2 June 2014

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Health Report 28 min 3 speakers 3 chapters transcribed 3 days ago

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Transcript generated automatically by AI and may contain errors.

What is the main focus of today’s Health Report episode?

Dr. Norman Swan 0:00

Hello and welcome to the Health Report with me, Norman Swan. Today we ask, can cancer really be prevented? We also ask how it's possible that there can be as much as a 36-fold difference in caesarean sections across Australia, a 7-fold difference in cardiac catheterisation to diagnose heart disease, and a 2-fold difference or more in hysterectomy and knee replacement rates. It doesn't seem due to differences in need across the nation, and it's too simplistic to say it's doctor-driven for profit. The fact is that it's potentially costing you and me as taxpayers a fortune. So more on that later. It's estimated that around half of women who smoke continue to do so in pregnancy, which, among many things, can seriously affect the lung development of the fetus.

Dr. Norman Swan 0:45

Now a trial of vitamin C in pregnant smokers has shown that it can help. The study was published in last week's edition of the Journal of the American Medical Association, and the editorial commenting on the findings was written by Professor Graham Hall, who's head of pediatric respiratory physiology research at the Telethon Kids Institute in Perth. There are

Graham Hall 1:04

studies in rats, some in monkeys, that have suggested that vitamin C in pregnancy blocks some of the effects of nicotine, and through this, ameliorate some of the negative effects of smoking on the lung development of offspring.

Dr. Norman Swan 1:23

Now, work in Perth, in fact, showed some years ago that smoking in pregnancy really is bad for the lungs of these babies.

Graham Hall 1:30

Yes, smoking during pregnancy is particularly harmful for lung development in the babies, but also mental health outcomes and behavior in babies whose mothers smoked are also adversely affected. So Smoking during pregnancy has a wide range of health effects on the baby, all of which are negative.

Dr. Norman Swan 1:51

And it's thought to be due to nicotine.

Graham Hall 1:53

Well, nicotine is one of the pathways, and obviously it's quite complex to tease out exactly which bit of smoking impacts on fetal development because cigarettes are full of a range of other incredibly harmful products. So tell me about this trial that they did that you commented on. This was quite an elegant trial following on from some of that animal research. This study was done in the United States. They recruited mothers who were smoking and who were unable to give up smoking following brief counseling sessions that encouraged them to do so. And they randomized the mothers to either receive vitamin C supplementation during their pregnancy or a placebo. And then they measured their lung function at about 50%.

Graham Hall 2:40

days of life and then again when the baby was one year of age and they also looked at what respiratory symptoms they had had in the first year of life so were they wheezing, did they need asthma medications for their wheeze and a range of other respiratory health outcomes as well.

Dr. Norman Swan 2:59

And what did they find?

Graham Hall 3:00

Well what they found is that at an average of three days of life the babies whose mothers had taken vitamin C had better lung function by about 10% and that at one year of age, the babies whose mothers had taken vitamin C, there was a small improvement in lung function, not quite as big as there were at three days of life. but also that those babies had half the amount of wheeze in the first year of life from 40% down to 20%, which is really quite a remarkable reduction.

Dr. Norman Swan 3:33

And this was significant statistically. In other words, it wasn't just by chance.

Graham Hall 3:36

Yes. So both of those impacts were statistically significant, suggesting that it's a real effect.

Dr. Norman Swan 3:43

And how much vitamin C for how long?

Graham Hall 3:45

They took it all the way through pregnancy. And the levels were sort of common to the type of vitamin C that you might take if you went down to a local health food store. Do you think this is a

Dr. Norman Swan 3:56

real

Graham Hall 3:56

effect?

How does vitamin C supplementation affect lung development in babies of pregnant smokers?

Graham Hall 3:57

I think it has the potential to be a real effect. It needs to be verified in further studies. But as a first step, And proof of concept, I think the results are quite promising.

Dr. Norman Swan 4:08

And did it matter the mother's level of smoking in terms of the effect of the vitamin C?

Graham Hall 4:12

So in this study, they didn't really look at the impact of how much mother smoked and whether that changed the outcome of vitamin C. The study wasn't big enough to really examine that effect.