Author Interviews, OBGYNE, Weight Research / 18.04.2014

MedicalResearch.com Interview with: Sneha Sridhar, MPH Kaiser Permanente, Division of Research 2000 Broadway, 3rd Floor Oakland, CA  94612 MedicalResearch.com: What are the main findings of the study?   Answer: We found that women whose weight gain during pregnancy exceeded the current Institute of Medicine (IOM) recommendations were 46% more likely to have an overweight or obese child at ages 2-5, compared to women who met the recommendations. The association was stronger among women who were of normal weight before pregnancy. These normal weight women were more likely to have an overweight or obese child if they gained either below or above the IOM recommendations.
Author Interviews, JAMA, OBGYNE, Weight Research / 15.04.2014

MedicalResearch.com Interview with: Dagfinn Aune MS Department of Epidemiology and Biostatistics School of Public Health Imperial College London St. Mary's Campus Norfolk Place, Paddington, London W2 1PG, UK MedicalResearch.com: What are the main findings of the study? Answer: We conducted a systematic review and meta-analysis of studies examining the association between maternal body mass index (BMI) and risk of fetal death, stillbirth, neonatal, perinatal and infant death. We found that the risk of all these outcomes increased with greater BMI in a dose-response fashion. For example even within the high end of what is considered the normal BMI range (BMI of 24-25) there was a 10-20% increase in the relative risk, but the strongest relations were seen for those who were obese and morbidly obese with 30-60% and 2-3 fold increases in the relative risk respectively (depending on the outcome examined).
Author Interviews, Lancet, OBGYNE / 09.04.2014

Enrique F. Schisterman, Ph.D. Chief and Senior Investigator Epidemiology Branch, DIPHR Eunice Kennedy Shriver National Institute of Child Health and Human Development Rockville, MD 20854MedicalResearch.com Interview with: Enrique F. Schisterman, Ph.D. Chief and Senior Investigator Epidemiology Branch, DIPHR Eunice Kennedy Shriver National Institute of Child Health and Human Development Rockville, MD 20854 MedicalResearch.com: What are the main findings of the study? Dr. Schisterman: Our results indicate that aspirin is not effective for reducing the chances of pregnancy loss in most cases. For the total number of women in the study, 13 percent of women who took aspirin and became pregnant subsequently experienced another loss, compared with 12 percent who took the placebo. Ultimately, 58 percent of women taking aspirin and 53 percent of the placebo group got pregnant and later gave birth. However, additional research is needed to investigate the finding that women who had experienced a single, recent pregnancy loss (before 4 1/2 months of pregnancy and within the past year) had an increased rate of pregnancy and live birth while on aspirin therapy. Among this group, 78 percent of those who took aspirin became pregnant, compared with 66 percent of those who took the placebo. For this subset of women, 62 percent of the aspirin group and 53 percent of the placebo group gave birth.
Autism, Genetic Research, NEJM, UCSD / 26.03.2014

MedicalResearch.com Interview with: Dr. Erik Courchesne PhD Professor, Department of Neurosciences UC San Diego School of Medicine MedicalResearch.com: What are the main findings of the study? Dr. Courchesne: “Building a baby’s brain during pregnancy involves creating a cortex that contains six layers,” Courchesne said. “We discovered focal patches of disrupted development of these cortical layers in the majority of children with autism.” The authors created the first three-dimensional model visualizing brain locations where patches of cortex had failed to develop the normal cell-layering pattern. The study found that in the brains of children with autism key genetic markers were absent in brain cells in multiple layers. “This defect,” Courchesne said, “indicates that the crucial early developmental step of creating six distinct layers with specific types of brain cells – something that begins in prenatal life – had been disrupted.”  The study gives clear and direct new evidence that autism begins during pregnancy.
Author Interviews, Infections, JAMA, OBGYNE / 19.03.2014

Shamez Ladhani, MRCPCH PhD Health Protection Services, Immunisation, Hepatitis, and Blood Safety Department, Public Health England, LondonMedicalResearch.com Interview with: Shamez Ladhani, MRCPCH PhD Health Protection Services, Immunisation, Hepatitis, and Blood Safety Department, Public Health England, London   MedicalResearch.com: What are the main findings of the study? Dr. Ladhani: Pregnancy was associated with an increased of serious infection by a bacterium called Haemophilus influenzae which is usually associated with respiratory tract infections. Nearly all the H. influenzae were unencapsulated; that is, they did not have an outer sugar capsule which is often required to make the bacterium more virulent. The encapsulated H. influenzae type b (Hib), for example, was the most common cause of bacterial meningitis in your children prior to routine immunisation. We also found that infection with unencapsulated H. influenzae was associated with poor pregnancy outcomes, including miscarriages, stillbirth and premature birth.
AHA Journals, Author Interviews, Diabetes, Heart Disease, OBGYNE / 18.03.2014

Erica P. Gunderson, PhD, MS, MPH Senior Research Scientist, Cardiovascular and Metabolic Section Division of Research, Kaiser Permanente Northern California Oakland, CA 94612-2304MedicalResearch.com Interview with: Erica P. Gunderson, PhD, MS, MPH Senior Research Scientist, Cardiovascular and Metabolic Section Division of Research, Kaiser Permanente Northern California Oakland, CA 94612-2304 MedicalResearch.com: What are the main findings of the study? Dr. Gunderson: The study found that: -   Gestational diabetes is a pregnancy complication that reveals a woman’s greater risk of future heart disease. -   Women who experience gestational diabetes face an increased risk of subclinical atherosclerosis (early heart disease) even if they do not develop type 2 diabetes or the metabolic syndrome years after pregnancy. -   Study participants with a history of gestational diabetes who did not develop diabetes or metabolic syndrome showed a greater carotid artery wall thickness (marker of early atherosclerosis) compared to those who never experienced gestational diabetes.  The vessel narrowing also could not be attributed to obesity or other risk factors for heart disease that were measured before pregnancy. -   Weight gain and blood pressure elevations in women with gestational diabetes were responsible for these differences in the artery wall thickness.
Author Interviews, BMJ, Nutrition, OBGYNE / 05.03.2014

MedicalResearch.com Interview with: Dr Linda Englund-Ögge Department of Obstetrics and Gynaecology, Institute of Clinical Sciences Sahlgrenska Academy, Sahlgrenska University Hospital Gothenburg, SwedenDr Linda Englund-Ögge Department of Obstetrics and Gynaecology, Institute of Clinical Sciences Sahlgrenska Academy, Sahlgrenska University Hospital Gothenburg, Sweden MedicalResearch.com: What are the main findings of the study? Answer: Women adhering to a prudent* or a traditional** dietary pattern during pregnancy had a significantly reduced risk of preterm delivery, even after adjusting for a range of confounders. The prudent pattern was also significantly associated to lower risk in the nulliparous, in spontaneous and in late preterm delivery. *, characterized by high intake of e.g. vegetables, fruit, whole grains and water to drink. **, characterized by high intake of e.g. boiled potatoes, fish and cooked vegetables.
ADHD, Author Interviews, JAMA / 25.02.2014

Jørn Olsen, M.D., Ph.D.  Professor Institute of Public Health, Department of Epidemiology UCLA Aarhus University Aarhus,DenmarkMedicalResearch.com Interview with: Jørn Olsen, M.D., Ph.D.  Professor Institute of Public Health, Department of Epidemiology UCLA Aarhus University Aarhus,Denmark MedicalResearch.com: What are the main findings of the study? Dr. Olsen: Acetaminophen (paracetamol) is drug being used by many, including pregnant women. In our data about half of all pregnant women in 1995 to 2002 had used the drug all least once during their pregnancy. The drug has shown hormonal disruptor properties in animal studies. We found that women who used this drug during pregnancy gave birth to children who 5 – 10 years later slightly more often had behavioral problems or were treated for ADHD. The risk was highest for those who took the medication late in pregnancy and/or had taken the drug several times. The increased risk was about 10-30%.
Author Interviews, OBGYNE, PLoS / 21.02.2014

Prof. Nicholas J. Wald Wolfson Institute of Preventive Medicine Barts and the London School of Medicine and Dentistry Queen Mary University of London London, United KingdomMedicalResearch.com Interview with: Prof. Nicholas J. Wald Wolfson Institute of Preventive Medicine Barts and the London School of Medicine and Dentistry Queen Mary University of London London, United Kingdom MedicalResearch.com: What are the main findings of the study? Prof Wald: The percentage of women who become pregnant without having taken folic acid supplements to reduce the risk of a neural tube defect declined from a relatively low proportion (35%) to an even lower one (31%) between 1999 and 2012. Moreover such use of folic acid in some groups of the population is much lower for example 17% in Afro-Caribbean women and 6% in women aged under 20.
Alcohol, Author Interviews, OBGYNE, PLoS / 18.02.2014

MedicalResearch.com: Interview with: Sylvia Lui Tommy’s Maternal and Fetal Health Research Centre The University of Manchester MedicalResearch.com: What are the main findings of the study? Answer: The research shows women who drink alcohol at moderate or heavy levels in the early stages of their pregnancy might damage the growth and function of their placenta – the organ responsible for supplying everything that a developing infant needs until birth
Allergies, Asthma, Author Interviews, Dermatology / 05.02.2014

Sabina Illi, Dipl.-Stat., MPH University Children's Hospital Lindwurmstr. 4 80337 Munich GermanyMedicalResearch.com Interview with: Dr. Sabina Illi, Dipl.-Stat., MPH University Children's Hospital Lindwurmstr. 4 80337 Munich Germany MedicalResearch.com: What are the main findings of the study? Answer: We observed that the offspring of atopic pregnant women that showed symptoms of atopy during pregnancy, i.e. atopic dermatitis or hay fever, had a higher risk of having the respective atopic disorder themselves. However, we do not know whether this is due to timing, i.e. pregnancy, or whether it merely mirrors the severity of maternal disease. Furthermore, in our study pregnant mothers with repeated colds during pregnancy were at increased risk of having a child that wheezed at pre-school age, this was statistically independent of the intake of medication.
Author Interviews, BMJ, OBGYNE, Pediatrics / 16.01.2014

Sophie Grigoriadis, MD, MA, PhD, FRCPC Head, Women's Mood and Anxiety Clinic:  Reproductive Transitions, Fellowship Director, Sunnybrook Health Sciences Centre, Scientist, Sunnybrook Research Institute Adjunct Scientist, Women's College Research Institute, Associate Professor, Faculty of Medicine, University of TorontoMedicalResearch.com Interview with: Sophie Grigoriadis, MD, MA, PhD, FRCPC Head, Women's Mood and Anxiety Clinic:  Reproductive Transitions, Fellowship Director, Sunnybrook Health Sciences Centre, Scientist, Sunnybrook Research Institute Adjunct Scientist, Women's College Research Institute, Associate Professor, Faculty of Medicine, University of Toronto MedicalResearch.com: What are the main findings of the study? Dr. Grigoriadis: Infants of women exposed to selective serotonin reuptake inhibitors (SSRIs) during late pregnancy (but not early) are at risk for developing persistent pulmonary hypertension of the newborn (PPHN). PPHN is a condition in which blood pressure remains high in the lungs following birth and which results in breathing difficulties.  The symptoms can range from mild to severe, but the condition can be managed successfully typically after SSRI exposure. It is important to note that the baseline risk for PPHN in the general population is low (about 2 per 1,000 live births), and so the increase in risk with SSRIs still represents a low overall risk for developing PPHN following SSRI exposure in late pregnancy (increasing to approximately 5 per 1,000 live births). This increased risk means that 286 to 351 women would have to be treated with an SSRI during late pregnancy in order to result in 1 additional case of PPHN.
Author Interviews, Karolinski Institute, OBGYNE, Weight Research / 16.11.2013

MedicalResearch.com: Interview with: Olof Stephansson MD, PhD Associate professor, senior consultant in obstetrics and gynaecologyDepartment of Medicine, Clinical Epidemiology Unit, Karolinska InstitutetDepartment of Women’s and Children’s Health, Division of Obstetrics and Gynaecology Karolinska Institutet, Stockholm, Sweden MedicalResearch.com: What are the main findings of the study? Answer: Women with a history of bariatric surgery have an increased risk of preterm delivery, a doubled risk for small-for-gestational-age births and a reduction in large-for-gestational-age births. Also when considering maternal weight, education, age, parity and year of birth. There was no increased for stillbirth or neonatal mortality.
Author Interviews, Gastrointestinal Disease, OBGYNE / 29.10.2013

MedicalResearch.com Interview with Dr. Ketil Stordal Researcher/consultant paediatrician National Institute of Public Health Norway MedicalResearch.com: What are the main findings of the study? Dr. Stordal: Mothers who used iron supplementation during pregnancy had an increased risk for having children with a diagnosis of celiac disease. This association was not caused by maternal anemia during pregnancy, anemia was not a predictor of celiac disease in the offspring. The risk for celiac disease when the mother had used the highest doses and for the longest period.
Author Interviews, NEJM, OBGYNE / 09.10.2013

Associate scientist Sunnybrook Health Sciences Centre 2075 Bayview Ave., Room M4 172a Toronto, ON M4N 3M5MedicalResearch.com Interview with: Jon Barrett, M.B.Bch., FRCOG, MD, FRCSC Associate scientist Sunnybrook Health Sciences Centre 2075 Bayview Ave., Room M4 172a Toronto, ON M4N 3M5 MedicalResearch.com: What are the main findings of the study? Dr. Barrett: For twins at 32-38 weeks gestation where Twin A is presenting cephalic a policy of planned CS does not benefit the baby or the mother, compared to a policy of planned VB, and planned CS will result in delivery at a earlier gestational age.
Author Interviews, Lancet, OBGYNE / 20.09.2013

Prof Sally K Tracy DMid Midwifery and Women's Health Research Unit University of Sydney, Royal Hospital for Women Randwick, NSW, AustraliaMedicalResearch.com Interview with: Prof Sally K Tracy DMid Midwifery and Women's Health Research Unit University of Sydney, Royal Hospital for Women Randwick, NSW, Australia MedicalResearch.com: What are the main findings of the study? Prof. Tracy: We recruited 1748 pregnant women, of all risk types, from two tertiary teaching hospitals in different states in Australia and allocated them to receive either caseload midwifery care (871) or standard maternity care (877). The study found more women in caseload midwifery experienced an unassisted vaginal birth without pharmacological analgesia, and fewer women experienced an elective caesarean. While the trial findings did not show a statistically significant difference in the rate of caesarean sections between either group, the overall rate fell by more than 20 percent from pre-trial levels. Newborn infants in both groups achieved similar physical assessment scores (Apgar scores). A slightly lower number of pre-term births and neonatal intensive care admissions among the midwifery caseload group was not statistically significant. Important secondary findings of the study include:
  • 30 percent more spontaneous onset of labour
  • less induction of labour
  • less severe blood loss, and
  • stronger likelihood of breastfeeding at discharge from hospital.
These small differences accounted for an overall difference of AU$566.74 less with caseload midwifery than with standard care. Caseload midwifery appeared to alter some of the pathways that recurrently contribute to increased obstetric intervention.  Having this level of continuity of care works on the assumption that women will labour more effectively, need to stay in hospital less time and feel a stronger sense of satisfaction and personal control if they have the opportunity to get to know their midwife at the beginning of pregnancy.
Alcohol, Author Interviews, Breast Cancer, JNCI, OBGYNE / 30.08.2013

MedicalResearch.com Interview with: Ying Liu, MD, PhD Instructor, Division of Public Health Sciences Department of Surgery Washington University School of Medicine 660 South Euclid Ave Campus Box 8100 St. Louis, MO 63110 MedicalResearch.com: What are the main findings of the study? Answer: Alcohol intake between menarche (first menstrual period) and first pregnancy was consistently associated with increased risks of breast cancer and proliferative benign breast disease. For every 10 gram/day alcohol intake (approximately a drink a day) during this specific time period, the risk for breast cancer increased by 11% and the risk for proliferative benign breast disease increased by 16%.
Author Interviews, NEJM, OBGYNE / 29.08.2013

MedicalResearch.com Interview with: Ms. Mølgaard-Nielsen Statens Serum Institut Artillerivej 5, 2300 Copenhagen S, Denmark MedicalResearch.com: What are the main findings of the study? Answer: Use of oral fluconazole during early pregnancy did not increase the risk of birth defects overall in common therapeutic doses. We also looked at 15 individual birth defects of previous concern and oral fluconazole was not associated with an increased risk for 14 of these birth defects.  However, we did see an increase in the risk of tetralogy of Fallot, an uncommon congenital heart defect, but the number of exposed cases was few.