Trusted Information for Healthy Pregnancies
Archive for March 31, 2010
This Week’s Celebrity Baby Bumps
Mar 31st
Amy Poehler accentuates her bump in black, Tiffani Thiessan poses before her baby shower, Claudia Schiffer wears a flowing gray frock with a colorful scarf, Bethenny Frankel looks comfortable in white sweats, Amy Adams dotes on her man while out shopping and later wears a blue dress to her baby shower.
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Stress and Pregnancy: Misconceptions and Building Immunity
Mar 31st
As sharply higher numbers of women work through pregnancy, many hear the same advice: Relax. Don't stress out or you will harm your unborn baby.
Contrary to old beliefs, however, research shows that ordinary day-to-day job and home stress isn't likely to cause low birth weight or other problems for most women. Traffic delays, work deadlines and other everyday hassles aren't likely to pose a threat to unborn babies, researchers say, and pregnant women who feel they are coping well tend to do just fine.
Instead, new studies are revealing a link between a certain kind of stress and some developmental delays in the baby: worrying excessively about the pregnancy itself.
This "pregnancy-specific anxiety" was linked to lower cognitive-development scores in babies at 12 months of age, based on a study published recently in Child Development by researchers at the University of California, Irvine, echoing other research. Women who experience this kind of anxiety worry excessively about potential problems with fetal development, miscarriage or giving birth.
Researchers don't yet understand the basis for this finding. Women may become excessively anxious about their pregnancies because they sense that something actually is amiss, which could account for the developmental delays. Or, a mother who is anxious and negative during pregnancy might tend to provide less nurturing and stimulating care after birth.
Whatever the cause, many obstetricians are urging pregnant women to stop obsessing about stress, and seek out more support from family and friends. "Most of my patients are so anxious it's outrageous," says Laura Riley, medical director of labor and delivery at Massachusetts General Hospital. "It's amazing how many people will come to my office and say, 'I've read that stress is very bad for pregnancy, and I'm all stressed out."' She tells patients, "Now you're all stressed-out about being stressed. This is just not helpful."
Some obstetricians are sending expectant moms to prenatal-care groups where they can get stress relief the old-fashioned way: by talking to other pregnant women. In a program called Centering Pregnancy, about 10 expectant mothers who are all at the same stage of a healthy pregnancy receive prenatal care in a group. In periodic two-hour sessions scheduled with the same frequency as standard one-on-one prenatal checkups, the women first get private screenings for blood pressure, weight and other health indicators, then gather for discussion.
A midwife or obstetrician also often gives a brief talk on a scheduled topic, answers questions and corrects misinformation.
In the process, "you create more of a support group" for mothers, lowering their stress, says Peter Bernstein, a specialist in maternal fetal medicine at Montefiore Medical Center, New York.
An estimated 300 medical-care facilities are offering Centering Pregnancy groups, says Sharon Rising, executive director of Centering Healthcare Institute, Cheshire, Conn., a nonprofit promoting group care.
A study of 1,047 young mothers, published in 2007 in Obstetrics & Gynecology, found those who received prenatal care in a Centering Pregnancy group had one-third fewer preterm births, compared with others who received standard care.
While most pregnant women face moderate stress, a smaller slice have unrelenting, chronic strain. Women facing more difficult circumstances, such as extreme poverty, racism or serious family problems, have a higher risk of preterm birth or developmental problems. Also, research shows that going through a traumatic event, such as a natural disaster, during the first trimester also raises the risk of premature delivery or low birth weight.
In coping with all kinds of stress, family and friends can help a lot. Social support—kind words, nurturing friends and surroundings that prompt smiles and laughter—is emerging as a powerful antidote to pregnancy stress.
A 2008 Swiss study that subjected 60 pregnant women to stressors, such as a simulated job interview and a math test before a camera and an audience, found those who reported more "daily uplifts" in their lives, such as smiling, laughing and receiving compliments, were less likely to react negatively to stress. Positive social experiences seem to act as a buffer, the study found.
Researchers increasingly believe that how individual women react to stress is a major factor in its effects. A study led by researchers at Michigan State University has linked a hostile attitude in and of itself—that is, the tendency in a pregnant woman to feel angry, suspicious, cynical, tense or nervous a lot of the time—with an increased risk of preterm birth.
Researchers say building "stress resiliency"—a habit of staying calm and optimistic, and continuing to care well for yourself through periods of heavy stress—is a key to healthy birth outcomes. Michael Lu, an author and associate professor of obstetrics and gynecology at University of California, Los Angeles, encourages women to start building resiliency against stress even before they become pregnant—forming good exercise, nutrition and sleep habits, and learning how to solve problems and face adversity without stressing out.
Learning to savor life's joys, be grateful, and look at seemingly negative events from a positive angle, he says, can set the stage for a pregnancy immune to the hazards of stress.
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Chemotherapy for Breast Cancer During Pregnancy Safe for Unborn Baby
Mar 31st
Women with breast cancer who are diagnosed while they are pregnant do not have to worry about endangering the health of their unborn babies if they are treated with chemotherapy, according to a study presented here at the 7th European Breast Cancer Conference (EBCC7).
Sybille Loibl, MD, Obstetrics and Gynaecology, University of Frankfurt, Frankfurt, Germany, presented the findings here on March 26.
So far the evidence upon which decisions about how to treat pregnant women with breast cancer is largely based on case studies and retrospective investigations.
The German Breast Group, of which Dr. Loibl is a member, set up a registry to collect data both retrospectively and prospectively from patients who have been diagnosed with breast cancer during pregnancy.
"Ours is the only international registry to focus on outcomes affecting both mother and baby," said Dr. Loibl during his presentation.
The team of researchers entered details of 235 patients prospectively (n = 119) and retrospectively (n = 116) between April 2003 and October 2009. Breast cancer was diagnosed, on average, 23 weeks into the pregnancy.
Out of 151 women, 91 received an average of 2 cycles of chemotherapy while they were pregnant.
The average gestational age of the babies at the time of delivery was 36 weeks, ranging between 28 and 42 weeks.
The average weight of babies exposed to chemotherapy during pregnancy was slightly lighter with an average of 2,636 mg compared with 2,791 mg in babies who were not.
Among the 91 babies born who were exposed to chemotherapy in utero, 1 died after birth, 1 suffered from necrotic enterocolitis, 1 died 3 weeks after birth, 1 developed sepsis, 1 developed neutropenia, and 2 had anemia. Three of these babies were born bald, and 1 had trisomia 18.
According to Dr. Loibl most of these problems were not related to the treatment for breast cancer but were due to other circumstances.
"Our study suggests that pregnant breast cancer patients can be treated as close as possible to standard recommendations and receive chemotherapy while they are pregnant," said Dr. Loibl.
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