“UT professor wins Ig Noble for research on balance in pregnancy - Austin American-Statesman” plus 4 more

UT professor wins Ig Noble for research on balance in pregnancy - Austin American-Statesman
Extraordinary death toll of H1N1 in pregnant women - Salon
Report finds nearly 13 million babies worldwide born premature, 1 ... - Minneapolis Star Tribune
Report: 13 Million Premature Babies Born Each Year - Time
1 million premature babies die each year, report finds - USA Today

UT professor wins Ig Noble for research on balance in pregnancy - Austin American-Statesman

Posted: 04 Oct 2009 07:39 PM PDT

UNIVERSITY OF TEXAS

By Erin Mulvaney
AMERICAN-STATESMAN STAFF
Monday, October 05, 2009

How is it that pregnant women don't topple over with all that extra weight out front?

University of Texas anthropology professor Liza Shapiro found an answer — that tell-tale back arch — for which she was honored Thursday at Harvard University with an Ig Nobel award, an annual tribute to scientific research that on the surface may seem goofy or strange but is often practical.

Honorees, who received their awards from Nobel Prize laureates, also included British researchers who found that cows with names give more milk than cows than those without and Swiss researchers who determined — by experiment — whether it is better to use a full or empty beer bottle as a weapon, according to the Ig Nobel Prize Web site.

Shapiro took a year to study why pregnant women are able to maintain their balance despite carrying an increasingly large load in front. Her findings were published in December 2007. She said it started when a colleague wondered why the lower back looks different in men and women.

"Science has always seen that pelvic shapes are different because of the birthing process, but no one had ever thought about the difference in male and female vertebrates," Shapiro said.

As pregnancy progresses, the curve in the lower back increases, which helps with balance. Shapiro, Daniel Lieberman, now a Harvard professor, and Katherine Whitcome, now an assistant anthropology professor at the University of Cincinnati, looked at 2 million-year-old fossils and found that bipeds evolved with the curve.

"I never thought of it as funny research," Shapiro said. "That never was really the way we were thinking."

emulvaney@statesman.com; 445-3812

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Extraordinary death toll of H1N1 in pregnant women - Salon

Posted: 04 Oct 2009 07:03 PM PDT

pregnant woman

Doctors are often compelled to make quick decisions in life threatening cases with only limited information. Unfortunately, pregnant women are now going to be put in the same situation.

The H1N1 flu has taken an extraordinary toll among pregnant women. A new vaccine will be available within the next few weeks. Because of the nature of the emergency, there has not been time to do any long term studies of the vaccine. Yet pregnant women will need to make a decision as soon as possible on whether to be vaccinated.

Many illnesses are more severe during pregnancy, but the H1N1 influenza has had an unexpectedly devastating impact among pregnant women. According to the CDC, there have been approximately 700 reported cases of H1N1 in pregnant women since April. Of these, 100 women have required admission to an intensive care unit and 28 have died. In other words, 1 out of every 25 pregnant women who contracted H1N1 died of it. By any standard, that is an appalling death rate.

There seem to be two reasons for the dramatically increased death toll. The first is the altered immune status of pregnant women making them particularly vulnerable to the virus. The second is that pregnancy compromises lung function. If a pregnant woman gets pneumonia as a complication of the flu, it is particularly difficult to insure that she gets enough oxygen.

We should ensure that pregnant women do not get H1N1 influenza and the best way to do that is by vaccination. The new H1N1 vaccine is similar to other influenza vaccines. We know that other influenza vaccines are not harmful in pregnancy, and there is no reason to believe that the H1N1 vaccine will have any side effects that differ from those normally expected after vaccination. There are no adjuvants added to the vaccine, either, so there will be no danger from adjuvants. However, there has been no time to study the long term effects of the vaccine, so no one can be sure about side effects.

Pregnant women are rigorously counseled to avoid any drugs, diagnostic tests, or treatments that might impact the developing embryo or fetus. Most women reflexively fear the idea of vaccination in pregnancy, although vaccination for many diseases presents no problems in pregnancy. The Centers for Disease Control and physicians are very concerned that pregnant women will refuse vaccination, with potentially lethal results.

How should pregnant women decide what to do? The best place to start is with what we know for sure. We have a great deal of evidence that H1N1 influenza is particularly lethal in pregnant women. To put it in perspective, the chance of a pregnant woman dying from H1N1 is greater than the chance of a heart patient dying during triple bypass surgery. That is not a trivial risk.

We have no evidence that the vaccine will cause any harm to pregnant women or their unborn children beyond the side effects associated with other flu vaccines, such as local irritation at the vaccine site, or the rare complication of Gullain Barre Syndrome. We have no reason to expect that the H1N1 vaccine will be any different.

It would be much easier to make the decision if we knew more, if we had some idea of how extensive the fall outbreak will be, if we had longer experience with the specific vaccine. Unfortunately, that information is not available to us and by the time it becomes available may more pregnant women may sicken and die unnecessarily.

Given the dramatic threat and the fact that we know of no unusual complications of vaccination, the decision seems clear. Every pregnant woman should get vaccinated as soon as possible.

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Report finds nearly 13 million babies worldwide born premature, 1 ... - Minneapolis Star Tribune

Posted: 04 Oct 2009 08:57 PM PDT

Yet even in very poor countries, there are steps to improve preemies' survival if only more mothers knew, said Dr. Joy Lawn, a pediatrician-turned-policy director for Save the Children who is based in South Africa.

"Even in educated families, there's a sense of fatalism if a baby is born preterm. There's no expectation they can do anything," Lawn said. "With pretty simple solutions, these deaths could be halved, but it doesn't seem to be a priority."

She points to Malawi, where traditionally new mothers have tied babies to their backs as they go about their day. Today, mothers of preemies are taught to tie them in front, under their clothes, kangaroo care-style, she said. The skin-to-skin contact keeps the infants' body temperature more stable, a key to survival, and they can nurse at will, promoting weight gain.

Now Uganda is starting to teach kangaroo care.

Babies born before completion of the 37th week of pregnancy are premature. The March of Dimes report found a small fraction in the U.S. are born before 32 weeks, the very early preemies who face the greatest risk of death and lifelong health problems. But even being born a few weeks early can lead to breathing problems, jaundice and learning or behavioral delays.

Among the risk factors:

_Lack of prenatal care to be sure the mother-to-be is adequately nourished and getting proper care for pregnancy-harming conditions such as diabetes, high blood pressure or infections.

_Smoking and alcohol use.

_Pregnancy before age 16 and after 35, or pregnancies spaced too closely, less than two years apart.

_Carrying twins or more.

_In wealthy nations, early elective inductions and cesarean sections.

Sunday's report is believed the first region-by-region estimate of prematurity, but it undercounts the problem by examining only singleton births to mostly healthy women, Howson said. As a result, it estimates 480,000 preemies are born in the U.S. and Canada each year when more precise U.S. government figures put that total at more than half a million in this country alone.

Whatever the precise number, the point is to increase research into the problem and note the simple steps to lessen preventable risks today, Howson said.

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Report: 13 Million Premature Babies Born Each Year - Time

Posted: 04 Oct 2009 09:47 PM PDT

(WASHINGTON) — They call it kangaroo care: A premature baby nestles skin-to-skin against mom's bare, warm chest. In Malawi, mothers' bodies take the place of too-pricey incubators to keep these fragile newborns alive.

Nearly one in 10 of the world's babies is born premature, and about 1 million infants die each year as a result, says a startling first attempt to measure a toll that in much of the world is hidden. (See photos of pregnant-belly art.)

It's a problem concentrated in poor countries, with the vast majority of the nearly 13 million preemies born each year in Africa and Asia, according to the report released Sunday by the March of Dimes.

But take a closer look at the proportion of all babies born too early. Those rates are highest in Africa, but followed closely by North America, concludes the first part of a collaboration with the World Health Organization to tackle the growing problem.

How? "That's the 13 million-baby question," said March of Dimes epidemiologist Christopher Howson, who headed the project being debated this week at a child health meeting in India.

Different factors fuel prematurity in rich countries and poor ones. Wealthy nations such as the United States have sophisticated neonatal intensive care units for the tiniest, youngest preemies. That produces headlines about miracle babies and leads to a false sense that modern medicine conquers prematurity — without acknowledging lifelong problems including cerebral palsy, blindness and learning disabilities that often plague survivors.

Scientists don't even know all the triggers for preterm birth or how to stop early labor once it starts, one reason that the report urges major new research. Nor does much of the world even track how many babies are born too soon, why or what happens to them.

"These are conservative estimates," Howson said. "As shocking as this toll is, that toll will only rise" as next year the WHO finishes a more in-depth country-by-country count.

Now Uganda is starting to teach kangaroo care.

Among the risk factors:

• Lack of prenatal care to be sure the mother-to-be is adequately nourished and getting proper care for pregnancy-harming conditions such as diabetes, high blood pressure or infections.

• Smoking and alcohol use.

• Pregnancy before age 16 and after 35, or pregnancies spaced too closely, less than two years apart.

• Carrying twins or more.

• In wealthy nations, early elective inductions and cesarean sections.

Whatever the precise number, the point is to increase research into the problem and note the simple steps to lessen preventable risks today, Howson said.

"What leads to a healthy outcome or adverse outcome are factors that begin far before that third trimester," he said, stressing care for infections and chronic conditions, better diet and family planning so the mom-to-be is healthier before she conceives. "We as an international community must think more upstream."

See TIME's Pictures of the Week.

See the Cartoons of the Week.

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1 million premature babies die each year, report finds - USA Today

Posted: 04 Oct 2009 05:15 PM PDT

The preterm birth rate in the USA is especially high: 12.7% of all babies are born early, according to the March of Dimes. That rate has increased 36% in the past 25 years, partly because of an increase in elective cesarean section, an increase in older mothers and the growing use of assisted reproduction, which increases the risk of twins, triples and higher-order multiple births, the report says.

Most of the increase in the USA is in "late preterm" babies, born at 34 to 36 weeks of pregnancy, the report says.

Some babies are at higher risk than others, the report says. In the USA, black babies are 1½ times as likely as whites to be premature — a major reason that black infant mortality is so much higher than that of whites, says Christopher Howson, vice president for global programs at the March of Dimes.

Doctors can do far more to save preemies than they could only a generation ago, says Nicholas Fisk, director of the University of Queensland Centre for Clinical Research in Australia, who wasn't involved in the report.

Yet doctors still have no reliable way to prevent preterm birth, Fisk says. At best, doctors can delay delivery by a day or two — just long enough to give women drugs to mature their babies' lungs. At 23 to 26 weeks of pregnancy, the odds of survival increase 2% to 3% with every day a baby remains in the womb, he says.

Fisk says drug companies are reluctant to create drugs for acute preterm labor because of the high cost of research and relatively low potential for profit, given that women might take them only for a few days.

Instead of focusing on acute preterm labor, Fisk says, researchers might help more women by identifying underlying problems, such as inflammation, that develop early in the pregnancy. For example, researchers have been studying the hormone progesterone, which might help women who are at high risk of early delivery because of a shortened cervix, Fisk says. Women would probably take progesterone for several weeks or months.

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