Child health news round-up (February 22 – March1, 2010)
Contents:
* IVF babies do fine, but their moms may be at risk
* IVF stillbirth risk four times higher, study finds
* Heart disease risk tied to mom’s number of births
* Physically fit students do better academically too: study
* Fertility problems may not affect kids’ coordination
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IVF babies do fine, but their moms may be at risk Tue Feb 23, 2010 3:16pm EST
NEW YORK (Reuters Health) – Babies born by in vitro fertilization (IVF) do not face an increased risk of birth defects, nor are they at greater risk of being smaller than normal, according to a study conducted in Japan.
But the researchers did find that women pregnant via IVF were more likely than those who conceived naturally to develop a pregnancy complication called placenta previa, in which the placenta blocks the opening to the birth canal.
Some studies comparing babies born through IVF and those conceived naturally have found worse outcomes for the IVF infants, including higher rates of birth defects and greater likelihood of low birth weight, Mai Fujii of the World Health Organization in Geneva and her colleagues note in their report.
But the authors of a review of the best available data on IVF outcomes published in 2005 concluded that the risks of IVF compared with other fertility boosting methods, such as drugs to stimulate egg production or artificial insemination, are “unknown,” Fujii and her team add.
In the current study, the researchers compared nearly 54,000 naturally conceived single babies with about 1,400 single babies born via IVF; the sample represented 6 percent of all babies born in Japan in 2006.
Just 23 of the IVF babies died as newborns, such a small number that the researchers were unable to gauge whether or not IVF increased infant death risk. About one in five IVF babies were low birth weight, compared to about one in six naturally conceived babies (the control group), but the difference was no longer statistically significant after the researchers adjusted for mother’s age, a baby’s gestational age at birth, and other factors.
About 2 percent of both the IVF babies and the control group infants had birth defects. While there is some evidence that IVF is linked to certain types of birth defects, the researchers note, the current study did not include specific information on the malformations infants had.
Both groups of babies were at similar risk of being born small for gestational age, while the ratio of boys to girls born was the same in the IVF and the control group.
These findings offer no evidence that IVF babies are more likely to have problems than naturally conceived infants, the researchers say, but they note that the small number of infant deaths and birth defects means they can’t rule out “small to moderate increases” in these risks.
However, 5 percent of women who became pregnant via IVF developed placenta previa, compared to 1.5 percent of the women who conceived naturally.
Placenta previa is a complication that occurs in the second or third trimester of pregnancy, which can lead to heavy vaginal bleeding and interfere with the birth process. According to the American College of Obstetricians and Gynecologists, placenta previa occurs in 1 in 200 women. It is more common in women who have had more than one child, have had a cesarean section, have had surgery on the uterus, and who are pregnant with twins or triplets.
SOURCE: Fertility and Sterility, online February 1, 2010.
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IVF stillbirth risk four times higher, study finds Kate Kelland (Editing by Andrew Roche) Tue Feb 23, 2010
LONDON (Reuters) – Women who get pregnant through in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) have a higher risk of stillbirth, scientists have found, although the overall risk is still low.
Researchers from Aarhus University Hospital in Denmark studied 20,000 single pregnancies and found a four-fold increased risk of stillbirths for women who had IVF or ICSI compared with women who conceived naturally.
“The results from our study emphasize the need for continuous follow-up of the outcome of fertility treatments so that the information given to infertile couples seeking treatment can be differentiated to their individual circumstances,” Kirsten Wisborg, who led the study, wrote in the Human Reproduction journal Wednesday.
She added, however, that the risk of stillbirth was still very low for IVF and ICSI pregnancies. The rate of stillbirth after IVF/ICSI was 16.2 per thousand, compared to 3.7 per thousand in fertile couples who conceived without medical help.
The researchers said it was not yet clear whether the increased risk was due to the fertility treatment itself or because of unknown factors specific to couples who IVF or ICSI.
IVF is the fertilization of an egg by sperm in a laboratory dish. In ICSI, an egg is fertilized by injecting a single sperm into it.
Doctors previously thought the greater risk of bad outcomes like stillbirths in assisted reproduction might be something to do with the underlying infertility of couples who have it.
But Wisborg and colleagues found that fertile couples who conceived within a year of trying, and so-called “sub-fertile” couples who took longer to conceive, had a similar risk to each other.
“This may indicate that the increased risk of stillbirth is not explained by infertility and may be due to other, as yet unexplained factors, such as the technology involved in IVF and ICSI or some physiological difference in the couples that require (it),” Wisborg wrote.
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Heart disease risk tied to mom’s number of births Joene Hendry Thu Feb 25, 2010
SOURCE: American Heart Journal, February 2010
NEW YORK (Reuters Health) – A woman’s risk of heart disease and stroke in middle-age and beyond may be associated with the number of children she gives birth to, a large study of Swedish women hints.
HEALTH
“Women having two births had the lowest risk of future cardiovascular disease,” Dr. Erik Ingelsson, at Karolinska Institutet in Stockholm, noted in an email to Reuters Health, while women having five or more births had the highest risk.
Prior studies looking at ties between number of births and women’s later risk of heart disease have yielded conflicting results. Most of these studies were small. Ingelsson and his colleagues looked for an association between number of births and heart disease risk in 1.3 million Swedish women after they turned 50.
During follow up lasting up to 23 years (average of 9.5 years), more than 65,000 heart disease-related events such as heart attack or stroke occurred, the researchers report in American Heart Journal.
Compared with women who gave birth twice (the lowest risk group), women with no, one, or three births had about 10 percent greater risk of future heart disease. The risk was 30 percent higher in women with four births and nearly 60 percent higher in women with five or more births.
The investigators found similar risks when analyzing a subset of nearly 600,000 women with complete pregnancy and birth records and at least one birth between 1973 and 2005. Taking into account pregnancy complications such as high blood pressure and pregnancy-related diabetes, and birth-related complications did not explain the link between number of births and later heart disease and stroke risk.
Pregnancy leads to marked changes in how blood flows in and through blood vessels, which can alter risk for heart disease and stroke. Ingelsson and colleagues say a better understanding of these changes may lead to a better understanding of heart disease and stroke in women.
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Physically fit students do better academically too: study Thu Feb 25, 2010 (Reporting by Joene Hendry of Reuters Health, Editing by Belinda Goldsmith)
NEW YORK (Reuters Health) – Getting students to exercise more might not just address obesity issues but also improve their grades with a U.S. study finding physically fit students tend to score higher in tests than their less fit peers.
Test scores dropped more than one point for each extra minute it took middle and high school students to complete a one mile run/walk fitness test, according to Dr. William J. McCarthy and colleagues at the University of California in Los Angeles.
Schools and parents seeking to optimize their students’ academic performance should take heed, McCarthy noted in an email to Reuters Health.
For optimal brain function “it’s good to be both aerobically fit and to have a healthy body shape.”
McCarthy and colleagues compared physical fitness and body weight measures with scores on California’s standardized math, reading, and language tests among 749 fifth-graders, 761 seventh-graders, and 479 ninth-graders who attended schools in Southern California between 2002 and 2003.
About half of the students were girls, 60 percent were white, 26 percent were of Hispanic ethnicity, and about 7 percent each were African American and Asian/Pacific Islander.
Almost 32 percent of the students were overweight and about 28 percent were obese, the researchers report in The Journal of Pediatrics. The researchers estimated students’ aerobic fitness according to their one-mile run/walk time on a flat track. With a 15-minute maximum allowed time to complete the test, the boys averaged slightly less than 10 minutes, while the girls averaged a little less than 11 minutes.
McCarthy’s team found that nearly two thirds of the students (65 percent) fell below the state fitness standard for their age and gender. Compared with these students, students who met or exceeded fitness standards had higher average test scores. Allowing for age, social and economic status, gender, ethnicity, and body size did not significantly alter this association.
Compared with students of desirable weight, overweight and obese students also scored significantly lower on tests, the researchers found.
These findings, McCarthy’s team notes, confirm and extend those of previous investigations. They say further studies are needed to figure out why aerobic fitness may play a role in academic performance.
If future studies confirm a cause-and-effect link between lower fitness and reduced academic performance, “schools will have to reverse their recent disinvestment in physical education ostensibly for the purposes of boosting student achievement,” they concluded.
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Fertility problems may not affect kids’ coordination Fri Feb 26, 2010
SOURCE: Human Reproduction, online February 6, 2010
NEW YORK (Reuters Health) – Despite some concerns to the contrary, parents’ fertility problems may have little effect on their children’s risk of coordination problems as they reach school age, a new study finds.
HEALTH
Some past research has found that babies born with the help of fertility treatment may, on average, have a slight delay in reaching some developmental milestones, like sitting up or walking.
That raises the question of whether they are more likely than their peers to have movement and coordination problems as they get older.
The new study, published in the journal Human Reproduction, looked at the risk of so-called developmental coordination disorder among 7-year-olds born to parents with and without fertility problems.
It’s estimated that about 5 percent of school-age children have some degree of developmental coordination disorder, which typically manifests as a persistent clumsiness. Children may frequently trip over their own feet, bump into things and have difficulty running, jumping or catching a ball. Some kids also have problems with fine motor skills, like writing and tying shoes.
The main concern with the disorder is that children may develop low self-esteem, sustain injuries when they try to be active, or avoid exercise altogether.
In the current study, researchers found that among more than 23,000 Danish 7-year-olds followed since birth, those conceived through infertility treatments had no increased risk of developmental coordination disorder. Nor was any particular infertility procedure linked to a heightened risk.
There was, however, evidence of a slightly higher risk of developmental coordination disorder among children whose parents had fertility problems but ultimately conceived naturally. These children — whose parents took longer than one year to conceive — were 35 percent more likely than children born to parents without fertility problems to screen positive for developmental coordination disorder.
Still, the vast majority did not have the disorder. Of the 1,614 children whose parents took longer than a year to conceive, 4 percent had signs and symptoms of developmental coordination disorder based on a standard screening questionnaire.
That compared with 3 percent of the 14,928 children whose parents had no fertility problems, and 3.5 percent of children conceived through infertility treatments.
“Our findings are overall reassuring,” write the researchers, led by Dr. Jin Liang Zhu of the University of Aarhus in Denmark.
Low fertility, they add, “may be modestly associated with the risk of developmental coordination disorder, but nothing in this study indicates an increased developmental coordination disorder risk related to assisted reproduction technologies.”
The researchers also found that children with delays in early developmental milestones, regardless of parents’ fertility, had a heightened risk of screening positive for developmental coordination disorder at age 7.
Compared with their peers, children who were not able to sit up on their own at 9 months of age were five times more likely to screen positive; the risk was nearly eight times higher among children who could not walk alone at the age of 16 months.
The findings, according to Zhu’s team, suggest that parents of children with such early developmental delays should talk with their doctors about any therapy that might be beneficial.