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Study: Aspirin increases the likelihood of pregnancy in women with recent pregnancy loss

BY Michael Johnsen

BETHESDA, Md. — A daily low dose of aspirin does not appear to prevent subsequent pregnancy loss among women with a history of one or two prior pregnancy losses, according to researchers at the National Institutes of Health.

However, in a smaller group of women who had experienced a single recent pregnancy loss, aspirin increased the likelihood of becoming pregnant and having a live birth.

Many health care providers prescribe low dose aspirin therapy for women who have had a pregnancy loss (miscarriage or stillbirth), and who would like to get pregnant again. However, the effectiveness of this treatment has not been proven, the researchers wrote. 

In the largest study of its kind, the researchers randomly assigned more than 1,000 women with a history of pregnancy loss to either daily low dose aspirin or a placebo. The women began taking the equivalent of one low dose aspirin (81 milligrams) each day while trying to conceive. The researchers reported that, overall, there was no difference in pregnancy loss rates between the two groups.

“Our results indicate that aspirin is not effective for reducing the chances of pregnancy loss in most cases,” stated first author Enrique Schisterman, chief of the Epidemiology Branch at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the institute that led the study.  

Schisterman, added, however, that additional research was needed to investigate the finding that women who had experienced a single, recent pregnancy loss (before 4 1/2 months of pregnancy and within the past year) had an increased rate of pregnancy and live birth while on aspirin therapy.

Among this group, 78% of those who took aspirin became pregnant, compared with 66% of those who took the placebo. For this subset of women, 62% of the aspirin group and 53% of the placebo group gave birth. 

The study authors hypothesized that aspirin therapy might increase the conception rate by increasing blood flow to the uterus. The researchers called for additional research to determine if aspirin therapy might be helpful for improving fertility in other subgroups as well, such as women who can’t establish a pregnancy because the embryo fails to implant in the uterus.

The findings appear in The Lancet.

For the total number of women in the study, 13% of women who took aspirin and became pregnant subsequently experienced another loss, compared with 12% who took the placebo.  Ultimately, 58% of women taking aspirin and 53% of the placebo group got pregnant and later gave birth.

 

 

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Medicaid prescription claims on the rise

BY Michael Johnsen

HORSHAM, Pa. — Symphony Health Solutions on Wednesday released research on the affects of the Affordable Care Act on Medicaid drug spending.

The research found that prescription claims for Medicaid patients increased in January by 10% and in February by 14% over the same periods last year. The study also uncovered that average out-of-pocket cost for contraceptives has dropped more than 58% since 2012.

“Even with Medicaid expansion less than three months old, we’re starting to see notable increases in Medicaid prescription claims,” stated Don Otterbein, SVP marketing and product management, Symphony Health Solutions. “We expect this trend to continue and — mostly likely — to increase as newly enrolled Medicaid patients seek healthcare services.”

Out-of-pocket costs for contraceptives began to decline for this class of medication immediately after implementation of the ACA birth control mandate in August 2012. These costs went from a high of $17.54 in July of 2012 down to $7.36 in February this year.

“These reductions in patient costs accelerated when plans launched their annual benefit designs in January 2013,” Otterbein said. “This trend is expected to continue this year although it is starting to slow.”

 

 

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CRN: Importance of vitamin D supplementation gaining credence

BY Michael Johnsen

WASHINGTON — The Council for Responsible Nutrition on Tuesday noted that the importance of vitamin D continues to be recognized by leading researchers. 

“The body of scientific research demonstrating beneficial results for vitamin D has grown in recent years," commented CRN SVP scientific and regulatory affairs Duffy MacKay. "We know that vitamin D is a critical conduit for multiple physiological bodily functions, as well as a tool for helping calcium absorption, which is essential to building strong bones," he said. "Now, a new systematic review and meta-analysis [recently published in the British Medical Journal] finds vitamin D supplementation may also play a significant role in reducing the risk of mortality, particularly in older adults."

Another meta-analysis published in the journal recognized a "suggestive" link between vitamin D supplementation and various conditions and recommended further research be done. "There are very few things that provide clear cut scientific evidence when you’re talking about chronic disease, and if adding a simple vitamin D supplement might provide even probable benefits in this area — as one of a host of healthy habits — we should encourage that step." 

The importance of vitamin D continues to be recognized by the scientific, medical and even regulatory communities, CRN noted. In its latest review of vitamin D, the Institute of Medicine raised the recommended levels for vitamin D. And last month, in a recently released proposed rule from the Food and Drug Administration on nutrition and supplements facts labels, the agency identified vitamin D as a ‘nutrient of public health significance,’ advising that vitamin D content be listed on food labels. 

 

 

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