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August 1, 2007, 8:45 PM CT

New pregnancy labeling rules

New pregnancy labeling rules
Thalidomide tragedy still fresh in our minds
September 12, 2007 marks the tenth anniversary of a public hearing that was hoped to spark substantial changes in the way drugs are labeled for use during pregnancy. However, 10 years after the FDA recognized that the rules needed to be revamped, they have not yet been modified, resulting in anxiety on the part of physicians and patients and the unnecessary termination of wanted pregnancies. A position paper published online in Birth Defects Research Part A, the official journal of The Teratology Society, reviews the history and rationale behind the effort to change pregnancy labeling and calls for the immediate approval of new rules that have been proposed by the FDA. The journal is available online via Wiley InterScience at

Written by the Public Affairs Committee of the Teratology Society, the paper notes that the possibility that medicine taken during pregnancy could cause congenital abnormalities became more widely understood in 1961, when birth defects caused by thalidomide started to be recognized. An increase in animal testing and reports of varying quality on birth defects in humans in the 1970s only served to confuse clinicians. The FDA introduced pregnancy labeling categories in 1979 that were meant to make it easier for doctors to determine the safety of prescribing drugs, but Teratology Society members found the categories lacked information about the nature, severity, timing, and treatability of potential fetal damage and overall found them to be unhelpful, as per the paper.........

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July 26, 2007, 9:42 PM CT

Weight and pregnancy

Weight and pregnancy
Gaining or losing weight in between pregnancies can have major health implications for an unborn baby, warn two senior obstetricians in todays BMJ.

While weight and obesity have long concerned women in relation to body image and lifestyle issues, few are aware of the possible risks that fluctuating weight could have on their unborn child, write Dr Jennifer Walsh and Professor Deirdre Murphy.

They point to two studies. The first, from Sweden, which observed that weight gain between pregnancies was strongly linked to major complications for the woman and baby in the months preceding, during and just after childbirth. This was independent of whether a woman was, by definition, overweight.

The scientists studied 207,534 women from the beginning of their first pregnancy to the beginning of their second. They found increased rates of pre-eclampsia, diabetes in the expectant mother, pregnancy induced hypertension and high birth weight if a womans body mass index (BMI) increased by just one to two units. A rise of more than three BMI units significantly increased the rate of stillbirths.

The key message, say the authors, is that women of normal weight should avoid gaining weight between pregnancies, while overweight and obese women are likely to benefit from weight loss before becoming pregnant.........

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July 23, 2007, 4:50 PM CT

Unintended Pregnancy Predicts Feelings That Parenting Is A Burden

Unintended Pregnancy Predicts Feelings That Parenting Is A Burden
The relationship between a mother and her infant is believed by a number of to be the foundation of healthy childhood development, but scientists at the University of Missouri-Columbia have found pregnancy acceptance to be the first step in forming the mother/child bond.

Analyzing data collected from the national evaluation of the Early Head Start program, Jean Ispa, professor and co-chair of the Department of Human Development and Family Studies in the College of Human Environmental Science (HES), and her colleagues, found associations between how accepting mothers were of being pregnant and their toddlers' security of attachment. In the study, 173 young, low-income black mothers, who either were pregnant or had delivered within the past 11 months, were questioned regarding their feelings about pregnancy. When children were about a year old, their attachment security to their mothers was assessed.

"The relation between mothers' pregnancy acceptance and toddler attachment security is noteworthy because if attachment problems continue into the later years, the child could have self-esteem problems, difficulty learning and a harder time forming relationships," Ispa said.

The scientists also observed that mothers who were not accepting of their pregnancies had a greater tendency to later feel that parenting is burdensome. These findings suggest a need for policies that support reproductive education, as per Ispa. In addition, pregnant women who struggle to accept motherhood may benefit from policies that encourage social service professionals to screen for low acceptance of pregnancy and provide extra support to women who are not happy to be pregnant.........

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July 17, 2007, 10:24 PM CT

Hereditary Link To Premenstrual Depression

Hereditary Link To Premenstrual Depression
A specific genetic variation may be tied to an increased.

risk for severe premenstrual depression, researchers at the University of North Carolina at Chapel Hill and the National Institute of Mental Health have found.

Known medically as premenstrual dysphoric disorder, or PMDD, this.

psychiatric condition affects roughly 8 percent of women in their.

childbearing years. It's characterized by bouts of major depression and/or anxiety and severe irritability during the second half of the menstrual cycle. Symptoms subside with the onset of each menstrual period.

While PMDD has been believed to be associated with hormonal changes over the.

course of the menstrual cycle, until now an explanation for the susceptibility to hormone-related mood changes has been elusive. "Our initial hope in the study was that by looking at steroid-related genes like those for receptors for steroid hormones such as estrogen, we would be able to find gene differences that might explain why some women have these mood disorders and others don't," said Dr. David R. Rubinow, the study's senior author and the Meymandi distinguished professor and chair of psychiatry at UNC School of Medicine. "This study may begin to provide important clues to the nature of that susceptibility".........

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July 2, 2007, 9:23 AM CT

IVF embryos are more likely to develop into twins

IVF embryos are more likely to develop into twins
Lyon, France: Evidence gathered from time-lapse recordings of the formation of early embryos (blastocysts) in the laboratory has revealed why embryos created via IVF and undergoing extended culture are more likely to develop into twins than those created via natural conception. Furthermore, the research has shown that the culture in which the IVF embryos are formed is possibly responsible for the embryos dividing into twins.

Dianna Payne, a visiting research fellow at the Mio Fertility Clinic, Yonago, Japan, told the 23rd annual meeting of the European Society of Human Reproduction and Embryology today (Monday 2 July) that about three pairs of twins per thousand deliveries occurred as a result of natural conception, but a number of more were born after IVF, even when only one embryo had been transferred to the mother (approximately 21 pairs per thousand deliveries). However, it was not known why this happened.

Using 33 surplus frozen-thawed embryos that had been donated for research, Ms Payne and her colleagues used computer software called MetaMorph [1], which creates a free-running film from single images taken every two minutes with a digital camera attached to a microscope. They then used the software to analyse data from the film.

After thawing, 26 of the 33 embryos (most of which were composed of between two and ten cells) developed to blastocyst stage in which the blastocoele is formed. This is a fluid-filled cavity in the blastocyst and is formed on about day four or five when the embryo forms tight junctions between the cells around its periphery. These outer cells (the trophectoderm) begin to pump fluid into the blastocoelic cavity where a micro-environment is formed in which the cells that will go on to develop into the body of the embryo (the inner cell mass or ICM) develop.........

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June 25, 2007, 8:17 PM CT

Traffic may influence Birth Weight

Traffic may influence Birth Weight
Together with colleagues from the French Institute for Health and Medical Research INSERM scientists at the GSF - National Research Center for Environment and Health in Neuherberg near Munich showed that exposure of pregnant women to fine particulate matter from traffic may reduce their children's birth weight. After the scientists had investigated the effects of the exposure of adults and children to particulate matter in the past, they are now first focussing on the risks to unborn life in this recent study. This is the continuation of the GSF's successful cooperation with the internationally renowned French research institution, with the common objective of tracing the causes of environment-related health disorders.

For the study which has now been published online, data from the cohort study LISA were used, in which the influence of living conditions and behaviours on the development of the immune system and allergies is studied. 1016 mothers and their children born in Munich between 1998 and 1999 were studied. All women included in the study had not moved out during the pregnancy. On the basis of a measuring campaign at 40 locations in the city of Munich, the concentrations of traffic-related atmospheric pollutants during pregnancy, including fine particulate matter (those with a diameter of less than 2.5 micrometers, PM2,5), could be modelled at the home address of the pregnant women. The model took into account the distance of each home from streets, the population density near the home as well as the fluctuations in the concentration of the air pollutants over time during the pregnancies.........

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June 15, 2007, 12:56 AM CT

When to turn breech babies

When to turn breech babies
An international study led by a McMaster researcher aims to determine if a manual procedure to turn breech babies in the uterus can result in fewer births by caesarean section.

The clinical trial, led by Eileen Hutton, assistant dean of midwifery at McMaster, is examining whether attempting to turn breech babies earlier in a pregnancy than the current practice will mean a higher success rate for the procedure, and ultimately fewer C-sections.

The number of births by caesarean section has been climbing in Ontario for the past five years. One of the reasons for the need for a C-section is fetuses that are in a breech presentation with their feet, instead of their heads, towards the pelvis. A fetus is in breech position in about one in every 25 to 30 full-term births. Eventhough breech babies can be delivered by vaginal birth, most care providers recommend caesarean births.

A procedure called external cephalic version (ECV), in which a doctor or midwife uses their hands to manipulate the mothers abdomen and help the baby turn in a somersault-like motion, is recommended for women whose babies are in breech position at 37 weeks gestation. The procedure is successful in turning the baby in about 30 per cent of first-time moms, and 58 per cent of subsequent pregnancies.........

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June 15, 2007, 11:23 AM CT

Breast Feeding Protects From Rheumatoid Arthritis

Breast Feeding Protects From Rheumatoid Arthritis
Breast feeding for a period of thirteen months or more has been shown to reduce the mothers the risk of developing rheumatoid arthritis (RA), as per new data presented today at EULAR 2007, the Annual European Congress of Rheumatology in Barcelona, Spain. In the study, the longer the breast feeding period, the lower the mothers risk of developing RA in later life. Comparable use of oral contraceptives (OCs) or hormone replacement treatment (HRT) did not show a significant effect on the risk of developing RA.

Lead researcher Dr Mitra Keshavarz, of Malm Hospital University, Sweden, said of the study, Whilst other studies suggest that hormonal factors play a part in the development of RA, and we know that pregnancy can result in an improvement in RA symptoms, we wanted to investigate the long term effect of breast-feeding. This study specifically highlights the potential of naturally-induced hormones in protecting individuals from developing RA in the future. Furthermore, it adds to the growing body of evidence in favour of breast feeding and its positive health implications this time demonstrating its protective benefits for the mother.

The study observed that breast feeding for 13 or more months was linked to a reduced risk of developing RA (odds ratio 0.46; confidence interval 95% 0.24-0.91). For women with between 1 and 12 months history of breast feeding, the odds ratio was 0.74, with a 95% confidence interval (0.45-1.20) compared directly to those who had never breast fed.........

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June 6, 2007, 9:15 PM CT

Better Ways To Preserve Human Eggs And Ovarian Tissue

Better Ways To Preserve Human Eggs And Ovarian Tissue
Three human eggs, donated to research because they were inadequate for fertilization, that have been vitrified then warmed.

Credit: Medical College of Georgia
The goal is to make human eggs, ovarian tissue, blood vessels, even whole organs available when needed.

To get there, scientists are directly comparing slow-freezing techniques, used successfully for decades to preserve sperm and embryos, to a more rapid method of cryopreservation that transforms tissues into durable glass-like structures.

Phase I trials under way at the Medical College of Georgia are comparing the two approaches in human ovarian tissue and eggs, or oocytes, as well as human-like cow ovarian tissue and eggs.

They start with reproductive tissues because young women with cancer produce a compelling need and are a good model for other tissues and organs.

What we tell patients is that right now the standard of care for people who are going through cancer treatment is to use egg donors later on, says Dr. Adelina M. Emmi, reproductive endocrinologist and medical director of MCG Reproductive Laboratories of Augusta.

Treatment for leukemia and cervical, ovarian, breast or other cancers often leaves women infertile because systemic chemotherapy and more focused radiation treatment, designed to kill rapidly spreading cancer cells, also can destroy dynamic reproductive tissue.

I dont think when you are faced with the reality that you may die, your fertility is the most important thing you are thinking or talking about, but there are a lot of women interested in talking about it, says Dr. Emmi. She hopes her work with Dr. Ying C. Song, cryobiologist, will one day give her more to say.........

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May 25, 2007, 7:31 PM CT

Alcohol use during pregnancy

Alcohol use during pregnancy
Preterm delivery, and especially "extreme prematurity" defined as less than 32 weeks of gestation are major contributors to perinatal sickness and death worldwide. A new study has observed that maternal alcohol use during pregnancy can contribute to a substantial increase in risk for extreme preterm delivery.

Results are reported in the recent issue of Alcoholism: Clinical & Experimental Research

"Preterm birth has increased in part because of assisted reproductive technology and indicated medical intervention, however, we believed that we could also detect the impact of alcohol," said Robert J. Sokol, distinguished professor of obstetrics and gynecology and Director of the C.S. Mott Center for Human Growth and Development at Wayne State University. "In most prior studies, pregnancy dating was much less certain; but we used ultrasound dating. Its like listening to FM radio, rather than AM radio that has a lot of static; it is easier to hear whats being said with less noise in the background."

Sokol and colleagues collected data on exposure to alcohol, cocaine and cigarettes, as well as corresponding outcomes, from 3,130 pregnant women and their infants. As noted above, the scientists also used ultrasound to provide specific pregnancy dating. Of the newborns, 66 were extremely preterm, 462 were mildly preterm, and 2,602 were term deliveries.........

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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.". Archives of obgyn news blog

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