Tag Archives: Ontario Ministry of Children and Youth Services

Kaiser Permanente study: More women using cannabis daily before and during pregnancy, research finds

20 Jul

The Ontario Ministry of Children and Youth Services explained why healthy babies are important. “Healthy babies are more likely to develop into healthy children, and healthy children are more likely to grow up to be healthy teenagers and healthy adults.” http://www.children.gov.on.ca/htdocs/English/topics/earlychildhood/health/index.aspx
Science Daily reported in Women, particularly minorities, do not meet nutrition guidelines shortly before pregnancy:

Black, Hispanic and less-educated women consume a less nutritious diet than their well-educated, white counterparts in the weeks leading up to their first pregnancy, according to the only large-scale analysis of preconception adherence to national dietary guidelines.
The study, published in the Journal of the Academy of Nutrition and Dietetics and led by the University of Pittsburgh Graduate School of Public Health, also found that, while inequalities exist, none of the women in any racial and socioeconomic group evaluated achieved recommendations set forth by the Dietary Guidelines for Americans.
Healthy maternal diets have been linked to reduced risks of preterm birth, fetal growth restriction, preeclampsia and maternal obesity.
“Unlike many other pregnancy and birth risk factors, diet is something we can improve,” said lead author Lisa Bodnar, Ph.D., M.P.H., R.D., associate professor and vice chair of research in Pitt Public Health’s Department of Epidemiology. “While attention should be given to improving nutritional counseling at doctor appointments, overarching societal and policy changes that help women to make healthy dietary choices may be more effective and efficient.”
Bodnar and her colleagues analyzed the results of questionnaires completed by 7,511 women who were between six and 14 weeks pregnant and enrolled in The Nulliparous Pregnancy Outcomes Study: Monitoring Mothers to Be, which followed women who enrolled in the study at one of eight U.S. medical centers. The women reported on their dietary habits during the three months around conception.
The diets were assessed using the Healthy Eating Index-2010, which measures 12 key aspects of diet quality, including adequacy of intake for key food groups, as well as intake of refined grains, salt and empty calories (all calories from solid fats and sugars, plus calories from alcohol beyond a moderate level).
Nearly a quarter of the white women surveyed had scores that fell into the highest scoring fifth of those surveyed, compared with 14 percent of the Hispanic women and 4.6 percent of the black women. Almost half — 44 percent — of black mothers had a score in the lowest scoring fifth…. https://www.sciencedaily.com/releases/2017/03/170317082514.htm

See, https://drwilda.com/tag/pregnancy/

Science Daily reported in More women using cannabis daily before and during pregnancy:

The number of women using cannabis in the year before they get pregnant and early in their pregnancies is increasing, and their frequency of use is also rising, according to new data from Kaiser Permanente.
The research, published July 19, 2019, in JAMA Network Open, examined self-reported cannabis use among 276,991 pregnant women (representing 367,403 pregnancies) in Northern California over 9 years and found that cannabis use has increased over time.
From 2009 to 2017, the adjusted prevalence of self-reported cannabis use in the year before pregnancy increased from 6.8% to 12.5%, and the adjusted prevalence of self-reported cannabis use during pregnancy increased from 1.9% to 3.4% (rates were adjusted for demographics). Annual rates of change in self-reported daily, weekly, and monthly-or-less cannabis use increased significantly, though daily use increased most rapidly.
Among women who self-reported cannabis use during the year before pregnancy, the proportion who were daily users increased from 17% to 25%, and weekly users increased from 20% to 22%, while monthly-or-less users decreased from 63% to 53% during the study period. Similarly, among women who self-reported cannabis use during pregnancy, the proportion who were daily users increased from 15% to 21%, and weekly users from 25% to 27%, while monthly users decreased from 60% to 52%.
“These findings should alert women’s health clinicians to be aware of potential increases in daily and weekly cannabis use among their patients,” said lead author Kelly Young-Wolff, PhD, MPH, a research scientist with the Kaiser Permanente Division of Research. “The actual numbers are likely higher, as women may be unwilling to disclose their substance use to a medical professional.”
In addition, the prevalence of daily and weekly cannabis use may have risen even further in the past year and a half following legalization of cannabis for recreational use in California in 2018, Young-Wolff said.
The data come from women’s initial prenatal visits at Kaiser Permanente in Northern California, which usually take place at around 8 weeks gestation, and do not reflect continued use throughout pregnancy. Investigators were unable to differentiate whether self-reported cannabis use during pregnancy occurred before or after women were aware that they were pregnant.
While the current findings are based on women’s self-reporting, the results are supported by the Kaiser Permanente research team’s December 2017 JAMA Research Letter showing an increase in prenatal cannabis use via urine toxicology testing. In this newer study, the authors focus on trends in frequency of use in the year before and during pregnancy.
Some women may use cannabis during pregnancy to manage morning sickness, the authors noted. The authors’ previous work published in JAMA Internal Medicine in 2018 found women with severe nausea and vomiting in pregnancy were nearly 4 times more likely to use cannabis during the first trimester of pregnancy.
Women may get the impression from cannabis product marketing and online media that cannabis use is safe during pregnancy, said Young-Wolff. However, there is substantial evidence that exposure to cannabis in pregnancy is associated with having a low-birthweight baby, and the American College of Obstetricians and Gynecologists recommends women who are pregnant or contemplating pregnancy discontinue cannabis use because of concerns about impaired neurodevelopment and exposure to the adverse effects of smoking….
More research is needed to offer women better, specific advice, said study senior author Nancy Goler, MD, an obstetrician/gynecologist and associate executive director of The Permanente Medical Group.
“There is an urgent need to better understand the effects of prenatal cannabis exposure as cannabis becomes legalized in more states and more widely accepted and used,” Dr. Goler said. “Until such time as we fully understand the specific health risks cannabis poses for pregnant women and their fetuses, we are recommending stopping all cannabis use prior to conceiving and certainly once a woman knows she is pregnant….”
https://www.sciencedaily.com/releases/2019/07/190719173602.htm

Citation:

More women using cannabis daily before and during pregnancy, research finds
Current advice is to avoid cannabis exposure during pregnancy
Date: July 19, 2019
Source: Kaiser Permanente
Summary:
The number of women using cannabis in the year before they get pregnant and early in their pregnancies is increasing, and their frequency of use is also rising, according to new data.

Journal Reference:
Kelly C. Young-Wolff, Varada Sarovar, Lue-Yen Tucker, Amy Conway, Stacey Alexeeff, Constance Weisner, Mary Anne Armstrong, Nancy Goler. Self-reported Daily, Weekly, and Monthly Cannabis Use Among Women Before and During Pregnancy. JAMA Network Open, 2019; 2 (7): e196471 DOI: 10.1001/jamanetworkopen.2019.6471

Here is the press release from Kaiser Permanente:

July 19, 2019

More women using cannabis daily before and during pregnancy
Current advice from Kaiser Permanente is to avoid cannabis exposure during pregnancy.
OAKLAND, Calif. — The number of women using cannabis in the year before they get pregnant and early in their pregnancies is increasing, and their frequency of use is also rising, according to new data from Kaiser Permanente.
The research, published July 19, 2019, in JAMA Network Open, examined self-reported cannabis use among 276,991 pregnant women (representing 367,403 pregnancies) in Northern California over 9 years and found that cannabis use has increased over time.
From 2009 to 2017, the adjusted prevalence of self-reported cannabis use in the year before pregnancy increased from 6.80% to 12.50%, and the adjusted prevalence of self-reported cannabis use during pregnancy increased from 1.95% to 3.38%. Annual rates of change in self-reported daily, weekly, and monthly-or-less cannabis use increased significantly, though daily use increased most rapidly.
Among women who self-reported cannabis use during the year before pregnancy, the proportion who were daily users increased from 17.1% to 25.2%, and weekly users increased from 20.4% to 22.0%, while monthly-or-less users decreased from 62.7% to 53.1% during the study period. Similarly, among women who self-reported cannabis use during pregnancy, the proportion who were daily users increased from 14.6% to 20.9%, and weekly users from 25.1% to 27.4%, while monthly users decreased from 60.3% to 51.8%.
“These findings should alert women’s health clinicians to be aware of potential increases in daily and weekly cannabis use among their patients,” said lead author Kelly Young-Wolff, PhD, MPH, a research scientist with the Kaiser Permanente Division of Research. “The actual numbers are likely higher, as women may be unwilling to disclose their substance use to a medical professional.”
In addition, the prevalence of daily and weekly cannabis use may have risen even further in the past year and a half following legalization of cannabis for recreational use in California in 2018, Young-Wolff said.
The data come from women’s initial prenatal visits at Kaiser Permanente in Northern California, which usually take place at around 8 weeks of pregnancy, and do not reflect continued use throughout pregnancy. Investigators were unable to differentiate whether self-reported cannabis use during pregnancy occurred before or after women were aware that they were pregnant.
While the current findings are based on women’s self-reporting, the results are supported by the Kaiser Permanente research team’s December 2017 JAMA Research Letter showing an increase in prenatal cannabis use via urine toxicology testing. In this newer study, the authors focus on trends in frequency of use in the year before and during pregnancy.
Some women may use cannabis during pregnancy to manage morning sickness, the authors noted. The authors’ previous work published in JAMA Internal Medicine in 2018 found women with severe nausea and vomiting in pregnancy were nearly 4 times more likely to use cannabis during the first trimester of pregnancy.
“Women may get the impression from cannabis product marketing and online media that cannabis use is safe during pregnancy,” said Young-Wolff. “However, there is substantial evidence that exposure to cannabis in pregnancy is associated with having a low-birthweight baby, and the American College of Obstetricians and Gynecologists recommends women who are pregnant or contemplating pregnancy discontinue cannabis use because of concerns about impaired neurodevelopment and exposure to the adverse effects of smoking.”
“There is still much that is unknown on the topic, including what type of cannabis products pregnant women are using and whether the health consequences differ based on mode of cannabis administration and frequency of prenatal cannabis use,” Young-Wolff noted.
More research is needed to offer women better, specific advice, said study senior author Nancy Goler, MD, an obstetrician-gynecologist and associate executive director of The Permanente Medical Group.
“There is an urgent need to better understand the effects of prenatal cannabis exposure as cannabis becomes legalized in more states and more widely accepted and used,” Dr. Goler said. “Until such time as we fully understand the specific health risks cannabis poses for pregnant women and their fetuses, we are recommending stopping all cannabis use prior to conceiving and certainly once a woman knows she is pregnant.”
The study was supported by a grant from the National Institute on Drug Abuse.
Young-Wolff and Kaiser Permanente Division of Research colleague Lindsay Avalos, PhD, MPH, have received a new 5-year grant from NIDA to support further research on maternal cannabis use during pregnancy. They plan to study whether prenatal cannabis use is associated with increased risk of adverse maternal, fetal, and neonatal outcomes using data from urine toxicology testing, self-reported frequency of prenatal cannabis use, and mode of cannabis administration. They will also test whether legalization of cannabis for recreational use in 2018 and local regulatory practices (such as retailer bans) are associated with variation in prenatal cannabis use.
Additional authors were Constance Weisner, DrPH, MSW; Varada Sarovar,;Lue-Yen Tucker; Mary Anne Armstrong; and Stacey Alexeeff, PhD, of the Kaiser Permanente Northern California Division of Research; and Amy Conway, MPH, of the Kaiser Permanente Northern California Early Start Program.
About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 12.3 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health.

Contacts
Jan Greene
janice.x.greene@kp.org
510-891-3653
Kerry Sinclair
ksinclair@webershandwick.com
310-710-0321

Humans have free will and are allowed to choose how they want to live. What you do not have the right to do is to inflict your lifestyle on a child. So, the responsible thing for you to do is to get birth control for yourself and the society which will have to live with your poor choices. Many religious folks are shocked because moi is mentioning birth control, but most sluts have few religious inklings or they wouldn’t be sluts. A better option for both sexes, if this lifestyle is a permanent option, is permanent birth control to lessen a contraception failure. People absolutely have the right to choose their particular lifestyle. You simply have no right to bring a child into your mess of a life. I observe people all the time and I have yet to observe a really happy slut. Seems that the lifestyle is devoid of true emotional connection and is empty. If you do find yourself pregnant, please consider adoption.

Let’s continue the discussion. Some folks may be great friends, homies, girlfriends, and dudes, but they make lousy parents. Could be they are at a point in their life where they are too selfish to think of anyone other than themselves, they could be busy with school, work, or whatever. No matter the reason, they are not ready and should not be parents. Birth control methods are not 100% effective, but the available options are 100% ineffective in people who are sexually active and not using birth control. So, if you are sexually active and you have not paid a visit to some agency, then you are not only irresponsible, you are Eeeevil. Why do I say that, you are playing Russian Roulette with the life of another human being, the child. You should not ever put yourself in the position of bringing a child into the world that you are unprepared to parent, emotionally, financially, and with a commitment of time. So, if you find yourself in a what do I do moment and are pregnant, you should consider adoption.
Children need stability and predictability to have the best chance of growing up healthy.

Children will have the most success in school if they are ready to learn. Ready to learn includes proper nutrition for a healthy body and the optimum situation for children is a healthy family. Many of society’s problems would be lessened if the goal was a healthy child in a healthy family.

Unless there was a rape or some forcible intercourse, the answer to the question is a woman who gets preggers with a “deadbeat dad” a moron – is yes.

Learn more about prenatal and preconception care.
http://www.nichd.nih.gov/health/topics/preconceptioncare/Pages/default.aspx
http://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/Pages/prenatal-care.aspx

See, Prenatal care fact sheet http://www.womenshealth.gov/publications/our-publications/fact-sheet/prenatal-care.html

Our goal as a society should be a healthy child in a healthy family who attends a healthy school in a healthy neighborhood. ©

 

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

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http://drwildareviews.wordpress.com/

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Northwestern University study: Heavier babies do better in school

27 Oct

The Ontario Ministry of Children and Youth Services explains why healthy babies are important. “Healthy babies are more likely to develop into healthy children, and healthy children are more likely to grow up to be healthy teenagers and healthy adults.” http://www.children.gov.on.ca/htdocs/English/topics/earlychildhood/health/index.aspx

The New York Times reported in the article, Heavier Babies Do Better in School:
A study of children in Florida found that those who were heavier at birth scored higher on math and reading tests in the third to eighth grades.
Like so many other parts of health care, childbirth has become a more medically intense experience over the last two decades. The use of drugs to induce labor has become far more common, as have cesarean sections. Today, about half of all births in this country are hastened either by drugs or surgery, double the share in 1990.
Crucial to the change has been a widely held belief that once fetuses pass a certain set of thresholds — often 39 weeks of gestation and five and a half pounds in weight — they’re as healthy as they can get. More time in the womb doesn’t do them much good, according to this thinking. For parents and doctors, meanwhile, scheduling a birth, rather than waiting for its random arrival, is clearly more convenient.
But a huge new set of data, based on every child born in Florida over an 11-year span, is calling into question some of the most basic assumptions of our medicalized approach to childbirth. The results also play into a larger issue: the growing sense among many doctors and other experts that Americans would actually be healthier if our health care system were sometimes less aggressive.
The new data suggest that the thresholds to maximize a child’s health seem to be higher, which means that many fetuses might benefit by staying longer in the womb, where they typically add at least a quarter-pound per week. Seven-pound babies appear to be healthier than six-pound babies — and to fare better in school as they age. The same goes for eight-pound babies compared with seven-pound babies, and nine-pound babies compared with eight-pound babies. Weight, of course, may partly be an indicator of broader fetal health, but it seems to be a meaningful one: The chunkier the baby, the better it does on average, all the way up to almost 10 pounds.
“Birth weight matters, and it matters for everyone,” says David N. Figlio, a Northwestern University professor and co-author of the study, which will soon be published in the American Economic Review, one of the field’s top journals… http://www.nytimes.com/2014/10/12/upshot/heavier-babies-do-better-in-school.html?abt=0002&abg=0&_r=0

Citation:

The Effects of Poor Neonatal Health on Children’s Cognitive Development (WP-13-08)
IPR-WP-13-08
David Figlio, Jonathan Guryan, Krzysztof Karbownik, and Jeffrey Roth
This working paper makes use of a new data resource—merged birth and school records for all children born in Florida from 1992 to 2002—to study the effects of birth weight on cognitive development from kindergarten through schooling. Using twin fixed effects models, the researchers find that the effects of birth weight on cognitive development are essentially constant through the school career, that these effects are very similar across a wide range of family backgrounds, and that they are invariant to measures of school quality. They conclude that the effects of poor neonatal health on adult outcomes are therefore set very early.
David Figlio, Orrington Lunt Professor of Education and Social Policy and of Economics, and Director and Faculty Fellow, Institute for Policy Research, Northwestern University
Jonathan Guryan, Associate Professor of Human Development and Social Policy, and Faculty Fellow, Institute for Policy Research, Northwestern University
Krzysztof Karbownik, Visiting Scholar, Institute for Policy Research, Northwestern University
Jeffrey Roth, Research Professor of Pediatrics, College of Medicine, University of Florida
Download working paper PDF http://www.ipr.northwestern.edu/publications/docs/workingpapers/2013/IPR-WP-13-08.pdf

Other articles have questioned whether heavier babies are healthier:

Bigger Baby Trend Worries Doctors As Health Concerns Mount Over Supersized Deliveries http://www.huffingtonpost.com/2013/08/19/bigger-baby-trend_n_3780699.html

Everyday Research blog analyzes the study in Heavier babies do better in school:
Questions
a) How do we know this is a correlational study? What are its variables?
b) Here’s a quote from the article:
Mr. Figlio estimates that, all else equal, a 10-pound baby will score an average of 80 points higher on the 1,600-point SAT than a six-pound baby. Another way to see the pattern is to look only at top-scoring students: Among the top 5 percent of test scorers in elementary school, one in three weighed at least eight pounds at birth, compared with only one in four of all babies.
Does this quote address statistical validity? Construct validity? External validity? or Internal validity?
c) Here’s a great addition. Underneath the main figure in the article, are tables of results for education, race, and age. The caption reads:
The effect of being heavier is similar across many different types of mothers.
Is this caption addressing potential moderators? potential mediators? or potential third variable problems?
d) Here’s another quote from the piece:
Florida offers a window on the issue because the state tracks children from birth through college…. The authors of the new study….used the data to compare birth weight with test scores from third through eighth grades, as well as with kindergarten readiness scores. They controlled for, among other factors, the health and sex of the baby, the length of the pregnancy and the health, age, race and education of the mother
Looking at the last sentence of this quote, is this statement addressing potential moderators? potential mediators? or potential third variable problems?
http://www.everydayresearchmethods.com/2014/10/heavier-babies-do-better-in-school.html

The question many parents ask is what is a healthy weight range.

The What to Expect article, Your Newborn’s Weight: What’s Normal, What’s Not discusses healthy weight:

So just what is average for a newborn? At birth, the average baby weighs about 7.5 pounds — though the range of normal is between 5.5 and ten pounds (all but five percent of newborns will fall into this range).
What makes your baby weigh more or less than the newborn in the next bassinet? Several factors come into play:
• Your own diet and weight, both before and during pregnancy (If you’re overweight, you may have a heavier baby. If you don’t get enough nutrients while you’re pregnant, your baby may be smaller.)
• Your prenatal health, including whether you drink, smoke, or have diabetes
• Your own birth weight, plus genetics (your size at birth, plus your and your hubby’s size now, can both play a role)
• Whether your baby is a boy or a girl (boys tend to be heavier)
• Whether this is your firstborn (they tend to be smaller than subsequent children)
• Whether your baby is a twin or triplet (multiples tend to be smaller than singletons)
• Your baby’s race (Caucasian babies are sometimes larger than African-American, Asian, or Native American infants)… http://www.whattoexpect.com/baby-growth/newborn-weight.aspx

The key is regular prenatal care.

The Eunice Kennedy Shriver National Institute of Child Health and Human Development reports in What is prenatal care and why is it important?

Prenatal Care
Women who suspect they may be pregnant should schedule a visit to their health care provider to begin prenatal care. Prenatal visits to a health care provider include a physical exam, weight checks, and providing a urine sample. Depending on the stage of the pregnancy, health care providers may also do blood tests and imaging tests, such as ultrasound exams. These visits also include discussions about the mother’s health, the infant’s health, and any questions about the pregnancy.
Preconception and prenatal care can help prevent complications and inform women about important steps they can take to protect their infant and ensure a healthy pregnancy. With regular prenatal care women can:
• Reduce the risk of pregnancy complications. Following a healthy, safe diet; getting regular exercise as advised by a health care provider; and avoiding exposure to potentially harmful substances such as lead and radiation can help reduce the risk for problems during pregnancy and ensure the infant’s health and development. Controlling existing conditions, such as high blood pressure and diabetes, is important to avoid serious complications in pregnancy such as preeclampsia.
• Reduce the infant’s risk for complications. Tobacco smoke and alcohol use during pregnancy have been shown to increase the risk for Sudden Infant Death Syndrome. Alcohol use also increases the risk for fetal alcohol spectrum disorders, which can cause a variety of problems such as abnormal facial features, having a small head, poor coordination, poor memory, intellectual disability, and problems with the heart, kidneys, or bones.2 According to one recent study supported by the NIH, these and other long-term problems can occur even with low levels of prenatal alcohol exposure.3

In addition, taking 400 micrograms of folic acid daily reduces the risk for neural tube defects by 70%.4 Most prenatal vitamins contain the recommended 400 micrograms of folic acid as well as other vitamins that pregnant women and their developing fetus need.1,5 Folic acid has been added to foods like cereals, breads, pasta, and other grain-based foods. Although a related form (called folate) is present in orange juice and leafy, green vegetables (such as kale and spinach), folate is not absorbed as well as folic acid.
• Help ensure the medications women take are safe. Certain medications, including some acne treatments6 and dietary and herbal supplements,7 are not safe to take during pregnancy.
Learn more about prenatal and preconception care. http://www.nichd.nih.gov/health/topics/preconceptioncare/Pages/default.aspx
http://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/Pages/prenatal-care.aspx

See, Prenatal care fact sheet http://www.womenshealth.gov/publications/our-publications/fact-sheet/prenatal-care.html

Our goal as a society should be a healthy child in a healthy family who attends a healthy school in a healthy neighborhood. ©

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
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