Posted by on October 22, 2013 - 10:07am

We all know that having children is expensive, but did you know that having your child in the United States can cost up to triple or quadruple the price as other developed countries? Pregnancy care and delivery costs have nearly tripled in the United States since 1996 and now range anywhere from $4,000 to $45,000. Gerard Anderson, an economist at the Johns Hopkins School of Public Health who specializes in international health costs said, “It’s not primarily that we get a different bundle of services when we have a baby, it’s that we pay individually for each service and pay more for the services we receive.” Paying “more” is an understatement. In the United States, the cumulative cost of nearly four million annual births exceeds $50 billion dollars.

These astronomical prices hit families hard, especially when maternity is not covered by many private insurance plans. Data from 2011 conclude that 62% of women covered by private insurance plans in the United States lacked maternity coverage. Even when women do have maternity coverage on their plans, they are slammed by higher copayments and deductibles. From 2004 to 2010, the prices that insurers paid for childbirth rose 49% for vaginal births and 41% for Caesarean sections in the United States. It’s hard to imagine that merely 20 years ago insured mothers typically paid nothing more than a nominal fee if they opted for a private hospital room or a television.

While childbirth costs have skyrocketed in the United States, other developed countries continue to keep comprehensive maternity care cheap or even free. Why is there such a large discrepancy? The reason is that the United States bills item by item instead of charging a flat fee for the care of an expectant mother, like in other countries. Some hospitals are starting to catch on and offer all-inclusive rates for pregnancy, but this is difficult to standardize across the United States, as birthing costs differ by geographic location. Luckily, the Affordable Care Act will mandate maternity coverage so that no expectant mother should be left paying entirely on her own, but the law is not clear about what aids are included in this coverage. Expectant parents should be excited about expanding their families, not worried about their latest $900 bill for an ultrasound. However, being aware of these financial burdens will help families make wiser choices about their healthcare to protect their loved ones.

Source: The New York Times

Posted by on October 16, 2013 - 10:06am

When a woman goes through menopause before age 40, it’s considered early menopause. When this occurs naturally, due to genetics or chromosome defects, it is known as primary ovarian insufficiency and happens to about 1 in 100 women. Early menopause may also result from medical treatments, like chemotherapy or radiation. Researchers from the United States and Japan have recently reported on a new technique in which the ovaries of women who went through early menopause were successfully “reawakened.”

This study included 27 women around age 30 who were infertile with primary ovarian insufficiency. Prior to menopause, eggs in the ovaries begin as follicles and remain that way until some of them mature each month. After menopause, some follicles may remain, but in a dormant state. The researchers’ goal was to activate the remaining follicles in the ovaries of women with primary ovarian insufficiency. To “awaken” the follicles, researchers followed several steps. First, they removed the ovaries and cut them into pieces. Next, they introduced a chemical to spur egg development and replaced the ovary fragments at the top of the fallopian tubes. Finally, the women in the study underwent hormone therapy.

In 8 of the 27 women, the sleeping follicles began to develop and form eggs. At this point, the researchers took eggs for in vitro fertilization (IVF). Following this treatment, one woman successfully had a baby, and another is pregnant.

While this study did not yield high success rates, it is gathering significant traction in the medical world. With additional study and refinement, success rates may increase or lead researchers towards other techniques that will offer hope for women who experience early menopause and want a child.

Source: Gallagher, James. "Early Menopause: Baby born after ovaries 'reawakened.'" BBC News. 30 September 2013.

Written by guest blogger Sarah Henning.  To learn more about menopause visit:  www.menopausenu.org

 

 

Posted by on August 2, 2013 - 2:36pm

Recent data from the Treatment Episode Data Set reveal that 4.8% of female substance abuse admissions (between the ages of 15 to 44) are pregnant at the time of entry. While this percentage has remained fairly stable since 2000, the percentage of these pregnant women reporting drug abuse has increased to 63.8%, an increase of almost 13% since 2000. Non-pregnant female admissions in the same age range reveal a similar pattern for drug use, while percentages for both groups reporting alcohol abuse has decreased. The report published by the Substance Abuse and Mental Health Services Administration (SAMHSA) writes that these trends “may highlight the need to focus greater attention on addressing drug abuse among this population.”

Any substance abuse by pregnant women can result in miscarriage or premature birth, as well as a plethora of other health-related and developmental problems for the baby and mother both. In light of these recent trends, it is clear more educational outreaches must be available to prevent this statistic from climbing any higher. SAMHSA Administrator Pamela S. Hyde calls for increased access to “prevention, support, and recovery services” that meet the specialized need of pregnant and postpartum women. SAMHSA’s already active Residential Treatment Program for Pregnant and Postpartum Women is a step in the right direction. This program encompasses comprehensive residential treatment and educates women on prevention, treatment, and recovery. Furthermore, the family-centered approach they take strengthens relationships beyond the substance users to encompass all affected victims. More programs modeled after the SAMHA platform would improve the education and prevention of life-threatening abuses to women across the globe.

Please click here to review the full report.

Posted by on June 18, 2013 - 10:39am

 

Policy changes are necessary to decrease the death rate of pregnant women in developing countries.  Research, according to Dr. Stacie E. Geller, does not end once scientists publish.  The true battle is implementing that research to affect global change.  Dr. Stacie E. Geller, Director of the Center for Research on Women and Gender at the University of Illinois at Chicago College of Medicine, puts research into practice by providing safe, affordable medication to pregnant women in developing countries.  Dr. Geller spoke last week at a forum held at Northwestern University's Feinberg School of Medicine and presented her research on Postpartum Hemorrhaging (PPH) and its dangers to women in developing countries.

In 2008, there were an estimated 358,000 maternal deaths occurring during childbirth, 99% of these deaths occurring in developing countries. Such global disparities are reflected in the limited access to skilled birth attendants, restricted access to medications, rudimentary delivery facilities, and complications surrounding reliable transportation and communication in developing countries.  Postpartum Hemorrhaging (PPH) is the leading cause of maternal mortality worldwide, accounting for 30-50% of all maternal deaths in Africa and Asia alone.  While the drug Oxytocin is used to prevent PPH in developed countries, developing countries do not have the resources to preserve and administer this drug.  Dr. Geller began studying the drug Misoprostol as an alternative to Oxytocin to be used in developing countries due to its low-maintenance storage and cost-effectiveness.

Dr. Geller, along with a team of researchers traveled to communities in India and Ghana to study Misoprostol for prevention of PPH in home-birth settings.  Their research proved that Misoprostol provides a safe and efficacious alternative to Oxytocin in these communities, but Dr. Geller didn’t stop there.  She worked with the Indian Ministry of Health to approve the use of Misoprostol for PPH prevention by Auxillary Nurse Midwives (ANMs). In Ghana, Dr. Geller engaged with health stakeholders at all levels, conducted community sensitization and trainings, monitored the safe use of Misoprostol, and empowered women to take control of their health.  Furthermore Dr. Gellar’s success strengthened the networks of health providers, decreased maternal mortality and morbidity (due to PPH), and established a model for all of Ghana and other developing countries.  Dr. Geller was a primary advocate credited for Misoprostol’s addition to the WHO’s list of essential medications for the prevention of PPH in 2011, an accreditation which has a lasting global impact.

Dr. Geller stresses the importance of political will in enacting policy changes from scientific research.  Government engagement is critical in reducing maternal deaths, and a scientist’s work is not over once research is published.  Advocating for women’s sexual and reproductive rights, their access to equal treatment, and their right to effective medicine should inspire all researchers to utilize their knowledge to facilitate global change.

To read more about Dr. Stacie Geller and her ongoing research, please click here.

 

Posted by on May 8, 2013 - 12:08pm

Women who take valproate (Depacon) during pregnancy may increase the risk of childhood autism and its spectrum disorders in their children, a population-based study showed.

In utero exposure to the drug was associated with a five-fold elevated risk of autism and three-fold elevated risk for autism spectrum disorder, Jakob Christensen, PhD, of Denmark's Aarhus University Hospital, and colleagues found.

The absolute risks were 2.5% and 4.4%, respectively, and remained significantly elevated after adjustment for parents' epilepsy and psychiatric disease, the group reported in the April 24 issue of the Journal of the American Medical Association.

"For women of childbearing potential who use anti-epileptic medications, these findings must be balanced against the treatment benefits for women who require valproate for epilepsy control," they concluded.  But "because autism spectrum disorders are serious conditions with lifelong implications for affected children and their families, even a moderate increase in risk may have major health importance," they added.

The American Academy of Neurology recommends avoiding valproate in pregnancy whenever possible due to cognitive and physical birth defect problems for children exposed in utero.

The additional risk of autism and spectrum disorders needs to be included in counseling for women now too, Kimford Meador, MD, and David Loring, PhD, both of Emory University in Atlanta, recommended in an accompanying editorial.

"Because approximately half of the pregnancies in the U.S. are unplanned, delaying discussions of treatment risks until a pregnancy is considered will leave a substantial number of children at unnecessary risk," they warned. "Women of childbearing potential should be informed of the potential risks of fetal valproate exposure before valproate is prescribed."

The drug has an indication for manic and mixed episodes in bipolar disorder and for migraine prevention in addition to seizure control.

Primary source: Journal of the American Medical Association

 

Posted by on March 25, 2013 - 1:25pm

Do you follow your doctor’s orders?  According to a new study, many new moms may be feeding their babies solid foods too soon – and sometimes they’re just following their doctors’ advice.  According to the American Academy of Pediatrics, babies should not begin consuming solids until they are at least six months old.  But a newly released study in Pediatrics found that almost all of the new mothers surveyed (almost 93%) introduced solid food before six months, and half of these women said it was because their pediatrician told them it was time to introduce solid food.  Click here for the full story on NBC News Vitals.

Posted by on February 5, 2013 - 10:52am

Women who are obese at the start of their pregnancy may be passing on insufficient levels of vitamin D to their babies, according to a new Northwestern Medicine® study.   The study found that babies born to lean mothers had a third higher amount of vitamin D compared to babies born to obese moms.

Vitamin D is fat-soluble, and previous studies have found that people who are obese tend to have lower levels of the vitamin in their blood. In this study, both obese and lean mothers had very similar levels of vitamin D at the end of their pregnancies, yet obese women transferred less vitamin D to their offspring compared to lean women.

“Nearly all of mothers in this study reported taking prenatal vitamins, which may be the reason why their own vitamin D levels were sufficient, but the babies born to the obese mothers had reduced levels of vitamin D,” said Jami L. Josefson, MD, first author of the study. “It’s possible that vitamin D may get sequestered in excess fat and not transferred sufficiently from an obese pregnant woman to her baby.” Josefson is an assistant professor of pediatrics at Northwestern University Feinberg School of Medicine and an attending physician at Ann & Robert H. Lurie Children's Hospital of Chicago.

It is unknown what health risks babies born with vitamin D insufficiency may face. Recent studies have linked low vitamin D in adults to an increase in autoimmune diseases, inflammation, and obesity.

The study, published Jan. 4 in the Journal of Clinical Endocrinology and Metabolism, was designed as part of a longer-term project to investigate whether body fat at birth is a predictor of body fat in later childhood and adulthood. Because vitamin D deficiency is associated with a host of health conditions, including obesity, the researchers included the analysis of the mothers’ and babies’ vitamin D levels.

Vitamin D levels were measured from blood collected from 61 mothers at 36 to 38 weeks gestation and umbilical cord blood was collected from their babies immediately following birth. Body fat, weight, and volume of the babies were also measured/“The range of body fat of the babies in this study was similar to other studies reporting neonatal body fat,” Josefson said. “What was novel about this study was that we found babies born with higher vitamin D levels had more body fat. That's in contrast to studies in children and adults who have an inverse relationship between levels of vitamin D and body fat, where the higher their vitamin D, the lower their fat.”

Josefson said more research needs to be done on the role vitamin D may play in the health of babies, and she plans to continue studying this sample again to follow up on the babies’ health outcomes.“Obese women may need larger amounts of vitamin D supplementation to provide their babies with sufficient levels of vitamin D while they are in the womb,” Josefson said.This study underscores the importance of understanding the evolving relationships between maternal obesity, vitamin D nutritional status and body fat in the neonatal period, childhood, and adulthood, Josefson said.

Source:  Northwestern News

Posted by on January 3, 2013 - 2:30pm

On Tuesday, December 18th the Women’s Health Research Institute hosted speakers at the monthly lunch series to discuss women’s health, HIV and the vast advances made in HIV care the past 20 years. Although many aspects of HIV transmission, susceptibility, physicality and progress were examined, I was intrigued most by the research presented by Dr. Patricia Garcia on HIV transmission from mother to child.

Dr. Garcia thoughtfully described her vision of a generation without HIV. In that vision, she touched upon the methods through which rapid testing can detect whether a mother is HIV positive, and how that information can be used, along with new prevention methods to create a generation born without HIV.

The data Dr. Garcia presented was very powerful, showing how changes in HIV diagnosis vary greatly by race and gender. She highlighted that of all AIDS diagnoses from 1985-2010, the estimated percentage among adult and adolescent females increased from 7% in 1985 to 25% in 2010.

  Dr. Garcia further showed how the state of Illinois had progressed greatly over the last 15 year, making rapid HIV testing easily available in 2005, at which point the knowledge of HIV status among pregnant women increased significantly. This development influenced the considerable reduction in HIV+ births in the state of Illinois.

 The message is one of continued hope and the success of good health care research. With hard work, women’s health experts and community members saw an issue amongst women and children that could be improved with access, knowledge and prevention, giving new life to an entire generation of children.

Posted by on November 10, 2012 - 10:53am

Heavy drinking during pregnancy disrupts proper brain development in children and adolescents years after they were exposed to alcohol in the womb, according to a study supported by the National Institutes of Health. The study is the first to track children over several years to examine how heavy exposure to alcohol in utero affects brain growth over time.

Using magnetic resonance imaging (MRI) scans, researchers found that brain growth patterns in children whose mothers drank heavily while pregnant differed from normal patterns of development seen in children who were not exposed to alcohol before birth.

The findings suggest that children with heavy alcohol exposure have decreased brain plasticity – the brain's ability to grow and remodel itself based on experience with the outside world. Such adaptation continues throughout one’s life and is crucial to learning new skills and adapting to the environment.

"This study documents the long-term impact of heavy prenatal alcohol exposure on brain development," said Ken R. Warren, Ph.D., acting director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), which provided most of the funding for the study.

"It underscores that heavy drinking during pregnancy often has lasting consequences for the child’s growth and development, and reminds us that women who are, who may be, or who are trying to become pregnant, should not drink alcohol."

The study currently appears online in the Oct. 31, 2012 issue of The Journal of Neuroscience.

During normal development, brain volume increases rapidly at a young age as new neural connections are formed, and then decreases in certain regions during adolescence as underused brain connections are cleared away to increase efficiency. While unexposed children showed this pattern of robust growth and reduction in the brain’s outmost layer, known as the cerebral cortex, those heavily exposed to alcohol typically only lost cortical volume.

In addition, heavier alcohol exposure was linked to lower intelligence, greater facial abnormalities, and little change in brain volume between scans.

The study findings may have implications for developing early treatments that could correct or improve these patterns of abnormal brain development.   The study authors write that this work may also help to understand and treat other disorders with abnormal brain growth in childhood and adolescence, such as autism.

This study was performed in conjunction with the Collaborative Initiative on Fetal Alcohol Spectrum Disorders, a consortium of FASD researchers supported by NIAAA. (More information at: www.cifasd.org)

 

 

 

Posted by on October 14, 2012 - 10:18am

 

The rising rates of diabetes during pregnancy was explored in a new study reported at a recent Obesity Society meeting.   Kelly Hunt, PhD, Medical University of South Carolina reported that the estimated rate of diabetes during pregnancy (combining gestational a pre-pregnancy diabetes)  increased from 5% to 8.7% among white women and from 5.7% to 9.7% among black women.

She said diabetes rates overall increased because of the obesity epidemic and the rising age at which women are giving birth.

"One thing that's good is that the awareness of diabetes during pregnancy has increased a lot in the past 20 years, which is important because you want either pre-pregnancy diabetes or gestational diabetes to be treated during pregnancy so that the impact on the infant is minimized," Hunt said.

Exposure to diabetes during pregnancy has been associated with birth defects, higher birth weight, and greater risks of childhood and adult obesity in the offspring.

"More interventions are needed, both to reduce the prevalence of diabetes prior to pregnancy and to prevent women who have gestational diabetes from subsequently developing type 2 diabetes," she added. "So I would say the take-home message is that we have a lot more work to do and with the obesity and diabetes epidemics, we really need to be thinking about how they're impacting the next generation."

Primary source: The Obesity Society
Source reference:
Hunt K, et al "Prevalence estimates of diabetes during pregnancy in United States women, 1980 to 2008" Obesity Society 2012; Abstract 744-P.

 

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