Interview with: Alain Chedotal, PhD Group Leader, Institut de la Vision (Inserm/UPMC/CNRS), Paris and Sylvain Berlemont, PhD CEO & Founder of Keen Eye Technologies, Incubateur Institut de la Vision, Paris MedicalResearch.com: What is the background for this study? What are the main findings?Response: What was known about human embryo development was based on histological techniques developed at the beginning of the twentieth century and no significant progress had been made for about fifty years. A few years ago our team found a method allowing to perform immunostaining on whole-mouse embryos and adult mouse brains. Complete 3D images of the intact samples could be obtained after they were cleared with solvents and imaged with a light sheet microscope. In this new study we have adapted this method to human embryos during the first trimester of gestation. We provide for the first time high-resolution 3D images of the developing peripheral nervous, muscular, vascular, cardiopulmonary, and urogenital systems. We found evidence for important in differences in the embryonic pattern of nerve branches between the right and left hands. We also present evidence for a differential vascularization of the male and female genital tracts concomitant with sex determination. (more…)
Author Interviews, Fertility, OBGYNE, Omega-3 Fatty Acids, Weight Research / 04.04.2017

MedicalResearch.com Interview with: Alex J. Polotsky, MD Associate Professor of Obstetrics and Gynecology University of Colorado Denver Practice homepageMedicalResearch.com: What is the background for this study? What are the main findings? Response: It has been well established that profound dietary changes occurred over the past 100 years. The type and amount of fat consumed has changed quite a bit over the course of 20th century. Intake of omega-3 polyunsaturated fatty acids (PUFAs), previously consumed in large quantities by humans from vegetable and fish sources, has dropped significantly. The typical Western diet (sometimes also called the typical American diet) provides an omega-6 to omega-3 fatty acid ratio of as high as 25:1, which is quite different from what it used to up until about the 19th century (believed to be about 1:1 ratio). In animal studies, diets enriched with omega-3 PUFA enhance early embryonic development and boost progesterone secretion. Obesity is well known to be associated with decreased progesterone production in women (even if a obese woman ovulates). The reasons for this are not clear. Obesity is also a state of low-grade chronic inflammation. Omega-3 fatty acids are well known to have anti-inflammatory properties. We sought to test whether dietary supplementation with omega-3 PUFA favorably affects reproductive hormones in women and whether this effect includes normalization of progesterone production in obesity. All women in the study tolerated supplementation well, and had significantly decreased their omega-6 to omega-3 ratios (they were normalized much closer to a 1:1 ratio). Omega-3 supplementation resulted in a trend for increased progesterone in obese women, thus enhancing ovulatory function. A 16 to 22 percent increase was observed. Additionally, the supplementation resulted in reduced systemic inflammation. (more…)
Author Interviews, HPV, NEJM, OBGYNE, Vaccine Studies / 30.03.2017

MedicalResearch.com Interview with: Anders Hviid Senior Investigator, M.Sc.,Dr.Med.Sci. Department of Epidemiology Research Division of National Health Surveillance & Research MedicalResearch.com: What is the background for this study?Response: HPV vaccination targeting girls and young women has been introduced in many countries throughout the world. HPV vaccines are not recommended for use in pregnancy, but given the target group, inadvertent exposure will occur in early unrecognized pregnancies. However, data on the safety of HPV vaccination in pregnancy is lacking. (more…)
Author Interviews, Cost of Health Care, Fertility, OBGYNE / 29.03.2017

MedicalResearch.com Interview with:Emily S. Jungheim, MD, MSCI Assistant Professor, Obstetrics and Gynecology Division of Reproductive Endocrinology and Infertility Washington University St. Louis, Missouri MedicalResearch.com: What is the background for this study? What are the main findings?Response: Many women with health insurance lack coverage for fertility treatment so they end up being self-pay for fertility treatments which can be expensive and limit access to care. 15 states have responded with mandates for employers to include fertility coverage in their employee insurance benefits, and 5 of these have comprehensive mandates that include IVF. Illinois is one of these states. Washington University is located on the border between Illinois and Missouri so our fertility center treats a number of women with coverage for fertility treatment and a large number of women who are self-pay for fertility treatment. We suspected that women requiring IVF to conceive were more likely to follow through with treatments if they had coverage so we decided to look at our data. Ultimately we confirmed our suspicions. Women with coverage were more likely to come back for additional cycles of IVF if they didn't conceive. Ultimately this ability to come back for additional treatment cycles led to a higher chance of live birth. (more…)
Author Interviews, Cancer Research, JAMA, OBGYNE, Pediatrics / 27.03.2017

MedicalResearch.com Interview with: Hazel B. Nichols, PhD, UNC Assistant professor Lineberger Comprehensive Cancer Center member UNC Gillings School of Global Public Health. MedicalResearch.com: What is the background for this study?Response: Each year more than 45,000 adolescent and young adult women (AYA, ages 15-39 years) are diagnosed with cancer in the United States. While many of these women may wish to have children in the years following diagnosis, there is currently little information available to address their concerns about the impact of cancer diagnosis and treatment on future pregnancy. We identified >2,500 women who had a child after their cancer diagnosis using data from the North Carolina Central Cancer registry and statewide birth certificate files. We investigated whether adverse birth outcomes, such as preterm birth and low birth weight, were more common among AYA cancer survivors compared to women without cancer. We also looked at infant Apgar scores, which measure newborn health, and a calculation called small-for-gestational age, which can indicate restricted growth during pregnancy. (more…)
Author Interviews, Johns Hopkins, OBGYNE, Pediatrics / 16.03.2017

MedicalResearch.com Interview with: Krishna K. Upadhya, M.D., M.P.H. Division of General Pediatrics & Adolescent Medicine Department of Pediatrics Johns Hopkins University School of Medicine Baltimore, MD 21287 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study reviewed medical literature to examine the question of whether minor teens should be treated differently from older women with regard to a future over the counter oral contraceptive product. Our analysis found that oral contraceptive pills are safe and effective for teens and there is no scientific rationale to restrict access to a future oral contraceptive pill based on age. (more…)
Author Interviews, Endocrinology, Lancet, OBGYNE, Pediatrics, Vitamin D / 07.03.2017

MedicalResearch.com Interview with: Audry H. Garcia PhD Scientist Department of Epidemiology Erasmus MC, University Medical Center Rotterdam Rotterdam, the NetherlandsMedicalResearch.com: What is the background for this study? Response: Fetal bone mineralisation requires an adequate transfer of calcium to the fetus by the end of the pregnancy. Considering that vitamin D is required to maintain normal blood concentrations of calcium, adequate 25-hydroxyvitamin D (25[OH]D) concentrations in pregnant women seem to be crucial for bone development of the offspring. Maternal vitamin D deficiency during pregnancy has been associated with abnormal early skeletal growth in offspring and might be a risk factor for decreased bone mass in later life.Several studies have linked vitamin D deficiency in fetal life to congenital rickets, craniotabes, wide skull sutures and osteomalacia. However, the evidence of long-lasting effects of maternal vitamin D deficiency during pregnancy on offspring’s skeletal development is scarce and inconsistent, and has led to contradictory recommendations on vitamin D supplementation during pregnancy. (more…)
Author Interviews, NEJM, OBGYNE, Thyroid Disease, UT Southwestern / 01.03.2017

MedicalResearch.com Interview with:Professor Brian Casey, M.D. Gillette Professorship of Obstetrics and Gynecology UT Southwestern Medical CenterMedicalResearch.com: What is the background for this study? Response: For several decades now, subclinical thyroid disease, variously defined, has been associated with adverse pregnancy outcomes. In 1999, two studies are responsible for increasing interest in subclinical thyroid disease during pregnancy because it was associated with impaired neuropsychological development in the fetus. One study showed that children born to women with the highest TSH levels had lower IQ levels. The other showed that children of women with isolated low free thyroid hormone levels performed worse on early psychomotor developmental tests. Together, these findings led several experts and professional organizations to recommend routine screening for and treatment of subclinical thyroid disease during pregnancy. Our study was designed to determine whether screening for either of these two diagnoses and treatment with thyroid hormone replacement during pregnancy actually improved IQ in children at 5 years of age. (more…)
Author Interviews, BMJ, Flu - Influenza, Karolinski Institute, OBGYNE, Pediatrics, Pharmacology / 01.03.2017

MedicalResearch.com Interview with: Dr. Sophie Graner Department of Women's and Childrens Health Karolinska Institute, Stockholm, Sweden MedicalResearch.com: What is the background for this study? What are the main findings?Response: Pregnant women are at increased risks of severe disease and death due to influensa infection, as well as hospitalization. Also influenza and fever increase the risk of adverse pregnancy outcomes for their infants such as intrauterine death and preterm birth. Due to this, the regulatory agencies in Europe and the US recommended post exposure prophylaxis and treatment for pregnant women with neuraminidase inhibitors during the last influenza pandemic 2009-10. Despite the recommendations, the knowledge on the effect of neuraminidase inhibitors on the infant has been limited. Previously published studies have not shown any increased risk, but they have had limited power to assess specific neonatal outcomes such as stillbirth, neonatal mortality, preterm birth, low Agar score, neonatal morbidity and congenital malformations. (more…)
Author Interviews, OBGYNE, Pediatrics / 28.02.2017

MedicalResearch.com Interview with:Dr. Alison McFadden, PhD Senior Research Fellow School of Nursing & Health Sciences University of Dundee MedicalResearch.com: What is the background for this study? What are the main findings?Response: The World Health Organization recommends that infants should be breastfed exclusively until six months of age with breastfeeding continuing as an important part of the infant’s diet until he or she is at least two years old. Breastfeeding has an important impact on the short-term and long-term health of both infants and their mothers. There is good evidence that not breastfeeding increases mortality and morbidity due to infectious diseases. Not breastfeeding is also associated with increases in hospitalisation for problems such as gastroenteritis, respiratory disease, and ear infections, as well as higher rates of childhood diabetes, obesity and dental disease. Breastfeeding is also important for women’s health. It’s been found that not breastfeeding is associated with increased risks of breast and ovarian cancer, and diabetes. Few health behaviours have such a broad-spectrum and long-lasting impact on population health, with the potential to improve life chances, health and well-being. It has been estimated that each year, 823,000 deaths in children under five years and 20,000 deaths from breast cancer could be prevented by near universal breastfeeding. However, many women stop breastfeeding before they want to as a result of the problems they encounter. Current breastfeeding rates in many countries do not reflect the WHO recommendation. Only around 37% of babies under six months worldwide are exclusively breastfed, and in many high and middle income countries, the rates are much lower. Good care and support may help women solve these problems so that they can continue to breastfeed. (more…)
Author Interviews, Exercise - Fitness, Gender Differences, Menopause, OBGYNE, PLoS / 28.02.2017

MedicalResearch.com Interview with: Dr. Eija K. Laakkonen PhD Assistant professor Gerontology Research Center Faculty of Sport and Health Sciences University of Jyväskylä MedicalResearch.com: What is the background for this study? Response: Physical activity improves health and may delay the onset of chronic diseases. For women in particular, the rate of some chronic diseases accelerates at middle age around the time of menopause; therefore it is important to identify the determinants of health-enhancing physical activity during midlife in this population. The main aim of this study was to characterize the level of physical activity and to examine the association between different female reproductive factors and objectively-measured physical activity in middle-aged women. The reproductive factors included cumulative reproductive history index, and perceived menopausal and pelvic floor dysfunction symptoms. (more…)
Author Interviews, Mental Health Research, OBGYNE, Pediatrics / 24.02.2017

MedicalResearch.com Interview with: Shannon K. de l’Etoile, Ph.D., MT-BC Associate Dean of Graduate Studies Professor, Music Therapy University of Miami Phillip and Patricia Frost School of Music Coral Gables, FL MedicalResearch.com: What is the background for this study?Response: Infant-directed (ID) singing allows infants to have emotionally-synchronized interactions with caregivers, during which they gain valuable experience in self-regulation. Maternal depression can disrupt mother-infant interaction, thus hindering infants’ efforts at self-regulation and possibly contributing to a depressed interaction style that can generalize to infant interaction with strangers. Additionally, maternal depression can alter the acoustic parameters of ID singing, such that mothers may not modify musical elements (i.e., tempo and key), to accommodate infant state. (more…)
Author Interviews, Environmental Risks, Global Health, OBGYNE, Pediatrics / 18.02.2017

MedicalResearch.com Interview with: Chris Malley PhD The Stockholm Environment Institute University of YorkMedicalResearch.com: What is the background for this study? Response: When a baby is born preterm (at less than 37 weeks of gestation, an indicator of premature birth), there is an increased risk of infant death, or long-term physical and neurological disabilities. For example, 965,000 infant deaths in 2013 (35% of all neonatal deaths) have been estimated to be due to preterm birth complications. In 2010, an estimated 14.9 million births were preterm – about 4–5% of the total in some European countries, but up to 15–18% in some African and South Asian countries. The human and economic costs are enormous. There are many risk factors for preterm birth – from the mother’s age, to illness, to poverty and other social factors. Recent research has suggested that exposure to air pollution could also be a risk factor. Our study quantifies for the first time the global impact of pregnant women's exposure to outdoor fine particulate matter (PM2.5) by combining data about air pollution in different countries with knowledge about how exposure to different levels of air pollution is associated with preterm birth rates. (more…)
Author Interviews, Diabetes, OBGYNE / 18.02.2017

MedicalResearch.com Interview with: Dr Sophie Jacqueminet Praticien Hospitalier Service de Diabétologie Pole Cardio Métabolisme Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix MedicalResearch.com: What is the background for this study? What are the main findings?Response: The proportion of women who are overweight or obese is increasing in almost all countries worldwide, and this is being accompanied by an increased risk of developing both type 2 diabetes (T2D) (whether pregnant or not) and gestational diabetes (GDM). While other studies have analysed the links between GDM and adverse outcomes in babies, very large studies that draw on an entire national database, study, are rare. In our research, all 796,346 deliveries taking place after 22 weeks in France in 2012 were included by extracting data from the hospital discharge database and the national health insurance system. Outcomes were analysed according to the type of diabetes and, in the GDM group, whether or not diabetes was insulin-treated. The cohort of 796,346 deliveries involved 57,629 (7.24%) mothers with gestational diabetes mellitus. Data linking the mother to the child were available for 705,198 deliveries (88% of the total). The risks of adverse outcomes were two to four times higher for babies of mothers with type 2 diabetes before pregnancy (pregestational diabetes) than for those with GDM. We then adjusted our data, limiting the analysis to deliveries after 28 weeks to ensure all women diagnosed with GDM were included (since diagnosis of GDM in most cases takes place at or after 28 weeks). Following adjustment, the increased risk of various complications for mothers with gestational diabetes versus mothers without GDM were: preterm birth 30%; Caesarean section 40%; pre-eclampsia/eclampsia 70%; babies born significantly larger than average size (macrosomia) 80%; respiratory distress 10%; birth trauma 30%; and cardiac malformations 30%. While these increased risks combine women with both insulin- and diet-treated GDM, most of the increased risk is found in women with insulin-treated GDM. This is because as stated above, the diabetes is more serious and blood sugar more difficult to control in women who need insulin treatment, resulting in a higher risk of complications than in those women treated with diet only. (more…)
Author Interviews, NEJM, OBGYNE, Pediatrics / 17.02.2017

MedicalResearch.com Interview with: Carla M. Bann, Ph.D. Division of Statistical and Data Sciences RTI International Research Triangle Park, NC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Several medical advances have been made over the past two decades to improve the care and survival of infants born pre-term. However, approaches to care differ greatly among providers for infants born at the limits of viability (22 to 24 weeks gestation), far earlier than the 40 weeks generally expected for a pregnancy to reach full-term. Little is known about the outcomes of these infants, particularly whether those who survive experience significant neurodevelopmental impairments. RTI served as the data coordinating center for this research that examined the survival and neurodevelopmental impairment at 18-22 months corrected age of over 4,000 infants born at 22 to 24 weeks gestation during 2000 to 2011 at medical centers participating in a national research network funded by the NIH. In this group of babies, infant survival improved over time from survival rates of 30 percent in 2000-2003 to 36 percent in 2008-2011. The proportion of infants who survived without a neurodevelopmental impairment also increased from 16 percent in 2000-2003 to 20 percent in 2008-2011. (more…)
Author Interviews, Depression, JAMA, OBGYNE / 17.02.2017

MedicalResearch.com Interview with: Lisa Underwood, PhD Research Fellow| Centre for Longitudinal Research Growing Up in New Zealand | Who are Today’s Dads? School of Population Health, Faculty of Medical & Health Sciences University of Auckland Auckland MedicalResearch.com: What is the background for this study? What are the main findings?Response: This study is part of the contemporary, longitudinal study Growing Up in New Zealand, which is tracking the development of more than 6000 children born in 2009 and 2010. In previous reports we investigated antenatal and postnatal depression symptoms among the mothers of our cohort children. In this study we looked at the partners of those mothers to explore whether men and women have different risks for depression in each perinatal period. Our main findings were that expectant fathers were at risk if they felt stressed or were in poor health. Elevated depression symptoms following their child’s birth, were also linked to social and relationship problems. The strongest predictor of postnatal paternal depression was no longer being in a relationship with the child’s mother. (more…)
Author Interviews, CDC, Fertility, OBGYNE / 11.02.2017

MedicalResearch.com Interview with: Saswati Sunderam, PhD Division of Reproductive Health National Center for Chronic Disease Prevention and Health Promotion CDC. MedicalResearch.com: What is the background for this study?Response: Assisted Reproductive Technology Surveillance – United States, 2014, the surveillance summary published this week in CDC’s Morbidity and Mortality Weekly Report (MMWR), presents state-specific data on assisted reproductive technology (ART) use and outcomes. The report compares ART infant outcome data with outcomes for all infants born in the U.S. in 2014, and provides data on the contributions of Assisted Reproductive Technology to total infants born, multiple birth infants, low birth weight infants, and preterm infants for each U.S. state, the District of Columbia, and Puerto Rico. (more…)
Author Interviews, Depression, OBGYNE / 01.02.2017

MedicalResearch.com Interview with:Kristina M. Deligiannidis, MD Associate Professor Center for Psychiatric Neuroscience The Feinstein Institute for Medical Research Director, Women’s Behavioral Health Zucker Hillside Hospital Northwell Health Associate Professor Psychiatry and Obstetrics & Gynecology Hofstra Northwell School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Because of effects on social behavior, including maternal behavior, oxytocin has often been seen as a potential mediator of postpartum depression and anxiety. The original objective of our study was to examine the relationship between the use of synthetic oxytocin during and after labor and the development of depressive and anxiety disorders within the first year postpartum. We hypothesized that women exposed to synthetic oxytocin before or during labor would have a reduced risk of postpartum depressive and anxiety disorders compared with those without any exposure. Our findings told the opposite story. We found that peripartum synthetic oxytocin exposure was associated with an increase in risk for the development of postpartum depression and anxiety. (more…)
Author Interviews, Cancer Research, Fertility, OBGYNE, Pediatrics / 30.01.2017

MedicalResearch.com Interview with: Tamar Wainstock, PhD Department of Public Health; Faculty of Health Sciences Ben-Gurion University of the Negev ISRAEL MedicalResearch.com: What is the background for this study? Response: There is a controversy in the medical literature regarding the possible association between infertility or infertility treatments, and the long-term offspring neoplasm risk: while some studies have found such an association, others have not. Since the number of offspring conceived following treatments are growing, and as they age, it is critical to clarify this possible association. (more…)
Author Interviews, BMJ, Endocrinology, Mayo Clinic, OBGYNE, Thyroid Disease / 27.01.2017

MedicalResearch.com Interview with:Dr. Spyridoula Maraka Assistant professor of medicine Division of Endocrinology and Metabolism Center for Osteoporosis and Metabolic Bone Diseases University of Arkansas for Medical Sciences and Central Arkansas Veterans Health Care System Little Rock ArkansasMedicalResearch.com: What is the background for this study? What are the main findings?Response: Subclinical hypothyroidism, a mild thyroid dysfunction, has been associated in pregnancy with multiple adverse outcomes. Our aim was to estimate the effectiveness and safety of thyroid hormone treatment among pregnant women with subclinical hypothyroidism. Using a large national US dataset, we identified 5,405 pregnant women diagnosed with subclinical hypothyroidism. Of these, 843 women, with an average pretreatment TSH concentration of 4.8 milli-international units per liter, were treated with thyroid hormone. The remaining 4,562, with an average pretreatment TSH concentration of 3.3 milli-international units per liter, were not treated. Compared with the untreated group, treated women were 38 percent less likely to experience pregnancy loss. However, they were more likely to experience a preterm delivery, gestational diabetes or preeclampsia. Moreover, the benefit of thyroid hormone treatment on pregnancy loss was seen only among women with higher TSH levels (4.1 to 10 mIU/L) before treatment. We also found that for women with lower levels of TSH (2.5–4.0 mIU/L), the risk of gestational hypertension was significantly higher for treated women than for untreated women. (more…)
Author Interviews, OBGYNE, Pediatrics, PLoS, Weight Research / 27.01.2017

MedicalResearch.com Interview with:Dr Rebecca Richmond PhD Senior Research Associate in the CRUK Integrative Cancer Epidemiology Programme MRC Integrative Epidemiology Unit School of Social and Community Medicine University of Bristol MedicalResearch.com: What is the background for this study? What are the main findings? Response: We have been involved in earlier work which applied the same methods used here (using genetic variants to provide causal evidence) and showed that higher maternal pregnancy body mass index (BMI) causes greater infant birth weight. The paper here aimed to build on that earlier research and asked whether maternal BMI in pregnancy has a lasting effect, so that offspring of women who were more overweight in pregnancy are themselves likely to be fatter in childhood and adolescence. Our aim was to address this because an effect of an exposure in pregnancy on later life outcomes in the offspring could have detrimental health consequences for themselves and future generations. However, we did not find strong evidence for this in the context of the impact of maternal BMI in pregnancy on offspring fatness. (more…)
Author Interviews, Baylor College of Medicine Houston, OBGYNE, Outcomes & Safety / 25.01.2017

MedicalResearch.com Interview with; Dr. Amirhossein Moaddab Postdoctoral Research Fellow at Baylor College of Medicine Houston, Texas MedicalResearch.com: What is the background for this study? Response:Based on data from the Centers for Disease Control and Prevention, the United States maternal mortality ratio is three to four times higher than that of most other developed nations. Previous studies from the demonstrated a possible association between weekend hospital admissions and higher rates of mortality and poor health outcomes. We investigated differences in maternal and fetal death ratios on weekends compared to weekdays and during different months of the year. In addition we investigated the presence of any medical and obstetrics complications in women who gave birth to a live child and in their offspring by day of delivery. (more…)
Author Interviews, OBGYNE, Weight Research / 25.01.2017

MedicalResearch.com Interview with:Alan Peaceman, MD Professor and Chief of Maternal Fetal Department of Obstetrics and Gynecology Northwestern Feinberg School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?Response: Excess maternal weight gain during pregnancy is very common in the United States, and has been associated with a number of pregnancy complications, including gestational diabetes, maternal hypertension, excess fetal size, and cesarean delivery. Children born to mothers who gained excessively during pregnancy are at much higher risk of developing obesity themselves. We performed a randomized trial where half of the women received an intensive intervention of diet and exercise counseling in an effort to limit their weight gain. Compared to the control group, those in the intervention gained on average 4 pounds less and were more likely to gain within recommended guidelines. Despite this improvement, however, we did not see any improvement in any of the pregnancy complications. (more…)
Author Interviews, Blood Pressure - Hypertension, OBGYNE / 24.01.2017

MedicalResearch.com Interview with: Dr. Lauren Theilen, MD Obstetrics/Gynecology specialist Salt Lake City, Utah. MedicalResearch.com: What is the background for this study? What are the main findings?Response: Women with a history of hypertensive disease of pregnancy are known to have increased risk of mortality from cardiovascular and other causes. Our study shows that hypertensive disease of pregnancy is strongly associated with deaths due to diabetes, heart disease, and stroke. The association is strongest for early mortality – deaths occurring before age 50 – and life expectancy decreases with increasing number of affected pregnancies. (more…)
Author Interviews, OBGYNE / 24.01.2017

MedicalResearch.com Interview with: Dr Josianne Paré MD, FRCSC Département d'obstétrique-gynécologie Faculté de médecine et des sciences de la santé de l'université de Sherbrooke 3001 12e avenue Nord, Sherbrooke (Québec), J1H 5N4 MedicalResearch.com: What is the background for this study? What are the main findings?Response: Prolonged labor is a significant cause of maternal and fetal morbidity and very few interventions are known to shorten labor course. Skeletal muscle physiology suggests that glucose supplementation might improve muscle performance in case of prolonged exercise and this situation is analogous to the gravid uterus during delivery. Therefore, it seemed imperative to evaluate the impact of adding carbohydrate supplements on the course of labor. Accordingly, we conducted a single centre prospective double-blind randomized-controlled trial comparing the use of parental IV of dextrose 5% with normal saline to normal saline in induced-nulliparous women. A total of 193 patients (96 in the dextrose with normal saline [NS+D] group and 97 in the normal saline group [NS] were analysed in the study. The median total duration of labor was 76 minutes shorter in the NS+D group (499 versus 423 minutes, p = 0.024) than in the NS group. There was no difference in the rate of caesarean section, instrumented delivery, APGAR score or arterial cord pH. (more…)
Anesthesiology, Author Interviews, JAMA, OBGYNE, Surgical Research / 20.01.2017

MedicalResearch.com Interview with: Adam Sachs MD Assistant Professor of Anesthesiology University of Connecticut School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?Response: When women undergo appendectomy or cholecystectomy during pregnancy they are obviously concerned about the well being of their fetus. Unfortunately, the majority of the data available to council pregnant women is outdated and medical practice has significantly changed since their publication. (more…)
Anemia, Author Interviews, Global Health, JAMA, OBGYNE / 17.01.2017

Ola Andersson, MD, PhD Department of Women’s and Children’s Health Uppsala University, Uppsala, SwedenMedicalResearch.com Interview with: Dr. Ola Andersson MD, PhD Uppsala University, Uppsala, Sweden MedicalResearch.com: What is the background for this study? Response: Anemia affects over 40% of all children under 5 years of age in the world. Anemia can impinge mental and physical performance, and is associated with long-term deterioration in growth and development. Iron deficiency is the reason for anemia in approximately 50% of the children.is. When clamping of the umbilical cord is delayed, ie after 3 minutes, iron deficiency up to 6 months of age can be prevented, but it has not been shown to prevent iron deficiency or anemia in older infants. At birth, approximately 1/3 of the child's blood is in the placenta. If clamping of the umbilical cord is done immediately (early cord clamping), the blood will remain in the placenta and go to waste (or can be stored in stem cell banks). If instead clamping is postponed for 3 minutes, most of the blood can flow back to the child as an extra blood transfusion, consisting of about one deciliter (1/2 cup) of blood, equivalent to about 2 liters (half a US gallon) of an adult. A blood donor leaves 0.4-0.5 liters of blood. Blood contains red blood cells that contain hemoglobin. Hemoglobin carries oxygen to the tissues of the body. Hemoglobin contains a lot of iron, and the extra deciliter of blood may contain iron that corresponds to 3-4 months of the need for an infant. The World Health Organization (WHO) recommends umbilical cord clamping at 1 minute or later, American College of Obstetricians and Gynecologists (ACOG) recommends umbilical cord clamping at 30-60 seconds or later. (more…)