Friday, February 28th, 2014
Low birth weight babies, whose organs are often underdeveloped, may face lifelong difficulties in metabolizing medications, which can complicate the treatment of illnesses they might encounter in the future. A new study from researchers at Oregon Health & Science University and Oregon State University is the first to implicate low birth weight as a permanent factor in drug response.
When more fully understood, low birth weight may be added to the list of factors already being considered in medication dosages, such as age, weight, gender and ethnicity. Some of that is already being done in infants. But right now it’s not one of the factors considered in adults, scientists say, and more work needs to be done before such consideration is warranted.
“Low birth weight affects the development of organs, as the fetus tries to finish development of the brain and, in a sense, sacrifice as necessary the ordinary development of organs such as the kidney,” said Ganesh Cherala, an assistant professor in the OSU/OHSU College of Pharmacy, in a statement. “But the kidney is one of the primary filtering agents in the body, and is directly involved in drug elimination.”
The kidneys of low birth weight individuals have a significantly impaired ability to filter and excrete foreign compounds, Cherala said. Since the biologic impact of a medication is affected by its absorption, metabolism and excretion, low birth weight individuals might be less able to excrete drugs.
However, the biologic processes are not that simple, Cherala said. Because of liver metabolism and other issues, in many cases low birth weight individuals end up having less response to a drug, instead of more.
“A pain killer, for instance, might end up being metabolized in the liver instead of making its way to the brain where it is supposed to function,” Cherala said. “You might need more of that same drug in a low birth weight individual to have the same effect.”
The complexities of these processes need additional study before recommendations could be made to alter drug dosages based on low birth weight status, Cherala said. But this issue could be important and should be further explored, he said.
Image: Prescription medication, via Shutterstock
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Monday, September 23rd, 2013
Pregnant women who are seriously overweight or obese are more than 50 percent less likely to deliver a baby who has a healthy birth rate, according to new research published in the Journal of the American Medical Association. More from NBC News:
Women with a body-mass index between 30 and 35 were 58 percent more likely than those at a healthy weight to deliver an extremely premature baby, a team of U.S. and Swedish researchers found after examining the medical and delivery records of 1,599, 551 Swedish moms. Pregnant women with a BMI between 35 and 40 were twice as likely as normal-weight moms to have an extremely premature baby, while those with BMIs of 40 or greater were nearly three times as likely to deliver an extremely premature baby.
“When a baby is born earlier than it should be born, the potential for all the organs not being fully developed is increased,” said Karen Cooper, director of Healthy Expectations, a program at the Cleveland Clinic that helps women lose weight before they become pregnant. The program also helps obese pregnant women such as Bufford make healthier lifestyle choices so they might minimize the risks to their babies.
“When it comes to being obese and being pregnant, the risk factors for things going wrong multiply very quickly,” Cooper told NBC News. “Along with that comes gestational diabetes, hypertension, and preeclampsia, which can eventually lead to eclampsia, which is a condition where seizures occur.”
A premature baby may need a ventilator to help with breathing and nutrients fed through an IV tube, said Dr. Sandra McCalla, director of obstetrics at the Maimonides Medical Center. Further, prematurity can put a baby at risk for future problems, McCalla said.
More than half of American women of reproductive age are overweight or obese, said Cooper. But dieting during pregnancy is not the solution to maternal obesity.
“We just really encourage them to have a healthy lifestyle,” Cooper said. “We put together exercise activities per the individual mom and a calorie plan specific to the mom to have them gain an appropriate amount of weight.”
Image: Overweight pregnant woman, via Shutterstock
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Tuesday, July 23rd, 2013
Women who get poor sleep during pregnancy–either not enough time asleep or restless sleep–may disrupt the immune system and lead to lower birth weight and other complications, a new study published in the journal Psychosomatic Medicine has found. More from ScienceDaily.com:
Women with depression also are more likely than non-depressed women to suffer from disturbed sleep and to experience immune system disruption and adverse pregnancy outcomes.
“Our results highlight the importance of identifying sleep problems in early pregnancy, especially in women experiencing depression, since sleep is a modifiable behavior,” said Michele Okun, Ph.D., assistant professor of psychiatry at Pitt’s School of Medicine and lead author of the report. “The earlier that sleep problems are identified, the sooner physicians can work with pregnant women to implement solutions.”
Adequate and high-quality sleep, both in pregnant and non-pregnant women as well as men, is essential for a healthy immune system. Pregnancy often is associated with changes in sleep patterns, including shortened sleep, insomnia symptoms and poor sleep quality. These disturbances can exacerbate the body’s inflammatory responses and cause an overproduction of cytokines, which act as signal molecules that communicate among immune cells.
“There is a dynamic relationship between sleep and immunity, and this study is the first to examine this relationship during pregnancy as opposed to postpartum,” added Dr. Okun.
While cytokines are important for numerous pregnancy-related processes, excess cytokines can attack and destroy healthy cells and cause destruction of tissue in pregnant women, thereby inhibiting the ability to ward off disease. For expectant mothers, excess cytokines also can disrupt spinal arteries leading to the placenta, cause vascular disease, lead to depression and cause pre-term birth.
Image: Sleeping pregnant woman, via Shutterstock
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Thursday, July 18th, 2013
A regular regimen of exercise–two or three periods of moderately intense activity weekly during the second and third trimesters of pregnancy–could help protect women from delivering high birth weight babies, as well as lowering the likelihood they will require a Cesarean section, according to new research published in the British Journal of Sports Medicine. More from ScienceDaily.com:
The researchers contacted a total of 780 Spanish pregnant women attending two primary health care centres in Leganés (Madrid). Finally, 510 gave their consent to participate in the study. They all recognized they were sedentary — that is, that they exercised for less than 20 minutes on fewer than 3 days a week.
The intervention group followed a training program that consisted of 55 minute sessions of aerobic, muscle strength and flexibility exercises on three days a week from weeks 10-12 to weeks 38-39 of pregnancy, while the control group received standard recommendations and care.
The results showed the training sessions did not reduce the appearance of gestational diabetes mellitus but did diminish the incidence of two major associated risks: macrosomia [high birth weight babies] (down by 58%) and caesarean delivery (which fell by 34%).
These findings “reinforce the need to encourage more supervised exercise interventions during pregnancy to combat the negative effects of gestational diabetes mellitus,” says Jonatan Ruiz, researcher in the University of Granada Department of Physical and Sports Education and corresponding author of the study.
Image: Pregnant woman exercising, via Shutterstock
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Monday, January 30th, 2012
Forgoing both epidural anesthesia and a Cesarean section, Kendall Stewardson gave birth to 13-Lb 12-oz son Asher last week, according to news reports, setting a record for the hospital where the birth took place, but not for the state of Iowa, where a 14 Lbs., 13 oz. baby was born in 1980.
Des Moines KCCI.com news reports:
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Baby Asher was born healthy and 9 days late. He was 23.5 inches long. His family has a history of big babies. Asher’s big brother Judah weighed 12 lbs., 1 oz. when he was born.
Both Stweardson and her husband Joshua were born weighing more than 10 Lbs.Kendall said she had no relevant medical conditions during her pregnancy. Often large babies can be traced back to gestational diabetes.