Stressing about pregnancy bad for baby?

Pregnancy-specific anxiety may be worse for a baby than normal stress according to modern research.

Pregnant women are commonly told to relax and reduce stress with the belief that life’s everyday stresses could harm the baby. But it may not be normal daily stress that does its worst.

Modern research is finding that pregnant women who say they are managing daily stress actually aren’t harming their baby that much. But when it comes to stressing about the pregnancy itself, woman may be doing more harm than they think.

“Most of my patients are so anxious it’s outrageous,” Laura Riley, medical director of labor and delivery at Massachusetts General Hospital, told the Wall Street Journal.

“It’s amazing how many people will come to my office and say, ‘I’ve read that stress is very bad for pregnancy, and I’m all stressed out.”‘ Riley goes on to tell her patients: “Now you’re all stressed-out about being stressed. This is just not helpful.”

Researchers at the University of California, Irvine recently published study results in the journal Child Development concerning an independent link between early “pregnancy-specific anxiety” and lower cognitive development scores in one year olds.

A 2009 study published in Infant and Child Development found that anxiety related to the pregnancy could be linked to temperamental problems in infants afterwards.

While its not fully understood how this specific type of anxiety is linked to the health of the child, obstetricians are increasingly telling their patients to not stress about the pregnancy itself. Many are recommending a special program called Centering Pregnancy.

Sharon Rising, the executive director of the Centering Healthcare Institute, told the Wall Street Journal that nearly 300 medical facilities in the U.S. are offering Centering Pregnancy groups. These groups gather pregnant women at or near the same point in pregnancy to first receive normal medical checkups and then huddle together to talk about their pregnancy concerns.

In 2007, a group of researchers looked at over 1,000 women who attended such groups and found that they were a third less likely to suffer a preterm birth. Additional research into maternal stress reduction has found similar results.

In light of such research, many researchers are suggesting women gain increased stress resiliency before they become pregnant. Learning how to stop worrying about the pregnancy itself and deal with problems with adversity makes it more likely that baby will be born with fewer problems.

         

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Sex hormones during pregnancy could reduce spatial memory

The sex hormones that circulate through the body during pregnancy could be responsible for anecdotal evidence of memory loss.

While many women have complained of memory loss during pregnancy and beyond, little research has been done to determine what may cause such a condition.

However, a new research study collaborated on by researchers at the University of Bradford and the Bradford Institute for Health in the United Kingdom has taken a small step in that direction.

“Women in general have been the butt of jokes that we have trouble finding our way around, navigating, and that has been a negative stereotype which I’ve always found to be denigrating,” midwife and head researcher Diane Farrar told CNN.

“I wanted to find out if there was scientific basis for the negativity where it concerned pregnant women.”

The study focused on 23 pregnant women and 24 non-pregnant women. A computerized spatial memory test was given to all participants, and a variety of attention, mood and anxiety tests were performed. Finally, hormonal levels were regularly checked. All tests were extended three months after the pregnant women gave birth.

During spatial testing, the pregnant women did significantly worse, especially during the second and third trimesters. The memory deficiency still lingered three months after delivery. Lowered mood and higher anxiety were more prevalent among the pregnant women, though those levels normalized three months after child birth.

“We know for sure that sex steroids at high levels can have damaging effects on neurons,” Farrar told LiveScience. However, Farrar cautioned that the study didn’t allow the researchers to draw direct parallels between the two.

“We can’t really check to see what’s happening, so it’s pretty difficult really,” she said. “We can only speculate that it could be the sex steroid levels that are affecting cognitive function.”

While the team recognized that depressive mood during pregnancy could have triggered memory loss, they noted that the pregnant women’s moods rebounded three months after birth yet their memory did not. LiveScience pointed out that such an indicator could signify neuronal damage by sex hormones that has yet to be fully repaired.

Though the study represents a small sample size, a clearer picture could be gained with further research. “It’s an area that needs looking at more, just to make things clearer to women,” Farrar told LiveScience.

The study results were presented during the Society for Endocrinology BES conference in Manchester, England last week.

         

Advance provision of emergency contraception not effective

Advance provision of emergency contraception was found to be ineffective at reducing unwanted pregnancy after review of several studies.

A collaborative effort of family planning researchers have concluded that providing emergency contraception in advance to large populations of women may not be as effective as believed.

The research, published in issue three of 2010’s Cochrane Database of Systematic Reviews, was based on a review of 11 different studies involving nearly 7,700 women from China, India, Sweden and the United States. Researchers specifically looked for correlations between advance emergency contraception provision and pregnancy and sexually transmitted infection (STI) rates. The team also looked at sexual habits and contraception use.

Family planning researcher Dr. Chelsea Polis, of Johns Hopkins University’s Bloomberg School of Public Health, explained the intent to The Voice of America, stating, “Advance provision of emergency contraception is the idea that providing women with a packet or several packets of pills in advance of need will allow them to access the medication more quickly, and that by accessing it more quickly, they’ll be able to use it within that recommended time frame.”

After analysis of the studies, the research team found similar pregnancy rates in women who had advance access to emergency contraception, compared to those women who didn’t. They also found that emergency contraception given in advance neither increased rates of unprotected sex and STIs, nor altered usage of other contraceptive methods.

The team did find that women who had advance access did use it an average of 13 hours sooner than women who didn’t, and those women were more likely to use emergency contraception at all.

Dr. Polis explained that the strategy didn’t work due to something called a “population level effect.”

“When you can’t say for sure whether all the women in the advance provision group actually used the medication, then you’re kind of looking at population level effect of a strategy, not the individual effect of a medication,” she told The Voice of America.

“Some women may not use emergency contraception when needed, even if they have it in advance,” she further explained in the research summary. “Like condoms, emergency contraception will not work if it is not used.”

The researchers suggested that family planning experts continue to focus on explaining pregnancy risks and ways to reduce those risks.

“Women should still be given information about and easy access to emergency contraception, because it is a safe and effective way to prevent unintended pregnancies for individual women who will use it when needed,” said Dr. Polis.

         

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.

         

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.

         

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