This section of the APPPAH Newsletter is intended to draw attention to items in the news that are pertinent to prenatal and perinatal psychology. APPPAH does not necessarily agree with, or vouch for, the scientific worthiness of any of the news items mentioned here. We mean merely to take note of what is going on, so that you may.
U.S. MATERNAL MORTALITY RATE SOARS, REPORTS DAILYBEAST.COM
"Over the past decade, the U.S. maternal mortality rate has nearly doubled, with about 500 women dying of pregnancy-related complications each year. That's a tiny percentage of the 4 million American women who give birth annually. But what's shocking is that among industrialized countries, the U.S. ranks an abysmal 41st on the World Health Organization's list of maternal death rates, behind South Korea and Bosnia—yet we spend more money on maternity care than any other nation."
Read the rest of this uber- mainstream story, entitled "Why Are So Many Moms Dying?", including seven proposed reasons for the alarming rise, at http://www.thedailybeast.com/blogs-and-stories/2010-03-24/why-are-so-man... dying/.
NAVAJO COMMUNITY BOASTS IMPRESSIVE BIRTHING STATISTICS
During the same week in March that the NIH held a conference about the country's dismal VBAC rates, which have plummeted since 1996, the New York Times ran a story about the relatively high rate of successful VBACs in Tuba City, Arizona. The Tuba City Regional Health Care Corporation's hospital, run by the Navajo Nation and financed partly by the Indian Health Service, prides itself on having a higher than average rate of vaginal births among women with a prior Cesarean, and a lower Cesarean rate over all (13.5 percent compared with the current 31.8 percent US average—a growing rate fed in part by repeat Cesareans in a non-VBAC culture). And this despite the fact that more Navajo women have high blood pressure or diabetes, both risk factors for Cesarean section. "As Washington debates health care, this small hospital in a dusty desert town on an Indian reservation, showing its age and struggling to make ends meet, somehow manages to outperform richer, more prestigious institutions when it comes to keeping Cesarean rates down, which saves money and is better for many mothers and infants." Read more at http://www.nytimes.com/2010/03/07/health/07birth.html?pagewanted=1.
STUDY: ACUPUNCTURE AND DEPRESSION DURING PREGNANCY
A study published in the March edition of Obstetrics and Gynecology examines the efficacy of acupuncture for treatment of depression during pregnancy. A group of 150 pregnant women who were diagnosed with major depressive disorder were randomized to receive either acupuncture specifically for depression or one of two active controls (control acupuncture or massage), administered in a double-blind format. Women who received acupuncture specific for depression experienced a greater rate of decrease in the severity of their symptoms compared with the combined controls. The study authors conclude that acupuncture could be a viable treatment option for depression during pregnancy. To review the study online, go to: http://journals.lww.com/greenjournal/Fulltext/2010/03000/Acupuncture_for... ncy__A.7.aspx [Courtesy Judy Meehan, National Healthy Mothers, Healthy Babies Coalition]
PRENATAL USE OF ANTIDEPRESSANTS AND DEVELOPMENTAL DELAY
Exposure to antidepressants in the womb was associated with slightly delayed developmental milestones in the first 19 months of life, particularly for boys, researchers found. At age 6 months, babies who were exposed to antidepressants in utero were twice as likely to be unable to sit without support as those whose mothers had untreated depression during pregnancy, according to a Danish study reported in the March issue of Pediatrics. And at 19 months, although gross motor function was similar in the two groups, exposed children were twice as likely to be unable to occupy themselves for longer than 15 minutes, a measure of attention, the researchers reported. However, most of the milestones that were evaluated were reached in similar amounts of time, and the mean times to sitting and walking without support were within the normal developmental range for both groups. "The potential delay in development thus might have limited, if any, clinical significance for the children but may suggest that human fetal brain development is susceptible to antidepressant exposure," the researchers wrote. Antidepressants are widely used during pregnancy, even though potential effects on the developing fetus are unclear. In rodent studies, exposure to selective serotonin reuptake inhibitors and tricyclic antidepressants in early life cause changes that persist into adulthood. However, results from human studies have yielded conflicting results. [Reported Feb 2010 in MedPage Today; published in Pediatrics, Pedersen L, et al "Fetal exposure to antidepressants and normal milestone development at 6 and 19 months of age" 2010; DOI: 10.1542/peds.2008-3655.]
GUM DISEASE LINK TO PREMATURE DELIVERY
Successful treatment for gum disease cuts the risk of pregnant women giving birth early, finds researchers at the University of Pennsylvania, whose preliminary data showed those whose gum disease was not treated successfully were three times more likely to give birth before 35 weeks. The study of 160 women was presented to the annual conference of the American Association for Dental Research. Doctors have previously established that severe gum infections cause an increase in the production of prostaglandin and tumor necrosis factor, chemicals that induce labor. The study enrolled women who were between six and 20 weeks' pregnant, all of whom had gum disease. All participants were given treatment, which was successful in only one third of the cases. The researchers found a "strong and significant association" between successful treatment and full-term births. Iain Chapple, from Birmingham Dental School in the UK, said this was a "controversial area," and that while some previous studies have shown an association between gum disease and early births, others had shown no association. He said the results "could reflect behavioral differences in the successfully treated group versus the unsuccessfully treated group," such as "poorer diets, smoking status, alcohol intake and many other issues." [Reported March 2010 by BBC NEWS: http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/8552317.stm]