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. Just reporting...
BREAKING NEWS: THE 1ST NINE MONTHS MAY SHAPE THE REST OF LIFE!
Forgive the editorial facetiousness; for most general readers the cover story of the Oct. 4 issue of Time magazine it may indeed be a major revelation to learn that in addition to genes, childhood experiences and adult lifestyle choices determining what we're like, there's "another powerful source of influence you may not have considered: your life as a fetus. The nutrition you received in the womb; the pollutants, drugs and infections you were exposed to during gestation; your mother's health and state of mind while she was pregnant with you—all these factors shaped you as a baby and continue to affect you to this day."
Revolutionary stuff! "This is the provocative contention of a field known as fetal origins, whose pioneers assert that the nine months of gestation constitute the most consequential period of our lives, permanently influencing the wiring of the brain and the functioning of organs such as the heart, liver and pancreas. In the literature on the subject, which has exploded over the past 10 years, you can find references to the fetal origins of cancer, cardiovascular disease, allergies, asthma, hypertension, diabetes, obesity, mental illness. At the farthest edge of fetal-origins research, scientists are exploring the possibility that intrauterine conditions influence not only our physical health but also our intelligence, temperament, even our sanity." So from my perch out here on the farthest edge, this editor feels encouraged that the Times, they are a-changin'. [http://www.time.com/time/health/article/0,8599,2020815,00.html?xid=rss-fullhealthsci-yahoo]
CDC STUDY ON CONGENITAL HEART DEFECTS & NEONATAL MORTALITY
Last week the Centers for Disease Control and Prevention (CDC) published a new study on neonatal deaths due to congenital heart defects, which are associated with preterm delivery and are the largest contributor to neonatal death attributed to birth defects. Among the findings: 4.2% of all deaths in the first 27 days of life were due to a congenital heart defect. Such deaths were 30% lower among preterm infants born to black mothers, compared to preterm infants born to white mothers. However, among term infants, those born to black mothers had 20% higher neonatal mortality attributable to congenital heart defects, compared to those born to whites. Why the racial differences by gestational age? The study's authors say it's unclear, and they call for additional study that looks at prenatal diagnosis, prevalence at birth of congenital heart defects and reporting of causes of death. [Courtesy of Judy Meehan at the National Healthy Mothers, Healthy Babies Coalition]
MATERNAL PRENATAL ANXIETY AND STRESS PREDICT INFANT ILLNESSES
A study published in the August edition of Pediatrics examines the potential relationship between maternal prenatal anxiety and stress, and increased infant illnesses and antibiotic use during the first year of life. Maternal prenatal anxiety and stress has been linked to detrimental outcomes on the offspring's development in both animal and human studies. The programming effects of prenatal stress on the physical health of offspring have also been shown in animal models, whereas they are confined to birth complications in human studies. In this study, both self-report and cortisol physiology were used to measure maternal prenatal anxiety and stress in 174 mothers with normal pregnancies and term deliveries. Throughout the infant's first year of life, monthly maternal interviews were conducted to gather information on infant illnesses and the use of antibiotics. A marked increase in respiratory, skin, and general illnesses as well as an increased use of antibiotics was found in relation to prenatal anxiety and stress. The authors conclude that these initial findings warrant further examination.
SKIN-TO-SKIN "MIRACLE": PREEMIE PRONOUNCED DEAD IS REVIVED
Kate and David Ogg were grief-stricken when doctors declared him dead following his premature birth at 27 weeks. The tiny body of their son was given to them so they could see him and say their goodbyes. Kate Ogg instinctively unwrapped her baby, Jamie, and also took off her hospital gown, so she was skin-to-skin with what she thought was a lifeless body of her son, who had not responded to 20 minutes of resuscitation efforts by doctors. (His twin sister had survived and was in an incubator.) She and her husband talked to Jamie, trying to make the most out of "those last precious moments" with their dead son: "We told him what his name was and that he had a sister. We told him the things we wanted to do with him throughout his life." The "an extra minute or two" they were hoping to spend with their son extended to about two hours. During that time, they were startled when Jamie gasped for air and then began making movements. Although this continued, doctors dismissed it as "reflex actions." Kate put some breast milk (which we in APPPAH know was the health elixir colostrum) on her finger, and Jamie eagerly took it. Repeated entreaties to the doctor to come witness this revival were ignored, and the Oggs finally had to lie to the nurses: "Tell him that we've come to terms with the death, and to just explain it all to us," is what brought the physician to their bedside. Examining Jamie with his stethoscope, he just shook his head and kept repeating, "I don't believe it..." The story—which took place in Australia—has brought worldwide attention to the merits of "Kangaroo Care" and the efficacy of skin-to-skin contact for stabilizing at-risk newborns. One news account cites the Karolinska Institute finding that 90% of preemies regained normal body temperature by using the mother-as-incubator approach, compared with just 60% who did so in a traditional incubator.
[Ed. comment: As so often happens, dealing with the "special needs" case may lead us to overlook that all newborns should be considered to have this "special need" of skin-to-skin contact with their mothers—along with their scent, heartbeat—and heart field—and that ideally all parents would seek to make the most out of those "first precious moments" with their newborn—an unparalleled investment in his or her lifelong well-being. How interesting it would be to follow these twins, to note any significant developmental differences, particularly in the psycho-social realm, between Jamie and his sister who went directly to the incubator for her first hours. Also interesting to compare differing coverage of the story, and the details that are deemed relevant or not, such as at http://www.dailymail.co.uk/health/article-1306283/Miracle-premature-baby... and http://today.msnbc.msn.com/id/38988444.]
CANCER RISK IN YOUTH CONCEIVED BY IN VITRO FERTILIZATION
A study examining increased risk for cancer among children who were conceived by in vitro fertilization was published in the August edition of Pediatrics. The study followed 26,692 children born after IVF from 1982 to 2005, and compared the number of children who had cancer from this sample with children who were not conceived by IVF. Out of the 38 statistically expected cases of various cancers, 53 were identified in children who were born after IVF. The authors concluded a moderately increased risk for cancer in the children who were conceived by IVF. Other risk factors found to be associated with the development of cancer included preterm birth and neonatal asphyxia.