Flu in Pregnancy May Increase Child’s Bi-Polar Risk 4x

Pregnant mothers’ exposure to the flu was associated with a nearly fourfold increased risk that their child would develop bipolar disorder in adulthood, in a study funded by the National Institutes of Health. The findings add to mounting evidence of possible shared underlying causes and illness processes with schizophrenia, which some studies have also linked to prenatal exposure to influenza.

“Prospective mothers should take common sense preventive measures, such as getting flu shots prior to and in the early stages of pregnancy and avoiding contact with people who are symptomatic,” said Alan Brown, M.D., M.P.H, of Columbia University and New York State Psychiatric Institute, a grantee of the NIH’s National Institute of Mental Health (NIMH). “In spite of public health recommendations, only a relatively small fraction of such women get immunized. The weight of evidence now suggests that benefits of the vaccine likely outweigh any possible risk to the mother or newborn.” [Read more…]

Violence During Pregnancy Can Lead to Reduced Infant Birth Weight

Pregnant women who are assaulted by an intimate partner are at increased risk of giving birth to infants of reduced weight, according to a population-level analysis of domestic violence supported by the National Institutes of Health.

The study analyzed medical records of more than 5 million pregnant women in California over a 10-year period. Although the results showed a pattern of low-weight births among women who experienced an assault, the study was not designed to establish cause and effect, and so could not prove that violence caused the reduced birth weights. Similarly, the study was not designed to provide a biological explanation for how violence against an expectant mother might cause her child to be of lower birth weight.

Infants born to women who were hospitalized for injuries received from an assault during their pregnancies weighed, on average, 163 grams, or one-third pound, less than did infants born to women who were not hospitalized, the study found. Assaults in the first trimester were associated with the largest decrease in birth weight.

Infants born weighing less than 2,500 grams, or 5.5 pounds, are considered low birth weight and have an increased risk of death or of developing several health and developmental disorders. Low birth weight infants also are at greater risk for sudden infant death syndrome (SIDS) as well as breathing problems, cerebral palsy, heart disorders and learning disabilities. The study found that among infants born to mothers who had experienced an assault, about 15 percent weighed less than 2,500 grams at birth. This rate was higher than the rate of low birth weight infants among pregnant women who were hospitalized after a car crash or for other injuries (8 to 10 percent) and more than double the rate among women who were not hospitalized while pregnant (6 percent).

Although women’s education level, rates of smoking, and nutritional habits are known to affect birth weight, the study concluded that the lower birth weights seen in the study could not be accounted for by these factors and were most strongly linked to the violence itself.

“These findings suggest that violence experienced by pregnant women could put their infants at increased risk for low birth weight and its subsequent health problems,” said Rosalind B. King, Ph.D., of the Demographic and Behavioral Sciences Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the NIH institute that funded the study. “It follows that programs to reduce violence against women might have the added benefit of reducing the number of low birth weight infants.”

The study was conducted by Anna Aizer, Ph.D., of Brown University, Providence, R.I. Her findings were published online in the Journal of Human Resources.

Using data collected between 1991 and 2002, Dr. Aizer compared the birth records in California to the records of pregnant women hospitalized in California as a result of injuries from assault.

She found that for every 100,000 women who gave birth in that period, 31 had been hospitalized for an injury from an assault while they were pregnant. Although these data did not distinguish between domestic violence and violence from other types of assault, previous research has shown that 87 percent of pregnant women with injuries were injured by an intimate partner.

The overall rate of assaults was 31 per 100,000 women. The study documented higher rates of assault among the poor (49.5 per 100,000), black women (157 per 100,000), and those without a high school education (39 per 100,000).

Dr. Aizer theorized that higher rates of violence among poor women might be a root cause of poor health and poverty that persists in some families from one generation to the next. A connection between violence during pregnancy, adult health, and future earnings is possible because all three factors are linked to low birth weight. Poor women are at greater risk for having low birth weight infants than are other women. In turn, when they reach adulthood, individuals born at low birth weight are at increased risk for such adult health problems as diabetes and heart disease. Also, when they reach adulthood, individuals born at low birth weight infants also earn less than their counterparts who were born at normal birth weight.

“The costs of violence against women may be borne not just by the victims but by the next generation as well,” said Dr. Aizer. “Given the importance of birth weight in determining adult education and income, these results suggest that the higher levels of violence experienced by poor women may also contribute to the intergenerational persistence of poverty.”

The American College of Obstetricians and Gynecologists has developed a slide presentation for physicians, advising them on how to screen patients for intimate partner violence, how to assess patients’ safety, and where to refer patients for additional help.

via Violence during pregnancy linked to reduced birth weight, September 8, 2011 News Release – National Institutes of Health (NIH).

Opioids in Early Pregnancy Doubles Risk of Birth Defects, Says Study

Babies born to women who take opioid pain killers such as codeine, oxycodone or hydrocodone just before or in early pregnancy are at increased but modest risk of birth defects, according to a study conducted by the Centers for Disease Control and Prevention.

The study, published in the American Journal of Obstetrics and Gynecology, found 2-3 percent of mothers interviewed were treated with prescription opioid pain killers, or analgesics, just before or during early pregnancy. The study did not examine illicit use of these medications. [Read more…]

Pregnant Women Should Take Greater Care of Novel H1N1 (“Swine Flu”) Virus

A recent study indicates that pregnant women are more severely impacted by a new H1N1 flu virus and should seek immediate treatment with antivirals.

Pregnant women infected with 2009 novel H1N1 had a higher rate of hospitalization and greater risk of death than the general population due to the H1N1 flu.

The data collected and analyzed by the Centers for Disease Control and Prevention (CDC) are the most comprehensive available to date on the impact of this novel H1N1 flu virus among pregnant women.

“The death of a pregnant woman is always heartbreaking, and unfortunately we have been hearing reports of otherwise healthy women dying from H1N1. If a pregnant woman feels like she may have influenza, she needs to call her healthcare provider right away,” said CDC′s Dr. Denise Jamieson, lead author of the study. “Clinicians who treat pregnant women should have a system in place for triaging pregnant women with influenza-like symptoms and they should not delay in initiating appropriate antiviral therapy. Some clinicians hesitate treating pregnant women with antiviral medications because of concerns for the developing fetus, but this is the wrong approach. It is critical that pregnant women, in particular, be treated promptly. ”

Six deaths of pregnant women with H1N1 were reported to CDC between April 15 and June 16, 2009, representing 13 percent of the total 45 deaths reported to CDC during that time period. All were healthy prior to infection of H1N1 and subsequently developed primary viral pneumonia leading to acute respiratory distress requiring mechanical ventilation. All pregnant women who died did not receive antivirals soon enough to benefit their treatment. CDC recommends that pregnant women with suspected or confirmed influenza infection receive prompt treatment with antiviral medication.

Based on past influenza pandemics and on seasonal influenza epidemics, pregnant women have increased rates of illness and death from influenza infection.

Despite recommendations from the Advisory Committee on Immunization Practices and the American College of Obstetricians and Gynecologists for inactivated flu vaccine for all pregnant women, seasonal flu vaccine coverage among pregnant women is very low (less than 14 percent).

Source: Centers for Disease Control (CDC), July 29, 2009; Lancet, August 8, 2009.

Teen Pregnancy May Be Reduced by Sex Education in Schools, Says Study

Sex education may reduce teen pregnancy without increasing the amount of sexual intercourse among teens, or the incidence of sexually transmitted diseases among them, according to new research.

"It is not harmful to teach teens about birth control in addition to abstinence," said study lead author Pamela Kohler, a program manager at the University of Washington in Seattle.

Which approach will postpone sexual experience? Instruction on birth control, or advice on how to say No. That’s the longstanding debate between sex educators and parents. The findings of a study analyzing the response from 1,719 teens, heterosexual and aged between 15 and 19, and the 2002 national survey, found that one in four teens received abstinence-only education, 9%—primarily those living in rural areas and the poor%—received no sex education at all, while the remaining two-thirds received comprehensive instruction with discussion of birth control.

Predictably, those teens receiving comprehensive sex education were 60% less likely to become pregnant or impregnating someone than those receiving no sex education at all. The one in four teens receiving abstinence-only education were 30% less likely to become pregnant than those receiving no sex education at all, although this number was dismissed as statistically insignificant by the researchers because so few teens fit the categories researchers analyzed.

The findings support comprehensive sex education, Kohler said. "There was no evidence to suggest that abstinence-only education decreased the likelihood of ever having sex or getting pregnant." Don Operario, Ph.D., a professor at Oxford University in England, said the study provides "further compelling evidence" about the value of comprehensive sex education and the "ineffectiveness" of the abstinence-only approach.

Still, the study does not show how educators should implement comprehensive sex education in the classroom, said Operario, who studies sex education. "We need a better understanding of the most effective ways of delivering this type of education in order to maximize audience comprehension and community acceptability."

The study appeared in the April, 2008 issue of the Journal of Adolescent Health.

Pregnancy After Breast Cancer

While many women who go through breast cancer do so in their 50’s and are no longer considering childbirth, women who are treated for breast cancer at a younger age are often left wondering whether or not they will be able to have children afterwards.

Breast cancer treatments often involve chemotherapy regimens that can affect ovarian function, but according to Daniel F. Hayes, an M.D. and clinical director of the breast cancer oncology program at the University of Michigan, many women can still safely conceive after breast cancer treatments.

Fertility is certainly a concern for women undergoing breast cancer treatment and Dr. Hayes points out that fertility is definitely something that should be discussed before treatment. "That discussion is going to be specific for each patient," he notes, "because it depends how old she is, whether she should get chemotherapy, what kind of chemotherapy, and whether she cares about maintaining fertility."

Ovarian function can be affected by multiple factors in breast cancer treatment—particularly chemotherapy. While most chemotherapies negatively affect ovarian function, younger women have a better chance of regaining their periods after treatment than their older counterparts who may be closer to menopause.

Other therapies that affect fertility are the newer hormone-based therapies, which are often given for up to five years. To become pregnant, women would have to stop taking the hormone therapy for a period of time before conception. Dr. Hayes discourages this course however, because, he says, the benefits of the therapy are so great.

 Studies have shown that there should be little worry that breast cancer treatment therapies have an adverse effect on the newborn children. The risk of birth defects or miscarriages was not shown to be elevated among women who have undergone chemotherapy.

Some Breast Cancer Facts

  • Number of American breast cancer diagnosis in 2007: 180,510
  • U.S. deaths from breast cancer in 2007: 40,910
  • Breast cancer is the #3 leading cause of female deaths in the United States.
  • With early detection, breast cancer can be cured in 80 percent of women.
  • It is recommended that women over 50 get a mammogram every 12 months.
  • Never ignore a lump or change in the look or feel of your breast.

Pesticides Linked to Diabetes in Pregnancy

A pregnant mother’s exposure to pesticides may affect the risk of her developing diabetes during pregnancy, new research suggests.

Dr. Tina M. Saldana and a team of researchers from the National Institute of Environmental Health Sciences in North Carolina assessed the risk of gestational diabetes amongst wives of farmers.

Source: Diabetes Care