Pregnancy and child birth (Part 2)
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Yesterday I ran out of time to write about research topics about pregnancy and childbirth – so here is part 2:
Archives of Pediatrics and Adolescent Medicine reports that when pregnant women get a flu shot and then give birth during the flu season the babies do not seem to be protected from respiratory disease as newborns. The research studied 3160 babies from mothers who were vaccinated and 37,969 who weren’t.
New data from the Centers for Disease Control and the National Center for Health Statistics show that around 30% of babies born in the US are through a C-section. This is a record high (in 2005), while the number of teenagers giving birth has gone down dramatically. The 2005 rate of teen (15-19) births was 40.4 out of 1000. In 1991 it was 61.8 in 1000 births.
A study in Obstetrics & Gynecology prevents evidence that amniocentesis during the 4-6th months ”midtrimester” of pregnancy does not raise the rate of a miscarriage. Amniocentesis is of course the procedure in which a needle is inserted through the abdomen to the uterus to get a sample of amniotic fluid for purposes of diagnosing genetic diseases, gender, etc. This study by Dr. Keith A. Eddleman from Mount Sinai School of Medicine, New York examined a large amount of data – from around 3000 women who had amniocentesis and 31,000 who didn’t. One of the interesting things they noticed was that in women over 35 the rate of miscarriage after amniocentesis was 1.06% and for women of that age range who didn’t have it was higher – 1.92%.
A few other odd and ends related to pregnancy and childbirth – metformin – given to women for polycystic ovary syndrome and type 2 diabetes does not seem to increase the risk of birth defect when given during the first trimester (Fertility and Sterility). Women who are given drugs to induce labor have nearly double the chance of an amniotic fluid embolism (Lancet). New guidelines suggest reducing the number of embryos implanted for in-vitro fertilization to 2 or less for women under age 35, 2 or 3 from 35 to 37, 4 for 38 to 40 and 5 for women over the age of 40. Research in the The Cochrane Library suggests that hypnosis, acupuncture, massage, relaxation, aromatherapy and acupressure may help to reduce labor pain.
And finally, a report from a Czech journal, Naturwissenschaften, suggests that women who are infected with the parasite that causes toxoplasmosis are more likely to have boys. Usually 51% of babies are boys, but in women with this parasite it was found that 61 percent of babies were boys. People can become infected with it from eating undercooked meat or exposure to the feces of cats. Pregnant women exposed to the parasite have a greater chance of having a baby with birth defects which is the reason pregnant women are recommended to have someone else clean their cat’s litterbox. The data also showed that the more antibodies the woman had to the parasite the more likely she was to have a boy – with the women who had the highest amount having a 72% chance of having a boy.
(Technorati Tags: amniocentesis, pregnancy, miscarriage, toxoplasmosis, childbirth)
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January 8, 2007
Pregnancy – diet, weight gain and diabetes
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I haven’t written much here about pregnancy and childbirth, mostly because it is not something I’ve had experience with. However, it is obviously a women’s health issue, so here is a summary of the topic from the past few months.
Pregnancy and Diet
The International Journal of Obstetrics and Gynecology reports that eating too much fish during pregnancy is dangerous because of the mercury levels. This isn’t new, but this most recent study was in women in Taiwan. Methylmercury – the form of mercury usually found in fish – can pass through the placenta and then to the fetus. Fish with higher levels of mercury like shark, swordfish, king mackerel and tilefish and are not recommended for pregnant women according to the FDA. Tilapia and shrimp has lower levels of mercury and are safer.
Diabetes and Pregnancy
The November issue of the Journal of Pediatrics includes research showing that babies whose mothers had diabetes while pregnant and needed to be treated with insulin had immature sucking abilities, possibly due to a less mature nervous system, than women whose diabetes was managed with diet.
Increasing levels of hemoglobin A1C early in pregnancy is associated with a poor outcome, although it was not as useful to predict the outcome of any individual pregnancy. The American Diabetes Association recommends the level of A1C to be 7.0 or lower. Research was in the journal Diabetes Care.
Many women of Mexican descent tend to have babies with high infant birth weights. This can be explained in part by the weight of the mother before and during pregnancy. This weight gain is sometimes associated with blood sugar levels that are excessive and abnormal according to the American Journal of Public Health.
On the other hand, a paper published in BJOG: An International Journal of Obstetrics and Gynecology indicates that women with a BMI less than 18.5 before pregnancy have a 72% higher chance of having a first trimester miscarriage. A higher intake of fresh fruits and vegetables can help as can taking vitamins especially those with folic acid or iron. Women in the study who had morning sickness were nearly 70% less likely to have a miscarriage.
Related to the above stories an article in Diabetes Care presents evidence that women who have given birth to 5 or more kids have a greater chance of getting type 2 diabetes later in life. The study looked at data from 7000 African-American and Caucasian women. It is not known if the effect is due to biology or lifestyle, but is independent from obesity and socioeconomic status.
Women with type 1 diabetes that keep their blood sugar under control have a lower chance of developing preeclampsia – published in BJOG.
(Technorati Tags: pregnancy, diabetes, childbirth, mercury, fish)
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- Pregnancy and newborn health
January 4, 2007
Recent trends and research in birth control
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Many women around the world still do not have the resources available to them to limit the number of children they give birth to. In some parts of Africa only about 10% of women are using any form of contraception. Around the world roughly 80 million women have unwanted pregnancies – and end up having unsafe abortions. A large number of these women are not getting access to family planning because of religious and political barriers.
Even in the United States, where teen pregnancies have been declining – the current administration still insists on promoting abstinence as the only way to teach young people to prevent unwanted pregnancies. This is despite a recent published report in the American Journal of Public Health showing that decline is due to increased use of contraceptives, not abstinence.
The data used was derived from interviews with over 2000 women in both 1995 and 2002. It was discovered that in women between 15 and 19 years old pregnancies went down by 34% and that this was primarily due to increased use of contraception such as birth control pills and condoms.
In a study in Obstetrics & Gynecology it was found that many young women – about half! – have never heard of IUD’s. Only 2.1% of women in the US use IUD’s, although they are more popular in other countries. Apparently many young women do not realize that they are safe now or how effective they are. It doesn’t surprise me that many women have not heard of them. And I would guess the problems with some of them in the past still influences some women, if even indirectly. Unless things have changed since I last read about IUD’s, I believe a doctor still has to insert and remove them. I would imagine that would keep many women from wanting to use them, it certainly is a factor for me.
Speaking of IUD’s – use of IUD’s and birth control pills may give some long term protection from endometrial cancer according to a report in the International Journal of Cancer. This study examined over 2000 Chinese women in the Shanghai area. It found that long term use of birth control pills reduced the risk of the cancer by as much as 50%. And IUD’s reduced the risk by 47%. It is not known what may be causing this effect but the progestin in birth control pills may decrease the overgrowth of cells in the endometrium. And IUD’s may help to eliminate abnormal and precancerous endometrial cells and reduce the number of estrogen receptors.
And additional studies on birth control pills indicates that women who have access to a larger supply of pills at a time, rather that just one month at a time are more likely to use them properly. No surprise here – sometimes you just can’t make it to the pharmacy in time. I wonder if this will prompt insurance companies to let us refill our medications in more reasonable time frames? Somehow I doubt it, insurance companies don’t exactly have our needs as a high priority. This study was published in Obstetrics & Gynecology by Dr. Diana Greene Foster and others at the University of California, San Francisco.
And the news I like to hear: according to a study in Contraception continuous use of ‘an oral contraceptive combination of levonorgestrel and ethinyl estradiol (LNG/EE) can safely eliminate menstruation in most women’. I doubt doctors will suddenly be telling us it is ok to stop having periods, but it is a step in the right direction. I have always been interested in this research, it is good to hear of more progress.
Well, that’s all for now – running out of time again!
(Technorati Tags: birth control , cancer, contraception, condoms, cancer, abortion)
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January 2, 2007
More breast cancer news
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It hasn’t been that long since I posted an update about breast cancer – but there is already a lot more to post about!
A paper in the Archives of Internal Medicine presents data from 116,000 women shows that those who have infertility issues due to an ovulation disorder also have a lower incidence of breast cancer – 25% less. Of course it is just a correlation, but indicates that there may be no long term consequences to infertility treatment as the risk was lowest in the women who had been treated for infertility with induced ovulation.
Another correlational study supports the previous evidence that weight gain increases the risk of breast cancer. This one was published in the International Journal of Cancer and states that there is around a 70% increase in the chance of developing breast cancer in women who gained more than 60 lbs between ages 20 and menopause. This is in contrast to women who gained no more than 20 lbs. over the same period.
The Journal of the National Cancer Institute has a report on 2437 women who have survived breast cancer – those who decreased their fat intake after treatment by around 40% had a lower return of cancer than those who didn’t. The effect may be due to the weight loss that went along with the fat intake reduction rather than the reduced fat level itself. Also, women with estrogen receptor-negative breast cancer may see the effect more than women with estrogen receptor-positive cancers.
Along those same lines, another study published in the Archives of Internal Medicine suggests that women who eat more red meat have a greater chance of developing estrogen receptor-positive breast cancer. Specifically, those who ate greater than 1.5 servings of red meat on an average day had nearly twice the chance of getting cancer than women who only had 3 or less servings in a week. This effect could be due to either hormone residues, iron or other carcinogens in the meat.
A few weeks ago Science published a report that shows that one of the active ingredients in the pill RU-486 may also help to stop the formation of breast cancer in mice with the BRCA-1 mutation. Progesterone can stimulate the development of breast cancer since it accelerates cell division. However, mifepristone (one of the ingredients in RU-486) blocks the action of progesterone.
There is lots more research out there – but I’m out of time today! I’ll try to keep my blog updated as much as possible with new research.
(Technorati Tags: breast cancer, brca-1, red meat, fat)
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- Preliminary research results and the media – more harm than good?
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