WOMEN'S HEALTH
Should postmenopausal women eat soy? University of Toronto researchers dispel myth about soy and cancer
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University of Toronto professor Laura Chiavaroli (left) and PhD student Gabrielle Viscardi
view moreCredit: University of Toronto
A University of Toronto study is providing reassuring evidence about the consumption of soy foods in women* who are postmenopausal.
The analysis of 40 randomized controlled trials in over 3,000 participants found that estrogen-like compounds in soy had no effect on key markers of estrogen-related cancers, supporting its safety as both a food and potential therapy.
Several health advocacy groups including the Canadian Cardiovascular Society already recommend soy foods as part of a healthy diet. They are a high quality and complete source of protein and are recognized by several national governmental health agencies — including Health Canada and the US Food and Drug Administration — as effective in reducing the risk of heart disease. Soy foods have also been shown to alleviate hot flashes associated with menopause, which affect many women and impact their quality of life.
“The risk of cardiovascular disease increases substantially as women go through menopause, so soy can offer dual benefits during this particular phase of life,” says Laura Chiavaroli, the study’s senior author and an assistant professor of nutritional sciences at U of T’s Temerty Faculty of Medicine.
Yet she notes that many people are hesitant to eat soy foods because they contain estrogen-like compounds called isoflavones, which are naturally found in plants and have a similar structure to the hormone estrogen. In animal studies, large doses of isoflavones have been linked to a higher risk of cancer.
“Something we hear very often is that people have a lot of concern about consuming soy because there are so many conflicting messages out there,” says Gabrielle Viscardi, a second-year PhD student in the department of nutritional sciences and the study’s lead author.
In their systematic review and meta-analysis, published in Advances in Nutrition, the researchers gathered results from trials that compared the effects of soy isoflavones on four different biological outcomes related to risk for endometrial and other female-related cancers. Those outcomes included the thickness of the uterus lining, the vaginal maturation index — a measure of estrogen status within the vaginal environment — and levels of circulating estrogen and follicle-stimulating hormone.
The trials followed postmenopausal women from around the world who had consumed either soy isoflavones or a non-isoflavone control for at least three months.
After assessing the risk of bias and quality of the evidence, the researchers concluded that consumption of soy isoflavones did not affect these four estrogen-related markers. Their findings support the idea that soy isoflavones behave differently from human estrogen, particularly when it comes to cancers that depend on estrogen to develop.
“We have estrogen receptors throughout our bodies but, contrary to the hormone estrogen, isoflavones from soy don’t bind to all the estrogen receptors equally,” says Viscardi, who is also a registered dietitian.
“That’s why we see a beneficial effect on the cardiovascular system and no effect on the female reproductive system.”
This difference in biological activity explains why soy isoflavones have been considered as a possible alternative to hormone replacement therapy (HRT), which is used to treat menopause symptoms by replacing the estrogen that the body stops producing during this period.
Chiavaroli, who is also an affiliate scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Unity Health Toronto, notes that some people do not want to take HRTs and are seeking alternative options.
Further, HRTs may also not be a good option for people at an increased risk of estrogen-sensitive cancers like breast cancer, as well as those with a history of heart disease and stroke. For these individuals, consuming soy foods as part of a balanced diet could help manage their menopausal symptoms while also reducing their risk for cardiovascular disease.
Chiavaroli says the study findings also align with Health Canada’s dietary guidelines that encourage people to choose plant-based proteins more often, a move that would also convey benefits for the environment.
“We hope our study will help people feel more comfortable including soy foods in their diet without being concerned that it’s going to increase their risk of estrogen-dependent cancer,” says Chiavaroli.
*Although menopause is sex-specific, we use the term women here to reflect the original study and the published trials it references. We recognize that some persons experiencing menopause may identify differently than with this gender.
This study was funded by the United Soybean Board (United States Department of Agriculture) and the Canadian Institutes of Health Research through the Canada-wide Human Nutrition Trialists’ Network.
Journal
Advances in Nutrition
Method of Research
Systematic review
Subject of Research
People
Article Title
Effect of Soy Isoflavones on Measures of Estrogenicity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Article Publication Date
27-Nov-2024
COI Statement
AZ is a part-time research associate at INQUIS Clinical Research Ltd, a contract research organization, and has received consulting fees from Glycemic Index Foundation. TAK has received research support from the Canadian Institutes of Health Research (CIHR), the International Life Science Institute (ILSI), and National Honey Board. He has been an invited speaker at the Calorie Control Council Annual meeting for which he has received an honorarium. He has received funding from the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. MM was employed by the Soy Nutrition Institute Global, an organization that receives funding from the United Soybean Board (USB) and from members involved in the soy industry. CWCK has received grants or research support from the Advanced Food Materials Network, Agriculture and Agri-Foods Canada (AAFC), Almond Board of California, Barilla, Canadian Institutes of Health Research (CIHR), Canola Council of Canada, International Nut and Dried Fruit Council, International Tree Nut Council Research and Education Foundation, Loblaw Brands Ltd, the Peanut Institute, Pulse Canada, and Unilever. He has received in-kind research support from the Almond Board of California, Barilla, California Walnut Commission, Kellogg Canada, Loblaw Companies, Nutrartis, Quaker (PepsiCo), the Peanut Institute, Primo, Unico, Unilever, and WhiteWave Foods/Danone. He has received travel support and/or honoraria from the Barilla, California Walnut Commission, Canola Council of Canada, General Mills, International Nut and Dried Fruit Council, International Pasta Organization, Lantmannen, Loblaw Brands Ltd., Nutrition Foundation of Italy, Oldways Preservation Trust, Paramount Farms, the Peanut Institute, Pulse Canada, Sun-Maid, Tate & Lyle, Unilever, and White Wave Foods/Danone. He has served on the scientific advisory board for the International Tree Nut Council, International Pasta Organization, McCormick Science Institute, and Oldways Preservation Trust. He is a founding member of the International Carbohydrate Quality Consortium (ICQC), Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD), is on the Clinical Practice Guidelines Expert Committee for Nutrition Therapy of the EASD, and is a Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. DJAJ has received research grants from Saskatchewan & Alberta Pulse Growers Associations, the Agricultural Bioproducts Innovation Program through the Pulse Research Network, the Advanced Foods and Material Network, Loblaw Companies Ltd., Unilever Canada and Netherlands, Barilla, the Almond Board of California, Agriculture and Agri-food Canada, Pulse Canada, Kellogg’s Company, Canada, Quaker Oats, Canada, Procter & Gamble Technical Centre Ltd., Bayer Consumer Care, Springfield, NJ, Pepsi/Quaker, International Nut & Dried Fruit Council (INC), Soy Foods Association of North America, the Coca-Cola Company (investigator initiated, unrestricted grant), Solae, Haine Celestial, the Sanitarium Company, Orafti, the International Tree Nut Council Nutrition Research and Education Foundation, the Peanut Institute, Soy Nutrition Institute (SNI), the Canola and Flax Councils of Canada, the Calorie Control Council, the Canadian Institutes of Health Research (CIHR), the Canada Foundation for Innovation (CFI), and the Ontario Research Fund (ORF). He has received in-kind supplies for trials as a research support from the Almond Board of California, Walnut Council of California, the Peanut Institute, Barilla, Unilever, Unico, Primo, Loblaw Companies, Quaker (Pepsico), Pristine Gourmet, Bunge Limited, Kellogg Canada, and WhiteWave Foods. He has been on the speaker’s panel, served on the scientific advisory board and/or received travel support and/or honoraria from Nutritional Fundamentals for Health (NFH)-Nutramedica, Saint Barnabas Medical Center, The University of Chicago, 2020 China Glycemic Index (GI) International Conference, Atlantic Pain Conference, Academy of Life Long Learning, the Almond Board of California, Canadian Agriculture Policy Institute, Loblaw Companies Ltd, the Griffin Hospital (for the development of the NuVal scoring system), the Coca-Cola Company, Epicure, Danone, Diet Quality Photo Navigation (DQPN), Better Therapeutics (FareWell), Verywell, True Health Initiative (THI), Heali AI Corp, Institute of Food Technologists (IFT), Soy Nutrition Institute (SNI), Herbalife Nutrition Institute (HNI), Saskatchewan & Alberta Pulse Growers Associations, Sanitarium Company, Orafti, the International Tree Nut Council Nutrition Research and Education Foundation, the Peanut Institute, Herbalife International, Pacific Health Laboratories, Barilla, Metagenics, Bayer Consumer Care, Unilever Canada and Netherlands, Solae, Kellogg, Quaker Oats, Procter & Gamble, Abbott Laboratories, Dean Foods, the California Strawberry Commission, Haine Celestial, PepsiCo, the Alpro Foundation, Pioneer Hi-Bred International, DuPont Nutrition and Health, Spherix Consulting and WhiteWave Foods, the Advanced Foods and Material Network, the Canola and Flax Councils of Canada, Agri-Culture and Agri-Food Canada, the Canadian Agri-Food Policy Institute, Pulse Canada, the Soy Foods Association of North America, the Nutrition Foundation of Italy (NFI), Nutra-Source Diagnostics, the McDougall Program, the Toronto Knowledge Translation Group (St. Michael's Hospital), the Canadian College of Naturopathic Medicine, The Hospital for Sick Children, the Canadian Nutrition Society (CNS), the American Society of Nutrition (ASN), Arizona State University, Paolo Sorbini Foundation, the Institute of Nutrition, Metabolism and Diabetes, the Lawson Centre Nutrition Digital Series, and the 19th Annual Stare-Hegsted Lecture. He received an honorarium from the United States Department of Agriculture to present the 2013 W.O. Atwater Memorial Lecture. He received the 2013 Award for Excellence in Research from the International Nut and Dried Fruit Council. He received funding and travel support from the Canadian Society of Endocrinology and Metabolism to produce mini cases for the Canadian Diabetes Association (CDA). He is a member of the International Carbohydrate Quality Consortium (ICQC). His wife, Alexandra L Jenkins, is a director and partner of INQUIS Clinical Research for the Food Industry, his 2 daughters, Wendy Jenkins and Amy Jenkins, have published a vegetarian book that promotes the use of the foods described here, The Portfolio Diet for Cardiovascular Risk Reduction (Academic Press/Elsevier 2020 ISBN:978-0-12-810510-8), and his sister, Caroline Brydson, received funding through a grant from the St. Michael’s Hospital Foundation to develop a cookbook for one of his studies. He is also a vegan. JLS has received research support from the Canadian Foundation for Innovation, Ontario Research Fund, Province of Ontario Ministry of Research and Innovation and Science, Canadian Institutes of health Research (CIHR), Diabetes Canada, American Society for Nutrition (ASN), International Nut and Dried Fruit Council (INC) Foundation, National Honey Board (U.S. Department of Agriculture [USDA] honey “Checkoff” program), Institute for the Advancement of Food and Nutrition Sciences (IAFNS; formerly ILSI North America), Pulse Canada, Quaker Oats Center of Excellence, The United Soybean Board (USDA soy “Checkoff” program), Protein Industries Canada (a Government of Canada Global Innovation Clusters), The Tate and Lyle Nutritional Research Fund at the University of Toronto, The Glycemic Control and Cardiovascular Disease in Type 2 Diabetes Fund at the University of Toronto (a fund established by the Alberta Pulse Growers), The Plant Protein Fund at the University of Toronto (a fund which has received contributions from IFF), and The Nutrition Trialists Network Research Fund at the University of Toronto (a fund which has received donations from the Calorie Control Council, Physicians Committee for Responsible Medicine, and vegan grants through the Karuna Foundation). He has received food donations to support randomized controlled trials from the Almond Board of California, California Walnut Commission, Peanut Institute, Barilla, Unilever/Upfield, Unico/Primo, Loblaw Companies, Quaker, Kellogg Canada, Danone, Nutrartis, Soylent, and Dairy Farmers of Canada. He has received travel support, speaker fees and/or honoraria from ASN, Danone, Dairy Farmers of Canada, FoodMinds LLC, Nestlé, Abbott, General Mills, Nutrition Communications, International Food Information Council (IFIC), Calorie Control Council, International Sweeteners Association, International Glutamate Technical Committee, Arab Beverages Association, and Phynova. He has or has had ad hoc consulting arrangements with Perkins Coie LLP, Tate & Lyle, Inquis Clinical Research, Ingredion, and Brightseed. He is a former member of the European Fruit Juice Association Scientific Expert Panel and a former member of the Soy Nutrition Institute (SNI) Scientific Advisory Committee. He is on the Clinical Practice Guidelines Expert Committees of Diabetes Canada, European Association for the study of Diabetes (EASD), Canadian Cardiovascular Society (CCS), and Obesity Canada/Canadian Association of Bariatric Physicians and Surgeons. He serves as an unpaid member of the Board of Trustees of IAFNS and formerly served as an unpaid scientific advisor for the Carbohydrates Committee of IAFNS. He is a Director at Large of the Canadian Nutrition Society (CNS), a founding member of the International Carbohydrate Quality Consortium (ICQC), an Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the EASD, and a director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. His spouse is an employee of AB InBev. LC has received research support from Protein Industries Canada (a Government of Canada Global Innovation Clusters), Alberta Pulse Growers, The United Soybean Board (USDA soy “Checkoff” program), and the Canadian Institutes of Health Research (CIHR). All other authors report no conflicts of interest to disclose.
Cervical cancer mortality among US women younger than age 25
JAMA Network
About The Study:
This study found a steep decline in cervical cancer mortality among U.S. women younger than 25 years between 2016 and 2021. This cohort of women is the first to be widely protected against cervical cancer by human papillomavirus (HPV) vaccines. The findings from this study in the context of other published research suggest that HPV vaccination affected the sequential decline in HPV infection prevalence, cervical cancer incidence, and cervical cancer mortality.
Corresponding Author: To contact the corresponding author, Ashish A. Deshmukh, PhD, MPH, email deshmukha@musc.edu.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jama.2024.22169)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
# # #
Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2024.22169?guestAccessKey=96c86a3c-4972-4bcc-8b6a-5957503cab01&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=112724
Journal
JAMA
Cervical cancer deaths in young women plummet after introduction of HPV vaccine
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Dr. Deshmukh is co-leader of the Cancer Prevention and Control Research Program at MUSC Hollings Cancer Center. His research focus is HPV-related cancers.
view moreCredit: MUSC Hollings Cancer Center
Cervical cancer deaths have plunged dramatically among women under age 25, and researchers at MUSC Hollings Cancer Center believe this is likely due to HPV vaccination.
Their study, published in JAMA, is the first to suggest the impact of HPV vaccination on cervical cancer deaths.
“We observed a substantial reduction in mortality – a 62% drop in cervical cancer deaths over the last decade, likely due to HPV vaccination,” said senior author Ashish Deshmukh, Ph.D., co-leader of the Cancer Prevention and Control Research Program at MUSC Hollings Cancer Center. “We cannot think of any other reason that would have contributed to such a marked decline.”
The human papillomavirus, or HPV, causes nearly all cases of cervical cancer. The HPV vaccine was introduced in 2006. At first, it was available only to adolescents, but eligibility has since been expanded to include adults up to age 45 in some cases.
Previous studies have looked at the rates of HPV infection, precancer and cervical cancer incidence since the introduction of the vaccine, and all of those indicators have declined. The next logical step was to look at death rates, Deshmukh said.
Although cervical cancer is rare in women under age 25, it does occur. By examining deaths in this age group, researchers were able to see the early impact of the vaccine. Women who were 25 in 2021, the final year included in this study, would have been 10 years old when the vaccine was introduced.
The researchers looked at cervical cancer deaths in three-year blocks of time. Through the 1990s, there were between 50 and 60 cervical cancer deaths nationally in women under the age of 25 in each three-year block of time. During the 2019-2021 time period, there were only 13 deaths.
However, the team sounded an alarm. Healthy People 2030 has a goal of reaching an 80% HPV vaccination rate, but the Centers for Disease Control and Prevention reported earlier this year that only about 60% of 13to 15 year olds have received the recommended doses.
“There has been a decline in HPV vaccination post COVID-19 in the most recent generation of U.S. adolescents. This is troubling as a decline in vaccination uptake would potentially lead to smaller gains,” Deshmukh said.
About MUSC Hollings Cancer Center
MUSC Hollings Cancer Center is South Carolina’s only National Cancer Institute-designated cancer center with the largest academic-based cancer research program in the state. With more than 150 faculty cancer scientists and 20 academic departments, it has an annual research funding portfolio of more than $50 million and sponsors more than 200 clinical trials across the state. Hollings offers state-of-the-art cancer screenings, diagnostic capabilities, therapies and surgical techniques within its multidisciplinary clinics to provide the full range of cancer care. Dedicated to preventing and reducing the cancer burden statewide, the Hollings Office of Community Outreach and Engagement works with community organizations to bring cancer education and prevention information to affected populations. For more information, visit hollingscancercenter.musc.edu
Journal
JAMA
Article Title
Cervical Cancer Mortality Among US Women Younger Than 25 Years, 1992-2021
Article Publication Date
27-Nov-2024
COI Statement
Dr. Sonawane reported receiving personal fees from Value Analytics Labs outside the submitted work. Dr. Deshmukh reported receiving consulting fees from Value Analytics Lab and Merck outside the submitted work. No other disclosures were reported.
Depression can cause period pain, new study suggests
Researchers identify potential genes linking depression to menstrual pain
Xi'an Jiaotong-Liverpool University
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A new study has identified a causal relationship between depression and dysmenorrhea using Mendelian randomisation to analyse both European and East Asian populations. Sleeplessness was identified as a potential mediator.
view moreCredit: Shuhe Liu, Zhen Wei, Daniel F. Carr John Moraros. https://doi.org/10.1093/bib/bbae589
Women are twice as likely as men to suffer from depression and often experience more severe physical symptoms. This gender difference is particularly evident during reproductive years and dramatically impacts the lives of hundreds of millions of people worldwide. However, although links between mental health and reproductive health have been found, the associations have remained underexplored.
In a new study published in Briefings in Bioinformatics, researchers from China and the UK have found that depression can increase the chances of a person experiencing menstrual pain (dysmenorrhea).
Shuhe Liu, lead author of the study and a PhD student at Xi'an Jiaotong-Liverpool-University (XJTLU), China, says: "We used a specialised technique called Mendelian randomisation to analyse genetic variation and identify specific genes that may mediate the effect of depression on menstrual pain.
"Our findings provide preliminary evidence that depression may be a cause, rather than a consequence, of dysmenorrhea as we did not find evidence that period pain increased the risk of depression."
The team analysed approximately 600,000 cases from European populations and 8,000 from East Asian populations and saw a strong link in both datasets. They also investigated the possibility that sleeplessness, often experienced by those suffering from depression, was a significant mediator between depression and dysmenorrhea.
"We found that increased sleep disturbances could exacerbate menstrual pain. Addressing sleep issues may therefore be crucial in managing both conditions. However, more research is required to understand the intricate links between these factors," says Liu.
Holistic approach
This study further highlights the need for a holistic approach when treating mental health and reproductive issues.
Liu says: "Mental disorders are often not considered when treating conditions such as period pain. Our findings emphasise the importance of mental health screening for people who suffer from severe menstrual pain. We hope this can lead to more personalised treatment options, and improved healthcare, and reduce the stigma surrounding the conditions.
"Our results provide evidence of a link between our neurological systems and the rest of the body. By exploring and understanding these relationships better, we can make a real difference to the millions of people experiencing period pain and mental health issues."
Liu is supervised by Professor John Moraros and Dr Zhen Wei from XJTLU, China and Dr Dan Carr from the University of Liverpool, UK.
Journal
Briefings in Bioinformatics
Method of Research
Case study
Subject of Research
People
Article Title
Deciphering the genetic interplay between depression and dysmenorrhea: a Mendelian randomization study
Article Publication Date
27-Nov-2024
Language used by mothers affects oxytocin levels of infants
University College London
Infants whose mothers regularly use language to describe what their child is thinking or feeling, have higher levels of the hormone oxytocin, finds a new study led by UCL researchers.
Oxytocin, a hormone that is involved in a range of psychological processes, plays an important role in social relationships, such as the development of the bond between a parent and child, and the formation of trust, and social understanding, across the lifespan.
For the research, published in Development and Psychopathology, 62 new mothers aged between 23 and 44 years old, and who had an infant between three and nine months old, were filmed interacting naturally with their baby for five minutes.
The researchers analysed the videos to see how well the mother accurately referred to her infant’s internal experience (e.g., their thoughts, feelings, desires and perceptions) during the interaction.
They also collected saliva samples from the infant and measured the level of the hormone oxytocin.
When the relationship between these two measures was analysed, the researchers found a positive correlation.
Lead author, Dr Kate Lindley Baron-Cohen (UCL Psychology & Language Sciences), said: “It has long been known that the hormone oxytocin is involved in intimate social relationships, including the attachment bond between a mother and her child. It is also known that how well a mother is attuned to her infant’s thoughts and feelings in the first year of life is a long-term predictor of the child’s social and emotional development. But the pathways underlying these effects have been unclear.
“We have, for the first time, discovered that the amount that a mother talks to their infant about their infant’s thoughts and feelings is directly correlated with their infant’s oxytocin levels. This suggests that oxytocin is involved in regulating children’s early social experience, and this is itself shaped by the way a parent interacts with their infant.”
For example, when a child demonstrates interest in a toy, a parent who displays understanding of their child’s internal state might say “Oh, you like this toy” or “You’re excited” and might imitate their child’s actions or facial expression. In this way the parent is mirroring the child’s internal experience, and the new results now reveal that this influences the infant’s oxytocin system as well.
The team also found that mothers who were experiencing postnatal depression referred less to their infant’s internal states than mothers who were not experiencing depression.
Dr Lindley Baron-Cohen said: “This study demonstrates a new psychobiological link between mothers and their infant, in which the mother’s emotionally sensitive speech is reflected in her infant’s hormone levels.
“This highlights the key role mothers play in their child’s early development, and indicates how mothers who are experiencing depression could be supported to facilitate their child’s social development.”
This research was funded by the National Institute for Health Research (NIRH) ARC North Thames, the Lord Leonard and Lady Estelle Wolfson Foundation, Wellcome Trust, the University of York, the Fund for Psychoanalytic Research through the American Psychoanalytic Association, the International Psychoanalytical Association, the Michael Samuel Charitable Trust, the Denman Charitable Trust, and the Galvani Foundation.
Journal
Development and Psychopathology
Article Title
Maternal mind-mindedness and infant oxytocin are interrelated and negatively associated with postnatal depression
Association of severe maternal morbidity with subsequent birth
JAMA Network
About The Study:
The findings of this study suggest that women who experience severe maternal morbidity in their first birth are less likely to have a subsequent birth. Adequate reproductive counseling and enhancing antenatal care are crucial for women with a history of severe maternal morbidity.
Corresponding Author: To contact the corresponding author, Eleni Tsamantioti, MD, MMedSc, email eleni.tsamantioti@ki.se.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jama.2024.20957)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
# # #
Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2024.20957?guestAccessKey=d104ece7-2c79-4a1c-ae18-3b23e049c6e6&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=112524
Women who suffer pregnancy complications have fewer children
Women who suffer severe complications during their first pregnancy or delivery are less inclined to have more babies, a study published in JAMA by researchers at Karolinska Institutet reports. Given the recent steady decline in birth rate in Sweden, the researchers propose monitoring in antenatal care to address the problem.
“The clinical monitoring of these women is essential, and they need individualised advice on possible future pregnancies,” says the study’s first author Eleni Tsamantioti, doctoral student at the Department of Medicine in Solna, Karolinska Institutet.
Birth rates and fertility have both been in steady decline in Sweden over the past years. In this new population-based study, the researchers have studied the association between severe maternal morbidity in first-time mothers and the likelihood of their having a second baby. The study comprised over a million women in Sweden who had their first baby between 1999 and 2021.
“We found that the likelihood of having more children was much lower in women who had experienced severe complications during their first pregnancy, delivery or postnatal period,” says the study’s last author Neda Razaz, associate professor at the same department. “Such events can often have a physical and mental impact on women for a long time to come.”
All in all, 3.5 per cent of the first-time mothers in the study suffered serious complications and were 12 per cent less likely to have a second baby. Most impacted were women who had experienced cardiac complications, a ruptured uterus or severe mental health problems, who were 50 per cent less likely to have another birth than women who had not experienced such complications.
Women who needed respiratory care or who suffered a cerebrovascular accident like stroke or intracranial haemorrhage were 40 per cent less likely to have a second baby. Acute kidney failure, severe preeclampsia and blood clotting were also associated with a lower probability of a second pregnancy. The researchers also compared the women with any sisters they had to control for familial factors.
“The reasons are hard to speculate on and may result from multiple factors, such as decreased desire for more children, trauma, infertility related to psychiatric medications, or lack of health counselling,” says Tsamantioti. “Proper support and monitoring by antenatal care staff is therefore essential for women who have suffered serious health problems during pregnancy or delivery.”
The study was financed by grants from the Swedish Heart-Lung Foundation, Region Stockholm, the ALF scheme and the Swedish Research Council. There are no reported conflicts of interest.
Publication: “Association of Severe Maternal Morbidity With Subsequent Birth”, Eleni Tsamantioti, Anna Sandström, Charlotte Lindblad Wollmann, Jonathan M Snowden, Neda Razaz, JAMA, online 25 November 2024, doi: 10.1001/jama.2024.20957.
Journal
JAMA
Article Title
Association of Severe Maternal Morbidity With Subsequent Birth
Article Publication Date
25-Nov-2024
Case Western Reserve University awarded $1.5 million to study vaginal bacterial linked to serious health risks
image:
Gina Lewin
view moreCredit: Case Western Reserve University
CLEVELAND—Bacterial vaginosis (BV), the most prevalent condition affecting the female reproductive system in women aged 15 to 44, is linked to such serious health risks as preterm birth, gynecological malignancies and sexually transmitted diseases.
But effective long-term treatments for BV are limited: More than half experience a recurrence within six months, according to several studies.
With a $1.5 million grant from the National Institutes of Health (NIH), researchers at the Case Western Reserve School of Medicine will study the dynamics of BV in hopes of identifying a more effective approach.
“We hope to gain insights into promoting health within the human microbiome and to find better ways to prevent and treat infections that involve multiple types of bacteria,” said Gina Lewin, assistant professor in the Department of Pathology at the School of Medicine. “This research is a promising step toward better treatments for BV and highlights Case Western Reserve’s commitment to advancing women’s health.”
BV, which causes pain, odor and discharge—in addition to possible serious health risks—occurs from an imbalance in vaginal bacteria.
Lewin and her team of microbial ecologists—also part of Case Western Reserve’s Center for Global Health and Diseases—will investigate the diversity of bacteria in the vaginal microbiome at a single-cell level. They will focus on the different strains of bacteria present and their individual behaviors.
Lewin’s approach will examine the genetic variations within thousands of bacterial cells from vaginal microbiome, which could lead to understanding how BV develops and why some women respond better to treatment than others. This aspect of the study will work with established patient groups in collaboration with researchers at the University of Manitoba, Canada.
In addition, researchers will examine how individual bacterial cells behave and interact with a host environment, using advanced sequencing technology.
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