JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. The Archives Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENT
JAMA NEWS RELEASES
(Embargoed for Release: 3:00 p.m. CT, Tuesday, March 25, 2008)
JAMA NEWS RELEASES
PRETERM BIRTH ASSOCIATED WITH DIMINISHED LONG-TERM SURVIVAL, REPRODUCTION
STUDY EXAMINES ASSOCIATION BETWEEN TYPE OF GENETIC CHARACTERISTICS AND CANCER
JAMA REPORT (VIDEO SCRIPT)
VIDEO: Windows Media | Quicktime
BABIES BORN PREMATURE MAY HAVE CONTINUED HEALTH RISKS DURING CHILDHOOD AND ADULTHOOD
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Embargoed for Release: 3:00 p.m. CT, Tuesday, March 25, 2008
Media Advisory: To contact Geeta K. Swamy, M.D., call Debbe Geiger at 919-660-9461. To contact editorial co-author Melissa M. Adams, M.P.H., Ph.D., call Lisa Bistreich at 919-316-3596.
PRETERM BIRTH ASSOCIATED WITH DIMINISHED LONG-TERM SURVIVAL, REPRODUCTION
CHICAGO—An analysis of births in Norway found that persons born preterm had an increased risk of death throughout childhood and lower rates of reproduction in adulthood, compared to persons born at term, according to a study in the March 26 issue of JAMA.
Preterm birth, defined as birth within 37 weeks after conception, is a leading cause of infant death in the industrialized world, after congenital abnormalities. Disability occurs in 60 percent of survivors born at 26 weeks and in 30 percent of those born at 31 weeks, according to background information in the article. Little is known about the long-term risk of death and overall health among persons born preterm.
Geeta K. Swamy, M.D., of Duke University Medical Center, Durham, N.C., and colleagues conducted a study to determine how preterm birth affects long-term survival, subsequent reproduction and next-generation preterm birth. “Such information may be useful to practitioners caring for families with survivors of preterm birth as well as parents of preterm infants,” the authors write.
The researchers analyzed data from the Medical Birth Registry of Norway for 1,167,506 births from 1967-1988. The group was followed up through 2002 for survival. There was also an analysis for those born from 1967-1976 for assessment of educational achievement and reproductive outcomes through 2004. Of the 1,167,506 births, 60,354 (5.2 percent) were preterm. The percentage born preterm was higher among boys (5.6 percent) than among girls (4.7 percent), which is consistent with the male-dominated sex ratio of all births.
The researchers found that the preterm participants had an increased risk of death throughout childhood. For boys born at 22 to 27 weeks, mortality rates were 1.33 percent and 1.01 percent for early (1 - 5.9 years) and late (6 – 12.9 years) childhood death, with a 5.3 times higher risk for early death, and 7 times higher risk for late childhood death. The mortality rate for girls born at 22 to 27 weeks was 1.71 percent for early childhood death, with a 9.7 times higher risk for early childhood death; there were no late childhood deaths.
For 28 to 32 weeks, the early and late childhood mortality rates among boys were 0.73 percent and 0.37 percent, with higher risks of death of 2.5 times, and 2.3 times, respectively. Girls born at 28 to 32 weeks did not have a significantly increased risk of childhood death.
Reproduction during adulthood was diminished for participants born preterm compared to those born at term. For men and women born at 22 to 27 weeks, absolute reproduction was 13.9 percent and 25 percent, with men being 76 percent less likely to reproduce; women, 67 percent less likely. For those born at 28 to 32 weeks, absolute reproduction was 38.6 percent and 59.2 percent for men and women, with lower rates of reproduction of 30 percent, and 19 percent, respectively. Preterm women but not men were at increased risk of having preterm offspring.
“In this study population, preterm birth was negatively associated with both long-term survival and reproduction. As the preterm birth survivorship continues to grow, further studies will show whether improvements in obstetric and neonatal care affect survival as well as reproductive capacity and long-term quality of life. Continued research aimed at elucidating causal pathways and better therapeutic approaches are imperative for successful strategies to prevent preterm birth,” the authors conclude.
(JAMA. 2008;299[12]:1429-1436. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
EDITORIAL: THE FUTURE OF VERY PRETERM INFANTS — LEARNING FROM THE PAST
In an accompanying editorial, Melissa M. Adams, M.P.H., Ph.D., of RTI International, and Wanda D. Barfield, M.D., M.P.H., of the Centers for Disease Control and Prevention, Atlanta, comment on the findings of Swamy and colleagues.
“At present, clinicians can extend guarded optimism to the families of children who are born very preterm. The findings of Swamy et al illustrate that the survival of preterm infants—although lower than that of their term peers—improves to adulthood. Nonetheless, compared with their adult term peers, fewer adult preterm survivors reproduce. These risks should be interpreted cautiously because the majority of preterm infants have good health and good reproduction. Norway demonstrates better outcomes than the United States, which has persistent, stark racial disparities.”
“Because lifetime risk of poor health is increased among individuals who were born preterm, patients should inform their clinicians about their history of preterm birth. This information may help clinicians identify and manage childhood and adult chronic conditions. Clearly, population-based data on preterm delivery and its long-term consequences may be pertinent medical history for the nation’s future health.”
(JAMA. 2008;299[12]:1477-1478. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, March 25, 2008
Media Advisory: To contact Charis Eng, M.D., Ph.D., call Raquel Santiago at 216-444-4235.
STUDY EXAMINES ASSOCIATION BETWEEN TYPE OF GENETIC CHARACTERISTICS AND CANCER
CHICAGO—Persons with a certain type of homozygosity (having two identical copies of the same gene, one inherited from each parent), may have a greater predisposition to cancer, according to a study in the March 26 issue of JAMA.
In previous research, the authors observed a low frequency of germline (those cells of an individual that have genetic material that could be passed to offspring) heterozygosity (possessing two different forms of a particular gene, one inherited from each parent) in cancer patients compared with controls, raising the question whether homozygosity could play a role in cancer predisposition. “Homozygosity is common in humans and extended homozygote tracts have been described in several studies. Cancer susceptibility genes are also numerous in the genome. These facts together increase the likelihood that homozygosity might occur in the loci [the specific site of a particular gene on its chromosome] of cancer susceptibility genes. One can then hypothesize that germline homozygosity at these loci may somehow contribute to cancer predisposition,” the researchers write.
Charis Eng, M.D., Ph.D., of the Cleveland Clinic Foundation, and colleagues conducted a study to determine the frequency of germline homozygosity in a large series of patients with three different types of solid tumors compared with population-based controls. The study included germline and corresponding tumor DNA, which was isolated from 385 patients with carcinomas (147 breast, 116 prostate, and 122 head and neck carcinomas), and was subjected to genetic analysis.
The researchers found: “Our data derived from 3 different solid tumors, validated in a fourth, demonstrate that high frequencies of germline homozygosity at specific markers are associated with these cancers compared with controls … Importantly, we were able to independently validate our observations in a different type of solid tumor, lung carcinoma, by showing an increased frequency of germline homozygosity in cancer cases compared with ancestry-matched controls.”
“...our observations here should be validated in these solid tumors and explored in other malignancies. If our data can be robustly replicated independently, then germline homozygosity at specific loci as low-penetrance alleles [one of a number of alternative forms of the same gene occupying a given position on a chromosome] predisposing to carcinomas could be taken into account in future cancer risk assessments and management beyond high-penetrance cancer susceptibility genes. Additionally, with further studies and fine structure analyses, it may be possible to use such data to predict the likelihood of loss of heterozygosity in a tumor at specific genomic loci if we knew the relative frequencies of germline homozygosity/heterozygosity at those same loci,” the authors write.
(JAMA. 2008;299[12]:1437-1445. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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JAMA REPORTS
VIDEO: Windows Media | Quicktime
BABIES BORN PREMATURE MAY HAVE CONTINUED HEALTH RISKS DURING CHILDHOOD AND ADULTHOOD
INTRO:
Preterm birth is a leading cause of infant mortality. Babies born before thirty-seven weeks gestation face a variety of health complications. While many do grow up to be perfectly healthy, a new study reveals some will continue to experience certain health problems as they grow older. Jennifer Mitchell explains in this week’s JAMA Report.
VIDEO:
Moms holding premature babies
AUDIO:
THEY ARE FRAGILE AND TINY AND WEIGH ONLY A FEW POUNDS. PARENTS OF THESE PREMATURE BABIES WORRY GREATLY ABOUT THEIR HEALTH.
VIDEO:
SOT/FULL
Super @: 10
Carla Ransom
Mother
Runs :09
AUDIO:
“She did have some problems with breathing and having her heart rate what they call brady down and had to be on a caffeine drip for over a week.”
VIDEO:
B-ROLL
Picture of baby in ICU
AUDIO:
CARLA RANSOM GAVE BIRTH TO LITTLE ALEXANDRA SEVEN AND A HALF WEEKS EARLY.
VIDEO:
SOT/FULL
Carla Ransom
Mother
Runs :08
AUDIO:
“I was certainly very hyper vigilant when bringing her home about whether she was breathing and when she was eating and very focused on how much she was eating.”
VIDEO:
B-ROLL
Picture baby in ICU
Moms and preterm babies
AUDIO:
A NEW STUDY, LOOKING AT HOW PREMATURE BABIES DO AS THEY AGE, INDICATES SOME FACE AN INCREASED RISK OF MORTALITY INTO CHILDHOOD COMPARED TO BABIES BORN FULL TERM.
VIDEO:
SOT/FULL
Super @: 45
Geeta Swamy, M.D.
Duke University Medical Center
Runs:10
AUDIO:
“Boys and girls born at the extreme premature range which we consider twenty-two to twenty-seven weeks had a much higher chance of mortality somewhere on the level of nine or ten times higher.”
VIDEO:
B-ROLL
Doctor talking to others
Doctor looking at data
Babies
AUDIO:
DOCTOR GEETA SWAMY WITH DUKE UNIVERSITY MEDICAL CENTER IS PART OF A TEAM OF RESEARCHERS WHO ANALYZED DATA FROM ABOUT SIXTY THOUSAND PREMATURE BIRTHS IN NORWAY. THEY ALSO LOOKED AT REPRODUCTION RATES AND FOUND MEN BORN PRETERM DID WORSE THAN WOMEN.
VIDEO:
SOT/FULL
Geeta Swamy, M.D.
Duke University Medical Center
Runs :05
AUDIO:
“Men were less likely to reproduce if they were born prematurely as compared to women.”
VIDEO:
B-ROLL
Researcher at computer
Mom rocks baby
Heart machine pan to baby
GFX/JAMA COVER
AUDIO:
RESEARCHERS SAY THE REASON FOR THIS IS STILL UNCLEAR BUT IT’S POSSIBLE MEDICAL PROBLEMS OR DIMINISHED COGNITIVE ABILITY COULD MAKE IT MORE DIFFICULT FOR SURVIVORS OF PRETERM BIRTH TO FIND A MATE. CONGENITAL PROBLEMS MAY CONTRIBUTE TO THE INCREASED RISK OF MORTALITY. THE STUDY APPEARS THIS WEEK IN JAMA, JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.
VIDEO:
SOT/FULL
Carla Ransom
Mother
Runs:05
AUDIO:
“As a parent of a preterm baby the more information you have the more comfortable you are.”
VIDEO:
B-ROLL
Mom and baby
Picture baby at six months
AUDIO:
RESEARCHERS SAY PARENTS NEED TO BE AWARE OF THE POSSIBLE LONG-TERM RISKS. FOR NOW, CARLA FOCUSES ON ONE DAY AT A TIME AND SAYS ALEXANDRA, NOW SIX MONTHS OLD, IS THRIVING AND DOING WELL. JENNIFER MITCHELL, THE JAMA REPORT.
TAG:
It’s important to point out that while there are risks, many premature infants do grow up and experience normal, healthy lives. Researchers say more studies are needed to help find ways to prevent premature births from occurring. Data for this study was collected from the Medical Birth Registry of Norway from 1967 through 2004. For more information about this study you can log on to www.jama.com.
