Pregnancy
Infections linked to premature births more common than thought, Stanford study finds
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Previously unrecognized and unidentified infections of amniotic fluid may be a significant cause of premature birth, according to researchers at the Stanford University School of Medicine.
An analysis of amniotic fluid from women in preterm labor indicated that 15 percent of the fluid samples harbored bacteria or fungi - an increase of 50 percent over previous estimates. The heavier the burden of infection, the more likely the women were to deliver younger, sicker infants.
“If we could prevent these infections in the first place, or detect them sooner, we might one day be able to prevent some of these premature births,” said research associate Dan DiGiulio, MD, who conducted the study in the laboratory of senior author David Relman, MD. About 12 percent of all births in this country are premature and the frequency of premature birth is increasing.
Mechanism for postpartum depression found in mice
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Researchers have pinpointed a mechanism in the brains of mice that could explain why some human mothers become depressed following childbirth. The discovery could lead to improved treatment for postpartum depression. Supported in part by the National Institute of Mental Health, of the National Institutes of Health, the study used genetically engineered mice lacking a protein critical for adapting to the sex hormone fluctuations of pregnancy and the postpartum period.
“For the first time, we may have a highly useful model of postpartum depression,” said NIMH Director Thomas R. Insel, M.D. “The new research also points to a specific potential new target in the brain for medications to treat this disorder that affects 15 percent of women after they give birth.”
“After giving birth, female mice deficient in the suspect protein showed depression-like behaviors and neglected their newborn pups,” explained Istvan Mody, Ph.D., of the University of California at Los Angeles, who led the research. “Giving a drug that restored the protein’s function improved maternal behavior and reduced pup mortality.”
Pregnancy Alone Is Not Associated with Increased Risk for Mental Disorders
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Pregnancy alone does not appear to be associated with an increased risk of the most prevalent mental disorders, according to a report in the July issue of Archives of General Psychiatry, one of the JAMA/Archives journals. However, post-partum women may have a higher risk of major depressive disorder.
Pregnant women and those who have recently given birth are said to be exceedingly vulnerable to psychiatric disorders, according to background information in the article. Psychiatric disorders in these groups of women have been linked to poor maternal health, inadequate prenatal care and adverse outcomes for their children including abnormal growth and development, poor behavior during childhood and adolescence and negative nutritional and health effects. “For these reasons, accurate information about the mental health status of women during pregnancy and the post-partum period is urgently needed.”
Oriana Vesga-López, M.D., of New York State Psychiatric Institute, New York, and colleagues analyzed data from interviews of 43,093 individuals who participated in a survey on alcohol, disorders and related conditions. Of these, 14,549 were women (age 18 to 50) who had been pregnant within the past year. Participants reported psychiatric disorders, substance use and whether they had sought treatment.
Mother’s vitamin D status during pregnancy will affect her baby’s dental health
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Low maternal vitamin D levels during pregnancy may affect primary tooth calcification, leading to enamel defects, which are a risk factor for early-childhood tooth decay. Today, during the 86th General Session of the International Association for Dental Research, investigators from the University of Manitoba (Winnipeg and Victoria) present the results of a study they conducted to determine the vitamin D status of pregnant women, the incidence of enamel defects and early-childhood tooth decay among their infants, and the relationship with pre-natal vitamin D levels.
Two hundred six pregnant women in their second trimester participated in the study. Only 21 women (10.5%) were found to have adequate vitamin D levels. Vitamin D concentrations were related to the frequency of milk consumption and pre-natal vitamin use. The investigators examined 135 infants (55.6% male) at 16.1 ± 7.4 months of age, and found that 21.6% of them had enamel defects, while 33.6% had early-childhood tooth decay. Mothers of children with enamel defects had lower, but not significantly different, mean vitamin D concentrations during pregnancy than those of children without defects.
However, mothers of children with early-childhood tooth decay had significantly lower vitamin D levels than those whose children were cavity-free. Infants with enamel defects were significantly more likely to have early-childhood tooth decay.
Pregnancy may help protect against bladder cancer
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Pregnancy seems to confer some protection against bladder cancer in mice, scientists have found.
Female mice that had never become pregnant had approximately 15 times as much cancer in their bladders as their counterparts that had become pregnant, according to new findings by investigators at the University of Rochester Medical Center. Their work appears online as a rapid communication in the journal Urology.
The researchers led by Jay Reeder, Ph.D., are focusing on a fact that has puzzled doctors and scientists for decades: Why does bladder cancer, the fifth most common malignancy in the nation, affect about three times as many men as women? Scientists long blamed men’s historically higher rates of smoking and greater exposure to dangers in the workplace, but the gap has persisted even as women swelled the workforce and took up smoking in greater numbers.
Treatment for cigarette, alcohol and drug use in pregnancy improves outcomes for mom and baby
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Pregnant women who receive treatment for substance abuse early in their pregnancy can achieve the same health outcomes as pregnant women with no substance abuse, according to a Kaiser Permanente study published online in the Journal of Perinatology.
The study, which is the largest to date, examined 49,985 women in Kaiser Permanente’s prenatal care program and found that integrating substance abuse screening and treatment into routine prenatal care helped pregnant women achieve similar health outcomes as women who were not using cigarettes, alcohol or other drugs. This is also the largest study to examine multiple substances: cigarettes, alcohol, marijuana, methamphetamines, cocaine and heroin.
“This program can happen everywhere and should become the gold standard for women who are pregnant and using cigarettes, alcohol or other drugs,” said study lead author Nancy C. Goler, M.D., an OB/GYN and Kaiser Permanente regional medical director of the Early Start Program for the organization’s Northern California operations. “The study’s big finding was that study participants treated in the Early Start program had outcomes similar to our control group, women who had no evidence of substance abuse.”
Pregnancy pounds may affect kids’ weight
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Women who gain too much weight during pregnancy might raise their child’s future risk of becoming overweight, a new study suggests.
Looking at data from more than 10,000 mother-child pairs, researchers at the University of Pennsylvania found that children whose mothers gained more than the recommended amount of weight during pregnancy were 48 percent more likely than other children to be overweight at age 7.
In the U.S., the Institute of Medicine (IOM) recommends that normal-weight women gain 25 to 35 pounds during pregnancy. Women who were overweight before becoming pregnant are encouraged to gain a little less—15 to 25 pounds—while underweight women should put on 28 to 40 pounds.
Mediterranean diet in pregnancy may curb allergies
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Women who eat a Mediterranean diet while pregnant could help stave off asthma and allergies in their children, a new study suggests.
The traditional Mediterranean diet is rich in plant-based foods—vegetables, fruits, whole grain breads and cereals, legumes, and nuts—as well as olive oil and fish. Adherents consume low to moderate amounts of dairy products and eggs, lesser amounts of white meat, and infrequently eat red meat.
Some studies have suggested that such eating patterns can lower children’s odds of asthma symptoms and skin and nasal allergies. But it’s unclear whether women can affect their children’s future allergy risks by following a Mediterranean diet during pregnancy.
Teen “pregnancy pact” shocks Massachusetts city
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A Massachusetts city is investigating an apparent teenage “pregnancy pact” that has at least 17 high-school girls expecting babies, four times more than last year, including many aged 16 or younger.
A high school health clinic in the city of Gloucester became suspicious after seeing a surge in girls seeking pregnancy tests. Local officials said on Thursday nearly half of those who became pregnant appear to have entered into a pact to have their babies together over the year.
“Some girls seemed more upset when they weren’t pregnant than when they were,” Gloucester High School principal Joseph Sullivan told Time magazine, which broke news of the pact on its Web site.
Better drugs needed for pregnant women in tropics
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More studies are urgently needed to find new and improved drugs to treat tropical diseases in pregnant women, scientists in Thailand said.
In an article published in PLoS Medicine, they said that while governments in developed countries had begun encouraging pharmaceutical companies to find new drugs for pregnant women, this was visibly absent in the tropics.
“There are few or no studies in pregnancy on most drugs used for the treatment of tropical infections, and so, few or no evidence-based recommendations,” Nicholas White and his colleagues at Mahidol University’s Mahidol-Oxford Tropical Medicine Research Unit wrote.
Severe Insulin Resistance may Increase Rate of Pregnancy and Birth Complications
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Testing pregnant women for insulin resistance with a simple blood test may be a new tool for predicting problems during pregnancy, according to a new study. The results will be presented at The Endocrine Society’s 90th Annual Meeting in San Francisco.
Insulin resistance is a condition in which the body blocks the effects of the hormone insulin. As a result, glucose, or sugar, builds up in the blood, and diabetes can develop. Insulin resistance lies behind the development of gestational diabetes - diabetes that develops during pregnancy - which increases the risk of pregnancy and birth complications. Therefore, the authors aimed to find out whether insulin resistance is linked to poor outcomes in pregnant women and newborns, said the lead author, Weerapan Khovidhunkit, MD, PhD, of Chulalongkorn University, Bangkok, Thailand.
It is standard for pregnant women to get a blood test for gestational diabetes between the 24th and 28th weeks of pregnancy, according to The Hormone Foundation, the public education affiliate of The Endocrine Society. This test is called the glucose challenge test or glucose challenge screening. If this test result is positive, the woman then has an oral glucose tolerance test (OGTT), in which her blood sugar levels are tested 3 hours after she drinks a glucose drink.
Birth defect risk doubles in pre-term babies
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Premature babies born in the United States are more than twice as likely to have a major birth defect as full-term infants, with the risk even higher among very pre-term babies, researchers said on Wednesday.
The researchers tracked nearly 7 million babies born between 1995 and 2000 in 13 states, accounting for about 30 percent of U.S. births, to better understand the relationship between birth defects and pre-term birth.
Most pregnancies last roughly 40 weeks. Babies born before 37 weeks of pregnancy are considered premature, and they are at risk for a range of health problems including birth defects.
Boyfriend’s gang membership boosts pregnancy risk
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Teen girls whose boyfriends are in a gang are nearly twice as likely to get pregnant as their peers whose boyfriends aren’t gang-involved, a new study from San Francisco demonstrates.
“The significant role of partner’s gang membership in increasing pregnancy risk highlights the importance of addressing the reproductive health needs of gang-involved youth,” Dr. Alexandra Minnis, of RTI International in San Francisco, and her colleagues report.
The rate of teen pregnancy among Latinas is significantly higher than it is among African Americans and whites, and while the birth rate for U.S. adolescents overall fell between 1994 and 2004, the decline was smallest among Latinas, Minnis and her team point out in the May 1 issue of the American Journal of Epidemiology.
28 million women at risk of unwanted pregnancy
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Each year, half of American women who would rather not get pregnant will have an unplanned pregnancy, often because they failed to use their contraceptive properly or forgot to use it at all, U.S. researchers said on Tuesday.
As a result, 28 million women in the United States are at risk for an unintended pregnancy, according to the study conducted by the Guttmacher Institute in New York.
They found one in four women is very likely to become pregnant because of inconsistent contraception use.
Mothers and Offspring Can Share Cells Throughout Life
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Cutting the umbilical cord doesn’t necessarily sever the physical link between mother and child. Many cells pass back and forth between the mother and fetus during pregnancy and can be detected in the tissues and organs of both even decades later. This mixing of cells from two genetically distinct individuals is called microchimerism. The phenomenon is the focus of an increasing number of scientists who wonder what role these cells play in the body.
A potentially significant one, it turns out. Research implicates that maternal and fetal microchimerism plays both adverse and beneficial roles in some autoimmune diseases as well as the prevention of at least one cancer. This double-edged sword in turn has opened new avenues of study of the body’s immune system and the possibility of developing new tests and therapies.
Two of the world’s leading researchers in microchimerism are J. Lee Nelson, M.D., of Fred Hutchinson Cancer Research Center’s Clinical Research Division; and V.K. Gadi, M.D., Ph.D., assistant professor of medicine at the University of Washington. Nelson also is a professor of medicine at the University of Washington. Gadi is also a research associate in the Hutchinson Center’s Clinical Research Division.
