Trusted Information for Healthy Pregnancies
child development
Heavier Birth Weight Tied to Later Conduct Troubles
May 6th
Among twins whose weight differs markedly at birth, the heavier child is more likely to have conduct problems at ages 3 and 4, a new study finds.
"The findings suggest an effect of birth weight differences on development of subsequent conduct problems," researchers led by Dr. David Mankuta of Hadassah Hebrew University Hospital in Jerusalem, said in a news release. "Further studies are needed to clarify the mediating factors of this effect."
The team studied 112 pairs of Israeli twins in which one weighed at least 20 percent more than the other. The twins were born in 2004 and 2005.
The researchers found that the heavier twin had more conduct problems in 41 percent of the twin pairs. The twin who weighed less had more conduct problems in only 21 percent of the cases.
The study findings were published in the May issue of Archives of Pediatrics & Adolescent Medicine.
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Depression while pregnant ‘linked to violent behaviour in children’
Feb 5th
Mothers who suffer from 'baby blues' while pregnant are four times as likely to have children who become violent teenagers, a new study shows.
The link remained even if the mothers did not suffer depression after their children were born.
Research has previously suggested that postnatal depression can affect a child's subsequent behavior.
But experts from Cardiff and Bristol universities and King's College London believe that theirs is one of the first studies to look at the effects of suffering depression before a child's birth.
Many women are depressed during their pregnancy and research by Tommy's, the baby charity, suggests that it may even be more common before the birth of a child than after.
It is estimated that as many as between 10 and 15 per cent of women could suffer the condition while they are expecting.
Prof Dale F Hay, from Cardiff University, who led the latest study, said: "Much attention has been given to the effects of postnatal depression on young infants, but depression during pregnancy may also affect the unborn child."
The study looked at 120 mothers from the Bristol area.
The researchers interviewed the women while they were pregnant, after they gave birth and when their children were aged four, 11, and 16 years old.
Their findings, published in the journal Child Development, show that women who were depressed while they were pregnant were four times as likely to have children who were violent by the age of 16 as the other mothers.
The children were also more likely to exhibit other forms of anti-social behavior, the research found.
However, the study also found that women who had been angry or disruptive teenagers themselves were more likely to go on to be depressed while they were pregnant.
Prof Hay added: "Although it's not yet clear exactly how depression in pregnancy might set infants on a pathway toward increased anti-social behavior, our findings suggest that women with a history of conduct problems who become depressed in pregnancy may be in special need of support."
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Prenatal Exposure to Flame-Retardant Compounds Affects Neurodevelopment of Young Children
Jan 27th
Prenatal exposure to ambient levels of flame retardant compounds called polybrominated diphenyl ethers (PBDEs) is associated with adverse neurodevelopmental effects in young children, according to researchers at the Columbia Center for Children's Environmental Health (CCCEH) at Columbia University's Mailman School of Public Health.
The study is online in Environmental Health Perspectives and will be released in the April 2010 print issue.
PBDEs are endocrine-disrupting chemicals and widely used flame-retardant compounds that are applied to a broad array of textiles and consumer products, including mattresses, upholstery, building materials, and electronic equipment. Because the compounds are additives rather than chemically bound to consumer products, they can be released into the environment. Human exposure may occur through dietary ingestion or through inhalation of dust containing PBDEs.
The researchers found that children with higher concentrations of PBDEs in their umbilical cord blood at birth scored lower on tests of mental and physical development between the ages of one and six. Developmental effects were particularly evident at four years of age, when verbal and full IQ scores were reduced 5.5 to 8.0 points for those with the highest prenatal exposures.
"The neurodevelopmental effects of prenatal exposure to PBDEs have not previously been studied among children in North America, where levels are typically higher than in Europe or Asia," said Julie Herbstman, PhD, first author on the paper and a research scientist in Environmental Health Sciences at the Mailman School of Public Health. "The findings are consistent with effects observed in animal studies and, if replicated in other North American populations, they could have important public health implications."
Frederica Perera, DrPh, professor of Environmental Health Sciences at the Mailman School, CCCEH Director, and coauthor added, "These findings are of potential concern, because IQ is a predictor of future educational performance; and the observed reductions in IQ scores are in the range seen with low level lead exposure." This research underscores the need for preventive policies to reduce toxic exposures occurring in utero."
The investigators controlled for factors that have previously been linked to neurodevelopment in other studies, including ethnicity, mother's IQ, child's sex, gestational age at birth, maternal age, prenatal exposure to environmental tobacco smoke, maternal education, material hardship, and breast feeding.
The study is part of a broader project examining the effects of chemicals released by the World Trade Center's destruction on pregnant women and their children. However, residential proximity to the World Trade Center site did not affect levels of PBDE exposure.
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Nurse Program During Pregnancy Reduces Child’s Criminality
Jan 5th
Girls whose mothers were visited at home by nurses during pregnancy and the children's infancy appear less likely to enter the criminal justice system by age 19, according to a report in the January issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
John Eckenrode, Ph.D., of Cornell University, Ithaca, N.Y., and colleagues studied 310 19-year-olds whose mothers were enrolled in the Nurse-Family Partnership program in Elmira, N.Y., in which nurses visited homes to help women improve health-related behaviors during pregnancy, provide more competent care during infancy and improve their economic self-sufficiency through appropriate life choices. A total of 400 pregnant women enrolled in the study between 1978 and 1980; 85 percent of them were age 19 or younger, unmarried or from households with low socioeconomic status.
Of the 310 families followed up when the children were 19 years of age, 140 were in the control group, 79 received visits during pregnancy only and 91 received visits during pregnancy and infancy. Families in the program received an average of nine home visits by nurses during pregnancy and 23 from birth through the child's second birthday.
Compared with the 73 in the comparison group, the 44 girls whose families were visited during pregnancy and infancy were less likely to have been arrested by age 19 (10 percent vs. 30 percent) or convicted (4 percent vs. 20 percent), and had fewer lifetime arrests (an average of 0.1 vs. 0.54) and convictions (0.04 percent vs. 0.37 percent). When the analysis was restricted to girls whose mothers were high-risk (unmarried or low-income), those who were visited by nurses had fewer children (11 percent vs. 30 percent) and were less likely to use Medicaid (18 percent vs. 45 percent) than those who were not visited.
For boys, the likelihood of an arrest increased significantly in both the intervention and control groups after age 12, with no difference in arrests between groups through age 19.
"In the current debate over health care reform, the question of the cost vs. benefit of investing in prevention has become a hot topic," writes J. David Hawkins, Ph.D., of the University of Washington, Seattle, in an accompanying editorial.
"The Nurse-Family Partnership Program costs about $7,000 per child. Benefit-cost analyses for the already published effects of the program have found that it produces total benefits of about $41,000 per child of low-income, unmarried, nurse-visited mothers and about $9,000 per child of lower-risk nurse-visited mothers, a positive benefit-cost ratio in both cases."
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Aspirin During Pregnancy May Help Preemies
Dec 29th
The children of women who take low-dose aspirin during pregnancy because they are at high risk for delivering prematurely might have fewer behavioral problems at age 5, new research suggests.
Obstetricians sometimes give low-dose aspirin to pregnant women who are apt to have such complications as fetal growth restriction (when a fetus doesn't grow properly in the womb) or preeclampsia (high blood pressure that's dangerous to both mother and the fetus), said Dr. Ashley Roman, a clinical assistant professor of obstetrics and gynecology at NYU Langone Medical Center. Roman was not involved in the research.
In the study, French researchers used data on 656 children born before 33 weeks of gestation to 584 women from nine regions in France. A full-term birth is at 40 weeks' gestation. The women had a history of placental vascular disease, fetal growth restriction, chronic hypertension, and renal or autoimmune diseases.
About 21 percent of the women took low-dose aspirin during pregnancy.
At age 5, children whose mothers had taken aspirin were slightly less likely to have behavioral difficulties or hyperactivity, though the results were not statistically significant, according to the study.
In addition, the babies whose mothers had taken aspirin faced no increased risk for death, cerebral lesions or cerebral palsy.
One of the fears of giving aspirin to women during pregnancy is that aspirin interferes with platelet function, which is important for blood clotting. Because of that, it could raise the risk for brain bleeds in already susceptible premature infants, Roman said. The study found no increase in the risk for brain bleeds.
The study findings are published online Dec. 21 and in the January print issue of the journal Pediatrics.
Still, much remains unknown about the role of aspirin in pregnancy, including exactly how well or why aspirin works, Roman noted. One theory is that fetal growth restriction might be caused by tiny blood clots in the placenta, and aspirin helps blood flow between the placenta and the fetus. Low-dose aspirin is also taken by adult men and women at risk for heart attack and stroke.
Dr. Michael Katz, senior vice president for research and global programs at the March of Dimes, said the study is intriguing, but the findings are too preliminary to be of much help to women or their physicians. Many women in the study were also given other drugs, including corticosteroids, and it's unknown how much that affected the outcomes.
"Behavioral difficulties," as cited in the study, is a broad term that could encompass everything from excessive temper tantrums to learning disabilities to hyperactivity to autism, he said, each of which could have very different underlying causes.
Premature babies are at higher risk for neurological problems, including learning disabilities, cerebral palsy, and hearing and vision problems.
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Alcohol in Pregnancy has Variety of Possible Effects
Nov 23rd
A new study from Perth's Telethon Institute for Child Health Research has found evidence that the amount and timing of alcohol consumption in pregnancy affects child behavior in different ways.
The study has just been published online in the international journal Addiction.
Lead author Colleen O'Leary said the analysis was drawn from a random sample of more than 2000 mothers who completed a questionnaire three months after the baby's delivery, and were then followed up when the child was 2, 5 and 8 years of age.
"Mothers who reported what we would classify as heavy drinking in the first trimester of pregnancy were nearly three times as likely to report that their child suffered with anxiety and/or depression or somatic complaints," Ms O'Leary said.
“Those who drank moderately during that first trimester were twice as likely to report those types of behavioral issues for their child.
“Exposure to moderate or heavy levels of alcohol in late pregnancy increased the risk of aggressive types of behaviors in the child.
“This research suggests that both the timing and the intensity of alcohol exposure in the womb affect the type of behaviour problems expressed.”
In this study low levels of alcohol did not increase the risk of harm to the baby. However, the evidence clearly shows that the risk to the baby increases with increasing amounts consumed.
“It should also be noted that in this study moderate exposure is classified as drinking 3-4 standard drinks per occasion- that's about two normal glasses of wine-and no more than a bottle of wine drunk over a week.”
Heavy drinking included women who were drinking the equivalent of more than a bottle of wine per week.
“Not every child will be affected by prenatal exposure to alcohol. However it is important that women have this information about increased risk so that they can make informed decisions to give their child the best start to life,” Ms O'Leary said.
The National Health and Medical Research Council recommend that the safest choice for women who are pregnant or planning a pregnancy is to abstain from alcohol.
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ADHD Linked to Lead and Cigarette Exposure During Pregnancy
Nov 23rd
Children whose mothers smoked during pregnancy or who were exposed to lead have more than double the risk of having attention-deficit hyperactivity disorder (ADHD) as other children, new research shows.
And with exposure to both cigarettes and lead, the chances of having ADHD soared. Children whose mothers smoked during pregnancy and whose blood showed signs of lead exposure had eight times the risk of having ADHD.
"When you have both exposures, there is a synergistic effect," said study author Dr. Tanya Froehlich, a developmental and behavioral pediatric specialist and an assistant professor of pediatrics at Cincinnati Children's Hospital Medical Center.
The researchers concluded that about 38 percent of ADHD cases among children aged 8 to 15 in the United States may be caused by prenatal exposure to tobacco smoke, while 25 percent of ADHD cases are due to lead exposure, according to the study in the Nov. 23 online issue of Pediatrics.
Froehlich and her colleagues used data on 2,588 children aged 8 to 15 from around the nation who took part in the 2001-2004 National Health and Nutrition Examination Survey. Tobacco exposure was assessed by asking mothers if they smoked during pregnancy, while lead concentrations were measured by a blood test.
About 8.7 percent of children met the criteria for ADHD, which is marked by inattentiveness, difficulty focusing, impulsivity and hyperactivity, according to the study. The ADHD group included 16.8 percent of children whose mothers smoked during pregnancy, compared to 6.6 percent of children whose mothers did not smoke.
Lead exposure was divided into three groups: low, medium and high. About 5.2 percent of children who had the lowest lead blood levels had ADHD. About 9.1 percent of children in the middle range had ADHD, while 13.6 percent of children in the highest third had ADHD, the researchers found.
About 28.6 percent of children who were exposed to both prenatal smoking and who had higher blood lead concentrations had ADHD, Froehlich said.
Researchers did not find a strong link between exposure to secondhand cigarette smoke during childhood and ADHD.
Alarmingly, even children in the upper third had lead exposure levels lower than what the federal government considers "elevated." The U.S. Centers for Disease Control and Prevention considers levels of 10 micrograms per deciliter "actionable," Froehlich said. In the study, children in the upper third had blood lead levels that were 1.3 micrograms per deciliter or greater; children in the middle group had levels between 0.9 and 1.3 micrograms per deciliter.
About 250,000 U.S. children aged 1 to 5 have blood lead levels greater than 10 micrograms of lead per deciliter of blood, according to the CDC. Though blood lead levels have generally dropped in recent years, children, particularly those in poor, inner-city neighborhoods, may still be exposed to lead from peeling paint in old buildings. Leaded paint was banned for most residential uses in the United States in 1978.
Children may also ingest lead from old water pipes, soil and toys. In the last few years there have been multiple recalls, some by major toy manufacturers such as Mattel and Fisher-Price, of products manufactured in China that contained unsafe levels of lead.
"Lead is out there, and we need to take precautions, such as making sure we keep kids away from peeling paint and make sure they practice good hand washing before they eat if they are playing in the soil," Froehlich said.
In addition, good nutrition, including making sure children have adequate levels of iron and calcium, can also protect from lead exposure. Children with iron and calcium deficiencies absorb more lead than children with better diets, Froehlich explained.
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Newborn Babies Cry in Tongues Learned in the Womb
Nov 5th
Only days after birth, babies have a bawl with language. Newborn babies cry in melodic patterns that they have heard in adults’ conversations — even while in the womb, say medical anthropologist Kathleen Wermke of the University of Würzburg in Germany, and her colleagues.
By 2 to 5 days of age, infants’ cries bear the tuneful signature of their parents’ native tongue, a sign that language learning has already commenced, the researchers report in a paper published online November 5 in Current Biology.
Fluent speakers use melodic patterns and pitch shifts to imbue words and phrases with emotional meaning. Changes in pitch and rhythm, for example, can indicate anger. During the last few months of fetal life, babies can hear what their mothers or other nearby adults are saying, providing exposure to melodies peculiar to a specific language, Wermke says. Newborns then re-create those familiar patterns in at least some of their cries, she proposes.
“Our data support the idea that human infants’ crying is important for seeding language development,” Wermke says. “Melody lies at the roots of both the development of spoken language and music.”
Scientists already knew that, in the final months of gestation, babies can hear people talking, especially their mothers. Newborns prefer the sound of their mothers’ voices to the voices of other people, for example. In the days after birth, babies show signs of discriminating the sound of their native language from others and of recognizing when voice-like tones change in pitch.
Wermke’s team goes further, suggesting that newborns adapt their cries to melodic patterns characteristic of whatever language they have heard spoken.
She and her colleagues studied 60 healthy newborns, 30 born into French-speaking families and 30 born into German-speaking families. The researchers recorded 2,500 cries as mothers changed babies’ diapers, readied babies for feeding or otherwise interacted with the youngsters.
Acoustic measures allowed the researchers to identify 1,254 cries (in this case, a cry is a vocalization produced with a single breath) that contained clear rising-and-falling arcs suitable for a detailed analysis.
German newborns’ cries tended to start out high-pitched and gravitate to increasingly lower pitches. French newborns’ cries started out low-pitched and then moved higher. Comparable high-to-low and low-to-high intonation patterns characterize words and phrases used by fluent speakers of German and French, Wermke says.
Newborns strive to imitate their mothers’ behaviors however they can, in order to attract attention and foster bonding, Wermke proposes. Newborns can readily mimic the musical structure of what a mother says, in her view.
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