"Found" needles pose low infection risk for kids

Children who are accidentally stuck with an improperly discarded needle or syringe appear to be at low risk for acquiring hepatitis or HIV, new research suggests.In a study published in the journal Pediatrics, Canadian researchers found that of 274 children with needlestick injuries, none became infected with HIV or the hepatitis B or C viruses.

Nevertheless, parents should immediately seek medical advice whenever a child is stuck by a potentially contaminated needle, say Dr. Caroline Quach and her colleagues.

To insure efficacy, "most prophylactic (preventive) measures need to be given early after the injury," Quach, from Montreal Children's Hospital and McGill University, told Reuters Health.

For their study, Quach and her colleagues assessed the risk of infection among 274 children who'd been stuck by a potentially contaminated needle and were seen over a 19-year period at two major pediatric hospitals in Montreal.

The children, most of whom received therapies to prevent infection, were followed for six months. This is the longest period of time over which someone could develop antibodies against the viruses in question and therefore show they were infected, Quach explained.

After six months the investigators found no hepatitis B, hepatitis C or HIV infections among the children they were able to test.

Children frequently find discarded needles in "safe" areas such as parks and around home, Quach said. Children may pick up these needles and intentionally stick themselves "not realizing there is a potential health threat associated to a needlestick injury," she noted.

The children in her study were 8 years old, on average, and in most cases had been stuck by a discarded needle found in the street or a park. About 65 percent of the children intentionally picked up the needle.

The number of needlestick injuries followed and treated in this study "is large enough to comfort us in the low risk of transmission of infections," Quach said.

Still, she and her colleagues say, children may need to be better educated about the dangers of discarded needles.

SOURCE: Pediatrics, August 2008.

28 million women at risk of unwanted pregnancy

Tue May 13, 11:07 AM ET

CHICAGO (Reuters) - Each year, half of American women who would rather not get pregnant will have an unplanned pregnancy, often because they failed to use their contraceptive properly or forgot to use it at all, U.S. researchers said on Tuesday.

As a result, 28 million women in the United States are at risk for an unintended pregnancy, according to the study conducted by the Guttmacher Institute in New York.

They found one in four women is very likely to become pregnant because of inconsistent contraception use.

Some of this gap is due to lack of access to health care, with many women saying they cannot afford some of the more effective methods of contraception such as birth control pills that require a doctor's visit and prescription.

"It is critical to have a better understanding of what is preventing women from using contraception consistently and correctly, or even at all," Dr. Jennifer Frost, a senior research associate at Guttmacher, said in statement.

The research involved surveys of women and family planning providers nationwide. Among the results, they found that more than half of women who have a gap in contraceptive use of at least one month have experienced some type of major life event -- such as the end of a relationship, a move, job change or personal crisis.

They also found that many women are not satisfied with their current method of contraception, a problem that can lead to missing birth control pills or failure to keep a condom handy, for example.

Last month the National Center for Health Statistics reported there were almost 6.4 million pregnancies in 2004, down 6 percent from 1990. Forty-five percent were to women who were not married, and there were 1.22 million abortions and 1.06 million stillbirths and miscarriages.

The researchers also found that many women who are lax about birth control are simply ambivalent about preventing a pregnancy and confessed that they would be very pleased if they found out they were pregnant.

The researchers said women who are the least motivated to avoid pregnancy are far less likely to use birth control pills, or any contraceptive method at all on a consistent basis.

They said a woman's attitude toward pregnancy, her satisfaction with her method and her experiences with gynecologists and other providers of contraception play a far bigger role in a woman's risk of pregnancy than other major risks, such as poor education and poverty.

Frost said doctors and other health providers should start by helping women to find the best contraceptive method for them.

"The more we can remove the remaining barriers to consistent use, the better we will be at ensuring that all women can avoid unwanted pregnancies and plan the children they want, when they want them," Frost said.

Mother's mental health tied to child's development

By Anne Harding Wed May 14, 3:59 PM ET

NEW YORK (Reuters Health) - Evaluating the emotional health and social connectedness of pregnant women may help determine if their children will need extra help to meet developmental goals later on, Canadian researchers say.

If children get this assistance early, there's a good chance they will do just fine, Dr. Suzanne C. Tough of the University of Calgary in Alberta, the study's lead author, told Reuters Health.

But Tough and her team found that more than half of the three-year-olds in their study who were identified as being at high risk for developmental problems had never been referred for assessment to see if they actually did have speech and language delays.

"We miss these children when our early intervention can be most effective," the researcher continued. Kids with mild to moderate delays who could make "huge strides" without extensive help are actually the most likely to fall through the cracks, she added.

To investigate early risk factors for developmental problems, which can, in turn, increase the likelihood that a child will fail in school and have behavioral issues, Tough and her colleagues looked at 791 mothers who had participated in prenatal care study and their children, who were now pre-school-age. All of the women had uncomplicated pregnancies and deliveries.

While 11 percent of the children were gauged to be at high risk for developmental problems, just 43 percent of these high-risk kids had been assessed. Those who were born preterm were more likely to have been identified as at risk, as were children who had undergone hearing tests and those with vision problems.

Children were more likely to be at high risk for developmental problems if they were male, had ear infections, came from a low-income environment, or had a mother with poor mental health during the prenatal period and after the child was born. Problems typically included depression, a history of abuse and a poor level of contentment.

Fifty-three percent of the kids who met each of these criteria were at high risk. However, when the mother's poor mental health was removed from the equation, the risk fell by 30 percent, to 18 percent.

"The big surprise to me in this data was just how important maternal mental health can be," Tough said.

The women typically didn't have serious psychiatric problems, she added, but were simply in poor mental and emotional health and frequently lacked good connections in their community and to friends and family.

Tough and her team are now evaluating whether a program that brings pregnant women together to help them build social networks will improve children's outcomes.

SOURCE: BMC Pregnancy and Childbirth, published online May 6, 2008.