Thursday, April 25th, 2013
Pregnant women who use an anti-epilepsy drug called valproate have babies that are 5 times more likely to be diagnosed with an autism spectrum disorder (ASD), according to a new study published in the April 24 issue of the Journal of the American Medical Association. More from CBS News:
“This is an important risk factor and one that can be avoided or at least the risk reduced in women who don’t need to take this and can take another drug,” Dr. Kimford Meador, a professor of neurology at Emory University in Atlanta, said to Businessweek. Meador wrote an accompanying editorial published in the same journal issue. “This is the strongest evidence to date that there is a link between fetal exposure and childhood autism or autism spectrum disorder.”
The Centers for Disease Control and Prevention now estimates that 1 in 50 school age children may have an autism spectrum disorder (ASD). ASDs are a group of developmental brain disorders that affect social, communication and behavioral development. The disorders can range in severity from people with milder symptoms — called Asperger syndrome — to those with autistic disorder or “classic” autism.
Researchers looked at 665,615 babies born in Denmark between 1996 and 2006. The children were followed for an average of 8.8 years. Out of the group, 5,437 were diagnosed with an autism spectrum disorder, and 2,067 were diagnosed with childhood autism specifically.
The researchers found that mothers of 2,644 children took anti-epileptic drugs during pregnancy, with 508 specifically taking valproate. They determined that valproate was linked to an absolute risk of 4.42 percent for an ASD and 2.5 percent for childhood autism.
For women who had epilepsy who did not take valproate, the absolute risk of having a child with an ASD was 2.44 percent, with 1.2 percent receiving a diagnosis of childhood autism.
In January 2013, a British study of 415 children also linked autism to mothers taking valproate. Those results were published in the Journal of Neurology, Neurosurgery & Psychiatry.
“Women for whom valproate is a treatment option should discuss the risks and benefits of this drug with their doctor prior to pregnancy, to ensure that their health and that of the potential child is optimized,” Rebecca Bromley, a clinical psychologist and research associate at the University of Liverpool who led the British study, told HealthDay.
Image: Pregnant woman, via Shutterstock
Wednesday, April 17th, 2013
Advising pregnant women in poor and developing countries to sleep on their sides might help lower the rate of stillborn children by at least 25 percent, according to a new study conducted in Ghana. More from The New York Times:
A graduate student’s summer project, the study is relatively small — it included only 220 women interviewed about their sleep habits just after giving birth in one hospital in Ghana.
But because Ghana has such a high rate of stillbirth, said Louise M. O’Brien, the professor at the University of Michigan’s Sleep Disorders Center who oversaw the project, by Jocelynn Owusu, the conclusion seemed clear: If pregnant women avoid sleeping on their backs, 25 percent of all stillbirths in poor countries might be prevented.
The study, published online last month by The International Journal of Gynecology & Obstetrics, also found that loud snoring — which is worsened by back (supine) sleeping — raised the likelihood that a pregnant woman would get high blood pressure, a condition that may lead to a complication known as pre-eclampsia, which can kill both mother and child if left untreated or not stopped by Caesarean section.
The Ghanaian study echoed one conclusion drawn from larger studies in the United States and New Zealand, Dr. O’Brien said: that apnea in pregnant women raises blood pressure and increases risk to the baby.
The leading theory, she said, is that when a heavily pregnant woman sleeps on her back, the uterus compresses the vena cava, the blood vessel going up the spine that returns blood to the heart. That starves the fetus, leading to smaller babies and more stillbirths. Supine sleeping also closes the airways, leading to oxygen deprivation, which raises blood pressure. Closed airways lead to snoring.
“In the delivery room, when an obstetrician sees a baby in distress, they often flip the woman on to her side,” Dr. O’Brien said. “But people haven’t thought through the connection to the months prior to delivery.”
In wealthy countries, blood pressure is lowered with drugs and apnea is prevented with breathing machines. But the drugs are little used in Africa and the machines are too costly.
Image: Pregnant woman sleeping on her side, via Shutterstock
Friday, April 12th, 2013
Fertility drugs that stimulate the functioning of a woman’s ovaries do not add to her chances of developing ovarian cancer later in life, a new study has found. Though previous studies had made similar conclusions, many of those were conducted outside of the United States, whereas the new study was conducted on U.S. women. Reuters has more:
“One important message is women who need to use fertility drugs to get pregnant should not worry about using these fertility drugs,” said Dr. Albert Asante, lead author of the study and a clinical fellow in the division of reproductive endocrinology at the Mayo Clinic in Rochester, Minnesota….
….Infertility, defined as not getting pregnant after a year of trying, is experienced by about 15 percent of couples.
Asante’s team looked specifically at whether women in the study who reported being infertile- whether or not they had taken fertility drugs – had a greater chance of developing ovarian cancer, and found no added risk.
Asante said one explanation for the result is that most of the women in his study had infertility issues, but eventually became pregnant. He would still expect to see a higher risk of ovarian cancer if he had included more women who never ended up having a baby.
Asante left open the possibility that long term use of fertility drugs – more than one year – could impact the chance of developing ovarian cancer, and to be safe these women might benefit from additional monitoring for tumors.
He said that because ovarian cancer is rare and develops later in life, there is a need for longer studies to thoroughly assess the effect of fertility drugs.
According to the National Cancer Institute, close to 13 out of every 100,000 women develop ovarian cancer, most commonly in their 60s. Family history of the disease or certain gene mutations raise a woman’s risk considerably.
Image: Fertility injection, via Shutterstock
Wednesday, April 10th, 2013
The Food and Drug Administration has approved the return of a drug that was widely used to treat morning sickness until it came off the market 30 years ago. Bendectin, now called Diclegis, will return to the market in early July after extensive study has shown it is safe and effective. Time.com has more:
Monday’s FDA decision means a new version of the pill once called Bendectin is set to return to U.S. pharmacies under a different name — Diclegis — as a safe and effective treatment for this pregnancy rite of passage.
In the intervening decades, the treatment is widely believed to have undergone more scrutiny for safety than any other drug used during pregnancy.
“There’s been a lot of buzz about this. Nothing better has come along” to treat morning sickness in those 30 years, said Dr. Edward McCabe, medical director for the March of Dimes, who welcomed the step.
“We know safety-wise, there’s zero question,” said Dr. Gary Hankins of the University of Texas Medical Branch in Galveston, who headed one of the company-financed studies of Diclegis that led to its approval.
U.S. sales of Diclegis are expected to begin in early June, according to Canada-based manufacturer Duchesnay Inc. The company has long sold a generic version of the pill in Canada under yet another name, Diclectin.
For all the names, the main ingredients are the same: Vitamin B6 plus the over-the-counter antihistamine doxylamine, found in the sleep aid Unisom. U.S. obstetricians have long told nauseated pregnant women how to mix up the right dose themselves.
In fact, in 2004 the American College of Obstetricians and Gynecologists issued guidelines calling the combination a first-line therapy.
The difference that prescription-only Diclegis would offer: Combining both ingredients with a delayed-release coating designed to help women take a daily dose before their nausea sets in.
This news follows a Danish study last month that showed that Zofran, another morning sickness medication, is also safe.
Image: Woman suffering from nausea, via Shutterstock
Friday, March 29th, 2013
A 15 pound, 7 ounce baby named George was born six weeks ago in England in a surprising–and harrowing–experience for the boy’s mother, Jade King, who birthed him vaginally. Yahoo.com has more:
No one realized just how big George was until his head had emerged, at which point his shoulders got temporarily stuck and he went without oxygen for five minutes.
“There was about 20-odd doctors in the room, and that’s when it got really scary,” King recalled.
Once the baby was out, he was given a 10 percent chance of survival and transferred from Cheltenham to another hospital, in Bristol. He was kept there for four and a half weeks and then went home, and just received normal results from an MRI.
“It might just be that he’s a little bit slow with his learning,” his mom added. “So hopefully it’s just minor little things.”
George has only gained a pound since his birth, and has been wearing clothes sized for a 3-to-6-month old from day one (his mom had to give away all the newborn onesies that were awaiting him at home). He is the second-biggest baby ever born vaginally in the UK, according to various reports; the larger baby weighed just an ounce more.
In George’s case, doctors were unsure of what caused his hugeness, the medical term for which is called macrosomia. But the condition is often caused by mom having had gestational diabetes during her pregnancy, according to the American Congress of Obstetricians and Gynecologists.
Image: Woman giving birth at hospital, via Shutterstock