Kaiser Daily Women's Health Policy Report Highlights Recently Released Journal Articles

Main Category: Fertility
Also Included In: Pregnancy / Obstetrics;  Breast Cancer
Article Date: 08 Aug 2006 - 15:00 PDT


The following highlights recently released journal articles on women's health issues.

Pregnancy & Childbirth

• "Obstetric and Delivery Outcome of Pregnancies Achieved After Laparoscopic Myomectomy," Fertility and Sterility: Renato Seracchioli of the University of Bologna in Italy and colleagues examined 158 pregnancies that occurred after a total of 514 laparoscopic fibroid surgeries. The study finds that the average time from the surgery to conception is 18 months. In addition, the miscarriage rate among the study participants was 27%, which is approximately equal to the findings of other reports on laparoscopic fibroid surgery but is higher than the miscarriage rates in the general population, which are about 10% to 15%, according to the study. The researchers also found no cases of uterine rupture, which is the most serious complication that occurs in pregnant women who have undergone a uterine surgery (Reuters Health, 7/31).
  


• "Fatty Acid Amide Hydrolase Deficiency Limits Early Pregnancy Events," Journal of Clinical Investigation: Sudhansu Dey of Vanderbilt University in Nashville, Tenn., and colleagues discovered that tetrahydrocannabinol (THC), an ingredent in marijuana, binds to receptors that exist in eggs, sperm and newly formed embryos and might cause miscarriages or ectopic pregnancies. Dey said, "Our observation of defects of preimplantation events and pregnancy failure in mice exposed to excessive THC raises concern that the adverse effects of maternal use of marijuana could be seeded very early in pregnancy" (BBC News, 8/1). The researchers conclude that the study findings might be "clinically relevant for fertility regulation in women" (Dey et al., Journal of Clinical Investigation, August 2006).
  


• "Morning Compared With Evening Induction of Labor," Obstetrics & Gynecology: Jodie Dodd of the University of Adelaide in Adelaide, Australia, and colleagues looked at 620 women who were scheduled to induce labor and randomly assigned 280 of them to undergo a morning induction and 340 to undergo an evening induction. The study finds that women who undergo a morning induction are less likely to require an infusion of the hormone oxytocin, which helps cause more contractions, than women who undergo an evening induction. In addition, morning induction is associated with a lower duration of labor compared with an evening induction, according to the study. There were no statistical differences among rates of maternal or infant complications, the study finds (Reuters Health, 8/1). The researchers suggest, "For women who require induction of labor, consideration should be given to admission in the morning rather than admission in the evening" (Dodd et al., Obstetrics & Gynecology, August 2006).
  


• "Paternal Age and Spontaneous Abortion," Obstetrics & Gynecology: Karine Kleinhaus of Columbia University's Mailman School of Public Health and colleagues studied about 14,000 women who were pregnant in the 1960s and 1970s. The study finds that in pregnancies resulting from intercourse with a man ages 40 or older, the risk of miscarriage is 60% greater than if the man is between ages 25 and 29. The study also finds that the risk of a miscarriage is three times greater if the man is between ages 35 and 39 compared with men younger than age 25 (Reuters Health, 7/31). The researchers concluded, "Increasing paternal age is significantly associated with spontaneous abortion, independent of maternal age and multiple other factors" (Kleinhaus et al., Obstetrics & Gynecology, August 2006). The authors said that despite the higher risk of miscarriage, older paternal age might raise the risk only slightly in a particular couple (Reuters Health, 7/31).

Public Health

• "Changes in Mucosal and Humoral Atopic-Related Markers and Immunoglobulins in Elite Cyclists Participating in the Vuelta a Espana," International Journal of Sports Medicine: Alejandro Lucia of the Universidad Europea de Madrid in Spain and colleagues examined 16 women breast cancer survivors who were either assigned to a group in which they continued their normal activity pattern or took part in an exercise group that participated in three 90-minute training sessions a week and did a variety of exercises. Women in the exercise group over eight weeks showed an increased quality of life compared with women in the control group, according to the study. In addition, researchers found that women in the exercise group had improved rates of oxygen uptake compared with women in the control group. "Our data, together with those of previous research with cancer patients/survivors emphasize the beneficial effects of exercise programs," researchers concluded (Reuters Health, 7/31).
  


• "Comprehensive Side Effect Profile of Anastrozole and Tamoxifen as Adjuvant Treatment for Early-Stage Breast Cancer: Long-Term Safety Analysis of the ATAC Trial," Lancet Oncology: Researchers compared the use of the breast cancer drug anastrozole, sold as AstraZeneca's Arimidex, with the use of the breast cancer drug tamoxifen among more than 6,000 postmenopausal women living with breast cancer that had not spread out of the breast to determine which medication is better tolerated. The five year clinical trial finds that significantly fewer women in the Arimidex group experienced adverse effects that caused them to withdraw from treatment compared with the tamoxifen group (Reuters, 8/1). In addition, the researchers said that the women taking Arimidex had a lower breast cancer recurrence rate than the woman taking tamoxifen (Lancet Oncology, 8/8). Researchers said that Arimidex should be the preferred initial treatment in postmenopausal women with breast cancer (Reuters, 8/1).

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