maternal morbidity

Mamas on Bedrest: A Step Closer to “Curing” Pre-Eclampsia!

October 20th, 2014

IMG_3750 1x13Mamas, Exciting News!!

Researchers at the Center for Perinatal Research at the Nationwide Children’s Hospital in Ohio have identified a Urine test that detects proteins in pregnant mamas’ urine that indicate pre-eclampsia. Pre-Eclampsia is one of the most common reasons mamas are prescribed bed rest, and one of the leading causes of preterm labor, prematurity and even death in mamas globally. This new finding is significant because this current research shows that pre-eclampsia, more specifically the proteins found in the urine of pregnant women with pre-eclampsia, are also associated with diseases of neurodegenerative diseases of aging such as Parkinson’s Disease, Mad Cow Disease and Alzheimers Disease.

Dr. Irina Buhimschi, director of the Center for Perinatal Research at Nationwide Children’s Hospital in Ohio and lead author of the paper. While Dr. Buhimschi admits that this is definitely a huge breakthrough in pre-eclampsia research, she admits that physicians and researchers are still no closer to knowing why some women develop pre-eclampsia and why others don’t. Pre-eclampsia is still responsible for some 75,000 deaths annually, mostly in poorer, developing nations. The proteins noted in mamas’ urine are now easily identified with a simple and inexpensive urine test called the Congo Red Dot Test. This simple test merely requires that clinicians place a small amount of urine on a test paper and if a large red dot develops, they know that the urine contains proteins indicative of pre-eclampsia.While we have reported on the Congo Red Dot test previously, a simple test like the Congo Red Dot test could really be a breakthough in treatment in these areas and significantly lower maternal mortality.

Brenda Torigiani's feet at 7 months.Pre-Eclampsia is diagnosed when a mama has high blood pressure and protein in the urine. Mamas will also often experience facial and extremity swelling. Left untreated, pre-eclampsia leads to dizziness, visual changes, seizures, stroke, swelling and weight gain, organ (kidney) failure and death. Pre-Eclampsia is a leading cause of preterm delivery, yet once the baby and placenta are delivered, mama’s symptoms resolve.

The connection between pre-eclampsia and other neurodegenerative diseases such as Alzheimers has yet to be determined. Additionally, no one yet knows if women who develop pre-eclampsia are at greater risk for developing Alzheimers or Parkinson’s Diseases or have some sort of protection. These questions will definitely have to be answered in subsequent research. In the meantime, having a low technology, easy to perform and inexpensive test to screen for pre-eclampsia may well reduce the maternal mortality associated with it tremendously worldwide. Even here in the US, this low lost, low tech test, performed early, may enable obstetricians to begin treating women early with antihypertensive medications and ward off the more serious signs and symptoms of pre-eclampsia. The next step-or perhaps leap-is that perhaps them mamas who have pre-eclampsia may not need to be placed on bed rest-so long as their blood pressures are stabilized on medications, they are no longer spilling proteins into their urine and they are not having any signs of seizure, stroke or organ failure. Finally, combining these findings with the Pluristem Technology, and yes, we may in fact be on the way to eradicating pre-eclampsia!!

Reference: MacLean’s Digital Magazine

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Mamas on Bedrest: Breastfeeding Cuts Breast Cancer Risks in Black Women

October 13th, 2014

Black Baby BreastfeedingHi Mamas,

We all know that “Breast is Best”! Yet in this country, many women are still unaware of the benefits of breastfeeding. Nowhere is this more evident than in the Black community where the US Centers for Disease Control and Prevention noted that only 62% of African American mothers initiated breastfeeding as of 2010 data. By 6 months, only 32% of those mothers were still breastfeeding. So while lactation consultants and others will continue to promote breastfeeding citing the benefits to the baby, there is now an equally significant reason to promote breastfeeding in African American Mamas: Breastfeeding likely protects African American women against Estrogen Receptor negative breast cancer.

Estrogen Receptor negative breast cancer is a very aggressive form of breast cancer and African American women are affected at a disproportionately higher rate than white women. While breastfeeding has been shown to reduce the risk of cancer, this has previously only been shown in Estrogen Receptor positive cancers. According to this current study, African American women who have given birth had a 33% higher risk for ER-negative breast cancer than those who had never given birth, and a 37% higher risk for triple-negative breast cancer. However, breast-feeding lowered the risk for both ER-negative and triple-negative disease. Christine Ambrosone, PhD, chair of the Department of Cancer Prevention and Control at the Roswell Park Cancer Institute in Buffalo, New York summarizes the findings this way:

“These data might partially explain why black women are disproportionately affected by ER-negative breast cancer; although they typically have more children than white women, they have a lower prevalence of lactation. In addition, for every age category in the United States, the incidence of triple-negative breast cancer is higher in black women than in non-Hispanic white women.”

Some researchers are skeptical of the findings, stating that it has yet to be determined that pregnancy is causative of Estrogen Receptor Negative Breast Cancer and breastfeeding reduces risk. However, Dr. Ambrose and her colleagues hold firm that their data suggest that pregnancy and childbirth might actually increase the incidence, but that breast-feeding might lower the risk.

Personally, I feel that since such a simple act could have such a significant outcome, it only makes sense to increase awareness and increase the emphasis among African American women to breastfeed. To date, there is no compelling reason for black women NOT to breastfeed. Now, with the known potential benefits to the baby and the ever emerging benefits to black mamas-now a potential protection against an aggressive form of breast cancer-breastfeeding is becoming more of a necessity than ever!

October is Breast Cancer Awareness Month. Mamas, please share this vital information with other (black) mamas you may know who are either on the fence about breastfeeding or who are against breastfeeding. This data is too important not to share! The potential costs are too great and the solution too simple and readily available. Thank you. Let me know how you fared in the comments section below.

References: 

Medscape OB/GYN and Women’s Health

Julie R. Palmer, Emma Viscidi, Melissa A. Troester, Chi-Chen Hong, Pepper Schedin, Traci N. Bethea, Elisa V. Bandera, Virginia Borges, Craig McKinnon, Christopher A. Haiman, Kathryn Lunetta, Laurence N. Kolonel, Lynn Rosenberg, Andrew F. Olshan and Christine B. Ambrosone. “Parity, Lactation, and Breast Cancer Subtypes in African American Women: Results from the AMBER Consortium” Journal of the National Cancer institute (2014) 106 (10): dju237

Mamas on Bedrest: Game ON!

October 4th, 2013

Wendy Davis is running for Governor of Texas!! The image of her on the cover of Texas Monthly shows her with her now trademark sneakers and the tagline, “Game On”.

Okay, what does this have to do with Mamas on Bedrest you may be asking? It means that women will once again get a chance to receive medical care that has long been denied here in Texas.

Texas has some of the worst records when it comes to women’s health. According to Cecile Richards, The President of Planned Parenthood,

“Over the past two years, 76 women’s health centers have been forced to close their doors and stop providing affordable, lifesaving cancer screenings, birth control, STD testing, and basic preventive care. And when Governor Perry and his allies ended the Texas Women’s Health Program, more than 130,000 women were shut off from accessing the health care they need, purely because of politics.”

In addition, in Texas, many health insurance plans do not offer maternity coverage. Yup. You read me right. Health insurance policies are not required to cover maternity care, and many of the carriers who cover Texas women don’t provide coverage for maternity services as part of their standard insurance plans. What they do is offer women “the opportunity to purchase an additional rider for maternity care.” In other words, if your insurance policy doesn’t include maternity coverage, you must pay for the rider or wing it and hope that you don’t incur ANY complications for which you will be responsible. I know many women who have fared just fine in this system. They receive their care from excellent midwives and many have home or birthing center births. But for those of us who are high risk, or for those of us who become high risk, not having maternity coverage and developing a complication during pregnancy can cause catastrophic financial damage.

Now, we all need to take a breath. Wendy Davis has simply announced that she is running for governor. She has not yet won. But for Texas women, this is the best news to come in a really long time. The fact that there is even a potential that someone may become an elected official that actually CARES about women’s health and is willing to take a stand for it and demand it on behalf of thousands of women is great new indeed.

Some people see Davis as purely an abortion rights advocate. If you only see her in that light, you are missing the much larger picture. Davis stands for women, children and those which many call “the underserved”. She is a champion or education, something desperately needed as Texas schools rank near the bottom in the country on per pupil spending. She has fought against education cuts 2 years ago and was able to get reinstated $3billion dollars of the $5billion cut in education.  It’s going to be a tough battle. Davis is going up against a strong “good ole boy” establishment and a strong candidate in Gregg Abbott. Many of the “status Quo” are not taking her campaign too seriously. They feel that while there is a lot of national attention focused on Davis, within Texas, she’s not going to be able to make the impact necessary to win the election.

I hope that they are wrong.

The Texas Department of State Health Services reports that the infant mortality rate overall in Texas is 6.1/1000 live births. However, black infants die at a rate of 11.4/1000 live births. Additionally, the Maternal mortality rate overall is 24.6/100,000  births with black women having a maternal mortality rate of 53.9.  Analysts from the state and the US Centers for Disease Control and Prevention attribute these numbers to lack of access to quality medical care.

Now Wendy Davis, if elected governor of Texas won’t be able to change all that is wrong with Texas women’s health care overnight. She will still have to contend with the “good ole boy” network and the very conservative right which is a large segment of the electorate in Texas. However, the demographics have changed alot over the years and there are substantial numbers of women and ethnic minorities able to vote. We will all have to see if these changing demographics are enough to turn the tide on the electorate, to elect Wendy Davis governor and to positively effect access to quality, comprehensive Women’s health care in Texas.