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    Drinking in pregnancy tied to subtle changes in babies’ faces

    by UNTV News   |   Posted on Monday, June 12th, 2017

    A pregnant woman is seen in a handout photo. REUTERS/Newscom

    (Reuters Health) – Women who drink even a little bit of alcohol during pregnancy may be more likely than other mothers to have babies with slight facial abnormalities that have been linked to developmental problems, a recent study suggests.

    When researchers examined data from facial images for 415 one-year-old children, they found subtle changes in babies’ faces mostly around the nose, eyes and lips associated with almost all levels of alcohol exposure regardless of whether drinking occurred only in the first trimester or throughout the pregnancy.

    “We are surprised to see these differences in facial shape with low doses of alcohol exposure, which in our study was defined as two standard drinks on any one occasion and no more than seven in a week,” said lead study author Evelyne Muggli of the Murdoch Children’s Research Institute and the University of Melbourne in Australia.

    “This means that any level of alcohol contributes to the way the face is formed and raises questions about the possible impact on brain development, which is the subject of further research,” Muggli said by email.

    The facial changes found in the study are so subtle they aren’t visible to the naked eye, Muggli said. They can only be seen with sophisticated three-dimensional facial shape analysis, and they don’t necessarily mean that unborn babies have been harmed if mothers consumed some alcohol while pregnant, Muggli added.

    But differences around the middle of the face and nose seen with alcohol exposure during pregnancy in the study resemble anomalies associated with fetal alcohol spectrum disorder, researchers report in JAMA Pediatrics.

    Differences were most pronounced between children with no exposure to alcohol in utero and children with low exposure in the first trimester, particularly in the forehead, the study found.

    Compared to children not exposed to any alcohol when their mothers were pregnant, kids with moderate to high exposure in the first trimester had differences in their eyes, mid-face and chin. Changes in the chin were also seen with binge drinking in the first trimester

    Most women who do drink during pregnancy only drink a little bit and often stop once they realize they’re pregnant, limiting fetal alcohol exposure to the first trimester, Carol Bower of the University of Western Australia writes in an accompanying editorial.

    Up to about one in 20 children may be affected by fetal alcohol spectrum disorder (FASD), which can lead to cognitive impairment including irreversible brain damage.

    Children exposed to alcohol in the womb may have learning challenges such as deficits in memory or speech as well as behavior problems like hyperactivity.

    The study wasn’t a controlled experiment designed to prove how or if different levels of alcohol exposure at different points in pregnancy might impact children’s faces, or cause specific developmental problems.

    In addition, all of the children in the study were white, and it’s possible facial changes associated with alcohol exposure during pregnancy might look different in children from other racial or ethnic groups, the researchers note.

    Even so, the findings add to a growing body of evidence on the fetal development effects of even low levels of alcohol consumption during pregnancy, said Heather Carmichael Olson, of the University of Washington School of Medicine.

    “It is a substance that can change fetal development, and can be associated with lifelong changes in learning and behavior,” Carmichael Olson, who wasn’t involved in the study, said by email.

    “If any amount of prenatal alcohol exposure can lead to physical changes in fetal development, as the current study suggests, so that it’s not just high doses or long-term drinking that have measurable effects, the safest advice that providers can give is that women who want a healthy pregnancy should avoid this biological risk factor if they are considering pregnancy or are pregnant,” Carmichael Olson added. — By Lisa Rapaport

    SOURCE: bit.ly/2rv58kQ JAMA Pediatrics, online June 5, 2017.

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    Even moderate drinking linked to changes in brain structure, study finds

    by UNTV News   |   Posted on Thursday, June 8th, 2017

     

    FILE PHOTO: A laboratory assistant holds one hemisphere of a healthy brain in the Morphological unit of psychopathology in the Neuropsychiatry division of the Belle Idee University Hospital in Chene-Bourg near Geneva, Seitzerland in a March 14, 2011 file photo. REUTERS/Denis Balibouse/File Photo

    Drinking even moderate amounts of alcohol is linked to changes in brain structure and an increased risk of worsening brain function, scientists said on Tuesday.

    In a 30-year study that looked at the brains of 550 middle-aged heavy drinkers, moderate drinkers and teetotallers, the researchers found people drank more alcohol had a greater risk of hippocampal atrophy – a form of brain damage that affects memory and spatial navigation.

    People who drank more than 30 units a week on average had the highest risk, but even those who drank moderately – between 14 and 21 units a week – were far more likely than abstainers to have hippocampal atrophy, the scientists said.

    “And we found no support for a protective effect of light consumption on brain structure,” they added.

    The research team – from the University of Oxford and University College London – said their results supported a recent lowering of drinking limit guidelines in Britain, but posed questions about limits recommended in the United States.

    U.S. guidelines suggest that up to 24.5 units of alcohol a week is safe for men, but the study found increased risk of brain structure changes at just 14 to 21 units a week.

    A unit is defined as 10 milliliters (ml) of pure alcohol. There are roughly two in a large beer, nine in a bottle of wine and one in a 25 ml spirit shot.

    Killian Welch, a Royal Edinburgh Hospital neuropsychiatrist who was not directly involved in the study, said the results, published in the BMJ British Medical Journal, underlined “the argument that drinking habits many regard as normal have adverse consequences for health”.

    “We all use rationalizations to justify persistence with behaviors not in our long term interest. With (these results) justification of ‘moderate’ drinking on the grounds of brain health becomes a little harder,” he said.

    The study analyzed data on weekly alcohol intake and cognitive performance measured repeatedly over 30 years between 1985 and 2015 for 550 healthy men and women with an average age of 43 at the start of the study. Brain function tests were carried out at regular intervals, and at the end of the study participants were given a MRI brain scan.

    After adjusting for several important potential confounders such as gender, education, social class, physical and social activity, smoking, stroke risk and medical history, the scientists found that higher alcohol consumption was associated with increased risk of brain function decline.

    Drinking more was also linked to poorer “white matter integrity” – a factor they described as critical when it comes to cognitive functioning.

    The researchers noted that with an observational study like this, no firm conclusions can be drawn about cause and effect. They added, however, that the findings could have important public health implications for a large sector of the population. — By Kate Kelland | LONDON

    (Editing by Robin Pomeroy)

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    Smoking during pregnancy tied to eye damage in kids

    by UNTV News   |   Posted on Thursday, March 9th, 2017

    A woman is silhouetted as she smokes a cigarette in central Sydney August 1, 2013. REUTERS/Daniel Munoz

    (Reuters Health) – When women smoke during pregnancy or have underweight babies their children have a greater risk of developing a type of retina damage, a Danish study suggests.

    Researchers focused on the thickness of what’s known as the retinal nerve fiber layer, made of fibers in the optic nerve that transmit visual information from the eye to the brain. When the retinal nerve fiber layer is too thin, people may have an increased risk of vision impairment and glaucoma, an eye disease that can lead to blindness.

    Previous studies have linked maternal smoking to underweight babies, researchers note in JAMA Ophthalmology. Because low birth weight is also associated with having a thinner retinal nerve fiber layer, smoking could have a direct and indirect effect on the optic nerve and its connections to the retina, researchers note.

    In the current study, researchers examined data from eye exams on 1,323 children at age 11 or 12 and found both smoking and low birth weight independently associated with thinner retinal nerve fiber.

    “Smoking for a relatively short time interval during pregnancy can have lifelong consequences to the exposed fetus,” said Dr. Christopher Kai-Shun Leung, a researcher at the Chinese University of Hong Kong and author of an editorial accompanying the study.

    In the study, 80 percent of the mothers didn’t smoke during pregnancy. Another 2 percent of mothers stopped smoking during pregnancy and about 18 percent continued to smoke throughout pregnancy.

    Roughly 4 percent of their babies were born at a low birth weight.

    Eye exams for all of the kids found they had an average retinal nerve fiber thickness of 104 micrometers.

    Children of mothers who smoked during pregnancy had retinal nerve fiber that was typically 5.7 micrometers thinner than in kids whose mothers didn’t smoke at all while pregnant.

    There wasn’t a difference between children of nonsmoking mothers and kids born to women who stopped smoking during pregnancy.

    In low birth weight children, average retinal nerve fiber was 3.5 micrometers thinner than with kids born at a normal weight.

    The study wasn’t a controlled experiment designed to prove that either smoking or low birth weight cause eye damage.

    Another limitation of the study is the lack of data on socioeconomic status of the mothers, which can influence tobacco use and the risk of pregnancy complications, the authors note. Researchers also lacked data on alcohol use during pregnancy, a habit that often accompanies smoking and that can independently impact fetal development.

    For women who did smoke during pregnancy, researchers didn’t know how many cigarettes they smoked or how often they smoked.

    Lead study author Hakan Ashina of Righospitalet in Copenhagen didn’t respond to emails seeking comment.

    The differences in retinal nerve fiber layer thickness found in the study aren’t big enough to produce detectable eye problems, Leung said by email.

    “However, a thinner retinal nerve fiber layer has been connected to a higher risk of development of glaucoma,” Leung added. “Monitoring the retinal nerve fiber layer in children with history of maternal smoking and/or low birth weight would be important.”

    SOURCE: bit.ly/2mmxNWz and bit.ly/2lEDnoB JAMA Ophthalmology, online March 2, 2017.

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    Obese couples may take longer to conceive

    by UNTV News   |   Posted on Wednesday, March 1st, 2017

    The legs of women are pictured as they walk along a street in Paris, France, October 14, 2015. REUTERS/Jacky Naegelen

    (Reuters Health) – – Couples who are obese may take longer to achieve pregnancy than partners who aren’t as overweight, a recent U.S. study suggests.

    Previous studies in women have linked obesity to difficulties getting pregnant. In the current study, neither male nor female obesity alone was linked to taking a longer time to conceive, but when both partners were obese, the couple took up to 59 percent longer to conceive than non-obese counterparts.

    “If our results are confirmed, fertility specialists may want to take couples’ weight status into account when counseling them about achieving pregnancy,” said lead study author Rajeshwari Sundaram of the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Bethesda, Maryland.

    “The benefits of a healthy weight are well known: obesity increases the risk for diseases such as type 2 diabetes, heart disease and cancer,” Sundaram added by email.

    Sundaram and colleagues focused on the relationship between pregnancy and body mass index (BMI), a ratio of weight to height. A BMI between 18.5 and 24.9 is considered a healthy weight, while 25 to 29.9 is overweight, 30 or above is obese and 40 or higher is what’s known as morbidly obese. (The National Heart, Lung and Blood Institute has an online BMI calculator here: bit.ly/1D0ZqDv.)

    An adult who is 5 feet 9 inches tall and weighs 160 pounds, for example, would have a BMI of 23.6, which is in the healthy range. An obese adult at that height would weigh at least 203 pounds and have a BMI of 30 or more.

    Researchers categorized individuals into two subgroups: obese class I, with a BMI from 30 to 34.9, and obese class II, with a BMI of 35 or greater.

    Overall, 27 percent of the women and 41 percent of the men were obese class I or heavier.

    Then, the researchers compared the average time to conceive for couples where neither partner was obese to couples where both fell into the obese class II group.

    Couples in the obese class II group took 55 percent longer to achieve pregnancy than their normal weight counterparts, the study team calculated.

    After accounting for other factors that influence fertility such as age, smoking status, exercise and cholesterol levels, obese class II couples took 59 percent longer to get pregnant.

    About 40 percent of the men and 47 percent of the women also had enough excess fat around the midsection to potentially influence fertility.

    In addition, 60 percent of the women and 58 percent of the men said they exercised no more than once a week, the researchers report in Human Reproduction.

    Beyond its small size, another limitation of the study is that it wasn’t a controlled experiment designed to determine whether obesity directly causes infertility, the authors note. It also focused on couples in the general population, not people undergoing treatment for infertility, so the results might not reflect what would happen for all couples trying to conceive, the researchers point out.

    However, unlike many other studies of obesity and fertility, the current analysis used height and weight measured by clinicians instead of relying on participants to report this information themselves, which may make the findings more accurate.

    Obesity can influence fertility by altering hormone levels in both men and women, converting testosterone to estrogen, said Dr. Jeffrey Goldberg, section head of reproductive endocrinology at the Cleveland Clinic in Ohio.

    “If you have more fat there is more conversion from testosterone to estrogen,” Goldberg, who wasn’t involved in the study, said.

    It makes sense that obese couples would take longer to conceive because excess weight doesn’t just impact fertility in women.

    “For women extra weight impairs ovulatory function,” Goldberg said. “For guys, having lower testosterone and higher estrogen impairs sperm production and having a lot of fat around the scrotum, fat thighs and fat around the abdomen raises the scrotal temperature and that can also have an adverse effect.”

    SOURCE: bit.ly/2ldct2A Human Reproduction, online February 3, 2017.

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