Emergency C-Section Raises Depression Risk For New Moms

MedicalResearch.com Interview with:

Valentina Tonei, PhD  British Academy Research Associate Department of Economics and Related Studies University of York, UK

Dr. Tonei

Valentina Tonei, PhD
British Academy Research Associate
Department of Economics and Related Studies
University of York, UK

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

Response: There has been a growing utilisation of Caesarean sections in the past decades. To put it in a perspective, in the United Kingdom, the caesarean section rate was about 26% in 2015, while in 1990s it was about 12-15%. A similar increase has been observed in other countries, for example in the USA. So, while this study focuses on the United Kingdom, I believe that the evidence from this research can apply also to other countries.

I study the health consequences for mothers who give birth through an emergency caesarean. Thanks to previous studies, we are well-aware of the implications for mothers’ physical health; instead, this research sheds light on the impact on new mothers’ mental health. I find that new mothers who have an emergency caesarean delivery are at higher risk of developing postnatal depression in the first 9 months after the delivery.  Continue reading

Mothers of Infants Born With Major Birth Defect are at Increased Risk of Cardiovasular Disease

MedicalResearch.com Interview with:

Eyal Cohen, MD, MSc, FRCP(C) Associate Scientist and Program Head (interim), Child Health Evaluative Sciences Research Institute, The Hospital for Sick Children Staff Physician, Division of Paediatric Medicine, The Hospital for Sick Children Professor, Paediatrics and Health Policy, Management & Evaluation The University of Toronto 

Dr. Cohen

Eyal Cohen, MD, MSc, FRCP(C)
Associate Scientist and Program Head (interim), Child Health Evaluative Sciences
Research Institute, The Hospital for Sick Children
Staff Physician, Division of Paediatric Medicine, The Hospital for Sick Children
Professor, Paediatrics and Health Policy
Management & Evaluation
The University of Toronto

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

Response: Having a child with a major birth defect can be a life-changing and stressful event for the child’s mother.  This stress may be associated with higher risk of premature cardiovascular disease.

We found that mothers of infants born with a major birth defect had a 15% higher risk of premature cardiovascular disease that a comparison group of mothers.  The risk was more pronounced, rising to 37% among mothers who gave birth to a more severely affected infant (and infant born with major birth defects affecting more than one organ system). The risk was apparent even within the first 10 years after the birth of the child.

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Pregnant Women Have Same Low Rate Of Adverse Surgical Outcomes As Non-Pregnant Patients

Robert A. Meguid, MD MPH FACS Assistant Professor Section of General Thoracic Surgery Division of Cardiothoracic Surgery Department of Surgery University of Colorado Denver | Anschutz Medical Campus Aurora, CO 80045MedicalResearch.com Interview with:
Robert A. Meguid, MD MPH FACS

Assistant Professor Section of General Thoracic Surgery
Division of Cardiothoracic Surgery Department of Surgery
University of Colorado Denver | Anschutz Medical Campus
Aurora, CO 80045

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

Dr. Meguid: The surgical literature on adverse outcomes after surgery on pregnant patients is conflicting.  We know that the majority of surgery performed on pregnant patients is not elective (and just over 50% of it in the database studied was emergency surgery).  We expected to find an increased rate of adverse outcomes in those pregnant patients.  However, when we matched the pregnant and non-pregnant women who underwent surgery in the database, with excellent matching on all available preoperative characteristics and on the actual operation performed, we found similar, low rates of 30-day postoperative death and complication.  In this study, pregnant patients had undergone a broad spectrum of different types of operations, including general, vascular, thoracic, head and neck, non-obstetric gynecologic and urologic, orthopedic, reconstructive, and neuro-surgery.  Given the concern that we as surgeons have over operating on pregnant patients, both for the well-being of the patient and her child, our findings are reassuring.  This suggests that we as a medical profession are diligent in minimizing risk to pregnant women who need surgery that cannot be delayed until after the child’s birth.  Again, this study faces the limitations of being unable to assess any short term harm done to the fetus and the subsequent long term outcome of the child.

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Insulin May Be Better Than Glyburide For Some With Gestational Diabetes

MedicalResearch.com Interview with:
Dr. Michele Jonsson Funk, PhD
Research Associate Professor, Dept of Epidemiology
Director, Methods Core, Center for Women’s Health Research
University of North Carolina at Chapel Hill and
Dr. Wendy Camelo Castillo, MD, PhD
Post-doctoral fellow at the University of Maryland

Medical Research: What is the background for this study?

Response: Gestational diabetes is a condition that affects between 8-11% of pregnant women worldwide. In the United States, the prevalence of gestational diabetes has more than doubled since the 1990’s. Most women can control their blood glucose levels with changes in diet and exercise, but approximately 10% need to take medication during pregnancy. Over the last decade, the use of glyburide (a pill) to manage gestational diabetes has increased and it is now used more often than insulin (an injectable).

Medical Research: What are the main findings?

Response: Treatment with glyburide (compared with insulin) was associated with higher risks of admission to the neonatal intensive care unit (NICU) (by 41%), respiratory distress (by 63%), hypoglycemia in the newborn (40% ), birth injury (35% ) and being large for gestational age (43% ).  The risk of NICU admission, large for gestational age and respiratory distress between glyburide and insulin treated women was increased by 3.0%, 1.4% and 1.1% respectively. Continue reading