Women’s News: Antidepressants And Pregnancy: SSRIs Do Not Up Risk Of Infant Death, Study Says

Women’s News: Antidepressants And Pregnancy: SSRIs Do Not Up Risk Of Infant Death, Study Says

Women’s Health: A New Year’s Resolution for our Nation’s Leaders: Prioritize Women’s Health

Women’s Health: A New Year’s Resolution for our Nation’s Leaders: Prioritize Women’s Health

A Message From The Creator

A Message From The Creator

A Message From The Creator

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Women’s Health: A New Year’s Resolution for our Nation’s Leaders: Prioritize Women’s Health

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Paula A. Johnson, MD, MPH

Executive Director of the Connors Center for Women’s Health and Gender Biology and Chief of the Division of Women’s Health, Brigham and Women’s Hospital

The new year is upon us and new year’s resolutions abound. But what of our nation’s leaders? What will they pledge to change in 2013? How about a new year’s resolution to listen to the voters and pledge to focus on women’s health in its totality? In the New Year a record number of women will be sworn in as United States senators setting the stage for a renewed focus on women’s issues, including women’s health. On Election Day, women voters spoke loud and clear to give President Barack Obama a second term. While pundits and politicos might attribute this significant ten-point gender gap to abortion politics, a deeper look at women voters’ sentiments unveils a different story. Women want a comprehensive view of women’s health, including preventive care and women’s health research to be a policy priority.

For far too long, the view of women’s health has been limited and has been more a political football than a serious policy discussion. And that political discussion has centered on abortion, critically important but not representative of all of women’s health. Voters, and in particular women voters, have a much more comprehensive vision of women’s overall health and wellness across the lifespan. In fact, findings from Lake Research Partners’ national survey of general election voters indicate that 60 percent of women voters and over half (53 percent) of all voters want women’s health, including access to preventive services for all women and more women’s health research, to be a top or high priority for the next President.1 Policymakers would be wise to take heed: voters want women’s health to be more than a political wedge issue; they want it to be a policy priority.

Who are the 53 percent who place such a high priority on women’s health? The answer might surprise you. They encompass a broad spectrum of our electorate with conflicting viewpoints and diverse demographics including nearly one in three (30 percent) who are anti-choice on the issue of abortion. Nearly half (46 percent) of men and two-thirds of Black and African American men polled place a high priority on women’s health as did voters surveyed from diverse political ideologies including: a majority (77 percent) of Democrats, nearly half (48 percent) of Independents, one in four (27 percent) Republicans and nearly one-third (31 percent) of Americans who voted for Romney.

Unfortunately, while voters recognize women’s health is an important priority for our nation, many of our government leaders do not. Women’s health research is woefully underfunded andlikely to experience further cuts. We as a nation also lack specific commitments to stratify and routinely report health care data by sex, severely impeding our ability to evaluate health care outcomes for women. These realities make it highly unlikely that the United States can comprehensively evaluate health reform’s impact on women, 51 percent of the population.

As for women’s preventive health services, without a specific plan of action, the necessary monitoring and evaluation of the historic preventive services provision available to women without cost-sharing under the ACA will never happen. This is a particularly sobering thought given that this provision has the potential to save lives and improve the quality of life for millions of women by preventing chronic diseases, including diabetes, arthritis, and cardiovascular disease. For those concerned about the added cost of such a plan, consider the fact that the epidemic of chronic disease in women costs our health care system an estimated $466 billion in direct costs each year.

At this historic moment, when the promise of health care reform stretches before us and the foundation of our new health care system continues to take shape, integrating women’s health in all aspects of reform will pay enormous dividends for our nation’s health care system over time. Results from the 2012 election indicate that the American public understands the importance and immediacy of women’s health as a policy issue. Will our leaders listen? Can they really afford not to?

1Lake Research Partners. Banners from a Nationwide Phone Survey of 1220 Registered, Likely 2012 General Election Voters. November 4-6, 2012.

Read More:  http://www.huffingtonpost.com/paula-a-johnson-md-mph/womens-health-care_b_2404279.html?utm_hp_ref=womens-health

 

Women’s News: Antidepressants And Pregnancy: SSRIs Do Not Up Risk Of Infant Death, Study Says

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Catherine Pearson

Catherine.Pearson@huffingtonpost.com

Taking the most popular type of antidepressants during pregnancy does not increase the risk of stillbirth or newborn death, according to the latest sweeping study in a string of investigations probing the safety of pregnant women taking the drugs.

Researchers analyzed data from more than 1.6 million women in Nordic countries, including nearly 30,000 women who had filled a prescription for a selective serotonin reuptake inhibitor (SSRI) while pregnant.

Women who took an SSRI did have higher rates of stillbirth and infant death than those who did not. “However,” study co-author Dr. Olof Stephansson, a clinical epidemiologist with Karolinska University Hospital in Sweden told HuffPost, “this was because of an increased proportion of smokers, older [maternal] age, diabetes and hypertensive disease.”

“The risk increase,” he explained, “was attributed to [those] factors and not the medication.”

The data used in the study was obtained from prescription registries in Denmark, Finland, Iceland, Norway and Sweden, as well as from patient and birth registries in those countries. The findings were published in the Journal of the American Medical Association this week and funded, in part, by the Swedish Pharmacy Company.

“This data is some of the best in the world [for] doing population-based research,” said Dr. Katherine Moore, an assistant professor of psychiatry with the Mayo Clinic, who did not work on the study. “It integrates data from multiple sources: out-patient and in-patient, pharmacy records. This study offers additional evidence supporting the safety of SSRI use in pregnancy.”

A 2009 joint report from the American College of Obstetricians and Gynecologistsand American Psychiatric Association found that up to 23 percent of women have at least one depressive episode while pregnant. Women with mild symptoms should consider not using SSRIs during pregnancy, that report recommended, but women with severe depression should continue taking medication as untreated severe depression carries potential risks for both mom and baby.

But not all recent research supports the safety of SSRIs during pregnancy. A widely covered study published in November in the journal Human Reproduction found that pregnant women who take SSRIs may have a greater risk of pregnancy complications, including birth defects, preterm birth and miscarriage.

Dr. Adam Urato, chairman of obstetrics and gynecology at MetroWest Medical Center in Massachusetts and an author on that study, expressed some concerns about the latest research.

“The [JAMA] study looked at information on dispensed drugs, not ingested drugs and these numbers are often quite different,” he said in an email to The Huffington Post. “When exposure information is inexact … the result is often that we do not find evidence of harm from a drug,” Urato added.

A woman might get misclassified as taking an SSRI and having a good outcome, but actually belonged in the ‘not taking an SSRI’ group, he said.

Though the authors of the new study found no significant link between SSRI use during pregnancy and risk of stillbirth or newborn death, they stressed that decisions about treatment options must take into account other possible outcomes.

“Previous studies have found an increased risk for congenital cardiac malformations for Paroxetine [known by trade names like Paxil] and a modest risk increase for persistent pulmonary hypertension among newborns,” Stephansson said.

“This is the most individualized medicine we can do,” agreed Moore. “These risk-benefit discussions are so crucial for each patient and their partner — if a partner’s involved.”

“For mild symptoms, we should absolutely consider non-pharmacologic treatments first, to avoid any risk to the fetus,” she said. “But when medication is suggested by moderate to severe symptoms of depression, providers and patients can feel confident about the safety of [SSRIs].”

When patients have moderate to severe symptoms, however, “providers and patients can feel confident about the safety of [SSRIs],” said Moore.

Read More:  http://www.huffingtonpost.com/2013/01/03/antidepressants-pregnancy-ssri_n_2403280.html?utm_hp_ref=women&ir=Women

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