Pregnant air travellers face a higher risk of blood clots, but they can reduce their risks by walking airplane aisles, drinking water and doing calf exercises, according to a new review.
For women with additional risk, doctors may recommend compression stockings and injectable blood thinners while traveling, the authors write in the Journal of Travel Medicine.
“Both pregnancy and air travel are risk factors for venous thromboembolism, or a blood clot in the legs or lungs,” said senior author Dr. Leslie Skeith of the University of Calgary, a member of the CanVECTOR Canadian thrombosis research network.
Blood clots affect about one to two per 1,000 non-pregnant people each year and are the third leading cause of vascular death after heart attacks and strokes, the authors note. With more than two billion passengers flying each year, about 150,000 cases of travel-related blood clots are diagnosed annually.
Long-distance flights tend to increase the risk by three-fold, yet travel-related studies either don’t include pregnant women or only include a small number and don’t directly investigate how pregnancy increases the risk.
“There is very little evidence to guide what pregnant and postpartum women should do to prevent blood clots while travelling,” Skeith told Reuters Health by email.
Skeith and her colleagues review the many factors that play into an individual’s risk for a blood clot, including height, weight, recent surgery, pregnancy, use of oral contraceptives, hormone replacement therapy and a family history of clots or diseases that promote clotting.
Why pregnancy heightens clot risk
With pregnancy in particular, they write, the risk is higher because of physiological changes, such as slower blood flow and blood vessel dilation. Pelvic blood vessels may also be compressed as the uterus grows. Starting in early pregnancy, the body starts to become hypercoagulable, or more likely to form blood clots. These risks remain higher until about 12 weeks after giving birth.
Although the average pregnant or postpartum air traveler faces an increased risk of clots, the absolute risk estimate is low at less than 1 per cent, the study found.
Pregnant women with other risk factors, such as inherited blood problems, obesity and recent surgery, may face a higher blood clot risk, however. Although the risk depends on individual factors, women with a history of blood clots tend to have a four per cent higher risk while pregnant, and those with hormonal-associated blood clots tend to have a six per cent higher risk while pregnant.
For most women with a history of blood clots, the risk during air travel still remains low at just over one per cent. At the same time, pregnant women who face these higher risks should consider using more extensive blood clot prevention measures while travelling, such as the injectable blood thinner low-molecular-weight heparin (LMWH).
Aspirin trial begins
“It is known that LMWH prophylaxis lowers the risk of recurrent thrombosis in women with previous venous thromboembolism,” said Dr. Ida Martinelli of the University of Milan, who wasn’t involved in the study.
However, some studies show that certain blood conditions and blood thinners can lead to complications during delivery, so it’s best to consult a doctor for individual recommendations.
Skeith and colleagues are now studying whether aspirin can prevent blood clots in postpartum women with risk factors for clots. The pilot randomized trial, called PARTUM, is expected to start in 2020.
“We desperately need more research to better prevent blood clots in pregnant and postpartum women,” Skeith said. “We recommend talking to your doctor about different options.”
Goodbye Pfizer, hello Comirnaty: Top COVID-19 vaccines given brand names in Canada – CBC.ca
Health Canada has approved brand names for Pfizer, Moderna and Oxford-AstraZeneca vaccines and announced the change on social media today.
The Pfizer-BioNTech vaccine has now been dubbed Comirnaty, which the company says represents a combination of the terms COVID-19, mRNA, community, and immunity.
The Moderna vaccine will go by SpikeVax and the AstraZeneca vaccine will be named Vaxzevria.
Pfizer and Moderna say the change marks the full approval of the vaccines by Health Canada, which were previously approved under an interim order that was set to expire today.
During the interim order, the vaccines didn’t go by their brand names, but now that new and more long-term data has been submitted and approved they will go by their permanent name.
“Health Canada’s approval of Comirnaty for individuals ages 12 and older affirms the vaccine’s safety and efficacy shown in longer term data submitted to Health Canada — and hopefully that licensure may improve vaccine confidence among Canadians,” Pfizer spokesperson Christina Antoniou wrote in a statement.
It’s the first time SpikeVax, until now known as the Moderna vaccine, has been fully approved anywhere in the world, Stephane Bancel, the company’s CEO, said in a press release Thursday.
Health Canada points out the vaccines themselves are not changing — only the names are.
Although the name change has been approved, Canada will still receive vials labelled Pfizer-BioNTech for the next several months.
The FDA approved new names in the United States earlier this summer, and the vaccines have been going by their brand names in the EU since the spring.
Better mental health support needed for pregnant individuals during Covid-19 pandemic: Study – Hindustan Times
Better mental health support needed for pregnant individuals during Covid-19 pandemic: Study
- A new study finds that more mental health support is needed for pregnant people during the pandemic after it was found that nearly three-quarters of individuals who were pregnant during this time reported moderate to high levels of distress.
A team of researchers suggested that more mental health support is needed for pregnant individuals after a survey found nearly three-quarters of individuals who had been pregnant during the pandemic reported moderate to high levels of distress, and one in five experienced depressive symptoms.
The findings of the study appeared in the journal titled ‘Canadian Family Physician’.
The researchers, led by clinicians at Unity Health Toronto, surveyed nearly 1,500 participants online – 87 per cent of whom were Canadian – who had been pregnant during the Covid-19 pandemic. Nearly 69 per cent of respondents reported moderate to high levels of distress and 20 per cent had depressive symptoms.
“The high levels of distress highlight the importance of considering mental health centrally in support for this population,” said Dr Tali Bogler, study lead author and family physician and chair of family medicine obstetrics at St. Michael’s Hospital of Unity Health Toronto.
“The findings also highlight the overall impact the pandemic has had on families in general and the downstream impact this will have,” added Dr Bogler.
A limitation of the study was that it did not have comparable data on distress levels among pregnant people prior to the pandemic. However, a population-based survey conducted in Japan before the pandemic found 28 to 32 per cent of pregnant people reported distress.
Researchers also sought to learn more about what the common sources of concern were for expectant parents during the pandemic. Participants were provided with a list of 27 concerns and asked to indicate their level of concern for each issue.
The top five concerns during pregnancy included: hospital policies regarding support persons in labour; not being able to introduce their baby to loved ones; getting sick from Covid-19 while pregnant; not being able to rely on family or friends after labour for support; and conflicting medical information on Covid-19 in pregnancy and newborns, especially early in the pandemic.
There were differences in the concerns of first-time and second/third-time parents. First-time parents were more concerned about the cancellation of in-person prenatal classes and hospital tours, whereas second/third-time parents were more concerned about the transmission of Covid-19 from older children in the home.
The authors said that family physicians are well placed to support perinatal mental health and can engage in screening practices and offer appropriate treatment, such as counselling, public health nursing, and psychiatric appointments. They also recommend hospitals better utilize technology to help address parents’ concerns by arranging more virtual check-ins and hospital tours and provide more online resources with evidence-based information on Covid-19 relevant to expectant and new parents.
“Clinicians and hospital administrators need to explore innovative ways to increase perinatal support,” said Dr Bogler, who is also one of the leads of the Pandemic Pregnancy Guide, a virtual platform that provides medical information on pregnancy and Covid-19 and helps form a community for expecting parents during the pandemic.
This story has been published from a wire agency feed without modifications to the text. Only the headline has been changed.
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