MedicalResearch.com Interview with:Rebecca J. Schmidt, M.S., Ph.D.
Assistant Professor
Department of Public Health Sciences
The MIND Institute School of Medicine
University of California Davis
Davis, California 95616-8638
MedicalResearch: What are the main findings of the study?Dr. Schmidt: Women who had children with autism reported taking iron supplements during pregnancy and breastfeeding less often than women who children who were typically developing. Mothers of children with autism also had lower average iron intake.
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MedicalResearch.com Interview with: Audrey J. Gaskins, Sc.D.
Postdoctoral Research Fellow
Department of Nutrition
Harvard School of Public Health
Medical Research: What are the main findings of the study?Answers: In our large prospective cohort study, we found that higher adherence to several healthy dietary patterns (e.g. the Alternate Healthy Eating Index 2010, Alternate Mediterranean Diet, and Fertility Diet) prior to pregnancy was not associated with risk of pregnancy loss.
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MedicalResearch.com Interview with: Steven Ball
Telethon Kids Institute
University of Western Australia
West Perth, WA 6872, Australia
Medical Research: What are the main findings of the study?Answer:Our study suggests that the amount of time between pregnancies has less of an effect on birth outcomes than previously thought.
Relative to pregnancies that started 18-23 months after a previous birth, pregnancies that followed shorter spacing had very little increased risk of preterm birth, low birth weight or small-for-gestational-age. Longer pregnancy spacing showed increased risk of low birth weight and small-for-gestational-age, but not of preterm birth.
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MedicalResearch.com Interview with: Jared Baeten, MD PhD
Professor, Departments of Global Health and Medicine
Adjunct Professor, Department of Epidemiology
University of Washington
Seattle, WA 98104
Medical Research: What are the main findings of the study?Dr. Baeten: Among heterosexual African couples in which the male was HIV positive and the female was not, receipt of antiretroviral pre-exposure preventive (PrEP) therapy did not result in significant differences in pregnancy incidence, birth outcomes, and infant growth compared to females who received placebo.
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MedicalResearch.com Interview with: David Olds, Ph.D.
Professor of Pediatrics and Director
Prevention Research Center for Family and Child Health
University of Colorado Department of Pediatrics
Aurora, Colorado 80045
Medical Research: What are the main findings of the study?Dr. Olds: We’ve conducted a randomized controlled trial of a program of nurse home visiting for low-income women with no previous live firths during pregnancy and the first two years of the child’s life, with randomization of participants beginning in 1990. In our most recent follow-up of mothers and children in Memphis, those who received nurse-visitation were less likely to have died over a 2-decade period following the child’s birth than those in the control group. Death among mothers and children in these age ranges in the US is rare and extraordinarily important for what it tells us about the health of the population studied in this trial.
For children, the reduction in death was present for preventable causes, that is, sudden infant death syndrome, injuries, and homicide. All of the child deaths for preventable causes were in the control group, for whom the rate was 1.6%. None of the nurse-visited children died of preventable causes.
The reductions in maternal mortality were found for two nurse-visited groups combined for this report: one received prenatal and newborn visitation and a second received visitation during pregnancy and through child age two. Overall, mothers assigned to the control group were nearly 3 times more likely to die than those assigned to the two nurse-visited conditions. The relative reduction in maternal mortality was particularly pronounced for deaths linked to maternal behaviors -- suicide, drug overdose, injuries, and homicide; for these external causes of death, 1.7% of the mothers in the control group had died, compared to 0.2% of those visited by nurses.
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MedicalResearch.com Interview Invitation Dr. Krista Huybrechts MD PhD
Brigham & Women’s Hospital
Department of Medicine
Division of Pharmacoepidemiology & Pharmacoeconomics
Boston, MA 02120
MedicalResearch: What are the main findings of the study?Dr. Huybrechts: In this cohort study including 949,504 pregnant women enrolled in Medicaid, we examined whether the use of selective serotonin reuptake inhibitors (SSRIs) and other antidepressants during the first trimester of pregnancy is associated with increased risks for congenital cardiac defects. In order to control for potential confounding by depression and associated factors, we restricted the cohort to women with a depression diagnosis and used propensity score adjustment to control for depression severity and other potential confounders. We found no substantial increased risk of cardiac malformations attributable to SSRIs. Relative risks for any cardiac defect were 1.25 (95%CI, 1.13-1.38) unadjusted, 1.12 (1.00-1.26) depression-restricted, and 1.06 (0.93-1.22) depression-restricted and fully-adjusted. We found no significant associations between the use of paroxetine and right ventricular outflow tract obstruction (1.07, 0.59-1.93), or the use of sertraline and ventricular septal defects (1.04, 0.76-1.41); two potential associations that had been of particular concern based on previous research findings.
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MedicalResearch.com Interview with:
Antonio E. Frias, MD
Associate Professor | Division of Maternal Fetal Medicine
Oregon Health & Science University
Director, Diabetes and Pregnancy Program
Assistant Scientist | Oregon National Primate Research Center
Portland, Oregon 97239
MedicalResearch: What are the main findings of the study?Dr. Frias: Resveratrol supplementation in pregnant nonhuman primates fed a Western-style diet improved maternal metabolism, restored placental blood flow, reduced placental inflammation and improved lipid deposition in the fetal liver. However, there was an unexpected disruption of fetal pancreatic development that is very concerning.
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MedicalResearch.com Interview with:Wei Bao MD, PhD
Postdoc fellow, Epidemiology Branch
Division of Intramural Population Health Research
NICHD/National Institutes of Health
Rockville, MD 20852
MedicalResearch: What are the main findings of the study?Dr. Wei Bao: This study, to our knowledge, is the first attempt to examine the associations of physical activity and sedentary behaviors with risk of type 2 diabetes mellitus (T2DM) among women with a history of gestational diabetes mellitus (GDM), which is a high-risk population of T2DM. The main findings are:
(1) Physical activity is inversely associated with risk of progression from GDM to T2DM. Each 5-metabolic equivalent hours per week increment of total physical activity, which is equivalent to 100 minutes per week of moderate-intensity physical activity or 50 minutes per week of vigorous physical activity, was related to a 9% lower risk of T2DM; this inverse association remained significant after additional adjustment for body mass index (BMI).
(2) An increase in physical activity is associated with a lower risk of progression from gestational diabetes mellitus to T2DM. Compared with women who maintained their total physical activity levels, women who increased their total physical activity levels by 7.5 MET-h/wk or more (equivalent to 150 minutes per week of moderate-intensity physical activityor 75 minutes per week of vigorous physical activity) had a 47% lower risk of T2DM; the association remained significant after additional adjustment for BMI.
(3) Prolonged time spent watching TV, as a common sedentary behavior, is associated with an increased risk of progression from gestational diabetes mellitus to T2DM. Compared with women who watched TV 0 to 5 hours per week, those watched TV 6 to 10, 11 to 20, and 20 or more hours per week had 28%, 41%, and 77%, respectively, higher risk of T2DM. The association was no longer significant after additional adjustment for BMI.
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MedicalResearch.com Interview with:Flor M. Munoz, MDDepartment of Pediatrics
Department of Molecular Virology and Microbiology
Baylor College of Medicine, Houston, Texas
MedicalResearch.com: What are the main findings of the study?Dr. Munoz:
1. Tdap vaccine was safe and well tolerated during pregnancy
2. Women who are pregnant have adequate responses to the Tdap vaccine, similar to those of women who are not pregnant.
3. Antibodies to pertussis are efficiently transferred to the fetus through the placenta so that babies of mothers who were vaccinated during pregnancy had significantly higher concentrations of antibody at birth and up to 2 months of age, when compared to infants of mothers who were vaccinated post-partum.
4. Higher antibody concentrations in the first two months of life are likely to provide protection against pertussis during this period of high vulnerability
5. Infants of mothers who were vaccinated during pregnancy had adequate responses to their routine pertussis vaccines at 2, 4, and 6 months of age, and had expected and adequate responses to their 4th dose of vaccine at 1 year of age. The absolute concentration of antibodies to some of the pertussis antigens might be modestly lower after the primary series of vaccines in some infants of mothers who were vaccinated during pregnancy, but this difference does not persist after the 4th dose.
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Dr. Donald Redelmeier, MD Professor, Full SGS Member
Director, Clinical Epidemiology Unit
Sunnybrook Health Sciences Centre
Toronto, ON
MedicalResearch: What are the main findings of the study?Dr. Redelmeier: We identified every woman in Ontario, Canada, who gave birth to a newborn baby between 2006 and 2011 and then evaluated each driver for the months before, during, and after pregnancy. This amounted to about half a million women who accounted for almost 8000 serious crashes that sent the driver to hospital. We found that the second trimester of pregnancy led to a 42% increase in the risk of a serious motor vehicle crash. The increased risk included diverse populations, distinct obstetrical cases, different crash characteristics. The risk equated to about twice the population norm but was still below male drivers at this age.
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MedicalResearch Interview: Dr Nicoline van der Maas MD
Epidemiologist
National Institute for Public Health and the Environment
Centre for Infectious Disease Control
Epidemiology and Surveillance
The Netherlands
MedicalResearch: What are the main findings of the study?Dr. van der Maas: The main finding, presented at the ESPID, is that we found no difference in growth, development and infection related contact rates with the general practitioner after the first year of life between infants of unvaccinated mothers and infants of mothers, vaccinated with an adjuvanted Influenza A (H1N1) vaccine during the second and third trimester of pregnancy.
The offer of a H1N1 vaccination to pregnant women in their second and third trimester did not have a negative impact on infants’ health during the first year of life.
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MedicalResearch.com Interview with:Jessica A. Grieger (BSc(hons), R Nutr, PhD)
Post-doctoral research fellow
Robinson Research Institute, University of Adelaide
MedicalResearch: What are the main findings of the study?
Dr. Grieger: The study aimed to identify associations between maternal dietary patterns in the 12 months before conception on fetal growth and preterm delivery. We report that a one standard deviation increase in the scores on the high-protein/fruit pattern was associated with decreased likelihood for preterm birth, whereas a one standard deviation increase on the high-fat/sugar/takeaway pattern was associated with increased likelihood for preterm birth as well as shorter gestation and birth length.
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MedicalResearch.com Interview with: Dr Kate Bramham
Division of Women's Health
King's College London
Women's Health Academic Centre KHP
London, SE1 7ER
MedicalResearch.com: What are the main findings of the study?Dr. Bramham:This meta-analysis of nearly 800,000 pregnancies from 55 studies has shown that women with chronic hypertension have a significantly increased incidence of pregnancy complications including superimposed pre-eclampsia, preterm delivery, low birth weight infants, perinatal loss and neonatal unit admission.
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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.
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MedicalResearch.com Interview with: Dagfinn AuneMS
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).
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MedicalResearch.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.
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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.
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MedicalResearch.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.
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MedicalResearch.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.
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MedicalResearch.com Interview with:Dr 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.
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MedicalResearch.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%.
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MedicalResearch.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.
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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
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MedicalResearch.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.
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MedicalResearch.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.
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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.
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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.
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MedicalResearch.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.
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MedicalResearch.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. (more…)
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%.
(more…)
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MedicalResearch.com Interview with:
Rebecca J. Schmidt, M.S., Ph.D.
Assistant Professor
Department of Public Health Sciences
The MIND Institute School of Medicine
University of California Davis
Davis, California 95616-8638
MedicalResearch: What are the main findings of the study?
Dr. Schmidt: Women who had children with autism reported taking iron supplements during pregnancy and breastfeeding less often than women who children who were typically developing. Mothers of children with autism also had lower average iron intake.
(more…)
