FDA to release guidance on medication use during pregnancy
Posted by on May 10, 2015 - 9:55am

This June, the Food and Drug Administration (FDA) will release a revision to prescription guidelines--the first since 1979.   These new guidelines will provide  up-to-date and specific information to doctors about the risks and benefits of medication that pregnant women may need to control other conditions.   The rule of thumb over the years has just been to tough it out and not take any medicines that may (or may not) hurt the mother or the fetus. Research in this area is limited because pregnant women are excluded from most drug trials.  Dr. Katherine Wisner, WHRI Leadership Council Member and expert on mood disorders at Northwestern U, "Pregnant women get sick and sex women get pregnant.   But somehow we have created this myth of the medication-free pregnancy."   We've all heard stories about pregnant women who have serious depression and stop their meds---harming themselves or their baby because their condition is out of control. 

The old system used a scoring system of A, B, C, D, and X with ' X" being the most dangerous.  The new system will have three components:

  • Information on dosing and risks to the fetus
  • Known risks about the drug's impact on breast feeding (e.g. will it concentrate in the milk)
  • Drug's impact on fertility.

According to the CDC, about 90% of pregnant women are on at least one prescribed or OTC medication.  Providing doctors more labeling information with help them determine safe options for treatment and help women have a healthier pregnancy.. 

Read more in the Chicago Tribune.

Smoking Mom may affect Daughter's Reproductive Health
Posted by on March 25, 2015 - 4:15pm

Daughters of mothers who smoked during pregnancy enter puberty at a younger age.  As a result, these offspring start their periods earlier---a risk factor for uterine, endometrials and breast cancers later in life.  Study researchers from Australia say that maternal smoking could create health problems in daughters even before they are born.

Health risks children often have when a mother smokes during pregancy include low birth rate, asthma, type 2 diabetes and obesity.   This new study suggests that there are many more possible adverse effects that are just beginning to be  discovered and may evolve over a lifetime in the exposed fetus.  According to study author, Alison Behie, there are several factors that influence when a girl has her first period:  puberty age of mother, body weight of the girl at ages 8-9, and based on this study, mother's smoking habit.

This study only followed girls till ages 12-13 and the next study will look at girls 14-15 years.  This data will need to be teased out for confounding factors and other influences but it does suggest that mothers who smoke while pregnant may want to consider stopping the habit-at least while pregnant.

 

 

Medicine, Pregnancy and Breastfeeding
Posted by on December 6, 2014 - 9:33am

Some women need to take medicines during pregnancy for health problems like diabetes, depression, morning sickness or seizures. Always talk with your doctor, nurse, or pharmacist before taking any medicines, vitamins or herbs. Don't stop taking your prescription medicines unless your health care provider says that it is OK.

Lots of women need to take medicines while they are pregnant. Learn how you can sign-up for a pregnancy registry to share your experience with medicines.

Use these resources to help you talk with your health care provider about the medicines you take during your pregnancy.

Alaskan campaign places pregnancy tests in bar bathrooms
Posted by on June 17, 2014 - 8:41am
As the state with the highest rates of fetal alcohol syndrome (FAS) in the U.S., Alaska is introducing a new campaign aimed at preventing pregnant women from drinking, the Anchorage Daily News reported. Starting in December, pregnancy tests will be placed in the bathrooms of 20 bars and restaurants across the state.

The state-funded program initiated by researchers from the University of Alaska will study whether posters warning women of the dangers of drinking while pregnant are more effective when posted on pregnancy test dispensers, as opposed to simply being hung on the wall. Posters accompanying the pregnancy test will encourage women to participate in a phone or online survey about the project, in exchange for prizes. In addition to interviews with bar patrons and staff, the surveys will provide researchers with knowledge as to whether the project was effective.

Linked with brain damage and growth problems in children, fetal alcohol syndrome can occur in an unborn child within just one month of conception, the Anchorage Daily News reported. Because Alaskan women of child-bearing age are 20 percent more likely to engage in binge drinking than in other states nationwide, researchers hope the campaign will help women discover unexpected pregnancies early.

"This is not a strategy for the chronic alcoholic who is drinking regardless of whatever message they see," Jody Allen Crowe, who started a similar initiative in Minnesota and is contributing to the project in Alaska, told the Anchorage Daily News. "This is really focused on the 50 percent of unexpected pregnancies, to find out they are pregnant as early as possible."

Though researchers have said they will also supply condoms in every bathroom where pregnancy tests are distributed, the condoms will not be paid for by a state grant.

Wonder what Sarah Palin thinks!!

Click for more from Anchorage Daily News.

Depression During Pregnancy
Posted by on April 22, 2014 - 9:53am

Depression, especially in pregnancy, is a sensitive subject.  It impacts the woman, her child and her family and it affects between 14 and 23% women during pregnancy.  Because of hormonal changes during pregnancy, a woman may not realize she is suffering from depression.  A new, comprehensive guide about this condition that discusses symptoms and treatment to help  women and their family members understand and cope with this issue is now available from the a site called PsychGuides.   For a helpful resource visit   Living with Depression during Pregnancy

Also, if you live in the Chicago area, the Asher Center for the Study and Treatment of Depression and Mood Disorders  has just opened at Northwestern Medicine that provides expertise in hormone-related depression.

Acupuncture and Women's Health
Posted by on March 18, 2014 - 2:56pm

Acupuncture has been used in Eastern countries to address women's health issues but is not readily adopted in the U.S. especially by the medical establishment.   A new study reports preliminary data indicating that acupuncture may improve menstrual health and overcome delays in becoming pregnant. There are experimental data indicating that acupuncture can influence female reproductive functioning, although the actual mechanisms involved are not yet clarified. Acupuncture is a complex intervention yet the evaluation of acupuncture research designs and outcome measures expect a level of commensurability difficult to achieve in complex interventions. A focus on effectiveness rather than efficacy may be a solution. Further research  is needed that includes the rich traditions of acupuncture practice and the rigorous methods of evidence-based research.

Source:   International Journal of Women's Health 17 March 2014.

Addressing Misconceptions about Fertility and Conception
Posted by on February 13, 2014 - 3:59pm

A recent report in Fertility & Sterility has indicated that among women between the ages of 18 and 40, there is a significant amount of misconception regarding fertility and becoming pregnant. Dr. Illuzzi, an OB/GYN at Yale University School of Medicine, led a study in which 1,000 women of various ages and backgrounds completed a survey about their knowledge of reproductive health. The results showed a lack of knowledge across the board, with higher educated women knowing only slightly more than less educated women.

Over one-third of the women surveyed believed that specific positions during intercourse, such as elevating the pelvis, increase the odds of conception, although there is no scientific evidence to back this up. Additionally, only 10 percent of women know when the best time of the month to conceive is. The majority of women thought that sex must take place after ovulation to become pregnant, while in reality, pregnancy is most optimal when intercourse occurs 1 to 2 days prior to ovulation.

Other notable findings in the study include women’s thoughts on what can decrease fertility and prevent conception. Around 25% of surveyed women were unaware that factors such as obesity, smoking, and a history of sexually transmitted disease can cause infertility. In fact, the number one factor women cited as causing infertility was stress. Stress can have many negative side-effects, but according to Dr. Illuzzi, research does not currently support that it leads to infertility. While most of the women surveyed were aware that conception becomes more difficult with age, many did not know that later pregnancies are also more likely to result in miscarriage and chromosomal defects.

If you are concerned about fertility, or have questions about becoming pregnant, it is best to talk to your doctor, but you can get more information on websites such as the American College of Obstetricians and Gynecologists.

Source: Doucleff, Michaeleen. “You’d Think We’d Have Baby-Making All Figured Out, But No.” NPR. 27 January 2014.

Swedish Surgeons Take Innovative Transplant Approach to Childbirth
Posted by on January 15, 2014 - 4:21pm

Swedish doctors are attempting an innovative surgery to give womb-less women the opportunity to give birth to their own children. Nine women in Sweden have received womb transplants and doctors intend to help these women (through in-vitro fertilization) become pregnant and carry their own children. Each of the nine patients was either born without a uterus or had it removed due to cervical cancer. This is the fist major experiment to test the possibility of live, biological births in womb transplant patients.

Many European countries prohibit using a surrogate to carry a pregnancy, which leaves women without wombs fewer fertility options. Womb transplants that can lead to successful pregnancies and births have been attempted before—in Turkey, Saudi Arabia, Britain, and Hungary—but have been unsuccessful. Lead researcher, Dr. Mats Brannstrom said, “This is a new kind of surgery; we have no textbook to look at.” Press over these transplants has given hope to former cervical cancer patients (who lost a uterus to cancer) as well as to the one in every 4,500 women born without a womb.

The largest unknown for the scientists is how the pregnancies will proceed. The babies will need ample nourishment from the placenta and blood flow needs to be optimal—which are difficult variables to control for with womb transplants. Brannstrom and his colleagues intend to begin the in-vitro process in the next couple of months—testing their transplant success in their human subjects after finding victory in their mouse, sheep, and baboon subjects. If successful, this will be a major contribution to science, offering an alternative for women who have few childbirth choices.

Source: Associated Press

Hypertension during Pregnancy May Mean Hot Flashes later
Posted by on December 30, 2013 - 1:11am

New research shows that women with high blood pressure during pregnancy may be at higher risk of having troublesome menopausal symptoms in the future. A research study from the Netherlands examined the relationship between hypertensive diseases and hot flashes and night sweats.

Investigators looked at 853 women who regularly visited a cardiology clinic. Among these women, 274 had a history of high blood pressure during their pregnancy, such as preeclampsia. Participants were classified as having hypertension (high blood pressure) if her systolic blood pressure was 140 mmHg or higher, if her diastolic was 90 mmHg or higher, or if she took antihypertensive medication.

The study revealed that women with a history of hypertensive pregnancy disease were more likely to have vasomotor symptoms of hot flashes and night sweats during menopause. Hot flashes and night sweats are considered vasomotor because of sudden opening and closing of blood vessels near the skin. 82% women with history of hypertension during pregnancy had hot flashes and night sweats, compared to 75% women without. Moreover, women with hypertension during pregnancy reported experiencing hot flashes and night sweats for a longer time period.

Researchers concluded that the findings were modest but more research needs to be done to establish a definite association. One must also consider that every woman experiences menopause differently; you  might have symptoms that are barely noticeable, while your friends could experience almost all of them. To learn more about the different types of symptoms during menopause, visit the Women's Health Research Institute's menopause website here.

 

 

 

Crohn's disease and pregnancy
Posted by on October 24, 2013 - 9:13am

The obstetrical and gynecological manifestation of Crohn's disease is particularly challenging for young women and demands special attention, according to an article in the International Journal of Women's Health. Pregnant women with CD are considered high-risk patients due to associated complications. Some of the prevalent complications are premature birth, low birth weight, and congenital anomalies. To minimize the risk for adverse pregnancy/birth outcomes, it is recommended that remission of CD symptoms be achieved before conception. Treatment of CD in pregnant women is similar to that among the nonpregnant population, and there is no valid reason to terminate it, since most of the drugs are proven to be safe. Women with CD who wish to conceive or are already pregnant need to be properly advised according to the newest guidelines on the subject, given by the European Crohn’s and Colitis Organization. Gynecological manifestations are another special feature of CD. They are important in that they may facilitate early recognition of the underlying disease, which usually stays unrecognized for years before intestinal manifestation; in this way, the underlying manifestations are often mistreated.

Source: Int. J of Women's Health October 2013 Volume 2013:5 Pages 681 - 688

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