October 8, 2008, 9:37 PM CT

Guidelines urge physical activity during pregnancy

Moderate physical activity during pregnancy does not contribute to low birth weight, premature birth or miscarriage and may actually reduce the risk of complications, as per a Michigan State University professor who contributed to the U.S. government's first-ever guidelines on physical activity.

Kinesiology professor James Pivarnik and doctoral students Lanay Mudd and Erin Kuffel wrote the section on pregnancy and postpartum activity as part of the 2008 Physical Activity Guidelines unveiled Oct. 7 in Washington, D.C., by the Department of Health and Human Services. Pivarnik, president-elect of the American College of Sports Medicine, attended the event and spoke on behalf of the organization and MSU.

"There has been quite a dramatic change in regards to pregnancy and exercise," said Pivarnik, who has studied the topic for more than 20 years. "While it used to be thought that avoiding exercise meant avoiding harm to the fetus, research now shows physical activity can not only improve health of the mother but also provide potential long-term benefits for the child".

Specifically, the guidelines call for women to get at least 150 minutes of moderate-intensity aerobic activity per week during pregnancy and the postpartum period, preferably spread throughout the week. In addition to health benefits, moderate physical activity also may reduce the length of labor, evidence suggests. The guidelines call for women to avoid doing activities that involve lying on their back after the first trimester and activities with high risk of falling or abdominal trauma......... Posted by: Emily      Read more         Source

September 25, 2008, 11:06 PM CT

Continuous glucose monitoring in diabetic pregnant women

Continuous glucose monitoring as part of antenatal care for women with diabetes improves maternal blood glucose control and lowers birth weight and risk of macrosomia* (excessive birth weight in babies), as per a research studypublished on bmj.com today.

During pregnancy it is important that women with diabetes keep their blood glucose under control. If not, there may be an increase in the amount of glucose reaching the baby, which makes the baby grow faster than normal, and may cause difficulties at birth as well as an increased longer term risk of insulin resistance, obesity and type 2 diabetes.

Evidence suggests that measuring glucose more often improves outcomes, but the optimum frequency of blood glucose testing is not known.

Dr Helen Murphy and his colleagues examined whether continuous glucose monitoring during pregnancy can improve maternal glucose control and reduce birth weight and risk of macrosomia in babies of mothers with diabetes.

They recruited 71 pregnant women with type 1 and type 2 diabetes from antenatal clinics in the UK.

The women were randomly assigned to standard antenatal care (intermittent self monitoring of glucose levels using the finger prick technique) or intermittent monitoring plus continuous glucose monitoring (using glucose values from subcutaneous tissues measured electronically every 10 seconds, giving up to 288 measurements a day)......... Posted by: Emily      Read more         Source

September 25, 2008, 11:04 PM CT

English health care system failing to encourage breastfeeding

The English healthcare system is failing to encourage breast feeding and a national strategy to promote breast feeding is urgently needed, say experts on bmj.com today.

In the UK, the women most likely to use formula milk are young, white and from low socioeconomic backgrounds, and this has created a major public health and inequalities challenge, write Professor Mary Renfrew from the University of York and Professor David Hall from the University of Sheffield.

It is well known that breast feeding improves infant health, and it has been shown to be the single most important preventive approach to saving children's lives.

In spite of national and international policy initiatives, 40% of women in the UK who start to breast feed discontinue by the time their baby is 6 weeks old, and only 20% of infants are exclusively breast fed at six weeks.

Yet evidence has shown that the main reasons cited for discontinuing breastfeeding could be easily remedied. For example, problems getting the baby to feed, or women reporting that breast feeding is painful.

In addition, recent data show that health professionals, particularly doctors, are not adequately trained in giving advice on breast feeding, and often do not know how to position the baby so that feeding is effective and pain free......... Posted by: Emily      Read more         Source

September 17, 2008, 5:15 PM CT

Physical Therapy Treatment Resolves Symptoms Of Urinary Incontinence In Women

In response to a new study reported in the Journal of the American Medical Association showing that pelvic floor disorders, such as urinary incontinence, affect up to one-quarter of American women, the American Physical Therapy Association (APTA) is urging women who suffer from this widespread disorder to consider therapy from a physical therapist.

Recent research has demonstrated physical treatment's effectiveness at treating the symptoms of urinary incontinence. A study reported in the Annals of Internal Medicine (March 18, 2008) reports that pelvic floor muscle training, in conjunction with bladder training, resolved the symptoms of urinary incontinence in women. As per APTA, proper preventive measures and therapy by a physical therapist can help patients manage, if not alleviate, this often debilitating condition.

The study, which included 96 randomized controlled trials and 3 systematic reviews from 1990 through 2007, concluded that pelvic floor muscles training and bladder training resolved urinary incontinence in women, as in comparison to drug treatment, electrostimulation, medical devices, injectable bulking agents, and local estrogen treatment.

"The Annals of Internal Medicine study is significant for a number of reasons, none more so than because it provides the highest levels of evidence to support the importance of intervention by a physical therapist who specializes in treating urinary incontinence," says Cynthia E Neville, PT, BCIA-PMDB, director of Women's Health Rehabilitation at the Rehabilitation Institute of Chicago......... Posted by: Emily      Read more         Source

September 17, 2008, 5:08 PM CT

Pelvic disorders affect large number of women

Nearly one-quarter of all women suffer from pelvic-floor disorders, such as incontinence, at some point in their lives, a national study, including scientists from UT Southwestern Medical Center, has found.

The study of nearly 2,000 women in seven U.S. cities observed that 23.7 percent of participants had experienced at least one pelvic-floor disorder, and the risk increased with age.

"This study is the first nationwide study to confirm what we consider a high prevalence of pelvic-floor disorders in the U.S.," said Dr. Joseph Schaffer, professor of obstetrics and gynecology at UT Southwestern and an author of the study, which appears in today's issue of the Journal of the American Medical Association.

"Nearly a quarter of all women suffer from at least one pelvic-floor disorder, and, with the aging of the population, this will become more prevalent," he said.

The national rate of pelvic-floor disorders has not been well-studied, eventhough several regional studies have observed that almost 10 percent of women go through surgery for such conditions at some point in their lives, while one-third of those women have two or more surgeries.

The current study was designed to assess the national rate of such disorders. The participating women were interviewed in 2005 and 2006 at their homes or at a mobile interview center and did not undergo physical examination. The questions were part of the National Health and Nutrition Examination Survey......... Posted by: Emily      Read more         Source

September 10, 2008, 8:43 PM CT

Gap junction protein vital to successful pregnancy

Scientists studying a critical stage of pregnancy implantation of the embryo in the uterus have found a protein that is vital to the growth of new blood vessels that sustain the embryo. Without this protein, which is produced in higher quantities in the presence of estrogen, the embryo is unlikely to survive.

This is the first study to detail the mechanism by which the steroid hormone estrogen spurs cell differentiation and blood-vessel growth in the uterus during pregnancy, the scientists report.

The findings, from scientists at the University of Illinois, Emory University, Baylor College of Medicine and New York University, appear in the journal Development

Connexin 43 (Cx43) belongs to a family of proteins that form junctions between cells that regulate the flow of ions and small signaling molecules from cell to cell. At the time of embryo implantation, this gap junction protein is essential to the rapid growth of new blood vessels needed to support the development of the embryo and allow it to implant in the uterine wall, the scientists discovered.

The scientists chose to study Cx43 after analyzing genes that are activated in the presence of estrogen in uterine cells. They observed that Cx43 was prominent among the genes whose expression was increased in cells after exposure to estrogen......... Posted by: Emily      Read more         Source

September 9, 2008, 8:54 PM CT

Calcium during pregnancy reduces harmful blood lead levels

Pregnant women who take high levels of daily calcium supplements show a marked reduction in lead levels in their blood, suggesting calcium could play a critical role in reducing fetal and infant exposure.

A new study at the University of Michigan shows that women who take 1,200 milligrams of calcium daily have up to a 31 percent reduction in lead levels.

Women who used lead-glazed ceramics and those with high bone lead levels showed the largest reductions; the average reduction was about 11 percent, said Howard Hu, chair of the Department of Environmental Health Sciences at the School of Public Health.

Hu is the principal investigator of the study and one of the senior authors on the paper, which is available online in Environmental Health Perspectives, the official journal of the U.S. National Institute for Environmental Health Sciences. Hu, who is also affiliated with the University of Michigan School of Medicine, said this is the first known randomized study examining calcium supplementation on lead levels in pregnant women.

"We and others have previously shown that during pregnancy, mothers can transfer lead from their bones to their unborn -- with significant adverse consequences--making maternal bone lead stores a threat even if current environmental lead exposures are low," Hu said. "This study demonstrates that dietary calcium supplementation during pregnancy may constitute a low-cost and low-risk approach for reducing this threat."........ Posted by: Emily      Read more         Source

September 9, 2008, 8:44 PM CT

Eating fish while pregnant and longer breastfeeding

Both higher fish consumption and longer breastfeeding are associated with better physical and cognitive development in infants, as per a research studyof mothers and infants from Denmark. Maternal fish consumption and longer breastfeeding were independently beneficial.

"These results, together with findings from other studies of women in the U.S. and the United Kingdom, provide additional evidence that moderate maternal fish intake during pregnancy does not harm child development and may on balance be beneficial," said Assistant Professor Emily Oken, lead author of the study.

The study, which appeared in the recent issue of the American Journal of Clinical Nutrition, was conducted by scientists from the Department of Ambulatory Care and Prevention of Harvard Medical School and Harvard Pilgrim Health Care and the Maternal Nutrition Group from the Department of Epidemiology at Statens Serum Institut in Copenhagen, Denmark. These findings provide further evidence that the omega-3 fatty acids found in fish and compounds in breast milk are beneficial to infant development.

The study team looked at 25,446 children born to mothers participating in the Danish Birth Cohort, a study that includes pregnant women enrolled from 1997-2002. Mothers were interviewed about child development markers at 6 and 18 months postpartum and asked about their breastfeeding at 6 months postpartum. Prenatal diet, including amounts and types of fish consumed weekly, was assessed by a detailed food frequency questionnaire administered when they were six months pregnant......... Posted by: Emily      Read more         Source

September 3, 2008, 6:55 PM CT

Natural childbirth makes mothers more responsive to own baby-cry

A new study has observed that mothers who delivered vaginally in comparison to caesarean section delivery (CSD) were significantly more responsive to the cry of their own baby, identified through MRI brain scans two to four weeks after delivery.

The results of the study, would be published recently in The Journal of Child Psychology and Psychiatry, suggest that vaginal delivery (VD) mothers are more sensitive to own baby-cry in the regions of the brain that are believed to regulate emotions, motivation and habitual behaviours.

CSD is a surgical procedure, in which delivery occurs via incisions in the abdominal and uterine wall. It is considered necessary under some conditions to protect the health or survival of infant or mother, but it is controversially linked with postpartum depression. In the US the occurrence of CSD has increased steeply from 4.5% of all deliveries in 1965 to a recent high in 2006 of 29.1%.

The critical capacity of adults to develop the thoughts and behaviours needed for parents to care successfully for their newborn infants is supported by specific brain circuits and a range of hormones. The experience of childbirth by VD compared with CSD uniquely involves the pulsatile release of oxytocin from the posterior pituitary, uterine contractions and vagino-cervical stimulation. Oxytocin is a key mediator of maternal behaviour in animals......... Posted by: Emily      Read more         Source

August 31, 2008, 8:14 PM CT

'Superbug' breast infections controllable in nursing mothers

A number of nursing mothers who have been hospitalized for breast abscesses are afflicted with the "superbug" methicillin-resistant Staphylococcus aureus, or MRSA, but as per new research by UT Southwestern Medical Center physicians, conservative therapy can deal with the problem.

The study focused on hospitalized women with mastitis, and showed that MRSA was much more likely to be found in those who had both mastitis (an inflammation of the milk glands) and abscesses (pockets of infection).

"The take-home message is that a patient with mastitis does not necessarily need an antibiotic against MRSA," said Dr. George Wendel, professor of obstetrics and gynecology and senior author of the study, which appears in the recent issue of the journal Obstetrics and Gynecology. "She will improve with a less specific antibiotic as long as she also empties her breasts, either through feeding or pumping, and if there's an abscess, gets it treated".

The study also showed that if a nursing mother has an abscess, she does not immediately need antibiotics against MRSA, but can be switched to them if tests reveal she has MRSA.

The study was designed to determine which antibiotic therapy is best for severe cases of mastitis, which can be caused by clogged milk ducts with or without infection, and breast abscesses, which are caused by bacterial infections, generally by aureus. There are a number of strains of staph, one of which is MRSA......... Posted by: Emily      Read more         Source

August 27, 2008, 9:13 PM CT

Pregnancy situations have impact on brain development

Brain development in infants who are born very prematurely is still incomplete. Factors that cause premature birth may have an impact on the development of the premature infant's brain both during pregnancy and later on after birth. A project conducted as part of the Academy of Finland Research Programme on Neuroscience (NEURO) is concerned to study brain growth and development invery premature or low-weight infants.

The central nervous system in small premature infants is highly susceptible to damage as the immature organism tries to adapt to the intensive care environment following release from the intrauterine environment. Researchers working on the PIPARI project at Turku University Central Hospital have followed premature low-weight infants and investigated factors impacting the growth and development of their brain as well as their two-year prognosis from pregnancy onwards. A total of 232 pre-term infants have been followed and in comparison to 246 full-term controls. The children will be followed for a total of six years, from birth through to school age.

The results of the project indicate that the redistribution of foetal blood flow, indicative of placental insufficiency, leads to smaller brain volume in preterm infants at term equivalent age. In this situation the foetus directs a larger proportion of the blood flow to its brain......... Posted by: Emily      Read more         Source

August 27, 2008, 6:56 PM CT

Factors may prevent postpartum smoking relapse

Eventhough a number of women quit smoking during pregnancy to protect their unborn children from the effects of cigarettes, half of them resume the habit within a few months of giving birth.

By shedding light on the factors that enable the other half to put down that cigarette for good, a study by scientists at the University of North Carolina at Chapel Hill could lead to programs designed to help women quit and stay quit.

As per the study, women with a live-in partner who shared some of the burden of child-rearing were more likely to remain smoke free, while women who were single mothers or who lacked the social and financial resources to deal with being a new parent were more likely to relapse.

"In the future we can look at these and other factors in women who quit smoking during pregnancy to assess who is at low or high risk of relapse," said Carol E. Ripley-Moffitt, MDiv, research associate in UNC's department of family medicine and the study's lead author. "We can then offer more intensive interventions for those at higher risk to address the physical, behavioral and social issues correlation to relapse".

Smoking during pregnancy increases the risks of pregnancy complications, decreased birth weight and SIDS (Sudden Infant Death Syndrome), Ripley-Moffitt said. She noted that the past 15 years have seen a steady decrease in the number of women who smoke while pregnant, in part because of an overall decline in smoking rates among all women of childbearing age and in part because of interventions targeting women during the prenatal period......... Posted by: Emily      Read more         Source

August 20, 2008, 1:27 AM CT

Alcohol dependence linked to delayed childbearing

Alcohol use during the teen years can not only lead to subsequent alcohol problems, it can also lead to risky sexual behavior and a greater risk of early childbearing. An examination of the relationship between a lifetime history of alcohol dependence (AD) and timing of first childbirth across reproductive development has observed that AD in women is linked to delayed reproduction.

Results would be reported in the recent issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"Reproductive dysfunctions include a range of menstrual disorders, sexual dysfunctions, and pregnancy complications that include spontaneous abortion or miscarriage," explained Mary Waldron, assistant professor of psychiatry at Washington University School of Medicine and corresponding author for the study. "Teenagers who drink tend to have disruptions in their menstrual cycle as well as unplanned pregnancies."

These complications may become more pronounced with time, added Sharon C. Wilsnack, Chester Fritz Distinguished Professor in the department of clinical neuroscience at the University of North Dakota School of Medicine & Health Sciences. "Higher rates of reproductive dysfunction in adult women may reflect the cumulative effects of longer exposure to alcohol for older women than for female adolescents," she said......... Posted by: Janet      Read more         Source

August 18, 2008, 8:55 PM CT

Oral contraceptives may ease suffering of women with severe PMS

A new clinical trial at the University of North Carolina at Chapel Hill using a popular low-dose contraceptive could uncover a more effective therapy for the 5 to 10 percent of women who suffer from premenstrual dysphoric disorder (PMDD).

PMDD is much more severe than premenstrual syndrome, or PMS. The disorder interferes with a woman's ability to function effectively several days out of each month, every month. Physical symptoms include bloating, low energy, heart palpitations and joint or muscle pain. Far more disruptive emotional symptoms include irritability, anxiety, depression, mood swings, difficulty focusing and trouble sleeping. For a number of women with PMDD, five or more of these symptoms occur the week before menstruation starts and disappear a few days after the period begins.

The National Institute of Mental Health awarded UNC a $3 million grant for a five-year clinical trial using a low-dose contraceptive called YAZ (ethinyl estradiol/drospirenone). The trial is based on prior research by David Rubinow, M.D., the Asad Meymandi Distinguished Professor and chair of psychiatry in the UNC School of Medicine.

Rubinow discovered it is the change in not the level of reproductive hormones that triggers depression in women who are susceptible to PMDD. In other words, women with the disorder don't have abnormal levels of reproductive hormones, but are more sensitive to the shifts in them that occur previous to menstruation. That sensitivity triggers mood symptoms......... Posted by: Emily      Read more         Source

July 15, 2008, 10:40 PM CT

Caesarean section: no consensus on best technique

Despite the routine delivery of babies by caesarean section, there is no consensus among medical practitioners on which is the best operating method to use. In a systematic review published in The Cochrane Library, scientists call for further studies to establish the safest method for both mother and infant.

"Caesarean section is a very common operation, yet there is a lack of high quality information available to inform best practice," says researcher Simon Gates of the Clinical Trials Unit at the University of Warwick.

Techniques used during caesarean section operations depend largely on the preferences of individual surgeons. Their personal preference can affect the length of the operation, amount of blood lost, risk of infection and the level of pain experienced by a woman following surgery.

The review includes 15 trials that together involved 3,972 women. Eventhough results from several of these trials suggest that single layer closure of the uterus after delivery reduces blood loss and operation times in comparison to double layer closure, there was no information on other important outcomes such as infection and subsequent complications. The scientists found only very limited data on incision techniques and instruments, as well as methods used to close the uterus. They were therefore unable to make recommendations as to the most appropriate surgical procedure......... Posted by: Emily      Read more         Source

July 9, 2008, 7:30 PM CT

Predicting birthweights in obese mothers

Scientists have found what they believe to be the most accurate way of predicting the birth-weight of babies born to the growing number of obese mothers, as per a research studyin the UK-based journal Ultrasound in Obstetrics and Gynecology

Experts from the University of Rochester Strong Memorial Hospital in Rochester, New York, USA, have recorded accurate results in more than nine out of ten cases using the gestation-adjusted projection method (GAP).

The GAP method uses a range of ultrasound measurements, taken when the mother is 34 to 36 weeks pregnant, and a mathematical formula to determine whether the baby is larger than the average size of babies for its gestational age. This data is then used to predict the final birth weight.

GAP is very useful when a pregnant woman is obese, as this often makes it difficult for medical staff to obtain a clear ultrasound image of her baby. This is especially true at the end stages of pregnancies, when most birth weight measurements are obtained, so doing this earlier in the pregnancy is a distinct advantage. Prior research carried out at the University of Rochester has already shown GAP to be accurate when used on diabetic and non-diabetic patients.

"Obesity is a risk factor for almost all complications correlation to pregnancy" explains Dr Loralei Thornburg from the Division of Maternal Fetal Medicine at the University. "It is especially important to identify high birth-weight babies over 4,000 grams (just under nine pounds) as these are linked to higher complication rates for mothers and babies......... Posted by: Emily      Read more         Source

July 7, 2008, 9:34 PM CT

Pregnancy and risk of heart attack

Eventhough acute myocardial infarction (AMI) is rare in women of child-bearing age, pregnancy can increase a woman's risk of heart attack 3- to 4-fold, as per a research studyreported in the July 15, 2008, issue of the Journal of the American College of Cardiology Since women today may delay having children until during the later part of life, and advances in reproductive medicine enable older women to conceive, the occurrence of AMI linked to pregnancy is expected to increase.

The study, authored by Arie Roth, M.D., Tel Aviv University in Israel, and Uri Elkayam, M.D., University of Southern California (USC), is a follow up to their initial report released in 1995. The report is based on a review of 103 women with pregnancy-related AMI in the last decade and outlines key recommendations for the diagnosis and therapy of this condition in pregnant women that also considers the health and safety of the developing baby.

"It's extremely important that physicians who take care of women during pregnancy and after delivery be aware of the occasional occurrence of AMI in pregnancy and not overlook symptoms in these young patients," said Dr. Elkayam, who is a professor of Medicine and Obstetrics and Gynecology at USC. "Eventhough a number of of the standard principles for diagnosing and treating AMI in non-pregnant patients also apply to pregnant women, two patients need to be treatedthe mother and her babyand the health status of both should play a major role in the selection of diagnostic and therapeutic strategies"......... Posted by: Emily      Read more         Source

July 3, 2008, 8:55 PM CT

Disclosing violence to primary care or obestetrics

Scientists from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) observed that patients who disclose intimate partner violence (IPV) to their clinicians of any type did not experience serious harm. However, those who disclosed IPV in a primary care or obstetrics/gynecology setting received the most benefit. The findings, which appear in the Biomedical Central Public Health Journal, also conclude that disclosures made in an emergency department setting were more problematic from the patient's point of view.

Scientists studied 27 IPV survivors recruited through community support programs in Massachusetts. The participants were given in-depth interviews to ascertain types of medical encounters relating to abuse, with encounters described as either single interactions or continued contact over a period of time.

Participants described disclosure of IPV to medical personnel. They also reported episodes in which they were asked about or treated for an IPV related problem in which they did not disclose. The scientists determined the medical specialty in which the encounters occurred, and limited their focus to emergency department, obstetrical/gynecological care, and primary care. The scientists also labeled whether harms occurred as a result of any disclosure as well as the perceived helpfulness (beneficial or not)......... Posted by: JoAnn      Read more         Source

July 1, 2008, 9:29 PM CT

Find ways to predict IVF success

Scientists at the Stanford University School of Medicine have identified a method that can predict with 70 percent accuracy whether a woman undergoing in vitro fertilization therapy will become pregnant. This information may someday help the tens of thousands of couples who want to undergo IVF each year, and their doctors, decide on their course of action.

The new method involves using four factors to determine a woman's chance of becoming pregnant from an IVF cycle. These variables may prove "critical in counseling patients, improving therapy, and ultimately in developing. more customized therapys," the authors wrote in a paper that will appear in the July 2 issue of Public Library of Science-ONE

The research was led by Mylene Yao, MD, assistant professor of obstetrics and gynecology, whose work focuses on early embryo development.

IVF is a therapy given to boost the chances for women to get pregnant. During IVF, a woman is given drugs to stimulate ovulation, and her eggs are removed from the ovaries. The eggs are then combined with sperm in a culture dish in a laboratory.

A typical IVF cycle produces five to 12 embryos, and doctors aim to transfer the "best quality" one or two into a woman's uterus. Doctors use a variety of criteria to identify which embryos are most likely to result in a live birth, including how the embryo looks and whether the embryo has hit certain milestones, such as having reached the eight-cell stage by its third day of existence......... Posted by: Emily      Read more         Source

June 18, 2008, 9:08 PM CT

Caesarean sections associated with risk of asthma

Babies born by Caesarean section have a 50 % increased risk of developing asthma in comparison to babies born naturally. Emergency Caesarean sections increase the risk even further. This is shown in a new study based on data from 1.7 million births registered at the Medical Birth Registry at the Norwegian Institute of Public Health.

The goal of the study was to investigate the possible link between being born by Caesarean section and later development of asthma.

Summarised results from the study:.

• In comparison to children born in the natural way (i.e. spontaneously and vaginally), children born by Caesarean section had an approximately 50 % increased risk of developing asthma.
• Children born vaginally, but with assistance from vacuum or forceps, had a 20 % increased risk of asthma.
• For children born between 1988 and 1998, planned Caesarean section was linked to an approximately 40 % increased risk of asthma while emergency Caesarean section was linked to a 60 % increased risk.

.

Why do Caesarean sections give an increased risk of asthma?

- We found a moderately strong association between birth by Caesarean section and asthma in childhood, says doctor and research fellow Mette Christophersen Tollånes, who works for both the Norwegian Institute of Public Health and the Department of Public Health and Primary Health Care at the University of Bergen, Norway......... Posted by: Emily      Read more         Source

June 16, 2008, 10:09 PM CT

Abortion drug's off-label use may have led to deaths

Preliminary U-M studies indicate that oral use of RU-486's companion drug misoprostol is safe, but vaginal use may undermine body's immune responses.

The off-label use of a drug given with RU-486 to terminate a pregnancy may be responsible for a handful of rare, fatal infections seen in women taking the drugs since 2000, a study by University of Michigan researchers suggests.

The drug misoprostol is FDA-approved to be taken by mouth along with RU-486 to end a pregnancy. But a number of women have received the drug vaginally as part of the two-drug combination, a method of delivery not reviewed by the FDA.

In animal and cell culture studies, the U-M scientists observed that misoprostol, when given directly in the reproductive tract, suppresses key immune responses and can allow a normally non-threatening bacterium, Clostridium sordellii, to gain the upper hand and cause deadly infection. When absorbed through the stomach, however, the drug did not compromise immune defenses or cause illness.

The study, which appears today online ahead of print in the Journal of Immunology, also has implications for understanding dangerous infections that occur during pregnancy.

"Infections after medicine abortions are rare, and Clostridium infections after abortion are exceedingly rare," says David Aronoff, M.D., an infectious disease specialist who led the U-M study......... Posted by: Emily      Read more         Source

June 16, 2008, 9:19 PM CT

Complex Changes in the Brain's Vascular System Occur after Menopause

A number of women experience menopausal changes in their body including hot flashes, moodiness and fatigue, but the changes they don't notice can be more dangerous. In a new study, scientists at the University of Missouri have discovered significant changes in the brain's vascular system when the ovaries stop producing estrogen. MU researchers predict that currently used estrogen-based hormone therapies may complicate this process and may do more harm than good in postmenopausal women.

"Before menopause, women are much more protected from certain conditions such as heart disease and stroke, but these vascular changes might explain why women lose this protection after menopause," said Olga Glinskii, research assistant professor of medical pharmacology and physiology in MU's School of Medicine and lead author of the study. "Because the body eventually will naturally adapt to the loss of estrogen, we advise extreme caution when using estrogen-based treatment in postmenopausal women".

In their study, MU scientists removed the ovaries of pigs, which have a reproductive cycle similar to humans, to create postmenopausal conditions. Two months after the ovaries were removed, they observed dramatic differences in the brain's vascular system. There was a huge loss of micro vessels, and blood vessels became "leaky"......... Posted by: JoAnn      Read more         Source

June 16, 2008, 9:16 PM CT

Hot flashes underreported and linked to forgetfulness

Women in midlife underreport the number of hot flashes that they experience by more than 40 percent, and these hot flashes are associated with poor verbal memory, as per a research studyby scientists at the University of Illinois at Chicago.

The study is published online and will appear in the September/recent issue of the journal Menopause

It is the first study to explore the relationship between objectively measured hot flashes and memory performance.

Memory complaints are common at midlife, and prior research indicates that about 40 percent of midlife women report forgetfulness.

Many studies have looked at the relationship between menopausal symptoms (vasomotor symptoms, hot flashes and sleep disturbances that accompany hot flashes) and memory complaints and found no relationship between subjective, or self-reported, hot flashes and objective performance on memory tests in women.

These findings have left a number of to assume that there is no relationship between menopausal symptoms and memory dysfunction in women, said Maki.

"The problem is that the physiology of hot flashes and the science of hot flashes is more complex than we previously understood," she said.

The scientists enrolled 29 midlife women with moderate to severe hot flashes in an observational study. The women wore monitors that measured changes in skin conductance during a hot flash. Both subjective and objective hot flashes were recorded during a 24-hour period. The average number of objective hot flashes was 19.5 per day......... Posted by: Janet      Read more         Source

June 9, 2008, 8:27 PM CT

Mother's obesity and newborn deaths

maternal obesity appears to have no impact on the early survival of infants born to white women, the situation is different for black women, scientists report in the June 2008 issue of the journal Obstetrics & Gynecology.

Infants of obese black mothers had a higher risk of death in the first 27 days following birth than newborns of obese white mothers, the scientists found. Furthermore, this black disadvantage in neonatal infant mortality widened with an increase in the body mass index (BMI).

"Even if the infant of an obese black woman survives pregnancy, labor and delivery, that baby is at greater risk of dying than a baby born to an obese white woman," said the study's lead author Hamisu Salihu, MD, PhD, associate professor of epidemiology at the USF College of Public Health.

The scientists analyzed more than 1.4 million births recorded from Missouri's vital records database, covering the period 1978 through 1997. The database linked black and white mother-infant pairs. Among all women, the likelihood of neonatal death (up to 27 days following death) and early neonatal death (up to six days following death) was 20 percent greater than for nonobese women, the researcher found.

Further analysis revealed that the higher risk of neonatal deaths among newborns of obese mothers was confined to blacks only. The rate of neonatal deaths increased significantly with rising BMIs of black women (ranging from 50 to 100-percent increments). However, the offspring of obese white mothers, regardless of the severity of maternal obesity, had no greater risk of neonatal death than the newborns of nonobese women......... Posted by: Emily      Read more         Source