Health Tip: Sleep Positions While You're Pregnant

As your pregnancy progresses, sleeping may become a little more uncomfortable each month.The American Pregnancy Association offers these suggestions to help you sleep more comfortably during pregnancy:

* Try sleeping on your side -- particularly your left side, if it's comfortable. Bend your knees, and place a pillow between your knees.
* Also try a pillow under your belly, for support.
* If heartburn bothers you, prop up your upper body with pillows.
* If you feel short of breath, lie on your side or propped up with pillows.
* You should avoid sleeping on your back and on your stomach during pregnancy.

Robot Playmates Help Autistic Kids With Social Skills

Many children with Autism Spectrum Disorders (ASD) interact more easily with mechanical devices than with humans, according to new reports. Researchers at the University of Southern California Viterbi School of Engineering, who have presented their finding at various conferences in the United States and in Europe this summer, found that Socially Assisted Robotics (SAR) that blow bubbles, toot horns and even make facial expressions appear to increase the child's speech and interaction levels.

"I am gratified by these preliminary results," Maja Mataric, a professor at the USC Interaction Laboratory, said in a news releases issued by the university. "I believe that Socially Assistive Robotics has a part to play in helping families, both the affected children and their parents and siblings."

The initial study, reported in a June Conference on Interaction Design for Children with Special Needs in Chicago, paired an ASD child with a colorful bubble-blowing wheeled robot that either operated on its own or blew bubbles when the child pushed a button.

"We found that the behavior of the robot affects the social behavior of a child (both human-human interaction and human-robot interaction): social behavior with a contingent robot was greater than with a random robot," the report stated.

"Generally, when the robot was acting contingently, the child was more sociable," the authors wrote.

Two other presentations -- made at the International Symposium on Experimental Robotics in Athens, Greece, in July, and at the IEEE Proceedings of the International Workshop on Robot and Human Interactive Communication -- discuss these results and efforts to make the robots flexible and useful tools in ASD therapy.

High Blood Sugar Tied to Pregnancy Complications

By Serena Gordon
HealthDay Reporter Wed May 7, 11:46 PM ET

WEDNESDAY, May 7 (HealthDay News) -- Women with high blood sugar levels during pregnancy face an increased risk of complications, even if the high blood sugar readings don't meet the criteria for gestational diabetes.
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In a large, international study, researchers found that for each standard deviation increase in blood sugar, there was a greater risk of complications, such as having a large birth weight baby or needing a Caesarean section delivery.

"We found strong independent associations between a mother's blood sugar levels during an oral glucose tolerance test and 28 weeks of gestation and the pregnancy outcomes," said the study's lead author, Dr. Boyd Metzger, the Tom D. Spies professor of metabolism and nutrition at the Feinberg School of Medicine at Northwestern University in Chicago.

What this means for pregnant women right now, however, isn't clear.

"Because the relationship between the mother's blood glucose level and risk tend to be continuous and linear, it is not clear where the risk reaches the point where treatment should optimally begin," said Metzger.

"We were hoping there would be a breakpoint," explained another of the study's authors, Dr. Don Coustan, professor and chair of obstetrics and gynecology at the Warren Alpert Medical School of Brown University in Providence, R.I. "But, the relationship between glucose levels and outcomes were continuous, which means it will be difficult to decide where to put the 'treating' point."

Coustan added that there will be a conference in June where pregnancy and diabetes experts will likely debate the pros and cons of treating hyperglycemia. For now, he said, he suspects that "doctors will still use the glucose threshold they're currently using."

One thing that was clear from the study is that higher odds of complications, like an increased risk of C-section or a large baby, are related to high blood sugar and not to other conditions, such as obesity or older maternal age, according to Metzger.

Results of the study were published in the May 8 issue of the New England Journal of Medicine.

The study included more than 23,000 pregnant women from 15 centers in nine countries. None of the women had diabetes. All of the women underwent glucose tolerance testing between 24 and 32 weeks of gestation. This test is performed by first taking a fasting blood sugar reading, then having the woman drink a high-carbohydrate liquid -- in this case a 75-gram carbohydrate drink; 100 grams is standard in the United States -- and then rechecking blood sugar levels at one and two hours to assess how the body is processing the high sugar load.

The higher a woman's blood sugar levels were, the more likely she was to have a C-section, to develop preeclampsia, have premature delivery and to have the delivery complication known as shoulder dystocia, the study found.

Babies born to women with higher glucose levels were more likely to have high insulin levels, low blood sugar, and to have a large birth weight, all indications of exposure to high glucose levels.

The odds of these complications changed continuously as blood sugar levels rose. For example, a woman with the highest levels of blood sugar (but not diabetes) had large babies 26 percent of the time, compared to just 5 percent for women with the lowest blood sugar levels.

"Basically, what they found out is that there is no threshold where you know to treat. That makes it difficult to know what to do with these findings," said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

A second study in the same issue of the journal looked at the use of the oral diabetes medication metformin, versus insulin, the standard treatment for gestational diabetes. The study included 751 women, randomly assigned to receive metformin or insulin treatment.

The researchers found that metformin was well-tolerated, although almost 43 percent of the women eventually required the use of supplemental insulin. There were no serious adverse events reported for mother or baby from the use of metformin, according to the study.

Of this study, Zonszein said, "My guess is that until we have larger studies, there's not going to be a big change in recommendations, because we have so much experience with insulin." But, he added, many women and obstetricians may welcome these findings because "giving a pill is easier than giving insulin." He said another oral medication, glyburide, was also found effective in another small trial.

Mom's high normal blood sugar risky: study

By Karla Gale Thu May 8, 8:54 AM ET

NEW YORK (Reuters Health) - Pregnant women who have blood sugar levels above normal but below those signaling full-blown diabetes are more likely than women with lower blood sugar levels to experience several adverse pregnancy outcomes, new research indicates.

It is well known that high blood sugar levels indicative of the diabetes that occurs during pregnancy present risks for expectant mothers and their infants. The current study is believed to be the first to show that higher blood sugar levels -- not high enough to be considered diabetes -- also convey these increased risks.

In a study of nearly 24,000 pregnant women who had their blood sugar levels tested between 24 and 32 weeks of pregnancy, researchers found that the higher the mother's blood sugar level, the greater the chances that she would require Caesarean delivery and deliver an abnormally large baby.

Dr. Boyd E. Metzger from Northwestern University Feinberg School of Medicine in Chicago, and colleagues also found that the higher the mother's blood sugar levels, the more likely the women were to develop a potentially serious condition called preeclampsia marked by a spike in blood pressure and the more likely their infants were to be born prematurely, and to experience shoulder dystocia -- a condition in which an infant's shoulder becomes lodged inside the mother's body, effectively halting the birth process.

"These relationships are continuous and generally increase incrementally over the range of blood (sugar) levels we saw in the study," Metzger noted in a statement.

The question remains, Metzger told Reuters Health, "at what level of risk should we intervene? That is a big question that can't be addressed by this research."

He noted that a meeting to discuss these issues is scheduled next month immediately following the annual meeting of the American Diabetes Association.

SOURCE: The New England Journal of Medicine, May 8, 2008.

Gene May Be Key to Pregnancy Complication

By Steven Reinberg
HealthDay Reporter Mon May 12, 11:47 PM ET

MONDAY, May 12 (HealthDay News) -- A gene called COMT, already known for its role in schizophrenia, also plays a significant part in the dangerous obstetric complication known as preeclampsia, a new study finds.

Although the current study was done in mice, the researchers envision a time when the findings could be used as a test to identify women at risk of preeclampsia -- and even as a means of preventing the condition.

"This gene regulates the oxygenation of the placenta," explained lead researcher Raghu Kalluri, a professor of medicine at Harvard Medical School. "Preeclampsia is a pregnancy disorder where the placenta is hypoxic (isn't receiving enough oxygen)," he added.

Preeclampsia, which affects about 5 percent of all pregnancies, is a leading cause of sickness for pregnant women and their infants. Symptoms of preeclampsia include high blood pressure, protein in the urine and swelling.

The COMPT (catechol-O-methyltransferase) gene is involved in breaking out estrogen into a metabolite called 2ME (2-methoxyestradiol), which prevents a shortage of oxygen in the placenta. When the gene does not function properly, levels of 2-ME are reduced, setting in motion a series of events that lead to preeclampsia, Kalluri explained.

The report was published online in the May 12 issue of Nature.

In their current experiments, the researchers worked with mice that did not have the COMT gene, and therefore do not produce 2-ME. After 14 weeks of gestation -- equivalent to the third trimester of human pregnancy -- the mice developed high blood pressure and other symptoms of preeclampsia, the researchers found.

The mice also delivered their pups earlier than normal, with a high incidence of stillborn offspring. Once the pups were delivered, the mother's health return to normal, the researchers found.

However, when the mice were given supplemental 2-ME, symptoms of preeclampsia disappeared, Kalluri said.

Kalluri's team found that COMT levels were deficient, and 2-ME levels were also lower, in women diagnosed with preeclampsia.

Because 2-ME is found in the blood and urine, the researchers hope to use their finding to develop a urine test that would identify women at risk from preeclampsia, Kalluri said. "This can be designed as a urine strip test, like pregnancy tests are," he said.

In addition, giving 2-ME to women who have low levels of this protein may prevent them from developing preeclampsia, Kalluri said. "We can give back the missing amount to bring levels back to where they should be," he said.

One expert believes the results are promising, but said more work is needed before 2-ME could become either a screening test or treatment.

"This is an interesting and novel study, which gives insight into the pathophysiology of preeclampsia," said Dr. Arun Jeyabalan, an assistant professor in the division of maternal fetal medicine in the department of Obstetrics, Gynecology and Reproductive Sciences at Magee Women's Hospital, University of Pittsburgh.

Jeyabalan said that it will be sometime before these findings can be extended to patients. Using these findings to develop a screening test is something worth looking into, she added.

"Most of this work is of animals, and I think we have to be cautious before we extend these findings to humans," Jeyabalan said. "But it is something that is definitely worth testing in the future."

Breastfeeding halves rheumatoid arthritis risk

Tue May 13, 1:55 AM ET

LONDON (Reuters) - Women who breastfeed their babies longer are less likely to get rheumatoid arthritis, Swedish researchers said on Tuesday.
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Mothers who breastfed for 13 months or more were half as likely to get the painful joint condition as women who never breastfed, said Mitra Pikwer and colleagues at the Malmo University Hospital in Sweden, who led the study.

"Although it is difficult to separate the effect of breast feeding from that of childbirth, our data suggest that rheumatoid arthritis is inversely associated with long-term breastfeeding, rather than with the number of children born," they said.

The researchers said they wanted to see if a larger, community-based study would echo earlier studies on the links between breastfeeding or the use of oral contraceptives and the condition affecting about 20 million people worldwide.

Rheumatoid arthritis is an autoimmune disease caused when the body confuses healthy tissues for foreign substances and attacks itself.

Some drugs to treat the condition seek to reduce inflammation directly while others tone down the immune system's response, which can leave some patients vulnerable to infections and cancer.

The Swedish team compared 136 women with rheumatoid arthritis and 544 women of similar age without the disease. They also found that breastfeeding for between up to 12 months made women 25 percent less likely to get the joint condition.

The findings bolster previous research linking breastfeeding to a reduced risk of the disease. But, as with other studies, the Swedish teams said they did not know the exact reason why.

Breastfeeding is known to provide multiple benefits for the baby and studies have shown the practice may also protect mothers from breast and ovarian cancers.

The study published in the British Medical Journal's Annals of the Rheumatic Diseases also suggested that oral contraceptives -- thought to offer protection because they contain certain hormones -- did not seem to make a difference.

(Reporting by Michael Kahn)

28 million women at risk of unwanted pregnancy

Tue May 13, 11:07 AM ET

CHICAGO (Reuters) - Each year, half of American women who would rather not get pregnant will have an unplanned pregnancy, often because they failed to use their contraceptive properly or forgot to use it at all, U.S. researchers said on Tuesday.

As a result, 28 million women in the United States are at risk for an unintended pregnancy, according to the study conducted by the Guttmacher Institute in New York.

They found one in four women is very likely to become pregnant because of inconsistent contraception use.

Some of this gap is due to lack of access to health care, with many women saying they cannot afford some of the more effective methods of contraception such as birth control pills that require a doctor's visit and prescription.

"It is critical to have a better understanding of what is preventing women from using contraception consistently and correctly, or even at all," Dr. Jennifer Frost, a senior research associate at Guttmacher, said in statement.

The research involved surveys of women and family planning providers nationwide. Among the results, they found that more than half of women who have a gap in contraceptive use of at least one month have experienced some type of major life event -- such as the end of a relationship, a move, job change or personal crisis.

They also found that many women are not satisfied with their current method of contraception, a problem that can lead to missing birth control pills or failure to keep a condom handy, for example.

Last month the National Center for Health Statistics reported there were almost 6.4 million pregnancies in 2004, down 6 percent from 1990. Forty-five percent were to women who were not married, and there were 1.22 million abortions and 1.06 million stillbirths and miscarriages.

The researchers also found that many women who are lax about birth control are simply ambivalent about preventing a pregnancy and confessed that they would be very pleased if they found out they were pregnant.

The researchers said women who are the least motivated to avoid pregnancy are far less likely to use birth control pills, or any contraceptive method at all on a consistent basis.

They said a woman's attitude toward pregnancy, her satisfaction with her method and her experiences with gynecologists and other providers of contraception play a far bigger role in a woman's risk of pregnancy than other major risks, such as poor education and poverty.

Frost said doctors and other health providers should start by helping women to find the best contraceptive method for them.

"The more we can remove the remaining barriers to consistent use, the better we will be at ensuring that all women can avoid unwanted pregnancies and plan the children they want, when they want them," Frost said.