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Medscape
31 minutes ago
- Medscape
Can Metformin Prevent Severe Morning Sickness?
TOPLINE: Daily metformin use in the month before pregnancy is associated with more than 70% reduction in risk for hyperemesis gravidarum in first pregnancies. The protective effect persists in second pregnancies with 82% lower risk, even after accounting for the high recurrence risk, while cannabis use and selective serotonin reuptake inhibitors increase risk. METHODOLOGY: Researchers analyzed data from 5414 participants who reported on daily medication and substance use in the month prior to pregnancy and level of nausea and vomiting during pregnancy. Participants were recruited through the Hyperemesis Gravidarum Education and Research Foundation social media sites from January 2023 to September 2024. Analysis included logistic regression to estimate crude and multivariate associations between use of 32 common substances and severe nausea and vomiting of pregnancy/hyperemesis gravidarum. Final multivariate models incorporated tobacco use and maternal age, while number and type of additional drugs used and race/ethnicity showed minimal influence. TAKEAWAY: Prepregnancy metformin use was associated with more than 70% reduction in risk for hyperemesis gravidarum (adjusted relative risk [aRR], 0.29; 95% CI, 0.12-0.71; P = .007). Tobacco use showed significant reduction in risk (aRR, 0.51; 95% CI, 0.30-0.86; P = .011), while selective serotonin reuptake inhibitors were linked to increased risk (aRR, 2.41; 95% CI, 1.33-4.38; P = .004). Metformin use before a second pregnancy was associated with 82% lower risk for severe nausea and vomiting/hyperemesis gravidarum (adjusted odds ratio [aOR], 0.18; 95% CI, 0.06-0.59; P = .005), even after adjusting for an 86% recurrence risk. Cannabis use (aOR, 3.48; 95% CI, 1.80-6.75; P < .001) and selective serotonin reuptake inhibitors (aOR, 1.84; 95% CI, 1.12-3.04; P = .016) before a second pregnancy were associated with increased risk. IN PRACTICE: 'Metformin, which is routinely used pre- and post-conception, may be a safe and affordable treatment to offer patients with a prior history of hyperemesis gravidarum to decrease the chance of recurrence. Clinical trials are warranted to investigate metformin use prior to pregnancy to lower hyperemesis gravidarum risk, thereby mitigating the associated adverse maternal and offspring outcomes,' wrote the authors of the study. SOURCE: The study was led by Neelu Sharma, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California in Los Angeles. It was published online in American Journal of Obstetrics and Gynecology. LIMITATIONS: The hyperemesis gravidarum-enriched approach to participant recruitment may have introduced selection bias, as individuals with multiple occurrences may have been more likely to participate. However, the authors noted that similar recurrence rates were reported in previous prospective studies. Additionally, the indication, timing, and dosage for each medication or substance was unknown. While conditions commonly treated with metformin like diabetes and polycystic ovary syndrome have been associated with increased risk for hyperemesis gravidarum, any confounding by indication would bias results upward rather than explain the observed inverse associations. DISCLOSURES: Marlena S. Fejzo disclosed being a consultant for NGM Biosciences, receiving stock and fee for service. The remaining coauthors reported having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Fast Company
41 minutes ago
- Fast Company
Lonely at work? Emotional intelligence can help
While remote work offers several benefits such as flexibility, working from home can also be lonely. In one survey almost a quarter (23%) of remote workers reported feeling lonely. Loneliness at work can result in decreased productivity, and feelings of dissatisfaction. Emotional intelligence can help us understand what to do to feel more connected at work. Here are four steps to take: Develop Self-Awareness Most of us experience periods of loneliness. Being self-aware allows us to better recognize when we are feeling lonely, link it to what is going on at the time, and come up with solutions. Even being able to express what we are feeling can help alleviate loneliness, as naming what we're feeling helps us to gain more control over our emotions. Consider journaling when you feel lonely to understand what you're feeling, as well as what situations cause these feelings. Discovering the circumstances that cause loneliness may help you avoid or alleviate loneliness in the future. Manage Emotions There are various methods for regulating and coping with our emotions, and one size does not fit all. Some methods that are known to work are deep breathing, mindfulness, walking in nature, or simply getting away momentarily from the setting we are in. I have found taking a short break from whatever is stressing me out and imagining a relaxed pleasurable experience helps me regulate my emotions. Experiment with different practices to learn what works for you. Increase Empathy If we are high in empathy, we will be more likely to reach out to others if we are experiencing feelings of loneliness. One way to increase empathy is to identify the emotions you hear someone bring up in conversations. For example: 'I hear you are feeling angry, sad, or afraid.' Chances are others share our feelings, and may be hesitant to reach out, unaware that others are struggling with the same problem. By increasing our empathy and reaching out, we form bonds, increase vulnerability, openness, and connection. Knowing that we are not alone in our situation and having people we can reach out to for support can go a long way in making us feel more connected. Build connections As humans we are hardwired to connect with others. This becomes even more important for remote workers. Creating opportunities to build connections is something that everyone needs to take ownership of, from leaders on down. Set aside some social time where everyone can share what is going on in their lives apart from work. If you have regular online meetings, take a few minutes to share something personal, such as challenges, struggles, and joys. If you have colleagues in the same city, try to get together in person on occasion. Encourage and support each other to come up with ideas on how to connect. Leadership could also host office lunches, where the company covers the cost of lunch and provides space for an informal online get-together. One of the ongoing topics could be how other people experience loneliness and what tools they use to work through it. Leaders can use their emotional intelligence to combat the loneliness associated with remote work. In my book Bigger Hearted: a Retired Pediatrician's Prescriptions for Living a Happier Life, I describe how the head of a local mental health center worked to alleviate loneliness on his team. He called each of them during their work hours, staying up late for several nights so he could talk to those who covered late-night emergencies. It may also help to s eek value and connection outside of work, whether through time with family and friends, hobbies, or volunteer work. Having something where you know you will be seen, heard, and supported can help alleviate loneliness and offer a bright spot in the day to look forward to.
Fast Company
41 minutes ago
- Fast Company
How to trick your nervous system into calming down when you're stressed at work
Understanding how your body works can be the key to reducing stress. For example, you're probably aware of your fight-or-flight response —the body's way of preparing itself when it believes it's being threatened. What happens is your sympathetic nervous system is activated, pumping adrenaline and glucocorticoid steroids into your system that give you hyper focus, energy and strength to handle the situation. Fight-or-flight was a survival mechanism during hunter-gatherer times, when the threat of wild animals was real. Today, however, it's often triggered by non-life-or-death events, such as the evening news, tight deadlines, or traffic. On the flipside of fight-or-flight is rest-and-digest. It's the body's way of rebalancing itself after the danger has passed. In this case, your parasympathetic nervous system is in charge, decreasing your heart rate and blood pressure and providing a sense of calm. Sometimes, though, the body has a hard time getting back into rest-and-digest. It stays in a state of stress and anxiety. When this happens, it's often due to your vagal tone, which is the activity in your vagus nerve, says Kevin Tracey, M.D., author of The Great Nerve: The New Science of the Vagus Nerve and How to Harness Its Healing..
