Author Interviews, BMJ, CDC, OBGYNE / 10.07.2015

Jennita Reefhuis, PhD Epidemiologist with CDC National Center on Birth Defects and Developmental DisabilitiesMedicalResearch.com Interview with: Jennita Reefhuis, PhD Epidemiologist with CDC National Center on Birth Defects and Developmental Disabilities Medical Research: What is the background for this study? Dr. Reefhuis: There are previous reports on the link between birth defects and SSRIs. However, the results across some of these studies conflicted. It is not clear whether one SSRI might be safer than other SSRIs. Medical Research: What are the main findings? Dr. Reefhuis: Reassuringly, we found that the five earlier reported links between specific birth defects and sertraline were not found again. We did find that some birth defects occur two to three times more frequently among babies born to mothers who took paroxetine and fluoxetine in early pregnancy.
Author Interviews, JAMA, OBGYNE, Toxin Research / 26.03.2015

Dr. Bradley S. Peterson, M.D Director of the Institute for the Developing Mind The Saban Research Institute of Children’s Hospital Los Angeles Children’s Hospital Los AngelesMedicalResearch.com Interview with: Dr. Bradley S. Peterson, M.D Director of the Institute for the Developing Mind The Saban Research Institute of Children’s Hospital Los Angeles Children’s Hospital Los Angeles Medical Research: What is the background for this study? Dr. Peterson: Neurotoxic PAH (polycyclic aromatic hydrocarbons) are ubiquitous in the environment, in the home and in the workplace. Emissions from motor vehicles, oil and coal burning for home heating or power generation, wildfires and agricultural burning, hazardous waste sites, tobacco smoke and charred foods are all sources of exposure. PAH readily crosses the placenta and affects an unborn child’s brain; earlier animal studies showed that prenatal exposure impaired the development of behavior, learning and memory. Our group previously reported that exposure to airborne PAH during gestation was associated with multiple neurodevelopmental disturbances, including development delay by age 3, reduced verbal IQ at age 5, and symptoms of anxiety and depression at age 7. Medical Research: What are the main findings? Dr. Peterson: Together with Virginia Rauh, ScD and Frederica Perera, DrPH, PhD of Columbia University’s Mailman School of Public Health, we conducted a brain imaging study to test the effects on brain structure of PAH exposure during the final trimester of pregnancy.  We used magnetic resonance imaging (MRI) to measure the brains of 40 children from a cohort of more than 600 mother-baby pairs from minority communities in New York City. These 40 children were carefully selected to have no other exposures that would affect brain development. Our findings showed that prenatal PAH exposure led to reductions in nearly the entire white matter surface of the brain’s left hemisphere – losses that were associated with slower processing of information during intelligence testing and more severe behavioral problems, including ADHD and aggression.  Postnatal PAH exposure – measured at age 5 – was found to contribute to additional disturbances in development of white matter in the dorsal prefrontal region of the brain, a portion of the brain that supports concentration, reasoning, judgment, and problem-solving ability.
Author Interviews, Genetic Research, JAMA / 20.02.2015

Dr. Peter Forster PhD Fellow of Murray Edwards College and McDonald Institute at the University of CambridgeMedicalResearch.com Interview with: Dr. Peter Forster PhD Fellow of Murray Edwards College and McDonald Institute at the University of Cambridge   Medical Research: What is the background for this study? What are the main findings?   Dr. Forster: As a result of our paternity testing work at the Institute for Forensic Genetics in Munster (Germany), we have accumulated a pool of over 24,000 parents and their children, of whom we know for certain that they are biologically related. Occasionally we observe a new mutation in these children, which must have come either from the sperm or the egg of one of the parents. As we analyse highly variable microsatellite DNA (a repetitive type of DNA, also know as STR DNA, which stands for "short tandem repeat" DNA), we can fairly easily find out whether the mutation has come from the mother or the father. It turns out that the fathers contribute 6-7 times more mutations to the children than the mothers do. This has long been known. What is new is that we have observed that the male and female teenagers at puberty do NOT set out with the same low mutation load, but instead, the teenage boys already have a sixfold higher mutation load in their sperm than the girls in their oocytes.
Author Interviews, Disability Research, Pediatrics, Race/Ethnic Diversity / 14.02.2015

MedicalResearch.com Interview with: Ying Wang, PhD, MPH Data Management, Analysis & Research Office of Primary Care and Health System Management New York State Department of Health Empire State Plaza  Albany, NY  12237 Medical Research: What is the background for this study? What are the main findings? Dr. Wang: The purpose of the study was to examine the survival of children with one or more of 21 major birth defects in the United States.  We used data from 12 population-based birth defects surveillance programs that participate in the National Birth Defects Prevention Network.  The study included nearly 100,000 infants born with birth defects between 1997 and 2007. We found that children who were born with hypoplastic left heart syndrome (a severe congenital heart defect) had the lowest chance of survival across multiple ages (up to 28 days of life, 1 year, 2 years, and 8 years of life), compared to children with any other birth defects studied.  We also found that the chances of survival up to 1 year of life was greater than 90% for babies born with spina bifida, cleft palate, cleft lip with or without cleft palate, pyloric stenosis, gastroschisis, or Down syndrome. For most birth defects, survival was poorer among non-Hispanic black mothers and Hispanic mothers compared to non-Hispanic white mothers.
Author Interviews, CDC, OBGYNE, Supplements / 15.01.2015

Jennifer Williams MSN, MPH, FNP-BC National Center on Birth Defects and Developmental Disabilities CDC, Atlanta, Georgia MedicalResearch.com Interview with: Jennifer Williams MSN, MPH, FNP-BC National Center on Birth Defects and Developmental Disabilities CDC, Atlanta, Georgia Medical Research: What is the background for this study? What are the main findings? Response: Neural tube defects are serious birth defects of the brain and spine that can cause significant disability and death. Studies have shown that taking 400 mcg of folic acid daily before and during pregnancy can reduce the prevalence of neural tube defects. Therefore, in 1992, the US Public Health Service (USPHS) recommended that all women of childbearing age in the United States who are capable of becoming pregnant consume 400mcg of folic acid per day to reduce the risk of neural tube defects. To help women meet this requirement, in 1998 the US Food and Drug Administration (FDA) mandated that folic acid be added to enriched grain products for the prevention of neural tube defects. This study looks at how many neural tube defects have been prevented annually since folic acid fortification. Using data from birth defects tracking systems, researchers found that since folic acid fortification, the birth prevalence of neural tube defects has decreased by 35% in the United States, which translates to about 1,300 babies that are born each year without a neural tube defect who might otherwise have been affected.  This study also reports that the number of babies born with a neural tube defect annually differs by the mother’s race/ethnicity. Hispanic mothers continue to be at the highest risk for having a baby with a neural tube defect.
OBGYNE, Pediatrics, Weight Research / 16.11.2014

MedicalResearch.com Interview with: Ian R. Macumber MD Pediatric Nephrology, Seattle Children's Hospital Seattle, Washington Medical Research: What are the main findings of the study? Dr. Macumber: The main finding is that there is a strong association between maternal obesity and odds of congenital anomalies of the kidney and urinary tract (CAKUT) in offspring.  This relationship remains strong when looking at offspring with renal malformation (excluding non-renal congenital anomalies of the kidney and urinary tract), or in offspring with isolated congenital anomalies of the kidney and urinary tract (no congenital anomalies elsewhere in the body).  There is a dose-response relationship to this association, with the offspring of extremely obese mothers have even higher odds of having congenital anomalies of the kidney and urinary tract.
Author Interviews, Depression, Heart Disease, NEJM, OBGYNE / 19.06.2014

Dr. Krista Huybrechts MD PhD Brigham & Women’s Hospital Department of Medicine Division of Pharmacoepidemiology & Pharmacoeconomics Boston, MA 02120MedicalResearch.com Interview Invitation Dr. Krista Huybrechts MD PhD Brigham & Women’s Hospital Department of Medicine Division of Pharmacoepidemiology & Pharmacoeconomics Boston, MA 02120 MedicalResearch: What are the main findings of the study? Dr. Huybrechts: In this cohort study including 949,504 pregnant women enrolled in Medicaid, we examined whether the use of selective serotonin reuptake inhibitors (SSRIs) and other antidepressants during the first trimester of pregnancy is associated with increased risks for congenital cardiac defects. In order to control for potential confounding by depression and associated factors, we restricted the cohort to women with a depression diagnosis and used propensity score adjustment to control for depression severity and other potential confounders. We found no substantial increased risk of cardiac malformations attributable to SSRIs. Relative risks for any cardiac defect were 1.25 (95%CI, 1.13-1.38) unadjusted, 1.12 (1.00-1.26) depression-restricted, and 1.06 (0.93-1.22) depression-restricted and fully-adjusted. We found no significant associations between the use of paroxetine and right ventricular outflow tract obstruction (1.07, 0.59-1.93), or the use of sertraline and ventricular septal defects (1.04, 0.76-1.41); two potential associations that had been of particular concern based on previous research findings.
Author Interviews, OBGYNE, PLoS / 21.02.2014

Prof. Nicholas J. Wald Wolfson Institute of Preventive Medicine Barts and the London School of Medicine and Dentistry Queen Mary University of London London, United KingdomMedicalResearch.com Interview with: Prof. Nicholas J. Wald Wolfson Institute of Preventive Medicine Barts and the London School of Medicine and Dentistry Queen Mary University of London London, United Kingdom MedicalResearch.com: What are the main findings of the study? Prof Wald: The percentage of women who become pregnant without having taken folic acid supplements to reduce the risk of a neural tube defect declined from a relatively low proportion (35%) to an even lower one (31%) between 1999 and 2012. Moreover such use of folic acid in some groups of the population is much lower for example 17% in Afro-Caribbean women and 6% in women aged under 20.
Author Interviews, NEJM, OBGYNE / 29.08.2013

MedicalResearch.com Interview with: Ms. Mølgaard-Nielsen Statens Serum Institut Artillerivej 5, 2300 Copenhagen S, Denmark MedicalResearch.com: What are the main findings of the study? Answer: Use of oral fluconazole during early pregnancy did not increase the risk of birth defects overall in common therapeutic doses. We also looked at 15 individual birth defects of previous concern and oral fluconazole was not associated with an increased risk for 14 of these birth defects.  However, we did see an increase in the risk of tetralogy of Fallot, an uncommon congenital heart defect, but the number of exposed cases was few.