Folic Acid Part of Fight Against Autism?

New research out of Norway suggests that taking vitamin supplements containing folic acid before conception is linked with a reduced risk – perhaps by as much as 40 percent – of having a child who develops autism.

Folic acid is found naturally in foods like dried beans, peas, nuts and leafy greens, and celebrated for its work helping the body manufacture healthy new cells. It’s also regarded as highly important for soon-to-be-pregnant women, thanks to its power preventing major birth defects related to babies’ brains and spines (like spina bifada, where the two sides of an embryo’s spine fail to join, leaving an incomplete or exposed cord).

Eager to know more, NPR tapped URMC autism expert Dr. Susan Hyman for her take on the new research that included more than 85,000 women. We’re deviating from our traditional Q&A approach and instead pointing you directly to the full NPR report (you can also read a transcript), here.

Susan. L. Hyman, M.D., has three decades of experience treating and researching autism spectrum disorders and is the chair of the American Academy of Pediatrics committee on autism, often acting as a spokesperson for the organization. Hyman’s recent research has focused on the diet and nutrition of children with autism and on the most effective behavioral treatments for the developmental disorder.

URMC’s Division of Neurodevelopmental and Behavioral Pediatrics – in collaboration with the Strong Center for Developmental Disabilities – houses one of the largest Autism Spectrum treatment and research programs in New York State. In addition to diagnostic assessment and clinical treatment, school and community education and consultation, the Division also provides Information and Referral Services and web-based resources, all designed to aid people affected by Autism and those who care for them.

For more information about autism treatment, research and assessment at URMC, click here.

Alcohol, Caffeine, Heat: Surviving Pregnancy in Summer

On a warm evening at the neighborhood barbecue, most pregnant women opt for ice water or lemonade over chilled wine or a cold beer. They’re simply following years of well-established advice that any amount of drinking during pregnancy carries risks and heavy drinking, in particular, leads to intellectual problems later in the child’s life.

A new study, however, of approximately 1,600 Danish women and their children suggests that light drinking might be okay. Researchers looked at the influence of low to moderate alcohol consumption during pregnancy on children’s intelligence, and found no effect on average IQ scores of preschoolers. According to the study authors, light drinking is fairly common among pregnant women in Denmark.

We asked URMC high-risk pregnancy experts Dr. Eva Pressman and Dr. Christopher Glantz, to shed some light on the drinking issue, which was recently addressed in BJOG: An International Journal of Obstetrics and Gynecology. And since it’s no fun being pregnant during an extra-hot summer, we also wondered about hydration and whether it’s okay to sip those refreshing iced coffee drinks.

Scripts: The Danish study looks at the effects of low to moderate alcohol consumption during pregnancy. How many drinks are included in these two categories?

Glantz:  Low alcohol consumption is one to four drinks per week, and moderate consumption is five to eight drinks per week. This study compared women who didn’t drink at all to women who drank up to eight drinks a week, and found no significant differences in children’s IQ measurements at 5 years old. There was no demonstrable effect on IQ until nine drinks per week.

This study was large and thorough and accounted for many factors that could have influenced outcomes, like whether mom also smoked during pregnancy, and mom’s age and body mass index or BMI. The study’s accuracy is limited, however, by how honest the pregnant women were when they estimated their alcohol intake, given that there’s a tendency to under-report intake, especially during pregnancy.

Scripts: So what message should women take away? Can they safely enjoy a weekly cocktail in pregnancy?

Pressman: The study authors conclude — and we agree — that the most conservative advice for women is to avoid alcohol during pregnancy. Overall, however, I think this study is important and reassuring to patients who may consume low or moderate amounts of alcohol before knowing they’re pregnant. 

Glantz: Instead of concluding that social drinking is okay during pregnancy, the best perspective from the study is that pregnant women don’t need to overly fret that an occasional drink will cause lasting damage to the fetus.

Scripts: Aside from refraining from drinking, what other advice do you give women to ensure they have a safe, healthy pregnancy and that their baby will have the best possible start to his or her life?

Glantz: Women should eat a healthy, balanced diet and take vitamins and iron if they are prescribed, but not at the expense of eating appropriately. For example, don’t force the vitamins or iron pills if they’re making you vomit. Women should also exercise moderately, and not smoke or take illicit drugs.  Check with your obstetrician about whether to continue medications prescribed before pregnancy (preferably, do this before you get pregnant). Try to get eight hours of sleep each night, come to your prenatal appointments, and undergo testing when it’s advised.

Pressman: I would add that certain vaccines (influenza and tetanus-diptheria-pertussis) are recommended during pregnancy to protect the baby before they can receive their own vaccines.

Scripts: What about caffeine during pregnancy? Can women safely drink coffee or soda?

Pressman: One or two servings of caffeine (8 oz. coffee or 12 oz. soda) a day is fine.  Some of the fancier coffee-house drinks can be the equivalent of four cups of coffee, though. So ask how much caffeine is in a specialty drink before ordering.

Scripts: Finally, it has been a warm summer across the country. Should pregnant women be wary of the extreme heat and take precautions? 

 Glantz: Yes, it’s best not to become overheated during pregnancy.  Not only can prolonged higher body temperatures cause problems in fetal development, but it’s essential that pregnant women be adequately hydrated to support circulation and to avoid fainting.  Avoid prolonged direct exposure to sun and have access to air conditioning and cold water.

For more information about maternity care at URMC, call 585-275-7480 or visit http://www.stronghealth.com/services/womenshealth/maternity/index.cfm.

Pregnancy: The 9-Month Marathon

Nursery décor.  Daycare. The just-right designer stroller.

When you’re pregnant, there’s no shortage of decisions.

But what about  the myriad of other health choices pregnant women make, almost unconsciously? Whether to reach for that second slice of pizza, or try an apple instead? If  they should take a post-dinner walk around the neighborhood, or camp out on the couch (with a book of baby names)? Late night TV, or a solid eight hours of sleep?

And of course, we’ve all heard the phrase “eating for two,” but what does that really mean? Is pregnancy really cart blanche to pound your way through a nightly pint of Haagan-Daz? Or does it, perhaps, suggest something more powerful – that expecting women have a unique responsibility to make health choices for not only themselves, but, by default, for their babies?

Sure, noshing on a nutrient-rich diet when you’re nauseated – or when you’re only craving french fries and pickles – isn’t easy. Neither is working out when you’re exhausted from growing a human.

Still, these healthy habits are incredibly important. In the clip below, we asked maternal fetal medicine expert Dr. Loralei Thornburg to explain why.

Craving Social Support for Your Pregnancy?

Researchers from the University of Rochester and Cornell University have teamed up to launch a major study, “eMoms Rochester,” that will assess how effectively electronic and web-based strategies can promote healthy behaviors in women both during pregnancy and immediately after their babies are born.

This innovative research effort is the first of its kind and part of a broader federal initiative to evaluate how technologies, such as cell phones, can be employed to improve health.  Women who participate will not only receive information on how to be healthy during and after their pregnancies, but could also receive up to $140 in gift cards as a small “thank you.”

Want more information about the “eMoms Rochester” study? Just visit www.emomsroc.org or call (585) 273-3090.

Get the Lead Out: Understanding – and Avoiding – Lead Poisoning

Big box home improvement stores have thrown down the gauntlet, holding summertime paint sales that practically beg you to renovate.

But don’t reach for that scraper just yet. If you’re living in a home built before 1978 (if you live in Rochester, the chances are good, considering a whopping 87 percent of the city’s housing was constructed prior to 1950), there are real, often under-appreciated health risks associated with stirring up dust from old, lead-based paints. Risks are especially concerning for children’s developing brains and nervous systems.  What’s more, symptoms of lead poisoning might not be obvious until effects surface later in life in the form of learning disabilities, difficulty concentrating, reproductive troubles, and more.

Wondering why lead was added to paint to begin with? Or how you can protect yourself and loved ones from exposure risks during your next renovation project? Watch the clip below to hear environmental health expert Dr. Katrina Korfmacher discuss some history, risks and safety considerations related to lead paints. (You also can learn more about URMC’s efforts to eliminate lead poisoning in the Rochester area, here.)

Remember: Lead poisoning is preventable, but its effects are irreversible. Practice prudence when you paint, sand or scrape.

For additional national and local resources, check out:

• http://www.epa.gov/lead/
• http://www.letsmakeleadhistory.org/
• http://www.cityofrochester.gov/lead/ (Alternately, you can call 585-428-LEAD with concerns.)
• http://www.monroecounty.gov/eh-leadpoisoning.php (Dial 585-753-5087 to learn more.)

Pesticides: Pursuing that Lush, Lovely Lawn

Darn you, dandelion.

As summer unfurls in upstate New York, homeowners seek ways to keep lawns and newly mulched flower beds weed- and pest-free.

But do we too often reach for chemicals to help our horticultural pursuits? And what are the lingering health concerns with residential pesticides anyway? If a chemical is commercially available, isn’t it presumably safe?

Not necessarily, says URMC expert Dr. Bernard Weiss, who believes many consumers are unaware of the threats that even low-levels of pesticides might pose, especially to the developing fetus and very young children (which is why pregnant women are warned to be very cautious about the kinds of pesticides they use in and around the home). In fact, according to Dr. Weiss, some studies estimate that consumers may use 10 times the amount of chemical pesticides on their lawns as farmers apply to their crops.

To gain some clarity on this topic, we spoke to Dr. Weiss, whose research focuses on how exposure to toxic agents – from metals, to air pollutants, to pesticides – might be influencing our learning and cognitive capacities, motor and sensory performance, even differences between males and females.

Some highlights:

1) Pesticides aren’t always what we think. Beyond the obvious weed-killers, the term “pesticides” can refer to just about any product aimed at scaring off (or killing off) pests — including insect repellant lotions and sprays.

2) Unborn babies, newborns and young children are most at risk for the negative cognitive developmental effects that might be tied to pesticide exposure. Because of the way they behave (constantly putting things in their mouths, crawling low to the ground), youngsters are most at risk for exposure to pesticides ingested, inhaled, or even absorbed into their skin. What’s more, since their blood-brain barrier may be a bit “leaky” (and imperfect at protecting their yet-developing brains), they have most at stake. For these same reasons, pregnant and breastfeeding women are often encouraged to take extra precaution and avoid contact with pesticides.

3) We conduct safety tests on pesticides one at a time, but often use them in combinations — so it’s hard to appreciate real-life risks. What’s more, the Environmental Protection Agency is still hard at work developing a system to assess neurotoxicity. Until we’ve established a set of standards, it’ll be difficult to fully understand the subtle and long-term risks pesticides might pose, Weiss says.

To hear more of Dr. Weiss’s comments, just watch the clip below.

Prenatal Libations: Can Moms-to-be have an Occasional Glass of Wine?

New U.K.-based research published last week suggests that enjoying the occasional alcoholic refreshment during pregnancy may not have significant developmental impact on babies up to age 5.

This sort of light drinking – no more than a couple of small glasses of wine, or half-pint glasses of beer, each week – does not appear to hinder children’s performance on a battery of behavioral and cognitive tests.

But in the clip below, expert Dr. Eva Pressman cautions that the study isn’t perfect, and may not give the whole story.  (You can also read more about the study, as covered by WebMD, here.)

Dr. Pressman directs the division of Maternal Fetal Medicine at URMC’s Strong Memorial Hospital. Pregnant? You can click here to learn more about our maternity care.