Releases Saturday 16 August 2003
No 7411 Volume 327
Please remember to credit the BMJ as source when publicising
an
article and to tell your readers that they can read its full text on
the
journal's web site (http://bmj.com).
If your story is posted on a website please include a link back to
the source BMJ article (URL's are given under titles).
(1) TAKING PAINKILLERS DURING PREGNANCY
INCREASES RISK OF MISCARRIAGE
(2) TWINS
HAVE LOWER RISK OF SUICIDE THAN
GENERAL POPULATION
(3) SICKNESS
RECORDS CAN PREDICT
EMPLOYEE DEATHS
(4) JURY
STILL OUT OVER RISKS OF HEADING A
SOCCER BALL
(1) TAKING PAINKILLERS
DURING PREGNANCY
INCREASES RISK OF MISCARRIAGE
(Exposure to non-steroidal anti-inflammatory
drugs
during pregnancy and risk of miscarriage:
population
based cohort study)
http://bmj.com/cgi/content/full/327/7411/368
Women who take non-steroidal anti-inflammatory
drugs
(NSAIDs) or aspirin during pregnancy increase
their risk
of miscarriage by 80 per cent, finds a
study in this
week's BMJ.
Researchers in California interviewed 1,055
pregnant
women immediately after their pregnancy
was confirmed.
They asked the women about their drug
use since they
became pregnant, their reproductive history,
known or
potential risk factors for miscarriage,
and
sociodemographic characteristics.
They found that use of NSAIDs during pregnancy
increased the risk of miscarriage by 80%.
The risk was
much higher when NSAIDs were taken around
conception or were used for longer than
a week. Taking
account of other factors, including drinking
alcohol or
coffee, did not change the results.
Aspirin was similarly associated with an
increased risk of
miscarriage but paracetamol was not, regardless
of
timing and duration of use.
All three drugs work by suppressing the
production of
prostaglandins (fatty acids needed for
successful
implantation of an embryo in the womb).
Because
NSAIDs and aspirin act on the whole body,
they could
lead to abnormal implantation that predisposes
an
embryo to miscarriage. In contrast, paracetamol
acts
only in the central nervous system, which
may explain
why it has no effect on risk of miscarriage,
explain the
authors.
These findings will need confirmation,
say the authors.
Meanwhile, it may be prudent for physicians
and women
who are planning to be pregnant to be
aware of this
potential risk and avoid using NSAIDs
around
conception.
Contact:
Laura Marshall, Kaiser Permanente Media
Relations,
Oakland, California, USA
Email: laura.h.marshall{at}kp.org
(2) TWINS HAVE
LOWER RISK OF SUICIDE THAN
GENERAL POPULATION
(Risk of suicide in twins: 51 year
follow up study)
http://bmj.com/cgi/content/full/327/7411/373
Twins have a lower risk of suicide compared
with the
general population, concludes a study
in this week's
BMJ.
Researchers in Denmark identified 21,653
same sex
twins born from 1870 to 1930 and established
date and
cause of death from 1943 to 1993. They
compared
suicide rates with the general population.
Twins (both men and women) had a substantially
lower
suicide rate compared with the general
population. This
supports the view that strong family ties
reduce the risk
for suicidal behaviour, say the authors.
The strongest risk factor for suicide is
mental illness, and
other studies have found mental illness
to be slightly more
common among twins than among singletons.
"This
should lead to a higher proportion of
twins committing
suicide compared with the general population,
but our
findings show exactly the opposite, further
underscoring
the importance of strong family ties,"
they conclude.
Contact:
Professor Kaare Christensen, Danish Twin
Registry,
Institute of Public Health, University
of Southern
Denmark, Odense, Denmark
Email: kchristensen{at}health.sdu.dk
(3) SICKNESS RECORDS
CAN PREDICT
EMPLOYEE DEATHS
(Sickness absence as a global measure
of health:
evidence from mortality in the Whitehall
II prospective
cohort study)
http://bmj.com/cgi/content/full/327/7411/364
Employees who take long spells of sick
leave more than
once in two years are at a higher risk
of death than their
colleagues with no such absence, conclude
researchers
in this week's BMJ.
They obtained sickness absence records
for 6,895 male
and 3,413 female civil servants until
the end of 1989 and
analysed associations with death until
1999.
Deaths increased as the medically certified
absence rates
(spells of more than 7 days) increased.
Men and women
who had more than five medically certified
absences
over 10 years had a death rate two to
five times greater
than those with no such absence.
In contrast to medically certified absences,
the
researchers found no significant association
between self
certified absences and death. However,
their findings
suggest that, compared with no absence,
taking a few
absences decreases rather than increases
the risk of
death because short-term absences may
represent
healthy coping behaviours.
Medically certified sickness absences may
well capture
the full array of illnesses employees
experience during
their job contract, say the authors. These
routinely
collected data could be used as a global
measure of
health differentials between employees.
Contact:
Professor Mika Kivimaki, Finnish Institute
of
Occupational Health, Helsinki, Finland
Email: mika.kivimaki{at}ttl.fi
(4) JURY STILL
OUT OVER RISKS OF HEADING A
SOCCER BALL
(Editorial: Brain injury and heading
in soccer)
http://bmj.com/cgi/content/full/327/7411/351
Heading the ball in soccer is unlikely
to cause brain injury
but head to head collisions might, says
a leading sports
physician in this week's BMJ.
Concern was first raised following the
case of Jeff Astle,
a former England player, whose death was
described as
an "industrial disease" suggesting that
repeated heading
of soccer balls during his professional
career was the
cause of his neurological decline.
Heading a soccer ball results in head accelerations
of
less than 10g whereas the minimum values
for the
development of sport-related concussion
are 40-60g,
writes Dr Paul McCrory. In contrast, head
to head
contact can generate enough of the forces
required to
cause brain injury as in any conventional
head injury.
This has led for calls for the use of protective
headgear
for soccer players, but research has found
that
commercially available soft helmets have
only a limited
protective role in this setting.
It seems unlikely that subconcussive impacts
such as
seen in head to ball contact will cause
chronic
neurological injury, he says. Although
head to head
contact may cause concussive injury, it
is both
uncommon and unlikely to result in cumulative
brain
injury.
Most head to head contact is inadvertent,
and coaching
techniques and visual perception training
may help in a
few cases but is unlikely to eliminate
this problem
entirely. Soft shell helmets or head protectors
currently
do not have the capability to prevent
concussive trauma
and hence cannot be recommended, he concludes.
Contact:
Paul McCrory, Research Fellow, Centre for
Sports
Medicine Research and Education, Brain
Reseaerch
Institute, University of Melbourne, Victoria,
Australia
Email: pmccrory{at}compuserve.com
FOR ACCREDITED JOURNALISTS
Embargoed press releases and articles are available from:
Public Affairs Division
BMA House
Tavistock Square
London WC1H 9JR
(contact: pressoffice{at}bma.org.uk)
and from:
the EurekAlert website, run by the American
Association for the
Advancement of Science
(http://www.eurekalert.org)
What's new
Keep updated
Services
Tools
Online poll
Resources
Print issues
