Being obese while pregnant can cause long-term danger to women’s hearts, according to obstetrician/gynecologists at Beersheba’s Soroka University Medical Center and the community health department at Ben-Gurion University who conducted follow-ups of mothers over more than a decade. Dr.
Shimrit Yaniv-Salem, under the supervision of Prof. Eyal Scheiner, head of a maternity department at the hospital, found in the retrospective study that severe overweight during pregnancy is an independent risk factor for heart disease.
She presented her findings at a meeting on pregnancy held recently in New Orleans and concluded that obese pregnant women would benefit from cardiovascular-risk screening that could lead to early detection and secondary prevention of cardiovascular disease.
The researchers studied data from pregnant women who had their babies between 1988 and 1999 and were followed-up until 2010.
Long-term cardiovascular disease was compared among women with and without obesity in pregnancy (who had a body mass index before pregnancy of at least 30). Those who developed cardiovascular disease were categorized according to whether they underwent simple or complex heart attacks or invasive and non-invasive cardiac procedures.
During the 11-year period, 46,688 women who delivered were recruited, and of that number, 1,221 were to be obese. A decade later, these patients had higher rates of simple cardiovascular events, non-invasive diagnostic procedures and cardiovascular-related hospitalizations.
There was not only an association between obesity in pregnancy, future risk for cardiovascular morbidity, but also earlier heart attacks.
Scheiner said the results were “of major importance to the obstetricians counseling patients on their future risk for cardiovascular complications. It is important for secondary prevention, early detection, and specific screening programs for this population,” he added. “As obstetricians, we should remember to advise our obese patients not only regarding possible obstetrical issues, but also for long-term cardiovascular complications.
Pregnancy is a unique window of opportunity which has an important role in promoting life style modifications.”
IMPROVING KIDNEY & LIVER TRANSPLANTATION The quality of kidney and liver donations is important for the longevity of transplants and the health of recipients. Thus it’s critical to know which organs are suitable for transplantation, as well as to use techniques that preserve an organ’s function after donation.
Several studies published in the British Journal of Surgery address these issues and offer ways to maximize the use of donated organs. In the first study, Dr.
Rajeev Desai of the UK’s Blood and Transplant, led a team that assessed transplants from 17,639 donors, including 61 donors with cancer who were considered to have an unacceptable/high risk of transmitting cancer through their donated organs. The researchers found no cancer transmission in 133 recipients of organs from these 61 donors. At 10 years after transplantation, the organs from donors with an unacceptably high risk provided each recipient with more than seven additional years of survival on average.
“The findings of our research indicate that the perceived risk of certain organ donors to their recipients is likely to have been overestimated.
Organ donors with a history of certain types of cancers who are excluded from transplantation in fact pose very little risk of cancer transmission to their recipients,” said Desai. “These organs can be transplanted with very little risk to their recipients, resulting in significant improvement in the survival and health of the recipients.”
In another study, Dr. Olivier Detry of the University of Liége in Belgium revealed excellent results from liver transplants from deceased donors who were older than what is usually recommended.
The study looked specifically at donation after circulatory death (DCD), in which circulation, heartbeat and breathing have stopped (as opposed to brain death, in which all the functions of the brain have stopped). A total of 70 DCD liver transplants were performed: 32 from donors aged 55 years and younger, 20 from donors between 56 and 69 years and 18 from donors aged 70 years and older. Organ and patient survival rates were not different at one and three years after transplantation between the three groups. “As the population of Western countries is ageing, we will have to consider older donors even more often in the future,” said Detry.
ISRAELI HEADS INT’L NEONATOLOGY ASS’N Although international medicine should be free of politics, there aren’t many qualified Israelis who head international associations dedicated to specific medical fields. Now Prof. Francis Mimouni, director of the neonatology division at Jerusalem’s Shaare Zedek Medical Center, has shown it is possible. He was recently elected secretary-general of the International Neonatology Association.