Western' maternal diet appears to raise obesity risk in offspring

Diet composition around the time of pregnancy may influence whether offspring become obese, according to a new study using animal models at The Scripps Research Institute (TSRI).

"Your diet itself matters, not just whether you are gaining excess weight or developing gestational diabetes," said TSRI Associate Professor Eric Zorrilla, who led the study in collaboration with Tim R. Nagy of the University of Alabama at Birmingham and Barry E. Levin of the Veterans Affairs (VA) Medical Center of East Orange, New Jersey, and Rutgers University.

In fact, the researchers found that giving females a typical American, or Western, diet appeared to set the next generation up for lifelong obesity issues.

This work was published recently in the American Journal of Physiology and featured in APSselect, a collection of the best research papers from all journals published by the American Physiological Society.

It's Not Just about Weight

The researchers made this discovery by studying two lines of rats, one selectively bred to be obesity-resistant to a high-fat diet and one bred to be unusually vulnerable. Rats from each group were fed either a diet with the same overall fat, saturated fat, carbohydrate and protein levels as a typical Western diet, or a lower-fat, higher-grain control diet.

The scientists found that female rats given a Western diet in the weeks leading up to pregnancy, during pregnancy and during nursing had offspring more prone to obesity at birth, during early adolescence and -- many months later -- through adulthood. This occurred even if the mothers themselves did not overeat and maintained a healthy weight, body fat and insulin status.

Zorrilla said the results were surprising because, whereas previous studies had shown that overweight mothers were more likely to have overweight offspring, the new findings suggest that diet alone can make a difference independent of weight gain.

The Western diet seemed to set in motion a metabolic "program" that lasted throughout the rat's life. Although these rats slimmed down during puberty and early adulthood, they still showed a lower basal metabolic rate (less energy expended at while rest) and higher food intake during that time, which led to a return of obesity in mid-adulthood.

"What we found interesting was that you sometimes see the same thing in humans, when a kid goes through a growth spurt," said study first author Jen Frihauf, who recently completed her PhD through the University of California, San Diego, while working in the Zorrilla lab at TSRI.

The researchers also spotted an interesting difference in the effects of the Western diet between the obesity-vulnerable and obesity-resistant lines: in females, the diet impaired the reproduction of the obesity vulnerable lines. Significantly fewer of females were able to reproduce, and those that did reproduce had fewer offspring. "This wasn't the focus of the study, but it supports the idea that a Western diet promotes infertility in mothers vulnerable to diet-induced obesity," said Zorrilla.

The researchers also identified elevated levels of several molecules, such as insulin and hormones called leptin and adiponectin, starting at birth in both the Western diet and genetically vulnerable offspring. This hormone profile may serve as an early biomarker for detecting obesity risk.The Takeaway for Moms: Better Nutrition

Research is ongoing into which aspects of a Western diet trigger these effects -- and the molecular changes in the offspring responsible for them. Zorrilla said the findings should raise awareness of the importance of a healthy pre- and post-natal diet. For example, doctors may want to discuss nutrition with all women who are pregnant or are planning to become pregnant, not just those already overweight.

"Doctors often use weight gain as a hallmark of a healthy pregnancy," said Frihauf. "But we realized there was something going on in utero that wasn't detectable in the mother's weight."

Frihauf added that few pregnant women, even in the United States, eat a high-fat, high-sugar diet all day, every day. "We're not trying to tell pregnant women not to occasionally splurge on a piece of cake," she said.

Studies have also shown that paternal diet, through "epigenetic" mechanisms that control how genes are expressed, can affect obesity risk in offspring, added Zorrilla, so nutritional information may be valuable for potential fathers as well.

In addition to Zorrilla, Nagy, Levin and Frihauf, the study, "Maternal Western Diet Increases Adiposity Even in Male Offspring of Obesity-Resistant Rat Dams: Early Endocrine Risk Markers," was authored by Éva M. Fekete, previous of TSRI and now at The University of Wisconsin-Madison.

This study was supported by the National Institutes of Health (grants R01DK-070118, R01DK-30066, R01DK-076896, F31DA026708-01A2, R21DK-077616, P30DK-056336 and P30DK-079626) and the Research Service of the VA.

Embryo freezing

Embryo freezing is a process that allows embryos to be preserved for later use. the primary a hit pregnancy attributable to freezing a woman's healthy embryos become in the Eighties. considering the fact that then, many embryos had been frozen for later use.

The embryos may be saved to enable a future being pregnant, to donate to others, for scientific studies or for training functions.

The technique starts offevolved through the use of hormones and different medications to stimulate the manufacturing of probably fertile eggs. The eggs are then extracted from the female's ovaries to either be fertilized in a lab or frozen for later use.

a success fertilization can also result in at least one healthy embryo, that may then be transferred to the lady's womb or uterus. optimistically, the embryo will increase and the girl can convey the growing infant thru pregnancy to a live beginning.

considering that fertilization often effects in a couple of embryo, the remaining embryos can be preserved via freezing.

Stroke risk higher for younger than older pregnant women

Researchers found that pregnant older women had a similar stroke risk as their non-pregnant counterparts, while younger pregnant women were found to be at more than double the risk of stroke than non-pregnant women of the same age. Lead study author Dr. Eliza C. Miller, of the Department of Neurology at Columbia University Medical Center (CUMC) in New York, and team published their findings in JAMA Neurology. Each year, around 795,000 people in the United States are affected by stroke, and it is the cause of more than 130,000 deaths. It is well known that pregnancy can raise stroke risk; gestational diabetes , high blood pressure, and increased bleeding after birth are all factors that can make expectant mothers more susceptible to stroke. According to Dr. Miller and colleagues, stroke affects around 34 in every 100,000 pregnancies in the United States, and this number is on the increase. "The incidence of pregnancy-associated strokes is rising, and that could be explained by the fact that more women are delaying childbearing until they are older, when the overall risk of stroke is higher," notes senior study author Dr. Joshua Z. Willey, assistant professor of neurology at CUMC. "However," he adds. "very few studies have compared the incidence of stroke in pregnant and non-pregnant women who are the same age." Assessing stroke risk by age at pregnancy For their study, Dr. Miller and team set out to determine the risk of stroke during pregnancy by age. Using data from the New York State Department of Health Statewide Planning and Research Cooperative System (SPARCS) inpatient database, the researchers were able to pinpoint 19,146 women in New York State aged 12-55 years who had been hospitalized for stroke between 2003-2012. Of these women, 797 (4.2 percent) were pregnant or had given birth in the last 6 weeks. The researchers looked at the incidence of stroke for both pregnant and non-pregnant women across four age groups: 12-24 years, 25-34 years, 35-44 years, and 45-55 years. Overall, the team found that stroke incidence increased with age; there were 14 stroke events per 100,000 pregnant or postpartum women aged 12-24, while the stroke events for pregnant or postpartum women aged 45-55 were 46.9 per 100,000. Stroke risk doubled for younger expectant mothers However, when it came to assessing stroke risk relative to non-pregnant women, the team found younger women fared worse. For women aged 12-24, the researchers identified 14 stroke events per 100,000 pregnant or postpartum women, compared with 6.4 per 100,000 for women aged 12-24 who were not pregnant - representing a more than twofold greater risk of stroke for expectant or new mothers. Among women aged 25-34, pregnant or postpartum women were 1.6 times more likely to have a stroke event than non-pregnant women of the same age, the team reports. However, among women aged 35-44, stroke incidence among pregnant or postpartum women was comparable to that of non-pregnant women, at 33 per 100,000 and 31 per 100,000, respectively. Among women aged 45-55, stroke incidence was higher for non-pregnant women, at 73.7 per 100,000, compared with 46.9 per 100,000 for pregnant or postpartum women. Based on their findings, Dr. Miller and team say it is perhaps time to increase focus on identifying and reducing stroke risk among younger pregnant women.

NIH study links morning sickness to lower risk of pregnancy loss

A new analysis by researchers at the National Institutes of Health has provided the strongest evidence to date that nausea and vomiting during pregnancy is associated with a lower risk of miscarriage in pregnant women. The study, appearing in JAMA Internal Medicine, was conducted by researchers at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and other institutions.

“Our study confirms that there is a protective association between nausea and vomiting and a lower risk of pregnancy loss.”

—Stefanie N. Hinkle, Ph.D, Scientist, NICHD’s Epidemiology Branch

Nausea and vomiting that occurs in pregnancy is often called “morning sickness,” as these symptoms typically begin in the morning and usually resolve as the day progresses. For most women, nausea and vomiting subside by the 4th month of pregnancy. Others may have these symptoms for the duration of their pregnancies. The cause of morning sickness is not known, but researchers have proposed that it protects the fetus against toxins and disease-causing organisms in foods and beverages.

“It’s a common thought that nausea indicates a healthy pregnancy, but there wasn’t a lot of high-quality evidence to support this belief,” said the study’s first author, Stefanie N. Hinkle, Ph.D, a staff scientist in NICHD’s Epidemiology Branch. “Our study evaluates symptoms from the earliest weeks of pregnancy, immediately after conception, and confirms that there is a protective association between nausea and vomiting and a lower risk of pregnancy loss.”

For their study, Dr. Hinkle and her colleagues analyzed data from the Effects of Aspirin in Gestation and Reproduction (EAGeR) trial, in which researchers tested whether taking daily low-dose aspirin prevents women who experienced one or two prior pregnancy losses from experiencing a future loss.

The authors looked at data from all the women in the study who had a positive pregnancy test.  The women kept daily diaries of whether they experienced nausea and vomiting in the 2nd through the 8th week of their pregnancies and then responded to a monthly questionnaire on their symptoms through the 36th week of pregnancy. The study authors noted that most previous studies on nausea and pregnancy loss were not able to obtain such detailed information on symptoms in these early weeks of pregnancy. Instead, most of studies had relied on the women’s recollection of symptoms much later in pregnancy or after they had experienced a pregnancy loss.

In the EAGeR trial, a total of 797 women had positive pregnancy tests, with 188 pregnancies ending in loss. By the 8th week of pregnancy, 57.3 percent of the women reported experiencing nausea and 26.6 percent reported nausea with vomiting. The researchers found that these women were 50 to 75 percent less likely to experience a pregnancy loss, compared to those who had not experienced nausea alone or nausea accompanied by vomiting.Culled from nih.

Preterm , low - birth -weight babies more likely for women with hearing loss

P regnant women with hearing loss may be more likely to give birth prematurely or have low- birth -weight babies . This is the conclusion of new research published in the American Journal of Preventive Medicine.
Researchers

suggest women with hearing loss are at greater risk of having preterm or low-birth-weight babies.
In the United States, around 15 percent of adults have some degree of hearing loss.
Lead investigator Dr. Monika Mitra, Ph.D., of the Lurie Institute for Disability Policy at Brandeis University in Waltham, MA, and colleagues note that many individuals with hearing loss have other health issues, largely because hearing problems reduce beneficial exposure to media, healthcare messages, health communication, and learning opportunities.
What is more, Dr. Mitra and team say healthcare providers rarely receive training on the best way to communicate with patients who have hearing loss, which can make it hard for clinicians to provide optimal care.
Among expectant mothers, research has shown that women with hearing loss are less satisfied with their prenatal care and have fewer prenatal visits than those without hearing loss.
However, the authors say there have been no population-based studies exploring how hearing loss may influence birth outcomes for pregnant women - until now.
Worse birth outcomes for pregnant women with hearing loss
For their study, the researchers analyzed data from the 2008-2011 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project (HCUP).
Of the almost 18 million deliveries that occurred over the 4-year period, the team identified around 10,500 that occurred among young women with hearing loss.
Birth outcomes - including preterm birth and low birth weight - were compared between women with and without hearing loss, and the researchers also looked at the women's insurance coverage and presence of other medical conditions.
Compared with women who did not have hearing loss, those who did were at greater risk of giving birth prematurely and having a low-birth-weight baby, the team found.
Additionally, the analysis revealed women with hearing loss were less likely to have private insurance than those without hearing loss.
Medicare paid for more than 13 percent of births among women with hearing loss, compared with only 0.6 percent of births among women without hearing loss. Delivery-related hospitalizations among women with hearing loss were most commonly paid for by Medicare and Medicaid.
In terms of health issues, the researchers found that women with hearing loss were almost twice as likely to have at least two co-existing health conditions than women without hearing loss, and they were also more likely to be admitted to urban teaching hospitals.
New framework could identify risk factors for poor birth outcomes
Dr. Mitra and colleagues believe their findings highlight the importance of understanding the causes of poorer birth outcomes among women with hearing loss, and they say there needs to be more focus on addressing these issues.
On that note, the researchers say they have developed a perinatal health framework that has pinpointed a number of individual and mediating risk factors for poor birth outcomes among women with physical disabilities, which could be adapted to identify such factors among women with hearing loss.

Surrogacy

• On this page
• What is surrogacy?
• Is surrogacy for me?
• How does surrogacy work?
• What is my chance of having a baby with surrogacy?
• What are the risks of surrogacy?
• Legal issues associated with surrogacy
• Surrogacy treatment abroad
• Payment issues
• Where do I start?
• What is surrogacy?
• Surrogacy is when another woman carries and gives birth to a baby for the couple who want to have a child.
• The HFEA does not regulate surrogacy. We recommend that you should seek legal advice before proceeding with this option.
• Is surrogacy for me?
• Surrogacy may be appropriate if you have a medical condition that makes it impossible or dangerous to get pregnant and to give birth.
• The type of medical conditions that might make surrogacy necessary for you include:
• absence or malformation of the womb
• recurrent pregnancy loss
• repeated in vitro fertilisation (IVF) implantation failures.
• How does surrogacy work?
• Full surrogacy (also known as Host or Gestational) - Full surrogacy involves the implantation of an embryo created using either:
• the eggs and sperm of the intended parents
• a donated egg fertilised with sperm from the intended father
• an embryo created using donor eggs and sperm.
• Partial surrogacy (also known Straight or Traditional) - Partial surrogacy involves sperm from the intended father and an egg from the surrogate. Here fertilisation is (usually) done by artificial insemination or intrauterine insemination (IUI).
• Intrauterine insemination (IUI)
• Back to top
• What is my chance of having a baby with surrogacy?
• It is quite difficult to determine a success rate for surrogacy, as many factors are relevant, including:
• the surrogate’s ability to get pregnant
• the age of the egg donor (if involved)
• the success of procedures such as IUI and IVF
• the quality of gamete provided by the comissioning couple.
• The age of the woman who provides the egg is the most important factor that affects chances of pregnancy.
• Back to top
• What are the risks of surrogacy?
• The risks associated with surrogacy depend on the type of surrogacy (full or partial) undertaken. Generally, the risks associated with full surrogacy are similar to those for IVF.
• Risks of fertility treatment
• There is also a risk of transferring HIV and hepatitis, and so screening of everyone involved in surrogacy involving IUI is recommended, and required in surrogacy arrangements involving IVF.
• If a registered donor at a licensed clinic is used, the donor will automatically be screened.
• Legal issues associated with surrogacy
• Surrogacy involves complicated legal issues and we recommend that you seek your own legal advice before making any decisions. It is important to know that surrogacy arrangements are unenforcable.
• It is also advisable to receive counselling before starting the surrogacy process, to help you think about all the questions involved.
• Legal issues around surrogacy
• Back to top
• Surrogacy treatment abroad
• According to various surveys, many patients who travel overseas for treatment are very satisfied with the standard of care and quality of treatment they receive. However, if you are considering travelling abroad for treatment, you are advised to carry out thorough research. We have created a page that specifically discusses the considerations around treatment abroad
• Considering treatment abroad: issues and risks
• The Foreign and Commonwealth Office (FCO) has launched guidance on surrogacy overseas to give parents information about the process to help inform them of the sort of issues they may face when embarking on a surrogacy arrangement in a foreign country. The guidance urges prospective parents to ensure they are fully aware of the facts and are well prepared before starting what can be a long and complex process.
• Back to top
• Payment issues
• Paying surrogate expenses- You are not allowed to pay for a surrogate in the UK – commercial surrogacy is illegal. However, the intended parents are responsible for the reasonable expenses of the surrogate (for example, clothes.
• Extra expense may be incurred should the surrogate have twins or more.
• Clinic surrogacy fees - Fees to the clinic will depend on whether the arrangement involves insemination only or IVF procedures. The fees will also vary depending on which clinic is used and how many attempts you have.
• In vitro fertilisation (IVF)
• You should ensure that you know the full costs involved before starting surrogacy treatment.
• Remember: commercial surrogacy is illegal in the UK – people thinking about surrogacy should be wary of agencies purporting to offer this service.
• Back to top
• Where do I start?
• Once you have decided, in consultation with your fertility specialist, that a surrogacy arrangement is suitable for your circumstances, you must find a surrogate.
• Fertility clinics are not allowed to find a surrogate mother for you. There may be unregulated organisations in the UK that may be able to help you – the Infertility Network UK (INUK) may be a good starting point.
• INUK website
• You should also be prepared to make the appropriate legal arrangements in order to be recognised in law as the parent of the child.
• Choosing a surrogate - You will want to choose a woman capable of having a safe, healthy pregnancy and birth. It is also vital that you build up a trusting relationship with the surrogate.
• Culled from hfea.