Showing posts with label Linked. Show all posts
Showing posts with label Linked. Show all posts

Friday, May 11, 2012

Pre-Pregnancy Obesity Linked To Lower Test Scores In Offspring

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Main Category: Obesity / Weight Loss / Fitness
Also Included In: Pregnancy / Obstetrics
Article Date: 10 May 2012 - 1:00 PDT

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Women who are obese before they become pregnant are at higher risk of having children with lower cognitive function - as measured by math and reading tests taken between ages 5 to 7 years - than are mothers with a healthy pre-pregnancy weight, new research suggests.

In this large observational study, pre-pregnancy obesity was associated, on average, with a three-point drop in reading scores and a two-point reduction in math scores on a commonly used test of children's cognitive function.

Previous research has suggested that a woman's pre-pregnancy obesity can have a negative effect on fetal organs, such as the heart, liver and pancreas. Because fetal development is rapid and sensitive to a mother's physiological characteristics, Ohio State University researchers sought to find out whether a mother's obesity also could affect the fetal brain.

"One way you measure the effects on the brain is by measuring cognition," said Rika Tanda, lead author of the study and a doctoral candidate in nursing at Ohio State.

The research also supported findings in previous studies suggesting that several other conditions affect childhood cognition, including how stimulating the home environment is, family income and a mother's education and cognitive skills.

"The new piece here is we have a measure associated with the fetus's environment to add to that set of potential risk factors," said Pamela Salsberry, senior author of the study and a professor of nursing at Ohio State. "If we have a good way to understand the risks each child is born with, we could tailor the post-birth environment in such a way that they could reach their maximum capabilities."

The research appears online and is scheduled for future print publication in the Maternal and Child Health Journal.

The researchers used data from the National Longitudinal Survey of Youth (NLSY) 1979 Mother and Child Survey, a nationally representative sample of men and women who were 14-21 years old in December 1978. From that dataset, Tanda collected information on 3,412 children born to NLSY mothers who had been full-term births, were between 5 and almost 7 years old at the time of their interview and who had no diagnosed physical or cognition problems.

In addition to documenting a number of characteristics about the mothers and the family environment, the researchers gauged the children's cognitive function based on their performance on Peabody Individual Achievement Test reading recognition and math assessments.

The researchers calculated the mothers' body mass index (BMI) based on their reported heights and weights. More than half of mothers had normal BMIs before pregnancy, and 9.6 percent were obese, meaning they had a BMI of 30 or higher.

Controlling for all other variables, the analysis showed that maternal pre-pregnancy obesity was negatively associated with math and reading test scores. Children of obese women scored, on average, three points lower on reading and two points lower on math than did children of healthy-weight women. The mean reading score among all the children was 106.1 points and the mean math score was 99.9.

Though the score differences seem small, Tanda noted that these effects of pre-pregnancy obesity were equivalent to a seven-year decrease in the mothers' education and significantly lower family income, two other known risk factors that negatively affect childhood cognitive function.

Tanda said clinicians could use these findings to help encourage women patients of childbearing age to maintain a healthy weight, especially if they plan to get pregnant.

"This is a large population study, so at the individual level we can't say that one person's decision to change her weight will change her child's outcome," she said. "But these findings suggest that children born to women who are obese before pregnancy might need extra support."

Added Salsberry, "It's not only for their child's sake. It's also important for the health of the mother. But it is important to understand that maternal obesity during pregnancy could have implications for their children as well."

Without actual measures of women's and fetuses' insulin levels, inflammation and blood sugar readings, scientists can't say for sure how pre-pregnancy obesity might affect the fetal brain. But previous studies have suggested that a mother's impaired metabolic processes affect the fetal brain cell growth and formation of synapses.

The researchers also noted that obesity doesn't automatically equate to unhealthy.

"There may be two obese moms that in fact have very different metabolic profiles. For the purposes of this study, her weight is a stand-in for biological data that we would like to have but don't," Salsberry said.

Socioeconomic data from the study supported previous findings that several post-birth conditions can have a positive association with higher children's test scores. These include a stimulating home environment with plenty of books, a safe play environment and frequent family meals; higher family income; and higher maternal education levels and cognitive function. Girls and first-born children also performed better on the math and reading tests than did boys and younger siblings.

With all these data combined, Tanda said, the study also reveals how health disparities can have long-lasting effects.

"Young females who grow up poor, who have less access to healthy foods resulting in diets that are of poorer quality, are at higher risk of having children with disadvantages and repeating this cycle," she said.

The researchers are continuing to examine additional influences on childhood cognition, including race, sex and age differences among mothers.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our obesity / weight loss / fitness section for the latest news on this subject. This study was supported by a grant from the Ruth L. Kirschstein National Research Service Award predoctoral fellowship sponsored by the National Institute of Nursing Research.
Additional co-authors included Patricia Reagan and Muriel Fang of Ohio State’s Department of Economics and the Center for Human Resource Research.
Written by Emily Caldwell
Ohio State University Please use one of the following formats to cite this article in your essay, paper or report:

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Pregnancy Rates And Cost Per Pregnancy Improve Linked To Weight Loss Intervention

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Main Category: Pregnancy / Obstetrics
Also Included In: Obesity / Weight Loss / Fitness
Article Date: 09 May 2012 - 11:00 PDT

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At the 19th European Congress on Obesity in Lyon, France, the annual meeting of the European Association for the Study of Obesity, Dr Kyra Sim from The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders at the University of Sydney in Australia presented a new study, which shows that weight loss intervention in obese women who undergo fertility treatment substantially improves their chance of pregnancy and other health indicators, whilst also saving substantial costs per achieved pregnancy.

The study is the first to evaluate the economic value of the impact of women's weight loss strategies on fertility treatment. The randomized controlled trial involved 49 women aged 37 years or younger, with an average BMI of = 30 kg/m2, who were in an assisted reproductive technology program.

The researchers randomized 27 women to a 12-week intervention, consisting of a very-low-energy diet for the first six weeks, after which the women went on a low-energy diet combined with a weekly group multidisciplinary program. The other 22 women in the control group received recommendations for weight loss and the same printed material. The researchers measured multiple parameters at baseline and at 12 weeks. Follow up was at 12 months to confirm whether a pregnancy had occurred.

The findings demonstrated the women in the intervention group registered an average weight loss of 6.6 kg, with a 9 cm waistline reduction compared with those in the control group who lost 1.8 kg on average with a 1 cm reduction in waist circumference. The results also showed that pregnancy rates were significantly improved amongst those in the intervention group with 48% compared to 14% in the control group.

The number of assisted reproductive cycles needed to become pregnant was also less amongst the intervention group, together with a decline in maternal and fetal risk factors. The researchers also noted that the intervention group showed metabolic, hormonal and psychological improvements. The intervention saved US$9360 (AU$9,035 - EUR€6,900 - GBP5865) per pregnancy.

Dr Sim states that the study highlights the significance of implementing a program of preconception weight management together with providing specific information about the maternal and fetal risks of obesity in pregnancy, and concludes:

"A weight-loss intervention, incorporating dietary, exercise and behavioral components, is associated with significantly better pregnancy and economic outcomes in a group of obese women undergoing assisted reproductive technology."

Written By Petra Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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Wednesday, May 9, 2012

Discovery Of First Gene Linked To Missing Spleen In Newborns

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Main Category: Infectious Diseases / Bacteria / Viruses
Also Included In: Pregnancy / Obstetrics;  Genetics
Article Date: 07 May 2012 - 1:00 PDT

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Researchers at Weill Cornell Medical College and Rockefeller University have identified the first gene to be linked to a rare condition in which babies are born without a spleen, putting those children at risk of dying from infections they cannot defend themselves against. The gene, Nkx2.5, was shown to regulate genesis of the spleen during early development in mice.

The study, published online in Developmental Cell, raises the hope that a simple genetic screening test for Nkx2.5 mutations can be developed that will alert parents that their developing child may be missing the organ, which could then be confirmed with a diagnostic scan.

"The great news is that with the appropriate preventive antibiotic treatment these children will not succumb to fatal infections. This test could potentially save lives," says the study's lead investigator, Dr. Licia Selleri, an associate professor in the Department of Cell and Developmental Biology at Weill Cornell Medical College.

Because defense against infections depends, in part, on the spleen, children known to be born without the organ require treatment with a regimen of antibiotic therapy throughout their lives. But most diagnoses of this condition, congenital asplenia, are made during an autopsy after a child dies, suddenly and unexpectedly, from a rapidly lethal infection, usually from bacteria that causes pneumonia or meningitis, Dr. Selleri says. "For those reasons, we believe this condition is not quite as rare as believed. Not every child who dies from an infection is given an autopsy."

Long search for genetic culprits

Patients with congenital asplenia usually lack a spleen as the sole abnormality, but sometimes have abnormalities of the heart and blood vessels. The majority of those cases arise sporadically, so are not believed to be inherited. One form of this disorder is known as Isolated Congenital Asplenia (ICA), characterized by a spleen that is missing but with no other developmental abnormalities. The cause is believed to be genetic, but no candidate genes in humans had been found before this study.

This research project was a collaboration between Dr. Selleri and her colleagues, and Rockefeller University's Dr. Jean-Laurent Casanova, professor in the St. Giles Laboratory of Human Genetics of Infectious Diseases. Dr. Casanova had led a previous study describing 20 ICA patients, of which most children suffered their first serious infection by age one, and nine died of an invasive pneumonia.

Dr. Selleri has long been studying congenital asplenia in the laboratory using the mouse as a model system and had previously discovered that a transcription factor known as Pbx is the prime regulator of spleen development in mouse models. Dr. Matthew Koss, a recent Ph.D. graduate who had studied in Dr. Selleri's lab, led the effort to create a strain of mice that lacked Pbx in the spleen, and were born without a spleen. He identified a regulatory module that is controlled by Pbx and targets Nkx2.5, a gene downstream of Pbx, in the developing spleen of the mouse embryo. He also discovered that Pbx controls the growth of the spleen by directly regulating the expression of Nkx2.5, which in turn controls cell proliferation within the primitive spleen organ.

Then, in Dr. Casanova's lab, Alexandre Bolze, a graduate student, sequenced genetic samples from ICA patients and analyzed them using whole exome sequencing technology, which allows sequencing of the entire coding genome of multiple patients -- a technique routinely employed by Dr. Casanova. Bolze found that Nkx2.5 was mutated in a family of asplenic patients, some of which died from lethal infections -- confirming the importance of Nkx2.5 in human congenital asplenia as in the mouse model of the disorder.

"This study illustrates the unique strength in using mouse models and human genetics hand-in-hand," says Dr. Selleri. "It demonstrates how genetic pathways identified in mouse models can be exploited to further understand the pathogenesis of human disease towards a better prenatal diagnosis."

She says that other patients and families with this disorder need to be studied in order to develop a comprehensive prenatal test. "It may be that there are other mutations that are acting in concert or independently of Nkx2.5 in other asplenic patients," Dr. Selleri says. Those studies in human patients are currently underway in the Rockefeller University lab, while at the Weill Cornell lab additional studies on mouse models are ongoing.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our infectious diseases / bacteria / viruses section for the latest news on this subject. The research was funded by the National Institutes of Health, the March of Dimes and Birth Defects Foundation, the Associazione Italiana Ricera Cancro, the Marie Curie Foundation and the St. Giles Foundation.
Other co-authors include Dr. Andrea Brendolan, Dr. Matilde Saggese, Dr. Terence D. Capellini and Dr. Ekaterina Bojilova from Weill Cornell Medical College; Dr. Bertrand Boisson from Rockefeller University; Dr. Owen W.J. Prall, Dr. David Elliott, Dr. Mark Solloway and Dr. Richard P. Harvey from the Victor Chang Cardiac Research Institute in Darlinghurst, Australia; Dr. Elisa Lenti from the Fondazione Centro San Raffaele Del Monte Tabor in Milan, Italy; Dr. Chisa Hidaka from the Hospital of Special Surgery; Dr. Ching-Pin Chang from Stanford University School of Medicine; and Dr. Nizar Mahlaoui from Necker Hospital in Paris, France.
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Saturday, May 5, 2012

Insecticide Exposure During Pregnancy Linked To Alterations In Brain Structure And Cognition

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Main Category: Pregnancy / Obstetrics
Also Included In: Public Health;  Neurology / Neuroscience
Article Date: 02 May 2012 - 0:00 PDT

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Even low to moderate levels of exposure to the insecticide chlorpyrifos during pregnancy may lead to long-term, potentially irreversible changes in the brain structure of the child, according to a new brain imaging study by researchers from the Columbia Center for Children's Environmental Health at the Mailman School of Public Health, Duke University Medical Center, Emory University, and the New York State Psychiatric Institute. The changes in brain structure are consistent with cognitive deficits found in children exposed to this chemical.

Results of the study appear online in PNAS.

The new study is the first to use MRI to identify the structural evidence for these cognitive deficits in humans, confirming earlier findings in animals. Changes were visible across the surface of the brain, with abnormal enlargement of some areas and thinning in others. The disturbances in brain structure are consistent with the IQ deficits previously reported in the children with high exposure levels of chlorpyrifos, or CPF, suggesting a link between prenatal exposure to CPF and deficits in IQ and working memory at age 7.

The study also reports evidence that CPF may eliminate or reverse the male-female differences that are ordinarily present in the brain. Further study is needed to determine the consequences of these changes before and after puberty, the researchers say.

Notably, the brain abnormalities appeared to occur at exposure levels below the current EPA threshold for toxicity, which is based on exposures high enough to inhibit the action of the key neurological enzyme cholinesterase. The present findings suggest that the mechanism underlying structural changes in the brain may involve other pathways.

According to the lead author, Virginia Rauh, ScD, Professor at the Mailman School of Public Health and Deputy Director of the Columbia Center for Children's Environmental Health, "By measuring a biomarker of CPF exposure during pregnancy, and following the children prospectively from birth into middle childhood, the present study provides evidence that the prenatal period is a vulnerable time for the developing child, and that toxic exposure during this critical period can have far-reaching effects on brain development and behavioral functioning."

"By combining brain imaging and community-based research, we now have much stronger evidence linking exposure to chlorpyrifos with neurodevelopmental problems," adds senior author Bradley S. Peterson, MD, Chief of Child & Adolescent Psychiatry, New York State Psychiatric Institute, and Director of MRI Research in the Department of Psychiatry, Columbia University Medical Center.

In the current study, the researchers used MRI to evaluate the brains of 40 New York City children, ages 5 to 11, whose mothers were enrolled prenatally in a larger cohort study. Researchers compared 20 children with high exposures to CPF with 20 children with lower exposures; all exposures occurred prior to the EPA ban on household use of the chemical in 2001. They found brain anomalies were associated with the higher exposure.

Since the 2001 ban, a drop in residential exposure levels of CPF has been documented by Robin Whyatt, DrPH, a co-author on the present study and Professor of Clinical Environmental Health Sciences and Co-Deputy Director of the Columbia Center for Children's Environmental Health at the Mailman School. However, the chemical continues to be present in the environment through its widespread use in agriculture (food and feed crops), wood treatments, and public spaces such as golf courses, some parks, and highway medians. People near these sources can be exposed by inhaling the chemical, which drifts on the wind. Low-level exposure can also occur by eating fruits and vegetables that have been sprayed. Although the chemical is degraded rapidly by water and sunlight outdoors, it has been detected by the Columbia researchers in many urban residences years after the ban went into effect.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our pregnancy / obstetrics section for the latest news on this subject. The study was supported by the National Institute of Environmental Health Sciences Grants 5P01ES09600, P50ES015905, and 5R01ES08977, as well as pilot funding through ES009089; EPA STAR Grants RD834509, RD832141, and R827027; National Institute of Mental Health Grants MH068318 and K02-74677; and the John and Wendy Neu Family Foundation.
Additional co-authors included Frederica P. Perera and Megan K. Horton, Mailman School; Ravi Bansal, Xuejun Hao, and Jun Liu, Columbia University Medical Center; Dana Boyd Barr, Emory University; and Theodore A. Slotkin, Duke University.
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