Vaginal Progesterone May Reduce Miscarriages in Women with Bleeding in Early Pregnancy

MedicalResearch.com Interview with:

Prof. Arri Coomarasamy MBChB, MD, FRCOGInstitute of Metabolism and Systems ResearchProfessor of GynaecologyDirector of Tommy's National Centre for Miscarriage ResearchUniversity of Birmingham

Prof. Coomarasamy

Prof. Arri Coomarasamy MBChB, MD, FRCOG
Institute of Metabolism and Systems Research
Professor of Gynaecology
Director of Tommy’s National Centre for Miscarriage Research
University of Birmingham

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Progesterone hormone is known to be essential to maintain a pregnancy. Researchers and clinicians have debated for over 50 years whether progesterone supplementation in women with early pregnancy bleeding could rescue a pregnancy from miscarrying. There were some clinical studies suggesting progesterone could be useful, but the studies were of poor quality and small, so we could not be certain.

So the current study, called the PRISM trial, was conducted using very sound methods and on a large population of women, in fact over 4000 women in the UK, to produce a definitive answer to this question. Overall, there were more babies in the group of women given progesterone compared with the group of women given the dummy placebo tablets, but there was statistical uncertainty in this finding.

However, when we looked at the sub-population of women who were at high risk of miscarriage because of not only bleeding in early pregnancy but also having a history of previous miscarriage, we found progesterone was shown to have clear benefit. This is a hugely important finding as there is now a treatment option to women with early pregnancy bleeding and a history of previous miscarriages.

Continue reading

Link Between Night Shift Work and Miscarriage

MedicalResearch.com Interview with:

Luise Mølenberg BegtrupInstitute of Public HealthUniversity of Southern Denmark | SDU

Luise Mølenberg Begtrup

Luise Mølenberg Begtrup
Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There are indications that working fixed night shifts is associated with a higher risk of miscarriage.

Since many women work rotating shifts including night shifts, we were interested in examining the association between the amount of night work and miscarriage. We were able to do this by use of detailed exposure data based on payroll data.

Continue reading

How Do Men Express Grief After Pregnancy Loss?

MedicalResearch.com Interview with

Haley Kranstuber Horstman, Ph.D.Department of CommunicationUniversity of Missouri

Dr. Kranstuber Horstman

Haley Kranstuber Horstman, Ph.D.
Department of Communication
University of Missouri

MedicalResearch.com: What is the background for this study?

Response: Miscarriage is a prevalent health concern, with one in five pregnancies ending in miscarriage, which is a pregnancy loss before 20 weeks’ gestation. Past research has shown that women who have miscarried often suffer mental health effects such as heightened grief, depression, loneliness, and suicidality.

Although much of the research on coping with miscarriage has focused on women’s health, many miscarriages occur within romantic relationships and affect the non-miscarrying partner as well. Women in heterosexual marriages report that their husband is often their top support-provider. Past research has shown that husbands suffer with mental health effects after a miscarriage, sometimes for even longer than their wives, but are not often supported in their grief because miscarriage is a “woman’s issue” and they feel uncomfortable talking about it.

Continue reading

Thyroid Treatment Did Not Improve IVF Miscarriage Rate in Women With Thyroid Antibodies But Normal Thyroid Function

MedicalResearch.com Interview with:
Professor Tianpei Hong, MD, PhD
Of behalf of Prof. Jie Qiao and all the coauthors,
Director, Department of Endocrinology & Metabolism
Director, Department of Laboratory Medicine
Peking University Third Hospital
Beijing, China

MedicalResearch.com: What is the background for this study?

  • Ÿ           Women who test positive for thyroid autoantibodies have been reported to be at 2- to 3-fold higher risk of spontaneous miscarriage than those who test negative. However, the effect of levothyroxine on miscarriage among women with positive thyroid autoantibodies and normal thyroid function has been documented in limited studies with conflicting results.
  • Ÿ           Given the substantial difficulty achieving successful pregnancy among infertile women, identifying optimal treatment for infertile women who test positive for thyroid autoantibodies is particularly important. There are a few randomized clinical trials showing a beneficial effect of levothyroxine treatment on pregnancy outcomes among women undergoing in vitro fertilization and embryo transfer (IVF-ET). However, the sample size of those trials was rather small which may weaken the quality of the evidence.
  • Ÿ           Therefore, the Pregnancy Outcomes Study in euthyroid women with Thyroid Autoimmunity after Levothyroxine (POSTAL) study was conducted in Peking University Third Hospital to evaluate whether levothyroxine treatment initiated before IVF-ET could decrease the miscarriage rate and improve the live birth rate in infertile women who tested positive for antithyroperoxidase antibody but had normal thyroid function.

Continue reading

Nausea and Vomiting During Pregnancy May Signal Less Risk of Pregnancy Loss

MedicalResearch.com Interview with:
Stefanie N. Hinkle, Ph.D.

Staff Scientist | Epidemiology Branch
Division of Intramural Population Health Research
Eunice Kennedy Shriver National Institute of Child Health and Human Development
National Institutes of Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Thank you for the interest in our research. Nausea and vomiting are very common early in pregnancy and these symptoms can be difficult for women. Before we began this study there was very limited high-quality data on the implications of these difficult symptoms in pregnancy. Our study is unique because we asked women to report their symptoms continuously throughout their pregnancy before they may or may not have gone on to have a loss. We found that among women with 1 or 2 prior pregnancy losses, women who have nausea, and particularly nausea with vomiting, were less likely to have a pregnancy loss.

Continue reading

Do High Phthalates Levels Increase Risk of Miscarriage?

MedicalResearch.com Interview with:
Dr. Jianying Hu
Laboratory for Earth Surface Processes
College of Urban and Environmental Sciences
Peking University, Beijing People’s Republic of China 

Medical Research: What is the background for this study? What are the main findings?

Response: Early pregnancy loss or first-trimester miscarriage is the most common complication of human reproduction, and the miscarriage incidence is increasing around the world in the recent decades. Though there are many causes for miscarriage, approximately 40% of early pregnancy loss remains unexplained. Exposure to endocrine disrupting chemicals (EDCs) has been considering one of major risk factor to affect female reproduction. Of these EDCs related to reproductive toxicity, phthalates is of concern due to their wide usage and contamination in environment, and the reproductive toxicity in the female mouse.

Our study found that the levels of phthalates in the women who underwent miscarriage were statistically significantly high, and the risk of clinical pregnancy loss was associated with urinary concentration of phthalate metabolites.

Continue reading

New Blood Test May Be Better Able To Detect Increased Risk of Miscarriage

MedicalResearch.com Interview with:
Dr. Ali Abbara
Imperial College London, United Kingdom

Dr. Abbara: What are the main findings of the study?

MedicalResearch: We found that a novel blood test for kisspeptin was able to identify asymptomatic pregnant women who were at increased risk of subsequent miscarriage. Blood kisspeptin performed better than the more commonly measured pregnancy hormone BHCG in identifying women at increased risk of miscarriage.  Continue reading

NSAIDS and Risk of Miscarriage

MedicalResearch.com Interview with:
Dr. Sharon Daniel MD, MPH
Physician, Intern in pediatrics at Soroka Medical Center, Beer-Sheva, Israel
PhD Candidate
and
Prof. Amalia Levy (MPH, PhD
Epidemiologist, Head of the Department of Public Health
Principle Investigator.
Ben-Gurion University of the Negev in Beer-Sheva, Israel,

MedicalResearch.com: What are the main findings of the study?

Answer: We tested the risk for miscarriage following the use of NSAIDs (ibuprofen, diclofenac, naproxen, indomethacin, etodolac) on the first trimester of pregnancy. We did not find increased risk among women who took those drugs during the first trimester of pregnancy, although we did find increased risk after the use of indomethacin. We found higher risk after the use of specific NSAIDs (Celecoxib, Rofecoxib, Etoricoxib) which are usually used to treat inflammatory diseases, only the exposure group was very small.
Continue reading