Heartburn and acid reflux are common medical disorders in pregnancy and can result in serious discomfort and complications. Furthermore, some pregnant women also experience more severe gastrointestinal conditions, such as helicobacter pylori infections, peptic ulcers, and zollinger-ellison syndrome. To allow the use of proton pump inhibitors (ppis) in pregnancy, the fetal safety of this drug class must be established. The aim of this study is to determine the fetal safety of ppis during early pregnancy through systematic literature review.methods. All original research assessing the safety of ppis in pregnancy was sought from inception to july 2008. Two independent reviewers identified articles, compared results, and settled differences through consensus. The downs-black scale was used to assess quality. Data assessed included congenital malformations, spontaneous abortions, and preterm delivery.
A random effects meta-analysis combined the results from included studies.
Results:of the 60 articles identified, 7 met inclusion criteria. Using data from 134,940 patients, including 1,530 exposed and 133,410 not exposed to ppis, the overall odds ratio (or) for major malformations was 1.12 (95% confidence interval, ci: 0.86-1.45).
Further analysis revealed no increased risk for spontaneous abortions (or=1.29, 95% ci: 0.84-1.97); similarly, there was no increased risk for preterm delivery (or=1.13, 95% ci: 0.96-1.33).
In the secondary analysis of 1,341 exposed and 120,137 not exposed to omeprazole alone, the or and 95% ci for major malformations were 1.17 and 0.90-1.53, respectively.
Conclusions:on the basis of these results, ppis are not associated with an increased risk for major congenital birth defects, spontaneous abortions, or preterm delivery. The narrow range of 95% cis is further reassuring, suggesting that ppis can be safely used in pregnancy.
am j gastroenterol 2009; 104:1541-1545; doi:10.1038/ajg.2009.122; published online 2009.
Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.
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Showing posts with label pregnancy. Show all posts
Showing posts with label pregnancy. Show all posts
Saturday, July 18, 2009
Friday, July 17, 2009
Women Still Drinking During Pregnancy
Despite the Surgeon General's warning that alcohol can affect unborn children, pregnant women haven't changed their drinking habits much over the past two decades, the CDC saidAbout 40% of women realize they're pregnant at four weeks' gestation, a critical period for fetal organ development,
The U.S. Surgeon General has consistently advised women against drinking alcohol during pregnancy. National prevalence of fetal alcohol syndrome is about 0.5 to 2.0 cases per 1,000 births, but the other fetal alcohol spectrum disorders occur about three times as often, the researchers said.
Women with the highest rates of drinking during pregnancy were older, college graduates, employed, and unmarried.
Between 2001 and 2005, 17.7% of pregnant women ages 35 to 44 reported having at least one drink in the past 30 days, compared with 8.6% of women ages 18 to 24.
While it's not well understood why drinking habits differ across certain aspects of social status, the researchers had a few possible explanations. It could be that older women may be more alcohol dependent and have more difficulty abstaining from alcohol while pregnant, they speculated. Also, they said, more-educated women and employed women might have more discretionary money to spend on alcohol. And unmarried women might attend more social occasions where alcohol is served, the researchers said. They emphasized that healthcare providers should routinely ask women of childbearing age about their alcohol use and inform them of the risks of drinking during pregnancy.
Alcohol use levels before pregnancy are a strong predictor of alcohol use during pregnancy, the researchers said. Many women who use alcohol continue to do so during the early weeks of gestation because they don't realize they're pregnant, as about half of all births are unplanned.
Denny CH, et al "Alcohol use among pregnant and nonpregnant women of childbearing age -- U.S., 1991 -- 2005 MMWR 2009; 58(19): 529-32
Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.
* Tune in tomorrow for ARE THE PPI’S SAFE IN PREGNANCY?
Deepen your understanding of "medical malpractice"... www.MedMalBook.com
The U.S. Surgeon General has consistently advised women against drinking alcohol during pregnancy. National prevalence of fetal alcohol syndrome is about 0.5 to 2.0 cases per 1,000 births, but the other fetal alcohol spectrum disorders occur about three times as often, the researchers said.
Women with the highest rates of drinking during pregnancy were older, college graduates, employed, and unmarried.
Between 2001 and 2005, 17.7% of pregnant women ages 35 to 44 reported having at least one drink in the past 30 days, compared with 8.6% of women ages 18 to 24.
While it's not well understood why drinking habits differ across certain aspects of social status, the researchers had a few possible explanations. It could be that older women may be more alcohol dependent and have more difficulty abstaining from alcohol while pregnant, they speculated. Also, they said, more-educated women and employed women might have more discretionary money to spend on alcohol. And unmarried women might attend more social occasions where alcohol is served, the researchers said. They emphasized that healthcare providers should routinely ask women of childbearing age about their alcohol use and inform them of the risks of drinking during pregnancy.
Alcohol use levels before pregnancy are a strong predictor of alcohol use during pregnancy, the researchers said. Many women who use alcohol continue to do so during the early weeks of gestation because they don't realize they're pregnant, as about half of all births are unplanned.
Denny CH, et al "Alcohol use among pregnant and nonpregnant women of childbearing age -- U.S., 1991 -- 2005 MMWR 2009; 58(19): 529-32
Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.
* Tune in tomorrow for ARE THE PPI’S SAFE IN PREGNANCY?
Deepen your understanding of "medical malpractice"... www.MedMalBook.com
Monday, June 8, 2009
FOLIC ACID AND PREGNANCY
Recent evidence suggested that folic acid might decrease the birth prevalence of congenital heart defects, the most common of all birth defects.
Believe it or not, the existing evidence for an association between folic acid and congenital heart defects, however, was still inconclusive in 2007—even though doctors have been prescribing it for a long time. This lack of solid evidence even necessitated a statement from the American Heart Association Council which emphasized the importance of this possible association and the need for corroborative evidence from population based studies.
Canadian researchers examined rates of severe congenital heart defects during the 9 years before folic acid fortification of grains was implemented (1990–1998) and during the 7 years afterward (1999–2005).
They found that while the heart defect rate remained stable before fortification, it dropped an average of 6% per year in the period after.
The authors conclude that the data "support the hypothesis that folic acid has a preventive effect on heart defects.”
SUMMARY:
What is already known on this topic
Animal studies show that folic acid might prevent congenital heart defects. Evidence from one randomized controlled trial and several case-control studies is supportive but not conclusive because prior to this study evidence was lacking from from population based studies.
What this study adds
The birth prevalence of severe congenital heart defects in Quebec, Canada, decreased after the implementation of a public health policy to increase the folic acid intake at the population level. This population based study supports previous evidence that intake of folic acid around conception has a preventive effect on congenital heart defects
BMJ 2009;338:b1673
COMMENT: The evidence now is irrefutable. Folic acid must be part of the nutritional supplements taken in pregnancy.
Live interview Monday, June 8th 11AM, ET with Sybil Tonkonogy on WNTN (AM 1550), Newton, MA. Interview will also air live on radio's web site, http://www.wntn.com
Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.
Believe it or not, the existing evidence for an association between folic acid and congenital heart defects, however, was still inconclusive in 2007—even though doctors have been prescribing it for a long time. This lack of solid evidence even necessitated a statement from the American Heart Association Council which emphasized the importance of this possible association and the need for corroborative evidence from population based studies.
Canadian researchers examined rates of severe congenital heart defects during the 9 years before folic acid fortification of grains was implemented (1990–1998) and during the 7 years afterward (1999–2005).
They found that while the heart defect rate remained stable before fortification, it dropped an average of 6% per year in the period after.
The authors conclude that the data "support the hypothesis that folic acid has a preventive effect on heart defects.”
SUMMARY:
What is already known on this topic
Animal studies show that folic acid might prevent congenital heart defects. Evidence from one randomized controlled trial and several case-control studies is supportive but not conclusive because prior to this study evidence was lacking from from population based studies.
What this study adds
The birth prevalence of severe congenital heart defects in Quebec, Canada, decreased after the implementation of a public health policy to increase the folic acid intake at the population level. This population based study supports previous evidence that intake of folic acid around conception has a preventive effect on congenital heart defects
BMJ 2009;338:b1673
COMMENT: The evidence now is irrefutable. Folic acid must be part of the nutritional supplements taken in pregnancy.
Live interview Monday, June 8th 11AM, ET with Sybil Tonkonogy on WNTN (AM 1550), Newton, MA. Interview will also air live on radio's web site, http://www.wntn.com
Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.
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