Kaiser Daily Women's Health Policy Report Highlights Recently Released Journal Articles

The following highlights recently released journal articles on women's health issues.

Pregnancy & Childbirth
"Interpregnancy Weight Change and Risk of Adverse Pregnancy Outcomes," The Lancet: Eduardo Villamor of the Harvard School of Public Health's Department of Nutrition and Sven Cnattingius of the Karolinska Institute's Department of Medical Epidemiology and Biostatistics in Stockholm, Sweden, looked at the records of 151,025 Swedish women who each gave birth to two infants from 1992 through 2001, examining differences in the woman's body mass index -- a calculation from a person's height and weight -- at the beginning of each pregnancy, the AP/South Florida Sun-Sentinel reports. The study finds that women who increased BMI by one or two points between the two pregnancies increased their risk of developing diabetes and high blood pressure during the second pregnancy by up to 40%. Women who increased their BMI by three or more units increased their risk of still birth by 63%, according to the study (Cheng, AP/South Florida Sun-Sentinel, 9/29). Villamor said, "Women do not need to become overweight or obese in order to increase their chances of having poor gestational outcomes. A relatively modest increase in weight between pregnancies could lead to serious illnesses" (BBC News, 9/28).
NPR's "Morning Edition" on Sept. 29 reported on the study. The segment includes comments from Aaron Caughey, a maternal-fetal specialist at the University of California-San Francisco, and Cnattingius (Neighmond, "Morning Edition," NPR, 9/29). The complete segment is available online in RealPlayer.

Public Health
European Society for Medical Oncology Congress, Istanbul, Turkey: Bella Kaufman of the Chaim Sheba Medical Center in Israel and colleagues at the conference on Monday presented results of a Phase III clinical trial sponsored by Roche that is studying the use of Roche's drug Herceptin and AstraZeneca's Arimidex for hormone therapy in postmenopausal women testing positive for hormone receptors and living with an aggressive form of advanced-stage breast cancer called HER2, Reuters reports. The study finds that cancer in women who only took Arimidex progressed after an average of 2.4 months, compared with 4.8 months for women taking both Arimidex and Herceptin. Women taking both drugs survived an average of 28.5 months, compared with 23.9 months for women taking Arimidex alone, but the difference is not statistically significant, according to the study. Roche said it plans in May to file for approval around the world for use of the two drugs together (Reuters, 10/2). Researchers at the conference also presented data from a four-year clinical trial of 5,000 patients testing the effectiveness of Novartis's Femara in reducing the risk of breast cancer recurrence. The study finds that women taking Femara had an 18% lower risk of recurrence after 51 months than women who were taking the breast cancer recurrence drug tamoxifen. Among women whose breast cancer had spread to the lymph nodes at the time of diagnosis or who had undergone chemotherapy, the risk of recurrence was reduced by 23% if they were receiving Femara and by 26% if they were receiving tamoxifen (Reuters Health, 10/2).

"Impact on Survival of Time From Definitive Surgery to Initiation of Adjuvant Chemotherapy for Early Stage Breast Cancer," Journal of Clinical Oncology: Women with early stage breast cancer can delay the initiation of chemotherapy for up to three months following surgery but postponing it beyond that point can increase the risk of recurrence and death, according to the study (Ubelacker, CP/London Free Press, 10/3). Caroline Lohrisch of the BC Cancer Agency and colleagues analyzed the medical records of 2,594 women diagnosed with breast cancer who received adjuvant chemotherapy from 1989 through 1998 to determine if the time chemotherapy was initiated influenced survival rates (Lohrisch et al., Journal of Clinical Oncology, 10/2). The study finds that 31% of the women who initiated chemotherapy 12 to 24 weeks after surgery experienced a relapse, compared with 18% to 26% of women who began chemotherapy prior to 12 weeks after surgery. In addition, the timing of chemotherapy affected the five-year survival rate. The study finds that 84% of women who began chemotherapy within four weeks of surgery were alive five years after diagnosis. The researchers recorded a five-year survival rate of 85% among women who began their therapy four to eight weeks following surgery and a survival rate of 89% among women who started therapy eight to 12 weeks following surgery. Among the women who started chemotherapy more than 12 weeks following survey, the five-year survival rate decreased to 78%, according to the study. "Time matters, but not in as short a time interval as we think, so patients can be reassured if they're feeling anxiety because they don't feel their treatment is starting fast enough," Lohrisch said. Mark Clemons, head of breast medical oncology at Princess Margaret Hospital in Toronto, said, "This is an important study because delay in commencement of any cancer therapy is extremely scary for patients who are understandably worried that any delay might lead to a worsening of their prognosis." He added, "It's also important from a physician and a health care system point of view that we set targets and goals to make sure that we're treating patients within appropriate time frames" (CP/London Free Press, 10/3).















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View drug information on Arimidex; Femara; Herceptin.