Tuesday, February 28, 2006

Health Tip: Paxil and Pregnancy Don't Mix

Health Tip: Paxil and Pregnancy Don't Mix
Pregnant women should avoid the drug, FDA says

(HealthDay News) -- Researchers have found that taking Paxil, a popular antidepressant, in the first three months of pregnancy can increase the risk of birth defects, the U.S. Food and Drug Administration said in a December 2005 news release.

"FDA is advising patients that this drug should usually not be taken during pregnancy, but for some women who have already been taking Paxil, the benefits of continuing may be greater than the potential risk to the fetus," the agency said.

The FDA recommends that expectant mothers who are taking -- or considering taking -- Paxil and similar antidepressants discuss with their doctors the potential risks and benefits.

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

The Fight Against Birth Defects Starts Early

The Fight Against Birth Defects Starts Early
Women should take measures to ensure a healthy pregnancy before conceiving

WEDNESDAY, Feb. 22 (HealthDay News) -- Alicia Clendennin of Quaker Hill, Conn., was 18 weeks' pregnant when routine blood tests revealed her unborn child had a high risk of suffering some sort of birth defect.

Clendennin, now 47, went for an ultrasound, and doctors described what they were seeing as they ran the device over her belly.

"That's when they saw the opening in his back and determined that he did have spina bifida," Clendennin said of the test, performed 11 years ago. "They explained to me right then what they were finding."

Clendennin, a nurse by training and these days an administrator for a home care company, said she couldn't believe what she was hearing. She'd been taking folic acid for years. She'd avoided alcohol. She's not overweight and doesn't smoke.

But her instincts told her the diagnosis was true.

Spina bifida is a neural tube defect, or a birth disorder involving incomplete development of the brain, spinal cord or their protective coverings, according to the U.S. National Institutes of Health. It is caused by the failure of the fetus's spine to close properly during the first month of pregnancy, and at its most extreme can cause paralysis and mental retardation.

Birth defects form, in most cases, extremely early, so the steps a woman can take to try to ensure a healthy pregnancy should be taken far in advance of conception, experts say.

"Many birth defects form during the embryonic period, before a woman even realizes she's missed her first period," said Amy Case, who represents a program that monitors birth defects for the Texas Department of State Health Services.

"Before she can say, 'Oh I'm pregnant, I need to take of myself,' the damage may be done," added Case, who also serves as secretary/treasurer of the National Birth Defects Prevention Network.

It's a tough concept to grasp and keep in mind, studies have shown.

For example, the number of American women taking folic acid supplements -- one of the easiest ways to prevent serious birth defects of the brain and spine -- decreased from 40 percent in 2004 to 33 percent in 2005, according to a March of Dimes study.

But half of all pregnancies in the United States are unplanned, Case said. That means all women of childbearing years owe it to themselves -- and their potential offspring -- to do what they can to prevent birth defects.

"Women who can become pregnant should take very good care of their bodies," she said. "Many of the things they can do need to be done really before they conceive."

About one in 33 infants in the United States is born with a birth defect, and the causes of most defects remain a mystery.

Folic acid has been associated with the prevention of neural tube defects like spina bifida and anencephaly, or incomplete brain formation.

Doctors recommend that women take a vitamin containing 400 micrograms of folic acid every day to prevent these defects from occurring. Again, for the folic acid to work most effectively, it should be in a woman's diet prior to conception.

"You really need to have the folic acid taken on a regular basis three months prior to conception," DaSilva said. "Pregnancy is not a nine-month event. It should be considered a one-year event, with the first months spent preparing your body."

The number of women taking folic acid shot up when the March of Dimes conducted a public campaign for the supplement's use in the late 1990s, DaSilva said. But those numbers have slowly slipped over time.

"Like with everything, unless it's always in the spotlight people have short memories," DaSilva added.

"Someone who plans to have a baby should see a pediatrician, discuss her medical status and review what medication she is taking so the baby won't have birth defects," DaSilva said.

DaSilva also urges women to educate themselves about the ways they can better care for themselves and, as a result, their child-to-be.

Clendennin's pregnancy was difficult: she went into premature labor three times, and spent the last 10 weeks of the pregnancy in bed, resting, trying to give her unborn son a chance to grow as big as possible before she delivered him.

Three hours after Morgan was born, he underwent surgery to close his back.

He's had 14 surgeries since, 12 of them before he was 2 years old. Most of the surgeries dealt with neurological issues caused by hydrocephalus, a secondary defect discovered after his birth that causes excessive fluid in the brain. Shunts were placed in his head to drain off the excess fluid.

Because of these surgeries, and aggressive action taken by his doctors early on, Morgan now is living a mostly normal life.

Morgan has no signs of mental retardation, Clendennin said. He's in braces from the ankles down, but is able to walk without any assistive equipment at all.

The boy is an avid skier, hitting icy, expert slopes without fear, his mother said. He's also shown an artistic side, enjoying theater and art and singing.

Clendennin said knowing what was in store for her son before he was born helped her plan for the good care he's gotten since.

"I really believe it's important to have the prenatal testing done so you know what's going on with the child and you can make important decisions," she noted. "If you know in advance, you can pick your hospitals. You can pick your surgeons. You can pick your method of delivery."

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

Moms' Genetics Might Help Produce Gay Sons

Moms' Genetics Might Help Produce Gay Sons
Women with multiple gay sons make a key chromosomal choice, study suggests

TUESDAY, Feb. 21 (HealthDay News) -- New research adds a twist to the debate on the origins of sexual orientation, suggesting that the genetics of mothers of multiple gay sons act differently than those of other women.

Scientists found that almost one fourth of the mothers who had more than one gay son processed X chromosomes in their bodies in the same way. Normally, women randomly process the chromosomes in one of two ways -- half go one way, half go the other.

The research "confirms that there is a strong genetic basis for sexual orientation, and that for some gay men, genes on the X chromosome are involved," said study co-author Sven Bocklandt, a postdoctoral researcher at the University of California at Los Angeles.

The link between genetics and sexual orientation has been a hot topic for more than a decade as a few scientists have tried to find genes that might make people gay or straight. In the new study, Bocklandt and colleagues examined a phenomenon called "X-chromosome inactivation."

While females have two X chromosomes, they actually require only one and routinely inactivate the other, Bocklandt said. "That way, both men and women have basically one functional X chromosome," he added. Men have both an X and Y chromosome, but the Y chromosome plays a much smaller role, he said.

Women typically inactivate one of their two X chromosomes at random. "It's like flipping a coin," Bocklandt said. "If you look at a woman in any given (bodily) tissue, you'd expect about half of the cells to inactivate one X, and half would inactivate the other."

In the new study, researchers looked at 97 mothers of gay sons and 103 mothers without gay sons to see if there was any difference in how they handled their X chromosomes. The findings appear in the February issue of the journal Human Genetics.

"When we looked at women who have gay kids, in those with more than one gay son, we saw a quarter of them inactivate the same X in virtually every cell we checked," Bocklandt said. "That's extremely unusual."

Forty-four of the women had more than one gay son.

In contrast, 4 percent of mothers with no gay sons activated the chromosome and 13 percent of those with just one gay son did.

The phenomenon of being more likely to inactivate one X chromosome -- known as "extreme skewing" -- is typically seen only in families that have major genetic irregularities, Bocklandt said.

What does this all mean? The researchers aren't sure, but Bocklandt thinks he and his colleagues are moving closer to understanding the origins of sexual orientation.

"What's really remarkable and very novel about this is that you see something in the bodies of women that is linked to a behavioral trait in their sons," he said. "That's new, that's unheard of."

Still, there are caveats. Dr. Ionel Sandovici, a genetics researcher at The Babraham Institute in Cambridge, England, pointed out that most of the mothers of multiple gay sons didn't share the unusual X-chromosome trait. And the study itself is small, which means more research will need to be done to confirm its findings, Sandovici said.

Ultimately, Sandovici added, the origins of sexual orientation remain "rather a complicated biological puzzle."

And this line of research does have its critics. Some have worried that, in the future, manipulation of a "gay gene" or genes might be used as a method of preventing homosexuality in utero, or perhaps even after. But Bocklandt said these kinds of fears shouldn't stand in the way of legitimate scientific research.

"We're trying to understand one of the most critical human traits: the ability to love and be attracted to others. Without sexual reproduction we would not exist, and sexual selection played an essential role in evolution," he said. "Yet, we have no idea how it works, and that's what we're trying to find out. As with any research, the knowledge you acquire could be used for benefit or harm. But if [scientists] would have avoided research because we were afraid of what we were going to find, then we would still be living in the stone age."

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

Drug Might Help Prevent Fetal Alcohol Syndrome

Drug Might Help Prevent Fetal Alcohol Syndrome
Mice exposed to nicotinamide appeared to be protected, scientists say

TUESDAY, Feb. 21 (HealthDay News) -- Nicotinamide, a drug commonly used to treat certain autoimmune diseases, may also help prevent fetal alcohol syndrome, mouse studies suggest.

Fetal alcohol syndrome refers to a number of health problems suffered by babies born to mothers who drank alcohol during pregnancy.

In this study, researchers at Weill Medical College of Cornell University, New York, injected alcohol into mouse pups shortly after they were born. Since mouse brain development happens a bit later than it does in humans, the brain development in newly born mice is about equivalent to that of human fetuses in the third trimester of pregnancy.

This single injection of alcohol into the newborn mice was comparable to levels a human fetus is exposed to during a bout of excessive drinking by a pregnant mother, the researchers explained. The alcohol caused the death of brain cells in the baby mice, who exhibited a number of behavioral abnormalities when they became adults.

In another group of baby mice, the researchers injected nicotinamide two hours after they injected the alcohol.

In this group of mice, the amount of brain cell death appeared to be no greater than that seen during normal brain development. The mice also showed no behavioral abnormalities in adulthood, the researchers add.

A weaker protective effect was noted when nicotinamide was injected eight hours after the alcohol injection.

While this research is in the early stages, it does suggest that nicotinamide may help protect a fetus against alcohol damage if the mother takes the drug soon after she drinks. However, the authors emphasized that the best way to prevent fetal alcohol syndrome is for pregnant women, or those who may become pregnant, to avoid drinking.

The study was published in the Feb. 20 issue of the Public Library of Science.

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!