News in brief - July 14, 2003

Cesarean deliveries at all-time high - FDA approves nasal flu vaccine - Walking and diabetes

Cesarean deliveries at all-time high

More than a quarter of pregnant women deliver by cesarean, according to preliminary 2002 data released by the Centers for Disease Control and Prevention. The rate for all cesareans was 24% in 2001 but now is slightly more than 26% for all women, although African-American women have the highest rate at almost 28%.

The rate of primary cesarean increased from 17% to 18% and the rate of vaginal birth after cesarean fell from 16% to 13%.

The report also found that the overall birth rate declined by 1% and the teen birth rate was at an all-time low, declining 5%.

"The reduction in teen pregnancy has clearly been one of the most important public health success stories of the past decade," said Health and Human Services Secretary Tommy Thompson.

Older women, however, are having quite a few babies. Birthrates among women ages 35 to 39 increased by 2% and the birth rate for women 40 to 44 increased by 6%.

FDA approves nasal flu vaccine

The Food and Drug Administration will allow FluMist, the first nasally administered flu vaccine, to be sold this coming flu season.

The product is the first approved live influenza vaccine and intended for healthy people ages 5 to 49. Children will need two doses at least six weeks apart. Adults and adolescents need only one.

Government officials hope that this move will take the pressure off the injectable vaccine supply, which has been unstable over the past few years, and possibly make people who don't like needles more likely to get immunized against the flu.

"This new vaccine provides another option for protection against influenza and will potentially increase the availability of the injected killed virus vaccine for those people at highest risk," said FDA commissioner Mark B. McClellan, MD, PhD.

FluMist also marks the return of Wyeth to the flu vaccine market. The company announced its withdrawal from the injectable flu vaccine market last year and will be co-marketing FluMist along with its manufacturer MedImmune Vaccines Inc.

More than 80 million doses of the injectable vaccine are expected for the coming flu season.

Walking and diabetes

Walking appears to be linked with lower death rates among adults with diabetes, according to an article in the June 23 Archives of Internal Medicine.

Adding to the evidence that being active leads to better health, walking and other forms of physical exercise were key components of lifestyle changes shown to prevent progression to diabetes among people with impaired glucose tolerance.

Physical activity also has been shown to improve insulin sensitivity, glycemic control and cardiovascular risk factors in people who already have diabetes.

Researchers at the Centers for Disease Control and Prevention examined data on 2,896 adults, 18 and older, with diabetes who participated in the 1990 and 1991 National Health Interview Survey. Of the participants, 39.2% were also considered overweight and 32.4% were obese.

Researchers found that one death per year might be preventable for every 61 people who could be persuaded to walk at least two hours per week.