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.
HOME BIRTH RISKS UNDER SCRUTINY IN CONTROVERSIAL NEW STUDY
An international study finds that women who plan home births recover more rapidly from childbirth, but run a greater risk of their child dying. Taking data from more than 500,000 births in North America and Europe, researchers publishing in the American Journal of Obstetrics and Gynecology found death rates for babies in planned home births were double that of those in planned hospital births.
When researchers controlled for babies with congenital abnormalities, the risk increased to threefold. When deaths occurred among the home birth group, they were overwhelmingly attributed to respiratory problems during birth and failed attempts at resuscitation. Mervi Jokinen of the Royal College of Midwives said the study was interesting, but questioned the validity of its findings for countries like the UK. "Comparison of the results is difficult because the study's authors are working with data collected differently in many countries. Here we have services delivered by midwives who are skilled and experienced at home births and resuscitating newborns." Dr. Michael Klein, an emeritus professor of family practice and pediatrics at the University of British Columbia, put a finer point on it, saying that the researchers' conclusions are "crap" that don't consider the facts. Klein said, "It's a politically motivated study that was motivated by the American College of Obstetrics and Gynecology who is unalterably opposed to home birth, and they probably were quite happy to publish this article because it fits with their political position." University of British Columbia epidemiologist Patricia Janssen said the American study mixes their work with research dating back to the 1970s, and surveys with as few as five recorded births. "The data and the methods taints the quality of the study," Janssen said, noting the review includes studies where the qualifications of the caregiver were not known. [Reported July 2010 by BBC News, http://news.bbc.co.uk/2/hi/health/10465473.stm; and CBC News, http://www.cbc.ca/canada/british- columbia/story/2010/07/02/home-births-safety.html.]
A NOVEL NEUROBIOLOGICAL MODEL FOR BABY BLUES AND PPD
Researchers at the Max Planck Institute for Human Cognitive and Brain Sciences in Germany have demonstrated that proportional to the 100- to 1000-fold drop in estrogen levels in the days following birth, levels of the enzyme monoamine oxidase A (MAO-A) increase dramatically throughout the female brain. The enzyme can be found in higher concentra- tions in glial cells and monoamine-releasing neurons, where it breaks down the neurotransmitters serotonin, dopamine, and norepinephrine. As well as being responsible for transmitting signals between nerve cells, these neurotransmitters also influence mood. If they are deficient, we initially feel sad, and later have a high risk of becoming depressed. Severe baby blues symptoms can be viewed as a prodromal stage for postpartum depression. From this perspective, researchers, publishing in Archives of General Psychiatry, suggest that preventing depressive symptoms in the immediate postpartum period may have powerful impact for prophylaxis of postpartum depression. "Attempts can be made to either lower elevated levels of MAO-A with selected antagonist drugs, or to increase the concentration of monoamine neurotrans- mitters that can elevate mood. Both have the goal of keeping levels of monoamine neurotransmitters in the brain balanced after birth. Given the need to develop treatments that are compatible with breastfeeding, the intake of dietary supplements of monoamine precursors in the early postpartum period would be a promising strategy to maintain a sufficient balance of monoamines during this time. This includes the administration of precursor supplements such as the amino acids tryptophan and tyrosine, which the body can convert into the neurotransmitters serotonin, norepinephrine, and dopamine, respectively." [Reported June 2010 by Stone Hearth Newsletter; read more at http://www.mpg.de/english/illustrationsDocumentation/documentation/pressReleases/2010/pressRelease20100616/]
C-SECTION BABIES SKIP "THE BACTERIAL SLIDE"
A new study shows that bacteria found on C-section babies just minutes after delivery is drastically different from the bacteria found on babies who are delivered vaginally. The findings pique interest in light of previous research suggesting that babies delivered via cesarean section may be more prone to health complications, such as asthma. But Stanford researcher Elizabeth Costello cautions against jumping to any conclusions. "Those theories relate to the hygiene hypothesis, which posits that the more we restrict our exposure to microbes, the less our immune system understands how to deal with them appropriately." Costello, one of the lead authors of the study, says her research simply shows a difference between the microbes babies are exposed to in the first moments of life, depending on the method by which they were delivered. "Whether or not those differences contribute later on is something that further studies will have to address," she says. [Reported June 2010 by NPR; listen to story and interview w/ Costello on All Things Considered at http://www.npr.org/templates/player/mediaPlayer.html?action=1&t=1&islist... or read at http://www.scpr.org/news/2010/06/27/study-c-section-babies-skip-the-bacterial-slide/.]