Obstetrics and Gynaecology - Research Publications
Permanent URI for this collection
Search Results
1 - 10 of 398
-
Item
-
ItemNo Preview AvailableSexual identity and mental health in young people: an opportunity to reduce health inequity(Elsevier, 2019)One in every 25 Britons aged 16–24 years identifies as lesbian, gay, or bisexual. 1 Cross-sectional studies consistently report that sexual-minority young people have poorer mental health profiles than their heterosexual peers, 2 including higher prevalence of self-harm and suicide attempts. 3 However, without longitudinal data to document changes over time, these findings are of little clinical utility.
-
ItemConsequences of β-Thalassemia or Sickle Cell Disease for Ovarian Follicle Number and Morphology in Girls Who Had Ovarian Tissue Cryopreserved.(Frontiers Media SA, 2020)Women with β-thalassemia (BT) and sickle cell disease (SCD) have a high risk of infertility and premature ovarian insufficiency. Different fertility preserving strategies, including ovarian tissue cryopreservation (OTC) and oocyte cryopreservation has been considered, and healthy babies have been born after successful OTC and transplantation. We evaluated follicle number and follicle health in ovarian tissue from a cohort of BT and SCD patients who underwent OTC before the age of 18 years. Patients undergoing OTC from 2002 to 2019 were included. A total of 14 girls and adolescents with BT and four with SCD, aged 2.8-17.4 years at OTC were included together with a reference group of 43 girls and adolescents with non-anemia diseases considered to have normal ovaries aged 0.6-17.9 years at OTC. Ovarian follicle density was measured in cortex biopsies and compared to the reference group. Expression of proteins associated with follicular health was evaluated using immunohistochemistry. Follicles were detected in the ovarian cortex biopsies from all patients with BT and SCD. The follicle densities were within the 95% prediction interval of the reference group in all cases. A similar expression of six proteins essential for follicular health was detected using immunohistochemistry in BT, SCD, and references. OTC should be considered an option for young girls and adolescents with BT and SCD.
-
ItemPrenatal alcohol exposure and infant gross motor development: a prospective cohort study (vol 19, 149, 2019)(BMC, 2019-07-04)Following publication of the original article [1], the authors opted to revise the first paragraph of the section "Characteristics associated with maternal drinking in pregnancy". Below is the updated version.
-
ItemDelineating a role for the mitochondrial permeability transition pore in diabetic kidney disease by targeting cyclophilin D(PORTLAND PRESS LTD, 2020-01)Mitochondrial stress has been widely observed in diabetic kidney disease (DKD). Cyclophilin D (CypD) is a functional component of the mitochondrial permeability transition pore (mPTP) which allows the exchange of ions and solutes between the mitochondrial matrix to induce mitochondrial swelling and activation of cell death pathways. CypD has been successfully targeted in other disease contexts to improve mitochondrial function and reduced pathology. Two approaches were used to elucidate the role of CypD and the mPTP in DKD. Firstly, mice with a deletion of the gene encoding CypD (Ppif-/-) were rendered diabetic with streptozotocin (STZ) and followed for 24 weeks. Secondly, Alisporivir, a CypD inhibitor was administered to the db/db mouse model (5 mg/kg/day oral gavage for 16 weeks). Ppif-/- mice were not protected against diabetes-induced albuminuria and had greater glomerulosclerosis than their WT diabetic littermates. Renal hyperfiltration was lower in diabetic Ppif-/- as compared with WT mice. Similarly, Alisporivir did not improve renal function nor pathology in db/db mice as assessed by no change in albuminuria, KIM-1 excretion and glomerulosclerosis. Db/db mice exhibited changes in mitochondrial function, including elevated respiratory control ratio (RCR), reduced mitochondrial H2O2 generation and increased proximal tubular mitochondrial volume, but these were unaffected by Alisporivir treatment. Taken together, these studies indicate that CypD has a complex role in DKD and direct targeting of this component of the mPTP will likely not improve renal outcomes.
-
ItemNo Preview AvailableThe New Generation Antiplatelet Agent Prasugrel Represents an Exciting Novel Candidate Therapy for Preeclampsia.(SPRINGER HEIDELBERG, 2020-03)
-
ItemHow do health practitioners in a large Australian public hospital identify and respond to reproductive abuse? A qualitative study(ELSEVIER SCIENCE INC, 2019-10)OBJECTIVE: Reproductive abuse is defined as a deliberate attempt to control or interfere with a woman's reproductive choices. It is associated with a range of negative health outcomes and presents a hidden challenge for health practitioners. There is a dearth of research on reproductive abuse, particularly qualitative research. This study aims to address this gap by exploring how health practitioners in a large Australian public hospital identify and respond to reproductive abuse. METHODS: We conducted semi-structured interviews with n=17 health practitioners working across multiple disciplines within a large metropolitan public hospital in Victoria. Data were analysed thematically. RESULTS: Three themes were developed: Figuring out that something is wrong; Creating a safe space to work out what she wants; and Everyone needs to do their part. CONCLUSIONS: Practitioners relied on intuition developed through experience to identify reproductive abuse. Once identified, most practitioners described a woman-led response promoting safety; however, there were inconsistencies in how this was enacted across different professions. Lack of clarity around the level of response required was also a barrier. Implications for public health: Our findings highlight the pressing need for evidence-based guidelines for health practitioners and a 'best practice' model specific to reproductive abuse.
-
ItemUmbilical endometriosis: a potential encounter for general surgeons(WILEY, 2019-04)
-
ItemNo Preview AvailableTrans-generational stress regulation: Mother-infant cortisol and maternal mental health across the perinatal period(PERGAMON-ELSEVIER SCIENCE LTD, 2019-11)Understanding maternal mental health and cortisol regulation across pregnancy and the relationship to the development of the offspring's stress regulation is critical to a range of health outcomes. The aim of this study was to investigate infant and maternal cortisol in women with depression. Data were obtained from 241 pregnant women within the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS), a selected pregnancy cohort study. Depression was measured using the Structured Clinical Interview for DSM-IV (SCID-IV) and repeat Edinburgh Postnatal Depression Scale (EPDS). Repeated measures of antidepressant use, stressful events, anxiety symptoms and maternal hair cortisol concentrations (HCC) and infant cortisol at 12 months postpartum in saliva and hair. Socio-emotional outcomes were measured at 12 months by maternal report on the Brief Infant and Toddler Socio-emotional Assessment (BITSEA). This study found that maternal depression was not associated with maternal HCC. Anxiety, stress and antidepressant use were not associated with maternal HCC. Independently, higher maternal 3rd trimester maternal depressive and anxiety symptoms were associated with lower infant cortisol response at 12 months of age. A higher number of postpartum stressful events was associated with lower infant cortisol response. Lower infant stress reactivity was associated with higher externalizing symptoms at 12 months of age. Future studies are required to understand implications for later mental health.
-
ItemNo Preview AvailableThe role of trauma and partner support in perinatal depression and parenting stress: An Australian pregnancy cohort study(SAGE PUBLICATIONS LTD, 2019-05)BACKGROUND: Improving our understanding of the relationship between maternal depression and parenting stress is likely to lie in the range of additional factors that are associated with vulnerability to depression and also to parenting stress. OBJECTIVES: To examine the role of trauma and partner support, in understanding the relationship between perinatal depression and parenting stress. METHODS: This study utilises data from 246 women in a pregnancy cohort study that followed women from early pregnancy until their infant was 12 months. Included were both women with a diagnosis of depression and those without depression. The measures included Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Edinburgh Postnatal Depression Scale, Childhood Trauma Questionnaire, Social Support Effectiveness Questionnaire and the Parenting Stress Index. RESULTS: We found women with depression were more likely to report a history of childhood trauma. Depressive symptoms were positively associated with parenting stress while partner support was negatively associated with parenting stress. The protective role of partner support for parenting distress was observed in those with no history of childhood abuse and low depressive symptoms, but not in those with a trauma history and high depressive symptoms. CONCLUSIONS: These findings highlight the importance of early trauma in understanding the protective role of support on the relationship between parenting and depression. These findings can inform future studies and the refinement of future interventions aimed at both perinatal depression and parenting.