Author Interviews, Biomarkers, NEJM, OBGYNE / 06.01.2016

MedicalResearch.com Interview with: Stefan Verlohren, MD, PhD Consultant and Senior Lecturer Maternal-Fetal Medicine Klinik für Geburtsmedizin / Department of Obstetrics Charité Campus Mitte Berlin  Medical Research: What is the background for this study? What are the main findings? Dr. Verlohren: Preeclampsia affects 2–5% of pregnancies worldwide, and is a potentially life threatening syndrome for both mother and child. Treatment options for preeclampsia are very limited, with delivery being the only ‘cure’; however, early detection and monitoring are beneficial for improving maternal and fetal outcomes. Development of preeclampsia is very difficult to predict: its clinical presentation is variable and its signs and symptoms overlap with other conditions. There has been an unmet medical need for improved prediction of preeclampsia, i.e. predicting which women will develop preeclampsia and which will not. Women with suspected preeclampsia are often hospitalized until preeclampsia and related adverse outcomes are ruled out. Others who require hospitalization may be overlooked because their symptoms were nonspecific (e.g. headache). Preeclampsia has been linked with impaired function of the placenta. Placental development is highly dependent on blood vessel formation; before and during preeclampsia, levels of molecules involved in blood vessel inhibition or growth are altered in the maternal bloodstream. In particular, soluble fms-like tyrosine kinase-1 (sFlt-1) (a molecule that inhibits blood vessel growth) is increased and placental growth factor (PlGF) (a molecule that encourages blood vessel growth) is decreased. This study has established that the ratio of these two molecules (sFlt-1:PlGF) can be used to predict whether preeclampsia will develop or not. The sFlt-1:PlGF ratio can be calculated with a blood test (the Elecsys® sFlt-1 immunoassay and Elecsys® PlGF immunoassay). PROGNOSIS has validated the sFlt-1:PlGF ratio cutoff level of 38 for prediction of preeclampsia. For women with suspected preeclampsia, the Elecsys® immunoassay sFlt-1:PlGF ratio of 38 or below has a high negative predictive value to rule out preeclampsia or adverse fetal outcomes in the next week. A Elecsys® immunoassay sFlt-1:PlGF ratio of more than 38 indicates that preeclampsia or fetal adverse outcomes may develop in the next four weeks. In conjunction with other diagnostic and clinical information, the Elecsys® immunoassay sFlt-1:PlGF ratio can be used to guide patient management. (more…)
Author Interviews, OBGYNE, Surgical Research / 03.01.2016

MedicalResearch.com Interview with: Gabriele Saccone, MD Department of Neuroscience Reproductive Sciences and Dentistry School of Medicine University of Naples Federico II Naples, Italy Vincenzo Berghella, MD Department of Obstetrics and Gynecology Division of Maternal-Fetal Medicine Thomas Jefferson University Philadelphia, PA 19107, USA Medical Research: What is the background for this study? What are the main findings? Dr Saccone: Preterm birth (PTB) is the number one cause of perinatal mortality in many countries, including the US. The annual societal economic burden associated with Preterm birth in the US was at least $26.2 billion in 2006, or about $51,600 per infant born preterm. Defining risk factors for prediction of PTB is an important goal for several reasons.
  • First, identifying women at risk allows initiation of risk-specific treatment.
  • Second, it may define a population useful for studying particular interventions.
  • Finally, it may provide important insights into mechanisms leading to Preterm birth.Prior surgery on the cervix, such as cone biopsy and LEEP procedures, is associated with an increased risk of spontaneous PTB. History of uterine evacuation for abortion, by either induced termination of pregnancy (I-TOP) or treatment of spontaneous abortion (SAB) by suction dilation and curettage (D&C) or by dilation and evacuation (D&E), which may involve mechanical and/or osmotic dilatation of the cervix, has been associated with an increased risk of PTB in some studies, but not in others. Our systematic review and meta-analysis pooled data from 36 studies including 1,047,683 women with prior abortion. We found that history of surgical abortion is an independent risk factor for Preterm birth and also other obstetric complications including low birth weight and small for gestational age, while prior medical abortion with first-trimester mifepristone or mid-trimester misoprostol was not associated with an increased risk of PTB. The biological plausibility to explain our findings is not completely clear. However, three main hypotheses can be made.
  • The increased risk of Preterm birth could result from the overt or covert infection following surgically uterine evacuation,
  • as well as from mechanical trauma to the cervix leading to increased risk of cervical insufficiency.
  • Moreover, surgical procedures including curettage during D&E may result in scar tissue that may increase the probability of faulty placental implantation.
(more…)
Author Interviews, Hospital Acquired, Infections, OBGYNE, Outcomes & Safety / 30.12.2015

MedicalResearch.com Interview with: Muhammad A. Halwani, MSc, PhD Faculty of Medicine, Al Baha University Al Baha, Saudi Arabia.  Medical Research: What is the background for this study? What are the main findings? Response: The study idea was based on examining the current rate of post cesarean section infections that were detected in the hospital at the time. It was hypothesized that the detected infections were actually less than the real number identified. Therefore, we challenged the traditional surveillance method that was applied in the hospital with a new enhanced methodology which is telephone follow-ups for patients who under go C-section operations. Our main finding proved that this new applied method was able to detect more cases than the traditional one. Using phone calls as a gold standard, the sensitivity of the standard methodology to capture SSI after cesarean increased to 73.3% with the new methodology identifying an extra five cases. These patients represented 26.3% (5 of 19) of all the patients who developed SSI. In other words, for every 100 C-section procedures there were 2.6% missed cases which the new method was able to detect. The duration of the calls ranged from 1 to 5 minutes and were well received by the patients. (more…)
Asthma, Author Interviews, JAMA, OBGYNE, Pediatrics / 01.12.2015

MedicalResearch.com Interview with: Dr Mairead Black MBChB, MRCOG, MSc Research Fellow, Wellcome Trust Clinical Lecturer, Obstetrics and Gynaecology School of Medicine and Dentistry, Division of Applied Health Sciences University of Aberdeen Aberdeen Maternity Hospital, Cornhill Road Aberdeen AB25 2ZD  Medical Research: What is the background for this study? Dr. Black: The current thinking is, if a baby is exposed to labour, then it is also exposed to ‘good bacteria’ that mothers pass on during the birth, and they are also exposed to a degree of natural stress at the time of birth that might make them more resistant to developing future illnesses. The World Health Organisation formerly recommended that no more than 15 percent of deliveries should be C-sections. However rates in some countries have soared – China and Brazil have rates in excess of 50%, whilst in the UK the figure is 26% with almost half of these being planned in advance. The main purpose of this study was to explore whether health outcomes in children up to very early adulthood differ according to how they are delivered and whether avoiding labour entirely, i.e. via a planned C-section, could put children at a disadvantage compared to those delivered vaginally or by emergency C-section, where most will have been exposed to labour. The study analysed data from over 300,000 births between 1993 and 2007 across Scotland, using routinely collected data from seven linked databases. (more…)
Author Interviews, OBGYNE, Race/Ethnic Diversity / 30.11.2015

Medical research.com Interview with: Rada K. Dagher, Ph.D. Assistant Professor University of Maryland School of Public Health Department of Health Services Administration College Park, MD 20742 MedicalResearch: What is the background for this study? Dr. Dagher: In the United States, 51% of all pregnancies are unintended, and these happen disproportionately among racial and ethnic minorities. For example, in 2008, rates of unintended pregnancies were 69% among African American women, 56% among Hispanic women, and 40% among White women. Our study utilized 2006-2010 data from a nationally representative dataset, the National Survey of Family Growth, to investigate the reasons behind these racial/ethnic disparities. MedicalResearch: What are the main findings of this study? Dr. Dagher: The main findings of this study are as follows. Age and marital status differences explained both racial and ethnic disparities, where being single and younger than 20 years old at the time of conception contributed to the differences in unintended pregnancy between African American and White women, and between Hispanic and White women. However, there were also unique factors explaining the differences in unintended pregnancy between African Americans and Whites (respondent’s mother’s age at first birth, income, and insurance status) and the differences between Hispanics and Whites (U.S. born status and educational level). These findings provide support for culturally-tailored public health interventions that target at-risk groups of women such as younger, unmarried, lower income, lower educated, non-U.S. born women and those with public insurance, in order to reduce racial/ethnic disparities in unintended pregnancy. MedicalResearch: What should clinicians and patients take away from your report? Dr. Dagher: Our findings suggest that interventions to reduce racial and ethnic differences in unintended pregnancy should take into account multiple factors at multiple levels of influence. For example, at the policy level, the Affordable Care Act has mandated that health plans cover women’s preventative health care, including contraceptives, without cost sharing. Thus, primary care providers could educate their patients about these new policy provisions and encourage them to take advantage of them, especially patients at higher risk of unintended pregnancy such as women who are younger than 20, unmarried, non-U.S. born, have lower income, and those with public insurance. (more…)
Author Interviews, Lancet, OBGYNE / 29.11.2015

MedicalResearch.com Interview with: Gordon C S Smith, MD PhD DSc FMedSci Professor & Head of Department, Obstetrics and Gynaecology, Cambridge University Cambridge UK Medical Research: What were the key findings of the study? Dr. Smith: We demonstrated that using ultrasound to scan all women in the last 3 months of pregnancy increased the detection of small babies. Our routine approach to antenatal care identified 1 in 5 small babies. Our research approach on the same patients, where all women were scanned in the last third of pregnancy, resulted in 3 in 5 small babies being detected. We also found that, when we identified small babies, there was a scan measurement which helped us to distinguish which of those small babies were at increased risk of complications. Medical Research: What's the problem with small babies? Dr. Smith: We have known for many years that small babies are at increased risk of subsequent complications, both in the short term and long term. For example, they are more likely than normal sized babies to have difficulties during labour due to shortage of oxygen. We assume that this is because their growth has been restricted. This leads to them being less well prepared to face the stress of labour. We think that the poor growth usually occurs because of a problem in the way the placenta functions. The placenta, also known as the afterbirth, is the organ which allows the transfer of nutrients and oxygen to the baby. If the placenta isn’t functioning properly it is likely to impair the growth of the baby in the womb. If we suspect during a pregnancy that the baby is small, it influences a number of aspects of the care of the mother. For example, we might deliver the baby earlier, we might recommend delivery in a high risk unit. It might also influence decisions about whether a mother has a caesarean delivery, or how the baby is monitored during labour. (more…)
Addiction, Alcohol, Author Interviews, Cannabis, OBGYNE, Ophthalmology, Pediatrics / 28.11.2015

MedicalResearch.com Interview with: Professor Benjamin Thompson PhD School of Optometry and Vision Science Faculty of Science, University of Waterloo Waterloo, Ontario Canada Medical Research: What is the background for this study? Dr. Thompson: Our investigation was part of the longitudinal Infant Development and Environment and Lifestyle (IDEAL) study that was designed to investigate the effect of prenatal methamphetamine exposure on neurodevelopment. Although the negative impact of prenatal drug exposure on a wide range of neurodevelopmental outcomes such cognitive and motor function is established, the effect on vision is not well understood. To address this issue, vision testing was conducted when children in the New Zealand arm of the IDEAL study turned four and half years of age. Although the primary focus of the IDEAL study was the impact of methamphetamine on neurodevelopment, the majority of children enrolled in the study were exposed to a range of different drugs prenatally including marijuana, nicotine and alcohol. Many children were exposed to multiple drugs. This allowed us to investigate the impact of individual drugs and their combination on the children’s visual development. Alongside standard clinical vision tests such as visual acuity (the ‘sharpness’ of vision) and stereopsis (3D vision), we also tested the children’s ability to process complex moving patterns. This test, known as global motion perception, targets a specific network of higher-level visual areas in the brain that are thought to be particularly vulnerable to neurodevelopmental risk factors. (more…)
Author Interviews, NEJM, OBGYNE / 26.11.2015

MedicalResearch.com Interview with: Arri Coomarasamy, MBChB, MD, FRCOG Professor of Gynaecology and Reproductive Medicine University of Birmingham Medical Research: What is the background for this study? What are the main findings? Professor Coomarasamy: Progesterone is a natural hormone that is essential to maintain a healthy pregnancy, and more than 60 years ago clinicians and researchers began to ask if progesterone supplementation in the first trimester of pregnancy could help to reduce the risk of miscarriage for women with a history of recurrent miscarriage. The evidence achieved in some small controlled clinical trials conducted before the PROMISE (progesterone in recurrent miscarriage) trial suggested a benefit from progesterone therapy, but without sufficient certainty to usefully guide clinical practice. Five years after it began, the PROMISE trial has provided a definitive result. It is clear, it is important, and it is not the result that many anticipated. Our study of more than 800 women with a history of unexplained recurrent miscarriage has shown that those who received progesterone treatment in early pregnancy were no less likely to miscarry than those who received a placebo (or dummy treatment). This was true whatever their age, ethnicity, and medical history. (more…)
Author Interviews, OBGYNE, Outcomes & Safety / 25.11.2015

MedicalResearch.com Interview with: Dr William L Palmer Honorary research fellow Dr Foster Unit, Department of Primary Care and Public Health, Imperial College London, London Medical Research: What is the background for this study? Dr. Palmer: For the majority of women and their newborns, their care will be safe and result in good outcomes. However, previous research has suggested that outcomes across a range of healthcare areas might be worse at weekends. We therefore undertook to investigate whether there was an association between day of delivery and complications, using a range of different outcomes: perinatal mortality and - for both women and neonate - injury, infection and emergency readmission rates. Our analysis was based on every delivery to public health services in the NHS in England across a two-year period so accounting for some 1.3 million births. To account for possible differences in case-mix and maternal characteristics we controlled for a range of factors including gestational age, delivery type, maternal age, birth-weight, and pre-existing diabetes or hypertension.  (more…)
Author Interviews, OBGYNE, Social Issues / 03.11.2015

MedicalResearch.com Interview with: Susan Cha, PhD Division of Epidemiology Department of Family Medicine and Population Health School of Medicine Virginia Commonwealth University Richmond, VA  Medical Research: What is the background for this study? What are the main findings? Dr. Cha: We used data from the 2006-2010 National Survey of Family Growth to evaluate the association between couple pregnancy intentions and rapid repeat pregnancy (RRP) in women. Results indicated that the odds of RRP was primarily influenced by paternal rather than maternal desire for pregnancy. For instance, couples where the father intended the pregnancy but not the mother were 2.5 times as likely to have rapid repeat pregnancy than couples who both intended their pregnancy. Furthermore, more than 85% of women in the study reported no contraceptive use between pregnancies. (more…)
Author Interviews, BMJ, Exercise - Fitness, OBGYNE / 12.10.2015

Katrine M. Owe PhD Department of Psychosomatics and Health Behaviour Norwegian Institute of Public Health Norwegian National Advisory Unit on Women's Health Oslo University Hospital, Rikshospitalet OSLO, NorwayMedicalResearch.com Interview with: Katrine M. Owe PhD Department of Psychosomatics and Health Behaviour Norwegian Institute of Public Health Norwegian National Advisory Unit on Women's Health Oslo University Hospital, Rikshospitalet OSLO, Norway  Medical Research: What is the background for this study? What are the main findings? Dr. Owe: Pelvic girdle pain affects 20-45% of all pregnancies and may lead to functional disability, higher levels of depression, reduced quality of life and higher prevalence of sick leave during pregnancy. Many women with pelvic girdle pain often have difficulties performing daily life activities such as walking, standing, sitting and turning over in bed. The aetiology and pathogenesis of pelvic girdle pain are still unknown but some modifiable and non-modifiable risk factors have been identified. Our results showed that women who exercised before they became pregnant with their first child, had the lowest risk of developing pelvic girdle pain in pregnancy. Even those women who reported low frequencies of exercise had a reduced risk of pelvic girdle pain compared with non-exercisers. Exercising up to five times weekly before pregnancy was protective against pelvic girdle pain and no further benefits were reached with higher frequencies of exercise. It seems that women who are running, jogging, playing ballgames/netball, doing high impact aerobics or orienteering before pregnancy, has the lowest risk of pelvic girdle pain. (more…)
Author Interviews, Baylor University Medical Center Dallas, OBGYNE, Pediatrics / 17.08.2015

Arpitha Chiruvolu MD FAAP Neonatologist Baylor University Medical Center Department of Neonatology Dallas, TX 75246 MedicalResearch.com Interview with: Arpitha Chiruvolu MD FAAP Neonatologist Baylor University Medical Center Department of Neonatology Dallas, TX 75246  MedicalResearch: What is the background and main findings of the study? Dr. Chiruvolu: There is growing evidence that delaying umbilical cord clamping (DCC) in very preterm infants may improve hemodynamic stability after birth and decrease the incidence of major neonatal morbidities such as intraventricular hemorrhage (IVH) and necrotizing enterocolitis. Recently, the American College of Obstetricians and Gynecologists (ACOG) published a committee opinion that supported delaying umbilical cord clamping in preterm infants, with the possibility for a nearly 50% reduction in IVH. However, the practice of DCC in preterm infants has not been widely adopted, mainly due to the concern of a delay in initiating resuscitation in this vulnerable population. Furthermore, there is uncertainty regarding the magnitude of published benefits in very preterm infants, since prior trials were limited by small sample sizes, wide variability in the technique and inconsistent reporting of factors that may have contributed to clinical outcomes. We recently implemented a delaying umbilical cord clamping quality improvement (QI) process in very preterm infants at a large delivery hospital. The objective of this cohort study was to evaluate the clinical consequences of a protocol-driven delayed umbilical cord clamping implementation in singleton infants born £ 32 weeks gestation. We hypothesized that DCC would not compromise initial resuscitation and would be associated with significant decrease in early red blood cell transfusions and IVH compared to a historic cohort. Delayed umbilical cord clamping was performed on all the 60 eligible infants. 88 infants were identified as historic controls. Gestational age, birth weight and other demographic variables were similar between both groups. There were no differences in Apgar scores or admission temperature, but significantly fewer infants in theDelayed umbilical cord clamping cohort were intubated in delivery room, had respiratory distress syndrome or received red blood cell transfusions in the first week of life compared to the historic cohort.  A significant reduction was noted in the incidence of IVH inDelayed umbilical cord clamping cohort compared to historic control group (18.3% versus 35.2%). After adjusting for gestational age, an association was found between the incidence of IVH and Delayed umbilical cord clamping with IVH significantly lower in the DCC cohort compared to historic cohort with odds ratio of 0.36 (95% CI 0.15 to 0.84, P <0.05). There were no significant differences in mortality and other major morbidities. (more…)
Author Interviews, Cost of Health Care, OBGYNE, Pharmacology / 14.07.2015

Nora V. Becker MD/PhD candidate Department of Health Care Management and Economics Wharton School, University of Pennsylvania, in Philadelphia. MedicalResearch.com Interview with: Nora V. Becker MD/PhD candidate Department of Health Care Management and Economics Wharton School, University of Pennsylvania, in Philadelphia. Medical Research: What is the background for this study? What are the main findings? Response: The Affordable Care Act mandates that private health insurance plans cover prescription contraceptives with no consumer cost sharing. The positive financial impact of this new provision on consumers who purchase contraceptives could be substantial, but it has not yet been estimated. Using a large administrative claims data set from a national insurer, we estimated out-of-pocket spending before and after the mandate. We found that mean and median per prescription out-of-pocket expenses have decreased for almost all reversible contraceptive methods on the market. The average percentages of out-of-pocket spending for oral contraceptive pill prescriptions and intrauterine device (IUD) insertions by women using those methods both dropped by 20 percentage points after implementation of the ACA mandate. We estimated average out-of-pocket savings per contraceptive user to be $248 for the IUD and $255 annually for the oral contraceptive pill. (more…)
Author Interviews, Cost of Health Care, OBGYNE, Yale / 10.07.2015

Xiao Xu, Ph.D. Assistant Professor Department of Obstetrics, Gynecology & Reproductive Sciences Yale School of MedicineMedicalResearch.com Interview with: Xiao Xu, Ph.D. Assistant Professor Department of Obstetrics, Gynecology & Reproductive Sciences Yale School of Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Xiao Xu: While research has shown hospital variation in costs of care for other conditions, we know little about whether and how hospitals differ in costs of childbirth related care. With nearly 4 million births each year, childbirth is the most common reason for hospital admission in the U.S. Understanding the pattern and causes of variation in resource utilization during childbirth among hospitals can help inform strategies to reduce costs. Our study used data from 463 hospitals across the country and analyzed hospital costs of maternity care for low-risk births. We found that hospital varied widely in average facility costs per maternity stay. (more…)
Author Interviews, OBGYNE, Technology, University of Pennsylvania / 24.06.2015

Dan Dongeun Huh, Ph.D. Wilf Family Term Chair & Assistant Professor Department of Bioengineering University of Pennsylvania Philadelphia, PA 19104MedicalResearch.com Interview with: Dan Dongeun Huh, Ph.D. Wilf Family Term Chair & Assistant Professor Department of Bioengineering University of Pennsylvania Philadelphia, PA 19104 Medical Research: What is the background for this study? What are the main findings? Response: The placenta is a temporary organ central to pregnancy and serves as a major interface that tightly regulates transport of various endogenous and exogenous materials between mother and fetus.  The placental barrier consisting of the closely apposed trophoblast epithelium and fetal capillary endothelium is responsible for maintaining this critical physiological function, and its dysfunction leads to adverse pregnancy outcomes.  Despite its importance, barrier function of the placenta has been extremely challenging to study due to a lack of surrogate models that faithfully recapitulate the key features of the placental barrier in humans.  Our study aims to directly address this long-standing technical challenge by providing a microengineered in vitro system that replicates architecture, microenvironment, and physiological function of the human placenta barrier.  This “placenta-on-a-chip” device consists of microfabricated upper and lower cell culture chambers separated by a thin semipermeable membrane, and the placental barrier is generated by culturing human trophoblasts and fetal endothelial cells on either side of the membrane with steady flows of culture media in both chambers.  This microfluidic cell culture condition allowed the cells to form confluent monolayers on the membrane surface and to create a bi-layer tissue that resembled the placental barrier in vivo.  Moreover, the microengineered barrier enabled transport of glucose from the maternal chamber to the fetal compartment at physiological rates. (more…)
Author Interviews, Cost of Health Care, Endocrinology, OBGYNE, Yale / 12.06.2015

Aileen Gariepy, MD, MPH Assistant Professor Section of Family Planning Department of Obstetrics, Gynecology, and Reproductive Sciences Yale School of Medicine New Haven, CT 06510MedicalResearch.com Interview with: Aileen Gariepy, MD, MPH Assistant Professor Section of Family Planning Department of Obstetrics, Gynecology, and Reproductive Sciences Yale School of Medicine New Haven, CT Medical Research: What is the background for this study? What are the main findings? Dr. Gariepy: Women who have just given birth are often highly motivated to prevent a rapid, repeat pregnancy.  For women who desire the contraceptive implant, a highly effective reversible form of contraception that is placed in the arm and can last for 3 years, new research shows that it is more cost-effective to place the implant while women are still in the hospital after giving birth, compared to delaying insertion to the postpartum visit 6-8 weeks later which is currently the most common practice. When the costs associated with the implant insertion and the costs of unintended pregnancy are compared in women who receive immediate contraceptive implant insertion (while still in the hospital after giving birth) to women who are asked to come back in 6-8 weeks for the implant insertion (delayed insertion), immediate insertion is expected to save $1,263 per patient.  Based on these estimates, for every 1,000 women using postpartum implant, immediate placement is expected to avert 191 unintended pregnancies and save $1,263,000 compared with delayed insertion in the first year. Cost savings would continue to increase for the second and third year after insertion. In fact, over half of U.S. pregnancies are unintended.  Maternal and infant care costs for unintended pregnancies amount to $11.1 billion annually for public insurance programs alone. The immediate postpartum period (after delivery but before discharge home) provides an ideal opportunity for initiating contraceptives as patients are motivated and timing is convenient. However, the majority of insurance company policies do not provide coverage for insertion of the contraceptive implant when the new mother is still in the hospital.  This lack of reimbursement is the most significant barrier to providing this highly effective contraceptive method for women who have just delivered a baby.  Surprisingly, the reason most insurance companies do not offer reimbursement for immediate insertion is due to an outdated insurance protocol, “the global obstetric fee” which precludes separate reimbursement of individual procedures (like inserting the implant). The main reason that immediate insertion results in cost savings is because more women will get the implant compared to a strategy of delayed insertion.  Women can get pregnant again within 4 weeks of delivering a baby.  Starting contraception as soon as possible after giving birth is important because most women will resume sexual activity before their postpartum office visit and therefore will be at risk of pregnancy. And approximately 35% of women do not return for a postpartum visit. Even for women who want another pregnancy soon, the implant has benefits.  When women conceive and deliver a baby within 2 years of last giving birth, there is a significantly higher risk of poor maternal and neonatal outcomes, including preterm birth, low birth weight, and even early neonatal and maternal death.  Birth spacing is better for moms and babies. (more…)
Author Interviews, BMJ, OBGYNE, Weight Research / 03.12.2014

Stefan Johansson, MD PhD consultant neonatologist Stockholm, SwedenMedicalResearch.com Interview with: Stefan Johansson, MD PhD consultant neonatologist Stockholm, Sweden Medical Research: What is the background for this study? Dr. Johansson: Maternal obesity (BMI ≥ 30) has previously been linked to increased infant mortality. However, research has not produced consistent results. For example, there are disagreements whether infants to overweight mothers (BMI 25-29) are at increased risk, and research on BMI-related specific causes of death is scarce. (more…)
Author Interviews, OBGYNE, Surgical Research / 08.10.2014

MedicalResearch.com Interview with: Jason D. Wright, M.D. Sol Goldman Associate Professor of Obstetrics and Gynecology Chief, Division of Gynecologic Oncology Columbia University College of Physicians and Surgeons New York, New York 10032 Medical Research: What are the main findings of the study? Dr. Wright: The use of robotic assisted ovarian surgery (oophorectomy and cystectomy) has increased rapidly and compared to laparoscopic alternatives, robotically assisted surgery is associated with a small increase in complication rates and substantially greater costs. (more…)
Author Interviews, General Medicine, JAMA, Pediatrics / 17.09.2014

Lex W Doyle MD BS MSc FRACP Professor of Neonatal Paediatrics Department of Obstetrics and Gynaecology The Royal Women’s Hospital Parkville, Victoria, AustraliaMedicalResearch.com Interview with: Lex W Doyle MD BS MSc FRACP Professor of Neonatal Paediatrics Department of Obstetrics and Gynaecology The Royal Women’s Hospital Parkville, Victoria, Australia Medical Research: What are the main findings of the study? Dr. Doyle: From collectively pooling data from five large trials carried out around the world over the past 20 years, we know that magnesium sulfate given under strict medical protocols in hospital to women threatening to deliver preterm reduces the risk of cerebral  palsy in their children in early childhood.  Following  from this knowledge, magnesium sulfate is now given routinely to women, under strict medical conditions, who are threatening to deliver very early in Australia, and in other parts of the world, to try to prevent cerebral palsy in their child.  What we do not know is if magnesium sulfate used this way has any longer-term effects on the brain or on other important outcomes. One of the initial studies that contributed to the overall evidence about cerebral palsy was carried out in Australia and New Zealand and completed more than 10 years ago.  Over 1000 women and their babies were enrolled in that study and although the rate of cerebral palsy was not substantially reduced by magnesium sulfate in our study, we showed that there were fewer children at 2 years of age who were not walking in the group whose mothers were given magnesium compared with those whose mothers were given placebo.  With this knowledge, and given the unknown longer-term benefits or risks, we re-evaluated the children from our study at school-age, between 6-11 years of age.  We thoroughly evaluated their brain function, including movement and co-ordination, thinking ability, behaviour, and school progress, as well as general health and well-being.  The basic message from our longer-term study is that magnesium sulfate, as used in our trial, does not have any substantial benefits or harms on brain or cognitive function, or any other outcome at school age. (more…)
Author Interviews, MRSA, OBGYNE / 10.01.2014

MedicalResearch.com Interview with: Dr. Andrea Parriott MPH, PhD Department of Epidemiology Fielding School of Public Health University of California Los Angeles

MedicalResearch.com: What are the main findings of the study? Dr. Parriott:  We wanted to know whether hospital and provider volume (i.e. the number of deliveries performed by each hospital and provider per quarter) and cesarean section rates were predictors of the risk of methicillin-resistant Staphylococcus aureus (MRSA) infection before discharge from the hospital (after delivering a baby). We did not find an association between any of these variables and risk of MRSA infection. (more…)
OBGYNE, Thromboembolism / 24.07.2013

MedicalResearch.com Interview with: Sheree Boulet, DrPH, MPH Assisted Reproductive Technology Surveillance and Research Team Women's Health and Fertility Branch Division of Reproductive Health Centers for Disease Control and Prevention MedicalResearch.com: What are the main findings of the study? Dr. Boulet: Between 1994-2009, the rate of pregnancy-related hospitalizations with venous thromboembolism (VTE) increased by 14%. We also found that the prevalence of hypertension, obesity, diabetes, and heart disease increased over the same time period for pregnancy hospitalizations with VTE. (more…)