Friday, June 26, 2009

Invention allows pregnant women to hold models of their unborn babies

Pregnant women are being given the chance to hold life-size models of their unborn babies, thanks to an invention that converts data from ultrasound and MRI scans.

Jorge Lopes, a Brazilian designer, uses 3-D printing technology to create the plaster models, which go on show tomorrow at an exhibition at the Royal College of Art in London.

But the invention has already attracted the attention of medical experts. “For doctors this is a fantastic development and it is absolutely unique,” said Stuart Campbell, head of obstetrics and gynaecology at King’s College London and a pioneer of the use of ultrasound diagnosis in the 1980s.

The technology is being trialled at a clinic in Rio de Janeiro. “It’s amazing to see the faces of the mothers. They can see the full scale of their baby, really understand the size of it,” said Dr Lopes.

A blind woman registered at the clinic has also volunteered to try out the technology at her next scan.

Professor Campbell is keen to use the technology as an educational tool for expectant parents and to help mothers who have difficulty bonding with their babies. It could also allow parents better to understand physical abnormalities that are diagnosed during pregnancy.

Dr Lopes, 42, first came across the 3-D printing method, known as rapid prototyping, when he was working on the reconstruction of archaeological finds such as dinosaurs and Egyptian mummies for museums. He is working at the RCA, on secondment from the Brazilian Ministry of Science and Technology.

Dr Lopes is now focusing on developing simple software that doctors would be able to use independently and on the spot.

Source

Earlier depressive mood linked with preterm birth

Both black and white women with symptoms of depressive mood prior to becoming pregnant have increased risk for preterm birth; but black women have twice the risk as white women, researchers report in the Journal of Women's Health.

"The black-white disparity in preterm birth may be in part a consequence of different exposures to depressive mood prior to pregnancy," Dr. Amelia R. Gavin, at the University of Washington in Seattle, told Reuters Health.

However, previous investigations of this association were inconclusive, leading Gavin and colleagues to assess links between race, preterm birth, and prepregnancy depressive mood among 555 women who were 24 years old on average when they gave birth.

The researchers used data collected from 1990 through 1996 for a larger long-term investigation of heart disease risk, in which the women had participated.

In the current study, 18.1 percent of the 249 black women gave birth prior to 37 weeks gestation. This preterm birth rate was more than twice the 8.5 percent rate seen among the 306 white women.

Prepregnancy depressive mood was also more prevalent among black versus white women - 9.4 versus 7.2 percent. Depression scale examinations conducted in 1990 to 1991, showed black women with higher depressive mood scores than white women - 13.0 versus 9.5.

Furthermore, black women's risk for preterm birth remained more than twice that of white women's risk when Gavin's team allowed for other factors associated with preterm birth, such as body weight and sociodemographic characteristics.

"Reproductive outcomes must be viewed in light of women's health over the entire life-course, as well as during pregnancy," Gavin said.

These current findings suggest "the experience of cumulative health disadvantages or 'weathering,'" may play a role in increased risk for preterm birth, Gavin notes.

She and colleagues, therefore, suggest replication of this study in a larger population of women.

Source

Earlier depressive mood linked with preterm birth

Both black and white women with symptoms of depressive mood prior to becoming pregnant have increased risk for preterm birth; but black women have twice the risk as white women, researchers report in the Journal of Women's Health.

"The black-white disparity in preterm birth may be in part a consequence of different exposures to depressive mood prior to pregnancy," Dr. Amelia R. Gavin, at the University of Washington in Seattle, told Reuters Health.

However, previous investigations of this association were inconclusive, leading Gavin and colleagues to assess links between race, preterm birth, and prepregnancy depressive mood among 555 women who were 24 years old on average when they gave birth.

The researchers used data collected from 1990 through 1996 for a larger long-term investigation of heart disease risk, in which the women had participated.

In the current study, 18.1 percent of the 249 black women gave birth prior to 37 weeks gestation. This preterm birth rate was more than twice the 8.5 percent rate seen among the 306 white women.

Prepregnancy depressive mood was also more prevalent among black versus white women - 9.4 versus 7.2 percent. Depression scale examinations conducted in 1990 to 1991, showed black women with higher depressive mood scores than white women - 13.0 versus 9.5.

Furthermore, black women's risk for preterm birth remained more than twice that of white women's risk when Gavin's team allowed for other factors associated with preterm birth, such as body weight and sociodemographic characteristics.

"Reproductive outcomes must be viewed in light of women's health over the entire life-course, as well as during pregnancy," Gavin said.

These current findings suggest "the experience of cumulative health disadvantages or 'weathering,'" may play a role in increased risk for preterm birth, Gavin notes.

She and colleagues, therefore, suggest replication of this study in a larger population of women.

Thursday, June 25, 2009

Preemies, preeclampsia linked to neighborhoods with heavy air pollution

Women exposed to air pollution from freeways and congested roads are much more likely to give birth to premature babies and suffer from preeclampsia, according to a study by University of California scientists published Wednesday.

The findings, based on pregnant women in the Long Beach/Orange County region of Southern California, add to the growing evidence that car and truck exhaust can jeopardize the health of babies while they are in the womb.

Reviewing the birth records of more than 81,000 infants, researchers found that the risk of having a baby born before 30 weeks of gestation increased 128 percent for women who live near the worst traffic-generated air pollution.

In addition, preeclampsia increased 42 percent for women who lived in those areas, according to the study, published online in the scientific journal Environmental Health Perspectives. Preeclampsia, a serious illness that involves high blood pressure, can endanger the baby and the mother.

The team of scientists from University of California, Irvine and UCLA studied babies born in Long Beach, near the Ports of Los Angeles and Long Beach, and in adjacent Orange County. Those areas are traversed by several major freeways used by commuters as well as heavy-duty trucks delivering goods to and from the ports.

The infants’ birth records were matched with their addresses and then compared with traffic patterns and estimates of two pollutants—particulates and nitrogen oxides—from vehicles near the mothers’ homes.

The study was unique in that the researchers constructed a database estimating what the pregnant women breathed in their own neighborhoods--within three kilometers, or less than two miles, of their homes. Previous studies have used general air pollution measurements, which is a less accurate estimate of what people are exposed to.

Only traffic-generated emissions were included in the study, not pollutants from factories and other sources.

Other recent studies have linked air pollutants to preterm births and low birth weights. But until now, “no study has associated air pollution with preeclampsia. This is the first one,” Wu said.

In the study, 8 percent of the 81,186 babies were preterm, including 1 percent that were “very preterm,” or under 30 weeks of gestation.

The link to air pollution was strongest for the “very preterm” babies, who often weigh less than three pounds and have the greatest risk of serious health problems. The researchers compared women who lived in areas with the most traffic-related pollution with women who lived in areas with the least traffic pollution. Those in the polluted areas were 128 percent more likely to deliver “very preterm” babies.

The risk of less severe preterm babies—those born between 30 and 37 weeks--was about 30 percent higher for women living in the areas with a lot of traffic emissions.

About 3 percent of the study’s pregnant women had preeclampsia, which can result in premature babies. Its causes are unknown, although doctors think it is related to abnormal growth of the placenta.

The new study focused on “an important area of research, since there are a lot of reasons to believe that there is something happening with environmental chemicals and preeclampsia,” Woodruff said. “Women with preeclampsia have high blood pressure, and some air pollutants can increase blood pressure. This is a serious condition, and these women are at risk of adverse pregnancy outcomes.”

Source

Chemical Used in Plastics May Affect Newborn Size

As if expectant mothers don't have enough to worry about, new research suggests that a woman's exposure to phthalates, a chemical compound found in many plastics, may be linked to low birth weight in infants.

The report, to be published in the upcoming issue of The Journal of Pediatrics, found notable levels of the compound -- which is used to make hard plastics soft and flexible -- in the cord blood and first stools of more than 70 percent of infants included in the study. Higher levels of phthalates were found among those born with a low birth weight.

Low birth weight is a risk factor for children and the leading cause of death in those under 5 years of age. Cardiovascular and other diseases in adulthood have also been associated with low birth weight, according to information provided in a journal news release.

"The results showed that phthalate exposure was ubiquitous in these newborns, and that prenatal phthalate exposure might be an environmental risk factor for low birth weight in infants," study leader Dr. Renshan Ge, of the international Population Council, said in the news release.

Although the researchers did not find a direct link, the study adds more to the pile of evidence against phthalate exposure, which has already been associated with damage to endocrine function. Phthalates are found in many common household items, including food packaging, toys and shampoo.

The study, conducted by researchers from the International Population Council, and Fudan University and Second Military Medical University in Shanghai, looked at 201 babies and their mothers between 2005 and 2006. Eighty-eight of the newborns had low birth weight.

Source

Wednesday, June 24, 2009

ACOG Issues Guidance for Fetal Heart Rate Monitoring

New guidelines from the American College of Obstetricians recommend the use of a three-category system to simplify the interpretation of fetal heart rate (FHR) tracings during labor.

The guidelines, published in the July issue of Obstetrics & Gynecology, were developed by the ACOG Committee on Practice Bulletins with the help of George Macones, MD, of Washington University in St. Louis.

They replace a 2005 practice bulletin and support the recommendations of the Eunice Kennedy Shriver National Institute of Child and Health Development workshop on electronic fetal monitoring held last year.

"Our goal with the ACOG guidelines was to define existing terminology and narrow definitions and categories so that everyone is on the same page," Dr. Macones said.

FHR monitoring has been expanding since 1980, when it was used in 45% of women in labor. By 2002, it was used in 85% of deliveries.

But there has been an inconsistent use of terminology and variability in the interpretation of FHR tracings, according to the new guidelines.

In one study, four obstetricians reviewed 50 FHR tracings and agreed on only 22% of them. Two months later, the same obstetricians re-examined the tracings and changed their interpretation on 21%.

To simplify interpretation of tracings, the guideline authors recommended classifying them into three categories on the basis of baseline heart rate, decelerations, and accelerations:

  • * Category I: Normal tracings with no action required.
  • * Category II: Uncertain tracings that require continued evaluation and possible additional testing to assess fetal status.
  • * Category III: Abnormal tracings that warrant immediate attention and possible intervention. This may include maternal oxygen, changing the mother's position, discontinuing labor stimulation, or treating maternal hypertension. If the tracings do not return to normal, the fetus should be delivered.

The authors also addressed the relative efficacy of the two types of FHR monitoring -- electronic fetal monitoring and manual auscultation.

Compared with intermittent manual auscultation, electronic fetal monitoring was associated with increased rates of cesarean delivery, with cesarean delivery for abnormal FHR, acidosis, or both, and with operative vaginal delivery.

Electronic fetal monitoring reduced the risk of neonatal seizures, but not the risk of perinatal mortality or cerebral palsy.

"Given that the available data do not show a clear benefit for the use of electronic fetal monitoring over intermittent auscultation," the authors wrote, "either option is acceptable in a patient without complications."

However, they said, "the labor of women with high-risk conditions (e.g., suspected fetal growth restriction, preeclampsia, and type 1 diabetes) should be monitored with continuous FHR monitoring."

Other recommendations and conclusions included:

  • * When describing uterine activity, the terms hyperstimulation and hypercontractility should be abandoned.
  • * FHR tracing should be reviewed every 30 minutes in the first stage of labor and every 15 minutes in the second stage. The intervals should be shortened in patients with complications.
  • * When the FHR tracing includes recurrent variable decelerations, consider amnioinfusion to relieve umbilical cord compression.
  • * Pulse oximetry has not been proven clinically useful in evaluating fetal status.
Source

Tuesday, June 23, 2009

Vitamin B12 deficiency linked to birth defects

It's long been known that another nutrient, folic acid, lowers the risk of neural tube defects -- devastating malformations of the brain and spine, including spina bifida.

Now researchers are reporting that women who have low vitamin B12 levels shortly before and after they get pregnant are at significantly greater risk of delivering a child with a neural-tube defect.

Vegans and women who eat little or no meat, fish, eggs, milk or cheese are at the highest risk, as are women with stomach or intestinal problems, including inflammatory bowel disease, that keep them from absorbing enough B12.

The finding needs to be confirmed by more studies. But the researchers say women at risk should be tested for B12.

"Nobody should get pregnant with low vitamin B12 levels," said Dr. James Mills, a senior investigator with the U.S. National Institute of Child Health and Human Development. "Women who are on diets that exclude animal products should check with their physician before they get pregnant."

It's the second time in recent years scientists have warned women about adequate vitamin B12. Researchers from St. Michael's Hospital in Toronto reported two years ago that low vitamin B12 triples the risk of neural-tube defects. It's estimated about one-third of neural tube defects in Canada may be due to B12 deficiencies.

The vitamin is important for healthy nerve cells and red blood cells. It's also needed to help make DNA.

Neural-tube defects occur early in pregnancy. The embryo forms a brain and spinal cord by essentially folding a flat portion of embryo into a tube. If that tube doesn't close completely, the result is either spina bifida, which can cause paralysis, or anencephaly, a defect of the brain and skull that is "uniformly fatal early in infancy or before," Mills said. Some affected babies are delivered stillborn. "This neural tube rolling up and closing is completed by the 28th day of pregnancy. A lot of women don't even know they're pregnant by that point," Mills said.

For their study, researchers tested blood samples collected during early pregnancy from three groups of Irish women: two groups were carrying a child with a neural-tube defect and the third group of women had already had one child born with a neural-tube defect and were at risk for another. There were 278 women in total.

The researchers measured the women's vitamin B12 and folate levels and compared them to "control" pregnant women who were not carrying a baby with a neural-tube defect.

In all three groups, women with low B12 concentrations had between a two- and threefold higher risk of having a baby with a neural-tube defect compared to women with higher levels.

Source

Judy Reyes Expecting First Child

Judy Reyes, who stars as sassy nurse Carla on Scrubs, is expecting her first child with her boyfriend, director George Valencia, her rep tells PEOPLE exclusively.

The Alma Award-winning actress, 41, who appeared on HBO’s Oz, recently starred in the Lifetime movie Little Girl Lost: The Delimar Vera Story. She also appeared in Glow Ropes: The Rise and Fall of a Bar Mitzvah Emcee, a Los Angeles Latino Film Festival award winner written and co-directed by George.

The baby is due in November.

Source

Monday, June 22, 2009

Matthew McConaughey to Play Papa Again

The ab-fab actor celebrated his first Father's Day with 11-month-old son Levi by announcing he and his partner, Brazilian model Camila Alves, are adding to their brood.

"Happy Father's Day. It's my first, and the last 11 months with Levi and Camila have been the most rewarding adventure to date. We have more blessed news to celebrate this Father's Day that makes this time next year double the fun. Levi is going to be a big brother," the 39-year-old Sahara star writes on his reggae-playing website, matthewmcconaughey.com.

"Yeah, we pulled off the greatest miracle in the world one more time. Camila and I are expecting our second child, bringing more life into the world, making more to live for. The future looks bright as the family grows, and we thank you for all the well wishes you send our way."

The bongo-loving Texan signed off with his catchphrase:

"Viva la evolucion, naturally, and in the mean times and all time, just keep livin, Matthew and Camila."

Source