Journal round up: caesareans, contraceptives & vitamin D

3 minute read


Here's TMR's picks from the leading medical journals over the past fortnight


 

Here’s TMR’s pick from the leading medical journals over the past fortnight:

Caesareans lift obesity

Children delivered via caesarian are more likely to pile on the kilograms during adolescence and early adulthood than their siblings born via vaginal delivery.

In a 16-year study of 22,068 children, caesarian delivery increased the risk of obesity by 15% compared with vaginal birth.

Within families, caesarian-born children had 64% higher odds of reaching an unhealthy weight than their vaginal-born brothers and sisters.

Study participants completed questionnaires from ages nine to 14 through to ages 20 to 28. The risks of obesity for children delivered via caesarian persisted into early adulthood.

Exposure to gastrointestinal microbiota at birth could explain these differences, the authors suggested.

Caesareans account for nearly one-third of all births in Australia, according to 2015 WHO statistics.

JAMA Pediatrics, online 6 September

OCP is ovarian cancer hero

The 12% drop in ovarian cancer in Australia is largely thanks to oral contraceptives, an international analysis shows.

Rates of ovarian cancer have been falling across the world since 2002, and are predicted to continue to decline until 2020, according to the analysis of 28 countries’ data since 1970.

Between 2002 and 2012, the Australian death rate decreased from 4.84 to 4.27

Australia and New Zealand also had the lowest rates of ovarian cancer in young people, and globally the biggest falls were in this younger and middle-aged group. A reduction in HRT and improved diagnosis and treatment might also play a part, the authors wrote.

Ann Oncol; online 6 September 

Fans may harm elderly

Elderly patients under heatwave conditions show increased thermal and cardiac strain when exposed to electric fans, a US study has found.

Nine patients, aged 68 on average, were subjected to a constant temperature of 42C and relative humidity of 30%, raised gradually to 70%. But whereas using fans elevates sweat loss in young adults, it resulted in a greater heart rate and core temperature in the older patients.

The study suggests prolonged use of fans could be detrimental for elderly adults during heatwaves due to their diminished sweating capacity.

JAMA; online 6 September

Asthma and vitamin D

Lowering the risk of severe asthma attacks might be as simple as adding vitamin D to standard treatments, a Cochrane review has found.

The review found that vitamin D supplements halved the risk of hospitalisation or ED attendance due to severe acute asthma attacks from 6% to around 3%.

The results were based on seven double blind, randomised, placebo-controlled trials involving people with mild to moderate asthma.

The authors cautioned that the review did not include children or people with severe asthma and it was not clear whether vitamin D was effective for all patients or just those with low vitamin D levels.

Cochrane DB Syst Rev, online 5 September

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