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Overweight mothers linked to infant heart defects

Overweight mothers linked to infant heart defects

Women who are overweight or obese when they get pregnant are more likely to give birth to children with congenital heart defects, according to a U.S. government study released on Thursday.

The study, conducted by the U.S. Centers for Disease Control and Prevention, concluded that women who were overweight or obese at the time they became pregnant were 18 percent more likely to give birth to babies with heart defects, while severely obese women had a 30 percent increased risk.

The babies had problems including obstructive defects on the right side of the heart and defects in the tissue separating the heart’s two upper chambers, the researchers reported in the American Journal of Obstetrics and Gynecology.

“Congenital heart defects are the most common types of birth defect, and among all birth defects, they are a leading cause of illness, death and medical expenditures,” said Dr. Edwin Trevathan, a CDC expert on birth defects and developmental disabilities.

The CDC, the U.S. government’s disease watchdog, recommends that overweight women work with their doctors to achieve a healthy weight before pregnancy.

Researchers examined the health of 6,440 infants with congenital heart defects and 5,673 infants without problems, all of whose mothers were interviewed as part of the CDC’s National Birth Defects Prevention Study.

They assessed obesity according to each woman’s body mass index, or BMI, which relates weight to height. A woman 5 feet, 5 inches tall and weighing 190 pounds (86 kg) would have a BMI of 31.6, while a woman of the same height who weighs 160 pounds (72 kg) would have a BMI of 26.6.

The researchers defined overweight as a BMI of 25 to 29.9, moderate obesity as a BMI of 30 to 34.9 and severe obesity as a BMI of 35 or above.

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U.S. court reinstates Alaska smoker case versus Altria

U.S. court reinstates Alaska smoker case versus Altria

A U.S. appeals court on Monday reinstated an Alaska lawsuit against Altria Group Inc’s Philip Morris USA by the survivor of a deceased smoker, saying her state product liability claims were not preempted by federal law and should have been tried in state court.

Altria and Philip Morris had argued the state claims could not go forward against them and Alaska Commercial Co, a local retailer, because a victory for plaintiffs Dolores Hunter and the estate of Benjamin G. Francis could result in a ban of cigarette sales in the state.

Francis, a native Alaskan, died at 52 of lung cancer in December of 2004, leaving a 10-year-old son and Hunter, his common law wife, his attorney Don Bauermeister said. Hunter was appointed the personal representative of his estate by a state court.

A lower court agreed the state claims were barred by “congressional intent not to ban the sale of cigarettes” and dismissed the case due to Hunter’s failure to bring a claim under federal law, the opinion by the Ninth U.S. Circuit Court of Appeals said.

But the appeals court ruled that Altria had “failed to establish a clear conflict between Hunter’s claim and federal law” and that U.S. regulatory laws “do not provide strong evidence of a federal policy against more stringent state regulation.”

The court found the case did not belong in federal court and instructed it be remanded to Alaska state court for further proceedings.

Jack Marshall, a spokesman for Philip Morris and Altria, said the companies were disappointed by the appeals court ruling and planned to “defend the case vigorously in state court.”

“It is important to note that the decision addressed only where the case should be tried and does not address the merits of the plaintiff’s claim,” Marshall said.

Bauermeister said his client, Hunter, was “very relieved and excited” about the appeals court ruling that will return the case to the court in the native Alaskan village of Bethel where it was filed. She hopes the lawsuit will “hold (Altria) accountable” not only for Francis’ death, but for high rates of smoking among Alaska’s native peoples, he said.

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Defibrillators may not save women, study finds

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Defibrillators may not save women, study finds

Despite their widespread use, implantable defibrillators to protect against deadly heart rhythms do not prevent deaths in women with advanced heart failure, U.S. researchers said on Monday.

They said implantable defibrillators — which detect abnormal heart rhythms and offer a life-saving shock to restore a regular heartbeat — do not appear to protect men and women equally.

“There seems to be much less significant benefit” in women, said Dr. Christian Machado of Providence Hospital Heart Institute and Medical Center in Michigan, whose study appears in the Archives of Internal Medicine.

“Implantable cardioverter-defibrillators are being implanted in hundreds of thousands of women without substantial evidence of benefit,” Dr. Rita Redberg of the University of California, San Francisco, wrote in a commentary in the journal.

Nearly 22 million people worldwide suffer from heart failure, a chronic condition in which the heart struggles to pump blood. Heart failure affects about 5.3 million Americans, and nearly half are women.

People with heart failure are six to nine times more likely than most people to suffer sudden cardiac death, a dangerous heart rhythm in which the heart quivers but does not pump blood to the organs. Implantable defibrillators can detect this rhythm and deliver a shock to restore a normal heart beat.

Many clinical trials have found implantable defibrillators save lives and are cost-effective; but too often, the studies are overpopulated with men, Machado said.

He and colleagues searched published clinical trials data on implantable defibrillators from 1950 to 2008.

“Our trials are biased toward males. Seventy to 80 percent are made up of male subjects,” Machado said.

His team analyzed five trials with a total of 934 women with advanced heart failure. None showed defibrillators significantly decreased the rate of death from any cause compared with drug therapy alone.

Among the 3,810 men in the studies, however, there was a significant reduction in the rate of death among those who had a defibrillator.

Machado said many women with heart failure are routinely offered defibrillators to safeguard against sudden cardiac arrest, even though the device may not help them live longer.

He said it would not be ethical to do a randomized clinical trial to prove women do not benefit, but said ongoing studies should be sure to focus on the effects in both men and women.

“We need to do a better job in trials recruiting at least the same amount of women as we do men. We have failed to do that,” he said.

Implantable defibrillators, which cost between $20,000 to $30,000 to implant, represent a $6 billion global market for companies such as Medtronic Inc, Boston Scientific Corp and St. Jude Medical Inc.

Dr. Mark Carlson of medical device maker St. Jude Medical said in a statement that women enrolled in clinical studies evaluating heart failure have tended to be sicker than men in the same studies, and they have tended to be undertreated in general.

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