Author Interviews, Coffee, OBGYNE / 25.08.2020

MedicalResearch.com Interview with: Professor Jack E. James, PhD Reykjavík University Reykjavík Iceland  MedicalResearch.com: What prompted this study?  Response: Chronic exposure to any chemical during pregnancy is cause for concern. There should be no exception simply because that chemical, caffeine, happens to be widely consumed. Caffeine is a habit-forming substance of no nutritional value. If anything, its widespread consumption suggests that it should be given special attention. Concern is heightened by what is known about the effects of caffeine on the human body, where it affects neural processes in the brain, including networks that control respiration and heart function. When consumed during pregnancy, caffeine readily crosses the placenta, exposing the fetus to the drug. Notably, the fetus is largely physically incapable of metabolising caffeine – that ability develops during the first year of life. Pregnancy studies have shown that caffeine can interfere with fetal heart function and oxygenation.  (more…)
Author Interviews, OBGYNE / 30.06.2020

MedicalResearch.com Interview with: Prof Roger Gadsby MBE Honorary Associate Clinical Professor Warwick Medical School University of Warwick MedicalResearch.com: What is the background for this study? Response: The term "morning sickness" is widely used to describe the nausea and vomiting symptoms that occur in pregnancy. Previous research has reported that symptoms can occur both before and after midday but little has been published describing the daily and weekly pattern of symptoms. MedicalResearch.com: What are the main findings? Response: Using a database of 256 women who kept daily symptom diaries from the onset of symptoms till around 7 weeks of pregnancy, the study modeled the daily symptom patterns and changes in daily patterns by week of pregnancy. Nausea occurred throughout the day. Vomiting had a defined peak in the morning, but can occur throughout the day (more…)
Allergies, Author Interviews, JAMA, OBGYNE / 05.06.2020

MedicalResearch.com Interview with: Niklas Andersson MS Department of Epidemiology Research Statens Serum Institut Copenhagen S, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Second-generation antihistamines are among the most commonly prescribed drug classes during pregnancy. Fexofenadine is a widely used antihistamine but given the limited fetal safety on the use of antihistamines during pregnancy in general, current clinical guidelines only recommend the use cetirizine and loratadine during pregnancy when needed due to a larger body of fetal safety data for these antihistamines. (more…)
Author Interviews, CMAJ, Endocrinology, OBGYNE / 02.06.2020

MedicalResearch.com Interview with: Lois Donovan MD FRCPC Clinical Professor Cumming School of Medicine Division on Endocrinology and Metabolism and Department of Obstetrics and Gynecology University of Calgary MedicalResearch.com: What is the background for this study? 1) We observed in our clinical practices that minor TSH elevations in early pregnancy frequently normalized without intervention. 2) Recent randomized control trials have failed to show benefit of treating women with levothyroxine with minor TSH elevations in pregnancy  (more…)
Author Interviews, OBGYNE, Pediatrics / 21.05.2020

MedicalResearch.com Interview with: Yanmin Zhu, M.S., Ph.D. Postdoctoral Research Fellow Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women's Hospital and Harvard Medical School  MedicalResearch.com: What is the background for this study? Response: Animal studies and case reports suggest a potential teratogenic effect associated with the use of high doses of fluconazole during pregnancy. The malformations reported in case reports have a distinct phenotype, including femoral bowing, thin ribs, cleft palate, and abnormal craniofacial ossification. A few controlled studies have examined the risk of congenital malformations associated with the use of fluconazole during the first trimester, but findings are inconsistent. (more…)
Anesthesiology, Author Interviews, COVID -19 Coronavirus, OBGYNE / 13.04.2020

MedicalResearch.com Interview with: Dr. Alicia Warlick, MD Anesthesiologist at UNC/Rex, American Anesthesiology Raleigh, North Carolina MedicalResearch.com: As a physician working on the frontlines of the COVID-19 battle, how are you addressing expecting mothers’ concerns about the disease and how it might impact their pregnancy? Response: While COVID-19 has disrupted nearly every aspect of healthcare, whether its virtual appointments or delayed surgeries; there are certain things that are inevitable – like childbirth. As this virus continues to take over the country and we learn more about it each day, pregnant women are facing new challenges and fears. For women approaching their due dates, questions about staying healthy, keeping their baby safe and limiting their risk of exposure while in the hospital are all leading to anxiety and stress. And while policies and guidelines are constantly changing, as physicians we need to remind our patients that we are there to alleviate their concerns, address their questions and remind them to not lose sight of the joy the comes with bringing a child into the world. It’s a scary time for everyone, but by working together and supporting one another, we will get through this. (more…)
Author Interviews, Diabetes, Kidney Disease, OBGYNE, Race/Ethnic Diversity / 30.03.2020

MedicalResearch.com Interview with: Silvi Shah, MD, MS, FACP, FNKF, FASN Assistant Professor Division of Nephrology University of Cincinnati Cincinnati, OH-45267 MedicalResearch.com: What is the background for this study? Response: The study identified 42,190,790 pregnancy related hospitalizations between Jan. 1, 2006 and Dec. 31, 2015, using data from the from the Nationwide Inpatient Sample. (more…)
Asthma, Author Interviews, Brigham & Women's - Harvard, NEJM, Pediatrics, Vitamin D / 10.02.2020

MedicalResearch.com Interview with: Augusto A. Litonjua, M.D., M.P.H. Professor - Department of Pediatrics, Pulmonology Interim Chief - Department of Medicine , Pulmonary Diseases and Critical Care Professor - Department of Medicine , Pulmonary Diseases and Critical Care University of Rochester MedicalResearch.com: What is the background for this study? Response: Vitamin D deficiency and insufficiency is prevalent worldwide. Prior observational studies have shown that low vitamin D levels have been associated with the development of asthma. Animal studies have reported that antenatal vitamin D is important for lung development in utero. Thus, we conducted a randomized, double-blind, controlled trial of vitamin D supplementation in pregnant women to see if we could prevent the development of asthma and wheezing illnesses in young children. The initial report of the trial results showed that children born to mothers in the vitamin D supplementation arm had lower risks for developing either asthma or recurrent wheezing episodes over the first 3 years, but this was not statistically significant (p=0.051)(Litonjua et al. JAMA 2016). (more…)
Author Interviews, Dermatology, HPV, Infections, JAMA, OBGYNE / 08.01.2020

MedicalResearch.com Interview with: Niklas Worm Andersson, MD Department of Clinical Pharmacology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen NV, Denmark MedicalResearch.com: What is the background for this study? What is Podophyllotoxin used for? Response: Podophyllotoxin is an antimitotic agent primarily used in the local treatment of anogenital warts, which are among the most prevalent sexually transmitted diseases worldwide. Most women affected by anogenital warts are of childbearing age and during pregnancy, they may become symptomatic, enlarge, or multiply. While podophyllotoxin is part of first-line treatment of anogenital warts for the non-pregnant population, it is contraindicated during pregnancy. Fetal safety data are limited and to our knowledge, no previous human data exist to help inform on this issue. (more…)
Author Interviews, Infections, OBGYNE / 04.12.2019

MedicalResearch.com Interview with: Giovanni Piedimonte, MD, FAAP, FCCP Vice President for Research Institutional Official Professor of Pediatrics Tulane University MedicalResearch.com: What is the background for this study? Response: We have been testing the hypothesis that, when a pregnant woman catches a common cold with a virus called respiratory syncytial virus (RSV), viral particles can spread from the mother’s respiratory tract to the unborn child via the placenta. Preliminary data in animal models suggest that this is possible, and might cause changes in lung growth predisposing the offspring to develop asthma after birth. Recently, also human data have supported this theory. However, an essential step to conclusively demonstrate vertical transmission of respiratory viruses was the confirmation that human placentas can be infected and allow the transmission of such germs, which is the main finding of this study. (more…)
Alcohol, Author Interviews, Heart Disease, Pediatrics / 06.10.2019

MedicalResearch.com Interview with: Dr Jiabi Qin, MD, PhD Xiangya School of Public Health Central South University Changsha, China  MedicalResearch.com: What is the background for this study? Response: Congenital heart defects (CHDs), defined as a gross structural abnormality of the heart or intrathoracic great vessels occurring in embryonic period and affected nearly 1% of lives births, is the most common of all congenital defects and remains a major cause of mortality and morbidity in fancy and childhood. With a worldwide prevalence of CHDs now estimated to be 1.35 million newborns with CHDs every year, the number of CHDs is steadily increasing, representing a major global health burden. The association between maternal alcohol exposure and the risk of congenital heart defects (CHDs) has been explored, but little is known about the association between paternal alcohol exposure and the risk of CHDs. Furthermore, subsequent studies regarding the association between alcohol exposure and the risk of congenital heart defects have not yield consistent results. Therefore, given the inconsistency of existing literatures and insufficient evidence of primary studies, further an update meta-analysis based on the new and previously is evidently required. Especially, to our knowledge, any meta-analysis between paternal alcohol exposure and the risk of CHDs have not been conducted.  (more…)
Author Interviews, Kidney Disease, OBGYNE / 02.10.2019

MedicalResearch.com Interview with: Silvi Shah, MD, MS, FACP, FASN| Assistant Professor Division of Nephrology, University of Cincinnati Cincinnati, OH-45267 MedicalResearch.com: What is the background for this study? Response: Our study uses data from the largest retrospective cohort of dialysis patients in the United States from the United States Renal Data System to determine pregnancy rates and factors associated with pregnancy in 47,555 women aged 15-44 years on dialysis. We identified 2,352 pregnancies with a rate of 17.8 pregnancies per 1000 person-years (PTPY) with the highest rate in women aged 20-24 years (40.9 PTPY). (more…)
Author Interviews, Infections, JAMA, OBGYNE, USPSTF / 01.10.2019

MedicalResearch.com Interview with: Melissa A. Simon, M.D., M.P.H. Member, U.S. Preventive Services Task Force George H. Gardner professor of clinical gynecology, Vice chair of clinical research Department of Obstetrics and Gynecology Professor of preventive medicine and medical social sciences Northwestern University Feinberg School of Medicine  MedicalResearch.com: What is the background for this study? Response: Asymptomatic bacteriuria, or ASB, is when someone has bacteria in their urine but does not have any signs or symptoms of a urinary tract infection. For pregnant people, this can be a major health concern resulting in severe, even life-threatening, infections that can lead to serious harms for both the mother and the baby. The Task Force’s primary finding in updating its recommendation on this topic was that screening for ASB continues to be beneficial in preventing complications and preserving the health of mothers and their babies during pregnancy.  (more…)
Author Interviews, Cannabis, Depression, OBGYNE / 08.08.2019

MedicalResearch.com Interview with: Jamie A. Seabrook, Ph.D. Associate Professor, School of Food and Nutritional Sciences Brescia University College at Western University Adjunct Research Professor, Dept of Paediatrics, Western University Adjunct Associate Professor, Dept of Epidemiology & Biostatistics, Western University Scientist, Children's Health Research Institute Scientist, Lawson Health Research Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: Alcohol, tobacco, and cannabis are the most commonly used substances during pregnancy. High alcohol consumption has been linked with preterm birth, and tobacco and/or cannabis use is associated with low birth weight. Much of what we know about predictors of drug use during pregnancy comes from the United States and Australia, with limited studies in Canada. The objective of our study was therefore to assess the relative effects of socioeconomic, demographic, and mental health risk factors associated with drug use during pregnancy. Our retrospective cohort study consisted of 25,734 pregnant women from Southwestern Ontario. We found that maternal depression was the top risk factor associated with all three substances. Compared to women who were not depressed during their pregnancy, women who were depressed were 2.2 times more likely to use alcohol (95% CI: 1.6, 2.9), 1.7 times more likely to smoke tobacco (95% CI: 1.5, 2.0), and 2.6 times more likely to use cannabis (95% CI: 2.0, 3.4). (more…)
Author Interviews, Education, Gender Differences, JAMA, Surgical Research / 07.08.2019

MedicalResearch.com Interview with: Maria S. Altieri, MD, MS Invasive Surgery Stony Brook, NY MedicalResearch.com: What is the background for this study? What are the main findings? Response: For majority of residents, training years coincide with prime child bearing years.  Historically, surgical residency has not been conducive for having children, as it is one of the most demanding experiences, requiring long hours, high stress levels, and the acquisition of clinical and technical skills over a short period of time. However, with recent trends towards a more favorable work-life balance and the 80-hour work week, more male and female residents are having children or considering having children during training.  Thus, the topic of parental leave during residency is becoming more fundamental.  However, there is little research on the attitudes of residents towards their pregnant peers and parental leave. We wanted to examine the perceptions of surgical trainees towards parental leave and pregnancy during residency.  Through understanding the perceptions of current residents, obstacles could be identified which could lead to potential changes in policies that could help to normalize parenthood and parental leave during surgical training.    (more…)
Author Interviews, Hepatitis - Liver Disease, JAMA, OBGYNE, USPSTF / 24.07.2019

MedicalResearch.com Interview with: Melissa Simon, M.D., M.P.H.  George H. Gardner Professor of Clinical Gynecology Vice Chair of Clinical Research, Department of Obstetrics and Gynecology Professor of Preventive Medicine and Medical Social Sciences Northwestern University Feinberg School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hepatitis B is a viral infection of the liver caused by the hepatitis B virus, or HBV. HBV causes liver disease, which can be either a mild, short-term illness, or a serious, lifelong issue. The U.S. Preventive Services Task Force has reaffirmed its 2009 recommendation that clinicians screen all pregnant people for HBV at their first prenatal visit. This is an A recommendation. (more…)
Author Interviews, JAMA, Johns Hopkins, OBGYNE, Race/Ethnic Diversity / 20.07.2019

MedicalResearch.com Interview with: Alison Gemmill, PhD Assistant Professor Johns Hopkins Bloomberg School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: A growing body of evidence suggests that the circumstances surrounding the 2016 presidential election may have had a uniquely negative impact on the health of U.S. Latino population. Few studies, however, have evaluated the population health implications of the election for Latina mothers and their children. We used national data and methods that control for temporal patterning to test the hypothesis that preterm birth rose above otherwise expected levels among Latina women in the U.S. following the election of Donald Trump. We find that the number of preterm births among Latina women increased above expected levels following the election. Specifically, we find 3.5 percent more preterm births among Latinas than projected for nine months following election. (more…)
Annals Internal Medicine, Author Interviews, OBGYNE, Rheumatology / 17.07.2019

MedicalResearch.com Interview with: Bella Mehta, MBBS, MS Assistant Attending Physician, Hospital for Special Surgery Instructor, Weill Cornell Medical College MedicalResearch.com: What is the background for this study? What are the main findings? Response: For women with lupus, pregnancy has long been considered high-risk and associated with both medical and obstetric complications. In the 1960s and 1970s, pregnancy was thought to be contraindicated in lupus patients. Beginning in the 1980s, and especially in the 1990s, many studies identified specific risk factors for pregnancy complications and proposed best-practice management guidelines. We wished to see whether these advances improved pregnancy outcomes for lupus patients. Our study showed a decline in maternal mortality and other outcomes in lupus patients. The improvement in pregnancy outcomes was observed more so in lupus patients than those without lupus.  (more…)
Author Interviews, OBGYNE, Pediatrics, PLoS, Weight Research / 16.06.2019

MedicalResearch.com Interview with: Henry J. Nuss, Ph.D. Assistant Professor Louisiana State University Health Sciences Center School of Public Health New Orleans, LA  MedicalResearch.com: What is the background for this study? Response: Childhood obesity rates in the U.S. have been increasing within the past 30 years. We can point to things like sedentary lifestyle, energy-dense, nutrient-poor foods and savvy marketing techniques of large food corporations that target kids and their parents to buy food items that aren’t healthy. That said, we do know that women who have an unhealthy weight status (as measured by BMI ≥ 25) tend to have offspring that eventually attain an unhealthy weight status themselves. Aside from environmental factors, could this be due to maternal programming or perhaps something in the breastmilk? Or both? We saw some interesting research that showed breastfed infants/toddlers born to asthmatic moms were more likely to develop asthma. Furthermore, this association became stronger the longer the infants/toddlers were breastfed. The conclusion here is that it must be something in the breastmilk. We knew that asthma and obesity are both inflammatory in nature and that there are specific pro- and anti-inflammatory and obesogenic bioactive compounds in human breastmilk. Some have been studied before but there were no studies at the time that tied all of the pieces together. If we could target specific compounds in the milk that were associated with unhealthy growth patterns in infants then we could perhaps be more specific in how we fight this problem. (more…)
Anesthesiology, Author Interviews, Duke, OBGYNE, Opiods, Pain Research, Surgical Research / 29.05.2019

MedicalResearch.com Interview with: Ashraf Habib, MDChief of the Division of Women’s Anesthesia and Professor of AnesthesiologyDuke University Ashraf Habib, MD Chief of the Division of Women’s Anesthesia Professor of Anesthesiology Duke University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was a multicenter study conducted in 13 clinical sites in the United States enrolling patients undergoing elective Cesarean-section and receiving spinal anesthesia. 186 patients were enrolled and randomized to receive EXPAREL, a long-acting, non-opioid option to manage postsurgical pain, administered via transversus abdominis plane (TAP) field block, mixed with plain bupivacaine or TAP block with plain bupivacaine alone. A TAP block numbs the nerves that supply the abdominal wall. We presented the data at the 51st Annual Meeting of the Society of Obstetric Anesthesia and Perinatology (SOAP) in Phoenix, AZ. We aimed to collect clinical evidence that a multimodal postsurgical pain regimen using a TAP block with EXPAREL (bupivacaine liposome injectable suspension) together with regularly scheduled acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) could reduce opioid consumption more so than a standard multimodal pain control approach that combines TAP block with standard bupivacaine, regularly scheduled acetaminophen, and NSAIDs. (more…)
Author Interviews, CDC, OBGYNE, Race/Ethnic Diversity / 17.05.2019

MedicalResearch.com Interview with: 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. (more…)
Aging, Author Interviews, Fertility, OBGYNE / 15.05.2019

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, JAMA, OBGYNE, Weight Research / 09.05.2019

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. (more…)
Author Interviews, Endocrinology, OBGYNE / 08.05.2019

MedicalResearch.com Interview with: 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. (more…)
ADHD, Author Interviews, JAMA, OBGYNE, Pediatrics, Pharmacology / 08.04.2019

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Lancet, OBGYNE, Pediatrics, Weight Research / 28.03.2019

MedicalResearch.com Interview with: 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.  (more…)
Author Interviews, Cannabis, JAMA, Mental Health Research, OBGYNE / 28.03.2019

MedicalResearch.com Interview with: 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. (more…)