Undiagnosed type 2 diabetes tied to adverse pregnancy outcomes | Intervention helps boost nutrition, exercise in pregnant women | Prenatal phthalate exposure tied to ASD traits in boys
February 24, 2020
OBGYN SmartBrief
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Lead Story
Pregnant women with undiagnosed type 2 diabetes had higher risk of cesarean section, preeclampsia and shoulder dystocia, as well as adverse pregnancy outcomes such as perinatal mortality, delivery before 37 weeks, delivery before 34 weeks and neonatal ICU visits compared with women who had gestational diabetes. The study in Diabetic Medicine found that complication rates were comparable for women with undiagnosed type 2 diabetes and diabetes diagnosed before pregnancy.
Full Story: Healio (free registration)/Endocrine Today (2/20) 
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Pregnancy Care & Childbirth
A study in Frontiers in Endocrinology found that a continuous behavioral-lifestyle intervention in pregnancy assisted by a smartphone app improved dietary intakes, physical activity, and motivation to engage in exercise. The findings, based on data from 565 pregnant women with overweight and obesity, showed that dietary glycemic index and glycemic load at 28 weeks' gestation -- as well as mean daily energy, carbohydrates, sugars, free sugars, fat, saturated fat, calcium and sodium intake -- were significantly lower among those in the intervention group.
Full Story: Endocrinology Advisor (2/18) 
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Researchers found that boys, but not girls, whose mothers had elevated exposure to phthalates, which are found in household products and cosmetics, during pregnancy were more likely to develop autism spectrum disorder traits -- including restricted interests, repetitive behaviors and social impairment -- compared with those with lower prenatal phthalate exposure. However, the findings in Environmental Health Perspectives didn't associate increased prenatal phthalate exposure to higher odds of autism traits among those whose mothers had sufficient folic acid intake during gestation.
Full Story: HealthDay News (2/19),  United Press International (2/19) 
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Primary Care, Gynecologic Care & Women's Health
The risk of developing type 2 diabetes is lower by 9% for women who had breastfed for 6 to 12 months, 15% for two years, and 27% for more than two years, compared with women who did not breastfeed, according to a study in Diabetes Care. The findings, based on data from 4,372 women aged 25 and older with a history of gestational diabetes, also showed that longer duration of lactation was linked to lower A1C, fasting plasma insulin and C-peptide concentrations among women without type 2 diabetes during follow-up.
Full Story: Pharmacy Times (2/2020) 
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Domestic abuse was found to be associated with cardiovascular disease, subsequent type 2 diabetes and all-cause mortality, but not hypertension, in a study published in the Journal of the American Heart Association. Researchers also discovered that those who experienced domestic abuse were more likely to drink alcohol excessively, as well as to have at least one comorbidity and greater use of lipid-lowering medications at baseline, compared with women who had no experience of domestic abuse.
Full Story: Healio (free registration)/Cardiology Today (2/23) 
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Health Policy & Legislation
Race, location and limitations to abortion access and family-planning services are contributing factors to maternal mortality in the US, and restricting access to such care will only cause rates to rise, writes Summer Sherburne Hawkins, associate professor of social work. For instance, black women in Washington, D.C., have an average maternal mortality rate of 59.7 deaths per 100,000 live births, compared with 5.6 per 100,000 in Nevada.
Full Story: NBC News (2/18) 
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A study in JAMA Network Open found alcohol-induced deaths from 2000 to 2016 increased between 3.1% and 3.6% per year for women and from 1.4% to 1.8% for men. Rates increased across the country, including urban and rural areas as well as and wealthier and poorer counties, said lead researcher Susan Spillane.
Full Story: HealthDay News (2/21) 
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Practice Management & Professional News
Simulation tech prepares doctors of tomorrow
(Guillermo Arias/Getty Images)
Medical schools and hospitals across the country are investing in simulation technology -- including virtual headsets, video games and robots that simulate coughing, bleeding and giving birth -- to train doctors. "We are really trying to spend time thinking through what is most useful for students, what will help them learn how to be outstanding doctors," says Kaiser Permanente Dean Mark Schuster.
Full Story: Fast Company online (2/20) 
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CDC researchers found that this season's flu vaccine yielded 45% overall efficacy, with 50% efficacy against the influenza B/Victoria virus strain and 37% efficacy against influenza A(H1N1). The findings in the agency's Morbidity and Mortality Weekly Report also showed that the vaccine was 55% effective in youths ages 6 months to 17 years, indicating "substantial protection".
Full Story: CNN (2/20),  Healio (free registration)/Infectious Diseases in Children (2/20) 
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One thing I've learned is be comfortable in your skin, and more importantly, be comfortable in your shoes.
Octavia Spencer,
actress, writer
February is Black History Month
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