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A study in Obstetrics & Gynecology found about one-quarter of stillbirths in the US may have been preventable. The main potentially preventable reasons for stillbirth included placenta problems, complications such as diabetes, preterm labor and high blood pressure, and pregnancies in which there is more than one fetus, the study found.
HealthDay News (1/19)
A study in Obstetrics & Gynecology showed a 4.9% rate of obstetric anal sphincter injury. Risk factors included vacuum-assisted vaginal delivery and a prolonged second stage of labor.
A Pew Research Center report said 86% of women ages 40 to 44 are mothers, compared with 80% in 2006, with the increase credited in part to more births among women who never marry and those with advanced degrees. Women had, on average, 2.07 children during their lifetime, an increase from 1.86 in 2006, the lowest rate recorded.
Women with gestational diabetes were at increased risk of developing type 2 diabetes, ischemic heart disease and hypertension, but not cerebrovascular disease, according to a retrospective study in PLOS Medicine. Researchers evaluated primary care data for 46,399 women in the UK with and without gestational diabetes.
A study in the Annals of Internal Medicine linked the use of methimazole and propylthiouracil, two antithyroid drugs, during the first three months of pregnancy to an increased risk of congenital malformations in live births. Researchers said the study shows methimazole use should be minimized during the first trimester of pregnancy and a current recommendation to switch from methimazole to propylthiouracil during pregnancy should be reconsidered.
Healio (free registration) (1/22)
CDC researchers found that the percentage of US women ages 15 to 44 who received prescriptions for attention-deficit/hyperactivity disorder drugs rose by 344% between 2003 and 2015, with the highest increase — 700% — among those ages 25 to 29. The findings in the agency’s Morbidity and Mortality Weekly Report also showed that the greatest increases occurred in Southern and Western states, and Adderall, Vyvanse and Ritalin were the most commonly prescribed medications.
The New York Times (free-article access for SmartBrief readers) (1/18), USA Today (1/19), Medscape (free registration) (1/18)
A study in JAMA Oncology found use of oral contraceptives for at least 10 years was associated with a 34% lower risk of endometrial cancer and a 40% lower risk of ovarian cancer. The findings, based on 196,536 women ages 50 to 71, showed significant reductions in ovarian cancer risk among women who smoked, were obese and exercised infrequently, while the strongest reductions for endometrial cancer risk were seen among smokers and those with obesity.
Surgeons at Texas Children’s Hospital employed an experimental technique for prenatal surgery to treat spina bifida, using small slits in the uterus to insert a camera and instruments. The surgery allowed the mother to carry the child to term and have a vaginal birth, with the infant moving his legs and feet after birth, indicating the operation prevented damage to spinal nerves.
CDC and Brazilian researchers analyzed data on Zika virus infections and microcephaly for births in Brazil’s Paraiba state between Aug. 1, 2015, and Feb. 1, 2016, and found that infants with microcephaly were more likely to have had Zika virus infection or been born to a mother who had Zika infection in the first trimester. The findings were published in The Lancet Child & Adolescent Health.
Investigators from St. Jude Children’s Research Hospital created a new gene therapy designed to develop fully functioning immune systems for infants and young children diagnosed with severe combined immunodeficiency, or “bubble boy,” disease. The therapy involves taking the patient’s bone marrow and incubating it with a re-engineered virus that carries a normal copy of the gene to replace mutations, which results in patients building immune systems and developing antibodies for the first time four months after treatment.
Thirty-five percent of febrile infants ages 1 day to 90 days who underwent respiratory viral testing by polymerase chain reaction tested positive for human rhinovirus, researchers reported in Pediatrics. The findings showed higher odds of bacterial infection among those with HRV than in those with non-HRV viruses, while the likelihood of urinary tract infection was similar among those with HRV at any age, but invasive bacterial infection risk was lower among those ages 29 days and older.
Adverse changes to vaginal bacteria may be linked to risk of premature birth, a study in BMC Medicine showed. “This study is one of the first to show that around almost half of pregnant women may have an unbalanced vaginal microbiota before premature rupture, providing further evidence of the role of bacteria in some cases of premature births,” lead researcher David MacIntyre said.
From 2002 and 2014, the percentage of pregnant women hospitalized for spontaneous subarachnoid hemorrhage increased from 4% to 6%, and the rate was higher among black women than for Hispanics and whites. The study, which was scheduled for presentation at an American Stroke Association conference, found women in their 20s had the highest rate of this rare type of stroke, and the risk decreased with age.
HealthDay News (1/24)
UK researchers reported in PLOS Medicine there was a reduced likelihood of urinary incontinence and pelvic organ prolapse among mothers who delivered by cesarean, but pregnancy after cesarean delivery was tied to higher odds of miscarriage, placental abruption, placenta accreta, placenta previa and stillbirth. The study also showed youths born by cesarean section were more likely to be obese before age 5 and develop asthma before age 12, compared with those delivered vaginally.
Researchers linked every 10 microgram per cubic meter increase in maternal exposure to fine particulate matter smaller than 1 micrometer throughout pregnancy to 9% increased odds of preterm birth, 20% higher likelihood of very preterm birth and 29% increased risk of extremely premature birth. The findings in JAMA Pediatrics were based on 2013 to 2014 data involving more than 1.3 million healthy singleton pregnancies in China.
A Norwegian study in BMJ Open found consumption of probiotic milk during pregnancy may reduce the risk of certain complications. Consuming probiotic milk in early pregnancy was associated with a reduced risk of preterm birth, while consumption in late pregnancy was tied to a lower risk of preeclampsia.
A study in the Journal of Clinical Endocrinology & Metabolism found overweight and normal-weight women with polycystic ovary syndrome who used metformin daily for two years had improved menstrual cycle regularity and reduced body mass index, luteinizing hormone and testosterone. The findings, based on 119 overweight and normal-weight women with the disease, showed that the benefit was mostly seen during the first six months of metformin use.
Medscape (free registration) (1/23)
Extremely preterm infants benefit overall from early treatment with low-dose hydrocortisone, according to a study in Pediatrics. Researchers said that compared with a placebo, the biggest benefits of hydrocortisone were found in infants born after placental vascular disease.