Contemporary OB/GYN week in review: Anemia, cardiovascular risks, and more

Thank you for visiting the Contemporary OB/GYN® website. Take a look at some of our top stories from last week (Monday, October 14 - Friday, October 18, 2024), and click each link to read and watch anything you may have missed.

Ensuring successful treatment of anemia in pregnancy

Anemia affects nearly 30% of reproductive-age women worldwide, and anemia in pregnancy has an estimated global prevalence of 37%, with iron-deficiency anemia being the most common cause. Anemia in pregnancy is associated with increased maternal and fetal/neonatal morbidity.

According to the 2021 World Health Organization report, the prevalence of anemia in pregnancy ranges from 12% in the US to nearly 60% in some African countries. Within the US, the prevalence of anemia in pregnancy is 2 times higher in non-Hispanic Black patients compared with non-Hispanic White patients.

Recent studies have shown successful treatment of anemia in pregnancy can significantly reduce risk of preterm birth and preeclampsia. The CDC has recommended universal iron supplementation in pregnancy except in the case of certain genetic disorders such as hemochromatosis. Treatment maintains maternal iron stores, supports maternal erythropoiesis, and benefits neonatal iron stores.

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Mammograms may reveal hidden cardiovascular risks, study finds

In an interview with Contemporary OB/GYN, Lori Daniels, MD, FACC, professor of cardiovascular medicine at UC San Diego, discussed her study on the connection between breast arterial calcification (BAC) seen on mammograms and cardiovascular outcomes, such as heart disease and mortality.

BAC is calcium buildup in breast arteries, often identified during routine mammograms. While BAC has been present in imaging for a long time, it has only recently been recognized as a potential cardiovascular risk marker. Women with BAC, especially those with higher quantities, have a greater likelihood of developing conditions such as heart failure, stroke, heart attacks, and an increased risk of all-cause death.

The study analyzed over 18,000 mammograms and followed participants for up to 11 years to observe cardiovascular events. The results revealed that women with more BAC had a significantly higher risk of adverse cardiovascular outcomes, even when adjusting for typical risk factors such as smoking, cholesterol, blood pressure, and age.

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High prevalence of genital sensory impairment in menopausal women with sexual dysfunction

A new study presented at the 25th Annual Fall Scientific Meeting of the Sexual Medicine Society of North America has shed light on a largely understudied aspect of menopause: the impact of menopause on female genital sensory pathways and its potential contribution to sexual dysfunction. While the hormonal effects of menopause have been widely researched, this study focuses on the integrity of somatic afferent pathways responsible for genital sensation, such as the dorsal and perineal nerve branches of the pudendal nerve.

The research highlights the use of genital quantitative sensory testing to assess the function of these pathways in menopausal patients with sexual dysfunction. The study's objective was to evaluate sensory thresholds for vibration, cold, and warm sensations in two cohorts of menopausal women: those with genitourinary syndrome of menopause and those with persistent genital arousal disorder or genito-pelvic dysesthesia, conditions in which neurologic impairment is more documented.

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Longer lasting contraception use reported post-Dobbs

Women are seeking more invasive and longer lasting contraception following the Supreme Court’s Dobbs v. Jackson Women's Health Organization decision in June 2022 even when living in states with continued abortion access, according to a recent study presented at the 25th Annual Fall Scientific Meeting of the SMSNA.

An increase in longer acting and permanent contraceptive options was reported between the pre­-Dobbs and post-Dobbs periods, with intrauterine device use increasing from 47% to 48% and salpingectomy increasing from 15% to 24%. Shorter acting options such as Nexplanon and Depo-Provera were used less frequently post-Dobbs compared to pre-Dobbs.

The number of vasectomies performed monthly also increased from a mean of 35.6 pre-Dobbs to 53 post-Dobbs. This indicated an increase of 49%.

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FDA updates FLUBLOK flu vaccine label to include pregnant adults

The FDA has updated the label for the influenza vaccine FLUBLOK (Recombinant flu vaccine; Sanofi) to include safety information for pregnant individuals aged 18 years or older, according to Sanofi.

This update was made to comply with recommendations about annual flu vaccine administration before the end of October by the Centers for Disease Control and Prevention. FLUBOK’s safety in pregnant women has been found consistent with a standard-dose flu vaccine in a recent study.

Results indicated no increased risk of adverse pregnancy, birth, or neonatal outcomes among patients taking FLUBOK compared to those taking the comparator vaccine. Eclampsia and preeclampsia were the most common outcome from both vaccines, with a rate of 8.4% in both groups.

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