Dec
05
2020

Mother’s Lifestyle Predicts Heart Attack Risk for Offsprings

By | Cardiovascular disease, cholesterol, Diabetes, exercise, food, heart attack, High Blood Pressure, lifestyle, Nutrition, Smoking, Stroke

A European Society of Cardiology study found that mother’s lifestyle predicts heart attack risk for offsprings. This study was published in the Journal of Preventive Cardiology, a journal of the European Society of Cardiology. It was also summarized in Science Daily. The study author Dr. James Muchira of Vanderbilt University, Nashville said: “This maternal influence persists into the adulthood of their offspring.” What he meant is that the study found that lifestyles of mothers influence the choices of lifestyles of the offsprings, and with poor choices even determine when the next generation gets their heart attack or stroke.

In previous research the team established that both genetic factors as well as environmental and lifestyle factors are responsible for cardiovascular disease. Now the researchers wanted to determine the influence of each parent on the risk of cardiovascular disease of the offspring.

Set-up of the study

The study was done with offspring and the parents of the Framingham Heart Study. 1989 children from 1989 mothers and 1989 fathers were enrolled 1971 and followed for 46 years. The average age of the offspring at enrolment was 32 years. The study ended 2017. Dr. Muchira said: ”Crucially, the study followed children into most of their adult life when heart attacks and strokes actually occur.”

Risk factors for cardiovascular disease

The researchers rated the risks of fathers and mothers in the study according to 7 factors.

  • Smoking status (non-smoker preferred)
  • Diet (healthy or not)
  • Physical activity
  • Body mass index (normal or not)
  • If blood pressure is too high
  • Level of blood cholesterol
  • Blood sugar values

The researchers established three categories of cardiovascular health: poor (fulfilment of 0 to 2 factors); intermediate (fulfilment of 3 to 4 factors) and ideal (fulfilment of 5 to 7 factors). The researchers wanted to know how long the offspring were able to live without symptoms of cardiovascular disease.

Findings of the study

Here are the findings of the study.

  • Children of mothers with ideal cardiovascular health lived free of cardiovascular symptoms for 27 years; they were on average 32+27= 59 years when symptoms started.
  • Children of mothers with poor cardiovascular health lived free of cardiovascular symptoms for 18 years; they were 32+18= 50 years old when symptoms started; this is 9 years earlier than children from mothers with ideal cardiovascular health.
  • Father’s cardiovascular health did not influence the children’s onset of cardiovascular symptoms.

Cardiovascular risks of the children are due to a combination of things

A combination of the health status during the pregnancy and the environment in early life influenced the children.

Dr. Muchira said: “If mothers have diabetes or hypertension during pregnancy, those risk factors get imprinted in their children at a very early age. In addition, women are often the primary caregivers and the main role model for behaviors.” Sons were much more affected by their mother’s cardiovascular health status. Dr. Muchira explained: “This was because sons had more unfavourable lifestyle habits than daughters, making the situation even worse. It shows that individuals can take charge of their own health. People who inherit a high risk from their mother can reduce that risk by exercising and eating well. If they don’t, the risk will be multiplied.”

Discussion

We remember that the Framingham Heart Study long time ago established the above-mentioned risk factors for heart disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159698/ It is also important for the offspring to quit smoking as this is a high-risk factor for heart disease. Next eat a balanced diet, like the Mediterranean diet. With this you eat more vegetables, less meat, more fish and add olive oil. Engage in regular exercise, which will raise the protective HDL cholesterol. Keep your body mass index low (in the 21.0 to 22.0 range, but definitely below 25.0). Keep your blood pressure in the normal range (120/80 or less). Make sure that your blood cholesterol and blood sugar values are normal. This will give you the lowest risk to develop a heart attack or a stroke.

Mother’s Lifestyle Predicts Heart Attack Risk for Offsprings

Mother’s Lifestyle Predicts Heart Attack Risk for Offsprings

Conclusion

We are normally concerned about our own cardiovascular health. But in a new study researchers examined children of participants in the Framingham Heart Study and their parents. This showed that the cardiovascular health status of the mother had a significant influence on the children’s  cardiovascular health. The offspring had an average age of 32 years when the researchers started to follow them for 46 years. When the mother was in poor cardiovascular health, the offspring developed cardiovascular symptoms at age 50. But when the mother’s cardiovascular health was ideal, the children got symptoms of cardiovascular disease only at age 59. This delay of 9 years of disease onset was purely due to the mother’s cardiovascular health status.

Risk management of cardiovascular risks

The authors of the study say that the children can do a lot to minimize the cardiovascular risk. They need to work to reduce the known risk factors and also start a regular exercise program. The authors of the study mentioned that even people who inherited a risk for cardiovascular disease benefit significantly from cutting out risk factors for cardiovascular disease.

Sep
21
2013

In Vitro Fertilization As A Last Resort To Get Pregnant

By | Infertility, Women’s Diseases

Since its invention in 1978 there have been 5 million babies born through in vitro fertilization (IVF). According to the World Health Organization there are about 120 to 160 million couples worldwide struggling with infertility problems.

Assisted reproduction technology (a fancy name for artificial insemination) has been helped a lot by the breakthrough discovery in the US with regard to ultrasound identification of mature follicles in the ovaries. The second technical breakthrough, another ultrasound method done trans-vaginally to recover eggs from the identified mature follicles, has also helped the IVF technology (Ref.1).

When all of the cases of infertility in the United States are broken down into what causes them, the following was found (Ref. 2):

20% of cases of infertility were caused by anovulation, about 35% were due to abnormal semen production in the male, 30% by pelvic disease (fibroids, tubal blockage, polycystic ovaries), and 15% of cases were unexplained.

Process of artificial insemination

There are a number of steps that have to be followed to be successful with IVF.

a) Hormonal stimulation of the ovaries: The first step in getting eggs from a woman who desires IFV is to stimulate her ovaries to produce several mature follicles. This is achieved with gonadotropins, which are hormones that lead to ovarian overstimulation. Over the years this has been fine tuned with gonadotropin-releasing hormone (GnRH) analogues given first (stimulating release of LH and FSH from the pituitary gland). Subsequently follicle-stimulating hormone (FSH) is given, which causes the ovaries to produce follicles that can be identified on a TV screen using ultrasound technology. When follicle maturity is established with the ultrasound method, human chorionic gonadotropin can be given to trigger ovulation. However, when this is done and combined with artificial insemination through depositing sperm via a catheter into the uterus, the pregnancy rates judged by today’s standards to be too low (in the order of 15 to 20% per cycle).

b) Harvesting of eggs:

Nowadays the 2 or 3 follicles that have been identified as mature by ultrasound are used for follicular aspiration. With transvaginal sonography and a long needle that comes out from the ultrasound probe, the specialist will be able to harvest the mature eggs from the follicular cysts.

c) In vitro fertilization methods:

There are basically two methods for fertilization. First the standard IVF method is simply to add sperm to the eggs in a Petri dish with growth medium. After spontaneous fertilization the eggs undergo cell division. Compared to this standard IVF the success rates have been found to be higher with a newer method, called intracytoplasmic sperm injection (ICSI). In this case a single sperm is injected through a fine needle into the egg. On the 2nd or 3rd day of in vitro culture with either of these methods of fertilization the embryos consist of 6 to 8 cells. The embryos (typically one or two) are now introduced into the uterus of the mother by the specialist.

In Vitro Fertilization As A Last Resort To Get Pregnant

In Vitro Fertilization As A Last Resort To Get Pregnant

Success rates of in vitro fertilization (IVF)

Approximately 10% of all U.S. couples with women of the reproductive age are infertile, approximately more than 7 million women; the incidence of infertility steadily increases in women after the age of 30. Among fertile couples who have sex during the week before ovulation, about 20% achieve a pregnancy.  If regular unprotected sex does not lead to a pregnancy within one year, the couple is considered infertile (that is the medical definition of infertility). With infertile couples using intrauterine insemination there is a pregnancy success rate of about 8 to 9% per cycle. However, IVF has a success rate of 30% per cycle. The chance of a pregnancy after six cycles of IVF is 72% provided the woman is in close contact with the IVF specialist and follows all of the instructions carefully. If the woman does not adhere to the program (this includes some dropouts), the pregnancy rate for IVF is only 51% in 6 months (Ref.2).

In 2010 the Nobel Prize for Physiology and Medicine went to Bob Edwards for his outstanding work on IVF. His work has improved the success rate for pregnancy of infertile couples significantly.

Costs of in vitro fertilization (IVF)

The conventional IVF cost is about 60,000$ to achieve a successful pregnancy; a newer, simplified IVF version costs only 265$, a method which has been developed for development countries. In the simplified version fertility drugs are given as generic tablets. The pregnancy rate for IVF is about 34% in this study from Belgium involving 100 infertile couples so far with the women being under the age of 36.

Gender selection and genetic abnormalities

Gender selection is highly controversial and is not being practiced. However, there are gender specific genetic abnormalities that can be identified in the 2 to 3 day old embryo after a few in vitro cell divisions. If DNA analysis shows an X-linked abnormality, this genetic abnormality would not be implanted into the womb. An embryo with a normal DNA test would be implanted instead (male or female). There are obvious ethical guidelines that have to be followed and these have been in place for a number of years.

The following overview of IVF contains a mini video showing a single sperm injection into an egg (the intracytoplasmic sperm injection method or ICSI). This is the latest in IVF technology, but also the most expensive option.

Complications with in vitro fertilization (IVF)

A review article in the Journal of Obstetrics and Gynecology in March of 2004 (Ref. 3) compared the complications and outcomes of single baby pregnancies (=singletons) that were either conceived normally (control group of 1.9 million spontaneous singletons) or conceived by IVF (12,283 IVF singletons pooled from 15 studies). Compared to normally conceived babies the group of IVF conceived babies had a perinatal mortality rate, which was 2.2-fold higher, the rate of preterm deliveries was 2.0-fold higher, low birth weight was 1.8-fold higher, a very low birth weight was 2.7-fold more common and the classification of “small for gestational age” based on birth weight was 1.6-fold higher. The medical researchers found a number of reasons for this: compared to normally conceived babies, the rate of IVF conceived babies had a higher rate of placenta previa, early preterm delivery, spontaneous preterm delivery, gestational diabetes, preeclampsia, and neonatal intensive care admissions were also significantly more common.

Other observations

If anovulatory cycles are the reason for infertility, clomiphene treatment can often restore regular menstrual cycles, but according to Ref. 2 there is an 8% risk for multiple gestations (twins, triplets) with a higher infant mortality rate.

For women with tubal obstruction IVF is better than attempting to do tubal reconstruction.

Women with unexplained infertility (no cause found despite thorough investigations) are treated by controlled ovarian stimulation as mentioned above and by inserting semen from the husband into the uterine cavity through a small plastic catheter (intrauterine insemination). With this combination pregnancy success rates of 10% per cycle can be achieved and this should be the first approach to cases of unexplained infertility (Ref.2)

Fibroids in the uterus are from estrogen dominance, so are polycystic ovaries. Replacement of missing progesterone with bioidentical progesterone cream will often shrink or melt the fibroids away, cure the ovaries of polycystic disease and restore fertility (this is not taught in medical schools and will not be told to most women attending fertility clinics). There are countless numbers of women attending fertility clinics needlessly; had they only checked their hormone status with saliva hormone tests and corrected the hormone imbalances with bioidentical hormones.

In vitro fertilization with or without ICSI has a pregnancy success rate of 50% per cycle for women less than 30 years of age. Above the age of 30 these numbers are lower and genetic abnormalities are higher necessitating the more expensive ICSI fertilization method. The pregnancy rate is also directly related to how many embryos are transferred into the womb. Usually 1 or 2 embryos are inserted. Twins are not uncommon with IVF.

Conclusion

In 35 years in vitro fertilization has developed into a sophisticated tool that helps women who previously were considered to be permanently infertile to conceive a normal pregnancy. Despite these technical advances we should not lose sight why infertility is such a problem today. Two main factors come to mind: sexually transmitted diseases can scar up the Fallopian tubes making it impossible for the sperm to reach their goal, the fertile egg. Men can also get scarring of their collecting ducts for the sperm (from epididymitis) from Chlamydia and other VD. Secondly, couples are settling into marriage much later in life, often well beyond their 30th birthday. Ideally a woman should have her first pregnancy between 20 and 25, when she is most fertile. If these things don’t fall into place, there is a cost to IVF and there are the associated risks discussed.

More information on infertility: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/infertility-php/

References

1. Adam: Grainger & Allison’s Diagnostic Radiology, 5th ed. © 2008 Churchill Livingstone, CHAPTER 53 – Imaging in Obstetrics and Infertility.

2. Lentz: Comprehensive Gynecology, 6th ed. © 2012 Mosby: Treatment of the causes of infertility.

3. Review article in the Journal of Obstetrics and Gynecology in March of 2004 (March 2004, Volume 103, Issue 3: pages 551-563) examined the complication rates of IVF.

Last edited Nov. 7, 2014

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Oct
01
2008

Go Easy On Tempra And Tylenol In Young Kids

By | Asthma, Infectious Disease, Prevention

With cold and flu season around the corner, the medicine shelf will fill up with remedies that provide symptomatic relief for those who caught a bug. Children who have an elevated temperature will very likely receive over the counter medication such as Tempra drops or Tylenol for children. These preparations have been around for decades, and parents are usually confident that they are harmless.
A Lancet article points out that there are certain risks associated with them, and the most sensitive age group are the youngest children. A study documented that the mother’s use of paracetamol (identical to acetaminophen or Tylenol) during pregnancy can be associated with the development of asthma in 6 to 7 year old children. More recently 205,487 children in the age group of 6 to 7 were included in a survey. The children were from 73 centers in 31 countries. In the analysis of data the use of paracetamol in the first year of life was checked against the risk of asthma symptoms once the children were 6 to seven years old. Paracetamol use in the first year of life also played a role in the increased risk of rhinoconjunctivitis and eczema.

Go Easy On Tempra And Tylenol In Young Kids

Go Easy On Tempra And Tylenol In Young Kids

With these results, parents should resort to the children’s’ Tylenol and Tempra drops only, if fairly aggressive intervention is necessary. Too often over the counter meds are used “just in case he or she is coming down with something”. Symptomatic home remedies in children such as lukewarm baths to bring down an elevated temperature, cool fluids bring relief, and ice packs still have their place in the control of mild febrile symptoms.

The Lancet 2008; 372:1039-1048

Last edited December 3, 2012

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Jun
01
2008

Boost Babies’ Health with Mom’s Diet

By | Allergies, Asthma, Health, Nutrition, obstetrics, Prevention, Vitamins and supplements

Prenatal supplements and good advice on proper nutrition during pregnancy have long been included in proper prenatal care. Importance has been placed on folic acid to prevent neural tube defects in the fetal development. Calcium is recommended, often in the form of dairy products, but it does not end there: just swallowing the supplement and adding some more milk may be helpful but not quite enough. Certain dietary habits have been found more beneficial, such as the eating habits in the Mediterranean countries. A research team from the University of Crete in Heraclion, Greece included women who were involved in antenatal care at all general practices in Menorca, Spain. The study took place in the time frame of 12 month starting in 1997. After six and a half years 460 children were also included in the analysis.

Dietary habits were studied and assessed by food questionnaires and the children were assessed for the development of allergies and asthma.

Boost Babies’ Health with Mom’s Diet

Boost Babies’ Health with Mom’s Diet

The children of mothers who consumed the most vegetables, fish and legumes were almost 80% less likely to have persistent wheeze and more than 40 % less likely to have allergies. The results are consistent with the fact that a high level of adherence to the Mediterranean diet during pregnancy is protective not only to the mother but also to the child.

More information about prenatal visits (where nutritional habits are checked as well): http://nethealthbook.com/womens-health-gynecology-and-obstetrics/pregnancy-labor-delivery-2/prenatal-visits/

Reference: The Medical Post, April 22, 2008, page 25

Last edited December 18, 2014

Apr
01
2006

Vitamin D Deficiency Affects Asthma

By | Asthma, Nutrition, obstetrics, Vitamins and supplements

New findings from an observational study point to the intake of vitamin D during pregnancy as a way to curb childhood asthma.
Dr. Carlos Camargo at Harvard Medical School and his colleagues followed more than 2000 pregnant women and their children, and data on 1,194 subjects over the span of three years are now available. Risk factors for asthma in the children at age 3 showed an inverse relationship with the women’s consumption of vitamin D. The lowest intake of vitamin D was 356 IU; the highest was at 724 IU.
The children of mothers who consumed the highest amount of vitamin D were half as likely to have wheezing in the first three years of life compared to those whose moms had the lowest vitamin D intake.

The children’s vitamin intake did not have any effects on the result, suggesting that it is within pregnancy vitamin D supplementation is of importance.

A study of investigators in London going back to 2005 reaffirms the fact, that vitamin D has a positive impact on respiratory health. Vitamin D was given to steroid-resistant asthmatics. Authors of the study suggested that the therapeutic response to glucocorticoids was increased in this group.

Vitamin D Deficiency Affects Asthma

Vitamin D Deficiency Affects Asthma

Further epidemiological investigations are needed to study the benefits of vitamin D as an inexpensive prenatal supplement to prevent childhood asthma.

More informaation on:

1. Asthma: http://nethealthbook.com/lung-disease/asthma-introduction/

2. Vitamin D3: http://nethealthbook.com/news/higher-vitamin-d-levels-associated-lower-risk-mortality/

Reference: The Medical Post, March 21, 2006, page 1 and 60

Last edited Oct. 31, 2014

Jun
01
2005

Smoking During Pregnancy Linked To Adult Asthma

By | Asthma, Lung Disease, obstetrics, Prevention, Women’s Diseases

Smoking during pregnancy has been found to be harmful to the unborn child, and secondary smoke has long been recognized as a health risk for children. Doctors and health care providers keep on pointing out the hazards: aside the risk for the mother-to-be there are the consequences for the children: low baby birth weights, respiratory problems for children.
In the meantime there is another good reason for the pregnant woman (and other household members) to quit. Passive smoking for the unborn child and in childhood seems to have a lasting effect on the airways. There is an increased risk for adult respiratory problems and asthma, reports Dr.Trude Duelien-Skoge, who is a respiratory physician at the University of Bergen, Norway. A long-term study was concluded between 1985 and 1996 involving 2,819 adults. Those participants, who had been exposed to tobacco smoke as unborn babies, were three times more likely to develop adult asthma than individuals whose mothers were non-smokers. Exposure to tobacco smoke in childhood alone was associated with a two-fold risk for adult asthma.

The worst consequences were born by the group that was exposed to tobacco smoke as unborn children and during childhood: they were three-and-a-half times more likely to develop asthma as adults. Several studies pointed to the fact that there are structural changes in the airways of children who had prenatal exposure to tobacco smoke. This does not come as a surprise, as many toxic chemicals from cigarette smoke pass freely across the placenta, and prenatal smoke exposure has been associated with a host of childhood illnesses. From early changes the road is paved to either slow progression of disease or inducing vulnerability in the airways, which only becomes evident with later exposures.

Smoking During Pregnancy Linked To Adult Asthma

Smoking During Pregnancy Linked To Adult Asthma

Due to the far-reaching health risk it is all the more important to be aware of prevention: neither should the unborn child be exposed to cigarette smoke, nor should the growing child be subjected to it, and all efforts should be made to convince the adult smoker of the benefits of quitting smoking.

More information on:

Asthma: http://nethealthbook.com/lung-disease/asthma-introduction/

High risk pregnancies: http://nethealthbook.com/womens-health-gynecology-and-obstetrics/pregnancy-labor-delivery-2/high-risk-pregnancies/
Reference: The Medical Post, May 3, 2005, page 25

Last edited October 28, 2014

Sep
01
2003

Stillbirth Associated With High Coffee Consumption In Pregnancy

By | Nutrition, Women’s Diseases

A study entitled “Maternal consumption of coffee during pregnancy and stillbirth and infant death in first year of life” by Dr. K. Wisborg et al. was published recently in the British Medical Journal (BMJ 2003; 326: 420-423).

The pregnancy outcome of 18,478 women who completed a questionnaire at their first prenatal visit was studied. They were asked about coffee consumption and the following 4 groups were identified: group 1 consisted of the 43% of women who drank no coffee. Group 2 (34%) drank 1-3 cups per day, group 3 drank 4-7 cups per day (18%). Group 4 drank 8 or more cups per day (5%).

Below are the results in tabular form.

The surprising result was that a small amount of coffee (1-3 cups per day) was actually reducing the risk of stillbirth by 30% when compared to women who drank no coffee at all. However, from 4 cups of coffee per day or more there was a sharp increase of stillbirths within the first year (=sum of stillbirths and deaths within the first year of life).

Stillbith Associated with High Coffee Consumption in Pregnancy

Stillbith Associated with High Coffee Consumption in Pregnancy

The authors suggest that physicians should advise their pregnant patients to limit coffee consumption in pregnancy to 1 or 2 cups of coffee or the equivalent of caffeinated drinks per day as a precautionary measure.

Stillbirth coffee study
Groups with varying amounts of coffee consumption: Risk increase of stillbirth compared to group 1 as control:
group 2  (1- 3 cups per day) -30%
group 3 (4 – 7 cups per day) 80%
group 4 (8 or more cups per day) 300%

Last edited December 9, 2012