In this study, the association between second-trimester maternal serum 25-hydroxyvitamin D concentrations and risk of small for gestational age (SGA) in singleton live births was evaluated. Serum samples at 12-26 weeks of gestation for 25-hydroxyvitamin D were assayed in a sample of participants in a multicenter clinical trial of low-dose aspirin for the prevention of preeclampsia in high-risk women (n=792). The risk of SGA was assessed after adjustment for confounders including maternal prepregnancy obesity, race, treatment allocation, and risk group. The results showed that thirteen percent of neonates were SGA at birth. Mean vitamin D concentrations were lower in women who delivered SGA compared with non-SGA neonates. In adjusted models, vitamin D concentrations of 50-74 nmol/L and 75 nmol/L or greater compared with less than 30 nmol/L were associated with 43% (95% CI 0.33-0.99) and 54% (95% CI 0.24-0.87) reductions in risk of SGA, respectively. Race and maternal obesity each modified this association. White women with vitamin D of 50 nmol/L or greater compared with less than 50 had a 68% reduction in SGA risk and nonobese women with greater than 50 had a 50% reduction in SGA risk. The authors conclude that maternal vitamin D status in the second trimester is associated with risk of SGA. Obstet Gynecol. 2014. PMID: 24463662.

In this study, the authors evaluated the effectiveness of a pilot program that used multiple complementary and alternative medicine (CAM) therapies, focusing on self-care behaviours for treatment of generalized anxiety disorder (GAD). The study occurred at a military treatment facility in the Pacific Northwest. Participants were a convenience sample of volunteers seeking treatment, there were 37 enrolled in total who had a documented history of GAD or met screening criteria based on the GAD-7. The participants received acupuncture treatments once a week for 6 weeks and engaged in yogic breathing exercises, self or partner-assisted massage therapy using scented oils, episodic journaling, nutrition counseling, and exercise. The results showed that 68% of the participants completed the program. There were significant reductions in anxiety pre- and posttest using GAD-7 and there were also individual subscale reductions on the Depression Anxiety Stress Scale-21. While not specifically targeted for treatment, secondary exploratory outcomes included reductions in use of anxiolytic medication and in the pain scale. The authors conclude that in this pilot study, a multimodal intervention focusing on self-care behaviours may be feasible for patients seeking adjunctive treatments, and that it may produce anxiolytic effects validated measures. Altern Ther Health Med. 2013. PMID: 23981404.

In this pilot study, the safety, efficacy, and feasibility of acupuncture was evaluated in treating aromatase inhibitor-induced arthralgia. Aromatase inhibitors are recommended as adjuvant hormone treatment for postmenopausal women with early breast cancer, but a significant portion experience joint pain and stiffness. A total of 32 patients were randomized to receive either sham or real electroacupuncture twice weekly for 6 weeks. Outcomes of joint pain, stiffness, and physical function were measured with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), overall pain and severity and interference with the BPI-SF and quality of life with the Functional Assessment of Cancer Therapy-General (FACT-G) instrument. Hand strength was assessed by a grip test, and a serum marker of inflammation (CRP) was also measured. All assessments were performed at baseline, 6 weeks, and 12 weeks, except for blood samples at baseline and 6 weeks only. The results showed that there were no significant differences in outcome measures, however positive trends were observed in stiffness and physical function at week 12 in favour of real electroacupuncture. The authors conclude that acupuncture is feasible and safe in patients with breast cancer with joint pain caused by aromatase inhibitors. Acupunct Med. 2013. PMID: 23722951.

In this study, a total of 966 mother-child pairs were evaluated. 492 of the children had autism spectrum disorders (ASD), 154 had developmental delays (DD), and 320 had typical development (TD). The pairs were obtained from the Childhood Autism Risks from Genetics and the Environment (CHARGE) Study, a population-based casecontrol study. Standardized measures confirmed developmental status. Interviews with biological mothers ascertained prenatal SSRI use, maternal mental health history, and sociodemographic information. The results showed that the prevalence of prenatal SSRI exposure was lowest in the TD children (3.4%) but did not differ significantly from ASD (5.9%) or DD (5.2%) children. Among boys, prenatal SSRI exposure was nearly 3 times as likely in children with ASD relative to TD (OR 2.91, 95% CI 1.07-7.93). The strongest association occurred with first-trimester exposure (OR 3.22, 95% CI 1.17-8.84). Exposure was also elevated among boys with DD (OR 3.39, 95% CI 0.98-11.75) and was strongest in the third trimester (OR 4.98, 95% CI 1.20-20.62). Findings were similar among mothers with anxiety or mood disorder histories. The authors conclude that in boys, prenatal exposure to SSRIs may increase susceptibility to ASD or DD. Pediatrics. 2014. PMID: 24733881.