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December 11, 2008, 5:11 AM CT

Late preterm births present serious risks to newborns

Late preterm births present serious risks to newborns
More than half a million babies are born preterm in the United States each year, and preterm births are on the rise. Late preterm births, or births that occur between 34 and 36 weeks (approximately 4 to 6 weeks before the mother's due date), account for more than 70% of preterm births. Despite the large number of affected babies, a number of people are unaware of the serious health problems correlation to late preterm births. A new study and an accompanying editorial soon would be published in The Journal of Pediatrics investigate the serious neurological problems linked to late preterm births.

Dr. Joann Petrini of the March of Dimes and his colleagues from institutions throughout the United States studied more than 140,000 babies born between 2000 and 2004, ranging from preterm (30-37 weeks) to full term (37-41 weeks). The scientists reviewed the babies' neurological development and observed that late preterm babies were more than three times as likely to be diagnosed with cerebral palsy as full term babies. They also observed that late preterm babies were at an increased risk for developmental delay or mental retardation.

Editorialist Dr. Michael Kramer of McGill University points out that the "rates of preterm births are increasing, particularly in the United States, and the associated risks are a serious public health concern." He sees the increasing number of twins and induced labors as contributing factors in the rise of preterm births. "The rise in twins may be due to the use of fertility therapys like hormones and in-vitro fertilization," Dr. Kramer explains. However, he notes that the increased risks may not always come from early delivery itself, but from other underlying problems, such as gestational diabetes, that may lead to early delivery.........

Posted by: Emily      Read more         Source


December 6, 2008, 4:00 PM CT

Secondhand smoke raises odds of fertility problems

Secondhand smoke raises odds of fertility problems
If you need another reason to quit smoking, consider that it may diminish your chances of being a parent or grandparent. Researchers at the University of Rochester Medical Center have observed that women exposed to second hand smoke, either as adults or children, were significantly more likely to face fertility problems and suffer miscarriages.

An epidemiologic analysis of more than 4,800 non-smoking women showed those who were exposed to second hand smoke six or more hours per day as children and adults faced a 68 percent greater chance of having difficulty getting pregnant and suffering one or more miscarriages. The study is published online in Tobacco Control and is one of the first publications to demonstrate the lasting effects of second hand smoke exposure on women during childbearing years.

"These statistics are breathtaking and certainly points to yet another danger of second hand smoke exposure," said Luke J. Peppone, Ph.D., research assistant professor at Rochester's James P. Wilmot Cancer Center.

In the study, four out of five women reported exposure to second hand smoke during their lifetime. Half of the women grew up in a home with smoking parents and nearly two-thirds of them were exposed to some second hand smoking at the time of the survey.........

Posted by: Emily      Read more         Source


December 4, 2008, 5:21 AM CT

Cutting the cord to determine babies' health risk

Cutting the cord to determine babies' health risk
Despite the well-known dangers of first- and secondhand smoke, an estimated ten percent of pregnant women in the U.S. are smokers. Exposure of a developing baby to harmful cigarette byproducts from mothers who smoke affects an estimated 420,000 newborns each year and poses a significant health care burden.

Now, in the first study of its kind, a team of scientists has completed a global assessment of newborns' umbilical cord blood to better understand the fetal health risks from smoking mothers. The research was led by Johns Hopkins University and included Rolf Halden, a researcher from the Biodesign Institute at Arizona State University.

"Cigarette smoking is a massive onslaught on human physiology," said Halden, who works in the institute's Center for Environmental Biotechnology. Cigarette smoke is known to contain more than 4,000 chemicals, potentially affecting the health of a newborn baby on multiple levels, including low birth weight, premature delivery and small size for gestational age. The exact cause of these health effects continues to be the subject of investigation.

"Unfortunately, maternal cigarette smoking puts babies at risk of adverse birth outcomes and increases susceptibility to other diseases during the later part of life," said Halden.........

Posted by: Emily      Read more         Source


December 4, 2008, 5:20 AM CT

Concerns about embryo disposition

Concerns about embryo disposition
Fertility patients who are done having children feel responsible for the stored, frozen embryos left over from their therapy, yet more than half are against implanting the embryos in anyone else, as per a new study by scientists at Duke University Medical Center.

"This really turns our moral presumptions on their heads," says Anne Drapkin Lyerly, MD, an obstetrician/gynecologist and bioethicist at Duke, and lead investigator of the findings that appear online in Fertility & Sterility

"Parents care very much about what happens to their embryos, but that doesn't mean they want them to become children. Our study shows that a number of feel they have to do what they can to prevent their embryo from becoming a child".

The survey of more than 1,000 fertility patients is the largest and only multi-site study to shed important light on the state of the nation's 500,000 frozen embryos currently in storage. It reveals previously unexplored concerns that patients have about their embryos, and it comes at a time when several states and even the federal government are attempting to enact legislation that would either assert an embryo is a person, allow abandoned embryos to be adopted by another couple, or allow unused embryos to become "wards of the state."........

Posted by: Emily      Read more         Source


December 1, 2008, 6:06 PM CT

Maternal exposure to folic acid antagonists

Maternal exposure to folic acid antagonists
Exposure to folic acid antagonists during pregnancy is linked to a higher risk of placenta-mediated adverse outcomes such as preeclampsia, placental abruption, fetal growth restriction or fetal death reports a retrospective cohort study published in CMAJ http://www.cmaj.ca/press/pg1263.pdf.

Folic acid antagonists include a broad range of drugs used to treat epilepsy, mood disorders, high blood pressure and infections. As approximately 50% of pregnancies in industrialized countries like Canada are unplanned, there is a risk of unintended exposure to these medications.

The study, conducted by scientists from Ottawa, Montreal, Saskatoon and Hunan, China looked at 14 982 women who had taken folic acid antagonists one year previous to delivery and 59 825 women who did not. Dr. Shi Wu Wen and co- scientists observed that maternal exposure to folic acid antagonists was linked to a slightly higher risk of adverse pregnancy outcomes. They suggest re-classifying some folic acid antagonists and recommend increased folic acid supplements for women requiring folic acid antagonists during pregnancy.

In a related commentary http://www.cmaj.ca/press/pg1243.pdf, Dr. Joel Ray suggests the research study presents some "thought-provoking findings, but the results may not be ready for adoption by clinical practitioners or drug policy makers." He cites some real concerns with the study design and the need for clinically relevant finding as cautions about translating findings into practice.........

Posted by: Emily      Read more         Source


October 31, 2008, 5:12 AM CT

Gaining too much weight during pregnancy

Gaining too much weight during pregnancy
A study by the Kaiser Permanente Center for Health Research of more than 40,000 women and their babies observed that women who gained more than 40 pounds during their pregnancies were nearly twice as likely to have a heavy baby. Reported in the recent issue of Obstetrics & Gynecology, the study observed that more than one in five women gains excessive weight during pregnancy, doubling her chances of having a baby that weighs 9 pounds or more.

"Too a number of women gain too much weight during pregnancy. This extra weight puts them at higher risk for having heavy babies, and these babies are programmed to become overweight or obese during the later part of life," said study lead author Teresa Hillier, MD, MS, an endocrinologist and senior investigator at the Kaiser Permanente Center for Health Research in Oregon and Hawaii. "A big baby also poses serious risks for both mom and baby at birth--for mothers, vaginal tearing, bleeding, and often C-sections, and for the babies, stuck shoulders and broken collar bones. ".

While scientists have known for some time about the link between diabetes during pregnancy and heavier birth weights, and recently have learned how maternal weight gain affects the birth weight, this is the first study to determine that women who gain excessive weight are even more likely to have heavy babies than women who are treated for gestational diabetes.........

Posted by: Emily      Read more         Source


October 8, 2008, 9:37 PM CT

Guidelines urge physical activity during pregnancy

Guidelines urge physical activity during pregnancy
Moderate physical activity during pregnancy does not contribute to low birth weight, premature birth or miscarriage and may actually reduce the risk of complications, as per a Michigan State University professor who contributed to the U.S. government's first-ever guidelines on physical activity.

Kinesiology professor James Pivarnik and doctoral students Lanay Mudd and Erin Kuffel wrote the section on pregnancy and postpartum activity as part of the 2008 Physical Activity Guidelines unveiled Oct. 7 in Washington, D.C., by the Department of Health and Human Services. Pivarnik, president-elect of the American College of Sports Medicine, attended the event and spoke on behalf of the organization and MSU.

"There has been quite a dramatic change in regards to pregnancy and exercise," said Pivarnik, who has studied the topic for more than 20 years. "While it used to be thought that avoiding exercise meant avoiding harm to the fetus, research now shows physical activity can not only improve health of the mother but also provide potential long-term benefits for the child".

Specifically, the guidelines call for women to get at least 150 minutes of moderate-intensity aerobic activity per week during pregnancy and the postpartum period, preferably spread throughout the week. In addition to health benefits, moderate physical activity also may reduce the length of labor, evidence suggests. The guidelines call for women to avoid doing activities that involve lying on their back after the first trimester and activities with high risk of falling or abdominal trauma.........

Posted by: Emily      Read more         Source


September 25, 2008, 11:06 PM CT

Continuous glucose monitoring in diabetic pregnant women

Continuous glucose monitoring in diabetic pregnant women
Continuous glucose monitoring as part of antenatal care for women with diabetes improves maternal blood glucose control and lowers birth weight and risk of macrosomia* (excessive birth weight in babies), as per a research studypublished on bmj.com today.

During pregnancy it is important that women with diabetes keep their blood glucose under control. If not, there may be an increase in the amount of glucose reaching the baby, which makes the baby grow faster than normal, and may cause difficulties at birth as well as an increased longer term risk of insulin resistance, obesity and type 2 diabetes.

Evidence suggests that measuring glucose more often improves outcomes, but the optimum frequency of blood glucose testing is not known.

Dr Helen Murphy and his colleagues examined whether continuous glucose monitoring during pregnancy can improve maternal glucose control and reduce birth weight and risk of macrosomia in babies of mothers with diabetes.

They recruited 71 pregnant women with type 1 and type 2 diabetes from antenatal clinics in the UK.

The women were randomly assigned to standard antenatal care (intermittent self monitoring of glucose levels using the finger prick technique) or intermittent monitoring plus continuous glucose monitoring (using glucose values from subcutaneous tissues measured electronically every 10 seconds, giving up to 288 measurements a day).........

Posted by: Emily      Read more         Source


September 25, 2008, 11:04 PM CT

English health care system failing to encourage breastfeeding

English health care system failing to encourage breastfeeding
The English healthcare system is failing to encourage breast feeding and a national strategy to promote breast feeding is urgently needed, say experts on bmj.com today.

In the UK, the women most likely to use formula milk are young, white and from low socioeconomic backgrounds, and this has created a major public health and inequalities challenge, write Professor Mary Renfrew from the University of York and Professor David Hall from the University of Sheffield.

It is well known that breast feeding improves infant health, and it has been shown to be the single most important preventive approach to saving children's lives.

In spite of national and international policy initiatives, 40% of women in the UK who start to breast feed discontinue by the time their baby is 6 weeks old, and only 20% of infants are exclusively breast fed at six weeks.

Yet evidence has shown that the main reasons cited for discontinuing breastfeeding could be easily remedied. For example, problems getting the baby to feed, or women reporting that breast feeding is painful.

In addition, recent data show that health professionals, particularly doctors, are not adequately trained in giving advice on breast feeding, and often do not know how to position the baby so that feeding is effective and pain free.........

Posted by: Emily      Read more         Source


September 17, 2008, 5:15 PM CT

Physical Therapy Treatment Resolves Symptoms Of Urinary Incontinence In Women

Physical Therapy Treatment Resolves Symptoms Of Urinary Incontinence In Women
In response to a new study reported in the Journal of the American Medical Association showing that pelvic floor disorders, such as urinary incontinence, affect up to one-quarter of American women, the American Physical Therapy Association (APTA) is urging women who suffer from this widespread disorder to consider therapy from a physical therapist.

Recent research has demonstrated physical treatment's effectiveness at treating the symptoms of urinary incontinence. A study reported in the Annals of Internal Medicine (March 18, 2008) reports that pelvic floor muscle training, in conjunction with bladder training, resolved the symptoms of urinary incontinence in women. As per APTA, proper preventive measures and therapy by a physical therapist can help patients manage, if not alleviate, this often debilitating condition.

The study, which included 96 randomized controlled trials and 3 systematic reviews from 1990 through 2007, concluded that pelvic floor muscles training and bladder training resolved urinary incontinence in women, as in comparison to drug treatment, electrostimulation, medical devices, injectable bulking agents, and local estrogen treatment.

"The Annals of Internal Medicine study is significant for a number of reasons, none more so than because it provides the highest levels of evidence to support the importance of intervention by a physical therapist who specializes in treating urinary incontinence," says Cynthia E Neville, PT, BCIA-PMDB, director of Women's Health Rehabilitation at the Rehabilitation Institute of Chicago.........

Posted by: Emily      Read more         Source



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Did you know?
The addition of testosterone to hormone therapy in women after menopause enhances their sexual function. However, it may also reduce HDL cholesterol (the "good" cholesterol) in women, according to a systematic review of current evidence."If the reduction in HDL had been associated with an increase in triglycerides [fatty acids] or LDL cholesterol it would be of great concern," said Dr. Susan Davis, professor of medicine at Monash University, Melbourne, Australia, and study co-author "However, as an isolated finding the significance is difficult to interpret." She added, "Testosterone has not been found to alter other coronary heart disease risk factors.".

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