Archive for February, 2010

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Two to three times more pregnant women may soon be diagnosed and treated for gestational diabetes, based on new measurements for determining risky blood sugar levels for the mother and her unborn baby, according to a study that was coordinated by investigators at Northwestern University Feinberg School of Medicine.

"As result of this study, more than 16 percent of the entire population of pregnant women qualified as having gestational diabetes," said lead author Boyd Metzger, M.D., the Tom D. Spies Professor of Metabolism and Nutrition at Feinberg and a physician at Northwestern Memorial Hospital. "Before, between 5 to 8 percent of pregnant women were diagnosed with this."

Blood sugar levels that were once considered in the normal range are now seen as causing a sharp increase in the occurrence of overweight babies with high insulin levels, early deliveries, cesarean section deliveries and potentially life-threatening preeclampsia, a condition in which the mother has high blood pressure that affects her and the baby.

Large babies, the result of fat accumulation, are defined as weighing in the upper 10 percent of babies in a particular ethnic group. Because large babies increase the risk of injury during vaginal delivery, many of the women in the study were more likely to have a cesarean section.

The good news, Metzger noted, is recent studies show women with mild gestational diabetes, who were treated with lifestyle and diet changes as well as blood sugar monitoring, greatly reduced their risk of complications. As a result of treatment, the women had smaller babies, fewer cesarean deliveries and less preeclampsia, Metzger said.

Based on a study of more than 23,000 women in nine countries, Metzger and an international group of 50 experts concluded a fasting blood sugar level of 92 or higher, a one-hour level of 180 or higher on a glucose tolerance test or a two-hour level of 153 or higher on a glucose tolerance test constitute serious risks to the mother and baby. Previously, these levels had been considered in the safe, normal range, and two elevated levels were required for a diagnosis of gestational diabetes.

"At these levels, the frequency of having an overweight baby is almost double, the frequency of having preeclampsia is almost double, and the frequency of early delivery is 40 percent greater," Metzger said. "These are really substantial differences."

"This study says these risks to pregnancy are like many things we deal with in medicine," Metzger said. "The risk of having a stroke doesn't begin when your blood pressure is 140 over 80. That's when we say you have hypertension, but that's not where the risk begins to affect your health. That starts sooner. A similar situation is how your cholesterol level relates to the risk of having heart disease. It doesn't begin at 200. That's where it reaches the threshold where common treatments can reduce the risks."

"Our research represents an examination of risks and a consensus about how high a level the risk needs to reach before a diagnosis should be made and treatment should be considered," Metzger said.

For the past decade, the rate of gestational diabetes as previously measured has soared as much as 50 percent. "We shouldn't be surprised," Metzger said. "The fact that we have a lot of gestational diabetes to deal with is consistent with the major impact that diabetes and obesity are having in our population at large. How could we expect pregnancy to escape that?"

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A mother's nurture may provide powerful protection against risks her baby faces in the womb, according to a new article published online today in the journal Biological Psychiatry. The research shows that fetuses exposed to high levels of stress hormone - shown to be a harbinger for babies' poor cognitive development - can escape this fate if their mothers provide them sensitive care during infancy and toddler-hood.

The new study represents the first, direct human evidence that fetuses exposed to elevated levels of the stress hormone cortisol may have trouble paying attention or solving problems later on. But what may be more intriguing is the study's second finding – that this negative link disappears almost entirely if the mother forges a secure connection with her baby.

"Our results shape the argument that fetal exposure to cortisol – which may in part be controlled by the mother's stress level – and early caregiving experience combine to influence a child's neurodevelopment," said study author Thomas O'Connor, Ph.D., professor of Psychiatry and of Psychology at the University of Rochester Medical Center, and director of the Wynne Center for Family Research. "If future studies confirm these findings, we'll need to not only engineer ways to reduce stress in pregnancy, but we'll need to also promote sensitive caregiving by moms and dads."

For the study, researchers recruited 125 women at an amniocentesis clinic in an urban maternity hospital, taking a sample of their amniotic fluid so that stress hormones in it could be measured. The mothers were at 17 weeks gestation on average; only mothers with normal, healthy pregnancies and subsequent deliveries were followed.

When their children reached 17 months of age, researchers administered a Bayley infant developmental scale test, which relies on puzzles, pretend play, and baby "memory" challenges to gauge youngsters' cognitive development. They also observed the baby and mother using the Ainsworth "Strange Situation" test, which judges child-rearing quality, categorizing mom-baby pairs as either showing secure or insecure attachment to each other.

With cortisol levels, relationship quality results, and cognition scores in hand, researchers analyzed how the first two measures might influence the third. Indeed, for children showing "insecure attachment" to their mothers, a high prenatal cortisol level was linked with shorter attention spans and weaker language and problem-solving skills. But interestingly, for kids who enjoyed secure relationships with their moms, any negative link between high prenatal cortisol exposure and kids' cognitive development was eliminated.

"This is such refreshing news for mothers," O'Connor said. "Pregnancy is an emotional experience for many women, and there is already so much for mothers to be careful of and concerned about. It's a relief to learn that, by being good parents, they might 'buffer' their babies against potential setbacks."

O'Connor goes on to note a couple important nuances of the study. The first is that the amniotic (in-utero) cortisol studied could result from two sources, and it's hard to pinpoint which. It might, for instance, be passed along the placenta from an anxious mother to her unborn baby – or it could be created and excreted directly by a stressed fetus itself.

This study plays into the much larger theory of "fetal programming," which suggests that events in the womb may prime the developing child for long-term health and developmental outcomes. Past studies, for instance, have found a pregnant mother's diet can sway a child's long-term risk for heart disease, diabetes and obesity. Along with diet, prenatal stress has emerged as another large-looming factor in such programming.

"Our results support this emerging theory," said London-based study co-author, Vivette Glover, Ph.D. "In neurology, the idea emerging is that unborn children sense their mothers' stress hormone levels, programming them for greater watchfulness. We're trying to determine whether or not that sensitivity comes with greater anxiety during childhood, and if so, what we can do about it."

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Celebrities aren't the only ones giving their babies unusual names. Compared with decades ago, parents are choosing less common names for kids, which could suggest an emphasis on uniqueness and individualism, according to new research.

Essentially, today's kids (and later adults) will stand out from classmates. For instance, in the 1950s, the average first-grade class of 30 children would have had at least one boy named James (top name in 1950), while in 2013, six classes will be necessary to find only one Jacob, even though that was the most common boys' name in 2007.

The researchers suspect the uptick of unusual baby names could be a sign of a change in culture from one that applauded fitting in to today's emphasis on being unique and standing out. When taken too far, however, this individualism could also lead to narcissism, according to study researcher Jean Twenge, of San Diego State University.

The results come from an analysis of 325 million baby names recorded by the Social Security Administration from 1880 to 2007. The research team figured out the percentage of babies given the most popular name or a name among the 10, 20, or 50 most popular for that year and sex. Since it wasn't required that people get a social security card until 1937, names before that time may not be random samples of the population, the researchers note.

Results showed parents were less likely to choose those popular names as time went on. For instance, in the late 1800s and early 1900s, about 5 percent of babies were named the top common name, while more recently that dropped to 1 percent.

• About 40 percent of boys received one of the 10 most common names in the 1880s, while now fewer than 10 percent do.
• For girls, the percentage with a top-10 name dropped from 25 percent in about 1945 to 8 percent in 2007.
• Similar results were seen for the top-50 names. About half of girls received one of the 50 most popular names until the mid-20th century. Now, just one in four have these names.

This trend in baby-naming didn't show a constant decrease. Between 1880 and 1919, fewer parents were giving their children common names, though from 1920 to the 1940s common names were used more often than before. Then, when baby boomers came on the scene, so did more unusual names.

The results held even when the researchers accounted for immigration rates and increasing Latino populations, which could bring relatively less common names into the mix.

"The most compelling explanation left is this idea that parents are much more focused on their children standing out," Twenge told LiveScience. "There's been this cultural shift toward focusing on the individual, toward standing out and being unique as opposed to fitting in with the group and following the rules."

The positive side of individualism, Twenge said, is that there is less prejudice and more tolerance for minority groups. But she warns that when individualism is taken too far, the result is narcissism.

Past research has shown that back in the 1950s parents placed a lot of importance on a child being obedient, which has gone way down. "Parenting has become more permissive and more child-focused and [parents] are much more reluctant to be authority figures," Twenge said.

As for whether these unusually named kids will have personalities to match is not known.

"It remains to be seen whether having a unique name necessarily leads to narcissism later in life," Twenge said. "If that unique name is part of a parent's overall philosophy that their child is special and needs to stand out and that fitting in is a bad thing, then that could lead to those personality traits."

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When Stinne Holm Bergholdt of Denmark was diagnosed with bone cancer at age 27, she was afraid she wouldn't be able to have children.

So she asked her doctors if they could remove an ovary before her treatment and transplant it back afterward to preserve her fertility.

More than six years later, Bergholdt and her husband now have two daughters, making her the first woman in the world to give birth twice after an ovary transplant. "It's hard to believe it's really true," said Bergholdt. "It's like a dream that I never would have thought possible a few years ago."

On the day before she started chemotherapy, doctors took 13 strips of ovarian tissue from Bergholdt's right ovary and froze them. After eight months of cancer treatment and another year of recovery, doctors reimplanted seven of the strips, or about 20 percent of an entire ovary.

Bergholdt's ovary began working again after a few months, and she then had in-vitro fertilization to become pregnant. Nearly a year later, she gave birth to daughter Aviaja, now 3. Bergholdt's treatment was paid for by the Danish health system.

When Bergholdt and her husband decided they wanted a second child, they went back to the fertility clinic, but it turned out that she was already pregnant. About a year ago, she gave birth to another daughter, Lucca.

"We were really surprised that she had done it herself," said Dr. Claus Yding Andersen, one of Bergoldt's doctors at University Hospital of Copenhagen. "We did not expect the ovary transplant to still be working after four years."

The transplant is working so well that Bergholdt is currently using birth control to avoid becoming pregnant again.

Eight children have been born worldwide to women who have had ovary transplants but no other woman has had more than one pregnancy after having a transplant.

The technique has been mostly used for cancer patients, but could become more widespread as the technology is refined, Andersen said.

"It shows we can stop the clock by freezing the ovaries," he said.

Women who want to delay having children might also be interested in the procedure although that could raise some ethical issues, he added.

Others thought an ovary transplant was much too invasive to become more widespread.

"To suggest that a healthy woman would have two operations (to remove and reimplant the ovary) for the sake of social convenience, to have children later, is ludicrous," said Allan Pacey, a fertility expert at the University of Sheffield, who was not linked to the research. "It's far easier to just freeze your eggs."

Still, Pacey said Bergholdt's case proved that ovary transplants were a viable way to preserve women's fertility and should reassure cancer patients they won't automatically be left sterile.

For Bergholdt, the transplant was a blessing.

"It was very hard to believe after everything I'd been through I could actually have children," she said. "Now that we know this technique works, it should be available to every woman who goes through cancer treatment."

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Rebecca Gayheart wears a gray turtleneck sweater and fringed boots, Jenna Elfman dons shades of gray with some black flats, Dannii Minogue goes gold, Anne-Marie Duffy rocks the red dress, Claudia Schiffer ties up her bump in the afternoon and later looks amazing in all black.

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Depression during pregnancy is relatively common, affecting about 10 to 15% of women. While there is a growing body of literature supporting the reproductive safety of certain antidepressants, many women and their physicians would prefer to avoid the use of these medications during pregnancy; thus, there is a clear need for effective non-pharmacologic treatments for [...]

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A Wisconsin couple had just one request for the hospital where their baby was to be born this week: Get us married, STAT.

Originally scheduled for Wednesday afternoon, the wedding of parents-to-be Erin Heather and Mark Weber was to take place only a week before their baby's Feb. 26 due date.

But when Heather went into labor prematurely, at about 2:30 a.m. Wednesday, Feb. 17, she and her boyfriend of 11 years rushed to St. Mary's Hospital in Madison to say their "I do's" in a makeshift chapel there instead, at 11 in the morning rather than 4:30 in the afternoon.

On the way, they stopped to pick up the marriage license – and notified St. Mary’s about their needs, all according to the Wisconsin State Journal.

An ordained minister friend of Weber's officiated at the ceremony, which was attended by a few friends, a handful of hospital staff – and a smattering of journalists.

The couple were in such a hurry to get married because, the new dad informed the newspaper, of "old-fashioned grandparents" and a desire to officially be "a family" when their child arrived.

The baby, a girl, was born Thursday night.

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