Why Do 700 US Women Die of Pregnancy-Related Causes Each Year?

MedicalResearch.com Interview with:

Emily Petersen, MD.Lead for the Pregnancy Mortality Surveillance SystemDivision of Reproductive Health

Dr. Peterson

Emily Petersen, MD.
Lead for the Pregnancy Mortality Surveillance System
Division of Reproductive Health  

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

Response: About 700 women die of pregnancy-related causes each year in the United States. The new analysis provides much-needed perspective on the circumstances surrounding pregnancy-related deaths and summarizes potential strategies to prevent future deaths.

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Father’s Age Linked To Pregnancy Problems and Childhood Disorders

MedicalResearch.com Interview with:

Nancy Phillips, MDClinical Assistant ProfessorRutgers Robert Wood Johnson Medical SchoolWomen's Health InstituteNew Brunswick, NJ

Dr. Phillips

Nancy Phillips, MD
Clinical Assistant Professor
Rutgers Robert Wood Johnson Medical School
Women’s Health Institute
New Brunswick, NJ

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

Response: The background of this article was as an interest piece prompting a literature review. We both felt it represented an underserved clinical need.

The main findings are that the paternal age at conception does impact pregnancy outcomes,  including pregnancy complications, fetal chromosomal anomalies and childhood cancers and psychological disorders. Continue reading

Which Matters More? Pre-Pregnancy Obesity vs Pregnancy Weight Gain?

MedicalResearch.com Interview with:

Dr-Romy GaillardRomy Gaillard MD PhD
LifeCycle Project-Maternal Obesity and Childhood Outcomes Study Group
Erasmus MC

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

Response: Obesity among women of reproductive age is a major problem for society. Scientists have long known that maternal weight before and during pregnancy are associated with pregnancy outcomes. Gestational weight gain is necessary to ensure healthy development of the fetus, but too much weight gain is associated with a higher risk of pregnancy complications.

The magnitude of the associations of maternal weight before and during pregnancy with the risks of pregnancy complications, as well as the optimal amount of weight that especially obese women should gain during pregnancy were not well-known. Continue reading

Vaginal Progesterone May Reduce Miscarriages in Women with Bleeding in Early Pregnancy

MedicalResearch.com Interview with:

Prof. Arri Coomarasamy MBChB, MD, FRCOGInstitute of Metabolism and Systems ResearchProfessor of GynaecologyDirector of Tommy's National Centre for Miscarriage ResearchUniversity of Birmingham

Prof. Coomarasamy

Prof. Arri Coomarasamy MBChB, MD, FRCOG
Institute of Metabolism and Systems Research
Professor of Gynaecology
Director of Tommy’s National Centre for Miscarriage Research
University of Birmingham

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

Response: Progesterone hormone is known to be essential to maintain a pregnancy. Researchers and clinicians have debated for over 50 years whether progesterone supplementation in women with early pregnancy bleeding could rescue a pregnancy from miscarrying. There were some clinical studies suggesting progesterone could be useful, but the studies were of poor quality and small, so we could not be certain.

So the current study, called the PRISM trial, was conducted using very sound methods and on a large population of women, in fact over 4000 women in the UK, to produce a definitive answer to this question. Overall, there were more babies in the group of women given progesterone compared with the group of women given the dummy placebo tablets, but there was statistical uncertainty in this finding.

However, when we looked at the sub-population of women who were at high risk of miscarriage because of not only bleeding in early pregnancy but also having a history of previous miscarriage, we found progesterone was shown to have clear benefit. This is a hugely important finding as there is now a treatment option to women with early pregnancy bleeding and a history of previous miscarriages.

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Is There a Link Between Benzodiazepines During Pregnancy and Childhood ADHD?

MedicalResearch.com Interview with:

Dr. Angela Lupattelli, PhDSchool of PharmacyUniversity of Oslo

Dr. Lupattelli

Dr. Angela Lupattelli, PhD
School of Pharmacy
University of Oslo

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

Response: Between 1-4% of pregnant women take at least once a benzodiazepine and/or a z-hypnotic medication during the course of gestation. These medications are generally used intermittently in pregnancy, mainly for treatment of anxiety disorders and sleeping problems, which are not uncommon conditions among pregnant women.

However, data regarding the safety of benzodiazepine and/or a z-hypnotic in pregnancy on child longer-term development are sparse. For instance, studies on child motor skills are only available up to toddler age, and little is known in relation to other child developmental domains. So, there is an urgent need to better understand whether prenatal use of benzodiazepine and/or a z-hypnotic medication may pose detrimental longer-term child risks. Continue reading

Metformin in Pregnancy Associated With Increased Obesity in Children

MedicalResearch.com Interview with:

Liv Guro Engen Hanem, PhD CandidateDepartment of Clinical and Molecular MedicineNorwegian University of Science and Technology

Liv Guro Engen Hanem

Liv Guro Engen Hanem, PhD Candidate
Department of Clinical and Molecular Medicine
Norwegian University of Science and Technology

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

Response: The antidiabetic drug metformin is increasingly used in pregnancy: to treat gestational diabetes and type 2 diabetes, and to prevent pregnancy complications related to polycystic ovary syndrome (PCOS) and obesity. Metformin passes the placenta, and the fetus is thus exposed to the drug. Although no teratogenicity has been reported, metformin might have long-term effects on offspring health.

This study is a follow-up of cardiometabolic risk factors of 141 5- to 10-year-old children born in the PregMet study. This study was a double-blind, randomized controlled trial (RCT) designed to test the hypothesis that metformin given throughout pregnancy reduces the prevalence of pregnancy complications that are associated with the common endocrine disorder PCOS. Pregnant women with PCOS were randomized to receive metformin or placebo throughout pregnancy.  Continue reading

Marijuana Use During Pregnancy May Increase Risk of Psychosis in Offspring

MedicalResearch.com Interview with:

Jeremy FineB.A. in Philosophy, Neuroscience, and PsychologyWashington University in St. Louis, Class of 2019

Jeremy Fine

Jeremy Fine
B.A. in Philosophy, Neuroscience, and Psychology
Washington University in St. Louis, Class of 201

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

Response: Alongside increasingly permissive marijuana use attitudes and laws, the prevalence of marijuana use among pregnant mothers has increased substantially (by 75% between 2002 and 2016), with some evidence that pregnant women may be using cannabis to combat pregnancy-related nausea.

Our data came from the Adolescent Brain Cognitive Development (ABCD) Study, which included over 4,000 subjects with data on maternal marijuana use during pregnancy.

Our main finding was that the children of mothers who used marijuana after learning they were pregnant had a small but significant increase in risk for psychosis in their future.

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Central Care Improved Survival of Extremely Premature Infants

MedicalResearch.com Interview with:

Mikael Norman, MD, PhD, ProfessorKarolinska Institutet & Karolinska University HospitalStockholm, Sweden 

Dr. Norman

Mikael Norman, MD, PhD, Professor
Karolinska Institutet & Karolinska University Hospital
Stockholm, Sweden 

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

Response: So far, preterm birth has been difficult to predict and prevent. In particular, extremely preterm birth has continued to be an issue in terms of optimal care before and after birth, costs and long term health outcomes. Therefore, studies on how the management and outcome varies over time in these patients are important.

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How Do Men Express Grief After Pregnancy Loss?

MedicalResearch.com Interview with

Haley Kranstuber Horstman, Ph.D.Department of CommunicationUniversity of Missouri

Dr. Kranstuber Horstman

Haley Kranstuber Horstman, Ph.D.
Department of Communication
University of Missouri

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

Response: Miscarriage is a prevalent health concern, with one in five pregnancies ending in miscarriage, which is a pregnancy loss before 20 weeks’ gestation. Past research has shown that women who have miscarried often suffer mental health effects such as heightened grief, depression, loneliness, and suicidality.

Although much of the research on coping with miscarriage has focused on women’s health, many miscarriages occur within romantic relationships and affect the non-miscarrying partner as well. Women in heterosexual marriages report that their husband is often their top support-provider. Past research has shown that husbands suffer with mental health effects after a miscarriage, sometimes for even longer than their wives, but are not often supported in their grief because miscarriage is a “woman’s issue” and they feel uncomfortable talking about it.

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Simple Urine Test May Allow Pregnant Women to Detect Preeclampsia at Home

MedicalResearch.com Interview with:

Dr. Kara Rood MDMaternal-fetal Medicine PhysicianThe Ohio State University Wexner Medical Center

Dr. Rood

Dr. Kara Rood MD
Maternal-fetal Medicine Physician
The Ohio State University Wexner Medical Center

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

Response: This is a simple, rapid, non-invasive test for early recognition of preeclampsia. 

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

Response: Aid in timely diagnosis to help provide closer observations to pregnancies with complicated by preeclampsia, to prevent the devastating adverse pregnancies outcomes for mom’s and babies that can occur when pregnancies become complicated by preeclampsia.

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IVF Birth Weights Show Steady Increase Over Three Decades

MedicalResearch.com Interview with:
Prof. Daniel R Brison PhD, FRCPath
Scientific Director
Department of Reproductive Medicine
Manchester University NHS Foundation Trust
Old St. Mary’s Hospital
Manchester U.K and

Catherine M Castillo PhD
Maternal & Fetal Health Research Centre
Division of Developmental Biology and Medicine
School of Medical Sciences, Faculty of Biology, Medicine and Health
The University of Manchester 

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

Response: IVF conceived children have been known to have poorer birth outcomes when compared to spontaneously conceived children. Even when excluding twins and triplets, which result from more complicated pregnancies, IVF singletons have an increased risk of low birth weight and being born small for “dates” (length of gestation).  This is important as studies carried out in non-IVF children show that low birth weight is associated with slightly higher risk of disease in later life.

We knew from the literature that birth outcomes differed within the IVF population depending on the type of treatment used; for example, singletons conceived from frozen/thawed embryos are born with higher average birth weights when compared to their fresh embryo conceived counterparts. Our research team wanted to investigate whether IVF practices and technologies per se (which have advanced quite rapidly over the years since 1978 when the first IVF baby was conceived) were associated with differences in singleton birth weight.

In attempting to quantify historical changes in laboratory practice going back as far as we could, we discovered that our outcome of interest – birth weight – had indeed increased notably throughout the time period covered by the available data. Besides observing an increase in birth weight of almost 180g over the study period (when accounting for child gender, gestational age and maternal parity), we also observed that frozen embryo transfer was associated with higher birth weight, and spontaneous fetal reduction and longer duration of infertility were associated with lower average birth weight.

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High-Dose Vitamin D During Pregnancy Did Not Reduce Risk of Childhood Asthma

MedicalResearch.com Interview with:

Bo Chawes, MD, PhD, DMScAssociate ProfessorC‌openhagen Prospective Studies on Asthma in ChildhoodH‌erlev and G‌entofte H‌ospitalU‌niversity of C‌openhagen

Dr. Chawes

Bo Chawes, MD, PhD, DMSc
Associate Professor
C‌openhagen Prospective Studies on Asthma in Childhood
H‌erlev and G‌entofte H‌ospital
U‌niversity of C‌openhagen

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

Response: There has been a global surge in vitamin D deficiency happening in parallel with an increase in prevalence of childhood asthma, which suggests that low maternal vitamin D levels during pregnancy may increase asthma risk in the child.

Due to that we conducted a randomized double-blinded controlled trial within the Danish COPSAC2010 cohort (www.copsac.com) of 7-fold (2,800 IU/d) vs. standard dose (400 IU/d) of vitamin D supplementation from pregnancy week 24 aiming to reduce offspring asthma risk. At age 3, we observed a non-significant 24% reduced risk of recurrent asthma-like symptoms, ie. recurrent wheeze, in the high-dose vitamin D group. In the current study, we followed 545 of the 581 children in the study till age 6, where an asthma diagnosis can be established and observed no effect of the high-dose vitamin D supplement on the child’s risk of asthma. 

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Risk of Spontaneous Abortion & Birth Defects with Oral Yeast Drug During Pregnancy

MedicalResearch.com Interview with:

Anick Bérard PhD FISPE Research chair FRQS on Medications and Pregnancy Director, Réseau Québécois de recherche sur le médicament (RQRM) Professor, Research Chair on Medications, Pregnancy and Lactation Faculty of Pharmacy, University of Montrealand Director, Research Unit on Medications and Pregnancy Research Center CHU Ste-Justine

Dr. Bérard

Anick Bérard PhD FISPE
Research chair FRQS on Medications and Pregnancy
Director, Réseau Québécois de recherche sur le médicament
Professor, Research Chair on Medications, Pregnancy and Lactation
Faculty of Pharmacy, University of Montrealand
Director, Research Unit on Medications and Pregnancy
Research Center
CHU Ste-Justin

 

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

Response: Yeast infections are common during pregnancy (10%). Although topical treatments are first-line therapies, yeast infections during gestation are often more severe and are resistant to topical options. Hence, low dose oral fluconazole is often the treatment of choice for pregnant women (1 dose for 1 day).

Human and animal studies have shown that high dose of fluconazole is teratogenic.Few studies are available for the risk associated with low dose of fluconazole (the most used during pregnancy). Also, no one has studied the combined effect of low- and high-dose fluconazole use during pregnancy on overall adverse pregnancy outcomes (spontaneous abortions, stillbirths and major malformations).  Continue reading

Adverse Outcomes More Likely in Infants Born to Mothers Who Get the Flu

MedicalResearch.com Interview with:

Kim NewsomeCDC

Kim Newsome

Kim Newsome, MPH
National Center on Birth Defects and Developmental Disabilities
CDC 

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

Response: This study supports data from previous studies that have shown increased risks for infants born to pregnant women who are severely ill with flu.

MedicalResearch.com: What are the main findings?

Response: Our study found that severely ill women with 2009 H1N1 influenza during pregnancy were more likely to have adverse birth outcomes (such as their baby being born preterm or of low birth weight) than women without influenza. 

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Life in the Womb Can Program Future Heart Disease

MedicalResearch.com Interview with:

Professor Dino A. Giussani PhD ScD FRCOG Professor of Developmental Cardiovascular Physiology & Medicine Department of Physiology Development & Neuroscience University of Cambridge UK Director of Studies in Medicine College Lectureship in Medicine '1958' Gonville & Caius College

Prof. Giussani

Professor Dino A. Giussani PhD ScD FRCOG
Professor of Developmental Cardiovascular Physiology & Medicine
Department of Physiology Development & Neuroscience
University of Cambridge
Director of Studies in Medicine
College Lectureship in Medicine ‘1958’
Gonville & Caius College
UK

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

Response: Heart disease kills 1 in 3 people worldwide.  When we hear about heart disease, the first thing we think of is a gene-environent interaction.  That is to say, how our genes interact with traditional lifestyle factors, such as smoking, obesity and/or a sedentary lifestyle to promote an increased risk of cardiovascular disease.  However,  it has also become established that the gene-environment interaction early in life may be just as, if not more, important in ‘programming’ future heart health and heart disease. That is to say, how the quality of the intrauterine environment in which we develop may also shape our future heart risk.  Evidence from human sibling-pair studies suggests that these relationships are causal, that they occur independently of genotype and that they are significantly influenced by the quality of the intrauterine environment during pregnancy.  For instance, bariatric surgery to decrease the weight of obese women reduced the risk of obesity, insulin resistance and raised blood pressure in children born after surgery compared to those born before. Therefore, these studies highlight a disproportionate risk of disease in offspring born from the same mother but under different in utero conditions, providing strong evidence in humans that the environment experienced during this critical period of development directly influences long-term cardiovascular health.

One of the most common outcomes of complicated pregnancy in humans is chronic fetal hypoxia, as can occur during placental insufficiency or preeclampsia.

The main findings of our study show that prenatal hypoxia can programme future heart disease in the offspring and that maternal treatment with the antioxidant vitamin C can be protective (see paper attached). Continue reading

Breast Cancer Risk Remains Elevated 20-30 years After Childbirth

MedicalResearch.com Interview with:

Dale P. Sandler, Ph.D.  Chief, Epidemiology Branch National Institute of Environmental Health Sciences NIH

Dr. Sandler

Dale P. Sandler, Ph.D.
Chief, Epidemiology Branch
National Institute of Environmental Health Sciences
NIH

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

Response: Not having children is a well-established risk factor for breast cancer, but most of this evidence comes from studies of postmenopausal women since breast cancer before menopause is relatively uncommon. There is growing evidence that some risk factors differ for premenopausal and postmenopausal breast cancer – for example obesity which increases risk for breast cancer after menopause but appears to be protective before menopause.

There was some evidence that breast cancer risk increased shortly after pregnancy. It was thought that this risk lasted for 5 to ten years. Studies were unable to fully characterize the duration of this increase in risk or evaluate factors such as breast feeding, age at birth, or family history of breast cancer that could modify the relationship between recent pregnancy and breast cancer risk. Breast cancer before menopause or age 55 is relatively rare, and few individual studies are large enough to answer these questions.

To answer these questions, we formed the Breast Cancer Collaborative Group, a pooling project involving 20 prospective cohort studies. We included 890,000 women from 15 of these long-term studies across three continents, including over 18,000 incident breast cancer cases.  Continue reading

Less Time in the Womb Linked to Less Education and Income in Adulthood

MedicalResearch.com Interview with
"Pregnancy 1" by operalynn is licensed under CC BY 2.0Josephine Funck Bilsteen, MSc
Department of Pediatrics, Hvidovre University Hospital, Hvidovre,
Section of Epidemiology, Department of Public Health
University of Copenhagen
Copenhagen, Denmark

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

Response: The background of this study is that there is increasing recognition of the longer-term health and social outcomes associated with preterm birth such as independent living, quality of life, self-perception and socioeconomic achievements. However, much less is known about differences in education and income among adults born at different gestational weeks in the term period.

In this study shorter gestational duration, even within the term range, was associated with lower chances of having a high personal income and having completed a secondary or tertiary education at age 28 years. This is the first study to show that adults born at 37 and 38 completed weeks of gestation had slightly lower chances of having a high income and educational level than adults born at 40 completed weeks of gestation.  Continue reading

Does Zofran (ondansetron) for Nausea & Vomiting Cause Birth Defects?

MedicalResearch.com Interview with:

Krista F. Huybrechts, M.S., Ph.D. Assistant Professor of Medicine at Harvard Medical School Epidemiologist in the Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women’s Hospital. Boston, MA 02120

Dr. Krista Huybrechts

Krista F. Huybrechts, MS PhD
Associate Professor of Medicine
Brigham and Women’s Hospital
Harvard Medical School
Boston, MA 02120 

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

Response: Pregnant women often experience nausea and vomiting, particularly during the first trimester.  Early treatment is recommended to relieve symptoms and prevent progression to hyperemesis gravidarum.  Although not formally approved for this indication, ondansetron is the most frequently prescribed treatment for nausea and vomiting in pregnancy in the US: 22% of pregnant women reportedly used ondansetron in the US in 2014. Despite this common use, the available evidence on the fetal safety of ondansetron is limited and conflicting, and the possibility of a doubling in risk of cleft palate and cardiac malformations has been raised.

We therefore evaluated the association between ondansetron exposure during the first trimester of pregnancy, the period of organogenesis, and the risk of congenital malformations in a cohort of 1,816,414,publicly insured pregnancies using the nationwide Medicaid Analytic eXtract data for 2000-2013.  A total of 88,467 women (4.9%) were exposed to ondansetron during the first trimester.  After adjusting for a broad range of potential confounding variables, we found no association with cardiac malformations (RR = 0.99; 95% CI, 0.93 – 1.06)  and congenital malformations overall (RR = 1.01; 95% CI, 0.98 – 1.05). For oral clefts, we found a 24% increase in risk (RR=1.24; 95% CI, 1.03 – 1.48), which corresponds to an absolute risk of 2.7 per 10,000 births (95% CI, 0.2 – 5.2 per 10,000 births).  These findings were consistent across sensitivity analyses, conducted to address potential misclassification and confounding bias. 

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How Do Pregnant Women Decide Which Foods To Avoid To Prevent Food Allergies in Their Children?

MedicalResearch.com Interview with:

Dr-Karen Robbins

Dr. Robbins

 Karen Robbins, M.D.
Allergist at Children’s National Health System 

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

Response: The background is that mothers are often concerned that something they did contributed to their children developing food allergies. Many will relate that they ate a lot of one specific food allergen while pregnant, and question how this could have impacted their unborn child. We realized that we hear a lot of anecdotal stories in clinic, but were not sure how frequently mothers try to alter their diet in the hopes of preventing food allergy in their children. We also were not sure where families get information or guidance on this topic. Continue reading

Kicking in Womb Helps Babies Develop Sense of Their Own Body

MedicalResearch.com Interview with:
"38 week fetus" by Zappys Technology Solutions is licensed under CC BY 2.0Kimberley Whitehead

Neuroscience, Physiology & Pharmacology
University College London

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

Response: Fetuses move a lot! Very similar movement patterns are seen in both pre-term and full-term newborn infants, but their function is unclear. In animals such as rats, spontaneous movement and consequent feedback from the environment during the early developmental period trigger specific patterns of electrical activity in the brain that are necessary for proper brain mapping.

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Amphetamine Use Even Higher than Opioids Among Rural Pregnant Women

MedicalResearch.com Interview with:

Lindsay Admon, MD MSc Assistant Professor, Department of Obstetrics & Gynecology Institute for Healthcare Policy and Innovation  University of Michigan

Dr. Admon

Lindsay Admon, MD MSc
Assistant Professor, Department of Obstetrics & Gynecology
Institute for Healthcare Policy and Innovation
University of Michigan

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

In our previous work (https://journals.lww.com/greenjournal/Fulltext/2017/12000/Disparities_in_Chronic_Conditions_Among_Women.19.aspx), we identified higher rates of deliveries complicated by substance use among rural women. We knew that some of this difference would be accounted for by opioids.What we didn’t expect was that when we took a closer look, amphetamine use disorder accounted for a significant portion of this disparity as well.

The main findings of this study are that, between 2008-09 and 2014-15, amphetamine and opioid use among delivering women increased disproportionately across rural compared to urban counties in three of four census regions. By 2014-15, amphetamine use disorder was identified among approximately 1% of all deliveries in the rural western United States, which was higher than the incidence of opioid use in most regions.

Compared to opioid-related deliveries, amphetamine-related deliveries were associated with higher incidence of the majority of adverse gestational outcomes that we examined including pre-eclampsia, preterm delivery, and severe maternal morbidity and mortality.   Continue reading

Cochrane Reviews Fish Oil Supplements To Reduce Premature Births

MedicalResearch.com Interview with:
“omega 3” by Khaldaa Photographer is licensed under CC BY 2.0Philippa Middelton MPH

Associate Professor
Healthy Mothers, Babies and Children
South Australian Health and Medical Research Institute
Adelaide, Australia 

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

Response: For several decades, it has been known that fish or fish oils can lengthen gestation.
In our Cochrane review of 70 studies and nearly 20,000 women we show that fish oil (mainly as omega-3 fatty acid supplements), prevents premature birth, specifically

  • An 11% reduction in premature birth < 37 weeks gestation;
  • And a 42% reduction in premature birth < 34 weeks gestation.

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Heavy Exposure to Air Pollution During Pregnancy May Raise Air Pollution Risk

MedicalResearch.com Interview with:
"Cairo Air Pollution with less smog - Pyramids1" by Nina Hale is licensed under CC BY 2.0Lief Pagalan, MSc

Faculty of Health Sciences, Simon Fraser University
Research Trainee, Centre for Hip Health and Mobility
Vancouver Coastal Health Research Institute

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

Response: Pregnant women more heavily exposed to air pollution had higher chances of having children with autism spectrum disorder (ASD).

The causes of ASD are not fully understood, but this study adds to the growing evidence that environmental risk factors have a role to play. Our study found an association between autism spectrum disorder in the children of women more heavily exposed to air pollution. We observed these results using well-defined cases of ASD and in Vancouver, Canada, which typically has lower air pollution. These findings are consistent with studies done in the U.S., Israel, and Taiwan, which have also found an increased risk of ASD from exposure to air pollution.  Continue reading

Severe Maternal Morbidity Can Be Identified, and Sometimes Prevented

MedicalResearch.com Interview with:

Joel Ray MD, MSc, FRCPC Institute of Health Policy, Management and Evaluation Faculty of Medicine University of Toronto, Toronto

Dr. Ray

Joel Ray MD, MSc, FRCPC
Institute of Health Policy, Management and Evaluation
Faculty of Medicine
University of Toronto, Toronto

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

Response: Many women who die within childbirth or soon thereafter experience rapid onset of morbidity/illness before succumbing. Thus, severe maternal morbidity (SMM) offers a detectable (or set of detectable) conditions that might be dealt with before they progress to a fatality. Even so, severe maternal morbidity alone can be non-fatal, but create disability for a new mother (e.g., a stroke), or prolong separation of mother and newborn.

So, we showed that, as the number of severe maternal morbidity indicators rises, so does the probability of maternal death. This relation was exponential in nature.   Continue reading

More Postnatal Depression with Baby Boys?

MedicalResearch.com Interview with:
Dr Sarah Myers PhDDr Sarah Myers PhD

Honorary Research Associate
UCL Department of Anthropology

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

Response: Postnatal or postpartum depression is unfortunately common after giving birth; a figure often quoted is 15%, but some studies have found much higher numbers. Postnatal depression is associated with a range of poorer outcomes for mothers and their infants, and the financial costs of treating maternal mental ill health put health services under considerable strain. Studies have found that providing additional emotional support to at risk mothers, for instance via peer support programmes or regular phone calls with health visitors, can reduce the likelihood of them developing the condition. Therefore, it is really important that we understand the full range of risk factors that put women at greater risk of becoming depressed after giving birth.

There is increasing evidence for a link between inflammation and depression, with factors that trigger an inflammatory immune response also increasing the likelihood of depressive symptoms. The opens up the possibility of finding new risk factors for postnatal depression based on known associations with inflammation.

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Prenatal Heavy Cannabis Exposure May Diminish Cognitive Functioning Into Adulthood

MedicalResearch.com Interview with:

Ryan J. McLaughlin, PhD Assistant Professor Department of Integrative Physiology & Neuroscience College of Veterinary Medicine Washington State University Pullman, WA 99164-7620

Dr. McLaughlin

Ryan J. McLaughlin, PhD
Assistant Professor
Department of Integrative Physiology & Neuroscience
College of Veterinary Medicine
Washington State University
Pullman, WA 99164-7620

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

Response: The use of cannabis during pregnancy is a growing health concern, yet the long-term cognitive ramifications for developing offspring remain largely unknown. Human studies exploring the long-term effects of maternal cannabis use have been sparse for several reasons, including the length and cost of such studies, as well as the fact that experimentally assigning mothers to smoke cannabis during pregnancy is obviously ethically impractical. Animal models of maternal cannabis use have been advantageous in this respect, but they have been limited by the drugs used (synthetic cannabinoids vs. THC vs. cannabis plant) and the way that they are administered. In our study, we used a more translationally relevant animal model of maternal cannabis use that exposes pregnant rat dams to whole plant cannabis extracts using the intra-pulmonary route of administration that is most common to human users. Our preliminary data indicate that twice-daily exposure to a high-dose cannabis extract during pregnancy may produce deficits in cognitive flexibility in adult rat offspring. Importantly, these rats did not experience general learning deficits, as they performed comparably to non-exposed offspring when required to follow a cue in their environment that dictate reinforcer delivery. Instead, deficits were observed only when rats were required to disregard this previous cue-based strategy and adopt a new egocentric spatial strategy in order to continue receiving the sugar reinforcers.

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Medications Commonly Used During Pregnancy Not Associated With Higher Autism Rates

MedicalResearch.com Interview with:

Magdalena Janecka PhD Department of Psychiatry Icahn School of Medicine at Mount Sinai

Dr. Janecka

Magdalena Janecka PhD
Department of Psychiatry
Icahn School of Medicine at Mount Sinai

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

Response: Our paper explored the association between maternal use of medication during pregnancy and the rates of autism in a large cohort from Israel. This followed on from a number of earlier studies reporting that the use of certain medications – for example antidepressants – during pregnancy is associated with higher rates of autism in children. However, rather than test the effects of any particular drug, or a set of drugs aggregated based on maternal condition, our large dataset allowed us to group all medications prescribed to pregnant women based on their drug target, and in the subsequent analyses focus on over 50 groups that included drugs with neurotransmitter-relevant targets – for example agonists and antagonists of their receptors.

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Maternal Smoking Linked to Early Puberty in Offspring

MedicalResearch.com Interview with:

Nis Brix M.D., PhD Student Department of Public Health Department of Epidemiology Aarhus University Hospital Nis Brix M.D., PhD Student
Department of Public Health
Department of Epidemiology
Aarhus University Hospital 

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

Response: Several studies have indicated a secular trend towards earlier puberty. This is a potential concern as early puberty has been linked to an increased risk of a number of diseases, such as obesity, diabetes, cardiovascular diseases and certain types of cancer. For this reason, our research team are interested in identifying potential modifiable causes of early puberty.

Smoking during pregnancy may be such a modifiable cause of early puberty in the children. Former studies have already linked smoking during pregnancy to earlier age at the daughters’ first menstrual period, a relatively late marker of pubertal development, but other markers of puberty are less studied, especially in the sons.

We studied 15,819 sons and daughters. The mothers gave detailed information on smoking during their pregnancies, and the children gave information on a number of pubertal milestones half-yearly from the age of 11 years. The milestones for the sons were age at voice break, first ejaculation of semen, pubic hair and testicular growth, armpit hair growth and onset of acne. For the daughters the milestones were age at their first menstrual period, pubic hair growth, breast development, armpit hair growth and onset of acne.

Our results suggested that the more cigarettes the mother smoked during her pregnancy the earlier her children, both sons and daughters, went through puberty. If the mother smoked more than ten cigarettes a day during pregnancy, the children appeared to go through puberty, on average, three to six months earlier than the children of non-smoking mothers. Continue reading

Is Pregnancy a “Stress Test” for Future Dementia Risk?

MedicalResearch.com Interview with:
"Pregnancy 1" by operalynn is licensed under CC BY 2.0Heather Boyd, Ph.D.
Senior researcher
Department of Epidemiology Research
Copenhagen Denmark

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

Response: We have known for a while that women who have had preeclampsia report different types of cognitive impairment (difficulties with short-term memory, attention deficits) in the years and decades after their pregnancies, and there are a few imaging studies suggesting that these women may have more white matter lesions in the brain and more signs of brain atrophy than women with uncomplicated pregnancies. We also know that women who have had preeclampsia are at increased risk of cardiovascular disease in the years and decades after delivery. Taken together, it was not a great leap to hypothesize that women with a history of preeclampsia might also be at increased risk of dementia later in life. However, the existing epidemiological data were unconvincing, possibly because it takes a great deal of power (a very large study population) to study links between two conditions that often occur decades apart.

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Neural Tube Defects Are Preventable: Buy Corn Masa Flour and Tortilla Products That Contain Folic Acid

MedicalResearch.com Interview with:
"Tortillas di una miscela di mais azzurro tostato" by fugzu is licensed under CC BY 2.0Vijaya Kancherla, PhD

Research Assistant Professor, Department of Epidemiology
Epidemiologist, Center for Spina Bifida Prevention
Rollins School of Public Health
Emory University
Atlanta GA 30322

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

 Response: The scientific evidence since 1991 has shown that folic acid prevents from 35%-95% of neural tube birth defects that are caused due to low folic acid (also known as vitamin B9) in the mother’s diet prior to conception and during early pregnancy. Neural tube defects form in the embryo at 4th week of gestation when most women are unaware they are pregnant.

Taking any amount of folic acid after the 4th week of pregnancy will not prevent neural tube defects. There is no cure for these birth defects. So, it matters for women to have enough folic acid prior to conception and in the first four weeks of pregnancy. If a woman is not taking prenatal vitamins that early, folic acid fortified foods come to rescue. Foods fortified with folic acid will prevent folate deficiency for everyone, and offer the benefit to mothers who were not planning their pregnancies or were not taking folic acid pills. If corn masa flour and tortillas were fortified with folic acid, that would help millions of reproductive aged women have healthy stores of folic acid in their bodies, to prepare them for their pregnancy, irrespective of their pregnancy plans.

Prior to April 2016, folic acid (also known as vitamin B9) was not allowed to be added to corn masa flour (or products made from masa such as tortillas and tortilla chips) in the US. So, there was no expectation of having folic acid in these products.

The March of Dimes, Spina Bifida Foundation, the American Academy of Pediatricians, Gruma Corporation and others filed a petition with the US FDA and succeeded in allowing millers to voluntarily add folic acid to corn masa flour and tortillas as a food additive. This regulation was implemented by the US FDA in April 2016.  Continue reading