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Category: pregnancy and childbirth

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Years ago the advice was to really limit exercise during pregnancy, but times have changed. Now studies find exercise during pregnancy beneficial for both the mother and baby. From Discover:

Exercise During Pregnancy Benefits Mom—And Baby, Too

Women who exercise with baby on board have been known to have, among other things, lower risks of gestational diabetes and pregnancy-induced high blood pressure than those who don’t.

In 1985, the American Congress of Obstetricians and Gynecologists came out with their first set of guidelines for exercise during pregnancy—guidelines, now considered conservative, that included suggestions like keeping strenuous activities to 15 minutes or less. Since then, research has turned that idea on its head. Exercise is now thought to be—for most women with healthy pregnancies—a boon for the mother's health, and for the baby she carries as well.

It’s been known that those who exercise—including pregnant women—tend to have lower resting heart rates than those who don’t. Lower heart rates can be a sign of an efficient heart; high heart rates have been linked to greater risk of cardiovascular disease. May, now at East Carolina University in North Carolina, has long been interested whether benefits like this extended to baby.  In a 2010 study, she and her colleagues collected a group of 26 pregnant women who reported that they’d been exercising three times a week for more than 30 minutes per session.  When researchers brought the moms into the lab at 36 weeks, they found that the babies in their bellies, too, had lower heart rates than those carried by the moms they studied who weren’t regular exercisers.

The results indicate that exercise during pregnancy, far from harming the fetus, can be incredibly beneficial for both mom and baby. And timing matters: exercise during pregnancy, as opposed to pre-pregnancy fitness, seems to be doing something extra-special, May says. In this most recent study, about half of the group hadn’t exercised previously, and still saw similar effects on their babies’ hearts. 

Such benefits to the heart may last into a child’s early life. Earlier this year, May and colleagues found that month-old infants still had higher heart rate variability if they had exercised along with their moms in utero. Another set of results from May’s group, not yet published, suggests that kids up to six years old still carry some of these early workouts with them: youngsters whose moms exercised while pregnant have higher “ejection fractions,” which indicates their hearts are pumping blood more efficiently.

Studies report that only about 10 to 30 percent of pregnant women are following recommended exercise guidelines—for healthy women, at least 30 minutes of moderate exercise most, if not all, days, according to the American Congress of Obstetricians and Gynecologists.. (Of course, some women can’t safely exercise during part or all of their pregnancy, and active women should watch out for warning signs while exercising, such as bleeding or contractions.)

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Researchers found that many common chemicals, including Triclosan, interfere with normal sperm function. Perhaps this is contributing to fertility problems.From Science Daily:

Endocrine disruptors impair human sperm function, research finds

A plethora of endocrine-disrupting chemicals interfere with human sperm function in a way that may have a negative impact on fertilization. These are the findings of a German -- Danish team of researchers from the Center of Advanced European Studies and Research in Bonn, Germany, and the University Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark. The work, which is published in EMBO reports,suggests that endocrine disruptors may contribute to widespread fertility problems in the Western world in a way that hitherto has not been recognized.

Endocrine disruptors are present in food, textiles, drugs, household, and personal-care products such as plastic bottles, toys, and cosmetics. Proving the deleterious effects of endocrine disruptors on human beings has been difficult due to a lack of suitable experimental systems.

"For the first time, we have shown a direct link between exposure to endocrine disrupting chemicals from industrial products and adverse effects on human sperm function,'' said Niels E. Skakkebaek, professor and leader of the Danish team.

Hundreds to thousands of chemicals can be rapidly tested for their potential to interfere with human sperm function using the bioassay developed by the researchers. In this initial study, about one hundred chemicals were tested. Around one third, including ultraviolet (UV) filters like 4-methylbenzylidene camphor (4-MBC) used in some sunscreens, the anti-bacterial agent Triclosan used in toothpaste, and di-n-butylphthalate (DnBP), showed adverse actions.

Altogether, the study indicates that endocrine disruptors might disturb the precisely coordinated sequence of events underlying fertilization in several ways: the chemicals might evoke changes in swimming behaviour at the wrong time and wrong place, hinder navigation of sperm towards the egg, and hamper penetration into the protective egg coat.

Different article about the same research, and here they also discuss the very important finding that mixtures of common chemicals have an even stronger adverse "cocktail effect" on sperm. From The Independent:

Chemicals in soap can cause male infertility, claim scientists

They also found that the concentrations needed to trigger these adverse reactions were similar to the very low levels commonly found within the human body. In addition, they showed for the first time that there was a “cocktail effect”, when a number of chemicals worked together to amplify their individual effects.

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From NPR:

More Hints That Dad's Age At Conception Helps Shape A Child's Brain

Traditionally, research has focused on women's "biological clock." But in recent years, scientists have been looking more and more at how the father's age at conception might affect the baby, too. A study published Wednesday hints that age really might matter — in terms of the child's mental health.

Researchers from the University of Indiana and the Karolinska Institute found that compared with children fathered by men who were 20-24 years old, kids born to dads who were 45 or older were three times as likely to have autism and 13 times as likely to have ADHD. Kids born to older dads were also more likely to go on to develop substance abuse problems and get lower grades in school. The findings appear in JAMA Psychiatry.

To figure out how paternal age was related to children's psychiatric health, the researchers looked at millions of parents in Sweden who had children between 1973 and 2001. The researchers took into account the mother's age, as well as other demographic factors that might play a role in the child's cognitive development and mental health.

"There's a growing body of literature that suggests that advancing paternal age is associated with a host of problems," D'Onofrio tells Shots. Another study, published in JAMA Psychiatrylast month, found that the children of older fathers seemed to be at greater risk for developing schizophrenia and autism.

D'Onofrio and his colleagues paid special attention to siblings and cousins, and found that even among kids in the same extended family, a dad's age when his child was born made a difference.

The results are in line with a growing body of research linking older fatherhood with various developmental problems in children.

However, the study looks only at how paternal age and children's mental health are associated — it's a correlation, Reichenberg cautions, not a proven causal link. Scientists haven't yet determined the mechanisms of the effect. But it doesn't seem to be simply a matter of overdiagnosis among the children of older parents, the scientists say. Other research has found that as men get older, their sperm cells are more likely to contain random mutations that might, theoretically, contribute to disorders like autism in their kids.

Ultimately, men and women of all ages, he says, should remember that age is only one of many factors influencing the developing baby's health.

"The most important thing is [that] future mothers and fathers should still go ahead and have children, even if the father is older than 45 or 50," Reichenberg says. "Most of these children will be absolutely fine."

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Acetaminophen was the one nonprescription medication that for decades pregnant women thought was safe to take. Looks like not any more - a study found that taking acetaminophen during pregnancy was associated with hyperkinetic disorder and ADHD at age 7. And the longer it was taken during pregnancy, the stronger the association. From Science Daily:

Use of acetaminophen during pregnancy linked to ADHD in children, researchers say

Acetaminophen, found in over-the-counter products such as Excedrin and Tylenol, provides many people with relief from headaches and sore muscles. When used appropriately, it is considered mostly harmless. Over recent decades, the drug, which has been marketed since the 1950s, has become the medication most commonly used by pregnant women for fevers and pain.

In a report in the current online edition of JAMA Pediatrics,researchers from the UCLA Fielding School of Public Health show that taking acetaminophen during pregnancy is associated with a higher risk in children of attention-deficity/hyperactivity disorder and hyperkinetic disorder. The data raises the question of whether the drug should be considered safe for use by pregnant women.

ADHD, one of the most common neurobehavioral disorders worldwide, is characterized by inattention, hyperactivity, increased impulsivity, and motivational and emotional dysregulation. Hyperkinetic disorder is a particularly severe form of ADHD.

The UCLA researchers used the Danish National Birth Cohort, a nationwide study of pregnancies and children, to examine pregnancy complications and diseases in offspring as a function of factors operating in early life. The cohort focuses especially on the side effects of medications and infections. The researchers studied 64,322 children and mothers who were enrolled in the Danish cohort from 1996 to 2002. 

More than half of all the mothers reported using acetaminophen while pregnant. The researchers found that children whose mothers used acetaminophen during pregnancy were at a 13 percent to 37 percent higher risk of later receiving a hospital diagnosis of hyperkinetic disorder, being treated with ADHD medications or having ADHD-like behaviors at age 7. The longer acetaminophen was taken -- that is, into the second and third trimesters -- the stronger the associations. The risks for hyperkinetic disorder/ADHD in children were elevated 50 percent or more when the mothers had used the common painkiller for more than 20 weeks in pregnancy.

"It's known from animal data that acetaminophen is a hormone disruptor, and abnormal hormonal exposures in pregnancy may influence fetal brain development," Ritz said. Acetaminophen can cross the placental barrier, Ritz noted, and it is plausible that acetaminophen may interrupt fetal brain development by interfering with maternal hormones or through neurotoxicity, such as the induction of oxidative stress, which can cause the death of neurons.

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Children's brain development being harmed by chemicals in the environment - both before birth and in childhood -  is such an important topic that here are excerpts from two articles about the same report that was just released (in Lancet Neurology).  From Time:

Children Exposed to More Brain-Harming Chemicals Than Ever Before

In recent years, the prevalence of developmental disorders such as autism, attention deficit/hyperactivity disorder (ADHD) and dyslexia  have soared. While greater awareness and more sophisticated diagnoses are partly responsible for the rise, researchers say the changing environment in which youngsters grow up may also be playing a role.

In 2006, scientists from the Harvard School of Public Health and the Icahn School of Medicine at Mount Sinai identified five industrial chemicals responsible for causing harm to the brain — lead, methylmercury, polychlorinated biphenyls (found in electric transformers, motors and capacitors), arsenic (found in soil and water as well as in wood preservatives and pesticides) and toluene (used in processing gasoline as well as in paint thinner, fingernail polish and leather tanning). Exposure to these neurotoxins was associated with changes in neuron development in the fetus as well as among infants, and with lower school performance, delinquent behavior, neurological abnormalities and reduced IQ in school-age children.

Now the same researchers have reviewed the literature and found six additional industrial chemicals that can hamper normal brain development. These are manganese, fluoride, chlorpyrifos, dichlorodiphenyltrichloroethane, tetrachloroethylene and polybrominated diphenyl ethers. Manganese, they say, is found in drinking water and can contribute to lower math scores and heightened hyperactivity, while exposure to high levels of fluoride from drinking water can contribute to a seven-point drop in IQ on average. The remaining chemicals, which are found in solvents and pesticides, have been linked to deficits in social development and increased aggressive behaviors.

But they say the growing body of research that is finding links between higher levels of these chemicals in expectant mothers’ blood and urine and brain disorders in their children should raise alarms about how damaging these chemicals can be. The developing brain in particular, they say, is vulnerable to the effects of these chemicals, and in many cases, the changes they trigger are permanent. “The consequence of such brain damage is impaired [central nervous system] function that lasts a lifetime and might result in reduced intelligence, as expressed in terms of lost IQ points, or disruption in behavior,” they write in their report, which was published in the journal Lancet Neurology.

Same report, from Science Daily: Growing number of chemicals linked with brain disorders in children

"The greatest concern is the large numbers of children who are affected by toxic damage to brain development in the absence of a formal diagnosis. They suffer reduced attention span, delayed development, and poor school performance. Industrial chemicals are now emerging as likely causes," said Philippe Grandjean, adjunct professor of environmental health at HSPH.

The study outlines possible links between these newly recognized neurotoxicants and negative health effects on children, including:  - Manganese is associated with diminished intellectual function and impaired motor skills  - Solvents are linked to hyperactivity and aggressive behavior - Certain types of pesticides may cause cognitive delays.

Grandjean and co-author Philip Landrigan, Dean for Global Health at Mount Sinai, also forecast that many more chemicals than the known dozen or so identified as neurotoxicants contribute to a "silent pandemic" of neurobehavioral deficits that is eroding intelligence, disrupting behaviors, and damaging societies. But controlling this pandemic is difficult because of a scarcity of data to guide prevention and the huge amount of proof needed for government regulation. "Very few chemicals have been regulated as a result of developmental neurotoxicity," they write.

The authors say it's crucial to control the use of these chemicals to protect children's brain development worldwide. They propose mandatory testing of industrial chemicals and the formation of a new international clearinghouse to evaluate industrial chemicals for potential developmental neurotoxicity.

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Take note: all of us are exposed to these contaminants because they are in our environment.  The Inuit exposure is just more concentrated. From Feb. 7, 2014 Environmental Health News:

Contaminants have variety of effects on Arctic baby IQs

Babies in Arctic Canada are at risk of specific effects on their mental abilities, depending on which contaminants they are exposed to in the womb, according to a new study.While lead, methylmercury and polychlorinated biphenyls (PCBs) all are linked to neurological effects, each seems to have a different effect on infants, the scientists concluded. For example, PCBs seemed to impair the babies’ ability to recognize things they have seen.

The study involved 94 Inuit infants and their mothers from Nunavik, in northern Quebec. PCBs, mercury and other pollutants hitchhike north via prevailing winds and currents from industrialized areas, and then accumulate in food webs, predominantly in the eastern Arctic. Because the Inuit in Canada and Greenland eat top predators such as beluga whales and seals, they are among the world’s most contaminated human beings. The scientists measured the babies’ prenatal exposure to the three contaminants by testing cord blood, and then administered standard mental development tests at 6.5 months and 11 months. 

“Each contaminant was independently associated with impairment of distinct aspects of cognitive function with long-term implications for cognitive development – PCBs with visual recognition memory, methylmercury with working memory and an early precursor of executive function, lead with processing speed – deficits that can already be detected during the first year of life,” the authors wrote.

For the research, scientists at Quebec’s Centre de Recherche du CHUQ, who have been studying effects of contaminants on Inuit children for two decades, teamed up with Wayne State University scientists who conducted groundbreaking work in the Great Lakes linking PCBs to reduced IQs in the 1990s.