Tag Archives: pregnancy

Pregnant women with COVID 22x higher risk of dying than uninfected

In a recent study published in JAMA Pediatrics, an international team of researchers from Argentina, Brazil, Egypt, France, Ghana, India, Indonesia, Italy, Japan, Mexico, Nigeria, North Macedonia, Pakistan, Russia, Spain, Switzerland, the US and led by investigators from the University of Oxford (UK) studied 2,130 pregnant women age 18 and older and their newborns at 43 different institutions in 18 different countries from March to October 2020, as part of the observational INTERCOVID Multinational Cohort Study. For each woman who tested positive for COVID-19 before delivery, two unmatched, uninfected women of similar gestational age (±2 weeks) were enrolled.

The 706 COVID-19 patients were at much higher risk than their 1,424 uninfected counterparts for preeclampsia/eclampsia (eclampsia is a serious condition where high blood pressure results in seizures during pregnancy), pregnancy-related high blood pressure, infections requiring antibiotics, intensive care unit (ICU) admission, referral to a higher level of care, preterm delivery, medically indicated preterm delivery, severe neonatal illness, and severe perinatal illness and death.

Women with COVID-19 diagnosis, already at high risk of preeclampsia and COVID-19 because of preexisting overweight, diabetes, hypertension, and cardiac and chronic respiratory diseases, had almost 4 times greater risk of developing preeclampsia/eclampsia, which could reflect the known association with these comorbidities and/or the acute kidney damage that can occur in patients with COVID-19.

Compared with uninfected women, those who tested positive for COVID-19 had a lower rate of spontaneous labor but higher rates of cesarean birth and preterm delivery and fetal distress (signs before and during childbirth indicating that the fetus is not well). The most common indications for preterm delivery among women with a COVID-19 diagnosis were preeclampsia/eclampsia (24.7%), small fetus for gestational age (15.5%), and fetal distress (13.2%).

Of the COVID-19 patients, 13% of their 416 newborns tested were also positive for coronavirus. Exclusive breastfeeding and newborn test positivity were not linked.

Cesarean birth was linked to an increased risk of newborn infection, while breastfeeding was not. Mean maternal age was 30.2 years, and 48.6% of infected women were overweight early in pregnancy, compared with 40.2% of uninfected women.

Of the women with a coronavirus diagnosis, 1.6% died (maternal death ratio, 159 per 10,000 births); four of them died of severe preeclampsia, three of respiratory failure requiring mechanical ventilation, and one of a pulmonary embolism. Five women had worsening respiratory failure before delivery, two of whom underwent cesarean delivery and later died, and two developed cough, shortness of breath, and fever within 7 days after a normal delivery and died. Among the uninfected women, one died due to preexisting liver cancer and cirrhosis.

Women infected with SARS-CoV-2 stayed in the ICU for, on average, 3.73 days longer than uninfected women. Increased risk of serious maternal complications in COVID-19 patients was tied to fever and shortness of breath, as were complications in newborns. But the 44.0% of infected women with no symptoms were at higher risk for only maternal illness and preeclampsia.

This multinational cohort study showed that COVID-19 in pregnancy was associated with consistent and substantial increases in severe maternal morbidity and mortality and neonatal complications.

Coronavirus may damage the placenta during pregnancy

Not everyone is affected in the same way by the novel coronavirus. We know by now that the elderly and men are among the most vulnerable but other groups are also seeing diverse effects due to the virus, including pregnant women, according to a new study.

Credit Flickr

A small study from Northwestern Medicine Prentice Women’s Hospital in Chicago looked at the placentas of 16 pregnant women who had tested positive from COVID-19. All had damage to the placenta, with one pregnancy ending in miscarriage.

Of the 15 other women who delivered healthy babies, 12 (or 80%) had vascular malperfusion (placental injury), a condition that can limit blood flow between the mom and fetus.

Meanwhile, six (or 40%) had placental blood clots, the study showed. Every single woman had at least one affection.

“Most of these babies were delivered full-term after otherwise normal pregnancies, so you wouldn’t expect to find anything wrong with the placentas, but this virus appears to be inducing some injury in the placenta,” said in a statement senior author Dr. Jeffrey Goldstein, assistant professor of pathology at Northwestern University.

No problems were found in the live-born infants, but the findings reaffirmed the importance of monitoring pregnant women more closely. This can be done by doing non-stress tests to examine the placenta or by doing growth ultrasounds to check the development of the baby.

“This preliminary glimpse into how COVID-19 might cause changes in the placenta carries some pretty significant implications for the health of a pregnancy. We must discuss whether we should change how we monitor pregnant women right now,” said in a statement Emily Miller, co-author.

As the first organ to form, the placenta acts as the lungs, gut, kidney, and liver of the fetus, being responsible for shuttling oxygen and nutrients from the mother’s bloodstream. It’s also responsible for the hormonal changes in the mother’s body. Looking at the placenta helps to understand what happened to the baby in the uterus and what could happen to the baby and the mother in the future.

“There is an emerging consensus that there are problems with coagulation and blood vessel injury in COVID-19 patients. Our findings support that there might be something clot-forming about coronavirus, and it’s happening in the placenta,” said Goldstein.

The women that were part of the study delivered their babies at Northwestern Medicine Prentice Women’s Hospital and they all tested positive for COVID-19. Four came in with flu-like symptoms three to five weeks before delivery and tested positive for the virus, while the rest tested positive when they came to the hospital to deliver.

The authors wrote in their study that 14 of the babies were born full-term and with normal weights, while one was premature. “They beautifully normal babies, but our findings indicate a lot of the blood flow was blocked off and many of the placentas were smaller than they should have been,” Miller said.

The research was subject to some limitations. The relatively low number of patients limited the assessment of low frequency or variable outcomes. At the same time, the study didn’t formally test causality or the direct relationship between SARS-CoV-2 infection and the development of placental pathology.

The American College of Obstetricians and Gynecologists had already warned that pregnant women are a high-risk population for coronavirus. This is because of their larger risk of mortality from respiratory infections such as the flu.

The study was published in the American Journal of Clinical Pathology.

Australian lizard is the first vertebrate seen to lay eggs and give birth in one pregnancy

Researchers at the University of Sydney report observing a three-toed skink (Saiphos equalis) lay eggs and give birth to live babies in the same litter. This is the first time a vertebrate has been witnessed doing so.

Image credits Bernard DUPONT / Flickr.

Three-toed skinks are one of the very few “bimodally reproductive” species we’ve ever found, animals in which some individuals lay eggs and others give birth to live offspring. But we’ve never seen one to do both. This world-first observation could help guide our research into the evolution of pregnancy.

Mixed approach

The lizard is native to the east coast of Australia. Individuals in the northern highlands of New South Wales typically birth live young, while those in and around Sydney lay eggs. Dr. Camilla Whittington at the University of Sydney reports on one of the lizards which lay three eggs and then weeks later give birth to a live baby from the same pregnancy.

“It is a very unusual discovery,” said Dr Camilla Whittington, from the School of Life and Environmental Sciences and Sydney School of Veterinary Science at the University of Sydney, the study’s lead author.

“We were studying the genetics of these skinks when we noticed one of the live-bearing females lay three eggs,” Dr Whittington said. “Several weeks later she gave birth to another baby. Seeing that baby was a very exciting moment!”

She quips that this finding makes the animal, which looks like a tiny snake with tinier legs, one of the “weirdest lizards in the world”.

Oh my god, that’s cute.
Image via Wikimedia.

The team published their observations along with advanced microscopy of the egg-coverings (shells). They explain that the first vertebrates laid eggs, and that some evolved over thousands of years to hold the young inside their bodies as they developed. Eventually, the length of time they did so became longer and led to them giving birth to live offspring.

Mammals are typically associated with this type of reproduction, but there are many modern reptile species that give birth, from turtles and lizards to snakes, crocodiles, and dinosaurs.

However, finding an individual that can both lay eggs and give birth is truly an incredible find. The team likens it to a snapshot in the process of evolution, allowing us to better understand it in action. The team hopes that more research on this animal can help us determine how major reproductive leaps take place in nature.

“Put in the context of evolutionary biology, being able to switch between laying eggs and giving live birth could allow animals to hedge their bets according to environmental conditions,” Dr Whittington adds.

The paper “Facultative oviparity in a viviparous skink (Saiphos equalis)” has been published in the journal Biology Letters.

autism

High levels of estrogen in womb might increase risk of developing autism

Autism or autism spectrum disorder (ASD), refers to a broad-range of lifelong, developmental disability that affects how a person communicates with and relates to other people and how they experience the world around them. Research suggests that autism develops from a combination of genetic and nongenetic, or environmental influences.

Amniotic fluid surrounds the baby in the womb, as seen in an ultrasound. Image credits: Nevit Dilmen.

Scientists have recently identified a link between exposure to high levels of estrogen sex hormones in the womb and increased risk of developing autism. The findings of the research supported by the Autism Research Trust, the Medical Research Council, and Wellcome, are published in the journal Molecular Psychiatry.

This study is the first to show that elevated levels of prenatal amniotic estradiol, estriol and estrone are each associated with autism, with estradiol levels being the most significant predictor of the likelihood of autism.  The discovery adds further evidence to support the prenatal sex steroid theory of autism, which was first proposed two decades ago.

In 2015, a team of scientists at the University of Cambridge and the State Serum Institute in Denmark measured the levels of four prenatal steroid hormones. The scientists discovered that androgens in the amniotic fluid were higher in male fetuses who developed autism. These androgens are produced in higher quantities in male than in female fetuses on average, so it could explain why autism occurs more often in boys. They are also known to masculinize parts of the brain and to affect the number of connections between brain cells.

The same group of scientists has built on their previous findings by testing the amniotic fluid samples from the same 98 individuals sampled from the Danish Biobank. Amniotic samples from more than 100,000 pregnancies were measured but this time looking at another set of prenatal sex steroid hormones called estrogens. This is an essential next step because some of the previously-studied hormones are directly converted into estrogens.

All four estrogens were significantly higher, on average, in the 98 fetuses who developed autism later, compared to the 177 fetuses who did not develop autism. High levels of prenatal estrogens were even more predictive of the likelihood of autism than were high levels of prenatal androgens (such as testosterone). Prenatal estrogens have effects on brain growth and masculinize the brain in many mammals (contrary to the popular belief of estrogen feminizing the brain).

Professor Simon Baron-Cohen, Director of the Autism Research Centre at the University of Cambridge, who led this study and who first proposed the prenatal sex steroid theory of autism, said: “This new finding supports the idea that increased prenatal sex steroid hormones are one of the potential causes for the condition. Genetics is well-established as another, and these hormones likely interact with genetic factors to affect the developing fetal brain.”

Alex Tsompanidis, a PhD student in Cambridge who worked on the study, said: “These elevated hormones could be coming from the mother, the baby or the placenta. Our next step should be to study all these possible sources and how they interact during pregnancy.”

Dr Alexa Pohl, part of the Cambridge team, said: “This finding is exciting because the role of estrogens in autism has hardly been studied and we hope that we can learn more about how they contribute to fetal brain development in further experiments. We still need to see whether the same result holds true in autistic females.”

The team cautioned that these findings cannot and should not be used to screen for autism. “We are interested in understanding autism, not preventing it,” added Professor Baron-Cohen.

Dr. Arieh Cohen, the biochemist on the team based at the State Serum Institute in Copenhagen, said: “This is a terrific example of how a unique biobank set up 40 years ago is still reaping scientific fruit today in unimagined ways, through international collaboration.”

Credit: Pixabay.

Abortions don’t harm women’s health but denying them does

Credit: Pixabay.

Credit: Pixabay.

In May, the state of Alabama passed a bill banning abortions. Other states subsequently introduced similar policy banning abortions after a heartbeat is detected in the fetus. While it’s not certain whether such bills can actually be enforced, it’s quite clear that the United States is riding a pro-abortion wave. Its supporters claim that abortions not only take the fetus’ life but also threaten the mother’s. A new study, however, found evidence to the contrary. According to data gathered from 30 American abortion clinics, abortions are not associated with any health risks for pregnant women but not being permitted to take an abortion led to health problems.

Researchers at the University of California, San Francisco, used data from the Turnaway Study, a 2014 longitudinal study that followed the health of pregnant women who wanted an abortion but in some cases were denied since they were past the gestation limit. The researchers examined the health records of 874 women who applied for abortions at 30 U.S. facilities between 2008 and 2010. Among the participants, 326 received a first-trimester abortion, 382 had a second-trimester abortion, and 163 were denied abortion and gave birth.

Despite what pro-life groups might suggest, the study indicates that having an abortion is not detrimental to women’s physical health. On the other hand, being denied access to an abortion led to health problems. For instance, five years after they were denied an abortion, 27% of women rated their overall health as fair or poor, compared to 20% of the women who received an abortion.

The women who give birth were more likely to report chronic headaches, migraines, and join paint compared to those who had received an abortion. Two women even died in the first few weeks after giving birth.

This study is important because it offers unique insights that other studies have not touched upon. For instance, the study involved women who sought an abortion rather than those who chose to give birth. Women who want pregnancies are generally healthier, researchers say. It also examined women who received abortions in the second trimester, a group that is often overlooked. The findings suggest that there is no difference in health risks between women who received abortions in the first and second trimester.

Although it is unlikely that the abortion ban will be enforced in any American state (abortion has been recognized as a Constitutional right), these findings can be taken as evidence in favor of women’s right to abortion.

“Although some argue that abortion is detrimental to women’s health, these study data indicate that physical health is no worse in women who sought and underwent abortion than in women who were denied abortion. Indeed, differences emerged suggesting worse health among those who gave birth,” the authors concluded in the Annals of Internal Medicine.

Credit: Pixabay.

Fathers-to-be who smoke can harm babies

Credit: Pixabay.

Credit: Pixabay.

Despite considerable progress, there are still many pregnant women who are not fully aware of the significant risks that smoking poses to babies. But it’s not just mothers that need to stay away from smoking. According to a new study, fathers-to-be who smoke may place their offspring at an increased risk of congenital heart defects.

Smoking during pregnancy causes adverse health outcomes that can affect women and infants during and after pregnancy — such as placenta previa, placental abruption, miscarriage, preterm birth, and premature membrane rupture. Infants born to women who smoke are also at higher risk for low birthweight (LBW), stillbirth, infant death (sudden infant death syndrome, or SIDS). Smoking can also lead to conceptual delay and infertility in women of childbearing age. Despite these risks, according to US Pregnancy Risk Assessment Monitoring System, 23% of US women smoked in the 3 months before pregnancy and almost 11% smoked during the last trimester of pregnancy.

The reason why tobacco smoke is associated with so many harmful effects has to do with the high number of carcinogens — chemicals that cause cancer — that it contains. These carcinogens accumulate in the body causing damage to all organs, including the reproductive ones, but also the developing fetus. Because smoking alters the chemical environment of the smoker’s body, for instance by lowering oxygen supply, this can affect the outcome of a healthy pregnancy even before a woman conceives.

“Smoking is teratogenic, meaning it can cause developmental malformations. The association between prospective parents smoking and the risk of congenital heart defects has attracted more and more attention with the increasing number of smokers of childbearing age,” Dr. Jiabi Qin, from the Xiangya School of Public Health, Central South University in China, said in a statement.

Congenital heart defects are the leading cause of stillbirth, affecting 8 in 1,000 babies born worldwide. One of the leading causes of congenital heart defects is smoking during pregnancy.

While most studies have focused on women smokers, Qin and colleagues performed the first study that examined the relationship between paternal smoking and the risk of congenital heart defects in offspring. The researchers combed through 125 studies involving 137,574 babies born with congenital heart defects 8.8 million parents.

Strikingly, the risk of congenital heart defects was much greater in men who smoke than in woman smokers. According to the results of the meta-analysis, the associated risk of congenital heart defects increased by 74% for men smoking, 124% for passive smoking in women, and 25% for women smoking (all compared to no exposure). These risks are significant because maternal passive smoking and paternal smoking are more common than maternal active smoking. This may be due to the many pregnant women who are aware that they risk harming their babies if they smoke but place less emphasis on exposure to tobacco smoke in their environment.

“Women should stop smoking before trying to become pregnant to ensure they are smoke-free when they conceive,” said Dr. Qin. “Staying away from people who are smoking is also important. Employers can help by ensuring that workplaces are smoke-free.”

“Doctors and primary healthcare professionals need to do more to publicize and educate prospective parents about the potential hazards of smoking for their unborn child,” he added.

The findings appeared in the European Journal of Preventive Cardiology.

Stress might reduces fertility in women, but not in men

Credit: Pixabay.

Women who are under considerable stress may find it more difficult to conceive, according to a new study. The findings, however, did not apply to men.

Living a modern, fast-paced lifestyle is taking its toll on Americans. According to a 2017 Gallup poll, about eight in ten Americans say they frequently (44%) or sometimes (35%) encounter stress in their daily lives. Women are more likely to report frequent stress than men (49% vs 40%), which can trigger anxiety and depression.

Researchers at the Boston University School of Medicine investigated whether there was any association between stress and the odds of conception for women among the general population. To this aim, they turned to the Pregnancy Study Online (PRESTO), a preconception cohort that followed couples for 12 months or until pregnancy, whichever came first.

PRESTO included 4,769 women and 1,272 men who had no prior history of infertility and had not been trying to conceive for more than six menstrual cycles.

The researchers measured perceived stress among the participants by employing a 10-item test designed to assess how unpredictable and overwhelming individuals find their life circumstances. Each item referred to the past month and had five response choices, ranging from 0 (never) to 4 (very often). Both partners had to complete the perceived stress scale (PSS), whose maximum score is 40, indicating severe daily stress.

Besides PSS, the researchers also assessed data on diet, sleep, household income, frequency of intercorse, and demographic factors such as race or ethnicity.


Association between baseline women’s and men’s scores on the Perceived Stress Scale (PSS) and fecundability. Credit: Boston University School of Medicine.

On average, the baseline perceived stress score was about 1 point higher among women than in men, in line previous surveys and studies. The study’s most important finding, however, was that women who scored 25 or higher on the PSS were 13% less likely to conceive than women with PSS scores under 10. This association was stronger among women who had been trying to conceive for no more than two menstrual cycles and were under 35 years old.

The researchers note that only a small proportion of this association can be explained by less frequent intercourse and increased menstrual cycle irregularity due to stress.

Another important finding was that the PSS score did not seem to influence a man’s odds of conception. If there’s really a causal relationship, perhaps stress may interfere with a woman’s hormonal balance in such a way as to interfere with conception.

The authors have proposed several biological mechanisms through which stress might directly affect a woman’s fecundability. For instance, stress is known to be associated with higher levels of corticotropin-releasing hormones and glucocorticoids, which could delay or inhibit the surge of luteinizing hormones directly involved in ovulation induction. Stress might also reduce ovarian reserves.

More research will be required in order to establish such a causal link. In the meantime, couples who find it hard having a baby might want to consider managing their stress.

The findings appeared in the American Journal of Epidemiology.

More evidence showing pertussis vaccination for pregnant women is safe and effective

Pregnant-woman-injection-image

Credit: Total Assist

Pertussis, also known as whooping cough, can last a long time – sometimes over two months (hence, it is also called the “100-day cough”). It is a respiratory infection caused by the bacterium Bordetella pertussis and can be particularly dangerous and potentially life-threatening in infants. After fits of several coughs, someone with pertussis often needs to take bouts of deep breaths which result in a “whooping” sound. Click here to hear how whooping cough sounds in a child. Coughing can be so severe that it is hard for babies to feed, drink, or breathe. The best way to protect against pertussis is by getting vaccinated.

What vaccines are available?

DPT refers to a class of combination vaccines against diphtheria, pertussis, and tetanus. DTaP and Tdap refer to similar combination vaccines in which the component with a lower case “a” is acellular (does not contain complete cells). The lower case “d” and “p” indicate smaller concentrations of diphtheria pertussis components. Tdap is for everyone 11 years and older, including pregnant women, while DTaP is for children 2 months through 6 years of age.

Pertussis | The JAMA network.

There has been a recent resurgence of pertussis despite widespread childhood vaccination particularly during the gap between birth and receipt of the first vaccine dose at around 2 months of age. The first dose may provide some protection against fatal infection, but full protection is not achieved until completion of all the required doses. Immunization of pregnant women to protect newborns through transplacental transfer of antibodies has been proposed and is recommended in some countries.

Is Tdap vaccination for pregnant women effective?

Yes! One of the largest-ever studies, published in Pediatrics, looked at the effectiveness of prenatal vaccination against pertussis.  It found that the vaccine is more than 91% effective in preventing the life-threatening infection in the first 2 months of life. This is higher than the average 85% protection provided by the DTaP vaccine after the second shot recommended for babies at 4 months.

Another study published in the American Journal of Preventive Medicine shows the effectiveness of the Tdap vaccine for infants whose mothers receive the vaccine during pregnancy. The study reviewed more than 675,000 pregnancies in the U.S. from 2010-2014. Researchers looked at hospitalizations and outpatient visits for pertussis in the infants through 18 months of age. The clinical outcomes show that the immunity passed from the mother to the fetus during pregnancy protected the infant during the first six months of life before the infant completes the full course of the pertussis vaccine themselves. The study found that in the first six months of life for infants whose mothers were immunized during pregnancy, there was a 75% reduction of pertussis hospitalizations.

Is Tdap vaccination for pregnant women safe?

Naturally, mothers want to be sure that the vaccine is safe. Research has shown there is no link between Tdap vaccination during pregnancy and the risks of preterm delivery or low birth weight. A recent study of almost 82,000 children born over a 4-year period showed that Tdap vaccination given to mothers was not associated with increased risk of autism spectrum disorder in children. This retrospective cohort study looked at the autism diagnosis for children born at Kaiser Permanente hospitals in Southern California between 2011 and 2014. The study was published in Pediatrics. The research showed that 569 (or 1.5%) children whose mothers received the Tdap vaccination were later diagnosed with autism, compared with 772 (or 1.8%) children whose mothers did not get the vaccine.

The Centers for Disease Control and Prevention, the American College of Obstetricians and Gynecologists and the American College of Nurse-Midwives recommend Tdap vaccination in pregnant women regardless of prior vaccination status, at any time during pregnancy. The vaccine should preferably be administered between 27 and 36 weeks gestation so as to maximize antibody transfer from the mother to the baby. In 2013, the CDC started recommending that all women receive the Tdap vaccine during every pregnancy in order to pass the immunity on to the fetus. With this recent study, pregnant women can be reassured that there is no indication of an increased risk of autism spectrum disorder in children after being exposed prenatally to the Tdap vaccine.

book pixabay

Pregnant women urged to sleep on side to lower risk of stillbirth

A study of 1,000 British women suggests the risk of stillbirth doubles if women go to sleep on their backs during the third trimester. The results confirm the results of smaller studies performed in Australia and New Zealand. Doctors now advise pregnant women to sleep on their side during the last three months of pregnancy, including during daytime naps.

book pixabay

Credit: Pixabay.

“What I don’t want is for women to wake up flat on their back and think ‘oh my goodness I’ve done something awful to my baby,” Prof Alexander Heazell, clinical director at the Tommy’s Stillbirth Research Centre at St Mary’s Hospital in Manchester, told the BBC. 

“The question that we asked was very specifically what position people went to sleep in and that’s important as you spend longer in that position than you do in any other.

“And also you can’t do anything about the position that you wake up in but you can do something about the position you go to sleep.”

The UK oddly has one of the highest rates of stillbirth in the developed world, with about one in 225 pregnancies ending in stillbirth. In the Greater Manchester area, Dr. Heazell and colleagues have managed to reduce the incidence of stillbirth by 30 percent. Their most recent study involving 291 pregnancies that ended in stillbirth and 735 women who had a live birth suggests sleeping on the side could drastically the risk of the child dying. The findings appeared in the British Journal of Obstetrics and Gynaecology (BJOG).

According to the researchers, there’s a major artery that runs down the front of the spine and which is heavily involved in delivering blood to vital organs. Pregnant women in their last trimester have a heavy uterus which can pressure the artery by when on the back, disrupting blood flow. Previously, doctors used to think that this disruption predominantly affected the mother but there’s now ample evidence that suggests the baby is profoundly affected as well.

According to Dr. Heazell, the position you fall asleep in is the most important since it is the one you spend the most time in while sleeping. If you’re pregnant and wake up on your back, you shouldn’t worry — just turn your back onto the side and return to sleep.

Doctors also advise pregnant women to use a pillow behind the back to encourage side-sleeping. It doesn’t matter which side, left or right.

The British pregnancy charity Tommy’s is now campaigning to raise awareness of the study’s findings.

Good fathers’ testosterone level drops when expecting a baby

A news study found that men show shifts in behavior from mating-oriented to parent-oriented while their partners’ pregnancy develops. These changes are determined by changes in testosterone levels across pregnancy and hormonal linkage with their partner.

Image credits Chris Price / Flickr

It’s almost hard to imagine that every caring dad was once a skirt-chasing ball of hormones — but it’s true. Somewhere along their transition to parenthood, biology puts a stop to men’s carefree days of sowing wild oats and turns their attention towards nurturing children. This is a very solid strategy from an evolutionary point of view, but we didn’t know exactly how it happened.

A new study found that the answer may be testosterone. While high levels of this androgenic steroid hormone have been associated with aggression and competitive behavior, lower levels promote nurturing behaviors, particularly those related to caring for offspring.

Previous studies show that fathers who are in a relationship and are more involved with children’s care show lower testosterone levels that men who don’t have children. Lower levels of salivary testosterone have also been tied to higher self-reported levels of relationship satisfaction and commitment, a lower interest in sex outside of marriage and a lower chance of divorce. So it would seem that a father’s decrease in testosterone levels during the transition to parenthood leads him from exploring new mating opportunities towards investment into the current relationship and caring for offspring.

Led by Darby Saxbe of the University of Southern California, the study followed 27 couples expecting their first child during pregnancy and first few months after birth. The parents’ testosterone levels were measured during this pregnancy, and participants rated their investment, commitment, and satisfaction with their partner a few months after their child’s birth.

The team found that fathers showed significant declines in testosterone while the pregnancy progressed, and a significant positive correlation with the mother’s testosterone levels. A better correlation between the mother’s and father’s testosterone levels during pregnancy was associated with higher levels of father involvement after the child’s birth —  the degree of synchrony between the parents predicted the fathers’ investment, commitment, and satisfaction in the couple relationship.

Interestingly, they also found that testosterone levels before the birth of the child predicted the relationship outcomes after the birth, even after adjusting for fathers’ scores of investment early on in the pregnancy.

“The direction of our effects suggests that hormonal change and synchrony predict relationship investment, not the other way around; that is, relationship investment at the first prenatal assessment was not significantly associated with testosterone change or coordination with mothers,” concluded the authors.

The full paper, “Fathers’ Decline In Testosterone And Synchrony With Partner Testosterone During Pregnancy Predicts Greater Postpartum Relationship Investment” has been published in the journal Hormones and Behavior.

pregnant woman

Alcohol while pregnant: not even a drop, American Academy of Pediatrics urges

“No amount of alcohol should be considered safe to drink during any trimester of pregnancy,” wrote the  the American Academy of Pediatrics in a report which identified ingesting alcohol during pregnancy as the leading cause of preventable birth defects.

pregnant woman

Credit: Public Domain

“There is no safe amount, no safe time, and no safe type of alcohol to drink during pregnancy. It’s just not worth the risk,” said Dr. Cheryl Tan, an epidemiologist at the CDC.

The literature linking the dangers of alcohol during pregnancy is vast and extensive. It’s also very confusing. Drinking alcohol while pregnant can cause all sorts of complications like  fetal alcohol spectrum disorder, a group of conditions causing different abnormalities. One study cited by the pediatricians suggests the risk of having a baby with growth retardation increases even if a woman has just one alcoholic drink a day. Mothers who drunk during pregnancy were more likely to have kids with neurodevelopment issues such as troubles with abstract reasoning, information processing, and attention-deficit/hyperactivity disorder.

“The research suggests that the smartest choice for women who are pregnant is to just abstain from alcohol completely,” said Dr. Janet F. Williams, one of the leading authors of the report from the American Academy of Pediatrics.

Now, you might that’s not news. After all we see the government-mandated warnings on alcoholic beverage labels everywhere nowadays. The science, however, isn’t quite clear. While there are a lot of studies that suggest the risk of child abnormalities goes up with alcohol intake, others didn’t reach the same conclusions. One study published in 2008 found “children born to mothers who drank up to 1–2 drinks per week or per occasion during pregnancy were not at increased risk of clinically relevant behavioural difficulties or cognitive deficits compared with children of abstinent mothers.” What’s more in a fit of irony, the same researchers found  boys born to mothers who had up to 1–2 drinks per week or per occasion were less likely to have conduct problems or hyperactivity.  Girls were less likely to have emotional symptoms and peer problems compared with those born to abstainers. And strikingly, boys born to light drinkers had higher cognitive ability test scores. Another study found total abstinence from alcohol during pregnancy was correlated with an increased risk of stillbirth (alcohol inhibits uterine contractions). There are other studies which don’t support the hypothesis that mild drinking is linked to child abnormalities. Is it that  the standards for confounding factors and statistical significance may have been too low? Might be. It’s likelier, however, that these differences in findings can be attributed to the dose. The literature on the subject isn’t very clear on what constitutes “light”, “mild” or “binge” drinking, and most accounts rely on self-reporting which can be inaccurate.

What the American Academy of Pediatrics is doing is staying on the safe side, considering that this is the most ethical position available. According to the report, 10% of women regularly ingest alcoholic beverages and 3% say they consume more varied drinks on marked occasions.

seahorse

How male sea horses turn pregnant and carry their young

Seahorses are a unique oddity seeing how males, not females, carry the pregnancy and deliver the young. It’s like that embarrassing Arnold Schwarzenegger movie. You know, the one where he participants in a weird science experiment and gets himself pregnant. Seahorses are a lot more interesting, though – they do this in real-life. Not much was known about this peculiar process encountered nowhere else in the animal kingdom. But Australian researchers at University of Sydney have now peered through the molecular and genetic mechanism that males use to nurture their young.

seahorse

seahorse

The whole seahorse reproduction process is interesting, for that matter. The male and female first engage in a beautiful dance, which can extend for days at a time each taking turns in the dancing ritual. Once the two have had enough or are satisfied with their partner, the female would lay something like 1,500 eggs in the male’s pouch. Mr. mom will then safe guard and nurture the eggs until they’re ready to hatch 45 days later. Females will check-up on the male daily during this whole time.

The males will puff up very large as they are getting closer and closer to the young being born. Researchers believe this is to ward off predators by making himself seem bigger.

A pregnant sea stallion. Image: Flickr

A pregnant sea stallion. Image: Flickr

Dr Camilla Whittington from the University’s School of Biological Sciences says the males are real heroes, nurturing their young during pregnancies much like female mammals. By closely following them, Whittingtton and colleagues found the male deliver nutrients through their pouch like energy-rich lipids, and calcium to allow them to build their tiny skeletons. Also, during the pregnancy the males have an altered gene expression judging from blood samples taken from the pouches, much like human mums.

“Regardless of your species, pregnancy presents a number of complex challenges, like ensuring you can provide oxygen and nutrients to your embryos. We have evolved independently to meet these challenges, but our research suggests that even distantly related animals use similar genes to manage pregnancy and produce healthy offspring,” Whittington said.

One of the interesting things about the brood pouch is that it appears to have evolved independently multiple times. There are two major lineages of seahorses and pipefish — trunk-brooding and tail-brooding — and the brood pouch structure independently evolved in each of these groups. Naturally, the question arises: how do you go from looking and behaving like a normal fish and turning into such a unique creature? Texas A&M University evolutionary biology researcher Adam Jones says “the first step in the evolutionary process was the elongation of the fish’s body, which the lab is currently studying. The next step was the addition of other unique structural features that seahorses possess, such as the bending of the fish into its unique shape. The head of a seahorse is unusual because unlike most fish, a seahorse’s head is at a 90-degree angle to its body, Jones explained. Seahorses also have a prehensile tail, meaning that, unlike most fish, they can use their tail to grasp onto things.”

Once they hatch, the baby seahorses are very vulnerable.  Less than 1% of them live long enough to become mature enough to mate themselves. Habitat loss and tourism can make things even worse. There are actually farms  that specifically work towards increasing the population. They will take the young and ensure they are protected for the early stages of life. Then they will return them to the wild as they mature.

Pregnant-woman-injection-image

Vaccination starts with pregnancy, for everyone’s good health

Soon to be mommies are up for some of their stressful times, since it seems they’re bombarded with all sorts of contradictory information how to deliver their babies as healthy and safe as possible. After labor, there are other things to consider as well: the baby should sleep on his back, car seats are safer for newborns etc etc. The most important message mommies are missing, however, is that pregnant women and their babies need vaccines to stay healthy, according to  Saad Omer, a researcher the Royal Society for Public Health.

Parents and vaccines

Pregnant-woman-injection-image

Credit: Total Assist

“When you start talking about childhood vaccines with parents after their babies are born, it is already too late,” he says. “Young parents are more receptive when they are pregnant. There are already lots of messages that are targeted to them during pregnancy, such as breastfeeding and safety. We need to add mother and child vaccinations to that.”

Omer and colleagues were among the first to prove babies born during flu season (October 1 to May 31) and whose mothers were vaccinated during pregnancy were less likely to be premature or small for their gestational age than babies born to unvaccinated mothers. In another study, Omer demonstrated that vaccinating pregnant women against influenza also protected the newborn babies. Thanks to his work,  the World Health Organization now recommends the use of the influenza vaccination globally, especially among pregnant women.

“Vaccinating pregnant women is especially important in developing countries,” he says. “Here in the United States, premature babies go to the NICU. In many parts of developing countries, there is no NICU. Worldwide, 1 million deaths are associated with preterm births.”

But why aren’t enough women doing it? According to Omer, it all stats with health care providers. Women are more likely to get vaccinated during pregnancy and more likely to have their children vaccinated if their health care provider recommends doing so.

“Health care providers are the most trusted source of immunization information,” Omer says. “How physicians approach vaccination with parents has an impact on vaccination update rates. If vaccination is treated as a routine part of care, then children are more likely to get boosters.”

Vaccine noncompliance, or vaccine refusal, raises everyone’s risk of disease, he notes. “Vaccine-preventable diseases such as measles, influenza, and pertussis often start among persons who forego vaccinations, spread rapidly within unvaccinated populations, and also spread to other subpopulations.”

Oddly enough, fewer people are vaccinating themselves or their children. In 2010, a pertussis outbreak in California was thought to be due to a waning immunity from vaccines, but Omer and team were the first show that something else was at play. They found areas with high rates of children entering kindergarten with a nonmedical exemption for vaccines were 2.5 times more likely to be living in a pertussis cluster. The state’s rate of nonmedical exemption more than tripled during the 10 years prior to the outbreak. Why? Well, have you seen the anti-vaccine posts on facebook and elsewhere on the net? There you have it.

As far as I can tell, it all started with a claim – later proven wrong on numerous occasions – that vaccines cause autism in children. In 2007, nearly 5,000 parents of autistic children filed a lawsuit against the federal government, claiming that childhood vaccines (specifically the mercury-containing thimerosal in the vaccines) caused their children’s autism. To this day vaccination skepticism still lingers, despite pseudoscience rebuttals.  Thousands of parents have been frightened into rejecting or delaying immunizations for their children. The immunization rate has dropped, resulting in the return of endemic measles in the U.K. and various outbreaks of vaccine-preventable diseases in the U.S. children have died. Herd immunity has been lost. This is no joke, this is a serious threat to public health!

It’s believed 3% US parents are hardcore vaccine skeptics, while 25% are so-called “fence sitters” who may decline some but not all child vaccines, and they should be the focus of the public health community, Omer says. “We don’t want them to move into the refusal group.”

“The bottom line is that vaccines are still one of the most effective tools we have for preventing disease in children,” he adds. “Maintaining high levels of vaccine coverage will help ensure that we keep the progress we’ve made in eradicating or warding off childhood diseases.”

Maternal exposure to cannabis has drastic consequences on the child, study finds

Fetal brain development has been found to be drastically endangered by maternal drug exposure, according to an ongoing study by an international consortium of researchers from Karolinska Institutet. Cannabis consumption during pregnancy can impair the brain development of the fetus, bringing dreadful long-lasting effects after the child is born. The main consequences are affecting the nerve cells from forming connections, limiting the reaction to stimuli and the amount of information that can be processed by the brain and dramatically slowing the entire cognitive processes.

The study published in the EMBO Journal is explained to have been motivated by the increasing number of pregnant women consuming cannabis linked to the abnormal development of the nerve cells of the cerebral cortex. The effects of marijuana have been studied on mice and THC – the active ingredient in cannabis – delta-9-tetrahydrocannabinol was found to affect the part of the brain that is being responsible for forming memories and higher thinking skills of the unborn fetus. The facts show that an increasing number of children suffer from maternal drug consumption during pregnancy, reason for which the study wasn’t only made on mice but on human brain tissue as well in order for the research to be relevant.

Researcher Tibor Harkany is not only an active member of the Karolinska Institutet. Professor at the Medical University in Vienna, Austria, the deficits in the fetus development are irreversible and may bring life-long modifications to the brain function, as mentioned above. Not all the children that have been exposed to THC will immediately suffer of visible dysfunctions, but the risk of delayed neuropsychiatric diseases is a major one nonetheless. As he declares, ‘even if THC only would cause small changes its effect may well be sufficient to sensitize the brain to later stressors or diseases to provoke neuro-psychiatric illnesses in those affected in the future’.

The article, published on 27th January, tests the effects of marijuana on the fetal brain in three main ways: growing brain cells from mice in the presence of THC, injecting pregnant mice with THC and studying the brains of aborted human fetuses whose mothers had been repeatedly consuming cannabis during pregnancy. The specific protein that the scientists found in the nerve cells is called Superior Cervical Ganglion 10 (SCG10), vital for the development of functional brain connections. The levels of this protein were abnormally lower in the case of human and mice fetuses that have been exposed to THC, clearly suggesting that the exposure to cannabis is drastically affecting the developing brain.

The problem remains controversial nonetheless, since there are studies promoting both sides of the problem spectrum, especially in the countries where cannabis consumption is legalized for the masses.

Happy Couple

Parents live longer than childless couples, study shows

Happy CoupleA new study released by Danish researchers at Aarhus University has found a correlation that suggests that couples that are unable to conceive children have a higher mortality rate than those that are.

The study studied more than 21,000 couples having in vitro fertilization treatment between 1994 and 2005. During this period, 15,210 children were born and 1,564 were adopted. Unfortunately, 96 women and 200 men among the participants died.

When correlated with data of fertile couples, the researchers found that the death rate for childless women was four times as high as those who gave birth to their own child, while childless men were twice as likely to meet an early death. Failing to conceive a child often comes as a heavy burden, and the researchers also looked into this. Their findings suggest childless couples were twice as likely to suffer mental illness as those who adopted children.

The researchers, however, stress that their findings are only based on correlations, not cause-effect. As to why this might happen, study co-author Esben Agerbo, an associate professor at Aarhus University in Aarhus, Denmark makes a guess:

“My best guess is health behaviors,” he said. “When people have kids, they tend to live healthier.”

Couples with children tend to chose a healthier life style that can help them take better care of their young, while also serving as an example. Also, having children may boost a parent’s will to live in the event of a deadly accident or illness. Study critics, however, point out that the study at hand handles a secific situation and cannot be applied to the larger population.

“People having IVF tend to be desperate for a child, if they are unsuccessful they may be depressed- it may even be this rather than childlessness that is playing a part,” Ingrid Collins, a consultant psychologist, said in comments to BBC News on the study.

“It is complicated and many factors play a part in death rates- people with deep spiritual belief, being married, having a higher social class – these can all help in living longer,” she added.

Oddly, the findings are on par with a similar a 2011 Stanford University study that found found childless married men had a higher risk of dying from cardiovascular disease after the age of 50, than men who had two or more children.

The findings were reported in the Journal of Epidemiology and Community Health.

Consuming Fish During Pregnancy Improves Child’s IQ: Study

Infants born to mothers who consumed more fish during pregnancy have recorded improved verbal intelligence, fine motor skills and pro-social behavior, says a latest study. The study, reported in the American Journal of Clinical Nutrition was  coordinated by the University of Granada(Spain) professor Cristina Campoy Folgoso. The researchers collected blood samples from 2,000 women at 20 gestational weeks and from the umbilical cord of the infant at birth for the study.

This study was conducted within the framework of the NUTRIMENTHE project (“Effect of diet on offspring’s cognitive development”), which received funding of 5.9 million Euros from the European 7th Framework Programme.

It is believed that the chemical docosahexaenoic acid (DHA) contained in the fish oil contributes to the normal development of the brain and eye of the fetus and breastfed infants.

The European Commission also supports this view  with the fish oil being the primary source of long-chain Omega-3 fatty acids as docosahexaenoic acid (DHA), the main component of brain cell membranes.

The researchers collected blood samples from 2 000 women at 20 gestational weeks and from the umbilical cord of the infant at birth, and analyzed concentrations of long-chain fatty acids of the series omega-3 and omega-6.Then, they determined the genotype of 18 polymorphisms in the FADS gene cluster.

The aim of this study was to assess the effects of maternal fish intake -as a source of Omega-3 and Omega-6 fatty acids- on fetal development, and to determine how the different genotypes affect long-chain fatty acid concentrations in the fetus.

Dr. Pauline Emmett (University of Bristol), Dr. Eva Lattka (Helmholtz Zentrum München, the German Research Center for Environmental Health) and their research teams have determined how FADS gene cluster polymorphisms affect long-chain polyunsaturated fatty acid concentrations in women during pregnancy.

According to the researchers, fatty acid concentrations in umbilical cord blood depend on maternal and offspring genotypes. Accordingly, maternal genotypes are mainly related with omega-6 fatty acid precursors, and offspring genotypes are related with the more highly elongated fatty acids of the omega-6 series.

The study also revealed that concentrations of docosahexaenoic acid (DHA) of the Omega-3 series -main component of brain cell membranes- depend on maternal and offspring genotypes.

Dr Lattka states that “the fetal contribution of long-chain polyunsaturated fatty acids of the omega-6 series is more relevant than expected; fetal DHA concentrations depend on maternal and fetal metabolism”, and concludes that “the amount of DHA transmitted to the fetus through the placenta might be crucial for fetal development”.

In a previous study, this research team proved that fish intake during pregnancy is correlated with the IQ in 8-year old children. The study revealed that fish intake is correlated with maternal blood DHA concentrations.

However, it has not been clarified whether maternal DHA concentrations are directly correlated with the offspring’s IQ. The NUTRIMENTHE project –which is expected to conclude in 2013 – is aimed at elucidating this question.

Last October, the researchers involved in the NUTRIMENTHE project –coordinated by the University of Granada- organized an International Symposium on “Nutrition and Cognitive Function” during the European Nutrition Conference held in Madrid.

Researchers from Belgium, Germany, Hungary, Italy, Netherlands, Poland, UK, USA and Spain (Rovira i Virgili and Granada) –involved in the NUTRIMENTHE consortium- participated in this event. //EOM//