QUICK STUDY : A weekly digest of new research on major health topics

Tuesday, September 5, 2006

birth defects

Painkillers during pregnancy may be linked to abnormalities.

· THE QUESTION Medications generally considered safe and reliable may have unexpected consequences when taken during a pregnancy. Might that be the case with pain relievers called NSAIDs (nonsteroidal anti-inflammatory drugs)?

· THIS STUDY analyzed medical data on children born to 36,387 women; 2,571 of these babies were born with a birth defect. Women who had taken NSAIDs -- mainly Aleve (naproxen), Advil (ibuprofen), Vioxx (rofecoxib), Celebrex (celecoxib) and Cataflan or Arthrotec (diclofenac) -- during their first trimester of pregnancy were twice as likely to have had a child with a birth defect as were women who did not take such pain relievers. Heart defects, specifically cardiac septal abnormalities, were most common.

· WHO MAY BE AFFECTED BY THESE FINDINGS? Pregnant women. About 150,000 babies are born each year in the United States with some type of birth defect. Problems affecting the heart and circulatory system affect the most infants.

· CAVEATS Whether the women who took NSAIDs had medical conditions that increased the risk of birth defects in their children was unknown. Also unknown was whether the women took a high enough dose of NSAIDs to cause problems. The study was conducted before Vioxx was taken off the market because of an increased occurrence of heart attacks among people taking it; about 15 percent of the women in the study took Vioxx.

· FIND THIS STUDY September issue of Birth Defects Research (Part B); abstract available online at http://www.interscience.wiley.com/journal/bdrb (click on "Early View").

· LEARN MORE ABOUT birth defects at http://www.marchofdimes.com and http://www.kidshealth.org (click on "Parents").

ASTHMA

Mother's vitamin E level seems to affect risk for children.

· THE QUESTION As asthma has become considerably more common, some people believe that a lack of vitamins or minerals -- especially during early life -- may influence the development of the breathing disorder. Does their theory hold up?

· THIS STUDY analyzed diet and medical data on 1,253 pregnant women and their children. At 5 years old, about 12 percent of the children had been diagnosed with asthma. Children whose mothers had taken in the lowest amounts of vitamin E while pregnant were five times more likely to have asthma than were children whose mothers had registered the highest levels of the nutrient. The children's intake of vitamin E did not affect whether they had asthma.

· WHO MAY BE AFFECTED BY THESE FINDINGS? Pregnant women. Women, pregnant or not, are advised to consume at least 22 milligrams daily of vitamin E, which is found in vegetable oils, nuts, leafy green vegetables and fortified cereals.

· CAVEATS Vitamin E levels were determined from a combination of blood tests and the participants' recall of foods eaten. The authors theorized that a woman's vitamin E intake during pregnancy "could modulate the development of asthma by influencing fetal airway development."

· FIND THIS STUDY Sept. 1 issue of the American Journal of Respiratory and Critical Care Medicine; abstract available online at http://www.atsjournals.org .

· LEARN MORE ABOUT asthma at http://www.nhlbi.nih.gov/health and http://www.aafa.org .

RHEUMATOID ARTHRITIS

Common drugs do not appear to raise the risk of cancer.

· THE QUESTION Various studies have reported that people with rheumatoid arthritis are more likely to develop cancer than are those who don't have it. Might this be related to the drugs taken to treat the chronic disease?

· THIS STUDY analyzed medical data on 7,830 people with rheumatoid arthritis, all 65 and older. Most people had been prescribed methotrexate to treat their arthritis symptoms; about 15 percent were taking a different type of disease-modifying anti-rheumatic drug (DMARD), including the so-called biologic medications etanercept (Enbrel) and infliximab (Remicade). Blood and lymphatic cancers were diagnosed in 69 people; solid tumors were found in 604 participants. Although blood cancers were somewhat more common among people taking biologic drugs than those taking methotrexate, overall there was less than a 5 percent difference in cancer risk between the groups.

· WHO MAY BE AFFECTED BY THESE FINDINGS? Anyone with rheumatoid arthritis, a chronic disease that affects more than 2 million Americans.

· CAVEATS Before they started taking the drugs, people who took biologic DMARDs generally had more severe rheumatoid arthritis than the others. One of the nine authors had received grants and fees from several pharmaceutical companies.

· FIND THIS STUDY Aug. 31 online issue of Arthritis & Rheumatism; abstract available at http://www.interscience.wiley.com/journal/arthritis (click on "Early View").

· LEARN MORE ABOUT drug treatments for rheumatoid arthritis at http://patients.uptodate.com (click "Arthritis and rheumatism") and http://www.arthritis.org/conditions (click on "Drug Guide").

--Linda Searing

The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.