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She joined the MJH Life Sciences team in December 2019. She graduated from Youngstown State University in 2019 with a bachelor's degree in journalism and a minor in political science. Prior to graduating, Morgan worked as the editor-in-chief of her college newspaper. She went on to work as an assignment editor at a broadcast news station in Youngstown, Ohio, before joining 

 You can reach her at mebert@mjhlifesciences.com.

A study found that women with hyperemesis gravidarum face significantly increased risks of multiple mental health conditions.

Hyperemesis gravidarum linked to mental health disorder risks

Lariah M. Edwards, PhD, is an associate research scientist at the Columbia University Mailman School of Public Health.

Lariah M. Edwards, PhD, explains how avoiding risky ingredients in care products may lower health risks while highlighting the need for stronger safety regulations.

How safer personal care product selection can reduce chemical exposure

Emma N. Cleary is a PhD candidate at Indiana University Bloomington.

A study found that judicious prenatal opioid prescribing does not substantially increase the risk of autism or ADHD in children.

Emma N. Cleary explains opioid use is not linked to offspring ADHD or autism

A study found reduced quality of life in women with premenstrual disorders, especially in anxiety, depression, and pain domains.

Premenstrual disorders linked to reduced quality of life

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A recent clinical study presented by Koji Ishikawa, MD, PhD, orthopedic spine surgeon at Duke University, and Tony M. Keaveny, PhD, Founder and Chief Science Officer of O.N. Diagnostics, compared the effects of romosozumab, teriparatide, and denosumab on bone strength in patients with osteoporosis. 

The analysis focused on the hip and spine, where fracture risk is particularly great. Results showed that romosozumab provided substantially greater improvements in bone strength after 1 year of treatment compared to the other 2 drugs. At the spine, for example, romosozumab increased bone density by approximately 25% but boosted bone strength by about 40%, highlighting that strength gains are not fully reflected by bone density measurements from standard DXA scans.

The findings are significant because fracture prevention depends more on improved breaking strength than on density alone. Data from real-world clinical care also suggest even greater percentage gains than those seen in earlier phase-2 and phase-3 trials. 

Notably, romosozumab demonstrated the unique ability to transform highly osteoporotic vertebrae into bones at much lower risk of biomechanical failure, as shown through virtual stress testing models. According to the researchers, romosozumab stands out as the most effective treatment for strengthening both hip and spine bones, offering a compelling advantage over teriparatide and denosumab.

Below, Keaveny shares further details on their presentation 

”(SUN-416) Greater increase in bone strength with romosozumab vs teriparatide or denosumab in women with postmenopausal osteoporosis in real-world clinical setting

 and Ishikawa provides an overview of the presentation 

“(SUN-564) Greater increases in bone strength estimates of virtual bone-implant constructs for spinal surgery with romosozumab vs teriparatide or denosumab in women with postmenopausal osteoporosis”. 

Please provide an overview of your presentation about bone strength from romosozumab vs teriparatide or denosumab.

This study compared the breaking strength of the hip and spine bones for different osteoporosis drug treatments and showed that the strength benefits after 1 year of treatment were substantially greater for romosozumab compared to both teriparatide and denosumab.

Spinal instrumentation remains challenging in patients with bone fragility. The concept behind this project is to provide additional support for achieving favorable surgical outcomes, beyond surgical techniques. Based on simulation-based biomechanical analysis, we found that romosozumab offered multiple advantages over denosumab and teriparatide in terms of biomechanical parameters relevant to spinal surgery.

What is the significance of these findings?

Changes in bone density as measured by clinical-standard DXA testing are difficult to interpret because what matters most in terms of fracture reduction is how much the 

 changes. This study is significant because it demonstrates the substantial benefits for breaking strength – more than for bone density. For example, at the spine, romosozumab increased bone density by about 25% but bone strength by about 40%. So, the benefits of the treatment are underestimated when measured by bone density. And of course, those benefits were greater for romosozumab than either of the other 2 treatments.

Evaluating mechanical parameters such as screw fixation strength or bone-breaking force in clinical practice for assessing drugs effects is impractical and often difficult with traditional biomechanical methods. To address this, we developed a simulation approach using patient CT data. Our findings provide a new perspective on their effectiveness in the context of implant surgery.

What were the main takeaways of your presentation?

As we have seen in other clinical trials, romosozumab is the better treatment in terms of its bone-strengthening benefits, both at the hip and spine. Here we have data from actual clinical care.

After 1 year of treatment, romosozumab showed greater improvements than denosumab and teriparatide in surgical instrumentation-related biomechanical analyses.

What other research about the impact of romosozumab on bone strength would you like to highlight?

These results suggest even greater gains, percentage-wise at least, for these highly osteoporotic and treatment-naïve patients from clinical care than what we observed in a prior phase-2 BCT study in women with low bone mass (Keaveny JBMR 2017) and also in a phase-3 imaging substudy of osteoporotic women with prior bisphosphonate therapy (Langdahl Lancet 2017).

In a previous study, we were the first to demonstrate the potential benefits of short-term romosozumab treatment (3 months) in reducing postoperative complications after spinal surgery (Ishikawa K, JOR Spine 2024). Taken together with the present findings, our research further supports the role of romosozumab for surgical support.

These results are particularly compelling at the spine for romosozumab because the drug benefit is so large — it takes a highly osteoporotic bone and transforms it into one at much lower risk of biomechanical failure. This is seen visually with the virtual stress testing. Here, virtual forces are placed on the bone that would normally fracture and crush an osteoporotic bone. After treatment with romosozumab, that same level of force produces almost no damage in the bone. Romosozumab appears to be the only drug treatment that can transform the osteoporotic vertebra in this way.

Even the best surgeons face complications when patients have osteoporosis. Yet perioperative bone health care is often overlooked. Our studies underscore the importance of assessing and managing bone health in perioperative settings to improve surgical outcomes.

Recent work presented at the 2025 annual meeting of American Society of Bone & Mineral Research found that romosozumab significantly outperformed teriparatide and denosumab in improving hip and spine bone strength. 

Clinical

Romosozumab outperforms teriparatide and denosumab in bone strength

Neonatal acidemia, indicated by umbilical cord arterial pH (UApH) under 7.05 at birth, is associated with a higher risk of death, cerebral palsy (CP), and epilepsy in long-term follow-up, according to a recent Swedish cohort study published in the 

American Journal of Obstetrics & Gynecology

Umbilical cord blood pH has long been used as a marker of neonatal acid-base status and a diagnostic tool for neonatal acidemia.

 However, large-scale evidence linking specific pH thresholds to long-term neurodevelopmental outcomes has been limited.

“Cord arterial pH [less than] 7.05 is linked to a higher likelihood of death, [CP] and epilepsy, but no other mental or organ system diseases. A marked increase in risk for CP, epilepsy, and intellectual disability was noted at cord arterial pH [less than] 6.95,” wrote investigators.

Researchers conducted a retrospective cohort study using birth data from January 1, 1997, to May 8, 2012, at Skåne University Hospital in Malmö, Sweden. After applying validation criteria for arterial pH and excluding incomplete records, 35,931 singleton infants were included. Of these, 912 were classified as acidemic based on a UApH under 7.05, while 35,019 were nonacidemic based on a UApH of 7.05 or greater.

Umbilical cord blood samples were drawn immediately after birth, and pH values were analyzed within 15 minutes. Researchers linked maternal and neonatal data to national health care registers, allowing follow-up for up to 20 years. Outcomes included mortality, organ system diseases, and neurodevelopmental disorders, coded according to the 

Mortality up to age 20 years was higher in the acidemic group at 4.1 per 1000 vs nonacidemic infants at 1.4 per 1000. No differences were found in causes of death between groups. Analyses across all organ systems revealed no significant differences in disease incidence between acidemic and nonacidemic infants.

Subanalyses revealed a higher risk of CP (1.0% vs 0.2%; adjusted HR, 4.35; 95% CI, 2.17-8.73) and epilepsy (1.6% vs 0.9%; adjusted HR, 1.71; 95% CI, 1.02-2.88) among acidemic infants. Intellectual disability incidence was higher in acidemic infants (1.4% vs 0.9%), but did not reach statistical significance (adjusted HR, 1.74; 95% CI, 0.99-3.04).

Dose-response analysis showed the risk of CP increased with declining UApH, becoming statistically significant at under 6.95. At this threshold, cumulative risk at 20 years was nearly 5% for CP, 12% for epilepsy, and 6% for intellectual disability, compared with less than 1% for nonacidemic infants.

The findings suggest that adverse neurodevelopmental outcomes may occur at higher UApH values than previously assumed. Additionally, they may inform clinical guidelines on monitoring and intervention for neonates with acidemia. They underscore the need for careful assessment of infants with UApH under 7.05 and particularly under 6.95, for timely detection and management of potential neurodevelopmental disorders. 

Investigators recommended further studies to refine risk thresholds and explore combined use of cord pH with other clinical markers to improve prediction of long-term outcomes. The importance of extended follow-up was also highlighted.

“At an age of 20 years the incidence of CP was doubled compared with at 5 years of age. Similarly, the incidence of both epilepsy and intellectual disability quadrupled at 20 years as compared to 5 years when UApH was [less than] 6.95," wrote investigators.

Zaigham M, Källén K, Sundberg TM, Olofsson P. Long-term outcomes after neonatal acidemia. 

l. 2025;233(3):195.e1-195.e11. doi:10.1016/j.ajog.2025.02.028

Malin GL, Morris RK, Khan KS. Strength of association between umbilical cord pH and perinatal and long term outcomes: systematic review and meta-analysis. 

New data show umbilical cord arterial pH under 7.05 at birth is associated with a higher risk of cerebral palsy, epilepsy, and death.

Umbilical cord acidemia linked to long-term neurodevelopmental risks

Data presented at the European Association for the Study of Diabetes Annual Meeting from September 15 to September 19, 2025, has indicated increased cardiovascular risk in patients taking oral hormone replacement therapy (HRT).

Prior data has indicated no significant impact of HRT on blood clot or stroke risk in women with type 2 diabetes (T2D). However, this research has unveiled a 2-fold increase in pulmonary embolism (PE) risk among patients with T2D taking oral HRT vs transdermal HRT, alongside a 21% increased risk of heart disease.

“Our study suggests that up to 5 years of regulator-approved doses of transdermal HRT appears safe in a large cohort of women in midlife with T2D and that the use of HRT skin patches is not associated with an excess increased risk of cardiovascular complications,” said Matthew Anson, BSc, researcher at the University of Liverpool.

“However, given increased risks with oral HRT, we propose that women with T2D should not be prescribed oral estrogen therapy,” added Anson.

The data was gathered from 3 analyses evaluating the impact of oral and transdermal HRT and cardiovascular, gynecological, and estrogen-related cancer risks in women with T2D. The TriNetX global database, including 140 health care organizations from the United States and Europe, was evaluated for electronic health records.

Of the participants, 75% were White, 17% Black, and 2% Asian. The study population was aged a mean 59 years, and the mean follow-up duration was 5 years. Participants were classified as either initiating HRT and statin, or controls initiating statin alone.

Relevant outcomes included PE, deep vein thrombosis (DVT), ischemic stroke, ischemic heart disease, and ovarian, breast, and endometrial cancer. In the first analysis, these outcomes were compared between women taking transdermal estrogen HRT with T2D vs without T2D, matched 1:1 based on age and ethnicity.

A 90% increase in DVT risk, 77% increase in heart disease risk, and 89%increase in stroke risk were observed in women with T2D vs those without T2D. No increases in PE or breast cancer risks were observed.

According to authors, these increased risks are largely because of the impacts of T2D on cardiovascular health. This leads women with T2D to experience increased risks vs those without T2D before considering additional factors.

In the second analysis, transdermal HRT use was compared with no HRT use in women with T1D matched 1:1 based on age, ethnicity, body mass index, blood glucose, and hypertension history. The risk of heart disease was reduced 25% in those taking HRT, but no other risks were significantly impacted.

Finally, investigators compared risks based on oral vs transdermal HRT use. Patients were matched 1:1 using the same characteristics as the second analysis. While no significant impacts on stroke, DVT, heart disease, or cancer risks were reported, the results highlighted the 2-fold increase in PE risk and a 21% increase in heart disease risk from oral vs transdermal HRT.

Menopausal women often experience symptoms such as hot flashes and night sweats. Additionally, data has indicated HRT may reduce the need for antidepressants in these patients.

 Therefore, HRT may be prescribed as a form of symptom relief.

“The decision to use HRT, even for a short period of time, is very difficult for many women," said Anson. "We hope our data will provide the increasing number of postmenopausal women living with T2D and their physicians with more evidence to consider when weighing the risks vs benefits of the most appropriate HRT formulation."

Researchers sound warning about women with type 2 diabetes taking oral HRT. News release. European Association for the Study of Diabetes. September 14, 2025. Accessed September 16, 2025. https://www.eurekalert.org/news-releases/1098060

Krewson C. HRT may reduce antidepressant need in menopausal women. Contemporary OB/GYN. March 1, 2025. Accessed September 16, 2025. https://www.contemporaryobgyn.net/view/hrt-may-reduce-antidepressant-need-in-menopausal-women

New research shows oral HRT increases cardiovascular risks in women with type 2 diabetes, while transdermal HRT appears to be safer.

Oral HRT linked to increased heart risks in T2D patients

Screening for primary cytomegalovirus (CMV) during the first trimester may be cost-effective by allowing treatment provision, according to a recent study published in the 

American Journal of Obstetrics & Gynecology.

More than 50% of individuals in the US are infected by CMV by the age of 40 years. In pregnancy, this can lead to congenital cytomegalovirus (cCMV), which is the primary infectious source of birth defects in US offspring.

 This has led to increased focus on managing this condition among clinicians and researchers.

“However, universal screening for CMV during pregnancy has long been opposed in the US, as screening is complex, given the need for differentiation between primary and secondary infections, and previously, no treatments were known to prevent vertical transmission of CMV,” wrote investigators.

As new CMV treatments have emerged in recent years, investigators built a decision-analytic model to evaluate the cost-effectiveness of first-trimester primary CMV screening. Inputs for the model were found through searches of the PubMed database, with a theoretical cohort of 2,869,141 patients established.

Study groups included patients receiving primary CMV in the first trimester and those without screening. Baseline primary CMV rates in US patients were used to determine true primary CMV cases. When undergoing screening, patients received testing with a serum immunoglobulin (Ig)G, followed by assessment with a serum IgM.

In the model, valacyclovir treatment was only applied to patients identified with primary CMV. False negative screenings or cases of no screening in patients with primary CMV were assumed to have cCMV identified by abnormal ultrasound findings. It was also assumed that treatment would not be given to patients with no screening or without positive results.

An analysis of a randomized controlled trial and 2 cohort studies were referenced to estimate CMV transmission rates to the fetus in patients with and without treatment. A branch was also included for women diagnosed with CMV but declining amniocentesis.

Alongside vertical CMV transmission, stillbirths, abortions, neonatal deaths, neurodevelopmental disability, hearing loss, quality-adjusted life years (QALYs), and costs were reported as outcomes, with the latter based on a societal perspective. Costs and QALYs were both discounted at an annual rate of 3%.

Relevant costs included excess cCMV management costs in the first year of life and costs of valacyclovir treatment and CMV screening, obtained from Centers for Medicare and Medicaid Services databases. Literature was assessed for all other costs.

There were 2,869,141 pregnant patients included in the theoretical cohort, with CMV screening and treatment linked to 2898 fewer vertical transmissions, 94 fewer abortions, 19 fewer stillbirths, and 11 fewer neonatal deaths. Screening and treatment were also linked to reductions in hearing loss and neurodevelopmental disability of 460 and 263, respectively.

Overall, universal screening was estimated to save $242.2 million and lead to 3437 additional QALYs. Additionally, the willingness to pay threshold was never crossed, indicating no significant changes from an individual variable’s uncertainty. The model also highlighted a negative correlation between the efficacy of screening and the utility of hearing loss.

Cost-effectiveness was even reported when reducing the specificity of the tests by more than 60%. In a univariable sensitivity analysis, the cost-effectiveness of universal screening was increased up to 17-fold vs the current cost of screening tests. Finally, a multivariable analysis indicated cost-effectiveness from universal screening in 100% of samples.

The results indicated cost-effectiveness from primary CMV infection screening in the first trimester, followed by treatment with valacyclovir. Investigators recommended further research to address contradictions between this data and prior cost-effectiveness studies.

“To support that effort, further primary research, particularly with larger sample sizes, is needed to provide more evidence that valacyclovir or other CMV treatments are effective and safe in pregnancy,” wrote investigators.

Dzubay SK, Gagliuso AH, Arora M, Doshi U, Caughey AB. Universal screening and valacyclovir for first trimester primary cytomegalovirus: a cost-effectiveness analysis. 

2025;233(3):191.e1-191.e9. doi:10.1016/j.ajog.2025.02.009

Saldan A, Forner G, Mengoli C, Gussetti N, Palù G, Abate D. Testing for cytomegalovirus in pregnancy. 

 2017;55(3):693-702. doi:10.1128/JCM.01868-16

A study found universal first-trimester cytomegalovirus screening could reduce poor pregnancy outcomes and save health care costs.

First-trimester cytomegalovirus screening found to be cost-effective

Researchers from Mayo Clinic have identified factors other than clogged arteries leading to heart attacks in women aged under 65 years, publishing their findings in the 

Journal of the American College of Cardiology.

Nontraditional factors were linked to more than 50% of heart attacks in this population, including embolism, spontaneous coronary artery dissection (SCAD), and other conditions. While women presented with fewer heart attacks than men, these patients were more likely to have their primary causes of heart attack misdiagnosed.

"This research shines a spotlight on heart attack causes that have historically been under-recognized, particularly in women," said Claire Raphael, MBBS, PhD, study author and interventional cardiologist at Mayo Clinic. “When the root cause of a heart attack is misunderstood, it can lead to treatments that are less effective—or even harmful."

Frequent misdiagnoses were reported when SCAD, often presenting in younger, otherwise healthy women, was the cause of a heart attack. In these cases, plaque buildup was often cited as the source of a heart attack.

Both men and women presented with atherosclerosis as the most common source of heart attacks, but the rate of atherosclerosis was only 47% in women vs 75% in men. Additionally, despite having lower heart injury levels, patients with stressors such as anemia or infection leading to a heart attack had the greatest 5-year mortality rates.

Investigators highlighted other key findings, such as 68% of overall heart attacks being caused by typical plaque buildup, but the majority in women being linked to nontraditional causes. A 6-fold increase in the prevalence of SCAD was also reported in women vs men.

Stress-related triggers and mortality outcomes

Overall, stressors such as anemia or infection were the second-most common source of heart attacks. Additionally, the 5-year mortality rate from these sources was the most significant at 33%.

Less than 3% of heart attack cases were unexplained, making it rare for a source not to be identified. Investigators concluded that this data may be used to guide the diagnosis and management of heart attacks in younger adults.

“Clinicians must sharpen their awareness of conditions like SCAD, embolism, and stress-related triggers, and patients should advocate for answers when something doesn't feel right," said Rajiv Gulati, MD, PhD, senior author and chair of the Division of Interventional Cardiology and Ischemic Heart Disease at Mayo Clinic.

Sex-specific outcomes have also been reported following a heart attack.

 At the European Society of Cardiology (ESC) Congress 2025, these data were highlighted alongside research indicating worse outcomes among women taking β-blockers. These included increased mortality, reinfarction, and hospitalization for heart failure risks.

The trial was launched in 2018 and assessed the impact of β-blocker therapy in patients with heart failure. Overall, the HR for adverse events in patients taking β-blockers vs no β-blockers was 1.04.

Notably, while the difference in incidence rates significantly differed among women with vs without β-blockers, no significant difference was observed among men, with an HR of 0.94. This highlighted greater rates of the primary composite outcome among women vs men.

This increase in risk was primarily driven by increased mortality, most prominent in women with preserved left ventricular ejection fraction and those taking high doses of β-blockers.

"Our findings suggest that a one-size-fits-all approach may not be appropriate and that sex-specific considerations are crucial for cardiovascular interventions prescriptions,” said Xavier Rosselló, MD, PhD, study investigator and cardiologist at University Hospital Son Espases in Mallorca, Spain.

Mayo Clinic study reveals hidden causes of heart attacks in younger adults, especially women. News release. Mayo Clinic. September 15, 2025. Accessed September 17, 2025. https://www.eurekalert.org/news-releases/1098036

Campbell P. Beta-blockers linked to worse outcomes in women following a heart attack. Contemporary OB/GYN. August 31, 2025. Accessed September 17, 2025. https://www.contemporaryobgyn.net/view/beta-blockers-linked-to-worse-outcomes-in-women-following-a-heart-attack

A study found that more than half of heart attacks in women aged under 65 years stem from factors beyond clogged arteries.

Emma N. Cleary

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