Archive for the ‘Planning for Baby’ Category

Antidepressant use and what it means for pregnant women

Tuesday, February 2nd, 2016

Doctor with womanMore than 15% of reproductive-aged women have filled a prescription for an antidepressant medication during the years 2008-2013 according to a new analysis released by the Centers for Disease Control and Prevention (CDC).

An antidepressant is a medication used to treat depression. Some commonly used antidepressants are sertraline (Zoloft), bupropion (Wellbutrin, Zyban), and citalopram (Celexa).

Why is this important?

There is conflicting evidence about the potential link between some antidepressants and certain birth defects.  Antidepressant medication use during pregnancy has been increasing in the U.S. Given that 50% of all pregnancies are unplanned, antidepressant use may  occur during the first weeks of pregnancy, a critical time for fetal development.

Further research on antidepressant safety during pregnancy is needed so that health care providers can advise women about the potential risks and benefits of using certain antidepressants before, during and between pregnancies.

What is being done?

The CDC’s initiative, Treating for Two: Safer Medication Use in Pregnancy, provides women and their health care providers with reliable and accessible information on common medication used during pregnancy. The CDC aims to expand and accelerate research on prescription antidepressant use during pregnancy so that women have up-to-date information and providers can make informed treatment decisions and prescribe the safest medications.

What can you do?

If you are thinking about pregnancy or are  pregnant, speak with your prenatal care provider about any medications you are taking.

If you’re taking an antidepressant and find out you’re pregnant, don’t stop taking the medicine without talking to your provider first. Not taking your medicine may be harmful to your baby, and it may make your depression come back.

Bottom line

Talk with all of your providers about the benefits and risks of taking an antidepressant during pregnancy and decide together on your treatment plan.

Anencephaly: causes, risks & what you can do

Monday, January 25th, 2016

About 1,206 pregnancies are affected by anencephaly each year in the U.S.

Anencephaly is a serious birth defect in which a baby is born without parts of the brain, skull and scalp. As a baby’s neural tube develops and closes, it helps form the baby’s brain and skull, spinal cord, and back bones. Anencephaly is a type of neural tube defect (NTD) that happens if the upper part of the neural tube does not close all the way. A baby with anencephaly will be missing large parts of the brain that are necessary for thinking, hearing, vision, emotion and coordinating movement. Other parts of the brain are often not covered by bone or skin.

Babies born with anencephaly have reflexes such as breathing and response to touch and sound, however because of the severity of the condition, almost all babies with anencephaly die before birth or within a few hours or days after birth.

What causes anencephaly?

In most cases, the cause is unknown. Some cases are caused by a change in the baby’s genes or chromosomes. Anencephaly may also be caused by a combination of genes and other environmental factors. Scientists are continuing to study anencephaly in order to discover the causes.

What are the risk factors?

  • Low intake of folic acid before getting pregnant and in early pregnancy increases the risk of having a pregnancy affected by a NTD including anencephaly.
  • Babies born to Hispanic mothers are at an increased risk for anencephaly; reasons for the increased risk are not well understood.

How is anencephaly diagnosed?

  • During pregnancy: a woman can have screening tests done during her prenatal visits. Anencephaly would result in an abnormal result on a blood or serum screening test. Anencephaly might be seen during an ultrasound.
  • After a baby is born: anencephaly is immediately seen at birth.

Is there anything you can do to lower your risk?

Yes.

  • Take a multivitamin with at least 400 micrograms of folic acid every day before and early in pregnancy. Make sure to take your multivitamin even if you are not thinking about becoming pregnant any time soon. Since the U.S. started requiring that folic acid be added to certain foods, there has been a 28% reduction in cases of babies born with NTDs.
  • If you are pregnant, make sure you go to all of your prenatal visits and eat a well-balanced diet
  • Avoid alcohol and smoking and talk to your provider about any medications or drugs you are taking.

Have questions? Email us at AskUs@marchofdimes.org.

 

What you need to know about birth defects

Monday, January 18th, 2016

snugglingEvery 4 ½ minutes in the US, a baby is born with a birth defect. That means that nearly 120,000 (or 1 in every 33) babies are affected by birth defects each year. They are a leading cause of death in the first year of life, causing one in every five infant deaths and they lead to $2.6 billion per year in hospital costs alone in the United States.

What are birth defects?

Birth defects are health conditions that are present at birth. They change the shape or function of one or more parts of the body and can affect any part of the body (such as the heart, brain, foot, etc). They may affect how the body looks, works, or both.

There are thousands of different birth defects and they can be very mild or very severe. Some do not require any treatment, while others may require surgery or lifelong medical interventions.

What causes birth defects?

We know what causes certain birth defects. For instance, drinking alcohol while you are pregnant can cause your baby to be born with  physical birth defects and mental impairment. And genetic conditions, such as cystic fibrosis or sickle cell disease, are the result of inheriting a mutation (change) in a single gene. However, we do not know what causes the majority of birth defects. In most cases, it is a number of complex factors. The interaction of multiple genes, personal behaviors, and our environment all may all play a role.

Can we prevent birth defects?

Most birth defects cannot be prevented. But there are some things that a woman can do before and during pregnancy to increase her chance of having a healthy baby:

  • See your healthcare provider before pregnancy and start prenatal care as soon as you think you’re pregnant.
  • Get 400 micrograms (mcg) of folic acid every day. Folic acid reduces the chance of having a baby with a neural tube defect.
  • Avoid alcohol, cigarettes, and “street” drugs.
  • Talk to your provider about any medications you are taking, including prescription and over-the-counter medications and any dietary or herbal supplements. Talk to your provider before you start or stop taking any type of medications.
  • Prevent infections during pregnancy. Wash your hands and make sure your vaccinations are up to date.
  • Make sure chronic medical conditions are under control, before pregnancy. Some conditions, like diabetes and obesity, may increase the risk for birth defects.
  • Learn about your family health history.

Have questions? Email us at AskUs@marchofdimes.org.

Folic acid fortification saves millions of dollars and reduces neural tube defects

Friday, January 15th, 2016

grainSince the U.S. started requiring that folic acid be added to certain foods (known as fortification), there has been a 28% reduction in cases of babies born with neural tube defects (NTDs). In addition, a recent study has found that fortification also saves hundreds of millions of dollars each year in medical and associated costs.

In 1998, to help women of child-bearing age get more folic acid, the US Food and Drug Administration mandated that grains, such as bread, pasta, and breakfast cereal be fortified with folic acid. Getting the right amount of folic acid before pregnancy helps to prevent birth defects of the brain and spinal cord, called neural tube defects (NTDs). Neural tube defects include anencephaly and spina bifida.

A study published this week, estimates how much money has been saved by fortifying grain products with folic acid. The study suggests that each year, folic acid fortification saves about $603 million dollars more than the cost of fortification. The estimated lifetime cost for medical care, special education, and caregiver time for a child born with spina bifida is approximately $791,900. Since fortification prevents about 767 cases of spina bifida each year, the annual cost savings are substantial. The authors of the study conclude that “Fortification with folic acid is effective in preventing NTDs and saves hundreds of millions of dollars each year.”

The March of Dimes supports fortifying corn masa flour with folic acid. By targeting food made with corn masa for folic acid fortification, it would be possible to lower the rate of NTDs among the Hispanic population as well.

Keep in mind that even if you eat a well-balanced diet that includes fortified foods, fruits and vegetables, it can still be hard to get enough folic acid. So make sure you take a multivitamin with 400 micrograms of folic acid every day.

Have questions? Email us at AskUs@marchofdimes.org.

Three common folic acid myths

Friday, January 8th, 2016

pills-moon vitaminWe receive a lot of questions about folic acid. Here are three of the most common misconceptions people seem to have.

Myth #1: Folic acid reduces the risk for ALL birth defects.

TRUTH: Folic acid reduces the risk of certain birth defects.

Folic acid reduces the risk for a very specific type of birth defect called a neural tube defect (NTD). The neural tube is the part of a developing baby that becomes the brain and spinal cord. A NTD can happen when the neural tube doesn’t close completely. This results in birth defects such as anencephaly and spina bifida. If all women take 400 micrograms (mcg) of folic acid every day before getting pregnant and during early pregnancy, it may help reduce the number of pregnancies affected by NTDs by up to 70 percent.

Myth #2: Folic acid will help me to get pregnant.

TRUTH: Folic acid is important to take before pregnancy, but it will not help you to become pregnant.

Folic acid does not help a woman to conceive. However, it is recommended that ALL women take folic acid, even if they are not trying to get pregnant. This is because folic acid can help prevent neural tube defects only if it is taken BEFORE pregnancy and during the first few weeks of pregnancy, often before a woman even knows she is pregnant.

The neural tube is one of the first structures that is formed in a developing embryo, therefore you need to make sure you are taking folic acid BEFORE you are pregnant. And because nearly half of all pregnancies in the United States are unplanned, it’s important that all women take folic acid every day, even if they are not planning to get pregnant. So take a multivitamin that has 400 micrograms of folic acid in it every day. Most multivitamins have this amount, but check the label to be sure.

Myth #3: I eat a healthy diet, so I can get enough folic acid from food.

TRUTH: It may be possible, but most women will not get enough from their diet.

Folic acid is naturally available in many fruits and vegetables, including:

  • Beans, like lentils, pinto beans and black beans
  • Leafy green vegetables, like spinach and Romaine lettuce
  • Asparagus
  • Broccoli
  • Peanuts (But don’t eat them if you have a peanut allergy)
  • Citrus fruits, like oranges and grapefruit

Many flours, breads, cereals, and pasta are fortified with folic acid, as well. This means they have folic acid added to them. You can look for the words “fortified” or “enriched” on the package to know if the product has folic acid in it.

However, it’s hard to get all the folic acid you need from food. And according to the Institute of Medicine (IOM), your body only absorbs about 50 % of that. So even if you eat foods that have folic acid in them, make sure you take your multivitamin each day too.

Some women, like those who’ve had a pregnancy affected by NTDs or women with sickle cell disease, may need more folic acid. Talk to your provider to make sure you get the right amount.

Have questions? Email us at AskUs@marchofdimes.org.

Folic acid – why is it important?

Monday, January 4th, 2016

folic acid vitaminFolic acid is a B vitamin that promotes cell growth and helps prevent certain birth defects. It is Folic Acid Awareness Week – a great time to become familiar with how this vitamin can help you and your baby.

Your body needs to make new cells every day for blood, skin, hair and nails. Folic acid also plays an important role in helping red blood cells carry oxygen from your lungs to all parts of your body.

How can folic acid help your baby?

Folic acid helps prevent birth defects of the brain and spine, called neural tube defects, if taken before pregnancy and during the first few weeks of pregnancy.  So it is helpful to get in the habit of taking a multi-vitamin with at least 400 micrograms of folic acid every day, before you become pregnant.

Even if you are not planning to become pregnant, your body needs folic acid for normal growth and development.

What if you’re already pregnant?

Most pregnant women need to take a multi-vitamin with 600 micrograms of folic acid. Talk with your prenatal provider to see if this is the right dosage for you. A pregnant women needs extra folic acid throughout pregnancy to help produce the additional blood cells your body needs during pregnancy. Folic acid also supports the rapid growth of the placenta and fetus.

Can you get folic acid anywhere else?

Yes. Many foods have folic acid added to them. On packages of flour, breads, cereals and pastas, look for the words “fortified” or “enriched” – it means the product has folic acid added to it.

You can also get folic acid in its natural form – folate – in some fruits and vegetables. Folate can be found in spinach, black beans, peanuts and orange juice. Learn about the difference between folic acid and folate here.

Bottom line:

Even if you eat a well-balanced diet that includes fortified foods, fruits and veggies, it can still be hard to get enough folic acid every day.  By taking a multi-vitamin with at least 400 micrograms of folic acid every day, you will be sure to get the amount you need.

 

Antidepressant use and the risk of ASD

Friday, December 18th, 2015

medication bottlesA new study suggests that the use of antidepressants during pregnancy, specifically in the second and third trimesters, may increase the risk of autism spectrum disorder (ASD) in children.

While these findings help to add to our understanding of autism, it is important to recognize that this study does not prove that antidepressant use causes autism. It is difficult to determine whether the increased risk of ASD is the result of antidepressants or the result of the underlying depression.

Researchers looked at data from more than 145,000 births between 1998-2009. They found that when mothers took antidepressants during the second and third trimesters, the chance that the child would develop ASD was higher when compared to children whose mothers did not take antidepressants. Keep in mind that the overall risk of having a child with autism is 1%. This study suggests that the risk increases to 1.87% if a woman is taking certain antidepressants.

The increase was seen with a specific type of antidepressants called selective serotonin reuptake inhibitors (SSRIs). SSRIs are the most commonly prescribed antidepressant medicines and include medications like citalopram (Celexa®), escitalopram (Lexapro®), fluoxetine (Prozac®), paroxetine (Paxil®) and sertraline (Zoloft®).

There are a number of causes of ASD but we don’t know all of them. More research is needed. However, there are some factors that we know increase the chance of ASD:

  • Having pregnancy complications. Some research shows that there may be a link between ASD and pregnancy complications that lead to low birthweight, premature birth or cesarean birth.
  • Taking certain prescription medicines, like valproic acid or thalidomide, during pregnancy. Taking these medicines during pregnancy has been linked with a higher risk of having a child with ASD.
  • Having an older parent. Babies born to older parents are more likely to have ASD.
  • Having genes linked to ASD. Researchers are studying a number of genes that may be linked to ASD. Children who have a brother or sister with ASD are more likely to have ASD themselves.
  • Having a genetic or chromosomal condition. ASD happens more often in children who also have certain genetic or chromosomal conditions, like fragile X syndrome or tuberous sclerosis.

Important:  If you are pregnant or thinking about getting pregnant and are taking antidepressants, you should not stop taking them until you talk to your health care provider. Together you can look at the possible risks of these drugs on your baby as well as the risk of having your depression come back if you stop taking your medicine. Learn as much as you can about the medicines so you can make the best choice for you and your baby.

Have questions? Email us at AskUs@marchofdimes.org.

Knowing your family health history may help your baby

Wednesday, November 18th, 2015

Family at Thanksgiving dinnerRecently I had an appointment with a new healthcare provider and had to complete a health history form at my first visit. It was 3 pages long and took me about 20 minutes to do while in the waiting room. As I was sitting there, I realized that I didn’t know the answers to some of the questions, especially about my relatives.

Was this really that important?

In one word? Yes.

A family health history (FHH) form is a record of health conditions and treatments that you, your sisters, brothers, parents, aunts, uncles, grandparents and great grandparents have had. It can help you figure out the medical problems that run in your family. Knowing your FHH may just save your life. It may also have a direct effect on your baby’s health.

How can a FHH form help your baby?

The FHH form will help your provider see if any of the conditions or diseases that run in your family will affect your baby. For example, premature birth can run in families. And, certain conditions such as diabetes or high blood pressure put you at a higher risk to have a premature baby.

If you and your partner complete a FHH form and share it with your prenatal provider, you may learn about the health of your baby before she is born. The earlier in your pregnancy that your provider is aware of health conditions, the sooner your provider can decide on treatments for you.

It would be even better if you could complete and share this information with your provider before pregnancy, at a preconception checkup. This way, your provider can help you become as healthy as possible before pregnancy.

Use our FHH form

Here is a form that you can print out and complete.  Print one copy for yourself and one for your partner/spouse. We suggest you take it with you to family gatherings (Thanksgiving anyone?) and ask your relatives to help you fill in the blanks. You may very well find out information about diseases and conditions that run in your family and put you at risk. Early detection is often key in successfully managing a disease.

Here are tips on how to gather information from relatives.

Knowing your risk for certain conditions and that your provider is on top of treatment options, should put your mind at rest. And, knowing you are doing your best to take care of your baby’s health should make you feel even better.

So, when you sit down to apple pie, start a conversation, and fill in your FHH form. The information you share with your family may make a positive difference in everyone’s lives.

Have questions? Text or email us at AskUs@marchofdimes.org.

Pregnancy after a preemie

Friday, November 13th, 2015

You may know that having had a premature baby increases your risk to give birth early in your next pregnancy. No one knows for sure what causes a woman to have a premature baby. However, it is important to understand what factors may make you more likely to give birth early and understand how you may be able to reduce your risk.

When you are ready to think about having another baby after you have had a preemie, here are some things to consider:

When to get pregnant again

Getting pregnant too soon after having a baby increases your chance of giving birth early. If possible, wait at least 18 months between giving birth and getting pregnant again. This gives your body time to recover.

Manage preexisting health conditions

Having diabetes or high blood pressure puts you at a higher risk to have a premature baby. Talk to your health care provider about how to best manage these conditions before you get pregnant again. And weighing too much or too little can also be a risk factor. Try to get to a healthy weight before you get pregnant again.

Prevent infections

Having an infection during pregnancy may increase your chance of giving birth early. Always wash your hands thoroughly and practice good hygiene. This won’t prevent all infections, but it can help. Also, get tested for STDs before you become pregnant.

Treatments for preterm labor

Some women may be able to receive progesterone treatment or cerclage in their next pregnancy to reduce their chances of giving birth early again. Talk to your provider to see if these treatments may be right for you.

In the video below, Dr. Siobhan Dolan discusses who may be a good candidate for progesterone treatment:

If you are planning on getting pregnant again, make sure you talk to your health care provider about what you may be able to do to reduce your risk of premature birth. Together, the two of you can make a plan so that hopefully your next pregnancy can be closer to 40 weeks. You can also go to our online community Share Your Story to talk to other women who gave birth early and are planning a pregnancy or are pregnant again.

Have questions? Text or email us at AskUs@marchofdimes.org.

Thinking about becoming pregnant? Are you worried about your diabetes?

Monday, November 9th, 2015

Diabetes and pregnancyDiabetes can cause problems during pregnancy, such as premature birth, birth defects and miscarriage. But don’t panic; with some planning ahead, you can become as healthy as possible before you become pregnant.

When you eat, your body breaks down sugar and starches from food into glucose to use for energy. Your pancreas (an organ behind your stomach) makes a hormone called insulin that helps your body keep the right amount of glucose in your blood.  When you have diabetes, your body doesn’t make enough insulin or can’t use insulin well, so you end up with too much sugar in your blood.

Too much sugar can cause serious health problems, like heart disease, kidney failure and blindness. High blood sugar can be harmful to your baby during the first few weeks of pregnancy when his brain, heart, kidneys and lungs begin to form. It’s really important to get treatment for diabetes to help prevent problems like these.

If you are thinking about becoming pregnant and have diabetes, here are a few tips:

  • Manage your diabetes to get your blood glucose levels in to your target range. Try to get it under control 3-6 months before you start trying to become pregnant.
  • Take a multivitamin that contains at least 400 micrograms of folic acid every day.
  • Talk to your provider about any medications you are taking to make sure that they are OK to continue taking when you do get pregnant. He or she may want to change some medications now, before you get pregnant.
  • Eat healthy foods and keep moving.
  • Get support and guidance. Talk with your provider, a diabetes educator or a dietician about how to manage your diabetes.

Not sure if you are at increased risk of developing diabetes? Read our post to find out.

Remember: If you are thinking about becoming pregnant, now is the time to talk to your doctor about getting as healthy as you can before you conceive. Take small steps now toward a healthy pregnancy and a healthy baby.

Have questions? Text or email us at AskUs@marchofdimes.org.