Prof. Crowther[/caption]
Professor Caroline Crowther MB ChB, DCH, FRANZCOG, MD, DDU, FRCOG, CMFM
Maternal Fetal Medicine Subspecialist
Professor of Maternal & Perinatal Health
Liggins Institue
Waipapa Taumata Rau | University of Auckland
MwdicalResearch.com: What is the background for this study?
Response: Gestational diabetes is a growing and significant health problem worldwide for women affected and their babies. Treatment of gestational diabetes improves maternal and infant health but it remains unclear what degree of maternal hyperglycaemia should be used to make the diagnosis. Because of this uncertainty, recommended diagnostic criteria vary around the world.
The GEMS randomised trial assessed whether use of lower glycaemic diagnostic criteria, recommended by the International Association of Diabetes and Pregnancy Study Groups would improve perinatal health, without increasing maternal risks, compared to use of higher criteria, and to assess the effects on use of the health services.
Prof. McManus[/caption]
Richard McManus MA PhD MBBS FRCGP FRCP
Professor of Primary Care
Dr. McManus chairs the Blood Pressure Monitoring Working Party
of the British Hypertension Society
Nuffield Department of Primary Care Health Sciences
MedicalResearch.com: What is the background for this study?
Response: About one in ten people who are pregnant develop high blood pressure and almost half of these go onto to have pre-eclampsia. Many pregnant women and individuals are already measuring their own blood pressure – well over half of those with high blood pressure in a recent large survey in the UK but until recently there were no data to support this.
Dr. Wu[/caption]
Pensée Wu, MBChB, MD(Res)
Senior Lecturer, Honorary Consultant Obstetrician
Subspecialist in Maternal Fetal Medicine
School of Medicine, Keele University
Staffordshire, UK
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We looked at outcomes in pregnancies conceived with assisted reproductive technology and compared those with pregnancies that were conceived naturally.
Using a hospital admissions database in the U.S. called the National inpatient sample between 2008 and 2016, we included >100,000 pregnancies conceived with assisted reproductive technology and 34 million naturally conceived pregnancies.
We found that women with assisted reproductive technology-conceived pregnancies had doubled the risk of acute kidney injury and arrhythmias (irregular heart beats). These women also had a 1-3-1.6-fold risk of preterm birth, Caesarean delivery and placental abruption (placenta separating from the womb).
We concluded that women should be informed of these risks during pre-pregnancy counselling.
Dr. Hinkle[/caption]
Stefanie N. Hinkle, PhD
Assistant Professor
Department of Biostatistics
Epidemiology and Informatics
Perelman School of Medicine
University of Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: Over 80% of U.S. women of reproductive age consume caffeine daily.While most women decrease consumption after becoming pregnant, many continue to consume caffeine throughout pregnancy.
The American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women limit their caffeine consumption to <200 mg/d out of an abundance of caution due to potential associations with pregnancy loss and fetal growth restriction at higher intakes. There remains limited data on associations with maternal cardiometabolic outcomes in pregnancy.
Dr. Howard[/caption]
Jeffrey Howard, PhD
Associate Professor
Department of Public Health
College for Health, Community and Policy
University of Texas at San Antonio
MedicalResearch.com: What is the background for this study?
Response: Drug and alcohol related mortality has been on the rise in the US for the past decade, which has drawn a lot of focus from researchers. At the same time maternal mortality, deaths caused by pregnancy complications, is recognized to be higher in the US than in other developed nations.
Very little has been reported about deaths among pregnant and recently pregnant women that are not caused by pregnancy complications, so my collaborators and I wanted to explore this. We did not anticipate that drug and alcohol deaths and homicides would account for so many deaths among pregnant and recently pregnant women.
Dr. Toledo[/caption]
Christine Toledo, PhD, MSN, APRN, FNP-C
Assistant Professor
Christine E. Lynn College of Nursing
Florida Atlantic University
MedicalResearch.com: What is the background for this study?
Response: According to the United States Centers for Disease Control and Prevention, between 11 and 20 percent of women who give birth each year in the U.S. have postpartum depression symptoms, equating to nearly 800,000 women every year. Postpartum Depression provides significant health risks to both the mother and child and is the greatest risk factor for maternal suicide and infanticide.
Dr. Caughey[/caption]
Aaron B. Caughey, M.D., M.P.P., M.P.H., Ph.D.
Professor and ChairDepartment of Obstetrics and Gynecology
Associate dean for Women’s Health Research and Policy
Oregon Health & Science University in Portland, OR.
Founder and Chair, Centers for Disease Control and Prevention–funded
Oregon Perinatal Collaborative
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Preeclampsia is one of the most serious health problems that can occur during pregnancy. It can lead to preterm birth, and in some cases even death of the pregnant person and their baby.
The Task Force looked at the latest available evidence and found that low-dose aspirin can help prevent preeclampsia in pregnant people who are at highest risk, and it can also protect their babies. This new final recommendation is consistent with the Task Force’s 2014 recommendation statement and has the potential to save many lives.
Helen Trottier Ph.D
Assistant Professor, Department of Social and Preventive Medicine,
Researcher, CHU Sainte-Justine Research Center
Université de Montréal
Montréal, Québec, Canada
MedicalResearch.com: What is the background for this study?
Response: We know that HPV infection can have serious consequences such as the development of cancerous lesions in the cervix. HPV infection is also very prevalent in young women of childbearing age but the possible consequences of HPV in pregnancy have been poorly studied. Some population registers around the world have shown a reduction in the risk of preterm birth with HPV mass vaccination, but we must be careful with this kind of ecological correlation.
We have set up a large cohort study in pregnant women to study the association between HPV in pregnancy and preterm birth by targeting certain HPV genotypes and the duration of the infection.
Dr. Oken[/caption]
Emily Oken MD MPH
Professor, Harvard Medical School
Professor in the Department of Population Medicine
Associate Director and Advisor, Oliver Wendell Holmes Society.
Professor, Department of Nutrition, Harvard School of Public Health
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In this study of over 11,000 mothers and children, we found that a mothers with higher weight in late pregnancy had children with poorer performance on tests of cognition and behavior in childhood and adolescence.
The findings are consistent with results from studies in other populations around the world, as well as animal experiments. This research suggests that maternal nutrition is important for child health over the long-term, and specifically provides support for mothers to try to achieve healthy weight and nutritional status during pregnancy.
If you’re absolutely sure that you neither want nor are ready for a child in this stage of your life, abortion isn’t the only option....
Dr. Chien-Wen Tseng[/caption]
Chien-Wen Tseng, M.D., M.P.H., M.S.E.E.
The Hawaii Medical Service Association Endowed Chair
Health Services and Quality Research
Professor, and Associate Research Director
Department of Family Medicine and Community Health
University of Hawaii John A. Burns School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Gaining weight during pregnancy is natural but gaining too little or too much weight can be harmful for pregnant people and their babies. For the first time, the Task Force reviewed the evidence and found that counseling pregnant people on healthy weight gain during pregnancy can lower their risk for diabetes during pregnancy, emergency cesarean deliveries, and babies born with a birth weight that is too high. Pregnant people may not know what amount of weight gain is healthy during pregnancy, or how weight gain can affect their pregnancy and baby.
We recommend that clinicians offer all pregnant people counseling on healthy weight gain throughout their pregnancy for healthier, safer pregnancies.
Dr. Carlson[/caption]
Susan E. Carlson Ph.D.
Associate Dean for Research
Program Director,, AJ Rice Professor
Department of Dietetics and Nutrition
University of Kansas Medical Center
Kansas City, KS
MedicalResearch.com: What is the background for this study? What are its benefits?
Response: DHA is an omega-3 fatty acid. Good food sources include some types of seafood (e.g., salmon, tuna, trout) and chicken eggs. Persons in the USA and in much of the developing world consume little dietary DHA. DHA supplements in pregnancy have been linked to lower risk of preterm birth for 20 years, especially early preterm births (<34 weeks gestation). For about 10 years, prenatal supplements with about 200 mg DHA have been readily available in the USA, however, no study has asked if this amount of DHA is optimal to reduce early preterm birth. Participants were given a supplement of 1000 mg or 200 mg DHA beginning before 20 weeks gestation using an adaptive randomization that periodically assigned more participants to the group with the fewest early preterm births.
Dr. Andersson[/caption]
Niklas Worm Andersson, MD
Department of Epidemiology Research
Statens Serum Institut,
Copenhagen Denmark
MedicalResearch.com: What is the background for this study?
Response: "Findings from some previous fetal safety studies on topical corticosteroid use in pregnancy have raised concerns for an increased risk of newborns being small for gestational age or having low birth weight, in particular among pregnancies where larger amounts of potent to very potent agents have been used."
Prof. Papageorghiou[/caption]
Aris Papageorghiou MBChB, MRCOG
Professor of Fetal Medicine and the Clinical Research Director
Oxford Maternal and Perinatal Health Institute
University of Oxford
MedicalResearch.com: What is the background for this study?
Response: Our study was really guided by a key question: does Covid-19 in pregnancy increase the risk of adverse maternal and neonatal outcomes as compared with pregnant women who do not have the infection?
The question is highly relevant because of the known deleterious effects of other coronavirus infections in pregnancy, e.g. SARS (severe acute respiratory syndrome) and MERS-CoV (Middle East respiratory syndrome coronavirus).
In order to answer this question we undertook this multinational cohort study.
Prof.Auger[/caption]
Nathalie Auger
Professeure agrégée de clinique
École de santé publique - Département de médecine sociale et preventive
University of Montreal
MedicalResearch.com: What is the background for this study?
Response: COVID-19, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been a major public health concern. The number of infected pregnant women continues to increase. Pregnant women and infants are particularly susceptible to COVID-19 because the physiologic changes of pregnancy involve cardiovascular, respiratory, and immune changes that may alter the response to SARS-CoV-2 infection. Fetuses may be exposed to SARS-CoV-2 during critical periods of development. The nature of the association between COVID-19 and pregnancy outcomes remains unclear and meta-analyses of pregnant women with COVID-19 are lacking.
Dr. Wymore[/caption]
Erica M. Wymore, MD MPH
Assistant Professor, Neonatal- Perinatal Medicine
Department of Pediatrics, Section of Neonatology
University of Colorado School of Medicine
Children's Hospital Colorado
[caption id="attachment_56868" align="alignleft" width="161"]
Dr. Bunik[/caption]
Maya Bunik, MD, MPH | Professor, Pediatrics
Medical Director, Child Health Clinic, Primary Care | Breastfeeding Management Clinic
Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS)
School of Medicine| University of Colorado Anschutz Medical Campus
Children's Hospital Colorado
MedicalResearch.com: What is the background for this study?
Response: Marijuana legalization has been increasing in the United States, with increasing consumption of marijuana products. Currently, the American Academy of Pediatrics (AAP), American College of Obstetricians and Gynecologists (ACOG) and Academy of Breastfeeding Medicine (ABM) do not recommend marijuana use during pregnancy or lactation due to concerning though limited data on the effects of perinatal marijuana exposure.
As there has been increasing prevalence of women using marijuana during pregnancy due to legalization and perceptions of safety, we sought to determine the duration of THC excretion in breast milk among women who had evidence of marijuana use at delivery and abstained post-partum.
Although we might not all have grown up knowing for sure if children were in our future, or already have our baby names picked out - James if it’s a boy Violet if it’s a girl - having the decision whether or not to have children taken away from us, due to biological issues inside our bodies, can be devastating.
When trying to have children, it can of course, become very frustrating when you aren’t getting pregnant. If you find this is the case, it is recommended that you go to the doctor after one year of failing to conceive. It’s always a good idea to get tested to really understand what is happening in your body. The main signs a woman may be infertile is if her menstrual cycles are too long (35 days or more) or are too short (21 days or less).
When going for fertility tests, it is good to have an idea of what to expect. For women, samples of blood will most likely be tested to check for the presence of the hormone Progesterone. For men, a semen sample is obtained for analysis, checking its quality and quantity.
Sitting in a waiting room waiting for the results of yet more testing takes its toll, and it’s easy to feel helpless as the image of the life you had planned drifts further out of reach. Luckily nowadays, these results don’t have to be so final as we finally have other options.
Dr. Maru[/caption]
Sheela Maru, MD, MPH
Department of Health System Design and Global Health and
Arnhold Institute for Global Health and
Department of Obstetrics, Gynecology and Reproductive Science
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study?
Response: Universal screening for SARS-CoV-2 infection on Labor and Delivery (L&D) units is a critical strategy to manage patient and health worker safety, especially in a vulnerable high-prevalence community. We describe the results of a SARS-CoV-2 universal screening program at the L&D Unit at Elmhurst Hospital in Queens, NY, a 545-bed public hospital serving a diverse, largely immigrant and low-income patient population and an epicenter of the global pandemic.
Dr. Spann[/caption]
Marisa N. Spann, PhD, MPH
Columbia University Irving Medical Center
New York, New York
MedicalResearch.com: What is the background for this study?
Response: Prior research has demonstrated that higher maternal pre-pregnancy body mass index is associated with adverse long-term outcomes for offspring including obesity, poorer cognitive and social abilities, and increased risk of psychiatric disorders.
MedicalResearch.com: What are the main findings?
Response: In this study, we investigated the association of maternal pre-pregnancy body mass index with fetal growth and neonatal functional connectivity and found that maternal pre-pregnancy BMI has a significant positive correlation with fetal weight and with greater thalamic connectivity of the brain.
Dr. Shafiee[/caption]
Hadi Shafiee, PhD
Assistant Professor, Harvard Medical School
Brigham and Women's Hospital
Department of Medicine
MedicalResearch.com: What is the background for this study? What are some of the characteristics that AI uses to identify blastocysts witha better chance of successful implantation?
Response: In-vitro fertilization (IVF), while a solution to many infertile couples is still extremely inefficient with a success rate of nearly 30% and is both mentally, physically, and economically taxing to patients. The IVF process involves the insemination of eggs and the culture of embryos externally in a fertility lab before transferring the developed embryo to the mother.
A major challenge in the field is deciding on the embryos that need to be transferred during IVF, such that chances of a healthy birth are maximal and any complications for both mother and child are minimal. Currently, the tools available to embryologists when making such are extremely limited and expensive, and thus, most embryologists are required to make these life-altering decisions using only their observational skills and expertise. In such scenarios, their decision-making process is extremely subjective and tends to be variable.
Prof. James[/caption]
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.
Dr. Donovan[/caption]
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
Dr. Zhu[/caption]
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.
If a patient is experiencing signs or symptoms of bacterial vaginosis, such as vaginal discharge or a bad odor, they should consult with their clinician. We encourage all pregnant persons to talk with their providers about how to have a healthy pregnancy. ...
Dr. Warlick[/caption]
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.