Trusted Information for Healthy Pregnancies
Folate
Migraine drugs don’t up birth defect risk: study
Feb 16th
A study in nearly 70,000 pregnant women has found no link between migraine drugs called triptans and the risk of birth defects.
However, the researchers did find a "slight increase" in the risk of excessive bleeding during labor, and the failure of the uterus to contract normally after delivery, for women who used the drugs while pregnant.
Triptans are among the most powerful drugs used for migraine; others include aspirin, Excedrin, and ibuprofen.
While as many as three in 10 women may develop migraines during their childbearing years, women often shy away from using such drugs during pregnancy because of safety concerns, according to study co-author Katerina Nezvalova-Henriksen of the University of Oslo in Norway and her colleagues.
However, the authors of the study in Headache note, untreated migraine may itself carry risks for mother and child; some studies have linked it to pre-eclampsia, a potentially deadly pregnancy complication.
"While it is important to exert caution when using any medications during pregnancy, this study indicates" that pregnant women can either start or continue taking triptans without "any major risk" of miscarriage, premature delivery, or other bad outcomes, the authors conclude.
Nezvalova-Henriksen and her team studied nearly 70,000 women. Two percent, or 1,535, had used sumatriptan (Imitrex), rizatriptan (Maxalt), zolmitriptan (Zomig), or eletriptan (Relpax) in pregnancy.
Less than one percent -- 373 women -- had used the drugs before getting pregnant but not during pregnancy.
The overall birth defect rate, which encompasses everything from large birthmarks to serious heart problems, was the same among women who had taken triptans during pregnancy and those who didn't have migraines: 5 percent. Among those who had used triptans in the past but not during pregnancy, it was slightly higher: 6 percent.
The women who used triptans were also more likely than non-triptan users to take other drugs during pregnancy, including acetaminophen (Tylenol) with codeine and non-steroidal anti-inflammatory drugs such as ibuprofen.
However, the rate of major birth defects - such as serious problems of the limbs or internal organs -- was 3 percent for all three groups. That rate - about one in 33 births - is about what would be expected for all birth defects in the general population.
The researchers did find that women who used triptans in their second or third trimester were more likely to develop a condition called atonic uterus, in which the uterus fails to contract back to its normal size after delivery. This is the leading cause of excessive bleeding after delivery. They were also more likely to lose significant amounts of blood during labor and delivery.
And during pregnancy, they were more likely to suffer from vomiting than women who had never used the drug; they were also more likely to develop pre-eclampsia or eclampsia, and more likely to have deficiencies in the B-vitamin folate.
While many women who suffer migraines will experience improvements in their symptoms after their first trimester, Nezvalova-Henriksen and her team note, those whose symptoms don't improve by then aren't likely to get better.
Source
Folic Acid May Help Prevent Fetal Heart Defects
Dec 9th
Here's another reason for pregnant women to take folic acid supplements: they help prevent fetal heart malformations, new research from the Netherlands suggests.
"Given the relatively high prevalence of congenital heart defects worldwide, our findings are important for public health," Dr. Ingrid M. van Beynum of Radboud University in Nijmegen and her colleagues write.
Folic acid supplements are now recommended for all pregnant women, and women planning on becoming pregnant, in order to prevent birth defects involving the neural tube such as spina bifida. Many countries, including the US, now require bread and other wheat products to be fortified with folic acid for this reason, but this practice hasn't been adopted in The Netherlands.
To investigate further, the researchers used a national register of birth defects to identify 611 mothers who had given birth to a child with a heart defect, matching them to 2,401 women who delivered babies with genetic defects or other birth defects unrelated to folate.
Women who took a supplement containing at least 400 micrograms of folic acid were nearly 20 percent less likely to have a child with a heart defect, compared to other non-folate-related malformations, while their risk compared to the general population was 26 percent lower.
Their risk of having a child with a heart defect involving the septum -- which separates one side of the heart from the other -- was nearly 40 percent lower than that of the general population.
The current study couldn't show whether taking more or less than 400 micrograms of folic acid would be more effective in preventing heart defects, the researchers note, although there's increasing evidence that heavier women may need to take more folic acid to get the same protective effects.
The researchers conclude that women who want to become pregnant should take folic acid supplements around the time of conception, not only to prevent neural tube defects but also to reduce the risk of congenital heart defects.
Source
Low Folate Levels in Pregnancy Tied to ADHD
Nov 4th
Low folate levels during pregnancy are associated with higher odds for attention-deficit/hyperactivity disorder in offspring aged 7 to 9, new research has found.
The findings seem to support the long-held belief that folate (folic acid) levels in expectant mothers influence their children's nervous system development.
The researchers also found that children of mothers with low folate levels had notably smaller head circumference at birth, which may indicate a slower rate of prenatal brain growth.
The study was released online Oct. 28 in advance of publication in an upcoming print issue of the Journal of Child Psychology and Psychiatry.
The results are special cause for concern in relation to low-income families, where a mother's nutritional health receives a low priority, and women are less likely to take folic acid supplements prior to becoming pregnant.
Source
Study Links Folic Acid Supplement in Late Pregnancy to Asthma in Offspring
Nov 4th
Women who take folic acid supplements during the later months of pregnancy may be increasing their baby's risk of developing asthma, according to a newly released Australian study.
Found in its natural form in leafy green vegetables, legumes and some nuts, folic acid is commonly recommended to women trying to conceive to prevent neural defects in the first weeks of pregnancy.
But the Australian study found that women who continue to take folic acid late into pregnancy were 30 percent more likely to give birth to a child which would develop asthma.
"We see a substantial proportion of women taking these folate supplements throughout pregnancy, and it may be because people think it is entirely benign," said Michael Davies, associate professor at Adelaide University.
"Folate is incredibly important because of its role in preventing neural tube defects (like spina bifida). But because it is so important, and so bioactive, it needs to be treated with some respect as well."
Of the 550 women studied, those who took the folic acid supplements before conception and not more than several weeks into their pregnancy had no increased risk of asthma in their children.
But women who took it during weeks 16 to 30 of the pregnancy increased their risk of having a child with asthma by about 30 percent, according to the research, published in the American Journal of Epidemiology.
"Our finding should be reassuring to women who take folate for the purpose of preventing neural tube defects because we found no evidence of early supplementation (leading to asthma)," Davies told newswire AAP.
Davies said a diet rich in natural folate carried no increased risk of asthma for the baby.
Source