InfoMedSearch Newsletters
Pregnancy

:: June 2009


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Highlighted Article

Problems for Babies of Obese Mothers Start in Womb “A pre-diabetic condition -- insulin resistance -- is more often present at birth in babies of obese mothers than in those of lean mothers, according to a new report. Insulin resistance means that glucose processing is impaired, so there's a risk of developing diabetes. While it's recognized that children of obese women may have metabolic irregularities when they become adolescents and adults, "our study supports the contention that this may have its onset during pregnancy," Dr. Patrick M. Catalano told Reuters Health.”

Clinical Guidelines

ACOG Issues Guidelines on Managing Obesity in Pregnancy (2009)

AHRQ - Perinatal Depression: Prevalence, Screening Accuracy, and Screening Outcomes (2005)

AHRQ - Screening for Lead Levels in Childhood and Pregnancy (2006)

Institute of Medicine Sets New Guidelines for Weight Gain During Pregnancy (2009)

New Guidelines Shed Light on Use of Psychiatric Medications During Pregnancy

NGC - Anemia in pregnancy. (2008)

NGC - Assessment of risk factors for preterm birth. (2001)

NGC - Caesarean section. (2004)

NGC - Chronic hypertension in pregnancy. (2001)

NGC - Clinical policy: critical issues in the initial evaluation and management of patients presenting to the emergency department in early pregnancy. (2003)

NGC - Diagnosis and classification. In: Diagnosis, evaluation and management of the hypertensive disorders of pregnancy. (2008)

NGC - Diagnosis and management of preeclampsia and eclampsia. (2002)

NGC - DoD/VA clinical practice guideline for management of uncomplicated pregnancy. (2003)

NGC - Gestational diabetes. (2005)

NGC - Hypertensive disorders of pregnancy: pre-eclampsia, eclampsia. (2005)

NGC - Interventions for postpartum depression. (2005)

NGC - Management of labor. (2007)

NGC - Prediction, prevention, and prognosis of preeclampsia. In: Diagnosis, evaluation and management of the hypertensive disorders of pregnancy. (2008)

NGC - Preterm birth prevention. (2004)

NGC - Pre-eclampsia community guideline. (2004)

NGC - Routine prenatal and postnatal care. (2006)

NGC - Routine prenatal care. (2007)

NGC - Screening for asymptomatic bacteriuria: recommendation statement. (2004)

NGC - Screening for gestational diabetes mellitus: U.S. Preventive Services Task Force recommendation statement. (2008)

NGC - Screening for Rh(D) incompatibility: recommendation statement. (2004)

NGC - Standards of medical care in diabetes. III. Detection and diagnosis of gestational diabetes mellitus (GDM). (2005)

NGC - Systemic diseases in pregnancy. (2006)

NGC - The management of severe pre-eclampsia/eclampsia. (2006)

NGC - The investigation and treatment of couples with recurrent miscarriage. (2003)

NGC - Treatment of the hypertensive disorders of pregnancy. In: Diagnosis, evaluation and management of the hypertensive disorders of pregnancy. (2008)

NGC - Trial of Labor After Cesarean (TOLAC) (2005)

NGC - Ultrasound scanning during pregnancy. (2004)

NGC - Vaginal birth after cesarean. (2004)

NGC - Vaginal birth after previous cesarean delivery. (2004)

NICE - Caesarean section (2004)

RNAO - Interventions for Postpartum Depression 2005

The pre-eclampsia community guideline (PRECOG): how to screen for and detect onset of pre-eclampsia in the community (2005)

Internet Sites

Related InfoMedSearch Topics

Related Topics - Highlighted Articles

Vitamins: B9 (Folic Acid)

Epidemiology of neural tube defects. (Am J Med Genet C Semin Med Genet. 2005) "The epidemiological investigation of the common open neural tube defects (NTDs), anencephaly, and spina bifida, has a long history. The most significant finding from these past studies of NTDs was the identification of the protective effect of maternal, periconceptional supplementation with folic acid."


Food: Fish

Methyl mercury exposure in Swedish women with high fish consumption. (Sci Total Environ. 2005) "We studied the exposure to methyl mercury (MeHg) in 127 Swedish women of childbearing age with high consumption of various types of fish, using total mercury (T-Hg) in hair and MeHg in blood as biomarkers. ? Hair mercury levels exceeded the levels corresponding to the EPA reference dose (RfD) of 0.1 microg MeHg/kg b.w. per day in 20% of the women. Thus, there seems to be no margin of safety for neurodevelopmental effects in fetus, for women with high fish consumption unless they decrease their intake of certain fish species."

 

Birth-Labor

Neonatal Outcomes May Be Better With Vaginal Birth After Cesarean Delivery “Neonates born after elective subsequent cesarean delivery have significantly higher rates of respiratory morbidity and neonatal intensive care unit (NICU) admission and longer length of hospital stay vs those with vaginal birth after cesarean (VBAC), according to the results of a retrospective cohort study reported in the June issue of Obstetrics & Gynecology.”

Top 10 Things No One Tells You About Labor & Delivery

 

Contaminants

 

Depression and Postpartum Depression

Screening at 2 Months Identifies Most Women With Postpartum Depression “Using a well-child visit to screen for postpartum depression 2 months after delivery will catch the majority of women likely to develop the condition within the first 6 postpartum months, new research suggests.”

 

General Information
Nutrition and Supplements

Carnitine status of pregnant women: effect of carnitine supplementation and correlation between iron status and plasma carnitine concentration. (Eur J Clin Nutr. 2009)

Vitamin supplements may lessen miscarriage risk “Taking vitamins before and during early pregnancy is associated with reduced risk for miscarriage, researchers have determined. However, it may be that the connection is related to generally healthy practices among vitamin takers. "These results need to be replicated before formal conclusions are drawn," emphasized Dr. Reem Hasan, at the University of North Carolina-Chapel Hill. Supplemental vitamin recommendations for women who are pregnant, or are planning to become pregnant, are aimed mainly at reducing the risk of birth defects, Hasan and colleagues note in the American Journal of Epidemiology. Their study provides evidence "that vitamins may reduce the risk of miscarriage as well," Hasan told Reuters Health.”

 

Pre-Eclampsia

Intake of vitamin C and E in pregnancy and risk of pre-eclampsia: prospective study among 57 346 women. (BJOG. 2009) “CONCLUSIONS: Low dietary intake of vitamin C was associated with a trend towards an increased incidence of either severe pre-eclampsia, eclampsia or HELLP. A small increase in the incidence of severe disease was also seen in the group of women with a high intake of vitamin E from supplements and dietary sources.”

 

Risks - Allergies, Asthma, and Rhinitis

Fish oil supplementation in pregnancy and lactation may decrease the risk of infant allergy. (Acta Paediatr. 2009)

Maternal vitamin D intake during pregnancy is inversely associated with asthma and allergic rhinitis in 5-year-old children. (Clin Exp Allergy. 2009) “CONCLUSION: Maternal vitamin D intake from foods during pregnancy may be negatively associated with risk of asthma and AR in childhood.”

 

Risks - General

Exposure To Phthalates May Be A Risk Factor For Low Birth Weight In Infants “A new study soon to be published in the Journal of Pediatrics examines the possibility that in utero phthalate exposure contributes to low birth weight in infants. Low birth weight is the leading cause of death in children under 5 years of age and increases the risk of cardiovascular and metabolic disease in adulthood.”

Fetal exposure to phthalates - a pilot study. (Int J Hyg Environ Health. 2009) “Our results suggest that several phthalates or their metabolites, respectively, reach the human fetus, which might be able to affect fetal health.”

Flu During Pregnancy May Increase Risk Of Schizophrenia In Certain Offspring ““The good news is that most fetuses exposed to influenza virus while in the womb will not go on to develop schizophrenia. The bad news is that the prior association between influenza infection and later development of psychotic disorders was supported,” comments John Krystal, M.D., the editor of Biological Psychiatry. This finding has the potential to influence efforts to develop prevention, early intervention and treatment strategies, such as taking steps to maintain careful hygiene and, if clinically appropriate, administration of the influenza vaccination to reduce infection among women prior to pregnancy. Dr. Krystal notes, “It also raises an important unanswered question: How does influenza virus affect the vulnerable developing brain and how can we prevent or reverse the consequence of fetal influenza infection in vulnerable individuals before they develop schizophrenia?” “

Frequent Snoring in Pregnancy Could Signal Blood Sugar Trouble “"Snoring may be a sign of poor air flow and diminished oxygenation during sleep that can cause a cascade of events in your body," Facco explained. "This may activate your sympathetic nervous system, so your blood pressure rises at night. This can also provoke inflammatory and metabolic changes, increasing the risk of diabetes or poor sugar tolerance." The study also found that pregnancy increases the likelihood that a woman will snore. Early in pregnancy, frequent snoring was reported by only 11 percent of the women in the study, but by the third trimester, 16.5 percent snored frequently. Although the cause for the link between snoring and gestational diabetes in not well understood, Facco suggested that it could be due to weight gain and fluid retention, which could cause increased airway resistance. In gestational diabetes, pregnant women who had not previously been diagnosed with diabetes develop high blood sugar levels. It is estimated to occur in about 4 percent of pregnant women, and those who develop it are at higher risk for type 2 diabetes later in life, according to background information in the news release.”

High prevalence of vitamin D deficiency among pregnant women and their newborns in an Iranian population. (J Womens Health (Larchmt). 2009)

Women's First-trimester Working Conditions Impact Infant Birthweight

 

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