Trusted Information for Healthy Pregnancies
pregnancy
Zolpidem (Ambien) in Pregnancy: Is it Safe?
Nov 22nd
It is estimated that up to 95% of women experience some type of sleep disturbance during pregnancy. While for many women the insomnia is relatively benign and may respond to simple interventions, other women experience more severe insomnia which has a significant impact on their quality of life and ability to function. While zolpidem (Ambien), [...]
ACOG Focuses on Smoking Cessation in Pregnant and Postpartum Women
Nov 10th
In the November issue of Obstetrics & Gynecology, The American College of Obstetricians and Gynecologists (ACOG) has issued recommendations to providers regarding efforts to support smoking cessation in pregnant and postpartum women. The article states that while about half of women smokers stop smoking during pregnancy, about 13% of women in the United States continue [...]
Clinical Update: Use of Stimulant Medications in Pregnancy
Sep 27th
Approximately 4% of the adult population suffers from ADHD. Attention and executive functioning difficulties also occur in those with mood and psychotic disorders and require treatment strategies similar to those used to address ADHD symptoms. First line medications most often used to treat ADHD in adults are Dextroamphetamine (Dexedrine, Adderall) and Methylphenidate (Concerta, Ritalin, Metadate). [...]
Should SSRIs Be Tapered Prior To Delivery?
Sep 8th
Increased muscle tone, jitteriness, sleep disturbance, irritability, feeding problems, mild respiratory distress and myoclonus have been reported as symptoms of a potential neonatal distress syndrome related to exposure to SSRIs in late pregnancy. The average duration of symptoms reported is 48 hours. It is estimated that between 25-30% of SSRI-exposed infants are at risk for [...]
The Importance of Proper Dosing of Antidepressants during Pregnancy
Aug 30th
Pregnancy and the postpartum period is a time of increased risk for depression. Therefore, women who are treated with antidepressant medications must consider whether or not to stay on medication during pregnancy. Despite reassuring data regarding the reproductive safety of various antidepressants, a woman may prefer not to continue medication during pregnancy due to concerns [...]
Antidepressants and Risk of Spontaneous Abortion
Jun 21st
Although the last several decades of research have yielded important findings regarding the safety of antidepressants during pregnancy, some areas are still understudied. For example, there are no conclusive results concerning the risk of spontaneous abortions following antidepressant exposure during the first trimester. Several recent meta-analyses, including one from the Motherisk program (Hemels, 2005), have [...]
Valproic Acid and the Risk of Major Malformations
Jun 14th
Previous studies have indicated that infants exposed to valproic acid in pregnancy are at increased risk for a range of malformations, including neural tube defects. While these studies have shown an association between valproic acid and various malformations, they have been limited in their ability to quantify the risk of certain, less common malformations. To [...]
Study: Oral Bacteria can Lead to Stillbirth
May 12th
Scientists say they've identified a culprit behind stillbirths and miscarriages in seemingly healthy pregnant women. It turns out that oral bacteria -- even the kinds that exist normally -- can travel through an open wound in the mouth into the bloodstream, settle in the placenta and potentially end a pregnancy.
When bacteria migrate from their normal environment (where they usually don't cause harm) to a new one, problems can arise. The placenta doesn't have an immune system, and it can become inflamed when the oral bacteria set up shop. This can lead to premature births as well as deaths, researchers say.
Yiping Han of the Case Western Reserve School of Dental Medicine led the study. She said they expected the bad bacteria, like the kind that causes gingivitis, to be responsible for aborted or premature pregnancies.
"We found many bacteria did locate to the placenta, but they were not the most famous periodontal pathogens," said Han. "In fact, many of the bacteria were the kind that are found in healthy people's mouths. The normal healthy woman is under risk. People should be concerned about it."
This research comes on the heels of earlier studies linking gum health to heart disease. Han said more research needs to be done to find out exactly which kinds of bacteria are colonizing the placenta so more effective treatments and therapies can be designed for pregnant women.
In the meantime, the American Dental Association recommends several ways to protect the health of your mouth. Fewer cuts and wounds inside your mouth means the oral bacteria will have less of a chance to get into the bloodstream and affect a pregnancy.
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Stress early in pregnancy increases risks to babies
May 10th
Stressful situations in early pregnancy can lead to the birth of babies who are underweight or born too early, new research from China shows. Timing of the stress, the researchers found, was the key.
"The findings are modest, but significant," the authors write in the American Journal of Obstetrics and Gynecology.
The risks of premature births increased two-fold in women who were exposed to severe life events during their first and second trimesters - weeks 1-12 and 13-24, respectively. Premature birth, the authors note, is the single largest contributing factor in infant deaths in the developing world.
Researchers from Anhui Medical University, led by Dr. Peng Zhu, followed 1,800 pregnant women receiving prenatal treatment in 2008 at one hospital. The participants were surveyed on financial conditions, emotional support, traumatic events and their relationships with their spouses. Were jobs or fortunes lost, were family members cheated, did the family move, did a family member die or suffer an illness, or was there fighting or divorce?
There were 96 (5.3 percent) premature births and 55 (3.1 percent) low birth-weight babies.
Earlier studies have found that future moms with stressful lives were at greater risk of delivering preterm or low birth-weight babies. This study - looking at a long list of potentially stressful events experienced during pregnancy only - concluded that the earlier in pregnancy the stress occurred, the greater the risk.
The Zhu team found that premature birth was more than twice as likely if severely stressful events occurred during the first and second trimesters, but not the third. Low birthweight was nearly three times more likely if stress happened during the first trimester, compared to if it happened during the second or third trimester.
While for the most part consistent with earlier research, the Chinese researchers caution that the reach of their findings could be limited.
For instance, they warn that faulty memories, the small number of women in some of the stress categories, and the possibility that the list of stress events was flawed could weaken the power of the results.
The Zhu team concluded that health planners seeking to reduce the incidence of pre-term and low-weight births must take maternal stress into account when designing intervention programs.
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Smoking moms tied to lasting kids’ sleep woes
May 10th
Mothers who smoke during pregnancy are more likely to have children with sleep problems from birth all the way through age 12, new research shows.
"The more cigarettes that mothers smoked during pregnancy, the more sleep problems the children had," Dr. Kristen Stone of Women and Infants Hospital in Providence, Rhode Island, one of the study's authors, told Reuters Health.
What's more, while most of the women who smoked during pregnancy used at least one other drug, Stone and her team found that nicotine was the only substance associated with sleep problems.
Stone and colleagues from centers in Miami, Detroit, and Memphis are following nearly 1,400 children born in 1993, 1994 or 1995 to investigate the long-term effects of exposure to substances during pregnancy.
The current study included children for whom data was available up to age 12. Among the 808 study participants, 374 had been exposed to cocaine or opiates such as heroin before birth, while 434 had not.
Children's mothers or other caregivers reported on whether a child had difficulty falling asleep and staying asleep during three periods: one month to four years of age; five to eight years, and nine to 12 years. Being exposed to cocaine, opiates, marijuana, or alcohol in the womb had no effect on a child's risk of having sleep problems, but nicotine did, and problems were seen at each of the three time points.
The researchers do not report what percentage of children had sleeping problems, but used a common measure of such problems that assigns points for items such as talking in one's sleep, sleepwalking, and having trouble falling asleep.
The link remained even after the researchers took into account factors such as socioeconomic status, whether or not a child had been abused, and whether the mother or caregiver smoked after the child was born.
The findings shouldn't be seen as showing that prenatal use of alcohol and drugs aside from cigarettes isn't as harmful to a child's sleep as smoking in pregnancy, Stone noted. Cigarettes are different from other substances, she explained, in that a person who smokes will typically do so much more frequently than a drug abuser uses cocaine or opiates.
Further, she said, many of the mothers in the study were using multiple substances while they were pregnancy. "When those substances are inside of us at the same time, they basically become a whole new substance because of their interactions with each other," she added. All of this makes it difficult to tease out the effects of nicotine and other drugs, according to the researcher.
When a child does have sleep problems, Stone said, "early and careful attention" to these issues can go along way toward helping that child sleep better.
"Even an emphasis on basic behavioral sleep education could serve those children well," she added. "Doing that would then likely improve the daytime experience for those children as well."
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