Friday, December 17, 2010
"This study isn't saying exposure to air pollution or exposure to traffic causes autism," said Heather Volk, lead author of the paper and a researcher at the Saban Research Institute of Children's Hospital Los Angeles. "But it could be one of the factors that are contributing to its increase."
Reported cases of autism cases increased by 57% between 2002 and 2006, according to the Centers for Disease Control and Prevention, although professionals still debate whether rates have actually risen or a greater proportion of autistic children is being diagnosed. An estimated 1 in 110 children is diagnosed with autism today. There is no cure, although research has shown that various therapies can mitigate some symptoms, especially if begun early in life.
In the current study, published online in the journal Environmental Health Perspectives, researchers looked at 304 children with autism and, for comparison, 259 children who were developing normally. The children, between the ages of 24 months and 60 months at the start of the study, lived in communities around Los Angeles, San Francisco and Sacramento.
Each family was evaluated in person, and all of the children received developmental assessments. Researchers collected data on where each child's mother lived during pregnancy and at the time of birth, and the proximity of the homes to a major road or freeway.
Children living about 1,000 feet from a freeway at birth — about 10% of the sample — had a two-fold increase in autism risk. The link held up even after researchers controlled for other factors that may influence development, such as ethnicity, parental education, maternal age and exposure to tobacco smoke.
The study did not find a link between autism development and proximity to a major road, as opposed to a freeway. That may be due to the type and quantity of chemicals dispersed on freeways compared with major roads, Volk said. In Los Angeles, some freeways carry more than 300,000 vehicles daily.
Gayle Windham, chief of the epidemiology surveillance unit with the California Department of Health Services Environmental Investigations Branch, said the study did not directly implicate air pollution as a risk factor for autism because it did not have a way of measuring how much pollution the mothers were exposed to during pregnancy.
"They are using a proxy measure for air pollution, which is distance to a freeway," she said. "But you still don't know how much time the women spent at home or working or commuting." Windham was not involved in the study.
Windham was the lead author of a 2006 study, also published in Environmental Health Perspectives, that found that children with autism were about 50% more likely to have a birth residence in an area with hazardous air pollutants. The study was based on air pollution data from the Environmental Protection Agency that was matched to birth records in the San Francisco Bay Area.
Research like this suggests environmental factors need more attention, said Clara Lajonchere, vice president of clinical programs for the advocacy group Autism Speaks. Lajonchere was not involved in the study.
"The implication could be very far reaching in terms of prevention and public health concerns," Lajonchere said. "I think it's pretty well established that genes play a huge role in autism. But there is something going on beyond genetics."
Chronic exposure to air pollution during pregnancy is thought to have physical effects on the fetus. High levels of carbon monoxide, nitrogen dioxide and particulate matter have been linked to a higher risk of preterm birth and low birth weight. Chemicals such as ozone, sulfur dioxide and polycyclic aromatic hydrocarbons, or PAHs, have also been identified as harmful to a developing fetus.
"We know there are some chemicals in air pollution coming from diesel exhaust that might be a good forerunner to look at," Volk said. "But right now we really don't know what it is about air pollution that is associated with autism."
Families residing close to freeways may have to wait for more research before scientists can issue advice or recommendations on what to do about this potential risk, Volk said. For one thing, this study requires replication, she said. In addition, future studies will attempt to identify the level of exposure to particular pollutants.
Sorenstam, 40, announced on her website and via Twitter that she is pregnant. She expects to have her and husband Mike McGee's second child next summer.
"Mike and I are happy to share that our family will be a foursome by early summer," Sorenstam wrote. "Ava is ready to be a big sister."
The couple's first child, Ava, was born Sept. 1, 2009.
Sorenstam has often said that she never used the word "retire" when announcing she was stepping away from the game at the end of the 2008 season, leading to speculation that she might one day return.
Since walking away after 73 LPGA Tour titles, including 10 major championships, she has kept busy with various business ventures, including an academy near her Orlando home.
The only woman to shoot 59 and one of only six to complete a career Grand Slam, Sorenstam was a dominant force in the game, especially during a five-year stretch when she won 43 times and finished in the top 3 in nearly 70 percent of her starts.
She also made worldwide headlines when she became the first woman in 58 years to compete in a PGA Tour event, doing so at the Colonial in 2003.
It was her obstetrician wanting to know where the heck she was. Did Aneka forget that today was the day for her cesarean section? How could she have forgotten?
No, Aneka hadn't forgotten. She hadn't shown up intentionally.
"She told me, 'You're being irresponsible. Your baby could die. You could die,'" Aneka recalls. Then the doctor hung up.
Aneka (she doesn't want her last name used) had already resolved to not have a C-section, even though the doctor told her it was absolutely necessary. She wasn't going to be opened up surgically, no matter what her doctor said, no matter what any doctor said.
In some online communities, Aneka is a hero who defied the obstetrical establishment and gave birth her way. To many doctors, however, she's a risk-taker who put her and her baby in peril by giving birth at home.
Aneka's story begins nine years ago with the birth of her first daughter, Nya. After 10 hours of labor, her doctor told her she wasn't progressing quickly enough, and she needed a C-section.
In a postpartum visit six weeks later, the doctor told her she'd needed the surgery because her hips were too small to pass the baby.
Four years later, doctors told Aneka she couldn't deliver her second child vaginally, since Nya had been delivered by C-section. Studies show when a woman gives birth vaginally after having had a previous C-section, there's a higher chance her uterus will rupture since she's pushing against scar tissue.
Then again, when Aneka was pregnant with her third child, son Adasjan, she had a C-section for the same reason.
When she became pregnant with her fourth child, a boy named Annan Ni'em, she expected to have a fourth C-section. But about seven months into her pregnancy, Aneka started to read more about childbirth online, and noticed a documentary by actress Ricki Lake called "The Business of Being Born," a film released in 2008 that questions the way American women have babies.
"I was a little bit angry after watching documentary," she said. "It made me realize I'd been robbed of the birthing experience. If possible, all women should be allowed to birth naturally."
"I asked my doctor if I could try delivering vaginally, and she said no," Aneka says. "I called the hospital and they said they wouldn't allow it, and I called three other hospitals and they wouldn't let me deliver vaginally, either."
The closest hospital that would let her try to deliver vaginally was in Manassas, Virginia, about 90 minutes from her Maryland home. She and her husband, Al, decided that was too far.
So just seven weeks away from her December 1 due date, Aneka contacted the International Cesarean Awareness Network, an advocacy group that promotes vaginal births after cesareans, or VBACs.
"She asked me if I could find someone who would deliver her vaginally," remembers Bobbie Humphrey, who works with ICAN. "She started to cry because she'd heard 'no, no, no you can't do this' so many times."
But Humphrey told her yes, that she knew of a midwife who would be willing to deliver her baby at home.
An article in Midwifery Today, written by Barbara Stratton, the National VBAC ban chair for ICAN, lists several approaches women have used to protest a VBAC denial.
On December 5, three days after the C-section that never took place, Annan Ni'em was born at home. He weighed 9 pounds, 6 ounces and was delivered after 20 hours of labor, and, she says, just four minutes of pushing. He was completely healthy.
"We were all crying at the delivery," says Humphrey, a doula who assisted the midwife at the birth. "It was very emotional. I was just so proud of Aneka."
Vaginal births after cesarean sections pose some risk, but so does having another cesarean. After weighing the risks of each, the American College of Obstetricians and Gynecologists came out with a statement earlier this year saying it's reasonable to consider allowing women who've had two C-sections to try to have a vaginal delivery.
The group added that there's limited data about what should happen with women, like Aneka, who've had more than one previous cesarean.
Despite the ACOG statement, many doctors and hospitals refuse to do VBACs because of the risk. Women who try to deliver vaginally after cesarean have between a 0.5 percent and a 0.9 percent chance of having a uterine rupture -- a potentially deadly complication for both mother and baby, according to the American College of Obstetricians and Gynecologists.
Women with two previous C-sections have a 1 percent to 3.7 percent risk of a uterine rupture, according to ACOG.
Studies show the risk for a uterine rupture goes up if the woman's labor is induced. Aneka's was not.
Dr. Jeffrey Ecker, a spokesman for ACOG and director of obstetrical clinical research and quality assurance at Massachusetts General Hospital, warns against reaching too many conclusions from Aneka's successful VBAC at home.
"Anecdote is no way for folks to make plans," he says. "Just because something turned out well for one patient doesn't mean there are no risks and it will turn out well for you."
He says there's a reason that uterine rupture is more likely when a woman's had a C-section.
"You cut into the muscle of the uterus during a cesarean, and it heals with a scar that is often weaker than the muscle that was there before surgery," he says. "The scar can be weak enough that the contractions cause it to separate."
In that case, blood flow to the placenta can be interrupted, and the baby doesn't get enough oxygen.
In its latest position paper, ACOG recommended that VBACs be attempted "in facilities with staff immediately available to provide emergency care."
"There is potential for catastrophe if [a uterine rupture] happens in a home environment," says Dr. William Grobman, an ACOG spokesman and associate professor in the Department of Obstetrics and Gynecology at the Feinberg School of Medicine at Northwestern University.
Grobman says he understands Aneka's desire not to have another C-section.
"This was a last resort. This was a choice because she had no other options," he says.
But Aneka says if she has another child, she'll give birth at home.
"Once you have that experience there's no other way to go, being in the comfort of your home without any unnecessary interventions and feeling like you're in charge," she says.
Thursday, December 16, 2010
The announcement from the office of Sen. Kirsten Gillibrand, D-N.Y., who has pushed for such a ban, says new federal crib standards will take effect in June, stopping the sale, manufacture, resale, and distribution of drop-side cribs.
The new rules also will prohibit drop-side crib use at motels, hotels, and child care facilities.
The announcement was made in Washington by Gillibrand, Inez Tenenbaum, chairman of the Consumer Product Safety Commission, Rep. Joseph Crowley, D-N.Y., Rep. Jan Schakowsky, D-Ill., and the parent of a child said to have died because of a faulty crib.
The CPSC’s new standards also will require mattress supports to be stronger, crib hardware to be sturdier, and more rigorous safety testing of baby beds.
The CPSC, the government’s top regulator of children’s products, says cribs with drop-down sides have hidden hazards that can cause strangulation or suffocation.
“Enough is enough,” Gillibrand says in her statement. “Time and time again, drop-side cribs have trapped and suffocated infants, destroying families across the country.”
She says the products “are deadly” and the new rules will save lives.
Michele Witte, who lives in Long Island, N.Y., was with the officials when the new rules were announced. She says she lost a child, a 10-month old boy named Tyler, due to a drop-side crib.
The news release says more than 11 million drop-side cribs have been recalled in the past three years.
The CPSC says parents using drop-side cribs should check the beds to make sure they work properly and haven’t been the subject of a recall. The Juvenile Products Association, which represents most of the crib industry, says most that are assembled properly and that haven’t been recalled can be used safely.
Electrical recordings made of infant brain activity within 24 hours of birth show the parts responsible for language processing react only to mom's voice, lead researcher Maryse Lassonde of the University of Montreal and Sainte-Justine University Hospital Research Centre said on Thursday.
The brain signals showed that while the infants did react to other women's voices, these sounds only activated the voice recognition parts of their brains.
"This is exciting research that proves for the first time that the newborn's brain responds strongly to the mother's voice and shows, scientifically speaking, that the mother's voice is special to babies," Lassonde said in a release. "[The] mother is the primary initiator of language."
The study marks the first brain research conducted on such young babies.
The research — published in this month's Cerebral Cortex journal — involved placing electrodes on the heads of 16 sleeping babies and then asking their mothers to make the short "A" vowel sound. The process was then repeated with a female nurse.
The scans showed their mothers' voices activated parts of the left hemisphere of the babies' brains, in particular those parts responsible for language learning. When the nurse spoke, it activated the right hemisphere of the babies' brains, which is associated with voice recognition.
The researchers say their study took into account the "novelty" aspect involved in processing a stranger's voice by arranging for the pregnant mother to meet with the nurse regularly before birth. In addition, speech analysis ensured the nurse's and mother's voices were comparable.
Scientists have long known that infants have some innate language capacities — when a baby hears the "A" sound, they will make the mouth shapes needed to imitate it, even if they have never seen it spoken.
"In order for my wife and I to have our life, we need to be up front and I need to be able to share things with you and be real," Cannon, 30, said on his 92.3 Now radio show Thursday. "I didn't even tell my wife I was gonna do this," he admitted. "I'm probably gonna get yelled at for not getting permission...We are having twins!"The confirmation comes after he tried to avoid answering after a slip made by Mariah.
"It's a touchy issue, because you never want to speak on too much stuff too early, but my wife, at one time, she referred to her stomach as 'they' and that probably wasn't the wrong thing for her to do," he told E!. "That's all I'm gonna say."
Wednesday, December 15, 2010
The three-year study showed that mothers who were vaccinated while pregnant successfully kept their newborns from being hospitalized with influenza 91.5 percent of the time. The study looked at the hospitalizations of infants up to 6 months old. There are currently no flu vaccines for children under 6 months of age.
For the study, the researchers looked at the
Comparisons showed that, of the infants who did not come down with the flu, the overwhelming majority had mothers who had received the vaccine while expecting.
Yale medical student Marietta Vazquez, the study's senior author, said getting the shot while pregnant is an effective way for mothers to protect their infants. It's especially important, since there are no vaccines for children under six months old. And it's cost-effective, she said, since it protects two people with one shot.
Even before the new findings, which are published Wednesday in Clinical Infectious Diseases, health professionals have recommended flu shots for pregnant women since influenza can lead to miscarriages. Also, pregnancy can make women more susceptible to the flu because of its effect on the immune system.
As far as types of vaccinations, pregnant women should get the flu shot made from an inactivated virus. The
10. Encourage Nesting Instincts. Many pregnant women possess strong urges to paint, remodel, move furniture, and otherwise begin to make changes to their environment. This is biology telling her to get things ready for the baby. Rather than fighting these urges or getting frustrated with the changes, get involved and ask how you can help with the nesting process.
9. Keep the Car Parked on a Level Surface (and Warm it Up for Her). If you have a slope to your driveway, park the car in a fashion that reduces the risk of falling or slipping, especially during icy or snowy conditions. While you're monitoring car care, run out and start it a few minutes before she has to get in, too. Chivalry ranks above saving the planet by the 3rd
8. Ask How She's Feeling. It's hard for the other person to truly understand the full extent of the physical changes occurring during a pregnancy. Stay engaged and make sure to ask your partner how she's feeling. It's important for her to know that a) you're interested and b) that you care.
7. Make Dinner. As the pregnancy develops, the motivation and ability to move around the kitchen may diminish. Keep your partner happy and healthy with surprise meal preparations that are good for her and the baby.
6. Say I Love You. Saying these three simple words allows your partner to know that she's not alone during a sometimes scary, bodily transformation.
5. Talk to the Baby. By the second trimester, the baby can hear you. Ask your partner if you can read to the baby or even talk to her belly during bedtime. Cuddle up at night and pick a story that will keep all three of you interested.
4. Start a Pre-Birth Journal. Suggest to your wife or partner the idea of keeping a "Daddy" or "Soon-to-be-Parents" Journal. This can be something as simple as a notebook in which you keep daily thoughts on world events, life, and/or the conversations you are having together leading up to the birth of your child. It'll be a piece of you that your teenage son or daughter can read one day.
3. Help Her Feel Sexy. For some women, the last thing on their minds during pregnancy is sex. For others, their drive becomes stronger. No matter the situation,
2. Talk Money. Don't wait until the baby arrives to share breaking news on your finances or the fact that you can't afford the crib you both have been talking about for four months. Sit down before the baby is due and look at your budget together. Talk openly about the economic changes and opportunities a baby will bring. Make it a positive conversation...not something scary or negative. Talking money isn't about adding stress, it's about taking it away and being prepared financially.
1. Vacuum. Yes. Vacuum. Better yet, vacuum AND dust. Believe it or not, it's often the little things that count the most during this time, especially when you're cooped up inside during the winter months. If you happen to already vacuum, then pick up a chore that she typically does (laundry anyone?) no matter how much you hate it.
Tuesday, December 14, 2010
A rep for the actress, who just marked her 40th birthday Sunday, confirms to UsMagazine.com that she and hubby Paul Bettany, 39, are expecting.
Connelly is already mom to the duo's 7-year-old son Stellan and 13-year-old son Kai (from her previous relationship with photographer David Dugan).
The star, who wed Bettany in Scotland in 2003 after they met filming the Oscar-winning flick A Beautiful Mind, opened up to Glamour last year about how she knew he was The One.
"It was something about the way that we were together," she told the mag. "He stood out to me as someone singular and rare and beautiful, and I liked the way he was in the world. I liked the way he was with people. I liked the way he was with my son and the way he made me feel."
Izabelle Evans can now see up to three feet in front of her after groundbreaking stem cell treatment in China costing over $78,000.
Parents James Evans and Hollie McHugh said nothing could beat the feeling of the first time their daughter looked into their eyes and said: "mummy" and "daddy."
Hollie, 24, of Hayling Island, Hampshire said: "The results were better than we could ever have dreamed of. If you walk past she can see you and say 'hiya.' It is amazing because doctors here said she couldn't see anything at all before we went."
Izabelle was blind from birth after being born with Septo Optic Displasia - a congenital condition which affects just five in one million babies and also causes hormone deficiency and mobility problems. It means she had only a few hundred optic nerves to her brain whereas she needs millions to be able to see.
Her parents decided to send Izabelle for treatment in China after researching her condition on the internet and raised the money needed in just over a year. Her parents had hoped the controversial stem cell treatment - which is not available in the UK - would improve her sight, speech and mobility. It involves injecting the spinal canal with cells taken from the umbilical cords of healthy babies. The cells are then used to rebuild the optic nerves.
Hollie said: "We've seen lots of changes. Her speech has improved a lot. Before she went she could only say one or two words but now we can have a little conversation with her. Her walking has improved and she can support her own weight on her legs now. She went back to school and they have seen a difference too. She picks things up and holds them close to her face. A couple of days after we got back I put the Christmas tree up and she reached out to grab for the lights. Last year she wasn't even aware we had a Christmas tree. It's just amazing. I can't wait for her to open her presents and experience it all for herself."
The month-long stay in China's Qingdao Chengyang People's Hospital was not easy for the family. Izabelle had to endure gruelling treatment with just two days off a week. She often became very upset when having the stem cell treatment and it was hard for her parents to see her in pain. Izabelle also had acupressure, standing therapy, physiotherapy and electric wave therapy to stimulate her tight muscles, which is another aspect of her condition.
Her father James, 24, said: "We're going to wait six months because the stem cells continue to work for six months if she stays healthy. We're going to keep an eye on her, see how her vision is, and then decide if we'll go back out there again and see if we can improve even more."
Monday, December 13, 2010
"They told me that they would go directly through my stomach with a needle into my uterine wall, directly into her heart," Wells says.
Wells is one of 200 or so women who have undergone an incredibly delicate operation that can actually prevent their babies from being born with a fatal heart defect called hypoplastic left heart syndrome, or HLHS.
Without this operation, these babies are born with half a heart. But if it works, fetal surgery enables them to develop almost normally.
About 17,000 U.S. babies are born every year with a serious heart defect. Nobody knows how many might benefit from the kind of fetal surgery Wells had.
But few are as lucky as she and her daughter. Either their heart problems go undiscovered, or they're diagnosed too late, or the diagnosing physician isn't aware that doctors in a few centers are doing fetal surgery to prevent HLHS.
The root cause of HLHS, much of the time, is a partially blocked valve that regulates blood flow from the heart's main pumping chamber, the left ventricle, to the aorta, which carries blood to the entire body.
When the aortic valve doesn't open fully, the fetus's left ventricle gets exhausted from pumping against the pressure of the stuck valve. Over crucial weeks of prenatal heart development, the left ventricle shrivels (that's what "hypoplastic" means) and becomes useless.
The defect is fatal unless surgeons do a heroic re-plumbing operation that allows the weaker right ventricle, which normally pumps blood to the lungs, to serve the whole body. Even when it's successful, patients live a limited life.
The goal of fetal heart surgery is "to open the aortic valve at a point when the left ventricle is not quite beyond irreparable damage," says Dr. Wayne Tworetzky, a cardiologist at Children's Hospital in Boston.
Doing that requires considerable skill. In Kim Wells' case, Dr. Louise Wilkins-Haug, a specialist in maternal-fetal medicine, pushed a long needle through Wells' swollen belly, through the muscle of her uterine wall, and into the beating heart of the fetus within.
At 23 weeks, that heart was only three-quarters of an inch long. "It's about the size of a grape," Tworetzky says.
The real target — the faulty aortic valve — was even tinier, "probably the size of the tip of a ballpoint pen," he says.
Once the needle was aimed precisely at the teensy valve, another doctor, cardiologist Audrey Marshall, pushed a guide wire through the needle. A miniature balloon slipped over the wire.
The aim was to thread that wire, and then the balloon, through the blocked aortic valve, then inflate the balloon — gently dilating the stuck valve.
It wasn't easy. For one thing, it's hard to maneuver the balloon into the right place. In Wells' case, it took several tries. First it went into the wrong valve, then the wire bumped into the interior wall of the fetus's heart and curled over.
Even with state-of-the-art ultrasound images displayed on a big screen, it's hard for the doctors to see exactly where the balloon is. "It's like trying to find a golf ball in a snowstorm," Tworetzky says. His job is to help interpret the ultrasound image for the other doctors.
Then there's the time factor. "We really have to get this done within seconds or at most several minutes from when the needle is first placed inside the [fetal] heart," Tworetzky says.
Otherwise, the fetus's heart may slow down, a condition called bradycardia. And in fact, as the team was inflating the fetal valve in Kim Wells' case, the tiny heart did slow down.
"If the heart slows down or even stops, there's a chance we may lose the fetus," Tworetzky says.
In Wells' case, he detected another ominous sign — fluid around the heart.
"We are sticking a needle into the heart, and not surprisingly, there can be bleeding," he explains. "That can compress the heart." And that too can be fatal.
So Dr. James Lock made the decision to stop the operation. As chief of cardiology at Children's Hospital, he is sort of the leader of the orchestra.
"Bring everything out of the body, everything out of the body," Lock called out. Quickly, the others pulled out the guide wire, the balloon and the long needle.
The team thought they had successfully opened up this fetus's stuck valve. But at that point, nobody could be sure whether the operation was a success.
As Kim Wells' pregnancy continued, ultrasound scans showed things were looking good. And when she had her baby 15 weeks later, the newborn's heart had developed normally.
Now that little girl, Hannah, is a lively, inquisitive 4-year-old. "She runs circles around our oldest daughter, who is completely healthy," Kim Wells laughs. "Yeah, she's a real ball of energy."
Hannah did require two heart procedures — one as a newborn to dilate her aortic valve a little more, and another open-heart operation at age 3 to repair a tear in one of the valve's three leaflets. And she'll probably need some more down the road.
But her father, John Wells, says that's nothing. "She has four chambers of her heart that are functioning," he says. "So that is the success story of the fetal intervention."
But few are as fortunate as Hannah Wells. At least half the time, serious heart defects — a broad category that includes aortic valve problems but many other disorders — aren't detected during pregnancy, Tworetzky says.
He says more parents should ask their obstetricians or ultrasound technicians to take a close look at the developing fetal heart to make sure there are four pumping chambers, and four valves. "They shouldn't be shy to ask their doctor, 'Did you see this?' " Tworetzky says. Because sometimes, at birth or even before, something can be done about it.
Babies who watched 60 minutes of TV daily had developmental scores one-third lower at 14 months than babies who weren't watching that much TV. Though their developmental scores were still in the normal range, the discrepancy may be due to the fact that when kids and parents are watching TV, they're missing out on talking, playing, and interactions that are essential to learning and development.
This new study, which appeared in the Archives of Pediatric and Adolescent Medicine, followed 259 lower-income families in New York, most of whom spoke Spanish as their primary language at home. Other studies examining higher-income families have also come to the same conclusion: TV watching not only isn't educational, but it seems to stunt babies' development.
But what about "good" TV, like Sesame Street? The researchers didn't find any pluses or minuses when compared to non-educational programs designed for small children, like SpongeBob SquarePants. Earlier research by some of the same scientists, most of whom are at New York University School of Medicine-Bellevue Hospital Center, has found that parents whose children watch non-educational TV programs like Spongebob SquarePants spend less time reading to their children or teaching them.
At this point, parents reading this are probably saying D'oh! TV is so often a parent's good friend, keeping kids happily occupied so the grownups can cook dinner, answer the phone, or take a shower. But clearly that electronic babysitter is not an educational aid.
The bottom line: This latest study adds more fuel to a recommendation from the American Academy of Pediatrics that babies under age 2 watch no TV at all. If you've just got to watch Dexter, it's best to make sure the tots are fast asleep.
A registry of 313 pregnant breast cancer patients found the greatest risk to the infants was premature birth, according to a study presented at the San Antonio Breast Cancer Symposium. About twice as many women who didn’t get chemotherapy had early deliveries, 33 percent versus 17 percent, probably to allow them to start treatment sooner, the researchers said.
Pregnancy in those with breast cancer is relatively rare, affecting about 2 percent to 3 percent of patients, said Sibylle Loibl, the lead author of the paper from the German Breast Group. As women delay pregnancy until later in life, however, the number may be on the rise, she said.
“The study demonstrates that it is possible to treat pregnant breast cancer patients close to the standard of care for nonpregnant patients,” Loibl said in an e-mail response to questions. Women who are pregnant should continue their pregnancies and start treatment normally, she said.
There were 142 newborns exposed to chemotherapy in the database. Among them, there were four infections, four birth defects, two cases of anemia, one case of jaundice and one child born small for gestational age. Among children born to women who didn’t get chemotherapy, there was one case of a birth defect, one temporary apnea, one with low blood sugar, one case of jaundice.
The two groups weren’t directly comparable because the patients had different types of breast cancer at different stages and received a variety of treatments, the researchers said. Still, the results for the newborns weren’t significantly different after one month or five years, though Loibl said they are still monitoring the children.
The information from the German database is reassuring, said Gretchen Kimmick, an oncologist at Duke Cancer Institute in Durham, North Carolina.
“It reconfirms that we can safely use chemotherapy to treat breast cancer during pregnancy, with minimal adverse effects on the baby,” she said in a statement.