reproductive health
For anyone considering taking the pill after giving birth
Taking hormonal birth control in the first year after having a baby was associated with a 1.5 times higher "instantaneous" risk of depression as opposed to not taking it, according to a study published yesterday in JAMA Network Open. That applies to the combination pill, non-oral combination methods (patch, ring), and non-oral progestogen methods (implant, injection, hormonal IUDs), but not the progestogen-only pill. And for those who took the combination pill, the risk was higher the earlier that treatment started.
The results are based on a nationwide Danish dataset including everyone who gave birth to their first child between 1997 and 2022. In that cohort of more than 610,000 first-time parents, 40% started some sort of hormonal birth control in the first year. The increased risk was particularly pronounced for patients without a prior mental health issue. It's critical for providers to talk about these potential risks with patients, the study authors wrote.
(Some reading suggestions from the STAT archives: a feature about how women with postpartum depression can fall through the cracks and a beautiful First Opinion about the experience by one of STAT's own editors.)
mistakes
When retracted studies sneak into systemic analysis
Over the decade between January 2013 and April 2024, the highest-impact medical journals published 61 systematic reviews with 173 meta-analyses that included at least one retracted study. Oops! In most cases, the study was retracted after the review was published, and 11 reviews have since been revised or retracted. That's all according to, well, a systematic review, published yesterday in JAMA Internal Medicine.
The review found that, overall, the impact was "modest," as recalculated effect estimates mostly remained within a narrow confidence interval. The small changes to the results that did occur were most often in favor of the tested intervention, and the changes were meaningful in 14% of the analyses. Researchers and journal editors should have a process in place to manage the possibility of retractions and how they affect these analyses, the authors write.
global health
An HIV 'miracle drug' in jeopardy
The Trump administration's decision to sharply cut international assistance and close USAID has left the future of the hugely successful President's Emergency Plan for AIDS Relief, or PEPFAR, in question. The program, estimated to have saved 26 million lives since its inception in 2003, was on track to save millions more: In collaboration with other global funders, PEPFAR was slated to deploy resources to distribute Gilead Sciences' lenacapavir. The rollout of the "miracle" HIV prevention drug, which only needs to be administered by injection twice yearly, is now in jeopardy.
Secretary of State Marco Rubio in January signed a waiver for PEPFAR to only fund prevention for pregnant and breastfeeding women, leaving out vulnerable populations such as adolescent girls and young men who have sex with men. But PEPFAR's future funding, even for that narrow population, is uncertain.
One international aid and HIV expert says that ensuring lenacapavir is available is a "deal not to be missed," because the drug is an American innovation that could yield profits for Gilead if it licenses the medicine as planned. In doing so, this would not only create jobs for Americans, but save millions of lives in poor countries. That, she says, is reason for Trump to get on board. Read more from Ed Silverman and Jason Mast.
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