Must be the wooden shoes.  Researchers from Vrije University (between Amstelveenseweg and De Boelelaan Streets in Amsterdam –Look it it up if you don’t believe me), have studied the development of eggs in over 500 Dutch women to determine why women over age 35 have twins more frequently than [...]]]> Source:  Journal of Human Reproduction;  BBC Health

Must be the wooden shoes.  Researchers from Vrije University (between Amstelveenseweg and De Boelelaan Streets in Amsterdam –Look it it up if you don’t believe me), have studied the development of eggs in over 500 Dutch women to determine why women over age 35 have twins more frequently than women under age 30.

Quick medical lesson:  Twins occur when 1 fertilized egg divides into 2 infants (identical) or when 2 eggs become fertilized instead of just 1 (non-indentical).  3/4 of all twin pregnancies are non-identical.  A hormone called FSH (Follicle Stimulating Hormone) starts the process of egg production in the ovaries.

Back to the study.  Of the 500 women, 105 developed multiple follicles.  Of those, 55 were found in women over age 35 while just 5 were to women under age 30. Why?  Well, it appears that prior to menopause women overcompensate (that’s NOT a value judgment) and produce higher levels of FSH.   Typically this will not result in multiples only due to the relative age of the eggs.  However, a number of women produce viable eggs late into their reproductive lives making this phenomenon possible.

So while advanced maternal age is more commonly associated with infertility, it is also associated with high fertility. The more you know…

~Posted by D.M. Schwadron, Esquire

I know, I know…Let them sleep on their backs…No wait, only on their stomachs…No wait, on their backs but no pillows…or blankets…No smoking…No pets…Never in bed with you…

Perhaps it’s no wonder why the Amercian Academy of Pediatrics is constantly revising guidelines [...]]]> Source:  U.S. National Institutes of Health; Journal of the American Medical Association, February 3, 2010

I know, I know…Let them sleep on their backs…No wait, only on their stomachs…No wait, on their backs but no pillows…or blankets…No smoking…No pets…Never in bed with you…

Perhaps it’s no wonder why the Amercian Academy of Pediatrics is constantly revising guidelines for infant sleep.  There is a wealth of information seemingly linking SIDS (Sudden Infant Death Syndrome) with, well, everything.  The latest?  Serotonin. Huh?  Okay, back to biochemistry class we go.  Serotonin is a neurotransmitter, don’t worry about what kind, it’s presence or absence in sufficient quantities is  broadly responsible for the regulation of mood, appetite, sleep, muscle contraction, and some cognitive functions including memory and learning. Modulation of serotonin at synapses is thought to be a major action of several classes of pharmacological antidepressants.  As an interesting aside (well interesting to me anyway) certain foods, carbohydrates mostly -pasta, chips also seem to have a serotonin level response.

So why all the chemistry talk? Because researchers studying the brains of infants who have died from SIDS have found that they were producing low levels of serotonin. No, they weren’t depressed, well not emotionally anyway.  However, to the extent that serotonin may be responsible for breathing they may be onto something.  How much lower?  26% lower according to this study. Measures of an enzyme required to manufacture serotonin (tryptophan hydroxylase for those of you playing the home game) were also 22% lower in the brains of the SIDS death infants studied.

Yes, they are still currently recommending the whole back sleeping thing. For a complete list of sleeping guidelines see http://www.nicdh.nih.gov/sids/ or speak with your pediatrician or obstetrician.

~Posted by D.M. Schwadron, Esquire

Admittedly it was a small, focused study of 36 newborns, 17 of whose mothers smoked during pregnancy.  It is, however, alarming and instructive.  Babies that had been exposed to cigarette smoke in utero (While in Mommy’s belly) demonstrated abnormal heart rates and blood pressures.

But that’s not all. . .rather than [...]]]> Source:  BBC Health; Karolinska Institute (Sweeden)

Admittedly it was a small, focused study of 36 newborns, 17 of whose mothers smoked during pregnancy.  It is, however, alarming and instructive.  Babies that had been exposed to cigarette smoke in utero (While in Mommy’s belly) demonstrated abnormal heart rates and blood pressures.

But that’s not all. . .rather than dissipate with age, the abnormalities appear to have worsened from one week to age one. According to lead researcher, Dr. Gary Cohen, “Babies of smokers have evidence of persistent problems in blood pressure regulation that start at birth and get worse over time” and “[E]arly life exposure to tobacco can lead to long lasting reprogramming of the infant blood pressure control mechanism.”

And Dr. Cohen adds, this might be the mechanism which explains why infants of smokers are at increased risk for SIDS (Sudden Infant Death Syndrome) or “Cot death” as it is known in the UK.

~Posted by D.M. Schwadron, Esquire

According to the CDC, some 3,000 pregnancies a year are ffected by spina bifida or anencephaly (, neural tube defects caused by the incomplete development of the brain and spinal cord).  Studies have shown that women taking 400 mcg of folic acid daily both before and during pregnancy [...]]]> Source: U.S. Centers for Disease Control & Prevention

According to the CDC, some 3,000 pregnancies a year are ffected by spina bifida or anencephaly (, neural tube defects caused by the incomplete development of the brain and spinal cord).  Studies have shown that women taking 400 mcg of folic acid daily both before and during pregnancy may reduce the risk of neural tube defects by up to 70%.

Is it safe? Folic acid is a type of B vitamin.  It is largely recognized as safe.

When should you take folic acid? Neural tube and spinal defects occur in the first few weeks of pregnancy, often before a woman finds out that she is pregnant.  All women of child-bearing age should get in the habit of taking folic acid daily.  This is true even if they are not planning to get pregnant.

Where do you get folic acid? You can get your vitamin with folic acid with or without a prescription in one of several ways.  You can take a multivitamin or a small, single supplement of folic acid.  Unless your doctor suggests a special type, you do not need to choose among vitamins for women or active people, or even to go with a low carbohydrate diet. A basic multivitamin meets the needs of most women.

Another way to get enough is to eat a serving of breakfast cereal every day that has been enriched with 100% of the daily value of folic acid. Not every cereal has this amount. Check the label on the side of the box, and look for one that has “100%” next to folic acid.

Safe, Effective and readily obtainable.

~Posted by David Marc Schwadron, Esquire

The vast majority of women who are pregnant are also taking at least one prescription drug. In our modern, hectic and stressful society, antidepressant and anti-anxiety medications are among them.  But are they really safe?

The answer is we really don’t exactly know…exactly. There are [...]]]> Source:  US Dpt. of Health & Human Services; www.womens.health.gov; Wall Street Journal

The vast majority of women who are pregnant are also taking at least one prescription drug. In our modern, hectic and stressful society, antidepressant and anti-anxiety medications are among them.  But are they really safe?

The answer is we really don’t exactly know…exactly. There are studies which show minimal issues but there is surprisingly little medical evidence to support the notion that the majority of common prescriptions are truly “safe” for your baby.  The following classifications demonstrate how much we don’t know.  The FDA is currently funding a study to evaluate about one million births between 2001 and 2007, the time when a number of these medications became quite popular.  Ask questions of your doctor.  lots of questions.  The good ones will answer you.

~Posted by David Marc Schwadron, Esquire

Controversy on the MS (Multiple Sclerosis) front.  Multiple Sclerosis is an inflammatory disease of the central nervous system which can cause severe disability and death.  A joint Belgian and Dutch study tracking 330 women with MS over the course of 18 years suggest that for [...]]]> Source: Journal of Neurology, Neurosurgery and Psychiatry, BBC Health, MS Society

Controversy on the MS (Multiple Sclerosis) front.  Multiple Sclerosis is an inflammatory disease of the central nervous system which can cause severe disability and death.  A joint Belgian and Dutch study tracking 330 women with MS over the course of 18 years suggest that for those who became pregnant and gave birth, severe disability associated with MS took longer to develop.

This is stark contrast to prior studies which have long supported the notion that MS worsens following pregnancy and birth.  The MS Society has issued a statement suggesting “flaws” in the study and too small a sample size. But there was some concession that the release of hormones during pregnancy could have a beneficial effect on the immune system and its ability to fight MS.

Researchers say that women who gave birth to one or more children prior to the onset of their MS Symptoms were 34% less likely to progress than those women who remained childless.  Moreover (legal speak for “also) women who had children AFTER their MS became symptomatic were 39% less likely to progress than childless women.

Put this one down as too early to say, but consider those lifetime decisions carefully now that there is more information emerging. As always, consult your physician before electing to become pregnant, with or without symptomatic MS.

~Posted by David Marc Schwadron, Esquire

A recently published study on Hypergylcemia (hyper = too much) and it’s effect upon pregnant women suggests (because we never really know for sure) that glucose levels at the High-normal end during the first trimester increase the risk of poor pregnancy outcomes including gestational diabetes.

The current recommended screening for [...]]]> Source: Diabetes Care, 2009; 32: 1639-1643.

A recently published study on Hypergylcemia (hyper = too much) and it’s effect upon pregnant women suggests (because we never really know for sure) that glucose levels at the High-normal end during the first trimester increase the risk of poor pregnancy outcomes including gestational diabetes.

The current recommended screening for gestational diabetes is at the start of the third trimester. For those of you struggling with math, that’s two trimesters later and since we are talking about trimesters, it’s toward the end of pregnancy.  Intuitively it seems to be a good idea to test women earlier then later so that any complications of pregnancy may be avoided.  If these results prove reliable then perhaps new recommendations are in order.

Yes, I’m aware that the fasting test is miserable, second only to that test where you have to basically drink a gallon of horribly flavored sugar-water.  Oh, and that whole weighted speculum thing.  I’m only responsible for the blog posts.

Posted by David Marc Schwadron, Esquire