Women's Health Watch
JANUARY 13, 2011
Expectant Moms Keep Smoking a Secret
Women who smoke during pregnancy often deny the habit, according to a survey conducted by the Centers for Disease Control and Prevention (CDC). The findings suggest that as many as 1 in 4 pregnant women who smoke choose not to tell their health care providers.
Lead investigator Patricia Dietz, DrPH, of the CDC’s division of reproductive health, said the findings cast doubt on current estimates of the smoking rate among pregnant women.
Writing in the December 22 online issue of the American Journal of Epidemiology, researchers reported that 13% of pregnant women were active smokers, smoking an average of 11 cigarettes per day. When completing a health questionnaire about their smoking habits, 23% failed to answer truthfully.
To identify the fibbers, researchers followed the questionnaire with a blood test for cotinine—a metabolite of nicotine that reveals exposure to tobacco smoke. Because women’s bodies metabolize cotinine faster, the test was imperfect, the researchers noted.
Both age and socioeconomic status helped determine how likely women were to divulge their habit. Pregnant smokers aged 20 to 24 years and those receiving Medicaid or other government-provided health insurance were among those most likely to hide their habit.
The report underscores the need for targeted smoking cessation counseling by pharmacists, particularly among this patient population.
High Doses of Fertility Drugs Boost Odds for Obese Women
New research confirms that higher doses of fertility drugs can help obese women who are struggling to conceive. Among women with higher BMIs, increasing the dose of ovulation-stimulating drugs yields a success rate comparable to that of normal-weight women, researchers found.
In a report in the journal Fertility and Sterility, lead author Irene Souter, MD, of Massachussetts General Hospital in Boston, wrote that increasing drug doses largely cancels out the negative impact obesity can have on a woman’s chances. In her study of 477 normal, overweight, and obese women, conception rates were similar across all weight classes.
Among those included in the study, 25% of normal, 37% of overweight, and 36% of obese women conceived after receiving fertility treatments. Higher doses of fertility drugs “bring the chances of conceiving close to that of a normal woman, and you’ve got a good chance of a live birth,” Dr. Souter told Reuters Health.
Cost is a barrier, however—obese women can expect to pay approximately $200 more for fertility treatment. Although women should be encouraged to reach a healthy weight before trying to conceive, the results offer hope for obese women whose past attempts have been unsuccessful. PT
Excess Red Meat Raises Women’s Stroke Risk
Women at risk for stroke should consider cutting back on red meat, based on the findings of a large Swedish study. Researchers found that women who ate at least 3.6 ounces of red meat per day were 42% more likely to experience a stroke than those who ate less than an ounce per day. Eating large amounts of processed meat also increased women’s risk.
The study, led by Susanna Larsson, PhD, of Stockholm’s Karolinska Institutet, examined red meat consumption in 34,670 women aged 39 to 73 years. During an average follow-up of 10 years, Dr. Larsson and colleagues identified 1680 cases of stroke. The team divided women into 5 groups according to their selfreported totals of processed meat and red meat consumption.
Both processed and red meats raised risk of cerebral infarction, but not other types of stroke. Women in the top tenth for red meat consumption had the highest risk of cerebral infarction; those in the top fifth had a 22% higher risk than those in the bottom fifth. Among women who ate the most processed meat, risk was 24% higher.
“Findings from this study suggest that red and processed meat consumption may increase the risk of cerebral infarction in women,” the authors concluded. Their results appeared in the December 16 online issue of Stroke, a journal published by the American Heart Association.
Fast Fact: Babies born to women who smoke during pregnancy are 30% more likely to be born prematurely, have higher odds of being underweight, and are 1 to 3 times more likely to die of Sudden Infant Death Syndrome.
Treatment of Melanoma
In this Pharmacy Times program for Health Systems Pharmacists, Nanaz Amini, PharmD, RPh, MS, of the Angles Clinic, provides a pharmacist’s perspective on the management of melanoma.