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.
MEANS TO REDUCE VIOLENCE IN SOCIETY MAY BEGIN IN UTEROResearch out of the University of Pennsylvania School of Nursing and reported in the journal Aggression and Violent Behavior suggests that attention to health factors during prenatal development could prevent violence in later life. Regarding recent research demonstrating a biological basis of crime, this article's author, Penn nursing assistant professor Jianghong Liu, explains, "'Biological' does not mean only genetic factors, but also health factors, such as nutritional deficiency and lead exposure, which influence biological processes." Dr. Liu's study emphasizes the prenatal, perinatal, and postnatal periods, which are critical times for both a child's neurodevelopment and for environmental modifications. Among the early health risk factors Dr. Liu identifies are prenatal and postnatal nutrition, lead exposure, tobacco use during pregnancy, maternal depression and stress, birth complications, traumatic brain injury, and child abuse. Dr. Liu's research indicates that identifying early health risk factors is an important first step in preventing childhood aggression and teenage delinquency, which have been shown to lead to violence in adulthood.Says Dr. Liu, "As a society we should invest in better health care for early life—as early as a growing fetus—in order to minimize their health risk factors for violence." [Sept. 2011, ScienceDaily Science News; it bears noting that Dr. Lui published in our own JOPPPAH's Issue 18(4), in 2004—an article entitled "Prenatal and Perinatal Complications as Predispositions to Externalizing Behavior."]
NEUROPSYCHOLOGICAL SCARS FROM DOMESTIC VIOLENCE ALSO BEGIN IN UTEROA German research team asked twenty-five mothers whether they had suffered extreme stress caused by abuse from boyfriends or husbands while they were pregnant, and then rated their emotional level. They then monitored the behavior of a particular gene in their children, aged nine to nineteen. The gene—for the glucocorticoid receptor—is involved in the brain's response to stress. The researchers found that the gene was far less active in children whose mothers were victims of domestic abuse when they were pregnant. Study author Helen Gunter said: "It changes the way that people respond to stress and they may have a reduced ability to respond to stress." Carmine Pariante, of the Institute of Psychiatry at Kings College London, said: "This paper confirms that the early foundation years start at minus nine months. We have known for some time that maternal stress and depression during pregnancy induce a unique response in the offspring, by affecting children's behavior well into adolescence and children's ability to modulate their own stress response. This study shows that the glucocorticoid receptor is subject to a key biological change that contributes to the organization of this offspring response. This confirms that pregnancy is uniquely sensitive to a challenging maternal psychosocial environment–much more than, for example, after the baby is born. As we and others have been advocating, addressing maternal stress and depression in pregnancy is a clinically and socially important strategy." [July 2011, Daily Mail Online, Health]
PITOCIN A RISK FACTOR FOR ADHDExamining the medical records from 172 women from diverse regions across the country who gave birth between three and twenty-five years ago has led researchers from the Department of Psychiatry at Colorado State University to conclude that Pitocin is a significant risk factor for developing later ADHD. The study, reported in the Journal of Attention Disorders, found that children whose mothers were exposed to pitocin during labor had nearly double the risk of ADHD as compared to the children with no exposure to Pitocin—67.1% versus 35.6%, respectively. [May 2011, Pregnancy & Childbirth @ Suite101]
PITOCIN SHORTENS LABOR "BUT DOES LITTLE ELSE"The New York Times reports that The Cochrane Library published a report online suggesting that Pitocin may not be accomplishing its purpose. Researchers at England's Nottingham University Hospitals pooled data from eight randomized studies involving 1,338 low-risk women in the first stage of labor. Compared with no treatment, the use of Pitocin shortened labor by about two hours, but it did not achieve its putative goal—to reduce the number of Caesarean sections or increase the number of unassisted deliveries. Whether it was given early or late in labor made no difference. It appeared to cause no harm to babies or mothers [Ed. note: see above item], but the sample was too small know if it has any effect on the death rates of newborns. "We need better ways of managing slow progress in labor," said Dr. George J. Bugg, the lead author and an obstetrician at Nottingham University Hospitals. "It's a real problem, and the method we've relied on for so many years doesn't actually work." [July 2011, NYT Research]
ASTHMA RISK FACTOR: STRESS, DEPRESSION, AND ANXIETY IN PREGNANCYA study reported in the Annals of Allergy, Asthma & Immunology supports mounting research finding that the prenatal period is a time when children are particularly susceptible to asthma-related risks. The study of 279 inner-city African-American and Hispanic women was conducted before and during pregnancy, and after birth. "Approximately 70 percent of mothers who said they experienced high levels of anxiety or depression while they were pregnant reported their child had wheezed before age 5," said Marilyn Reyes, lead author. "Understanding how maternal depression affects a child's respiratory health is important in developing effective interventions." [Follow research conducted by Antonio Madrid, PhD funded by APPPAH, Mental Insight, Huizenga, and Van Strum and published in the APPPAH journal – http://birthpsychology.com/person/antonio-madrid]
ASTHMA PROTECTIVE FACTOR: EXCLUSIVE BREASTFEEDINGA new study published online in the European Respiratory Journal found that feeding a baby on only breast milk, for up to 6 months after birth, can reduce their risk of developing asthma-related symptoms in early childhood. Examining the impact of the duration of breastfeeding and the introduction of alternative liquids or solids in addition to breast milk, researchers from the Generation R Study, Erasmus Medical Center in The Netherlands, used questionnaires to gather data on over 5,000 children. Children who had never been breastfed had an increased risk of wheezing, shortness of breath, dry cough and persistent phlegm during their first 4 years, compared to children who were breastfed for more than 6 months. Children who were fed other milk or solids during their first 4 months in addition to breast milk had an increased risk of wheezing, shortness of breath, dry cough and persistent phlegm during the first 4 years, compared to children who were exclusively breastfed for their first 4 months. [July 2011, Stone Hearth News]
C-SECTION NOT BEST OPTION FOR BREECH BIRTHPhysicians should no longer automatically opt to perform a cesarean section in the case of a breech birth, according to new guidelines by the Society of Obstetricians and Gynecologists of Canada—in response to new evidence that shows many women are safely able to vaginally deliver babies who enter the birth canal with the buttocks or feet first. Since around 2000, because some studies suggested that breech births were associated with an increased rate of complication when performed vaginally, many medical schools stopped training their physicians in breech vaginal delivery. The problem, according to SOGC executive vice-president André Lalonde, is that now—when reassessment of the research has demonstrated its relative safety—there is a serious shortage of doctors to teach and attend these deliveries. SOGC will launch a nationwide training program to ensure that doctors will be adequately prepared to offer vaginal breech births. [June 2009, Globe and Mail; Ed. note: Despite the fact that this story is over two years old, it continues to seem like unknown news that is of great importance to report, which we somehow didn't back then.]
NEW YORK TIMES AND BBC HIGHLIGHT MOVE TOWARD NON-HOSPITAL BIRTH"A small but growing number of American women are making the choice to deliver at home": so reports the world paragon of news, the New York Times. From 2004 to 2008, the number of home births in the United States inched upward to 28,357—still less than 1 percent of the 4.2 million births each year, but up by 20% nonetheless. The article mentioned last year's controversial AJOG paper that featured research finding that babies born at home are three times as likely as those born in a hospital to die before they are four weeks old—and the ensuring firestorm among experts. It said that one of the chief criticisms of the paper, which was a meta-analysis of previously published work, was that it evidently lumped together the outcomes of planned home births and much more dangerous unplanned home births, a fact pointed out by Eileen K. Hutton, director of the midwifery education program at McMaster University in Hamilton, Ontario. Dr. Hutton's own studies have compared the outcomes of planned hospital births to low-risk women and planned home births to low-risk women who were attended by the same midwives—and that research found no differences in babies' survival. The NYT article also featured basic information for the mainstream reader regarding homebirth, which unfortunately included the following: "Both ACOG and the American College of Nurse Midwives agree that women who want to try to have a vaginal delivery after having had a first baby by Caesarean section (known as a VBAC) should be in the hospital." Meanwhile, the BBC reports the Royal College of Obstetricians and Gynaecologists' position that too many births take place in hospitals and that "more midwife-led units are needed for women with low-risk pregnancies." [Aug. 2011, NYT Health; July 2011, BBC News, Health]
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