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About 60% of both women with epilepsy and those without epilepsy became pregnant within a year of stopping contraceptives, according to a study in JAMA Neurology. Median time to pregnancy, sexual activity and ovulatory rates also were comparable.
Pregnant women with HIV who were treated with an antiretroviral regimen of tenofovir, emtricitabine and ritonavir-boosted lopinavir did not have higher rates of adverse birth outcomes than women who received other ART regimens, according to an analysis in the New England Journal of Medicine. The findings were based on data from two cohort studies in the US.
A study in Diabetes, Obesity and Metabolism showed that pregnant women with type 1 or type 2 diabetes had a significantly higher miscarriage risk if they took noninsulin antidiabetic medications with or without insulin during the first trimester of their pregnancy, compared with those who received insulin alone. Researchers evaluated 1,194 women and found a lower risk of having a child with major malformations among those on noninsulin antidiabetic medications, with or without insulin, than those on insulin alone.
Endocrinology Advisor (4/26)
Women who became pregnant using assisted reproductive technology had lower rates of perinatal mortality before 28 weeks gestation, researchers told the American College of Obstetricians and Gynecologists’ annual meeting. Overall perinatal mortality rates associated with assisted reproductive technology increased from 2006 to 2011, however, even as perinatal mortality rates without assisted reproductive technology were stable.
The American College of Obstetricians and Gynecologists issued a committee opinion saying that long-acting reversible contraceptives yielded increased efficacy, continuation and satisfaction rates among teen users, compared with short-acting contraceptives. The recommendations in Obstetrics & Gynecology urged OB-GYNs to adhere to sexually transmitted infection screening guidelines; encourage teens using LARC to use male or female condoms to curb STI risk; provide counseling on reversible contraception; and ensure access to contraceptives for all sexually active teens.
eMPR/HealthDay News (4/27)
US District Judge Thomas Rice has prohibited HHS from terminating funding to Planned Parenthood for the Teen Pregnancy Prevention Program in multiple states, saying the funds were “arbitrarily and capriciously” discontinued before the 2020 scheduled completion date. Rice said the HHS argument that the cuts fit the “best interest of the federal government” did not meet the agency’s published conditions for terminating the program early.
A study in the American Journal of Tropical Medicine and Hygiene found that 48% of infants with confirmed congenital Zika syndrome had seizures in the first months of life. “Our findings serve as an alert on the high potential risk of epilepsy and death associated with CZS in early infancy and the need to actively screen for seizures and initiate timely treatment,” the study team said.
Hastings, Neb., certified nurse-midwife Holly Eckhart said throughout history the job of the midwife has been to walk with women on their journey, starting in adolescence and going into old age. Labor and delivery registered nurse Brandy Rogers, who is studying to become a CNM, said the region has an underserved patient population that midwives can reach.
Researchers found that men and women who adopted all five low-risk lifestyle factors — body mass index of 18.5 to 24.9 kg/m2, a high diet quality score, at least 30 minutes of vigorous exercise daily, never smoking and moderate alcohol intake — had an estimated life expectancy of 37.6 and 43.1 years at age 50, respectively, compared with 25.5 and 29.0 years among those who adopted zero low-risk factors. The findings in Circulation were based on data from the Nurses’ Health Study and the Health Professionals Follow-up Study.
A data brief from the CDC’s National Center for Health Statistics showed a decrease in the number of US females ages 10 to 14 who gave birth from 2000 to 2016. The birth rate for this group reached a record low in 2015 and 2016, at 0.2 births per 1,000 females, down from 0.9 births per 1,000 females in 2000.
The American College of Obstetricians and Gynecologists this week recommended women receive treatment for a “fourth trimester,” beginning within three weeks of birth and focusing on maternal physical, social and psychological well-being. The recommendation for ongoing care, published in Obstetrics & Gynecology, called for an initial postpartum assessment and follow-up to include issues such as emotional well-being, infant care, sexuality, contraception and sleep.
A new Indiana law will require hospitals to certify their NICU level designation with the Indiana State Department of Health. ISDH Maternal and Child Health division director Martha Allen said the agency is establishing perinatal centers as part of efforts to regionalize care with a goal of making sure every mother and infant is at the right facility for the level of care they require.
A study in Pediatrics showed a nearly 2.6% post-arterial ischemic stroke in-hospital mortality rate among neonates and children, while 64.6% of cases with reported causes of death were due to strokes. Researchers also found that congenital heart disease and posterior plus anterior circulation stroke were the strongest in-hospital mortality risk factors for pediatric AIS, while stroke presentation without seizure was associated with mortality only among neonates and Hispanic ethnicity was associated with mortality only among children.
2 Minute Medicine (4/25)