OBGYNE, Pediatrics, Weight Research / 30.08.2017

MedicalResearch.com Interview with: Leanne M. Redman MS, PhD LPFA Endowed Fellowship Associate Professor Pennington Biomedical Research Center Baton Rouge, Louisiana  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Two well-documented risk factors for aberrant weight gain and obesity is whether your mother was obese when she was pregnant and the amount of weight she gained. Up until now few studies have asked questions about whether the pattern of weight gain in pregnancy affect outcomes in offspring, such as birth weight. In a cohort of over 16,000 pregnant women and infants, we found that regardless of the obesity status (BMI) of the mother at the time of pregnancy, weight gain that occurs up until week 24, had the strongest effect on infant birth weight. Infants born to mothers who had weight gain in excess of the 2009 IOM guidelines from conception until week 24, had a 2.5 times higher likelihood of being born large for gestational age. The weight gain that occurred after 24 weeks until delivery, did not attenuate this risk. (more…)
Author Interviews, OBGYNE, Pediatrics / 21.07.2017

MedicalResearch.com Interview with: Parvati Singh B. Tech, MBA, MPA PhD student, Department of Public Health, University of California, Irvine and Dr. Tim Bruckner, first author MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study builds upon earlier research by our group which showed that male fetal deaths rose and the number of liveborn males fell after the 9/11 attacks. Here we show that, in California, the number of live born males with birth defects fell after 9/11. This finding appears consistent with the notion that frail male gestations, such as those with defects, may have been lost in utero as a result of the stress induced by the 9/11 attacks. (more…)
Author Interviews, BMJ, Exercise - Fitness, OBGYNE, Weight Research / 20.07.2017

MedicalResearch.com Interview with: Shakila Thangaratinam Professor of Maternal and Perinatal Health Joint Director of BARC (Barts Research Centre for Women's Health) Women's Health Research Unit | Multidisciplinary Evidence Synthesis Hub (MESH) Barts and the London School of Medicine and Dentistry R & D Director for Women's Health Queen Mary University of London  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pregnant women who are overweight or obese, or who gain excess weight gain in pregnancy are at high risk of complications. We wanted to find
  1. If healthy diet and physical activity in pregnancy reduced weight gain, and improved outcomes for the mother and baby
  2. If the effects of the interventions differed according to the characteristics of the mother such as body mass index, parity, ethnicity, and underlying medical condition
We established a network (International Weight Management in Pregnancy i-WIP) of researchers from 16 countries, and 41 institutions to answer the above. We found that women who followed a healthy diet and moderate physical activity gained less weight in pregnancy than other women; this beneficial effect was observed irrespective of mother's body mass index, parity, ethnicity, and underlying medical condition. Diet and physical activity in pregnancy has a beneficial effect on weight gain in pregnancy, and lowers the odds of caesarean section, and gestational diabetes. (more…)
Author Interviews, Fertility, OBGYNE / 15.06.2017

MedicalResearch.com Interview with: Prof. Dr. João Martins Pisco MD PhD Radiologia de Intervenção Hospital Saint Louis - Rua Luz Soriano PortugalProf. Dr. João Martins Pisco MD PhD Radiologia de Intervenção Hospital Saint Louis - Rua Luz Soriano Portugal MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background for the study is the good results I started to check in patients with uterine fibroids who could conceive a successful pregnancy with live birth following embolization. MedicalResearch.com: What should readers take away from your report? Response: The readers should know that fertility can be restored following embolization of uterine fibroids, particularly if the embolization is partial. The wish of conception in patients with uterine fibroids is not a contraindication for fibroids embolization. (more…)
Author Interviews, NEJM, OBGYNE, Yale / 21.05.2017

MedicalResearch.com Interview with: Hugh S. Taylor, M.D. Anitta O’keeffe Young Professor and Chair Departemnt of Obstetrics, Gynecology and Reproductive Sciences Yale School of Medicine Chief of Obstetrics and Gynecology Yale-New Haven Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Elagolix is an investigational, oral gonadotropin-releasing hormone (GnRH) receptor antagonist that blocks endogenous GnRH signaling by binding competitively to GnRH receptors. Administration results in rapid, reversible, dose-dependent inhibition of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) secretion, leading to reduced ovarian production of the sex hormones, estradiol and progesterone, while on therapy. Data from two replicate Phase 3 studies evaluating the efficacy and safety of elagolix were published in the New England Journal of Medicine. Elagolix demonstrated dose-dependent superiority in reducing daily menstrual and non-menstrual pelvic pain associated with endometriosis compared to placebo. At month three and month six, patients treated with elagolix reported statistically significant reductions in scores for menstrual pain (dysmenorrhea, DYS) and non-menstrual pelvic pain (NMPP) associated with endometriosis as measured by the Daily Assessment of Endometriosis Pain scale. The safety profile of elagolix was consistent across both Phase 3 trials and also consistent with prior elagolix studies. Ultimately, the studies showed that both elagolix doses (150 mg QD and 200 mg BID) were effective in improving dysmenorrhea, non-menstrual pelvic pain and quality of life over 6 months in women with endometriosis-associated pain. The elagolix safety/tolerability profile was consistent with the mechanism of action. (more…)
Author Interviews, OBGYNE, Telemedicine / 20.05.2017

MedicalResearch.com Interview with: Abigail R.A. Aiken, MD, MPH, PhD Assistant Professor LBJ School of Public Affairs Faculty Associate Population Research Center University of Texas at Austin Austin, TX, 78713Abigail R.A. Aiken, MD, MPH, PhD Assistant Professor LBJ School of Public Affairs Faculty Associate Population Research Center University of Texas at Austin Austin, TX, 78713 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We've known for some time that women in Ireland and Northern Ireland self-source their own abortions using online telemedicine. In fact, this model has revolutionized abortion access for Irish women. Yet very little was previously known about the outcomes of those abortions. How safe and effective are they? We wanted to address that knowledge gap with this study. What this research shows is that self-sourced medication abortion, conducted entirely outside the formal healthcare setting, can have high rates of effectiveness and low rates of adverse outcomes. Women can successfully manage their own abortions and recognize the symptoms of potential complications. Among the small number who experienced such a symptom, virtually all sought in-person medical attention as advised. (more…)
Author Interviews, CMAJ, Fertility, Karolinski Institute, OBGYNE / 08.05.2017

MedicalResearch.com Interview with: Neda Razaz, PhD, MPH Postdoctoral Fellow Reproductive Epidemiology Unit Karolinska Institutet MedicalResearch.com: What is the background for this study? What are the main findings? Response: Multiple births of twins and triplets – and the associated health risks – have increased in many high-income countries, with a respective two-fold and three-fold increase in recent decades. In Canada, triplet births or higher have increased from 52.2 per 100 000 live births to 83.5 between 1991 and 2009, mainly because of an increase in fertility treatments for older women of child-bearing age. In this study we found that among twin and triplet pregnancies that were reduced to singleton or twin pregnancies, there was a substantial reduction in complications such as preterm birth and very preterm birth. Although rates of death and serious illness were not lower among all multifetal pregnancies that were reduced, pregnancies that resulted from fertility treatments did show a significant reduction in rates of death or serious illness following fetal reduction. (more…)
Author Interviews, Environmental Risks, OBGYNE, Pediatrics / 03.05.2017

MedicalResearch.com Interview with: Laura Birks, MPH, Predoctoral Fellow ISGlobal Instituto de Salud Global de Barcelona - Campus MAR Barcelona Biomedical Research Park (PRBB) (office 183.01B) Barcelona, Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies in Denmark and the Netherlands have reported associations between prenatal cell phone use and child behavioral problems, but findings have been inconsistent and based on retrospective assessment of cell phone use. This study aimed to assess this association in a multi-national analysis, using data from three cohorts with prospective data on prenatal cell phone use, together with previously published data from two cohorts with retrospectively collected cell phone use data. We found that cell phone use during pregnancy was associated with increased risk for behavioral problems in offspring, specifically hyperactivity/inattention problems. This association was fairly consistent across cohorts and between cohorts with retrospectively and prospectively collected cell phone use data. While our models were adjusted for many confounders, it is possible that other factors could explain this association, such as hyperactivity in the mother or parenting styles (variables that were not collected in these cohorts). Furthermore, to date there is no known biological mechanism that could explain the association. (more…)
Author Interviews, Cancer Research, JAMA, OBGYNE, Pediatrics / 27.03.2017

MedicalResearch.com Interview with: Hazel B. Nichols, PhD, UNC Assistant professor Lineberger Comprehensive Cancer Center member UNC Gillings School of Global Public Health. MedicalResearch.com: What is the background for this study? Response: Each year more than 45,000 adolescent and young adult women (AYA, ages 15-39 years) are diagnosed with cancer in the United States. While many of these women may wish to have children in the years following diagnosis, there is currently little information available to address their concerns about the impact of cancer diagnosis and treatment on future pregnancy. We identified >2,500 women who had a child after their cancer diagnosis using data from the North Carolina Central Cancer registry and statewide birth certificate files. We investigated whether adverse birth outcomes, such as preterm birth and low birth weight, were more common among AYA cancer survivors compared to women without cancer. We also looked at infant Apgar scores, which measure newborn health, and a calculation called small-for-gestational age, which can indicate restricted growth during pregnancy. (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, 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…)
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…)
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, Endocrinology, Fertility, OBGYNE / 21.10.2016

MedicalResearch.com Interview with: Kavita Vedhara FAcSS Professor of Health Psychology Division of Primary Care School of Medicine University Park,Nottingham MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been a longstanding interest in the role of the hormone cortisol in fertility, because of its potential to affect the functioning of the biological systems that influence both conception and pregnancy. This interest has extended to IVF, with researchers exploring the relationship between levels of the hormone and pregnancy since the advent of the treatment in the late 1970s. However, a recent review showed that the relationship between cortisol and pregnancy in IVF was unclear. A number of reasons were highlighted for this, including that all of the studies to date had relied on short-term measures of the hormone measured in blood, saliva, urine and sometimes follicular fluid. Such measures can only capture hormone levels over a matter of minutes and hours. Such ‘snapshots’ are unable to give us an accurate picture of the levels of hormone over longer periods of time. This is important because any clinically relevant effects of cortisol on fertility are only likely to occur in the context of long-term changes in the hormone. In recent years it has become possible to measure long-term levels of cortisol in hair. Cortisol is deposited in the hair shaft and because human hair grows, on average, 1cm per month, a 3cm sample of hair closest to the scalp can tell us about levels of cortisol in the previous 3 months. We used the development of this technique to examine whether long term levels of cortisol (as measured in hair), or short term levels of cortisol (as measured in saliva) could predict whether or not women going through IVF would become pregnant. If you are trying to obtain a perfect cortisol balance, I use this product that helps to do just that. (more…)
Author Interviews, Columbia, JAMA, Mental Health Research, OBGYNE, Pediatrics / 13.10.2016

MedicalResearch.com Interview with: Alan S. Brown, M.D., M.P.H. Professor of Psychiatry and Epidemiology Columbia University Medical Center Director, Program in Birth Cohort Studies, Division of Epidemiology New York State Psychiatric Institute  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Maternal use of antidepressants during pregnancy has been increasing.  A previous study from a team that I led in a national birth cohort in Finland showed that mother’s use of a serotonin reuptake inhibitor antidepressant is related to an increased risk of depression in offspring.  We sought to evaluate whether these medications also increased risk of speech/language, scholastic, and motor outcomes in offspring.  We found an increased risk (37% higher risk) of speech/language disorders in offspring of mothers exposed to SSRIs in pregnancy compared to mothers who were depressed during pregnancy but did not take an SSRI during pregnancy. (more…)
Author Interviews, JAMA, Karolinski Institute, Mental Health Research / 05.10.2016

MedicalResearch.com Interview with: Gustaf Brander Department of Clinical Neuroscience Karolinska Institutet MedicalResearch.com: What is the background for this study? Response: Obsessive-compulsive disorder (OCD) is believed to be caused by a complex interaction between genetic and environmental factors. Whereas genetic studies are well underway, the research on environmental factors has been lagging behind. As they explain a significant portion of the variance, are potentially malleable, and are essential for understanding how the genetic component works, this area of research is of great importance. (more…)
Author Interviews, Diabetes, OBGYNE / 19.09.2016

MedicalResearch.com Interview with: Anastasia Katsarou PhD LUND University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study is using data from the Mamma study which screened pregnant women during 2003-2005. During this period, we gathered results from the oral glucose tolerance tests that the women underwent at the 28th week of pregnancy. We used data on the 2hour blood glucose levels from these tests and the frequency of women who were diagnosed with gestational diabetes and grouped them into months and seasons. We gathered also data on the mean monthly temperatures from the Swedish Meteorological and Hydrological Institute. We observed that the 2hour glucose levels and the frequency of women diagnosed with gestational diabetes were statistically significantly higher during the summer months. (more…)
Author Interviews, OBGYNE, Pediatrics, PLoS / 16.09.2016

MedicalResearch.com Interview with: Joseph Leigh Simpson, MD FACOG, FACMG President at International Federation of Fertility Societies March of Dimes Foundation White Plains, NY MedicalResearch.com: What is the background for this study? Response: Preterm birth (PTB) is the most common single cause of perinatal and infant mortality, affecting 15 million infants worldwide each year with global rates increasing. A total of 1.1 million infants die each year. Preterm births and their complications are the leading cause of deaths in children under age 5. The biological basis of preterm birth remains poorly understood, and for that reason, preventive interventions are often empiric and have only limited benefit. Large differences exist in preterm birth rates across high income countries: 5.5 percent in Sweden and at present 9.6 percent in the U.S. The International Federation of Gynecologists and Obstetricians (FIGO)/March of Dimes Working Group on Preterm Birth Prevention hypothesized that identifying the risk factors underlying these wide variations could lead to interventions that reduce preterm birth in countries having high rates. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Mental Health Research, OBGYNE / 19.08.2016

MedicalResearch.com Interview with: Krista F. Huybrechts, M.S., Ph.D. Assistant Professor of Medicine Harvard Medical School Epidemiologist Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital Boston, MA 02120 MedicalResearch.com: What is the background for this study? Response: The use of antipsychotic medications during pregnancy has doubled in the last decade. Yet, information on the safety of antipsychotic medication use during pregnancy for the developing fetus is very limited: existing studies tend to be small (the largest study available to date includes 570 exposed women) and findings have been inconsistent. Concerns have been raised about a potential association with congenital malformations. The objective of our study was to examine the risk of congenital malformations overall, as well as cardiac malformations given findings from earlier studies, in a large cohort of pregnant women. We used a nationwide sample of 1.3 mln pregnant women insured through Medicaid between 2000-2010, of which 9,258 used an atypical antipsychotic and 733 used a typical antipsychotic during the first trimester, the etiologically relevant period for organogenesis. We also examined the risks associated with the most commonly used individual medications. (more…)
Author Interviews, Environmental Risks, NIH, OBGYNE, Ovarian Cancer / 18.08.2016

MedicalResearch.com Interview with: Clarice Weinberg, Ph.D. Deputy Branch Chief Biostatistics and Computational Biology Branch National Institute of Environmental Health Sciences National Institutes of Health Research Triangle Park, NC 27709 MedicalResearch.com: What is the background for this study? What are the main findings? Response: A number of studies have reported a link between genital use of talc powders and ovarian cancer. We wondered whether the practice of douching could contribute to that risk by moving fibers and chemicals into and up the reproductive tract. We are carrying out the Sister Study, a large cohort study that enrolled more than 50,000 women who each had a sister diagnosed with breast cancer and who are consequently at increased risk of ovarian cancer. During the Sister Study enrollment interview, we asked each of them about their douching and use of talc in the previous 12 months. During approximately 6 years of follow up, 154 participants developed ovarian cancer. Our statistical analyses did not show any relationship between talc use and risk of ovarian cancer, but we estimated that women who had said they douched had almost double the risk for ovarian cancer compared to women who did not douche. (more…)
Author Interviews, Genetic Research, JAMA, OBGYNE / 17.08.2016

MedicalResearch.com Interview with: Gabriel Lazarin MS Vice President,Counsyl Medical Science Liaisons MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study finds there is a significant opportunity to identify more pregnancies affected by serious conditions, across all ethnicities, through the clinical use of expanded carrier screening (ECS). We found that compared to current prenatal genetic testing guidelines, expanded carrier screening for 94 genetically inherited conditions better addresses the risk of having a pregnancy affected with a serious condition. Certain physicians have been offering ECS since 2010. However, in order for it to come into routine use, a group of major medical organizations last year stated a need for further data regarding the frequency of previously unscreened genetic variants. This study uses real test results from approximately 350,000 people to provide that data. (more…)
Author Interviews, JAMA, Pediatrics, Pharmacology / 16.08.2016

MedicalResearch.com Interview with: Dr Evie Stergiakouli Lecturer in Genetic Epidemiology and Statistical Genetics MRC Integrative Epidemiology Unit University of Bristol Bristol UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Acetaminophen is considered safe to use during pregnancy. However, research suggests that acetaminophen use in pregnancy is associated with abnormal neurodevelopment. It is possible that this association might be confounded by unmeasured behavioural factors linked to acetaminophen use. We compared acetaminophen use during pregnancy to postnatal acetaminophen use and partner's acetaminophen use. Only acetaminophen use during pregnancy has the potential to cause behavioural problems in the offspring. Any associations with postnatal acetaminophen use and partner's acetaminophen use would be due to confounding. Behavioural problems in the offspring were only associated with acetaminophen use during pregnancy. (more…)
Author Interviews, Diabetes, Education, OBGYNE / 09.08.2016

MedicalResearch.com Interview with: Dr Valerie Holmes Senior Lecturer Centre for Public Health School of Medicine, Dentistry and Biomedical Science Queen's University Belfast Belfast MedicalResearch.com: What is the background for this study? Response: Women with diabetes, type 1 diabetes and type 2 diabetes, are advised to plan for pregnancy as there are higher risks of complications for both the mother and baby when compared to the general maternity population. Careful planning in partnership with diabetes care teams, especially in relation to achieving optimum blood glucose control and taking folic acid can significantly reduce the risks. However, while most women know that they should plan for pregnancy, they are unaware as to why this is important or how to engage with the process, and thus the majority of women (up to two thirds of women) enter pregnancy unprepared. This study describes the implementation of a regional preconception counsellng resource, in the format of a DVD, into routine care in Northern Ireland to raise awareness of pregnancy planning. The authors assessed if the introduction of this resource improved pregnancy planning among women with diabetes in the region. (more…)
Author Interviews, Menopause, OBGYNE / 05.08.2016

MedicalResearch.com Interview with: Louise Wilson PhD Candidate The University of Queensland MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hysterectomy remains one of the most common gynecological procedures worldwide, with rates highest among women aged between 40 and 50. Between 30 and 40% of women aged in their 40s and 50s experience hot flushes and night sweats (vasomotor symptoms) that can greatly impact upon their overall quality of life. There is consistent evidence that women who have a hysterectomy and both ovaries removed are more likely to report more frequent or severe vasomotor symptoms, probably due to the abrupt decline in estrogen levels post-surgery. For women who have a hysterectomy with ovaries retained, the evidence is less clear. We wanted to increase our understanding of the symptom experiences of these women. We examined 17 years of data from more than 6,000 women in the Australian Longitudinal Study on Women’s Health. Approximately one in five of the women had a hysterectomy with ovarian conservation before the age of 50. We found that a third of these women experienced hot flushes that persisted in the long term, and around one in five were afflicted by constant night sweats. These rates were double those of women who did not have a hysterectomy over the 17-year study period, and could not be explained by differences in lifestyle or socio-economic factors. (more…)
Author Interviews, OBGYNE, Science, Surgical Research / 05.08.2016

MedicalResearch.com Interview with: Dr David A MacIntyre MRC Career Development Fellow Lecturer in Reproductive Systems Medicine Institute of Reproductive and Developmental Biology Department of Surgery and Cancer Imperial College London UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Preterm birth is the leading cause of death in children under 5 years of age. One of the first things that can happen to a women before suffering a preterm birth is early opening of the cervix, which is the neck of the womb. This also puts her and the baby at risk of infection. One of the few preventative treatments available for these women is a cervical cerclage. This is when a surgeon uses one of two types of suture thread to stitch the cervix closed. This provides mechanical support to the pregnancy and is thought to help prevent infections from ascending from the vaginal into the uterus. One type of suture thread used is thin, monofilament nylon, which appears similar to fishing line. The other is a thicker thread - around 5mm thick - that is comprised of smaller threads woven together like a shoe lace. The thicker woven thread - called multifilament - is used in around 80 per cent of procedures as surgeons believe it to be stronger, and more efficient at holding the cervix closed. In this study, we first looked at 671 women who had the procedure at five UK hospitals over the last ten years. Around half had the thinner 'fishing line' thread, while the other half had the thicker 'shoe lace' thread. The results revealed the thicker thread was associated with increased rate of intrauterine death compared to the thinner thread (15 per cent compared 5 per cent). The rate of intrauterine death in a normal pregnancy is around 0.5%. The thicker tape was also associated with an increased preterm birth rate compared to the thinner tape - 28 per cent compared to 17 per cent. The rate of preterm birth among the general population is around 7 per cent, but the cervical stitch procedure is only performed on women already deemed at high risk of premature birth. We then conducted a second study with 50 women who were due to have the cervical stitch procedure. Half received the thinner thread, while half received the thicker thread. We monitored the women at 4, 8 and 16 weeks after the procedure through ultrasound scans and analysis of bacteria in their reproductive tract. The results suggested that women who received the thicker thread had increased inflammation around the cervix. There was also increased blood flow, which is associated with the cervix opening before labour. Crucially, we also found that women who received the thicker thread had more potentially harmful bacteria in the vagina and around the cervix. (more…)
Author Interviews, CDC, OBGYNE, Zika / 04.08.2016

MedicalResearch.com Interview with: Charlan D. Kroelinger, PhD Division of Reproductive Health National Center for Chronic Disease Prevention and Health Promotion CDC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Zika virus infection during pregnancy can cause microcephaly and other severe fetal brain defects. Doctors have also found other problems in pregnancies and among infants infected with Zika virus before birth, such as absent or poorly developed brain structures, defects of the eye, hearing deficits, and impaired growth. Nearly half of all pregnancies in the United States are unintended. Increased access to birth control may lead to reductions in unintended pregnancies, which may result in fewer adverse pregnancy and birth outcomes in the context of a Zika virus outbreak. A new report from CDC estimates that use of highly effective, reversible forms of birth control, called long-acting reversible contraception (LARC), which includes intrauterine devices (IUDs) and implants, remains lower than use of moderate or less effective methods such as oral contraceptive pills and condoms, although contraception use varied across states and by age group and race/ethnicity. CDC scientists used data from four state-based surveillance systems to estimate contraception use for non-pregnant and postpartum women at risk for unintended pregnancy and sexually active female high school students who live in states with the potential for local Zika virus transmission. Less than one in four sexually active women of reproductive age and fewer than one in 10 sexually active female high school students reported using LARC. A higher percentage of postpartum women reported LARC use. Moderately effective and less effective contraceptive methods, including pills, patches, rings, injections, condoms and other barrier methods, were used more frequently than highly effective methods. These estimates are of concern because the most commonly used methods of contraception are not as effective at preventing unintended pregnancy. (more…)