Register for NIH Podcast Advises Women On How to Achieve a Healthy Pregnancy
Researchers Hope to Reduce the Risk of Preterm Birth
Women can increase their chances for a healthy pregnancy by eating right,
exercising, not smoking, and getting early medical care, says a podcast
featuring a National Institutes of Health obstetrician who oversees research on
pregnancy and birth.
A healthy pregnancy, in turn, may help to reduce the chances of early labor and
preterm birth.
The NIH’s Office of Research on Women’s Health monthly podcast, "Pinn Point on
Women’s Health," provides updates on women’s health research. The podcast is
hosted by Vivian W. Pinn, M.D., director of NIH’s Office of Research on Women’s
Health. This month’s podcast focuses on ways to reduce the risk of giving birth
prematurely by getting a pregnancy off to the healthiest start possible.
"Being born too soon poses a number of health risks," Dr. Pinn said. "We all
know children who were born prematurely who turn out all right. Others are not
so lucky."
Many preterm infants die within the first year of life, Dr. Pinn explained.
Others may develop heart problems, blindness, deafness, or severe learning
disabilities.
"There are treatments for all of these conditions," Dr. Pinn said. "But it’s far
easier to do everything possible to carry a pregnancy to term than it is to fix
the things that can go wrong when a pregnancy ends too early."
This month, Dr. Pinn interviewed Catherine Y. Spong, M.D., chief of the
Pregnancy and Perinatology Branch of the Eunice Kennedy Shriver National
Institute of Child Health and Human Development (NICHD). Dr. Spong offered
advice on getting a pregnancy off to the best start possible. Preterm birth is
not well understood and can occur in apparently healthy women. But adopting good
habits and taking care of yourself increases the chances that a pregnancy will
be healthy and the chances that it will proceed to term. Dr. Spong described
current treatments to reduce the risk of preterm birth in certain categories of
at risk women, and provided updates on NIH pregnancy research.
Dr. Spong noted that 1 in 8 pregnancies in the United States ends with a preterm
birth. Moreover, the number of preterm births has increased by 16 percent in the
past decade.
"The best time to start preparing for pregnancy is before that pregnancy even
occurs," Dr. Spong said. "About half of all pregnancies, in fact, are
unintended. So it is really important for women who could become pregnant to
have optimized their health during this time."
Dr. Spong identified eight steps women can take to help ensure healthy
pregnancies and healthy babies.
Take a supplement containing folic acid, which can be found in prenatal vitamins
or eat a breakfast cereal fortified with folic acid and other vitamins. All
women of child-bearing age should have 400 micrograms of the vitamin each day.
Folic acid reduces the chances that a baby will have a neural tube defect, a
class of birth defects that could result in partial paralysis or damage to the
baby’s brain.
Don’t drink alcohol. Don’t take illicit drugs. Don’t smoke. Smoking and taking
illicit drugs are not good for you or your baby. Smoking and exposure to smoke
increases the risk of preterm birth and for small babies. Drinking alcohol
during pregnancy could cause birth defects and medical conditions that include
mental retardation, learning deficits along with specific facial
characteristics.
Eat a varied, healthy diet. Proper nutrition is important for you and the baby.
Obesity can complicate pregnancy. Information on proper nutrition during
pregnancy is available at http://mypyramid.gov
Exercise regularly and continue your exercise routine during pregnancy
Take a vitamin B12 supplement if you eat little or no animal products. Lack of this vitamin can also increase the chances of neural tube defects
Make sure your immunizations are up to date. It is best to do this prior to pregnancy because some vaccinations are best given prior to pregnancy
Notify your doctor as soon as you know you’re pregnant so you can schedule the best time to be seen
Let your doctor know if you have any medical conditions. Ideally, get them
under control prior to pregnancy.
A normal pregnancy lasts 40 weeks, Dr. Spong said. Doctors consider delivery
before 37 weeks to be preterm. Women who have had previous preterm deliveries
are most likely to give birth early.
Doctors may prescribe the hormone progesterone to pregnant women carrying a
single baby and who have had a previous preterm delivery, Dr. Spong said. Taking
progesterone, decreases by one-third a woman’s risk of having another preterm
birth.
Women younger than 17 or older than 35 also have a high risk of giving birth
prematurely. A woman’s risk of an early birth increases if she has medical
problems involving her cervix or if she is carrying twins, triplets, or other
multiple pregnancies.
Research has shown that smokers and obese pregnant women also are at higher risk
of preterm delivery, Dr. Spong said.
Multiple births are common among women who use fertility treatments to become
pregnant, Dr. Spong said. The increasing use of fertility treatments could help
explain the increase over the past decade in preterm births.
Even if they stay healthy and follow doctors’ advice, some women still may go
into labor early, Dr. Spong said. Doctors may give women a drug to try to stop
preterm labor. A recent NICHD network study found that magnesium sulfate, a
treatment used to try to delay labor, also reduces preterm babies’ risk for
cerebral palsy, she said.
A woman in premature labor may also receive a corticosteroid to improve the
baby’s health if the baby is born preterm. Corticosteroids are hormones that
cause the baby’s lungs to mature. This treatment will help to prevent
respiratory problems if labor can’t be delayed and the baby is born prematurely.
Preterm labor is difficult to diagnose. Women who experience four to six painful
contractions in an hour should contact their doctors, she said.
NIH-funded researchers are continuing to investigate why some women go into
preterm labor and how to stop it once it starts.
Dr. Spong also described another important study on pregnancy, involving women
carrying a baby with spina bifida.
Spina bifida, or myelomeningocele, is a rare birth defect that occurs when the
spinal cord does not form properly. Spina bifida is one of the neural tube
defects, which affect the brain and spinal cord. With spina bifida, the spine
fails to develop normally and paralysis may occur below the spinal defect. Women
who have low levels of the vitamin folic acid in the weeks before and after
conception are most at risk. Babies with the condition often need surgery a few
days after birth to repair the spine.
Dr. Spong said that NICHD is seeking volunteers pregnant with a child with spina
bifida for a study that will look at whether performing surgery on the fetus
while it is still in the womb is more effective than the current practice of
waiting until after the baby is born. Half will undergo the surgery during
pregnancy and the other half will receive the standard surgery after birth. The
study will determine which technique is better for the baby’s health.
The study, known as MOMS, or the Management of Myelomeningocele Study, is
looking for new participants. More information about the study and how to
volunteer is available at
http://www.spinabifidamoms.com
To hear Dr. Pinn’s podcast, visit the Office of Research on Women’s Health home
page at http://orwh.od.nih.gov
and click on "Preterm Birth" under "Podcasts." Information on how to use
podcasts, is available at
http://videocast.nih.gov/faq/podcast/default.asp
The NICHD sponsors research on development, before and after birth; maternal,
child, and family health; reproductive biology and population issues; and
medical rehabilitation. For more information, visit the Institute’s Web site at
http://www.nichd.nih.gov/
The Office of Research on Women’s Health (ORWH), Office of the Director,
National Institutes of Health (NIH) serves as a focal point for women’s health
research at the NIH. For more information about NIH’s Office of Research on
Women’s Health, visit
http://orwh.od.nih.gov/
The Office of the Director, the central office at NIH, is responsible for
setting policy for NIH, which includes 27 Institutes and Centers. This involves
planning, managing, and coordinating the programs and activities of all NIH
components. The Office of the Director also includes program offices which are
responsible for stimulating specific areas of research throughout NIH.
Additional information is available at
http://www.nih.gov/icd/od/
The National Institutes of Health (NIH) — The Nation's Medical Research Agency —
includes 27 Institutes and Centers and is a component of the U.S. Department of
Health and Human Services. It is the primary federal agency for conducting and
supporting basic, clinical and translational medical research, and it
investigates the causes, treatments, and cures for both common and rare
diseases. For more information about NIH and its programs, visit
www.nih.gov
