Tag Archives: Pregnancy

Michigan Medicine – University of Michigan study: One in 100 new mothers go on to long-term opioid painkiller use; risk rises with size of Rx

28 Jul

American Pregnancy posted, Using Narcotics For Pain Relief During Childbirth:

Using Narcotics for Pain Relief During Labor: Types & Side Effects
Many women end up relying on some type of method to reduce the physical pain of childbirth. As you prepare for labor, it is important to become familiar with the pain medications that are available, how they work, their risks and their benefits.
The method you choose for pain relief will depend on your personal preference, your health care provider’s recommendation, and the availability of medications at your birthing facility.
What are Opiates?
Opiates are a type of analgesic given to relieve pain. When used during childbirth, opiates are considered the first option after natural methods for pain relief such as labor in water, deep breathing, and massage.
Opiates are given in small doses and usually administered during the early stages of labor in an attempt to avoid potential side effects for both the mother and baby.
What are the advantages of using opiates during childbirth?
Opiates offer pain relief and do not interfere with a woman’s ability to push during labor. Unlike an epidural, an opiate does not numb the pain; it instead helps to take some“edge” off of the pain. Opiates can help reduce anxiety and improve the mother’s ability to cope with painful contractions.
What are the potential side effects of opiates?
Mothers can experience the following side effects:
• Nausea
• Vomiting
• Itching
• Dizziness
• Sedation
• Decreased gastric motility
• Loss of protective airway reflexes
• Hypoxia due to respiratory depression
How will the opiates affect my baby?
Opiates cross the placenta during labor and can produce the following side effects in the baby:
• Central nervous system depression
• Respiratory depression
• Impaired early breastfeeding
• Altered neurological behavior
• Decreased ability to regulate body temperature
For these reasons, your baby might need other medication to counteract the effects of the opiate. Naloxone is a medication given in small doses that can reverse the respiratory depression that opiates can cause in a baby. It is usually given intravenously and its effects can be seen within a few minutes and can last up to 2 hours.
What types of opiates are used during childbirth?
The most frequently used narcotic medications are:
• Morphine
• Stadol
• Fentanyl
• Nubain
• Demerol
Demerol:
Demerol is a popular choice for pain relief during labor. Demerol alters how the mother recognizes the pain she is experiencing by binding to the receptors found in the central nervous system.
The advantages of Demerol include:
• Can be given by injection into the muscle, the vein or by a Patient Controlled Analgesia (PCA) pump
• Fast-acting – starts working in less than 5 minutes
How can Demerol affect me and my baby?
Demerol can cause drowsiness, nausea, vomiting, respiratory depression, and maternal hypotension (low blood pressure). If injected within 2-4 hours of delivery, Demerol has been found to cause breathing difficulties in some babies.
Morphine:
In recent years, morphine has not been routinely used as a method of pain relief during labor because it has been found to depress the baby’s ability to breathe.
Stadol:
Stadol has been found to relieve pain when given in the first stage of labor. This narcotic is considered more potent than Demerol. It is usually given intravenously in small doses, usually 1 to 2 mg.
The advantages of using Stadol include:
• Starts working in less than five minutes
• Is a sedative
• Has minimal fetal effects
• Causes minimal nausea
How can Stadol affect me and my baby?
Stadol can cause the mother to have respiratory depression, dizziness, and dysphoria (a state of feeling unwell and unhappy). Stadol can cause respiratory depression in the baby.
Fentanyl:
Fentanyl is a synthetic opiate that provides mild to moderate sedation. The advantages of using Fentanyl include:
• Begins working quickly (although, usually only lasts 45 minutes)
• Minimal sedation
• Minimal fetal effects
How can Fentanyl affect me and my baby?
You and your baby can experience some sedation and/or nausea. According to Danforth’s Obstetrics and Gynecology, babies born to mothers who used Fentanyl to relieve pain during labor were less likely to need naloxone (medication to help with breathing) than babies born to mothers who used Demerol.
Nubain:
Nubain is an opiate agonist-antagonist comparable to morphine. The advantages of using Nubain include:
• Begins working within 5 minutes of administration
• Minimal nausea
• Minimal fetal effects
How can Nubain affect me and my baby?
Nubain can cause the mother to have sedation and dysphoria (a state of feeling unwell and unhappy)…. https://americanpregnancy.org/labor-and-birth/narcotics/

A University of Michigan study found that some mothers go on to long-term use of opioid painkillers.

Science Daily reported in One in 100 new mothers go on to long-term opioid painkiller use; risk rises with size of Rx:

Nearly half of American women having a baby in the last decade received a prescription for a powerful opioid painkiller as part of their birth experience, a new study shows.
And one or two in every hundred were still filling opioid prescriptions a year later — especially those who received birth-related opioid prescriptions before the birth, and those who received the largest initial doses.
In a study of records from more than 308,000 women who gave birth from 2008 to 2016, researchers from the University of Michigan find the percentage of women filling opioid prescriptions in the days and months after giving birth declined over time. This may have resulted from growing awareness of the broader national epidemic.
But they note that there is still ample room for providers to adopt effective pain control strategies — for both vaginal and Caesarean births — that don’t include giving new mothers opioid pills if other pain treatments work for them.
Writing in JAMA Network Open, U-M obstetrician and health services researcher Alex Friedman Peahl, M.D., and her colleagues explore opioid prescribing to women with private insurance who hadn’t received opioids for a year before delivering. They limited the study to women who didn’t suffer major birth complications or have any other procedures in the year after a birth.
“Overall, we see rates of opioid persistence higher than previously documented for women having C sections, at about two percent,” says Peahl. “For women who delivered vaginally, one-quarter received opioid prescriptions, although current guidelines call for a step-wise approach to pain management, starting with non-narcotic medications such as ibuprofen and acetaminophen. One percent of vaginal birth mothers were still receiving opioids months later.”
Peahl and her colleagues hope their findings bolster efforts by national groups to help birth care teams adopt opioid-sparing pain care methods. Birth care at Von Voigtlander Women’s Hospital, part of the U-M academic medical center Michigan Medicine, already includes such approaches.
Peahl says she tells her birthing patients, “Pain after birth is like a mountain: once you’re at the peak, it is harder to get down. Using non-narcotic pain medications before opioids can help better manage your pain by preventing you from reaching that peak.”
Alternatives to opioids
Peahl’s experience treating birth pain with fewer opioids extends back to her training in Rhode Island, where birthing women once routinely went home from the hospital with prescriptions for 20 to 40 opioid painkiller pills. Then, the state legislature passed a limit of 20 pills for acute pain prescriptions, and she worked with the birth team where she trained to develop alternate pain care approaches.
Using long-lasting opioids for the height of birth pain as part of an epidural, and reserving oral opioids for “breakthrough” post-birth pain, is possible, says Peahl.
Acetaminophen, and non-steroidal anti-inflammatory drugs such as ibuprofen can provide effective pain relief in the days after birth, Peahl says, especially if women receive education during birth preparation about their proper use. She recently presented data at a conference showing such an approach can reduce post-discharge opioid painkiller use.
A team of U-M obstetric clinicians also recently published a paper in the American Journal of Obstetrics & Gynecology that laid out the case for opioid-sparing approaches to pain care after C-section births. Such an approach, called Enhanced Recovery After Surgery or ERAS, has already risen in popularity for other OB/Gyn procedures such as hysterectomy… https://www.sciencedaily.com/releases/2019/07/190726111025.htm

Citation:

One in 100 new mothers go on to long-term opioid painkiller use; risk rises with size of Rx
Date: July 26, 2019
Source: Michigan Medicine – University of Michigan
Summary:
Nearly half of American women having a baby in the last decade received a prescription for a powerful opioid painkiller as part of their birth experience, a new study shows. And one or two in every hundred were still filling opioid prescriptions a year later — especially those who received birth-related opioid prescriptions before the birth, and those who received the largest initial doses.

Journal Reference:
Alex F. Peahl, Vanessa K. Dalton, John R. Montgomery, Yen-Ling Lai, Hsou Mei Hu, Jennifer F. Waljee. Rates of New Persistent Opioid Use After Vaginal or Cesarean Birth Among US Women. JAMA Network Open, 2019; 2 (7): e197863 DOI: 10.1001/jamanetworkopen.2019.7863

Here is the press release from University of Michigan:

Kara Gavin

July 26, 2019 11:15 AM

1 in 75 New Moms Go on to Long-Term Opioid Painkiller Use
Examination of post-birth pain care patterns over time finds declines in opioid prescribing, but opportunities for more non-opioid-based care.

Nearly half of American women having a baby in the last decade received a prescription for a powerful opioid painkiller as part of their birth experience, a new study shows.
And one or two in every hundred were still filling opioid prescriptions a year later – especially those who received birth-related opioid prescriptions before the birth, and those who received the largest initial doses.
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In a study of records from more than 308,000 women who gave birth from 2008 to 2016, researchers from the University of Michigan found the percentage of women filling opioid prescriptions in the days and months after giving birth declined over time. This may have resulted from growing awareness of the broader national epidemic.
But they note that there is still ample room for providers to adopt effective pain control strategies – for both vaginal and caesarean births – that do not include giving new mothers opioid pills if other pain treatments work for them.
In the new issue of JAMA Network Open, U-M obstetrician and health services researcher Alex Friedman Peahl, M.D., and her colleagues explore opioid prescribing to women with private insurance who had not received opioids for a year before delivering. They limited the study to women who did not suffer major birth complications or have any other procedures in the year after a birth.
“Overall, we saw rates of opioid persistence higher than previously documented for women having c-sections, at about 2%,” says Peahl. “For women who delivered vaginally, one-quarter received opioid prescriptions, although current guidelines call for a step-wise approach to pain management, starting with non-narcotic medications such as ibuprofen and acetaminophen. One percent of vaginal birth mothers were still receiving opioids months later.”
Peahl and her colleagues hope their findings bolster efforts by national groups to help birth care teams adopt opioid-sparing pain care methods. Birth care at Von Voigtlander Women’s Hospital, part of the U-M academic medical center Michigan Medicine, already includes such approaches.
Peahl says she tells her birthing patients, “Pain after birth is like a mountain: once you’re at the peak, it is harder to get down. Using non-narcotic pain medications before opioids can help better manage your pain by preventing you from reaching that peak.”
Alternatives to opioids
Peahl’s experience treating birth pain with fewer opioids extends back to her training in Rhode Island, where birthing women once routinely went home from the hospital with prescriptions for 20 to 40 opioid painkiller pills. Then, the state legislature passed a limit of 20 pills for acute pain prescriptions, and she worked with the birth team where she trained to develop alternate pain care approaches.
Using long-lasting opioids for the height of birth pain as part of an epidural, and reserving oral opioids for “breakthrough” post-birth pain, is possible, says Peahl.
Acetaminophen, and non-steroidal anti-inflammatory drugs such as ibuprofen can provide effective pain relief in the days after birth, Peahl says, especially if women receive education during birth preparation about their proper use. She recently presented data at a conference showing such an approach can reduce post-discharge opioid painkiller use.
A team of U-M obstetric clinicians also recently published a paper in the American Journal of Obstetrics & Gynecology that laid out the case for opioid-sparing approaches to pain care after c-section births. Such an approach, called Enhanced Recovery After Surgery or ERAS, has already risen in popularity for other OB/Gyn procedures such as hysterectomy.
Building on surgical opioid studies
Peahl, a National Clinician Scholar at the U-M Institute for Healthcare Policy and Innovation (IHPI), teamed up with IHPI members from the Michigan Opioid Prescribing and Engagement Network for the new study. Senior author Jennifer Waljee, M.D., M.P.H., M.S., helped Peahl adopt an approach already used to study opioid prescriptions after inpatient surgery.
Using IHPI-purchased data, they looked at women who filled an opioid prescription in the immediate week before giving birth, up to the third day afterward. This allowed them to include women whose doctors wrote a prescription to have on hand before they went to the hospital.
They defined persistent use as those women who filled at least one more opioid prescription within three months of delivering, and another up to a year after delivering. In addition to excluding women with prior opioid use and those in treatment for substance abuse, the study left out women who had any sort of medical procedure within a year of having a baby, including readmission for additional surgical procedures, and women whose birth hospitalization lasted more than a month.
“The silver lining in these data is that we see drops of several percentage points in the filling of initial prescriptions over time, although nearly 24% of women who delivered vaginally in 2016, and nearly 73% of those who had a c-section, still had these pills on hand,” says Peahl.
Women most at risk of persistent use
While the researchers could not tell from the data how many opioid pills the women actually took, they note that unused pills can pose a risk of their own. Excess opioids can be misused by others, diverted for illicit sale, or discovered by curious children.
Looking more closely at the data, they showed that risk of opioid persistence was higher in certain groups of women. Women who had their babies in their teens or early 20s, and those who had more medical issues at the time of birth, especially diagnoses related to pain or mental health, had higher rates of persistence. So did mothers in the South and Midwest and women who used tobacco during pregnancy.
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But the biggest factors – and the one that health care providers can actually modify – was the size of the initial prescription for opioids that the women filled and the timing of when that prescription was given. The larger the vial, the more likely they were to refill multiple prescriptions in the months after giving birth. Similarly, women who filled prescriptions prior to birth were more likely to develop new persistent use.
This is similar to what Waljee and her colleagues have seen in surgical patients, which has led them to create prescribing guidelines for surgical teams that are based on what patients say they actually needed to take for pain control. The guidelines for c-sections published on the Michigan-OPEN site recommend that women receive between zero and 20 five-milligram oxycodone tablets or the equivalent.
Next steps
Peahl and her colleagues are currently contacting new mothers who received opioid painkillers to find out how many pills they took out of the total number they were prescribed and given. This could inform more evidence-based recommendations in the near future. They are also assessing the impact of a new ERAS protocol that was launched on July 8, which includes more robust patient education and shared decision making about opioid prescriptions at the time of discharge.
They also hope to study Medicaid data on a national level, expanding on the single-state analysis others have done. And, they hope to study data on the half of women who could notbe included in the current study because they had received opioid prescriptions in the year before they had their baby.
“No matter which way they deliver, women should be able to get up and spend time with their new baby,” says Peahl. “Pain, and the effects of pain control medications, should not get in the way of their birth experience and bonding with their infant.”
In addition to Peahl and Waljee, the study’s authors include Vanessa K. Dalton, M.D., John R. Montgomery, M.D., Yen-Ling Lai and Hsou Mei Hu. Peahl, Dalton, and Waljee are members of IHPI. The study was funded by Peahl’s IHPI NCSP fellowship.
DOI: 10.1001/jamanetworkopen.2019.7863

Nancy D. Campbell, PhD wrote in When Should Screening and Surveillance Be Used during Pregnancy?

Ethics in the kinds of risky situations described above is not a mere preoccupation with abstract principles—nor should ethics be understood as limited to technical details. Ethics is practical, often arising as a result of specific cases with particular histories of harm and injustice. Enjoined to do no harm, physicians arguably have a duty to reduce harm and certainly to provide care that does not coerce, stigmatize, or criminalize.
Physicians share responsibility to ensure access to the full range of reproductive health care and drug treatment for their patients who need it. Physicians also share with drug-using pregnant women responsibility to bring about healthy births and humane treatment for all concerned—mothers, babies, and children. Ensuring access to the full range of evidence-based drug treatment should be considered part of these affirmative duties. Biomedical surveillance should be conducted only for clinical purposes having to do with ensuring access to and delivering quality health care. Just because we have surveillance technology does not mean we should use it against the very women who need to be enrolled in caring for their infants. “Mom” is part of the cure, and compassionate care demands that surveillance be judiciously used in therapeutic spaces…. https://journalofethics.ama-assn.org/article/when-should-screening-and-surveillance-be-used-during-pregnancy/2018-03

Resources:

Prescription opioids during pregnancy https://www.marchofdimes.org/pregnancy/prescription-opioids-during-pregnancy.aspx

Using Narcotics For Pain Relief During Childbirth               https://americanpregnancy.org/labor-and-birth/narcotics/

Opioid use during pregnancy                                                      https://www.mayoclinic.org/opioid-use-during-pregnancy/art-20380741/in-depth/art-20380741
Doctors’ responsibility in opioid crisis                              http://cmajnews.com/2016/11/18/doctors-responsibility-in-opioid-crisis-cmaj-109-5359/

Untangling the medical ethics of prescribing opioids                                            https://www.ama-assn.org/delivering-care/ethics/untangling-medical-ethics-prescribing-opioids

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

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http://drwildareviews.wordpress.com/

Dr. Wilda ©
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Aarhus University study: Infant mortality is higher for low-skilled parents

1 Jul

In 3rd world America: Money changes everything, moi wrote:

The increased rate of poverty has profound implications if this society believes that ALL children have the right to a good basic education. Moi blogs about education issues so the reader could be perplexed sometimes because moi often writes about other things like nutrition, families, and personal responsibility issues. Why? The reader might ask? Because 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 societies’ problems would be lessened if the goal was a healthy child in a healthy family. There is a lot of economic stress in the country now because of unemployment and underemployment. Children feel the stress of their parents and they worry about how stable their family and living situation is.
Sabrina Tavernise wrote an excellent New York Times article, Education Gap Grows Between Rich and Poor, Studies Say:
It is a well-known fact that children from affluent families tend to do better in school. Yet the income divide has received far less attention from policy makers and government officials than gaps in student accomplishment by race.
Now, in analyses of long-term data published in recent months, researchers are finding that while the achievement gap between white and black students has narrowed significantly over the past few decades, the gap between rich and poor students has grown substantially during the same period….http://www.nytimes.com/2012/02/10/education/education-gap-grows-between-rich-and-poor-studies-show.html?emc=eta1

Teachers and schools have been made TOTALLY responsible for the education outcome of the children, many of whom come to school not ready to learn and who reside in families that for a variety of reasons cannot support their education. All children are capable of learning, but a one-size-fits-all approach does not serve all children well. Different populations of children will require different strategies and some children will require remedial help, early intervention, and family support to achieve their education goals.

Science Daily reported in Infant mortality is higher for low-skilled parents:

Infants of women with a short-term education are more likely to die within the first year of life. In more than half of cases, the cause of death is premature childbirth and low fetal weight. This is shown by research from Aarhus University and Aarhus University Hospital.
In Denmark, four out of 1,000 newborn babies die before reaching their first birthday. Now, a new research project shows that women with short-term (primary and lower secondary education less than nine years) or no education have an increased risk of their child dying during the first year. Premature birth and low fetal weight can explain 55-60 per cent of cases.
Yongfu Yu and Jiong Li from Aarhus University and Aarhus University Hospital are behind the study….
The results have just been published in PLoS Medicine. They are based on a national population study of 1.99 million children born in Denmark in the years 1981-2015.
“To reduce the risk of premature childbirth and low fetal weight will be helpful. One way among others of doing this is by increased focus on improving the health of socially and financially disadvantaged women before and during pregnancy,” says Yongfu Yu….
“Even in a welfare society like Denmark, pregnant women with short-term education need more resources to address social challenges in order to improve the health of infants in general and reduce child mortality in particular,” says Yongfu Yu. https://www.sciencedaily.com/releases/2019/06/190627114027.htm

Citation:

Infant mortality is higher for low-skilled parents
Date: June 27, 2019
Source: Aarhus University
Summary:
Infants of women with a short-term education are more likely to die within the first year of life. In more than half of cases, the cause of death is premature childbirth and low fetal weight.

Yongfu Yu et al. Mediating roles of preterm birth and restricted fetal growth in the relationship between maternal education and infant mortality: A Danish population-based cohort study, PLOS Medicine (2019). DOI: 10.1371/journal.pmed.1002831
Journal information: PLoS Medicine

Here is the press release from Aarhus University:

NEWS RELEASE 27-JUN-2019
Infant mortality is higher for low-skilled parents
Infants of women with a short-term education are more likely to die within the first year of life. In more than half of cases, the cause of death is premature childbirth and low foetal weight. This is shown by research from Aarhus University and Aarhus Un
AARHUS UNIVERSITY
Infants of women with a short-term education are more likely to die within the first year of life. In more than half of cases, the cause of death is premature childbirth and low foetal weight. This is shown by research from Aarhus University and Aarhus University Hospital.
In Denmark, four out of 1,000 newborn babies die before reaching their first birthday. Now, a new research project shows that women with short-term (primary and lower secondary education less than nine years) or no education have an increased risk of their child dying during the first year. Premature birth and low foetal weight can explain 55-60 per cent of cases.
Yongfu Yu and Jiong Li from Aarhus University and Aarhus University Hospital are behind the study.
“Despite the fall in child mortality in recent decades, there still remains a socio-economic imbalance in the infant mortality rate. Something needs to be done about that,” Jiong Li says.
The results have just been published in PLoS Medicine. They are based on a national population study of 1.99 million children born in Denmark in the years 1981-2015.
“To reduce the risk of premature childbirth and low foetal weight will be helpful. One way among others of doing this is by increased focus on improving the health of socially and financially disadvantaged women before and during pregnancy,” says Yongfu Yu.
He hopes that the results can contribute to the prevention of premature deaths in infants.
“Even in a welfare society like Denmark, pregnant women with short-term education need more resources to address social challenges in order to improve the health of infants in general and reduce child mortality in particular,” says Yongfu Yu.
###
Background for the results:
The study is a cohort study covering 1,994,618 new born babies in Denmark between 1981-2015.
The study is financed by grants from Lundbeck Foundation, the Danish Council for Independent Research, Novo Nordisk Fonden, Nordic Cancer Union, Karen Elise Jensens Fond, National Natural Science Foundation of China, the U.S. National Institute of Environmental Health Science, the U.S. National Library of Medicine, the National Center for Advancing Translational Science, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
The scientific article has been published in PLoS Medicine.
Contact:
PhD, MSc. Postdoc, Yongfu Yu
Aarhus University, Department of Clinical Medicine and
Aarhus University Hospital, Department of Clinical Epidemiology
Tel.: (+1) 4244022194
Email: yoyu@clin.au.dk
PhD, Associate Professor, Jiong Li
Aarhus University, Department of Clinical Medicine and
Aarhus University Hospital, Department of Clinical Epidemiology
Tel.: (+45) 8716 8401
Email: yoyu@clin.au.dk
Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.
https://www.eurekalert.org/pub_releases/2019-06/au-imi062719.php

Here is information about the Adverse Child Experiences Study. The Centers for Disease Control and Prevention provides access to the peer-reviewed publications resulting from The ACE Study. http://acestudy.org/
https://drwilda.com/2012/11/09/study-some-of-the-effects-of-adverse-stress-do-not-go-away/

Science Daily reported in Infantile memory study points to critical periods in early-life learning for brain development:

A new study on infantile memory formation in rats points to the importance of critical periods in early-life learning on functional development of the brain. The research, conducted by scientists at New York University’s Center for Neural Science, reveals the significance of learning experiences over the first two to four years of human life; this is when memories are believed to be quickly forgotten — a phenomenon known as infantile amnesia.
“What our findings tell us is that children’s brains need to get enough and healthy activation even before they enter pre-school,” explains Cristina Alberini, a professor in NYU’s Center for Neural Science, who led the study. “Without this, the neurological system runs the risk of not properly developing learning and memory functions…”
https://www.sciencedaily.com/releases/2016/07/160718111939.htm

Citation:

Infantile memory study points to critical periods in early-life learning for brain development
Date: July 18, 2016
Source: New York University
Summary:
A new study on infantile memory formation in rats points to the importance of critical periods in early-life learning on functional development of the brain. The research reveals the significance of learning experiences over the first two to four years of human life.
Journal Reference:
1. Alessio Travaglia, Reto Bisaz, Eric S Sweet, Robert D Blitzer, Cristina M Alberini. Infantile amnesia reflects a developmental critical period for hippocampal learning. Nature Neuroscience, 2016; DOI: 10.1038/nn.4348

Our goal as a society should be:

A healthy child in a healthy family who attends a healthy school in a healthy neighborhood ©

Resources:

The Effects of Stress on Your Body
http://www.webmd.com/mental-health/effects-of-stress-on-your-body

The Physical Effects of Long-Term Stress
http://psychcentral.com/lib/2007/the-physical-effects-of-long-term-stress/all/1/

Chronic Stress: The Body Connection
http://www.medicinenet.com/script/main/art.asp?articlekey=53737

Understanding Stress Symptoms, Signs, Causes, and Effects
http://www.helpguide.org/mental/stress_signs.htm

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/

r. Wilda ©
https://drwilda.com/

Stanford Medicine study: Older fathers associated with increased birth risks, study reports

8 Nov

Typically, older mothers are the subject of risk factor analysis for pregnancy after 35. The Mayo Clinic staff wrote in Pregnancy after 35: Healthy moms, healthy babies:

Understand the risks
The biological clock is a fact of life, but there’s nothing magical about age 35. It’s simply an age at which various risks become more discussion worthy. For example:
• It might take longer to get pregnant. You’re born with a limited number of eggs. As you reach your mid- to late 30s, your eggs decrease in quantity and quality. Also, older women’s eggs aren’t fertilized as easily as younger women’s eggs. If you are older than age 35 and haven’t been able to conceive for six months, consider asking your health care provider for advice.
• You’re more likely to have a multiple pregnancy. The chance of having twins increases with age due to hormonal changes that could cause the release of multiple eggs at the same time. The use of assisted reproductive technologies — such as in vitro fertilization — also can play a role.
• You’re more likely to develop gestational diabetes. This type of diabetes, which occurs only during pregnancy, is more common as women get older. Tight control of blood sugar through diet and physical activity is essential. Sometimes medication is needed, too. Left untreated, gestational diabetes can cause a baby to grow significantly larger than average — which increases the risk of injuries during delivery. Gestational diabetes can also increase the risk of premature birth, high blood pressure during pregnancy, and complications to your infant after delivery.
• You’re more likely to develop high blood pressure during pregnancy. Research suggests high blood pressure that develops during pregnancy is more common in older women. Your health care provider will carefully monitor your blood pressure and your baby’s growth and development. You will need more frequent obstetric appointments and you might need to deliver before your due date to avoid complications.
• You’re more likely to have a low birth weight baby and a premature birth. Premature babies, especially those born earliest, often have complicated medical problems.
• You might need a C-section. Older mothers have a higher risk of pregnancy-related complications that might lead to a C-section delivery. An example of a complication is a condition in which the placenta blocks the cervix (placenta previa).
• The risk of chromosome abnormalities is higher. Babies born to older mothers have a higher risk of certain chromosome problems, such as Down syndrome.
• The risk of pregnancy loss is higher. The risk of pregnancy loss — by miscarriage and stillbirth — increases as you get older, perhaps due to pre-existing medical conditions or fetal chromosomal abnormalities. Research suggests that the decrease in the quality of your eggs, combined with an increased risk of chronic medical conditions such as high blood pressure and diabetes, could increase your risk of miscarriage. Ask your health care provider about monitoring your baby’s well-being during the last weeks of pregnancy.
While further research is needed, studies suggest that men’s ages at the time of conception — the paternal age — also might pose health risks for children…. https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/pregnancy/art-20045756

Stanford Medicine studied the risk factors associated with older fathers.

Science Daily reported in Older fathers associated with increased birth risks, study reports:

A decade of data documenting live births in the United States links babies of older fathers with a variety of increased risks at birth, including low birth weight and seizures, according to a new study by researchers at the Stanford University School of Medicine.
The data even suggest that the age of the father can sway the health of the mother during pregnancy, specifically her risk for developing diabetes.
“We tend to look at maternal factors in evaluating associated birth risks, but this study shows that having a healthy baby is a team sport, and the father’s age contributes to the baby’s health, too,” said Michael Eisenberg, MD, associate professor of urology.
Data from more than 40 million births showed that babies born to fathers of an “advanced paternal age,” which roughly equates to older than 35, were at a higher risk for adverse birth outcomes, such as low birth weight, seizures and need for ventilation immediately after birth. Generally speaking, the older a father’s age, the greater the risk. For example, men who were 45 or older were 14 percent more likely to have a child born prematurely, and men 50 or older were 28 percent more likely to have a child that required admission to the neonatal intensive care unit.
Still, these numbers aren’t reason to drastically change any life plans, as the risks are still relatively low, Eisenberg said. He compared the increased risks to buying lottery tickets. “If you buy two lottery tickets instead of one, your chances of winning double, so it’s increased by 100 percent,” he said. “But that’s a relative increase. Because your chance of winning the lottery started very small, it’s still unlikely that you’re going to win the lottery. This is a very extreme example, but the same concept can be applied to how you think about these birth risks.”
Instead, Eisenberg sees the findings as informational ammunition for people planning a family and hopes that they will serve to educate the public and health officials.
A paper describing the study will be published online Nov. 1 in the The British Medical Journal. Eisenberg is the senior author. Resident physician Yash Khandwala, MD, is the lead author…. https://www.sciencedaily.com/releases/2018/11/181101133759.htm

See, Pregnancy at Dr. Wilda https://drwilda.com/tag/pregnancy/

Citation:

Older fathers associated with increased birth risks, study reports
Date: November 1, 2018
Source: Stanford Medicine
Summary:
A decade of data documenting live births in the United States links babies of older fathers with a variety of increased risks at birth, including low birth weight and seizures, according to a new study.

Infants of older fathers are at greater risk of birth complications
BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4595 (Published 01 November 2018) Cite this as: BMJ 2018;363:k4595
Linked research
Association of paternal age with perinatal outcomes
Paternal factors in preconception care: the case of paternal age
BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4466 (Published 31 October 2018) Cite this as: BMJ 2018;363:k4466

Here is the press release from Stanford Medicine:

Older fathers associated with increased birth risks

From the data of more than 40 million births, scientists at Stanford have linked paternal age to birth risks, and even risks to the mother’s health.
A decade of data documenting live births in the United States links babies of older fathers with a variety of increased risks at birth, including low birth weight and seizures, according to a new study by researchers at the Stanford University School of Medicine.
The data even suggest that the age of the father can sway the health of the mother during pregnancy, specifically her risk for developing diabetes.
“We tend to look at maternal factors in evaluating associated birth risks, but this study shows that having a healthy baby is a team sport, and the father’s age contributes to the baby’s health, too,” said Michael Eisenberg, MD, associate professor of urology.
Data from more than 40 million births showed that babies born to fathers of an “advanced paternal age,” which roughly equates to older than 35, were at a higher risk for adverse birth outcomes, such as low birth weight, seizures and need for ventilation immediately after birth. Generally speaking, the older a father’s age, the greater the risk. For example, men who were 45 or older were 14 percent more likely to have a child born prematurely, and men 50 or older were 28 percent more likely to have a child that required admission to the neonatal intensive care unit.
Still, these numbers aren’t reason to drastically change any life plans, as the risks are still relatively low, Eisenberg said. He compared the increased risks to buying lottery tickets. “If you buy two lottery tickets instead of one, your chances of winning double, so it’s increased by 100 percent,” he said. “But that’s a relative increase. Because your chance of winning the lottery started very small, it’s still unlikely that you’re going to win the lottery. This is a very extreme example, but the same concept can be applied to how you think about these birth risks.”
Instead, Eisenberg sees the findings as informational ammunition for people planning a family and hopes that they will serve to educate the public and health officials.
A paper describing the study was published online Nov. 1 in the British Medical Journal. Eisenberg is the senior author. Resident physician Yash Khandwala, MD, is the lead author.
Increased risks at 35
Back in 2017, Eisenberg published a study showing that the number of older men fathering children was on the rise. Now, about 10 percent of infants are born to fathers over the age of 40, whereas four decades ago it was only 4 percent.
“We’re seeing these shifts across the United States, across race strata, across education levels, geography — everywhere you look, the same patterns are being seen,” Eisenberg said. “So I do think it’s becoming more relevant for us to understand the health ramifications of advanced paternal age on infant and maternal health.”
Having a better understanding of the father’s biological role will be obviously important for the offspring, but also potentially for the mother.
Eisenberg and his colleagues used data from 40.5 million live births documented through a data-sharing program run by the Centers for Disease Control and Prevention and the National Center for Health Statistics. The researchers organized the information based on the fathers’ age — younger than 25; 25 to 34; 35 to 44; 45 to 55; and older than 55 — and controlled for a variety of parameters that might skew the association between the father’s age and birth outcomes, such as race, education level, marital status, smoking history, access to care and the mother’s age.
The data suggested that once a dad hits age 35, there’s a slight increase in birth risks overall — with every year that a man ages, he accumulates on average two new mutations in the DNA of his sperm — but birth risks for infants born to fathers of the subsequent age tier showed sharper increases.
Compared with fathers between the ages of 25 and 34 (the average age of paternity in the United States), infants born to men 45 or older were 14 percent more likely to be admitted to the NICU, 14 percent more likely to be born prematurely, 18 percent more likely to have seizures and 14 percent more likely to have a low birth weight. If a father was 50 or older, the likelihood that their infant would need ventilation upon birth increased by 10 percent, and the odds that they would need assistance from the neonatal intensive care unit increased by 28 percent.
“What was really surprising was that there seemed to be an association between advanced paternal age and the chance that the mother would develop diabetes during pregnancy,” said Eisenberg. For men age 45 and older, their partners were 28 percent more likely to develop gestational diabetes, compared with fathers between 25 and 34. Eisenberg points out that possible biological mechanisms at play here are still a bit murky, but he suspects that the mother’s placenta has a role.
Beyond correlation
Moving forward, Eisenberg wants to look into other population cohorts to confirm the associations between age and birth risks, as well as begin to decode some of the possible biological mechanisms.
“Scientists have looked at these kinds of trends before, but this is the most comprehensive study to look at the relationship between the father’s age and birth outcomes at a population level,” said Eisenberg. “Having a better understanding of the father’s biological role will be obviously important for the offspring, but also potentially for the mother.”
Other Stanford co-authors of the study are professor of obstetrics and gynecology Valerie Baker, MD; professor of pediatrics Gary Shaw, DrPH; professor of pediatrics David K. Stevenson, MD; and professor of biomedical data, Ying Lu, PhD.
Eisenberg is a member of Stanford Bio-X, the Stanford Child Health Research Institute and the Stanford Cancer Institute.
Stanford’s Department of Urology also supported the work.
By HANAE ARMITAGE
Hanae Armitage is a science writer for the medical school’s Office of Communication & Public Affairs. Email her at harmitag@stanford.edu. http://med.stanford.edu/news/all-news/2018/10/older-fathers-associated-with-increased-birth-risks.html

There are benefits and cautions for those becoming parents after 35.

Dinah Wisenberg Brin wrote in the CNBC article Older-Parent Families: Advantages and Disadvantages:

Beyond the retirement and college-planning decisions, middle-aged parents may be caring for their own frail, elderly parents at the same time they’re raising preschoolers, a potentially costly prospect that points to another issue: No built-in support network of youthful grandparents who can babysit during parental getaways. CFP Kahler knows this first hand.
“Our childcare bill is as much as our airfare bill,” he says. Trading childcare with other families can defrays the costs, though, he adds.
The age factor similarly can make it difficult for middle-age parents to find willing and able guardians to name in their wills. Lindsay recalls a former client couple in their 40s with young children who had trouble completing their estate planning because they had only older siblings and no one willing to be named as guardians.
“Sometimes it just comes down to making the best decision out of a number of poor alternatives,” Kahler says. “It may mean sending them out of state to someone, you may be looking to nieces and nephews who could potentially raise a child.”
Older-parent families can face other advantages and disadvantages, as well.
“I think my kids will need less therapy than if I’d had kids in my 20s,” Kahler jokes. On the other hand, he notes there are costs associated with the care of an aging body. “I tell my kids, `The horsey can only go up and down the hallway a couple of times before the horsey runs out of gas.’ ” https://www.cnbc.com/id/44378785

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

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Dartmouth College study: Humans and others exposed to prenatal stress have high stress levels after birth

15 Apr

Moi reported about the effect stress has on genes in Penn State study: Stress alters children’s genomes https://drwilda.com/2014/04/08/penn-state-study-stress-alters-childrens-genomes/ A Tulane Medical School study finds that family violence or trauma alters a child’s genomes.

Science Daily reported in the article, Family violence leaves genetic imprint on children:

A new Tulane University School of Medicine study finds that the more fractured families are by domestic violence or trauma, the more likely that children will bear the scars down to their DNA.
Researchers discovered that children in homes affected by domestic violence, suicide or the incarceration of a family member have significantly shorter telomeres, which is a cellular marker of aging, than those in stable households. The findings are published online in the latest issue of the journal Pediatrics.
Telomeres are the caps at the end of chromosomes that keep them from shrinking when cells replicate. Shorter telomeres are linked to higher risks for heart disease, obesity, cognitive decline, diabetes, mental illness and poor health outcomes in adulthood. Researchers took genetic samples from 80 children ages 5 to 15 in New Orleans and interviewed parents about their home environments and exposures to adverse life events….
The study found that gender moderated the impact of family instability. Traumatic family events were more detrimental to young girls as they were more likely to have shortened telomeres. There was also a surprising protective effect for boys: mothers who had achieved a higher level of education had a positive association with telomere length, but only in boys under 10.
Ultimately, the study suggests that the home environment is an important intervention target to reduce the biological impacts of adversity in the lives of young children, Drury said. http://www.sciencedaily.com/releases/2014/06/140617102505.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily%2Ftop_news%2Ftop_science+%28ScienceDaily%3A+Top+Science+News%29&utm_content=FaceBook

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

Science Daily reported in Humans and others exposed to prenatal stress have high stress levels after birth:

Vertebrate species, including humans, exposed to stress prenatally tend to have higher stress hormones after birth, according to a new Dartmouth-led study published in Scientific Reports. While previous research has reported examples of maternal stress experience predicting offspring stress hormones in different species, this study is the first to empirically demonstrate the impact of prenatal stress on offspring stress hormone levels using data from all known studies across vertebrates.
Through a meta-analysis of 114 results from a total of 39 observational and experimental studies across 14 vertebrate species, including birds, snakes, sheep and humans, the study examines the impact of prenatal exposure to maternal stress on offspring. The researchers analyzed the role of the hypothalamic pituitary adrenal (HPA)-axis, the stress physiological system that is shared across all vertebrates, which ultimately, results in the production of stress hormones known as “glucocorticoids.” The HPA-axis is the hormonal system responsible for mobilizing an animal’s stress response. Offspring exposed prenatally to maternal stress were found to have more stress hormone levels (glucocorticoids) after birth. This could reflect a biological adaptation with an evolutionary history, as more stress hormones could increase an animal’s chances for survival in a stressful environment.
In the present study, the researchers tested the strength of the effect of prenatal stress on offspring stress hormone levels across a range of characteristics. Remarkably, the effects of prenatal stress on offspring stress hormones were consistent across species, regardless of evolutionary relationships or factors, such as brain or body size. There were also no differences when considering offspring sex, age of the offspring at the time of assessment, or the timing of the stressor exposure prenatally or its severity.
Only two factors influenced the size of the effect. Experimental studies had a stronger effect than observational studies. In addition, studies that measured glucocorticoid recovery showed a greater association with prenatal stress than was observed at baseline or during peak glucocorticoid response….
An animal’s stress response tends to be activated by external factors, such as when its see a predator or whether food is availabile. Higher stress hormone levels among offspring may help extend survival but come at a cost and may affect other physiological systems, such as reproduction. In humans, the mere anticipation of stress or just thinking about prior experiences of discrimination or trauma can activate a stress response. Overactive stress hormones can lead to chronic health problems in humans, including anxiety, depression and cardiovascular disease.
One of the studies included in the meta-analysis looked at how maternal stress hormones in pregnant snow hares changed in relation to the abundance of their natural predators, lynxes, over a 10-year cycle. The research team found that in years where there were more lynxes, snow hare offspring had more stress hormones and anti-predator behaviors….’’ https://www.sciencedaily.com/releases/2018/04/180410161135.htm

Citation:

Humans and others exposed to prenatal stress have high stress levels after birth
Date: April 10, 2018
Source: Dartmouth College
Summary:
Vertebrate species, including humans, exposed to stress prenatally tend to have higher stress hormones after birth, according to a new study. While previous research has reported examples of maternal stress experience predicting offspring stress hormones in different species, this study is the first to empirically demonstrate the impact of prenatal stress on offspring stress hormone levels using data from all known studies across vertebrates.

Journal Reference:
1. Zaneta M. Thayer, Meredith A. Wilson, Andrew W. Kim, Adrian V. Jaeggi. Impact of prenatal stress on offspring glucocorticoid levels: A phylogenetic meta-analysis across 14 vertebrate species. Scientific Reports, 2018; 8 (1) DOI: 10.1038/s41598-018-23169-w

Here is the press release from Dartmouth College:

Public Release: 10-Apr-2018
Study finds humans and others exposed to prenatal stress have high stress levels after birth
Dartmouth College
Vertebrate species, including humans, exposed to stress prenatally tend to have higher stress hormones after birth, according to a new Dartmouth-led study published in Scientific Reports. While previous research has reported examples of maternal stress experience predicting offspring stress hormones in different species, this study is the first to empirically demonstrate the impact of prenatal stress on offspring stress hormone levels using data from all known studies across vertebrates.
Through a meta-analysis of 114 results from a total of 39 observational and experimental studies across 14 vertebrate species, including birds, snakes, sheep and humans, the study examines the impact of prenatal exposure to maternal stress on offspring. The researchers analyzed the role of the hypothalamic pituitary adrenal (HPA)-axis, the stress physiological system that is shared across all vertebrates, which ultimately, results in the production of stress hormones known as “glucocorticoids.” The HPA-axis is the hormonal system responsible for mobilizing an animal’s stress response. Offspring exposed prenatally to maternal stress were found to have more stress hormone levels (glucocorticoids) after birth. This could reflect a biological adaptation with an evolutionary history, as more stress hormones could increase an animal’s chances for survival in a stressful environment.
In the present study, the researchers tested the strength of the effect of prenatal stress on offspring stress hormone levels across a range of characteristics. Remarkably, the effects of prenatal stress on offspring stress hormones were consistent across species, regardless of evolutionary relationships or factors, such as brain or body size. There were also no differences when considering offspring sex, age of the offspring at the time of assessment, or the timing of the stressor exposure prenatally or its severity.
Only two factors influenced the size of the effect. Experimental studies had a stronger effect than observational studies. In addition, studies that measured glucocorticoid recovery showed a greater association with prenatal stress than was observed at baseline or during peak glucocorticoid response.
“Animals, including humans, modify their stress hormones in response to their environment. Your stress response is set like a thermostat– your body can amp up or down stress hormones in response to anticipated environmental conditions,” explains lead author Zaneta Thayer, an assistant professor of anthropology at Dartmouth.
An animal’s stress response tends to be activated by external factors, such as when its see a predator or whether food is availabile. Higher stress hormone levels among offspring may help extend survival but come at a cost and may affect other physiological systems, such as reproduction. In humans, the mere anticipation of stress or just thinking about prior experiences of discrimination or trauma can activate a stress response. Overactive stress hormones can lead to chronic health problems in humans, including anxiety, depression and cardiovascular disease.
One of the studies included in the meta-analysis looked at how maternal stress hormones in pregnant snow hares changed in relation to the abundance of their natural predators, lynxes, over a 10-year cycle. The research team found that in years where there were more lynxes, snow hare offspring had more stress hormones and anti-predator behaviors.
“Our stress response is meant to be adaptive to acute stress, such as being chased by predators. However, humans’ stress response is often triggered by social evaluative threats and is not serving the adaptive purpose that it was designed for,” added Thayer. “This research confirms what other scientists have long speculated that there are trends across species when it comes to linking prenatal stress and offspring hormonal stress responses.”
Prior work co-authored by Thayer has explored early origins of humans’ health disparities and the impacts of maternal stress during pregnancy on offspring’s postnatal stress hormone levels.
###
Thayer is available for comment at: Zaneta.Marie.Thayer@dartmouth.edu.
Meredith A. Wilson at the University of Illinois Urbana-Champaign, Andrew W. Kim at Northwestern University and Adrian V. Jaeggi at Emory University, also served as co-authors of the study.
Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.
https://sciencesources.eurekalert.org/pub_releases/2018-04/dc-sfh041018.php

Here is information about the Adverse Child Experiences Study. The Centers for Disease Control and Prevention provides access to the peer-reviewed publications resulting from The ACE Study. http://acestudy.org/
https://drwilda.com/2012/11/09/study-some-of-the-effects-of-adverse-stress-do-not-go-away/

Science Daily reported in Infantile memory study points to critical periods in early-life learning for brain development:

A new study on infantile memory formation in rats points to the importance of critical periods in early-life learning on functional development of the brain. The research, conducted by scientists at New York University’s Center for Neural Science, reveals the significance of learning experiences over the first two to four years of human life; this is when memories are believed to be quickly forgotten — a phenomenon known as infantile amnesia.
“What our findings tell us is that children’s brains need to get enough and healthy activation even before they enter pre-school,” explains Cristina Alberini, a professor in NYU’s Center for Neural Science, who led the study. “Without this, the neurological system runs the risk of not properly developing learning and memory functions…”
https://www.sciencedaily.com/releases/2016/07/160718111939.htm

Citation:

Infantile memory study points to critical periods in early-life learning for brain development
Date: July 18, 2016
Source: New York University
Summary:
A new study on infantile memory formation in rats points to the importance of critical periods in early-life learning on functional development of the brain. The research reveals the significance of learning experiences over the first two to four years of human life.

Journal Reference:
1. Alessio Travaglia, Reto Bisaz, Eric S Sweet, Robert D Blitzer, Cristina M Alberini. Infantile amnesia reflects a developmental critical period for hippocampal learning. Nature Neuroscience, 2016; DOI: 10.1038/nn.4348

Our goal as a society should be:

A healthy child in a healthy family who attends a healthy school in a healthy neighborhood ©

Resources:

The Effects of Stress on Your Body
http://www.webmd.com/mental-health/effects-of-stress-on-your-body

The Physical Effects of Long-Term Stress
http://psychcentral.com/lib/2007/the-physical-effects-of-long-term-stress/all/1/

Chronic Stress: The Body Connection
http://www.medicinenet.com/script/main/art.asp?articlekey=53737

Understanding Stress Symptoms, Signs, Causes, and Effects
http://www.helpguide.org/mental/stress_signs.htm

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 ©
https://drwilda.com/

University of Melbourne study: Securing a child’s future needs to start during parents’ teen years

26 Feb

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 Securing a child’s future needs to start during parents’ teen years:

The article in the latest edition of Nature argues that tackling health problems including obesity, mental health, poor nutrition and substance abuse in young people before they become parents is essential for the best possible start to life for their future children.
Researchers from the Murdoch Children’s Research Institute (MCRI) and the University of Melbourne said that taking action once a woman knows she is pregnant is often starting too late.
Young women and men often carry lifestyle and health risks from adolescence into pregnancy, they added, even if this happens in their 20s or 30s.
Lead author Professor George Patton said: “The first 1000 days of a child’s life are crucially important, but that is too late to be taking action. Current policies to promote the best possible start to life in Australia along with most other countries are starting too late.
“Health and lifestyle in the months immediately before pregnancy matters for both young mothers and fathers-to-be,” Professor Patton said.
“The health system now only kicks into action with a woman’s first antenatal visit, most often eight to 14 weeks into a pregnancy. We need the health service system to be engaged before pregnancy — and it should go beyond its current focus on contraception to tackle broader health risks and emotional well-being in both young women and men….
The paper brought together data from around 200 countries and from more than 140 recent research papers.
It considered mechanisms other than genes for how health and growth was transmitted between generations, including changes in a father’s sperm or a mother’s ovum, maternal influences around the time of conception and in later pregnancy, and parenting in the first two years after birth.
In high and middle income countries, the paper highlighted three main areas for action in adolescence: mental health, obesity and substance abuse.
Professor Patton said: “Maternal depression during pregnancy may affect a baby’s development before birth and the mother-child bond after birth. Both depression in pregnancy and after birth are generally a continuation of pre-pregnancy mental health problems that date back to adolescence….” https://www.sciencedaily.com/releases/2018/02/180221131932.htm

Citation:

Securing a child’s future needs to start during parents’ teen years
Date: February 21, 2018
Source: University of Melbourne
Summary:
A child’s growth and development is affected by the health and lifestyles of their parents before pregnancy — even going back to adolescence — according to a new paper.

Journal Reference:
1. George C. Patton, Craig A. Olsson, Vegard Skirbekk, Richard Saffery, Mary E. Wlodek, Peter S. Azzopardi, Marcin Stonawski, Bruce Rasmussen, Elizabeth Spry, Kate Francis, Zulfiqar A. Bhutta, Nicholas J. Kassebaum, Ali H. Mokdad, Christopher J. L. Murray, Andrew M. Prentice, Nicola Reavley, Peter Sheehan, Kim Sweeny, Russell M. Viner, Susan M. Sawyer. Adolescence and the next generation. Nature, 2018; 554 (7693): 458 DOI: 10.1038/nature25759

Here is the press release from the University of Melbourne:

Securing a child’s future needs to start during parents’ teen years
22 February 2018
A child’s growth and development is affected by the health and lifestyles of their parents before pregnancy – even going back to adolescence – according to a new paper.
The article in the latest edition of Nature argues that tackling health problems including obesity, mental health, poor nutrition and substance abuse in young people before they become parents is essential for the best possible start to life for their future children.
Researchers from the Murdoch Children’s Research Institute (MCRI) and the University of Melbourne said that taking action once a woman knows she is pregnant is often starting too late.
Young women and men often carry lifestyle and health risks from adolescence into pregnancy, they added, even if this happens in their 20s or 30s.
Lead author Professor George Patton said: “The first 1000 days of a child’s life are crucially important, but that is too late to be taking action. Current policies to promote the best possible start to life in Australia along with most other countries are starting too late.
“Health and lifestyle in the months immediately before pregnancy matters for both young mothers and fathers-to-be,” Professor Patton said.
“The health system now only kicks into action with a woman’s first antenatal visit, most often eight to 14 weeks into a pregnancy. We need the health service system to be engaged before pregnancy – and it should go beyond its current focus on contraception to tackle broader health risks and emotional well-being in both young women and men.
“Today’s adolescents will be the largest generation to become parents in human history. We need to invest in their physical, social and emotional development to guarantee not only their own future health but that of their children.”
The paper brought together data from around 200 countries and from more than 140 recent research papers.
It considered mechanisms other than genes for how health and growth was transmitted between generations, including changes in a father’s sperm or a mother’s ovum, maternal influences around the time of conception and in later pregnancy, and parenting in the first two years after birth.
In high and middle income countries, the paper highlighted three main areas for action in adolescence: mental health, obesity and substance abuse.
Professor Patton said: “Maternal depression during pregnancy may affect a baby’s development before birth and the mother-child bond after birth. Both depression in pregnancy and after birth are generally a continuation of pre-pregnancy mental health problems that date back to adolescence.”
There is a rapid increase in obesity across adolescence and young adulthood, according to the authors. Maternal obesity during pregnancy predicts later childhood obesity, poorer cognitive skills and greater childhood behavioural problems.
Smoking, alcohol and drug use rise steeply in adolescence, the researchers said. They found consistent and clear evidence that persisting maternal tobacco, alcohol, cannabis and other illicit drug use in pregnancy adversely affects offspring growth
and development. Stopping use when a woman recognises she is pregnant may be too late to address the early effects on a baby.
“Some risks for children like parental obesity and depression need a long-term approach. At a time when obesity, mental health problems and heavy substance use have become common in young adults, prevention beginning in adolescence will be essential,” Professor Patton said.
For many lower income countries, the paper recommended major actions around ending child marriage, delaying first pregnancy through contraception and girls staying in school, and tackling under-nutrition.
“We need health services to go beyond a traditional focus on reproductive health, to a more comprehensive and integrated engagement with adolescent and young adult health; and we need to create health-promoting environments in the families, schools, workplaces and communities where adolescents are growing up,” Professor Patton said.
The authors also questioned the age range of adolescence. Current research suggests that physical and neurological growth continues into the 20s. The paper said this, combined with social changes such as the later adoption of adult roles, meant adolescence was better considered to range between 10 and 24.
University of Melbourne and MCRI researcher and paper author Professor Susan Sawyer said: “From this perspective, adolescence occupies a greater proportion of the life-course with greater relevance for human development than ever before. An extended adolescence creates an opportunity for this generation to acquire greater assets and capabilities and that will make a huge difference not only for themselves but for their children.” http://newsroom.melbourne.edu/news/securing-child%E2%80%99s-future-needs-start-during-parents%E2%80%99-teen-years

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 ©

Blogs by Dr. Wilda:

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

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

Dr. Wilda ©
https://drwilda.com/

Aarhus University study: Using antidepressants during pregnancy may affect your child’s mental health

9 Sep

Laura G Owens wrote in the Huffington Post article, What I Wished I’d Had: Maternal Mental Health Screening:

When I was pregnant nineteen years ago I wish my doctor had warned me I might be at risk for postpartum depression.
Her words wouldn’t have freaked me out, they would have helped me cope when the darkness did indeed hit.
I wish during my 6 week check-up (when I was at my private worst) my Ob-Gyn had handed me a mental health screening and even if I lied on every question, she still explained how the “baby blues” are different than depression.
In January for the first time the United States Preventive Services Task Force recommended screening pregnant and postpartum women for maternal mental illness.
Hopefully now more health care practitioners will talk to women so those who suffer know they’re not bad people or rotten mothers or God knows, alone.
The fact is worldwide 10% of pregnant women and 13% of postpartum women have a mental disorder and the numbers are even higher in developing countries.
While maternal mental illness is often lumped into the catchall “postpartum depression” it’s more complicated than a single kitchen sink diagnosis.
Symptoms can show up during pregnancy or long after birth and they don’t always look like depression, sometimes they look like:
• Anxiety
• Panic disorder
• Post-traumatic stress disorder
• Obsessive compulsive disorder
• Psychosis
Alone, or in combination.
Mental illness has always been stigmatized but especially inside the idealized institution of motherhood where pretending superhuman resilience to change, sleep deprivation, anger, frustration, fear, anxiety and sadness awards women the coveted “best” mother prize…. http://www.huffingtonpost.com/laura-g-owens/maternal-mental-health-screening_b_9485446.html

The timing of a pregnancy should include diagnosis of potential maternal mental health issues and what treatment may be necessary.

Science Daily reported in Using antidepressants during pregnancy may affect your child’s mental health:

The use of antidepressants has been on the rise for many years. Between 2 and 8% of pregnant women are on antidepressants. Now researchers from the National Centre for Register-based Research at Aarhus BSS show that there is an increased risk involved in using antidepressants during pregnancy.
The researchers, headed by Xiaoqin Liu, have applied register-based research to the study of 905,383 children born between 1998 and 2012 with the aim of exploring the possible adverse effects of the mother’s use of antidepressants during her pregnancy.
They found that out of the 905,383 children in total, 32,400 developed a psychiatric disorder later in life. Some of these children were born to mothers who were on antidepressants during their pregnancy, while other children had not been exposed to medication.
“When we look at children born to mothers who discontinued and continued antidepressant treatment during pregnancy, we can see an increased risk of developing a psychiatric disorder if the mothers continued antidepressant treatment while pregnant,” says Xiaoqin Liu, who is the lead author of the article, which has just been published in BMJ-British Medical Journal.
More specifically, the researchers divided the children into four groups depending on the mother’s use of antidepressants before and during pregnancy. The children in group 1 had not been exposed to antidepressants in the womb. In group 2, the mothers had been taking antidepressants up until the pregnancy, but not during. In group 3, the mothers were using antidepressants both before and during the pregnancy. Group 4 consisted of children, whose mothers were new users of antidepressants and had started taking the medication during the pregnancy.
The result of the study showed an increased number of children with psychiatric disorders in the group in which the mothers had been using antidepressants during their pregnancy. Approximately twice as many children were diagnosed with a psychiatric disorder in group 4 (14.5%) than in group 1 (8%). In groups 2 and 3 respectively, 11.5% and 13.6% were diagnosed with a psychiatric disorder at age 16 years.
Psychiatric disorders are hereditary
In their analyses, the researchers took into account that heritability also plays a part in determining who will be diagnosed with a psychiatric disorder, and that it is not just a question of being exposed to antidepressants in the womb…. https://www.sciencedaily.com/releases/2017/09/170907112400.htm

Citation:

Using antidepressants during pregnancy may affect your child’s mental health
Date: September 7, 2017
Source: Aarhus University
Summary:
The use of antidepressants during pregnancy increases the risk of your child being diagnosed with a psychiatric disorder later in life, a study of almost one million Danish children shows. However, heritability also plays a part, according to the researchers.
Journal Reference:
1. Xiaoqin Liu, Esben Agerbo, Katja G Ingstrup, Katherine Musliner, Samantha Meltzer-Brody, Veerle Bergink, Trine Munk-Olsen. Antidepressant use during pregnancy and psychiatric disorders in offspring: Danish nationwide register based cohort study. BMJ, 2017; j3668 DOI: 10.1136/bmj.j3668

Here is the press release from Aarhus University:

Using antidepressants during pregnancy may affect your child’s mental health
A study from Aarhus BSS of almost one million Danish children shows that the use of antidepressants during pregnancy increases the risk of your child being diagnosed with a psychiatric disorder later in life. However, heritability also plays a part, according to the researchers.
2017.09.07 | Ingrid Marie Fossum
The use of antidepressants has been on the rise for many years. Between 2 and 8% of pregnant women are on antidepressants. Now researchers from the National Centre for Register-based Research at Aarhus BSS show that there is an increased risk involved in using antidepressants during pregnancy.
The researchers, headed by Xiaoqin Liu, have applied register-based research to the study of 905,383 children born between 1998 and 2012 with the aim of exploring the possible adverse effects of the mother’s use of antidepressants during her pregnancy.
They found that out of the 905,383 children in total, 32,400 developed a psychiatric disorder later in life. Some of these children were born to mothers who were on antidepressants during their pregnancy, while other children had not been exposed to medication.
“When we look at children born to mothers who discontinued and continued antidepressant treatment during pregnancy, we can see an increased risk of developing a psychiatric disorder if the mothers continued antidepressant treatment while pregnant,” says Xiaoqin Liu, who is the lead author of the article, which has just been published in BMJ-British Medical Journal.
More specifically, the researchers divided the children into four groups depending on the mother’s use of antidepressants before and during pregnancy. The children in group 1 had not been exposed to antidepressants in the womb. In group 2, the mothers had been taking antidepressants up until the pregnancy, but not during. In group 3, the mothers were using antidepressants both before and during the pregnancy. Group 4 consisted of children, whose mothers were new users of antidepressants and had started taking the medication during the pregnancy.
The result of the study showed an increased number of children with psychiatric disorders in the group in which the mothers had been using antidepressants during their pregnancy. Approximately twice as many children were diagnosed with a psychiatric disorder in group 4 (14.5%) than in group 1 (8%). In groups 2 and 3 respectively, 11.5% and 13.6% were diagnosed with a psychiatric disorder at age 16 years.
Psychiatric disorders are hereditary
In their analyses, the researchers took into account that heritability also plays a part in determining who will be diagnosed with a psychiatric disorder, and that it is not just a question of being exposed to antidepressants in the womb.
“We chose to conduct the study on the assumption that psychiatric disorders are highly heritable. For this reason, we wanted to show that is too narrow if you only look at autism, which is what many previous studies have done. If heritability plays a part, other psychiatric disorders such as depression, anxiety, ADHD-like symptoms would also appear in the data,” says Trine Munk-Olsen, who is also one of the researchers behind the study.
Indeed, the study also shows that the increase covers not only autism but also other psychiatric disorders such as depression, anxiety, and ADHD. Thus it becomes clear that the mother’s underlying psychiatric disorder matters in relation to the child’s mental health later in life. At the same time, it cannot be ruled out that the use of antidepressants further increases the risk of psychiatric diseases in the child.
“Our research shows that medication seems to increase the risk, but that heritability also plays a part,” says Trine Munk-Olsen, who also points out that it might be the mothers who suffer from the most severe forms of depression who need to take medication during their pregnancy.
Not just black and white
The researchers hope that the study can increase the focus on the fact that the research results are not just black and white. This could help doctors advise women on the use of antidepressants both before and after their pregnancy. Some women might be able to discontinue treatment with the medication while pregnant. However, the researchers also acknowledge that some women need medication and stress that the consequences of an untreated depression are severe and can lead to serious consequences to both mother and child.
The most important message is that we ensure and safeguard the mental well-being of the pregnant women, and for some women, this involves the use of antidepressants.
“These women should not feel guilty about taking antidepressants. Even though there is an increased risk of the child developing a psychiatric disorder later in life, our research shows that we cannot blame medication alone. Heritability also plays a part,” says Trine Munk-Olsen.
Facts:
• The article “Antidepressant use during pregnancy and psychiatric disorders in the offspring: A Danish nationwide register-based cohort study” has been published in the medical journal BMJ-British Medical Journal.
• The research has been conducted by researchers at the National Centre for Register-based Research at Aarhus BSS in collaboration with an American and a Dutch psychiatrist.
• The research has been partly funded by The Lundbeck Foundation Initiative for Integrative Psychiatric Research”- iPSYCH, as well as the National Institute of Mental Health (NIMH) (R01MH104468)
• The study includes all children born in Denmark between 1998 and 2012. The study followed the children until 2014, where some of the children were 16,5 years old.
Further info:
Trine Munk-Olsen
Senior Researcher
National Centre for Register-based Research
Aarhus BSS, Aarhus University
tmo@econ.au.dk
+45 87165749 / + 45 51505161
¬Xiaoqin Liu
Postdoc
National Centre for Register-based Research
Aarhus BSS, Aarhus University
lxq@econ.au.dk
+45 87165358

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 societies’ problems would be lessened if the goal was a healthy child in a healthy family.

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 ©
https://drwilda.com/

University of Pittsburgh Schools of the Health Sciences study: Women, particularly minorities, do not meet nutrition guidelines shortly before pregnancy

20 Mar

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

Citation:

Women, particularly minorities, do not meet nutrition guidelines shortly before pregnancy

Date:       March 17, 2017

Source:    University of Pittsburgh Schools of the Health Sciences

Summary:

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 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.

Journal Reference:

  1. Uma M. Reddy, MD et al. Racial or Ethnic and Socioeconomic Inequalities in Adherence to National Dietary Guidance in a Large Cohort of US Pregnant Women. Journal of the Academy of Nutrition and Dietetics, March 2017 DOI: 10.1016/j.jand.2017.01.016

Here is the press release from U Pitt:

Women, Particularly Minorities, Do Not Meet Nutrition Guidelines Shortly Before Pregnancy

PITTSBURGH, March 17, 2017 – 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 today 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.

The scores increased with greater education levels for all three racial/ethnic groups, but the increase was strongest among white women. At all levels of education—high school or less through graduate degree—black mothers had the lowest average scores.

When scores were broken down into the 12 aspects of diet, fewer than 10 percent of the women met the dietary guideline for the whole grains, fatty acids, sodium or empty calories categories.

Approximately 34 percent of the calories—or energy—the women consumed were from empty calories. Top sources of energy were sugar-sweetened beverages, pasta dishes and grain desserts. Soda was the primary contributor to energy intake among black, Hispanic and less-educated women. Women with a college or graduate degree consumed more energy from beer, wine and spirits than any other source.

Juices and sugar-sweetened beverages combined for a much larger proportion of vitamin C intake than solid fruits or vegetables for black, Hispanic and less-educated women. The opposite was true for white women or more-educated women.

For all groups, green salad was the only vegetable in the top 10 sources of iron. Green salad and processed cereals were the top two sources of folate for all groups except black women, whose second highest folate source was 100 percent orange or grapefruit juice. Folate and iron are important nutrients for developing fetuses and healthy pregnancies.

“Our findings mirror national nutrition and dietary trends.  The diet quality gap among non-pregnant people is thought to be a consequence of many factors, including access to and price of healthy foods, knowledge of a healthy diet, and pressing needs that may take priority over a healthy diet,” said Bodnar, also an associate professor of obstetrics, gynecology and reproductive sciences at Pitt’s School of Medicine. “Future research needs to determine if improving pre-pregnancy diet leads to better pregnancy and birth outcomes. If so, then we need to explore and test ways to improve the diets for everyone, particularly women likely to become pregnant.”

Additional authors on this research include senior author Uma M. Reddy, M.D., of the Eunice Kennedy Shriver National Institute of Child Health and Human Development; as well as Hyagriv N. Simhan, M.D., of Pitt; Corette B. Parker, Dr.P.H., and Heather Meier, both of RTI International; Brian M. Mercer, M.D., of Case Western Reserve University; William A. Grobman, M.D., and Alan M. Peaceman, M.D., both of Northwestern University; David M. Haas, M.D., and Shannon Barnes, R.N., both of Indiana University; Deborah A. Wing, M.D., and Pathik D. Wadhwa, M.D., Ph.D., both of the University of California Irvine; Matthew K. Hoffman, M.D., of the Christiana Care Health System; Samuel Parry, M.D., and Michal Elovitz, M.D., both of the University of Pennsylvania; Robert M. Silver, M.D., and Sean Esplin, M.D., both of the University of Utah; George R. Saade, M.D., of the University of Texas; Ronald Wapner, M.D., of Columbia University; and Jay D. Iams, M.D., of The Ohio State University.

This study is supported by grant funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, as well as RTI International grant U10 HD06336, Case Western Reserve University grant U10 HD063072, Columbia University grant U10 HD063047, Indiana University grant U10 HD063037, Pitt grant U10 HD063041, Northwestern University grant U10 HD063020, University of California Irvine grant U10 HD063046, University of Pennsylvania grant U10 HD063048 and University of Utah grant U10 HD063053.

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http://www.upmc.com/media/NewsReleases/2017/Pages/bodnar-pregnancy-nutrition.aspx

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 Planned Parenthood or some other 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 ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©

http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©

http://drwildareviews.wordpress.com/

Dr. Wilda ©

https://drwilda.com/