An exuberant patient of ours had this to say about her experience with RSCNJ.
“I have recently started working with Dr. Zeigler and he has been GREAT! He is extremely patient and down to earth! So far I have nothing bad to say! I have worked with a previous facility that was a disaster! Dr. Z is easy to get along with, explains all options, and makes you feel comfortable. Hina is the PA in the office when Dr. Z is unavailable she is there to answer your questions and get you a timely appointment! She is kind and patient as well!”
Thanks to her! And please read more kind reviews—with and without exclamation points!—on our web site.
We recently told you about new recommendations calling for vigilant blood pressure screening in pregnant women. New research shows just how important that screening may be. Although pregnancy-related stroke is rare, women with preeclampsia are at higher risk of stroke during pregnancy and postpartum. The study finds that urinary tract infections, chronic high blood pressure and bleeding or clotting disorders increase the risk of pregnancy-related stroke in those women.
Research in the American Heart Association’s journal Stroke report that preeclampsia affects 3 percent to 8 percent of all pregnancies. Related strokes are incredibly rare—one study found just 2 in 1,000 women with preeclampsia suffered a pregnancy-associated stroke. But those unlucky few were seven times more likely to have severe preeclampsia or eclampsia and about three times more likely to have infections when they arrive at hospital, or had high blood pressure before developing preeclampsia or had blood disorders involving clots or excessive bleeding.
“Preeclampsia is a very complex disorder that’s not completely understood,” said Eliza Miller, M.D., study lead author and vascular neurology fellow at New York-Presbyterian Hospital/Columbia University Medical Center in New York City. “Our study sought to discover if there are other risk factors or clues that may help identify the women with preeclampsia who are at the highest risk for pregnancy-related stroke. We were looking for risk factors that could be prevented or treated.”
Researchers noted a link with urinary tract infections was interesting “because those infections are not only treatable, but could be preventable,” Miller said. She added, “Preeclampsia is a very common disorder, and a lot of people are not aware of its association with stroke. Women with preeclampsia should take any neurological symptoms, such as severe headache, very seriously, especially during the postpartum period.”
According to a study in The Journal of Allergy and Clinical Immunology, women with uncontrolled asthma during pregnancy are more likely to have children that develop asthma at an early age.
Asthma is one of the most common chronic diseases affecting pregnant women. In most cases, pregnant women should manage their disease though the use of medication in the same manner as women who are not pregnant. The level of control a mother has over her asthma may affect the risk of her child developing the disease at an early age, the study suggests.
Researchers at Aarhus University in Denmark and Icahn School of Medicine at Mount Sinai in New York looked at data from 7,188 children born in Denmark to mothers with active asthma during their pregnancy. They found that mothers who had uncontrolled asthma during pregnancy were more likely to have children with early-onset persistent asthma compared to mothers who had controlled asthma.
The researchers cited separate studies reporting that 24% of women do not take prescribed anti-asthmatics during pregnancy, and the frequency of poor inhaler technique ranged from 41% to 54%. Because of this discrepancy, the authors suggest health professionals be alert and encourage proper medication usage.
“In-utero exposure to uncontrolled asthma is associated with an increased asthma risk of the child,” said lead author Xiaoqin Liu. “This may suggest that maintaining asthma control during pregnancy is an area for possible prevention of asthma in future generations.”
We are pleased to announce that Dr. Virginia Mensah has joined the Reproductive Science Center of New Jersey as our newest specialist in Reproductive Endocrinology and Infertility. Dr. Mensah is a devoted physician, committed to providing excellent medical and surgical care for her patients.
Dr. Mensah received her medical degree from the University of Illinois at Chicago, College of Medicine, and went on to complete her obstetrics and gynecology residency at Johns Hopkins Hospital. She completed her fellowship training in reproductive endocrinology and infertility at Women and Infants Hospital, which is affiliated with the Warren Alpert Medical School of Brown University in Rhode Island.
She is a member of the American Society for Reproductive Medicine and a fellow of the American College of Obstetricians and Gynecologists. Her clinical interests include infertility; in vitro fertilization; pre-implantation genetic diagnosis and screening; and oocyte cryopreservation for fertility preservation.
In a first-of-its-kind study, researchers from the Icahn School of Medicine at Mount Sinai found an elevated risk of intellectual disability (ID) in children born to mothers treated with antidepressants, but the risk was not statistically significant and is likely due to other factors, including parental age and the parents’ psychiatric history. The study was published in the journal JAMA Psychiatry.
The study examined the risk of ID in 179,000 children born in Sweden in 2006 and 2007. Approximately 4,000 of those children were exposed to antidepressants and other psychotropic medications during pregnancy. The researchers compared the risk in these children with a subsample of 23,551 children whose mothers were diagnosed with depression or anxiety prior to childbirth but did not use antidepressants during pregnancy.
ID was diagnosed in 0.9% of exposed children and 0.5% of unexposed children. After adjusting for other potential risk factors, including parental age, the risk of ID after exposure to antidepressant medication was not statistically significant in both the full-population sample and in the sub-sample of women with a history of depression.
The researchers note that while the study was conducted in Sweden, the findings are applicable in most countries where antidepressants are prescribed. “Our study provides more information for clinicians to evaluate the risks in pregnant women taking antidepressants,” said co-author Abraham Reichenberg, PhD, Professor of Psychiatry, Icahn School of Medicine at Mount Sinai. “It should be factored into other considerations such as the increased risk for the mother if not medicated, the drug’s side effects, and other medical conditions.”
Our patients often post wonderful reviews of our care. Here are two recent posts.
“We love Dr. Ziegler and staff. Everyone is so nice and helpful. Since my first visit they have felt like family and helped us throughout this entire process. Highly recommend.”
“Dr. Ziegler and his staff were amazing throughout my entire IUI cycle. Everyone was so caring and attentive to details. I will miss their care now that I’m discharged to my OB.”
Thanks to them, at to all our other patients who post nice comments, which you can read on our web site.
A study in the journal Neurology has found an interesting benefit from breastfeeding. Women who breastfeed longer may be less likely to develop multiple sclerosis than those who don’t breast-feed or nurse for a shorter time.
After studying nearly 400 women with MS or an earlier syndrome that precedes MS, called clinically isolated syndrome (CIS), researchers found that mothers who had breastfed one or more children for a total of 15 months or longer were 53 percent less likely to develop MS or CIS than those with zero to four months of total breast-feeding.
“No one has shown before that breastfeeding could have a prolonged benefit on the mother’s immune system,” said study author Dr. Annette Langer-Gould, a research scientist in neurology at Kaiser Permanente in Pasadena, Calif. “This is one more piece of evidence that women who want to breastfeed should be supported to do so. It’s not just good for the baby, but may have prolonged maternal health benefits.”
An estimated 400,000 Americans have MS, an incurable autoimmune disease that affects women of childbearing age more often than men or older women. The study’s authors think that longer periods of breastfeeding may lower inflammatory cells that may play a role in MS, though that has not been proven.
The US Preventive Services Task Force, an independent panel of experts that makes evidence-based recommendations about preventive medical services, recently updated its guidance on preeclampsia. It recommends that doctors screen all pregnant women for preeclampsia, a serious complication tied to high blood pressure. Expectant mothers should have their blood pressure checked throughout their pregnancy, even if they have no signs or symptoms of preeclampsia, according to the USPSTF.
Preeclampsia is associated with high blood pressure in pregnant women after 20 weeks of pregnancy. It is one of the most serious health problems affecting pregnant women and is a leading cause of preterm delivery and low birth weight in the U.S. “Preeclampsia can progress quickly and lead to severe complications for both the mother and infant,” said Task Force member Maureen G. Phipps, M.D., M.P.H. “It is critical that women be screened for preeclampsia during every clinical visit throughout their pregnancy.”
Blood pressure screening has few harms, while complications from preeclampsia for the mother can include stroke, seizures and organ failure. Complications for the infant include slow growth inside the uterus, low birth weight, placental abruption, preterm labor, and even death. The only way to completely treat the condition is to deliver the baby, and often before the baby’s due date if the condition worsens. “If a pregnant woman has high blood pressure during a clinical visit, she should receive further testing and evaluation,” said Task Force vice chair David C. Grossman, M.D., M.P.H. “Several high blood pressure measurements are needed to diagnose preeclampsia.”
The recommendation was published in the Journal of the American Medical Association.
Listen up, men: For stronger, healthier sperm, keep your bedroom quiet.
A study in the journal Environmental Pollution found that men who slept where the noise level was often higher than the noise of a suburban neighborhood had worse fertility than men in quieter bedrooms.
Researchers from Seoul National University, in South Korea, looked at health insurance data on more than 206,000 men aged 20 to 59. They calculated noise exposure levels from the men’s residential location and a national noise information system. They found men were 14 percent more likely to be diagnosed with infertility if exposed to noise at night over 55 decibels—about the noise from an air conditioner or a suburban street.
Women seem to have the same response to noise. Other research has linked noise levels to an increased risk for premature birth, miscarriage and birth defects, according to the study.
“Delegates at the 2017 AMA Annual Meeting voted in support of WHO’s designation of infertility as a disease,” the AMA announced. “The declaration could have a broader impact on how patients, insurers and society conceive of and act with regard to infertility.”
“Causes of infertility are present in both men and women, with about 40 percent of all infertile couples demonstrating a combination of factors,” the AMA continues. “And in about 15 percent of couples, no physiological dysfunction can be identified, making a definite diagnosis difficult. Infertility in both men and women leads to a decline in many quality-of-life metrics, including depression, shame, guilt, inadequacy and social isolation. Early treatment of infertility improves these metrics and the overall prospects of pregnancy, according to data provided in the resolution adopted by the AMA House of Delegates.”
You can read the full announcement on the AMA web site.
William Ziegler, DO, FACOG
Alan Martinez, MD
Virginia Mensah, MD,FACOG