Trusted Information for Healthy Pregnancies
genetics
Both parents’ race may affect gestational diabetes risk
May 6th
Researchers found that among nearly 140,000 women in one large California health plan, Asian women had the highest rate of gestational diabetes, at nearly 7 percent. They were followed by Native American women, at 5.6 percent, and Latina women, at 5 percent.
Rates of gestational diabetes among white and black women, meanwhile, stood between 3 and 4 percent.
But it wasn't only women's race and ethnicity that mattered, the study found. Expectant fathers' backgrounds also showed an independent association with the risk of gestational diabetes.
When the father was Asian or Hispanic, the researchers found, a woman's risk of gestational diabetes was 41 percent and 29 percent higher, respectively, compared with when the father was white. That was with other factors -- including the mother's race and ethnicity, age, body weight and education -- taken into account.
Native American ethnicity was also linked to relatively higher risks, though the association was weakened when other factors were considered.
Estimated to affect between 3 percent and 8 percent of pregnant women in the U.S., gestational diabetes arises during pregnancy and goes away soon after childbirth, though women who develop it have a higher-than-average risk of eventually developing type 2 diabetes.
Gestational diabetes can raise the risk of certain pregnancy complications, like high blood pressure in the mother and having a larger-than-normal baby, which may require a C-section.
Studies have shown that in the U.S., minorities generally have a higher risk of gestational diabetes than white women do.
These latest findings, published in the American Journal of Obstetrics & Gynecology, confirm a role for women's race and ethnicity in gestational diabetes risk.
But they also suggest that "in addition to women who are Asian, Latina, or Native American, women whose partners are of these racial/ethnic groups also appear to be at higher risk for (gestational diabetes)," write Dr. Aaron B. Caughey and his colleagues at the University of California, San Francisco.
The findings may help guide gestational diabetes screening, the researchers note.
For women at average risk of gestational diabetes, doctors typically perform a blood sugar test at some point in the second trimester. Those considered to be at high risk may be screened at their first prenatal visit and then retested later in pregnancy.
It is not clear why certain racial and ethnic groups are at increased risk of gestational diabetes, but genetic predisposition likely plays a role, according to Caughey's team.
They point out that a number of studies have found increased risks among Asian women, despite the fact that they have relatively low levels of obesity, a risk factor for both gestational and type 2 diabetes.
As for why the father's race and ethnicity matters, the researchers explain that fathers' genes, as well as mothers', influence hormones in the placenta. Placental hormones, in turn, affect a pregnant woman's sensitivity to the hormone insulin, which regulates blood sugar. Impaired insulin sensitivity can then lead to gestational diabetes.
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Mother-daughter pregnancy sickness link found
Apr 30th
Pregnant women are three times more likely to suffer from severe morning sickness if their mothers did, say Norwegian researchers,
Around 2% of women suffer excessive nausea and vomiting in pregnancy - known as hyperemesis gravidarum - which can require hospital treatment.
But a study of 2.3 million births showed a threefold higher rate in those whose mothers had the condition.
Experts said the results could help women better understand their risk.
Hyperemesis is defined as excessive sickness which starts before the 22nd week of pregnancy and in its most serious form it can lead to dehydration and weight loss because women cannot keep food or water down.
It can be extremely debilitating, women can't work, can't look after their families and they need to be admitted to hospital.
It is the most common cause of admission to hospital in early pregnancy and can be a cause of low birth weight and premature birth.
The researchers said that previous studies have attributed the condition to "psychological causes".
They analyzed birth records, which included information on pregnancy complications, from 1967 to 2006.
It found the daughters of women who had the condition during their pregnancy had a 3% risk compared with 1% in those whose mothers did not have it.
But there was no increased risk to the female partners of sons whose mothers had suffered from the illness.
The researchers said although the results suggest a genetic link between mothers and daughters, it is also possible that there are lifestyle or environmental factors shared between mother and daughter that increase the risk.
Dr Catherine Nelson-Piercy, a consultant obstetric physician at Guy's and St Thomas' Foundation Trust in London, said that better understanding of the genetic risks of hyperemesis may help clinicians when counseling women about the risk of recurrence in future pregnancies.
She said many women were undertreated because of the legacy of thalidomide - a drug given for morning sickness in the 1960s which caused birth defects - despite the availability of safe drugs.
"It is safe to take anti-sickness drugs and it's better for the baby and the pregnancy to treat this condition than let the woman get very severely ill and risk complications."
Patrick O'Brien, spokesman for the Royal College of Obstetrics and Gynaecology, said the study added to growing evidence that many conditions in pregnancy, such as diabetes or high blood pressure, were linked to a "genetic predisposition".
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Prenatal testing curbs some genetic diseases
Feb 18th
Some of mankind's most devastating inherited diseases appear to be declining, and a few have nearly disappeared, because more people are using genetic testing to decide whether to have children.
Births of babies with cystic fibrosis, Tay-Sachs and other less familiar disorders seem to have dropped since testing came into wider use, The Associated Press found from interviews with numerous geneticists and other experts and a review of the limited research available.
Now, more women are being tested as part of routine prenatal care, and many end pregnancies when diseases are found. One study in California found that prenatal screening reduced by half the number of babies born with the severest form of cystic fibrosis because many parents chose abortion.
More couples with no family history of inherited diseases are getting tested before starting families to see if they carry mutations that put a baby at risk. And a growing number are screening embryos and using only those without problem genes.
The cost of testing is falling, and the number of companies offering it is rising. A 2008 federal law banning gene-based discrimination by insurers and employers has eased fears.
Genetic testing pushes hot-button issues: abortion, embryo destruction and worries about eugenics - selective breeding to rid a population of unwanted traits.
Some diseases - sickle cell, cystic fibrosis, Tay-Sachs, thalassemia, spinal muscle atrophy - occur when people inherit two bad genes, one from each parent. The genes can pass quietly for generations until two carriers mate; then children have a one-in-four chance of getting the disease.
Comparisons to couples not given prenatal screening suggested that screening had cut births of babies with severe disease in half, researchers reported at a genetics conference in 2008. Studies in Canada, Italy, Australia and in Europe also found that cases dropped after screening began.
Gene testing hasn't led to declines in all diseases. Sickle cell, a blood disorder that causes anemia and pain and raises the risk of stroke, has not dropped. It mostly afflicts blacks; gene carriers are said to have sickle cell "trait," which sounds harmless.
"Now we're actually learning that it's not as benign as we thought it was," and that carriers have higher risks for certain medical problems, said Dr. Lanetta Jordan, a Florida physician and chief medical officer of the Sickle Cell Disease Association of America.
Newborn screening is finding more sickle cell carriers and cases, but this doesn't seem to affect parents' future family plans, Jordan said.
The number of fertility treatments that include embryo screening has been on the rise in recent years, with nearly 5,200 screenings in 2006, according to the Society for Assisted Reproductive Technology. Carrier testing also is rising. A California company, Counsyl, sells a $349 saliva test for genes for more than 100 inherited disorders. Several thousand people used it over the last year, the company reports.
Eliminating disease is a noble goal but also "should give us pause," Lerner, the Columbia historian, wrote recently in the New England Journal of Medicine.
"If a society is so willing to screen aggressively to find these genes and then to potentially to have to abort the fetuses, what does that say about the value of the lives of those people living with the diseases?" he asked.
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Wanted: Volunteers, All Pregnant
Feb 16th
The woman sent by government scientists visited the Queens apartment repeatedly before finding anyone home. And the person who finally answered the door - a 30-year-old Colombian-born waitress named Alejandra - was wary.
Although Alejandra was exactly what the scientists were looking for - a pregnant woman - she was "a bit scared," she said, about giving herself and her unborn child to science for 21 years.
Researchers would collect and analyze her vaginal fluid, toenail clippings, breast milk and other things, and ask about everything from possible drug use to depression, At the birth, specimen collectors would scoop up her placenta and even her baby’s first feces for scientific posterity.
She ultimately decided that participating would “help the next generation.”
Chalk one up for the scientists, who for months have been dispatching door-to-door emissaries across the country to recruit women like Alejandra for an unprecedented undertaking: the largest, most comprehensive long-term study of the health of children, beginning even before they are born.
Authorized by Congress in 2000, the National Children’s Study began last January, its projected cost swelling to about $6.7 billion. With several hundred participants so far, it aims to enroll 100,000 pregnant women in 105 counties, then monitor their babies until they turn 21.
It will examine how environment, genes and other factors affect children’s health, tackling questions subject to heated debate and misinformation. Does pesticide exposure, for example, cause asthma? Do particular diets or genetic mutations lead to autism?
But while the idea is praised by many experts, the study has also stirred controversy over its cost and content.
In August, the Senate committee overseeing financing for the study accused it of “a serious breach of trust” for not disclosing that the initial price tag of $3.1 billion would more than double, and said the study needed to release more information if it wanted to get “any” financing in the next budget year.
And an independent panel of experts and some members of the study’s own advisory committee say it misses important opportunities to help people and communities — emphasizing narrower medical questions over concerns like racial and ethnic health differences, leaving unresolved crucial ethical questions concerning what to tell participants and communities about test results.
“This study is of the magnitude of the accelerator in CERN, or a trip to the moon — a really big science issue,” said Milton Kotelchuck, a professor at the Boston University School of Public Health and a member of the independent panel. “But if you have a flawed beginning, then you’ve got 20 years of working on a flawed study.”
Officials are making changes, putting all but the pilot phase, to involve 37 locations, on hold while conducting an inquiry into the cost and scientific underpinnings, Dr. Collins said. Some data may no longer be collected if “we can’t afford” it, he said, and every aspect will receive “the closest possible scrutiny.”
The study is far from its plan of recruiting 250 babies a year for four or five years in each community. By December, 510 women were enrolled and 83 babies were born in the first seven locations, including Orange County, Calif., and Salt Lake County, Utah.
That was after knocking on nearly 64,000 doors, screening 27,000 women and finding 1,000 who were pregnant and in their first trimester (and therefore eligible).
The time and information required from families could also make the study “too burdensome to be conducted the way it is,” said Dr. Susan Shurin, former acting director of the National Institute of Child Health and Human Development, part of the National Institutes of Health and the study’s supervising agency. The fear is women will “go ‘Oh no, you again,’ and slam the door in your face.”
Specimens include blood, urine, hair and saliva from pregnant women, babies and fathers; dust from women’s bedsheets; tap water; and particles on carpets and baseboards. They are sent to laboratories (placentas to Rochester, N.Y., for example), prepared for long-term storage, and analyzed for chemicals, metals, genes and infections.
Participants provide the names and phone numbers of relatives and friends, so researchers can find them if they move. As children grow, scientists, including outside experts, can cross-reference information about their medical conditions, behavioral development and school performance.
Besides looking at widespread conditions, like diabetes, the study will consider regional differences. Maureen Durkin, principal investigator in Waukesha County, Wis., wonders if radium in the county’s water, and houses built on “farm fields that may be contaminated with nitrates and atrazine,” have different health consequences than pollution or industrial chemicals in Queens.
But study officials are trying to determine what information to give participants and when. Some experts say people should get results of their chemical or genetic tests only if medical treatments exist because otherwise it only causes anxiety. Others agree with Patricia O’Campo, a member of the study’s advisory committee and the independent panel, who says the study should be “less ivory towerish” and disclose more information to families and communities.
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Newborn testing faces challenges in using leftover blood spots for research
Feb 9th
A critical safety net for babies - that heelprick of blood taken from every newborn in the U.S. - is facing an ethics attack.
After those tiny blood spots are tested for a list of devastating diseases, some states are storing them for years. Scientists consider the leftover samples a treasure, both to improve newborn screening and to study bigger questions, like which environmental toxins can harm a fetus's developing heart or which genes trigger childhood cancers.
But seldom are parents asked to consent to such research - most probably do not know it occurs - raising privacy concerns that are shaking up one of public health's most successful programs. Texas is poised to throw away blood samples from more than five million babies to settle a lawsuit from parents angry at what they call secret DNA warehousing. A judge recently dismissed a similar lawsuit in Minnesota.
Michigan just moved four million leftover blood spots into a new "BioTrust for Health," planning a public education campaign about the research potential and how families can opt out.
Advisers to the U.S. government hope to have national recommendations in two months on how to assure all babies still get their newborn tests while allowing parents more say in what happens next.
"It's a critical thing that we take action," says advisory board member Sharon Terry of the non-profit Genetic Alliance. She says distrust over the leftover blood spots threatens public confidence in newborn screening itself.
"The sunshine on the information - educating parents - is the way lesser threat. Done well and done right, there will be an enormous benefit overall to the system," she says.
Newborn screening is not new. It began in the 1960s, and today every baby is supposed to be tested for at least 29 rare genetic diseases in hopes of catching the fraction who need early treatment to help avoid brain damage or death. Now being added to the list: Bubble-boy disease, formally known as SCID for severe combined immune deficiency.
The program catches about 5,000 babies a year in need of treatment.
Because newborn screening is mandatory, only a handful of states provide much upfront parent education. Leftover spots mainly are used for double-checking that newborn tests are accurate. Sometimes, families ask geneticists to study them after a child's death from a disease doctors can't immediately diagnose.
But as scientists sought to use the leftovers for broader research, suddenly the informing of parents - especially about long-stored spots - became an issue. While blood spots are stripped of identifying information before being handed over to scientists, people generally need to consent to participate in research.
"My kid is not a lab rat. You have to ask before you can use him in an experiment, before you can use his blood, his tissues, his DNA, whatever," says Andrea Beleno, one of the Texas parents who sued. Among their worries: that genetic information about the children could fall into the wrong hands.
Had she only been asked, Beleno adds, she probably would have let her son's blood spot be stored.
To scientists who pore through dusty warehouses in search of blood samples stored by health department ID codes - not the babies' names - privacy concerns are exaggerated.
"There's a gap between the name and the DNA. ... There's no way one could just put one's hands on these blood spots and know anything about that person," says Dr. Christopher Loffredo of Georgetown University, who needed families' permission to cull about 1,200 blood spots stored in Maryland for a study that linked a pregnant woman's smoking or exposure to certain chemical solvents to fetal heart defects.
Still, Dr. Jennifer Puck of the University of California, San Francisco, who created the new SCID test using leftover blood spots, understands parents' concerns.
"DNA is your personal signature, and it uniquely identifies us," Puck says. "We all have to become more careful and more specific in terms of what we're going to do with the blood spots."
Bioethicist Aaron Goldenberg of Case Western Reserve University studied parent attitudes, and found three-quarters would be willing to have their baby's leftover blood spot used for research if they were asked first. But they generally oppose that research without consent.
The balancing act for states, he says, is separating the two issues - lifesaving newborn screening and other use of the leftover blood - in the little time available to educate parents.
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Use of Acetaminophen in Pregnancy Associated With Increased Asthma Symptoms in Children
Feb 5th
Children who were exposed to acetaminophen prenatally were more likely to have asthma symptoms at age five in a study of 300 African-American and Dominican Republic children living in New York City. Building on prior research showing an association between both prenatal and postnatal acetaminophen and asthma, this is the first study to demonstrate a direct link between asthma and an ability to detoxify foreign substances in the body. The findings were published this week in the journal Thorax.
The study, conducted by the Columbia Center for Children's Environmental Health at Columbia University's Mailman School of Public Health, found that the relationship was stronger in children with a variant of a gene, glutathione S transferase, involved in detoxification of foreign substances. The variant is common among African-American and Hispanic populations. The results suggest that less efficient detoxification is a mechanism in the association between acetaminophen and asthma.
The researchers assessed the use of analgesics during pregnancy and found that 34 percent of mothers reported acetaminophen use during pregnancy, and 27 percent of children had wheeze, an asthma-related symptom. The children whose mothers had taken acetaminophen were more likely to wheeze, visit the emergency room for respiratory problems, and develop allergy symptoms, compared to those children whose mothers did not take acetaminophen. The risk increased with increasing number of days of prenatal acetaminophen use. The children in this study live in neighborhoods of New York City that have been the hardest hit by the asthma epidemic: Northern Manhattan and the South Bronx.
Acetaminophen use among children in the U.S. has increased substantially since the early 1980s and has become increasingly common among women during pregnancy so that most women in the U.S. take acetaminophen during pregnancy. This increase coincided with a doubling of the prevalence of asthma among children in the country between 1980 and 1995.
"These findings might provide an explanation for some of the increased asthma risk in minority communities and suggest caution in the use of acetaminophen in pregnancy," says Matthew S. Perzanowski, PhD, assistant professor of Environmental Health Sciences at the Mailman School of Public Health.
Reasons for prenatal acetaminophen use vary, but in this study population the observed associations with headaches suggest pain management as likely; however, other host factors that caused mothers to take acetaminophen and also cause asthma may explain their association. While infection is one such potential confounder, the Mailman School researchers found no association between the reported use of antibiotics and acetaminophen, and adjustment for antibiotic use during pregnancy did not affect the results.
According to the researchers, the prevalence of current wheeze diminished as the children aged, from 40 percent at age one year to 25 percent, 17 percent and 27 percent at ages two, three, and five, respectively. However, the association between prenatal acetaminophen exposure and current wheeze strengthened as the children aged.
The Columbia Center for Children's Environmental Health study adjusted relative risks for sex, race/ethnicity, birth order, maternal asthma, maternal hardship, exposure to environmental tobacco smoke, antibiotic use and postnatal acetaminophen use.
In a similar study conducted in the UK, the frequency of acetaminophen use during pregnancy and the magnitude of association in the UK study were similar to that in New York City.
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Blood test tells fetal sex in early pregnancy
Jan 19th
Normally, parents who want to know the sex of their baby before it's born find out through ultrasound done in the second trimester. A blood test that can be done early in pregnancy is highly accurate at determining the sex of the fetus, however, a new study finds.
The test is important, write the authors of the study, because in some cases, there are medical reasons to determine fetal sex earlier. That has traditionally meant invasive tests, like amniocentesis, which carry a small risk of miscarriage.
Consequently, maternal blood tests that pick up certain markers of fetal sex have been developed and put into use in recent years. So far, research has shown the accuracy of these tests to vary widely, depending on the methods used.
In this latest study, published in the journal Obstetrics & Gynecology, researchers in the Netherlands found that the testing method used at their center was 100 percent accurate in determining fetal sex among nearly 200 pregnant women.
Part of what's new about the findings is that they show the effectiveness of blood testing as it is done in routine practice -- and not just in the research setting, Dr. Ellen van der Schoot, of Sanquin Research Amsterdam, told Reuters Health in an email. The study does not discuss costs, nor when the test might be available to the general public.
Still, the findings, according to van der Schoot and her colleagues, support using the tests in cases where fetal sex is important in detecting or managing certain inherited medical conditions.
For example, congenital adrenal hyperplasia (CAH) is a genetic disorder that causes girls to develop abnormal external genitalia and male-like characteristics like a deep voice and excessive body hair.
It is possible, however, to treat the disorder with the steroid dexamethasone as soon as pregnancy is established, so knowing the fetal sex sooner is better than later.
Similarly, fetal sex is key in genetic disorders linked to abnormalities in the X chromosome. These disorders -- such as hemophilia and Duchenne/Becker muscular dystrophy -- are almost always seen in boys rather than girls, because boys inherit only one X chromosome, from the mother. (Girls inherit an X chromosome from each parent.)
In cases where a mother is known to carry an X-linked genetic defect, blood testing for fetal sex tells doctors whether further, invasive testing for the particular genetic disorder should be done. If the fetus is female, invasive tests can be avoided.
In the current study, van der Schoot and her colleagues looked at 201 pregnant women who had blood testing at their lab between 2003 and 2009. The test, done as early as the seventh week of pregnancy, determines fetal sex by looking for two genes found on the Y sex chromosome.
Only men carry the Y chromosome, so when these genes were found in a pregnant woman's blood sample, the fetus was assumed to be male. When the test did not detect the genes, the mother's blood was analyzed further to confirm that certain other fetal DNA was present; with that confirmation, the researchers concluded that the fetus was female.
Of the 201 women in this study, blood tests gave conclusive results to 189. In each case, that result turned out to be correct.
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Mothers’ Genes Important in Preterm Birth Risk
Dec 9th
A mother's genes may be an important factor in the risk of preterm birth, two new studies suggest.
Past research has shown that genes likely play a role in a pregnant woman's odds of delivering prematurely - before the 37th week of pregnancy.
The risk is increased, for example, among women who were themselves born prematurely or have a sister who ever gave birth preterm, And findings from twin studies suggest that up to 40 percent of preterm deliveries involve some genetic susceptibility.
But little is known about the specifics of how genes influence preterm labor.
The two new studies, reported in the American Journal of Epidemiology, suggest that the mother's genes - rather than genes affecting fetal development that are inherited from both parents - are key.
In one study, Danish researchers analyzed national database information on more than 1 million singleton births in Denmark between 1978 and 2004. They found that, not surprisingly, women with a history of preterm delivery were at increased risk of having a subsequent early birth.
But the risk was also elevated among women with a mother, sister or half-sister (born to the same mother) who had delivered prematurely. Compared with women without such a family history, these women were 60 percent more likely to have a preterm birth.
In contrast, preterm births among female members of the father's side of the family, or among the female partners of a woman's male relatives, had no bearing on a woman's own risk of premature delivery.
The findings were similar in the second study - this one of more than 989,000 births in Sweden between 1992 and 2004. Researchers found that sisters of women who had delivered preterm had an 80 percent higher risk of early delivery, versus women without that family history.
There was no evidence of an increased risk, however, when a brother's partner had delivered prematurely. Nor was there evidence that the increased risk shared by sisters was explained by non-genetic factors that could influence the chances of preterm delivery, like smoking or lower education levels.
Overall, the researchers estimate that mothers' genes account for one-quarter of the variation in preterm delivery risk across the population. In contrast, fetal genes - which are inherited from both parents - showed little influence.
The vast majority of women in the studies did not deliver early, regardless of family history. In the Danish study, for example, about 7 percent of women with a sister who had delivered prematurely had a preterm birth themselves; that compared with 4.5 percent of women whose sisters had no history of preterm delivery.
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“Flat-Head” Syndrome – Environment or Genetics?
Nov 17th
- No one wants a baby with deformational plagiocephaly. But what is it and how is it caused?
- According to a new study in the journal Pediatrics; when it comes to infants' risk of developing a flat spot on the head, environment appears more important than genes.
- The study, looked at more than 20,000 babies treated for deformational plagiocephaly - misshapen areas in the skull that most commonly manifest as a flattening at the back of the head.
- Factors both before and after birth contribute to plagiocephaly. Crowding in the womb is a risk factor, for instance, with the problem being more common in twins and other multiples.
- After birth, repetitive pressure on one area of an infant's head -- from repeatedly sleeping in the same position, or spending too much time in swings or "bouncy seats" -- can also lead to plagiocephaly.
- However, researchers have also questioned whether genetic predisposition might play an important role. Some studies have found that plagiocephaly tends to run in families, but that could reflect either genetic influences or parenting practices.
- In the new study, researchers found that "twinning" was associated with a higher risk of plagiocephaly, but there was no evidence of a difference between identical and fraternal twins.
- Because identical twins share all of their genes and fraternal twins share only about half, on average, the finding suggests that genetic predisposition does not explain the tendency of plagiocephaly to run in some families.
- On the other hand, environmental factors like position in the womb and an infant's sleep position were important. For instance, 15 percent of babies with plagiocephaly had been born in the breech position -- with the feet or buttocks, rather than the head, closest to the birth canal; that compares with roughly 3.5 percent of births in the general population.
- Sleep position, meanwhile, was the most important factor in the "lateralization" of the plagiocephaly. That is, babies who usually slept with their heads turned to the right usually developed a flat spot on the right side of the head, while those who favored the left side usually developed plagiocephaly on that side of the head.
- "What our work may imply is that if there is a genetic predisposition for (a) variation like deformational plagiocephaly, there is not any one genetic factor, but instead many, and that there may be different factors in different populations of ethnic diversity," senior researcher Dr. Brian C. Verrelli told Reuters Health in an email.
- On the other hand, it seems that environmental factors are "very important" in causing plagiocephaly, according to Verrelli, an assistant professor at Arizona State University in Tempe.
- And that, the researcher noted, implies that plagiocephaly can not only be avoided, but also that there is a "high probability" that it will be easily treated.
- Since pediatricians began recommending that infants be put to sleep on their backs to lower the risk of sudden infant death syndrome (SIDS), studies have noted a rise in plagiocephaly. To counter that, experts generally recommend that infants get plenty of supervised "tummy time" when they are awake, and that parents avoid leaving them in carriers, swings or other seats for a prolonged period.
- Plagiocephaly is often treated in a similar manner -- tummy time during waking hours and periodically turning the baby's head when he or she is sleeping, for instance. In some cases, infants are outfitted with a helmet that they wear for a few months to help reshape the skull as it grows.
Lower Pregnancy Risks By Asking Mom’s History
Nov 12th
Experts say it's wise to know both your parents' health histories, but ask your mom the right questions and you may be able to avoid a struggle later on. "Knowing your mother's gynecological history can really arm you with what you need to know to take proactive steps in the future," says Tracy Gaudet, MD, executive director of Duke Integrative Medicine at Duke University and author of Body, Soul and Baby. Here are questions to help you start talking:
Did you have preeclampsia?
Preeclampsia is a pregnancy-induced condition that’s marked by high blood pressure, excess protein in the urine, severe headaches, and sudden weight gain that can lead to preterm birth and may require bed rest or induced labor near the end of a pregnancy. Women whose mothers had it are often thought to be at higher risk during their own pregnancies. But other factors may be more significant than your mom’s experience, Dr. Greene says. They include being overweight or older than 35, carrying multiples, having preexisting high blood pressure, or simply being pregnant for the first time. Of course, if you have any of these risk factors to go along with a mom who had preeclampsia, that can nudge the risk even higher.
How knowing helps: Tell your obstetrician if your mom had preeclampsia; she may want to monitor you extra closely. Keep your weight gain in the safe range (25 to 35 pounds if you’re not over- or underweight starting out), and go easy on salty and sugary foods.
Do we have a family history of any disease?
Family history can predict many health risks beyond gyno concerns, including heart disease, diabetes, some cancers, osteoporosis, depression, and stroke. You want to know both of your parents’ histories, “but the links to these diseases are often stronger on the maternal side for a daughter,” Dr. Pinkerton says.
How knowing helps: Your mom’s history may prompt your doc to refer you to a genetic counselor, who can discuss a blood test that screens for genetic mutations. For many other diseases, a healthy lifestyle and simple preventive measures (such as watching your sugar intake if diabetes is a threat) can lower your risk, no matter the family connection. If your mom suffers from low bone mass, or osteopenia, that’s useful info, Dr. Pinkerton says.
“You’ll want to build bone density in your 30s by eating enough calcium and doing weight-bearing exercises like lifting weights or practicing yoga,” she explains. And in your mid-40s, a bone-density test should go on your list of issues to discuss with your doctor.
Read about Genetically Related Birth Defects.
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