Body weight important health factor in pregnancy – regardless of country of birth, States study

Overweight is a major contributor to complications during pregnancy and childbirth – this applies to both women born in Sweden and women who have moved here, something that has not been well researched so far. Interventions that promote a healthy weight have the potential to prevent complications for all women, the researchers conclude. The study was conducted by researchers at Linköping University and Karolinska Institutet and is published in The Lancet Public Health.

In Sweden and similar high-income countries, there are inequalities in women’s health during pregnancy and childbirth. Women who have migrated to Sweden from other countries are more affected by various serious complications compared to Swedish-born women. The risk of complications is particularly high in women born in certain parts of the world. It is not clear why, but many different factors that affect health can contribute to this inequality. One possible factor is body weight. It is more common among migrant women from certain regions to have underweight, overweight or obesity (a disease where the person has overweight with a BMI of 30 or more) when they become pregnant.

“We know that overweight and obesity are linked to many complications during pregnancy and childbirth for women born in Sweden. Therefore, we wanted to investigate whether the inequalities in pregnancy complications between women born in different countries can to some extent be explained by differences in body weight. If you know that there are health inequalities, you want to find out why, in order to be able to do something about the inequalities in the next step,” says Pontus Henriksson, senior associate professor at the Department of Health, Medicine and Caring Sciences at Linköping University, who led the study.

What is new about this study is that the researchers have been able to estimate to what extent the complications, such as gestational diabetes, could be avoided if all women were of normal weight when they became pregnant.

“For example, we concluded that about half of all cases of gestational diabetes could potentially be prevented. This applies to both women born in Sweden and foreign-born women,” says Maryam Shirvanifar, PhD student at Linköping University and first author of the study.

The researchers believe that efforts to promote a healthy weight could help all women, no matter where in the world they were born.

“A healthy weight is good for everyone. The earlier in life the better, because once obesity is established, it is difficult to treat,” says Pontus Henriksson.

The study paints a complex picture. The importance of body weight differs between different complications. For example, high body weight contributes more to gestational diabetes than other complications.

But what about being underweight in early pregnancy, how does this affect the risks? To the surprise of the researchers, underweight does not seem to contribute significantly to the complications investigated.

In their study, the researchers followed almost two million pregnancies – basically all births in Sweden from 2000 to 2020. The researchers studied eight complications that can affect the mother or baby during pregnancy, or during and after childbirth. Using data from several national registers, they were able to investigate the relationship between a woman’s BMI at the first antenatal visit and complications depending on which region of the world the mother was born in.

In their analyses, the researchers took into account several factors, including socio-economic data. However, some factors that could affect a woman’s health during pregnancy and childbirth, such as quality of treatment in healthcare, communication barriers, stress linked to migration and differences in health-promoting behaviour, could not be investigated in the current study as it uses register data. Therefore, further research is needed to study more factors that can affect health during pregnancy in different groups.

The research was funded with support from the Swedish Research Council and is a collaboration between researchers at LiU and Karolinska Institutet (among others Viktor Ahlqvist and Cecilia Magnusson).

In their study, the researchers examined eight different complications in the mother and baby:

– severe complication in the mother that could be fatal

– preeclampsia

– gestational diabetes

– infant mortality in the first year of life

– preterm birth (before 37 weeks of pregnancy) and extremely preterm birth (before 28 weeks of pregnancy)

– low Apgar score (assessment of newborn baby’s vitality)

– large baby (in relation to length of pregnancy)

– small baby (in relation to length of pregnancy)

Reference:

Shirvanifar, Maryam et al., Adverse pregnancy outcomes attributable to overweight and obesity across maternal birth regions: a Swedish population-based cohort study, The Lancet Public Health, DOI:10.1016/S2468-2667(24)00188-9.

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In pregnant women with SLE , spontaneous and indicated preterm birth proportions are high, Meta-analysis finds

Recent meta-analysis conducted by Abheiden et al. aimed to determine the proportions of spontaneous and indicated preterm birth in pregnancies of women with systemic lupus erythematosus (SLE). The study included 21 articles with data from 8157 pregnancies and found that, on average, 31% of the pregnancies resulted in preterm birth, including 14% spontaneous and 16% indicated preterm birth. It was noted that pregnancies were almost equally affected by spontaneous and indicated preterm birth, which is a noteworthy finding as the risk of spontaneous preterm birth is less well recognized in women with SLE. The study highlighted the implications of these findings for counseling and management in pregnancy. The authors emphasized the importance of applying this information in (prepregnancy) counseling and management in pregnancy. They also highlighted the need to increase awareness among treating physicians and to provide better instructions to patients during pregnancy. The high proportions of spontaneous and indicated preterm birth in women with SLE were considered important for guiding further research on associated risk factors and the development of interventions to reduce spontaneous preterm birth in SLE pregnancies.

Risk Factors and Causes

The study discussed possible risk factors for spontaneous preterm birth in women with SLE, including inflammation due to systemic disease, increased production of cytokines and prostaglandins, placental insufficiency, and other factors such as viral or bacterial infections and fibroid necrosis. It was also pointed out that the high proportion of preterm prelabor rupture of membranes (PPROM) instances in this study should be further investigated to determine the cause and whether the risk can be reduced.

Potential Interventions

The meta-analysis also discussed potential interventions to reduce spontaneous preterm birth in women with SLE, including routine universal midtrimester sonographic cervical length evaluation, the use of vaginal progesterone, and the prescription of aspirin to prevent hypertensive disorders of pregnancy. However, the authors noted a lack of studies in the specific population of women with SLE, and called for further research to evaluate the potential beneficial effects of these interventions.

Acknowledged Limitations

The study acknowledged certain limitations, such as heterogeneities in the available studies, possible publication bias, and the lack of detailed information concerning women with SLE experiencing preterm birth. Despite these limitations, the findings of the meta-analysis provide important insights into the high proportions of spontaneous and indicated preterm birth in women with SLE and the implications for counseling, management, and further research.

Key Points

1. The meta-analysis aimed to determine the proportions of spontaneous and indicated preterm birth in pregnancies of women with systemic lupus erythematosus (SLE) and included 21 articles with data from 8157 pregnancies. It found that, on average, 31% of the pregnancies resulted in preterm birth, including 14% spontaneous and 16% indicated preterm births. This suggests that pregnancies of women with SLE are almost equally affected by spontaneous and indicated preterm birth.

2. The study highlighted the implications of these findings for counseling and management in pregnancy. The authors emphasized the importance of applying this information in (prepregnancy) counseling and management in pregnancy. They also highlighted the need to increase awareness among treating physicians and to provide better instructions to patients during pregnancy.

3. The high proportions of spontaneous and indicated preterm birth in women with SLE were considered important for guiding further research on associated risk factors and the development of interventions to reduce spontaneous preterm birth in SLE pregnancies.

4. The study discussed possible risk factors for spontaneous preterm birth in women with SLE, including inflammation due to systemic disease, increased production of cytokines and prostaglandins, placental insufficiency, viral or bacterial infections, and fibroid necrosis. Furthermore, the study pointed out the need for further investigation into the high proportion of preterm prelabor rupture of membranes (PPROM) instances in this population.

5. Potential interventions to reduce spontaneous preterm birth in women with SLE were also discussed, including routine universal midtrimester sonographic cervical length evaluation, the use of vaginal progesterone, and the prescription of aspirin to prevent hypertensive disorders of pregnancy. However, the authors noted a lack of studies in the specific population of women with SLE and called for further research to evaluate the potential beneficial effects of these interventions.

6. The study acknowledged certain limitations, such as heterogeneities in the available studies, possible publication bias, and the lack of detailed information concerning women with SLE experiencing preterm birth. Despite these limitations, the findings of the meta-analysis provide important insights into the high proportions of spontaneous and indicated preterm birth in women with SLE and the implications for counseling, management, and further research.

Reference –

Abheiden CNH, Blomjous BS, Slaager C, Landman AJEMC, Ket JCF, Salmon JE, Buyon JP, Heymans MW, de Vries JIP, Bultink IEM, de Boer MA. Systemic lupus erythematosus is associated with an increased frequency of spontaneous preterm births: systematic review and meta-analysis. Am J Obstet Gynecol. 2024 Oct;231(4):408-416.e21. doi: 10.1016/j.ajog.2024.03.010. Epub 2024 Mar 16. PMID: 38492714.

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Obstetric Complications linked to Severe Psychopathology in Schizophrenia Spectrum Disorders, suggests study

Spain: A recent study published in Neuroscience & Biobehavioral Reviews has revealed that patients with schizophrenia and related disorders who have experienced obstetric complications exhibit a higher clinical symptom burden compared to those without such a history.

“Our findings indicate that obstetric complications (OCs) are linked not only to a higher risk of developing psychosis but also to more severe symptoms,” the researchers wrote. 

Obstetric complications, which include issues such as preeclampsia, low birth weight, and maternal infections during pregnancy, have long been a topic of interest in psychiatric research. Schizophrenia (SZ) is a serious mental health disorder influenced by gene-environment interactions, with obstetric complications increasing the risk of developing the condition. Recent research indicates that OCs may also worsen the symptoms of SZ.

Against the above background, Maria Florencia Forte, Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Barcelona, Spain, and colleagues conducted a systematic review and meta-analysis to thoroughly assess the differences in psychopathology between individuals with and without exposure to OCs with schizophrenia and related disorders.

For this purpose, the researchers conducted a systematic search of PubMed, PsycINFO, and SCOPUS to identify eligible studies. They retrieved a total of 4,091 records through systematic and citation searches. Ultimately, 14 studies were included in the review, with 12 meeting the criteria for meta-analysis, involving 2,992 patients.

The investigation yielded the following insights:

  • The analysis indicated that schizophrenia patients exposed to obstetric complications exhibited significantly higher levels of positive symptoms (SMD=0.10), general psychopathology (SMD=0.37), total clinical symptomatology (SMD=0.44), and depressive symptoms (SMD=0.47).
  • There were no significant differences in negative symptomatology or overall functioning.

The results of this meta-analysis indicate a clear link between obstetric complications and more severe symptoms in schizophrenia spectrum disorders. Patients with a history of OCs showed greater severity in positive symptoms, depressive symptoms, and overall symptom severity compared to those without OCs, but there were no differences in negative symptoms or functional outcomes.

The findings highlight how issues during pregnancy and childbirth can affect the progression of schizophrenia, even in the early stages of the illness. However, due to the limited number of studies available, more research is needed to explore the specifics of stressful perinatal events, including their type and timing, to better understand their impact on individuals with psychosis.

“Recognizing early life complications could serve as a warning sign for future challenges, providing an opportunity to create tailored interventions that improve both clinical and functional outcomes for those affected,” the researchers concluded.

Reference:

Forte, M. F., Oliva, V., De Prisco, M., Garriga, M., Bitanihirwe, B., Alameda, L., González-Segura, À., Vieta, E., Baeza, I., Parellada, E., Penadés, R., Ramos-Quiroga, J., Amoretti, S., Mezquida, G., & Garcia-Rizo, C. (2024). Obstetric complications and psychopathology in schizophrenia: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 167, 105913. https://doi.org/10.1016/j.neubiorev.2024.105913

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Twice-Daily Deuruxolitinib Significantly Improves Alopecia Areata Over 24 Weeks: Study

Researchers found that twice-daily deuruxolitinib (Leqselvi), at an 8 mg dose, significantly improved hair satisfaction of patients with severe alopecia areata over 24 weeks. Alopecia areata represents an autoimmune disorder which may cause thinning hair on the scalp. A recent study presented at the European Academy of Dermatology and Venereology (EADV) Congress in September 2024, illustrates the drug deuruxolitinib in the role of a selective inhibitor of Janus Kinase (JAK)-1 and JAK-2. It has been approved by the FDA for treatment among adult patients diagnosed with severe alopecia areata.

Alopecia areata (AA) causes immense suffering for the afflicted patient, mainly because it alters the body image dramatically. Therefore, Sun Pharmaceutical Industries Limited had different types of presentations of key abstracts at the EADV Congress that highlighted the clinical effectiveness and safety of deuruxolitinib. The key objectives of the studies published were the drug’s indication of stimulating capacity towards scalp hair regrowth and increasing patients’ satisfaction with their appearance. Two landmark studies, THRIVE-AA1 and THRIVE-AA2, recently reported the results of this treatment in the largest cohort of patients with severe alopecia areata.

1,223 adults from Canada, the U.S., and Europe were recruited in the two studies. They all had at least 50% loss of scalp hair at the start of the study. The research involved random assignment of the participants to either the treatment group that received 8 mg or 12 mg deuruxolitinib twice a day or the placebo group. Such studies were meant to achieve a Severity of Alopecia Tool (SALT) score of 20 or less at week 24, representing a significant reduction from hair loss since a SALT score of 100 represents complete loss of scalp hair and a score of 0 no hair loss at all. The baseline SALT scores for the two trials were THRIVE-AA1 at about 85.9 and THRIVE-AA2 at about 87.9.

  • At Week 24, 95% of the patients in the 8 mg treatment group showed clinically significant hair satisfaction.

  • Both THRIVE-AA1 and THRIVE-AA2 studies confirmed that the patients had significantly important hair regrowth as evidenced by many of the patients that attained a reduction in SALT score.

  • The stated treatment with the dose of 8 mg deuruxolitinib, administered twice a day, is said to have induced quite considerable regrowth of scalp hair as well as improvements in the mental state of those patients who commonly lose hair and experience psychological stress because of it.

Two other posters presented at the EADV Congress covered deuruxolitinib with regards to its therapeutic effect on the improvement of the psychological status of alopecia areata patients. According to the results of the studies, a more significant hair regrowth is correlated with a better emotional well-being profile, with reduced symptoms of anxiety and depression. Besides, posters were focused on the optimization of the dose for the 8 mg therapy regimen giving an insight into maximizing the therapeutic efficiency with minimal side effects.

Treatment with deuruxolitinib twice daily at 8 mg has proven to induce significant hair satisfaction and subjective improvements in mental well-being in patients suffering from severe alopecia areata for as long as 24 weeks. EADV Congress Study Deuruxolitinib has been proven to be an effective treatment method in improving quality of life for individuals facing such a challenging condition.

Reference:

Sun Pharma Presents New Clinical Efficacy and Safety Data in Severe Dermatological Conditions at the 2024 European Academy of Dermatology and Venereology (EADV) Congress. https://sunpharma.com/wp-content/uploads/2024/09/Press-Release-new-clinical-efficacy-and-safety-data-present-at-the-2024-EADV-Congress.pdf. Presented at the European Academy of Dermatology and Venereology (EADV) Congress 2024. Amsterdam, Netherlands. 25-28 September.

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Katihar Medical College intern attacked with knife, Medicos strike over ongoing threats for 6 months

An intern doctor at Katihar Medical College, Bihar was recently attacked by the local goons when he, along with two of his classmates, went outside the city on their motorcycles to a car showroom.

On their way back on Tuesday, when they stopped for a tea break, they were attacked by some goons. While two of the intern doctors managed to escape from the spot, one was attacked with a knife behind the ear and near the chin. Later, filing a police complaint, the victim medico identified one of the goons as a nursing student from the same medical college.

For more details, click the link below

Katihar Medical College Intern Attacked by Goons- Medicos on Strike Alleging Continous Threats for Last 6 Months

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Doctor challenges NBE order cancelling Post-MBBS diploma admission, HC rejects plea

The Delhi High Court recently dismissed a plea challenging an order issued by the National Board of Examinations holding that it did not have the territorial jurisdiction to adjudicate the same.

NBE had cancelled the admission of the petitioner’s admission to the NBEMS Diploma Course for the 2023 Session, citing delayed joining of the course. When the petitioner challenged the NBE’s order dated 19.09.2024 before the High Court, the HC bench of Justice Purushaindra Kumar Kaurav held that the essential, material and integral cause of action, i.e. the admission of the petitioner, leave application, its acceptance, the joining and leave letter and the subsequent rejection of the candidature- “all have arisen beyond the territorial jurisdiction of this Court”.
For more details, click the link below

Doctor challenges NBE Order Cancelling Post MBBS Diploma Admission, HC junks Plea

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Gujarat Govt raises medical teachers’ salaries to tackle doctors shortage

To address the ongoing shortage of doctors, the Gujarat government on Wednesday announced pay raises for contractual medical teachers in government hospitals associated with medical colleges.

Health Minister Rishikesh Patel said on Wednesday that the state government has decided to increase the monthly salaries of contractual medical teachers by 30 per cent to 55 per cent.

For more details, click the link below

Gujarat Govt announces pay raise for contractual medical teachers

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AI-supported dermatology for darker skin tones, thanks to new data set

In many countries in Africa, up to nine out of ten children suffer from a skin problem, and there are far too few local dermatologists. Artificial intelligence could help with diagnosis, but needs to be trained with the relevant images, so researchers have created a new data set for dark skin tones.

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Different types of teenage friendships critical to well-being as we age, scientists find

Being a teenager is hard, confusing—and crucially important. Scientists studying teenage socializing have found that teenage friendships could lay essential foundations for well-being in later life, and that not just the kinds of friendships teenagers experience but the timing of those friendships is critical.

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Breakdancers may risk ‘headspin hole’ caused by repetitive headspins, doctors warn

Breakdancers may be at risk of developing a condition caused by repeatedly doing a cardinal move of their practice and performance—the headspin—warn doctors in the journal BMJ Case Reports.

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