plus 4, Warning over obesity in pregnancy - The Guardian

Warning over obesity in pregnancy - The Guardian
Vaccines during pregnancy and breastfeeding - abc40
High blood pressure in pregnancy a heart risk - StarPhoenix
Gisele Lined Up Her First Post-Pregnancy Shoot - Nymag.com
National Zoo hopes for a panda pregnancy - Washington Post

Warning over obesity in pregnancy - The Guardian

Posted: 09 Jan 2010 04:44 PM PST

All mothers-to-be should be weighed regularly during pregnancy to help combat the many dangers to women's and babies' health from maternal obesity, a group of medical experts is urging.

The National Obesity Forum (NOF) – an influential group of doctors and nurses specialising in weight problems – wants ministers to introduce the change because excessive weight gain among expectant mothers is becoming such a serious problem.

"A pregnant woman should have her weight monitored regularly during pregnancy at all antenatal appointments with midwives, GPs and obstetricians, because every risk of pregnancy, both to the mother and to the baby, is increased with maternal obesity," Dr David Haslam, the NOF's chairman, told the Observer.

"Obesity in pregnant women can lead to all sorts of problems, including the death of the mother, or the death of the baby through stillbirth or the baby having foetal abnormalities, or the woman suffering pre-eclampsia or gestational diabetes, or needing a Caesarean section because either she or the baby is too big," he added.

Piling on the pounds in pregnancy beyond the recommended amount can be dangerous, Haslam said. "The risk of rapid weight gain in pregnancy is that every single complication of pregnancy gets worse for both the mother and the baby. The benefits of regular weighing of women would be enormous. It would create awareness of the problem and lead to measures being put in place to reduce the risk." For example, if a pregnant woman was gaining excess weight, a dietician could start giving her advice on her diet and level of physical activity, said Haslam, who is a GP and also a hospital doctor specialising in obesity medicine at the Luton and Dunstable Hospital in Bedfordshire.

At the moment women in England have their height and weight taken when they have their first antenatal appointment, the so-called "booking visit", in order to indicate their Body Mass Index (BMI). Only those with a high BMI are usually checked after that.

Many women would find the idea upsetting, patronising or offensive, admitted Haslam. "Yes, women will undoubtedly think this is intrusive, but that's ridiculous because this would be being done for medical reasons, to protect the health of the mother and baby. It's possible that some women will be against this, and they would have the right not to stand on the scales. But they would be foolish to refuse," he added. "To refuse to be weighed would be to deny the clinician the tools of his trade to ensure a healthy outcome to the pregnancy."

The NOF's stance has divided medical opinion. Dr Anne Dornhorst, an expert in diabetes and pregnancy at Imperial College London and a doctor at the capital's Hammersmith Hospital, said she understood why Haslam and the NOF were urging firmer action to counter maternal obesity. She pointed to the Centre for Maternal and Child Enquiries' reference to "substantial evidence that obesity in pregnancy contributes to increased morbidity and mortality for both mother and baby".

That includes evidence that 35% of women who die in childbirth are obese – they had a BMI of at least 30. About 30% of pregnant women are overweight or obese.

Obese women spend 4.83 more days in hospital than other new mothers. Babies whose mothers are obese are also 3.5 times more likely to need to be admitted to a neonatal intensive care unit.

"There's a large body of thought out there that childbirth is completely natural and shouldn't be medicalised. But we know that obesity is a danger for the pregnancy and that it influences the baby's growth and risk of obesity in later life," said Dornhorst, who favoured regular weighing of all overweight and underweight expectant mothers rather than all pregnant women.

But Janet Fyle, midwifery adviser to the Royal College of Midwives, said it would be "counter-productive" to change the current practice because women with very high BMIs were already identified and given extra monitoring if necessary.

A spokeswoman for the Royal College of Obstetricians and Gynaecologists agreed, saying: "Obesity is identified as a risk factor at time of booking and a referral is made appropriately. As per the National Institute for Heath and Clinical Excellence (NICE) antenatal care guidelines, there is no compelling evidence for routine weighing of all women at every visit."

Pregnant women, parents and toddlers are the targets of a new government healthy lifestyles campaign, launched last week, called Start4Life. It involves promotion of breastfeeding and advice on when to start babies on solid food. But the NOF believes that far more extensive measures are needed.

In 2008 NICE, which advises the NHS on what treatments and procedures are worthwhile, said only mothers-to-be whose weight might lead to medical complications should be assessed regularly. Two of NICE's working groups are currently investigating problems associated with weight and pregnancy, one on weight gain during pregnancy, the other on weight loss after pregnancy. It will distil their advice into a new set of guidelines for NHS staff to follow in a few months' time.

A Department of Health (DH) spokesman ruled out introducing routine regular weighing. "NICE antenatal care guidelines state that normal weight and height should be measured at the booking appointment and the woman's body mass index should be calculated. The guidelines say that repeated weighing during pregnancy should be confined to circumstances in which clinical management is likely to be influenced," he said.

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Vaccines during pregnancy and breastfeeding - abc40

Posted: 09 Jan 2010 02:49 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

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High blood pressure in pregnancy a heart risk - StarPhoenix

Posted: 09 Jan 2010 11:21 AM 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.

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Gisele Lined Up Her First Post-Pregnancy Shoot - Nymag.com

Posted: 08 Jan 2010 09:14 AM PST

Oh, when will Gisele unveil her post-baby body to the world? She's probably hiding out in her house in Boston with Tom Brady until she loses the extra five pounds of baby weight she gained. But soon enough she'll shoot an ad campaign for Brazilian jeans company Colcci, according to Made in Brazil. Brazilian papers report that David Sims will shoot the ads in Boston, which is kind of strange since it's not a go-to destination for fashion shoots, but as long as Gisele is holed up there with Tom and baby Benjamin (bless her for choosing a real name!), fashion companies are sure to flock to her. Especially for the coveted bumpless reveal. As soon as she can and will travel again, we imagine people will start flying her around so they don't have to journey to fashion-starved Boston, where it's painfully cold, the streets make no sense, and Red Sox baseball hats are the "It" accessory year-round.

Fashion Rio, Jesus Luz At SPFW, Gisele, And Beyoncé In Rio [Made in Brazil]

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National Zoo hopes for a panda pregnancy - Washington Post

Posted: 09 Jan 2010 02:06 PM PST

Mei Xiang, the National Zoo's female adult giant panda, went into heat about noon, and she and the zoo's adult male, Tian Tian, started mating, much of which was captured on the public panda cam, the zoo said.

The activity signals another early start to Washington's annual panda pregnancy watch, and comes at a momentous time for zoogoers and panda lovers across the region.

Interest is particularly high after officials announced last month that the zoo's beloved 4-year-old panda, Tai Shan, will be leaving for China, a departure expected to occur within the next few weeks. And his parents, Mei Xiang and Tian Tian, are scheduled to be returned to China later this year.

"The fact that this is potentially the last year that we will have Mei Xiang and Tian Tian, everybody feels that, and everybody's thinking about it," zoo spokeswoman Pamela Baker-Masson said Saturday. "We would love to have another cub at the National Zoo."

Giant pandas are native to China, which owns all giant pandas in U.S. zoos. The adults are here on a 10-year loan, which expires this year. Tai Shan, born at the zoo in 2005, was scheduled to be sent to China two years ago. But the Chinese granted an extension.

Female pandas are in heat for about 48 hours, typically in spring. But this is the second consecutive January that Mei Xiang has gone into heat.

In past years, Tian Tian has tried but failed to mate naturally. Tian Tian fathered Tai Shan via artificial insemination. In general, male pandas don't breed well in captivity. Baker-Masson said Saturday that zoo experts would probably let Tian Tian try again, and unless they were 100 percent sure he had succeeded, they would probably turn to insemination, which results in a pregnancy about half the time.

Once a panda is pregnant, the gestation period lasts 90 to 185 days.

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