Medical Bulletin 11/August/2025 - Video

Here are the top medical news for the day:

Pregnancy Complications Like Stillbirth and Preeclampsia May Predict Stroke Risk Before 50

Women who experience complications during pregnancy may face a higher risk of having a stroke before the age of 50, according to a new study published in Neurology, the medical journal of the American Academy of Neurology. While the overall likelihood of early stroke remains low, the research suggests that complications such as preeclampsia, preterm birth, and stillbirth could serve as early indicators of elevated stroke risk.

The study, led by Dr. Frank-Erik De Leeuw of Radboud University in Nijmegen, the Netherlands, analyzed data from 1,072 women who had experienced at least one pregnancy. Of those, 358 had an ischemic stroke between the ages of 18 and 49, while 714 did not. Researchers compared the prevalence of various pregnancy complications between the two groups, focusing on conditions such as gestational diabetes, preterm delivery, miscarriage, and low birth weight.

The analysis showed that 51% of women who had a stroke had experienced at least one pregnancy complication, compared to just 31% of those who had not. After adjusting for age at first pregnancy, the researchers found women with a stroke were more than twice as likely to have had at least one complication.

The strongest associations emerged for stillbirth, linked to nearly five times the risk of early stroke, followed by preeclampsia, which was associated with a fourfold increase. Preterm birth and small-for-gestational-age babies were tied to nearly three times the risk. Many of these cases were associated with strokes from large artery disease, often related to atherosclerosis.

“While the overall risk of stroke is still very low, our study found pregnancy complications may be an early warning sign of stroke risk—even before age 50,” said Dr. De Leeuw. “Knowing this history could help doctors identify those who may benefit from early prevention and cardiovascular care.”

A limitation of the study is its reliance on self-reported data for some complications, which may lack the accuracy of medical records. Additionally, the researchers couldn’t account for all conventional stroke risk factors.

Reference: History of Pregnancy Complications and the Risk of Ischemic Stroke in Young Women, Verburgt, Esmée, Hilkens, Nina A. et al., doi: 10.1212/WNL.0000000000214009, Neurology, Wolters Kluwer, doi: 10.1212/WNL.0000000000214009

Heavy Drinking Linked to Higher Risk of Unintended Pregnancy: Study Finds

A new study published in the journal Addiction has found that non-pregnant women with a strong desire to avoid pregnancy are significantly more likely to experience an unintended pregnancy if they drink heavily. According to the research, heavy drinkers in this group had a 50% higher risk of becoming pregnant within a year compared to those who drank moderately or not at all. In contrast, cannabis use did not appear to increase the likelihood of unintended pregnancy.

Conducted by researchers at the University of California, San Francisco, the study focused on a subgroup of 936 non-pregnant women aged 15 to 34, all of whom expressed a strong desire to avoid pregnancy.

Researchers found that among the 936 women, 429 reported heavy drinking, based on a standardized alcohol screening questionnaire, and 362 reported cannabis use—including 157 who used cannabis daily or almost daily. Interestingly, both heavy drinkers and frequent cannabis users reported a stronger desire to avoid pregnancy compared to their peers.

Over the 12-month study period, 71 women in the high-avoidance group became pregnant. Of those, more than half (38) had been heavy drinkers. This was more than the combined number of unintended pregnancies among moderate or non-drinkers. In contrast, only 28 pregnancies occurred among cannabis users, indicating that cannabis use did not elevate the risk of undesired pregnancy.

Lead author Dr. Sarah Raifman noted, "In the meantime, given the potentially life-altering effects of fetal alcohol spectrum disorders (which occur when a fetus is exposed to alcohol through the mother's drinking) and the fact that the risk of FASD increases with the amount and duration of the mother's drinking, it's important for doctors and clinicians to support women who drink heavily to stop drinking as soon as they suspect an unintentional pregnancy."

The study underscores the need for better reproductive health counseling and support for women who drink heavily, especially those who strongly wish to avoid pregnancy.

Reference: Sarah Raifman, Sarah C. M. Roberts, Corinne H. Rocca. Alcohol and drug use and attainment of pregnancy preferences in the southwestern United States: A longitudinal cohort study. Addiction, 2025; DOI: 10.1111/add.70135

WHO Advises Against Routine Antibiotic Use in COVID-19 Cases Without Bacterial Infection

The World Health Organization (WHO) has issued new guidance discouraging the use of antibiotics in COVID-19 patients—even in severe cases—when there is no clear evidence of a bacterial co-infection. These updated recommendations, published in the WHO Clinical Management of COVID-19: Living Guideline, are based on findings from a recent systematic review and meta-analysis evaluating outcomes in patients who received antibiotics for COVID-19.

The updated recommendations apply to healthcare professionals, including clinicians, allied health workers, facility managers, and hospital administrators involved in managing patients with COVID-19 or post-COVID-19 conditions.

"For patients with non-severe COVID-19 and a low clinical suspicion of a concurrent bacterial infection, we recommend no empirical antibiotics. For patients with severe COVID-19 and a low clinical suspicion of a concurrent bacterial infection, we suggest no empirical antibiotics," the WHO stated in the guidance.

The recommendations come amid growing concern over antimicrobial resistance and a need to curb unnecessary antibiotic use. WHO noted that the environment in which COVID-19 care is delivered has evolved considerably since 2020. This includes reduced disease severity, lower hospitalization rates, and the integration of COVID-19 care into general healthcare systems following the withdrawal of emergency measures.

In response to this changing landscape, WHO has also streamlined its guidelines to focus specifically on COVID-19-related care. "This different environment has prompted a review of the scope and content of all existing guidance. In order to maintain a clear focus and relevance, we have removed recommendations which would be considered general medical principles, and those which are no longer specific to the management of COVID-19," it added.

The WHO emphasized that SARS-CoV-2 continues to cause preventable illness and death, though the widespread rollout of vaccines and treatments has substantially reduced the severity and fatality of the disease. "However, the virus continues to evolve in terms of infectivity, immune escape, and disease severity. This guideline robustly and transparently addresses the changing landscape and evidence availability, and the continual development of treatment and management strategies for COVID-19," the organization stated.

The updated guidance aims to promote evidence-based clinical practices while mitigating the global threat of antibiotic resistance.

Reference: https://app.magicapp.org/#/guideline/j1WBYn