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Low-dose aspirin may reduce risk for pre-term birth in first-time mothers

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Jan. 23 (UPI) — First-time mothers may be able to reduce their risk for delivering pre-term by taking low-dose aspirin, a new study by researchers at the Eunice Kennedy Shriver National Institute of Child Health and Human Development has found.

In results published Thursday in the Lancet, researchers report that daily low-dose aspirin, taken starting as early as the sixth week of pregnancy through the 36th week, may lower the risk for pre-term birth among first-time mothers.

Overall, the clinical trial, which included more than 11,000 women in several low- and middle-income countries, determined that women taking daily low-dose aspirin were 11 percent less likely to deliver before the 37th week of pregnancy, compared to those given a placebo.

“Our results suggest that low-dose aspirin therapy in early pregnancy could provide an inexpensive way to lower the preterm birth rate in first-time mothers,” study co-author Marion Koso-Thomas, of NICHD’s Pregnancy and Perinatology Branch, said in a statement.

According to NICHD, pre-term birth is the most common cause of infant death and the leading cause of long-term neurological disability in children. While advances in newborn care have improved survival for babies born prematurely, care is often limited or unavailable in many parts of the world, researchers say.

Previous studies have suggested low-dose aspirin could reduce risk for pre-eclampsia, a potentially life-threatening blood pressure disorder that occurs during pregnancy, but researchers say the studies were too small too draw firm conclusions from.

The NICHD study enrolled 11,976 first-time mothers from seven sites in India, Pakistan, Zambia, Democratic Republic of the Congo, Guatemala and Kenya. Roughly half were assigned at random to receive 81 milligrams of aspirin daily; the rest were given a daily placebo.

Women remained in the study only if they maintained a pregnancy for more than 20 weeks.

In all, pre-term birth — delivery prior to week 37 — occurred in 11.6 percent of the women who took aspirin and in 13.1 percent of the women who took the placebo. Similarly, birth prior to week 34 occurred in 3.3 percent of the aspirin group compared to 4 percent of the placebo group.

Women in the aspirin group also had a lower rate of perinatal mortality — stillbirth or newborn death in the first seven days of life — compared to the placebo group. The risk for high blood pressure disorders of pregnancy at term did not differ significantly between the groups, researchers reported.



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Probiotics may help ease depression, study shows

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Probiotic supplements might help ease depression symptoms in some people, a new research review suggests.

Researchers found that across seven small clinical trials, various probiotics seemed to improve symptoms in patients with clinical depression — at least in the short term.

The studies build on a growing research interest in the role of gut health — specifically, the balance of bacteria dwelling there — and brain health.

But experts stressed that the probiotic trials had a number of limitations, and it’s too soon to draw any conclusions.

For one, a “placebo effect” cannot be ruled out, according to Sanjay Noonan, the lead author on the research review.

And, he said, besides being small, the trials did not look at the longer term: All lasted about two to three months.

According to Noonan, “no definitive statements can be made” on whether people with depression stand to benefit from probiotics.

“It would be conjecture to try and suggest anything about the long-term efficacy of probiotic therapy,” he said.

Noonan and his colleagues at Brighton and Sussex Medical School in England reported the findings July 6 in the journal BMJ Nutrition, Prevention & Health.

Probiotics are live bacteria and yeast that naturally dwell in the body. Probiotic supplements are marketed as a way to restore a healthier balance of good bacteria.

The digestive system, in particular, hosts a vast array of bacteria and other microbes — known as the “gut microbiome.” And those organisms are believed to do more than just aid in digestion.

Research suggests the microbes are involved in everything from immune defenses to producing vitamins, anti-inflammatory compounds, and even chemicals that influence the brain.

Meanwhile, a number of studies have linked the makeup of the gut microbiome to the risks of various health conditions. These include brain-based conditions like Alzheimer’s and autoimmune diseases like type 1 diabetes and rheumatoid arthritis.

In a 2019 study, researchers found that people with depression showed differences in specific gut bacteria, versus those without depression. Levels of two types of bacteria — Coprococcus and Dialister — were reported to be “consistently depleted” in people with depression.

But none of that proves a lack of those bacteria, or any others, actually helps cause depression. And for now, no one knows if any probiotics can help treat it.

“It’s important to stress that this area of research is in an extremely early phase,” Noonan said.

He said the point of this review was to look at the existing evidence on probiotics, and not to offer answers.

The trials in the review each contained fewer than 100 people. And they most often tested any of three probiotic strains: L. acidophilus, L. casaei and B. bifidum. One trial tested a probiotic combined with a “prebiotic” — compounds that promote the growth of probiotics.

On average, the review found, study patients’ depression symptoms improved over two to three months. Some trials, however, did not include a comparison group that took inactive supplements, to help account for the placebo effect. (That’s the phenomenon in which people feel better simply because they are receiving treatment and believe it will work.)

Another issue is the trials give no clues on which bacterial strains might be helpful, according to John Cryan, a professor at University College Cork in Ireland.

“There is a tendency in the field to ‘lump’ all commercially available strains into the same category independent of the level of evidence there is,” Cryan told the nonprofit Science Media Centre.

But, he added, “we know that strains really matter, and this review is not able to identify what it is about specific strains that render them with beneficial effects.”

Kevin Whelan, a professor at King’s College London, made similar points. “Probiotics often contain different strains of bacteria, and we do not know if the supplements, sachets and fermented milks you find on supermarket shelves will work,” he told SMC.

Whelan also stressed that most patients in the trials were taking antidepressants.

“So it is crucial that probiotics are seen as complementary to standard treatments recommended by your doctor,” he said, “and not as an alternative.”

More information

The U.S. National Center for Complementary and Integrative Health has more on probiotics.

Copyright 2020 HealthDay. All rights reserved.



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Many COVID-19 hot spots affect areas around state borders, experts say

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July 8 (UPI) — Many current COVID-19 hotspots across the country are in areas along state borders because different governments have taken different approaches to contain spread of the new coronavirus, the experts behind the U.S. COVID Atlas said Wednesday.

This includes regions in Arkansas and Tennessee, as well as Louisiana and Mississippi, which are effectively separated by the Mississippi River, they said.

Parts of southern Arizona and California have also been similarly impacted, according to the researchers.

“With a patchwork of policies across the country, it’s not surprising to see hot spots along state borders,” Marynia Kolak, a member of the team that developed the atlas, said during a conference call with reporters Wednesday that was hosted by the Robert Wood Johnson Foundation.

In some states, “there have been a lot of mixed messages” from officials, said Kolak, who is assistant director for health informatics at the University of Chicago’s Center for Spatial Data Science.

As a result, the new coronavirus has spread even in areas of states with strict social distancing and mask-wearing measures because they border on states that have taken a less stringent approach, Kolak said.

Kolak and her colleagues developed the U.S. COVID Atlas in March, and the tool has been tracking confirmed cases of the virus across the country since.

This week, they added new “county-level data” for the pandemic that developed out of a partnership with County Health Rankings and Roadmaps, which tracks health and socioeconomic trends for all U.S. counties, she said.

With the new data, the atlas doesn’t necessarily identify counties at risk of an outbreak, but rather those that might be particularly vulnerable should one occur.

This could be due to high levels of poverty, poor overall health and lack of healthcare infrastructure, said Marjory Givens, deputy director of County Health Rankings and Roadmaps.

The county-level data highlights “underlying health inequities,” Givens said.

That includes differences in life expectancy and prevalence of conditions such as diabetes, heart disease and excessive drug and alcohol use, all of which have been linked with increase risk for severe illness and death from COVID-19, Givens said.

Even before the coronavirus pandemic, life expectancy varied across the United States by up to 40 years because of differences in overall health and access to healthcare services, said Givens, who also is associate director of the University of Wisconsin Population Health Institute.

The pandemic has served to underscore many of these differences in “Native American and segregated urban communities,” as well as in the so-called “Black Belt,” or poor, rural communities in the south with populations that have a majority of black people, Givens said.

The U.S. COVID Atlas is a free, open-source tool that is updated daily. In addition to historical data on the pandemic, it includes resources for local governments as they plan outbreak responses or take steps to improve overall health in the local communities, Kolak said.

With the new data from County Health Rankings & Roadmaps, the atlas “provides a more detailed landscape of the disease,” with information “previously hidden” by the focus on the national impact of the pandemic and its effects in large metropolitan areas, said Kolak, who worked on a similar tool for opioid epidemic.

“COVID-19 is a national story with a local experience and each hot spot has its own story,” she said.



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2 in 3 parents would send kids to school in the fall, survey finds

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About two-thirds of U.S. parents say they’ll send their kids to school again this fall, and most also support COVID-19 testing and social distancing policies for schoolchildren, a new survey finds.

Among parents, only about 12 percent said they would not send at least one of their kids to school, while 21 percent were still uncertain about their decision. Many are waiting to hear more about their schools’ plans.

Many parents said they had no choice but to send their children to school because they had to work.

For many families, a surge in COVID-19 cases would make them reconsider sending children to school, the survey found.

Most did support measures to safeguard kids against the new coronavirus.

Those measures could include fewer children on buses, daily temperature screening, alternating classroom and online learning, testing school staff and requiring staff and older kids to wear masks, researchers report.

For the report, researchers from the Susan B. Meister Child Health Evaluation and Research Center at the University of Michigan, Ann Arbor, surveyed nearly 1,200 parents in Michigan, Ohio and Illinois in June.

“Families are facing a challenging decision regarding whether to send their children to school for in-person classes in the middle of the COVID-19 pandemic,” said researcher Dr. Kao-Ping Chua, a pediatrician at Michigan Medicine C.S. Mott Children’s Hospital.

“On the one hand, sending children to school could increase the risk of COVID-19 among children and family members. On the other hand, children who don’t return to in-person school may experience disruptions in their education,” Chua said. “Some families simply don’t have a choice because they need to go to work.”

According to the survey, 75 percent of parents supported daily temperature checks and testing of kids if one tested positive for COVID-19.

Over 60% supported limiting the number of kids on buses, alternating between in-person and virtual classes, staggering arrival and pick-up times, and random weekly COVID-19 testing for staff.

Half supported random weekly COVID-19 testing of kids and having children eat meals in classrooms, not in cafeterias.

Most parents supported face masks for staff and middle and high school students, but not for younger children, especially kindergarten through second grade.

There wasn’t much support for closing playgrounds and halting all extracurricular activities.

“Preferences for the number and types of measures vary among parents,” Chua said in a university news release. “But they broadly agree with the notion that schools should take steps to keep children as safe as possible.”

More information

For more on COVID-19 and schools, head to the U.S. Centers for Disease Control and Prevention.

Copyright 2020 HealthDay. All rights reserved.



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