Author: Trisha

CNN — Pregnant women who are obese or overweight have an increased risk of delivering a stillborn baby, according to a new study published Tuesday in the Journal of the American Medical Association.

Researchers looked at 38 studies to better understand the potential risks to an unborn child in relation to its mother’s body mass index. They found even a modest increase in an obese pregnant woman’s weight is linked to an increased risk of fetal death, stillbirth and infant death.

The highest risk was in women with a BMI over 40 (30 is considered obese). These women were two to three times more likely to experience complications. Even women with a BMI over 25 (which is considered overweight) were found to experience increased complications.

“We found weak, but statistically significant increases in risk even within what is considered the normal ranges of BMI,” lead study author Dagfinn Aune said in an e-mail. “For example, the relative risk of stillbirth, perinatal and infant death increased by 20%, 11% and 10% already at a BMI of 25 compared with a BMI of 20, however, the really strong associations were observed among women who were either obese or severely obese who had up to two- to three-fold increases in the risk compared to lean women.”

While the risk is increased for women with higher BMIs, he said, the absolute risk is low — meaning it’s uncommon.

But “it is quite devastating for the parents it happens to,” he said. “I think at least when you get into the obese or severely obese range there is reason for concern. In addition, overweight and obesity is associated with increased risk of many other pregnancy complications, so when you look at the total picture it’s not trivial.”

Women need to be at their optimum health before deciding to have a baby, said Dr. Jeanne A. Conry, president of the American College of Obstetricians and Gynecologists.

“Healthy lifestyle is critical. Eating healthy and getting 30 minutes of exercise every day are among the most important choices a woman can make. Fifty percent of pregnancies are unplanned, so a woman who is not fit and not using contraception places her infant and herself at risk,” Conry said.

The study findings were not a surprise, Conry said — obesity is already known to be associated with complications that can lead to an unhealthy fetus.

“A higher risk of birth defects is seen in women who are obese, and some of these defects may not be compatible with life, or may result in an infant that is compromised,” she said. “Obese women have a much higher incidence of diabetes and of hypertension, and such medical problems may lead to early delivery that results in the loss of an infant.”

Conry suggests women engage in “preconception planning” and decide what their reproductive goals are for the year to ensure a healthy mom and baby. She recommends women who aren’t ready to have a baby use contraception.

And when a woman decides she wants to have a baby, Conry said, she “needs to be close to her ideal body weight, needs to be exercising, needs to have blood pressure and blood sugar in good control, and should not be on any medications that can cause birth defects.”

Biological mechanisms could help explain the association between increasing maternal BMI and risk of fetal and infant death, the study suggests.

Higher BMIs are also associated with increased risk of other pregnancy complications, Aune said, such as “gestational diabetes, preeclampsia, gestational hypertension, macrosomia (oversized fetus) and congenital anomalies.” Those can all lead to a higher risk of stillbirths or infant deaths.

“One study has suggested that obstetric conditions and placental abnormalities may explain approximately half of all stillbirths,” Aune said. “It has also been suggested that thinner women may be better at recognizing decreased fetal movements, which may precede fetal deaths.”

The-CNN-Wire

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CNN — Nearly 80,000 people die as a result of drinking alcohol each year in North and Latin America, according to a new study published Tuesday in the Journal Addiction.

Researchers looked at alcohol as the cause of death by examining death certificates, over a two-year period in 16 North and Latin American countries. Men accounted for 84% of alcohol-related deaths.

Maristela Monteiro, study author and a senior advisor on alcohol and substance abuse at the Pan American Health Organization, says people are drinking too much and “it’s killing people before they should be dying.”

“These deaths are all 100 percent preventable,” she says.

But how much is too much? According to The Centers for Disease Control and Prevention, heavy drinking is defined as consuming more than one drink per day for women and two drinks for men. One drink is considered 0.6 ounces of pure alcohol — equivalent to a 12-ounce beer, 1.5 ounces of 80-proof liquor, or a 5-ounce glass of wine.

Researchers found liver disease was the most common cause of death, but a wide range of diseases including heart disease, stroke, epilepsy, falls, suicides, transport-related injuries, and interpersonal violence were also revealed.

The highest death rates were in El Salvador, Guatemala, and Nicaragua, which are also three of the four countries with the highest level of alcohol consumption, according to the report.

“In countries that have less resources, less health care, less services, in addition you have more risk of dying from an alcohol-related problem,” says Monteiro.

Monteiro says only about 30% of doctors in the United States ask patients about their drinking and have a conversation about it. She suggests people who think they may have a problem do a screening intervention at home.

Another study, published Wednesday in the journal Neurology, looked at alcohol as it related to memory loss and found throwing back two and a half drinks per day speeds up memory loss in middle-aged men.

Researchers followed 5,000 men and 2,000 women for 10 years and found those who had 2.5 drinks of wine, beer or hard liquor daily accelerated memory loss by up to 6 years. This was not seen in those who do not drink or who drink moderately.

“The present study confirms that moderate alcohol consumption is probably not deleterious for the brain. However, heavy alcohol consumption, even in midlife, might have consequences on cognitive functioning at older ages,” says study author Severine Sabia in an email. She is a research associate from the Whitehall II study at University College London.

The study found alcohol consumption higher than 36 grams per day (which is equivalent to 2.5 12 oz. beers ,for example) in men was associated with accelerated decline in all cognitive functions, but in women there was only weak evidence that heavy drinking was associated with a faster decline. The study did not include a high number of female drinkers so researchers weren’t able to find a statistical relevance in how much women drink in relation to cognitive decline. But Sabia says they did find for women “abstinence from alcohol was associated with faster decline in the global cognitive score and executive function.”

“What this shows in men, heavy drinking is not good, the role of moderate drinking in cognitive health remains an open-ended question,” says Emory neurologist Dr. William Hu. “Most people want to hear drinking a glass of wine a day is good for your brain. This study is inconclusive on that,” he adds.

When asked about how alcohol effects brain function, Sabia says “heavy alcohol consumption is associated with higher risk of vascular disease which, in turn, may increase the risk of cognitive impairment. Furthermore, heavy alcohol consumption has detrimental short and long-term effects on the brain, including direct neurotoxic effect, pro-inflammatory effects, and indirect impact via cerebrovascular disease and vitamin deficiency.”