Mom’s age at birth linked to daughter’s later childlessness

UNTV News   •   January 11, 2018   •   2941

Pregnant women attend a yoga class in Madrid March 17, 2009. REUTERS/Susana Vera

(Reuters Health) — Moms who have children later in life are more likely to have daughters who don’t have kids, according to a new study.

Compared with women born to 20- to 24-year-old mothers, daughters born to mothers in their mid-20s or 30s were more likely to be childless, the study authors report in the journal Human Reproduction.

“In many countries, couples are having children later and later, and there haven’t been many studies of future reproduction,” said study author Dr. Olga Basso of McGill University in Montreal, Canada.

Basso and colleagues analyzed data from the U.S.-based Sister Study on more than 43,000 women born between 1930 and 1964.

Overall, about 7,600 women – or nearly 18 percent – hadn’t given birth. The researchers found that as maternal age at delivery went up, so did the odds that daughters would be childless.

Compared with study participants born to 20- to 24-year-old mothers, for instance, the odds of childlessness were 21 percent higher for participants born to mothers ages 25-29, 30 percent higher for women born to mothers ages 30 to 34, and 40 percent higher for women born to mothers who were 35 or older.

Basso and colleagues want to know why. They’re interested in future studies about changes in biology, behavior and socioeconomic status and how those could affect birth and childlessness.

“It could be that women who have children at an older age have daughters instilled with different behaviors,” Basso said. “They may have different ambitions and different plans.”

“I was concerned when I saw these findings because I really think women should have children when they’re ready as a matter of choice,” she told Reuters Health by phone. “I don’t want people to believe, as a result of this, that they need to have children when they’re 25.”

Additional studies are looking at the effect of father’s age on childlessness and the historical trends of childbirth.

“We’ve seen an increase in age at first birth, or when women have their first child, but the age hasn’t changed much for last birth,” said Ruben Arslan of the Max Planck Institute for Human Development in Berlin, Germany. Arslan, who wasn’t involved with this study, researches delayed childbearing.

“In past decades, women had children for longer and had more children,” Arslan told Reuters Health by phone. “What we’re seeing is not unprecedented, and it’s not a reason to get worried about childbearing now.”

The main limitation of the study is that researchers didn’t know whether women’s childlessness was by choice and intentional.

“It’s important to think about the consequences and social structures that would give women more choices,” said Dr. Sarah Hayford of Ohio State University in Columbus. Hayford, who wasn’t involved with this study, researches childlessness trends in the U.S.

“The question of childlessness is often framed as a negative outcome, without asking about whether it was voluntary or not,” Hayford told Reuters Health by phone. “But studying the voluntary nature is a complicated task, especially over a broad population, when it’s such a personal decision.”

The cultural context is key, too. A stronger family orientation, religiosity, and other cultural values may contribute to earlier childbearing, which may be passed down to children, said Dr. Martin Kolk of Stockholm University in Sweden, who studies intergenerational patterns of childbearing but wasn’t involved with this study.

“Fertility decisions are often shared between daughters (and sons) and mothers (and fathers),” Kolk told Reuters Health by email. “We’re seeing additional evidence that there is a strong familial and cultural factor affecting childbearing.”

SOURCE: bit.ly/2FnQ4dy Human Reproduction, online December 4, 2017.

Miscarriage rates triple for women with top radiation exposures

UNTV News   •   December 21, 2017

A child touches her pregnant mother’s stomach at the last stages of her pregnancy in Bordeaux April 28, 2010. REUTERS/Regis Duvignau

(Reuters Health) – Pregnant women exposed to high radiation levels from sources like cell phones, wireless devices and cell towers miscarried at nearly three times the rate as those exposed to low levels, according to new research.

“I hope this study makes us rethink the notion that magnetic field non-ionizing radiation exposure is safe or has no health risk,” said lead author Dr. De-Kun Li, a senior research scientist at the Kaiser Permanente Division of Research in Oakland, California. “This is certainly something we can’t just ignore.”

Cell phones, cordless phones and other wireless devices, appliances, power lines, smart-meter networks and cell towers generate non-ionizing radiation from magnetic fields. Writing in Scientific Reports, Li and his team call rapidly proliferating electromagnetic field emissions “a ubiquitous environmental exposure and a serious looming public health challenge.”

For the study, more than 900 pregnant women in the San Francisco area carried meters that measured their exposure to electromagnetic field radiation for 24 hours. After accounting for age, race, education and smoking, expectant mothers with the highest exposure levels during their typical weekday routines were 2.7 times as likely to miscarry as women with the lowest levels.

Researchers could not determine the emission sources of the radiation. But they write that traditional sources, such as power lines and appliances, generate low-frequency magnetic fields, while emerging sources, such as cell phones and smart-meter networks, generate higher frequencies.

The results underscore the need for additional research into possible health harms of a technology to which virtually everyone in the U.S. is now exposed, whether by choice or circumstance, Li said.

“We really want people to start rethinking the assumption that magnetic-field exposure is safe,” he said in a phone interview. “We really, really need more research because everybody is exposed, including the genetically vulnerable and fetuses.”

Olga V. Naidenko, a senior science advisor with the Environmental Working Group in Washington, D.C. who was not involved with the study, described the findings as “very compelling” and “very alarming.”

Like Li, she called for more research into the biological effects of electromagnetic radiation.

“We need a better understanding about what sources of non-ionizing radiation around the house most contribute to health risk, so that families – and everyone – have the necessary information to protect their health,” she said in an email.

In the meantime, she advises children and adults, especially pregnant women, to decrease exposure to electromagnetic radiation by keeping cell phones and other wireless devices away from their bodies.

“If someone is really concerned, distance is their friend,” Li said. “Keep away from the source. You don’t have to stand right next to the microwave. There’s nothing to watch anyway.”

Li said Kaiser, an integrated healthcare delivery system whose members comprise nearly one-third of the residents in its Northern California catchment area, would not issue a warning to pregnant women about electromagnetic radiation. But the California Department of Public Health did issue guidance last week that long-term use of cell phones could pose health harms.

“Although the science is still evolving, there are concerns among some public health professionals and members of the public regarding long-term, high use exposure to the energy emitted by cell phones,” Dr. Karen Smith, California’s public health officer, said in a written statement.

“We know that simple steps, such as not keeping your phone in your pocket and moving it away from your bed at night, can help reduce exposure for both children and adults,” she said.

Joel Moskowitz, director of the Center for Family and Community Health at the University of California, Berkeley, who was not involved with the new study, said it builds on previous research, which found that electromagnetic exposure during pregnancy increased the risk of miscarriage.

“Pregnant women and couples trying to conceive children should minimize their exposure to the electromagnetic fields produced by household appliances and wireless devices, including cell phones,” he said by email.

Previous studies have linked radiation from long-term cell phone use to an increased risk of brain cancer and lower sperm counts, Naidenko said.

A federal study last year found an increased risk of cancer associated with magnetic field non-ionizing radiation exposure in rodents. Li called the findings from the National Toxicology Program “stunningly important.”

“They found the exact cell type of tumor observed in humans. To me, it’s very strong evidence it might be the same,” he said.

“We are never going to say we’re going to take away your device,” he said. “Engineers are going to figure out a way to use the device in a safe way. But if we bury our heads in the sand, that’s a travesty.”

Pregnant women need routine blood pressure checks

UNTV News   •   April 26, 2017

A child touches her pregnant mother’s stomach at the last stages of her pregnancy in Bordeaux April 28, 2010. REUTERS/REGIS DUVIGNAU

(Reuters Health) – Pregnant women should get their blood pressure checked at each prenatal visit to screen for preeclampsia, a potentially fatal complication that can damage the kidneys, liver, eyes and brain, new U.S. guidelines say.

While many doctors already monitor blood pressure throughout pregnancy, the U.S. Preventive Services Task Force (USPSTF) updated its guidelines for the first time since 1996 to stress that screening at every visit can help doctors catch and treat preeclampsia before it escalates from a mild problem to a life-threatening one.

“Preeclampsia is one of the most serious health problems affecting pregnant women,” task force member Dr. Maureen Phipps, a women’s health researcher at Brown University in Providence, Rhode Island, said by email.

“Because this condition is common and critical, the Task Force offers two separate recommendations to help women lower the risk associated with preeclampsia – screening for preeclampsia is recommended for all pregnant women, and women at high risk of developing the condition can take low-dose aspirin to help prevent it,” Phipps added by email.

The screening recommendations, published on Tuesday in JAMA, apply to women without a history of preeclampsia or high blood pressure. Separate guidelines advise low-dose aspirin after the first 12 weeks of pregnancy for women with a history of elevated blood pressure. (bit.ly/2oIwP5B)

Preeclampsia can progress quickly, and typically develops after 20 weeks of pregnancy. Blood pressure screening earlier in pregnancy can show normal results for women who go on to develop preeclampsia.

In addition to elevated blood pressure, women with preeclampsia may also have excess amounts of protein in their urine, as well as swelling in the feet, legs and hands.

Women may suffer from stroke, seizures, organ failure and in rare cases, death. For babies, complications include slower growth inside the uterus, low birth weight and death.

Risks for preeclampsia include a history of obesity, diabetes, kidney disease, lupus or rheumatoid arthritis, as well as a mother or sister who has experienced the condition.

Because the risks of preeclampsia increase with age, women may be able to lower their chances of developing this complication by having babies sooner, said Dr. Dana Gossett, an obstetrics and gynecology researcher at the University of California, San Francisco, and co-author of an accompanying editorial in JAMA.

“Beyond that, it is also important to ensure that all health problems are well managed prior to pregnancy,” Gossett said by email. “High blood pressure should be under good control, other diseases like kidney disease or lupus should be well controlled, and women should try to be close to their ideal body weight prior to conception.”

Checking blood pressure at every prenatal visit can help prevent complications for mothers and babies alike, said Dr. Martha Gulati, chief of cardiology at the University of Arizona College of Medicine in Phoenix and author of a separate editorial in JAMA Cardiology.

“This is something that should be provided to every woman as part of preventive care,” Gulati said by email. “We will save lives and prevent complications and death in pregnant women with this simple, cost-effective” test that doesn’t take much time.

SOURCE: bit.ly/2oGYMKe and bit.ly/2peNbnM JAMA, online April 25, 2017; and bit.ly/2q1qDH4 JAMA Cardiology, online April 25, 2017.

Successful pregnancy possible even with heart defects

admin   •   January 19, 2017

A pregnant woman stands on a scale before receiving a prenatal exam at the Maternity Outreach Mobile in Phoenix, Arizona October 8, 2009. REUTERS/JOSHUA LOTT

(Reuters Health) – Women who are born with high-risk heart defects can have successful pregnancies if they get the right medical support, according to new U.S. guidelines.

The guidelines are the first from the American Heart Association to offer a road map to women with congenital heart defects who have long been told to avoid pregnancy altogether, said Mary Canobbio, a researcher at the University of California, Los Angeles and chair of the committee that drafted the advice.

“Historically the tendency has been to advise these women to avoid pregnancy because the defect and surgeries done to keep these women alive are complex and the long term survival is difficult to predict – so concern has been that the ‘added burden’ of pregnancy could potentially cause more problems and decrease their own long term survival,” Canobbio said by email.

Congenital heart defects such as defective vessels, leaky valves or holes in the heart muscle are among the most common types of birth defects. These structural problems can cause symptoms like abnormal heart rhythm and breathing difficulties and may require surgery or a heart transplant.

While most girls born today with congenital heart disease will reach childbearing age, pregnancy carries a risk of complications for both these mothers and their babies.

One concern is that women’s blood volume increases by 50 percent during pregnancy to help support her growing baby. That means the mother’s heart must be able to handle the additional burden, Canobbio said.

Hormonal changes during pregnancy can also increase the risk of irregular heart rhythm and blood clotting. In healthy women these changes aren’t usually a problem, but in women with structural heart damage this can increase their risk of stroke, Canobbio added.

Pre-pregnancy counseling is essential for women with complex congenital heart defects so that they have a clear understanding of how their heart abnormalities could affect both their own health and the health of their child during a pregnancy, the new guidelines advise.

For some structural heart problems, and women with a family history of these problems dating back several generations, genetic screening before conception can help estimate the odds that women may pass heart defects on to their children.

Once pregnant, a delivery plan is also essential, so the medical team can anticipate problems that could happen during and following delivery and be prepared.

Ideally, women should deliver their babies at medical centers that have a cardiologist experienced in managing complex congenital heart disease, obstetricians trained in high-risk maternal-fetal medicine, cardiac anesthesia and a cardiac surgical team.

After delivery, women need monitoring for up to six months because the effects of pregnancy can linger that long, the guidelines also note.

The scientific statement, published in Circulation, will likely set a new standard of prenatal, delivery and postpartum care for women with congenital heart defects because this marks the first time a leading U.S. cardiology group has weighed in, said Dr. Wayne Franklin, medical director of the adult congenital heart disease program at Texas Children’s Hospital in Houston.

“The take-home message here is that women should talk to their cardiologist, and also obtain preconception counseling with a maternal-fetal-medicine specialist, if they have a heart problem but are considering pregnancy,” Franklin, a researcher in obstetrics and cardiology who wasn’t involved in the guidelines, said by email.

That’s because normal changes in blood volume, heart rate and blood pressure that happen in every pregnancy can adversely affect women with congenital heart disease, Franklin said.

And, mothers with congenital heart disease have an 8- to 10-fold increase in the chance of their baby having a congenital heart defect, Franklin added. With close monitoring, many problems in developing infants can be detected before infants are born.

“We now know that with close collaboration with a multi-disciplinary team, we can achieve excellent outcomes for both the mother and baby,” Franklin said.

SOURCE: bit.ly/2jy5dAO Circulation, online January 10, 2017.

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