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

Main Category: Women's Health / Gynecology
Also Included In: Pregnancy / Obstetrics;  Pediatrics / Children's Health;  Fertility
Article Date: 31 Oct 2006 - 15:00 PDT

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

Pregnancy & Childbirth

• Fertility treatment: Couples who have fertility problems and undergo fertility treatment are more likely to have a child with such conditions as autism, cerebral palsy and cancer, according to a study presented on Wednesday at the American Society for Reproductive Medicine in New Orleans, BBC News reports (BBC News, 10/26). Mary Croughan of the University of California-San Francisco and colleagues examined over 19,000 medical records of 4,000 women and their children ages six and younger from 1994 through 1998, London's Guardian reports. According to the study, 2,000 of the women experienced fertility problems, and 2,000 did not have problems conceiving. The study found that while the health of the child usually was associated with the medical problems of the parents, in vitro fertilization and other fertility treatments also might have affected the child's health. In addition, the study found that women with fertility problems had more pregnancy and delivery complications, including preeclampsia, preterm labor, delivery difficulties and caesarean sections (Sample, Guardian, 10/26). The researchers also found that the risk of five conditions -- autism, cancer, cerebral palsy, mental retardation and seizures -- was 2.7 times higher in the children born to women who had fertility problems compared with those who did not. Moderate developmental problems -- including learning disabilities, serious sight or hearing disorders and attention deficit disorder -- were 40% more common in the children born to women with fertility problems (BBC News, 10/26).
  

• "Amniotic-Fluid Embolism and Medical Induction of Labor: a Retrospective, Population-based Cohort Study," Lancet: Michael Kramer of McGill University Faculty of Medicine and colleagues looked at the records from more than three million births in Canada from 1991 through 2002 (Kramer et al., Lancet, 10/26). The researchers found 180 cases of pregnant women experiencing a condition called amniotic-fluid embolism, during which tears cause amniotic fluid to travel into the woman's circulatory system, BBC News reports. Of the 180 cases, 24 of the women died (BBC News, 10/20). Although 17% of all the pregnant women were given drugs to induce labor, about 28% of the women experiencing amniotic-fluid embolism were given the drugs, and 42% of the women who died were given the drugs. The researchers wrote that the "absolute risk" of increase of amniotic-fluid embolism for women undergoing "medical induction" of labor is "very small: four or five total cases and one or two fatal cases per 100,000 women induced." However, they add that women and physicians "should be aware of the risk if the decision is elective" (Reuters, 10/19).
  

Public Health

• "Effect of Obesity on Survival in Epithelial Ovarian Cancer," Cancer: Andrew Li of Cedars-Sinai Medical Center in Los Angeles and colleagues included 216 women who underwent surgery for ovarian cancer at the hospital from 1996 through 2003 in a study to determine the effect that excess weight had on cancer diagnosis, progression and survival time, Reuters Health reports. The study finds that obese or overweight participants were more likely to be diagnosed at stage one -- before the cancer spreads -- compared to normal-weight women (Harding, Reuters Health, 10/23). However, "patients with advanced stage [cancer], obesity was independently associated with both shorter time to recurrence and shorter overall survival," the researchers wrote, concluding, "These findings suggest an effect of excess body weight on tumor biology, and studies are underway to elucidate the molecular and hormonal mechanisms underlying these clinical observations" (Li et al., Cancer, October 2006).
  

• "Screening for Breast Cancer With Mammography," Cochrane Library: Peter Gotzsche and M. Nielsen of the Nordic Cochrane Centre in Copenhagen, Denmark, collected data from six studies conducted over seven years in the U.S. and Europe comparing 500,000 healthy women in their 40s, 50s and 60s with no history of breast cancer who were randomly assigned to receive or not to receive mammography screening, Reuters Health reports. Gotzsche and Nielsen found that women who underwent screening were 15% to 20% less likely to die of breast cancer than the women who did not undergo screening. However, the researchers also found that women who underwent screening were 30% more likely to be treated for a nonlife-threatening cancer (Reuters Health, 10/24). The study also found that 200 out of every 2,000 women in the screening group experienced distress and anxiety because of false positive results, Gotzsche said. "Women invited to screening should be fully informed of both benefits and harm," according to Gotzsche. "When screening advocates and their organizations produce information materials, they generally emphasize the benefits and omit information on the major harms," Gotzsche said, adding, "This needs to be corrected to ensure that women can give genuinely informed consent before joining a screening program" (BBC News, 10/18).
  

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