Publications by authors named "Shruthi Mahalingaiah"

Background: Associations between early-life menstrual cycle characteristics (MCC) and gestational diabetes (GDM) remain unclear.

Objectives: To evaluate associations between early-life MCCs and GDM in first pregnancy, across pregnancies and its recurrence.

Methods: This analysis included participants from a US-based digital cohort enrolled between 11/2019 and 9/2023 who provided consent, completed relevant surveys, were without diabetes and aged ≥18 at first pregnancy (n = 30,473).

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  • * Found that Black/African American patients had a higher likelihood of missed diagnoses compared to non-Hispanic White patients, and reliance on Medicaid or charity insurance increased this risk.
  • * Highlighted the need for further research into the underlying causes of these disparities to improve early diagnosis and intervention for PCOS.
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  • A study evaluated the prevalence of androgen excess (AE) symptoms in 24,435 participants from a U.S. digital cohort, focusing on signs like hirsutism, chin hair, hair loss, and acne from November 2019 to December 2022.
  • Results revealed that possible hirsutism was at 6.9%, chin hair at 12.6%, hair loss at 1.7%, and moderate to severe acne at 31.8%, with variations noted across different age groups and demographics.
  • The findings suggest that AE symptoms differ by age, ethnicity, and body mass index, indicating the need for more inclusive health evaluations in diverse populations.
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Purpose Of Review: Hypoparathyroidism (hypoPTH) is a rare disease that requires diligent adherence to treatment regimens to prevent hypocalcemia but also treatment-induced hypercalcemia and hypercalciuria. The menstrual cycle, pregnancy, and lactation can all impact calcium homeostasis but there is little known regarding the impact of ovarian stimulation. Furthermore, the limited reports suggest no clear association between menstrual phase and calcium balance among those with hypoPTH.

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  • Research indicates that exposure to PFAS during pregnancy could increase the risk of developing obesity and related health issues later in life.
  • A study involving 547 women showed that higher levels of certain PFAS, like PFOS, in early pregnancy are linked to increased midlife weight and body fat, while others like perfluorononanoate were associated with lower weight.
  • The findings suggest that specific PFAS exposures during pregnancy might have different impacts on maternal body fat, potentially affecting long-term heart and metabolic health.
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Between 2010 and 2016, elective oocyte cryopreservation (OC) increased in use by 880% in the United States; however, there have been increasing reports of regret among patients after elective OC. There is a growing need for individualized counseling on the timing and number of oocytes to cryopreserve for patients to make informed choices and set realistic expectations, but currently available tools seem to be insufficient. The purpose of this review is to describe the OC calculators currently available online, identify sources of regret, and illustrate the need for unified counseling tools for improved patient care and education.

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Background: Approximately 13% of women in the United States of reproductive age seek infertility services. Assisted reproductive technology (ART), including in vitro fertilization, is used to help patients achieve pregnancy. Many people are not familiar with these treatments prior to becoming patients and possess knowledge gaps about care.

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Background: The menopausal transition involves significant sex hormone changes. Environmental chemicals, such as urinary phthalate metabolites, are associated with sex hormone levels in cross-sectional studies. Few studies have assessed longitudinal associations between urinary phthalate metabolite concentrations and sex hormone levels during menopausal transition.

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  • Early menarche is linked to negative health outcomes, and trends in the US show it's happening earlier, but more research is needed on how factors like socioeconomic status and BMI impact this.
  • The study aims to analyze trends in age at menarche and how long it takes to achieve regular menstrual cycles while considering early-life BMI's role as a mediator.
  • Data from 71,341 female participants reveal that the average age of menarche decreased over the decades, with a notable increase in cases of early and very early menarche.
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  • Polycystic ovary syndrome (PCOS) is a common condition that causes irregular menstrual cycles and is linked to cardiovascular and metabolic issues, but more research is needed on its specific relationships and interventions.
  • The study aimed to analyze how PCOS, time to menstrual regularity from menarche, and irregular cycles impact the occurrence of various cardiometabolic conditions in participants using the Apple Research app.
  • The research involved a large group of US-based individuals, finding that 12.3% had PCOS, with a focus on various cardiovascular and metabolic health outcomes, while also considering how lifestyle factors may influence these associations.
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Objective: To evaluate the association between the urinary benzophenone-3 concentrations and measures of ovarian reserve (OR) among women in the Environment and Reproductive Health study seeking fertility treatment at Massachusetts General Hospital (MGH) in Boston, Massachusetts.

Design: Prospective cohort study.

Setting: MGH infertility clinic in Boston, Massachusetts.

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Background: Evidence suggests that exposure to per- and polyfluoroalkyl substances (PFAS) increases risk of high blood pressure (BP) during pregnancy. Prior studies did not examine associations with BP trajectory parameters (i.e.

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Introduction: Predictive models have been used to aid early diagnosis of PCOS, though existing models are based on small sample sizes and limited to fertility clinic populations. We built a predictive model using machine learning algorithms based on an outpatient population at risk for PCOS to predict risk and facilitate earlier diagnosis, particularly among those who meet diagnostic criteria but have not received a diagnosis.

Methods: This is a retrospective cohort study from a SafetyNet hospital's electronic health records (EHR) from 2003-2016.

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  • * A systematic review of 30 trials (over 2,200 participants) evaluated the impact of inositol and found it may improve some metabolic outcomes but is less effective for others compared to metformin.
  • * The overall conclusion is that there's limited evidence supporting inositol use in managing PCOS, urging clinicians and patients to weigh the uncertain benefits against personal preferences in treatment decisions.
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Background: Menstrual cycle tracking apps (MCTAs) have potential in epidemiological studies of women's health, facilitating real-time tracking of bleeding days and menstrual-associated signs and symptoms. However, information regarding the characteristics of MCTA users versus cycle nontrackers is limited, which may inform generalizability.

Objective: We compared characteristics among individuals using MCTAs (app users), individuals who do not track their cycles (nontrackers), and those who used other forms of menstrual tracking (other trackers).

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Increased fossil fuel usage and extreme climate change events have led to global increases in greenhouse gases and particulate matter with 99% of the world's population now breathing polluted air that exceeds the World Health Organization's recommended limits. Pregnant women and neonates with exposure to high levels of air pollutants are at increased risk of adverse health outcomes such as maternal hypertensive disorders, postpartum depression, placental abruption, low birth weight, preterm birth, infant mortality, and adverse lung and respiratory effects. While the exact mechanism by which air pollution exerts adverse health effects is unknown, oxidative stress as well as epigenetic and immune mechanisms are thought to play roles.

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Purpose Of Review: Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) are becoming increasingly popular for the treatment of type II diabetes and obesity. Body mass index (BMI) thresholds at in vitro fertilization (IVF) clinics may further drive the use of these medications before infertility treatment. However, most clinical guidance regarding optimal time to discontinue these medications prior to conception is based on animal data.

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Introduction: Predictive models have been used to aid early diagnosis of PCOS, though existing models are based on small sample sizes and limited to fertility clinic populations. We built a predictive model using machine learning algorithms based on an outpatient population at risk for PCOS to predict risk and facilitate earlier diagnosis, particularly among those who meet diagnostic criteria but have not received a diagnosis.

Methods: This is a retrospective cohort study from a SafetyNet hospital's electronic health records (EHR) from 2003-2016.

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  • This study analyzed menstrual cycle length and variability using data from over 165,000 cycles tracked by 12,608 participants in the US.
  • It found that menstrual cycles tend to shorten with age until around 50, after which they lengthen, and that cycles are longer on average for Asian and Hispanic women compared to white women.
  • Additionally, participants with higher body weight (BMI ≥ 40 kg/m) exhibited longer and more variable menstrual cycles, particularly those aged under 20 and over 50, highlighting the need for further research into the factors affecting menstrual health.
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  • * Researchers found that using hair oil might lead to babies being smaller than expected, while using nail polish seemed to help babies be longer at birth.
  • * Overall, the results suggest that using different personal care products can affect pregnancy outcomes, especially hair oil during the early months of pregnancy.
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Background: Previous studies have linked environmental exposures with anti-Müllerian hormone (AMH), a marker of ovarian reserve. However, associations with multiple environment factors has to our knowledge not been addressed.

Methods: We included a total of 2,447 premenopausal women in the Nurses' Health Study II (NHSII) who provided blood samples during 1996-1999.

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  • The study investigated abnormal uterine bleeding patterns by analyzing menstrual tracking data while considering demographic and health factors.
  • It included participants from the Apple Women's Health Study, focusing on individuals who weren't pregnant, breastfeeding, using hormones, or menopausal, and confirmed the accuracy of their tracking.
  • Results showed that 16.4% of participants experienced some form of abnormal bleeding, with specific prevalence rates for irregular, infrequent, prolonged menses, and spotting, noting a significantly higher prevalence among Black participants.
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COVID-19 vaccination may be associated with change in menstrual cycle length following vaccination. We estimated covariate-adjusted differences in mean cycle length (MCL), measured in days, between pre-vaccination cycles, vaccination cycles, and post-vaccination cycles within vaccinated participants who met eligibility criteria in the Apple Women's Health Study, a longitudinal mobile-application-based cohort of people in the U.S.

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