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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Tuesday, November 19th, 2013
Women who have had bariatric surgery as a weight loss solution may face an elevated risk of some pregnancy complications, including giving birth to babies who have low birth weight and are born prematurely, a new study has found. More from The New York Times:
The authors of the research, published in BMJ, looked at roughly 15,000 births that took place in Sweden between 1992 and 2009, including about 2,500 among women who had had had weight loss surgery. On average, the women delivered about five years after the surgery.
After controlling for age, smoking and other factors that could influence pregnancy complications, the researchers found that 10 percent of children born to women who had undergone bariatric surgery were delivered prematurely, compared with 6 percent in the other group.
A similar pattern was found for low birth weight. Five percent of children born to mothers in the surgery group were small for their gestational age, compared with 3 percent in the other group.
The researchers speculate that the trends could be driven by deficiencies in vitamins and minerals, which occur after bariatric surgery and could affect fetal and placental growth.
Image: Pregnant belly, via Shutterstock
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Monday, October 21st, 2013
The number of women who become pregnant using donor eggs has risen in the last decade, although the number of healthy babies born on time and at a healthy weight remains less than ideal for that group. More from The Associated Press:
That ideal result occurred in about 1 out of 4 donor egg pregnancies in 2010, up from 19 percent a decade earlier, the study found.
Almost 56 percent resulted in a live birth in 2010, and though most of these were generally healthy babies, 37 percent were twins and many were born prematurely, at low birth weights. Less than 1 percent were triplets. Low birth weights are less than about 5½ pounds and babies born that small are at risk for complications including breathing problems, jaundice, feeding difficulties and eye problems.
For women who use in vitro fertilization and their own eggs, the live-birth rate varies by age and is highest — about 40 percent — among women younger than 35.
Women who use IVF with donor eggs are usually older and don’t have viable eggs of their own. Because the donor eggs are from young, healthy women, they have a good chance of success, generally regardless of the recipient’s age.
The average age of women using donor eggs was 41 in 2010 and donors were aged 28 on average; those didn’t change over 10 years.
The study, by researchers at Emory University and the federal Centers for Disease Control and Prevention, was published online Thursday in the Journal of the American Medical Association and presented at the American Society for Reproductive Medicine’s annual meeting in Boston.
Image: Pregnant woman, 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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Wednesday, August 21st, 2013
A new study from Denmark suggests that moms who quit smoking right before or right after getting pregnant are more likely to give birth to normal-weight babies than women who continue to puff.
Of the nearly 1,800 women in the study, those who quit smoking did gain about six more pounds than those who continued to smoke, and they gained roughly the same amount in the year after delivery. But their babies weighed the same, on average, as the babies of moms who never smoked. Low-birth-weight babies face higher risk for infections, respiratory disorders, and learning disabilities.
Reuters has more details:
“The big thing to get out of this study is that quitting early in pregnancy is as helpful in respect to the birth weight of your baby as never having smoked while you were pregnant,” Dr. Amber Samuel, a maternal-fetal medicine expert at Emory University School of Medicine in Atlanta, said.
“I think that can be an inspiration to moms who are looking to make a change in their lives.”
According to the American Cancer Society, between 10 and 15 percent of women smoke during pregnancy. Studies have linked smoking to premature birth and other complications, such as birth defects, low birth weight, and stillbirth.
Infants have a three to four times higher risk of dying from sudden infant death syndrome, or “crib death,” if their mothers smoke during and after pregnancy. Children exposed to secondhand smoke also have more ear infections, pneumonia, bronchitis, asthma, and other health problems.
The new study included 1,774 women who were part of the “Smoke-free Newborn” study conducted in Copenhagen, Denmark, between 1996 and 1999.
Twice during pregnancy, researchers surveyed women about their smoking status. To double-check whether women who said they quit smoking really did, their saliva was checked for cotinine – created when nicotine is broken down in the body.
About 38 percent of women were smokers before becoming pregnant, and half of them quit right before or soon after, Dr. Line Rode of Copenhagen University Hospital and colleagues found.
During pregnancy, nonsmokers gained almost 30 pounds, on average, smokers gained 29 pounds and quitters gained 35 pounds.
Image: Pregnant belly with cigarette, via Shutterstock
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