Posts Tagged ‘pregnancy risk’

New BPA Research – Is Your Plastic Water Bottle Toxic?

February 20, 2010

According to an article published in WebMD Health News, two recent studies suggest that the plastic chemical bisphenol A (BPA) is not toxic to the brain and that it does not inhibit the development of the human reproductive system. One of the studies was funded by the plastics industry. Both studies were originally published in Toxicological Sciences.

BPA is an organic chemical compound, which is used as an additive or building block in several plastics. Its primary purpose is to harden plastic. For this reason, BPA is found in a wide variety of consumer products such as plastic bottles, cups, and even baby milk bottles.

“Some experts are concerned that exposure to BPA and its weak estrogen-like effects, especially during critical periods of development, may be linked to a range of health hazards, including behavioral effects, reproductive problems, cancers, heart disease, and diabetes.”

The two studies in question were designed to specifically study the impact of BPA on the brain and the reproductive system. Both studies used animal models.  The study that focused on neurotoxicity found that female rats and their litters did not develop neurological defects from exposure to BPA.  The study that focused on BPA’s impact on the reproductive system found that rats exposed to low doses of BPA in utero and throughout the breastfeeding period maintaind healthy reproductive systems.

Notwithstanding these new findings, many remain concerned about the toxicity of BPA. Even the FDA reversed its position regarding the safety of BPA in January 2010 and called for additional research on the subject. Previous studies appear to suggest that BPA is toxic. For example, in an article published in Reproductive Toxicology in 2007, 38 experts agreed that average levels of BPA in humans are above those that appear to cause harm in animals.  In 2009, an article publushed in Molecular and Cellular Endocrinology, sumarized past BPA research and concluded that:

“The potential for BPA to influence body weight is suggested by in vitro studies demonstrating effects of BPA on adipocyte differentiation, lipid accumulation, glucose transport and adiponectin secretion. Data from in vivo studies have revealed dose-dependent and sex dependent effects on body weight in rodents exposed perinatally to BPA. The mechanisms through which perinatal BPA exposure acts to exert persistent effects on body weight and adiposity remain to be determined.”

Another study published in the Journal of American Medical Association specifically addressed the impact of BPA on humans.  The study concluded that there was a strong positive correlation between the amount of  BPA in a person’s urine and the incidence of heart disease, diabetes, and enzyme abnormalities.  These are just a few of the many research studies suggesting a link between BPA and varous medical complications.

Contributing Author:  Jon Stefanuca

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Study: Screening Tools Accurately Identify Postpartum Depression – Focus Group: Urban Minority Moms

February 20, 2010

In a study led by the University of Rochester Medical Center and published online by the journal Pediatrics, researchers have determined that there is a high degree of accuracy in making the initial determination of postpartum depression (“baby blues”) in urban, minority women when using three depression screening tools.   This research was funded by the National Institute of Mental Health 

This study is reported in a recent article posted in Medical News Today.

Many women experience the so-called “baby blues.” When the feelings persist or worsen it may be clinical depression. The symptoms include insomnia, persistent sadness, lack of interest in nearly all activity, anxiety, change in appetite, persistent feelings of guilt, and thoughts of harming oneself or the baby. Postpartum depression affects up to 14 percent of new mothers in the United States, with higher rates among poor and minority women.

These screening tools have previously been evaluated but this is the first time they have been tested with a group for whom there is not much data – low-income women, especially African-American women, said Linda H. Chaudron, M.D., associate professor of Psychology, Pediatrics and of Obstetrics and Gynecology.

The three screening tools being evaluated were the Edinburgh Postnatal Depression Scale, the Beck Depression Inventory II and the Postpartum Depression Screening Scale.  By clicking on any of the links we have supplied to these tests, the reader can readily see just how simple they are and how quickly they can be administered (as reported – 5 minutes or less).

These screening tests are just that – screening mechanisms.  Healthcare providers dealing with new mothers should be mindful of using these tools and thereby be in a position to help these mothers during this difficult time in their lives.  This is not something restricted to obstetricians  – it is for all healthcare providers who come in contact with any new moms, whom they suspect may be suffering from “baby blues.”  Don’t assume all is well on the home front – ask!  It won’t take much time, but it could provide much needed help for your patients.


Fibroids during pregnancy increases risk of stillborn birth.

February 9, 2010

Fibroids, which occur in an estimated 5% to 20% of women, have been reported by researchers at Washington University in St. Louis, Missouri  to increase the risk of stilborn birth. The study was presented Saturday, February 6th,  at the annual meeting of the Society for Maternal-Fetal Medicine in Chicago.

It is known that many women who have fibroids are without any symptoms.  What is of importance is that women typically undergo sonography at 16 to 22 weeks.  It is at this time that such asymptomatic fibroids can be detected.

This study looked retrospectively at over 64,000 births.  After numerous other factors were excluded and a subgroup identified, the investigators found that women with  fibroids and in whom there was evidence of intrauterine growth restriction (IUGR) were at a relative increased  risk of having a stillbirth (fetal death in utero – FDIU).

“Our results showed that women with a combination of fibroids and fetal growth restriction were at two-and-a-half times the risk of having a stillbirth, though the absolute risk remained rare,” said Dr. Alison G. Cahill, one of the study’s authors. “This may lead to a future recommendation for serial growth scans to monitor fetal growth in women with fibroids.”

One related question remains: will the cost-effectiveness of serial sonograms for this group at risk drive the decision-making on setting a new standard for surveillance?

If you are pregnant and know you have fibroids, this is a subject for discussion with you obstetrician.  If you are unaware of the presence of fibroids and undergo the usual 16-22 week sonogram, it might not be a bad idea to inquire about the presence of asymptomic fibroids when this test is interpreted.  We have been involved in a number of cases of FDIU and the emotional devastation it causes a family when it occurs is simply awful.

Should you be interested in more information about fibroids, the US Department of Health and Human Services has a good FAQ on this topic.

FDA announces research program for prescription drugs in pregnancy

January 2, 2010

On December 30, 2009, the FDA announced that a new collaborative research program to study the effects of prescription medications taken by women during pregnancy.  This program is called the Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP) and will be a collaborative effort among the FDA, and researchers at the HMO Research Network Center for Education and Research in Therapeutics (CERT), Kaiser Permanente’s multiple research centers and Vanderbilt University.

The FDA references in its announcement an article in the American Journal of Obstetrics and Gynecology, which states  that it estimates that two-thirds of women who are pregnant take at least one prescription medication during their pregnancy.

One might think that there had been a number of clinical trials relating to medications taken during pregnancy prior to this collaborative effort; however, this appears not to be the case since there were too many concerns about the health of the mother and fetus preventing such a study in the past.

For more details  on this long-overdue research study, see the FDA’s announcement.