Friday, November 20, 2009

Pregnant Women Unaware of How Long Pregnancy Should Last

Recent reports show that the rate of preterm deliveries continues to climb in the United States. Now, a new study suggests one reason why: Many women are confused about what constitutes a full-term birth in the first place.

About one-quarter of new mothers surveyed in the study considered a baby born at 34 to 36 weeks of gestation to be full term, while slightly more than half of women considered 37 to 38 weeks full term.

Though technically speaking, preterm births are babies born prior to 37 weeks, 39 to 40 weeks is optimal, according to the researchers.

Many women interviewed were also unaware that babies born even a little bit premature are at a higher risk of serious health problems compared to babies born at term, the new survey shows.

Misconceptions about what constitutes full gestation and how soon it's safe to schedule an elective induction or cesarean delivery are contributing to increasing numbers of premature births in the United States, said lead study author Dr. Robert L. Goldenberg, professor of obstetrics and director of research at Drexel University College of Medicine in Philadelphia.

The study, which included 650 first-time mothers ages 21 to 45 from around the nation who had health insurance, is in the December issue of Obstetrics & Gynecology.

When asked, "What is the earliest point in pregnancy that it is safe to deliver the baby, should there not be other medical complications requiring early delivery?", more than half chose 34 to 36 weeks, 41 percent chose 37 to 38 weeks and less than 8 percent chose 39 to 40 weeks.

However, experts warn that any delivery short of 39 weeks puts a baby at higher risk of respiratory distress, sepsis (blood infection) and needing to be placed in the neonatal intensive care unit, according to background information in the study. Only one-quarter of new moms realized 39 to 40 weeks was safest.

Technically, the World Health Organization and other major medical organizations define preterm births as babies born before 37 weeks. But that definition was developed some 50 years ago and is outdated, said Dr. Alan Fleischman, medical director for the March of Dimes.

More recently, studies have shown that babies born even a bit too early -- at 37 or 38 weeks -- have a greater chance of chronic respiratory disease and learning disorders than children born at 39 weeks or later.

Babies born between 34 and 37 weeks are six times more likely to die during their first week or life and three times more likely to die during their first year than babies born at 39 or 40 weeks, Fleishman added.

In many situations, there is probably some medical reason for choosing to deliver early -- perhaps the mother has slightly elevated blood pressure, for example, Goldenberg said.

"I call them semi-electives," Goldenberg said. "I believe over the last 15 or 20 years, the practice is evolving to deliver those babies earlier and earlier when there is no evidence of benefits."

TV shows and news reports about very premature babies that survive may also be fueling misconceptions, Goldenberg said. Some women are left with the impression that if babies born before 30 weeks can survive, infants that are just a little bit premature should have no problems.

The last few weeks of gestation are critical to fetal development. All of the organs continue to mature in preparation for moving from the womb to the outside world, Fleischman explained. Between 35 and 40 weeks, the fetal brain grows by about 50 percent.


Pregnancy Through the Decades

As hard as pregnancy may be today, it doesn't compare to having a baby several decades ago.

Helen Rohweder: "I had the first one August '36. Richard was in June '38. Carol was March '45."

Compared to 1936, being pregnant today may seem like a piece of cake. If you suspected you were pregnant decades ago, you'd have to see a doctor to confirm your suspicions. The home pregnancy test did not hit the mainstream until the late 1970s. Today all it takes is a dollar and a trip to the store to find out the truth. Home tests are so accurate that doctors don't see a newly-pregnant woman until she's eight weeks along. Now a woman can even test to see if she's fertile at home.

Dr. Joel Carlson: "Fertility evaluation - we have a lot more tests available now if there could be an auto-immune issue, anatomical issue, certainly a hormonal issue with regards to ovulation. We can make ovulation occur on a particular day if we needed to."

As for your diet, nothing was off limits and prenatal care wasn't a big issue. Most pregnant women today are overly cautious about what they do - and don't - put into their bodies. It seems crazy now but not too long ago, moms-to-be were encouraged to have a drink or two to take the edge off during pregnancy.

As for ultrasounds, what ultrasound? Up until the 1980s it was rare for a woman to get an ultrasound if her pregnancy was going smoothly. Before ultrasounds everything - including the gender of the baby - was a surprise. Long gone are those days of not knowing.

Helen: "We'd had two boys so when Caroline was born the doctor just hurriedly came to Walt and said, 'It's a girl. It's a girl.' But we didn't have tests like they do now."

Carlson: "Ultrasound has certainly given us the window inside especially with the invention of 3-d and 4-d ultrasounds where you actually get to see what they look like."

Delivery back then was also for women only. Husbands were typically told to wait outside in the waiting room. There were maternity wards and hospitals, but a lot of women had their babies at home. If you decided to have your baby in the hospital many years ago, the experience was a bit different.

Helen: "When you had a baby then you were in the hospital for 10 days."

Today, moms also have many choices when it comes to their birthing plan. Josie Hatch, a mother of three, had her first child at the hospital and her second and third at home with a midwife. That has become more and more popular these days.

Josie: "The labor was so much less painful at home because it was more comfortable at home."

Pregnancy has changed drastically over the years but the one thing I would go back in time for is that hospital bill.

Helen: "Our son Richard framed the bill from our doctor and it was $25. Can you imagine that now?"


Expectant Parents See Michael Jackson on Ultrasound

Parents-to-be Dawn Kelley and William Hickman were looking at the ultrasound scan of their unborn baby when they realized it looked like the late pop singer.

Mother-of-six Miss Kelley, 34, went for her 20-week scan at Sunderland Royal as normal last month, but doctors could not see the fetus's stomach or diaphragm.

A few weeks later she was sent to Grindon Lane Walk in Centre for a closer look.

The more powerful scanner there is normally used to examine internal organs so the images it produces much more detailed.

Mr Hickman said: “We were looking at the pictures again, and I just saw Jacko there.

“None of us are really Michael Jackson fans. I mean I like him, but we’re not crazy about him or anything.”

The children Chris, 16, Amanda, 15, Jason, 13, Alisha, 10, Ami-Lee, six, and Kye, four, all see the famous singer’s face in the scan photo too.

But the new family member will not be called Michael – the couple already know they are having a girl.

Miss Kelley is 24 weeks pregnant and due to give birth to her daughter in March. She said: “I’ve had plenty of scans before and none of the photos have ever looked like this one. It’s a bit spooky really.

“But it is my seventh child, and they say seven is a mythical number.”


Thursday, November 19, 2009

Toddler Helps Deliver Mom's Baby

Two-year-old Jeremiha Taylor can count to five, he's potty trained, oh, and he's a pro at delivering a baby. Seriously. On Friday, this little man was instrumental in the birth of his baby brother when his mom unexpectedly went into serious labor right on the living room sofa.

"I laid on the couch and he went and got a towel. He grabbed a towel on his own," mom Bobbye Favazza told The Commercial Appeal of Memphis. "It happened so fast. My water broke and the baby came two to three minutes later. I just pushed and he caught him."

When emergency personnel finally arrived Favazza was holding her baby, the cord still attached, and they waddled over to the front door to let them in. Ambulance workers cut the cord and transferred mom and baby to a local hospital, where they were discharged a short time later with no complications.

The birth of Favazza's fourth child, named Kamron Taylor, didn't go remotely as planned. She had a cesarean section scheduled for Dec. 6 — she delivered all her kids that way — and she did have some pains the night before Kamron's birth, but didn't think they were related to labor.

Instead, she woke up the morning of Friday the 13th and conducted family business as usual. But when her water broke just before 8:30 a.m. she knew she had little time to spare. She called her mother, who frantically called 911, and her 3-year-old panicked and sat on the couch and cried. Meanwhile, Jeremiha calmly sprang to action — and the rest is history.

"He's my little hero," Favazza declared. "It was like he knew what to do."

Perhaps she has an aspiring ob/gyn on her hands.


Wednesday, November 18, 2009

Pregnant Women With MS Have Good Outcomes

Good news for women with multiple sclerosis (MS) who are pregnant or thinking about becoming pregnant. A study published Wednesday shows that while women with MS have a somewhat heightened risk of certain pregnancy complications, by and large, their pregnancies are as healthy as other women's.

Using a national database on nearly 19 million deliveries in the U.S., researchers found that women with MS had marginally higher risks of cesarean delivery and intrauterine growth restriction -- where a newborn's weight is below the 10th percentile for his or her gestational age.

Among more than 10,000 women with MS who gave birth between 2003 and 2006, 42 percent had a C-section, compared with roughly 33 percent of women overall. Meanwhile, intrauterine growth restriction was seen in almost 3 percent, versus 2 percent of other women. Still, the overall findings, published in the medical journal Neurology, are being seen as good news for women with MS -- a disorder that is more prevalent among women of childbearing age than any other group.

MS is believed to arise from an abnormal immune system attack on the body's own myelin, a protective sheath surrounding nerve fibers in the brain and spine. This leads to symptoms such as muscle weakness, numbness, vision problems and difficulty with coordination and balance.

Years ago, women with MS were advised to avoid pregnancy, out of concern that it could exacerbate the disease. But studies in recent decades have shown that the opposite is true; many women see a remission in their symptoms during pregnancy -- possibly because immune system activity naturally declines and levels of anti-inflammatory corticosteroids naturally rise during pregnancy.

The current study included information on 10,055 pregnant women with MS, as well as 4,730 with epilepsy and 187,239 with diabetes -- two disorders already associated with higher risks of certain pregnancy complications.

Overall, women with either MS or epilepsy had elevated risks of C-section delivery and intrauterine growth restriction compared with U.S. women overall. They did, however, generally fare better than women with diabetes, who had higher rates of additional complications, like high blood pressure and premature rupture of the sac surrounding the fetus.

Women who are planning on becoming pregnant also need to talk with their doctors about whether they should stop taking any of their MS medications. It is not known whether the so-called disease-modifying drugs often used for MS are safe during pregnancy, and research suggests that at least one -- beta-interferon -- may be associated with miscarriage.

Chakravarty noted that the drug methotrexate, sometimes used for MS, is known to cause birth defects.


This Week's Celebrity Baby Bumps

Tiffani Thiessen is spotted in all black with no bump showing yet, Kourtney Kardishian is using lots of spandex as her due date nears, Rebecca Gayheart giggles in a gray dress with black leggings, Jenna Elfman sports a funky black number with silver studs, and Camila Alves seriously rocks her casual preggo-style in both instances pictured.


Preeclampsia Linked to Thyroid Problems Later

New research offers bad news for women who develop a condition known as preeclampsia during pregnancy: They're at higher risk of reduced thyroid function and may be more likely to have thyroid problems in later life.

Preeclampsia develops in the second half of pregnancy and can cause serious problems such as extremely high blood pressure. The causes aren't clear, but may have something to do with high levels of proteins in the body.

Researchers in the United States and Norway looked at two groups of pregnant women: those who developed preeclampsia and those who didn't, and published their study findings in the Nov. 18 online edition of BMJ.

In the U.S study, researchers compared 140 healthy pregnant women who developed preeclampsia with 140 women who didn't. Those who had the condition showed double the levels of thyroid-stimulating hormone as those who didn't develop preeclampsia.

The Norwegian study followed 7,121 pregnant women for about 20 years and found that having had preeclampsia, especially in two pregnancies, boosted the risk that they would have high concentrations of the hormone years after being pregnant.

The researchers suggest that doctors should closely follow women who develop preeclampsia, keeping an eye out not just for heart and kidney disease, which are known risks, but also thyroid disease.


Tuesday, November 17, 2009

Environment Key in Baby "Flat-Head" Syndrome

When it comes to infants' risk of developing a flat spot on the head, environment appears more important than genes, a new study finds.

The study, published in the journal Pediatrics, looked at more than 20,000 babies treated for deformational plagiocephaly - misshapen areas in the skull that most commonly manifest as a flattening at the back of the head.

Factors both before and after birth contribute to plagiocephaly. Crowding in the womb is a risk factor, for instance, with the problem being more common in twins and other multiples.

After birth, repetitive pressure on one area of an infant's head -- from repeatedly sleeping in the same position, or spending too much time in swings or "bouncy seats" -- can lead to plagiocephaly.

However, researchers have also questioned whether genetic predisposition might play an important role. Some studies have found that plagiocephaly tends to run in families, but that could reflect either genetic influences or parenting practices.

In the new study, researchers found that "twinning" was associated with a higher risk of plagiocephaly, but there was no evidence of a difference between identical and fraternal twins.

Because identical twins share all of their genes and fraternal twins share only about half, on average, the finding suggests that genetic predisposition does not explain the tendency of plagiocephaly to run in some families.

On the other hand, environmental factors like position in the womb and an infant's sleep position were important. For instance, 15 percent of babies with plagiocephaly had been born in the breech position -- with the feet or buttocks, rather than the head, closest to the birth canal; that compares with roughly 3.5 percent of births in the general population.

Sleep position, meanwhile, was the most important factor in the "lateralization" of the plagiocephaly. That is, babies who usually slept with their heads turned to the right usually developed a flat spot on the right side of the head, while those who favored the left side usually developed plagiocephaly on that side of the head.

"What our work may imply is that if there is a genetic predisposition for (a) variation like deformational plagiocephaly, there is not any one genetic factor, but instead many, and that there may be different factors in different populations of ethnic diversity," senior researcher Dr. Brian C. Verrelli told Reuters Health in an email.

On the other hand, it seems that environmental factors are "very important" in causing plagiocephaly, according to Verrelli, an assistant professor at Arizona State University in Tempe.

And that, the researcher noted, implies that plagiocephaly can not only be avoided, but also that there is a "high probability" that it will be easily treated.

Since pediatricians began recommending that infants be put to sleep on their backs to lower the risk of sudden infant death syndrome (SIDS), studies have noted a rise in plagiocephaly. To counter that, experts generally recommend that infants get plenty of supervised "tummy time" when they are awake, and that parents avoid leaving them in carriers, swings or other seats for a prolonged period.

Plagiocephaly is often treated in a similar manner -- tummy time during waking hours and periodically turning the baby's head when he or she is sleeping, for instance. In some cases, infants are outfitted with a helmet that they wear for a few months to help reshape the skull as it grows.


Avoiding Premature Birth - Advice for the Pregnant Mom

In honor of prematurity awareness day, we present to you some sobering statistics:

  • Currently the number of premature births in the United States is over 540,000 per year.
  • The United States' infant mortality rate exceeds that of China, New Zealand, Canada, Hong Kong, Israel, Japan, Australia, and Singapore.
  • It's estimated that simply by cutting the preterm birth rate in the US in half, to match Sweden's, would save approximately 8,000 babies.
  • Even though preemies in the US are more likely to survive than anywhere else, they are still more likely to die than full-term infants.
  • Just under half of premature babies grow up with some form of neurological or developmental disorder.
  • Premature infants can develop lifelong health issues such as cerebral palsy, blindness, hearing loss and learning disabilities.
  • Despite the increase in medical advances in the US, the amount of premature births has increased 36% in the last 25 years.
  • It is the group of “late preterm” births, which occur after 34-37 weeks of pregnancy, that are the fastest growing subgroup of premature births.

The increase in premature birth in the US is attributed to many causes. The smallest, most fragile babies are mostly attributed to poor women who lack prenatal health care and social support. Since reproductive technologies are usually not covered by insurance, the implantation of multiple embryos has become common practice and increases the chances of premature birth. Early inductions and cesareans are also to blame, according to experts. Babies should typically not be delivered before 39 weeks without a medical reason.

Here are things that each pregnant woman can do to avoid a premature birth:

  • Get proper prenatal care throughout your pregnancy.
  • Don’t smoke, drink or take drugs while pregnant.
  • Avoid violent or abusive situations.
  • Lower stress levels. Only take on as much as you are capable of, avoid extremely stressful situations and practice stress-relief exercises as needed.
  • Avoid early elective inductions and cesareans. These might be used in emergency situations for the better of mom and baby, but elective cesareans and inductions should not be undertaken before 39 weeks of pregnancy.
  • Eat a well-balanced, nutritious diet, including fish or fish oil and folic acid.
  • Exercise regularly.
  • Avoid exposure to environmental toxins like car exhaust, pesticides and phthalates.
  • Avoid working situations where you need to stand for long periods of time.

To learn more about premature labor, click here.

Monday, November 16, 2009

Second Daughter on the Way for Joey Lawrence!

Joey Lawrence and his wife Chandi Yawn-Nelson are expecting their second child, according to PEOPLE.

Due April 3rd, the baby will be another girl, joining “very excited” big sister Charleston, 3 ½.

“I am Estrogen Man,” laughs Joey. “I’m from a family of all boys, and when I told my best friend Dave that my wife and I were having a second girl, he said, ‘Look at you, my best buddy Estrogen Man!’”

The latest addition to the Lawrence family will be named Liberty Grace, the actor shares. The first name “is something I’ve always loved,” Joey, 33, explains, while Grace is in honor of his grandmother, who passed away earlier this year.

While they’re awaiting Liberty’s arrival, Joey and wife Chandie — whom he wed in July 2005 — will be working with the Hot Moms Club to design their dream nursery. It will appear in Pregnancy magazine next year, along with a giveaway of a matching nursery. “I liked the idea of, ‘Let’s do something and let’s give something away,’” the Dancing With the Stars alum notes.

The actor will be keeping busy on the work front as well, with two projects in the pipeline this winter.

First up is a new ABC Family show Joey will also be executive producing, costarring Melissa Joan Hart. “This is my return to half-hour comedy,” the former Blossom star tells PEOPLE. “It’s about two characters forced into each other’s lives — the classic ‘I hate you, now I’m going to fall in love with you.’” With filming beginning later this month, the as-yet untitled show will air next summer.


Phthalates in Pregnant Women Affect Masculinity of Baby Boys

The fact that hormone-disrupting chemicals present in various household products are interfering with the development of children has been substantiated by researchers at the University of Rochester in New York State, who have reported that baby boys born to mothers with above-normal levels of 'phthalates' generally depict less masculine behavior.

The study, published in the International Journal of Andrology, states that phthalates block the activity of male hormones like androgens, thereby changing masculine brain development.

The findings of the study were based on a phthalate-tracing test that the researchers conducted on the urine samples from mothers in the 28th week of pregnancy. The women, who gave birth to 74 boys and 71 girls, during 2000-2003, were contacted again by researchers, who then inquired from the mothers about the personalities of their toddlers, the kind of toys and activities they liked.

It was found that boys born to mothers with high phthalate levels were less likely to play with guns, cars, and trains; and mostly indulged in “gender neutral” activities, like sports.

The study’s lead author, Shanna H. Swan, a professor of obstetrics and gynecology at the University of Rochester Medical Center, said that the results of the study are “consistent with our prior findings that link phthalates to altered male genital development,” as well as “compatible with current knowledge about how hormones mold sex differences in the brain, and thus behavior.”