June 11, 2009, 5:11 AM CT

Depressed mood may lead to premature birth

Scientists trying to uncover why premature birth is a growing problem in the United States and one that disproportionately affects black women have observed that pre-pregnancy depressive mood may be a risk factor in preterm birth among both blacks and whites.

Black women, however, have nearly two times the odds of having a preterm birth in comparison to white women, as per Amelia Gavin, a University of Washington assistant professor of social work and main author of a newly released study that appears online in the recent issue of the Journal of Women's Health.

"Preterm births are one of the most significant health disparities in the United States and the overall number of these births increased from 10.6 percent in 2000 to 12.8 percent in 2005," she said.

While there may be some sort of link between giving birth prematurely and depressed mood, the study found no cause and effect, said Gavin, who studies health disparities. She believes the higher preterm birth rate among blacks appears to be the result of declining health over time among black women.

For this study, premature birth referred to any child born after less than 37 weeks of gestation. Normal gestation ranges from 38 to 42 weeks. Data for the study was drawn from a larger longitudinal investigation looking at the risks for cardiovascular disease among more than 5,000 young adults in four metropolitan areas. The Coronary Artery Risk Development in Young Adults Study also collected information about mental health and pregnancy outcomes. Between 1990 and 1996, 555 women in the larger study gave birth. These women were the subjects in the depression-premature birth study......... Posted by: Emily      Read more         Source

June 11, 2009, 5:03 AM CT

Snoring pregnant women

If you are pregnant and your mate complains your frequent snoring is rattling the bedroom windows, you may have bigger problems than an annoyed, sleep-deprived partner.

A newly released study from scientists at the Northwestern University Feinberg School of Medicine has observed that women who reported frequent snoring during their pregnancy were more likely to develop gestational diabetes -- a condition than can cause health problems for the mother and baby. The study also found pregnancy increases the likelihood that a woman will snore.

This is the first study to report a link between snoring and gestational diabetes.

For the study, 189 healthy women completed a sleep survey at the time of enrollment (six to 20 weeks gestation) and in the third trimester.

Pregnant women who were frequent snorers had a 14.3 percent chance of developing gestational diabetes, while women who did not snore had a 3.3 percent chance. Even when scientists controlled for other factors that could contribute to gestational diabetes such as body mass index, age, race and ethnicity, frequent snoring was still.

linked to the disease.

Principal investigator Francesca Facco, M.D., a fellow at Northwestern's Feinberg School, will present her findings at the SLEEP 2009 23rd Annual Meeting of the Associated Professional Sleep Societies June 11......... Posted by: Emily      Read more         Source

May 20, 2009, 6:54 PM CT

Risk of Gestational diabetes

Gestational diabetes happens in more than three per cent of pregnancies in Ontario. Commonly the condition resolves itself after delivery, but a number of studies have shown that these women are at a very high risk for developing "regular" type 2 diabetes during the later part of life. New research out of the Institute for Clinical Evaluative Sciences (ICES) has observed that even women with mild abnormalities in their blood sugar during pregnancy, previously thought not to have any clinical significance, are 2.5 times more likely to develop type 2 diabetes in comparison to those who had completely normal glucose testing.

• To test for gestational diabetes, women receive a glucose challenge test (GCT) in the late second trimester of pregnancy. If the result of this test is abnormal, they go on to have a diagnostic test, called the oral glucose tolerance test (OGTT). If this test does not show gestational diabetes, women are reassured their glucose levels are normal and that no further testing is needed.
• However, recent studies have suggested that women who have even mild abnormalities on either the GCT or the OGTT do actually have subtle differences in their metabolism after pregnancy.
• The study examined 15,000 pregnant women aged 20-49 in Ontario who had a mild abnormality on their GCT but did not ultimately get diagnosed with gestational diabetes. They were in comparison to about 60,000 pregnant women who did not have abnormalities on their GCT. The women were followed for 6.4 years after delivery, and those who had had an abnormal GCT were 2.5 times more likely to develop type 2 diabetes in comparison to those who had not had an abnormal GCT.

........ Posted by: Emily      Read more         Source

May 20, 2009, 5:22 AM CT

Post menopausal hormone replacement and breast cancer

The risk of developing breast cancer due to taking hormone replacement treatment may be the same for women with a family history of the disease and without a family history, a University of Rochester Medical Center study concluded.

The study, published online this week in the journal Epidemiology, adds to the evolving picture of what factors, either alone or in combination, boost breast cancer risk among postmenopausal women. It also refutes the notion, held by a number of in the medical community, that a familial predisposition to breast cancer enhances the carcinogenic effects of estrogen.

"Eventhough we know that family history is a risk factor, we don't know yet what it is about family history that conveys the risk," said Robert E. Gramling, M.D., D.Sc., assistant professor of Family Medicine and of Community and Preventive Medicine at URMC. "Some have proposed that it might be an increased sensitivity to estrogen, but our data did not support that notion. In fact, this study suggests the causal pathway based on family history is probably not estrogen sensitivity".

Scientists analyzed data from the Women's Health Initiative randomized trial, which followed 16,608 postmenopausal women, ages 50 to 79, who took hormone replacement treatment (HRT) or a placebo pill between 1993 and 2002. Among the participants, 349 cases of invasive breast cancer occurred during a mean follow-up period of 5.6 years......... Posted by: Janet      Read more         Source

May 18, 2009, 5:30 AM CT

Genetic links to age of first menstrual period and menopause

Newly identified gene variants linked to the age at which females experience their first menstrual period and the onset of menopause may help shed light on the prevention of breast and endometrial cancer, osteoporosis, and cardiovascular disease.

In a newly released study, scientists from Harvard School of Public Health (HSPH), Brigham and Women's Hospital (BWH), National Cancer Institute (NCI), and the Broad Institute of Harvard and MIT report that they have identified 10 genetic variants in two chromosomal regions linked to age at menarche (the first menstrual period), and 13 genetic variants in four chromosomal regions linked to age at natural menopause. The paper, "Genome-wide association studies identify loci linked to age at menarche and at natural menopause," will publish online in Nature Genetics on May 17, 2009 ( http://www.nature.com/ng/journal/vaop/ncurrent/index.html ).

Menarche and natural menopause are two important physiological events in a woman's life. An early onset of menarche and later menopause are well-established risk factors for the development of breast cancer and endometrial cancer, the scientists explain. Conversely, early menopause increases risk of osteoporosis and cardiovascular disease.

Prior studies have suggested both menarche and menopause appears to be partially under genetic control. To identify common genetic variants influencing these states, the scientists analyzed more than 317,000 gene variants in a total of 17,438 women from the Nurses' Health Study (NHS) and the Women's Genome Health Study (WGHS) based at BWH......... Posted by: Emily      Read more         Source

May 15, 2009, 5:29 AM CT

Quitting smoking during pregnancy?

Scientists from the Peninsula Medical School and the University of Bristol, using data from the Avon Longitudinal Study of Parents and Children and the Exeter Family Study of Childhood Health, have identified a common genetic variant that explains why some women may find it more difficult to quit smoking during pregnancy.

Their paper, "A common genetic variant in 15q24 nicotinic acetylcholine receptor gene cluster (CHRNA5-CHRNA3-CHRNB4) is linked to a reduced ability of women to quit smoking in pregnancy", is published in Human Molecular Genetics

Maternal smoking during pregnancy is linked to low birth weight and problems at birth. Statistically, women are more likely to quit smoking during pregnancy that at any other time in the lives, but some pregnant women continue to smoke despite a strong and direct public health message.

The study tested whether a genetic variant that is correlation to greater cigarette consumption was also responsible for a reduced likelihood of quitting smoking during pregnancy.

The research team studied 7,845 women of European descent from the South West of England. Using 2,474 women who smoked regularly immediately before they became pregnant, the association between the variant and smoking cessation and smoking quantity during pregnancy was analysed......... Posted by: Emily      Read more         Source

May 13, 2009, 5:29 AM CT

Taking folic acid for a year before pregnancy

Women who take folic acid supplements for at least one year before they become pregnant may cut their risk of having a premature baby by half, as per research published this week in the online journal, PLoS Medicine

The study links pre-conceptional folate supplementation of at least one year to reduced early premature delivery rates of 50 to 70 percent, regardless of age, race or other factors. Of particular note is the drop in very early premature births, those babies who are at the greatest risk of complications such as cerebral palsy, mental retardation, chronic lung disease, and blindness.

The study is an observational analysis based on the self-reporting of folate supplementation by 38,033 participants in an earlier trial sponsored by the National Institutes of Health (NIH.) The current study only examined singleton pregnancies and excluded pregnancies with medical or obstetrical complications such as preeclampsia, chronic hypertension, or other abnormalities.

"Through the NIH trials, we received highly accurate evidence of gestational age enabling us to determine that folate supplementation for at least one year is associated with a 70 percent decrease in very early preterm deliveries (20 to 28 weeks gestation) and up to a 50 percent reduction in early preterm deliveries of 28 to 32 weeks," said Radek Bukowski, M.D., Ph.D., associate professor, in the Department of Obstetrics and Gynecology, at the University of Texas Medical Branch at Galveston, the lead study author......... Posted by: Emily      Read more         Source

May 5, 2009, 5:22 AM CT

Iron deficiency in womb and brain maturation

Iron plays a large role in brain development in the womb, and new University of Rochester Medical Center research shows an iron deficiency may delay the development of auditory nervous system in preemies. This delay could affect babies ability to process sound which is critical for later language development in early childhood.

The study reviewed 80 infants over 18 months, testing their cord blood for iron levels and using a non-invasive tool -- auditory brainstem-evoked response (ABR) -- to measure the maturity of the brain's auditory nervous system soon after birth. The study observed that the brains of infants with low iron levels in their cord blood had abnormal maturation of auditory system in comparison to infants with normal cord iron levels.

"Sound isn't transmitted as well through the immature auditory pathway in the brains of premature babies who are deficient in iron as in comparison to premature babies who have enough iron," said Sanjiv Amin, M.D., associate professor of Pediatrics at the University of Rochester Medical Center and author of the abstract presented today at the Pediatric Academic Society meeting in Baltimore. "We suspect that if the auditory neural system is affected during developmental phase, then other parts of the brain could also be affected in the presence of iron deficiency"......... Posted by: Emily      Read more         Source

May 4, 2009, 5:14 AM CT

Late motherhood boosts family lifespan

Women who have babies naturally in their 40s or 50s tend to live longer than other women. Now, a newly released study shows their brothers also live longer, but the brothers' wives do not, suggesting the same genes prolong lifespan and female fertility, and appears to be more important than social and environmental factors.

"If women in your family give birth at older ages, you may well have a chance of living longer than you would otherwise," says the study's main author, demographer Ken R. Smith, a professor of family and consumer studies at the University of Utah. "If you have a female relative who had children after age 45, then there appears to be some genetic benefit in your family that will enhance your longevity".

For descendants of the Utah and Quebec pioneers studied, "you appears to be able to look at the ages when your female ancestors gave birth rather than just their longevity in estimating how long you may live," says Smith, whose study will be published online May 4 and in the June 10 print issue of the Journal of Gerontology: Biological Sciences

The scientists examined high-quality genealogical records from the Utah Population Database at the University of Utah with its records of 1.6 million Utah Mormon pioneers and their descendants. They also used the University of Montreal's Program on Demographic History Research, which has records on 400,000 people who lived in heavily Catholic Quebec between 1608 and 1850......... Posted by: Emily      Read more         Source

April 30, 2009, 9:50 PM CT

Management of asthma during pregnancy

Pregnant women with asthma, the most common condition affecting the lungs during pregnancy, should actively manage their asthma in order to optimize the health of mother and the baby, as per new management recommendations reported in the current issue of the New England Journal (NEJM)

"Though studies suggest asthma during pregnancy can increase health risks for mom and baby, our research shows that women who manage their asthma can have as healthy a pregnancy as women who don't have asthma," said Michael Schatz, MD, main author of the NEJM recommendations and chief of the Allergy Department at Kaiser Permanente Medical Center, San Diego, Calif. "A number of studies suggest that asthma can increase the risk of pregnancy complications, including preeclampsia, low birth-weight babies or preterm birth, however, women with well-controlled asthma in pregnancy generally have good pregnancy outcomes. Women who have asthma and are considering pregnancy should speak with their doctors to develop a treatment plan".

The recommendations are based to a large degree on a 12-year Kaiser Permanente study of 1,900 pregnant women, and a Maternal Fetal Medicine Units network study of 2,620 women from 16 university hospital centers around the country. Both studies concluded that women with actively managed asthma are just as likely to have healthy pregnancies and babies as women who don't have asthma......... Posted by: Emily      Read more         Source

April 30, 2009, 5:26 AM CT

Preserving eggs for reproduction

Cryoprotectants needed to preserve eggs for reproduction need to be given in stages, albeit rapid ones, say researchers who have developed a mathematical model that predicts optimal time for loading and unloading these drugs.

Their studies in Rhesus monkey eggs, which are very similar to human eggs, show that a two-step process of easing into and out of the drugs needed to help protect eggs at subzero temperatures dramatically reduces the amount eggs contract and expand in the process.

These dramatic size shifts can literally rip an egg apart or, at the very least, reduce the chances it can be fertilized, says Dr. Ali Eroglu, reproductive biologist and cryobiologist in the Medical College of Georgia Schools of Medicine and Graduate Studies.

Researchers first looked at how fast the three most usually used cryoprotectants - dimethylsulfoxide, ethylene glycol and propylene glycol - permeate monkey eggs. Faster permeability is better with these drugs which must be given at room temperature when their toxicity levels are high. With permeability rates in hand, MCG researchers used a mathematical model, developed in collaboration with Villanova University in Pennsylvania, to successfully predict optimal loading and removal times.

They found propylene glycol works best in monkeys. The drug penetrated the egg membrane faster and got out faster, Dr. Eroglu and colleagues report in the recent issue of Molecular Reproduction & Development......... Posted by: Emily      Read more         Source

April 28, 2009, 5:21 AM CT

Pregnancy safe with epilepsy, avoid valproate

New guidelines developed by the American Academy of Neurology and the American Epilepsy Society show it's relatively safe for women with epilepsy to become pregnant, but caution must be taken, including avoiding one particular epilepsy drug that can cause birth defects. The guidelines are reported in the April 27, 2009, print issue of Neurology, the medical journal of the American Academy of Neurology, and will be presented April 27, 2009, at the Academy's Annual Meeting in Seattle.

The guidelines recommend women with epilepsy avoid taking the drug valproate during pregnancy.

"Strong evidence shows that valproate is associated with an increased risk for fetal malformations and decreased thinking skills in children, whether used by itself or with other medications," said lead guideline author Cynthia Harden, MD, Director of the Epilepsy Division at the University of Miami's Miller School of Medicine and member of the American Academy of Neurology.

The guidelines also suggest, if possible, women with epilepsy should not take more than one epilepsy drug at a time during pregnancy since taking more than one seizure drug has also been found to increase the risk of birth defects in comparison to taking only one medication.

"Overall, what we found should be very reassuring to every woman with epilepsy planning to become pregnant," said Harden. "These guidelines show that women with epilepsy are not at a substantially increased risk of having a Cesarean section, late pregnancy bleeding, or premature contractions or premature labor and delivery. Also, if a woman is seizure free nine months before she becomes pregnant, it's likely that she will not have any seizures during the pregnancy"......... Posted by: Emily      Read more         Source

April 22, 2009, 5:11 AM CT

New chemo combination against recurrent gynecologic cancers

Recurrent and metastatic endometrial and ovary cancers can be notoriously difficult to treat: They have spread to other organs and typically have developed resistance to chemotherapy; and patients already heavily treated with chemotherapy may not be able to endure more chemo. Now, physicians at Albert Einstein College of Medicine of Yeshiva University have shown that a combination of two chemotherapy drugs not only produced clinical benefit for such patients but were also well tolerated. The findings are published online in the journal Gynecologic Oncology

"Women with recurrent gynecologic cancers have often had multiple rounds of chemotherapy, which can cause tumor cells to develop resistance to these drugs," says Mark H. Einstein, M.D., associate professor of obstetrics & gynecology and women's health at Einstein, who headed the study. "This resistance can make it difficult for doctors to devise a therapy protocol that will impact the cancers while avoiding the often-severe side effects that certain chemotherapy drugs can cause, especially when patients have already been heavily pretreated with other anti-cancer drugs".

In prior clinical studies, the chemotherapy drugs topotecan and docetaxel showed effectiveness when used separately against recurrent gynecologic cancers. The phase 2 trial conducted by Dr. Einstein and colleagues─the first to evaluate the combination of the drugs for this purpose─involved 24 women with recurrent uterine, ovarian, fallopian or peritoneal cancers. The women were given the topotecan-docetaxel combination on Day 1 of the trial and then weekly for three weeks; after a one-week rest, the women received another three-week therapy cycle, ultimately undergoing six such therapy cycles......... Posted by: Emily      Read more         Source

April 21, 2009, 5:14 AM CT

Breastfeed your children to prevent heart attack

The longer women breastfeed, the lower their risk of heart attacks, strokes and cardiovascular disease, report University of Pittsburgh scientists as per a research findings reported in the recent issue of Obstetrics & Gynecology

"Heart disease is the leading cause of death for women, so it's vitally important for us to know what we can do to protect ourselves," said Eleanor Bimla Schwarz, M.D., M.S., assistant professor of medicine, epidemiology, and obstetrics, gynecology and reproductive sciences at the University of Pittsburgh. "We have known for years that breastfeeding is important for babies' health; we now know that it is important for mothers' health as well".

As per the study, postmenopausal women who breastfed for at least one month had lower rates of diabetes, hypertension and high cholesterol, all known to cause heart disease. Women who had breastfed their babies for more than a year were 10 percent less likely to have had a heart attack, stroke, or developed heart disease than women who had never breastfed.

Dr. Schwarz and his colleagues observed that the benefits from breastfeeding were long-term ― an average of 35 years had passed since women enrolled in the study had last breastfed an infant.

"The longer a mother nurses her baby, the better for both of them," Dr. Schwarz pointed out. "Our study provides another good reason for workplace policies to encourage women to breastfeed their infants." ......... Posted by: Emily      Read more         Source

April 17, 2009, 5:08 AM CT

Exercise During Pregnancy

No one doubts that mothers - particularly pregnant mothers - are among the busiest people on earth. And while the benefits of exercise for these women and their developing fetuses are widely known, a number of expectant mothers do not exercise. A survey examining daily activities of moms-to-be will soon be released as part of a larger study looking at the effect of maternal exercise on fetal development. The results suggest, among other things, that exercising during pregnancy does not require "stealing" time from other activities.

The study was conducted by Linda E. May, Kansas City University of Medicine and Biosciences (KCUMB), Kansas City, MO; Alan Glaros, KCUMB, and Kathleen M. Gustafson, University of Kansas Medical Center, Kansas City, KS and is entitled Differences Among Exercisers and Non-Exercisers During Pregnancy. The team will discuss its study at the 122nd Annual Meeting of the American Physiological Society (APS; www.the-aps.org/press), which is part of the Experimental Biology 2009 scientific conference. The meeting will be held April 18-22, 2009 in New Orleans.

The Study and Background

Based on prior research findings, over one-third (36 percent) of pregnant moms cite time as the main reason for not participating in regular aerobic exercise. With this in mind, the scientists wanted to determine if women who exercised during pregnancy spent less time doing specific activities in order to have time for exercise and to determine if there were any trends between mothers who exercised during pregnancy and those that do not......... Posted by: Emily      Read more         Source

April 7, 2009, 5:12 AM CT

Does acupuncture work in hot flushes?

Acupuncture cannot be shown to have any positive effect on hot flushes during the menopause. This is the conclusion of a systematic review of literature by three groups in Daejon, Busan (South Korea) and Exeter (UK), reported in the current edition of the peer-evaluated journal Climacteric

A number of women are concerned by the unfavourable publicity given to HRT use, but still have to deal with the symptoms which can occur during and after the menopause. A significant minority of women look for alternatives to HRT to deal with these symptoms. Often these alternatives are untested, and it can be impossible to balance the risks and benefits of these therapys against the risks and benefits of conventional therapys or the discomfort of untreated menopause.

The scientists evaluated studies on the use of acupuncture for the relief of hot flushes during the menopause. They identified 106 studies in total, which they eventually narrowed down to the six most relevant to the study. These six studies were randomised controlled trials (RCTs), which included testing the effects of real acupuncture against the effect of sham acupuncture. Only one RCT reported favorable effect of acupuncture on the frequency and severity of hot flush after 4 weeks follow-up, while the other five RCTs demonstrated no such effects......... Posted by: Emily      Read more         Source