Category: Obstetrics & Gynaecology

Categories : Obstetrics & GynaecologyTags :

Immune System Overreaction Linked to Deadly Flu in Pregnancy

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Researchers have discovered why influenza can lead to life-threatening complications during pregnancy.

Source: Pixabay CC0

In most people, influenza stays in the upper respiratory tract – mainly the nose – and clears without spreading further. But during pregnancy, the virus can extend beyond the lungs into the cardiovascular system, increasing the risk of severe complications for mothers and babies.

Now a new preclinical study using animal models reveals precisely why the virus can spill into the bloodstream during pregnancy, opening the door for targeted treatment. The study is a bilateral partnership between Trinity College Dublin, with collaborators from RMIT University and the University of Adelaide and is published in Science Advances.

Researchers identified a viral sensor in the immune system, known as TLR7, that can become overactive during pregnancy, amplifying inflammation and spreading disease into the bloodstream.

Blocking TLR7 could help prevent the harmful inflammation that makes flu in pregnancy so dangerous. This work can help protect developing babies by stopping the placenta from becoming overly inflamed during flu infection.

Professor John O’Leary, School of Medicine, Trinity, said: “This international research is of high impact in relation to our understanding of viruses and pregnancy and the role of the maternal immune response.”

What is the potential impact of this research? 

Earlier studies from RMIT have shown that severe flu in pregnancy can have long‑term impacts on babies’ brain development, by inflaming blood vessels and reducing the flow of oxygen and nutrients from mother to baby.

This new study pinpoints the underlying cause of that damage, reshaping our understanding of flu‑related risk in pregnancy and opening the door to more targeted therapies.

RMIT co-lead author, Prof. Stavros Selemidis, said future treatments could focus on the immune system rather than the virus itself.

“Our study shows that in pregnancy, the problem isn’t just the flu virus – it’s the immune system overreacting. That’s where future treatments could really make a difference,” he explained.

“We’re ready to work with partners to help develop the next generation of therapies and clinical guidelines.”

Next steps for this work: The team is planning further research on how to target TLR7 to reduce the risk of severe influenza and pregnancy complications.

You can read the paper: ‘TLR7 alters the maternal immune landscape during influenza A infection to increase maternal and fetal morbidity’, on the Science Advances website.

Source: Trinity College Dublin

Categories : Mental Health Obstetrics & GynaecologyTags :

Sedatives in Pregnancy Not Linked to Psychiatric Disorders in Children

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Findings offer reassurance to clinicians and pregnant women, say researchers 

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A large South Korean study published by The BMJ finds no increased risk of psychiatric or neurodevelopmental disorders, such as ADHD and autism, in children whose mothers used sedative drugs (benzodiazepines or Z-hypnotics) during pregnancy.

Benzodiazepines and Z-hypnotics are used to alleviate anxiety and insomnia, which are among the most common conditions during pregnancy.

Previous studies have examined the short term safety of benzodiazepine and Z-hypnotic use in pregnancy, but evidence on their psychiatric and neurodevelopment effects in children remains scarce.

To fill this evidence gap, researchers used South Korea’s National Health Information Database to track nearly 3.8 million children born between 2010 and 2022.

Pregnancies exposed to benzodiazepines or Z-hypnotics were compared with unexposed pregnancies and with women who had used these drugs before but not during pregnancy (past users).

Twelve specific neurodevelopmental and general psychiatric disorders were assessed, including substance use disorder, schizophrenia, personality disorder, intellectual disability, autism, ADHD, and behavioural disorder.

Factors, such as mother’s age, income, underlying conditions and other medication use were also taken into account.

Among the 3 809 949 children, 94,482 (2.5%) were exposed to benzodiazepines or Z-hypnotics during pregnancy, 3 715 467 were unexposed, and 147 307 were born to past users.

During the tracking period of up to 14 years, a total of 10 060, 311 997, and 15 645 events occurred in the exposed, unexposed, and past user groups, respectively.

Overall, rates of psychiatric disorders were slightly higher (19.2%) in exposed children compared with 13.8% in unexposed children and 16.5% in the past user group.

However, these associations were no longer significant when the researchers used sibling analysis to disentangle drug effects from shared family, genetic, and environmental factors, and no increased risk was found for individual psychiatric disorders.

Further analyses were generally consistent with the main findings, although some estimates, such as exposure in early and late pregnancy, and longer durations of Z-hypnotic use specifically, remained modestly elevated in certain groups.

This is an observational study, so can’t establish cause and effect, and the researchers acknowledge that a prescription may not always reflect actual ingestion and their follow-up period may be insufficient to capture late onset conditions such as schizophrenia or personality disorders. What’s more, this study was not designed to assess the overall safety of these drugs but specific psychiatric outcomes in children.

However, use of a large, nationally representative database and rigorous methods to overcome confounding suggest the results withstand scrutiny.

As such, they say this study suggests “no substantial evidence that prenatal exposure to benzodiazepines or Z-hypnotics increases the risk of psychiatric disorders in children.”

Although these findings provide reassurance about neuropsychiatric safety, further research is needed to clarify the modest elevations seen in some analyses and help inform discussions when considering sedative therapy in pregnancy, they add.

In a linked editorial, researchers agree that this evidence is reassuring, but this does not mean that sedatives should be prescribed without caution.

Clinicians should be mindful of signals around prolonged use and late pregnancy exposure, while also balancing the risks of untreated maternal psychiatric illness, they write.

However, they conclude that this study “offers a compelling example of how observational research can generate reliable estimates of prenatal drug safety.

Source: The BMJ Group

Categories : Obstetrics & Gynaecology Surgeries & ProceduresTags :

Tranexamic Acid Prevents Severe Bleeding in Caesarean Births

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New trial adds high quality evidence on benefits of tranexamic acid for high-risk women

Photo by Jonathan Borba on Unsplash

Giving tranexamic acid to women with placenta praevia (when the placenta covers the cervical opening) undergoing caesarean birth leads to a significant yet modest reduction in severe bleeding after delivery with no evidence of an increase in serious adverse events, finds a trial from China published by The BMJ today.

Tranexamic acid is widely used to prevent or reduce heavy bleeding usually after surgery or trauma. It works by inhibiting blood clot breakdown and is recommended for the treatment of severe bleeding after childbirth (postpartum haemorrhage).

But high quality evidence on its prophylactic use to prevent postpartum haemorrhage in high risk women remains scarce.

To address this gap, researchers in China set out to examine the effect of tranexamic acid in women with placenta praevia, a group at high risk of severe bleeding.

The trial included 1694 pregnant women with placenta praevia who were scheduled for caesarean delivery at 24 maternity units across China between July 2023 and March 2025.

Participants received prophylactic oxytocin – standard treatment to reduce blood loss after delivery – and were randomly assigned to receive either intravenous tranexamic acid (845 women) or placebo (849 women) over 10 minutes, starting within five minutes of umbilical cord clamping.

The main outcome measure was postpartum haemorrhage, defined as blood loss of at least 1000 mL or red blood cell transfusion within two days after delivery. Serious adverse events including blood clots, seizures, acute kidney or liver injury, and maternal death, were also recorded.

The results show that prophylactic tranexamic acid reduced the rate of postpartum haemorrhage by 15%, from 35.1% to 29.7% compared with placebo. This means that for every 19 women receiving prophylactic tranexamic acid, one case of postpartum haemorrhage would be prevented.

Rates of serious adverse effects were similar between the two groups.

The researchers acknowledge various limitations including that the findings are specific to women with placenta praevia receiving prophylactic oxytocin and therefore may not apply to other obstetric populations. However, this was a well-designed trial and results were consistent after further analyses, suggesting that the findings are robust.

As such, they conclude: “In a high risk population – specifically, women with placenta praevia undergoing caesarean delivery – prophylactic tranexamic acid leads to a statistically significant but modest reduction in the incidence of postpartum haemorrhage.”

“Future studies in diverse international settings are warranted to validate these results and to identify specific patient subgroups most likely to benefit from prophylactic use of tranexamic acid,” they add.

In a linked editorial, UK researchers point out that this modest reduction in bleeding understates the impact, particularly in women at high risk of harm from bleeding, for whom even modest relative risk reductions translate into worthwhile benefits.

The focus should now shift from whether tranexamic acid reduces bleeding to how it is used to maximise patient benefit, they say, noting that in non-obstetric surgery, tranexamic acid is given before incision, but in caesarean section trials it is delayed until after cord clamping to avoid placental transfer.

They recommend evaluating pre-incision administration for caesarean section, while carefully monitoring maternal and neonatal outcomes.

Source: The BMJ Group

Categories : Environmental Effects Obstetrics & GynaecologyTags :

Plastic Additives Tied to Millions of Preterm Births Worldwide

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Photo by FLY:D on Unsplash

Exposure to a chemical commonly used to make plastic more flexible may have contributed to about 1.97 million preterm births in 2018 alone, or more than 8 percent of the world’s total, a new analysis of population surveys shows. The chemical was also linked to the deaths of 74 000 newborns, the researchers further estimate.

The toxin, di-2-ethylhexylphthalate (DEHP), is part of a group of chemicals called phthalates, which appear in cosmetics, detergents, bug repellents, and other household products. Experts have found that these substances can break down into microscopic particles and enter the body through food, air, and dust.

Led by NYU Langone Health researchers, the new study focused on preterm birth, which is a major risk factor for lasting learning and developmental issues and is a leading cause of infant death, according to the World Health Organization.

The new analysis provides the first global estimate of preterm births connected to exposure to DEHP and explores which parts of the world are most affected, according to the authors. A report on the findings published online March 31 in the journal eClinicalMedicine.

“By estimating how much phthalate exposure may contribute to preterm birth worldwide, our findings highlight that reducing exposure, especially in vulnerable regions, could help prevent early births and the health problems that often follow,” said study lead author Sara Hyman, MS.

Past studies have linked DEHP exposure to cancer, heart disease, and infertility, among many other health concerns, added Hyman, an associate research scientist at NYU Grossman School of Medicine. There is also a large body of research connecting the chemical to preterm birth.

According to the new work, DEHP exposure may have contributed to 1.2 million years lived with disability, a measure of all the years that people have lived or will live with illnesses, injuries, and other health issues caused by being born prematurely.

Hyman said that while the phthalate is in widespread use, certain regions are estimated to bear a much larger share of the health impacts than others, with the Middle East and South Asia representing 54 percent of estimated illness from preterm birth. These areas have rapidly growing plastics industries and high levels of global plastic waste.

Africa, which accounted for 26 percent of health problems from DEHP-linked preterm birth, has a disproportionate share of deaths compared with its share of overall premature cases. The researchers said this reflects the region’s higher underlying death toll from preterm birth.

For the study, the research team estimated DEHP exposure in 2018 across 200 countries and territories by pulling data from large national surveys in the United States, Europe, and Canada. They also used estimates from earlier investigations to fill in regions that did not have their own data.

The team then drew on earlier research that assessed how phthalate exposure may affect preterm birth and combined those findings with their global exposure estimates. Finally, they combined this information with worldwide figures on preterm births and deaths to gauge what share of these outcomes might be linked to DEHP.

The scientists repeated these steps for another phthalate called diisononyl phthalate (DiNP), a common replacement for DEHP. According to the results, DiNP may pose a similar risk as DEHP, having contributed to about 1.88 million preterm births around the world. The financial costs associated with newborn deaths ranged from millions to hundreds of billions of dollars for both phthalates.

“Our analysis makes clear that regulating phthalates one at a time and swapping in poorly understood replacements is unlikely to solve the larger problem,” said study senior author Leonardo Trasande, MD, MPP, Professor of Pediatrics at NYU Grossman School of Medicine. “We are playing a dangerous game of Whac-A-Mole with hazardous chemicals, and these findings highlight the urgent need for stronger, class-wide oversight of plastic additives to avoid repeating the same mistakes.”

Dr Trasande, who is also a professor in the Department of Population Health and director of the Division of Environmental Pediatrics and the Center for the Investigation of Environmental Hazards, cautions that the investigation was not designed to establish that DEHP and DiNP directly or alone cause preterm birth, nor did it take into account other types of phthalates.

In addition, because there is some uncertainty in the data, the researchers looked at a range of possible values rather than just one estimate. This uncertainty range showed that the true impact of DEHP could be up to four times smaller than the main estimate or slightly higher. Even under the most conservative estimates, the results point to a substantial health burden, said Hyman.

Despite the limits of this kind of global modelling, added Hyman, the work lays important groundwork for future studies to confirm and refine these results and begins to fill a major gap in understanding the extent to which plastic chemicals affect preterm birth worldwide.

Source: NYU Langone Health

Categories : Expert Opinion Obstetrics & GynaecologyTags :

How Women Are Harmed When Clinicians Rely on the Lab More Than the Patient

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Photo by Karolina Grabowska on Pexels

Across the world, countless women enter perimenopause only to be told that “everything is normal” because their blood tests do not match their symptoms.

This is one of the most damaging failures in modern women’s health. Perimenopause is not a laboratory diagnosis. It is a clinical diagnosis, made by listening to the woman and recognising the pattern of hormonal transition. Yet many clinicians continue to rely on FSH, LH and oestrogen levels – tests that were never designed to diagnose perimenopause and are physiologically incapable of doing so.

1. Hormone levels in perimenopause are wildly erratic

Oestrogen does not decline smoothly. It surges, crashes, and oscillates unpredictably. FSH and LH follow the same chaotic pattern. A single blood test captures only a moment in this turbulence. It cannot represent the hormonal instability that defines the transition.

This is why women with severe vasomotor symptoms often have “normal” results, while women with mild symptoms may show “abnormal” ones.

Erratic physiology produces erratic numbers. The numbers do not reflect the suffering.

2. Lab ranges do not correlate with symptoms

Laboratory ranges were created for research and population studies – not for diagnosing perimenopause. They do not account for:

  • daily hormonal swings
  • stress
  • sleep deprivation
  • illness
  • cycle timing
  • individual sensitivity to hormonal change

A woman may be drenched in night sweats, unable to sleep, emotionally unstable, and struggling to function – yet her blood tests may look “normal”. This leads to the most common and harmful phrase in women’s health: “Your results are normal, so this is not hormonal.”

3. The harm of relying on lab results

When clinicians wait for “abnormal” results before offering help, women suffer. They are:

  • dismissed
  • misdiagnosed
  • told they are anxious or depressed
  • denied treatment
  • left to struggle through years of avoidable distress

Or are treated inappropriately for life with antidepressants, mood stabilisers, axyiolytics and sedatives. These do little to address the underlying problem but create another set of problems: addiction and a range of side effects. This is not medicine. This is neglect disguised as protocol.

Suffering is prolonged because clinicians rely on lab results rather than the woman’s symptoms. Treating the lab instead of the woman is a betrayal of clinical responsibility.

4. The only test worth doing

There is one test that adds value: TSH and T4 – to exclude thyroid disease, which can mimic some perimenopausal symptoms. Beyond this, further hormone testing wastes time, money, and emotional energy.

5. The clinical truth

Perimenopause is diagnosed by listening to the woman, not by chasing fluctuating hormones. If she has:

• hot flushes

• night sweats

• irritability

• emotional instability

• sleep disturbance

• cycle changes

— she is in perimenopause, regardless of what the blood tests say.

The woman’s story is the evidence.

The numbers are often unreliable and misleading tools.

Dr E.V. Rapiti • April 2026

www.drrapiti.com

Categories : Environmental Effects Obstetrics & GynaecologyTags :

How One ‘Forever Chemical’ Can Disrupt Foetal Facial Development

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Researchers discovered perfluorodecanoic acid is the most toxic during foetal craniofacial development

Credit: Chemical Research in Toxicology (2026). doi:10.1021/acs.chemrestox.5c00468

Researchers have long associated per- and polyfluoroalkyl substances (PFAS), commonly known as “forever chemicals,” to certain severe birth defects but exactly how these pollutants harm a developing foetus has remained mostly a mystery. New research now provides the first clear molecular explanation, showing how one PFAS, called perfluorodecanoic acid (PFDA), can trigger craniofacial abnormalities before birth.

The research was published in ACS Chemical Research in Toxicology.

“Most people are exposed to small amounts of PFAS in everyday life but higher exposure can occur through contaminated water, living near manufacturing sites or certain jobs like firefighting and ski waxing, which is why it’s so important to understand the chemicals better,” said the paper’s senior author Jed Lampe, PhD, associate professor at University of Colorado Anschutz Skaggs School of Pharmacy and Pharmaceutical Sciences. “We wanted to understand which PFAS compounds are truly harmful during foetus development, especially for people with higher exposure, and how they cause damage.”

There are approximately 15 000 PFAS used in consumer and industrial products but scientists are increasingly finding that only some pose serious health risks. In this study, Lampe worked with the paper’s first author Michaela Hvizdak and co-author Sylvie Kandel to test 13 commonly found PFAS and discovered PFDA as the most toxic during foetal craniofacial development.

They demonstrated a possible link between PFDA and the extensive facial changes observed in humans and laboratory animals, with some estimates indicating a 10% increased risk at extremely low exposure levels. 

“This finding moves us beyond association by providing a clear explanation for how PFDA can interfere with foetal development. It’s a critical step toward understanding a vast and complex class of environmental chemicals,” said Lampe.

The cause of underdeveloped eyes and an abnormal jaw

They found that PFAS disrupts retinoic acid, a molecule essential for shaping the face and head during early pregnancy. Retinoic acid regulates hundreds of genes and its levels must be controlled. Because a foetus cannot produce or safely eliminate excess retinoic acid, it relies entirely on the mother to maintain the homeostatic balance of the hormone.

The researchers discovered PFDA blocks CYP26A1, a key enzyme responsible for breaking down excess retinoic acid. When this enzyme is inhibited, retinoic acid levels can rise too high, disrupting normal facial development. PFDA also suppresses the genes that produce this enzyme through a separate biological pathway, delivering a “double hit” to the system that regulates early development.

“As a result, severe craniofacial abnormalities can develop, including underdeveloped eyes and abnormal jaw formation, which were the most common effects of PFDA exposure during foetal development,” said Lampe.

The researchers hope by providing a molecular explanation for this abnormality that the research and scientific community can work to develop targeted laboratory assays and computer‑based screening tools to quickly rank PFAS by risk. They say this could help regulators and manufacturers distinguish more dangerous compounds from safer alternatives and guide the design of less toxic chemicals in the future.

They also hope the research can open the door to practical interventions for people with higher exposure, such as firefighters and ski wax technicians. This could include looking into how to reduce exposure levels and whether strategies can be developed to lower PFDA during pregnancy to protect foetal development.

By Julia Milzer

Source: CU Anschutz Medical Campus

Categories : Diet and Nutrition Obstetrics & GynaecologyTags :

Study: Intermittent Fasting Positively Affects Female Hormones in PCOS 

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Photo by Sora Shimazaki on Pexels

Polycystic ovary syndrome, or PCOS, affects as many as 18% of all childbearing-age women. The condition occurs when a woman’s body produces too androgens, chiefly testosterone. Menstrual irregularity, obesity and even infertility can result.

The first line of treatment is typically hormonal birth control, said UIC professor of nutrition Krista Varady. But there can be negative side effects to mood, libido and metabolism, plus an increased stroke risk in some people, Varady said.

“We’re looking for other ways of lowering testosterone levels in these women,” she said. “One way is through weight loss. If someone loses around 5% of their body weight, they can actually help lower testosterone levels and sidestep any kind of drug intervention.”

A new study led by Varady tested how one weight-loss method — intermittent fasting — affects hormones and symptoms in patients with PCOS. Published in Nature Medicine, the research shows that restricting eating to a six-hour daily window decreased testosterone without negatively affecting female hormones. The study also showed that weight loss through calorie counting decreased testosterone. 

However, some critics of intermittent fasting have posited that the diet disrupts female hormones, Varady said.

“There’s a particular sentiment that intermittent fasting is really bad for women.” This is untrue, she said. “This study and several other studies published by our lab and others show that intermittent fasting can actually improve female hormone levels, particularly in women with PCOS.” 

Varady and her colleagues studied a type of intermittent fasting called time-restricted eating. In this method, you eat only during a set six- or eight-hour period each day. During the remaining 18 or 16 hours, you fast with calorie-free beverages and water until the next day. 

Simply put, the strategy helps people eat less, Varady said. So does counting calories, a method Varady and her colleagues tested alongside intermittent fasting in the study. But intermittent fasting had some additional benefits.

“It’s a way of reducing energy intake without having to do really complicated calorie counting,” she said about intermittent fasting. Varady and others have shown in previous work that eating only during an eight-hour window can cut around 300 to 500 calories a day.

In addition to obesity and insulin resistance, which raise risks of diabetes and heart disease, PCOS can cause ovarian cysts, acne and facial hair growth.

In a group of 76 pre-menopausal women with PCOS, the researchers tested how outcomes differed after six months between time-restricted eating between 1 and 7 p.m. daily and calorie counting. Both diet schemes ended up cutting participants’ intake by about 200 calories per day, the team found, leading to average weight loss of about 10 pounds over the six months.

Both groups also experienced a decrease in testosterone concentrations. But only time-restricted eating reduced free androgen index, the ratio between testosterone and the protein that transports it through the blood, which is a marker of how much active testosterone is reaching a body’s tissues. It also improved A1C levels, a risk marker for diabetes, Varady said.

Though intermittent fasting did not lessen other PCOS symptoms, like menstrual period irregularity, Varady suggested those symptoms might improve with longer time on the diet and greater weight loss.

About 80% of the participants in the time-restricted eating group said they were going to continue the diet, Varady said.

Story by Tess Joosse

Source: EurekAlert!

Categories : Environmental Effects Obstetrics & GynaecologyTags :

Breakdown Products from ‘Eco-friendly’ Plastics Impede Foetal Development in Mice

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Nanoplastics from biodegradable plastics can cross the placenta and accumulate in foetal organs

PLA plastic breakdown product Oligomeric nanoplastics can penetrate the placental barrier and reach the foetus. Image credit: Dr Jia Lv (CC-BY 4.0)

When the “eco-friendly” bioplastic, polylactic acid (PLA), biodegrades, the resulting nanoplastics can accumulate in the foetuses of pregnant mice and interfere with foetal growth. Yichao Huang and De-Xiang Xu of Anhui Medical University, China, and Mingliang Fang of Fudan University, China, report these findings in a new study published March 26thin the open-access journal PLOS Biology.

PLA, which is made from corn starch and sugarcane, came onto the market as a biodegradable alternative to conventional plastics around two decades ago and has since become one of the most widely used bioplastics. Due to exponential growth in the production of PLA for packaging and medical applications, humans are increasingly exposed to its main breakdown product, oligomeric lactic acid (OLA) nanoplastics, which have recently been shown to have negative health effects.

In the new study, researchers exposed pregnant mice to OLA at doses proportional to what a human typically consumes and looked for impacts on the mouse pups. They demonstrated that OLA crosses the placenta and accumulates in various organs in the fetus. Furthermore, they showed that OLA interferes with a signaling pathway that controls the development of blood vessels in the placenta, which leads to slower growth of the fetus. This is a concern, because in humans, low birth weight is associated with an increased risk of stillbirth, as well as a higher risk of developing multiple other health problems later in life.

This work is the first animal study to evaluate the developmental health effects from the breakdown products of a supposedly eco-friendly plastic in pregnant mammals. The researchers propose that future work should focus on evaluating the exposure levels and health risks associated with eco-friendly plastics in humans, and a rethinking of our approach to plastic alternatives.

The authors add, “One of our co-authors Dr Mengjing Wang had previously discovered that the widely merchandised PLA microplastics undergo gut enzyme–mediated hydrolysis into oligomeric products that are toxic to the intestinal tract and can trigger enteritis.”

“To follow up on this work, as toxicologists, we went on to ask an additional question: do these oligomeric products, aka OLA, pose developmental threat particularly during the susceptible stage in utero?”

“What we have found was quite astonishing to us. Even under realistic exposure dose scenario during pregnancy, OLA nanoplastics can penetrate the placenta and even reach the foetus, in a mouse model. Such exposure would then cause placental vascular dysplasia and further lead to compromised foetal development.”

“While biodegradable plastics present a viable path to mitigate traditional plastic pollution, their potential health hazards necessitate a recognition in responsibility toward informed consumer intentions and conscientious usage.”

Provided by PLOS

Categories : Obstetrics & GynaecologyTags :

Why Women’s Health Drives Economic Resilience 

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Photo by The Creative Exchange on Unsplash

By Merilynn Steenkamp, Managing Director, Southern Africa, Multi-Country Network, Roche Diagnostics

Across South Africa, women play a central role in sustaining economic activity. They lead classrooms, staff hospital wards, run small businesses, work in agriculture, build enterprises and manage households. In many communities, they are the primary earners and the primary caregivers.1

In March, as South Africa observes International Women’s Month, recognising women’s contribution also means ensuring that systems are structured to protect their health. Reliable access to early diagnostics remains one of the most practical levers available to support that protection.

When women experience illness, the impact extends well beyond a single diagnosis. Time away from work affects income, productivity and career progression. In informal employment, where many South African women operate without formal protections, illness can immediately reduce household earnings. The economic effects are felt first at the family level, then across communities.

Women make up the majority of South Africa’s health and social services workforce. They also carry a disproportionate share of unpaid care work in households². Globally, UN Women reports that women reinvest up to 90 percent of their income into their families and communities³. That reinvestment strengthens education, nutrition and long-term stability across generations.

Imagine a young nurse, working at a local clinic, earning a mid-level salary. As the sole breadwinner in her home, living month-to-month, she must use the funds available to pay school fees and associated costs for her children. As she also cares for her aged mother, five people rely on her steady income to survive. If she becomes seriously ill for an extended period of time, the effects are potentially catastrophic for her family, and compound pressure on the economy at large.

South Africa continues to carry a high burden of infectious diseases, including tuberculosis⁴ and HIV, while non-communicable diseases such as diabetes and cancer are rising. Cervical cancer remains the second most common cancer among South African women⁵. But when this cancer is detected early, the five-year relative survival rate exceeds 90 percent. That makes it imperative to raise awareness around early detection, as when cervical cancer is diagnosed at an advanced stage, survival drops significantly⁶.

Early and accurate diagnostics protect women’s ability to remain economically active, particularly for preventable illnesses. Early testing enables faster treatment, reduces complications and limits the need for more complex interventions later. In the case of infectious diseases, it also reduces transmission and protects colleagues, families and communities.

South Africa has a strong laboratory foundation to build on. The National Health Laboratory Service operates one of the largest diagnostic networks in the region, supporting large-scale testing every day⁷. Leveraging existing laboratory capacity allows screening and early detection programmes to expand in ways that are sustainable and aligned with national health priorities.

High-performance HPV testing, rapid HIV diagnostics, molecular tuberculosis testing and integrated blood panels are examples of tools that shorten the path from suspicion to confirmation. Reducing diagnostic delays supports workplace continuity and strengthens health system efficiency. In a country focused on improving workforce participation and economic resilience, this connection is direct.

Protecting women’s health strengthens household stability, supports workforce participation and reinforces economic resilience. Prioritising early diagnosis is a clear and measurable way to invest in South Africa’s long-term growth. 

It starts at home, with our mothers, sisters and daughters. Let’s keep reminding them, every now and then, to take a moment and consider their own well-being, for them, and for all of us.  

References

  1. Statistics South Africa. Quarterly Labour Force Survey (QLFS). Available at: https://www.statssa.gov.za/?page_id=16408
  2. Statistics South Africa. South Africa Time Use Survey. Available at: https://www.statssa.gov.za
  3. UN Women. Facts and figures: Economic empowerment. Available at: https://www.unwomen.org
  4. World Health Organization. Global Tuberculosis Report. Available at: https://www.who.int/teams/global-tuberculosis-programme/tb-reports
  5. Cancer Association of South Africa (CANSA). Cervical cancer. Available at: https://cansa.org.za/cervical-cancer/
  6. National Cancer Institute. Cervical Cancer Survival Rates. Available at: https://www.cancer.gov/types/cervical/survival
  7. National Health Laboratory Service (NHLS). About NHLS. Available at: https://www.nhls.ac.za/

Categories : Neurology Obstetrics & GynaecologyTags :

More Evidence Tying Epilepsy Drugs in Pregnancy to Developmental Risks

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Study adds weight to previously reported risks and calls for monitoring of new antiseizure drugs

Photo by SHVETS production

Findings published by The BMJ reinforce previous research linking use of the antiseizure drug valproate during pregnancy to neurodevelopmental disorders such as ADHD and autism in children, and indicate no substantial risk for several other antiseizure drugs including levetiracetam and lamotrigine.

However, the researchers say continued monitoring of the few signals – possible associations between a medicine and an unintended side effect – that emerged (eg, for zonisamide) will be important.

Antiseizure drugs are commonly and increasingly used by women of childbearing age for conditions like epilepsy, bipolar disorders, and migraine prevention. Women with epilepsy are advised to continue taking these during pregnancy, as uncontrolled seizures pose risks to both mother and child.

Yet, while valproate use during pregnancy has been linked to impaired neurodevelopment in children, information on other antiseizure drugs is limited.

To address this gap, researchers analysed claims data for pregnancies with diagnosed epilepsy from two large US public and commercial insurance databases, spanning the period from 2000 to 2021.

They compared 14,993 children exposed to at least one antiseizure medication during the second half of pregnancy with 8,887 unexposed children. Of these, 5,505 were followed for at least 5 years and 2,516 for at least 8 years after birth.

Potentially influential factors including mother’s age, ethnicity, mental health, substance use, other medication use and underlying conditions were also taken into account.

Valproate and zonisamide showed associations with several neurodevelopmental disorders, whereas levetiracetam and phenytoin were not associated with an increased risk of any of the studied outcomes.

Although no meaningful associations were found for topiramate and lamotrigine across most outcomes, there was a potential signal for intellectual disability (both drugs) and learning difficulty (topiramate only). However, the authors note that  these findings are based on small numbers and require confirmation in follow-up studies.

Several other drugs were also associated with a risk increase for intellectual disability. However, the authors note that these estimates are based on small numbers and therefore should be interpreted with caution.

Carbamazepine and oxcarbazepine also showed a modest risk increase for ADHD and behavioral disorders.

This is an observational study, so no definitive conclusions can be drawn about cause and effect, and the authors point to several limitations including relying on insurance claims data and the potential influence of other unmeasured factors such as underlying epilepsy type and severity.

However, the use of two large nationwide databases of insured pregnant women linked to their children enhanced the generalisability of their findings and enabled them to assess the risk of specific neurodevelopmental disorders associated with individual antiseizure medications. Results were also consistent after additional analyses, suggesting that they are robust.

As such, they conclude: “Our study reinforces the substantial risks of neurodevelopmental disorders associated with prenatal valproate exposure and suggests the need to further evaluate the safety of zonisamide during pregnancy.”

“Continued monitoring of newer antiseizure drugs and the few potential signals that emerged (ie, the moderate increased risk of ADHD and behavioural disorder after carbamazepine and oxcarbazepine exposure, and the association of several antiseizure drugs with intellectual disability) will be important,” they add.

Source: BMJ Group