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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June 14, 2006
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The New England Journal of Medicine had a recent article about how the use of angiotensin-converting–enzyme (ACE) inhibitors by women in their first trimester of pregnancy can result in major congenital malformations.
Previously it had been shown that the use of ACE inhibitors during the 2nd and 3rd trimesters of pregnancy could result in an increased chance of fetopathy.
ACE inhibitors are used to treat hypertension and cardiovascular disorders. They work by lowering arteriolar resistance and increasing venous capacitance; increasing cardiac output and cardiac index, stroke work and volume, lowering renovascular resistance, and leading to increased natriuresis (from Wikipedia)
The study looked at 29,507 babies born between 1985 and 2000 . Of these 209 were exposed to ACE inhibitors in just the first trimester and 202 were exposed to other antihypertensive drugs in just the first trimester. The rest were not exposed to any medications for hypertension during gestation.
Based on vital records and hospitalization claims while they were under a year old it was determined the ones exposed to the drugs during the 1st trimester had a greater chance of major congenital malformations. The authors of the study suggest that ‘exposure to ACE inhibitors during the first trimester cannot be considered safe and should be avoided’. Reference: New England Journal of Medicine Volume 354:2443-2451 June 8, 2006 Number 23
(Technorati Tags: pregnancy, ACE inhibitors, trimester, hypertension, NEJM)
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May 22, 2006
Got twins?
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A new study by Dr. Gary Steinman shows that women who drink milk are 5 times more likely to have twins than women who don’t eat or drink any animal products.
The study compared the number of twins born to women who ate a regular diet, vegetarians (who do consume dairy products), and vegans (no animal products).
Gary Steinman believes that levels of IGF (insulin-like growth factor) may be involved. IGF is released from the liver in response to growth hormone. It results in ovaries being more sensitive to follicle stimulating hormone – which increases ovulation.
Since IGF enters milk, including cow’s milk, this may be why milk drinkers have a greater chance of having twins. Vegans have a 13% lower level of IGF in their blood.
Some women just naturally have higher levels of IGF. Black women have higher rates of twin births and they also have higher levels of IGF in their blood. Asian women tend to have much lower IGF levels and also the lowest rate of twin births. Caucasian women have levels some where in between.
Also, in cows, genes that influence the chance of having twins are near the gene for IGF.
Possible explanations for the number of twins has increased in the last 30 years include fertility treatments, women delaying pregnancy and hormones fed to cows.
Gary Steinman works at the Long Island Jewish Medical Center in New Hyde Park, New York and this study appears in the Journal of Reproductive Medicine, in the May 2006 issue.
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What genetic disorders does prenatal genetic testing detect?
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Hsien Hsien Lei at Genetics and Health asks ‘What genetic disorders does prenatal genetic testing detect?’ in her most recent genetics quiz.
The answer?
‘Down syndrome, trisomy 13, trisomy 18, sex chromosomal abnormalities, and other rare genetic disorders resulting in mental retardation and/or physical problems.’
See more of her genetics quizzes here!
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