Wednesday, July 10th, 2013
Women who smoke while they are pregnant may be putting their babies’ hearing at risk, among other health concerns associated with smoking, according to a study published in the journal JAMA Otolaryngology. More from USA Today:
Previously, prenatal smoking has been linked to negative consequences in children of all ages, including premature birth, low weight or underdevelopment and asthma. Now, a connection also has been made between smoking while pregnant and hearing loss in adolescents, according to a new study published in the journal JAMA Otolaryngology.
“Cigarette smoking is probably the worst man-made epidemic,” says Michael Weitzman, study author and a professor at the New York University School of Medicine.
In a group of 964 kids ranging in age from 12 to 15 from the National Health and Nutrition Examination Survey in 2005-2006, about 16% of parents confirmed prenatal smoke exposure. In most cases, kids with exposure were roughly three times more likely to have mild hearing loss. Kids without exposure also were found to hear better by three decibels in comparison with those who were exposed.
Image: Pregnant woman with cigarette, via Shutterstock
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Monday, May 13th, 2013
Women who contract the flu virus during pregnancy may have children who are born with a higher risk of developing a bipolar disorder, a new study published in the journal JAMA Psychiatry has found. More from CBS News:
“These findings may have implications for prevention and identification of pathogenic mechanisms that lead to” bipolar disorder, concluded the researchers, led by Dr. Alan Brown, a professor of clinical psychiatry and epidemiology at Columbia University Medical Center in New York City.
Researchers studied a pool of more than 900 U.S. children. More than 200 had been enrolled in the Child Health and Development Study, which tracked kids born between 1950 and 1966. The remaining 700 participants were controls matched by age and gender, obtained from county health databases.
The researchers found 92 cases of bipolar disorder out of the entire participant pool. After combing through data, their analysis revealed having flu during pregnancy was tied to a four-fold risk increase that offspring would develop bipolar disorder by the time they became adults.
The study was published May 8 in JAMA Psychiatry.
Bipolar disorder is characterized by ups and downs that are more extreme than a person typically experiences. It often develops in a person in their late teens or early 20s, though some people may experience symptoms in childhood, notes the National Institute of Mental Health.
Image: Pregnant belly, via Shutterstock
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Friday, May 10th, 2013
Pregnant women who are in need of dental care too often find themselves facing obstacles including refusal to treat or a delay in treatment. The issue is due to a number of reasons, ranging from lack of oral health attention from OB-GYNs to outdated ideas among dentists that it’s not safe to treat pregnant women. The New York Times reports:
The problem among dentists is decades old. Many “were taught in dental school that you can’t treat a pregnant woman,” said Dr. Renee Samelson, a professor of obstetrics and gynecology at Albany Medical Center, who was an editor of the first guidelines on oral health in pregnancy, which were published by the New York State Department of Health and advised on two more sets of guidelines. Dentists simply erred on the side of caution, she added: “There was no evidence of harm.”
Today, although dental treatment during pregnancy is considered beneficial, some dentists still hesitate to see pregnant women, because they fear litigation or harm to the fetus, or their knowledge of appropriate care lags behind the current evidence. One 2009 survey of 351 obstetrician gynecologists nationwide found 77 percent reported their patients had been “declined dental services because of pregnancy.”
“A lot of dentists still fear treating pregnant women, and think, ‘What happens if I have to do an X-ray?’ or ‘What happens if I give antibiotics or local anesthesia?’” said Dr. Howard Minkoff, the chairman of obstetrics and gynecology at Maimonides Medical Center in Brooklyn. “None of these are legitimate reasons not to provide appropriate care for women.”
Since 2006, a few state organizations and dental associations have issued practice guidelines declaring that dental care is safe and effective at any stage of pregnancy, including diagnostic X-rays, cavity restorations and root canals.
OB-GYNs should check for bleeding gums or oral infection and refer a patient to a dentist if her last visit was longer than six months ago, according to the first national consensus statement on dental care during pregnancy, published in September by the National Maternal and Child Oral Health Resource Center at Georgetown University.
The statement advised dentists to provide emergency care in any trimester. OB-GYNs can be consulted, as necessary, if a pregnant patient is diabetic or hypertensive, or if general anesthesia is required.
Image: Dentist with woman, via Shutterstock
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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
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Friday, March 8th, 2013
A Florida woman found herself in the unusual position earlier this week of receiving an email from her obstetrician in which the doctor threatened to send police to her home if she refused to come to the hospital for an immediate cesarean section to deliver her fifth child. Lisa Epsteen had delivered her four previous children by cesarean, but had enlisted the help of Dr. Jerry Yankowitz, chairman of the University of South Florida’s department of obstetrics and gynecology, to attempt the high-risk process of vaginal-birth-after-cesarean (VBAC).
Epsteen was ultimately able to schedule her surgery for March 8, as she wanted, days after she received the email from Yankowitz stating, according to the Tampa Bay Times:
“I am deeply concerned that you are contributing to a very high probability that your fetus will die or your child will incur brain damage if born alive. At this time, you must come in for delivery,” Yankowitz wrote.
“I would hate to move to the most extreme option, which is having law enforcement pick you up at your home and bring you in, but you are leaving the providers of USF/TGH no choice,” he continued.
After contacting advocacy groups, Epsteen was able to delay the surgery and avoid police action. The Times reports:
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Yankowitz was frank with Epsteen about the risks she faced after four caesareans, she said. They met multiple times during her pregnancy, and he stayed in touch by email.
In their last meeting on Friday, she said he urged her to think about his recommendation that she have a caesarean. Epsteen had developed gestational diabetes, another risk factor, plus the baby was not in a good position for a vaginal delivery.
When an ultrasound Tuesday showed the fetus in possible distress, other USF physicians sent her directly to Tampa General and wanted to deliver right then.
But she questioned their alarm. Besides, she couldn’t leave her 2-year-old son with strangers. She was driving the family’s only car, so her husband, a team leader at a call center, couldn’t get to her.
“In Dr. Yankowitz’s defense, and all of the other physicians there, I don’t think they are trying to cover themselves. I think they really do have the best interests of my child and myself at heart,” she added. “On the other hand, this is not the way to go about protecting my baby or me.”
Yankowitz was named the USF chair of obstetrics and gynecology in late 2010. He is one of the few doctors in the nation who is doubly certified in genetics and maternal fetal medicine, according to the USF website. His areas of expertise include ultrasound diagnostics.
After the lawyer got involved, Yankowitz sent a subsequent email saying he wouldn’t send law enforcement to Epsteen’s home. “I personally recognize and respect your right to make the medical treatment decisions for both you and your unborn child. . . . In that regard, please understand my frustration as I truly believe you and your child are in jeopardy.”