Tuesday, April 22nd, 2014
Mothers who have low vitamin D levels while they are pregnant may face more cavities when their kids are toddlers, according to a new study conducted by Canadian researchers. More from Reuters:
Previous studies have shown that vitamin D deficiency among mothers can lead to defects in the enamel of their toddlers’ teeth – which have already begun to develop in the womb – and that these defects can increase the risk of tooth decay.
Dr. Robert J. Schroth from University of Manitoba’s dental school in Winnipeg and his team wondered whether low vitamin D levels in mothers during pregnancy would also translate into higher cavity rates for their toddlers.
They measured vitamin D levels in the second or early third trimester in 207 pregnant women and then examined the teeth of 135 of their children when they were an average of 16 months old. Mothers-to-be were recruited from a predominantly poor, urban area.
Women’s vitamin D levels were mostly in the normal range, but about a third had levels that were too low.
Depending on what definition of cavities the researchers used, 23 to 36 percent of the toddlers had cavities.
Prenatal vitamin D levels were significantly lower in women whose toddlers later had cavities than in women whose toddlers did not have cavities, according to findings published Monday in Pediatrics.
In fact, there was a direct relationship between low vitamin D levels in mothers and higher numbers of cavities in their toddlers.
Besides low vitamin D levels in mothers, defects in the tooth enamel were also associated with cavities in kids.
The researchers believe that improving nutrition during tooth formation and in early childhood could reduce the risk of cavities. They say, “Prevention efforts should begin during pregnancy by bolstering maternal nutrition, either through improved dietary intake or supplementation with vitamin D.”
Image: Toddler at the dentist, via Shutterstock
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Wednesday, April 16th, 2014
New research has linked a mother’s weight with the risk that her baby could either be stillborn or die shortly after birth. Reuters has more:
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The risk was greatest among the most obese women, the authors write in The Journal of the American Medical Association.
“The main message of the study is that maternal overweight and obesity increases the risk of fetal death, stillbirth and infant death,” said Dagfinn Aune, the study’s lead author, from Imperial College London.
“Since excess weight is a potentially modifiable risk factor, further studies should assess whether lifestyle and weight changes modifies the risk of fetal and infant death,” he told Reuters Health in an email.
Stillbirths, when a child dies in the womb toward the end of pregnancy, account for a large part of the estimated 3.6 million neonatal deaths that occur each year, the researchers point out.
Previous studies have linked women’s weight during pregnancy to the risk of their children dying in the womb or shortly after delivery due to complications. Some could not show their findings were not due to chance, however.
For the new study, the researchers pulled together data from 38 studies. Together, these included over 45,000 accounts of child deaths that occurred shortly before or after delivery, although a few studies counted deaths up to one year after birth.
According to the U.S. National Institutes of Health, a person of normal weight would have a body mass index (BMI) – which is a measure of weight in relation to height – between 18.5 and 24.9.
An adult who is 120 pounds and five feet, five inches tall, for example, would have a BMI of 20.
A BMI between 25 and 29.9 is considered overweight, and a score of 30 or above is considered obese.
Wednesday, April 9th, 2014
For women who are at high risk of developing pre-eclampsia, a potentially dangerous condition in which pregnant women’s blood pressure spikes and their babies need to be delivered immediately, a low dose of aspirin during pregnancy might be a wise preventative measure, according to a new recommendation by a federal government task force. More from The New York Times:
The United States Preventive Services Task Force’s draft recommendation follows a growing scientific consensus that low doses may be beneficial to some high-risk women and their offspring. Low-dose aspirin reduced the risk of pre-eclampsia by 24 percent in clinical trials, according to a systematic review underpinning the new recommendation, which was published in Annals of Internal Medicine.
Low-dose aspirin also reduced the risk of premature birth by 14 percent and of intrauterine growth restriction — a condition in which the fetus doesn’t grow as fast as expected — by 20 percent.
“For every four women who would have gotten pre-eclampsia, one case is prevented,” said Dr. Ira M. Bernstein, the chair of department of obstetrics, gynecology and reproductive sciences at the University of Vermont. “The ability to prevent a quarter of disease is substantial.”
Pre-eclampsia is a condition usually occurring in the second half of pregnancy and characterized by high blood pressure, protein in the urine, liver disease and blood-clotting abnormalities.
It is a leading complication for expectant mothers and their infants, affecting roughly 4 percent of pregnancies nationwide. The only “cure” is delivery. When a pregnant women develops pre-eclampsia in the second trimester, her infant often must be delivered prematurely to avoid severe maternal complications, like stroke.
The task force recommended that women at high risk for pre-eclampsia take 81 milligrams of low-dose aspirin daily after 12 weeks of gestation. High-risk women include those who have had pre-eclampsia in a prior pregnancy, especially those who have had to deliver preterm; women carrying multiple fetuses; and women who had diabetes or high blood pressure at conception.
But the task force also advised that expectant women with multiple moderate-risk factors “may also benefit from low-dose aspirin.” These risks include obesity, a family history of pre-eclampsia, women older than 35, and African-American women.
Image: Pregnant woman taking pill, via Shutterstock
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Monday, March 17th, 2014
A major doctor’s group is urging obstetricians to have serious, often difficult conversations with their patients, telling them that being overweight or obese can have negative impact on both their fertility and their pregnancy health. More from Time.com:
The latest news about the negative effects of our nation’s obesity epidemic on everything from fertility to pregnancy and maternal mortality recently prompted the American College of Obstetricians and Gynecologists (ACOG) to urge doctors to talk with patients about the benefits of slimming down before trying to conceive. It’s part of an ongoing push to make chats about women’s “reproductive lifespan” as routine as an annual pap smear. Just as doctors have historically shied away from telling women that their eggs are getting too old, many haven’t been eager to point out that a woman’s size might come in between her and her dream of becoming a mother.
“For a woman who’s been trying for a year, the last thing she wants to hear is to take another year off to lose weight,” explains Dr. Jeanne Conry, ACOG president and assistant physician in chief at The Permanente Medical Group in Roseville, California. “But if a woman walks into my office who’s been trying to get pregnant and she has a body mass index of 30 or over [more than 180 pounds for a 5’5” woman] and she’s having an irregular period, the first thing we’re going to do is discuss a healthy diet and exercise program.”
Of course, doctors point out that the majority of the estimated 30% of obese women in the U.S. have no problems conceiving. But there’s a growing body of evidence that’s difficult to ignore. Obesity raises a woman’s risk of gestational diabetes, hypertension, premature delivery, miscarriage, and stillbirth. A mother’s chance of having to undergo a caesarian section is 34% if her BMI is over 30, and 47% if her BMI is over 35—compared to 21% for women with a BMI under 30, according to one study. There’s even evidence that babies born to obese women have a greater chance of suffering neural defects than those whose mothers are normal weight, and will be at greater risk of being obese themselves.
In one recent survey of more than 3,300 women, one-third responded they didn’t believe or were unsure whether a woman’s weight affected her chances of conceiving. The doctors’ organization hopes that encouraging ob-gyns to broach the topic will educate women about that connection, considering that about 6% of infertility is due to obesity (another 6% is due to being too thin), according to statistics by the American Society for Reproductive Medicine. (That goes for men, too, since a recent French study showed their excess poundage contributed to low sperm production.) The good news is that 70% of these women will get pregnant naturally after they lose or gain enough weight to get closer to a healthier BMI.
The other goal is to help patients set and achieve weight-loss goals, or even consider weight loss surgery if they’re severely obese. But adding those expectations on top of conceiving can feel daunting to many women, says Julie Friedman, PhD, a psychologist who directs a weight management program comprised of counseling, workshops, and support groups, at Insight Behavioral Health Centers, a chain of outpatient mental health treatment centers based in Chicago. “They’ve struggled with their weight their whole lives and now they’re going through something so stressful, saying ‘Now you’re telling me to lose weight when I’m this stressed out and trying for a baby?’”
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Image: Overweight woman, via Shutterstock
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Monday, March 17th, 2014
Pregnant women who are exposed to high levels of secondhand smoke face a higher risk of suffering a miscarriage, stillbirth, or fetal death–as high a risk, in fact, as if the women had smoked during pregnancy themselves. More from Reuters on a new study published in the journal Tobacco Control:
“We often think of the diseases that secondhand smoke causes as diseases of older people,” epidemiologist Andrew Hyland told Reuters Health. “The results of this study show that secondhand smoke can affect even unborn babies.”
Hyland led the study at the Roswell Park Cancer Institute in Buffalo, New York. He and his colleagues found the pregnancy risks associated with women’s secondhand smoke exposure were almost as high as the risks related to their own cigarette smoking.
The study was the first to investigate the effects of secondhand smoke using quantified, lifetime exposure levels. The analysis arms clinicians like Dr. Maurice Druzin, from Stanford University Medical Center in California, with facts to try to persuade expectant fathers and others living with pregnant women to refrain from smoking at home.
“This is excellent ammunition for us to emphasize what we’ve known for a long time, but now we’ve got data to support it,” Druzin, who was not involved in the study, told Reuters Health.
“This is the first study that shows that secondhand smoke has the same effect as being a primary smoker,” he said. “That is a game changer.”
Hyland’s team used data from a study of 80,762 women between the ages of 50 and 79 years old. Researchers asked the women about their own smoking and the amount of secondhand smoke they were exposed to as children and adults, as well as about their history of pregnancy problems.
Among women who never smoked themselves, the chances of having a stillbirth were 22 percent higher for those who were exposed to any tobacco smoke than for unexposed women. That was after the researchers took into account other potential contributors, including women’s weight, education and alcohol drinking.
For women who were exposed to the highest lifelong levels of secondhand smoke, the risk of having a stillbirth was even greater – 55 percent higher than among unexposed women.
The researchers defined the highest level of exposure to secondhand smoke as at least 10 years of exposure during childhood, at least 20 years during adulthood and at least 10 years in the workplace.
At that level, a woman’s risk of a tubal ectopic pregnancy was 61 percent higher than among unexposed women, and her risk of a miscarriage was 17 percent higher.
“We’re not talking about an elevated risk of a rare event,” Hyland said of the miscarriage finding. “We’re talking about something that happens all the time.”
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Image: Man smoking near pregnant woman, via Shutterstock
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