Monthly Archive for December, 2010

Home For The Holidays

MASSILLON, OH — There’s nothing like being home for the holidays.

Just ask Vince and Amie Spicocchi.

The Massillon couple will spend their first holiday with all of their children – including quintuplets Amie gave birth to by Cesarean in August – under one roof.

“It’s going to be fun,” Vince said.

“The only difference is we are not going to be leaving the house,” Amie added. “We normally visit Vince’s family on Christmas Eve and then my family on Christmas Day.”

Instead, a small gathering of family will join the Spicocchis at their home on Christmas Day to celebrate the babies’ first Christmas.

“This is the first time we are under the same roof for a holiday,” Vince said. “For Thanksgiving, Paige and Enzo were still in the hospital.”

Born nearly four months early at 24 weeks and three days, the quintuplets – Ilah, Paige, Enzo, Ellie and Gia – remained at Akron Children’s Hospital for the first few months of their life. Amie’s due date was Nov. 20.

In singles and pairs, the babies began coming home: Gia was the first on Nov. 10. Her sisters Ilah and Ellie followed on Nov. 12, Paige on Nov. 26, and finally Enzo on Nov. 29.

“I think they are growing very well,” said Amie, now a mother of seven, including the quints and 14-year-old Taylor and 5-year-old Grady. “(Doctors) are very happy with how they have gained (weight).”

Ellie weighs in at 10.1 pounds, followed by Enzo at 9.13 pounds, and the three girls each weigh 9.3 pounds.

“Their weight has been increasing since the time they were discharged,” Vince said. “They are doing what they are suppose to be doing.”

Considering they are multiples and were born premature, the Spicocchis say their babies are doing remarkably well, but they know they are not out of the woods.

“People don’t realize they were only given a 10 percent chance of making it when we found out (we were pregnant with quints),” Vince said. “Here we are now eight or nine months later, not only are they all here but they are doing well. You are humbled by that.”

“People talk about miracles,” Amie said. “The fact that all five of them were delivered is truly a miracle and we don’t take that for granted.”

Vince said the day the babies were born, doctors gave them a 50 percent survival rate.

“We’ve already beaten the odds,” Vince said.

“You are thankful for that each day,” Amie added.

A healthy, happy home

Keeping the babies healthy is of utmost importance.

To that end, house rules have been posted at the front door – the most important keeping hands washed and clean, and not allowing visitors who are sick or who live with someone who is sick.

Other rules: Don’t knock on the door – five babies are sleeping. No unannounced visitors. And no perfume around the babies.

Ellie, her parents say, appears to be coming down with what could be a cold.

“Something like that could knock them down,” Vince said. “You don’t want to introduce any unnecessary germs.”

A helping hand

Juggling five babies is no easy task, and the Spicocchis rely on family and friends to help keep the babies fed and happy.

The babies are fed seven times a day – that’s 35 bottles and about 50 diapers each day.

“The dietitian recently said we could skip one feeding, so we are skipping the 4:30 a.m. feeding,” Amie said.

Vince’s father and stepmother help with the 1:30 a.m. feeding.

“Sometimes it is just us and sometimes there is a person for each baby,” Vince said. “If we have two people show up, it makes it pretty easy.”

Even with extra sets of hands, it takes about an hour to feed all five babies.

“It’s kind of like the movie ‘Groundhog Day,’” Vince said noting once you finish changing, feeding and putting the babies to sleep, it is time to start all over.

The couple is sleeping in shifts, Vince said, joking he sometimes gets out of the 1:30 a.m. feeding if he has to work the next day. Vince is a Massillon firefighter and works a 24-hour shift.

“I try to get a good night sleep (before a shift),” he said.

To give their volunteers a break, they have enlisted the services of PINK – Postpartum Infant Nurturing Kare.

The Jackson Township-based group, Amie said, is not well-known in the area but travels out of state to provide their services.

PINK offers infant assistance for a seven-hour period one to two times a week.

“It gives us a chance to hang out with the other kids or to get some sleep,” Vince said. “They specialize in premature babies and multiples. It gives everyone a break so we don’t overtax our volunteers.”

‘Actual age’

While the quintuplets were born nearly five months ago – on Aug. 3 – doctors still consider them only four weeks old – their adjusted age based on Amie’s due date.

“Their age right now is four and half months but they don’t go by their actual age,” Vince explained. “They look at their level (based on their adjusted age) of around four weeks.

“They are preemie babies and they are still within in the normal range (for size) and are doing normal things. They act just like newborns.”

Adjusting to nine

All the preparation for bringing the babies home paid off, Vince said.

But one thing the couple wasn’t prepared for is the planning it takes just to make doctor visits.

“We’ve only had to take all five (at the same time) once,” he said. “But we really had to plan it out. You need one person inside (the doctor’s office), one person in the car and one person to carry them (into the office).”

After a little trial and error, Vince was able to fit all five of the babies’ car seats in their vehicle, but that only leaves room for two passengers – it doesn’t fit the entire family of nine.

Starting to smile

The couple said people visiting their home are surprised by how calm the environment is with five babies.

“They expect it to be a zoo and it can be,” Vince said.

“There are times when it is pretty crazy,” Amie said.

“It’s amazing how normal they are,” Vince said. “They are starting to smile.”

“It’s reassuring,” Amie said.

Amie and Vince continue to be thankful for the generosity of their family and friends and complete strangers.

“We want to thank everybody who has helped us,” Vince said. “The support from people we don’t know who send us cards and well wishes and donations. It’s overwhelming the support.”

 

Teen Birthrate Hits Record Low

By Rob Stein, Washington Post Staff Writer

The rate at which U.S. women are having babies continued to fall between 2008 and 2009, federal officials reported Tuesday, pushing the teen birthrate to a record low and prompting a debate about whether the drop was caused by the recession, an increased focus on encouraging abstinence, more adolescents using birth control or a combination of those factors.

The birthrate among U.S. girls ages 15 to 19 fell from 41.5 to 39.1 births per 1,000 teens – a 6 percent drop to the lowest rate in the nearly 70 years the federal government has been collecting reliable data, according to a preliminary analysis of the latest statistics.

“The decline in teen births is really quite amazing,” said Brady E. Hamilton of the National Center for Health Statistics, who helped perform the analysis.

The decrease marked the second year in a row that the birthrate among teens fell, meaning it has dropped for 16 out of the past 18 years. The 8 percent two-year decline strengthens hopes that an alarming 5 percent increase over the preceding two years was an aberration.

“Just in time for the holidays, a steep decline in teen birth has been announced,” said Sarah Brown of the Campaign to Prevent Teen and Unplanned Pregnancies. “We now are, thankfully, back on track.”

The reason for the record low remains unclear, but some experts attributed it to the recession, noting that the overall fertility rate as well as the total number of births in the United States fell a second straight year in 2009 as well.

“I would not have guessed that teenagers would be most responsive to the economic downturn, but maybe we need to revise our stereotypes,” said Samuel Preston, a professor of demography at the University of Pennsylvania.

Brown and others agreed:

“When money is very tight, all of us think harder about taking risks, expanding our families, taking on new responsibilities,” Brown said. “Now, I know that teens may not be as savvy about money as those in their 20s and 30s – they probably don’t stress over 401 (k)s like the rest of us – but many teens live with financially stressed adults, and they see neighbors and older friends losing jobs and even losing houses. So they, too, feel the squeeze and may be reacting to it by being more prudent. . . . Maybe part of tightening our belts includes keeping our zippers closed, too!”

That fits with research released in the spring by the Pew Research Center, which found that states hit hardest by the recession experienced the biggest drops in births.

“Our evidence definitely suggested there was a link between the economic circumstances and what was going on with fertility,” said Gretchen Livingston, a Pew senior researcher. “I suspect that’s what we’re seeing with these lower numbers. This fits with the historical picture as well.”

Others suggested that the intense concern about the 2005 to 2007 increases and the attention it generated–including Bristol Palin’s campaign against teen pregnancy, MTV’s “16 and Pregnant” series and Washington’s birth control-vs-abstinence debate – may have gotten through to teens. Some data, for example, indicate that use of birth-control pills and other forms of contraception among teen girls is increasing.

“Although the data are preliminary, it looks like improved contraceptive use is again driving the decline in teen birthrates,” said John Santelli of Columbia University’s Mailman School of Public Health.

The general fertility rate fell from 68.6 births per 1,000 females ages 15 to 44 to 66.7 in 2009, and the total number of births fell from 4,247,694 to 4,131,019, That direction appears to be continuing into 2010, according to early statistics collected between January and June. The overall drop pushed the fertility rate to about 2.01, a 4 percent decrease from 2008.

That is the largest decline since 1973, and it put the total fertility rate below the level needed to sustain the size of the population for the second year after being above the replacement rate in 2006 and 2007 for the first time in 35 years.

The birthrate for women in their early 20s fell 7 percent, which is the largest decline for this age group since 1973, according to the report. The rates also fell for women in their late 20s and 30s, although it continued to increase for women in their early 40s.

The rise in teen pregnancies had triggered an intense debate about whether increased funding for sex-education programs that focus on encouraging abstinence may be playing a role. As a result, proponents of abstinence education welcomed the new data, saying they exonerated their approach.

“These trends show that the risk-avoidance message of abstinence has ‘sticking power’ for young people,” said Valerie Huber of the National Abstinence Education Association. “This latest evidence shows that teen behaviors increasingly mirror the skills they are taught in a successful abstinence education program.”

Huber and others noted that the Obama administration has significantly reduced funding for abstinence-focused programs.

“With a change in policy away from abstinence education, we may expect to see a reversal of the teen pregnancy birthrate in the years to come,” said Jeanne Monahan of the Family Research Council.

But critics of abstinence programs, who argue that the approach does not work, attributed the drop to the recession.

“We certainly don’t want recession to be the most effective form of birth control in the U.S.,” said James Wagoner of Advocates for Youth. “We still need structural reforms in sex education, contraceptive access and pragmatic public policies to ensure a long-term decline in the teen birthrate – during good economic times as well as bad.”

The Obama administration has launched a $110 million teen pregnancy prevention effort that will support a range of programs, including those that teach about the risks of specific sexual activities and the benefits of contraception and others that focus primarily on encouraging teens to delay sex.

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.

Autism More Likely in Kids Whose Moms Live Near Freeways

Having a mother who lived within 1,000 feet of a freeway while pregnant doubles a child’s odds of having autism.

The finding comes from a study looking at environmental factors that might play a role in autism. University of Southern California researcher Heather E. Volk, PhD, MPH, and colleagues collected data from 304 California children with confirmed autism and from 259 children who developed normally.

“It has been estimated that 11% of the U.S. population lives within 100 meters [328 feet] of a four-lane highway, so a causal link to autism or other neurodevelopmental disorders would have broad public health implications,” the researchers note.

Exposure to air pollution during pregnancy is suspected of a wide range of negative effects on the fetus. A particularly crucial period may be the third trimester, when the brain develops rapidly.

Air pollution is particularly heavy within a thousand feet of a highway. Volk and colleagues found that the 10% of women who lived closest to a freeway during pregnancy were within about 1,000 feet of center line. Children born to these women were 86% more likely to have autism than kids born to women who lived farther from the freeway.

The relationship was stronger for women who lived within 1,000 feet of a freeway during their third trimester. Children born to these women were 2.2 times more likely to have autism.

Interestingly, the odds of autism remained unchanged when the researchers controlled for factors such as child gender or ethnicity, household education, maternal age, and maternal smoking.

It’s becoming clear that a child’s genetic inheritance has a lot to do with whether that child has autism. But genes do not explain why one child develops autism while another does not. Many researchers believe that something or a combination of things in the environment trigger autism in genetically susceptible kids. That exposure may come while the child is still in the womb.

But what is it about living near a freeway that might trigger autism? Is it really air pollution? Or could it be the noise?

Volk and colleagues note that their findings should be confirmed in studies that measure the actual air pollutants to which pregnant women living near freeways are exposed.

The Volk study appears in the Dec. 16 online issue of Environmental Health Perspectives, published by the U.S. National Institute of Environmental Health Sciences.

Researchers find new source of immune cells during pregnancy

This article makes for a bit harder reading but none-the-less is still interesting.

UCSF researchers have shown for the first time that the human fetal immune system arises from an entirely different source than the adult immune system, and is more likely to tolerate than fight foreign substances in its environment.

The finding could lead to a better understanding of how newborns respond to both infections and vaccines, and may explain such conundrums as why many infants of HIV-positive mothers are not infected with the disease before birth, the researchers said.

It also could help scientists better understand how childhood allergies develop, as well as how to manage adult organ transplants, the researchers said. The findings are described in the Dec. 17 issue of Science.

Until now, the fetal and infant immune system had been thought to be simply an immature form of the adult system, one that responds differently because of a lack of exposure to immune threats from the environment. The new research has unveiled an entirely different immune system in the fetus at mid-term that is derived from a completely different set of stem cells than the adult system.

“In the fetus, we found that there is an immune system whose job it is to teach the fetus to be tolerant of everything it sees, including its mother and its own organs,” said Joseph M. McCune, MD, PhD, a professor in the UCSF Division of Experimental Medicine who is a co-senior author on the paper. “After birth, a new immune system arises from a different stem cell that instead has the job of fighting everything foreign.”

The team previously had discovered that fetal immune systems are highly tolerant of cells foreign to their own bodies and hypothesized that this prevented fetuses from rejecting their mothers’ cells during pregnancy and from rejecting their own organs as they develop.

The adult immune system, by contrast, is programmed to attack anything it considers “other,” which allows the body to fight off infection, but also causes it to reject transplanted organs.

“The adult immune system’s typical role is to see something foreign and to respond by attacking and getting rid of it. The fetal system was thought in the past to fail to ‘see’ those threats, because it didn’t respond to them,” said Jeff E. Mold, first author on the paper and a postdoctoral fellow in the McCune laboratory. “What we found is that these fetal immune cells are highly prone to ‘seeing’ something foreign, but instead of attacking it, they allow the fetus to tolerate it.”

The previous studies attributed this tolerance at least in part to the extremely high percentage of “regulatory T cells”– those cells that provoke a tolerant response – in the fetal immune system. At mid-term, fetuses have roughly three times the frequency of regulatory T cells as newborns or adults, the research found.

The team set out to assess whether fetal immune cells were more likely to become regulatory T cells. They purified so-called naïve T cells – new cells never exposed to environmental assault – from mid-term fetuses and adults, and then exposed them to foreign cells. In a normal adult immune system, that would provoke an immune attack response.

They found that 70 percent of the fetal cells were activated by that exposure, compared to only 10 percent of the adult cells, refuting the notion that fetal cells don’t recognize outsiders. But of those cells that responded, twice as many of the fetal cells turned into regulatory T cells, showing that these cells are both more sensitive to stimulation and more likely to respond with tolerance, Mold said.

Researchers then sorted the cells by gene expression, expecting to see similar expression of genes in the two cell groups. In fact, they were vastly different, with thousands of genes diverging from the two cell lines. When they used blood-producing stem cells to generate new cell lines from the two groups, the same divergence occurred.

“We realized they there are in fact two blood-producing stem cells, one in the fetus that gives rise to T cells that are tolerant and another in the adult that produces T cells that attack,” Mold said.

Why that occurs, and why the immune system appears to switch over to the adult version sometime in the third trimester, remains unknown, McCune said. Further studies will attempt to determine precisely when that occurs and why, as well as whether infants are born with a range of proportions of fetal and adult immune systems – information that could change the way we vaccinate newborns or treat them for such diseases as HIV.

Mariah Carey and Nick Cannon are expecting twins

This from the Los Angeles Times.

Mariah Carey is expecting twins, her husband confirmed on his “Rollin With Nick Cannon” radio show Thursday morning. But apparently the story was already out.

“She shared with the president and the first lady that we are having twins,” Cannon said. “I haven’t even told my wife I was doing this, so I am probably going to get yelled at for not getting permission.”

The missus apparently couldn’t keep mum when talking to to the first couple at the Sunday taping of “Christmas in Washington.” Hey, when the first lady asks you a question, you tell her first, right?

The special, hosted by Ellen DeGeneres, airs Friday on TNT. Carey has said she’s expecting “in the spring.”

Fergie preparing for motherhood?


Fergie has revealed that she is planning to cut down on her work before becoming a mother.

The Black Eyed Peas singer admitted that from next year she plans to be “very selective” with her career.

When asked if she plans to bring her children with her on tour like singer Sarah McLachlan, Fergie replied to HollyBaby: “I’m trying to slow down on the touring, that’s the plan for next year, just being selective – only big things.

“I’ve been touring for eight years straight on and off, so it’s time. I need some balance time.”

The 35-year-old added that she believes her husband Josh Duhamel will make a good father.

She explained: “He’d make an amazing father. He’s great with kids. I mean he can pick ‘em up and swing them around. He was around kids all his life so he’s going to help me because I wasn’t around young, infant babies.

“He knows how to change a diaper. He knows how to do everything, so I’m the luckiest wife.”

Enjoy your kids: They don’t stay young for long

The picture currently on the desktop of my computer is of my two older children.

My daughter, the oldest, is about 2 years old and is lying on a pillow next to her 4-month-old baby brother. Her light brown hair is wispy and her arms have that chubby toddler look to them.

My son is wearing a blue onesie, his tongue is sticking out, and he has that funny, unfocused wide-eyed look that only babies get (probably thanks to the camera hovering over his face). The picture is already five years old.

When my kids were very little, during what I called my baby years because it felt like I had one baby after another during the course of five years, people often commented on the same thing: Enjoy this phase, it’ll go by fast.

Caught up in diaper changing, waking up multiple times a night and not being able to leave home without a giant bag of supplies, I thought to myself, “Enjoy this? I’m exhausted – I can’t wait till the day they can all walk by themselves!”

Don’t get me wrong, I love my children and loved them when they were very little, too. However, I still recall the work of keeping an eye on a baby nonstop just in case he crawled too close to the steps or put some random piece of trash in his mouth. Or juggling a car seat and a toddler who liked to run away from me at the park (my daughter did this all the time!). Or the effort it took to get three kids in and out of the car when none of them knew how to buckle themselves.

Today, though, I’m feeling a little more sentimental and am beginning to understand what people mean when they remind me to enjoy this phase. Seeing a picture of my daughter at 2 years old is a reminder that we can never go back in time. I will never get to spend time with her at that point in her life again. That infant/toddler phase is almost over for our family now that my youngest is a few months shy of turning 4. I see our old pictures and think, wow, they were so little (and so cute). They’re not even very big now!

What will I be thinking in 10 years?

Twenty years?

Naturally, time will keep passing. I’ll keep trying to remember to enjoy watching my kids grow, but inevitably I’ll always look back and be amazed at how quickly they change.

Just this weekend, we took the kids on a bike ride, and I thought about how often my husband and I looked forward to being able to have outings like that.

Well, here we are at this point in time. Can we step back and appreciate it the way we ought to?

Jen Kayton is a freelance writer and mother of three children. She also works at Colorado State University. You can reach her at jenniferkayton1@hotmail.com.

Sophia and Aiden lead Top 100 Baby Names of 2010

.. Please step down, Isabella. Sophia is taking your place as the most popular girl’s name of 2010.

Congratulations, Aiden. You’ve held onto the number-one boy’s spot for the sixth year in a row.

Welcome to the pack, Liam and Abigail. You’re now officially a part of the coveted top 10.

BabyCenter released its list of the Top 100 Baby Names of 2010 today. The online parenting and pregnancy destination compiled some 350,000 baby names and combined those that sound the same but have different spellings (such as Sophia and Sofia) to create a true measure of popularity.

Top 10 Girls’ Names of 2010

1.Sophia
2.Isabella
3.Olivia
4.Emma
5.Chloe
6.Ava
7.Lily
8.Madison
9.Addison
10.Abigail

Top 10 Boys’ Names of 2010

1.Aiden
2.Jacob
3.Jackson
4.Ethan
5.Jayden
6.Noah
7.Logan
8.Caden
9.Lucas
10.Liam

What’s influencing baby-naming parents? Parents turned to pop culture, politics, a bygone era, and the ever-popular Old Testament for inspiration. Here’s a look at the Hottest Baby Name Trends of 2010:

•Glee’s cheerleader queen Quinn may be mean, but her name is certainly popular, jumping up in the ratings a whopping 60 percent. Finn, Jenna, and Lea are also singing a happy tune.

•The critically acclaimed drama Mad Men has struck a nerve with the American public. Dishy Don (as in Draper) inched up the charts, and his ex-wife is bringing the cool back to Betty. The silver-haired fox Roger rose 21 percent, while his wife, Jane, also gained popularity.

•The names of the moms on MTV’s reality show 16 and Pregnant are also popular: Maci, Farrah, and Katelynn are up by 60, 51, and 7 percent, respectively.

•Sarah Palin’s daughters’ names – Bristol, Willow, and Piper – are climbing the ladder, but the name Sarah is actually in decline.

•The golden age of film (think 1930 to 1959) played a starring role in this year’s list. Audrey, Ava, Scarlett, Evelyn, Vivien, and Greta all got rave reviews.

•Parents are reaching back for names…way, way back to the Old Testament. Jacob has made the BabyCenter top ten for the past ten years, while Levi, Caleb, Elijah, and Jeremiah are rising in the charts. For more about the hottest trends see BabyCenter’s Baby Names Special Report of 2010.

What about names below the top ten? Some are flying up the list, while others are spiraling downward.

•Newcomers who broke into the top 100 include Annabelle (69), Stella (72), Nora (83), Jeremiah (90), Hudson (96), and Ryder (97).

•Ellie, who leapfrogged 26 spots to come in at number 61, is a rising star.

•So is Charlotte, who was bumped up 20 to number 38.

•And then there’s Grayson, who enjoyed a 25-spot jump to land at number 66.

•Some names lost a lot of ground. Brooke shot down 23 spots to number 82, while Hayden tumbled 20 spots to number 91.

•Ashley and Brendan exited the top 100 entirely.

What’s up for next year? BabyCenter uses a top-secret algorithm to unearth the names that are likely to become even more popular in 2011.

•Of the top 100 girls’ names from 2010, it looks like Layla, Lila, Evelyn, Charlotte, Lucy, Ellie, Aaliyah, Bella, Claire, and Aubrey will continue to rise in 2011.

•Of the top 100 boys’ names from 2010, BabyCenter predicts that Eli, Colton, Grayson, Wyatt, Henry, Mason, Landon, Charlie, Max, and Chase will gain momentum in 2011.

And what about names that haven’t even broken into the top 100? Who will be next year’s newcomers?

•Among the less popular names now moving up the girls’ list are Isla, Adalyn, Giuliana, Olive, Kinsley, Evangeline, Paisley, Vivienne, Maci, and Kinley.

•And although Bentley, Kellan, Kingston, Aarav, Ryker, Beckett, Colt, Paxton, Jax, and Lincoln are well below the top 100 on the boys’ list, they’re all fast climbers.

Pregnancy-related deaths rise in the U.S. — But still rare for a woman to die from birth complications

By Amy Norton of Reuters

NEW YORK (Reuters Health) – While it remains rare for a woman in the U.S. to die from pregnancy complications, the national rate of pregnancy-related deaths appears to be on the upswing, a new government study finds.

Researchers at the U.S. Centers for Disease Control and Prevention (CDC) found that between 1998 and 2005, the rate of pregnancy-related deaths was 14.5 per 100,000 live births. And while that rate is low, it is higher than what has been seen in the past few decades.

The researchers caution that the extent to which the rise reflects a true elevation in women’s risk of dying is unclear. Recent changes in how causes of death are officially reported by states to the federal government may be at least partially responsible for the findings.

However, it is also possible that part of the increase is “real.” According to the new data, deaths from chronic medical conditions that are exacerbated by pregnancy, including heart disease, appear to account for a growing number of pregnancy-related deaths.

In contrast, deaths from actual obstetric complications — namely, hemorrhaging and pregnancy-related high blood pressure disorders — are declining.

The absolute risk of a U.S. woman dying from pregnancy-related problems is still “very small,” lead researcher Dr. Cynthia J. Berg, of the CDC’s division of reproductive health, said in an interview.

But, she added, the new findings do underscore the importance of women “making sure they are in the best possible health before pregnancy.”

All women, Berg said, should try to have a pre-pregnancy visit with their ob-gyn and, if needed, get their weight and any chronic medical conditions, like high blood pressure or diabetes, under control before becoming pregnant.

For their study, Berg and her colleagues looked at data on 4,693 pregnancy-related deaths reported to the CDC between 1998 and 2005. Pregnancy-related death was any death occurring during or within one year of pregnancy that was attributed to a pregnancy complication.

The researchers estimate that for that eight-year period, the national rate of pregnancy-related death was 14.5 for every 100,000 live births.

In contrast, in 1979, there were just under 11 maternal deaths per 100,000 live births in the U.S. — a rate that fell to as far as 7.4 per 100,000 in 1986, before beginning a gradual increase.

In addition, the racial gap that has long been seen in pregnancy-related deaths shows no signs of narrowing. Between 1998 and 2005, the death rate among black women was 37.5 per 100,000 live births, versus 10.2 per 100,000 among white women and 13.4 per 100,000 for all other racial groups combined.

The reasons for the upward trend in the overall rate of pregnancy-related deaths are not certain, and more studies are needed to tease apart the contributing factors, Berg said.

One factor, according to the researchers, could be two technical changes in how causes of death are officially reported. In 1999, the U.S. adopted an updated system for coding causes of death — one that allowed more deaths to be classified as “maternal.”
Then in 2003, the standard death certificate was revised to include a “pregnancy checkbox,” which increased the number of deaths that could be linked, in timing, to pregnancy.

However, recent years have seen not only a change in the rate of pregnancy-related deaths, but in the specific causes.

Berg explained that the proportion of deaths from “direct causes” — obstetrical complications like hemorrhaging — is going down, while the proportion attributed to indirect causes — that is, medical conditions worsened by pregnancy — is increasing.

Hemorrhaging, for example, accounted for just under 30 percent of pregnancy-related deaths between 1987 and 1990, but only 12 percent between 1998 and 2005. High blood pressure disorders (mainly pre-eclampsia and eclampsia) also accounted for about 12 percent of deaths in 1998-2005 — down from around 18 percent in 1987-1990.

On the other hand, there was a sharp increase in the proportion of deaths attributed to heart problems. In the most recent time period, just over 12 percent of pregnancy-related deaths were attributed to “cardiovascular conditions,” while just under 12 percent were attributed to cardiomyopathy, an enlargement of the heart.

In 1987-1990, only about five percent of deaths were linked to cardiomyopathy, and a smaller percentage to cardiovascular conditions.

This study cannot weed out the precise reasons for these patterns. But Berg pointed out that “our population is changing.”

More women of childbearing age today are obese or have chronic health problems like high blood pressure and diabetes than in years past. So that could help explain the shifting pattern in the causes of pregnancy-related deaths, according to Berg.

The bottom line for women, she said, is that while the odds of dying from pregnancy-related problems remains quite low, it is important to go into pregnancy in the best possible health.

The CDC has information on pre-pregnancy health.

SOURCE: http://link.reuters.com/vah38q Obstetrics & Gynecology, December 2010.