Sunday, February 11, 2007


Nitroglycerin - the explosive chemical in dynamite - can significantly improve the health of babies born prematurely, finds a new study in the American Journal of Obstetrics and Gynecology. The chemical, given as a skin patch to women in premature labour, was able to improve the outcome for babies with fewer side effects for the mother than other drugs. Babies born before 37 weeks of pregnancy are at high risk of death or disability, so women who go into premature labour are given drugs to prolong the pregnancy. But until now, none has been shown to improve the outcome for babies.

The study involved 153 Canadian women who had gone into premature labour between 24 and 32 weeks of pregnancy. They were randomly assigned to receive either a nitroglycerin patch or an inactive placebo patch, and their babies were monitored for any illnesses after birth. Compared to the placebo, women with the nitroglycerin patch had half the risk of delivering their babies before 28 weeks of pregnancy, and gave birth to healthier babies. However, the nitroglycerin patches caused more side effects for the mother - most commonly headache and skin irritation - than the placebo.


Journal abstract from here or here reproduced below:

Randomized double-blind placebo-controlled trial of transdermal nitroglycerin for preterm labor

By Graeme N. Smith et al.


Despite advances in perinatal medicine, the incidence of preterm birth continues to increase. The primary goal of tocolytic therapy is to reduce neonatal morbidity and mortality. While studies have demonstrated a prolongation of pregnancy, no tocolytic has been shown to improve neonatal outcomes. The objective of this randomized placebo-controlled trial was to determine the effect of transdermal nitroglycerin on neonatal outcomes in women who present in preterm labor.

Study design

We randomized 153 women in labor between 24 and 32 weeks to receive either transdermal nitroglycerin or placebo patches. The primary outcome was a composite of neonatal morbidity (chronic lung disease, intraventricular hemorrhage, periventricular leukomalacia, necrotizing enterocolitis) and mortality. Secondary outcomes included birth within 48 hours, birth before 28, 34, and 37 weeks, number of doses of antenatal corticosteroids received, side effects, and adverse events.


Infants born to transdermal nitroglycerin treated mothers (n = 74) had a statistically significantly reduced composite outcome compared to placebo treated mothers (n = 79) (relative risk 0.29 [95% confidence interval 0.08, 1.00] [p = 0.048]; risk difference ?0.10 [95% confidence interval ?0.19, ?0.01); number needed to treat 10 [95% confidence interval 5, 100]). Birth prior to 28 weeks was reduced (relative risk 0.50, 95% confidence interval 0.23, 1.09). Transdermal nitroglycerin caused significantly more maternal side effects (relative risk 1.41, 95% confidence interval 1.06, 1.86).


Transdermal nitroglycerin may reduce neonatal morbidity and mortality as a result of decreased risk of birth before 28 weeks.


Its role in preventing neural tube defects is of course already known

Folate supplements taken during early pregnancy can reduce the baby's risk of the facial birth defects known as cleft lip and palate by more than one third, concludes a study in the latest issue of the British Medical Journal.

Folate (or folic acid) is a B vitamin found in green leafy vegetables, citrus fruits, beans and whole grains, and the recommended daily intake for adults is 400 micrograms (mcg). Taking extra folate before and during pregnancy is known to reduce the risk of the birth defect spina bifida.

Researchers studied 377 babies with cleft lip and/or palate, 196 babies with cleft palate alone and 763 babies with no facial defects. Mothers were surveyed to determine their intake of folate and other vitamins from both diet and supplements. Taking folate supplements of at least 400mcg per day reduced the chances of cleft lip (with or without cleft palate) by 39 per cent. Women with folate-rich diets who also took folate supplements had the lowest risk of having a baby with a cleft lip.


Journal abstract below

Folic acid supplements and risk of facial clefts: national population based case-control study

By Allen J Wilcox et al.

Objective: To explore the role of folic acid supplements, dietary folates, and multivitamins in the prevention of facial clefts.

Design: National population based case-control study.

Setting: Infants born 1996-2001 in Norway.

Participants: 377 infants with cleft lip with or without cleft palate; 196 infants with cleft palate alone; 763 controls.

Main outcome measures: Association of facial clefts with maternal intake of folic acid supplements, multivitamins, and folates in diet.

Results: Folic acid supplementation during early pregnancy was associated with a reduced risk of isolated cleft lip with or without cleft palate after adjustment for multivitamins, smoking, and other potential confounding factors (adjusted odds ratio 0.61, 95% confidence interval 0.39 to 0.96). Independent of supplements, diets rich in fruits, vegetables, and other high folate containing foods reduced the risk somewhat (adjusted odds ratio 0.75, 0.50 to 1.11). The lowest risk of cleft lip was among women with folate rich diets who also took folic acid supplements and multivitamins (0.36, 0.17 to 0.77). Folic acid provided no protection against cleft palate alone (1.07, 0.56 to 2.03).

Conclusions: Folic acid supplements during early pregnancy seem to reduce the risk of isolated cleft lip (with or without cleft palate) by about a third. Other vitamins and dietary factors may provide additional benefit.


Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

Trans fats:

For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.


No comments: