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Fertility Drugs Contribute Heavily to Multiple Births

January 16, 2010 By

fertility drugs contribute heavily to multipla births_The widespread use of so-called fertility drugs, not just high-tech laboratory procedures, likely plays a larger role than previously realized in the growing problem of premature births in the United States, because these drugs cause a high percentage of multiple births, the March of Dimes said today.

The organization’s comments came in response to a study published in the American Journal of Epidemiology by authors from the Centers for Disease Control and Prevention (CDC) and the March of Dimes that found controlled ovarian hyperstimulation (COH) drugs — used to stimulate a woman’s ovaries to speed the maturity and multiply the production of eggs — accounts for four times more live births than assisted reproductive technologies (ARTs) such as in vitro fertilization.

“Many people have focused on the role of ARTs in multiples and have not fully appreciated that fertility drugs alone are responsible for one out of every five multiple births,” said Alan R. Fleischman, M.D., medical director of the March of Dimes. “COH drugs are widely prescribed, and some health care professionals — and their patients — are not aware of the serious risks of fertility drugs to women and their babies. There is a very high possibility of multi-fetal pregnancy resulting from use of these drugs, and that brings a high risk of prematurity and lifelong health problems for the babies as a consequence.”

“The March of Dimes urges more research and leadership from professional societies to develop specific guidelines and encourage acceptance of best practices for the proper use and dosage of fertility drugs, as well as the careful counseling and monitoring of women treated with these drugs. Women who are taking fertility drugs should always ask their doctor what they can do to prevent having a multi-fetal pregnancy,” Dr. Fleischman said.

Dr. Fleischman noted that approximately 88,000 babies are born preterm annually as a result of the recent increase of twins, triplets, and other multiple births. About 60 percent of twins, more than 90 percent of triplets, and virtually all quadruplets and higher-order multiples are born prematurely, he noted. In addition to the increased risks associated with multiple birth, studies have also suggested that even infants born singly, but conceived with ovulation stimulation are at increased risk for preterm delivery than naturally conceived single births, the study authors pointed out.

Dr. Fleischman said it is critical for the American Society for Reproductive Medicine, the American College of Obstetricians and Gynecologists, and other clinical societies to develop clear guidelines on the use of fertility drugs to help prevent many premature births.

The study found that 4.6 percent of live births in 2005 resulted from fertility drug use, a figure 4 times higher than the 1.2 percent of births resulting from ARTs. A total of 22.8 percent of babies born as multiples were conceived using fertility drugs alone.

The study authors conclude that more than 190,000 infants per year are conceived with fertility drug use, but also say this figure is an underestimate because there is no system for population-based surveillance of births resulting from fertility drug treatment.

“The estimates from this analysis, together with separate published estimates from the National ART surveillance system, indicate that in all, approximately 6 percent of US infants are now exposed to ovulation stimulation treatments,” stated Laura Schieve, epidemiologist at the CDC’s National Center on Birth Defects and Developmental Disabilities. “Thus, we must continue to study both the short- and long-term health outcomes among the many women treated and the many children annually conceived with these infertility treatments.”

More than 540,000 babies are born too soon each year in the U.S. Preterm birth costs the nation more than $26 billion annually, according to the Institute of Medicine. It is the leading cause of newborn death, and babies who survive an early birth face the risk of lifelong health problems such as breathing problems, mental retardation, cerebral palsy, developmental delays, vision and hearing loss. Even babies born just a few weeks too soon (34-36 weeks gestation, also known as late preterm birth) have higher rates of death and disability than full-term babies.

The March of Dimes is the leading nonprofit organization for pregnancy and baby health. With chapters nationwide and its premier event, March for Babies(R), the March of Dimes works to improve the health of babies by preventing birth defects, premature birth and infant mortality. For the latest resources and information, visit marchofdimes.com or nacersano.org. For free access to national, state, county and city-level maternal and infant health data, visit PeriStats, at marchofdimes.com/PeriStats. PR Newswire

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Adolescents With Earlier Bedtimes At Less Risk Of Depression, Suicidal Thoughts

January 2, 2010 By

adolescents with earlier bedtime_A study in the Jan. 1 issue of the journal Sleep found that adolescents with bedtimes that were set earlier by parents were significantly less likely to suffer from depression and to think about committing suicide, suggesting that earlier bedtimes could have a protective effect by lengthening sleep duration and increasing the likelihood of getting enough sleep.

Results show that adolescents with parental set bedtimes of midnight or later were 24 percent more likely to suffer from depression (odds ratio = 1.24) and 20 percent more likely to have suicidal ideation (OR=1.20) than adolescents with parental set bedtimes of 10 p.m. or earlier. This association was appreciably attenuated by self-reported sleep duration and the perception of getting enough sleep. Adolescents who reported that they usually sleep for five or fewer hours per night were 71 percent more likely to suffer from depression (OR=1.71) and 48 percent more likely to think about committing suicide (OR=1.48) than those who reported getting eight hours of nightly sleep. Participants who reported that they “usually get enough sleep” were significantly less likely to suffer from depression (OR=0.35) and suicidal ideation (OR=0.71).

Lead author James E. Gangwisch, PhD, assistant professor at Columbia University Medical Center in New York, N.Y., said that the results strengthen the argument that short sleep duration could play a role in the etiology of depression.

“Our results are consistent with the theory that inadequate sleep is a risk factor for depression, working with other risk and protective factors through multiple possible causal pathways to the development of this mood disorder,” said Gangwisch. “Adequate quality sleep could therefore be a preventative measure against depression and a treatment for depression.”

Data were collected from 15,659 adolescents and their parents who had participated in the National Longitudinal Study of Adolescent Health (Add Health), a school-based, nationally representative, probability-based sample of U.S. students in grades seven to 12 in 1994 to 1996. Seven percent of participants (1,050) were found to have depression using the Centers for Epidemiologic Study-Depression Scale, and 13 percent (2,038) reported that they seriously thought about committing suicide during the past 12 months. Depression and suicidal ideation were associated with later parental set bedtime, shorter sleep duration, self-perception of not getting enough sleep, female sex, older age and lower self-perception of how much parents care.

Fifty-four percent of parents reported that their adolescent had to go to bed by 10 p.m. or earlier on weeknights, 21 percent reported setting a bedtime of 11 p.m., and 25 percent reported setting a bedtime of midnight or later. Caucasians were more likely than adolescents of other racial/ethnic groups to have a parental set bedtime of 11 p.m. Nearly 70 percent of adolescents reported going to bed at a time that complied with the weeknight bedtime that was set by their parents. Adolescents reported going to bed only about five minutes later on average than their parental set bedtime.

The average adolescent-reported sleep duration was seven hours and 53 minutes, which contrasted sharply with the nine or more hours of nightly sleep that the AASM recommends for adolescents. Participants with a parental set bedtime of 10 p.m. or earlier reported that they usually slept for an average of eight hours and 10 minutes, which was 33 minutes more than adolescents with a bedtime of 11 p.m. (seven hours, 37 minutes) and 40 minutes more than those with a bedtime of midnight or later (seven hours, 30 minutes). With the exception of sleep durations of 10 hours or more per night, higher average self-reported sleep durations were associated with progressively earlier average bedtimes.

The authors reported that there are a number of potential mechanisms by which chronic partial sleep deprivation could contribute to depression and suicidal ideation. A lack of sleep may affect the modulation of emotional brain responses to aversive stimuli; produce moodiness that hinders the ability to cope with daily stresses and impairs relationships with peers and adults; and affect judgment, concentration and impulse control.

They also suggested that behavioral interventions that involve educating adolescents and their parents about healthier sleep hygiene practices and helping them modify maladaptive sleep habits could sever as primary preventative measures against depression and suicidal ideation.

An abstract of this study (#1064) was presented in Seattle, Wash., on June 9, 2009, at SLEEP 2009, the 23rd Annual Meeting of the Associated Professional Sleep Societies LLC (APSS). redOrbit

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Study: Eating Fish Reduces Dementia Risk

July 21, 2009 By

fish filet_Kathleen Blanchard – A large recent study shows that regular fish consumption can reduce our risk of dementia, a condition that affects 24 million people worldwide. The benefits of fish oil have been widely studied. The new study is the first to explore dementia and dietary fish intake in low to middle income countries.

The study, published in the August 2009 issue of the American Journal of Clinical Nutrition, suggests that Omega 3 fatty acids from fish oils can help ward of dementia later in life, extending previous findings that fish oils are beneficial for brain health.

Investigators explored dementia and diet in seven countries to find the link, conducting face to face interviews and assessments of cognitive decline among 14,960 participants in China, India, Cuba, the Dominican Republic, Venezuela, Mexico, and Peru.

With the exception of India, fish consumption was found to be associated with lower incidence of dementia in low to middle income countries. The study group included individuals over age 65.

Oily fish are a good source of polyunsaturated fatty acid, known to contribute to overall health and well-being. Fish oils can help prevent heart disease, heart attack, by reducing inflammation. Omega 3 fatty acids have also been found to be neuroprotective, preserving brain function, in past studies.

Previous studies of industrialized countries have shown that omega 3 fatty acids from fish can slow cognitive decline, and is linked to lower risk of dementia with aging. Because red meat consumption is higher in industrialized societies, scientists have been unable to determine if red meat consumption contributes to dementia.

The researchers are still not certain whether red meat contributes to declining brain health and memory loss, though there was a modest increase in dementia found among older individuals who consume more red meat.

The current study supports the role of omega 3 fatty acids from fish to reduce our chances of dementia. The research clarifies that dementia risk is  reduced in low to middle income countries as the result of consuming fish, extending previous research in industrialized countries. Consuming more fish can reduce our risk of dementia later in life, especially combined with other healthy lifestyle factors to include regular aerobic activity.

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