Journals Watch - Hot tea, smoking and labour

Too busy to read all the journals? Let Dr Gwen Lewis bring you up to date on the latest research.

Hot tea and oesophageal cancer BMJ online 2009; 338: 6,929
Golestan, an area of northern Iran, is known to have a high incidence of oesophageal squamous cell carcinoma. The tea-drinking habits of this area were studied in a population-based case control study in which 300 proven cases of oesophageal cancer were found.

The results of the study showed that, compared with drinking lukewarm or warm tea, drinking hot or very hot tea was associated with an increased risk of oesophageal cancer. The risk was associated with the time tea was left between pouring and drinking it.

At least I have little to worry about - firstly I don't like tea and secondly, like most GPs, I end up drinking my almost cold coffee between patients.

Are babies getting bigger? Med J Aust 2009; 190(6): 312-15
It is my impression in my own practice that newborn babies are getting bigger. This was certainly the case in New South Wales, Australia between 1990 and 2005.

All live-born singleton births delivered at 37 weeks' gestation or more were studied - a total of 1,273,924 births. Mean birth weight increased by 23g for boys and 25g for girls, while the proportion of babies born large-for-gestational age (defined as >90th centile for sex and gestational age) increased from 9.2 per cent to 10.8 per cent for boys - a relative increase of 18 per cent - and from 9.1 per cent to 11 per cent for girls - a relative increase of 21 per cent.

Increasing maternal age, higher rates of gestational diabetes and a decline in smoking rates contributed to the findings.

Breastfeeding and rheumatoid arthritis Ann Rheumatic Dis 2009; 68: 526-30
More than 18,000 women in Sweden were studied and incidence rates of rheumatoid arthritis (RA) identified. The 136 women who developed RA were matched with four controls in each case.

It was found that a longer history of breastfeeding was associated with significantly reduced risk of RA, even after adjustment for smoking. Use of oral contraceptives did not have the same effect.

This sounds like a further reason to encourage breastfeeding for a prolonged duration.

Text to stop smoking Tob Control 2009; 18: 88-91
Reducing smoking rates is high on the government health agenda with many initiatives in place. Rates of quitting are improved when additional input in the form of nicotine-replacement or other medication is used. But would text messaging support help?

A total of 200 participants responded to radio, poster and leaflet-based promotions regarding the trial of mobile phone-based smoking cessation support in London.

At four weeks there was a greater than double self-reported quitting rate of 26 per cent versus 12 per cent.

This appears an effective and easy means of delivering smoking cessation support in the short term. The long-term effects are due to be studied in the near future.

Does stopping smoking early in pregnancy help? BMJ online 2009; 338: b1,081
Smoking is known to have adverse effects on pregnancies, including growth retardation and increasing the risk of preterm birth. I had not previously read about the effects of stopping smoking early in pregnancy on these risks.

A total of 2,504 women in Australia and New Zealand were studied. Of these women, 80 per cent were non-smokers, 10 per cent stopped smoking within the first 15 weeks of pregnancy and 10 per cent continued to smoke while pregnant.

There were no differences in rates of spontaneous pre-term birth or small for gestational age infants between the non-smokers and those who stopped smoking, while current smokers had higher rates of both spontaneous pre-term birth and small for gestational age infants than either of the other groups.

It appears that the adverse effects of smoking may be reversible if smoking is stopped in early pregnancy. We should therefore do all we can to encourage and help women to stop smoking while pregnant.

Effect of eating during labour BMJ online 2009; 338: b784
When I was in labour with my children, I was advised to take only sips of water. Women have been discouraged from eating during labour for years, but does a light diet really have any harmful effects?

Results of this prospective randomised controlled trial of 2,426 nulliparous women at term with a single, cephalic presenting fetus and in early labour would seem to show no adverse effect of a light diet.

The primary outcome was spontaneous vaginal delivery rate, which was the same in both groups at 44 per cent.

In addition, no difference was found between the groups on duration of labour, the incidence of vomiting, neonatal outcome or the Caesarean section rate. I was rather alarmed to see that the Caesarean section rate in both groups was 30 per cent, which seems very high.

There appears to be no reason why women should not eat a light diet while in labour. This might make the whole experience a little more pleasant.

  • Dr Lewis is a GP in Windsor, Berkshire, and a member of our team who regularly review the journals.

The quick study

  • Oesophageal cancer risk is increased by drinking hot or very hot tea.
  • Mean birth weight in newborns appears to be increasing.
  • Breastfeeding appears to protect against development of rheumatoid arthritis.
  • Quitting smoking may be assisted by patients receiving mobile phone- based support.
  • Pregnant patients who stop smoking in early pregnancy reduce the risk to the fetus.
  • Eating during labour appears to have no adverse effect on mother or baby.

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