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Keep up to date with these brief reports on the latest research work being done around the world and what it means for you and your baby. Nicotine exposure in the womb | Kangaroo care for preterm babies | PGD could cut miscarriage rate | Babywalkers cause delays | Ulcer bacteria linked with cot death | Should foods be fortified with folic acid? | Stress may affect your baby Nicotine exposure in the wombMaternal smoking during pregnancy is a recognised risk factor for sudden fetal and infant death as well as respiratory disease in childhood. Now a new study indicates that nicotine on its own also affects organ development in the fetus. This is an important finding as nicotine replacement therapy in the form of patches and inhalers is often recommended to pregnant women trying to give up smoking. The study, published in the American Journal of Respiratory and Critical Care Medicine, looked at the effects of fetal exposure to nicotine on the lung function of young lambs. The lambs were exposed to a similar amount of nicotine to that of a human fetus whose mother smoked moderately. Researchers compared the lung function of nine lambs which had been exposed to nicotine in the womb with that of 12 non-exposed lambs. The animals' lung functions were tested repeatedly for five weeks after birth. The nicotine exposed lambs had a significantly different breathing pattern to the control group. At five days and 21 days after birth the nicotine exposed lambs had lower tidal volumes and higher respiratory rates than the control group. The effects at five days were more pronounced than at 21 days. Dr. Hakan Sundell and colleagues from the Department of Paediatrics at Vanderbilt University School of Medicine in Nashville, Tennessee, concluded that prenatal nicotine exposure appeared to have long-term effects on the postnatal breathing pattern, suggesting altered lung function and that, while the changes were most marked close to birth, they persisted during the initial postnatal period.
Kangaroo care for preterm babiesA recent study carried out in Israel and published in Pediatrics has found that kangaroo care has a positive effect on parent-child interactions and infant development in premature infants. Kangaroo care is prolonged and regular skin to skin contact between mother and child. In the study the contact was for one hour a day over a two week period. A group of 73 premature babies who received kangaroo care in the neonatal intensive care unit were compared with 73 premature babies who received standard incubator care. All the babies were of comparable birthweight, prematurity, medical severity and demographics. The babies were examined at 37 weeks (gestational age), three months and six months. Researchers compared how the babies reacted to their parents, maternal depression, mother-infant interaction, infant temperament and cognitive development. The babies who received kangaroo care were more alert and interacted more positively with their mothers who were more responsive to their needs. The mothers from the kangaroo group also suffered less depression and perceived their babies as less abnormal than the mothers of the incubator care babies. At six months, the kangaroo care babies performed better in mental and motor development tests than the babies who received standard incubator care. The researchers concluded that kangaroo care was beneficial both for the premature infant and the parents.
PGD could cut miscarriage rateA technique called preimplantation genetic diagnosis (PGD) could help women suffering from repeated unexplained miscarriage. Research, presented at the European Society of Human Reproduction and Embryology annual conference in Vienna, showed that chromosomal abnormalities in embryos were an important cause of unexplained recurrent miscarriages. Carmen Rubio of the Instituto Valenciano de Infertilidad, Spain said that she and her colleagues had successfully reduced the risk of miscarriage and achieved normal pregnancy rates in women suffering from recurrent miscarriage and implantation failure. The women's embryos were screened for chromosomal abnormalities during IVF and the embryos found to be normal were transferred to the womb. PGD was used in 71 couples where the woman had suffered two or more miscarriages and in 42 couples with implantation failure. A control group of 28 fertile women having PGD for other reasons was included in the study. One third more embryos in the recurrent miscarriage and implantation failure group had abnormal chromosomes compared with those in the control group. Embryos were twice as likely to be abnormal in women under 37 years old. As age is a risk factor for abnormalities in women over 37, this is an important finding showing that abnormal chromosomes are implicated in recurrent miscarriage and implantation failure. Similar pregnancy rates were achieved in all three groups (34.3% in the RM group, 32.4% in the IF group and 29% in the control group) using the screened embryos. The miscarriage rate was reduced from high risk to close to the average rate of 15%. Ms Rubio said: "Our study shows that, in some couples suffering from repeated unexplained miscarriages or implantation failure, chromosomal abnormalities in the embryo can be the cause of the problem. High pregnancy rates and a decreased risk of further miscarriages can be achieved in these couples by using PGD to select only the normal embryos to be transferred into the uterus. PGD could also be used as a diagnostic tool to identify couples with an increased risk of producing embryos with chromosomal abnormalities and even couples whose embryos are all abnormal."
Babywalkers cause delaysA recent study carried out at the School of Physiotherapy, UCD, and published in the British Medical Journal has concluded that babywalkers delay infant development. Researchers asked the parents of 190 healthy children attending nine different day care centres in the North of Ireland to record the age that their children reached certain developmental milestones. Of the children 83 were boys and 107 girls, all were born at full term, premature infants were excluded from the study. Over half of the children used babywalkers (54%) between approximately 24 weeks and 54 weeks old. The children using babywalkers achieved crawling, standing alone, and walking alone up to four days later than non-users. Researchers found a strong association between the amount of babywalker use and the extent of developmental delay in the infants. The researchers concluded that babywalkers were associated with delays in achieving normal locomotive milestones and, as they were also linked to an increased risk of injury, parents should be advised against using them.
Ulcer bacteria linked with cot deathA type of bacteria known to cause stomach ulcers may also contribute to SIDS (sudden infant death syndrome, also known as cot death), according to researchers from Manchester University writing in the Archives of Disease in Childhood. The researchers found the Helicobacter pylori bacteria in the windpipe of a large proportion of babies who died from SIDS. The bacteria can be passed from adult to baby via the adult's saliva, so it's important to avoid bad practice such as sucking dummies before giving them to your baby. A total of 32 babies aged up to seven months who had died of SIDS were studied, Researchers found two genes present that indicated H pylori infection in 28 out of the 32 babies. When they examined babies who had died of other causes, they found the same gene was present in only one of eight tissue samples. Researchers say that, as well as causing inflammation, H pylori can lead to the release of ammonia into the bloodstream, and this has been associated with SIDS in earlier research. SIDS is the unexplained sudden death of a baby aged under a year. Although research and campaigns led by the Foundation for the Study of Infant Deaths (FSID) has resulted in a 70% drop, around eight babies still die from SIDS in the UK each week. It claims more babies' lives than meningitis, road traffic accidents and leukaemia and other forms of childhood cancer. Joyce Epstein, director of the Foundation, said that the findings were interesting, but were at a hypothetical stage at the moment. "It is uncertain whether this study has any practical implications," she said. At the same time, she reminded parents to take established steps that have been shown to reduce the risk of cot death. These are:
Should foods be fortified with folic acid?The Health Department and the Food Standards Agency plan to consult the public on whether wheat flour should be fortified with folic acid. Folates and folic acid are forms of a B vitamin necessary for healthy blood and nerve development in pregnancy. Folates occur naturally in foods such as leafy green vegetables and oranges. Folic acid is an artificial form used in dietary supplements and for fortifying foods, and is more easily absorbed by the body. Earlier this year (2000), a UK government committee reported on the role of folic acid in preventing NTDs (neural tube defects), including spina bifida. The research examined the health aspects of food fortification and concluded that fortifying flour with 240 micrograms of folic acid per 100g in food products would reduce the risk of an NTD in babies by 41%. Women who could become pregnant will still be advised to take dietary supplements of folic acid. The report estimates that of 93 babies born with an NTD in England and Wales in 1998, 38 could have been prevented if flour was fortified with the vitamin. Consulting the public aims to gather views from organisations and the public regarding these recommendations. The consultation document sets out the scientific evidence, and raises issues such as technical feasibility and consumer choice. For women planning pregnancy, current government advice is to:
Stress may affect your babySevere emotional stress during pregnancy could result in malformations in the unborn baby, according to new research published in the Lancet recently. Danish researchers found that serious life events such as job loss, separation and bereavement could result in abnormalities such as neural tube defects and cleft lip in babies before birth. It's known that emotions such as fear, anger and elation cause the release of different chemicals into the bloodstream and that this can affect the growing baby. Rest assured, though, that short periods of anxiety or anger don't appear to have any long-term effects on unborn babies. It's quite natural to worry about pregnancy, birth and beyond, so it's important to relax as much as possible. You can find out more about relaxation techniques, including yoga, fitness and aromatherapy classes for pregnancy, at your local parentcraft class and leisure centre or health club. Talking over concerns with friends and family can help enormously, too. For further information: Active Birth Centre MAMA (Meet-a-Mum Association)
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