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.
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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Thursday, September 19th, 2013
A new study published in the American Journal of Obstetrics and Gynecology has found that women who give birth at home are 10 times more likely to have stillbirths; first-born children who are delivered at home are 14 times more likely to be stillborn. More from ABC News:
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In the largest study of its kind, investigators at New York-Presbyterian/Weill Cornell Medical Center in New York City reviewed data from a sampling of 13 million of the nearly 17 million singleton full-term births in the United States between 2004-2007. These included births to parents of all races, ethnic groups and income levels.
Among their findings: Babies born at home were nearly 10 times more likely to be stillborn, and the risk of stillbirth increased to 14 times for firstborns. Babies born at home were also almost four times more likely to experience neonatal seizures or serious neurologic dysfunction compared with babies born in hospitals.
The study’s results were confirmed by analyzing birth certificate files from the National Center for Health Statistics to evaluate deliveries by physicians and midwives in the hospital and at home from 2007 to 2010. The researchers looked at Apgars, scores that assess the health of an infant one minute and five minutes after birth. A five-minute Apgar score of zero is considered a stillbirth. About 10 percent of these babies survive, though often with major health problems.
“Childbirth is one of the most wonderful moments in humanity, and people deserve the best of all circumstances, including enhancing the experience and reducing unnecessary interventions,” said Dr. Amos Grunebaum, chief of labor and delivery at New York-Presbyterian/Weill Cornell Medical Center, and the study’s lead author. “Having said that, it’s not only about experience. It’s also about making sure the baby is born safely.”
Grunebaum said that the study associated risk with the location of a planned birth, rather than the credentials of the person delivering the baby. When a child is born at home, typically there is only the midwife or doctor to address any unpredictable circumstances that arise, but in the hospital, a team of specialists can be mobilized in seconds if needed, he said.
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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