plus 4, High blood pressure in pregnancy a heart risk - Windsor Star

High blood pressure in pregnancy a heart risk - Windsor Star
Pregnancy is not a disease - Trentonian
Job conditions tied to pregnancy outcomes - StarPhoenix
Vaccines during pregnancy and breastfeeding - abc40
1 in 5 W.Va. babies exposed to drugs or alcohol in womb, study says - Charleston Gazette

High blood pressure in pregnancy a heart risk - Windsor Star

Posted: 12 Dec 2009 08:30 PM PST

NEW YORK (Reuters Health) - Women who had an increase in blood pressure during pregnancy are likely to develop heart disease at an earlier age than women who maintained normal blood pressure while they were pregnant, Chilean researchers report.

Dr. Gloria Valdes of Pontificia Universidad Catolica, Santiago and colleagues studied 217 women with an average age of about 61 years, who underwent a coronary artery examination about 30 years after their last pregnancy.

As reported in the medical journal Hypertension, 146 women had had normal blood pressure during their pregnancies while 71 women had hypertension during at least one pregnancy.

About half of all the participants were found to have significant coronary artery disease. Valdes told Reuters Health that women with hypertensive pregnancies developed significant narrowing in their coronary arteries about three years sooner than women with normal blood pressure during pregnancy.

Furthermore, during 10 years of follow-up, there was a significantly greater increase in the number of clogged arteries in the hypertensive group (28 percent) than in the normal blood pressure group (22 percent).

"Gestational hypertension represents a positive stress test for future cardiovascular risk, which should prompt early management of cardiovascular risks," Valdes commented.

She added, "Obstetricians need to identify women with a family history of premature cardiovascular disease, as this doubles the risk of a hypertensive pregnancy."

SOURCE: Hypertension, April 2009.

fivefilters.org featured article: Normalising the crime of the century by John Pilger

Pregnancy is not a disease - Trentonian

Posted: 12 Dec 2009 10:25 PM PST

By KATHRYN JEAN LOPEZ

Denying women taxpayer-funded abortions is just like denying men taxpayer-funded aphrodisiacs. Such is the mantra of Sen. Barbara Boxer, abortion-rights heroine.

For Boxer and her feminist sisters-in-arms, the health care debate is about gender discrimination, plain and simple. And with every Viagra commercial run on MSNBC, it must get hotter and hotter under their Ann Hand eagle brooches.

Boxer was arguing against Democratic Sen. Ben Nelson and Republican Sen. Orrin Hatch's proposed amendment in the Senate health care bill that would prohibit taxpayer funding of abortion.

On the Senate floor, Boxer complained: "There is nothing in this amendment that says if a man some day wants to buy Viagra, for example, that his pharmaceutical coverage cannot cover it, that he has to buy a rider."

Boxer argued: "The men who have brought us the Nelson-Hatch amendment don't single out a procedure that is used by a man, or a drug that is used by a man, that involves his reproductive health care ..."

She went on to say to the men who are the majority of the Senate: "I support a man's privacy just as I support a woman's privacy. So it is very clear to me that this amendment would be the biggest rollback to a woman's right to choose in decades."

But this isn't a mere issue of an individual's privacy. And abortion and Viagra are very different things.

"Senator Boxer must surely know the difference between what Viagra produces and what abortion produces," Dr. Donna J. Harrison, president of the American Association of Pro-Life Obstetricians and Gynecologists, responds. "The use of Viagra involves a few short-term risks to the person who ingests Viagra, but abortion not only results in a dead baby, but also in increasing the mother's risk of pre-term birth in subsequent pregnancies, and increasing her risk of suicide, major depression and substance abuse."

Further support of Boxer's comparison is even more alarming. "Male impotence is a disease," Dr. Kathleen Raviele, immediate past president of the Catholic Medical Association, points out. "Pregnancy is not a disease; it is a normal process by which the human race is perpetuated." She adds: "Abortion is not health care." Boxer may not come out and say pregnancy is or can be considered a disease, but she will tell you abortion is health care.

And the abortion supporters are angry not just because of Nelson-Hatch and a similar prohibition/protection amendment (depending on your point of view) that passed in the House of Representatives, and may just be in the final bill. There is pent-up frustration bursting forth. Boxer and sisters are venting right now over existing restrictions that they deem an evil compromise, restrictions that they screech are unfair to women because men can't get pregnant and therefore have no equal impediment to their reproductive rights.

But is it shameful to respect the consciences of Americans who oppose abortion as a human rights issue?

Assuming Sen. Boxer survives next year's re-election fight, she may have some female pushback in the next session of Congress. Even though groups like NOW want to convince legislators that they represent the common woman and man, they don't. As Dr. Raviele points out: "The majority of Americans are now opposed to elective abortions."

Technology, testimony and experience make it harder to assert that abortion is just another medical procedure, or, if you want to run with the Viagra analogy, treatment. And that's the real reason Sen. Boxer is so pumped up about her dysfunctional comparison. In the spirit of the Supreme Court decision that legalized abortion, government interference may be her last resort.

fivefilters.org featured article: Normalising the crime of the century by John Pilger

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Job conditions tied to pregnancy outcomes - StarPhoenix

Posted: 12 Dec 2009 06:07 PM PST

NEW YORK (Reuters Health) - Pregnant women who work physically demanding jobs, long work weeks or irregular hours may be at increased risk of delivering prematurely or having an underweight baby, a new study suggests.

Researchers found that among more than 1,100 pregnant women they followed, those who said their jobs required them to be very physically active were at increased risk of having a low-birthweight newborn.

Overall, 21 percent of these women delivered an underweight baby, compared with 14 percent of women with fewer physical demands at work, according to findings published in medical journal BJOG.

In addition to physical demands, long work hours, shift work and temporary contract work were all linked to either preterm delivery or low birthweight.

Women who worked 40-plus hours per week or worked a shift schedule had a heightened risk of delivering an underweight baby. Those doing temporary contract work, had a four-fold higher risk of preterm delivery than those with permanent jobs.

The study cannot weed out the reasons for the links, according to the researchers, led by Dr. Isabelle Niedhammer of the University College Dublin in Ireland.

In the case of temporary contract work, Niedhammer told Reuters Health, it may be that these types of jobs carry poorer work conditions, including higher levels of stress.

For its part, physically demanding work -- including jobs that require lifting, carrying heavy loads or long periods of standing -- has been linked to adverse effects on pregnancy in previous studies, Niedhammer pointed out.

In this study, women in low-skill jobs were more likely to perform shift work, have long worked weeks or work physically demanding jobs.

However, the researchers accounted for factors like women's education and lifestyle habits such as smoking, and found that work conditions seemed to affect pregnancy outcomes independently of socioeconomic.

According to Niedhammer, the findings suggest that women should talk to their doctors about their jobs during their first prenatal care visit -- and, if necessary and possible, make adjustments to their work conditions.

And because job conditions are potentially modifiable, she and her colleagues conclude, more studies should examine how specific conditions can affect the health of a pregnancy.

SOURCE: BJOG, online April 7, 2009.

fivefilters.org featured article: Normalising the crime of the century by John Pilger

Vaccines during pregnancy and breastfeeding - abc40

Posted: 12 Dec 2009 04:34 PM PST

From the Flu and Cold Health Center

Congratulations on your pregnancy! You're eating right, getting extra rest and taking your prenatal vitamins. After all, you want to do everything you can to ensure a healthy baby! But have you given any thought to protecting yourself and your baby against infectious diseases—like seasonal influenza and the H1N1 flu virus, an additional flu risk this year?

It's important to consider vaccination part of your prenatal care. That's why the U.S. Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) has specific recommendations for pregnant and breastfeeding women. The committee notes that there is no evidence of risk to your developing baby if you are vaccinated with an inactivated viral or bacterial vaccine while pregnant. In either case, the committee notes, the "benefits of vaccinating pregnant women usually outweigh the potential risks when the likelihood of disease exposure is high, when infection would pose a risk to the mother or fetus, and when the vaccine is unlikely to cause harm."

The CDC's ACIP recommends both the seasonal flu vaccination and the H1N1 vaccine for pregnant and breastfeeding women and for people 6 months to 24 years.

The CDC also identifies four safe and effective optional vaccines for pregnant women, if you have been or could be exposed to any of the following bacterial and viral diseases: Hepatitis B, tetanus-diphtheria, meningococcal and rabies.

So what makes the flu vaccines so important? Well, you're much more likely to be exposed to influenza in any given year than meningitis or rabies. Plus, pregnancy-related changes in your immune and respiratory systems mean that you are at higher risk for flu-related complications. In fact, if you get the flu while you're pregnant, you're more likely to be hospitalized with complications. Another good reason to get vaccinated against the flu is that a recent study found that your vaccine could protect your baby during his or her first six months—when infants can't receive a flu vaccine, yet when they are very vulnerable to flu-related complications.

This year, the novel H1N1 flu ("swine flu") poses an additional risk. At this point, scientists expect illnesses from H1N1 flu to continue for some time, so it's important for people—especially pregnant women or parents of infants and young children—to be as informed about the virus as possible.

Make Flu Vaccines a Family Affair

You're not the only one who needs a vaccine. The people around you should also get flu vaccines this season. That reduces the risk that they'll catch the flu and bring it home to you or your newborn.

Not one but two vaccines are recommended this year: One for seasonal flu and one for H1N1 flu.

There are also two forms of seasonal flu vaccine: the inactivated virus vaccine, delivered as an injection; and the attenuated virus vaccine, delivered as a nasal spray. Pregnant women should only receive the inactivated, injection form. The nasal spray vaccine is approved only for use in healthy people 2 to 49 years of age who are not pregnant.

One other thing: If you're severely allergic to eggs (the vaccine is grown in eggs), had a severe reaction to a flu vaccine in the past or are under six months of age, you should not be immunized. Also, if you have a fever, wait until you're better before getting the vaccine.

You have another consideration when it comes to the vaccine: thimerosal or thimerosal free? Thimerosal is a mercury compound that has been used for more than 80 years to preserve vaccines. Numerous studies find no harmful effects from the preservative in children or adults. Still, some people worry about it, which is why manufacturers have now made a thimerosal-free vaccine available. Ask your healthcare provider about your options.

Here's something else you should be aware of: Flu vaccines are not foolproof. It will not provide 100 percent protection against the flu. When the seasonal flu vaccine and the circulating viruses are similar, the vaccine can prevent the flu among 70 to 90 percent of healthy adults under 65.

Even if you do get the flu, the vaccine can still protect you against flu-related complications by minimizing the severity of the illness.

And, contrary to flu myths, you cannot get the flu from a flu shot or the nasal vaccine. If you get sick after a vaccine, it's just coincidence. In fact, the most common side effect of the shot is a little soreness at the injection site, and the most common side effect of the spray is a runny nose or nasal congestion.

Now's the Time

The best time for a flu shot is between September and December, before flu season really peaks in January, February or later. It usually only takes about two weeks for your body to make antibodies (immune system proteins that help your system recognize the flu virus) to the virus. So even if you get vaccinated after December, you still get some protection.

While a single vaccine lasts the entire season, it won't protect you next winter because your immunity fades. Plus, flu viruses change from year to year. That's why it's important to get vaccinated every year.

Guidelines for High-Risk Groups

Pregnant women and children are considered high risk for both seasonal flu and the H1N1 flu virus and potential related complications. That's why vaccinations for these groups are such an important consideration and are highly recommended by federal government and health professional groups, such as the American College of Obstetricians and Gynecologists.

For information on other high-risk populations, visit the CDC's flu information Web site: http://www.flu.gov/

Remember, if you are a new mom breastfeeding your baby, you should get vaccinated against both seasonal and H1N1 influenza. If you have already delivered your baby, you're eligible for the nasal, or "attenuated," version of the vaccines. In fact, you can have any type of vaccine—except the smallpox vaccine—while breastfeeding with no worries about it negatively affecting your baby in any way.

So what are you waiting for? Pick up the phone and make an appointment for your seasonal flu and H1N1 flu vaccines. Your health and your baby's health depend on you!

For more on protecting yourself from the flu during pregnancy, visit: www.healthywomen.org/flufree

fivefilters.org featured article: Normalising the crime of the century by John Pilger

1 in 5 W.Va. babies exposed to drugs or alcohol in womb, study says - Charleston Gazette

Posted: 12 Dec 2009 08:44 PM PST

CHARLESTON, W.Va. -- Nearly one-fifth of babies in West Virginia are born to mothers who used drugs or alcohol while pregnant, a new study shows -- evidence of a problem far worse than previous research has revealed.

Marijuana, opiates and alcohol topped the list of substances used by pregnant women, whose babies' umbilical cord tissues were analyzed for the Marshall University study.

Overall, 19 percent of the babies were exposed to drugs or alcohol during pregnancy.

Researchers found evidence of marijuana use in 7 percent of the samples. Five percent of the samples tested positive for alcohol. Five percent tested positive for opiates, which include prescription painkillers.

Many of the mothers had used multiple drugs.

But the seemingly startling numbers don't shock the people who take care of drug-addicted mothers and babies. They say they have seen a crisis unfolding in West Virginia delivery rooms for a decade.

"I wasn't surprised because I've been on the front lines," said Marshall University obstetrician David Chaffin, who conducted the study with other doctors. "We've seen a tremendous increase in the number of mothers who are on drugs."

Dr. Chaffin has seen babies "zonked out on Valium" -- sleepy, weak, and struggling to breathe. He has seen babies vomit and cry as they as they suffer from opiate withdrawal.

Medical literature indicates that between 10 percent and 14 percent of babies nationally are exposed to drugs and alcohol in the womb, Chaffin said. But other studies have used different methods to gauge the problem, so experts can't compare them.

A mother's addiction can plague a child long after birth, said Nancy Tolliver, director of the West Virginia Perinatal Partnership. Alcohol abuse during pregnancy is a leading cause of mental retardation.

"We know that even if they don't have obvious symptoms at the time they're born, many of these babies have learning difficulties later in their life, and social adjustment difficulties," Tolliver said. "It's got to be absolutely extensive, the social cost of this."

The Perinatal Partnership has tried to measure the problem before. Working with the West Virginia Health Care Authority, it found that medical claims for treating babies with withdrawal symptoms had doubled between 1999 and 2004, she said.

And last year, surveys showed that about 5 percent of West Virginia women reported using drugs or alcohol while pregnant.

The umbilical cord study -- which was funded by the state Office of Maternal, Child and Family Health -- is considered more accurate, in large part because it doesn't rely on someone telling the truth in a survey.

The researchers analyzed 759 umbilical cord samples of babies born this August. The women and babies were anonymous.

Researchers received the specimens from eight hospitals, which tried to collect samples from every delivery:

Bluefield Regional Medical Center

Raleigh General Hospital in Beckley

Thomas Memorial Hospital in South Charleston

Charleston Area Medical Center

Cabell Huntington Hospital

Ruby Memorial Hospital in Morgantown

Wheeling Hospital

City Hospital in Martinsburg

The study revealed geographical differences.

Alcohol use ranged from 1 percent at Cabell Huntington to 15 percent at Wheeling Hospital.

A few drinks during pregnancy wouldn't show up in lab tests, Chaffin said: "It appears that it takes at least two or three drinks a day for a couple weeks to start showing up."

Drug use was most common among the mothers at Raleigh General, where 19 percent of the umbilical cords tested positive. It was lowest at City Hospital in Martinsburg and Thomas Memorial Hospital in South Charleston, at 10 percent.

None of the samples tested positive for cocaine or for buprenorphine, which is used to treat opiate addiction. Only one tested positive for amphetamines.

The researchers didn't test for nicotine. West Virginia has the nation's highest rate of smoking among pregnant women, at 27 percent. Smoking during pregnancy has been shown to increase the risk of premature and underweight babies.

Not all of the babies are addicted to the drugs to which they were exposed, Chaffin said. Treating an infant who is addicted can cost up to $36,000, he said, compared to $2,000 for a healthy one.

"Then there's the societal cost of having reduced function in one in five of the children born," he said. "These troubled or damaged babies have been born into families that are already dysfunctional, and are more likely, perhaps, to perpetuate the problem."

Early intervention is crucial, Tolliver said. But many women are afraid to tell their doctors they use illegal drugs, and could avoid prenatal checkups because of that fear.

This year, state lawmakers passed the "Uniform Maternal Screening Act," which requires all maternity health providers to screen for pregnancy risks, including substance abuse. The health provider cannot report the mother's answers to police or Child Protective Services during the pregnancy.

The mother could still be reported if her baby is in danger after birth, she said. The state Department of Health and Human Resources is working to implement the program, which could be ready by spring.

Last month, a report requested by Gov. Joe Manchin outlined a statewide strategy to fight drug and alcohol addiction. The plan doesn't specifically address mothers and babies, but some lawmakers say they are hopeful the issue will get attention because the governor has indicated a commitment to tackling substance abuse problems.

Chaffin presented the study to a legislative committee on health last week.

"I think the results were a shocker to the committee members," said Sen. Evan Jenkins, D-Cabell. "It's the comprehensiveness of the study and the clear proof that the problem is worse" than previously thought.

House Health and Human Resources Chairman Don Perdue said lawmakers have known that drug abuse among mothers was bad, "but now we know that we may be in crisis."

"The issue has been on the table, but now I believe this data sets fire to it," said Perdue, D-Wayne.

With 20,000 babies born a year in West Virginia, addiction could be hurting up to 4,000 babies annually.

Sen. Dan Foster, D-Kanawha, said he fears a "tremendous loss of human capital."

"These children will be raised by a mother who is a substance abuser," he said. "These kids don't have much of a chance."

Substance abuse among pregnant women is usually entwined with domestic violence, poverty, and mental health issues, said Jeannie Clark, director of Perinatal Programs for the state Department of Health and Human Resources.

"They're very stressed and that seems to be the common, underlying thread," she said. "They are under so much stress that they try to cope with these problems by smoking or using drugs."

Sixty percent of pregnant women in West Virginia earn so little money that they qualify for Medicaid, she said.

Like Chaffin, Clark said the study's findings were not surprising. In the state's Right from the Start program, nurses and social workers help low-income women with doctor's appointments, child birth classes, family planning, nutrition, and other matters, she said. They often see women struggling with addiction, and can help with that, too.

Clark said she worries about the caseworkers who go to homes plagued by drugs -- which often come with violence.

"It's a crisis for us," she said.

Reach Alison Knezevich at alis...@wvgazette.com or 304-348-1240.

Alcohol exposure

Hospital % drugs % alcohol

Bluefield Regional Medical Center 14 4

Raleigh General Hospital 19 2

Thomas Memorial Hospital 10 8

Charleston Area Medical Center 16 8

Cabell Huntington Hospital 17 1

Ruby Memorial Hospital 13 4

Wheeling Hospital 12 15