Friday, November 06, 2009

Singing in Pregnancy May Be Harder Work

Hormonal fluctuations make it harder for women to sing during pregnancy, a new study finds.

Many professional singers have difficulty singing while pregnant, but it hasn't been known whether this was because of hormones or other causes, such as decreased lung capacity as the baby grows.

In this study, researchers followed a professionally trained singer through 12 weeks of pregnancy and for 12 weeks after she gave birth. Once a week, the singer was recorded reading and singing into a device able to measure the pressure exerted to make each sound. This data was then matched with measurements of the singer's hormone levels.

The researchers found that increased levels of hormones during pregnancy correlated with changes to the singer's vocal folds. These temporary changes forced the singer to use more pressure from her lungs to sing the same notes as when she wasn't pregnant.

"It seems that it's harder work during pregnancy to sing," study author Filipa La of Aveiro University in Portugal, said in a news release from the American Institute of Physics. But she added that this is a single case study, and larger studies need to be done before doctors could give reliable advice to professional singers.

The study was presented recently at the meeting of the Acoustical Society of America, in San Antonio, Texas.


Financing a Pregnancy with No Health Insurance

First, fill out a questionnaire at to see if you're eligible for any government benefits.

Pregnant women can use federally funded health centers that permit you to pay what you can afford, based on your income. They can provide complete care when you're pregnant as well as a host of other health services. To find one in your area, type in your address at

Medicaid is a federally funded state-run program that may help low-income families. The Kaiser Family Foundation provides an excellent database detailing what Medicaid may cover, at Just click on your state. Unfortunately, a spokesman for the Centers for Medicare and Medicaid Services confirms there is no centralized federal database to provide pregnant women information on where to go either at local or state levels for Medicaid services.

Each state has a "Women Infants and Children" program, which provides nutritious foods, nutrition education and referrals to health and other social services. Administered by the USDA Food & Nutrition Service, this program covers low income, pregnant, postpartum and breast-feeding women, and children up to age 5 who are at nutrition risk. A household of four would qualify if its annual income is less than $40,793, according to the USDA Food & Nutrition Services. For more information, go to Be sure also to examine other federally sponsored nutritional programs located near the bottom of that same web page.

For information on prenatal services in your community, call 1-800-311-BABY. For information in Spanish: 1-800-504-7081.

The State Children's Health Insurance Program may help children of families who make too much to qualify for Medicaid but can't afford private health. Go to or call 1-877-543-7669.

Indian Health Service provides public health care services to American Indians and Alaskan natives as well as non-Indian women who are pregnant with an eligible Indian's child. Contact

Some labor unions, professional clubs, associations and organizations offer private group plans to members, which may be lower-cost.

Other options:

  • Talk to your hospital about a payment plan. Negotiate fiercely and try to obtain a list of all fees and necessary services in advance.
  • A birthing center. This may cost $3,000 to $4,000, compared with $10,000 for a hospital. But consider this only if you are perfectly healthy and expect no complications. Find whether the center is properly licensed in your state and check staff credentials. You can search for a birthing center at
  • Consider a midwife. Midwives charge less than one-third for their services compared with regular hospital care, and many prefer the personal touch and the natural nature of childbirth through a midwife. Ask your doctor or hospital for referrals. You also can search a data base at the American College of Nurse-Midwives at But shop around and carefully evaluate credentials, built-in safeguards, cleanliness and what insurance exists on the facility and/or midwife in the event of a problem.

Thursday, November 05, 2009

Free Weekend of Access to Caregiver Website is allowing free access this weekend to the premium services offered on their website in honor of National Family Caregiver Month. Find caregivers in your area, run background checks, and contact caregivers directly for free! You can find babysitters, nannies, senior caregivers, special needs caregivers, tutors, pet sitters and housekeepers. Visit their website to find out more!

IPhone Application Translates Babies Cries

The Cry Translator listens to a whining child and analyzes the pitch, volume, tone and inflection of his nerve-jangling noise. Ten seconds later, it provides you with one of five “translations”: hungry, sleepy, stressed, annoyed or bored.

The idea of this $30 iPhone application, apart from preying on the anxieties of new parents, is to help teach you the meanings of the distinctive sounds and to help out babysitters who might otherwise try to feed your three-month old (hunger) instead of just switching over to the Family Guy from American Idol (bored). The application even gives advice on what to do, depending on the translation.

According to the seller, Biloop Technologic, clinical tests have proven the app to be accurate 96% of the time, and it will “continue to translate crying regardless of the age of the child”. This last is an excellent feature, and will help me determine the cause the next time the Lady starts to blubber. On previous experience, I can guess it will most likely be “annoyed” or “bored”. On sale here until November 11th for $10.


Woman to Broadcast Child's Birth Live

For many people, it's one of life's most intimate moments. But for a 23-year-old Minnesota teacher, the birth of her first child will be an event open to anyone in the world.

For the past few months, Lynsee (who asked to keep her last name private) has been sharing daily details about her pregnancy on the social network MomsLikeMe. When she gives birth in the next few days, more than a thousand women who follow her online -- plus anyone else with an Internet connection -- will be able to watch a live broadcast of her child's birth from their computes.

"We wanted to share this experience," Lynsee said about the decision she made with her husband Anders. "If I were in a classroom, I'd be teaching about development. It was a way for me to teach… A way for me to use myself as a textbook."

The day Lynsee found out she was pregnant, she joined the MomsLikeMe site for the Twin Cities area. She and her husband had just moved to Minneapolis-St. Paul and, not knowing many people, she found the Web site to be a good way to meet other women and learn about local resources.

Soon after joining, she answered a message from the site's manager asking pregnant women in the area to contact her. And before she knew it, Lynsee wasn't just a member of the online mothers' network, she was a contributor.

After talking it over with her husband, the young woman agreed to share every last detail of her pregnancy through a daily blog, and then finish off the project with a live Internet broadcast of the delivery.

How did her husband feel? "He was a little hesitant at first, as was I," Lynsee said. But after MomsLikeMe assured them that the video would be shot tastefully, the parents-to-be embraced the idea.

"I shared pretty much anything -- it's pretty much a tell-all blog," Lynsee said about her online postings.

When she gives birth, a cameraman will be in the hospital room with Lynsee, her husband, her mother and her midwife. A second camera will be mounted in the corner. Lynsee said there will not be any graphic shots taken from over the midwife's shoulder.

In addition to the live broadcast, anyone registered with her group on MomsLikeMe will be able to chat with Lynsee while she's in the delivery room.

"I hope to give women a sense of empowerment and joy because it's a very miraculous everyday event," she said. "We're just sharing the story from the empowerment and emotional aspects."

Since making the decision to broadcast the birth, Lynsee said she has not had any second thoughts, and said her family has been 100 percent supportive.

But some mommy bloggers said they were surprised to see someone use new technology to reveal so much.

Would you consider broadcasting your birth live? Would you consider watching another person's birth live?


Newborn Babies Cry in Tongues Learned in the Womb

Only days after birth, babies have a bawl with language. Newborn babies cry in melodic patterns that they have heard in adults’ conversations — even while in the womb, say medical anthropologist Kathleen Wermke of the University of W├╝rzburg in Germany, and her colleagues.

By 2 to 5 days of age, infants’ cries bear the tuneful signature of their parents’ native tongue, a sign that language learning has already commenced, the researchers report in a paper published online November 5 in Current Biology.

Fluent speakers use melodic patterns and pitch shifts to imbue words and phrases with emotional meaning. Changes in pitch and rhythm, for example, can indicate anger. During the last few months of fetal life, babies can hear what their mothers or other nearby adults are saying, providing exposure to melodies peculiar to a specific language, Wermke says. Newborns then re-create those familiar patterns in at least some of their cries, she proposes.

“Our data support the idea that human infants’ crying is important for seeding language development,” Wermke says. “Melody lies at the roots of both the development of spoken language and music.”

Scientists already knew that, in the final months of gestation, babies can hear people talking, especially their mothers. Newborns prefer the sound of their mothers’ voices to the voices of other people, for example. In the days after birth, babies show signs of discriminating the sound of their native language from others and of recognizing when voice-like tones change in pitch.

Wermke’s team goes further, suggesting that newborns adapt their cries to melodic patterns characteristic of whatever language they have heard spoken.

She and her colleagues studied 60 healthy newborns, 30 born into French-speaking families and 30 born into German-speaking families. The researchers recorded 2,500 cries as mothers changed babies’ diapers, readied babies for feeding or otherwise interacted with the youngsters.

Acoustic measures allowed the researchers to identify 1,254 cries (in this case, a cry is a vocalization produced with a single breath) that contained clear rising-and-falling arcs suitable for a detailed analysis.

German newborns’ cries tended to start out high-pitched and gravitate to increasingly lower pitches. French newborns’ cries started out low-pitched and then moved higher. Comparable high-to-low and low-to-high intonation patterns characterize words and phrases used by fluent speakers of German and French, Wermke says.

Newborns strive to imitate their mothers’ behaviors however they can, in order to attract attention and foster bonding, Wermke proposes. Newborns can readily mimic the musical structure of what a mother says, in her view.


11-year-old gives birth on her wedding day

An 11-year-old girl became one of the world's youngest mothers - after she went into labor at her wedding.

Kordeza Zhelyazkova, from Sliven, Bulgaria, was still wearing her wedding dress and tiara when she was rushed to the hospital, where she gave birth to a 5-pound, 8-ounce girl.

"I'm not going to play with toys anymore - I have a new toy now," Kordeza told reporters as she showed off little Violeta.

Kordeza - who got pregnant two weeks after her 11th birthday - told the News of the World: "It feels I must grow up. I am not going back to school."

The baby's 19-year-old dad, Jeliazko, met Kordeza when he rescued her from bullies in the playground.

"I was walking past the school when I saw some boys mocking her and I told them to leave her alone," he said. "Then she arranged to meet me and asked me out on our first date.

"We didn't plan to have sex or a baby, although I fell in love with Kordeza the moment I saw her," Jeliazko said.

But within a week, Kordeza was pregnant - and Jeliazko was facing six years in jail for having sex with a minor. The age of consent in Bulgaria is 14.

"I thought she was 15," he said. "She didn't tell me she was 11. I was really scared."

"I didn't want to say in case he wouldn't fancy me," Kordeza confessed.

"I didn't know I was pregnant until my grandmother saw I had put on weight," she added. "I just thought I'd eaten too many burgers."

"It's normal for our girls to have babies young," said Kordeza's grandmother Dida, 55. "It's our tradition. But I didn't want it for my Kordeza - I felt she was too young."

The family planned a three-day Roma wedding so Kordeza and Jeliazko could be married before the baby arrived.

But Kordeza went into labor on the second day. "I had been having pain in the morning and a couple of hours into the wedding, it got worse."

She was rushed to hospital and gave birth 20 minutes later.

"It was quite easy but painful, too," she said. "I was very happy when I saw her. She has a nose like me and hair like Jeliazko."

Violeta's grandmothers will be her guardians, and Kordeza and her daughter will receive about $115 a month in state benefits.


Sarah Michelle Gellar Shares Her Birth Story

New mom Sarah Michelle Gellar shows off her beautiful baby girl, Charlotte Grace, in the new issue of People magazine.

She and her husband Freddie Prinze Jr share the story of Charlotte's birth on September 19th - a week before her due date!

"I went into labor at the gym!" the 32-year-old former Buffy the Vampire Slayer star reveals. "I didn't really believe it. I just felt a little nauseous, and my trainer said to me, 'Um, isn't your baby coming next week? Maybe it's time now?' I said, 'Oh no, I doubt it...'"

"Later that night, she was like, 'OK, I think I might be in labor, but you should get some more sleep,'" Freddie recalls. "She was very calm, very centered, very prepared. I'm telling you, this girl is like Gandhi. It was like, three pushes and the baby was out."

Charlotte Grace is the first child for the couple, who wed in 2002.


Wednesday, November 04, 2009

This Week's Celebrity Baby Bumps

Gisele Bundchen wears a fabulous maternity dress while out for a date with Tom Brady, Johnny Knoxville and his pregnant girlfriend take a stroll through a flea market, Kourtney Kardishian busts out the leopard print, Rebecca Gayheart keeps it simple with a pair of jeans and a black top, Jenna Elfman wears a cute black dress at an event in LA, and Camila Alves brings home a baby bunny while wearing a great blue maternity dress paired with a cute, white cardigan sweater.

Source Source

Low Folate Levels in Pregnancy Tied to ADHD

Low folate levels during pregnancy are associated with higher odds for attention-deficit/hyperactivity disorder in offspring aged 7 to 9, new research has found.

The findings seem to support the long-held belief that folate (folic acid) levels in expectant mothers influence their children's nervous system development.

The researchers also found that children of mothers with low folate levels had notably smaller head circumference at birth, which may indicate a slower rate of prenatal brain growth.

The study was released online Oct. 28 in advance of publication in an upcoming print issue of the Journal of Child Psychology and Psychiatry.

The results are special cause for concern in relation to low-income families, where a mother's nutritional health receives a low priority, and women are less likely to take folic acid supplements prior to becoming pregnant.


Study Links Folic Acid Supplement in Late Pregnancy to Asthma in Offspring

Women who take folic acid supplements during the later months of pregnancy may be increasing their baby's risk of developing asthma, according to a newly released Australian study.

Found in its natural form in leafy green vegetables, legumes and some nuts, folic acid is commonly recommended to women trying to conceive to prevent neural defects in the first weeks of pregnancy.

But the Australian study found that women who continue to take folic acid late into pregnancy were 30 percent more likely to give birth to a child which would develop asthma.

"We see a substantial proportion of women taking these folate supplements throughout pregnancy, and it may be because people think it is entirely benign," said Michael Davies, associate professor at Adelaide University.

"Folate is incredibly important because of its role in preventing neural tube defects (like spina bifida). But because it is so important, and so bioactive, it needs to be treated with some respect as well."

Of the 550 women studied, those who took the folic acid supplements before conception and not more than several weeks into their pregnancy had no increased risk of asthma in their children.

But women who took it during weeks 16 to 30 of the pregnancy increased their risk of having a child with asthma by about 30 percent, according to the research, published in the American Journal of Epidemiology.

"Our finding should be reassuring to women who take folate for the purpose of preventing neural tube defects because we found no evidence of early supplementation (leading to asthma)," Davies told newswire AAP.

Davies said a diet rich in natural folate carried no increased risk of asthma for the baby.


Tuesday, November 03, 2009

The 2009 Holiday Gift Guide is Here!

Before you start your Christmas shopping make sure you check out Maternity & Style's 2009 Gift Guide. They are featuring gifts for rockin' dads, stylish moms and beautiful babies. The latest and most desirable jewelry, toys and electronics can be found in a matter of minutes. You won't be disappointed and neither will your family!

Click here for The 2009 Holiday Gift Guide.

Antidepressants During Pregnancy Tied to Children's Health

Babies whose mothers used antidepressants during pregnancy visit the doctor more often and have higher risks of certain health problems than other children their age, a new study suggests.

The study looked at the medical records of nearly 39,000 Norwegian children through the first year of life. It found that rates of congenital heart defects and physical therapy -- a potential sign of movement-related problems -- were elevated among babies whose mothers used antidepressants throughout pregnancy.

These children also tended to have more doctor visits and higher rates of certain other health problems, like respiratory and digestive symptoms. However, those rates were also elevated among children whose mothers had stopped using antidepressants before pregnancy.

This raises the possibility that the risks were related to the mother's depression itself, rather than antidepressant use, according to the researchers, led by Dr. Tessa Ververs of the University Medical Center Utrecht in the Netherlands.

The bottom line for women on the medications is that the decision to continue or stop during pregnancy is an individual one. Women should talk with their doctor about what is best for them, Ververs told Reuters Health in an email.

Initial studies on the drugs' safety were "reassuring," Ververs and her colleagues note, but some recent reports have linked the medications to problems in newborns -- including cases of congenital heart defects.

Antidepressant use in the third trimester has also been connected to higher risks of respiratory distress, feeding problems and irritability in newborns, the researchers note in their report published in the British obstetrics journal BJOG.

Of the 38,602 babies in the current study, 197 were born to mothers who used antidepressant throughout pregnancy. Another 820 mothers had stopped using the medications before pregnancy, while 543 used them only at certain points during pregnancy. Most women on medication during pregnancy -- 71 percent -- used a selective serotonin reuptake inhibitor (SSRI) such as paroxetine (Paxil) or fluoxetine (Prozac).

Ververs and her colleagues found that of the children whose mothers had used antidepressants throughout pregnancy, three had to have a major heart procedure performed in their first year of life. That made them six times more likely than children whose mothers had never used antidepressants to need a heart procedure.

The risk was not elevated among children whose mothers had stopped taking antidepressants.

When it came to doctor visits during the first year of life, both children whose mothers had continued to use antidepressants and those whose mothers had stopped tended to see the doctor more often than children whose mothers had never taken antidepressants. Similarly, both groups of children had higher rates of antibiotic use and respiratory or intestinal symptoms.

It's possible that mothers' depression itself was a factor here, according to Ververs' team. Past studies have found that depressed mothers tend to take their children to the doctor more often than other mothers do.

Compared with other mothers, Ververs and her colleagues note, depressed moms may find it more difficult to cope with problems like respiratory ills and digestive symptoms.

More studies, the researchers write, are needed to tease apart the relationships between mothers' mental health, medication use and specific health problems in infants.

For now, they say, the evidence does support fetal screening for heart defects when mothers continue to use antidepressants during pregnancy.


Smoking During Pregnancy Linked to Behavioral Problems in Children

New research set to be published in the Journal of Epidemiology and Community Health suggests that mothers who smoke while pregnant are essentially toying with the brain chemistry of their future children.

“There are 4000 toxic substances in cigarette smoke, and many of these will pass into the brain of the fetus, and it is possible that they could have an effect on how the brain chemistry works,” said Professor Alan Maryon-Davis, president of the Faculty of Public Health, to the BBC.

The research involved more than 14,000 pairs of mothers and their children, all participants in the Millennium Cohort Study, a study that focused on children born in the U.K. between 2000 and 2001.

First, mothers were put into categories based upon the amount of cigarettes they smoked during pregnancy. Then, using a validated questionnaire called Strengths and Difficulties, mothers were asked to grade their children’s level of hyperactivity, type of temperament, frequency of fights, and ease of distraction. Taking into account factors that might influence the results, including socioeconomic status, mother’s age, and level of education, the researchers began analyzing the data.

It was found that nearly one in ten women smoked heavily during pregnancy, 12.5 percent smoked lightly during pregnancy, and 12.4 percent said they stopped smoking while pregnant.

Boys of mothers who smoked heavily while pregnant were almost twice as likely to have behavioral problems, while boys of mothers who smoked lightly while pregnant had an 80 percent increased likelihood of having an attention deficit disorder.

Researchers found a significant increase in likelihood that those girls of mothers who smoked lightly or heavily had conduct issues.

“Smoking during pregnancy may damage the developing structure and function of the fetal brain, which has already been shown to be the case in animals”, said the authors.

“The fetal development of boys may also be more sensitive to this kind of chemical assault, which might explain why boys are more likely to have behavioral problems than girls.”


Pregnant Women Who Smoke Caught Lying by Scientists

A new study casts doubt on the accuracy of self-reported smoking during pregnancy. The study, published last week in the British Medical Journal, involved a random sample of 3,475 pregnant women in Scotland. Researchers compared the women's self-reported smoking status with results of blood tests that measured the women's recent nicotine exposure.

According to the results, 24% of women admitted smoking during their pregnancy, yet the "gotcha" blood tests revealed that the real percentage of smokers was more like 30%—meaning that one-fifth of smokers were well...pleading the fifth.

How does that translate to the U.S.? Among reproductive age women in the U.S., an estimated 22% smoke. And even if a 9-month hiatus from the habit was an easy order, not all women consider pregnancy sufficient reason to stop puffing.

Between 10 and 12% of American women smoke during pregnancy, according to the Centers for Disease Control and Prevention. The CDC also estimates that 30% of low birth weight babies (often weighing less than 5.5 pounds), 10% of premature births, and 5% of infant deaths in the U.S. are a result of prenatal smoking.

Back in Scotland, the study authors conclude by calling for better methods of identifying pregnant smokers so that accurate data is used to form policy and provide patient care, such as greater access to smoking cessation services.


Monday, November 02, 2009

Smoking During Pregnancy Linked to Drug Use in Teenagers

Teenagers whose mothers smoked during pregnancy are more likely to experiment with drugs, according to a new study.

The research, carried out by scientists at the University of Nottingham, found children exposed to cigarette smoke in the womb were more likely to experiment with alcohol, tobacco and cannabis.

This is because prenatal exposure to maternal smoking may affect the development of the orbitofrontal cortex, a part the brain which evaluates rewards and regulates emotion.

Academics analysed MRI scans from almost 400 teenagers and found that those born to mothers who smoked during pregnancy had a thinner orbitofrontal cortex.

Scientists then found those suffering from a thinning of this part of the brain were more likely to experiment with a wider range of drugs.

The most commonly used illegal substances among the participants in the study were alcohol, tobacco, cannabis, stimulants and psychedelic drugs.

Professor Tomas Paus, senior author of the study at the University of Nottingham, said: "These findings demonstrate significant consequences of prenatal exposure to maternal cigarette smoking on a child's brain.

"But our findings need to be interpreted with caution: we could only show an association, not a causal effect of maternal smoking on brain and behaviour. Such causality can be, and has been, demonstrated only in experimental models.

"It is also important to note that almost half of the children of mothers smoking during pregnancy showed no differences in the brain and behaviour, suggesting that something protected them from the adverse effect of cigarette smoke."


Study Shows Importance of Support for Fathers from Mothers

As much as mothers want their partners to be involved with their children, experts say they often unintentionally discourage men from doing so. Because mothering is their realm, some women micromanage fathers and expect them to do things their way, said Marsha Kline Pruett, a professor at the Smith College School for Social Work at Smith College and a co-author of the new book “Partnership Parenting,” with her husband, the child psychiatrist Dr. Kyle Pruett (Da Capo Press).

Yet a mother’s support of the father turns out to be a critical factor in his involvement with their children, experts say — even when a couple is divorced.

Her research, part of a project based at Princeton and called the Fragile Families and Child Wellbeing Study, found that when couples scored high on positive relationship traits like willingness to compromise, expressing affection or love for their partner, encouraging or helping partners to do things that were important to them, and having an absence of insults and criticism, the father was significantly more likely to be engaged with his children.

Uninvolved fathers have long been accused of lacking motivation. But research shows that many societal obstacles conspire against them. Even as more fathers are changing diapers, dropping the children off at school and coaching soccer, they are often pushed aside in ways large and small.

“The walls in family resource centers are pink, there are women’s magazines in the waiting room, the mother’s name is on the files, and the home visitor asks for the mother if the father answers the door,” said Philip A. Cowan, an emeritus professor of psychology at the University of California, Berkeley, who along with his wife, Carolyn Pape Cowan, has conducted decades of research on families. “It’s like fathers are not there.”

In recent years, several fathers’ rights organizations have offered father-only parenting programs and groups, and studies have shown that these help men become more responsive and engaged with their children.

But a new randomized, controlled study conducted by the Pruetts and the Cowans found that the families did even better if mothers were brought into the picture.

In the study, low-income couples were randomly placed into a father-mother group, a father-only group and a control group of couples. The controls were given one information session; the other two groups met for 16 weeks at family resource centers in California, discussing various parental issues.

In both of those groups, the researchers found, the fathers not only spent more time with their children than the controls did but were also more active in the daily tasks of child-rearing. They became more emotionally involved with their children, and the children were much less aggressive, hyperactive, depressed or socially withdrawn than children of fathers in the control group.

But notably, the families in the couples group did best. They had less parental stress and more marital happiness than the other parents studied, suggesting that the critical difference was not greater involvement by the fathers in child-rearing but greater emotional support between couples.


Study ties common antibiotics with birth defects

Researchers studying antibiotics in pregnancy have found a surprising link between common drugs used to treat urinary infections and birth defects. Reassuringly, the most-used antibiotics in early pregnancy — penicillins — appear to be the safest.

Bacterial infections themselves can cause problems for the fetus if left unchecked, experts said, so pregnant women shouldn't avoid antibiotics entirely. Instead, women should discuss antibiotics choices with their doctors.

The new study is the first large analysis of antibiotic use in pregnancy. It found that mothers of babies with birth defects were more likely than mothers with healthy babies to report taking two types of antibiotics during pregnancy: sulfa drugs (brand names include Thiosulfil Forte and Bactrim) and urinary germicides called nitrofurantoins (brand names include Furadantin and Macrobid).

It was the first time an association had been seen between urinary tract treatments and birth defects, said lead author Krista Crider, a geneticist with the Centers for Disease Control and Prevention, which funded the research.

Used for many decades, the antibiotics in question predate the Food and Drug Administration and its requirements for rigorous safety testing. The FDA now grades all drugs for safety to the fetus based on available research, but rigorous studies are so lacking in many cases, that no antibiotics get the highest grade of "A."

Sulfa drugs are the oldest antibiotics and some animal studies have found harm during pregnancy. Nitrofurantoins previously have been viewed by doctors as safe to treat urinary tract infections during pregnancy.

The study, appearing in November's Archives of Pediatrics and Adolescent Medicine, may cause doctors to change the drugs they choose to treat pregnant women with infections. The findings were released Monday.

The researchers analyzed data from more than 13,000 mothers whose infants had birth defects and nearly 5,000 women who lived in the same regions with healthy babies.

The women were interviewed by phone from six weeks to two years after their pregnancies. Those who remembered taking antibiotics during the month before conception through the first three months of pregnancy were identified as exposed to antibiotics.

The women's memories could have been faulty, a substantial weakness of the study, which the authors acknowledged. About one-third of the women who took antibiotics couldn't remember the specific type of drug they took.

It's also unclear whether the birth defects were caused by the drugs or by the underlying infections being treated, Crider said.

Birth defects linked to sulfa drugs included rare brain and heart problems, and shortened limbs. Those linked to nitrofurantoins (ny-troh-fyoor-AN'-toyns) included heart problems and cleft palate. The drugs seemed to double or triple the risk, depending on the defect.

The FDA recommends that pregnant women discuss medications with their doctors, said FDA spokeswoman Sandy Walsh. The agency has proposed changes to prescription drug labeling that would require more complete information for women of childbearing age, pregnant women and those who breastfeed.