Week 34 of pregnancy reduces breast cancer risk: study

Kosovan girls dressed as ballet dancers hold roses and perform in front of the National Theatre on October 10, 2018 during the International Breast Cancer Awareness Month, to raise awareness on breast cancer and to promote prevention. (AFP)
Updated 24 October 2018
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Week 34 of pregnancy reduces breast cancer risk: study

  • The link between pregnancy and breast cancer risk reduction is well known among medical researchers, who have suggested breast cells fundamentally alter their composition when a woman first falls pregnant and they prepare to produce milk

PARIS: Women’s bodies undergo a “striking” change during a specific week of pregnancy that can significantly reduce their risk of developing breast cancer later in life, scientists said Tuesday.
Previous research has highlighted how women under the age of 30 can reduce their risk of contracting breast cancer later in life by having a baby.
But a new study by experts in Denmark and Norway claims to have identified the precise week of pregnancy when the change occurs.
“If you deliver a child at week 33 you get the child, which is great, but you don’t get the bonus of having a lower risk of breast cancer for the rest of your life,” Mads Melbye, from the University of Copenhagen’s Department of Clinical Medicine and lead study author, told AFP.
“It’s a very distinct change in risk when you go from week 33 to week 34.”
A typical pregnancy lasts 40 weeks and a baby born before 37 weeks is considered premature.
Melbye and his team studied a huge database of nearly four million women in Denmark and Norway stretching back almost 40 years.
It listed the age at which each of them gave birth, how far into a pregnancy each birth occurred and whether or not they contracted breast cancer later in life.
They found that women who gave birth after 34 weeks had an average 13.6 percent lower risk of developing breast cancer compared to women who had no children.
For pregnancies that ended a week earlier, the reduction in risk — while still there — was only 2.4 percent.
Melbye said what changes in women during this vital week of gestation remains a mystery.
“We don’t know what that is, but knowing that you have to get to this point of the pregnancy makes it much easier for researchers to focus because we have to know what happens around that week to understand this,” he said.
He said it may be possible a woman’s body sends a signal after 34 weeks of pregnancy to boost immunity against environmental causes of breast cancer.
“To the best of our knowledge it must have something to do with a specific biological effect that the cells reach at 34 weeks.”

The link between pregnancy and breast cancer risk reduction is well known among medical researchers, who have suggested breast cells fundamentally alter their composition when a woman first falls pregnant and they prepare to produce milk.
But Melbye and his team found that a second or third pregnancy of at least 34 weeks reduced the risk of breast cancer even further.
This held true even in women who experienced stillbirths after 34 weeks, meaning the change is unlikely to be linked to breastfeeding.
Authors of the study, published in the journal Nature Communications, said it would allow scientists to better probe the link between pregnancy and breast cancer risk by focusing on a narrow window during which the “striking” change occurs.
Although the reduction of risk is dramatic, there’s a catch: researchers found that the additional protection against breast cancer only comes in women under 30.
“It’s not only the first childbirth; every childbirth has its own reduction in breast cancer risk but there’s a trick to this: You have to have your kids before you turn 29,” said Melbye.
“Because after that age there’s no extra bonus in breast cancer risk (reduction).”


Blood donation in the Middle East: The gift of life that is easy to give

Updated 14 June 2019
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Blood donation in the Middle East: The gift of life that is easy to give

  • World Blood Donor Day observed on June 14 to raise awareness of the life-saving importance of blood donation
  • Regular, voluntary donors are vital worldwide for adequate supply of safe blood and blood products

DUBAI: Blood donations in the Middle East have been described as “the gift of life” as the region struggles to cope with the demands posed by conflicts, humanitarian emergencies and the medical needs of a growing population.

International health experts have called on regular donors to step forward to mark World Blood Donor Day on June 14.

This year’s campaign focuses on blood donation and universal access to safe blood transfusion, and according to the World Health Organization (WHO), more donors are needed “to step forward to give the gift of life.”

Those who benefit most from blood donations include people suffering from thalassaemia, a blood disorder that affects hemoglobin and the red blood cell count, as well as victims of road accidents, cancer patients and sickle-cell disease patients.

Experts say while the Gulf Cooperation Council (GCC) countries have launched numerous initiatives to raise awareness of the lifesaving importance of blood donation, there is an increasing need across a wider region for regular donors.

“Many countries in the region face challenges in making sufficient blood available while also ensuring its quality and safety, especially during humanitarian emergencies and conflicts,” Dr. Ahmed Al-Mandhari, WHO regional director for the Eastern Mediterranean, told Arab News.

The GCC countries say they collect in total more than 10 whole blood donations per 1,000 population per year, or about 1 percent, Al-Mandhari said.

According to WHO, blood donations by 1 to 3 percent of the population are sufficient to meet a country’s needs. Even so, achieving self-sufficiency is a daunting challenge for many countries.

Al-Mandhari said that more than 90 percent of the blood is collected from voluntary, unpaid donors, aged from 18 to 44, with an increasing proportion of repeat donors. What is more, blood demand is unpredictable and even differs with each blood type. “For example O- blood can be given to patients with all blood types. But AB+ can only be given to patients with AB+,” he said.

Then there is the issue of short shelf life.

“To be ready to help patients in all hospitals, countries aim to stock usually six days’ worth of each blood type at all times,” Al-Mandhari said. “Since blood has a short shelf life — a 42-day window — and cannot be stockpiled, blood banks are forced to depend on donors to help maintain stocks.”

WHO’s most recent report on blood safety and availability points to “gaps in the key elements of national blood systems” in the Middle East.

A Saudi donor flashes the v-sign for victory as he gives blood in Jeddah. The Kingdom has one of the highest rates of repeat donors in the region. (AFP )

While GCC countries have taken steps to keep stocks at optimum levels, other countries in the Middle East are lagging behind international standards. The WHO report shows wide variations in annual blood-donation rates among countries, ranging from 0.7 per 1,000 population in Yemen to 29 per 1,000 population in Lebanon.

Al-Mandhari laid out the solution in a few easy steps: “Governments need to provide adequate resources, and put in place systems and infrastructure to increase the collection of blood from voluntary, regular unpaid blood donors, provide quality donor care, promote and implement appropriate clinical use of blood; and set up systems for oversight and surveillance across the blood-transfusion supply chain.”

On the positive side, Saudi Arabia recorded a rate of 13.8 per 1,000 population, with a healthy spread across all age groups. The country also has one of the highest rates of repeat donors (91 percent) in the region. According to the WHO report, the proportion of repeat, voluntary, non-remunerated blood donation in the Kingdom is 65.3 percent, which “will keep the prevalence of transfusion-transmissible infections among blood donors at much lower levels than in the general population.”

In recent years, Saudi health officials have introduced a number of measures to ensure adequate stocks in blood banks, including those run by the Ministry of Health and dedicated centers. These include a large facility at King Fahad Medical City (KFMC) and the country’s Central Blood Bank.

In the Kingdom, to be eligible for blood donation, donors must be aged over 17, weigh more than 50 kg, and have passed a brief medical examination. The health ministry recently launched Wateen, an app designed to ease blood-donation procedures and help ensure facilities across the Kingdom have adequate quantities of blood by 2020.

KFMC officials say that every day at least 2,000 units of blood components are needed to sustain a minimum supply for patients at the facility and other governmental and non-governmental hospitals in Riyadh. Donated blood components are essential for the management of cases involving cancer, sickle-cell disease, organ transplant, surgery, childbirth and trauma, to name just a few.

The situation is not very different in the other GCC countries, which also need more donors.

In the UAE, Dubai Blood Donation Center, which accounts for roughly half of the total blood collected in the emirates, frequently highlights the urgent need for donors. In 2018 alone, it ran 635 blood-donation campaigns, which resulted in 63,735 donors and a collection of 50,456 blood units.

While all blood types are needed, negative blood types are in greater demand due to their rarity. “There is a continuous demand for all blood types as blood lasts for only 42 days. So donors are always needed to come forward to replenish these stocks,” Dr. Mai Raouf, director of Dubai Blood Donation Center, said.

“People can donate blood every eight weeks, with each donation potentially saving up to three lives,” she told Arab News. 

Given that transfusion of blood and blood products save millions of lives every year, and the fact that “regular donors are the safest group of donors,” the importance of encouraging people to return to donate blood, rather than be one-time donors, can hardly be overemphasized, experts say.

“Without a system based on voluntary, unpaid blood donation, particularly regular voluntary donation, no country can provide sufficient blood for all patients who require transfusion,” Al-Mandhari said.

“WHO is calling on all countries in the region to celebrate and thank individuals who donate blood — and to encourage those who have not yet donated blood to start donating,” he said.