Author: Susan Scutti,

The lives of Jessica Allen and her husband, Wardell Jasper, were changed permanently and for the better by a rare medical phenomenon. Their unique story begins with the hope of extending a lifeline to another couple around the globe.

Allen, 31, a California mom with two growing boys, decided to become a surrogate mother and carry the baby of another couple, she told the New York Post. Although the $30,000 paycheck (plus expenses) would benefit her family, she also yearned to share the joy she knew by helping a woman who struggled to give birth.

“No woman in the world should have to live their life without experiencing the love and the bond from a mother and a child,” she told ABC News.

Working with a San Diego-based surrogacy agency, Omega Family Global, Allen was matched with a couple from China, where the use of surrogates is illegal.

In April 2016, a single male embryo from the couple was implanted in Allen’s uterus at an Irvine-based in vitro fertilization center. Nine days later, blood tests confirmed the pregnancy.

Unexpected news arrived six weeks later during her checkup; while examining her, her doctor said, “Well, I definitely see that there is another baby,” she told ABC News.

Allen said her doctor explained to her that “the chance of an embryo splitting is very small, but it does happen,” and this split meant the second baby was an identical twin of the first. Allen felt surprised but also happy for the Chinese couple.

A bonus was that her payment was increased by $5,000 for the second child.

At 38 weeks’ gestation, on December 12, 2016, Allen delivered what she believed to be identical twin boys via cesarean section at Riverside Community Hospital, she told the New York Post. Though she never saw the babies herself, she was shown a photo.

“I did notice one was much lighter than the other — you know, obviously,” she told ABC News. “They were not identical twins.”

A month later, there was some shocking news. A DNA test confirmed that the second baby was not a twin to the implanted embryo — but actually Allen and her husband’s biological son.

“I don’t know how to describe it. We were floored. We were like, how did this happen?” she told ABC News.

Omega Family Global’s lawyer, Matthew Faust, said the agency is unable to address any particular facts of this story.

CNN has not been able to reach the California couple.

An unusual occurrence of superfetation might explain what happened, but one expert believes it may be more complicated than that.

Rare phenomena

“Superfetation is generally defined as becoming pregnant while the mother is already pregnant,” David Haig, a professor of biology at Harvard University who was not involved in the surrogacy, wrote in an email. However, he added, “the surrogacy means that it doesn’t fit neatly into the classical definition of superfetation.”

Superfetation is sometimes suspected when twins, at birth, are very different sizes and so apparently different ages.

In such cases, Haig said, the mother is believed to have conceived a second time during an ongoing pregnancy.

“I can remember reading about an old case where the twins were delivered at different times,” Haig said. “The mother came to the doctor with abdominal pains. He said you are in labor. She said, I cannot be — I delivered a month ago.”

Despite her protests, the twice-pregnant woman delivered a second child one month after the first, Haig said.

Another phenomenon, heteropaternity, occurs “when a woman produces twins with different fathers,” he said. Sometimes, this has been called superfecundation.

In such cases, a woman would have had intercourse with two men, presumably at different times, Haig explained. “But then two eggs are fertilized by the mixed sperm within her reproductive tract,” he added.

“This case is a bit of the mix of the two situations. I did not see a suggestion that the ‘twins’ were different gestational ages but they were conceived by different men and had different mothers as well.”

Allen told the Post that she and her husband “did not have sexual intercourse until we were given permission by the IVF doctor, who recommended the use of condoms.”

The rare phenomenon she experienced, then, may have also included another infrequent occurrence: a condom fail.

Both superfetation and heteropaternity are rare phenomena, according to Haig.

Part of the family

After confusion and some difficulty in getting her baby returned to her, Allen and Jasper were reunited with their son in February. Allen told ABC News that her son, renamed Malachi and now 10 months old, is part of their family.

“We didn’t plan this,” Jasper told ABC News. “It’s an emotional situation.”

Surprise, though, does not diminish the family’s joy.

“He’s just so smart, so intelligent, you know,” Allen told ABC News. “He’s learning fast. He’s got two big brothers to run after and learn from.”

A car accident at 20 years old left a French man in a vegetative state for 15 years. But after neurosurgeons implanted a vagus nerve stimulator in his chest, the man, now 35, is showing signs of consciousness, according to a study published Monday in the journal Current Biology.

Vagus nerve stimulation is already used to help people with epilepsy and depression. This cranial nerve runs from the brain to other parts of the body, including the heart, lungs and gut; vagus means “wandering” in Latin.

The study results challenge ideas that consciousness disorders lasting longer than 12 months are irreversible, the researchers believe.

A demonstration of what’s possible

Vagus nerve activity is “important for arousal, alertness and the fight-or-flight response,” wrote Dr. Angela Sirigu in an email. She is an author of the study and neuroscientist at the Institut des Sciences Cognitives Marc Jeannerod in Lyon, France.

Sirigu and her colleagues decided to test the ability of vagus nerve stimulation to restore consciousness in a patient in a vegetative state. Patients in a vegetative state show no evidence of consciousness, mental function or motor function. Unlike a coma, a vegetative state includes intermittent periods of eye opening; this seemingly hopeful sign, though, is not a normal waking, just a random physiological occurrence.

Vagus nerve stimulation begins with a surgeon implanting a device in the chest and threading a wire under the skin. This wire joins the vagus nerve and the device, which sends electrical signals along the nerve to the brain stem (where the spinal cord and brain connect) and in turn this transmits impulses to certain areas in the brain.

Stimulating the vagus nerve activates “a natural physiological mechanism,” wrote Sirigu in an email.

Sirigu and her colleagues selected the man, who had been in a vegetative state for 15 years “showing no sign of change since his car accident,” she wrote. “We therefore put ourselves in a difficult challenge by selecting a patient with the worst outcome.”

The reason for that choice is that if any changes occurred in the patient after vagus nerve stimulation, then “these could not be the result of chance,” she added.

After a single month of stimulation, the patient’s attention, movements and brain activity significantly improved, according to the authors.

“Our results show major changes at the brain level,” Sirigu said. One electroencephalogram or EEG signal, “a brain rhythm previously shown to distinguish vegetative from minimally conscious state patients, significantly increased,” she wrote, particularly in areas important for “movement, body sensations and awareness.” A PET scan, a type of imaging test, showed increases in metabolic activity in the brain, as well.

Dr. Nicholas Schiff, a neuroscientist at Weill Cornell Medicine and NewYork-Presbyterian who also researches consciousness, said some will look at this case and say, “It’s one patient, and they didn’t really move him into a new functional category. And then they will say, ‘What’s the point here?’ ” said Schiff, who was not involved in this study.

Yet the new study is “another demonstration of what is possible to do, and it’s a new technique, and it might have some real advantages for some patients,” he said.

The human brain’s ‘greater potential’

“The general point here is that taken together with all the other information that we have now, it’s very clear that the severely injured human brain has greater potential than it’s given credit for,” Schiff said. “So you can lay around for years and, in principle, still be responsive to medications, devices and other things.”

Even with that much brain injury, you can still “move the dial,” said Schiff.

What’s new in this study is stimulation of the vagal nerve on the outside of the brain, he said. “The nerve sends impulses down into the stomach area,” he explained. Instead, the researchers send impulses up through the nerve, and that activates the brain through multiple synaptic pathways.

In the United States, an estimated 50,000 patients are in a vegetative state, and about 300,000 are in a minimally conscious state, Schiff said.

“We’ve now known for a long time that we can do something for very severely injured brains, but the science has not been met with any kind of infrastructure to catch up with it,” he said. More funding for research is needed, he added.

Dr. James L. Bernat, a professor of neurology and medicine at the Geisel School of Medicine at Dartmouth, referred to the new case report as “provocative” and “exciting.”

Bernat, who also was not involved in the research, praised Sirigu and her colleagues for their choice of patient: someone in a long-term vegetative state.

“If they had, for example, chosen someone who had been in a vegetative state for three months after a traumatic brain injury and then showed improvement a month later with the intervention, a critic might say, ‘Well, wait a minute. We know that a lot of people who are vegetative for three months spontaneously improve in that time period, so it may not be the intervention,’ ” Bernat said.

He noted that every case of vegetative state is unique based on what caused damage to the brain, how severe that injury was and what regions were harmed.

A vegetative state can be caused by a variety of injuries, including traumatic brain injury, injury to neurons caused by a lack of oxygen and blood flow during cardiac arrest or meningitis, he explained.

For these reasons, the vagus nerve stimulation technique will not work with all patients, Bernat noted, still it’s worth doing more studies to find out which patients will benefit from it.

A better understanding of how brain damage harms consciousness would involve learning about how the brain maps the pathways of normal consciousness, said Bernat. “How does normal consciousness occur? And how does unconscious occur?” Bernat asked. “There’s a lot of basic work that needs to be done.”

Plausibly, this work would also contribute to explaining neurodegenerative diseases, like Alzheimer’s disease, as well as cognitive impairment resulting from traumatic brain injury.

New research of consciousness “has the potential to extend beyond the relatively small group of people who have these conditions,” said Bernat. Consciousness disorders are, in a sense, “an orphan group of diseases that has been somewhat neglected, not entirely, but somewhat by funding agencies,” Bernat said. “I would like to see more funding for research.”

Sirigu said she is planning a large study involving collaboration with several research centers to confirm and extend the therapeutic potential of the vagus nerve stimulation technique.

“More basic research will also be important for advancing our understanding of this fascinating capacity of our mind to produce conscious experience,” she said.

After giving birth, some mothers experience extreme sadness, anxiety and other symptoms of postpartum depression.

Screening mothers for depression during early well-child visits led to significantly fewer reports of depression at nine months postpartum, a new study of 3,000 Dutch women found.

Just 3% of the screened mothers experienced minor or major depression at nine months postpartum, compared with 8.4% of the mothers who weren’t screened during the visits, according to the research, published Thursday in the journal Pediatrics.

When it goes unrecognized, postpartum depression can grow serious. If untreated, symptoms may worsen, and recovery may take longer, lead author Dr. Angarath I. van der Zee-van den Berg explained in an email.

“In the worst of cases, a mother could commit suicide. The depression can lead to stress in her relationships, especially in the relationship with her partner,” wrote van der Zee-van den Berg, who is completing a Ph.D. in Health Technology and Services Research at the University of Twente. “Also, mothers with postpartum depression have an increased risk of future depressive episodes. Finally, it may take a long time to accept that the period, often expected to be joyful, turned out to be so different.”

Wellness for babies — and mothers

In the Netherlands, well-child care centers offer free visits — commonly, one at-home visit two weeks after the birth of a child and then about seven subsequent visits at the center itself — to parents of all newborns. These visits, which boast a 95% participation rate, include monitoring a child’s growth, development, health and vaccinations.

For the study, 1,843 mothers visiting Dutch well-child care centers between December 1, 2012, and April 1, 2014, received screening for symptoms of depression at one, three and six months postpartum. Mothers who showed signs of being at risk for major depression at those times were referred to their family physician or a mental health professional.

A separate group of 1,246 mothers received only the usual care during their well-child care visits during the same period.

At two weeks postpartum, all the mothers answered questions on the Edinburgh Postnatal Depression Scale, a well-known screening tool. This depression scale “is not a diagnostic instrument; when a mother scores above the threshold, further diagnosis is necessary,” van der Zee-van den Berg noted.

Nine months later, the same scale was used to test for symptoms of depression. At 12 months, each mother’s mental health and quality of parenting was evaluated along with her child’s socioemotional development.

“It is not easy for mothers to share their feelings, so it is important that the professional is able to build a trust relationship,” van der Zee-van den Berg said. “Well child care professionals have this opportunity, as they have frequent contact with the mother.”

The results at nine months postpartum showed that fewer mothers in the screening group experienced symptoms of major depression compared with unscreened mothers: 0.6% versus 2.5%. This represents a reduction “by more than 60%” in the likelihood of depression among the screened mothers compared to the usual care group, wrote van der Zee-van den Berg.

Screened mothers also showed better mental health, less anxiety and higher-quality parenting.

Negligible differences in the children’s socioemotional development could be seen across the two groups.

“Implementing screening is a simple and effective way to reduce the burden of postpartum depression — provided that diagnosis and treatment can be offered,” van der Zee-van den Berg wrote.

Treatment options for moms

US Centers for Disease Control and Prevention research shows that about one in nine women experiences postpartum depression.

Mothers who have a family history of depression, those who abuse alcohol and those with a personal history of depression are more likely than others to experience postpartum symptoms. Other factors — including stress, low social support, pregnancy and birth complications, being a teen mom, preterm birth, birth to multiples and birth to a child requiring hospitalization — also put women at higher risk of depression.

Kate Jolly, a professor of public health and primary care at the University of Birmingham in the United Kingdom, wrote in an email that the new study was “pretty good quality.” Still, Jolly, who was not involved in the research, pointed out a few flaws.

A main problem was imbalance, she said: Mothers with certain traits, particularly those who reported previous episodes of depression, were not equally divided between the two groups.

“A past history is the greatest predictor of postnatal depression, and rates were higher in the usual care group,” Jolly wrote.

In her own published research, she and her co-authors reported that exercise is effective in reducing postpartum depressive symptoms.

For women experiencing postpartum depression, “cognitive behavioral therapy or other evidence based counseling is the therapy of choice,” van der Zee-van den Berg wrote, basing her opinion on the most recent advice from the US Preventive Services Task Force.

Jolly wrote that “we can’t be sure whether exercise means depression can be avoided, but symptoms can be reduced. Trials have generally not included women with the most severe depression, so I think it is accurate to say that exercise is a useful tool for women with mild to moderate depression.”

Still, she said, the most important thing to help women with postnatal depression might be “to reduce the stigma around the condition.”

“Many women are reluctant to admit they have a problem because they fear they will be judged as a bad parent,” Jolly said.

‘Somebody cared enough to ask’

Dr. Marian F. Earls, director of pediatric programs for Community Care of North Carolina, found the new study to be “really exciting.”

Earls was not involved in the research, though she was the lead author of a 2010 report from the American Academy of Pediatrics that recommended postpartum depression screening for mothers during infant wellness visits.

Extensive studies have not been done, so there’s scant information about how well this is implemented throughout the United States. However, based on Medicaid billing data in her own state of North Carolina, 73% of mothers there are being screened at the one-month child wellness visit.

“That doesn’t mean people are doing it at all the recommended ages,” Earls said, noting that “we’ve asked folks to screen at the one-, two-, four- and six-month infant wellness visits — based on when depression might peak, minor or major.” Just as in the Netherlands, practitioners in the United States generally use the same easy-to-score Edinburgh scale, she said.

She noted that, in the new study, infants of mothers with depression did not show differences in their level of social and emotional development compared with babies of mothers with no symptoms.

“One of our recommendations is that if you have moms for whom depression screening was positive, then you should follow their infants closely for their social-emotional development,” Earls said. “That relationship is so important.”

Overall, she believes and hopes that screening for postpartum depression during wellness visits “will continue to grow. I think people understand the importance of this.”

Plus, screening has “other positive effects,” she said.

It’s not only helpful for moms who have depression. Feedback from other moms indicates they appreciated that “somebody cared enough to ask,” she said.

“It has really strengthened the relationship between the primary care clinician and the family,” Earls said. “It also helps people understand that if (depression) occurs, this is a safe place to bring up those concerns.”

Take a movement break every 30 minutes, say experts. No matter how much you exercise, sitting for excessively long periods of time is a risk factor for early death, a new study published Monday in Annals of Internal Medicine found.

There’s a direct relationship between time spent sitting and your risk of early mortality of any cause, researchers said, based on a study of nearly 8,000 adults. As your total sitting time increases, so does your risk of an early death.

The positive news: People who sat for less than 30 minutes at a time had the lowest risk of early death.

“Sit less, move more” is what the American Heart Association encourages all of us to do. But this simplistic guideline doesn’t quite cut it, said Keith Diaz, lead author of the new study and an associate research scientist in the Columbia University Department of Medicine.

“This would be like telling someone to just ‘exercise’ without telling them how,” Diaz wrote in an email.

Exercise guidelines are precise, he explained. For example, the US Centers for Disease Control and Prevention recommends adults do moderate-intensity aerobic exercise for two hours and 30 minutes every week, plus muscle strengthening activities on two or more days a week.

“We need similar guidelines for sitting,” said Diaz.

“We think a more specific guideline could read something like, ‘For every 30 consecutive minutes of sitting, stand up and move/walk for five minutes at brisk pace to reduce the health risks from sitting,’ ” he said, adding the study “puts us a step closer to such guidelines,” but more research is needed to verify the findings.

Aging means more sitting

To understand the relationship between sedentary behavior and early death, Diaz and his colleagues at Columbia, NewYork-Presbyterian/Weill Cornell Medical Center and other institutions turned to the REasons for Geographic and Racial Differences in Stroke (REGARDS) project, a study sponsored by the National Institutes of Health.

“The REGARDS study was originally designed to examine why blacks (and particularly blacks in the Southern US) have a greater risk for stroke than whites,” said Diaz. He and his co-researchers tracked for an average of four years 7,985 black and white adult participants, age 45 or older, who had signed on to participate in the REGARDS project.

To measure sedentary time for these adults, the research team used hip-mounted accelerometers. During the study period, the team recorded 340 total deaths considered “all-cause mortality” — any death, regardless of cause.

Analyzing the data, the team found that sedentary behavior, on average, accounted for about 12.3 hours of an average 16-hour waking day.

“As we age, and our physical and mental function declines, we become more and more sedentary,” wrote Diaz.

Previous studies of adults have found daily sitting time to average just nine to 10 hours per day. The higher average in his own study is likely “due to the fact we studied a middle- and older-aged population,” Diaz wrote. “It could also be partly due to the fact that we used an activity monitor to track sedentary time rather than using self-report.”

Measuring duration, the researchers clocked participants sitting, on average, for 11.4 minutes at a stretch.

As total sedentary time increased, so did early death by any cause, the results indicated. And the same was true for longer sitting stretches. Overall then, participants’ risk of death grew in tandem with total sitting time and sitting stretch duration — no matter their age, sex, race, body mass index or exercise habits.

“We found that there wasn’t a threshold or cutoff where one’s risk for death dramatically increased,” said Diaz, explaining that risk of death increased with more sitting. “To give you a specific number, those who sat for more than 13 hours per day had a 2-fold (or 200%) greater risk of death compared to those who sat for less than about 11 hours per day.”

“Bout duration is a little trickier,” said Diaz. Still, he said, the study results indicate that those who frequently sat in stretches less than 30 minutes had a 55% lower risk of death compared to people who usually sat for more than 30 minutes at a stretch.

Finally, people who frequently sat for more than 90 minutes at a stretch had a nearly two-fold greater risk of death than those who almost always sat for less than 90 minutes at a stretch, he said.

Underlying reasons ‘unclear’

How sedentary behavior impacts our health in negative ways is “unclear and complex,” wrote Dr. David A. Alter, an associate professor at the University of Toronto in Ontario, in an editorial published with the study. Alter, who did not contribute to Diaz’ research, said some scientists theorize that more sitting leads to reductions in insulin sensitivity, while others believe net calorie expenditures decline as sitting increases.

The study was not designed to reveal why sitting increases the risk of early death, noted Alter, who described the study as “methodologically rigorous,” and its findings “robust.”

Arguably, he said, the study’s most important contribution involved disentangling two sedentary behaviors: total daily sedentary time and uninterrupted sedentary bout duration.

“Persons with uninterrupted sedentary bouts of 30 minutes or more had the highest risk for death if total sedentary time also exceeded 12.5 hours per day,” noted Alter. “Conversely, in those whose daily sedentary volumes were low, uninterrupted bout lengths had little if any associated effects on mortality.”

By teasing out these two threads, the findings show excessive sitting is bad and even worse if it is accumulated in lengthy, uninterrupted bouts throughout the day, noted Alter.

Dr. Suzanne Steinbaum, director of women’s heart health at Lenox Hill Hospital in New York said, “The more we sit the worse it is. The longer the duration of sitting, the more negative the impact on our cardiovascular health.”

Steinbaum, who was not involved in the study, said moving around every 30 minutes is recommended.

“The first time we do this, the positive effects are immediate,” she said. “We need to pay more attention to moving.”

Asked if, say, a standing desk might be helpful for those who work desk jobs, Diaz said “there is limited evidence to suggest that standing is a healthier alternative to sitting.”

“So if you have a job or lifestyle where you have to sit for prolonged periods, the best suggestion I can make is to take a movement break every half hour,” said Diaz. “Our findings suggest this one behavior change could reduce your risk of death.”