Trusted Information for Healthy Pregnancies
prenatal care
Why Prenatal Care Matters during Your Pregnancy
Apr 30th
It is important that pregnant women see a physician more often than just to confirm their pregnancies and to have their babies delivered. Quality prenatal care by an established OB/GYN or nurse practitioner throughout the entirety of the pregnancy is the best way to monitor a baby's growth and to identify any problems or complications early on, before they become a health threat to the future mother or her unborn child. During these prenatal visits, a mother-to-be is also educated on how to care for herself during a healthy pregnancy, and also how to manage unique circumstances-such as gestational diabetes-that can emerge during pregnancy. Statistics show that women who make regular visits to health care providers during their pregnancy have healthier babies, are less likely to give birth prematurely, and are less likely to have other serious pregnancy-related issues. A pregnant woman's OB/GYN will often refer her and her partner to helpful support groups or Lamaze classes. These health care practitioners also connect low-income pregnant women with referrals to much-needed government services, such as WIC.
During a normal, low-risk pregnancy, it is recommended that a woman make prenatal visits about once a month during her first 28 weeks; twice a month from week 28 to week 36; and up to once a week after week 36, according to helpful information compiled by the March of Dimes. Those with higher-risk pregnancies may need to make more frequent visits with their doctor.
Knowing the approximate due date is another reason prenatal visits are useful because this helps women determine how much time they will have to prepare for a new baby. Prenatal visits also provide an opportunity to receive an ultrasound to determine the sex of the baby after it has reached the appropriate point of development.
The education a woman receives about pregnancy and childbirth during prenatal visits is invaluable. Women will learn the important role prenatal vitamins play in the healthy development of the baby, how to manage their weight during pregnancy, and answer any tricky questions they may have about their pregnancy. Topics a pregnant woman may want to discuss with a health care practitioner during a prenatal visit might include: sexual activity during pregnancy, exercise during pregnancy, the risk factors associated with being pregnant as a teen or older adult, what changes to expect in your body during pregnancy, and how to manage discomfort during pregnancy.
This guest post is contributed by Jennifer Johnson, who writes on the topics of NP Schools. She welcomes your comments at her email Id: j.johnson19june@gmail.com.
Less sunlight in first trimester of pregnancy linked to MS
Apr 30th
Region of birth and lower levels of exposure to ultraviolet radiation during the first trimester of pregnancy were both independently associated with an increased risk of multiple sclerosis (MS) in adult life, shows research published in the BMJ.
The study was conducted across five states and one territory in Australia, among people born between 1920 and 1950 who were still alive at the time of the 1981 population census. A prevalence survey of MS had also been carried out in 1981.
There were 1524 patients with multiple sclerosis born in Australia 1920-50 from a total population of 2 468 779. Researchers analyzed their data by sex, month and year of birth and region of birth.
As expected, MS was more than twice as common among women as among men.
Overall, people born in November-December (first trimester in the Australian winter) had a third higher risk of subsequently developing MS than those born in May-June (first trimester in the summer).
When researchers analyzed their data by region of birth, they found that people born in regions with the lowest average levels of ambient ultraviolet radiation had a more than four times greater risk of subsequently developing MS than those born in the sunniest regions.
The association with month of birth was accounted for by the month- and region-specific ambient ultraviolet radiation during the first trimester – the effect of month of birth did not persist after adjustment for first trimester ultraviolet radiation.
The authors discuss the implications for prenatal care, and conclude: “Vitamin D supplementation for the prevention of multiple sclerosis might also need to be considered during in utero development.”
Source
Mom’s anemia may raise schizophrenia risk in offspring
Feb 10th
Children of mothers who had been diagnosed with anemia during pregnancy, most likely due to iron deficiency, had a significantly elevated risk of developing the mental disorder, the study's lead researcher Dr. Holger Srensen of the University Hospital of Copenhagen in Demark, told Reuters Health by email.
Iron is necessary for the production of hemoglobin, a protein that distributes oxygen throughout the body. Because a pregnant woman carries an additional set of organs and tissues -- and almost 50 percent more blood -- she needs extra iron to ensure that enough oxygen gets around.
"We speculate that maternal iron deficiency may disrupt essential pathways that affect the delivery of oxygen and nutrients to the fetus," Srensen said. Earlier research has suggested that a failure to meet the iron demands of a developing brain might heighten a child's vulnerability to disorders such as schizophrenia.
To further investigate this potential link, Srensen and colleagues analyzed the psychiatric outcomes of a large group of Danish children born between 1978 and 1998 -- the biggest cohort in which the relationship has been examined. Each child was followed from age 10 until the onset of schizophrenia, death or the study's closure on December 31, 2008.
Among 1,115,752 newborns, 17,940 (1.6 percent) were exposed to anemia in the womb. A total of 3,422 -- including 41 from the exposed group -- went on to develop schizophrenia, according to the report published in the journal Schizophrenia Bulletin.
After accounting for differences between the two groups and other relevant factors, including the parents' ages and history of mental illness, exposure to anemia in the womb was associated with a 60 percent increased risk of schizophrenia in offspring during the 20 years of the study.
The researchers further concluded that 0.58 percent of schizophrenia cases (a total of about 20 diagnoses) could have been prevented had there been no cases of anemia among the mothers.
These figures may be underestimates of anemia's true impact, according to Srensen and colleagues. It is possible that some pregnant women received anemia diagnoses and treatment from general practitioners outside the hospital, and therefore outside of the Danish registry used for the study.
Schizophrenia diagnoses may have been under reported as well. Even the oldest cohort members were only followed until age 30. Rates of schizophrenia peak around age 22 or 23, noted Srensen, so the study "may have missed around 50 percent of cases with a later onset."
The researchers also lacked access to the women's precise hemoglobin levels, which prevented assessment of the relative severity of anemia.
Despite its unresolved relationship with schizophrenia, prevention and treatment of maternal anemia remains straightforward. "Checking for iron-deficiency anemia (or anemia from other causes), and correcting a deficit," Srensen said, "is relatively simple in a clinical setting."
Source
Ultrasounds during pregnancy soar
Jan 5th
The number of ultrasounds administered to pregnant women has soared over the past decade, new research suggests.
A new study finds that the annual number of ultrasounds rose to 3,264 per 1,000 pregnancies in 2006 from 2,055 per 1,000 in 1996.
The proportion of pregnancies with at least four ultrasounds in the second or third trimesters grew to 18.7 per cent in 2006 from 6.4 per cent in 1996. Women who were deemed low-risk by their physicians received more ultrasounds than women categorized as high-risk.
Women fell into a high-risk category if the pregnancy endangered their life, required a genetics consultation or amniocentesis, or if they had a history of complications in a previous pregnancy. All other pregnancies were considered low-risk.
The study of 1,399,389 single deliveries was conducted between 1996 and 2006 by researchers at McMaster University in Hamilton, Toronto's Institute for Clinical Evaluative Sciences, and St. Michael's Hospital in Toronto. It is published in the Jan. 4 issue of the Canadian Medical Association Journal.
"Although guidelines generally recommend that two ultrasound examinations be performed in a pregnancy without complications — one in the first trimester for measurement of nuchal translucency to screen for aneuploidy (a chromosomal abnormality), and one in the second trimester to screen for fetal anomalies — it is conceivable that the proliferation of prenatal ultrasonography reflects changes in maternal risk over time," write the authors.
The authors speculate that many factors could be involved in the spike in ultrasounds. They attribute it to "defensive medicine," meaning doctors are erring on the side of caution, the desire of physicians to reduce patient anxiety, requests from mothers and even the "entertainment value of seeing one's fetus."
Over the course of the 10-year study period, the proportion of women aged 34-54 rose to 20.4 per cent of all pregnancies from 15.1 per cent in 1996. The number of high-risk pregnancies also grew to 19.3 per cent from 15.7 per cent.
The study's authors also point out that the cost of administering ultrasounds to women at low risk of pregnancy complications is high. At $64 per exam in Ontario, the cumulative total of ultrasound exams in the province since 1996 is $30 million.
It also questions the safety of multiple ultrasounds, noting that some studies have shown that frequent scans may cause the fetus's growth to be restricted, delayed speech and non-right-handedness. As well, the study points out that benign findings on ultrasounds can lead to invasive and potentially risky procedures that are not necessary, such as amniocentesis.
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.
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