Archive for the 'Health' Category

Page 3 of 4

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.

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.

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.

The Lucky One

By Jenny Feldon, blog post at Pregnancy.com

35 weeks. It seems almost impossible that this much time has gone by since I first saw that pink plus sign on a white plastic stick. Holiday decorations are already in store windows; by Christmas I could have a weeks-old infant cradled in my arms. Sometimes I look back and think “How did I get here? And how did it happen so fast?”

Along with my rapidly approaching due date, there’s another date permanently engraved on my mind. A day on the calendar that was supposed to mark the same kind of joy for one of my dearest friends that my own due date promises for me. But that date is empty now, a blank spot where there used to be a big red exclamation point. Because I am the lucky one, the one who gets to keep her miracle. And my friend—an amazing woman, a phenomenal mother—is grieving not one, but two pregnancies she’s lost in the same 35 weeks I’ve been happily, uneventfully pregnant.

It’s at her recommendation—and with her blessing—that I write this very difficult post. Miscarriage is a very common, very real part of many women’s journeys toward motherhood. I’m particularly inspired by Project Pregnancy blogger Lexi Walters Wright, whose beautifully written, brave posts remind me how incredibly fortunate I am—how fortunate every mom is—to have a healthy child growing up before my eyes, and even luckier to have rolled the dice and conceived a second time. But remembering how lucky I am is not enough to provide support to my friend, to help her through her grief without being a living, breathing reminder of her pain. What do you say when you desperately want to ease a friend’s pain—but can only make things worse?

We met when our babies were just a few months old, and it was instant friend karma. Our daughters are less than two weeks apart, and we’ve tackled every challenge of new motherhood together, from breastfeeding to pureeing broccoli to those first trips down the big kid slide. We made stay-at-home mommyhood into an adventure, with coffee playdates, music classes and field trips to the aquarium. She has parented my daughter almost as much as I have; she is one of the reasons my long months with J out of town have been bearable.

Around the same time, we decided it was time for #2. My friend had lost a pregnancy before her daughter C was born, and was considerably more cautious—and anxious—about the conception process than I was. Still, we bought ovulation sticks together, peed on pregnancy tests together, and looked at each other wide-eyed with shock and joy when we realized we’d both hit the jackpot—and were expecting our #2s just two days apart.

I had complications early in this pregnancy I hadn’t experienced with E. Bleeding started around 6 weeks, and I would sit in the bathroom, terrified and alone, wondering what was happening. She was my sounding board, my reassuring voice. When she also started first trimester bleeding, I blithely assured her everything would be fine. Wasn’t she just being overly neurotic because she’d had a miscarriage before C? If she was allowed to reassure me, I was allowed to poo-poo her fears too. Or so I thought.

Just before our 12-week milestones, my friend’s ultrasound showed no heartbeat. In an email more concerned with my feelings than her own, she broke the news, letting me know she and her husband were drowning their tears in sake and sushi, and were focused on being grateful for the gorgeous, smart toddler they had at home. They were optimistic about trying again. Typically brave, typically cheerful. Heartbreakingly honest.

I cried for hours. Why her? Why not me? Suddenly, irrevocably, my joy and her pain were inextricably woven. And there was nothing I could say, no help or soothing words I could offer her, that could excuse the fact that I was still pregnant and she was not. I desperately wanted to trade places. At least if it were my pain, I could deal with it, be in control of it. But to watch someone so close to me suffer and not be able to a single thing to help—it was intolerable.

Selfishly, I was grieving a little bit for me, too. I wanted to take this journey with one of my dearest friends. Everything was supposed to work out perfectly. I’d envisioned joint baby showers and shuffling down the hospital hallway with my IV pole to have the world’s first post-partum slumber party—just her, me, and our newborns. Our #2s should have had birthday parties together, gone to the DMV together to get their driver’s licenses. All those silly, selfish dreams were shattered. I wanted to be unequivocally elated and excited about the new life inside me. Instead I felt sad, lost, and so, so guilty.

My friend is one of the strongest and bravest people I know. But no amount of bravery can take away her pain, and I hate that my own healthy pregnancy is a constant reminder of what she should have had—twice, now, since I conceived #2. Our conversations have become an elaborate dance, with her asking me about the pregnancy to prove she’s OK with it, and me trying everything to avoid the topic entirely so as not to cause her any more sorrow. If I could make my growing belly disappear in her presence, I would. I do my best to pretend there’s nothing more important going on in my life than preschool and potty training, because those subjects are things we can still share. But despite our best efforts, the chasm between us grows ever wider. It‘s the exact distance between the baby that is, and the baby that is no longer.

Is there ever a right thing to say to a friend or loved one that has suffered this kind of loss? Can women who haven’t had fertility problems ever say the right thing to a woman who has? Even with the best of intentions, every word out of my mouth is potentially the most wrong thing I could say. I can’t understand what it feels like. I can’t make any of it better. And what I am doing—growing bigger and more pregnant by the minute—is, in some ways, the worst thing of all.

I know how genuinely happy my friend is for me, and how much she hates that I feel guilty when I should be celebrating this upcoming new life. I believe with my whole heart that she will have another child, one as healthy and precocious and absolutely perfect as her sweet daughter C. She is an incredible friend, a loving wife, an amazing mother. She doesn’t deserve the sorrow she’s been dealt (who does?) but she’ll triumph anyway, because that’s who she is. She inspires me every day.

And so do all the other women who have struggled with the pain and loss of infertility and miscarriage. To all of you out there who have suffered like my sweet friend: Is there anything us “lucky ones” can do, or say, to support you the way we so desperately want to? Or at the very least, minimize the damage our happily pregnant selves can inflict on still-raw wounds? Nothing can take away the pain of loss, and in many ways that chasm will always exist. But I’d love to hear advice on what to do, what not to say, and how to bridge the gap that inevitably grows between women whose paths have turned away from each other.

Why the health of pregnant women matters to us all

By Annie Murphy Paul,author of “Origins: How the Nine Months Before Birth Shape the Rest of Our Lives.”

“Pregnant Is the New Sexy,” read the T-shirt a friend gave me when I was a few weeks away from my due date. With my swollen ankles and waddling walk, I wasn’t so sure – but it’s hard to deny that pregnancy has become rather chic. Glossy magazines flaunt actresses’ and models’ rounded, half-clad bellies on their covers. Inside they chronicle celebrities’ pregnancies in breathless detail, from the first “bump” sighting to the second-trimester weight gain to the baby-gear shopping spree. And now comes the news that “What to Expect When You’re Expecting” – the advice bible that has sold more than 14 million copies – will be made into a feature film.

There’s something wrong with this picture. Even as Americans fuel a rapidly growing pregnancy industry of designer maternity jeans and artsy pregnancy portraits, we’re ignoring the real news about these nine months. An emerging science known as the developmental origins of health and disease – DOHaD for short – is revealing that the conditions we encounter in the womb can have a lifelong impact on our health and well-being, affecting everything from our appetite and metabolism to our susceptibility to disease to our intelligence and temperament.

The more we learn about these effects, the clearer it becomes that investing in maternal health would return larger and longer-lasting dividends than almost any other comparable public health investment. But as a nation, we’re heading in exactly the opposite direction, spending more and more of our limited resources on the later stages of life instead of where they can make the most difference: at the very beginning.

Take obesity. Many anti-obesity initiatives concentrate on changing adults’ behavior, trying to persuade us to eat less and exercise more. But research shows that these efforts have limited effectiveness. A recent analysis of U.S. obesity-prevention campaigns, conducted by Olaf Werder of the University of New Mexico, concluded that their “overall impact on obesity has been negligible.”

Even public health programs aimed at school-age children come too late: Almost a third of American children over age 2are already overweight or obese, according to the National Health and Nutrition Examination Survey. Clearly, the conditions that contribute to obesity must begin exerting their influence very early in children’s lives – as early as their time in the womb.

DOHaD research shows that the intrauterine environment of a woman who is significantly overweight when she conceives – or who puts on excessive weight during pregnancy – affects the developing fetus in ways that make it more likely to become overweight itself one day. Scientists are still figuring out exactly why this happens, but it appears that prenatal experience may alter the functioning of organs such as the heart and the pancreas, may shift the proportion of lean and fat body mass, and may influence the brain circuits that regulate appetite and metabolism.

In a cleverly designed study published in the Journal of Clinical Endocrinology and Metabolism in 2009, researchers compared children born to the same mothers before and after they’d had successful anti-obesity surgery. Children born after their mothers’ surgery weighed less at birth and were three times less likely to become severely obese than their older brothers and sisters. Weight-loss surgery isn’t for everyone, of course. Still, what if before conceiving, overweight women were routinely counseled by their doctors about the effects of their weight on future offspring? And what if women who were gaining weight too rapidly in pregnancy were offered more help in controlling it?

The results might look something like those found in studies of diabetes treatment during pregnancy. Research shows that the children of diabetic women are more likely than others to develop diabetes – in one recent study, seven times more likely. Like obesity, diabetes has a strong genetic component, but scientists are also beginning to focus on the effects of a diabetic intrauterine environment. For example, a long-running study of the Pima Indians of Arizona, who have one of the highest rates of diabetes in the world, concluded that exposure to the disease while in the womb was responsible for about 40 percent of the diabetes cases studied.

A pregnant woman’s diabetes can also affect the odds that her child will become obese. In a study of almost 10,000 mother-child pairs, researchers from the Center for Health Research at Kaiser Permanente Northwest found that women who developed diabetes during pregnancy and were not treated had children who were twice as likely to become obese as the children of women without that illness. Pregnant women whose diabetes was treated with insulin, however, had children with no additional risk of obesity. Simply by controlling their mothers’ blood sugar during pregnancy, in other words, the expected doubling of these children’s obesity risk was completely reversed.

Even the mental health of a pregnant woman can have a long-term impact on her offspring. A 2008 study by researchers at the Kaiser Permanente Oakland Medical Center in California found that women with even mild symptoms of depression are 60 percent more likely to deliver early than other women; those who are severely depressed have double the risk of premature birth. The babies of depressed women are also more likely to have low birth weight, to be irritable and to have trouble sleeping.

Of course, these complications may come about in part because many depressed women don’t take good care of themselves: They may eat poorly, smoke or drink alcohol, or fail to get prenatal care. But depression itself may shift the biochemical balance in a woman’s body in a fateful manner. For one thing, the stress hormone cortisol, which is often elevated in people with depression, may cross the placenta, directly affecting fetal development, and it may also affect a pregnant woman’s blood vessels, reducing the oxygen and nutrients that reach the fetus.

The case seems pretty clear: We should make a nationwide effort to ensure that every obstetrician checks every pregnant patient’s mental state, along with her weight and blood pressure. Women who show signs of depression should be offered therapy or, in cases that warrant it, carefully administered antidepressant medication.

Adult behavior can be difficult to change, as we know from the general ineffectiveness of anti-obesity campaigns. But pregnant women are a special case: They’re usually highly motivated, they’re typically in regular contact with health-care providers, and they have to keep up their efforts for only nine months. Pregnancy therefore offers a singular opportunity to improve lives for decades to come, via interventions that cost little compared with the enormous price tags for obesity, diabetes, low birth weight and premature delivery.

So why isn’t this critical window one of our top health-care priorities?

Part of the reason may simply be our preference for quick fixes and for dealing with only those problems that exist in the here and now. It can be hard to wrap our heads around the notion that a woman’s diet or mental state today will have a serious effect on her children’s health many years out. But there’s a less obvious reason that resistance to maternal health initiatives might crop up among the liberal-leaning individuals who typically support public health initiatives and women’s health-care issues: abortion politics.

Caring for the fetus, protecting the fetus from harm – to abortion rights advocates, such measures sound like the steps antiabortion forces have taken to try to establish a fetus’s rights. What’s the difference between controlling a diabetic pregnant woman’s blood sugar and, say, charging a pregnant woman who uses drugs with child abuse? Between telling an obese pregnant woman that her weight may predispose her child to obesity and requiring a woman to look at an ultrasound of her fetus before proceeding with an abortion?

The crucial difference lies in the intent behind the intervention and in the way it’s carried out. Help in achieving a healthy pregnancy must be offered to pregnant women, not forced upon them. And the aim behind such efforts must be to foster the health and well-being of the woman and her fetus, not to score political points.

Ultimately, research on the developmental origins of health and disease should lead us to a new perspective on pregnancy, one that’s not about coercing or controlling women – nor about ogling or fetishizing them – but about helping them, and their future children, be as healthy and as happy as they can be.

Painkillers in Pregnancy Linked to Male Infertility

Study Suggests Even Tylenol During Pregnancy May Affect Male Testes

By Daniel J. DeNoon of WebMD Health News

Reviewed by Laura J. Martin, MD

Common over-the-counter painkillers taken during pregnancy may be to blame for a global rise in male infertility.

Even acetaminophen (Tylenol) may put a developing boy’s future reproductive health at risk, suggest findings from a study of some 2,300 Danish and Finnish women by Henrik Leffers, MD, PhD, of Rigshospitalet, Copenhagen, Denmark, and colleagues.

The researchers suggest that acetaminophen, ibuprofen, aspirin, and other NSAID painkillers act as hormonal “endocrine disruptors” and interfere with normal male sexual development. Chemicals in the environment, such as phthalates, act as endocrine disruptors and have in the past been blamed for harmful effects on human sexual development.

“A single [acetaminophen] tablet (500 milligrams) contains more endocrine disruptor potency than the combined exposure to the ten most prevalent of the currently known environmental endocrine disruptors during the whole pregnancy,” Leffers says in a news release.

Despite the strong language, the researchers note that their findings are based on a small number of boys whose testicles were late to descend — a risk factor for poor future semen quality. While they note that more study is needed, they stress the urgency of such studies.

“Although we should be cautious about any over-extrapolation or overstatement … the use of these compounds is, at present, the best suggestion for an exposure that can affect a large proportion of the human population,” Leffers says.

The Leffers study is based on questionnaires from the mothers of 834 Danish boys and 1,463 Finnish boys, and on interviews with the mothers of 491Danish boys (285 of whom also were among those who filled out the questionnaires). All of the boys were examined for signs of undescended testicles (congenital cryptorchidism).

In the end, the researchers identified only 42 boys with signs of undescended testicles. Over 64% of these boys were born to mothers who took painkillers during pregnancy.

Women who took more than one kind of mild painkiller were more than seven times more likely to have a boy with signs of undescended testicles.

It appeared that painkillers taken during the second trimester of pregnancy were particularly risky — increasing risk of congenital cryptorchidism by 2.3-fold.

Nevertheless, these risks are based on very small numbers of affected boys. The vast majority of boys born to women who reported painkiller use did not have any sign of undescended testicles.

Leffers and colleagues will continue to follow up on the boys through sexual maturity.

Leffers’ team also performed rat studies showing that acetaminophen and NSAID painkillers can affect sexual maturation.

The Leffers study appears in the advance online edition of the journal Human Reproduction.

10 quirky facts about kissing

By Laura Schaefer, author of Man with Farm Seeks Woman with Tractor: The Best and Worst Personal Ads of All Time.

Think you know a thing or two about kissing? You probably do. But the facts below are so off the beaten path, we’ll bet you don’t know them all — and they could come in handy. Not only could they provide some steamy “Did you know…?” small talk, but they’ll help you see all the benefits a satisfying liplock can bring into your life. Happy smooching!

1. Two out of every three couples turn their heads to the right when they kiss.

2. A simple peck uses two muscles; a passionate kiss, on the other hand, uses all 34 muscles in your face. Now that’s a rigorous workout!

3. Like fingerprints or snowflakes, no two lip impressions are alike.

4. Kissing is good for what ails you. Research shows that the act of smooching improves our skin, helps circulation, prevents tooth decay, and can even relieve headaches.

5. The average person spends 336 hours of his or her life kissing.

6. Ever wonder how an “X” came to represent a kiss? Starting in the Middle Ages, people who could not read used an X as a signature. They would kiss this mark as a sign of sincerity. Eventually, the X came to represent the kiss itself.

7. Talk about a rush! Kissing releases the same neurotransmitters in our brains as parachuting, bungee jumping, and running.

8. The average woman kisses 29 men before she gets married.

9. Men who kiss their partners before leaving for work average higher incomes than those who don’t.

10. The longest kiss in movie history was between Jane Wyman and Regis Tommey in the 1941 film, You’re in the Army Now. It lasted 3 minutes and 5 seconds. So if you’ve beaten that record, it’s time to celebrate!

All Pregnant Women Should Get Flu Shot, Say OB-Gyns

This from Frederik Joelving of Reuters Health

Despite landing in the hospital more often if they catch the flu, no more than a quarter of pregnant women in the U.S. get vaccinated against it.

That’s according to the American College of Obstetricians and Gynecologists, which has issued a recommendation urging all pregnant women to get the flu shot.

While the recommendation itself isn’t new, the statement, published in the journal Obstetrics and Gynecology, adds evidence on the safety and effectiveness of the vaccine, said Dr. William M. Callaghan of the Centers for Disease Control and Prevention in Atlanta.

He said the CDC and several medical associations back the statement, which notes that the shot not only protects the woman, but also her baby.

Flu vaccines aren’t approved by the Food and Drug Administration for infants younger than six months of age, but babies can get the protective antibodies naturally through breast milk if their mother got the vaccine.

While some flu vaccines contain the mercury-based preservative thimerosal, a study out last week found the compound did not increase the risk of autism, as some have worried. (See Reuters Health story of September 13)

The statement does not recommend against vaccines containing preservative, but notes that thimerosal-free alternatives are available.

It adds that there have been no reports of side effects in pregnant women or their babies, but that women should only get the inactivated vaccine.

Last week, the CDC asked healthcare providers to encourage pregnant women to get flu shots.

This could have a large impact on women’s decision-making, according to data from 2006 and 2007 surveys of pregnant women in Georgia and Rhode Island.

The findings, also published in Obstetrics and Gynecology, show less than one in five women in Georgia had been vaccinated against the seasonal flu. Many of those who hadn’t, said their doctors had never broached the topic.

By contrast, nearly a third of women in Rhode Island had been vaccinated, with encouragement from a healthcare provider increasing the chances more than 50 times.

In its letter to physicians, the CDC said pregnant women were more susceptible to severe illness caused by flu, and accounted for one in 20 deaths from H1N1 influenza (swine flu) in 2009. By comparison, only one in 100 was pregnant in the population.

“We know for certain that there are changes in the immune system that allow the pregnancy to continue,” Callaghan told Reuters Health. “Perhaps the downside is that they also allow the virus to persist.”

The U.S. flu season starts in October and lasts through May.

Source : Obstetrics & Gynecology Journal