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Diet

  • Tylenol during Pregnancy may be linked to ADHD

    It seems there are so many rules during pregnancy that it gets very confusing about what we need to take, like Folic Acid, and what we should avoid, like alcohol, caffeine and many pain medications. Now the latest research has uncovered that many seemingly benign over the counter pain relievers, including Tylenol, that are often prescribed to pregnant women, may not be as safe as we thought.

    A new study from Demark published Monday in the journal of JAMA Pediatrics now suggests that over-the-counter pain relievers with acetaminophen when used during pregnancy may be associated with ADHD behavioral problems in children. Although this is new research and the study authors were careful to state that “exhibiting ADHD-like behaviors” is not necessarily the same as being diagnosed with ADHD. All the same, it is cause for concern and for caution in taking medication containing acetaminophen as the active ingredient. This news is especially alarming since Tylenol has long been considered one of the safer medications pregnant women were advised to take for a fever, headache or the many aches and pains of pregnancy.

    If you have taken Tylenol during pregnancy do not panic. The study suggests that the risk is more highly associated with taking acetaminophen for long periods of time and particularly later in pregnancy. The women in the study that reported used acetaminophen pain relieving medications for 20 weeks or more had a 50% increase in requesting ADHD medication in their children later on. It is too early to assume that this is a cause and effect relationship but there is certainly enough evidence to avoid Tylenol and any medication containing acetaminophen during pregnancy if possible or at least to be very cautious in dosage and how long it is taken during pregnancy.

    This study reminds us to be extra vigilant about medications during pregnancy and to be sure to consult your doctor if you have any questions about any medication. No question is a stupid question for your doctor. Also it is important to do your own research on medications in addition to consulting your doctor as studies such as this one are very new and may not have made the rounds to all the medical communities. It is also important to have these conversations with your doctor to inform them of new information that may not have been known when they were in medical school and is not yet common knowledge.

    This study is also a reminder that we cannot assume that what we did prepregnancy exercise-wise, work-wise, or medication-wise is also safe during pregnancy and nursing postpartum. Also, it is a constant re-evaluation of what is best as our bodies are constantly changing during pregnancy, so nothing is static. If you are having pain issues there are many non pharmacological ways you can explore to deal with pain including massages, baths and acupuncture to name a few. While we do not want to be paranoid about everything we do, it is also better to err on the safe and conservative side during pregnancy when in doubt.

    Knowledge is power. It is important to do your own research during pregnancy and make your own informed decision about everything you decide to do. The end of day do not stress over your choices, just know you did the best you could do which is really what parenting is all about. None of us is perfect and guilt gets us nowhere, but informed decisions are the best way we can be the responsible and loving parent for our child that we all want and strive to be.

  • Folic Acid during Pregnancy may reduce Baby’s risk of Autism

    Most of us have received the news flash that we should take our prenatal vitamins and in particular we should take our folic acid when we are pregnant. Folic acid is an important vitamin for helping prevent neural tube defects in babies. However, did you know that it may help reduce autism?

    Now this is even more relatable a reason for most of us as autism is almost always in the news, seemingly on the rise or at least on the rise in terms of diagnosis and is surrounded by a shroud of mystery and debate over how a child can get it or be born with it.

    A new study in Norway found a very strong correlation between a reduction in autism and women who took folic acid supplements four weeks before their pregnancy and through at least the 8th week of their pregnancy. Women who took Folic Acid daily during this time period saw a 40% reduction in autism in their children (when they were tested about 8 years later) as compared to the children of the pregnant women in the group who did not take folic acid for this time period. This is a huge reduction in autism!

    Apparently timing does matter. The earlier you can start supplementing with folic acid prior to conception, the better. The study found that in terms of autism risk that the folic acid supplements did not seem to have any impact beyond the 22nd week of pregnancy. The crucial time interval was from four weeks before conception to eight weeks into the pregnancy.

    Of course it does not hurt to continue on with folic acid throughout your pregnancy and who knows, maybe there’s further benefits or risk reductions that are yet to be uncovered from continuing with folic acid beyond the first trimester. However, what researchers have uncovered so far is enough evidence to start any woman even thinking about having a baby to be popping a folic acid supplement right away.

    So what is folic acid? It is the B vitamin that helps with the construction and repair of DNA molecules which is the genetic code that controls all of the body’s cells, including the brain cells. It is especially important to take it early in pregnancy during the development of the baby’s spine and nervous system to prevent neural tube defects, including spina bifida. Doctors typically recommend that all women who are planning on getting pregnant to take 400 micrograms of folic acid daily from a multivitamin and continue taking this amount throughout their early pregnancy.

    Now with 1 out of 88 children diagnosed with autism we hope that this research will help us reduce the risk of childhood autism and increase awareness of our ability to potentially prevent this disability by supplementing with Folic Acid early in our pregnancy and even before. Knowledge is power so let’s empower ourselves and those we know with this scientific knowledge and preventative health measure of supplementing daily with Folic Acid if we are pregnant or hope to become pregnant. It’s an easy lifestyle adder that can reap benefits in our child’s health and well-being for a lifetime.

  • Lifestyle Factors you can Change to avoid Miscarriage

    Obviously during pregnancy, the last thing you want to worry or even think about is a miscarriage. I know for me it was almost a feeling that if you don’t think it, it won’t happen, just stay positive, right? Obviously stress is something that you want to lesson to make your pregnancy journey safer and better overall. However, there are times I believe reliable information about what we fear, may actually be helpful and allow us to be more empowered to make better health and lifestyle decisions during our pregnancy. This is why I would like to share some research by scientists in Denmark recently published in International Journal of Obstetrics and Gynecology on miscarriage and how we can avoid it.

    In this study it was determined that miscarriages during pregnancy could be lowered by as much as 25% by modifying or avoiding high risk behaviors duing pregnancy. These risk factors included factors including lack of exercise or too vigorous (or risky) exercise, too much alcohol consumption, smoking(at all), drinking coffee, overtime and evening work schedules, regular heavy lifting, weight gain, and advanced maternal age. Of course if you are already pregnant and at an “advanced maternal age” there’s not much you can modify about that factor but there are plenty of other risk factors we can affect in our lifestyle to reduce our risks and improve our pregnancy health and our baby’s health.

    Apparently weight was an important factor for pregnancy viability and pregnancy health as well as the baby’s health. If you were overweight before you were pregnant then you do not need to gain the recommended 25-35 pounds during pregnancy. You can gain far less but you will need to be extra vigilant about healthy calories so that your baby (and you) get the nutrients you need. Talk to your doctor about your weight and do not avoid the subject or wait for them to bring it up. New research shows that doctors in the United States are less likely to bring up a pregnant woman’s weight gain if she is gaining too much than they did in previous years. Obviously it is not always a popular subject and one that is often the last thing mentioned before the end of the visit if at all. As a result of less emphasis on our weight gain and pregnancy diet, our pregnancy obesity rates have skyrocketed in recent years and this factor is affecting rates of healthy pregnancies overall. These health risks include stillbirth rates, high blood pressure (preeclampsia), gestational diabetes (leading to higher weight babies and childhood obesity), more complications during labor and delivery and a harder time losing the weight after pregnancy. Instaed of feeling guilty, we need to address the problem directly with our doctor and admit if we are having problems with our pregnancy weight and ask for help.

    As a mom of three I understand the problems with weight gain during pregnancy. I had severe morning sickness with all three of my babies yet I gained more than the recommended weight with my first two pregnancies, particularly the first. It seemed high carbs and sugars were the only thing my body could keep down or that seemed appealing whenever the sickness would subside. Even though I stayed active during my pregnancies it seems that food choices and quantities would really drive my weight gain more than I could offset those calories with exercise. I also admit that I was guilty of over indulging in sweets as all my forgiving stretchy pregnancy clothes seemed to hide the extra pound or two that was rapidly creeping on. On the other side, you definitely do want to gain enough weight if you are underweight or not gaining enough to support your pregancy and development of your baby. It is a delicate balance and seems unfair that pregnancy is a time we should need to worry about our weight at all. My recommendation is to be proactive in talking to your doctor and even getting a dietician referral if you have any difficulties or questions with your weight. It is never too late to be proactive about your pregnancy health.

    Obviously exercise is good for us during pregnancy and promotes a healthy pregnancy, so it is important to keep a regular safe exercise regime that your doctor approves and to be flexible in adjusting your routine during each stage of your pregnancy. Pay attention to your body and make sure you are not over straining it by lifting too heavy of a weight (and this includes childcare routines where children 40 pounds or more are lifted and carried). Also make sure that you hydrate regularly as your body requires more water and you may need to take more frequent breaks, particularly if you feel you are overheating or your heart rate is too high. If an exercise involves more balance, like tennis, be extra careful as your center of gravity is constantly shifting and your ligaments and tendons are looser during pregnancy. This is maybe a time to just "practice" a safe sport and not compete if you are the competitive type!

    If you smoke, then pregnancy is an excellent time, reason and motivation to quit.Alcohol and coffee consumption have long been a hot topic in pregnancy circles. Although some doctors say a small amount of alcohol or caffeine is OK during pregnancy, no one seems to know exactly how much is OK. If you want to err on the safe side it is probably best to tee-total on both alcohol and caffeine or at least to strongly limit your intake. You will have plenty of time to enjoy a cocktail or two as well as extra mochas in years to come. There are always other options to choose from for beverage choices such as an alcohol free beer or decaf latte or tea.

    Work schedules and stress are not always easy factors to control. One major way to reduce the risk of miscarriage is to pay attention to our physical and emotional stress level and get the sleep we need. The study did find that night and overtime schedules increased women’s health risks during pregnancy as well as heavy lifting jobs. If these factors are a issue for you then you might want to check out your company’s pregnancy, health and maternity leave policies as there may be allowances for you to alter your high risk job demands during pregnancy, especially with your doctor’s permission. Sometimes you can work directly with your manager to work out a flex-time schedule or work at home schedule that allows you to take more rest. Or, you may need a doctor’s note to excuse you from certain tasks, such as heavy lifting on the job, or to get an early maternity leave. If you cannot, then you may need to re-assess if the job and its hours and determine if it is worth the risk of your pregnancy health.

    Pregnancy is a time to be selfish about your health and your baby’s health and not a time to be “tough” about taking on undo physical and emotional challenges that could challenge you and your baby's health. Your body is making a baby which takes a huge amount of energy and strength and affects not only your hormone levels but your physical abilities and needs. You will need more sleep as well as better nutrition, and more friendly work hours. Do not be afraid to speak up for what you need at home or at work, even if you feel like a wimp asking for extra time off or permission to get out of a physically demanding job. You can make it up when you are not making a baby. As everyone knows, pregnancy is not for wimps!

  • Exercise During Pregnacy to Make your Baby Smart!

    As Holiday Season approaches many of us find ourselves munching on more cookies, eating more pie and indulging in bigger meals. It’s easy to do as the weather is cooler and you may be surrounded by friends and family and lots of yummy goodies. Although pregnancy is not a time to diet, it is perfectly ok and even recommended to exercise, especially when you need to offset some extra helpings of stuffing or pumpkin pie.

    Not only is exercise good for maintaining a healthy pregnancy weight, it’s also good for your brain, nerves and self-esteem. More recently researchers are uncovering new benefits of exercise to the developing fetus. Two studies presented a few weeks ago at the Society of Neuroscience suggest that exercise during pregnancy gives unborn children a neurological advantage with “more mature and effective brain patterns.” Dave Ellemberg, a neuroscientists at the University of Montreal says active moms can give their kids “a kickstart even before they are born.” He continues, “What we found is that there’s this amazing transfer from what the mother does onto her child.”

    What better motivation is there to exercise since not only are you improving your own body and mind during pregnancy but that of your unborn child’s at the same time. Another recent study performed at Dartmouth University found similar results with the potential for exercise to leave “long-lasting effects on the behavior and cognitive function of the offspring.”

    Even as little as thirty minutes a day of moderate exercise can help with weight gain, mood and prepare mothers for labor, says Laura Riley, Director of labor and delivery and obstetrics and gynecology at Massachusetts General Hospital. She continues, that pregnant women who exercise are more mobile throughout their pregnancy and report less aches and pains during pregnancy.

    How much you exercise and the type of exercise you choose to do should depend on your fitness level. In general it is recommended that women should continue the exercise they already do and just adjust the level to their weight and abilities as the pregnancy progresses. Even just walking will do wonders for your body and your baby.

    There are obvious safety precautions such as staying clear of contact sports or those that require advanced coordination, such as biking (maybe consider a stationary bike). Also steer clear of exercise that involves flat on the back positions that can cause back strain or cut off the blood flow. Also you should not do abdominal work since those muscles are stretched to support your baby.

    Most importantly stay in tune with your body and take more frequent breaks. Also, be sure to hydrate more often as your body will need more liquids when you are pregnant. Finally be sure to be in close communication with your doctor on all exercise you pursue to make sure it is recommended and safe.

  • Oreos are More Addictive than Drugs

    Did you ever find yourself opening a new package of Oreo Cookies just to find that you simply could not stop eatting them? One to two Oreos turned into 5-6 and then some and the desire to eat more just increased? Well turns out you are not alone and it turns out there is good scientific data out there to explain why.

    A new study by students at Connecticut College found that when rats ate Oreo cookies they activiated more neurons in the rats’ brain (in their pleasure centers) than hard addictive drugs such as cocaine or morphine.

    Neuroscience Professor Joseph Schroeder said in in a school press release, “Our research supports the theory that high-fat/high sugar foods stimulate the brain in the same way that drugs do.” He continued, “It may explain why some people can’t resist these foods despite the fact that they know they are bad for them.”

    Jamie Honohun, the student behind the research, said she was interested in exploring how foods with high fat and sugar content contritube to obesity that in prevalent in low-income communities. She concluded that the risk was higher because of there low price point.

    “Even though we associate significant health hazards in taking drugs like cocaine and morphine, high-fat/high-sugar foods may present even more of a danger because of their accessibility and affordability, said Jamie Honohun.

    I’m sure if they did a study on pregnant rats, they would probably find an even higher correlation to addiction to sugar cravings as many pregnant women do once they get past the throws of morning sickness.

    On a more comical note, the study did find that the Oreo lab rats would break open the cookie and “eat the middle first” much like we do.

  • Is Seafood Safe to Eat During Pregnancy?

    Once you’re pregnant, everything you do in your life that affects your health needs to be examined closer to ensure the healthy development of your baby. Nutritional needs top the charts with increased attention to your diet which may be further complicated by morning sickness which, for some women, can last the entire nine months of pregnancy.

    It comes as no surprise that lean protein is an optimal source of nutrition for anyone’s diet, but especially an expecting mom. In terms of calories per portion, seafood such as fish, particularly of the salmon variety which packs in those important fatty acids with low calories per portion can be a great choice. However, many pregnant women steer clear from seafood altogether with all the news we hear about mercury levels being dangerously high and a risk for the health of a developing fetus.

    While some seafood may be best to avoid during pregnancy, it is not a great idea to cut out seafood altogether as they contain many nutrients that are vital to our baby’s health and development. As the saying goes don’t throw the baby out with the bath water. In the same notion don’t throw all the fish out of your diet with the worries of mercury and contamination, but do choose wisely. There are plenty of great seafood choices that are very beneficial to our developing fetus' health as well as our own.

    For starters, omega-3 fatty acids aid in brain development and provide high levels of lean protein. Fish can serve as a powerful weapon against birth defects when choosing the low mercury varieties such as salmon, sardines, haddock and cod. Seafood which is high in mercury which you should avoid during pregnancy include shark, king mackerel, swordfish and tilefish. In moderation, tuna is not a problem as long as you avoid the albacore and blufin varieties and limit your consumption to a few servings a month.

    It is also a good idea to steer clear of fish caught in contaminated lakes or rivers that can carry high levels of polychlorinated biphenyls, or PCBs which could travel to the placenta and affect the development of the fetus. So do be cautious when eating fish from local lakes and rivers.

    Raw shellfish and uncooked sushi are also seafood choices you should postpone during pregnancy. Also, make sure that cooked mussels, clams and oysters are actually cooked all the way through so that salmonella is not a threat. Pathogens such as salmonella are destroyed through cooking, otherwise they can cause severe food poisoning in pregnancy and may cross the placenta to the fetus as well.

    It is easy to be overwhelmed with all the mercury and food poisoning cautions and simply avoid seafood altogether during pregnancy, but this would be a disservice to your developing baby and yourself as there are so many benefits to safe seafood choices, such as salmon for dinner. Seafood during pregnancy can be a very healthy choice, just choose wisely and space out your seafood meals and portion sizes for moderation.

  • New guidance on vitamin D recommends midday sunshine

    New health advice recommends short spells in the sun - without suncream and in the middle of the day.

    Seven organisations have issued joint advice on vitamin D, which the body gets from natural sunlight.

    The nutrient keeps bones strong, and protects against conditions like osteoporosis.

    The guidance was drawn up because it is thought fears about skin cancer have made people too cautious about being in the sun.

    Cancer Research UK and the National Osteoporosis Society are among the bodies which agree that "little and frequent" spells in summer sunshine several times a week can benefit your health.

    The experts now say it is fine to go outside in strong sun in the middle of the day, as long as you cover up or apply sunscreen before your skin goes red.

    'Too negative'

    A good diet and sensible sun exposure will be adequate for most people to minimise their cancer risk.”

    End Quote Professor Peter Johnson Cancer Research UK

    Professor Rona Mackie, from the British Association of Dermatologists, said: "Total sun protection with high factor suncream on all the time is not ideal, in terms of vitamin D levels.

    "Even Australia has changed its policy on this. They're now producing charts showing parts of Australia where sun protection may not be required during some parts of the year.

    "Some of the messages about sun exposure have been too negative. UK summer sunshine isn't desperately strong. We don't have many days in the year when it is very intense.

    "What's changed is that we're now saying that exposure of 10 to 15 minutes to the UK summer sun, without suncream, several times a week is probably a safe balance between adequate vitamin D levels and any risk of skin cancer."

    Official government advice already recommends vitamin D supplements for pregnant women and children aged under five.

    But the experts who wrote the joint statement say mothers often are not made aware of this recommendation. They suggest women consult their GP.

    Winter levels of vitamin D can be helped by a break in the tropical sun - or by eating oily fish, liver and fortified margarine.

    'Complex area'

    Cancer Research UK's chief clinician, Professor Peter Johnson, said: "A good diet and sensible sun exposure will be adequate for the great majority of the UK population to minimise their cancer risk.

    "The area of vitamin D and cancer is complex.

    "There's some evidence, which is strongest in bowel cancer, that low levels of vitamin D in the blood correlate with the risk of developing cancer.

    "But that doesn't mean those low levels cause bowel cancer.

    "We think overall that low levels of vitamin D are unlikely to be major contributors to the chances of developing cancer in the UK population."

    The joint statement also highlighted questions about vitamin D that warrant further research.

    These include finding out the optimal levels of vitamin D, and more detail about the role of dietary sources and supplements.

  • Tip of the Day: Pregnancy-friendly Caesar salad

    This delicious article from JILL REED at the OC Register

    I didn’t have too many cravings when I was pregnant with Ben.

    I mostly craved salsa. Which was fine until heartburn set in during the third trimester. Then even oatmeal was painful.

    But I also had a pretty consistent craving for Caesar salad. Of course, the traditional preparation with raw eggs was out of the question. And anytime I asked about it at a restaurant they said that they did indeed use raw eggs.

    So I decided to experiment a bit using mayonnaise. Because of how it is processed, store-bought mayo is OK to eat if you are expecting.

    I had great success. And, even though I am not pregnant anymore, I still use this recipe because it is easy and it keeps well for a few days in the fridge.

    I do use anchovies in this. I know some people are not really fond of those funny little fish. I like the layer of flavor they add to a Caesar, and they get pulverized when this dressing is blended. But if they are not your thing, just leave ‘em out.

    By the way, anchovies are low in mercury and high in all sorts of other good stuff. Anchovies are OK in moderation for pregnant women.

    Pregnancy-friendly Caesar salad
    (makes 6-8 servings, depending on how large of a salad you like)

    1/4 cup extra-virgin olive oil
    1/2 cup mayonnaise (I use light mayo and it works great)
    4 oil-packed anchovy fillets, drained
    2 tablespoons fresh lemon juice
    2 large garlic cloves, coarsely chopped
    1 teaspoon Dijon mustard
    Freshly ground pepper
    1 1/2 pounds romaine lettuce, torn into bite-size pieces
    Your favorite croutons
    1/4 cup freshly grated Parmesan cheese

    Directions:

    1. In a food processor (I use my mini processor for such a small batch) or a blender, combine the mayonnaise, anchovies, lemon juice, garlic and mustard and blend until smooth. With the processor on, slowly pour in the olive oil and blend until smooth and combined. Season the dressing with pepper to taste.

    2. In a large bowl, toss the romaine with the croutons. Add the dressing and toss. Sprinkle the Parmesan over the salad, toss again and serve right away.

    3. Leftover dressing will keep in the fridge for a few days. Just give it a quick whisk before you use it.

  • Doctors Break Down Which Pregnancy ‘Tips’ Really Matter

     

    By Matt Brennan of The Beacon-News

    While the lists of pregnancy do’s and don’ts can be extensive, there is one thing women should not lose track of as they go through the process, and that’s enjoying it.

    That’s the advice of Dr. Susan Acuna, obstetrician/gynecologist on staff with Central DuPage and Delnor Community hospitals.

    Women should remember to enjoy the experience of having a child moving around inside them, she said. While they experience that thrill, there are things they can be doing to keep themselves and the baby healthy.

    There is a lot of information out there. It can be overwhelming. Some of the information and ideas have a stronger medical basis than others. It is best to follow the recommendations that have a stronger basis in medicine and science, she said.

    “Many women come in and say, ‘I heard I should avoid lunch meat and peanut butter,’” Acuna said. “Those are not based on any factual information.”

    The concern about peanuts or peanut butter is that eating them would increase the baby’s chance of picking up the allergies. It’s not based on enough science, she said. With lunch meat, she said to just make sure that it is reasonably fresh.

    The most important thing for women to do during pregnancy is to take a prenatal vitamin, Acuna said.

    “It’s shown to prevent birth defects,” she said. “That’s an important thing that women may or may not know.”

    Provena Mercy Medical Center nutritionist Melissa Gash said that making sure calorie intake is correct for the patient’s height and weight is important.

    “You really only need about 300 extra calories a day,” she said. “It’s really minimal what you have to increase.”

    To put it in perspective, the extra calories can be achieved with a glass of milk and an apple, she said. The normal recommended weight gain during a pregnancy is about 25 to 30 pounds. Many women gain much more than that, she said.

    “They wonder why they can’t lose that weight after the baby’s out,” she said.

    Yoga, Pilates and prenatal water aerobics have all increased in popularity recently, said Dr. Natalie Roche of Fox Valley Women and Children’s Health Partners. The exercises can help to alleviate some of the pain associated with pregnancy, she said.

    There are some exercises that should be avoided during pregnancy, such as biking, roller skating and jumping on a trampoline, Acuna said.

    “I recommend they avoid any activity that would put them at risk of falling,” she said.

    Running, biking on a stationary bike and working out on an elliptical machine are all safer forms of exercise, she said.

    Gash is on her third pregnancy, she said. She also runs a nutrition seminar for pregnancy at Provena Mercy called “From Pickles to Ice Cream.” Cravings are legitimate, she said. Many pregnant women have them. But, “a lot of women use them as an excuse,” she said.

    Morning sickness and nausea are fairly common, especially during the first 12 weeks of pregnancy, she said.

    “Sometimes you’re just not going to feel that good those first couple weeks,” she said.

  • Genetics May Play A Part In A Woman's Chance For Nausea During Pregnancy

    Researchers found that women were more likely to experience a serious form of morning sickness if their mothers or sisters did as well.

    Looking specifically at a very severe form of nausea known as hyperemesis gravidarum (HG), the authors found that women with sisters who had HG were 17 times more likely to also develop HG. Women with this condition have unrelenting, excessive nausea and vomiting that puts them at risk of malnutrition, dehydration and significant weight loss.

    Study author Dr. Marlena Fejzo of the University of Southern California-Los Angeles told Reuters Health she wasn't surprised by the findings, since previous research has shown that severe morning sickness is more likely to affect both members of identical twin pairs, hinting at a heritable element.

    However, in the new study, she added, “the degree of heredity is very exciting because it suggests genes are involved, and when we find those genes, we may finally understand the cause of severe nausea in pregnancy and be able to make new treatments that are designed to treat the cause rather than the symptoms.”

    Most pregnant women - an estimated 75 percent - experience some morning sickness, according to the American Pregnancy Association, but 1 percent suffer the extreme HG form of illness that can require hospitalization.

    It's unclear why some women become nauseous while pregnant and others don't. Even animals such as dogs and monkeys appear to experience a form of morning sickness, Fejzo noted. “There are even reports of snakes avoiding food during pregnancy,” she said in an e-mail.

    To investigate whether severe forms of nausea might have genetic roots, Fejzo and her team reviewed information collected from 207 women who experienced HG during pregnancy and had at least one sister who had also been pregnant. They compared their responses to 110 of the patients' female friends who had relatively nausea-free pregnancies, serving as controls.

    The researchers found that 14 percent of women who experienced HG during pregnancy had sisters who also had HG, versus less than 1 percent of women who did not have HG.

    When combining HG with other severe forms of morning sickness - persistent nausea that was not bad enough to require IV fluids or nutrition - a family history also appeared to put women at higher risk. Specifically, 34 percent of women with HG also had an affected sister, versus 8 percent of women who were never diagnosed with HG.

    Among 469 women with HG and 216 of their female friends, 33 percent of those with HG had a mother with severe nausea or HG as well, versus only 8 percent of their friends.

    “There can be variation in nausea and vomiting from one pregnancy to the next, which suggests that not only genes are involved but also other factors,” Fejzo noted. “For example, some studies suggest a female fetus or carrying multiple fetuses results in more nausea. So I would speculate that the level of nausea in pregnancy is a combination of both genetic factors and non-genetic factors.”

    One concern about these findings, noted Dr. Andrej Grjibovski at the Norwegian Institute of Public Health, who did not participate in the study, is that women with HG might have been more likely to volunteer to participate in the study if they had relatives who were also affected. And since these women recruited the controls themselves, they “may not be representative of the general population,” he cautioned.

    Still, Grjibovski said in an e-mail that he was “not at all” surprised by the findings, since other research has suggested both maternal and paternal genes may play a role in HG. A recent analysis of more than 2 million birth records showed that women whose mothers suffered from a serious type of morning sickness were at triple the risk of the condition themselves.

    HG hospitalizes more than 59,000 women every year in the U.S. A recent review of 27 large studies concluded that there is no reliable treatment for nausea in early pregnancy. Still, options include dietary changes (such as eating small meals and avoiding spicy foods), alternative therapies such as acupressure and hypnosis, and some prescription anti-nausea medications.

    Fejzo said her team is currently planning a study to compare the genes of 1,000 women with HG to those of 1,000 of their unaffected friends. “With this approach, we should be able to identify the genetic variants that predispose to HG and then hopefully create new, more effective medications that are designed to correct the cause of the disease as opposed to the current medicines which are used to treat the symptoms.”

    Source: American Journal of Obstetrics & Gynecology, online October 25, 2010.

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