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Parenting

Flour with Added Folic Acid Is Reducing Birth Defects

2:00

Folic acid is a B vitamin that is known to help prevent certain types of birth defects in newborns. In January 1998, the FDA added a requirement that folic acid be added to breads, cereals, and other products that use enriched flour. These fortified foods include most enriched breads, flours, corn meals, rice, noodles, macaroni, and other grain products.

Since then, a new report shows that serious birth defects have fallen 35 percent. While that is certainly wonderful news, a 2014 study found that as many as 25 percent of American women are still not receiving even the minimum amount of recommended folic acid from either their diet or through supplements.

Women who don't get enough folic acid have an elevated risk of giving birth to a child with conditions called neural tube defects, the best known of which is spina bifida, which often causes paralysis.

Health experts began recommending that women of childbearing age take folic acid in 1992 because studies showed that taking 400 micrograms a day could reduce spina bifida and related birth defects by up to 70%.

Doctors now recommend that women who are considering having children start taking folic acid before trying to get pregnant. Since some pregnancies are not necessarily planned, many doctors recommend that women of childbearing age take a daily multivitamin that contains folic acid.

The benefits of folic acid have been researched for quite some time and since food producers began adding folic acid to grains, that simple step has prevented more than 1,300 babies a year from being born with spina bifida or related conditions, according to a report from the Centers for Disease Control and Prevention.

Authors of the new study found that Hispanic women are more likely to have a baby with spina bifida or a similar birth defect.

That's partly because the "masa harina" corn flour used in tortillas and other Hispanic foods isn't fortified with folic acid, the study says. The March of Dimes has petitioned the FDA to require that folic acid be added to corn flour. Adding folic acid to corn flour would prevent another 40 cases of spina bifida or related conditions each year, the report says.

"Even with fortification, there will be some women that do not get the recommended amount of folic acid every day," says Candice Burns Hoffmann, of the CDC's National Centers for Birth Defects and Developmental Disabilities. "We still have more work to do."

If you’re considering having a baby, talk to your doctor before becoming pregnant about the benefits of folic acid and how much you may need.

Sources: Liz Szabo, http://www.usatoday.com/story/news/nation/2015/01/15/folic-acid-birth-defects/21784019/

http://www.spinabifidaassociation.org

Your Baby

Should Pregnant Women Buckle-Up?

2.00 to read

Should expectant mothers buckle up and make sure the air bag is turned on before driving or riding in a car?  Absolutely say researchers in a recent study by the Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC.

Many women are concerned that, in case of an accident, seat belts and /or air bags might harm their unborn child, but according to the study, expectant mothers who are not restrained during a car crash are more likely to lose the pregnancy than those who are.

According to the March of Dimes, nearly 170,000 pregnant women are involved in a motor vehicle accident each year.

"One thing we're always concerned about is (educating) patients on seatbelt use," said Dr. Haywood Brown, the chair of Obstetrics and Gynecology at Duke University Medical Center and senior author of the new study.

"Nonetheless, like all individuals, some choose and some do not choose to wear their seatbelt," he added.

For the study, Brown and his colleagues searched through the trauma registry at Duke University Hospital. They found 126 cases of women in their 2nd and 3rd trimesters that had been in a car crash and were cared for at the hospital between 1994 and 2010.

What they discovered was that 86 mothers were wearing a seat belt when the crash occurred. Of that group, 3.5 percent or (3) fetuses died.

12 mothers were not wearing a seat belt. Of the unrestrained group, 25 percent or (3) fetuses died. 

"The bottom line is, you've got to wear your restraint because it decreases the risk not only for your injuries but injury to your child," Brown told Reuters Health.

Where should the seat belt be placed? The American College of Obstetricians and Gynecologists recommends that the seat belt be fitted low across the hipbones and below the belly.

The March of Dimes offers more seat belt and air bag guidelines for pregnant women:

  • Always wear both the lap and shoulder belt.
  • Never place the lap belt across your belly.
  • Rest the shoulder belt between your breasts and off to the side of your belly.
  • Never place the shoulder belt under your arm.
  • If possible, adjust the shoulder belt height to fit you correctly.
  • Make sure the seat belt fits snugly.
  • Driving can be tiring for anyone. Try to limit driving to no more than 5-6 hours per day.
  • Never turn off the air bags if your car has them. Instead, tilt your car seat and move it as far as possible from the dashboard or steering wheel.
  • If you are in a crash, get treatment right away to protect yourself and your baby.
  • Call your health provider at once if you have contractions, pain in your belly, or blood or fluid leaking from your vagina.

Researchers found that first time mothers were the least likely to use a seat belt. Brown noted it's possible that the habit of buckling in children might prompt mothers to put on their own seatbelt.

Mothers-to-be also worry about airbags and whether they could harm the fetus if a crash causes deployment.

In the study, airbags came out in 17 of the accidents, and in those cases the mother was more likely to experience the placenta separating from the uterus - a condition that can be fatal for the mother or the fetus.

Another researcher, not involved in the study, suggested to Reuters Health that the severity of the accidents, and not the airbags, might have been the cause of the serious consequences.

Brown said some women will disarm the airbag for fear that it will damage the baby in case of a crash, but "it's not the smart thing to do because it will save your life if the airbag comes out."

A study, from researchers in Washington State, found that airbags did not increase the risk of most pregnancy-related injuries.

No one likes to think about the damage a car accident can cause, but the reality is that seat belts and air bags save lives. Mothers-to-be, like everyone else, should use theirs when driving or riding in a car. You may need to make some adjustments so that your seat belt fits safely and correctly and the air bag is not right up next to your stomach, but taking those few extra steps could mean the difference between life and death.

Sources: Kerry Grens, http://www.reuters.com/article/2013/03/08/us-buckle-up-during-pregnancy-idUSBRE92710P20130308

http://www.marchofdimes.com/pregnancy/stayingsafe_seatbelts.html

Your Baby

Could higher cigarette taxes save babies lives?

1:45

A new study says that when the cost of cigarettes increase, fewer babies die.  The study links rising cigarette taxes to a decline in infant deaths.

Specifically, researchers said that each $1 per pack increase in the overall tobacco tax rate over the years 1999-2010 may have contributed to two fewer infant deaths each day.

The dangers of smoking during pregnancy are well documented. Complications include infant nicotine addiction, lower oxygen for the growing baby, increased chances of miscarriage, an increase of a baby developing respiratory problems and sudden infant death syndrome to name just a few.

Fortunately, U.S. smoking rates have declined during the years examined in the study – 1999 to 2010.

The research doesn't directly prove that higher taxes translate into fewer infant deaths. Still, "we found that increases in cigarette taxes and prices were associated with decreases in infant mortality," said study author Dr. Stephen Patrick, an assistant professor of pediatrics and health policy at Vanderbilt University in Nashville.

In the new study, researchers tracked infant death rates and tobacco taxes from 1999-2010, when inflation-adjusted tobacco taxes on the state and federal levels rose from 84 cents a pack to $2.37 per pack. During the same time period, the number of infant deaths per 1,000 live births fell from 7.3 to 6.2 overall, and from 14.3 to 11.3 among African-Americans.

Other factors were also considered that might influence infant mortality including family income and education. Researchers still found an association with the rising cigarette taxes.

Patrick acknowledged that it's possible that factors other than cigarette taxes contributed to the decline in the infant death rate. One possibility is that medical care improved over that time, leading to fewer deaths. But Patrick said that prospect is unlikely since such a change would presumably be seen in all states, and the study didn't reveal that kind of trend.

The researchers also examined the effect of tobacco prices, and found that increases appeared to have the same level of impact on infant mortality as tax hikes.

What about the prospect that pregnant women and new mothers might choose to spend money on tobacco -- including higher taxes -- instead of on their children? "That would only occur if smoking is a large share of the household expenditures," Levy said. And, he said, it's important to note that research has shown that higher taxes are especially likely to lead to less smoking among the poor.

While there may be other contributing factors that reduce the number of infant mortality during the research dates, researchers noted that the higher cost of cigarettes means more pregnant women will smoke either not at all or less and that’s a good thing for the babies they deliver.

The study was published online in the journal Pediatrics.

Sources: Randy Dotinga, http://www.kfvs12.com/story/30638397/higher-cigarette-taxes-tied-to-fewer-infant-deaths

http://www.webmd.com/baby/smoking-during-pregnancy

Daily Dose

More Zika Virus Cases

1:15 to read

I have been receiving a lot of phone calls from patient families, especially from mothers who are either pregnant or thinking about becoming pregnant, with their concerns and confusion over the Zika virus.  Several of these women have trips scheduled to Mexico and the Caribbean in the coming weeks, and called to ask what they should do?

While I don’t want to be an alarmist, I do think there is real concern that this virus seems ia spreading amid new reports of countries who have identified the Zika virus and associated microcephaly in newborns.  The list of countries grows daily, and in fact, the CDC website has being updated with a new map showing the distribution of the virus.  

The Zika virus is transmitted to humans by the bite of an Aedes mosquito that has been infected by the virus.  There is no human to human transmission, but a mosquito could bite an infected person and then become infected itself and go on to bite another human.  It is a cycle.  Travelers to Zika-affected countries will ultimately bring the virus back to the United States where it is expected to spread to states with warmer and humid climates (such as TX, FL, MS, LA and HA) as summer approaches.

The CDC has already issued a warning for pregnant women and those who are planning to become pregnant to avoid travel to the 20 countries ( and growing) who have known Zika virus. As I told my patients, is it worth it to go on vacation or to attend a wedding and risk ( even the slightest risk) becoming infected with this virus and having a child who is born with microcephaly (small head) and abnormal brain growth??? Short of wearing mosquito netting to cover yourself from head to toe, copious amounts of DEET insect repellent and staying inside (which is not foolproof) …I  just think it may be time to re-think plans to travel to these areas while more research and data is being gathered.  The World Health Organization and the CDC have researchers investigating all aspects of Zika virus, including trying to develop a vaccine, but all of this takes time. 

While for most people the Zika virus causes a mild illness with headache, fever, pink eye and joint aches, the effects on the unborn baby may be devastating. The CDC has also just issued guidelines for OB/Gyns who may see women who are pregnant that have returned from a trip to one of these areas with Zika and show signs of a “viral infection” with symptoms as above. In this case, the recommendation is that a blood test is done to confirm Zika virus and if the mother is positive she should have serial ultrasounds (every 3-4 weeks)  performed to monitor the baby’s head growth. Unfortunately, not all pregnant women who may be infected with the virus will have symptoms ( p to 80% of people may not feel ill ), and their babies could possibly be affected as well.  While it seems that the virus may be more likely to affect a fetus during the first trimester, it is difficult to pick up microcephaly on ultrasound before the second trimester.

So….this story continues to evolve and new recommendations should be expected as more information is gathered. But my advice continues to be…”why risk it?” . To have any concern, doubt,  or worry about exposure is enough for me to advise my patients to change their plans!

Stay tuned. This story is not going away…..

Your Baby

Eating Fish During Pregnancy Benefits Baby’s Brain Development

2:00

Can eating more fish during pregnancy help babies’ brains function better as they grow older? Yes, according to a new study from Spain. The researchers say that mothers who eat three substantial servings of fish – each week- during pregnancy may be giving their children an advantage as they mature.

Researchers followed nearly 2,000 mother-child pairs from the first trimester of pregnancy through the child’s fifth birthday and found improved brain function in the kids whose mothers ate the most fish while pregnant, compared to children of mothers who ate the least.

Even when women averaged 600 grams, or 21 ounces, of fish weekly during pregnancy, there was no sign that mercury or other pollutants associated with fish were having a negative effect that offset the apparent benefits.

“Seafood is known to be an important source of essential nutrients for brain development, but at the same time accumulates mercury from the environment, which is known to be neurotoxic,” lead author Jordi Julvez, of the Center for Research in Environmental Epidemiology in Barcelona, said in an email to Reuters Health.

This important health concern prompted the U.S. Food and Drug Administration (FDA) to come up with a guideline for pregnant women in 2014. It encourages women to eat more fish during pregnancy, but limit the intake to no more than 12 ounces per week.

For this study, researchers analyzed data from the Spanish Childhood and Environment Project, a large population study that recruited women in their first trimester of pregnancy, in four provinces of Spain, between 2004 and 2008.

Julvez and colleagues focused on records of the women’s consumption of large fatty fish such as swordfish and albacore tuna, smaller fatty fish such as mackerel, sardines, anchovies or salmon, and lean fish such as hake or sole, as well as shellfish and other seafood.

Women were tested for blood levels of vitamin D and iodine, and cord blood was tested after delivery to measure fetal exposure to mercury and PCB pollutants. At ages 14 months and five years, the children underwent tests of their cognitive abilities and Asperger Syndrome traits to assess their neuropsychological development.

On average, the women had consumed about 500 g, or three servings, of seafood per week while pregnant. But with every additional 10 g per week above that amount, children’s test scores improved, up to about 600 g. The link between higher maternal consumption and better brain development in children was especially apparent when kids were five.

The researchers also saw a consistent reduction in autism-spectrum traits with increased maternal fish consumption.

Mothers’ consumption of lean fish and large fatty fish appeared most strongly tied to children’s scores, and fish intake during the first trimester, compared to later in pregnancy, also had the strongest associations.

“I think that in general people should follow the current recommendations,” Julvez said. “Nevertheless this study pointed out that maybe some of them, particularly the American ones, should be less stringent.”

Julvez noted that there didn’t appear to be any additional benefit when women ate more than 21 ounces (about 595 g) of fish per week.

“I think it's really interesting, and it shed a lot more light on the benefits of eating fish during pregnancy,” said Dr. Ashley Roman, director of Maternal Fetal Medicine at NYU Langone Medical Center in New York.

“I think what's interesting about this study compared to some data previously is that they better quantify the relationship between how much fish is consumed in a diet and then the benefits for the fetus and ultimately the child,” said Roman, who was not involved in the study.

Roman also noted that pregnant women should avoid certain fish such as tilefish, shark, swordfish and giant mackerel. These are larger fish with longer life spans that may accumulate more mercury in their tissue.

While fish may be a great source of protein and benefit brain development in utero, most experts agree that women should consult their obstetrician about what fish are safer to eat and how much they should eat during pregnancy.

The study was published online in the January edition of the American Journal of Epidemiology

Source: Shereen Lehman, http://www.reuters.com/article/us-health-pregnancy-fish-idUSKCN0UW1S4

 

 

 

Daily Dose

The Flu Vaccine For Moms-To-Be

I have the opportunity to see (not treat) a lot of pregnant women in my practice and they have been asking me my opinion about flu vaccine during pregnancy.

They were inquiring about both seasonal flu vaccine and H1N1 (swine) flu vaccine. The statistics surrounding pregnancy, influenza and secondary infections or other complications have been documented for several years. Retrospective studies done in the late 1990s showed that healthy pregnant women were more likely to have complications from influenza and had higher death rates than expected. This was especially noted in women in the last trimester of their pregnancies. Due to these studies the CDC and ACOG (American College of Obstetrics and Gynecology) recommended that all pregnant women receive seasonal influenza vaccine. Despite these recommendations, more than 50 percent of OB’s recently surveyed do not routinely recommend flu vaccine and do not provide vaccine in their offices. I see many expectant mothers who are totally surprised when I ask them if they have received a flu vaccine from their OB. In fact only 1 in 7 pregnant women are being vaccinated. This may be partially due to the fact that OB’s have not routinely been vaccine providers, as we pediatricians have been, and are now becoming more aware about universal recommendations for flu vaccine in pregnancy and are ordering vaccine for their patients to receive during routine obstetrical visits. Flu vaccine is safe throughout pregnancy. This year is especially significant in that the H1N1 (swine) flu has also caused serious complications and deaths in pregnant women. The data shows that a disproportionate number of the deaths seen from swine flu (about 6 percent) were in pregnant women. Pregnant women are four times more likely to be hospitalized than other flu sufferers. This may be due physiological changes in lung function during pregnancy, as well as to differences in immune function. Regardless of the reasons, pregnancy in and of itself puts a woman at increased risk of serious complications, hospitalization and even death. Pregnancy is typically a time that we see the “the glow of pregnancy”, not complications or even death from having the flu. As an added benefit of vaccination, the antibodies that a pregnant woman will produce after vaccination will then be transported across the placenta to help protect the newborn. Passive transport of maternal antibodies may be the best protection for a newborn in the first two months of life. This is especially important for those infants being born during the height of the flu season. As you know we cannot give an infant flu vaccine until they are six months of age. With both H1N1 influenza currently circulating throughout the U.S. and seasonal flu yet to come, now is the time to make sure that you are vaccinated, especially if you are pregnant. Lastly, pregnant women should not receive live –attenuated flu vaccine (Flu-mist), but should receive the injectable flu vaccine for both seasonal flu and H1N1. You may receive both flu vaccines on the same day.  It is equally important for the father of the baby to be immunized against both types of flu to minimize the newborn’s risk of exposure as well. The best protection for a newborn is vaccination of those who will be caring for the infant during the flu season!! That’s your daily dose, we’ll chat again soon.

Parenting

Why Moms-To-Be Might Want to Hire a Doula

2:00

Ever heard of a doula?  You’re not alone if the answer is no.  The word “doula” comes from the ancient Greek meaning “ a woman who serves.”

According to DONA International, a doula is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.

A recent study found that women with doula care had 22% lower odds of giving birth prematurely, and were less likely to have a C-section. (Among the women with doulas, 20.4% gave birth via cesarean, compared to 34.2% of women without doulas.)

For pregnant women, doulas can offer emotional and physical support throughout the pregnancy and labor; either in a hospital setting or at home.  There are also doulas that are certified to help mothers postpartum.

While many people may not have heard of doulas, they are beginning to gain some recognition.  TIME Magazine recently published an article on the 4 reasons why moms-to-be should consider hiring one.  The author spoke with Jada Shapiro, founder of the doula referral service, Birth Day Presence, in New York City.

1. They provide extra care and support:

Although every doula has a unique approach, their main role is to care for the mom-to-be. 

“Doulas offer continuous support to women both during pregnancy and after childbirth,” Shapiro explains.

“In a way, we are trying to recreate what was typical in old-world communities when women were surrounded by a vast support system of female friends and relatives during pregnancy.”

And while doulas are not medical professionals, they possess a wealth of knowledge about pregnancy and childbirth that can be extremely helpful for expectant moms.

“We work closely with our clients to de-mystify pregnancy terminology and help women interpret their options,” says Shapiro. 

That said, one of the most common misconceptions about doulas is that they interfere with a woman’s obstetrician. Shapiro says it’s important to note that this is not the case. “Doulas complement the care a woman receives from her doctor,” she says. “We don’t get in the way of medical decisions.”

She also adds that while many people believe you can only work with a doula if you want a medicine-free birth, this is also untrue: Women with all kinds of birth plans can find it helpful to consult a doula during their pregnancy.

2. They can assist with pain management:

Moms-to-be are well aware of the stories of pain during labor and delivery as well as the growing physical un-comfortableness that comes with being pregnant.

“Doulas are well-trained in physical comfort and can offer a wide range of pain relief techniques and tools,” says Shapiro, including acupressure, hydrotherapy, birthing balls, massage, and suggesting position changes during labor. Doulas can also help moms relax with soothing imagery, music, and breathing exercises.

This individualized level of care can help moms feel a little calmer during one of the most physically and emotionally challenging days of their lives. “I believe that many mothers just feel generally more cared for and less alone during the experience of childbirth with the help of a doula,” Shapiro says.

 

3.They provide support to both moms and their partners:

“Something I hear from many of my clients is that they can’t believe how intimate their childbirth experience was, even with a doula there,” says Shapiro.

She adds that because childbirth can be such an overwhelming experience for families, having the support of a third party can be just as useful for partners as it is for moms-to-be: 

“Doulas can help recall important information from midwife or doctor appointments, lend a helping hand if mom needs a massage, or just generally absorb some of the stress from the partner,” she says. “In this way, a doula can allow partners to be fully present in the experience.”

4. They’re there for you on the big day:

“Doulas are typically on-call 24/7 during a client’s ‘due window’ of 36 to 42 weeks,” says Shapiro.

When a woman goes into labor, her doula will be available for physical and emotional support both while she’s laboring at home as well as accompanying her to the hospital.

And in addition to the aforementioned relaxation and pain relief techniques, doulas know a lot about childbirth (Shapiro, for example, has attended “more than 350” births in her 13 years as a professional doula).

“During labor, doulas might suggest alternate positions; encourage different non-medical techniques to potentially help speed up dilation, such as walking around; and just generally act as a sounding board for difficult medical decisions,” she says.

If you’re interested in learning more about doulas, you can check out the DONA International website at www.dona.org. It has information on where you can find a certified doula and how the process works.

Sources: Kathleen Mulpeter, http://news.health.com/2016/01/28/what-is-a-doula-4-reasons-pregnant-women-might-want-one/

Your Baby

Eating Chocolate While Pregnant May Improve Mom and Baby’s Health!

1:45

 Put another check in the win column for a reason to eat chocolate - as though anyone really needs one!

 A new study suggests that moms-to-be that eat a small piece of chocolate every day may improve their baby’s cardiovascular health and reduce the risk for preeclampsia.

 Researchers found that their findings held up regardless of whether the chocolate consumed contained high or low amounts of flavonoids, a group of phytochemicals that have antioxidant abilities. Various studies have also suggested that flavonoids may offer heart health benefits.

 As with most studies, the research did not prove that eating chocolate during pregnancy caused better circulatory health in pregnant women and their babies, only that there was an association.

 "Our observations suggest that a regular small consumption of dark chocolate -- whether or not the level of flavanol is high -- from the first trimester of pregnancy, could lead to an improvement of placental function," said study author Dr. Emmanuel Bujold. He is a professor of obstetrics and gynecology at Universite Laval in Quebec City, Canada.

 Bujold's team decided to see whether differences in flavanol content had any effect on the pregnancies of nearly 130 women.

 All of the women in the study were at the 11- to 14-week mark of their pregnancy, and carrying one child.

 All were instructed to consume 30 grams of chocolate (a little more than one ounce) each day over a 12-week period. That's equivalent to about one small square of chocolate per day, Bujold said.

 Half of the women consumed high-flavanol chocolate, while the other half was given low-flavanol chocolate. All were then tracked until their delivery date.

 Regardless of which type of chocolate was consumed, the women faced the same risk for both preeclampsia and routine high blood pressure. Placental weight and birth weight was also the same in both groups, the investigators found.

 Similarly, fetal and placental blood circulation levels, as well as in-utero blood velocity, did not appear to be affected by shifting flavanol levels.

 However, simply consuming a small amount of chocolate -- no matter what the flavanol content -- was associated with notable improvements in all blood circulation and velocity measures compared to the general population, the researchers said.

 Bujold said this suggests that there's something about chocolate, apart from flavanol levels, that may exert a positive influence on the course of pregnancy. Finding out exactly what that is "could lead to improvement of women's and children's health, along with a significant reduction of treatment cost," he said.

 While that’s good news for chocolate lovers, Bujold cautions that pregnant women keep the portion small and calorie intake low.

 So, a bit of chocolate daily while pregnant is not going to hurt you, in fact it just may give you and your baby’s health a little boost.

 The findings were scheduled for presentation at the Society for Maternal-Fetal Medicine's annual meeting, in Atlanta. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

 Source:  Alan Mozes, http://consumer.healthday.com/vitamins-and-nutrition-information-27/food-and-nutrition-news-316/small-square-of-chocolate-each-day-during-pregnancy-may-help-mom-and-baby-707736.html

Your Baby

Gap Between Pregnancies Linked to Autism

2:00

Does it make a difference how long a woman waits between pregnancies in the health of her newborn?  According to a new large study, the closer the pregnancies, the higher the risk that her child will have autism or other neurodevelopmental disabilities.

"Based on the current best available evidence, it appears that the ideal inter-pregnancy interval -- the time elapsed between the birth of the immediate older sibling and the conception of the younger sibling -- is 2 to 5 years, in order to reduce the risk of autism," said study author Dr. Agustin Conde-Agudelo. He is a researcher at the World Health Organization Collaborating Center in Human Reproduction at the University of Valle in Cali, Colombia.

Researchers looked at existing studies involving more than 1.1 million children and also found that waiting too long between pregnancies (5 years or more) could raise the odds of autism.

The reasons for the link between short pregnancy spacing and autism are not known noted Conde-Agudelo. He said that scientists believe nutrition and other factors may play a role.

The study doesn’t prove that either long or short intervals between pregnancies actually causes autism, just that there seems to be an association between the two.

Conde-Agudelo and his team reviewed seven large studies reporting a link between short birth spacing and autism. The investigators found that children born to women with less than 12 months between pregnancies were nearly twice as likely to develop autism as children born to women with three years or longer between pregnancies.

Three of those studies also reported a significant link between long pregnancy spacing and autism, especially for two milder types, which were formerly called Asperger's syndrome and pervasive developmental disorder.

Meanwhile, the findings also suggested that shorter pregnancy spacing was associated with an increased risk of developmental delays and cerebral palsy, which can affect body movement, muscle coordination and balance.

Conde-Agudelo and other researchers conjectured that the mother’s depleted levels of folic acid between closely spaced pregnancies might play a role in the rise of autism risk.

The B vitamin folic acid is necessary for proper brain and spinal cord development in fetuses, and women are typically advised to take folic acid supplements during pregnancy.

As for longer pregnancy intervals also potentially linked to autism, Conde-Agudelo said it's been hypothesized that related factors such as infertility, unintended pregnancy and maternal inflammation levels may affect autism possibility.

Most neurodevelopmental disabilities, including autism, are thought to be caused by a complex mix of factors. These include genetics, environment, parental health and behaviors during pregnancy, and complications during birth, the researchers said in background notes.

The study was published in the April online edition of the journal Pediatrics, and will appear in the May print issue.

Story source: Maureen Salamon,  http://consumer.healthday.com/cognitive-health-information-26/autism-news-51/pregnancies-close-together-may-raise-autism-risk-study-says-709733.html

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