Healthy isn?t something you are or aren?t. It?s a hundred little things: eating a banana, walking in the park, putting a bandage on a boo-boo, playing tag, reading up on ways to keep you and your family well and safe. It?s a balance between living well and taking care, and you can start right where you are.
A blog by Christina Elston
Healthy isn't something you are or aren't. It's a hundred little things: eating a banana, walking in the park, putting a bandage on a boo-boo, playing tag, reading up on ways to keep you and your family well and safe. It's a balance between living well and taking care, and you can start right where you are.


Archive for the ‘Pregnancy and Childbirth’ Category

Egg Freezing No Longer Experimental

Monday, November 5th, 2012

The American Society for Reproductive Medicine (ASRM) has removed the “experimental” label from egg freezing techniques used to preserve a woman’s fertility. But it still isn’t recommending the procedure for widespread use, saying it may give women “false hope,” and encourage them to delay childbearing.

Fertilized embryos have long been frozen and used to help infertile couples conceive, but the freezing of unfertilized eggs has only been closely studied as a reproductive technique since around 2001. It has mainly been used in women who were facing cancer treatment or other health issues that would damage their eggs. The ASRM’s previous report on egg freezing in 2008 called the technique experimental, and recommended that it only be offered in that context.

When used with in vitro fertilization, the new report, released at the society’s annual meeting Oct. 22, concludes that previously frozen eggs are as likely as fresh to produce healthy babies. But the society’s statement urges caution.

The quality of a woman’s eggs declines with age, making this an important factor. ASRM also cited a lack of data on safety, effectiveness, cost and emotional risks. “Patients who wish to pursue this technology should be carefully counseled,” says the report.

CDC Panel Recommends Whooping Cough Shot For All Pregnant Women

Wednesday, October 31st, 2012

With the U.S. on its way to a record-breaking number of whooping cough cases this year, an advisory panel for the Centers for Disease Control and Prevention (CDC) recommended Oct. 24 that all pregnant women be vaccinated against the illness – even if they had already received the vaccine before they became pregnant.

The illness, also known as pertussis, is a bacterial infection that causes a cough so violent it becomes difficult to breathe. Infants cannot be vaccinated against pertussis until they are two months old, and are most vulnerable to the disease.

The 32,000 cases already reported this year in the U.S. included 16 deaths, most of them infants. The country hasn’t seen an outbreak of these proportions since 1959.

The panel recommended in 2011 that pregnant women get a Tdap shot – which protects against tetanus, diphtheria and pertussis – if they had not previously received one. They now recommend the shots for all pregnant women because some of the immunity will transfer to her newborn, helping protect babies until they can begin receiving vaccines. Being vaccinated will also help ensure the new mother is healthy at the time of delivery, and doesn’t pass whooping cough along to her newborn.

Snoring During Pregnancy Points To Risk For High Blood Pressure

Thursday, September 27th, 2012

Fathers-to-be should keep their ears open at night and listen for snoring from the other side of the bed. It turns out that women who begin snoring during pregnancy are also at risk for high blood pressure and dangerous pregnancy complications.

Preeclampsia, a sudden spike in a woman’s blood pressure after her 20th week of pregnancy, leads to babies being born too soon, too small, and often needing critical care. The condition is also life threatening for mothers. Women who develop preeclampsia often have high blood pressure before or during pregnancy.

When researchers from the Sleep Disorders Center at the University of Michigan looked at data on more than 1,700 pregnant women, they found that about 25% started snoring frequently (three to four nights a week) during pregnancy. They were twice as likely to have high blood pressure as non-snoring women.

Study authors, whose work was published in the American Journal of Obstetrics and Gynecology, say that if doctors pay attention to this simple sign, they could prevent up to 19% of blood pressure problems during pregnancy, leading to healthier mothers and babies.

Sleep-disordered breathing, they say, can be treated with a CPAP (continuous positive airway pressure) machine, which uses mild air pressure to keep airways open. A study into whether use of CPAP decreases blood pressure in pregnant women is ongoing.

Government Cautions Caregivers About SimplyThick For Babies

Wednesday, September 19th, 2012

Babies born prematurely often have trouble swallowing their food – and keeping it down – because their digestive reflexes aren’t yet fully developed. A product called SimplyThick can help make breast milk or formula thicker and easier for them to swallow, but parents and caregivers are being cautioned about its use.

That’s because SimplyThick could be linked with a life-threatening condition called necrotizing entercolitis (NEC), where tissue in the intestine becomes inflamed and dies. Since May 2011, the Food and Drug Administration (FDA) has tracked 22 cases where infants being fed SimplyThick developed NEC. Thirteen of those babies required surgery, and seven died.

Further study of the product, sold at pharmacies across the country, is needed before the link with NEC is certain, but FDA recently reviewed all cases and advises parents to contact their doctors before using SimplyThick in babies.

Parents and others caring for infants using SimplyThick should watch for bloated stomach, greenish-tinged vomiting and bloody stools as signs of potential problems. FDA’s review of problems connected with the product was published Sept. 18 in The Journal of Pediatrics.

 

 

More Pregnant Women Are Taking Blood Pressure Drugs, But Is It Safe?

Monday, September 10th, 2012

High blood pressure, also called hypertension, is a dangerous side-effect of the inactivity and obesity crises plaguing the U.S. The condition can cause heart, kidney and other serious health problems, and is treated with a host of different medications. But what if the person being treated is pregnant?

It turns out that nearly 5% of pregnant women are given prescriptions to treat hypertension, and a look at more than 48,000 of these prescriptions shows that some were for drugs not considered safe for unborn babies.

Harvard Medical School researchers crunched data on Medicaid patients and found that use of antihypertensive drugs jumped from 3.5% of the population to 4.9% between 2000 and 2006. And the drugs prescribed to pregnant women included ACE inhibitors (with brand names like Lotensin, Capoten, Vasotec and Monopril) and angiotensin receptor blockers (sold as Atacand, Teveten, Avapro and others), which have been shown to cause poor growth, kidney problems and death in newborns – especially if the mother takes them during her second or third trimester. “If women are taking one of these blood pressure medications and they become pregnant or plan to do so, they and their doctors should discuss treatment choices during pregnancy,” says study author Brian T. Bateman, M.D.

Methyldopa (brand name Aldomet) and labetalol (brand names Normodyne and Trandate) are preferred during pregnancy, but Bateman says there isn’t much information on which blood pressure drugs are safest and most effective for women to use. More research is urgently needed.

This study appears Sept. 10 in the American Heart Association’s journal Hypertension, and was funded by the National Institutes of Health.

Learn more about types of blood pressure medications from the American Heart Association.

Study Says Declining Circumcision Rates Could Cost U.S. Billions

Monday, August 20th, 2012

Circumcision was once standard procedure for baby boys in the U.S. But as parents began to question whether it was really necessary, rates began to fall. And the practice continues to be controversial.

National and international studies point to the health benefits of circumcision – removal of the foreskin at the tip of the penis – finding it holds back buildup of bacteria and viruses in the penis’ skin folds. But the American Academy of Pediatrics (AAP) has stopped short of recommending it for all. In a post on their website dated July 30, the AAP says that while the organization believes circumcision has potential medical benefits, as well as risks, “the existing scientific evidence is not sufficient to recommend routine circumcision.” They suggest leaving the decision to individual parents and pediatricians.

Today just 55 % of the 2 million boys born yearly in the U.S. are circumcised, down from 79% in the 1970s and 1980s.

But Johns Hopkins disease experts and health economists warn that if parents continue to opt out, pushing circumcision rates down toward the 10% level that exists in Europe, rates of disease could climb – along with health care costs. The team constructed an economic model to predict the costs of not circumcising a male newborn, drawing on information from multiple studies and databases tracking the number of infections and numbers of new people infected.

If circumcision rates in the U.S. dropped to European levels, the model predicted:

• A 12% increase in men infected with HIV

• A 29% increase in men and 18% increase in women infected with human papillomavirus (HPV), which is closely associated with cervical cancer

• A 19% increase in men infected with herpes

• A 211% increase in male urinary tract infections

• A 50% increase in cases of female bacterial vaginal infections.

The researchers calculated that every infant boy not circumcised leads to $313 in illness-related costs that wouldn’t have been sustained if the circumcision had been performed. This would add up to $4.4 billion in avoidable costs if the circumcision rate in the U.S. dropped to 10%.

“There are health benefits to infant male circumcision in guarding against illness and disease, and declining male circumcision rates come at a severe price, not just in human suffering, but in billions of health care dollars as well,” said senior investigator Aaron Tobian, M.D., a Johns Hopkins epidemiologist.

The study was published online today in the Archives of Pediatrics & Adolescent Medicine.

Breast Milk For Tiniest Babies May Need a Little Help

Friday, August 17th, 2012

Mama’s milk clearly reigns as the best diet for all babies, and its benefits are especially important to babies born early or at very low birth weight (VLBW). VLBW and preemie babies fed breast milk are less likely to get infections, including a sometimes-fatal illness that kills intestinal tissue.

But because they haven’t been in the womb long enough to store up a normal stockpile of protein, calories, iron, calcium and vitamins, these early, tiny infants grow better when doctors supplement their mothers’ milk with some extra nutrients.

Researchers from the University of Iowa looked at birth records of VLBW babies (babies weighing less than 1,250 grams at birth) born between 2003 and 2005. All stayed in the hospital two to three months after birth, and all received supplements. The study found that all of the babies grew within the normal range, but that those receiving more than 75% human milk (and 25% supplement) grew more slowly than those fed less human milk and greater amounts of supplements.

The researchers recommend that care providers pay special attention to the amount of protein and calories these tiny babies receive, so that they get all the benefits of mother’s milk, but still grow as they should.

The study was published Aug.17 in the journal BMC Pediatrics.

‘Early Full Term’ Birth Linked With Lower Reading and Math Scores

Wednesday, July 11th, 2012

The link between preterm birth and risk of lower academic achievement has been established in a number of studies. But new research suggests that – when it comes to brain development – even for full-term babies, every week counts. Scientists have now found that babies born at the earlier end of the “full-term” range are more likely to have lower reading and math scores in third grade than those born just a few weeks later.

Researchers from Columbia University, Morgan Stanley Children’s Hospital and Mount Sinai School of Medicine started with birth records for all singleton babies born to mothers residing in New York City from 1988 to 1992. They then matched the records for those born between 37 and 41 weeks’ gestation (the range considered “full term”) with those same children’s third grade reading and math scores on standardized tests administered in New York City public schools.

In all, they matched records for more than 128,000 children, a group large enough to add significance to their findings. In general, test scores in both reading and math improved for each additional week babies spent in the womb. The most significant deficits were found in children born at 37 and 38 weeks.

Children born at 37 weeks’ gestation had a 14% greater risk of having mild reading impairment, 23% greater risk of having moderate reading impairment and 33% greater risk of having severe reading impairment than those born at 41 weeks. They also had a 16% greater risk of mild and 19% greater risk of moderate math impairment.

This was true even when researchers took a host of other factors that could hamper academic achievement – from the number of years a mother spent in school to lack of prenatal care, substance abuse, history of smoking, race/ethnicity and characteristics of the neighborhood where the mother resided – into account.

The study’s authors note that babies’ brains are growing rapidly between 37 and 41 weeks’ gestation, increasing their gray matter 50% and their white matter threefold. Being in the uterus, they say, likely supports this development. “Early term birth,” as the authors call it, could disrupt this growth. Based on their findings, the authors have two take-home messages for parents and doctors.

First, women and doctors planning early deliveries for nonmedical reasons should consider the potential impact of their decisions – which, as this study shows, lasts at least into elementary school. And second, pediatricians and parents should watch “early term” children in case they need extra educational support.

The study was published online July 2, and in the August issue of Pediatrics.

Have No Fear – And You Might Have Shorter Labor

Monday, July 9th, 2012

While mothers are generally a brave lot, the prospect of becoming mothers – specifically childbirth – terrifies some women. And a study out this summer shows that these women tend to spend longer in labor than women approaching delivery without fear.

Norwegian researchers surveyed more than 2,200 women pregnant with a single child who intended to deliver vaginally. In response to a questionnaire, they determined that around 7.5% of the women had fear of childbirth.

When the women had their babies, those with a fear of childbirth labored more than 90 minutes longer on average than those who were not afraid. Even when researchers accounted for factors such as whether the women had previously given birth, epidural analgesia, instrumental vaginal delivery and labor induction, women with fear still labored an average of 47 minutes longer.

Overall, average labor lasted 8 hours for women with fear of childbirth, and 6 hours and 28 minutes for women without. Women with fear of childbirth were also more likely to have their babies delivered by instrumental vaginal delivery or emergency cesarean.

Fear of childbirth has been attributed to young maternal age, being a first-time mother, pre-existing psychological issues, lack of social support and a history of abuse.

Experts say the connection between fear of childbirth, longer labor, and increased risk of obstetrical interventions needs to be explored further, so doctors and midwives can give pregnant women the support and advice they need. The study was published June 27 in BJOG: An International Journal of Obstetrics and Gynaecology.

 

Untreated Fever During Pregnancy More Than Doubles Autism Risk

Thursday, May 24th, 2012

Researchers from the UC Davis MIND Institute have linked untreated fever during a mother’s pregnancy with increased risk of autism or developmental delays in her child. In a large study including detailed information on participants, they found that women who reported fever had 2.12 times higher odds of having a child with autism and 2.5 times higher odds of having a child with developmental delay than women who reported no fever during pregnancy, or those who took anti-fever medication.

The study involved more than 1,100 women and their babies.

“If someone has fever during pregnancy they should take it seriously,” says lead study author Ousseny Zerbo, now a postdoctoral researcher with Kaiser Permanente, adding that this means taking over-the-counter anti-fever medication, and seeking medical attention if the fever persists. “Particularly during pregnancy, a lot of people don’t want to take any medication,” Zerbo says.

But treating fever also treats the acute inflammation that accompanies it, and this could be the connection between fever and autism risk. Another recent study based on the same data found that mothers who were obese or had diabetes – conditions associated with chronic inflammation in the body – were also more likely to have children with autism.

Both studies were based on data from the Childhood Autism Risk from Genetics and the Environment (CHARGE) study, which collected information on a large group of California children ages 2 to 5.

Infection with bacteria or viruses triggers a healing response that releases inflammatory elements from white blood cells into the bloodstream. Called cytokines, these elements are able to cross the placenta, and could impact a developing baby’s brain. “I think we need to do a lot more study regarding inflammation during pregnancy,” says Zerbo.

The study was published online May 23 in the Journal of Autism and Developmental Disorders.