Folic Acid May Reduce Risk of Autism Associated With Pesticide Exposure During Pregnancy

MedicalResearch.com Interview with:

Rebecca J. Schmidt, M.S., Ph.D.  Assistant Professor, Public Health Sciences UC Davis California

Dr. Schmidt

Rebecca J. Schmidt, M.S., Ph.D. 
Assistant Professor, Public Health Sciences
UC Davis California

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

Response: Maternal folic acid taken near conception has been linked to reduced risk for autism in the child in previous studies.

Separate studies show that exposure to pesticides during pregnancy is associated with increased risk for autism.

Animal studies demonstrate that folic acid and other B-vitamins can attenuate effects of certain environmental contaminants, including pesticides.

This case-control study examined combined maternal folic acid and pesticide exposures in relation to autism in the child.

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Study Evaluates Pediatric Outcomes of Antidepressant Use During Pregnancy

MedicalResearch.com Interview with:

Xiaoqin Liu, PhD Department of Economics and Business Economics Aarhus University

Dr. Xiaoqin Liu

Xiaoqin Liu, PhD
Department of Economics and Business Economics
Aarhus University 

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

Response: Previous research on the long-term neurodevelopmental outcomes of serotonin-reuptake inhibitor (SSRI) use during pregnancy has primarily focused on offspring risk of autism spectrum disorder. Given SSRIs cross the placental barrier and affect the fetal brain, in-utero SSRI exposure may increase risks of other psychiatric disorders as well as autism spectrum disorder.

We conducted a population-based study to look at a range of diagnostic groups of psychiatric disorders in children whose mothers used antidepressants during pregnancy. This was possible because of the nature of information available in Danish population registers, allowing us to follow children for many years. We found increased risks of various diagnostic groups of psychiatric disorders in children whose mothers continued antidepressant treatment during pregnancy, in comparison to children whose mothers stopped antidepressant treatment before pregnancy.

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Maternal Cell Phone Use Did Not Adversely Affect Children’s Language or Motor Skills At Age 5

MedicalResearch.com Interview with:

Jan Alexander, MD,PhD Norwegian Institute of Public Health Oslo Norway

Dr. Alexander

Jan Alexander, MD,PhD
Norwegian Institute of Public Health
Oslo Norway 

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

Response: The background for this study was the widespread uncertainty and general concern among the public about increasing exposure to weak radio frequency electromagnetic fields (EMF-RF). The concern on whether using your cell phone while pregnant can harm your foetus are mainly due to the extensive use of cell phones, that emit EMF-RF. Even though the RF-EMF exposure that may reach the foetus is very low, evidence from previous epidemiological studies with mothers and children are inconsistent as to whether EMF-RF emission from cell phone might harm the developing brain of the foetus. This includes also animal experiments where the exposure may be very different from that in humans.

We therefore studied the association between maternal cell phone use during pregnancy and child’s neurodevelopment at 3 and 5 years. We included around 45,000 mother and their children from all over Norway from the Norwegian Mother and Child Study (MoBa study) and used language development as the outcome because we in previous studies found this parameter to be sensitive to exposure to neurotoxicants. T

here was no evidence of a harmful effect of the mother using her cell phone during pregnancy on her child’s neurodevelopment at 3 and 5 years. Surprisingly, we even found that the more the mother was using her cell phone during pregnancy the better language and motor skills her child had at 3 years of age. We observed no associations when the child was 5 years old.

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How Much Does Mother’s BMI Influence Children’s Metabolic Health?

MedicalResearch.com Interview with:

Prof. Deborah A Lawlor MSc(Lond), MBChB, PhD(Bristol), MPH(Leeds), MRCGP, MFPHM Professor of Epidemiology MRC Integrative Epidemiology Unit at the University of Bristol NIHR Bristol Biomedical Research Centre Population Health Sciences, Bristol Medical School Oakfield House, Oakfield Grove, Bristol

Prof. Lawlor

Prof. Deborah A Lawlor
MSc(Lond), MBChB, PhD(Bristol), MPH(Leeds), MRCGP, MFPHM
Professor of Epidemiology
MRC Integrative Epidemiology Unit at the University of Bristol
NIHR Bristol Biomedical Research Centre
Population Health Sciences, Bristol Medical School
Oakfield House, Oakfield Grove, Bristol

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

Response: As the obesity epidemic has occurred there has been increasing concern about pregnant women being more adipose (having higher levels of fat) during their pregnancy. One particular concern is that women who are on average fatter will have more extreme changes in pregnancy on their lipid, fatty acid, amino acid and glucose levels. In normal ‘healthy’ pregnancy these metabolites increase during pregnancy as part of the physiological response to pregnancy which ensures that the developing fetus has sufficient fuel (nutrients – fats, proteins, sugars) for healthy growth and development. Women who are more adipose tend to have a more extreme change in these fuels and as a consequence the developing fetus is ‘overfed’. There is a linear relationship between a pregnant woman’s body mass index and her infants birth weight, such that each increment greater adiposity (body mass index) of the mother there is on average and increment greater infant birth weight.

Recently, using a method that uses genetic variants (Mendelian randomization) we have shown that this association is likely to be causal (JAMA 2016). But whether there is a lasting effect on offspring health of being overfed in the uterus is unknown. There are concerns that there will be a lasting effect and that for daughters of more adipose women, this would mean that they go into their pregnancies on average fatter and with higher levels of the metabolites that could then overfeed their developing fetus. If this were the case it would mean the obesity epidemic could be accelerated across generations.

There are associations of mothers body mass index with later offspring body mass index, BUT this might not be anything to do with developmental overfeeding of the feeding in the uterus – it could simply reflect shared lifestyles that offspring adopt from their mother (and father) or shared genetic effects. In this study we tried to separate out whether there was evidence for a long-term offspring effect on their lipids, fatty acids, amino acids, glucose, and an inflammatory marker, of having a mother who was on average fatter during her pregnancy that was due to overfeeding in the uterus, as opposed to shared family lifestyle and genetics. We did this by comparing associations of mothers pre-pregnancy BMI with offspring outcomes to the same associations of fathers pre-pregnancy BMI with the same outcomes.

Our assumption here was that fathers BMI could not directly result in overfeeding of the fetus and so if the associations were similar this would suggest that they were largely driven by family factors.

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Dieting and Physical Activity During Pregnancy Linked To Lower C-Section Rate

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 

Prof. Thangaratinam

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.

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Prenatal Acetaminophen Linked To Decreased Masculinization and Testosterone in Male Offspring

MedicalResearch.com Interview with:
David M. Kristensen, PhD
Assistant Professor                                                                                                         Novo Nordisk Foundation Center for Protein Research
Faculty of Health and Medical Sciences, University of Copenhagen,
Blegdamsvej 3A, DK-2200 Copenhagen, Denmark

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

Response: We have demonstrated that a reduced level of testosterone during fetal life by paracetamol means that male characteristics do not develop as they should. This also affects sex drive. In the trial, mice exposed to paracetamol at the foetal stage were simply unable to copulate in the same way as our control animals. Male programming had not been properly established during their foetal development and this could be seen long afterwards in their adult life. Moreover, the area of the brain that controls sex drive – the sexual dimorphic nucleus – had half as many neurons in the mice that had received paracetamol as the control mice. The inhibition of testosterone seem to have led to less activity in an area of the brain that is significant for male characteristics.

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Maternal Obesity Linked To Increased Risk of Congenital Malformations in Offspring

MedicalResearch.com Interview with:
Dr. Martina Persson

Clinical Epidemiology Unit
Department of Medicine Solna
Karolinska University Hospita

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

Response: It is well known that obesity increases risks of several maternal, fetal and neonatal complications including congenital malformations. However, it has not been clear if risks of malformations are increased also in offspring of normal weight mothers or if risks increase with degree of maternal obesity.

In this study, we found progressively increasing risks of major congenital malformations in the offspring with a mother’s overweight and obesity severity.

MedicalResearch.com: What should readers take away from your report?

Response: The most sensitive period of fetal organ development is the first eight weeks of gestation and it is during this time a mother´s BMI may influence risks of malformations. Thus, it is important to try to obtain a normal bodyweight before conception.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Our results should be confirmed in other populations and mechanisms behind the increased risks of malformations associated with maternal obesity should be further explored.

MedicalResearch.com: Is there anything else you would like to add?

Response: Obesity is a major health problem in many countries in the world. Preventive measures to halt the obesity epidemic should be implemented at all levels of society.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

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Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Unhealthy Weight Gain in Pregnancy Is Now the Norm

MedicalResearch.com Interview with:

 

Professor Helena Teede MBBS, FRACP, PhD Executive Director Monash Partners Academic Health Research Translation Centre Director Monash Centre for Health Research and Implementation Monash University

Prof. Teede

Professor Helena Teede MBBS, FRACP, PhD
Executive Director Monash Partners Academic Health Research Translation Centre
Director Monash Centre for Health Research and Implementation
Monash University

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

Response: Reproductive aged women are gaining weight rapidly both before and during pregnancy. Here in 1.3 million pregnancies internationally we show that almost 3 in 4 have unhealthy weight gain (half with excess weight gain and one quarter with inadequate gain)

MedicalResearch.com: What should readers take away from your report?

Response: For women establish your healthy weight for your height and try to stay within this for better fertility, pregnancy and for your and your child’s health. Regardless of your starting weigh,  aim to gain within targets in pregnancy. Seek help to do so.

For health professionals: unhealthy weight gain in pregnancy is now the norm, we must monitor women in pregnancy wand support them to gain healthy weight for better health outcomes. Weighing is not enough with health professionals needing skills in healthy conversations and support strategies for women.

For governments and policy makers this life stage around pregnancy is an optimal time to tackle obesity prevention and is targeted by WHO.

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Study Finds No Link Between First Trimester Influenza Vaccination and Major Structural Birth Defects

MedicalResearch.com Interview with:

Dr. Elyse Olshen Kharbanda, MD MPH HealthPartners Institute Minneapolis, MN

Dr. Kharbanda

Dr. Elyse Olshen Kharbanda, MD MPH

HealthPartners Institute
Minneapolis, MN

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

Response: Pregnant women who get the flu are at an increased risk for severe illness. To protect pregnant women, the Advisory Committee on Immunization Practices recommends women receive inactivated influenza vaccine (IIV) during any trimester of their pregnancy.

This study used data from the Vaccine Safety Datalink to evaluate if there was an increased risk for selected major structural birth defects for infants whose mothers received IIV in the first trimester of pregnancy versus infants who were unexposed to IIV. Among over 425,000 live births, including 52,856 whose mothers received IIV during first trimester, we evaluated risks for major structural birth defects.  In this large observational study, we did not observe increased risks for major structural birth defects in offspring following first trimester maternal inactivated influenza vaccine exposure.

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Older Maternal Age Continues To Be Increased Risk Factor For Adverse Outcomes

Sarka Lisonkova, MD, PhD Assistant Professor, Department of Obstetrics and Gynaecology, University of British Columbia. Children’s and Women’s Health Centre

Dr. Lisonkova

MedicalResearch.com Interview with:
Sarka Lisonkova, MD, PhD

Assistant Professor,
Department of Obstetrics and Gynaecology,
University of British Columbia.
Children’s and Women’s Health Centre

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

Response: Adverse fetal and infant outcomes associated with maternal age were known and our study confirms that the risk of fetal and neonatal death and severe neonatal morbidity increases among mothers over 30 years. We also knew that older mothers are more likely to have hypertension, diabetes, and other chronic diseases, and they are more likely to develop gestational diabetes, hypertension during pregnancy, and preeclampsia. These complications may put the fetus or newborn at risk, but are generally not considered to be potentially life threatening to the mother. Our study adds new information on the rates of severe maternal morbidities that have a high case-fatality rate, lead to organ damage, or have serious health implications such as hysterectomy. Our study also adds the information on the rates of any severe adverse birth outcome – for baby or mom – in the association with maternal age, which is important for counseling. Women usually want to know ‘what are the chances that anything bad happens’.

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