Posts Tagged ‘prenatal care’

U.S. study shows fewer babies are dying in their first year of life

Wednesday, March 22nd, 2017

The death of a baby before his or her first birthday is called infant mortality. A new report released by the CDC shows that the infant mortality rate in the U.S. dropped 15% from 2005 to 2014. In kangaroo-care-242005 the rate was 6.86 infant deaths per 1,000 live births. In 2014, the rate dropped to 5.82 deaths per 1,000 live births.

While the study did not look at the underlying causes of the decline, it did report valuable information:

  • Infant mortality rates declined in 33 states and the District of Columbia. The other 17 states saw no significant changes.
  • Declines were seen in some of the leading causes of infant death including birth defects (11% decline), preterm birth and low birthweight (8% decline), and maternal complications (7% decline).
  • The rate of sudden infant death syndrome (SIDS) declined by 29%.
  • Infant mortality rates declined for all races, except American Indian or Alaska Natives.
  • Infants born to non-Hispanic black women continue to have an infant mortality rate more than double that of non-Hispanic white women.

“On the surface, this seems like good news. But it is far from time to celebrate,” said Dr. Paul Jarris, chief medical officer for the March of Dimes. “What is concerning, though, is that the inequities between non-Hispanic blacks and American Indians and the Caucasian population have persisted.” Dr. Jarris adds, “This report highlights the need to strengthen programs that serve low income and at-risk communities, especially those with the highest infant mortality rates.”

The infant mortality rate is one of the indicators that is often used to measure the health and well-being of a nation, because factors affecting the health of entire populations can also impact the mortality rate of infants.

What can you do?

Having a healthy pregnancy may increase the chance of having a healthy baby. Here are some things you can do before and during pregnancy:

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

Infant mortality. These two words should never go together.

Wednesday, September 21st, 2016

emotional couple sittingInfancy should mark the beginning of life, not the end. Even though the rates of infant deaths are at an all-time low, far too many babies still die before their first birthday. For this reason, September is Infant Mortality Awareness Month – a time for us to share the sad fact that babies still die in infancy, and to help spread the word about how to fix this problem.

In 2013, in the United States, 23,446 infants died before reaching their first birthday, which is an infant mortality rate of 6.0 per 1,000 live births. Or, put another way, on an average day in the U.S., 64 babies die before reaching their first birthday.

What causes infant death? Can it be prevented?

“Preterm birth, or being born too early (before 37 weeks of pregnancy), is the biggest contributor to infant death,” according to the CDC. In 2013, about one third (36%) of infant deaths were due to preterm-related causes. Among non-Hispanic black infants, the rate of preterm-related death is three times higher than those of non-Hispanic white infants.

Other causes of infant mortality include low birth weight, birth defects, pregnancy complications for the mother, SIDS (sudden infant death syndrome), and unintentional injuries (accidents). Although the rate of infant deaths in the U.S. has declined by almost 12% since 2003, the death of any infant is still one too many.

Having a healthy pregnancy may increase the chance of having a healthy baby.

A woman can help reduce her risk of giving birth early by getting a preconception checkup, staying at a healthy weight, and avoiding alcohol and street drugs during pregnancy. Spacing pregnancies at least 18 months apart and getting early and regular prenatal care during pregnancy are also key parts of a healthy pregnancy.

It’s part of our mission

The March of Dimes is committed to preventing premature birth, birth defects and infant mortality. It is our hope that through continued research, we will have a positive impact on the lives of all babies so that fewer families will ever know the pain of losing a child.

If you or someone you know has lost a baby, we hope that our online community, Share Your Story, will be a place of comfort and support to you. There, you will find other parents who have walked in your shoes and can relate to you in ways that other people cannot. Log on to “talk” with other parents who will understand.

Even in the year 2016, “the U.S. has one of the highest rates of infant mortality in the industrialized world,” according to NICHQ, the National Institute for Children’s Health Quality.

The March of Dimes is working hard to make this fact history.

Have questions? Send them to our Health Education Specialists at AskUs@marchofdimes.org.

 

Your developing baby

Friday, March 18th, 2016

There are specific times during a baby’s development when a certain body part is especially vulnerable to damage from harmful substances and exposures. These substances can include alcohol, medications, and cigarette smoking. The chart below shows these critical periods. If something interferes or disrupts development during these times, the result may be a birth defect.

developing baby

*Image courtesy of NOFAS.

Birth defects

The dark blue segments on the picture above show when certain body parts are most at risk for major birth defects. Major birth defects cause significant medical problems and may require surgery or other treatment. Some examples of major birth defects include heart defects and spina bifida.

The light blue sections of the chart show periods when fetal development is susceptible to minor birth defects and functional defects. Minor birth defects do not cause significant problems and usually do not require medical intervention, such as treatment or surgery. Minor birth defects include things like the shape of the ears or certain facial features. Functional defects affect how a part of the body works. For example, hearing loss can be a functional defect.

Timing of exposures

According to MotherToBaby, “Harmful exposures during the first trimester have the greatest risk of causing major birth defects. This is because of the many, important developmental changes that take place during this time. The major structures of the body form in the first trimester. These include the spine, head, arms and legs.  The baby’s organs also begin to develop. Some examples of these organs are the heart, intestines and lungs.”

While exposures during the first trimester do pose the greatest risk of birth defects, exposures during the second and third trimester can cause problems with growth as well as minor birth defects. Factors that affect growth can put babies at risk for other health problems.

The brain continues to develop throughout pregnancy, after the baby is born, and into young adulthood. Harmful substances and exposures during the second and third trimester can cause developmental delays and learning disabilities.

Planning for pregnancy is important

Looking at the chart above, it is easy to see why preconception care is so important. Crucial fetal development happens very early in pregnancy– in many cases, before a woman even knows that she is pregnant. Seeing your health care provider BEFORE pregnancy and discussing any medications you are taking and underlying medical conditions, like diabetes or high blood pressure, can help you be better prepared for pregnancy and to reduce your risk of birth defects.

*We would like to thank the National Organization on Fetal Alcohol Syndrome (NOFAS) for allowing us to use their fetal development chart. Please visit their website for more important information about fetal alcohol spectrum disorders.

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.

Epilepsy and pregnancy

Thursday, May 21st, 2015

speak to your health care providerEvery year in the US, approximately 20,000 women with a seizure disorder give birth. Most of these pregnancies are healthy. But there are a few additional concerns that women who have epilepsy must consider when thinking about getting pregnant.

What is epilepsy?

Epilepsy is a brain disorder in which a person has repeated seizures over time. Seizures are episodes of disturbed brain activity that cause changes in attention or behavior. Epilepsy is a specific type of seizure disorder.

People with epilepsy are usually prescribed medication to help to control seizures. These are known as antiepileptic drugs (AEDs). There are a number of different types of AEDs and they are prescribed depending on age, the type of seizure, and the side effects of the medications. Some individuals with epilepsy may need more than one AED to control their seizures.

Can epilepsy cause problems during pregnancy?

If you have epilepsy and are thinking about getting pregnant, there are a few important things that you need to consider.

  • Women who have epilepsy have an increased chance to have a baby with a birth defect compared to women who do not have epilepsy. This may be the result of the epilepsy or the AEDs used to control seizures. Some AEDs have been associated with an increased risk of cleft lip and palate, neural tube defects, and heart defects.
  • Pregnancy can cause a change in the number of seizures. Most women with epilepsy will have no change in the number of seizures they experience or they will have fewer seizures during pregnancy. A few women will experience more seizures.

Controlling seizures during pregnancy is very important. Having a seizure during pregnancy can cause problems for you and your baby. Seizures during pregnancy can cause:

  • Decreased oxygen to the baby and fetal heart rate deceleration during the seizure.
  • Injury to the baby as a result of any falls or trauma experienced during the seizure. This can include premature separation of the placenta from the uterus (placental abruption) or miscarriage.
  • Preterm labor
  • Premature birth

Should you continue to take anti-seizure medications during pregnancy?

Many women with epilepsy are concerned about taking their AEDs during pregnancy. But according to ACOG, “Because there are serious risks associated with having a seizure during pregnancy and because the potential risk of harm to your baby from taking AEDs is small, experts recommend that seizures be controlled with AEDs, if necessary, during pregnancy. However, the type, amount, or number of AEDs that you take may need to change.”

Will you need any special care during your pregnancy?

One of the most important things that any woman can do to have a healthy pregnancy is to schedule a preconception checkup. If you have epilepsy, it is important to talk to your prenatal care provider as well as your neurologist prior to getting pregnant. Here are some other things to consider:

Before pregnancy:

  •  Review your seizure medications with both your prenatal provider and your neurologist. If changes need to be made, it is better to do this prior to getting pregnant.
  • Take a prenatal vitamin with folic acid. Talk to your health care team about how much folic acid is right for you.
  • Eat a healthy diet, get enough sleep, and avoid cigarettes, alcohol.

During pregnancy:

  • Plan for additional visits to your health care providers. Medication levels will need to be monitored to make sure they stay consistent.
  • Talk to a genetic counselor about prenatal testing.
  • Most women with a seizure disorder can have a vaginal birth.
  • Women with epilepsy are encouraged to breastfeed. Talk to your health care team.

If you have epilepsy, planning and working with your health care team can help to ensure that you have the healthiest pregnancy possible.

Questions?  Send them to AskUs@marchofdimes.org.

 

Concerns surrounding “keepsake” ultrasounds

Friday, February 20th, 2015

pr_mr_lg_ultrasound1The first ultrasound is one of the most exciting times in pregnancy. Most parents can’t wait for the opportunity to share their baby’s first pictures with family and friends. However, it is important to remember that an ultrasound is a medical imaging technique and should only be done under the supervision of medical professionals, such as your doctor and/or a trained ultrasound technician. “Keepsake” ultrasounds offered by commercial businesses are not recommended.

Ultrasound is the most commonly used tool for viewing a developing baby. Sound waves bounce off curves and shapes within your body and these patterns are then translated into images. Standard ultrasound creates a 2-D image of a developing baby. Some women have an ultrasound during the first trimester to confirm and date the pregnancy—this is called an early ultrasound.  But not all providers offer this. Most doctors perform an ultrasound between 18 and 20 weeks. At this time your provider will check your baby’s heartbeat, muscle tone, movement and overall development.

Although it is always fun and exciting to see your unborn baby on the ultrasound monitor, it is very important to remember that this is a medical procedure. You may have seen places in a mall that offer “keepsake” 3-D or 4-D ultrasound pictures or videos for parents. While ultrasounds have been used for over 30 years and are considered safe for you and your baby, the American College of Obstetricians and Gynecologists, the Food and Drug Administration and the American Institute of Ultrasound in Medicine do not recommend these non-medical ultrasounds. The people doing them may not have medical training and may give you wrong or even harmful information.

In a recent consumer update regarding fetal keepsake images, the FDA warns that “In creating fetal keepsake videos, there is no control on how long a single imaging session will last, how many sessions will take place, or whether the ultrasound systems will be operated properly.” And although there is no evidence that ultrasound may cause harm to an unborn baby, there is also no medical benefit to exposing the baby to unnecessary ultrasound waves only for the purposes of keepsake images.

If you are pregnant, talk to your doctor about when to schedule your ultrasound. He or she will be more than happy to give you pictures to take home with you. You can read more about the different types of ultrasound that your provider may recommend, when they are offered, and what information they may be able to provide here.

Pregnancy in women with congenital heart disease

Monday, February 9th, 2015

heart and stethoscopeMost women who have congenital heart disease and decide to get pregnant will have a safe pregnancy with minimal risks. However, there are many factors that may need to be considered. During pregnancy, your heart has much more work to do. It has to beat faster and pump more blood to both the mother and the baby. If you are a woman who has congenital heart disease, then this extra stress on your heart may be a concern. Considering these issues before pregnancy and being prepared for potential complications can help you feel more confident and more in control throughout your pregnancy.

Preconception planning
The most important thing you can do if you are a woman with congenital heart disease is to talk to both your cardiologist and obstetrician before you get pregnant. This will allow you to understand what risks (if any) are involved for your pregnancy. You can also determine if there are any concerns with your heart that need to be fixed prior to pregnancy—for instance, do you need to alter any medications or have any surgical repairs? Doing all of this before pregnancy will allow you to make sure your heart and your overall health is ready for pregnancy.

Some medications carry a risk for birth defects. These include ACE inhibitors and blood thinners. Therefore, if you are taking these medications and want to have a baby, it is important to talk to your doctor about their safety and potential alternatives that may work for you. However, you should never stop taking any medications without your doctor’s approval.

You may also want to meet with a genetic counselor to review the risks of passing congenital heart disease on to your baby. This risk will vary depending on the cause of the heart disease.

Pregnancy
During pregnancy you and your doctors will want to minimize any risks for both you and your baby. You will need to have regular follow-ups with both your obstetrician and cardiologist. It is important that your doctors work together and coordinate your care. Some women will need to be followed by a maternal-fetal medicine specialist (an obstetrician who manages high-risk pregnancies).

Although most women with congenital heart disease have safe pregnancies, symptoms of heart disease can increase, especially during the second and third trimesters when the heart is working much harder. This may mean additional visits to both your cardiologist and obstetrician.

Typically if you have a personal or a family history of congenital heart disease, your obstetrician will offer you a fetal echocardiogram at around 18-20 weeks of pregnancy. This is a specialized ultrasound that allows your doctor to check out the anatomy of your baby’s heart and look for major structural changes. Not all heart defects can be identified through fetal echo though.

Delivery
It may surprise you to learn that most women with congenital heart disease can have a normal vaginal delivery. You and your doctor will want to discuss pain management options and have a plan in place. You may need additional monitoring both during and after delivery. This can include oxygen monitoring as well as EKGs (electrocardiogram—a test that checks for problems with the electrical activity of your heart).

If you have congenital heart disease work with both your obstetrician and cardiologist so that you can have the best outcome possible. As with most chronic medical conditions, planning for your pregnancy will allow you to make informed decisions about what is best for you and your baby.

 

Thinking of getting pregnant? Get your blood pressure checked.

Friday, February 6th, 2015

blood pressureWhen was the last time you had your blood pressure checked? Nearly one in three adults has high blood pressure or hypertension. And yet, many of us do not even know that we have it. High blood pressure can be especially dangerous for both mom and baby during pregnancy. If you have high blood pressure and are thinking about getting pregnant, it is very important that you talk to your health care provider and get it under control as soon as possible.

Blood pressure is the force of the blood pushing against the walls of the arteries (blood vessels that carry oxygen-rich blood to all parts of the body). When the pressure in the arteries becomes too high, it is called high blood pressure or hypertension.

If you are 20 pounds or more overweight or if you have a family history of hypertension, you are at an increased risk to have high blood pressure yourself.

If you do have high blood pressure, there are a few lifestyle changes that you can make to get it under control, and to help prepare your body for pregnancy:
• Eat healthy foods and reduce your intake of salt, cholesterol, and saturated fats
• Exercise regularly
• Get to a healthy weight
• Don’t smoke or drink alcohol.

Not all medications for high blood pressure are safe to continue during pregnancy. If you are taking any prescriptions to manage your hypertension, make sure you discuss them with your doctor. You should never stop taking any medications without talking to your provider first.

About 8 percent of women have problems with high blood pressure during pregnancy. Although most health problems can be managed with regular prenatal care, pregnant women with high blood pressure are more likely than women without high blood pressure to have these complications:
• Low birthweight: when a baby weighs less than 5 pounds, 8 ounces. High blood pressure can narrow blood vessels in the uterus and your baby may not get enough oxygen and nutrients, causing him to grow slowly.
• Premature birth: birth that happens before 37 weeks of pregnancy. A pregnant woman with severe high blood pressure or preeclampsia may need to give birth early to avoid serious health problems for her and her baby.
• Placental abruption: the placenta separates from the wall of the uterus before birth. It can separate partially or completely. If this happens, your baby may not get enough oxygen and nutrients.

Work with your provider before and during your pregnancy to control your blood pressure. Making a few changes now can help you to have a safer, healthier pregnancy.

Depression during pregnancy: what you need to know

Tuesday, August 12th, 2014

sad woman with coffee mugDepression is a serious medical condition. It is an illness that involves the body, mood and thought. It affects the way a person feels about themselves and the way they think about their life. So many people were shocked and saddened by the news about Robin Williams. But unfortunately, depression is far more common than many of us realize. And regrettably, many people still feel that depression is a sign of weakness and do not recognize it as the biological illness that it is.

As many as 1 out of 5 women have symptoms of depression during pregnancy. For some women, these symptoms are severe. Women who have been depressed before they conceive are at a higher risk of experiencing depression during pregnancy than other women.

Signs of depression
Depression is more than just feeling sad or “blue.” There are physical signs as well. Other symptoms include:
• Trouble sleeping
• Sleeping too much
• Lack of interest
• Feelings of guilt
• Loss of energy
• Difficulty concentrating
• Changes in appetite
• Restlessness, agitation or slowed movement
• Thoughts or ideas about suicide

It may be hard to diagnose depression during pregnancy. Some of its symptoms are similar to those normally found in pregnancy. For instance, changes in appetite and trouble sleeping are common when you are pregnant. Other medical conditions have symptoms similar to those of depression. A woman who has anemia or a thyroid problem may lack energy but not be depressed. If you have any of the symptoms listed, talk to your health care provider.

Treatment options
Since depression is a serious medical condition, it poses risks for you and your baby. But a range of treatments are available. These include therapy, support groups and medications.

It is usually best to work with a team of health care professionals including:
• Your prenatal care provide
• A mental health professional, such as a social worker, psychotherapist or psychiatrist
• The provider who will take care of your baby after birth

Together, you and your medical team can decide what is best for you and your baby.

If you are on medication and thinking about getting pregnant, talk to your doctor. You will need to discuss whether you should keep taking the medication, change the medication, gradually reduce the dose or stop taking it altogether.

If you are taking an antidepressant and find that you are pregnant, do not stop taking your medication without first talking to your health care provider. Call him or her as soon as you discover that you are expecting. It may be unhealthy to stop taking an antidepressant suddenly.

If you or someone you know is experiencing any signs of depression, please talk to your health care provider or someone you trust. Help is available and you can feel better.

Click here to read more News Moms Need blog posts on: pregnancy, pre-pregnancy, infant and child care, help for your child with delays or disabilities, and other hot topics.

Group B strep infection

Friday, July 18th, 2014

Between 35-37 weeks of your pregnancy your prenatal care provider will test you for Group B strep. Group B streptococcus (also called Group B strep or GBS) is a common type of bacteria that can cause infection.

Many people carry Group B strep—in fact about 25% of pregnant women are carriers.  GBS bacteria naturally live in the intestines and the urinary and genital tracts. It is not known how GBS is transmitted in adults but you can’t get it from food, water, or things you touch. An adult can’t catch it from another person or from having sex, either.  Most people do not even know they are carriers since adults usually show no signs or symptoms related to GBS.

GBS, however, can be passed to your newborn during labor and delivery and it can make your baby very sick. Babies with a GBS infection may have one or more of these illnesses:

• Meningitis, an infection of the fluid and lining around the brain

• Pneumonia, a lung infection

• Sepsis, a blood infection

According to the CDC, in the US, group B strep is the leading cause of meningitis and sepsis in a newborn’s first week of life.

There are two kinds of GBS infections:

1. Early-onset GBS: Signs like fever, trouble breathing and drowsiness start during the first 7 days of life, usually on the first day. Early-onset GBS can cause pneumonia, sepsis or meningitis. About half of all GBS infections in newborns are early-onset.

2. Late-onset GBS: Signs like coughing or congestion, trouble eating, fever, drowsiness or seizures usually start when your baby is between 7 days and 3 months old. Late-onset GBS can cause sepsis or meningitis.

The good news is that early-onset GBS infection in newborns can be prevented by a simple test. During your third trimester, your provider will take a swab of the vagina and rectum. Results are available in a day or so. This test will need to be done in each pregnancy.

If you do have GBS, then your provider will give you an antibiotic through an IV (medicine given through a tube directly into your bloodstream) during labor and delivery. Usually this is penicillin (if you are allergic to penicillin, there are other options available). Any pregnant woman who had a baby with group B strep disease in the past, or who has had a bladder (urinary tract) infection during this pregnancy caused by group B strep should also receive antibiotics during labor.

Unfortunately late-onset GBS cannot be prevented with IV antibiotics. Late-onset GBS may be due to the mother passing the bacteria to her newborn, but it may also come from another source, which is often unknown.

Treatment for babies infected with either early-onset GBS or late-onset GBS is antibiotics through an IV.

Currently researchers are testing vaccines that will help to prevent GBS infections in both mothers and their babies.

If you have any questions about this topic or other pregnancy and newborn health issues, please email the Pregnancy and Newborn Health Education Center at askus@marchofdimes.org.