A study looks at the efficacy of aspirin in reducing preterm preeclampsia. Plus: The CDC reports on antidepressant use in the United States. Also, a look at whether vaginal estrogen postmenopause increases the risk of heart disease and certain types of cancer.
Low-dose aspirin may be beneficial for women who are at high risk of developing preterm preeclampsia, according to results of a multicenter, double-blind trial published in The New England Journal of Medicine.
Researchers randomly assigned 1776 women with singleton pregnancies who were at high risk of preterm preeclampsia to receive either a daily dose of 150 mg of aspirin or a placebo from 11 to 14 weeks of gestation until 36 weeks of gestation. The study’s primary outcome was delivery with preeclampsia before reaching 37 weeks of gestation. During the trial, 152 women withdrew their consent and 4 women were lost during the study’s follow-up, leaving 822 women in the placebo group and 798 women in the aspirin group.
Preterm preeclampsia occurred in 13 women from the aspirin group and 35 in the placebo group (odds ratio in the aspirin group, 0.38; 95% confidence interval, 0.20 to 0.74; P = 0.004). Adherence was found to be good with reported intake of over 85% or more of the required tablets in 79.9% of the participants. No significant difference was seen between the groups in the incidence of neonatal adverse outcomes or other adverse outcomes.
The researchers concluded that treating women at high risk for preterm preeclampsia with low-dose aspirin resulted in lower rates of diagnosis of the condition.
CDC report: Antidepressant use increasing
A new report by the Centers for Disease Control and Prevention (CDC) shows that antidepressant use in the United States increased nearly 65% over a 15-year period and that women were more likely than men to take the drugs. The findings, published in a National Center for Health Statistics (NCHS) data brief, are based on an analysis of data from the National Health and Nutrition Examination Survey (NHANES).
More than 14,000 individuals aged 12 and older were represented in NHANES, which is a continuous assessment of the health and nutrition of the American people. The survey sample is designed to be nationally representative of the US civilian noninstitutionalized population. The report on antidepressants looked at participants from the NHANES 2011 to 2014 household interview alone and compared to data from 1999 to 2002.
Between 2011 and 2014, women were about twice as likely as men to have taken antidepressants, at all time points and across all age groups. Looking at antidepressant use over the last month, researchers found that overall, 16.5% of women had taken the drugs versus 8.6% of men.
The pattern also held true when the researchers looked at race. In every race and Hispanic-origin group, women were more likely than men to have taken antidepressants in the past month. Non-Hispanic white women were also more likely to have taken the drugs than women of any other race or Hispanic-origin group.
In terms of length of antidepressant use, there were no statistically significant differences between women and men. Overall, 68% of those aged 12 and over who took antidepressants had been on the medication for at least 2 years. Moreover, of those taking these drugs, between 2011 and 2014, 27.2% of women and 21.4% of men had been using antidepressants for at least 10 years.
Does vaginal estrogen increase risk of heart disease and some cancers?
Results of a new study in Menopause appear to indicate that postmenopausal women who use vaginal estrogen are not at increased risk of cancer and various other diseases like coronary heart disease (CHD), stroke, and deep vein thrombosis.
The researchers used data from participants in the Women’s Health Initiative Observational Study, which recruited from 40 US clinical centers. The women studied were aged 50 to 79 years at baseline and did not use systemic estrogen therapy during follow-up (n = 45,663, median follow-up 7.2 years). The authors collected data on CHD, invasive breast cancer, stroke, pulmonary embolism, hip fracture, colorectal cancer, endometrial cancer, death, and self-reported use of vaginal estrogen (cream, tablet). Adjustment for covariates was done with Cox proportional-hazards regression models.
Among women who had an intact uterus, risks of colorectal cancer, endometrial cancer, pulmonary embolism/deep vein thrombosis, and invasive breast cancer were not significantly different for use or nonuse of vaginal estrogen. Risks of CHD, all-cause mortality, global index events (GIEs), and fracture were lower among women who used vaginal estrogen than among the nonusers (GIE adjusted hazard ratio 0.68, 95% confidence interval 0.55-0.86). In women who had undergone hysterectomy, the risk of each GIE component and overall GIE showed no significant difference between users and nonusers (GIE adjusted hazard ratio 0.94, 95% confidence interval 0.70-1.26).
The investigators concluded that risks of cardiovascular disease and certain cancers were not increased in postmenopausal women who use vaginal estrogen.