Safe mama, safe baby

Pharmacy student’s work focused on improving care for expectant moms

By Emily Miller

For the first time, a UF College of Pharmacy doctoral student in the department of pharmaceutical outcomes and policy has received a dissertation award from the Agency for Healthcare Research & Quality. The $42,000 award will help Caitlin Knox complete her study involving pre-existing diabetes and pregnancy. “It’s a huge honor,” she said. “It’s great to know that I am doing something that other people think will make a difference.” Knox’s study seeks to evaluate the comparative safety of the three most commonly used oral anti-diabetic drug classes in pregnant women with pre-existing diabetes. By analyzing a Medicaid Analytic eXtract database and supplementary information from birth certificates, Knox is looking at how often women with pre-existing diabetes are getting pregnant and what anti-diabetic medications they are using before, during and after pregnancy. “Medicaid covers between 40 and 50 percent of all live births,” she said. “In my comparative safety study, I will be looking to see if one oral anti-diabetic medication is safer than the other, with respect to the risk of the women having obstetric complications. It’s important for clinicians and mothers to know so that they can make an informed decision about which medication they are going to be prescribing and taking.” In Knox’s study, obstetric complications refer to cesarean section deliveries, preterm delivery, preeclampsia or deep vein thrombosis. The Chicago native has focused on this area of research for four years because she finds pregnancy fascinating, particularly the complexity of being able to achieve the best health outcomes for the mother and child. “It’s a complicated process to begin with and then you add these other factors in,” she said. “It’s so easy for something to go wrong with pregnancy.” Nearly 26 million Americans have diabetes, with between 90 and 95 percent of these cases attributed to Type 2 diabetes, according to the American Diabetes Association. Although Type 2, which is linked to obesity and age, is typically diagnosed in patients over 40, more and more younger people are being diagnosed. The increasing prevalence of Type 2 diabetes in young adults is important, because more young women will be diagnosed with diabetes during their reproductive years. “It’s something we didn’t have to deal with as a society 20 years ago, so there is not as much research on the different medications that are used to treat pre-existing diabetes during pregnancy,” she said. “I saw that gap and after speaking with my adviser, we decided that this would be a place that I could really make a difference.” Knox’s research is unique, she said, because it focuses on the mother’s health. “A lot of pregnancy research tends to focus on birth defects, and birth defects are very important but they also tend to be very rare, whereas the obstetric complications are a lot more common,” she said. The award will be used to pay for data acquisition, future publishing costs and travel expenses so Knox can present her findings at conferences. The funds also allow her to do less teaching and spend more time conducting additional research and helping others develop independent studies from her research.

Caitlin Knox