3 Steps to Lower a Woman's Risk of Premature Birth

TUESDAY, Aug. 30, 2016 (HealthDay News) -- Up to one-quarter of preterm births might be prevented if women paid attention to three risk factors that are under their control, new research suggests.

Those factors include spacing pregnancies well, beginning at a healthy weight and gaining the recommended amount during the pregnancy, the researchers found.

"These are all risk factors for a really serious health outcome -- preterm birth," said study co-author Dr. Emily DeFranco. She is a researcher at the Center for Prevention of Preterm Birth at Cincinnati Children's Hospital.

Babies born before 37 weeks' gestation are considered preterm. Being born early puts babies at risk for breathing, heart, gastrointestinal and developmental problems, among other issues.

In the United States, the overall rate of preterm birth is 11.4 percent -- more than twice as high as that in several other developed countries, the researchers said.

Experts have identified many risk factors for preterm birth, so DeFranco's team looked at some that are manageable to see what role they might play.

The investigators used records of nearly 400,000 births between 2006 and 2011 to examine the three risk factors. None were multiple births.

More than 90 percent of the women had at least one of the three risk factors, the study findings showed.

Only 6 percent had none, providing what researchers called an "ideal" comparison group. Their pregnancies were well spaced, their weight was healthy at the start and the mothers gained no more, or less, than recommended during pregnancy.

These "ideal" women had a preterm birth rate of 7.6 percent, according to DeFranco, who is also an associate professor of maternal-fetal medicine at the University of Cincinnati College of Medicine.

Women who had less than a year between pregnancies as well as those who gained too little weight during pregnancy had higher rates of preterm births, the study authors said.

The highest rate of preterm births -- at 25 percent, more than triple that of the ideal group -- occurred among women who were underweight when they got pregnant, had shorter gaps between pregnancies and inadequate weight gain during pregnancy, the researchers reported.

Women who are underweight are advised to gain 28 to 40 pounds during pregnancy, while normal weight women should aim for 25 to 35 pounds, according to Institute of Medicine recommendations. Overweight women should gain 15 to 25 pounds, and those who are obese should only gain 11 to 20 pounds.

A body mass index (BMI) between 18.5 and 24.9 is considered a healthy weight. BMI is an estimate of body fat based on height and weight.

"You have some control over your risk of a preterm birth," DeFranco said, urging women to pay attention to the factors they can adjust. Other risks are not changeable. For instance, black women are more likely to have preterm births, as are women who have had a previous one and those who conceive through in vitro fertilization, the researchers said.

Dr. David Mendez, a neonatologist at Nicklaus Children's Hospital in Miami, reviewed the study. He pointed out that the findings build on some things that doctors have suspected.

"It does appear to show that the uterus needs some recovery time, and the mom needs to be at a healthy weight to have the best outcome," he said. Paying attention to the recommended weight gain is also important, he added.

For women who are trying to conceive, Mendez said, the message seems to be to try to get to a healthy weight ahead of time.

The findings were published online recently in the Maternal and Child Health Journal.

SOURCES: Emily DeFranco, D.O., associate professor, maternal-fetal medicine, University of Cincinnati College of Medicine, and researcher, Center for Prevention of Preterm Birth, Cincinnati Children's Hospital; David Mendez, M.D., neonatologist, Nicklaus Children's Hospital, Miami; Aug. 3, 2016, Maternal and Child Health Journal, online

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3 Steps to Lower a Woman's Risk of Premature Birth

Ebola May Be Present in Semen for Year or More

TUESDAY, Aug. 30, 2016 (HealthDay News) -- Ebola virus stays present in semen longer than previously thought, and is more likely to be found in older men, researchers report.

The deadly virus can be transmitted through semen.

Preliminary findings from 429 male Ebola survivors taking part in a national screening program in the African nation of Liberia showed that 9 percent (38) had fragments of Ebola in their semen.

Of those 38 men, 63 percent tested positive for Ebola in their semen a year after recovering from the disease. One man's semen still had evidence of Ebola at least 565 days after he recovered from the illness, the study found.

Men older than 40 were more likely to have Ebola fragments in their semen than younger men, the study authors said.

Along with testing semen for Ebola, the Men's Health Screening Program (MHSP) in Liberia provides counseling and education about safe sex, and led to a significant increase in the number of men reporting condom use or abstinence. Nearly 75 percent of men who at the start of the study said they had sex without condoms later said they used condoms during sex.

"This program provides important insights into how long Ebola remains in semen, a key component to preventing flare-ups of the disease and protecting survivors and their loved ones," Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, said in an agency news release.

"It also shows how investments in public health capacity can save lives," he added.

The CDC collaborates with the Liberian Ministry of Health to operate the Men's Health Screening Program, which is open to male Ebola survivors ages 15 and older. They have their semen tested monthly. Those who have two consecutive tests showing no sign of Ebola no longer get tested.

"Before this outbreak, scientists believed that Ebola virus could be found in semen for three months after recovery. With this study, we now know that virus may persist for a year or longer," said Dr. Moses Soka, coordinator of Ebola Virus Disease Survivor Clinical Care at the Liberian Ministry of Health.

"We now have many more Ebola survivors than ever before. This work demonstrates the importance of providing laboratory testing and behavioral counseling to empower survivors to make informed decisions to protect their intimate partners," Soka said.

The study was published Aug. 30 in the The Lancet Global Health journal.

The Ebola epidemic in West Africa that began in March 2014 was a human tragedy of terrible proportion, leaving more than 11,000 dead.

The epidemic, now over, occurred in Guinea, Liberia and Sierra Leone.

SOURCE: U.S. Centers for Disease Control and Prevention, news release, Aug. 30, 2016

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Heart Attack Before 50 Ups Early Death Risk

TUESDAY, Aug. 30, 2016 (HealthDay News) -- The risk of early death after a heart attack has lessened over the past 30 years among those younger than 50. But it's still nearly twice as high as the general public, Danish researchers report.

This higher risk is driven mainly by conditions such as high blood pressure, diabetes and obesity, which are more common among people who've had a heart attack, said lead researcher Dr. Morten Schmidt.

"Patients with a heart attack in young age should be advised that an excess risk of fatal events persists, warranting compliance to their prescribed medicine and efforts to reduce modifiable lifestyle-related risk factors, particularly smoking," said Schmidt, a researcher at Aarhus University Hospital in Denmark.

Schmidt's team looked at long-term survival of nearly 22,000 Danes who'd had a heart attack before age 50. The patients were followed for roughly 11 years, and compared with almost 217,000 people in the general population.

The researchers found some good news. Between 1980-1989 and 2000-2009, premature deaths within the first 30 days after a heart attack dropped from 13 percent to 3 percent. Deaths from 31 days to one year fell from about 5 percent to 1.6 percent, while deaths from one to 10 years after a heart attack declined from 24 percent to 9 percent.

"About half of the decline in deaths from heart attacks since 1980 is due to prevention, in particular reductions in the number of people who smoke," Schmidt said.

The other half is likely due to a combination of factors, such as early treatment to restore blood flow to the damaged part of the heart, improved hospital care and better management of high blood pressure and high cholesterol, he said.

However, some bad news emerged from the report, too. Within the first year after a heart attack, the overall risk of death was nearly two times higher compared to the general population. Women were three times more likely to die if they'd had a heart attack compared with those who hadn't, and men had twice the risk.

The reason for this gender difference is not known, Schmidt said.

Overall, more people who had a heart attack before 50 had more risk factors for heart disease than the general public, the researchers said.

For instance, 12 percent of heart attack patients suffered from intermittent chest pain (angina); 11 percent had high blood pressure; 7 percent were diabetic, and almost 5 percent were obese. These conditions affected only about 1 percent or less of the general population, according to the report.

Among the under-50 patients, more than eight out of 10 who'd had a heart attack were between 40 and 49. Only 2 percent were under 30, the researchers found.

The results were published online Aug 30 in the journal Circulation.

"It is well-established that individuals who have a heart attack at a younger age, even if surviving the initial episode, remain at higher risk for long-term mortality compared to those who have not had a prior heart attack," said Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles.

These findings highlight why a focus on heart heath and primary prevention of heart attack is essential among people of all ages, said Fonarow, a spokesman for the American Heart Association.

"This can be accomplished by maintaining healthy blood pressure, cholesterol levels and weight, along with not smoking and remaining physically active," he said.

SOURCES: Morten Schmidt, M.D., Ph.D., researcher, Aarhus University Hospital, Denmark; Gregg Fonarow, M.D., spokesman, American Heart Association, and professor, cardiology, University of California, Los Angeles; Aug. 30, 2016, Circulation, online

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Just Spraying Adult Mosquitoes Won't Curb Zika

MONDAY, Aug. 29, 2016 (HealthDay News) -- Female mosquitoes can transmit the Zika virus to their eggs and offspring, and this may make it harder to contain outbreaks, a new lab study suggests.

Control programs that focus only on adult mosquitoes may not halt Zika's spread, the researchers warned.

The researchers injected laboratory-grown Aedes aegypti mosquitoes, which spread the virus, with Zika and tracked its spread to their offspring.

"The implications for viral control are clear," said study co-author Dr. Robert Tesh, of the University of Texas Medical Branch in Galveston.

"Spraying affects adults, but it does not usually kill the immature forms -- the eggs and larvae," said Tesh. As a result, "spraying will reduce transmission, but it may not eliminate the virus."

Based on their findings, the study authors say larvicide should become an integral part of efforts to stop the spread of the virus.

"Since Zika virus has emerged as a global health emergency, most research has focused on the virus and its effects on humans. There is far less research on the virus in its mosquito host," Tesh said.

"But if you want to control Zika, you also have to know about the behavior of this virus in mosquitoes," he added.

Zika virus can cause severe brain damage in newborns whose mothers were infected during pregnancy. While mosquito bites are the main source of transmission, experts say the virus can also be spread sexually.

The study was published online Aug. 29 in the American Journal of Tropical Medicine and Hygiene.

SOURCE: American Journal of Tropical Medicine and Hygiene, news release, Aug. 29, 2016

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Heart Birth Defects Dropped After Folic Acid Was Added to Food

MONDAY, Aug. 29, 2016 (HealthDay News) -- The introduction of folic acid-fortified foods in Canada was associated with a decrease in babies being born with heart defects, a new study found.

Researchers reviewed data from nearly 6 million births in Canada. The births occurred between 1990 and 2011. Folic acid food fortification became mandatory for all types of flour, enriched pasta and cornmeal in 1998 in Canada.

During the study period, there was an 11 percent decline in rates of congenital heart defects overall. But decreases weren't seen in all types of heart defects present at birth.

The biggest declines -- between 15 percent and 27 percent -- were in structural defects of the heart, such as holes in the wall of the heart or a narrowing of the major artery (the aorta) that carries blood to the body from the heart, the investigators found.

But, there was no reduction in heart defects at birth caused by an abnormality in the number of an infant's chromosomes, the findings showed.

An estimated 650,000 to 1.3 million children and adults in the United States have congenital heart disease, the researchers said. A hole in the wall of one of the heart's ventricles is the most common type of defect in children. These defects account for nearly 620,000 of the cases, the researchers added.

Folic acid deficiency during pregnancy can cause a number of complications. These include anemia and neural tube defects (such as spina bifida, an abnormality of the spine and spinal cord), the researchers explained.

Women who are likely to get pregnant should start taking folic acid supplements before conceiving because they may not get enough folic acid from their diet alone, said study senior author Dr. K.S. Joseph. He's a professor of obstetrics and gynecology at the University of British Columbia in Vancouver.

Joseph added that the study findings likely apply to the U.S. population as well. That's because the United States began fortifying foods with folic acid around the same time as Canada, he said.

Although the study found an association between folic acid food fortification and a decline in certain heart-related birth defects, it did not prove a cause-and-effect relationship.

The study was published Aug. 29 in the journal Circulation.

SOURCE: Circulation, news release, Aug. 29, 2016

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Study: Trained Experts Can Spot Breast Cancer in 'Blink of An Eye'

MONDAY, Aug. 29, 2016 (HealthDay News) -- Trained radiologists can identify abnormal mammograms in a half-second, a new study says.

The experiments by American and British researchers confirm anecdotes about experienced radiologists' ability to quickly determine when a breast X-ray is suspicious.

While radiologists would never spend only a half-second to assess a real mammogram, these results suggest there are detectable signs of breast cancer that radiologists notice immediately, the study authors said.

"Radiologists can have 'hunches' after a first look at a mammogram. We found that these hunches are based on something real in the images," study senior author Jeremy Wolfe said. "It's really striking that in the blink of an eye, an expert can pick up on something about that mammogram that indicates abnormality."

Wolfe heads the Visual Attention Laboratory at Brigham and Women's Hospital and is a professor of ophthalmology and radiology at Harvard Medical School, both in Boston.

"Not only that, but they can detect something abnormal in the other breast, the breast that does not contain a lesion," he added in a hospital news release.

The study findings were published Aug. 29 in the Proceedings of the National Academy of Sciences.

"These results suggest that there may be something in the nominally normal breast that looks abnormal and is detectable," Wolfe said. "Together, these results suggest that radiologists may be picking up on some sort of early, global signal of abnormality that is unknown to us at this point."

Defining that signal could lead to development of better imaging tools and improved medical training, he said.

SOURCE: Brigham and Women's Hospital, news release, Aug. 29, 2016

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Study: Trained Experts Can Spot Breast Cancer in 'Blink of An Eye'