Women's Health
Study Links Colic in Infants to Migraines in Moms
MONDAY, Feb. 20 -- Experts are beginning to believe some that some non-headache health problems in childhood -- such as vomiting and vertigo -- might be linked to migraines later in life. Now, a new study suggests a connection between mothers with migraines and colic in infancy.
Colic is a condition marked by excessive crying in an otherwise healthy child.
"Mothers with a history of migraine were more than two-and-a-half times more likely to have a baby with colic than mothers who didn't have migraine," said study author Dr. Amy Gelfand, a pediatric neurologist with the Headache Center at the University of California, San Francisco.
The findings were released online Feb. 20 and Gelfand and colleagues will present them in April at the American Academy of Neurology's annual meeting in New Orleans.
The researchers developed a questionnaire to help pinpoint whether a baby had colic and to identify mothers who had been diagnosed with a migraine, a condition believed to have a strong genetic link.
"We surveyed the mothers when they brought their babies into the pediatrician's office for their two-month well-baby check-up," Gelfand said.
Data from 154 mothers and their babies showed that nearly 29 percent of the babies whose mothers had a history of migraine had colic, compared with about 11 percent of babies whose moms did not report migraines.
"There was a trend when fathers answered the survey, too," Gelfand added. She said 93 survey-takers answered paternal migraine history questions. The results: about 22 percent of colicky babies had a father with migraine compared to only nearly 10 percent of the babies who did not have the condition.
Chronic and often disabling, migraine headaches affect more than 29 million Americans, according to the U.S. Department of Health and Human Services' Office on Women's Health.
Three-quarters of migraine sufferers are women and previous research suggests about half of migraine sufferers remain undiagnosed.
"The bottom line is that migraine is an inherited disorder that involves the whole body," said neurologist and pain medicine specialist Dr. Joel Saper, director of the Michigan Headache & Neurological Institute, in Ann Arbor.
Saper, who was not involved in the study, said people who are prone to migraine react to overstimulation throughout the course of their lives. He said the new research suggests "it's very possible colic is an early manifestation of migraine."
Saper explained that babies and children have immature nervous systems that don't work the same way as an adult's. He said migraine -- a neurological condition -- might manifest differently in babies and children.
"The underlying pathophysiology might be the same, but the reflexes are different," Saper said.
The researchers said colic did not appear to be linked to the sex of a child. Also, while they did not ask whether babies were breast- or bottle-fed, other studies suggest colic rates do not differ for the two groups of infants, Gelfand noted. She said it's still being debated whether cow's milk protein might play a role in some children, though.
Currently, most parents are advised to wait out the weeks or months it takes for colic to resolve, to sooth and hold their baby, and to ask for help -- a parent time-out -- if the chronic crying frays nerves.
Commenting on the study, pediatrician Dr. Tai Lockspeiser, an assistant professor of pediatrics at the University of Colorado School of Medicine and Children's Hospital Colorado, said, "All babies cry and colic is just one end of the spectrum." She recommends "the 5 S's System" made popular by Dr. Harvey Karp: swaddling, sucking, side-lying, shushing and swaying. "There are some great YouTube videos of this online that demonstrate exactly what these are," Lockspeiser said.
For her part, Gelfand said that "it's too early to change any kind of protocol for colic. But this gives pediatricians and neurologists another hypothesis to consider. Parents could try non-medication strategies that help some adult migraine sufferers, she said.
"Turning down loud music, going to a quiet room and decreasing stimulation might help," Gelfand said. She also suggested moms and dads keep a "crying diary" to track when colic flare-ups tend to occur and anything that seems to calm the baby.
Saper said the new research offers another clue into the evolution of migraine in an individual. "We are now able to say this child may be on a pathway."
The next research step will be to follow the babies over the years, said Gelfand.
"Right now we're using the mothers' migraines, but what we really want to know is do these babies themselves go on to have migraine," she said.
The data and conclusions of this research should be viewed as preliminary until published in a peer-reviewed journal.
SOURCES: Amy Gelfand, M.D., pediatric neurologist, Headache Center, University of California, San Francisco;Tai Lockspeiser, M.D., assistant professor of pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado; Joel Saper, M.D., director, Michigan Headache and Neurological Institute, Ann Arbor, Mich.; Feb. 20, 2012, abstract, American Academy of Neurology annual meeting (April 2012), New Orleans
THURSDAY, Feb. 16 -- An alarming increase in ectopic pregnancy-related deaths among Florida women is likely caused by illicit drug use and delays in seeking medical care, a U.S. report released Thursday says.
The finding that deaths from ectopic pregnancies jumped fourfold in the past decade in Florida points to a need for improved access to health care and greater awareness of the importance of early pregnancy testing, officials from the U.S. Centers for Disease Control and Prevention said in a report published in the Feb. 17 issue of the agency's Morbidity and Mortality Weekly Report.
"This is the first report of an abrupt increase in ectopic pregnancy deaths identified in the United States in recent times," the CDC researchers said in the report.
Ectopic pregnancy is a life-threatening condition that occurs when an egg is fertilized outside of the uterus, usually in the fallopian tube. If undetected, the mother-to-be may die from hemorrhage due to tubal rupture.
From 1999 to 2008, Florida's death rate from ectopic pregnancy was similar to the national rate -- 0.6 deaths per 100,000 live births -- but it jumped dramatically in recent years to 2.5 per 100,000 births in 2009-2010. While 13 ectopic-related deaths were reported in Florida in the decade 1999 to 2008, nearly that number -- 11 -- were reported in just 2009-2010, the agency said. During that time, the proportion of deaths caused by ectopic pregnancies soared from 3.5 percent of all pregnancy-related deaths to 10.8 percent, the report noted.
Compared to the earlier period, the women who died from tubal pregnancy in 2009-2010 were more likely to be single, white or Hispanic, lack health insurance and have less than a high school education, the report found.
Officials said the women who died during 2009-2010 were more likely to have collapsed from hemorrhage before seeing a health care provider than the women who died during 1999-2008. And several women tested positive for illicit drug use, including cocaine.
Nationwide, between 1 percent and 2 percent of pregnancies are ectopic, but these abnormal pregnancies account for between 3 percent and 4 percent of pregnancy-related deaths. However, the death rate from ectopic pregnancies steadily declined nationally in the late 20th century through 2007, the latest year for which figures are available.
The study has several limitations, the researchers stressed. Full medical information was not available for the deceased women, and drug testing was not routine during much of the earlier period.
Efforts to educate women on the dangers of drug use before and during pregnancy are essential, the CDC researchers added.
-- Margaret Steele
SOURCE: Morbidity and Mortality Weekly Report, news release, Feb. 16, 2012
Women With the Autoimmune Diseases Often Have Fewer Children Than Desired, Study Finds
By Salynn Boyles
WebMD Health News
Reviewed by Louise Chang, MD
Feb. 16, 2012 -- More than half of women diagnosed with lupus or rheumatoid arthritis prior to completing their families end up having fewer children than they had planned for, new research suggests.
The study is among the first to examine infertility, pregnancy loss, and family planning choices in women with the autoimmune diseases.
Lupus, RA, and Childbirth
Rheumatoid arthritis (RA) and lupus are often diagnosed in younger women, yet their impact on childbearing is not well understood.
It is clear from earlier research that women with rheumatoid arthritis tend to have fewer children than healthy women and that women with lupus have more miscarriages.
But the reasons for this are not so clear, and prior studies have not examined how living with a chronic autoimmune disease impacts family size and family planning decisions, says Duke University Medical Center investigator Megan Clowse, MD, who runs the center's autoimmune disease pregnancy registry.
"We wanted to learn more about how having lupus or rheumatoid arthritis influenced these decisions," she says.
Clowse and colleagues surveyed 578 women with rheumatoid arthritis and 114 with lupus enrolled in a national autoimmune disease registry.
Among their findings:
- 55% of the women with rheumatoid arthritis and 64% of those with lupus who were interested in having children reported having fewer children than they had hoped to have.
- Rheumatoid arthritis patients who had fewer children than planned were one-and-a-half times more likely to report problems with infertility than patients who had as many children as they had hoped for.
- Lupus patients who had fewer children than they had planned to have had a three-fold higher miscarriage rate than lupus patients who had the number they had planned for. There was no significant difference in infertility rates.
WEDNESDAY, Feb. 15 -- Infants with birth defects who are born on weekends or at night do just as well as those delivered on a weekday, a new study says.
Both groups of infants stayed at the hospital for the same amount of time, had the same rates of admission to the neonatal intensive care unit, and required antibiotics or breathing assistance the same number of times, said the researchers from the University of Rochester Medical Center in New York.
The findings suggest that pregnant women carrying babies with birth defects should deliver when their bodies are ready, regardless of the day or time, the researchers said.
They analyzed data from 220 infants with known, non-lethal birth defects who were born between 2000 and 2010.
A number of studies have examined the association between delivery time and outcomes for healthy infants, but there was no current research on infants with birth defects, according to the authors of the new study.
"When we know that a baby will need further testing or surgical repair during the newborn period due to an identified abnormality, we typically try to arrange the delivery on a weekday," Dr. Eva Pressman, a professor and director of the high-risk pregnancy program at the medical center, said in a university news release.
"But the bottom line is that the timing of delivery isn't terribly important; if a woman goes into labor in the middle of the night or over the weekend her baby will do just as well," she added.
The findings suggest there is no reason to induce labor or perform a cesarean section solely to deliver an infant with a birth defect during the day, said senior study author Dr. Loralei Thornburg, an assistant professor of maternal-fetal medicine.
"If there is no medical reason for inducing labor it is best to let the baby come on its own time, because we know elective induction is associated with negative outcomes for mom, including increased rates of cesarean delivery, greater blood loss and an extended length of stay in the hospital, and is without significant benefits for the baby," she said in the news release.
The study was scheduled for presentation Friday at the annual meeting of the Society for Maternal-Fetal Medicine in Dallas.
Research and conclusions presented at medical meetings should be considered preliminary until published in a peer-reviewed medical journal.
-- Robert Preidt
SOURCE: University of Rochester, news release, Feb. 10, 2012
FRIDAY, Feb. 10 -- A new childbirth study says 39 weeks' gestation is the best time for elective Cesarean delivery for women who have previously delivered via C-section.
The research was slated for presentation Friday at a meeting of the Society for Maternal-Fetal Medicine in Dallas.
"Prior studies have compared the perinatal risks of elective delivery at 37 to 41 weeks' gestation, but didn't evaluate the hazard of delivery versus not delivering at a specific time point," Dr. Giuseppe Chiossi, who conducted the study for the U.S. National Institute of Child Health and Human Development, said in a society news release.
"We wanted to compare the risks of elective repeat Cesarean at each gestational age starting at 37 weeks with the cumulative maternal and neonatal risks of not delivering at that particular gestational age," Chiossi said.
The researchers found that elective repeat Cesarean deliveries at a later gestational age were associated with much lower rates of poor health results for infants compared to deliveries at 37 and 38 weeks.
They also found that poor infant results were much more frequent in pregnancies that continued beyond 39 weeks compared to those in which the baby was delivered through elective surgery at 39 weeks.
Mothers' health results tended to be better with continued pregnancy rather than elective Cesarean at 37 or 38 weeks, but the difference was significant only at 37 weeks. Mothers' results were much worse for later deliveries compared to elective Cesarean at 39 weeks.
Research presented at medical meetings should be considered preliminary until published in a peer-reviewed medical journal.
-- Robert Preidt
SOURCE: Society for Maternal-Fetal Medicine, news release, Feb. 7, 2012
FRIDAY, Feb. 10 -- Breast-feeding reduces the risk of obesity in children born to mothers with diabetes during their pregnancy, a new study indicates.
Researchers followed 94 children of diabetic mothers and 399 children of non-diabetic mothers from birth until age 13.
It's known that children of diabetic pregnancies are at increased risk for obesity. The Colorado School of Public Health researchers wanted to assess how breast-feeding affected the growth of body-mass index (BMI), an indicator of childhood obesity.
The study found that children of diabetic pregnancies who were breast-fed for at least six months had a slower BMI growth as they grew older than those who were breast-fed for less than six months. The study found similar results in children of non-diabetic pregnancies.
The study was published online recently in the International Journal of Obesity.
"Breast-feeding support represents an important clinical and public health strategy to reduce the risk of childhood obesity," study author and epidemiologist Tessa Crume said in a University of Colorado Denver news release.
The findings offer another reason to encourage and support mothers to breast-feed for at least six months, the time recommended by the American Academy of Pediatrics, the release said.
"We can work with pediatricians, obstetricians and the public health community to give these women targeted support immediately following birth," Crume said.
-- Robert Preidt
SOURCE: University Colorado Denver, news release, Feb. 8, 2012
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