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Thursday, June 25th, 2015
When my doctor suggested I was a candidate for a C-section because I was carrying twins in breech position, I didn’t flinch. I was happy to do what was recommended for our safety. Of course, I would have hesitated if I felt like I could be putting the babies in danger in any way.
Headlines frequently seem to blare scary news that can be daunting—and confusing!—to expecting mamas. For instance, the initial findings of a new study published online in the journal JAMA Psychiatry suggest a scary link between cesarean deliveries and autism: Results appear to show that children born by C-section were 21 percent more likely to be diagnosed with autism spectrum disorder.
However, those of us mamas who delivered by C-section will be relieved to know this: The C-section/autism association did not hold up in further analysis of siblings. What that means it that the first, scary-seeming results were not actually causal, and instead were likely related to other factors—like genetics or environment.
Autism spectrum disorder is thought to affect nearly two thirds of one percent of children all around the world, and here in the U.S., experts put that figure about two and a half times higher—at about 1.5 percent. Various factors—including C-section—have been investigated as possible causes.
To further the investigation, this latest study out of Europe looked at data for live births from 1982 through 2010. The huge study group included 2.7 million children, with nearly 13 percent of those delivered by cesarean. Of the total group, about 1 percent were diagnosed with autism. Importantly, the sibling control portion of the study found no association between mode of delivery and autism.
The study concluded that “…because the association between birth by [cesarean section] and [autism spectrum] did not persist in the sibling control analysis, we can conclude that there is no causal association.”
And that news can certainly bring a sigh of relief for c-section mamas like me.
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Alesandra Dubin is a new twin mom. She’s also a Los Angeles-based writer and the founder of lifestyle blog Homebody in Motion. Follow her on Facebook, Instagram, Google+ and Twitter.
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Tuesday, April 29th, 2014
There has been an ongoing debate over whether inducing labor really increases or decreases your chance of having a C-section. According to a new study conducted at Queen Mary University in London, forget everything you’ve read about inducing labor (which is when a doctor gives you medicine like pitocin, or other drugs, to artificially start or speed up your contractions) boosting your chances of needing a C-section.
In fact, according to their analysis of 157 studies involving 31,000 births, pregnant women whose labor is induced are 12 percent less likely to need a cesarean delivery than those whose doctors take a “wait-and-see” approach.
According to Health Day, “the 12 percent lower risk of cesarean delivery was seen in term or post-term pregnancies that were induced, but not in preterm births, the authors noted.
Inducing labor lowered the chance of cesarean delivery in both high- and low-risk pregnancies, and it also reduced the risk of fetal death and complications in mothers, the findings showed.
The researchers also found that the widely-used drug prostaglandin E2 was linked to a reduced risk of cesarean delivery. However, use of the hormone oxytocin, and amniotomy (the deliberate rupture of the amniotic sac) did not lower the chance of C-section.
Labor is induced in about 20 percent of deliveries, for myriad reasons—including (but not limited to) being one to two weeks past your due date; having gestational diabetes (and your doctor fears your baby may be getting too big); having too little amniotic fluid, or your baby isn’t growing as it should; if your water breaks but your labor doesn’t start on its own; or if you develop preeclampsia.
In other great induction news, last week the American College of Obstetricians and Gynecologists debunked a recent study by Duke University’s Medical Center that stated that women who had induced labors were more likely to have newborns on the autism spectrum. ACOG claims there is insufficient evidence to support this theory, and therefor doctors should not change their practice of using inductions when needed. As with all things, speak to your doctor if you’re concerned about your chances of being induced so you have all of the facts about the risks and benefits.
On a personal note, being induced isn’t as scary as it sounds—though I understand being freaked out about it. My ob-gyn induced me at 39 weeks—my water had broken at 4:00 am, and by 8:00 am I was still just dilated one measly centimeter. I also had gestational diabetes, so she worried that I could end up having to have a C-section if all did not go well. Luckily, all did go well. In fact, after getting the pitocin at around 9:00 am, I went to sleep and when I woke up at noon, I was fully dilated. I couldn’t believe I had slept through most of my major contractions! If you have to be induced, I hope things go equally well for you!
When is your due date? Check our due date calculator!
TELL US: Have you ever had to be induced in one of your pregnancies? Share your stories.
Image of woman in labor courtesy of Shutterstock.
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Thursday, April 10th, 2014
While a mom’s weight before and during pregnancy is often a hot topic (we worry about eating enough of the right things and as few of the bad things as possible), we often forget that it takes two (at least) to make a baby. So how much does the dad’s health and DNA contribute to your baby bundle? Researchers at the Norwegian Institute of Public Health found that obese fathers up the risk of autism in their children more so than obese moms. That’s right—the dad-to-be’s weight seems to be more of a contributing factor than the mom-to-be’s!
They studied nearly 93,000 Norwegian children at three, five and seven. The mothers answered detailed questions about their own—and their children’s—mental and physical health, while the dads completed a questionnaire about their mental and physical health while their partners were pregnant. The researchers also collected data from the Norwegian Patient Registry and from studies of children who were referred for evaluation and treatment of possible autism or Asperger’s syndrome.
The researchers adjusted for variables that may also be associated with the development of autism in the child. In addition to adjusting for maternal obesity, they considered education, age, smoking, mental disorders, hormone therapy before pregnancy, use of folic acid, maternal diabetes, preeclampsia and the baby’s weight at birth. The researchers found that the risk remained unchanged when adjusted for socio-demographic and lifestyle factors.
The findings say that maternal obesity has little association with the development of autism in the child. However, they found a doubled risk for development of autism and Asperger’s syndrome in the child if the father was obese, compared with a normal weight father. (But note, the odds are small: just under 0.3 percent of kids with obese dads were diagnosed with autism, versus 0.14 percent of kids with fathers at healthy weights.)
Doctors still don’t know why a father’s obesity could cause a higher rate of autism in his kids. There could be an indirect association with certain gene variations, or obese men might be more likely to have certain environmental exposures that contribute to autism. But there also might be a direct tie, like the extra weight might actually alter sperm quality, leading to malformations that would cause autism. More research needs to be done on the subject to find a definite cause and effect, but all signs point to the fact that both mom and dad’s health contribute to whether you’ll have a healthy baby. So if you’re trying to get pregnant, set a standing date for a couple’s workout!
TELL US: Are you surprised to hear that a dad’s weight could raise his baby’s autism risk?
How much do you know about toddler nutrition? Put your IQ to the test.
Image of man’s belly courtesy of Shutterstock.
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Asperger's, Autism, Diabetes, Folic Acid, Obese Dads, Obese Moms, Obesity, Preeclampsia, pregnancy, pregnant | Categories:
Everything Pregnancy, Healthy Pregnancy, Must Read, Pregnancy News
Friday, March 28th, 2014
I’m sure each of you reading this knows someone who has been diagnosed with autism. Though autism is hard to diagnose before 24 months, symptoms often surface between 3 and 18 months. Autism is thought to be the result of a combination of contributing factors, from genes, including a fathers’ older age at conception, to environmental exposure such as pollution and infections during pregnancy. The actual development of autism, however, scientists say, starts while the child is still in the womb—as early as in the second trimester of pregnancy.
A report published in the New England Journal of Medicine concludes that the brains of autistic children showed differences from the brains of kids without the disorder in areas that normally develop in the second trimester of pregnancy. According to the Centers for Disease Control and Prevention, 1 in 68 children has an autism spectrum disorder. That is a 30 percent increase from the 1 in 88 stat that was released just two years ago. While people are debating whether the increase in autism is actual, or if anything that can’t be diagnosed is now just being labeled autism, boys seem to be diagnosed with it the most. The CDC estimates 1 in 41 boys have autism—which is an astounding 4.5 times more prevalent than in girls (1 in 189).
A group of scientists from around the country working with the National Institute of Child Health and Human Development and the Harvard Brain Tissue Resource Center obtained frozen cubes of brain tissue taken from children ages 2 to 15, who had died. The samples were taken from three areas of the brain that play a role in socialization, emotions and communication—areas that are usually troublesome for kids with autism.
According to the LA Times, “The researchers analyzed 11 samples from children with autism and 11 samples from typically developing children. They were looking to see whether the samples had developed into six distinct layers—each with its own set of gene markers—which should happen in prenatal development.”
In 10 of the 11 samples from children with autism, the researchers found patches of tissue where some layers were missing. In the 11 samples that were used as controls, only one had an abnormal patch. While this study is not able to tell what causes the development of autism, it points to the fact that autism might be able to be diagnosed earlier than previously thought, and therefore behavioral therapies can begin even sooner, allowing autistic children to learn techniques to lessen the symptoms of their developmental disorder. That sounds like something to cheer about to me!
TELL US: Do you or someone you know have a child with autism? Do you think earlier diagnosis of autism equals better behavioral outcomes?
Image of sonogram courtesy of Shutterstock.
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Monday, February 10th, 2014
For years there have been the two camps of mamas-to-be: Those who want a completely natural birth, free of all drugs, and those who can’t get an epidural fast enough. Now French researchers who’ve studied pregnant mice are suggesting that there is a link between women getting an epidural during childbirth and their children developing autism.
The reason being that when you’re given an epidural, it is blocking your body’s natural release of oxytocin—which helps your uterus contract; is considered the love hormone because it helps you bond with your baby post-birth; and serves as a diuretic, reducing chloride levels. According to the Independent, chloride ions are kept deliberately high in the neurons of the fetus while developing in the womb. But in a natural birth the mother’s production of oxytocin lowers the chloride levels quickly during labor. In the pregnant mice studied, when the oxytocin was blocked similarly to what an epidural does, chloride ions continue to remain high after birth, leading to developmental brain disorders and autism.
However, the study doesn’t answer what happens when synthetic oxtytocin, called pitocin, is introduced into the system. Pitocin is usually given to a woman to help induce labor, either because she is past her due date or the doctor thinks the labor needs to be sped up in order to have a safer delivery.
Another recent study sings the praises of inducing a pregnancy (which is when a doctor gives you medicine like pitocin, or other drugs, to artificially start or speed up your contractions) as a major way to stave off the need for a C-section. Though this is contrary to a British study from two years ago that said the use of pitocin doesn’t lower the risk of a Cesarean section. Their findings stated that the use of pitocin sped up labor by about two hours, but that it did not lessen the need for a C-section or increase the number of unassisted births.
Meanwhile, an anxiety-inducing study was also recently published in the journal, JAMA Pediatrics, that says inducing a pregnancy can increase a child’s chance of having autism. Researchers say the method used to kick-start the labor process likely doesn’t cause the autism, but it comes from a larger underlying problem with the pregnancy. Studies have found that children are at higher risk for autism if they are born early or very small; if they are in medical distress during delivery; if they have older mothers or fathers; or if they are born less than a year after an older sibling. Autism risk also goes up if a mother has diabetes or high blood pressure; is obese; is exposed to significant air pollution during pregnancy; had low levels of folic acid; or makes antibodies toxic to the fetal brain.
So what’s a pregnant woman to do? Freak out, it seems! And of course, talk to your doctor, read up as much as you can, and make informed decisions about what’s right for you. Epidural or no epidural? To induce or not to induce?
TELL US: Are you planning on having an epidural? Why or why not? If your child has autism, did you have an epidural? Please share your stories below.
Image of woman with newborn courtesy of Shutterstock.
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