Drinking alcohol is linked to reduced chances of pregnancy

Study suggests women should avoid alcohol in second half of menstrual cycle

June 8, 2021

Science Daily/European Society of Human Reproduction and Embryology

A study of the associations between drinking alcohol and the chances of becoming pregnant suggests that women who want to conceive should avoid heavy drinking. In the second half of menstrual cycle even moderate drinking is linked to reduced chances of pregnancy.

The study, published today (Wednesday) in Human Reproduction[1], one of the world's leading reproductive medicine journals, investigated alcohol intake and fecundability, which is defined as the probability of conceiving during a single menstrual cycle. It is the first study to look at this according to the difference phases of women's menstrual cycles.

Researchers led by Dr Kira Taylor, associate professor of epidemiology and population health at the University of Louisville School of Public Health and Information Sciences (Kentucky, USA), analysed data from the Mount Sinai Study of Women Office Workers. Women aged 19-41 years were recruited between 1990 and 1994 and followed for a maximum of 19 menstrual cycles. The women completed daily diaries reporting how much alcohol they drank and what type, and they provided urine samples on the first and second day of each menstrual cycle in order to check for pregnancy.

Heavy drinking was defined as more than six alcoholic drinks a week, moderate drinking was three to six drinks a week, and binge drinking was defined as four or more drinks on a single day. Each drink consisted of a third of a litre of beer (355 millilitres), a medium glass of wine (148 millilitres), or just under a double shot of spirits (44 millilitres). The researchers collected information on factors that could affect the results, such as age, medical history, smoking, obesity, use of birth control methods and intention to become pregnant. Data on 413 women were available for the current study.

Dr Taylor said: "We found that heavy drinking during any phase of the menstrual cycle was significantly associated with a reduced probability of conception compared to non-drinkers. This is important because some women who are trying to conceive might believe it is 'safe' to drink during certain parts of the menstrual cycle.

"During the luteal phase, which is the last two weeks of the menstrual cycle before bleeding would start and when the process of implantation occurs, not only heavy drinking but also moderate drinking was significantly associated with a reduced probability of conception.

"At the time of ovulation, usually around day 14 of the cycle, consuming a lot of alcohol -- either heavy or binge drinking -- was significantly associated with reduced chances of conception."

Compared to non-drinkers both moderate and heavy drinking during the luteal phase was linked to a reduction in the odds of conceiving by about 44%. Heavy drinking during the ovulatory part of the cycle was also associated with significant 61% reduced odds of becoming pregnant. However, the researchers stress these are all estimates and should be treated with caution. [2]

"If we assume that a typical, healthy, non-drinking woman in the general population who is trying to conceive has approximately a 25% chance of conceiving during one menstrual cycle, then out of 100 women approximately 25 non-drinkers would conceive in a particular cycle, about 20 moderate drinkers would conceive and only about 11 heavy drinkers would conceive," said Dr Taylor. "But the effect of moderate drinking during the luteal phase is more pronounced and only about 16 moderate drinkers would conceive.

"Our study only included a few hundred women and, while we believe the results strongly suggest that heavy and even moderate alcohol intake affects the ability to conceive, the exact percentages and numbers should be viewed as rough estimates."

Each extra day of binge drinking was associated with an approximate 19% reduction in the odds of conceiving during the luteal phase and a 41% reduction during the ovulatory phase [3]. The researchers found no difference in their results between different types of drinks.

The study is not able to show that drinking alcohol causes the reduction in the chances of becoming pregnant, only that it is associated with it. Possible biological mechanisms that might explain the association could be that alcohol intake affects the processes involved in ovulation so that no egg is released during the ovulatory part of the cycle, and that alcohol could affect the ability of a fertilised egg to implant in the womb.

Dr Taylor said: "This is the first study to examine the effect of alcohol on fecundability during specific phases of the menstrual cycle, using daily data on alcohol and other important factors such as smoking and unprotected intercourse over a period of up to 19 menstrual cycles."

Limitations of the study included the fact that not all women were trying to conceive; alcohol intake has increased since the time of the study and the women in the study were leaner, on average, than women today; the study used self-reported data and women might under-report their alcohol consumption; and the influence of drinking by male partners was not assessed.

She concluded: "Finally, the results in this study should not be construed to mean that drinking alcohol prevents pregnancy. In other words, alcohol is not birth control. Even if a woman drinks alcohol heavily, if she has unprotected intercourse, she can become pregnant."

Notes

[1] "The association between alcohol intake and fecundability during menstrual cycle phases," by Mohammad Yaser Anwar et al. Human Reproduction journal.

[2] Odds are different to "chances" or the "probability" of becoming pregnant. Converting odds ratios to "chances" or "probability" is complicated. However, if you want to use them then, still working on the assumption that the average woman has a 25% chance of conceiving per menstrual cycle, moderate or heavy drinking during the luteal phase was associated with a 40% reduced chance of conceiving, and heavy drinking during the ovulatory window was associated with a 54% reduced chance of conceiving. 

[3] If you want to convert these odds ratios to "chances" or "probability" the figures are: each extra day of binge drinking was associated with an approximate 16% reduction in the probability of conceiving during the luteal phase and 35% reduction during the ovulatory phase.

https://www.sciencedaily.com/releases/2021/06/210608203716.htm

Bacteria are connected to how babies experience fear

New research shows that an infant's gut microbiome could contain clues to help monitor and support healthy neurological development

June 4, 2021

Science Daily/Michigan State University

New research from MSU shows that an infant's gut microbiome could contain clues to help monitor and support healthy neurological development

Why do some babies react to perceived danger more than others? According to new research from Michigan State University and the University of North Carolina, Chapel Hill, part of the answer may be found in a surprising place: an infant's digestive system.

The human digestive system is home to a vast community of microorganisms known as the gut microbiome. The MSU-UNC research team discovered that the gut microbiome was different in infants with strong fear responses and infants with milder reactions.

These fear responses -- how someone reacts to a scary situation -- in early life can be indicators of future mental health. And there is growing evidence tying neurological well-being to the microbiome in the gut.

The new findings suggest that the gut microbiome could one day provide researchers and physicians with a new tool to monitor and support healthy neurological development.

"This early developmental period is a time of tremendous opportunity for promoting healthy brain development," said MSU's Rebecca Knickmeyer, leader of the new study published June 2 in the journal Nature Communications. "The microbiome is an exciting new target that can be potentially used for that."

Studies of this connection and its role in fear response in animals led Knickmeyer, an associate professor in the College of Human Medicine's Department of Pediatrics and Human Development, and her team to look for something similar in humans. And studying how humans, especially young children, handle fear is important because it can help forecast mental health in some cases.

"Fear reactions are a normal part of child development. Children should be aware of threats in their environment and be ready to respond to them" said Knickmeyer, who also works in MSU's Institute for Quantitative Health Science and Engineering, or IQ. "But if they can't dampen that response when they're safe, they may be at heightened risk to develop anxiety and depression later on in life."

On the other end of the response spectrum, children with exceptionally muted fear responses may go on to develop callous, unemotional traits associated with antisocial behavior, Knickmeyer said.

To determine whether the gut microbiome was connected to fear response in humans, Knickmeyer and her co-workers designed a pilot study with about 30 infants. The researchers selected the cohort carefully to keep as many factors impacting the gut microbiome as consistent as possible. For example, all of the children were breastfed and none was on antibiotics.

The researchers then characterized the children's microbiome by analyzing stool samples and assessed a child's fear response using a simple test: observing how a child reacted to someone entering the room while wearing a Halloween mask.

"We really wanted the experience to be enjoyable for both the kids and their parents. The parents were there the whole time and they could jump in whenever they wanted," Knickmeyer said. "These are really the kinds of experiences infants would have in their everyday lives."

Compiling all the data, the researchers saw significant associations between specific features of the gut microbiome and the strength of infant fear responses.

For example, children with uneven microbiomes at 1 month of age were more fearful at 1 year of age. Uneven microbiomes are dominated by a small set of bacteria, whereas even microbiomes are more balanced.

The researchers also discovered that the content of the microbial community at 1 year of age related to fear responses. Compared with less fearful children, infants with heightened responses had more of some types of bacteria and less of others.

The team, however, did not observe a connection between the children's gut microbiome and how the children reacted to strangers who weren't wearing masks. Knickmeyer said this is likely due to the different parts of the brain involved with processing potentially frightening situations.

"With strangers, there is a social element. So children may have a social wariness, but they don't see strangers as immediate threats," Knickmeyer said. "When children see a mask, they don't see it as social. It goes into that quick-and-dirty assessment part of the brain."

As part of the study, the team also imaged the children's brains using MRI technology. They found that the content of the microbial community at 1 year was associated with the size of the amygdala, which is part of the brain involved in making quick decisions about potential threats.

Connecting the dots suggests that the microbiome may influence how the amygdala develops and operates. That's one of many interesting possibilities uncovered by this new study, which the team is currently working to replicate. Knickmeyer is also preparing to start up new lines of inquiry with new collaborations at IQ, asking new questions that she's excited to answer.

"We have a great opportunity to support neurological health early on," she said. "Our long-term goal is that we'll learn what we can do to foster healthy growth and development."

https://www.sciencedaily.com/releases/2021/06/210604135433.htm

Healthy diet before, during pregnancy linked to lower complications

June 2, 2021

Science Daily/NIH/Eunice Kennedy Shriver National Institute of Child Health and Human Development

A healthy diet around the time of conception through the second trimester may reduce the risk of several common pregnancy complications, suggests a study by researchers at the National Institutes of Health. Expectant women in the study who scored high on any of three measures of healthy eating had lower risks for gestational diabetes, pregnancy-related blood pressure disorders and preterm birth. The study was conducted by Cuilin Zhang, M.D., Ph.D., and colleagues at NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). It appears in the American Journal of Clinical Nutrition.

The researchers analyzed dietary data collected multiple times during pregnancy from the NICHD Fetal Growth Study. Nearly 1,900 women responded to questionnaires on their diets at eight to 13 weeks of pregnancy and were asked to estimate what they ate in the previous three months. At 16 to 22 weeks and 24 to 29 weeks, the women identified what they ate in the previous 24 hours. Their responses were scored according to three measures of healthy eating: the Alternate Healthy Eating Index (AHEI), Alternate Mediterranean Diet (AMED), and Dietary Approaches to Stop Hypertension (DASH) diet. All three measures emphasize consumption of fruits, vegetables, whole grain, nuts and legumes while limiting red and processed meat.

Overall, the researchers found that following any of the diets around the time of conception through the second trimester was associated with a lower risk of gestational diabetes, hypertension, preeclampsia and preterm delivery. For example, women with a high AHEI score at 16 to 22 weeks had a 32% lower risk for gestational diabetes than women with a low AHEI score. Women with a high DASH score at eight to 12 weeks and 16 to 22 weeks had a 19% lower risk for pregnancy-related high blood pressure disorders. A high AMED score at 24 to 29 weeks or a high DASH score at 24 to 29 weeks was associated with a 50% lower risk for preterm birth.

https://www.sciencedaily.com/releases/2021/06/210602091425.htm

Fat around the heart linked to increased risk of heart failure

May 24, 2021

Science Daily/The Mount Sinai Hospital / Mount Sinai School of Medicine

Having excess pericardial fat -- fat around the heart -- increases the risk of developing heart failure, especially in women, according to new Mount Sinai research.

Women with high amounts of pericardial fat are twice as likely to develop heart failure, while men are 50 percent more likely, according to the study, published in the May 24 online issue of the Journal of the American College of Cardiology. It is the largest study to identify the link between pericardial fat and heart failure, which could potentially lead to early intervention and heart disease prevention.

"For nearly two decades we have known that obesity, based on simple measurement of height and weight, can double one's risk of heart failure, but now, we have gone a step further by using imaging technology to show that excess pericardial fat, perhaps due to its location close to the heart muscle, further augments the risk of this potentially fatal condition -- heart failure" explains lead researcher Satish Kenchaiah, MD, Associate Professor of Medicine (Cardiology) at the Icahn School of Medicine at Mount Sinai. "This work provides us with an important tool to stratify patients into higher and lower risk of heart failure, which can possibly lead to early intervention and heart failure prevention to ultimately save people's lives."

Researchers involved with a multi-institutional collaboration examined the association between pericardial fat and the risk of heart failure by using chest computed tomography (CT) scans from the Multi-Ethnic Study of Atherosclerosis (MESA), a medical research study sponsored by the National Heart, Lung, and Blood Institute of the National Institutes of Health. This prospective study used CT scans from nearly 7,000 women and men between 45 and 84 years of age across the United States with diverse racial backgrounds to measure pericardial fat. None of the participants had evidence of heart disease when the study began.

Researchers followed these participants for more than 17 years and noted that almost 400 of them developed heart failure. Their analysis found that excess pericardial fat was associated with a higher risk of heart failure in both women and men, even after adjusting for established risk factors for heart failure such as age, cigarette smoking, alcohol consumption, sedentary lifestyle, high blood pressure, high blood sugar, high cholesterol, and heart attacks. After accounting for these risk factors for heart failure, high pericardial fat volume increased the risk of developing heart failure by approximately 100 percent, or double, in women and about 50 percent in men. For this study, the researchers defined excess or "high" pericardial fat volume as 70 cubic centimeters (2.4 fluid ounces) or more in women, and 120 cubic centimeters (4 fluid ounces) or more in men. Amounts below that were considered "normal."

The researchers also reported that pericardial fat was weakly or moderately correlated with indicators of being overweight or obese such as body mass index, waist girth, hip circumference, and waist-to-hip ratio, and that it remained a risk factor for heart failure above and beyond the risk from being overweight or obese. In fact, pericardial fat was associated with new heart failure cases regardless of whether the participants were lean, overweight, or obese. Also, in a smaller sample of participants who underwent abdominal CT scans to determine the amount of belly fat beneath the skin and in the abdomen, pericardial fat predicted the risk of heart failure even after taking excess belly fat into consideration.

The link between pericardial fat and heart failure was similar among all racial and ethnic groups represented in the study: white, Black, Hispanic, and Chinese.

"Our research provides strong evidence that excess pericardial fat substantially raises the risk of heart failure," says Dr. Kenchaiah. "Additional studies are needed to confirm our findings. Future research in this field should also focus on ways and means, such as eating a heart-healthy diet and staying physically active, to achieve and maintain optimal body weight and reduce and avoid fat deposition around the heart."

https://www.sciencedaily.com/releases/2021/05/210524161834.htm

Mothers' depression impacts mother-infant relationships

Women with depression during pregnancy, or with a history of depression, had a reduced quality of mother-infant interaction

May 25, 2021

Science Daily/King's College London

In a study funded by National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre (BRC) researchers examined whether depression, either before or during pregnancy, affects the mother-infant relationship. The research was published today (Tuesday 25 May) in BJPsych Open.

Researchers looked at the quality of mother-infant interactions eight weeks and 12 months after birth in three groups of women; healthy women, women with clinically-significant depression in pregnancy, and women with a lifetime history of depression but healthy pregnancies.

The study used a sample of 131 women: 51 healthy mothers with no current or past depression, 52 mothers with depression referred to the South London and Maudsley NHS Foundation Trust Perinatal Psychiatry Services, and 28 'history-only' mothers with a history of depression but no current diagnosis.

Quality of interaction 

At both eight weeks and 12 months, mothers and babies in the depression and history-only groups displayed a reduced quality of interaction. Specifically, at eight weeks, 62% in the group of mothers with depression during pregnancy and 56% in the group of mothers with a history-only of depression scored in the lowest category of relationship quality, where therapeutic interventions are recommended, compared with 37% in the healthy group. All mother and baby groups improved in their quality of interaction between 8 weeks and 12 months which researchers say indicates that with time all mothers and their babies can become more attuned to each other.

At six days, new-born babies of mothers in the depression and history-only groups had decreased social-interactive behaviour, which, together with maternal socio-economic difficulties, was also predictive of a reduced quality of interaction, while postnatal depression was not.

Dr Rebecca Bind, lead author and Research Associate at Institute of Psychiatry, Psychology & Neuroscience, King's College London, says: "Our findings suggest that perinatal mental health professionals should offer support not only to women with depression during pregnancy, but also to pregnant women with a history of depression, as they may also be at risk of interaction difficulties. Future research should try to understand why a history of depression, despite a healthy perinatal period, may impact the developing relationship."

Senior author Carmine Pariante, Professor of Biological Psychiatry at the Institute of Psychiatry, Psychology & Neuroscience, King's College London and Consultant Perinatal Psychiatrist at the South London and Maudsley NHS Foundation Trust, said:

"We recommend that healthcare professionals provide pregnant women at risk of interaction difficulties with examples of positive caregiving behaviours, and with ways to engage their babies and understand their needs, all of which could be incorporated into parenting and birth classes and health visits. We also suggest that interventions that can help the mother-infant interaction should be made more widely available, such as video feedback, where a clinician and mother discuss what behaviours work best to engage and comfort the baby, and structured mother-baby activities, such as art and singing groups. This is especially important because we know that the early years are vital for future mental health and wellbeing."

The relationship between mothers and infants was assessed using the Crittenden Child-Adult Relationship Experimental-Index which assesses 'dyadic synchrony', a term that describes the quality of the relationship as a whole. Researchers analysed films of three-minute interactions filmed at eight weeks and 12 months postnatal. Mothers played with their babies while researchers scored the relationship based on seven aspects of behaviour: facial expression, vocal expression, position and body contact, affection and arousal, turn-taking contingencies, control, and choice of activity. The researchers are grateful to the women and their infants who participated in the PRAM-D study and to everyone on the study team who recruited, collected, and analysed data.

https://www.sciencedaily.com/releases/2021/05/210525084315.htm

Study finds women with osteoporosis and low bone density are at increased risk of hearing loss

Bisphosphonates, commonly prescribed to reduce bone fracture risks, were not shown to alter likelihood of hearing loss

May 24, 2021

Science Daily/Brigham and Women's Hospital

Hearing loss is the third most common chronic health condition in the United States. Previous studies of people with hearing loss have uncovered higher prevalence of osteoporosis -- a disease in which the bones become weak and brittle -- and low bone density (LBD). But research on whether these conditions may influence risk of hearing loss over time is scarce. It is also unknown whether hearing loss can be avoided by taking bisphosphonates, the primary medication used to prevent fractures in people with reduced bone density. As part of the Conservation of Hearing Study (CHEARS), researchers from Brigham and Women's Hospital analyzed data from nearly 144,000 women who were followed for up to 34 years. They found that risk of subsequent moderate or worse hearing loss was up to 40 percent higher in study participants with osteoporosis or LBD. The study, published in the Journal of the American Geriatric Society, also found that bisphosphonates did not alter risk of hearing loss.

"Adult onset hearing loss is typically irreversible; therefore, CHEARS focuses on identifying potentially modifiable risk factors that may contribute to hearing loss," said study leader Sharon Curhan, MD, ScM, of the Channing Division of Network Medicine at the Brigham. "We were inspired by a recent study that found that bisphosphonates may help prevent noise-induced hearing damage in mice. We wanted to investigate whether bisphosphonates alter risk of hearing loss in adults, in addition to whether there is a longitudinal association between osteoporosis or LBD and risk of subsequent hearing loss."

For their analysis, the researchers used data from the decades-long Nurses' Health Study (NHS) and NHS II, two large ongoing prospective cohorts of female registered nurses, established in 1976 and 1989, respectively. The researchers examined hearing loss that was moderate or worse in severity, as self-reported by participants on questionnaires completed every two years. Additionally, they used the CHEARS Audiometry Assessment Arm to incorporate data on participants' audiometric thresholds (a measure of hearing sensitivity based on the loudness of sound).

In both the NHS and NHS II cohorts, the researchers found that the risk of hearing loss was higher in women with osteoporosis or LBD, and that taking bisphosphonates did not moderate the elevated risk. More research is required to understand whether the type, dose or timing of bisphosphonate use might influence its impact.

The researchers found that a history of vertebral fracture was associated with up to a 40 percent higher risk of hearing loss, but the same did not hold true for hip fractures, the two most common osteoporosis-related fractures. "The differing findings between these skeletal sites may reflect differences in the composition and metabolism of the bones in the spine and in the hip," Curhan said. "These findings could provide new insight into the changes in the bone that surrounds the middle and inner ear that may contribute to hearing loss."

While the underlying mechanisms by which osteoporosis and LBD may contribute to aging-related hearing loss remain unclear, the researchers suggest that abnormal bone remodeling and changes in the pathways involved in maintaining bone homeostasis may influence the integrity of the bone that protects the nerves and structures involved in hearing or alter ion and fluid metabolism in the cochlea, the main structure involved in hearing.

Advantages of using data from these well-characterized cohorts include the large study population, extensive array of detailed information, impressive follow-up rates and reliable information on health-related outcomes, as the participants are trained health care providers. However, the researchers note that their study is limited in its generalizability, as participants are predominantly white, with similar educational achievements and socio-economic statuses. Curhan points out that additional studies that examine these associations in men and non-white women would be informative.

Additionally, the investigators plan to examine in the future whether calcium and vitamin D intake are associated with hearing loss, as they have been shown to help prevent osteoporosis. Previously, the researchers found that eating a healthy diet, staying physically active, not smoking, and maintaining a healthy weight all help reduce the risk of hearing loss.

"Osteoporosis and low bone density may be important contributors to aging-related hearing loss," Curhan said. "Building lifelong healthy diet and lifestyle habits could provide important benefits for protecting bone and hearing health in the future."

https://www.sciencedaily.com/releases/2021/05/210524110252.htm

'No level of smoke exposure is safe'

Study links secondhand smoke during pregnancy to epigenetic changes in babies

May 19, 2021

Science Daily/Virginia Commonwealth University

Nearly a quarter of pregnant women say they've been around secondhand smoke -- in their homes, at work, around a friend or relative -- which, according to new research, is linked to epigenetic changes -- meaning changes to how genes are regulated rather than changes to the genetic code itself -- in babies that could raise the risk of developmental disorders and cancer.

The study, published today in Environmental Health Perspectivesby researchers at Virginia Commonwealth University Massey Cancer Center, is the first to connect secondhand smoke during pregnancy with epigenetic modifications to disease-related genes, measured at birth, which supports the idea that many adult diseases have their origins in environmental exposures -- such as stress, poor nutrition, pollution or tobacco smoke -- during early development.

"What we recommend to mothers in general is that no level of smoke exposure is safe," said study lead author Bernard Fuemmeler, Ph.D., M.P.H., associate director for population science and interim co-leader of the Cancer Prevention and Control program at VCU Massey Cancer Center. "Even low levels of smoke from secondhand exposure affect epigenetic marks in disease-related pathways. That doesn't mean everyone who is exposed will have a child with some disease outcome, but it contributes to a heightened risk."

Fuemmeler and colleagues analyzed data from 79 pregnant women enrolled in the Newborn Epigenetics Study (NEST) between 2005 and 2011. During the first trimester, all had a concentration of cotinine -- a nicotine byproduct -- in their blood consistent with low levels of smoke exposure, ranging from essentially none to levels consistent with secondhand smoke.

After these women gave birth, the researchers sampled the umbilical cord blood, which is the same blood that circulates through the fetus in utero, and performed what's referred to as an epigenome-wide association study (EWAS) to search for correlations between blood cotinine levels of the mothers during pregnancy and epigenetic patterns in the babies at birth.

When cotinine levels were higher, the newborns were more likely to have epigenetic "marks" on genes that control the development of brain function, as well as genes related to diabetes and cancer.

These marks could mean either unusually many or unusually few molecules bound to the DNA strand, which affects how accessible a particular gene is. If a gene is bound up tightly by lots of marks, then it's harder for molecular machinery to access and less likely to be expressed. On the other hand, if a gene is relatively unencumbered, then it might be expressed at higher levels than normal. Tipping the scale in either direction could lead to disease.

To solidify their results, the team repeated the analysis in a separate sample of 115 women and found changes to two of the same disease-related epigenetic regions -- one that regulates genes involved in inflammation and diabetes and another that regulates cardiovascular and nervous system functions -- are correlated with cotinine levels in mothers.

In all cases, the analyses controlled for race, ethnicity, age, prior number of children and maternal education.

"It highlights the importance of clean air," said Fuemmeler, who is also a professor of health behavior and policy in the VCU School of Medicine and holds the Gordon D. Ginder, M.D., Chair in Cancer Research at Massey. "It's important not only for our homes, but also in the environment. Clean air policies limit smoke in public, and for pregnant women that may have long-term effects on offspring."

https://www.sciencedaily.com/releases/2021/05/210519120815.htm

10 Tips For New Moms

 Guest post by: Dema Sawaqed

You have just given birth and are experiencing a mixture of excitement, pride, immense joy, and fatigue.

 In short, nothing more normal. 

 And while you think you are, well, quiet at least for a few weeks, reality forces itself on you, sometimes a little abruptly. 

 To prepare yourself as much as possible and be calm, here are the 10 things to do after your pregnancy:

 Let’s get started,

 1. Express your feelings

As 50 to 80% of young mothers, pregnancy and childbirth may give way, for a few days (or just a few hours) to a baby blues. 

 Do not panic!

 This is perfectly normal and should dissipate quickly. 

 But to deal with you as easily as possible, it is highly recommended to talk about it and especially not to keep it to yourself.

 Share your thoughts with anyone you think can understand and help you deal with it. Like your health staff, partner, family member, or friend.

 2. Postpartum consultation

 We may think (and wish) that childbirth is the end of medical visits of all kinds, Nay! 

 Mothers should quickly think about the post-natal consultation (within six to eight weeks after birth).

3. Resumption of contraception

Even if this is not really our main concern during a stay in the maternity hospital, it should be considered if you do not want to immediately follow a second pregnancy. 

You might as well take advantage of the presence of professionals to ask questions and choose your contraceptive method.

4. Learn to let go

This is one of the main keys to remaining calm and taking on your new role as a mom while ensuring the daily tasks. 

The trick? 

Do not hesitate to ask those around you!

5. Take care of your marital life to avoid the baby clash

 Needless to say…

 The arrival of a child within a couple changes things considerably!

 The spouse suddenly becomes a parent, and the couple becomes a family, with the key to new situations to manage and new roles to assume. 

 It is thus common that the first months following a birth generate difficulties, even a real upheaval, which can go as far as separation. 

 To avoid this, 

 ..take care of your marital life as soon as possible and as much as you can!

 6. Think about yourself and have fun

 … But we also think of ourselves! 

 Forgetting yourself by living only for your little one is not the best solution. 

 Allow yourself moments of pleasure just for yourself that you can be completely fulfilled. 

 And as known: Happy mom.. Happy baby!

 7. Do some sports

Of course, we all want to find the line quickly after pregnancy. 

 Only here, things are not so simple, and each woman is different on this point. 

 Rule? 

 Wait for the post-natal consultation and the doctor's opinion, then take it easy if there are no contraindications. 

 Walking, swimming, cycling or yoga are recommended to start. 

 Jogging or tennis are to be avoided.

 8. Anticipate returning to work

It is the best way of returning to an active life without too much stress.

 Anticipating means finding a childcare arrangement and organizing future days according to work and transport schedules

 ...but also discussing with your employer to possibly adjust their schedules to help you take care of your little one.

 9. Find childcare for your baby 

 Babysitter or childcare center?  

In all cases, the choice of childcare must be anticipated from the time of pregnancy, to allow the baby and the mother to be confident and perfectly reassured.

10. Enjoy!

 With all these things to do, we would almost forget the essential: enjoying your baby and every moment spent together!

 Time flies by so fast.. 

 Remember to enjoy your little one being so little as much as you can!

 About 

Dema JS is the founder of newbabysmell.com and a mother of two little kids. 

Dema had her MBA from St. John’s University- NYC in dual concentrations: Executive Management and Marketing Management. 

Contact: Please email dema@newbabysmell.com or go to newbabysmell.com

Long term use of prescription meds for insomnia not linked to better quality sleep

No difference between those who did and didn't take these drugs for 1-2 years

May 11, 2021

Science Daily/BMJ

Long term use of prescription meds for insomnia doesn't seem to improve disturbed sleep in middle-aged women, suggests research published in the online journal BMJ Open.

There was no difference in sleep quality or duration between those who did and didn't take these meds for 1 to 2 years, the findings show.

Disturbed sleep -- difficulty falling and/or staying asleep and waking early -- is common. An estimated 9 million adults in the US alone say they take prescription meds to try and get a good night's sleep.

Poor quality sleep is associated with ill health, including diabetes, high blood pressure, pain and depression, and various drugs are prescribed to induce shut-eye.

These include benzodiazepines, Z-drugs which include zolpidem, zaleplon and eszopiclone, as well as other agents mostly intended for other conditions (off label use), such as quelling anxiety and depression.

The clinical trial data indicate that many of these drugs work in the short term (up to 6 months), but insomnia can be chronic, and many people take these drugs for longer, say the researchers.

They therefore wanted to assess the effectiveness of drugs used to tackle insomnia over the long term among an ethnically diverse group of middle aged women who developed sleep disorders.

The women were all part of the Study of Women's Health Across the Nation (SWAN), a long term multicentre study looking at biological and psychosocial changes arising during the menopause. The women's average age was 49.5 and around half were white.

Sleep disturbances were defined as difficulty falling asleep, frequent awakening, and waking up early and rated on a 5-point scale, ranging from no difficulty on any night (1) to difficulty on 5 or more nights of the week (5), reported during an average of 21 years of monitoring.

Sleep disturbances, as measured on the ratings scale, were compared among those who did and didn't take prescription meds to improve their sleep after 1 and 2 years.

Some 238 women who started using medication to tackle insomnia during the monitoring period were matched with 447 women who didn't take these drugs.

Both groups of women reported difficulty falling asleep on 1 out of every 3 nights, waking frequently on 2 out of 3 nights, and waking up early on 1 in every 3 nights of the week. More than 70% of women in both groups reported disturbed sleep at least 3 times a week.

To begin with, sleep disturbance ratings were similar between the two groups of women. Those taking prescription meds for their sleep problems had average scores for difficulty falling asleep, waking up frequently, and for waking up early of 2.7, 3.8, and 2.8 respectively.

This compares with equivalent ratings of 2.6, 3.7, and 2.7, respectively, for those not taking prescription meds to get a good night's sleep.

After 1 year, average ratings among those taking the meds were 2.6, 3.6, and 2.8, respectively. The equivalent average scores among those not using prescription meds for their sleep problems were 2.3, 3.5, and 2.5, respectively.

None of the 1 year changes was statistically significant nor did they differ between the two groups. And after 2 years there were no statistically significant reductions in sleep disturbances among those taking prescription meds compared with those who didn't.

This is an observational study, and as such can't establish cause, only correlation. What's more, around half of the women were current or former smokers and 1 in 5 were moderate to heavy drinkers, both of which may affect sleep quality.

Information collected on prescription meds was also collected only at annual or biennial study visits, and there may have been intermittent or periods of no use between visits, say the researchers. Nor were there any objective measures of sleep quality.

Nevertheless, conclude the researchers: "Sleep disturbances are common and increasing in prevalence. The use of sleep medications has grown, and they are often used over a long period, despite the relative lack of evidence from [randomised controlled trials]."

These drugs may work well in some people with sleep disturbances over several years, but the findings of this study should give pause for thought to prescribing clinicians and patients thinking about taking prescription meds for sleep disturbances in middle age, they add.

https://www.sciencedaily.com/releases/2021/05/210511201131.htm

Bacteria do not colonize the gut before birth

It happens during and after birth

May 10, 2021

Science Daily/McMaster University

It is well known that each person's gut bacteria is vital for digestion and overall health, but when does that gut microbiome start?

New research led by scientists from McMaster University and Charité -- Universitätsmedizin Berlin in Germany has found it happens during and after birth, and not before.

McMaster researchers Deborah Sloboda and Katherine Kennedy examined prenatal stool (meconium) samples collected from 20 babies during breech Cesarean delivery.

"The key takeaway from our study is we are not colonized before birth. Rather, our relationship with our gut bacteria emerges after birth and during infancy," said Kennedy, first author of the study and a PhD student, whose findings are published in Nature Microbiology.

Recent studies have sparked controversy by claiming that we are colonized by gut bacteria before birth. But, Kennedy said, studies such as these have been criticized for the ways they control for contamination.

"By including only breech caesarean deliveries in healthy pregnant women we were able to avoid the transmission of bacteria that occurs naturally during a vaginal birth," said Thorsten Braun, co-senior author and lead obstetric consultant and deputy director of the Department of 'Experimental Obstetrics' at Charité -- Universitätsmedizin Berlin.

Kennedy said recent data suggest that a person's relationship with their own gut bacteria is most important in early life, during critical stages of immunological and physiological development.

Sloboda, co-senior author, agrees.

"The fact that colonization of infants' guts occurs during and after their births, means that not only is it vulnerable to early environmental influences, but could also offers a window of potential intervention," said Sloboda, professor of biochemistry and biomedical sciences at McMaster and the Canada Research Chair in perinatal programming.

"While many of the exact mechanisms surrounding gut bacteria and their role in our early development is unclear, discovering when and how we are colonized is a key first step."

https://www.sciencedaily.com/releases/2021/05/210510133138.htm

New mothers twice as likely to have post-natal depression in lockdown

May 11, 2021

Science Daily/University College London

Almost half (47.5%) of women with babies aged six months or younger met the threshold for postnatal depression during the first COVID-19 lockdown, more than double average rates for Europe before the pandemic (23%), finds a new study led by UCL researchers.

Women described feelings of isolation, exhaustion, worry, inadequacy, guilt, and increased stress. Many grieved for what they felt were lost opportunities for them and their baby, and worried about the developmental impact of social isolation on their new little one.

Those whose partners were unable or unavailable to help with parenting and domestic tasks, particularly where they were also dealing with the demands of home schooling, felt the negative impacts of lockdown most acutely.

Researchers surveyed 162 mums in London between May and June 2020 using a unique social network survey designed in response to lockdown. Participants listed up to 25 people who were important to them and shared who they had interacted with and how, whether in person, by phone, video call or messaging on social media.

The women also reported on their well-being with researchers basing depression ratings on the Edinburgh Postnatal Depression Scale, the most commonly used tool. This allowed them to capture the full range of mothers' social interactions, as well as their mental health.

The findings are published today (11 May 2021) in the journal Frontiers in Psychology.

The more contact new mums had with people, either remotely or face-to-face, the fewer depressive symptoms they reported, suggesting reduced social contact during lockdown may have increased the risk of postnatal depression.

However, where women had maintained some face-to-face contact with family members, they were actually more likely to have depressive symptoms than women who saw fewer of their relatives. Researchers think this reflects family responding to mums who were struggling with their mental health, potentially breaking lockdown rules to help them.

Many mothers felt that lockdown created a 'burden of constant mothering' without anyone around to help, and that while virtual contact (video calls/phone calls/texts/social media messages) helped, it was still inadequate. Virtual contact meant women had to actively ask for help, because friends and family couldn't see them struggling, which they felt amplified the stresses of motherhood.

Dr Sarah Myers (UCL Anthropology) said: "Caring for a new baby is challenging and all new mothers suffer some level of mental, physical and emotional exhaustion. Low social support is one of the key risk factors for developing postnatal depression. Social distancing measures during lockdown created so many barriers to having practical help and meaningful support from others in the weeks and months after their baby's arrival, leading many new mothers to feel totally overwhelmed.

"It really does take a village to raise a child, especially in a crisis when everyone is dealing with increased demands, stresses and significant life events. Our survey shows that lockdowns leave new mothers more vulnerable to postnatal depression, and that digital solutions might help but they are not the answer. Policy makers must take this into account as we continue to deal with COVID-19, for the sake of mums, babies and whole families."

Not everything new mums experienced as a result of lockdown was negative. Some felt it 'protected' family time, leading to better bonding. Other benefits included partners being around more to co-parent and help out than if the UK had not been in lockdown.

Dr Emily Emmott (UCL Anthropology) said: "New mothers with more than one child were hardest hit, left to deal with newborns on top of multiple demands like home schooling. First-time mothers often felt cheated out of precious time spent together with their babies and family or friends, making coming to terms with the change of identity and isolation that new mothers often feel even harder.

"But, where partners were at home more because of lockdown, and able to share the relentless tasks and household chores or take care of existing children, new mums felt the benefits. Some reported that it helped everyone develop closer relationships and that the family benefited overall from spending this time together. This should also be food for thought when we look at support for parents with new babies, not just in a pandemic."

Comments from new mothers surveyed about their experiences included: "It has definitely made me more anxious -- am I doing enough for my baby, is she ok, is she healthy and happy, should I be doing more, do people think I'm a good mother? Much of this is because it's hard to communicate online."

A first-time mother said, "I feel I'm making it up as I go along and have no one to guide me," while another mum said, "I worry that my child isn't getting the development they deserve as they are not getting enough stimulus."

One mum described how, "We haven't had anyone come over to give us a break since before lockdown and it's exhausting."

Another said: "I think lockdown has made me feel like I'm not a person in my own right anymore. Not having anyone to hold him or to help out a bit makes me feel it's all me and it's a lot of pressure, which I can resent. I feel like I don't have any time to rest." While another mum said, "I am an exhausted mum not able to concentrate on either of my children and this is taking a toll on everyone."

https://www.sciencedaily.com/releases/2021/05/210511123619.htm

Sugar-sweetened drinks linked to increased risk of colorectal cancer in women under 50

Sugary beverage consumption in adolescence, young adulthood associated with increased risk

May 6, 2021

Science Daily/Washington University School of Medicine

Colorectal cancer diagnoses have increased among people under age 50 in recent years and researchers are seeking reasons why. A new study led by Washington University School of Medicine in St. Louis has found a link between drinking sugar-sweetened beverages and an increased risk of developing colorectal cancer in women under age 50. The findings suggest that heavy consumption of sugary drinks during adolescence (ages 13 to 18) and adulthood can increase the disease risk.

The study, published online May 6 in the journal Gut, provides more support for public health efforts that encourage people to reduce the amount of sugar they consume.

"Colorectal cancer in younger adults remains relatively rare, but the fact that the rates have been increasing over the past three decades -- and we don't understand why -- is a major public health concern and a priority in cancer prevention," said senior author Yin Cao, ScD, an associate professor of surgery and of medicine in the Division of Public Health Sciences at Washington University. "Due to the increase in colorectal cancer at younger ages, the average age of colorectal cancer diagnosis has gone down from 72 years to 66 years. These cancers are more advanced at diagnosis and have different characteristics compared with cancers from older populations.

"Our lab is funded by the National Cancer Institute (NCI) and the National Comprehensive Cancer Network to identify risk factors, the molecular landscapes, and precision screening strategies for these cancers so that they can be detected earlier and even prevented," said Cao, who also has a master's of public health. "In past work, we have shown that poor diet quality was associated with increased risk of early-onset colorectal cancer precursors, but we have not previously examined specific nutrients or foods."

Compared with women who drank less than one 8-ounce serving per week of sugar-sweetened beverages, those who drank two or more servings per day had just over twice the risk of developing early-onset colorectal cancer, meaning it was diagnosed before age 50. The researchers calculated a 16% increase in risk for each 8-ounce serving per day. And from ages 13 to 18, an important time for growth and development, each daily serving was linked to a 32% increased risk of eventually developing colorectal cancer before age 50.

Sugar-sweetened drink consumption has been linked to metabolic health problems, such as type 2 diabetes and obesity, including in children. But less is known about whether such high-sugar beverages could have a role in the increasing incidence of colorectal cancer in younger people. Like early-onset colorectal cancer rates, consumption of such drinks has increased over the past 20 years, with the highest consumption level found among adolescents and young adults ages 20 to 34.

The researchers analyzed data from the Nurses' Health Study II, a large population study that tracked the health of nearly 116,500 female nurses from 1991 to 2015. Every four years, participants answered surveys that included questions about diet, including the types and estimated amounts of beverages they drank. Of the total participants, over 41,000 also were asked to recall their beverage habits during their adolescence.

The researchers identified 109 diagnoses of early-onset colorectal cancer among the nearly 116,500 participants.

"Despite the small number of cases, there is still a strong signal to suggest that sugar intake, especially in early life, is playing a role down the road in increasing adulthood colorectal cancer risk before age 50," said Cao, also a research member of Siteman Cancer Center. "This study, combined with our past work linking obesity and metabolic conditions to a higher risk of early-onset colorectal cancer, suggests that metabolic problems, such as insulin resistance, may play an important role in the development of this cancer in younger adults."

With the increasing rates in mind, the American Cancer Society has recently lowered the recommended age for a first screening colonoscopy to 45, down from the previously recommended age 50 for people at average risk. Those with additional risk factors, such as a family history of the disease, should start even earlier, according to the guidelines.

Since the study only included female nurses, most of whom were white, more work is needed to examine this link in people of more diverse races, ethnicities and genders.

While sugar-sweetened beverages were linked to an increased risk of early-onset colorectal cancer, some other drinks -- including milk and coffee -- were associated with a decreased risk. This observational study can't demonstrate that drinking sugary beverages causes this type of cancer or that drinking milk or coffee is protective, but the researchers said that replacing sweetened beverages with unsweetened drinks, such as milk and coffee, is a better choice for long-term health.

"Given this data, we recommend that people avoid sugar-sweetened beverages and instead choose drinks like milk and coffee without sweeteners," Cao said.

https://www.sciencedaily.com/releases/2021/05/210506183353.htm

Thin and brittle bones strongly linked to women's heart disease risk

Thinning lower spine, top of thigh bone and hip predictive of raised heart attack/stroke risk

May 6, 2021

Science Daily/BMJ

Thin and brittle bones are strongly linked to women's heart disease risk, with thinning of the lower (lumbar) spine, top of the thigh bone (femoral neck), and hip especially predictive of a heightened heart attack and stroke risk, suggests research in the journal Heart.

Osteoporosis, often dubbed brittle bone disease, is common, particularly among women after the menopause. It is characterised by thinning and weakened bones and a heightened fracture risk.

Previously published research indicates that people with osteoporosis often have atherosclerosis (artery hardening and narrowing), suggesting that both conditions may be linked.

The risk of a cardiovascular death is higher in women (21%) than it is in men (15%), and the predictive risk framework for heart disease is skewed towards men, so factors that better identify women at higher risk of a heart attack or stroke are needed, say the researchers.

Millions of women are screened for osteoporosis using a DXA scan, so this assessment might provide an ideal opportunity to identify any potential associations between thinning bones and atherosclerosis, and those women most at risk of heart disease, without incurring any additional costs or further exposure to radiation, they add.

To test this out, the researchers reviewed the medical records of 50-80 year old women who had had a DXA scan to check for osteoporosis at Seoul National University Bundang Hospital between 2005 and 2014.

After excluding those who already had heart disease and other serious illness at the time of the scan, the final analysis included 12,681 women whose health was tracked for an average of 9 years, using national registry data.

In all, 468 women (around 4%) had a heart attack or stroke during the monitoring period. Some 237 (2%) died.

Thinning/weakened bones, expressed as a low bone mineral density score at the lumbar spine, femoral neck, and hip, were independently associated with a heightened (16% to 38%) risk of heart attack or stroke after taking account of potentially influential factors, such as age, high blood pressure, high cholesterol, smoking, and a previous bone break.

And a formal diagnosis of osteoporosis was also independently associated with a 79% higher risk of cardiovascular disease.

Adding bone mineral density score or a clinical diagnosis of osteoporosis or osteopenia (precursor to osteoporosis) to clinical risk factors more effectively predicted risk than clinical risk factors alone.

It's not clear exactly how osteoporosis and atherosclerosis might be linked, but long term inflammation and cumulative oxidative stress have key roles in both age-related bone loss and atherosclerosis, while sex hormones, particularly oestrogen, help regulate bone turnover and the vascular system, explain the researchers.

This is an observational study, and as such can't establish cause, only correlation. And the researchers acknowledge several limitations to their findings: the study included women from one medical centre in South Korea so the results might not be more widely applicable.

And they weren't able to gather potentially important information on physical activity levels or steroid use, both of which affect bone mineral density and cardiovascular disease risk.

Nevertheless, they conclude: "Considering that [DXA scanning] is widely used to screen for osteopenia and osteoporosis in asymptomatic women, the significant association between [bone mineral density] and higher risk of [cardiovascular disease] provides an opportunity for large-scale risk assessment in women without additional cost and radiation exposure."

In a linked editorial, Drs Dexter Canoy and Kazem Rahimi of the Nuffield Department of Women's and Reproductive Health, University of Oxford, agree, adding that further research in different settings is warranted.

But they suggest: "Perhaps it is high time to establish how bone health affects vasculature and understand the underlying pathophysiology that links osteoporotic and atherosclerotic conditions. In doing so, we might just discover new ways to improve the treatment of, and care for, the hearts and minds of women, as well as of men."

https://www.sciencedaily.com/releases/2021/05/210506183351.htm

Men with chest pain receive faster, more medical attention than women

Women with possible heart attack wait longer and undergo less testing, study finds

May 6, 2021

Science Daily/American College of Cardiology

Among younger adults visiting the emergency department for chest pain, women may be getting the short end of the stick. Compared with men of similar age, women were triaged less urgently, waited longer to be seen, and were less likely to undergo basic tests or be hospitalized or admitted for observation to diagnose a heart attack, according to new research being presented at the American College of Cardiology's 70th Annual Scientific Session.

The study is the first to examine emergency room management of chest pain specifically among younger adults (age 18-55 years). Heart disease is the leading cause of death in women and is becoming more common in younger adults. About one-third of women who were hospitalized for a heart attack in the past two decades were under the age of 55, a proportion that has grown in recent years.

"Women should trust their instincts," said Darcy Banco, MD, an internal medicine resident at NYU Langone Health and the study's lead author. "Women should seek care right away if they experience new chest discomfort, difficulty breathing, nausea, vomiting, fatigue, sweating or back pain, as these could all be signs of a heart attack. The most important thing a woman can do is to seek medical care if she is worried and to ask specific questions of her doctor."

Chest discomfort is the most common symptom of a heart attack in both men and women, but research shows that women can have a broader range of accompanying symptoms that may not initially be recognized as a sign of a heart attack. Chest discomfort caused by a heart attack can be perceived as pain, pressure, tightness or another uncomfortable sensation.

The study is based on data collected by the National Hospital Ambulatory Medical Care Survey between 2014-2018. Researchers extrapolated the data to represent an estimated 29 million emergency department visits for chest pain in the U.S. among adults aged 18-55; women comprised nearly 57% of those visits.

Researchers found that women reporting chest pain were equally likely to arrive at the hospital by ambulance but significantly less likely than men to be triaged as emergent. On average, women waited about 11 minutes longer to be evaluated by a clinician. Women were also significantly less likely to undergo an electrocardiogram (EKG), the standard initial test used to diagnose a heart attack, or to receive cardiac monitoring or be seen by a consultant, such as a cardiologist.

Medical guidelines recommend that all patients with possible heart attack symptoms receive an EKG within 10 minutes of arrival in the emergency department to minimize the time to treatment.

"Time is very important when you're treating heart attacks," Banco said. "The longer people wait, the worse their outcomes can be."

The study did not examine the reasons why women with chest pain were treated differently than men. Banco suggested that pre-conceived notions of risk--rather than overt discrimination--likely play a role. Historically, heart attacks have been most common in older men, and clinicians may be less likely to suspect a heart attack among patients outside of that demographic. Banco suggested clinicians should appreciate that younger women represent a growing portion of heart attack patients.

"We, as health care providers, should continue to learn about how best to triage and diagnose patients with heart attacks, particularly among those who have historically been under-diagnosed or under-treated," Banco said. "We are learning that heart attacks take many forms. We need to continue to raise awareness and make sure all patients are diagnosed and treated properly, even if they're not the 'classic' demographic for a heart attack. [This knowledge] will help us improve care for all."

https://www.sciencedaily.com/releases/2021/05/210506105435.htm

Exercise aids the cognitive development of children born preterm

May 6, 2021

Science Daily/University of Basel

A premature start in life can cause problems even into teenage years. A study by the University of Basel and the University Children's Hospital Basel (UKBB) indicates that training motor skills in these children helps even when they are older.

Children that are born before the 37th week of pregnancy remain under close medical supervision while they are young. Any cognitive limitations often disappear after a few years. However, children who come into the world even before the 32nd week of gestation still exhibit differences even into their teenage years. In a new study, researchers led by Dr. Sebastian Ludyga and Professor Uwe Pühse have demonstrated that these children have weaker impulse control compared with children born at term (after the 37th week of pregnancy). This can, for example, have disadvantages in school performance and is linked to behavioral problems and a higher susceptibility to addiction.

As the research team reports in the journal Developmental Cognitive Neuroscience, these differences in impulse control can be fully explained by the children's motor skills. "In other words, premature children who had very well-developed motor skills were practically equal to children born at term when it came to impulse control," explains Ludyga.

In their study, the researchers compared a group of 54 very preterm children aged 9 to 13 years with a control group of children of the same age who had been born at term. To test impulse control, the sports scientists conducted a "go/no go" test with the children. When given a signal, the young study participants had to push a button as quickly as possible. When given a different signal, they were not allowed to push the button -- in other words, they had to suppress their impulse to move.

During the experiment, the researchers monitored certain brain activity parameters using an EEG (electroencephalogram) to determine how the children processed the stimulus. A comparison of the two groups showed that on average, the premature children found it more difficult to suppress the impulse to move due to impaired attention processes.

In further experiments, the researchers tested gross and fine motor skills, as well as ball handling. They found that the greater the deficit in motor skills, the more limited the impulse control in the children born very preterm.

"We conclude from these findings that targeted motor skills training could also reduce cognitive limitations," explains Ludyga. The researchers now want to test this in a follow-up study.

Ludyga says that there are few support options for very premature children as they grow into teenagers unless they come under scrutiny for a different reason, such as ADHD or another illness: "Limited impulse control at this age, even if it sorts itself out later, can have negative consequences and restrict these children's educational opportunities."

In younger children in particular, the development of motor and cognitive skills are closely linked. The time window from 9 to 13 years is therefore a promising period in which to reduce cognitive deficits in children born very preterm.

https://www.sciencedaily.com/releases/2021/05/210506105422.htm

Risk of developmental difficulties remains high among children born early

Preterm birth continues to pose a large burden for families, healthcare, and educational systems, say researchers

April 28, 2021

Science Daily/BMJ

Children born preterm (before 37 weeks of pregnancy) remain at high risk of developmental difficulties that can affect their behaviour and ability to learn, finds a study published by The BMJ today.

These difficulties were found not only in children born extremely preterm (22-26 weeks) but also in those born very and moderately preterm (between 27 and 34 weeks), say researchers.

Survival of preterm babies has increased worldwide. Children born early often have developmental issues, but studies have mainly focused on those born extremely preterm (22-26 weeks' gestation) and less is known about children born very and moderately preterm (27-34 weeks' gestation).

Given how important it is to identify children most at risk of developmental difficulties, researchers in France set out to describe neurodevelopment among children born before 35 weeks compared with children born at full term.

Their findings are based on 3,083 French children aged 5½ born after 24-26, 27-31, and 32-34 weeks gestation who were taking part in the EPIPAGE-2 study (designed to investigate outcomes of preterm children over the past 15 years) and a comparison group of 600 children born at full term.

Neurodevelopmental outcomes such as cerebral palsy, sensory impairments (blindness and deafness), and brain function (cognition), as well as behavioural difficulties and movement disorders, were assessed using recognised tests.

To further assess the family and social burden of prematurity, measures such as the need for extra support at school, visits to a psychiatrist, speech therapist or physiotherapist, and parental concerns about development, were also recorded.

After adjusting for other potentially influential factors, the researchers found that rates of neurodevelopmental disabilities increased as gestational age decreased.

For example, among the 3,083 children assessed, rates of severe to moderate neurodevelopmental disabilities were 28%, 19% and 12% and rates of mild disabilities were 39%, 36%, and 34% among children born at 24-26, 27-31 and 32-34 weeks, respectively.

Assistance at school was used by 27%, 14% and 7% of children born at 24-26, 27-31, and 32-34 weeks, respectively. And about half of children born at 24-26 weeks received at least one developmental intervention which fell to 26% for those born at 32-34 weeks.

Behaviour was the concern most commonly reported by parents.

Rates of neurodevelopmental disabilities were also higher in families with low socioeconomic status.

This is an observational study, so can't establish cause, and the researchers point to some limitations that may have affected their results. However, by assessing a wide range of developmental and behavioural issues, they were better able to reflect the complexity of difficulties faced by these children and their families.

As such, they say their findings indicate that preterm birth "continues to pose a large burden for families, healthcare, and educational systems."

Although rates of severe to moderate neurodevelopmental disabilities decreased with increasing gestational age, they point out that around 35% of the moderately to extremely preterm born children had mild disabilities requiring special care or educational services.

And a considerable proportion of parents had concerns about their child's development, particularly about behaviour, which warrant attention, they add.

"Difficulties faced by these groups of children and their families should not be underestimated," they conclude.

https://www.sciencedaily.com/releases/2021/04/210428192712.htm

Childhood psychiatric symptom risk strongly linked to adverse exposures during gestation

April 28, 2021

Science Daily/Massachusetts General Hospital

Harmful exposures during pregnancy, including some that occur even before pregnancy is recognized, appear to significantly increase a child's risk for psychiatric or behavioral problems early in life, researchers from Massachusetts General Hospital report.

In their study of 9,290 children from the ages of 9 to 10 living in 21 communities in the United States, the researchers found that children subjected during pregnancy to two or more of six adverse exposures were significantly more likely to have clinically significant scores on the Child Behavior Checklist (CBCL), indicating a higher level of problems such as depression, attention difficulties or anxiety.

The adverse prenatal exposures are unplanned pregnancy; maternal use of alcohol, tobacco or marijuana before pregnancy was recognized; complications during pregnancy (such as high blood pressure or gestational diabetes); and complications during labor and delivery. Pre-term birth or Caesarean delivery were not associated with increased risk.

"While individually these factors had previously been associated with similar risks in prior, often smaller studies, this is the first time that we were able to gauge the effect of cumulative exposures, which were fairly dramatic," says lead author Joshua L. Roffman, MD, MMSc, director of the Mass General Early Brain Development Initiative.

For example, while children with none of the exposures during their mother's pregnancy had only a 7% chance of developing clinically significant psychiatric symptoms, this risk increased steeply and in a linear fashion, such that those with four or more of the exposures had a 29% chance of clinically significant symptoms.

As the researchers report in their study, published in the open-access journal PLOS ONE, they saw similar patterns across a range of specific symptoms, from mood and anxiety to attention and thought disturbances.

The associations between prenatal exposures and psychiatric symptoms in childhood held up even when the researchers accounted for other factors that might skew the results, such as the mother's socioeconomic status, or exposures after birth that are known to increase a child's risk for psychiatric disorders, such as a traumatic life event.

To validate their findings, Roffman and colleagues also tested them in a separate group of non-twin siblings who differed in their exposures during pregnancy, and here too the data showed that the sibling with the higher number of exposures was at greater risk for more severe symptoms.

A limitation of the results is that they are based on the mother's recall of events during pregnancy, although the frequency of adverse events closely followed national trends. The study did not measure the effects of maternal infections or stress during pregnancy, although each of these has also been associated with increased risk in previous studies.

Given the additive effects of the common exposures they studied, Roffman and colleagues speculate that the "floor" of risk for psychiatric symptoms may have been raised for children born during the COVID-19 pandemic.

"Our findings reinforce the importance of the prenatal environment for brain health and for reducing risk of psychiatric symptoms in childhood. This brings increased urgency to the need to discover, develop and implement early life interventions that mitigate some of these risks," says Roffman, who is also an associate professor of Psychiatry at Harvard Medical School (HMS).

Improving child brain development and psychiatric health is the main goal of the Mass General Early Brain Development Initiative, a multidisciplinary collaboration among staff in the Departments of Psychiatry, Obstetrics, Pediatrics and Medicine.

https://www.sciencedaily.com/releases/2021/04/210428140901.htm

Breastfeeding linked to higher neurocognitive testing scores in offspring

April 27, 2021

Science Daily/University of Rochester Medical Center

New research finds that children who were breastfed scored higher on neurocognitive tests. Researchers in the Del Monte Institute for Neuroscience at the University of Rochester Medical Center (URMC) analyzed thousands of cognitive tests taken by nine and ten-year-olds whose mothers reported they were breastfed, and compared those results to scores of children who were not.

"Our findings suggest that any amount of breastfeeding has a positive cognitive impact, even after just a few months." Daniel Adan Lopez, Ph.D. candidate in the Epidemiology program who is first author on the study recently published in the journal Frontiers in Public Health. "That's what's exciting about these results. Hopefully from a policy standpoint, this can help improve the motivation to breastfeed."

Hayley Martin, Ph.D., a fourth year medical student in the Medical Scientist Training Program and co-author of the study, focuses her research on breastfeeding. "There's already established research showing the numerous benefits breastfeeding has for both mother and child. This study's findings are important for families particularly before and soon after birth when breastfeeding decisions are made. It may encourage breastfeeding goals of one year or more. It also highlights the critical importance of continued work to provide equity focused access to breastfeeding support, prenatal education, and practices to eliminate structural barriers to breastfeeding."

Researchers reviewed the test results of more than 9,000 nine and ten-year-old participants in the Adolescent Brain Cognitive Development (ABCD) study. Variations were found in the cumulative cognitive test scores of breastfed and non-breastfed children. There was also evidence that the longer a child was breastfed, the higher they scored.

"The strongest association was in children who were breastfed more than 12 months," said Lopez. "The scores of children breastfed until they were seven to 12 months were slightly less, and then the one to six month-old scores dips a little more. But all scores were higher when compared to children who didn't breastfeed at all." Previous studies found breastfeeding does not impact executive function or memory, findings in this study made similar findings.

"This supports the foundation of work already being done around lactation and breastfeeding and its impact on a child's health," said Ed Freedman, Ph.D., the principal investigator of the ABCD study in Rochester and lead author of the study. "These are findings that would have not been possible without the ABCD Study and the expansive data set it provides."

https://www.sciencedaily.com/releases/2021/04/210427110611.htm

Overgrowth of gut yeast in newborns may increase asthma risk

April 20, 2021

Science Daily/eLife

An overgrowth of yeast in the gut within the first few months of life may cause changes to the immune system that increase the risk of asthma later on, shows a study published today in eLife.

Asthma is a common and sometimes difficult-to-manage, life-long lung condition that affects one in 10 children in developed countries. The findings explain a possible cause of asthma and may help scientists develop new strategies to prevent or treat the condition.

The period just after birth is a critical window for the development of a healthy immune system and gut microbiome. Disruptions to gut bacteria that produce anti-inflammatory compounds called short-chain fatty acids (SCFAs) early in life have previously been linked to asthma.

"We recently showed that overgrowth of a type of gut yeast called Pichia kudriavzevii in newborns in Ecuador is associated with an increased risk of asthma," says first author Rozlyn Boutin, an MD/PhD student in the Department of Microbiology and Immunology at the University of British Columbia, Vancouver, Canada. "In this study, we wanted to see if we could replicate these findings in children from an industrialised setting and identify how fungi of the gut microbiota affect the development of the immune system."

Boutin and colleagues began with a study of 123 newborns in Canada, who are part of the CHILD Cohort Study. They again found that an overgrowth of Pichia kudriavzevii in the stools of the newborns during the first three months of life was associated with a higher risk of asthma.

To understand how this yeast overgrowth might contribute to asthma later in life, the team applied Pichia kudriavzevii to newborn mice with immature gut microbiota communities. In this mouse model of asthma, the team found that the newborns exposed to the yeast experienced more lung inflammation than those who were unexposed. Applying Pichia kudriavzevii to an adolescent mouse model, however, did not cause this excess inflammation.

"Our findings show that there is a critical window in early life where disruptions in the gut microbiota caused by Pichia kudriavzevii affect the development of the immune system and increase the risk and severity of asthma later in life," Boutin says.

Previous studies have shown that bacterial

Shift-work causes negative impacts on health, affects men and women differently

April 21, 2021

Science Daily/University of Waterloo

Shift-work and irregular work schedules can cause several health-related issues and affect our defence against infection, according to new research from the University of Waterloo.

These health-related issues occur because the body's natural clock, called the circadian clock, can be disrupted by inconsistent changes in the sleep-wake schedule and feeding patterns often caused by shift work. To study this, researchers at Waterloo developed a mathematical model to look at how a disruption in the circadian clock affects the immune system in fighting off illness.

"Because our immune system is affected by the circadian clock, our ability to mount an immune response changes during the day," said Anita Layton, professor of Applied Mathematics, Computer Science, Pharmacy and Biology at Waterloo. "How likely are you to fight off an infection that occurs in the morning than midday? The answer depends on whether you are a man or a woman, and whether you are among quarter of the modern-day labour force that has an irregular work schedule."

The researchers created new computational models, separately for men and women, which simulate the interplay between the circadian clock and the immune system. The model is composed of the core clock genes, their related proteins, and the regulatory mechanism of pro- and anti-inflammatory mediators. By adjusting the clock, the models can simulate male and female shift-workers.

The results of these computer simulations conclude that the immune response varies with the time of infection. Model simulation suggests that the time before we go to bed is the "worst" time to get an infection. That is the period of the day when our body is least prepared to produce the pro- and anti-inflammatory mediators needed during an infection. Just as importantly, an individual's sex impacts the severity of the infection.

"Shift work likely affects men and women differently," said Stéphanie Abo, a PhD candidate in Waterloo's Department of Applied Mathematics. "Compared to females, the immune system in males is more prone to overactivation, which can increase their chances of sepsis following an ill-timed infection."

The study, Modeling the circadian regulation of the immune system: sexually dimorphic effects of shift work, authored by Waterloo's Faculty of Mathematics' Layton and Abo, was recently published in the journal PLoS Computational Biology.

https://www.sciencedaily.com/releases/2021/04/210421082937.htm