Friday, February 12, 2010

Excess weight raises pregnancy risks: study

Being overweight or obese increases a woman's chances of having an extra-big baby, even after the effects of pregnancy-related, or "gestational," diabetes are taken into account, new research shows.

Excess weight in and of itself also sharply increased a woman's risk of pre-eclampsia, a potentially deadly pregnancy complication, Dr. Boyd E. Metzger of Northwestern University Feinberg School of Medicine in Chicago and his colleagues found.

Women have more difficulty delivering very large babies, while these newborns are also at risk of suffering injury during birth, including shoulder dislocation. While women who are overweight or obese are known to run a greater risk of having very large babies and experiencing other pregnancy complications, it has been difficult to separate out the effects of a mother's weight from those of gestational diabetes, Metzger and his colleagues note in the British Journal of Obstetrics and Gynecology.

This led them to investigate whether body mass index (BMI) -- a standard measure of weight in relation to height used to gauge how fat or thin a person is -- might influence pregnancy risks and fetal and newborn health, independently of a woman's blood sugar levels.

The study involved 23,316 women from 15 different medical centers in nine different countries. All had undergone an oral glucose tolerance test, which is used to identify women with, or at risk for, pregnancy-related diabetes; at that time, their height and weight were measured, too.

The researchers then used statistical techniques to control for women's oral glucose tolerance test results. Even after this adjustment, they found that the women with BMIs of 42 or greater, denoting severe obesity (for example, a 5-foot-5-inch tall woman weighing at least 250 pounds), were at more than triple the risk of having an excessively large baby, compared to the thinnest women in the study, who had BMIs of 22.6 or less (a 5'5" woman weighing less than 138 pounds).

The heaviest women's risks of having a C-section were more than doubled, while their likelihood of pre-eclampsia was 14-fold greater than for the leanest women. However, the heaviest women's risk for delivering a preterm baby was actually cut in half.

These findings help sort out the role BMI and gestational diabetes each play in the risk of complications of pregnancy and delivery, Metzger told Reuters Health in an interview.

He noted that recent studies have shown that dietary changes can effectively treat gestational diabetes for more than 90 percent of women with the condition.

"We're pretty confident that treating gestational diabetes going forward is going to continue to be beneficial," the researcher said. "We have much less evidence at this point as to how to neutralize or reduce the impact of overweight on pregnancy outcome."

What is becoming clear, he added, is that it's probably a woman's weight before she gets pregnant, rather than how much she gains during pregnancy, that's important in determining risk.

Source

How can a pregnant homeowner avoid remodeling hazards?

There are two points during a remodeling project that are critical times at which to consider the impact of potentially hazardous materials during pregnancy.

The first is during demolition, when materials are removed or disturbed, as some of the materials may have been manufactured with known toxins such as asbestos and lead.

The second is during the construction phase, when you should be aware of potentially harmful products used to manufacture building materials that will go in your home.

To stay safe, before beginning demolition, I recommend getting a hazmat inspection by a licensed inspector. This inspection will determine if there is asbestos in any materials that will be removed or disturbed.

For example, asbestos was used in old vinyl sheet flooring, in adhesives used for installing floor tile, in popcorn ceilings and in insulation around furnaces and ducts.

While the asbestos in these building materials is not a danger to health if left undisturbed, demolition or removal of the materials releases the asbestos into the air and becomes a health hazard.

As most people are aware, paint manufactured before 1978 may contain lead, which could lead to lead poisoning if ingested.

Not so well known is that pre-1978 ceramic tile may also contain lead. When lead compounds are locked up in the paint or tile glazing, they are benign to human health.

However, crushing, abrading or shattering of a glaze and sanding or scraping of paint can release a fine dust in which the lead becomes a health risk.

So don't think just because you're not ingesting flaky paint chips that you're safe from lead.

With demolition over, when you begin selecting products for the remodel, pay attention to products that may contain formaldehyde and/or other volatile organic compounds (VOCs).

Both formaldehyde and VOCs can be found in a variety of building materials. Cabinets and shelving often are constructed from pressed-wood products that use glues that may contain formaldehyde.

In general, formaldehyde off-gassing sources emit less and less formaldehyde over time.

However, it can take weeks, and sometimes even months or years, to disappear completely.

Long-term exposure to moderate formaldehyde concentrations (at levels lower than those causing irritation) may be linked to respiratory symptoms and allergic sensitivity, especially in children.

Many contractors and building-material suppliers are aware of the importance of good indoor air quality and can guide you to products and practices that will provide a healthy environment for you and your family.

Source

Thursday, February 11, 2010

Free Parenting Application for iPhones Available for 4 days

Tap into the collective wisdom of over 30 parenting experts in this insightful and accessible iPhone app.

Dealing with a toddler tantrum? Struggling with teen angst? Or maybe you've got a few quiet moments to focus on empowering yourself as a parent. Turn to the Parenting the Future iPhone app. Wyatt-MacKenzie has gathered well-known authors, leading parenting coaches, and world-renowned luminaries in parenting education.

The easiest way to get the free download is to search for "Parenting the Future" in your Apps store. You can also access it using this link and downloading through iTunes.

Interview with Kristi Yamaguchi on Motherhood

Olympic ice skating champion Kristi Yamaguchi, 38, is living life to the fullest these days! From competing on Dancing with the Stars to signing on to be a special correspondent for Today during the 2010 Winter Olympics, this busy wife and mother of two is finding balance and having a blast.

Kristi recently opened up to Working Mother about her passion of figure skating and life with daughters, Keara Kiyomi, 6, and Emma Yoshiko, 4, and husband, former Olympic/retired pro-hockey player, Bret Hedican, 39.

On how her children have changed her life: "I want to be there for my kids. My priorities have changed drastically, and I’m lucky I was ready for that. I’d done everything I ever wanted to do in skating. I’d toured with Stars on Ice for ten years. I was ready to hang up the skates, unpack my suitcase and not pack it for a very long time.”

On her daughters' distinctive personalities: “After the first one is born, you think the second one will be the same—but she’s not. Keara is very social, outgoing and adaptable. I see a lot of myself in Emma. She’s Mommy’s girl, like I was. She’s a little shy in social situations until she gets comfortable. Keara is more artistic. She loves imaginary play. Emma has really good athletic ability. She’s physically tough. It will be interesting to see what they choose to do.”

On balancing her career and her family life: “In my twenties I never thought I’d still be working this hard in my thirties. I do feel lucky that I did a lot of my skating, which would have been hard on me as a mom, early on—all that touring and living on the road. I’m happy I’m still busy—off the ice. I still juggle. Sometimes I think I overextend myself because I’m traveling too much and am away from the kids. It’s a fine line to find that balance. These days I make business decisions based on whether something is worth my time away from my kids.”

On what inspired her to skate: “I was born with clubfeet, and I had plaster casts on my legs from when I was a couple of months old until age 1. When the casts came off, I wore corrective shoes connected by a brace to turn my feet until I was about 2. The braces hurt my legs a lot, and I remember trying to walk with a bar in between my feet—I had to shuffle. I was lucky they corrected it when I was so young. Skating wasn’t assigned to me, but when I wanted to skate, the doctors said it would help. I expressed an interest when I was about 4 or 5. I’d seen the Ice Follies, the Ice Capades. I remember seeing Peggy Fleming and Dorothy Hamill and wanting to capture the magic of those shows.”

On her biggest surprise since becoming a mother: “I’ve realized how precious life is. When I was younger, I was more adventurous. I felt invincible. I was game for everything. As a mom, I don’t want to get injured because then I can’t take care of my kids. Even getting on an airplane, I’m more conscious of…Like they say, once you have a child, your heart is forever outside your body. I totally understand that now.”

Source

Pregnant Man Expecting Third Child

The world's first pregnant man is pregnant again ... with baby number three!

Who can forget the day Oregon native Thomas Beatie, a transgender living as a man, and his wife welcomed baby girl Susan (June 29, 2008)? Or the day Beatie gave birth to his second child, a boy (June 9, 2009)?

Now, in keeping with his one-kid-per-year tradition, Beatie is pregnant with his third child and is proudly showing off his baby bump.

Source

Husband wakes from coma after wife whispers in his ear that he has become a grandfather

Some things are worth waking up for.

And after two weeks in a coma David Russell finally opened his eyes - after his wife told him he had just become a grandfather.

Doctors had previously warned Helen Russell that the prognosis for her 60-year-old husband was not good.

But on hearing the news of the latest addition to the family, the farmer is making a full recovery.

Mr Russell was left fighting for his life after he fell 12ft onto concrete while replacing guttering on a barn roof.

He then underwent a five-hour operation to remove a blood clot from his brain before lapsing into the coma.

His 57-year-old wife was warned he would probably wake up with serious brain damage, but after their first grandchild Edie was born two weeks later she whispered in his ear: 'Come on granddad you have got to wake up now.'

Mrs Russell says that on hearing the news her husband stirred from his coma and gave her a wink.

She said yesterday: 'The doctors didn't even think that he would survive the operation, which was absolutely horrific news to be given. 'He did survive but when he failed to come out of an induced coma they said the best case scenario was that he would be brain damaged and severely impaired.

Mr Russell, who is now expected to make a full recovery, said: 'The doctors told my wife that there was a risk that although I was going to survive I may be severely brain damaged.

'The next day Helen told me that we had become grandparents and I apparently opened my eyes and blinked and winked, but I don't remember it.'

Mr Russell was well enough to see his granddaughter three weeks later while he was undergoing rehabilitation at Gloucester Royal Hospital.

He said: 'It was just fantastic to meet Edie and I have got her to thank for saving my life. When she is older I will tell her that she helped bring me out of a coma.'

Source

Wednesday, February 10, 2010

Osteopathic care may ease late-pregnancy back pain

Doctors in osteopathic medicine (DOs) are medical doctors additionally trained in gentle manipulative techniques to help restore function, range of motion, and lessen pain in bones and adjoining muscles supporting the neck, back, chest, shoulders, and hips.

Osteopathic manipulation may particularly benefit pregnant women seeking medication-free back pain relief, note Dr. John C. Licciardone and colleagues at University of Texas Health Science Center in Fort Worth.

The study, in the American Journal of Obstetrics and Gynecology, included 144 otherwise healthy pregnant women, about 24 years old on average, with moderate levels of back pain and related movement difficulties during late pregnancy.

The women were randomly assigned to one of three groups: usual obstetric care only, usual obstetric care plus weekly 30-minute osteopathic manipulation treatments from the 30th week of pregnancy through delivery, or usual obstetric care plus sham ultrasound skin stimulation sessions.

Over the course of the study, women in the osteopathic group reported improved back pain and related symptoms, Licciardone noted in an email to Reuters Health. The sham ultrasound group reported no pain improvement and those in the standard care group reported increased pain. However, none of these differences were statistically significant.

Late pregnancy back-related movement problems generally worsened until delivery, but did so to a lesser degree in the osteopathic manipulation group.

Overall, these results suggest osteopathic manipulation may compliment conventional obstetric care, Licciardone and colleagues conclude.

Source

Mom's anemia may raise schizophrenia risk in offspring

Children of mothers who had been diagnosed with anemia during pregnancy, most likely due to iron deficiency, had a significantly elevated risk of developing the mental disorder, the study's lead researcher Dr. Holger Srensen of the University Hospital of Copenhagen in Demark, told Reuters Health by email.

Iron is necessary for the production of hemoglobin, a protein that distributes oxygen throughout the body. Because a pregnant woman carries an additional set of organs and tissues -- and almost 50 percent more blood -- she needs extra iron to ensure that enough oxygen gets around.

"We speculate that maternal iron deficiency may disrupt essential pathways that affect the delivery of oxygen and nutrients to the fetus," Srensen said. Earlier research has suggested that a failure to meet the iron demands of a developing brain might heighten a child's vulnerability to disorders such as schizophrenia.

To further investigate this potential link, Srensen and colleagues analyzed the psychiatric outcomes of a large group of Danish children born between 1978 and 1998 -- the biggest cohort in which the relationship has been examined. Each child was followed from age 10 until the onset of schizophrenia, death or the study's closure on December 31, 2008.

Among 1,115,752 newborns, 17,940 (1.6 percent) were exposed to anemia in the womb. A total of 3,422 -- including 41 from the exposed group -- went on to develop schizophrenia, according to the report published in the journal Schizophrenia Bulletin.

After accounting for differences between the two groups and other relevant factors, including the parents' ages and history of mental illness, exposure to anemia in the womb was associated with a 60 percent increased risk of schizophrenia in offspring during the 20 years of the study.

The researchers further concluded that 0.58 percent of schizophrenia cases (a total of about 20 diagnoses) could have been prevented had there been no cases of anemia among the mothers.

These figures may be underestimates of anemia's true impact, according to Srensen and colleagues. It is possible that some pregnant women received anemia diagnoses and treatment from general practitioners outside the hospital, and therefore outside of the Danish registry used for the study.

Schizophrenia diagnoses may have been under reported as well. Even the oldest cohort members were only followed until age 30. Rates of schizophrenia peak around age 22 or 23, noted Srensen, so the study "may have missed around 50 percent of cases with a later onset."

The researchers also lacked access to the women's precise hemoglobin levels, which prevented assessment of the relative severity of anemia.

Despite its unresolved relationship with schizophrenia, prevention and treatment of maternal anemia remains straightforward. "Checking for iron-deficiency anemia (or anemia from other causes), and correcting a deficit," Srensen said, "is relatively simple in a clinical setting."

Source

Tuesday, February 09, 2010

Third-hand smoke a danger to babies, toddlers

Add a new health threat to smoking: In addition to the harm caused by actually smoking and exposure to second-hand smoke, so-called third-hand smoke may also pose a threat, particularly to babies and toddlers.

A new study reveals that the residue of nicotine that lingers on surfaces can react with another chemical in the air to form potent carcinogens - chemicals linked to various cancers. While first-hand smoke is that inhaled directly by the smoker and second-hand is the smoke exhaled (and inhaled by others), third-hand smoke is the residue from second-hand smoke.

Anyone who has entered a confined space — a room, an elevator, a vehicle, etc. — where someone has recently been smoking, knows that the scent lingers for an extended period of time.

"The burning of tobacco releases nicotine in the form of a vapor that adsorbs strongly onto indoor surfaces, such as walls, floors, carpeting, drapes and furniture. Nicotine can persist on those materials for days, weeks and even months," said Hugo Destaillats, a chemist with Lawrence Berkeley National Laboratory in San Francisco, and one of the authors of the study.

Scientists have been aware for several years that tobacco smoke sort of sticks to surfaces where it can react with other chemicals. But reactions of residual smoke constituents with molecules in the air have been overlooked as a source of harmful pollutants, the researchers of the new study say.

"Our study shows that when this residual nicotine reacts with ambient nitrous acid it forms carcinogenic tobacco-specific nitrosamines or TSNAs," Destaillats said. "TSNAs are among the most broadly acting and potent carcinogens present in unburned tobacco and tobacco smoke."

Unvented gas appliances are the main source of nitrous acid indoors.

The researchers used cellulose as a model of indoor material, and exposed it to cigarette smoke. They then exposed it to a "high but reasonable" concentration of nitrous acid for three hours. The levels of newly formed TSNAs were 10 times higher after the nitrous acid exposure. The TSNAs also formed quickly, the researchers found.

"Given the rapid absorption and persistence of high levels of nicotine on indoor surfaces, including clothing and human skin, our findings indicate that third-hand smoke represents an unappreciated health hazard through dermal exposure, dust inhalation and ingestion," said lead author Mohamad Sleiman, also of Berkeley Lab.

Since most vehicle engines emit some nitrous acid that can infiltrate the passenger compartments, tests were also conducted on surfaces inside the truck of a heavy smoker, including the surface of a stainless steel glove compartment. These measurements also showed substantial levels of TSNAs.

Individuals are most likely exposed to these TSNAs through either inhalation of dust or the contact of skin with carpet or clothes, suggesting third-hand smoke might pose the greatest hazard to infants and toddlers.

And the study's findings, detailed in the Feb. 8 issue of the journal Proceedings of the National Academy of Sciences, indicate that opening a window or deploying a fan to ventilate the room while a cigarette burns does not eliminate the hazard of third-hand smoke.

"Smoking outside is better than smoking indoors but nicotine residues will stick to a smoker's skin and clothing," said study co-author Lara Gundel, also of Berkeley Lab. "Those residues follow a smoker back inside and get spread everywhere."

Source

Mom's Lifestyle in Early Pregnancy Affects Baby's Size

The lifestyle habits you bring into pregnancy can have lasting effects on your baby's health, new research shows.

A Dutch study found that women who smoked, had high blood pressure or low folic acid levels in early pregnancy had babies that were smaller in the first trimester of pregnancy and had a higher risk of complications later.

"Our study demonstrates that several maternal physical characteristics and lifestyle habits, such as smoking and non-use of folic acid supplements, affect first-trimester fetal growth," said study senior author Dr. Vincent Jaddoe, a pediatric epidemiologist at Erasmus Medical Center in Rotterdam, the Netherlands.

"First-trimester growth restriction is associated with higher risks of adverse birth outcomes and accelerated postnatal growth rates. Thus, the first trimester of pregnancy seems to be a very critical period for fetal growth and development. This is important, since it suggests that the fetus is already affected before pregnant women visit their midwife or obstetrician," he said.

For the study, published in the Feb. 10 issue of the Journal of the American Medical Association, the researchers followed 1,631 pregnant women from their first trimester through their pregnancies. The growth of their offspring was assessed until the children were 2.

The average age of the mothers was 31, and 71 percent were white. More than half had a higher than high school education. The average body mass index was 23.5, which is normal (over 25 is considered overweight). About one-quarter smoked at the start of the study.

The researchers found that certain factors affected the likelihood that a fetus would have a small crown to rump length (a standard way to measure babies using ultrasound). Babies whose mothers smoked or had higher diastolic blood pressure readings (diastolic is the bottom number in blood pressure) were more likely to be smaller. Women who didn't use folic acid supplements and those with higher levels of red blood cells also had smaller babies, according to the study.

A small size during the first trimester translated to a higher risk of certain complications later in the pregnancy, such as preterm birth and low birth weight.

Babies that had first-trimester growth restriction had 7.2 percent odds of being born preterm compared to 4 percent for babies who weren't growth-restricted. Odds of low birth weight were 7.5 percent for growth-restricted babies compared to 3.5 percent for other babies. And, the odds of being born small-for-gestational-age were 10.6 percent for babies who were growth-restricted compared to 4 percent for babies who grew normally during early pregnancy.

Jaddoe and Dr. Gordon Smith, author of an accompanying editorial in the same issue of the journal, believe that when a woman is exposed to poor lifestyle habits in early pregnancy, it may affect development of the placenta, which then affects the fetus' ability to survive and thrive.

The bottom line for women is that it's important to go to the doctor before getting pregnant to find out what steps to take to ensure that you're in the best shape possible before you get pregnant, such as quitting smoking and taking folic acid supplements.

Source

Milk in pregnancy may lower MS risk

Mothers-to-be can reduce their babies' risk of developing multiple sclerosis in later life by drinking milk, research suggests.

The link emerged from a study of 35,794 female nurses whose mothers provided information about their diet during pregnancy. Of the nurses taking part, 199 developed multiple sclerosis (MS) over a 16-year period.

The researchers found that the risk of MS was lower among women born to mothers who drank a lot of milk while pregnant. A similar trend was seen for vitamin D. Mothers who had a relatively high vitamin D intake during pregnancy also gave birth to daughters with a reduced risk of MS.

Dr Fariba Mirzaei, from the Harvard School of Public Health in Boston, US, who led the study, said: "The risk of MS among daughters whose mothers consumed four glasses of milk per day was 56% lower than daughters whose mothers consumed less than three glasses of milk per month.

"We also found the risk of MS among daughters whose mothers were in the top 20% of vitamin D intake during pregnancy was 45% lower than daughters whose mothers were in the bottom 20% for vitamin D intake during pregnancy."

She added: "There is growing evidence that vitamin D has an effect on MS. The results of this study suggest that this effect may begin in the womb."

Exposure to sunlight, oily fish such as salmon and mackerel and fortified milk are key sources of vitamin D.

Source

Newborn testing faces challenges in using leftover blood spots for research

A critical safety net for babies - that heelprick of blood taken from every newborn in the U.S. - is facing an ethics attack.

After those tiny blood spots are tested for a list of devastating diseases, some states are storing them for years. Scientists consider the leftover samples a treasure, both to improve newborn screening and to study bigger questions, like which environmental toxins can harm a fetus's developing heart or which genes trigger childhood cancers.

But seldom are parents asked to consent to such research - most probably do not know it occurs - raising privacy concerns that are shaking up one of public health's most successful programs. Texas is poised to throw away blood samples from more than five million babies to settle a lawsuit from parents angry at what they call secret DNA warehousing. A judge recently dismissed a similar lawsuit in Minnesota.

Michigan just moved four million leftover blood spots into a new "BioTrust for Health," planning a public education campaign about the research potential and how families can opt out.

Advisers to the U.S. government hope to have national recommendations in two months on how to assure all babies still get their newborn tests while allowing parents more say in what happens next.

"It's a critical thing that we take action," says advisory board member Sharon Terry of the non-profit Genetic Alliance. She says distrust over the leftover blood spots threatens public confidence in newborn screening itself.

"The sunshine on the information - educating parents - is the way lesser threat. Done well and done right, there will be an enormous benefit overall to the system," she says.

Newborn screening is not new. It began in the 1960s, and today every baby is supposed to be tested for at least 29 rare genetic diseases in hopes of catching the fraction who need early treatment to help avoid brain damage or death. Now being added to the list: Bubble-boy disease, formally known as SCID for severe combined immune deficiency.

The program catches about 5,000 babies a year in need of treatment.

Because newborn screening is mandatory, only a handful of states provide much upfront parent education. Leftover spots mainly are used for double-checking that newborn tests are accurate. Sometimes, families ask geneticists to study them after a child's death from a disease doctors can't immediately diagnose.

But as scientists sought to use the leftovers for broader research, suddenly the informing of parents - especially about long-stored spots - became an issue. While blood spots are stripped of identifying information before being handed over to scientists, people generally need to consent to participate in research.

"My kid is not a lab rat. You have to ask before you can use him in an experiment, before you can use his blood, his tissues, his DNA, whatever," says Andrea Beleno, one of the Texas parents who sued. Among their worries: that genetic information about the children could fall into the wrong hands.

Had she only been asked, Beleno adds, she probably would have let her son's blood spot be stored.

To scientists who pore through dusty warehouses in search of blood samples stored by health department ID codes - not the babies' names - privacy concerns are exaggerated.

"There's a gap between the name and the DNA. ... There's no way one could just put one's hands on these blood spots and know anything about that person," says Dr. Christopher Loffredo of Georgetown University, who needed families' permission to cull about 1,200 blood spots stored in Maryland for a study that linked a pregnant woman's smoking or exposure to certain chemical solvents to fetal heart defects.

Still, Dr. Jennifer Puck of the University of California, San Francisco, who created the new SCID test using leftover blood spots, understands parents' concerns.

"DNA is your personal signature, and it uniquely identifies us," Puck says. "We all have to become more careful and more specific in terms of what we're going to do with the blood spots."

Bioethicist Aaron Goldenberg of Case Western Reserve University studied parent attitudes, and found three-quarters would be willing to have their baby's leftover blood spot used for research if they were asked first. But they generally oppose that research without consent.

The balancing act for states, he says, is separating the two issues - lifesaving newborn screening and other use of the leftover blood - in the little time available to educate parents.

Source

The headmistress who was back at work seven hours after giving birth

Surprisingly for an independent school, it's not a sex or drugs scandal that has brought St Mary's in Calne, Wiltshire, to the public attention. It's simply that the girls' school's headmistress Dr Helen Wright, like thousands of other women, has given birth.

But unlike these women, 39-year-old Dr Wright has had her baby and gone straight back to work. And I mean straight back. A mere seven hours after labor she was behind her desk, baby Jessica in tow. And instead of being sectioned, she's being lauded as a pioneer in the work-life-balance debate.

'People expect me to be pretty special and a role model,' she trilled when interviewed about her decision to go without maternity leave. 'Most mothers want their daughters to have the exhilarating excitement of a career they love and the joy of a family. I have that and I want to show the girls at St Mary's that's not an impossible dream.'

She then blithely suggested that women should consider the alternative to paying for childcare or looking after their children at home - taking their babies to work with them.

As any woman who has ever worked will know, this is ridiculous. As a teacher, I can't possibly bring my daughter into the classroom. What doctor, lawyer or shop assistant could bring their children to work?

I would argue that - despite what my generation was told 20 years ago - most women can't have it all, and anyone who continues to perpetuate the myth is behaving with criminal irresponsibility.

Far more honest is Jill Berry, the headmistress of Dame Alice Harpur in Bedford, another exclusive independent girls' school. Women, she says, can succeed in their careers and they can succeed at motherhood, but to do both is impossible without huge sacrifices.

Source

Monday, February 08, 2010

Older mothers' kids have higher autism risk, study finds

A 10-year study examining 4.9 million births in the 1990s has found more evidence that there's a link between autism and the mother's age at conception.

The link between the parents' age and children's health is not entirely new. Prior studies have indicated that babies born to older women have higher risks of birth defects, low birth weight and certain chromosome problems, such as Down syndrome.

A 2007 Kaiser Permanente study conducted in California reported that autism risk increased with both the mother's and father's age. An Israeli study based in statistics from 1980s had isolated only paternal age as being linked with increased risk for autism.

Dr. Max Wiznitzer, a pediatric neurologist at Rainbow Babies & Children's Hospital in Cleveland, Ohio, said the latest research had a far larger sample size.

In the latest study, researchers found that mothers over the age of 40 had 51 percent higher odds of having children with autism compared with mothers between the ages 25 and 29.

The father's age also played a factor, but only when he had a child with a woman under 30.

"When the mom has minimal age risk of an autistic child, we do see increased risks as dads get older," said lead author Janie Shelton, a graduate student researcher at UC-Davis.

It's unclear why the mother's age has more bearing in autism risk than the father's.

The study authors emphasize that while autism rates have risen 600 percent in the past two decades, older women having children contributed to only 5 percent more cases of autism.

As more women delay childbearing, it's important to keep the study in perspective, said Geraldine Dawson, chief science officer of Autism Speaks, the nation's largest autism science and advocacy organization.

"I don't think a mom blaming herself is going to help us understand what's causing autism or help prevent further cases," she said. "I would urge parents not to blame themselves, regardless of what age they are."

Shelton and the co-authors obtained all birth records in California from 1990 to 1999 and then collected data from the state's Department of Developmental Services to count the number of autism diagnoses from children born during that decade.

How parental age increases autism risks remains unknown, but several hypotheses exist. Some suggest that the cumulative effects of the environment, changes to the autoimmune system, stress and reproductive technology may affect autism risk.

Source

Birth planning leads to surprising increase in premature births

The rising trend of expectant mothers being involved in every aspect of planning their births has had an unintended consequence - a rise in pre-term deliveries.

"It never would have occurred to me or anyone I knew to think you had any kind of control over when the baby would come out," said Laura Crawford, who gave birth more than a decade ago.

Crawford, producer of the Kentucky Educational Television documentary "Born too Soon," said the increasing incidence of what is called late pre-term births is among the topics explored in the film.

Prematurity rates in the nation have increased quietly over the past two decades, according to public health officials. The premature-birth rate in Kentucky is 15.2 percent, and it's rising faster than the national rate, which is 12.7 percent. Kentucky has one of the highest rates of pre-term births, trailing only Louisiana, Alabama, Mississippi and South Carolina.

Some of Kentucky's rise is related to some not-so surprising subjects, including the rate of maternal smoking (more than twice the national average), poverty and environment.

Other reasons are more surprising. They include the rise in scheduling births.

It's just within the last three or four years that the scope of the problem of late pre-term births - babies born between 34 and 36 weeks' gestation - has become apparent, said Dr. Ruth Shepherd, division director for maternal and child health in Kentucky's Department of Public Health. Roughly 10 percent of all babies born in Kentucky fall into the late pre-term category.

Ideally, she said, babies shouldn't be delivered before 39 weeks.

Often, there are legitimate reasons for early delivery, especially if the health of mother or child is at risk.

Increasingly, choices are made for reasons other than health. Delivery might be scheduled to coincide with grandparents' dates of arrival from out of town, or before Dad must ship out for Iraq.

There are several complicating factors, Crawford said. The documentary states that people tend to underestimate the impact of premature births, especially late pre-term births. They tend to overestimate how accurately a due date can be determined.

Shepherd said there can be real consequences. They can include immediate physical challenges, including underdeveloped lungs and long-term problems involving learning and behavioral disabilities, for example.

And even if a mother gets an ultrasound within the first 16 weeks - the best way to accurately determine the due date - the date can be off by two weeks either way.

Those two weeks can be crucial, she said.

"It's an issue of planning and control," she said. Planning is good. The Centers for Disease Control and Prevention recommends that mothers have a birth plan. But, Shepherd said, "you can take it too far if you don't pay attention to the science."

Source

Most Pregnant Women Never Tested for the Most Common Birth Defect

Three out of five women who have given birth to a child with a congenital heart defect (CHD) -- the number-one birth defect and leading killer of infants and newborns -- were never tested for the defect during pregnancy. This is according to a survey just released by Little Hearts, Inc.

These findings come just as CHD Awareness Week begins (Feb. 7 - 14). The Little Hearts survey found that 60 percent of parents did not know their child had a CHD until after giving birth -- because the mothers were not tested for heart defects during pregnancy.

Of these parents, nearly three out of four (71.6 percent) wished they had known their child had a CHD during pregnancy -- mostly because they would have given birth at a hospital more equipped to handle the care of newborns with a CHD (41.6 percent).

"Congenital heart defects kill more children than childhood cancer, and yet, pregnant women are not routinely tested -- and newborns are not routinely screened -- for this defect," says Lenore Cameron, President and Executive Director, Little Hearts, Inc. "Early detection is absolutely critical to the successful treatment of congenital heart defects and, in countless cases, it saves lives."

Those families that did know their child had a CHD before giving birth (40.0 percent) reaped tremendous benefits from knowing in advance:

  • Three out of five (59.5 percent) said they gave birth at a hospital more equipped to handle the care of newborns with a CHD
  • One in five (19.8 percent) prepared themselves mentally and emotionally for the arrival of a seriously ill child
  • Others did their homework: 14.9 percent of respondents said they arranged for a pediatric cardiologist in advance of their baby's arrival, and 5.8 percent said that knowing in advance was most beneficial because it gave them time to do research on CHDs during the pregnancy

More Survey Results

  • Four out of five respondents (81.7 percent) said neither parent of the heart child had any family history of CHDs
  • Giving birth to a child with a CHD was more common for women in their 30s (65.2 percent) than in any other age group
  • Three out of four respondents (76.1 percent) said the mother did not take prescription drugs (which is considered a CHD risk factor) while pregnant with the heart child
  • Almost all respondents (96.4 percent) have only one child with a congenital heart defect; 3.6 percent have two or more children with a CHD
  • Nearly three out of five respondents (58.0 percent) said their heart child has two or more CHDs; 42.0 percent said their heart child has one CHD
  • The most common CHD among children of respondents was Hypoplastic Left Heart Syndrome (30.3 percent), a very serious heart defect that occurs when the left side of the heart does not develop completely

There are approximately 35 different types of CHDs. Some may be treated with surgery, medicine and/or devices, such as artificial valves and pacemakers. In the last 25 years, advances in the treatment of heart defects have enabled half a million U.S. children with serious CHDs to survive into adulthood. However, many cases of sudden cardiac death in young athletes are caused by undiagnosed CHDs and childhood-onset heart disease.

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