Uro­cortin lev­els point to pre­ma­ture births

The Weekend Australian - Travel - - Health - Com­piled by Dr Chris­tine White

NINE months is a long time to wait for the birth of a baby, but if it hap­pens too early, the new­born’s health may be at risk. Now sci­en­tists have dis­cov­ered a re­li­able way to pre­dict whether a baby will be born pre­ma­turely, giv­ing doc­tors some ad­vance warn­ing. Pre­ma­ture birth is de­fined as birth be­fore 37 weeks of preg­nancy. Women can show signs of pre­ma­ture labour, in­clud­ing painful reg­u­lar con­trac­tions of the uterus and di­la­tion of the cervix, but go on to de­liver at term (af­ter 37 weeks). The study, in the cur­rent is­sue of the Jour­nalofClin­i­cal En­docrinol­o­gyandMetabolism , in­cluded 85 women ad­mit­ted to hospi­tal with signs of early labour be­tween 28 and 34 weeks of preg­nancy. They were each given a blood test for uro­cortin. Uro­cortin lev­els in those who gave birth pre­ma­turely were 38 per cent higher than those who went on to de­liver at term. The new blood test could be­come an im­por­tant tool in car­ing for women and ba­bies at risk of pre­ma­ture birth. J Clin En­docrinol Metab 2007;92:4734-4737 (Flo­rio P, et al) SMOK­ERS are at in­creased risk of de­vel­op­ing type 2 di­a­betes com­pared to non-smok­ers, con­cludes a new study in the Jour­nal of the Amer­i­can Med­i­cal As­so­ci­a­tion. Re­searchers com­bined the re­sults of 25 sep­a­rate stud­ies, pub­lished be­tween 1992 and 2006, in­volv­ing a to­tal of 1.2 mil­lion par­tic­i­pants. Over­all, there were 45,844 new cases of di­a­betes re­ported dur­ing the fol­low-up pe­ri­ods rang­ing from 5 to 30 years. Heavy smok­ers (20 or more cig­a­rettes per day) had a 61 per cent in­creased risk of de­vel­op­ing di­a­betes com­pared to non­smok­ers, and lighter smok­ers (less than 20 cig­a­rettes per day) had a 29 per cent in­creased risk. Even for­mer smok­ers had a 23 per cent in­creased risk com­pared to non-smok­ers. The study doesn’t prove that smok­ing causes di­a­betes, say the au­thors, as smok­ing of­ten goes hand-in-hand with other un­healthy habits such as lack of ex­er­cise, poor diet and high al­co­hol in­take. But the link is very strong, and pro­vides yet an­other rea­son to kick the habit. JAMA 2007;298:2654-2664 (Willi C, et al) HIGH blood pres­sure could lead to mild brain dam­age and dif­fi­cul­ties with think­ing and learn­ing, con­cludes re­search in the Archives of Neu­rol­ogy. The find­ings fur­ther high­light the im­por­tance of keep­ing blood pres­sure un­der con­trol. Mild brain dam­age— known as ‘‘ cog­ni­tive im­pair­ment’’ — can be an early warn­ing sign of Alzheimer’s dis­ease. Re­searchers stud­ied 918 adults aged 65 and older (av­er­age age 76.3) with no cog­ni­tive im­pair­ment. Ev­ery 18 months for nearly five years, par­tic­i­pants were in­ter­viewed and given health and brain func­tion tests. Dur­ing this time, 334 peo­ple de­vel­oped mild cog­ni­tive im­pair­ment, in­clud­ing me­mory, think­ing and learn­ing prob­lems. Hav­ing high blood pres­sure in­creased the risk of such brain dam­age by 40 per cent, sug­gest­ing that main­tain­ing nor­mal blood pres­sure could help to pro­tect the brain as we age. Arch Neu­rol 2007;64:1734-1740 (Reitz C, et al) BA­BIES de­liv­ered by elec­tive cae­sarean sec­tion have a four-fold greater risk of de­vel­op­ing breath­ing prob­lems com­pared to ba­bies born by vagi­nal de­liv­ery or emer­gency cae­sarean, ac­cord­ing to a study pub­lished on­line in the Bri­tishMed­i­calJour­nal this week. The find­ings sug­gest that labour may help to ma­ture the baby’s lungs, and sup­port the ar­gu­ment for re­duc­ing the num­ber of elec­tive cae­sare­ans per­formed. The study in­cluded 34,458 healthy ba­bies born in Den­mark be­tween 37 and 41 weeks of preg­nancy. In to­tal, 2687 in­fants were de­liv­ered by elec­tive cae­sarean sec­tion. Com­pared to ba­bies born by vagi­nal de­liv­ery or emer­gency cae­sarean at the same stage of preg­nancy, those born by elec­tive cae­sarean at 37 weeks of preg­nancy were four times more likely to de­velop breath­ing prob­lems. Those born by elec­tive cae­sarean at 38 and 39 weeks of preg­nancy had three-fold and dou­ble the risk, re­spec­tively. If cae­sarean de­liv­ery is cho­sen, say the au­thors, then it should be post­poned un­til af­ter 39 weeks of preg­nancy to limit the ef­fect on the baby’s lungs. BMJ 2007;doi:10.1136/bmj.39405.539282.BE (Hansen AK, et al) TESTOS­TERONE ther­apy could help older men to slow down the age­ing process, with new Aus­tralian re­search in the Jour­nalof Clin­i­calEn­docrinol­o­gyandMetabolism show­ing that the hor­mone can boost mus­cle and de­crease fat. Led by doc­tor Carolyn Al­lan and col­leagues at Prince Henry’s In­sti­tute in Melbourne, the study in­volved 60 healthy, non-obese men aged 55 and older with low testos­terone lev­els. They were ran­domly as­signed to use ei­ther testos­terone patches or in­ac­tive placebo patches for 12 months, and body com­po­si­tion was mea­sured at the be­gin­ning and end of the study. In the testos­terone group, blood lev­els of the hor­mone in­creased by an av­er­age of 30 per cent over 12 months, while testos­terone lev­els in the placebo group fell by 10 per cent. Com­pared to the placebo patches, testos­terone patches in­creased mus­cle size and de­creased ab­dom­i­nal fat, mak­ing the patches a promis­ing approach to low­er­ing the risks of di­a­betes and heart dis­ease in age­ing men. J Clin En­docrinol Metab 2007;doi:10.1210/jc.2007-1291 (Al­lan CA, et al) OVER-40s who can still climb stairs and carry the gro­ceries have a re­duced risk of stroke com­pared to those in worse phys­i­cal shape. A new study, pub­lished in the latest is­sue of Neu­rol­ogy, ex­am­ined 13,615 healthy men and women be­tween the ages of 40 and 79. Par­tic­i­pants were given a health check and sur­veyed about their phys­i­cal fit­ness, in­clud­ing their abil­ity to climb stairs, carry gro­ceries, kneel, bend and lift. Over the next 7.5 years, there were 244 strokes. Peo­ple who scored in the top 25 per cent on the phys­i­cal func­tion test had a 50 per cent lower risk of stroke than those with the low­est test scores, re­gard­less of other health and lifestyle fac­tors. Ac­cord­ing to the au­thors, fit­ness test­ing could iden­tify those at an in­creased risk of stroke who may ben­e­fit the most from pre­ven­ta­tive treat­ments. Neu­rol­ogy 2007;69:2243-2248 (Myint PK, et al) Want to know more? Items are ref­er­enced where pos­si­ble. A ref­er­ence such as ‘‘ 2007;35:18-25’’ means the source ar­ti­cle was pub­lished on pages 18-25 in vol­ume num­ber 35 of the pub­li­ca­tion, in 2007. A doi num­ber or web­site ad­dress is used for re­search pub­lished on a jour­nal’s web­site.

Blood pres­sure: Too high and it can lead to mild brain dam­age

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