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Doctors and scientists have been trying for years to learn what causes preeclampsia, a common complication of pregnancy characterized by high blood pressure and protein in the urine, and a major cause of premature delivery and maternal and fetal deaths. A new study found that molecules that send detrimental signals are abundant in the placentas and umbilical cords of preeclampsia patients.
During pregnancy, the placenta functions like a trading post of sorts: Inside the pancake-shaped organ, maternal and fetal blood is trucked through, nutrients and oxygen are delivered to the developing fetus, and waste products are shipped out for disposal. All of that life-sustaining traffic requires a multitude of molecular signals, and the study zeroed in on the bad signals that may be involved in preeclampsia.
Researchers compared protein levels in samples from placentas and umbilical cords of 10 women who had experienced preeclampsia and 10 who had not. They found that proteins that signal both cell stress and cell death were significantly higher in samples taken from the women who had experienced preeclampsia. The researchers say that the increase in those factors could reduce nutrient transport and send bad signals to the maternal vascular system, which circulates blood. These circulating factors may also pass the placental barrier and affect the fetus.
In addition to analyzing which molecules were more pronounced in preeclampsia, the researchers looked at the effects of the syndrome on study participants’ babies. They found that the average hospital stay for preeclampsia babies was significantly longer: Those newborns stayed six days on average, while the babies born to mothers without preeclampsia stayed a little over three days on average.
Now that the molecular signal problems have been discovered, the focus will shift to finding ways to therapeutically block them one day to prevent preeclampsia.
Full story. Annals of Internal Medicine article Sept 2014 Low-Dose Aspirin Use for the Prevention of Morbidity and Mortality From Preeclampsia: U.S. Preventive Services Task Force Recommendation Statement
Most people know that smoking during pregnancy is a bad idea. The CDC warns that smoking during pregnancy can increase the likelihood of a miscarriage, Sudden Infant Death Syndrome (SIDS), and certain birth defects like a cleft lip or palate, and premature birth.
New research, published in the Journal of the American Medical Association (JAMA) Psychiatry in July, is adding “conduct disorders” to that list of health risks. Mothers who smoked during pregnancy were more likely to have children who had behavioral issues, the study found.
“The evidence is emerging that smoking in pregnancy and the frequency of smoking in pregnancy is correlated with developmental outcomes after (children) are born,” senior author Gordon Harold, professor of developmental psychopathology at the University of Leicester in England, said.
The CDC estimates that 13 percent of women smoked during their last three months of pregnancy. A 2012 survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) showed that an even higher amount, 21.8 percent of white women aged 15 to 44, smoked while pregnant. Black and Hispanic women’s rates lingered around 14.2 and 6.5 percent respectively.
Becoming a young adult is exciting, difficult, and scary for both parents and teens. It is a time of increasing independence and change, no matter what the situation.
August 1st – 7th is World Breastfeeding Week. This year’s theme: Breastfeeding: A Winning Goal – For Life! asserts the importance of increasing and sustaining the protection, promotion and support of breastfeeding.
MOST has several resources available to families who want to breastfeed their multiples.
“This was my first and only pregnancy and I was terrified. The first few weeks, of what would ultimately be 291 days in the NICU, were simply a blur as I dealt with the shock of such an early and traumatic delivery. Two of my girls faired pretty well, all things considered. My third seemed to bear the brunt of their extremely preterm birth. No one expected her to live the first few days but weeks passed and she defied the odds, my worries switched from whether or not she would live to what kind of life she would have. Would she walk and talk? Would she go to school, play sports or dance? Or would the issues she was facing as an infant prohibit her from living a “typical” life.
MOST connected me with another mom whose support gave me hope. Her situation mirrored mine in several ways, with one of her boys struggling far worse than the other two. She was three years down the road and talking with her, hearing that the unknown is scary but it could be handled and that I would come out stronger than I ever knew, that is what got me through. Maybe I would not have the family I envisioned with three healthy children running around my home, but we would be a family. We might be carting around an oxygen tank and a feeding bag or two, but you learn, you adapt and you realize that there is always hope, no matter what the ultimate outcome may be.
Hope was the greatest gift I could have been given and even when we did ultimately lose my daughter at 14 months old, I thought I didn’t belong in the HOM community anymore. I didn’t feel like a twin mom either and honestly considered dropping out of my same age triplet group. But it was the MOST community that continued to embrace me, lift me up and reminded me that I still was and always would be a triplet mom.” – Keira
After her daughter’s death, Keira was connected to MOST’s Lost Angels, a private support group for families who have experienced a loss to help them through their time of grief.
Please help MOST continue to help families like the Keira’s by making a donation online today. Or you may call the MOST office at 631-859-1110. We’d love to hear from you! Thank you.
Every family needs routines. They help to organize life and keep it from becoming too chaotic. Children do best when routines are regular, predictable, and consistent.
One of a family’s greatest challenges is to establish comfortable, effective routines, which should achieve a happy compromise between the disorder and confusion that can occur without them, and the rigidity and boredom that can come with too much structure and regimentation, where children are given no choice and little flexibility.
Parents seem to affect their kids’ physical activities in three ways — by acting as role models, by helping kids be active (by taking them to the park, for instance), and by being active with them. “All three aspects are thought to be important,” Esther van Sluijs, group leader, said, “but it has generally been unclear how directly mother and child’s physical activity are related.”
In the study, the researchers used devices called accelerometers to track 554 children, all 4 years old, and their mothers for as many as seven days. “The more activity a mother did, the more active her child,” van Sluijs noted.
Specifically, for every single minute of moderate-to-vigorous activity that the mother did, her child was more likely to do 10 percent more of a similar level of activity. Those extra minutes add up over time, according to researchers.
“If activity in mothers and children can be encouraged or incorporated into daily activities so that more time is spent moving, activity levels are likely to increase in both,” van Sluijs said. “In return, this is likely to have long-term health benefits for both.”
Another expert focused on the issue of fathers and what role they might play.
“This is a big question not addressed here,” said Leann Birch, a professor at the University of Georgia’s department of foods and nutrition who studies children and obesity. But, she said, research on parenting suggests that fathers tend to engage in more rough-and-tumble and high-action play with kids than mothers.
Also, she said, “some of our own work showed that reported activity by dads was more important than by moms in predicting the activity of daughters, especially in organized sports during later childhood.”
Adapted from an article in Medline Plus.
Bill was caught between jubilation and terror when he learned he and his wife were going to have triplets. He had a lot of questions and was very concerned about his wife’s health and how they were going to manage their miracles after delivery.
The doctor referred Bill to MOST, a place where his questions could be answered and his first-time dad and triplet dad fears could be eased. Everyone at MOST “has been fully invested in the well-being of my wife, daughters, and us as a family.”
“We felt very prepared when we had our NICU tour due to our conversations with MOST and the information that we read in the MOST book. My wife and I are truly grateful for everything that you have done for our daughters and us.”
Please help MOST continue to help families like the Bill’s by making a donation online today. Or you may call the MOST office at 631-859-1110. We’d love to hear from you! Thank you.
MOST’s book, Expecting Multiples: The Most Comprehensive Guide to High-risk Twin & All Triplet, Quadruplet or More Pregnancies, is available at Amazon.com.
A team of University of California, San Francisco, obstetricians and bioengineers is building a wireless device that can be inserted into a pregnant woman’s vagina to monitor her cervix and, when necessary, send an alert that the woman may be going into premature labor.
The device, which will be similar in size and shape to a diaphragm used for birth control, would be the first early-warning system for preterm labor, which is the main cause of death among newborns worldwide.
It’s still in early development, but the device, called the Smart Diaphragm, just got $2.7 million from the Bill & Melinda Gates Foundation to start manufacturing and expand clinical trials. A prototype has been tested in about 15 pregnant women at UCSF, and a larger study is planned for this summer.
“We need a way to have an early heads up – who needs to be seen by a doctor, who needs surveillance. That’s what drove us,” said Dr. Larry Rand, an obstetrician and the lead developer of the diaphragm.
“For 30 years, we’ve been doing research on preventing preterm birth,” Rand said. “But we’ve been focusing too much on the uterus and the contractions, and that’s sort of like trying to treat a heart attack after someone has chest pains.”
Monitoring the cervix at a molecular level, he said, may be the answer. Rand believes the cervix may be critical for understanding preterm birth because it undergoes subtle molecular changes a long time – weeks, perhaps- before labor begins.
When preterm labor is detected now – either because a woman has started having contractions or because an ultrasound has detected a change in the size or shape of her cervix – it’s usually so far advanced that there aren’t many options for doctors to stop it.
The cervix softens when the collagen starts to break up. Ordinarily, collagen forms a tight crisscross pattern, like a basket weave, that keeps the cervical tissue stiff. But something causes that basket weave to loosen.
Rand’s device cups the cervix and monitors the collagen, ideally revealing when the basket weave starts to come undone. The device is embedded with two types of sensors – one to monitor electric currents moving through the cervical tissue, and one to monitor fluorescent light. As collagen breaks down, electrical currents move more easily through the tissue and the tissue bounces back light in a different pattern.
“We’re measuring multiple times throughout pregnancy. We’re getting in essence a virtual biopsy of the cervix,” said Mozziyar Etemadi, a postdoctoral bioengineer from UCSF and UC Berkeley who’s working with Rand on building the diaphragm. “This wasn’t possible even 10 years ago. The tools that we’re using didn’t exist – the electronics and the wireless connectivity were not there.”
The idea is to insert the diaphragm into a woman’s vagina at some point early in the pregnancy to get a baseline reading on her cervix. Then, the woman would reinsert the diaphragm periodically during pregnancy – maybe every few days or so – to get more readings.
The data would be transmitted wirelessly to cloud storage, where it would be accessible by the patient and doctors. If her collagen structure was changing enough to raise concern, an alert would go out, either to the patient or her doctor, or both.
When all four of our babies were finally discharged from the NICU, I wondered when and if we would ever take them all out anywhere. They were so fragile that fears of returning to the NICU were painfully apparent, and hard to shake. As the babies grew and thrived, we began itching to take them places. Part of the fun of having a new baby is taking them out to explore the world, right? Aside from adventures, there’s always the reality of what must be accomplished outside the home, say grocery shopping and doctor’s appointments to name a few. Continue reading Getting Out With Toddler Multiples