Posts tagged ‘pregnancy’
The length of pregnancy can vary naturally by as much as five weeks, research suggests.
The study of 125 women is the first to calculate gestation by pinpointing the exact time of conception.
It found age, time to implantation and their own weight as babies were also linked to pregnancy length.
An expert said the findings, in the journal Human Reproduction, challenged whether a “due date” for women was helpful.
Due dates can be calculated from working out 280 days after the start of the woman’s last menstrual period, or more accurately by ultrasound.
Yet only 4% of women deliver when predicted and only 70% within 10 days of their estimated due date.
The research team at the US National Institute of Environmental Health Sciences measured hormone concentrations in daily urine samples taken from women trying to conceive naturally to determine exactly when ovulation and implantation of the fertilised egg had occurred.
They found that the average length from ovulation to birth was 268 days, just over 38 weeks.
Once they had excluded six premature births, they found that gestation varied naturally by as much as 37 days.
Dr Anne Marie Jukic said: “We were a bit surprised by this finding. We know that length of gestation varies among women, but some part of that variation has always been attributed to errors in the assignment of gestational age.
This is a very interesting piece of work and knowing when is the right time to deliver is a huge issue”
Dr Virginia BeckettRoyal College of Obstetricians and Gynaecologists
“Our measure of length of gestation does not include these sources of error, and yet there is still five weeks of variability. It’s fascinating.”
The study also showed that embryos that took longer to implant also took longer from implantation to delivery.
Older women were more likely to have longer pregnancies and there was also a link between gestation and a mother’s weight when she was born.
The researchers also found that length of previous or subsequent pregnancies was related to the length of the one being studied, suggesting a consistency about when women deliver.
But they said it was too early to make any clinical recommendations.
“I think the best that can be said is that natural variability may be greater than we have previously thought and, if that is true, clinicians may want to keep that in mind when trying to decide whether to intervene on a pregnancy,” said Dr Jukic.
Dr Virginia Beckett, spokesperson for the Royal College of Obstetricians and Gynaecologists, said very little was known about the exact mechanisms that determine when labour begins.
“This is a very interesting piece of work and knowing when is the right time to deliver is a huge issue.”
She added it supports the suggestion that giving someone a “due date” may not be a great idea and can make women feel anxious when they go over.
“It would be better to say, ‘You will be delivered by this time’ to take the pressure off.”
Women in low-income countries are particularly at risk from iron deficiency during pregnancy
Taking daily iron supplements during pregnancy can cut the risk of anaemia and the chance of having a small baby, says research from Harvard University.
Studies of two million women found that taking even a tiny amount of iron cut the risk of anaemia by 12% and low birth weight by 3%.
Pregnant women in the UK are not given iron supplements unless their iron levels are found to be low.
Serious iron deficiency tends to affect women in poorer countries.
The British Medical Journal study analysed the results of more than 90 randomised trials and studies involving pregnant women in countries including China and Tanzania.
For every additional 10mg of iron taken each day, up to a maximum of 66mg per day, the risks of anaemia and low birth weight decreased, the study said.
“There is a need here in the UK to focus on ensuring better pre-conception health”
Royal College of Midwives
Birth weight was found to increase by 15g with each 10mg of iron taken.
But researchers found no reduction in the risk of premature birth as a result of iron use.
Previous studies have suggested there could be a higher risk of low birth weight and premature birth in pregnant women with anaemia.
The study says iron deficiency is the most common cause of anaemia during pregnancy, especially in low and middle income countries, affecting about 32 million pregnant women in 2011.
The study authors are calling for improved antenatal care in countries where iron deficiency is common and say future research should look at “feasible strategies of iron delivery”.
The World Health Organization currently recommends a dose of 60mg per day for pregnant women.
Dr Batool Haider, study author from the department of epidemiology and nutrition at Harvard University’s school of public health, said even high-income countries could take something from the research.
Iron in pregnancy
In the UK, iron supplements are not routinely offered to all pregnant women.
NICE, the body which provides guidance on health matters, says that iron supplements “may have unpleasant maternal side effects”.
These can include constipation, indigestion and bloating.
Iron levels are checked at various points during pregnancy by a GP or midwife.
If found to be low, dietary advice or an iron supplement may be recommended, such as ferrous sulphate.
Lean meat, green leafy vegetables, dried fruit, nuts and many breakfast cereals contain iron.
“The recently estimated prevalence of iron deficiency anaemia during pregnancy in Europe was estimated to be 16.2% in 2011,” she said.
NICE guidelines, however, say that iron supplements should not be offered routinely to all pregnant women in the UK.
Janet Fyle, professional policy adviser at the Royal College of Midwives, said ensuring pregnant women had the right level of iron was important.
“Women’s iron levels are checked at specific times during pregnancy. Appropriate action is taken if required, such as dietary advice or an iron supplement may be recommended.
“There is perhaps a need here in the UK for us to focus on ensuring better pre-conception health, so that women contemplating pregnancy can adjust their diet to include appropriate nutrients before becoming pregnant.”
She added: “The problem of serious iron deficiency tends to affect low income countries, where some women may already have poor health status before pregnancy and have the added burden of not being able to afford iron supplements.”
Dr Roger Marwood, consultant obstetrician and spokesman for the Royal College of Obstetricians and Gynaecologists, said the effects of iron on pregnant women in low and high income countries in the study were hard to ignore.
“This large study shows all the signs of there being a real effect – and it shows that even low doses can have a significant effect.”
He said women who are intolerant to iron can suffer from indigestion, bloating and other stomach problems.
But reducing the dose should also reduce the side effects.
PUTRAJAYA: Malaysia has been chosen as the pilot country for a pre-pregnancy diabetes prevention research project involving young married couples.
Known as “Jom Mama”, it sees a private-public partnership between the Health Ministry and Danish company, Novo Nordisk Pharma (Malaysia) Sdn Bhd.
It is also the first project worldwide under Novo Nordisk’s “Changing Future Health” initiative to prevent diabetes and other non-communicable diseases (NCD).
Health Ministry secretary-general Datuk Farida Mohd Ali said yesterday the collaboration marked a milestone between Malaysia and Denmark in terms of healthcare.
She said the research project was aimed at raising health literacy among young couples on the dangers of NCD, mainly obesity and diabetes, which was on the rise in the country and the preventive measures that could be taken.
“The ministry is hoping to gain real results and insights from this project, which will help the government in reducing the critical level of NCD.”
A memorandum of understanding was signed between Novo Nordisk and the Health Ministry, witnessed by Crown Princess Mary of Denmark.
Pregnant women who consume one or two drinks a week may not cause any harm to their fetuses.
Research showed that children born to light drinkers had similar cognitive test scores and levels of behavioral difficulties as children born to mothers who stopped drinking during pregnancy.
“There appears to be no increased risk of negative impacts of light drinking in pregnancy on behavioral or cognitive development in 7-year-old children,” co-author Yvonne Kelly, co-director of the ESRC International Centre for Lifecourse Studies (ICLS) at University College London, said in a press release.
The Centers for Disease Control and Prevention state that drinking alcohol during pregnancy can lead to birth defects and disabilities in children called fetal alcohol spectrum disorders (FASD). They are some of the most preventable birth defects and developmental disabilities. The CDC also points out that there is no amount of alcohol that is safe to drink while pregnant, and all drinks with alcohol can hurt a fetus.
Currently about one out of 13 pregnant women admits to using alcohol, according to the CDC.
- 1 in 13 pregnant women drink alcohol, CDC says
- CDC: 1 in 8 U.S. women binge drink 3 times a month
- 1 in 7 new moms may suffer from postpartum depression
- Moderate drinking during pregnancy may not affect child’s neurodevelopment
The study authors point out, however, that while high levels of drinking have been linked to birth defects, not many studies have been done on lighter drinkers. To determine whether low levels of alcohol consumption had an effect, researchers looked at information from 10,534 7-year-olds who were enrolled in the Millennium Cohort Study, a U.K. study of infants born between 2000 and 2002. They visited the subjects at home, as well as interviewed the subjects’ parents and teachers and gave them questionnaires to fill out about the child’s social and emotional behavior.
The study group was just split up into children whose mothers who never drank (12.7 percent), children whose mothers who drank but not during pregnancy (57.1 percent), children whose mothers were light drinkers during pregnancy (23.1 percent) and children whose mothers drank more when they were pregnant (7.2 percent). The researchers focused on light drinkers and mothers who did not drink during pregnancy.
Children who were born to light drinkers — meaning up to two drinks a week — had higher but not significantly different cognitive scores compared to kids whose mothers who stopped drinking while pregnant. In fact, boys were shown to have slightly higher reading and special skills if they were born to mothers who had low levels of drinking.
As for behavioral problems, there was also no statistically significant differences between the groups, though boys were shown to have fewer behavioral problems.
“We need to understand more about how children’s environments influence their behavioral and intellectual development. While we have followed these children for the first seven years of their lives, further research is needed to detect whether any adverse effects of low levels of alcohol consumption in pregnancy emerge later in childhood,” Kelly said.
Linda Geddes, author of the pregnancy book “Bumpology,” told the BBC that the new research could help women decide if they want to drink while pregnant.
“A lot of women are conflicted — they know their mothers had a little to drink while pregnant with them, and they see friends and relatives drinking — they may think the occasional drink is OK, but they also know the absolute safest thing to do is not to drink at all as the evidence is limited and they want to do the best by their babies,” she said. “So this research is very reassuring for pregnant women – it is probably OK to have a glass or two.”
Dr. Keith Eddleman, director of obstetrics at the Mount Sinai Medical Center in New York City, said to HealthDay that the new information makes sense with what other research has shown.
“Doctors have also known that an occasional drink during pregnancy is probably not a problem for your baby, especially if it is after the first trimester,” he said. “This is based on the observation that the incidence of Fetal Alcohol Syndrome in countries where light alcohol consumption with dinner is commonplace and is no different from the incidence of the same disorder in countries where any alcohol consumption during pregnancy is considered taboo.”
But he warned that doctors are still unsure how much alcohol is safe for the fetus.
“The problem is that no one knows the exact amount of alcohol consumption that is safe, so many doctors in this country choose a conservative approach and tell their patients not to drink any alcohol,” he said.
Depression can happen during pregnancy too
More than a third of women who become depressed during their pregnancy have suicidal thoughts, suggests a snapshot survey carried out by the Royal College of Midwives and Netmums.
The poll of 260 mothers with antenatal depression found they were at greater risk of worsening mental health problems then women with postnatal depression.
Only 22% sought help from their GP.
Experts say women with the condition need more support.
The Department of Health has announced that £25m will be made available to improve maternity facilities for mothers and babies, and an NHS information service for parents is to include videos on how to spot signs of postnatal depression.
If we can identify women as early as possible then we could prevent them declining into much more serious mental health problems”
Cathy Warwick Royal College of Midwives
Antenatal depression, which occurs during pregnancy, is less known and talked about than postnatal depression, which happens after the birth of a baby.
This small survey suggests that those who suffer from depression during pregnancy are at greater risk of worsening mental health problems than those who have postnatal depression alone.
According to the survey, 80% of women with depression in pregnancy also went on to have postnatal depression.
About 56% of those surveyed had problems during their first pregnancy but almost 66% said they had problems during their second.
Just over half of the women said their illness had affected their relationship with their baby and 38% said they had problems bonding with their baby.
Only 30% were warned about antenatal depression by midwives and most of the women said it took a few months before they realised that they had a problem.
Just 22% sought medical help from their GP at that point – perhaps because only one in three women were aware of the possibility of becoming depressed during pregnancy.
Just 27% reported being asked how they felt emotionally during their pregnancy.
Hayley was 12 weeks pregnant when she started feeling awful.
“I had bad sickness and I just thought I was really tired, but it was getting worse,” she says.
“I was constantly crying. I didn’t want to talk about being pregnant and I kept imaging things were wrong with the baby.”
Everyone kept telling Hayley she was lucky to be pregnant, particularly since she had been told she would never conceive.
She went to GP for help but was given no support.
“Everyone is so aware of postnatal depression. They give you advice on the warning signs after you’ve had baby.”
Instead, she was crippled with fear and anxiety during her pregnancy and couldn’t get excited about the arrival of her first child.
“I went from being happy to living under black cloud.”
When Toby was born, everything changed and Hayley was on a real high.
During her second pregnancy, Hayley did not suffer antenatal depression, but she was diagnosed with delayed postnatal depression when her son Zac was two.
“I hit the black cloud again – but this time help was there immediately.”
Cathy Warwick, chief executive of the Royal College of Midwives, said the survey showed an urgent need to identify and help women with antenatal and postnatal depression.
“If we can identify women as early as possible then we could prevent them declining into much more serious mental health problems.”
Sally Russell, co-founder of Netmums, said depression and anxiety could make life very difficult for parents with a new baby.
“Midwives can do a lot to help and reassure, so they should be open with mothers and fathers-to-be about the condition and trained to spot the signs.
“Those suffering often don’t know who to talk to, so it’s essential they know they can be open and honest about how they are feeling with midwives.”
Health Minister Dr Dan Poulter, who announced the £25m fund to improve maternity services, said hospitals would be able to bid for en suite facilities, rooms where fathers can stay overnight or facilities like birthing pools.
“A new arrival in the family is a joyous time but can present challenges for mums and families, particularly new families. I want to help women and their partners as much as possible,” he said.
The NHS Information Service for Parents is available to every new parent to sign up to if their chid is under six months old. From next year it will support parents with babies and young children up to 18 months old.
Dr Poulter added: “Women with postnatal depression need care and support, not stigma. That’s why early diagnosis for this traumatic condition and support for parents is so important.”
In May, the government also pledged to recruit an extra 4,200 health visitors and give them training to diagnose postnatal depression.