You’ve probably seen the recent headlines or shared Facebook posts with sensationalized titles along the same lines as The Washington’s Post headlines of “Hold up, new moms: Before eating your placenta, consider this new study.” I propose a new headline of, “New paper and literature review say absolutely nothing new” but that’s not going to draw nearly as much buzz, social media activity, or page clicks that bring up ad revenue as the headlines making bolder statements. Let’s take a look at what these new publications are and what it is actually saying, headlines aside.
First, we have Northwestern Research Assistant Stephanie A. P. Schuette, BA and Principal Investigator Crystal Clark, MD of the Asher Center for the Study & Treatment of Depressive Disorders, Department of Psychiatry and Behavioral Sciences published a paper on the results of a small, targeted survey study regarding awareness and beliefs related to placentophagy. The survey was distributed to only 153 female patients ages 19-57 at Northwestern Hospital from both the postpartum unit of Prentice Women’s Hospital as well as and psychiatry patients in their women’s mental health clinic.₁ This is a small “convenience sample” from a targeted population, not a randomized sample which is the gold standard in unbiased representation of data.
The population size for this study should be mothers living in the US if you’re looking for this data to speak for all such women. That’s quite a large number. Even if you’re looking to make to population for the study solely mothers in the Chicagoland area, that is still quite a large number, considering that the 2010 US Census has the female population of Chicago clocking in at 1,388,232.₂ Subtract 622,683 for the percent of people under 18 and 277,647 for those over 65 and you’re still left with 487,902 women between the ages of 19 and 64, which is about the same range as the survey respondents.
A sample size of 153 survey respondents is not indicative of the hospital population which does 12,000+ births a year, let alone Chicago as a whole, or the United States. The survey covers 0.0003% of the female Chicago population within the target age range and cannot be used to make broad generalizations about placentophagy even if the questions asked actually addressed experienced benefits and risks, which they do not. The survey respondents were also disproportionate with the racial distribution of the city’s population, as per the US census. So to start with, we’re looking at data that doesn’t have much to say in regards to extrapolating to the rest of the regional or national population.
Let’s look at what they’re actually asking these 153 Chicago females age 19-57 at their facility.
Patients were asked₁:
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If they had heard of placentophagy and where
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If they believed there were benefits or risks to placentophagy
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If they were willing to try placentophagy
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If they were more willing to try placentophagy or medication
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If they had tried placentophagy
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If they felt healthcare providers should discuss placentophagy with patients
What was not assessed, despite the headlines:
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Any benefits or risks of placentophagy
The conclusion actually states, “Women are choosing placentophagy and reporting multiple benefits despite the lack of empirical evidence of therapeutic efficacy. More research examining the actual content of placenta tissue and capsules is necessary in order to determine the true potential benefits, and risks, of this practice.”₁
Somehow we jumped from the paper’s conclusion that women are reporting benefits and more research is necessary to the headlines we’ve seen in the news this past week.₁ Schuette and Clark stating that a literature review of published works does not yield empirical evidence of placental benefits, nor does it yield empirical evidence of risks.
The second paper that came up in the news this week was a literature review from Northwestern’s Cynthia Coyle which reviewed ten publications related to placentophagy and did not yield empirical evidence of the benefits reported by mothers. This is not news. ₃ Mothers, placenta specialists and critics alike have been calling for actual, scientifically valid research for years because it has not yet been done. The 2013 Selander, Cantor, Young & Benyshek study also includes a literature review with the same finding that more research needs to be done to concretely establish the reported benefits.₄
Another 2013 study, by Cremers and Graff Low, in Maine had a sample size of 215 including women and men, to determine similarly how many had heard of placentophagy, participated in it, etc.₅ The findings of this study were different than Northwestern’s survey of 153, which could be accounted by regional differences as well as a larger variance in prenatal care and beliefs. The respondents to the Northwestern survey, as well as the two above mentioned surveys were predominantly Caucasian convenience samples and not randomized samples of the target population. Until further research is done, such literature reviews and convenience sample surveys will not yield fruitful or significant results.
According to Mark Kristal, PhD, studies of non-human mammalian mothers show significant benefits however we need medically relevant human studies to determine if these significant benefits translate. We know we need more research and we would love to see it done.₆ APPA members would even be thrilled to participate in the preparation of placentas for studies. Should any researchers be interested in conducting unbiased, un-sensationalized work they are certainly encouraged to contact us with study proposals.
Sources:
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http://www.feinberg.northwestern.edu/research/news/research_day/2015/All-Clinical-Abstracts.pdf
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http://quickfacts.census.gov/qfd/states/17/1714000.html
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http://www.northwestern.edu/newscenter/stories/2015/06/eating-the-placenta-trendy-but-no-proven-health-benefits-and-unknown-risks–.html#sthash.9aSom19R.dpuf
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http://bit.ly/1GuSWn7
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http://www.tandfonline.com/doi/pdf/10.1080/07399332.2013.79832
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http://www.buffalo.edu/news/releases/2012/03/13306.html
