Childbirth
Virtual childbirth simulator improves safety of high-risk deliveries
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Newly developed computer software combined with magnetic resonance imaging (MRI) of a fetus may help physicians better assess a woman’s potential for a difficult childbirth. Results of a study using the new software were presented today at the annual meeting of the Radiological Society of North America (RSNA).
Because a woman’s birth canal is curved and not much wider than a fetus’s head, a baby must move through the canal in a specific sequence of maneuvers. A failure in the process, such as a head turned the wrong way at the wrong time, can result in dystocia, or difficult labor.
“The mechanics of the human birth canal make for a very complicated delivery process compared to other mammals,” said Olivier Ami, M.D., Ph.D., an obstetrician in the Department of Radiology at Antoine Béclère’s Hospital, Université Paris Sud, France. “We now have computer-simulated childbirth to identify potential problems.”
Using the new software, called PREDIBIRTH, Dr. Ami and a team of researchers processed MR images of 24 pregnant women. The result was a three-dimensional (3-D) reconstruction of both the pelvis and the fetus along with 72 possible trajectories of the baby’s head through the birth canal. Based on these simulations, the program scored each mother’s likelihood of a normal birth.
Study links pollutants to a 450 percent increase in risk of birth defects
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Pesticides and pollutants are related to an alarming 450 percent increase in the risk of spina bifida and anencephaly in rural China, according to scientists at The University of Texas at Austin and Peking University.
Two of the pesticides found in high concentrations in the placentas of affected newborns and stillborn fetuses were endosulfan and lindane. Endosulfan is only now being phased out in the United States for treatment of cotton, potatoes, tomatoes and apples. Lindane was only recently banned in the United States for treatment of barley, corn, oats, rye, sorghum and wheat seeds.
Strong associations were also found between spina bifida and anencephaly and high concentrations of polycyclic aromatic hydrocarbons (PAHs), which are byproducts of burning fossil fuels such as oil and coal. Spina bifida is a defect in which the backbone and spinal canal do not close before birth. Anencephaly is the absence of a large part of the brain and skull.
Streptococci and E. coli continue to put newborns at risk for sepsis
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Bloodstream infections in newborns can lead to serious complications with substantial morbidity and mortality. What’s more, the pathogens responsible for neonatal infections have changed over time. In recent years, however, antibiotic prophylaxis given to at-risk mothers has reduced the incidence of early-onset group B streptococcal infections among their babies.
A new nationwide, multi-site study aimed at determining current early-onset sepsis rates among newborns, the pathogens involved, and associated morbidity and mortality demonstrates that the most frequent pathogens associated with sepsis are group B streptococci (GBS) in full-term infants and Escherichia coli in preterm infants.
The study, which included nearly 400,000 newborns, also found that infection rates in newborns increased with decreasing gestational age and birth weight. The overall rate of infection was 0.98 per 1,000 live births; 0.41 per 1,000 live births involving GBS and 0.28 per 1,000 live births involving E. coli.
Study finds that folate does not offer protection against preterm delivery
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In a study to be presented today at the Society for Maternal-Fetal Medicine’s (SMFM) annual meeting, The Pregnancy Meeting ™, in San Francisco, researchers will present findings that show that folate intake before and during pregnancy does not protect Norwegian women against spontaneous preterm delivery.
“Sufficient folate intake has been studied as a possible protecting factor against spontaneous preterm delivery with conflicting results,” said Verena Senpiel, M.D., one of the study’s authors. “Preterm delivery is the major cause of perinatal mortality and morbidity worldwide and still difficult to predict and prevent. So when a recent American study found that preconceptional folate supplementation could reduce the risk for early spontaneous preterm delivery 50-70% we hoped to confirm these findings in another big cohort study.”
The study selected controls and cases from the Norwegian Mother and Child Cohort Study (http://www.fhi.no/) that included 72,989 children. Cases were defined as singleton live births with spontaneous onset of preterm delivery between 22 and 36 gestational weeks and after pregnancies without medical or obstetric complications. Controls were chosen according to the same criteria, except spontaneous onset of term delivery between gestational weeks 39 and 40. Folate data was obtained from questionnaires completed at gestational week 17, 22 and 30, including a semi-quantitative food frequency questionnaire in the second trimester (week 22).
Hold the Gas? Inhaled Nitric Oxide of No Benefit to Most Premature Babies
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A new Johns Hopkins Children’s Center study challenges the widespread practice of treating premature babies with nitric oxide gas to prevent lung problems, neurological damage and death. The research, based on analysis of 22 major studies of the effect of nitric oxide in babies born before 34 weeks of age, found no evidence of benefit in most infants.
Overall, the Hopkins review found that babies who received nitric oxide in the neonatal intensive care unit didn’t fare any better than those who didn’t. The babies who received the treatment were no less likely to die, develop chronic lung disease of prematurity, suffer cerebral palsy or have neurological or cognitive impairments, the researchers found.
The findings, to appear in the February issue of the journal Pediatrics, point against the routine use of inhaled nitric oxide in all premature babies and call for careful, case-by-case evaluation of each baby’s degree of brain and lung maturation to determine if nitric oxide would help, hurt or do nothing for a patient, the researchers say.
Study Looks at Suspected Link Between Corn Mycotoxin and Birth Defects
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A Creighton University School of Medicine researcher has been awarded a $2.7 million grant by the National Institutes of Health (NIH) to investigate a possible link between the ingestion of tortillas and corn-based food products contaminated with a fungal toxin and increased risk for birth defects.
The three-year award is a collaborative effort among investigators at Creighton, the U.S. Department of Agriculture-Agricultural Research Service (USDA-ARS) in Athens, Georgia; Duke University Medical Center in Durham, N.C., and Centro de Investigaciones en Nutricion y Salud (CIENSA) in Guatemala.
Janee Gelineau-van Waes, D.V.M., Ph.D., principal investigator and associate professor in Creighton’s Department of Pharmacology, will use the grant to continue her research studying a potential connection between exposure to fumonisin during early pregnancy and an increased risk for having a baby with a neural tube defect (NTD).
Fish oil no help for mom’s mood, baby’s development
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Fish oil capsules are a cheap and easy way to get omega-3 fatty acids, but they don’t help pregnant women steer clear of postpartum depression.
Nor do they boost mental development in their babies, according to researchers from Australia who tested the effect of daily supplements during the second half of pregnancy—a period that spans the growth spurt in the fetus’ brain.
The researchers gave more than 2,000 women either vegetable oil or fish oil containing docosahexaenoic acid (DHA), which earlier studies have hinted—but not proved—might improve pregnancy outcomes.
Diabetes linked to birth defects, but obesity is not
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A study published in the medical journal Obstetrics & Gynecology has cleared obesity as a condition that causes birth defects, but the news was not so good for diabetics.
The 13 year study looked at the pregnancies of 41,902 women whose weight was at or near obesity to determine if extra pounds were indicative of increased incidence of birth defects. The results of the study showed that obesity in and of itself showed “no significant independent association between maternal obesity” and birth defects.
The study went on to conclude that “diabetes was significantly associated with the increase in the rate” of birth defects.
Loss of “Guardian Angel” Gene Prompts Premature Birth
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Mutation of a gene that helps protect the body from genetic instability leads to cellular and molecular changes in the pregnant uterus that trigger premature birth, according to a study appearing online Feb. 1 in the Journal of Clinical Investigation.
The research by scientists in the Division of Reproductive Sciences, part of the Perinatal Institute at Cincinnati Children’s Hospital Medical Center, sheds new light on the still poorly understood genetic and physiological reasons for preterm births. The findings could help lead to the development of new strategies for treating and preventing prematurity, according to Sudhansu K. Dey, Ph.D., director of Reproductive Sciences at Cincinnati Children’s and the study’s senior investigator.
“Preterm birth and prematurity are problems that pose huge long-term social and economic liabilities, and there is an urgent need for research with new approaches to combat this public health concern,” Dr. Dey said.
Worried about baby bust? Study says births may rise
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- Wealthy countries worried about their shrinking birth rates may have had their prayers answered. If they get just a little richer, birth rates should head up again, U.S. researchers reported on Wednesday.
They studied 24 countries over 30 years, looking at fertility rates and a measure of education, income and lifespan called the human development index.
“Although development continues to promote fertility decline at low and medium human development index levels, our analyses show that at advanced human development index levels, further development can reverse the declining trend in fertility,” Hans-Peter Kohler of the University of Pennsylvania and colleagues wrote in the journal Nature.
Breastfeeding could save 1.3 million child lives: WHO
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Teaching new mothers how to breastfeed could save 1.3 million children’s lives every year, but many women get no help and give up trying, the World Health Organization said on Friday.
Less than 40 percent of mothers worldwide breastfeed their infants exclusively in the first six months, as recommended by the WHO. Many abandon it because they don’t know how to get their baby to latch on properly or suffer pain and discomfort.
“When it comes to doing it practically, they don’t have the practical support,” WHO expert Constanza Vallenas told a news briefing in Geneva, where the United Nations agency is based.
Birth size linked to weight gain and inflammation
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The results of a study published in the European Heart Journal indicate there is an association between lower birth weight and greater weight gain from childhood to adulthood and with low-grade inflammation in adulthood.
“Impaired fetal growth and growth during infancy or childhood may trigger inflammatory pathways leading to activated low-grade inflammation in adulthood,” Dr. Paul Elliott, of Imperial College London, UK, and colleagues write. They suggest that this inflammation may be an “intermediate factor” that links impaired fetal growth and cardiovascular disease, a relationship that has been previously found.
Using data from a study in northern Finland that began in 1966, the researchers examined the relationships between fetal growth, weight gain from childhood to adulthood, and low-grade inflammation measured by blood levels of C-reactive protein (CRP), a “biomarker” for inflammation, meaning higher than normal levels suggest inflammation is occurring.
Birth Weight: Set And Match
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Two independent pieces of research published in this week’s Nature (Vol. 417, No. 6892 27 June 2002) could explain why some babies are born small, and could also lend credence to evolutionary theories about the competition between male and female genes.
Babies with low birth weights are more likely to die as newborns and have an increased chance of physical or mental development problems. Low birth weight is also linked to an increased risk of coronary heart disease, type 2 diabetes and respiratory problems later in life.
Nigerian women hurt in childbirth slowly find hope
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Soueiba Salisu endured the pains of childbirth for four days and four nights in a mud-brick house in her remote Nigerian village before her family, fearing for her life, took her to hospital.
When she arrived after hours of travel on unpaved tracks, doctors performed a caesarean section but it was too late. The baby was stillborn, and a few days later 15-year-old Salisu started leaking urine.
Baby born to brain dead American woman dies
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A baby girl born last month to a brain dead Virginia woman died early on Monday following surgery, according to a statement on a family Web site.
“With great sadness, we are asking for your prayers for the repose of the soul of 5-week-old baby Susan Ann Torres. She passed away last night after surgery for a perforated intestine,” the statement said.
