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Category: pregnancy and childbirth

Published on Leave a comment on Vitamin D Supplements During Pregnancy?

Vitamin D supplements are incredibly popular, but whether vitamin D supplements should be taken during pregnancy and at what dose is still debated, and studies have had conflicting results. Now a review by Canadian researchers of 43 studies of vitamin D supplementation during pregnancy found that there is "insufficient evidence to guide recommendations during pregnancy". They said that overall the studies were small or of low quality -  and the "available data did not provide evidence of benefit" from vitamin D supplementation during pregnancy.

They found that vitamin D supplementation slightly increased the mean (average) birth weight by 2 ounces (58.33 g), reduced the risk of small for gestational age births, and reduced the risk of the child wheezing at age 3. There was no effect on preterm birth, and there was a lack of evidence of benefits of prenatal vitamin D supplementation for maternal health conditions (e.g. gestational diabetes) during pregnancy.

Currently recommendations regarding vitamin D supplementation vary widely among medical and professional organizations, and WHO (World Health Organization) currently recommends against routine prenatal vitamin D supplementation. Luckily there are a number of studies going on right now on this issue that may help answer this question - how much vitamin D, if any, should be taken during pregnancy? From Medical Xpress:

Insufficient evidence to guide recommendations on vitamin D in pregnancy

There is currently insufficient evidence to guide recommendations on the use of vitamin D supplements in pregnancy, conclude researchers in The BMJ today. A team led by Dr Daniel Roth at The Hospital for Sick Children in Toronto, say some of the most critical questions about the effectiveness of taking vitamin D supplements during pregnancy "will probably remain unanswered in the foreseeable future."

Vitamin D helps maintain calcium levels in the body to keep bones, teeth and muscles healthy. Numerous studies suggest that taking vitamin D supplements may also help protect against heart disease, cancer, respiratory infections and asthma - as well as conditions related to pregnancy, such as preeclampsia and gestational diabetes. But results are conflicting and recommendations vary widely among medical and professional organisations.

So Dr Roth and his team set out to assess the current and future state of the evidence on vitamin D supplements during pregnancy. They analysed results from 43 randomised controlled trials involving 8,406 women, to estimate the effects of taking vitamin D supplements during pregnancy on 11 maternal and 27 child outcomes.... The results show that taking supplements during pregnancy increased vitamin D levels in both the mother's bloodstream and umbilical cord blood, but the researchers did not consistently find that higher doses of vitamin D led to healthier women and babies.

Overall, vitamin D increased average birth weight by 58 g and reduced the risk of having a small baby, but more detailed analyses weakened the authors' confidence in these findings. There was a lack of evidence of benefits of vitamin D supplements for maternal health conditions related to pregnancy, no effect on other birth outcomes of public health importance, such as premature birth, and scant evidence on safety outcomes.  [Original study.]

Published on Leave a comment on Group Recommends Against Vaginal Seeding

A while ago I posted the results of studies showing differences in infant  microbiomes (community of microbes) depending on whether the babies were delivered vaginally or by C-section, and also that "vaginal seeding" may eliminate some of these differences. [C-section babies also have a higher incidence of some health issues, such as allergies, asthma, etc.] Well....that research generated a lot of controversy both for and against, and resulted in many women requesting that "vaginal seeding" be done to their babies after they were delivered by C-section. Even the noted microbiome researcher Rob Knight publicly admitted that the procedure was done to his baby after his partner received a C-section.

Vaginal seeding is the process of swabbing the bodies of C-section babies (including the mouth and nose) with a gauze pad containing the vaginal fluids from their mothers in the minutes after birth - so that the baby is exposed to the same maternal microbes as a baby born vaginally (because mothers transmit microbes to the baby as it moves through the birth canal). Initial research showed this made the microbiomes of the C-section babies look a lot like vaginally born babies, especially their skin and oral microbiomes, but whether these differences persist after a few months is unclear.

Now the American College of Obstetrics and Gynecology (ACOG) has come out with a position paper that vaginal seeding should not be done to babies, except as part of an official clinical trial. Their main opposition to the procedure is fear of transmitting pathogenic bacteria or viruses (e.g. group B streptococci, and STDs). The main reasons in support of doing the  vaginal seeding procedure is the body of research finding differences among C-section and vaginally delivered babies (allergies, asthma, etc.), and the concern that at least some of this may be due to lack of  exposure to maternal vaginal microbes during delivery. Instead, ACOG suggests breastfeeding the baby to transmit maternal microbes to the baby to "seed the gut". And if "a patient insists on performing the procedure herself, ACOG recommends ob-gyns have a documented discussion of the potential risks".

As can be expected, there is an outcry and rejection by some (many?) of the ACOG position paper. At least the ACOG paper acknowledges that every woman can make her own decision regarding this issue, even though they may not support it. And absolutely everyone agrees that more research is needed. From Ars Technica:

Doctors warn new parents: Step away from the vaginal fluid swabs

To slather, or not to slather—that is the question that has been roiling doctors, scientists, and new parents recently. And a new ruling by a doctor’s group stands to muck up the debate further. Amid the birth of microbiome research, some scientists have advocated for smearing bacteria-laden vaginal secretions on any newborns who missed out—namely those born via Caesarian section. Scientists keenly hypothesize that such a gooey glaze can “seed” a more-or-less sterile infant with life-long microbial companions. These wee chums may help train an infant's immune system and dodge issues like allergies and asthma later in life. Several studies have indeed found correlations between C-section deliveries and higher risks of those conditions.

In the latest turn to the controversy, the American College of Obstetricians and Gynecologists’ (ACOG) Committee on Obstetric Practice issued a November opinion firmly wiping up the slimy idea. In its opinion, the committee said it: “…does not recommend or encourage vaginal seeding outside of the context of an institutional review board-approved research protocol, and it is recommended that vaginal seeding otherwise not be performed until adequate data regarding the safety and benefit of the process become available.”

The few studies we do have on infant microbiomes provide no clear answers on the significance of an early “seeding” for health. A 2016 review looking at the patterns of microbial communities in the guts of infants in their first year found that C-section babies did show differences in the first three months. However, those differences disappeared by six months. Similarly, a small study of 18 babies also published last year found that vaginal seeding could eliminate microbial differences between vaginally and C-section delivered babies. But the study only looked at the infants' microbiomes in that first month, and the health effects—if any—are unknown.

The most concerning thing about vaginal seeding, the committee argues, is the potential for transmitting pathogens, such as herpes simplex virus, human papilloma virus (HPV), group B streptococci, and Neisseria gonorrhea. .... If a woman insists on the seeding, the committee recommended she be thoroughly tested and informed of the risks—as well as discouraged.

Published on Leave a comment on Pesticide Use During Pregnancy and Childhood Brain Tumors

Once again a study finds that pesticide exposure is linked to an adverse health effect - that pesticide exposure in the home during pregnancy and early childhood is linked to an elevated risk of brain tumor in the child. Other studies have also found that pesticides used in the home are associated with a higher risk of childhood cancers.

This is because pesticides do cross the placental barrier, as the study researchers point out: "There is evidence that pesticides cross the fetal-placental barrier since residues of some insecticides have been found in umbilical cord blood, neonatal hair, and meconium following maternal exposure during pregnancy." Also, the International Agency for Research on Cancer (IARC) has classified "more than twenty pesticide chemical compounds as potential human carcinogens".

The following are examples (but there are more) of other studies finding pesticide and childhood cancer links: A meta-analysis published in 2015 in Pediatrics by researchers at Harvard University found that children exposed to indoor insecticides (also herbicides) have a higher risk of certain childhood cancers, specifically leukemia, lymphomas, and brain tumors. A 2013 study published in Cancer Causes and Control found that professional pest control applications in the home within a year of conception and during pregnancy was associated with a higher risk of childhood brain tumors. A review of studies published in 2010 found that pesticide exposure during pregnancy and childhood increased the risk of childhood leukemia.

The good news is that there are alternatives to exposing fetuses and children to toxic pesticides at home - by using alternative ways of dealing with pests, such as least toxic Integrated Pest Management (IPM) or organic methods. That means doing other things (such as sealing or caulking holes, putting out traps and baits, vacuuming), a focus on least toxic methods and on prevention (here and here), rather than routinely applying toxic pesticides. If needed, least toxic pesticides include boric acid and vinegar. Other sources of pesticide exposure for pregnant women and children are foods and exposure in settings outside the home - perhaps even a friend's yard. By the way, pesticide exposure for everyone is linked to a higher risk of health problems, not just pregnant women and children.

From Science Daily: Pesticide use during pregnancy linked to increased risk of childhood brain tumors

Previous epidemiological studies have suggested that exposure to pesticides during pregnancy may have a possible role in the development of childhood brain tumors. In a new International Journal of Cancer analysis, researchers found a link between maternal residential pesticide use -- particularly insecticides -- and the risk of childhood brain tumors. The analysis included 437 malignant childhood brain tumor cases and 3102 controls from two French studies. Pesticide use was associated with a 1.4-times increased risk of childhood brain tumors.

The investigators noted that many pesticide compounds are classified as probable carcinogens, and there is evidence that some insecticides can pass through the feto-placental barrier. "Although such retrospective studies cannot identify specific chemicals used or quantify the exposure, our findings add another reason to advise mothers to limit their exposure to pesticides around the time of pregnancy," said Nicolas Vidart d'Egurbide Bagazgoïtia, lead author of the study. [Original study.]

Published on Leave a comment on Obesity Associated With Poorer Sperm Quality

Another problem for overweight or obese men: an increased risk of poor sperm quality. Researchers in India found that compared to normal weight men, obesity was associated with lower sperm count, lower volume of semen, lower sperm concentration, poor sperm motility (the movement of sperm), as well as sperm defects. There is some evidence (from other studies and the researchers own work) that there is improvement in sperm quality with weight loss.

The researchers pointed out that other studies have shown that "paternal obesity at conception had deleterious effects on embryo health, implantation, pregnancy, and live birth rates." And that poor sperm quality is a cause of infertility. So.... what do the researchers recommend? Weight loss and exercise, and perhaps bariatric surgery, for obese men having fertility problems due to poor sperm quality. From Medical Xpress: 

As men's weight rises, sperm health may fall

A widening waistline may make for shrinking numbers of sperm, new research suggests. Indian scientists studied more than 1,200 men and found that too much extra weight was linked to a lower volume of semen, a lower sperm count and lower sperm concentration. In addition, sperm motility (the ability to move quickly through the female reproductive tract) was poor. The sperm had other defects as well, the researchers added. Poor sperm quality can lower fertility and the chances of conception.

"It's known that obese women take longer to conceive," said lead researcher Dr. Gottumukkala Achyuta Rama Raju, from the Center for Assisted Reproduction at the Krishna IVF Clinic, in Visakhapatnam. "This study proves that obese men are also a cause for delay in conception," he added.

But in continuing research, the study team is looking to see if losing weight will improve the quality of sperm. Although that study is still in progress, early signs look good that sperm quality improves as men lose weight, Rama Raju said. Recent reports have found that extreme weight loss after bariatric surgery reversed some of the sperm decline, he said.

For the study, Rama Raju and his colleagues used computer-aided sperm analysis to assess the sperm of 1,285 men. Obese men, they found, had fewer sperm, a lower concentration of sperm and inability of the sperm to move at a normal speed, compared with the sperm of men of normal weight. Moreover, the sperm of obese men had more defects than other sperm. These defects included defects in the head of the sperm, such as thin heads and pear-shaped heads.  [Original study.]

 Human sperm. Credit: Wikipedia

Published on Leave a comment on Living Near Farms and Pesticide Exposure

Two recent studies, both done in California, looked at different aspects of pesticide exposure. They highlight how people can be exposed to pesticides in the air they breathe, especially if they live in areas where pesticides are heavily applied (such as farms). But keep in mind that even in suburbia, every time a neighbor applies pesticides on the lawn or trees - there is drift, and so you are also exposed (e.g., breathing it, droplets on the skin).

The first study found that pregnant women with high pesticide exposure (living in areas near farms using pesticides) had increases in adverse birth outcomes (low birth weight, shorter pregnancy length, preterm birth, birth defects or abnormalities). No effects were seen with low pesticide exposure. But note that these results are what could be seen at birth - they do not include effects that can only be seen later, such as delayed development, learning disabilities, lower intelligence, asthma, autism - all effects found in some studies.

The other was a California Department of Pesticide Regulation (CDPR) 2016 report on air monitoring results (from 6 sites) of 32 chemicals (pesticides and breakdown products) in California. Some pesticides were not detected, some were only at trace amounts, and some were detected at higher amounts  - and the amounts fluctuated over the year and from site to site. [NOTE: They did not monitor for 2 widely used pesticides: glyphosate, which is in Roundup, and 2,4-D. Hmm...]. A Kern County high school monitoring site showed levels of the pesticide chlorpyrifos more than 18 times higher than EPA's "level of concern for pregnant women" - but yet these levels are considered OK for the general public.

Chlorpyrifos is "controversial" in that scientists (including EPA scientists), medical professionals, and farmworker organiztions asked that its use be banned due to its serious health effects on humans, but this year EPA chief Scott Pruitt refused to do so (he gave in to pesticide industry lobbying). The bottom line: What effect do the mixtures of pesticides (at chronic low levels) that we're exposed to have on us? Unknown. 

From Medical Xpress: Researchers unravel the negative effects of pesticide exposure on birth outcomes

Although common opinion holds that exposure to pesticides increases adverse birth outcomes, the existing body of scientific evidence is ambiguous..... A new study by researchers at UC Santa Barbara addresses the issue in a novel way—by analyzing birth outcomes in California's San Joaquin Valley. With more than one-third of the country's vegetables and two-thirds of its fruits and nuts produced there, the San Joaquin Valley, not surprisingly, is a heavy pesticide-use region. The UCSB team investigated the effect of exposure during pregnancy in this agriculturally dominated area and observed an increase in adverse outcomes accompanying very high levels of pesticide exposure. 

"For the majority of births, there is no statistically identifiable impact of pesticide exposure on birth outcome," said lead author Ashley Larsen, an assistant professor in UCSB's Bren School of Environmental Science & Management. "Yet mothers exposed to extreme levels of pesticides, defined here as the top 5 percent of the pesticide exposure distribution, experienced between 5 and 9 percent increases in the probability of adverse outcomes with an approximately 13-gram decrease in birth weight."

Using individual birth certificate records for more than 500,000 single births between 1997 and 2011, coupled with pesticide use data at a fine spatial and temporal scale, the scientists were able to determine if residential agricultural pesticide exposure during gestation—by trimester and by toxicity—influenced birth weight, gestational length or birth abnormalities.

They found negative effects of pesticide exposure for all birth outcomes—birth weight, low birth weight, gestational length, preterm birth, birth abnormalities—but only for mothers exposed to very high levels of pesticides—the top 5 percent of the exposure distribution in this sample.... Numerous chemicals are used daily in close proximity to residential areas, making it difficult to ascertain a specific responsible agent. As a result, in this study, the researchers looked at the combined results from all pesticides used in the region. [Original study.]

Excerpts from Beyond Pesticides: Neurotoxic Pesticide Detected in Air at High Levels in California County

The California Department of Pesticide Regulation (CDPR) released its 2016 air monitoring data where it was revealed that chlorpyrifos air concentrations for a one-month period at the air monitoring site on the campus of Shafter High School in Kern County was 39.4 nanograms per cubic meter (ng/m3) – more than 18 times higher than EPA’s level of concern for pregnant women (2.1 ng/m3).  Shafter High School is some distance from fields in an area where chlorpyrifos use is not as high as in other parts of Kern County or elsewhere in California. 

High chlorpyrifos levels at a school means that children and unsuspecting teachers and parents, especially those that may be pregnant, are breathing in unusually high levels of chlorpyrifos. Children exposed to high levels of chlorpyrifos have developmental delays, attention problems, attention-deficit/hyperactivity disorder problems, and pervasive developmental disorders.

Published on Leave a comment on Flame Retardants And Reduced IQ In Children

A new study that analyzed other studies (a meta-analysis) found that the class of flame retardant chemicals called PBDEs (commonly found in furniture and household products) has an effect on children's intelligence, so that it results in a loss of IQ points. Most of the studies looked at the child's exposure to flame retardants during pregnancy and then later IQ. They found that the child's IQ was reduced by 3.70 points for each ten-fold increase in flame retardant levels (thus, the higher the PBDE levels, the greater the effect on the child's IQ). This is of concern because flame retardants are in so many products around us, both in and out of the home. Older flame retardants (PBDEs) were phased out by 2013, but it turns out that the newer replacements (TBB and TBPH, including Firemaster 550) also get into people and also have negative health effects.

More and more research is finding health problems with flame retardants because they are "not chemically bound" to the products in which they are used - thus they escape over time. and get into us via the skin (dermal), inhalation (from dust), and ingestion (from certain foods and dust on our fingers). And because flame retardants are persistant, they bioaccumulate (they build up over time). They can be measured in our urine and blood. Evidence suggests that flame retardants may be endocrine disruptors, carcinogenic, alter hormone levels, decrease semen quality in men, thyoid disruptors, and act as developmental neurotoxicants (when developing fetus is exposed during pregnancy)  so that children have lowered IQ and more hyperactivity behaviors.

Where are flame retardants found? All around us, and in us. They are so hard to avoid because they're in electronic goods, in upholstered furniture, polyurethane foam, carpet pads, some textiles, the foam in baby items (car seats, bumpers, crib mattresses, strollers,nursing pillows, etc.), house dust, building insulation, and on and on. What to do? Wash hands before eating. Try to use a vacuum cleaner with a HEPA filter. Try to avoid products that say they contain "flame retardants". Only buy upholstered furniture with tags that say they are flame retardant free. The California Childcare Health Program has an information sheet on how to lower exposure to fire retardants. From Medical Xpress:

Flame retardant exposure found to lower IQ in children

A hazardous class of flame retardant chemicals commonly found in furniture and household products damages children's intelligence, resulting in loss of IQ points, according to a new study by UC San Francisco researchers. The study, published Aug. 3, 2017, in Environmental Health Perspectives, included the largest meta-analysis performed on flame retardants to date, and presented strong evidence of polybrominated diphenyl ethers' (PBDE) effect on children's intelligence. Despite a series of bans and phase-outs, nearly everyone is still exposed to PBDE flame retardants, and children are at the most risk," said UCSF's Tracey Woodruff, professor in the Department of Obstetrics, Gynecology and Reproductive Sciences..... 

The findings go beyond merely showing a strong correlation: using rigorous epidemiological criteria, the authors considered factors like strength and consistency of the evidence to establish that there was "sufficient evidence" supporting the link between PBDE exposure and intelligence outcomes. Furthermore, a recent report by the National Academies of Sciences endorsed the study and integrated evidence from animal studies to reach similar conclusions that PBDEs are a "presumed hazard" to intelligence in humans.

Researchers examined data from studies around the world, covering nearly 3,000 mother-child pairs. They discovered that every 10-fold increase in a mom's PBDE levels led to a drop of 3.7 IQ points in her child." "Many people are exposed to high levels of PBDEs, and the more PBDEs a pregnant woman is exposed to, the lower her child's IQ," said Woodruff. "And when the effects of PBDEs are combined with those of other toxic chemicals such as from building products or pesticides, the result is a serious chemical cocktail that our current environmental regulations simply don't account for." The researchers also found some evidence of a link between PDBE exposures and attention deficit hyperactivity disorder (ADHD), but concluded that more studies are necessary to better characterize the relationship.

PBDEs first came into widespread use after California passed fire safety standards for furniture and certain other products in 1975. Thanks to the size of the Californian market, flame retardants soon became a standard treatment for furniture sold across the country..... Mounting evidence of PDBEs' danger prompted reconsideration and starting in 2003 California, other states, and international bodies approved bans or phase outs for some of the most common PBDEs. PBDEs and similar flame retardants are especially concerning because they aren't chemically bonded to the foams they protect. Instead, they are merely mixed in, so can easily leach out from the foam and into house dust, food, and eventually, our bodies. [Original study.]

Published on Leave a comment on Is Male Fertility Plunging Downward?

Image result for human sperm, wikipedia The last post discussed the steep ongoing decline in sperm counts and sperm concentration in men from North America, Europe, Australia, and New Zealand. It mentioned a number of environmental causes that could be contributing to this, including the huge increase of chemicals, especially endocrine disruptors (chemicals that disrupt our hormones) over the past few decades.

But another study was also just published that showed (in mice) that effects of chronic exposure to endocrine disrupting chemicals are amplified over 3 generations - and each generation has even lower sperm counts, sperm concentration, and reproductive abnormalities. So each generation gets progressively worse with continued exposure.

As the researchers state: "Our findings suggest that neonatal estrogenic exposure can affect both the reproductive tract and sperm production in exposed males, and exposure effects are exacerbated by exposure spanning multiple generations. Because estrogenic chemicals have become both increasingly common and ubiquitous environmental contaminants in developed countries, the implications for humans are serious. Indeed, it is possible effects are already apparent, with population-based studies from the U.S., Europe, Japan, and China reporting reductions in sperm counts/quality and male fertility within a span of several decades." Yikes...

The World Health Organization (WHO) considers an impairment in ability to fertilize an egg at 40 million sperm per milliliter or below, and the level where WHO considers fertilization unlikely is 15 million sperm per milliliter. This is why the sperm count study discussed in the last post is so frightening: North American, Canadian, Australian, and New Zealand men  whose partners are not yet pregnant nor do they have children (i.e., they are not confirmed fertile men) have experienced a drop in average sperm count of about 50 percent over four decades, to 47 million sperm per milliliter. Niels Skakkebæk, a Danish pediatrician and researcher working on this topic said: "Here in Denmark, there is an epidemic of infertility."and "Most worryingly [in Denmark] is that semen quality is in general so poor that an average young Danish man has much fewer sperm than men had a couple of generations ago, and more than 90 percent of their sperm are abnormal." Uh-oh...What will it take for governments to address this serious issue?

In the meantime, see the last post for some tips on how to reduce your own exposure to endocrine disrupting chemicals. Just note that you can reduce exposure, but you can't totally eliminate exposure. Excerpts from Environmental Health News:

Science: Are we in a male fertility death spiral?

Margaret Atwood's 1985 book, The Handmaid's Tale, played out in a world with declining human births because pollution and sexually transmitted disease were causing sterility. Does fiction anticipate reality? Two new research papers add scientific weight to the possibility that pollution, especially endocrine disrupting chemicals (EDCs), are undermining male fertility.

The first, published Tuesday, is the strongest confirmation yet obtained that human sperm concentration and count are in a long-term decline: more than 50 percent from 1973 to 2013, with no sign that the decline is slowing. "The study is a wakeup that we are in a death spiral of infertility in men," said Frederick vom Saal, Curators’ Distinguished Professor Emeritus of Biological Sciences at the University of Missouri and an expert on endocrine disruption who was not part of either study.

The second study, published last week by different authors, offers a possible explanation. It found that early life exposure of male mouse pups to a model environmental estrogen, ethinyl estradiol, causes mistakes in development in the reproductive tract that will lead to lower sperm counts. According to vom Saal, the second study "provides a mechanistic explanation for a progressive decrease in sperm count over generations." What makes this study unique is that it examined what happened when three successive generations of males were exposed—instead of just looking only at the first. Hunt, in an email, said "we asked a simple question with real-world relevance that had simply never been addressed."

In the real world, since World War II, successive generations of people have been exposed to a growing number and quantity of environmental estrogens—chemicals that behave like the human hormone estrogen. Thousands of papers published in the scientific literature (reviewed here) tie these to a wide array of adverse consequences, including infertility and sperm count decline. This phenomenon—exposure of multiple generations of mammals to endocrine disrupting compounds—had never been studied experimentally, even though that's how humans have experienced EDC exposures for at least the last 70 years. That's almost three generations of human males. Men moving into the age of fatherhood are ground zero for this serial exposure.

So Horan, Hunt and their colleagues at WSU set out to mimic, for the first time, this real-world reality. They discovered that the effects are amplified in successive generations. They observed adverse effects starting in the first generation of mouse lineages where each generation was exposed for a brief period shortly after birth. The impacts worsened in the second generation compared to the first, and by the third generation the scientists were finding animals that could not produce sperm at all. This latter condition was not seen in the first two generations exposed. Details of the experimental results actually suggested that multiple generations of exposure may have increased male sensitivity to the chemical. [Original study.]

Published on Leave a comment on Antibiotics During Pregnancy and Miscarriage Risk

Image result for pills wikipedia Sometimes there is a need to take antibiotics during pregnancy. A recent study of 182,369 pregnant women found that the use of certain antibiotics during early pregnancy was linked with a higher rate of miscarriage before 20 weeks. These antibiotics included quinolones (Avelox, Cipro, Levaquin, Tequin), tetracyclines, sulfonamides (Septra, Bactrim), metronidazole (Flagyl), and macrolides (such as azithromycin, clarithromycin, but not erythromycin).

Certain antibiotics were not associated with spontaneous abortions. These antibiotics were penicillins, cephalosporins, nitrofurantoin, and erythromycin. The researchers pointed out that nitrofurantoin is a good antibiotic option for urinary tract infections - which is one of the most common infections in pregnancy. From Medscape:

Antibiotics During Pregnancy May Increase Miscarriage Risk

Use of certain antibiotics early in pregnancy is associated with an increased risk for spontaneous abortion, the authors of a new study report. Macrolides (except erythromycin), quinolones, tetracyclines, sulfonamides, and metronidazole all were associated with a greater risk, compared with penicillins, cephalosporins, or no antibiotic exposure at all, Flory T. Muanda, MD, and colleagues write in an article published in the May 1 issue of CMAJ. 

To assess the potential effect of antibiotics on miscarriage risk, Dr Muanda, from the Faculty of Pharmacy, Université de Montréal, Quebec, Canada, and colleagues analyzed data from the Quebec Pregnancy Cohort on pregnancies that occurred between January 1998 and December 2009....Women who experienced a clinically detected spontaneous abortion before gestational week 20 were considered cases, with the calendar date of the spontaneous abortion designated the index date.  Antibiotic exposure was defined as "having filled at least 1 prescription for any type of antibiotic either between the first day of gestation and the index date, or before pregnancy but with a duration that overlapped the first day of gestation," the authors explain. 

Antibiotic exposure occurred in 12,446 (13%) of those pregnancies, including 1428 that ended in spontaneous abortion (16.4% of all pregnancies ending in spontaneous abortion). Among the control patients, 11,018 (12.6% of all controls) were exposed to antibiotics.

In some instances, these findings support data from other studies, the authors point out. The class effect observed of tetracyclines and quinolones "supports current guidelines used in obstetrics that do not recommend use of these drugs in early pregnancy." Their finding that metronidazole was associated with a 70% increase in the risk for spontaneous abortion is similar to that of a study among Medicaid patients showing a 67% increased risk.... No increased risk was associated with nitrofurantoin, erythromycin, penicillins, or cephalosporins.

Published on Leave a comment on Stop Using Antimicrobial Containing Products

Stop using the damn antibacterial products! Yes, stop using stuff that says "antibacterial", "antimicrobial", "germ-killing",  or "anti-odor". Whether in personal care items, or bedding, or socks, or hand wipes, or wherever else you see those labels - don't buy them and try to avoid using them. Plain soap works just as well for cleaning hands (see FDA page). The "antibacterial" chemicals in soaps, toothpastes, body washes, etc. are absorbed by the body where they may do harm. Yes - HARM. The harms may not be known initially, but over and over, at some later point, the various chemicals are shown to cause harm - whether in humans or the environment, or both.

A case in point is the antimicrobial triclosan. It has been used for years in soooo many products, and religiously used by those concerned with "killing germs". It is now finally banned by the FDA from soaps and body washes because of the harms it causes. These include various health effects - and also because it's an endocrine disruptor (disrupts hormones).  And yes, it also crosses the placenta and has been associated with effects on the developing baby. For example, a recent study found an "inverse relationship" - that higher levels of triclosan in the mothers' urine during pregnancy (meaning they had used and absorbed more triclosan products) were associated with lower birth weight, length, head circumference, and gestational age (length of pregnancy). Of special concern to us at Lacto Bacto is that it also disrupts our microbes - remember that antimicrobial products (whether Triclosan in soap or antibiotics) kill off both beneficial and harmful bacteria.

As a recent study shows - triclosan is absorbed by pregnant women (and can be measured in their urine) and, it is absorbed and found in the urine of children who washed their hands or brushed their teeth with products containing triclosan.  And the higher the socioeconomic status, the more triclosan in the body - after all, people pay a premium for products that are "antimicrobial". While triclosan is now banned from being used in certain products (soaps and body washes), it is still allowed in many, many other products. And there are all those other antimicrobials that also should NOT be used. So please read the labels, especially the ingredient lists, and try to avoid antimicrobial, antibacterial, germ-killing, and anti-odor products. From Environmental health News:

Hygiene leaves kids with loads of triclosan

Levels of a controversial chemical meant to kill bacteria spike in the bodies of young children after they brush their teeth or wash their hands, according to a new study. U.S. manufacturers are phasing triclosan out of hand soaps after the Food and Drug Administration banned it effective last year amid concerns that the compound disrupted the body's hormone systems. It remains in Colgate Total toothpaste, some cleaning products and cosmetics. Health experts say exposure is best avoided for babies in the womb and developing children.

The latest study, published in the journal Environmental Science & Technology, is one of the first to show that children’s levels rise through their first few years of life. Hand washing and teeth brushing have speedy, significant impact on levels, the researchers found. Braun and colleagues tested the urine of 389 mothers and their children from Cincinnati, collecting samples from the women three times during pregnancy and from the children periodically between 1 and 8 years old.

They found triclosan in more than 70 percent of the samples. Among 8 year olds, levels were 66 percent higher in those that used hand soap. And more washing left the children with higher loads—those who reported washing their hands more than five times per day had more than four times the triclosan concentrations than those washing once or less per day. Children who had brushed their teeth within the last day had levels 2.5 times higher than those who had a toothpaste-free 24-hour span.

Braun said the levels of triclosan rose as the children aged, eventually leveling off. “Their levels were almost to moms’ levels by the time they reached 5 to 8 years of age.” This, he said, is likely due to more frequent use of personal care products as the kids aged. Despite the hand soap ban, triclosan remains on the market because it is effective at fighting plaque and gingivitis. Colgate uses 0.3 percent of the antibacterial to “fight harmful plaque germs.”.

Braun, however, said there is “quite compelling” evidence from animal studies that triclosan decreases thyroid hormone levels. Properly functioning thyroid hormones are critical for brain development. Just last month, using the same mothers and children, Braun and others reported that mothers’ triclosan exposure during pregnancy was linked to lower birth weights, smaller heads and earlier births. In addition, Pessah and colleagues reported triclosan hinders proper muscle development. The researchers used mice and fish, finding that triclosan affects the process responsible for muscle contraction.

Published on Leave a comment on Popular Weedkiller Found In Pregnant Women – What Are the Effects On Babies?

 News about the controversial pesticide Roundup and its active ingredient glyphosate just keep coming. Roundup is the most heavily used pesticide in the world, and it is used as a herbicide or weed-killer throughout the USA. Its use is rapidly rising, especially due to its use for preharvest applications on crops, and for genetically modified Roundup Ready crops. The chemical giant Monsanto (manufacturer of Roundup) insists that Roundup is safe for humans and the environment, but studies are indicating otherwise (see posts on Roundup). And yes, the pesticide and its residues are found wherever its presence is looked for. So one very important question is: If this heavily used pesticide is found in the foods we eat, and is around us (thus we have chronic low levels of exposure), what is it doing to us, if anything? 

This month the results of a study of 69 pregnant women receiving prenatal care at an Indiana obstetric practice was presented at a Children’s Environmental Health Network (CEHN) conference. The researchers reported that they found the presence of glyphosate and its breakdown products (aminomethylphosphonic acid or AMPA) in the urine of 91% of pregnant women. They found that higher levels of glyphosate were associated with lower than average birth weights and shorter pregnancy length (gestation age). Also, women living in rural areas had higher average glyphosate levels than women in urban/suburban regions. The researches suggested that it was because the rural women lived close to corn and soybean fields where glyphosate is heavily used.

The researchers also pointed out that this is especially worrisome because low birth weights and shortened pregnancy length (gestation) are seen as risk factors for many health and neurodevelopmental problems over the course of an individual’s life - lower cognitive abilities (including IQ), diabetes, heart disease, high blood pressure, and obesity. Of course the researchers plan to expand this research on more women.

But unfortunately US government agencies such as the FDA are not testing for the presence of glyphosate residues in foods (a major way we are exposed to glyphosate), even though they test for many other pesticides. So testing for the most heavily used pesticide in the world  in foods is deliberately not being done! It doesn't matter whether one thinks that Roundup (glyphosate) is harmful or not - we should know what foods this pesticide in the world appears in and at what levels. So far, whatever conventional foods are looked at, glyphosate residues are found. Even foods that one does not expect it in, such as honey. On the other hand, organic foods or crops are not allowed to use Roundup or glyphosate, so eating organic foods is the only way to avoid the pesticide. And of course, by not using Roundup or other glyphosate products on the property where you live.

The researchers and CEHN (Children’s Environmental Health Network) have put together a web-site documenting the increase in Roundup (glyphosate) use in the United States in the past few decades and why we should be concerned. There are many links at the thorough and well-researched site. If one looks at only a few pages, then look at the introduction page - The Project, the Birth Outcomes section, and the Biomonitoring Data page - which discusses "biomonitoring" to track levels of chemicals such as pesticides in human urine and blood, and why we should be concerned. They also discuss 2,4-D - another popular pesticide (herbicide or weed-killer), which is also used in many lawn "weed and feed" products. 2.4-D has serious health concerns, but its use is also rapidly increasing on farms due the increase in genetically modified crops (which allow it to be sprayed on crops without killing the crops).

Bottom line: We are being exposed to chronic low levels of pesticides in our environment and foods - and we really don't know what this is doing to us. We don't even know the extent of our exposures because it is not being measured. This is especially worrisome because our exposure to some of these pesticides is rapidly increasing.

From the investigative journalism site FERN: Researchers find glyphosate in pregnant women, worry about impact on infants

A team of scientists this week released early results of an ongoing study spotlighting concerns about the rising use of pesticides and reproductive risks to women and children. The researchers tested and tracked, over a period of two years, the presence of the common herbicide glyphosate in the urine of 69 expectant mothers in Indiana.

The team – led by Paul Winchester, medical director of the neonatal intensive care unit at the Franciscan St. Francis Health System and professor of clinical pediatrics at Riley Hospital for Children in Indianapolis, Ind. – found glyphosate residues in 91 percent of the women, and high levels of those residues appeared to correlate with shortened pregnancies and below-average birth weights adjusted for age. The findings alarmed the researchers because such babies are at increased risk of diabetes, heart disease, high blood pressure, and lower cognitive abilities. “Gestational age maximizes the size of your brain at birth, and any shortening is essentially a reduction of IQ points,” Winchester said in an interview with FERN’s Ag Insider. “It has not just health, but lifetime achievement implications.”

This is the first time that anyone has demonstrated glyphosate is present in pregnant women in the U.S., according to Winchester. However, the results were limited by a small sample size. He and his colleagues plan to submit their research to a peer-reviewed journal within the month and they hope to expand the study later this year. “The fact that we were able to find adverse effects on the small number of people we measured would imply a larger study is needed immediately to find out if this is prevalent everywhere,” Winchester says. “This is a critical piece of information that I think people should be concerned about.”

Glyphosate is the world’s most popular herbicide and the key ingredient in Monsanto’s Roundup weed killer. Globally, 9.4 million tons of glyphosate have been sprayed on crops, lawns, and gardens since the chemical was released on the market in 1974....Currently, concerns about the safety of glyphosate are at the center of a major national lawsuit. Monsanto is being sued by hundreds of U.S. consumers who say the company did not warn them, despite evidence, that the chemical can cause cancers such as non-Hodgkin lymphoma, a blood disease. A key piece of testimony in the suit is a 2015 International Agency for Research on Cancer (IARC) report stating that glyphosate is “probably carcinogenic to humans.” Monsanto contests the listing, citing rulings by the EPA, the European Chemicals Agency, and the European Food Safety Authority that did not find cancer risks.

Winchester has long studied the risks posed by agrochemicals, finding in a 2009 study that high levels of the farming chemical atrazine in water was associated with increased risk of genital birth defects in children. In the glyphosate study, Winchester and his colleagues considered whether water might again be the exposure route for the pregnant women they monitored. After testing water samples, the scientists concluded that it was not the source. They suspect diet may play a role. The Food and Drug Administration, however, recently suspended the testing of glyphosate residues in food, citing the need for improved validation methods.

Experts say the spread of weeds resistant to glyphosate in the Midwest is triggering intensification of herbicide use over longer periods of time. “Until this year, most herbicides in the Midwest were sprayed during a six-week window, but now heavy herbicide spray season will last at least four months, placing more women and children at heightened risk,” Phil Landrigan, dean for global health at Mount Sinai Medical School and a member of the research team, said in a statement. As a result, he and his colleagues predict the risk of reproductive problems and adverse birth outcomes will rise among women and children living in rural areas.

Another article on this research is from Carey Gillam for Huffington Post: Moms Exposed To Monsanto Weed Killer Means Bad Outcomes For Babies