Maternal Supplementation With Multiple Micronutrients Does Not Reduce Infant Mortality

CHICAGO -- December 23, 2014 -- In Bangladesh, daily maternal supplementation of multiple micronutrients, compared with iron-folic acid before and after childbirth, did not reduce all-cause infant mortality to age 6 months, but did result in significant reductions in preterm birth and low birth weight, according to a study published in the December 24/31 issue of JAMA.

Multiple micronutrient deficiencies are common among pregnant women in resource-poor regions of the world, especially in southern Asia. Co-existing with poor maternal nutrition across the region are excessive burdens of low birth weight (LBW), preterm birth, small size for gestational age, stillbirth, infant mortality, and maternal mortality. Gestational micronutrient deficiencies may contribute to avertable adverse birth outcomes.
Data for effects of antenatal multiple micronutrients supplementation on longer-term infant mortality are sparse for guiding policies in southern Asia, according to Keith P. West, MD, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and colleagues conducted a study in which pregnant women in Bangladesh (n = 44,567) were randomised to receive supplements containing 15 micronutrients or iron-folic acid alone, taken daily from early pregnancy to 12 weeks postpartum.
Among the 22,405 pregnancies in the multiple micronutrient group and the 22,162 pregnancies in the iron-folic acid group, there were 14,374 and 14,142 live-born infants, respectively, included in the analysis.
At 6 months, multiple micronutrients did not significantly reduce infant mortality; there were 764 deaths (54.0 per 1,000 live births) in the iron-folic acid group and 741 deaths (51.6 per 1,000 live births) in the multiple micronutrient group.
Multiple micronutrient supplementation resulted in a non-statistically significant reduction in stillbirths (43.1 vs 48.2 per 1,000 births) and significant reductions in preterm births (18.6 vs 21.8 per 100 live births) and low birth weight (40.2 vs 45.7 per 100 live births).
“Our study’s null finding is in agreement with a small number of trials that have provided an antenatal multiple micronutrient vs iron supplement, with or without folic acid, and found no effect on neonatal mortality,” the authors wrote. “Reasons for a null effect on postnatal survival after improvement in some birth outcomes with antenatal multiple micronutrient supplement use remains unknown, but may reflect a complex interplay between maternal and newborn sizes and differential responses to supplementation by causes of death.
”SOURCE: JAMA"December 23, 2014

Ondansetron, Tramadol Drug Interaction Identified

                In the early postoperative period, ondansetron is associated with increased requirements for tramadol consumption, according to a review and meta-analysis published online December 10 in Anaesthesia.
A.J. Stevens, from Flinders University in Bedford Park, Australia, and colleagues conducted a systematic review and meta-analysis to examine the presence of a drug interaction between tramadol and ondansetron that reduces the efficacy of tramadol. The authors reviewed data from six studies involving 340 participants. The studies compared the cumulative dose of tramadol administered by patient-controlled analgesia within the first 24 hours after surgery between subjects receiving tramadol alone and those receiving tramadol with ondansetron.
The researchers found that patients receiving ondansetron had an increased requirement for tramadol. At four, eight, 12, and 24 hours postoperatively, the standardized mean difference in tramadol, expressed in terms of standard deviations, was 1.03 (P<0 .001="" 0.66="" i="">P

=0.03), 0.86 (P<0 .001="" 0.45="" and="" i="">P=0.046), respectively. Over the 24 hours there was a significant linear time effect, indicating that the impact of ondansetron on tramadol consumption decreased over time. "The results support the presence of a drug interaction between tramadol and ondansetron in the early postoperative period that potentially decreases the effectiveness of tramadol," the authors write
                                                                Read More  (HealthDay News)

Elecsys® preeclampsia test from Roche

       Results of the PROGNOSIS^1,2 study presented at the 20th World Congress on Controversies in Obstetrics, Gynecology & Infertility in Paris, demonstrate the prognostic value of the Elecsys® preeclampsia test from Roche to predict the absence of preeclampsia for one week and the development of preeclampsia within the subsequent four weeks.

      The test result enables healthcare professionals to avoid unnecessary hospitalizations by reliably ruling out preeclampsia for one week and to improve outcome for mother and child by ruling in preeclampsia allowing optimized prenatal care.

       Preeclampsia is defined by hypertension associated with an increased amount of protein in the urine (proteinuria).^3,4.5 Other clinical symptoms of preeclampsia can include severe headache, sudden swelling of face, hands and feet and pain in the upper abdomen. However, both hypertension and proteinuria are poor in predicting the clinical onset of the disease and its progression.⁶

         The Elecsys preeclampsia test measures two proteins sFlt-1 (soluble fms-like tyrosine kinase-1) and PlGF (placental growth factor) in maternal blood. Depending on the test result, which is reflected as a ratio of the two proteins, physicians can reliably exclude or predict the development the disease short-term⁷, confidently focus on those women at high risk of preeclampsia.

- See more at: http://www.selectscience.net/product-news/roches-preeclampsia-test-helps-to-predict-this-life-threatening-condition-in-pregnant-women-at-risk/?artID=35800#sthash.oYpQJsdP.dpuf

1) in full: Prediction of short-term outcome in pregnant women with suspected preeclampsia study
2) Hund, M., et al. (2014). BMC Pregnancy and Childbirth 14, 324.

1) in full: Prediction of short-term outcome in pregnant women with suspected preeclampsia study
2) Hund, M., et al. (2014). BMC Pregnancy and Childbirth 14, 324. - See more at: http://www.selectscience.net/product-news/roches-preeclampsia-test-helps-to-predict-this-life-threatening-condition-in-pregnant-women-at-risk/?artID=35800#sthash.oYpQJsdP.dpuf

1) in full: Prediction of short-term outcome in pregnant women with suspected preeclampsia study
2) Hund, M., et al. (2014). BMC Pregnancy and Childbirth 14, 324. - See more at: http://www.selectscience.net/product-news/roches-preeclampsia-test-helps-to-predict-this-life-threatening-condition-in-pregnant-women-at-risk/?artID=35800#sthash.oYpQJsdP.dpuf

Results of the PROGNOSIS^1,2 study presented at the 20th World Congress on Controversies in Obstetrics, Gynecology & Infertility in Paris, demonstrate the prognostic value of the Elecsys® preeclampsia test from Roche to predict the absence of preeclampsia for one week and the development of preeclampsia within the subsequent four weeks.

The test result enables healthcare professionals to avoid unnecessary hospitalizations by reliably ruling out preeclampsia for one week and to improve outcome for mother and child by ruling in preeclampsia allowing optimized prenatal care.

Preeclampsia is defined by hypertension associated with an increased amount of protein in the urine (proteinuria).^3,4.5 Other clinical symptoms of preeclampsia can include severe headache, sudden swelling of face, hands and feet and pain in the upper abdomen. However, both hypertension and proteinuria are poor in predicting the clinical onset of the disease and its progression.⁶

The Elecsys preeclampsia test measures two proteins sFlt-1 (soluble fms-like tyrosine kinase-1) and PlGF (placental growth factor) in maternal blood. Depending on the test result, which is reflected as a ratio of the two proteins, physicians can reliably exclude or predict the development the disease short-term⁷, confidently focus on those women at high risk of preeclampsia.

“Results from the PROGNOSIS study mark a significant step forward in the prediction of preeclampsia,” said Prof Harald Zeisler, Department of Obstetrics and Gynecology at Medical University Vienna, Austria. “The Elecsys preeclampsia test allows physicians to predict the short term absence and manifestation of preeclampsia. Its application in clinical practice has the potential to reduce fetal and maternal morbidity and mortality as well as to avoid unnecessary hospitalizations.”

Preeclampsia occurs in approximately 1 in 20 pregnancies and is the second most common cause of maternal death.⁸ The disease can be life-threatening for mother and baby, especially if diagnosed late, and is an indication for immediate preterm delivery when acute. The majority of cases develop in healthy women bearing their first child. Medical conditions such as chronic hypertension, diabetes and renal disease are associated with an increased risk of developing preeclampsia.

“We are pleased to introduce a new and reliable approach to predicting which woman at risk will develop preeclampsia within short-term, making a true diffence to the management of this serious condition”, said Roland Diggelmann, COO of Roche Diagnostics. “The new data allows us to set new standard in prenatal care, avoid unnecessary hospitalization and anxiety for the mother and her family. This is yet another testament to our commitment in women’s health.”

References
1) in full: Prediction of short-term outcome in pregnant women with suspected preeclampsia study
2) Hund, M., et al. (2014). BMC Pregnancy and Childbirth 14, 324.
3) National Institute for Health and Clinical Excellence (NICE) (2011). Hypertension in pregnancy. NICE clinical guideline 107, London: RCOG Press.
4) ACOG Task Force on Hypertension in Pregnancy (2013). Hypertension in Pregnancy. Obstet Gynecol. 122, 1122-1131.
5) DGGG (2014). Diagnostik und Therapie hypertensiver Schwangerschaftserkrankungen. [http://www.awmf.org/uploads/tx_szleitlinien/015018l_S1_Diagnostik_Therapie_hypertensiver_
Schwangerschaftserkrankungen_2014-01.pdf]
6) Rana, S., et al. (2012) Circulation 125:911-9.
7) Elecsys® sFlt-1 and Elecsys® PlGF package inserts (Nov 2014). Roche Diagnostics Documentation, Basel.
8) Chaiworapongsa, T. et al. (2014). Nat Rev Nephrol 10, 466–480 - See more at: http://www.selectscience.net/product-news/roches-preeclampsia-test-helps-to-predict-this-life-threatening-condition-in-pregnant-women-at-risk/?artID=35800#sthash.oYpQJsdP.dpuf

Results of the PROGNOSIS^1,2 study presented at the 20th World Congress on Controversies in Obstetrics, Gynecology & Infertility in Paris, demonstrate the prognostic value of the Elecsys® preeclampsia test from Roche to predict the absence of preeclampsia for one week and the development of preeclampsia within the subsequent four weeks.

The test result enables healthcare professionals to avoid unnecessary hospitalizations by reliably ruling out preeclampsia for one week and to improve outcome for mother and child by ruling in preeclampsia allowing optimized prenatal care.

Preeclampsia is defined by hypertension associated with an increased amount of protein in the urine (proteinuria).^3,4.5 Other clinical symptoms of preeclampsia can include severe headache, sudden swelling of face, hands and feet and pain in the upper abdomen. However, both hypertension and proteinuria are poor in predicting the clinical onset of the disease and its progression.⁶

The Elecsys preeclampsia test measures two proteins sFlt-1 (soluble fms-like tyrosine kinase-1) and PlGF (placental growth factor) in maternal blood. Depending on the test result, which is reflected as a ratio of the two proteins, physicians can reliably exclude or predict the development the disease short-term⁷, confidently focus on those women at high risk of preeclampsia.

“Results from the PROGNOSIS study mark a significant step forward in the prediction of preeclampsia,” said Prof Harald Zeisler, Department of Obstetrics and Gynecology at Medical University Vienna, Austria. “The Elecsys preeclampsia test allows physicians to predict the short term absence and manifestation of preeclampsia. Its application in clinical practice has the potential to reduce fetal and maternal morbidity and mortality as well as to avoid unnecessary hospitalizations.”

Preeclampsia occurs in approximately 1 in 20 pregnancies and is the second most common cause of maternal death.⁸ The disease can be life-threatening for mother and baby, especially if diagnosed late, and is an indication for immediate preterm delivery when acute. The majority of cases develop in healthy women bearing their first child. Medical conditions such as chronic hypertension, diabetes and renal disease are associated with an increased risk of developing preeclampsia.

“We are pleased to introduce a new and reliable approach to predicting which woman at risk will develop preeclampsia within short-term, making a true diffence to the management of this serious condition”, said Roland Diggelmann, COO of Roche Diagnostics. “The new data allows us to set new standard in prenatal care, avoid unnecessary hospitalization and anxiety for the mother and her family. This is yet another testament to our commitment in women’s health.”

References
1) in full: Prediction of short-term outcome in pregnant women with suspected preeclampsia study
2) Hund, M., et al. (2014). BMC Pregnancy and Childbirth 14, 324.
3) National Institute for Health and Clinical Excellence (NICE) (2011). Hypertension in pregnancy. NICE clinical guideline 107, London: RCOG Press.
4) ACOG Task Force on Hypertension in Pregnancy (2013). Hypertension in Pregnancy. Obstet Gynecol. 122, 1122-1131.
5) DGGG (2014). Diagnostik und Therapie hypertensiver Schwangerschaftserkrankungen. [http://www.awmf.org/uploads/tx_szleitlinien/015018l_S1_Diagnostik_Therapie_hypertensiver_
Schwangerschaftserkrankungen_2014-01.pdf]
6) Rana, S., et al. (2012) Circulation 125:911-9.
7) Elecsys® sFlt-1 and Elecsys® PlGF package inserts (Nov 2014). Roche Diagnostics Documentation, Basel.
8) Chaiworapongsa, T. et al. (2014). Nat Rev Nephrol 10, 466–480 - See more at: http://www.selectscience.net/product-news/roches-preeclampsia-test-helps-to-predict-this-life-threatening-condition-in-pregnant-women-at-risk/?artID=35800#sthash.oYpQJsdP.dpuf

Results of the PROGNOSIS^1,2 study presented at the 20th World Congress on Controversies in Obstetrics, Gynecology & Infertility in Paris, demonstrate the prognostic value of the Elecsys® preeclampsia test from Roche to predict the absence of preeclampsia for one week and the development of preeclampsia within the subsequent four weeks.

The test result enables healthcare professionals to avoid unnecessary hospitalizations by reliably ruling out preeclampsia for one week and to improve outcome for mother and child by ruling in preeclampsia allowing optimized prenatal care.

Preeclampsia is defined by hypertension associated with an increased amount of protein in the urine (proteinuria).^3,4.5 Other clinical symptoms of preeclampsia can include severe headache, sudden swelling of face, hands and feet and pain in the upper abdomen. However, both hypertension and proteinuria are poor in predicting the clinical onset of the disease and its progression.⁶

The Elecsys preeclampsia test measures two proteins sFlt-1 (soluble fms-like tyrosine kinase-1) and PlGF (placental growth factor) in maternal blood. Depending on the test result, which is reflected as a ratio of the two proteins, physicians can reliably exclude or predict the development the disease short-term⁷, confidently focus on those women at high risk of preeclampsia.

“Results from the PROGNOSIS study mark a significant step forward in the prediction of preeclampsia,” said Prof Harald Zeisler, Department of Obstetrics and Gynecology at Medical University Vienna, Austria. “The Elecsys preeclampsia test allows physicians to predict the short term absence and manifestation of preeclampsia. Its application in clinical practice has the potential to reduce fetal and maternal morbidity and mortality as well as to avoid unnecessary hospitalizations.”

Preeclampsia occurs in approximately 1 in 20 pregnancies and is the second most common cause of maternal death.⁸ The disease can be life-threatening for mother and baby, especially if diagnosed late, and is an indication for immediate preterm delivery when acute. The majority of cases develop in healthy women bearing their first child. Medical conditions such as chronic hypertension, diabetes and renal disease are associated with an increased risk of developing preeclampsia.

“We are pleased to introduce a new and reliable approach to predicting which woman at risk will develop preeclampsia within short-term, making a true diffence to the management of this serious condition”, said Roland Diggelmann, COO of Roche Diagnostics. “The new data allows us to set new standard in prenatal care, avoid unnecessary hospitalization and anxiety for the mother and her family. This is yet another testament to our commitment in women’s health.”

References
1) in full: Prediction of short-term outcome in pregnant women with suspected preeclampsia study
2) Hund, M., et al. (2014). BMC Pregnancy and Childbirth 14, 324.
3) National Institute for Health and Clinical Excellence (NICE) (2011). Hypertension in pregnancy. NICE clinical guideline 107, London: RCOG Press.
4) ACOG Task Force on Hypertension in Pregnancy (2013). Hypertension in Pregnancy. Obstet Gynecol. 122, 1122-1131.
5) DGGG (2014). Diagnostik und Therapie hypertensiver Schwangerschaftserkrankungen. [http://www.awmf.org/uploads/tx_szleitlinien/015018l_S1_Diagnostik_Therapie_hypertensiver_
Schwangerschaftserkrankungen_2014-01.pdf]
6) Rana, S., et al. (2012) Circulation 125:911-9.
7) Elecsys® sFlt-1 and Elecsys® PlGF package inserts (Nov 2014). Roche Diagnostics Documentation, Basel.
8) Chaiworapongsa, T. et al. (2014). Nat Rev Nephrol 10, 466–480 - See more at: http://www.selectscience.net/product-news/roches-preeclampsia-test-helps-to-predict-this-life-threatening-condition-in-pregnant-women-at-risk/?artID=35800#sthash.oYpQJsdP.dpuf