Swedish Study Supports Coffee-Miscarriage Link

A new Swedish study reinforces the idea that drinking coffee during the first trimester of pregnancy increases the risk of a miscarriage--doubling the risk if enough is consumed. The Food and Drug Administration and the March of Dimes Birth Defects Foundation already warn women against drinking coffee during pregnancy, and the new study seemingly validates that warning.

Dr. Sven Cnattingius of the Karolinska Institutet in Stockholm and his associates studied 562 Swedish women who had miscarriages between the sixth and 12th weeks of pregnancy. They reported in the Dec. 21 New England Journal of Medicine that drinking the equivalent of one to three cups of American coffee per day increased the risk of miscarriage by 30%, three to five cups increased it by 40% and more than five doubled the risk. Cnattingius recommended that pregnant women drink no more than two cups a day.

Swedish women typically consume very strong coffee, containing about 180 milligrams of caffeine compared with the 100 milligrams in a cup of American coffee. The results were adjusted to reflect that difference.

Flu Shots May Protect Against Heart Attacks

A flu shot may significantly reduce the risk of a second heart attack, according to Texas researchers, providing one more good reason to get vaccinated.

Physicians already know that elderly people who contract influenza are at higher risk of dying, particularly of diseases such as pneumonia. The new findings suggest that influenza can render its victims more susceptible to coronary problems as well.

Dr. Morteza Naghavi and her colleagues at the University of Texas-Houston Health Sciences Center studied 218 heart patients, half of whom had had a second heart attack. Controlling for other risk factors, they concluded that the patients who had a flu shot had only one-third the risk of a second heart attack as patients who did not. The results were reported in the Dec. 18 Circulation: Journal of the American Heart Assn.

Fatty Diet Implicated in Osteoporosis

Eating lots of meat or a high-fat diet increases the risk of osteoporosis, according to two new studies. In one, Dr. Deborah Sellmeyer and her colleagues at UC San Francisco studied 1,035 women, ages 65 to 80. The women were grouped into three classes: those who had a high ratio of animal protein to vegetable protein in their diet; those who had a more balanced ratio; and those who had a low ratio. All of the women had similar bone densities at the start of the study.

The team reported in the January American Journal of Clinical Nutrition that after seven years, the women in the high-ratio group had 3.7 times as many bone fractures as those in the low-ratio group. Sellmeyer recommended that elderly women work to get more fruits and vegetables in their diet.

The second study was conducted in mice by biologist Farhad Parhami and his colleagues at UCLA, but the researchers think the results are applicable to humans. The team compared two groups of animals: one group received a high-fat diet to increase its cholesterol levels; the second received a normal, balanced diet.

The team reported in the January Journal of Bone and Mineral Research that, after seven months, the mice receiving the high-fat diet had a 43% decrease in the mineral content of their femoral bones and a 15% decrease in bone density. “High cholesterol may decrease overall bone production,” Parhami said.

Smoking Tied to Skin Cancer Risk

Smoking triples the risk of developing squamous cell carcinoma, the most common form of skin cancer, according to researchers from the Netherlands. Dr. Jan Nico Bowes Bavinck and his associates at the Leiden University Medical Center compared the risk of smoking in 580 patients with different types of skin cancer and 386 people without skin cancer.

They reported in the January Journal of Clinical Oncology that they found no link between smoking and basal cell carcinoma or melanoma. But current smokers were 3.3 times more likely to develop squamous cell carcinoma than nonsmokers. Pipe smokers were also at increased risk, but cigar smokers were not. Although the researchers do not know how smoking increases the risk, they speculate that carcinogens in the smoke damage DNA in skin tissue.

Drug Could Impede Fetal Brain Development

Medications for epilepsy taken during pregnancy may impair brain development in the fetus, according to British researchers. A team from the Mersey Regional Epilepsy Clinic studied almost 600 children of epileptic women registered at the clinic. Only 176 of the children had been exposed to an anti-epileptic drug during pregnancy.

The team reported in the January Journal of Neurology, Neurosurgery and Psychiatry that children whose mothers had taken the drugs during pregnancy were 50% more likely to have additional educational needs, such as attendance at special-needs schools or extra help with mainstream schooling. Those whose mothers had taken only the drug valproate had three times the normal risk of such needs, while those whose mothers took valproate in combination with other drugs had twice the normal risk. Those whose mothers took only carbamazepine, however, had no increased risk.

Pap Smears After Menopause: How Often?

Postmenopausal women who have a normal Pap smear do not need another one for at least two years, according to UC San Francisco researchers. If they have one sooner, the test is more likely to yield a false-positive result than to reveal a potential tumor, they found.

In general, for women who have been screened all of their lives and have tested negative for cervical abnormalities, the risk of developing new cervical disease is quite low. But researchers have not known how often to screen such women once they pass menopause.

Dr. George Sawaya and his colleagues studied 2,561 women with a mean age of 66.7. They reported in the Dec. 19 Annals of Internal Medicine that, one year after a normal Pap smear, 78 women (3%) had an abnormal smear. An additional 32 women (1.4%) had an abnormal smear in the second year. A total of 231 interventions were performed on these women, including repeat Pap smears, colposcopy and biopsy, and it was found that only one woman actually had a cervical lesion.

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Medical writer Thomas H. Maugh II can be reached at thomas.maugh@latimes.com.