Scottish children’s agency highlights legacy of drinking while pregnant

The agency Children in Scotland strives to highlight how thousands of the country’s children are affected by women who binge drink while pregnant.

The agency Children in Scotland has made the conservative estimate that at least 900 children in the country suffer direct, debilitating consequences of their mother having drunk heavily during the first three months of pregnancy. Thousands more are likely to have more subtle symptoms according to the agency’s report. (Note: Report is a PDF file.)

The report, delivered to the parliaments of both Scotland and the U.K. in March of 2009, cautions that undue emphasis has been placed on the effects of alcohol to the pregnant woman and not enough attention paid to the impact on the unborn child.

Many children exposed to large amounts of alcohol in vitro are later diagnosed with Foetal Alcohol Syndrome (FAS) and Foetal Alcohol Spectrum Disorder (FASD). These syndromes often result in visible birth defects and damage to the internal organs, frequently fatal. Yet less visible symptoms still occur including degradations in concentration, learning, and behavior.

But the agency stresses that the problems with alcohol don’t stop with pregnant mothers. “A significant percentage of children throughout the United Kingdom are harmed in various ways and to varying degrees by alcohol,” states the report.

“Sometimes the negative effects are caused by alcohol consumption among children and young people themselves. In addition, there is abuse and/or neglect of children resulting from the drinking problems of parents or the other adults in their lives.”

Dr. Jonathan Sher, director of research, policy and programs at Children in Scotland, told The Herald: “Foetal alcohol syndrome is the proverbial tip of the iceberg. It is easier to diagnose because the damage can be seen. Thousands more children, teenagers and adults across Scotland have suffered serious harm to their brains that is invisible, but continues to have a negative impact on their learning, behavior, wellbeing and life chances.”

The Scottish government began addressing alcohol use in the country over a year ago, and recently began the first phase of accepting evidence to back its proposal to combat the country’s alcohol-related issues. Dr. Sher and Children in Scotland submitted another report (PDF) to the Scottish parliament this past January.

The agency, along with seven other children’s organizations in the U.K., has called for the government to require minimum pricing on alcohol as part of a comprehensive plan to battle the problem. “[T]he minimum price for alcohol should be set high enough to demonstrably discourage/reduce consumption significantly,” said Children in Scotland in their January 2010 report.

“It is not sufficient to set a minimum price that creates the illusion of having ‘done something’, but which still allows young people cheap and easy access to unhealthy levels of drinking. To be effective as a deterrent, the price of alcohol must make unhealthy consumption out of reach as a ‘pocket money’ expense for young people.”

However, the Scotsman reported in mid-February that the minimum price bill has hit a snag concerning its legality.

         

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Acupuncture May Help Depression During Pregnancy

Results of a new study from Stanford University suggest that women experiencing depression during pregnancy may find some relief with acupuncture.

Acupuncture originates from China where it has been practiced for thousands of years.  An acupuncture treatment involves the insertion of very thin needles through the patient’s skin at specific points on the body.  Needles are inserted to various depths.  According to traditional Chinese medical theory, acupuncture points are located on meridians through which gi vital energy runs. Acupuncture remains controversial among Western medical doctors and scientists.

The Stanford study covered 150 women who were 12 to 30 weeks pregnant and experiencing major depression.  52 women were randomly assigned to undergo acupuncture treatment specifically developed for depression symptoms.  49 women were assigned to regular acupuncture, and 49 were assigned to Swedish massage. The women in the acupuncture group received 12 sessions of 25 minutes each without knowing which type of acupuncture treatment they received.

Eight weeks later nearly 66% of the women in the acupuncture-for-depression group reported at least a 50% reduction in their symptoms.  Less then half of the women treated with massage or regular acupuncture reported similar results.

The study is drawing attention because depression symptoms are typically higher during the third trimester of pregnancy.  Despite the normal increase in depression during that last phase of pregnancy, the women receiving acupuncture specifically designed to relieve depressive symptoms found relief from their symptoms.

To read more about acupuncture and massage for depression in pregnancy, see Depression During Pregnancy at the Stanford School of Medicine web site for Psychiatry and Behavorial Sciences.

Depression symptoms are a serious matter, and they should not be ignored.  For further discussion of depression symptoms, see Depression Information on Healthline and talk with your doctor.

         

Early weight gain during pregnancy puts mother at risk of gestational diabetes

Excessive early weight gain during pregnancy puts a mother at risk of developing gestational diabetes later in the pregnancy.

New research out of the Kaiser Permanente Division of Research in Northern California has linked excessive weight gain — especially during the first trimester — with the development of gestational diabetes later in the pregnancy.

The research, published online in the March issue of Obstetrics and Gynecology, found that the risk of gestational diabetes increased by 50 percent in those women who gained too much weight early on.

Gestational diabetes, a type of glucose intolerance commonly occurring during the second or third trimester, has been found to complicate up to seven percent of pregnancies in the United States, requiring early delivery and Caesarean sections. It often leads to type-2 diabetes and increases the risk the baby will develop diabetes and fight obesity later in life.

“There has been a dramatic rise in gestational diabetes within the past decade,” the study’s lead author, Dr. Monique M. Hedderson, told WebMD. “Women who develop gestational diabetes are more likely to have preterm deliveries and C-sections. And even after delivery they are at increased risk for developing type-2 diabetes.”

The researchers spent three years gathering data from 1,145 pregnant women of ethnically diverse populations in Northern California. The team examined the overall rate of pregnancy weight gain in the women leading up to a test for gestational diabetes between weeks 24 and 28. They also measured the rate of weight gain per trimester and compared their data with the 2009 recommendations set by the Institute of Medicine (IOM).

The IOM guidelines state that women of average weight should gain between 25 and 35 pounds during pregnancy. For overweight women, the gain should be no more than 25 pounds. Those women classified as obese should gain no more than 20 pounds.

During the first trimester, weight gains of between 1.1 pounds and 4.4 pounds are recommended regardless of pre-pregnancy weight.

The study is thought to be the first of its kind to link early weight gain with gestational diabetes. The results have led the researchers to suggest certain guidelines for controlling weight during the first trimester. Limiting extra calories to roughly 100 to 300 a day and reducing fat intake to less than 30 percent of total calories are recommended.

Kaiser Permanente has released a YouTube video with lead author and recent mother Dr. Monique M. Hedderson explaining the results. You can watch it here.

         

NHS advises future mothers about myths of pregnancy

The NHS has drafted guidelines that advise future mothers about the most common myths of pregnancy.

The NHS and other organizations have turned to the National Institute for Health and Clinical Excellence (NICE) to develop new guidelines regarding physical activity and weight for future mothers.

The guidelines, currently under professional review until March 18, attempt to dispel the myth of “eating for two”, consuming full fat milk, and quick weight loss.

Dr. Mike Kelly, director of the public health excellence centre at NICE, said: “In today’s society women are bombarded by often conflicting advice on what constitutes a healthy diet and how much physical activity they should do during pregnancy and after birth.”

“We want all women to be supported before, during and after they have children so that both they and their babies have the healthiest outcome possible.”

The guidelines address the idea that women should eat for two people, stating that in reality women only need to eat an additional 200 calories during the last three months of pregnancy. The authors also suggested that consuming full fat milks and cheeses wasn’t necessary.

Exercise was also addressed in the guidelines. “In terms of physical activity, women are encouraged to remain active and fit in order to cope with labour as well as helping to get back into shape after the birth,” said the authors.

“Normal daily activity such as walking, dancing and sport are encouraged for as long as the woman feels comfortable. Women are discouraged from exhausting themselves, and are informed that they may need to slow down as pregnancy progresses.”

NICE also warned of the societal pressures associated with quick weight loss after birth. “There is evidence that weight and body shape concerns are affected by size prior to pregnancy, and more importantly, the way that women perceive their usual and changed shape in respect to their own and other’s ideals,” said NICE in the guidance.

The Telegraph also noted “celebrity claims of unrealistic rapid weight loss” after birth, referencing Heidi Klum, Myleene Klass, Halle Berry and Jennifer Lopez as potentially unrealistic examples.

The Royal College of Midwives’ Jane Munro was pleased with the release of the guidance, stating that most women were concerned about weight before, during and after pregnancy.

“It will be particularly helpful in dispelling post-pregnancy myths,” she told the BBC. “Women need to understand that losing weight after giving birth can be a slow process, and that physical exercise and gradual weight loss will not impact on their ability to breastfeed.”

The guidance currently under review can be found at the NICE Web site.

         

Coronation Street Star Supports Midwife-Led Care

More used to delivering lines than delivering babies, Coronation Street actor Julie Hesmondhalgh bumped into a familiar face when a group of midwives from across Greater Manchester called at the Rovers Return.

Amongst the group there to raise awareness of the

local telephone service Direct to Midwife was Linda Fairley, who was Julie’s midwife whilst pregnant with daughter Martha, now 8.

The Corrie favourite was reunited with Linda, who helped care for her at Tameside General Hospital, Greater Manchester and after posing for a picture said:

“My experience with Linda and the team in Tameside was fantastic when I was pregnant with Martha and I strongly believe in midwife-led antenatal care. They offered me reassurance and advice when I needed it the most.

”The telephone line, available to women across Greater Manchester, means that by calling 0800 121 4400, pregnant women can choose to speak to a midwife as soon as they know they are pregnant instead of their GP, often gaining access to antenatal care more quickly.

Julie said: “The Direct to Midwife telephone number is a great idea, because it offers mums-to-be a simpler way of accessing the care they need. It is safe for a woman to speak to a midwife as soon as she knows she is pregnant and it is better to do it sooner rather than later.”

The midwives visited the famous cobbles to hand over a set of posters for display around the Corrie studios, which has become famous in recent years for so many cast members becoming mums and dads.

Linda, still a midwife looking after mums-to-be in Tameside said: “The experience of midwives means we’re often best placed to look after pregnant women and their babies, making sure specialist care is available if needed. We can ensure that women are booked for important early screening tests and appointments in good time.”

“Direct to Midwife brings us closer to women of all backgrounds, as it offers a translator and textphone service too. An early appointment with a midwife can help to reassure women and their partners about the journey ahead.”

The introduction of Manchester’s Direct to Midwife telephone number is designed to offer more widely the choice of using a midwife as first point of contact. On calling, women will be put in touch with the team of midwives closest to where they live.

         

Official numbers reveal UK girls pregnant at 10

Official numbers out of the UK reveal that girls as young as 10 are getting pregnant.

The U.K.’s newspaper The Sun has revealed that in the last eight years, at least 15 girls aged 10 and 39 girls aged 11 became pregnant in England and Wales.

The Sun received its data through a Freedom of Information request, finding that in total there have been 63,487 reported pregnancies in girls aged 15 and younger since 2002.

The numbers were as follows: 15 girls aged 10; 39 girls aged 11; 268 girls ages 12; 2,527 aged 13; 14,777 aged 14; and 45,861 aged 15. It was not clear how many of the pregnancies were carried out in full or aborted.

The Sun noted that before this data was released, it was believed that the youngest mother in the U.K. was a Scottish girl who conceived at age 11 and gave birth at 12.

The numbers provide a clearer picture of what has generally been known already — England is struggling with teen pregnancy. England still remains the teen pregnancy capital of Europe according to numbers by the World Health Organization. Additionally, it was reported in November 2009 that England overtook France for having the most reported abortions in 2007.

As the numbers received by The Sun give no indication of neither the number of reported and unreported abortions nor miscarriages, the number of teen pregnancies is likely to be even higher.

Many Conservatives in office blame teen pregnancies on attempts at early sex education. With Labour’s call to have all children five and older receive compulsory sex education, outrage has become more prominent.

“There are far too many schools telling children they are entitled to become sexually active when it is ‘right for them’,” said Norman Wells, of the Family Education Trust.

Anastasia de Waal, of U.K. think tank and charity Civitas, agreed, telling The Sun: “We have kids behaving as adults, not realizing the complications. Often the girls feel they have to have sex to please their older boyfriends.”

         

Depression during pregnancy may predict child’s antisocial behavior

The depression of a woman during pregnancy may lead to antisocial behavior in her child later in life.

Researchers at Cardiff University, the University of Bristol and King’s College London have concluded that a mother’s antisocial history may predict her child’s antisocial behavior.

The research, published in the January/February 2010 issue of the journal Child Development, focused on 120 British youth and their mothers for over 16 years. The researchers interviewed the mothers of the children while pregnant. They followed up with interviews after the birth, and then later when the children were 4, 11, and 16 years of age.

Researchers found that women who suffered from depression while pregnant were four times as likely to have children who demonstrated antisocial behavior, compared to those women who weren’t depressed while pregnant. In addition, the team found that women who had a violent past were more prone to depression while pregnant, indicating a predictive pattern.

While analyzing the study results, they researchers looked for environmental and demographical links between depression during pregnancy and children’s antisocial behavior, but they couldn’t find any. Factors such as the mother’s education, IQ, ethnicity and social class seemed to have no noticeable impact on the link.

Dr. Dale F. Hay, professor of psychology at Cardiff University in Wales and lead researcher for the 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.”

Despite the research, Dr. Hay and his team weren’t certain of why a link existed, but they suggested that special support services should be opened up to those affected.

“Although it’s not yet clear exactly how depression in pregnancy might set infants on a pathway toward increased antisocial behavior, our findings suggest that women with a history of conduct problems who become depressed in pregnancy may be in special need of support,” said Dr. Hay.

It is estimated that nearly 10 percent of pregnant women have major depression and 20 percent see their depression symptoms worsen during pregnancy.

While the rates are comparable to similarly-aged non-pregnant woman, difficulties exist when managing the health of pregnant women with depression. Treatment using antidepressants is often not an option due to the risk of the developing fetus. Additionally, little research has been done on the treatment of that demographic.

         

Scientists reject theory of ‘baby brain’ during pregnancy

Kate Winslet & Myleene Klass have both claimed to have had, "Baby Brain"

Scientists in Australia have rejected the theory of “baby brain”, the idea that women have memory lapses due to a pregnancy.

The idea that a woman who becomes pregnant suffers memory lapses has been cited as fact by many authors promoting self-help books for pregnant women. Those authors may want to reconsider.

New research out of Australia has found no link between a woman’s brain functions and pregnancy or motherhood.

Led by Dr. Helen Christensen of the Centre for Mental Health Research at Australian National University, the researchers focused on 1,214 women between the ages of 20 and 24. Those women were assessed in 1999 on their working memory, cognitive speed, and immediate and delayed recall. The team followed up with the women in 2003 and again in 2007.

They found that women who were pregnant during the assessments showed no decline in cognitive functions. Additionally, those women who had become mothers during the course of the study showed no cognitive losses.

In a statement by Dr. Christensen and her team, she said: “Not so long ago, pregnancy was ‘confinement’ and motherhood meant the end of career aspirations. Our results challenge the view that mothers are anything other than the intellectual peers of their contemporaries.”

“Women and their partners need to be less automatic in their willingness to attribute common memory lapses to a growing or new baby. And obstetricians, family doctors and midwives may need to use the findings from this study to promote the fact that ‘placenta brain’ is not inevitable.”

Dr. Christensen believes the idea that women lose cognitive functions during pregnancy is entirely psychological.

“Part of the problem is that pregnancy manuals tell women they are likely to experience memory and concentration problems, so women and their partners are primed to attribute any memory lapse to the ‘hard to miss’ physical sign of pregnancy,” she said.

The research, published in the February edition of the British Journal of Psychiatry, would appear to run contrary to past research that suggested brain size shrinks in pregnant women.

In January 2002, a study was published in the American Journal of Neuroradiology that found women’s brain volume shrunk by nearly four percent during pregnancy. However, it is speculated that the volume loss isn’t directly related to cognitive losses, but rather is a product of the brain creating new circuitry to allow the mother to better protect the child.

         

Women found to have only 12 percent of ‘ovarian reserve’ by age 30

New research suggests that by the age of 30, a woman’s ovarian reserve may dwindle to only 12 percent of what they were born with.

Are you a woman waiting to conceive a child until after the age of 30? New research provides further evidence of the challenges that await you if you do.

Researchers out of the University of St. Andrews and Edinburgh University have collected data on 325 women from the U.K., U.S. and parts of Europe. The women represented a broad range of ages and had their reserve of eggs assessed.

The data was then plotted on a graph to provide a clearer picture of potential decline in the ovarian reserve of women from conception to menopause.

They found that on average, roughly 300,000 egg cells exist as a newborn, but the researchers were surprised at how quickly the available reserve declined in women.

Co-author of the study, Dr. Hamish Wallace, said of the decline: “Our research shows that they are generally over-estimating their fertility prospects. Our model shows that for 95 percent of women, by the age of 30 years, only 12 percent of their maximum ovarian reserve is present, and by the age of 40 years only three percent remains.”

The researchers also found significant variance in the size of women’s ovarian reserves. Some women were found to have nearly two million egg cells while others had counts as low as 35,000.

The research, published in the journal Public Library of Science One, supports other research findings that women who wait until their 30s or later are at significant risk of fertility-related problems.

Dr. Tom Kelsey, a study researcher at St. Andrews, said: ‘Women often do not realize how seriously ovarian reserve declines after the age of 35. Every year that goes by you are losing a big proportion of your ovarian reserve.”

Some doctors already suggest that women should receive fertility screening at the same time they receive screenings for cervical cancer. A simple blood test that measures the amount of estradiol, the predominate sex hormone in females, can be performed by a gynecologist. The test can measure the potential reserve of eggs a woman has, determining if she has a reasonable chance for conception.

         

Opinions changing about eating and drinking during labor

Opinions are changing about whether of not it is safe for a woman to eat and drink during labor.

As anesthesia practices during labor have changed, so have the opinions of doctors about the safety of eating and drinking during labor.

Concerns of respiratory ailments caused by regurgitating food and inhaling food particles into the lungs (known as Mendelson’s syndrome) while under general anesthesia have left doctors advising against the consumption of food or liquid during labor. But with the shift to safer, regional anesthesia, researchers are reconsidering those restrictions.

Dr. Jeffrey Ecker, an obstetrician at Massachusetts General Hospital in Boston, told WebMD: “We are, as we speak, in the process of re-evaluating our practice, as I believe other hospitals are. We are trying to find a balance between what makes patients happy and comfortable and what makes the anesthesiologist comfortable.”

A recently published review of related research by the Cochrane Collaboration, an international not-for-profit organization that analyzes and distributes information about medical research, has concluded that “women should be able to make their own decisions” when it comes to eating and drinking during labor.

The research team reviewed five different studies involving 3,130 pregnant women, following them through childbirth. All women were considered to have a low risk of requiring general anesthesia during labor. The team found little to no evidence that choosing whether or not to consume food or liquids had any disadvantage or benefit.

Dr. Mandisa Singata, a study author from South Africa’s East London Hospital Complex, said in a press release: “Since the evidence shows no benefit or harms, there is no justification for [the prohibition of eating or drinking] during labor, provided women have a low risk for complications. Women should be able to make their own decisions about whether they want to eat or drink during labor or not.”

A slow shift towards this policy was seen in August 2009 when the American College of Obstetricians and Gynecologists changed their stance to allow for “modest amounts” of liquids such as water, tea, juice, coffee or carbonated beverages. Yet, the group still holds firm on the policy of not eating during labor.

“Allowing laboring women more than a plastic cup of ice is going to be welcome news for many,” said Dr. William H. Barth, Jr., also of Massachusetts General Hospital, in a press release last August. “As for the continued restriction on food, the reality is that eating is the last thing most women are going to want to do since nausea and vomiting during labor is quite common.”

The research team of the Cochran Collaboration agrees that eating may not be comfortable for many women during labor, but the team recognized that some women do have the desire to eat and found little to prevent them from doing so.

The team also noted that they could not find any research specifically aimed at women who had higher risks of requiring general anesthesia, suggesting that more research needed to be conducted on that group before conclusions could be drawn.

         

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