Tuesday, March 21, 2006

Calcium Cuts Pregnancy Complications

Calcium Cuts Pregnancy Complications
Supplements eased preeclampsia-linked trouble but not its incidence, study found

FRIDAY, March 10 (HealthDay News) -- Boosting the calcium intake of pregnant women with low dietary calcium can help prevent complications from a dangerous condition known as preeclampsia, in which a woman's blood pressure rises dramatically, a new global study found.

However, the extra calcium did not significantly reduce the number of women who got preeclampsia, according to Dr. Jose Villar of the World Health Organization, lead author of the study that appears in the March issue of the American Journal of Obstetrics & Gynecology.

"It was not as positive as one would like," Dr. Marshall Lindheimer, professor emeritus of medicine and obstetrics and gynecology at the University of Chicago, said of the calcium-preeclampsia prevention link. He is a co-author on the study.

The 1.5 gram calcium supplement taken daily by women in the study "didn't prevent the disease, all it did was to decrease the severity," Lindheimer said. But it did decrease the rate of maternal and newborn deaths, he said.

Preeclampsia affects about 9 percent of pregnancies worldwide, according to Villar. It can lead to premature delivery and the need for a Caesarean section. If it progresses to a more serious condition, eclampsia, the woman can suffer seizures or coma. In the worst cases, preeclampsia can cause disability or death of mother or fetus.

In the study, Villar and his team assigned more than 8,300 women who were receiving health care from one of eight centers in six countries to either the calcium-supplementation group or a placebo group. Before the study, all the women took in less than 600 milligrams a day of dietary calcium, or about half the amount recommended during pregnancy.

When the researchers followed up, they found the rate of preeclampsia was not statistically different between the groups. But eclampsia was lower in those treated, with 17 women in the calcium group stricken with eclampsia compared to 25 in the placebo group. Severe gestational high blood pressure was higher in the placebo group, too, with 59 of the women developing hypertension vs. 43 in the calcium-treated group.

Newborn death was also less likely in the supplementation group, with 0.9 percent infant deaths in the calcium group compared to 1.3 percent in the placebo group.

Finally, the risk of early preterm delivery -- before 32 weeks -- was 2.6 percent in the calcium group, but 3.2 percent in the placebo group.

Women in the study received health care at centers in Argentina, Egypt, India, Peru, South Africa and Vietnam. Each center is part of the World Health Organization's Maternal and Perinatal Research Network.

The cause of preeclampsia is still unknown, and there's no way to prevent it. A relationship between calcium deficiency and preeclampsia has long been suspected.

Lindheimer said it's not clear how calcium may help. "It may affect the contractability of the blood vessels," he said. "Intracellular calcium is very important in muscle physiology." Insufficient calcium consumption may lead to more constriction of the vessels, he said. "When you replenish the calcium, they [vessels] are in a more dilated state. It may be that effect which makes the disease less severe."

The study results are of greatest value mostly outside the United States, Lindheimer said, where calcium deficiency is a bigger problem.

But the study might also serve as a useful reminder for U.S. doctors to urge their pregnant patients to get enough calcium, he said.

While the study results don't necessarily apply to American women, the findings are interesting, said Dr. Ashley Roman, an assistant professor of obstetrics and gynecology at the New York University School of Medicine.

"It helps us to understand the process of preeclampsia better," she said. "When it comes to preeclampsia, we are still in the dark ages. We have been studying it for years, and we don't know what causes it, how to predict it well, and we really don't know how to prevent it."

Roman tells her pregnant patients to be sure to take in 1,200 milligrams of calcium daily, if not from diet, then from a calcium supplement.

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

Postpartum Depression Impacts Infant Care

Postpartum Depression Impacts Infant Care
Depressed moms less likely to breast-feed, play with new baby, study finds

WEDNESDAY, March 8 (HealthDay News) -- Mothers who suffer symptoms of depression after childbirth are less likely to breast-feed, play with, read to, or otherwise interact with their newborns, new research shows.

The nationwide study, by researchers from the Johns Hopkins Bloomberg School of Public Health and Columbia University, included nearly 4,900 mothers from 15 pediatric care centers.

It found that about 44 percent of mothers with postpartum depressive symptoms were likely to be breast-feeding at two to four months after the birth of their baby, compared with nearly 57 percent of mothers without depressive symptoms.

Other findings included:

  • At two to four months following birth, 87.4 percent of mothers with depressive symptoms were likely to play with their infants at least once a day, compared with 91.9 percent of mothers with no symptoms of depression;
  • At the same point in time, 22.4 percent of mothers with depressive symptoms were likely to show their newborns books, compared with 28.2 percent of mothers without symptoms of depression.

However, depressive symptoms did not seem to affect a mother's baby-related safety practices, such as placing the infant in the correct sleeping position or lowering the temperature of the home water heater. Overall, adherence to safety practices was high among all the mothers in the study.

"Maternal depressive symptoms are very common in early infancy. We found nearly 18 percent of the mothers in our study reported experiencing some symptoms of depression two to four months after the birth of their children," study corresponding author Dr. Cynthia S. Minkovitz, a professor in the department of population and family health sciences at Bloomberg, said in a prepared statement.

"These symptoms clearly have an unfavorable impact on a mother's parenting practices, particularly those that involve active engagement with the child. Our results highlight the importance of screening new mothers for depressive symptoms," Minkovitz said.

The study appears in the March issue of the Archives of Pediatrics and Adolescent Medicine.

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

Kids' Asthma Linked to Maternal Nutrition

Kids' Asthma Linked to Maternal Nutrition
Researchers find Vitamin D could make a difference

SATURDAY, March 4 (HealthDay News) -- The link between maternal health and childhood asthma is becoming clearer.

Researchers presenting new studies at the annual meeting of the American Academy of Allergy, Asthma and Immunology in Miami Beach have recorded associations between maternal nutrition and stress with asthma in children.

One study found that expectant mothers who take higher amounts of vitamin D may decrease their child's risk for asthma.

Vitamin D deficiency is common in areas where asthma is also widespread, raising the suspicion that the two are linked, said Dr. Carlos Camargo, senior author of the study and an associate professor of medicine and epidemiology at Harvard Medical School in Boston.

Camargo and his team followed 1,300 mother-child pairs for more than three years.

By the time the children were 2 years old, there was already a clear association between higher vitamin D intake when the mother was pregnant and lower risk of wheezing and asthma in the children, he said at a news conference Saturday in Miami Beach.

And, he added, the three-year link was even stronger.

The results of previous studies suggest that vitamin D may have an effect on a fetus's developing immune system.

"Doctors should understand that vitamin D insufficiency is real," Camargo said. "It's important to get it from diet or supplements and the way to do that is through fortified milk, fish and supplements. And that is totally independent of our findings."

A Canadian study found that pregnant women who have asthma are more likely to have premature babies and to have babies with low birth weight.

This survey of 13,980 children born in Manitoba found that mothers who suffered from asthma were, on average, 2.77 times more likely to have a baby born at less than 28 weeks' gestation and 3.04 times more likely to have a baby born at less than 32 weeks' gestation than a non-asthmatic mother.

"Maternal asthma is a risk factor for prematurity and low birth weight in babies, and physicians and other health-care professionals need to assess present and past asthma even up to five years prior in order to properly assess risk for premature labor," said lead author Dr. Joel Liem, a research fellow in pediatric allergy and clinical immunology at the University of Manitoba.

Another research group at the same university found that children of mothers who experienced stress (defined as visiting a doctor or getting a prescription for depression or anxiety) were 1.3 times more likely to develop asthma. "The highest risk was in children with repeat exposure to mother's stress," said Anita Kozyrskyj, lead author of the study and associate professor of pharmacy and medicine at the university.

Kozyrskyj could only speculate on the possible mechanisms behind this association. "It may be related to the fact that stress alters mom's behavior, and there is some evidence that stress in the first year of life can cause some changes to the gastrointestinal system," she said.

Asthma affects more than 18 million people in the United States, with total direct medical expenditures reaching into the billions.

Not surprisingly, researchers are fast in the pursuit of causes as well as better ways to treat the disease.

Other studies presented this week in Miami Beach found that children and parents of children were under-reporting how much asthma medication the child was taking. By one measure, only one-third of the medicine was actually being used.

The study was undertaken to try to understand why people don't adhere to medication guidelines.

"Most patients don't follow daily treatment regimens no matter how good their doctor is," said Bruce Bender, lead author and head of pediatric behavioral health at National Jewish Medical and Research Center in Denver. "That disconnect is huge, and it's a large factor in how well we control asthma in kids and adults."

Finally, another study done at the VA Greater Los Angeles Healthcare System found that patients with intermittent (as opposed to persistent) asthma accounted for nearly half of all asthma-related emergency department visits.

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

Some Pregnant Women at Higher Risk of Gestational Diabetes

Health Tip: Some Pregnant Women at Higher Risk of Gestational Diabetes
May require careful monitoring

(HealthDay News) -- Gestational diabetes is diabetes that is found for the first time when a woman is pregnant.

Diabetes means that a woman's blood sugar is too high, a condition that isn't good for her or her baby, according to the National Diabetes Information Clearinghouse.

Of every 100 pregnant women, three to eight develop gestational diabetes.

Women are at higher risk if they are overweight or have a family history of diabetes.

If a woman is at higher risk, it's recommended that she be checked for the condition during one of her first prenatal visits.

If she is found to have gestational diabetes, doctors will recommend exercise and changes in diet, and in some cases, will prescribe insulin.

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