Tuesday, February 28, 2006

More Studies on Everything Pregnant

Stress in Early Pregnancy Linked to Miscarriage
Ease anxieties before you get pregnant, experts advise

TUESDAY, Feb 21 (HealthDay News) -- Pregnant women who are stressed out during the first three weeks after conception are nearly three times as likely to miscarry, a new study finds.

"Try to provide yourself with what you consider a good environment. The less stress, the better," advised lead researcher Pablo Nepomnaschy, a postdoctoral fellow at the National Institute of Environmental Health Sciences of the National Institutes of Health in Research Triangle Park, N.C.

His team published its findings in this week's issue of the Proceedings of the National Academy of Sciences.

The NIH team evaluated 61 women over 12 months, collecting each woman's urine three times a week to check for pregnancy status and levels of cortisol, a stress-linked hormone.

"This study is special in the sense that we include cortisol data," said Nepomnaschy, He added that they did this testing very early in the pregnancy because "most pregnancy losses take place in the first three to four weeks after conception."

Of the 61 women, 22 got pregnant. Nine carried to term and 13 miscarried. Women with increased cortisol levels during the first three weeks of pregnancy were 2.7 times more likely to miscarry, the researchers found.

In all, miscarriages occurred in 90 percent of pregnancies in which the women had increased cortisol levels and in 33 percent of those with normal cortisol levels.

Nepomnaschy said it's unclear why a boost in cortisol might raise miscarriage risks, but he offered a hypothesis: "The body might interpret that [increased cortisol level] as conditions deteriorating, and maybe that might trigger an abortion mechanism."

The women studied were all residents of a rural area of Guatemala. "This population is more alike than any population in the United States," Nepomnaschy said, explaining that he was trying to get a sample of women who were similar in lifestyle, ethnicity and culture to rule out other factors linked to miscarriage. The women studied had similar diets and activity levels, and were all of the same ethnicity.

Another expert, Dr. Mary Stephenson, an obstetrician-gynecologist who runs the Recurrent Pregnancy Loss Program at the University of Chicago, said, "It's an intriguing article. Certainly more research is needed. But it is a potential mechanism by which miscarriage may occur."

Other studies have looked at the cortisol/miscarriage link, Stephenson said. "The results have been conflicting. There are some studies in animals that suggest that stress increased the risk of miscarriage. And doctors have long suspected that stress does the same in people."

About 15 percent of recognized pregnancies end in miscarriage, according to the March of Dimes. But Stephenson said that statistic usually includes pregnancies that made it to six weeks. "When you count the ones that occur before six weeks, up to half of pregnancies end in miscarriage," she noted.

The best advice for women trying to get pregnant is to de-stress your life before you conceive, she said.

"I talk about this a lot with my patients," Stephenson said. "I recommend that before they get pregnant, they take a serious look at their lifestyle."

And that includes getting enough sleep, so fatigue isn't an issue. "Fatigue is a type of stress," Stephenson said.

Going to be a dad? Pregnant Partner? Visit www.thefunkystork.com for more information on pregnancy and life as an expectant father.

Health Tip: Avoid Needless Ultrasounds of Fetus
FDA says they could be dangerous

(HealthDay News) -- The U.S. Food and Drug Administration has warned against taking a picture of a developing fetus merely as a keepsake.

These images can show facial features, hair and even the developing baby's sex.

But the FDA says while ultrasounds are generally safe, they can affect developing tissues and may cause a rise in fetal temperature.

Also, prenatal images being marketed for non-medical reasons are often done by less-experienced personnel and may expose a fetus to a longer period of imaging than one performed by a medical technician.

The FDA recommends that women limit ultrasounds to those done for medical reasons only.

Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!

Preemie Babies Have Reduced Lung Function
The problem is especially pronounced in boys, researchers say

THURSDAY, Feb. 16 (HealthDay News) -- Many healthy but premature infants younger than 12 weeks old have reduced lung function, a new Brazilian study finds.

"Preemie" boys are more likely to experience impaired lung capacity than girls, the researchers added, as are babies that quickly put on weight.

"There was a noticeable reduction in expiratory flows in the preterm groups compared with control infants and reference values," researcher Dr. Marcus H. Jones, of the Hospital Sao Lucas in Porto Alegre, said in a prepared statement.

The findings appear in the current issue of the American Journal of Respiratory and Critical Care Medicine.

The study involved 62 premature infants with no significant neonatal respiratory disease and 27 full-term infants.

Previous studies on full-term infants have noted reduced lung function in boys. After adjusting for gestational age and weight, Jones and his colleagues found that expiratory flows were 30 percent lower in the preterm male infants. The findings could help explain why preemie male babies have a higher risk of death from respiratory illness than girls, the researchers said.

Even premature infants who appear to have a healthy lung capacity may have some reduced function, the team noted. "The increased risk of wheezing, chronic cough and hospital readmissions early in life suggests that some degree of airway obstruction is present even in preterm infants without neonatal respiratory distress," Jones said.

He said the findings indicate that gestational age does have an independent effect on expiratory flows -- the amount of breath expelled by the lungs.

"There is up to a 7 percent increase [in expiratory flow] per week of gestation. It also reinforces the hypothesis that prematurity alone has an important role in the development of persistent airway obstruction," Jones said.

Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!

Science Reveals Secret to Sperm's Success
Key protein helps them penetrate an egg

WEDNESDAY, Feb. 15 (HealthDay News) -- Successful sperm use their tails to make one final jump into the egg -- and new research is revealing just how it happens.

A protein called CatSper1 is crucial to the ability of sperm to suddenly switch their tail movement from a smooth swimming motion to the sharp snap that thrusts them into the ovum, U.S. researchers report in the current issue of the journal Nature.

The discovery could lead to new avenues of research into male infertility or contraceptives that might block sperm from entering an egg, say the researchers at the Howard Hughes Medical Institute in Chevy Chase, Md.

Using an analytical technique to study electrical currents inside sperm, the researchers discovered that CatSper1 was a major component of the cellular calcium ion channel -- a mechanism that's largely responsible for proper sperm movement and male fertility.

"It's like opening a chamber in an ancient pyramid, because no one had ever seen inside sperm cells to measure all the currents that control their activity," researcher David E. Clapham said in a prepared statement.

"We are already measuring many of these currents and beginning to answer questions about what they are and what they do," he said.

Clapham said he and his colleagues plan to do further studies examining electrical currents and other inner workings of sperm.

Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!

Overweight Women Risk Problem Pregnancies
Some simple steps can reduce likelihood of high blood pressure, gestational diabetes

SATURDAY, Feb. 11 (HealthDay News) -- With one-third of American women heavy enough to be termed obese, and many others at a weight deemed unhealthy, it's no surprise doctors are becoming more concerned about women who are too heavy before they get pregnant.

The reason: They -- and their babies -- are at higher risk for health problems.

So last August, the American College of Obstetricians and Gynecologists issued an opinion on obesity during pregnancy, cautioning women and doctors about the risk that obesity poses to pregnant women and their babies.

For women who are obese before becoming pregnant, there is a heightened risk of miscarriage, blood-pressure problems, pregnancy-related diabetes and, perhaps, a greater need for Caesarean-section delivery, said Dr. Laura Riley, an obstetrician-gynecologist at Massachusetts General Hospital and former chairwoman of ACOG's obstetric practice committee.

"There's also a higher risk of the baby being overweight," she said, adding that a baby of about 10 pounds at birth is deemed overweight. Babies of heavy mothers are at greater risk of stillbirth, prematurity, neural tube defects and higher rates of childhood obesity, according to ACOG.

Women who aren't obese but are heavy -- with a body mass index (a ratio of weight to height) of between 25 and 30 -- are also at increased risk of diabetes, high blood pressure and a C-section if they gain too much weight during pregnancy, Riley said. A BMI of 18.5 to 24.9 is considered normal; a BMI of 25 to 29.9 is considered overweight; a BMI higher than 30 is deemed obese.

Ideally, "women should get down to their ideal body weight before they get pregnant," Riley said. "But it is not always easy." And not always feasible. "If you are 41, do you want to wait a year to lose the weight? Probably not," she added.

"But if you could get to your ideal body weight, that is what you should do," Riley said. "At the very least, you should see a nutritionist and figure out how you can minimize your weight gain" during pregnancy.

According to the ACOG recommendations, women of normal weight before pregnancy should gain 25 to 35 pounds while expecting; overweight women 15 to 25 pounds; and obese women, 15 pounds.

Netty Levine, a registered dietitian at the Nutrition Counseling Center at Cedars-Sinai Medical Center in Los Angeles, often works with pregnant women who are heavy. She cautions them not to diet, which is not recommended during pregnancy, but to focus on making "lifestyle changes for you and your future family."

For instance, Levine recommends that overweight women sit down and complete a food diary of what they eat for several days. Then she evaluates that record to see if the women are getting enough protein and calcium, and if they are eating too much fat or sugar. She also looks to see if portion sizes are too large -- one of the most common weight-control mistakes.

"This is no time to lose weight," Levine tells women who were too heavy when they got pregnant. "But you can keep it to a minimum." For obese women, that means 15 pounds or so.

For women who are heavy and hoping to get pregnant, Levine agreed with Riley -- the best idea is to slim down first. That might not require drastic changes, she tells women. Make small changes. "Get off those smoothies, drink more water. If you like waffles, top them with strawberries, just pass on the butter and syrup," she said.

Levine evaluates a woman's entire day -- and lifestyle -- and decides where the problem spots are when it comes to overeating. "Some people eat healthfully at home but have a business lunch every day. Or they eat healthfully at work and get home at night and overeat." Zeroing in on the trouble spots can help women fix the problem, she said.

Going to be a dad? Pregnant partner? Visit www.thefunkystork.com for more info on pregnancy and life as an expectant dad!