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

One Type of ART in HIV-Positive Pregnant Women Likely Increases Risk of Neurological Problems in Children

MedicalResearch.com Interview with:

Claudia Syueping Crowell, MD Lead author of the study Assistant professor of pediatrics University of Washington and  Seattle Children's Hospital

Dr. Syueping Crowell

Claudia Syueping Crowell, MD
Lead author of the study
Assistant professor of pediatrics
University of Washington and
Seattle Children’s Hospital

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

  • This research was conducted as part of the SMARTT (Surveillance Monitoring for ART Toxicities) study, which is an observational cohort study of HIV exposed uninfected children with the overall aim of studying the long-term safety of fetal and infant exposure to prophylactic antiretroviral (ARV) therapy.
  • This particular analysis was conducted in response to prior studies that showed an increased risk of seizures and other neurologic conditions in children who were exposed to ARVs in utero.
  • The aim of our study was to determine if in utero exposure to any particular ARV is associated with the diagnosis of neurologic conditions later in infancy and childhood.
  • In our cohort of 3747 HIV-exposed uninfected children we found 237 children who had neurologic conditions, 16 of whom were exposed to efavirenz in utero and 4 of whom were exposed to dolutegravir in utero.
  • The most common neurologic diagnoses were microcephaly, febrile seizures, non-febrile seizures and eye related disorders.
  • When comparing various antiretroviral medications, we found that children of women whose ART regimen included efavirenz were more likely to be diagnosed with a neurologic condition than children of women whose ART regimen did not include efavirenz (9.6% vs. 6.2%). This translated to a 60% higher risk of being diagnosed with a neurologic condition in the efavirenz exposed group after controlling for other risk factors.
  • We also found a suggestion of an association between in utero dolutegravir exposure and later diagnosis of a neurologic condition but the number of children exposed to dolutegravir was small (number of exposed children = 94). 

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Folate Metabolites Linked To Increased Risk of Autism Spectrum Disorder

MedicalResearch.com Interview with:

Juergen Hahn PhD, Professor and Department Head Department of Biomedical Engineerin Department of Chemical & Biological Engineering Center for Biotechnology and Interdisciplinary Studies Rensselaer Polytechnic Institute

Prof., Hahn

Juergen Hahn PhD, Professor and
Department Head Department of Biomedical Engineerin
Department of Chemical & Biological Engineering Center for Biotechnology and Interdisciplinary Studies
Rensselaer Polytechnic Institute

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

Response: Recent estimates indicate that if a mother has previously had a child with autism spectrum disorder, the risk of having a second child with ASD is ~18.7% whereas the risk of ASD in the general population is ~1.7%.

This work investigated if there is a difference in metabolites of the folate one carbon metabolism and the transulfuration pathway between the mothers that have had a child with ASD and those that have not. Furthermore, we investigated if there is a difference among the mothers who have had a child with autism spectrum disorder based upon if the child that they were pregnant with will have an ASD diagnosis by age 3. This part required follow up with the mothers three years later.

The main findings are that there are statistically significant differences in the metabolites between the mothers who have previously had a child with autism spectrum disorder, who have an 18.7% probability of having another child with ASD, and those who have not, who have an 1.7% probability of having a child with autism spectrum disorder.

However, we did not find differences among the mothers based upon if the child will be diagnosed with ASD at age 3.

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

Response: Based upon the measurements it is not possible to determine during a pregnancy if a child will be diagnosed with ASD by age 3. However, differences in the folate-dependent transmethylation and transsulfuration metabolites are indicative of the risk level (High Risk of 18.7% vs. Low Risk of 1.7%) of the mother for having a child with autism spectrum disorder.

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

Response: This study has not been replicated and we also had to make a number of assumptions which are listed in the paper. These points should be looked at in future research. My recommendation would be to replicate the comparison between mothers who have had a child with .autism spectrum disorder and those who have not and focus on recruiting an approximately equal number of mothers for each group and try to match the two groups by age and ethnicity.

Citation:

Maternal metabolic profile predicts high or low risk of an autism pregnancy outcome

KathrynHollowoodabStepanMelnykcOleksandraPavlivcTeresaEvanscAshleySidesdRebecca J.SchmidteIrvaHertz-PicciottoeWilliamElmseElizabethGuerreroeUweKrugeraJuergenHahnabfS. JillJamesc
Research in Autism Spectrum Disorders

Volume 56, December 2018, Pages 72-82

Sep 22, 2018 @ 3:18 pm

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Could a Low-Gluten Diet During Pregnancy Protect Offspring from Diabetes?

MedicalResearch.com Interview with:
Knud Josefsen, senior researcher
Bartholin Institute, Rigshospitalet,
Copenhagen K, Denmark

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

Response: In a large population of pregnant women, we found that the risk of the offspring being diagnosed with type 1 diabetes before the age of 15.6 years (the follow up period) was doubled in the group of women ingesting the highest amounts of gluten (20-66 g/day) versus the group of women ingesting the lowest amounts of gluten (0-7 g/day). For every additional 10 grams of gluten ingested, the risk for type 1 diabetes in the child increased by a factor of 1.31.

It the sense that it was a hypothesis that we specifically tested, we were not surprised. We had seen in animal experiments that a gluten-free diet during pregnancy protected the offspring from diabetes, and we wanted to see if we could prove the same pattern in humans. There could be many reasons why we would not be able to show the association, even if it was there (sample size, low quality data, covariates we could not correct for and so on), but we were off course pleasantly surprised that we found the association that we were looking for, in particular because it is quite robust Continue reading

Babies Born During Peak Pollen Season Have IgE in Cord Blood

MedicalResearch.com Interview with:
“Pollen” by John S. Quarterman is licensed under CC BY 2.0Bircan Erbas, Associate Professor
Reader/Associate Professor, Department of Public Health
School of Psychology & Public Health
La Trobe University 

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

Response: Around the world allergic respiratory diseases especially in children is a major problem. Studies have already shown that cord blood IgE can be used to identify children at risk for allergic diseases. Our previous research showed that exposure to high levels of outdoor pollen, especially grass, in the first couple of months after birth increased risk of allergic respiratory diseases. Based on this, we suspected that exposure to high grass pollen during pregnancy could be also important. Continue reading

Young Pregnant Women More Likely To Be Depressed Than Their Mothers

MedicalResearch.com Interview with:

Rebecca Pearson, PhD Lecturer in Psychiatric Epidemiology Centre for Academic Mental Health School of Social & Community Medicine University of Bristol

Dr. Pearson

Rebecca Pearson, PhD
Lecturer in Psychiatric Epidemiology
Centre for Academic Mental Health
School of Social & Community Medicine
University of Bristol

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

Response: We know depression and anxiety are common in young women and during pregnancy when there are also implications for the developing child.

It is therefore important to investigate whether symptoms are rising given the pressures of modern life.

We found that compared to their mothers generation in the 1990s young pregnancy women today are more likely to be depressed. This was driven largely by symptoms of anxiety and feeling overwhelmed rather than feeling down.  Continue reading

TDAP Vaccine During Pregnancy Protects Infants Against Whooping Cough

MedicalResearch.com Interview with:

Sylvia Becker-Dreps, MD MPH Associate Professor, Department of Family Medicine Associate Director, Office of International Activities (Latin America Focus) Director, UNC Program in Nicaragua University of North Carolina at Chapel Hill Chapel Hill, NC 27599-7595

Dr. Becker-Dreps

Sylvia Becker-Dreps, MD MPH
Associate Professor, Department of Family Medicine
Associate Director, Office of International Activities (Latin America Focus)
Director, UNC Program in Nicaragua
University of North Carolina at Chapel Hill
Chapel Hill, NC 27599-7595

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

 Response: Pertussis (or whooping cough) is a respiratory infection caused by bacteria. It has been becoming more common in the US over the past two decades. Infants are more likely to be hospitalized and die of the disease. They are especially vulnerable in the first months of life because they have not yet had time to complete the DTaP vaccine series themselves. (Currently, infants receive 3 doses of DTaP at 2,4, and 6 months of age.) Immunizing mothers allows the mothers to pass antibodies against pertussis through the placenta and provide passive immunity to infants early in life. In early 2013, the CDC recommended that pregnant women receive a Tdap vaccine in every pregnancy. That recommendation was based on studies of the immune response to the vaccine, not real cases of pertussis.

Our study examined clinical cases of pertussis in over 675,000 infants throughout the US. We found that in the first six months of life, infants of vaccinated mothers (those that received Tdap during pregnancy) had 75% less pertussis hospitalizations and 50% less pertussis cases overall.  Continue reading

Hypertension Disorders in Pregnancy Associated With Increase in ASD and ADHD in Offspring

MedicalResearch.com Interview with:
“Blood Pressure” by Bernard Goldbach is licensed under CC BY 2.0Ali Khashan, PhD
Senior Lecturer in Epidemiology
School of Public Health & INFANT Centre
University College Cork
Cork, Ireland

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

Response: There is some evidence to suggest an increased likelihood of neurodevelopmental disorders in relation to hypertensive disorders in pregnancy, however consensus is lacking. Considering hypertensive disorders in pregnancy are among the most common prenatal complication, we decided to synthesise the published literature on this topic by conducting a comprehensive systematic review and meta-analysis.

Our main findings suggest that hypertensive disorders in pregnancy are associated with about 30% increase in the likelihood of autism spectrum disorders (ASD) and ADHD in the offspring, compared to offspring not exposed to hypertensive disorders in pregnancy. Continue reading

ADHD More Common if Grandmother Used DES During Pregnancy

MedicalResearch.com Interview with:

Marianthi-Anna Kioumourtzoglou ScD Assistant Professor Environmental Health Sciences Mailman School of Public Health Columbia University 

Dr. Kioumourtzoglou

Marianthi-Anna Kioumourtzoglou ScD
Assistant Professor
Environmental Health Sciences
Mailman School of Public Health
Columbia University 

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

Response: The prevalence of neurodevelopmental disorders, like attention deficit/hyperactivity disorder (ADHD) has been increasing. One of the hypothesized risk factors for increased risk for neurodevelopmental disorders is a class of chemicals known as endocrine disrupting chemicals (EDCs). These chemicals are known to interfere with the endocrine system, i.e. the system that uses hormones to control and coordinate metabolism, reproduction and development. Several high production volume chemicals, ubiquitously present in commercial products, are known or suspected endocrine disruptors. Because of their widespread use in consumer products, the population-wide exposure to known and suspected EDCs is very high.

Recently, there has been increased attention in the potential effects of EDCs on neurodevelopment that span multiple generations. Animal studies have provided evidence that exposure to EDCs, such as phthalates and bisphenol A (BPA), alter the behavior and social interactions in mice in three to five generations after exposure. However, evidence of such multi-generational impacts of EDC exposure on neurodevelopment in humans is unavailable, likely because of the lack of detailed information on exposures and outcomes across generations.

For this study we leveraged information from a nationwide cohort, the Nurses’ Health Study II (NHSII), to investigate the potential link between exposure to diethylstilbestrol (DES) and third generation ADHD, i.e. ADHD among the grandchildren of the women who used DES while pregnant. DES is a very potent endocrine disruptor that was prescribed between 1938 and 1971 to pregnant women thought to prevent pregnancy complications. In the United States, between 5 and 10 million women are estimated to have used DES, although the exact number is not known. DES was banned in 1971, when was linked to vaginal adenocarcinomas (a rare cancer of the reproductive system) in the daughters of the women who had used it during pregnancy. Since then, DES has been also linked to multiple other reproductive outcomes in DES daughters, as well as with some reproductive outcomes in the grandchildren of the women who used it, such as hypospadias and delated menstrual regularization. However, to our knowledge, no study to date has evaluated the association between DES, or any other EDC, and multigenerational neurodevelopment.

Continue reading

No Link Found Between Autism and Maternal Fish Ingested During Pregnancy

MedicalResearch.com Interview with:
“Fish” by Dhruvaraj S is licensed under CC BY 2.0Dr Caroline M Taylor
Wellcome Trust Research Fellow
Centre for Child and Adolescent Health
Bristol Medical School, University of Bristol
Oakfield House, Oakfield Grove, Bristol

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

Response: Mercury is a toxic metal that is widespread in the environment. In pregnancy, mercury in the mother’ bloodstream is transferred through the placenta to the fetus, where is can affect development of the nervous system. Mercury from vaccines has been the focus of attention particularly in regard to a link with autism in children. However, the amount of mercury used in the vaccines is small in comparison with mercury from the diet and atmospheric pollution, and in the EU at least, childhood vaccines no longer contain this preservative. The fear that mercury is linked to autism has persisted, despite increasing evidence that this is not the case.

The aim of our study was to look at mercury from the diet rather than vaccines – specifically from fish – in pregnant women. We measured the women’s mercury levels in their blood and asked them about how much fish they ate. We then followed up their children for 9 years and recorded how many of them had autism diagnosed within that time. We also measured how many of them had autist traits by measuring their social and communication difficulties.  The data were part of the Children of the 90s study (Avon Longitudinal Study of Parents and Children – ALSPAC), which is based in Bristol, UK.

Continue reading

ADHD More Common in Grandchildren of Women Who Used DES During Pregnancy

MedicalResearch.com Interview with:

Marianthi-Anna Kioumourtzoglou ScD Assistant Professor Environmental Health Sciences Mailman School of Public Health Columbia University 

MarianthiAnna Kioumourtzoglou ScD
Assistant Professor
Environmental Health Sciences
Mailman School of Public Health
Columbia University 

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

Response: The prevalence of neurodevelopmental disorders, like attention deficit/hyperactivity disorder (ADHD) has been increasing. One of the hypothesized risk factors for increased risk for neurodevelopmental disorders is a class of chemicals known as endocrine disrupting chemicals (EDCs). These chemicals are known to interfere with the endocrine system, i.e. the system that uses hormones to control and coordinate metabolism, reproduction and development. Several high production volume chemicals, ubiquitously present in commercial products, are known or suspected endocrine disruptors. Because of their widespread use in consumer products, the population-wide exposure to known and suspected EDCs is very high.

Recently, there has been increased attention in the potential effects of EDCs on neurodevelopment that span multiple generations. Animal studies have provided evidence that exposure to EDCs, such as phthalates and bisphenol A (BPA), alter the behavior and social interactions in mice in three to five generations after exposure. However, evidence of such multi-generational impacts of EDC exposure on neurodevelopment in humans is unavailable, likely because of the lack of detailed information on exposures and outcomes across generations.

For this study we leveraged information from a nationwide cohort, the Nurses’ Health Study II (NHSII), to investigate the potential link between exposure to diethylstilbestrol (DES) and third generation ADHD, i.e. ADHD among the grandchildren of the women who used DES while pregnant. DES is a very potent endocrine disruptor that was prescribed between 1938 and 1971 to pregnant women thought to prevent pregnancy complications. In the United States, between 5 and 10 million women are estimated to have used DES, although the exact number is not known. DES was banned in 1971, when was linked to vaginal adenocarcinomas (a rare cancer of the reproductive system) in the daughters of the women who had used it during pregnancy. Since then, DES has been also linked to multiple other reproductive outcomes in DES daughters, as well as with some reproductive outcomes in the grandchildren of the women who used it, such as hypospadias and delated menstrual regularization. However, to our knowledge, no study to date has evaluated the association between DES, or any other EDC, and multigenerational neurodevelopment. Continue reading

Does Acupuncture Increase Live Births For Women Undergoing IVF?

MedicalResearch.com Interview with:
“Acupuncture Needle” by Acid Pix is licensed under CC BY 2.0
Caroline Smith, PhD
Professor Clinical Research
Western Sydney University Research Theme Champion Health and Wellbeing

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

Response: Despite technological improvements to IVF the success of IVF treatment remains low. Consequently, new drugs, laboratory techniques and other treatments need to be developed and rigorously tested to explore their effects on producing healthy babies for women undergoing IVF.  In 2002, the first randomised controlled trial of acupuncture administered a specific form of IVF acupuncture at the time of embryo transfer.

The results indicated the chance of achieving a pregnancy from acupuncture was twice that to women undergoing IVF treatment alone. From mid 2000s many women have started to use adjunctive treatments such as acupuncture whilst undergoing IVF.  We conducted and reported on a  pilot study in 2006 which produced results suggesting a benefit. It is important that these findings were rigorously examined in a larger trial.

Findings are presented from our trial presented in JAMA. Our study of over 800 Australian and New Zealand women undergoing acupuncture treatment during their IVF (in vitro fertilization) cycle has failed to confirm significant difference in live birth rates.

Continue reading

Is It Safe to Have a Vaginal Birth after Cesarean Section?

MedicalResearch.com Interview with:
“Childbirth” by DAVID Swift is licensed under CC BY 2.0
Dr. Carmen Young
Department of Obstetrics and Gynecology
University of Alberta

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

Response: For women who have had a single previous cesarean section, the optimal mode of delivery in a subsequent pregnancy is controversial. This is because there are risks and benefits to attempting a vaginal birth after cesarean section (VBAC) or having an elective repeat cesarean section. Attempted VBAC is associated with a higher risk of uterine rupture and other maternal and infant complications. Repeat cesarean sections are associated with an increased risk of surgical complications and placental complications in subsequent pregnancies. Furthermore, it is difficult to predict which patients will have a successful VBAC.

This study is unique in that it uses recent Canadian data, allowing assessment of the impact of contemporary obstetrical care on maternal and neonatal outcomes in Canada.

Continue reading

Diet Soda and Excess Sugar During Pregnancy May Depress Child’s Cognition

MedicalResearch.com Interview with:
“Soda” by Jannes Pockele is licensed under CC BY 2.0Juliana F. W. Cohen, ScM, ScD

Department of Health Sciences
Merrimack College
North Andover MA 01845.

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

Response: Sugar consumption among Americans is above recommended limits and this excess intake may have important health implications.

This study examined the associations of pregnancy and offspring sugar consumption, as well as sugar-sweetened beverages, other beverages (diet soda, juice), and fruit consumption with child cognition.

This study found that when pregnant women or their children consumed greater quantities of sugar, as well as when women consumed diet soda during pregnancy, this was associated with poorer childhood cognition.  However, children’s fruit consumption was associated with higher cognitive scores.

Continue reading

Prenatal Exposure to SSRIs May Be Linked to Changes in Infant Brain Development

MedicalResearch.com Interview with:

Jiook Cha, PhD Assistant Professor Division of Child and Adolescent Psychiatry  Columbia University Medical Center  New York, NY 10032

Dr. Jiook Cha

Jiook Cha, PhD
Assistant Professor
Division of Child and Adolescent Psychiatry
Columbia University Medical Center
New York, NY 10032

MedicalResearch.com: What did we already know about the connection between maternal SSRI use during pregnancy and infant brain development, and how do the current study findings add to our understanding? What’s new/surprising here and why does it matter for mothers and babies?

Response: Prior studies have shown mixed results in terms of the associations between maternal SRI use during pregnancy and offspring’s brain and cognitive development. Neurobiological studies with animal models suggest that SSRI use perturbs serotonin signaling and that this has important effects on cognitive development (a study conducted an author of this paper, Jay Gingrich, MD, PhD: Ansorge et al., 2004, Science). The human literature has been more mixed in terms of the associations of prenatal exposure to SSRI with brain and cognitive development.

In our study, we used neonatal brain imaging because this is a direct, non-invasive method to test associations between SSRI use and brain development at an early developmental stage, limiting the effects of the post-natal environment. In our study, we had two different control groups, that is, a non-depressed SSRI-free group (healthy controls), and depressed but SSRI-free (SSRI controls) group. Also, in our study we used rigorous imaging analytics that significantly improve the quantitative nature of MR-derived signals from the brain structure using two of the nation’s fastest supercomputers (Argonne National Laboratory and Texas Advanced Computing Center) and allows robust reconstruction of brain’s grey and white matter structure in the infants’ brains.

We report a significant association of prenatal exposure to SSRI with a volume increases within many brain areas, including the amygdala and insula cortex, and an increase in white matter connection strength between the amygdala and insular cortex. We were surprised by the magnitude of the effects (or the statistical effect size), compared with other brain imaging studies in psychiatry with children or adults’ brains. Importantly, it should be noted that our estimates of brain structure are still experimental and for research-purpose only. This means that our data need to be replicated and rigorously tested against confounders in order to make a firm conclusion. While our study suggests a “potential” association between prenatal exposure to SSRI and a change in fetal or infant brain development, we still need more research. 

tracts_in_the_brain

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Two Genes Linked to Severe Nausea and Vomiting in Pregnancy

MedicalResearch.com Interview with:

Marlena Fejzo, PhD Aassociate researche David Geffen School of Medicine UCLA.

Dr. Fejzo

Marlena Fejzo, PhD
Aassociate researche
David Geffen School of Medicine
UCLA. 

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

Response: Most women experience some nausea and vomiting of pregnancy, and the worst 2% are diagnosed with Hyperemesis Gravidarum which is associated with poor maternal and fetal outcomes. I had HG in 2 pregnancies. In my second pregnancy my HG was so severe that I could not move without vomiting and did not keep any food or water down for 10 weeks. I was put on a feeding tube, but ultimately lost the baby in the second trimester. I am a medical scientist by training so I looked into what was known about HG. At the time, very little was known, so I decided to study it. I partnered with the Hyperemesis Education and Research Foundation (HER) and we did a survey on family history of .Hyperemesis Gravidarum that provided evidence to support a role for genes. I collected saliva samples from HG patients and their unaffected acquaintances to do a DNA study. Then I partnered with the personal genetics company, 23andMe to do a genome scan and validation study, which identified 2 genes, GDF15 and IGFBP7, linked to HG.

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Zika Birth Defects More Severe When Mothers Infected During First Trimester

MedicalResearch.com Interview with:

This image depicts a posterior view of a patient’s back, captured in a clinical setting, upon presenting with this blotchy rash. After a diagnostic work-up, it was determined that the rash had been caused by the Zika virus. Note: Not all patients with Zika get a rash CDC image

This image depicts a posterior view of a patient’s back, captured in a clinical setting, upon presenting with this blotchy rash. After a diagnostic work-up, it was determined that the rash had been caused by the Zika virus.
Note: Not all patients with Zika get a rash
CDC image

Professor Bruno Hoen, M.D., Ph.D
Dept of Infectious Diseases, Dermatology, and Internal Medicine
University Medical Center of Guadeloupe 

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

Response: Zika virus (ZIKV) infection during pregnancy has been identified only recently to cause severe birth defects, including microcephaly, other brain defects, and the congenital Zika syndrome. However, the magnitude of this risk was not clearly defined, with discrepancies between observational data from Brazil and the U.S. Zika Pregnancy Registry. We implemented a cohort study of pregnant women who have been exposed to ZIKV throughout the outbreak that hit the Caribbean in 2016.
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Can Probiotics and Fish Oil Supplements During Pregnancy Reduce Childhood Allergies?

MedicalResearch.com Interview with:
Dr Robert Boyle, 
Reader in Paediatric Allergy
Department of Medicine
Imperial College London

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

Response: Diet in early life may influence whether or not an infant develops allergies or autoimmune disease. We undertook a project for the UK Food Standards Agency to evaluate the evidence for this.

MedicalResearch.com: What are the main findings? 

Response: We found that a probiotic supplement during the last 2-4 weeks of pregnancy and during breastfeeding may reduce an infant’s chances of developing eczema; and that omega-3 fatty acid supplements taken from the middle of pregnancy (20 weeks gestation) through the first few months of breastfeeding may reduce an infant’s chances of developing food allergy. We also found links between longer duration of breastfeeding and improved infant health, but for most other variations in diet during pregnancy or infancy we did not find evidence for a link with allergies or autoimmune disease.

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Pregnancy in Type 1 Diabetes: Glucose Control Can Reduce Fetal Overgrowth

MedicalResearch.com Interview with:

Rachel McGrath BSc (Hons), PhD Senior Research Fellow - Department of Endocrinology, RNSH Clinical Senior Lecturer - Northern Clinical School University of Sydney

Dr. Rachel McGrath

Rachel McGrath BSc (Hons), PhD
Senior Research Fellow – Department of Endocrinology, RNSH
Clinical Senior Lecturer – Northern Clinical School
University of Sydney 

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

Response: Women with type 1 diabetes are significantly more likely to experience complications during pregnancy and to have infants with high birth weights. This can result in adverse outcomes at the time of delivery for both mother and baby, and can also predispose infants to obesity and chronic disease in later life.

The relationship between maternal blood glucose levels and foetal growth in type 1 diabetes in pregnancy has not been completely elucidated. Thus, we examined the association between maternal glycaemic control and foetal growth by examining serial ultrasound measurements and also by determining the relationship between HbA1c (a measure of circulating glucose exposure over a three month time period) and infant birth weight.

We found that maternal glucose levels were directly related to foetal abdominal circumference in the late second and third trimesters and also to birth weight. We also confirmed the results of previous studies to show that the optimal HbA1c during pregnancy to reduce the likelihood of large-for-gestational-age neonates is < 6%.  Continue reading