“Pregnancy Is No Time to Refuse a Flu Shot - New York Times” plus 4 more

Pregnancy Is No Time to Refuse a Flu Shot - New York Times
Penelope Cruz Reacts to Pregnancy Rumors & Kissing Scarlett Johansson - WOKR 13
Penelope Cruz On Kissing Scarlett Johansson, Javier Bardem And The ... - Huffingtonpost.com
Pregnant? Get a flu shot _ but it may be a hassle - Napa Valley Register
Pregnant? Experts advise a flu shot - detnews.com

Pregnancy Is No Time to Refuse a Flu Shot - New York Times

Posted: 28 Sep 2009 09:26 PM PDT

This article is by Anne Drapkin Lyerly, Margaret Olivia Little and Ruth R. Faden.

Pregnant women are deluged with advice about things to avoid: caffeine, paint, soft cheese, sushi. Even when evidence of possible harm is weak or purely theoretical, the overriding caveat is, "Don't take it, don't use it, don't do it."

In a few contexts, the admonition is warranted; in most, it is merely inconvenient and anxiety provoking. But in the case of pandemic influenza, it may be deadly. With the second wave of swine flu at hand, and up to 50 percent of the public at risk, the usual mode of thinking about pregnancy and medications threatens to make a worrisome situation worse.

The dangers of this mentality became frighteningly apparent this summer, when a study in The Lancet reported strikingly high rates of death and of complications like pneumonia in pregnant women with H1N1 influenza. Pregnancy meant a fourfold risk of hospitalization, sometimes with a tragic outcome; all the pregnant women who died had been relatively healthy to begin with.

The Centers for Disease Control and Prevention have since put pregnant women at the top of the priority list for the vaccine, and have recommended that pregnant women start antiviral medications as soon as possible after exposure to the virus and after the onset of flu symptoms.

But if experience is any indication, even these forceful recommendations may not be enough to overcome reluctance among pregnant women and those who care for them. Even though the seasonal flu vaccine is recommended for pregnant women in particular, in one study only 15 percent received the vaccine — a rate far lower than any adult group for whom it is recommended.

And despite recommendations that antiviral drugs be started as soon as flu symptoms appear, many pregnant women in the Lancet study were not treated soon enough. Delays ranged from 6 to 15 days from the time that symptoms started, and 2 to 14 days from the time the women were seen by a doctor. Not one of the six pregnant and relatively healthy women who died received medication within 48 hours of the onset of her illness.

This is a sadly familiar pattern. After the thalidomide disaster of 1960s, and the very real concerns it raised about the impact of drugs on fetal development, many ended up viewing the use of any medicine by pregnant women as anathema. As a result, doctors and women alike often eschew or discontinue medications for serious illnesses, even when the harms of untreated disease, for women and the children they bear, are worse than any risks of medication.

Poorly treated asthma during pregnancy, for example, is associated with higher rates of pregnancy complications for women, as well as growth problems in the fetus and premature delivery. By contrast, women whose asthma is controlled with medication do as well as women without asthma, and so do their babies. Untreated diabetes early in pregnancy elevates the chances of severe birth defects to as high as 1 in 4.

And yet even when the evidence is clear, pregnant women find it hard to fight against the "don't take it, don't use it, don't do it" mentality, which focuses our minds and emotions only on the risks of taking a drug. Obscured from view are the risks of the disease itself.

Overcoming this mindset will take work on several fronts. Every effort needs to be made to alert pregnant women and clinicians about the special risks of H1N1 in pregnancy. Educational efforts need to be honest about the reasoning behind these important recommendations, including both the limits of what we know and the reasons that concern for pregnant women is now so great.

But the key to success, now and in the future, will be the conduct of research that is specific to the needs of pregnant women. Concerns about the ethics of research involving these women mean that we know far less about how to treat or prevent disease during pregnancy than for other adults and children. The urgent threat of H1N1 flu has brought into sharp relief the fact that pregnant women can and should be protected through research, not from it.

Studies enrolling pregnant women in trials of vaccines for swine flu, financed by the National Institute of Allergy and Infectious Diseases, are now under way at six major medical centers. Researchers are also studying ways to guide the use of antiviral drugs to suit pregnant women's changed metabolisms. Experts suggest that studying blood samples from as few as two dozen women is all we need to determine whether the standard adult dose of antivirals is effective for treatment or protection during pregnancy.

If there was ever a time to rewrite the playbook on how to think about drugs, vaccines and pregnancy, this is it. The lives of women and babies depend on it.

Anne Drapkin Lyerly is an associate professor of obstetrics and gynecology at Duke, Margaret Olivia Little is director of the Georgetown Kennedy Institute for Ethics, and Ruth R. Faden is director of the Johns Hopkins Berman Institute of Bioethics.

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Penelope Cruz Reacts to Pregnancy Rumors & Kissing Scarlett Johansson - WOKR 13

Posted: 28 Sep 2009 04:25 PM PDT

Rumors have been swirling as to whether Penelope Cruz is pregnant with her actor boyfriend Javier Bardem's baby -- the actress talks to Vanity Fair magazine about the reports and answers the question: Of her female costars, who is the better kisser, Scarlett Johansson or Charlize Theron?

Cruz locked lips with Johansson in the 2008 film 'Vicky Cristina Barcelona' -- which also starred Bardem -- and kissed Theron in the 2004 movie 'Head in the Clouds.' When asked to compare her smooches with the sexy stars, the Oscar-winning actress told VF, "No matter how I answer that I will be in trouble. Both were pretty beautiful partners."

As for the baby bump rumors, the actress answered the question by telling a story about her 'Volver' director Pedro Almodóvar. She said Almodóvar attempted to squash the pregnancy rumors when a journalist asked him about it on a red carpet, but it was to no avail and the gossip continues.

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Penelope Cruz On Kissing Scarlett Johansson, Javier Bardem And The ... - Huffingtonpost.com

Posted: 28 Sep 2009 03:21 PM PDT

Penelope Cruz appears in the November issue of Vanity Fair. The new issue hits newsstands in New York and Los Angeles on September 30 and nationally on October 6.

The press release with juicy excerpts from her cover interview with Ingrid Sischy is below, the whole profile is here.

PRESS RELEASE:
NEW YORK, N.Y.--Penélope Cruz, notoriously private and press-shy, tells Vanity Fair contributing editor Ingrid Sischy in a rare revealing moment that she is not pregnant with boyfriend Javier Bardem's baby.

"My most nosy Parker question--one that I felt it was my duty as a reporter to ask--was whether the widespread rumors that there was a wee Bardem-Cruz on the way were true," writes Sischy. "Here, unlike before, there was no telling silence from Cruz. Instead she answered no but in a rather baroque, roundabout way, detailing how [director Pedro] Almodóvar had tried, to no avail, to put that rumor to rest when a journalist asked him about it on a red carpet."

Normally mum when it comes to her relationship with Bardem ("It's more that she is protective of their privacy to a point that is striking even for performers who don't like to kiss and tell," Sischy writes), when Sischy brought up a U2 concert that she and Bardem had attended in Paris, mentioning that she'd heard Cruz was playing air guitar during some of the songs, Cruz squealed with delight, saying, "Javier is even better at air guitar!"

Sischy asks Cruz who was a better kisser: Scarlett Johansson, with whom she shared a famous make-out session in Vicky Cristina Barcelona, or Charlize Theron, whom Cruz smooched in the 2004 film Head in the Clouds. "No matter how I answer that I will be in trouble," she says. "Both were pretty beautiful partners."

Sophia Loren--Cruz's co-star in the upcoming film Nine--tells Sischy that Cruz "has become a real friend. We talked a lot about life and our careers. I talked about De Sica, she talked about Almodóvar. When it was my last day she came to my dressing room. She was crying, and I was crying. This is the first time that I have left a film crying because we got so upset about leaving each other."

Sischy writes that Cruz's anxiety is fascinating, coming from someone who is so fearless on-screen. "I've always been a worrier," says Cruz. "Since I was a little girl I've always felt that if I had a moment of peace I'd wonder: Are you sure you can afford to feel like this?"

Growing up in Alcobendas, Spain, outside of Madrid, Cruz and her sister, Mónica, hung out at their mother Encarna's hair salon every day. "It was my first acting school," she tells Sischy. "I would pretend to be doing my homework, but I was really observing the women. I found their behavior mesmerizing--what they were hiding, how they left feeling a little different after they'd been helped to become a little more like whom they wanted to look like. They treated the place a little bit like a psychologist's office. They would share all their secrets."

Mónica tells Sischy there were early indications that her sister would become a star: "Now, when we watch videos from when we were little we fall about laughing because it was so obvious. Whenever Penélope appeared in front of the camera she was acting or singing or dancing or all of them at once."

Woody Allen, Cruz's director for Vicky Cristina Barcelona, is effusive in his assessment of her ability, but tells Sischy, "I never thought about her as a person, because when I work I'm not interested in the person except as a performer. When she turned out to be lovely, that was nice, but I would have been O.K. if she had been a bitch." Regarding her beauty, he adds: "I don't like to look at Penélope directly. It is too overwhelming."

On the set of Nine, director Rob Marshall remembers, "She'd be the last one in that soundstage working, and I'd have to say, 'Penélope, it's over.' The day we were shooting her big song, 'A Call from the Vatican,' she was out there working so hard. In the middle of the number she does all this work with ropes--she was swinging on them and it was scary and she had formed calluses and her hands were bleeding. Daniel [Day-Lewis] was screaming to her from the back of the soundstage that she is a warrior. We had told her she should wear gloves, but she was like, 'No, no, no--I have to feel it.' There's this huge sheath of pink satin that she slides down on. When we finished the number she had disappeared behind the satin and was in tears. I said, 'Are you unhappy with what you did?' She said, 'No, no. It's that it is over, and I loved every second. I want to install ropes in my bedroom so I don't have to let go of it.' "

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Pregnant? Get a flu shot _ but it may be a hassle - Napa Valley Register

Posted: 28 Sep 2009 10:30 PM PDT

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Pregnant? Experts advise a flu shot - detnews.com

Posted: 28 Sep 2009 10:02 PM PDT

Lauran Neergaard / Associated Press

Washington -- It's hard for pregnant women to escape the message: You're at extra risk from swine flu -- it could trigger premature labor, hospitalize you for weeks, even kill you -- so be among the first in line for vaccine next month. But only about one in seven pregnant women get a flu shot each winter.

While federal health officials are working hard to raise that number this year, repeated swine flu warnings won't automatically overcome a key obstacle: Many obstetricians don't vaccinate. And not only are many women reluctant to go hunting for flu shots elsewhere, historically some pharmacists and other providers have been wary of vaccinating them.

"Maybe this year we can change that culture," says Dr. Anne Schuchat of the Centers for Disease Control and Prevention.

Any kind of flu is risky during pregnancy, and pregnant women have been on the get-a-flu-shot priority list for years. Their reluctance to take medication during pregnancy is one reason for the low vaccination rates.

With swine flu, what doctors call the 2009 H1N1 strain, pregnant women make up 6 percent of H1N1-confirmed deaths but account for only 1 percent of the populace, the CDC says.

Vaccine is a two-for-one deal during pregnancy: The mother's body makes flu-fighting antibodies that easily cross to the fetus, explains Dr. Neil Silverman of the University of California, Los Angeles. That's important because flu can easily kill newborns, yet babies can't be vaccinated until they're 6 months old.

The CDC and American College of Obstetricians and Gynecologists are urging obstetricians to partner with a nearby site -- a hospital or drugstore, for example -- to guarantee their patients a flu-shot source.