New Method to Predict Pregnancy Disorder Developed

Researchers have developed a simple, low-cost way to predict preeclampsia, one of the leading causes of maternal-foetal mortality worldwide. Preesimpleclampsia can cause devastating complications for women and babies, including brain and liver injury in mothers and premature birth. 

"In developing nations, preeclampsia is a leading cause of death for both mothers and babies. In Ghana, it's responsible for 18 per cent of maternal deaths," said the study researcher.

But it can be treated using medication that lowers blood pressure once diagnosed," he added.
For the study, researchers assessed the health status of over 500 pregnant Ghanaian women using Suboptimal Health Questionnaire. Combining scores for fatigue, heart health, digestion, immunity and mental health, the questionnaire provides an overall "suboptimal health score" that can help predict chronic diseases. 

The researchers found that 61 per cent of women who scored high on the questionnaire went on to develop preeclampsia, compared with just 17 per cent of women who scored low. 

When these results were combined with blood tests that measured women's calcium and magnesium levels, the researchers were able to accurately predict the development of preeclampsia in almost 80 per cent of cases. 

According to the researchers, preeclampsia was very treatable once identified, so providing an early warning could save thousands of lives. 

"Both blood tests for magnesium and calcium and the Suboptimal Health Questionnaire are inexpensive, making this ideally suited to the developing world where preeclampsia causes the most suffering," he said. 

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Stressed Pregnancy Might Hinder Infants’ Brain Development

While stress is at no time considered healthy, maternal stress during or even before pregnancy can affect the infant’s brain development, found a new study. The study looked at the relationship between maternal stress and brain development in 251 premature kids. Researchers found evidence for the impaired development of a white matter tract, the uncinate fasciculus, in babies whose mothers experience more stress in the prenatal period. These findings were published in the Journal Biological Psychiatry.

The mothers completed a questionnaire that asked them about their experiences of stressful events, ranging from everyday stress such as moving house or taking an exam to more severe stressors like experiencing bereavement, separation or divorce.

A score of severity of stress was calculated based on how many stressors they experienced as well as how severe those stressors were. This is what was related to the baby’s brain.
Researchers used a medical imaging technique called diffusion tensor imaging that was specifically developed to look at the structure of the white matter, which has previously been implicated in anxiety disorders – adults that have an anxiety disorder may show changes in the tract.

We found that in the mums that were more stressed during pregnancy and the period before birth, white matter was altered in the babies, said lead researcher.

Clinicians have an important role to play when speaking with expectant mothers. While questions are asked about depressive symptoms, few questions are asked about general stress and anxiety. Women who deal with stressful life events during pregnancy are not picked up by their GPs or by their health care providers very often.

It is not diagnosed as often as it should be during pregnancy and we are trying to emphasise that maternal mental health during pregnancy can impact the baby’s brain development which may impact on their outcomes later in life, researcher added.
Antenatal services need to be aware that it is important to think about stress of the mums and we need to have some kind of support there for the mums who identify that they are stressed, the researcher opined.

There is some evidence to suggest that if mothers experience poor mental health during pregnancy that leads to adverse outcomes in the baby – obstetric outcomes, lower birth weight or premature birth.
A mother’s poor mental health may also lead to altered early behavior such as more frequent crying.

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Heart abnormalities from premature birth can be corrected with exercise in young adulthood

People who suffer from heart abnormalities due to preterm birth could correct the damage with exercise in young adulthood, according to a study. Around one to two per cent of adults today were born more than two months prematurely (very preterm) and have heart abnormalities that increase their risk of cardiovascular disease.

For instance, the heart is smaller and has to pump harder to supply the body with blood. "Until now we did not know if this was permanent or amenable to improvement.

Now, for the first time, we have shown how to make preterm hearts function as well as their peers. No drugs were required - just a 14-week exercise programme," said co-principal investigator.

The study enrolled 14 participants aged between 18-29 years, of whom eight were born very preterm and six acted as controls.

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Premature birth linked to increased risk of chronic kidney disease

As part of a recent study, researchers have discovered links between premature birth and increased risk of chronic kidney disease.

According to the study, preterm and early term birth are strong risk factors for the development of chronic kidney disease (CKD) from childhood into mid-adulthood.

The researchers claim that given the high levels of preterm birth, and better survival into adulthood, these findings have important public health implications.

Preterm birth (before 37 weeks of pregnancy) interrupts kidney development and maturity during late-stage pregnancy, resulting in fewer nephrons forming (filters that remove waste and toxins from the body).

Lower nephron number has been associated with the development of high blood pressure and progressive kidney disease later in life, but the long-term risks for adults who were born prematurely remain unclear.

As part of the study, a team of researchers set out to investigate the relation between preterm birth and risk of CKD from childhood into mid-adulthood.

Using nationwide birth records, they analysed data for over 4 million single live births in Sweden during 1973-2014. Cases of CKD were then identified from nationwide hospital and clinic records through 2015 (maximum age 43 years).

Overall, 4,305 (0.1 pc) of participants had a diagnosis of CKD, yielding an overall incidence rate of 4.95 per 100,000 person-years across all ages (0-43 years).

After taking account of other factors that might be important, they found that preterm birth (less than 37 weeks) was associated with a nearly twofold increased risk of CKD into mid-adulthood (9.24 per 100,000 person-years).

Extremely preterm birth (less than 28 weeks) was associated with a threefold increased risk of CKD into mid-adulthood (13.33 per 100,000 person-years).

A slightly increased risk (5.9 per 100,000 person-years) was seen even among those born at early term (37-38 weeks).

The association between preterm birth and CKD was the strongest up to age 9 years, then weakened but remained increased at ages 10-19 years and 20-43 years.

These associations affected both males and females and did not seem to be related to shared genetic or environmental factors in families.

This is an observational study, and as such, can’t establish cause, and the researchers acknowledge some limitations, such as a lack of detailed clinical data to validate CKD diagnoses and potential mis-classification of CKD, especially beyond childhood.

However, the large sample size and long-term follow up prompt the researchers to conclude that preterm and early term births are strong risk factors for the development of CKD from childhood into mid-adulthood.

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Omega-3 fatty acids during pregnancy reduces risk of premature births

Increasing the intake of omega-3 fatty acids during pregnancy reduces the risk of premature births, says a new research. While the length of most pregnancies is between 38 and 42 weeks, the earlier a baby is born, the greater the risk of death or poor health. Premature babies are at higher risk of a range of long-term conditions including visual impairment, developmental delay and learning difficulties.
 
The findings showed that increasing the daily intake of long-chain omega-3s lowered the risk of having a premature baby (less than 37 weeks) by 11 per cent (from 134 per 1,000 to 119 per 1,000 births). It also lowered the risk of having an early premature baby (less than 34 weeks) by 42 per cent (from 46 per 1,000 to 27 per 1,000 births) as well as decreased the risk of having a small baby by 10 per cent.

 Increasing the intake of omega-3 fatty acids during pregnancy reduces the risk of premature births, says a new research. While the length of most pregnancies is between 38 and 42 weeks, the earlier a baby is born, the greater the risk of death or poor health. 

Premature babies are at higher risk of a range of long-term conditions including visual impairment, developmental delay and learning difficulties.

The findings showed that increasing the daily intake of long-chain omega-3s lowered the risk of having a premature baby (less than 37 weeks) by 11 per cent (from 134 per 1,000 to 119 per 1,000 births). It also lowered the risk of having an early premature baby (less than 34 weeks) by 42 per cent (from 46 per 1,000 to 27 per 1,000 births) as well as decreased the risk of having a small baby by 10 per cent.

"There are not many options for preventing premature birth, so these new findings are very important for pregnant women, babies and the health professionals who care for them," said a researcher.

"We don't yet fully understand the causes of premature labour, so predicting and preventing early birth has always been a challenge. This is one of the reasons omega-3 supplementation in pregnancy is of such great interest to researchers around the world."

For the study,  the team looked at 70 randomised trials involving 19,927 women at low, mixed or high risk of poor pregnancy outcomes.

The optimum dose was a daily supplement containing between 500 and 1,000 milligrams of long-chain omega-3 fats (containing at least 500mg of DHA) starting at 12 weeks of pregnancy.

Premature birth, a critical global health issue and the leading cause of death for children under five years old worldwide, accounts for close to 1 million deaths annually. 

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Exposure To Air Pollution Before Birth Could Be Affecting The DNA Of Newborn Babies

Air pollution is responsible for 5.5 million of the 9 million deaths caused by pollution every year, making it the main cause of death by pollution in the world. Now, researchers have begun to understand the terrible effects air pollution is having on babies exposed to it in the womb.

The latest research,  looked at the DNA in umbilical cord blood from newborn babies born in a country, before and after a coal-burning power plant was closed in 2004. Several findings suggest that the pollution has affected the children’s DNA.

The team observed that babies born before the plant was shut down had shorter telomeres than those born afterward. Telomeres are a specialized section of DNA that allows chromosomes to be copied faithfully. After each copy, during cell division, the telomeres get shorter. Eventually, the shortened telomeres lead the copies to be less faithful and this has been linked to aging, cancer, heart disease, cognitive decline, and even premature death.   

The team confirmed that the shorter telomeres observed in those born before the coal plant shut down are associated with the presences of polycyclic aromatic hydrocarbons, a toxic component of air pollution from coal plants, and that they also led to a lower level of brain-derived neurotrophic factor, a protein involved in neuronal growth.

"An individual's telomere length at birth is known to influence their risk for disease decades later during adulthood," co-author said in a statement. However, "Further follow-up is needed to assess the role telomere length plays in health outcomes in the context of early life exposure to air pollution."

Out of the 255 children tested at birth in the study (half born before, and half after the shutdown), 210 were tested again at age 2 to check if the telomeres length was associated with neurodevelopment issues. They did not find any link, though this doesn’t exclude telomere length-associated development issues at a later age.

"The new study adds to the evidence that closing this coal-burning power plant was beneficial to the health and future well-being of newborns there," said lead author. "Moreover, we know that lowering exposure to air pollution anywhere will be beneficial to children's health and long-term potential."

The role of coal power plants in producing toxic fumes is undeniable and it is important to tackle this environmental danger to safeguard our health and the health of future generations.

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How microbial bacteria could help detect signs of premature births

It came to light with a recent study that changes to the communities of microbes living in the reproductive tract of pregnant women could help to spot those at risk of giving birth prematurely.

The study found that the subtle changes to the bacteria present in the vagina were strongly associated with the woman's waters breaking early which led preterm birth of the baby, i.e. before 37 weeks. According to the researchers, it could have an impact on the health of mother and baby, including increasing the risk of sepsis for newborns.

In the published study, the team of researchers also highlighted that while the standard antibiotic treatment given to women whose waters break early, a precursor of labour, can help to reduce infection, for a small subset of women it may actually be detrimental.

They explained that for a small proportion of women the treatment, administered as a protective measure in hospital, can disrupt the balance of the mother's microbes by eradicating the 'good' bacteria and allowing more harmful bacteria to take their place in the vagina - with potentially devastating consequences for the baby.

The team suggested alternative treatments should be used for these women to mitigate their risk. They pointed out that in case of preterm birth, rupture of amniotic sac leaves baby more susceptible to infections as compared to normal birthing circumstances.

The team looked at the impact of premature rupturing of the membrane and antibiotic treatment on the vaginal microbia.

They took swabs from the vaginas of pregnant women at different points during their pregnancy and analysed them to reveal the types of bacteria present, their proportions, and any changes. Samples were collected from a prospective group of 250 pregnant women with and without risk factors for giving birth prematurely - such as having a history of preterm birth or miscarriage - of which 27 did, in fact, have a premature birth.

They also collected samples from a second, smaller group of 87 women who presented to the hospital with premature membrane rupture.
 
Previous research had shown that over the course of pregnancy the bacteria that colonize the vagina became less diverse and were dominated chiefly by Lactobacillus species - the same type of bacteria found elsewhere in the body including the gut and mouth.

Thorough analysis revealed that premature membrane rupture was associated with a shift in the microbia, with a drop in Lactobacillus and an increase in other types of bacteria, including potentially harmful bugs such as Staphylococcus and Streptococcus.

The team also analyzed samples from the small group of women with premature rupture before and after the preventative antibiotic treatment - oral erythromycin, four times a day for 10 days. Swabs were taken before treatment and then at 48 hours, one week and two weeks.

The study also revealed associations between specific vaginal bacteria and newborns who developed sepsis following delivery. While the mothers of healthy babies were dominated by Lactobacillus, samples from the mothers of newborns with sepsis revealed a greater diversity of bacteria, including the presence of Streptococcus and E. coli.

The group added that further studies are needed to assess current clinical guidelines for women with premature rupture and that developing alternative ways to treat women, such as using more selective antibiotics, could potentially improve outcomes for women and their babies.

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