Does too much weight gain during pregnancy put child at risk?

A team of researchers has linked too much weight gain during pregnancy with cardiovascular disease risk factors in children later in life.

New research finding out of the University of Bristol suggest that women who are pregnant control their weight gain for the benefit of their future children.

The researchers looked at data on 5,154 mother and child pairs, collected during the Avon Longitudinal Study of Parents and Children in 1991 and 1992. During that study 14,541 pregnant women were followed. However the Bristol researchers found that nearly a third of the participants had the specific data they needed.

Mothers were weighed before the pregnancy and at regular intervals during the pregnancy. Additional weight and BMI information was examined for all the children at the age of nine. The team also examined the blood cholesterol data, which was available for 3,457 of the children.

The team wasn’t surprised to find that women who were overweight before becoming pregnant yielded overweight children. They did find it curious that regardless of pre-pregnancy weight, weight gain during pregnancy seemed to have an impact on a child’s risk of having high body fat, high blood pressure, and low levels of good HDL cholesterol.

The team suggested that fat mass plays a key role in determining weight and cardiovascular outcomes in children, but the team was hesitant to suggest this was the only factor. The researchers suggested that long- and short-term risk factors in mother and children need to be more closely analyzed before suggesting that women control their weight.

Additionally, the National Health Service of the UK issued a statement with other cautions.

“[O]ther important lifestyle factors, such as diet and activity levels in both the mother and child, were not considered,” the NHS analysis said. “This makes it difficult to say that the mother’s weight gain during pregnancy affects the child’s body fat rather than the lifestyle habits common to both. Also, mother and child are genetically linked, and shared genetic factors could affect their tendency for weight gain.”

The study was published in the June issue of the journal Circulation.

         

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Expert: Men who get involved with pregnancy may inevitably feel like failure

A medical expert claims that men who get involved with their partner’s pregnancy may have their confidence destroyed and injure their potential relationship with the child in the future.

Dr. Jonathan Ives, of the Centre for Biomedical Ethics at the University of Birmingham, is fighting against what he calls the “false, modern rhetoric of equal involvement that has sprung up around parenting.”

Dr. Ives and partner Dr. Heather Draper have been working on a two-year research study titled “The Moral Habitus of Fatherhood” and plan on expressing their views at a pregnancy conference in June. According to the pair’s research, men risk injuring their own opinion of themselves by trying too hard to become involved with their partner’s pregnancy.

“There is a modern, moral ideology of fatherhood that says if you’re not intimately involved in every aspect of your baby’s development, you’re failing,” Ives told the Guardian. He claims that men often try to get involved in an intimate, proactive way only to discover that their role is a very passive one during pregnancy. Often this leads to emotional detachment, he said.

“Having begun the fathering role already feeling a failure may destroy his confidence,” said Ives.

“It can then be very difficult for him to regain faith in himself once the baby is born and move from that passive state to being a proactive father. His role in the family is no longer clear to him. He effectively becomes deskilled as a parent and this can lead to problems bonding with the child.”

Ives’ comments follow a recently reported study that found that fathers are also susceptible to postpartum depression. That study found that over 10 percent of fathers became depressed during the prenatal and early postnatal period, with the number jumping to over 25 percent between three and six months after birth.

Dr. Draper suggested that there were other, more positive ways for fathers to get involved with their partners and children. “There are many different preparations for fatherhood and attending antenatal classes and being present at the birth are not the only, or even necessarily the best, methods,” she said. “Society must be realistic about what men can actually contribute”.

         

Scotland renews efforts to curtail smoking in pregnant women

Health officials in Scotland are renewing their efforts to reduce the rate of smoking in pregnant women, warning of the risk to them and their babies.

Doctors, agencies and government officials in Scotland are working together to get the word out: if you smoke while pregnant, you’re risking more than your own life.

Following on the heels of research by Glasgow and Stirling universities for the NHS that only three out every 100 women quit smoking while pregnant, the British Medical Association and Action on Smoking and Health are working with doctors to promote the United Nation’s World No Tobacco Day.

“Around one in five women smoke during pregnancy and, although this is an improvement on previous years, it reflects the lack of knowledge among Scots about the health risks of smoking, not only to themselves, but to the health of their children,” BMA Scotland’s deputy chairman Dr. Sally Winning told The Herald.

AHS Scotland’s chief executive, Sheila Duffy, explained the No Tobacco Day: “The theme of this year’s World No Tobacco Day is gender and tobacco with an emphasis on marketing to women. The World Health Organisation has produced some excellent posters showing the dangers of smoking and the illnesses it can cause and are calling on countries to ban all tobacco advertising, promotion and sponsorship.”

“Research shows that the tobacco industry is using the cigarette packet more aggressively and more effectively as a marketing tool to recruit smokers as other promotional avenues are closed,” Duffy added.

The BMA and AHS campaigns follow the revelation that Scots are increasingly looking for help with giving up smoking. The NHS estimated that almost 70,000 people tried to quit smoking in Scotland in 2009, an increase of 35 percent over 2008.

“We need to offer more smoking cessation support to adults and parents to help those who wish to stop smoking stay stopped,” Winning told the BBC.

         

Study: Dads also susceptible to postpartum depression

A new study has convincingly showed that dads are also prone to suffering prenatal and postpartum depression.

Depression and motherhood have been linked in the past, but are fathers also susceptible to prenatal or postpartum depression? New research out of Eastern Virginia Medical School seems to indicate “yes.”

“Depression affects both parents and both parents should be on the lookout for it,” lead researcher James Paulson said of the results of his team’s research, set to be published in the May 19 issue of the Journal of the American Medical Association.

Paulson and his team analyzed the results of 43 medical studies, which represented 28,004 participants and discovered that 10.4 percent of fathers became depressed in the prenatal and postpartum periods. The team also discovered that between three and six months after birth, the numbers jumped to 25.6 percent of fathers becoming depressed.

He also noted that those rates were eerily similar to the rates found in women. “[T]he findings look remarkably like the research documenting the effects of mom’s depression,” Paulson told MSNBC. This has led Paulson and his team to question the old school of thought about prenatal and postpartum depression in women.

“The traditional thinking was postpartum depression among women was related to hormonal changes,” Paulson told National Public Radio. With this new evidence, the issue of what causes the depression takes on a more complex look.

While hormones could play a part in the equation (24 percent of women were found to become depressed at pregnancy and nearly 42 percent between three and six months after birth), the researchers questioned the societal structures in place in the U.S.

“Three months is when family leave runs out [in the U.S.], and I can’t help but wonder if that has something to do with it,” Paulson said. “But there is also a lot going on with the child by that time.”

The researchers noted a marked difference between depression rates of both women and men in the U.S. and other countries. They found that paternal depression rates were 14.1 percent in the U.S. and only 8.2 percent elsewhere around the world.

Paulson stressed that a stronger family approach to this depression should be taken. “Going from being a single person to a parent is a real shock,” he told NPR. “And certainly both parents trying to cope with a big change in life can be stressful.” He suggested that the entire family be looked at as a whole when diagnosing and treating prenatal and postpartum depression.

         

Higher vitamin D intake may decrease pregnancy and Caesarean risks

New research shows that a higher intake of vitamin D may significantly decrease pregnancy and Caesarean risks in women.

There have long been fears that pregnant women could injure the fetus growing inside them by consuming too much vitamin D. Now that view is being challenged by new research.

New research by Dr. Bruce Hollis, director of pediatric nutritional sciences at the Medical University of South Carolina, and Dr. Michael F. Holick, researcher at Boston University School of Medicine, indicates that pregnant women aren’t typically getting enough vitamin D in their diets.

Dr. Hollis and his colleagues looked at 500 women who were at least 12 weeks pregnant, dividing the group of women into dosage levels. Some women took 400 IU of vitamin D while others took 2,000 and 4,000 IU. The team found that the women who consumed 4,000 IU of vitamin D daily were least likely to go into labor early, give birth prematurely or suffer an infection during pregnancy.

“Pregnant women need to take 4,000 IU of vitamin D a day,” said Hollis. “We didn’t see a single adverse effect. It was absolutely safe, and we saw a lot of improved outcomes. The risk of preterm labor was vastly decreased and so was the risk of other complications of pregnancy.”

Dr. Elisa Ross, of the Cleveland Clinic Institute of Women’s Health, commented on the study results, telling WCTV: “In the olden days, we thought vitamin D could be associated with certain birth defects and may cause more calcium to build up in the women’s blood. If this study is confirmed - which I am hoping it will be - it will increase the amount of vitamin D we recommend 10-fold.”

Some experts cautioned that the results of the study, presented to academics at the meeting of the Pediatric Academic Societies in Vancouver, British Columbia on May 1, should be taken lightly since women in their first trimester were not tested. Some suggested that additional research be done to also test the blood levels of vitamin D going to the fetus.

As for Dr. Holick, the research he and his team conducted involved 253 women who gave birth at a Boston, Massachusetts hospital. The women were 25 years old on average, and all lived in the Boston area for the entire pregnancy. The team measured vitamin D levels in the blood directly after the women gave birth. They found that women with vitamin D deficiencies were nearly four times likely to give birth via Caesarean.

Holick and his team hope to further test their theories and determine if increases in vitamin D intake while pregnant can be tied to lower risk of Caesarean.

Their research is published in the April issue of the Journal of Clinical Endocrinology and Metabolism.

         

Study: Women in US waiting longer for children, more children born to unwed mothers

A new research study conducted by Pew has found that women are waiting longer for children and are increasingly likely to be unwed when they have them.

New research suggests continued changes in U.S. approaches and perceptions to pregnancy.

The Pew Research Center combined census and government health statistics with a survey of 1,003 adults (of which 770 were parents) about their attitudes and perceptions of pregnancy in the U.S. and found significant changes in the demographic.

Looking at the statistics, Pew found that the number of women who gave birth after the age of 35 jumped from 368,000 in 1990 to 603,000 in 2008, with nearly one in seven babies being born to them in 2008.

Pew contrasted that increase with a decrease in teen pregnancy numbers. They found that in 1990, the number of births to women under the age of 20 was 533,000. In 2008, that number had fallen to 441,000.

With this shift rose the average age a woman waits to have her first child. In 1990, the average age for a first child was 24; it was 25 in 2008.

“The demography of motherhood in the United States has shifted strikingly in the past two decades,” said Pew in its report.

Suzanne Bianchi, a sociologist at UCLA, agreed that the findings represent a clear change.

“It’s clear that young adult transitions are being postponed,” Bianchi told The Washington Post. “Children born to highly educated mothers increasingly are born later in life. The mothers are usually married, and they have a much higher chance of raising children in a stable marriage that lasts through a child’s childhood.”

But Pew noted that the number of women waiting to have children until married has actually decreased significantly in the U.S.

“Another notable change during this period was the rise in births to unmarried women … a record 41 percent of births in the United States were to unmarried women, up from 28 percent in 1990,” the Pew authors noted.

Pew’s survey results seemed to back up the finding. When asked, 79 percent of respondents said that they knew an unmarried woman who had at least one child, while 68 percent said that knew an unmarried man in the same situation.

The results of the study can be found on Pew’s Web site.

         

Nearly one in four US women are ambivalent about getting pregnant

New research has found that nearly one out of four women in the US is “OK either way” about getting or not getting pregnant.

While it’s generally true that with each generation of people attitudes shift, scientists like to know how and why. Enter Julia McQuillan, professor of sociology at the University of Nebraska-Lincoln.

McQuillan wanted to know how women in the U.S. view pregnancy now, so she gathered up a research team and set off to find out.

“We assumed 50 years after the pill, most women would be controlling their reproduction,” McQuillan told USA Today last week. But what she and her team found ran contrary to that assumption.

McQuillan and her team surveyed nearly 4,000 U.S. women between the ages of 25 and 45 who were sexually active. The team discovered that 23 percent of the women responded that they were “OK either away,” saying that they were neither trying to conceive nor trying to actively prevent conception.

“This finding dramatically challenges the idea that women are always trying, one way or another, to either get pregnant or not get pregnant,” said McQuillan of the results.

“It also shows that women who are OK either way should be assessed separately from women who are intentional about pregnancy.”

McQuillan suggested that doctors approach this special subset of women in a slightly different way rather than simply assuming that they don’t want children because they’re not actively trying.

“Clearly, many women are less intentional about pregnancy,” McQuillan told CNN. “Yet this group should be treated as if they will likely conceive and should therefore get recommendations such as ensuring adequate folic acid intake and limiting alcohol intake.”

The study found that 71 percent of the women surveyed were actively not trying while 6 percent were. Of the remaining ambivalent women, 73 percent stated that they would like to have a child. Curiously, this group also reported the highest number of children they thought ideal at 3.17 children on average.

The results of the study will appear in an upcoming issue of the Maternal and Child Health Journal.

         

Smoking while pregnant found to increase risk of ‘cross eyes’ and reduced fertility in baby

Smoking while pregnant increases the chance of eye problems and low fertility counts in babies, according to two separate scientific studies.

Research on how women who smoke while pregnant affect the development of their child has been going on for decades. Recently published studies in the American Journal of Epidemiology and Philosophical Transactions of the Royal Society B add to the mountain of evidence that smoking while pregnant is detrimental to the developing baby.

Dr. Tobias Torp-Pedersen and his team of researchers at the Statens Serum Institut in Copenhagen, Denmark found that smoking while pregnant increased the risk of strabismus, a condition in which the eyes are unable to align evenly.

Dr. Torp-Pedersen said that little is known about the origin of the condition, but theorized that chemical disturbance could yield degeneration in the eye muscles and nerves. “Nicotine and other substances in tobacco, alcohol and caffeine all affect the brain in some way,” said Dr. Torp-Pedersen. “Minor disturbances to the developing brain could plausibly lead to strabismus.”

The team reviewed 1,300 cases of strabismus in children born between 1996 and 2003 using data from the Danish National Birth Cohort. Included in the data were interviews with the children’s mothers during and after pregnancy.

“We were able to show that each extra cigarette smoked per day during pregnancy exerted a 5 percent increase in strabismus risk, which is a new finding,” Torp-Pedersen told Reuters Health.

In a second, unrelated study, Professor Richard Sharpe of the Queen’s Medical Research Institute in Edinburgh performed a comprehensive review of numerous medical studies on the effects chemicals and obesity have on the sperm production of male babies.

Sharpe found that a mother’s smoking habits while pregnant had much more of an impact on a male’s sperm production than cigarette exposure outside the womb, later in life. He theorizes that the risk is greater in the womb because toxins in the blood stream reduces the number of sertoli cells, highly specialised cells needed to support the growth of young sperm all the way through to a man’s adult life.

Sharpe was skeptical, however, about how much any individual chemical in the womb contributes to poor sperm development. He did suggest that large “cocktails” of a variety of chemicals may have a combined effect, but more research was required he said.

“The high prevalence of low sperm counts in young men across Europe today is a cause for concern, especially when considered together with the trend for ever-later age for first pregnancy in the female partner,” said Sharpe in his review.

“As this review has shown, evidence for widespread or major effects of individual lifestyle or environmental factors on spermatogenesis in adulthood is largely lacking, whereas there is growing evidence that prenatal exposures of males (due to maternal lifestyle or exposure) can have a major impact on capacity to produce sperm in adulthood.”

Dr. Allan Pacey, a Sheffield University expert in male fertility, told the Daily Mail: “This review reminds us that the sperm production capacity of men is probably established quite early in life and perhaps even before they are born. This highlights the importance of women having healthy pregnancies and not exposing their baby to harmful chemicals, such as cigarette smoke.”

Dr. Torp-Pedersen’s research appears in the March issue of American Journal of Epidemiology, while Professor Sharpe’s work appears in the upcoming May 27 issue of Philosophical Transactions of the Royal Society B.

         

Scientists discover genetic link between low birth weight and diabetes

Scientists have discovered that there is a genetic link between low birth weights in babies and the onset of Type 2 diabetes later in life.

The collaborative effort of scientists from Britain, Finland, the Netherlands and the United States has yielded important research which could change the way diabetes is dealt with in the future.

The team of scientists analyzed the results of 19 medical studies on pregnancy and birth, spanning over 38,000 European participants. The researchers found two genetic variants that were strongly linked to a baby’s birth weight, and one of those variants was also linked to how susceptible a person is to developing Type 2 diabetes.

In an interview with the Scotsman, Jim Wilson, a researcher at the University of Edinburgh said: “Finding two gene variants that decrease birth-weight is the first exciting step to unraveling the well known associations between birth-weight and killer diseases in later life. It is particularly interesting that one of these variants is also a risk factor for Type 2 diabetes.

“These genes will begin to reveal the biology behind how low birth weight increases the risk of adult-onset diabetes, heart disease and high blood pressure,” he added.

The second variant linked to diabetes is the gene called ADCY5. According to the researchers’ data, people who inherit two copies of this gene in two specific genetic regions have a 25 percent increased chance of developing diabetes later in adulthood.

Professor Mark McCarthy, lead diabetes researcher at the University of Oxford, found that the genetic variants were somewhat common in Europeans.

“[In] European populations we think that about 10 percent of the population have at least all four birth-weight-lowering variants,” he told ABC news.

However, McCarthy cautioned that the genetics variants alone are not responsible for low birth weights, but environmental factors must still be considered.

“I think these are all factors that go into the mix. These are not genetic effects that will say irrespective of everything else that you will end up with a small baby.”

Dr. Rachel Freathy, a researcher at the Peninsula Medical School in Exeter, agreed, telling the Press Association, “It is now important for us to establish how much of the association is due to our genes and how much is due to the environment because this will inform how we target efforts to prevent the disease.”

The research is published in the journal Nature Genetics.

         

Aerobic exercise during pregnancy reduces birth weight of baby

Regular aerobic exercise during pregnancy is likely to reduce a baby’s birth weight and reduce the risk of obesity later in childhood.

A growing body of evidence suggests that regular moderate exercise during pregnancy is healthy for both mother and child. A joint study out of the U.S. and New Zealand on 84 first-time mothers has recently added to that evidence.

The team of researchers, based out of the University of Auckland in New Zealand and Northern Arizona University in the United States, divided the 84 mothers into two groups: one group who exercised regularly and one control group. The women in the exercise group were instructed to perform 40 minutes of exercise on an exercise bike no more than five times a week. The routine had to continue until at least the thirty-sixth week of gestation.

Researchers also gauged insulin sensitivity in the women during the pregnancy. Insulin is an important hormone which helps regulate the flow of nutrients to the baby during pregnancy. There have been previous concerns about a woman’s maternal insulin sensitivity while exercising, with fears that too much exercise adversely restricts fetal nutrition.

After measuring birth weights and body mass indexes (BMI) of the babies within 48 hours of birth, the teams analyzed their data, finding that the babies of the women from the exercise group were approximately 0.32 pounds (143 grams) lighter than those of the women in the control group. More importantly, the teams found that insulin sensitivity in the mothers didn’t seem to disrupt fetal nutrient flow.

“The physiological response to pregnancy appears to supersede the chronic improvements in insulin sensitivity previously described in response to exercise training in non-pregnant individuals,” said Dr. Paul Hofman of the University of Auckland, co-author of the study.

“Our findings show that regular aerobic exercise alters the maternal environment in some way that has an impact on nutrient stimulation of fetal growth, resulting in a reduction in offspring birth weight,” added Hofman. “Given that large birth size is associated with an increased risk of obesity, a modest reduction in birth weight may have long-term health benefits for offspring by lowering this risk in later life.”

In the U.K., official medical guidance already encourages women to take light exercise regularly and not to overeat during pregnancy.

The team will have their study results published in the May issue of the Journal of Clinical Endocrinology & Metabolism.

         

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