Medical Monday: Medical Portion

Maternal mortality rates are once again in the headlines, although this time the focus is on Virginia and not Texas. Virginia has 38.2 point two deaths per 100,000 live births. The Virginia Medical Examiner's Office investigated, finding that, "Women who die pregnancy related deaths in Virginia more often die from not having health care than from hemorrhaging, cesarean section complications or other maladies linked to birth." Virginia is not isolated in this regard as the American College of Obstetricians and Gynecologists has reported that there has been a 26% increase in maternal mortality in the United States from the years 2000 to 2014.

In the good news department, we have evidence for a common sense phenomenon. Data reported this month in the Journal Birth has demonstrated that "Physical activity during and after pregnancy improves psychological well-being and may protect against postpartum depression”

A new report in the American Journal of Clinical Nutrition has found that women with gestational diabetes who consume a high proportion of refined grains may give birth to children with a higher risk of obesity by age 7.

A study was performed using a federal nutrition program and an Internet-based program for weight loss. Results on 371 women indicated that this Internet-based weight loss intervention helped women shed their baby weight, i.e.their postpartum pounds. This study was funded by the National Institutes of Health and was published in the Journal of the American Medical Association. 

More data has come in against the practice of water birth. The Arizona Department of Health has identified two cases of Legionnaire's disease which occurred in newborns following water birth.  In both these cases the babies had been born at home in hot tubs. The Department noted that tapwater is not sterile and that legionella bacteria can grow in plumbing systems. While ACOG supports water labor it does not support water birth, citing a lack of definitive evidence showing safety and benefit.

Breast-feeding has numerous benefits for the baby and some obvious ones from mom. However it is somewhat counterintuitive that breast feeding should protect a woman against heart attack and stroke. Nonetheless new study has shown that “ breast-feeding may help mothers lower the risk of heart attack and stroke even decades after giving birth".  Breast-feeding for any amount of time confers a 9% reduction in the risk of coronary artery disease and reduces risk of stroke by 8%.These findings are published in the Journal of the American Heart Association.

A report produced from the Population Reference Bureau calls attention to the difficulties that young women face. The report is called "Losing ground: Young women's well-being across generations in United States". It has quantitatively documented that women in the US are”…poorer than their mothers and grandmothers when they were young, more likely to commit suicide and to be shut out of high tech jobs .” It concludes that ”social and structural barriers continue to obstruct the advancement of female members of generation X and millennials."

In-line with the last report, it's been determined that" opioid related hospitalizations among women in the United States have increased far faster than among men between 2005 and 2014." This has been determined by looking at data from the US agency for healthcare research and quality. Such hospitalizations have risen by 75% during this time interval. 

Breast cancer is in the news. It turns out that a low dose of aspirin i.e. baby aspirin taken daily may reduce the risk of breast cancer in women who have type II diabetes. This is preliminary research published in the Journal of Women's Health.

The National Institutes of Health has recently reported good news regarding breast cancer. Apparently breast cancer rates have been steadily declining since 2005 at a rate of 1.8 % per year.

ACOG has maintained their position that women should be offered mammograms beginning at age 40. Thereafter they should be given every one or two years through a joint determination by the patient and her physician.

 

Stay tuned for more breaking news from the exciting world of Obstetrics and Gynecology next week on Medical Monday.