Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Now on Colorado's Morning News, President Trump says the FDA
will notify doctors that pregnant women should not take tail
and All due to an increased risk of autism. However,
doctors worry this could now create more risks during pregnancy.
Speaker 2 (00:13):
The maker of thailand All recently a statement defending the
over the counter drug as safe for expectant moms and
joining us now in the ka Comma Spirit Health Hotline,
Maternal and Feudal Medicine, Obstetrics and Gynecology, Pregnancy and reproduction
Physician at u See Health and Shoots Medical Campus, doctor
Heather Straub, doctor, Welcome to Colorado's Morning News. Just from Jump.
Is it safe for pregnant moms to use tail and
(00:35):
All during pregnancy?
Speaker 3 (00:37):
The evidence overwhelmingly suggests that that's the case. You know,
titan All's been out since the nineteen fifties, It's been
used safely in pregnancy for decades and decades, and the
overwhelming evidence suggests there is no credible link between thailand
All use in pregnancy and autism.
Speaker 2 (00:54):
When should it be used?
Speaker 3 (00:57):
So with any medication in pregnancy, it's a risk be
a fit question, and so in the first trimester fevers
can actually cause neural tube defects, and so having high
fevers and early pregnancy is dangerous not only for the
mom but also for the baby, and so thailand Al
in that setting is a very reasonable choice. As pregnancy
(01:18):
goes along, you know, the non steroidal anti inflammatory such
as idprofen or a leave there's evidence, strong evidence of
credible harm to the baby. So if a mom has
a headache, or aches and pains or twists and ankle,
tilan al really is the medication of choice in the
second and third trimester.
Speaker 2 (01:38):
Doctor, what study is the administration citing for this decision?
Are you familiar with it?
Speaker 3 (01:44):
You know, I'm not exactly sure which study in particular.
But the problem with doing research in pregnancy is number one,
you know, the only way to get a really solid
piece of data is a randomized control. So that means
that you have two groups of people and one group
(02:05):
gets the medication in this case, that would be the
tile and AL. Another group would get something that's a
placebo that's not the tile and AL, and you look
prospectively to see what the outcomes are. And since there
isn't that kind of evidence, then the evidence comes from
studies that look retrospectively, so they say, okay, here is
(02:25):
a group of people whose kids have autism. Here's a
group of people whose kids don't have autism. Do you
remember taking kiln al? And there's there's problems with that
type of study because number one, you know, if you
have a kid who has something going on, you may
remember things a little more vividly during your pregnancy, like,
oh gosh, I do remember I took tile in all
(02:46):
Maybe that's the reason this outcome has happened. And there's
also concerns around correlation versus causations. So when you're looking
at epidemiology, there's a set of rules, the Bradford Hill criteria,
to suggest that what you're seeing truly reflects what's going
on biologically. So the way to think about that is,
(03:07):
you know, in the summer there's an increased risk of
people getting sunburned, and in the summer there's an increased
sales of ice cream. So someone could say, because you
have a sunburn, there's an increased sales of ice cream.
Those are two true things, but there's no plausibility as
to why they're linked. And so you know, it's one
(03:29):
of those things when you're studying thing medications in pregnancy
in particular, we'd use a lot of epidemiologic data, and
so we have to be cautious about whether it stands
up to sort of basic scrutiny, and this link really
does not meet those criteria at all.
Speaker 1 (03:47):
Doctor Straub. When we talk about the studies when it
comes to autism, what are some of the environmental and
physical factors things that have been studied that they say
this could be a link. There's multiple factors that they
believe could be causing it, but a pinpointing exactly what
those are can be a challenge.
Speaker 3 (04:05):
Absolutely, And I think one of the challenges with autism
in particular is that you know, it really over the
last well since I graduated med school in the early
two thousands, the prevalence of it, or how frequent we
see it has definitely gone up. But there is concern
that that's not because it's actually happening more frequently, but
(04:28):
because we're have a better diagnostic and screening criteria. And
so I think in these early stages of research, it's
very hard to go back retrospectively because the outcome the
thing that we're looking at, you know, twenty years ago
when I was in medical school was not the same
(04:50):
way of being defined as it is now. And so
I think moving forward, there are some target genes that
have some promise and things like that, and so I think,
you know, prospectively, moving forward, we have an opportunity to
do some further research. But I think retrospectively, there isn't
anything that is panning out to have that credible, strong,
(05:14):
persistent association.
Speaker 2 (05:16):
When it comes to issues like this, doctor, what question
should we as lay people as newspeople, And frankly, what
questions honestly should the administration or any administration ask when
it comes to health before they put out some sort
of protocols or studies or alerts to people for healthcare.
Speaker 3 (05:34):
That's a really good question. And I think it's really hard,
even as a physician to sometimes interpret the scientific literature,
and so I think some of the things to look
at are what the sources. You know, a regulously peer
reviewed article is helpful. Having multiple studies supporting the same
outcome is helpful. You know, if studies are clear about
(05:57):
what confounders or things that could be explaining this underlying
association is helpful. There are a lot of national and
international societies that have experts that go through and try
to consolidate the literature. So there's Cochrane Reviews, which is
an international database of revealing information. You know, there's the
(06:23):
American College of Obstetricians and Gynecologists in the United States.
This society from Maternal Fetal Medicine. These are pregnancy specific societies.
But I think getting multiple sources is helpful, and also
looking at the quality of the studies and then asking yourself, Okay,
what is the bias of the person or the people
(06:43):
presenting this. If a study is sponsored by a drug
company and it says a drug is effective, you know,
that always gives me a little pause to make sure
I go through and really rigorously look at the data.
Speaker 1 (06:55):
See you, Maternal Fetal Medicine physician, it's doctor Heather Straub.
Doctor strap thank you too much for your insight on
this this morning.
Now on Colorado's Morning News, President Trump says the FDA
will notify doctors that pregnant women should not take tail
and All due to an increased risk of autism. However,
doctors worry this could now create more risks during pregnancy.
Speaker 2 (00:13):
The maker of thailand All recently a statement defending the
over the counter drug as safe for expectant moms and
joining us now in the ka Comma Spirit Health Hotline,
Maternal and Feudal Medicine, Obstetrics and Gynecology, Pregnancy and reproduction
Physician at u See Health and Shoots Medical Campus, doctor
Heather Straub, doctor, Welcome to Colorado's Morning News. Just from Jump.
Is it safe for pregnant moms to use tail and
(00:35):
All during pregnancy?
Speaker 3 (00:37):
The evidence overwhelmingly suggests that that's the case. You know,
titan All's been out since the nineteen fifties, It's been
used safely in pregnancy for decades and decades, and the
overwhelming evidence suggests there is no credible link between thailand
All use in pregnancy and autism.
Speaker 2 (00:54):
When should it be used?
Speaker 3 (00:57):
So with any medication in pregnancy, it's a risk be
a fit question, and so in the first trimester fevers
can actually cause neural tube defects, and so having high
fevers and early pregnancy is dangerous not only for the
mom but also for the baby, and so thailand Al
in that setting is a very reasonable choice. As pregnancy
(01:18):
goes along, you know, the non steroidal anti inflammatory such
as idprofen or a leave there's evidence, strong evidence of
credible harm to the baby. So if a mom has
a headache, or aches and pains or twists and ankle,
tilan al really is the medication of choice in the
second and third trimester.
Speaker 2 (01:38):
Doctor, what study is the administration citing for this decision?
Are you familiar with it?
Speaker 3 (01:44):
You know, I'm not exactly sure which study in particular.
But the problem with doing research in pregnancy is number one,
you know, the only way to get a really solid
piece of data is a randomized control. So that means
that you have two groups of people and one group
(02:05):
gets the medication in this case, that would be the
tile and AL. Another group would get something that's a
placebo that's not the tile and AL, and you look
prospectively to see what the outcomes are. And since there
isn't that kind of evidence, then the evidence comes from
studies that look retrospectively, so they say, okay, here is
(02:25):
a group of people whose kids have autism. Here's a
group of people whose kids don't have autism. Do you
remember taking kiln al? And there's there's problems with that
type of study because number one, you know, if you
have a kid who has something going on, you may
remember things a little more vividly during your pregnancy, like,
oh gosh, I do remember I took tile in all
(02:46):
Maybe that's the reason this outcome has happened. And there's
also concerns around correlation versus causations. So when you're looking
at epidemiology, there's a set of rules, the Bradford Hill criteria,
to suggest that what you're seeing truly reflects what's going
on biologically. So the way to think about that is,
(03:07):
you know, in the summer there's an increased risk of
people getting sunburned, and in the summer there's an increased
sales of ice cream. So someone could say, because you
have a sunburn, there's an increased sales of ice cream.
Those are two true things, but there's no plausibility as
to why they're linked. And so you know, it's one
(03:29):
of those things when you're studying thing medications in pregnancy
in particular, we'd use a lot of epidemiologic data, and
so we have to be cautious about whether it stands
up to sort of basic scrutiny, and this link really
does not meet those criteria at all.
Speaker 1 (03:47):
Doctor Straub. When we talk about the studies when it
comes to autism, what are some of the environmental and
physical factors things that have been studied that they say
this could be a link. There's multiple factors that they
believe could be causing it, but a pinpointing exactly what
those are can be a challenge.
Speaker 3 (04:05):
Absolutely, And I think one of the challenges with autism
in particular is that you know, it really over the
last well since I graduated med school in the early
two thousands, the prevalence of it, or how frequent we
see it has definitely gone up. But there is concern
that that's not because it's actually happening more frequently, but
(04:28):
because we're have a better diagnostic and screening criteria. And
so I think in these early stages of research, it's
very hard to go back retrospectively because the outcome the
thing that we're looking at, you know, twenty years ago
when I was in medical school was not the same
(04:50):
way of being defined as it is now. And so
I think moving forward, there are some target genes that
have some promise and things like that, and so I think,
you know, prospectively, moving forward, we have an opportunity to
do some further research. But I think retrospectively, there isn't
anything that is panning out to have that credible, strong,
(05:14):
persistent association.
Speaker 2 (05:16):
When it comes to issues like this, doctor, what question
should we as lay people as newspeople, And frankly, what
questions honestly should the administration or any administration ask when
it comes to health before they put out some sort
of protocols or studies or alerts to people for healthcare.
Speaker 3 (05:34):
That's a really good question. And I think it's really hard,
even as a physician to sometimes interpret the scientific literature,
and so I think some of the things to look
at are what the sources. You know, a regulously peer
reviewed article is helpful. Having multiple studies supporting the same
outcome is helpful. You know, if studies are clear about
(05:57):
what confounders or things that could be explaining this underlying
association is helpful. There are a lot of national and
international societies that have experts that go through and try
to consolidate the literature. So there's Cochrane Reviews, which is
an international database of revealing information. You know, there's the
(06:23):
American College of Obstetricians and Gynecologists in the United States.
This society from Maternal Fetal Medicine. These are pregnancy specific societies.
But I think getting multiple sources is helpful, and also
looking at the quality of the studies and then asking yourself, Okay,
what is the bias of the person or the people
(06:43):
presenting this. If a study is sponsored by a drug
company and it says a drug is effective, you know,
that always gives me a little pause to make sure
I go through and really rigorously look at the data.
Speaker 1 (06:55):
See you, Maternal Fetal Medicine physician, it's doctor Heather Straub.
Doctor strap thank you too much for your insight on
this this morning.
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