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Category: pregnancy and childbirth

Published on Leave a comment on Avoid Consuming Caffeine During Pregnancy

Pregnant women receive all sorts of advice on what to do or not do during pregnancy. For years medical guidelines in both the US and Europe have been that moderate (up to 200 mg) ingestion of caffeine during pregnancy is OK, which means about 2 cups of regular coffee a day.

However, a recent review of studies by Reykjavik University Professor Jack E. James found that ingesting caffeine during pregnancy is linked to health problems and that there is no safe level during pregnancy. In other words,  caffeine and caffeinated beverages should be avoided during pregnancy and when trying to conceive.

Health problems associated with caffeine intake during pregnancy are miscarriage, stillbirth, low birth weight and/or small for gestational age, childhood leukemia, and childhood overweight and obesity. Studies typically found a dose-response effect - the more caffeine is ingested, the more negative health effects.

Human studies looking at this issue are observational, but negative health effects are supported by animal research going back more than four decades. Caffeine crosses the placenta and goes to the baby. Negative health effects occur because the fetus can not clear the caffeine well because it lacks an enzyme that metabolizes caffeine.

Professor James points out that the industry established and funded the group ILSI (International Life Sciences Institute) which successfully fought any FDA warnings about caffeine and pregnancy, and which attacked any research suggesting it could be harmful to pregnancy or the fetus. [Why am I not surprised about the success of the industry group? And that they published their own "research" showing caffeine was benign in response to scientific research showing negative health effects.]

Excerpts from Science Daily: No safe level of caffeine consumption for pregnant women and would-be mothers

Women who are pregnant or trying to conceive should be advised to avoid caffeine because the evidence suggests that maternal caffeine consumption is associated with negative pregnancy outcomes and that there is no safe level of consumption, finds an analysis of observational studies published in BMJ Evidence Based Medicine.   ...continue reading "Avoid Consuming Caffeine During Pregnancy"

Published on Leave a comment on Conception Rates Are Different After C-Sections and Vaginal Births

Well.., given the high rate of C-sections in the US (32%) and many other countries, this is disturbing news. A study found that if a woman delivers her first baby by C-section (Cesarean birth), than her rates of conceiving again and also carrying the second baby successfully to term (a live birth) are lower than women who deliver a first baby vaginally.

The Penn State College of Medicine researchers looked at "unprotected intercourse and resulting conceptions", so it really was a measure of conception rates, and not a matter of choice. The study followed more than 2000 women for 3 years after the first birth, but it is unknown if these findings continue in year 4 and more. By the way, other studies over the years have had similar findings.

What could be causing these results? The researchers point out that it has been reported that many women (61%) develop a defect at the site of the cesarean incision (a cesarean scar defect) that may increase the risk of infertility.

From Science Daily: Women who deliver by C-section are less likely to conceive subsequent children

Women who deliver their first child by cesarean section (C-section) are less likely to conceive a second child than those who deliver vaginally, despite being just as likely to plan a subsequent pregnancy, according to Penn State College of Medicine researchers. The team followed more than 2,000 women for three years after they delivered their first child.  ...continue reading "Conception Rates Are Different After C-Sections and Vaginal Births"

Published on Leave a comment on High Heat and Pregnancy

High heat is not good for a developing baby during pregnancy. And neither is air pollution. A just published large study concluded that higher temperatures from climate change and increased air pollution (from ozone and fine particulates PM2.5) increases the risk of giving birth to premature, underweight, or stillborn children.

The researchers analyzed 68 studies, for a total of 32,798,152 births in the United States. Almost 33 million births! Another important finding was that those at highest risk were persons with asthma and minority groups, especially black mothers.

The researchers point out that animal studies find the same things: "that both air pollutant and heat exposure may contribute to adverse obstetrical outcomes". So there is lots of support for these findings of harmful effects.

Another recent study (by Univ. of California researchers) drew similar conclusions: that exposure to heatwaves during the week before birth was strongly linked to an increased risk of preterm delivery. And the hotter the temperature or the longer the heatwave, the greater the risk.

Since the long-term forecast is for increasing temperatures and longer duration heat waves throughout the world, these findings are very worrisome.

The study published in the JAMA Network Open (a Journal of the American Medical Association): Association of Air Pollution and Heat Exposure With Preterm Birth, Low Birth Weight, and Stillbirth in the USA: Systematic Review

A NY Times discussion of the findings: Climate Change Tied to Pregnancy Risks, Affecting Black Mothers Most

Discussion of earlier study (Feb. 2020) from Science Daily: Heatwave exposure linked to increased risk of preterm birth in California

Published on Leave a comment on COVID-19 During Pregnancy

Worrisome news: having a COVID-19 infection during pregnancy may be injuring the placenta, even if the pregnant woman has no symptoms (asymptomatic) and the baby appears healthy at birth. The human placenta is the temporary organ that nourishes and maintains the developing fetus during pregnancy. It provides oxygen and nutrients to the baby, and removes waste products.

A small study by doctors at the Feinberg School of Medicine (Chicago, Illinois) examined 16 placentas after babies were born - 15 in the third trimester (all live, healthy babies), 1 in the second trimester (after the fetus died). The placentas of women who were currently infected with COVID-19 or had it earlier in the pregnancy showed abnormal or injured blood vessels, which can result in insufficient blood flow between the mother and developing baby. Two common types of injuries were abnormal blood vessels (maternal vascular malperfusion) and blood clots in the placenta (intervillous thrombi).

The study authors said that pregnant women should therefore be monitored more carefully, perhaps with non-stress tests (to see how well the placenta is delivering oxygen) or ultrasounds to measure growth. The good news is that currently the evidence does not suggest that pregnant women have more severe COVID-19 infections than non-pregnant women.

Also good news is that the 15 babies born in the third trimester appeared healthy and normal weight (only one was pre-term, but healthy), and that at birth all the babies were negative for COVID-19. Thus, they did not get the infection from their mothers during pregnancy.

Excerpts from Science Daily: Placentas from COVID-19-positive pregnant women show injury

The placentas from 16 women who tested positive for COVID-19 while pregnant showed evidence of injury, according to pathological exams completed directly following birth, reports a new Northwestern Medicine study.   ...continue reading "COVID-19 During Pregnancy"

Published on Leave a comment on Sign Up For Registry Tracking Effects of COVID-19 On Pregnancy and Newborns

Infected with COVID-19 during pregnancy and worried about the pregnancy and baby? A national registry has just been established that is tracking the effects of coronavirus COVID-19 on the pregnancy and on newborns. This is because the virus is so new that we don't know what, if any, effects it has on pregnancy and on the baby. Does it harm the developing baby during the first 2 trimesters or cause problems during pregnancy? We just don't know.

Normally something like this takes a long time to set up and implement, but this has just started and already over 400 pregnant women have signed up. Women can sign up through their health care provider or on their own at the registry website. The registry is called the Pregnancy Coronavirus Outcomes Registry (PRIORITY).

So far the one small study out of China that was done was reassuring, but it only looked at the last trimester of pregnancy. So please consider signing up for the national PRIORITY registry. The more women sign up, the more we will learn.

On a related note, people are pushing back at the  CDC guidelines suggesting that newborns born to women with COVID-19 infections should be removed and put into isolation. And if breastfeeding, to pump the breast milk and have a healthy caregiver feed the baby. That guideline is absolutely NOT supported by evidence. Also, the virus has not been detected in breastmilk.

An excerpt from Medscape (the medical professional site) on the CDC guidelines: "Some experts say the recommendation to separate mothers with confirmed or suspected COVID-19 from their infants after delivery is not supported by evidence and could cause lasting harm."  Absolutely.

From Medscape: COVID-19 Registry Tracks Pregnant Women, Newborns

A multidisciplinary team of researchers has created a national registry to study how COVID-19 affects pregnant women and their newborns.  ...continue reading "Sign Up For Registry Tracking Effects of COVID-19 On Pregnancy and Newborns"

Published on Leave a comment on Tips For Reducing Exposures to Harmful Chemicals

Did you know that our modern lifestyle is exposing us to thousands of harmful chemicals? All of us are exposed to many harmful chemicals daily - in ordinary household products, at work and school, in our food, and in the air and water around us. These chemicals are found in plastics, in stain resistant finishes, non-stick cookware, flame retardants, fragrances, pesticides, water resistant finishes, and antimicrobial products.

All these chemicals have made our lives easier in many ways, but they have a dark side. The chemicals leach out of the products and get on us and in us, and can be measured in our blood and urine.

They are linked to all sorts of health problems (reproductive effects, infertility, neurological effects, lower IQs, immunological problems, cancers, etc.) and the list is growing annually. Many are hormone (endocrine) disruptors. Developing children and fetuses are especially vulnerable, and the effects can be life-long.

We all have many of these harmful chemicals in our body. No one can totally avoid all these chemicals, but we can lower our exposure to many of them quite a bit. These chemicals get in us various ways: we ingest them (in food and water), we absorb them through the skin, and we breathe them in (e.g. in household dust and in the air).

Many chemical levels can be reduced quickly - within a few days or weeks (for example, by switching to different personal care products, switching to organic foods, and not eating canned foods).

It is especially important to lower exposures to these harmful chemicals if you are considering conceiving a child, are pregnant, or have children. Many of these chemicals are linked to fertility problems for both men and women, and researchers think this is why male fertility is dropping so rapidly over the past few decades.

Yes, it does require a life-style change, and it does require reading labels, but it is worth it. Following these tips should also have the added bonus of improving your gut microbial communities. It's all related.

HOW TO REDUCE EXPOSURE TO HARMFUL CHEMICALS:

IN GENERAL - Try for a more “natural and non-toxic” lifestyle, and reduce use of plastics (including vinyl) and pesticides.

  • Read labels of personal care products, household products, and clothing. Avoid products with parabens and oxybenzone. Avoid products that are antimicrobial, antibacterial, anti-odor, anti-stain, anti-mildew, and nonstick.
  • Use unscented or fragrance-free products, including personal care products. Avoid fragrances or scented versions of products.
  • Don't use air fresheners, dryer sheets, scented candles, incense, essential oils.

FOOD

  • Buy foods and beverages in glass bottles and jars whenever possible.  Store food in glass, stainless steel, or ceramic containers. Avoid plastic bottles and containers.
  • Avoid canned foods, including aluminum cans - they are all lined with plastics containing BPA or equally bad BPA alternatives. Canned foods are a major source of endocrine disruptors.   ...continue reading "Tips For Reducing Exposures to Harmful Chemicals"

Published on Leave a comment on Flame Retardant Chemicals Have Harmful Effects Before Birth

Please, only buy or use sofas and upholstered chairs that do NOT contain any flame retardant chemicals. Be sure to look at the tags attached to the furniture that are required by a California law since 2015 (called Technical Bulletin 117-2013) to be on each new sofa and upholstered furniture. It will tell you if it contains flame retardant chemicals or not.

This is especially important if at some point you are thinking of having a child, if you are pregnant, or if you have children. The problem is that the flame retardant chemicals, which were added for decades to the foam in upholstered furniture, migrate out and so get into us (through the skin, inhaling, or by swallowing). Unfortunately, almost all of us have flame retardants in our bodies.  Where they can cause health problems.

Two new studies were published recently showing harms from exposures to flame retardants. The first found an association between flame retardant chemicals before birth (when the pregnant woman is exposed, it gets to the developing baby) and later reading problems.

The second study found that exposures to pesticides and flame retardants have overtaken  lead and mercury as leading contributors to IQ loss in children.

The researchers looked at exposure to major groups of endocrine disrupting chemicals during pregnancy and effects on the children. Yes - once again, chemicals frequently found all around us are hormone disruptors, and these chemicals also negatively affect neurological development. One result with higher exposure is that it lowers IQ. The 4 groups are: flame retardants (polybrominated diphenyl ethers or PBDEs), certain pesticides (organophosphates), mercury (methymercury), and lead. Exposures to the first three have the biggest effect during pregnancy (they cross the placenta and so get to the baby).

The researchers found an interesting result: organophosphate pesticide (such as chlorpyrifos) exposure and IQ loss attributed to it has increased since 2003. And that since the EPA did not ban chlorpyrifos (widely used on crops), then organophosphate pesticide "levels will continue to climb in the United States population due to ingestion of chlorpyrifos-treated crops". NOTE: these pesticides are allowed on conventional crops, but NOT organic crops.

How to avoid exposure? Hard to totally avoid exposure to these chemicals, but you can lower your exposure. Eat as many organic foods as possible. Try to avoid buying or having flame retardant sofas, upholstered chairs, and other upholstered furniture in your home. [Note: if they say that they use "safer" replacement chemicals - still avoid that furniture. The replacements are similar chemicals and may be just as bad or worse.] Frequently open windows to "air out" the home.

Excerpts from Science Daily: Prenatal exposure to flame retardants linked to reading problems   ...continue reading "Flame Retardant Chemicals Have Harmful Effects Before Birth"

Published on Leave a comment on Air Pollution and the Brain, Part 1

Several recent studies have highlighted the negative effects of air pollution on the brain, specifically from the tiniest particles in polluted air (called PM 2.5). These tiny particles get to the human brain and cause all sorts of damage. Even at levels within government guidelines.

Two studies found that with higher chronic (daily) exposure to PM2.5 air pollution there were structural changes to the brain. Which is negative to brain health, of course.

With chronic exposure to higher levels of  PM2.5 air pollution: one study found greater declines in memory and more Alzheimer's-like brain atrophy in older women in the USA; and the second study found that higher prenatal exposure was associated with a smaller corpus callosum (a part of the brain) later in childhood. Thus structural changes in the brain!

The tiniest particles are 2.5 micrometers or less in diameter, about 1/30th the width of human hair - and referred to as PM2.5. These fine particles are produced by all sorts of combustion, including motor vehicles, power plants, residential wood burning, agricultural burning, some industrial processes, and forest fires. Typically there is much more exposure to PM2.5 in busy urban streets, and less in quiet suburban streets.

Researchers in Barcelona, Spain found that long-term higher prenatal exposure to PM2.5 particulate matter, especially during the last trimester of pregnancy, is associated with a smaller corpus callosum in children between the ages of 8 and 12 years. This is an important finding because a smaller (reduced volume) corpus callosum is found in ADHD (attention deficit hyperactivity disorder), ASD (autism spectrum disorder), and hyperactivity. So here we see a structural change in the brain from air pollution at PM2.5 levels that are considered acceptable (within guidelines) by the European Union!

A report called The State of Global Air/2018 stated that studies show that long-term exposure to PM2.5  particles in the air "is the most consistent and robust predictor" of death from heart disease and stroke, lung cancer, and respiratory illnesses. And then there are nitrogen oxides and ozone, which are also linked to death. There are also nanoparticles (e.g., from friction of tires being used) that penetrate deep into the human body.

A 2018 The Guardian article called air pollution "the new tobacco". And that it's time to tackle this epidemic. Yup. Unfortunately, current air pollution standards are being relaxed in all sorts of ways under the current U.S. administration. Beware!

First study. Excerpts from Medical Xpress: Exposure to PM 2.5 pollution linked to brain atrophy, memory decline  ...continue reading "Air Pollution and the Brain, Part 1"

Published on Leave a comment on Pregnancy, Endocrine Disrupting Chemicals, and Lower IQ

The evidence is building, study by study, that we are all exposed to a mixture of hormone disrupting chemicals (endocrine disruptors) on a daily basis, and that these have serious health effects, including on the developing fetus during pregnancy. Researchers found that early prenatal exposure to a mixture of endocrine disrupting chemicals  was associated with lower levels of cognitive functioning (lower IQ scores) at age seven, particularly among boys.

Researchers in New York City and Sweden looked at the impact of 26 endocrine disrupting chemicals during pregnancy on 718 Swedish mother-child pairs. It appeared that the higher the exposure during pregnancy, the more of an effect at age 7. Especially harmful was the BPA replacement chemical BPF - this is because it is chemically related to BPA.

Endocrine disrupting chemicals (EDCs) include bisphenols (BPA and its replacement  chemicals, such as BPF - used in products called "BPA free"), phthalates (especially used in vinyl products), parabens, chemicals used in flame retardants and non-stick coatings,  and some pesticides (e.g. the commonly used chlorpyrifos).

Especially worrisome is that while scientists typically test chemicals one at a time to determine their safety, in the real world we are all exposed to mixtures of these chemicals in our food, consumer products (including personal care products and cosmetics), and environment. Some of these chemicals can cross the placenta during pregnancy and so have an effect on the developing the fetus, including brain and neurological development. Yes, some of these chemicals are only in the body for a short time, but during critical developmental  stages, the effects can be big - even at very low exposures.

Bottom line: If trying to conceive a child or during pregnancy, try to minimize exposure to plastics, pesticides, flame retardants, non-stick cookware, stain-proofing (in fabric and rugs), fragrances and scented products (including air fresheners and dryer sheets), and food stored in cans and plastic containers. Avoid triclosan, anti-odor, antibacterial, anti-germ products and clothing. Avoid parabens (in lotions, etc). Read labels. Glass and stainless steel is perfectly fine. Use unscented or fragrance free products as much as possible.

From Medical Xpress: Chemicals in consumer products during early pregnancy related to lower IQ   ...continue reading "Pregnancy, Endocrine Disrupting Chemicals, and Lower IQ"

Published on Leave a comment on Air Pollution Has Harmful Effects During Pregnancy

Two recent studies point out the dangers of air pollution to the developing fetus. The first study found an association with high levels of air pollution during pregnancy and lower IQ years later when the children were between the ages of 4 to 6 (as compared to women exposed to less traffic-related air pollution during pregnancy).

The second study found that soot (tiny carbon particles) from air pollution  (e.g. vehicle exhaust) are breathed in by the pregnant woman, and then make it to her placenta during pregnancy and cross over to the baby's side of the placenta. (The placentas were collected and examined after delivery.) The fact that these tiny particles found in polluted air are breathed in by the pregnant woman and reach the baby's side of the placenta and accumulate, suggests to the researchers how air pollution causes harm to the fetus. They also found that the more particles the pregnant woman was exposed to throughout pregnancy, the more particles were detected on the baby's side of the placenta ("placental load").

The placenta used to be viewed as a barrier to toxins, but NOPE - it's not. (As we already know with alcohol and drugs, etc.)

But now some good news: In the first study, pregnant women who had higher levels of folate in their blood - meaning they had better nutrition and higher intake of folic acid during pregnancy, appeared to have a protective effect on the developing baby. As the researchers said: "Maternal folate levels may modify the impact of prenatal air pollution exposure on child cognition." In those with the lowest folate levels during pregnancy, the negative effects of air pollution during pregnancy on the developing fetus appeared to be the strongest (6.8 points lower IQ). Folate is naturally occurring in many fruits, vegetables, beans, peas, and nuts, and is in the form of folic acid in vitamin supplements. Best is a good diet.

From Medical Xpress: Offspring of pregnant women exposed to high level of pollutants may have lower IQs   ...continue reading "Air Pollution Has Harmful Effects During Pregnancy"