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 Arkansas MedicalResearch.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, Sweden MedicalResearch.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…)
Author Interviews, JAMA, OBGYNE, Pediatrics / 13.01.2017

MedicalResearch.com Interview with: Dr. Alex Kemper, MD, MPH, MS Member,US Preventive Services Task Force Professor of Pediatrics and Professor in Community Medicine Department of Pediatrics Duke University School of Medicine MedicalResearch.com: What is the background for this study? Response: Neural tube defects, where the brain or spinal cord do not develop properly in a baby, can occur early in pregnancy, even before a woman knows she is pregnant. Taking folic acid before and during pregnancy can help protect against neural tube defects. Most women do not get enough folic acid in their diets, so most clinicians recommend that any woman who could become pregnant take a daily folic acid supplement. (more…)
Author Interviews, Global Health, JAMA, OBGYNE, Surgical Research / 09.01.2017

MedicalResearch.com Interview with: Jianmeng Liu, PhD, MD Professor in Epidemiology and Biostatistics Director, Institute of Reproductive and Child Health/key Laboratory of Reproductive Health Ministry of Health Director, Office for National Maternal and Child Health Statistics of China Peking University Health Science Center Beijing, China MedicalResearch.com: What is the background for this study? Response: Cesarean overuse can jeopardize maternal and child health. It has been widely concerned that cesarean rate in China is at an extremely high level. Concerns about “alarming” rates increased after a World Health Organization (WHO) report that 46.2% of births were delivered by cesarean in 2007-2008, based on analysis of deliveries in 21 hospitals of 3 provinces of China. Since 2002, reducing the cesarean rate has been a national priority, and a variety of policies, programs and activities have emerged at both the central and local governments. Previous national estimates of cesarean rates have been based on surveys with limited geographical coverage. Given the marked diversity of geography, economy, and life circumstances throughout China, survey estimates are likely to be sensitive to the area sampled. By analyzing county-level national data on cesarean rates that have been collected since 2008, this study aimed to determine the overall rate and change in rate of cesarean deliveries, examine geographic variation, and, in areas where declines occurred, assess changes in maternal and perinatal mortality. (more…)
Author Interviews, Environmental Risks, OBGYNE, Pediatrics / 06.01.2017

MedicalResearch.com Interview with: Nathalie Auger MD MSc FRCPC Montréal, Québec MedicalResearch.com: What is the background for this study? What are the main findings? Response: We carried out this study because congenital heart defects take a large share of birth defects, but not much is known on its risk factors. In previous research, we found that very high temperatures in the summer were associated with a greater risk of stillbirth. We sought to determine whether elevated outdoor heat could also be linked with congenital heart defects in a sample of about 700,000 pregnancies. (more…)
Author Interviews, OBGYNE, Pediatrics, Pediatrics, Weight Research / 06.01.2017

MedicalResearch.com Interview with: Edwina Yeung, Ph.D Investigator, Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development MedicalResearch.com: What is the background for this study? Response: About 1 in 5 pregnant women in the United States is obese. Other studies have looked at mothers’ obesity in terms of children’s development, but no U.S. studies have looked at whether there might be a contribution from the father’s weight. MedicalResearch.com: What are the main findings? Response: One of the main findings of this study is that maternal obesity is associated with a delay in fine motor skill-- the ability to control movement of small muscles, such as those in the fingers and hands. Paternal obesity is associated with a delay in personal-social skills including the way the child interacts with others. Having both a mother and a father with severe obesity (BMI≥35) was associated with a delay in problem solving ability. (more…)
Author Interviews, Lancet, OBGYNE, Surgical Research / 22.12.2016

MedicalResearch.com Interview with: Dr Rachael Wood PhD Consultant in Public Health Medicine - women and children's health NHS National Services Scotland Information Services Division Edinburgh MedicalResearch.com: What is the background for this study? Response: Mesh surgery for female stress urinary incontinence and pelvic organ prolapse is currently controversial. Mesh surgery was introduced to overcome recognised limitations of traditional, non-mesh, surgery for these conditions, in particular extensive surgery and long hospital stays for incontinence and high failure/recurrence rates for prolapse. Mesh surgery may therefore offer additional benefits over traditional surgery. Mesh surgery may also carry additional risks however, with patient advocacy groups highlighting cases of severe, long term, mesh-related complications in some women who have undergone mesh surgery. We therefore used routinely available, population based hospital discharge records from Scotland to identify women having mesh and non-mesh procedures for incontinence and prolapse. We then followed the women up for up to 5 years to assess how often they were readmitted for complications or further incontinence or prolapse surgery. (more…)
Author Interviews, Gender Differences, Lancet, OBGYNE, Surgical Research / 21.12.2016

MedicalResearch.com Interview with: Prof. Cathryn Glazener PhD Health Services Research Unit University of Aberdeen Aberdeen,UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prolapse is a condition that affects up to half of all women after childbirth. Women notice a bulge or discomfort in their vaginas due to pressure from the bladder, bowel or womb moving downwards. Women who have surgery for their prolapse have a 3 in 10 chance of needing at least one more operation, so the success rate is not great. Gynaecologists hoped that by reinforcing their repairs the success rate would get better. PROSPECT was a pragmatic, multicentre randomised controlled trial conducted in 35 centres across the UK. Women undergoing their first operation for prolapse were randomised to having a standard repair of the front or back wall of the vagina, or a repair reinforced by synthetic non-absorbable mesh, or a biological graft. We found that, in contrast to previous research, women were just as likely to be cured after standard surgery rather than reinforced repairs. They were just as likely to have other symptoms such as bladder or sexual problems, and other adverse effects such as infection, bleeding or pain. However, about 1 in 10 of the women who had mesh did have mesh exposure when a small portion of the mesh becomes visible through the vaginal wall. Although many women did not have symptoms, about half of those women needed a small operation to remove or bury the exposed mesh. (more…)
Author Interviews, OBGYNE, UCLA, Zika / 20.12.2016

MedicalResearch.com Interview with: Karin Nielsen, MD, MPH Professor of Clinical Pediatrics Division of Pediatric Infectious Diseases David Geffen School of Medicine at UCLA Director, Center for Brazilian Studies MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our research was a prospective study in which pregnant women in Rio de Janeiro who developed a rash in the last 5 days between the end of 2015 to mid 2016 were screened for possible infection with Zika virus by a special molecular test (PCR) which looked for the virus in blood or urine. Women who were found to have Zika virus in either blood, urine or both were followed throughout time to look for pregnancy and infant outcomes. We also followed women who had a negative PCR test for Zika as a comparison group. By July 2016, we had outcomes known for 125 Zika affected pregnancies, of these 58 had abnormal outcomes, with 9 fetal losses and 49 babies who had abnormal findings on physical exam or brain imaging, all consistent with neurologic abnormalities. This meant 46% of the pregnant women in our study had an abnormal pregnancy outcome, and 42% of live birth infants were found to have an abnormality in the first few months of life. (more…)
Author Interviews, MRI, OBGYNE, Pediatrics / 17.12.2016

MedicalResearch.com Interview with: Prof Paul D Griffiths, FRCR and Cara Mooney, Study Manager: MERIDIAN Clinical Trials Research Unit The University of Sheffield  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Around three in every 1000 pregnancies is complicated by a fetal abnormality. In the UK Ultrasonography (USS) has, for many years, been the mainstay of antenatal screening and detailed anomaly scanning to detect such abnormalities.  However previous studies have suggested that in utero Magnetic Resonance (iuMR) imaging may be a useful adjunct to USS for detecting these brain abnormalities in the developing fetus. This study was designed to test the diagnostic accuracy and clinical impact of introducing fetal MR in to the diagnostic pathway. Our results show that iuMR has an overall diagnostic accuracy of 93% compared to ultrasound at 68%, this is an increase in diagnostic accuracy of 25%. When divided into gestational age group the improvement in diagnostic accuracy ranged from 23% in the 18-23 week group, and 29% in the 24 week and over group. IuMR provided additional diagnostic information in 49% of cases, changed prognostic information in at least 20% and the contribution to clinical management was felt to be at least ‘significant’ in 35% of cases. IuMR also had high patient acceptability with at least 95% of women stating that they would have an iuMR if a future pregnancy were complicated by a fetal brain abnormality. (more…)
Author Interviews, FASEB, Microbiome, OBGYNE, Stanford / 09.12.2016

MedicalResearch.com Interview with: Carlos Simón, M.D., Ph. D. Professor of Obstetrics & Gynecology. Valencia University, Spain Scientific Director, Igenomix SL. Adjunct Clinical Professor, Department of Ob/Gyn, Stanford University, CA Adjunct Professor, Department of Ob/Gyn, Baylor College of Medicine, TX MedicalResearch.com: What is the background for this study? What are the main findings? Response: The main findings of this study reside in the concept that the uterine cavity, which has been classically considered as a sterile organ, possess its own microbiome and that the composition of this uterine microbiome have a functional impact on the reproductive outcome of IVF patients. (more…)
Author Interviews, OBGYNE, Pediatrics, Social Issues / 09.12.2016

MedicalResearch.com Interview with: Jonathan Y. Bernard, PhD Inserm UMRS 1153 – Centre for research in Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS) Team ORCHAD: early Origin of the Child Health And Development Hôpital Paul Brousse MedicalResearch.com: What is the background for this study? What are the main findings? Response: Despite the World Health Organization’s recommendations promoting breast feeding, wide variations in breast feeding initiation rates are observed among Western countries: some reach >95%, while others remain <80%. Many individual-level determinants of breast feeding are known, including maternal age, education, ethnicity, smoking and employment status. Less is known regarding cultural determinants, such as religion, which could be underlying and explain rate differences between and within countries. We aimed at comparing countries’ breast feeding rates with the proportions of Catholics and Protestants. We thus carried out an ecological study by collating publicly available online data for 135 countries. We additionally gathered within-country data for 5 Western nations: France, Ireland, the UK, Canada and the USA. We found that, in Western countries, the proportion of Catholics was negatively correlated with the rate of breast feeding. This was also observed within countries in France, Ireland, the UK and Canada. In the USA, where breast feeding rates vary hugely between states, race was an important confounder. Interestingly, we also found the correlation in non-Hispanic whites. All our findings hold even when we account for wealth indicators, such as gross domestic product per capita. (more…)
Author Interviews, OBGYNE / 01.12.2016

MedicalResearch.com Interview with: Dr. Kenji Tanimura M.D., Ph.D. Assistant professor Division of Obstetrics and Gynecology Graduate School of Medicine and Hideto Yamada M.D., Ph.D. Professor and Chairman Department of Obstetrics and Gynecology Kobe University Graduate School of Medicine MedicalResearch.com: What is the background for this study? Response: Congenital cytomegalovirus (CMV) infection can cause long-term neurological sequelae, such as hearing difficulties and mental retardations, in affected children. Some investigators reported that early diagnosis and antiviral therapy can improve neurological outcomes in symptomatic congenital infected infants. However, universal screening of newborns for congenital CMV infection is not yet available. Therefore, the development of non-invasive methods for prenatal detection of mothers and newborns at high risk for congenital CMV infection has been desired. We aimed to determine maternal clinical, laboratory, and ultrasound findings that effectively predict the occurrence of congenital CMV infection in high-risk pregnant women, who were positive for CMV IgM. We performed maternal blood screening for CMV IgG and IgM, and 300 IgM-positive pregnant women, including 22 with congenital CMV infection, received series of examinations. We evaluated maternal clinical and laboratory findings, including serum CMV IgM and IgG, IgG avidity index, antigenemia testing, and CMV-DNA PCR for the maternal serum, urine, and uterine cervical secretion, and prenatal ultrasound findings. (more…)
Author Interviews, Emory, Fertility, OBGYNE / 01.12.2016

MedicalResearch.com Interview with: Jennifer F. Kawwass, MD, FACOG Assistant Professor, Emory Reproductive Center Director of Third Party Reproduction, Emory Reproductive Center MedicalResearch.com: What is the background for this study? Response: With the increasing use of assisted reproductive technology (ART), the number of cryopreserved embryos in storage has increased, as residual viable embryos from an in vitro fertilization (IVF) cycle may be frozen for future use. Each embryo maintains attributes reflective of the age of the female at time of the original oocyte retrieval. Embryo donation, a form of third-party reproduction, involves donation without compensation of previously formed embryos to another couple for implantation. Limited published data exist detailing outcomes of donor embryo cycles. Patients and clinicians would benefit from information specific to donor embryo cycles to inform fertility treatment options, counselling, and clinical decision-making. We sought to quantify trends in donor embryo cycles in the United States, to characterize donor embryo recipients, and to report transfer, pregnancy, and birth outcomes of donor embryo transfers. (more…)
Author Interviews, BMJ, Fertility, OBGYNE / 21.11.2016

MedicalResearch.com Interview with: David McLernon PhD MPhil BSc Research Fellow in Medical Statistics Medical Statistics Team Institute of Applied Health Sciences University of Aberdeen Foresterhill Aberdeen MedicalResearch.com: What is the background for this study? Response: Normally when a couple attend a fertility clinic to begin IVF treatment they are only informed about their chances of having a baby for the first attempt of IVF. In actual fact the first treatment is often unsuccessful and many couples will go on to have several complete cycles of the treatment– each involving the transfer of one or two fresh embryos potentially followed by one or more frozen embryo transfers. We felt that a prediction model that could calculate the chances of having a baby over the complete package of treatment would provide better information for couples. (more…)
AHRQ, Author Interviews, Cost of Health Care, OBGYNE, Surgical Research / 20.11.2016

MedicalResearch.com Interview with: Kamila Mistry, PhD MPH AHRQ MedicalResearch.com: What is the background for this study? Response: Although the overall cesarean section (C-section) rate in the United States has declined slightly in recent years, nearly a third of all births continue to be delivered by C-section—higher than in many other industrialized countries. A number of medical as well as nonmedical factors may contribute to high C-section rates. C-section is the most common surgical procedure performed in the United States. This operation carries additional risks compared with vaginal delivery, such as infection and postoperative pain. A C-section also may make it more difficult for the mother to establish breastfeeding and may complicate subsequent pregnancies. Consensus guidelines from the American Congress of Obstetricians and Gynecologists and other national efforts to improve perinatal care have shown promise in reducing nonmedically indicated C-sections. However, recent research has found wide variation in hospital C-section rates even for low-risk deliveries. (more…)
Author Interviews, Brigham & Women's - Harvard, OBGYNE, Pediatrics / 18.11.2016

MedicalResearch.com Interview with: Melissa C. Bartick, MD, MSc Department of Medicine Cambridge Health Alliance Harvard Medical School Cambridge, MA MedicalResearch.com: What is the background for this study? Response: This is the first study ever to combine maternal and pediatric health outcomes from breastfeeding into a single model. We had published a cost analysis of suboptimal breastfeeding for pediatric disease in 2010, which found that suboptimal breastfeeding cost the US $13 billion in costs of premature death costs and medical expenses, and 911 excess deaths. We followed that up with a maternal cost analysis which found about $18 billion in premature death costs and medical expenses. In both these studies, most of the costs were from premature death. We were unable to combine the results of these two studies because their methodologies were different, and both of them, especially the pediatric portion needed to be updated. (more…)
Author Interviews, JAMA, OBGYNE, Surgical Research, Weight Research / 15.11.2016

MedicalResearch.com Interview with: Brodie Parent, MD MS General Surgery R4 University of Washington MedicalResearch.com: What is the background for this study? What are the main findings? Response: We already knew that women with a history of bariatric surgery are a high risk group when it comes to childbirth. Our study has confirmed prior data which show that infants from these women are at a higher risk for being premature, low birth-weight, or requiring ICU admission. However, this is some of the first data which looks at their risk over time after recovery from the operation. Data from this study show that risks to the infant are highest in the first 3 years after an operation, and diminish over time. This suggests that women should wait a minimum of three years after an operation before attempting conception. (more…)
Author Interviews, OBGYNE, Pediatrics / 10.11.2016

MedicalResearch.com Interview with: Jason Bentley, MBiostat Doctoral Fellow Menzies Centre for Health Policy University of Sydney MedicalResearch.com: What is the background for this study? Response: Planned birth (labor induction or pre-labor caesarean section) is a decision to intervene and so determines a gestational age at birth that would have otherwise been later if pregnancy had progressed through to spontaneous labor. Significant changes in clinical practice have seen an increase in planned births before 39-40 completed week’s gestation from an increased use of primary and repeat cesarean section and a greater use of labor induction. At a population level this has resulted in a decrease in modal gestational age with planned birth accounting for almost half of births before 39-40 weeks. Clinical research has indicated that the threshold for planned birth and the gestational age for intervening has reduced. Numerous reasons have been given as justification for this including litigation, patient and provider perception of safety versus risk, reduced perinatal mortality, increased fetal monitoring, maternal age, obesity and convenience. There has also been the clinical perception that birth just before the optimal date carries little significant morbidity, with a focus on short-term risks to mother or baby only rather than longer-term outcomes. It is of paramount importance to ensure there are no unintended harms from such a significant shift in clinical practice. This study investigated whether the timing of planned birth was associated with poorer developmental outcomes at school age. (more…)