Tag: Annals of Internal Medicine

A ‘Baby’ Aspirin a Day May Help Prevent a Second Pregnancy Loss

A ‘Baby’ Aspirin a Day May Help Prevent a Second Pregnancy Loss

Women who have had a pregnancy loss and are trying to get pregnant again may benefit from a daily low-dose aspirin.

Nicholas Bakalar

  • Jan. 27, 2021, 12:07 p.m. ET

For women who have had a pregnancy loss and are trying to become pregnant again, a simple routine might increase their chances: taking one baby aspirin a day.

A previous randomized trial suggested that aspirin had no beneficial effect. But a re-analysis of the data, concentrating on women who were strictly adherent to the dosage, shows that a daily 81-milligram tablet taken while trying to become pregnant and throughout pregnancy is highly effective. The new report is in Annals of Internal Medicine.

The re-analysis included 1,227 women aged 18 to 40 who had one or two pregnancy losses and were trying to get pregnant again. The researchers found that compared with placebo, taking a baby aspirin five to seven days a week resulted in eight more pregnancies, 15 more live births, and six fewer pregnancy losses for every 100 women in the trial. The key was strict adherence to the aspirin regimen.

Women who were most adherent were more likely to be married, non-Hispanic white and of higher socioeconomic status, and less likely to be smokers. The association of daily aspirin use with successful pregnancy was apparent even after controlling for these factors.

The lead author, Ashley I. Naimi, an associate professor of epidemiology at Emory University, cautioned that the findings apply only to women who have lost one or two pregnancies, but those women, he said, “could consider low-dose aspirin provided there are no other contraindications for aspirin use.” Check with your doctor about taking a daily low-dose aspirin.

The Best Shoes for Knee Arthritis

The Best Shoes for Knee Arthritis May Be Stiff, Stable and Cushioned Ones

People with knee arthritis were less likely to report pain and stiffness if they wore stable, supportive shoes, versus flat-soled, flexible ones.

Nicholas Bakalar

  • Jan. 19, 2021, 5:00 a.m. ET

Some experts recommend flat, flexible shoes for people with knee osteoarthritis, whereas others say stable, supportive shoes are better. Now a randomized trial has found that the latter — a stiff and stable shoe with good cushioning — is better than a supple and bendable one.

Osteoarthritis is the most common joint disorder in the United States. According to one recent estimate, 14 million Americans suffer from the pain and stiffness of knee arthritis.

Australian researchers randomly assigned 164 men and women, average age 65, to wear either a flexible or stiff shoe for at least six hours a day for six months. Footwear in the flat shoe category included the Merrell Bare Access, the Vivobarefoot Primus Lite, the Vivobarefoot Mata Canvas, the Lacoste Marice and the Converse Dainty Low. In the stable supportive group, shoes included the ASICS Kayano, the Merrell Jungle Moc, the Rockport Edge Hill, the Nike Air Max 90 Ultra and the New Balance 624.

Before and after the study, the researchers administered questionnaires and scales measuring pain, function and comfort. The report is in Annals of Internal Medicine.

The researchers found that 58 percent of those wearing stable shoes achieved a clinically significant reduction in pain, compared with 40 percent wearing the flexible shoes. On assessments of function, 11 percent more stable shoe wearers reported improvements. Those who wore stable shoes were also less likely to report other problems: 15 percent of the stable shoe wearers reported such issues as knee swelling, ankle or foot pain, or pain in other parts of the body caused by the shoes, compared to 32 percent of those wearing flexible shoes.

The senior author, Rana S. Hinman, a professor of physiotherapy at the University of Melbourne, said that while a supportive shoe is helpful, it is not a substitute for other effective strategies like weight control and exercise.

Still, she said, “based on our clinical trial, people with knee osteoarthritis should choose to wear stable, supportive shoes with thicker cushioned soles, rather than flat shoes with thin, flexible soles that have no cushioning.”