January 20, 2006, 0:44 AM CT

Women's Silent Health Problem

It's a topic that is discussed so infrequently - for reasons that are easy to understand - that it may seem it isn't much of a problem. But new research shows that fecal incontinence is prevalent among U.S. women, particularly those in older age groups, those who have had numerous babies, women whose deliveries were assisted by forceps or vacuum devices, and those who have had a hysterectomy.

A number of women in the study who had fecal incontinence also had another medical condition, such as major depression or diabetes, and often experienced urinary incontinence in addition to FI. The findings are reported in the American Journal of Obstetrics and Gynecology.

"Increased attention should be paid to this debilitating condition, particularly considering the aging of our population and the available therapys for FI," says senior author Dee E. Fenner, M.D., associate professor of obstetrics and gynecology, and director of gynecology, at the University of Michigan Medical School. "It is very important to the health of women that clinicians are aware of the prevalence of FI and can treat their patients accordingly".

The study, led by the University of Washington, was a postal survey of 6,000 women ages 30-90 who were enrolled in a large HMO in Washington state (the condition also affects men, but only women were involved in the study). Of the 64 percent who responded, the prevalence of FI was found to be 7.2 percent, with the occurrence increasing notably with age. FI was defined as loss of liquid or solid stool at least monthly.........

Posted by: Sue      Permalink


January 15, 2006, 2:54 PM CT

Addressing Expecting Moms Concerns

Is there an Emory doctor in the house? You can find one each month in the pages of Pregnancy Magazine. Gynecologist Stephen Weiss, MD has been appointed as the publication's resident physician, and uses his expertise to educate readers in a monthly QandA column in the magazine geared toward expecting moms.

Dr. Weiss's first column helped readers sort through questions about breast-feeding, toddler tantrums, and fatigue. His upcoming columns will address issues such as incontinence, labor stages, and exercise.

"This is an ideal opportunity for both Emory and 'Pregnancy Magazine'," says Dr. Weiss, an assistant professor in the department of obstetrics and gynecology, Emory University School of Medicine. "I'm honored to be able to help answer the unaddressed questions that women have about pregnancy and the transition into motherhood. I may never see most of the women who read my column in my office, but they'll be aware of the commitment and expertise in women's health the Emory team has to offer."

Below are two examples of questions Dr. Weiss answered from the Pregnancy Magazine (January 2006) readers:.

Q: I have been feeling extreme fatigue as a result to giving birth. Sometime it's hard for me to even hold my baby for long periods of time. How can I get my strength back?.........

Posted by: Emily      Permalink


January 12, 2006, 11:17 PM CT

Eating Disorders May Cause Problems In Infants

Certain complications during and immediately after birth are associated with the development of the eating disorders anorexia nervosa and bulimia nervosa, as per a studyin the recent issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.

Eating disorders are believed to be caused by a complex interaction of genetic and environmental factors, according to background information in the article. Observational reports suggest that problems during neurodevelopment in the fetus might lead to anorexia nervosa or bulimia nervosa later in life, and some studies have found a correlation between obstetric complications and anorexia nervosa. "Obstetric complications might have more than one role in the etiopathogenesis of eating disorders; first, they may cause hypoxic-induced damage to the brain that impairs the neurodevelopment of the fetus, and second, the adequacy of nutrition during pregnancy and in the immediate postnatal period seems to influence the nutritional status of the adult and appetite programming throughout life," the authors write.

Angela Favaro, M.D., Ph.D., and his colleagues at the University of Padua, Italy, completed an analysis of 114 females with anorexia nervosa, 73 with bulimia nervosa and a control group of 554 without either condition, all born at Padua Hospital between Jan. 17, 1971, and Dec. 30, 1979. Fifteen of the people with anorexia, 22 with bulimia and all of the control subjects had participated in a prior study of the prevalence of eating disorders in Padua. The authors added in a sample of 99 people with anorexia and 51 with bulimia who had been referred to an outpatient clinic for their conditions. They then merged the samples and analyzed data about obstetric complications obtained from hospital archives.........

Posted by: JoAnn      Permalink


January 10, 2006, 6:05 PM CT

Can you become pregnant after breast cancer treatment?

Scientists at Duke University Medical Center have shown that ovarian hormone levels may predict which women are likely to become infertile after chemotherapy to treat breast cancer.

Their findings may ultimately enable physicians to identify at-risk breast cancer patients who could benefit from fertility-preserving therapys, said Carey Anders, M.D., lead author of the study.

Infertility is a common side effect of cancer therapies such as chemotherapy and radiation, because such therapies can damage rapidly dividing cells such as granulosa cells in the ovaries. No method exists to identify which women are at greatest risk of premature ovarian failure, defined as the loss of menses for more than six months. Often times, the condition is permanent.

In the current study, the scientists showed that women who developed premature ovarian failure had lower levels of the ovarian hormone inhibin A before chemotherapy and six months after chemotherapy had ended. Their levels of inhibin B were also lower six months after chemotherapy.

Conversely, women who resumed menses after therapy had higher levels of inhibin A before receiving chemotherapy and six months afterward. The same effects were seen with another ovarian hormone, estradiol.

Results of the study will be presented Thursday, Dec. 8, 2005, at the annual San Antonio Breast Cancer Symposium.........

Posted by: Emily      Permalink


January 9, 2006, 10:41 PM CT

More children in the United States will be protected

The 2006 Childhood and Adolescent Immunization Schedule was released recently, with the updated schedule including new recommendations that will help protect adolescents from meningitis and pertussis (also known as "whooping cough") and all children from hepatitis A. The annual childhood and adolescent immunization schedule is a joint effort of the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP). The 2006 immunization schedule can be located at CDC's Morbidity and Mortality Weekly Report (MMWR) Recommended Childhood and Adolescent Immunization Schedule --- United States, 2006.

" This new schedule reflects the great strides we are making to protect children against serious diseases," said Anne Schuchat, M.D., director of the National Immunization Program at the Centers for Disease Control and Prevention (CDC). "Thanks to new vaccines, we can now protect children and adolescents from more diseases than at any time in our history. In almost every case, vaccines are the best and most effective way to prevent the harm that is caused by these infectious diseases".

The recently licensed meningococcal conjugate vaccine (MCV4) is being recommended to protect against meningococcal disease, while the new Tetanus, Diphtheria and acellular Pertussis recommendation stems from the availability of new "booster" vaccines known as Tdap that will help reduce the number of cases of whooping cough among adolescents. Under the updated schedule, these vaccines would be routinely administered to children when they are 11 to 12 years old.........

Posted by: JoAnn      Permalink


January 9, 2006, 10:32 PM CT

Estimating Frequency of Birth Defects

Among the 18 major birth defects studied, orofacial clefts (cleft lip and cleft palate) were the most common birth defect in the United States, affecting an estimated 6,800 infants annually, according to the Centers for Disease Control and Prevention (CDC) estimates released in its journal Morbidity and Mortality Weekly Report (MMWR). Major birth defects are conditions that are present at birth and have a serious, adverse impact on health, development or functional ability.

The condition with the second highest prevalence was Down syndrome, which affects about 5,500 infants a year. Among the 18 major birth defects selected for this study, each of 10 different types of birth defects affected more than 1,000 babies per year.

"Birth defects are a leading cause of death in the first year of life," said Jose Cordero, director of CDC's National Center on Birth Defects and Developmental Disabilities. "With more accurate estimates of how often and where birth defects are occurring, we hope to learn more about how we can prevent them. With improved information, we can better plan for and address the health and education needs of children with birth defects".

Eventhough federal, state and local surveillance data suggest that approximately 3 percent of babies born in the United States are affected by a major birth defect of some type, this is the first effort to develop population-based national prevalence estimates for these 18 specific birth defects.........

Posted by: JoAnn      Permalink


January 9, 2006, 10:24 PM CT

Age And Success Of Assisted Reproductive Technology

More than 48,000 babies were born in the United States as a result of assisted reproductive technology (ART) procedures carried out in 2003, the Centers for Disease Control and Prevention (CDC) reported today. This is up from the 45,751 babies born as a result of ART in 2002. ART includes infertility therapy procedures in which both egg and sperm are handled in the laboratory. The most common ART procedure is in vitro fertilization.

CDC's ninth annual ART report summarizes national trends and provides information on success rates for 399 fertility clinics around the country. Overall, 28 percent of ART procedures resulted in the birth of a baby for women who used their own fresh eggs.

The 2003 report offers more evidence that a woman's age is one of the most important factors in determining whether she will have a live birth by using her own eggs. "Women in their 20s and early 30s had relatively high rates of success for pregnancies, live births, and single live births," said Victoria Wright, a public health analyst in CDC's Division of Reproductive Health. "But success rates declined steadily once a woman reached her mid-30s."

Overall, 37 percent of the fresh non-donor procedures started in 2003 among women younger than 35 resulted in live births. This percentage of live births decreased to 30 percent among women aged 35-37, 20 percent among women aged 38-40, 11 percent among women aged 41-42 and 4 percent among women older than 42.........

Posted by: Emily      Permalink


January 7, 2006, 4:03 PM CT

Take Folic Acid To Reduce Birth Defects

January 9-15 is Folic Acid Awareness Week and the March of Dimes is reminding women capable of having a baby to add folic acid to their diet - before starting a family.

If all women of childbearing age took 400 micrograms of folic acid daily - before and during pregnancy -- it could help prevent up to as much as 70 percent of pregnancies affected by neural tube defects, (NTDs), serious birth defects of the brain and spine, according to the U.S. Centers for Disease Control and Prevention.

Julia Flores of Chicago knows the benefits of folic acid. Her first child, 10-year-old Gabriel was born with a brain stem malformation. Her second baby, Nicholas, was born three years later with spina bifida and lived only three hours.

Before her next pregnancy, Mrs. Flores' doctor prescribed 800 micrograms of folic acid daily. Her third baby, Jacob, who will be five in May, was born healthy.

"Thank goodness my doctor knew about folic acid and prescribed it for me. I'm not planing to have any more children, but I still take it in a multivitamin, " said Mrs. Flores. "I tell all the women I know to take folic acid. Just take it. My sister's doctor instructed her to take it because of my history - and her babies are fine".

Since 1995, the March of Dimes and the CDC have recommended that all women of childbearing age take 400 micrograms of folic acid daily, before conception and continuing into the early months of pregnancy. NTDs occur in the first few weeks after conception, often before a woman knows she's pregnant and affects about 3,000 pregnancies annually.........

Posted by: JoAnn      Permalink


January 3, 2006

Black Baby Girls Better At Surviving Premature Birth

Black baby girls born weighing 2.2 pounds or less are more than twice as likely to survive as white baby boys born at the same weight, when a number of preemies are still too tiny to make it on their own, University of Florida scientists have found.

Analyzing data from more than 5,000 premature births, UF scientists pinpointed a link between gender and race and the survival rates of babies born at extremely low weights, according to findings released recently (Jan. 3) in the journal Pediatrics. It's the first scientific evidence of a phenomenon doctors have observed for years, said Dr. Steven B. Morse, a UF assistant professor of pediatrics and the article's lead author.

Baby girls of both races had the strongest advantage when born weighing less than 1,000 grams, about 2 pounds or as much as a quart of milk, Morse said. Girls had nearly twice the odds of surviving as baby boys did, and black infants also had a slight survival advantage over whites, the research shows. Overall, black baby girls were twice as likely to survive compared with white baby boys, 1.8 times more likely to survive than black boys and 1.3 times more likely to live than white baby girls.

"When you're talking about survival, that's very significant," Morse said. "We have known in general that females tend to have better survival rates than males and blacks better than whites. But quantifying that and finding if there was a statistical significance had yet to be done".

Morse and other scientists from the UF Maternal Child Health Education and Research and Data Center also analyzed the infants' developmental ages and weights at birth, combining these data with race and gender to specify the odds of survival for babies born in each demographic.

Nationwide, nearly a half million babies are born prematurely each year, according to the National Center for Health Statistics. Only about 1 percent of all babies born weigh less than 2 pounds, and one of the first questions parents of these infants ask is if their child will live, said Morse, who as a neonatologist works with families every day. Having accurate data can help families and doctors make better decisions at a time when choices can be hard to make, he said.........

JoAnn      Permalink


December 30, 2005

'Coaching' in labor makes little difference

When a woman is giving birth, having a "coach" tell her to push during contractions makes almost no difference in shortening labor, and may actually increase her risk of subsequent problems with her bladder, scientists at UT Southwestern Medical Center have found.

For the most part, it doesn't matter whether the mother is coached or not, the scientists report in the recent issue of the American Journal of Obstetrics and Gynecology. And scientists noted that further study must be done to determine if bladder problems were permanent.

"Oftentimes, it's best for the patient to do what's more comfortable for her," said Dr. Steven Bloom, lead author of the paper and interim chair of obstetrics and gynecology at UT Southwestern.

In the study, UT Southwestern scientists focused on second-stage labor - the time in which the cervix is fully dilated and the baby begins to descend. This report follows an earlier one that found a rise in pelvic-floor problems among coached women.

The new study involved 320 women at Parkland Memorial Hospital who were giving birth for the first time, had uncomplicated pregnancies and did not receive epidural anesthesia. They were randomly assigned, with both groups tended by nurse-midwives. Of the two groups, 163 were coached to push for 10 seconds during a contraction, and 157 told to "do what comes naturally".

For women who were randomly assigned to the coaching group, the second stage of labor was shortened by 13 minutes, from 59 to 46 minutes.

"There were no other findings to show that coaching or not coaching was advantageous or harmful," Dr. Bloom said.

The earlier study, reported in the recent issue of Obstetrics and Gynecology, involved the same group of women. In it, scientists investigated whether coaching causes long-term problems to the mother's pelvic region.........

Emily      Permalink