Friday, February 05, 2010

Infantino Sling Rider Deaths

It's been reported that a third infant has died from the use of the Infantino Sling Rider. Unfortunately, the Infantino Sling Rider and other "bag" slings are not safe. A blog called Babysosmart, has some very good information on the topic:

For the last 4 years+ I've been teaching what I call a "Benefits of Babywearing" class through several local venues. My goal has always been to open parents eyes to all the amazing physical and emotional health benefits that babywearing gives to a baby. It still blows my mind. Not the idea of babywearing, but the science behind it all. An infant's development is measurably physically improved by babywearing...

But not all baby carriers are equal, and not all of them are safe. I'll admit it: I bring a couple of the "bad carriers" to each class that I teach, to demonstrate the potential problems that can arise from using a "bad carrier." One of these "bad carriers" (and I don't usually say bad, except in regards to this one that I'm about to discuss now) is the Infantino Sling Rider. And it's BAD. I've always referred to it "lovingly" as "the Sling of Death."

My overwhelming concern with this particular style of carrier, what we refer to as a "bag sling" or "bag-style sling", is the awkward and unsafe position into which the baby slips when he is placed inside the carrier. There is no feature to keep the baby's body in good alignment, so the baby usually ends up in what we call the "chin-to-chest" position. I'm a nurse, a pediatric nurse, and just hearing those words said in relation to an infant under three months old is akin to hearing someone say they gave their newborn a razor blade to play with. Wouldn't do it, dumb, a no-brainer, and worse, dangerous. The chin-to-chest position is just that-- the infant's chin drops down to rest on their chest, and their little, teeny, floppy airway is occluded-- folded in half, if you will. The infant airway, or trachea or breathing tube, is pretty unremarkable at this stage, at least in regards to it's ability to maintain itself. It's soft, floppy, and extremely narrow; that's why infants are so grossly affected when they're hit with the common cold, for example. Let me just say it bluntly: an infant can cut off their own ability to breathe if they are placed in the chin-to-chest position.

Others have been voicing their concerns for several years as well. In fact, one third-party group reviewed the Infantino Sling Rider (along with several other styles/brands of carriers) back in the fall of 2006 or 2007, documented their findings, and presented it to the manufacturer in the following February, assuming that eyebrows would be raised, red flags would be waved, and that the offending carrier would be pulled from the market, at least until modifications could be made to make it safe for use. I'm willing to bet that they were more shocked to hear the manufacturer say (and not an actual quote, mind you)-- "Have their been any documented deaths in one of our carriers? Until then, we aren't willing to do anything."

I have pushed people to LEARN how to use their carriers correctly over the years, as even a good carrier can be used incorrectly and potentially be the "cause" of a problem (I say "cause" because it's not actually the carrier that causes the problem, it's the wearer not using it correctly). Three biggest instances of this are: a "bigger baby, let's say a 6- or 8-month old, that's just really pitching a fit, and the parent is trying to force the baby into the carrier, and the baby is thrashing, throwing itself around, a recipe for disaster. A baby carrier is just that, a carrier, not a restraining device. Next example, a parent not tightening the carrier up, wearing it very loose and low, baby hanging out, again, looking for a fall, or the potential for the baby to fall into the chin-to-chest position. I've seen this several times, usually a ring sling, and the parent is attempting to carry the baby in the cradle position, but is not adjusting the sling to support the baby, allowing the baby to just kind of curl up inside the body of the sling. And the third instance, wearing a carrier that is too big for you-- usually it is a pouch, or pouch sling, and the baby is sliding into . . . the chin-to-chest position, and we've already been through those dangers. It is critical to make sure not only that the carrier you are using fits you, but that you are also using it correctly.

My heart goes out to the families of these beautiful babies whose lives were needlessly lost. The data was there, several years ago, and the manufacturer KNEW about the dangers their product posed to babies, they just didn't care. They were busy padding their pockets.

Note: Other similar dangerous "bag style slings": the Boppy "sling", the PreMaxx "sling," the JJ Cole "sling", the bag sling by Serena and Lily, to name a few.

Read more here.

Agricultural Chemical Spray Linked to Birth Defect Risk

There's a link between a birth defect called gastroschisis and the agricultural chemical atrazine, a new study has found.

Gastroschisis is an abdominal wall defect in which the intestines, and sometimes other organs, develop outside the abdomen through an opening in the abdominal wall. The incidence of this birth defect, also called infant abdominal hernia, has doubled to quadrupled over the past 30 years.

In the new study, researchers at the University of Washington in Seattle investigated whether environmental exposures were a factor in a higher than normal number of cases in the eastern part of the state.

"Our state has about two times the national average number of cases of gastroschisis," study co-author Dr. Sarah Waller said in a news release. "The life expectancy for fetuses with this diagnosis is better than 90 percent; however it requires delivery at a tertiary care center with immediate neonatal intervention, which often separates families and can cause serious financial and emotional stress."

Waller and colleagues analyzed 805 cases of live-born infants with gastroschisis between 1987 and 2006, along with 3,616 normal infants who acted as controls. The researchers matched birth certificates with U.S. Geological Survey databases of agricultural spraying of atrazine, nitrates, and 2,4-dichlorophenoxyacetic acid.

Gastroschisis occurred more often among infants born to mothers who lived less than 25 kilometers (or about 15.5 miles) from the site of high surface water contamination with atrazine. There was no increased risk associated with the other chemicals. The study authors also found that the risk of gastroschisis was higher for women who conceived in the spring (March through May), when agricultural chemical use is more prevalent.


Natural Delivery OK in Cases of Intrauterine Growth Restriction

Waiting for natural birth is as effective as inducing labor in pregnant women with intrauterine growth restriction (IUGR), a new study shows.

IUGR, which affects about 10 percent of pregnant women, means that the fetus is much smaller than normal. At birth, these babies are more likely to have low blood sugar, an abnormally high red blood cell count and trouble maintaining their body temperature. These babies are also at increased risk for jaundice, infections and cerebral palsy.

Later in life, people who were restricted-growth babies may be more prone to behavioral disorders, obesity, heart disease, type 2 diabetes and high blood pressure.

Currently, doctors have two main approaches for women with suspected IUGR who are nearing delivery. Some doctors induce labor because they're concerned about complications, while others await natural delivery.

This study compared the effectiveness of the two strategies among 650 women in The Netherlands. The researchers found that median birth weight was significantly lower among babies born after induced labor (2,420 grams) than among those in the spontaneous delivery group (2,560 grams). Both groups of babies had similar rates of adverse post-delivery outcomes.

The findings show that waiting for birth is equally as effective as inducing labor, the researchers concluded.


Use of Acetaminophen in Pregnancy Associated With Increased Asthma Symptoms in Children

Children who were exposed to acetaminophen prenatally were more likely to have asthma symptoms at age five in a study of 300 African-American and Dominican Republic children living in New York City. Building on prior research showing an association between both prenatal and postnatal acetaminophen and asthma, this is the first study to demonstrate a direct link between asthma and an ability to detoxify foreign substances in the body. The findings were published this week in the journal Thorax.

The study, conducted by the Columbia Center for Children's Environmental Health at Columbia University's Mailman School of Public Health, found that the relationship was stronger in children with a variant of a gene, glutathione S transferase, involved in detoxification of foreign substances. The variant is common among African-American and Hispanic populations. The results suggest that less efficient detoxification is a mechanism in the association between acetaminophen and asthma.

The researchers assessed the use of analgesics during pregnancy and found that 34 percent of mothers reported acetaminophen use during pregnancy, and 27 percent of children had wheeze, an asthma-related symptom. The children whose mothers had taken acetaminophen were more likely to wheeze, visit the emergency room for respiratory problems, and develop allergy symptoms, compared to those children whose mothers did not take acetaminophen. The risk increased with increasing number of days of prenatal acetaminophen use. The children in this study live in neighborhoods of New York City that have been the hardest hit by the asthma epidemic: Northern Manhattan and the South Bronx.

Acetaminophen use among children in the U.S. has increased substantially since the early 1980s and has become increasingly common among women during pregnancy so that most women in the U.S. take acetaminophen during pregnancy. This increase coincided with a doubling of the prevalence of asthma among children in the country between 1980 and 1995.

"These findings might provide an explanation for some of the increased asthma risk in minority communities and suggest caution in the use of acetaminophen in pregnancy," says Matthew S. Perzanowski, PhD, assistant professor of Environmental Health Sciences at the Mailman School of Public Health.

Reasons for prenatal acetaminophen use vary, but in this study population the observed associations with headaches suggest pain management as likely; however, other host factors that caused mothers to take acetaminophen and also cause asthma may explain their association. While infection is one such potential confounder, the Mailman School researchers found no association between the reported use of antibiotics and acetaminophen, and adjustment for antibiotic use during pregnancy did not affect the results.

According to the researchers, the prevalence of current wheeze diminished as the children aged, from 40 percent at age one year to 25 percent, 17 percent and 27 percent at ages two, three, and five, respectively. However, the association between prenatal acetaminophen exposure and current wheeze strengthened as the children aged.

The Columbia Center for Children's Environmental Health study adjusted relative risks for sex, race/ethnicity, birth order, maternal asthma, maternal hardship, exposure to environmental tobacco smoke, antibiotic use and postnatal acetaminophen use.

In a similar study conducted in the UK, the frequency of acetaminophen use during pregnancy and the magnitude of association in the UK study were similar to that in New York City.


Depression while pregnant 'linked to violent behaviour in children'

Mothers who suffer from 'baby blues' while pregnant are four times as likely to have children who become violent teenagers, a new study shows.

The link remained even if the mothers did not suffer depression after their children were born.

Research has previously suggested that postnatal depression can affect a child's subsequent behavior.

But experts from Cardiff and Bristol universities and King's College London believe that theirs is one of the first studies to look at the effects of suffering depression before a child's birth.

Many women are depressed during their pregnancy and research by Tommy's, the baby charity, suggests that it may even be more common before the birth of a child than after.

It is estimated that as many as between 10 and 15 per cent of women could suffer the condition while they are expecting.

Prof Dale F Hay, from Cardiff University, who led the latest study, said: "Much attention has been given to the effects of postnatal depression on young infants, but depression during pregnancy may also affect the unborn child."

The study looked at 120 mothers from the Bristol area.

The researchers interviewed the women while they were pregnant, after they gave birth and when their children were aged four, 11, and 16 years old.

Their findings, published in the journal Child Development, show that women who were depressed while they were pregnant were four times as likely to have children who were violent by the age of 16 as the other mothers.

The children were also more likely to exhibit other forms of anti-social behavior, the research found.

However, the study also found that women who had been angry or disruptive teenagers themselves were more likely to go on to be depressed while they were pregnant.

Prof Hay added: "Although it's not yet clear exactly how depression in pregnancy might set infants on a pathway toward increased anti-social behavior, our findings suggest that women with a history of conduct problems who become depressed in pregnancy may be in special need of support."


Thursday, February 04, 2010

Healthy Baby Campaign Uses Texts to Reach Mothers

Expectant mothers are getting a new tool to help keep themselves and their babies healthy: pregnancy tips sent directly to their cell phones.

The so-called text4baby campaign is the first free, health education program in the U.S. to harness the reach of mobile phones, according to its sponsors, which include Johnson & Johnson, Pfizer, WellPoint and CareFirst BlueCross and Blue Shield. Wireless carriers including AT&T, Verizon and Sprint have agreed to waive all fees for receiving the texts.

Organizers say texting is an effective means of delivering wellness tips because 90 percent of people in the U.S. have cell phones.

"Especially if you start talking about low-income people, cell phones are the indispensable tool for reaching them and engaging them about their health," said Paul Meyer, president of Voxiva, a company which operates health texting programs in Africa, Latin America and India.

Studies in those countries have shown that periodic texts can reduce smoking and other unhealthy behaviors in pregnant mothers.

Meyer said the U.S. program, run by Voxiva, will be the largest health-related texting program ever undertaken.

Under the new service, mothers-to-be who text "BABY" to 511411 will receive weekly text messages, timed to their due date or their baby's birth date. The messages, which have been vetted by government and nonprofit health experts, deal with nutrition, immunization and birth defect prevention, among other topics. The messages will continue through the baby's first birthday.

Text4baby is expected to be announced Thursday morning by officials from the White House's Office of Science and Technology Policy. Government officials will be publicizing the campaign in speeches and promotional materials.

Organizers hope the effort can curb premature births, which can be caused by poor nutrition, excessive stress, smoking and drinking alcohol. About 500,000 babies are born prematurely in the U.S. each year, and 28,000 infants die before their first birthday, according to the Healthy Mothers, Healthy Babies Coalition. The nonprofit is among the sponsors of the campaign.

"The real scary thing is that we're an industrialized nation and we're not doing very well on infant mortality, and we know prematurity is a big part of that," said the group's director, Judy Meehan.

Currently the U.S. ranks 30th worldwide for infant mortality, according to Meehan, behind most Western European nations.

Researchers at the George Washington University have agreed to evaluate the effectiveness of text4baby by measuring health trends for mothers and newborns.


With C-Section, Stitches May Be Best

Women who've had a cesarean delivery are less likely to suffer complications if their wound is closed using sutures rather than staples, says a U.S. study.

It included more than 400 women who underwent cesarean delivery in labor or scheduled cesarean delivery and were interviewed two to four weeks after the procedure.

The researchers at the Lehigh Valley Health Network in Allentown, Pa., found that: wound separation rates were 16.8 percent for staples and 4.6 percent for sutures; composite wound complication rates were 21.8 percent for staples and 9.1 percent for sutures; and that 36 percent of women who received staples required post-surgery physicians visits, compared with 10.6 percent of women who received sutures.

Median surgery time for women who received staples was 49 minutes, compared with 57 minutes for those who received sutures.

The researchers concluded that the use of staples for cesarean delivery wound closure is associated with increased risk of wound complications and post-operative physician visits. They said their findings suggest that sutures may be the preferred method.

The study was to be presented Thursday at the annual meeting of the Society for Maternal-Fetal Medicine in Chicago.


Acupuncture Found Effective Against Depression During Pregnancy

In a study to be presented February 4 at the Society for Maternal-Fetal Medicine's (SMFM) annual meeting, The Pregnancy Meeting ™, in Chicago, researchers will unveil findings that show that acupuncture may be an effective treatment for depression during pregnancy.

"Depression during pregnancy is an issue of concern because it has negative effects on both the mother and the baby as well as the rest of the family," said Dr. Schnyer, one of the study's authors.

About 10% of pregnant women meet criteria for major depression and almost 20% have increased symptoms of depression during pregnancy. The rates of depression in pregnant women are comparable to rates seen among similarly aged non-pregnant women and among women during the postpartum period, but there are far fewer treatment studies of depression during pregnancy than during the postpartum period.

Dealing with depression is difficult for pregnant women because the use of anti-depressants poses concerns to the developing fetus and women are reluctant to take medications during pregnancy.

In the study, an evaluator-blinded randomized trial, 150 participants who met the Diagnostic & Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for Major Depressive Disorder were randomized to receive either acupuncture specific for depression (SPEC, n=52) or one of two active controls: control acupuncture (CTRL, n=49) or massage (MSSG, n=49). Treatments lasted eight weeks (12 sessions). Junior acupuncturists masked to treatment assignment needled participants at points prescribed by senior acupuncturists. Massage therapists and patients were not blinded. The primary outcome was the Hamilton Rating Scale for Depression, administered by blinded raters at baseline and after four and eight weeks of treatment. Data were analyzed using mixed effects models and by intent-to-treat.

The results showed that the women who received SPEC experienced a significantly greater decrease in depression severity compared to the combined controls or CTRL acupuncture alone. They also had a higher response rate (63.0%) than the combined controls or CTRL acupuncture alone. Symptom reduction and response rates did not differ significantly between controls (CTRL 37.5% and MSSG 50.0%). Mild and transient side effects were reported by 43/150 participants (4 in MSSG; 19 in CTRL, 20 in SPEC). Significantly fewer participants reported side-effects in MSSG than the two acupuncture groups.

"The results of our study show that the acupuncture protocol we tested could be a viable treatment option for depression during pregnancy" said Dr. Schnyer.


Wednesday, February 03, 2010

Birth month determines who becomes a sports star

Do you have sports star dreams for your unborn child? Well, then plan the baby in such a way that he or she is born in the month of January, claims a researcher.

By studying the seasonal patterns of population health, senior research fellow Dr. Adrian Barnett from Queensland University of Technology's Institute of Health and Biomedical Innovation concluded that the month you were born in could influence your future health, fitness and sports ability.

The results of the study are published in the Springer book Analyzing Seasonal Health Data, by Barnett, co-authored by researcher Professor Annette Dobson from the University of Queensland.

To reach the conclusion, Barnett analyzed birthdays of professional Australian Football League (AFL) players and found a disproportionate number had their birthdays in the early months of the year, while many fewer were born in the later months, especially December.

The Australian school year begins in January. "Children who are taller have an obvious advantage when playing the football code of AFL," Dr. Barnett said. "If you were born in January, you have almost 12 months' growth ahead of your classmates born late in the year, so whether you were born on December 31stor January 1st could have a huge effect on your life."

Dr. Barnett found there were 33 percent more professional AFL players than expected with birthdays in January and 25 percent fewer in December. He said the results mirrored other international studies which found a link between being born near the start of school year and the chances of becoming a professional player in the sports of ice hockey, football, volleyball and basketball.

"Research in the UK shows those born at the start of the school year also do better academically and have more confidence," he said. "And with physical activity being so important, it could also mean smaller children get disheartened and play less sport. If smaller children are missing out on sporting activity then this has potentially serious consequences for their health in adulthood."


Tuesday, February 02, 2010

Excerpt from 'Get Me Out': A History of Childbirth

Eve, the first woman to become pregnant, suffered from excruciating pain during the delivery because she cheated on her diet. God told her to not eat an apple, but she was tempted by the serpent's claim that the forbidden fruit would endow her and Adam with worldly knowledge. In God's fury, he transformed the serpent into a belly-crawling creature. Then he turned to Eve and said, "I greatly multiply your pain in childbearing; in pain you shall bring forth children."

The thought pattern was set. Women deserved pain. In 1591, Eufame Maclayne was burned at the stake for asking for pain relief during the birth of her twins. Attitudes did not change much when safer anesthetics were discovered in the middle of the nineteenth century. Most people thought they were fine for surgery but not childbirth. Devout men and women believed that the pain in childbirth was a heavenly duty. If you couldn't endure the agony of childbirth, how would you handle the ups and downs of motherhood? (Why no equivalent hazing process for fathers? Vasectomies without pain meds?) Pain relief became somewhat acceptable when Queen Victoria asked Dr. John Snow for a whiff of chloroform to ease her delivery during the birth of Prince Leopold on April 7, 1853. But only somewhat.

Birth from antiquity through the Middle Ages was an all-girls affair orchestrated by men who had never seen a baby born. It was considered obscene for a man to enter the delivery room, yet they wrote the guidebooks, doling out advice based on hunches handed down over generations. (In 1522, Dr. Wert, a German doctor, was sentenced to death when he was caught dressing like a woman and sneaking into a delivery room.) Their words of wisdom (or of ignorance) were a man-made concoction of myth, herbs, astrology, and superstition. Nearly everything was about good sex and good thoughts and eating and drinking the right things. It was not simple. As far back as 1500 BC, probably even earlier, women had access to all sorts of explicit information about sex, pregnancy tests, abortions, and contraceptives.

If you were lucky to be in a city, you may have been helped by a licensed midwife (European cities started educating and registering midwives around the fifteenth century); if you were in the rural outback, you may have had an uneducated but experienced midwife or a female family friend. In any event, you were surrounded by a gaggle of women. Oddly enough, expectant women were not supposed to be catered to, but to cater. You were expected to act as hostess and serve the aptly coined "groaning beer" and "groaning cakes." Friends of the laboring woman were called "gossips," as in God sibs, as in siblings of God. You can assume they did what all women would do under the circumstances — sit around and talk about other people. So what was once an epithet for "close-to- God" morphed into a term for "behind-the-back chatter."

Women were told how to speed labor (a concoction of herbs), what to eat (nothing too spicy), what to drink (not too much wine), and what to think (no angry thoughts). Women were told how long to breast-feed and when to hand the baby to a wet nurse. They were told to have enough sex because a splash of sperm moistens the womb. They were also told not to have too much sex because it wears out the baby-making machinery. That's why "whores have so seldome children," one guide said, because "satiety gluts that womb." In France, pregnant women rarely left the house after dark because they were told that if they looked at the moon, the baby would become a lunatic or sleepwalker.

Reprinted from Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank by Randi Hutter Epstein. Copyright 2010 by Randi Hutter Epstein.


Pregnancy baby brain lapse 'a myth'

Expectant mums need to stop blaming their bump for memory lapses, say experts who want to dispel the "baby brain" myth.

Neither pregnancy nor motherhood addle a woman's brain, say the researchers based on their study of 1,241 women both before and after having babies.

Any absentmindedness might be adaptive, shifting attention to the baby, the British Journal of Psychiatry says.

Lead researcher Professor Christensen said: "Part of the problem is that pregnancy manuals tell women they are likely to experience memory and concentration problems - so women and their partners are primed to attribute any memory lapse to the 'hard to miss' physical sign of pregnancy.

Her team from The Australian National University followed up the large group of women at four-year intervals using memory tests.

During the course of the study more than half of the women fell pregnant, but this did not appear to have any impact on memory.

The test scores remained unchanged before and after pregnancy and did not differ greatly between the group of women who became mums and the group of those who did not.

Professor Christensen and her team said: "Not so long ago, pregnancy was 'confinement' and motherhood meant the end of career aspirations.

"Our results challenge the view that mothers are anything other than the intellectual peers of their contemporaries.

"obstetricians, family doctors and midwives may need to use the findings from this study to promote the fact that 'placenta brain' is not inevitable."

Cathy Warwick of the Royal College of Midwives said: "It is about time that some research lays to rest this notion of pregnant women and the 'baby brain' myth.

"The physical and emotional stresses on a woman's body from pregnancy can make women feel more tired than usual.

"As we all know tiredness - for men as well as women - can make us lose concentration and cause us to function less effectively.

"This is why midwives encourage pregnant women to take appropriate rest breaks, at home and at work. Many pregnant women will need this rest, and all of them deserve it."


Safety of 'souvenir' ultrasound baby scans in question

Parents-to-be should weigh the possible risks of going for non-essential scans purely to get keepsake pictures of their unborn babies, experts conclude.

Although ultrasound scans to check the baby's health are entirely justifiable and safe, the Health Protection Agency is concerned about "boutique" scanning.

Its independent advisory board looked at the available evidence for any possible health ill effects.

It said more research is needed to determine the long-term consequences.

There have been some unconfirmed reports suggesting possible neurological effects on the unborn child.

The concern is that with souvenir scans the beam of ultrasound stays static over the baby's head for longer in order to get a sharp mug shot.

Some studies have linked ultrasound scans to higher rates of left-handedness in baby boys.

The report found no evidence to suggest that routine ultrasound scans used for antenatal checks in hospitals negatively affected the health of babies.

But the evidence surrounding commercial ultrasound use was too patchy to make a judgment.

Chairman of the report, Professor Anthony Swerdlow, said: "Ultrasound has been widely used in medical practice for 50 years, and there is no established evidence of specific hazards from diagnostic exposures.

"However, in the light of the widespread use of ultrasound in medical practice, its increasing commercial use for 'souvenir' fetal imaging, and the unconfirmed indications of possible neurological effects on the fetus, there is a need for further research on whether there are any long-term adverse effects of diagnostic ultrasound."

The British Medical Ultrasound Society agreed with the HPA findings.

They urged all patients who had diagnostic scans booked to keep their scheduled appointments as these ultrasound scans have been arranged for a clinical purpose.

They said it was also fine to take home keepsake pictures from these scans - but advised parents against seeking scans solely for the purpose of getting a "nice snapshot for the baby book".


Childhood asthma in premature babies linked to pregnancy bug

A common complication during pregnancy may predispose children born prematurely to asthma, a large study reports today.

The condition, chorioamnionitis, is inflammation of the fetal membranes and amniotic fluid from a bacterial infection. It is thought to be linked to more than half of all preterm births, before 37 weeks' gestation, scientists write in today's Archives of Pediatric and Adolescent Medicine.

The infection may have ascended to the uterus from the mother's genital tract or traveled through her bloodstream from a more remote site, such as her gums or upper respiratory tract, says lead author Darios Getahun, a scientist at Kaiser Permanente Southern California's Department of Research and Evaluation in Pasadena.

In animals, chorioamnionitis has been shown to cause lung and brain damage in offspring, Getahun says. Scientists also have found lung scarring in infants who died after pregnancies complicated by the condition.

Getahun and his co-authors analyzed electronic health records for all singleton children born at Kaiser's Southern California hospitals in 1991 to 2007, a total of 397,852. Of those, 28,869 were preterm.

Among children born full-term, chorioamnionitis wasn't linked to an increased risk of being diagnosed with asthma by age 8. But among those born prematurely, the condition was associated with double the risk of childhood asthma in blacks, a 70% increase in Hispanics and a 66% increase in whites. The researchers observed these differences even after accounting for other possible risk factors such as whether the mother smoked or had asthma herself. Only in Asian/Pacific Islanders preemies did chorioamnionitis not seem to make a difference in childhood asthma risk.

Getahun speculates that chorioamnionitis wasn't related to asthma risk in full-term children because their mothers might not have had it as long as those born prematurely. But, he adds, his team didn't have information about how early in their pregnancy women were diagnosed.

Diagnosing the condition is tricky, Getahun says, because symptoms — fever in the mother, tenderness or pain in the uterus, foul-smelling amniotic fluid — aren't definitive, and some women never exhibit symptoms. Getahun's team is now trying to find a marker in the mother's blood that would signify her symptoms are because of chorioamnionitis.

A study of 1,096 children published in 2008 found a higher risk of wheezing by age 2 in preemies whose mothers had had chorioamnionitis.


Monday, February 01, 2010

Father forced to deliver own baby in maternity ward

A father was forced to deliver his own baby in a maternity ward after the midwife abandoned them.

Thomas Howard, 33, frantically pressed the emergency buzzer to alert staff at the Royal Blackburn Hospital, Lancashire, for help when he realized the newborn's arrival was imminent.

But when no one at the maternity suite arrived to deliver the baby, he had to act.

Father-of-five Mr Howard said by the time the midwife had returned, his partner Emily Baron had already given birth.

Emily, 26, had been taken to hospital after going into labor. After arranging for family members to look after their other children, Thomas arrived half an hour later and noticed Emily was losing blood.

'When I asked the midwife if this was normal she said she didn't know, which didn't fill me with confidence at all,' said Mr Howard.

'She then went away, leaving me and Emily on our own. It was then I noticed the baby's head coming through. I pressed the buzzer to get some assistance, but nobody came and I decided that I would have to step in.

'I have never done anything like it before, but I've seen others do it a few times, so I had a rough idea.

'The baby was lying at the end of the bed between Emily's legs and I was cleaning the mucous out of her mouth and making sure she could breathe when the midwife came back in.

I was in shock at what had happened but the nurse didn't say anything to me. She just carried on as if it was normal.'

Madeline Louise Howard was born at 8.15am last Tuesday weighing 4lb 15oz.

The couple are angry at the poor care they received and were worried because of problems at previous births. Thomas and Emily have four other children - Reece, nine, Dylan, six, Adam, two, and one-year-old Deni.

The National Childbirth Trust (NCT) have also criticized the hospital's treatment as an example of the midwife shortage facing the UK.

An NCT spokesperson said: 'Being left alone in labor in hospital is unacceptable.

Mr Howard, of Blackburn, added: 'I know that these nurses are busy and work very hard, but I feel the department is understaffed.

'My one-year-old daughter was born with a cleft lip, and Adam had breathing difficulties at birth. They both needed assistance at delivery, and if this had happened to them, I dread to think what the outcome would have been.

'It's just a massive relief that this has gone okay and she's doing well.'

Only a fortnight ago the Nursing and Midwifery Council said the midwifery profession is 'still playing catch-up' after a report warned Britain's rising birth rate was leading to a shortage of staff.

Ruth Gildert, divisional general manager in Family Care for East Lancashire Hospitals NHS Trust, apologized to the couple for having to deliver their daughter alone.

'We cannot comment in detail for reasons of patient confidentially but our midwives supervise all women very closely during labor.

'However there may, on some occasions, be the need to briefly leave the room and a baby can be born unexpectedly quickly, especially if this is not the mother's first child.

'As a result of the concerns expressed we will be looking very closely into what happened and we will be contacting the family directly to discuss their concerns with them. We understand both mother and baby are doing well.'