Dr. Flom[/caption]
Julie Flom, MD MPH
Clinical Fellow
Division of Allergy & Immunology
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study?
Response: Women who are minorities and of lower socioeconomic have particularly high rates of exposure to chronic ongoing adversity such as poverty as well as traumatic stressors in their lifetime and are also more likely to have low birthweight infants. Not all women exposed to chronic adversity or trauma transfer this risk to the next generation – it is primarily when the trauma results in changes in her bodies’ ability to handle ongoing stress that the developing child can be impacted.
Our group undertook a study to investigate whether women with increased exposure to traumatic stressors over her lifetime were at higher risk of having low birthweight infants and also whether effects of trauma would only be evident among women who produced higher levels of cortisol, the major stress response hormone, while pregnant.
Dr. Metzger[/caption]
Boyd E Metzger, MD
Professor Emeritus of Medicine (Endocrinology)
Feinberg School of Medicine
Northwestern University
MedicalResearch.com: What is the background for this study?
Response: The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study showed that higher levels of a mother’s blood sugar during pregnancy are associated with higher risks of increased birthweight, fatter babies, delivery by Cesarean Section, low blood sugar in newborn babies and high levels of insulin in the cord blood at birth.
It is not clear whether levels of a mother’s blood sugar during pregnancy are associated with risk obesity later in life as is known to occur in offspring or pre-existing maternal diabetes mellitus. With funding from the National Institutes of Health, the HAPO Follow Up Study addressed this in a subset of nearly 5,000 mothers and their children from the original HAPO Study 10-14 years later (average 11.4 years).
Dr. Moniz[/caption]
Michelle H. Moniz, MD, MSc
Assistant Professor
Department of Obstetrics and Gynecology
Ann Arbor, MI 48109-2800
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We wanted to examine whether Medicaid expansion in Michigan was associated with improved access to birth control/family planning services in our state. We conducted a survey of enrollees in the Michigan Medicaid expansion program (called "Healthy Michigan Plan").
We found that 1 in 3 women of reproductive age reported improved access to birth control/family planning services after joining HMP. Women who were younger, who were uninsured prior to joining HMP, and those who had recently seen a primary care clinician were most likely to report improved access.
MedicalResearch.com Interview with: Professor Rosalind John Head of Biomedicine Division, Professor School of Biosciences Cardiff University Cardiff UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: I have been studying a really remarkable family of genes called “imprinted genes” for the last 20 years. For most genes, we inherit two working copies...
Dr. Carlson[/caption]
Dr. Dawn Carlson MD MPH
Vice President, General Medicine Development
AbbVie
MedicalResearch.com: Please provide some background on this announcement. Would you briefly explain what endometriosis is? Whom does it affect and how does it interfere with quality of life?
Response: Endometriosis is one of the most common gynecologic disorders in the U.S that affects an estimated one in 10 women of reproductive age. It occurs when tissue similar to the lining of the uterus starts growing outside of the uterus, where it doesn’t belong.
The symptoms of endometriosis, including pain with menstrual periods and between periods, and with sexual intercourse, can be debilitating and significantly impact day-to-day activities of women’s lives, personally and professionally. Unfortunately, women with endometriosis can suffer for up to 10 years and visit multiple physicians before receiving a proper diagnosis. Unresolved endometriosis pain results in higher healthcare costs from emergency department visits and repeat surgeries.
Dr. Pearson[/caption]
Rebecca Pearson, PhD
Lecturer in Psychiatric Epidemiology
Centre for Academic Mental Health
School of Social & Community Medicine
University of Bristol
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We know depression and anxiety are common in young women and during pregnancy when there are also implications for the developing child.
It is therefore important to investigate whether symptoms are rising given the pressures of modern life.
We found that compared to their mothers generation in the 1990s young pregnancy women today are more likely to be depressed. This was driven largely by symptoms of anxiety and feeling overwhelmed rather than feeling down.
Dr. Cluett[/caption]
Dr Elizabeth R Cluett PhD MSc RM RGN PGCEA PFHEA
Senior Lecturer, Faculty of Health Sciences
University of Southampton
Southampton UK
MedicalResearch.com:What is the background for this study?
Response: Water immersion during labor and birth is increasingly popular and is becoming widely accepted across many countries, and particularly in midwifery-led care settings.
Immersion in water during labor and birth facilitates physiological labor and birth, offers women a non-pharmacological pain relief option and facilitates a sense of choice, control and comfort; qualities strongly associated with women’s satisfaction with their birth experience.
Dr. Roffman[/caption]
Joshua L. Roffman, MD
Department of Psychiatry
Mass General Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Autism, schizophrenia, and other serious mental illness affecting young people are chronic, debilitating, and incurable at present. Recent public health studies have associated prenatal exposure to folic acid, a B-vitamin, with reduced subsequent risk of these illnesses. However, until this point, biological evidence supporting a causal relationship between prenatal folic acid exposure and reduced psychiatric risk has remained elusive.
We leveraged the rollout of government-mandated folic acid fortification of grain products in the U.S. from 1996-98 as a "natural experiment" to determine whether increased prenatal folic acid exposure influenced subsequent brain development. This intervention, implemented to reduce risk of spina bifida and other disabling neural tube defects in infants, rapidly doubled blood folate levels among women of childbearing age in surveillance studies.
Across two large, independent cohorts of youths age 8 to 18 who received MRI scans, we observed increased cortical thickness, and a delay in age-related cortical thinning, in brain regions associated with schizophrenia risk among individuals who were born during or after the fortification rollout, compared to those born just before it. Further, delayed cortical thinning also predicted reduced risk of psychosis spectrum symptoms, a finding that suggests biological plausibility in light of previous work demonstrating early and accelerated cortical thinning among school-aged individuals with autism or psychosis.
Dr. Gina Ogilvie[/caption]
Dr. Gina Ogilvie | MD MSc FCFP DrPH
Professor | Faculty of Medicine | University of British Columbia
Canada Research Chair | Global control of HPV related disease and cancer
Senior Public Health Scientist | BC Centre for Disease Control
Senior Research Advisor | BC Women's Hospital and Health Centre
BC Women's Hospital and Health Centre
Vancouver, BC
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: HPV is known to be the cause of 99% of cervcial cancers.
In this study, we compared the routine screening test for cervical cancer, Pap test, to HPV testing.
We found that by using HPV testing, women were significantly more likely to have cervical pre-cancers detected earlier. In addition, women with negative HPV tests were significantly less likely to have pre-cancers 48 months later.
Dr. Stuart[/caption]
Jennifer J. Stuart, ScD
Postdoctoral Research Fellow in Reproductive & Cardiovascular Epidemiology
Department of Epidemiology
Harvard T.H. Chan School of Public Health
Division of Women's Health
Brigham and Women's Hospital and Harvard Medical School
MedicalResearch.com: What is the background for this study?
Response: Preeclampsia and gestational hypertension are common pregnancy complications involving high blood pressure that develops for the first time during pregnancy and returns to normal after delivery. Approximately 10 to 15% of all women who have given birth have a history of either preeclampsia or gestational hypertension. Previous studies have shown that women with a history of high blood pressure in pregnancy are more likely to develop cardiovascular disease events like heart attack and stroke later in life when compared to women with normal blood pressure in pregnancy. However, what is less clear is to what extent these women are more likely to develop chronic hypertension, diabetes, and high cholesterol and when these risk factors begin to emerge after pregnancy.
We examined this question in a cohort of nearly 60,000 American women who we were able to follow for up to 50 years after their first pregnancy. Previous studies have been limited by small numbers, short follow-up, or a lack of information on shared risk factors, such as pre-pregnancy body mass index, smoking, and family history. This research was conducted within the Nurses’ Health Study II, which collected data on these pre-pregnancy factors in tens of thousands of women over several decades.
Dr. Roberts[/caption]
Sarah CM Roberts, DrPH
Associate Professor
ObGyn&RS
Zuckerberg San Francisco General
UCSF
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Thirteen states have laws that require abortions to be provided in Ambulatory Surgery Centers (ASCs); many of these laws apply only in the second trimester. We examined outcomes from more than 50,000 abortions provided in two facility types: Ambulatory Surgery Centers and office-based settings.
We found that there was no significant difference in abortion-related complications across facility type; in both settings, about 3.3% had any complication and about 0.3% had a major complication. There also was no significant difference in complications across facility types for second trimester and later abortions.
Dr. Lorenzo[/caption]
Melissa Lorenzo MD
Pediatric medical resident
Dr. Lorenzo is currently training at the University of Toronto, however the research was conducted while a medical student at Queens University
MedicalResearch.com: What is the background for this study?
Response: Preterm infants are born before 37 weeks gestation, with late preterm neonates defined as infants born between 34 weeks to 37 weeks gestation. Of all preterm births, over 70% of babies are born in the late preterm period. Late preterm births are common, affecting 12.5% of all births in the United States.
Compared to infants born at term, late preterm neonates are at increased risk for many common complications following birth such as jaundice, low blood sugar, and respiratory distress, prolong hospital stay, admission to the neonatal intensive care unit, and increase readmission rate after hospital discharge. There are many causes for preterm delivery- two important ones are early onset of labour either spontaneous or after premature rupture of membranes, and medically indicated delivery prior to full term gestation due to chronic diseases in mother affecting her health in pregnancy, fetal medical reasons, or placental insufficiency. There is a debate that the risk of neonatal complications is affected by the causes of preterm delivery with immaturity acting as a contributing factor. The relative contribution of immaturity versus the reason for delivery and the resulting neonatal complications is unclear.
Giulia Muraca, PhD, MPH
Postdoctoral Fellow
School of Population and Public Health
BC Children’s Hospital Research Institute
Faculty of Medicine
University of British Columbia
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: While cesarean delivery rates have increased in Canada over the last few decades, as in most industrialized settings, the rate of forceps and vacuum deliveries have declined. These opposing trends have led to recommendations to increase forceps and vacuum delivery rates as a strategy to reduce cesarean delivery rates.
We found that the rate of obstetric trauma in Canada increased significantly in recent years, especially among forceps deliveries. In first-time mothers, the rate of obstetric trauma increased by 7% among forceps deliveries (from 19.4% in 2004 to 26.5% in 2014) and in women who had a previous cesarean delivery, the rate of obstetric trauma among forceps deliveries increased by 9% (from 16.6% to 25.6%).
We found that a 1% increase in the forceps and vacuum delivery rate in Canada was associated with approximately 700 additional cases of obstetric trauma and 18 additional cases of severe birth trauma annually among first-time mothers alone.
Dr. Sagar[/caption]
Manish Sagar, MD
Infectious Disease Physician at Boston Medical Center
Boston MA
MedicalResearch.com: What is the background for this study?
Response: Women compromise the majority of new infections in the world and most of them acquire the virus after sexual exposure. The goal of the study was to understand how HIV establishes initial infection in the female genital tract. We obtained discarded vaginal tissue and isolated cells present in the outermost layer that contact the virus during exposure.
Dr. Davidge[/caption]
Sandra T. Davidge, PhD, FCAHS
Executive Director, Women and Children's Health Research Institute
Canada Research Chair in Maternal and Perinatal Cardiovascular Health
Professor, Depts. of Ob/Gyn and Physiology
University of Alberta
Edmonton, Alberta
Canada
MedicalResearch.com: What is the background for this study?
Response: This research contributes to the growing body of literature that developmental programming of adult onset cardiovascular disease originates in the womb.
Our study is among the first to discover that maternal age may be considered a ‘prenatal stress’ in certain circumstances.
Dr. Ananth[/caption]
Dr. Cande V. Ananth, PhD, MPH
Adjunct professor
Department of Health Policy and Management
Mailman School of Public Health
Columbia University, NY
MedicalResearch.com: What is the background for this study?
Response: Preterm delivery rates have declined between 2005 and 2014 in the US and in several European countries. Since reductions in preterm and early term deliveries, and perinatal mortality remain a global health priority, determining the relationship between gestational age distribution and perinatal mortality, remains a challenge. Efforts expended to a more complete understanding of the impact of new interventions, policies, and practices on reducing the burden of early deliveries, and in turn improvements in perinatal survival will be of tremendous benefit for clinical management and care of women during their pregnancy and the newborn.
Dr. Fejzo[/caption]
Marlena Fejzo, PhD
Aassociate researche
David Geffen School of Medicine
UCLA.
MedicalResearch.com: What is the background for this study?
Response: Most women experience some nausea and vomiting of pregnancy, and the worst 2% are diagnosed with Hyperemesis Gravidarum which is associated with poor maternal and fetal outcomes. I had HG in 2 pregnancies. In my second pregnancy my HG was so severe that I could not move without vomiting and did not keep any food or water down for 10 weeks. I was put on a feeding tube, but ultimately lost the baby in the second trimester. I am a medical scientist by training so I looked into what was known about HG. At the time, very little was known, so I decided to study it. I partnered with the Hyperemesis Education and Research Foundation (HER) and we did a survey on family history of .Hyperemesis Gravidarum that provided evidence to support a role for genes. I collected saliva samples from HG patients and their unaffected acquaintances to do a DNA study. Then I partnered with the personal genetics company, 23andMe to do a genome scan and validation study, which identified 2 genes, GDF15 and IGFBP7, linked to HG.
Ning Liu PhD Student
Senior Research Analyst at ICES
Institute of Health Policy, Management and Evaluation
Institute for Clinical Evaluative Sciences
University of Toronto
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Previous studies suggested intergenerational tendencies between a mother and her daughter in fertility patterns, such as when they give birth to a child for the first time, or the total number of children they have during their lifetime.
We explored whether there is also an intergenerational tendency for induced abortion practices between a mother and her teen daughter.
To do so, we used anonymized records of 431,623 daughters and their mothers, and found that a teenage daughter was twice as likely to have an induced abortion if her mother had had an induced abortion.
Mahsa Nordqvist MD
Department of Obstetrics and Gynecology
Sahlgrenska University Hospital
Gothenburg, Sweden
MedicalResearch.com: What is the background for this study?
Response: We have shown in earlier observational studies that there is an association between probiotic intake and lower risk of preterm delivery and preeclampsia. Since pregnancy is a time of rapid change and different exposures can have different effect depending on the time of exposure, we wanted to find out if there is any special time point of consumption that might be of greater importance when it comes to these associations.
Placenta - Wikipedia Image[/caption]
Daniel C Benyshek, PhD
Professor, Department of Anthropology
Adjunct Professor, UNLV School of Medicine
Co-Director, Metabolism, Anthropometry and Nutrition Lab
UNLV
Sharon M. Young, PhD (first author)
MedicalResearch.com: What is the background for this study?
Response: Over the last several decades, human maternal placentophagy (postpartum ingestion of the placenta by the mother) has emerged as a rare but increasingly popular practice among women in industrialized countries seeking its many purported health benefits. Human placentophagy advocates, including many midwives, placenta encapsulation specialists, lactation consultants, and mothers who have experienced positive results previously from the practice, regularly claim improved lactation, energy levels, and postpartum mood, among other benefits, as a result of placentophagy. These advocates regularly speculate that these self-reported effects are likely due to (beneficial) changes to postpartum maternal hormone profiles as a result of the practice. While maternal placentophagy is ubiquitous among land mammals, including our closest primate relatives, recent research has shown that human maternal placentophagy is unknown as a traditional cultural practice. The conspicuous cross-cultural absence of maternal placentophagy among humans (as a long-standing traditional practice) thus remains a mystery. Our study is an important first step in the scientific (evolutionary and clinical) investigation of this rare but increasingly popular maternal practice.
Our study was a double-blind, and placebo controlled trial, meaning that there was a placenta group and a placebo group, and the participants and researchers didn't know which supplement a participant had until the end of the study. We included 27 healthy women, recruited during pregnancy, who met with the researchers 4 times across pregnancy and early postpartum. At each meeting, they answered questionnaires on topics of interest (e.g., mood, energy, bonding, social support etc.), and we collected blood and saliva samples. At the first two meetings, they were not yet taking a placenta or placebo supplement, so we could collect baseline measures for their hormones and questionnaire data. After the second meeting, they were instructed to take either placenta or placebo supplements. Once the study had ended, we compared data between the two groups to identify any differences.
Prof. Wald[/caption]
Professor Sir Nicholas Wald FRCP FRS
Professor of Preventive Medicine
Wolfson Institute of Preventive Medicine
Barts and The London School of Medicine and Dentistry
Queen Mary University of London
London
MedicalResearch.com: What is the background for this study?
Response: Prenatal screening for Down’s syndrome (trisomy 21), Edwards syndrome (trisomy 18) and Patau syndrome (trisomy 13) by maternal plasma DNA analysis has an improved screening performance compared with conventional screening but is too expensive to be performed routinely and has a technical failure rate.
The aim of the study was to take advantage of the improved screening performance of the DNA analysis in conjunction with the existing methods thereby providing a seamless testing interface between the “old” and the “new” methods that would detect a larger proportion of affected pregnancies with a much lower false-positive rate, at a much reduced cost compared with universal DNA testing and with no failed tests. The novel approach was to conduct a conventional screening test using a screening cut-off level that identifies about 10% of women with the highest risks of having an affected pregnancy (much higher than in conventional screening) and then to perform a DNA test using a portion of the original blood sample collected for the conventional test. Progressing to the DNA test was automatic for these high risk women without their having to be recalled for counseling and a fresh blood sample (ie as a reflex response hence the term “reflex DNA screening”).
Dr. Buher-Kane[/caption]
Jennifer Buher Kane PhD
Assistant Professor, Department of Sociology
University of California, Irvine 92697-510
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: It’s not uncommon for new parents to relocate in search of neighborhoods with better schools, safer streets and healthier, more kid-friendly activities. But our new study found that living in such neighborhoods before a baby is born protects against the risks of poor birth outcomes.
Published online this month in SSM – Population Health, the research shows that having highly educated, wealthy neighbors reduces an expectant mother’s risk of delivering a low-weight or preterm baby – health markers that can be associated with neurodevelopmental problems, language disorders, learning disabilities and poor health later in life.
Our study is the first to look at how both the level of affluence and disadvantage — two sociologically distinct attributes of neighborhoods — affect newborn health; past studies have only explored the impact of neighborhood disadvantage. Neighborhood disadvantage signals factors such as poverty, unemployment, or underemployment. On the other hand, neighborhood affluence is thought to signal the presence of locally-based community organizations that can meet the needs of all residents – health-related and otherwise – regardless of one’s own socioeconomic resources.
Dr. Beam[/caption]
Andrew L. Beam, PhD
Instructor in Biomedical Informatics
Department of Biomedical Informatics
Harvard Medical School
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study is one piece of a larger story regarding the use of 17-alpha-hydroxyprogesterone caproate (17P) to treat recurrent preterm birth. This drug was originally only available in a compounded form, but since receiving an orphan drug designation in 2011, a branded and manufactured form was marketed under the name "Makena". This branded form was then sold for a much higher price than the compounded version, but a study that provided concrete data on pricing and outcomes had not been done.
Dr. Duo Li[/caption]
Duo Li, PhD
Chief professor of Nutrition
Institute of Nutrition and Health
Qingdao University, China.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Childhood obesity is becoming an emerging public health issue worldwide, owing to its association with a variety of health problems at younger ages in adulthood, including obesity, type 2 diabetes and cardiovascular diseases. Identification of prenatal and early life risk factors is key for curbing the epidemic of the childhood obesity.
Main finding of the present study is that among pregnant women, elevated blood pressure is associated with a greater risk of overweight and obesity for their children.
Dr. Warshak[/caption]
Dr. Carri R. Warshak, MD
Associate Professor of Obstetrics & Gynecology
University of Cincinnati
MedicalResearch.com: What is the background for this study?
Response: Cesarean deliveries are the most common major surgical procedure performed in the United States. A common complication of cesarean section is wound infections that can include infections in the skin and incision site, or infections in the uterus itself after delivery. These complications can lead to prolonged hospitalization after delivery for antibiotics and even further surgery in severe infections. Often these wound complications lead to delayed healing, wound opening which can sometimes take several weeks to heal. Studies have demonstrated as many as 12% of women experience a surgical site infection after delivery.
Obesity is a strong risk factor for increased surgical site infections. Increasing maternal weight increases the risk of wound complications, with a two to five fold increase in risk, making surgical site infections and common and concerning complication of cesarean delivery in obese women.
Dr. Larsen[/caption]
Ashley Larsen, PhD
Assistant professor
Bren School of Environmental Science & Management
University of California, Santa Barbara
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The relationship between pesticides and adverse birth outcomes has been recognized as an important question for quite some time, and there have been many good studies on the topic. Since randomly exposing people to different levels of pesticides is clearly unethical, researchers focused on the health consequences of non-occupational pesticide exposure often have to choose between detailed studies that follow a couple hundred or couple thousand individuals through pregnancy or larger scale studies that use easier to observe, but less accurate metrics of pesticide exposure (e.g. nearby crops or crop types). Here we tried to provide complementary insight by bridging the gap between detail and scale using detailed pesticide use data and individual birth certificate records for hundreds of thousands of births in an agriculturally dominated region of California. While we found negative effects of pesticide use on birth outcomes including low birth weight, preterm birth and birth abnormalities, these effects were generally in the magnitude of a 5-9% increase in probability of an adverse outcome, and only observed for individuals exposed to very high levels of pesticides.